Maternal TB is associated with increased MTCT of HIV. Prevention of TB among HIV-infected mothers should be a high priority for communities with significant HIV/TB burden.
The PK Superpulse system provides faster removal of tissue in a bloodless field with better views and a safer environment of saline irrigation with efficacy comparable to that of conventional TURP. However, further randomized trials with extended follow-up may be needed to better define the role of the PK Superpulse system in treating patients with symptomatic BPH.
Pearson's correlation coefficient. Outcome measures were considered statistically significant at P £ 0AE05. Epi info 6 and SPSS statistical packages were used for the analysis. Evaluation of results and impact A statistically significant increase in students' self-reported knowledge, skills and attitudes regarding EBM was found. Mean scores for their understanding of the EBM concepts increased from 2AE20 ± 0AE85 to 3AE17 ± 0AE80 on a 4-point rating scale (P < 0AE001). Student knowledge of the EBM process also increased significantly (P < 0AE05). Mean scores for student knowledge about the need for effective literature search processes in EBM practice were similar and relatively high in the preand post-surveys: 3AE24 ± 0AE71 and 3AE33 ± 0AE89, respectively. Although textbooks remained their major source of evidence, increased use of the Internet (P ¼ 0AE0003), Cochrane database (P ¼ 0AE0001) and secondary EBM resources (P ¼ 0AE045) was reported. Students' use of EBM resources for questions related to patient care increased (P ¼ 0AE0001). Student-perceived limitations to EBM practice included lack of training (77AE8%) and lack of role models among teachers (60AE9%). The EBM course was perceived by students to have enhanced their learning (74AE1%) and provided lifelong learning skills (90AE7%). A positive correlation was found between knowledge about EBM, the use of EBM resources and application of EBM concepts to patient care questions, while a negative correlation was noted between knowledge and misconceptions about EBM. Students strongly supported the inclusion of the EBM course in the undergraduate curriculum (90AE7%).An EBM course, even with resource constraints, is a feasible, beneficial and desirable educational programme for medical students that is associated with significant self-perceived benefits that include enhancement of learning, provision of lifelong learning skills and increased use of EBM resources. Context and setting The teaching of undergraduate medical students is frequently conducted in separate academic departments, without integration to interrelate or unify subjects. The Medical Council of India wants an increase in integration, in order to provide students with a holistic rather than fragmented learning perspective. Why the idea was necessary This project was designed to establish a method for vertical and horizontal integration which takes advantage of the abundant number of patients in developing countries and eliminates the need for written case scenarios. A curriculum intervention was created using studentcentred clinical case-based learning (CBL) to enhance clinical learning. What was done A total of 6 residents and faculty in the surgery department were trained as CBL facilitators during 3 workshops. Each facilitator conducted 8 sessions for 6 groups of students (8-10 per group) during a final-year surgery rotation; 55 students from another surgery rotation, conducted in a traditional manner, acted as control. Both groups were introduced to concept mapping and each student produced...
BackgroundHIV-infected and HIV-exposed, uninfected infants experience a high burden of infectious morbidity and mortality. Hospitalization is an important metric for morbidity and is associated with high mortality, yet, little is known about rates and causes of hospitalization among these infants in the first 12 months of life.MethodsUsing data from a prevention of mother-to-child transmission (PMTCT) trial (India SWEN), where HIV-exposed breastfed infants were given extended nevirapine, we measured 12-month infant all-cause and cause-specific hospitalization rates and hospitalization risk factors.ResultsAmong 737 HIV-exposed Indian infants, 93 (13%) were HIV-infected, 15 (16%) were on HAART, and 260 (35%) were hospitalized 381 times by 12 months of life. Fifty-six percent of the hospitalizations were attributed to infections; gastroenteritis was most common accounting for 31% of infectious hospitalizations. Gastrointestinal-related hospitalizations steadily increased over time, peaking around 9 months. The 12-month all-cause hospitalization, gastroenteritis-related hospitalization, and in-hospital mortality rates were 906/1000 PY, 229/1000 PY, and 35/1000 PY respectively among HIV-infected infants and 497/1000 PY, 107/1000 PY, and 3/1000 PY respectively among HIV-exposed, uninfected infants. Advanced maternal age, infant HIV infection, gestational age, and male sex were associated with higher all-cause hospitalization risk while shorter duration of breastfeeding and abrupt weaning were associated with gastroenteritis-related hospitalization.ConclusionsHIV-exposed Indian infants experience high rates of all-cause and infectious hospitalization (particularly gastroenteritis) and in-hospital mortality. HIV-infected infants are nearly 2-fold more likely to experience hospitalization and 10-fold more likely to die compared to HIV-exposed, uninfected infants. The combination of scaling up HIV PMTCT programs and implementing proven health measures against infections could significantly reduce hospitalization morbidity and mortality among HIV-exposed Indian infants.
Maternal TB is associated with increased MTCT of HIV. Prevention of TB among HIV-infected mothers should be a high priority for communities with significant HIV/TB burden.
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