ABSTRACT

Antidepressant drugs provide relief to depressed patients. However, they have been historically blamed to cause worsening or an emergence of suicidal behavior. This has been a keen concern in recent years, especially in the pediatric population. There have been many studies regarding this issue and evidences have been equivocal. Several mechanisms of action for the suicidal behavior have been proposed. Clinical characteristics suggestive of vulnerable patients have been identified. The current review is an attempt to gather available evidence to help the clinician to arrive at an appropriate treatment decision while weighing the risk-benefit ratio of prescribing antidepressant drugs.

ABSTRACT

Hyperplastic polyps with serrated morphology are known to have increased neoplastic progression. They show characteristic epigenetic alterations too and are difficult to diagnose on endoscopy. Histopathology is necessary for evaluation and confirmation with further molecular studies for management. A brief discussion of serrated polyps with newer concepts based on recent articles is hereby reviewed.

ABSTRACT

Background: Histology has been traditionally taught using microscopes and glass slides with stained tissues. However, traditional approaches to teaching may not address the learning preferences of the millennial students. Advancements in technology have provided new opportunities for teaching and learning in medical education. Digital histological images are increasingly being used to teach histology to medical and dental students of late. The significance and feasibility of use of the virtual microscope and virtual images warrant reflection.
Objectives: To collect and review studies from published medical literature. To compare the experience in our institution with data available from the literature review.
Materials and  Methods: A review of published medical literature on the implementation, strengths and limitations, and impact of the use of virtual microscopy (VM) has been conducted. The findings have been compared with the experience in our institution.
Result: Most of the studies that evaluated students’ learning outcomes in histology after being taught using VM have reported significant improvements in the students’ performance. Our experience has been the same.
Discussion: In comparison with the traditional microscope-based approach of teaching histology, VM is at least as effective if not more for learning tissues at the microscopic level. The advantages of adopting VM far outweigh its limitations.
Conclusion: A judicious blending of traditional and technology based instruction would be beneficial to the tech-savvy generation of medical students.

ABSTRACT

Phyllodes tumor of the breast is a biphasic fibroepithelial tumor. Morphologically they contain cleft-like spaces with large tumors’ exhibiting cystic spaces. Here, we present a rare case of a benign cystic papillary phyllodes tumor in a 45-year-old female who presented with a breast lump.

ABSTRACT

We are presenting a case of a 30-year-old pregnant lady with Para2 Gravida2. She underwent an earlier lower segment caesarean section (LSCS) for her first baby. Her second delivery was also through LSCS but had excessive bleeding and hence subtotal hysterectomy was done. During this procedure, patient went in for an “on table” cardiac arrest. She was resuscitated and referred to our hospital in post cardiac arrest status for post-resuscitation care. We share our postresuscitation care experience of this patient.

ABSTRACT

Background: As the thyroid dysfunctions are common endocrinal disorders seen during pregnancy, it may go unnoticed due to nonspecific symptoms. The maternal thyroid dysfunction has an adverse impact on both maternal and fetal outcome. Therefore, the evaluation of thyroid functioning during the first trimester avoids complications both in mother and fetus.
Objectives: The present study was conducted to assess the maternal thyroid functions (triiodothyronine [T3], thyroxine [T4], and thyroid stimulating hormone [TSH]) during the first trimester of pregnancy and also to determine the proportion of thyroid dysfunction in these subjects.
Materials and Methods: 80 apparently normal the first trimester pregnant women were randomly selected and were aged between 18 and 35 years from the outpatient department of Obstetrics and Gynaecology, Vijayanagara Institute of Medical Sciences, Ballari. The T3, T4, and TSH levels were estimated using chemiluminescent immunoassay method.
Results: The mean total T3 and T4 levels were significantly increased during 10-12 weeks of gestation as compared to 6-9 weeks with P value of 0.03 and 0.02, respectively. Based on American Thyroid Association guidelines for TSH values during the first trimester of pregnancy, the proportion of thyroid dysfunction was found to be high, of which 16.3% were in hypothyroid range, and 2.5% were in hyperthyroid range.
Conclusion: A high proportion of thyroid dysfunctions (16.3% in hypothyroid range and 2.5% in hyperthyroid range) was observed during the first trimester of pregnancy, and hence a routine antenatal screening is suggested, to diagnose the thyroid dysfunction at the earliest.

ABSTRACT

Background: In obesity, as excessive tissue accumulates, an altered metabolic profile occurs along with a variety of adaptations/alterations in the cardiac structure and functions even in the absence of comorbidities.
Aim and Objectives: To study heart rate variability (HRV) and to compare in the pre-prandial and post-prandial state in obese and non-obese young healthy females.
Methodology: 50 obese and 50 non-obese young healthy females aged between 21 and 25 years were selected based on body mass index. HRV was recorded in both pre- and post-prandial state by using computer based software device, digital finger pulse photoplethysmography (DFP) to identify separate frequency components, i.e., total power (TP), low-frequency (LF) power and high frequency (HF) power.
Results: All the statistical methods were carried out through the SPSS for windows version 16.0. The independent samples T-test procedure was done to compare the means for the two groups. P value ≤ 0.05 was considered statistically significant. HRV analysis found significantly lower values of LF, HF in millisecond square (ms2) and HF in the normalized unit (nu) and higher values of LF (nu) and LF/HF ratio among the obese group in both pre- and post-prandial state when compared to the non-obese group.
Conclusion: Our data indicate that obese subjects have decreased parasympathetic activity as evidenced by decrease in TP (ms2), LF (ms2), HF (ms2), and HF (nu), and increase in sympathetic activity as evidenced by increase in HR, LF (nu) and LF/HF ratio in both pre- and post-prandial state.

ABSTRACT

Introduction: Medical students require sound knowledge about HIV/AIDS and professional risks and should be able to offer appropriate information to society. Furthermore, they are not different from sexually active students of other disciplines in their attitudes and risk behaviors.
Aims and Objectives: To know about the awareness about HIV/AIDS among medical students. To benefit student’s knowledge, attitude, and behavior toward HIV/AIDS.
Materials and Methods: A close ended questionnaire study of 144 students from 1st year, i.e., 100 from medical and 44 from dental courses; to improve the overall knowledge of AIDS between the age group of 18-19 years were conducted at Medical and Dental college immediately after joining the course to know their knowledge, attitude, and practice about HIV/AIDS.
Results: The majority of students (67.3%) were acquainted and knew the meaning and abbreviations of HIV/AIDS. A large number of students (93.75%) were aware of the mode of transmission through unprotected sex. A moderate number of them (76.3%) were aware of counseling centers and unfortunately only 16.6% believed there is treatment. 92% were willing to go for voluntary testing and only 20.8% opted for safe sex measures. An overwhelming response was seen regarding youth and medico role to prevent AIDS/HIV, sex education at high schools, testing before marriage, etc. a little was known to them regarding prevention and another mode of transmission of HIV/AIDS.
Conclusion: Awareness program should be carried out.

ABSTRACT

Background: Blackboard and PowerPoint (PPT) teaching have been used in physiology teaching. Howevrer, the superiority of these aids has not been proven. The present study was conducted to evaluate the impact of the PPT and chalk board based lectures on medical students.
Aim: The purpose of this study is to compare the impact of blackboard teaching with PPT teaching in 1st year medical students.
Materials and Methods: A cross-sectional study was conducted in the Department of Physiology, VMKV Medical College, Salem. 40 Medical students were randomly divided into two groups. Each group of students was allowed to attend a session of blackboard teaching followed by a multiple choice questions (MCQs) test, then a PPT teaching session with an MCQs test at the end. The MCQs answer sheets were evaluated for assessing the knowledge of the students by these teaching aids. The differences in the marks obtained in the groups were analyzed by independent Students t-test.
Results: The marks obtained by students taught by blackboard were comparatively higher than those taught by PPT teaching. The differences were found to be statistically significant (P < 0.05).
Conclusion: The present study suggests that chalk board teaching is more advantageous than the PPT teaching in the 1st year medical students.

ABSTRACT

Background: Cognitive dysfunction has increased in menopausal women, which indicate the initiation of dementia.Body mass index (BMI) have been shown to influence brain development in relationship to early and late measures of cognitive function. A strong interaction between brain areas is involved in cognitive, emotional, and metabolic regulatory functions controlling body weight.
Aim: To assess serum lipid profile, BMI, atherogenic index of plasma (AIP) and cognitive functions in postmenopausal women and to correlate the serum lipid profile, BMI, AIP with cognitive functions in postmenopausal women.
Methodology: A cross-sectional study was carried out with 40 premenopausal and 40 postmenopausal at the gynecological outpatient department of Vinayaka Missions Kirupananda Variyar Medical College, Salem. For all the study subjects, the lipid parameters were measured using the standard kits and the cognitive assessment was done by Addenbrooke’s cognitive examination (ACE) – ACE-revised (ACE-R). ACE and its revised version (ACE-R) which includes five domains for assessing the mini mental status.
Results: The BMI, total cholesterol, low-density lipoprotein, triglycerides and AIP were significantly a higher among the post-menopausal women when compared to the premenopausal women (P < 0.05). Similarly, the high-density lipoprotein levels were lower in the study group when compared to the control group. All the cognitive parameters including the ACE-R total and the mini mental scale examination score were comparatively higher in the premenopausal women than the post-menopausal and the difference was found to be statistically significant (P < 0.05).
Conclusion: Altered lipid levels have a definite association with decreased cognitive abilities in postmenopausal women. Interventions to lower the lipid levels may be a potential strategy for prevention of cognitive impairment.