Comparison of student performance by assessment through Objective Structured Practical Examination versus the Conventional Method for second year MBBS students in Microbiology.

INTRODUCTION: Objective Structured Practical Examination (OSPE) is a comprehensive tool for assessment. We wanted to improve our assessment methods and make it a more competence-based evaluation. Thus this study was designed to compare the effectiveness of Objective Structured Practical Examination with that of Conventional Practical Examination. METHODS: This interventional study was carried out in Department of Microbiology atCIMSH, Lucknow over six months from October 2019 till March 2020. One hundredsecond year MBBS students were enrolled. The students were divided into two groups offifty for the conventional examination group (controls) and the OSPE group.On the first day, the cases appeared for OSPE while the controls for conventional examination.On the second day, the groups were crossed over. The students appearing for OSPEwere assessed by their scores at different stations. Feedback forms with a prestructured questionnaire were given to the students and the examiners after OSPE on both days to record their perceptions. Finally, the students' scores were tabulated and comparedstatistically. Microsoft Excel and SPSS were used for data analysis. The data was presented as percentages, mean and standard deviation. Student t test was used and the significance was checked, using p value <0.05. RESULTS: Overall in OSPE, the students scored higher and the result was statisticallysignificant. The proportion of students in higher marks range was more for OSPE thanthat for the conventional method. The difference was statistically significant (p<0.001).Feedback taken from examiners as well as from the students in the form of astructured questionnaire to analyze their perceptions was very encouraging. CONCLUSIONS: OSPE is a comprehensive assessment modality for practical evaluationof MBBS students. OSPE proved to be an effective tool that improved the students'scores in microbiology.

Evaluation of Various Diagnostic Techniques for the Diagnosis of Pulmonary and Extra Pulmonary Tuberculosis at a Tertiary Care Center in North India.

INTRODUCTION: Tuberculosis (TB) is a one of the main causes of mortality and morbidity worldwide. Bactec MGIT (Mycobacteria Growth Indicator Tube) system is a rapid, reliable automated system for early diagnosis of pulmonary and extra pulmonary TB in setups where purchase of expensive instruments is not possible. The present study was thus carried out to evaluate AFB microscopy, culture on Lowenstein Jensen media and micro MGIT system for early and accurate diagnosis of Tuberculosis. METHODS: A total of 280 samples were processed for direct AFB smear examination, and culture on micro MGIT and LJ media. The identification of Mycobacterium tuberculosis complex in positive cultures was done by MPT64 Ag card test (BD MGIT TBC Identification Test). RESULTS: Out of the processed samples, (47.1%) 132/280 were positive for Mycobacterium spp by Micro MGIT, (35%) 98/280 on LJ medium and (25.7%) 72/280 by AFB smear. A total of (48.5%) 136 samples were positive by a combination of Micro MGIT and LJ medium. Among the total positive samples (136/280), Micro MGIT was found to be positive in 97% (132/136) of samples, LJ was positive in 72% (98/136), while 52.9% (72/136) were positive by AFB smear. CONCLUSION: Manual MGIT System is a simple and efficient, safe to use the diagnostic system. It does not require any expensive/special instrumentation other than the UV lamp for the detection of fluorescence. In areas with limited resources where the purchase of expensive instruments such as the MGIT 960 is out of scope, the use of manual MGIT for rapid susceptibility testing for MDR-TB could be an option. We would recommend testing MGIT 960 using first and secondline drugs to determine DST.

Magnitude and pattern of hepatitis B infection in clinically suspected infectious hepatitis at a tertiary care hospital in urban India.

INTRODUCTION: Hepatitis B virus (HBV) is a parenterally transmitted viral illness of significant public health importance. The prevalence of HBV related viral hepatitis still remains debatable. OBJECTIVES: The objective of the following study is to determine the magnitude and pattern of HBV infection in clinically suspected infectious hepatitis at a tertiary care hospital in urban India. MATERIALS AND METHODS: This prospective study was conducted in the Department of Microbiology at Lady Hardinge Medical College, New Delhi, over a period of 1 year from January 2008 to December 2008. All the serum samples taken from subjects (600 study and 200 control) were tested for hepatitis B surface antigen (HBsAg) using commercially available enzyme linked immunosorbent assay kit. Serum samples testing positive for HBsAg were tested for hepatitis B e antigen, immunoglobulin M (IgM) capture anti hepatitis D virus (HDV), IgM anti hepatitis B surface and IgM anti hepatitis B core. RESULTS: 24 (4%) serum samples tested positive for HBsAg in the study group while 5 (2.5%) tested positive in the control. Maximum seropositivity of HBsAg was in 20-30 years of age group in the study group (7.6%) followed by 11-20 years (4.5%), 0-10 years (2.8%) and >40 years (2.5%). The difference in seropositivity in study and control group was statistically insignificant in all the age groups (P > 0.05). Out of 24 cases positive for HBsAg, 4 cases (16.6%) were co infected with HDV in study group while there were none in control group. CONCLUSIONS: HBV is a common cause of parenterally transmitted viral hepatitis and hence, it is recommended that measures for public awareness regarding safe infection practices and safe sex practices should be undertaken to limit its spread.

Evaluation of rapid response team implementation in medical emergencies: A gallant evidence based medicine initiative in developing countries for serious adverse events.

BACKGROUND: Rapid response team (RRT) has been implemented in developed countries with the aim of early recognition and response to critical care triggers for the better patient outcome. However, the data concerning their efficacy is hardly available until date from Indian subcontinent. AIMS: To evaluate the impact of RRT implementation on patient outcome during medical emergencies. SETTINGS AND DESIGN: Retrospective observational study of RRT records of in-bed patients of super specialty academic teaching hospital. MATERIALS AND METHODS: RRT record forms during the first half of the year from January 2012 to June 2012 were included for all inpatients and out-patients irrespective of their age, gender and diseases profile after their inclusion in the system. Outcomes such as patient stayed in the room, patient transfer to intensive care unit (ICU), patient discharge and generation of code blue event, mortality and length of stay in hospital/ICU were measured. STATISTICAL ANALYSIS: Descriptive analysis was performed with the help of statistical software STATA 9.0 and R 2.13.2 (StataCorp LP, Lakeway Drive College Station, Texas, USA). RESULTS: Analysis of 41 RRT calls showed decreased code blue calls by 2.44% and decrease in mortality by 4.88%. Average length of stay in ICU and hospital post RRT assistance for patients was 2.55 and 6.95 days respectively. Conversely percentage of patients requiring a higher level of care was more (75.61%) than those who stayed in their rooms/wards (24.39%). CONCLUSION: Implementation of RRT in this hospital was associated with reduced code blue events and its attendant mortality outside the ICU settings. However, more number of patient requiring higher levels of care delineates the need for a larger evidence based medicine study.