Publications

INTRODUCTION: Problem-based learning (PBL) is a student-centered learning approach in which students learn through analyzing and solving problems.

JUSTIFICATION: Traditional teaching program is in the form of a dictated lecture and is teacher-centered. A larger number of topics can be covered without active student participation. In PBL, which promotes deep learning, students learn to justify their knowledge with the help of cognitive skills and complex thinking.

METHODS: This retrospective study was done after obtaining Institutional Human Ethics Committee (IHEC) approval. Data collected from three internal assessment examinations (IAEs) written between the period of January 2017 and August 2017 by 151 students pursuing second-year MBBS training in the Department of Pharmacology. Examination papers for second-year MBBS students contain questions such as short notes, ultrashort, and PBL.

RESULTS: Wilcoxon Mann-Whitney test analysis of IAE-1 with IAE-2 and IAE-1 with IAE-3 in SPSS software gave p-value-0.393 and 0.020, respectively. Using analysis of variance (ANOVA), IAE-2 with PBL and IAE-3 with PBL showed p-value 0.001, which was statistically significant. There was an increase in the pass percentage [number of students who scored 40 and above in IAE-3 (with PBL) when compared to IAE-1 (without PBL)].

CONCLUSION: This audit showed definite knowledge improvement by the students using PBL as a tool along with a traditional teaching program.

INTRODUCTION: Gestational diabetes mellitus (GDM) is hyperglycemia diagnosed for the first time during the second or third trimester of pregnancy. It often leads to neonatal complications. Effective management of GDM is crucial to mitigate such risks. This study evaluates the effectiveness of ambulatory glucose profile (AGP) vs self-monitoring of blood glucose (SMBG) in managing GDM.

METHODS: This 18-month observational study was conducted at All India Institute of Medical Sciences, Raipur, India, involving 65 pregnant women diagnosed with GDM. Thirty-two patients wore the flash glucose monitoring system (AGP group) and 33 performed SMBG (SMBG group). Blood glucose levels were monitored using AGP and SMBG, with data collected on fasting, postprandial glucose levels, and hypoglycemic events till 15 days after enrollment. Statistical analysis was performed using IBM Statistical Package for the Social Sciences (SPSS) version 21.

RESULTS: The AGP group showed significant reductions in blood glucose levels across all measured times. Mean blood glucose concentrations decreased significantly in both groups from enrollment till 15 days, with no significant intergroup differences. The AGP group had a higher mean time in range (92 vs 90%) and lower time above range (4 vs 6%) compared to the SMBG group. Hypoglycemic events were fewer in the AGP group.

CONCLUSION: AGP demonstrated superior effectiveness in managing GDM by providing continuous glucose monitoring, improving glycemic control, and reducing hypoglycemic events compared to SMBG. AGP is recommended for better glucose management in GDM patients.

INTRODUCTION: Healthy habits such as regular physical activity, a balanced diet and tobacco abstinence are associated with better health-related quality of life (HRQoL) in cancer survivors. However, there is limited evidence on this relationship in Latin American countries, where socioeconomic and cultural factors may influence adherence to healthy behaviours.

OBJECTIVES: To evaluate the relationship between adherence to healthy lifestyle recommendations and HRQoL in cancer survivors in Uruguay.

MATERIALS AND METHODS: A cross-sectional study was conducted with 241 early-stage cancer survivors treated at two hospitals in Uruguay. Adherence to healthy habits was assessed using a questionnaire based on the American Cancer Society recommendations. HRQoL was measured using the RAND-36 questionnaire. Categorical variables were analysed using the chi-square test, while continuous variables were analysed using Student's t-test or the Mann-Whitney test. The correlation between SF-36 dimensions and healthy habits was assessed using Spearman's coefficient.

RESULTS: The median age was 66.7 years and 55.2% were women. The most common cancers were breast (31.1%), colorectal (28.2%) and prostate (26.6%). A total of 62.7% of participants adhered to three or more healthy habits. Adherent patients showed significantly higher HRQoL scores, particularly in physical function (62.68 versus 45.67, p < 0.001), energy/fatigue (64.83 versus 45.89, p < 0.001) and emotional well-being (69.43 versus 53.02, p < 0.001). Adherence to multiple healthy habits was significantly correlated with improvements in physical and mental domains, with energy/fatigue showing the strongest correlation (rs = 0.66, p < 0.001).

CONCLUSION: Adherence to healthy habits has a cumulative positive impact on the HRQoL of cancer survivors. This study highlights the need to design comprehensive interventions to promote healthy behaviours in this population, contributing to the global evidence on cancer care and underscoring its importance in developing countries.

Merkel cell carcinoma (MCC) is a rare and aggressive tumour of the skin, characterised by a high rate of local recurrence and lymph node involvement. We present the case of a 58-year-old woman who developed a 5-cm tumour on the right lower eyelid, leading to ocular occlusion. Magnetic resonance imaging revealed an exophytic lesion in the right orbit, and a biopsy confirmed the diagnosis of MCC. After complete surgical resection and cervical emptying, the patient was treated with adjuvant radiotherapy. The final diagnosis was MCC, stage pT3 pN1 M0. The periocular location and tumour size were determinants in the treatment decision.

Amidst the global disparities in providing Paediatric Palliative Care (PPC), the compounded realities in the Eastern Mediterranean region intensify the need for palliative care for children with cancer. This region hosts 12% of children needing PPC worldwide within limited specialised services, training and resources exacerbated by political instabilities. Immediate effective responses may reside in promoting interdisciplinary capacity-building combined with action planning among healthcare professionals, stakeholders and advocates for patients and their families. In response to these pressing needs, the First Regional Interdisciplinary PPC Workshop was held in-person in Rabat, Morocco on 6-8 November 2024, aiming to strengthen regional interdisciplinary healthcare professionals' capacity through training and collaborative action planning to improve PPC integration in cancer treatment. Eighty-five attendees representing 15 countries including regional healthcare professionals, international experts, foundation representatives and policymakers united in the commitment to promote PPC integration and enhance the quality of life for children with palliative care needs, particularly those with cancer living in this region. Over 3 days, participants engaged in training, discussions and action planning. Day one provided essential skills to deliver PPC at the patient care level (micro-level), day two discussed institutional implementation of PPC services (meso-level), day three tackled national and regional endeavours to promote PPC integration (macro-level). At the conclusion of the workshop, participants gained knowledge and confidence in various PPC skills. They shared their plans to establish PPC teams/units, apply symptom management and communication skills, train colleagues within their settings, conduct research and maintain networking to encourage collaboration opportunities. The workshop marked a pivotal step to deepen understanding of the PPC landscape and resources in the region. This impactful experience laid the foundations for different opportunities in practice, research, policy and advocacy to accelerate PPC integration in the Eastern Mediterranean region, fostering collective efforts to improve childhood cancer care globally.