Abstract Introduction: Social determinants of health (SDOH) are key drivers of health outcomes and inequities. Despite their importance, integration of SDOH into continuing medical education (CME) remains variable. This study evaluates the impact of targeted CME interventions on clinician awareness and engagement with SDOH within a large healthcare system. Materials and Methods: A quasi-experimental pre–post study was conducted at St. Luke’s University Health Network. Survey data from CME participants were collected in 2023 (pre-intervention) and 2025 (post-intervention) to assess familiarity with SDOH and perceived helpfulness of related education. Interventions included dissemination of baseline survey results to CME planners and incorporation of an SDOH-focused question into CME activity applications. CME activity content from 2022 and 2024 was analyzed to assess changes in SDOH-related programming. Results: Overall, the familiarity with priority SDOH increased from 42.8% in 2023 to 48.8% in 2025. Perceived helpfulness of CME addressing key SDOH domains improved from 39.1% in 2023 to 67.1% for access to care, 60.9% for mental/behavioral health, and 61.4% for chronic disease prevention in 2025. The proportion of CME activities addressing public and community health increased from 4.4% (44/1031) in 2022 to 23.7% (293/1238) in 2024, representing a nearly sevenfold increase. Conclusions: Targeted CME interventions, including feedback dissemination and integration of SDOH prompts into planning processes were associated with substantial improvements in SDOH-focused educational content and its perceived value. These findings highlight a scalable, cost-effective strategy for aligning CME programming with population health priorities and advancing health equity.These findings highlight a scalable, cost-effective strategy for aligning CME programming with population health priorities and advancing health equity. The following core competencies are addressed in this article: Professionalism, Practice-based learning and improvement, and Systems-based practice.
Abstract Medical education prepares the undergraduate and postgraduate students with the desired knowledge, skills, and professional competencies required to meet the complex needs of patients and health systems. Learning objectives that are specifically framed act as a foundation stone in the structuring of medical curriculum and ensures that teaching–learning activities, assessments, and expected educational outcomes are in complete alignment. The available literature suggests the presence of different barriers-cum-challenges, especially in institutions that have carried out the task of cocreation of learning objectives within their settings. Acknowledging the need for training medical students for future clinical challenges, student engagement, and a wide range of benefits that can be derived through the co-creation of learning objectives, there is an urgent need to effectively address the identified barriers for improving the overall process. To conclude, cocreation of learning objectives can prepare medical students to the complex needs of the healthcare system. The need of the hour is to identify the potential barriers and then address them in a structured manner through sensitization of students, training of faculty, and extending institutional support. The following core competencies are addressed in this article: Medical Knowledge and Practice-Based Learning and Improvement.
Abstract Solitary fibrous tumors (SFTs) comprise <2% of all soft tissue tumors, with approximately two-thirds of these tumors occurring in the pleura. These tumors are characterized by a NAB2-STAT6 fusion, with CD34 and STAT6 positivity on histology. Seminal vesicle tumors of any type are quite infrequent, with SFTs emanating from the seminal vesicle being so infrequent that no formal incidence has been calculated. This report is a case of a large SFT of the seminal vesicle found on digital rectal examination. Initial management was open en bloc surgical resection of the tumor, followed by scheduled surveillance. After two disease-free years, the patient experienced multiple local recurrences, necessitating re-excision. SFTs of the seminal vesicle are exceedingly rare, and histopathology is key to diagnosis. The following core competencies are addressed in this article: Medical decision making, diagnostic evaluation, evidence based medicine.
Abstract Introduction: There is hardly any evidence to comprehend the effect of passive ultrasonic irrigation during endodontic re-treatment, especially when used with or without gutta-percha solvents. The aim of the present study was to assess the impact of refined orange oil as gutta-percha solvent, while to compare passive ultrasonic irrigation with syringe irrigation on the cleanliness of dentinal tubules in endodontic re-treatment cases. Materials and Methods: The present in vitro study included 60 extracted intact human mandibular premolars. Again, canal preparations were done, while the samples were divided into three groups, including a control group (Group 1) wherein the canals were left unobturated ( n = 20), while in Group 2, endodontic re-treatment with refined orange oil solvent ( n = 20) and in Group 3, without refined orange oil was accomplished ( n = 20). Again, Group 2 and Group 3 were divided into two subgroups, wherein in subgroup A ( n = 10), the syringe irrigation technique was used, while in subgroup B ( n = 10), passive ultrasonic irrigation was performed. All the samples were evaluated under scanning electron microscope (SEM) to assess the cleanliness of dentinal tubules. Results: Statistically significant differences were observed between different groups with Group 3 revealing the highest mean values at all levels (coronal – 0.17200, middle – 0.20800, apical – 0.31500), followed by Group 2 and Group 1 ( P < 0.001). Furthermore, subgroups A revealed higher mean values than subgroups B with statistically significant results ( P < 0.05 to P < 0.001). Conclusions: Passive ultrasonic irrigation, when used with refined orange oil solvent, resulted in significantly cleaner dentinal tubules at all levels than the syringe irrigation technique. The following core competencies are addressed in this article: Practice-based learning and improvement, Patient care and procedural skills, Systems-based practice, Medical knowledge.
Abstract Introduction: Traditional assessment methods often demonstrate subjectivity, variability, and lack of standardization, with the disadvantage of inconsistencies and bias in assessment. Objective Structured Practical Examination (OSPE) overcomes these challenges with a structured approach, ensuring students’ assessment of essential skills and knowledge, aligning with the principle of modern medical education. The study aimed to compare the effectiveness of OSPE with conventional practical examination and evaluate perceptions of students and faculty regarding its effectiveness. Materials and Methods: A prospective, crossover study conducted among 88 second-year MBBS students at HIMSR, New Delhi, over a period of 6 months. Two OSPE modules were developed: Peripheral smear examination and the heat coagulation test for urine. Students were randomly divided into two groups of 44 students each. Performance scores were compared using a paired t-test. Students’ and faculty perceptions were obtained using a 5-point Likert scale. Cronbach’s α was used to calculate the internal consistency of the perception tool. Results: In the peripheral smear module, the mean scores in OSPE were higher (6.08 ± 1.43) than the conventional method (4.95 ± 0.84, P < 0.0001). In the urine module, the mean scores obtained in OSPE were higher (5.90 ± 1.16) than conventional (5.43 ± 0.97, P < 0.043). Overall, in respective modules, 75% and 61% of students scored higher. Students’ feedback (Cronbach’s α = 0.945) reflected OSPE as well-structured, clearly defined, and fairer, while faculty feedback (Cronbach’s α = 0.863) highlighted its objectivity and effectiveness but noted its greater logistics effort. Conclusion: OSPE significantly improved student performance and was strongly appreciated by both students and faculty despite its logistic challenges. Due to its validity and reliability, it can be incorporated into pathology assessment under competency-based medical examination (CBME).
Introduction: It is traditionally taught that traumatically injured patients should be transported to a hospital by emergency medical services in a timely manner to decrease morbidity and mortality. However, there is also thought to be a potential benefit in delaying transport to provide potentially life-saving interventions prehospitally. The purpose of this paper is to review the available literature on whether time spent in the pre-hospital setting affects morbidity and mortality of traumatically injured patients. Materials and Methods: A scoping review of published studies on PubMed and Google Scholar search engines was performed using keywords relevant to our study. Our search yielded a total of 871 studies, which were then narrowed down by review of the title and abstract to 81 relevant articles. These studies were reviewed in depth by the authors, yielding 14 studies that evaluated patient outcomes in relation to prehospital time for traumatically injured patients. The secondary review of articles yielded an additional 3 papers relevant to our review. Results and Conclusion: The results of the available studies are mixed but seem to favor the notion that morbidity and mortality are reduced when traumatically injured patients are transported in a timely fashion. This scoping review also highlights the need for studies that standardize definitions of time, level of care provided, and model of care delivery. The following core competencies are addressed in this article: Practice-based learning and improvement, Patient care and procedural skills, Systems-based practice, and Medical knowledge
Introduction:Despite the importance of assessing research productivity and impact, such data are lacking in resource-limited settings, where research faces substantial challenges. The aim of this study was to assess biomedical and health sciences publications of authors from Marrakesh in PubMed-indexed peer-reviewed journals from 2015 to 2019.Materials and Methods:This was a bibliometric study. Relevant papers were searched in PubMed and examined. Collected data included the authors' information (affiliation and collaborations), articles' characteristics (such as record type and study design), and the journals' characteristics (language, open access, and impact factor). Statistical analyses were descriptive using mainly counts and percentages.Results:A total of 494 authors published 715 manuscripts with an average number of publications per author of 1.4 +/- 0.9 (mean +/- standard deviation). More than half of the authors (55.2%) were affiliated with Moroccan University Hospitals. International collaboration was recorded in 31% of the papers. Half of the articles (49.7%) were original articles, and more than one-third were case reports. Among the original articles, the most commonly used study designs were cross-sectional studies and case series (24.2% and 23.6%, respectively). More than half of the articles were published in English, and 47.1% were published in open-access journals.Conclusion:The results emphasize the patterns of research productivity in our context, including limited scientific evidence and insufficient collaborative research projects. There is a need to promote research and improve its quality in resource-limited settings to enhance its impact on population health through integrated research-capacity-building initiatives.The following core competencies are addressed in this article:Medical knowledge.
Introduction:Existing literature suggests that oral potentially malignant epithelial lesions (oral PMELs) show increased predisposition towards frank malignant transformations. Furthermore, while numerous studies have assessed neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) in various general body cancers, limited research has explored these markers in the context of oral PMELs and oral squamous cell carcinomas (OSCCs). The present study aimed to evaluate the diagnostic role of NLR and PLR in oral submucous fibrosis (OSMF), one of the well-known oral PMELs, and OSCC patients.Materials and Methods:The present observational study included 99 subjects/patients, divided into three groups, with 33 patients clinically diagnosed with OSMF constituting Group A, 33 patients with clinically diagnosed and histopathologically proven OSCC constituting Group B, and 33 age-and sex-matched normal, healthy adults (acting as controls) constituting Group C. Furthermore, complete blood counts were assessed for all subjects/patients, while the data obtained were statistically analyzed.Results:The mean NLR and PLR values showed a gradual increase from the controls to OSMF to OSCC patients (the mean NLR being 2.19 +/- 0.26 in controls to 2.30 +/- 0.90 in OSMF and 4.64 +/- 2.42 in OSCC patients, with the mean PLR being 0.06 +/- 0.01 in controls to 0.07 +/- 0.02 in OSMF and 0.15 +/- 0.08 in OSCC patients) with the results being statistically highly significant (P = 0.0001).Conclusions:The study concluded that the mean NLR and PLR values may serve as possible diagnostic adjuncts in OSMF and OSCC patients, implying the role of the same as potential clinical markers during the ongoing process of malignant transformation.The following core competencies are addressed in this article:Practice-based learning and improvement, Patient care and procedural skills, Systems-based practice, Medical knowledge.
Introduction:This cross-sectional study examines the relationship between sleep disturbance, bruxism, and psychological disturbance in children with airway obstruction. Materials and Methods:Children with nasal obstruction presenting to the epartment of Ear, Nose, and Throat (ENT) and Pediatrics, MS Ramaiah University of Applied Sciences, Bangalore were recruited for the study. A prefabricated questionnaire was administered to the child's parent or caregiver to assess the presence of bruxism and other associated factors. Associations between sleep disturbance, bruxism, and psychological disturbance in airway obstruction patients were analyzed using the Chi-square test. The level of significance was set at P < 0.05. Results:Of the 120 study children (47.5% females), 77.5% presented with airway obstruction, 72.5% presented with sleep disturbance, bruxism was 68.3%, and psychological disturbance was seen in 46.7% children. Children aged 7-10 years presented with a higher percentage of the presence of airway obstruction, sleep disturbances, bruxism, and psychological disturbances compared to other age groups (3-6 years and 11-15 years). 77.2% females and 60.3% males had bruxism, and this difference was found to be statistically significant. Children with airway obstruction show significantly higher rates of sleep disturbance (88.2% vs. 37%) and bruxism (81.7% vs. 22.2%) but were less strongly associated (P = 0.04) with elevated psychological disturbance (51.6% vs. 29.6%). Conclusion:Airway obstruction among children strongly predicts sleep issues and bruxism, suggesting clinical screening in sleep medicine or ENT contexts in India. The following core competencies are addressed in this article:Medical knowledge, Patient care, Practice-based learning and improvement, Systems-based practice.
Post-cesarean isthmocele is a rare but serious complication characterized by a defect in the uterine scar, which can result in gynecological and urological issues. This case report highlights a unique presentation in a patient with multiple cesarean sections. A 45-year-old woman, with a history of five cesarean sections, the last performed in 2014, was referred for secondary amenorrhea and recurrent ovarian cysts noted since early 2024. She was also having some difficulty passing urine and was admitted to Al-Batool Teaching Hospital on November 7, 2024, where she complained of intense pain in the lower abdomen, which had an index of loins and back pain, with development of fever and rigors. The patient, gravida 5, para 5 with 5 previous repeat cesarean deliveries, was referred to our hospital with her imaging studies demonstrating a large collection in the right adnexa (trans vaginal ultrasound), with a clear connection between the endometrial cavity and the collection, wherein hemorrhagic particles were noted., on MRI there is bulky uterus, the endometrium is filled with fluid collection which is hyper intense in T1 and T2 image. Laparotomy showed dense adhesions between the uterus and urinary bladder, collection between uterus and urinary bladder, and a sizeable defect on the previous cesarean scar. Surgical management consisted of total hysterectomy and resection of the right ovary and fallopian tube. Postoperative course was unremarkable with stable vital signs, normal urinary output, and minimal drain output. This case emphasizes the complexities of post-cesarean isthmocele, its potential complications and there are lot of risk factors can be avoided to prevent its occurrence.The following core competencies are addressed in this article:Medical knowledge, Patient care and procedural skills, Systems-based practice.
Introduction:The increasing number of confirmed human monkeypox (HMPX) cases in Sudan underscores the need for early disease detection, management, and prevention, which cannot be achieved without proper knowledge and up-to-date evidence-based information. The objective of this study was to assess knowledge and attitudes regarding HMPX among Sudanese healthcare workers (HCWs).Materials and Methods:This cross-sectional study aimed to assess HCWs' knowledge and attitudes toward HMPX. An online questionnaire was prepared with relevant up-to-date information that was adjusted to fit the objectives of this study. Nonprobability convenience sampling was used, and the questionnaire was distributed through various social media platforms.Results:A total of 384 participants from various healthcare sectors were enrolled in this study. About 67.7% of the participants were female, and 70.1% were 25-35 years old. Of the 384 respondents, 70.6% had received relevant medical education about monkeypox. A majority of the assessed population lacked knowledge about the rash onset of the disease, how to differentiate monkeypox from smallpox, and whether a vaccine was available. Poor knowledge of monkeypox was shown to be affected by various factors.Conclusion:In Sudan, HCWs' attitudes and knowledge about monkeypox infection are insufficient. As previous epidemics and pandemics such as coronavirus disease 2019 have shown, training and knowledge assessment are crucial, particularly when there is evidence of considerable improvement with related and specialized information.The following core competencies are addressed in this article: Patient care and procedural skills, Medical knowledge, Professionalism, Practice-based learning and improvement, Systems-based practice and Interpersonal and communication skills.Conclusion:In Sudan, HCWs' attitudes and knowledge about monkeypox infection are insufficient. As previous epidemics and pandemics such as coronavirus disease 2019 have shown, training and knowledge assessment are crucial, particularly when there is evidence of considerable improvement with related and specialized information.The following core competencies are addressed in this article: Patient care and procedural skills, Medical knowledge, Professionalism, Practice-based learning and improvement, Systems-based practice and Interpersonal and communication skills.
Introduction:Postoperative use of medications is usually recommended to relieve pain and inflammations following surgical removal of the impacted teeth, although, despite adequate measures, complications still persist. The present trial analyzed and compared the effect of Dexamethasone and Diclofenac sodium administered preoperatively on complications, including neural pain perceptions in patients undergoing surgical extractions for impacted mandibular third molars. Materials and Methods:The present, double-blind, randomized control trial comprised 90 healthy, adult patients, aged between 18 and 45 years, who were advised surgical removal of impacted mandibular third molars. The selected patients were randomly assigned to three groups using the simple randomized sampling and were administered 2 cc of normal saline (in controls) and 75 mg of Diclofenac sodium along with 8 mg of Dexamethasone in different groups as a single preoperative, intramuscular (IM) injection before procedure, while the various clinical indicators such as pain, swelling (edema), and trismus were assessed preoperatively and subsequently, on the 2nd and 7th postoperative days. Again, the Chi-square test was used to test the association between the variables studied, whereas the one-way analysis of variance was used to compare the means of independent groups to determine whether they were significantly different from each other. P < 0.05 was considered statistically significant. Results:Severe pain was reported in the maximum patients in control Group (Group A) followed by Group C and Group B on the 2nd and 7th postoperative days. Furthermore, maximum mouth opening was recorded on the 7th postoperative day in Group C wherein patients were administered Dexamethasone, while the normal facial contours were restored in all three groups with minimal to no swelling reported in different groups on the 7th postoperative day.Conclusion:Based on the results obtained in the present trial, it can be concluded that a single preoperative dose of either Dexamethasone and Diclofenac sodium might not benefit patients significantly when administered through the IM route.The following core competencies are addressed in this article: Practice-based learning and improvement, Patient care and procedural skills, Systems-based practice, and Medical knowledge. Conclusion:Based on the results obtained in the present trial, it can be concluded that a single preoperative dose of either Dexamethasone and Diclofenac sodium might not benefit patients significantly when administered through the IM route.The following core competencies are addressed in this article: Practice-based learning and improvement, Patient care and procedural skills, Systems-based practice, and Medical knowledge.
Introduction:This study investigated the prevalence of imposter syndrome and its correlation with personality traits among medical, dental and allied health undergraduate students in urban Bengaluru, India.Materials and Methods:A cross-sectional survey was conducted among 3rd- and 4th-year medical, dental and allied health students aged 18 years or older in a single institution in urban Bengaluru. Data collection relied on validated self-reported instruments: the Clance Imposter Phenomenon Scale (CIPS) measured Imposter Syndrome, and the Big Five Inventory (BFI) assessed personality traits. Statistical analyses, including descriptive statistics, Chi-square tests, Spearman rank correlation tests and multivariate analysis of variance, were employed to characterize the sample and identify significant relationships.Results:Data were collected from 378 respondents; 347 participated and passed data cleaning. Three were excluded for being in early academic years, and 28 reported preexisting mental health conditions. About 50.7% of participants experienced moderate-to-high levels of imposter syndrome. Year of study (P = 0.423) and background (discipline) (P = 0.24) did not demonstrate statistically significant associations with imposter syndrome levels. Fourth-year MBBS students had the highest prevalence (32%), followed by 3rd-year MBBS students (25.7%), for imposter syndrome. High rates (ranging from 33.3% to 44.8%) were observed amongst 3rd-year students across all disciplines for imposter syndrome. Multivariate analyses further revealed a weak positive correlation between imposter syndrome and the personality trait of openness (P = 0.252).Conclusion:Certain personality traits may predispose individuals to experience Imposter Syndrome, underscoring the need for targeted interventions and systemic changes within medical, dental, and allied health education institutions to address this issue effectively.The following core competencies are addressed in this article: Interpersonal and communication skills, Practice-based learning and improvement, Professionalism, Systems-based practice.Conclusion:Certain personality traits may predispose individuals to experience Imposter Syndrome, underscoring the need for targeted interventions and systemic changes within medical, dental, and allied health education institutions to address this issue effectively.The following core competencies are addressed in this article: Interpersonal and communication skills, Practice-based learning and improvement, Professionalism, Systems-based practice.
Abstract St. Luke’s University Health Network (SLUHN) in Bethlehem, PA, USA holds an annual Research Day Symposium to highlight research projects, quality improvement (QI) projects, and case reports completed by residents, medical students, fellows, and other trainees within the hospital system. The event is organized by the Research and Innovations Department, with collaboration and consultation from the Graduate Medical Education department, Information Technology department, Temple/St. Luke’s Medical School, the various residency programs within SLUHN, and fellowship faculty. Residents, medical students, and fellows are invited to submit their research project, QI project, or case report. A select panel of 10 judges would review all submissions, 2 judges to each submission. All projects were invited to present either in a podium presentation or a quick shot video format. Winners were selected during the live event of the Research Day Symposium and judged by a live audience. Three podium presentations and 1 quick shot presentation were highlighted. This document contains 15 research abstracts and 13 case reports from the 2025 Research Day Symposium. The following core competencies are addressed in this article: Interpersonal and communication skills, Medical knowledge, Patient care and procedural skills, Practice-based learning and improvement, Professionalism, Systems-based practice
Lymphomas are a diverse group of malignancies originating from lymphoid cells, which can affect any organ system and present with a wide variety of symptoms. Non-Hodgkin's lymphoma accounts for the majority of lymphomas and can involve extranodal sites in up to 50% of cases. Primary pancreatic lymphomas are rare, with Burkitt's lymphoma (BL) being an exceptionally uncommon variant. We report the case of a 16-year-old male who presented with symptoms of gastric outlet obstruction, abdominal discomfort, and weight loss. Diagnostic imaging revealed a diffusely enlarged pancreas causing duodenal compression, and histopathological examination confirmed a diagnosis of primary pancreatic BL. The patient was treated with a chemotherapy regimen and a feeding jejunostomy to maintain nutrition. Following treatment, he showed significant clinical improvement and remained asymptomatic at 6 months. This case underscores the rarity of primary pancreatic BL and highlights the importance of considering it in differential diagnoses for gastric outlet obstruction, particularly in younger patients. Early diagnosis and treatment are crucial for improving outcomes.The following core competencies are addressed in this article: Medical knowledge, Patient care, Practice based learning and improvement.
Here, we present a case of a 40-year-old female patient who presented with complaints of bleeding per rectum, pain during defecation, and something coming out per rectum for the past 3 months. On per rectal examination, a polypoidal growth was seen coming out of the rectum. The clinical diagnosis was given as a rectal polyp. The patient underwent surgical resection of rectal polyp postclinical diagnosis. The excised specimen was received in the Histopathology Department of Sumandeep Vidyapeeth. Here, we performed the gross and microscopic examination of the polyp. The histopathological diagnosis of malignant gastrointestinal stromal tumor (GIST) was given after confirmation with immunohistochemistry. GISTs are rare mesenchymal tumors commonly found in the stomach and small intestine, with rectal involvement being exceedingly uncommon. This report aims to highlight the diagnostic challenges, treatment strategies, and outcomes associated with this unusual presentation. The following core competencies are addressed in this article: Medical knowledge, Patient care.
