Risk factors and determinants of pulmonary function impairments in chronic respiratory diseases in Ethiopia: A hospital-based cross-sectional study

Introduction: Chronic respiratory diseases (CRDs) are diseases of the lung airways and parenchyma. Globally, they are the leading causes of morbidity and mortality. This study aimed to characterize the common CRDs, along with their lung function and possible determinants in symptomatic patients attending Bishoftu General Hospital, Ethiopia. Methods: A cross-sessional study was conducted at the outpatient of Bishoftu Hospital, Ethiopia from June 2019 to March 2020. Consecutive adult patients aged 18 and above with CRDs (≥8 weeks) were recruited. Questionnaires were used to collect data on demographics, symptoms, diagnoses, and putative risk factors. Lung function was measured by spirometry. Result: A total of 170 participants were recruited, the majority 102(60.0%) were female. The mean age was 49 years (SD=16). The most common symptoms were wheezing in the last twelve months 156 (91.8%), cough 138 (81.2%), and severe exertional breathlessness 137 (80.6%). Thirty-nine (22.9%) were either active or passive smokers. Half of the patients (50.3%) were exposed daily to vapors, dust, gases, or fumes and 58 (34.3%) were exposed to biomass smoke. In total, 138 (81.2%) had a positive allergen skin prick test. Chronic bronchitis (49.1%) and asthma (36.1%) were the most common clinical diagnoses. Classification of lung function revealed 23 (15%) normal, 29 (19%) obstructive, 36(23.5%) restrictive and 61(39.9%) mixed patterns. Airflow obstruction was independently associated with increasing age (p<0.05), exertional breathlessness (p<0.001), previous history of asthma (p<0.05), BMI (p<0.05), and doctor-diagnosed chronic obstructive pulmonary disease (p<0.001) and asthma (p<0.05). Conclusion: This study shows a high burden of abnormal lung function in patients attending clinics because of CRDs symptoms. These findings support the critical need for spirometry services to determine lung abnormality in patients with chronic respiratory symptoms.

Unraveling the Sugar Rush: A Cross-sectional Study of Knowledge, Attitudes, and Practices Related to Sugar- Sweetened Beverages Consumption among Malaysian Young Adults

@#Introduction: The consumption of sugar-sweetened beverages (SSBs) among young adults in Malaysia has witnessed a notable increase in recent years, giving rise to concerns regarding the potential adverse health effects, including obesity and diabetes. Despite the urgent need for targeted interventions, there is a dearth of research examining the knowledge, attitudes, and practices (KAP) related to SSBs among Malaysian young adults. To address this research gap, the present study aims to assess the level of KAP concerning SSB intake and its associated factors in this specific population. Methods: A cross-sectional study was conducted involving 408 Malaysian young adults aged between 15 and 29 years. Respondents completed an online questionnaire survey, which encompassed the assessment of socio-demographic characteristics and KAP regarding SSB consumption. The collected data were analyzed using IBM’s Statistical Package for the Social Sciences (SPSS) version 22.0. Spearman correlation tests were performed at a significance level of 0.05. Results: The majority of respondents demonstrated moderate knowledge (60%) and practices (60%), while exhibiting a high positive attitude (100%) towards reducing SSB consumption. Significant correlations were observed between knowledge and attitude (p = 0.003, rs = 0.148) and between knowledge and practice (p = 0.005, rs = 0.138). Moreover, the attitude scores were found to be significantly associated with gender (χ2 (1, N = 408) = 10.421, p = 0.001) and locality (χ2 (1, N = 408) = 4.106, p = 0.043), while the practice scores exhibited a significant association with ethnicity (p = 0.006). Conclusion: This study provides valuable insights into the relationship between KAP related to SSB consumption and socio-demographic factors among Malaysian young adults. The findings underscore the importance of utilizing these insights to develop strategic interventions that aim to curtail SSB consumption and promote a healthy lifestyle, ultimately contributing to the reduction of non-communicable diseases. Health authorities are encouraged to capitalize on these findings to design targeted interventions tailored to the unique needs and circumstances of this population.

Evaluation the Effect of Ginseng Plant Root Extract on Complications of Azathioprine on Ovarian Follicles and TSH, LH and Progesterone Hormones in Rats

Background: The search for herbal remedies has gained significant attention due to chemical drugs’ potentially harmful side effects. Finding plants that can mitigate these adverse effects is crucial for enhancing the well-being of individuals undergoing chemical drug treatments. Aim: Numerous studies have demonstrated the potent antioxidant properties of ginseng. Azathioprine, a widely used drug, has been shown to induce detrimental side effects on various body tissues. Thus, this study aimed to assess the efficacy of ginseng in reducing the harmful effects of azathioprine on ovarian tissue. Materials and Methods: In this study, mice were divided into groups and injected with ginseng root extract and azathioprine. Ovarian weight and histological analysis were conducted to evaluate the number of ovarian follicles and corpus luteum. Furthermore, the levels of FSH, LH, and progesterone in the blood of the study groups were assessed using ELISA. Results: In treatment group 4 (ginseng extract and azathioprine), compared to treatment group 2 (azathioprine only), a significant increase in the weight of both left and right ovaries was observed. Treatment group 4 also exhibited a notable increase (P<0.05) in the number of primordial, primary, and atretic follicles. The concentration of progesterone significantly increased in treatment group 4 compared to treatment group 2 (p<0.01). Conclusion: The findings of this study indicate that azathioprine can have destructive effects on ovarian tissues, while ginseng extract demonstrates the potential to reduce these detrimental side effects. Furthermore, ginseng extract appears to positively regulate FSH and progesterone hormones.

Dealing with Outbreak of Monkey Pox Virus in Iran

Iran has raised concerns about the new outbreak of monkeypox (MV), it’s a serious issue for our 85 million population. Iran has identified its first case of monkeypox reported 16, Aug, woman aged 34, in the city of Ahvaz. The outbreak of the Monkeypox virus increasing daily in many areas, and causes deaths are reported. This article deals with the ongoing outbreak of monkeypox virus (zoonotic) that belongs to the genus orthopoxvirus, which was confirmed in May, 2022 and has similar symptoms as of smallpox but is less contagious and less severe illness than smallpox. The article also deals with its signs and symptoms, diagnosis, prevention, and treatment.

Evaluation-of-pulmonary-function-test-in-chronic-obstructive-pulmonary-disease-patients

Chronic obstructive pulmonary disease (COPD) is a progressive inflammatory disease that affects the airways, alveoli, and pulmonary vasculature, leading to irreversible airflow limitation and loss of elastic recoil. This disease is highly prevalent in clinical practice, affecting approximately 10% of adults over 40 years of age, and it is expected to become the third leading cause of death by 2030. The study was conducted on 54 COPD patients diagnosed based on GOLD guidelines. The study observed a statistically significant association between Spirometric staging and the duration of symptoms. The mean value of FEV1/FVC, FEV1 in %, and 6MWD in meters decreased significantly as the grade of GOLD stage increased from stage II to stage III and stage IV. The study showed that COPD is associated with various co- morbidities, including hypertension, diabetes mellitus, hypothyroidism, and coronary artery disease. The study concludes that FEV1, BMI, MMRC grading, and the 6-minute walk test are significant predictors of morbidity among COPD patients. The study recommends early detection and management of COPD to prevent its progression and associated morbidity

Survival Outcomes and Patterns of Failure in Maxillary Alveolus Squamous Cell Carcinoma

Abstract Introduction Squamous cell carcinoma (SCC) of the maxillary alveolus is a relatively rare disease. There is lack of data on this subsite as compared with other sites. The factors that affect survival in cases of maxillary alveolar SCC are tumor stage, local and cervical metastases, histological grading, and the margin status. Objectives To evaluate the overall survival (OS), the disease free survival (DFS), and the complex interaction and effects of margin status, histological differentiation, habits (such as smoking and the use of smokeless tobacco products), and cervical and distant metastases based on clinicopathological data. Methods We examined the electronic database at our hospital from 2003 to 2017. We included all cases with a histopathological diagnosis of SCC of the maxillary alveolus. Tumors originating primarily from the maxillary alveolus were included, while those originating from adjacent subsites, like the hard palate, the buccal mucosa or the maxillary sinus were excluded. We also excluded all the patients who were not operated on with a curative intent. Results More than half of the patients had stage-IV tumors at the time of presentation, while only one fourth of them had nodal metastasis. The rate of recurrence increased in cases of primary tumors in advanced stages and the degree of histological differentiation. The 2-year and 5-year OS rates were of 54.5% (18 patients) and 30.3% (10 patients) respectively. Conclusion Primary tumors in advanced stages, histological grade, and presence of nodal metastasis are poor prognostic markers in terms of long-term survival.

Acute kidney injury in COVID-19 patients receiving remdesivir: A systematic review and meta-analysis of randomized clinical trials

Abstract Objectives: Remdesivir is an antiviral agent with positive effects on the prognosis of Coronavirus Disease (COVID-19). However, there are concerns about the detrimental effects of remdesivir on kidney function which might consequently lead to Acute Kidney Injury (AKI). In this study, we aim to determine whether remdesivir use in COVID-19 patients increases the risk of AKI. Methods: PubMed, Scopus, Web of Science, the Cochrane Central Register of Controlled Trials, medRxiv, and bio-Rxiv were systematically searched until July 2022, to find Randomized Clinical Trials (RCT) that evaluated remdesivir for its effect on COVID-19 and provided information on AKI events. A random-effects model metaanalysis was conducted and the certainty of evidence was evaluated using the Grading of Recommendations Assessment, Development, and Evaluation. The primary outcomes were AKI as a Serious Adverse Event (SAE) and combined serious and non-serious Adverse Events (AE) due to AKI. Results: This study included 5 RCTs involving 3095 patients. Remdesivir treatment was not associated with a significant change in the risk of AKI classified as SAE (Risk Ratio [RR]: 0.71, 95% Confidence Interval [95% CI] 0.43‒1.18, p = 0.19, low-certainty evidence) and AKI classified as any grade AEs (RR = 0.83, 95% CI 0.52‒1.33, p = 0.44, low-certainty evidence), compared to the control group. Conclusion: Our study suggested that remdesivir treatment probably has little or no effect on the risk of AKI in COVID-19 patients.

Retinoic acid loaded with chitosan nanoparticles improves spermatogenesis in scrotal hyperthermia in mice / 대한생식의학회지

Objective@#High temperatures can trigger cellular oxidative stress and disrupt spermatogenesis, potentially leading to male infertility. We investigated the effects of retinoic acid (RA), chitosan nanoparticles (CHNPs), and retinoic acid loaded with chitosan nanoparticles (RACHNPs) on spermatogenesis in mice induced by scrotal hyperthermia (Hyp). @*Methods@#Thirty mice (weighing 25 to 30 g) were divided into five experimental groups of six mice each. The groups were as follows: control, Hyp induced by a water bath (43 °C for 30 minutes/day for 5 weeks), Hyp+RA (2 mg/kg/day), Hyp+CHNPs (2 mg/kg/72 hours), and Hyp+RACHNPs (4 mg/kg/72 hours). The mice were treated for 35 days. After the experimental treatments, the animals were euthanized. Sperm samples were collected for analysis of sperm parameters, and blood serum was isolated for testosterone measurement. Testis samples were also collected for histopathology assessment, reactive oxygen species (ROS) evaluation, and RNA extraction, which was done to compare the expression levels of the bax, bcl2, p53, Fas, and FasL genes among groups. Additionally, immunohistochemical staining was performed. @*Results@#Treatment with RACHNPs significantly increased stereological parameters such as testicular volume, seminiferous tubule length, and testicular cell count. Additionally, it increased testosterone concentration and improved sperm parameters. We observed significant decreases in ROS production and caspase-3 immunostaining in the RACHNP group. Moreover, the expression levels of bax, p53, Fas, and FasL significantly decreased in the groups treated with RACHNPs and RA. @*Conclusion@#RACHNPs can be considered a potent antioxidative and antiapoptotic agent for therapeutic strategies in reproductive and regenerative medicine.

Impact of COVID-19 on the Prevalence of Dry Eye Among Young Adults in Kuala Lumpur Malaysia

@#film quality and the quantity of secretion. This low quality of tear secretion can lead to the rapid breakup of tears. In recent times, particularly since the COVID-19 pandemic, the prevalence of dry eye has increased. Relevant studies found that the prevalence of dry eye is higher in females than males. This research work is based only on symptoms of dry eye disease in Malaysia to determine its prevalence among students at the UCSI University KL campus because of the increase in reported cases of dry eyes especially post Movement Control Order (MCO). Methods: A total of 199 students, ranging in age 17 to 30, were included in this research. This is a cross-sectional study that was conducted on participants who fulfilled the inclusion criteria. Demographic questionnaires and Ocular Surface Disease Index (OSDI) results were collected. Results: On the UCSI KL Campus, students who suffer from dry eye are 82% of the population. The Pearson Chi-Square test showed a significant difference between gender and dry eye, X2 (1, N= 199) = 8.64, p < 0.0033. Female students are more likely to develop dry eye than male students. Conclusion: The prevalence of dry eyes among UCSI students is high. This could be attributable to prolonged or improper mask-wearing. It is suggested that researchers and health policymakers should take heed to these emerging risk factors related to wearing of mask.

Probabilistic Tractography Between Nucleus Accumbens and Other Reward-related Brain Areas in Malay Female Adolescents

@#Introduction: Studies show that adolescents are more reward sensitive compared to other age groups. The nucleus accumbens (NAcc) has been identified as a key brain area involved in reward through its connectivity to other reward-related brain areas. Our study aimed to characterise the white matter structural connectivity of nucleus accumbens with brain areas that are most often associated with reward in female adolescents. Methods: Fifteen healthy female Malay adolescents were recruited and underwent diffusion-weighted brain scanning. Two behaviour scales were also given to verify typical reward responsiveness. Then, probabilistic tractography and NAcc segmentation were performed on the data using FMRIB Software Library (FSL). Probabilistic tractography was performed to determine the relative connection probability of nucleus accumbens (NAcc) to areas shown to be associated with reward, namely amygdala, anterior cingulate cortex (ACC), medial orbitofrontal cortex (mOFC), hippocampus, ventrolateral prefrontal cortex (vlPFC) and dorsolateral prefrontal cortex (dlPFC). Connectivity-based segmentation of NAcc was performed to determine the spatial distribution of its connectivity with the target brain areas according to the highest connection probability. Results: The highest relative connection probability was found between NAcc to mOFC, while the NAcc parcellation showed the widest distribution of connection to mOFC compared to the other five targets on both sides of the brain. Conclusion: Our findings demonstrated the strongest structural connectivity and widest distribution between NAcc and mOFC compared with other brain areas related to reward. This study’s findings could be used as baseline to compare with people with atypical reward circuit problems.

Methods of Delivering Oral Hygiene Instructions Among Orthodontic Patients: The Past, Current and Future (Cara Penyampaian Arahan Penjagaan Kebersihan Mulut Kepada Pesakit Ortodontik: Dahulu, Kini dan Akan Datang) / Jurnal Sains Kesihatan Malaysia

@#This review paper aims to present the evolution in methods of delivering oral hygiene information to orthodontic patients. Orthodontic fixed appliance treatment confers numerous benefits to patients in terms of occlusion, function and aesthetics, but it is associated with unwanted consequences due to challenges in maintaining oral hygiene. The ways of delivering oral hygiene information to patients have progressed over the years. Recent years have seen an increase in the popularity of incorporating technology in delivering oral hygiene information and monitoring of oral hygiene practices. The use of video-based instructions to web-based platforms such as Massive Open Online Course (MOOC) and social media platforms such as YouTube, Instagram and TikTok have all become a mode of oral hygiene information conveyance. Mobile apps are now a popular means to keep track of oral care practices such as toothbrushing frequency. The active ingredients of oral care products have improved providing a greater anticariogenic and antiplaque effect to the user as have the design of toothbrushes and even dental floss. In the future, more advanced technology may be used, such as artificial intelligence (AI) and machine learning, to create intelligent machines that can help educate patients on oral health maintenance and improvement.

A Case of Painful Diplopia after COVID-19 Vaccination: Could It Be Tolosa-Hunt Syndrome? / 가정의학회지

Herein, we report a rare case of Tolosa-Hunt syndrome (THS) following coronavirus disease 2019 (COVID-19) vaccine administration. A 64-year-old patient presented with recurrent horizontal diplopia and ipsilateral orbital pain, 2 weeks after being administered the COVID-19 vaccination. A diagnosis of THS was based on the relevant criteria after ruling out the differential diagnoses. The clinical presentation improved with corticosteroid administration. THS must be recognized as a complication of COVID-19 vaccination. This association can be explained by an autoimmune response.

Neurosurgical Management of Cerebrospinal Tumors in the Era of Artificial Intelligence : A Scoping Review

Central nervous system tumors are identified as tumors of the brain and spinal cord. The associated morbidity and mortality of cerebrospinal tumors are disproportionately high compared to other malignancies. While minimally invasive techniques have initiated a revolution in neurosurgery, artificial intelligence (AI) is expediting it. Our study aims to analyze AI’s role in the neurosurgical management of cerebrospinal tumors. We conducted a scoping review using the Arksey and O’Malley framework. Upon screening, data extraction and analysis were focused on exploring all potential implications of AI, classification of these implications in the management of cerebrospinal tumors. AI has enhanced the precision of diagnosis of these tumors, enables surgeons to excise the tumor margins completely, thereby reducing the risk of recurrence, and helps to make a more accurate prediction of the patient’s prognosis than the conventional methods. AI also offers real-time training to neurosurgeons using virtual and 3D simulation, thereby increasing their confidence and skills during procedures. In addition, robotics is integrated into neurosurgery and identified to increase patient outcomes by making surgery less invasive. AI, including machine learning, is rigorously considered for its applications in the neurosurgical management of cerebrospinal tumors. This field requires further research focused on areas clinically essential in improving the outcome that is also economically feasible for clinical use. The authors suggest that data analysts and neurosurgeons collaborate to explore the full potential of AI.

The Rising trend of obesity among secondary school children of rural background

Background: Earlier obesity was a disease of the affluent but with changing trend, moderniza?on, sedentary lifestyles overweight/ obesity is increasing in the rural popula?on too. Children of the present genera?on are prone to obesity which will hamper life in the future. Scien?fic evidence shows that unhealthy diet and physical inac?vity are major global determinants of non-communicable diseases. Aim & Objec?ves: To es?mate the prevalence of obesity, to study the life style factors and to analyze the socio-demographic factors that influence obesity. Materials & Methods:A crosssec?onal study was carried out in 400 children between the age group of 12–15 years. Informed consent was obtained from school authori?es to collect informa?on from the children. Height and weight were measured using standard procedure and BMI (kg/m) was calculated. Overweight and obesity was assessed by BMI following the WHO guidelines. The ques?onnaire assessed life style, physical ac?vity, dietary habits and socio-demographic data. Results:Prevalence of obesity was 25.2% (101 children). The sta?s?cally significant (p<0.05) factors which influenced obesity was transport to school, physical ac?vity, watching television while ea?ng, consump?on of ready made food items, ea?ng in between meals and the socioeconomic status. Conclusion:The prevalence of overweight and obesity was 25.2% as per the BMI (WHO) classifica?on. Use of motor transport, lack of physical ac?vity and sedentary life are major factors.

A Case Report of Successful Fibrinolysis in a Multiple Coronary Ectasia ST-segment Elevation Myocardial Infarction Validated by Coronary Angiography

Coronary artery ectasia (CAE) often presents in the form of an acute coronary syndrome (ACS) caused by slow blood flow leading to thrombus formation in ectatic coronary arteries. The usual approach is thrombectomy with intracoronary thrombolysis but often does not guarantee immediate blood flow. A 45-year-old male presented with anginal chest pain and was diagnosed with ST-segment elevation myocardial infarction (STEMI), managed Immediately with tissue plasminogen activator(t-PA) followed later with coronary angiography revealing diffused Multiple coronary ectasia MCEA with no identified culprit lesions afterward. The patient was followed up periodically, with favorable outcomes on daily aspirin, direct oral anticoagulant (DOAC), and guideline-directed medical therapy (GDMT) for coronary artery disease (CAD) and reduced ejection fraction heart failure (HF-rEF). This case management strategy was dictated by available resources at the time of presentation; however, it signifies the importance and favorable outcome of thrombolysis in CEA/STEMI patients. Future large-scale studies are required toward defining the duration as well as the choice of long-term anticoagulation.

EVALUATION DES STAGES HOSPITALIERS A L‘HOPITAL CHEIKH KHALIFA : POINT DE VUE DE L‘ENSEIGNANT ET DE L‘ENSEIGNE

Introduction : Les stages hospitaliers sont une pierre angulaire de la formation médicale des étudiants de Médecine. L'évaluation de ces stages permet d'en améliorer la qualité pédagogique. L'objectif de cette étude est d'évaluer les stages hospitaliers à l'hôpital cheikh khalifa ibn zaid de Casablanca et des enseignements par les étudiants, et par les encadrants de stages. Matériels et Méthodes : ème Il s'agit d'une évaluation bidirectionnelle du stage d'été de juin et juillet 2019, par les étudiants de 2 cycle des études médicales d'une part, et par les enseignants d'autre part, au niveau des différents services de l'Hôpital Cheikh Khalifa de Casablanca. Notre outil d'évaluation est représenté par 2 questionnaires comportant plusieurs items à questions fermées, et dont les réponses sont effectuées sur une échelle qualitative à 4 et 5 niveaux de Likert modifiée. Résultats : 51 étudiants et 46 enseignants ont participé à notre étude. Les résultats sont moyennement satisfaisants du point de vue enseignés d'une part, et du point de vue enseignants d'autre part. 67% des étudiants ont amélioré leurs compétences. 50% des enseignants ne sont pas formés en pédagogie. Le contenu de la formation hospitalière et les objectifs pédagogiques ne sont pas prédéfinis et communiqués aux étudiants en début de stage. Les méthodes d'enseignement adoptées ne permettent pas toujours un apprentissage pratique, car dans 74% des cas, les visites médicales au lit du malade ne sont pas organisées. L'évaluation en fin de stage ne concerne que les étudiants, et est faite essentiellement de façon théorique. Conclusion : Une modification du type d'enseignement ainsi que du mode d'évaluation des compétences est nécessaires. L'apprentissage doit être pratique et le plus proche possible des situations réelles, idéalement au lit du malade, pour favoriser l'acquisition du savoir faire et du savoir être, complémentaires du savoir procédural acquis à la faculté.

Facteurs prédictifs de l'issue de l'accouchement sur utérus cicatriciel, service de gynécologie obstétrique EHS Batna, Algérie / Predictive factors of the outcome of delivery on scar uterus in the department of obstetrics - gynecology EHS Batna, Algeria

Introduction. La pratique de césariennes est en augmentation constante dans le monde, soulevant la problématique de la gestion des femmes enceintes ayant un utérus cicatriciel. L'objectif de notre travail était d'identifier les facteurs significativement associés au succès de l'épreuve utérine au sein de notre service, afin de réaliser une sélection rigoureuse des candidates à la tentative de voie basse. Méthodes. Nous avons mené une étude épidémiologique descriptive, rétrospective, mono centrique au niveau de l'EHS mère ­ enfant Batna du 1er janvier 2018 au 31 décembre 2019 ayant intéressé les femmees porteuses d'un utérus cicatriciel d'origine obstétricale avec un âge de grossesse supérieur à 22 SA. Résultats. Au cours de notre étude nous avons recensé 3002 accouchements sur utérus cicatriciel. Le taux de tentatives de voie basse après césarienne était de 46,84 % avec un taux de succès de 89,19 %. Les principaux facteurs qui favorisent le succès de la tentative de voie basse après césarienne étaient : un antécédent d'accouchement par voie vaginale après la césarienne (p <0,001) la multiparité (p=0,0002), une césarienne précédente pour présentation podalique (p<0,001), un intervalle inter génésique de 12 mois et plus (p <0,001), des conditions locales favorables (dilatation du col supérieure à 4 cm ; p=0,02 et la p=0,02 et la rupture artificielle des membranes ; p =0,02 et la rupture artificielle des membranes ; p=0,03). Les facteurs qui défavorisent le succès de la TVBAC étaient : un antécédent de césarienne pour stagnation ou non-engagement à dilatation complète (p<0,001), un terme d'accouchement supérieur à 40 SA (p=0,002), un poids de naissance supérieur à 4000 g (p<0,001). Les facteurs qui ne semblent pas influencer l'issue de l'épreuve utérine étaient : l'âge maternel, l'âge de réalisation de la première césarienne, la présence de pathologies maternelles et la réalisation de radiopelvimétrie Conclusion. Les facteurs de succès et d'échec d'une TVBAC sur utérus cicatriciel sont importants à relever pour les décisions ultérieures de la voie d'accouchement, la situation obstétricale doit être soigneusement évaluée et en cas de doute, faire appel à une décision collégiale.

The Benefits and Challenges of Clinical Work-based Surface Anatomy Learning Among Preclinical Medical Students

@#Knowledge on surface anatomy enables medical students and graduates to locate anatomical structures exteriorly, improve their clinical and procedural skills and interpret ultrasonographic and radiographic images. Hence, a standard surface anatomy knowledge is essential for attainment of clinical skill competency. Nevertheless, there is lack of attention given on surface anatomy in the medical curriculum as it is usually delivered didactically or during selfstudy by the students. Owing to limitations in cadaveric dissection in many institutions, lecture-based instruction, e-learning materials, living anatomy models, radiological imaging and anatomy software are used in teaching surface anatomy; however, none of these methods proved to be effective over the others. Furthermore, some of these teaching resources lack clinical relevancy, possibly impeding students’ appreciation on learning surface anatomy. Hence, integrating clinical input during surface anatomy teaching by involving patients in an actual clinical environment is pertinent. This article demonstrates the benefits and challenges of teaching surface anatomy in the clinical setting to medical students and highlights the need to design an evidence-based framework of work-based surface anatomy learning.

Pharmacovigilance and Its Importance for Primary Health Care Professionals / 가정의학회지

Pharmacovigilance is used to detect, assess, understand, and prevent the adverse effects of medications. The need for safety monitoring has evolved around unfortunate incidents in history, with deaths caused by anesthesia and congenital malformations from thalidomide use. Reports from adverse drug reactions (ADRs) are stored in a global database and can be used to evaluate the associations between various medications and associated ADRs. Clinicians play an important role in the recognition and reporting of ADRs to national pharmacovigilance centers (NPCs). The purpose of NPCs is to make the clinicians understand their functions, including the monitoring, investigation, and assessment of ADR reports, along with periodical benefit-risk assessments of medications via multiple sources. A case study on NPCs and the types of safety issues evaluated by them are provided to illustrate their role in medicine safety surveillance. ADR monitoring was also combined with vaccine safety surveillance approaches. Overall, this study will provide insights to clinicians on the importance of pharmacovigilance in maintaining patient safety with the proper use of medications.

Preliminary Results of Instantaneous Centre of Rotation Change after Thoracic Instrumentation in Adolescent Idiopathic Scoliosis Patients

@#Introduction: The instantaneous centre of rotation (ICR) is the centre of motion with zero velocity where a rigid body moves in a particular plane. ICR, as a dynamic measurement, gives more accurate results in terms of quality and quantity of the vertebral motions compared to range of motion (ROM). We aimed to determine the effect of thoracic instrumentation on cervical movement of adolescent idiopathic scoliosis (AIS) patients who had undergone thoracic level instrumentation by measuring pre-operative and post-operative ICR change in a pilot study Materials and methods: A total of 25 AIS patients were included in this study. C4-C5 and C6-C7 segmental ICR were determined by pre-operative and post-operative cervical flexion-extension radiographs. In addition, cervical sagittal parameters and global sagittal parameters were investigated. Results: There was no statistically significant change in ICR location post-operatively in both x and y coordinates at C4- C5 segment (p: 0.326 and p: 0.946, respectively) and C6-C7 segment (p: 0.209, p: 0.086, respectively). There was a positive correlation between LCL and C4-C5 ICR y coordinate (r: 0.481), but not with C6-C7 ICR y coordinate (r: -0.2, p: 0.398). T5-T12 kyphosis decreased (p: 0.002) and T1 pelvic angle (0.003), SVA (0.02) and sacral slope (0.049) increased significantly post-operatively. T1S was correlated with LCL (r: 0.595, p: 0.002), T5-T12 kyphosis (r: 0.423, p: 0.035), SVA (r: 0.658, p<0.001) and C2-C7 SVA (r: 0.416, p: 0.039). Conclusion: The ICR for cervical region was not changed post-operatively in AIS patients with thoracic instrumentation. There was no relationship found between the development of post-operative cervical kyphosis or lordosis and ICR, which represents the quality and quantity of intervertebral motion. The T1 vertebra plays a key role for cervical, thoracic, and global parameters interaction.