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BACKGROUND: The National Medical Council has recognized the importance of self-directed learning (SDL) for medical graduates and it has been included as one of the competencies for Indian Medical Graduates. The present study was conducted to explore different determinants, and the factors facilitating and deterring of SDL among medical undergraduates. MATERIALS AND METHODS: This cross-sectional qualitative study was conducted with 40 phase 2 MBBS students and data were collected through focused group discussions over a period of four weeks. A content analysis approach was used in the analysis. RESULTS: The participants included 23 women (58%) and 17 men (42%). The study revealed three main themes and six sub-themes as factors deterring SDL. The majority of participants (84%) favored individual learning, while a smaller number preferred team-based learning. DISCUSSION: Cognitive factors emerged as the most common barriers, including problems with initiation and engagement in SDL and the enormous amount of data available. Educational environmental factors, such as heavy workloads and time constraints, as well as frequent assessments, were also identified as barriers. Attitudinal and mental barriers encompassed issues like lack of practical experience, difficulties in adapting to new learning environments, and challenges in concentration and focus. CONCLUSION: Overall, this study fills gaps in our understanding of factors deterring students’ engagement in SDL and provides valuable insights for educators and institutions in implementing effective SDL activities. By addressing these barriers, medical education can equip students better to become lifelong learners and meet the evolving demands of the medical profession.

Introduction: Laboratory diagnosis of Corona Virus Disease- 2019 (COVID-19) plays a major role in diagnosing and treating infection. The corner stone in strategic public health interventions and breaking the chain of transmission was diagnostic laboratory testing and case-based data. The purpose of the study was to establish quality control standards for RT-PCR testing laboratory by performing Root Cause Analysis (RCA) of invalid Internal Control (IC). Aim: The aim of the study was to estimate the percentage of invalid IC and to describe the most probable associated factors. Materials and Methods: This cross-sectional observational study was conducted at the RT-PCR laboratory in Microbiology department of Govt. Kilpauk Medical College and Hospital for a period of one month, October 2021. The nasopharyngeal and oropharyngeal swabs collected for COVID-19 testing were included in the study. A detailed check-list was prepared by the author for evaluating of invalid IC. Results: All the variables of RT-PCR test were categorised as pre-analytical, analytical and postanalytical phases and each and every component was assessed as per the protocol. Out of 23500 samples included in the study, a positive test result for COVID-19 was obtained in 164 (0.69%) and a negative result in 22533 (95.89%) patients. Around 803 (3.41%) samples included in the study showed an invalid IC. Conclusion: Current observation showed that an invalid IC could be caused by any factors starting from sample collection to reporting. Major causes for an invalid IC were due to improper extraction and sample collection.

Introduction: Dengue is a viral infection with diverse clinical manifestations. Infection in most of the patients is subclinical. It may also present as undifferentiated fever, severe dengue like Dengue Haemorrhagic Fever (DHF) and Dengue Shock Syndrome (DSS). Secondary dengue infection predisposes to severe dengue, a serious threat to the community as they increase morbidities and mortality. The diagnosis of secondary infection is either by Polymerase Chain Reaction (PCR) to detect the serotype or dengue IgG/IgM antibody ratio. A ratio of more than 1.1 is evidence of secondary dengue. Aim: To find out the prevalence of secondary dengue by measuring the dengue anti-IgG/IgM ratio by Enzyme Linked Immunosorbent Assay (ELISA) test. Materials and Methods: This cross-sectional observational study was conducted at Government Kilpauk Medical College, Chennai for a period of six months from July 2021 to December 2021. Sample size was 450 calculated at 95% confidence level, (CI 28.3-38.3) with 33.3% as prevalence. Blood samples were collected and Nonstructural Protein 1 (NS1) antigen assay was done. The IgG and IgM antibodies assays were done for NS1 antigen positive individuals. The IgG/IgM ratio was calculated in patients who were positive for both IgG and IgM. Statistical analysis was done with Statistical Package for Social Sciences (SPSS) version 20.0. Percentage, mean and standard deviation were calculated. Results: Total of 450 patients were included, out of which 194 were NS1 antigen positive, 106 were males and 88 females with the mean age 25±14.85 years. NS1 antigen was positive in 89.17%. Two-tailed Fisher’s-exact test showed a significant proportion of patients among NS1 positive were positive for both IgG and IgM. An IgG/IgM ratio of >1.1 was found in 62.04%. The association between IgG/IgM ratio of >1.1 and thrombocytopenia was significant [p-value=0.00504, Odd’s ratio (OD) =3.316]. Conclusion: Dengue IgG/IgM antibody ratio of more than 1.1 on the third day of symptom onset and the platelet count assist in the early diagnosis of secondary dengue thereby helps clinicians to initiate the appropriate treatment at the right time, reduce mortality rate and decrease the economic burden of the country.

Fish vibriosis is among the most common diseases that is caused by a bacteria belonging to the genus Vibrio (Vibrio anguillarium). It causes considerable economic loss in the commercial cultivation of Asian sea bass (Lates calcarifer). The resistance of microorganisms to antibiotics has resulted in a growing need for developing a new antibacterial therapy that is effective in aquaculture. The aim of this study is to develop neem nanoemulsion with antibacterial activity against V. anguillarium to identify a possible alternative to the commonly used antibiotics in aquaculture. Neem nanoemulsion was prepared and the effectiveness was studied both in vitro and in vivo (agar well diffusion assay and artificial infection). Injection and immersion challenge of neem nanoemulsion formulated the fish less susceptible to V. anguillarium infection. The results confirmed the potential use of neem nanoemulsion as a source of antibacterial compounds or as a healthpromoting medicine for fish culture. [ABSTRACT FROM AUTHOR]

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Attention-deficit/hyperactivity disorder (ADHD) remains one of the most prevalent mental health diagnoses identified in school-age children. Affected children show an increased risk for school failure, social difficulties, and the development of psychiatric co-morbidities. Despite the availability of evidence-based behavioral protocols for managing ADHD-related impairments, psychologists often encounter difficulties involving parents in the sustained implementation of these interventions. Cognitive-behavioral treatment aims to teach children with Attention Deficit Hyperactivity Disorder (ADHD) strategies to help them increase their self-control and problem-solving abilities, through modeling, role playing and self-instruction. Cognitive-behavioral treatment has shown mixed effectiveness regarding ADHD behaviors Cognitive-behavioral therapy (CBT) can address treatment obstacles through emphasizing psycho-education, the development of a collaborative treatment context. This article presents a case study of Jay, a 9-year-old child with ADHD. He was supplemented with child-focused CBT strategies by the psychologist and parental behavioral management training by the parent. This case study outlines a central role of CBT intervention in collaboration with the Parent in managing ADHD children. [ABSTRACT FROM AUTHOR]

Finite element mesh generators exist in the public domain, a few even based on a parametric device description. The typical mesh generator requires some man–machine interaction to define the points and boundary conditions, and does not work for non-stop optimization iterations for which we need a mesh dynamically evolving through the iterations with optimization variables as changing parameters. Such mesh generators as do exist are rare, commercial, and not easily available to researchers except at great cost and never with the code to modify them to suit individual needs. We take a regular open source mesh generator and write a script-based interface as open source to run non-stop for optimization. We then use it to create a non-destructive evaluation system for army ground vehicles’ defect characterization and use it equally for machine design. A simple scheme of averaging neighbour heights gives us a smooth geometry without having to use Bezier curves. The mesh runs on the central processing unit but finite element optimization is on the graphics processing unit for speed and practicable testing times. [ABSTRACT FROM PUBLISHER]

Background and Objective: To evaluate the association between severe generalized periodontitis and carotid intima-media thickness (CIMT) in young, otherwise systemically healthy individuals. Materials and Methods: A total of 60 systemically healthy individuals of age between 20 and 40 years were included in the study. Group I consisted of 30 individuals with healthy periodontal tissue and Group II with 30 individuals with severe generalized periodontitis. Ultrasonographic evaluation of bilateral CIMT at the level of common carotid artery was done. Results: The overall mean intima-media thickness (IMT) in Group I was 0.52 ± 0.07 mm and in Group II was 0.61 ± 0.07 mm. Bivariate analysis considering the binomial IMT (≥0.6) as outcome variable showed odd's ratio = 16 for probing depth and clinical attachment loss. The final model of stepwise logistic regression using binomial IMT (>0.6) as outcome variable showed statistical significance with clinical attachment loss suggesting that as the clinical attachment loss increases the IMT also increases. Conclusion: Severe generalized periodontitis is associated with subclinical atherosclerosis in young systemically healthy patients.

Introduction: Developing research skills and attitude to practice health research is an important area to be focused during undergraduate medical education. Aim: To assess the knowledge, attitude and perceived barriers among first year medical students to practice research skills during under graduate medical course. Materials and Methods: This survey-based cross-sectional study was conducted among 205 (male: 93, female: 112) first year medical undergraduate students of a tertiary care medical school in Chennai, Tamil Nadu, India. The questionnaire consisted of demographic data, four true or false type, three open-ended questions for knowledge, a Likert’s scale of point 1-5 to assess the perceived promoting factors and barriers to taking up research during under graduation and yes or no type questions to assess the practice of research. Analysis of data were done using SPSS version 16.0 and data is expressed in proportions. Results: The survey results showed 72% of the participants had an acceptable level of knowledge on the basic research concepts and 81% of them had a high positive attitude to practice research during different years of undergraduate medical course. The mainly perceived barriers are lack of time (79%), lack of research skills training (87%) and academic overload to acquire professional skills (50%), to take up research during under graduation. Conclusion: The study participants are with moderate awareness towards research skills and very positive to take up research during their under graduation period. The structured research skills training and effective support system will help them to overcome the barriers and motivate them to undertake research and also pursue research as a career.

BACKGROUND: Metacognition is the awareness and the capability to regulate one's own thinking process. Metacognition is critical in medical education for clinical reasoning and management. Hence, the objective of this study is to evaluate the construct validity and reliability of the Metacognitive Awareness Inventory (MAI) among first-year medical and dental students, from a private medical university in India, using confirmatory analysis and internal consistency method. MATERIALS AND METHODS: This was a cross-sectional study using convenient sampling. Fifty-two-item MAI was administered to 933 first-year medical and dental students from a private medical university in India. Exploratory factor analysis (EFA), principal component analysis, Cronbach's α, and confirmatory factor analysis with global fit indices were performed. Structural equation modeling (SEM) was performed to evaluate the relationship between the structural path and factors using AMOS version 22. RESULTS: During EFA, 12 items with 0.80). SEM for each item (observed) and factor (unobserved) illustrated the hypothesized model. CONCLUSION: The resultant 40-item model based on MAI designed by Schraw is a valid and reliable tool for assessing the metacognitive awareness of Indian students. Employing a valid and reliable tool in assessing the metacognitive awareness will help the academicians in incorporating appropriate curricular interventions.

Aim: This study was conducted to estimate the prevalence of enteric parasites in HIV patients in Chennai and to correlate with CD4 counts and diarrhoeal status. Material and Methods: Faecal specimens from 100 HIV infected individuals with CD4 < 1000/µl were screened for enteric parasites with wet mounts, modified acid-fast stain for coccidian parasites, modified trichrome stain for Microsporidia, before and after the stool concentration. Agar plate culture for Strongyloides was put up. Chi-square and ANOVA tests were used for statistical analysis. Results: Study group comprised of 38 subjects with acute diarrhoea, 30 with chronic diarrhoea (> 2 weeks) and remaining 32 without diarrhoea. Enteric parasites were detected in 33% of subjects; Isoapora belli (21) being the commonest followed by E.histolyt/Entamoeba dispar (5), Entamoeba coli (2), Cryptosporidium spp (2), Hookworms (2), Strongyloides stercoralis (2), Giardia lamblia (1) and Microsporidium spp (1). There was a significant inverse relation between CD4 counts and duration of diarrhoea. Opportunistic parasites were isolated from the subjects with wide range of CD4 counts and different diarrhoeal status but most commonly from chronic diarrhoea patients. Conclusion: The prevalence of intestinal parasitic infections in HIV patients is high in Chennai, India, especially at CD4

Background and Objectives: The emergence of methicillin resistant Staphylococcus aureus (MRSA) and extended spectrum β– lactamases (ESBLs) in neonatal intensive care unit patients is increasing. This study aims to find out the bacteriological profile in neonatal sepsis and study their antimicrobial susceptibility pattern including detection of MRSA and ESBLs. Materials and Methods: This study was conducted for a period of one and a half years from January 2010 to June 2011 in a tertiary care hospital in Chennai. A total of 182 blood samples were collected using sterile precautions. They were processed following standard laboratory protocol. Antibiogram was done using appropriate antibiotics by Kirby-Bauer disc diffusion method. Isolated Staphylococcus aureus were tested for methicillin resistance using Cefoxitin disc (30µg), ESBL was detected using combined disc method, MIC reduction and Polymerase chain reaction, metallobetalactamases using EDTA and Amp-C beta lactamases using AmpC disc test. C-reactive protein (CRP) was estimated for all the cases. Results: Out of the 182 cases, 110 (60.4%) were culture positive. Fifty five (63.9 %) of early onset sepsis cases had Gram negative bacteria (GNB) and 19 (79.1%) of late onset sepsis cases had Gram positive bacteria. Out of the total pathogens, 31 (28.1%) were Klebsiella pneumoniae and 30 (27%) were Staphylococcus aureus. 17 (56.6 %) of Staphylococcus aureus were found to be MRSA and they were 100% sensitive to Vancomycin. 33 (67.3%) of Enterobacteriaceae were ESBL producers. ESBL isolates were 100% sensitive to Imipenem. Three (6.1%) of Enterobacteriaceae were AmpC producers and 3 (27.2%) of Pseudomonas aeruginosa were MBL producers. CRP was positive in 99 (54.3%) cases, out of which 94 (94.9%) were culture positive. Conclusion: Klebsiella spp. and Staphylococcus aureus were the commonest bacteria causing neonatal sepsis in this centre. Multidrug resistance among the isolates was common. Early diagnosis and institution of specific antibiotics after studying the sensitivity pattern will help in reducing neonatal morbidity and mortality and prevent emergence of drug resistant strains.