Expanded disability status scale in Multiple Sclerosis: Relationship to visual evoked potential

Background: Multiple sclerosis (MS) prevalence in Iraq is 11.73/100,000 it causes disability in younger adults. Expanded Disability Status Scale (EDSS) can monitor MS disability while Visually Evoked Potentials (VEP) serves as a marker of myelination. Objectives: To explore the relationship between EDSS and VEPs in multiple sclerosis patients. Patients and Methods: A cross-sectional study was conducted in Ghazi Al- Hariri Hospital from first of Nov 2021 till the end of Jan 2022. Fifty patients with multiple sclerosis were compared to 50 healthy individuals. EDSS Data were collected using a structured questionnaire, P100 latency were measured using VEP. The Correlation was used to investigate the relationship between P100- latencies and EDSS. P value ≤0.05 was considered significant. Results: The average age of MS cases was 33.5±8.01 years, and the mean EDSS was 2.8±2.86. A significant difference in the latency period was reported. The study showed a significant positive correlation between EDSS and P100 latency period. Conclusions: Using non-invasive procedures like VEPs can help to monitor and detect deterioration and improvement in MS patients

Multiple choice questions and essay questions in assessment of success rate in medical physiology

Background: Assessment is an important part of the learning cascade in education. Students realize it as an influential motivator to direct and guide their learning. The method of assessment determines the way the students reach high levels of learning. It has been documented that one of factor affecting students’ choice of learning approach is the way how assessment is being performed. Many methods of assessment namely multiple choice questions, essay questions and others are mainly used to assess basic science knowledge in undergraduate education. Objectives: The aim of this study is to compare multiple choice questions (MCQ) and essay questions (EQ) (record the success and failure rate of multiple choice questions (MCQ) and essay questions (EQ)) in regards to the Physiology questions. Methods: A retrospective study was done in which the results of the physiology exams -held in the medical college in Baghdad University -in 2010 are recorded. The number of students underwent the exam was 255. A total of 100 essay questions (EQs) and 100 multiple choice questions (MCQs) were evaluated from the written examinations delivered to second year medical students questions belonged to final examination. Results: Regarding essay questions that have been answered, 33.5% of the questions were not answered as a total. 188 students out of 255 had succeeded which represent 73.7% of the students. Out of 78 marks for MCQ, 46.33 had been achieved, and out of 22 marks for essay 12.9 have been achieved. the success in MCQ questions was 82.9% while in the Essay questions was 67.7% and the failure in both types was 12.5%. Out of 100 questions for both MCQ and Essay questions 55.1±7.9 questions were answered for the MCQ and 51.1±15.3 Essay questions were answered. In general the percentage of the succeeded students was 73. 7% and that of failed students was 26.3%. Conclusion: There is no significant difference in the success rate between MCQs and EQs. الخلفية: يعد التقييم عنصرا هاما في سلسلة التعلم في التعليم. يدرك الطلاب أنها حافز مؤثر لتوجيه تعلمهم. ويحدد أسلوب التقييم طريقة وصول الطلبة إلى مستويات عالية من التعلم. وقد تم توثيق أن أحد العوامل التي تؤثر على اختيار الطلاب لموقف التعلم هو طريقة تقييمهم. يتم تطبيق العديد من أساليب التقييم وهي أسئلة الاختيار من متعدد، أسئلة مقالة وغيرها أساسا لفحص العلوم الأساسية الفهم في التعليم الجامعي. الهدف: الهدف من هذه الدراسة هو مقارنة أسئلة الاختيار من متعدد وأسئلة مقال (تقييم نجاح وفشل معدل أسئلة الاختيار من متعدد وأسئلة مقال) فيما يتعلق باسئلة علم وظائف الأعضاء. الطريقة: أجريت دراسة بأثر رجعي تم فيها تسجيل نتائج امتحانات علم وظائف الأعضاء - التي تم تسجيلها في الكلية الطبية لجامعة بغداد - في عام 2010. وبلغ عدد الطلاب الذين خضعوا للامتحان 255. تم تقييم مجموعه 100 أسئلة مقالة و 100 أسئلة الاختيار من متعدد من الامتحانات المكتوبة التي تدار لطلاب الطب السنة الثانية (الأسئلة تنتمي إلى الامتحان النهائي) النتائج: فيما يتعلق بأسئلة المقالات التي تم الرد عليها، لم يتم الإجابة على 33.5٪ من الأسئلة في المجموع. وقد نجح 188 طالبا من أصل 255 طالبا يمثلون 73.7 في المائة من الطلاب. ومن أصل 78 علامة ل سؤال متعدد الاختيارات، تم تحقيق 46.33، ومن أصل 22 علامة للمقالة 12.9 قد تحققت. وكان النجاح في الأسئلة متعدد الاختيارات، 82.9٪ في حين كان في أسئلة المقال 67.7٪ والفشل في كلا النوعين كان 12.5٪. من أصل 100 سؤال لكل من الأسئلة متعدد الاختيارات و اسئلة المقال، تم الرد على 55.07 ± 7.99 من الأسئلة متعدد الاختيارات و 51.13 ± 15.28 للمقالة. وبشكل عام بلغت نسبة الطلبة الناجحين 73.7٪، وبلغت نسبة الطلبة الفاشلين 26.3٪ الخلاصة: كان معدل النجاح لكل من الأسئلة متعدد الاختيارات وأسئلة المقال نفسه تقريبا مما أدى إلى معدل نجاح إجمالي 73.7٪ الذي يلبي نتائج الدراسات الأخرى التي أجريت مقارنة نوعي الأسئلة

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