Objective: To evaluate the preliminary surgical results of Endoscopic Type I Tympanoplasty among patients with inactive chronic otitis media without ossicular pathology. Methods: Design: Prospective Series. Setting: Tertiary Government Hospital. Participants: Seventy patients with inactive mucosal chronic otitis media (COM) with air bone gap (ABG) of ≤ 40 dB on the preoperative audiogram scheduled to undergo Type I Tympanoplasty between July 2018 and December 2020 were enrolled. Results: Seventy-three (73) ears were evaluated. The overall rate of graft uptake was 95.9% at 12 weeks. There was a statistically significant (p<.001) improvement in hearing on comparison of pre-operative (25.74 ± 7.34 dB) and post-operative (14.82 ± 6.55 dB) air bone gap. The duration of surgery was less than one hour in 76.7% and 77.2 % patients experienced only mild post[1]operative pain. Conclusion Endoscopic tympanoplasty can provide good results with respect to graft uptake and hearing gain with short surgical duration and minimum postoperative morbidity. Longer follow up of at least 6 months (for graft uptake) and preferably not less than 12 months (for hearing results) may confirm our preliminary findings.
Pain, Postoperative ; Tympanic Membrane Perforation ; Hearing ; Morbidity

Introduction: Simulation of the clinical setting incorporates an educational approach connecting a learner to a particular environment of learning. Undergraduate students in the health sector experience anxiety during simulation that influences their performance which ultimately affects their learning outcome. This study attempts to correlate the impact of stressors on learning outcome of high-fidelity patient simulation (HFPS) in undergraduate medical education. Objective: This research is to analyze the impact of stressors and its relevance on the learning outcome of HFPS as a teaching-learning tool for the management of emergency surgical conditions including trauma. Materials and Methods: This study is a Quasi-experimental time series design. A total number of 347 final-year undergraduate (MBBS) students of Melaka-Manipal Medical College, Malaysia. They were grouped and assessed individually by pre-test and post-tests on their knowledge, performance and associated stressor scores. The one-way repeated measure of Analysis of Variance (ANOVA) was used to determine the statistically significant differences in total score at pre-test simulation and post-test-simulation sessions. Friedman test was used for assessment of individual components of stressors. Pre-test and post-tests scores were compared to note progress in confidence and stress reduction. P value <0.001 was considered statistically significant. Results: ANOVA with Bonferroni post hoc analysis showed a statistically significant (p <0.001) difference in stressor score over time. The drop-in stress was significant initially but flattened out later. Conclusion: Stress significantly decreased as the students were exposed to more sessions of HFPS which ultimately translated into better learning outcome.

Introduction: Medical simulation is a technique that allows interactive and immersive activity by recreating all or part of a clinical experience without exposing the patients to the antecedent risks. High-fidelity patient simulation-based teaching is an innovative and efficient method to address increasing student enrolment, faculty shortages and restricted clinical sites. Objectives: To assess the effectiveness of high-fidelity patient simulation (HFPS) as compared to video-assisted lecture-based teaching method (VALB) among undergraduate medical students. Methods: he study was a Randomized Controlled Trial which involved 56 final year undergraduate medical students. The effectiveness of teaching based on HFPS (intervention group) and VALB (control group), on acquisition of knowledge, was assessed by multiple choice questions (MCQs) in the first and fourth week. Similarly, the skills competency was assessed by objective structured clinical examination (OSCE) in the second and fourth week. Mean and standard deviation (SD) for total score of knowledge and skills assessments were used as outcome measures. P value < 0.05 was considered to be statistically significant. Results: In both groups, students had significant higher mean MCQ scores at Post-tests. The intervention group had higher mean change score of MCQ marks than the control group but the difference was not statistically significant. In both the first and second skills assessments, mean OSCE scores for intervention group were higher than control group but this difference was not statistically significant. Conclusion There was significant gain in knowledge in both methods of teaching but did not reach statistical difference in terms of skills enhancement in the intervention group as compared to the control group.
Education, Medical, Undergraduate