The implementation of problem-based learning in collaborative groups in a chiropractic program in Malaysia / 보건의료교육평가

PURPOSE: Problem-based learning (PBL) is usually conducted in small-group learning sessions with approximately eight students per facilitator. In this study, we implemented a modified version of PBL involving collaborative groups in an undergraduate chiropractic program and assessed its pedagogical effectiveness. METHODS: This study was conducted at the International Medical University, Kuala Lumpur, Malaysia, and involved the 2012 chiropractic student cohort. Six PBL cases were provided to chiropractic students, consisting of three PBL cases for which learning resources were provided and another three PBL cases for which learning resources were not provided. Group discussions were not continuously supervised, since only one facilitator was present. The students' perceptions of PBL in collaborative groups were assessed with a questionnaire that was divided into three domains: motivation, cognitive skills, and perceived pressure to work. RESULTS: Thirty of the 31 students (97%) participated in the study. PBL in collaborative groups was significantly associated with positive responses regarding students' motivation, cognitive skills, and perceived pressure to work (P<0.05). The students felt that PBL with learning resources increased motivation and cognitive skills (P<0.001). CONCLUSION: The new PBL implementation described in this study does not require additional instructors or any additional funding. When implemented in a classroom setting, it has pedagogical benefits equivalent to those of small-group sessions. Our findings also suggest that students rely significantly on available learning resources.

The use of epidural analgesia in elective lower segment caesarean section at North Okkalapa General Hospital

A prospective study on the use of epidural anaesthesia in lower segment caesarean section at NOGH was carried out on 41 patients who had been admitted to NOGH from the 1st May 1995 to the 30th April 1996. All the necessary preoperative assessments were done. Epidural analgesia, but using a combination of 0.5 per cent Marcaine and 2 per cent lignocaine was given. the mean duration of induction delivery period was 15 minutes, mean one-minute Apgar score was 7.95. About seventy three per cent (73.17 per cent) of the patients could start breast feeding soon after delivery in the operation theatre and the remaining patients could breast feed their babies soon after leaving the theatre. No serious complication was encountered apart from 7.3 per cent of the patients who had minor complications. The mean duration of postoperative analgesia was 10.46 hours and the mean pain score 1.6. Among these, 39.02 per cent did not require any post-operative analgesia, 39.02 per cent were relieved by placebo injection, 12.19 per cent by injection Diazepam, 7.33 per cent by injection volteran while 2.44 per cent required injection morphine.

The use of epidural analgesia in elective lower segment caesarean section at North Okkalapa General Hospital

A prospective study on the use of epidural anaesthesia in lower segment caesarean section at NOGH was carried out on 41 patients who had been admitted to NOGH from the 1st May 1995 to the 30th

Effectiveness of sodium bisulfite on the stability of Russell's viper (Daboia russelli siamensis) venom toxoid under various storage conditions

Crude Russell's viper venom toxoid was prepred by slow and step-wise formalinization to a final concentration of 0.8 per cent formalin. Then 35 per cent sodium bisulfite was added to half volume of the toxoid. Two types of toxoid were stored at different storage temperatures. At two monthoy interval, the immunogenicity of these toxoid were tested in mice. The antibody levels in immunized mice were measured by ELISA. The toxoid with sodium bisulfite was more immunogenic than the toxoid without it. Therefore the reversion of formaldehyde lindage during storage was less in toxoid which contained sodium bisulfite.

Objective assessment of meconium content in amniotic fluid

In the first part, a sample set of meconium and amniotic fluid solutions with concentrations of 15 percent, 10 percent, 7.5 percent, 5 percent, 3 percent and 1.5 percent was prepared by mixing fresh meconium with clear amniotic fluid. After centrifugation, meconiumcrit values were measured similar to haematocrit measurement. A graph was constructed from meconium concentration and respective meconiumcrit values. A linear relationship was found. In the second part meconiumcrit readings were measured from meconium-stained amniotic fluid obtained from women in labour. fetal and neonatal morbidity were increased significantly in cases where meconium level reached >10 percent. The cut-off level requiring tracheal intubation was found to be 15 percent. High meconiumcrit levels could alert the obstetrician to the possibility of neonatal morbidity and the need for intensive resuscitative measures.

Incidence of sex chromatin among the Burmese

Buccal smears from 1001 Burmese adults (508 males and 493 females) ranging in age from 15 to 78 were studies for sex chromatin. The frequency of sex chromatin was found to be from 9 to 65 per cent, averaging 40.36 per cent (S.D. 12.6) in female 8 and 0 to 5 per cent in males. Out of 493 females, one cell of one girl was double sex chromatin positive and out of 508 males, one cell of one man was also found to be double sex chromatin positive. There was no significant difference in sex chromatin counts between different age groups. Out of 493 females, 28 women with regular menstrual cycles were chosen randomly and divided into four groups according to their menstrual cycle. The menstrual days of the women contained in the first group were between first and eighth days. That of the second group was between nineth and twelveth days, that of the third group was between thirteenth and sixteenth days, that of the last group was between nineteenth and twenty-eighth or thirtieth days. The mean sex chromatin counts of first group was 37 per cent (S.D. 5.6), of the second group was 12.5 per cent (S.D.6), the third group was 30.6 per cent (S.D. 10.2) and those of the fourth group was 25 per cent (S.D.5). Buccal smears were also taken from 10 healthy university girls for four times according to their menstrual cycles. The first time was between first and eighth days, the second time was between nineth and twelveth day, the third time was between thirteenth and eighteenth days and the fourth time was between nineteenth and twenty-eighth or thirteenth days. The mean chromatin counts of the first time was 34.4 per cent (s>d>7.6), of the second time was 26.5 per cent (s.D.7.8) of the third time was 26.6 per cent (S.D.5.6) and that of the fourth time was 34.4 per cent (S.D.7.5)

A study of maternal deaths at the Central Women's Hospital (1975-1979)

A study of maternal deaths during the 5-year period between1975 and 1979 is presented During the 5.year period studied there was a total of 242 maternal deaths.185 cases were due to obstetric causes and 57 cases were due to nonobstetric causes. Heart disease particularly rhuematic heart lesion and viral hepatitis were responsible for most of the deaths in non-obstetric causes. Out of 185 obstetric deaths 115 cases or 62.16 per cent were due to abortion. Sepsis is the main cause of maternal death. It accounts for 65.4 per cent of obstetric deaths. Septic abortion is a major contributory factor in the cause of maternal deaths due to infection. The overall trend in maternal deaths have reduced from 1965 to 1979. The pattern of change as regards the cause of deaths have also altered; infection alone being on the rise whereas other causes such as haemorrhage, pre-eclampsia, pulmonary embolism etc are on the decline.

Incidence of sex chromatin in certain gynecological disorders

Sex chromatin determination was done in buccal smears of 28 gynaecological cases; comprising 13 cases with primary amenorrhoea, 7 cases with secondary amenorrhoea and 8 cases with primary infertility. Two cases with sex chromosomal aberrations were found among 13 primary amenorrhoeic cases, one with double sex chromatin in 15 percent of buccal mucosal cells and another with sex chromatin count as low as two percent. Both of them had Turner's phenotype. The incidence was found out to be 15.38 percent in primary amenorrhoeic cases and 7.14 percent in all gynaecological cases.

Clinical trial of Let-htoke-gyi (Holarrhena antidysenterica) hydrochloride in Trichomonas

32 patients suffering from Trichomonas vaginalis were treated with Flagyl and Let-Htoke-Gye hydrochloride by means of random allocation of the drugs. On analysing the various data available Let-Htoke-Gyi-hydrochloride given systemically is found to be inefficient against Trichomonas vaginitis. Its side effects on the whole are more than those of Flagyl.