Perception of rotating interns on emergency medicine posting of undergraduate curriculum and future career

Introductions: Competency in basic knowledge and skill of emergency care is the fundamental goal of all the medical graduates irrespective of their specialty. The aim of this study is to understand the view of young doctors regarding the importance of emergency medicine (EM) both during internship and undergraduate MBBS curriculum. Methods: This was a descriptive cross sectional study conducted at emergency department, KIST Medical College, Lalitpur, Nepal, during 2016 to 2017. Interns were asked to fill up preformed questionnaires to explore the effectiveness of the posting and its necessity to integrate in undergraduate medical education. Results: All the respondent medical interns accepted emergency medicine posting was fruitful. Ninety-six (62.3%) thought one month Emergency Department (ED) posting as appropriate. All the participants thought EM should be included in the undergraduate curriculum (UG). Majority believed it would be appropriate in third year (42%) and final year (42%). One hundred and thirteen (73.4%) wanted to pursue emergency medicine career however 41 (26.6%) were reluctant. Conclusions:  All the interns surveyed accepted emergency medicine to be fruitful and should be included in the undergraduate curriculum with one month emergency department posting, and two thirds wanted to pursue it as future career. Keywords: emergency department posting, emergency medicine, perception of interns, undergraduate medical curriculu

Battle between Host Immune Cellular Responses and HCMV Immune Evasion

Human cytomegalovirus (HCMV) is ubiquitously prevalent. HCMV infection is typically asymptomatic and controlled by the immune system in healthy individuals, yet HCMV can be severely pathogenic for the fetus during pregnancy and in immunocompromised persons, such as transplant recipients or HIV infected patients. HCMV has co-evolved with the hosts, developed strategies to hide from immune effector cells and to successfully survive in the human organism. One strategy for evading or delaying the immune response is maintenance of the viral genome to establish the phase of latency. Furthermore, HCMV immune evasion involves the downregulation of human leukocyte antigens (HLA)-Ia molecules to hide infected cells from T-cell recognition. HCMV expresses several proteins that are described for downregulation of the HLA class I pathway via various mechanisms. Here, we review the wide range of immune evasion mechanisms of HCMV. Understanding the mechanisms of HCMV immune evasion will contribute to the development of new customized therapeutic strategies against the virus