COVID-19 is a strong disruptive force that has not only influenced our global health and economy but also has changed the way we teach, learn and communicate with our students. It has disturbed the regular education pattern and the standard practices that we adapted over many years. The challenge is beyond changing the mode of delivering instructions from face to face to online. The real challenge is in creating a culture that supports the adoption of innovative practices, which require different skills and competences from the teacher, student, mentor and administrator, and at the same time maintaining the quality of the products. In other words, changing what was exceptional to be the norm over a short period of time. This article describes our approach "Open Learning" in managing such change. Our over-riding philosophy is about ensuring that students have high quality resources, and the enthusiasm and learning skills to benefit from them. At the same time we want to optimise the use of the available online applications and learning management system so that their use is within the capability of our faculty. This paper describes the evolution of our approach and the principles upon which it has been based. Our experiences over the past few months will transform the educational experience of our students over the years to come.
Rheumatic and musculoskeletal diseases (RMDs) encompass a spectrum of degenerative, inflammatory conditions predominantly affecting the joints. They are a leading cause of disability worldwide and an enormous socioeconomic burden. However, worldwide deficiencies in adult and paediatric RMD knowledge among medical school graduates and primary care physicians (PCPs) persist. In October 2017, the World Forum on Rheumatic and Musculoskeletal Diseases (WFRMD), an international think tank of RMD and related experts, met to discuss key challenges and opportunities in undergraduate RMD education. Topics included needs analysis, curriculum content, interprofessional education, teaching and learning methods, implementation, assessment and course evaluation and professional formation/career development, which formed a framework for this white paper. We highlight a need for all medical graduates to attain a basic level of RMD knowledge and competency to enable them to confidently diagnose, treat/manage or refer patients. The importance of attracting more medical students to a career in rheumatology, and the indisputable value of integrated, multidisciplinary and multiprofessional care are also discussed. We conclude that RMD teaching for the future will need to address what is being taught, but also where, why and to whom, to ensure that healthcare providers deliver the best patient care possible in their local setting.
Aim The current study assessed the case fatality rate (CFR) across different income level countries of the world, and the virulence pattern of COVID-19, against the backdrop of panic and uncertainty faced by many governments, who are trying to impose draconian containment measures to control the outbreak. Subjects and Methods: Data on confirmed cases and number of deaths due to coronavirus infection were retrieved from the WHO as on 30 March 2020, and examined for the various income level countries, per the World Bank criteria. The CFR was calculated country-wise and estimated for the various groups such as low, lower-middle, upper-middle, and high-income, and the data was analyzed. Results The overall CFR for the high income countries was 5.0%, compared with a CFR of 2.8% for low-income countries. The upper-middle-income countries showed a CFR of 4.3%, while the lower-middle-income countries stood at 3.7%. The results from our study predict that the maximum CFR in high-income countries will be contained at approximately 5% (95% CI). The CFR for the low, lower-middle, and upper-middle-income countries will range between 2.8 and 4.3% (95% CI). Conclusion COVID-19, irrespective of its transmissibility, produces a lower CFR compared with that of SARS-Cov and MERS-Cov, although COVID-19 has infected eight times more countries than MERS-Cov and SARS-Cov, and caused a higher number of deaths. The nation-wide lockdown measures to prevent the spread of the virus may be reconsidered, given the hardships for the population and their impact on the economic system.
Objective:To assess the frequency of foot ulcers and their risk factors among diabetic patients visiting surgery department in a university teaching hospital in Ajman, UAE especially in relation to gender, nationality and age, blood glucose levels and lipid profile. Materials and Methods: This hospital-based retrospective record analysis was conducted for patients with diabetes mellitus visiting department of surgery for a period of 8 years from 2002 to 2010. Diabetic patients with foot ulcers were cases and those without were controls. Results: Among the diabetic patients recruited for this study, 75% were males and 25% were females. Among these diabetic patients, 76.3% of male patients were diagnosed with foot ulcers as opposed to 23.8% of female patients. Majority of diabetic patients were from Asia (53.1%) and MiddleEast (33.8%). Diabetic foot ulcers were reported more in Asian patients (57%) compared to patients from Middle East (29.1%). Diabetic foot ulcers were most prevalent in the age group 50 to 59 years (42.5%) and least prevalent in the age group 20 to 29 years (5%). The mean HDL, total cholesterol, LDL and VLDL were all higher for diabetic patients with foot ulcer than controls with levels of only HDL being statistically significant (p<0.05). Mean HDL levels for cases was 37.3±8.3 whereas that for controls was 31.3±7.9. The mean Post Prandial blood glucose is 286.4 mg/dl for diabetic patients without foot ulcer which is significantly higher than diabetic patients with foot ulcer who had a mean value of 249.6 mg/dl but there was no significant difference in mean fasting glucose values. Conclusion: Asian middle-aged male diabetics are most likely to have foot complications. HDL levels were high whereas post-prandial blood glucose levels were comparatively low in diabetics with foot ulcers than without.
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