scholarly journals COVID-19: ramifications in surgical practice

2020 ◽  
Vol 7 (1) ◽  
pp. 73-76
Author(s):  
Harish Chandra Neupane ◽  
Tseten Yonjen Tamang ◽  
Siddeshwar Angadi ◽  
Nikki Shrestha ◽  
Ganesh Dangal
Keyword(s):  
New Developments ◽  
Surgical Practice ◽  
Surgical Department ◽  
Surgical Residents ◽  
Medical Facilities ◽  
High Incidence ◽  
New Guidelines ◽  
Exerted Pressure ◽  
The Impact ◽  
India And China

Nepal lies between two large countries (India and China) who have reported high incidence of COVID-19. It is only logical that we prepare the best with the limited medical facilities that we have. There are numerous challenges that impact the surgical department and the hospital administration in general. New guidelines are being formulated and updated frequently. The challenge to provide sufficient personal protective equipment, limited finances and need to train staffs are pertinent challenges. A change in the method of treatment and execution has exerted pressure on the surgeons with a need to keep abreast of new developments. We describe the numerous impacts of the COVID-19 on surgical practice, the impact on surgeons, patients, surgical residents and even the hospitals which have led to all “new normal” in surgery.

scholarly journals The impact of COVID-19 pandemic on training and mental health of residents: a cross-sectional study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Eman Alshdaifat ◽  
Amer Sindiani ◽  
Wasim Khasawneh ◽  
Omar Abu-Azzam ◽  
Aref Qarqash ◽  
...  
Keyword(s):  
Mental Health ◽  
Residency Training ◽  
Training Programs ◽  
Cross Sectional Study ◽  
Protective Equipment ◽  
Sectional Study ◽  
Cross Sectional ◽  
Surgical Residents ◽  
Tertiary Center ◽  
The Impact

Abstract Background Residency programs have been impacted by the Coronavirus disease 2019 (COVID-19) pandemic. In this study we aim to investigate and evaluate the impact of the pandemic on residents as well as residency training programs. Methods This was a cross-sectional study including a survey of 43 questions prepared on Google forms and electronically distributed among a convenience sample of residents training at a tertiary center in North Jordan during the COVID-19 pandemic. Data were collected in the period between October 30th and November 8th of 2020. The survey included questions that addressed the impact of the pandemic on residents’ health as well as training programs. The study participants included residents in training at KAUH in 2020 and were stratified according to the type of residency program (surgical residents (SRs) and non-surgical residents (NSRs)). Statistical methods included descriptive analysis, Chi-square or Fisher’s exact test, Mann Whitney U test, and Cramer’s V and r statistics as measures of effect sizes. Results Of all 430 residents, 255 (59%) responded to the survey. A total of 17 (7%) of residents reported being infected with COVID-19 and a significant difference was reported between SRs and NSRs (10% vs 4%, V = .124 “small effect” (95% CI; .017–.229), p = 0.048). Approximately, 106 (42%) reported a decrease in the number of staff working at the clinic and 164 (64%) reported limited access to personal protective equipment during the pandemic. On a 4-point Likert scale for the feeling of anxiety, the median was 2 (2–3 IQR) in the NSRs group, vs 2 (1–2 IQR) in the SRs groups, with the NSRs being more likely to feel anxious (r = 0.13 “small effect” (95% CI; 0.007–0.249), p = .044). Similarly, the proportion of residents who reported feeling anxious about an inadequacy of protective equipment in the work area was significantly greater in the NSRs group (90.3% vs 75.2%; V = .201 “small effect” (95% CI; .078–.313), p = .001), as well as the proportion of residents who reported feeling increased stress and anxiety between colleagues being also significantly higher in the NSRs group (88.1% vs 76%; V = .158 “small effect” (95% CI; .032–.279), p = .012). Conclusion The burden of the ongoing pandemic on the mental health status of residents is very alarming and so providing residents with psychological counseling and support is needed. Also, critical implications on the flow of residency training programs have been noticed. This necessitates adapting and adopting smart educational techniques to compensate for such limitations.

scholarly journals The Impact of Ultraviolet Radiation on the Aetiology and Development of Uveal Melanoma

Cancers ◽  
2021 ◽  
Vol 13 (7) ◽  
pp. 1700
Author(s):  
Melissa Chalada ◽  
Charmaine A. Ramlogan-Steel ◽  
Bijay P. Dhungel ◽  
Christopher J. Layton ◽  
Jason C. Steel
Keyword(s):  
Risk Factors ◽  
Ultraviolet Radiation ◽  
Uveal Melanoma ◽  
World Health Organisation ◽  
World Health ◽  
Genetic Mutations ◽  
High Incidence ◽  
The World ◽  
The Impact

Uveal melanoma (UM) is currently classified by the World Health Organisation as a melanoma caused by risk factors other than cumulative solar damage. However, factors relating to ultraviolet radiation (UVR) susceptibility such as light-coloured skin and eyes, propensity to burn, and proximity to the equator, frequently correlate with higher risk of UM. These risk factors echo those of the far more common cutaneous melanoma (CM), which is widely accepted to be caused by excessive UVR exposure, suggesting a role of UVR in the development and progression of a proportion of UM. Indeed, this could mean that countries, such as Australia, with high UVR exposure and the highest incidences of CM would represent a similarly high incidence of UM if UVR exposure is truly involved. Most cases of UM lack the typical genetic mutations that are related to UVR damage, although recent evidence in a small minority of cases has shown otherwise. This review therefore reassesses statistical, environmental, anatomical, and physiological evidence for and against the role of UVR in the aetiology of UM.

708 Examining the Management of Acute Lower GI Bleeds in Order to Improve Policies and Reflect Safe and Updated Guidance

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
L Han ◽  
H White ◽  
K Bosch ◽  
M Nair
Keyword(s):  
Gastrointestinal Bleeding ◽  
Surgical Intervention ◽  
Lower Gastrointestinal Bleeding ◽  
University Hospital ◽  
British Society ◽  
Shock Index ◽  
Surgical Department ◽  
Upper Gi ◽  
Cardiovascular Comorbidities ◽  
New Guidelines

Abstract Introduction Acute lower gastrointestinal bleeding (LGIB) tends to occur in elderly patients with complex comorbidities. At North Middlesex University Hospital (NMUH), LGIB patients are primarily managed by the surgical department. We amended local policies by integrating aspects of new guidelines published by the British Society of Gastroenterology (BSG). Method Handover documentation between November 2019 and January 2020 established patients admitted with LGIB (n = 45). Further data regarding the management of these patients was collated from clinical software and compared to standards set from BSG guidelines. Results We found NMUH to be efficient in ruling out upper GI bleeds via 24-hour OGDs and had low surgical intervention rates (0.02%). 40% of patients were transfused with an admission haemoglobin above suggested NICE thresholds, accounting for cardiovascular comorbidities. 56% of patients were discharged without a documented anticoagulation plan. Over 50% of patients did not have BSG recommended inpatient investigations. Conclusions Updated Trust guidelines aim to uphold areas that NMUH were shown to excel in, while reiterating NICE transfusion thresholds and include guidance regarding anticoagulant and antiplatelet medications. The Oakland score and shock index have been integrated into local protocols and will aid clinicians in making safe decisions in the management of LGIB patients.

scholarly journals Academic relationships between Hungarian professors and the Second Vienna Medical School

2021 ◽  
Author(s):  
Béla Szende ◽  
Attila Zalatnai
Keyword(s):  
Medical Education ◽  
Medical School ◽  
Medical Doctors ◽  
Surgical Department ◽  
Treatment And Prevention ◽  
Obstetrics And Gynaecology ◽  
Practice Of Medicine ◽  
Vienna Medical School ◽  
The University ◽  
The Impact

SummaryThis article discusses the impact of the ‘second’ Vienna Medical School, hallmarked by Karl Rokitansky, Joseph Skoda and Ferdinand Hebra, on the study and practice of medicine in Hungary. Six medical doctors’ lives and achievements are outlined, who formed a bridge between Vienna and Budapest through their studies and work. Four of them returned to Hungary and promoted the cause of medicine and medical education there. Lajos Arányi (1812–1877) founded in 1844 the Institute of Pathology at the University of Pest. János Balassa (1814–1868) took the Chair of the Surgical Department. Ignaz Philip Semmelweis (1818–1865), the ‘Saviour of Mothers’, received a position at the Department of Obstetrics and Gynaecology in Vienna in 1846. Gustav Scheuthauer (1832–1894) became Arányi’s successor. Each of them continued to keep contact with their tutors in Vienna, especially with Karl Rokitansky, and followed the clinicopathological conception pioneered by the Vienna Medical School regarding diagnostics, treatment and prevention of diseases. Two physicians remained in Vienna: Mór Kaposi (1837–1902), who became known worldwide posthumously due to the connection between Kaposi’s sarcoma and AIDS, was the director of the Department of Dermatology of the Vienna University in 1878. Salomon Stricker (1837–1898) undertook the leadership of the Department of General and Experimental Pathology in 1872.

scholarly journals China in medieval Indian imagination: “China”-inspired images in medieval South Asia

2021 ◽  
pp. 1-28
Author(s):  
Jinah Kim
Keyword(s):  
Historical Context ◽  
Cultural Exchanges ◽  
Imperial Power ◽  
Physical Presence ◽  
Different Types ◽  
First Millennium ◽  
Chinese Buddhists ◽  
Medieval India ◽  
The Impact ◽  
India And China

Abstract Cross-cultural exchanges between India and China during the first millennium are often understood through a Buddhist lens; by investigating the impact of Indian Buddhist sources, be they literary, doctrinal, or artistic, to receiving Chinese communities. In these cultural transactions, instigated by traveling pilgrim-monks and enacted by imperial power players in China, India emerges as a remote, idealized, and perhaps “hollow” center. Imagined or real, the importance of images of India in medieval Chinese Buddhist landscape has been established beyond doubt. What seems to be missing in this unidirectional looking is the impact of these cultural communications in India. What were the Indian responses to Chinese Buddhists' demands and their physical presence? How was China imagined and translated in medieval India? This essay proposes to locate the activities of Chinese monks in India and the iconographies of China-inspired Indian Buddhist images within the larger historical context of shifting cultural and political geography of the medieval Buddhist world. By exploring different types of evidence from borderlands, vis-à-vis the monolithic concepts of China and India, the essay also complicates the China–India studies' comparative model.

scholarly journals Association between stress and bilateral symmetrical alopecia in free-ranging Formosan macaques in Mt. Longevity, Taiwan

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Chen-Chih Chen ◽  
Ai-Mei Chang ◽  
Ming-Shan Tsai ◽  
Yen-Hua Huang ◽  
Kurtis Jai-Chyi Pei ◽  
...  
Keyword(s):  
Total Population ◽  
Causative Factor ◽  
Population Status ◽  
Adrenocortical Activity ◽  
High Incidence ◽  
Normal Hair ◽  
The Mean ◽  
The Individual ◽  
Free Ranging ◽  
The Impact

AbstractSince 2013, a high incidence of bilateral symmetrical alopecia has been observed in free-ranging Formosan macaques (Macaca cyclopis) in Mt. Longevity, Taiwan. We hypothesized that stress induces alopecia in this population. To verify our hypothesis, we evaluated the histopathological characteristics of skin biopsy and used a validated enzyme immunoassay (EIA) for fecal glucocorticoid metabolite (FGM) analysis, which act as an indicator of stress experienced by the individual. Follicular densities were lower (2.1–3.0 mm2) in individuals with symmetrical alopecia than in those with normal hair conditions (4.7 mm2). Furthermore, anagen to catagen/telogen ratios were lower in individuals with alopecia (0–1.4) than in those with normal hair (4.0). The histopathological characteristics of alopecia were similar to those of telogen effluvium, which indicates that stress is one of the possible etiologies. On the basis of the analytical and biological validation of EIAs for FGM analysis, 11β-hydroxyetiocholanolone was considered suitable for monitoring adrenocortical activity in both sexes of Formosan macaques. The mean concentrations (standard error; sample size) of 11β-hydroxyetiocholanolone were 2.02 (0.17; n = 10) and 1.41 (0.10; n = 31) μg/g for individuals with and without alopecia, respectively. Furthermore, the results of logistic regression analysis show that 11β-hydroxyetiocholanolone (p = 0.012) concentration was positively associated with alopecia. Thus, stress was the most likely to trigger symmetrical alopecia in Formosan macaques in Mt. Longevity. Although stress can decrease the fitness of an individual, considering the population status of Formosan macaques in Taiwan is stable and alopecia was only observed in our study area, which is isolated from other populations, the impact on the total population of Formosan macaque in Taiwan is limited. Nonetheless, stress-induced immunosuppression and alopecia might affect the local abundance and increase zoonosis risk due to frequent human–macaque contact in Mt. Longevity. Future studies are suggested to focus on the causative factor of stress and the effects of stress and alopecia on the health and welfare in the Formosan macaques.

Editorial | Stop the Academic Bullying: Our Internal Reflections for a Fairer Peer Reviews [Hentikan Perundungan Akademik: Refleksi Internal untuk Penilaian Sejawat yang Lebih Adil]

2021 ◽  
Vol 36 (1) ◽  
Author(s):  
Edwin Adrianta Surijah
Keyword(s):  
Career Development ◽  
Peer Review ◽  
Well Being ◽  
Editorial Note ◽  
Peer Reviews ◽  
Academic Bullying ◽  
New Guidelines ◽  
The Impact

Academic bullying in peer reviews is a cultural problem. This Editorial Note is intended to identify the unhelpful comments/critiques and to highlight the impact of unprofessional peer reviews toward the well-being and career development of fellow researchers. We acknowledge that we are part of the problems, and the necessary steps are needed to break the chain of the academic bullying culture in peer reviews. New guidelines for editors and reviewers are part of the solutions to promote constructive comments, as well as stronger internal consolidation throughout the peer reviews process.   Perundungan akademik dalam penilaian sejawat (peer review) adalah sebuah permasalahan kultur. Catatan Editorial ini bertujuan mengindentifikasi komentar atau kritik yang tidak membangun, serta menggarisbawahi dampak penilaian sejawat yang tidak profesional terhadap kesejahteraan dan pengembangan karir sesama peneliti. Kami menyadari bahwa kami merupakan bagian dari permasalahan ini, dan diperlukan langkah-langkah untuk memutus rantai kultur perundungan akademik dalam penilaian sejawat. Pedoman baru bagi editor dan mitra bestari merupakan bagian dari solusi untuk mendorong komentar yang konstruktif, serta konsolidasi internal yang lebih kuat dalam proses penilaian sejawat.

scholarly journals The impact of surgeon-based ultrasonography for parathyroid disease on a British endocrine surgical practice

2012 ◽  
Vol 94 (1) ◽  
pp. 17-23 ◽  
Author(s):  
SR Aspinall ◽  
S Nicholson ◽  
RD Bliss ◽  
TWJ Lennard
Keyword(s):  
Minimally Invasive Surgery ◽  
Primary Hyperparathyroidism ◽  
Minimally Invasive ◽  
Negative Predictive Value ◽  
Invasive Surgery ◽  
Predictive Value ◽  
Surgical Practice ◽  
Parathyroid Disease ◽  
Operative Findings ◽  
The Impact

INTRODUCTION Surgeon-based ultrasonography (SUS) for parathyroid disease has not been widely adopted by British endocrine surgeons despite reports worldwide of accuracy in parathyroid localisation equivalent or superior to radiology-based ultrasonography (RUS). The aim of this study was to determine whether SUS might benefit parathyroid surgical practice in a British endocrine unit. METHODS Following an audit to establish the accuracy of RUS and technetium sestamibi (MIBI) in 54 patients, the accuracy of parathyroid localisation by SUS and RUS was compared prospectively with operative findings in 65 patients undergoing surgery for primary hyperparathyroidism (pHPT). RESULTS The sensitivity of RUS (40%) was below and MIBI (57%) was within the range of published results in the audit phase. The sensitivity (64%), negative predictive value (86%) and accuracy (86%) of SUS were significantly greater than RUS (37%, 77% and 78% respectively). SUS significantly increased the concordance of parathyroid localisation with MIBI (58% versus 32% with RUS). CONCLUSIONS SUS improves parathyroid localisation in a British endocrine surgical practice. It is a useful adjunct to parathyroid practice, particularly in centres without a dedicated parathyroid radiologist, and enables more patients with pHPT to benefit from minimally invasive surgery.

scholarly journals 4020 Impact of Patients’ Health Literacy Level on Patients’ Health Outcomes

2020 ◽  
Vol 4 (s1) ◽  
pp. 137-137
Author(s):  
Dae Hyun Kim ◽  
Larry Hearld ◽  
William Opoku-Aygeman
Keyword(s):  
Health Literacy ◽  
Health Outcomes ◽  
Medical Information ◽  
Linear Regression Models ◽  
Negatively Associated ◽  
Surgical Department ◽  
Lengths Of Stay ◽  
Health Literacy Level ◽  
Literacy Level ◽  
The Impact

OBJECTIVES/GOALS: The objective of this study is to examine the relationship between gastro-intestinal (GI) patients’ health literacy levels and patients’ health outcomes (length of stay, readmission, complication). METHODS/STUDY POPULATION: A research team at the University of Alabama at Birmingham (UAB) ‘s Gastro-Intestinal (GI) surgical department collected inpatient GI patients’ health literacy data by distributing the Brief Health Literacy Screen (BRIEF) survey to patients are about to be discharged. Patients’ health outcomes data were gathered through Business Objects, an online platform that allows physicians and researchers to access and gather patients’ medical information with an IRB approval. After accounting for necessary control variables, logistic regression and multiple linear regression models will be run to assess whether there is a significant relationship between patients’ health literacy levels and patients’ health outcomes. RESULTS/ANTICIPATED RESULTS: Three specific hypotheses are proposed in this study. H1: GI patients’ health literacy levels will be negatively associated with their lengths of stay H2: GI patients’ health literacy levels will be negatively associated with their readmission status to the hospital H3: GI patients’ health literacy levels will be negatively associated with their complication status to the hospital DISCUSSION/SIGNIFICANCE OF IMPACT: This study allows us to further our understanding of patients’ health literacy level and its’ relationship with important health outcomes. By looking at a variety of diverse health outcomes, the impact of a patients’ health literacy level on that patients’ health outcomes will be observed more clearly.

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