ABSTRACT
Background: Understanding the style of learning and thinking (SOLAT) of the students is necessary to keep students actively involved in learning, which could influence the academic performance of the students. Aim: The objective of this study was to compare the right and left hemisphere preferences for processing information with academic performance of medical students in both theory and practical exams. Materials and Methods: The hemispheric preference score for learning and thinking style among first year MBBS (95) and BDS (42) students was determined by SOLAT tool prepared by Dr. V. Venkataraman (1994). A comparison of the hemispheric score between high achievers and low achievers in theory and practical exams was performed by using the unpaired Student's t-test and Mann-Whitney U-test. Results: The mean hemispheric scores for the right hemisphere, left hemisphere, and whole brain were 26.51, 14.5, and 6.76, respectively. High achievers in theory exam and practical exam received a higher left-hemispheric score and whole-brain score than low achievers; the difference in the mean value of hemispheric score was statistically not significant. Conclusion: There was no statistically significant relationship between academic achievement and hemispheric preference scores.
ABSTRACT
There is limited literature of objective assessments of foramina of skull base using computed tomography (CT) scan. This study was carried out to analyze the dimensions of foramen ovale (FO), foramen spinosum (FS), and foramen rotundum (FR) using CT scan imaging of the human skull and their associations with sex, age, and laterality of the body. Materials and methods: A cross-sectional study was carried out in the Department of Radiodiagnosis and Imaging at BP Koirala Institute of Health Sciences (BPKIHS), Nepal using a purposive sampling method. We included 96 adult patients (≥18 years) who underwent CT scan of the head for any clinical indications. All those participants below 18 years, inadequate visualization or erosions of skull base foramina, and/or not consenting were excluded. Appropriate statistical calculations were done using the statistical package for social sciences (SPSS), version 21. The P-value of less than 0.05 was considered statistically significant. Results: The mean length, width, and area of FO was 7.79±1.10 mm, 3.68±0.64 mm, and 22.80±6.18 mm2, respectively. The mean length, width, and area of FS was 2.38±0.36 mm, 1.94±0.30 mm, and 3.69±0.95 mm2, respectively. Similarly, the mean height, width, and area of FR was 2.41±0.49 mm, 2.40±0.55 mm, and 4.58±1.49 mm2, respectively. The male participants had statistically significant higher mean dimensions of FO and FS (P<0.05) than the female participants. There were statistically insignificant correlations of dimensions of these foramina with age and between the left and right side of each foraminal dimensions (P>0.05). Conclusions: The sex-based difference in dimensions of FO and FS should be clinically considered in evaluating the pathology of these foramina. However, further studies using objective assessment of foraminal dimensions are required to draw obvious inferences.
ABSTRACT
During health emergencies such as the COVID-19 pandemic, healthcare workers face numerous ethical challenges while catering to the needs of patients in healthcare settings. Although the data recapitulating high-income countries ethics frameworks are available, the challenges faced by clinicians in resource-limited settings of low- and middle-income countries are not discussed widely due to a lack of baseline data or evidence. The Nepali healthcare system, which is chronically understaffed and underequipped, was severely affected by the COVID-19 pandemic in its capacity to manage health services and resources for needy patients, leading to ethical dilemmas and challenges during clinical practice. This study aimed to develop a standard guideline that would address syndemic ethical dilemmas during clinical care of COVID-19 patients who are unable to afford standard-of-care. A mixed method study was conducted between February and June of 2021 in 12 government designated COVID-19 treatment hospitals in central Nepal. The draft guideline was discussed among the key stakeholders in the pandemic response in Nepal. The major ethical dilemmas confronted by the study participants (50 healthcare professionals providing patient care at COVID-19 treatment hospitals) could be grouped into five major pillars of ethical clinical practice: rational allocation of medical resources, updated treatment protocols that guide clinical decisions, standard-of-care regardless of patient's economic status, effective communication among stakeholders for prompt patient care, and external factors such as political and bureaucratic interference affecting ethical practice. This living clinical ethics guideline, which has been developed based on the local evidence and case stories of frontline responders, is expected to inform the policymakers as well as the decision-makers positioned at the concerned government units. These ethics guidelines could be endorsed with revisions by the concerned regulatory authorities for the use during consequent waves of COVID-19 and other epidemics that may occur in the future. Other countries affected by the pandemic could conduct similar studies to explore ethical practices in the local clinical and public health context.
Subject(s)
COVID-19 Drug Treatment , COVID-19 , COVID-19/epidemiology , Ethics, Clinical , Evidence-Based Medicine , Health Services , Humans , Nepal , Pandemics , Practice Guidelines as TopicABSTRACT
INTRODUCTION: Length of long bones is taken as an important contributor for estimating one of the four elements of forensic anthropology i.e., stature of the individual. Since physical characteristics of the individual differ among different groups of population, population specific studies are needed for estimating the total length of femur from its segment measurements. AIM: Since femur is not always recovered intact in forensic cases, it was the aim of this study to derive regression equations from measurements of proximal and distal fragments in Nepalese population. MATERIALS AND METHODS: A cross-sectional study was done among 60 dry femora (30 from each side) without sex determination in anthropometry laboratory. Along with maximum femoral length, four proximal and four distal segmental measurements were measured following the standard method with the help of osteometric board, measuring tape and digital Vernier's caliper. Bones with gross defects were excluded from the study. Measured values were recorded separately for right and left side. Statistical Package for Social Science (SPSS version 11.5) was used for statistical analysis. RESULTS: The value of segmental measurements were different between right and left side but statistical difference was not significant except for depth of medial condyle (p=0.02). All the measurements were positively correlated and found to have linear relationship with the femoral length. CONCLUSION: With the help of regression equation, femoral length can be calculated from the segmental measurements; and then femoral length can be used to calculate the stature of the individual. The data collected may contribute in the analysis of forensic bone remains in study population.
ABSTRACT
The human body dimensions are affected byecological, geographical, populational, sex andage- related factors. Craniometry has wide applications in Forensic Medicine, Plastic Surgery, Orthodontics, Archeology and identification of the origins of ethnical groups. This study was designed to determine the influence of ethnicity on head forms present in adult males and females of Eastern Nepal. This non-interventional comparative cross-sectional study was conducted in a normal healthy pure ethnic population with a sample size of 600 (300 male and 300 female)belonging to a 17-26 age group in the Sun sari and Morang districts of Eastern Nepal. Data were collected among each ethnic group, i.e., Indigenous, Indo-Nepalese and Tibeto-Nepalese, each consisting of 200 individuals (100 male and 100female) between November 2010 to January2012. The Maximum Head Length in mm and Maximum Head Breadth in mm were measured, and Cranial Indices were calculated. Anova and independent t-test were used to compare the means among different groups. A 'P' value o f 0.05 was considered to be statistically significant. Both males and females of Eastern Nepal were Brachycephalic (81.16±3.16 and 81.85±3.02 respectively). The CI of Tibeto-Nepalese, Indigenous and Indo-Nepalese was 84.75±0.99(Brachycephalic), 82.17±1.17 (Brachycephalic), and 77.60±0.65 (Mesocepalic) respectively. The CI were 84.70±1.06 (Brachycephalic), 81.42±1.10 (Brachycephalic) and 77.35±0.67 (Mesocephalic) for Tibeto-Nepalese, Indigenous and Indo-Nepalese males. The CI were 84.80±0.91 (Brachycephalic), 82.92±0.63 (Brachycephalic) and 77.85±0.52 (Mesocephalic)for Tibeto-Nepalese, Indigenous and Indo-Nepalese females respectively. The results showed ethnic variations in all parameters, indicating the influence of ethnicity on cranial anthropometry
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