International Journal of Integrative Medical Sciences

Number 9, 2015

152-156
Antigrade Humerus Interlocking Nailing for Diaphyseal Fractures of Humerus: A Study of Clinical Outcomes

Authors: Prasanth Ganji *, PR Naidu Pothula, Nandam Ramarao, Raj Kumar Vijay, Bharath chandra katragadda, Yeseswi Tellakula.

Abstract

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Number of views: 299

Back ground: Humerus fractures are one the most common fractures in orthopaedic practice. Apart from conservatives methods surgery is the mainstay in method of treatment of humerus fractures. Among the surgical options antigrage nailing, retrograde nailing, plating are the options. Present study was done to analyze the clinical outcomes of antigrade nailing in diaphyseal fractures of humerus. Materials and Methods: 12 cases were treated with antigrade interlocking nailing among the 12 cases (11 cases were closed and 1 grade 1 compound) 9 were fresh cases and two were presented after one week of injury. of the 12 cases 8 middle 1/3,3 were middle1/3and distal 1/3 junction and one is segmental fracture. Cases were fallowed for up to three years. Results: Excellent results were seen in 8 good in 3 where 1 case went to delayed union. Conclusion: Antigrde humerus nailing is a effective method of diphyseal fractures of humerus. It has advantageous over compression plating as it is less invasive, no blood loss, and no risk of iatrogenic radial nerve palsy. Shoulder stiffness can prevented by meticulous repair of rotator cuff, avoiding protrusion of nail and early institution of physiotherapy. KEY WORDS: Humerus fracture, Antigrade Nailing, Retorgrade Nailing, Plating, Diaphyseal fracture, Internal fixation.

157-162
A Review of Use of eLearning in Pharmacology

Authors: Ashwin Kamath.

Abstract

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Number of views: 343

Teaching in pharmacology is predominantly lecture based. While practical sessions do include problem solving and case scenarios the teaching methodologies are inadequate in empowering the students to handle real life scenarios which require integration of theory and practice, application of knowledge and skills to find a viable solution to a defined problem. Use of elearning in such situations is still in its infancy in Indian medical colleges and thus provides a unique opportunity to improve the existing teaching and learning methods. This review will look into studies describing various forms of eLearning methodologies adopted for teaching pharmacology to health professionals as well as those which have tried to assess the effect of eLearning approach adopted in teaching pharmacology across the globe. KEY WORDS: eLearning, Pharmacology, teaching, Lectures, Teaching methodologies.

Number 8, 2015

145-150
CBL in Medical Education Effective Learning Methodology than PBL

Authors: Montosh Chakraborty 1, Shivakrishna Gouroju *2, Pinki Garg 3, Karthikeyan P 4, Prerna Singh 2.

Abstract

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Number of views: 324

The conventional teaching and learning methods in medical education yearns for a change. The newer and effective small group interactive teaching methodologies are being looked into. Problem based learning and case based learning modules were taken into consideration in this study. Although PBL is student centred but it lacks able guidance of the teacher involved and effective participation of all the students. The deficiencies encountered in PBL are taken care of in case based learning study. It is a guided enquiry approach where the teacher plays a vital role in the preparation of the case based problem, organizing the CBL session under his guidance and providing constructive and relevant information during the sessions. Students are the speakers and presenters. Generally, most of the studies refer to the advantages of CBL and PBL in regard to traditional teaching. This study compares the learning effectiveness amongst the two approaches. A total of 126 first year medical students were included in the study. Students were divided into two groups such that both the groups have similar academic knowledge. The effectiveness of the teaching methodologies was reflected in the better performance of the students in the evaluation tests conducted after the said sessions. Both the groups performed better in the evaluation tests conducted after the PBL and CBL session. But the performance was better in the group which attended CBL on the same topic. The difference in the mean marks of the two groups being statistically significant. . However it seems important to develop more consistent research in this field, namely, longitudinal studies with larger samples. KEY WORDS: Case Based Learning; Problem Based Learning, medical Education.

Number 7, 2015

140-143
The Risk Factor Atherosclerosis in Ageing for Heart Attacks

Authors: V. S. Bhagyalakshmi 1, M. V. Sailaja *2, Vijitha 3.

Abstract

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Number of views: 312

Ageing is a normal physiological process characterized by alterations in cell and tissue structures associated with a reduction in functional capacity-physical, sexual, mental. More than 80% of all deaths due to cardiovascular diseases occur in elderly people above 60 years. Coronary artery disease is also associated with ageing and is likely to involve multiple vessels, mainly left coronary artery and there is a graded and progressive reduction in the homeostatic reserve function of organs and systems. Consistent changes in the autonomic system accompany ageing and influence cardiovascular function. Atherosclerosis is a chronic inflammatory process of the arterial wall induced by endogenous toxic plasma lipid components; it is a major initiator of thrombosis related to abnormal vascular flow and loss of endothelial vascular integrity. In our study we examined 20 males aged 50 to 70 years with hyper tension, smokers, alcoholic and 20 normal healthy individuals aged between 40 to 49 years are controls. Blood pressure recording was done and Lipid Profile was estimated from the both groups. The SBP and DBP was found to be greater in aged group when compared with control group which can be attributed to changes in large arteries causing stiffness of elastic tissue leads to much thicker and less flexible walls. This causes on increase in the force of ventricular contraction and SBP. The increase in large vessel stiffness plays a central patho physiological role in hypertension in older individuals. The lipid levels of the subjects are greater than the controls. This also as a risk factor for atherosclerosis related with ageing. This is one of the predisposing factors for heart attacks and cerebral strokes. KEY WORDS: Lipid Profile, Atherosclerosis, Endothelium, SBP, DBP, Echo.

Number 6, 2015

134-138
PBL: An Effective Method of Reinforcement Learning

Authors: Montosh Chakraborty 1, Shivakrishna Gouroju *2, Pinki Garg 3, Karthikeyan P 4.

Abstract

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Number of views: 317

The teaching method in undergraduate MBBS curricula is expected to develop a vast range of intellectual, visual and manual skills, in the learning and incorporate large amounts of factual information to practice technical and technological procedures. Problem based learning (PBL) is small group teaching and learning program, which emphasizes and stimulates the team work and problem solving ability, independent learning and create a broader understanding of the complexity of medicine. The students must become proficient in assessing their individual learning progress and that of their peers. So our study aims to evaluate the efficiency of PBL in the enhancement of knowledge of 126 learners. We measured the student preference regarding PBL system. The participants were divided into 2 groups on the basis of before theory and after theory test marks and were sex matched. After that group-I attended revision of theory class and group-II attended PBL class with the same teacher on the same topic. After revision theory class and the PBL session, learner’s response was increased significantly when compared with before and after theory class. When we compared PBL with after theory revision class the learning knowledge was significantly increased (p-values 0.00). Students who used the problem-based learning method showed better understanding of the subject and it also encouraged active student participation in the learning process. KEY WORDS: Problem based learning, traditional learning, teaching.

Number 5, 2015

115-120
Randomized Control Trial of IVIG as An Adjuvant in the Treatment of Preterm and or Low Birth Weight Neonatal Sepsis

Authors: Sekar M.N, Anjan Kumar VS, Ravi Kumar P, Siva Ramudu K, Mallikarjuna M, Sasi Kumar B

Abstract

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Number of views: 318

Introduction: In developing countries neonatal sepsis ranks as most common illness responsible for neonatal mortality especially in low birth weight and preterm babies. In India, it is responsible for 25-50% of neonatal deaths in spite of early diagnosis and treatment. There have been many trials on various adjuvant therapies (like leukocyte transfer,GCSF, GMCSF, fibronectin, IVIG, FFP) in addition to specific antimicrobial therapy. There is still some controversy in the role of IVIG in treatment of neonatal sepsis. Hence the study was undertaken to evaluate the efficacy of IVIG in treatment of neonatal sepsis. Materials and Methods: 30 in group total 60 babieswith gestation < 32 wks and wt < 2000 gmwere enrolled in the study if they had one or more clinical features of sepsis and had elevated C –reactive protein (>10mg/dl). Babies in both groups underwent investigations includingmicro ESR,WBC count, ANC, Platelet count, LFT, Blood culture & Urine culture. In IVIG group samples were drawn before giving IVIG. Results: There is no significant decrease in mortality, severity of illness and duration of hospital stay in IVIG group than control group. Conclusions: As of other studies, our study also did not show any significant role of IVIG as an adjuvant in the treatment of sepsis in preterm or low birth weight neonates. KEYWORDS: Leukocyte transfer,GCSF, GMCSF, Fibronectin, IVIG and FFP.

121-127
Problem Based Learning (PBL) for Large Groups Medical Students e-Problem Solving Test: A Mutation Causing Retinoblastoma (Rb)

Authors: Kumar Ponnusamy, Jegathambigai Rameshwar Naidu, Ravindra Kumar Boddeti, Prejna Barki.

Abstract

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Number of views: 321

E-learning can be used to enhance and aid the implementation of problem-based learning (PBL). Through e-learning, learning can take place anywhere and anytime through the communication tools that it has. This feature provides a channel of communication among medical students and content experts in medicine that is not bounded by the class time and physical presence. Therefore, e-learning has been identified as a learning system that can greatly enhance the implementation of PBL among undergraduate-medical students. Conceptmaps can be successfully used to teach conceptual thinking, thus increasing students’ competence in critical thinking in the modern paradigm. The purpose of this paper is to put forth effective strategies for utilizing elearning in PBL formedical and allied health science education with amodel PBL on Retinoblastoma (Rb). Some effective strategies that have been identified are: (a) the use of online-learning tool to deliver structured assigned independent e-PBL problems to students, (b) content expert-facilitator-initiated communication for the PBL case scenario on the e-learning platform, (c) frequent availability of content expert on-medical education online for facilitation, and (d) the use of online resources such as relevant case scenarios, videos, research component such as reviewjournal for reflection, construction of conceptmaps and assessment. These strategies will enable amore efficient and effective implementation of out-come based self-directed structured assigned independent learning e-PBLs related to difference modules ofmedicine, with relatively less number of content experts and in short time for large group of medical and allied health sciences students. KEY WORDS: e-learning, e-problem based learning, Medical science education, Interactivity, Supplemental digital content, Research components, Conceptmapping, Retinoblastoma.

128-132
St John’s Wort and Related Drug Interactions: A Review

Authors: Sujit Kumar Sarker, Ratna Paul, Himel Pal, Soe Wunna Shwe.

Abstract

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Number of views: 352

Introduction: St John’swort (HypericumperforatumL.) is a perennial plant that has transparent perforations on its leaves. It has been used as medicinal herb since ancient time. Medicinal values:Many bioactive compounds have been isolated fromSt John’swort. Among those compounds hypericin and hyperforin are well studied. Both have antidepressant effects. This herb has also antineoplastic, antiviral and many other effects. Oil macerates are also used in wound healing. St John’s wort extracts are used as complementary medicine in many countries. Pharmacology: Few studies suggests that it inhibitsmonoamine oxidase and re-uptake of serotonin, dopamine and norepinephrine. But it causes induction of liver cytochrome oxidase enzymes and also causesmany adverse effects including mania and photosensitivity. Drug interactions:Most of the drug interactions occur due to its enzyme induction properties. It can also reduce plasma concentration of antidepressants like amitriptyline and SSRI. It increases serotonergic effects of antidepressants such as duloxetine and venlafaxine. Data suggests that it has significant interactions with antiepileptics, combined oral contraceptives, calcium channel blockers, lipid regulating drugs (statins), antivirals and many more. Conclusion: Although most popular use of St John’s wort is mild to moderate depression, it should be taken under supervision of physician as many cases its concomitant uses are not advisable. KEY WORDS: St John’s wort, Drug interactions.

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