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Background. A culture of quality is believed to drive institutes toward excellence through feedback. Multiple surveys at educational institute help to get a deeper insight into institutional performance and curricular execution. Since problem-based learning (PBL) is an important component of the hybrid curriculum, thus stakeholders’ opinion on PBL satisfaction is worth discussing. This study intended to determine the trends in students’ satisfaction with PBL over the years and to report on the importance of curricular changes that can be incorporated based on students’ needs. Methods. This is a descriptive cross-sectional study that was conducted at the College of Medicine (COM), King Saud Bin Abdul Aziz University for Health Sciences (KSAU-HS), Jeddah, Saudi Arabia. All male and female medical students, using consecutive sampling technique, were included in the study. End-of-course evaluation reports for the academic years ranging from 2013 to 2019 on PBL satisfaction, with a response rate of ≥60%, were included in this study. Results. Overall, students at the COM, Jeddah were satisfied with PBL. A declining but satisfactory trend followed by a sharp rise in satisfaction was observed in this study. Pearson correlation reported a positive relationship between PBL problems, tutors, and PBL sessions (r = 0.82, p<0.001). Conclusions. Transition from three sessions to two sessions per PBL case can be considered as an effective and efficient way of curricular execution. We found that the tutor, the case, and session dynamics were positively correlated after the incorporation of the feedback. Thus, highlighting the facts that inculcating a culture of responding to feedback can lead to innovations in medical teaching and can help to improve the curricular execution and students’ satisfaction.

Background. Medical education is an unusual field whereby a teacher does not receive formal training to become a teacher and is usually marred by quality and effectiveness in imparting the curriculum. To add to the insult, the additive burden of administrating the implementation of the courses does affect the teaching capabilities of a particular teacher. At the College of Medicine (COM), a rigorous procedure for selecting suitable “course coordinators” is followed as they not only serve as administrators for the curriculum implementation but also serve as the role models for the students and their peers as well. Each course coordinator is an important cogwheel in the curriculum as each one can have a positive impact on the overall quality and success of the program. At COM, twenty-one courses are taught in the curriculum, and the execution of each course is led by the duo of coordinator and co-coordinator. The course coordinator is the one primarily involved in the execution, selection of faculty, ensuring smooth flow and delivery of objectives, finalizing and execution of the exam, and responding to students and faculty’s needs during and after the course execution and is the primary person to suggest an effective action plan based on needs to improve the course for the upcoming academic year. Aim. The aim of our study was to assess whether a good teacher can be an effective course coordinator and what the impact of a good teacher/course coordinator is on student satisfaction levels. Methods. This study is a descriptive cross-sectional study carried out for five academic years from 2013-14 till 2017-18. The sample included both male and female sections of the medical program, and the courses for the study were selected as consecutive sampling techniques. The data was retrieved from the evaluation units’ records for the period of 2013–18. SPSS version 20.0 was used for data analysis. Results. Our data reflects a strong positive correlation between course coordinator, course coordinator as a faculty, overall evaluation of the course, and mean faculty rating. Additionally, a strong positive correlation between the mean evaluation of all domains and overall course evaluation for both preclinical and clinical years of the medicine program was also found. Conclusions. Carefully selected effective teachers as course coordinators do have a positive impact on two domains of the course quality, that is, overall satisfaction and faculty ratings by medical students.

Background Conventional hand suture techniques for intestinal anastomosis have been standard practice for decades, but the development of staplers has significantly impacted surgical procedures. Staplers, designed to simplify surgery, have been increasingly used in various gastrointestinal surgeries, including pediatric procedures. Colostomy takedown in infants is a commonly performed surgical procedure in pediatric surgery, yet the optimal technique remains debated. This study aims to compare the outcomes of linear stapler anastomosis and hand-sewn anastomosis for elective closure of loop colostomies in children. The hypothesis is that linear stapler anastomosis offers advantages over hand-sewn anastomosis in terms of operative time, recovery, and hospital stay. Aim To compare the outcomes of linear stapler and hand-sewn anastomosis in the elective closure of pediatric loop colostomies. Methods This prospective, randomized controlled study was conducted at Sher-i-Kashmir Institute of Medical Sciences (SKIMS), Soura, J&K, India, between 2021 and 2023. A total of 70 infants were enrolled, randomly assigned to two groups: Group A (35 infants) underwent SA (Stapled Anastomosis), and Group B (35 infants) underwent HS (Hand-Sewn Anastomosis). Both groups were matched for clinical characteristics. The primary outcomes included operative time and time to return of bowel movements. Secondary outcomes included anastomotic leaks, wound infections, and length of hospital stay. Data analysis was performed using appropriate statistical methods including t-tests and chi-square tests. Results The mean age of patients was 5.79 ± 3.23 months in Group A and 4.21 ± 3.13 months in Group B. The mean time to return of bowel movements was significantly shorter in Group A (24.82 ± 6.34 h) compared to Group B (47.56 ± 5.65 h, p = 0.05). Oral feeding was commenced earlier in Group A (2.18 ± 0.39 days) than in Group B (3.16 ± 0.37 days, p < 0.001). Both groups had a follow-up of 1.81 ± 0.98 years, with no cases of anastomotic leakage or small bowel obstruction in either group. Hospital stay was shorter in Group A (53.82 ± 6.34 h) compared to Group B (79.56 ± 15.65 h, p < 0.0003).

World Health Organization (WHO) recommends hospitalisation and injectable antibiotics for clinical sepsis / possible serious bacterial infection (PSBI) in young infants up to two months of age. However, some young infants with low-mortality risk signs of PSBI may not require hospitalisation, for which evidence needs to be generated. This is a protocol for a multicentre, individually randomised, open-label trial that will be conducted in seven sites in six countries Bangladesh, Ethiopia, India (two sites), Nigeria, Pakistan and Tanzania. All sites will use this common protocol with the same study design, inclusion of participants, intervention, comparison, and outcomes, as well as quality control and analysis procedures to contribute to the overall sample size. All young infants (age <60 days) presenting at study hospitals with any single low-mortality risk sign (high body temperature ≥38°C, severe chest indrawing, or fast breathing of ≥60 breaths per minute in <7 days old infants) will be randomised to either outpatient care with injectable gentamicin for two days and oral amoxicillin for seven days (intervention) or inpatient care with injection gentamicin plus injection ampicillin along with supportive treatment, where needed, for seven days (control). We plan to enrol 7000 eligible young infants, 3500 infants in each of the two study arms. A trained and standardised independent outcome assessor will visit all enrolled cases on days two, four, eight and 15 post-randomisation to assess the study outcomes in both intervention and control groups. The primary outcome of poor clinical outcome, defined as death within two weeks of initiation of treatment, deterioration during the 7-day treatment period, or persistence of the presenting sign at the end of the 7-day treatment period, will be compared to assess if the outpatient treatment leads to superior or at least non-inferior clinical outcome than inpatient treatment. The selected sites have extensive research experience. The methods and all study procedures will be harmonised through central training of research staff by WHO, standardisation exercises for clinical signs, central data coordination centre and internal and external monitoring. Continuous evaluation of the enrolment by the sites will be carried out through regular calls, databased monitoring, and site visits by WHO monitors. This trial has received ethical approvals from the WHO and local site institutional ethics committees. If the results show that young infants with any single low-mortality risk PSBI sign can be effectively and safely treated on an outpatient basis, it may substantially increase access to treatment for infants and families with poor access to health facilities. It may also reduce the human, financial and material costs to the health system and allow the currently overloaded health facilities to focus on more critically ill infants. This evidence will contribute toward making a case for reviewing the current WHO PSBI management guideline. International Standard Randomised Controlled Trial Number ISRCTN44033252.

Hospitalisation and a seven-day injectable antibiotics course are recommended by the World Health Organization (WHO) to treat suspected clinical neonatal sepsis / possible serious bacterial infection (PSBI). Some infants presenting with PSBI signs associated with a moderate risk of mortality may only need a two-day hospitalisation followed by outpatient care treatment with oral antibiotics to complete seven days of antibiotics. A multi-centre, individually randomised, open-label trial will be conducted in seven sites in six countries: Bangladesh, Ethiopia, India (two sites), Nigeria, Pakistan and Tanzania. A common protocol will be used with the same study design, including the participants, intervention, comparison, outcomes, quality control, and analysis procedures. 0-59 days old infants presenting with moderate-mortality risk signs (low body temperature (<35.5°C), movement only when stimulated, stopped feeding well) or two or more signs of clinical severe infection (CSI) will be assessed and pre-enrolled. After 48 hours of hospital stay, clinically stable infants with a negative C-reactive protein test will be randomised either to hospital discharge on oral amoxicillin (intervention) or continued hospitalisation (control) arm. The intervention arm will receive oral amoxicillin for five days, whereas the control arm will receive injection gentamicin plus injection ampicillin for five more days plus supportive therapy if needed. We plan to enrol 5250 eligible young infants, 2625 infants in each of the two study arms. An experienced, well-trained independent outcome assessor will visit all enrolled cases on days 4, 8 and 15 after the initiation of treatment to assess the study outcomes in both intervention and control arms. The primary outcome of poor clinical outcome defined as death between randomisation and day 15 of initiation of treatment, deterioration during the 7-day treatment period, or persistence of the presenting sign of CSI at the end of the 7-day treatment period will be compared to assess if an early discharge and outpatient treatment leads to superior or at least non-inferior clinical outcome than continued inpatient treatment. The harmonisation of activities, including methods and processes, will be carried out diligently. Central training will be conducted by the WHO coordinating team, a central data coordination centre to collate all data, standardisation exercises for all clinical signs and internal and external monitoring. All the selected sites have extensive research experience. Through regular online and physical meetings, data-based monitoring, and physical site visits by WHO monitors, quality assurance and harmonisation will be ensured. This trial has been approved by the WHO and local site institutional ethics committees. If the results show that young infants with moderate-mortality risk PSBI signs can be safely and effectively treated on an outpatient basis after a shorter hospital stay, it will reduce the burden on the hospitals, potentially reduce nosocomial hospital infections and increase access to treatment for families with poor access to health facilities. It may also reduce the health system costs (human and materials) and allow the overburdened hospitals to pay more attention to critically ill young infants. In addition, this evidence will contribute to making a case for reviewing the WHO PSBI guideline. International Standard Randomised Controlled Trial Number, ISRCTN16872570.