Comparative study between academic performances of traditional versus competency-based medical education M.B.B.S. curriculum students in Pharmacology

Background: The new competency-based undergraduate curriculum (CBME) was implemented in India from the academic year 2019. However, there has been no clear-cut comparison on its effect on the academic performance of the students. Aim and Objective: This study aims to find the comparison between students of traditional and CBME curriculum in the subject of pharmacology based on their academic parameters. It also aims to establish comparison and correlation of academic performance with gender, home place area, and mode of learning used. We also aim to determine whether objective parameters like multiple choice question (MCQ) section of preliminary examination show any correlation with final university examination performance. Materials and Methods: This is a cross-sectional type of study. Seventy-seven students from traditional old curriculum and 98 students from CBME new curriculum batches participated with informed consent. The data for analysis between old and new curriculum batches were done using the mark obtained in final university examination in the subject of pharmacology. Quantitative parameters, that is, total marks overall, total theory marks, total marks in practical and oral viva combined, total marks in internal assessment and MCQ marks of preliminary examination, and qualitative variables such as gender of the student, home place area, that is, rural or urban and mode of learning used (physical or physical and digital) were obtained from the participants. IBM-SPSS version 25 software was used to perform descriptive statistics, independent t-tests, and Pearson’s correlation. Results: The results clearly demonstrate that the old curriculum batch of 2018 performed better than 2019 in overall as well as practical aspects of the subject. Pearson’s correlation between all the quantitative parameters, that is, total marks overall, total theory marks, total marks in practical and oral viva combined, total marks in internal assessment, and MCQ marks of prelims for the batch of 2019 showed positive correlation with each other. Conclusions: This study concludes that the old curriculum batch performed better than new curriculum batch in the subject of pharmacology. MCQ examination held in offline mode helps in better correlation with final university results as compared to online mode.

Captopril in the treatment of cardiovascular manifestations of indian red scorpion (Mesobuthus tamulus concanesis Pocock) envenomation.

OBJECTIVES: To study outcome of patients with scorpion envenomation treated with oral captopril in the ICU of a Tertiary Care, University Hospital in Mumbai. METHODS: Retrospective analysis of all patients with scorpion sting admitted to Medical Intensive Care Unit of a tertiary care university hospital in Mumbai between 1993 and 2003. RESULTS: Of 38 patients with cardiovascular manifestations, six had tachycardia alone and 8 had hypertension; these patients received oral captopril 12.5-25 mg thrice daily with no deaths. Pulmonary oedema with normal blood pressure and high central venous pressure (CVP) was seen in 10 patients. Five patients had hypotension, low CVP but no pulmonary oedema; with fluid infusion, these patients had correction of low CVP and hypotension, but developed pulmonary oedema. Pulmonary oedema resolved in all 15 patients with captopril (6.25-25 mg thrice daily): one patient died of ventricular tachycardia. Nine patients had cardiogenic shock; 6 patients, whose blood pressure improved with dopamine received, captopril; 1 of these 6 died. The other three patients did not respond to maximum vasopressor therapy and could not be given captopril; all three died. Four of the 5 deaths occurred in patients weighing < 25 kg suggesting that severity of cardiovascvlar manifestations also depends on body weight of the victim. CONCLUSION : Afterload reduction with oral captopril is safe and effective in scorpion envenomation with cardiovascular manifestations. Results are similar to those with other vasodilators.

Technical complications of feeding jejunostomy: a critical analysis.

INTRODUCTION: A retrospective review of patients undergoing feeding jejunostomy (FJ) was undertaken in order to evaluate procedure related complications and their impact on final outcome. PATIENTS AND METHODS: Ninety six patients had FJ at the department of Surgical Gastroenterology, SGPGIMS from January 1989 to December 1995. RESULTS: FJ as an adjunct was performed in 89 patients with predominantly oesophageal (n = 62) and pancreatic surgery (n = 17). Seven patients had FJ as the only procedure. Fifteen patients (15.2%) had complications related to FJ. Minor complications (7.2%) included dislodgement (n = 3), blockage of the tube (n = 2) and pericatheter leak (n = 2). Major complications (8.3%) which needed surgical intervention were, detachment of the jejunostomy from the abdominal wall (n = 3), leak into the peritoneal cavity (n = 3), jejunal perforation by the tip of the catheter (n = 1) and peritonitis after removal of the tube (n = 1). Procedure related mortality was 3.2%. CONCLUSIONS: FJ should not be treated as a minor procedure and due attention to the technical details is required in its performance, otherwise it may well become the cause of a poor result following a very successful major operation.