Medical Education Papers & Publications

Purpose of review: This narrative review aims to assess the effectiveness of multimodal analgesia protocols (MAPs) in managing postoperative pain and reducing opioid consumption. The review evaluates the safety profile of MAPs, identifies the most effective components for different surgical contexts, and discusses their broader applicability in clinical practice. Given the growing concerns around opioid use, the focus is on alternative strategies that can offer comparable or superior pain relief with fewer side effects. Recent findings: Recent studies have demonstrated that MAPs, which combine various pharmacological and non-pharmacological methods, significantly reduce postoperative pain intensity and opioid use. These protocols show superiority over traditional opioid-centric approaches without increasing adverse events like nausea and respiratory depression. Incorporating regional anesthesia, nonsteroidal anti-inflammatory drugs, and nerve blocks has enhanced recovery, minimized complications, and improved patient outcomes. Furthermore, MAPs can be tailored to specific surgical settings, with combinations of medications like ketamine, acetaminophen, and dexamethasone proving effective in different clinical scenarios. Summary: Multimodal analgesia offers a viable approach to optimize postoperative pain management, reducing opioid-related risks and improving recovery outcomes. By utilizing the synergistic effects of different pain relief modalities, MAPs can achieve better pain control while minimizing opioid consumption. The review underscores the need for the broader adoption of MAPs and further research to refine these protocols, aiming for long-term improvements in surgical care and patient experiences

Karishma

Background: Malaria in pregnancy (MiP) remains a critical public health concern in Nigeria, with significant implications for maternal and fetal health. Despite national policy guidelines advocating the use of Intermittent Preventive Treatment in pregnancy using Sulphadoxine- Pyrimethamine (IPTp-SP), its uptake remains suboptimal in many rural communities. This study aimed to assess the factors influencing IPTp-SP utilization among pregnant women attending antenatal clinics (ANCs) in rural areas of Abia State. Methods: A descriptive cross-sectional study design was adopted, involving 422 pregnant women selected through a multistage sampling technique across three predominantly rural Local Government Areas (LGAs): Ugwunagbo, Isiala Ngwa South, and Ukwa East. Data were collected using a structured, interviewer-administered questionnaire and analyzed using SPSS version 25. Descriptive statistics, chi-square tests, and Pearson correlation analyses were employed to examine associations between socio-demographic variables, accessibility, beliefs, health system factors, and IPTp uptake. Statistical significance was set at p < 0.05. Results: The majority of respondents were married (82.0%), aged between 25 and 34 years (46.9%), and had attained at least secondary education (71.1%). Key barriers to IPTp uptake included drug unavailability (30.6%), long waiting times (28.9%), fear of side effects (19.4%), and cultural beliefs (23.0%). Notably, only 24.6% reported consistent IPTp-SP availability during ANC visits, and 46.4% had to purchase the drugs outside the clinic. Correlation analysis revealed significant associations between IPTp uptake and distance to clinic (r = -0.412, p = 0.001), health education (r = 0.562, p < 0.001), drug availability (r = 0.489, p = 0.002), and cultural beliefs (r = -0.297, p = 0.012). Chi-square analysis confirmed significant relationships between IPTp uptake and education level (χ² = 19.438, p = 0.001), awareness (χ² = 24.511, p < 0.001), and satisfaction with ANC services (χ² = 14.257, p = 0.003). Conclusion: The study highlights multifaceted determinants affecting IPTp-SP uptake among pregnant women in rural Abia State. These include socio-demographic factors, health system challenges, cultural beliefs, and availability of services. Interventions aimed at increasing awareness, ensuring consistent drug availability, and improving ANC service delivery are critical to enhancing IPTp coverage in rural Nigeria.

Karishma

Background: Evidence has suggested that school-based physical activity programs (SBPAPs) including structured physical education, extracurricular sports, and activity-based learningenhance memory and other cognitive functions. However, evidence on whether Indian adolescents can achieve improved cognition or increased academic performance also remains scarce. This study aimed to examine the relationship between SBPAPs and academic performance among Indian adolescents. Methods: A cross-sectional, mixed study was carried out from October 2024 to March 2025 in public and private secondary schools in Haryana and Punjab, north India. A total of 300 students aged 13 to 17 years were divided into an intervention group (n = 150) who participated in structured physical activity (PA) of at least 150 minutes per week and a comparison group (n = 150) who were involved in less than 30 minutes of PA per week. Academic performance was assessed in terms of composite scores of core subjects, while the level of PA was measured using the Physical Activity Questionnaire for Adolescents. Independent samples t-tests, one-way analysis of variance (ANOVA), and Pearson’s correlation analysis were all used for quantitative data handling. Qualitative data gathered from focus group discussions and key informant interviews with a subsample (n = 30) were thematically analyzed. Results: There were no significant differences in baseline demographics between the groups (p > 0.05). Compared with the comparison group, the intervention group showed significantly higher academic scores (mean = 76.4%, SD = 7.8; mean = 70.6%, SD = 8.4) with a moderate-to-large effect size (t = 6.30, p < 0.001, d = 0.72). A one-way ANOVA found that academic performance differed significantly among PA intensity levels (F(2,297) = 19.44, p < 0.001). There was a moderate positive correlation between PA levels and academic achievement (r = 0.44, p < 0.01). Qualitative findings corroborated quantitative data, showing that physically active students displayed improved concentration, emotional regulation, and academic motivation. Conclusions: Partaking in structured SBPAPs significantly increases Indian adolescents’ academic performance. These findings imply the necessity of including physical education in the academic curriculum as a low-cost, scalable method for supporting both cognitive growth and educational achievement.

Karishma

India is a country of immense diversity. It is home to people of many different racial, languages, ethnic, religious, and national backgrounds. Groups of people in India differ from each other not only in physical or demographic characteristics but also in distinctive patterns of behavior and these patterns are determined by social and cultural factors like language, region, religion, and caste. Apart from behaviour, economic development, level of education and political culture of the people in various social segments differ from region to region. More you can say that economy and cultures have been enriched by the contributions of migrants from round the globe. In an increasingly globalised world, migratory movements is continuously shaping the countries all over the world. Some countries like India and Ireland, which set the example of economic development and social integration, have the positive impact of the migration by globalisation and some countries like USA, which recently witness racism, xenophobia and discrimination have the negative impact on the migrants. It does not mean India do not face fragmentation and USA do not have cohesion. USA have many stories which show successful integration process, that facilitated the lives of immigrant communities, but being a developed country it still suffers from cultural alienation. In these countries, borders are built within borders to create cultural divides that do not allow people to integrate. Recently, this problem has become more prominent due to the rise of terrorism, clash of cultures in the world, leading to the glorification of stereotypes. People are becoming less accepting towards anyone who does not belong to their region. Migration does not stop after people move from one place to another place. The main question start after that ‘now what’ they will do. That is why this topic needs to be discussed thoroughly in order to find better solutions. This paper will begin with an analysis of different approaches to Migration, discuss the target groups for integration policies, provide indicators of the current situation of migrants and proceed to an analysis of integration tools: legislation, social policies and participatory processes. It will focus not only on the impact of migration but also on social integration, mix culture like indo-western culture in a comparative basis.

Ekta Meena

India is a country of immense diversity. It is home to people of many different racial, languages, ethnic, religious, and national backgrounds. Groups of people in India differ from each other not only in physical or demographic characteristics but also in distinctive patterns of behavior and these patterns are determined by social and cultural factors like language, region, religion, and caste. Apart from behaviour, economic development, level of education and political culture of the people in various social segments differ from region to region. More you can say that economy and cultures have been enriched by the contributions of migrants from round the globe. In an increasingly globalised world, migratory movements is continuously shaping the countries all over the world. Some countries like India and Ireland, which set the example of economic development and social integration, have the positive impact of the migration by globalisation and some countries like USA, which recently witness racism, xenophobia and discrimination have the negative impact on the migrants. It does not mean India do not face fragmentation and USA do not have cohesion. USA have many stories which show successful integration process, that facilitated the lives of immigrant communities, but being a developed country it still suffers from cultural alienation. In these countries, borders are built within borders to create cultural divides that do not allow people to integrate. Recently, this problem has become more prominent due to the rise of terrorism, clash of cultures in the world, leading to the glorification of stereotypes. People are becoming less accepting towards anyone who does not belong to their region. Migration does not stop after people move from one place to another place. The main question start after that ‘now what’ they will do. That is why this topic needs to be discussed thoroughly in order to find better solutions. This paper will begin with an analysis of different approaches to Migration, discuss the target groups for integration policies, provide indicators of the current situation of migrants and proceed to an analysis of integration tools: legislation, social policies and participatory processes. It will focus not only on the impact of migration but also on social integration, mix culture like indo-western culture in a comparative basis.

Ekta Meena

In this paper, investigations are made to analyze the human body temperature during wound healing process due to surgery. Wound is considered after the skin graft. Skin graft is a technique used in plastic surgery. Skin is the first line of defense between the human and environment, it is very susceptible to damage. Internal body or core temperature (Tb) is one of the clinical vital signs along with pulse and respiratory rates. Any disturbance in body temperature will drive complexities in wound healing process. These studies are important in the mechanism of establishing the limits of thermal regulation of human body during the healing process in different situations and conditions. The Finite element method is used to analyze tissues temperature for normal tissues (donor site) and abnormal tissues (tissues after surgery). Appropriate boundary conditions have been framed. Numerical results are obtained using Crank Nicolson Method.

Manisha Jain

Physically unclonable function (PUF) is a hardware security module preferred for hardware feature based random number and secret key generation. Security of a cryptographic system relies on the quality of the challenge-response pair, it is necessary that the key generation mechanism must unpredictable and its response should constant under different operating condition. Metastable state in CMOS latch is undesirable since it response becomes unpredictable, this feature used in this work to generate a unique response. A feedback mechanism is developed which forces the latch into the metastable region; after metastable state, latch settle to high or state depends on circuit internal condition and noise which cannot be predicted. Obtained inter hamming variation for 8 PUF is 51% and average intra hamming distance is 99.76% with supply voltage variation and 96.22% with temperature variation.

Abhishek Kumar

One of the unique features of Indian society is prevalence of caste system which was originated thousands of years back to demarcate the people engaged in different occupation or jobs. Initially it was not much rigid but gradually people belonging to upper castes for their own selfish means to maintain their monopoly made this arrangement hereditary and started treating people of lower castes disgracefully. For preservation of this system, people started controlling their women to prevent inter-caste marriages and the concept of endogamy came up. This robbed away many types of freedom from women. For women belonging to lower castes, this situation is worse as they are doubly subjugated on the basis on caste as well as gender. Men belonging to their own caste treat them as secondary beings. This paper throws light on this intersection. How intersection of these two kinds of inequalities place them at the lowest position in Indian society. Dr. B.R. Ambedkar rises as their leader who all his life worked for empowerment of downtrodden section of society. He argues that education is the primary tool for evading these differences among people. He further emphasizes to adopt the concept of exogamy to break the backbone of Indian caste system and to immediately leave a religion or culture which legitimizes such system of inequality among people of the same land.

Swati sharma

One of the unique features of Indian society is prevalence of caste system which was originated thousands of years back to demarcate the people engaged in different occupation or jobs. Initially it was not much rigid but gradually people belonging to upper castes for their own selfish means to maintain their monopoly made this arrangement hereditary and started treating people of lower castes disgracefully. For preservation of this system, people started controlling their women to prevent inter-caste marriages and the concept of endogamy came up. This robbed away many types of freedom from women. For women belonging to lower castes, this situation is worse as they are doubly subjugated on the basis on caste as well as gender. Men belonging to their own caste treat them as secondary beings. This paper throws light on this intersection. How intersection of these two kinds of inequalities place them at the lowest position in Indian society. Dr. B.R. Ambedkar rises as their leader who all his life worked for empowerment of downtrodden section of society. He argues that education is the primary tool for evading these differences among people. He further emphasizes to adopt the concept of exogamy to break the backbone of Indian caste system and to immediately leave a religion or culture which legitimizes such system of inequality among people of the same land.

Swati sharma

Bhaishajya kalpana is an art and science of preparing and dispencing medicine. Guggulu is a Niryasa (oily latex) achieved from small tree called Indian bedellium. Botanical name is commiphora mukul. Guggulu is an amorphous, translucent, solid adhesive, oleo-gum resin is produced by the process of gummosis from its plant. Many other Ayurvedic classics have mentioned various formulations of Guggulu for the treatment of various ailments. Bhashajya ratnawali followed various kalpana use for formuations. Guggulu kalpana is secondary formulations of bhaishajya kalpana. . Guggulu is one among the best binding agents and its used as single or compound drug in the form of pills, Formulations which contains Guggulu as main ingredient, they can be called as Guggulu kalpana. Here in Bhaishajya Ratnawali, Guggulu is used in yoga for both purposes, as a base and as well as medicament also.In bhaishajya Ratnavali Guggulu when modified into different formulations. It can also be used in many diseases along with different combinations of drugs with their anupana, Guggulu kalpana beneficial in treating many diseases. The Guggulu Kalpana is indicated in almost all the strotovikaras and also a number of research works have been proved the wide range of action of Guggulu .

Suri abhiram

Bhaishajya kalpana is an art and science of preparing and dispencing medicine. Guggulu is a Niryasa (oily latex) achieved from small tree called Indian bedellium. Botanical name is commiphora mukul. Guggulu is an amorphous, translucent, solid adhesive, oleo-gum resin is produced by the process of gummosis from its plant. Many other Ayurvedic classics have mentioned various formulations of Guggulu for the treatment of various ailments. Bhashajya ratnawali followed various kalpana use for formuations. Guggulu kalpana is secondary formulations of bhaishajya kalpana. . Guggulu is one among the best binding agents and its used as single or compound drug in the form of pills, Formulations which contains Guggulu as main ingredient, they can be called as Guggulu kalpana. Here in Bhaishajya Ratnawali, Guggulu is used in yoga for both purposes, as a base and as well as medicament also.In bhaishajya Ratnavali Guggulu when modified into different formulations. It can also be used in many diseases along with different combinations of drugs with their anupana, Guggulu kalpana beneficial in treating many diseases. The Guggulu Kalpana is indicated in almost all the strotovikaras and also a number of research works have been proved the wide range of action of Guggulu .

Suri abhiram

Tracing graduates has become an imperative for higher education institutions much more during the pandemic. This tracer determined the employment and employability status of the 2019 BSE graduates and identified the competencies they adequately acquired and deemed vital for work. It used descriptive design, and data were collected from the 103 graduates through a Google form with open and closed-ended questions administered between November and December 2020. Results revealed that most of the graduates had been employed in teaching and teaching-related jobs but mostly in contractual arrangements within the first and second six months after graduation. Many had their first jobs with meager salaries from the private sector. Communication, pedagogy, information communication technology, time management, and flexibility were the top competencies they adequately acquired and were beneficial in work. The study concluded that these graduates had acquired 21st-century skills in their respective degree programs. These results have corresponding implications for future research in confirming the most employable skills in secondary teaching. As recommended, classroom instruction might emphasize the development of these skills. Eventually, these become the competitive advantage and employability capitals of future graduates. Administering the licensure examination and the release of its results can be done within the first three months after graduation to lessen the cost of waiting.

Manuel Caingcoy

Living with epilepsy, its unpredictable seizures, and its comorbid conditions present many challenges over the time. Continued educational efforts can play a key role in helping people learn to live with epilepsy and understand epileptic medications over the life span. The aim of this study is to assess the impact of pharmacist-initiated education on patients with epilepsy. Prospective and observational pilot study to evaluate the impact of educational interventions during February and March, 2019 was conducted. A total of seven patients with epilepsy was included in this study. They received ordinary consultation care in National Centre of Epilepsy at Ali Omar Askar Hospital in Tripoli, Libya. Knowledge assessment questionnaire was assessed initially and patients were subjected to pharmacist-initiated education and they have given follow up reporting card. A follow up for one month has continuously been done and final evaluation included: knowledge assessment questionnaire, adverse drug reactions and epileptic attacks reporting. All the patients completed the pre and post education questionnaire. There was no significant difference between the patients’ knowledge before and after interventional questionnaire except for only two patients which is statistically significant (P=0.03) and (P=0.02) whose knowledge was significantly enhanced by post education. Thus, there are a lot of opportunities and challenges for pharmacists to play a role in epileptic care and education as patients with epilepsy are not knowledgeable about their illness regardless of age, educational background or duration of epilepsy. This role must be highly enforced and implemented in patients with epilepsy.

Mediterranean Journal of Pharmacy and Pharmaceutical Sciences

Market trends indicate that natural health products are being used to maintain health as well as prevent and treat many medical conditions. A recent Canadian survey showed that 71% of the Canadian population have used a natural health product. Among these, many reports that they take natural health products on a daily basis. This review emphasizes on Canadian post-market surveillance system that apply to natural health products for human use. The public's perception is that the natural health products are all-natural, safe and effective, but there is still a wide variety of harms linked with these products. The post-market surveillance system is the monitoring window to observe and control the adverse effects of using natural health products. There are many activities involved in the post-surveillance to ensure the quality of the approved natural health products. Despite the fact that post-market surveillance plays a very important role in eliminating and/or reduce the risk of using natural health products, there are still some challenges and more work to be done to improve the outcome of the post-market surveillance of the natural health products.

Mediterranean Journal of Pharmacy and Pharmaceutical Sciences

Background: The rising global DM epidemic is driving the problem of TB control. This research determined glycemic control in TB only infected and DM-TB comorbidity and the consequence of the double burden on treatment outcome. Methods: fifty M. TB infected subjects and fifty control subjects were enrolled into the study, all the participants gave consents. FPG and HbA1c were determined by Colorimetry. Data were analyzed using SPSS version 20.0 statistical package, differences between groups and variation among groups were determined by Student’s t-test and ANOVA respectively while the association between variables by Pearson’s correlation. Differences were considered statistically significant at p<0.05. Results: The mean FPG and HbA1c levels of TB subjects were significantly (P<0.05) higher than those of the control. The mean BMI of the TB infected subjects was significantly lower (p=0.001) than that of the controls. The mean age, FPG and HbA1c of TB subjects at the beginning phase of treatment were significantly lower (p<0.05) than those of subjects at the continuation phase of treatment. The mean age, FPG and HbA1c of subjects with DM-M.TB coexistence were significantly (p<0.05) higher than those of the M.TB only infected subjects. BMI of the DM-M.TB comorbidity subjects was lower than that of the M.TB only infected subjects (p=0.109). A significant positive correlation was obtained between HbA1C and FPG in M.tb infected subjects. (r=0.910, p=0.001). A negative correlation obtained between HbA1C and BMI in M.tb infected subjects. (r=0.267, p=0.061). Conclusion: Infection with mycobacterium tuberculosis poses a risk to DM and vice versa, which may adversely affect treatment outcome and control of both diseases. Firm efforts to control DM may likely have a significant valuable effect on TB treatment outcome.

Eworo Raymond

This brief inspects the situation with research in Indian advanced education and offers an outline of the idea of undergrad (UG) research as a method for change. The article endeavors a short survey of the public authority endeavors to further develop advanced education examination, and underlines the restrictions of their degree just as their ramifications. Through a sweeping audit of existing experimental and subjective investigations, this concise shows the advantages and effects of UG research on improvement of insightful characteristics in understudies also its impact on foundations. At last, it suggests methods of drafting this idea in the current arrangement of undergrad schooling in India, in view of remedies by the Chamber on Undergrad Exploration

Dr Gedam Kamalakar

Scholars who apply artificial intelligence to political questions seek, most generally, to expand the scope and relevance of political model analysis. By incorporating the effects of variable human notions, traditions, and meanings, they seek to humanize political models. Most early applications of artificial intelligence in political science research address substantive issues pertaining to political decision making. Most of these works apply production-system technology to construct choice models in for eign-policy decision contexts. In recent years, political applications have begun to diver sify. Today, lively research efforts flourish in widely varied application areas, such as computational text analysis, logic programming, computer learning, and conflict sim ulation. The works reviewed here constitute the early steps of a nascent program of study. Much remains to be accomplished. Nevertheless, the efforts conducted thus far suggest many potentially fruitful research avenues. Youth are the most essential and promising segment of every country’s population. India has a larger advantage over other countries in terms of becoming a global leader because we effectively tap into the youth’s potential. Quality education is the only way to achieve this. With artificial intelligence’s potential growth in India, now is the ideal time to incorporate AI in education to reap its benefits and prepare India’s young for the future. Artificial intelligence has great potential in India. India’s AI technology has the potential to make it a world leader in artificial intelligence. In India, AI technology is used effectively in nearly every area, including agriculture, healthcare, education, infrastructure, transportation, retail, manufacturing, and

Dr Gedam Kamalakar

Higher Education has an important role in the task of rebuilding a nation and it paves the way for overall development of a nation. The twentieth century has witnessed several revolutions like Green revolution, White revolution, I.T revolution etc; transforming human civilization in to new heights. At the start of 21st century, there is a lot of importance given to higher education. Every country realizes the value of higher education and the benefits accrue from it. There is a greater importance attached to higher education. “The social demands for higher education continue to increase. Indian higher education has a rich and complex history that spans millennia. This abstract provides an overview of the key developments in Indian higher education, highlighting its evolution from ancient times to the modern era. The history of Indian higher education is marked by the establishment of ancient centers of learning, the influence of various empires and dynasties, colonialism, and post-independence reforms. This abstract also touches upon the challenges and opportunities that have shaped the landscape of higher education in India.The history of Indian higher education can be divided into several distinct periods. In ancient India, centers of learning such as Takshashila and Nalanda emerged as renowned seats of knowledge, attracting students and scholars from across the world. These institutions laid the foundation for a tradition of rigorous intellectual inquiry

Dr Gedam Kamalakar

A state in southern India called Telangana has a rich and varied cultural history. There are numerous tribes in the area, and they have long coexisted peacefully with the environment. These tribes have distinctive traditions that have been handed down through the generations. The Gond, Koya, Lambada, and Banjara are notable tribes in Telangana. Over the years, these tribes have encountered several difficulties, such as land acquisition, displacement, and a loss of cultural identity. However, via several government initiatives and community-based programs, efforts are being undertaken to maintain their culture and give them more authority. Tribal Development has been in the agenda for discussion at several levels in different forums for quite some time and continues to be an important aspect for serious deliberation in Telangana, not only because of a significant portion of the tribal population but more importantly because of the inequality of their participation, both socially and economically. The conventional wisdom that the tribal population should not be integrated with the mainline population, does not cut ice any longer as tribals themselves are eager to participate in national development and construction. A major initiative to empower the tribals, in my view is through the provision of appropriate educational opportunities to the children of the tribal families, though the aspects like infrastructural and health are identified as critical inputs. The present book tries to disclose the situation of the Scheduled Tribes in Telangana State. Various eminent scholars and students, media friends delivered their observations through their research papers. As per the observations and findings, the book contains some valuable and instant suggestions for overall development of tribes that the Telangana State Government has to play a major role in this endeavour This article critically examines initiatives for greater participation in education by tribal communities in India, arguing that current policy does not effectively enough facilitate greater participation and may, in fact, go against the avowed principle of ensuring greater equity. The article relies on fieldwork-based study to support arguments for the need to be culturally sensitive in making appropriate provisions for the education of scheduled tribes in India. Reasons for high dropout rates and non-enrolment among tribal children are examined and some searching

Dr Gedam Kamalakar

In today's globalized world, the role of foreign direct investment (FDI) in shaping higher education cannot be overstated. This paper explores the multifaceted impact of FDI on higher education institutions worldwide, delving into its influence on academic programs, research endeavors, institutional infrastructure, and student experiences. Drawing upon a comprehensive review of scholarly literature, policy documents, and case studies, this paper elucidates the ways in which FDI contributes to the expansion and transformation of higher education systems across the globe. The analysis begins by examining the motivations driving foreign investors to engage with higher education, including economic imperatives, strategic partnerships, and knowledge transfer objectives. It then explores the diverse forms that FDI takes in the higher education sector, ranging from institutional partnerships and joint ventures to the establishment of branch campuses and research collaborations. By analyzing specific examples from different regions, this paper illustrates how FDI shapes the academic landscape, fosters innovation, and enhances internationalization efforts within higher education institutions.

Dr Gedam Kamalakar