This study aimed to assess the perceived need among surgical residents to revisit their anatomical knowledge and evaluate their attitude towards integrating clinical anatomists into surgical ...residency program curriculum.OBJECTIVEThis study aimed to assess the perceived need among surgical residents to revisit their anatomical knowledge and evaluate their attitude towards integrating clinical anatomists into surgical residency program curriculum.While medical students learn human anatomy during undergraduate years, the practical application of clinically oriented anatomy becomes vital in surgical specialties. However, this aspect has not been adequately addressed in Indian surgical residency programs.BACKGROUNDWhile medical students learn human anatomy during undergraduate years, the practical application of clinically oriented anatomy becomes vital in surgical specialties. However, this aspect has not been adequately addressed in Indian surgical residency programs.An 11-item questionnaire, including closed-ended and Likert-scale questions, was administered to 153 surgical residents. Consent was obtained, and responses were collected via Google Forms.METHODSAn 11-item questionnaire, including closed-ended and Likert-scale questions, was administered to 153 surgical residents. Consent was obtained, and responses were collected via Google Forms.Half of the respondents (50%) felt confident in their self-directed anatomy learning, but 87% believed integrating clinical anatomists would enhance their surgical expertise. Additionally, 88% saw value in revisiting cadaveric dissection. Third-year residents showed a significantly higher inclination towards cadaveric dissection. Deficiencies in the curriculum and time constraints were identified as major barriers.RESULTSHalf of the respondents (50%) felt confident in their self-directed anatomy learning, but 87% believed integrating clinical anatomists would enhance their surgical expertise. Additionally, 88% saw value in revisiting cadaveric dissection. Third-year residents showed a significantly higher inclination towards cadaveric dissection. Deficiencies in the curriculum and time constraints were identified as major barriers.The study highlights a perceived need among surgical residents to augment their anatomical knowledge, advocating for the integration of clinical anatomists and cadaveric dissection into training. A collaborative approach, emphasizing both horizontal and vertical integration of anatomy, is recommended to enhance surgical education and practice. (Tab. 4, Fig. 1, Ref. 25).CONCLUSIONThe study highlights a perceived need among surgical residents to augment their anatomical knowledge, advocating for the integration of clinical anatomists and cadaveric dissection into training. A collaborative approach, emphasizing both horizontal and vertical integration of anatomy, is recommended to enhance surgical education and practice. (Tab. 4, Fig. 1, Ref. 25).
Introduction Urinary bladder diverticulum (UBD) is commonly seen in urological practice and, in most cases, does not need treatment specifically directed towards it. However, it can give rise to ...symptoms that are not distinct from this finding. This makes the evaluation and management of this complex patient group challenging. We present our experience with robotic bladder diverticulectomy (RBD) for acquired bladder diverticulum to assess the outcomes and safety of this procedure when patient symptoms have failed to respond to either medical or surgical treatment directed at other associated contributing factors. Methods We retrospectively collected data on all patients who underwent RBD for persistent lower urinary tract symptoms (LUTS) at Royal Surrey County Hospital, Guildford, between 2016 and 2021, including baseline characteristics, urodynamic findings, intraoperative and postoperative outcomes, and a six-month follow-up. Patients who were diagnosed with cancer in the diverticulum, associated pathology that may contribute to their symptoms, or who had concomitant procedures at the time of RBD were excluded from this study. Results We had six patients who underwent RBD; the median age and body mass index (BMI) were 63.8 years (range 48-73) and 27.1 kg/m2 (range 24-32), respectively. The most common presenting symptoms were refractory LUTS and recurrent urinary tract infections (UTIs). The urodynamic evaluation revealed varying findings like bladder outlet obstruction (BOO), poor compliance, and equivocal readings in these patients. All patients reported incomplete bladder emptying and double voiding, with half practicing clean intermittent self-catheterization (CISC). Diverticulum size averaged 9.4 cm (range 8.5-12). The median operative time and blood loss were 166 mins (range 150-180) and 75 mls (range 50-100), respectively. The average length of stay was 1.6 days (range 1-3). Three patients developed UTIs within a month after surgery, requiring a course of oral antibiotics. Post-void residual (PVR) measured an average of 32.6 mls (range 0-161) postoperatively compared to a preoperative average of 249 mls (range 125-400), showing a two-tailed p-value of 0.016. The International Prostate Symptom Score (IPSS) score for these patients showed an average of 27.83 (range 24-31) preoperatively compared to the postoperative average of eight (range 7-12), showing a two-tailed p-value of 0.0001. Final histology showed no malignancy, and all patients reported symptom improvement, with none requiring CISC after surgery. Conclusion RBD is a safe and effective procedure in carefully selected patients with refractory LUTS and UTIs showing good postoperative and functional outcomes. The presence of a large diverticulum can have a complex effect on bladder dynamics. In the era of robotic surgery and enhanced recovery, discussion about diverticulectomy should be encouraged after proper evaluation and counseling for patients who have failed to improve with other measures of treatment for their symptoms.
In humans, especially in childhood, the more prevalent disease is dental caries. Dental caries can extensively destroy the tooth structure. Extensive loss of the tooth structure and premature loss of ...the primary tooth can lead to loss of vertical dimension, developing habits such as tongue thrusting and mouth breathing that may lead to malocclusion in future. The treatment of mutilated primary teeth should adequately reestablish the anatomy of the tooth, which helps to maintain the mastication, phonation, esthetics, and acts as a natural space maintainer. It is always challenging for the pediatric dentist to satisfactorily restore these teeth to maintain space, esthetics, and function. In recent years, both children and their parents have given priority to esthetics over primary dental care. This demands the innovation and the development of newer treatment options that should be biological and conservative. Hence, natural teeth are increasingly being used as a restorative material to treat damaged teeth with this desire for innovation. As a result, here we report a case of a severely mutilated primary tooth of a 2½-year-old child treated with the technique of biological restoration. This biological restoration procedure involves bonding a sterile dental structure to a tooth that needs treatment.
Purpose
Pediatric dentistry requires more than routine dental knowledge and skills in executing quality dental care. The quality of dental treatment is indirectly proportional to a child’s anxiety ...and fear. The recent distraction technique, the use of virtual reality (VR) devices has intrigued many researcher’s minds. Therefore, this study was conducted to assess the clinical feasibility and effectiveness of the VR device in reducing pain and anxiety in pediatric patients during mandibular primary molar extraction.
Methods
This research trial had 30 healthy children between the ages of 6 and 12 who required mandibular primary molar extraction. The subjects were divided into two groups using a simple randomization method. In the study group (
n
= 15), extraction was carried out using a VR device, whereas, in the control group (
n
= 15), extraction was carried out without the use of a VR device. Pre- and post-extraction anxiety levels were measured by Venham’s picture test (VPT) and the heart rate. After the procedure, pain and behavior were evaluated by the Wong-Bakers Faces pain rating scale (WBS) and FLACC Scale respectively.
Results
The pre-extraction values of the VPT and heart rate showed no statistically significant difference. This indicates that participants of both groups had a similar level of anxiety at baseline. There was a statistically significant increase (
p
= 0.028) between pre- and post-heart rates in the control group, with no significant change in the study group.
Conclusion
The use of a virtual reality device in children can reduce anxiety during primary molar extractions as evaluated by heart rate. Virtual reality devices might be an adjunct to high-quality dental care and to other behavior management methods. Definitive outcomes can be attained by encouraging studies overcoming the present limitations, and considering salivary biochemical indicators for the assessment of these devices.
The aims and objectives of this study were to evaluate and compare the flexural strength and microhardness of zinc reinforced glass ionomer cement and glass ionomer type IX cement.
The sample size of ...twenty each of group I (zinc-reinforced glass ionomer cement) and group II (glass ionomer type IX cement) were selected. The samples were prepared in the customized steel molds and subjected to test for flexural strength and microhardness. The flexural strength was determined by the three-point bending test. After determining the flexural strength, the fragments were used to determine Vickers Hardness by means of an automatic microhardness indenter. The flexural strength and microhardness was calculated for all samples and subjected to statistical analysis. Two sample
-test with unequal variances were used, as the data are found to be from the same material. The normality was checked by using the usual normal probability plot. For flexural strength,
value was found to be 0.007530. Hence, zinc-reinforced glass ionomer cement was superior to glass ionomer type IX cement. For microhardness the
value was found to be 0.0023. So, glass ionomer type IX cement was superior to zinc reinforced glass ionomer cement.
The zinc-reinforced glass ionomer cement showed enhanced flexural strength when compared to glass ionomer type IX cement, thus increasing the longevity whereas glass ionomer type IX cement had a better microhardness than zinc-reinforced glass ionomer cement. Hence, the mechanical properties of various materials should be considered for the long-term clinical success by selecting the appropriate material based on the clinical condition.
Patil K, Patel A, Kunte S,
. Comparative Evaluation of the Mechanical Properties of Zinc-reinforced Glass Ionomer Cement and Glass Ionomer Type IX Cement: An
Study. Int J Clin Pediatr Dent 2020;13(4):381-389.
Background:
Polymorphous light eruption (PLE) is the most common idiopathic photodermatoses, with a wide range of clinical presentations that tends to mimic a number of dermatoses.
Objective:
The aim ...was to study the clinicopathological profile in patients diagnosed with PLE.
Materials and Methods:
This was a cross-sectional, descriptive study of seventy clinically diagnosed cases of PLE over a period of 1 year, wherein following patient enrolment, they underwent a thorough clinical evaluation, followed by a skin biopsy that was studied categorically.
Results:
A male preponderance (62.8%) was observed. Majority of patients were in the 21-30 years’ age group (28.6%). Pruritus was witnessed in 98.5% of patients. The most common morphological type encountered was plaque PLE (35.7%), followed by lichen nitidus type (11.4%). Commonest site of involvement was sides and back of neck (75.7%), followed by dorsolateral aspect of both arms (31.4%). Hyperkeratosis was identified in 82.8%, spongiosis in 87.1%, liquefactive degeneration of basal cell layer in 82.8%, atrophy in 24.2%, and moderate-to-severe lymphocytic dermal infiltrates in 90% of our cohorts.
Conclusion:
PLE is a disorder with diverse clinical presentations, manifesting usually in the third decade of life that closely mimics a variety of other cutaneous disorders. Histological examination with certain specific criteria enables the clinician to arrive at a concrete conclusion in those cases where clinical findings alone pose diagnostic difficulties.
The branching pattern and the course of brachiocephalic trunk in relation to the trachea, thyroid gland has profound surgical importance. Any alteration in the normal course of the brachiocephalic ...trunk, if accidently ruptured during emergency tracheostomy or thyroid surgeries may lead to haemorrhage. Hence, anomalous course of vessels in the neck and thorax should be kept in mind to prevent iatrogenic injury to abnormal vessels. We present a case with a variable course of brachiocephalic trunk passing left to right transversely crossing trachea in a formalin fixed female cadaver. In this case report, brachiocephalic trunk had its origin from the arch of aorta to the left of trachea corresponding to the left margin of manubrium sterni. Then, it ascended along the left margin of trachea up to the lower border of the left lobe of thyroid gland taking a sharp bend of approximately 90° to hook around and cross the trachea transversely to the right side along the inferior margin of the right lobe of thyroid gland. Knowledge of the variable rather transverse course of the brachiocephalic trunk appears to be important in various surgical approaches such as tracheostomies, thyroidectomies and mediastinoscopies.
Objectives: To study the feasibility of use of color-coded rings as a proxy for partograph for early identification of slow progress of labor. Materials and Methods: Color-coded rings were devised as ...a tool using appropriate technology to translate the partographic principles into simpler, easy to understand methodology. The rings were in pairs of 4 colors i.e., red, blue, yellow, and green, ranging from 3 cm to 10 cm in diameter with a difference of 4 cm between rings of the same color. The midwife performed p/v examination of the woman in labor to assess the initial cervical dilatation and identify corresponding ring. P/V was to be repeated after 4 hours to reassess the cervical dilatation and compare it with the bigger ring of the same color indicating expected cervical dilatation. If existing cervical dilatation measured lesser, it was interpreted as slow progress of labor indicating referral. Results: 44 women 23 (22.1%) primis and 21 (13%) multis showed delayed progress of labor as judged by use of color-coded rings. 20 women (4 primis and 16 multis) showed satisfactory progress or delivered by the time arrangements for referral were made. Conclusion: Use of color-coded rings may serve as a valuable tool based on appropriate technology to assess slow progress of labor not only in the hands of nurse midwives but it also can serve as a training tool for TBAs to help facilitate timely referral of such cases.
Screening school children for urinary abnormalities is an inexpensive task but is not commonly undertaken in India. Although debated in western countries, its utility in early diagnosis of kidney ...disorders has been proved by studies from Asia. We examined the prevalence of asymptomatic urinary abnormalities (AUA), obesity, and hypertension in school children and analyzed data to identify potential risk factors among those detected with such abnormalities.
Children and adolescents 8 to 18 years of age of either gender, attending 14 public schools in West Bengal, were screened prospectively from July 2013 to July 2016 for detecting asymptomatic urinary abnormalities by a spot urine test using a dipstick. Sociodemographic profile, medical examination (weight, height, and blood pressure), and questionnaire-based data were recorded.
A total of 11,000 children were screened. Of these, data from 9306 children were available for AUA, obesity, and hypertension. The prevalence rate was 7.44% (95% confidence interval CI = 6.91%-7.97%) for at least 1 AUA. Isolated hematuria was present in 5.2% (95% CI 4.75%-5.65%), whereas isolated proteinuria was present in 1.9% (95% CI = 1.62%-2.18%). The prevalence of prehypertension was 13.43% (95% CI = 12.74%-14.12%) and that of hypertension and abnormal body mass index was 4.05% (95% CI = 6.43%-7.47%) and 38.67 (95% CI = 37.68%-39.66%) respectively.
The prevalence rates of AUA were comparable with those in some Asian countries but higher than in most developed countries. Of children and adolescents 8 to 18 years of age, those 13 to 18 years had significantly more high risk factors such as AUA, hypertension, and obesity.
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