Search

Self-directed learning (SDL) is a modality where learners are expected to take responsibility for their own learning, diagnose gaps in their learning, frame their own goals and resources for learning, implement appropriate learning strategies and evaluate learning outcomes. Flexibility and creativity in designing assignments for students to work individually or collaboratively are the keys to promoting SDL. The recent competency-based curriculum document from the National Medical Commission does not elaborate the concept or implementation of SDL, leaving it open to individual interpretation. We, herein, discuss the concept of SDL, address common misconceptions surrounding SDL, and elucidate strategies by which SDL skills can be inculcated in medical students using pre-existing opportunities in the curriculum. Flipped classrooms, reciprocal teaching, technology-enhanced methods, problem-based learning, and group projects are excellent ways of promoting SDL. SDL requires efforts and policies both at the teachers' level and at the institutional level; and is an important input to achieve the goal of being a lifelong learner by the Indian medical graduate.

With its colonial past, and a glaring problem of poverty and hunger, India oft fails to acknowledge a new, rapidly growing problem of overnutrition. With the economic boost and entry of various foreign players from the food industry, Indian citizens have been increasingly exposed to ultra-processed, high in sugar, salt and fat foods (HFSS foods). The last decade or so has seen an exponential rise in the consumption of such foods, leading to increasing prevalence of overweight- and obesity-related illnesses like diabetes, hypertension, etc. In this scenario, examining the efficacy of policy-related measures in reducing consumption of these harmful foods and preventing the associated health issues is paramount. Across the globe, several countries have explored options from taxation on HFSS foods to restricting marketing to children, as well as different practices for front of the pack labeling. In the context of India and its increasing burden of preventable, diet-related illnesses, the urgent need of instituting these preventive policies at national scale cannot be neglected.

We examine the effect of the news about merger of six banks into four major banks, employing the standard event study method with the market model on a sample of four bidders and six target banks. We find significant impact of merger announcement on the bidder and target banks. While the bidder banks are negatively impacted, the target banks experience positive impacts on the event day and day after, followed by negative results later on. No previous study is found to have addressed this question on how the merger announcements impact the bidder and target bank's stock returns in India.

A novel twin functional photocatalytic approach in which CO2 acted as a soft oxidant and facilitated oxidation of amines to imines along with the simultaneous reduction to methanol is described.

In Presentera every person is running after life,s goal. Hence does not have time to think and act for the healthy life and also not able to follow the proper Dincharya,Ratricharya,Ritucharyaand rules for healthy living as per Ayurveda and other life sciencesso that obesity has taken place as anmajor problem in majority of peoples. Sthaulya(Obesity) is such a disease ,whichprovides the platfrom for so many disease and complication like hypertension, Congenital heart disease,diabetes mellitus,impotency as well as psychological disorderslike stress,anxiety, depression etc. so in present study.We try to prove our hypothesis with data collected and analysed on the basis of patient taken in OPD and IPD level as open level randomized clinical trial. The material method, Analysis of data, Result and Conclusion is elaborated in the following Article.

We examine the impact of the recent restrictions/bans imposed by several nations on air travel to India in the light of the increasing number of infections amid the second wave of covid-19. We employ the standard event study method on a sample of 34 airline stocks across seven nations to find that the recent restrictions/ bans on air travel significantly impact the global airline industry, although the country-specific impacts are not similar. We find that the post-event reaction in all nations has been different from those evidenced during the global pandemic declaration. We are the first to examine these impacts during the current wave of the pandemic. It contributes to the literature on the effects of the pandemic on the global airline industry. Further, it also provides practical explanations to the investors on how the airline stocks react to the persistence of the pandemic

The emerging literature on prevalence of vitamin D deficiency in India, prevention and treatment strategies of rickets, and extra-skeletal benefits of vitamin D suggest the need for revising the existing guidelines for prevention and treatment of vitamin D deficiency in India.To review the emerging literature on vitamin D prevalence and need for universal vitamin D supplementation. To suggest optimum vitamin D therapy for treatment of asymptomatic and symptomatic vitamin D deficiency, and rickets. To evaluate the extra-skeletal health benefits of vitamin D in children.A National consultative committee was formed that comprised of clinicians, epidemiologists, endocrinologists, and nutritionists. The Committee conducted deliberations on different aspects of vitamin D deficiency and rickets through ten online meetings between March and September, 2021. A draft guideline was formulated, which was reviewed and approved by all Committee members.The group reiterates the serum 25-hydroxy vitamin D cutoffs proposed for vitamin D deficiency, insufficiency, and sufficiency as12 ng/mL, 12-20 ng/mL and20 ng/mL, respectively. Vitamin D toxicity is defined as serum 25OHD100 ng/mL with hypercalcemia and/or hypercalciuria. Vitamin D supplementation in doses of 400 IU/day is recommended during infancy; however, the estimated average requirement in older children and adolescents (400-600 IU/day, respectively) should be met from diet and natural sources like sunlight. Rickets and vitamin D deficiency should be treated with oral cholecalciferol, preferably in a daily dosing schedule (2000 IU below 1 year of age and 3000 IU in older children) for 12 weeks. If compliance to daily dosing cannot be ensured, intermittent regimens may be prescribed for children above 6 months of age. Universal vitamin D supplementation is not recommended in childhood pneumonia, diarrhea, tuberculosis, HIV and non-infectious conditions like asthma, atopic dermatitis, and developmental disorders. Serum 25-hydroxy vitamin D level of20 ng/mL should be maintained in children with conditions at high-risk for vitamin deficiency, like nephrotic syndrome, chronic liver disease, chronic renal failure, and intake of anticonvulsants or glucocorticoids.

Recent research has provided evidence for lack of transmission of SARS-CoV-2 through human milk and breastfeeding. Updating the practice guidelines will help in providing appropriate advice and support regarding breastfeeding during the coronavirus 2019 (COVID-19) pandemic.To provide evidence-based guidelines to help the healthcare professionals to advise optimal breastfeeding practices during the COVID-19 pandemic.Formulation of key questions was done under the chairmanship of President of the IAP. It was followed by review of literature and the recommendations of other international and national professional bodies. Through Infant and Young child (IYCF) focused WhatsApp group opinion of all members was taken. The final document was prepared after the consensus and approval by all members of the committee.The IYCF Chapter of IAP strongly recommends unabated promotion, protection and support to breastfeeding during the COVID-19 pandemic with due precautions.

Background The purpose of the study was to evaluate survival outcomes in post-operative oral tongue cancer patients undergoing adjuvant radiotherapy (RT) at a tertiary cancer care center and to critically review the impact of various clinical-pathological factors on recurrence and survival. Demographic factors, stage of all the histology proven oral tongue cancer, and treatment details were documented. Overall survival (OS) and recurrence-free survival (RFS) were analyzed along with the potential prognostic factors affecting outcome. Results One hundred forty-four post-operative oral tongue cancer patients referred to our department for adjuvant treatment were evaluated. Median age at presentation was 45 years. Forty-seven patients had pathological early stage disease (stages I and II) and 95 had locally advanced (stages III and IV) disease while post-op details were not present in 2 patients. At a median follow-up of 87 months (60–124) of alive patients, the median RFS for entire cohort was 62 months while median OS was 74 months respectively. Age, perineural invasion (PNI), and grade of the tumor emerged as independent prognostic factors for OS and RFS. Among patients with early stage disease, depth of invasion (DOI), age, and PNI were found as independent prognostic factors for RFS and OS. In locally advanced disease, higher grade, age, and PNI independently impacted the respective survival end points. Conclusions Age (> 45 years), higher grade, and presence of PNI showed inferior survival outcomes across the sub-groups (early versus locally advanced disease). This may warrant adjuvant treatment intensification. DOI > 10 mm was particularly found to worsen survival in early node negative SCC oral tongue patients.

When public health programs with single nutrients are perceived to have a poor impact on the target health outcome, the policy response can be to supply more, by layering additional mandatory programs upon the extant programs. However, we argue for extreme caution, because nutrients (like medicines) are beneficial in the right dose, but potentially harmful when ingested in excess. Unnecessary motivations for the reactionary layering of multiple intervention programs emerge from incorrect measurements of the risk of nutrient inadequacy in the population, or incorrect biomarker cutoffs to evaluate the extent of nutrient deficiencies. The financial and social costs of additional layered programs are not trivial when traded off with other vital programs in a resource-poor economy, and when public health ethical dilemmas of autonomy, equity, and stigma are not addressed. An example of this conundrum in India is the perception of stagnancy in the response of the prevalence of anemia to the ongoing pharmacological iron supplementation program. The reaction has been a policy proposal to further increase iron intake through mandatory iron fortification of the rice provided in supplementary feeding programs like the Integrated Child Development Services and the School Mid-Day Meal. This is in addition to the ongoing pharmacological iron supplementation as well as other voluntary iron fortifications, such as those of salt and manufactured food products. However, before supplying more, it is vital to consider why the existing program is apparently not working, along with consideration of the potential for excess intake and related harms. This is relevant globally, particularly for countries contemplating multiple interventions to address micronutrient deficiencies. Supplying more by layering multiple nutrient interventions, instead of doing it right, without thoughtful considerations of social, biological, and ethics frameworks could be counterproductive. The cure, then, might well become the malady.

Early childhood development refers to a child's development from conception till eight years of life, the first 1000 days being the most important. The WHO guideline on nurturing early childhood development encourages attention to good health, nutrition, opportunities for early childhood learning, responsive care, and security. The Indian Academy of Pediatrics (IAP) released its consensus statement on early childhood development in 2020 which highlighted the role of pediatricians to lead the community in general and parents in particular to understand how to nurture early childhood development. This article looks at the current undergraduate and postgraduate medical curricula in India to analyze how they address early childhood development. Based on identified lacuna, we have proposed suggestions for change in the current curriculum to ensure that the future doctors in general and pediatricians in particular are prepared for their intended role to promote nurturing care for early childhood development.

The electricity demand is increasing day by day and that is exhausting limited conventional energy resources rapidly. Thus, renewable energy is becoming very attractive source of electricity to meet the load and prevent the global warming threat. The challenges in integration of renewable energy sources are its intermittency and old existing power system infrastructure. Renewable energy sources collocated with energy storage facilities can mitigate the effect of renewable energy uncertainty. However, high penetration of green energy is only possible by upgrading the existing power system network. Most of the time transmission lines are under loaded from its actual power handling capacity, as worst possible power handling capacity of line is considered while scheduling power to generators. Actual power capacity of line depends on many environmental factors and changes accordingly with the weather conditions. This article elucidates the impact of weather variation on economic operation of a practical Indian 75 bus power system network placed at Uttar Pradesh, India. The simulation is carried out by accounting the proposed solar power plants in that region and the effect of dynamic line rating on renewable curtailment, thermal power fuel cost and line congestion has been studied.

Health is considered as the global challenge for human kind. According to World Health Organization (WHO), constant patient monitoring is said to be the highest standard in hospitals. The developing amount of data in healthcare industry has made predictable the big data techniques adoption in range of enhancing the healthcare delivery quality. Big data plays a significant role in medical industry by governing numerous amount of data, such that the information is maintained and gathered from various platforms. These are possible by performing big data analytics to analyse and capture every information, by resulting patient’s entire history and appropriate information at right time. Therefore, the present study reviews the dimension of big data and significance of IoE (Internet of Everything) in medical field and the application and challenges of big-data in Health care System are also reviewed. The study highlights the IoE based Big-data journey in Medical Industry.

We aimed to compare the efficacy of daily v. low dose depot oral vitamin D3 for treating nutritional rickets. We conducted a randomised controlled trial in the department of paediatrics of a tertiary care hospital catering to semi-urban and rural population in Delhi, India. We randomised sixty-six children aged 3 months to 5 years with nutritional rickets to receive either daily oral vitamin D3 drops (3–12 months: 2000 IU; > 12 months to 5 years: 4000 IU; n 33) for 12 weeks duration or a single oral depot dose of vitamin D3 granules (3–12 months: 60 000 IU; > 12 months to 5 years: 150 000 IU; n 33). Participants in both groups had comparable demographic characteristics, laboratory features and radiological severity of rickets. Thirty-three participants in each group received the assigned intervention and all were followed up till 12 weeks. At 12 weeks follow-up, children in both groups showed a significant improvement in all biochemical parameters (serum Ca, P, alkaline phosphatase (ALP), parathormone and 25(OH) vitamin D levels) as well as radiological healing. At 12 weeks, the mean serum 25(OH) vitamin D levels (nmol/l) were statistically comparable in both groups (daily: 120·2 (sd 83·2), depot: 108 (sd 74), P = 0·43) and 31 (93·9 %) children in each group had radiological healing (Thacher score < 1·5). Two children in each group persisted to have raised ALP, and one child each in the daily group continued to have hypocalcaemia and hypophosphataemia at 12 weeks. Low dose oral depot vitamin D3 is an effective alternative to daily oral vitamin D3 for nutritional rickets.