Dinesh T

Abstract

Introduction: The Vision 2015 of Medical Council of India states that the Indian medical graduate (IMG) should have the necessary competencies (Knowledge, Skills and Attitude) to assume his or her role as a health care provider to the people of India and the World. Early Clinical Exposure (ECE) is one of the measures taken by MCI to enact its vision. Objectives: This study was aimed to evaluate the effectiveness of ECE in learning clinical examination skills among preclinical students and to explore the perspectives of ECE among the students and faculty. Materials and Methods: Present study was conducted in the department of Physiology, Govt. Thiruvarur Medical College, Thiruvarur on 99 medical students. After obtaining informed, written consent pretest questionnaire was given to the study participants. After obtaining informed, written consent pre-test questionnaire was given to the study participants. After that students were allocated into Group 1 (n=49) and Group 2 (n=50) by simple random technique by lottery method. Group 1 students were trained on clinical examination of anemia in medicine ward (Early Clinical Exposure) and Group 2 students were trained on clinical examination of anemia in clinical physiology laboratory (Control). At the end of the session both groups were assessed by Post-test questionnaire and Objective Structured Clinical Examination (OSCE). Crossing over of the batches was done in the next session for training of clinical examination of jaundice. Feedback was obtained from the students (n=99) and faculty members involved in this (n=7). Results: There was a statistically significant difference present between the post test scores of Group 1 and Group 2 in anemia and jaundice (p Conclusion: Results of the present study justify the need of Early Clinical Exposure to teach clinical examination skills to first year medical students when compared to the traditional teaching method. Keywords: Early clinical exposure, First year medical students, Clinical examination skills.

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Abstract

Introduction: Craniovertebral junction (CVJ) is the most complex part of the cervical region. Congenital malformations of this region can cause serious neurological deficit and require a surgical intervention. The present study was undertaken to know the embryological basis of the CVJ and to identify commonly observed congenital CVJ abnormalities, their frequency and mode of presentation. Materials and Methods: Diagnosed cases of CVJ anomalies on computed tomography (CT) head were reviewed. Type of anomaly, clinical presentation, other associated malformations were recorded. Different types of variations were expressed in terms of percentage. Result: Congenital anomalies were seen in 26 cases. Fifteen types of anomalies were detected. Anomalies were either singly or in combination. Most common anomaly was basilar invagination (23.8%) followed by atlanto-occipital assimilation (19%). In seven cases additional anomalies of other vertebrae were present. Maximum eight cases were detected in age group of 11-20 years. There was male predominance. Commonest symptoms were weakness of extremities, neck pain, paresthesia, torticollis and gait disturbances. Conclusion: Congenital CVJ anomalies are rare. To prevent long-term neurological problems, early diagnosis and treatment of congenital bony CVJ anomalies is important. Keywords: Craniovertebral junction, Congenital, Anomaly.

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