Effects of targeted remediation in anatomy for first year medical students

Nachiket Shankar,Nachiket Shankar,Yogitha Ravindranath,Roopa Ravindranath,Henal Shah 대한해부학회 2019 Anatomy & Cell Biology Vol.52 No.1

The aim of this study was to assess the effectiveness of a questionnaire to guide targeted remediation among undergraduate medical students in anatomy. Seventy-five students from a medical college in South India who failed in the first internal theory examination were administered a validated 35-item questionnaire. The total and domain specific questionnaire scores were calculated. Specific weekly interventions for each student based on the questionnaire scores were conducted by appointed academic mentors for three months prior to the second internal examination. The dependent variable was performance in the second internal examination. The students were re-administered the questionnaire after the second internal examination. The independent variables were the marks obtained in the first internal examination, domain specific and total questionnaire scores, sex, and regularity of the student in attending the remedial sessions. Inferential statistical tests used were the chi-square test, independent sample t test, paired t test, multiple regression and binomial logistic regression. Of the 75 students who underwent remediation, 54 (72%) passed in the second internal examination. The scores in the second internal examination among these students was found to be significantly higher as compared to the first internal examination. The total, subject related and study skills questionnaire score were significantly lower after remediation. Students who were irregular had a significantly lower pass rate. The multivariate analysis showed that only the first internal marks added significantly to the prediction about second internal performance. This study provides evidence to show that struggling students perceive a benefit from targeted remediation.

Incorporation of zinc oxide nanoparticles improved the mechanical, water vapor barrier, UV-light barrier, and antibacterial properties of PLA-based nanocomposite films

Shankar, Shiv,Wang, Long-Feng,Rhim, Jong-Whan Elsevier 2018 Materials science & engineering. C, Materials for Vol.93 No.-

<P><B>Abstract</B></P> <P>Zinc oxide nanoparticles (ZnO NPs) were synthesized using zinc chloride and NaOH and they were incorporated to prepare PLA/ZnO NPs composite films. The SEM images showed that the ZnO NPs were cubical in shape with size ranged from 50 to 100 nm, and the PLA/ZnO NPs composite films were smooth and compact. The composite films exhibited strong UV-light barrier property with a slight decrease in the transparency. The thickness, tensile strength, and water vapor barrier property of the films increased significantly after incorporation of ZnO NPs. The TS of PLA films increased by 37.5%, but the WVP decreased by 30.5% from 3.11 × 10<SUP>−11</SUP> to 2.16 × 10<SUP>−11</SUP> g m/m<SUP>2</SUP>·Pa·s when 0.5 wt% of ZnO NPs was incorporated. The composite films exhibited potent antibacterial activity against food-borne pathogenic bacteria, <I>Escherichia coli</I> and <I>Listeria monocytogenes.</I> The developed films were applied to the packaging of a minced fish paste and showed strong antibacterial function. The prepared composite films could be used as antibacterial and UV-light barrier films for food packaging and biomedical applications.</P> <P><B>Highlights</B></P> <P> <UL> <LI> ZnO NPs were prepared using zinc chloride and NaOH. </LI> <LI> PLA/ZnO NPs composite films were prepared by a solvent casting method. </LI> <LI> PLA/ZnO NPs composite films exhibited strong antibacterial activity. </LI> <LI> PLA/ZnO NPs packaging increased the shelf-life of minced fish cake. </LI> </UL> </P> <P><B>Graphical abstract</B></P> <P>[DISPLAY OMISSION]</P>

Role of the Surgical Glove in Modified Vacuum-Assisted Wound Healing

Shankar Ram Hemmanur,Loka Vijayan Siddha 대한성형외과학회 2013 Archives of Plastic Surgery Vol.40 No.5

Vacuum-assisted wound healing has been proven to be more efficacious than conventional dressings. Vacuum dressing has been frequently modified given the restrictions in resources available. Here we present a modified method of vacuum dressing by using surgical or gynaecological gloves for lower and upper limb wounds. Vacuum dressing was applied with parts of a surgical or gynaecological glove and Opsite with T-tailing of the suction outlet. Vacuum-assisted wound healing using the surgical gloves showed relatively good wound healing in the amputation stump, finger, arm, and leg in the cases studied.

Prevention of Chemotherapy-Induced Nausea and Vomiting in Cancer Patients

Shankar, Abhishek,Roy, Shubham,Malik, Abhidha,Julka, PK,Rath, GK Asian Pacific Journal of Cancer Prevention 2015 Asian Pacific journal of cancer prevention Vol.16 No.15

The supportive care of patients receiving antineoplastic treatment has dramatically improved over the past few years and development of effective measures to prevent nausea and vomiting after chemotherapy serves as one of the most important examples of this progress. A patient who starts cancer treatment with chemotherapy lists chemotherapy-induced nausea and vomiting as among their greatest fears. Inadequately controlled emesis impairs functional activity and quality of life, increases the use of health care resources, and may occasionally compromise adherence to treatment. New insights into the pathophysiology of chemotherapy-induced nausea and vomiting, a better understanding of the risk factors for these effects, and the availability of new antiemetic agents have all contributed to substantial improvements in emetic control. This review focuses on current understanding of chemotherapy-induced nausea and vomiting and the status of pharmacological interventions for their prevention and treatment.

Equations for Cervical Lordosis and T1 Slope in Young Adults Without Any Neck Symptoms: An Analysis of 171 Radiographs

Shankar Acharya,Varun Khanna,Manoj Kumar 대한척추외과학회 2022 대한척추외과학회지 Vol.29 No.4

Study Design: Cross-sectional, record-based. Objectives: To analyze the cervical sagittal (CS) and thoracic inlet (TI) parameters in asymptomatic adults and form predictive equations for cervical lordosis (CL) and T1 slope (T1S). Summary of Literature Review: Normative values of CS parameters, including physiological CL, and their relationship with TI parameters among healthy Indian adults have been scarcely documented in the literature. Methodology: We analyzed cervical radiographs of 171 healthy adult volunteers and estimated normative values of CS and TI parameters. The thoracic inlet angle (TIA), neck tilt (NT) and T1S were the TI parameters, while the cervical parameters included C2- C7 CL (Cobb’s method), the cervical sagittal vertical axis (cSVA), and C7 slope (C7S). T1S-CL was also calculated. The correlations were estimated and predictive equations were established using simple linear and stepwise multiple regression. The paired-sample t-test was used to evaluate the statistical significance of differences between the estimated and measured values. Results: The mean age of participants was 30±7.76 years. The mean TIA, T1S, NT, CL, cSVA, C7S, and T1S-CL were 79.6°±9.08°, 29.5°±8.6°, 49.3°±8.7°, 21.4°±16.5°,18.8±12.4 mm, 25.7°±7.9°, 8.7°±13.8° respectively. We established the following predictive equations: CL= 0.66 T1S+0.57 TIA - 0.68 SVA - 30.9 (r=0.72; R2 =0.53; p<0.01); CL=0.68 TIA - 30.4 (r=0.41, R2 =0.34; p=0.04) and T1S= 4.45+ 0.72 C7S (r=0.77; R2 =0.62; p<0.01). There was no statistically significant difference between the predicted and the measured values of CL (t=0.09, p=0.973) or T1S (t=0.14; p=0.84). Conclusions: This analysis of sagittal parameters in an asymptomatic adult population provides valuable reference points for the management of various cervical alignment disorders.

Change in Trend in Various Clinico-Pathological Factors and Treatment Profile of Breast Cancer Patients: a Tertiary Cancer Centre Experience

Shankar, Abhishek,Roy, Shubham,Rath, GK,Kamal, Vineet Kumar,Bhandari, Menal,Kulshrestha, Rashi,Prasad, Neelam,Sachdev, Jaineet,Jeyaraj, Pamela Asian Pacific Journal of Cancer Prevention 2016 Asian Pacific journal of cancer prevention Vol.17 No.8

Background: Breast cancer is by far the most frequent cancer of women (23% of all cancers), ranking second overall when both sexes are considered together. Since there has been change in clinico-pathological factors and treatment profiles for breast cancer patients over the years, the present study to evaluate the change trends in India. Materials and Methods: A detailed analysis was carried out with respect to age, menopausal status, family history, disease stage, surgery performed, histopathology, hormone receptor status, and use of chemotherapy or hormonal therapy. Change in various clinico-pathological factors and treatments of breast cancer cases was recorded and analysed. Results: Mean age at presentation was found to be earlier in 2005-2006 compared with 1997-98 (p value: 0.046). More premenopausal women were diagnosed with breast cancer in 2005-2006 when this was compared with initial years of assessment (p value ${\leq}0.001$). When change in the receptor status was evaluated, we observed that there was a decrease in cases of ER and PR receptor positivity which was significant (p value: 0.007). Over the period of time, more f patients were not offered surgery initially in view of advanced disease when the two time periods were compared (p value: ${\leq}0.001$). There was a significant increase in patients who were initially offered neo-adjuvant chemotherapy in view of advanced disease at presentation (p value: ${\leq}0.001$). There was increasing number of patients who received palliative treatment for symptoms in 2005-2006 when compared to patients treated in 1997-98((p value: ${\leq}0.001$). Conclusions: Changes in mean age at presentation, premenopausal status, and stage at presentation have occurred over the years. More aggressive patterns of disease have become more common with early age at presentation and aggressive biological behaviour with receptor negative tumours.

Alginate-based nanocomposite films reinforced with halloysite nanotubes functionalized by alkali treatment and zinc oxide nanoparticles

Shankar, Shiv,Kasapis, Stefan,Rhim, Jong-Whan Elsevier 2018 International journal of biological macromolecules Vol.118 No.2

<P><B>Abstract</B></P> <P>Functionalized halloysite nanotubes were prepared by surface activation of halloysite (Hal) with sodium hydroxide and deposition of zinc oxide nanoparticles (ZnONP). The surface charge of Hal was changed from 0.18 ± 0.6 mV to −35.2 ± 2.8 mV after alkali treatment. The functionalized Hal (AT-Hal/ZnONP) was incorporated into alginate biopolymer as a reinforcing filler with different concentration of AT-Hal/ZnONP (1, 3, 5, and 7 wt% of alginate). Alginate films with AT-Hal/ZnONP exhibited a significant increase in the mechanical, water vapor barrier, and UV light barrier properties. The thermal stability of composite films has not changed after AT-Hal/ZnONP incorporation. The AT-Hal/ZnONP incorporated alginate films demonstrated strong antibacterial activity against food-borne pathogenic bacteria, <I>Escherichia coli</I> and <I>Listeria monocytogenes</I>. The nanocomposite film with 7 wt% of AT-Hal/ZnONP exhibited complete sterilization of <I>E. coli</I> and <I>L. monocytogenes</I> after 3 and 9 h of treatment, respectively.</P> <P><B>Highlights</B></P> <P> <UL> <LI> Halloysite (Hal) was activated with sodium hydroxide. </LI> <LI> Zinc oxide nanoparticles (ZnONP) were deposited on the alkali treated halloysite (AT-Hal). </LI> <LI> At-Hal/ZnONP was incorporated to form alginate-based nanocomposite films. </LI> <LI> The nanocomposite films increased mechanical, water vapor barrier, and UV light barrier properties. </LI> <LI> The nanocomposite films exhibited strong antibacterial activity. </LI> </UL> </P> <P><B>Graphical abstract</B></P> <P>[DISPLAY OMISSION]</P>

Protein Modifications in Isolated Heavy Metal Resistant Microorganisms from the Contaminated Environment

Shankar Congeevaram,Sridevi Dhanarani,Joon Hong Park,Michael Dexilin,Kaliannan Thamaraiselvi 대한환경공학회 2007 대한환경공학회 학술발표논문집 Vol.2007 No.12

Analysis of pile-up/sink-in during spherical indentation for various strain hardening levels

Shankar, S.,Loganathan, P.,Mertens, A. Johnney Techno-Press 2015 Structural Engineering and Mechanics, An Int'l Jou Vol.53 No.3

The measurement from the indentation process depends on the amount of pile-up or sink-in around the contact impressions. In this paper, finite element concept is utilized to study the pile-up and sink-in behaviour for the wide range of materials with different young's modulus, yield stresses, strain-hardening exponents and coefficient of friction values. The exact indentation model is created by using the two dimensional axisymmetrical model for simulating the spherical indentation process on the lines of Taljat and Pharr (2004) work. The result shows that during spherical indentation process the amount of pile-up is greatly influenced by the strain hardening exponents in addition to other material properties and depth of penetration. The numerical results from the finite element analysis are also validated using the exact multilinear material properties obtained from the tensile testing for the materials like mild steel, brass and aluminium.

Faculty perceptions regarding an individually tailored, flexible length, outcomes-based curriculum for undergraduate medical students

Shankar Pathiyil Ravi,Azhar Tayyaba,Nadarajah Vishna Devi,Er Hui Meng,Arooj Mahwish,Wilson Ian G. 한국의학교육학회 2023 Korean journal of medical education Vol.35 No.3

Purpose: The perception of faculty members about an individually tailored, flexible-length, outcomes-based curriculum for undergraduate medical students was studied. Their opinion about the advantages, disadvantages, and challenges was also noted. This study was done to help educational institutions identify academic and social support and resources required to ensure that graduate competencies are not compromised by a flexible education pathway.Methods: The study was done at the International Medical University, Malaysia, and the University of Lahore, Pakistan. Semi-structured interviews were conducted from 1st August 2021 to 17th March 2022. Demographic information was noted. Themes were identified, and a summary of the information under each theme was created.Results: A total of 24 (14 from Malaysia and 10 from Pakistan) faculty participated. Most agreed that undergraduate medical students can progress (at a differential rate) if they attain the required competencies. Among the major advantages mentioned were that students may graduate faster, learn at a pace comfortable to them, and develop an individualized learning pathway. Several logistical challenges must be overcome. Providing assessments on demand will be difficult. Significant regulatory hurdles were anticipated. Artificial intelligence (AI) can play an important role in creating an individualized learning pathway and supporting time-independent progression. The course may be (slightly) cheaper than a traditional one.Conclusion: This study provides a foundation to further develop and strengthen flexible-length competency-based medical education modules. Further studies are required among educators at other medical schools and in other countries. Online learning and AI will play an important role.