Need Assessment for Updating the MBBS Curriculum 2012 of Bangladesh.

Curriculum is the road map of any course and an instrument for developing the competencies of the human resources. The MBBS curriculum in our country was last updated in 2012 during the period of Millennium Development Goals (MDGs). Since then it has been under implementation in different government, non-government and Army medical colleges in association with different universities. "Health Professional for a New Century" now asks for a transformation of the education to strengthen the health systems for meeting the challenges of the 21st century. Curriculum reform is an important issue in transformative education and need assessment is the first and essential task to review and update any curriculum. The objective of the study was to assess the need to review and update the MBBS curriculum 2012 of Bangladesh. Review and updating of MBBS curriculum was organized by Centre for Medical Education (CME) and supported by World Health Organization (WHO). CME, DGHS, Dean offices, MOH&FW, BM&DC and all the government and non-government medical colleges were involved in this activity. Duration of study was 7 months from April 2019 to October 2019. Data were collected from academic councils of 102 medical colleges through structured questionnaire and through FGD with teachers and interns. Around 90(88.2%) academic councils agreed and 12(12%) disagreed about the appropriateness of existing four phases of MBBS curriculum. About 80(84.2%) academic councils agreed with 1.5 years duration of Phase I, 84(88.4%) agreed with one year duration of Phase II, 84(94.4%) agreed with one year duration of Phase III and 77(84.6%) agreed with 1.5 years duration of Phase IV. The study suggested the subjects for 2nd phase are, Pharmacology 74(84.1%), Pathology 53(60.3%), Forensic Medicine 46(52.3%), and for 3rd phase are Community Medicine 60(69.8%), Microbiology 54(62.8%). The study revealed that the subjects of overloaded contents are, Anatomy - 24(50%), Community Medicine - 35(72.9%) and Pathology - 19(39.6%). The study suggested incorporation of organized teaching-learning for behavioral science, communication skills, ethics and development of attitude by most of the academic councils. The study suggested that the increased duration of ambulatory care (outdoor/emergency) teaching. The study revealed around 84(83.2%) academic councils recommended that Single Best Answer (SBA) type of questions should be included in MCQ part for all subjects along with multiple true-false response and around 82(81.2%) academic councils recommended that Structured Essay Question (SEQ) should be included in written part along with Short Answer Question (SAQ). The study revealed that 58(58.6%) academic councils recommended that carry-on system should not be in Phase I and 53(53.5%) academic councils opined to introduce grading system in MBBS course. Most of the academic councils agreed about the appropriateness of existing four phases of MBBS curriculum. The subjects for 2nd phase are, Pharmacology - 84.1%, Pathology - 60.3%, Forensic Medicine - 52.3%, and for 3rd phase are Community Medicine - 69.8%, Microbiology - 62.8%. Most of the participants are in favour of the present curriculum components, grading system for assessment but not the carry-on system in Phase I. The study recommended for national level consultations involving the concerned persons for finalization of the MBBS curriculum.

Vaccination against COVID-19 in Bangladesh: Perception and Attitude of Healthcare Workers in COVID-dedicated Hospitals.

Healthcare professionals are the crucial and influencing source of information for vaccines and their communication among patients and communities that can accelerate successful vaccination in a country. This cross-sectional study was one of the first and foremost ones in Bangladesh to observe the basic perception and attitudes towards vaccination against COVID-19 among the healthcare workers (HCWs) - doctors, interns, nurses, ward boys, cleaners, and medical technologists of major COVID-dedicated hospitals. The cross-sectional questionnaire-based study was conducted in February 2021 among 550 HCWs to assess the perception and attitude towards vaccination against COVID-19. The study participants were targeted as the priority group for COVID-19 vaccination, working in two major COVID-dedicated hospitals, Holy Family Red Crescent Medical College Hospital (HF-center), and Sheikh Russel National Gastro-liver Institute and Hospital (SR-center) in Dhaka, Bangladesh during the pandemic. The questionnaire was structured with a three-point scale of responses from 'true', 'false', and 'do not know'. The responses were calculated on point-score as +1 for the correct response, -1 for the wrong response, and 0 for 'do not know' with an overall highest and the lowest possible score of +5 to -5. Absolute (n) and relative frequencies (%) were presented for qualitative variables, while quantitative variables were presented as mean (± standard deviation). Chi-square test was done for univariate analysis of qualitative variables and Student's t-test for quantitative variables. With the 95.27% response rate, including 204 males and 320 were female and the male: female ratio was 1: 1.56. The majority of the participants were doctors (45.8%) followed by nurses (27.9%), and MLSS (26.3%) respectively. The respondents were between 18 to 64 years of age with a mean of 36.17±10.94 years. Most of the respondents (95.99%) responded correctly about the cost-free availability of a vaccine against COVID-19 in the country, 87.40% preferred vaccination as safe and effective. Again 29.77% HCWs think the vaccine might not be safe or effective due to emergency authorization. Only 38.93% of respondents could respond correctly about the necessity of vaccines for children, 31.10% think the vaccination was not required instead of natural immunity. The positive perception and attitude of the frontline HCWs in COVID-dedicated hospitals in Bangladesh are crucial which will positively influence motivation and wide acceptance among the general population for the attainment of the nationwide vaccination program, and adopt effective strategic modification to minimize the gaps for a low-middle income country like Bangladesh with its resource constrain.

Correlation Between Endoscopic and Histological Activity in Ulcerative Colitis Using Validated Indices.

BACKGROUND AND AIMS: Endoscopy and histopathology are pivotal for evaluating disease activity in ulcerative colitis [UC]; correlation between validated endoscopic and histological indices has not been examined. We aim to correlate the Ulcerative Colitis Endoscopic Index of Severity [UCEIS] with two new validated histological indices in patients with established UC. METHODS: This was a single-centre cohort of patients with established UC, who underwent flexible sigmoidoscopy or colonoscopy by a single endoscopist. The UCEIS was scored at the worst affected area in the distal colon, which was biopsied; histological disease activity using Nancy [NI] and Robarts' Histological [RHI] indices was scored by a pathologist blinded to the endoscopy. Spearman correlation between the UCEIS, NI, and RHI, and between NI and RHI, was performed. RESULTS: A total of 125 patients, median age 37 years [range 16-81 years], with UCEIS scores [scale 0-8]: 0, n = 21; 1-3, n = 48; 4-6, n = 51; and 7-8, n = 5, were included. Correlation coefficients between UCEIS and NI [scale 0-4] were r = 0.84 (95% confidence interval [CI] 0.76-0.89, p < 0.001) and between UCEIS and RHI [scale 0-33] r = 0.86 [95% CI 0.80-0.90, p < 0.001]. The difference in correlation was not significant [p = 0.57]. There was excellent correlation between the two histological indices [r = 0.92, 95% CI 0.87-0.95, p < 0.001]. Quiescent disease activity defined as the absence of neutrophils [Nancy 0-1, Robarts 0-3] was most closely correlated with UCEIS = 0. CONCLUSIONS: The UCEIS strongly correlates with both NI and RHI. Complete mucosal healing is best defined as a UCEIS = 0/8, since this correlates with the absence of microscopic disease activity.