Chaurasia et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 4.0., which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Background The effective and efficient delivery of healthcare services that the National Medical Commission (NMC), India desires from Indian Medical Graduate (IMG) can only be fulfilled if the learner’s participation is extensive. Flipped classroom (FC) may promote enhanced as well as meaningful learning and critical thinking in students. By implementing this method trend can be changed from a teacher-centered approach to a student-centered approach, thus teaching-learning becomes more effective and interesting. It promotes learning and thinking helping the students in diagnosis and formulating appropriate management of patients during the clinical years of medical teaching of MBBS (Bachelor of Medicine and Bachelor of Surgery) and thereafter. Aim To compare FC and traditional didactic classroom (TDC) teaching for first-year MBBS students. Objectives -To evaluate FC method teaching for first-year MBBS students. -To compare effectiveness of FC and TDC teaching for first-year MBBS students. -To evaluate perception of students toward FC teaching method. Methodology The study was conducted after getting approval from the Institutional Ethics Committee. Total of 100 students volunteered to participate in the study after providing informed consent. Two groups based on pseudo randomization were created and subjected to the FC method and TDC method in module A and crossover of groups was done in module B. Both groups were subjected to post-test after intervention in modules. Feedback was obtained from students on their perception toward the FC method. Results There was a statistically significant difference (p<0.05) in post-test scores of both FC groups in both modules (FC Method: 14.77 ± 2.16 and 11.26 ± 1.76 vs TDC Method: 12.16 ± 2.05 and 10.03 ± 2.57). Overall positive feedback was received for FC method of teaching compared to TDC method. Conclusions Considering responses and results of the assessment, it can be concluded that the FC approach is beneficial for students. It enhances the learning of students. Perception of students toward medical teaching can be greatly improved. It helps students achieve better results in their learning. With larger sample size studies, this result of FC method being a better learning tool will gather more strength.
Introduction: Diabetes is the leading cause of chronic kidney disease (CKD) and is associated with excessive cardiovascular morbidity and mortality. Anemia is common among those with diabetes and chronic kidney disease and greatly contributes to patient outcomes. Observational studies indicate that low hemoglobin levels in such patients may increase risk for progression of kidney disease and cardiovascular morbidity and mortality. Objective: 1. Estimation of glycosylated hemoglobin (HbA1c) and hemoglobin level in patients with type II diabetes mellitus. 2. To determine the prevalence of anaemia in type 2 diabetes mellitus with or without chronic kidney disease. Methodology: This is a descriptive analytical cross-sectional study carried out in Dhiraj Hospital, Piparia, Vadodara. A total no of 100 consecutive patients were enrolled; 25 patients having Diabetes, 25 patients having diabetes and chronic kidney disease, 25 patients having only chronic kidney disease but no diabetes and 25 patients neither having diabetes nor chronic kidney disease taken as a control group. Results: Anemia was present in 37% diabetic patients, 17% in diabetic patients with chronic kidney disease, 3% in patients with only chronic kidney disease. Anaemia was significantly higher in patients with diabetes, chronic kidney disease and diabetes with chronic kidney disease. Conclusion: Anemia was more prevalent in persons with diabetes and diabetes associated with chronic kidney disease compared to persons without diabetes. Therefore anemia may be particularly harmful in individuals with diabetes and chronic kidney disease. Correction of anemia may have a significant role in prevention of other diabetic complications.
Background: Chronic kidney disease (CKD) is associated with premature atherosclerosis and increased incidence of cardiovascular morbidity and mortality. Several factors contribute to atherogenesis and cardiovascular disease in patients with CKD. Notable among the CKD-induced risk factors are lipid disorders, oxidative stress, inflammation, physical inactivity, anemia, hypertension, vascular calcification, endothelial dysfunction, and depressed nitric oxide availability. Objective: To assess the pattern of lipid profile in chronic kidney disease patients along with comparision of lipid profile in chronic kidney disease patients with diabetes mellitus and without diabetes mellitus. Methods: A total of 50 patients of chronic kidney disease (CKD)of age group 20-70 year and 50 age and sex matched healthy controls were included in this study. Blood specimens were collected from both groups and measurement of the lipid prfile, FBS, PPBS, S.creatinine and blood urea was done and compare results with the study group. Results: Total cholesterol and LDL was significantly raised in patients of CKD compared to controls The triglycerides were elevated. However, the statistical analysis showed that it was not significant. There was statistically significant variation found in triglyceride, VLDL and HDL when compared with the comorbid conditions of hypertension. Conclusion: There is significant amount of dyslipidemia is found in patients of CKD. so treatment of dyslipidemia will reduce mortality in CKD patients.
Introduction: Ischaemic Heart Disease (IHD) or Coronary Artery Disease (CAD) is the most prevalent chronic disease and the main leading cause of death in the world, with more than half a million newly diagnosed IHD patients each year. Central to this are disorders of lipoprotein metabolism. Apolipoprotein B (Apo B) and Apolipoprotein A1 (Apo A1) are structural and functional components of lipoprotein particles that serve as transporters of cholesterol. Apo B and Apo A1 are among the emerging markers for Cardiovascular Diseases (CVD). Routine conventional lipid profile does not incorporate these markers. Aim: To determine the level of Apo A1 and Apo B in patients of IHD with or without Type II Diabetes Mellitus (T2DM) and analyse the significance of these parameters over the conventional lipid profile. Materials and Methods: The case-control study was conducted at Government Medical College, Bhavnagar, Gujarat, India from July 2013 to December 2013. The study consists of 100 participants including 50 having IHD only (Group I), 50 having IHD with T2DM (Group II) as study groups and 50 healthy individuals (Group III) as control. Various biochemical parameters including Apo B and Apo A1 were analysed and statistically evaluated to come to conclusion. Results: The demographic details of the participants which shows no significant different in age and gender among groups I, II and III. Apo B and A1 were elevated in group I and II and were found highly significant (p-value <0.0001) as compared to the group III. There was positive correlation of serum Apo B levels with total cholesterol (r=0.495, p-value <0.0001), Low-Density Lipoproteins (LDL-C) (r=0.526, p-value <0.0001) and Apo A1 (r=0.685, p-value <0.0001) in group I and LDL-C (r=0.468, p-value=0.001) and Apo A1 (r=0.754, p-value <0.0001) in group II. Similarly, Apo A1 levels were positively correlated with Apo B (r=0.685, p<0.0001) in group I and LDL-C (r=0.305, p-value=0.031) and Apo B (r=0.754, p-value <0.0001) in group II. Conclusion: As the Apo B and Apo A1 cover both atherogenic and antiatherogenic lipid parameters respectively, it can be used as a better predictor of development of IHD with and without T2DM in comparison to conventional parameters of lipid profile.
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