Evaluation of a training programme to induct medical students in delivering public health talks

<p><b>INTRODUCTION</b>It is uncommon for medical students to deliver public health talks as part of their medical education curriculum. This study evaluated the effectiveness of a novel training programme that required medical students to deliver public health talks during their family medicine (FM) clerkship in a Singapore primary care institution.</p><p><b>METHODS</b>The FM faculty staff guided teams of third-year medical students to select appropriate topics for health talks that were to be conducted at designated polyclinics. The talks were video-recorded and appraised for clarity, content and delivery. The appraisal was done by the student's peers and assigned faculty staff. The audience was surveyed to determine their satisfaction level and understanding of the talks. The students also self-rated the effectiveness of this new teaching activity.</p><p><b>RESULTS</b>A total of 120 medical students completed a questionnaire to rate the effectiveness of the new teaching activity. 85.8% of the students felt confident about the delivery of their talks, 95.8% reported having learnt how to deliver talks and 92.5% perceived this new training modality as useful in their medical education. Based on the results of the audience survey, the speakers were perceived as knowledgeable (53.1%), confident (51.3%) and professional (39.0%). Assessment of 15 video-recorded talks showed satisfactory delivery of the talks by the students.</p><p><b>CONCLUSION</b>The majority of the students reported a favourable overall learning experience under this new training programme. This finding is supported by the positive feedback garnered from the audience, peers of the medical students and the faculty staff.</p>

Diagnostic importance of serous fluid examination for detection of various pathological conditions - A study of 355 cases.

Background: Cytological examination of exfoliated cells is very challenging and of paramount importance for diagnosis, staging and prognosis as the finding of cancer cells in such a specimen denotes that the patient has advanced and incurable cancer. Aims & Objective: To study serous effusion for various pathological conditions. Material and Methods: The study was performed on serous effusions. Serous effusions from pleural, pericardial and peritoneal fluid were included and all other fluids were excluded. Their clinical history and other relevant parameters were noted. Collection was performed with 18-gauge needle under local anaesthesia and sterile conditions. When delay, samples were stored at 2-6 ͦC. Conventional smear and or Cytospin method were performed. Ether alcohol (wet fixed) and air dried smears were used. H & E stain, papanicolaou stain and MGG stain were done. Results: Out of total 355 cases, 186 were of pleural fluid, 164 of peritoneal fluid and 5 were of pericardial fluid. 288 cases were benign, 24 cases were malignant effusion, 17 cases were suspicious of malignancy and 26 cases were degenerated. Transudate, haemorrhagic and straw coloured fluid were more common. Conclusion: Benign effusions are common in younger whereas malignant effusions are common in older people. A combined approach to morphology by may-grunwald giemsa, papanicolaou with haematoxylin and eosin stain was better than individual method. Recurrent hemorrhagic effusions are more common in malignant effusions. Conventional smear method can yield good result. Scattered cells are indicative of benign effusions and clusters, 3 D balls, papillary patterns indicate malignant effusions.

Selection of mode of biopsy in histopathological diagnosis of Soft tissue sarcoma depending on diagnostic accuracy and feasibility: Debatable issue in modern era.

Background: Biopsy method of choice is a controversy issue for diagnosis of soft tissue sarcoma which are traditionally been managed by wide excision surgery and radiotherapy. Chemotherapy is reserved for advanced cases. Aims & Objective: The objective of study was to evaluate diagnostic accuracy of various modes of biopsy focusing on image guided core needle biopsy (CNB). Material and Methods: Current study includes 50 cases of soft tissue sarcoma from January 2010 to October 2012. The Mode of biopsies included image guided CNB, open and excision biopsy. Effective accuracy of each was determined by accuracy of biopsy to provide adequate tissue for histopathological and other special examinations like immunohistochemistry to reach final diagnosis. Results: Out of total 50 cases CNB was done in 13 cases, open biopsy in 2 cases and in 35 cases excision biopsy was done. CNB was adequate in 92.31 % cases and 7.69 % cases it was inadequate. Open and excision biopsy were 100 % adequate. Conclusion: Image guided CNB is very helpful in early diagnosis and shows high accuracy especially for high-grade sarcoma. It is less invasive compared to others and differentiate benign from malignant. It is handful when preoperative diagnosis is essential for planning pre-operative chemotherapy especially in patients with primarily inoperable, advanced tumour with compromised performance status or recurrent tumour. But it should be properly directed and representative of whole tumour and require full radiological correlation by experienced hands. Tumours with myxoid pattern, lipomatous tumours and low grade sarcomas encounters lower diagnostic accuracy on CNB.

Study of metastasis in lymph node by fine needle aspiration cytology: our institutional experience.

Background: Fine needle aspiration cytology (FNAC) is a reliable as well as an inexpensive diagnostic method. It is suitable for the developing countries for the diagnosis of lymphadenopathy at any approachable site. Fine needle aspiration cytology not only confirms the presence of metastatic disease but also, in most cases, gives the clue regarding the origin of the primary tumor, prognosis as well in the management of patient for staging purposes. The aim of the study was to detect and diagnose metastasis in lymph nodes. Methods: A study was done of all metastatic lymph node lesions reported in Department of Pathology, Govt. Medical College, Surat from May 2011 to April 2012. Results: A total of 2355 cases of fine needle aspiration cytology were carried out of which 580 cases were of lymph node. Cytology results were positive for metastasis in 157 specimens (27.06%). The most common site was cervical lymph nodes. Maximum numbers of cases of metastatic tumors were in 41-50 yrs age group. There were 115 males and 42 females with a male predominance (Male:Female= 2.8:1). The most common malignancy was squamous cells carcinoma, seen in 118 cases (75.15%), followed by metastatic mammary carcinoma (13 cases, 8.29%). In 26 cases out of 580 cases, histopathological confirmation was done and diagnostic accuracy of FNAC was 100%. Conclusions: Fine needle aspiration cytology of lymphadenopathy is a useful tool in diagnosing metastatic lesions with good certainty.

Determination of sex from the anterior border of the human hip bone.

Background: The distinctive biometry of the anterior border of the human skeleton and its clear sexual dimorphism make it of interests from anatomical, forensic, obstetrical, radiological, archaeological and anthropological point of view for examination of skeleton remains. Aims & Objective: To determine the sex of human being from the anterior border of the hip bone. Material and Methods: For the present study total 306 normal dry human hip bones, out of which 202 are of male and 104 are of female, 141 are of Right side, 165 of Left side were studied. Osteometric board with graph paper and Sliding Vernier Calliper are used for all measurement. Results: Statistically highly significant(P ≤ 0.001) differences were detected between means in relation to sex for 6 variables ( The maximal width of the anterior border notch, The distance from the anterior superior iliac spine to the pubic tubercle , The distance from the anterior inferior iliac spine to the iliopubic eminence , The distance from the anterior inferior iliac spine to the pubic tubercle , The length of the notch between the anterior inferior iliac spine and the iliopubic eminence, The depth of the notch between the anterior inferior iliac spine and the iliopubic eminence), Statistically very significant differences(p≤0.005) were detected between means in relation to sex for 2 variables( Index of widening of the anterior interspinous notch, The depth of the anterior interspinous notch), Statistically significant differences(P≤.01) were detected between means in relation to sex for 1 variable (Index of widening of the notch between the anterior inferior iliac spine and the iliopubic eminence). These variables could be used for sex determination from the human hip bone or its fragments. Conclusion: Therefore we consider that these 6 variables are the best of the variables studied for sexing human hip bone (P < 0.001).

Morphometric study of mental foramina in dentate and edentulous human mandible in Gujarat Region.

Background & Objectives: will be useful for anatomists, anthropologists, aneasthetist, orthopedics and experts in the field of forensic medicine. The aim of the study was to examine the different morphometric variations of the human mandibles and comparing between dentate and edentulous mandibles is done. Methods: This study included only bone who exhibited no obvious bone pathology. All measurements were done bilaterally, performed with a stainless steel metric digital calliper with 0.01 mm precision. The relative position of the Mental foramena (MF)as analyzed with measurements made from nferior wall of mandible to the mandibular base, from anterior wall of mandible to the mandibular skeletal midline, from his posterior wall to the posterior mandibular rim. To determine this relation, the standard horizontal plane defined by Morrant was used. Briefly, the mandible was placed on a horizontal surface, to which the lower border of the mandible comes into greatest contact when vertical pressure is applied to the second molar teeth. Results: The most common location for the MF is a position aligned between second premolar and first molar (Rt. side 30% & Lt. Side 31%). Comparison of measurements of dentate and edentulous mandible is significnat on both sides. Conclusion: The knowledge of the distances from surgically encountered anatomical landmarks in the present study provide valuable information to dental surgeons that will facilitate effective localization of the neurovascular bundle passing through mental foramen thus avoiding complications from local anesthetic, surgical and other invasive procedures.

Correlation and regression analysis of stature in relation to head length in children.

Background & objective: Present study was carried out to find correlation and to derive a regression formula between head length and body height in Gujarat region. This is useful in anthropology, anatomy and forensic medicine. The material consists of 500 students from Gujarat. Methods: The age of subject was in the range of 8 to 18 years.The length of head was measured between two craniometric points, glabella and opisthocranion. Spreading caliper was used to measure head length. Height of the subject was measured with standard Height measuring instrument subject in anatomical position. Measurements were taken at fixed time to avoid diurnal variation. Results: The result obtained was analyzed and attempt was made to derive a formula between head length and total height of an individual. The result shows that there is a Moderate correlation between head length and height of an individual. Interpretation & conclusion: In present study the correlation co-efficient between height and head length is +0.30 Which is moderately significant and p value <0.05 and regression formula obtained is Y= 12.33 +7.75X.