Flipped classroom instructional approach in undergraduate medical education

Objective: In this study we implemented the “flipped classroom” model to enhance active learning in medical students taking neurosciences module at Aga Khan University, Karachi. Methods: Ninety eight undergraduate medical students participated in this study. The study was conducted from January till March 2017. Study material was provided to students in form of video lecture and reading material for the non-face to face sitting, while face to face time was spent on activities such as case solving, group discussions, and quizzes to consolidate learning under the supervision of faculty. To ensure deeper learning, we used pre- and post-class quizzes, work sheets and blog posts for each session. Student feedback was recorded via a likert scale survey. Results: Eighty four percent students gave positive responses towards utility of flipped classroom in terms of being highly interactive, thought provoking and activity lead learning. Seventy five percent of the class completed the pre-session preparation. Students reported that their queries and misconceptions were cleared in a much better way in the face-to-face session as compared to the traditional setting (4.09 ±1.04). Conclusion: Flipped classroom(FCR) teaching and learning pedagogy is an effective way of enhancing student engagement and active learning. Thus, this pedagogy can be used as an effective tool in medical schools

Three siblings with Charcot-Marie-tooth Disease with no other family history

Charcot-Marie-Tooth (CMT) disease is one of the most common inherited disorders of the peripheral nervous system. Patients diagnosed with CMT disease have axonal degeneration which results in muscle wasting, sensory loss and weakness. These patients have a very characteristic walking gait and shape of hands, along with other changes. Despite many common visible changes, no singular common genetic mutation for this disease or its cure has been identified. Therefore more case series for this disease needs to be identified so that future studies increase our knowledge about this disease. Here, we present a case series of 3 out of 4 siblings who have been diagnosed with CMT disease. Based on their age, these siblings show the different developmental stages of this disease. More of such case series need to be identified and reported so that we can identify the true genetic cause of this disease and develop a definitive cure for it

Temporal Lobe Epilepsy with Hippocampus Sclerosis: Prevalence, Etiology, And Treatment Options with Herbal Medicines

ABSTRACT Background and objectives: Epilepsy is a neurological disorder in which the patient suffers with two or more unprovoked seizures. It is one of the most common neurological disorders worldwide, affecting more than 70 million people. Currently various modes of effective treatments are available, but still there are many cases that remain drug resistant. Hence, there is a need to explore herbal medications for the treatment of drug resistant epilepsy. Methods: Recent reviews and research articles (2000-2022) from PubMed and Google Scholar have been explored. Review: Based on etiology, there are six categories of epilepsy: Genetic, Structural, Metabolic, Immune, Infectious, and Unknown epilepsy. Temporal lobe epilepsy with hippocampus sclerosis (TLE-HS) is one of the most common forms of structural epilepsy. Even though several new anti-epileptic drugs (AEDs) have been discovered, but the treatment of some cases, especially TLE-HS remain resistant to them. Surgery is one of the most effective treatment options for TLE-HS; however, this usually results in memory deficits, and occasionally, intracranial hematoma, delayed hydrocephalus, subdural empyema, and visual field defects in patients. Conclusion: Hence, to overcome drug resistance, new pharmacological and herbal therapies are required. Animal trials are first step in the development of new drugs, to study toxicity and efficacy of proposed drugs. Many herbs have anticonvulsant activity but remain an under-explored treatment option for epilepsy. Further research on herbal extracts as a possible treatment for epilepsy needs to be conducted

General practitioner\u27s knowledge regarding the diagnosis and drug therapy for acute myocardial infarction

OBJECTIVE: To assess the general practitioners (GP) knowledge regarding the diagnosis and initial drug therapy for acute myocardial infarction (AMI). METHODS: A questionnaire-based survey was conducted in randomly selected GPs of Karachi. Doctors working in community as GPs who were registered medical practitioners having a Bachelor of Medicine & Bachelor of Surgery degree were included in the study. Doctors working at tertiary care facilities or having a post graduate degree or post graduate training in a specialty other than family medicine were excluded from the study. RESULTS: A total of 186 GPs participated in our study. GPs who studied research journals were 2.33 times more likely to investigate serum cardiac troponins levels for the diagnosis of AMI compared to those who did not study research journals (P = 0.02). Twenty six percent of the GPs said that they would refer a patient with suspected AMI without treatment, while 76% said that they would consider some treatment prior to referral. Fifty eight percent of the GPs identified ST segment elevation myocardial infarction (STEMI) of \u3c 12 hours duration as an indication of thrombolysis while 28% identified posterior wall AMI as a thrombolytic indication. CONCLUSION: GPs, although adequately aware of the presenting features of AMI, were lacking in knowledge regarding the means for confirmation of diagnosis, initial drug therapy and were less likely to carry management steps in their practice

Herbal extracts: the future treatment option for drug-resistant epilepsy

Epilepsy is a neurological disorder characterised by two or more unprovoked seizures. The high prevalence and incidence of epilepsy globally, especially in Asia, has remained a big concern over the course of centuries. Patients are usually prescribed the already known anti-epileptic drugs, but even after going through three different generations of anti-epileptic drugs, some people still suffer from drug-resistant form of epilepsy. These patients are usually prescribed a higher dose of anti-epileptic drugs, which results in more adverse effects. That is why new treatment options, like herbal extracts, should be explored for patients who do not respond to the classic anti-epileptic drugs. The current narrative review was planned to explore if herbal extracts can be the future for the treatment of drug-resistant epilepsy. Key Words: Epilepsy, Herbal extracts, Drug-resistant epilepsy, Anti-epileptic drugs