In late February 2021, a prothrombotic syndrome was encountered for the first time in some of the recipients of ChAdOx1 CoV‐19 vaccine (AstraZeneca, University of Oxford, and Serum Institute of India). Since the hallmark of this syndrome is the development of thrombocytopenia and/or thrombosis between 4 and 42 days after receiving a COVID‐19 vaccine, it was named vaccine‐induced immune thrombotic thrombocytopenia (VITT). Other names include “vaccine‐induced prothrombotic immune thrombocytopenia” and “thrombosis with thrombocytopenia syndrome” by the Centers for Disease Control and the Food and Drug Administration (FDA). VITT appears similar to heparin‐induced thrombocytopenia in that “platelet activating” autoantibodies are produced in both these conditions due to prior exposure of COVID‐19 vaccine and heparin respectively, in turn causing thrombotic complications and consumptive thrombocytopenia. In this article, recent advances in the understanding of pathobiology, clinical features, investigative work‐up, and management of VITT are reviewed.
Background: Self-directed learning is a way of learning in which learner is the main regulator of learning and manages learning on its own according to the requirements. This concept implies that whatever a postgraduate trainee (PGT) will learn during his or her training is dependent on his self-ability to learn. Objective: To determine the self-directed learning readiness (SDLR) among postgraduate trainees of multiple specialties and to examine factors affecting it.Material and Methods: It was a cross-sectional study in which self-directed learning readiness of PGTs working at Shifa International Hospital Islamabad was investigated using a 58-item validated SDLR questionnaire.Results: Mean SDLR score of females (213.36) was more than males (206.13). Maximum mean score of SDLR was found at age of 37(n=1) (252.00) and at 33years (n=10) (236.40), respectively. Highest mean SDLR score was found among PGTs of Gynecology and Obstetrics (n=28), (230.11). Meantotal SDLR score initially increased from 204.65 to 218.50 from 1st to 2nd year but then remained static and start dropping at regular pace and became lowest at 5th year (200.36). Mean total SDLR score was highest among PGTs of poor socioeconomic background 237.33. Departments in which research activities were ongoing their postgraduate trainees showed an average SDLR score of 215.41.Conclusion: Study concluded that self-directed learning readiness of PGTs of Gynecology was highest with average SDLR in General Medicine and General Surgery PGTs. The SDLR was found more among PGTs with poor socioeconomic status and in departments with high ongoing research activities. However, SDLR has not shown any significant difference regarding gender and age.
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