A. van Schoor

Computer-based testing - the ideal tool to assess on the different levels of Bloom's taxonomy

Computer-based assessment became one of the most common forms of technology enhanced assessment since the 1990s. Blooms Taxonomy is widely used as a classification scheme to determine different levels of cognitive competencies. Using CBT for assessment has often been described as a tool to test on the lower levels of Blooms taxonomy and that it promotes rote learning because it is very difficult to write items that will test on the higher cognitive levels. A study was done in the Faculty of Health Sciences at the University of Pretoria to obtain the perception of students and lecturers regarding the level and use of computer-based objective assessment. From the study it is clear that it is a suitable assessment method to test on a variety of cognitive levels.

Perspectives on the use of PDAs as assessment tools

T he aim of every tertiary education programme is to produce competent professionals who are capable of meeting the challenges of their profession. They must possess certain personal, cognitive and technical attributes that enable them to perform the required tasks successfully. It is therefore the responsibility of all tertiary institutions to create opportunities for students to acquire these competencies.

Retromolar foramen: an anatomical study with clinical considerations

The retromolar canal and foramen, an anatomical variation in the mandibular retromolar area, houses and transmits neurovascular elements that may innervate the mandibular third molar and associated tissues. These structures have been implicated in local anaesthetic failure, loss of sensation in the normal distribution of the buccal nerve, and local haemorrhage during surgery. Examination of 885 dry mandibles showed that 70 had a retromolar foramen (8%). There were no significant differences between groups according to age, sex, or ancestry. The mean (SD) distance from molar to retromolar foramen was 16.8 (5.6) mm for the mandibular second molar and 10.5 (3.8) mm for the mandibular third molar. The link between these structures and failure of local anaesthesia seems tenuous at best. Bleeding may not represent a serious complication. Although there may be a possibility of perineural spread of infective and invasive pathology, we know of no reported cases. The only clear evidence of complications associated with a confirmed retromolar foramen seems to be loss of sensation in the normal distribution of the buccal nerve. Even though the retromolar foramen does not seem to be of great clinical importance, it could be a source of anxiety for the inexperienced practitioner.

Cognitive and learning strategies for longstanding temporal lobe lesions in a child who suffered from Herpes simplex virus encephalitis: a case study over 10 years

This article presents a case study indicating that Herpes simplex virus (HSV) encephalitis may cause permanent learning disabilities due to damage to the temporal lobes as it discusses the results of a case study extending over 10 years to determine the long‐term effects on both the anatomy of the brain and the intellectual functioning of the subject. Magnetic resonance imaging (MRI) scans were taken of the subject during the initial HSV encephalitis infection and subsequently six months after recovery. Follow‐up MRI scans were taken 10 years later. At this time the Senior South African Individual Scale—Revised IQ test was administered to determine any residual neuropsychological impairment due to HSV encephalitis infection. Follow‐up MRI analysis indicated permanent bilateral necrotic areas in the medial temporal lobe, while the IQ test revealed marked impairment of the short‐term memory, verbal memory, visual memory, visual scanning abilities and gestalt formation, which can be ascribed to temporal lobe lesions.

The thoracic surface anatomy of adult black South Africans

Surface landmarks or planes taught in anatomy curricula derive from standard anatomical textbooks. Although many surface landmarks are valid, clear age, sex, and population differences exist. We reappraise the thoracic surface anatomy of black South Africans. We analyzed 76 (female = 42; male = 34) thoracoabdominal CT‐scans. Patients were placed in a supine position with arms abducted. We analyzed the surface anatomy of the sternal angle, tracheal, and pulmonary trunk bifurcation, azygos vein termination, central veins, heart apex, diaphragm, xiphisternal joint, and subcostal plane using standardized definitions. Surface anatomy landmarks were mostly within the normal variation limits described in previous studies. Variation was observed where the esophagus (T9) and inferior vena cava (IVC) (T8/T9/T10) passed through the diaphragm. The bifurcations of the trachea and pulmonary trunk were inferior to the sternal angle. The subcostal plane level was positioned at L1/L2. The origin of inferior mesenteric artery was mostly inferior to the subcostal plane. Sex differences were noted for the plane of the xiphisternal joint (P = 0.0082), with males (36%) intersecting at T10 and females (36%) intersecting at T9. We provide further evidence for population variations in surface anatomy. The clinical relevance of surface anatomical landmarks depends on descriptions of normal variation. Accurate descriptions of population, sex, age, and body type differences are essential. Clin. Anat. 29:1018–1024, 2016.

An endometrial histomorphometric study of CD56 + natural killer cells in women with unexplained infertility

51 SAJOG • September 2017, Vol. 23, No. 2 Background. The number of peripheral blood and endometrial natural killer cells varies greatly during implantation and the first trimester of pregnancy and is thought to play a role in the maintenance of a healthy pregnancy. However, the role of endometrial CD56+ natural killer (NK) cells as an immunological mechanism in unexplained infertility is yet unknown. Objectives. The study aimed to enumerate the concentrations of CD56+ NK cells in endometrial samples, and to statistically compare these numbers between fertile and infertile women. Methods. A histomorphometric analysis was conducted using haematoxylin and eosin staining and an immunohistochemical approach was used for quantifying cell numbers. Results. Fifty samples were collected in equal parts between a study group of infertile female subjects (mean (standard deviation) age 35 (4), range 26 42 years) and a control group of multiparous fertile individuals (mean (SD) age 43.4 (6.3), range 30 55). The mean number of CD56+ NK cells present at different depths for both the study and control groups did not differ significantly. Age and group (study or control) were not significantly related to the mean number of CD56+ NK cells. However, for the late secretory phase the mean number of CD56+ NK cells was significantly higher than for the early phase. Conclusion. Our findings could not identify a statistically significant correlation between the number of CD56+ NK cells and infertility.

Clinical anatomy of the superior cluneal nerve in relation to easily identifiable bony landmarks

Background: Lower back pain (LBP) remains a common ailment among adult populations and a superior cluneal nerve (SCN) entrapment accounts for 10% of reported LBP cases. The diagnostic criteria for SCN entrapment include anaesthesia of the area supplied by the SCN after performing a nerve block. Several surgical reports describe the anatomy of the SCN but purely anatomical studies of the course of the SCN are rare. This study aimed to describe the location of the SCN in relation to easily identifiable bony landmarks. Methods: The SCN was identified as it pierced the thoracolumbar fascia and crossed over the posterior part of the iliac crest on both sides of 27 adult cadavers. A sliding dial calliper was used to measure the distance from the posterior superior iliac spine (PSIS) to the SCN and from the midline lumbar spinous processes to the nerve. Results: The PSIS to SCN measurement was found to be 69.6 ± 15.0 mm (mean ± SD) while the midline to SCN measurement was 72.1 ± 10.2 mm. Discussion: This study showed clear gender differences in the PSIS to SCN measurement, due to the sexual dimorphism of the bony pelvis. There was also found to be a positive correlation between the height of the sample and the distances of the SCN from both the midline and PSIS. This study provides a clear anatomical description of the course of the SCN as it crosses the iliac crest, which will allow for the successful identification of the SCN.