Teaching Institutions Research Articles

Institutional pedagogy and the transformation of residential care for, and with, disabled citizens

In this article, we build upon a historical and critical analysis of de-institutionalisation strategies, representing a fundamental shift in disability policy and practice starting in the 1960’s. We state that de-institutionalisation has commonly been interpreted and translated as a vital ‘transition’ – referring to the dismantling of residential care and institutions – in rights discourse, policy, and (self-) advocacy. Whereas de-institutionalisation currently often interferes with neo-liberal welfare state reforms, we argue that the focus on ‘transition’ tends to ignore controlling and oppressive institutional care cultures that circulate in a variety of settings, whether ‘community based’ or not. In this article, we elaborate on Francois Tosquelles’ Institutional Pedagogy as a theoretical framework to radically ‘transform’ (residential) care in a wide variety of settings. Our analysis is based on qualitative interviews with residential care providers and (self-) advocacy groups, and offers a more in-depth insight in the complexities of de-institutionalisation as ‘transformation’.

A Study of Onychoscopic Findings in Various Dermatological Disorders

Context: About 10% of all the dermatological conditions are comprised nail disorders. It is challenging for the dermatologists to diagnose nail disorders quickly without the help of invasive procedures. Aims: The aim of the study was to evaluate onychoscopic patterns associated with various nail disorders. Settings and Designs: Hospital-based cross-sectional observational study was conducted at a tertiary care teaching institute in Maharashtra, India from November 2019 to May 2021. Materials and Methods: One hundred and fifty patients, with a history and clinical presentation suggestive of nail disorders, were recruited in the study after confirming the clinical diagnosis. Patients having secondarily modified lesions were excluded. Dry as well as wet onychoscopy using polarized and nonpolarized modes was performed with the help of DermLite 4 dermoscope with an attached OnePlus 8T mobile phone camera to capture and save the dermoscopic images. Data were compiled and statistically analyzed using SPSS version 21.0. Statistical Analysis Used: Categorical variables were expressed in frequency and percentages. Data were entered in Microsoft Excel and analyzed using SPSS version 20. P value (using Z-test for proportions) was calculated wherever needed. Results: The majority of the patients were in the age group of 21–50 years with slight male preponderance. Overall most common onychoscopic findings studied in all the disorders were the nail plate alterations followed by chromonychia. The most common nail changes associated with connective tissue disorders were changes in the proximal nail fold capillaries along with changes in the curvature. The most common change observed in onychomycosis was chromonychia. Aurora borealis, spikes, and jagged edges of onycholytic plate with ruin pattern of hyperkeratosis were specific to onychomycosis. Inflammatory disorders of the nail unit (e.g., lichen planus and nail psoriasis) showed nail plate alterations with increased nail plate fragility. Conclusions: Some onychoscopic patterns are observed consistently with certain diseases, and these can be used for their diagnosis, hence, avoiding unnecessary biopsies, thus improving the patient outcome.

CLINICAL ASSESSMENT OF ANTIBIOTICS USED IN CHRONIC KIDNEY DISEASE: A LONGITUDINAL OBSERVATIONAL STUDY

Objective: The study was conducted to clinically evaluate the safety and efficacy of antibiotic drug consumption based on laboratory data, specifically White Blood Cells(WBC) and Glomerular Filtration Rate (GFR) before and after antibiotic use in patients with chronic kidney disease. Methods: This retro-prospective longitudinal study was conducted on 115 patients with Chronic Kidney Disease (CKD) based on 6 mo of data at a tertiary care teaching institute, Geetanjali Medical College and Hospital, in Udaipur, Rajasthan. Inclusion criteria were all the patients who were admitted in the nephrology department and were above 18 y, who were receiving antibiotics, and Creatine Clearance (CrCl) was ≤ 60 ml/min were included into this study. Exclusion criteria patients with renal replacement and lacking information of laboratory data (WBC, CrCl) and those who were below the age of 18 were excluded from the study. The data were analysed using descriptive analysis. Results: The mean age of the CKD patients was 50.10 (standard deviation=17.47) y. Males were found in greater numbers than that of females with 66 (58%) and 49(42%) respectively. Patients admitted with stage 5 CKD (66%) were greater than the patients with stage 4 CKD. 10 different types of antibiotics were provided to CKD patients, of which seven had irrational doses. Piptaz, Meropenem, and Teicoplanin have the highest irrational doses incidence. Conclusion: Patients with CKD Stages 4 and 5 were given systemic antibiotics at unreasonable dosages, most frequently in the forms of piptaz, aztreonam, and meropenem injections. The incidence of irrational antibiotic dosages provided to the CKD patients was still high.

Evaluating the Diagnostic Accuracy of Rapid Malaria Tests in Pediatric Patients: A Retrospective Cohort Study.

Background Malaria remains one of the most significant public health challenges, particularly in pediatric populations in developing countries. Rapid diagnostic tests (RDTs) have been widely adopted due to their ease of use and quick results, but their diagnostic accuracy, compared to microscopy, the gold standard, remains a topic of interest. Early and accurate detection of malaria is crucial in reducing complications and mortality in children, who are especially vulnerable to delayed or inaccurate diagnoses. Objective This study aims to evaluate the diagnostic accuracy of RDTs for diagnosing Plasmodium falciparum malaria in children, using microscopy as the gold standard for comparison. Methods A retrospective cohort study was conducted in the Pediatric Department of Lady Reading Hospital Medical Teaching Institution (MTI), Peshawar, from January 1, 2023, to December 31, 2023. A total of 140 pediatric patients (aged 12 years or below) who were clinically suspected of malaria were included. Patients were excluded if they had a prior confirmed diagnosis of malaria before admission, were already receiving anti-malarial treatment, or if their guardians did not provide consent for participation. Blood samples were collected from each patient and subjected to both RDT and microscopic examination. Statistical analyses, including sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and overall diagnostic accuracy, were calculated using SPSS version 24.0. Multivariate logistic regression was conducted to adjust for potential confounders such as age, gender, and parasitic load. Results Out of 140 children, 83 (58.57%) tested positive for malaria by RDT, while microscopy confirmed 80 (57.14%) positive cases. The sensitivity of RDT was 96.25% (95% CI: 89.43%-99.22%), and the specificity was 90.00% (95% CI: 79.49%-96.24%). The PPV was 92.77%, and the NPV was 94.74%, with a diagnostic accuracy of 93.57%. Multivariate logistic regression analysis indicated that parasitic load was a significant predictor of RDT accuracy, while age and gender were not. Conclusion RDT is a highly accurate diagnostic tool for detecting Plasmodium falciparum malaria in children, demonstrating high sensitivity and specificity compared to microscopy. RDTs can be effectively used in resource-limited settings, but attention should be given to parasitemia levels to ensure accurate diagnosis.

A Clinico-dermatoscopic Study of Vulvar Dermatosis at Rural-based Tertiary Care Teaching Institute

Introduction: The frequency and importance of vulval diseases are often underestimated due to the multifactorial nature of disease on the vulva. Dermoscopy can help provide clues for early diagnosis and insight into dermoscopic patterns. The present study was done with the objective to study the clinico-dermoscopic pattern of dermatosis and correlate the dermatoses with the age of the patient. Materials and Methodology: This was a prospective cross-sectional observational study conducted in the department of dermatology at a tertiary health care center over a period of 1½ year. All females with dermatosis affecting genital areas attending the skin outpatient department or ward were recruited after taking written consent. A detailed history was taken to collect demographic data. A thorough clinical examination and dermatoscopy were done. Descriptive statistics was used to depict the profile and dermatoscopic pattern. Results: Out of the 103 patients with vulvar dermatoses, 24 (23.30%) patients were in the age group of 41–50 years. A total of 43 (41.74%) patients had infective conditions, followed by 16 (15.53%) patients of papulosquamous group of disorders and 11 (10.67%) patients of eczema. Dermatoscopic findings had a surface scale in 40 (38.83%), vascular patterns in 22 (21.36%), red dots in 19 (18.45%), and structureless patterns in 13 (12.62%) with different vulvar dermatosis. In tinea cruris, out of 30 cases, 28 (93.33%) had surface scales, followed by 5 (16.67%) showing vascular pattern, whereas in lichen sclerosus et atrophicus, out of total of 10 cases, 8 (80%) had structureless pattern and 6 (60%) had vascular patterns. Discussion and Conclusion: Genital diseases represent a diagnostic challenge for clinicians. The use of dermoscopy improves the diagnostic accuracy by recognizing specific dermoscopic patterns. Limitation: Small sample size was the only limitation.

The role of combined problem-based learning (PBL) and case-based learning (CBL) teaching methodologies in dental education

BACKGROUND: Innovative methods of teaching such as problem-based learning (PBL) and case-based learning (CBL) have shown promising results in academic understanding and application and enable one to manage their patients in a better manner. The study aimed to analyze the role of a combination of PBL and CBL teaching methodologies in a dental teaching institute in India. MATERIALS AND METHODS: This prospective, cross-sectional randomized study comprised 500 students divided into two study groups, each consisting of 250 participants. Students in group A were provided PBL, whereas students in group B were exposed to CBL, followed by which questionnaire was distributed. Responses received were analyzed statistically for significance set at below 0.05. RESULTS: In this study, statistical difference in learning methods was observed with organizational capacities, self-process of learning, finding solutions for clinical diagnosis, encouraging self-learning, and developing skills for critical thinking process while comparing the PBL or CBL methodologies. CONCLUSION: According to this study’s findings, improvement in one’s knowledge and clinical skills by a subject is much better when both of these techniques are combined.

Exploring Intercultural Dynamics in Medical English Education in China: an In-depth Analysis and Strategic Enhancement

With the continuous development of modern society, information transmission has become more rapid and convenient, which has gradually increased the economic exchanges among various countries in the world, and has also led to more frequent communication among political, cultural, medical and other fields between different regions. At the same time, the mutual penetration and integration between foreign medical culture spread through English and domestic traditional medical concepts have also put forward new demands for the cultivation of high-quality talents in China's medical field. Researchers have explored the cross-cultural complexity of Medical English Teaching (MET) in Chinese higher education institutions and its impact on global medical communication. With the increasing internationalization of healthcare services, English, as the main language of medical communication, is gaining prominence in education. In this broader context. The status of English in global medical education and its teaching in non-native English-speaking environments are facing great challenges, especially in China's higher education settings. Based on an in-depth analysis of the literature and empirical research, this study reveals cross-cultural barriers to MET practice and adopts a mixed-methods research design that combines both quantitative and qualitative methods of data collection and analysis in order to comprehensively examine the current status of MET in China. Special attention was paid to teachers' intercultural competence development, teaching method innovation, and course content adaptation. Based on this, the researcher proposes targeted strategies aimed at improving intercultural competence in MET, including strengthening teacher training, improving curriculum design, and promoting the integration of intercultural communication skills. The findings of the study not only provide insights into existing MET practices, but also offer constructive suggestions for future educational strategies and research directions. Through this study, we expect to contribute a valuable reference and guidance to the field of medical English education in China and globally.

Results of Teacher Supervision at SMP Xaverius 7 Palembang

The process of learning activities supervised by a supervisor or educational expert is known as educational supervision. Providing feedback to teachers, providing suggestions for improvement, and ensuring that the learning process is in accordance with predetermined standards are the main objectives of educational supervision. In addition, data collection, classroom observation, discussion, and the creation of innovative teaching strategies and corrective measures are also included in educational supervision. As a result, improving the quality of teaching and learning in educational institutions depends heavily on educational supervision. Curriculum development and classroom learning models are two areas where educational supervision has a great influence on educational progress. Qualitative research is the type of this study. This qualitative research explains how principals’ academic supervision affects teachers’ professional development and classroom teaching standards. At SMP Xaverius 7 Palembang, 109 people participated in the study: the principal, the curriculum teacher, five members of the supervision team, five teachers of Bahasa Indonesia, PAK, mathematics, and civics, and grade VIII students. Collaborate with schools to plan supervision implementation, monitor implementation, observe academic supervisor evaluations, investigate academic supervision activities, and analyze test results obtained during academic inspections.

Cultivation of Social Attitudes Through The Project Program of Strengthening The Student Profile of Pancasila and The Student Profile of Rahmatan Lil Alamin.

The decline in social attitudes was caused by restrictions on community activities during the Covid-19 virus that hit the world, so the Indonesian government in 2020 imposed restrictions on community activities, including teaching and learning activities in educational institutions. Therefore, the impact of the enactment of the regulation causes a phenomenon of declining social attitudes in students. This is seen from teaching and learning activities that are only through digital and virtual in the sense that students do not have direct interaction between others, one of the flagship programs is P5- PPRA or the project to strengthen the Pancasila student profile and the rahmatan lil alamin student profile. At MTs Negeri 2 Sumenep, it has implemented an independent curriculum since 2022 and has implemented project-based lessons. Therefore, it is important to cultivate good social attitudes, especially through project activities to strengthen the Pancasila student profile and the rahmatan lil alamin student profile. The research conducted at Madrasah Tsanawiyah Negeri 2 Sumenep uses a qualitative approach with a descriptive type of research. This research was conducted to describe how to cultivate social attitudes through the Pancasila profile strengthening project program at MTS Negeri 2 Sumenep.

Prevalence of Non-ST-Segment Elevation Myocardial Infarction in Acute Coronary Syndrome With Unremarkable Electrocardiogram: A Cross-Sectional Study From Lady Reading Hospital, Medical Teaching Institute, Peshawar.

Introduction Patients admitted to the cardiac care unit with non-ST-segment elevation myocardial infarction frequently have inconclusive electrocardiogram results. In individuals presenting with sudden central chest discomfort, non-ST-segment elevation myocardial infarction should be suspected until confirmed or ruled out by a cardiac biomarker analysis. This study aims to determine the prevalence of non-ST-elevation myocardial infarction among acute coronary syndrome patients who present with normal electrocardiogram findings. Materials and methods This study was conducted from October 24, 2022, to April 24, 2023, and involved 120 patients who came to the cardiac emergency department at Lady Reading Hospital, Peshawar. These patients experienced chest pain and symptoms of acute coronary syndrome, all within 24 hours of the onset of their symptoms. Demographic data and clinical histories were recorded for each patient. Electrocardiograms were performed, and non-ST-segment elevation was observed. The diagnosis of non-ST-segment elevation myocardial infarction was confirmed by measuring cardiac troponin T levels. A threshold value greater than 0.5 ng/mL was considered diagnostic. Data analysis was performed using the Statistical Package for the Social Sciences (SPSS) (IBM SPSS Statistics for Windows, Version 23, Armonk, NY), and grammar was checked using the Grammarly software (Grammarly, Inc., San Francisco, CA). Results The study participants had an average age of 53.96 years, with a standard deviation of 8.57. Most participants were male, comprising 65.83% of the total population, while 34.17% were female. Among the participants, 26.66% were diagnosed with non-ST-segment elevation myocardial infarction, affecting 32 individuals. The results showed a significant correlation between the occurrence of non-ST-segment elevation myocardial infarction and male gender, as well as with individuals who had pre-existing comorbidities. The p-values for these associations were 0.032 and 0.043, respectively, indicating statistically significant relationships. Conclusion In conclusion, a significant proportion of patients who presented to the emergency department with acute coronary syndrome symptoms and a normal electrocardiogram were diagnosed with non-ST-segment elevation myocardial infarction. This highlights the need for special attention to male patients and those with comorbidities.

Investigating the Impact of Admission Requirements on Academic Performance in Khyber Pakhtunkhwa's Medical Teaching Institutions

Investigating the Impact of Admission Requirements on Academic Performance in Khyber Pakhtunkhwa's Medical Teaching Institutions

The Association Between Maternal ABO Blood Group and the Occurrence of Spontaneous Preterm Birth: A Retrospective Population-Based Cohort Study.

There is limited and inconsistent evidence that imply a relationship between ABO blood types and rate of preterm birth (PTB). We aim to examine the association between maternal ABO blood group and PTB rate. A retrospective-study conducted at a university teaching institution on data collected between 2013 and 2019. Women who delivered a viable neonate at ≥ 24 weeks without major malformations were included. Indicated PTBs were excluded. PTB and early PTB were defined as deliveries that occurred < 37 and < 34 weeks respectively. PTB was further divided into 3 subgroups according to etiology: membranes rupture, intact membranes, and placental abruption regardless of membranes' status. The primary outcome was spontaneous PTB rate. Of 19,301 women included, PTB and early PTB rates were 7.3% (1,418/19,301) and 2.3% (440/19,301) respectively. Rates of PTB in blood groups A, B, O, and AB, were 7.3%, 6.9%, 7.5%, and 7.5% respectively (p = 0.68). There was no significant difference according to etiology. Rates of early PTB were also comparable (p = 0.63). After adjustment for demographic and obstetric variables, blood type was associated with increased placental abruption rate among women who had early PTB (p = 0.038). Placental abruption rate was significantly higher in group A (22.5%) compared to group B (14.1%), (adjusted p = 0.04) and group O (14.0%), (adjusted p = 0.01). The rate in group AB was 17.1%, (adjusted p = 0.85). In conclusion, no association was found between a particular blood group and PTB rate. Women with group A, admitted in early PTB, had an increased risk that the underlying etiology was placental abruption.

Creative Maladjustment and Creative Subversion of Kazakhstan’s English Teachers: Doing Translanguaging in Concealment

ABSTRACT Kazakhstan’s government has been pushing for English proficiency to become globally competitive. Rhetoric about global competitiveness has resulted in various policies to promote English teaching and learning in primary, secondary, and tertiary institutions. English has eventually evolved as the language of instruction in many universities. The direct language teaching approach has been the mainstay for teaching English as a foreign language (EFL), whereby school administrators do not permit teachers to use the mother tongue. Instead, they are to teach English monolingually. With the monolingual approach to teaching, the teacher does not need to know the local languages of the students and is supposed to be a native speaker or have native-like proficiency in the English language. Most of the English teachers in Kazakhstan are local. This qualitative study explored English teachers’ experiences in elementary and secondary schools in Kazakhstan and how they navigated their daily lives in the classroom teaching EFL. The findings indicated that teachers have long been practicing creative maladjustment and creative subversion by utilizing a translanguaging approach to teaching English without knowing the efficacy of translanguaging in language learning. This article suggests introducing and developing translingual art-based practices for teaching and learning English in Kazakhstan.

Experiences of Students with the Implementation of the Theme of Shoah into Teaching

Aim. In this paper, we present selected results of a research survey conducted among teacher education students to determine their preconceptions about the implementation of the events of the Shoah into teaching at different levels of education. Methods. In this paper we answer the following research questions: Would the respondents welcome a greater curricular anchoring of the Shoah in the Framework Curriculum for Primary Education? Are prospective teachers interested in various books on the Shoah in their spare time? What methods and forms of work were used in teaching in connection with the events of the Shoah at the graduated primary school? In which year of primary school do respondents think it is appropriate to include Shoah topics? Are the respondents satisfied with the level of integration of the Shoah phenomenon into teaching at the Faculty of Education of Palacký University in Olomouc? Results. Most respondents believe that the Shoah phenomenon is only suitable for integration at the lower-secondary school. This preconception stems mainly from the respondents´ previous experience in primary schools. Conclusion. The results point to the fact that the transformation of the perception of the defined events, and the related broader possibilities of their application in Czech institutional teaching, will be quite complex. Cognitive value. It is necessary to begin to perceive the Shoah also in a certain transcendental, visceral level and, based on the internalisation of the resulting feelings, to begin to build pupils´ awareness of the importance of democracy, freedom, or tolerance.

Utilizing Un-enhanced Chest Computed Tomography Screening for Blunt Trauma Surgery Decisions.

Background Blunt chest trauma is a common and potentially life-threatening condition that requires prompt assessment for potential surgical intervention. Computed tomography (CT) of the chest has emerged as a valuable tool due to its heightened sensitivity and specificity in detecting thoracic injuries compared to conventional chest radiography. Objective This study aims to assess the impact of non-contrast CT chest findings on surgical decision-making and compare these findings with those from chest radiographs. Methods The study was conducted at the Accident and Emergency Department of Medical Teaching Institute, Lady Reading Hospital, Peshawar, Khyber Pakhtunkhwa, Pakistan. Patients of all ages and genders who presented with blunt chest trauma were included. Non-contrast CT chest scans were used as an initial screening tool and compared with traditional chest radiographs. Data collected included patient demographics, mechanism of injury, diagnostic findings, and treatment decisions. Imaging was performed using a GE Optima 16-slice scanner (Medsystems Sp. z o.o., Lublin, Poland). Results The study included 246 patients, of whom 210 (85.4%) were males. The most common age group was 50 years or older, comprising 71 (28.9%) of the sample. The predominant mechanism of trauma was road traffic accidents, reported by 188 (76.4%) patients. Hemopneumothorax was detected in 121 (49.2%) patients on CT scans compared to 34 (13.8%) patients on chest radiographs. On chest radiograph, the pneumothorax component was missed in 43 (17.5%) patients, and the hemothorax component was not detected in 21 (8.5%) patients. Patient management included conservative management in 30 (12.2%) cases and surgical intervention in the form of unilateral tube thoracostomy in 173 (70.3%) patients or bilateral tube thoracostomy in 43 (17.5%) patients. Conclusion Our study supports the use of non-contrast CT scans as a reliable diagnostic tool for blunt chest trauma, consistent with current literature. This approach facilitates prompt management decisions, particularly for initiating tube thoracostomy based on findings of pneumothorax and hemothorax. The rarity of mediastinal great vessel trauma further justifies minimizing routine contrast use, thereby enhancing the efficiency of trauma evaluations.

Dr. Dharmendra's Enduring Influence on Leprosy: From Laboratory to Disease Control.

A stalwart of Indian dermatology, Dr. Dharmendra was particularly known for his breakthrough research on leprosy. Spanning over several decades, his work was marked by significant contributions, including the development of Dharmendra's lepromin, which served as a critical diagnostic tool and in advancing the understanding of immunological aspects of leprosy. Born in 1900 in present-day Pakistan, his early education and work experiences set the foundation for his later achievements in leprosy research. Despite the social stigma associated with the disease at the time, Dr. Dharmendra's dedication led him to take up key roles, such as the first director of the National Leprosy Control Programme and head of the Central Leprosy Teaching and Research Institute in Chengalpattu. His work significantly impacted leprosy control efforts in India. ⁤⁤His legacy was further cemented by his leadership in founding the Indian Association of Leprologists and his tireless editorial work in the Indian Journal of Leprosy. Through his publications and ongoing research, even after retirement, he continued to influence the field. Dr. Dharmendra's life and work remain a cornerstone of leprosy research, inspiring future generations. His legacy continues to be felt in the ongoing efforts to combat leprosy.

An Assessment of the Administration of Teaching Practice in a Teacher Training Institution of Zimbabwe

This study sought to assess the administration of teaching practice in a primary education teacher training institution in Zimbabwe. The chosen population consisted of lecturers, school mentors and student teachers. Convenience sampling was used to select primary schools in Gwanda town. These were four in total. From these, purposive sampling was used to select heads of schools, teachers who were student-teacher mentors and student teachers who were in teaching practice. There were twelve teachers in total, and there were twelve student teachers. Purposive sampling was also applied to select lecturers who manned the chosen institution's teaching practice department. Semi-structured interviews were used to collect data from the heads of schools and lecturers, while focus group discussion guides were used to gather data from teachers and student teachers, respectively. As one of the core findings, it unveiled that some students went for teaching practice inadequately prepared to meet associated demands. Furthermore, some mentors seemed burdened by constantly supervising the student teachers while at the same time executing other school duties done by other teachers who were not mentors. Based on these, the study recommends intensification of the assessment of the readiness of student teachers to engage in the teaching practice exercise before the institution releases them to schools. In addition, teachers who are assigned the role of student-teacher mentorship should be relieved of other school duties as this might enhance their commitment to student-teacher development.

Outcomes of Prophylactic Inguinal Lymph Node Dissection in Malignancies of Lower Limb.

To evaluate the role of early prophylactic inguinal node dissection in patients with squamous cell cancer and melanoma of lower limb. From 2008 to 2018, a Tertiary Care Hospital connected to a teaching institute served as the site of this retrospective observational study. Patient records were gathered with the purpose of gathering clinical, investigative, surgical, pathological and follow-up information. We included 33 patients in this analysis out of the 47 patients we treated ourselves between 2008 and 2018; among these 33 patients, 21 (63.63%) had palpable inguinal nodes at the time of primary presentation. All 21 patients' FNAC tests were positive for metastases, in 16 patients (76.19%). 5 patients on FNAC (23.80%) exhibited not metastases. The remaining 12 patients did not have enlarged lymph nodes at the time of their initial presentation. Patients who did not have palpable lymph node were given the option of having a modified inguinal block dissection. 8 patients with metastatic disease have nodes that are positive in histology. In addition, out of 5 patients with negative nodes 4 (80%) showed evidence of metastasis. The conclusion of this retrospective observational study is that although palpable lymph nodes in groin are unquestionably a sign that inguinal nodes should be dissected, prophylactic lymph node dissection should be still done even if nodes are not palpable or provide a negative FNAC result. Given that delayed lymphadenectomy has a significant effect on survival, delaying inguinal lymphadenectomy in non-palpable nodes could cause you to lose the battle against cancer in your lower limb. The related surgical morbidity is the only downside to prophylactic lymph node dissection. This can, however, be effectively decreased with a modified inguinal lymphadenectomy operation.

Perceived outcomes of medical teaching institute reforms: insights from management, faculty, and administration in Pakistani tertiary health care

ObjectiveThe study aims to explore the perceived outcomes of Medical Teaching Institution (MTI) reforms on autonomy and overall performance within tertiary healthcare institutions in Khyber Pakhtunkhwa (KP) province, Pakistan.MethodologyA cross-sectional study was carried out from September 2023 to March 2024, involving interviews with frontline staff, administrative personnel, and senior management within MTI-affiliated institutions. The methodology employed, using both qualitative and quantitative data analysis techniques.ResultsThe study showed that institutional staff members’ knowledge and understanding of the MTI changes differed. Some observed very minor adjustments, while others saw advances in hospital operations and service delivery. Administrative complexity, political meddling, and resource allocation problems were noted as challenges. Positive results were also observed, though, and they included improved infrastructure, possibilities for staff training, and decision-making procedures.ConclusionDespite significant improved, there are still challenges, such as inconsistent staff comprehension, mixed impacts on service delivery, resource allocation issues, and political meddling. Addressing these issues necessitates improved communication, continuous evaluation, and coordinated efforts to improve administrative systems and obtain consistent funding.

Arthroscopic Reconstruction of an Anterior Cruciate Ligament Tear Using the Anatomic Single-Bundle Technique: A Clinical and Functional Outcome Evaluation.

The anterior cruciate ligament (ACL) consists of an anteromedial bundle and a posterolateral bundle giving anteroposterior and rotational stability to the knee. An ACL tear might lead to secondary changes in the knee joint if not operated in time. The aim of the study was to evaluate the clinical and functional results in patients with ACL tears treated by arthroscopic reconstruction using the anatomic single-bundle technique. This was a prospective study conducted between June 2015 and December2017 at a teaching institute in Kolkata, India, on patients who underwent single-bundle arthroscopic reconstruction of an ACL tear. A minimum follow-up of nine months was considered for all patients. The functional outcome was assessed via the Lysholm knee score. A total of 45 patients were included in this study, of which 34 (75.56%) and eight (17.78%) patients showed excellent and good results, respectively, at the final follow-up. The mean age in this study was 29.88±9.02 years. No complication was seen in 95.6% of patients. The mean Lysholm score by the end of nine months was 95.31±6.55. At the time of the final follow-up, all the patients returned to their same activity status prior to injury. Arthroscopic anatomic single-bundle ACL reconstruction using hamstring autograft is an effective treatment modality for ACL injuries. It restores the stability of the knee and is associated with good recovery of joint function with an early return to active lifestyle and sports activities. This procedure achieves excellent clinical and functional outcomes without any long-term disability.