Enhancing Medical Students' Reflective Capacity: Utilizing Reflective Practice Questionnaire as an Action Research Diagnostic Tool.

Introduction Reflection is the intentional evaluation of one's beliefs or understanding in consideration of the available evidence. Reflection has been noted to enhance profound learning and critical thinking and is an essential foundation of experiential learning. The Reflective Practice Questionnaire (RPQ) is a valid and reliable tool for assessing reflective capacity among medical students. It assesses not only reflective capacity but also other psychological constructs relevant to reflective practice, such as job satisfaction, confidence while interacting with patients, stress during patient interaction, desire for improvement, and feelings of uncertainty. The use of RPQ as a diagnostic tool for improving reflective capacity among medical students is scarcely available in the literature. Thus, the present study aimed to utilize the RPQ for identifying discrete action points for training and future improvement in reflective capacity. Materials and methods The present cross-sectional descriptive study was conducted among 300 medical students of a medical college. To identify the clusters or meaningful subgroups within the study population, cluster analysis was done. Inter-correlation between subscales of RPQ was performed by forming Pearson's correlation matrix to understand the dynamics between various subscales of RPQ. Results Five groups were identified in the cluster analysis: typical (25.6%), reflective (27%), non-reflective (16.7%), unconfident (14%), and overconfident (16.7%). This sets the template for specific action points for each group identified above. Reflective capacity was positively correlated with Desire for Improvement (DfI), General Confidence (CG), Communication Confidence (CC), and Job Satisfaction (JS). It was also positively correlated with negative outcomes such as Uncertainty (Unc) and Stress when Interacting with Patients (SiC). Conclusion RPQ can be used as a diagnostic tool in terms of reflective capacity for action research.

A Case Report on Myotendinous Junction.

Myotendinous junction is the transition zone between the muscle and its tendon. Hence, it is subject to immense stress within the muscle. In this study, it is found that muscles having a greater tensile have a more arranged myotendinous junction compared to muscles with lesser tensile strength. Cadaveric specimens - plantaris, gastrocnemius, and soleus have been histologically studied to study the same.

Computed tomography angiographic study of surgical anatomy of thyroid arteries: Clinical implications in neck dissection.

BACKGROUND: The course and variations of thyroid arteries must be understood by surgeons to prevent bleeding during operative procedures of the thyroid gland. There is limited scientific literature regarding the radiological anatomy of thyroid arteries in this geographical area, the Garhwal region of Sub-Himalayan belt, which is considered to be the endemic belt of goiter. Computed tomography angiography provides a three-dimensional orientation of the vascular and surgical anatomy of the entire cervical region. AIM: To estimate the proportion of variation in origin of thyroid arteries using Computed Tomography Angiography. METHODS: Using Computed Tomography Angiography, the presence and origin of the superior thyroid artery, inferior thyroid artery, and thyroid ima artery were observed and assessed. RESULTS: Out of total 210 subjects, superior thyroid artery was seen to be emerging from external carotid artery in 77.1% cases. The artery was found to be originating at the level of bifurcation of common carotid artery in 14.3% cases, whereas in 8.6% cases, it emerged as a direct branch of the common carotid artery. Similarly, the inferior thyroid artery was observed to be emerging from thyrocervical trunk, subclavian artery and vertebral artery in 95.7% cases, 3.3% and 1% cases, respectively. Thyroid ima artery was also reported in a subject, arising from the brachiocephalic trunk. CONCLUSION: To avoid vascular injuries, excessive and uncontrollable bleeding, intra-operative difficulties, and post-operative issues, it is imperative for surgeons to be aware of the course and variations of thyroid arteries.

Morphometry of Fetal Liver From Human Fetuses Between 12-36 Weeks Gestational Age.

Background of the study To assess the prenatal development of the human liver between 12-36 weeks of gestational age by measuring morphometric parameters using conventional autopsy and to evaluate the morphometric parameters of the human fetus and its liver and their correlation to predict the gestation age. Materials & methods The present study was conducted in the Department of Anatomy, All India Institute of Medical Sciences, Rishikesh, India, on 33 normal fetuses of gestational age 12-36 weeks collected from the Department of Obstetrics and Gynecology of the same institute. which were classified into five groups: A (12-16 weeks), B (17-21 weeks), C (22-26 weeks), D (27-31 weeks), and E (32-36 weeks). The parameters measured were liver weight, liver volume, transverse diameter, sagittal diameter, vertical length, length, and width of all four lobes of the liver, i.e., right, left, caudate and quadrate lobe. Also, general morphometric parameters of the fetuses were measured like fetal body weight, crown-rump length, crown-heel length, biparietal diameter, head circumference, chest circumference, abdominal circumference, hand length, foot length, inner inter-canthal distance, outer inter-canthal distance. The obtained data were statistically analyzed using ANOVA, and Pearson's correlation was assessed. Results There was a statistically significant increase amongst all the fetal general parameters and parameters of liver except bi-parietal diameter, p-value <0.001. The bi-parietal diameter was weakly statistically significant correlated with all other parameters except with chest circumference, crown-heel length, length and width of caudate lobe, and the width of the quadrate lobe and left lobe where it was statistically non-significant. Conclusion Bi-parietal diameter is a statistically non-significant parameter to calculate gestation age. The knowledge of morphological features and normal limits of dimensions of the liver with respect to gestational age is a reliable reference to help to prevent misdiagnosis of various pathological conditions of the liver like cirrhosis, hepatomegaly, fetal anemia, intrauterine growth retardation, congenital anomalies like Down's Syndrome, etc.

Cadaveric Study on the Morphology and Morphometry of Heart Papillary Muscles.

Introduction A normal atrioventricular valve complex of the heart consists of the atrioventricular (A-V) ring, cusps, chordae tendineae, and papillary muscles. The right ventricle contains three while the left ventricle contains only two papillary muscles, which are named according to their location. A thorough understanding of the normal anatomy as well as possible variations can help surgeons in various corrective surgeries involving papillary muscles. Material & methods The study included 50 formalin-preserved hearts procured from human cadavers of unknown age and cause of death. The number of papillary muscles along with their shape, size, and pattern were noted separately for each ventricle. Data were analyzed using SPSS Version 21.0 (IBM Corp., Armonk, NY). Results The left and right ventricles contained two and three papillary muscles, respectively, in all the hearts. In the right ventricles, conical shape and the single base and divided apex (SBDA) pattern were found to be most prevalent. Anterior papillary muscles exhibited the mean length of 12.71±3.81 and 16.41±4.33 in the right and left ventricles, respectively. Similarly, posterior papillary muscles exhibited a mean length of 12.40±3.03 and 14.64±3.92 in the right and left ventricles, respectively. Both differences were found to be statistically significant Conclusion For the appropriate functioning of valves, both anatomical and mechanical coherence of the papillary muscles is required. A very keen understanding of this valvular complex is thus essential for anatomists, physiologists, and cardiologists to deal with normal as well as pathological valvular conditions.

Viral Pandemics in the Past Two Decades: An Overview.

An epidemic that occurs worldwide, involving many countries and affecting a large population is called as a pandemic. The ongoing corona virus disease (COVID-19) pandemic has not only adversely affected the global healthcare infrastructure, but has significantly impacted world economy, socio-political and cultural environment. There are 219 different types of viruses, known at present to be able to infect human beings. This number is just a tip of the iceberg, with the possibility of a substantial pool of undiscovered human viruses and millions of other virus species (which affect plants and non-human animals) that can be potentially infectious to humans as well. Throughout human history there have been numerous pandemics and disease outbreaks that have not only led to huge loss of life, but also hindered economic growth and development. Therefore, in this review article we wanted to highlight major viral pandemics that have occurred in the last two decades, to understand factors contributing to their emergence, transmission and suggest ways to curb future outbreaks.

Ethephon, an organophosphorous, a Fruit and Vegetable Ripener: Has potential hepatotoxic effects?

INTRODUCTION: In the recent years, ethephon, 2-chloroethylphosphonic acid, is one of the most commonly used plant growth regulators. At present, it is being used on fruits, vegetables, and cereals for promoting pre- and post-harvest ripening. The effect of artificial ripening has become questionable because of various health-related issues. This study was conducted to note the morphology of liver after ethephon administration as it is the site where chemicals undergo first pass metabolism and probably will be affected by ethephon. Materials and. METHODS: Adult Wistar albino rats were divided into experimental and control groups (10 each). Ethephon was administered at a dose of 200 mg/kg/day by a gavage tube in the experimental rats for 14 days. The animals were sacrificed within 24 h of the last dose; liver was dissected and processed for light microscopy. Hematoxylin and eosin-stained sections were studied using an image-pro express analyzer. The data obtained from control and experimental groups were statistically analyzed. RESULTS: In the experimental rats, the body weight was found to be significantly decreased. The orderly arrangement of hepatocytes was disrupted and was replaced by blood-filled sinusoids. At sites, hepatocytes appeared to be degenerated. Councilman bodies with pyknotic nuclei and inflammatory infiltrations were seen. The population per unit area of the hepatocytes and Kupffer cells was 29.53 ± 10.65 versus 44.18 ± 10.31 and 25.12 ± 4.41versus 13.05 ± 6.5 in experimental and control groups, respectively. The decrease of hepatocytes and increase of Kupffer cells were found to be statistically significant. CONCLUSIONS: The observations in the liver are probably indicative of degenerative changes associated with ethephon. Hence, we can conclude that this plant growth regulator, Fruit and Vegetable Ripener, has hepatotoxic potential. General awareness and regarding the use of such plant growth regulators is must to reduce the intake.

Right Sided Sigmoid Colon and Redundant Loop of Descending Colon with Its Embryological Correlation and Clinical Significance.

Anatomical variations of colon are mostly developmental and can lead to variety of acute and chronic pathological conditions. So it becomes important to recognize and understand the importance of clinical implications of such anomalies to benefit surgeons, clinical geneticists and research community. We describe two cases of right sided sigmoid colon and long descending colon which had two segments: vertical and horizontal. The mesentery of ascending and descending colon was retained. This mesentery along with the mesentery of transverse colon was continuous with the mesentery of small intestine. There were variations in blood vessels supplying these anomalous colons. The findings of this study may be helpful to make surgeons and radiologists aware about different varieties of presentations while undertaking an investigative or surgical procedure in this area like sigmoidoscopy, percutaneous cecostomy and anterior transperitoneal aproach of kidney to avoid colon puncture.

Effect of ethephon on the liver in albino rats: A histomorphometric study.

BACKGROUND: Chemicals that are commonly used for artificial ripening and to increase the shelf life of fruits and vegetables are ethylene, ethane, calcium carbide, and ethephon. The present study was conducted to study the effect of ethephon on the morphometry of rat liver. METHODS: Ethephon was administered by oral gavage tube to 10 adult Wistar albino rats at a dose of 200 mg/kg body weight/day for 14 days. Ten controls were maintained. The animals were sacrificed within 24 h of administering the last dose by perfusion with formal saline under anesthesia. Liver was dissected and processed for paraffin embedding. Histomorphometric studies were done on randomly selected sections of the liver and the data obtained were tabulated and statistically analyzed. RESULTS: In the experimental rats, the hepatocytes had a mean long and short diameter of 15.02 ± 4.20 and 12.08 ± 3.02 µm, respectively. In the control animals, the mean long and short diameters were found to be 16.5 ± 3.59 and 13.9 ± 3.59 µm, respectively. The nucleus of the hepatocytes had a mean long and short diameter of 5.08 ± 1.93 and 5.08 ± 1.93 µm, respectively, in the ethephon-treated rats and 6.15 ± 1.72 and 6.05 ± 1.68 µm, respectively, in the control animals. The decrease in diameters of the hepatocytes and their nuclei was statistically significant. At some sites, the parenchyma showed pyknotic nucleus and inflammatory infiltrations. There was a statistically significant increase in the diameters of the central vein and sinusoids. Dilatation of the bile canaliculi was seen in between the hepatocytes. CONCLUSION: The plant growth regulator, insecticide, and fruit ripener, ethephon, caused inflammatory and degenerative changes in the liver with associated cholestasis, probably suggestive of toxic hepatitis.

Prevalence of hypertension and associated cardiovascular risk factors in Central India.

OBJECTIVES: To study the difference in the prevalence of hypertension and associated risk factors in urban and rural populations and the association of hypertension with various determinants. MATERIALS AND METHODS: A community-based cross-sectional study was conducted in 48 villages and 15 urban wards of Jabalpur District of Central India. Nine hundred and thirty-nine individuals aged 20 years and above (624 from rural areas and 315 from urban areas) were included in the study. The prevalence of hypertension and associated cardiovascular risk factors was assessed in the urban and rural populations. A pretested questionnaire was used to collect data on socio-demographic, behavioral, and dietary factors. Anthropometric measurements of weight, height, waist and hip circumference, and blood pressure measurements were taken using the standard methodology. The glucose oxidase-peroxidase and cholesterol oxidase-cholesterol peroxidase methods were used to measure plasma glucose and serum cholesterol, respectively. Bivariate analysis was followed by multivariate analysis to detect the odds of getting hypertension with various risk factors for the urban and rural populations separately. Hypertension was defined as per Joint National Committee (JNC) - VII criteria. RESULTS: The response rate was 97%. Overall prevalence of hypertension was 17%, with 21.4% in the urban population and 14.8% in the rural population. Significantly higher mean values of weight, height, body mass index (BMI), hip circumference (HC), waist circumference (WC), waist hip ratio (WHR), systolic blood pressure (SBP), fasting blood sugar (FBS), and serum cholesterol levels were mapped in the urban population in comparison with the rural population. Multivariate logistic regression analysis identified increasing age, parental history of hypertension, tobacco smoking, tobacco chewing, physical inactivity, high estimated per capita salt consumption, and BMI ≥27.5 kg/m(2) as independent predictors for hypertension in the urban population, while in the rural population, increasing age, physical inactivity, central obesity, tobacco chewing and tobacco smoking were independent predictors for hypertension. CONCLUSION: The prevalence of hypertension and other cardiovascular risk factors was high in both urban and rural communities. Therefore, there is a need for comprehensive health promotion programs to encourage lifestyle modification.