ABSTRACT
Fenofibrate is mainly used to reduce cholesterol level in patients at risk of cardiovascular disease. Thermal transition study with the help of differential scanning calorimetry (DSC) shows that the aforesaid active pharmaceutical ingredient (API) is a good glass former. Based on our DSC study, the molecular dynamics of this API has been carried out by broadband dielectric spectroscopy (BDS) covering wide temperature and frequency ranges. Dielectric measurements of amorphous fenofibrate were per-formed after its vitrification by fast cooling from a few degrees above the melting point (Tm ? 354.11 K) to deep glassy state. The sample does not show any crystallization tendency during cooling and reaches the glassy state. The temperature dependence of the structural relaxation has been fitted by single Vogel–Fulcher–Tamman (VFT) equation. From VFT fit, glass transition temperature (Tg) was estimated as 250.56 K and fragility (m) was determined as 94.02. This drug is classified as a fragile glass former. Deviations of experimental data from Kohlrausch–Williams–Watts (KWW) fits on high-frequency flank of α-peak indicate the presence of an excess wing in fenofibrate. Based on Ngai's coupling model, we identified the excess wing as true Johari–Goldstein (JG) process. Below the glass transition temperature one can clearly see a secondary relaxation (γ) with an activation energy of 32.67 kJ/mol.
ABSTRACT
Objectives: To identify the core competency areas for teaching and training interns in communication skills followed by evaluating effectiveness of the training subjectively, based on student perception. Methods: At the outset we identified five key areas where doctors faced difficulty in communication in their routine clinical practice. This was followed by a two day training programme to 160 interns consisting of videos, hand-outs, lectures and role plays with emphasis on deliberate practice of skills. At the end of the training, Intern‘s perception about the effectiveness of the programme and their selfperceived improvement in skills were assessed. Results: The core competency areas listed by the doctors were: breaking bad news; dealing with a parent resistant to immunisation; communicating with the distressed patient and irritated bystander in casualty, explaining risks and procedures; and dealing with a patient with psychosomatic complaints. Interns responses to the training methodology based on the core competencies were overwhelming with 91% rating the training as effective. Role play was the most appreciated learning technique. Increased self-perceived immediate improvement in Communication skills was reported by 85% of Interns. Conclusions: This exercise has helped us identify the key areas to be focused in communication skills training for interns in our setting, as well as design appropriate teaching learning methods to achieve the objectives. A systematic approach in developing a teaching-learning methodology stressing on the content and process of communication skills training relevant to the local context using a mix of experiential problem based and didactic methods should be stressed while framing a communication skill curriculum.