Background. Our study was taken up to explore the possible factors influencing poor performance of undergraduate students in clinical skill demonstration.Aims. Identification of factors leading to poor clinical skill development in undergraduate medical students.Settings and Design. This is an observational study.Methods and Material. The study population comprised the undergraduate students and teachers of the Department of Medicine. All were provided with structured questionnaires who responded anonymously which were then interpreted with the help of software statistical calculator.Results. Of the 145 students, only 57 (39.3%) actually attended medicine ward. The major factors that the students reported were large groups of students around a patient (94.74% ± 4.67), inadequacy of information in books of clinical medicine (78.9% ± 8.53), overcrowded unclean wards (73.7% ± 9.2), lack of practice of clinical methods at home (50.8% ± 10.4), and timing of classes (42.1% ± 10.3). Teachers cited poor attendance of students to wards (76.2% ± 17.1), poor condition of wards and lack of separate enclosures to teach (100%), and large groups around a single patient (66.67% ± 17.9).Conclusions. Absenteeism of students, overcrowding of wards, and lack of uniformity of study materials were prime factors.
Objectives:
One of the most prevalent autoimmune disease globally, rheumatoid arthritis (RA) is caused by interplay of multiple inflammatory mediators in specific joints. Altered redox balance is one of the key factors in pathophysiology of RA. This study aims to find whether oxidative stress in peripheral blood neutrophil correlates with the disease activity and disability associated with it.
Methods:
Ten healthy controls and 29 RA patients with moderate to severe disease activity (DAS28 score >3.2) were recruited and reactive oxygen species (ROS) level in peripheral blood neutrophil was measured using flow cytometry at baseline visit and after 6 months follow-up. Functional status of RA patients was measured using Health Assessment Questionnaire Disability Index (HAQ-DI).
Results:
RA patients showed significantly higher level of ROS in compared to healthy control. DAS28 correlated well with ROS at baseline visit (Pearson's
r
= +0.63) as well as follow-up visit (Pearson's r = +0.75). HAQ-DI showed weak positive correlation at baseline visit (Pearson's
r
= 0.1) but it was negative at follow-up visit (Pearson's
r
= -0.19).
Conclusions:
Oxidative stress mirrors the disease activity in RA and can be considered as a biomarker, but it is not related with functional ability of the patients.
Background: Anti-inflammatory activity of leaves of Bougainvillea spectabilis (family Nyctaginaceae) has already been demonstrated in experimental animals. As pain is one of the important components of inflammation, we had set forward a study this find out possible analgesic activity of the same in animal models Objective: Evaluation of analgesic effects of, Bougainvillea spectabilis in mice models. Methods: 215 gm of fresh dried leaves of Bougainvillea spectabilis (BS) were collected from the local area during the flowering season and air dried. Following Methanol extraction, under reduced pressure solvent was removed on a rotary evaporator. The lyophilized extract was collected and the yield was 8 gm. That was used as an emulsion prepared in propylene glycol and orally administered (20 and 50 mg/kg). Central and peripheral analgesic activities of Bougainvillea spectabilis (BS) were evaluated by tail flick, tail immersion test and writhing test (acetic acid induced) respectively. Study Design: This is an experimental study designed on animal models. Results: Bougainvillea spectabilis (BS) had shown no analgesic action in central analgesic model at different hours as the reaction time was less than 10 seconds at all time interval. With regard to peripheral analgesic activity, maximal activity was observed at 50 mg/kg b.w. The mean writhes ± standard deviation were 42.7±0.9 and 40±0.5 respectively in BS (20 mg/kg) and BS (50 mg/kg) in comparison to standard drug aspirin (33.3±0.4), control mice being 55.3±0.4. Conclusion: Our data indicates that Bougainvillea spectabilis (50 mg/kg) has a significant peripheral analgesic activity. Without isolating the active principles it's extremely difficult to pinpoint the mechanisms contributing to the observed analgesic activities of Bougainvillea spectabilis and extrapolate that in clinical practice.
Introduction: The disease spectrum of dengue, scrub typhus and typhoid presenting as acute febrile illness is often a diagnostic dilemma to the clinician. The purpose of this study is to compare the clinical features and laboratory parameters of children suffering from typhoid, dengue and scrub typhus and use these parameters in early identification of scrub typhus before conclusion is made from serological diagnosis.
Methods: A retrospective observational analytical study was conducted among children presenting with acute febrile illness in a tertiary care level hospital. Over the period of one year 113 cases were identified of which 39 were dengue, 44 were typhoid and 30 were scrub typhus.
Results: The mean age of the children was 7.45 ± 2.98 years, median was eight with an interquartile range of six to ten years. The male to female ratio was 1.3:1. Symptoms of vomiting (61.54%), headache (46.15%) and hepatomegaly (47.37%) were significantly higher among children with dengue fever. A significantly higher number of children with scrub typhus fever had temperature above 40°C. The incidence of low haemoglobin, raised C reactive protein, raised ALT and low albumin levels were significantly higher in them. Children with acute febrile illness having temperature > 40°C, absolute neutrophil/lymphocyte ratio > 2 early in the illness were more likely to suffer from scrub typhus with relative probability ratio (RPR) of 25.68 and 10.57 respectively (p < 0.001). Children with WBC < 5000/mm3 were more likely to be suffering from dengue with RPR of 10.60 (p < 0.001).
Conclusion: Children with acute febrile illness with temperature > 40°C and absolute neutrophil/lymphocyte ratio > 2 early in the illness were more likely to be suffering from scrub typhus.
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