Objective:Viva voce examination is an important tool of evaluation in medical examinations marred by high subjectivity. Gross subjectivity in viva voce assessment can be reduced by structuring it.Materials and Methods:The marks obtained in theory and viva voce (traditional viva voce examination [TVVE]) of I sessional, II MBBS students were compared and a huge disparity was identified. A structured viva voce examination (SVVE) was then proposed and experimented as an objective and standardized alternative. Sets of equitable question cards for SVVE were prepared, each having eight questions with two parts each, arranged successively with increasing difficulty, domains of learning, and appropriate marks. The percentage variation in scoring in viva versus theory marks was calculated for both TVVE and SVVE, and students were grouped as Group I (+100 to +51%); Group II (+50 to −50%); Group III (−51 to −100%); Group IV (−101 to −150%); Group V (−151 to −200%); and Group VI (< −200%) variation, as? inappropriate, appropriate, inappropriate, erroneous, more erroneous and most erroneous respectively. Student’s feedback on the SVVE was also obtained.Results:In TVVE (n = 128), the students distributed were:none,17.2%, 23.4%, 22.7%, 11.7% and 25% in Group I, II, III, IV, V, and VI in contrast to SVVE (n = 107) as 7.5%, 57.9%, 19.6%, 6.5%, 5.6%, and 2.8%, respectively. Marked disparity of TVVE was annulled with SVVE. Student’s feedback was quite encouraging with 83% overall acceptability and almost 66% preferred SVVE.Conclusion:SVVE was more realistic as compared to TVVE. Most of the students favored this approach.

Objective:Medical students as future doctors will play an important role in caring for HIV-infected patients. This study assessed and evaluated the existing level of knowledge of MBBS students about HIV/AIDS given through lecture delivery methods and by use of concept map (CM).Materials and Methods:This study was carried out on 150 professional MBBS students of tertiary care hospital. A pretest was conducted by giving 10 multiple choice questions (MCQ) of general awareness and 15 questions regarding pharmacotherapy of HIV/AIDS. In between pre- and post-test, a session of 1-week integrated teaching module was organized. After completion of integrated teaching, 2 h session of CM on general awareness and pharmacotherapy of HIV/AIDS was taken. A posttest was conducted using MCQs and problem-based question (PBQ) to assess the effect of integrated teaching and CM on their knowledge about HIV/AIDS. Feedback was also taken from the students to regarding their views about CM.Results:There was a significant increase in student’s score in MCQ test after integrated teaching than pretest (P < 0.05). There was also significant improvement in PBQ score after CM than that of after integrated teaching (P < 0.05). Students’ perception about the effectiveness of CM was positive.Conclusion:CM can make a significant improvement in the knowledge of medical students and were motivated and developed interest in the subject.

Background: Antimicrobials are a major class of drugs prescribed in Intensive Care Unit (ICU). Widespread use of empirical antibiotic therapy has facilitated the emergence of drug resistance, since empirical therapy is very often initiated at the outset, even before culture and sensitivity reports are available. The problem of drug resistance is on a rise, therefore, this study was planned to assess the drug resistance and sensitivity patterns of the blood isolates recovered from ICU.Methods: An observational- prospective study was conducted in the Tertiary care teaching hospital over a period of twelve months to assess antibiotic resistance and sensitivity pattern. A total of 104 consecutive patients receiving antibiotics in the ICU and having blood cultures with significant growth were included in the study. Blood sample was collected and after obtaining a culture growth, the identification and antimicrobial sensitivity testing was done.Results: Blood stream infection by Gram-negative bacteria (50.96%) was more common than Gram-positive bacteria (49.04%). Coagulase negative Staphylococci (CoNS) was the predominant single blood culture isolate (35.58%). Klebsiella pneumoniae (13.46%), Escherichia coli (12.50%), Acinetobacter baumannii complex (7.69%) were commonly isolated gram negative organisms. Gram positive isolates were resistant to beta lactams in maximum patients whereas Tigecycline, Linezolid, Daptomycin, Vancomycin, Nitrofurantoin and Teicoplanin were sensitive against them. Common gram negative isolates were sensitive to Colistin and Tigecycline but resistant to most of the antibiotics.Conclusions: A preponderance of gram negative bacteria over gram positive bacteria was noted with a higher degree of resistance to most of the first line antimicrobial agents.

Background: The aim of this study was to know the pattern & rationality of antimicrobial prescription by dental practitioners. Methods: It was questionnaire based cross sectional study. A total of 175 questionnaires were distributed to dental practitioners working in a tertiary care Dental College & Hospital and private practitioners in Jaipur (Rajasthan). The questionnaire contained questions about years of practice, diagnosis for which antimicrobial were prescribed, dosage and duration of antimicrobial drugs for prophylaxis, acute and chronic conditions, patient compliance & adverse effects. Data was expressed as counts and percentages. Results: Out of 175 questionnaires distributed, 150 were included in the study. 78% dentists had practices less than 5 years duration. Most common indications for which antimicrobials were prescribed were abscess, cellulitis, irreversible pulpitis, and acute gingivitis. Most common antimicrobials used for prophylaxis were Amoxycillin and Metronidazole. For the treatment of acute and chronic conditions, Amoxycillin, Metronidazole, Ofloxacin and Ornidazole alone or in combination were used. Only 20% dentist advised culture & sensitivity tests. 74% patients completed the recommended course of antimicrobials. 56% patients reported adverse drug reactions (ADRs) with the most common being nausea and vomiting, but only 13% dentists reported them to proper authorities. Conclusions: In this study, Amoxycillin and Metronidazole were the most common drugs used for the management of oral diseases, but were prescribed without culture & sensitivity in most cases. 56% patients reported ADRs, but only 13% dentists reported them to proper authorities. Appropriate measures need to be taken to promote rational prescribing and ADR reporting. [Int J Basic Clin Pharmacol 2013; 2(3.000): 311-314

Background: Cognitive decline with AEDs (Anti-epileptic drugs) is associated with learning and memory deficits especially in the younger age group. The data regarding the impact of levetiracetam and valproic acid as monotherapy on cognition in epileptic patients is scarce. The present study was done for evaluation of cognitive decline associated with the use of AEDs.Methods: Present study was a prospective study on 60 patients on AEDs for a period of 12 weeks. Patients were enrolled from the Department of Neurology, Swami Rama Himalayan University, Dehradun, Uttarakhand, India and divided into group A (levetiracetam) and group B (valproic acid) with 30 patients in each group. Permission from the institutional ethics committee and written informed consent was taken from all the patients. They were analyzed for cognitive impairment using MMSE and MoCA scales at baseline and 12 weeks.Results: The mean duration of disease was 2.13±1.1 years and 2.08±1.1 years and mean age of the patients was 14.67±1.9 years in group A and 16.20±1.6 years in group B. GTCS was present in 31 patients (52%) followed by partial seizures in 29 patients (48%). The mean change in the MMSE scores from baseline to 12 weeks was significant in group A 1.30±1.1 (p value <0.05) and change group B was -0.20±1.4 not statistically significant. The mean change was observed in MoCA scores from baseline to 12 weeks was significant in both groups A and B by 1.17±1.1 and -0.70±1.1 respectively (P value <0.05).Conclusions: Patients on levetiracetam showed cognitive improvement, whereas patients on valproic acid showed a decline in the MMSE and MoCA scores.