The trainee year--a critical appraisal.

Answers to questionnaires distributed to all trainees in the Scottish south-east region in 1972 and 1973 showed a wide variation between the standard of teaching in individual practices. This was partly due to a failure of the organizing bodies to give proper guidance on the modern concepts of training to the trainers, and partly to a lack of enthusaism by some of the trainers. It is particularly important that the training practices are well equipped with equipment and books and journals relating to general practice. For the trainee vocational training programmes, attendance at day release courses, contact with fellow trainees, and appropriate "on call" duties are similarly important. If these and other recommendations were brought to the attention of the trainers by an effective, co-ordinating committee, the standards of general practice teaching would rise, as would the quality of patient care in the community.     

Medical professionalism videos on YouTube: Content exploration and appraisal of user engagement

BackgroundSocial media has become the fastest growing platform for sharing and retrieving information and knowledge, and YouTube is one of the most popular and growing sources of health and educational information video-sharing website. But, videos on this open platform are not peer-assessed, therefore, the accessible data should be adequately assessed. Till date, no exploration and analysis for assessing the credibility and usefulness of Medical professionalism videos available on YouTube are conducted.ObjectiveTo analyze the video sources, contents and quality of YouTube videos about the topic of medical professionalism.MethodsA systematic search was accomplished on YouTube videos during the period between March 1, 2020 and March 27, 2020. The phrases as significant words used throughout YouTube web search were ‘Professionalism in Medical Education’, Professionalism in medicine’, ‘Professionalism of medical students’, ‘Professionalism in healthcare’. ‘Teaching professionalism’, ‘Attributes of professionalism’. The basic information collected for each video included author’s/publisher’s name, total number of watchers, likes, dislikes and positive and undesirable remarks. The videos were categorized into educationally useful and useless established on the content, correctness of the knowledge and the advices. Different variables were measured and correlated for the data analysis.YouTube website was searched the using keywords ‘Professionalism in Medical Education’, Professionalism in medicine’, ‘Professionalism of medical students’, ‘Professionalism in healthcare’. ‘Teaching professionalism’, and ‘Attributes of professionalism’.ResultsAfter 2 rounds of screening by the subject experts and critical analysis of all the 137 YouTube videos, only 41 (29.92%) were identified as pertinent to the subject matter, i.e., educational type. After on expert viewing these 41 videos established upon our pre-set inclusion/exclusion criteria, only 17 (41.46%) videos were found to be academically valuable in nature.ConclusionMedical professionalism multimedia videos uploaded by the healthcare specialists or organizations on YouTube provided reliable information for medical students, healthcare workers and other professional. We conclude that YouTube is a leading and free online source of videos meant for students or other healthcare workers yet the viewers need to be aware of the source prior to using it for training learning.     

Indomethacin--aspirin interaction: a clinical appraisal.

Plasma profiles of indomethacin after a 50-mg oral dose were constructed in six healthy volunteers before and after a week of aspirin treatment. Aspirin did not interfere with indomethacin plasma levels. To examine the clinical effect of concurrent indomethacin and aspirin treatment 20 patients with seropositive rheumatoid arthritis were given indomethacin 100 mg/day, aspirin soluble 4 g/day, and the two drugs taken together in random order. Analysis of the clinical indices of inflammation--articular index and mean pain score--and of the efficacy of each treatment showed no significant differences between the three treatment groups. With the proliferation in the number of anti-rheumatic drugs available, the case for giving two or more nonsteroidal anti-inflammatory drugs concurrently remains unproved.     

Oxidants and antioxidants in atherogenesis. An appraisal

Oxidized low density lipoprotein (Ox-LDL) has a plethora of components that are not present in native LDL. Their presence and quantity depends on the nature, type, and extent of oxidation. Lipids esterified to oxidized fatty acids are the major components formed during the early phase of oxidation and these show a number of proatherogenic properties in in vitro cell culture systems. Recently, evidence has been forthcoming to suggest that some of these oxidized lipids also could elicit "antioxidant;-antiatherogenic" responses from cells. Moreover, some of the cellular effects of Ox-LDL that were previously interpreted as atherogenic could also be reinterpreted to suggest an antiatherogenic cellular response. In addition to the above, the antioxidants that are carried in lipoproteins could have anomalous behavior attributable to their metabolism, ability to be internalized by arterial cells, and the presence of oxidative systems that could render them prooxidants. In conclusion, there are numerous contributing factors that need to be studied and understood before antioxidant therapy becomes an option for the treatment for cardiovascular diseases.     

Oxidative and reductive cleavage of folates--a critical appraisal.

A critical analysis has been made of the oxidative and reductive techniques employedfor cleavage of the C⁹-N¹⁰ bond of folic acid and its derivaatives. The assumption has previously been made that these cleavage reactions reduce folates to a common family of p-aminobenzoylglutamate derivatives varying only in the lengths of γ-polyglutamyl peptide side chains which are readily subjected to quantitative and qualitative analysis. This assumption is incorrect. Oxidation by potassium permanganate effectively cleaved folic acid, dihydrofolic acid, tetrahydrofolic acid, and 5-formyltetrahydrofolic acid to yield p-aminobenzoylglutamate. 5-Methyltetrahydrofolic acid was merely oxidized to 5-methyldihydrofolic acid while 5,10-methenyltetrahydrofolic acid and 10-formyltetrahydrofolic acid were oxidized to 10-formylfolate which was stable to further attack. Of all the folate derivatives tested only folic acid and dihydrofolic acid were cleaved to p-aminobenzoylglutamate by the zinc-hydrochloric acid reduction method. Both tetrahydrofolic acid and 5-methyltetrahydrofolic acid were stable under fully reducing conditions. 5,10-Methenyl-,10-formyl-, and 5-formyltetrahydrofolic acid yielded N-methyl-p-aminobenzoylglutamate. It is evident, therefore, that not only is the dominant mammalian tissue folate derivative, 5-methyltetrahydrofolate, resistant to cleavage by either method, but that a common family of p-aminobenzoylglutamate derivatives is not the end product of those folate compounds that are susceptible. While this may not invalidate the reports of the relative polyglutamate chain lengths of tissue folates such data should be regarded with some caution.     

Critical appraisal of domiciliary obstetric and neonatal practice.

Obstetric and neonatal data on 155 domiciliary deliveries were analysed. The findings illustrated the problems in adhering to generally recognised risk criteria for selecting cases for domiciliary confinement and the unpredictability of events in the newborn period. Awareness of the risks of home confinement have led to increased efforts to achieve 100% hospital delivery. At the West Middlesex Hospital, to make hospital confinement more acceptable to mothers, we have tried to alter inflexible hospital routines and to make previously austere labour wards less impersonal. The same midwife who has supervised the antenatal period brings the mother into the unit, and transfers her home as soon as possible afterwards..