How well do doctors understand a scientific article in English when it is not their first language? A randomised controlled trial

IntroductionEnglish is the lingua franca of science. How well doctors understand English is therefore crucial for their understanding of scientific articles. However, only 5% of the world’s population have English as their first language.MethodsObjectives: To compare doctors’ comprehension of a scientific article when read in their first language (Norwegian) versus their second language (English). Our hypothesis was that doctors reading the article in Norwegian would comprehend the content better than those reading it in English.Design: Parallel group randomised controlled trial. We randomised doctors to read the same clinical review article in either Norwegian or English, before completing a questionnaire about the content of the article.Setting: Conference in primary care medicine in Norway, 2018.Participants: 130 native Norwegian-speaking doctors, 71 women and 59 men. One participant withdrew before responding to the questionnaire and was excluded from the analyses.Interventions: Participants were randomly assigned to read a review article in either Norwegian (n=64) or English (n=66). Reading time was limited to 7 min followed by 7 min to answer a questionnaire.Main outcome measures: Total score on questions related to the article content (potential range −9 to 20).ResultsDoctors who read the article in Norwegian had a mean total score of 10.40 (SD 3.96) compared with 9.08 (SD 3.47) among doctors who read the article in English, giving a mean difference of 1.32 (95% CI 0.03 to 2.62; p=0.046). Age was independently associated with total score, with decreased comprehension with increasing age.ConclusionThe difference in comprehension between the group who read in Norwegian and the group who read in English was statistically significant but modest, suggesting that the language gap in academia is possible to overcome.

Objectively Structured Clinical Teaching (OSCT) in Undergraduate Clinical Teaching: A Pilot Study

In this study, the efficacy of a clinical teaching tool, objectively structured clinical teaching (OSCT) was assessed by comparing students’ performance in assessing standardised patients (SPs) and real patients (RPs). The final-year students were randomly divided into two arms and their performance in three different disciplines such as medicine, obstetrics and gynaecology (O&G) and primary care medicine (PCM) was assessed with RPs in one arm and SPs/simulated patients in the other. The assessments were conducted in history-taking, clinical examination and management stations by the content experts under a structured rubric. Students’ scores in each arm were compared in the respective disciplines and overall. The perceptions of both students and SPs were recorded. The OSCT and rotational average scores of the participant students in SPs and RPs were compared. The students’ mean scores for their rotational exam and OSCT were 65.31 ± 5.56 and 61.14 ± 8.53, respectively. The performance at the management station in O&G was significantly higher compared with medicine and PCM. The overall performance at all other stations in the three disciplines was comparable, with no significant difference. The reliability and content validity of OSCT was established by calculating Cronbach’s alpha and testing content validity. The results indicated that OSCT is an innovative and effective teaching tool that can be used in clinical teaching in the early clinical years to lower the student load in hospitals in a cost-effective manner.

Management of Laryngopharyngeal Reflux: A Practical Algorithm Management for Primary care Physicians

Laryngopharyngeal reflux (LPR) is a prevalent disease in the general population and may have acute or chronic clinical presentation. LPR may be misdiagnosed in primary care medicine regarding the lack of gastroesophageal reflux disease symptoms and the lack of findings at the gastrointestinal endoscopy. Depending on the physician field of expertise and experience, LPR may be clinically over- or under-diagnosed. The management of LPR is possible in primary care medicine but primary care physician has to consider some red flags that requires to address the patient to otolaryngologist or gastroenterologist. The use of patient-reported outcome questionnaire such as reflux symptom score-12 and the consideration of some oral and pharyngeal findings visualized through the mouth opening may help the primary care physician to evaluate the LPR findings at the diagnosis time and throughout treatment. In this review, we provide a practical algorithm of management of LPR for primary care physician or other specialists that cannot perform fiberoptic examination. In this algorithm, physician has to exclude some confounding conditions such as allergy or other causes of pharyngolaryngitis and red flags. Physician may prescribe an empirical treatment based on diet and behavioral changes with or without medication, depending on the complaint severity of the patient. In case of prescription of medication, proton pump inhibitors and alginate have to be considered in association to protect the upper aerodigestive tract mucosa from acid, weakly acid and alkaline pharyngeal reflux events.

Analysis of urine as an indicator of specific body conditions in pregnant women in rural mountainous region

<p class="abstract"><strong>Background:</strong> Urinalysis is a procedure for examining physical properties, particulate matter, cells, casts, crystals, organisms and solutes. Urinalysis is a routine screening and diagnostic tool used to identify infections including renal, urological, liver disease, diabetes mellitus and urinary tract infection (UTI). Urinalysis can be used to screen, glucose, leucocytes, nitrite and blood. Although urinalysis is an effective screening tool it should not be used in isolation to guide treatment because false positives, for example, nitrites, and false negatives, for example, glucose, can occur if the sample is contaminated or left to stand for too long. UTI is among the leading reasons for treatment in adult primary care medicine, accounting for a considerable percentage of antibiotic prescriptions. Aim of this study is to identify the markers of urinary tract infection by urine routine microscopic analysis in pregnant women.</p><p class="abstract"><strong>Methods:</strong> This was a two months prospective study from June 1st 2019 to July 31st 2019. Urine samples of 72 pregnant women coming routinely to OPD of GMC, Doda were examined by physical and biochemical analysis by microscopy methods. </p><p class="abstract"><strong>Results:</strong> Majority of samples were pale yellow with turbid appearance. Protein was present in most of the samples whereas glucose was present in a minor number of samples. Microscopy revealed increase in pus and epithelial cells count in most of the samples while bacteria were present in almost half of the samples.</p><p class="abstract"><strong>Conclusions:</strong> To conclude from the present study that appearance, presence of protein, pus cells, epithelial cell and bacteria, all taken together can serve as a strong indicator of UTI.</p>