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Table of Contents
April-June 2014
Volume 9 | Issue 2
Page Nos. 61-100
Online since Tuesday, December 9, 2014
Accessed 23,755 times.
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ORIGINAL ARTICLES
Prescribing rationality in Khartoum state, Sudan: An update
p. 61
Rayan Khalid Mahmoud, Salah Ibrahim Kheder, Hassan Mohammed Ali
DOI
:10.4103/1858-5000.146575
Aim:
Rational prescribing is one of the essential components of good medical practice targeted to provide successful and relatively safe drug therapies. The present study was carried to assess the rationality of the current prescribing practices in Khartoum State.
Methodology:
A descriptive, observational, 1-time study was carried out in Khartoum State hospitals and community pharmacies, to evaluate the five main prescribing indicators adopted by the WHO. Data were collected using the WHO prescribing indicator form.
Results:
The total number of prescriptions collected and analyzed was 7377 prescriptions, 67% from Khartoum city, 22.5% from Khartoum North city and 10.5% from Omdurman city. The total number of drugs prescribed was 20,482, the average number of drugs per prescription: 2.776 drugs, percentage of generics: 37.3%, percentage of antibiotics: 54.3%, percentage of injections: 38.6% and the percentage of drugs on the essential drug list (EDL) was 72.8%.
Discussion:
The number of encounters included in this study is sufficiently large compared to other previously reported studies allowing us to consider the results obtained as an acceptable representative of the total population to describe the overall prescribing pattern. Except for the value obtained for the percentage drugs on the EDL, the values of the other four indicators are indicative of prescribing irrationality in the study population.
Conclusion:
The observed irrational prescribing behavior necessitates the development of certain policies as well as practical and effective implementation mechanisms to promote rational prescribing. We, therefore, recommend the conduction of one or more of three interventions namely, administrative, managerial and/or educational addressing the prescribers population.
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Instructional preferences of medical students of first and third semester medical students in athletics training
p. 67
Amrith Pakkala, Chitradurga Palaiah Ganashree, Thippeswamy Raghavendra
DOI
:10.4103/1858-5000.146576
Background:
Athletics training is given using personality models, information processing models, social interaction models and instructional preference models. This study uses the VARK (Visual Auditory Read/Write Kinesthetic)- visual, auditory, read/write, and kinesthetic inventory to gather information as per instructional preference model for assessing learning preferences among first and third semester MBBS students with reference to athletics training.
Aim:
This study is designed to evaluate and compare instructional learning style preferences of first and third semester medical students in a peripheral medical college in India.
Materials
and Methods:
This study was conducted on first and third semester MBBS students with each group having 100 students each. VARK inventory version 7.1 was administered to determine the preferred instructional mode based upon the four sensory modalities- visual, auditory, read/write and kinesthetic with reference to athletics training.
Results:
About 80% of the first semester students had unimodal learning preferences out of which 11%, 49%, 5% and 15% students preferred visual, auditory, read/write and kinesthetic modes respectively. In comparison, significantly higher percentage (51%) of third semester students had multimodal learning preferences. Their unimodal learning preference was 4% visual, 6% auditory, 5% read/write and 14% kinesthetic modes. First semester students' auditory instructional style as the most preferred method, whereas the third semester students, preferred the kinesthetic mode.
Conclusion:
With the passage of time in the medical course, students adapt to a multimodal method of instruction. It is, therefore, in the interest of students to strengthen, encourage and adopt a multimodal approach to physical training rather than resorting to the conservative unimodal approach.
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Improving the skills training of the junior medical students can junior medical students attain a comparable skills competence to senior students?
p. 71
Ismat M Mutwali
DOI
:10.4103/1858-5000.146577
Context:
The system-based curriculum adopted at Alzaeim Alazhari University (AAU) (Sudan), entails integration of basic sciences, clinical knowledge and skills training during preclerkship period.
Aim:
The aim of this study was to illustrate how the utilization of the clinical skills laboratory (CSL) may improve the skills acquisition of preclerkship students and be assessed by Objective Structured Clinical Examination (OSCE).
Settings and Design:
clinical skills laboratory of the faculty of medicine AAU For the evaluation of the skills competency of junior medical students a case-controlled design was selected
Subjects and Methods:
All the required tools and materials were prepared. The skills required established. Groups of 10 students attended four sessions of 2 h in the CSL. The skills consisted from different procedural stations. Skills were taught and practiced on manikins, simulated patients and peer examinations. The competency of the junior students and a control group of senior students were evaluated by an OSCE. S
tatistical Analysis Used:
The results of the OSCE of the subjects (junior students) and control (senior students) were analyzed using SPSS version 13 as a software. All the values of the descriptive statistical analysis were expressed as percentages (mean ± standard deviation).
P
≥0.05 was considered as significant.
Results:
Junior students scored higher in two procedural stations and the overall score. Senior students obtained higher marks in physical examination and images interpretation stations. Higher scores of junior students in the procedural stations are because they used hands-on skills and senior students learned through observation.
Conclusions:
Junior students trained in the CSL, can attain comparable skills competency to senior students. They can outperform senior students in procedural skills. This confirms that CSL training can improve skills acquisition.
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Cerumen auris in Abubakar Tafawa Balewa University teaching hospital Bauchi, North-eastern Nigeria
p. 75
Abdullahi Musa Kirfi, Garba Mohammed Mainasara, Abubakar Tijjani Sa'idu, Mohammed Bello Fufore, Yohanna Joseph
DOI
:10.4103/1858-5000.146579
Background:
Cerumen Auris (Ear Wax) is a naturally occurring normally extruded product of the External Auditory Canal (EAC). Despite lots of work on cerumen auris in other parts of Nigeria and the world at large, there was no documented prevalence study in North-eastern Nigeria.
Objective:
The study aimed to determine the prevalence of cerumen auris, evaluate the methods of its removal and to evaluate the possible complications of methods of cerumen removal in Abubakar Tafawa Balewa University Teaching Hospital Bauchi Northeastern Nigeria.
Design:
A 1-year retrospective study of all patients seen with cerumen auris at the study center.
Materials and Methods:
Patients case files were retrieved, and data on demography, clinical presentation, examination, intervention, as well as complications, were extracted. The data was analyzed using SPSS version 16.
Results:
A total of 442 patients' case notes was reviewed, consisting 218 males and 224 females, age ranges from 1-month to 93 years, mean age was 18.76 ± 1.78, most frequent affected age group was 0-9 years accounting for 43.7%. The calculated hospital prevalence was 4.6%. Ninety-five percent of the patients had their cerumen auris removed via ear syringing. Twenty-one (4.8%) of the patients had canal abrasion, 2.3% had bleeding in the EAC, 1.4% of the patients had vertigo.
Conclusion:
Cerumen auris, when untreated, can lead to hearing loss and loss of concentration hence its removal using a safe and effective method is paramount. Ear syringing is found to be safe and effective method of cerumen auris removal.
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REVIEW ARTICLES
Incisional hernia: Risk factors, incidence, pathogenesis, prevention and complications
p. 81
Ismat M Mutwali
DOI
:10.4103/1858-5000.146580
Incisional hernia (IH) is one the most common postoperative complications of abdominal surgery. Its incidence remains high in spite of the great improvement in the techniques and suture materials used for closing the abdominal wall incisions. Many procedures and techniques were described for preventing and repairing IH, but up to date there is a lack of consensus regarding the best approach for preventing and repairing it. The aim of the present article is to review the risk factors, incidence, pathogenesis, prevention and complication of IH. A database search was performed using a combination of the search terms: IH, risk factors, incidence, pathogenesis, prevention, and complications. Some of the relevant reference lists were search manually to obtain more relevant literature.
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Characterization of coronary artery obstruction and related findings in ischemic heart patients using cardiac scintigraphy
p. 87
Eltayeb Wagiallah Eltayeb, Yousif Mohamed Y Abdallah, Mohamed E Gar-Elnabi, Mohamed Ahmed Ali
DOI
:10.4103/1858-5000.146582
This study conducted to characterize of coronary artery obstruction and related findings in ischemic heart patients using cardiac scintigraphy for the identification of myocardial ischemia, 146 patients were studied at basal conditions and also asked for fasting after night till the intravenous injection of the radiopharmaceutical, after the injection time about 15-20 min the patient should eat a fatty meal and chocolate for the good excretion of the gall bladder, to evaluate the performance and regional wall motion of the lef ventricle. The results showed that the body mass index percentage in this sample was in the range of 43.05-61.05. The number of patients who were catheter candidate was 56 patients with 43%, and the patients were not candidate to cathode were 74 patients with 57% of all patients. For the group of patients where type of ischemia was assessed, 29.5% of patients were reversible posterior and inferior wall, 15.1% of patients were fixed large from apex to base, 9.6% of patients were mild basal inferior wall, 4.8% of patients were mild anterior wall, 6.2% of patients were antro septal. 34.9% of patients were moderate ischemia.
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CASE REPORTS
Acute psychosis following diabetic ketoacidosis in an 11-year-old, management challenges in a resource-limited setting
p. 91
Ibrahim Aliyu
DOI
:10.4103/1858-5000.146583
Diabetes mellitus (DM) is the most common endocrine disorder in children and type 1 DM is the most common; however increasing incidence of type 2 DM is being reported, especially in western societies. Occurrence of psychiatric disorders has been associated with type 2 DM but is rare in those with type 1 DM; therefore the case of an 11-year-old girl who was treated for diabetic ketoacidosis, but suddenly developed acute psychotic symptoms shortly after regaining consciousness is reported. Atypical antipsychotic medications were avoided in this case for concerns of their risk of causing abnormal glucose metabolism.
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Novel use of ear plug for making intranasal impression
p. 93
Manu Rathee, Mohaneesh Bhoria, Renu Kundu
DOI
:10.4103/1858-5000.146584
The intranasal splint, stent, and septal obturator are indicated to maintain the patency of the nasal passage. The intranasal prosthetic aid fabrication requires recording of the intranasal anatomy. The problem encountered while making intranasal impression is to carry the impression material into nostrils because the anatomic constriction of the nasal cavity or the contracture caused by trauma or surgery prevents the making of the accurate impression. The thin consistency of elastic impression material used for this purpose does not provide enough resistance required for an extension of alae. The impression material is difficult to control as no prefabricated impression trays are available. An innovative use of ear plug for making intranasal impression is described. The use of ear plug serves to carry and support the impression material during insertion and setting. The flexibility of the ear plug permits easy removal after impression material is set.
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LETTERS TO EDITOR
Tet spells with acute kidney injury
p. 97
Ibrahim Aliyu, Ibrahim F Zainab
DOI
:10.4103/1858-5000.146585
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Cyanotic congenital heart disease: Our constraint in a resource-limited setting
p. 99
Ibrahim Aliyu, Zainab F Ibrahim
DOI
:10.4103/1858-5000.146586
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© Sudan Medical Monitor | Published by Wolters Kluwer -
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Online since 5 Mar, 2014