PURPOSE: Students joining medical studies may be motivated by many factors. However, there may also be some factors which may concern them. Although, it can be assumed that those joining medical studies would have largely been influenced positively, how the factors interact in different groups of students has not been studied adequately. METHODS: We conducted a questionnaire-based survey in first-year medical students. Besides the demographics and intentions about their future career plans, students rated a list of positively influencing items and a list of negatively affecting items relevant to our context that influenced their decision. We performed factor analysis followed by clustering of study participants. RESULTS: Ninety-seven students participated in the survey which comprised of 59% females with mean age of 18.6 years. The factors extracted were named as 'personal growth factor,' 'professional calling factor,' 'personal concerns factor,' and 'professional concerns factor.' Four distinct clusters of participants differing in their average ratings to each of the above factors were identified. CONCLUSION: This study provides information on the factors that influence students to join medical studies from an Indian context. The motivational patterns were varied in different sub-groups of students. The data obtained from this study may provide pointers to educators to plan training of students, changes in curricular structure that takes into account the expansion of medical education into specialties and beyond.
Career Choice ; Demography ; Education, Medical ; Female ; Humans ; India ; Intention ; Motivation ; Students, Medical

PURPOSE: Students joining medical studies may be motivated by many factors. However, there may also be some factors which may concern them. Although, it can be assumed that those joining medical studies would have largely been influenced positively, how the factors interact in different groups of students has not been studied adequately. METHODS: We conducted a questionnaire-based survey in first-year medical students. Besides the demographics and intentions about their future career plans, students rated a list of positively influencing items and a list of negatively affecting items relevant to our context that influenced their decision. We performed factor analysis followed by clustering of study participants. RESULTS: Ninety-seven students participated in the survey which comprised of 59% females with mean age of 18.6 years. The factors extracted were named as 'personal growth factor,' 'professional calling factor,' 'personal concerns factor,' and 'professional concerns factor.' Four distinct clusters of participants differing in their average ratings to each of the above factors were identified. CONCLUSION This study provides information on the factors that influence students to join medical studies from an Indian context. The motivational patterns were varied in different sub-groups of students. The data obtained from this study may provide pointers to educators to plan training of students, changes in curricular structure that takes into account the expansion of medical education into specialties and beyond.

Purpose: The study aimed to identify the motivational factors and demographic variables influencing the career preferences of medical students in India. Methods: We conducted a questionnaire-based survey at Christian Medical College, Vellore, India. The participants were 368 of the 460 medical students and interns enrolled at the institution from October 2015 to August 2016. We designed the questionnaire to collect demographic data, students’ preferences for career specialties, and the motivational factors influencing them. Then, we analyzed the influence of these factors and demographic variables on career preferences using regression analysis. Results: Of the 368 respondents, 356 (96.7%) expressed their intention to pursue a residency program after the Bachelor of Medicine and Bachelor of Surgery (MBBS) program, and about two-thirds indicated their preference to do so in India. The specialties most preferred by students were general surgery, general medicine (internal medicine), and pediatrics, while the least preferred were anatomy, obstetrics and gynecology, and community medicine. Factor analysis yielded three motivational factors, which we named ‘personal growth,’ ‘professional growth,’ and ‘personal satisfaction’ based on the items loaded in each. The motivational factors were predicted by demographic variables (gender, geographical background, current stage in the MBBS program, and the presence of relatives in the health professions). Demographic variables and the motivational factors also had significant influences on career preferences. Conclusion This study provides insights into the motivational factors that influence the career preferences of Indian medical students and interns. A robust longitudinal study would be required to study intra-individual variations in preferences and the persistence of choices.

OBJECTIVETo investigate the pharmacological effect of Nyctanthes arbortristis (NAT) leaf extract in the prevention of lung injury induced by silica particles.

METHODLung injury was induced in Swiss mice through inhalation exposure to silica particles (< 5 mu) using a Flow Past Nose Only Inhalation Chamber at the rate of -10 mg/m3 respirable mass for 5 h. Lung bronchoalveolar lavage (BAL) fluid collected between 48 and 72 h was subjected to protein profiling by electrophoresis and cytokine evaluation by solid phase sandwich ELISA. Lung histopathology was performed to evaluate lung injury.

RESULTSInhalation of silica increased the level of tumor necrosis factor-alpha (TNF-alpha), and of the 66 and 63 kDa peptides in the BAL fluid in comparison to sham-treated control. Pre-treatment of silica exposed mice with NAT leaf extract significantly prevented the accumulation of TNF-alpha in the BAL fluid, but the 66 and 63 kDa peptides remained unchanged. The extract was also effective in the prevention of silica-induced early fibrogenic reactions like congestion, edema and infiltration of nucleated cells in the interstitial alveolar spaces, and thickening of alveolar septa in mouse lung.

CONCLUSIONNAT leaf extract helps in bypassing silica induced initial lung injury in mice.

Administration, Oral ; Animals ; Bronchoalveolar Lavage Fluid ; Disease Models, Animal ; Enzyme-Linked Immunosorbent Assay ; Inhalation Exposure ; Male ; Mice ; Oleaceae ; chemistry ; Phytotherapy ; Plant Extracts ; pharmacology ; Pulmonary Fibrosis ; etiology ; prevention & control ; veterinary ; Silicon Dioxide ; adverse effects ; Silicosis ; prevention & control ; veterinary

OBJECTIVE: The hallmark of anxiety disorders is excessive fear. Previous studies have suggested that selective neural projections from Basal nucleus of stria terminalis (BNST) to amygdala and vice-versa precisely control the fear learning process. However the exact mechanism how the BNST controls fear consolidation and its extinction is largely unknown. In the present study we observed the changes in the BNST sub-regions following fear conditioning and its extinction. METHODS: The change in the number of positive neurons was determined by immunohistochemistry for Acetyl H3 (Histone 3), Acetyl H4 (Histone 4), cAMP response element binding Protein (CBP) and c-fos in three sub-regions of the BNST namely the anterio-lateral BNST (STLP) and anterio-medial BNST (STMA), and lateral-ventral BNST (STLV) of rats subjected to auditory fear conditioning and extinction. RESULTS: We found significant increase in the number of CBP, acetyl H3 and acetyl H4 positive neurons in the STMA and STLV but not in the STLP after fear conditioning. However, following fear extinction the number of CBP, acetyl H3 and acetyl H4 positive neurons increased significantly in the STLP but not in the STMA and STLV. Similar changes were observed in the number of c-fos positive neurons after fear consolidation and extinction. CONCLUSION: The results from this study suggest that the differential histone acetylation in the different sub-regions of the BNST following fear learning and its extinction may be responsible for changes in the neuronal activation patterns resulting in either fear or less fear.
Acetylation* ; Amygdala ; Animals ; Anxiety Disorders ; Cyclic AMP Response Element-Binding Protein ; Histones* ; Immunohistochemistry ; Learning ; Neurons ; Rats ; Septal Nuclei*

OBJECTIVETo study the modulation effect of pro- and anti-inflammatory cytokines following long term use of water soluble ethanol extracts from different organs of Nyctanthes arbortristis (NAT) in mouse model of arthritis.

METHODSArthritis was induced in mice by two injections of Freund's complete adjuvant on days 0 and 12 in the sub-planter surface of the right hind paw.

RESULTSInjection of adjuvant resulted in a maximum primary edema of the footpad with erythema, and edema and distortion of joints of the right hind paw after 24-48 hours. Second injection of FCA led to the formation of secondary swellings persisting more than four weeks that spread onto the other hind limb but to a lesser extent. Histological analysis of the ankle on day 47 showed marked evidence of cartilage destruction in association with pannus formation and moderate bone resorption. Proinflammatory cytokine levels in the inflamed joint homogenate were elevated on days 2, 14, and 47. Oral administration of leaf and fruit extracts in arthritic mice reduced joint homogenate levels of tumor necrosis factor-alpha, interleukin-1beta, and interleukin-6 on days 2, 14, and 47 in comparison to untreated arthritic mice. Interleukin-10 level was elevated in the inflamed joint on days 2, 14, and 47 in comparisons to untreated arthritic mice.

CONCLUSIONEvidence of lesser inflammation of the footpad and joint and associated histological observation support the therapeutic benefit of leaf and fruit extracts from Nyctanthes arbortristis. This study helps in understanding the mechanism of anti-inflammatory action of Nyctanthes arbortristis in the light of pro- and anti-inflammatory cytokine balance.

Animals ; Arthritis, Experimental ; drug therapy ; immunology ; pathology ; Cytokines ; metabolism ; Disease Models, Animal ; Female ; Mice ; Mice, Inbred BALB C ; Oleaceae ; chemistry ; Phytotherapy ; Plant Extracts ; isolation & purification ; therapeutic use

BACKGROUNDS/AIMS: Mirizzi's syndrome (MS) poses great diagnostic and management challenge to the treating physician. We presented our experience of MS cases with respect to clinical presentation, diagnostic difficulties, surgical procedures and outcome. METHODS: Prospectively maintained data of all surgically treated MS patients were analyzed. RESULTS: A total of 169 MS patients were surgically managed between 1989 and 2011. Presenting symptoms were jaundice (84%), pain (75%) and cholangitis (56%). Median symptom duration s was 8 months (range, <1 to 240 months). Preoperative diagnosis was possible only in 32% (54/169) of patients based on imaging study. Csendes Type II was the most common diagnosis (57%). Fistulization to the surrounding organs (bilio-enteric fistulization) were found in 14% of patients (24/169) during surgery. Gall bladder histopathology revealed xanthogranulomatous cholecystitis in 33% of patients (55/169). No significant difference in perioperative morbidity was found between choledochoplasty (use of gallbladder patch) (15/89, 17%) and bilio-enteric anastomosis (4/28, 14%) (p=0.748). Bile leak was more common with choledochoplasty (5/89, 5.6%) than bilio-enteric anastomosis (1/28, 3.5%), without statistical significance (p=0.669). CONCLUSIONS: Preoperative diagnosis of MS was possible in only one-third of patients in our series. Significant number of patients had associated fistulae to the surrounding organs, making the surgical procedure more complicated. Awareness of this entity is important for intraoperative diagnosis and consequently, for optimal surgical strategy and good outcome.
Bile ; Bile Duct Diseases ; Cholangitis ; Cholecystitis ; Cholestasis ; Diagnosis ; Fistula ; Gallbladder ; Humans ; Jaundice ; Mirizzi Syndrome* ; Prospective Studies ; Urinary Bladder

BACKGROUND/AIMS: This study was aimed at determining the factors associated with the development of benign biliary stricture (BBS) in patients who had sustained a bile duct injury (BDI) at cholecystectomy and developed bile leaks. METHODS: A retrospective analysis of 214 patients with BDI who were referred to our center between January 1989 and December 2009 was done. RESULTS: One hundred fifty-three (71%) patients developed BBS (group I), and 61 (29%) were normal (group II). By univariate analysis, female gender (p=0.02), open cholecystectomy as the index operation (p=0.0001), delay in the referral from identification of injury (p=0.04), persistence of an external biliary fistula (EBF) beyond 4 weeks (p=0.0001), EBF output >400 mL (p=0.01), presence of jaundice (p=0.0001), raised serum total bilirubin level (p=0.0001), raised serum alkaline phosphatase level (p=0.0001), and complete BDI (p=0.0001) were associated with the development of BBS. Furthermore, open cholecystectomy as the index operation (p=0.04), delayed referral (p=0.02), persistent EBF (p=0.03), and complete BDI (p=0.001) were found to predict patient outcome in the multivariate analysis. CONCLUSIONS: For the majority of patients with BDI, the risk of developing BBS could have been predicted at the initial presentation.
Alkaline Phosphatase ; Bile ; Bile Ducts ; Biliary Fistula ; Bilirubin ; Cholecystectomy ; Constriction, Pathologic ; Female ; Humans ; Jaundice ; Referral and Consultation ; Retrospective Studies ; Risk Factors

Marine sediment samples were collected from the coastal areas of Southern India, particularly in Kanyakumari District. Twenty-eight different fungal strains were isolated. The screening of fungi from marine sediment was done to isolate a potent fungus that can produce bioactive compounds for biomedical applications. Only three strains viz Trichoderma gamsii SP4, Talaromyces flavus SP5 and Aspergillus oryzae SP6 were screened for further studies. The intracellular bioactive compounds were extracted using solvent extraction method. The crude extracts were tested for its anti-microbial and anti-cancer properties and analytically characterized using Gas Chromatography Mass Spectrometry (GC-MS). All the three extracts were active, but the extract from T. flavus SP5 was found to be more active against various human pathogens, viz., Pseudomonas aeruginosa ATCC 27853 (17.8 ± 0.1), Escherichia coli ATCC 52922 (18.3 ± 0.3), and Candida tropicalis ATCC 750 (17.7 ± 0.4). It also exhibited cytotoxic activity against HEp2 carcinoma cell line with the LC value of 25.7 μg·L. The GC-MS data revealed the presence of effective bioactive compounds. These results revealed that the extract from isolated fungus T. flavus SP5 acted as a potent antimicrobial, antifungal, and anticancer agent, providing basic information on the potency of marine fungi towards biomedical applications; further investigation may lead to the development of novel anticancer drugs.
Anti-Bacterial Agents ; chemistry ; metabolism ; pharmacology ; Antineoplastic Agents ; chemistry ; metabolism ; pharmacology ; Bacteria ; drug effects ; Cell Line, Tumor ; Fungi ; drug effects ; Gas Chromatography-Mass Spectrometry ; Geologic Sediments ; microbiology ; Humans ; India ; Microbial Sensitivity Tests ; Talaromyces ; chemistry ; genetics ; isolation & purification ; metabolism

BACKGROUND: Helmet use reduces the risk and severity of head injury and death due to road traffic crash among motorcyclists. The protective efficacy of different types of helmets varies. Wearing firmly fastened full-face helmet termed as effective helmet use provides greatest protection. This study estimates the prevalence and factors associated with effective helmet use among motorcyclists in Mysuru, a tier II city in Southern India. METHODS: Cross-sectional road side observational study of 3499 motorcyclists (2134 motorcycle riders and 1365 pillion riders) at four traffic intersections was done followed by interview of random sample of 129 of the above riders. Effective helmet use proportion and effective helmet use per 100 person-minute of observation was calculated. Multivariate logistic regression analysis was done to identify factors associated with effective helmet use. RESULTS: Prevalence of effective helmet use was 28 per 100 riders and 19.5 per 100 person-minute of observation in traffic intersections. Prevalence rates of effective helmet use was higher among riders (34.5% vs pillion riders 18.1%), female riders (51.3% vs male riders 26.8%), and male pillion riders (30.5% vs female pillion riders 13.7%). Riders commuting for work and school and those ever stopped by the police in the past 3 months had significantly higher odds of effective helmet use. CONCLUSION Despite helmet use being compulsory by law for motorcyclists, the effective helmet use was low in Mysore. Strict enforcement and frequent checks by the police are necessary to increase the effective helmet use.
Adult ; Cities ; Craniocerebral Trauma ; prevention & control ; Cross-Sectional Studies ; Female ; Head Protective Devices ; statistics & numerical data ; Humans ; India ; Male ; Middle Aged ; Motorcycles ; statistics & numerical data ; Transportation ; Young Adult