Acute urinary retention and gastroparesis due to self-medication in an elderly male

An eighty-five years old man complained of difficulty in swallowing for relatively dry food items and water with occasional episodes of vomiting. He was a diabetic and hypertensive patient on treatment for long, suddenly reported pain and discomfort in the abdomen with inability to pass urine. All the parameters were within normal limits except prostate being 70 ml enlarged. He was catheterized with diagnosis of BPH with chronic urinary retention. TURP was advised but the case did not consent for it. On close scrutiny of detailed history, it was observed that the patient was on self-medication of homeopathic drugs which were causing smooth muscle relaxation of bladder and GIT, causing difficulty in deglutition and constipation. On discontinuation of drugs, these effects disappeared and the case did not need any further catheterization, concluding that the acute urinary retention was caused by self-medication induced constipation. It is hence inferred that self-medication with homeopathic medicines should be avoided specially by elderly as aging effects and co-morbid condition often coexist

Program management challenges of clinical studies: A qualitative critical assessment

Background: Organization, coordination, and discipline are required to complete any intricate operation, conducting a clinical experiment is no different. There are usually many moving components, from designing a plan, to conveying changes, to calculating risk, and excellent project management which are necessary to guarantee the study works successfully. Past evidence suggested that roadblock at any level hampers the progress of the clinical research. Understanding program management challenges hence becomes the key for timely and effective completion of clinical research. Methods: A cross-sectional qualitative enquiry involving stakeholders in clinical research program management. We used problem tree-based approach wherein we documented views of various stakeholders to understand the interaction, interdependence, and related interventional needs of bottlenecks for long-term research gains using modern management methods applicable in clinical settings. The best fit approach was also explored to augment maximum benefit in limited resource settings. Results: Non-alignment with state policy aims, a lack of effective coordination and communication among members, challenging logistic management, limited use of technology, a need for training, and an inefficient monitoring mechanism were among the major issues highlighted, and solutions were proposed. Conclusion: Study concludes that an Integrated Process-cum-Timeline-Based Management strategy with multisectoral emphasis is ideal for program management of clinical projects

Concept mapping a potential pedagogical strategy to foster meaningful learning in physiology students

BACKGROUND: Understanding of human physiology is critical for clinical practice and disease management. Escalating the teaching-learning method to improve conceptual knowledge may help the students to apply their knowledge in clinical scenarios. The present study was conducted to teach the use of concept mapping as a learning strategy to foster meaningful learning in physiology, compare its impact as a learning tool with traditional methods on meaningful learning, assess the cognitive gain, and find student’s perception regarding concept mapping. MATERIALS AND METHODS: The interventional study was conducted on first-year MBBS students. Depending upon marks obtained in previous internal assessments, the students were classified into “rapid learners” (RL) and “potential learners” (PL). By simple random sampling technique, both groups were divided into interventional (concept mapping) and control groups (question-answer discussion). After a pretest, all students had a lecture on glomerular filtration. The assignment was given to the interventional group to prepare a concept map on glomerular filtration, and question-answer were discussed for control groups. A surprise posttest was conducted after 2-3 days. RESULT: In our study, all four groups showed significant differences in the pretest and posttest scores using a paired t-test (P < 0.05). The mean score of gain in learning, raw gain (G0), absolute learning gain, relative learning gain, and average normalized gain compared between the interventional group and controls group showed statistically significant performance improvement in both RL and PL groups. CONCLUSION: The concept mapping strategy was more efficacious than the question-answer discussion. Concept mapping is an impactful learning tool to improve cognitive gain and potential pedagogical strategy to foster meaningful learning in physiology students