Pub Date : 2024-02-29DOI: 10.18203/2349-2902.isj20240592
Manish Jangra, Hansraj Ranga, B. Arora, Dr. Vidit
Spontaneous common bile duct (CBD) perforation is a rare and life threatening clinical condition. The course of management and choice of surgical intervention depends on clinical presentation; site, size, nature of defect. It is usually reported in infants and adults due to congenital anomalies and following invasive procedure respectively but spontaneous CBD perforation in older age groups is rare without underlying cause presenting as acute abdomen. In this case report, an 82-year-old female presented to the emergency room with an acute abdomen diagnosed as spontaneous CBD perforation and its prompt management and its successful outcome.
{"title":"Spontaneous common bile duct perforation: a rare case report","authors":"Manish Jangra, Hansraj Ranga, B. Arora, Dr. Vidit","doi":"10.18203/2349-2902.isj20240592","DOIUrl":"https://doi.org/10.18203/2349-2902.isj20240592","url":null,"abstract":"Spontaneous common bile duct (CBD) perforation is a rare and life threatening clinical condition. The course of management and choice of surgical intervention depends on clinical presentation; site, size, nature of defect. It is usually reported in infants and adults due to congenital anomalies and following invasive procedure respectively but spontaneous CBD perforation in older age groups is rare without underlying cause presenting as acute abdomen. In this case report, an 82-year-old female presented to the emergency room with an acute abdomen diagnosed as spontaneous CBD perforation and its prompt management and its successful outcome.","PeriodicalId":14372,"journal":{"name":"International Surgery Journal","volume":"21 21","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140409356","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-19DOI: 10.18203/2349-2902.isj20240333
Elizabeth Skalkos, Mina Sarofim, Stephany Game, Ruwanthi Wijayawardana, Nima Ahmadi, David L Morris
Background: Cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC) is an established treatment for peritoneal malignancy. A hypercoagulable state in these patients and the associated risk of venous thromboembolism (VTE), remains the most common cause of 30-day mortality. This study aimed to evaluate the prevalence and perioperative factors associated with baseline hypercoagulability detected by rotational thromboelastometry (ROTEM), a point-of-care haemostatic assay, in peritoneal malignancy patients. Methods: A retrospective cohort study was performed in a peritoneal malignancy unit on patients undergoing CRS between 2019 and 2023, who underwent preoperative ROTEM testing. Patients were divided into group A (hypercoagulable) and Group B (normal coagulation). Baseline characteristics, pathology results, operative details and post operative outcomes were reviewed. Univariate and multivariate analysis were used to identify factors associated with baseline hypercoagulability. Results: The 70 patients were included, 23 patients in group A (32.9%) and 47 patients in group B (67.1%). Group A had a lower preoperative haemoglobin (p<0.001), higher platelet count (p<0.001) and median peritoneal carcinomatosis index (33 vs 10, p=0.003). Appendiceal primary was associated with hypercoagulability (47.8% vs 23.4%, p=0.039). Group A required more intraoperative transfusion with red blood cells (p=0.014) but not platelets (p=0.6) or cryoprecipitate (p=0.8). Although group A had a higher incidence of VTE events (30.4% vs 23.4%) this was not statistically significant. Conclusions: Baseline hypercoagulability exists in one-third of patients with peritoneal malignancy and was associated with increased tumour burden and appendiceal primary. The increasing use of ROTEM is a valuable tool for perioperative management of complex peritoneal malignancy patients.
背景：腹腔镜手术（CRS）配合腹腔内热化疗（HIPEC）是治疗腹膜恶性肿瘤的成熟疗法。这些患者的高凝状态以及与之相关的静脉血栓栓塞症（VTE）风险仍是导致 30 天死亡的最常见原因。本研究旨在评估腹膜恶性肿瘤患者通过旋转血栓弹性测定法（ROTEM）（一种护理点止血测定法）检测到的基线高凝状态的发生率和围手术期相关因素：在腹膜恶性肿瘤科对2019年至2023年期间接受CRS手术、术前接受ROTEM检测的患者进行了一项回顾性队列研究。患者被分为A组（高凝状态）和B组（正常凝状态）。对基线特征、病理结果、手术细节和术后结果进行了回顾。采用单变量和多变量分析来确定与基线高凝相关的因素：70名患者中，A组23人（32.9%），B组47人（67.1%）。A组患者术前血红蛋白较低（P<0.001），血小板计数较高（P<0.001），腹膜癌变指数中位数（33 vs 10，P=0.003）。阑尾原发癌与高凝相关（47.8% 对 23.4%，P=0.039）。A 组术中需要输更多红细胞（P=0.014），但不需要输血小板（P=0.6）或低温沉淀（P=0.8）。虽然 A 组的 VTE 事件发生率更高（30.4% 对 23.4%），但并无统计学意义：结论：三分之一的腹膜恶性肿瘤患者存在基线高凝状态，这与肿瘤负荷增加和阑尾原发疾病有关。越来越多地使用 ROTEM 是复杂腹膜恶性肿瘤患者围手术期管理的重要工具。
{"title":"Prevalence and predictors of hypercoagulability detected by rotational thromboelastometry in peritoneal malignancy patients undergoing cytoreductive surgery","authors":"Elizabeth Skalkos, Mina Sarofim, Stephany Game, Ruwanthi Wijayawardana, Nima Ahmadi, David L Morris","doi":"10.18203/2349-2902.isj20240333","DOIUrl":"https://doi.org/10.18203/2349-2902.isj20240333","url":null,"abstract":"Background: Cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC) is an established treatment for peritoneal malignancy. A hypercoagulable state in these patients and the associated risk of venous thromboembolism (VTE), remains the most common cause of 30-day mortality. This study aimed to evaluate the prevalence and perioperative factors associated with baseline hypercoagulability detected by rotational thromboelastometry (ROTEM), a point-of-care haemostatic assay, in peritoneal malignancy patients.\u0000Methods: A retrospective cohort study was performed in a peritoneal malignancy unit on patients undergoing CRS between 2019 and 2023, who underwent preoperative ROTEM testing. Patients were divided into group A (hypercoagulable) and Group B (normal coagulation). Baseline characteristics, pathology results, operative details and post operative outcomes were reviewed. Univariate and multivariate analysis were used to identify factors associated with baseline hypercoagulability.\u0000Results: The 70 patients were included, 23 patients in group A (32.9%) and 47 patients in group B (67.1%). Group A had a lower preoperative haemoglobin (p<0.001), higher platelet count (p<0.001) and median peritoneal carcinomatosis index (33 vs 10, p=0.003). Appendiceal primary was associated with hypercoagulability (47.8% vs 23.4%, p=0.039). Group A required more intraoperative transfusion with red blood cells (p=0.014) but not platelets (p=0.6) or cryoprecipitate (p=0.8). Although group A had a higher incidence of VTE events (30.4% vs 23.4%) this was not statistically significant.\u0000Conclusions: Baseline hypercoagulability exists in one-third of patients with peritoneal malignancy and was associated with increased tumour burden and appendiceal primary. The increasing use of ROTEM is a valuable tool for perioperative management of complex peritoneal malignancy patients.","PeriodicalId":14372,"journal":{"name":"International Surgery Journal","volume":"35 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140451507","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-19DOI: 10.18203/2349-2902.isj20240332
Vigneshwar Bakthavachalam, M. M. Yusuf
Background: Coronary artery bypass graft (CABG) surgery has been the gold standard for the treatment of coronary artery disease over the years. It is recommended for patients with multi-vessel coronary artery disease, left main disease, diabetics, severe left ventricular dysfunction, unsuitable anatomy for percutaneous coronary intervention (PCI), and failed PCI. The usage of the left internal mammary artery (LIMA) in the CABG to the left anterior descending (LAD) artery has proven to be superior compared to PCI. Minimally invasive hybrid coronary revascularization (MIHCR) is gaining growing interest. Methods: This is a hospital-based prospective observational study with 200 patients followed up for a period of 30 days. This study aims to assess the early outcomes of MIHCR in the Indian population. Results: The 30-day mortality was comparable to other studies, and the number of days in the ICU and hospital stay was shorter than the routine CABG. There was no incidence of a wound infection or stroke. Blood product usage and the need for repeat revascularization and re-exploration were less. The short-term outcomes were promising. Conclusions: MIHCR has excellent short-term results and is safer than conventional OPCABG, as it is less invasive and avoids midline sternotomy. It also reduces the incidence of stroke and lesser usage of blood products, promoting early return of patients to their routine activities.
{"title":"Early outcomes of minimally invasive hybrid coronary revascularization","authors":"Vigneshwar Bakthavachalam, M. M. Yusuf","doi":"10.18203/2349-2902.isj20240332","DOIUrl":"https://doi.org/10.18203/2349-2902.isj20240332","url":null,"abstract":"Background: Coronary artery bypass graft (CABG) surgery has been the gold standard for the treatment of coronary artery disease over the years. It is recommended for patients with multi-vessel coronary artery disease, left main disease, diabetics, severe left ventricular dysfunction, unsuitable anatomy for percutaneous coronary intervention (PCI), and failed PCI. The usage of the left internal mammary artery (LIMA) in the CABG to the left anterior descending (LAD) artery has proven to be superior compared to PCI. Minimally invasive hybrid coronary revascularization (MIHCR) is gaining growing interest.\u0000Methods: This is a hospital-based prospective observational study with 200 patients followed up for a period of 30 days. This study aims to assess the early outcomes of MIHCR in the Indian population.\u0000Results: The 30-day mortality was comparable to other studies, and the number of days in the ICU and hospital stay was shorter than the routine CABG. There was no incidence of a wound infection or stroke. Blood product usage and the need for repeat revascularization and re-exploration were less. The short-term outcomes were promising.\u0000Conclusions: MIHCR has excellent short-term results and is safer than conventional OPCABG, as it is less invasive and avoids midline sternotomy. It also reduces the incidence of stroke and lesser usage of blood products, promoting early return of patients to their routine activities.","PeriodicalId":14372,"journal":{"name":"International Surgery Journal","volume":"25 13","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140450010","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-14DOI: 10.18203/2349-2902.isj20240326
Sahar M. Alnefaie
Lipomas are mesenchymal tumors composed of mature fat tissue and are considered one of the most common benign tumors. They are usually small in size, and giant lipomas are rare. The exact etiology of lipoma development is unclear, though several factors have been proposed. Intramuscular or subpectoral lipomas involving the pectoralis major muscle are uncommon. In this report, the author has described the case of a 52-year-old female patient who presented with an uncommon form of subpectoral, giant, recurrent breast lipoma. The patient had undergone a complete surgical excision. The author suggests an individualized assessment and treatment of each case.
{"title":"A giant, recurrent, subpectoral breast lipoma: case report","authors":"Sahar M. Alnefaie","doi":"10.18203/2349-2902.isj20240326","DOIUrl":"https://doi.org/10.18203/2349-2902.isj20240326","url":null,"abstract":"Lipomas are mesenchymal tumors composed of mature fat tissue and are considered one of the most common benign tumors. They are usually small in size, and giant lipomas are rare. The exact etiology of lipoma development is unclear, though several factors have been proposed. Intramuscular or subpectoral lipomas involving the pectoralis major muscle are uncommon. In this report, the author has described the case of a 52-year-old female patient who presented with an uncommon form of subpectoral, giant, recurrent breast lipoma. The patient had undergone a complete surgical excision. The author suggests an individualized assessment and treatment of each case.","PeriodicalId":14372,"journal":{"name":"International Surgery Journal","volume":"50 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139838231","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-14DOI: 10.18203/2349-2902.isj20240326
Sahar M. Alnefaie
Lipomas are mesenchymal tumors composed of mature fat tissue and are considered one of the most common benign tumors. They are usually small in size, and giant lipomas are rare. The exact etiology of lipoma development is unclear, though several factors have been proposed. Intramuscular or subpectoral lipomas involving the pectoralis major muscle are uncommon. In this report, the author has described the case of a 52-year-old female patient who presented with an uncommon form of subpectoral, giant, recurrent breast lipoma. The patient had undergone a complete surgical excision. The author suggests an individualized assessment and treatment of each case.
{"title":"A giant, recurrent, subpectoral breast lipoma: case report","authors":"Sahar M. Alnefaie","doi":"10.18203/2349-2902.isj20240326","DOIUrl":"https://doi.org/10.18203/2349-2902.isj20240326","url":null,"abstract":"Lipomas are mesenchymal tumors composed of mature fat tissue and are considered one of the most common benign tumors. They are usually small in size, and giant lipomas are rare. The exact etiology of lipoma development is unclear, though several factors have been proposed. Intramuscular or subpectoral lipomas involving the pectoralis major muscle are uncommon. In this report, the author has described the case of a 52-year-old female patient who presented with an uncommon form of subpectoral, giant, recurrent breast lipoma. The patient had undergone a complete surgical excision. The author suggests an individualized assessment and treatment of each case.","PeriodicalId":14372,"journal":{"name":"International Surgery Journal","volume":"49 14","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139778274","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-09DOI: 10.18203/2349-2902.isj20240317
James N. Sellars, Ryan Green, E. Jeyarajan
Vernix caseosa peritonitis is an uncommon pathology predominantly affecting post-partum women who have undergone caesarean section and has symptomatology identical to common intra-abdominal surgical pathology. Cross-sectional imaging may not differentiate this from an alternative aetiology, thus a broad range of differentials must be considered in the early post-partum patient. This case of a 26 year-old post-partum patient who underwent an appendicectomy for CT-confirmed appendicitis had a histological diagnosis of vernix caseosa peritonitis. This case demonstrates the diagnostic challenge of acute abdominal pain in the early post-partum period and the high index of suspicion that clinicians must have to reach these uncommon diagnoses.
{"title":"Vernix caseosa peritonitis: a mimic for post-partum appendicitis","authors":"James N. Sellars, Ryan Green, E. Jeyarajan","doi":"10.18203/2349-2902.isj20240317","DOIUrl":"https://doi.org/10.18203/2349-2902.isj20240317","url":null,"abstract":"Vernix caseosa peritonitis is an uncommon pathology predominantly affecting post-partum women who have undergone caesarean section and has symptomatology identical to common intra-abdominal surgical pathology. Cross-sectional imaging may not differentiate this from an alternative aetiology, thus a broad range of differentials must be considered in the early post-partum patient. This case of a 26 year-old post-partum patient who underwent an appendicectomy for CT-confirmed appendicitis had a histological diagnosis of vernix caseosa peritonitis. This case demonstrates the diagnostic challenge of acute abdominal pain in the early post-partum period and the high index of suspicion that clinicians must have to reach these uncommon diagnoses.","PeriodicalId":14372,"journal":{"name":"International Surgery Journal","volume":" 26","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139789477","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-09DOI: 10.18203/2349-2902.isj20240317
James N. Sellars, Ryan Green, E. Jeyarajan
Vernix caseosa peritonitis is an uncommon pathology predominantly affecting post-partum women who have undergone caesarean section and has symptomatology identical to common intra-abdominal surgical pathology. Cross-sectional imaging may not differentiate this from an alternative aetiology, thus a broad range of differentials must be considered in the early post-partum patient. This case of a 26 year-old post-partum patient who underwent an appendicectomy for CT-confirmed appendicitis had a histological diagnosis of vernix caseosa peritonitis. This case demonstrates the diagnostic challenge of acute abdominal pain in the early post-partum period and the high index of suspicion that clinicians must have to reach these uncommon diagnoses.
{"title":"Vernix caseosa peritonitis: a mimic for post-partum appendicitis","authors":"James N. Sellars, Ryan Green, E. Jeyarajan","doi":"10.18203/2349-2902.isj20240317","DOIUrl":"https://doi.org/10.18203/2349-2902.isj20240317","url":null,"abstract":"Vernix caseosa peritonitis is an uncommon pathology predominantly affecting post-partum women who have undergone caesarean section and has symptomatology identical to common intra-abdominal surgical pathology. Cross-sectional imaging may not differentiate this from an alternative aetiology, thus a broad range of differentials must be considered in the early post-partum patient. This case of a 26 year-old post-partum patient who underwent an appendicectomy for CT-confirmed appendicitis had a histological diagnosis of vernix caseosa peritonitis. This case demonstrates the diagnostic challenge of acute abdominal pain in the early post-partum period and the high index of suspicion that clinicians must have to reach these uncommon diagnoses.","PeriodicalId":14372,"journal":{"name":"International Surgery Journal","volume":"69 5-6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139849370","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-09DOI: 10.18203/2349-2902.isj20240318
James N. Sellars, Michael Van Der Mark, Joanna Neal, Tom Palesy, Lani Palesy, E. Jeyarajan
Background: Objective of the study was to determine the self-perceived preparedness and concerns of newly graduated junior doctors beginning their internship year in a regional based hospital in far North Queensland. Methods: A questionnaire investigating the basic demographics, future vocational intentions, perceived medical strengths, and greatest hopes and fears for the upcoming intern year was formulated. The survey was undertaken by all interns starting work in 2023 at Cairns Hospital in regional Far North Queensland. Basic statistical analysis was conducted in Microsoft Excel. Results: There were 52 total participants. Overall, 40 (76.9%) were aged 23 to 32 years, 45 (86.5%) had graduated from a Queensland university, and 25 (48.1%) had previous exposure to the medical field prior to internship, through a family member or previous work. New interns felt least prepared for discussions regarding dying and palliative care, N=14 (26.9%) at least “prepared”, certification of death, N=11 (21.2%) at least “prepared” and nasogastric tube insertion, N=14 (26.9%) at least “prepared”. The main concerns were feeling unsupported (N=31, 59.6%), tiredness and stress (N=28, 53.8%), and interacting with rude staff or experiencing bullying (N=27, 51.9%). Overall, interns felt least prepared for surgical (N=21, 40.4%) and after-hours rotations (N=19, 36.5%). Conclusions: The intern year can be daunting for recent graduates, particularly feeling a sense of isolation and fatigue, heightened by potential staff conflict and high-pressure settings in surgery and after-hours. Better preparation and support should be provided for interns to ensure a comfortable transition from university to work to optimise safe and effective patient care.
{"title":"Self-perceived preparedness of junior doctors for internship in regional far North Queensland","authors":"James N. Sellars, Michael Van Der Mark, Joanna Neal, Tom Palesy, Lani Palesy, E. Jeyarajan","doi":"10.18203/2349-2902.isj20240318","DOIUrl":"https://doi.org/10.18203/2349-2902.isj20240318","url":null,"abstract":"Background: Objective of the study was to determine the self-perceived preparedness and concerns of newly graduated junior doctors beginning their internship year in a regional based hospital in far North Queensland.\u0000Methods: A questionnaire investigating the basic demographics, future vocational intentions, perceived medical strengths, and greatest hopes and fears for the upcoming intern year was formulated. The survey was undertaken by all interns starting work in 2023 at Cairns Hospital in regional Far North Queensland. Basic statistical analysis was conducted in Microsoft Excel.\u0000Results: There were 52 total participants. Overall, 40 (76.9%) were aged 23 to 32 years, 45 (86.5%) had graduated from a Queensland university, and 25 (48.1%) had previous exposure to the medical field prior to internship, through a family member or previous work. New interns felt least prepared for discussions regarding dying and palliative care, N=14 (26.9%) at least “prepared”, certification of death, N=11 (21.2%) at least “prepared” and nasogastric tube insertion, N=14 (26.9%) at least “prepared”. The main concerns were feeling unsupported (N=31, 59.6%), tiredness and stress (N=28, 53.8%), and interacting with rude staff or experiencing bullying (N=27, 51.9%). Overall, interns felt least prepared for surgical (N=21, 40.4%) and after-hours rotations (N=19, 36.5%).\u0000Conclusions: The intern year can be daunting for recent graduates, particularly feeling a sense of isolation and fatigue, heightened by potential staff conflict and high-pressure settings in surgery and after-hours. Better preparation and support should be provided for interns to ensure a comfortable transition from university to work to optimise safe and effective patient care.","PeriodicalId":14372,"journal":{"name":"International Surgery Journal","volume":"345 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139848344","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-09DOI: 10.18203/2349-2902.isj20240318
James N. Sellars, Michael Van Der Mark, Joanna Neal, Tom Palesy, Lani Palesy, E. Jeyarajan
Background: Objective of the study was to determine the self-perceived preparedness and concerns of newly graduated junior doctors beginning their internship year in a regional based hospital in far North Queensland. Methods: A questionnaire investigating the basic demographics, future vocational intentions, perceived medical strengths, and greatest hopes and fears for the upcoming intern year was formulated. The survey was undertaken by all interns starting work in 2023 at Cairns Hospital in regional Far North Queensland. Basic statistical analysis was conducted in Microsoft Excel. Results: There were 52 total participants. Overall, 40 (76.9%) were aged 23 to 32 years, 45 (86.5%) had graduated from a Queensland university, and 25 (48.1%) had previous exposure to the medical field prior to internship, through a family member or previous work. New interns felt least prepared for discussions regarding dying and palliative care, N=14 (26.9%) at least “prepared”, certification of death, N=11 (21.2%) at least “prepared” and nasogastric tube insertion, N=14 (26.9%) at least “prepared”. The main concerns were feeling unsupported (N=31, 59.6%), tiredness and stress (N=28, 53.8%), and interacting with rude staff or experiencing bullying (N=27, 51.9%). Overall, interns felt least prepared for surgical (N=21, 40.4%) and after-hours rotations (N=19, 36.5%). Conclusions: The intern year can be daunting for recent graduates, particularly feeling a sense of isolation and fatigue, heightened by potential staff conflict and high-pressure settings in surgery and after-hours. Better preparation and support should be provided for interns to ensure a comfortable transition from university to work to optimise safe and effective patient care.
{"title":"Self-perceived preparedness of junior doctors for internship in regional far North Queensland","authors":"James N. Sellars, Michael Van Der Mark, Joanna Neal, Tom Palesy, Lani Palesy, E. Jeyarajan","doi":"10.18203/2349-2902.isj20240318","DOIUrl":"https://doi.org/10.18203/2349-2902.isj20240318","url":null,"abstract":"Background: Objective of the study was to determine the self-perceived preparedness and concerns of newly graduated junior doctors beginning their internship year in a regional based hospital in far North Queensland.\u0000Methods: A questionnaire investigating the basic demographics, future vocational intentions, perceived medical strengths, and greatest hopes and fears for the upcoming intern year was formulated. The survey was undertaken by all interns starting work in 2023 at Cairns Hospital in regional Far North Queensland. Basic statistical analysis was conducted in Microsoft Excel.\u0000Results: There were 52 total participants. Overall, 40 (76.9%) were aged 23 to 32 years, 45 (86.5%) had graduated from a Queensland university, and 25 (48.1%) had previous exposure to the medical field prior to internship, through a family member or previous work. New interns felt least prepared for discussions regarding dying and palliative care, N=14 (26.9%) at least “prepared”, certification of death, N=11 (21.2%) at least “prepared” and nasogastric tube insertion, N=14 (26.9%) at least “prepared”. The main concerns were feeling unsupported (N=31, 59.6%), tiredness and stress (N=28, 53.8%), and interacting with rude staff or experiencing bullying (N=27, 51.9%). Overall, interns felt least prepared for surgical (N=21, 40.4%) and after-hours rotations (N=19, 36.5%).\u0000Conclusions: The intern year can be daunting for recent graduates, particularly feeling a sense of isolation and fatigue, heightened by potential staff conflict and high-pressure settings in surgery and after-hours. Better preparation and support should be provided for interns to ensure a comfortable transition from university to work to optimise safe and effective patient care.","PeriodicalId":14372,"journal":{"name":"International Surgery Journal","volume":" 20","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139788454","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-08DOI: 10.18203/2349-2902.isj20240314
Sahar M. Alnefaie, Y. Asiri, R. S. Alqahtani, Maha O. Alshareef, Khalid M. Alzahrani, Sarah M. Albogami
Background: Breast cancer (BC) is the most common cancer among women worldwide. Among all types of cancer, 11.7% of cases diagnosed in 2020 were BC. Compare this to Saudi Arabia, where 28.8 out of every 100,000 women were diagnosed with BC. Furthermore, BC patients are more likely than other cancer survivors to use complementary and alternative medicine (CAM). Study aimed to investigate association between CAM use and BC recurrence rates in Saudi Arabia. Methods: A cross-sectional study was conducted on 106 participants recruited from breast surgery clinics. Targeted women were diagnosed with BC and treated at Al Hada armed forces hospital. The data were collected by interviewing the patients using a validated questionnaire. Results: The prevalence of CAM usage among BC patients was 35.8%. The recurrence rate of BC was 26.4%. CAM users accounted for 28.57% of the total, while non-CAM users comprised 71.43%. In addition, 50% of recurrences were distant metastases, and 50% occurred more than two years after diagnosis. Conclusions: In conclusion, more than one-third of BC patients in this region incorporate CAM into their treatment regimen. Our findings reveal a practical but not statistical significance of a lower recurrence rate of BC among CAM users compared to non-CAM. These results emphasize the importance of healthcare providers engaging in detailed discussions with BC patients regarding CAM usage in conjunction with planned medical and surgical therapies.
背景：乳腺癌（BC）是全球女性最常见的癌症。在所有类型的癌症中，2020 年确诊的病例中有 11.7% 为乳腺癌。相比之下，沙特阿拉伯每 10 万名妇女中就有 28.8 人确诊为乳腺癌。此外，与其他癌症幸存者相比，BC 患者更有可能使用补充和替代医学（CAM）。该研究旨在调查沙特阿拉伯使用 CAM 与 BC 复发率之间的关系：方法：对从乳腺外科诊所招募的 106 名参与者进行了横断面研究。研究对象为被诊断出患有乳腺癌并在 Al Hada 武装部队医院接受治疗的女性。数据是通过使用有效问卷对患者进行访谈收集的：结果：乳腺癌患者使用 CAM 的比例为 35.8%。乳腺癌的复发率为 26.4%。使用心理治疗方法的患者占总数的 28.57%，而未使用心理治疗方法的患者占 71.43%。此外，50%的复发为远处转移，50%的复发发生在确诊后两年以上。结论总之，该地区三分之一以上的 BC 患者将 CAM 纳入了治疗方案。我们的研究结果表明，使用 CAM 的 BC 复发率低于未使用 CAM 的 BC 复发率，这具有实际意义，但不具有统计学意义。这些结果强调了医疗服务提供者与 BC 患者就 CAM 的使用以及计划中的药物和手术疗法进行详细讨论的重要性。
{"title":"The association between complementary and alternative medicine use with breast cancer recurrence in Taif city, Saudi Arabia","authors":"Sahar M. Alnefaie, Y. Asiri, R. S. Alqahtani, Maha O. Alshareef, Khalid M. Alzahrani, Sarah M. Albogami","doi":"10.18203/2349-2902.isj20240314","DOIUrl":"https://doi.org/10.18203/2349-2902.isj20240314","url":null,"abstract":"Background: Breast cancer (BC) is the most common cancer among women worldwide. Among all types of cancer, 11.7% of cases diagnosed in 2020 were BC. Compare this to Saudi Arabia, where 28.8 out of every 100,000 women were diagnosed with BC. Furthermore, BC patients are more likely than other cancer survivors to use complementary and alternative medicine (CAM). Study aimed to investigate association between CAM use and BC recurrence rates in Saudi Arabia.\u0000Methods: A cross-sectional study was conducted on 106 participants recruited from breast surgery clinics. Targeted women were diagnosed with BC and treated at Al Hada armed forces hospital. The data were collected by interviewing the patients using a validated questionnaire.\u0000Results: The prevalence of CAM usage among BC patients was 35.8%. The recurrence rate of BC was 26.4%. CAM users accounted for 28.57% of the total, while non-CAM users comprised 71.43%. In addition, 50% of recurrences were distant metastases, and 50% occurred more than two years after diagnosis. \u0000Conclusions: In conclusion, more than one-third of BC patients in this region incorporate CAM into their treatment regimen. Our findings reveal a practical but not statistical significance of a lower recurrence rate of BC among CAM users compared to non-CAM. These results emphasize the importance of healthcare providers engaging in detailed discussions with BC patients regarding CAM usage in conjunction with planned medical and surgical therapies. \u0000 ","PeriodicalId":14372,"journal":{"name":"International Surgery Journal","volume":"9 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139853393","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：