Attributes of a good medical school: faculty perspective in local context

Background: Medical schools and institutions are required to meet the standards of national and international accreditation bodies. These standards guide the attributes of a good medical school. The current study was designed to identify the attributes of a good medical school from a local perspective

Methods: For this qualitative study based upon grounded theory, 25 participants were recruited through purposive sampling who underwent a workshop to get an insight about the attributes of a good medical school. They were asked to provide the faculty perspectives of a good medical school. The participant responses were put in online software 'Worditout' to look for the repetitions of words, followed by open coding technique. Initial coding was followed by a second phase of axial coding of the data in order to identify themes and thematic analyses of all the data were performed

Results: The teaching experience of the participants in medical schools varied from 2 to 20 years. In total, 198 responses/comments from all the participants were recorded. After doing the open and axial coding all the responses were summarized into four themes. The themes highlighted in order of the response frequency were: 1] improved learning strategies and opportunities; 2] modification and improvements in teaching methodologies; 3] standardised and programmatic assessment methods and 4] parameters of quality assurance and management

Conclusion: The attributes of a good medical school are guided by the national and international standards. However, some of the standards are contextual and our study showed these standards as attributes of a good medical school. It includes provision of better learning opportunities, teaching methodologies, standardised assessment and quality assurance

Thrombocytopenia and prolonged bleeding time in cirrhosis of liver

Platelets play central role in normal hemostsis. Thrombocytopenia is a common problem in cirrhosis of liver. This study was designed to correlate thrombocytopenia with the bleeding tendency in known cirrhotic patients. This retrospective study was done in Department of Pathology Gomal Medical College Dera Ismail Khan, from Jan 2006 to December 2008. Blood was taken from the selected patients and routine hematological tests were performed on all the EDTA collected samples. The tests were run on automatic hematology analyzer Nihon Model. In every case a thin film was made and stained with Giemsa and examined under microscope to verify manually the platelets count. Bleeding time was measured in all the patients by using Ivys method. The present study encompassed the evaluation of platelets count in 100 patients of hepatic cirrhosis and 50 normal controls were also included in the study. The mean age of the patients was 49+14 years. The most common physical signs were splenomegaly and ascites. Among these patients 92 had thrombocytopenia [p<0.01] and 44 had prolonged bleeding time [p<0.001]. Thrombocytopenia and prolonged bleeding time are significant findings in cirrhosis of liver

Pattern and outcome of admissions to neonatal unit of Khyber teaching hospital, Peshawar

To determine the number, disease pattern and outcome of admitted patients to neonatal unit. Khyber Teaching Hospital, Peshawar N.W.F.P from 1st Jan, 2005 to 31st Dec, 2005. Data of all the neonatal admissions was recorded and analyzed for age, weight at the time of admission, sex, reason for admission, duration of hospital stay and final outcome of these patients. Their referral source was also determined. A total of 1694 neonates were admitted during the year 2005. Among them male were 1219[71.96%] and females were 475 [28.04%]. Maximum number of patients was admitted during 1st 24 hours of life. Majority 1056 [62.33%] were referred from hospitals and maternity homes along with 458 [27.03%] home deliveries. Low birth weight accounted for 41.20% of total admissions. Neonatal infections were the next commonest cause of neonatal admissions which includes sepsis [26.03%], pneumonia [1.71%] and Meningitis [1.18%], premature babies [26.50%], N.N.J [19.95%], and birth asphyxia [16.52%]. Other causes of neonatal admission were congenital heart disease [1.41%], meconium aspiration syndrome [1.18%], I.U.G.R [0.82%] and R.D.S [0.59%]. Among total admissions 1212 [71.54%] were sent home after their complete recovery, 252 [14.87%] expired, left against medical advise [L.A.M.A] 120 [7.08%] and discharged on their attendants request 107 [6.31%]. Pre-maturity, neonatal infection, neonatal jaundice and birth asphyxia were the main causes of neonatal admissions. Increased awareness for in time referral to tertiary level hospitals is mandatory by those health workers who conduct deliveries at private hospital /maternity homes as well as those who conduct deliveries at homes

Frequency of heart failure in patients with beta thalassemia major

Estimated prevalence of beta thalassemia is 3-8% in Pakistan. Over the past three decades, regular blood transfusions have significantly increased the survival of these patients. There has been an increase in the frequency of complications, mainly caused by iron overload. The aim of this study was to determine the frequency of heart failure in patients with beta thalassemia major in this region. It was a descriptive audit of ward record, carried out in the Department of Paediatrics, District Headquarter Teaching Hospital, D.I.Khan, Pakistan, from January 2004 to December 2005. Case records of all beta thalassemia major patients admitted during this period were analyzed for heart failure. Clinical data recorded was age, sex and cardiac status of patients. Investigations including ECG, chest x-ray and echocardiography were evaluated. Two hundred and twelve patients of beta thalassemia were admitted during the study period. Clinical congestive cardiac failure was observed in 33 [15.6%] patients with the age range of 8-21 years. Fifty four patients [25.5%] had cardiomegaly on chest x-ray but were not having clinical heart failure. Age range of these patients was 5-12 years. As a whole heart failure and cardiomegaly on chest x-ray was observed in 87 [41.1%] patients. All these patients were above the age of 5 years. Heart failure is not uncommon in patients with beta thalassemia major in our setup. Regular transfusions and chelation therapy are recommended to reduce this complication

prospective study of enteropathogens and their sensitivity pattern in children with bloody diarrhoea/dysentery at Peshawar

Over a six months period, 1262 children with diarrhoea were studied prospectively at Postgraduate Medical Institute, Lady Reading Hospital Peshawar. This accounted for 19.4% of total admissions in the Paediatric Unit during the study period. One hundred and ten stool samples of children with bloody diarrhoea/dysentery were evaluated for enteropathogens and their sensitivity pattern. Out of the 110 samples, 29 samples [26.36%] yielded bacterial growth, with Shigella in 19[17.27%], E.coli in 8 [7.27%] and Salmonella in 2 [1.82%]. All organisms were found to be resistant to Co-trimexazole, Ampicilin and gentamycin, while all, except one were found sensitive to Nalidixic acid