BackgroundA general education in psychiatry does not necessary lead to good diagnostic skills. Specific training programs in diagnostic coding are established to facilitate implementation of ICD-10 coding practices. However, studies comparing the impact of these two different educational approaches on diagnostic skills are lacking. The aim of the current study was to find out if a specific training program in diagnostic coding improves the diagnostic skills better than a general education program, and if a national bias in diagnostic patterns can be minimised by a specific training in diagnostic coding.MethodsA pre post design study with two groups was carried in the county of Archangels, Russia. The control group (39 psychiatrists) took the required course (general educational program), while the intervention group (45 psychiatrists) were given a specific training in diagnostic coding. Their diagnostic skills before and after education were assessed using 12 written case-vignettes selected from the entire spectrum of psychiatric disorders.ResultsThere was a significant improvement in diagnostic skills in both the intervention group and the control group. However, the intervention group improved significantly more than did the control group. The national bias was partly corrected in the intervention group but not to the same degree in the control group. When analyzing both groups together, among the background factors only the current working place impacted the outcome of the intervention.ConclusionEstablishing an internationally accepted diagnosis seems to be a special skill that requires specific training and needs to be an explicit part of the professional educational activities of psychiatrists. It does not appear that that skill is honed without specific training. The issue of national diagnostic biases should be taken into account in comparative cross-cultural studies of almost any character. The mechanisms of such biases are complex and need further consideration in future research. Future research should also address the question as to whether the observed improvement in diagnostic skills after specific training actually leads to changes in routine diagnostic practice.

Hypospadias in dogs is a rare pathology in the veterinary practice. The manifestation of hypospadias in dogs is diverse, since there is a varying degree of damage to the urogenital apparatus. The owners of a Sheltie puppy at the age of 3 days came to the clinic due to the difficulty of determining sex, the presence of inflammation of the anus and abdominal skin, defecation and urination violations. Clinical examination of the puppy showed a blind-closed preputial sac, absence of the ventral wall of the prepuce and an open urogenital urine trough was located in its place in the abdominal wall area. On examination of the puppy at the age of 28 days, hyperaemia and swelling of the anus were noted, as well as prolapse of the rectum. Findings of the examination at the age of 4 months consisted of drying of the mucous part of the open urogenital canal chute and accumulation of pus in the underdeveloped preputial sac. Bilateral cryptorchidism and the absence of the scrotum were also found out. A decision on the surgical treatment was made. The anus and the opening of the urethra were separated to form a urethrostomy in the scrotum and restore the integrity of the anus. On the 5th post operative day, oedema and stricture of the reconstructed urethra resulted in difficulty urinating, followed by the formation of urinary fistula in the perineal region below the anus opening. As a result of the chosen surgical treatment approach, the problem with contact dermatitis of the perineum and pollakiuria was solved.

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