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Introduction: Perceptions of teachers and students about curriculum viability inhibitors are equally important yet may differ. Divergence can lead to destructive friction and adversely affect curriculum viability. Objectives: Our team aimed to find the perceptions of teachers and students on inhibitors affecting the viability of an implemented medical curriculum, report their convergence or divergence, and explore approaches to reduce divergence. Material and Methods: This is a mixed-method study. For quantitative data, teachers’ perceptions were collected through validated, targeted questionnaires measuring viability inhibitors. For qualitative data, a focus group discussion (FGD) among teachers explored possible approaches to diverging teachers’ perceptions. Results: The data was collected from 53 faculty members (100%). This study provides an approach to measure curriculum viability inhibitors in an undergraduate Dental curriculum, to find solutions of these inhibitors through focus group discussion. No difference in opinion was found in interdepartmental, designation regarding curriculum viability. Years of Experience in different departments affect the choice of assessment tools on the basis of K.S.A. Practical implication: this study will also helpful in improving the curriculum even when no strong inhibitors are present. Conclusion: We believe this approach might help to improve the curriculum, even when no strong inhibitors are present. The suggestions to deal curriculum inhibitors. Questionnaires measuring curriculum viability inhibitors can be used stand-alone or as part of the curriculum evaluation process. Keywords: Mixed method design; teacher perceptions; curriculum viability; curriculum inhibitors.

The second wave of COVID-19 pandemic has started globally, right now 220 countries are infected and a total of 71,351,695 confirmed cases and 1,612,372 deaths due to COVID-19 have been reported. Infection Prevention and Control (IPC) measures for COVID-19 all have proved vital in decreasing the transmission rates among the communities. Methodology: Unmatched Case-Control Study was conducted where cases were defined as “every PCR positive contact (symptomatic or asymptomatic) for any index case” similarly controls were defined as “every PCR negative contact (symptomatic or asymptomatic) for any index case who was home quarantined for 14 days based on suspicion by PDSRU team”. A simple random technique was used and 300 individuals were made part of this study. Results: The major findings of this study shows that PCR positive contacts poorly adopted certain COVID-19 IPC measures of interest in their daily life hence got infected. The odds for all the variables of interest were found to be statistically significant among cases as compared to controls like the odds for knowingly and intentionally contacted with a COVID-19 positive case was 13.7 times more among the PCR positive contacts as compare to PCR negative contacts (p = 0.00, C.I = 7.62 - 24.90), similarly, the odds of being a family member of the index COVID-19 case was 7.07 times more among the PCR positive contacts as compared to the PCR negative contacts (p = 0.00, C.I = 3.25 - 15.86). Conclusion: Before the development and availability of a vaccine, the only tools that can help prevent the spread of COVID-19 are IPC measures.

Background: COVID-19 Pandemic is still circulating within the human population and proving to be a deadlier disease with a mortality rate ranging from 0.5% to 7%. Since COVID-19 is a highly transmissible disease; there is always a probability for its outward spread towards the general public and community from the hospitals and healthcare facilities where they come to seek treatment. Methodology: A prospective cohort study design was used, considering the limited available resources and time—a total of 200 healthcare workers (including doctors, nurses, para-medical staff, janitorial staff, reception staff & pharmacists) working in the OPDs of the two major public sector hospitals of Quetta were made part of this study. The study participants were selected using a simple random sampling technique and selection was made from the daily attendance register. The study participants from “Hospital-A” were first of all educated and trained on various COVID-19 IPC measures later on various COVID-19-IEC materials; written in simple Urdu language, were displayed clearly everywhere in the OPD. Similarly, handwashing stations along with hand sanitizers/soaps and surgical face masks were also made available free of cost for all the study participants of Hospital-A. Moreover the importance and effectiveness of COVID-19 IPC measures were continuously announced in the OPD gallery of Hospital-A, these announcements used simple wording in local languages (i.e., Urdu, Pashto, Balochi and Brahvi). On the other hand, in the OPD of “Hospital-B”, no such interventions were made. The study participants of both the hospitals were followed for one month and observations like which group showed more on-job noncompliance towards various COVID-19 IPC measures were recorded. The data was recorded on daily basis (from 1st May-to-31st May 2021) after observing the study participants for compliance towards using face masks, face shields, personal protective gowns, gloves, hand sanitizers, maintaining 6 feet social distancing and implanting triage at his or her OPD counter. Any study participant with daily proper practice of at least face masks, gloves, hand sanitizer and maintaining a 6 feet social distancing SOPs during duty hours at the outdoor patients department was considered to be a compliant individual if even one of these minimum required SOPs has not practiced the study participant, he/she was classified as non-compliant individual. A checklist was used to record these findings for every study participant on daily basis by trained data collectors. Lastly, all the data was analyzed using Microsoft Excel 2007 version. Results: The major findings of this study are almost in line with the set objectives, the study results are clearly showing the Risk Ratio (RR) as 0.27, indicating that the intervention group participants were only 27% as likely to develop on-job non-compliance for various COVID-19 IPC measures compare to the non-intervention group. Discussion & Conclusion: It is highly recommended that various COVID-19 specific infection prevention and control interventions like COVID-19 IPC trainings, COVID-19 IEC and BCC materials be displayed clearly everywhere in the healthcare facilities especially in the OPD department. Moreover, audio announcements made in simple wording using local languages like Urdu, Pashto, Balochi and Brahvi could really serve as constant reminder tools especially in an OPD department where every next patient in the queue could present with a different infectious bug.

Introduction Olonic self-expanding metal stents (SEMS) are recommended in the management of malignant strictures, with obstruction. ublished studies have low caseloads and may not reflect real world practice. Methods All cases coded with endoscopic or image guided insertion of stent or tubal prosthesis (codes H214, H243, H244, H273, H274, H314) were reviewed to identify colonic SEMS cases. Electronic notes, endoscopy and radiology reports were reviewed. Data on, site of SEMS, indication, insertion method immediate late complications30-daymortality were noted. Results Episodes were coded of which 101 colonic stent insertions. SEMS insertions included local and tertiary referrals, either planned or in an emergency setting. Of the 101 cases, 58.4% of patients were male (n=59), with a median age of 75 years (range 28–95 years). The majority of SEMS (91.1%, n=92) were inserted endoscopically with fluoroscopy, with the remaining nine cases being inserted radiologically, by multiple operators. Indications for insertion included palliative (n=72) or curative (n=21) malignancy (defined by treatment intention on MDT outcome), with 4 cases being for benign disease. Most patients (79.2%) requiring SEMS had obstructive symptoms. complications included cases of perforation (%)of unknown cause. One case had an 8 day unplanned readmission. cases of stent migration (%) cases of stent occlusion secondary to tumour in-growth (%) cases (3.96%) of delayed perforation (which were felt to be tumour related). All cause 30 day mortality rate was 14.9% (n=15), with only 7 cases (6.93%) relating to stent failure or complication. Conclusions This large real-world data review highlights complication rates of SEMS in a heterogeneous population with multiple operators over 7 years of both emergency and planned procedures for malignant colonic strictures. Colonic SEMS is aand relatively safe therapeutic option for thepalliative management of colonic malignancy with obstruction

To improve patients’ acceptance of their kidney failure diagnosis and to empower them regarding their dialysis treatment choices. In partnership with patients and clinical staff (a consultant and two–three senior nurses were involved), they worked collaboratively to facilitate acceptance and decision making. The project had a four-pronged approach