Irritable bowel syndrome and gut microbiota.

PURPOSE OF REVIEW: To provide an overview of recent studies exploring the gut microbiota in pathogenesis and treatment of irritable bowel syndrome (IBS). RECENT FINDINGS: Primary bacterial gut disturbances have been linked to the development and severity of IBS. Dysbiosis, or alteration in the normal intestinal flora, modulates intestinal permeability, inflammation, gut motility and likely quality of life. These biomechanical changes are associated with enteric and central nervous system processing as well. When compared to healthy controls, IBS patients display poor quality of life measures and are at increased risk of depression and anxiety. The severity of psychological and gastrointestinal symptoms in IBS has been linked with a distinct intestinal microbiota signature. Efforts to modulate intestinal dysbiosis in IBS have shown little improvement in large systematic reviews. The low FODMAP diet reduces bacteria, such as Bifidobacterum and Actinobacteria. Although rifaximin improves symptoms, it may only stimulate a transient effect on the gut microbiota. Fecal microbiota transplant does not provide prolonged symptom relief in IBS. SUMMARY: This review elucidates recent advances in IBS and the gut microbiota. Microbiota changes are one underlying factor in perpetuating global IBS symptoms. The opportunity to exploit this disturbance through treatment modalities requires further investigation.

Knowledge, attitude, and practice of water-pipe smoking among medical students in Rawalpindi, Pakistan.

OBJECTIVES: To assess knowledge, attitude and practice of water-pipe smoking among medical students. METHODS: The cross-sectional study using self-administered questionnaire was conducted at Rawalpindi Medical College, Rawalpindi, in 2011, and included all five batches of medical students. SPSS 17 was used for statistical analysis of the data. RESULTS: The final sample comprised 724 participants; 505 (69.7%) being female and 219 (30.2%) being male students. Besides, 625 (86.6%) participants knew about shisha smoking, and 140 (22.4%) reported to have smoked shisha. Curiosity (n = 44; 31.4%) and social trends (n = 41; 29.2%) were cited as main reasons for shisha smoking. Overall, 572 (91.5%) participants thought shisha was dangerous for health, with majority 261 (41.8%) believing it to be more dangerous than cigarettes. CONCLUSIONS: There was awareness among medical students about the hazards of shisha smokng. Even then water-pipe smoking was relatively common among them.

Self-directed learning and research attitudes among medical students.

OBJECTIVE: To describe the correlation between Self-directed Learning (SDL) and medical students' attitude towards research, based on the premise that self-directed learners are independent, motivated, and curious learners. STUDY DESIGN: Observational cross-sectional study. PLACE AND DURATION OF STUDY: Rawalpindi Medical College, Rawalpindi, from August 2011 to January 2012. METHODOLOGY: One hundred and ninety-four students of final (5th) year class at Rawalpindi Medical College, Rawalpindi participated in this cross-sectional study. SDL ability of students was measured using Oddi's Continuing Learning Inventory (OCLI) whereas Attitude Towards Research (ATR) scale was used to measure their research attitudes. Spearman's rank-order analysis was performed to measure correlation between SDL scores on OCLI and all the 18 items on ATR scale. RESULTS: Statistically significant relationships with correlation coefficients ranging from +0.12 to +0.32 were found for the correlation between scores on the OCLI and eleven statements highlighting research use and positive attributes of research (14 items). Those students who participated in extra-curricular research projects (n=58, 29.9%) had relatively higher scores on OCLI as compared to those who did not participate (n=136, 70.1%, p=0.041). CONCLUSION: Self-directed learners show a positive attitude towards research, though the relationship is not strong.