Falx cerebelli and its associated occipital venous sinus: an anatomical study.

PURPOSE: This study presents the morphological variation of falx cerebelli, which helps to identify the possible variations in the presence of the occipital sinus in the posterior margin of the fold whose damage during midline incision of posterior cranial fossa surgeries may lead to internal hemorrhage. METHOD: The study was conducted on 48 cranial cavities exploring the falx cerebelli. Variations in the number of folds, its proximal and distal attachments, and the drainage pattern of the occipital sinus were evaluated by histological processing of the upper 1/3rd section of the falx fold. RESULTS: The variation in the number of folds recorded are single folds in 87.5%, double folded in 8.3%, and multiple folds (five and seven folded) in 4.2% of the cases. The variation in the proximal and distal attachments in single falx folds showed three combinations: Ramified triangular in 66.7%, both ramified type in 12.5%, and both triangular type in 8.3% of the cases. Double and multiple folds showed ramified and triangular types of variation in their attachments. Histological findings showed the presence of occipital venous sinuses in most of the single falx fold. Two aberrant venous sinuses were seen in a double and five-folded falx cerebelli. CONCLUSIONS: This study records the variations in the morphology of falx cerebelli. The histological data of this study sheds light on the drainage pattern of venous sinuses in the area whose negligence during midline incisions of brain surgeries may increase the possibility of hemorrhage.

Tangible impact of patient communication modules on medical students and interns.

Attitude, ethics, and communication are key attributes in the doctor-patient relationship and to strengthen these qualities, the National Medical Commission, the body that regulates medical education and medical professionals in India introduced a course called Attitudes, Ethics and Communication (AETCOM) in the undergraduate medical curriculum. The objective of this study was to ascertain the perceptible qualitative influence of the modules in communication in the AETCOM course and to obtain feedback on its implementation. In this cross-sectional study, the attitude of medical students in all stages of training including internship was first explored using a Communication Skills Attitude Scale. Out of 27 modules in AETCOM course, five modules named foundations of communication deal with communication, and they are taught from the first to final professional years of training. After introducing communication modules in AETCOM for all professional years, feedback was collected from interns who had completed training in all modules. The interns provided feedback with a validated scale and two focused group discussions. Additionally, feedback from faculty involved in teaching AETCOM was analyzed. There was a significant increase in the positive attitude scores in the final year and internship compared to the first year. Eighty percent of the interns agreed that communication modules in AETCOM were useful and that they equipped them with the communication skills required for actual practice during their internship. Faculty agreed that these modules motivated the students to acquire communication skills. However, faculty also felt that these modules alone may not be sufficient to learn communication skills.NEW & NOTEWORTHY In the current study, we have assessed the attitude of medical students toward learning communication skills in all stages of their training. The novelty of our study is that communication modules were formally introduced for the first time into the medical curriculum and feedback was obtained from a cohort of interns who completed training in all modules in communication from AETCOM. The feedback from faculty and students provided us with concepts to improvise these modules.

A clinical perspective on the anatomical study of digastric muscle.

One of the suprahyoid muscles is the digastric muscle which comprises anterior and posterior bellies joined by an intermediate tendon. Because of its close relationship with the submandibular gland, lymph nodes, and chief vessels of the neck, detailed knowledge about the morphometry of the digastric muscle is essential. The objective of the current cross-sectional evaluative study is to record morphometry along with the digastric muscle's origin, insertion, and variability. Forty human cadavers (25 males and 15 females) were dissected, and the head and neck regions were studied in detail. The attachment of the digastric muscle anterior belly to the digastric fossa of the mandible was noted, and the distal attachment of the posterior belly to the mastoid notch was traced. The length of the anterior belly from the digastric fossa to its intermediate tendon and the length of the posterior belly from the intermediate tendon to its mastoid attachment were measured. There is a fair correlation between the length of the neck and the length of the anterior and posterior belly. The study also identified two cases of bilateral accessory bellies of the anterior belly of the digastric. Normal morphometric data is provided by this study on details of the digastric muscle. It is significant from a clinical and surgical point of view as the muscle lies in proximity to the important structures of the neck.

Influence of pretesting and a near peer sharing real life experiences on CPR training outcomes in first year medical students: a non-randomized quasi-experimental study.

BACKGROUND: Existing literature on cardiopulmonary resuscitation (CPR) training focuses on the knowledge and skill components while the attitudinal component is rarely addressed. There is a need to explore how peer interaction, learning atmosphere, and communication influence learning effectiveness during CPR training. Therefore, this study's objective was to evaluate how a senior student (near peer) sharing their real-life experience of performing CPR would influence medical students' learning and readiness to perform CPR. METHODS: The present study involved 250 newly enrolled undergraduate medical students. The Solomon's four-group study design was used to evaluate the influence of both pretesting and peer interaction. Students belonging to two groups initially completed a pre-training knowledge test (pretest) and a questionnaire on readiness to perform CPR. Students from all four groups then participated in instructor-led hands-on skills training, after which the two intervention groups interacted with their senior, who shared their life experiences of performing CPR. Finally, all four groups underwent skills evaluation, immediate and delayed post-tests, and completed a questionnaire to assess readiness to perform CPR. The students also provided their feedback on the experience of interacting with a peer during the training. RESULTS: Post-test scores were significantly higher than pretest scores (Kruskal-Wallis test, p < 0.05). Scores were significantly higher in pretested intervention groups than in the non-pretested non-intervention group (p < 0.05). Delayed post-test scores were slightly but not significantly lower than the immediate post-test scores with no significant difference observed in the scores among the groups. The pretested groups showed more readiness to perform CPR and the pretested intervention group were least concerned about acquiring infection during CPR. Students in all groups were confident of performing chest compressions correctly, and found it inspiring and motivating listening to and discussing real-life experiences with a near peer. CONCLUSIONS: Hearing from peers about real-life CPR experience during CPR training sessions significantly impacted learning, enhanced student motivation to learn and may be an effective strategy to consider in routine CPR training. However, the positive effects of pretesting and peer interaction on knowledge were not sustained, highlighting a need for repeat training.

Changing paradigms in anatomy teaching-learning during a pandemic: Modification of curricular delivery based on student perspectives.

Objectives: This study is designed to explore students' perception of major educational changes and challenges encountered during the pandemic, as well as the effectiveness of Anatomy online teaching. Feedback from the students will be utilized to reform the online sessions in Anatomy, and make them more engaging. Methods: This observational study includes 250 first-year undergraduate medical students attending online Anatomy classes during the pandemic. A semi-structured questionnaire was designed to seek student responses, including mode/hours of interaction, facilitating/hindering factors, and assessment in online teaching. The quantitative findings were expressed in percentages. The open-ended questions were subjected to qualitative analysis, and themes were identified. Results: The number of hours spent on online sessions per day showed an increase during the pandemic. Students most often interacted with peers (n=124) through social media (n = 97) to clarify queries. Students opted for both asynchronous (55%) and synchronous modes (45%) of learning. The qualitative analysis identified the following thematic categories: facilitating factors, hindering factors, and measures taken to overcome hindering factors in online learning. Conclusion: There should be a balance between synchronous and asynchronous teaching methods to provide a better learning pace. Incorporation of more self-directed learning strategies would motivate students to learn better. The study concludes that online teaching should be designed to keep student feedback in mind, and tailored to suit student learning needs.

Serendipitous Discovery of a Benign Obturator Nerve Schwannoma: Case report with a brief clinical review.

Schwannomas are typically benign tumours of the peripheral nerves. However, they seldom arise from the obturator nerve. We report a case of an uncommon swelling (2.5 × 3.5 cm) in a 65-year-old male cadaver, found during a routine dissection session for first Bachelor of Medicine and Surgery students in the Department of Anatomy, Kasturba Medical College, Manipal, India, in 2019. It was seen originating from the left obturator nerve in the pelvis at the level of the sacral promontory. Histopathological investigation revealed a schwannoma. The hypocellular tumour was arranged in a sweeping fascicle pattern with patches of myxoid degeneration. Obturator schwannomas, though rare, can exist in cadavers, as seen in the present case. Hence, it should be considered as a differential diagnosis for clinical cases of pelvic masses and eliminated only after thorough radiological examination. Knowledge about the existence of such schwannomas is therefore essential.

One-month long foundation course for newly joined Indian medical undergraduates: Faculty and students' perspective.

BACKGROUND: A one-month long foundation course has been introduced at the entry-level for first-year MBBS (Bachelor of Medicine and Bachelor of Surgery) students in the medical institutions across India from 2019. Therefore, the present study is aimed at describing the experience of implementing a one-month long foundation course conducted for the Competency-based Undergraduate Medical Curriculum (CBUC) of Indian Medical Graduate as per the guidelines from the National Medical Commission (NMC) (erstwhile Medical Council of India, MCI). We have evaluated the student and faculty perceptions towards the effectiveness of the program. METHODS: The foundation course had six modules Orientation, Skills, Field visit to Community Health Centre, Professional Development including Ethics, Sports and Extracurricular activities, Computer Skills, and Language enhancement program. Regular feedback wascollected from students (N = 250) and teachers (N = 26) involved in the Foundation course using a semi-structured questionnaire. The program's overall feedback was also obtained at the end of the course, using a validated questionnaire. The quantitative findings were expressed in frequency and percentage. The qualitative observations (reflections of students and faculty) were subjected to thematic. RESULTS: The students and faculty appreciated the one-month long foundation course. The course's defined objectives were met as indicated by most students (98.4%) and faculty (75%). The course seemed to be useful for students to embark on a formal MBBS curriculum. It also exposed them to new knowledge and practices, as indicated by the feedback. Thematic analysis of the students' and faculty's reflections was carried out and two themes were identified, i.e., 'strengths' and 'challenges.' The Foundation Course Committee will work out appropriate remedial measures to overcome the challenges in the future sessions for subsequent batches. CONCLUSIONS: The one-month-long foundation course was found to be beneficial for newly joined students to get introduced and adjusted to higher education systems' demands. Also, the challenges faced during the program needs to be addressed with suitable remedial measures while implementing for subsequent batches. This effort will ensure a smooth conduct of the foundation course for the future batches of medical undergraduates and make the program more effective.

Lateral collateral ligament and anterolateral ligament of the knee - A morphological analysis with orthopedic significance.

BACKGROUND: The lateral collateral ligament (LCL) is the chief stabilizer of the lateral aspect of the knee to varus forces. Studies have confirmed the function of the anterolateral ligament (ALL), which improves the lateral knee stability by preventing excessive internal tibial rotation. Clinically, a persistent instability following anterior cruciate ligament reconstruction may be due to damage to the anterolateral structures. The finding has created a novel interest in anterolateral extra-articular operations. METHODS: This observational, cross-sectional study involved 42 dissected adult knees. The variations in morphology and morphometry of the LCL were identified and classified. The prevalence and the variabilities in the ALL were also noted. RESULTS: The variations in the shape of the LCL were classified into four types: (1) cord, (2) band, (3) mixed, and (4) inverted Y shaped, with a frequency of 69.04, 26.20, 2.38, and 2.38% of specimens, respectively. The cord type measured 50.4 ± 2.7 mm in length and 5 ± 0.9 mm in width. In comparison, the band type measured 50.1 ± 4.2 mm in length and 9 ± 1.6 mm in width. The ALL was identified in four (9%) of the specimens with a mean length of 35 ± 0.9 mm. Two types of ALL were observed, membranous wideband and distinct cord-like ALL. CONCLUSION: The anatomy of the lateral structures of the knee is inconsistent. The study has attempted to classify the different shapes of the LCL along with the frequency and prevalence of the ALL. Orthopedic surgeons and radiologists must note the LCL morphology and prevalence of the ALL due to their clinical implications.