Browsing by Author "Prabhu, Shakuntala"
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Item The Effect of Multi-source Feedback on Core Competencies of Pediatric Residents(Indian Academy of Pediatrics, 2022-02) Kulkarni, Shilpa; Prabhu, Shakuntala; Lakhan, TejalObjective: The study was conducted to evaluate impact of multisource feedback in pediatric residency training. Methods: A crossover study of pediatric residents at Wadia Children’s Hospital was conducted with assessment of core competencies like knowledge, practice-based learning, system-based practice, professionalism, communication skills and interpersonal interaction. After randomization both groups (A and B) were given MSF and traditional feedback, respectively and later the groups were crossed over to other method of feedback. Control faculty assessed both groups at three points – Pre-intervention, after first and after second intervention. Results: There were 16 residents in each group (13,7,7 in first, second and third year of residency, respectively). Both groups had comparable scores in all six competencies at entry point. Group A after MSF showed significant improvement in all six competencies (all P<0.01). No significant improvement was observed in group B after traditional feedback. After cross-over to MSF, group B showed statistically significant improvement in all core competencies. Traditional feedback to group A after crossover showed statistically significant improvement only in knowledge, professionalism and system based practice. Outcome: MSF was beneficial in improving competency based performance scores in pediatric residents.Item Syncope in children clinicoetiological correlation(Medip Academy, 2019-11) Fadnis, Madhura; Prabhu, Shakuntala; Venkatesh, Sumitra; Kulkarni, ShilpaBackground: Syncope is the abrupt cessation of cerebral blood flow leading to temporary loss of consciousness. Identification of etiology is utmost important as any syncopal event may be life threatening. Aim was to correlate the clinical and etiological causes of syncope in children and to note their investigational profile.Methods: Among 40 patients presenting with syncope and presyncope were studied. History of the event, precipitating factors were noted. They were investigated with the help of blood pressure, Electrocardiogram (ECG), 2D Echocardiogram and Electroencephalogram (EEG).Results: Out of the 40 patients of syncope 65% were above the age of 10 years with male preponderance (60%). Vasovagal syncope (57%) was the most common cause of syncope followed by orthostatic hypotension (15%), neurological (15%), and cardiac etiology (6%). In the neurological etiology the EEG showed diffuse slow background with occasional sharp bursts in right frontal area in 2 patients while in 4 patients sharp bursts were present in the centero-temporal region. 17% were classified as presyncope, 60% as mild and 22% as having severe syncope. There was a significant correlation of etiology of syncope with duration of hospitalization of more than 4 days and with recurrence of syncope. There was significant correlation of Evaluation of Guidelines in Syncope (EGSYS) score >3 with cardiogenic syncope. On follow up, neurological syncope patients had significant decrease in the number of syncopal episodes as they were immediately started on antiepileptics.Conclusions: Electrocardiogram, 2D Echocardiogram and Electroencephalogram are important tools for the early management and treatment of cardiac and neurological etiology of syncope.