Making fair, fairer - Implementing the FAIR-ER principles of education in an integrated curriculum

When an integrated organ system based curriculum was adopted by the University for its Medical School, curricular changes had to be implemented in the Clinical Clerkship phase called Phase 3. To design an effective educational strategy using certain principles of education such as Feedback, Active learning, Individual learning and Relevance [FAIR] together with Evaluation and Reflection. [FAIRER] The first batch of the Integrated Curriculum students of the MBBS program formed the study population. Certain principles of education such as Feedback, Active learning, Individualisation of learning and relevance that have been advocated for use to enhance learning, together with continuous evaluation and Reflection were applied in educational strategies for the implementation of the Integrated Curriculum Implementing the Integrated Curriculum for the Clinical phase of the MBBS program offered a tremendous opportunity to apply the F-A-I-R principles of education together with E-R that is Evaluation and Reflection. The scores obtained during the summative assessment and the positive student response validated the enhancement of learning objectively and subjectively

Treatment and prevention of a hospital based infection caused by crusted scabies: a rare variant of scabies

The purpose is to report a rare variant of scabies known as Norwegian or crusted scabies which was the source of an outbreak of scabies in the hospital and highlight the preventive and treatment aspects by which the infection was controlled. All staff members who were in contact with the patient with complaints of itching were screened. Diagnosis was made by the typical history and examination of all the affected staff members and also the family members. All affected contacts were treated with anti-scabetic treatments. Information leaflets highlighting the importance of containing the infection by preventive measures were distributed to the staff. All patients responded well to treatment. Because all staff members followed the preventative advice the infection was controlled without spreading it to their contacts. A rare variant of scabies was the cause of a nosocomial infection causing distress to the affected staff members and financial implications, as the hospital had to breathe cost of the expensive anti-scabetic preparations. Prompt treatment and appropriate preventative advice and care contained this rare parasitic nosocomial infection

Cutaneous adverse drug reactions in a tertiary healthcare centre in Ajman, United Arab Emirates

To study the various clinical patterns of cutaneous adverse drug reactions [ADRs] and to identify the causative drugs. A cross-sectional hospital based study was carried out with patients reporting with cutaneous ADRs to the Department of Dermatology at GMC Hospital, Ajman, U. A. E., between 2010 and 2012. Medical records of the patients were used to obtain demographic, diagnostic and ADR-related information. The data were subjected to detailed statistical analysis using SPSS. 19 software. A total of 43 patients were included [46.5% males and 53.5%females] in the study. The mean age of the patients was 30.07+.-13.63 years. The majority of the patients were from the Middle East, followed by Asian countries. The commonest cutaneous ADRs seen were maculo-papular rash [48.8%], Erythroderma [18.6%], urticaria [11.7%] and Fixed drug eruption [11.7%]. The drugs most responsible for the various cutaneous ADR were antimicrobials in 11[48.8%] and NSAIDs in 14 [32.5%] cases. Carbamazepine and Ciprofloxacin were responsible for two cases [6%] of life-threatening Stevens Johnson syndrome. Mean reaction timewas 5.63 +/- 0.5 days. Reactions were mild [46.7%], moderate [40%] and severe [13.3%]. Based on the WHO Causality assessment of ADRs, 34 [80%] cases were probable in nature; 8 [27%] possible and 1 [3%] case uncertain. A total of 5 [11.6%] cases had past history of ADRs. Three patients [9%] had secondary bacterial infection over ADR lesions and required antimicrobial treatment. The clinical pattern of ADRs and the drugs causing cutaneous ADRs was largely similar to that observed in other countries

Solitary skin nodule in a young male: a case of cutaneous leiomyosarcoma

A case of cutaneous leiomyosarcoma in a young male is reported and literature reviewed. A 31-year old Asian male presented to the Dermatology OP with the complaint of a solitary swelling in the posterior aspect of the upper third of left thigh. On examination a skin colored nodule of about 1.6 cm diameter was found. It was dome-shaped, firm to hard, fixed to the skin and tender. An excision biopsy was done and the specimen was sent for HPE study. The result of biopsy was reported as cutaneous leiomyosarcoma. Cutaneous leiomyosarcomas are uncommon malignant soft tissue tumors which arise from the smooth muscles of the skin, the superficial type from arectorpilori muscle and the deep from the vascular wall of the capillaries. They comprise about 2-3% of soft tissue sarcomas. Our patient was an apparently healthy male who wanted to remove a small swelling in the thigh which had recently appeared. There were no remarkable clinical features to make a clinical diagnosis of cutaneous leiomyosarcoma. It was only when the skin biopsy was done that the histopathological examination revealed a cutaneous leiomyosarcoma. Hence a histopathological examination is most useful and necessary for the diagnosis of soft tissue tumors. The prognosis of the condition can be predicted using criteria laid down by Jenson et al. Long term follow up is necessary because of the risk of recurrence and metastasis

Utilization and prescription patterns of Isotretinoin therapy in a hospital setting

To evaluate how closely hospital practice meets known standards in the prescription and utilization pattern of Isotretinoin therapy in GMC Hospital, Ajman. A retrospective observational study was conducted of patients who were prescribed Isotretinoin between October 2009 - September 2010, as an audit by the department to see how closely hospital practice meets known standards and the outcomes. 53 patients were treated in the age group of 16-44, of which 31 were females. No single pregnancy occurred during the study and there was no evidence of clinical depression. All patients reported significant improvement in their clinical condition. Based on this study it seems reasonable to conclude that Isotretinoin is an effective and well tolerated drug for the treatment of nodulocystic acne. The fact that no pregnancies occurred reflect on the adequate patient information and education. None of the patients had depression. Side effects seemed negligible due to the small sample size. Ordering a pregnancy test in unmarried females was culturally unacceptable in this region. Six female patients were married in whom a pregnancy test was done before starting therapy and during the course of treatment. This study was conducted to show that though hospital practice could not meet known standards due to regional and cultural factors, the fact that no pregnancies occurred, prove that patients were adequately informed