Assessing the validity of admission test into the internship programme at a private university in Pakistan

Objective: To report the development and validity assessment of a comprehensive model of assessment method comprising written test and multiple mini interviews for selection in a medical internship programme. Method: The psychometric validation study was conducted at the Aga Khan University, Karachi, and comprised anonymised scores of written admission test, multiple mini interviews and exit written exams for all the interns who completed their internships in 2018 and 2019. Correlation between admission and exit tests, and predictions were assessed. Data was analysed using SPSS 20. Results: There were 160 interns; 80(50%) each in 2018 and 2019. Mean scores were 68.8±4.40% for written tests and 76.7±4.66% for multiple mini interviews. The mean score for exit examination was 68.1±6.84%. The Cronbach\u27s alpha of scores on the written admission test was 0.82 and 0.88 for the two years, respectively, while for the multiple mini interviews, the corresponding values were 0.81 and 0.94. The written admission and exit tests were moderately correlated (0.44) while the correlations of multiple mini interviews scores with written admissions and exit tests were -0.28 and 0.04, respectively. Conclusion: The selection process should comprise multiple measures of assessment to ensure the selection of the best candidate

Acanthamoeba castellanii of the T4 genotype is a potential environmental host for Enterobacter aerogenes and Aeromonas hydrophila

Background: Acanthamoeba can interact with a wide range of microorganisms such as viruses, algae, yeasts, protists and bacteria including Legionella pneumophila, Pseudomonas aeruginosa, Vibrio cholerae, Helicobacter pylori, Listeria monocytogenes, Mycobacterium spp., and Escherichia coli. In this capacity, Acanthamoeba has been suggested as a vector in the transmission of bacterial pathogens to the susceptible hosts.Methods: Here, we used a keratitis isolate of A. castellanii of the T4 genotype and studied its interactions with two bacterial genera which have not been tested before, Enterobacter aerogenes, and Aeromonas hydrophila, as well as E. coli. Assays were performed to determine bacterial association with and invasion of A. castellanii. Additionally, bacterial survival intracellular of A. castellanii trophozoites as well as cysts was determined.Results: All three bacterial isolates tested, associated, invaded, and survived inside A. castellanii trophozoites as well as A. castellanii cysts. However, E. aerogenes and E. coli exhibited significantly reduced association with and invasion of A. castellanii as compared with A. hydrophila (P \u3c 0.01 using paired T-test, one tail distribution). In the long term survival assays, all three bacterial isolates tested remained viable inside A. castellanii trophozoites, while amoeba remained intact; however A. hydrophila exhibited higher survival inside amoebae (14.54±3.3 bacteria:amoeba ratio) compared with E. aerogenes (3.96±0.7 bacteria:amoeba ratio) and E. coli (5.85±1.1 bacteria:amoeba ratio). A. hydrophila, E. coli, and E. aerogenes remained viable during the encystment process and exhibited higher levels of recovery from mature cysts (14.13±0.89 A. hydrophila:amoeba ratio, 10.13±1.17 E. aerogenes:amoeba ratio, and 11.95±0.7 E. coli:amoeba ratio).Conclusions: A. hydrophila and E. aerogenes also joined the ranks of other bacteria that could benefit from A. castellanii. Because cysts can be airborne, these findings suggest that Acanthamoeba is a potential vector in the transmission of A. hydrophila and E. aerogenes to susceptible hosts

Predictive validity of Family Medicine Resident\u27s performance at induction with their future performance during residency.

Objective: To determine the predictive validity of induction assessment scores of family medicine residency program for performance in final year of residency.Study Design: Psychometric (predictive-validity) study.Place and duration of study: The Aga Khan University Hospital, Karachi, from 2008 to 2014.Methodology: All family medicine residents were evaluated. Family Medicine Residency induction assessment scores were used as independent predictor variables, whereas resident assessment scores during the final year residency program were used as dependent or outcome variables. Data was analyzed using SPSS version 19. Linear regression was used to determine predictive validity of induction scores as independent variables with outcome variables at 95% confidence level.Results: There were 33 residents. MBBS scores accounted for 30.1% of variance in final year Objective Structured Clinical Exam (OSCE) scores; whereas, induction written test accounted for 37.1% of variance in final year written test. Induction communication skill scores did not correlate with in-training communication skill scores or with the final year OSCE scores. Induction professionalism scores accounted for 13.7% of the variation in final year OSCE scores, but not with in-training continuous professionalism scores.Conclusion: Induction knowledge scores have acceptable predictive value for future knowledge and its application. Other valid and reliable assessment methods, such as multiple mini-interviews, should be explored for assessment of noncognitive domains at induction

The Higher The Quality Of Teaching The Higher The Quality Of Education

The higher education plays as leadership role in the system of education. Quality education can ensure security, welfare and prosperity of a nation. The key factors influencing the quality of higher education is the quality of faculty, curriculum standards, technological infrastructure available, research environment, accreditation regime, administrative policies, financing, evaluation and good governance. The main objectives of the study were (1) To evaluate the indicators of good teaching. (2) To examine the institutional policies for valuing the teaching. (3) To examine the contribution of teaching towards professional development of teachers. (4) To find out institutional efforts for enhancing the professional development of teachers. For study purposes five federal universities of Islamabad were taken and their faculties were included in the population. Twenty teachers of each university were taken as the sample of the study. This sample was selected with the help of the students from each department. As students are considered tougher evaluators of the teachers so the selection of the good teachers was completed on the basis of the five common competencies such as competencies related to subject and subject area teaching, competencies related to teaching and learning, competencies in research work and competencies related to professional behaviour .This survey type study was conducted through a questionnaire. The study concluded that good teaching does not pay any benefit to teachers except self-satisfaction and also finding that the requirements for quality teaching are not available in universities. The present study recommends the higher quality of teaching may be ranked and recognized at local, national and international level

Diversity Of Desired And Observed Levels Of Qualities Among Teacher Candidates Perceived By Private School Management

The trend of enrolment in private schools is growing rapidly. The criteria of quality for teacher candidates is complex one, great value is placed for oral interviews along with other formal techniques of selection process. The present study focused to investigate the desired and observed levels of qualities for teacher candidates perceived by their employers at private educational institutions in Pakistan. Interviews of personnel involved in selection process, a focus group discussion and a survey were used as the research method. After semi-structured interview with 20 employers the initial three levels of dimensions of qualities for teacher candidates i.e. dimensions of educational and professional knowledge; dimensions of teaching and professional skills; and dimensions of values and attitudes were developed and kept for  focus group discussion. In this way six qualities for each dimension were finalized and the survey was conducted to rate the desired and observed levels of 18 items. A total number of 139 responses were available through this survey. The mean of desired and observed responses for each item was calculated. The difference between means, standard deviations and t-values were also calculated. The differences in mean values for desired and observed levels for all three categories indicate that employers of private schools are not satisfied with the output of teachers training programs

Ultrasound-guided Intralesional Bleomycin Injection (IBI) for Treatment of Cutaneous Hemangiomas and Vascular Malformations

Purpose: To report the therapeutic outcome of ultrasound-guided intralesional injection of bleomycin in the treatment of cutaneous hemangiomas and vascular malformations. Material & Methods: The medical records of patients with cutaneous hemangiomas and vascular malformations treated with the intralesional injection of bleomycin under ultrasound guidance between August 2009 and June 2013 at the Indus Hospital, Karachi were reviewed retrospectively using a computerized medical record information management system. Data were extracted using a pre-coded performa that included patient demographics, type and location of lesion, number of treatments, presenting/pre- and post-treatment clinical symptoms (pain, swelling, heaviness, size, discoloration), ultrasound appearance and vascularity, and post-treatment side effects. The dose range of bleomycin was 0.5-1.0 mg/kg, but not exceeding 15 mg in a single session. A maximum of four treatments were given in any given patient except for one, who presented with recurrence after a year of complete resolution. Therapeutic outcome was determined using review of ultrasound images and recorded clinical assessment. Treatment response was categorized as: (i) complete resolution [more than 90% reduction]; (ii) substantial reduction [more than 50% reduction]; (iii) mild reduction [25% reduction]; or, (iv) no improvement [ \u3c 10% reduction]. Results: A total of 30 patients (16 female, 14 male), ranging in age from 8 months to 48 years (mean age 10.2 years), were treated from 2009 to 2013. There were 23 hemangiomas. Seven were vascular malformations, of which five were lymphatic malformations and two were venous malformations. Twenty-eight lesions were located in the head and neck region, and two were peripheral.. In 24 of the 30 patients (76%), treatment had been completed. In six patients (21%) treatment was ongoing at the time of this report. Seventeen of the 23 hemangiomas (74%) were completely resolved clinically and on ultrasound, five (22%) showed substantial improvement and one (4%) showed mild improvement. In five of the seven vascular malformations (71%) lymphatic malformations resolved completely, and two (29%) venous malformations showed substantial improvement. Of the 13 patients presenting with discoloration, there was complete resolution in one (7.7%), marked reduction in 11 (84.6%) and mild reduction in one (7.7%). Of seven patients presenting with pain, there was complete resolution in two (28.6%), marked reduction in two (28.6%), mild reduction in two (28.6%), and no improvement in one (14.3%). There were no pulmonary complications. Conclusion: Ultrasound-guided intralesional injection of bleomycin is an option to consider for the treatment of certain types of cutaneous hemangiomas and vascular malformations. Prospective studies should be undertaken to understand the various factors contributing to therapeutic success

Gold nanoparticle conjugation enhances the antiacanthamoebic effects of chlorhexidine

Acanthamoeba keratitis is a serious infection with blinding consequences and often associated with contact lens wear. Early diagnosis, followed by aggressive topical application of drugs, is a prerequisite in successful treatment, but even then prognosis remains poor. Several drugs have shown promise, including chlorhexidine gluconate; however, host cell toxicity at physiologically relevant concentrations remains a challenge. Nanoparticles, subcolloidal structures ranging in size from 10 to 100 nm, are effective drug carriers for enhancing drug potency. The overall aim of the present study was to determine whether conjugation with gold nanoparticles enhances the antiacanthamoebic potential of chlorhexidine. Gold-conjugated chlorhexidine nanoparticles were synthesized. Briefly, gold solution was mixed with chlorhexidine and reduced by adding sodium borohydride, resulting in an intense deep red color, indicative of colloidal gold-conjugated chlorhexidine nanoparticles. The synthesis was con- firmed using UV-visible spectrophotometry that shows a plasmon resonance peak of 500 to 550 nm, indicative of gold nanoparticles. Further characterization using matrix-assisted laser desorption ionization-mass spectrometry showed a goldconjugated chlorhexidine complex at m/z 699 ranging in size from 20 to 100 nm, as determined using atomic force microscopy. To determine the amoebicidal and amoebistatic effects, amoebae were incubated with gold-conjugated chlorhexidine nanoparticles. For controls, amoebae also were incubated with gold and silver nanoparticles alone, chlorhexidine alone, neomycin-conjugated nanoparticles, and neomycin alone. The findings showed that gold-conjugated chlorhexidine nanoparticles exhibited significant amoebicidal and amoebistatic effects at 5 M. Amoebicidal effects were observed by parasite viability testing using a Trypan blue exclusion assay and flow-cytometric analysis using propidium iodide, while amoebistatic effects were observed using growth assays. In contrast, chlorhexidine alone, at a similar concentration, showed limited effects. Notably, neomycin alone or conjugated with nanoparticles did not show amoebicidal or amoebistatic effects. Pretreatment of A. castellanii with goldconjugated chlorhexidine nanoparticles reduced amoeba-mediated host cell cytotoxicity from 90% to 40% at 5 M. In contrast, chlorhexidine alone, at similar concentrations, had no protective effects for the host cells. Similarly, amoebae treated with neomycin alone or neomycin-conjugated nanoparticles showed no protective effects. Overall, these findings suggest that gold-conjugated chlorhexidine nanoparticles hold promise in the improved treatment of A. castellanii keratitis

Frequency and Risk Factors of Depression among Medical Students: A Cross-Sectional Study in Karachi

OBJECTIVES The study aimed to determine the frequency of depression among medical students and to identify the different risk factors associated with depression. METHODOLOGY A cross-sectional study was conducted among medical students at a private medical college in Karachi. The study was initiated after approval was taken from the ethical committee. Consent was taken before the data collection after explaining the details of the study. Students were selected for this study as per inclusion criteria. They were provided with the PHQ-9 questionnaire in which they were inquired about the factors for depression. The total students with depression positive were presented by their frequencies with a 95% confidence interval. RESULTSThree hundred seventy medical students participated, and 207 (56%) tested positive for depression. Notably, depression was more prevalent among final-year students, with 80% affected. Additionally, the severity of depression gradually increased with advancing medical years, reaching the highest level in the final year, where 61 students (80%) reported significant depression. The most frequent causes of depression were living away from home and facing the challenges of a demanding curriculum. CONCLUSION The study findings revealed a higher likelihood of depression among medical students, particularly in their final year. This vulnerability was exacerbated by the stress associated with extensive coursework and peer pressure to achieve excellent exam grades