RESUMEN
BACKGROUND: 'Emergency remote learning' (ERL) has been undertaken as an emergency response globally to facilitate online shift of medical education due to COVID-19. Although medical students world-wide have reported an increased level of anxiety, factors in the academic setting during ERL that influenced anxiety levels have not been studied yet. The present study aimed to evaluate anxiety levels of first year medical students and its correlation with academic factors during ERL. METHODS: ERL for neuroanatomy was conducted for six weeks mainly by online small group teaching. At completion, feedback was collected from students (n = 97) which included a GAD-7 questionnaire for anxiety levels and a modified VARK analysis to record changes in learning styles. RESULTS: Of 97 students (M46, F51) 43.30% had minimal, 31.96% mild, 10.31% moderate and 14.43% severe anxiety. Academic exchanges such as student-teacher interaction (80.41%), tutor feedback (90.72%) and mentor meetings (81.44%) were reported to be advantageous. There was a significant (p = 0.0056) correlation between enjoyment of small group discussion and lower GAD-7 scores. There was significant change in perceived learning styles during ERL. Video calls (p = 0.018) and gaming (p = 0.022) were significant modes of stress relief. There was significant correlation (p = 0.022) between gaming and GAD-7 scores. CONCLUSION: About one-fourth of the students faced anxiety issues during ERL period. Small group interactions with focus on promoting connectedness and interaction, augmented by feedback, mentorship, familial and social support are important in reducing anxiety which should be kept in mind by educators while delivering such learning experiences.
RESUMEN
Langerhans cells (LCs) are the most effective antigen presenting cells against foreign bodies and carcinogens. Since the oral cavity is a portal of entry for these antigens, the aim of this study was to morphologically classify CD1a+ LCs, quantify them in the normal and malignant buccal mucosa, and evaluate their relation to the age of patients. Healthy buccal mucosal samples collected from 16 patients undergoing reconstructive operation, and malignant samples obtained from 15 patients undergoing radical oncological resection. were processed for immunohistochemistry four- to fivemicron thick sections were stained with CD1a antibody (CD1a). At 40X magnification, CD1a+ LCs were morphologically classified and quantified manually for a 25mm length of basement membrane using Cellsens image analysing software and the data was analysed. Two categories of CD1a+ LCs were identified in the normal and malignant buccal mucosa a) typical dendritic LCs and b) non-dendritic LCs (a new entity). Non-dendritic LCs were of significantly higher number compared to the typical dendritic LCs in the normal tissues (p -0.001). In the malignant group, the non-dendritic CD1a+ LCs were significantly fewer in number (p0.004), when compared to the normal group. Nondendritic LCs were also significantly fewer (p0.026) in patients over 60 years of age. This is the first report of non-dendritic Langerhans cells in normal buccal mucosa and malignant buccal mucosa using the CD1a marker. The significantly higher number of these cells in normal tissues and younger individuals supports their role as accessory antigen presenting cells
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