Application of case-based comprehensive teaching in ophthalmology teaching / 中华医学教育探索杂志

Objective To explore the effects of applying case-based teaching in the clinical education of ophthalmology. Methods The experimental control method was adopted in the study, with case-based teaching method in experimental group and traditional lecture-based learning in control group. The teaching effect was evaluated through theoretical test, case analysis score and the data of questionnaire investigation. Results In theoretical examination, the scores and score ≥ 80 rates of the experimental group were significantly higher than that of the control group (P<0.05), the results of differential diagnosis and total results in case analysis in the experimental group were higher than those in the control group, and there was significant difference (P<0.05). The results of the questionnaire showed that the students in the experimental group were more satisfied than those in the control group in terms of improving their learning interest and efficiency, clinical thinking ability, communication ability, teamwork spirit and satisfaction with teaching methods (P<0.05). Conclusion Comprehensive case-based teaching have achieved good results in ophthalmology teaching, which could motivate students' interest, improve the clinical ability and overall quality and it's favorable to improve the teaching quality in this field.

A propósito de un caso complejo: agitación psicomotora: ¿TEC y clozapina, sala de aislamiento? / About a complex case: psychomotor agitation: TEC and clozapine, isolation room?

Paciente de 25 años. Ingreso a Servicio de Urgencia. Paciente viene solo, desaseado, relata múltiples ideas bizarras, no sistematizadas. Pensamiento laxo, musita, interferido, a ratos discordante. Diagnóstico: Síndrome esquizomorfo. Antecedentes judiciales: Informe cumplimiento condena en Puerto Montt: Lesiones menos graves y Robo con violencia. Persiste amenazante, exaltado. Paranoide. Durante la tarde amenaza con colgase, cortarse o quemar colchón, cuelga sabana de ventana e intenta ahorcarse. Primera sesión de TEC, Cisordinol accutard. Contención física, Sujeciones. Modecate. Cortes en antebrazo, Amenaza con matar otros pacientes, al apagar las luces se sienta en cama de otro paciente en actitud intimidante, lo agrede con lápiz en ojo derecho. Reinicia TEC, Inicia clozapina 25mg/día. Hostil y desafiante ante funcionarios por el encuadre, Baja en recuento de blancos, inicia litio. Algo hostil y querellante con personal, probablemente relacionado con suspensión de TEC (20 sesiones). Clozapina 450mg/día, Litio 600 mg/día. Traslado de paciente para sala de aislamiento, Se retira chapa de aislamiento ­ Sala de observación, Cuidador especial constante, hombre, Mitones, solicitud a UGC apoyo

Patient of 25 years old. Entrance to Emergency Service. Patient comes alone, untidy, reports multiple bizarre ideas, not systematized. Lax thought, mumble, interfered, discordant at times. Diagnosis: Schizomorphic syndrome. Legal background: Condemning Report in Puerto Montt: Less serious injuries and robbery with violence. He persists threatening, exalted. Paranoid. During the afternoon threatens to hang, cut or burn mattress, hangs a blanket in window and tries to hang himself. First session of TEC, Cisordinol accutard. Physical restraint, Supports. Modecate. Cuts in forearm. Threat to kill other patients, when turning off lights sits in bed of another patient in intimidating attitude, strikes him with pencil in right eye. Restart TEC, Starts clozapine 25mg / day. Hostile and challenging with officials because of setting, White cells: Low counting, initiating lithium. Somehow hostile and prosecuting with staff, probably related to ECT suspension (20 sessions). Clozapine 450mg / day, Lithium 600mg / day. Transfer of patient to isolation room, Removal of insulation sheet - Observation room, Special caregiver constant, male, Mittens, request to UGC support.

Medialization and stabilization of the middle turbinate using a nasal septal flap in endoscopic sinus surgery

Objectives: To propose a simple technique to preserve, medialize and stabilize the middle turbinate through a planned medial synechiae formation using a nasal septal flap Methods: a. Study Design: Case series, surgical innovation b. Setting: Tertiary hospital (Kumamoto University Hospital, Japan) c. Participants, Patients or Population: Six patients suffering from chronic sinusitis unresponsive to medication. The indication for doing this technique was unstable turbinates after removal of diseased mucosa. Results: Twelve weeks after surgery, the patients reported significant resolution of symptoms (headache, nasal congestion, rhinorrhea, post-nasal drip and loss of smell). CTand endoscopic findings likewise revealed clear ostio-meatal complex, drained sinuses, and complete removal of polypoid mucosa. No major side effects were noted. Conclusions: This technique is especially encouraged when surgeons encounter an unstable middle turbinate after removing massive pathologic mucosal lesions. This is a preliminary report and further investigations are being carried out to validate the technique. (Author)