Vidushi Gupta

Effect of noise stress on autonomic function tests.

The study was carried out in 200 male volunteers. They were divided into two groups. The study group was exposed to noise levels of more than 80 dB(A) for more than 8 hours a day for a period of 6 months, working in the steel and hammer industry, whereas the control group was working under normal conditions. The mean age of subjects was 33.33 + 0.867 years and the mean noise level to which they were exposed was 90.34 + 0.781 dB(A). Various autonomic function tests were carried out in both the groups and results were analyzed using Z test. Heart rate was recorded on cardiofax ECG machine and blood pressure (BP) was recorded using sphygmomanometer. The tests depicted significant increase in the mean resting heart rate and the heart rate response to standing (P=0.000), 30:15 ratio (P=0.002), the valsalva ratio (P=0.017), the % change in diastolic BP response to standing (P=0.000) and valsalva maneuver (P=0.000), the systolic BP and diastolic BP after cold pressor test (P=0.000) in study group as compared to the control group. The significant higher results in study group may be attributed to increased sympathetic activity. Thus, noise presents as a significant health hazard. It is recommended that maximum allowable duration of exposure should be reviewed and strictly followed.

Skills' assessment during internship: A novel approach to enhance competencies among Indian medical graduates

Background: Internship is the best period for acquiring practical knowledge and skills in Community Medicine to become a successful primary health-care physician. Effectiveness of internship has been questioned in many research papers. Assessment of skills during internship holds a very important place, because if the interns are not assessed for the skills, these skills are usually not practiced. Aims and Objective: This study aimed to frame a conceptual setup and introduction of a system of skill assessment for interns at the end of Community Medicine posting for acquired skills in cognitive, psychomotor, and affective domains. Materials and Methodology: The study was a cross-sectional study. Totally 45 interns who completed their internship in Community Medicine at different points of time were inducted in the study. Before the starting of internship in Community Medicine, the interns were already briefed regarding their skills’ assessment at the end of the internship completion in the subject of Community Medicine. The interns were told about the skills which are already identified in the log book and were asked to practice it during their field training at respective places. Prior to assessing the skills, as this was a new method of assessment, the interns were briefed about the 10 skills. They were also briefed about the method of assessment which was a mix of Objective Structured Clinical Examination (OSCE) question stations and OSCE procedural stations. About 2 stations were kept for psychomotor domain, 1 for affective domain, and the rest 7 were of cognitive domain. Hence in total, there were 7 question stations and 3 procedural stations. Interns went through each station and had to answer the questions. Results: About 17 (37.8%) interns liked the assessment from very much to some extent, 21 (46.7%) interns were of the opinion that they practiced and learned skills because of this assessment as it was compulsory for them to learn, 20 (44.4%) interns said that this assessment introduction enhanced the learning process, and 18 (40%) interns liked the assessment system in an overall format. Overall, 22 (48.88%) interns liked the internship assessment very much. Nearly 24.44% of the interns did not like the assessment system. Conclusions: Skill assessment during internship offers an effective method to enhance competencies in Indian Medical Graduates (IMGs). The majority of the positive feedback of this innovative method from the interns validates the importance of structured efforts to achieve continuous professional development of IMGs.