Teaching Procedures and Skills in Medical Schools: Gaps, Weakness, and Challenges

There is deficiency and gaps among medical graduates in performing certain procedures and skills. Till recent years, some school used an apprenticeship model for teaching procedures. The way of teaching skills should be revised and reinforced. Medical schools showed adopt formal curricula based training for teaching procedure. In this letter, we would like to highlight the challenges and weakness in teaching procedure for undergraduates medical students. 

Gunshot Injuries: Patterns, Presentations, and Outcomes of Civilian Hospital Experiences in a Developing Country Setting

Background: Gunshot injuries are considered a health burden as well as one of the intricate emergencies in civilian medical practice. In this study, we aim to determine the pattern of presentation and management outcome in a general hospital setting in a sub-Saharan African country.Methods: This is a retrospective, hospital-based study conducted between January 2015 and December 2019 in a general teaching hospital to review the clinical presentation and management outcome of gunshot injuries. All patients’ records were reviewed during the study period.Results: The total number of patients involved in the study was 157 with 83% male predominant. About 50% were from the age group 20–29 years that were most affected. The commonest anatomical site affected in the study was the lower limb (41.4%) and upper limb (22.9%), and most of the patients had been diagnosed with limb fractures (49.7%) and soft tissue injuries (28.7%). Wound debridement is the commonest procedure performed for 91 (58.0%) patients. The site of the pullet has a significant relation to the management outcome with a P-value of 0.002. Additionally, about 45% (72 patients) have stayed more than 20 days and it was affected significantly by the types of treatment provided, which has a significant relation to a hospital stay with a P-value of 0.00.Conclusion: Most of the patients in this study were young males. Upper and lower limb fractures were the most common presentations. Wound debridement, bone fixation, and laparotomy were the most common treatments with significant success rates, despite prolonged hospital stays

Review of Plastic and Reconstructive Surgery in a General Hospital Setting: Experience from a Developing Country

Background: Plastic and reconstructive surgery in developing countries and underserved areas are significantly limited and face changes to start a proper service. This study presents a review of plastic surgery services and experiences in a district hospital located in an underserved area.Methods: This descriptive, retrospective, hospital-based study was conducted to review patients who presented to the plastic and reconstruction departments from January 2014 to January 2015. All patients seen in the outpatient clinic or emergency departments for plastic surgical consultation or management were included in the study.Results: The total of 403 cases fulfilled the inclusion criteria. The emergency surgical operation performed in our unit were distributed in the following descending order; fingertip injury (32%), cut wrist (12.7%), cut extensor tendon (9.9%), gunshot injuries (9.4%), fracture of a small bone of the hand (8.3%), and lower limb trauma. Surgery for congenital deformities constituted the most elective operation done in our unit (31.6 %), followed by tumor surgery (18.7%), burn surgery (17.3%), aesthetic surgery procedure (12.2%), and other miscellaneous cases (12.2%).Conclusion: This report demonstrates the efficacy of secondary hospital setting to accommodate a large volume of patients during the first year of establishment, and further predicting development needs, staff training, and governmental support

Graduates Perception towards Instructional Methods of Emergency Medicine: Affecting Their Self-confidence in Emergency Departments

Background: Teaching emergencies has the ability to provide medical students with animportant knowledge and skills. In this study, we assessed the perception of Faculty of medicine, University of Gezira graduates regarding instructional methods of emergencies and their performance in emergency departments. Materials and Methods: This is a cross-sectional survey, which was conducted among newly graduated doctors, during their internship rotation. We assessed the graduateperception about instructional methods of teaching EM during medical school and how they deal with emergencies. Likert’s scale of five points was used for assessment of the graduate response. This data was used for a correlation analysis. Result: Ninety three graduates were enrolled. Male doctors’ numbers was 41(44%). Most of the graduated doctors agreed that clinical round and practical session in teaching emergency are useful among 80(86%) and 74(79.6%) of them respectively. Less number of graduated students 45 (48.4%) and 43 (36.6%) agreed that Problem-based learning and Seminar are useful in teaching emergency. Numbers of graduates who feel competence to assess and diagnose patients, request a relevant investigation, and can put a treatment plan and start the managements are 60(68.8%), 76(81.8%) and 61 (65.6%) respectively. Conclusion: There are some strength and weakness in emergency teaching during medical school which affects their self-confidence when dealing with emergencies

Teaching Procedures and Skills in Medical Schools: Gaps, Weakness, and Challenges

There is deficiency and gaps among medical graduates in performing certain procedures and skills. Till recent years, some school used an apprenticeship model for teaching procedures. The way of teaching skills should be revised and reinforced. Medical schools showed adopt formal curricula based training for teaching procedure. In this letter, we would like to highlight the challenges and weakness in teaching procedure for undergraduates medical students

Mirror image polydactyly in a foot of young female with late presentation: management and three years follow-up

Background: Polydactyly (extra digits) is a common congenital anomaly which has familial tendency and its incidence vary widely a according to many factors including race, geographical distribution and familial tendency. It's commonly affect the hands but also can be found in the foot. We report a case of mirror foot polydactyly with late presentation with successful management. Case presentation: A 17-year-old female patient presented to our plastic surgery clinic complain of left foot deformity and inability to wear her shoe (closed) since birth. Examination of the left foot showed 4 extra digits in the medial aspect. The diagnosis of polydactyly (mirror foot) was made based on clinical and radiological finding. She underwent excision of the extra digit with correct the valgus deformity of the big toe. She had no postoperative complications with excellent result after 6 years follow up. Conclusion: This a case of mirror foot (9 toes) with late presentation. We successfully treated this case by removing the extra digit and correction of varus deformity of the big toe. Despite the late presentation, the outcome is goo

Tuberculous Abscess of the Anterior Abdominal Wall: An Unusual Site of Presentation

The skeletal muscles are rarely affected by tuberculosis because they are not a favorable site for the survival and multiplication of Mycobacterium tuberculosis. A case of tuberculous abscess in rectus abdominis muscle is described in a 20- year- old female in an apparently healthy individual without any past history of tuberculosis. The diagnosis was made by ultrasound-guided fine-needle aspiration and cytological examination which revealed caseating granuloma with central necrosis, lymphocytes, and giant cells, consistent with tuberculosis. After four weeks’ antituberculous treatment, she responded well and the abscess regressed considerably. In most cases, the muscle involvement is secondary and is caused by either hematogenous route or direct inoculation from a tuberculous abdominal lymph node or extension from underlying tubercular synovitis and osteomyelitis. This case cautions the clinicians and radiologists about the possibility of tuberculosis in considering the differential diagnosis of any lesion even in any unlikely anatomical area, especially in those areas where tuberculosis is endemic.</p

Review of Plastic and Reconstructive Surgery in a General Hospital Setting: Experience from a Developing Country

Abstract Background: Plastic and reconstructive surgery in developing countries and underserved areas are significantly limited and face changes to start a proper service. This study presents a review of plastic surgery services and experiences in a district hospital located in an underserved area. Methods: This descriptive, retrospective, hospital-based study was conducted to review patients who presented to the plastic and reconstruction departments from January 2014 to January 2015. All patients seen in the outpatient clinic or emergency departments for plastic surgical consultation or management were included in the study. Results: The total of 403 cases fulfilled the inclusion criteria. The emergency surgical operation performed in our unit were distributed in the following descending order; fingertip injury (32%), cut wrist (12.7%), cut extensor tendon (9.9%), gunshot injuries (9.4%), fracture of a small bone of the hand (8.3%), and lower limb trauma. Surgery for congenital deformities constituted the most elective operation done in our unit (31.6 %), followed by tumor surgery (18.7%), burn surgery (17.3%), aesthetic surgery procedure (12.2%), and other miscellaneous cases (12.2%). Conclusion: This report demonstrates the efficacy of secondary hospital setting to accommodate a large volume of patients during the first year of establishment, and further predicting development needs, staff training, and governmental support

Gunshot Injuries: Patterns, Presentations, and Outcomes of Civilian Hospital Experiences in a Developing Country Setting

Abstract Background: Gunshot injuries are considered a health burden as well as one of the intricate emergencies in civilian medical practice. In this study, we aim to determine the pattern of presentation and management outcome in a general hospital setting in a sub-Saharan African country. Methods: This is a retrospective, hospital-based study conducted between January 2015 and December 2019 in a general teaching hospital to review the clinical presentation and management outcome of gunshot injuries. All patients' records were reviewed during the study period. Results: The total number of patients involved in the study was 157 with 83% male predominant. About 50% were from the age group 20–29 years that were most affected. The commonest anatomical site affected in the study was the lower limb (41.4%) and upper limb (22.9%), and most of the patients had been diagnosed with limb fractures (49.7%) and soft tissue injuries (28.7%). Wound debridement is the commonest procedure performed for 91 (58.0%) patients. The site of the pullet has a significant relation to the management outcome with a P-value of 0.002. Additionally, about 45% (72 patients) have stayed more than 20 days and it was affected significantly by the types of treatment provided, which has a significant relation to a hospital stay with a P-value of 0.00. Conclusion: Most of the patients in this study were young males. Upper and lower limb fractures were the most common presentations. Wound debridement, bone fixation, and laparotomy were the most common treatments with significant success rates, despite prolonged hospital stays