Perception of medical students undertaking a problem-based learning curriculum: experiences during the pre-clerkship phase

Student's perceptions of pre-clerkship phase concerning their experience of the Problem-Based Learning [PBL] curriculum are variable. To determine how students in the pre-clerkship phase perceive problem-based learning and the changes in these perceptions with increasing experience. College of Medicine and Medical Sciences, Arabian Gulf University, Bahrain. Students were interviewed in focus groups and responses were used to develop a structured questionnaire, with 25 sets of questions on five components of the PBL process, which was distributed to 148 students. Response rates were 96%, 76% and 46% for years 2, 3 and 4, respectively. Students perceived PBL as interesting and it develops self-confidence. During tutorials, most of the students were willing to challenge each other but not the tutor. Students preferred discussions with peers to consulting seniors. As the seniority increase, students tended to discuss more during the second tutorial and tended to ask more questions. While preparing for end-of-unit examinations students attempted inter-problem integration less than intra-problem integration. Students perceived PBL as an interesting, though difficult, method of learning, which helps to develop their self-confidence but may result in gaps in their knowledge. The tendency to focus on clinical aspects of a given problem at the expense of its basic science concepts should be discouraged by careful construction of the problems and tutor guides. While students challenge their peers during discussion, all students do not prepare adequately for the second tutorial. Integrated learning can be further enhanced through focusing on the themes identified in the unit booklets and the use of integrated questions on these themes

Bandemia in sickle cell disease: a marker for differentiating osteomyelitis from vaso-occlusive crisis

Find out if bandemia [increase in the absolute band cell count] can differentiate osteomyelitis from vaso-occiusive crisis involving the bones in patients with sickle cell disease. Meaningful cut-off-points in the absolute band count [>/= 1000 and >/= 500] differentiation are also looked at. A retrospective review of records of 50 patients from each category for comparison was performed. Two cut-off-points were considered namely bandemia of >/= 1000 and >/= 500 and these were subjected to analysis. Bandemia [both >/= 1000 and >/= 500] was generally more prominent in cases of osteomyelitis as compared to VOC. There were problems with sensitivity and specificity of bandemia as a single criterion for differentiation between the two entities. Although seemingly we encounter higher counts of band white blood cells in cases of osteomyelitis occurring in patients with SCD as compared to VOC, yet because of low sensitivity in case of >/= 1000 as a cut-off-point and low sensitivity as well as non-specificity in case of >/= 500 as a cut-off-point, bandemia cannot be recommended as single diagnostic criterion

Bandemia in shigellosis

Bandemia is a phenomenon observed in infections caused by gram negative organisms, particulary of shigella species. The occurrence has not been quantitated as a diagnostic guideline implicating shigella organisms prior to availability of culture results. We have looked at bandemia in 55 patients with documented shigellosis and compared it to that in 36 non-shigella diarrhea cases. A 5% or more band cells in the peripheral blood smear is being proposed as a significant indicator of possibility of shigellosis given the proper clinical set up

Alpha-thalassaemia in Bahrain: haemoglobin H disease - not so benign

A retrospective analysis of the records of 76 in-patients seen at Salmaniya Medical Centre, Bahrain, during the period 1985-86 was carried out. The aim of the study was to determine the clinical manifestations of haemoglobin H disease. These patients were classified into three groups; their clinical and haematological details were carefully recorded. The study has revealed one important finding: contrary to old-held belief, haemoglobin H disease can have diversified and at times severe clinical manifestations. However, haemoglobin H disease still remains intriguing and requires the collaborative research efforts of Arabian Gulf countries

Fragile X-syndrome in a Bahraini family

Fragile X syndrome [Martin Bell Syndrome] has been the subject of wide medical interest in the past decade. We are reporting the first cases in a Bahraini family documented to have fragile X syndrome. Four sibs and a maternal brother have mental retardation with the typical clinical and cytogenetic picture of the syndrome

Arab Board for Medical Specialties: a decade of strifes and strides

On February 17, 1979 the By-laws of the Arab Board for Medical Specialities were approved by the Supreme Council representing seventeen Arab countries. Since then the Arab Board has made remarkable strides inspite of innumerable constraints, top of it comes the financial problem. Seventy one [71] hospitals in various Arab countries have been accredited following proper evaluation. One hundred twenty [120] programmes have been recognized for training toward certification in 4 major specializations, namely: General Surgery, Internal Medicine, Obstetrics/Gynaecology and Paediatrics [Table 1, 2]. Two hundred fully qualified and experienced physicians participate in the Scientific Councils to supersise and monitor the training programmes. Over 2700 physicians are enrolled in these programmes. A remarkable increase in enrollment [27%] was noted in 1988 registrants

Acute pyogenic meningitis in childhood: a 17-year experience in Bahrain

The aetiologic, epidemiologic and clinical aspects of 452 cases of acute pyogenic meningitis in children treated over a 17-year period, from January 1970 through December 1986, were reviewed. An aetiologic agent was identified in 237 cases [52.4%]. H influenzae b was the commonest organism isolated in the culture-positive cases. Ninety per cent [90%] of influenzal, 66% of pneumococcal and 42% of meningococcal meningitis cases were under 2 years of age. About 60% of influenzal and pneumococcal meningitis cases occurred during October through February. A male: female ratio of 2:1 in pneumococcal meningitis was consistently seen throughout the entire period of study. Gross neurological handicaps in 15% of H influenzae b and 14% pneumococcal meningitis were noted. Thirty per cent [30%] of the culture-proven and 59% of the culture-negative cases had received prior antibiotic treatment. Twenty-eight per cent [28%] of the cases presented with seizures and 85% of these were aged 1 year or less. Overall mortality was 9% with a marked reduction in mortality in culture-proven meningitis during the last 7 years of the study. Ampicillin-resistant H influenzae b was isolated from 3 cases, 2 of whom died

G Syndrome: a case report

A case is reported who had many features of G syndrome plus some additional findings, high arched palate, partial rotation of the gut and localised eventration of the diaphragm, none of which have been reported so far in this syndrome

Mucoviscidosis [cystic fibrosis of the pancreas] in Bahrain, Arabian Gulf

We report on 8 proved and 2 probable cases of mucoviscidosis diagnosed in Salmaniya Medical Centre over a period of 62 months. Six of the ten cases were anaemic, 4 were hypoproteinaemic and 2 had anasarca. In all instances there was history of siblings dying in early infancy from pulmonary and gastrointestinal problems. The two probable cases, on whom sweat chloride tests could not be carried out because of non-availability of the test kit at the time, were siblings of our proved cases

Maple Syrup urine disease in Bahrain

Two siblings with maple syrup urine disease [MSUD] are described here. The first patients was diagnosed rather late and second patient in the neoborn period. Both had signs of severe mental subnormality and cortical damage. They manifested with peculiar odour in the urine. The diagnosis of the disease was confirmed by plasma and urine chromatography. The two patients succumbed to the disease despite introduction of a special formula used in the treatment of this illness