bluuebunny/crossref_metadata_2025_split huggingface dataset:
Development of Analytic Rubric for Assessing Written Assignments for Evaluating Higher Order Cognition in the First Phase Neuroanatomy Module
Authors: Rani Anita , Gupta Sarika , Sehgal Garima , Singhal Rameshwari 
Published: December 2023

Abstract

Background:
Competency-based medical education has been recently launched for MBBS students in India by the National Medical Council. Successful implementation of the new curriculum requires not only concrete evidence of acquisition of competencies but also proper feedback to students for his growth in the required direction. In the first phase MBBS program, in the neuroanatomy module, frequently students’ ability to correlate patients’ signs and symptoms is asked during examinations to assess higher order cognitive skill. These questions are usually asked in written assessments as short essay responses. Currently, the use of analytic rubrics is limited in medical students’ written assessment. Teachers use their self-developed criteria to grade students for such answers. Analytic rubrics have evidence to improve case writing, presentation, surgical and soft skills. The present study aims to develop an analytic rubric to assess critical thinking abilities in written exams.

Methodology:
The study was carried out at KGMU, Lucknow. After developing the criteria and grading statements, two rounds of modified Delphi method of consensus building were conducted by involving 20 subject experts. The item-level validity index of 0.7 or above was set to retain the descriptors.

Results:
After the two rounds of consensus, an analytic rubric with 7 criteria, each with 3 performance levels as excellent (>75%), satisfactory (50%–75%), and unsatisfactory (<50%), was developed. All criteria and level descriptors were having content validity index above 0.7.

Conclusion:
The developed analytic rubrics with clear expectations will help learners to set their learning goals and faculty to assess their level of achievements more objectively.
Anatomy Teacher’s Perspectives on Using AnaVu: A Novel Low-resource Stereoscopic Projection System for Neuroanatomy Education
Authors: Yohannan Doris George , Oommen Aswathy Maria , Raju Nithin Kadakampallill , Thomas Bejoy , Rajan Jayadevan Enakshy , Govindapillai Umesan Kannavilakom , Harish Pawan , Kapilamoorthy Tirur Raman , Kesavadas Chandrasekharan , Sivaswamy Jayanthi 
Published: December 2023

Abstract

Background:
The authors had earlier studied the utility of stereoscopic projection of neuroanatomic three-dimensional models through AnaVu (a low resource stereoscopic projection system) on medical students. The tool was developed by collaboration between anatomy teachers, radiologists, and visualization experts. Although the preliminary results indicated advantages in learning, the perspective of the anatomy teachers, the end users of the tool, was not known and hence this study.

Methodology:
A cross-sectional study of the observational nature was conducted where Faculty of South Kerala was informed that they will be given an opportunity for a hands-on experience to use AnaVu. A 15-min session was given to each teacher. Their feedbacks were collected using a prevalidated questionnaire tool and open comments were also collected. Analysis was done using the software SPSS and RQDA.

Results:
Thirteen faculty members participated in the study. Quantitative analysis showed that teachers were able to teach (4 ± 0.57), likely to use it for teaching if made available (4 ± 0.71), found it easy to use (3.31 ± 0.48), and realistic to anatomy (3.62 ± 0.87). Qualitative analysis showed general appreciation and advantage in teaching spatial anatomy. Faculty also pointed limitations such as lack of interaction with students, eye strain, and need for training to use the tool.

Conclusion:
The study points to the utility of AnaVu, a low resource tool in teaching spatial anatomy. The study also dealt with the concerns that need to be addressed during the scaling of such a tool for utility in the Indian Anatomy education scenario.
Pedagogical Strategies in Medical Anatomy: A Comprehensive Review
Authors: Pandurangam Gayathri , Gurajala Swathi 
Published: December 2023

Abstract
Human anatomy is not just a subject at the level of basic sciences, but also it forms the foundation of medical and allied health sciences. A thorough understanding of the structure of the human body is crucial for students to diagnose and treat various health conditions. Hence, providing a deep insight into the subject with more hours dedicated to practical sessions was the trend followed in previous times. The reduction of teaching hours for anatomy as a part of curriculum change, the difficulty faced by the students to learn the subject within a short span, and the emphasis on anatomy faculty to make it interesting have led to the adoption of various modern teaching strategies and technology to complete the task. The article intends to discuss the contemporary methods of teaching and learning anatomy, elaborating the wide range of approaches and techniques.
During Virtual Anatomy Sessions, do Educators and Learners Feel More at Ease or Anxious? Revisiting the Covid-19 Lock Down Times
Authors: Shinde Amol Ashok , Patel Dinesh K. , Manvikar Purushottam Rao 
Published: December 2023

Abstract

Background:
The COVID-19 pandemic forced the entire education system to accept online teaching as the only way to complete the stalled MBBS teaching-learning. Later, the hybrid mode of teaching was started in many colleges. This study is a revisit to lockdown times from teacher’s and learner’s points of view to determine the various difficulties faced by teachers and learners during online classes.

Methodology:
In this longitudinal questionnaire-based survey, questionnaires in English were given to 750 MBBS students of 2019–2020, 2020–2021, and 2023–2024 batches and 47 MBBS teachers.

Results:
Sixty-three percent of students strongly agreed to selecting classroom lectures over online classes. Teachers faced technophobia in app-based education (39%) and absence of response while teaching (18%) as difficulties during online classes. Internet connection issues and unfriendly learning management system applications were the issues faced by the students.

Conclusion:
The integration of offline and blended learning can make teaching by teachers and interpretation by students better.
A Study Based on Perception of First Phase Undergraduate Medical Students and Faculty on Integrated Teaching in Anatomy
Authors: Konar Sudipto , Sarkar Sreetama , Mondal Maloy Kumar , Aggarwal Prerana 
Published: December 2023

Abstract

Background:
Integrated teaching has been recognized by the National Medical Commission as an effective method for enhancing knowledge and clinical correlation abilities among undergraduate medical students. This study aimed to assess the perceptions of first-phase undergraduate medical students and faculty toward the vertically integrated teaching–learning sessions in anatomy.

Methodology:
Three sessions of shared integration were conducted in the department of anatomy, involving the departments of surgery and orthopedics. After completion of the sessions, 147 students and 47 faculty members filled out prevalidated questionnaires to assess their perception of the integrated sessions. Feedback from the faculty was also taken. Statistical analysis was done by expressing the responses to the questionnaire on the five-point Likert scale as frequencies.

Results:
More than 85% of the students and faculty found these sessions engaging, interesting, and useful for understanding clinical problems related to anatomy. The students and faculty perceived the knowledge gained during these sessions as beneficial for answering university examination questions and for future clinical phases. However, 66% of the faculty expressed concerns about the time and coordination required for these sessions, and 89% considered arranging them challenging due to limited workforce availability.

Conclusion:
The findings indicate that undergraduate medical students perceive integrated teaching as a practical approach for acquiring anatomical knowledge and correlating it with the clinical aspects of a problem. Faculty members also acknowledged the usefulness of these sessions, but the challenges of regular arrangement were also highlighted. These results emphasize the importance of balancing clinical and anatomical education and provide insights for implementing integrated teaching strategies in the undergraduate medical curriculum.
Prevalence and Distribution of Postvoid Residual Urine Volume in a Hospital-Based Sample of Men with Symptomatic Benign Prostatic Hyperplasia
Authors: Anyimba SK , Amu OC , Nnabugwu II , Okoh AD , Nwachukwu CD , Iwenofu CA 
Published: December 2023

Background:
Benign prostatic hyperplasia (BPH) is a known cause of bladder outlet obstruction (BOO) in aging men. Patients present with lower urinary tract symptoms (LUTS), elevated postvoid residual urine (PVR), and reduced peak flow rate of urine. Although urodynamic study is the gold standard for diagnosing and quantifying BOO, it is invasive and as such urologists in their routine practice frequently rely on less invasive methods like PVR estimation to objectively assess BOO.

Aim:
To study the prevalence and distribution of PVR in a hospital-based population of men with symptomatic BPH.

Materials and Methods:
Patients aged 40 years and above were enrolled for the study. History was taken from each of the 170 participants recruited, and physical examination was done including digital rectal examination. Every one of them completed the International Prostate Symptom Score (IPSS) questionnaire and also had ultrasonography assessment of PVR. Relevant laboratory investigations (PSA, renal function test, full blood count, urinalysis, and urine culture) and uroflowmetry to determine the peak flow rate of urine (Qmax) were done.

Results:
A total of 170 subjects who met the inclusion criteria were enrolled for this study. The mean age of the subjects was 63.70 ± 9.92 years with a range of 42–88 years. The subjects had a mean PSA of 2.68 ± 0.91 ng/ml and a mean prostate volume of 70.8 ± 39.5 ml. The prevalence of significant PVR was 57.06%. The distribution of PVR was skewed with values ranging from 4.0 ml to 382.9 ml, a median value of 60.5 ml (interquartile range, IQR, =25.0–100.76), and a mean value of 77.70 ± 69.30 ml. An IPSS range of 8 to 23 with a mean value of 13.64 ± 4.14 and a median value of 13 (interquartile range = 10.0-16.0) was observed. The Qmax range was from 5 ml/s to 50 ml/s with a mean value of 20.25 ± 9.70 ml/s, and a median value of 18.0 ml/s (interquartile range = 14.0–24.0).

Conclusion:
This study showed that the prevalence of significant PVR volume among men with symptomatic BPH in our environment is high. There was also a high variation in the distribution of PVR among the subjects. Therefore, it is essential to create more public awareness especially among men in their fourth decade of life and above to visit a urologist whenever they have BPH symptoms so as to avoid impairment in quality of life and renal function associated with neglected significant PVR.
Percutaneous Radiofrequency Disc Decompression: A Study of 27 Patients
Authors: Živković N , Ruetten S , Tasić G , Janicijević A , Jelena K , Nikola J , Andjelković I , Jovanović S 
Published: December 2023

Background:
Percutaneous radiofrequency nucleoplasty is a true minimally invasive technique for treatment for radiculopathy caused by contained disc protrusions. This minimally invasive procedure uses controlled thermoablation for reducing the intervertebral disc and decompressing the lumbar nerve root. Material and Methods: Our study is a prospective analysis of 27 patients aged from 30 to 64 years with lumbar disc protrusion who were treated with percutaneous radiofrequency disc decompression (PRFD) between May 2018 and May 2019. Clinical follow-up was reported at 1 month, 3 months, and 6 months. The outcomes were assessed using a visual analog scale (VAS) and MacNab score.

Results:
Of the 27 patients, 14 were female and 13 were male. Their mean age was 53 ± 2 years. In all 27 patients, percutaneous radiofrequency nucleotomy was performed. An excellent outcome as reflected by MacNab score was observed in 17 patients (63%), a good outcome in 8 patients (29.7%), and a poor outcome in 2 patients (7.3%). Prior to treatment, the average back and leg VAS scores were 7.95 and 7.82, respectively. At sixth month follow-up, the back and leg VAS scores were reduced to 3.17 and 3.04, respectively. Patients with a poor outcome developed early recurrent disc prolapse and required endoscopic discectomy.

Conclusion:
PRFD is a safe and effective treatment of contained disc protrusion. PRFD is a good alternative to surgery. These procedures significantly increase quality of life in patients with lumbar radiculopathy.
Quality and Quantity of Nucleic Acids Extracted from Formalin-Fixed Paraffin-Embedded Lymphoma Biopsies from Nigerian Archived Biopsy
Authors: Uzoma IC , Taiwo IA , Ugwu NI , Durosinmi MA , Akinloye O 
Published: December 2023

Background:
Integrity of nucleic acids derived from archived formalin-fixed paraffin-embedded (FFPE) cancer specimens affects diagnosis, prognosis, and therapy. Several factors affect the quality and quantity of extracted nucleic acids and one of such factors is storage period.

Aim:
We investigated the impact of storage duration on the quality and quantity of nucleic acids extracted from archived FFPE lymphoma biopsies in Nigeria.

Materials and Methods:
A total of 53 FFPE biopsies diagnosed as lymphoma stored over several years (2008–2019) were analyzed. They were 22 chronic lymphocytic leukemia (CLL) cases, 17 Hodgkin lymphoma (HL) cases, and 14 diffuse large B-cell lymphoma, not otherwise specified (DLBCL, NOS). DNA was extracted from all the lymphoma samples which were analyzed for integrity and amplifiability using the four pairs of control genes polymerase chain reaction (PCR) primers of BIOMED-2 protocol, whereas RNA extraction was from 6 CLL cases used for qPCR analysis of RNU43.

Results:
For CLL, the mean DNA yield was 193.6 ng/µl (range: 3.0-533.0 ng/µl), whereas the mean A260/A280 ratio was 1.7 (1.2-1.9). For DLBCL, NOS, and HL, 255.5 ng/µl (range: 32.9-605.4 ng/µl), 1.8 (1.5-2.0) and 242.7 ng/µl (range: 1.3-886.0 ng/µl), and 1.7 (0.9-1.8), respectively. The extracted DNA gave amplifiable products of at least 200bp, whereas the RNA analysis showed CT values of <38 in all the samples. The mean RNA yield was 462.2 ng/µl (range: 74.7-1082.1), whereas the mean A260/A280 was 1.7 (1.5-1.8).

Conclusion:
Quantity and quality of nucleic acids from FFPE tissues stored for different time periods showed no significant difference in yield and quality.
The Relationship between Choroidal Thickness and Liver Damage in Simple Auto-immune Hepatitis Patients
Authors: Song D , Rong Y , Zhang C , Sun Y 
Published: December 2023

Background:
There was no sufficient clinical evidence on the relationship between auto-immune hepatitis (AIH) and risk of eye illness, except 11 uveitis cases where related AIH is reported currently.

Aim:
To determine the relationship between choroidal thickness (ChT) and liver damage in simple AIH patients without ocular symptoms after oral prednisone treatment.

Patients and Methods:
This prospective observational study included simple AIH patients. The patients’ ChT was measured by swept-source (SS)-optical coherence tomography (OCT), and the liver damage was evaluated by alanine aminotransferase (ALT) and aspartate aminotransferase (AST). ChT and liver functions were assessed prior to and after treatment. Then comparisons were made prior to and post treatment. The relationships between biochemical indexes of liver injury and ChT were evaluated after a mean (SD) of 24 (1.28) weeks of regular oral prednisone.

Results:
A total of 35 patients (31 females, aged 45.66 ± 11.62 years) were included. After treatment, ChT was significantly increased in all sectors (including the center sector, superior inner sector, inner nasal sector, inferior inner sector, inner temporal sector, superior outer sector, outer nasal sector, inferior outer sector, and outer temporal sector) (all P < 0.001). After treatment, both ALT (51.34 ± 44.16 vs 255.06 ± 107.84, P < 0.001) and AST (38.66 ± 27.12 vs 164.89 ± 85.58, P < 0.001) were significantly decreased. The increase of ChT in all sectors was significantly related to the decrease of ALT and AST (all P < 0.001).

Conclusion:
The improvement of ChT might reflect the remission of liver damage in simple AIH patients without ocular symptoms during oral prednisone treatment.
An Evaluation of the Effect of Using Irrigations at Different Temperatures on Pain, Edema, and Trismus during the Extraction of Bilateral Impacted Mandibular Third Molars: A Randomized Split-Mouth Clinical Trial
Authors: Dayanan C , Ozupek MF , Seyrek NK 
Published: December 2023

Background and Aim:
The surgical extraction of impacted wisdom teeth is a standard practice in dentistry. Unfortunately, inflammatory reactions such as discomfort, edema, and trismus frequently jeopardize patients’ well-being after the extraction of third molars. Saline solutions at room temperature (25°C) are routinely used in impacted tooth extraction. Refrigerated saline solutions were used to work with cold solutions, and as the refrigerator temperature was 4°C, this study was designed to have a cold solution temperature of 4°C. This study aimed to assess the influence of saline irrigation at various temperatures (4°C, 25°C) on postoperative edema, pain, and trismus after the extraction of impacted third molars.

Materials and Methods:
Eighteen patients with bilateral symmetrical mandibular impacted third molars were enrolled in this split-mouth, randomized, prospective, double-blind clinical trial. For each patient, one side was irrigated with a saline solution (% 0.9 isotonic sodium chloride) at 4°C (test), and the other side was irrigated with a saline solution at room temperature (25°C) (control). Pain, trismus, and facial edema were noted on the 2nd, 4th, and 7th days. A Mann–Whitney U-test was used to compare pairs, and a Wilcoxon signed-rank test was used to compare groups.

Results:
The two groups had no considerable differences in terms of pain levels and facial edema (P > 0.05). Regarding trismus, the maximum mouth opening for cold irrigation (4°C) was significantly higher than for room temperature irrigation (25°C) across all postoperative periods (P < 0.05).

Conclusion:
Cold irrigation therapy (4°C) exerts beneficial effects more than room temperature (25°C) irrigation on the trismus after impacted mandibular third molar surgery.
Discharge against Medical Advice in Eight Tertiary Hospitals in Nigeria: A Prospective Study
Authors: Anyaehie UE , Ede O , Edomwonyi EO , Ekwedigwe HC , Toluse AM , Muoghalu ON , Okoh N , Dabkana TM , Esan O , Ajiboye LO , Shodipo OM , Anikwe IA 
Published: December 2023

Background:
Discharge against medical advice (DAMA) is when a patient decides to leave the hospital without the consent of the treating physician. It poses serious clinical, ethical, and legal challenges to the individual physician as well as the hospital.

Aim:
To determine the prevalence and reasons for DAMA in orthopedic departments of eight tertiary hospitals in Nigeria.

Materials and Methods:
This was a prospective multi-center descriptive study undertaken in eight tertiary Nigerian hospitals. Consecutive patients who requested for DAMA within 1 year of the study and who consented to participate in the study had face-to-face interviews. Data obtained were documented in a questionnaire and analyzed with SPSS version 20.

Results:
The total number of patients studied was 373 with a mean age 34.7 ± 17.5 years. About a quarter of them (25.5%) were between 31 and 40 years. A prevalence rate of 1.9% was found with financial constraint being the predominant reason for DAMA (40.8%). Other reasons include family preference for unorthodox treatment (18.8%) and treatment dissatisfaction (7.0%) among others.

Conclusion:
The study findings indicate a low DAMA rate when compared to previous studies in this region. It also indicates that financial constraints, family preference for unorthodox care, and low educational status are major drivers of DAMA. Deepened health insurance and other measures that can reduce the prevalence of DAMA should be prioritized to improve treatment outcomes.
Return to Community Mental Health Centers after the Pandemic: A Qualitative Study on Turkish Patients’ Subjective Experiences
Authors: Türk A , Ünsal E , Engin E , Kayahan B 
Published: December 2023

Background:
Community mental health centers (CMHCs) are important institutions for individuals with chronic mental illness. During the COVID-19 period, patients with mental health could not optimally access care in CMHCs.

Aim:
To explore the experiences of patients using a CMHC after its closure due to the COVID-19 pandemic.

Patients and Methods:
This was a descriptive qualitative study that included 16 patients with mental disorders who regularly used CMHCs during the pre-pandemic period. Their data were collected between March 2022 and August 2022 using face-to-face, in-depth semi-structured interviews. All interviews were recorded and the content analysis method was used to analyze the data.

Results:
The age range of the 16 study participants was 29–53 years with a mean age of 40.8 ± 6.5 years. Nine (56.3%) participants were men, and 7 (43.7%) were women. Ten (62.5%) participants had schizophrenia, whereas 6 (37.5%) had bipolar disorder. According to content analysis, the five main themes that emerged based on the statements of participants were the effects of change, difficulties experienced, support needs, coping experiences, and suggestions. The results showed that although patients using CMHCs are struggling with the adverse consequences of the pandemic process, they also have difficulty managing their diseases and daily life due to their inability to access psychosocial services in the CMHCs.

Conclusion:
The patients reported their negative experiences and need for support during the pandemic. The study highlights the need to adequately accommodate mental health services delivery during future pandemics that may impose movement restrictions.
Fixed-drug eruption following first dose of SARS-CoV-2 (COVID-19) vaccine approved for children, an adverse event following immunization
Authors: Amrutiya Marut , Gorasiya Amit , Mistry Ankit , Malhotra Supriya 
Published: December 2023

Abstract:
Bullous fixed-drug eruption (FDE) is a rare but potentially severe cutaneous drug reaction that presents with erythema, edema, and bullae formation. FDE lesions are often caused by drugs such as antibiotics, anticonvulsants, and nonsteroidal anti-inflammatory drugs. The diagnosis of FDE is primarily clinical and may be supported by histopathological examination. Treatment for FDE lesions involves immediate discontinuation of the offending drug and supportive care, including topical and systemic corticosteroids. There is growing evidence to suggest that both COVID-19 and its vaccination can induce skin reactions. We report a case of a 14-year-old girl who developed a bullous FDE lesion following an anti-COVID-19 SARS-CoV-2 immunization.