Utility and perceptions about web-based academics among physicians during COVID-19 pandemic.

INTRODUCTION: Coronaviral disease-19 is the global challenge for medical fraternity and public health sector. Need of social distancing has compelled physicians and surgeons to continue medical education through virtual mode like webinar. OBJECTIVE: To study the perceptions, practice and preferences of medical residents and professionals about webinar-based teaching. METHODS: An internet-based google-sheet questionnaire was circulated via email and social media for opining different facts about webinar-based teaching. Responses were analysed further to find the facts and preferences. RESULTS: Our study showed that majority of participants found webinars as a useful and sustainable mode of teaching however some of them felt it as an overdone action resulting in unnecessary stress. CONCLUSION: Teaching through virtual mode (e.g. webinar) is definitely a valuable tool for medical education especially during the need of social distancing. Its frequency, quantity, and quality should be monitored properly for the optimum outcome.

Is There Any Benefit of Integrating Computer-assisted Learning with Conventional Teaching Format in Pharmacology to Demonstrate the Effects of Different Drugs on Mean Arterial Blood Pressure in an Anesthetized Dog?: A Comparative Study.

PURPOSE: Computer-assisted learning (CAL) tools are often used in medical education as it can complement conventional teaching formats and as an alternative to animal experiments in undergraduate medical students. To identify if there is any benefit of integrating CAL tools with conventional teaching format in pharmacology for a specific topic. MATERIALS AND METHODS: Two groups of fourth semester students, Group I (n = 55) and Group II (n = 60), were taught a specific topic in pharmacology using only conventional teaching format (Group I), and both conventional teaching format as well as CAL format (EP Dog version 1.1.0) (Group II). The students were assessed with two different sets of multiple-choice questions, relevant to the topic taught, immediately at the end of the teaching sessions and after 30 days. Acceptability of the two teaching sessions by the students was also assessed using Likert scale. RESULTS: There was no significant difference in the scores of the students of the two groups immediately after teaching (P = 0.1260), there is definitely better residual knowledge reflected by the significantly (P = 0.001) better test scores of the Group II students after 30 days in comparison to Group I students. However, there was no significant difference with regard to the acceptability of the CAL teaching format alone and along with the conventional teaching format between the two groups (P = 0.6033). CONCLUSION: Integrating CAL with conventional teaching format improves students' understanding and performance for a specific topic.

Perception of Learning Environment among Undergraduate Medical Students in Two Different Medical Schools through DREEM and JHLES Questionnaire.

INTRODUCTION: Assessment of learning environment is essential to assess the acceptability of the curriculum among students. Several tools are available to assess undergraduate medical students' perception of learning environment. Dundee Ready Education Environment Measure (DREEM) questionnaire is the most commonly used tool. Here, we have used both the widely used DREEM questionnaire and a relatively new questionnaire Johns Hopkins Learning Environment Scale (JHLES). AIM: Assessment of students' perception of learning environment of two eastern Indian medical schools using DREEM and JHLES questionnaire. MATERIALS AND METHODS: In this cross-sectional questionnaire based study, 200 students from Nil Ratan Sircar Medical College (NRSMC) and 78 students from College of Medicine and Sagore Dutta Hospital (CMSDH) of 5th semester batch duly completed the two questionnaires, DREEM scale and JHLES tool. The DREEM questionnaire has 50 questions arranged in five domains. The JHLES questionnaire has 28 questions arranged in seven domains. Comparison of scores between the two colleges was done by unpaired t-test. RESULTS: There were altogether 100 female and 178 male participants with mean age of 20.46±0.67. There were no significant difference between the overall DREEM score (p=0.81) and the JHLES scores (p=0.10) obtained from NRSMC and that obtained from CMSDH. Analysis of individual domain scores on DREEM scale revealed that there were no significant differences in domain scores for the two medical schools except for Students' Perception of Atmosphere (SPA) score (p=0.0086). JHLES revealed significant differences in terms of engagement, inclusion and safety, and physical space (p<0.001). The DREEM and JHLES results revealed positive correlation (r=0.59). CONCLUSION: Both DREEM and JHLES scores revealed comparable results from two schools with positive correlation between DREEM and JHLES tools, however some areas with low scores require modification especially the domain assessing Students' Academic Self-Perception (SASP) and Students' Social Self Perceptions (SSSP).

Is This a Drug?" Answers From Medical Students in a Tertiary Care Teaching Hospital in Eastern India.

INTRODUCTION: World Health Organization (WHO) defines what is drug and what is not. Second year MBBS students learn the principles of Pharmacology that they use in their later clinical practice life. The aim of the survey was to determine how medical students classify a range of preparations they might encounter in their professional lives and whether a brand name or a commercial preparation of a drug would influence their decision in the categorization of the preparation as a 'drug' or 'not a drug'. AIM: To assess the knowledge of medical students, if a substance or product is a drug. MATERIALS AND METHODS: We surveyed 2 concurrent years of medical students to classify 60 candidate medicinal preparations into "drug" and "not-drug" from a validated questionnaire. The candidate preparations were named either in generic or in their commercially available forms and they were all essential drugs as per WHO definition. RESULTS: The two groups of students, A and B, included 192 and 215 students respectively. Demographically there was little difference in the two groups. Agents like Aspirin, Paracetamol, Amphetamine, Salbutamol, Atropine, Dextromethorphan, Codeine, Diazepam, Ciprofloxacin ear drops, Levonorgestrol, Neosporin eye ointment, Furosemide, Metronidazole, Penicillin, Sorbitrate, Lignocaine, Methotrexate, Penicillin, Zolpidem and Thalidomide received almost unanimous votes as drugs. Arsenic trioxide, Fentanyl and petroleum jelly were considered to be "non-drugs" by most participants. The two groups did not differ significantly in their responses. CONCLUSION: Some major lacunae were noted in the knowledge of the participating students despite book teaching on the definition of a drug. Drugs used for prophylaxis and those used in physiological conditions or topically, were often missed. These gaps need to be filled by more emphasis on definition of a drug and its clinical applicability based on example and case based studies.

Pesticide use pattern among farmers in a rural district of West Bengal, India.

BACKGROUND: A vast majority of Indian population are engaged in agriculture. While pesticides help in increasing crop production, inappropriate pesticide storage practice and inadequate protective measures frequently causes accidental poisoning among farmers. OBJECTIVE: The present study was conducted to explore the pattern of pesticide use among farmers in a district of India with an attempt to identify the lacunae in their knowledge and awareness level on risks and hazards of pesticides use. MATERIALS AND METHODS: A cross-sectional questionnaire based study was conducted in the district of Burdwan, West Bengal, to address the study objective. Data analysis was performed by using descriptive statistical methods: Frequency, percentage, mean, standard deviation. RESULTS: In the present study alpha-cypermethrin (46%) was the most commonly used pesticide followed by methyl parathion (25.6%), imidacloprid (16.4%), dichlorvos (7.8%) and phorate (4.2%). The farmers used to store pesticides mostly in cowshed (48.4%) followed by storeroom (29.6%). During spraying of pesticides, farmers experienced headache (29.8%) followed by nausea (26%), burning sensation in eyes (9.8%), cough (9.2%), muscle cramps (2%). Regarding the personal protective measures taken by the farmers for spraying, covering nose, mouth with cloth combined with bath after spraying was the most common practice (27%). When asked about suggested actions to be taken if anybody becomes sick following exposure to pesticides, 86% of farmers prefer consulting a doctor. CONCLUSION: The study suggested that farmers of Burdwan were exposed to highly hazardous, restricted and banned pesticides, with insufficient protection. In this situation, educational and training interventions on pesticide handling and safety precautions are urgently needed.

Efficacy and safety of add on therapy of bromocriptine with metformin in Indian patients with type 2 diabetes mellitus: a randomized open labeled phase IV clinical trial.

OBJECTIVE: To compare the effectiveness and safety of add on therapy of bromocriptine with metformin in type 2 diabetes mellitus (DM) patients. MATERIAL AND METHODS: Adult type 2 DM patients fulfilling the inclusion criteria were randomized in three groups. Group A received metformin (1000 mg/ day), while group B patients were treated with metformin (1000 mg/day) plus bromocriptine (0.8 mg/day) and group C received metformin (1000 mg/day) plus bromocriptine (1.6 mg/day) for 12 weeks. Fasting plasma glucose (FPG), postprandial plasma glucose (PPPG), and body weight were measured at week 4, 8, and 12 visits and glycosylated hemoglobin (HbA(1C)) at week 12 visit. RESULTS: Metformin alone and in combination with bromocriptine in escalating dose (0.8 mg/day and 1.6 mg/day) significantly (P < 0.05) decreased FPG and PPPG levels at weeks 4, 8, and 12 compared with pretreatment values. HbA(1C) level in all three treatment groups significantly (P < 0.05) decreased at week 12 as compared with pretreatment baseline value. HbA1C level in groups B and C significantly (P < 0.05) decreased as compared with group A at week 12. Addition of bromocriptine to metformin also significantly (P < 0.05) decreased FPG and PPPG levels in a dose-dependent manner as compared with metformin alone. Intergroup analysis did not show any statistically significant change in weight of study subjects at different intervals. CONCLUSION: The combination of bromocriptine with metformin significantly decreased FPG, PPPG, and HbA1C compared with metformin alone in type 2 DM patients in a dose-dependent manner.

A Study on the Performance of Medical Students in Internal Assessment and its Correlates to Final Examinations of 2(nd) MBBS Pharmacology Curriculum in a Medical College of Eastern India.

OBJECTIVES: The present study was undertaken to assess whether performance in the continuous assessment method as determined by internal assessment, correlates to the final summative evaluation in 2(nd) professional MBBS students in Pharmacology for the last four years (2009-2012). MATERIALS AND METHODS: This study was conducted over a period of three months at Nilratan Sircar Medical College and Hospital, Kolkata (West Bengal, India). It was a retrospective non-interventional record-based study based on the students' score sheets of 2(nd) MBBS Pharmacology examinations. RESULTS: The strength of correlation between internal assessment marks and total summative examination was fond to be highly significant at p < 0.0001, thereby implying that continuous assessment plays a vital role in influencing the overall performance of the undergraduate medical students. CONCLUSION: This study revealed that performance in the internal assessment and final examination have a direct correlation although not completely linear, thereby indicating that other possible variables would have influenced the final result of the 2(nd) MBBS Pharmacology curriculum.

Cervical intramural pregnancy: Report of a rare case.

Cervical pregnancy is an extremely rare condition of ectopic pregnancy with potential grave consequences if not diagnosed and treated early. A case of intramural pregnancy in the cervix is being reported for its rarity. Early diagnosis is imperative to preserve fertility, otherwise if the pregnancy is disturbed, it may precipitate massive haemorrhage, which may require hysterectomy to save the patient.

The possible role of fluoxetine in adenomyosis: an animal experiment with clinical correlations.

INTRODUCTION: Fluoxetine is a commonly prescribed drug which is used in the psychiatric practice and adenomyosis is a common medical problem in women of the reproductive age group. OBJECTIVE: To explore the role of fluoxetine in the causation of adenomyosis. METHODS: Female Wistar rats (n=18) were divided into three groups (group I (the control), group II and group III) and they were treated with normal saline and oral fluoxetine (4mg/kg and 8 mg/kg) respectively for 100 days. Periodic serum prolactin measurements and histopathological examinations of the uterine horns of all the rats were done at the end. Comparison of the mean serum prolactin levels between the patients (n=15) who were diagnosed with adenomyosis, the healthy age sex matched controls and the female patients (n=20) who received fluoxetine for more than 3 months, before and after the fluoxetine administration, was done separately. Appropriate (paired or unpaired) t tests were used for the data analysis. RESULTS: Out of the 12 test group rats, 10 rats showed the features of adenomyosis histopathologically, along with significantly (p < 0.05) raised serum prolactin levels. The mean serum prolactin levels of the patients of adenomyosis in comparison to those of the controls and of the patients who were treated with fluoxetine (before and after the fluoxetine administration), were significantly high (p=0.001 in both the cases). CONCLUSION: Fluoxetine may have some role in the causation of adenomyosis; although for a stronger evidence, the follow-up of the patients who are treated with fluoxetine on a long term basis should be ideal.

Isolated plexiform neurofibroma of the tongue.

Neurofibromas (NF) are benign tumors of neural origin, of which roughly 90% appear as solitary lesions. They are classified into cutaneous, subcutaneous, and plexiform subtypes. Plexiform neurofibromas are the least common variant and usually are pathognomonic for NF I. Here, we present a very rare case of isolated plexiform neurofibroma with a painless enlarging mass of the tongue of an 11-year-old girl. This rare benign tumor has the potential for malignant transformation, and the diagnosis was difficult owing to the patient's age and to the insidious clinical presentation. The present case is a diffuse isolated plexiform neurofibroma of the tongue that was not associated with neurofibromatosis that was treated with intraoral surgery.

Hydatid cyst of ovary mimicking ovarian neoplasm with its imprint cytology.

BACKGROUND: Hydatid disease, caused by Echinococcus granulosus, is a common parasitic infection of the liver. Disseminated intra-abdominal hydatid disease may occur with the rupture of the hydatid cyst into the peritoneal cavity, producing secondary echinococcosis, but occasional cases of primary peritoneal hydatid disease involving the pelvis have been reported. Occasionally, the cyst does not rupture, but instead enlarges, thus mimicking an ovarian tumour. CASE REPORT: We present a 30-years-old woman with an intra-abdominal hydatid cyst that had no communication with the liver. It is therefore probably a primary case of ovarian hydatid cyst, which is very rare. An imprint smear was also taken, which revealed scolex with hooklets. CONCLUSIONS: The incidence of hydatid cyst in the female reproductive system is very low, constituting less than 0.5% of all hydatid cysts. Hence clinicians should consider hydatid cyst among differential diagnosis whenever a cystic pelvic mass is found.

Olanzapine-induced hepatopathy in albino rats: A newer model for screening putative hepatoprotective agents, namely silymarin.

BACKGROUNDS: This study was conducted to establish olanzapine-induced hepatopathy in Wistar albino rats as a newer model to screen putative hepatoprotective agents namely silymarin. MATERIALS AND METHODS: Albino rats were divided into three groups, namely vehicle control group (CG), olanzapine-treated group (OZ), and olanzapine plus silymarin (OZS) treated groups. Both the OZ and OZS groups were treated with the same dose of intraperitoneal olanzapine for 6 weeks and group OZS additionally received oral silymarin. Baseline and terminal hepatic enzymes (SGOT, SGPT, and ALP) were measured in all three groups. RESULTS: Histopathological examination of livers of both OZ and OZS groups showed degenerative changes, whereas those of control group showed normal architecture. Liver enzyme levels showed statistically significant rise in comparison to the control group as well as the respective base line values in both the test groups, but the differences in the rise of liver enzymes between the two test groups were not statistically significant. CONCLUSION: Olanzapine-induced hepatopathy in rats can be used as a model for screening putative hepatoprotective agents and in our setting silymarin has failed to provide any hepatoprotection.