ABSTRACT
Isolated limb weakness (monoparesis) has many possible etiologies. Although often assumed to be of a peripheral cause, it can be of central origin. This article describes a case from the Emergency Department of left lower limb weakness in a walk-in male patient on no medications, who had a 50-pack-year smoking history, type II diabetes, and asymptomatic atrial fibrillation. The patient had no history of previous episodes or trauma. His vitals were normal, and his speech and facial function were intact. The patient had full function of his upper limbs, no sensory deficits, and equal reflexes bilaterally. The singular clinical finding was decreased strength in the left leg compared to the right. Imaging revealed a right frontal intraparenchymal hemorrhage, which remained stable throughout his hospital admission. His muscle weakness was significantly improved upon discharge. In general, strokes can present with a variety of symptoms, which increase the risk of misdiagnosis. Monoparesis can be the singular sign of a stroke, and it is more common in the upper than the lower limbs.
ABSTRACT
BACKGROUND: The authors evaluated the effectiveness of using a patient simulator (MARC Patient Simulator [MARC PS], BlueLight analytics, Halifax, Nova Scotia, Canada), to instruct dental students (DS) on how to deliver energy optimally to a restoration from a curing light. Five months later, the authors evaluated the retention of the instruction provided to the DS. METHODS: Toward the end of the DS' first year of dental education, the authors evaluated the light-curing techniques of one-half of the class of first-year DS (Group 1) before and after receiving instruction by means of the patient simulator. Five months later, they retested DS in Group 1 and tested the remaining first-year DS who were then second-year DS and who had received no instruction by means of the patient simulator (Group 2). They gave DS in Group 1 and Group 2 MARC PS instruction and retested them. The authors also the tested fourth-year DS (Group 3) and dentists (Group 4) by using the MARC PS before giving any instruction by means of the MARC PS. RESULTS: The results of one-way analysis of variance (ANOVA) showed that there were no significant differences in the ability of dentists and DS to light cure a simulated restoration before they received instruction by means of the patient simulator (P = .26). The results of two-way ANOVA and Fisher protected least significant difference tests showed that after receiving instruction by means of the patient simulator, DS delivered significantly more energy to a simulated restoration, and this skill was retained. There were no significant differences between DS in Group 1 and Group 2 after they had received instruction by means of the patient simulator. CONCLUSIONS: The abilities of dentists and DS to light cure a simulated restoration were not significantly different. Hands-on teaching using a patient simulator enhanced the ability of DS to use a curing light. This skill was retained for at least five months. PRACTICAL IMPLICATIONS: The education provided to dentists and DS is insufficient to teach them how to deliver the optimum amount of energy from a curing light. Better teaching and understanding of the importance of light curing is required.
