Preparedness of medical students towards e-learning conducted during COVID-19 lockdown: A cross-sectional descriptive study.

BACKGROUND: COVID-19 lockdown has mandated the medical colleges to start academics using electronic mode. Synchronous e-learning was started by our institute to replicate traditional classes in line with the routine academic schedule. the objective of this study attempted to assess the e-learning readiness of the students of our institute. MATERIALS AND METHODS: A cross-sectional descriptive study was planned using the model proposed by Oketch et al. with local modifications. The questionnaire was designed in Google Forms and mailed to respond using Likert scale. The nonparametric data collected from the total 84 respondents were analyzed for validity and reliability of the questionnaire, mean values to know the readiness (mean = 3.4), and one-step multiple regression to know the predictors. RESULTS: The mean eLR (e-learning readiness) as evaluated from attitudinal readiness (MeanAR = 3.6), culture readiness (MeanCR = 2.3), material and technological readiness (MeanMTR = 3.7), and mental health readiness (MeanMHR = 2.4) is 3.03 (60.6% with n = 84). Multiple regression analysis revealed that all the variables except MHR can significantly predict e-learning readiness linearly (P < 0.05). CONCLUSION: The institute is ready for e-learning in terms of AR and MTR (mean values >3.4). CR and MHR still need a lot of improvisation to make it acceptable for e-learning. The model could explain 54.9% readiness level with CR as the most important predictor. More than 73% (n = 84) of the respondents have acknowledged the present form of online classes to be the best available option in COVID-19 lockdown and most of them are adapted to e-classes in the institute.

Fasting and postprandial lipid parameters: A comparative evaluation of cardiovascular risk assessment in prediabetes and diabetes.

CONTEXT: Dyslipidemia plays a crucial role in atherogenesis, in both prediabetes and diabetes. There persists a lacuna in the evaluation of postprandial lipid parameters in prediabetes. AIMS: To comparatively evaluate fasting and postprandial blood lipid parameters and atherogenic lipid ratios for cardiovascular risk assessment, in prediabetes and diabetes. MATERIALS AND METHODS: Fifty-one patients diagnosed with diabetes mellitus and thirty-two with prediabetes were selected for the study. Lipid profile and blood glucose were analyzed in fasting and postprandial blood samples. STATISTICAL ANALYSIS USED: Kolmogorov-Smirnov test, Shapiro-Wilk test, one-way ANOVA, and Pearson's regression analysis were applied. RESULTS: Postprandially, triglycerides (TG) was increased significantly in diabetes compared to controls (P < 0.01) and prediabetics (P < 0.05). Among the lipid ratios, triglyceride/high density lipoprotein (TG/HDLc) was significantly increased postprandially in diabetes compared to controls (P < 0.05). A comparative analysis of fasting and postprandial parameters within each group showed a significant increase in postprandial TG/HDLc compared to the fasting state in prediabetes (P < 0.001) and diabetes (P < 0.001). Postprandial TG (P < 0.01) and TG/HDLc (P < 0.01) showed a stronger correlation with HbA1c compared to fasting TG (P < 0.05) and TG/HDLc (P > 0.05). The prevalence of dyslipidemia and insulin resistance was higher in postprandial state than the fasting state in prediabetes and diabetes. CONCLUSIONS: Postprandial TG and the TG/HDLc reflect lipid abnormalities than the corresponding fasting variables in diabetes and prediabetes. Postprandial TG and TG/HDLc are better reflectors of cardiovascular status in prediabetes and diabetes.

Tracking lipid profile and atherogenic indices in the prediabetics of Andaman Nicobar Islands: A retrospective hospital-based study.

CONTEXT: Cardio vascular disease (CVD) is the leading cause of mortality and morbidity in diabetes mellitus (DM) contributing to 65% of all deaths with diabetic complications. The most important cause of CVD is atherosclerosis, and dyslipidemia acts as a marker of developing atherosclerosis. The derangement of lipid profile and atherogenic indices start in the prediabetic state, much before the development of DM. Detection of the deranged lipid profile and atherogenic indices in the prediabetic state can help devise the aggressive treatment strategy right from this stage, so as to arrest the development of CVD as a complication of diabetes. AIMS: To compare the lipid profile and atherogenic indices of prediabetics with controls and diabetics. SETTINGS AND DESIGN: The electronic medical records of 239 subjects were reviewed retrospectively. MATERIALS AND METHODS: About 187 cases consisting of 137 diabetics and 50 prediabetics were evaluated for serum fasting blood sugar, post prandial blood sugar, HbA1c, total cholesterol (TC), triglycerides (TGs), high-density lipoprotein cholesterol (HDLc), and low-density lipoprotein cholesterol (LDLc). Atherogenic indices [TC/HDLc, LDLc/HDLc, (TC-HDLc)/HDLc, TG/HDLc] were also evaluated in the two groups. Rest 52 age- and sex-matched subjects were taken as controls. STATISTICAL ANALYSIS USED: The comparisons were evaluated using SPSS statistical package version 20. RESULTS: TC, TG, LDLc, and the atherogenic indices were significantly increased in prediabetics as compared with controls. HDLc was significantly decreased in prediabetics. CONCLUSIONS: The altered lipid profile and atherogenic indices in prediabetics signify the increased susceptibility of prediabetics to CVD in the long run. Hence, we recommend screening of prediabetics for dyslipidemia to arrest the development of cardiovascular complications.

Evaluation of thyroid function in type 2 diabetes in north-eastern part of India: A hospital-based study.

BACKGROUND: Diabetes mellitus (DM) and thyroid dysfunctions are the two most common endocrine disorders to come across in any clinical practice. Both thyroid hormones and insulin act antagonistically in metabolic pathways or cycles of cells. The aim of our study is to look for thyroid dysfunction in patients with type 2 DM and its correlation with insulin resistance (IR). METHODS: A cross-sectional study was carried out among 80 newly diagnosed type 2 diabetic patients. Thyroid-stimulating hormone (TSH), free triiodothyronine, free thyroxine, and insulin were measured in fasting serum sample. Homeostasis model assessment for IR was calculated as per formula. RESULTS: Among 80 diabetic patients, 20 were hypothyroid, 4 were hyperthyroid, and 56 were found to be euthyroid. IR was found to be significantly higher in hypothyroid as compared to euthyroid patients. A positive association was found between TSH and IR (r = 0.230) among hypothyroid patients though association was not significant. In hyperthyroid patients, a strong negative correlation (r = -0.94933) was found between TSH and IR, but no association was found among euthyroid patients. CONCLUSION: The inability to recognize the presence of thyroid hormone dysfunction may be one of the important causes of poor management of type 2 DM. Therefore, there is a need for routine assay of thyroid hormones in type 2 diabetic patients to improve the medical management as well as to reduce the morbidity in them.

A Leap above Friedewald Formula for Calculation of Low-Density Lipoprotein-Cholesterol.

PURPOSE: The purpose was to compare the different calculated methods of low-density lipoprotein cholesterol (LDL-C) estimation and to determine which of them correlate best with the direct method. MATERIALS AND METHODS: The records of 480 samples for lipid profile were analyzed. Apart from the direct method, LDL-C was calculated by Friedewald low-density lipoprotein cholesterol method (F-LDL-C), modified Friedewald low-density lipoprotein cholesterol method (MF-LDL-C), and Anandaraja low-density lipoprotein cholesterol method (A-LDL-C). Paired t-test and Pearson correlation were evaluated between the different methods. Degree of agreement between the calculated methods and direct method was detected by Bland-Altman graphical plots. RESULTS: A strong correlation was found between all calculated LDL-C methods and direct low-density lipoprotein cholesterol method (D-LDL-C) assay, that is, F-LDL-C versus D-LDL-C = 0.94; A-LDL-C versus D-LDL-C = 0.93 and MF-LDL-C versus D-LDL-C = 0.95. No statistically significant difference was found between D-LDL-C and MF-LDL-C. Bland-Altman plot for MF-LDL-C showed minimal negative bias. CONCLUSIONS: The study pointed out that MF-LDL-C correlated maximally with D-LDL-C estimation at all levels of triglycerides and MF-LDL-C can be used in place of D-LDL-C when the direct method cannot be afforded.

Serum Copper as a Marker of Disease Activity in Rheumatoid Arthritis.

INTRODUCTION: Copper is an important trace element for normal growth and development of the body. It is also essential for maturation of collagen tissues. The purpose of the study was to estimate the serum copper levels in rheumatoid arthritis patients and to see its association with the various parameters of disease activity. MATERIALS AND METHODS: The study was carried out among 50 diagnosed rheumatoid arthritis patients (25 each of active disease & remission patients) and 50 age and sex matched controls. Fasting blood sample was collected for estimation of serum copper, haemoglobin level and ESR in the subjects. RESULTS: Mean serum copper level in the case group was found to be significantly higher than that of the control group (p-value<0.001). This increase of copper level was more in active disease than those with remission (p-value < 0.0001). A significant positive correlation was found between serum copper level and ESR, serum copper level and morning stiffness and a negative correlation was found between serum copper level and haemoglobin level in rheumatoid arthritis patients. CONCLUSION: In rheumatoid arthritis patients, serum copper level may be used as an additional biochemical marker for estimation of disease activity.

Dyslipidemia and associated risk factors in a resettlement colony of Delhi.

BACKGROUND: Cardiovascular diseases are a major cause of morbidity and mortality in India, with dyslipidemia contributing significantly to the risk. There are few community-based studies that highlight the burden and risk factors associated with dyslipidemia in the Indian population. OBJECTIVES: To determine the prevalence and risk factors associated with dyslipidemia among adults ages 18 years and older in a resettlement colony located in central Delhi. METHODS: A cross-sectional study that included a random sample of 200 adults was designed. A study tool based on the World Health Organization STEPwise approach to surveillance of noncommunicable diseases and their risk factors (STEPS) questionnaire was used. Fasting venous blood sample was collected to assess the lipid profile and anthropometric measures of the participants were recorded. Criteria based on the Third Report of the National Cholesterol Education Program Expert Panel on Detection, Evaluation and Treatment of High Blood Cholesterol in Adults were used to define the cut offs for dyslipidemia. Data were analyzed with the Statistical Package for Social Sciences, version 17. RESULTS: Of a total of 200 study subjects, 34% had increased total cholesterol levels (≥200 mg %), 38% had increased low-density lipoprotein levels (≥130 mg %), 40% had increased triglyceride levels (≥150 mg %), and 42% had low high-density lipoprotein levels (<40 mg %). Using the logistic regression model, we found age, hypertension, alcohol consumption, and abdominal obesity to be associated with increased odds of dyslipidemia. CONCLUSION: A high proportion of individuals in the community have dyslipidemia, often associated with modifiable risk factors. The situation demands programs aimed at risk factor reduction. A focus on behavior change and health promotion targeting the younger age group is recommended.