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Background Assessment drives learning. Student assessment cannot be neglected in the long ongoing online learning during COVID-19 pandemic to motivate and assess students' learning. Hence Patan Academy of Health Sciences (PAHS) conducted online assessment to medical undergraduates amidst limitations. Objective To measure the perception of online assessment of students which will provide applicable insights for the further improvement. Method This is a single center, cross-sectional and descriptive study. A Google form containing a semi-structured questionnaire was sent to MBBS students of Basic Science at PAHS who attended online classes and online examination. The responses from close ended questions expressed in percentage and Chi-square test was used to find the association. Open ended questions were analyzed using Braun and Clarke's thematic analysis. Result Of 118 students that responded, 75% passed the online examination. A majority of students (73%) stated that online exam motivated them in learning process and it could be a good alternative during pandemic time. However the most of students (56%) were unsatisfied with the modality of online assessment and reasons that they mentioned were technical problems (89%), inadequate online proctoring (77%), insufficient examination time (58%), lack of orientation to exam, lack of computer skills. Technical problem was worse in rural areas. Conclusion Even though online assessment motivated students' learning during online classes, a large number of students were unsatisfied with assessment modality.
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COVID-19 , Estudiantes de Medicina , Humanos , Pandemias , Estudios Transversales , Estudiantes , PercepciónRESUMEN
Background Integrated curriculum enhances students' learning and the retention of knowledge. At Patan Academy of Health Sciences, integrated organ system based curriculum is used with Problem Based Learning as the principle teaching learning method to foster students' learning. In addition, other approaches of integration were under taken such as integrated assessment; logical arrangement teaching learning methods (lectures and practicals); joint effort of faculty in curriculum planning and delivery; conducive environment to foster hidden curriculum. This study describes the perception of faculty and students on integration characteristics of Basic Science curriculum. Objective To measure the integration characteristics of Basic Science Curriculum. Method Tool was developed to measure integration characteristics of Basic Science Curriculum and ensure whether such planned integration has been achieved. Mixed method was used to measure the perception of the integration characteristics i) quantitatively by questionnaire survey to faculty and students ii) qualitatively by in-depth interview of students. Result Both faculty and students perceived that all the blocks in Basic Science was well integrated in the quantitative questionnaire survey. But, in the in-depth interview, students perceived integration of curriculum in organ system blocks were better integrated compared to Principle of Human Biology blocks where fundamentals of basic science disciplines were delivered. Students reflected that Problem Based Learning not only integrated Basic Science disciplines but also with clinical sciences and the social context. But, students perceived that Community Health Sciences curriculum was not so well integrated with Basic Science subjects. Conclusion Overall, this study showed that planned integration in Basic Science curriculum was successfully executed during curriculum implementation.
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Curriculum , Educación de Pregrado en Medicina/métodos , Aprendizaje , Aprendizaje Basado en Problemas/métodos , Humanos , Encuestas y CuestionariosRESUMEN
There is increasing prevalence of hypertension worldwide. Hypertension is an important risk factor for cardiovascular disease and renal disease which are the leading cause of death in the world. It is, therefore, very important to prevent progression of hypertension into these fatal diseases through appropriate treatment and monitoring. Microalbuminuria and dyslipidemia has been regarded as a predictor for cardiovascular and renal dysfunction in hypertension. In this study, we have included 130 hypertensive and 100 normotensive individuals of age > or = 25 years. Patients with a history of urinary tract infection, hematuria, renal failure, women with menstruation at the time of sample collection were excluded from this study. Measurements of anthropometric parameters; blood parameters like lipid profile, fasting blood sugar (FBS), creatinine after 8 hrs fasting and urine parameters like microalbumin and creatinine were done. The prevalence of microalbuminuria and macroalbuminuria is 17.7% and 3.1% respectively in hypertensive patients. Also, there was 9% prevalence of microalbuminuria in normotensive people. There was a significant association of hypertension with microalbuminuria and dyslipidemia, triglyceride, low density lipoprotein, high density lipoprotein, microalbumin creatinine ratio (MCR), body mass index (BMI), waist circumference (WC) and waist hip ratio (WHR) were significantly higher in hypertensive than in normotensive persons. These higher lipid levels, WC and MCR in hypertensive patient are established risk factors for progressing into diabetes and cardiovascular diseases. Hence, monitoring of these parameters would be beneficial for hypertensive patients in preventing the disease progression in this population.
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Albuminuria/epidemiología , Dislipidemias/epidemiología , Hipertensión/epidemiología , Adulto , Índice de Masa Corporal , Estudios de Casos y Controles , Femenino , Humanos , Lípidos/sangre , Masculino , Persona de Mediana Edad , Nepal/epidemiología , Prevalencia , Circunferencia de la Cintura , Relación Cintura-CaderaRESUMEN
BACKGROUND: Thyroid hormone has its effect in the lipid metabolism. Thus, thyroid disorder is usually associated with the dyslipidaemia. Hypercholesterolemia is an established risk factor for the cardiovascular disease (CVD) and therefore in case of overt hypothyroidism which is associated with hypercholesterolemia, CVD is most likely to occur. OBJECTIVES: controversies still persist about the hypercholesterolemia and sub clinical hypothyroidism. Hence, we conducted our study to elucidate the relation of thyroid hormone with cholesterol in different thyroid disorder. MATERIAL AND METHOD: All patients suspected of thyroid disorder within a period of one year were included in the study and free thyroxine-3 (fT3), free thyroxine-4 fT4, Thyroid Stimulating Hormone (TSH) and total cholesterol (TC) in the serum were estimated. Statistical analysis was carried out by using SPSS. 13. RESULTS: Among the 169 cases, 32.5% of the patients were having thyroid disorder. In which 8.3% were of hypothyroid, 7.1% were of sub clinical hypothyroid, 8.3% were of hyperthyroid, 7.7% were of sub clinical hyperthyroid and 1.2% cases were of pan hypothyroid. We observed significant negative correlation between TC & fT3(r = -0.226, p = 0.003), significant negative correlation between total cholesterol & fT4(r = -0.197, p = 0.010) and significant positive correlation between TC & TSH(r = 0.365, p = 0.000). Total cholesterol was significantly raised in hypothyroidism (Mean ±SD 283 ± 53, p = 0.000) in comparison to euthyroid population (mean ±SD, 195 ± 58). But cholesterol was not significantly increased in sub clinical hypothyroidism (mean ±SD, 240 ± 46) CONCLUSION: Our results show that total cholesterol level in serum is affected by the blood thyroid hormone level. Therefore, screening for hypercholesterolemia could be useful in patients with hypothyroidism to reduce associated disease.
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Colesterol/sangre , Hipotiroidismo/sangre , Enfermedades Cardiovasculares/sangre , Femenino , Humanos , Hipotiroidismo/epidemiología , Masculino , Nepal/epidemiología , Pruebas de Función de la Tiroides , Tirotropina/sangre , Tiroxina/sangreRESUMEN
BACKGROUND: Type 2 diabetes is the leading cause of end stage renal disease worldwide. Prevalence of diabetic nephropathy (DN) varies in the different ethnic groups. Nepal is country with great ethnic diversity. This study has been done to find the prevalence of microalbuminuria and macroalbuminuria in the two ethnic groups Jyapu and Brahmin. METHODS: In our study we have included two ethnic groups Jyapu and Brahmin type 2 diabetic patients. INCLUSION CRITERIA: Age ≥ 30 years, clinically diagnosed type 2 diabetic patients. EXCLUSION CRITERIA: Patients with a history of urinary tract infection, hematuria, renal failure, intercaste marriage and women with menstruation at the time of sample collection. RESULTS: The overall prevalence of albuminuria was 49.05%. The prevalence of microalbuminuria was 35.89% in Jyapu and 37.73% in Brahmin which was comparable. There was significantly higher prevalence of macroalbuminuria in Jyapu 20.75% and Brahmin 3.77%. Association of dietary habit was seen with microalbuminuria and macroalbuminuria in both ethnic groups. CONCLUSIONS: The overall prevalence of albuminuria in type 2 diabetes of our study was high and there was significantly higher macroalbuminuria in Jyapu compared with Brahmin. It, therefore, predicts a higher risk of having kidney disease in Jyapu population.
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Albuminuria/patología , Diabetes Mellitus Tipo 2/orina , Nefropatías Diabéticas/orina , Albuminuria/epidemiología , Estudios de Casos y Controles , Diabetes Mellitus Tipo 2/epidemiología , Diabetes Mellitus Tipo 2/patología , Nefropatías Diabéticas/epidemiología , Nefropatías Diabéticas/patología , Dieta , Etnicidad/estadística & datos numéricos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Nepal/epidemiología , Prevalencia , Factores de Riesgo , Estadísticas no Paramétricas , Relación Cintura-CaderaRESUMEN
Disturbed lipid profile is one of the most important and potent risk factors in ischemic heart disease (IHD). In recent years, it has been demonstrated that raised oxidative stress promotes several undesirable pathways including the formation of oxidised LDL (O-LDL) and oxidized cholesterol which encourages cholesterol accumulation in arterial tissues. We, therefore, aimed to ascertain the redox balance by measuring oxidative stress (OS) and total antioxidant activity (TAA) along with lipid profile to determine their possible association with IHD. Our study group comprised of 28 confirmed cases of IHD. The inclusion criterion was history of chest pain, ischemic changes in the ECG and good left ventricular (LV) function. Patients with diabetes mellitus, poor LV function, previous infarct and valvular heart disease were excluded. Lipid profile, plasma thiobarbituric acid reactive substances (TBARS), plasma total antioxidant activity (TAA) and urinary TBARS were estimated in these patients by standard procedures and the values were compared with 30 age, sex and socioeconomically matched normal healthy control subjects. Body mass index (BMI) and waist/hip ratio (W/H ratio) was also noted in both the groups. Lipid profile and OS (TBARS levels) were significantly raised in IHD patients. Though statistically not significant but TAA tended to be lower and urinary TBARS levels tended to be higher in patients. BMI, W/H ratio, smoking and alcohol did not show discernible association with lipid profile, OS or TAA. OS is significantly raised in majority of IHD patients. The non association of BMI, W/H ratio, smoking and alcohol with lipid profile, OS and TAA suggest that there are other risk factors which primarily contribute to the initiation and progression of IHD.
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Antioxidantes/metabolismo , Lípidos/sangre , Isquemia Miocárdica/metabolismo , Estrés Oxidativo , Femenino , Humanos , Masculino , Persona de Mediana Edad , Nepal , Sustancias Reactivas al Ácido TiobarbitúricoRESUMEN
AIMS AND OBJECTIVES: Diabetes mellitus (DM) is often termed as a disease of premature aging. Several studies have indicated lopsided redox balance due to pro oxidant environment as one of the important etiological factors. Some recent researches also indicate a causal relationship with oxidative stress (OS). So far, no study has been undertaken on this aspect in Nepali populations. We, therefore, aimed this maiden study in Nepali population to examine redox balance by measuring OS and antioxidant status along with lipid profile in 37 patients of DM type- 2 and 30 matched normal subjects. METHODOLOGY: Thirty seven patients of DM type-2 without any complications (mean age= 57.6+/- 10.6 years) and 30 normal subjects (mean age= 55.8 +/- 14.8 years) were included in this study. Body Mass Index (BMI) and Waist/Hip (W/H) ratio were measured. Fasting blood sample was collected for the analysis of total antioxidant activity (TAA), plasma and urinary thiobarbituric acid reactive substances (TBARS) and lipid profile by standard procedures in both the groups. The statistical analysis was done with SPSS 10 version. RESULTS: Total cholesterol, triglyceride, VLDL-cholesterol, LDL-cholesterol, plasma and urinary TBARS were significantly raised whereas, plasma TAA was significantly reduced in DM type-2 patients as compared to controls. The comparison of old and fresh cases revealed that though TAA was lower and PTBARS and UTBARS were higher in patients but did not attain the level of significance. W/H ratio is significantly higher in patients compared to normal subjects. But, no significant correlation of BMI and W/H with lipid profile is observed in both control and patients. CONCLUSION: Oxidative stress is raised in type 2 DM patients. This along with deranged lipid profile and decreased antioxidant status could be the risk factors in the development of complications associated with DM.
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Antioxidantes/metabolismo , Diabetes Mellitus Tipo 2/metabolismo , Lípidos/sangre , Estrés Oxidativo , Pesos y Medidas Corporales , Femenino , Humanos , Masculino , Persona de Mediana Edad , NepalRESUMEN
OBJECTIVES: To assess the effect of cigarette smoking on lipid peroxidation induced oxidative stress, antioxidants, uric acid and blood sugar in normal subjects. METHODS: The study included 61 normal subjects with regular smoking habit and 57 never-smokers normal subjects matched in respect to socio-economic status, age and BMI. Information regarding smoking habit and other personal details were collected by oral questionnaire. Total antioxidant activity (TAA), reduced glutathione (GSH), alpha-tocopherol (alpha-T), ascorbic acid (AA), uric acid (UA), plasma and urinary thiobarbituric acid reactive substances (TBARS), fasting blood sugar (FBS) and urinary creatinine (Cr) were estimated by standard procedures in both the groups. Ferric Reducing Antioxidant Power (FRAP) procedure is used to estimate TAA which measures total dietary antioxidants. Statistical analysis was done with SPSS version 10. RESULTS: The mean pack years smoked by smokers was 14.4 +/- 15.8. The plasma TBARS level in smokers and never-smokers was 2.6 +/- 0.8 and 2.5 +/- 0.6 micromol/L respectively. The respective figure for urinary TBARS level was 4.6 +/- 2.7 and 3.7 +/- 1.4 micromol/gmCr. Smokers did not show any significant difference from never-smokers with respect to GSH, alpha-T, AA, plasma TBARS and FBS. However, the smokers had significantly lower levels of TAA (p<0.05) and raised level of urinary TBARS (p<0.05) and uric acid (p<0.01) as compared to never-smokers. CONCLUSION: Our study suggests that smoking induces mild lipid peroxidation but the body is able to compensate for it by removing its adducts. Importantly it also indicates enhanced oxidation of purines which are essential components of both DNA and RNA. Dietary antioxidants are consumed to scavenge free radicals (FR) and other reactive species (RS) in smoke. Female smokers are more prone to oxidative insult than male smokers. In summary RS present in smoke induce mild lipid peroxidation but are not the major contributors of redox imbalance in smoke induced toxicity in the selected subjects.