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Background: The COVID-19 pandemic and subsequent lockdowns which happened worldwide made it imperative for everyone to explore newer methods of teaching and learning. Problem Based Learning (PBL) which is a student-centric method of teaching learning can be conducted using virtual platforms like Microsoft team and WhatsApp. This study was done to understand the perception, acceptance, and challenges in the implementation of PBL in a virtual format (Online PBL). Methodology: This is an institution based cross sectional study conducted over one year (1st December 2020 to 1st December 2021). All 150 first-year Medical students were included in the study. Four sessions of Online PBL were conducted using Microsoft team and WhatsApp. The assessment was done using Multiple Choice Questions (MCQs) and concept maps after each session. The student’s feedback was collected using a validated questionnaire and analyzed. Convenience sampling was used. The results were tabulated and SPSS was used for statistical analysis. Results: A total of 130 students attended the sessions. Amongst these, were 75 (62.5%) male and 45 (37.5%) female students. There was a significant improvement in the post-test score in all the sessions. 97 (80.8%) students agreed that the Problem based learning strategy is interesting. 102 (85%) of the students opined that PBL improved their reasoning skills. Students felt that virtual mode is feasible, interesting, and convenient. Conclusion: Students found PBL using virtual platforms to be interesting. Overall feedback and perception of the students were good. Online PBL encouraged the students towards self-directed learning and critical thinking without time constraints and geographical barriers.
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INTRODUCTION: Mild hypoxia has been seen in approximately one third of patients with chronic liver disease. Development of hypoxemia in patients with chronic liver disease, modifies the line of management and worsens the prognosis of the disease. Hence an early detection of hypoxemia in these patients is essential. Hypoxemia results from various causes in patients with chronic liver disease. Hepato pulmonary syndrome is an important cause in a patient with hypoxemia and chronic liver disease. Development of this complication in chronic liver disease indicates a poorer prognosis in these patients. Chronic liver disease is also known to be associated with pulmonary manifestations that affect both the pleural space and lung parenchyma. This study was undertaken to study the prevalence of hypoxemia and assess the prognosis in patients with chronic liver disease. MATERIALS AND METHODS: Fourty three patients aged 18 years and above with evidence of cirrhosis, admitted under the department of Medicine and Gastroenterology, were included in the study. A detailed history was taken and clinical examination were done in all patients. All patients underwent ultrasonography, LFT, biochemical tests and upper gastrointestinal endoscopy to confirm chronic liver disease, portal hypertension and varices, if any chest X-ray, 2-D transthoracic echocardiogram, viral studies and pulmonary function tests. The patients in whom arterial hypoxemia was detected with a positive contrast echocardiogram were considered to have hepato pulmonary syndrome. RESULTS: Six out of the 43 patients (13.9%) included in the study had hypo-xemia. Among these 6 patients with hypoxemia, 3 were found to have contrast enhanced echocardiographic evidence of intra pulmonary vascular dilatations and diagnosed hepato pulmonary syndrome. The other 3 patients had evidence of both, interstitial lung disease and pleural effusion contributing to hypoxemia. The patients with hepato pulmonary syndrome had a significant P (A-a) O2 gradient, died during the study period, indicating a poorer prognosis. CONCLUSIONS: We conclude that identification of hypoxemia and its aetiology in patients with chronic liver disease is essential. Identification of hepato pulmonary syndrome is important, as it carries a poor prognosis in patients with chronic liver disease.