ABSTRACT
Digoxin is a commonly prescribed drug in the management of heart failure and atrial fibrillation. Despite its widespread use, most clinicians have little experience with recognising clinical signs and symptoms that might suggest a potentially lethal drug toxicity. We herein describe two cases with specific reference to the electrocardiographic changes induced by digoxin and discuss the predisposing factors for toxicity, recognition of possible toxicity and treatment approaches.
ABSTRACT
<p><b>INTRODUCTION</b>This study aimed to assess the effectiveness of the use of a cardiopulmonary patient simulator in the teaching of second-year medical students. Effectiveness was measured in terms of the extent of knowledge retention and students' ability to apply the skills learned in subsequent real-life patient contact.</p><p><b>METHODS</b>In this study, ten third-year medical students who had previously undergone simulator training as part of their second-year curriculum underwent an objective structured clinical examination (OSCE) and a multiple-choice question (MCQ) test to assess their ability to apply the knowledge gained during the simulator training when dealing with real patients. The performance of this group of students was compared with that of a group of ten fourth-year medical students who did not undergo simulation training.</p><p><b>RESULTS</b>Although the third-year medical students performed well in the OSCE, they were outperformed by the group of fourth-year medical students, who had an extra year of clinical exposure. The MCQ scores of the two groups of students were similar. Post-simulation training survey revealed that students were generally in favour of incorporating cardiopulmonary simulator training in the preclinical curriculum.</p><p><b>CONCLUSION</b>Cardiopulmonary simulator training is a useful tool for the education of preclinical medical students. It aids the translation of preclinical knowledge into real-life clinical skills.</p>
Subject(s)
Female , Humans , Male , Cardiology , Education , Clinical Clerkship , Computer Simulation , Curriculum , Education, Medical , Educational Measurement , Learning , Singapore , Students, Medical , Surveys and Questionnaires , UniversitiesABSTRACT
The causes of abnormal T waves on electrocardiography are multiple and varied. Careful clinical history taking and physical examination are necessary for accurate identification of the cause of such abnormalities. Subsequent targeted specialised cardiac investigations, such as echocardiography or coronary angiography, may be of importance in the diagnosis of the underlying cardiac pathology. We present two cases of T wave inversions with markedly different aetiologies.
Subject(s)
Aged, 80 and over , Humans , Male , Middle Aged , Angioplasty, Balloon, Coronary , Methods , Aortic Valve Insufficiency , Diagnosis , Diagnostic Imaging , General Surgery , Cardiomyopathy, Hypertrophic , Diagnosis , Coronary Angiography , Methods , Echocardiography, Doppler , Methods , Electrocardiography , Myocardial Infarction , Diagnosis , Therapeutics , Sampling Studies , Severity of Illness Index , Treatment OutcomeABSTRACT
Objective To assess the safety and efficacy of mycophenolate mofetil (MMF) combined with low dose corticosteroid in the treatment of adults with minimal change nephrotic syndrome and concomitant HBsAg positive (MCNS-HBsAg). Methods Thirty adults with MCNS-HBsAg were enrolled in this prospective study and were assigned to two groups. The MMF group (n=14) received low dose of prednisone combined with MMF (MMF 1.0 to 2.0 g/d patients of Pred group versus 35.7% patients of MMF group. 43.8% patients of Pred group versus 21.4% patients of MMF group received lamivudine therapy. Elevation of alanine aminotransferase(ALT) ocurred in 50% patients of Pred group and 28.6% patients of MMF group. The complete remission (CR) rate after 24 weeks treatment was 11/14 in Pred group versus 10/12 in MMF group. 6/11 patients of the Pred group and 4/10 patients of the MMF group who achieved CR experienced relapses during follow-up. Conclusions Use of MMF combined with low dose prednisone is as effective as conventional prednisone regimen in treating adults with MCNS-HBsAg. The MMF protocol seems to be superior in HBV reactivation to conventional prednisone protocol.
ABSTRACT
To investigate the effects of Tangshenling Mixture (TSLM) and benazepril on rats with diabetic nephropathy (DN) and its mechanism.