ABSTRACT
BACKGROUND: Undergraduate medical examination is undergoing extensive re evaluation with new core educational objectives being defined. Consequently, new exam systems have also been designed to test the objectives. Objective structured practical examination (OSPE) is one of them. OBJECTIVES: To introduce OSPE as a method of assessment of practical skills and learning and to determine student satisfaction regarding the OSPE. Furthermore, to explore the faculty perception of OSPE as a learning and assessment tool. MATERIALS AND METHODS: The first M.B.B.S students of 2011 12 batch of Medical College, Kolkata, were the subjects for the study. OSPE was organized and conducted on "Identification of Unknown Abnormal Constituents in Urine." Coefficient of reliability of questions administered was done by calculating Cronbach's alpha. A questionnaire on various components of the OSPE was administered to get the feedback. RESULTS: 16 students failed to achieve an average of 50% or above in the assessment. However, 49 students on an average achieved >75%, 52 students achieved between 65% and 75%, and 29 students scored between 50% and 65%. Cronbach's alpha of the questions administered showed to be having high internal consistency with a score of 0.80. Ninety nine percent of students believed that OSPE helps them to improve and 81% felt that this type of assessment fits in as both learning and evaluation tools. Faculty feedback reflected that such assessment tested objectivity, measured practical skills better, and eliminated examiner bias to a greater extent. CONCLUSION: OSPE tests different desired components of competence better and eliminated examiner bias. Student feedback reflects that such assessment helps them to improve as it is effective both as teaching and evaluation tools.
ABSTRACT
BACKGROUND: Diabetic retinopathy is one of the leading causes of blindness in the world. Hypomagnesemia has been reported to occur at an increased frequency among patients with type 2 diabetes compared with their counterparts without diabetes. Hypomagnesemia has been linked to poor glycemic control. Many studies have been undergone to find out the precipitated factors of retinopathy such as duration and type of diabetes, hyperglycemia, hypomagnesemia and increased urinary total protein levels. AIM: This study was carried out to study the correlation between serum magnesium levels, glycosylated hemoglobin and urinary total protein levels in diabetic patients with retinopathy. MATERIALS AND METHODS: The study population comprised of 30 type 2 diabetic patients without retinopathy as Group 2, 30 type 2 diabetic patients with retinopathy as Group 3 in the age group 45-75 years as cases and 60 age and sex matched healthy individuals as controls (Group 1). Determination of Serum Magnesium (photometric xylidyl blue method), glycosylated hemoglobin, Hb1C (IFCC), fasting blood glucose, postprandial blood glucose (glucose oxidase method) and urine total protein (Pyrogallol red method) was carried out. The statistical software SPSS 11.0 and Systat 8.0 were used for the analysis of the data. RESULTS: Hypomagnesemia was observed in cases compared with both Group 2 and Group 3. FBS, PPBS, HbA1c, Urine total protein levels were increased in cases (without retinopathy and with retinopathy) compared with controls. CONCLUSION: Hypomagnesemia and albuminuria individually or in conjunction serve as indicators for dysglycemia and could be used as marker for the risk of development of diabetic retinopathy.
ABSTRACT
Acute appendicitis is a common emergency encountered by general surgeons and is managed effectively by timely appendicectomy. Open appendicectomy is usually the first abdominal operation which a surgical resident learns during his training. In this study, 912 appendicectomies were performed on clinical suspicion of acute appendicitis during the period of 6 years (2003-2008) at Medical College, Kolkata and all the appendix specimens were sent for histopathological confirmation. The negative appendicectomy rate in this study was 36.40% which was significantly higher (p < 0.01) than other contemporary studies. Similarly, females had a higher number of negative appendicectomy at 40.34% as against 26.80% for males ( p < 0.001). Of the 409 specimens (44.85%) thought of "normal" appendix intra-operatively, 77 came out to be having acute appendicitis in histopathology report (intra-operative assessment sensitivity of 86.72% and negative predictive value of 81.17%). So even though there is increased morbidity and mortality if acute appendicitis is not diagnosed early, there is always a tendency among surgeons for over diagnosis and adding to the cost of already burdened government healthcare centres in developing countries. A thorough work-up with pre-operative imaging and diagnostic laparoscopy where applicable is advised for appendicectomy before subjecting a patient presenting with right iliac fossa pain.
Subject(s)
Appendectomy , Appendicitis/surgery , Unnecessary Procedures , Acute Disease , Child , Child, Preschool , Female , Humans , MaleABSTRACT
Pancreaticogastrostomy is a less known operation for drainage. In this series pancreaticogastrostomy was done in 37 patients with dilated ducts during the period from 2002-2008. Anastomosis of the pancreas to the posterior wall of stomach was performed using pancreatic duct to gastric mucosa technique. The cases were followed up and it was seen that pancreaticogastrostomy is an effective operation for chronic pancreatitis. Most patients (89%) got relieved of pain for first several years. It is also a less time taking procedure to perform as no Roux-en-y construction is needed.
