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Conventional medical education does not provide adequate training to undergraduates to resolve healthcare-related ethical dilemmas. This quasi-experimental study using a pre-post design was conducted to assess knowledge, attitudes and practices in healthcare ethics (HCE) and evaluate the effectiveness of the introduction of HCE in ethical behaviour among medical undergraduates at the Mahatma Gandhi Institute of Medical Sciences in Sevagram, India. All the participants thought that knowledge of HCE is important. There was an improvement in the knowledge of HCE after the intervention, as both weighted mean and percentage consensus improved. In Phase I, absolute learning gain, relative learning gain, and normalised gain “g” were significantly higher after the intervention. In Phase II, the intervention showed low and moderate effectiveness in improvements in the affective and psychomotor domain, and in the ability to handle ethical issues, respectively; but no significant improvement in communication skills. During the feedback session, it was seen that a majority of the participants thought that it is the need of the hour to introduce skill-based HCE into their curriculum from the first year. It can be concluded that it is possible to improve knowledge, and affective, psychomotor ability to handle ethical issues among undergraduate medical students with formal training
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Kikuchi's disease (KD) also known as histiocytic necrotizing lymphadenitis is rare, idiopathic, generally self-limited cause of lymphadenitis. We present a case of twenty year young female who presented in critically ill state with fever, cervical and axillary lymphadenopathy, rash, vomiting and altered sensorium and found to have neurological, hepatic, renal and dermatological involvement. Kikuchi's disease should be considered in differential diagnosis of fever and lymphadenopathy and though benign can sometimes present with multi-organ involvement. It is because of rarity of this disease with unusual complications, present case is reported.
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We present a case of a 45-year-old female with history of four days of fever and rash with swelling over both limbs diagnosed on postmortem autopsy as Churg-Strauss disease and further give a brief overview of the disease.
RESUMO
Calorimetric technique has aroused considerable interest as a versatile tool in pharmaceutical industry and academia to provide useful information about thermodynamic and kinetic aspects of drug molecules. The present paper utilizes this technique to monitor the hydrolytic degradation of metronidazole and its prodrug with ciprofloxacin; i.e. 2-(2-methyl-5-nitroimidazol-1-yl)ethyl-1-cyclopropyl-6-fluoro-1;4-dihydro-4-oxo-7-(1-piperazinyl)-quinoline-3-carboxylate. The synthesis of the present mutual prodrug was envisaged to combine the antiprotozoal and anaerobic antibacterial effects of metronidazole with antibacterial effects of ciprofloxacin. Heat flux microcalorimeter was used to determine the rate of heat evolved during the degradation of the drug and prodrug as a function of concentration; pH and temperature. In terms of enthalpy of hydrolysis the response is exothermic both for drug and prodrug. However; the absolute value of the enthalpy of reaction (?rH0) is low for the prodrug. The degradation followed pseudo first order kinetics; showed marked stability at pH 3-7 followed by accelerated hydrolysis at higher pH; characteristic of general acid-base catalysis. The catalytic rate constant for hydrogen ion (kH) and hydroxyl ion (kOH) were found to be 0.413 and 526.1 M-1h-1; respectively; at 318.15 K. The hydrolysis of the prodrug was found to be approximately 50-60 times faster than that of the drug. This may be attributed to the fact that hydrolysis of ester group in prodrug is assisted by keto group on the ciprofloxacin. However; there is no effect of protonation of nitrogen in piperazine ring in ciprofloxacin on the hydrolysis due to the distance from the ester moiety