Impact of COVID-19 Lockdown on Medical Education in India and its Scope on Distance Learning

The year 2020 was frightened with the fight against unprecedented Coronavirus Disease-19 (COVID-19) pandemic situations which impacted extreme changes in everyone’s lives. Particularly healthcare system was not ready to tackle public health emergencies on immediate declaration of COVID-19 outbreak by World Health Organization (WHO), later the lockdown situations have helped a lot to tackle the situations worldwide. Coming to the medical education in India, there are 272 government medical colleges with teaching hospitals and 260 private medical colleges including deemed universities in India, a good asset to India. Total of 76,928 of Bachelor of Medicine, Bachelor of Surgery (MBBS) students were getting admitted in to the colleges every year with an average intake of 150-250 students per college and per year. The COVID-19 pandemic has strengthened distance & e-Learning worldwide. Distance & e-Learning is defined as application of computer technology to deliver training, including technology-supported learning either online, offline, or both. This technology has also helped a lot to the medical education across the world including India.

Intake of Flavonoids and Odds of Frailty Onset in Adults in the Framingham Offspring Cohort

Polyphenols (antioxidants derived from plant-foods) could play a role in inhibition of oxidative stress and frailty reduction, yet data on the polyphenol subclass of dietary flavonoids is limited. This study sought to determine the association between dietary flavonoids and frailty onset in middle-aged and older adults. This prospective cohort study included non-frail individuals from the Framingham Offspring Cohort (FOC) with total flavonoid intake (mg/day; defined as sum flavonols, flavan-3-ols, flavonones, flavones, and anthocyanins via Harvard Food Frequency Questionnaire), frailty (via Fried phenotype), and covariate information measured at baseline (1998-2001). Follow-up frailty was evaluated in 2011-2014. Logistic regression estimated odds ratio (OR) and 95% confidence intervals (95% CI) adjusting for relevant confounders. Participants (n=1,701; 55.5% female) had a mean age of 58.4 years (SD ± 8.3). Mean flavonoid intake was 309 mg/d (SD ± 266). After 12.4 years (SD ± 0.8), 224 (13.2%) individuals exhibited frailty. In age and sex adjusted models, every 50 mg/day of higher total flavonoid intake was associated with 3% reduced odds of frailty [OR (95%CI): 0.97 (0.94-1.00), p-value: 0.05). Further adjustment for smoking, energy and protein intake, and disease indicators did not appreciably change the association, and associations became non-significant (p-value=0.12). Thus, there was no association between flavonoid intake and odds of frailty onset in adults in the FOC. This could be due to participants' higher intake of flavonoids compared to average intake of ~200 mg/d in Americans.

How Effective is Curcumin in Prevention of Cancer

The human physiology is a significant and a complex process, which is designed accordingly with multitude of functions. Phytochemicals are naturally occurring compounds found in plants, have modulating potential which is useful regarding chemoprevention. Curcumin (diferuloyl methane) is the dried ground rhizome of the perennial herb “Curcuma Longa” Linn, under the family of “Zingiberaceae”. It is readily soluble in ethanol or acetone, dimethyl sulfoxide (DMSO), glacial acetic acid, poorly soluble in water since it is lipophilic in nature. In India, the average intake of turmeric is reported to as high as 2.0-2.5 g/day (approx. up to 0.1g of curcumin) no adverse effects have been studied at the population level. Curcumin triggers multiple biological mechanisms in tumour environment at different stages. Curcumin act on different cancer types such as colorectal, prostate, pancreatic, skin, headneck squamous cell carcinoma, breast, brain and glioblastoma. Various formulations have been prepared to improve the bioavailability and solubility of curcumin which includes nanoparticles, liposomes, phospholipid complexes, structural analogs, cyclodextrins, nanogels, solid dispersions etc.,

A comparison of grass silages harvested at first, second and third cut on feed intake and milk production of dairy cows

The objective of this study was to compare the milk production potential of first, second and third harvest of grass silage from the same sward in Northern latitudes. Three change-over design dairy cow feeding experiments were conducted during different years which differed markedly in weather conditions. The silages were supplemented with a cereal based The objective of this study was to compare the milk production potential of subsequent first, second and third cuts of grass silage from the same sward in Northern latitudes. Three change-over design dairy cow feeding experiments were conducted during different years which differed markedly in weather conditions. The silages were supplemented with a cereal based concentrate (average concentrate proportion 431 g kg-1 diet dry matter). Feed intake and milk production was highest with first-cut and lowest with third-cut silage. The energy corrected milk yields averaged over three experiments were 35.0, 33.2 and 31.9 kg d-1 for first, second and third harvest silages, respectively. Respective dry matter intakes were 23.1, 21.9 and 20.7 kg d-1. Compared to analysed feed values, the average intake of third-cut silages was lower than expected. Due to the high risk of low intake potential of third-cut silages, they are not recommended for cows in early lactation if there are other silages available.

Estimated average calcium – magnesium content in day meal in a sample of students from Faculty of Medicine of Sarajevo University

Nutrients are chemical substances obtained from food. They have different roles in body. Some are used as energy source, some as structural materials, and regulating agents. Nutrients may reduce the risks of some diseases. There are some recommendations about dietary intake of these nutrients for optimal health. This study aimed to estimate average calcium and magnesium content in day meal in a sample of students from Faculty of Medicine of Sarajevo University. A cross-sectional study was conducted during academic 2015/16 year at Faculty of Medicine of Sarajevo University. The survey covered 44 students. The research instrument was a self-administered questionnaire, by which 3-Day Diet Record was provided. The average intakes of calcium and magnesium were estimated using Nutritional analysis computer program (Nutrics Professional Nutrition Analysis Software). On daily level average intake of calcium was 718.39±311.14 mg in total sample and average intake of magnesium was 292.57±310.10 mg in total sample. Average Ca/Mg ratio was 2.45. In our sample cheese was top source of calcium with Ca/Mg ratio of 32.5, and bread was top source of magnesium with Ca/Mg ratio of 3.1. These results emphasize the importance of monitoring the food nutrition facts in order to achieve adequate nutrients intake.

Longitudinal Study Depicting Differences in Complementary Feeding and Anthropometric Parameters in Late Preterm Infants up to 2 Years of Age

Ensuring the nutritional demands of preterm (PT) infants during complementary feeding could contribute significantly to the infants’ long-term health and development. However, the dietary guidelines for complementary feeding in PT are scarce. Thus, describing dietary intake and identifying nutritional targets for these infants could be of great interest. The aim of this study is to assess the food intake and anthropometric parameters in a Mediterranean infant cohort from 6 to 24 months and to identify nutritional targets especially focused on late preterm infants. This is a longitudinal prospective study analyzing information from administered questionnaires about general characteristics and food frequency consumption in 115 infants (20 PT (32 to 36 gestational weeks), 95 full-term (FT)) at 6, 12 and 24 months of age. Results show that the differences in the prevalence of underweight observed in PT infants vs. FT infants are maintained for up to 6 months of age but disappear at 12 and 24 months. The age of inclusion of new foods and the average intake of the main food groups was not different from that of FTs. Although protein intake at 6 months was directly correlated with weight gain and growth in FT, these associations were not observed in PT. At the nutritional level, the low intake of vitamin D in preterm infants is noteworthy. These findings may be useful when designing new intervention strategies for this population group.

Energy and protein intake in medical and geriatric inpatients with MEDPass versus conventional administration of oral nutritional supplements: study protocol for the randomized controlled MEDPass Trial

Background Disease-related malnutrition is highly prevalent in hospitalized medical and geriatric inpatients. It is associated with negative outcomes such as muscle wasting, decline of functional status, and increased morbidity and mortality. Oral nutritional supplements (ONS) are frequently used in nutritional therapy to increase intake. However, compliance to ONS is often limited and maybe improved by prescribing ONS in small portions timed with the medication (MEDPass). However, it is unknown whether the MEDPass administration enhances patients’ total energy and protein intake. Methods The MEDPass Trial is a randomized, controlled, open-label superiority trial. Patients in the MEDPass group receive 50 ml of ONS four times per day, distributed with the medication rounds. Patients in the control group receive ONS between meals. The primary outcome is average daily energy intake (% of calculated daily requirement). For our power analysis, we assumed that administration of ONS in the MEDPass administration mode increases energy intake by at least 10% (i.e., by 200 kcal for an average energy requirement of 2200 kcal/day). Thus, with the inclusion of 200 patients, this trial has 80% power to demonstrate that intervention group patients have an average intake of 2200 kcal/day (SD 500 kcal) versus 2000 kcal/day (SD 500 kcal) in control group patients. Energy and protein intakes from ONS and all food consumed are monitored continuously throughout the hospital stay and are statistically compared to the patient’s requirements. Secondary outcomes include average daily protein intake (% of calculated daily requirement), average intake of ONS/day, the course of body weight, handgrip strength, appetite, and nausea. Furthermore, hospital length of stay and 30-day mortality are assessed. The primary statistical analysis will be performed as an intention-to-treat analysis adjusted for the stratification factors used in randomization. Discussion To our knowledge, this is the first randomized controlled trial assessing total energy and protein intake for the entire hospitalization period in patients receiving MEDPass versus conventional ONS administration. Thus, the MEDPass Trial will fill a gap and answer this relevant clinical question. Trial registration ClinicalTrials.gov NCT03761680. Registered on 3 December 2018. Kofam.ch SNCTP000003191. Registered on 15 October 2018

POLA KONSUMSI DAN SANITASI LINGKUNGAN BALITA STUNTING DI POLEWALI MANDAR

This study aims to analyze the pattern of consumption and environmental sanitation in stunting children in the Wonomulyo Polewali Mandar district. Method The study design used was analytic observational. The total sample was 101 toddlers aged 6-36 months, using simple random sampling method. The determination of nutritional status was processed using the WHO AntroPlus 2010 including the Semi Quantitative Food Frequency Questionnaire and an environmental sanitation questionnaire. Results: The frequency of frequent consumption of carbohydrates 79.21%, the frequency of animal protein (48.52%), vegetable protein (41.58%), fruit (46.58%), and beverages (43.6%). ), snacks (47.52%), and rare frequency of vegetables (44.54%). The average intake of energy (773.87 kcal), protein (18.19 gr), calcium (471.61 mg), and iron (8.15 mg). There was no significant relationship with the adequacy of nutrients for energy (p = 0.422), protein (p = 0.428), calcium (p = 0.075) and iron parameters had a significant relationship (p = 0.049). The results of environmental quality measurement obtained data on toddlers with short and very short nutritional status in the healthy environmental sanitation category as much as 18 (17.8%) and toddlers with short and very short nutritional status in the category of unhealthy environmental sanitation by 83 (82.2%). So that the results of the sig value test (2-sided) of 0.951> 0.05, it can be concluded that there is no relationship between nutritional status and unhealthy sanitary conditions. Conclusion: Iron adequacy is related to stunting status, while environmental sanitation quality is not related to stunting status.

The Ingestion and Perspective of Magnesium Consumption by Medicine Students: An Observational Brazilian Study

Magnesium is an important nutrient for the organism present in several enzymatic reactions. The reduced daily intake of this mineral (below 310 to 320 mg, for women, and 400 to 420 mg, for men) is associated with several chronic diseases. Thus, based on the hypothesis that medical students have a deficient intake of the mineral, this study sought to examine the intake of macronutrients by medical students at a college in the northwest of São Paulo and their thinking about the importance of the presence of the mineral of the diet. This research is a cross-sectional quali-quantitative study. The data used were obtained through a virtual questionnaire that contained several questions to identify gender, the notion of the importance of correct magnesium intake and the frequency of food consumption. The questionnaire was made available to academics between July and August 2020. The responses to the questionnaire were validated only after acceptance of the informed consent form. Thus, 147 responses were validated, with 92 responses from women and 55 from men. Then, from the amounts of magnesium present in food and the minimum and maximum frequencies of magnesium intake by students, the minimum (male 133.2 mg and female 128.5 mg) and maximum (male 232, 8 and female 229.5) of the daily magnesium intake by the students analyzed and their respective standard deviations, using these data, the Figure of the normal distribution for each type of daily average intake was plotted. Also, an opinion was obtained about the importance of magnesium intake on a scale of 1 to 5 (1 being irrelevant and 5 essential) and, from these data, it was observed that those who considered magnesium intake to be irrelevant (3 responses) presented a minimum and a maximum average (57.03 mg / day and 149.4 mg/day, respectively) of daily mineral intake below the 64 that considered it essential (140.06 mg/day and 238 mg / day) day, respectively). Finally, it is noted that the consumption of both sexes of the interviewees is close and both the maximum mean daily magnesium intake resides below the recommended amounts for daily consumption - mainly individuals of the sex but culino, who have a recommended intake value higher daily dose (400 to 420 mg/day) than females (300 to 310 mg). Thus, this data supports the initial hypothesis of the existence of a deficient daily consumption of magnesium by medical students, also, it can be related to a lower importance attributed to the presence of magnesium in the diet to a lower average daily intake.

Bone mineral density and nourishment

Some diet pattern is connected with higher risk of obesity and deficit of different nutrients. Both can contribute to complications of chronic disease like osteoporosis. The primary objective of this study was to analyze the correlation between bone mineral density and body mass, i.e. nutrients intake. The cross-sectional study included 25 patients who had regular osteodensitometrycal checkup. Patients anthropometrics' characteristics were collected by interview. Dietary pattern was estimated through food-frequency questionnaire and average meal was made. Nutritional analysis computer program (Nutrics Professional Nutrition Analysis Software) was used to analyze the average intake of nutrients from the food intake data. The average T score of hip was at level of osteopenia (-1.7), and BMI was 25.80 kg/m2. By comparing the results using Pearson coefficient, we found positive linear trend and statistical significance at p <0.05. The average T score of lumbar spine was at level of osteoporosis (-2,19), and average intake of calcium was 1519 mg. By comparing the results using Pearson coefficient, we found negative linear trend and statistical significance at p <0.05. These data indicate that BMI and nutrients intake are connected with the risk for osteoporosis. There is the need for osteoporosis prevention strategies based on nutrition recommendations.