Brain-derived neurotrophic factor (BDNF), which is expressed at high levels in the limbic system, has been shown to regulate learning, memory and cognition. Thyroid hormone is crucial for brain development. Hypothyroidism is a clinical condition in which thyroid hormones are reduced and it affects the growth and development of the brain in neonates and progresses to cognitive impairment in adults. The exact mechanism of how reduced thyroid hormones impairs cognition and memory is not well understood. This review explores the possible role of BDNF-mediated cognitive impairment in hypothyroid patients.

Background: Identification of the abnormal colonization of the genital tract by a culture based approach has been recommended by the CDC 2000. This will definitely aid in the early recognition of mothers who need to be effectively treated which in turn will prevent newborn infections. Objectives were to study the pattern of maternal vaginal flora in labor and to study the outcome in the neonate.Methods: This study was conducted on 250 mothers in labor and their babies followed up till discharge in the departments of OBG and neonatology in a tertiary care medical college hospital, Deliveries by caesarean section were excluded.Results: Of the 250 babies, 70 were small for gestational age (SGA) and of these 60 (85.71%) were born to colonized mothers; whereas among the appropriate for gestation (AGA) babies, 110 (61.11%) were those born to non-colonised mothers. A statistically significant association was found between SGA babies and maternal colonization. Whereas relation between maternal colonization and gestational age did not show a statistically significant difference.Conclusions: This study shows us that maternal vaginal colonisation in labor significantly impacted the baby's weight with increase in small for gestational age babies being more among the colonised mothers. Hence, finding the organism in the maternal vaginal flora and treating it as per sensitivity might result in lesser incidence of SGA babies.

Background: The traditional large group didactic lectures have many shortcomings, so small group discussions have been proposed to overcome some of these shortcomings. However, a typical Small Group Discussion (SGD) remains a mini-interactive lecture in most cases. To improve students’ participation and their better understanding, many newer teaching-learning methods have been tried. Jigsaw teaching method, a type of cooperative learning, is one of these new methods. Obviously, the usefulness of jigsaw teaching must be compared with other small group teaching methods. Objectives: The aim of this study was to compare the effectiveness of the Jigsaw teaching technique with the small group teaching method. Methods: A quasi-experimental study was conducted over one month in the Paediatrics Department of DM WIMS medical college. After obtaining written informed consent, 30 students were randomly selected and allocated to the SGD and jigsaw groups (15 students in each group). Four topics were taken to both the groups who were crossed over after one session (a total of eight exposures). Their post-intervention mean scores were tabulated and analyzed. The Likert scale was used to assess the students’ evaluations of the jigsaw method. Results: The results showed that the jigsaw method had better students’ performance, which was statistically significant with a P<0.05. Also, the students’ evaluation showed that they appreciated the jigsaw teaching method, but time constraints were noted as a drawback. Conclusions: Jigsaw teaching is an excellent small group teaching method to ensure better students’ participation and understanding and can add to our repertoire of teaching-learning methods, which Competency-Based Medical Education (CBME) warrants.

A BSTRACT Globally, we are seeing a rise in non-communicable diseases such as obesity, hypertension, diabetes, metabolic syndrome, chronic respiratory diseases, cancer, etc., due to stressful lifestyle in this competitive world. Most of the non-communicable diseases are associated with lifestyle behavior. Presently, the role of lifestyle medicine is very critical and important in the management of chronic lifestyle-associated disorders. Considering the above facts, we decided to review the literature to gain a deeper insight into the implications of lifestyle medicine in medical practice. A literature search was conducted on PubMed, Scopus and Google Scholar databases. We observed that lifestyle medicine intervention is a growing and newer discipline and is being employed along with conventional management of non-communicable diseases by medical practitioners today, as they are strongly associated with lifestyle behaviors and practices. Motivation for change in lifestyle is challenging because it depends on the patient’s determination and eagerness to adapt and accommodate to the newer lifestyle pattern. The medical practitioners should spend time in coaching patients on lifestyle-related health education. Guidance and coaching by medical practitioners will help patients adapt to practices of maintaining regular physical activity, a balanced diet, good sleep hygiene, and avoid addictions of tobacco and alcohol as part of life. Introducing real and progressive evidence-based behavioral changes to reduce the risks of lifestyle-related acute and chronic diseases in medical practice will reduce the burden of non-communicable disease.

Background: Neonatal sepsis is the most important cause of morbidity and mortality in developing countries. Early onset sepsis is attributed to abnormal bacterial colonization of the maternal urogenital tract which leads to either an ascending but silent amniotic fluid infection or symptomatic chorioamnionitis. Aims & Objectives: 1. To study the pattern of maternal vaginal flora in labor. 2. To study the outcome in the neonate. Methods: This study was conducted on 250 mothers in labor & their babies followed up till discharge in the departments of OBG & neonatology in a tertiary care medical college hospital, Deliveries by caesarean section were excluded. Results: Out of 250 mothers 130 (52%) of them showed colonization. Out of the 130 babies born to colonised mothers, 50 (38.46%) showed features of sepsis, while only 10 (8.34%) born to non-colonised mothers had features of sepsis. This study showed a statistically significant association between features of sepsis in babies and maternal vaginal colonization. Of the 60 babies with suspected sepsis, 40 had positive blood culture which is the gold standard investigation for sepsis. All of these culture positive babies i.e all 40(100%) had maternal colonization with a statistically significant association. Conclusion: This study shows that maternal vaginal colonisation has significant association with neonatal sepsis. Hence, finding the organism in the maternal vaginal flora and treating it as per sensitivity might result less cases of neonatal sepsis.

Introduction: Chronic renal diseases not only affects the personal life of an individual but also results in social and financial burden on their families too. Nephrotic syndrome is most common in the paediatric age group contributing to significant illness related morbidity and even mortality if not identified early and treated promptly. This common disease has shown varying clinical trends with studies attempting to document them. Aim: To study the clinical pattern and course of nephrotic syndrome in children. Materials and Methods: The study was a retrospective analysis of medical records of diagnosed nephrotic syndrome patients in the Paediatrics and Nephrology Departments of a Tertiary Care Medical college hospital. The patients were prospectively followed-up for a period of two years. A total of 90 patients were enrolled into the study and their case records were systematically reviewed to obtain the details regarding age, sex distribution, number of admissions, hospital stay during first admission, complications and interim problems, histopathology finding where indicated, diagnostic classifications based on traditional operational definitions, treatment received, duration of remission after first episode and its relation to future relapses and the final outcome were noted and then statistically analysed. Results: Of the 90 cases of nephrotic syndrome, 14 were lost during follow-up, so remaining 76 patients were included. There were 49 males (64.5%) and 27 females (35.5%). Steroid- Sensitive Nephrotic Syndrome (SSNS) was the most common type (59%). It was found that 67 (88.1%) patients had first episode within 1-5 years of age, 31(40.8%) had only 1st time admission, 35 (46%) had 2-4 times admissions, while the rest (13.2%) required more than 4 times admissions. Majority of the cases {48 (63.2%)} had hospital stay between 7-14 days. Infectious complications were the most common (35.3%) and 48 (63.1%) cases showed frequent relapse, while 16 (21%) never had a relapse. The final outcome showed 64 (84.2%) of the cases were in remission, 12 (15.8%) were still relapsing, and there was no mortality. Conclusion: Age of onset for nephrotic syndrome was 5 years in majority of cases. Males were more affected than females. Majority of the patients had hospital stay for 7-14 days. SSNS was the most common type of nephrotic syndrome and Urinary Tract Infection (UTI) was the most common infectious complication. As respiratory and UTIs account for majority of relapses, prevention of respiratory infections by observing respiratory etiquettes, early and aggressive treatment and respiratory protective vaccines will go a long way in prevention of relapses.

Many studies conducted after the pandemic period revealed that, while COVID-19 primarily injured the lungs, it also affects other organs in the form of cardiovascular complications, metabolic derangements, renal damage, and so on. Although we know that inflammatory cascades, complement activation, and pro-inflammatory cytokines are all involved in vasculitic processes that cause organ damage, we do not know the exact mechanism of complications such as acute respiratory distress syndrome (ARDS), cardiovascular ischemia, deep vein thrombosis, pulmonary thromboembolism, and brain injuries (embolism) that are frequently observed in COVID 19. The currently available biomarkers do not predict the severity of the aforementioned complications. As a result, more specific biomarkers such as serum calcium binding protein (S100B), glial fibrillary acid protein (GFAP), myelin basic protein (MBP), neuron-specific enolase (NSE), hs-TNI, (highly sensitive cardiac troponin) – HBDH, (Hydroxybutyrate Dehydrogenase), CK-MB (creatine kinase myocardial band), ST2 (suppression of tumorigenicity 2) are in need for early detection & improved clinical outcome.

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