Students' Perception of Online Platform Based Tutorial in Physiology Curriculum.

Tutorial is one of the effective ways of interactive small group teaching activity sessions. The tutorial is a short series of classes that is ideally conducted in the small group. The use of media in the form of online platforms in tutorials could be very useful. Aims of the study to evaluate the response and perception of students about the small group learning activities like Online platform tutorials in the medical undergraduate Physiology curriculum. This was the cross-sectional study done in the Physiology Department, AIIMS, Bhopal, India from 2022 to 2023 which involved first-year MBBS students (n=39). Five online platforms-based tutorials were taken whereby five topics- one for each system were discussed. In this form of tutorial, 20 to 25 minutes were focussed on discussion, followed by assessment by multiple choice questions through an online platform. Perceptions of students were assessed through a predesigned validated questionnaire, which involved open-ended and close-ended questions. Likert scale questionnaires were also used. The chi-square test and odds ratio was used to see the difference between categorical variable (yes vs. no). The mean and Median score of the Likert scale was reported. The major issue faced was the failure to promote writing skills followed by connectivity problems. Seventy-eight percent (78.0%) of participants liked this form of tutorial, and 94.0% of participants advocated using it in the future. Online platform-based tutorials motivated 84.0% of students to learn topics in a better way. However, 41.0% feared that it does not involve communication and 92.0% opined that writing skill is not promoted. Online platform-based tutorials should be used in the Physiology curriculum. However, infrastructure in the form of prior training and internet connection must be provided. Conventional forms of tutorial should also be used to promote communication and writing skills.

Endemicity and clinical picture of liver disease due to obstruction of the hepatic portion of the inferior vena cava in Nepal.

Obstructive lesion of the hepatic portion of the inferior vena cava is common in Nepal. The clinical data on 150 patients who were seen at the Liver Unit, Bir Hospital, Kathmandu, in three years from 1990 to 1992 were analysed. Although the majority of patients were over 20 years of age, 25 patients were below 10 years of age; there were more males than females in this study. This disease accounted for 17% of 866 patients with chronic liver disease and for nearly one quarter of 267 biopsies performed on this patient group during the same period. Obstructive lesions of the inferior vena cava seem to be more common among poor people with malnutrition. Clinically, our patient group could be divided into acute (n = 27), subacute (n = 43) and chronic (n = 80) cases. The important clinical features are hepatomegaly and/or ascites and, in chronic cases, prominent dilated superficial veins over the body trunk with cephalad flow. Ultrasound is the most helpful diagnostic procedure, especially in subacute and chronic cases, as it frequently demonstrates caval obstruction, thrombosis, dilated hepatic veins and intrahepatic collaterals. Diagnosis is confirmed by cavography, which shows a caval obstruction of varying lengths at the cavo-atrial junction or a marked narrowing of the hepatic portion of the vena cava. In subacute and chronic cases cavography also demonstrates collateral veins, such as the ascending lumbar, hemiazygos and azygos that drain into the superior vena cava. Chronic cases had periods of exacerbation often associated with bacterial infection. The aetiology of inferior vena cava obstruction at its hepatic portion is not known, but there seems to be a frequent association of bacterial infection with the disease.

Ascariasis, hookworm infection and serum retinol amongst children in Nepal.

The study reports on the association between serum retinol levels and prevalence of two intestinal helminths in a random sample of 592 children, 6-120 months of age. Faecal analyses were performed by Kato thick-smear technique, recording the presence of hookworm and Ascaris lumbricoides eggs. Serum retinol levels were determined by high pressure liquid chromatography (HPLC) and expressed in micrograms/dl. The presence of Ascaris lumbricoides eggs was associated with lower levels of serum retinol in children below 60 months of age (p < 0.05). The presence of hookworm eggs was not associated with lower levels of serum retinol in any age group. In addition children who received at least one course of mebendazole during the past 12 months recorded higher serum retinol levels than children who did not receive it (p < 0.01).

Intestinal helminths and risk of anaemia among Nepalese children.

Relationships between hookworm, A. lumbricoides and anaemia were studied utilising egg count in faecal specimens and haemoglobin levels from a cross-sectional sample of 641 Nepalese children, 6 to 120 months of age. Additional analyses were performed to assess the level of risk by age and worm load. Kato thick-smear technique was used to perform faecal analyses, recording the number of hookworm eggs and A. lumbricoides eggs in each sample of 50 mg of faeces. Haemoglobin levels were assessed by the Sahli method. The presence of eggs for each parasite was significantly associated with lower levels of haemoglobin (P < 0.001). Children infected with both parasites or hookworm alone presented higher depletion of haemoglobin. The presence of A. lumbricoides was more closely related with anaemia in the age group 72 to 119 months and for an intensity of infection higher than 8000 eggs per gram of faeces. Hookworm, correlated with lower levels of haemoglobin, affected less than 4% of the children in the sample and appear to be a serious risk factor at the individual level. A. lumbricoides, present in 51% of the children, was associated with moderate anaemia and represents a more important risk factor at the community level, especially if coupled with inadequate food and iron intake. Any public health intervention aimed at reducing anaemia prevalence in Nepal should consider effective measures for the control of soil-transmitted helminths.