Learning approaches of medical students in a case-based learning curriculum in pre-clinical year

Objective: To determine the learning approaches of medical students in their pre-clinical years in a case based learning curriculum

Study Design: Descriptive [Quantitative] study

Place and Duration of Study: Army Medical College Rawalpindi Pakistan, from Jan 2017 to Jul 2017

Materials and Methods: Two hundred students from 2nd year MBBS participated in the study by filling a 52 items questionnaire-Approach and study skills inventory for students. Students' scores were measured separately for surface, deep and strategic approaches. Gender difference regarding the preferred approach of students was also found out. Analysis was carried out by using student t-test on Microsoft Excel Sheet

Results: There is a significant difference [p-value <0.05] between the number of surface learners when compared with number of deep and strategic learners. A preference for the deep or strategic approaches has been noticed in both female and male students

Conclusion: The study provided evidence that even in very initial years of medical studies where case based learning has been introduced as a student-centered strategy, it is promoting a deep or strategic learning approach in medical students. These approaches have been considered helpful in making students lifelong learners. It also helps in identifying the surface learners at the same time. Their identification will help and guide teaching faculty and the curriculum planners about the scope of different teaching modalities to be used in the best interest of the students

Cardiovascular risk reduction comparison of felodipine and propranolol in patients of essential hypertension

Objective: To compare the efficacy of felodipine versus propranolol in patients of essential hypertension for Serum cholesterol, LDL cholesterol and HDL cholesterol

Study Design: Randomized controlled study

Place and Duration of Study: This study was conducted at the Accident and Emergency Department, Bahawal Victoria Hospital, Bahawalpur and Ansari Private Clinic Model Town B Bahawalpur from 1[st] July 2015 to 30[th] September 2015

Materials and Methods: Total 90 patients with essential hypertension having age range from 30 to 50 years were enrolled in this study for three months. Patient were randomly divided into three groups I, II and III, each group comprising 30 patients. Group I patients were treated with felodipine, Group II patients were treated with propranolol and group III patients were treated with placebo. Effects of these drugs on Lipid profile [Serum cholesterol, HDL cholesterol and LDL cholesterol] were compared

Result: Felodipine, treated patients exhibited markedly significant fall in the serum cholesterol [P<0.01], highly significant fall at the level of LDL cholesterol [P<0.001] and non-significant effect in HDL cholesterol. Whereas propranolol treated patients showed highly significant increase of serum cholesterol [P<0.001], markedly significant increase in LDL cholesterol [P<0.01] and markedly significant decreased in HDL cholesterol [P<0.01]

Whereas comparison of two drugs Felodipine and Propranolol displayed a highly increased [P<0.001] serum cholesterol, LDL cholesterol and markedly increased [P<0.01] HDL cholesterol

Conclusion: Result of this study showing that comparing the two drugs felodipine had significantly decreased Serum cholesterol and LDL Cholesterol, whereas propranolol increased the Serum cholesterol, LDL cholesterol and decreased HDL cholesterol. So felodipine prove its merit over propranolol

Perceived dental anxiety among patients according to different dental procedures

Human health behavior is presented in many traits. Among them fear is a strong factor that influences not only on health but also procedures and communication with health care provider. The objectives were to explore dental anxiety at various levels in different dental procedures among patients visiting Dental Hospital. A cross sectional survey was conducted on 702 patients visiting general out-patient Departments at Fatima Memorial Hospital College of Dentistry. A structured, standardized and validated questionnaire was used for the purpose of data collection [Modified Dental Anxiety Scale by Corah]. Informed consent was obtained from patients. Extreme anxiety level was found more in younger age and in female patients. Mean score was 13.2 [+ 4.3] which makes participant from slightly to fairly anxious while visiting any dentist for any procedure. According to ranking, extreme anxieties developed from procedures are as follows local anaesthesia is highest, tooth drill, Scaling, waiting area and next day appointment was ranked lowest respectively. It is important for dentist to focus on patient anxiety level particularly in younger and female patients. It also helps to carry out smooth dental treatment

Relationship of Child-Pugh classification with liver function tests and its clinical implication in patients of chronic liver disease

Child-Pugh classification currently remains the most important parameter to determine liver function in patients of chronic liver disease [CLD]. This study was carried out to find a relationship between abnormal Liver Function Tests [LFTs] and extent of liver damage in patients of CLD grouped as Child class A and B. To find a relationship between LFTs and severity of liver disease assessed by Child-Pugh scoring. Retrospective study. This study was conducted at the Medical Words of Services Hospital, Lahore from February 2009 to June 2009. It was a retrospective analysis of 40 patients aged 17-74 with CLD. Patients were selected from medical wards of Services Hospital Lahore. Patients were classified as Child class A and B on the basis of severity of liver function. Liver function tests including prothrombin time[PT], serum bilirubin, enzymes like Alkaline Phosphatase [ALP], Aspartate Transaminase [AST], Alanine Transaminase [ALT], serum Proteins and Albumin concentrations were performed by standard laboratory methods. It was observed that serum level of ALP, ALT, AST and the AST/ ALT ratio as well as prothrombin time were significantly increased in patients as compared to their controls. On the other hand level of total proteins and albumin were significantly decreased in patients as compared to their controls whereas the level of bilirubin remains insignificant. In Child class B patients the levels of serum bilirubin, ALP, ALT, AST and ratio AST/ALT were increased as compared to these parameters in Child class A patients. It was observed that level of serum ALP and ALT were non significantly and level of serum bilirubin, AST and AST/ALT ratio were significantly increased in Child class B patients as compared to the patients of Child class A. On the other hand level of serum total proteins and albumin were significantly decreased in Child class B patients as compared to patients of Child class A. Prothromin time is significantly increased in Child class B patients as compared to the patients of Child class A. Further deterioration in LFTs may warn a clinician about progress of disease in a patient of CLD and to further investigate about the liver function at that stage

Effect of amlodpine on lipid profile

Introduction: Now a days Calcium channel blockers and Beta blockers are widely used for the treatment of essential hypertension. Beta blockers have been observed to increase the serum cholesterol, serum triglycerides and serum LDL cholesterol levels, calcium channel blockers have been noted to have a beneficial effect on lipid profile. Setting: In outpatient clinic of Bahawal Victoria Hospital, Bahawalpur Period: From 1[st] Sep 2003 to 31 Mar 2004 [three months]

Material and Methods: Blood pressure, systolic and diastolic, and lipid profile [Serum cholesterol, LDL cholesterol, HDL cholesterol and serum triglycerides] were investigated in patients receiving Amlodipine therapy. This was a 3 months follow-up study, which was carried on 90 patients. The effects of drugs were assessed at various time intervals. Second generation Calcium channel blocker, Amlodipine, which is widely used for treatment of Hypertension was selected to observe its effect on serum lipid profile in various patients

Results: The mean systolic and diastolic blood pressure decreased from 158 mm Hg and 104.4 mm Hg to 122.26 mm Hg and 38.56 mm Hg respectively after 90 days of treatment with Amlodipine. The fall in serum cholesterol level [mg/dl] and LDL-cholesterol [mg/dl] was from 188.13 and 125.40 to 170.76 and 105.7 after respectively after 90 days

Conclusion: Amlodipine significantly reduced blood pressure, decreased the level of serum cholesterol and LDL cholesterol but did not affect significantly the HDL cholesterol and serum triglycerides