Introduction: We implemented online early clinical exposure (ECE) for medical undergraduate students during the pandemic and analyzed their feedback to assess the effectiveness of the session. Materials and methods: An online ECE on “Inborn Errors of Metabolism (IEM) and the Significance of Newborn Screening (NBS)” was scheduled, during which the participants were provided with information pertaining to the prevalence, morbidity, mortality, significance of NBS, and available treatment modalities that are currently accessible. Four case scenarios, which were developed in collaboration with clinicians, were discussed with the students. The students were divided into smaller groups, with each group being supervised by a faculty member. The feedback obtained from the students, using a five-point Likert scale, was subjected to analysis. Results: Around 87.5% of the total student population, specifically 175 out of 200 students, were actively engaged in the 4-hour session. Furthermore, a total of 152 students willingly participated in the questionnaire survey. The content validity ratio (CVR) and content validity index (CVI) yielded scores exceeding 0.95 and 0.86, respectively. Additionally, Cronbach's alpha was found to be 0.95. The majority of the students demonstrated the ability to relate their theoretical knowledge with the case scenarios and they expressed confidence in their capacity to remember this knowledge due to their comprehensive understanding of the underlying principles. Conclusion: The implementation of online ECE has emerged as a timely and viable solution in response to the challenges posed by pandemic circumstances.

Aim and background: The teaching strategy, self-directed learning (SDL), is a very important and effective method used for teaching and learning that enables medical students for lifelong learning, enabling them to fulfill their learning requirements in self-directing way, identify ideal learning resources, identify objectives ideal for learning, and also assess the process involved in learning all through their career. The objectives of the present study were to compare the effectiveness of SDL alone and SDL blended with lecture and to study the perceptions of students about SDL as a TL method. Methodology: A prospective observational study was conducted involving a total of 180 phase I MBBS students who gave voluntary consent for the study. Study protocol consisted of two sessions: Session 1: SDL alone, and Session 2: Lecture following SDL. A baseline pretest was conducted, and posttest was conducted after the completion of both sessions using a validated multiple-choice questionnaire, and students’ perception forms were analyzed. Results: There was a statistically significant increase in posttest scores compared to the baseline pretest scores, and further, there was a statistically significant increase in posttest scores of lectures following SDL sessions compared to posttest scores of an SDL session. Conclusion: Overall performance of the students was improved when a topic was taken as SDL followed by didactic lecture, which has been indicative of an improvement in learning outcomes when adopting the SDL module. Our study strongly recommends a sensible combination of SDL and lecture, rather than implementation of SDL alone, for phase one MBBS students. Clinical significance: Blended learning SDL combined with lecture has better outcomes as it enables the students to clinically correlate the topic learned in biochemistry.

Background: Auditing quality control practices is crucial for ensuring adherence to and compliance with the standard operating procedures of quality assurance. This study examines the internal quality control (IQC) practices in clinical biochemistry laboratories, focusing on their effectiveness in ensuring accurate and reliable test results. Materials and methods: A comprehensive audit was conducted every month, and records were reviewed periodically in a high-volume clinical biochemistry lab, assessing compliance with established IQC protocols and identifying areas for improvement. Chi-square test was used to assess any significant deviations in the practices from the established protocols. Results: Overall compliance with IQC practices was 98.8%. The compliance rates of 100% were observed for LJ Chart, Monthly CV%, measurement uncertainty, mean SD calculation, IQC lot verification, accuracy testing records, and kit verification records. Lower compliance rates were noted for patient moving average records at 95.8%. Out-of-control events occurred in 0.12% of the IQC tests. The overall average audit score for six months stands at 94.3%. Conclusion: The findings reveal very minimal variations in IQC implementation as compared to standard operating procedures and provide recommendations for enhancing quality control processes.

Background: Renal stones, commonly known as kidney stones, are a significant urological condition caused by the crystallization of dietary minerals in the kidneys. Their composition varies and can include calcium oxalate, calcium phosphate, uric acid, cystine, and other minerals. Fourier transform infrared (FTIR) spectroscopy, a semi-quantitative and automated method, is an advanced technique for determining stone composition, aiding in personalized treatment and prevention of recurrence. Objectives: The study aims to: • Analyze the mineral composition of renal stones using FTIR spectroscopy. • Classify the mineral components of renal stones. • Study the trends and morphological characteristics of stones. Methods: This cross-sectional study analyzed 3,789 renal stones received from August 2019 to May 2024. The stones were prepared and analyzed using the Agilent Cary 630 FTIR Analyzer. Data on mineral composition and morphology were collected and processed to identify various mineral trends and stone compositions. Results: Demographics: 76.3% of stones were from male patients, with the highest incidence in the 31–40 age-group. Composition: 93.5% of stones were of mixed composition, with calcium oxalate monohydrate being the most prevalent (38.3%). Rare compositions: Stones with rare compositions, such as xanthine and 2, 8-dihydroxyadenine, were identified, providing insight into specific metabolic disorders. Conclusion: Fourier transform infrared spectroscopy provides reliable results for stone composition, enabling effective and individualized treatment plans. The predominance of mixed stones underscores the need for multifactorial treatment approaches addressing dietary, metabolic, and infectious factors. Further research, particularly using advanced techniques like genetic testing, may enhance understanding of stone formation.

This review article delves into the significance of implementing entrustable professional activities (EPAs) within competency-based medical education (CBME) frameworks, particularly focusing on the MD Biochemistry program in India. EPAs represent units of professional practice that can be entrusted to a trainee upon demonstrating competence, bridging the gap between individual competencies and holistic professional capabilities. The MD Biochemistry program, unique to India, faces challenges in global recognition and career opportunities compared to equivalent programs worldwide. By aligning the program's curriculum with EPAs, specific professional tasks performed by MD Biochemists can be delineated, showcasing their capabilities on a global scale. This not only clarifies the program's scope but also opens avenues for MD Biochemistry graduates in diverse international roles and settings.

The term immunity mostly refers to adaptive immunity, even though innate immunity also plays a crucial role. Immunological memory is the key feature distinguishing adaptive immunity from innate immunity. Adaptive immunity features observed in innate cells, i.e., the immunological memory to past insults, has given an entirely new perspective to immunity. This is called trained immunity. Innate cells, after recognition of the pathogens, mount an exaggerated inflammatory response if challenged again. These responses protect not only against the target pathogen but also against other pathogens. This heterologous response of trained immunity is a unique property with a lot of therapeutic promise. Metabolic and epigenetic reprogramming of innate cells are the central mechanisms of trained immunity. This reprogramming, evoked by endogenous and exogenous stimuli, result in trained immunity which is now considered to be evolutionally conserved. It protects the organism in the same way as the adaptive immune memory. Though trained immunity is beneficial, maladaptation at times may lead to hyper-inflammatory state with detrimental effects. Trained immunity has found its applications in understanding many clinical conditions and possibly new therapeutic potential. In this review, a brief account of trained immunity, its mechanistic undercurrents and therapeutic exploitations are described.

The recent lipid management guidelines emphasize using low density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (non-HDL-C), and apo B levels as treatment targets. Out of these, LDL-C is the primary target of lipid management, non-HDL-C is the co-primary and ApoB is the secondary target. One-time estimation of lipoprotein(a) is sufficient presently to assess risk in view of the lack of specific drugs targeting it. Triglyceride levels ≥150 mg/dL in fasting and ≥175 mg/dL in non-fasting samples are considered risk modifiers for atherosclerotic cardiovascular disease. Lipid profile estimation in a non-fasting sample is considered good enough to manage a dyslipidemia patient. The inclusion of risk group-specific target range of lipid profile in biochemistry report format shall be more informative and helpful in ensuring better patient compliance.