bluuebunny/crossref_metadata_2025_split huggingface dataset:
Role of Structured Feedback of Direct Observation of Procedural Skills in improving Clinical Skill of Interns
Authors: Eralil Georgy J 
Published: July 2019

ABSTRACT

Objectives

To assess clinical skills of interns in selected procedures using direct observation of procedural skills (DOPS)
To assess the change in procedural skills among students who received a structured feedback on DOPS.

Materials and methods
The study was interventional and conducted between December 2015 and February 2016 at the Department of Obstetrics and Gynaecology of Sree Narayana Institute of Medical Sciences, Ernakulam, Kerala, India. In the study, investigator observed the trainee performing a practical procedure within the workplace and recorded a rating for each competency on the assessment form. Feedback was given expanding on the reasons for any ratings of development required and makes practical suggestions for any remedial steps. The intern is reassessed for the same procedure at a later stage and the impact on skills is scored. Then the structured feedback is provided, and later on again the score on skills obtained by DOPS are compared between pre- and post-values by Wilcoxon-signed rank test.

Results
The average of pre- and post-feedback values were compared by Wilcoxon signed rank test. The p-value calculated was <0.001, which is significant. None of the interns were competent to perform the procedure before feedback; 80% of them needed more practice and 20% needed supervision. After feedback, 53.3% achieved competency and 46.7% achieved competency needing supervision; 93.3% of interns regarded feedback as superior quality, while 6.7% regarded as satisfactory.

Conclusion
Direct observation of procedural skills can be used to assess clinical skills of interns in selected procedures and it brings changes in procedural skills among students who received a structured feedback on DOPS.

How to cite this article
Eralil GJ. Role of Structured Feedback of Direct Observation of Procedural Skills in improving Clinical Skill of Interns. J Postgrad Med Edu Res 2017;51(1):22-27.
Basaloid Squamous Carcinoma arising at Splenic Flexure of Colon
Authors: Vellaisamy Gnanapriya , Rout Pritilata , Crasta Julian , Ravikumar Gayatri 
Published: July 2019

ABSTRACT
Basaloid squamous carcinoma occurs most commonly in the upper aerodigestive tract. In the colon, the most common location is in the anal canal and is rarely reported proximal to the anal verge. Six cases are reported in the published literature, of which five are located distal to the splenic flexure. Outside the anal canal, it has been postulated that they arise from the basal cells, squamous metaplastic cells, or the cloacogenic embryologic cell rests. We report a case of a 57-year-old male patient who presented with short duration of abdominal pain and weight loss. Computed tomography (CT) abdomen revealed an irregular circumferential thickening in the terminal transverse colon, splenic flexure, and proximal descending colon. Colonoscopy showed a stricture in the splenic flexure, which was suspected for malignancy. Endoscopic biopsy was reported as poorly differentiated carcinoma. Left extended hemicolectomy was done, and a diagnosis of basaloid squamous carcinoma was made on histopathology. The tumor cells were positive for P63, CK 5/6; focally for CDX2; and negative for CK20, chromogranin, and CD56, confirming the histopathological diagnosis of basaloid squamous carcinoma. The patient is currently on adjuvant chemotherapy.

How to cite this article
Vellaisamy G, Ravikumar G, Crasta J, Rout P. Basaloid Squamous Carcinoma arising at Splenic Flexure of Colon. J Postgrad Med Edu Res 2017;51(1):33-36.
Calf Muscles Hypertrophy in Sarcoglycanopathy
Authors: Modi Manish , Choudhary Aditya , Goyal Manoj , Radotra Bishan D , Vasishta Rakesh K , Gaspar Balan L 
Published: July 2019

ABSTRACT
Though calf muscle hypertrophy is thought to be a signatory finding of dystrophinopathies, it can also be observed in other muscular dystrophies. Failure to recognise this may result in diagnostic errors. We present a patient with delta sarcoglycanopathy who had hypertrophy of the brachioradialis, gastrocnemius and extensor digitorum brevis.

How to cite this article
Choudhary A, Goyal M, Modi M, Radotra BD, Vasishta RK, Gaspar BL. Calf Muscles Hypertrophy in Sarcoglycanopathy. J Postgrad Med Edu Res 2017;51(1):40-41.
Assessment of Vertical Skeletal Patterns using a New Cephalometric Parameter: The Dhaval&mdash;Rohan Angle
Authors: Kumar Anil , Hegde Gautham , Lekhadia Dhaval Ranjitbhai , Rai Rohan , Hegde Niveditha , Sorake Abhinay 
Published: July 2019

ABSTRACT

Introduction
The aim of this study was to establish a new cephalometric parameter, named the Dhaval—Rohan angle (DR), to assess the vertical skeletal patterns on a lateral cephalogram with accuracy and reproducibility.

Materials and methods
One hundred and twenty pretreatment lateral cephalograms of the patients visiting the department of orthodontics and dentofacial orthopedics for treatment were obtained and divided into three groups. i.e., horizontal growth pattern, average growth pattern, and vertical growth pattern cases based on the routinely used cephalometric parameters; FMA, SN-GoGn, Y-axis angle and Jarabak ratio. This angle uses three skeletal landmarks, the point C (center of the condyle), point M (midpoint of premaxilla), and point G (center of the largest circle that is tangent to the internal inferior, anterior, and posterior surfaces of the mandibular symphysis).

Results
The one-way analysis of variance (ANOVA) test showed that the three groups studied were not the same for DR angle and the post hoc Tukey test found the groups to be significantly different. According to the Student's t-test, there was no statistically significant difference in mean values of DR angle between males and females.

Conclusion
Cephalometric evaluation of young adults shows that the DR angle below 28.5° indicates a horizontal growth pattern, between 28.5 and 32.5° indicate an average growth pattern and above 32.5° indicate a vertical growth pattern.

How to cite this article
Lekhadia DR, Rai R, Hegde N, Hegde G, Sorake A, Kumar A. Assessment of Vertical Skeletal Patterns using a New Cephalometric Parameter: The Dhaval—Rohan Angle. J Postgrad Med Edu Res 2017;51(1):7-11.
Usefulness of Awake Craniotomy for Low-grade Gliomas in Eloquent Areas
Authors: Bhagat Hemant , Mahakul Dibya J , Aggarwal Ashish , Savardekar Amey R , Ahuja Chirag K , Gupta Sunil K 
Published: July 2019

ABSTRACT
The biggest dilemma in a neurosurgeon's mind while operating upon low-grade gliomas in eloquent areas is—how to achieve maximal tumor excision while preserving the neurological function. This aim is difficult to achieve once patient is under general anesthesia and hence, patient cooperation cannot be sought to know the neurological function. A novel method to overcome this hurdle is to excise gliomas (especially in eloquent areas) in awake stage while constantly seeking patient cooperation to know the corresponding neurological function. In this study, we operated 10 patients in awake stage and achieved reasonable tumor excision with no added deficits at 3 months follow-up. Hence, this technique achieves a compromise between oncological principle of maximal tumor excision while simultaneously following the neurosurgical principle of no new added deficits.

How to cite this article
Mahakul DJ, Aggarwal A, Savardekar AR, Bhagat H, Ahuja CK, Gupta SK. Usefulness of Awake Craniotomy for Low-grade Gliomas in Eloquent Areas. J Postgrad Med Edu Res 2017;51(2):74-78.
Antimicrobial Stewardship Program of Postgraduate Institute of Medical Education and Research, Chandigarh: Running Fast to catch the Missed Bus
Authors: Arora Pankaj , Singh Gurpreet , Agarwal Ritesh , Ray Pallab , Kumar M Praveen , Shafiq Nusrat , Gautam Vikas , Kumar Gautam , Rohilla Rachna , Saha Shruti , Muralidharan Jayashree 
Published: July 2019

ABSTRACT
Antimicrobial stewardship is a coordinated multidisciplinary effort directed at judicious use of antimicrobials. While antimicrobial stewardship is a routine activity in the developed world, the concept has evolved only of late in the developing countries including India. Started initially as a research project, a formal antimicrobial stewardship committee was constituted in the institute. The present article highlights the work done so far, problems faced, and the future of antimicrobial stewardship related activities in the institute.

How to cite this article
Shafiq N, Kumar MP, Kumar G, Rohilla R, Saha S, Gautam V, Agarwal R, Ray P, Singh G, Muralidharan J, Arora P. Antimicrobial Stewardship Program of Postgraduate Institute of Medical Education and Research, Chandigarh: Running Fast to catch the Missed Bus. J Postgrad Med Edu Res 2017;51(3):123-127.
Conventional and Advanced Diagnostic Tools in Oral Cancer with Emphasis on Role of Dentist and Early Detection
Authors: Singla Smit , Verma Akhilesh , Goyal Snehil , Singla Itika , Shetty Anjali 
Published: July 2019

ABSTRACT
The prevalence of oral cancer is increasing worldwide day by day. Those who suffer from oral cancer have low survival rate compared with other cancer, mainly due to delay in the diagnosis, metastases, and presence of secondary tumors. For the dental profession, it is really challenging to diagnose oral precancer or oral cancer, particularly in its early stage of the disease. Early screening and advanced diagnostic tools play an important role in the early diagnosis and treatment planning of patients suffering from oral cancer. The diagnosis method usually includes histopathology and visualization adjuncts, such as toluidine blue, vizilite, etc. This study reviews the development of new upcoming tools for early detection, emphasis on the importance of role of dentist, and early detection of oral cancer.

How to cite this article
Singla S, Verma A, Goyal S, Singla I, Shetty A. Conventional and Advanced Diagnostic Tools in Oral Cancer with Emphasis on Role of Dentist and Early Detection. J Postgrad Med Edu Res 2017;51(3):128-133.
Factors leading to Nonhealing of severe Lip and Tongue Ulceration in a 10-month-old Infant with Spastic Quadriplegia
Authors: Gauba Krishan , Goyal Ashima , Kapur Aditi , Jaiswal Manoj A , Bhandari Sudhir 
Published: July 2019

ABSTRACT
This paper reports a 10-month-old spastic quadriplegic male child presenting with severe ulceration of ventral surface of tongue and lower lip due to the presence of mandibular and maxillary primary central incisors. The patient was on antiepileptic medication since birth. The recent development of ulcers aggravated the already deficient dietary intake due to his compromised medical status. After considering various treatment modalities, a conservative approach to cover the mandibular teeth and gum pads with a splint made in a flexible denture material was decided. The appliance incorporated an extraoral wire component for prevention of risk of inadvertent ingestion and to aid in attaching retentive components as and when needed. The challenges faced by the clinicians and the pitfalls influencing the ultimate outcome with this intervention are described.

How to cite this article
Kapur A, Bhandari S, Goyal A, Gauba K, Jaiswal MA. Factors leading to Nonhealing of severe Lip and Tongue Ulceration in a 10-month-old Infant with Spastic Quadriplegia. J Postgrad Med Edu Res 2017;51(3):140-143.
Sexual Orientation and Behavior in HIV-infected Individuals in Southeast Asia
Authors: Shrikhande Laxmi , Dargan Ritu 
Published: July 2019

ABSTRACT
The response of sexual behavior to HIV is an important input to predicting the path of the epidemic and to focusing prevention efforts. Existing estimates suggest limited behavioral response, but fail to take into account possible differences across individuals. Transmission through sexual contact is estimated to accounts for 75 to 85% of cumulative cases of HIV/AIDS to date. Mode of transmission is important predictors of risk. The statistical risk of infection through vaginal intercourse is notably low regardless of which partner is infected. Anal intercourse has higher infectivity due to the likelihood of damage to epithelial integrity. Generally, the environment for men who have sex with men (MSM), lesbians and transgender individuals is unsupportive and unsafe. They are usually victims of discrimination or more subtly as indifference. The stress on these individuals face as they cope with sexual orientation stigma may help to explain higher rates of risky sexual behaviors and injected drug use. Very little research has focused on Asian youth with altered sexual orientation. These individuals are at a higher risk of contracting the HIV virus than their heterosexual counterparts. Until we acknowledge these behaviors and work with people involved with these behaviors, we are not going to halt and reverse the HIV epidemic. Scaling up services adequately for key populations at higher risk for HIV infection globally, particularly in concentrated epidemics, is essential to halt and reverse epidemics at the population level. It is essential that the expansion of MSM HIV prevention and care services across Asia be driven by an agreed upon set of quality standards and guidelines.
Video Presentation Abstracts
Authors: Sung Tae-Yon , Yoon Jong Ho , Lee Yi Ho , Lee Yu-mi , Chung Ki-Wook , Hong Suck Joon 
Published: July 2019

ABSTRACT

BACKGROUND AND AIMS
In recent times, robot thyroid surgery has been performed worldwide in thyroid tumors, and reducing surgical complication is also an important factor in robot surgery besides thyroidectomy. This study presents the surgical technique of preserving the recurrent laryngeal nerve and parathyroid gland in transaxillary robot thyroid surgery.

METHODS
The drawback of robot thyroid surgery is that it cannot tell how strong the surgeon is holding and retracting the tissues or feels the thermal change when energy device is activated. Dissection or manipulation should be performed by layers and structures. The surgeon should not advance to the next procedure immediately after activating the coagulating energy device when related to tissues for preservation since there could be a thermal injury. After the activation, pause or make contact to a gauze placed in the operative field to check the spread of remaining heat. The shielded side of the device should be placed to the remnant structure side. By doing so, the thermal spread could be minimized. When coagulating vessels, the surgeon should not impatiently manipulate the grasped tissues since they could tear before fully coagulated and encounter bleeding. When preserving the recurrent laryngeal nerve and parathyroid gland, these surgical tips are very important to minimize the injury.

RESULTS
Applying such surgical techniques, the result of preserving the recurrent laryngeal nerve and parathyroid gland is safe and secure in robot thyroid surgery as presented in our video clip.

CONCLUSION
Endocrine surgeons perform functionally safe thyroidectomy and reduce the surgical complications in any type of thyroid surgery. The above-mentioned techniques will help preserve the recurrent laryngeal nerve and parathyroid gland in robot thyroid surgery
Oral Presentation IV
Authors: Cho Jin-Seong , Park Min-Ho , Yoon Jung-Han 
Published: July 2019

ABSTRACT

BACKGROUND AND AIMS
Prophylactic central lymph node dissection with total thyroidectomy (TT) for the treatment of papillary thyroid cancer (PTC) is controversial because of the possibility of increased morbidity with uncertain benefit. We evaluated the changing trends of lymph node ratio (LNR), recurrence, and radioablation therapy. Also, we evaluated the safety of omitting radioablation after TT with PTC, especially on low PNR (positive node ratio) N1a patients compared with high PNR N1a patients.

METHODS
Consecutive 147 N1a and 216 N0 patients who underwent TT with central neck dissection were enrolled. We divided 147 N1a patients into two groups: 96 high-PNR vs 51 low-PNR group according to 50% of PNR, and compared three groups including N0 group.

RESULTS
There were 21/147 (14.3%) recurrences on N1a intermediate-risk patients and 5/216 (2.3%) on N0 low-risk patients. Of these 21 recurrences, 20 (95.2%) occurred in the high-PNR group and only 1 (4.8%) was in the low-PNR group. The recurrence in low-PNR group (Graph 1; green line) was significantly lower than in high-PNR group (red line; log-rank p value = 0.003), but significantly not different from the N0 group (blue line; log-rank p-value = 0.889). Although this study was a retrospective nonrandomized trial with less number of patients, the 10-year recurrence of omitting RAI in low-PNR intermediate-risk N1a patients with less than 50% of PNR was shown to be comparable with 216 N0 low-risk patients.

CONCLUSION
Prophylactic central neck dissection may lead to upstaging and low recurrence, but also to overuse of radioablation. Lymph node ratio could be a useful predictor of recurrence and useful guidance in radioablation therapy.
Oral Presentation II
Authors: Sung Tae-Yon , Yoon Jong Ho , Han Minkyu , Lee Yi Ho , Lee Yu-mi , Song Dong Eun , Chung Ki-Wook , Kim Won Bae , Shong Young Kee , Hong Suck Joon 
Published: July 2019

ABSTRACT

BACKGROUND AND AIMS
To compare robot vs open thyroid surgery using inverse probability of treatment weighting (IPTW) with regard to oncologic safety in papillary thyroid carcinoma (PTC) patients.

METHODS
We enrolled 722 patients with PTC who underwent a total thyroidectomy with central compartment node dissection (CCND) at the Asan Medical Center in Korea from January 2009 to December 2010. These patients were classified into open thyroid surgery (n = 610) or robot thyroid surgery (n= 112) groups. We verified the impact of robot thyroid surgery on clinical recurrence and ablation/control-stimulated thyroglobulin (sTg) levels predictive of non-recurrence using weighted logistic regression models with IPTW.

RESULTS
Age, sex, thyroid weight, extent of CCND, and TNM stage were significantly different between the two groups (p < 0.05); however, there was no significant difference in the recurrence rate between the open and robot groups (1.5 vs 2.7%; p = 0.608). The proportion of patients with ablation sTg < 10.0 ng/mL and control sTg < 1.0 ng/mL was comparable between the two groups (p > 0.05). Logistic regression with IPTW using the propensity scores estimated by adjusting all of the parameters demonstrated that robot thyroid surgery did not influence the clinical recurrence (OR: 0.784; 95% CI: 0.150–3.403; p = 0.750), ablation sTg (OR: 0.950; 95% CI: 0.361–2.399; p = 0.914), and control sTg levels (OR: 0.498; 95% CI: 0.190–1.189; p = 0.130).

CONCLUSION
Robot thyroid surgery is comparable to open thyroid surgery with regard to oncologic safety in PTC patients.
Reference Values for the Adolescent/Adult Sensory Profile in Spain
Authors: Gándara-Gafo Berta , Santos-del Riego Sergio , Muñiz Javier 
Published: July 2019

Abstract
Importance: In Spain, only one culturally adapted assessment tool is available for children between ages 3 and 11 yr. There are no assessments of adolescent and adult sensory processing, and no normative data.
Objective: To obtain reference values for the Adolescent/Adult Sensory Profile (AASP) in Spain for adolescents (aged 11–17) and adults (aged 18–64 and ≥65).
Design: A multivariate analysis of variance was used to compare specific mean values (−2, −1, +1, and +2 standard deviation [SD]) by age group, gender, geographic area, education level, and employment status.
Participants: We randomly recruited 787 participants (55.8% female) aged 11 yr or older (mean age = 32.1, SD = 21.1) in Spain. We excluded those with a diagnosis of depression, chronic disease (e.g., diabetes, cancer, neurological disease), or cognitive disability and those who used medication that could affect the central nervous system.
Results: Quadrant mean (SD) scores ranged from 29.3 (6.6) for low registration to 49.1 (8.3) for sensory seeking, with significant differences by age group (p &lt; .001) in all quadrants. Significant differences were also found for scores in different quadrants by gender, geographic area, education level, and employment status. Although statistically significant, the differences between scores were not clinically relevant; the mean scores fell within the typical range for sensory processing.
Conclusions and Relevance: We offer reference values for the cultural adaptation to Spain of the AASP and recommend its use for the typically developing Spanish population ages 11 and older.
What This Article Adds: We provide normative data for the AASP for three age groups of the Spanish population: adolescents, adults, and older adults.
Time of sexual maturity and early egg quality of Japanese quails affected by in ovo injection of medicinal plants
Authors: Al-Shammari Karrar I. A. , Batkowska Justyna , Drabik Kamil , Gryzińska Magdalena M. 
Published: July 2019

Abstract. The aim of this study was to evaluate the time to sexual maturity and quality of initial eggs of Japanese quail affected by in ovo injection of plant extracts: ginger (GR), garlic (GC), oregano (O) and cinnamon (C). In total, 2400 eggs of Japanese quails were divided into six groups on the fifth day of incubation. Group I was the control group (NC), which was not injected. Other eggs were injected with 0.1 mL of liquid: group II – the positive control (PC) – with distilled water, group III with 1 % solution of GR, group IV with GC, group V with O and group VI with C. After hatching, the birds were reared in a cage system and fed with balanced mixtures, and 24 h lighting was used. The time at which birds reached sexual maturity was registered, while in the seventh week of rearing, 120 eggs were subject to quality evaluation. The traits of a whole egg (shape index as the ratio of egg width to egg length, weight, specific gravity), shell (strength, weight, thickness and density), albumen (weight, height), yolk (color, weight, index) were evaluated. At the earliest, on 36th day of life, eggs were laid by birds from the GC group, followed by C (37th day), O and NC (38th day), GR (39th day), and PC (41st day). During the first 2 weeks significantly more eggs were collected from the GC than from the other groups. The heaviest eggs derived from GC and GR groups, whereas the lightest came from the C group. Eggs from the GC group had the best shell strength and the greatest proportion of yolk. The use of medicinal herbs by injection in ovo may considerably modify both time of sexual maturity and quality of the initial eggs of Japanese quail.