Postgraduate medical journal
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Review
Chronic constipation and gut microbiota: current research insights and therapeutic implications.
Chronic constipation is a prevalent clinical condition. Its etiology and pathogenesis have not yet been fully understood. ⋯ In this review, we summarize the current research insights into the intricate relationships between chronic constipation and the gut microbiota and briefly discuss several different approaches for treating chronic constipation. The findings from this review may advance our understanding of the pathological mechanisms underlying chronic constipation and, ultimately, translate them into improvements in patient care.
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Navigating the labyrinthine process of securing higher speciality training poses formidable challenges for doctors in training. Achieving success in this endeavour demands more than a mere grasp of the prerequisites; it necessitates meticulous preparation and foresight. Dermatology, as a medical speciality, stands out on account of its appeal, encompassing a diverse patient population, expansive scope of work, work-life balance, a plethora of procedural variety, intellectual stimulation, and abundant research opportunities. ⋯ In light of this intensifying competition, this article seeks to furnish aspiring candidates with current and invaluable insights, serving as a guide to clinching a coveted national training number in their preferred speciality. While the landscape of higher speciality training encompasses numerous possibilities, this article concentrates primarily on dermatology, intertwining its guidance with relevance to other medical and surgical specialties. Through this exploration, readers will gain essential perspectives to navigate the intricacies of the application process and emerge as competitive contenders in the higher speciality training application process.
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Traditional assessments often lack flexibility, personalized feedback, real-world applicability, and the ability to measure skills beyond rote memorization. These may not adequately accommodate diverse learning styles and preferences, nor do they always foster critical thinking or creativity. The inclusion of Artificial Intelligence (AI), especially Generative Pre-trained Transformers, in medical education marks a significant shift, offering both exciting opportunities and notable challenges for authentic assessment practices. Various fields, including anatomy, physiology, pharmacy, dentistry, and pathology, are anticipated to employ the metaverse for authentic assessments increasingly. This innovative approach will likely enable students to engage in immersive, project-based learning experiences, facilitating interdisciplinary collaboration and providing a platform for real-world application of knowledge and skills. ⋯ Through navigating emerging assessment paradigms and promoting genuine evaluation of medical knowledge and proficiency, this collaborative effort aims to elevate the quality of medical education and better prepare learners for the complexities of clinical practice.
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Stenting malignant hilar biliary obstruction (MHBO) is challenging due to its complex structure, and it is less effective than blockages in the distal bile duct area. Plastic stents (PSs) and metal stents (MSs) are commonly used for stenting MHBO. This study aims to compare the outcomes of PSs and MSs in MHBO patients. ⋯ Both PS and MS are effective for managing MHBO, while MS offers greater efficacy in increased stent patency and lower reintervention rates. Key message What is already known on this topic Metal stents (MSs) and plastic stents (PSs) are used for palliative treatment of malignant hilar biliary obstruction (MHBO). MSs significantly reduced the need for reinterventions compared to PSs in patients with MHBO. What this study adds There were no significant differences between MSs and PSs in terms of technical success, clinical success, overall survival, stent migration, stent occlusion, or adverse events. How this study might affect research, practice, or policy The study's findings may prompt researchers to design more targeted studies to further investigate these specific outcomes in MHBO patients. The results encourage endoscopists to consider patient-specific factors, such as life expectancy and preference for minimizing recurrent procedures, when choosing between MSs and PSs for MHBO.