CAN RED CELL INDICES, FAMILY HISTORY OF

DIABETES MELLITUS & DAILY EXERCISE

INFLUENCE ACADEMIC PERFORMANCE OF

UNDERGRADUATE MEDICAL STUDENTS ?

AUTHOR : Amulya Govada

CO-AUTHORS: Dr.(Maj)Suma Kaza,

Dr.Mahathi Thotakura ,

Dr.NageswaraRao .

KATURI MEDICAL COLLEGE & HOSPITAL ,

GUNTUR.

INTRODUCTION

Academic performance of Undergraduate(UG) medical

education or preclinical years

- new challenges

- quality of clinical practice

- influenced by many factors

We studied three parameters :

Red cell indices (RCI), Daily exercise and Family history

of Diabetes Mellitus (DM).

•Ananya Mandal et al, Indian J Community Med. 2012 Apr-Jun; 37(2) : 126-129

•Albert Bandura ; Psychological review 1977,84,(2),191-215

•Shah Mohammad Abbas Waseem et al.,www.ijhsr,org.ISSN:2249-9571.

•Diabetes Mellitus and Nutritional Disorders :

Urbanization, junk food consumption

•Hematological parameters (RCI) :

Nutritional Anemia's

•DM Family history :

Inherited traits from parents.

INTRODUCTION……contd

•Santan Ghosh et al, Online journal of New horizons in Education 2013, vol 3(3).

•Yogesh Saxena et al, J Physiol and Pharmol 2011,55(4),pg 364-369.

•A M Peterson et al., PNAS 2014.111(43),pg 15316-1532.

Research highlights the need to provide information for

Educational achievement in the youth

•Intelligence is not the only genetically influenced traits.

•Changing biological needs & how to adjust accordingly.

INTRODUCTION…..contd

•R Peter, et al, International Journal of Basic and applied Medical Sciences 2012, vol2. (3)58-62

AIMS AND OBJECTIVES

• To analyze the influence of red cell

indices, Family history of DM and Daily

exercise on academic performance.

MATERIALS AND METHODS

• Selection of Subject

• Sample Collection

• Questionnaire

Selection of Subject :

• 100 UG medical students - KMCH.

• written consent was taken - subjects & principal

• Inclusion Criteria : 19-21 years.

• Exclusion Criteria: Hostel dwellers

Taken ill - last 4 weeks

On any type of medication

Sample Collection :

• 3 ml venous blood

• Values recorded by automated analyzer –HORIBA (5 - part)

Hb (Hemoglobin),

Hct (Hematocrit),

MCV (Mean Corpuscular Volume) ,

MCH(Mean Corpuscular Hemoglobin),

MCHC(Mean Corpuscular Hemoglobin concentration).

- based on WHO criteria as taken by Manjula et al.

•Manjula VD et al., http://WWW.ijmhs.net . ISSN:2277-4505.

Questionnaire :

• Family history of DM - as having at least one first

degree relative with DM as per Masaru Sakurai et al.

• Daily exercise

• % of Marks secured

•Masaru Sakurai et al ., journal of diabetes investigation volume 4,issue 3,may 2013.pg 261-268.

Students into various grades based on their

academic performance.

GRADE NO.OF TOTAL

STUDENTS

NO.OF GIRLS NO.OF BOYS

A

19 13 (68.42%) 7 (36.84%)

B 27 13 (48.14%) 14 (51.85%)

C 32 14 (43.75%) 18 (56.25%)

D 22 11 (50.00%) 11 (50.00%)

Incidence of anemia – Gender distribution

0.00%

10.00%

20.00%

30.00%

40.00%

50.00%

60.00%

70.00%

80.00%

90.00%

100.00%

NORMAL HB

REDUCED HB

70.05%

97.90%

29.41%

2.04%

GIRLS

BOYS

Academic performance of girls in relation to

their % of HB

30.00%

15.38%

35.71%

36.36%

% OF GIRLS WITH REDUCED HB

A GRADE

B GRADE

C GRADE

D GRADE

Mean values of hematological parameters in

relation to academic performance

39.541.23 41.46 40.34

86.05 87.3 86.40688.318

29 29.36 28.31 30

33.51 33.75 33.72 33.85

0

50

100

150

200

250

A B C D

MCHC

MCH

MCV

Hct

Distribution according to Hematological

parameters

A (19) B (27) C (32) D (22)

MCV

Low 2 2 7 2

High 1 0 1 1

MCH

Low 4 2 6 3

High 1 0 1 1

MCHC

Low 2 0 0 0

High 0 2 2 0

Hct

Low 3 2 2 5

High 1 0 0 0

Family history of DM in relation to

Academic performance

0.00%

20.00%

40.00%

60.00%

80.00%

100.00%

A B C D

POSITIVE FAMILY

H/O DM

NEGATIVE FAMILY

H/O DM

Involvement in daily exercise in relation to

Academic performance

0.00%

10.00%

20.00%

30.00%

40.00%

50.00%

60.00%

70.00%

80.00%

AB

CD

SUBJECTS WITH DAILY

EXERCISE

SUBJECTS WITHOUT

DAILY EXERCISE

DISCUSSION

% of girls with

anemia

% of boys with

anemia

Khaled

Eltohami

Medani et al

36.66% 4.60%

Shah

Mohammad

Abbas et al

38.46% 18.35%

Present study 29.41% 2.04%

•Khaled Eltohami Medani et al.,Int.j.pharm.Med.Res.2014;2(2);34-37.

•Brown et al.,http;//www.sodexofoundation.org/huger.

DISCUSSION ….contd

• Nutritional status

- major determinant of anemia.

- indirectly impacts academic performance.

• In our study most of the girls were anemic and 72.37% have

below average academic performance.

•Brown et al.,http;//www.sodexofoundation.org/hunger.

•Shah Mohammad Abbas Waseem et al.,www.ijhsr,org.ISSN:2249-9571.

DISCUSSION ….contd

Hb, MCV, MCH, MCHC levels were significantly different in

anemic and non-anemic subjects considering both genders.

• UG medical students of Lucknow.

• Government medical college Kottayam, Kerala.

In the present study, Red Cell Indices have shown similar

variations in Anemic and non-anemic subjects.

•Shah Mohammad Abbas Waseem et al.,www.ijhsr,org.ISSN:2249-9571.

•Manjula VD et al., http://WWW.ijmhs.net . ISSN:2277-4505.

DISCUSSION ……..contd

Physical activity promotes learning, concentration and success.

• Studies in the developed world - physical fitness positively

relates to academic performance in young adults.

• In our study 73.68% students with excellent academic

performance involved in daily exercise .

•Dwyer T et al., Pediatric Exercise Science 2001;13:225-237

•Kim HYP et al., Asia Pacific Journal of Clinical Nutrition 2003;12:186-192.

•Knight D et al., Perceptual and Motor skills 1993;756;1296-1298.

•Castelli DM et al. Journal of sport and Exercise Psychology 2007;29:23.,

DISCUSSION ….contd

Risk factor s of DM (jointly) :

Family history – unmodifiable

Daily exercise – modifiable

• 18 % with family history of DM and only 27.73% did daily

exercise.

• 30% of our subjects had family history of DM out of which

30% involved in daily exercise.

•Masaru Sakurai et al ., journal of diabetes investigation volume 4,issue 3,may 2013.pg 261-268.

CONCLUSION

84.21%

15.79%Daily exercise,- Family H/O

DM,Normal RCI

No Daily exercise,+Family

H/O DM,Abnormal RCI

Academic performance of UG students is positively

influenced when RCI is normal ,family history of DM

is absent and when daily exercise is performed.

Limitations

• Sample size

• Dissatisfaction in career choice

• Self-assessed depression

• Learning disorders

• Sleep disorders

• Parental-peer pressure

FURTHER STUDIES SHOULD BE PLANNED IN DIFFERENT

MEDICAL COLLEGES TO GAIN BETTER INSIGHT.

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