Expedited COVID-19 vaccine trials: a rat-race with challenges and ethical issues.

The intense global efforts are directed towards development of vaccines to halt the COVID-19 virus pandemic. There are 160 candidate vaccines under clinical trials across the world using different molecular targets and techniques. This race for the vaccine has several challenges and ethical issues like compressed timelines, generation and proper management of resources and finances, risks to the participating volunteers due to curtailed research trial processes, geopolitical contentions, misinformation through social media and parallel race with drugs. We feel that the fundamental principles of ethics: autonomy, beneficence, non-maleficence and justice should not be violated in this hastened vaccine development process. We recommend constitute a Consortium on a global platform to formulate, provide and monitor a comprehensive ethical umbrella to the process of vaccine development.

VEGF-A and cardiac autonomic function in newly diagnosed type 2 diabetes mellitus: A cross-sectional study at a tertiary care center.

INTRODUCTION: Cardiac autonomic neuropathy (CAN) is a key complication of type 2 diabetes mellitus (Ty2DM). Vascular endothelial-derived growth factor (VEGF-A) plays a key role in diabetic macrovascular and microvascular complications. It is shown to be elevated in diabetic neuropathy and has the potential to serve as a biomarker in Ty2DM. We evaluated VEGF-A levels and cardiac autonomic function in newly diagnosed Ty2DM patients. MATERIALS AND METHODS: Forty-four newly diagnosed patients (with symptoms within 1 year from the date of recruitment) were included in the study. Cardiac autonomic function was assessed using heart rate variability (HRV) and Ewing's battery tests. Ewing's scores were computed and tabulated. VEGF-A levels were estimated using enzyme-linked immunosorbent assay (ELISA). RESULTS: The patients demonstrated normal responses to the reactivity tests. Ewing's scores were 0 (0-0) and 0 (0-0) for sympathetic and parasympathetic parameters, respectively. The autonomic tone was impaired as assessed by HRV parameters. VEGF-A levels were elevated (308.3 ± 167.2 pg/mL) when compared with the previous literature. DISCUSSION: Impaired tone with normal reactivity was suggestive of early stage of autonomic neuropathy. Elevated VEGF-A levels may be attributed to a protective action of the factor seen in early stages of neuropathy in Ty2DM. Serial VEGF-A estimation in large cohorts of newly diagnosed diabetics may validate it as a biomarker in CAN seen in Ty2DM.

Peer-assisted teaching method to foster learning physiological basis of electrocardiography among 1st year medical graduate students: An interventional study.

INTRODUCTION: In peer-assisted teaching (PAT) method, students are encouraged to prepare, organize, and construct their learning program under the guidance of a teacher. The objective of the present study is to assess the benefits and outcome of PAT on students' understanding and knowledge of one of the important and difficult topics, "physiological basis of electrocardiography (ECG)." METHODS: A nonrandomized, interventional study was carried out in the department of physiology. Five peer tutors were selected and trained in the basics of ECG by a senior faculty of physiology for 12-14 h sessions over the 6-week period. These peer tutors then conducted a day-long workshop on five different subtopics of ECG, which was attended by 184 1st year medical students. Evaluation of the workshop was done through pre/posttest 20-item questionnaire score analysis and feedback questionnaire using a 5-point Likert scale items. RESULTS: The average pre- and posttest scores were 6.6 ± 2.73 and 13.3 ± 4.73, respectively. The average posttest scores were higher and statistically significant compared to pretest (R 2= 0.4275; P < 0.05). The class average normalized gain (g) for a posttest score was 101.5%. Of 184 students, 9.7% of students had >70% improvement from the pretest score, and 44.78% had more than 50% improvement in their posttest scores. CONCLUSION: We received a predominantly positive feedback for the usefulness of peer teaching as a learning method. Thus, PAT was found to be a feasible and effective way of teaching the difficult concepts in physiology.

Feasibility, effectiveness, and students' attitude toward using WhatsApp in histology teaching and learning.

OBJECTIVE: The present study assessed the feasibility, effectiveness, and students' attitude toward histology teaching using WhatsApp. MATERIALS AND METHODS: We conducted 6 months of histology teaching session on a "Histology learning WhatsApp group" consisting of 250 1st-year medical graduate students at Dr. S.N. Medical College, Jodhpur. A teacher posted a digital image of histology slides created using a mobile camera; a slide diagram sketched using hematoxylin and eosin pencil, identification points, and detail description of slide followed by discussion of queries. The feasibility was measured by adequate enrollment of students in the WhatsApp group, drop-out rate during the teaching period, acceptability of the by students based on their feedback, and perception of the teacher. To study the effectiveness, we conducted an online test pre- and posttests after every 2 months. The Student's attitude WhatsApp learning was assessed using the prevalidated feedback questionnaire. RESULTS: All the 1st-year medical graduate students admitted in the year 2016 enrolled and most of them were actively participated in the discussion conducted on WhatsApp group with zero dropout rate. Students' feedback indicated that students enjoyed learning using WhatsApp with better participation than traditional teaching method. Students liked anytime, anywhere learning using WhatsApp and it helped them to clear doubts. The statistical difference between average pre- and posttest scores (6.54 ± 2.33 and 16.37 ± 3.32, respectively) were statistically significant. CONCLUSIONS: We conclude that histology teaching using WhatsApp learning group is feasible, effective, and student-friendly method. It should be used more frequently to complement traditional teaching.