The need for narrative reflection and experiential learning in medical education: A lesson learned through an urban indigenous health elective

In this personal view article, I discuss a formative experience I had during an Urban Indigenous Health elective in which I participated while in my final year of medical school. The elective was developed on the foundation of an experiential learning model, which is central to Indigenous pedagogy and emphasizes learning through experience and narrative reflection. By transforming medical education into a place where such concepts are integrated and valued, I argue that we will create physicians who are self-aware, compassionate and able to provide culturally safe care to all patient populations they will serve in their future practices.     

Vertebral fracture efficacy during risedronate therapy in patients using proton pump inhibitors

Summary  

Recent evidence suggests that proton pump inhibitor (PPI) use may affect fracture risk, an important issue for patients being concurrently treated for osteoporosis. The results of our post hoc analysis showed that, regardless of PPI concomitant use, risedronate significantly reduced the risk of new vertebral fractures compared with placebo.     

Transient monocular abduction on upgaze with impaired downward pursuit in downgaze – a new pattern of misdirection?

A patient with a long history of diplopia on upgaze was examined clinically and electro-oculographically. Upward saccades were normal in the right eye, whilst the left eye made a diagonal saccade up and to the left, coming back to midline with a slow movement. Only minor underaction of her left lateral rectus was observed on examination and both adducting and abducting saccades were of normal velocity. Upward smooth pursuit was largely smooth, albeit with occasional saccadic intrusions; downward pursuit was smooth from upgaze to the horizontal and saccadic from there to downgaze. The saccadic defect could arise from a misdirected axonal projection from the third nerve nucleus to the left lateral rectus; the pursuit deficit could arise from a proposed misrouting of vertical smooth pursuit signals.     

Techniques,indications and complications of corneal debridement

The cornea is the most exposed surface of the eye and, as such, is vulnerable to external trauma and the risk of infection. Many corneal diseases alter shape, surface, and transparency and thus result in reduced vision. The external position of the cornea, however, lends itself to diagnostic and therapeutic maneuvers that are commonly performed and readily done in the clinic. More sophisticated techniques require the use of complex equipment such as excimer and femtosecond laser. Complications that develop from poor healing and/or secondary infection are best avoided with appropriate technique, antisepsis, and modification of wound healing. We review corneal debridement in the management of corneal disease.