Students, faculty perceptions and effectiveness of the early introduction of clinical skills teaching in the medical curriculum.

Objective: We hypothesized that the early introduction of clinical skills (CS) would help students to develop and apply clinical skills appropriately during the clinical years. Evaluating the perceptions of medical students and faculty regarding the early introduction of CS teaching and its effectiveness are important. Methods: The CS curriculum was designed by integration with the system-oriented problem-based curriculum in years 1 and 2 at the College of Medicine, KSU, from January 2019 to December 2019. Students and faculty questionnaires were also designed. The impact of CS teaching effectiveness was assessed by comparing OSCE results for year-3 students who received early CS sessions with those who did not. The total number of student respondents was 461/598; and 259 (56.2%) were male and 202 (43.8%) were female. The first- and second-year respondents were 247 (53.6%) and 214 (46.4%), respectively. The number of faculty respondents was 35/43. Results: The majority of students and faculty were satisfied that the early introduction of CS increased student confidence when dealing with real patients, provided the opportunity to master skills, consolidated theoretical knowledge and clinical skills, motivated learning, and increased the enthusiasm of students to become doctors. The third-year students who received CS teaching in years 1 and 2 (during 2017-2018 and 2018-2019) showed a significant increase in mean grades (p value; 0.00) in OSCE tests during their courses in surgery (from 32.6 to 37.4 for females; 35.2 to 35.7 for males) and medicine (31.2-34.1 for females; 34.3 to 37.7 for males), respectively, when compared to students who did not receive CS teaching during the academic year 2016-2017 (in surgery, 22.2 and 23.2; in medicine 25.1 and 24.2) for females and males respectively. Conclusion: Early exposure of medical students to CS is a positive intervention that bridges the gap between basic sciences and clinical practice.

Effects of adding neural mobilization to traditional physical therapy on pain, functional disability, and H-reflex in patients after lumbar laminectomy: A randomized controlled trial.

OBJECTIVE: To investigate whether adding neural mobilization to a standard postoperative physical therapy program could improve the outcomes of patients after lumbar laminectomy. DESIGN: A single blinded randomized controlled trial. SETTING: Outpatient setting. PARTICIPANTS: Sixty participants of both sexes who had undergone lumbar laminectomy. INTERVENTIONS: Participants were allocated randomly to two groups; study and control groups. All patients received a standard postoperative physical therapy program. Those in the study group received additional neural mobilization in the form of straight leg raising and dorsiflexion with two-ended slider. Treatment was administered three times/week for six successive weeks. OUTCOME MEASURES: Visual analog scale (VAS), Oswestry disability index (ODI), and H-reflex latency were measured pre and post-treatment. RESULTS: The mean age of participants was 44.23 ± 4.64 and 45.3 ± 5.3 in study and control groups respectively (P > 0.05). There were statistically significant differences in VAS, ODI, and H-reflex latency in favor of the study group (P < 0.05). The mean ± SD for VAS, ODI, and H-reflex latency pre vs post treatment was 6.13 ± 1.22 vs 1.40 ± 0.77, 64.46 ± 4.05 vs 16.86 ± 2.55, and 32.07 ± 2.76 vs 27.46 ±1.79 in study group and 5.86 ± 1.07 vs 2.46 ± 0.73, 63.93 ± 3.91 vs 23.40 ± 2.93, and 31.76 ± 2.69 vs 29.4 ± 1.94 in control group, respectively. CONCLUSIONS: Neural mobilization combined with traditional physical therapy program achieved better improvement in pain, functional disability and H-reflex in patients who underwent decompressive laminectomy than traditional physical therapy program only.

Congenital penile curvature presenting as unconsummated marriage. Repair by 16-dot plication with subjectively reported patient and partner satisfaction.

OBJECTIVE: To evaluate self-reported patient and partner satisfaction in cases of unconsummated marriage due to congenital penile curvature that was treated by the 16-dot plication procedure. PATIENTS AND METHODS: From March 2008 to March 2012, 24 couples presented to our institute with an unconsummated marriage due to congenital penile curvature. All patients were treated using the 16-dot plication operation. Patients were followed up for 3 months and were asked, with their partners, to complete a specific questionnaire to evaluate their satisfaction with the outcome of the operation. RESULTS: The duration of unconsummated marriage was 2-12 weeks. The mean (SD, range) angle of penile curvature was 57.4 (20.3, 30-110)°. All patients were able to consummate their marriage within a mean (SD, range) of 5.3 (1.3, 4-8) weeks after surgery. The overall satisfaction rate with the outcome of the operation among patients was nearly 100% for 'moderately satisfied' or greater, and among their partners was nearly 96% for 'moderately satisfied' or greater, at 3 months. CONCLUSION: The 16-dot plication technique is an easy procedure for the emergent correction of congenital penile curvature presenting as an unconsummated marriage. Most patients and their partners were pleased with the outcome of the procedure.

Suprapubic-assisted cystoscopic excision of intravesical tension-free vaginal tape.

We report on a 56-year-old woman with irritative voiding symptoms, which started 4 months after undergoing a TVT procedure for stress incontinence (SI). Evidence of the mesh coming through the left bladder wall did not emerge until cysto-urethroscopic examination 2 years after surgery. Excision was done via transurethral cystoscopy with the aid of endoscopic scissors placed through a 5-mm suprapubic port inserted into the dome of the bladder, thus avoiding laparotomy. A Foley catheter was left in for 3 days, and after removal, the patient's symptoms disappeared almost completely.