Making difficult decisions with older patients on medical wards.

Decision making with older people can be difficult because of medical complexity, uncertainty (about prognosis, treatment effectiveness and priorities), difficulties brought by cognitive and communication impairment and the multiple family and other stakeholders who may need to be involved. The usual approach, based on balancing benefits and burdens of a treatment, and then deciding on the basis of autonomy (or best interests for someone lacking mental capacity), within the constraints of resources and equity, remains valid, but is often inadequate. In addition, approaches relying on optimal communication and relationship building and professional virtues are important.

Faculty awareness and interest about bioethics in a private medical college of Islamabad, Pakistan.

This study sought to evaluate the awareness of bioethics among faculty at Shifa College of Medicine, Islamabad, Pakistan, and to assess their interest in becoming part of a bioethics discussion group and enhancing their knowledge of this subject. 122 faculty members from the medical college, hospital and school of nursing filled out a questionnaire on ethics. 53% were aware of bioethics as a specialty.

Revising an objective structured clinical examination in a resource-limited Pakistani Medical School.

Introduction: The objective structured clinical examination (OSCE) has not been used extensively in undergraduate medical education in resource-constrained locations, including Pakistan. The Shifa College of Medicine (SCM) in Islamabad modified an end-of-clerkship OSCE assessment in internal medicine for final year medical students from a previous static, pattern-recognition format to an interactive, clinical reasoning and skill-based format.

Methods: We modified the OSCE to be more dynamic and effective by creating a customized clinical skills laboratory, using standardized patients, developing competency checklists for OSCE stations, and stimulating more active participation from faculty members.

Frequency of the metabolic syndrome in adult type 2 diabetics presenting to Pakistan Institute of Medical Sciences.

Objective: To determine the frequency of metabolic syndrome in both genders, in a limited adult type 2 diabetic population presenting to Pakistan Institute of Medical Sciences, Islamabad.

Methods: This was a cross sectional study conducted in a tertiary care teaching hospital. During the six months of study period, 106 adult type 2 diabetics were examined and evaluated for the presence of metabolic syndrome according to the ATP-III criteria.

Empysematous gastritis--a case report with literature review.

Emphysematous gastritis is a condition characterized by gas within the wall of the stomach and associated, systemic toxicity. We are reporting to our knowledge the first case of emphysematous gastritis in a 76 year old female from Islamabad, Pakistan. She was admitted with five day history of upper abdominal discomfort and vomiting.