Introduction: The median nerve is usually formed by two roots contributed from the medial and lateral cords of the brachial plexus. Morphological variations of the median nerve can have clinical implications from the anesthetic and surgical points of view. In this cadaveric observation study, we report the variations of median nerve formation in the North Indian population. Methods: We observed the formation of the median nerve in 40 human cadaveric upper limb specimens. The specimens belonged to 20 right and 20 left upper limbs. Variations in the formation of the median nerve were noted.Results: Of the 40 dissected specimens, six (15%) had triple roots including a supernumerary root contributing to the medial nerve formation. The supernumerary root was a branch of the lateral cord in five cases, and it had an additional contribution from the medial cord in one case. The median nerve formation and continuation were located anterior or laterally in 39 specimens (97.5%) and medial in one (2.5%) in relation to the axillary artery. Conclusion:We observed supernumerary roots of varying morphology contributing to the median nerve formation. These variations should be considered during the administration of regional anesthesia and during the management of brachial plexus injuries. Further large multi-region studies will help in a better understanding of these variations.
The study of Medical Ethics [ME] is mandatory for health practitioners because there is hardly an area in medicine that doesn't pose an ethical dilemma. There is lack of awareness among physicians. Training of medical students should equip them to provide the best care to patients in an ethical manner without harm. The aim of this paper was to assess the awareness of undergraduate students to ME and take inputs about curricular changes as they are important stake holders. A prospective, cross sectional, observational study through a confidential questionnaire was utilized. 86 proformas were fit for analysis. Majority [68.6%] failed to define ME. Most had been exposed to ME in the college or through the print or visual media. Majority could not recall any incident of professional misconduct witnessed by them, while others recounted incidents such as taking gifts from pharmaceutical companies, rudeness to poor patients, mis-diagnosis due to casual approach towards patients, becoming personal with female patients, organ trafficking, conducting sex determination tests etc. Most were unaware about the existence or purpose of an institutional ethics committee. Regarding the need for studying ME 86.04% said they thought it is important. Majority suggested be interactive case presentations as a method of teaching ME. There is gross unawareness among medical students about the definition, scope and purpose of teaching ME. A drastic change in the medical curriculum is required and new and interesting teaching learning methods need to be evolved in order to train our students in ME.
The study of Medical Ethics [ME] is mandatory for health practitioners because there is hardly an area in medicine that doesn't pose an ethical dilemma. There is lack of awareness among physicians. Training of medical students should equip them to provide the best care to patients in an ethical manner without harm. The aim of this chapter was to assess the awareness of undergraduate students to ME and take inputs about curricular changes as they are important stake holders. A prospective, cross sectional, observational study through a confidential questionnaire was utilized. 86 proformas were fit for analysis. Majority [68.6%] failed to define ME. Most had been exposed to ME in the college or through the print or visual media. Majority could not recall any incident of professional misconduct witnessed by them, while others recounted incidents such as taking gifts from pharmaceutical companies, rudeness to poor patients, mis-diagnosis due to casual approach towards patients, becoming personal with female patients, organ trafficking, conducting sex determination tests etc. Most were unaware about the existence or purpose of an institutional ethics committee. Regarding the need for studying ME 86.04% said they thought it is important. Majority suggested be interactive case presentations as a method of teaching ME. There is gross unawareness among medical students about the definition, scope and purpose of teaching ME. A drastic change in the medical curriculum is required and new and interesting teaching learning methods need to be evolved in order to train our students in ME.
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