Lessons learnt: pilot of mid rotation feedback.

The Aga Khan University went through an external review of its undergraduate medical education in December 2006 based on the accreditation guidelines by the Liaison Committee for Medical Education (LCME). The external review panel comprised of international and local experts which developed a comprehensive report on its findings with regards to LCME standards of accreditation. In the final report of the external review one of the areas highlighted as not meeting the standards of LCME was documentation of formal mid-rotation feedback of the students by the faculty in AKU clerkships through years 3 to 5. A four hour faculty development workshop was organized by the Department of Medicine in collaboration with the Department for Educational Development to emphasize the role of feedback in improving student\u27s performance, improve faculty\u27s skill in giving effective feedback, and to come up with recommendations for documenting the formative feedback process. A mid-rotation feedback form was designed to facilitate the documentation process. Faculty members who participated in the workshop took a lead in piloting this form and reported the areas that could be further improved upon to facilitate the process of timely and effective feedback

Giardiasis in the Southwest Region of the United States: Causes and Preventive Measures

Giardia is a protozoan parasite of the small intestine, and a leading cause of diarrheal diseases worldwide in a variety of animals, as well as humans. Despite the decrease, Giardiasis remains the most commonly reported intestinal parasitic infection principally in the Southwestern region of the United States. The parasite is typically transmitted by fecal-oral route and may be transmitted by direct intake or indirectly from contaminated food or water. Symptomatic Giardiasis is often treated to reduce the duration of symptoms, to prevent future complications, and to minimize transmission of the parasite to other hosts. The clinical image of Giardiasis is mixed, with high variability in severity of clinical disease which can become chronic or be followed by post-infectious sequelae. At present, treatment options include nitroimidazoles derivatives; especially metronidazole, which has been the mainstay of treatment for decades and is still widely used. The Navajo Nation located in the Southwestern region of the United States has suffered from the scarcity of water expediting Navajo populations to use water resources such as underground water, river streams, lakes and surface water as their main source of accessibility. The lack of adequate domestic and municipal water has led several Navajo families to become ill with waterborne infectious diseases like Giardiasis. More recently, molecular methods have become amateur in diagnosis for testing patient samples as well as water samples for Giardiasis. Through direct immunofluorescent staining and other methods that detect intact organisms have improved the detection of Giardia trophozoites or cysts. An understanding of clinical and molecular variability of organisms is important for effective treatment and the response of remedies that are commonly used. The molecular classification of bacteria and viruses isolated from Indigenous patients might have their own specification that can be correlated with isolates from water samples collected from the same localities. This correlation could help us in source tracking and finding solutions for the communities who are already at risk due to the lack of infrastructure and resources. In this review of literature, the causes and preventive measures of Giardiasis are covered to potentially help understand the importance behind this parasitic disease, more specifically on the Navajo Nation of the Southwest of the US

Efficacy of Uterovaginal Packing Versus Uterine Balloon Tamponade to Control Postpartum Hemorrhage Due to Uterine Atony

OBJECTIVES To determine and compare the efficacy of Uterovaginal packing versus uterine balloon tamponade to control postpartum haemorrhage due to uterine atony unresponsive to medical treatment. METHODOLOGY This comparative prospective cross-sectional study was conducted in Hayatabad Medical Complex, OBG department. A total of 140 patients were categorised into two groups, group A underwent Uterovaginal packing and group B underwent uterine balloon tamponade. All women of 18 to 40 years with a history of delivery after 28 weeks of gestation, who developed primary postpartum haemorrhage due to uterine atony, unresponsive to medical treatment were included in the study. Women with a history of delivery before 28 weeks of gestation, secondary postpartum haemorrhage, genital tract trauma, retained placental tissue and membranes, placenta previa, morbidly adherent placenta, febrile illness and uterine structural lesion were excluded from the study. Efficacy was labelled if there was no ongoing blood loss after the procedure with concomitant hemodynamic stability. All information was recorded in a predesigned proforma, and data were analysed using SPSS version 22.RESULTS Our study included 140 women; 113 had a normal vaginal delivery, and 27 underwent cesarean section. Among cases with normal vaginal delivery, 45 women had Uterovaginal packing, and 68 had uterine balloon tamponade, while among cases of cesarean sections, 25 women had uterovaginal packing and 2 had uterine balloon tamponade. The efficacy of Uterovaginal packing was 90%, and that of uterine balloon tamponade was 87.1%, with no significant difference statistically (p- 0.51). Overall efficacy of both procedures was 88.6%.CONCLUSION All orthodontic and non-orthodontic treatment group participants required oral hygiene instructions and had periodontal treatment needs (TN1). The patients requiring scaling and prophylaxis and Oral hygiene instructions (TN 2) were more in the orthodontic treatment group than the non-orthodontic treatment group. A higher percentage of patients requiring complex treatment (deep scaling, root planning and complex surgical procedures), scaling and prophylaxis and Oral hygiene instructions (TN3) belonged to the non-orthodontic treatment group

Study of Postdatism with Respect to Fetomaternal Outcome at A Tertiary Care Hospital

OBJECTIVES This study aims to know our setup’s fetomaternal pregnancy complications that extend beyond 40 weeks of gestation. METHODOLOGY This is a prospective cross-sectional study of 390 patients with uncomplicated postdated pregnancies fulfilling the inclusion and exclusion criteria admitted to the department of Obstetrics and Gynecology (both in spontaneous labour and induced patient) at Hayatabad Medical Complex, a tertiary care hospital in Peshawar, KPK from July 2020 to June 2021.RESULTS Out of 390 patients, a majority (72.30 %) were in the age group of 20 – 35 years. Most of them (50.51%) presented at gestation 40+1 – 40+6 weeks. The majority (57.69%) were multigravida, and most (93.07%) were un-booked. Most delivered vaginally (80.51%), and 19.48% had C/section (including both emergency and elective). The most common indication for C/section was fetal distress (44.73%), followed by C/section on demand (18.42%). The majority>90% had Apgar score greater than seven at 5 minutes which was gestation dependent. Overall perinatal mortality was 4.07% which was also gestation dependent ranging from 0.5% at 40+1 – 40+6 weeks to 2.30% at and beyond 42 weeks of gestation. Neonatal morbidity in the form of Birth asphyxia, Meconium Aspiration Syndrome (MAS), Shoulder Dystocia and NICU admission also showed an increasing tendency with increasing gestation beyond 40 weeks. Maternal morbidity in the form of PPH, perineal tears 3°/4° and endometritis also showed a similar increasing trend with increasing gestation beyond 40 weeks. CONCLUSION Pregnancy continuing beyond 40 weeks has a definite risk to the fetus.

Antimicrobial Activity of Aloe Vera against Pathogenic Bacteria

Present study was conducted to determine the antimicrobial activity of Aloe Vera with ethanol against gram positive (Staphylococcus aureus) and gram negative (Escherichia coli, Klebsiella pneumoniae and Pseudomonas aeruginosa). The Agar well diffusion method was used to test the antimicrobial activity. The result shows that maximum inhibition observed against Staphylococcus aureus and Klebsiella pneumoniae (1mm---4mm), minimum inhibition was observed against Pseudomonas aeruginosa while negligible activity observed against Escherichia coli. This is important to used Aloe Vera for cosmetic and food purpose

Bioethics Education, Awareness of Ethics and Dissemination of Knowledge among Teachers and Students

The main goal of this study was to determine the awareness regarding bioethics education, knowledge and dissemination of knowledge among university teachers and students. This study's primary objective was to learn how educators cope with ethical disagreement inside the classroom and to clarify the factors that influence the way they cope. A total of 17 teachers and 26 students were selected for the study. A Questionnaire were designed and circulated among students and teachers of Jinnah University for Women. The data was collected and subjected to SPSS Software for statistical analysis. In total 43 teachers and students were surveyed out of which about 60% were aware of the importance of bioethics and were in opinion to add as a separate course in the syllabus. The results of the present study give us impression about the level of awareness to bioethics education and knowledge among teachers and students. The knowledge should be applied to conduct such study in larger population which will result in facilitation of services in both public and private sectors. The study revealed out the necessity of a comprehensive education programs related to bioethical issues and its awareness for the students as well as teachers

Effect of Burn Injury on the Dissemination of Candida albicans from the Skin of Mouse

Burn injury is associated with the greatly increased susceptibility of thermally injured patients to infection from a variety of pathogens. Candida albicans is a commensal of skin and has been reported as a severe pathogen in thermally injured patients. Systemic candidiasis has emerged as a major cause of death in burn patients. In this study, the ability of Candida albicans to infect thermally injured host and the host response to systemic infections with Candida albicans was studied by using burned mice. The C. albicans suspension was spreaded over the burn surface. Mice were sacrificed ten days after burn to check the presence of yeasts in the kidneys, lung, liver and spleen or burn wounds. After 48 hr. of incubation of culture plates yeasts were recovered from the kidneys, lung, liver, spleen of burned mice. This study describes the enhanced susceptibility of burned mice to systemic candidiasis and shows that a systemic infection with Candida can lead organisms to contaminate the wound

Effect of Cadmium Levels on the Growth Curve of Candida albicans

Environmental pollution by toxic heavy metals is one of the most pressing problems. Metals are released in the environment in industrial effluent. Cadmium is one of the heavy metal toxic to microorganisms; however, there are yeast strains resistant to this metal. One of yeast species Candida albicans is a diploid fungus (a form of yeast) that is a causal agent of opportunistic oral and genital infections in humans. In the present study, effect of Cadmium on the growth curve of Candida albicans was demonstrated. Candida albicans was grown both in the presence and absence of Cadmium in YEPD media. Growth curves of the Candida albicans were plotted to study the growth pattern of the yeast isolate. It was found that Candida albicans grow well at 50 µg/ml concentration of cadmium. The organism was found to be resistant to the used heavy metal. Growing metal resistant cells is very important as it can ensure better removal through the process of biosorption. Such approaches may help in the removal of toxic metals from the environmental thus reducing environmental pollution