Perception and preferences of teaching and learning methods among second year medical students: a cross sectional survey in a rural tertiary care teaching hospital

Background: Imparting a large amount of knowledge within a limited time period in a way it is retained, remembered and effectively interpreted by a medical student is considered to be a challenge which has resulted in crucial changes in the medical educational field, with a shift from didactic teacher centered and subject based teaching to the use of interactive, problem based, student centered learning. Learning styles and approaches of each medical undergraduate vary considerably and their learning needs also differ individually. The objective of the study was to assess the perception of 2nd year medical students towards teaching and learning methods, to know their preferences among 3 commonly used audio visual teaching methods chalk and board (CB), power point teaching (PPT) and over-head projector (OHP), to explore the most influencing qualities of a teacher perceived by these medical undergraduates.Methods: A cross-sectional descriptive questionnaire-based study was conducted among 2nd year medical students of AIMS, B. G. Nagar, Karnataka, India. A pre-designed, pre-tested self-administered questionnaire was used to collect data.Results: Total respondents were 184. Among them 116 were females (63.04%) and 68 were males (36.95%). All were within the age group of 19-21 years. Chalk and board (64%) was the most preferred teaching method. 76.63% students felt that chalk board facilitates interaction between students and teacher, 69.56% perceived that diagrams can be easily copied, 67.39% opined that clinical problems can be solved better. However to demonstrate the clinical conditions (70.65%) and covering more subject per lecture (59.23%)  students preferred ppt teaching. The preferred learning method in our study was small group discussion (29%) followed by tutorials (27%), self-study (23%) and lectures (16%). Approachability (54.89%) of a teacher towards students, good teaching skills (50.54%) and knowledge towards the subject (45.65%) are the most influencing qualities of a teacher perceived by these medical undergraduates.Conclusions: Chalk and board teaching remains the best preferred teaching aid which can be supplemented with PPT and OHP to improve medical teaching. Small group discussion is the most preferred learning method when compared with tutorial, student’s seminar and lectures indicating that students are more interested in active teaching and learning methods

Assessing the binding of nectin-1 and CD96 in human cells to investigate how herpes simplex virus evades the innate immune system

Nectin-1 is an adhesion protein that also serves as a receptor for herpes simplex virus (HSV) to enter cells. In epithelial tissues nectin-1 proteins naturally bind to other nectin-1 molecules on adjacent cells to organize intercellular junctions. Recently, our lab showed that human nectin-1 also binds to the natural killer (NK) cell receptor CD96 (Holmes et al, PloS One, 2019). CD96 modulates the immune response of NK cells, which are part of the innate immune system of mammals. NK cells play an important role in eliminating virally infected cells and cancer cells. When HSV infection occurs, nectin-1 located at the cell surface becomes internalized by endocytosis. We hypothesize that HSV down-regulates nectin-1 from the surface of infected cells to prevent their detection and destruction by NK cells. To study how nectin-1 and CD96 proteins bind to each other at cell contacts, cell lines expressing fluorescently tagged nectin-1 and CD96 are being generated. Previously, we used mouse melanoma B78H1 cells as a model which are normally deficient in both nectin-1 and CD96. B78H1 cells were transfected to stably express fluorescent human nectin-1 (hNectin-1GFP, green), however expression of fluorescent human CD96 (hCD96mCherry, red) appears to be unstable in these cells. Here, human cell lines 293 and K562 are being used. 293 cells are robust human embryonic kidney cells that are being used as a positive control for transfection. K562 cells are human myelogenous leukemia cells that have been shown previously in this lab to be deficient in nectin-1 and CD96. We are currently attempting selection of clonal cell lines for these constructs by fluorescent microscopy and flow cytometry. The cells that express fluorescent CD96 and nectin-1 will be mixed in co-cultures to observe co-localization of nectin-1 and CD96 at cell contacts. This approach will provide a unique setting to investigate and understand how HSV affects the NK cell innate immune response

A study of prevalence of tobacco use and related factors among medical students as per the Global Health Professions Student Survey protocol

Background: Physicians who smoke are less likely to ask patients about their smoking and initiate cessation interventions. Hence it is important to study the prevalence of tobacco use, attitude and training of health professional students. Objectives were to study prevalence and attitudes towards tobacco use and training related to tobacco cessation.Methods: Armed Forces Medical college-based cross-sectional survey by anonymous, self-administered questionnaire as per Global Health Professions Student Survey (GHPSS) was conducted. Data was compiled and analyzed for various variables as per the GHPSS questionnaire.Results: Forty-two percent of the students had ever smoked cigarettes and 24% were current smokers. Nearly one in five had tried their first cigarette before 20 years of age. Male gender was associated with smoking. There is a significant association between not smoking and support for smoking ban in public places. Almost all the respondents (98.1%) thought smoking should be banned in all enclosed public places. In light of 20.6% of all respondents who smoked in college buildings during past this year indicated a gap between their knowledge, attitude and behavior. There was a strong desire to quit smoking but only 42% reported receiving help/ advice to stop smoking. Only one in ten reported receiving formal training in smoking cessation techniques.Conclusions: The fight against tobacco can get a boost through interventions aimed at health care professional students. Active Interventions should be made to address smoking issues among medical students. Skill based medical school curriculum should incorporate and emphasize on acquiring effective smoking cessation skills

Studies on the hepatic and renal status of patients with sickle cell disease from western zone of Maharashtra, India

Background: Sickle cell disease (SCD) is the most common inherited monogenic genetic disorder in Indian tribal and non-tribal population. This condition is caused by mutations in the hemoglobin gene and inherited in an autosomal recessive pattern. Pathogenesis in SCD varies widely from patient to patient. Most of the infections affect SCD pathogenesis, so early diagnosis of the same is important.Methods: The present study was designed to evaluate the biochemical parameters to assess the hepatic and renal status in SCD subjects from west zone of Maharashtra, India. Patients with sickle cell disease (n=50) from primary health centres of Palghar were included in this study and age and sex matched healthy persons (n=50) were controls. Informed written consent was obtained from all the study subjects.Results: Our findings showed that Aspartate trasaminase (AST), Alanine transaminase (ALT), bilirubin and creatinine increased significantly above normal level in SCD subjects. Albumin and urea levels in SCD were found to have decreased in the SCD subjects. There is a slight increase in uric acid and creatinine levels; this indicates an adverse effect on hepatic function and moderate effect on renal function in sickle cell anemia patients. Most common events of SCD pathogenesis, can be categorized into hemolytic events and vaso-occlusive crisis-based events. Adverse effect on hepatic function can lead to further hemolytic events.Conclusions: Although specific biomarkers related to these different events needs to understand for assessment of pathogenesis, the ones we have studied can be useful to assess the status of hepatic and renal function to follow the effectiveness of therapeutic interventions.

Carrier relaxation dynamics in defect states of epitaxial GaN/AlN/Si using ultrafast transient absorption spectroscopy

The relaxation dynamics of the carriers through the defect levels in an epitaxial GaN film grown with an AlN buffer layer on Si has been performed on the femto-picosecond timescale, using ultrafast transient absorption spectroscopy (UFTS). The sample was pumped above and below the band gap and probed with a white light continuum (480-800 nm). A combination of bi and triple exponential decay functions at different probe wavelengths were used to fit the kinetic profile of the carriers in the defect continuum. Based on the UFTS measurements, a model is proposed which explains the dynamics in the shallow traps and deep level defects. Furthermore, to determine the role of the lattice in the relaxation dynamics, the experiment was conducted at a low lattice temperature of 4.2 K. The relaxation constants from the UFTS measurements confirm not only the presence of shallow and deep level defects but also the involvement of phonons in one of the relaxation processes

Novel Low-Temperature Poss-Containing Siloxane Elastomers

One route to increased aircraft performance is through the use of flexible, shape-changeable aerodynamics effectors. However, state of the art materials are not flexible or durable enough over the required broad temperature range. Mixed siloxanes were crosslinked by polyhedral oligomeric silsesquioxanes (POSS) producing novel materials that remained flexible and elastic from -55 to 94 C. POSS molecules were chemically modified to generate homogeneous distributions within the siloxane matrix. High resolution scanning electron microscope (HRSEM) images indicated homogenous POSS distribution up to 0.8 wt %. Above the solubility limit, POSS aggregates could be seen both macroscopically and via SEM (approx.60-120 nm). Tensile tests were performed to determine Young s modulus, tensile strength, and elongation at break over the range of temperatures associated with transonic aircraft use (-55 to 94 C; -65 to 200 F). The siloxane materials developed here maintained flexibility at -55 C, where previous candidate materials failed. At room temperature, films could be elongated up to 250 % before rupturing. At -55 and 94 C, however, films could be elongated up to 400 % and 125 %, respectively

Student’s perception towards learning medical sciences: problem based learning versus lecture based learning methods

Background: Problem-based learning (PBL) is one of the most commonly used educational methods in medical schools of different countries. By working through this method, students think critically, generate with ideas, and acquire the knowledge and skills required to become a doctor. The objectives were, this study aimed to compare problem-based learning with lecture-based learning in the education of medical students on different disciplines but addressing the 2nd year subjects as a whole & in particularly pharmacology.Methods: This cross-sectional observational study was conducted on medical students of Bidar Institute of Medical Sciences, Bidar. All the students were enrolled in the study were given with pretested questions after obtaining the institutional ethical clearance and informed consent from the students. Fully completed questionnaires were collected and analysed.Results: Students preferred problem-based learning over lecture-based learning (LBL) because of motivation boost, a higher quality of education, knowledge retention, class attractiveness, and practical use. However, the difference was not statistically significant. Although PBL edged over LBL, but most of them preferred integrated teaching going side by side, i. e, PBL along with LBL.Conclusions: Students’ percieves that the knowledge & understanding could be very easily acquired by PBL over LBL. Students felt Pharmacology should be taught with both ways, initially LBL followed by PBL for better understanding the concepts for clinical application

Laparoscopic adjustable gastric banding – should a second chance be given?

Background: Obesity is a chronic relapsing-remitting disease and a global pandemic, being associated with multiple comorbidities. Laparoscopic adjustable gastric banding (LAGB) is one of the safest surgical procedures used for the treatment of obesity, and even though its popularity has been decreasing over time, it still remains an option for a certain group of patients, producing considerable weight loss and improvement in obesity-associated comorbidities. Methods: The aim of this study was to evaluate the impact of weight loss following LAGB on obesity-associated comorbidities, and to identify factors that could predict better response to surgery, and patient sub-groups exhibiting greatest benefit. A total of 99 severely obese patients (81.2% women, mean age 44.19 ± 10.94 years, mean body mass index (BMI) 51.84 ± 8.77 kg/m2) underwent LAGB in a single institution. Results obtained 1, 2, and 5 years postoperatively were compared with the pre-operative values using SPPS software version 20. Results: A significant drop in BMI was recorded throughout the follow-up period, as well as in A1c and triglycerides, with greatest improvement seen 2 years after surgery (51.8 ± 8.7 kg/m2 vs 42.3 ± 9.2 kg/m2, p < 0.05, 55.5 ± 19.1 mmol/mol vs 45.8 ± 13.7 mmol/mol, p < 0.05, and 2.2 ± 1.7 mmol/l vs 1.5 ± 0.6 mmol/l). Better outcomes were seen in younger patients, with lower duration of diabetes before surgery, and lower pre-operative systolic blood pressure. Conclusions: Younger age, lower degree of obesity, and lower severity of comorbidities at the time of surgery can be important predictors of successful weight loss, making this group of patients the ideal candidates for LAGB