ABSTRACT
A published pilot study showed the feasibility of integrating ethics into physiology in a single medical college. However, questions were raised about feasibility of scale-up and acceptance across different colleges. To assess feasibility of integrating ethics into Physiology, first year MBBS students of three medical colleges (n=449, College A=149; 59M, 90F; College B=150; 78M, 72F; College C=150; 48M, 102F) were exposed to the integrated ethics programme. Triggers related to theory or practicals were included. Faculty volunteers conducted the sessions with feedback from observers and students. Students across three colleges felt that the programme was relevant (92%–98%), effectively integrated (86%–98%) [significantly greater number of College A students: (p=0.003)], seldom interfered with physiology teaching (59%–66%). Greater number of students from College C followed by College B and A opined to continue the integrated programme for future years (p=0.004). A scale-up study of integration of ethics programme across different colleges was perceived to be feasible by students and observers.
ABSTRACT
Introduction: Providing sedation techniques during the performance of diagnostic and therapeutic procedures on children decreases anxiety and discomfort. A number of drugs are available for the purpose. A retrospective record study in Paediatrics department of Burdwan Medical College & Hospital showed oral triclofos and per rectal diazepam were the two commonly used drugs for the purpose. However, intranasal midazolam is claimed to be a near ideal agent for procedural sedation. So, the above study was to compare efficacy and safety of intranasal midazolam over oral triclofos and per rectal diazepam. Methods: Participants having ASA score I or II having age group 1 to 6 years requiring non-invasive or minimally invasive procedure were divided into three groups- one group received oral triclofos sodium, second group received per rectal diazepam and third group received intranasal midazolam spray prior to the procedure. Levels of sedation and recovery were scored using Ramsey sedation score and modified Aldrete scoring system respectively. Induction of sedation was defined as attainment of Ramsey sedation score of at least 3. Complete recovery was defined as a minimum score of 10 of modified Aldrete scoring system. Results: Both times of induction and recovery were significantly higher in triclofos group when compared to other two groups. Level of sedation attained was higher in per rectal diazepam group, although there was no case of over sedation. Adverse effects were comparable except for nasal irritation which was exclusively limited to midazolam group. Cost of therapy was higher with intranasal midazolam therapy than with per rectal diazepam therapy. Conclusion: Per rectal diazepam appear to be a more ideal drug for procedural sedation over intranasal midazolam and oral triclofos.