In clinical education, experiential learning can be an important component of the instructional process. We know that in medical college hospitals, learning that takes place at patient’s bed side or in wards is totally different from learning that takes place in the classroom. Each patient encounter is a new learning experience where new information is internalized and applied in the context of previous knowledge and experience. This emphasizes the importance of experiential learning where medical students should have the opportunity to effectively and efficiently internalize, process, and apply new information. However, a major global challenge for the clinical education is the workload placed on the clinical teachers, who struggle to divide time between clinical, teaching, administrative, and other duties. Experiential learning helps to form an integrated approach to clinical teaching that simplifies the relationship between a physician’s clinical and educational duties and erase the distinction between teaching and patient care duties; the students are also benefited. Kolb proposed experiential learning theory, a four-stage cyclical model of knowledge development that combined individuals’ conscious recognition and transformation of experience, which was first published in 1984.Experiential learning can be applied throughout the medical educational environment by institutional development programmes, including longitudinal outcome assessment, curriculum development, student development, and faculty development. The use of experiential learning, where students are purposefully engaged in direct experience with an emphasis on reflection, increases the ability of students to develop clinical skills and competences during their clinical phase of medical education. This review paper aims to discuss how experiential learning can be integrated in clinical education.International Journal of Human and Health Sciences Vol. 06 No. 02 April’22 Page: 155-160
Background: Dyslipidemia contributes to the high cardiovascular risk in end stage renal disease (ESRD) or in dialysis patients; however, it remains an underestimated problem. Objective: To see the extent of dyslipidemia in patients of end stage renal disease i.e. chronic kidney disease (CKD) stage 5 who underwent hemodialysis or peritoneal dialysis procedure. Materials and Methods: This cross-sectional study was conducted from September 2016 to March 2018 Bangabandhu Sheikh Mujib Medical University (BSMMU) on 55 CKD (stage 5) patients where 31 in hemodialysis (HD) (group A) and 24 in continuous ambulatory peritoneal dialysis (CAPD) (group B). Serum lipid profile was estimated in both groups by using the standard laboratory technique. Results: Dialysis adequacy (Kt/V) was found 1.46 for HD patients (group A) and 1.81 for CAPD patients (group B).All serum lipids were higher in amount in CAPD patients than HD patients-total cholesterol (222.3±24.2 mg/dl vs. 198.9±28.4 mg/dl; p<0.05), triglycerides (179.6±24.7 mg/dl vs. 176.6±24.4 mg/dl; p<0.05), HDL cholesterol (40.8±3.90 mg/dl vs. 38.5±4.95 mg/dl; p>0.05) and LDL cholesterol (145.5±22.1 mg/dl vs. 123.2±26.5 mg/dl; p<0.05). Besides, dyslipidemia was more evident in CAPD patients than HD patients, as per raised serum total cholesterol (83.33% vs. 70.97%), raised triglycerides (95.83% vs. 83.87%), raised LDL (100% vs. 77.42%) and lowering of HDL cholesterol (87.5% vs. 80.65%) were found more in group B in comparison to group A. Conclusion: Dyslipidemic risk factors are highly evident in dialysis patients and the extent of dyslipidemia is observed more in CAPD than HD patients. KYAMC Journal Vol. 11, No.-3, October 2020, Page 113-117
Introduction: Ultrasound measurements of the intima media thickness (IMT) in the carotid arteries is a strong predictor for cardiovascular events both in the general and diseased population. Materials & Methods: This cross-sectional analytic study was conducted to observe correlation of CIMT with age, body mass index (BMI) and glomerular filtration rate (GFR) in chronic kidney disease (CKD). The study was done in Department of Nephrology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh, on 80 chronic kidney disease patients, from July 2014 to June 2015. All the biochemical parameters were measured according to the standard laboratory techniques. Body mass index (BMI) was calculated by person’s body weight divided by height. Glomerular filtration rate (GFR) was calculated using the modification of diet in renal disease (MDRD) formula. CIMT measurement was done by duplex study of carotid vessels through high resolution B-mode ultrasound. Results: Mean age of the patients was 36.1±9.5 years. 20 (25%), 26 (32.5%) and 34 (42.5%) patients were in CKD stage 3, 4 and 5 respectively. Age, serum creatinine and GFR showed statistically significant difference among stage 3, 4 and 5 CKD patients (p<0.001). However, no difference was evident in BMI and mean CIMT among stage 3, 4 and 5 CKD patients. Significant positive correlations were found between age and CIMT (r=+0.332; p=0.003) and BMI and CIMT (r=+0.294; p=0.008). However, no significant correlation was evident with estimated glomerular filtration rate (eGFR) and CIMT (r=–0.181; p=0.109). Conclusion: Age, serum creatinine and estimated glomerular filtration rate showed statistically significant difference among different stages of CKD patients (stage 3, 4 and 5). There were significant positive correlations found in between age and CIMT as well as BMI and CIMT in chronic kidney disease patients, with an exception to GFR and CIMT. Medicine Today 2021 Vol.33(2): 147-151
Congenital anomalies of kidney and urinary tract (CAKUT) is a group of abnormalities affecting the kidneys or other structures of the urinary tract that include ureters, urinary bladder and urethra. CAKUT include renal agenesis or hypodysplasia, multicystic dysplastic kidney, ureteropelvic junction obstruction, duplication of the pelvis, ureter, and/or kidney, congenital megaureter, ureterovesical junction obstruction, vesicoureteral reflux and posterior urethral valves. Those results from abnormal development of the urinary system and is present from birth (congenital), although the abnormality may not become apparent until later in life. The clinical spectrum of CAKUT has significant impact on long-term patient survival. We observed that the causes of CAKUT are complex, usually combination of genetic and environmental factors contribute to the developmental abnormalities of kidney and urinary tract in foetus. The genetic factors involved in most cases of CAKUT are unknown; however, syndromic CAKUT is caused by changes in the genes associated with the particular syndrome. Variations in the same genes can also underlie some cases of isolated CAKUT. This review paper aims to discuss genetic basis of CAKUT, i.e., identifying different genes involved in syndromic and non-syndromic CAKUT. Modern genetic testing facilities can provide a precise diagnosis that can help individualize clinical care by screening for specific complications, facilitate medical decision making, and provide better genetic counseling. CBMJ 2022 January: vol. 11 no. 01 P: 69-74
Background: Lupus nephritis (LN) is one of the most common and serious manifestations of systemic lupus erythematosus (SLE) that causes significant morbidity and mortality. Certain biomarkers for LN are sometimes able to assess treatment response in lupus nephritis. This study aimed to compare serum complement levels (C3 and C4) as markers of treatment response of LN and their relation to the LN class in renal biopsy. Methods: This prospective observational study was conducted in the Department of Nephrology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh from July 2018 to August 2019. Twenty seven patients who were diagnosed with LN after kidney biopsy were included in this study. Serum complement levels (C3 and C4), 24 hours urinary total protein (24-hr UTP) and anti-double-stranded DNA (anti-ds DNA) were measured in all patients at baseline, 3 months and 6 months after treatment initiation. These biomarker values before and after treatment were compared between the proliferative and non-proliferative LN patients. Results: Serum C3 levels were significantly different between patients with proliferative LN (Class III and Class IV) and non-proliferative LN (Class V) at baseline (0.47 ± 0.32 g/l versus 0.89 ± 0.43 g/l, p=0.009) and levels changed significantly 6 months after treatment initiation (p<0.001) and likewise for serum C4 levels (0.10 ± 0.06 g/l versus 0.24 ± 0.26 g/l, p=0.040). The values of 24-hr UTP and anti-ds-DNA were significantly different 6 months after treatment with p value <0.05 in both groups but C3 (p<0.001) and renal Systemic Lupus Erythematosus Disease Activity Index (rSLEDAI) (p<0.001) were only significant in the proliferative group. On the other hand, after 6 months treatment, C4 levels became relatively higher but that was not significant in both groups (p>0.05). Conclusion: After 6 months of treatment, serum C3 and C4 levels increased towards normal in both LN groups. Serum C3 and C4 levels in patients with LN correlate with disease activity. Therefore, serum complement (C3 and C4) levels may be utilized as serological biomarkers for treatment response of LN. Birdem Med J 2021; 11(2): 97-102
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