ObjectivesTo develop a population specific pharmacogenetic acenocoumarol dosing algorithm for north Indian patients and show its efficiency in dosage prediction.MethodsMultiple and linear stepwise regression analyses were used to include age, sex, height, weight, body surface area, smoking status, VKORC1 -1639 G>A, CYP4F2 1347 G>A, CYP2C9*2,*3 and GGCX 12970 C>G polymorphisms as variables to generate dosing algorithms. The new dosing models were compared with already reported algorithms and also with the clinical data for various performance measures. Odds ratios for association of genotypes with drug sensitive and resistant groups were calculated.ResultsThe pharmacogenetic dosing algorithm generated by multiple regression analysis explains 41.4% (p-value <0.001) of dosage variation. Validation of the new algorithm showed its predictive ability to be better than the already established algorithms based on similar variables. Its validity in our population is reflected by increased sensitivity, specificity, accuracy and decreased rates of over- and under- estimation in comparison to clinical data. The VKORC1-1639 G>A polymorphism was found to be strongly associated with acenocoumarol sensitivity according to recessive model.ConclusionsWe have proposed an efficient north India specific pharmacogenetic acenocoumarol dosing algorithm which might become a baseline for personalised medicine approach for treatment of patients in future.

Coronary artery aneurysm is a rare entity and is being seen more frequently with the increasing use of stents during PTCA. Proximal ligation and plication of the aneurysm with coronary artery bypass grafting in the present series provided good results. With this case series, we seek to establish an optimal surgical therapy for this rare entity.

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Effective teaching in schools requires flexibility, energy and commitment. Successful teaching also requires that teachers are able to address learner's needs and understand the variations in learner's styles and approaches. Teachers can accomplish these requirements while creating an optimal teaching-learning environment by utilizing a variety of teaching methods and teaching styles. If teachers use a variety of teaching methods and styles, learners are exposed to both familiar and unfamiliar ways of learning that provide both comfort and tension during the process, ultimately giving learners multiple ways to excel. Numerous teaching strategies such as white board, lecture, cooperative learning, writing assignments, demonstration, field trips, grouping, brainstorming, guest speakers, bulletin boards, debates, panel discussion, crossword puzzles, teaching with cases, team-based learning, team teaching, library research on topics or problems, audio-tutorial lessons, making of posters by students, puppets, use of motion pictures, educational films, videotapes, current events and internet are utilized in the modern classroom for secondary education. Each teaching strategies has their own pros and cons. This paper aims to present the effectiveness of selected teaching strategies: group discussions, real objects, audio-visual aids, computer assisted instructions, role play, work sheets, smart boards, quizzes, mind maps, team projects, individual projects, field trip and internet access in relation to the learning styles of the secondary school students.