BACKGROUND: The Achutha Menon Centre Diabetes Risk Score (AMCDRS), which was developed in rural Kerala State, South India, had not previously been externally validated. We examined the performance of the AMCDRS in urban and rural areas in the district of Vellore in the South Indian state of Tamil Nadu, and compared it with other diabetes risk scores developed from India. METHODS: We used the data from 4,896 participants (30 to 64 years) of a cross-sectional study conducted in Vellore (2010 to 2012), to calculate the AMCDRS scores using age, family history, and waist circumference. Sensitivity, specificity, positive predictive value (PPV), and negative predictive values (NPV), and the area under the receiver operating characteristic curve (AROC) were calculated for undiagnosed and total diabetes. RESULTS: Of the 4,896 individuals surveyed, 274 (5.6%) had undiagnosed diabetes and 759 (15.5%) had total diabetes. The AMCDRS, with an optimum cut-point of ≥4, identified 45.0% for further testing with 59.5% sensitivity, 60.5% specificity, 9.1% PPV, 95.8% NPV, and an AROC of 0.639 (95% confidence interval [CI], 0.608 to 0.670) for undiagnosed diabetes. The corresponding figures for total diabetes were 75.1%, 60.5%, 25.9%, 93.0%, and 0.731 (95% CI, 0.713 to 0.750), respectively. The AROC for the AMCDRS was not significantly different from that of the Indian Diabetes Risk Score, the Ramachandran or the Chaturvedi risk scores for total diabetes, but was significantly lower than the AROC of the Chaturvedi score for undiagnosed diabetes. CONCLUSION: The AMCDRS is a simple diabetes risk score that can be used to screen for undiagnosed and total diabetes in low-resource primary care settings in India. However, it probably requires recalibration to improve its performance for undiagnosed diabetes.
Cross-Sectional Studies ; Humans ; India* ; Primary Health Care ; ROC Curve ; Sensitivity and Specificity ; Waist Circumference

INTRODUCTION: Administration of parenteral medications may cause pain in infants. This study aimed to assess the efficacy of a nursery rhyme in increasing the comfort of infants after vaccination. METHODS: Infants who were brought to six barangay health centers for vaccination were recruited. Infants from three barangay health centers were randomly assigned to the experimental group, while infants from the other three were assigned to the control group. A Filipino nursery rhyme Tatlong Bibe was played to the experimental group. The comfort of each infant was then assessed by a pediatrician prior to, immediately after, and two minutes post-vaccination using the COMFORTB scale. Results were analyzed using independent t-tests. RESULTS: Prior to vaccination, the control and experimental groups had mean COMFORT-B scores of 12.46 and 12.74 (p = 0.634), respectively. The immediate post-vaccination mean COMFORT-B scores were 22.14 and 21.63 (p = 0.420), while the 2 minutes post-vaccination mean COMFORT-B scores were 16.40 and 16.49 (p = 0.927), respectively. There were no significant differences between groups for the three determinations. CONCLUSION Based on the study results, the nursery rhyme had no significant effect on the comfort of infants after vaccination.

Background and Objective: The COVID 19 pandemic has changed the way the human anatomy is taught. A necessary shift towards online instruction, combined with a decrease in cadaver donation has resulted in the need for maximizing formalinized, soft-embalmed, computerized, and plastinated cadaver specimens. Task-oriented activities allow students to demonstrate acquired knowledge and skills. It is the aim of this study to get the perspective of students in the utilization of available laboratory materials. Methods: One hundred forty-three students participated in task-oriented activities. Students demonstrated anatomy of the facial nerve, recurrent laryngeal nerve, and phrenic nerve by parotidectomy, thyroidectomy, and posterior neck dissection using formalinized cadaver and VH dissector™. Deep neck and sagittal structures in the plastinated specimen were identified using laser pointers. Ossicular mobility of the middle ear, and endoscopy of the nose and larynx were demonstrated using the soft embalmed cadaver. Students were surveyed on their perceptions on the utility of each cadaver specimen. Results: Formalinized and soft-embalmed cadaver were observed to present the most accurate anatomy, while the virtual dissector and plastinated specimens were seen to be the most sustainable and reusable. Conclusion Task-oriented learning in head and neck anatomy may use different cadaveric materials with varied accuracy and utility.
Anatomy ; Cadaver ; Education, Medical