International Journal of Applied and Basic Medical Research最新文献

Background: Despite the widespread acknowledgment of the need and significance of soft skills (SKs) in health professions education, the subject is not emphasized enough in training students. These skills can be taught to undergraduates through roleplay. Communication skills and teamwork were taught by scenario-based roleplay and assessed in this study.

Objectives: The study aimed to implement scenario-based roleplay as a method of teaching communication skills and teamwork to undergraduate medical students and to assess their perceptions.

Methodology: A prospective study was conducted in the simulation/skills laboratory among 41 Phase I undergraduate medical students. The SKs taught during the sessions included communication skills, empathy, and teamwork.

Results: The mean of the responses obtained from Gap Kalamazoo Communication Skills Checklist score in the first encounter was 27.0, 38.12 in the second encounter, and 41.24 in the third encounter. The mean scores showed a statistically significant difference between E1 and E2, E1 and E3, and E2 and E3. Posttest scores of students to self-efficacy questionnaire showed significant improvement compared to pre-test scores. Students in the present study opined that they could learn the aspects that could not have been learned in didactic lectures about communication skills and teamwork.

Conclusion: Scenario-based roleplay can be used as an effective method for teaching SKs such as communication skills and teamwork for undergraduate medical students. Different scenarios which replicate the real-life situations can be incorporated to help students to learn and face the real-life encounters.

Background: Improvement in the perioperative care has led to increased use of minimally invasive surgeries. Multiple physiological changes during minimally invasive surgeries are attributed to the creation of pneumoperitoneum.

Materials and methods: One hundred and nine patients who underwent laparoscopic cholecystectomy at a tertiary care hospital in north India meeting the inclusion and exclusion criteria were enrolled.

Results: Out of the total 109 patients, 13 were males and 96 females (M:F = 1:7.3), the mean basal metabolic rate was 28.95 kg/m². The mean systolic and diastolic blood pressure of the upper limb were 134.33 + 17.545 and 80.69 + 11.59 respectively. The mean systolic and diastolic blood pressure in lower limb (LL) were 142.32 + 21.552 and 79.44 + 11.94, respectively. Significant rise in the SBP was noticed in LL at the time of creation of Pneumoperitoneum and after changing the position for surgery (P < 0.05). The diastolic pressure in the LL rises significantly in the LL after creation of pneumoperitoneum, at induction, after reverse Trendelenburg position and extubation (P < 0.05). The mean arterial pressure increased significantly in the LL after the creation of pneumoperitoneum and persisted till the extubation (P < 0.05). A significant rise of ankle-brachial index (ABI) was observed in the patients after the creation of pneumoperitoneum and it remained significant till 15 min into surgery (P < 0.05). There was no correlation of ABI with weight and age of the patients on Pearson correlation.

Conclusion: There is rise in ABI of the patients undergoing laparoscopic cholecystectomy at the time of creation of pneumoperitoneum, after Trendelenburg position and 15 min into surgery.

Context: Angiogenesis, the formation of new blood vessels from preexisting vascular network, is essential for tumor growth and spread. Vascular endothelial growth factor (VEGF) is a potent angiogenic growth factor.

Aims: To assess the expression of VEGF in invasive carcinoma of no special type and its correlation with all the known prognostic factors of breast carcinoma.

Settings and design: Descriptive.

Materials and methods: Mastectomy specimens were studied noting the clinical details. The formalin-fixed tissues were subjected to routine processing and hematoxylin and eosin sections and studied extensively for all the histological prognostic factors. Representative sections from each case with the tumor were subjected to immunohistochemistry (IHC) staining with VEGF, estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2/neu) antibodies.

Statistical analysis used: Descriptive statistics, Chi-square tests, contingency table analysis using SPSS for Windows.

Results: One hundred and twelve cases of invasive carcinoma of special type were studied to evaluate various clinicopathological parameters. The association of VEGF with clinicopathological parameters and all the known prognostic factors was studied to note its significance. VEGF overexpression was observed in 69% of the cases. It was noted that larger tumor size, higher histological grade, lymphovascular invasion, nodal involvement, tumor necrosis, high microvessel density, ER negativity, PR negativity, and HER2/neu positivity had a significant statistical association with VEGF overexpression.

Conclusions: We conclude that incorporating VEGF as a biomarker along with the known factors into a prognostic index will not only help predict clinical outcome more accurately, but also determines the patient who can be benefited with combinational therapy including anti-VEGF factors.

Background: Supraglottic devices have revolutionized the current practice of airway management. We compared the clinical performance of a recently introduced BlockBuster™ Laryngeal mask airway with i-gel^® in adult patients under general anesthesia.

Methods: Following Institutional ethical clearance, the present study was conducted on 62 patients belonging to American Society of Anesthesiologists physical status 1 and 2 of either sex in the age group of 20-60 years under general anesthesia. Patients were randomly assigned to i-gel^® (I) and BlockBuster™ (B) groups (31 per group). Time for successful insertion, insertion success rate, ease of insertion, oropharyngeal leak pressures (OLPs), and complications were assessed.

Results: Mean insertion time of device was less in Group I (13.52 ± 2.58 s) than that of Group B (14.10 ± 2.04 s), which was neither clinically nor statistically significant (P = 0.330). OLP in Group B (24.52 ± 2.77 cm of H2O) was found to be significantly higher compared to Group I (20.81 ± 2.56 cm of H2O) with P < 0.001. Overall insertion and first attempt success was similar (i-gel^® 31/31 [100%] and 29/31 [93.5%] and BlockBuster™ 31/31 [100%] and 29/31 [93.5%], respectively). Ease of insertion (P = 0.684) and complications (P = 0.782) of both the devices were comparable.

Conclusions: Both the devices are useful and effective for airway management in adult under general anesthesia. Having a high OLP and comparable insertion time, risk of aspiration may be further reduced with the use of BlockBuster™ in comparison to i-gel^®.

Background: Many effective formulations are available in Ayurveda for various diseases. These formulations are lagging in standardization due to the absence of reference standards, whereas maintaining quality standards of given medicines is the need of an hour. Daruharidradi Ghanvati is one such combination of six herbal drugs containing Daruharidra, Meshshrungi, Vijaysar, Mamajjak, Jambubija, and Methikabij. Each drug is described in various Ayurvedic antidiabetic formulations.

Aim: The present study was aimed at setting a standard pharmacognostical and pharmaceutical profile of Daruharidradi Ghanavati.

Materials and methods: The study included the preparation of Daruharidradi Ghanavati using raw drugs. Later, Daruharidradi Ghanavati was subjected to pharmacognostical, physiochemical, and thin-layer chromatography analysis as per standard protocols.

Results: The final observations were recorded. Pharmacognostical findings matched with that of individual raw drugs with no major change in the microscopic structure of the raw drugs during the preparation of Ghanavati.

Conclusion: The quality of Daruharidradi Ghanavati tablet can be tested by pharmacognostical, physiochemical screening for the observations of the present study.

Introduction: Diagnosing diabetic neuropathy is a challenge at times as it is asymptomatic. Diagnosing diabetic neuropathy involves the use of quantitative sensory testing, nerve conduction study, and autonomic testing. Tempearture threshold testing (TTT) can aid in diagnosing small fiber neuropathy at early stages. This study aimed to assess the small fiber neuropathy using TTT in diabetes mellitus (DM) and correlate with age, duration of diabetes, and lipid profile.

Materials and methods: The study was commenced after obtaining ethics approval from the institute ethics committee. The study participants included 100 patients with type 2 DM of both genders between the ages of 40 and 65 years. The glycemic status and lipid profile were noted along with physical examination. Neuropathy assessment was done using Michigan Neuropathy Screening Instrument (MNSI) and TTT.

Results: The prevalence of small fiber neuropathy based on TTT was 63%. The lipid profile was similar in both the groups. The MNSI B scale had significantly higher scores in the neuropathy group. In the neuropathy group, the thresholds for hot were significantly greater in all four limbs and cold were significantly lower. Age and years of DM were positively correlated with the neuropathy. Hot threshold in the lower limb had shown a strong positive correlation.

Conclusion: The age and duration of diabetes are independent risk factors for diabetic peripheral neuropathy. Small fiber neuropathy is a prequel to the motor neuropathy. Hot threshold testing in the lower limb is more sensitive than cold threshold testing for diagnosing small fiber neuropathy.

Pulmonary sequestration and cystic pulmonary adenomatoid malformation are rare congenital cystic disorders of the lungs. The presence of both the diseases in the same individual is therefore very uncommon. Pulmonary sequestration is a nonfunctional pulmonary tissue mass that derives its blood supply from systemic blood supply other than pulmonary circulation. Congenital cystic pulmonary adenomatoid malformation represents a mass consisting of abnormal bronchiolar air spaces and a deficiency of functional alveoli. This is the case report of a 9-year-old girl with intermittent fever, left-sided chest pain, and cough for the past 15 days along with recurrent coughs since childhood suggestive of hybrid pulmonary sequestration, congenital cystic adenomatoid malformation, and dextrocardia.

The incisive foramen is also called as nasopalatine foramen. It is a funnel-shaped opening in the anterior maxilla which opens immediately behind the central incisor teeth through which nasopalatine blood vessels and nerves pass. The incisive foramen is continuous with the incisive canal or nasopalatine canal (NPC). Variations in size, shape, position, and number of NPCs exist. Anatomical variations in NPC cannot be appreciated on two-dimensional radiographs. A case of anatomical variation of the nasopalatine canal misdiagnosed as a periapical cyst is discussed.

Background: Standard histopathological parameters such as depth of invasion (DOI), lymphovascular invasion (LVI), and perineural invasion (PNI) are known parameters that can correlate with the prognosis and aggressiveness of oral squamous cell carcinomas (OSCCs). Tumor budding (TB) (≤5 tumor cells at infiltrating borders) and pattern of invasion (POI) are emerging histopathological parameters that have shown promising results as reliable risk factors in predicting nodal metastasis in early OSCCs.

Aim: The aim of the study was to assess TB and POI in OSCCs.

Materials and methods: A total of 33 surgical resection specimens of OSCC, including buccal mucosa and tongue with neck dissection, were selected. TB and POI along with standard parameters such as grade, DOI, LVI, PNI, lymph node status, and pathological staging were evaluated. These parameters were analyzed in comparison with lymph node involvement and pathological stage of the tumor using the Chi-square and Fischer's exact test. The SPSS software, v21, was used for statistical analyses.

Results: Most of OSCC were moderately differentiated tumors (63.64%). TB was present in 23 cases, in which 69.57% of cases showed low TB (<5 buds), while 30.43% of cases had higher TB (>5 buds). The worst POI (Patterns 4 and 5) was seen in 75.76% of cases. TB, POI, grade, PNI, DOI, and stromal pattern were significantly associated with the pathological stage of the tumor.

Conclusion: TB and POI are important and reliable in histopathological parameters in OSCCs.