Supervisors' perspective on electronic logbook system for postgraduate medical residents of CPSP

Objective: To find out the perspective of the supervisors about the role of electronic logbook [E-Logbook] of College of Physicians and Surgeons, Pakistan [CPSP] in monitoring the training of postgraduate medical residents of CPSP

Study Design: Descriptive cross-sectional study

Place and Duration of Study: College of Physicians and Surgeons Pakistan [CPSP], Karachi, from May to October 2015

Methodology: An electronic computer-based questionnaire designed in Hypertext Preprocessor [PHP] language was distributed to the registered CPSP supervisors through the e-log system. The questionnaire comprised of seven close ended questions. The data were entered and analyzed by SPSS version 20. Descriptive statistics were determined

Results: A total of 1,825 supervisors responded to the questionnaire. Fifteen hundred and ninety-eight [87.6%] supervisors gave regular feedback for their trainees, 88.2% considered it a better monitoring tool than conventional logbook, 92.5% responded that e-logbook helped in the regular assessment of the trainees, 87.8% believe that quality of training will improve after introduction of e-logbook, 89.2% found e-logbook useful in implementation of outcome-based learning and 88.4% considered e-logbook user-friendly. The main reasons for not providing regular feedback included the supervisors not familiar to e-logbook interface, internet access problems, and busy schedules of supervisors

Conclusion: There was a wide acceptability of the e-log system among the supervisors with positive perception about its usefulness. The common reasons that hinder the provision of regular feedback include not being familiar to e-log interface, internet access problem, busy schedule and some consider using e-logbook a cumbersome task. These reasons can be alleviated to provide a better training monitoring system for the residents

CPSP/HSE postgraduate overseas rotational programme: residents' perspective

Objective: to get direct upward feedback from the residents of first batch of CPSP/HSE Postgraduate Scholarship Programme

Study Design: mixed methods qualitative research study

Place and Duration of Study: CPSP, Regional Office, Lahore, in June 2015

Methodology: it is a mixed-method study that was conducted in June, 2015. Data was collected through an email survey with 33 medical residents doing their rotation in Ireland; and focus group discussions were carried out with 8 residents, who had successfully completed their rotation. Data were collected through pre-designed questionnaires comprising of open- and close-ended questions. The data were entered into SPSS version 21 and analyzed

Results: the mean age of residents was 29.9 +/- 1.1 years, 7 [21.2%] were females and 24 [72.7%] respondents were males. Residents agreed that HSE programme has improved their evidence-based decision making [mean score of 3.3 +/- 1.2] and enhanced professionalism [mean score of 3.6 +/- 1.1]. They disagreed that training has polished their procedural skills [mean score 2.4 +/- 1.2]. The identified strengths of the programme are: adopting a systematic approach towards patients, evidence-based decision making, better exposure and opportunities, financial stability and development of communication skills. The weaknesses are: less exposure to procedural skills, difficulty in synopsis and dissertation writing and difficulty in adjustment with rotational schedules

Conclusion: residents of CPSP/HSE Programme believed that CPSP/HSE has improved their professionalism, communication skills and increased their future opportunities for career growth. Better communication between CPSP focal person and residents will help sort out many minor but important issues

Effect of intracameral use of dexamethasone on corneal endothelial cells

To evaluate the effect of intracameral dexamethasone on corneal endothelium. Quasi experimental study. Layton Rehmatulla Benevolent Trust Eye Hospital, Lahore, from May 2011 to January 2012. Study subjects were adults of either gender with senile cataract who underwent phacoemulsification. They were divided in two groups, each had 110 patients. Group-A received subconjunctival injection of dexamethasone [2 mg/0.5 ml] at the end of surgery while group-B received intracameral injection of dexamethasone [0.4 mg/0.1 ml] at the end of surgery. Endothelial cell count was performed by specular microscopy pre-operatively and postoperatively at first week, first month and three months. Outcome measures included changes in endothelial cell count. Results were compared using t-test for means. There were 55 [50%] males and 55 [50%] females in group-A and 44 [40%] males and 66 [60%] females in group-B. In group-A, there were 66 [60%] right and 44 [40%] left eyes while group-B had 62 [56.36%] right and 48 [43.63%] left eyes. Mean age in group-A was 55.17 +/- 5.93 years and 54.87 +/- 5.55 years in group-B. Mean phacoemulsification time in group-A was 1.92 +/- 0.63 minutes and 1.82 +/- 0.54 minutes in group-B. After 3 months, in group-A, there was 7.55 +/- 1.19% endothelial cell loss while in group-B, there was 7.63 +/- 1.10% endothelial cell loss. The difference between the two groups was not statistically significant [p=0.614]. Use of intracameral dexamethasone at the end of cataract surgery is safe for corneal endothelium.

Active case detection among household contacts of multi drug resistant tuberculosis patients in a tertiary care setting

Close contacts of multi drug resistant tuberculosis patients are expected to be at increased risk of developing the disease and therefore need screening on priority basis to have an effective TB control program. Active household contact screening is an effective and cheaper way to detect and treat MDR-TB at its early stages. To determine active TB cases among household contacts of MDR-TB patients in a tertiary care setting. Descriptive study, conducted at PMRC TB Research Centre in collaboration with Institute of Chest Medicine, King Edward Medical University/Mayo Hospital, Lahore from November 2012 to December 2013. Patients suffering from MDR-TB and seeking treatment from Institute of Chest Medicine were selected as index patients. Their contacts [spouses, children, parents, siblings and other relatives] underwent sputum smear microscopy. Those found positive for AFB were subjected for MTB RIF assay by GeneXpert to determine rifampicin resistance. Data was analysed using IBM Statistics SPSS version 20.0. A total of 692 contacts of 112 MDR-TB patients were studied. Among them, 374[54%] were males and 318[46%] female. Seventeen contacts were found smear positive and of these 15[88%] were also confirmed as MTB by GeneXpert. Four [23%] contacts were rifampicin resistant. Of the affected contacts, majority were sisters [23.5%]. Active TB was detected in contacts of patients having MDR-TB with few also showing rifampicin resistance. TB screening should be done in all contacts of TB patients, especially those having drug resistance