Searching the way to keep students awake in class room

Team Based Learning [TBL] is gaining popularity as a small group teaching methodology in Medical institutions. Owing to its property of being less resource intensive it is especially useful in developing countries. Students being most important stakeholders need to be focused on research for implementation of the study was conducted to access the students' perceptions as they compare traditional lectures with new methodology in our context. A fifteen item five point Likert's scale questionnaire duly prepared by experts and piloted in students, was distributed among students of fourth year at the end of second module of Team based learning in the subject of internal medicine for fourth year MBBS class and collected after completion. Data was analyzed using SPSS 15. Independent t-test was performed and means were compared for TBL and Lecture methodology. Global rating was also comparedfor both. Total 174 students responded out of which 53 were males and 121 females. 61 students marked "excellent" category in overall rating with preference to TBL by 51 and lectures by 10. Among 121 marking in [good] category 81 were for TBL and 40 for lectures. All fifteen responses in the questionnaires favoured TBL. Comments included [excellent way of retention] for TBL. There was active participation of students throughout the sessions. Students favoured TBL as compared to lectures and therefore TBL is a suitable preferred methodology to incorporate active learning in our undergraduate curriculum

Tetanus; still cannot be prevented, a three year retrospective study in DHQ hospital, Faisalabad

Tetanus still remains a major public health problem in Pakistan like in most other developing countries, with a high morbidity and mortality. To study the demographic profile the clinical profile, the outcome of the tetanus patients and effectiveness of tetanus immunization coverage in district Faisalabad. Retrospective record based study. Surgical unit-5 DHQ Hospital, Faisalabad from January 2010 to December 2012. All data of 198 patients of tetanus of any age and sex, diagnosed clinically was collected, compiled and analyzed from the Medical Records Department of the Hospital. Out of 198 patients of tetanus,138[69.7%] were males and 60[30.3%] were females. Their ages ranged from 1 to 85 years with a mean and a standard deviation respectively of 29.36 and 17.48 years.162 [81.8%] were from rural and36[18.2%] were from urban areas. 47[23.7%] patients were having prior immunization and151[76.3%] were not immunized. The most common presenting symptoms were trismus [47.5%], body stiffness [24.2%],fits[19.2%] and respiratory distress[9.1%]. 23[11.6%] patients were having mild disease,71[35.9%] patients were having moderate disease,71[35.9%] patients were having severe disease and 33[16.7%] were having very severe disease. Overall mortality rate was 41.4%. Respiratory failure was the most common cause of death and there was statistically significant association between mortality and increasing grades of disease. By making expanded programme of immunization [EPI] more effective and removing flaws from out-dated vaccination through incomplete vaccination. By improving awareness in public and complete vaccination through EPI program, we can reduce the incidence of tetanus

Level of competence in clinical skills of medical officers working in the accident and emergency departments of district headquarter hospitals

To assess the competence in clinical skills of the medical officers [MOs] working in the Accident and Emergency [A and E] Departments of District Headquarter Hospitals [DHQH]

Study Design: Cross sectional study

Place and Duration of Study: DHQHs of Jhang and Sahiwal, in the month of December, 2008

Methodology: A questionnaire regarding 14 basic clinical skills applied in patient care in A and E Department was prepared with the help of district specialists, MOs and the nursing staff working in DHQHs. The responses were recorded by using modified Likert scale at seven levels of competence. Four respondents were asked to assess the competence of each MO: MO him/herself; a peer of the MO; consultant physician/surgeon; nurse working in the same department. The results were computed and analysed by using statistical software SPSS version 15

Results: In DHQH Sahiwal the collective mean of the level of competence of clinical skills by all the respondents [n=15] was highest for focused history [5.64 out of 7] and lowest for chest intubation [3.15 out of 7]. In DHQH Jhang the collective mean of the level of competence of clinical skills by all respondents [n=21] was highest for uretheral catheterization [5.20/7] and lowest for Cervical spine immobilization [3.18/7]. There was no significant difference in perceptions of different groups regarding level of skill for a particular doctor

Conclusion: The level of competence in clinical skills of MOs working in the A and E department of DHQHs is suboptimal and needs to be improved urgently to avoid unnecessary mortality and morbidity