Kashibai Navale Medical College Research Articles

Effect of Routine Vitamin D Supplementation on the Physical Growth of Exclusively Breastfed Infants at Six Months of Age: An Observational Study

Introduction: Vitamin D is essential for bone mineral metabolism and for the growth and development of the skeleton. The American Academy of Paediatrics and the Indian Academy of Paediatrics recommend the administration of 400 IU per day of oral Vitamin D to all infants in the first year of life. The authors hypothesised that routine supplementation of 400 IU of Vitamin D to exclusively breastfed infants would result in better physical growth. Aim: To examine the effect of routine vitamin D supplementation (400 IU/day) on the weight, length, and head circumference of term, exclusively breastfed infants at six months of age. Materials and Methods: An observational study was conducted at Department of Paediatrics, Smt. Kashibai Navale Medical College, Pune, Maharashtra, India, from November 2018 to March 2020, comparing the weight, length, and head circumference at birth and at six months of age for 111 exclusively breastfed term, appropriate for gestational age, healthy infants who were not supplemented with oral Vitamin D (Group-I) with 111 infants who were supplemented with 400 IU of oral Vitamin D daily (Group-II). Infants who presented at the Paediatric Out-Patient Department of SKNMC, Pune at around six months of age were enrolled in the study. Birth data and anthropometry at birth were recorded from available medical records. Statistical analysis was performed using Statistical Package for Social Sciences (SPSS) version 23.0. Quantitative data were presented with the mean and standard deviation. Comparison among the study groups was done using an unpaired t-test as per the results of the normality test. Association among the study groups was assessed with the help of a Student's t-test. A p-value of <0.001 was considered statistically significant. Results: The mean birth weight, length, and head circumference of infants who were not supplemented with vitamin D (Group-I) were 2907.57±250.18 gm, 53.34±1.47 cm, 35.99±1.067 cm, respectively, and those who were supplemented (Group-II) were 2901.08±231.63 gm, 53.75±1.51 cm, and 35.85±1.09 cm, which were comparable in both groups. At six months, the mean weight, length, and head circumference in Group-I and Group-II were 7211.08±626.39 gm, 70.25±1.58 cm, 43.82±1.19 cm, and 7973.87±532.31 gm, 70.90±1.75 cm, and 45.01±1.34 cm, respectively. There was an increase in anthropometric parameters in both groups. The increase was greater in GroupII than in Group-I and was statistically significant (p<0.001). Conclusion: Infants supplemented with vitamin D (400 IU/ day) demonstrated better physical growth in terms of higher anthropometric values.

Knowledge, Attitude and Practices towards COVID-19 Vaccine in Pregnant and Postpartum Women: A Cross-sectional Study

Introduction: Pregnant and lactating women have been included in the ongoing vaccination drive against Coronavirus Disease 2019 (COVID-19) by the Government of India. Despite the fact, the vaccination rates among this particular group were fairly dismal. Aim: To study the Knowledge, Attitude and Practices (KAP) related to the COVID-19 vaccine in pregnant and postpartum women in a tertiary care hospital. Materials and Methods: This cross-sectional study was conducted in Obstetrics and Gynaecology wards and Outpatient Department, Smt. Kashibai Navale Medical College and General Hospital (tertiary care hospital), Pune, Maharashtra, India, from August 2021 to October 2021 among 251 pregnant and postpartum patients. The data was collected using a face-toface questionnaire. The questionnaire included demographic characteristics of study participants and a set of questions to test the KAP towards COVID-19 vaccination in pregnancy. Results: A total of 251 pregnant and postpartum women, with a mean age of 24.54 years, were surveyed. Among all the participants, 223 (89.92%) knew about the existence of the COVID-19 vaccine, however, only 23 (9.16%) were vaccinated. The most common reasons for refusing the vaccine were concerns for their own safety (n=39, 17.5%) or that of the foetus (n=107, 48.1%), lack of awareness (58.5%), and lack of recommendation by healthcare workers (63.5%). Only 67.8% of subjects believed in the efficacy of the vaccine. Overall, 16 (9.41%) women with no history of miscarriages or abortions had taken the vaccine, whereas, seven (9.33%) participants with a history of miscarriage or abortions had taken the vaccine. Conclusion: The present study reported low acceptance of the COVID-19 vaccine in pregnant and postpartum women. Lack of awareness and concern for vaccine safety were the major reasons for this. Recognising the major reasons for vaccine hesitancy among this population will be useful for creating effective strategies to increase vaccine acceptance during this pandemic

Examining the place of the female condom in India’s family planning program: A qualitative investigation of the attitudes and opinions of key stakeholders in Pune, India

BackgroundWith overpopulation contributing to the depletion of planetary resources, the high rates of unintended pregnancies in India are a cause for concern. Despite the free supply of contraception options within India’s national family planning initiatives, women are generally offered hormonal options as temporary spacing methods. However, female condoms, a much neglected but potent woman initiated, non-hormonal multipurpose prevention device, are yet to be considered for inclusion in India’s contraceptive cafeteria. Thus, we aim to examine the place of female condoms among the contraceptive options, by analysing the perceptions of key stakeholders regarding its advantages and disadvantages, along with their opinions on how female condoms should be promoted.MethodsWe used purposive sampling to recruit and interview potential users and dispensers of the female condom. The interview participants visited or worked at family planning clinics in Pune at Smt. Kashibai Navale Medical College and General Hospital (SKNMC-GH), its urban and rural outreach clinics, and at Saheli (a non-governmental organisation for female sex workers). We conducted semi-structured interviews and coded our data inductively.ResultsWe interviewed 5 rural women, 20 urban women (including 10 female sex workers), 5 male partners of female sex workers, and 5 family planning healthcare providers. Nearly half (12/25) of the women we interviewed, said that they were eager to use female condoms in the future. Many participants perceived female condoms to be an instrument to empower women to be in control of their sexual and reproductive lives (15/35), and that it provided user comfort and confidence (4/35). Their perceived disadvantages are that they are relatively more expensive (6/35), users have limited experience (9/35), and women who buy or use them may be stigmatised and feel embarrassed (4/35). Yet, nearly three-quarters of potential users (21/30) and most healthcare providers (4/5), were confident that female condoms could become popular following extensive promotional campaigns, interventions to improve availability and access, and initiatives to enhance the knowledge of female users.ConclusionsFemale condoms have garnered support from both users and dispensers and have the potential to be widely adopted in India if family planning initiatives which increase awareness, knowledge, and access are systematically undertaken as with other contraceptive options.

UMBILICAL COILING INDEX AND ITS RELATIONSHIP WITH PERINATAL OUTCOMES

Aim: To evaluate any adverse perinatal outcomes associated with abnormal coiling of umbilical cord. Introduction:The primary objective of antenatal and intrapartum fetal surveillance both in early and late pregnancy is to prevent fetal death. One of the most important parts of the fetoplacental unit is the umbilical cord. It is now being studied in predicting the perinatal outcome. Materials and methods: This prospective study was conducted in Obstetrics and gynaecology department of a tertiary care hospital in Smt. Kashibai navale medical college and general hospital Narhe, Pune.Three hundred and fifty (350) umbilical cords of babies delivered either by vaginally or by lower segment caesarian section were examined. The umbilical coiling index was calculated by dividing the total number of coils by the length of the cord in cms. Subjects with umbilical coiling index below 10th percentile, between 10th and 90th percentile and above 90th percentile were defined as hypocoiled, normocoiled and hypercoiled respectively. It was then correlated with the following pregnancy outcomes: mode of delivery, preterm delivery, birth weight, meconium staining, Apgar score at 1 and 5 minutes, and neonatal intensive care unit (NICU) admissions. Hypocoiled cords were those having umbilical cord coiling index (UCI) less than 10th percentile and hypercoiled cords were those having UCI >90th percentile Statistical analysis was done . The results were statistically analysed by chi-square test. The p value ≤ 0.05 was considered statistically significant for all the analyses. Result: The mean UCI was 0.61 ± 0.16. The hypocoiled umbilical cords (UCI < 10th percentile) were significantly associated with low birth weight, meconium staining, low Apgar score at 1 minute, and increased NICU admissions with a p-value < 0.05. Conclusion:Abnormall UCI(hypocoiling) are significantly associated with adverse perinatal outcome.

Heart Rate Variability measured during rest and after orthostatic challenge to detect autonomic dysfunction in Type 2 Diabetes Mellitus using the Classification and Regression Tree model.

According to the World Health Organization, one in ten adults will have Type 2 Diabetes Mellitus (T2DM) in the next few years. Autonomic dysfunction is one of the significant complications of T2DM. Autonomic dysfunction is usually assessed by standard Ewing's test and resting Heart Rate Variability (HRV) indices. Resting HRV has limited use in screening due to its large intra and inter-individual variations. Therefore, a combined approach of resting and orthostatic challenge HRV measurement with a machine learning technique was used in the present study. A total of 213 subjects of both genders between 20 to 70 years of age participated in this study from March 2018 to December 2019 at Smt. Kashibai Navale Medical College and General Hospital (SKNMCGH) in Pune, India. The volunteers were categorized according to their glycemic status as control (n= 51 Euglycemic) and T2DM (n= 162). The short-term ECG signal in the resting and after an orthostatic challenge was recorded. The HRV indices were extracted from the ECG signal as per HRV-Taskforce guidelines. We observed a significant difference in time, frequency, and non-linear resting HRV indices between the control and T2DM groups. A blunted autonomic response to an orthostatic challenge quantified by percentage difference was observed in T2DM compared to the control group. HRV patterns during rest and the orthostatic challenge were extracted by various machine learning algorithms. The Classification and Regression Tree (CART) model has shown better performance among all the machine learning algorithms. It has shown an accuracy of 84.04%, the sensitivity of 89.51%, a specificity of 66.67%, with an Area Under Receiver Operating Characteristic Curve (AUC) of 0.78 compared to resting HRV alone with 75.12% accuracy, 86.42% sensitivity, 39.22% specificity, with an AUC of 0.63 for differentiating autonomic dysfunction in non-diabetic control and T2DM. It was possible to develop a Classification and Regression Tree (CART) model to detect autonomic dysfunction. The technique of percentage difference between resting and orthostatic challenge HRV indicates the blunted autonomic response. The developed CART model can differentiate the autonomic dysfunction using both resting and orthostatic challenge HRV data compared to only resting HRV data in T2DM. Thus, monitoring HRV parameters using the CART model during rest and after orthostatic challenge may be a better alternative to detect autonomic dysfunction in T2DM as against only resting HRV.

DATAANALYSIS OF LABORATORY FINDINGS AND ITS USE IN PREDICTING REQUIREMENT OF OXYGEN IN A COVID 19 POSITIVE PATIENTS AT TERTIARY CARE HOSPITAL IN PUNE MAHARASHTRA.

INTRODUCTION:The coronavirus disease 2019 (COVID-19) is caused by the virus SARS-CoV-2 and is declared as a global pandemic by the World Health Organization (WHO). There are many western and Chinese studies have done, but there is a need for research to evaluate the pattern of the haematological parameters of COVID-19 patients & predict requirement of Oxygen in the Indian population. MATERIALS AND METHODS: st A retrospective cross sectional study carried out on 150 COVID-19 positive patients admitted form 1 May th 2021 to 14 May 2021 in a tertiary care hospital, Smt. Kashibai Navale Medical College & General Hospital, India. RESULTS: The nal study population consisted of 150 patients. The Derived NLR and NLR & CRPhad higher specicity and positive predictive value. The accuracy of Derived NLR, NLR and CRPwas 66%, 64% and 63% respectively.The area under the ROC Curve (AUC) values of Derived NLR, NLR, and CRPindicates that there was a 65% probability that these signicant indicators were able to distinguish patients required oxygen or not (on room air). CONCLUSION: History of Diabetes, hypertension plays measure role as a prognostic factor in a COVID 19 Positive. But other hematological parameters like NLR, derived NLR, CRPferritin also plays measure role in predicting requirement of oxygen

Understanding Attitude towards Gender, Sexuality, Sexual Health Needs and Information Seeking Behaviour amongst First Year Medicine Students: An Observational Study

Introduction: The topics related to sexual attitude and reproductive health are not commonly and openly discussed. The scarcity of having open discussions especially with parents results in lack of awareness among adolescents about contraception, sexual values, beliefs and behaviour. First year medical students are usually in their last years of adolescence. In future, they are going to communicate with their patients on sexual health matters. Hence, it becomes essential to understand their own perspective regarding this. Aim: To understand the attitude of first year medical students towards gender, sexuality, sexual health needs and their information seeking behaviour. Materials and Methods: A cross-sectional survey was conducted, using a self-administered questionnaire.The study population comprised of 314 1st year medical students aged between 17- 20 years, at Smt. Kashibai Navale Medical College and General Hospital, Pune, Maharashtra, India.The questionnaire included sections on communication within family and friends, personal attitude towards sexuality and gender and information seeking behaviour. Statistical analysis was done by Chi-square test using Statistical Package for the Social Sciences (SPSS) software. Results: Total 314 first year MBBS (Bachelor of Medicine, Bachelor of Surgery) students (135 males, 179 females, mean age=18.35 years) participated in the study. More than 90% of students were interested to be in a relationship with opposite sex, yet more than 50% of them did not want to be involved in premarital sex as it was against their religious beliefs. More number of boys (65.93%), as compared to girls (38.55%), agreed that it’s ok to have sex before marriage with proper contraceptive measures. Maintenance of virginity until marriage was important for girls (56.98%) as compared to boys (37.04%) which was statistically significant (p<0.05). Students lacked communication with their parents on the topics of sexuality. A 95.86% used ‘internet’ to seek information on sexual health matters. Sexual problems (72.61%) and genital hygiene (73.89%) were the maximally searched topics on internet. 64.33% of students were interested in attending a formal course regarding sexual/reproductive health. Conclusion: Adolescents’ attitude about sexual matters is guided by their religious beliefs. There is a dearth of communication between the adolescents and their parents on sexual health matters. Majority preferred seeking information from friends and/ or via internet which can be unreliable at times.

Study on prevalence of maternal risk factors, morbidity and mortality in very low birth weight neonates

Background: Very low birth weight babies with respiratory complications are the commonest reason for admission in NICU. We wanted to identify maternal risk factors associated with it and ways to prevent it. The objective of the current study was to study the prevalence of maternal risk factors, morbidity and mortality in VLBW babies admitted in tertiary care hospital NICU.Methods: Cross sectional observational study performed on all very low birth weight (VLBW) neonates admitted in neonatal intensive care unit of tertiary care hospital attached with Smt. Kashibai Navale medical college, Pune from January 2019 to March 2020.Results: In our study VLBW babies were 2.2% (78/3545). Mean gestational age was 31.15±3.21 weeks; mean birth weight was 1226.24±250.95 grams. Small for gestational age (SGA) babies were 41% and 96% were preterm. Maternal risk factors were present in 61.53% of deliveries, commonest were anaemia in 30.06 % and preeclampsia in 24.35%. Resuscitation at birth was required in 30.76% babies. Morbidity profile showed respiratory distress syndrome in 46.15%, neonatal sepsis in 19.23% and patent ductus arteriosus in 16.66% babies. Overall survival was 74.35%. Prematurity and its complications like RDS requiring surfactant therapy and mechanical ventilation were significant contributors for mortality but only 23.07% mothers were found to have received antenatal steroids in the hospital .Conclusions: Anaemia and preeclampsia were commonly found risk factors present in 61.53% of mothers of VLBW babies. Use of antenatal steroids in mothers should be made compulsory to decrease mortality in VLBW preterm newborns.

Experimental Evaluation of Vitamin - D Supplementation on Memory and Learning Using Different Animal Models in Albino Rat

Aim: We conducted this study with the aim to investigate the effect of vitamin D3 on spatial learning and memory in healthy young albino rat.
 Study Design: Experimental evaluation.
 Place and Duration of Study: Department of Pharmacology, Smt. Kashibai Navale Medical College and General Hospital (SKNMCGH), Pune, between October 2019 to February 2020.
 Methodology: All the pharmacological experiments were conducted using Wistar albino rats (n=6), weighing between 100 g – 150 g. Total 18 animals (9 male and 9 female) were screened and marked into 3 different groups (6 in each group) Control (Normal saline 10 ml/kg), Vitamin D (Cholecalciferol 1000 IU/kg) and standard (Piracetam 200 mg/kg). Drugs were administered per os for 21 days. Elevated Plus Maze (Transfer Latency), Open Field Test (Rearing, Locomotion), Radial Arm Maze (Working and Reference memory) were used as amnesic models and their parameters for evaluation of this study.
 Results: After 21 days of treatment among all the three groups, Transfer Latency (p=9.55) in elevated plus maze, Working memory (p=0.454) and Reference memory (p=0.929) observed in radial 8 arm maze were non significant. In open field apparatus pellets count was significant (0.010), rest all parameters were non significant.
 Conclusion: The result of study suggests that no significant beneficial effect of Vitamin D was seen on various learning models as assessed by Elevated Plus Maze, Radial Arm Maze, Open Field Test.

Evaluation of tear film in cases of rheumatoid arthritis

To evaluate the tear film and calculate the prevalence of dry eye in Rheumatoid Arthritis patients based on disease activity. A cross-sectional study of 50 Rheumatoid Arthritis patients was performed in the Department of Ophthalmology, Smt. Kashibai Navale Medical College and Hospital, Pune. C-Reactive Protein (CRP), and Rheumatoid Factor (RF) labs were done. All patients underwent complete ophthalmic evaluation including assessment of visual acuity. Tear film assessment was done by calculating the Tear Meniscus Height (TMH) on Anterior Segment-Optical Coherence Tomography (AS-OCT). Fifty patients were studied. 44 were females and 6 were males with a mean age of 47.34 ± 10.33years. TMH was abnormal (≤300 microns) in 31 (62%) patients. RF was positive in 31 (62%) patients while CRP was raised (>3.0mg/L) in 30 (60%) patients. RF Positivity had a significant correlation with abnormal TMH values (ꭓ² = 5.15, p=.02). Raised CRP was not significantly associated with abnormal TMH values (ꭓ² = 0.39, p=.54).Conclusion: Dry eye evaluation should be considered in RA patients irrespective of the disease activity.

Transvaginal Sacrospinous Ligament Fixation: Revisited in Modern Gynecology

ABSTRACT Background To evaluate intraoperative and postoperative complications and to evaluate recurrence of vault prolapse in women who have undergone unilateral (left) sacrospinous ligament fixation. Aim To evaluate safety, effectiveness, and ease of sacrospinous ligament fixation for prevention and treatment of vaginal vault prolapse. Materials and methods This study was conducted between January 2016 and October 2017 at Smt. Kashibai Navale Medical College and General Hospital, Pune. This study included 106 patients (out of which18 had vault prolapse and 88 patients had III or IV degree uterine prolapse). Concomitant hysterectomy and sacrospinous ligament fixation were done in 88 patients with uterine prolapse, and patients with vault prolapse underwent sacrospinous ligament fixation. Sacropinous ligament fixation was combined with any other additional procedure if required for that patient. Results All complications including intraoperative and postoperative were noted in all patients. One patient had rectal injury (n = 1; 0.94%), 1 patient had abscess (n = 1; 0.94%), 1 patient had hemorrhage requiring blood transfusion (n = 1;0.94%), 1 patient had cystocele (n = 1; 0.94%), 3 patients had urinary tract infection (n = 3; 2.8%), 16 patients had postoperative fever (n = 16; 15%), 21 patients had postoperative pain (n = 21; 20%), and 2 patients had sciatic neuralgia (n = 2; 2.8%). No recurrence of vault prolapse was noted. Conclusion Sacrospinous ligament fixation is a safe, effective, and simple procedure for prevention and treatment of vaginal vault prolapse. How to cite this article Shastri SS, Darawade SP, Yedage NR. Transvaginal Sacrospinous Ligament Fixation: Revisited in Modern Gynecology. J South Asian Feder Obst Gynae 2020;12(3):155–158.

Introducing objective structured practical examination as a formative assessment tool for phase I medical professionals in physiology

Background: Assessment in medical education has lot of scope for improvement. Objective Structured Practical Examination (OSPE) involves direct observation of students’ performance at planned stations. As proposed by the new competency-based medical education curriculum, we introduced OSPE as a formative assessment tool on a pilot basis. Aims and Objectives: The aims of the study were to introduce OSPE, study its feasibility and acceptability among students and faculty and assess its impact on learner performance. Materials and Methods: Institutional Ethics Committee approved, analytical cross-sectional study conducted in the Department of Physiology Smt. Kashibai Navale Medical College and General Hospital, Pune. A batch of 50 First MBBS students volunteered, of which 44 appeared on the day of the exam (n = 44). Informed consent was taken. Students were randomly divided into two groups. Group I went for Traditional Practical Exam in hematology. Group II went for OSPE, consisting of ten stations, of which two were procedure stations having observers with checklists, and eight were response stations. Four minutes time was given at each station. Groups switched over after finishing. Feedback (Likert scale based Questionnaire) was collected from students and faculty. Students were given feedback about their performance in OSPE. Analysis of the questionnaire was done using unpaired t-test with SPSS software. Results: Students felt that OSPE is a uniform, unbiased tool for practical assessment, less stressful and can be used as a routine form of assessment. Faculty felt that OSPE though, needs a lot of groundwork is feasible to implement and would be more helpful in clinical physiology practical. Conclusion: OSPE is an effective assessment tool for precisely measuring practical skills. Giving feedback becomes easier because of checklists.

Usage of electronic devices and awareness regarding e-waste management amongst engineering college students: a cross-sectional study

Background: The total waste generated by obsolete or broken down electronic and electrical equipment was estimated to be 1,46,000 tonnes for the year 2005, which is expected to exceed 8,00,000 tonnes by 2012. However, according to the Green peace report in 2007, India generated 380,000 tonnes of e-waste. Only 3% of this made it to the authorized recyclers’ facilities.Methods: A cross-sectional study was carried out amongst 133 Engineering Students of Sinhgad Institute of Technology College, Lonavala, Pune which is located in a rural field practice area of Smt. Kashibai Navale Medical College, Pune during the period of June 2016 to December 2016. Data was collected by using a self-administered questionnaire and analyzed by using Epi. Info 7 and appropriate statistical tests were applied.Results: Almost 125 (94%) students replaced mobile phones in last five years. Common reason for replacement was desire for newer technology by 33 (26.4%) students and need for greater functionality by 29 (23.2%). The old mobile phones were kept at home by 34 (27.2%) students, followed by dumped by 31 (24.8%), it was also noted that many students sold the mobile phones and only 8 (6.5%) were aware of the e–waste management policy.Conclusions: Most of the students replacing the mobile phones frequently but the level of awareness about the e-waste management were low, so need to increase the awareness among the users for implementation of the e waste management policy.

Nerve conduction studies in patients with primary hypothyroidism

Background: Hypothyroidism is an important cause of peripheral as well as focal neuropathy. Reported prevalence of neuropathy in hypothyroidism is varied widely. Objective: To study nerve conduction abnormalities and to correlate electrodiagnostic findings with clinical features in patients with primary hypothyroidism. Materials and Methods: This study was done in Smt. Kashibai Navale Medical College, Pune, Maharashtra. Adult patients with primary hypothyroidism were included. Patients with other possible causes of neuropathy were excluded. Detailed medical history was obtained, and clinical examination and nerve conduction study by electrophysiological method were done in all patients. Results: Total 40 patients were included, of which, 25% patients showed evidence of neuropathy. Six patients had carpal tunnel syndrome while four had other peripheral neuropathy. Presence of neuropathy correlated independently with advanced age and female gender. There was significant correlation between presence of signs and symptoms of neuropathy to electrophysiologically confirmed neuropathy. Occurrence of neuropathy was more common in patients with duration of disease more than 5 years (44.44%) and obesity (50%), but these findings were not statistically significant (P = 0.08 and 0.09, respectively). No correlation found between etiology of disease, serum thyroid-stimulating hormone level and occurrence of neuropathy (P = 0.43, 0.9, respectively). Conclusion: Advanced age and female gender are important risk factors for development of neuropathy in patients with hypothyroidism. The thorough clinical examination is very important as clinical signs and symptoms are sensitive predictors for the presence of neuropathy.

Carpal Tunnel Syndrome in Hypothyroidism.

Carpal Tunnel Syndrome (CTS) is an entrapment neuropathy that occurs due to compression of median nerve in the carpal tunnel and hypothyroidism is one of the important causes of CTS. To study clinical profile of carpal tunnel syndrome in patients with primary hypothyroidism. This was cross-sectional study done in Smt. Kashibai Navale Medical College, Pune, Maharashtra. Adult patients with diagnosis of primary hypothyroidism were included in this study. Patients with other possible causes of CTS were excluded. Detailed medical history was obtained and all patients underwent clinical examination and nerve conduction study by electrophysiological method. Total 36 adult patients were included in this study, 86.1% females and 13.9% males. CTS were found in 6 (16.7%) patients. Increased Body Mass Index (BMI) and presence of clinical symptoms and/or signs of CTS correlated independently with presence of CTS in hypothyroidism. (p-value- 0.03 and < 0.0001 respectively). No correlation was found between gender, age of the patient, duration of disease, serum TSH level, aetiology of the disease, thyroid hormone replacement therapy and occurrence of CTS in hypothyroidism. Increase in BMI is an important risk factor for CTS in hypothyroidism and clinical evidence of CTS is a very sensitive parameter for the same.

Need of Ergonomics Arrangements for Orthopedic Surgeons

Neeraj Adkar1 and Harshal Tukaram Pandve2* 1Sai Shree Hospital and Replacement Center, Near Parihar Chowk, Aundh, Pune, Maharashtra, India 2Department of Community Medicine, Smt. Kashibai Navale Medical College, Narhe, Pune, Maharashtra, India *Corresponding author: Harshal Tukaram Pandve, Associate Professor, Department of Community Medicine, Smt. Kashibai Navale Medical College, Narhe, Pune, Maharashtra, India, Email: dr_harshalpandve@yahoo.co.in

Treatment of auricular seroma: a conservative, innovative, and effective approach.

Auricular seroma is a cystic swelling filled with serous fluid. It occurs spontaneously or following trauma. Successful treatment of the seroma remains a challenge because this disease has a high propensity for recurrence. The aim was to study the results of the Plaster of Paris (POP) cast in treatment of seroma in terms of complete resolution of swelling, recurrence, and auricular aesthesis. Prospective. Smt. Kashibai Navale Medical College and General Hospital. A total of 48 patients with auricular seroma were studied. They were treated with aspiration of the cyst followed by compression dressing with a POP cast, taking the contour of the pinna. The POP cast was kept for 3 days. The patients were followed up for 6 months for recurrence. Out of 48 patients, 43 patients had complete resolution of the swelling in a single application of the POP cast. Five patients needed 2 applications of the POP cast. Not a single patient had recurrence. Temporary discoloration or thickening of the pinna was noted in 8 patients. No major complications like perichondritis were noted. Aspiration and contour dressing using POP is an innovative and effective treatment for management of auricular seroma as it prevents surgical trauma and recurrence and gives cosmetically excellent results.

Effects of blood lead level on biochemical and hematological parameters in children with neurological diseases of Western Maharashtra, India

Lead is found in small but appreciable quantities in air, soil, drinking water, and food. Exposure to such amounts of lead does not lead to acute lead toxicity but produces subtle effects particularly in children. The aim of this study was to investigate the effects of blood lead level on biochemical and hematological parameters in children with neurological diseases in Western Maharashtra, India, and to estimate the blood lead level by liver and kidney function tests and hematological parameters in children with neurological disorders admitted to the pediatric ward and compare them with healthy controls. In this study, 30 children with various neurological disorders admitted to the pediatric ward of Smt. Kashibai Navale Medical College and General Hospital, Pune, Maharashtra, India, were compared with 30 age- and sex-matched healthy controls. Four milliliters of venous blood was collected for estimation of blood lead level, and biochemical and hematological parameters were determined using standard methods. Blood lead level was significantly increased in the study group (p<0.01, 65.38%) compared to that in the control group. When different neurological conditions were grouped into three groups according to blood lead levels, there was a significant difference between the groups. All other biochemical and hematological parameters were not significantly altered in the study group as compared to the control group. Neurologically challenged children are more vulnerable to lead intoxication. It is imperative for the parents to take extra care of their children's food habits and limit hand-to-mouth activities to prevent lead intoxication.

Attitude, perception and feedback of second year medical students on teaching-learning methodology and evaluation methods in pharmacology: A questionnaire-based study

Background:To assess the student's attitude, perception and feedback on teaching–learning methodology and evaluation methods in pharmacology.Materials and Methods:One hundred and forty second year medical students studying at Smt. Kashibai Navale Medical College, Pune, were selected. They were administered a pre-validated questionnaire containing 22 questions. Suggestions were also asked regarding the qualities of good pharmacology teachers and modification in pharmacology teaching methods. Descriptive statistics were used and results were expressed as percentage.Results:Majority of the students found cardiovascular system (49.25%) as the most interesting topic in pharmacology, whereas most of the students opined that cardiovascular system (60.10%), chemotherapy (54.06%) and central nervous system (44.15%) are going to be the most useful topics in internship. 48.53% students preferred clinical/patient-related pharmacology and 39.13% suggested use of audiovisual-aided lectures. Prescription writing and criticism of prescription were amongst the most useful and interesting in practical pharmacology. Students expressed interest in microteaching and problem-based learning, whereas seminars, demonstrations on manikin and museum studies were mentioned as good adjuvants to routine teaching. Multiple Choice Question (MCQ) practice tests and theory viva at the end of a particular system and periodical written tests were mentioned as effective evaluation methods. Students were found to have lot of interest in gathering information on recent advances in pharmacology and suggested to include new drug information along with prototype drugs in a comparative manner.Conclusion:There is a need of conducting few microteaching sessions and more of clinical-oriented problem-based learning with MCQ-based revisions at the end of each class in the pharmacology teaching at undergraduate level.

Biochemistry handouts covering all lecture topics as study guide to focus during exam preparation in first year medical undergraduates in India

Medical undergraduates experience a lot of stress before the final examination at the end of first academic year of one year duration in India. Biochemistry handouts including all lecture topics were developed as study guide to be used along with textbook for final exam preparation. To help students focus biochemistry study so that subject understanding is facilitated, exam anxiety is reduced and academic performance is enhanced. Six sets of handwritten handouts including all lecture topics were distributed to the first year undergraduates (n=100) of 2009-10 batch in biochemistry department of Smt. Kashibai Navale Medical College, Pune, under Maharashtra University of Health Sciences. Grouping of lecture topics in different sets was based on correlation between them wherever possible. All lecture topics were discussed in question and answer format. All answers contained only subheadings, important concepts and relevant examples. These handouts were used by the students mainly in the preparatory leave before the final examination. All the participants agreed in their feedback that the handouts helped them to focus textbook study before the final examination. They also reported better understanding and reduction in anxiety during exam preparation. Academic performance of participant students in end of year examination was significantly enhanced (p value < 0.05) when compared to that of the students of 2008-09 batch without the intervention of handouts. The handouts covering all lecture topics as study guide were valuable aid for a more organized study. Such resource material developed by faculty can help undergraduates in coping with academic stress in first year of medical education.