Effect of Teachers Training Workshop Outcomes on Real Classroom Situations of Undergraduate Medical Students.

BACKGROUND: Faculty development by conducting regular training, workshops and research related to medical education has been a key feature to upgrade quality of medical education. OBJECTIVE: The aim of this study was to explore responses of the health science teachers, students and peers after the workshop after providing training on student assessment tools and teaching-learning methods. METHOD: Two teacher-training workshops were conducted to the faculty members of B.P. Koirala Institute of Health Sciences from the departments of basic, clinical and allied sciences in Oct. 2010 and Jan. 2011. Qualitative questionnaire based study was conducted, and the questions were validated before the study by expert peer review process. The effect of the training workshop in real classroom outcomes was assessed incorporating student's feedback, evaluation by peers and the self-evaluation by the teacher trainees. RESULT: Pre-test and post-test scores of the participating teachers, before and after the workshop were 62.53 and 71.17 respectively. Among the participants 90.3% teachers expressed enhanced in their role as a teacher for medical undergraduates after the workshop. CONCLUSION: In present study, the faculty members showed accrued interest to participate in teacher's training workshops. The peer evaluation of teacher's performance in their real classroom situations were rated higher than evaluation by the students. Therefore, such training workshops will have a greater impact on the ability of teachers in effective teaching in real classroom situations.

Prevalence of metabolic syndrome in chronic kidney disease: a hospital based cross-sectional study.

BACKGROUND: The components of metabolic syndrome (MetS) are the established risk factors of chronic kidney disease (CKD). Therefore, MetS and interplay of its various components, have deleterious effects on patients with chronic kidney disease. The aims of our study was to find out the prevalence of MetS in chronic kidney disease patients and to find out the association of each component of MetS with chronic kidney disease. METHODS: A Hospital based cross-sectional study was carried out from February 2008 to August 2009. One hundred and sixty confirmed chronic kidney disease diagnosed patients were included in this study. Chronic kidney disease was defined from national kidney foundation guidelines. Anthropometric measurements of subjects were noted in a semi-structured pro-forma. Fasting blood sample was collected for the estimation of fasting blood glucose, triglyceride and HDL-cholesterol. Chronic kidney disease patients were diagnosed as having the metabolic syndrome by using the modified National Cholesterol Education Program Adult Treatment Program III criteria. Data were assessed by the t-test and Chi Square Test. RESULTS: Sixty (37.5%) of the chronic kidney disease patients had MetS according to modified National Cholesterol Education Program Adult Treatment Program III criteria. The prevalence of hypertension, high fasting blood glucose, high triglyceride, low HDL Cholesterol and high waist circumference in chronic kidney disease patients was 112 (70.0%), 36 (22.5%), 74(46.25%), 98 (61.25%) and 30 (18.75%) respectively. Among the five components of the metabolic syndrome, waist circumference has the highest positive predictive value (73.34%) for chronic kidney disease. CONCLUSIONS: MetS occurs in more than one-third of chronic kidney disease patients. The prevalence of individual components of MetS is higher in chronic kidney disease patients.

Spectrum of thyroid dysfunction in patients visiting Kantipur Hospital, Kathmandu, Nepal.

Thyroid disorder is most common endocrine abnormality in the general population and its prevalence increases with age. The screening of thyroid disorder is advised in high risk population. This hospital based cross-sectional study was conducted in Department of Biochemistry, Kantipur Hospital, Kathmandu, Nepal. Patients having complains of thyroid disease from February 2010 to January 2011 were enrolled in this study. Thyroid parameters such as FT3, FT4 and TSH were measured by ELISA technique. Among total 472 subjects 393(83.27%) were female whereas 79(16.73%) were male. The prevalence of thyroid dysfunction was 36.0% (n=170). The different patterns of thyroid dysfunction in Kathmandu valley were: hypothyroid (11.6%), subclinical hypothyroid (16.9%), hyperthyroid (4.0%), and subclinical hyperthyroid (3.6%) respectively. Subjects having all thyroid parameters normal i.e. euthyroid were 63.9%. In conclusion, this study reveals a higher prevalence of thyroid dysfunction in Kathmandu region. This study recommends community based nationwide epidemiological studies on a regular basis to monitor thyroid dysfunction in Nepalese populations.

Adenosine deaminase in CSF and pleural fluid for diagnosis of tubercular meningitis and pulmonary tuberculosis.

Tuberculosis (TB) is one of the most common infectious diseases in developing countries including Nepal. Delay in diagnosis and treatment of tuberculosis results in poor prognosis of the disease. This study was conducted to estimate diagnostic cut off values of Adenosine Deaminase (ADA) in cerebrospinal fluid (CSF) and pleural fluid and to evaluate the sensitivity, specificity, positive and negative predictive values ofADA in pleural fluid and CSF from patients with tuberculous and non-tuberculous disease. A total of 98 body fluid (CSF: 24, Pleural fluid: 74) specimens were received for the estimation of ADA. ADA activity was measured at 37 degrees C by spectrophotometric method of Guisti and Galanti, 1984 at 625nm wavelength. Among the patients enrolled for the study subjects for which CSF were received (n = 24) included 8 tuberculous meningitis (TBM), and 16 non-tubercular meningitis (NTM). Pleural fluid samples (n = 74) were received from 19 pulmonary TB with pleural effusion, 17 PTB without pleural effusion and 37 of non-tuberculous disease patients. CSF ADA activity were (11. 1 +/- 2.03 IU/L) and (5.3 +/- +1.89 IU/L) (p <00001) in TM and non-NTM groups and Pleural fluid ADA activity were (10 +/- 22.18 IU/L) and (23.79 +/- 11.62 IU/L) (p < 0.001) in PTB and non-TB groups respectively. ADA test in body fluids, which is simple, cost-effective and sensitive, specific for the tubercular disease is recommended to perform before forwarding the cumbersome and expensive procedures like culture and PCR for TB diagnosis.

Prevalence of methicillin resistant Staphylococcus aureus in school children of Pokhara.

Present study was carried out to find out the prevalence of methicillin resistant Staphylococcus aureus (MRSA) in school children of Pokhara city in western, Nepal. A total of 184 randomly selected children younger than 15 years were included in the study. Nasal swabs collected were subjected to standard bacteriological culture. S. aureus isolates were identified by mannitol fermentation, coagulase positivity and DNase positivity. Antimicrobial susceptibility test was performed on muller-hinton agar (MHA) by modified Kirby-Bauer disc diffusion method. Out of total 184 nasal swabs, S. aureus was isolated in 31.0% (n=57). Among the isolates, 35.1% (n=20) were from male children whereas 64.9% (n=37) were from female. There was no significant sex difference in colonization of S. aureus. Out of 57 isolates, 56.1% (n=32) were MRSA. MRSA isolates indicated relatively high rate of resistance to antibiotic cloxacillin (68.7%) followed by ofloxacin (40.6%), tetracycline (15.6%), erythromycin (9.4%), ciprofloxacin (6.2%) and vancomycin (3.1%).This study showed a high prevalence of MRSA carriage in school children indicating the spread of MRSA in the community.