Mini-cex: an assessment tool for observed evaluation of medical postgraduate residents during their training program: an overview and recommendations for its implementation in cpsp residency program

The mini-CEX is a workplace-based assessment to assess professional performance of medical trainees. Proper reporting of the gap between desired and observed performance forms the basis and the incentive for the trainees to improve their skills. It plays a key role by combining learning with assessment There is an urgent need for including this form of assessment in our clinical training programs especially postgraduate residents training

Age and gender specific stroke risk factors in a teaching hospital in Khyber Pakhtunkhwa

To determine age and gender specific stroke risk factors in a teaching hospital in Khyber Pakhtunkhwa. A hospital based descriptive study was performed in medical units of Lady Reading Hospital, Peshawar, from July 2011 to March 2012. A total of 100 patients of 18 years and above and of both genders were included. Study patients with first-ever acute stroke were divided into three groups; Group A young adult [<40 years], Group B, middle-aged [40-60 years], and Group C elderly [>60 years]. In these 03 groups, stroke risk factors were compared. Patients were assessed for hypertension, ischemic heart disease, hyperlipidemia, atrial fibrillation, diabetes mellitus and smoking. SPSS version 18.0 was used for statistical analysis. A sample of 100 patients was taken comprising 68% males and 32% females. Study patients had a mean age of 63.44 +/- 13.849. There were 08 patients in Group A, 29 in Group B, and 63 patients in Group C. Overall, hy-pertension was found in [62%], followed by smoking [47%], coronary artery disease [33%], diabetes mellitus [28%], hyperlipidemia [24%] and atrial fibrillation [21%]. Pattern of distribution of stroke risk factors is age and gender specific. Majority were found to have hypertension. Hypertension, diabetes mellitus, atrial fibrillation and hyperlipidemia differ significantly among the 03 age groups. Smoking was significantly different in males and females

Antibiotic sensitivity pattern of Salmonella serotypes in patients with enteric fever in a teaching hospital

To determine the sensitivity of salmonella serotypes to antibiotics in patients with enteric fever. This descriptive study was carried out in medical units of Lady Reading Hospital Peshawar from January 2008 to December 2011. Patients were included by consecutive sampling technique. Blood samples were collected from patients with clinically suspected enteric fever and were sent to hospital laboratory for culture and sensitivity[C/S]. Salmonella colonies were identified using standard biochemical tests including fermentation of glucose, negative urease reaction, lysine decarboxylase, negative indole test, H2S production, and fermentation of dulcitol. Serological confirmation tests included polyvalent antisera for flagellar and somatic antigens. Antibiotic susceptibility was checked by Kirby- Bauer disc diffusion method for 22 antibiotics. Blood cultures of 106[61%] patients out of 173 patients were positive for salmonella species. Salmonella Typhi was found in 54.7% while salmonella paratyphi A in 32.1% and B in 13.2%. The sensitivity of salmonella species for ceftriaxone and ceftazidime was found to be 100%, followed by imipenem[98.1%] and meropenem [96.2%]. The sensitivity of drugs like amoxicillin, chloramphenicol and co-trimaxazolewere 2.8%, 12.3% and 22.6% respectively. Regarding quinolones, most sensitive was moxifloxacin49.1%, followed by ciprofloxacin 48.1%. Salmonella typhi was fully sensitive to meropenum, ceftriaxoneand cetazidime while paratyphi A or B was fully sensitive to ceftriaxone, ceftazidime and imipenem. The sensitivity of salmonella species was very low to the first line agents such as amoxicillin, chloramphenicol and co-trimaxazole. Salmonella species were fully sensitive to third generation cephalosporins such as ceftriaxone and ceftazidime

Tobacco use as contributory factor in peptic ulcer disease

To find out the association of tobacco as a contributory factor in patients presenting with peptic ulcer disease [PUD]. Design: A descriptive case study. Place and Duration of Study: Department of Medicine, Postgraduate Medical Institute, Lady Reading Hospital, Peshawar, from May 2001 to April 2002. Subjects and A total number of 100 consecutive patients, 76 males and 24 females, with endoscopically proven peptic ulcer were enrolled in the study. The ages of the patients ranged from 25 to 70 years; with mean age of 48 years + 12.26 standard deviations, [mean age of men 49 years + 12.88 SD, and mean age of women 45 years + 9.67 SD]. All the patients underwent endoscopy after an overnight fast, using lignocaine [4% solution or jelly] as topical anaesthetic, with Pentax FG29 video-endoscope. Fifty-six% of all the patients with PUD used tobacco, 33% as cigarette, 18% took it as 'naswar' and 5% of patients used it in both the forms. Of these, 85.7% [48/56] patients had duodenal ulcer and 14.3% [8/56] patients had gastric ulcer. All these patients were male, none of the female patients used tobacco in any form. Moreover, 40% of PUD patients reported long-term use of nonsteroidal anti-inflammatory drugs [NSAIDs]. This study supports the view that use of tobacco is associated with PUD in men