Pediatric faculty and residents’ perspectives on In-Training Evaluation Reports (ITERs)

Background: In-training evaluation reports (ITERs) are used by over 90% of postgraduate medical training programs in Canada for resident assessment.  Our study examined the perspectives of faculty and residents in one pediatric program as a means to improve the ITER as an evaluation tool.Method: Two separate focus groups were conducted, one with eight pediatric residents and one with nine clinical faculty within the pediatrics program of Memorial University’s Faculty of Medicine to discuss their perceptions of, and suggestions for improving, the use of ITERs.Results:  Residents and faculty shared many similar suggestions for improving the ITER as an evaluation tool.  Both the faculty and residents emphasized the importance of written feedback, contextualizing the evaluation and timely follow-up.  The biggest challenge appears to be the discrepancy in the quality of feedback sought by the residents and the faculty members’ ability to do so in a time effective manner.  Others concerns related to the need for better engagement in setting rotation objectives and more direct observation by the faculty member completing the ITER.Conclusions: The ITER is a useful tool in resident evaluations, but a number of issues relating to its actual use could improve the quality of feedback which residents receive

Telemedicine For Retinal Care In Developing Nations: The Orbis Cyber-Sight Programme, 2003-2011

ORBIS International has provided a web-based ophthalmic disease consultation service, Cyber-Sight, for developing nations since 2003. The system connects partner physicians with mentor physicians. We have reviewed consultations concerning retinal cases submitted from June 2003 to December 2011. Of 943 retinal consultations reviewed, 117 were excluded, mainly for reasons of technical limitations at the partner sites. Of the 826 included cases, 504 patients were male and 322 were female. The average age of the patients was 43 years (range 2 months to 86 years). Cases were submitted from partner physicians in 30 countries, with five countries accounting for 82% of the cases (India, Vietnam, Indonesia, China, Jordan). There was a rise in the case submission rate to a peak of 251 cases in 2010. The mean consultant response time was 5 days (SD 9). The mean time to case closure was 19 days (SD 92). The most common diagnoses were diabetic retinopathy (n = 101), retinal vascular occlusion (n = 75) and retinal detachment (n = 61). The working diagnosis submitted by the partner did not match the mentor\u27s diagnosis in 153 cases (19%). The number of incorrect initial partner diagnoses demonstrates that the teleretinal programme serves a useful diagnostic role for partner physicians. The Cyber-Sight programme is a viable method of delivering advanced retinal expertise to partner institutions and increasing capacity for partner doctors in the developing world. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav

Synthesis, antimicrobial and antioxidant activities of some 5-pyrazolone based Schiff bases

A series of nine new biologically active Schiff bases 5a–i were synthesized by a condensation of 4-acyl-5-pyrazolones 3a–c with aromatic diamines 4a–d, and characterized by elemental analysis, mass and spectroscopic data. All the compounds showed antibacterial activity against Bacillus subtilis and Escherichia coli, good antifungal activity against Phytophthora infestanse and Aspergillus niger, and ferric-reducing antioxidant power (FRAP)

A comprehensive review of SARS-CoV-2 vaccines: Pfizer, Moderna & Johnson & Johnson

The novel coronavirus outbreak was declared a pandemic in March 2020. We are reviewing the COVID-19 vaccines authorized for use in the United States by discussing the mechanisms of action, administration, side effects, and efficacy of vaccines developed by Pfizer, Moderna, and Johnson & Johnson. Pfizer and Moderna developed mRNA vaccines, encoding the spike protein of SARS-CoV-2, whereas Johnson & Johnson developed an adenovirus vector-based vaccine. Safety has been shown in a large cohort of participants in clinical trials as well as the general population since emergency approval of vaccine administration in the US. Clinical trial results showed the Pfizer and Moderna vaccines to be 95.0%, and the Johnson & Johnson vaccine to be 66.0% effective in protecting against moderate and symptomatic SARS-CoV-2 infection. It is important to keep medical literature updated with the ongoing trials of these vaccinations, especially as they are tested among different age groups and upon the emergence of novel variants of the SARS-CoV-2 coronavirus

EFFECT OF PHARMACOGENOMIC TESTING ON PEDIATRIC MENTAL HEALTH OUTCOME; A 6 MONTH FOLLOW UP - supplemental material

   Supplementary Figure 1: Multiple regression of enzyme metabolizer status as reported from PGT on treatment outcomes. Of the enzymes tested, only COMT metabolizer status was significantly associated with better treatment outcomes.    Supplemental Figure 2: Trend of decreasing CGI Severity scores with COMT Val158 isoforms. The x-axis represents isoform types from PGT: 1 = homozygous COMT Met158/Met158; 2 = heterozygous COMT Met158/Val158; 3 = homozygous COMT Val158/Val158. Because Met158 variants have been shown to have lower activity than Val158 variants, these genotypes can be used as a rough proxy for metabolizer speeds, with Met158/Met158 and Val158/Val158 representing slow and fast metabolizers respectively.    Supplemental Figure 3: Mean values of CGI-improvement scores among individuals with ADHD tested for COMT variants are shown. Patients in each group experienced significant (p>0.001) improvement over baseline. While small sample sizes prevented conclusions of statistical significance, absolute improvement and odds of improvement were greatest for patients with Val/Val variants. </p

Peptide Engraftment on PEGylated Nanoliposomes for Bone Specific Delivery of PTH (1-34) in Osteoporosis

Bone-specific functionalization strategies on liposomes are promising approaches to delivering the drug in osteoporotic conditions. This approach delivers the drug to the bone surface specifically, reduces the dose and off-target effects of the drug, and thereby reduces the toxicity of the drug. The purpose of the current research work was to fabricate the bone-specific peptide conjugated pegylated nanoliposomes to deliver anabolic drug and its physicochemical evaluations. For this, a bone-specific peptide (SDSSD) was synthesized, and the synthesized peptide was conjugated with a linker (DSPE-PEG2000-COOH) to obtain a bone-specific conjugate (SDSSD-DSPE). Purified SDSSD-DSPE was characterized by HPLC, Maldi-TOF, NMR, and Scanning Electron Microscope/Energy Dispersive Spectroscopy (SEM/EDS). Further, peptide-conjugated and anabolic drug-encapsulated liposomes (SDSSD-LPs) were developed using the ethanol injection method and optimized by Central Composite Design (CCD) using a statistical approach. Optimized SDSSD-LPs were evaluated for their physicochemical properties, including surface morphology, particle size, zeta potential, in vitro drug release, and bone mineral binding potential. The obtained results from these studies demonstrated that SDSSD-DSPE conjugate and SDSSD-LPs were optimized successfully. The particle size, % EE, and zeta potential of SDSSD-LPs were observed to be 183.07 ± 0.85 nm, 66.72 ± 4.22%, and −25.03 ± 0.21 mV, respectively. SDSSD-LPs demonstrated a sustained drug release profile. Further, the in vitro bone mineral binding assay demonstrated that SDSSD-LPs deliver the drug to the bone surface specifically. These results suggested that SDSSD-LPs could be a potential targeting approach to deliver the anabolic drug in osteoporotic conditions

Aneurysm management in patients over 80 years old with good grade subarachnoid haemorrhage

BackgroundAn increasing proportion of aneurysmal subarachnoid haemorrhage (aSAH) occurs in older patients, in whom there is widespread variability in treatment rates due to a different balance of risks. Our aim was to compare outcomes of patients over 80 years old with good grade aSAH who underwent treatment of their aneurysm with those who did not.MethodsAdult patients with good grade aSAH admitted to tertiary regional neurosciences centres contributing to the UK and Ireland Subarachnoid Haemorrhage Database (UKISAH) and a cohort of consecutive patients admitted from three regional cohorts were included for analysis. Outcomes were functional outcome at discharge, three months and survival at discharge.ResultsIn the UKISAH, patients whose aneurysm was treated were more likely to have a favourable outcome at discharge (OR 2.34, CI 1.12–4.91, p = .02), at three months (OR 2.29, CI 1.11–4.76, p = .04), and lower mortality (10% vs. 29%, OR 0.83, CI 0.72–0.94, p &lt; .01). In the regional cohort, a similar pattern was seen, but after correction for frailty and comorbidity there was no difference in survival (HR 0.45, CI 0.12–1.68, p = .24) or favourable outcome at discharge (OR 0.83, CI 0.23–2.94, p = .77) and at three months (OR 1.03, CI 0.25–4.29, p = .99).ConclusionsBetter early functional outcomes in those undergoing aneurysm treatment appear to be explained by differences in frailty and comorbidity. Therefore, treatment decisions in this patient group are finely balanced with no clear evidence overall of either benefit or harm in this cohort