Neurosurgical Knowledge of Interns in New Zealand: The Potential for Improvement.

Aims: Insufficient exposure of students to neurosurgery and neuroradiology has often been a matter of concern in medical schools across USA, Canada, UK and Europe. When taking into account the high incidence and mortality from head injuries in the form of subarachnoid and intracranial haemorrhages, it becomes evident that core knowledge in basic neurosurgical imaging and diagnoses need to be an essential part of medical training. The aim of this pilot study was to investigate the level of basic neurosurgical knowledge with regard to image interpretation in interns who were in their first postgraduate year in New Zealand. Study Design: Clinical and educational research paper. Place and Duration of Study: Wellington, New Zealand from January 2011 to January 2012. Methodology: Fifty interns in their first postgraduate year were invited to complete a neurosurgical imaging questionnaire with images of common neurosurgical findings (obvious subarachnoid and intracranial haemorrhages) randomly mixed with normal studies. Five computerized tomography (CT) scan images were required to be matched to five diagnoses. Results: All respondents agreed to participate. The mean score for the all 50 interns was 40% (95% CI 37.3 - 42.4), with a range of 0 to 80%. Thirty-six interns (72%) had a score of less than 60% and thus failed to demonstrate basic competency on the examination. None of the interns scored a full 100%. Conclusion: This study suggests that only 28% of newly qualified New Zealand doctors were able to demonstrate a basic level of competence in the evaluation of neurosurgical imaging at the start of their internship. Improvement of the undergraduate neurosurgical curriculum is strongly suggested.

Diagnostic dilemma in a case of early spinal tumour fracture (Plasmacytoma): a case report.

MRI findings of D12 fracture were suspicious of a pathological fracture. However, biopsy did not show any evidence of tumour. This resulted in the patient following up after one and half years with an epidural mass lesion and neurological deterioration. This paper highlights some of the MRI features of fractures associated with underlying pathology over traumatic or osteoporotic fracture.

Seroprevalence of IgG antibodies to Helicobacter pylori among gastrointestinal endoscopists, radiologists and paramedical personnel.

BACKGROUND: The route of transmission of Helicobacter pylori is unknown. Since the organism has been isolated from saliva, gastric juice and stool, medical personnel could be at high risk for acquiring the infection during procedures like gastrointestinal endoscopy. AIMS: To study whether endoscopy is a professional hazard for acquisition of H. pylori. METHODS: We studied the prevalence of IgG antibodies to H. pylori in endoscopists (n = 17), radiologists (n = 17) and personnel from paraclinical branches (n = 35); microbiology (n = 21), pathology (n = 7) and forensic medicine (n = 7); among the paraclinical personnel five were at high risk because they worked with cultures of H. pylori. Subjects answered a questionnaire regarding upper gastrointestinal symptoms, and precautions taken at the work place against infection. The serum was tested for IgG antibodies to H. pylori using a microwell ELISA and a rapid card test. RESULTS: H. pylori antibodies were present in five (29.4%) endoscopists, three (17.6%) radiologists and seven (20%) paraclinical personnel; only one of the 5 high risk para medical personnel was positive. There was no correlation between the duration of performing endoscopies and the H. pylori IgG status. CONCLUSION: Endoscopy is not a risk factor for acquiring H. pylori infection.

Dental plaque: an unlikely reservoir of Helicobacter pylori.

BACKGROUND AND AIM: Dental plaque has been suggested as a reservoir for Helicobacter pylori, though data in this regard are conflicting. We evaluated the prevalence of H. pylori DNA in dental plaque using polymerase chain reaction (PCR). METHODS: Antral H. pylori status of 156 patients with acid-peptic disease (APD) was studied by rapid urease test (RUT), histology and culture. Dental plaque obtained from these 156 patients and 92 healthy volunteers was evaluated for the presence of H. pylori using RUT, culture and PCR. RESULTS: H. pylori was present in 133 antral biopsy samples by RUT and/or histology. The dental plaque of 37 patients with APD and 21 healthy volunteers tested positive by RUT. H. pylori was not isolated by culture from any of the dental plaques. PCR gave a significant amplification product in 11 of 248 (4.4%) dental plaque samples, 7 from patients with APD and 4 from normal healthy volunteers. CONCLUSION: The frequency of H. pylori in the dental plaque is low, and this is unlikely to be a prominent site of infection with H. pylori.

Influence of cellular differentiation on ultraviolet induced DNA damage and its repair mechanisms in B. cereus.

Susceptibility to UV irradiation of B. cereus BIS-59 spores undergoing germination at various stages-dormant spores to vegetative cell stage and their ability to recover from radiation damage were studied. For a given dose of radiation, the number of spore photoproducts (SPP) formed in the DNA of dormant spores was about 5-times greater than that of thymine dimers (TT) formed in the DNA of vegetative cells. At intermediate stages of the germination cycle, there was a rapid decline in the UV radiation-induced SPP formed in DNA with a concomitant increase in the UV radiation-induced TT formed in DNA. Bacterial spores undergoing germination (up to 3 hr) in the low nutrient medium (0.3% yeast extract) displayed much higher resistance to UV radiation than those germinating in the rich nutrient medium, even though there was no discernible difference under the two incubation conditions in respect of the extent of germination and the time at which the outgrowth stage appeared (3 hr). This was due to the formation TT in the DNA of spores germinating in the low nutrient as compared to that of spores germinating in the rich-nutrient medium. In UV-irradiated dormant spores, SPP formed in the spore DNA did not disappear even after prolonged incubation in the non-germinating medium. However, when the UV-irradiated dormant spores were germinated in low or rich nutrient medium, a significant proportion of SPP in DNA was eliminated. The dormant spores incubated in either of the germinating media for 15 min and then UV-irradiated were capable of eliminating SPP (presumably by monomerization) even by incubation in a non-germinating medium and in the complete absence of protein synthesis (buffer holding recovery), thereby implying that spore-repair enzymes were activated in response to initial's germination. The acquisition of photo-reactivation ability appeared in spores subjected to germination only in the rich-nutrient medium at the outgrowth stage and required de novo synthesis of the required enzymes.

Quantitative evaluation of muscle relaxation induced by Kundalini yoga with the help of EMG integrator.

The present work is aimed to quantify the degree of relaxation of muscle under the effects of Kundalini Yoga with the help of EMG integrator. The data collected from 8 individuals (4 males 4 females) on the degree of muscle relaxation at the end of meditation revealed a significantly decreased muscle activity amounting to 58% of the basal level in both the sexes.