Many medical educators are experimenting with innovative ways of E-learning. E-learning provides opportunities to students for self-directed learning in addition to other advantages. In this study, we designed and evaluated an interactive E-learning module in pharmacology for effectiveness, acceptability and feasibility, with the aim of promoting active learning in this fact-filled subject. A quasi-experimental single-group pre-test/post-test study was conducted with fourth-semester students of the second professionals course (II MBBS), selected using non-probability convenience sampling method. An E-learning module in endocrine pharmacology was designed to comprise three units of interactive PowerPoint presentations. The pre-validated presentations were uploaded on the website according to a predefined schedule and the 42 registered students were encouraged to self-learning using these interactive presentations. Cognitive gain was assessed using an online pre- and post-test for each unit. Students’ perceptions were recorded using an online feedback questionnaire on a 5-point Likert scale. Finally, focused group discussion was conducted to further explore students’ views on E-learning activity. Significant attrition was observed during the E-learning activity. Of the 42 registered students, only 16 students completed the entire E-learning module. The summed average score of all three units (entire module) was increased significantly from 38.42 % (summed average pre-test score: 11.56/30 ± 2.90) to 66.46 % (summed average post-test score: 19.94/30 ± 6.13). The class-average normalized gain for the entire module was 0.4542 (45.42). The students accepted this E-learning activity well as they perceived it to be innovative, convenient, flexible and useful. The average rating was between 4 (agree) and 5 (strongly agree). The interactive E-learning module in pharmacology was moderately effective and well perceived by the students. The simple, cost-effective and readily available Microsoft PowerPoint tool appealed to medical educators to use this kind of simple E-learning technology blended with traditional teaching to encourage active learning among students especially in a rural setup is attractive.

Students of the second professional MBBS course of the Indian medical curriculum (II MBBS) perceive pharmacology as a ‘Volatile Subject’ because they often find it difficult to remember and recall drug names. We evaluated the usefulness of crossword puzzles as a self-learning tool to help pharmacology students to remember drug names. We also measured the students’ satisfaction with this learning method. This was an open-label randomized, two-arm intervention study, conducted with II MBBS students (n = 70), randomly selected and assigned to two groups A (n = 35) and B (n = 35). Two self-learning modules containing crossword puzzles with antihypertensive and antiepileptic drug terms were prepared and pre-validated. Hard copies of both crossword puzzles were administered to Group A (Intervention group) on two different occasions. One hour was allotted to solve a puzzle. Students were allowed to refer to their textbooks. Group B (Control group) underwent the self-learning module without the crossword puzzles. In both groups, pre- and post-test knowledge was assessed. Students’ perceptions of the crossword puzzles were assessed using a pre-validated 10-item questionnaire. Responses to items 1–8 were recorded using a 5-point Likert scale. Responses to item 9 were recorded on a 10-point rating scale while item 10 was an open–ended question. The crossword completion index was 92.86 %. In group A, the average pre-test score was 6.09 whereas the average post-test score was 12.87 (p < 0.05). In group B, average pre- and post-test scores were 6.03 and 9.74, respectively. A significant difference (p < 0.001) was observed between the post-test scores of the two groups. The absolute learning gain was 33.9 % in Group A and 18.55 % in Group B. The response rate for the questionnaire was 100 %. Of the students, 71.43 % strongly agreed that crossword puzzles enhanced their knowledge of antihypertensive and antiepileptic drugs and were helpful for remembering and recalling the drug names, 60 % students found it challenging and a good problem solving activity and 85.71 % students opined that it was a good self-learning, recreational activity. The test scores improved when crossword puzzles, designed to improve retention of drug names, were incorporated in the self-study modules of pharmacology training. Students rated the crossword puzzles as a challenging and effective self-learning tool. Students’ acceptability for crossword puzzles further favours their usefulness as a self-learning tool. The crossword puzzle is an effective tool for ‘recreational learning’ and can be used as an active learning strategy to promote self-directed learning.

Background/Aims: Alcohol is the leading cause of liver cirrhosis, which results in portal hypertension and subsequently, culminates into esophageal varices and esophgeal variceal bleeding. Esophagogastroduodenoscopy is gold standard for diagnosis of varices. Non-invasive markers based on clinical, laboratory & ultrasonographic parameters can be utilised for prediction of risk of esophageal varices & variceal bleed in alcoholic cirrhosis from central India. Materials and Methods: This was a cross sectional observational study. Child Turcot Pugh scores, MELD, AST ALT Ratio(AAR), AST Platelet Ratio Index(APRI), FIB-4 index and Platelet count-Spleen diameter(PC/SD) ratio were calculated for all patients and correlated with esophagogastroduodenoscopy findings. Short term follow up was done for variceal bleeding. Results: Total 202 male patients were included with mean age of 43.77±9.95 years. 188(93%) patients had esophageal varices. 61(30.19%) patients had variceal bleeding. On univariate analysis platelet count, APRI, spleen bipolar diameter, and PC/SD ratio were significantly associated with varices. For prediction of esophageal varices, only PC/SD ratio was significant and showed area under the curve of 65.6% at cut-off of <997. CTP score, FIB-4, APRI, and PC/SD ratio were significant for variceal bleeding. At cut-off <985 PC/ SD ratio had sensitivity of 82% and specificity of 63% with AUC of 78% for prediction of variceal bleeding. Also, FIB-4 and APRI had diagnostic accuracy of 64% and 61% with AUC of 74% and 72% respectively for bleed. Conclusion: FIB-4 and PC/SD may be useful among armamentarium of non-invasive markers for predicting esophageal varices and risk of variceal bleeding in alcoholic liver cirrhosis.