Journal Issue: No 3, Issue 31, JULY-SEPT, 2010
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Volume
Number
Issue Date
2010
Journal Title
Journal ISSN
1812-2027
Journal Volume
Articles
Changing scenario of postgraduate medical education in Nepal
(kathmandu University, 2010) Nepal, BP
NA
Fostering research skills in undergraduate medical students through Mentored Student Projects: Example from an Indian medical school
(Kathmandu University, 2010) Devi, V; Abraham, RR; Adiga, A; Ramnarayan, K; Kamath, A
ABSTRACT
Background
Healthcare decision-making is largely reliant on evidence–based medicine; building
skills in scientific reasoning and thinking among medical students becomes an important
part of medical education. Medical students in India have no formal path to becoming
physicians, scientists or academicians.
Objectives
This study examines students’ perceptions regarding research skills improvement after
participating in the Mentored Student Project programme at Melaka Manipal Medical
College, Manipal Campus, India. Additionally, this paper describes the initiatives taken
for the continual improvement of the Mentored Student Project programme based on
faculty and student perspectives.
Methods
At Melaka Manipal Medical College, Mentored Student Project was implemented in
the curriculum during second year of Bachelor of Medicine and Bachelor of Surgery
programme with the intention of developing research skills essential to the career
development of medical students. The study design was cross-sectional. To inculcate
the spirit of team work students were grouped (n=3 to 5) and each group was asked to
select a research project. The students’ research projects were guided by their mentors.
A questionnaire (Likert’s five point scale) on students’ perceptions regarding
improvement in research skills after undertaking projects and guidance received
from the mentor was administered to medical students after they had completed
their Mentored Student Project . The responses of students were summarised using
percentages. The median grade with inter-quartile range was reported for each item in
the questionnaire. The median grade for all the items related to perceptions regarding
improvement in research skills was 4 which reflected that the majority of the students
felt that Mentored Student Project had improved their research skills. The problems
encountered by the students during Mentored Student Project were related to time
management for the Mentored Student Project and mentors.
Results
This study shows that students acknowledged that their research skills were improved
after participating in the Mentored Student Project programme.
Conclusions
The Mentored Student Project programme was successful in fostering positive attitudes
among medical students towards scientific research. The present study also provides
scope for further improvement of the Mentored Student Project programme based on
students’ and faculty perspectives.
Key Words
curriculum, medical students, mentored student projects, methodology, research skills
Urological complications after Kidney transplantation
(Kathmandu University, 2010) Chalise, PR; Sharma, UT; Gyawali, PR; Shrestha, GN; Joshi, BR; Gurung, GS; Ghimire, RK; Kafle, MP; Sigdel, MR; Shah, DS; Raut, KB; Sidharth
ABSTRACT
Background
Renal transplantation is a regular service at Tribhuvan University Teaching Hospital and
complications have been known to occur after it. This study was conducted to assess
complications after transplantation.
Objectives
To determine the incidence of urological complications after living related renal
transplantation at Tribhuvan University Teaching Hospital.
Methods
A clinical study was performed (from August 2008 to July 2010) which included 50
living-related renal transplantations at Tribhuvan University Teaching Hospital. All the
donors and recipients were evaluated preoperatively with necessary investigations and
followed up postoperatively with standard hospital transplant protocol. The incidence
of urological complications were documented and analyzed.
Results
Fifty living-related, renal transplantations were carried out during the study period.
Seven doors had minor post operative complications; three had post operative fever,
two had chest infections and each one had superficial surgical site infections and
severe pain at incision site. Ureteroneocystostomy was performed with double J stent
in all recipients. Urological complications were noted in 12 (24%) recipients. Clinical
significant hematuria occurred in four cases. One patient had ureteric necrosis and
urinary leak which required re-exploration post operatively. Two patients developed
delayed ureteric stricture which were managed by antegrade Double J stenting and
ureteric reimplantation. Peri-graft abscess occurred in two cases, which were drained
percutaneously. surgical site infections was seen in one case.
Conclusions
Urological complications are inevitable in renal transplantation and our complications
rate appears similar to that reported in literature.
Key words
double J stent, renal transplantation, urological complications
The role of the injection Botulinum Toxin A in cases of Essential Blepharospasm Syndrome, Hemifacial Spasm and Meige’s Syndrome
(Kathmandu University, 2010) Bastola, P; Chaudhary, M; Agrawal, JP; Shah, DN
ABSTRACT
Background
Benign Essential Blepharospasm Symdrome is a neuropathologic disorder. The cause of
blepharospasm is multifactorial. It is unlikely that a single defect in this elusive control
centre is the primary cause of this disease.
Objectives
To evaluate the role of botulinum toxin A in treating cases of Essential Blepharospasm
Symdrome, Hemifacial Spasm and Meige’s Syndrome, and to assess orbicularis oculi
muscle post treatment, in the patients who attended neuro-ophthalmology clinic and
the general outpatient department of BP Koirala Lions Centre for Ophthalmic studies.
Methods
A prospective, interventional study was carried out on all the patients of Essential
Blepharospasm Symdrome, Hemifacial Spasm and Meige’s syndrome who underwent
treatment with botulinum toxin A in BP Koirala Lions Centre for Ophthalmic studies
during a study period of one and half years. Pre- treatment grading of the spasm
was done with Jankovic spasm grading and post treatment response was seen with
assessment of orbicularis oculi muscle and improvement in functional impairment
scale. Relevant findings were noted.
Results
A total of 40 cases were enrolled in the study. The mean Jankovic spasm grading in
cases of essential blepharospasm, hemifacial spasm and Meige’s syndrome was 3.61
(+ Standard deviation 0.50, range 3-4), 3.21 (+Standard deviation 0.63, range 2-4)
and 3.67 (+- Standard deviation 0.57, range 3-4) respectively. The mean value for
reappearance of significant spasms (in months) in cases of essential blepharospasm,
hemifacial spasm and Meige’s syndrome was 4.3 (+ Standard deviation 1.6, range
2.0-6.5), 5.8 (+Standard deviation 1.4, range 3-8) and 4.5 (+ Std.deviation 2.8, range
2.5-6.5) respectively. Blepharoptosis was the commonest complication accounting for
66.6% of the complications.
Conclusions
The movement disorders like Essential Blepharospasm, Hemifacial Hpasm and Meige’s
syndrome are treated by different modalities. An acceptable and effective treatment
modality has been a long felt need in these cases. Our study has shown that injection
of botulinum toxin A has been a safe and effective method of treating these cases in
Nepal.
Key Words
essential blepharospasm syndrome, hemifacial spasm, jankovic spasm grading, meige’s
syndrome