Ways of teaching: Striving to enhance student\u27s understanding in classroom setting

Learning is enhanced when instruction is being designed in-relation to students’ learning styles. Attention to learning styles and learner’s diversity has shown an increase students’ motivation towards learning. Effective teaching is defined as maximizing learner educational achievement, and teacher and student subject contentment. The key attributes of effective teaching are teacher’s preparation; knowledge on the subject; attitude; enthusiasm; and content clarity. Moreover, applying various theories of learning such as behaviorism, cognitivism and humanism are the effective ways to enhance students’ learning journey. Therefore, these effective teaching strategies should be promoted and encouraged in the real world of teaching

Substantial and sustained reduction in under-5 mortality, diarrhea, and pneumonia in Oshikhandass, Pakistan : Evidence from two longitudinal cohort studies 15 years apart

Funding Information: Study 1 was funded through the Applied Diarrheal Disease Research Program at Harvard Institute for International Development with a grant from USAID (Project 936–5952, Cooperative Agreement # DPE-5952-A-00-5073-00), and the Aga Khan Health Service, Northern Areas and Chitral, Pakistan. Study 2 was funded by the Pakistan US S&T Cooperative Agreement between the Pakistan Higher Education Commission (HEC) (No.4–421/PAK-US/HEC/2010/955, grant to the Karakoram International University) and US National Academies of Science (Grant Number PGA-P211012 from NAS to the Fogarty International Center). The funding bodies had no role in the design of the study, data collection, analysis, interpretation, or writing of the manuscript. Publisher Copyright: © 2020 The Author(s).Peer reviewedPublisher PD

Energy conservation of bio-nanofluids past a needle in the presence of Stefan blowing : lie symmetry and numerical simulation

Thermal energy management associated with the transmission of heat is one of the main problems in many industrial setups (e.g. pharmaceutical, chemical and food) and bioengineering devices (e.g. hospital ventilation, heating, cooling devices, heat exchanger and drying food, etc). The current study aims to examine thermo-bioconvection of oxytactic microorganisms taking place in a nanofluid-saturated needle with the magnetic field. Stefanblowing is applied. The leading equations of continuity, momentum and energy, species transport equations for oxygen concentration and population density of microorganisms are reduced dimensionless and Lie symmetry group transformations are used to generate appropriate invariant transformations. The resulting similarity boundary value problem (in which the blowing parameter is coupled with concentration) have been simulated using MATLAB (2015a) bvp5c built in function. The impact of the emerging factors on the nondimensional velocity, temperature, nanoparticle concentration and motile microorganism density functions and their slopes at the wall, are pictured and tabulated. Justification with published results are included. It is found that all physical quantities decrease with Stefan blowing and increase with power law index parameter. With elevation in magnetic field parameter i.e., Lorentzian drag force, the friction factor reduces while the local Nusselt number, local Sherwood number, and the local motile microorganism density wall gradient increase. Present study could be used in food and pharmaceutical industries, chemical processing equipment, fuel cell technology, enhanced oil recovery, etc

Adomian decomposition method simulation of Von Kármán swirling bioconvection nanofluid flow

The study reveals analytically on the 3-dimensional viscous time-dependent gyrotactic bioconvection in swirling nanofluid flow past from a rotating disk. It is known that the deformation of the disk is along the radial direction. In addition to that Stefan blowing is considered. The Buongiorno nanofluid model is taken care of assuming the fluid to be dilute and we find Brownian motion and thermophoresis have dominant role on nanoscale unit. The primitive mass conservation equation, radial, tangential and axial momentum, heat, nano-particle concentration and micro-organism density function are developed in a cylindrical polar coordinate system with appropriate wall (disk surface) and free stream boundary conditions. This highly nonlinear, strongly coupled system of unsteady partial differential equations is normalized with the classical Von Kármán and other transformations to render the boundary value problem into an ordinary differential system. The emerging 11th order system features an extensive range of dimensionless flow parameters i.e. disk stretching rate, Brownian motion, thermophoresis, bioconvection Lewis number, unsteadiness parameter, ordinary Lewis number, Prandtl number, mass convective Biot number, Péclet number and Stefan blowing parameter. Solutions of the system are obtained with developed semi-analytical technique i.e. Adomian decomposition method. Validation of the said problem is also conducted with earlier literature computed by Runge-Kutta shooting technique

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

Multiorgan MRI findings after hospitalisation with COVID-19 in the UK (C-MORE): a prospective, multicentre, observational cohort study

Introduction: The multiorgan impact of moderate to severe coronavirus infections in the post-acute phase is still poorly understood. We aimed to evaluate the excess burden of multiorgan abnormalities after hospitalisation with COVID-19, evaluate their determinants, and explore associations with patient-related outcome measures. Methods: In a prospective, UK-wide, multicentre MRI follow-up study (C-MORE), adults (aged ≥18 years) discharged from hospital following COVID-19 who were included in Tier 2 of the Post-hospitalisation COVID-19 study (PHOSP-COVID) and contemporary controls with no evidence of previous COVID-19 (SARS-CoV-2 nucleocapsid antibody negative) underwent multiorgan MRI (lungs, heart, brain, liver, and kidneys) with quantitative and qualitative assessment of images and clinical adjudication when relevant. Individuals with end-stage renal failure or contraindications to MRI were excluded. Participants also underwent detailed recording of symptoms, and physiological and biochemical tests. The primary outcome was the excess burden of multiorgan abnormalities (two or more organs) relative to controls, with further adjustments for potential confounders. The C-MORE study is ongoing and is registered with ClinicalTrials.gov, NCT04510025. Findings: Of 2710 participants in Tier 2 of PHOSP-COVID, 531 were recruited across 13 UK-wide C-MORE sites. After exclusions, 259 C-MORE patients (mean age 57 years [SD 12]; 158 [61%] male and 101 [39%] female) who were discharged from hospital with PCR-confirmed or clinically diagnosed COVID-19 between March 1, 2020, and Nov 1, 2021, and 52 non-COVID-19 controls from the community (mean age 49 years [SD 14]; 30 [58%] male and 22 [42%] female) were included in the analysis. Patients were assessed at a median of 5·0 months (IQR 4·2–6·3) after hospital discharge. Compared with non-COVID-19 controls, patients were older, living with more obesity, and had more comorbidities. Multiorgan abnormalities on MRI were more frequent in patients than in controls (157 [61%] of 259 vs 14 [27%] of 52; p<0·0001) and independently associated with COVID-19 status (odds ratio [OR] 2·9 [95% CI 1·5–5·8]; padjusted=0·0023) after adjusting for relevant confounders. Compared with controls, patients were more likely to have MRI evidence of lung abnormalities (p=0·0001; parenchymal abnormalities), brain abnormalities (p<0·0001; more white matter hyperintensities and regional brain volume reduction), and kidney abnormalities (p=0·014; lower medullary T1 and loss of corticomedullary differentiation), whereas cardiac and liver MRI abnormalities were similar between patients and controls. Patients with multiorgan abnormalities were older (difference in mean age 7 years [95% CI 4–10]; mean age of 59·8 years [SD 11·7] with multiorgan abnormalities vs mean age of 52·8 years [11·9] without multiorgan abnormalities; p<0·0001), more likely to have three or more comorbidities (OR 2·47 [1·32–4·82]; padjusted=0·0059), and more likely to have a more severe acute infection (acute CRP >5mg/L, OR 3·55 [1·23–11·88]; padjusted=0·025) than those without multiorgan abnormalities. Presence of lung MRI abnormalities was associated with a two-fold higher risk of chest tightness, and multiorgan MRI abnormalities were associated with severe and very severe persistent physical and mental health impairment (PHOSP-COVID symptom clusters) after hospitalisation. Interpretation: After hospitalisation for COVID-19, people are at risk of multiorgan abnormalities in the medium term. Our findings emphasise the need for proactive multidisciplinary care pathways, with the potential for imaging to guide surveillance frequency and therapeutic stratification

Rhino cerebral mucormycosis in systemic lupus erythematosus

Systemic lupus erythematosus (SLE) is a multisystem connective tissue disease. Patients with SLE develop cutaneous infections due to immune dysregulation and treatment with immunosuppressive agents. Deep fungal infections are rare in SLE but are important cause of morbidity. We report a case of successfully treated rhino cerebral mucormycosis (RCM) in a female patient with SLE

Multiple eccrine spiradenomas in zosteriform distribution involving three dermatomes

Eccrine spiradenoma is an uncommon benign tumor of the sweat glands, most frequently characterized by a solitary, painful, deep-seated nodule. A case of multiple spiradenomas in a zosteriform distribution involving three dermatomes is described with its clinico-pathological features