Purpose Acanthamoeba and fungal infections can be recalcitrant to therapy - more so when the deeper layers of the corneas are involved. We describe the diagnosis and successful management strategies employed in a case of deep keratitis due to co-infection with Acanthamoeba and Cladosporium sp. Observations Once the diagnosis of co-infection with both Acanthamoeba and Cladosporium was made, treatment was initiated with a combination of PHMB, chlorhexidine, natamycin, and voriconazole; to which the response was favorable. Signs of relapse with spread of the infection to the deeper plane and the presence of endothelial exudates were noted at 5 weeks. This was attributed to poor compliance. Though the response to re-initiation of therapy under direct supervision was once again favorable; it was only after the introduction of intrastromal voriconazole repeated at timely intervals that rapid and complete resolution was obtained. Conclusions Severe keratitis due to fungi or Acanthamoeba very often requires surgical intervention. Complete resolution with medical therapy was obtained only after the introduction of intrastromal voriconazole; thereby avoiding a therapeutic keratoplasty. The addition of voriconzole both topically and particularly intrastromally facilitated faster resolution as well as restricted the duration of therapy with more toxic drugs such as phmb and chlorhexidine.

India stands at a critical point on its path to be among the fastest growing economies of the world. The nation however is faced with paradoxes. India needs to leverage its vast demographic potential by educating and training over 130 million people in the age group of 18-23 years with skills and capabilities relevant to the demands of a modern knowledge based economy. Further, there remains an urgent need to reform the vast and unwieldy legacy higher education system that seems to have lost much of its relevance in today's technologically advanced and connected world. The education infrastructure in the country is inadequate to support our ambitious targets of increased enrolment, while it faces challenges of quality and relevance to the job market and cannot provide universal access to training and education.The Twelfth Five-Year Plan (2012-17) of the statutory body responsible for governing higher education in India opens with: 'Higher education in India is passing through a phase of unprecedented expansion, marked by an explosion in the volume of students, a substantial expansion in the number of institutions and a quantum jump in the level of public funding'.In this context the present paper makes an attempt to examine the various challenges of Higher Education in India that need to be addressed based upon the analysis of primary data obtained in survey. HEIs have a commitment to the development of a knowledge based society in its mission to move towards faster economic development.

Medical education in Malaysia is facing challenges related to the increasing number of local private and foreign medical universities. The key issue is whether the system is producing doctors who have adequate competencies for fundamental patient-centred care. The Malaysian Medical Licensing Examination (MMLE) was proposed by the Ministry of Health (MOH) as a common licensing examination for which all graduates must sit prior to obtaining registration to practice. Currently, this exam is only taken by Malaysian students graduating from foreign medical colleges. However, the local Malaysian universities, both public and private, have different curricula for preparing undergraduates for future housemanships. The question is whether the educational programs of these universities are robust enough in delivering curricula that produce safe and competent doctors. Moving forward, it must be determined whether there is a need for extending the Malaysian Medical Licensing Examination (MMLE) to all graduates of both local and foreign medical universities, thereby creating a marker of excellence by which to measure Malaysian education and practice.

Introduction: Just-in-Time Teaching (JiTT) is a novel method of teachinglearning used in various disciplines of science and humanities. It is a technique that scaffolds the students learning process by reducing the cognitive load which is the load related to the executive control of working memory. Just in time teaching underpins the concept that expertise in learning originates from the knowledge already stored in long term memory and with subsequent interaction between the learner and teacher motivates enhanced active learning and optimizes the intellectual performance. Objective: The objective of the study is to assess the acceptability of JiTT over traditional lecture teaching among the medical students. Method: In a cross sectional pilot study, three hundred thirty five students participated in a questionnaire based study that grades the various aspects of the traditional lecture series. After the implementation of JiTT method for a period of four months, three hundred two students completed the questionnaire, grading the same variables for JiTT. The analysis was done by using SPSS version 11 applying Paired t test and McNemar's Test. Result: The results of our study highlighted that JiTT technique was perceived superior to traditional teaching with statistically significant outcomes in the clarity of the topic (p=0.003,) duration of the session (p=0.002), knowledge gained and orientation for exams (p=0.044). The students perceived JiTT method as less monotonous (p=0.005) increasing their alertness during these sessions (p=0.002). Conclusion: We therefore propose that Just-in-Time Teaching method is a more interactive and acceptable teaching-learning tool shifting the nature of teaching to a more student-centric approach as perceived by the medical students. This is the first pioneer study on JiTT to be performed on undergraduate medical students so far.

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