A randomised crossover study to compare the cross-sectional and longitudinal approaches to ultrasound-guided peripheral venepuncture in a model

Ultrasound skills teaching in UK medical education: A systematic review

BACKGROUND

Sonography is increasingly integrated into medical curricula to prepare students for clinical practice. In 2022, we conducted a systematic review to explore the degree to which ultrasound skill acquisition is incorporated into undergraduate medial education in the United Kingdom.

METHODS

A search of Medline and Embase databases from 2003 to 2022 identified 15 relevant articles. Studies were included if they described ultrasound skills training in UK undergraduate medical education.

FINDINGS

A range of teaching methods were reported including didactic demonstrations, hands-on experience and combinations thereof. Portable machines were more common than cart-based machines, and most demonstrators were ultrasound-trained clinicians. Ultrasound teaching is well received, with improvements in confidence using ultrasound, motivation to learn anatomy and retention of knowledge.

DISCUSSION

Obstacles to integration were noted including training, cost, curriculum time constraints and the issue of incidental pathology. One study demonstrated that anatomists with appropriate training could provide ultrasound teaching, reducing the need for clinicians or sonographers. Costs may be reduced by renting machines or purchasing portable/hand-held devices. Allowing access to machines during student's free time may address scheduling difficulties. A final recommendation is to pre-scan volunteers prior to the teaching session.

CONCLUSION

We have outlined approaches to ultrasound skills teaching and the inherent hurdles to this, as well as potential solutions. This may aid educators wishing to augment their curricula. Although there are relatively few studies from the United Kingdom, there is consensus that students enjoy the incorporation of ultrasound practice and believe it complements existing teaching, especially in a small group setting.

In vitro experiments of Pediculus humanus capitis (Phthiraptera: Pediculidae) resistance to permethrin and 6-paradol in East Jakarta: Detoxification enzyme activity and electron microscopic changes in lice

Background and Aim:

Pediculus humanus capitis, the human head louse, remains a global health problem. This study evaluated the resistance of head lice to permethrin and 6-paradol mediated by in vitro detoxification enzyme activity experiments and to describe physical changes in the lice using scanning electron microscopy (SEM).

Materials and Methods:

The adult stages of P. h. capitis were collected from patients exposed to 1% permethrin and three different concentrations of 6-paradol (0.00005%, 0.0001%, and 0.00015%) using a filter paper diffusion bioassay. Healthy P. h. capitis adults served as the control. The in vitro bioassays were conducted after 10, 20, 30, and 60 min of exposure. The activities of acetylcholinesterase (AChE), glutathione S-transferase (GST), and oxidase were analyzed. Physical changes in the lice were analyzed using SEM.

Results:

Permethrin and 6-paradol exhibited low toxicity against the lice. At 60 min, 1% permethrin had killed 36.7% of the lice present, while 6-paradol had killed 66.7-86.7%. Permethrin induced significantly elevated AChE, GST, and oxidase activity; 6-paradol also caused significantly elevated AChE, GST, and oxidase activity. Permethrin did not cause any ultrastructural morphological changes on the lice, while 6-paradol severely damaged the head, thorax, respiratory spiracles, and abdomen of the dead lice.

Conclusion:

This in vitro experimental of P. h. capitis is the first study to report P. h. capitis in East Jakarta shows complete resistance to permethrin and 6-paradol, and to describe the associated increase in AChE, GST, and oxidase activity. It was observed that 6-paradol severely damaged the head, thorax, respiratory spiracles, and abdomen of the dead lice.

Education in the placement of ultrasound-guided peripheral venous catheters: a systematic review

BACKGROUND

Placing a peripheral vein catheter can be challenging due to several factors, but using ultrasound as guidance increases the success rate. The purpose of this review is to investigate the knowledge already existing within the field of education in ultrasound-guided peripheral vein catheter placement and explore the efficacy and clinical impact of different types of education.

METHODS

In accordance with PRISMA-guidelines, a systematic search was performed using three databases (PubMed, EMBASE, CINAHL). Two reviewers screened titles and abstracts, subsequently full-text of the relevant articles. The risk of bias was assessed using the Cochrane Collaboration risk of bias assessment tool and the New Ottawa scale.

RESULTS

Of 3409 identified publications, 64 were included. The studies were different in target learners, study design, assessment tools, and outcome measures, which made direct comparison difficult. The studies addressed a possible effect of mastery learning and found e-learning and didactic classroom teaching to be equally effective.

CONCLUSION

Current studies suggest a potential benefit of ultrasound guided USG-PVC training on success rate, procedure time, cannulation attempts, and reducing the need for subsequent CVC or PICC in adult patients. An assessment tool with proven validity of evidence to ensure competence exists and education strategies like mastery learning, e-learning, and the usage of color Doppler show promising results, but an evidence-based USG-PVC-placement training program using these strategies combined is still warranted.

Ultrasound imaging and guidance in the management of knee osteoarthritis in regenerative medicine field

Ultrasound (US) is an excellent imaging tool to evaluate most of the structures in the knee joint. US is useful in various applications of regenerative medicine, starting from the biomaterial harvesting stage of the procedures, it can thus/conveniently be used for the diagnosis and treatment of various forms of knee osteoarthritis (OA) where the interventions need to be carried out under US guidance. In this paper, we have reviewed US guided bioharvesting of venous blood, bone marrow and adipose tissue, the US evaluation of the knee joint and the relevant findings in knee OA along with US guided regenerative interventions for the knee joint.