Effectiveness and perceptions of MBBS students about process-oriented guided inquiry learning in biochemistry.

Background: On reviewing our teaching methods through students' feedback, we realized they were dissatisfied with the present teaching methodology of lectures in terms of knowledge retention and problem-solving. This issue was addressed using student-centred and cooperative learning methodology, i.e. process-oriented guided inquiry learning (POGIL) where pre-designed questions guide students to enquire concepts, with reflection writing exercise helping students to strengthen their concepts. This study analysed the effectiveness and perceptions of POGIL sessions conducted after lectures. Methods: The study was approved by the institutional ethical committee. A total of 42 (7 groups; each group with 6 members of high, low and average achievers) consented and POGIL-sensitized MBBS phase I students were part of the study. One-hour POGIL sessions were conducted a week after lecturing with reading material. Pre-, post- and retention test multiple-choice questions (MCQs) were administered for assessment of effectiveness and a close-ended questionnaire for recording perception. Results: Post-test and retention test MCQ scores were statistically higher than pre-test scores both in all participants and low achievers (p<0.05). Around 60% of the students felt that the POGIL activities and working in teams helped them to understand concepts. Reflection analysis revealed the best and least understood concept and students came up with memory aids to remember complex metabolic regulation. Conclusion: POGIL might be a promising reinforcement strategy to lectures in biochemistry and preferred tool to address the issue of low achievers in the class.

Fructose-1,6-diphosphatase deficiency: a treatable neurometabolic disorder.

Fructose-1,6-diphosphatase (FDPase) deficiency is usually considered an inborn error of fructose metabolism, however, strictly speaking it is a defect of gluconeogenesis. The disorder is manifested by the appearance of hypoglycaemia, ketosis and lactic acidosis (neonatally or later during fasting or induced by fructose) and may also be life-threatening. FDPase deficiency can be suspected using simple bedside tests such as glucometer random blood sugar, Benedict's test, Rothera's test and Seliwanoff's test. We report our experience with two cases of FDPase deficiency and review the relevant literature. We also describe the fructosuria in these cases during the crises period, which has not been stressed in the literature.

Parotid fistula secondary to suppurative parotitis in a 13-year-old girl: a case report.

INTRODUCTION: The most common cause of parotid fistula is trauma, followed by malignancy, operative complications (parotidectomy or rhytidectomy) and infection. Acute suppurative parotitis can rarely produce parotid fistula. There are various treatment options available, however it is necessary to standardize the treatment according to the duration of history and the patient's general condition. CASE REPORT: A 13-year-old Indo-Caucasian girl presented to us with a two-year history of clear watery discharge from a wound just above and behind the angle of her right jaw. A diagnosis of salivary (parotid) fistula was made based on clinical examination and investigations. The parotid fistula was successfully managed. CONCLUSION: Parotid fistula secondary to suppurative parotitis is rare and difficult to manage successfully. Meticulous dissection, complete excision of the fistulous tract with closure of the parotid fascia and layered closure of the incision followed by application of a post-operative pressure bandage, anticholinergic agents and antibiotics contribute significantly to the successful management of this difficult clinical condition.