The Dundee Ready Education Environment Measure: A prospective comparative study of undergraduate medical students' and interns' perceptions in Oman.

OBJECTIVES: This study aimed to assess perceptions of the educational environment in Oman among medical undergraduate students and interns using the Dundee Ready Education Environment Measure (DREEM) tool. METHODS: This cross-sectional study was conducted between October 2016 and April 2017 at the Oman Medical College (OMC), Sohar, Oman. A total of 737 medical undergraduate students and interns from the OMC and College of Medicine & Health Sciences of Sultan Qaboos University in Muscat, Oman, were invited to complete the DREEM questionnaire in the form of an online survey. Mean overall scores, subscale scores and individual item scores were subsequently compared between undergraduate students and interns. RESULTS: A total of 418 undergraduate students and interns completed the survey (response rate: 56.7%). The mean overall DREEM score was 130.75 ± 12.69. While interns had higher mean DREEM scores than undergraduate students, this difference was not significant (133.00 ± 17.64 versus 128.50 ± 15.53; P = 0.326). The mean score percentages for the perceptions of learning (66.7% versus 58.3%; P = 0.028) and perceptions of teachers (75% versus 68.2%; P = 0.038) subscales were significantly higher among OMC interns compared to undergraduate students from the same college. The perceptions of the environment subscale received the lowest mean score percentages among undergraduate students and interns from both colleges. CONCLUSION: Overall, medical undergraduate students and interns viewed the educational environment in Oman in a positive light. It is possible that undergraduate students' perceptions of the educational environment may become more favourable as they progress with their medical career and become interns.

A retrospective analysis of early experience with modified complete primary repair of exstrophy bladder (CPRE) in neonates and children.

OBJECTIVE: To study the problems faced during the surgery and follow-up of modified complete primary repair of exstrophy (CPRE) technique. Initial experience with CPRE and its short- and long-term outcomes with respect to continence status and psychosocial impact are reported. MATERIALS AND METHODS: A retrospective review of the hospital case records from March 2008 to September 2012 was performed. Data of patients with bladder exstrophy managed by a single paediatric surgeon using modified CPRE technique were analysed. Quality of life and psychosocial impact of the surgery were assessed using Pediatric Quality of Life Inventory (PedsQL 4.0) and compared with those of typical peers. RESULTS: Eight children (age 4 days-12 years) underwent CPRE using modified Mitchell's technique. Two patients (25%) experienced early postoperative complications, with infection and fistula developing in one each. All the patients were doing well on follow-up, with variable continence rates and good cosmesis. Mean duration of follow-up was 18.5 months (range 6 months-4 years). Five out of seven (71%) children were continent or partially continent. One case was lost to follow-up. PedsQL scores were comparable with those of age-matched peers in all domains except the social functioning domain in 8-12 years age group (83.53 ± 9.70 vs. 77.86 ± 10.22, P < 0.05). CONCLUSION: Our preliminary results with modified CPRE in neonates and children have been encouraging. No major complications were observed. Continence rate was satisfactory and cosmetic results were good. Though the technique is being practiced at several Indian centres, there is a paucity of comprehensive Indian data on CPRE.

Clinico-investigative profile of infantile and late-infantile neuronal ceroid lipofuscinoses.

Neuronal ceroid lipofuscinosis is a group of progressive neurodegenerative disorders characterized by accumulation of ceroid lipopigment in lysosomes in neurons and other cell types. This study is a retrospective review of charts of patients with a diagnosis of infantile and late-infantile neuronal ceroid lipofuscinosis seen between January 2009 and December 2011. Of the 16 patients, 5 had infantile type and 11 had late-infantile neuronal ceroid lipofuscinosis. Diagnosis was confirmed by appropriate enzyme assay. Clinical presentation was quite varied. Common presenting features included refractory seizures, developmental delay/regression, and abnormal movements. Visual failure was not common in the present case series, and novel neuroimaging finding in the form of isolated dentate nucleus hyperintensities were noted. During follow-up, all patients had a progressive downhill course and one patient died. Prenatal diagnosis could be offered to one family. This study suggests that infantile and late-infantile neuronal ceroid lipofuscinosis is not uncommon in this region of the country and the phenotype may be different.