CME Model of DMIMS (DU) Wardha: The 10 Point Action Program for Learning and Quality as the Outcome.

Tremendous advances are taking place in the field of medical sciences, continuously changing the concept, approach to management and the outcome of several diseases. Maintenance of professional competence remains an exercise of lifelong learning and an essential requirement for evidence - based medical practice. This is in essence the concept of Continuing Medical Education (CME). Datta Meghe Institute of Medical Sciences (DMIMS) is established as Deemed University (DU) in 2005.  Since then CME has been a regular experience. To augment the efficacy of these activities University Center named “Center for Health Professionals Education and Research” (CHPER) identified 10 areas to attain the desirable outcome of CME activities held at DMIMS (DU). It offers a simplified and more rational approach to credit based CMEs and accordingly recommendations and actionable strategies are planned. Keywords: Continuing Medical Education, Accreditation, Deemed Universit

Virulence Characteristics and Genetic Affinities of Multiple Drug Resistant Uropathogenic Escherichia coli from a Semi Urban Locality in India

Extraintestinal pathogenic Escherichia coli (ExPEC) are of significant health concern. The emergence of drug resistant E. coli with high virulence potential is alarming. Lack of sufficient data on transmission dynamics, virulence spectrum and antimicrobial resistance of certain pathogens such as the uropathogenic E. coli (UPEC) from countries with high infection burden, such as India, hinders the infection control and management efforts. In this study, we extensively genotyped and phenotyped a collection of 150 UPEC obtained from patients belonging to a semi-urban, industrialized setting near Pune, India. The isolates representing different clinical categories were analyzed in comparison with 50 commensal E. coli isolates from India as well as 50 ExPEC strains from Germany. Virulent strains were identified based on hemolysis, haemagglutination, cell surface hydrophobicity, serum bactericidal activity as well as with the help of O serotyping. We generated antimicrobial resistance profiles for all the clinical isolates and carried out phylogenetic analysis based on repetitive extragenic palindromic (rep)-PCR. E. coli from urinary tract infection cases expressed higher percentages of type I (45%) and P fimbriae (40%) when compared to fecal isolates (25% and 8% respectively). Hemolytic group comprised of 60% of UPEC and only 2% of E. coli from feces. Additionally, we found that serum resistance and cell surface hydrophobicity were not significantly (p = 0.16/p = 0.51) associated with UPEC from clinical cases. Moreover, clinical isolates exhibited highest resistance against amoxicillin (67.3%) and least against nitrofurantoin (57.3%). We also observed that 31.3% of UPEC were extended-spectrum beta-lactamase (ESBL) producers belonging to serotype O25, of which four were also positive for O25b subgroup that is linked to B2-O25b-ST131-CTX-M-15 virulent/multiresistant type. Furthermore, isolates from India and Germany (as well as global sources) were found to be genetically distinct with no evidence to espouse expansion of E. coli from India to the west or vice-versa

The Business Model: Recent Developments and Future Research

This article provides a broad and multifaceted review of the received literature on business models in which the authors examine the business model concept through multiple subject-matter lenses. The review reveals that scholars do not agree on what a business model is and that the literature is developing largely in silos, according to the phenomena of interest of the respective researchers. However, the authors also found emerging common themes among scholars of business models. Specifically, (1) the business model is emerging as a new unit of analysis; (2) business models emphasize a system-level, holistic approach to explaining how firms “do business”; (3) firm activities play an important role in the various conceptualizations of business models that have been proposed; and (4) business models seek to explain how value is created, not just how it is captured. These emerging themes could serve as catalysts for a more unified study of business models

Risk factors and microbial colonization of soft contact lens storage cases and conjunctiva of asymptomatic lens users

Microbial colonization of contact lens users are more than non-contact lens users due to many factors affecting natural defense mechanism. The presence of a contact lens on the cornea represents a foreign body that can alter tear flow, prevent oxygen and ionic diffusion and cause superficial alterations to the integrity of the epithelial layer. This in turn may render the cornea susceptible to microbial attachment and infection. This work was carried out to study the microbial flora (other than viruses) and factors affecting the microbial colonization of conjunctiva and contact lens storage cases. The study group comprised of randomly selected 93 asymptomatic soft contact lens users attending Medicine OPD for complaints other than eye diseases. One hundred age-and sex-matched healthy non-lens users were included as control. Two swabs each from contact lens storage cases and conjunctiva from study group and one from conjunctiva of control group were taken and inoculated for bacterial, fungal and Acanthamoeba culture. Detailed history regarding change of contact lens solution, duration of use of contact lenses per day and change of contact lens set were taken to study these factors in relation with microbial colonization of contact lens and conjunctiva. Microbial colonization was seen in 32/93 (34.41%) in both samples of the same patient. Microbial colonization was more in persons using contact lens more than 8 h and using the same contact lens for more than one year. A higher value (34.41%) of microbial colonization was recorded in asymptomatic contact lens users when compared with the Control group (4%). Culture positivity showed statistically significant correlation with factors such as duration of use of contact lenses/day and change of lenses. Use of the same contact lens for more than one year increases the microbial colonization