Is hydronephrosis a risk factor for complications in conventional percutaneous nephrolithotomy?

Objective: To assess Hydronephrosis as a Risk Factor for complications in Conventional Percutaneous Nephrolithotomy. Study Design: Cross Sectional Descriptive study. Setting: Kidney Centre Post Graduate Training Centre, Karachi. Period: January to December 2020. Material & Methods: This study was done to know post-operative complications including bleeding, infection, and incomplete stone clearance in patients with or without hydronephrosis undergoing percutaneous nephrolithotomy. After applying the inclusion/ exclusion criteria it was found that the patients with hydronephrosis had less bleeding as compared to the no hydronephrosis group. In the same way, they also had fewer nephrostomy tubes placed, and chest drain insertion. All other complications were approximately the same in each group. Patients were selected using non-probability consecutive sampling technique. Percentage and frequencies were determined for quantitative variables. Mean and standard deviation were determined for quantitative variables. Results: Total 300 cases were studied fulfilling inclusion criteria. There were 70.07% male and 29.3% female cases. Age range of the patients was 18-60 years. There were 52.7% cases with hydronephrosis, placed in one group and 47.3% cases were without hydronephrosis placed in other group. Most common complication was postoperative bleeding reported in 48.9% cases with hydronephrosis as compared to 56.2% cases without hydronephrosis. Mean operative time was 115.7 ± 41.9 minutes in patients with hydronephrosis and 135 ± 35.4 minutes in patients without hydronephrosis. Conclusion: Patients with hydronephrosis experienced less postoperative complications, after PCNL as compared to those without hydronephrosis.

Herd Routines and Veterinary Advice Related to Dry-Cow Therapy and Treatment with Internal Teat Sealants in Dairy Cows

Dry-cow therapy with antibiotics (DCT) and treatment with internal teat sealants (ITS) are often used to control mastitis in dairy cows. However, the knowledge on farmer and veterinary compliance with recommendations for DCT and ITS is scarce. Thus, the main aim was to collect information on farmer routines and veterinary advice for such treatments. Associations with herd and veterinary variables were also studied. Web-based questionnaires including questions on demographics and the use of DCT and ITS were sent to 2472 farmers and 517 veterinarians in Sweden. The answers were summarized descriptively, and associations with demographics were evaluated using univariable regression models. The response rate was 14% for farmers and 25% for veterinarians. Among the farmers, 81% used selective DCT (SDCT), 3% used blanket DCT (BDCT), and 16% did not use DCT. Almost all (93%) veterinarians prescribed DCT and among those most recommended SDCT while 8% recommended BDCT. Eighty-two percent of the farmers did not use ITS and 45% of the veterinarians never prescribed ITS. Milking system and milk production, and post-graduate training and number of mastitis cases per month were associated with the largest numbers of farmer and veterinary answers, respectively. In conclusion, many farmer routines and veterinary advice complied with the recommendations available at the time, but a clear need for more education was also identified. The results also indicated that an up-date of the national recommendations was warranted.

Perception and practices of operative and endodontic specialists in Pakistan towards the use of dental magnification

BACKGROUND: The perceptions and trends of magnification use in dentistry need to be determined since magnification significantly enhances clinical practice. OBJECTIVE: To assess perception and practices of Operative and Endodontic specialists currently working in Pakistan, regarding use of magnification. METHODS: A structured questionnaire administered for this analytical cross-sectional study recorded demographics, trends of magnification devices used in practice and their perceived advantages and disadvantages by the specialists with close-ended questions and three-point Likert scale. RESULTS: Out of 91 forms, 77 responses were received (response rate of 84%). Most participants had 1–4 years’ practical experience, were employed at both faculty and clinical positions, were more interested in operative/restorative procedures and used TLL (through the lens loupes) at low magnification. Use of magnification devices was learnt mostly during post-graduate training and was used daily or weekly for complicated cases. Noteworthy perceptions included improved treatment quality and standard of care. However, they were also perceived as irritating, increasing treatment time, with adverse effect on eyesight with prolonged use. No statistically significant correlation was found between the variables recorded (p > 0.05). CONCLUSIONS: Most specialists used magnification devices in some form and were abreast with their advantages. Proper training and continued dental education courses can help dispel any observed misapprehensions.

The making of child and adolescent psychiatrists in Australia and New Zealand

Child and adolescent psychiatry has an opportunity to adapt alongside the advancements in medical knowledge, post-graduate training, epidemiological realities and clinical service models. Here, we are guided by the mental health needs of our community’s young and their families in our review of child and adolescent psychiatry training in Australia and New Zealand. We recognise that training must respond to clinical demand and service reform while ensuring a range of clinical and educational experiences to deliver expectable competencies in order to produce child and adolescent psychiatrists that meet the communities’ needs now and in the future. We argue that training programmes be subject to rigorous evaluation by embedding continuing cycles of improvement including regular review and international bench marking.

Frequency of Stillbirths in Obese Pregnant Women

Objective: To determine the frequency of stillbirths in obese pregnant women. Design of the Study: It’s a descriptive cross-sectional study. Study Settings: This study was carried out at Department of Obstetrics and Gynecology, Lady Reading Hospital Peshawar from January 2018 to July 2018. Material and Methods: In this study a total of 289 patients were observed. Detailed history was taken from each patient, period of gestation was calculated from 1st trimester scan, conducted by a person having at least 2 years post-graduate training experience in his/her respective field. Height/Weight measurements were done by the same standardized equipment’s for all enrolled patients and BMI calculation done by standard WHO formula before delivery. Baby after delivery was examined and looked for presence/absence of vital signs by the designated obstetrician. Outcome of pregnancy either alive or stillborn baby was recorded for each patient in order to fulfill the objective of study. To control bias and confounding, exclusion criteria had strictly followed. All the data was recorded on a pre-designed Proforma and subjected to analysis. Results of the Study: Our study shows that mean age of 28.87 +3.92 years Forty two percent patients were primi gravid and 58% patients were multi gravida. Forty three percent patients were primi para while 57% patients were multi para. Ninety percent babies were alive while 10% babies were still birth. Conclusion: Our study concludes that the frequency of still births was 10% in obese pregnant women. Keywords: still births, obese, pregnant women, primi para, WHO.

Prospective Observational Evaluation of Predatory Journals in Critical Care Pharmacy Practice: Defining Characteristics Associated With Receiving Unsolicited Invitations to Publish

Open-access publishing promotes accessibility to scholarly research at no cost to the reader. The emergence of predatory publishers, which exploit the author-pay model by charging substantial publication fees for publication in journals with questionable publishing processes, is on the rise. Authors are solicited through aggressive marketing tactics, though who is targeted is not well described. The purpose of this study was to identify characteristics associated with critical care pharmacists that make them targets of unsolicited invitations to publish. A prospective, observational study of critical care pharmacists was performed. Participants archived emails received by their professional email that were unsolicited invitations to submit their original work for publication in a journal (unsolicited journals). Variables were evaluated to determine which were associated with unsolicited invitations; these were compared to legitimate journals, defined as all PubMed-indexed journals in which the participants were previously published. Twenty-three pharmacist participants were included, all of whom were residency and/or fellowship trained and practicing in an academic medical center. Participants had a median of 7 years of experience since their post-graduate training, 6 years since their last change in professional email address, and 2 years since their first PubMed-indexed publication. From these participants, 136 unsolicited and 59 legitimate journals were included. The average number of invitations increased 1.04 (95% CI, 1.02–1.05) times for every additional PubMed-indexed publication ( P < .001). Most unsolicited journals were considered predatory. Legitimate and unsolicited journals differed significantly. The number of previous PubMed-indexed publications strongly correlates with the likelihood of critical care pharmacists receiving unsolicited publication invitations, often from predatory journal.

Postgraduate Course “History and Philosophy of Science”: What? How? What for?

The article addresses the problem of teaching the course of history and philosophy of science. This course has been taught to graduate students of Russian universities for more than 15 years. But disputes over its content and expediency still do not subside, but only flare up with renewed vigor. Those disputes were in three directions. The author proposes to return to the discussion of the existing problems in each of the areas of criticism of postgraduate discipline. These are: 1) the content of the subject from the standpoint of the coordination of its historical and philosophical parts (What?); 2) pedagogical and methodological support of training (How?); and 3) the ultimate goals of postgraduate training in general (For what?). The questions “how?” and “ what for?” are included in a broader context – the formation of the competence of a future scientist, his readiness to solve complex and non-trivial scientific problems. Reflections outlined in the article are built into the overall picture of post-graduate training in universities that has developed to date. The author sums up his reflections by calling for non-stop communication in a mode of continuous “recursive adjoining”. Such a strategy, in his opinion, remains the most reliable means of highquality promotion of both teaching and training of graduate students in general.

Motivations and Barriers for Veterinarians When Facilitating Fertility Management on UK Dairy Farms

It is economically essential, but challenging, for dairy farmers to manage bovine fertility. Vets can help farmers to improve fertility, and this is cost-effective bringing benefits for production, animal health and welfare, and the environment. However, the extent to which vets are involved in fertility varies considerably between farms, for reasons that are unclear. This study investigated the motivators and barriers that vets perceive when trying to increase their involvement with fertility management on UK dairy farms. Interviews were conducted with 20 vets and four themes identified. The first, “clinical baggage,” highlighted vets' disillusionment due to past experiences of low uptake of their advice by farmers. Consequently, some vets made assumptions about farmer needs and behaviours, and exhibited ageist stereotyping. These issues, along with concerns and fatigue associated with repeatedly offering the same advice which was not acted upon, negatively influenced vets' engagement with farmers. The second theme “stuck in the comfort zone” revealed a loss of enthusiasm by some senior vets, whilst others lacked confidence to engage due to perceived gaps in their knowledge. Vets also reported farmers not perceiving their problems and lack of farm data or facilities, as barriers. The “vet-farmer relationship” theme highlighted building trust and developing strong relationships which were key drivers for vets to proactively engage and to “go the extra mile” for their clients. The final theme “money matters” explored vets' motivations to improve their clients' profitability and included the future sustainability of their own businesses. Our themes provide useful insight into the challenges vets face and provide key areas that can be targeted in future interventions to improve veterinary involvement in fertility management. For example, post-graduate training and support for vets needs to consider factors such as reflection, mentorship, stereotyping, relationships, communication, and leadership skills. This type of postgraduate support is currently limited for vets and requires investment from stakeholders if improvements in production, animal health and welfare, and the environment are to be achieved. Our findings are informative for facilitating veterinary involvement in any disease context, and are relevant for stakeholders including governments, educators, charities, farmer representatives, environmentalists, and veterinary leaders.

Surgical Perspective: UWI Graduates Path to a Certificate of Completion of Training (CCT) & Fellowship in the UK

Surgical post graduate training is a rapidly evolving field that has seen major technological shifts in its delivery of care. Our aim in this article is to deliver a viewpoint of a contemporary roadmap for the University of the West Indies (UWI) graduate. The overall path and length of training schemes in the United Kingdom (UK), in respect to general surgery and urology is presented. It is important for the reader to understand that the UWI graduate has many different avenues they can pursue to gain entry onto a UK surgical training programme. The Caribbean should benefit from the connectivity and collaboration with our international colleagues. Keywords: surgery, postgraduate, training, general surgery, urology, fellowship