Neurophobia : the inconvenient truth

Medical schools have implemented strategies in response to neurophobia to counteract the negative perception and improve neuroscience experiences for undergraduate medical students. In this study, we explored the attitudes, perceptions and preferred learning approaches of undergraduate and postgraduate medical students toward the teaching, facilitation, learning and assessment of neuroanatomy, as well as their perceptions on its relevance in the South African medical curriculum. A total of 299 undergraduate and five postgraduate students from the University of Pretoria participated in this study. We used a multi-method approach in which the undergraduate students completed an anonymous quantitative questionnaire, while the postgraduate students participated in a qualitative focus- group discussion. Undergraduate medical students preferred lecture notes to study from above any other type of literature and mainly used laptop computers as preferred electronic devices in preparation for their assessments. The favourite topic was cranial nerves, and the least popular was histology of the nervous system. Postgraduate students shared their undergraduate neuroanatomy experiences and provided constructive feedback and suggestions to undergraduate students and lecturing staff. Ineffective teaching methods and limited contact time remain factors that contribute to neurophobia in South Africa. Students perceive neuroanatomy as an interesting and important subject in their medical degree. However, changes are needed to modernize neuroanatomy and make it more accessible and student-friendly. The challenge then remains: how do we, as lecturers, modernize neuroanatomy in the medical curriculum to make it contemporary and clinically applicable?https://eurjanat.comam2024AnatomyEducation InnovationSDG-04:Quality Educatio

Degenerative trends of the palmaris longus muscle in a South African population

The literature reports that the palmaris longus muscle (PL) is only found in mammals in which the forelimbs are weight-bearing extremities. It is suggested that the function of this muscle has been taken over by the other flexors in the forearm. Terms used in the literature to describe the diminishing of this muscle include retrogressive or phylogenetic degenerative trends. The aims of this study were to determine the prevalence of PL in a South African population and whether a phylogenetic degenerative trend for the PL exists. To determine the prevalence of the PL, five groups, representing different age intervals (Years 0–20, 21–40, 41–60, 61–80, and 81–99) were used. A sample of 706 participants of various ages was randomly selected. Statistical analysis included comparisons of the prevalence of the muscle between males and females and left and right sides, using a student t-test. A Chi-squared test was used to determine a possible phylogenetic degenerative trend of PL within the five groups. The sample yielded a bilateral absence of the PL in 11.9% of the cases. The muscle was unilaterally absent on the left side in 7.65% and 6.94% on the right side. The Chi-squared tests revealed a P-value of 0.27 for the left arm and 0.39 for the right arm. No obvious trend could be established for the phylogenetic degeneration of the PL in this study. It would appear that the PL muscle should not be considered as a phylogenetically degenerating muscle in a South African population.http://onlinelibrary.wiley.com/journal/10.1002/(ISSN)1098-2353hb201

Multi-centre evaluation of real-time multiplex PCR for detection of carbapenemase genes OXA-48, VIM, IMP, NDM and KPC

Background: Resistance to carbapenem antibiotics is emerging worldwide among Enterobacteriaceae. To prevent hospital transmission due to unnoticed carriage of carbapenemase producing micro-organisms in newly admitted patients, or follow-up of patients in an outbreak setting, a molecular screening method was developed for detection of the most prevalent carbapenemase genes; blaOXA-48, blaVIM, blaIMP, blaNDM and blaKPC.Methods: A real-time multiplex PCR assay was evaluated using a collection of 86 Gram negative isolates, including 62 carbapenemase producers. Seven different laboratories carried out this method and used the assay for detection of the carbapenemase genes on a selection of 20 isolates.Results: Both sensitivity and specificity of the multiplex PCR assay was 100%, as established by results on the strain collection and the inter-laboratory comparisons.Conclusions: In this study, we present a multiplex real-time PCR that is a robust, reliable and rapid method for the detection of the most prevalent carbapenemases blaOXA-48, blaVIM, blaIMP, blaNDM and blaKPC, and is suitable for screening of broth cultured rectal swabs and for identification of carbapenemase genes in cultures

Neurophobia : a side effect of neuroanatomy education?

Neuroanatomy in the medical curriculum tends to be challenging for both lecturers and students. Students and lecturers perceive the relevance and importance of neuroanatomy differently. If not taught sufficiently, students develop a dislike or fear (termed neurophobia) for the subject. This fear prevents them from being receptive to the teaching and consequently applying the neuroanatomy knowledge in the clinical environment. Information on the approach and perception of undergraduate neuroanatomy lecturers in South Africa regarding neuroanatomy in the medical curriculum is scarce and inconclusive. A study was undertaken to explore the attitudes and perceptions of neuroanatomy lecturers towards the relevance of neuroanatomy, as well as the teaching techniques and approach thereof, in the medical curriculum. In order to determine whether the lecturers’ teaching approach and attitudes could be a contributing factor to neurophobia. In a cross-sectional qualitative study, neuroanatomy lecturers from the nine South African medical schools were invited to complete an anonymous online questionnaire. Results were thematically analysed and grouped. Lecturing staff from seven of the medical schools participated in this study and included fourteen respondents. The respondents classified themselves mainly as either proficient (78.6%) or experts (15.8%) in their neuroanatomy teaching experience. All the respondents acknowledged that neuroanatomy is important in their students’ medical training. A lecturer’s perceptions and attitude towards the subject or content, greatly affect the facilitation approaches and techniques used. This might have far- reaching consequences for students as it might impact on their attitude towards the content.https://link.springer.com/journal/109162023-11-22hj2023AnatomyEducation Innovatio

平成25年度KALCSプログラム事業の概要

BACKGROUND:The objective of our study was the development of a semi-quantitative real-time PCR to detect uropathogens. Two multiplex PCR reactions were designed to detect Escherichia coli, Klebsiella spp., Enterobacter spp., Citrobacter spp., Proteus mirabilis, Enterococcus faecalis, and Pseudomonas aeruginosa. 16S based PCR was performed in parallel to detect Gram-positive and Gram-negative bacteria. Firstly to identify non-targeted agents of infection in the same urine specimen, and secondly to quantify background flora. The method was evaluated in comparison with standard bacterial culture, and a commercial PCR kit for detection of uropathogens. FINDINGS:Analysis with a known panel of 116 clinical isolates yielded a PCR specificity of 100%. Analysis of urine specimens from 211 patients revealed a high correlation of PCR Cq values with both culture positivity and quantity. Concordance between PCR and culture was 98% when both methods yielded results. PCR was found to be more sensitive than culture. With a cut-off Cq value of 33, the negative predictive value of PCR was 94%. The 16S PCR confirmed most results. One specimen was positive by 16S PCR suggesting another cause of infection not detected by the specific PCR assays. CONCLUSION:We conclude that it is feasible to detect and identify uropathogens by multiplex real-time PCR assay

Determining the extent of the dural sac for the performance of caudal epidural blocks in newborns

BACKGROUND : Information regarding the position and relationship of vital structures within the caudal canal is important for anesthesiologists who perform a caudal block. This information can be acquired by anatomical dissection, with ultrasound technology, or radiological studies. AIMS : The aim of this study was to determine the position of the dural sac in neonates by measuring the distance of the termination of the dural sac from the apex of the sacral hiatus in neonatal cadavers. METHODS : After careful dissection, the distance from the apex of the sacral hiatus to the dural sac was measured in a sample of neonatal cadavers. RESULTS : In 39 neonatal cadavers, the mean distance from the apex of the sacral hiatus to the dural sac was 10.45 mm. The range of this distance was between 4.94 and 26.28 mm. The mean distance for females was 9.64 mm (range from 6.66 to 15.09); that for males was 10.90 mm (range between 4.94 and 26.28). Linear regression with the log of this distance as the outcome variable gave an estimated 3.3% increase in the distance for each 1 cm increase in the length of the neonate (95% CI for this proportion was 1.91‐4.71). CONCLUSION : Anesthesiologists should be aware of the short distance between the sacral hiatus and the dural sac when performing caudal blocks, the shortest distance was 4.94 mm. Armed with this knowledge, caudal techniques should be modified to improve the safety and reduce the risk of complications, such as dural puncture.The Department of Anatomy and the National Research Foundation (NRF).http://wileyonlinelibrary.com/journal/pan2019-10-01hj2018Anatom

Screening rectal swabs for carbapenemase genes

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Graphic showing the correlation between positive cultures and PCR Cq values.

<p>Comparison of PCR and culture results for <i>E</i>. <i>coli</i>. Cq values of PCR are depicted in the blue bars ranging from Cq22-Cq40 on the left axis. The red bars depict positive cultures with growth of 10³, 10⁵, and >10⁵ cfu/ml on the right axis. Low Cq values correspond with high loads of micro-organisms, and thus with larger yield of positivity and quantities of cultures.</p

Analysis of results of PCR and the Seegene kit.

<p>Analysis of results of PCR and the Seegene kit.</p

PCR positive urine specimens with inconclusive culture results (n = 18).

<p>PCR positive urine specimens with inconclusive culture results (n = 18).</p