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In Oman, the prevalence of health care associated methicillin resistant Staphylococcus aureus [HA-MRSA] is unknown. Therefore, to estimate the prevalence of HA-MRSA, we collected nasal swabs and swabs from cell phones on sterile polyester swabs and immediately inoculated on the mannitol salt agar containing oxacillin from medical students and hospital health care providers. Antibiotic susceptibility testing of the isolates was then performed using the Kirby Bauer's disc diffusion method. Additionally, a brief survey questionnaire was used to acquire demographic data. Amongst the 311 participants enrolled, nasal colonization with HA-MRSA was found in 47 individuals (15.1%, 95% confidence interval [CI]=11.1%, 19.1%). HA-MRSA was also isolated from the cell phone surfaces in 28 participants (9.0%, 95% CI=8.6%, 9.3%). 5 participants (1.6%) showed positive results both from their nasal swabs and from their cell phones. Antibiotic resistance to erythromycin [48%] and clindamycin [29%] was relatively high. 9.3% HA-MRSA isolates were vancomycin resistant [6.6% nasal carriage]. There was no statistically significant correlation between HA-MRSA isolates and the demographic characteristics or the risk factors namely gender, underlying co-morbidities like diabetes, hypertension, skin/soft tissue infections, skin ulcers/wounds, recent exposure to antibiotics, or hospital visits (p>0.05, Chi-square test).

BackgroundThe prevalence of community-associated methicillin-resistant Staphylococcus aureus [CA-MRSA] is unknown in Oman.MethodsNasal and cell phones swabs were collected from hospital visitors and health-care workers on sterile polyester swabs and directly inoculated onto a mannitol salt agar containing oxacillin, allowing growth of methicillin-resistant microorganisms. Antibiotic susceptibility tests were performed using Kirby Bauer’s disc diffusion method on the isolates. Minimum inhibitory concentration (MIC) was determined for vancomycin and teicoplanin against the resistant isolates of MRSA by the Epsilometer [E] test. A brief survey questionnaire was requested be filled to ascertain the exposure to known risk factors for CA-MRSA carriage.ResultsOverall, nasal colonization with CA-MRSA was seen in 34 individuals (18%, 95% confidence interval [CI] =12.5%–23.5%), whereas, CA-MRSA was additionally isolated from the cell phone surface in 12 participants (6.3%, 95% CI =5.6%–6.98%). Nasal colonization prevalence with hospital-acquired [HA] MRSA was seen in 16 individuals (13.8%, 95% confidence interval [CI] =7.5%–20.06%), whereas, HA-MRSA was additionally isolated from the cell phone surface in 3 participants (2.6%, 95% CI =1.7–4.54). Antibiotic sensitivity was 100% to linezolid and rifampicin in the CA-MRSA isolates. Antibiotic resistance to vancomycin and clindamycin varied between 9–11 % in the CA-MRSA isolates. Mean MIC for vancomycin amongst CA- and HA-MRSA were 6.3 and 9.3 μg/ml, whereas for teicoplanin they were 13 and 14 μg/ml respectively by the E-test. There was no statistically significant correlation between CA-MRSA nasal carriage and the risk factors (P>0.05, Chi-square test).ConclusionsThe prevalence of CA-MRSA in the healthy community hospital visitors was 18 % (95% CI, 12.5% to 23.5%) as compared to 13.8% HA-MRSA in the hospital health-care staff. Despite a significant prevalence of CA-MRSA, these strains were mostly sensitive. Recommendation: The universal techniques of hand washing, personal hygiene and sanitation are thus warranted.

The essential oil of Teucrium stocksianum Boiss. subsp. stocksianum leaf grown in Oman was analyzed by GC-MS. Forty seven components amounting to 76.1% of the total oil were identified. The major constituents were α-cadinol (7.6%), β-selinene (6.4%), trans-verbenol (5.9%), caryophyllene oxide (5.7%), α-phellandren-8-ol (5.0%), verbenone (5.0%) and δ-cadinene (5.1%). The antimicrobial activity of the oil was tested against a panel of seventeen bacterial and six fungal strains by the disc diffusion method. The oil inhibited the growth of all test organisms at various levels; however, it showed significant inhibitory activity against Staphylococcus and Streptococcus species, as well as yeasts. The minimal inhibitory concentrations (MIC) were also determined.

A hydrodistilled oil from the leaves of Teucrium mascatense Boiss. was analyzed by GC/MS. Twenty-one components amounting to 91.2% of the oil were identified with linalool (27.8%), linalyl acetate (12.6%) and β-eudesmol (10.1%) being the major constituents of the oil. The antimicrobial activity of the oil was tested against a panel of 17 bacterial and six fungal strains by the disc diffusion method. The oil inhibited the growth of all test organisms at various levels. The minimal inhibitory concentrations (MIC) were also determined.

Introduction: Case based teaching methodology is a discrete approach to interactive group-based learning. Its implementation along with didactic teaching schedule has an added advantage by evoking interest in students by placing them in a dilemma taken from a real-life example and motivates them for self-directed learning. The aim of the present exercise was to introduce the students to an alternative method of learning compared with the traditional one used, to enhance self-directed learning and correlate the theoretical contents with its applied aspect. Method: A study was done in spring semester with 2 nd year medical students at OMC, Muscat, Oman. Didactic lecture followed by case study after few days on ECG topic from CVS was taught. Four random groups were made within the class having a student leader for coordination. Pre-test was conducted before a clinical case scenario with applied MCQ's were discussed week after the topic taught which was followed by post-test. Another clinical case dealing with respiratory system was discussed within the semester in a similar fashion. Feedback survey questionnaire with a response of 5 points Likert's scale was filled by participant after completion of the course. Focus group discussion was conducted among randomly selected 15 students to have in-depth feedback about methodology. Result: Out of 95, 91 students qualified the inclusion criteria. Statistically significant increase in the academic score were obtained on the topics taught by CBM (p < 0.005) from pre and post test. Descriptive statistical analysis for 28 questions showed positive response by 92.3% students for improvement in their knowledge related to human physiology while 83.5% accepted that the methodology helped them to relate topic with the clinical situation. While 75.9% of students accepted that CBM encouraged them to use various resources material. In focus group discussion students commented that methodology helped them to correlate theoretical information with its clinical application and they started reading more books and gathers information from other resources. Conclusion: Case based teaching provides opportunity for students to use different resource materials and clarify the concepts, other than have better interaction with the instructor.

Interactive animations to enhance learning of concepts in immunologyNirmal A Pathare What problem was addressed? Immunological concepts are, in general, difficult to understand. As animations are available to help elucidate concepts, and learning styles have been shown to vary widely in students, we wanted to evaluate whether showing animations with options for interaction as opposed to showing animations simply as movie clips would provide improved learning experiences. What was tried? We administered the VARK (visual, aural, read/write, kinaesthetic) questionnaire 1 to our Year 3 pre-medicine students (n = 84), who were then shown two animations incorporated in PowerPoint lectures on innate and adaptive immunity. The class was divided into two groups in a crossover study to remove bias. One group of students was shown the first animation without any pauses for discussion. The same group was shown the second animation with pauses in which interactive trigger questions were used to stimulate discussion. The process was reversed for the second group. A pre-and post-activity assessment with single-answer, multiple-choice questions (MCQs) was performed after teaching to assess efficacy. The MCQ quizzes used peer-reviewed critical thinking questions on concepts from both the topics. The study protocol was approved by the institutional research and ethics committee.The pre-and post-test results in both groups, before animation and immediately after viewing the animation with or without pauses, showed an overall significant improvement. However, the improvement was more significant when students watched animations with strategic pauses (p < 0.05, Wilcoxon signed rank test). The VARK questionnaire is designed to investigate the preferences of students for particular modes of information and was analysed by the total number of responses to determine the preferences of students for each category. Overall, 15% of students preferred a single (i.e. visual [V], 2.5%; aural [A], 10.0%; read/write [R], 0%; kinaesthetic [K], 2.5%) mode of information presentation, whereas the majority of students (85%) preferred the multimodal form of information presentation. The preferred combinations of modes in descending order were: ARK (17.50%); VRK (15.00%); AK (13.00%); VAR (6.25%); VA (6.25%); AR (5.00%); VAK (3.75%); VK (3.75%), and VR (2.50%). Additionally, 7.50% of students preferred to use all four modes (i.e. VARK).What lessons were learned? As most students (85%) preferred the multimodal form of information presentation to learn efficiently, presenting a blend of visual, auditory, reading, writing and kinaesthetic activity would be ideal. However, a preference for auditory input, even as a unimodal presentation, was clear, as were both visual and kinaesthetic cues in this study cohort. As an innovative teaching and learning method that can help to optimise intended learning outcomes, rather than showing the complete video animation clip, it is preferable to insert probing questions at strategic points because they stimulated discu...

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