Training ambidexterity – A survey-based analysis on the dexterity of ophthalmologists in performing standard ophthalmic procedures

Purpose: Our study was designed to determine ophthalmologists’ dexterity in performing standard ophthalmic procedures at various levels of expertise via a structured questionnaire. Methods: A structured questionnaire was administered via the Google platform from August 20 to September 19, 2022, to assess the perspectives and preferences of ophthalmologists concerning their proficiency in using their right hand, left hand, or both hands to perform routine tasks required in the practice of ophthalmic medicine and surgery. Results: Two hundred and three participants took part in the survey. A majority (n = 162, 79.8%) of the clinicians considered themselves right?handed, nine (4.4%) considered themselves left?handed, and 32 (15.7%) considered themselves ambidextrous. Also, 86% (n = 174) of the participants considered ambidexterity an essential trait in the practice of ophthalmic medicine and surgery. The number of cataract surgeries performed had an impact on the comfort of using both hands for performing anterior vitrectomy (P < 0.001), injection of viscoelastic (P < 0.001), and toric marking (P < 0.05), but not on the performance of capsulorhexis and switching of foot pedals. The number of procedures carried out had an impact on the comfort of using both hands in gonioscopy (P < 0.001), 90 D evaluation (P < 0.001), and 20 D evaluation (P < 0.05). More years of experience had an impact on skills involving the use of both hands for slit lamp joystick usage (P < 0.05) and laser procedures (P < 0.001). Conclusion: Irrespective of a person’s handedness, trained ambidexterity in the required fields is achievable and has a significant impact on one’s ability to perform the required skill optimally and appropriately.

Technique modifications in manual small-incision cataract surgery for left-handed cataract surgeons

Learning manual small-incision cataract surgery (SICS) is essential for ophthalmic surgeons as it provides an alternative to phaco-emulsification in complicated cases. Nearly 10% of ophthalmic surgeons are left-handed. Left-handed surgeons do face more difficulties because of their laterality, which have been highlighted in various surveys even in other surgical specialities. Surgical training programs, residency programs, and fellowships have traditionally been designed considering the right hand as the dominant hand. Left-handed surgeons (LHSs) are at disadvantage as they are trained by right-handed surgeons (RHSs), which may result in more initial intra-operative errors. Intra-ocular lenses are also designed such that dialing into the bag is relatively difficult for LHSs. Developing customized training modules for LHSs can help them overcome the laterality challenges and enhance their surgical capabilities. In this article, we herein present a brief description of the SICS technique for LHSs, elaborating the crucial steps and customized maneuvers that, if performed differently, may make surgeries easier for them

The implication of using dominant hand to perform laryngoscopy: an analysis of the laryngoscopic view and blade-tooth distance

BACKGROUND: Existing laryngoscopes are designed to be handled by the left hand, whereas most healthcare professionals are right-handed. However, controlling the laryngoscope device requires considerable strength and refinement to control the blade. We examined the usefulness of a right-handed laryngoscope to validate its clinical applicability. METHODS: One hundred sixty-four patients for general anesthesia were involved. Laryngoscopy was performed twice for each patient, once using a conventional left-handed Macintosh No. 3 laryngoscope and once using a right-handed one, by 25 right-handed and 18 left-handed laryngoscopists. The perpendicular distance from the tip of the maxillary incisor to the flange of each blade was measured when the maximum visibility of the glottis was obtained. We compared the distances, chances of directly contacting the tooth, laryngoscopic views and subjective feeling of difficulty in handling device between the two laryngoscopes. RESULTS: For the right-handed laryngoscopists, distance varied significantly between the two laryngoscopes (5.0 ± 3.5 and 5.7 ± 3.7 mm [mean ± standard deviation] for the conventional and right-handed laryngoscopes, respectively [P < 0.001]). The right-handed laryngoscope was associated with a decreased chance of directly contacting the teeth (P = 0.001). Additionally, the right-handed laryngoscope provided a better view than the conventional one (P = 0.005). Conversely, most of the left-handed laryngoscopists felt that the procedure using a conventional laryngoscope was easier than with a right-handed one. CONCLUSIONS: When a right-handed laryngoscopist uses a right-handed laryngoscope, a better laryngoscopic view and a reduced chance of blade contact with the teeth can be achieved.

Protective effects of left-handed pantoprazole sodium on the rat model of gastric ulcer generated by pyloric ligation / 中国比较医学杂志

Objective The aim of this study was to investigate the effect of left-handed pantoprazole sodium on rat models of gastric ulcer generated by pyloric ligation .Methods The rat models induced by pylorus ligation were treated with a single intravenous injection of left-handed pantoprazole sodium .The gastric ulcer inhibition rate , volume of gastric juice, activity of pepsin, and level of serum gastrin were determined and gastric mucosa tissue was examined by pathology . Results The gastric ulcer index , volume of gastric juice , activity of pepsin and level of serum gastrin in the rats pretreated with left-handed pantoprazole sodium (0.9, 1.8, 3.6 mg/kg, i.v.) were significantly lower than those in the model group .The lesions of gastric mucosa were also improved in the pantoprazole-treated groups .Conclusions Left-handed pantoprazole sodium has remarkable protective effects on the gastric mucosa in rat models of gastric ulcer induced by pyloric ligation.

Analysis of Grip and Pinch Strength in Korean People / 대한정형외과학회잡지

PURPOSE: We wanted to investigate the grip and pinch strength of hands and establish the clinical normative data for Korean people. MATERIALS AND METHODS: A sample of 234 Korean males and 281 Korean females (age: 10 to 84) were tested. Grip strength and pinch strength were tested twice with 5 minute interval between tests. RESULTS: Generally, hand strength peaked at 30 to 39 of age for both males and females. The average grip strength was 48.8 kg for males and 28.23 kg for females and they were 11% stronger than 12 years before in both groups. Tip pinch strength peaked in the forties, but key pinch and tripod pinch peaked in the thirties. All the peak hand strength was obtained in the 30 to 39 age group of females. Among the pinch strengths, key pinch was the strongest. For the right-handed people, the grip and pinch strengths of the right hand were stronger than those of the left hand. However, for the left-handed people, the left hand was stronger than the right hand only for the tripod pinch (p<0.005). CONCLUSION: The hand strength of Koreans peaked in the 30 to 39 age group. Key pinch was the strongest among the three pinch strengths. Right-handed people have a stronger right hand than the left hand, but the left-handed people have almost the same hand strength in both hands, except for the tripod pinch.

Chain flexibility and configurational dimensions of left handed Z- DNA and right handed B-DNA helices.

The configurational behaviour of flexible helices of right handed B- and left handed Z-types have been analysed using statistical mechanical procedures. The configurationependent parameter, most importantly, the persistence length has been computed, using the heminucleotide scheme of treating polynucleotide chains under the approximation that perturbations in the backbone torsions produce sufficient flexibility in these helices. The values of persistence lengths obtained for Z-helices are very much higher than that of B-helices indicating that former is less flexible compared to the latter. These are in accordance with the results obtained recently on B- and Z-forms of poly(dG-dC) · (dG-dC) using light scattering studies. Also the persistence lengths of BII-DNA helices characterised by a skew 3'-hemiucleotide ( ε ~ 270°), and also when they coexist with B-DNA have been computed and the values lie within the range of experimentally reported values on B-helices. It is argued that the decrease in the persistence length values of B-DNA at higher salt concentration is due to additional small fluctuations in sugar residue torsions induced due to neutralisation of electrostatic repulsions between adjacent phosphates of the nucleotide. Noteworthy is that these are correlated to winding angle variations and the consequent bending of the helix.