Mannequin-based simulation as an educational tool for learning injection techniques: medical students’ view points

Background: Mannequin-based training devices are simulation adjuncts that mimic reality in healthcare settings for acquiring basic procedural skills, without compromising patient safety. The current study aims to explore students’ perceptions of mannequin-based simulation as an educational tool and perceived changes in self-confidence by using a mixed-method research.Methods: This questionnaire‑based study was conducted in 2nd year MBBS students. Pre-validated questionnaires measured the quantitative and qualitative aspects of simulation-training in-terms of their relevance as teaching–learning tool, perceived benefits of sessions, and their importance for future use. The study further attempted to note any perceived change in students’ confidence, measured before and after sessions. Chi-square and Fischer-exact test were computed for quantitative responses. Wilcoxon signed-rank test (two-tailed) was used to analyse students’ confidence rating before and after simulation. Categorical data were represented as frequencies and proportions.Results: Overall, the sessions were well received by students. Over 90% of students agreed that simulation is a safe, enjoyable and feasible modality for acquiring basic clinical skills. Majority opined that sessions helped them integrate basic-life sciences and clinical concepts, improved attention span and urged inclusion in undergraduate curriculum. Students perceived significant improvements (p<0.001) in confidence post-training. Free-text responses were positive with students highlighting the need for simulation sessions and suggestions for improvement.Conclusions: Most students consider mannequin-based learning as an essential tool to acquire procedural skills. By promoting active student engagement and impactful learning, simulations justify inclusion in medical curriculum for better patient safety

Transition in pharmacology: From theoretical knowledge of medicines to practice-oriented approach. Do role-plays help?

Background: Pharmacology, a subject criticized by medicos as ‘dry and volatile’ is in a stage of constant reformation. Traditional teaching-learning in pharmacology has focused more on theoretical knowledge of medicines with little emphasis on the art and science of communicating the same to patients in actual practice. Role-play is one novel method which attracts learners to gain knowledge through concrete experience, there-by bringing in a behavioural change that persists eventually. The objective of this study was to evaluate the effectiveness of role-play as an educational tool in teaching patient education and counseling skills regarding medications prescription for ischemic heart disease (IHD).Methods: A quantitative, randomized, interventional study with pre & post-OSPE using a pre-validated checklist (modified-Calgary-Cambridge) was conducted in 84, II-MBBS students. The scores obtained in intervention group (Lecture-IHD counseling + Role-play) were compared with the control group (Lecture) using Wilcoxon test for paired-data and Mann-Whitney test for inter-group comparisons.Results: Paired-data analysis showed an increase in post-test mean scores in both control and intervention groups following training. However, inter-group comparisons revealed statistically significant improvement in 8 of the 13 parameters in intervention group. Students in intervention group stressed more on pharmacological aspects of medications, along with emergency measures and need for follow-up. Hence it can be said that role-plays played a significant role in improving communication skills regarding medications prescription.Conclusions: Medical communication skills course for II-MBBS students may enable them to demonstrate better patient-doctor interactions. Role-plays are an effective tool to acquire technical and behavioural skills to deal with real-life situations through simulation

A rare case report of oral prednisolone dependence in a middle aged man

Dependence is an uncommon, but potentially sinister complication of corticosteroid therapy. prednisolone was the most frequently implicated corticosteroid in steroid dependence. Here we report a rare case of oral prednisolone dependence in middle aged man  who had chronic asthma

Pathophysiology of heart failure and frailty: a common inflammatory origin?

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/136680/1/acel12581_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/136680/2/acel12581.pd

2,3,6-Triphenyl­piperidin-4-one

In the title mol­ecule, C23H21NO, the piperidine ring adopts a chair conformation, with the N and carbonyl C atoms as flaps, which deviate on either side of the chair by −0.706 (3) and 0.494 (3) Å, respectively. All three phenyl rings are in equatorial positions on the piperidine ring, making angles with the puckering plane of 73.5 (1), 73.1 (1) and 67.2 (1)°. Though there is no classical hydrogen bonding, the crystal is stabilized by inter­molecular C—H⋯π contacts and π–π stacking inter­actions involving phenyl rings [centroid–centroid distance = 4.424 (2) Å]

Design and Analysis of a Sustainable LV Residential Microgrid

AbstractIn the present scenario, power cuts are daily occurrences in many parts of the world. People all over the world would like to avoid these unscheduled power cuts and have a reliable, secure and clean electricity. For an affordable energy usage, sustainable power generation with renewable resources are highly recommended for environment friendly generation of energy with lower carbon footprints. They are isolated from the utility grid in case of any power outage or power blackouts. The key objective of this work is to model a self-sustained microgrid from the existing Indian distribution feeder, which means a small scale interconnected, centralized single controllable system where the particular arena is supplied with distributed energy resources like solar and wind instead of the main grid. The existing system of a particular region supplied with 42 bus system layout connected with 100 KVA transformer. Wind and the solar sources are designed individually and this hybrid energy is interconnected with the layout model to make up a small, modern self-sustained grid called the microgrid. The results are obtained in PSCAD software package with several case studies

Assessment on awareness of rational prescribing practices among medical interns in a tertiary care hospital: a questionnaire based study

Background: Awareness about rational use of Medicines is required to improve the quality of health care system. Attitude towards rational drug use is also an utmost importance as they constitute the future generation doctors.Methods: A set of 13 questionnaire is given to the interns through an online link to their e-mail which contains informed consent and questionnaires. Respondents has to select the best suitable option and after which the data will be compiled and statistically analyzed.Results: Age of the study participants range from 22-26yrs. Half of them have finished major postings. Almost 96.1 % of them were aware of the term essential drugs. Only 25% of them said that they have NLEMI at work place, 75% of them were aware of the term Rational use of Medicines. Only 32% of them were aware of the term P drugs. 44% of them were aware of STEP criteria for selection of drug and 47% of them were aware of the updated prescribing format. 8% knew the difference between old and new prescription format, 25% of them always prescribe. Almost 82% of them narrate regarding the disease and drug therapy, 31% of them prescribe only generic name.Conclusions: Educational intervention like CME and practical hands on training in Rational use of Medicines would help them in better understanding of the subject and its clinical implications thereby decreasing the prescribing errors

Inulin Fermentable Fiber Ameliorates Type I Diabetes via IL22 and Short-Chain Fatty Acids in Experimental Models

Nourishment of gut microbiota via consumption of fermentable fiber promotes gut health and guards against metabolic syndrome. In contrast, how dietary fiber impacts type 1 diabetes is less clear

Epidemiological, clinical, haemato-biochemical and therapeutic evaluation of canine trypanosomosis in Mumbai

Evaluation of 20 confirmed clinical cases of canine trypanosomosis caused by Trypanosoma evansi in Mumbai from June 2012 to May 2013 was done to compile the basic information on parasitological, epidemiological, clinical, clinico-pathological and chemotherapeutic aspects. The disease was predominantly found in the localities having substantial equine and bovine population thus underlining the potential source for canine cases. Molecular analysis of few representative samples also confirmed the ability of the organisms to crossover from one species to other species of host. The disease was characterized by clinical signs such as depression, anorexia, anaemia, fever, splenomegaly, hepatomegaly and oedema of legs and paraclinical findings such as low levels of TEC, Hb and PCV indicating anaemic trend, elevated levels of alkaline phosphatase, AST, ALT and hyperglobulinaemia associated with reversing of albumin: globulin ratio. Hypoglycaemic trend noted in the study was found positively correlated with intensity of parasitaemia. Blood glucose levels were inversely related to degree of parasitaemia. The chemotherapeutic options, diminazeneaceturate and antrycideprosalt although cleared parasitaemia but failed to provide complete recovery, as 50% of cases eventually died in spite of specific chemotherapy suggesting some secondary involvement in the disease entity

CRT-700.34 Short-Term Outcomes Among Aortic Valve Stenosis Patients Undergoing Impella-Supported High-Risk Percutaneous Coronary Intervention

Background: Among patients undergoing percutaneous coronary intervention (PCI), severe aortic stenosis (AS) is associated with an increased risk of adverse outcomes. Although the use of mechanical circulatory support with Impella has been shown to improve 90-day outcomes in patients undergoing high-risk PCI (HRPCI), there is little information about the safety of this approach in pts with severe AS. We, therefore, sought to evaluate the efficacy and safety outcomes of Impella-supported HRPCI among patients with varying severity of AS. Methods: We studied patients enrolled in PROTECT III—a multicenter study of patients undergoing Impella-supported HRPCI. Patients were classified according to the severity of AS: none/trivial, mild, moderate, and severe. The primary outcome was the rate of major adverse cardiac and cerebrovascular events (MACCE) at 90 days, defined as the composite of all-cause death, MI, stroke/ TIA, and revascularization. Secondary outcomes included in-hospital PCI-related complications, stroke/TIA, and vascular complications requiring surgery. Results: Of 596 patients with echocardiographic data, 490 had no/trivial AS, and 34, 27, and 45 had mild, moderate, or severe AS, respectively. Patients with AS were older, less likely to have diabetes, more likely to have left main disease, and had higher left ventricular ejection fractions (Table). Severely calcified lesions and the use of atherectomy were more frequent among patients with moderate or severe AS. There were no differences in rates of PCI-related complications, stroke/TIA, 30-day MACCE, or 90-day MACCE according to AS severity. Rates of transfusion were higher among patients with AS—regardless of severity. Conclusion: Among patients undergoing Impella-supported HRPCI, PCI-related complications and 90-day outcomes did not differ based on AS status or severity