rajeev aravindakshan

Assessing and improving infection prevention and control (IPC) knowledge and practicing skills among medical students who are the future medical practitioners is crucial for reducing the burden of healthcare-associated infections (HAIs). In this study, we assessed the IPC knowledge of undergraduate clinical-year medical students before and after interventional IPC modular training and evaluated the effectiveness and students’perception on structured modular IPC training presented to them.

This cross-sectional interventional study was conducted on single medical cohort comprising of 145 final-yearundergraduate medical students of the academic year 2022-23 at COMHS. Pre-test, post-test, and feedback questionnaire were used as the assessing tools. The data were collected, entered into Excel sheet, and analyzed using SPSS software version 22. McNemar and Paired-T tests were carried out, and a P-value<0.05 was considered significant. Feedback of the questionnaire was analyzed using 3 Point Likert Scale as agree, neutral, and disagree.

Overall, mean IPC knowledge scores after training (37.65±1.37) was significantly higher as compared to beforetraining (25.13±4.51). Prior knowledge scores on certain aspects of IPC such as duration of hand washing, steps of hand washing, sequence of donning and doffing of PPE, use of N95 mask, and appropriate sharp and needle precautions, and biomedical waste management were varied from 13.6% to 65.6%. However, overall participants’ knowledge (P<0.001) on these aspects increased significantly after the training. The majority of the participants (>90%) perceived IPC training as an excellent tool to improve IPC knowledge and practicing skills.

IPC training had a significant impact in gaining adequate IPC knowledge and practicing skills among ourparticipants. Therefore, it is recommended that IPC training should be implemented in the undergraduate medical curriculum with greater emphasis on practicing skills.

Modern competency‑based medical education emphasizes student‑centered teaching‑learning strategies where students take responsibility of their own learning. Student‑centered approaches facilitate multifaceted learning such as observation, critical evaluation, analysis, deeper understanding, and application of knowledge. The current study aims at assessing the students’ perception on utilization of clinical case problem‑solving approach (CCPS) to promote their lifelong learning.

The present cross‑sectional study was conducted at College of Medicine and Health Sciences (CoMHS) during the year 2021‑2022. MD3 students of the academic year 2021‑2022 were the study participants. The study was approved by institutional Ethic and Review Committee. Students’ performances were assessed through pre‑test and post‑test performances. Students’ feedback was collected through a predesigned questionnaire on a 3‑point Likert scale. Cronbach’s alpha coefficient test was used to assess the reliability of the questionnaire. The data was entered to Microsoft Excel and analyzed using SPSS software version 22. Paired t‑test was used to compare pre‑test and post‑test scores and the data was expressed as numbers and percentages.

In total, 103 participants were included in the study. Post‑test scores were significantly higher compared to pre‑test scores (p < 0.05). Questionnaire results showed that CCPS approach was accepted as an effective learning strategy. Majority (>90%) of the students expressed CCPS approach was interesting, motivated to learn, encouraged peer discussion, enhanced knowledge, and clarified their topic‑related doubts. More than 80% students opined that CCPS enhanced their critical thinking, problem‑solving ability, deep learning, and lifelong learning skills. Nearly 90% of the students suggested for including such sessions for more topics in immunology course in future.

From our study results, it can be concluded that CCPS is an effective learning strategy to encourage students’ engagement and promote their deep learning skills.

In COVID pandemic, attending the continuing medical education, workshops, and conferences with physical attendance is not possible. We designed, developed, and hosted the first of its kind academic virtual/online conference at par with an in‑person academic conference to disseminate the expertise of the renowned subject experts along with researchers to present their research work due to the ongoing pandemic. We, in this article, had summarized the most critical steps in order to make the process easier for first‑timers while providing our more comprehensive walkthroughs on each step. We choose a live session of the speakers on the Zoom meeting mode to retain the atmosphere of a live conference. WhatsApp, Google (Google Meet and E‑mail), and Kahoot were other platforms to communicate with speakers, researchers, and participants to seamlessly participate. A number of advantages in terms of protection for delegates/speakers and their families came from the Virtual Conference on Nutrition and Health, restricting the spread of COVID‑19, low budget for organizers, economically much cheaper alternatives both for speakers and participants, dissemination of knowledge, time productive, and meeting research paper presentation eligibility for a professional course. When one is new to technology, try adding an innovative aspect as a starting point to future virtual and in‑person events, and seeing how it works is imperative. Ensuring Internet bandwidth, updated hardware, or webcam and/or microphone functionality at the participant end is critical.

Concept maps are graphical representations of knowledge that connect concepts, ideas, and relationships. The present study aims at assessing the perception of medical students in utilization of concept maps as a tool to foster their lifelong learning skills in immunology. The current study was approved by Institutional Ethics and Review Committee. Third-year undergraduate (MD3) medical students of the academic year 2021-22 were sensitized about the concept map study and included after obtaining their informed consent. The students worked in teams to find answers and link the different words or phrases of the concept maps. At the end of the immunology course, students’ perception on concept map-based learning strategy was assessed. A pre-designed, selfadministered questionnaire, pre-validated by subject experts for relevance and feasibility, was used for the study. The questionnaire included some quantitative questions assessed by using 3-pointLikert Scale and an open-ended question to receive students’ comments on concept map-based learning strategy. The responses were collected and analyzed using SPSS version 22. Descriptive statistics was used for the quantitative variables, tabulated as numbers and percentages while the qualitative data was analyzed by thematic analysis. The quantitative data results were prioritized but supported by students’ comments on open ended question.
Out of 133 eligible participants, 109 students who volunteered and completed the study were included. Majority of our participants (>80%) welcomed the concept map-based learning strategy. Almost 4 out of 5 expressed that concept maps are interesting and enjoyable, encourage active participation, peer discussion, and enhance critical thinking and problem-solving skills. More than 80% of the students agreed that concept maps promoted deep understanding of the topic and lifelong learning. Nearly 3 out of 4 students suggested including concept maps in many immunology topics in future. Majority of students penned down positive comments indicating concept map tool facilitates metacognitive skills. From the study, it can be concluded that concept maps are effective active learning strategies to improve themetacognitive domain of medical students in immunology course, thus assisting them to become better lifelong learners.

Gamification involving application of elements of game play that provides unique opportunities to learners to sail through complex medical concepts is gaining importance in medical education. The current study was aimed at assessing the perception of medical students regarding checkerboard game in enhancing learning process.

The present prospective cross‑sectional study was conducted at the microbiology department. The fifth-year medical students of the academic year 2018–19 were the participants. Pre‑ and post‑test scores and self‑administered questionnaire regarding effectiveness of the checkerboard game‑based learning were used as assessing tools. The data were collected, tabulated, and statistically analyzed using SPSS version 20. The pre‑ and post‑test scores of students were statistically analyzed using paired t test. A descriptive analysis on the 3‑point Likert scale of effectiveness survey was measured and expressed in percentages.

In total, 124 fifth-year medical students participated in the study. Majority (89.5%) of them liked the game, nearly 86% opined that game was enjoyable and created interest. Approximately 88% indicated game helped them to understand the topic, enhanced learning, and thus improved the knowledge. Most students (79%) also believed that game encouraged critical thinking and problem solving, while 75% felt that it improved their communication skills. Around 70% felt that game was also useful for exam preparation and nearly 90% recommended to use the game more frequently.

From the results of the study, it can be concluded that checkerboard game‑based learning method is effective in fostering learning process and cognition of medical students in the microbiology course

Team-based learning (TBL) is a highly structured, instructive, and student-focused pedagogy used by medical educators to foster the students’ learning. The present study aimed to qualitatively explore the students’ perception of the effectiveness of online synchronous TBL pedagogical strategy in promoting learning outcomes. A cross-over interventional study was conducted on MD4 year medical students, using four modified TBL sessions on common immunological diseases on four different dates. 139 participants were divided into 4 groups [35 each in A, B, C, & 34 in D]. For TBL session 1, Group A and group B were the study and control groups, respectively. For the second session on different topics, the groups were reversed with group B and group A as the study and control groups, respectively. The same was followed for groups C and D. The means and standard deviations of the pre-test and post-test scores were compared after calculating the improvement in scores from pre- to post-tests. Repeated measures ANOVA suitably coded in SPSS for cross-over design was used to find out confounding by sequence of interventions with a p-value of on a 3-point Likert scale. The data were analyzed using SPSS version 22 and expressed as number and percentage. The post-test scores of the students who participated in the TBL session were significantly higher when compared to the self study (SS) arm. The overall improvement in scores was 4.98 (1.4) in TBL group, whereas in the SS arm it was only 2.29 (1.51). The new method was found far superior to the self-study method regardless of being applied before or after the comparison mode of self-study (p <0.0001). The scores of the self-study was marginally better when offered first rather than after a TBL session, indicating the negative effect of cross-over on SS mode (P=0.024). The overall response of our students toward the effectiveness of online TBL pedagogy was overwhelmingly positive in terms of an opinion survey which had a Cronbach’s alpha of 0.932. The majority (>80%) perceived TBL as an enjoyable active session that promoted their active participation and engagement through student-led discussions. Many stated that TBL enhanced their critical thinking, problem-solving ability, communication skills, and knowledge. TBL is an instructive and highly structured teachinglearning strategy, welcomed by the majority of our participants. Online TBL sessions are effective in fostering the students’learning and can be used confidently when needed.

Antibiotics once regarded as magic bullets are no more considered so. Overuse of antibiotics in humans, agriculture, and animal husbandry has resulted in the emergence of a wide range of multidrug‑resistant (MDR) pathogens which are difficult to treat. Antimicrobial resistance (AMR) is a serious global health problem associated with high mortality in the era of modern medicine. Moreover, in the absence of an effective antibiotic, medical and surgical interventions can highly become a risk. In recent times, the decreased incline of pharmaceutical industries toward research and development of newer effective antibiotics to fight this MDR pathogens have further fuelled the scarcity of antibiotics, thus the number of antibiotics in the pipeline is extremely limited. Hence it is high time for the development of new strategies to fight against dangerous MDR pathogens. Currently, several novel approaches explored by scientists have shown promising results pertaining to their antimicrobial activity against pathogens. In this article, the authors have summarized various novel therapeutic options explored to contain AMR with special attention to the mechanism of action, advantages, and disadvantages of different approaches.

Globally Noncommunicable Diseases is lead causes of mortality. This calls for the need of sensitive and cost appropriate screening tools to identify asymptomatic healthy individuals with higher risk and/or subclinical NCD in the community. The study aims to generate pilot evidence based, validated, good quality, cost appropriate, and sustainable risk assessment score for NCD for developing countries like India.

This descriptive retrospective study of diabetic camp data of 84 patients was conducted. A risk score having 10 questions and three measurements for NCDs appropriate for Indian communities was generated. It was compared to IDRS, FINDRISC, FRS, CBAC, and WHO/ISH prediction charts.

The study finally included 36 patients with NCD as case and 44 subjects without NCD as control. The means of weight, waist circumference, blood pressure, and blood sugar were significantly different among the two groups. AMNRAS of more than 14 was highly predictive for an individual to be at risk of NCD or sub clinical case of NCD requiring evaluation. The proposed cut‑off of 8 for AMNRAS, the sensitivity and NPV was highest compared to other score, 88.9% and 84.6%, respectively. Score for the Area under curve was significantly higher for AMNRAS [0.83 (0.74 to 0.92)] compared to other scores.

AMNRAS has higher performance parameters than the other five tested in the present study. Other scoring system performs only modestly in discrimination of NCD cases. The accuracy of AMNRAS for NCD risk will have to be determined in large size cohorts.

In diabetic foot infections (DFIs), the diversity of microbial profile and ever‑changing antibiotic‑resistance patterns emphasize accurate characterization of microbial profile and antibiotic susceptibility pattern. The aim of the study was to investigate the pathogens associated with DFI and their antibiotic susceptibility patterns.

A cross‑sectional retrospective study was conducted at a tertiary‑care hospital, Oman. The socio‑demographic and microbiological profile and antibiotic susceptibility patterns of pathogens isolated from patients with DFIs from January 2013 to December 2018 were reviewed. Quantitative and qualitative variables were expressed as mean ± standard deviation and percentages, respectively. A Chi‑square test was used for testing the association between multidrug‑resistant (MDR) organisms and variables.

In total, 233 isolates recovered from 133 clinical specimens with an average of 1.8 organisms per specimen were included in the study. Fifty‑six and forty-four percent of specimens showed monomicrobial and polymicrobial growth of two or more organisms, respectively. The frequency of isolation was predominant among males (65%). Aerobic Gram‑negative rods were predominantly (75%) isolated compared to Gram‑positive organisms (25%). Staphylococcus aureus and Pseudomonas aeruginosa were the most frequently isolated Gram‑positive and Gram‑negative bacteria, respectively. Thirty‑eight percent of them were MDR strains. Gram‑negative organisms showed fairly good susceptibility ranging from 75% to 100% to carbapenems, aminoglycosides, and piperacillin‑tazobactam. While doxycycline and trimethoprim‑sulfamethoxazole showed good susceptibility toward Gram‑positive organisms.

DFIs are often polymicrobial with a predominance of Gram‑negative pathogens. This study recommends the use of carbapenems and doxycycline for empirical therapy of Gram‑negative and Gram‑positive bacterial DFIs, respectively.

Critically ill patients on mechanical‑ventilation are always at a higher risk of acquiring ventilator‑associated respiratory infections. The current study was intended to determine the antibiotic‑resistance pattern of bacteria recovered from the endotracheal (ET) specimens of ventilated patients.

This was a single‑centered, retrospective study carried out in a 400‑bed tertiary care hospital in Oman. The data of profile and antibiotic resistance pattern of bacterial isolates recovered from ET aspirates of ventilated patients during the period from January 2017 to August 2019 were retrieved from hospital database. The data were analyzed using the Statistical Package for the Social Sciences (SPSS) software version 22 (IBM, Armonk, New York, USA). Descriptive statistics were applied to find the frequencies and percentages. Charts and tables were constructed.

In total, 201 bacterial isolates recovered from ET secretions of 154 ventilated patients were studied. The rate of isolation was predominant among males (65.6%) and in elderly people (50%). Gram‑negative bacilli (GNB) were predominantly (88.6%) isolated. Acinetobacter baumannii (31.3%) was the most common isolate and 86% of them were multidrug‑resistant strains. Klebsiella pneumoniae (23.9%) and Pseudomonas aeruginosa (22.9%) were the other common GNB, whereas Staphylococcus aureus was the most frequently isolated Gram‑positive bacteria. Gentamicin showed good in vitro activity against S. aureus and all the GNB except A. baumannii reflecting good choice for empirical therapy.

Gram‑negative bacteria were the predominant isolates in ET secretions of ventilated patients. There was an alarmingly high rate of antimicrobial resistance among GNB. A rational use of antibiotics, regular monitoring of antibiotic resistance and use of right combination of drugs, in addition to refining of existing infection control practices are critical to control the emergence of drug‑resistant strains.