Objectives: To identify factors that predict the occurrence of seizures in patients with aneurysmal subarachnoid hemorrhage (SAH) and to evaluate the efficacy of antiepileptic drugs (AEDs) in preventing in-hospital seizures among patients who undergo clip occlusion of ruptured intracranial aneurysms. Methods: In this retrospective study, the medical charts of 205 patients admitted for aneurysmal SAH in Philippine General Hospital (PGH) and who underwent craniotomy and clipping of aneurysm from January 2011 to June 2014 were reviewed. Demographic, radiologic, and clinical factors were converted into categorical variables and their association with the occurrence of seizures analyzed. The incidence of seizures among patients who received an AED (AED cohort) and those who did not receive an AED (No AED cohort) were compared. Secondarily, the effects of seizures and AED use on early postoperative outcomes were determined using the Glasgow Outcome Scale (GOS) on the day of discharge. Results: Among 205 patients with aneurysmal SAH, 31 (15.1%) developed seizures. 21 (10.2%) had seizures at onset of SAH and only seven (3.4%) had in-hospital seizures. Aneurysm re-rupture (OR 5.26, p-value 0.045) and the presence of a parenchymal clot (OR 2.90, p-value 0.043) were independent predictors for seizure occurrence. There was no significant difference in the incidence of seizures in the AED cohort and in the No AED cohort (4/100, 4% vs. 3/99, 3%, p-value 0.714). AED use was associated with a higher proportion of patients with a discharge GOS score of 3 or less (28.0% vs 12.1%, p-value 0.005). Conclusion The results of the study do not support the routine use of AEDs in patients with aneurysmal SAH.
Seizures ; Aneurysm ; Subarachnoid Hemorrhage ; Craniotomy ; Phenytoin ; Levetiracetam ; Anticonvulsants

Background and Objective: Neuroanatomy is both terrifying to learn and problematic to teach, and the different methods of neuroanatomical education have their own strengths and weaknesses. In this cross-sectional study, we evaluated the perception of undergraduate medical students towards the combined use of plastinated and formalinpreserved brain specimen in their neuroanatomy course. Methods: A bridging program was designed for students whose medical education was interrupted by the COVID-19 pandemic in order to reinforce the knowledge and understanding of anatomy that they acquired in a virtual environment. A total of 175 first year medical students participated in this learning activity, which included seven stations in neuroanatomy spread across two hours, and covered the anatomy of the circle of Willis, brainstem, cranial nerves, spinal cord, internal cerebrum, and external cerebrum. To evaluate short-term learning, the students were asked to take a quiz containing 10 multiple-choice questions before and after the learning activity. In addition, the students also answered a survey containing 11 Likert-type questions asking about their perception of the learningactivity. Results: Following the learning activity, mean test scores increased from 4.73 (SD 1.74) to 5.32 (SD 1.52; mean difference 0.59, p = 0.008). Majority of the students (mean 81%, range 43-93%) had a neutral or positive perception of plastinated brain specimen, and on factor analysis, plastinated brain specimen were found to be both practical and useful for learning neuroanatomy. However, the participants perceived plastinated brain specimen alone to be insufficient for learning neuroanatomy, and a multimodal approach to learning neuroanatomy is ideal. Conclusion Plastinated brain specimens were found to be an effective complement to formalin-preserved brain, and these should be used by medical schools when designing neuroanatomy learning activities for their students.
Neuroanatomy

Background and Objective: The pandemic acted as an accelerator for the development of online teaching formats in anatomy and histology worldwide. The authors introduce a bridging program that reinforces the knowledge and understanding of gross and correlative anatomy and histology acquired in a virtual environment in preparation for its future clinical application. The study aims to evaluate the Learning Enhancement in Anatomy Program (LEAP) conducted among first-year medical students at the College of Medicine, University of the Philippines Manila. Methods: This descriptive cross-sectional study aims to determine the initial experience of implementing a learning enhancement program and assess areas for its improvement. An internally validated questionnaire was given to students after the program to gauge students’ reactions (Kirkpatrick Level 1 evaluation). Pre- and post-tests were administered to evaluate knowledge acquisition (Kirkpatrick Level 2 evaluation). Short-term behavioral peer evaluation (Kirkpatrick Level 3 evaluation) was also instituted. Results: One hundred fifty-two (152) students participated in the study. General reactions from students to the LEAP were consistently positive, with a steady majority of the students rating ‘5’ or a ‘Strongly Agree’ to positive statements regarding the program. Higher ratings for more traditional teaching methods, such as cadavers, formalinized specimens, and bones, compared to virtual systems were apparent. However, inter-student variation in preference for teaching modalities was observed. All stations of the LEAP were evaluated satisfactorily, with most gross anatomy stations rated higher than histology stations. A significant increase was noted in the total post-test scores compared to pre-test scores. This improvement in test scores was observed in the anatomy and histology subcategories and in six of the seven organ system modules. Perceived behavioral outcomes were also generally positive. Conclusion The LEAP is a worthwhile endeavor, garnering overwhelmingly positive reactions and a significant improvement in test scores. Future studies are necessary to fine-tune teaching and training in a blended learning environment.
Anatomy ; COVID-19 ; Education, Medical ; Program Evaluation