ABSTRACT
Background: Complementary and alternative medicine is very robust in some parts of the world. The study was done to impart the experiential learning related to sources of drugs in a pharmacy practical class for MBBS students.Methods: We used ingredient-tray (I-Tray) teaching tool consisting of two parts to generate experiential learning in MBBS students about ethno pharmacological sources of drugs. Innovatively designed I -tray filled with two sizes plastic containers (100 ml and 50 ml sizes used for collecting biological samples of sputum and urine) containing crude drug medicinal sources which were arranged in gutters of the tray. They were sorted into five categories such as plants (flowers of Vinca rosea, bark of Terminalia arjuna, roots of Rauwolfia serpentine and Eucalyptus leaves); animals (formalin preservatives freshwater leech, shells and vaccines); minerals (kaolin, potassium permanganate and charcoal); oils and others. Three charts of 4 square feet sizes were used for demonstration of synthetic, microbiological and genetically engineered drug sources.Results: The students’ approval rate of I-tray was mean yes value of 105.78 for a tool of active learning out of total 113 students. Around 100%, 98.23 % and 97.35% students utilised application of concept (cognition), faculty of smell (affective) and volunteering (psychomotor) in the class. However female students had statistically significant score against this set up of the class depicting gender specificity of the learning process.Conclusions: Thus teaching traditional sources of drugs through I-tray impart higher order social, place based and experiential learning of medicine.
ABSTRACT
Background: The global incidence of oral cancer occurs in low-resource settings. Community-based oral screening is a strategic step toward downstaging oral cancer by early diagnosis. The mobile health (mHealth) program is a technology-based platform, steered with the aim to assess the use of mHealth by community health workers (CHWs) in the identification of oral mucosal lesions. MATERIALS AND METHODS: mHealth is a mobile phone-based oral cancer-screening program in a workplace setting. The participants were screened by two CHWs, followed by an assessment by an oral medicine specialist. A mobile phone-based questionnaire that included the risk assessment was distributed among participants. On specialist recommendation an oral surgeon performed biopsy on participants. The diagnosis by onsite specialist that was confirmed by histopathology was considered as gold standard. All individuals received the standard treatment protocol. A remote oral medicine specialist reviewed the uploaded data in Open Medical Record System. Sensitivity, specificity, positive and negative predictive values were calculated. Inter-rater agreement was analyzed with Cohen's kappa coefficient (κ) test, and the diagnostic ability of CHWs, onsite specialist, and remote specialist was illustrated using receiver operating characteristic curve. RESULTS: CHWs identified oral lesions in 405 (11.8%) individuals; the onsite specialist identified oral lesions in 394 (11.4%) individuals; and the remote specialist diagnosed oral lesions in 444 (13%). The inter-rater agreement between the CHW and the onsite specialist showed almost perfect agreement with the κ score of 0.92, and a substantial agreement between CHW and remote specialist showed a score of 0.62. The sensitivity, specificity, positive and negative predictive values of CHWs in the identification of oral lesion were 84.7, 97.6, 84.8, and 97.7%, respectively. CONCLUSION: The trained CHWs can aid in identifying oral potentially malignant disorders and they can be utilized in oral cancer-screening program mHealth effectively.
ABSTRACT
Background: Choosing an appropriate Drug Delivery System (DDS) influences the acceptability, adherence and better outcome of the therapy in the patients. The present study was planned to evaluate the second year MBBS students on standardized patients (SP) using Group Objective Structured Clinical Encounters (GOSCE) after content delivery by traditional power point class versus experiential teaching methodology.Methods: DDS practical class was held in two larger groups after adding two odd sub-groups (1+3) as ‘A’ (64 students) and even sub-groups (2+4) as ‘B’ (66 students). The formative GOSCE evaluation was done 2 weeks after the classes by the trained physician examiners as per the Medical Council of Canada pre-determined scoring instruments.Results: The average magnitude of change in GOSCE scoring is extremely statistical significant on t-test (P< 0.0001) in favour of experiential teaching methodology for all the skills. The statistical significant percentage of students were able to extract the treatment history in respect of eliciting problem, reasons for non-compliance, methods of intake, explain the technique and showed the courteous professional behaviours.Conclusions: The clinical cases as SP in pharmacology teaching for developing competency based communication skills and GOSCE are the appropriate methodology for evaluation of large student group for experiential DDS training.
ABSTRACT
Aims: To evaluate therapeutic rationality of combining long-acting β2-agonists (formoterol) with duration of action of 12 hours and anticholinergics (tiotropium) with 24 hours as fixed dose inhaled combination (FDC) still widely prescribed in developing countries in COPD patients. Study Design: A randomized, double-blind, placebo-controlled, parallel design study. The three regimens that were used; tiotropium 18 μg once a day in the morning along with the formoterol matched placebo in the evening, the FDC of tiotropium 18 μg plus formoterol 12 μg once a day in the morning and formoterol matched placebo in the evening and the same FDC of the two drugs once a day in the morning and once a day formoterol 12 μg in the evening in patients of COPD without any co-morbidity. Place and Duration of Study: Tertiary care pulmonary medicine university teaching government hospital of Delhi, India; 1 year. Methodology: Sixty COPD patients (Male, Avg. age 56±11 years) divided into 3 groups of 20 each without any comorbidity were admitted in the hospital for 24 hours. The spirometry, perception of dyspnea on Borg's scale and vitals such as blood pressure (BP) and pulse rate (PR) were recorded at the following interval 30 minutes, 2 hours, 12 hours after the morning dose and 30 minutes and 12 hours after the evening dose. Results: Addition of formoterol in the evening along with the FDC in the morning enhanced the peak effects in percentage predicted FEV1 (82.55+/-12.639), FEV1/FVC (0.592±0.097) that remained till the next dose (24 hours) which was statistically (P=.05) superior to the tiotropium alone group (75.55+/-17.981) as well as FDC alone group (74.55+/-12.655). Conclusion: There is no advantage of FDC once a day over tiotropium alone. However addition of evening dose of formoterol has shown therapeutic superiority over once a day FDC of the two in COPD.