Kamaljit Singh

The attitudes and perceptions of medical students towards basic science subjects during their clinical years: A cross-sectional survey

Introduction: In the conventional system of medical education, basic subjects are taught in the 1st year with least interdisciplinary interaction. The objective of this study was to explore the students’ perception about content, need and application of basic science subjects during the clinical years of their medical education. Materials and Methods: A total of 300 questionnaires were distributed among students randomly after taking their written consent for participation in the study. About 265 completely filled questionnaires were received back and the response was analyzed. Results: Students identified anatomy as the subject with overloaded syllabus (75.4%) and also with maximum clinical application with 50.1% of them considering it the most important basic subject. Students were satisfied with the practical integration of subjects to impart clinical skills, but considered problem based learning a better method of teaching. According to 37%, 43.8% and 33.2% of respondents respectively; anatomy, biochemistry and physiology curriculum should only cover the general concepts to give the working knowledge of the subject. Approximately, 65% of the respondents were able to recall the knowledge of anatomy and physiology while biochemistry was retained by 40%. Conclusions: Overall, the attitudes of students toward basic science subjects were positive. The learning experience for them can be improved significantly by better clinical integration of the subjects.

Age shift: Breast cancer is occurring in younger age groups - Is it true?

Context: Carcinoma of the breast is the most common malignancy in females. At present carcinoma breast is the leading cancer in urban India and has overtaken cancer cervix in incidence. Epidemiological studies at regional and global levels suggest the occurrence of carcinoma breast at a younger, premenopausal age in Indian and Asian women as compared with western women. Knowledge of this factor emphasizes the need to modify the timing of modalities of detection of early carcinoma and its management. According to literature, majority of carcinoma breast cases in the western countries present in Stages I and II of the disease whereas in India majority cases present in Stage III of the disease. The objective of this study is to observe age of occurrence of breast cancer and stage of cancer in this health facility. Other epidemiological factors such as diabetes and obesity were also recorded. Materials and Methods: A record based descriptive study was conducted in 100 patients of histopathologically confirmed breast cancer. Results: Mean age of subjects was 50.1 ± 10.5 years. Age distribution showed two peaks at 41-50 years and 51-60 years with 42 and 24 patients, respectively. Subjects who also had co-existing diabetes, hypertension, and obesity were 14, 14 and 6%, respectively. This study shows that 45% of the total patients were having advanced carcinoma breast (Stage III) at the time of reporting and 77% of these patients were below 50 years of age. Conclusion: Breast cancer is now occurring increasingly in younger age groups in India when compared with western countries and a more aggressive nature of the disease strikes Indian women in their reproductive period. This stresses the need for change in modalities of early cancer detection, modifying, and adjusting control efforts and multidisciplinary therapeutic efforts.

A study to compare the plasma glucose levels obtained in sodium fluoride and citrate buffer tubes at a tertiary care hospital in Punjab.

Objectives: Recent guidelines for estimation of glucose recommend the use of citrate buffer tubes to inhibit glycolysis if the sample cannot be cooled immediately and separated within 30 min. These tubes are currently not available in India. We prepared the citrate tubes and compared the glucose results obtained with sodium fluoride tubes. Methods: Random blood samples of 44 apparently healthy volunteers were collected in three pairs of citrate buffer and sodium fluoride tubes during September to October 2013. They were labeled as 0 h, 1 h and 2 h samples indicating a delay in centrifugation to separate plasma. Glucose was analyzed on the fully auto analyzer in duplicates using glucose oxidase-peroxidase method. Results: The mean glucose concentrations at 0 h in citrate tubes were 105.8 ± 19.5 mg/dl compared to 99.6 ± 18.3 mg/dl in sodium fluoride tube. There was statistically significant difference in the glucose levels measured in plasma separated from citrate buffer tube and sodium fluoride tube at 0 h, 1 h, and 2 h. The difference between citrate and sodium fluoride tube results ranged from 6.1 mg/dl at 0 h to 7.4 mg/dl at 2 h. Glucose levels decreased significantly at 2 h in both citrate and sodium fluoride tubes. Conclusion: There is a significant decrease in glucose levels in sodium fluoride tubes even with immediate separation of plasma. There is urgent need to standardize the preanalytical conditions for glucose estimation so that effective inhibition of glycolysis can be done.

Are sodium and potassium results on arterial blood gas analyzer equivalent to those on electrolyte analyzer

Objectives: The present study was conducted with the aim to compare the sodium (Na) and  potassium (K) results on arterial blood gas (ABG) and electrolyte analyzers both of which use direct ion selective electrode technology. Materials and Methods: This was a retrospective study in which data were collected for simultaneous ABG and serum electrolyte samples of a patient received in Biochemistry Laboratory during February to May 2015. The ABG samples received in heparinized syringes were processed on Radiometer ABL80 analyzer immediately. Electrolytes in serum sample were measured on ST-100 Sensa Core analyzer after centrifugation. Data were collected for 112 samples and analyzed with the help of Excel 2010 and  Statistical software for Microsoft excel XLSTAT 2015 software. Results: The mean Na level in serum sample was 139.4 ± 8.2 mmol/L compared to 137.8 ± 10.5 mmol/L in ABG (P < 0.05). The mean difference between the results was 1.6 mmol/L. Mean K level in serum sample was 3.8 ± 0.9 mmol/L as compared to 3.7 ± 0.9 mmol/L in ABG sample (P < 0.05). The mean difference between the results was 0.14 mmol/L. Statistically significant difference was observed in results of two instruments in low Na (<135 mmol/L) and normal K (3.5-5.2 mmol/L) ranges. The 95% limit of agreement for Na and K on both instruments was 9.9 to −13.2 mmol/L and 0.79 to −1.07 mmol/L respectively. Conclusions: The clinicians should be cautious in using the electrolyte results of electrolyte and ABG analyzer in inter exchangeable manner.