Background Palliative care is an essential component of health responses in humanitarian settings, yet it remains largely unavailable in these settings, due to limited availability of palliative care training for healthcare professionals. Online training programs which connect experts to clinicians in the field have been proposed as an innovative strategy to build palliative care capacity humanitarian settings. Objective To describe the implementation and evaluate the impact of delivering palliative care education using an established virtual learning model (Project ECHO) for healthcare clinicians working in the Rohingya refugee response in Bangladesh. Program acceptability and the impacts on learners’ self-reported knowledge, comfort, and practice changes were evaluated. Methods Using the Project ECHO model, an education program consisting of 7 core sessions and monthly mentoring sessions was developed. Each session included a didactic lecture, case presentation and interactive discussion. Surveys of participants were conducted before and after the program to assess knowledge, confidence, and attitudes about palliative care as well as learning experiences from the program. Results This virtual palliative care training program engaged 250 clinicians, including nurses (35%), medical assistants (28%) and physicians (20%). Most participants rated the program as a valuable learning experience (96%) that they would recommend to their colleagues (98%). Participants reported improvements in their knowledge and comfort related to palliative care after participation in the program, and had improved attitudes towards palliative care with demonstrated statistical significance (p < 0.05). Conclusions Virtual training is a feasible model to support healthcare providers in a humanitarian health response. Project ECHO can help to address the urgent need for palliative care in humanitarian responses by supporting healthcare workers to provide essential palliative care to the growing number of individuals with serious health-related suffering in humanitarian settings.
Objectives: Different teaching aids are advocated in the medical colleges for delivery of lectures such as power point presentation, blackboard, transparency sheet, overhead projectors, extempore and lecture sheets .The aim of our study was to compare the more acceptable teaching methods between the students of Dhaka Medical College and Enam Medical College. Materials and Methods: Total one hundred students were selected from fourth year in each medical college. They were asked to fill in a fourteen item questionnaire about their perception of five lecture delivery methods. Questionnaire was properly explained. The results were analyzed separately to find out any differences between preferences of teaching methods in both medical colleges. Results: In DMC 50% students preferred traditional blackboard method ,25% PowerPoint presentations, 5% both blackboard and PowerPoint, 16% extempore and 4% lecture sheet .On the other hand, in EMC, 53% mentioned PowerPoint presentation as most acceptable, 38% blackboard, 5% combined blackboard and PowerPoint and 4% extempore. Some important comments were recorded which could be valuable for the medical teachers. Conclusion: The study showed that students of DMC clearly prefer traditional blackboard method rather than other teaching aids, whereas students of EMC prefer PowerPoint presentation. The study does not bring out any evidence based superiority of any lecture delivery method. It appears that any teaching aid can be appropriate and effective if the teachers are properly trained. This highlights the need for formal training in teaching technologies for good presentation and thus motivate the students. DOI: http://dx.doi.org/10.3329/bjmed.v21i2.13612 Bangladesh J Medicine 2010; 21: 60-64
Osteoarthritis (OA) is a leading cause of disability in the elderly. The goal of OA treatment is to control symptoms, prevent disease progression, minimize disability, and improve quality of life. The management can be divided into non pharmacologic interventions, pharmacologic interventions, and surgical options. Pharmacologic interventions can be further subdivided into symptomatic therapy and potential structureor disease-modifying therapy. There are, at present, no specific pharmacologic therapies that can prevent the progression of joint damage due to OA. Acetaminophen is the first line of therapy, although most of the patient requires NSAIDs. Risk of gastrointestinal (GI) bleeding and cardiovascular risk need to be considered, especially for elderly. With inflammatory components, intra-articular glucocorticoid injection gives short term benefit. Compared with corticosteroid injections, hyaluronan injections have similar clinical effects. But it is more costly. So far research with potential structure- and disease-modifying drugs in osteoarthritis includes tetracyclines, glycosaminoglycan polysulfuric acid, pentosan polysulfate, diacerein, glucosamine and others. Scientists are looking for new therapeutic targets like IL-1 receptor antagonist (IL-1Ra), mitogen-activated protein (MAP) kinases inhibitors, NF-kappaB inhibitors. Gene therapy, Chondrocyte and stem cell transplants showed some promise in animal models. Keyword: Osteoarthritis, pharmacologic therapy, disease modifying therapy DOI: http://dx.doi.org/10.3329/jom.v12i2.7690 JOM 2011; 12(2): 142-148
Background and objective : C-reactive protein (CRP) is a well-known inflammatory biomarker and is associated with cardiovascular risk. Our objective was to see whether it is also associated with hypertension and its complications.Methodology : This prospective observational study was carried out in general outpatient department (OPD) of a tertiary level hospital on a total of 112 patients, among them 71 were hypertensive and 41 were normotensive. Baseline CRP was measured in all subjects and followed them up to six months to see any association between the level of CRP and hypertensive complications.Results : It is found that mean CRP was 2.923 (± 0.294) in hypertensive subjects and 1.058 (± 0.330) in normotensive subjects. No association is found between level of CRP and hypertensive complications.Conclusion : CRP is raised in hypertension. But it is not established that its level can predict the complication of hypertension.Bangladesh Crit Care J March 2018; 6(1): 3-6
Sclerosteosis is a rare autosomal recessive disorder, characterized by progressive, generalized bony overgrowth of thecalvarium and mandible with cranial nerve entrapment and raised intracranial pressure, and abnormalities of thedigits. Due to narrowing of the foramina of the cranial nerves, facial nerve palsy, hearing loss and atrophy of the opticnerves can occur. It is clinically and radiologically very similar to van Buchem disease, both of which shows generalizedhyperostosis and sclerosis leading to a markedly thickened and sclerotic skull, with mandible, ribs, clavicles and alsolong bones. Van Buchem disease is differentiated from sclerosteosis by the absence of hand malformations and alarge stature. Here we describe a case of a 45 years-old-female presented with progressive enlargement of right sideof mandible, continuous pain in the right side of the face, right sided lower motor type of facial palsy, bilateral sensoryneural type of hearing loss along with polydactyly and syndactyly. The final diagnosis of sclerosteosis was made byclinical features and radiological findings and exclusion of other causes of hyperosteosis. The particular interest of thispaper is to present a case of sclerosteosis, and to demonstrate the differences between that entity and other sclerosingdiseases of bone.Keywords: Sclerosteosis; van Buchem disease; HyperosteosisDOI: 10.3329/jom.v11i2.5477J MEDICINE 2010; 11 : 207-211
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