Morādābād, India
Morādābād, India

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Vishwakarma K.,TMMC and RC | Sharma M.,TMMC and RC | Matreja P.,TMMC and RC | Giri V.,TMMC and RC
Indian Journal of Pharmacology | Year: 2016

Objective: Assessment method can influence student learning. Use of objective structured practical examination (OSPE) has been reported in various institutes with great benefits. We evaluated OSPE for the assessment of practical skills in pharmacology examination for undergraduate medical students and compared it with conventional practical examination (CPE). Materials and Methods: After sensitizing the 2nd year MBBS students to OSPE, the students were divided into four batches with twenty students in each batch. Students were assessed by attending five OSPE stations, each for duration of 5 min. The effectiveness was assessed through a student's feedback questionnaire and was checked for its reliability by Cronbach's alpha. The result of OSPE was compared with that of CPE of the same batch. Results: Cronbach's alpha of the feedback questionnaire was 0.71, with high internal consistency. The feedback given was categorized into three domains: cognitive, psychomotor, and affective, and an assessment was also done for its further use. In cognitive domain, 74% of the students felt that the questions asked and the syllabus taught were well correlated. In psychomotor domain, 81% agreed that it is excellent for assessing the applied part of the subject. Seventy percent of students opined that it was associated with lesser stress than CPE. On overall assessment, 76% rated this methodology as good/satisfactory and 23% as excellent in terms of better scoring. There was a significant difference in the mean score between the results of OSPE and CPE (P < 0.001, df = 158, confidence interval = 95%). Conclusion: OSPE is a feasible and skill enhancing tool for the assessment in pharmacology examinations for undergraduate students. Key message: OSPE (Objective structured Practical Examination) is a feasible, meaningful and skill enhancing tool for assessment in pharmacology for undergraduate students. There are several benefits of OSPE as an assessment method including objectivity and uniformity in assessment of students. © 2016 Indian Journal of Pharmacology Published by Wolters Kluwer - Medknow.


Saxena I.,Deparment of Biochemistry | Kumar M.,Tmmc and Rc | Barath A.S.,AIIMS | Verma A.,Tmmc and Rc
Journal of Clinical and Diagnostic Research | Year: 2015

Background and Objectives: Response to experimental pain depends on the nature of the pain stimulus, as well as on gender, racial, cultural and socioeconomic factors. This study investigates the effect of age on pain sensitivity and cardiovascular reactivity produced by experimental pain. We have also compared the values of body mass index (BMI) and resting blood pressure of volunteers with the normal values. Materials and Methods: The study was conducted on 83 Indian males of different age groups. The volunteers were divided into 4 groups: Children, Young Adults, Middle-Aged Adults and Old Adults; and their basal parameters (BMI, resting pulse and blood pressure) were recorded. Selected volunteers were subjected to cold pressor task (CPT). Pain sensitivity (PS) (pain threshold, tolerance and pain rating on a visual analog scale) and cardiovascular reactivity (CVR) (increase in pulse and blood pressure) were recorded. Results: Many volunteers had abnormal values of BMI and resting blood pressure and had to be excluded from the study. PS and CVR between different groups were compared by one-way ANOVA. Significant differences in PS were observed, with highest pain sensitivity in Children and lowest in Old Adults. No significant differences were observed in the CVR. Conclusion: The high numbers of volunteers with abnormal basal parameters (BMI and resting blood pressure) show an urgent need to educate the general public about the dangers and risk factors of obesity and hypertension. Less exposure of children to painful encounters may be responsible for their high pain sensitivity while higher values of resting blood pressure and decreased sensitivity of the sensory systems with advancing age may be responsible for the hypoalgesia observed in old adults. © 2015,Journal of Clinical and Diagnostic Research. All rights reserved.


Kumar M.,TMMC and RC | Kumar J.,TMMC and RC | Saxena I.,AIIMS
Journal of Clinical and Diagnostic Research | Year: 2012

Background and Objectives: The pain sensitivity of a person depends on the type of pain, his/her genetics, racial and cultural factors. Its dependence on the gender is debatable. The significance of the psychological or the behavioural intervention in pain management is gaining importance, along with a reduction in the doses of the analgesics. We wished to investigate (a) whether Indian subjects showed a pain response which was similar to that which was reported for American subjects, (b) whether sex-related differences in the pain response were present in the Indian population, and (c) which method of mental distraction (from a choice of the presence of a male/female attendant, preferred music, and solving simple arithmetic problems) was best suited for the Indian subjects. Methods: The cold pressor task was performed on a group of 80 subjects (38 females who were in the proliferative or the secretory phase of the menstrual cycle) under the conditions which have been mentioned above, as well as in the absence of mental distractants. Results: The female subjects endured pain for a longer duration while they listened to the music of their choice; the male subjects endured pain longer while they were in conversation with the female attendants. Interpretation and Conclusions: A comparison with the reported data showed the Indian males to be more pain-sensitive than the American males. Sex related differences in the pain sensitivity were absent in the Northern Indian subjects. Preferred music was the most effective mental distractant for females, while a conversation with the female attendants was the most effective distractant for the male subjects.


Saxena I.,Deparment of Biochemistry | Shivankur V.,AIIMS | Kumar M.,TMMC and RC
Journal of Clinical and Diagnostic Research | Year: 2016

Introduction: Early neonates (1-7-day-old) may develop acute kidney injury or acute renal failure due to functional (pre-renal, may be caused by decreased renal perfusion), intrinsic (renal, may be caused by acute insult), or obstructive (due to anatomic urinary tract obstruction) causes. Urinary protein estimation is important for diagnosis, follow-up and prognosis of disease. The Protein Creatinine Ratio (PCR) has been successfully used to establish proteinuria in different types of patients. Aim: This study was undertaken to establish normal PCR range in neonates, to rule out abnormal protein excretion in sick neonates. Materials and Methods: A total of 37 normal early neonates of age 0-3 days were enrolled for this study. Random spot urine samples were collected in paediatric urine bags for protein and creatinine estimation.Results: The urinary PCR varied between 0.1-0.8. The range of PCR values obtained was greater in 0-1 day old infants, compared to infants older than one day. Changes in PCR values were due to variations in the creatinine excretion.Conclusion: Urinary PCR values ≤ 0.8 indicate normal protein excretion. However, reference intervals of PCR should be established for narrow age groups in case of early neonates, e.g. 0-6h, 6-12h, 12-24h, 24-72h old babies. © 2016, Journal of Clinical and Diagnostic Research. All rights reserved.


Saxena I.,AIIMS | Kapoor S.,TMMC and RC | Gupta R.C.,NIMS
Journal of Clinical and Diagnostic Research | Year: 2013

Background and Objectives: Excretion of urinary protein increases to 300 mg/d (from up to 150 mg/d) in normal pregnancy. Values above this may be due to disorders that can endanger the patient or her pregnancy. Quantitative analysis of 24-hour urine is considered the gold standard for ascertaining daily protein excretion. Routine laboratory tests performed on spot urine samples indicate protein concentration in the particular sample, and can lead to diagnostic error if urine output is less or more than 1L/d. The Protein Creatinine Index (PCI) shows good correlation with 24-hour protein estimation. However, PCI varies with sex and race. We have correlated the results of qualitative estimation procedures and the dipstick values with protein creatinine index. Material and Methods: We measured protein and creatinine in spot urine samples obtained from 57 pregnant and 80 non- pregnant healthy women of 18-36 years, and calculated PCI. We also tested the samples qualitatively for proteins by routine tests and dipsticks. Results: Normal range of PCI in non-pregnant women, determined by a non-parametric method was 30-150. PCI was increased significantly in pregnancy (maximum increase in the third trimester). Amongst the qualitative tests, heat coagulation test gave the lowest percentage of false positives and a slightly higher percentage of false negatives compared to Heller's nitric acid and sulphosalicylic acid tests, and dipsticks. Interpretations and Conclusions: We conclude that heat coagulation test be used for initial screening, with PCI being performed on all samples testing positive to rule out false positives.


Saxena I.,Aiims | Kumar G.,TMMC and RC | Kumar M.,TMMC and RC | Kumar J.,TMMC and RC
Journal of Clinical and Diagnostic Research | Year: 2013

Background and Objectives: Low blood glucose levels have been associated with a hostile behaviour. The individuals who show aggressiveness and hostility are more likely to develop hypertension and cardiac diseases. The future hypertension has been linked with a high cardiovascular reactivity to stress. We have investigated the association of the blood glucose lev- els with the Cardio Vascular Reactivity (CVR) to stress. Methods: 46 volunteers were subjected to stress (which was induced by the cold pressor task) in the fasting state and again, half an hour after the ingestion of 75 grams of glucose. The CVR in both conditions was compared in terms of an increase in the heart rate and the blood pressure. Results: The resting pulse was lower and the blood pressure was higher in the fasting condition, as compared to the values which were obtained in the 1/2 hour post-prandial condition. The CVR to stress was significantly higher in the fasting condition. Interpretation and Conclusion: The increased resting heart rate and the decreased resting blood pressure in the 1/2 hour- Post-Prandial (PP) condition was due to the higher levels of histamine in the post-prandial state. Low blood glucose levels are associated with a higher CVR to stress. This suggests that the persons are prone to develop future hypertension, those with frank hypertension, and the chronic pain sufferers should avoid prolonged fasts, in order to lower their CVR to the stress stimuli which are encountered in the daily life.


PubMed | TMMC and RC and Himalayan Institute of Medical science
Type: Journal Article | Journal: Annals of Indian Academy of Neurology | Year: 2016

We aimed to compare the efficacy of fixed doses of bupropion and ropinirole and iron alone for the treatment of restless legs syndrome (RLS) and to look for the tolerability of these medications.Patients diagnosed with RLS were randomly divided into three groups with thirty patients in each group (Group A: Bupropion [300 mg/day], Group B: Ropinirole [0.25-0.5 mg/day], and Group C: Oral iron [150 mg elemental iron] along with folic acid [500 g]). Each participant was then assessed for severity of RLS, as well as RLS-related quality at the baseline, and thereafter, every 14IRLS scores differed significantly from baseline visit to last (RLS severity decreased across time in all three groups; however, the ropinirole treatment was better than the bupropion and iron-folate therapy. Moreover, RLS-related quality of life although improved among all groups, it was comparable among three groups.


Chandak S.,TMMC and RC | Kumar A.,TMMC and RC
Journal of Clinical and Diagnostic Research | Year: 2014

This is a unique case of cervical rib since the patient presented as a firm neck swelling of short duration which was clinically palpable as a superficial neck mass and referred for FNAC for the same. Since FNAC did not yield any positive result, the patient was then referred for CT which showed bilateral cervical ribs with pseudoarticulation with the 1st thoracic rib on the right side which is quite rare. The clinical importance of our case is to keep in mind a differential diagnosis of cervical rib in firm to hard clinically palpable posterior triangle neck masses. It is also important to diagnose cervical ribs in patients undergoing CT of the neck since they are under reported as determined in previous studies.


Kumar J.,TMMC and RC | Kumar G.,TMMC and RC | Sharma A.,TMMC and RC | Khan F.A.,TMMC and RC | Sharma S.,TMMC and RC
Journal of Clinical and Diagnostic Research | Year: 2012

Aims and Objectives: To compare the haemoglobin concentration, the Differential Laeukocyte Count (DLC) and the Packed Cell Volume (PCV) in the blood of smokers and non-smokers. Methodology: 150 young adults who were of the age group of 20-30 years were selected for this study. Out of the 150, 75 were smokers and 75 were non-smokers. The subjects who suffered from any diseases were excluded. The methods which were used for this study were-Sahli's method for the estimation of haemoglobin, the Tally Chart Method for the determination of the differential laeukocyte count and Wintrobe's method for the determination of the PCV. Observations: In the present study, the means of the neutrophil counts in the passive smokers, occasional smokers and the active smokers (<10 cig. /day) were higher than those in the non-smokers, whereas it was lesser in the active smokers (>10 cig./day). The eosinophil counts in the passive smokers, occasional smokers and the active smokers (>10 cig. /day) were slightly higher than those in the non-smokers, whereas it was lesser in the active smokers (<10 cig./day). But the difference was not significant. The packed cell volume of the active smokers (> 10 cig./day) was significantly higher than that of the non-smokers (p=0.0033). In the active smokers (< 10 cig./day), the packed cell volume was quite significant than that in the non-smokers (p=0.078). Conclusion: Our study showed that that smoking had an effect on the blood parameters. A majority of the parameters showed higher values in the smokers than in the non-smokers. These mainly included haemoglobin, packed cell volume (PCV) and the differential leukocyte count (DLC).


Narasimhaiah A.,TMMC and RC | Ansari M.,TMMC and RC | Haritwal A.,TMMC and RC | Awasthi S.,TMMC and RC
Kathmandu University Medical Journal | Year: 2013

Fallopian tube neoplasms are rare. We report a rare case of fallopian tube papilloma discovered incidentally in a 45 year old female, operated for procidentia. Right tube was dilated at the infundibular region, with friable grey white tissue in the lumen. Microscopy showed delicate branching papillae lined by a single layer of epithelium resembling tubal lining. There were no features to suggest a reactive hyperplasia in response to inflammation or of aggressive behaviour.

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