Learning approaches and performance of medical students

Objective: To identify the best assessment method for medical students with different learning approaches.Methods: The cross-sectional questionnaire-based study was conducted at Bahria University Medical and Dental College, Karachi, from March 2010 to April 2011, and comprised first year medical students. The questionnaire was tailored from the Approaches and Study Skills Inventory for Students on a five-point scale Deep approach, Surface apathetic approach and Strategic approach were assessed through relevant sub-scales. Response to questions was summed for the subscales and main scales for a learning approach. Mean scores for aggregate marks obtained by multiple choice questions, short answer questions, problem-based learning and objective structured physical examination were derived. Coefficient of variation was estimated to find the most reliable assessment method.Results: Of the 100 students enrolled, 98(98%) completed the study. Of them, 51(52%) were girls and 47(48%) were boys. Overall, 70(71.4%) students displayed Strategic approach, and 13(13.3%) showed Surface apathetic approach. Objective structured physical examination had the least variation (12.27) for all approaches whereas maximum variation (14.92) was observed by problem-based learning scores.Conclusions: Assessment by problem-based learning scores was able to demarcate deep learners whereas consistent scores were obtained by objective structured physical examination which failed to discriminate variance in performance by different learners

Knowledge Management at Higher Educational Institutes in Bangladesh: The case study of self-assessed processes of two educational Institutions

Knowledge Management of higher education is correlated to self-assessment process .This can act as a well-thought-out groundwork for effective decisions and work plan relating to quality assurance at Bangladesh. The research was created on secondary sources and presents qualitative research. Department of Accounting and Information System of Jagannath University (JU), Bangladesh and Department of Pharmacy, Dhaka International University (DIU). In command of progress and ensure excellence in Advancement of Educational Institutions are obligatory to be more receptive to the global varying requirements of both types of internal and external stakeholders as observed by the authors. University Grants Commission (UGC), Bangladesh should come forward with ranking system of journal rankings   to improve quality of research as observed by the authors. Employability skill among the students with originality and inventive nature is being required. For selecting teachers, in the circular of public universities they should refrain from advertising that private university passed students cannot apply as suggested by the authors. Authors’   recommended that  the country need to shape own branding through formulating National educational qualification framework from preprimary to Tertiary level of education with an appropriate connection and evaluation     not following mainly Malaysia but also developed nations need to be prepared

NMDA encephalitis in an elderly with poor prognosis

We present a case of a 65 years old man from Islamabad who presented with six months history of psychiatric and behavioural symptoms, significant weight loss. Later on he developed difficulty swallowing and altered sensorium. This was followed by an episode of shortness of breath leading to respiratory arrest, followed by ICU stay on ventilator support, then developed focal deficit in form of left sided weakness, dysautonomia, bradycardia leading to cardiac arrest and another cardiopulmonary resuscitation, myoclonic jerks, orofacial dyskinesias, status epilepticus, coma ultimately resulting in death of the patient. Patient was found to be NMDA receptor antibody positive. CT chest and abdomen did not reveal any hidden malignancy. Patient was given intravenous pulse steroids for 5 days followed by five sessions of plasmapheresis but did not respond. He stayed on ventilator support for 40 days and did not improve. This is the second case of antibody proven NMDA encephalitis from Pakistan, the first being from Islamabad as well and published in this journal

Occupational stress: an analysis of the causes

Occupational stress may have an impact on the effectiveness of an organisation. Excessive workload or demand, stressful deadlines, long working hours, insufficient number of staff, lack of support from co-workers and supervisors, annoying co-workers, unsatisfied customers, and hazardous working conditions, among others are some of the underlying causes of occupational stress. Job uncertainty due to impending retrenchment, restructuring or management changes and hostile work environment could also give rise to occupational stress. Occupational stress often results in high dissatisfaction among the employees in terms of job mobility, burnout and poor work performance and less effective interpersonal relations at work. Excessive or unmanageable demands, insufficient support from co-workers and unsatisfactory working conditions may affect staff-motivation and productiveness. Longterm stress or traumatic events at work may have affect the workers physically and psychologically. In light of the above, this paper seeks to deliberate on the causes of occupational stress with reference to unmanageable workload,job insecurity, sexual harassment, workplace discrimination and employer’s unlawful conduct

Occupational stress: an analysis of the causes

Occupational stress may have an impact on the effectiveness of an organisation. Excessive workload or demand, stressful deadlines, long working hours, insufficient number of staff, lack of support from co-workers and supervisors, annoying co-workers, unsatisfied customers, and hazardous working conditions, among others are some of the underlying causes of occupational stress. Job uncertainty due to impending retrenchment, restructuring or management changes and hostile work environment could also give rise to occupational stress. Occupational stress often results in high dissatisfaction among the employees in terms of job mobility, burnout and poor work performance and less effective interpersonal relations at work. Excessive or unmanageable demands, insufficient support from co-workers and unsatisfactory working conditions may affect staff-motivation and productiveness. Longterm stress or traumatic events at work may have affect the workers physically and psychologically. In light of the above, this paper seeks to deliberate on the causes of occupational stress with reference to unmanageable workload, job insecurity, sexual harassment, workplace discrimination and employer’s unlawful conduct

Kashmiri refugees at the verge of hepatitis B and C epidemic in the State of Azad Jammu and Kashmir, Pakistan

OBJECTIVE: To determine the seroprevalence of hepatitis B and C among immigrants residing refugee camps in Muzaffarabad, Azad Kashmir, Pakistan, and to identify possible risk factors for HBV and HCV transmission. METHODS: Around 1,225 individuals inhabiting Muzaffarabad refugee camps, participated in the study. A qualitative Immuno-Chromatographic Technique was used for initial screening and PCR test was used for detection of HBV and HCV in participants. The major risk factors for HBV and HCV transmission were assessed using a questionnaire approach. RESULTS: Around 86 (7.0%) individuals were observed for HBsAg presence, and 215 (17.5%) individuals were found positive for Anti-HCV. Only 32 (2.6%) individuals were confirmed for HBV DNA and 126 (10.3%) individuals were positive for HCV RNA after PCR. Demographically, both HBsAg and Anti-HCV were found more prevalent in female (4.4% HBsAg and 10.8% Anti-HCV) population as compared to male (2.6% HBsAg and 6.7% Anti-HCV) population. Surprisingly, the HBsAg (23.5%) and Anti-HCV (41.1%) appeared to be more frequent in the age group 62–75 years. Previous history of hepatitis in the family (p < 0.0001), blood transfusion (p = 0.0197) dental treatment (p < 0.0001) and tattooing or piercing on any part of the body (p = 0.0028) were assessed as significant risk factors in HBV and HCV transmission. CONCLUSIONS: Presence of 7.0% HBsAg and 17.5% Anti-HCV in a small fragment of the migrant population cannot be overlooked. Lack of awareness among people and negligence of health department could escalate the situation

Workplace misconduct and the requirement of due inquiry: with reference to the practice in Malaysia

This paper discusses the concept of workplace misconduct and the requirement of a domestic or due inquiry to establish the alleged act and with reference to the practice in Malaysia. The issues considered herein are as follows: (a) whether the disciplinary or domestic inquiry is essential in an impending dismissal for alleged gross misconduct; and (b) whether the dismissal carried out without convening a disciplinary inquiry violates the principles of natural justice thereby rendering the dismissal unfair

Attitude and perception towards vaccination against poliomyelitis in Peshawar, Pakistan

OBJECTIVE: This research aimed to quantitatively assess the general public's awareness, attitude and perception of polio and its vaccination in Peshawar KPK, Pakistan. METHODS: We conducted a survey-based study to understand the surge in polio cases from 2015 to 2019 in the Peshawar city of the Khyber Pakhtunkhwa (KPK), Pakistan. A pre-tested questionnaire-based study was conducted in 2019 to assess the attitude and general perception of residents of Peshawar KPK towards polio vaccination. RESULTS: Out of 241 country-wide polio cases, 63 (26.1%) polio cases were reported in Peshawar city from 2015–2019. The questionnaire revealed that individuals between 18–30 years of age had sufficient knowledge (65.1%) about polio. Male and female participants had equal awareness (~ 43%). Participants with higher education (45.9%), those with better financial status (49.5%), individuals with children < 5 years of age (46.4%), and those who had experience of a polio patient (63.1%) had better knowledge. Participants inhabiting the central city were better aware (50.5%) of polio than individuals living in the outskirts. CONCLUSION: The data indicated that poor knowledge and negative attitudes of people towards polio vaccination are the main causes of the polio eradication program's failure. Moreover, religious beliefs, unchecked migration between the Pak-Afghan border, and lack of knowledge about polio vaccination are identified as critical barriers to polio eradication

Outcome of inadvertent high dose BCG administration in newborns at a tertiary care hospital, Karachi- Case series

Bacillus Calmette-Guérin (BCG) vaccine is given to newborns soon after birth. BCG vaccine overdose has been rarely reported. Here we report the outcome of newborns who accidently received high dose BCG at a tertiary care hospital, Karachi. We reviewed records of 26 newborns, who accidentally received intradermal high dose BCG, used for the treatment of urinary bladder cancers and 80 times higher dose than the BCG used for routine vaccination. The incident happened from 14-16th April, 2016 at Aga Khan University Hospital, Karachi. Analysis was carried out using SPSS. A total of 23/26(88.5%) newborns were followed for atleast 3 months and 11/26 (42.3%) were followed for atleast one year. 13/26 (50%) were male. All 26 patients were prescribed isoniazid and rifampicin for 3 months. 3/26 (11.5%) were lost to follow-up before completion of anti-tuberculous drugs (ATT). Lesions at the BCG site were observed in 16/26 (61.5%) infants, of which 15 (93.8%) had a papule, 3 (18.8%) developed a pustule, 3 (18.8%) had skin induration and 2 (12.5%) had skin erythema. Axillary lymphadenopathy was observed in 1/26 (3.8%) patient. Coagulation was deranged in 3/26 (11.5%) of babies. Intracranial bleeding was observed in 1/26 (3.8%) case. Localized skin lesions were the most common adverse events. None of them developed clinical tuberculosis. Chemoprophylaxis for inadvertent high dose BCG administration should be given for atleast 3 months. Furthermore, vigilant follow-up, transparency and disclosure are the vital steps in the management of any medical error