BACKGROUND Learning clinical biochemistry has a lot of importance in understanding the clinical subjects which are taught later. Enhancing the interpretation skills of biochemical lab reports helps students in learning the clinical diagnosis, treatment and prognosis of a disease. It also provides platform for early clinical exposure and motivates student centered learning. METHODS Pre and post learning outcomes on interpretation skills of Liver Function Test (LFT) were undertaken. Totally 134/147 students participated & were assessed for interpretation skills with 9 LFT reports. Small group teaching comprised of one faculty for 30 students. LFT was taken as didactic lecture and case-history-based learning; interpretation of LFT reports was discussed. After 2 weeks, clinical biochemistry reports and Biochemistry Test Request Forms (TRF) of OP and IP with brief clinical history were provided to the students. Pre and post-test scoring was done, and students' feedback perception was also obtained. RESULTS The residual knowledge for interpretation of LFT after didactic lecture and casehistory-based learning was incorrectly done by >50% of the students. Interpretation skill was lowest for Newborn LFT (18/134). Clinical biochemistry reports were effective in enhancing student's interpretation skills with p value <0.05. Student's interpretation skills of normal/abnormal LFT improved from 28 to 72%. Students agreed that this session motivated them for further learning and selfassessment. CONCLUSIONS Multiple ways of teaching and learning assessment methods should be adopted to understand the clinical relevance of laboratory investigations for improving the interpretation skills among undergraduate medical students.
BACKGROUND Smoking is one of the most common addictions of modern times and needs to be studied in a community as a public health issue. Also, smoking is a modifiable risk factor for type-2 DM. The smoking-related diseases share common pathophysiologies of imbalance of systemic oxidants and antioxidant status, increased inflammatory reactions, insulin resistance and dyslipidaemia. Biochemical assay of serum Gamma-Glutamyl Transferase (GGT) activity is a low cost and highly sensitive laboratory test. Studies have indicated GGT is moderately elevated before the onset of other traditional risk factors for type-2 DM. So, among hepatic markers, the baseline GGT analysis can be an early risk marker of type 2 diabetes in cigarette smokers has to be studied. MATERIALS AND METHODS This is a case-control study on male cigarette smokers. 57 smokers were studied clinically and biochemically for plasma insulin, glucose and liver enzymes including GGT using standard biochemical methods and compared with 42 age and sex matched non-smokers as controls. RESULTS The mean serum GGT in smokers (25.45 ± 10.8) was increased compared to non-smokers (18.8 ± 5.8). Smokers GGT (r=0.396) and HOMA-IR (r=0.352) showed significant positive association with duration of smoking (p<0.05) than fasting blood glucose. Multiple regression analysis showed only duration of smoking (p=0.001) as a dependable factor on GGT. 24.5% (14/57) smokers showed an increased GGT >24 IU/L. Regression analysis showed none of the diabetic risk factors were observed to be dependent on GGT including other liver enzymes. Regression analysis showed GGT is not an independent risk factor for DM. Although, the mean fasting blood glucose (91.4 ± 21.3), BMI (26.1 ± 9.3) and HOMA-IR (7.3 ± 2.3) was increased among cigarette smokers with GGT >24 IU/L. CONCLUSION The baseline GGT assay in cigarette smokers might be associated with the proinflammatory status or be a marker of oxidative stress of smoke toxins. Smokers with baseline GGT >24 IU/L develop insulin resistance should be investigated in future longitudinal studies for prediabetes to consider cigarette smoking as an important modifiable risk factor of type-2 DM.
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