Electives in Medical Curriculum- An Insight of Medical Students

Background: Electives include courses that are interest based, where the students are free to choose the course content. NMC has introduced electives in medical curriculum and it has been implemented for the first time in various medical colleges. Aims and Objectives: The objective of this study is to assess the perception of MBBS students regarding Electives program. Methodology: This cross-sectional study was conducted among the first batch of MBBS students that completed the electives program after taking their consent and approval from ethical committee. Electives Experience scale (EES) and Electives Rating Scale (ERS) were developed, tested, and used for this study. Median, inter quartile range, Cronbach’s alpha and Mann Whitney tests were used for analysis. Results: Most of the students learnt theory, practical, AETCOM (ethics & communication), clinical skills and research in both blocks of posting but research was more focussed in block 1 and practical knowledge and clinical skills in block 2. For the Likert scales (EES-1, EES-2, ERS-1, ERS-2 & ERS), Cronbach’s alpha was found to be quite robust for all the scales. Median and inter quartile range were calculated for EES and ERS scores. Mann Whitney test showed significant gender difference for EES-2. If the student had got elective of his/her choice in block 1, the mean ranks of EES & ERS were significantly higher but if the student had got the elective of his/her choice in block 2, significantly higher scores were seen in overall ERS, ERS-2 and EES-2 only. Conclusion: Electives is a welcome addition to the medical curriculum. However, proactive approach from the student is a must to utilize this opportunity to the fullest

Unicystic ameloblastoma in 3 year old paediatric patient: a rare entity

Unicystic ameloblastoma (UA) is a benign epithelial odontogenic tumor of the jaws that commonly occurs in 2nd and 3rd decade of life. In fact, this entity is rare in children under 12 years of age. It is characterised as a distinct variant of ameloblastoma, exhibiting a less aggressive behaviour and a lower rate of recurrence than solid conventional ameloblastoma. There are very few reported cases of UA occurring in children below five years of age. The purpose of this case report is to describe a case of UA involving the crown of an unerupted maxillary second premolar in a 3 year old girl. The pathogenesis, clinical appearance, radiographic presentation, histological findings and management of the tumour have also been discussed

Effect of chronic exposure to biomass fuel smoke on pulmonary function test parameters

Background: Life in a typical Indian household revolves around the cooking area, and Indian women spend much of their time there. Cooking stoves in most households are nothing more than a pit, a chulha (a U-shaped construction made from mud), or three pieces of brick. Cooking under these conditions entails high levels of exposure to cooking smoke. Aim of this study was to evaluate the effect of Chronic Exposure to Biomass Fuel Smoke on Pulmonary Function Test Parameters.Methods: 60 non-smoking women without any history of any major chronic illness in the past were selected for this study. The study group comprised of 30 rural female subjects who were chronically exposed to biomass fuel smoke combustion and 30 age matched urban female subjects exposed chronically to clean fuel combustion (Liquified Petroleum Gas–LPG) in Haryana (India). All the subjects were evaluated for pulmonary function tests by RMS Medspiror.Results: Biomass exposure index came out to be 85.68±3.69 for women cooking on biomass and LPG index was 64.17±6.97 for women cooking on LPG. This implies significant chronic exposure of women to biomass fuel smoke. The lung function parameters were significantly lesser in biomass exposed rural women [FEV1 (p<0.01), FVC (p<0.01), FEF25-75 (p<0.01), FEV1/FVC ratio (p<0.01), PEFR (p<0.01), MVV (p<0.01)] than the LPG exposed urban women. The evaluation of PFT suggested obstructive type of pulmonary disease.Conclusion: The derangement in pulmonary function parameters in women exposed to biomass smoke pollutants could be due to chronic significant exposure as suggested by high Biomass exposure Index. Inadequate ventilation in cooking area without chimney/vent also contributed to pulmonary function derangement and COPD.

Preliminary Investigation of Beagle Dog as Substitute for Humans in Bioequivalence Studies

Purpose: To assess the suitability of beagle dog as an animal model for the evaluation of formulations in bioavailability and bioequivalence studies.Methods: A generic cetirizine 10 mg tablet formulation was compared with another reference formulation using beagle dog as animal model. A crossover oral comparative bioavailability study was conducted on cetirizine tablet 10 mg in healthy, male dogs under fasting conditions. The  formulations were administered orally with the aid of water. Serial blood samples were collected from pre-dose to 48.0 h post-dose and plasma concentrations of cetirizine were determined using validated liquid chromatography-tandem mass spectrometry (LC-MS/MS) analytical method. Pharmacokinetic parameters were calculated using  non-compartmental analysis while bioavailability was assessed using an analysis of variance (ANOVA) model for humans and dogs.Results: Cetirizine plasma concentrations in dog were comparatively  higher, in relation to human plasma concentrations, due to the smaller blood volume in former. There was a delay in time to reach maximum plasma concentration (Tmax) in dog. Cetirizine formulations were found to be bioequivalent in either of the species (dog and human). The ratio (test\reference) of least-squares mean for area under plasma concentration curve from time zero to last detectable concentration (AUC0-t), area under plasma concentration curve extrapolated to infinity (AUC0-‡ ) and maximum plasma concentration (Cmax), calculated for the dogs were comparable to those for humans. AUC0-t, AUC0-‡ and Cmax ratios ranged within 92.81 - 106.80 % for dogs and 95.43 . 104.84 % for humansConclusion: The results suggest that beagle dogs can be used in place of humans in bioequivalence tests on generic products of cetirizine.Keywords: Cetirizine, Beagle dog, Bioavailability, Bioequivalence, Pharmacokinetics, Noncompartmenta

Local environmentalism in peri-urban Ghaziabad: emergent ecological democracy?

This paper explores the potential of a range of peri-urban environmentalisms to come together in support of sustainable urbanisation. The present-day ‘urban,’ along with the dominant planning visions of urbanisation, lack in inclusivity, deliberative democracy, grassroots innovations, and bottom-up processes of knowledge generation. To sustainably transform this scenario, there is a need for the participation of various sections of citizens, who should be seen not just as subjects of planning, but as creators of a planning framework that emerges from both contestations and innovations in everyday living. Our earlier research on a peri-urban village situated between Delhi city and Ghaziabad town suggested that there is little support for continuation of agriculture in such areas, despite its strategic importance for sustainable urban development. Agriculture could contribute to the greening of urban spaces while enhancing the livelihoods of the poor, recycling urban waste and producing perishable food items for the urban populations. However, we found that present-day government schemes, as they unfold–often under the banner of sustainability–tend to exacerbate peri-urban inequalities. Having observed local citizen environmental action in Ghaziabad, we wanted to understand the potential role it could play in dealing with the environmental crises facing the district and region. During the course of our research we came across a distinctive peri-urban civil society activism, which cannot be viewed in binaries and reflects a pluralist spectrum that allows for alliance building. This environmentalism in Ghaziabad is distinct from the ‘environmentalism of the poor’ practiced by rural and forest dwelling groups; from the dominant elite urban ‘green development’ practices and discourses of ‘bourgeois environmentalism’; and from the urban politics of the poor. It reflects the possibility of creating bridges across sectional interests–rural and urban, red and green ideological streams– and across classes

Local Environmentalism in Peri-Urban Spaces in India: Emergent Ecological Democracy?

This paper explores the potential of a range of peri-urban environmentalisms to come together in support of sustainable urbanisation. The present-day ‘urban,’ along with the dominant planning visions of urbanisation, lack in inclusivity, deliberative democracy, grassroots innovations, and bottom-up processes of knowledge generation. To sustainably transform this scenario, there is a need for the participation of various sections of citizens, who should be seen not just as subjects of planning, but as creators of a planning framework that emerges from both contestations and innovations in everyday living. Our earlier research on a peri-urban village situated between Delhi city and Ghaziabad town suggested that there is little support for continuation of agriculture in such areas, despite its strategic importance for sustainable urban development. Agriculture could contribute to the greening of urban spaces while enhancing the livelihoods of the poor, recycling urban waste and producing perishable food items for the urban populations. However, we found that present-day government schemes, as they unfold–often under the banner of sustainability–tend to exacerbate peri-urban inequalities. Having observed local citizen environmental action in Ghaziabad, we wanted to understand the potential role it could play in dealing with the environmental crises facing the district and region. During the course of our research we came across a distinctive peri-urban civil society activism, which cannot be viewed in binaries and reflects a pluralist spectrum that allows for alliance building. This environmentalism in Ghaziabad is distinct from the ‘environmentalism of the poor’ practiced by rural and forest dwelling groups; from the dominant elite urban ‘green development’ practices and discourses of ‘bourgeois environmentalism’; and from the urban politics of the poor. It reflects the possibility of creating bridges across sectional interests–rural and urban, red and green ideological streams– and across classes.ESRCEcosystem Services and Poverty Alleviation (ESPA) Programm

A comparative study of serum calcium and magnesium levels in women with pre-eclampsia and normotensive women

Background: Pre-eclampsia is transient but potentially dangerous complication of pregnancy. Despite of pre-eclampsia's prevalence and severity, the pathophysiology of this multisystem disorder is still poorly understood and its aetiology has not yet been fully elucidated. Recently, nutritional deficiency especially micronutrients deficiency is gaining prominence in the pathogenesis of pre-eclampsia. Hypocalcaemia and hypomagnesaemia have been implicated in the pathogenesis of pre-eclampsia. This study has been done to compare serum calcium and magnesium levels in women with pre-eclampsia and normotensive women and their association with severity of pre-eclampsia.Methods: 50 women with pre-eclampsia and 50 normotensive women were included in the study and serum calcium and magnesium levels were measured. Data were analyzed.Results: The serum ionic calcium concentration was significantly lower in the pre-eclamptic cases compared to the normotensive controls (3.34±1.35 versus 4.37±0.74, p=0.0000) similarly serum magnesium concentration was significantly lower in the pre-eclamptic cases compared to the normotensive controls (1.68±0.41 versus 1.94±0.42, p-0.002). Mean serum ionic Ca levels in severe pre-eclampsia group was significantly lower than normotensive pregnant women (p=0.0000) as well as mild pre-eclampsia group (p=0.001). Mean serum Mg in severe pre-eclampsia was significantly lower than normotensive pregnant women (p=0.0008) as well as mild pre-eclampsia group (p=0.03). Serum ionic Ca and Mg had a negative correlation with systolic and diastolic blood pressure.Conclusions: Based on this study, measurements of serum ionic calcium and magnesium among women at risk of for pre-eclampsia may be used to predict the onset and severity of pre-eclampsia