Notes

Non-immune hydrops fetalis: A couple of case accounts.
Copyright © 2019 American Chemical Society.Cervicovaginal atresia with a functional uterus is rare. There are no established surgical methods to treat this condition, and only a few reports have been published on surgical techniques. Furthermore, postoperative complications, such as restenosis, often require reoperation. A 19-year-old woman was pointed out cervical hypoplasia and referred to our hospital for further examination and treatment. A pelvic examination revealed that the vagina had a slight recession with a blind end. Transrectal ultrasound and pelvic magnetic resonance imaging revealed congenital vaginal agenesis and cervical hypoplasia. Elective surgery was performed after reshaping the vagina. A radical surgery was performed 10 months later after sufficient self-dilation by using Frank's technique in an outpatient setting. At first, we approached by laparoscopically to correct autologous peritoneum and to bladder detach, then the cervical canal was identified. Next, a skin biopsy punch was used several times to hollow out the cervical tissue to shape and expand the cervical canal. A catheter was then placed in the uterus and autologous peritoneum was wrapped around it and fixed to the cervical canal. The catheter was removed 6 weeks postoperatively, and the patient continued dilating her vagina until she was able to have sexual intercourse, and then stopped the self-dilation. Eight months postoperatively, the patient did not report any menstrual irregularities. Voxtalisib It is important to make corrections to prevent restenosis of the vagina and cervical canal and prevent the symptoms from recurring. Make use of autologous peritoneum as graft onto the cervical canal is effective method for the treatment of cervicovaginal atresia.Gastric volvulus is a rare entity. Its diagnosis remains tricky and challenging. In recent years, the incidence of gastric volvulus has shown a rise in postbariatric surgery patient. Several cases were reported of gastric remnant volvulus post-laparoscopic sleeve gastrectomy and laparoscopic gastric bypass. Laparoscopic gastric greater curvature plication is a new and experimental restrictive technique for weight loss. Several of its complications were reported in the literature but never was a case of volvulus postgastric plication reported, as far as we know. We present this rare case with an atypical presentation and go through similar cases in the literature.Introduction This interactive didactic session is designed for first-year medical students to explore the common clinical symptom of headache and its various management strategies. The session provides an opportunity to cover a variety of drugs, mechanisms of action, drug-drug interactions, and routes of administration in a single 50-minute time frame. Methods Using a modified case-based approach, we designed an interactive session for 41 first-year medical students. Students prepared for the session using basic learning objectives and a table of drugs that treat headache pain. In class, we distributed a patient scenario and a series of discussion questions to explore headache management. We assessed student performance using questions purchased from the National Board of Medical Examiners and student perceptions using both qualitative and quantitative data collected from faculty and end-of-block evaluations. Results Student performance on purchased questions related to content was significantly increased when compared to the national average (n = 5; 90.6% ± 6.0% vs. 82.6% ± 8.5%; p = .0052). Student perceptions of the overall quality of the faculty, content presentation, and material were positive (4.4 out of 5.0). Two themes emerged in the end-of-block evaluations Students commented positively on the prereading materials, and students commented on the need to address underlying physiology associated with the discussed pharmacology. Discussion This flexible activity can be delivered in a short time (50 minutes) by a single faculty member in a variety of curricular structures. Our data demonstrate strong student performance and suggest that incorporating additional content would enhance delivery. Copyright © 2020 Cleveland and LeClair.Introduction Dietary factors are recognized as a major contributor to the global burden of disease, and the obesity epidemic continues to be a major public health problem. Patients rely on doctors for dietary advice and to serve as role models for health behaviors. However, nutrition content is significantly underrepresented in medical school curricula. Methods We created an interactive session to address this gap during the ambulatory medicine rotation for senior medical students and delivered it as a 90- to 120-minute interactive monthly didactic session. We focused on reviewing evidence-based diet patterns for weight loss and hypertension and on use of practical tools for diet assessment and counseling. Immediately and 1 month after delivery, we administered a knowledge and confidence assessment survey to evaluate the session impact. Results We incorporated the session into the regular didactic time of the clerkship. Sixty-six students attended over an 8-month period, of whom 42 completed the survey. Immediately and 1 month after delivery, participants reported statistically significant improvements (p less then .001) in their confidence in the domains measured. Participants' knowledge scores increased immediately and 1 month after the session compared to before participation. Discussion We delivered a single recurring seminar on diet patterns and practical tips that was well received by fourth-year medical students during the ambulatory medicine clerkship. The seminar was a practical and interactive way of delivering important nutrition content to the medical school curriculum, and we demonstrated retention of confidence and knowledge of the delivered content. Copyright © 2020 Berz et al.Introduction Significant gaps remain in the training of health professionals regarding the care of individuals who identify as lesbian, gay, bisexual, and transgender (LGBT). Although curricula have been developed at the undergraduate medical education level, few materials address the education of graduate medical trainees. The purpose of this curriculum was to develop case-based modules targeting internal medicine residents to address LGBT primary health care. Methods We designed and implemented a four-module, case-based, interactive curriculum at one university's internal medicine residency program. The modules contained facilitator and learner guides and addressed four main content areas understanding gender and sexuality; performing a sensitive history and physical examination; health promotion and disease prevention; and mental health, violence, and reproductive health. Knowledge, perceived importance, and confidence were assessed before and after each module to assess curricular effectiveness and acceptability.
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