Comparison of the Efficacy of Tramadol and Paroxetine in the Management of Premature Ejaculation.

Objective The goal of this study was to compare the efficacy of tramadol and paroxetine in the treatment of primary premature ejaculation (PE). Study design This study was a randomized controlled trial performed in the outpatient department of Nishtar Hospital, Multan, from January 2017 to January 2018. Methodology One hundred six patients were diagnosed with PE and included in the study. The patients were categorized into two groups receiving either tramadol or paroxetine through a lottery randomization method. The main variables were baseline PE, baseline satisfaction after intercourse, baseline intravaginal ejaculatory latency time (IELT), ejaculation control, difficulty in ejaculation, and after-treatment satisfaction with sexual intercourse and IELT. We used IBM SPSS Statistics for Windows, Version 23.0 (Armonk, NY: IBM Corp.) for data analysis, and p≤0.05 was considered statistically significant. Results Ejaculation control, difficulty in ejaculation, and distress due to ejaculation in patients in the tramadol group was noted as 24.5%, 7.5%, and 7.5%, respectively. Ejaculation control, difficulty in ejaculation, and distress due to ejaculation in the paroxetine group was noted as 49.1%, 17%, and 24.5%, respectively. The differences were statistically significant within the groups at baseline and after treatment of PE (p<0.001). Conclusion Tramadol is an effective and useful drug as compared to paroxetine for the treatment of PE. Tramadol can be used as an alternative to other medications for the treatment of lifelong PE.

Retrocaval ureter: a rare cause of intermittent right flank pain in a 37 years old lady.

A 37 years old female presented with 6 months history of intermittent right flank pain. She was otherwise fit and had no other complaints. Her lab investigations were normal. Abdominal ultrsonography revealed moderate hydronephrosis and proximal hydroureter but no calculus. Retrograde ureteropyelography findings were consistent with the diagnosis of retrocaval ureter, a rare clinical condition. Surgical exploration confirmed the presence of right retrocaval ureter. The ureter was transected and transposed anterior to inferior vena cava and ureteropelvic anastomosis was performed. Postoperative recovery was uneventful.

Students' feedback on teaching and assessment at Nishtar Medical College, Multan.

OBJECTIVE: To obtain feedback on teaching and assessment methods in professional undergraduate medical examinations. METHODS: The study was conducted at Nishtar Medical College, Multan, Pakistan, from May 21 to May 26, 2012. A written questionnaire covering topics on various teaching and assessment methods was used to get feedback from students of 2nd, 3rd, 4th and 5th year M.B.B.S. SPSS version 17 was used for statistical analysis. RESULTS: Of the 534 questionnaires distributed, 538 (99%) were returned duly filled. Overall, 382 (71%) students were satisfied with all aspects of the lectures delivered and 393 (73%) students agreed that teaching staff was punctual in delivering lectures. Although 312 (58%) students were satisfied with the teaching conducted in the wards, students felt dissatisfaction with the teaching carried out in outpatient departments and operating theatres. Multimedia was favoured by 306 (56%) students as a supporting teaching tool. Although the students agreed that questions asked in examinations were relevant and the pattern of Objective Structured Clinical Examination (OSCE) / Objective Structured Practical Examination (OSPE) was satisfactory, they felt that the time allowed was insufficient. 399 (74%) students agreed that multiple modes of assessment improved their knowledge and skill. There was no consensus among the students on the best form of assessment. Number of students favouring short essay questions (SEQ's), multiple choice questions including true/false type, single best choice questions (BCQ'S) and descriptive questions were 209(38.8%), 176(32.7%), 70 (13%) and 28 (5%) respectively. There was disparity in students' satisfaction in internal assessment and university examination. Although 226 (42%) students were satisfied with internal assessment, 199 (37%) were satisfied with university assessment. CONCLUSION: Overall, the students were satisfied with the lectures and clinical teaching conducted in the wards. Preferred methods of assessment included short essay questions (SEQ's) and multiple choice questions. Most of them wanted sufficient time for OSCE/OSPE and the satisfaction with university examination was only 37%.