High-Fidelity, Indigenously Prepared, Low-Cost Moulage as a Valid Simulation Tool to Improve Trauma Education

Background Simulation-based trauma education facilitates repeated practice in a controlled and safer environment for the learner without any risk to the patient's well-being. Moulage contributes to the perception of reality during training using standardized patients. However, the high cost of commercial moulage items is often prohibitive for regular use. This study aimed to assess the effectiveness of indigenously prepared, low-cost moulage as a valid simulation tool to improve trauma education, explore possible replacements of commercial moulage products, and determine their merits and demerits. Methodology Readily available economic items were used to make low-cost moulage on the simulated patients to replicate trauma victims. A cross-sectional design used a pre-validated Modified Moulage Authenticity Rating Scale to collect data from 61 participants of Advanced Trauma Life Support and Advanced Trauma Care for Nurses courses to analyze the effectiveness and fidelity of moulage. Results In total, 54 (89%) participants scored the low-cost moulage to provide high fidelity effectively. The majority of respondents graded the authenticity of moulage as good. Overall, 46 (75%) participants felt moulage injuries were quite realistic. All agreed that the moulage-based simulation offered a good teaching-learning alternative to assess and manage trauma victims. Further, 45 (73%) participants felt they were in an actual clinical situation, and 58 (95%) stated it could help them in their clinical practice. Conclusions Indigenously prepared, low-cost moulage is a feasible and cost-effective means to enhance fidelity in simulation-based trauma education. It can also be a possible replacement for commercial moulage. Further research is needed to rigorously evaluate the effectiveness of indigenously prepared, cost-effective moulage in trauma education to enhance patient care outcomes. This technique can also be easily translated into other simulation-based medical education domains.

Evaluation of the Diurnal Cycle of Blood Pressure and Sleep in Shift Workers

BACKGROUND

Circadian misalignment of physiological factors in shift workers is poorly studied in the Indian population. In the present study, 24-hour blood pressure measurements were taken on the same subject twice, once during his morning and night shifts. Sleep was also monitored by a self-reported sleep diary, which was confirmed with an activity monitor, and the sleep quality was assessed using sleep questionnaires.

OBJECTIVE

This study aimed to discover the pattern of blood pressure variation, the dipping and non-dipping status, and its correlation with sleep.

METHODOLOGY

This observational study was conducted in the Department of Physiology, All India Institute of Medical Sciences (AIIMS), Rishikesh, from April 2019 to September 2019, among security guards working rotating shifts in the Rishikesh hospital premises. Participants were given an activity sheet with instructions to document their daily activities for a complete 24-hour period on the designated measurement day, including recording the time of waking up and going to sleep. A wrist-worn activity monitor was utilised to assess the self-reported sleep duration provided by each participant on the activity sheet.

RESULTS

The present study showed the mean age of the participants as 27.03 ± 2.71 years, along with a mean body mass index (BMI) of 22.10 ± 1.64. Sleep duration was significantly higher during the morning shift (5.81 ± 1.08 hours) compared to the night shift (4.02 ± 1.70 hours) on the day of ambulatory blood pressure monitoring (ABPM) recording. The mean difference in systolic blood pressure between night shift workers between their awake and sleep periods was 15.91 ± 8.44 mmHg. However, no statistically significant disparity was seen when comparing the systolic blood pressure at the 24-hour mark during wakefulness and sleep between those working morning and night shifts (p >0.05).

CONCLUSION

The current study's findings indicate that participation in shift work, particularly night shift work, could potentially play a role in the emergence of irregular circadian blood pressure patterns and potentially lead to a lack of nocturnal blood pressure decline.

COVID-19-induced Stress in Health-care Workers: Effect of 8-week Common Yoga Protocol on Autonomic Function and Inflammatory and Oxidative Stress Markers

Background

COVID-19 pandemic posed a huge stress on health-care givers affecting their physical and mental health. Wellness strategies like yoga can improve flexibility, resilience, and outlook.

Aim

The present study explored the effect of 8-week standard common yoga protocol (CYP) intervention on autonomic functions, emotional stress, oxidative stress, and inflammation markers in the nurse group of health-care givers.

Materials and Methods

It is a randomized controlled trial where 50 nurses underwent CYP and 50 participated as controls. Anthropometric parameters, cardiovascular parameters, autonomic function including time and frequency domain parameters, biochemical parameters, and psychological stress using the questionnaire were assessed before and after 8-week CYP.

Results

Total 88 nurses completed the study with 42 and 46 participants, respectively, in the CYP and control groups. CYP intervention resulted in a significant reduction in cardiovascular parameters systolic blood pressure, diastolic blood pressure, mean arterial pressure, pulse pressure, and rate pressure product (P < 0.001, P < 0.001, P < 0.001, P < 0.001, and P = 0.002, respectively), perceived stress score and Depression, Anxiety, and Stress Scale psychological variables of depression, anxiety, and stress, and serum lipid parameters compared to the control group. CYP significantly increased total power, low frequency, high frequency, root mean square of successive differences between adjacent NN intervals, change in successive normal sinus (NN) intervals exceeds 50 ms, and pNN50% (P < 0.001, P = 0.006, P = 0.006, P = 0.039, P < 0.001, and P = 0.013, respectively) suggesting improved resting autonomic modulation and parasympathodominance due to higher vagal efferent activity. There were significant reductions in serum cortisol, tumor necrosis factor-alpha, interleukin (IL)-1, and IL-6 in both the groups. Serum telomerase significantly reduced (P = 0.024) and total antioxidant capacity (P = 0.036) increased in the CYP group post intervention.

Conclusion

CYP intervention was beneficial in improving psychophysiological, autonomic, and biochemical profile of the nurse group of health-care workers.

Acquisition of Higher-Order Cognitive Skills (HOCS) Using the Flipped Classroom Model: A Quasi-Experimental Study

Introduction

Flipped classroom refers to a teaching model where the lecture and homework elements of the class are reversed. Students develop knowledge and understanding during the pre-class session, and use the in-class time for active learning such as small group discussions, wherein they are expected to develop the skills of problem-solving (application) and critical thinking (analysis). An educational psychologist, Benjamin Bloom, proposed Bloom’s Taxonomy for the cognitive domain. According to this taxonomy, knowledge, and understanding have been considered to be lower-order cognitive skills (LOCS), while application (problem-solving), analysis (critical thinking), synthesis, and evaluation have been considered higher-order cognitive skills (HOCS). Only one study has reported that flipped classroom approach helps in the acquisition of HOCS such as application, analysis, synthesis, and evaluation. The present study aims to compare the flipped classroom model with the traditional lecture model and focuses particularly on the acquisition of HOCS such as application and analysis, by assessing the students using multiple-choice questions based on clinical vignettes.

Methods

The study was conducted in the Department of Physiology at Government Medical College, Bhavnagar. A total of 102 students in two groups, Group A (n=52) and Group B (n=50), participated in all the phases of the study. In the flipped classroom group, students watched the pre-recorded videos and studied standard textbooks, followed by a group discussion in the class. The traditional Lecture group attended the didactic lecture only. Topic I was taught to Group A using the flipped classroom model and to Group B using the traditional didactic lecture approach. Topic II was taught to Group B by using the flipped classroom method and to Group A using the traditional didactic lecture.

Both groups of students were assessed after a gap of one week with multiple-choice questions based on clinical vignettes for checking the HOCS. These questions were designed based on Blooming Biology Tool (BBT).

The feedback collected responses regarding the learning experience, perceived value of the flipped classroom, the course materials, the teaching process, and the evaluation system.

Results

The students, who participated in the flipped classrooms, performed statistically better than those in the traditional lecture model (5.36 ± 1.69 vs. 4.94 ± 1.34) (p<0.05). The students strongly agreed that the flipped classroom method was an enjoyable way of learning: it enhanced their problem solving and analytical ability as well as developed their ability to work as team members and plan their own work. Students in both the flipped classrooms gave a similar perception indicated by the small effect size (r <0.3).

Conclusion

The pre-class time of the flipped classroom model helps students remember the facts and understand the concepts (both lower-order cognitive skills), and uses the valuable in-class time to master the application of the concepts and critically analyze them (application and analysis being higher-order cognitive skills).

Preparedness of Undergraduate Medical Students to Combat COVID-19: A Tertiary Care Experience on the Effectiveness and Efficiency of a Training Program and Future Prospects

Introduction

Due to the nature of the coronavirus disease 2019 (COVID-19) pandemic, final year medical undergraduate students have had to be involved in patient management in different countries. The same was the case with India. This study was conducted with the objective to analyze the effectiveness and efficiency of preparedness training to combat COVID-19 in pre-final and final-year medical students at a tertiary care institute in North India.

Methods

A pre-post study was conducted among final and pre-final year medical undergraduate students. Data was collected as pre-test and post-test multiple-choice questions (MCQs) and clinical vignettes.

Results

A total of 179 medical undergraduate students attended the training. Scores on general instructions, personal protective equipment (PPE) donning and doffing, hand hygiene, biomedical waste management, contact tracing, cleaning and disinfection, ECG, and COVID-19 management improved significantly after the training. Pre-test scores on ECG, simulation, COVID-19 management were 21.58±5.311, 17.05±4.501, and 23.84±4.067, respectively. Post-test scores on ECG, simulation, COVID-19 management were 28.01±6.826, 23.84±4.067, and 6.93±1.726, respectively. Pre-test and post-test scores were statistically significant (p=0.0001). 

Discussion

Our preparedness training program was effective in delivering the intended skills. The efficiency of the training program was demonstrated through simulation. We created a trained pool of medical undergraduate students to assist clinicians in COVID-19-related supportive care.

Cardiovascular Autonomic Function Tests in Patients of Obsessive-Compulsive Disorder: A Cross-Sectional Study

BACKGROUND

Patients with psychiatric disorders are at an increased risk of developing cardiovascular disease, reducing life expectancy. Autonomic dysfunction has been linked to this increased risk; many studies have found reductions in heart rate variability (HRV). Only a few studies have systematically explored the relationship between obsessive-compulsive disorder (OCD) and autonomic function, and they have found contradicting results. The present study is intended to explore comprehensive autonomic functions in OCD patients and compare them with healthy controls.

METHODS

A total of 18 OCD patients meeting Diagnostic and Statistical Manual of Mental Disorders - 5 (DSM-5) criteria were enrolled to undergo comprehensive autonomic function testing, and the results were compared with 25 age- and sex-matched healthy controls.

RESULTS

Time-domain parameters of HRV such as standard deviation of the RR intervals, coefficient of variance of RR intervals, standard deviation of differences between adjacent RR intervals, root square of the mean of the sum of the squares of differences between adjacent RR intervals, and percentage of number of RR interval differences ≥ 50 ms were significantly lower in OCD patients, indicating lesser parasympathetic tone. Frequency-domain parameters such as total power and very low frequency were significantly lower in OCD patients, indicating a significant decrease in autonomic tone. Nonlinear parameters such as dispersion of points perpendicular to the line of identity and dispersion of points along the line of identity were significantly lower in OCD patients, indicating altered vagal and sympathetic tone. In autonomic reactivity tests, the fall in systolic blood pressure during the lying to standing test and change in diastolic blood pressure during the cold pressor test were significantly altered in OCD patients, indicating abnormal sympathetic reactivity. There was no significant correlation between autonomic parameters and the severity of OCD.

CONCLUSION

OCD is characterized by a decreased parasympathetic tone and abnormal sympathetic reactivity compared to normal controls.

Molecular characterization of lung carcinomas: A study on diagnostic, predictive, and prognostic markers using immunohistochemical analysis at a Tertiary Care Center in Uttarakhand, India

INTRODUCTION:

Focused studies in different geographic regions would delineate the underlying biological differences and molecular alterations in non-small cell lung cancer (NSCLC) worldwide. Previous studies in literature have documented limited characterization by studying a minimal number of biological markers. This study was done to evaluate expression of multiple immunomarkers including diagnostic, prognostic, and predictive markers in NSCLC for its characterization.

MATERIALS AND METHODS:

This was an observational study conducted on 60 consecutive cases of NSCLC. Immunomarkers comprising of p63, p40, TTF-1, napsin A, B-Raf, c-Met, phospho-AKT (P-AKT), PTEN, anaplastic lymphoma kinase (ALK), epidermal growth factor receptor (EGFR) and K-Ras, synaptophysin, chromogranin and pan-cytokeratin were evaluated on paraffin-embedded tissue sections of NSCLC.

RESULTS:

Age of patients with NSCLC in our study ranged from 35 to 90 years, and 93.3% of them were chronic smokers. 93.3% of cases presented in late stages (Stages III and IV) and 78% of cases were squamous cell carcinoma (SCC). EGFR positivity was noted in 83.3% of cases. ALK was positive in one case while C-Met and PTEN immunopositivity was noted in only two cases. Ten cases showed positivity for K-Ras and 90% of these were SCC. Ten cases were positive for B-Raf and 80% of these were SCC. 30% of cases showed immunopositivity for P-AKT. None of the molecular markers was found to have statistically significant correlation with clinicopathological parameters.

CONCLUSION:

SCC is the predominant histological subtype of NSCLC in the region of Uttarakhand, India, with a high proportion of cases harboring EGFR mutation. Variable expression of K-Ras, P-AKT, ALK 1, and PTEN in NSCLC signifies that molecular profile of every case is individualistic and independent. We attribute this to ethnicity, influence of implicated substance or metabolite in tobacco, and variable mutations incurred in tumor cells over a period of time.

Evaluation of Sensitization Program on Occupational Health Hazards for Nursing and Allied Health Care Workers in a Tertiary Health Care Setting

Background: Occupational health hazard pertaining to health care providers is one of the neglected areas that need serious attention. Any compromise in their safety would result in reduction in workforce, which may affect patient care, keeping in mind the wide gap between the required number and actual health care workers (HCWs) available in the world over.

Aim: This study was undertaken to evaluate the change in knowledge through a sensitization training program on occupational health hazards and vaccination for HCWs.

Materials and Methods: Participants of the study included nursing and allied HCWs of a tertiary care health institute in Uttarakhand, India. Multiple training sessions, each of around 180 min, were held periodically in small groups with 20–40 participants over 2 years. Participants were assessed with pretest and posttest questionnaires, and feedback was taken. Questionnaires comprised three categories: general safety and ergonomics, biological hazards, and chemical and radiation hazards. Data of incident reporting for needlestick injury from 2017 to 2019 were retrieved. All data were compiled in Excel sheet and analyzed.

Results: A total of 352 participants were included in the study. Mean ± SD for pretest and posttest scores were 5.3 ± 2.13 and 11.22 ± 2.15, respectively. There was considerable improvement in knowledge, which was found to be statistically significant with p-value of 0.001 for all categories. Participants in their feedback suggested for inclusion of psychosocial aspect in further training programs.

Conclusion: Low baseline knowledge prior to attending the course highlights a need for an intervention through such structured sensitization program to create awareness and educate HCWs on common occupational health hazards and vaccination. Statistically significant improvement in posttest knowledge highlights effectiveness of the training program. A drastic rise in incident reporting for needlestick injury reflects fairly good impact of training program. Regular and appropriate form of training can reduce injuries resulting from occupational hazards and ensure healthy workforce contributing toward a positive impact on national economy.

Rapid Workforce Development to Combat the COVID-19 Pandemic: Experience From a Tertiary Health Care Centre in North India

Introduction During a large-scale disease outbreak, one needs to respond to the situation quickly towards capacity building, by identifying areas that require training and planning a workable strategy and implementing it. There are limited studies focused on fast-track workforce creation under challenging circumstances that demand mandatory social distancing and discouragement of gatherings. This study was conducted to analyze the planning process and implementation of fast-track training during the Coronavirus disease (COVID-19) pandemic, and evaluate its effectiveness in building a rapid, skilled, and massive workforce. Methods A cross-sectional study was conducted to evaluate rapid preparedness training delivered from March to June 2020, based on documents and data regarding the process, planning, and implementation for large-scale capacity building. Pre-test and post-test scores were compared to assess the effectiveness of training. The number of personnel trained was evaluated to determine the efficiency of the training program. Data on COVID-19 among health care workers (HCWs) were analyzed. Results The Advanced Center of Continuous Professional Development acted as the central facility, quickly responding to the situation. A total of 327 training sessions were conducted, including 76 online sessions with 153 instructors. The capacity-building of 2,706 individuals (913 clinicians and 1,793 nurses, paramedics, and non-medical staff) was achieved through multiple parallel sessions on general precautionary measures and specialized skills within four months. The rate of hospital staff infected with COVID-19 was found to be 0.01% over five months. Conclusions A fast-track, efficient, large-scale workforce can be created through a central facility even under challenging circumstances which restrict gatherings and require physical distancing. A training action plan for disease outbreaks would be a useful resource to tackle such medical emergencies affecting substantial populations in future.

Internship orientation: An essential facilitatory bridging step for medical students

Background

Internship is a facilitatory period that hones skills and helps in the evolution of a qualified medical student to a competent doctor. The feeling of a final year student joining as a fresh intern after successfully completing the final professional examination will be directionless without a bridging initiative through a buffer program. Fresh interns need to be oriented to the fundamentals of working effectively with a patient as a whole and not as a separate discipline. This study was done to evaluate the effectiveness of the internship orientation program and to assess the feedback of participants about this program.

Methodology

This was a study conducted on 235 freshly joined medical interns. The process included evaluation of a well-structured seven-day orientation program by prevalidated structured Multiple Choice Questions (MCQs) and feedback.

Results

All interns performed satisfactorily in the post-test with a mean score of 74.13 ± 7.18. Post-test scores were highest for procedure skills and communication skills, including medical ethics. Overall, 232 (99%) of interns responded that the program was useful and it successfully enhanced their clinical skills; 221 (94%) of interns expressed that the content of the program was excellent to good; and 228 (97%) of interns felt that the method used for training was appropriate. Interns also documented that there were a few new skills that were acquired by attending this program.

Conclusion

There is an unmet need for an internship orientation program across all medical colleges to lay a strong foundation for naive interns. Based on the results, we recommend an internship orientation program for a smooth and swift transition from that of a medical student to professional life. It will orient the interns and lay the foundation for the next level of assignment in building their professional career.

Alternative Strategy Adopted in Practical Assessment for Pathology Postgraduate Certification Examination Amidst COVID-19 Nationwide Lockdown: An Indian Experience with a Novel Hybrid Method of Assessment

BACKGROUND

A major concern and challenge faced by the educational institution during coronavirus disease (COVID-19) pandemic and consequent lockdown is the timely conduct of the summative assessment. Unlike cognitive assessment, real-time practical assessment through online mode, without compromising principles of assessment is difficult. This study was performed to analyze an alternative hybrid approach adopted for the postgraduate practical summative assessment in pathology.

MATERIALS AND METHODS

Evaluation of the process of summative assessment was done where internal and external examiners synchronously assessed examinees real-time on-site (face to face) and off-site (remotely through live videoconferencing) respectively. A pre-validated questionnaire on a novel approach for assessment and feedback (with close-ended on 5-point Likert scale and open-ended questions) were administered to nine participants comprising three final year postgraduates in pathology, four examiners (two internal and two externals) and two technical experts from the Department of Pathology. Overall scores obtained by all examinees were recorded. A pre-validated questionnaire and feedback were administered to the participants to assess the novel approach to assessment.

RESULTS

The mean performance score obtained by examinees was 63.5% in the summative assessment. Feedback analysis revealed that 85% of participants strongly agreed and the rest (15%) agreed that essential minor deviations introduced in this novel mode of assessment did not compromise basic principles and goals of assessment. Quality of assessment through this mode of assessment was graded as good to excellent. All participants responded that this mode of examination may be applied in the future under similar circumstances.

CONCLUSION

This study concludes that an alternative novel hybrid method of real-time synchronous assessment with on-site and off-site examiners may be a feasible and successful model for conducting summative assessment and can be practiced in time of need.

Scientific literacy and the medical student: A cross-sectional study

BACKGROUND

Problem-solving, critical thinking, communication skills and the ability to interpret data are four core components of scientific literacy, which any student must acquire during the educational process. This is of specific relevance to the medical profession as doctors need to be 'scientific' in their approach. The nine domains of scientific literacy are further grouped under two major abilities: understanding methods of enquiry that lead to scientific knowledge and the ability to organize, analyse and interpret quantitative data and scientific information.

METHODS

We included all first-year medical students within the first 2 months of admission in four medical colleges of India. We used the Test of Scientific Literacy Skills, a self- administered questionnaire, which is a validated and standardized tool for evaluating scientific literacy among students.

RESULTS

A total of 525 medical students participated in our study over 3 years-335 were males and the majority of students (73.5%) had joined medical college from schools affiliated with the Central Board of School Education system. The presence of scientific literacy skills across the study sample was low.

CONCLUSION

The relative lack of scientific literacy uncovered by our study needs to be addressed by medical colleges, using innovative student-centred approaches and incorporating social media literacy. Reforms are urgently required in the school education system, which serves as a feeder to the medical education system.

Effect of Organic Dust Exposure on Pulmonary Functions in Workers of Vegetable Market with Special Reference to its Microbial Content

Context:

Wholesale vegetable market is a rich source of generation of organic dust as loads of fruits and vegetables are loaded and unloaded here daily. Thus, regular workers are exposed to this organic dust for a considerable period of time depending on their work schedule. This study was planned to determine the microbial status of organic dust and to explore its association with pulmonary functions in the workers of wholesale vegetable market in Rishikesh.

Materials and Methods:

It was a cross-sectional exploratory/observational study. Thirty-five apparently healthy adult males were selected from vegetable market having no history of any chronic illness. Smokers and alcoholic were excluded from the study. The same number of age- and sex-matched controls with the same exclusion criteria were recruited from workers not working in the vegetable market and also not exposed to any other kinds of organic dust. Microbial culture of air in the vegetable market was done. It was compared with the microbial status of air in the working place of controls. Pulmonary functions of all the workers were performed with the help of digital spirometer (Helios 401).

Results:

Bacterial and fungal concentration was found to be significantly higher in the air of vegetable market as compared to air in the workplace of controls (such as coagulase-negative staphylococci >25 colony-forming unit (CFU) at incubation temperature vs. 10–12 CFU at incubation temperature, significant growth of Mucor, Aspergillus niger, and Candida nonalbicans in vegetable market as compared to workplace of controls). Pulmonary function parameters (percentage forced expiratory volume in 1^st s (FEV₁), percentage predicted forced expiratory flow in mid-half of expiration, and FEV₁) of workers exposed to organic dust in vegetable market were also significantly lower (P < 0.05).

Conclusion:

Exposure of organic dust is associated with compromised pulmonary functions and there is a need of formulation of safety guidelines.

Association of Interictal Epileptiform Discharges with Sleep and Anti-Epileptic Drugs

BACKGROUND

The presence of interictal epileptiform discharges (IEDs) in electroencephalogram (EEG) is diagnostic of epilepsy. Latent IEDs are activated during sleep. Anti-epileptic drugs (AEDs) improve sleep. AEDs, sleep, and IEDs may interact and affect epilepsy management.

PURPOSE

To explore the occurrence of IEDs and its association with sleep and AED status in suspected patients of epilepsy.

METHODS

EEG records were collected of suspected patients of epilepsy who reported to the electrophysiology laboratory of a tertiary care hospital during 1 year. The anthropometric details, clinical presentations, and AED status of the patients were recorded from the EEG records. Patients were divided into 2 categories based on whether AEDs had been started prior to the EEG evaluation (category-I) or not (category-II). The occurrences of IEDs in EEG recordings in both categories were analyzed.

RESULTS

In 1 year, 138 patients were referred for diagnostic EEG evaluation. One-hundred-two patients fulfilled the inclusion criteria, of which 57 patients (53%) belonged to category-I and 45 patients (47%) belonged to category-II. Incidence of IEDs, suggestive of definite diagnosis of epilepsy in category-I was 88% and in category-II was 69%, and this difference was statistically significant (p = 0.02).

CONCLUSION

The increased proportion of IEDs in category-I patients may be due to high clinical suspicion or compounding interaction of AEDs and sleep. More extensive studies are required to delineate the complex interaction of AEDs, sleep, and IEDs so that judicious yet prompt management of epilepsy can be carried out.

Role of yoga and meditation in the context of dysfunctional self: a hypothetico-integrative approach

Aaron T. Beck describes habitual patterns of schemas (ie, organized patterns of thought or behavior) as vital elements of emotional and behavioral experience, whereas biased processing of information accompanies psychopathological states. In this article, the authors propose a hypothetico-integrative approach to understanding the role of yoga and meditation. This approach is based on the background of Beck's model of the psychopathology of the dysfunctional self. The authors have found that the practices common to most forms of yoga and meditation are (1) focusing of attention; (2) creating a state of relaxation; and (3) developing mindfulness through efferent attenuation, sensory attenuation, and nonanalytic attention. Biological studies of meditation and yoga have found a tendency toward use of the relaxation response, the involvement of the attentional networks, and, likely, the cingulatecortex, particularly in the process of bare attention (ie, awareness without thought). This highest level of nonjudgmental awareness may help in obtaining a better-adjusted resilient self.

A comparative study of visual reaction time in table tennis players and healthy controls

Visual reaction time is time required to response to visual stimuli. The present study was conducted to measure visual reaction time in 209 subjects, 50 table tennis (TT) players and 159 healthy controls.

METHODS

The visual reaction time was measured by the direct RT computerized software in healthy controls and table tennis players. Simple visual reaction time was measured. During the reaction time testing, visual stimuli were given for eighteen times and average reaction time was taken as the final reaction time.

RESULTS

The study shows that table tennis players had faster reaction time than healthy controls. On multivariate analysis, it was found that TT players had 74.121 sec (95% CI 98.8 and 49.4 sec) faster reaction time compared to non-TT players of same age and BMI. Also playing TT has a profound influence on visual reaction time than BMI.

CONCLUSION

Our study concluded that persons involved in sports are having good reaction time as compared to controls. These results support the view that playing of table tennis is beneficial to eye-hand reaction time, improve the concentration and alertness.