scholarly journals The Use of Commercially Available Non-Medical Grade USB Cameras for Physician Guided ENT Out-Patient Self-Examination During the COVID-19 Pandemic

2021 ◽  
Vol 36 (1) ◽  
pp. 50
Author(s):  
Rentor Cafino
Keyword(s):  
Oral Cavity ◽  
Learning Curve ◽  
Outpatient Department ◽  
Set Up ◽  
Self Examination ◽  
Medical Grade

ABSTRACT Objective: To describe the use of commercially available, non-medical grade USB cameras in a non-contact examination of simple cases involving the ears, nose and oral cavity of patients during the COVID-19 pandemic Methods: Design: Instrument innovation Setting: Tertiary Government Training Hospital Participants: Patients who consulted at the ENT-HNS outpatient department during the COVID-19 pandemic. Results: Commercially available USB cameras were able to provide basic visualization of the ears, nose and oral cavity. The non-medical grade USB cameras captured lower quality images when compared to the medical grade endoscopes but provided enough visualization to aid in the examination and diagnosis of simple cases. There was a learning curve in using the set-up but patients were able to adjust well, taking an average time of 2.7 minutes to complete the examination. Conclusion: Non-medical grade USB cameras may play a role in aiding otolaryngologists in examining simple cases during the COVID-19 pandemic. Integration of this system into current examination practices may offer an extra layer of protection for otolaryngologists and patients alike. However, the use of these instruments as part of regular ENT practice may be controversial and will need further study.

Learning curve and robot set-up/operative times in singly docked totally robotic Roux-en-Y Gastric bypass

2014 ◽  
Vol 28 (5) ◽  
pp. 1629-1633 ◽  
Author(s):  
Subhashini Ayloo ◽  
Eduardo Fernandes ◽  
Nabajit Choudhury
Keyword(s):  
Gastric Bypass ◽  
Learning Curve ◽  
Set Up

scholarly journals Decoding the learning curve of non-descent vaginal hysterectomy in the era of laparoscopy- experience at a Zonal Hospital

2021 ◽  
Vol 10 (5) ◽  
pp. 2015
Author(s):  
Shikha Sharma ◽  
Jafar Husain ◽  
Anshul Jain ◽  
Sruthi Bhaskaran ◽  
Raj Singh ◽  
...  
Keyword(s):  
Learning Curve ◽  
Vaginal Hysterectomy ◽  
Limited Resource ◽  
Laparoscopic Hysterectomy ◽  
Military Hospital ◽  
Vaginal Route ◽  
Program Objective ◽  
Group 2 ◽  
Set Up ◽  
Group 1

Background: Despite of the increasing popularity of laparoscopic hysterectomy, vaginal route still stays pertinent. Non descent vaginal hysterectomy (NDVH) involves d steep learning curve and hence, should be a fundamental part of every Gynaecology residency program. Objective of the study was to assess the learning curve of NDVH surgery skill at a Military Zonal Hospital by a single Specialist over a period of two years.Methods: Retrospective study conducted at Military Hospital, Agra between June 2015 to June 2017 on 30 patients who underwent NDVH for benign gynaecological conditions.Results: The average blood loss was noted to reduce from a mean of 285ml (±108.94) in the first 20 cases (Group 1) to 227ml (±110.89) in the next 10 cases (Group 2) despite of the average uterine size increasing from 8.5 (±1.43) weeks in Group 1 to 10.2 (±2.39) weeks in Group 2. The average time taken in minutes was also seen to reduce from 89.75 (±12.62) in Group 1 to 70.5 (±16.50) in Group 2 indicating an improvement of surgical skills. The average 24 hr post-operative haemoglobin fall of 0.8gm% was similar between the two groups.Conclusions: Acquiring NDVH skills is a slow but rewarding process. NDVH involves no incisions, no elaborate set-up, avoids complications of general anaesthesia and pneumo-peritoneum and displays similar results as of laparoscopy. In limited resource countries vaginal route may be the only available minimally invasive option for hysterectomy. Hence, it’s pertinent that Gynecologists are trained in the same. 

INTRODUCTORY

PEDIATRICS ◽  
1960 ◽  
Vol 26 (5) ◽  
pp. 872-874
Author(s):  
Carl C. Fischer
Keyword(s):  
Medical Profession ◽  
Program Committee ◽  
Medical Economics ◽  
Pediatric Practice ◽  
Office Practice ◽  
Medical Office ◽  
Letter To The Editor ◽  
Set Up ◽  
Self Examination

In A Final act of what I can only interpret as retribution for the tasks imposed upon them, your Program Committee drafted its chairman to set up the concluding program of this session in a form of a panel on the topic, "Can the New Pediatrics be Practiced?" Fortunately, no restrictions as to content or participants were given and for this, at least, my thanks to the committee. Periodic episodes of self-examination by various segments of the medical profession have been among the more salutary advances of Medicine for generations, but increasing emphasis upon the change in pediatric practice seems to date back only about 3 years to a Letter to the Editor of the Journal of Pediatrics by Dr. Frank L. Tabrah in December, 1957. This letter quoting an article of the November, 1956 issue of Medical Economics, stated among other things that "1/3 of the pediatricians in practice were dissatisfied" and contained such challenging statements as, "well-babies still frequent the pediatrists' office, but it is inconceivable that any physician with intelligence and interest in the unusual, can long survive the routine of playing grandmother for years on end in a well-baby practice. Few men will knowingly accept such a career—in time the specialty may lose the top quality men it has attracted in past years, pediatric medical office practice is not enough; there are too many private pediatric practices being started today that will be abandoned from sheer boredom." Dr. Tabrah's letter was followed by a reply by one of our panelists, Dr. Lee Hill, and in the same issue by an article entitled "Pediatric Rewards" by Dr. A. H. Parmelle, Sr.

Comparison of Transradial vs Transfemoral Access in Neurovascular Fellowship Training: Overcoming the Learning Curve

2021 ◽  
Author(s):  
Fadi Al Saiegh ◽  
Ahmad Sweid ◽  
Nohra Chalouhi ◽  
Lucas Philipp ◽  
Nikolaos Mouchtouris ◽  
...  
Keyword(s):  
Radiation Dose ◽  
Learning Curve ◽  
Fellowship Training ◽  
Learning Curves ◽  
Fluoroscopy Time ◽  
Site Infection ◽  
Procedure Time ◽  
Access Site ◽  
Contrast Volume ◽  
Set Up

Abstract BACKGROUND The transradial access (TRA) is rapidly gaining popularity for neuroendovascular procedures as there is strong evidence for its benefits compared to the traditional transfemoral access (TFA). However, the transition to TRA bears some challenges including optimization of the interventional suite set-up and workflow as well as its impact on fellowship training. OBJECTIVE To compare the learning curves of TFA and TRA for diagnostic cerebral angiograms in neuroendovascular fellowship training. METHODS We prospectively collected diagnostic angiogram procedural data on the performance of 2 neuroendovascular fellows with no prior endovascular experience who trained at our institution from July 2018 until June 2019. Metrics for operator proficiency were minutes of fluoroscopy time, procedure time, and volume of contrast used. RESULTS A total of 293 diagnostic angiograms were included in the analysis. Of those, 57.7% were TRA and 42.3% were TFA. The median contrast dose was 60 cc, and the median radiation dose was 14 000 μGy. The overall complication rate was 1.4% consisting of 2 groin hematomas, 1 wrist hematoma, and 1 access-site infection using TFA. The crossover rate to TFA was 2.1%. Proficiency was achieved after 60 femoral and 95 radial cases based on fluoroscopy time, 52 femoral and 77 radial cases based on procedure time, and 53 femoral and 64 radial cases based on contrast volume. CONCLUSION Our study demonstrates that the use of TRA can be safely incorporated into neuroendovascular training without causing an increase in complications or significantly prolonging procedure time or contrast use.

scholarly journals Prevalence of oral mucosal lesions in a tertiary care centre: one-year prospective study

2020 ◽  
Vol 6 (9) ◽  
pp. 1704
Author(s):  
Smruti Milan Tripathy ◽  
Poonji Gupta ◽  
Akshay Jain ◽  
Probal Chatterji
Keyword(s):  
Oral Cavity ◽  
Early Stage ◽  
Tertiary Care ◽  
Outpatient Department ◽  
Research Centre ◽  
Tertiary Care Centre ◽  
Medical College ◽  
Number Of Patients ◽  
Malignant Lesions ◽  
One Year

<p class="abstract"><strong>Background:</strong> Lesions of the oral cavity are very common among the general population and account for a significant number of patients in the outpatient department of otorhinolaryngology. The lesions of oral cavity can cause varied symptoms like pain, dysphagia, and difficulty in speaking. The lesions can range from simple benign conditions to life threatening malignancies.</p><p class="abstract"><strong>Methods:</strong> This study was conducted in the department of otorhinolaryngology, Teerthanker Mahaveer Medical College and Research Centre from January 2019 till December 2019. All the 256 patients who presented to the outpatient department with lesions in the oral cavity during the given time period were included in the study after getting informed and written consent.  </p><p class="abstract"><strong>Results:</strong> Aphthous ulcers were the most common lesion (18.7%) found in this study. Buccal mucosa (50%) and anterior 2/3<sup>rd</sup> of tongue (34.3%) were the most common sites involved. Total of 204/256 (79.6%) patient had some form of addiction which included both smoked and smokeless form of tobacco as the most common type of addiction. Among the tobacco smokers, 24/80 (30%) had pre malignant and malignant lesions while among tobacco chewers 37/76 (48.6%) had pre malignant and malignant lesions.</p><p class="abstract"><strong>Conclusions:</strong> Lesions of the oral cavity are common among Indian population due to high prevalence of tobacco addiction. A thorough history taking and examination can detect premalignant and malignant lesions at an early stage, so that timely treatment can reduce the mortality rates in such patients.</p>

scholarly journals Cryopreservation of Mesenchymal Stem Cells Using Medical Grade Ice Nucleation Inducer

2020 ◽  
Vol 21 (22) ◽  
pp. 8579
Author(s):  
Nicholas M. Wragg ◽  
Dimitris Tampakis ◽  
Alexandra Stolzing
Keyword(s):  
Stem Cells ◽  
Mesenchymal Stem Cells ◽  
Regenerative Medicine ◽  
Stable Process ◽  
Ice Nucleation ◽  
Rate Of Change ◽  
Freezing And Thawing ◽  
Rapid Fall ◽  
Set Up ◽  
Medical Grade

Mesenchymal stem cells (MSCs) can differentiate into multiple different tissue lineages and have favourable immunogenic potential making them an attractive prospect for regenerative medicine. As an essential part of the manufacturing process, preservation of these cells whilst maintaining potential is of critical importance. An uncontrolled area of storage remains the rate of change of temperature during freezing and thawing. Controlled-rate freezers attempted to rectify this; however, the change of phase from liquid to solid introduces two extreme phenomena; a rapid rise and a rapid fall in temperature in addition to the intended cooling rate (normally −1 °C/min) as a part of the supercooling event in cryopreservation. Nucleation events are well known to initiate the freezing transition although their active use in the form of ice nucleation devices (IND) are in their infancy in cryopreservation. This study sought to better understand the effects of ice nucleation and its active instigation with the use of an IND in both a standard cryotube with MSCs in suspension and a high-throughput adhered MSC 96-well plate set-up. A potential threshold nucleation temperature for best recovery of dental pulp MSCs may occur around −10 °C and for larger volume cell storage, IND and fast thaw creates the most stable process. For adhered cells, an IND with a slow thaw enables greatest metabolic activity post-thaw. This demonstrates a necessity for a medical grade IND to be used in future regenerative medicine manufacturing with the parameters discussed in this study to create stable products for clinical cellular therapies.

scholarly journals Tuberculosis of the Oral Cavity Affecting Alveolus: A Case Report

2011 ◽  
Vol 2011 ◽  
pp. 1-3 ◽  
Author(s):  
Bipin Kumar
Keyword(s):  
Case Report ◽  
Oral Cavity ◽  
Outpatient Department ◽  
Granulomatous Lesion ◽  
Alveolar Region ◽  
Histological Features ◽  
Acid Fast Bacilli ◽  
Ulcer Margin ◽  
First Case

We report a first case of tuberculosis of oral cavity affecting the left alveolus from Nepal in a 63-year-old male who came to otorhinolaryngology outpatient department with a complaint of an ulcer in the oral cavity and pain in bilateral ear and throat. An ulcer measuring 1.8 cm in diameter with irregular friable margin and bleeding on touch was found in the left upper alveolar region of the oral cavity. Biopsy from the ulcer margin revealed histological features of necrotizing granulomatous lesion. Stain for acid fast bacilli was positive.

scholarly journals Institutional Transference and Disengagement: A Study of an Outpatient Clinic

1971 ◽  
Vol 16 (3) ◽  
pp. 227-232 ◽  
Author(s):  
H. M. Sampath ◽  
E. Kingstone ◽  
B. Dhindsa
Keyword(s):  
Outpatient Clinic ◽  
The Other ◽  
Outpatient Department ◽  
Treatment Staff ◽  
One To One ◽  
Set Up ◽  
The One ◽  
Entire Treatment

This paper describes an outpatient clinic where many of the patients are chronic attenders who resist all attempts at discharge. Their dependency needs and the difficulty of one-to-one treatment are outlined. On the one hand there is the almost insatiable demand for magical medications, and on the other the frustration of the therapists trying to deal with this situation. To circumvent these difficulties, the concept of institutional transference was fostered by a policy of disengagement. As a result a flexible therapeutic set up was evolved allowing for the fulfillment of dependency needs and the maintenance of satisfactory morale, not only among the patients but also among the entire treatment staff. The clinic, instead of being viewed as merely a place for difficult and incurable patients, is now seen as a useful alternative in the treatment armamentarium of the outpatient department.

scholarly journals Mouth Self-Examination for Prevention and Control of Oral Cavity Cancer

2020 ◽  
Vol 58 (225) ◽  
Author(s):  
Gambhir Shrestha ◽  
Leison Maharjan
Keyword(s):  
Early Detection ◽  
Oral Cavity ◽  
Oral Cavity Cancer ◽  
Low Cost ◽  
Oral Lesions ◽  
Non Invasive ◽  
Prevention And Early Detection ◽  
Self Examination ◽  
And Control ◽  
Public Health Strategies

Oral cavity cancer is one of the most common preventable cancers in the world. The burden of thedisease is high in South Asia. Therefore, public health strategies such as creating awareness anddisease screening should be advocated for its prevention and early detection. Mouth self-examinationserves both the purposes. It is easy to perform, non-invasive, and low-cost methods. It not only helpsin the early detection of suspicious oral lesions but also helps people to quit their high-risk behaviorssuch as consumption of tobacco and alcohol.

scholarly journals Learning Curves of Robotic Spine Surgery in a System Lack of Active Perception: Potential Roles of Teamwork and Unmet Needs

2021 ◽  
Author(s):  
Yu-feng Su ◽  
Tai-Hsin Tsai ◽  
Keng-Liang Kuo ◽  
Chieh-Hsin Wu ◽  
Cheng-Yu Tsai ◽  
...  
Keyword(s):  
Learning Curve ◽  
Spine Surgery ◽  
Unmet Needs ◽  
Learning Curves ◽  
University Hospital ◽  
Active Perception ◽  
Test Analysis ◽  
Orthopedic Surgeons ◽  
Individual Surgeon ◽  
Set Up

Abstract Background: The aim of this study was to investigate the learning curve of robotic spine surgery quantitatively with the well-described power law of practice.Methods: Kaohsiung Medical University Hospital set up a robotic spine surgery team by the neurosurgery department in 2013 and the orthopedic department joined the well-established team in 2014. A total of 150 cases and 841 transpedicular screws were enrolled into 3 groups: the first 50 cases performed by neurosurgeons, the first 50 cases by orthopedic surgeons, and 50 cases by neurosurgeons after the orthopedic surgeons joined the team. The time per screw and accuracy by each group and individual surgeon were analyzed.Results: The time per screw for each group was 9.56±4.19, 7.29±3.64, and 8.74±5.77 minutes respectively. The accuracy was 99.6% (253/254), 99.5% (361/363), and 99.1% (222/224), respectively. The first group took significantly more time per screw, but without significance on the nonlinear parallelism test. Analysis of 5 surgeons and their first 10 cases of short segment surgery showed the time per screw by each surgeon was 12.28±5.21, 6.38±1.54, 8.68±3.10, 6.33±1.90, and 6.73±1.81 minutes. The first surgeon who initiated the robotic spine surgery took significantly more time per screw and the nonlinear parallelism test also revealed only the first surgeon had a steeper learning curve. Conclusions: This is the first study to demonstrate that differences of learning curves between individual surgeons and teams. The roles of teamwork and the unmet needs due to lack of active perception are discussed.

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