An experience in postgraduate medical education with special relevance to neonatology

This paper reports an experience with the workshop type of educational methodology for post graduate medical students. A workshop was organised in neonatologyfor the students andby the students. Programme evaluation revealed that it was a useful and interesting learning experience.     

Quality of life assessment in patients with dentofacial deformity undergoing orthognathic surgery—A systematic review

The aim of this systematic review was to evaluate the benefits of orthognathic surgery to quality of life, the different motivations and perceptions of patients towards orthognathic surgery, and the various methods that have been used to analyze these changes, in patients who undergo orthognathic surgery for dentofacial deformities. A review of the literature was carried out, and articles published from 2001 to June of 2012 that satisfied the inclusion criteria were included in the review. A total of 21 articles were included. The results indicate that orthognathic patients experience an improvement in quality of life after surgery. Each individual patient has different motivations and expectations from the treatment. Also the use of validated instruments helped in quantifying results. Further research should be aimed at higher levels of evidence in study design, quantifying the changes for different types of dentofacial deformities and surgeries, and have a longer follow-up duration.     

Evaluation of a molecular beacon real-time PCR assay for detection of Baylisascaris procyonis in different soil types and water samples

Baylisascaris procyonis is a helminth parasite commonly found in North American raccoons (Procyon lotor) that is a cause of clinical neural, ocular, and visceral larva migrans in humans when infective eggs are ingested. Rapid detection of B. procyonis eggs in contaminated soil and water would assist public health analysts in evaluating risks associated with public exposure to areas of known raccoon activity. In this study, a molecular beacon probe-based real-time polymerase chain reaction (PCR) assay was developed to enable rapid and specific detection of eggs of Baylisascaris spp. The molecular beacon assay targeted the cytochrome oxidase subunit 2 (cox-2) gene of B. procyonis. To determine method sensitivity, experiments testing various egg levels (250, 25, and five eggs) were performed by seeding into 0.5-g soil samples or 0.5-mL water samples. Different soil sample types were extracted using a commercial nucleic acid extraction kit. Specificity testing using previously characterized helminth tissue specimens indicated that the assay was specific to Baylisascaris spp. Little real-time PCR inhibition was observed for most of the soil and water samples. A seed level of 250 eggs was detected for all soil types, and two seed levels (25 and five eggs) were detected for surface water samples. These results demonstrate that the reported real-time PCR assay was effective for the sensitive detection of B. procyonis in a wide range of soil types, and should be a useful tool for investigations of soil or water potentially contaminated with eggs of this parasite.     

Generalisability in unbalanced,uncrossed and fully nested studies

Medical Education 2010: 44 : 367–378 Objectives There is growing interest in multi‐source, multi‐level feedback for measuring the performance of health care professionals. However, data are often unbalanced (e.g. there are different numbers of raters for each doctor), uncrossed (e.g. raters rate the doctor on only one occasion) and fully nested (e.g. raters for a doctor are unique to that doctor). Estimating the true score variance among doctors under these circumstances is proving a challenge. Methods Extensions to reliability and generalisability (G) formulae are introduced to handle unbalanced, uncrossed and fully nested data to produce coefficients that take into account variances among raters, ratees and questionnaire items at different levels of analysis. Decision (D) formulae are developed to handle predictions of minimum numbers of raters for unbalanced studies. An artificial dataset and two real‐world datasets consisting of colleague and patient evaluations of doctors are analysed to demonstrate the feasibility and relevance of the formulae. Another independent dataset is used for validating D predictions of G coefficients for varying numbers of raters against actual G coefficients. A combined G coefficient formula is introduced for estimating multi‐sourced reliability. Results The results from the formulae indicate that it is possible to estimate reliability and generalisability in unbalanced, fully nested and uncrossed studies, and to identify extraneous variance that can be removed to estimate true score variance among doctors. The validation results show that it is possible to predict the minimum numbers of raters even if the study is unbalanced. Discussion Calculating G and D coefficients for psychometric data based on feedback on doctor performance is possible even when the data are unbalanced, uncrossed and fully nested, provided that: (i) variances are separated at the rater and ratee levels, and (ii) the average number of raters per ratee is used in calculations for deriving these coefficients.     

Persistence of Candida sp. 115 during hydrolysis of penicillin G and metabolism of phenylacetic acid

The growth of Candida sp. 115 was investigated on the constituents of penicillin G hydrolysis reaction mixture. Neither penicillin G nor 6-aminopenicillanic acid was degraded or utilised for growth. The yeast accepted phenylacetic acid, sodium acetate and glucose as growth substrates. Phenylacetic acid was metabolised via p-hydroxy phenylacetic acid, which was the only accumulated metabolite. The enzymes responsible for hydroxylation of phenylacetic acid were induced by phenylacetic acid and sodium acetate.     

Asthma Control and Patient Satisfaction Among Early Pediatric Users of Montelukast

Objective: To assess asthma control and patient satisfaction among pediatric users of montelukast in a clinical practice setting.

Study Design: A prospective study of 175 children with persistent asthma, 6 to 14 years of age, who initiated treatment with montelukast between Feb-1998 and Aug-1998, in primary care and pediatric offices across the United States. Data on asthma control and satisfaction with treatment was collected in physicians' offices after enrollment and by survey to the patients' homes at 1 month of treatment.

Results: Across the study population, improvements in mean scores for asthma control and parent satisfaction were observed at the 1-month follow-up compared with baseline. At 1 month, 57.7% of patients had none of four issues indicative of poor asthma control, compared with 19.4% at baseline. Similarly, after 1 month of treatment with montelukast, 2.7 times as many parents reported being very satisfied with asthma therapy (using montelukast) compared with the previous controller therapy regimen at baseline. During the 1-month follow-up period, montelukast was used as the only controller medication by 18.3% of patients, and in combination with another controller medication by 81.7%.

Conclusions: Observations from this study over one month suggest that a significant percentage of pediatric patients successfully managed their asthma with montelukast and their parents were satisfied with their medication, compared to baseline.     

Dispersion of organic contaminants from wastewater treatment outfall in Masan Bay, Korea

Masan Bay is a land locked shallow water system with poor water circulation. The bay is surrounded by thickly populated cities with considerable industrialization. A wastewater tratment plant (WWTP) manages both domestic and industrial sewage from Masan and Changwon cites and empties the treated water into the bay. Since persistent chemicals of toxic nature escape this process an experiment was designed to investigate in sediments the distribution and dissipation of 5 major groups of agro- and industrial chemicals (51 chemicals in total) from the point of discharge in all directions of the bay. Target chemicals showed patterns of distribution that agreed with expected spatial ditribution model and minor deviations due to diffuse sources of input (e.g. runoff from streams and creeks; ship building and port activities). Thus it is understood that WWTP plays an important role in distributing pollutants to Masan Bay.