ABSTRACT
Background: Simulated Patient Case [SPC] software is a powerful educational tool used in several medical colleges to augment the clinical competence of students
Objective: To evaluate the impact of this software on the clinical competence of medical students
Design: A Prospective Pilot Study
Setting: Arabian Gulf University, Bahrain
Method: One hundred five fifth-year medical students attending internal medicine clerkship were divided into two groups: 43 [41%] students used the DXR software [group A] and 62 [59%] students did not use the software [group B]. The grades obtained at the end of clerkship examination of the students who used the SPC software [DXR] [group A] was compared to the grades of the students who did not use the software [group B]. In addition, we compared the performance of this cohort using DXR in year 4 with their grades at the end of clerkship examination. P-value of < 0.05 was
considered statistically significant
Result: Group A students performed better than group B at the end of the clerkship exam, which revealed that the differences in the mean scores were statistically significant [P-value < 0.030]. A positive correlation between the students DXR scores in year 4 and their grades in clerkship exam [year 5] was found. The correlations between the DxR [SPC] scores and the student's scores of different exam components [SAQs, OSCE, mid-rotation, bed-side and clinical exams] was statistically significant [P-value=0.01]
Conclusion: The beneficial effect of the DXR SPC software on clinical competence was revealed. Therefore, we recommend it for students' clerkship training
ABSTRACT
Objectives: The current study aimed to carry out a post-validation item analysis of multiple choice questions [MCQs] in medical examinations in order to evaluate correlations between item difficulty, item discrimination and distraction effectiveness so as to determine whether questions should be included, modified or discarded. In addition, the optimal number of options per MCQ was analysed
Methods: This cross-sectional study was performed in the Department of Paediatrics, Arabian Gulf University, Manama, Bahrain. A total of 800 MCQs and 4,000 distractors were analysed between November 2013 and June 2016
Results: The mean difficulty index ranged from 36.70-73.14%. The mean discrimination index ranged from 0.20-0.34. The mean distractor efficiency ranged from 66.50-90.00%. Of the items, 48.4%, 35.3%, 11.4%, 3.9% and 1.1% had zero, one, two, three and four nonfunctional distractors [NFDs], respectively. Using three or four rather than five options in each MCQ resulted in 95% or 83.6% of items having zero NFDs, respectively. The distractor efficiency was 91.87%, 85.83% and 64.13% for difficult, acceptable and easy items, respectively [P <0.005]. Distractor efficiency was 83.33%, 83.24% and 77.56% for items with excellent, acceptable and poor discrimination, respectively [P<0.005]. The average Kuder-Richardson formula 20 reliability coefficient was 0.76
Conclusion: A considerable number of the MCQ items were within acceptable ranges. However, some items needed to be discarded or revised. Using three or four rather than five options in MCQs is recommended to reduce the number of NFDs and improve the overall quality of the examination
ABSTRACT
Objective: To evaluate the course of jaundice in newborns with G6PD reduced activity compared to G6PD normal activity
Design: A Prospective Study
Setting: Salmaniya Medical Complex and Jidhafs Maternity Hospital, Bahrain
Method: This is a prospective study on newborns from May to September of 2015. Total Serum Bilirubin [TSB] was measured from day one of life to day seven for all neonates. G6PD activity was documented from the records
Results: One hundred twenty-five children were included in the study; 71 [56.8%] were newborns with normal G6PD activity and 54 [43.2%] were G6PD reduced activity. The mean TSB was significantly higher in newborns with G6PD reduced activity 11.23 +/- 3.50 mg/dl compared to newborns with G6PD normal activity 9.52 +/- 4.16 mg/dl [P-value 0.001]
The mean TSB on day one for newborns with G6PD reduced activity was higher compared to newborns with G6PD normal activity; 6.37 +/- 6.76 mg/dl and 1.82 +/- 1.94 mg/dl respectively [P-value 0.078]
Conclusion: The course of hyperbilirubinemia in children with G6PD reduced activity was different compared to children with G6PD normal activity. The mean TSB was significantly higher in newborns with G6PD reduced activity. A bilirubin level of 6mg/dl during the first neonatal day could be an indicator for the presence of G6PD reduced activity in the newborn
ABSTRACT
Background: Anti-epileptics taken during pregnancy might lead to low birth-weight and birth defects which could be associated with neonatal morbidity and mortality
Objective: To evaluate the effects of maternal exposure to therapeutic doses of topiramate on the growth of 20-day rat fetuses. Design: An Experimental Animal Study. Setting: Teratology Laboratory, Anatomy Department, College of Medicine and Medical Sciences, Arabian Gulf University, Bahrain
Method: Three groups of Sprague-Dawley pregnant rats were used in the experiment: control, Topiramate 50mg/Kg BW and Topiramate 100 mg/Kg BW. Topiramate was administered by intragastric intubation from day 6 through day 19 of gestation. Cesarean section was performed on day 20. Resorption was calculated, placental weight and umbilical cord length were measured. Fetuses were collected to assess their growth parameters: fetal weight [FW], biparietal diameter [BPD], crown-rump length [CRL] and head length [HL]. Ponderal index and CRL/HL ratio were calculated to indicate the type of growth restriction
Result: The Topiramate treated groups showed an insignificant increase in the rate of resorption, a significant decrease in umbilical cord length, placental weight and highly significant reduction in fetal growth parameters. No significant changes were noticed in fetal growth parameters between Topiramate groups. A positive correlation was found between FW and UCL, PW, CRL, HL and BPD in all examined groups. Ponderal index and CRL/HL ratio indicate symmetrical growth restriction of the fetuses in both treated Topiramate groups
Conclusion: The doses of Topiramate, which were given to pregnant rats were equivalent to the human therapeutic range; the drug led to symmetrical fetal gross restriction with few abnormal fetuses and placentae. Topiramate attributed effects were not dose related. The drug should be taken with caution during pregnancy
ABSTRACT
Objective: To assess the efficacy of low-dose prednisolone in patients with ITP
Design: A Prospective Randomized Controlled Trial
Setting: Salmaniya Medical Complex, Kingdom of Bahrain
Method: A randomized controlled trial was conducted comparing the conventional-dose to a lowdose of prednisolone [0.25 mg/kg/day]. Forty-one patients with ITP were enrolled in the study; 21 patients were randomized to low-dose prednisolone [group I] and 20 patients received the conventional-dose [group II]
Result: The overall remission rate [OR] for both groups was 78.05%. There was no statistically significant difference between both groups in terms of group overall remission 17 [81%] versus 15 [75%], group complete remission 11 [52.4%] versus 10 [50%] or partial remission rate 6 [28.6%] versus 6 [25%]. In addition, failure rate, relapse rate, and splenectomy rate were similar and not statistically significant. Two [10%] patients developed complications related to steroids therapy, both were in group II, but were not statistically significant
Conclusion: Although the study had a small number of patients, it revealed that low-dose of prednisolone [0.25 mg/kg/day] is as effective as the conventional-dose [1 mg/kg/day] and probably, safer. Accordingly, we recommend the use of low-dose prednisolone as initial therapy for ITP rather than the high-dose