There is significant difference between basal LES pressure in patients of bronchial asthma and control population (8.70 ± 2.67 mmHg versus 16.64 ± 5.52, p < 0.0001). 66.67% of the asthma patients have reduced LES pressures (<10 mmHg). The correlation coefficient between basal LES pressure and prebronchodilator FEV1% predicted is 0.596 (p < 0.0001, 95% CI 0.3002-0.7872). Obstructive airway impairment in adult patients of bronchial asthma is associated with hypotensive LES. GER, due to hypotensive LES may contribute to deterioration of spirometric parameters in asthma patients.

Background: Increased pulmonary ventilation helps lowlanders and natives to maintain arterial oxygenation at high altitudes. Natives of Ladakh have been shown to have similar ventilatory parameters as Tibetans at 3300 m. But there is limited literature comparing these parameters in Ladakhi natives with acclimatized lowland sojourners.Methods: End-tidal carbon dioxide partial pressure (EtCO 2 ), blood oxygen saturation (SpO 2 ) and hemoglobin concentration (Hb) were measured in 276 participants, 126 native highlanders (NHL -40 females, 86 males) and 150 acclimatized lowlanders (ALL -60 females, 90 males).Results: EtCO 2 was greater in the NHL compared to the ALL, (33.8 AE 3.3 vs 31 AE 2.5 mmHg) although SpO 2 was lower (90.9 AE 2.4 vs 91.7 AE 2.3%). When grouped by sex, NHL males had significantly greater EtCO 2 than NHL females, ALL males and ALL females. Hb and calculated arterial oxygen content was similar in Ladakhis and acclimatized lowlanders, although greater in males compared to females. Systemic blood pressure, heart rate and the proportion of hypertensives was significantly greater in the ALL. Conclusion:Native Ladakhis, have a significantly greater resting EtCO 2 (especially in males) and lower SpO 2 than acclimatized lowlanders. Blood Hb concentration and oxygen content is, however, similar in natives and acclimatized lowlanders of the same sex.

Background: Multiple choice questions (MCQs) play a pivotal role in various types of assessment in medical schools, due to the ease with which these can be administered and evaluated. Although primarily employed for assessment, the direct role of MCQ-assisted teaching learning (MATeL) may be explored among teachers and students as an aid to learning. Aims and Objectives: The present study endeavors to evaluate how MATeL helps students improve their performance and to explore the correlation between MCQ and short answer questions (SAQ) performance of students on a given topic of instruction in physiology. Materials and Methods: For MATeL topics, a total of 25 MCQs, based on five specific learning objectives, were discussed with 94 students of the 1 st year Bachelor of Medicine and Bachelor of Surgery course, and in-depth evaluation of each of the correct choices was done during the lectures. For the non-MATeL topics, the students were advised to read up the topic before the lecture which was followed by an exhaustive discussion on the same. At the end of the lecture series, a formative written assessment was carried, and the MCQ and SAQ scores were analyzed for each of the students. Results: Mean scores for both SAQs and MCQs was significantly higher in MATeL than the non-MATeL topics (SAQs 5.31 vs. 4.36, t = 2.5; MCQs 7.18 vs. 6.68, t = 5.23). There was a good correlation between total MCQ and total SAQ scores for the students (r = 0.34, P < 0.05, 95% confidence interval: 0.15-0.51). For the non-MATeL topics, SAQ scores correlated with the MCQ scores but not for the MATeL topics. Students show improved scores in their formative written assessment when the lectures are assisted with use of MCQs, than when MCQs are not employed before and during the lecture. Conclusions: MCQs may form a vital component during teaching when delivering important concepts, and their use may not be restricted to the traditional role during the assessment.

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