Journal of Clinical and Diagnostic Research 

About: Journal of Clinical and Diagnostic Research is an academic journal published by JCDR Research and Publications Private Limited. The journal publishes majorly in the area(s): Medicine & Internal medicine. It has an ISSN identifier of 0973-709X. It is also open access. Over the lifetime, 3585 publications have been published receiving 5240 citations.

Effect of Iron Deficiency on Glycation of Haemoglobin in Nondiabetics

Abstract: Background: Protein glycation is a spontaneous reaction that is believed to play a key role in the pathogenesis of many clinical disorders. The glycation of proteins is enhanced by elevated glucose concentrations. The major form of protein glycation with a clinical consideration is glycated haemoglobin (HbA1c). The HbA1c fraction is abnormally elevated in chronic hyperglycaemic diabetic patients and it correlates positively with the glycaemic control. However, increased glycated haemoglobin levels have been documented in iron de.ciency anaemic patients without any history of diabetes. Aims and Objective: The aim of this study was to determine the effect of IDA on the HbA1c levels in nondiabetic patients, so as to consider IDA as an important factor which influenced the HbA1c levels, while monitoring the glycaemic status of diabetics. Methodology: Fifty non-diabetic, anaemic patients and 50 age-matched healthy subjects were enrolled in this study. The patients who had glucose tolerance abnormalities (impaired glucose tolerance or diabetes mellitus), haemoglobinopathies, haemolytic anaemia, infestation, chronic alcohol ingestion and chronic renal failure were excluded from the study. Haematologic investigations were done and the fasting and postprandial glucose and HbA1c levels were measured in all the subjects. Results: The mean HbA1c (7.6 ± 0.5%) level in the patients with IDA was higher than that in the control group (5.5% ± 0.8) (p 0.05). The haemoglobin, serum ferritin, fasting and postprandial glucose, and the HbA1c levels were normal in the control group (p > 0.05). Conclusion: HbA1c is not affected by the blood sugar levels alone, and there are various confounding factors when HbA1c is measured, especially that of iron de.ciency, which is the commonest of the de.ciency diseases worldwide. It is hence prudent to rule out IDA before making a therapeutic decision, based on the HbA1c levels.

A study on students' perceptions for online zoom-app based flipped class sessions on anatomy organised during the lockdown period of COVID-19 epoch

Abstract: Introduction: In the present situation of containment for COVID-19 epoch, the physical classroom sessions in medical colleges were suspended by different Government advisories. Faculties have been guided by the university as well as institution to carry on the online teaching to the medical students. As the students were not present physically so flipped class model has been implemented using the Zoom cloud app for teaching Anatomy. Aim: To explore the perception of undergraduate students of Anatomy regarding online Zoom-app based flipped class sessions and to obtain the suggestions for improvement of such classes organised during the lockdown period of COVID-19. Materials and Methods: Ten gross Anatomy topics and 10 histology slides (total 15 sessions; one session for each gross anatomy topics and five sessions covering two slides for each day) were discussed in flipped class mode. For each session the text materials were served to the students two days before. On the third day, face to face interactive classes were undertaken using the Zoom platform; for the entire 199 students of Anatomy. After completion of one month, students' perceptions were obtained by semi-structured questionnaire made with Google form. Results: Although the department has organised almost daily Zoom sessions with pre-shared study material; in flipped classroom mode, but majority of the students opined for maximum three days per week Zoom sessions instead of every day's classes. Total 92% preferred the current strategy of advanced sharing of study material instead of concurrent sharing of text. Almost 93.5% students felt the study material helpful to them, 79% students found the Zoom sessions helpful for their doubt clearance. Strikingly, 53.36% students confessed that they failed to keep up with the progress of the classes in daily mode. There was a mixed reaction for continuing such mode of teaching in the post-lockdown era. The network connectivity became a broad issue as constrain to almost all of them to participate in online discussion platform. Conclusion: As the students and teachers were new in the online mode of teaching; so students feedbacks were felt need for future planning. The students had an opinion to lessen the number of classes so that they can cope up with the study material. However, majority of them wanted to move back to their classrooms rather than remain in the online mode of learning.

Perception of Nepalese community pharmacists towards patient counseling and continuing pharmacy education program:A multicentric study

Abstract: Objective: To study the perception of community pharmacists towards patient counseling and continuing pharmacy education programs. Methods: A semi structured questionnaire was developed by the researchers. The research was carried out in six major cities in Nepal, namely Kathmandu, Pokhara, Biratanagar, Birgunj, Nepalgunj and Bhairahawa. The filled questionnaires were analyzed as per the study objectives. Results: Altogether, 60 community pharmacists were included. Among them, 88.33% (n=53) were male. More than 50 patients visit most of the community pharmacies [36.67% (n=22)] daily. Most of the dispensers [56.67% (n=34)] took 1-5 minutes for dispensing a prescription. In most of the pharmacies [56.67% (n=34)], there were 2-5 dispensers and the qualification of a majority of dispensers were orientation training. Most of them [56.67% (n=340] believed that counseling was necessary as it was their own duty, but however, 48.33% (n=29) said that it was necessary to increase patient compliance. Our finding suggests that 83.33% (n=50) of retailers were facing some problems during patient counseling. All participants were interested in the continuing pharmacy education program. Conclusion: On the whole, the community pharmacists had a positive response towards patient counseling. Our findings suggest the need for continuing pharmacy education programs in Nepal to strengthen the concept of patient counseling.

Generic Medicines as A Way to Improve Access and Affordability: A Proposed Framework for Pakistan

Abstract: Medicines play an important role in health systems throughout the globe; however one third of the world population does not have access to essential medicines. Generic drugs have been instrumental in reducing cost and improving affordability. Generic penetration varies in the developing world and the sale of generics are growing in all the major markets, but the proper domestic availability of generics and their quality use is still a question mark. With the increasing population and shrinking resources, generics could be a recipe for improving the access to and affordability of medicines in Pakistan. However, to gain a wider health professionals' support, it is vital to understand the issues surrounding generic medicines. This proposed strategy will document the relative importance of the acceptance of generics in Pakistan. This attempt will ameliorate the perception and credibility of generic drugs among providers, prescribers, and consumers. Moreover, this effort will provide the baseline data to assist policy makers to promote the quality use of generic drugs.