Practice-based learning is the key objective of postgraduate education. COVID-19 has revealed that medical institutions may need to adopt adaptive strategies to guide their students. The aim of this study is to describe the perception of Philippine medical clerks towards their surgical preparedness with an Enriched Virtual Mode (EVM)-Hybrid Learning during the pandemic. A cross-sectional survey was conducted among 176 fourth-year students using a 21-item 4-point-Likert questionnaire. Descriptive analysis showed that students sustained a strong enthusiasm for surgery (composite mean = 2.83 ± 0.62), with the highest ratings given to skill-oriented subjects, such as practical minors (3.05 ± 0.82) and clinical surgery (3.03 ± 0.78). Preparedness was similarly high (3.17 ± 0.46): practice was regarded as essential (3.50 ± 0.68) and operating-room exposure useful (3.22 ± 0.68), though time for hands-on practice was adequate (2.84 ± 0.74). Preference scores revealed a desire for richer tactile experience (3.36 ± 0.37), with scrubbing, suturing and live surgery observation receiving most support (>3.50). Overall satisfaction reached a moderate-to-high level (2.99 ± 0.48) but lagged behind interest and preparedness, indicating that limited physical immersion tempered fuller contentment. These suggest that while a blended curriculum can preserve enthusiasm and sense of readiness, emphasis on protected skills laboratories and increased exposure to the operating room may be needed to translate conceptual competence into experiential fulfillment.

Human ; Male ; Female ; Young Adult: 19-24 Yrs Old ; Cross-sectional Studies ; Education ; Curriculum ; Perception ; Observation ; Schools, Medical ; Personal Satisfaction ; Learning ; Mental Competency ; Laboratories ; Pandemics

BACKGROUND: Biceps tenodesis is a technique frequently performed in shoulder surgeries. Various techniques have been described, but there is no consensus on which technique restores the length-tension relationship. Restoration of the physiologic length-tension relationship has been correlated to better functional outcomes, such as decreased incidence of residual pain or weakness of the biceps. The objective of this study was to measure the anatomic relationship of the origin of the biceps tendon with its zones in the upper extremity. This would provide an anatomic guide or an acceptable placement of the tenodesis to reestablish good biceps tension during surgery METHODS: The study used nine adult cadavers (five males, four females) from the [withheld for blinded review]. Nine shoulder specimens were dissected and markers were placed at five points along each biceps tendon: (1) Labral origin (LO) (2) Superior bicipital groove (SBG) (3) Superior border of the pectoralis tendon (SBPMT) (4) Musculotendinous junction (MTJ) and (5) Inferior border of the pectoralis tendon (IBPMT). Using the origin of the tendon as the initial point of reference, measurements were made to the four subsequent sites. The humeral length was recorded by measuring the distance between the greater tuberosity and the lateral epicondyle as well as the tendon diameter at the articular surface. RESULTS: The intraclass correlation coefficient was excellent across all measures. A total of nine cadavers were included. Mean age of patients was 66.33 years old, ranging from 52-82 years old. These were composed of five male and four female cadavers. The mean tendon length was 24.83mm ± 4.32 from the origin to the superior border of the bicipital groove, 73.50mm ± 6.96 to the Superior Border Pectoralis Major Tendon, 100.89mm ± 6.88 to the Musculotendinous Junction, and 111.11mm ± 7.45 to the Inferior Border Pectoralis Major Tendon. The mean tendon diameter at the articular origin was 6.44mm ± 1.76. CONCLUSION This study provided measurement guidelines that could restore the natural length-tension relationship during biceps tenodesis using the interference screw technique in Filipinos. A simple method of restoring a normal length-tension relationship is by doing tenodesis close to the articular origin and creating a bone socket of approximately 25mm in depth, using the superior border of the bicipital groove as a landmark.
Tenotomy ; Tenodesis

Background: Tuberculosis arthritis is a type of extrapulmonary manifestation of tuberculosis (TB) and can be seen in many clinical forms, especially in developing countries. Aims: This study will look into the quality of life (QoL) of patients who were diagnosed with tuberculous arthropathy of the extremity and underwent surgery at the University of Santo Tomas Hospital (USTH) from January 2014 to December 2016 using the Tagalog SF – 36 questionnaire. Methods: All patients who underwent surgery for TB arthropathy at USTH for three years were included. The Tagalog SF – 36 questionnaire was administered to the patients during follow-up to assess the QoL scores. A detailed evaluation of the questions was performed to depict any pattern on specii c areas that affect the QoL of patients. Results: Patients who underwent surgery scored high for role emotional (mean 93.33) and lowest on the bodily pain scale (mean 69.2). Higher physical component scores (PCS) were noted in patients who underwent surgery in 2014 compared to 2015 and 2016. Higher mental component scores (MCS) scores were also noted in patients operated in 2014 compared to 2015 and 2016. All patients have good QoL scores after surgery and complete medical treatment as demonstrated by the SF-36 scores. Tuberculous arthropathy can affect the physical and mental aspects of patients. No signii cant difference in mean scores by year were seen in all the scales of the SF-36 (p = >0.05). Conclusion All patients have good QoL scores after surgery and complete medical treatment as demonstrated by the SF-36 scores. QoL scores showed more improvement as the duration post-treatment is longer.
Tuberculosis ; Quality of life

Teriparatide has been known to aid in the treatment of osteoporosis but its use in the management of fracture disorders is poorly documented. This review aims to show that teriparatide administration may improve the healing process in fractures that fail to unite after sustaining trauma. A total of 22 reported cases have been identifi ed from 2009 to 2017. Teriparatide doses were given in a median duration of 5.6 months with a median time to complete union of 8.5 months. This review systematically summarizes all clinical case reports of non-union treated with teriparatide for us to gain insight into its off-label use.
Teriparatide