The Hospitalist Huddle: a 1-year experience of teaching Hospital Medicine utilizing the concept of peer teaching in medical education

Mohammed Elhassan Department of Internal Medicine, Division of Hospital Medicine, UCSF/Fresno Center for Medical Education and Research, Fresno, CA, USA Background: The relatively new specialty of Hospital Medicine in the USA is one of the fastest growing fields in internal medicine. Academic hospitalists are largely involved in the medical education of postgraduate residents and medical students. Little is known about the effectiveness of peer-to-peer teaching in internal medicine residency training programs and how the medical residents perceive its educational value in learning Hospital Medicine.Materials and methods: The Hospitalist Huddle is a weekly educational activity newly established by our Hospitalist Division to facilitate the concept of peer-to-peer teaching. It requires medical residents to teach and educate their peers about the clinical topics related to Hospital Medicine. Faculty hospitalists serve as facilitators during the teaching sessions. A survey ­disseminated at the end of the first year of its implementation examined the residents’ perception of the educational value of this new teaching activity.Results: Most residents reported that they see the Huddle as a useful educational forum which may improve their skills in teaching, create a better educational and learning environment during their inpatient rotation, and improve their understanding of Hospital Medicine. Most residents also prefer that their peers, rather than faculty hospitalists, run the activity and do the teaching.Conclusion: The survey results support the notion that teaching and learning with flat hierarchies can be an appealing educational method to medical residents to help them understand Hospital Medicine during their medical wards rotation. Some areas need to be improved and others need to be continued and emphasized in order to make this novel educational activity grow and flourish in terms of its educational value and residents’ satisfaction. Keywords: graduate medical education, peer-to-peer teaching, teaching Hospital Medicine, medical residents’ educatio

Malaria and pre-eclampsia in an area with unstable malaria transmission in Central Sudan

<p>Abstract</p> <p>Background</p> <p>Placental malaria and pre-eclampsia occur frequently in women in tropics and are leading causes of maternal and perinatal morbidities and mortality. Few data exist concerning the interaction between placental malaria and pre-eclampsia.</p> <p>Methods</p> <p>A case control study was conducted in Medani Hospital, which locates in an area of unstable malaria transmission in Central Sudan. Case (N = 143) were women with pre-eclampsia, which was defined as systolic blood presure≥140 mm Hg or diastolic blood pressure ≥ 90 mm Hg and proteinuria. Controls were parturient women (N = 143) without any blood pressure values > 139/89 mm Hg or proteinuria. Obstetrical and medical characteristics were gathered from both groups through structured questionnaires. Placental histopathology examinations for malaria were performed.</p> <p>Results</p> <p>Twenty-eight (19.6%) vs. 16 (11.2%); <it>P </it>= 0.04 of the cases vs. controls, had placental malaria infections. Five (2%), 1 (2%) and 22 (28.0%) vs. 1, 2 and 13 of the placentae showed acute, chronic and past infection on histopathology examination in the two groups respectively, while 115 (80.4%) vs.127 (88.8%) of them showed no infection, <it>P </it>= 0.04. In multivariate analysis, while there were no associations between age, parity, educational level, lack of antenatal care, blood groups and body mass index and pre-eclampsia; family history of hypertension and placental malaria (OR = 2.3, 95% CI = 1.0-5.2; <it>P </it>= 0.04) were significantly associated with pre-eclampsia.</p> <p>Conclusion</p> <p>Placental malaria was associated with pre-eclampsia. Further research is needed.</p

Effect of Conjunctive Use of Water for Paddy Field Irrigation on Groundwater Budget in an Alluvial Fan

Rosana G. Moreira, Editor-in-Chief; Texas A&M UniversityThis is a Technical Paper from International Commission of Agricultural Engineering (CIGR, Commission Internationale du Genie Rural) E-Journal Volume 5 (2003): A. Elhassan, A. Goto, and M. Mizutani. Effect of Conjunctive Use of Water for Paddy Field Irrigation on Groundwater Budget in an Alluvial Fan. Vol. V. December 2003

Response of aerobic rice (Oryza sativa L.) to seed rate and inter-row spacing, Gezira State, Sudan

&nbsp;&nbsp;&nbsp; Field experiments were conducted for two consecutive seasons (2013/14 and 2014/15) at the Gezira Research Station Farm, Wad Medani, Sudan under irrigation condition. A randomized complete block design with four replicates was used. Treatments were arranged in a factorial combination of four inter-row spacing (15, 20, 25 and 30 cm) and five seed rates (59, 71, 83, 95 and 107 kg/ha). Data collected consisted of growth attributes, grain yield and yield components. Data collected were subjected to standard analysis of variance procedure. The results showed that seed rate, inter-row spacing and their interaction exhibited highly significant differences in grain yield and yield components. The highest grain yield was obtained by the seed rate of 95 kg/ha and 15 cm inter-row spacing in both seasons and the combined analysis. To obtain high grain yield of aerobic rice under Gezira conditions, 95 kg/ha seed rate and inter-row spacing of 15 cm is recommended to be used

EPIDEMIOLOGY OF MATERNAL MORTALITY AND POOR PERINATAL OUTCOMES IN DIFFERENT REGIONS OF SUDAN

Background: Both maternal mortality and poor perinatal outcomes (mainly; low birth weight, stillbirth and perinatal mortality) are health as well as obstetrics indicators. Thus, there is an urgent need to investigate epidemiology of maternal mortality and poor perinatal outcomes in the different regions of Sudan. Objectives: To investigate the epidemiology of maternal mortality and poor perinatal outcomes in the different regions of Sudan. Methods: Various cross- sectional, case -control, and Cohort studies were conducted during the last 7 years. Results:&nbsp; Maternal mortality was ranged 442 (146/33034)-640 (63/9841) / 100000 birth in the different regions of Sudan, most of these were due to communicable diseases. Low birth weight was reported in 15.3% (80/524), 12.5% (260/2076), 12.6% (97/1224), 14.9% (64/430) 12.6% in New Halfa, Khartoum, Medani and Elfashir, respectively. Anaemia was risk factors for low birth weight in Elfashir and in Medani; it was risk factor for fetal anaemia in New Halfa and risk factor for stillbirth in Kassala. There were 21 (206/9841), 29 (981/34015), 35(46/1293)/ 1000 stillbirths and 33(44/1342)/1000 in Elfashir, Medani, Khartoum respectively and Kassala, respectively. There was 9.2% (46/500) perinatal death in New Halfa. Conclusion: More effort should be paid to reduce the high maternal and perinatal mortality. More care should be toward nutrition, malaria prevention and other communicable disease

Water Harvesting of the area North of Khartoum Bahri

The purpose of this study is to solve the problem of rain water of the area north of the Khartoum Bahri and protect the Villages from the floods, and conduct a comprehensive hydrological study of the water basins passing through that area. The methods used in this study were to collect data from different sources such as Digital Elevation Maps, Urban development maps, Rainfall data. In addition to hydrological, hydro geological studies and survey works. These data were analyzed using hydraulics equations and probability distribution functionsf(x). From the results the basins catchment drainage has been identified and planned based on hydrology, geological and topography of the area and it was found that the basins that produce the torrents, mostly located north east of the catchment, the area of these catchment is 11.5 km 2. The maximum out flow for catchment is about 138 m3/s in the central of catchment area, and is considered the best selected area for the construction of water harvesting technique. Normal distribution has been found to be the best fitted distribution for the representation of the annual rainfall in study area. Conclusion and recommendation drawn from this study is to Construct embankment or dike to prevent the water passing in the north-east direction of the study are

RAK CERVIKSA U TRUDNOĆI: PRIKAZ BOLESNICE

The case of 29 years old pregnant III-para at 38 weeks of gestational age is presented. The patient was admitted complaining of vague abdominal pain. By speculum examination the large cervix with reddish ulcerative cervical canal was established and punch biopsy performed. The pathohistological diagnosis was well differentiated squamous cell carcinoma. No local metastases or lymph node or other signs of cancer spreading were present (stage 1a). The CS was done, born vital newborn of 2 kg weight, proceeded to total abdominal hysterectomy with bilateral salpingoophorectomy. The pathohistological finding was: Stromal invasion of 3 mm in depth and 6 mm in lateral spread (FIGO stage 1a1). Postoperative period was uneventfull, the patient was reffered to Institute of Nuclear Medicine for further management, where she received only 2 cycles of radiation and chemotherapy and thereafter stopped the treatement. Two years later the patient presented very ill and passed because of uremia.Prikazana je bolesnica dobi 29 godina, III-para, s oko 38 tjedana trudnoće. Primljena je zbog nejasnih boli u donjem trbuhu. Pregledom u spekulima nađen je krupni cerviks s ulceracijom u cervikalnom kanalu. Pod anestezijom je učinjena biopsija cerviksa i dobivena patohistološka dijagnoza: dobro diferencirani karcinom pločastih stanica. Nije bilo lokalnih metastaza, širenja u limfne čvorove ili drugih znakova širenja raka (stupanj 1a). Učinjen je carski rez i nastav¬ljena totalna histerektomija s obostranom salpingooforektomijom. Patohistološki nalaz je bio: stomalna invazija 3 mm u dubinu i postranična zahvaćenost 6 mm (FIGO stupanj 1a1). Postoperativni je tijek bio uredan, bolesnica je upućena u Zavod za nuklearnu medicinu radi zračenja i kemoterapije. Primila je samo dva ciklusa terapije i tada napustila liječenje. Nakon dvije godine pacijentica se pojavila vrlo bolesna, umrla je od uremije