Background: Our aim was to explore how specialty preferences of medical students at various stages of their undergraduate training period match with their final choice for postgraduation. Methods: One batch of medical students was followed from the 1st year until they joined postgraduate degree. We collected data on demographic information, their first, second, third preferences for a specialty and three least likely preferences at each phase of the undergraduate course using our previously published questionnaire. Results: Out of the 100 eligible students in the batch, 18 refused to participate or withdrew from the study. Complete data on specialty preferences were available for 60 participants. A total of 37 students from the batch joined our institution for postgraduation in various specialties, of which we had data of 36 students of their specialty preferences in their initial years of undergraduate training. We found that half (18 out of 36) of these students chose their specialty for postgraduation which was indicated as their first, second, or third preferences on at least one of the three time points. While 14 students chose a specialty that did not feature in either their most or least likely preferences in any of the time points, for 4 students, the final choice for the postgraduate degree featured in their list of least likely preferences on at least one occasion. Conclusion: We found that the final choice for their postgraduation correlated with their preference in the first 3 years of their undergraduate training course in half of the students.
Artificial intelligence (AI) has made inroads into different fields. Health educators and students also need to adapt to the AI boom. This review discusses the AI-related terminologies that are relevant to the stakeholders of health education, using AI tools for performing a search, designing different types of teaching/learning aids, designing different types of assessments, performing a critical review of a manuscript, and preparing a protocol/manuscript. This review also highlights the challenges and limitations of using AI and methods to overcome them.
Background: Hyponatremia in tuberculous meningitis (TBM) is a commonly observed dyselectrolytemia with morbid outcomes if not addressed promptly. Hyponatremia independently contributes to poorer outcomes in hospitalized patients. Several authors reported the occurrence of hyponatremia among TBM patients in a frequency ranging from 35% to 71%. Due to meagre research on the condition, its frequency, the effect of its severity, and outcome, this study was conducted to determine the effect of the severity of hyponatremia in TBM. Aim: To determine the effect of the severity of hyponatremia and inhospital outcome in patients with TBM. Materials and Methods: It is a hospital-based, descriptive, observational, cross-sectional study conducted on 55 patients of >14 years of age diagnosed with TBM with hyponatremia. Hyponatremia was classified as severe, moderate, and mild, respectively. The severity of TBM was categorized using the Medical Research Council (MRC) grading. Disability was assessed with the help of the modified Rankin score (mRS). Death in the hospital and its possible causes were noted. Duration of Study: This study had been conducted over a period of 2 years, from August 2022 to July 2024. Results: Of the 55 patients, 34 individuals (61.8%) had definitive TBM, 17 patients (30.9%) had probable TBM, and four patients (7.3%) had possible TBM. Cerebral salt wasting (CSW) was the most common cause of hyponatremia observed in 25 patients (45.5%), followed by syndrome of inappropriate antidiuretic hormone secretion (SIADH) seen in 15 patients (27.3%). Mild hyponatremia was identified in 16 individuals or 29.1% of the total. Moderate hyponatremia was detected in 23 individuals, accounting for 41.8% of the total. Severe hyponatremia was found in 16 individuals, or 29.1% of the total. Forty-one patients presented in MRC Grade III severity, representing 74.5% of all cases. Mortality in our study was 29%. The mean serum sodium of expired patients was 116.25 ± 5.6 mmol/L. The severity of hyponatremia is strongly associated with mortality and poorer outcomes. Higher mRS scores at discharge correlate with the severity of TBM. Conclusion: Hyponatremia can be considered a poor prognostic factor for mortality in TBM. The severity of hyponatremia is related to poorer outcomes.
Evidence-based medicine (EBM) is foundational to modern clinical training, yet traditional EBM education often privileges published research and clinician expertise while underemphasizing patient and community knowledge. Calls to strengthen person-centered care, disability justice, and equity-oriented practice have increased interest in integrating lived experience into EBM teaching to shape how learners understand evidence, uncertainty, and decision-making. This scoping review aimed to map the literature on including lived experience in EBM education for medical learners, with attention to pedagogical approaches, learning outcomes, implementation considerations, and evidence gaps. Following the preferred reporting items for systematic reviews and meta-analyses extension for scoping reviews framework, we systematically searched MEDLINE, Embase, CINAHL, PsycINFO, and Scopus from inception to July 2025. Eligible studies described EBM teaching interventions or curricula that incorporated lived-experience partners in design, delivery, assessment, or learning activities. Twenty-six studies were included. Four themes emerged: (1) redefining “evidence” through epistemic plurality (integrating experiential knowledge alongside research and clinical expertise); (2) improving relevance, humility, and shared decision-making skills (linking appraisal to values, context, and real-world trade-offs); (3) power, tokenism, and ethical partnership (compensation, emotional labor, representation, and safeguarding); and (4) measurement limits and uneven integration across EBM competencies (stronger emphasis on attitudes and communication than on rigorous appraisal outcomes). Including lived experience in EBM education is a promising approach to strengthen relevance, equity, and shared decision-making by broadening what counts as evidence and how evidence is applied. However, the literature is constrained by variable definitions, tokenistic risks, and limited evaluation using validated EBM competence measures.
Objectives: Large vessel occlusion (LVO) stroke is typically more severe and associated with less favorable outcomes. But LVOs also provide an opportunity for neurovascular intervention in the form of endovascular therapy (EVT) within golden hours. This study is aimed to identify the time gap as well as treatment gap in LVO stroke at the primary care level, along with its risk factors and clinical features. Methodology: This prospective observational study included data from 104 patients with LVO stroke on Day 0, 7, or at the time of discharge and at 3 months over a period of 18 months. Glasgow Coma Scale, National Institute of Health Stroke scale (NIHSS), Modified Rankin Scale (MRS) and Barthel index were used for patient monitoring. SPSS version 27 was used for data analysis. Results: Majority of the cohort belonged to be middle-aged with a male preponderance. Hypertension (69.23%), diabetes (43.27%), addiction (54.82%), and anterior circulation LVO (81.7%) with aphasia (18.27%) were prevalent. About 55.8% of LVO patients attended primary care level after 4.5 h of their symptoms (mean time of 6.86 h). 64.4% of the study population was diagnosed as LVO more than 24 h later. NIHSS score at Day 0, with positive correlation with computed tomography collateral score and outcome (MRS score at day 7 and 90), was a significant observation. Conclusion: NIHSS score (Day 0), MRS during discharge, duration, and complications of hospital stay significantly affected long-term outcome. Significant correlation was found between socioeconomic status and education of the patients with time to identification of LVO.
