Disposal of syringes, needles, and lancets used by diabetic patients in Pakistan

To assess the use, handling and disposal of insulin injection equipment by diabetic patients in Pakistan. We conducted a cross-sectional study at diabetic clinics in five tertiary centers in Pakistan. All diabetic patients [type 1/type 2] who were on insulin for more than 1 month, were included. An Urdu [local language]-translated questionnaire was used to collect information on insulin administration equipment, the site and frequency of needle use, insulin syringe/pen/lancet disposal, sharing of needles and knowledge about diseases that are spread by sharing contaminated needles. Of 375 patients, 58% were female. The mean [SD] duration of diabetes was 12.3 [7.3] years, and the duration of insulin use was 4.4 [4.3] years. The majority of the patients used syringes [88.3%] for insulin administration. Additionally, the majority of the patients disposed of used devices [syringes, 92%; pens, 75%; and lancets, 91%] in the household garbage collection bin. About half of the patients [n = 185] reported being educated by their physicians about the disposal of sharps. Those who were educated by a physician [adjusted odds ratio [adjOR]: 0.36; 95%CI: 0.16-0.81] or could read/write English [adjOR: 0.32; 95%CI: 0.11-0.92] were less likely to dispose of syringes and needles in the household garbage. The common disposal of sharps in the household garbage has implications for disease transmission. Education on the safe disposal of sharps may improve the disposal practices

Evidence for the best modality of delivering undergraduate medical curriculum

Shifa College of Medicine, Islamabad, Pakistan in its quest for excellence in medical education has adopted an integrated medical curriculum approach where basic and clinical science subjects have been integrated horizontally as well as vertically across the five years of undergraduate medical curriculum. The mode of curricular delivery is an area where we are experimenting with Interactive large group discussions, Structured Interactive Sessions, Problem based learning and Case based Instruction formats. There is always a divide in the faculty to accept as to which modality of curricular delivery is the best for the students and ultimately for the patients who are at the receiving end of this exercise