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Introduction: Evidence based medicine and practice needs to have a robust and reliable curriculum. This curriculum has been designed keeping in mind the latest technology and teaching strategies. There has been a major shift in context to the patient physician relations, care and utilisation of best available evidence in making informed decisions about the various treatment options and approaches to patient care. Nurses form an integral component of the healthcare delivery system and of the health system itself. There has been substantial research in the nursing principles and indexed nursing journals are publishing articles pertaining to the various disciplines and components of nurse practitioners and related patient care services
Methodology: It is a cross sectional study and total of 50 registered nurses were recruited from a public hospital to engage in the evaluation for statistically meaningful and valid results or interpretations. A self-administered questionnaire was distributed among 62 registered nurses; 12 registered nurses did not fill the questionnaire therefore 50 registered nurses were recruited
Result: Pie chart shows the major differences in frequency of all themes, the junior registered nurses have more knowledge about EBM as compared to their seniors 70% and 10% respectively but when asked about doing post-graduation the seniors showed more interest as compared to junior nurses 67% and 2% respectively. The junior nurses showed more counselling ability and also practiced EBM. Overall there was significant decline in senior nurses' performance when compared with junior nurses p-value is 0.001
Conclusion: Evidence based medicine is based on three components; utilising prior knowledge based on clinical experience, searching systematically evidence and acknowledging patient's preferences. Junior registered nurses understand evidence based medicine and are eager to apply EBM in their career whereas senior nurses where more interested in obtaining higher degree and were less interested in patient care
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Replacement of concepts is another terminology used for misconceptions which are developed at an early and theoretically the student considers it as correct and builds all other related concepts upon it. This eventually become so strong that when they reach their professional studies it becomes extremely difficult to replace the misconception and erase the previously formed schema in their minds. This problem became so prominent that research into students' misconceptions started and are still continuing so as to identify the areas where replacement of concepts is required providing elaborative evidence about the nature of students' understandings This research is concentrated on particularising the essential differences between "students' and experts' ideas" on a topic that will affect lifelong learning
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Background and Objective: Feedback has been identified as one of the key strategies for learning in the outcome-based curriculum. Students are more interested in their grades paying little attention to the feedback, may not understand the importance of feedback and its effect on their performance because of their perception, and beliefs. Non-constructive feedback will not result in the improvement of the students' performance. This study aims to explore; student's perception of useful feedback; the purpose of feedback and believes about written feedback
Methods: This analytical cross-sectional study was conducted from November 2017 to January 2018 at Majmaah University. Students studying in clinical phase were recruited. Data were collected from 121 students by self-structured questionnaire using complete enumeration sampling method
Results: Majority of the students [45.5%] disagreed that the feedback should always contain marks; [49.6%] commented that the tutor did not provide enough constructive feedback. While we ask the purpose of feedback [62.8%], agree with two-way nature of feedback, and it is helpful to find there expected performance. Almost two third [67.8%] of the students believe that limited feedback is the reason for frustration and they did not receive comments for improvement
Conclusions: Students are aware of the purpose of feedback. Senior students give more value to feedback and in the opinion that feedback provides useful suggestions for future improvement and limited feedback is the reason for frustration. The results highlight the need for more structured feedback mechanism, and there is a need for faculty engagement in training to fill the existing gapes to create an effective educational alliance
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Objective: To find out the factors attributed to success and failure by medical students and how have they developed those attributes
Study Design: Mixed method sequential research
Place and Duration of Study: Bahria University Medical and Dental College Karachi, from Mar 2016 to Sep 2016
Material and Methods: In the first phase, quantitative research question addressed the different attributing factors for success and failure among medical students belonging from second to final year bachelor of medicine and bachelor of surgery [MBBS] course through survey questionnaire. A total of three hundred and thirty three students participated in survey. In the second phase, focus group discussions [FGD] and interviews were carried out from fifteen high and fifteen low achievers of different participant classes to probe in depth significant factors by exploring reasons for such attributions
Results: The quantitative analysis of results revealed that significantly large percentage of students passing the professional examination in annual examinations attributed their success to hard work, interest in the medical subjects, faith in their abilities, lectures and tutorials, module examinations and studying in small groups. The students passing in supplementary on the contrary were less hardworking and regular in their classes and faced financial issues.The major themes of attribution to success emerging from focus group discussion [FGD] of high achievers were effective learning strategies, support from parents and family, confidence and communication skills and hard work.The key themes of attribution to failure developed from interviews with low achievers were difficulty in adjustment, irregularity in classes and revision, deficient learning strategies and partisan role of teachers
Conclusion: High achieving medical students attributed their success primarily to internal, controllable and unstable factors like hard work and specific effort following effective learning strategies as well as external factor like support from parents and family. On the other hand low achieving medical students attributed their failures to internal controllable factors like difficulty in adjustment,deficient learning strategies, carelessness, lack of hard work and irregularity from classes
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Objective: To analyze the psychometric indices of Anatomy question items in modular system assessment
Methods: A quantitative study was done to determine the quality of MCQs and to analyze the performance of 1[st] year 100 MBBS students. Each module covers different subjects of MBBS curriculum but psychometric analysis was done on the subject of Anatomy only. The assessment results of 3 modules were taken and checked by item analysis to see the mean differences between the modules using ANOVA. Post hoc analysis was determined by using Tukey HSD test
Results: A total of 140 one best [OB] Anatomy MCQ. items were calculated for difficulty index, discriminatory index and reliability. Difficulty index was found to be higher in module I when compared with module II and III. Discriminatory index comparatively showed higher results in module II whereas reliability of module III was significantly higher than the other modules. Results were considered to be significant with p-value <0.05
Conclusions: The psychometric analysis of Anatomy MCQs showed average difficulty, good discrimination and reliability
Subject(s)
Humans , Anatomy , StudentsABSTRACT
Objective: To assess the hepatoprotective effect provided by fresh garlic on fatty liver induced by high-fat diet
Methods: This experimental study was carried out at BMSI, JPMC from October to November 2008. Thirty adult albino rats, 200-240 gram weight, were divided into three groups. Group A received control diet, Group B received high-fat diet [20 mg butter/100 gm diet] and Group C received high-fat diet with fresh garlic [20 mg butter with 6 gm fresh garlic/100 gm diet]. The groups were further divided on the basis of duration of treatment, four weeks and eight weeks respectively. The rats were sacrificed, liver removed, weighed and relative liver weight calculated. Hepatic tissue was processed and tissue slides stained with haematoxylin and eosin
Results: There was significant increase in relative liver weight in group B animals as compared to the control animals, which decreased significantly in group C. Haematoxylin and eosin stained sections revealed ballooned hepatocytes having vesicular appearance with pyknotic nuclei in high-fat group which were preserved to a great extent in group C animals
Conclusion: This study has shown that use of fresh garlic along with high-fat diet prevents its damaging effects on liver to a great extent
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MicroRNAs [miRs] are non-coding ribonucleic acids consisting of about 18-22 nucleotide bases. Expression of several miRs can be altered in breast carcinomas in comparison to healthy breast tissue, or between various subtypes of breast cancer. These are regulated as either oncogene or tumor suppressors, this shows that their expression is misrepresented in cancers. Some miRs are specifically associated with breast cancer and are affected by cancer-restricted signaling pathways e.g. downstream of estrogen receptor-alpha or HER2/neu.Connection of multiple miRs with breast cancer, and the fact that most of these post transcript structures may transform complex functional networks of mRNAs, identify them as potential investigative, extrapolative and predictive tumor markers, as well as possible targets for treatment. Investigative tools that are currently available are RNA-based molecular techniques. An additional advantage related to miRs in oncology is that they are remarkably stable and are notably detectable in serum and plasma.Literature search was performed by using database of PubMed, the keywords used were microRNA [52 searches] AND breast cancer [169 searches]. PERN was used by database of Bahria University, this included literature and articles from international sources; 2 articles from Pakistan on this topic were consulted [one in international journal and one in a local journal]. Of these, 49 articles were shortlisted which discussed relation of microRNA genetic expression in breast cancer. These articles were consulted for this review
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Objective: To explore the mentoring program on a subset of Pakistani medical students in a private medical college
Method: Total students targeted were 300 MBBS students of 1[st] Year [group B], 2[nd] Year [group C] and 3[rd] Year [group D], of these 256 students filled the self-reported questionnaire. The questionnaire was based on Likert Scale. The statements in the questionnaire are designed in a positive manner so that if the students agree to them the level of satisfaction with the mentoring program was considered significantly good. Open-ended questionnaires were also given so as to have a clearer concept of the students' perception. This study is a mixed method study catering to both quantitative and qualitative domains
Results: The overall results reported that the junior students of group B and group C showed higher satisfaction in being mentored as compared group D [p-value=0.001]. All three groups were compared with each other to check the response of every statement by applying Tukey's test. Analysis of the result showed that majority of the students considered mentoring program a beneficial tool for their academic and non-academic lives. The students of all three years have reported that the mentor is mostly available and helps to reconcile internal conflicts. They also confirmed that their mentor keeps records but most of the students have reported that communication via email is limited
Conclusion: Majority of students of Bahria University Medical and Dental College are able to carry on with their academic and non-academic routine due to the presence of mentoring. The medical students appreciated the presence of a mentor during thick and thin; they have also accepted that it is due to the presence of this guide that they are able to continue with their difficult studies in these difficult times
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To determine faculty perception on journal club [JC] presentation at Bahria University Medical and Dental College [BUMDC], Karachi. Pakistan. It was a cross sectional study conducted from January 2009 to December 2012 to acquire faculty member's feedback on JC presentations in structured meeting at BUMDC. Feedback was acquired by a self-reported questionnaire on a 3-pt Likert scale with a score of 1= disagree, 2= neutral, 3 = agree. Respondents were divided into Group I; senior faculty [professors, associates and assistants] and Group II of junior faculty [lecturers]. Chi square test was applied to compare categorical variables; results considered significant with p value <0.05. A total of 75JC presentations were made in study period. In Group I, response was acquired by 5 Professors, 3 Associate Professors and 7 Assistant Professors whereas 34 lecturers comprised of Group II. Both groups responded to usefulness of JC equally without any significant difference. JC encouraged literature search in 35[72%], enabled 38[78%] to recall their knowledge and 34[70%] to understand study objectives. The participants 34[70%] were able to comprehend research methodology, 19[38%] understood biostatistics and 29[59%] evaluated the paper critically. The exercise motivated 36[74%] and 30[62%] participants were able to design their research projects. Orientation of research at BUMDC was made possible by JC discussions which encouraged literature review from reputable journals, understanding of research methodology and critical appraisals that facilitated formulation of research plans
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Rapidly developing cataract in idiopathic hypoparathyroidism is rare. Here we report, a case of cataract which developed rapidly and was associated with idiopathic hypoparathyroidism in a 20- year-old female patient. The case is being reported for its rarity and early diagnosis which was presented in a tertiary care hospital. For cases like these, prompt treatment is essential which may result in prevention of complications like vision loss. As per literature research via pubmed.com, this is the first case report of rapidly developing cataract in a patient of idiopathic hypoparathyroidism in Pakistan
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This survey was carried out from November 2008 till Dec 2011 to establish problem based learning [PBL] as part of hybrid modular curriculum at Bahria University Medical and Dental College [BUMDC] Karachi. It describes all steps undertaken to facilitate implementation of PBL system of education at BUMDC. During this period faculty was exposed to training workshops after which they were sequenced to prepare and present PBL in structured meetings and conduct them as facilitators. Faculty was exposed to 5 training workshops after which a total of 12, 27, 29 and 28 PBLs in 2008, 2009, 2010 and 2011 were prepared, presented and facilitated respectively. PBL system of education was implemented at BUMDC by stepwise measures which facilitated faculty members to prepare and apply this strategy for learning of medical students
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Background: The presence of around 12 or more follicles in one or both ovaries with diameter ranging from 2-9mm is known as polycystic ovaries [PCO]. This condition is associated with hyperandrogenemia and is one of the most common causes of infertility. Due to increase in use of ultrasonography as a diagnostic tool, more cases of PCOs are being timely reported. This has also lead to diagnosis of PCO in younger age group
Objective: To measure the effect of age on ovarian and uterine morphology in infertile women with polycystic ovaries [PCO]
Methods: The cross sectional study was conducted in Karsaz Hospital, Karachi from January 2010 to March 2011. One hundred infertile women with PCOs were subdivided into age groups [years] 20-30 [group I] and 31- 40 [group II]. The ovarian volume [OV], follicles count [FC] and size [FS], uterine area [UA] and endometrial thickness [Endo] were determined by ultrasonography. Unpaired t-test was applied to analyze the result
Results: The ovarian morphology showed a significant decrease in group II; the OV transabdominally was 14.26 +/- 2.42 vs 10.56 +/- 1.0 [0.00] and transvaginally 14.93 +/- 2.55 vs 11.75 +/- 1.06 [0.00]. The FC was 14.00 +/- 1.60 vs 12.3 +/- 0.78 [0.023] and FS was 8.23 +/- 8.9vs 3.29 +/- 6.9 [0.00]. The uterine morphology however showed a significant increase in group II. The UA was 87.79 +/- 5.83 vs 118.71 +/- 22.83 [0.00] and endo was 0.46 +/- 0.10 vs 0.57 +/- 0.12 [0.00]
Conclusion: Ovarian morphology variables include OV, FC and FS decrease in the older infertile group of women with PCOs but the uterine morphology variables showed an increase in area with thickening of endometrium in the older group. The association of endometrium and PCOs has not been reported in this part of the world and the study is an attempt to fill this gap and prevent misdiagnosis of endometrial cancer
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To correlate ovarian and uterine morphology in sub fertile patients having polycystic ovarian syndrome with their body mass index [BMI] and eating habits One hundred subjects were included in this cross sectional study having ages between 20-40 years with history of subfertility for the past two years. BMI [kg/m2] was measured according to WHO protocol. Ovarian volume, follicle count and size, uterine area, endometrial thickness were measuredsonographically and noted. Dietary habits were recorded by a structured questionnaire from all participants According to BMI two groups of 50 subjects each were formed; group I= 25.6 +/- 4.7 kg/m2 and group II= 28.6 +/- 5.7 kg/m2. The follicular count was 14.41 +/- 2.18 and 12.75 +/- 2.80; the follicular size [in mm] was 8.23 +/- 0.41and 3.29 +/- 0.25 [p-value 0.023 and 0.001]. The uterine area [in cm2] and endometrial thickness [in cm] was 86.9 +/- 25.7 and 117.2 +/- 29 [p-value 0.001 and0.05]. The ovarian volume [OV] estimated by trans-abdominal scan [TAS] was10.87 +/- 2.49 cm3 and 14.33 +/- 3.17 cm3 [p-value=0.022]. The trans-vaginal scan[TVS] showed OV; 11.44 +/- 2.36 cm3 and 14.79 +/- 2.19 cm3 [p-value=0.034]. A weak positive correlation of BMI with OV [TVS] was observed [r=0.05]. The ovarian volume in those women who consumed fast food frequently was significantly raised as compared to those who rarely ate fast food; the difference was 14.57 +/- 3.75 vs. 9.62 +/- 2.43 [p value 0.00]. With increasing body mass index the ovarian volume, uterine area and endometrial thickness increases. However the follicular count and follicular size is reduced with higher BMI
Subject(s)
Humans , Female , Body Mass Index , Feeding Behavior , Uterus/anatomy & histology , Fertility/physiology , Polycystic Ovary Syndrome , Surveys and Questionnaires , Association , Fast Foods/adverse effects , Cross-Sectional StudiesABSTRACT
Background: Problem based learning [PBL] introduced by Howard Barrows at McMaster University in 1969 is generally regarded as an effective learning strategy with an active process of personal cognitive construction. Many medical colleges have adapted this methodology as partial or complete part of their curriculum. This strategy not only caters to the knowledge domain but also polishes attitude and soft skills in an individual
Objectives: To evaluate efficacy of PBL development program carried out at Bahria University Medical and Dental College [BUMDC]
Methods: It was a cross sectional study conducted after completion of PBL development program at BUMDC from November 2008 till Dec 2011. Perception of faculty members about the program was acquired by purposeful sampling technique through a self reported questionnaire. All faculty members involved in PBL program were included. Their response was assessed on a 5-point Likert scale with a score of 1=strongly disagree [SDA], 2-disagree [DA], 3=neutral [N], 4= agree [A], 5=strongly agree [SA].The data was analyzed by SPSS version 15
Results: Faculty was exposed to 5 training workshops after which a total of 12, 27, 29 and 28 PBLs in 2008, 2009, 2010 and 2011 respectively were prepared and presented in structured meetings. The participants who responded [96%] were 34 lecturers, 10 Assistant Professors, 2 Associate Professors and 3 Professors. It was found that 37% of respondents who did not have prior experience of constructing PBL learnt to apply this learning strategy. They also became aware of its existence, importance, significance, relevance and corrected their deficiencies [73%]
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To compare the morphology of pelvic reproductive organs between fertile and infertile women with polycystic ovaries. This cross sectional comparative study was performed at Rahat Hospital, Karsaz Karachi from January 2008 to December 2008. In which 100 women diagnosed with polycystic ovaries identified by ultrasound were inducted for the study; 50 were fertile and 50 were infertile [20-40 years]. Trans abdominal scan [TAS] was performed to rule out abnormalities other than PCO. Ovarian volume [OV] in cm[3], follicle count [FC] and size [FS] in mm, uterine area [UA] in cm[2], endometrial thickness [Endo] in mm were measured and noted by transvaginal scanning [TVS] ; Basal Metabolic Rate [BMI] was calculated and correlated with endometrial thickness. Unpaired t-test and Pearson correlation were used for analysis. In the total fertile and infertile women with PCO the following result was obtained OV-TAS 7.33 +/- 3.17 vs. 10.87 +/- 2.49 [0.001], OV-TVS 8.79 +/- 2.19 vs. 12.44 +/- 2.36 [0.001], FC 14.41 +/- 2.18 vs. 14.75 +/- 2.80 [0.245], FS 3.26 +/- 0.22 vs. 8.99 +/- 0.45 [0.001], BMI 25.6 +/- 4.7vs. 27.6 +/- 5.7 [0.04], UA 86.9 +/- 25.7 vs. 117.2 +/- 29.0 [0.001] and Endo 4.5 +/- 1.4 vs. 5.8 +/- 1.9 [0.052]. BMI and endometrial thickness showed a positive correlation with 'r' value of 0.06[0.05] in the infertile women and a negative correlation with 'r' value of - 0.40[0.05] in fertile women. The OV, FS, BMI, UA and Endo show a significant increase in the infertile women who are suffering from PCO. However the FC showed no significant difference between the two groups. The BMI and endometrial thickness has shown a positive correlation with infertility
Subject(s)
Humans , Female , Reproduction , Fertility , Reproductive Health , Infertility, Female , Polycystic Ovary Syndrome/ultrastructure , Cross-Sectional StudiesABSTRACT
To determine impact of structured meetings on learning and faculty development. The observational cross sectional study was conducted at Bahria University Medical and Dental College from October 2010 to March 2011. Feed back of all faculty members of university was acquired on weekly structured meeting [with alternating theme of journal club and problem based scenario presentation] by a self reported questionnaire. The responses obtained on a 5-point Likert scale were divided into two groups; I, senior faculty [professors, associates and assistants] II, junior faculty [lecturers]. Chi square test was applied to compare categorical variables and results considered significant with p value< 0.05. 49 faculty members; 15 in Group I and 34 in Group II responded, 90% respondent considered it to be a healthy activity. Senior faculty agreed to the usefulness of structured meetings in terms of faculty development, social interaction, provision of learning opportunities, upgrading of presentation, communication, listening and critical appraisal skills, understanding of biostatistics, self awareness, personal productivity and tolerance to listen to criticism more than the junior faculty [p-value 0.000]. The perception regarding weekly structured meeting indicated that it enhanced faculty's knowledge, improved presentation skills, enhanced confidence level, developed positive attitudes and promoted educational leadership qualities in the faculty all through interaction and dialogue
Subject(s)
Humans , Male , Female , Faculty , Learning , Problem-Based Learning , Cross-Sectional Studies , Surveys and Questionnaires , TeachingABSTRACT
To compare the ovarian reserve and BMI in fertile and subfertile women aged 20-39 years by ultrasonography. A comparative study. The Ultrasound Clinic, PECHS, Karachi, from March to December 2006. Eighty women, 40 fertile and 40 subfertile, were subdivided into age groups of 20-29 and 30-39 years. Total ovarian volume [OV] was determined transabdominally [OV-TA] and tranvaginally [OV-TV], antral follicle count [AFC] was performed transvaginally; and BMI was calculated. Unpaired t-test and Pearson correlation tests were used for analysis. In the total and subfertile females, aged 20-29 years, OV-TA obtained was 10.47 +/- 3.81 ml vs. 7.0 +/- 2.67 [p=0.015], OV-TA was 12.55 +/- 4.53 ml vs. 8.36 +/- 2.36 ml [p=0.001]; AFC was 7.35 +/- 3.02 vs. 5.7 +/- 3.57 [p=0.027] and BMI was 23.4 +/- 3.9 vs. 26.5 +/- 4.7 [p=0.006]. In the older group of fertile and subfertile females, aged 30-39 years, OV-TA was 7.92 +/- 2.01 ml vs. 6.74 +/- 2.38 [p=0.097], OV-TA was 9.97 +/- 2.99 vs. 7.73 +/- 2.40 p=0.012], AFC was 5.30 +/- 2.05 vs. 3.05 +/- 2.46 [p=0.003], and BMI was 24.4 +/- 3.8 vs. 27.4 +/- 4.80 [p=0.034]. A significant negative correlation was present between ovarian volume and BMI in the older fertile women only [p=0.001 r=0.3] whereas no significant correlation was seen in the two parameters in any other group [r=0.1]. The ovarian reserve decreased with increasing age. The lack of ovarian reserve may lead to subfertility of early ovarian ageing. Ovarian volume showed decrease with an increase in the BMI, indicating the possible decrease in fertility with an increase in a woman's weight
Subject(s)
Humans , Female , Ovarian Follicle , Body Mass Index , FertilityABSTRACT
To determine ovarian reserve in naturally fertile adult women. Cross-sectional, analytical study. Healthy fertile females [n = 70] aged 20-39 years with proven natural fertility were recruited between March and December 2006. Of these, 40 met the inclusion criteria. Total ovarian volume was calculated using the transabdominal and transvaginal ultrasound approach and an antral follicle count was performed transvaginally. The height and weight of each individual was taken to calculate the BMI, and the correlation made between ovarian volume [determined transvaginally] and the BMI. The women were divided into 2 groups of 20 each viz, between 20-29 years, and between 30-39 years. Total ovarian volume determined by transabdominal scan was 13 +/- 3.46 ml and 7.92 +/- 2.0 ml respectively in the two groups, and by transvaginal route was 15.13 +/- 4.37 ml and 9.97 +/- 2.99 ml respectively [p-value of both was 0.001].The AFC was 9.40 +/- 2.37and 5.3 +/- 2.05 in the two groups [p-value 0.001]. The BMI of the 2 groups was 23.4 +/- 3.97 and 24.4 +/- 3.8 [p-value 0.421].The correlation between ovarian volume and BMI was -0.40 [p-value 0.05]. Ovarian volume and antral follicle count were reduced significantly in the older age group; there was no difference between the BMI of the two age groups. When BMI of all women was plotted against ovarian volume, a decrease in the ovarian volume was observed with an increase in BMI
Subject(s)
Humans , Female , Ovary/anatomy & histology , Fertility , Cross-Sectional Studies , Body Mass Index , Ovarian Follicle , Age FactorsABSTRACT
Ovarian reserve is an estimate of the primordial follicle pool in the ovaries and is indicative of the reproductive age of a woman. This estimate helps in assessing a woman's reproductive potential, in predicting her possible response in assisted conception, and in screening women for "early ovarian ageing" as a possible cause for subfertility. Over the years, several methods have been used for its determination. These include biochemical parameters such as estradiol, FSH/LH levels and ratio, inhibin-B and anti-mullerian hormone levels, sonographic measurement of ovarian volume, antral follicle count and follicular volume, dynamic tests of ovarian function, and ovarian biopsy. In this paper these methods are briefly described, and their advantages and disadvantantages are discussed with a view to finding accurate, available and easily reproducible methods for assessing ovarian reserve. This article is a review of several articles obtained from the Internet, www.pubmed.com, Pakistan scientific and technological information centre [PASTIC] and several authors via e-mail