RESUMEN
In India, there has been a shift from using unclaimed bodies to voluntary body donation for anatomy dissections in medical colleges. This study used in-depth qualitative interviews to explore the deeper intent, values and attitudes towards body donation, the body and death, and expectations of the body donor (N = 12), as well as their next of kin (N = 7) and representative religious scholars (N = 12). All donors had enrolled in a body bequest programme in a medical school in South India. This study concludes that body donors are philanthropists with deep-rooted values of altruism and service, who are often willing to forgo traditional religious and cultural death rituals. The next of kin are often uncomfortable with the donor's decision, and this suggests that it is important that dialogue/counselling occurs at the time of the bequest, if the donor's wishes are to be respected. Religious injunctions are often misinterpreted; this implies that religious leaders/scholars can play a significant role in addressing these misconceptions which are barriers to body donation. Body bequest programmes in India may be enhanced by positioning body donation as 'daana'-giving without any expectation of return for a higher purpose, including ceremonies of respect in medical colleges. Furthermore, increased public engagement and awareness about body bequest programmes are also important to enhance participation. When medical students internalise what body donors expect of them, i.e. altruism, empathy with patients and becoming 'good doctors', it will help to ensure that the donation was not in vain and that the dead truly teach the living.
RESUMEN
PURPOSE: The utility of peer-assisted learning (PAL) in anatomy education has been recognized. In this study, PAL was incorporated into osteology teaching for the first-year medical students and compared to traditional didactic methods (TDM). METHODS: This was a cross-over intervention study. The class of 60 students was divided into two equal groups. The first group underwent PAL for five upper limb osteology sessions and TDM for all lower limb osteology classes. The second group underwent TDM for five upper limb osteology classes and PAL for lower limb osteology classes. A pre-session test (PrST) and post-session test (PoST) were conducted for each session using multiple choice type questions. Perceptions of students about PAL were collected using a questionnaire. Between and within group differences were estimated using the independent sample T test and paired T test, respectively. The responses in the questionnaire were summarized and open-ended responses categorized into broad themes. RESULTS: Greater group differences were noted in the PrST as compared to the PoST mean scores, with the PAL group showing higher mean scores for both upper and lower limb sessions. Significantly higher PoST scores compared to PrST scores for all the sessions were observed regardless of the method used. Significantly higher scores in the PrST or PoST scores were noted in the PAL group for five sessions. Most aspects of PAL were appreciated by the students. CONCLUSIONS: This study provides evidence that PAL is at least as effective as TDM in learning osteology among the first-year medical students.
Asunto(s)
Educación de Pregrado en Medicina/métodos , Osteología/educación , Grupo Paritario , Enseñanza , Estudios Cruzados , Evaluación Educacional/estadística & datos numéricos , Femenino , Humanos , India , Aprendizaje , Masculino , Evaluación de Programas y Proyectos de Salud , Estudiantes de Medicina/psicología , Estudiantes de Medicina/estadística & datos numéricos , Encuestas y Cuestionarios/estadística & datos numéricosRESUMEN
The thoracic splanchnic nerves and celiac ganglia play a major role in pain management of upper abdominal disorders, particularly chronic pancreatitis and pancreatic cancer. The variable anatomy of the splanchnic nerves is becoming increasingly important in view of the splanchnicectomy being used more often for relief of pain originating from the upper abdominal viscera. In the present study variations of the roots of origin, formation and course of the splanchnic nerves were observed by using gross dissections of eighty-eight sides of thirty-four adult and ten foetal cadavers. The greater splanchnic nerve was found on both sides of all the adult cadavers as well as foetal specimens (100%). The lesser splanchnic nerve was found in 95.45% (84 sides) of the sides. The lesser splanchnic nerve was found to be absent unilaterally in four adult cadavers (two each of right and left sides). The least splanchnic nerve was found in 67.5% of the sides. Excepting a right side of one adult female cadaver and a left side of a male cadaver, where the highest root of the greater splanchnic nerve originated from T3, in all other cases the highest root of the greater splanchnic nerve originated from T4 ganglion onwards. The greater splanchnic nerve was formed by two or more roots. A maximum number of seven roots was found in three sides of adult female cadavers (3.4%). In a large number of instances (54 cases - 64.28%) the lesser splanchnic nerve was formed by a single root. Awareness and appreciation of the variant patterns of the splanchnic nerves is of great importance to the surgeon undertaking thoracic splanchnicectomy, since this technique has been demonstrated to be of tremendous potential in pain abolition or control because of its simplicity and absence of any morbidity and potential mortality associated with thoracotomy
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Asunto(s)
Ganglios Simpáticos/anatomía & histología , Variación Anatómica , Nervios Esplácnicos/anatomía & histología , Dolor Abdominal/etiología , Vísceras/inervación , Dolor Visceral/etiología , Toracotomía/métodos , Neoplasias Pancreáticas/cirugíaRESUMEN
The unilateral complete absence of the pectoralis major and serratus anterior muscles in the absence of other anomalies is very rare. The complete absence of the pectoralis major and serratus anterior on the right side was observed during routine dissection of an elderly male cadaver of South Indian origin. Nodularity of the right fifth rib near the fifth costochondral junction was seen. The lateral pectoral and long thoracic nerves were present on the right side. Moderate right-sided disuse atrophy was noted in the pectoralis minor and the rotator cuff muscles due to a shoulder arthrodesis performed on that side. No abnormalities were noted on the left side. There was no family history of any upper limb anomalies suggestive of Poland's syndrome. The findings in the present case could be either due to a sporadic variant of Poland's syndrome or an isolated congenital unilateral absence of the pectoralis major and serratus anterior.