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Background Health benefits of physical activity measured in terms of metabolic equivalent minutes (MET-minutes per week) have been established. However, factors affecting physical activity, like age, gender, body mass index, waist-hip ratio, particularly in rural communities have not been documented on a large sample. Methods Baseline physical activity data of more than 4000 subjects over 30 years of age, who were enrolled in a randomised community-based study on non-communicable diseases, were analysed. Global Physical Activity Questionnaire was used and anthropometric measurements were classified according to the MONICA study manual. Three domains of physical activity were measured as MET-minutes per week - activity at work, travel to and from places and recreational activities. Association of MET-minutes with sociodemographic variables and risk factors for cardiovascular diseases was studied. Results Mean MET-minutes per week of females were found to be significantly lower than that of males and decreased with advancing age and higher BMI in both genders. Married persons, normal BMI, normal waist-hip ratio, lower leisure time activity had demonstrated higher MET values (P = 0.000). In our study, the prevalence of inactivity (<600 MET-minutes) was 3.2% which was similar in both males and females. As high as 96.2% of the subjects had MET-minutes of > 1200. Nearly 50% of the subjects had leisure time ranging from 121 to 240 minutes per day. Conclusion A large majority of adults over 30 years of age in a rural community in Karnataka (96.2%) had very high MET-minutes per week of >1200 per day. Abnormal BMI, higher waist-hip ratio and more leisure time were associated with lower MET-minutes which are modifiable. About 50% had more than 2 hours of leisure time per day. It is recommended that health promotion for active lifestyle should be encouraged.

Introduction: The pandemic caused by SARS Corona Virus-2 (COVID-19) has caused widespread mortality globally. The hallmark of the disease is the "cytokine storm," which is caused due to dysregulated immune system activation. Numerous inflammatory markers are used to predict the severity and mortality of the infection. Serum Cystatin C levels are associated with immune responses to exogenous and endogenous antigens. Our study was done to assess serum cystatin C as a marker of severity and mortality among patients admitted with COVID-19 infection. Methodology: This cross-sectional study was conducted in a tertiary care center in South India. Sixty-nine patients with mild and severe COVID-19 infection admitted to the hospital were included in the study. Serum Cystatin C levels were estimated at admission. The levels were correlated with disease severity and mortality. Receiver operating characteristic curves (ROCs) was constructed for Cystatin C to predict severity and mortality. The computation of sensitivity, specificity, and positive and negative predictive values was done using optimal cut-off points. SPSS 18 was used for the statistical analysis. Version 18.0 of PASW Statistics for Windows. SPSS Inc., Chicago. Results: Out of 69 patients, 28 (40.5%) had a mild illness, and 41 patients (59.4%) had severe COVID-19 illness. Mean serum Cystatin C levels measured at the time of admission among patients with mild illness was 1.83 (SD-1.53), and among patients with severe illness was 3.84 (SD- 2.59) (p<0.001). The area under receiver operating characteristic curves (ROC) for serum cystatin C for predicting COVID-19 severity and mortality was 0.904 and 0.768, respectively (p<0.001). Conclusion: Patients with severe COVID-19 disease had considerably higher serum levels of Cystatin C than those with mild COVID-19 illness. Cystatin C levels can be useful for predicting mortality and severity among patients admitted with COVID-19 infection.

Background: Estimation of adiponectin levels in diabetic and non-diabetic fatty liver and healthy controls. Methods: We studied 25 subjects for diabetic fatty liver, 25 subjects for non-diabetic fatty liver and 25 healthy controls. Clinical evaluation included anthropometric measurements, BMI, biochemical investigations and adiponectin estimation by ELISA. Results: There were 15 males (60%) and 10 (40%)females subjects in the DFL group, 18 males (72%) and 7 females (28%) subjects in the NDFL group and 13 males (52%) and 12 females (48%) subjects in the control group. 80% (20) of the DFL patients and 72% (18) subjects of NDFL group had BMI >25kg/m 2. 80% (12 males and 8 females) of subjects in the DFL group and 68% (12 males and 5 females) had a waist circumference that indicated central obesity as per Indian cutoffs (>90 cm for females and >80 cm for males). The mean adiponectin (μg/ml) ± SD levels in DFL were 4.03 ± 0.43, NDFL was 5.01 ± 0.55 and in controls was 7.63 ± 0.66, the difference being statistically significant with P <0.001. The difference in the adiponectin levels was statistically significant between each of the three groups with P <0.001. There was no difference in serum adiponectin levels between males and females in all three groups. Conclusion: The chief conclusion of this study are that serum adiponectin levels are lower in subjects with NAFLD than those without it; adiponectin levels are inversely related to the degree of steatosis in NAFLD, with the lowest levels in more severe forms of steatosis.

Introduction: Integrated teaching helps the students to understand the concepts well and conceptualise the subject well. Clinical cases introduced in the first year are interesting and stimulative for the student but may overwhelm and confuse the student. Aim: To know the perception and acceptance of integrated teaching among the first year MBBS students which include multiple case scenarios. Materials and Methods: This educational research is a cross-sectional observational study involving first year medical students in Ramaiah Medical College, Bangalore. Study was conducted for a period of one year (August 2018 to June 2019). Horizontal integration of a system in the first year MBBS subjects were done. This was followed by an interactive session conducted by a Clinician basically comprising of multiple case scenarios on the particular system. The sessions focussed on integration of basic medical science subjects and their application in the case scenarios. Six organ-systems were similarly covered. The integrated sessions involved in-class discussions of the clinical cases and were designed, implemented and moderated by two faculties (clinicians and basic science faculty). Collected data were entered into MS Excel, and analysis was done using SPSS software. The students’ feedback regarding the perception of integrated teaching was collected on the Five point likerts scale using a validated questionnaire and analysed. Results: The number of students included in the study was 140. About 135 (96.4%) of the students felt that integrated teaching using multiple case scenarios motivates them to learn in a better way. About 133 (95%) of students felt that integrated teaching helps them to understand concepts well, stimulates the critical thinking. About 136 (97.14%) of students felt that integrated teaching helped them to understand the topic in a holistic way. Conclusion: The students felt that the integrated teaching using multiple case scenarios enhanced their perception and comprehension of the diseases and helped them to understand the relevance of application of pre-clinical knowledge in clinicalpractise.