RESUMO
BACKGROUND: Fibromyalgia syndrome is a widespread chronic pain condition identified by body-wide pain, fatigue, cognitive fogginess, and sleep issues. In the past decade, repetitive transcranial magnetic stimulation has emerged as a potential management tool.. In the present study, we enquired whether repetitive transcranial magnetic stimulation could modify pain, corticomotor excitability, cognition, and sleep. METHODS: Study is a randomized, sham-controlled, double-blind, clinical trial; wherein after randomizing thirty-four fibromyalgia patients into active or sham therapy (n = 17 each), each participant received repetitive transcranial magnetic stimulation therapy. In active therapy was given at 1 Hz for 20 sessions were delivered on dorsolateral prefrontal cortex (1200 pulses, 150 pulses per train for 8 trains); while in sham therapy coil was placed at right angle to the scalp with same frequency. Functional magnetic resonance imaging was used to identify the therapeutic site. Pain intensity, corticomotor excitability, cognition, and sleep were examined before and after therapy. RESULTS: Baseline demographic and clinical parameters for both active and sham groups were comparable. In comparison to sham, active repetitive transcranial magnetic stimulation showed significant difference in pain intensity (P < 0.001, effect size = 0.29, large effect) after intervention. Other parameters of pain perception, cognition, and sleep quality also showed a significant improvement after the therapy in active therapy group only, as compared to sham. CONCLUSIONS: Findings suggest that repetitive transcranial magnetic stimulation intervention is effective in managing pain alongside cognition and sleep disturbances in patients of fibromyalgia. It may prove to be an important tool in relieving fibromyalgia-associated morbidity.
RESUMO
The COVID-19 pandemic and worldwide lockdowns brought major changes in education systems. There was a sudden obligatory shift toward utilization of digital resources for teaching and learning purposes. Medical education, specifically physiology teaching, comprises hands-on training in the laboratory. It is challenging to offer a course like physiology in a virtual format. The objective of this study was to assess the effectiveness and influence of virtual classroom technology on online physiology education in a sample size of 83 first-year MBBS undergraduates. A questionnaire comprising questions related to technology accessibility and utilization, comprehensibility and effectiveness of instructions, faculty proficiency, and learning outcomes was administered to the group. The responses were collected and analyzed. Validation through principal components and factor analysis showed that online teaching is not very effective and has a limited application in the physiology education of undergraduate MBBS students. Our study also revealed that virtual physiology teaching of undergraduate medical students during the COVID-19 pandemic had a moderate level of effectiveness.NEW & NOTEWORTHY In the present qualitative study, we have conducted and validated an online physiology teaching platform at a medical college to continue medical education during the peak times of the COVID-19 pandemic and prolonged lockdowns. Furthermore, we have evaluated the effectiveness of online physiology teaching through multidimensional feedback from undergraduate MBBS students. It is experimental evidence of inadequate sustainability, moderate efficacy, limited application, and poor first-hand experience gained by the students in virtual physiology teaching in a preclinical and clinical setting.
