Importance of faculty role modelling for teaching professionalism to medical students:Individual versus institutional responsibility

OBJECTIVE: This study explores the perceptions of final year medical students and clinical faculty with regard to role modelling in teaching professionalism. METHODS: In this qualitative research design, we used the Constructivist Grounded Theory model. Six semi-structured interviews with faculty from six clinical specialties and three focus group discussions with 22 final year students were conducted. We applied initial, focused and selective coding along with a thematic analysis of the subject to develop a core category. This is the first part of a larger study that addresses the impact of positive role modelling on teaching professionalism. Findings relevant to negative role modelling are being reported in a subsequent paper. RESULTS: The results showed consensus that positive role modelling is the most important strategy for teaching professionalism to medical students. A disturbing finding was a perceived deteriorating level of inspirational positive role modelling. A lack of institutional support and weak regulatory control were pointed out as potential factors contributing towards this deterioration. CONCLUSION: Positive role modelling was found to be the most effective way to teach professionalism to medical students. However, it cannot be truly effective unless institutions play their role which is pivotal in promoting a culture of professionalism. This can be materialized by recognizing and facilitating conscientious and explicit role modelling by the medical faculty. In addition, an effective regulatory control by the concerned authorities could play an important role

Role of Serum Vitamin B12 and Glutathione Peroxidase during Third Trimester of Pregnancy with Gestational Diabetes Mellitus

Objective: To investigate the role and relationship of serum Vitamin B12 and Glutathione peroxidase in pregnancy with gestational diabetes mellitus (GDM). Study Design: Comparative cross-sectional study. Place and Duration of Study: Physiology Department, University of Health Sciences, Lahore Pakistan, from Feb 2019 to Mar 2020. Methodology: Ninty pregnant women were recruited, fulfilling the inclusion and exclusion criteria. Women with GDM were the cases, and those without GDM were the controls. Serum Vitamin B12 and Glutathione peroxidase were measured by ELISA. Results: Serum Vitamin B12 was significantly lower in cases compared to controls (158.98±7.38 and 357.48±42.07mg/dL, respectively, at p<0.001. Glutathione peroxidase was also significantly lower in cases compared to controls (2.68±1.13U/mL and 5.53±1.05U/mL, respectively, at p<0.001. Correlation analysis showed that Vitamin B12 and Glutathione peroxidase had a significant positive correlation in cases (p<0.001 and rho=0.76) and a non-significant correlation in controls (p=0.87 and rho=-0.024). Linear regression analysis showed that Vitamin B12 positively affects Glutathione peroxidase (β=0.13, p<0.001).Vitamin B12 and Glutathione peroxidase have a significant, negative effect on fasting blood glucose (β =-0.06, p<0.001 and β=- 3.66, p<0.001, respectively). Conclusion: Deficient Vitamin B12 leads to reduced Glutathione levels in GDM pregnancy. A deficiency of these two predicts elevated blood sugar levels

Effects of a high-dose 24-h infusion of tranexamic acid on death and thromboembolic events in patients with acute gastrointestinal bleeding (HALT-IT): an international randomised, double-blind, placebo-controlled trial

Background: Tranexamic acid reduces surgical bleeding and reduces death due to bleeding in patients with trauma. Meta-analyses of small trials show that tranexamic acid might decrease deaths from gastrointestinal bleeding. We aimed to assess the effects of tranexamic acid in patients with gastrointestinal bleeding. Methods: We did an international, multicentre, randomised, placebo-controlled trial in 164 hospitals in 15 countries. Patients were enrolled if the responsible clinician was uncertain whether to use tranexamic acid, were aged above the minimum age considered an adult in their country (either aged 16 years and older or aged 18 years and older), and had significant (defined as at risk of bleeding to death) upper or lower gastrointestinal bleeding. Patients were randomly assigned by selection of a numbered treatment pack from a box containing eight packs that were identical apart from the pack number. Patients received either a loading dose of 1 g tranexamic acid, which was added to 100 mL infusion bag of 0·9% sodium chloride and infused by slow intravenous injection over 10 min, followed by a maintenance dose of 3 g tranexamic acid added to 1 L of any isotonic intravenous solution and infused at 125 mg/h for 24 h, or placebo (sodium chloride 0·9%). Patients, caregivers, and those assessing outcomes were masked to allocation. The primary outcome was death due to bleeding within 5 days of randomisation; analysis excluded patients who received neither dose of the allocated treatment and those for whom outcome data on death were unavailable. This trial was registered with Current Controlled Trials, ISRCTN11225767, and ClinicalTrials.gov, NCT01658124. Findings: Between July 4, 2013, and June 21, 2019, we randomly allocated 12 009 patients to receive tranexamic acid (5994, 49·9%) or matching placebo (6015, 50·1%), of whom 11 952 (99·5%) received the first dose of the allocated treatment. Death due to bleeding within 5 days of randomisation occurred in 222 (4%) of 5956 patients in the tranexamic acid group and in 226 (4%) of 5981 patients in the placebo group (risk ratio [RR] 0·99, 95% CI 0·82–1·18). Arterial thromboembolic events (myocardial infarction or stroke) were similar in the tranexamic acid group and placebo group (42 [0·7%] of 5952 vs 46 [0·8%] of 5977; 0·92; 0·60 to 1·39). Venous thromboembolic events (deep vein thrombosis or pulmonary embolism) were higher in tranexamic acid group than in the placebo group (48 [0·8%] of 5952 vs 26 [0·4%] of 5977; RR 1·85; 95% CI 1·15 to 2·98). Interpretation: We found that tranexamic acid did not reduce death from gastrointestinal bleeding. On the basis of our results, tranexamic acid should not be used for the treatment of gastrointestinal bleeding outside the context of a randomised trial

Perceived Usage and Benefits of Metacognitive Strategies by University Students

oai:ojs2.real.spcrd.net:article/1Currently, the use of metacognitive strategies by students is highly being encouraged for their effective learning. Metacognitive strategies are those learning devices which become learners’ need for their optimal learning. Likewise, metacognitive strategies enable learners to become more confident, skillful, self-evaluator, and more independent by managing and directing their learning process at their own in the best way. Considering the benefits of using metacognitive strategies for students, the theme has not been qualitatively explored about the use of strategies by the students in universities of Pakistan. The purpose of this research work is to explore the perceived use, the extent of use, and benefits of metacognitive strategies by university students in Multan City. Survey research design was used for the accomplishment of the objectives. All students of three public sector universities of Multan city were selected as population. Qualitative data were analyzed through content analysis. The process started by tracing themes, followed by calculation of frequencies and percentages of students’ opinions to explore the frequency of use, extent of use, benefits, and awareness about using metacognitive strategies by university students. For calculation of frequencies and percentages, basic statistics was used. The results found that summarization, highlighting, note taking, bulleting and the concept mapping are the most frequently used learning strategies by university students. It was further found that most of the students use metacognitive strategies during exams, quizzes and tests, but their learning process was improved by using metacognitive strategies. It was recommended for the teachers to promote usage of group learning, discussion method and book reading habits among students and for the policy makers and teachers to create awareness about the frequent use, benefits and importance of metacognitive strategies in the improvement of university students’ learning

Negative faculty role modelling - is it a reflection of deteriorating societal values?

BACKGROUND: Negative faculty role modelling is an area of growing concern especially due to its implications on medical professionalism. The study aims to explore the impacts of negative role modelling on professionalism of medical students in the context of Pakistan.METHODS: This qualitative study is part of a larger study exploring impacts of role modelling on professionalism of students. It is based on Constructivist Grounded Theory involving six semi-structured interviews with clinical faculty and three focus group discussions with 22 students. Initial, focused, selective coding and thematic analysis was used to find the core category.RESULTS: Three overarching categories were developed: traits observed with negative role models; impact of negative role modelling; factors promoting negative role modelling. Subcategories of impacts included negative impact on professionalism, emotional impact, and its paradoxical positive impact. Negative role modelling, a manifestation of declining professionalism, was attributed to deteriorating societal values; further compounded by the lack of required mechanisms by institutions and the regulatory authority at their respective levels.CONCLUSIONS: In the absence of a strong moral platform at societal level, the burden of responsibility rests with the faculty and more importantly with institutions and regulatory bodies to discourage negative role modelling and educate students to recognize, reflect on and avoid negative behaviours and adopt strong professional values.</p

Potential of Trichoderma Isolates to Control Plant Pathogen, Leaf Rust on Different Commercial Wheat Varieties/Genotypes

The efficiency in the treatment of leaf rust of wheat was examined for the plant leaf extracts of neem and Moringa at varied concentrations of 50, 100, and 150 ml correspondingly. All treatments decreased fungal growth in vitro by greater than 90%. The germination of spores was decreased by 91.99% in the presence of neem leaf extract at 150 ml concentration. The percentage of pustules/leaf was reduced by foliar spray of the same treatments on seedlings of the wheat plant. The wheat plants show the greatest response against the pathogen of leaf rust by plant extract second foliar application on the fourth day of infection. Spray application of 150 ml, 100 mL of neem leaf extracts, and 150 ml of Moringa leaf extracts at wheat seedlings and rust development completely prevented four days after leaf rust inoculation. The application of treatments of all extracts on wheat plants at the mature stage significantly reduced the disease (ACI, average infection coefficient) and increased the efficacy of plant extract application as compared with control but neem 150 ml treatment was most effective in all. There was a higher increase of the chlorophyll and phenol content in wheat plants

Negative faculty role modelling – is it a reflection of deteriorating societal values?

Negative faculty role modelling is an area of growing concern especially due to its implications on medical professionalism. The study aims to explore the impacts of negative role modelling on professionalism of medical students in the context of Pakistan. This qualitative study is part of a larger study exploring impacts of role modelling on professionalism of students. It is based on Constructivist Grounded Theory involving six semi-structured interviews with clinical faculty and three focus group discussions with 22 students. Initial, focused, selective coding and thematic analysis was used to find the core category. Three overarching categories were developed: traits observed with negative role models; impact of negative role modelling; factors promoting negative role modelling. Subcategories of impacts included negative impact on professionalism, emotional impact, and its paradoxical positive impact. Negative role modelling, a manifestation of declining professionalism, was attributed to deteriorating societal values; further compounded by the lack of required mechanisms by institutions and the regulatory authority at their respective levels. In the absence of a strong moral platform at societal level, the burden of responsibility rests with the faculty and more importantly with institutions and regulatory bodies to discourage negative role modelling and educate students to recognize, reflect on and avoid negative behaviours and adopt strong professional values.</p

Grasp of wheat leaf rust through plant leaves extract and bioagent as an eco-friendly measure

The efficiency in the treatment of leaf rust of wheat was examined for plant leaf extracts of Neem and Moringa at varied concentrations of 50, 100, and 150 ml correspondingly. All treatments decreased fungal growth in vitro by greater than 90%. The germination of spores was decreased by 91.99% in the presence of neem leaf extract at 150 ml concentration. The percentage of pustules/leaf was reduced by foliar spray of the same treatments on seedlings of the wheat plant. The wheat plants show the greatest response against the pathogen of leaf rust by plant extract second foliar application on the 4th day of infection. Spray application of 150 ml, 100 ml of neem leaf extracts, and 150 ml of Moringa leaf extracts at wheat seedlings, rust development completely prevented four days after leaf rust inoculation The application of treatments of all extract on wheat plants at the mature stage significantly reduced the disease (ACI, average infection coefficient) and increase the efficacy of plant extracts application as compared to control but Neem 150 ml treatment was most effective in all. The chlorophyll and phenol content in wheat plants represented a higher increase. In the case of the first or second-spray application, while the grain yield components of 1000 kernel weight had improved, the second-spray application was more efficient in that respect. To manage leaf rust disease in Bahawalpur, it may thus be inferred that plant extracts are beneficial for a safer biological control compared to synthetic fungicides