Surgery Commons^™

Morbidity And Mortality Meetings; A New Digital Portal To Enhance Learning And Objectivity, Saqib Kamran Bakhshi, Kiran Ehsan, Gulzar S. Lakhani, Ather Enam

Section of Neurosurgery

Morbidity and mortality meetings have long been part of surgical education and practice. They have undergone several modifications over time to include improvement in patient safety and outcomes as an essential utility of conducting morbidity and mortality meetings. Time and again, it has been proposed in literature that standardisation of case discussion results in the efficiency of these meetings. Learning opportunities can be compiled for system improvement. The current review article was planned to present a newly implemented digital morbidity and mortality portal at the Aga Khan University Hospital (AKUH), Karachi, aiming at homogenising the discussion and to add objectivity …

Screening For Malnutrition In Oral Cavity Cancer Patients Prior To Treatment: A Cross-Sectional Study, Haissan Iftikhar, Anwar Suhail, Amna Urooba, Karim Rizwan Nathani, Zeeshan Shaikh, Muhammad Wasif

Section of Otolaryngology, Head & Neck Surgery

This study was conducted to assess the frequency of pre-operative malnourishment in patients being treated for oral cavity squamous cell carcinoma. A retrospective chart review was carried out at the Aga Khan University Hospital, Karachi, on 62 patients. Patients were screened pre-operatively through a standard nutritional assessment tool at the time of admission to assess for malnutrition. Mean age of presentation was 48.34±13.11 years, mean height was 165 ± 8.62cm, weight 66.09±14.98 kg and BMI of 24.09±4.84. Males were 82.3% and 17.7% were females. At the time of admission, a significant number or patients, 12 (19.4%) were prone to malnourishment, …

Training In Temporal Bone Surgery: A Review Of Current Practices, Muhammad Wasif, Abdul Basit Shah Vardag, Ainulakbar Mughal, Syed Akbar Abbas, Shayan Khalid, Hamdan Ahmed Pasha

Section of Otolaryngology, Head & Neck Surgery

The temporal bone consists of complex anatomy, and the presence of various vital structures in close proximity makes the surgery of temporal bone highly challenging. Such a surgery requires years of training under the direct observation of trainers. Over the course of history, different training models have been adopted by experts to help train the young surgeons in this complex procedure. Cadaveric dissections of the temporal bone remains the gold standard in training of residents as the cadavers present the actual anatomical details which the surgeons encounter while operating on patients. However, due to scarcity of available cadavers, their one-time-only …

Predictors And Risk-Adjusted Outcomes Of New-Onset Postoperative Atrial Fibrillation In Surgical And Transcatheter Aortic Valve Replacement [Post-Af Ravr Protcol], Julia Dokko, Samantha Novotny, Xiaoyue Zhang, Sohaib Agha, Ashutosh Yaligar, Natalie Kolba, Vineet Tummala, Puja Parikh, Aurora Pryor, Henry Tannous, A. Laurie Shroyer, Thomas Bilfinger

Department of Surgery Faculty Publications

No abstract provided.

Treatment Of Comminuted Patellar Fractures Using Modified Cerclage Wiring, Mohamed Shawky, Usama Abd Allah, Mohamed Bissar

Al-Azhar International Medical Journal

ABSTRACT Background: Comminuted patellar fracture is still challenging. It is essential to restore the articular cartilage with rigid internal fixation. Objective: to assess the outcome of modified cerclage wiring fixation in patients with comminuted patellar fracture. Patients and methods: This study was done in orthopedic surgery department at Al-Azhar University Hospitals, during the period from December 2019 to November 2020. A total of 15 patients with comminuted fracture of patella were maneged by modified cerclage wiring. 12 patients were males (80.0%) and 3 patients were females (20.0%). Their age was 18-64 (average 38.87±14.80) years. All patients had unilateral patellar fractures. …

Simulation Based Team Training In Surgery - A Review, Syed Muhammad Nazim, Qamar Riaz

Section of Urology

The healthcare environment in surgery is complex, dynamic and often ambiguous. Besides subject knowledge and technical skills, other competencies, such as team work, communication skills and situation awareness, are required to ensure better patient-related outcome. Teams that demonstrate poor non-technical skills make more technical errors, often resulting in patient morbidity or mortality. Different hospital-based locations, such as operating rooms, intensive care units, emergency rooms and surgical wards, are the areas where poor team dynamics prevail. Simulation-based team training is a strategy to provide inter-professional training and experiential learning opportunities for surgeons, anaesthetists and allied health professionals. It helps them to …

Innovation In Surgical Training: Simulating Prosthetic Heart Valves And Annuloplasty Rings Using Pacifiers For Cardiac Surgery Wet-Labs In A Resource Limited Setting, Sara Iqbal, Waris Ahmad

Section of Cardiothoracic Surgery

Conducting a hands-on cardiac wet-lab on valvular surgeries in a resource-limited setting is restricted by the lack of prosthetic heart valves and annuloplasty rings for developing cognitive and technical skills required to understand and protect the three-dimensional cardiac anatomy. In recent times, simulation is regarded as an effective tool in surgical education and has proven to improve the technical skills of trainees. The current short report presents a novel simulator to mimic heart valve replacement surgeries by using a pacifier as a prosthetic valve and annuloplasty ring. Considering resource-constraints in the local context, pacifier-based valve simulators can be usedful as …

Paradigm Shift In The Surgical Training: The Era Of Innovation, Simulation And Beyond, Syed Shahabuddin, Shiraz Hashmi, Yasir Khan, Shahid Ahmed Sami

Section of Cardiothoracic Surgery

This is an era of transformation of surgical education and training. Modern methods of training are being introduced at a rapid pace and are being adopted in surgical practice not only to improve the outcomes and patient satisfaction, but also to provide an opportunity to develop a new well-structured training curriculum by integrating both traditional and modern approaches to teach and learn surgical skills. Various surgical simulators are in use as training aids and are constantly undergoing further refinement and development. To achieve a smooth transition in surgical training to modern methods, a structured programme has to be developed and …

Ultrasonography In Early Diagnosis And Follow Up Of Amniotic Fluid Abnormalities For Assessment Of The Fetal Growth And Fetal Well Being, Ali Ismaeal

Al-Azhar International Medical Journal

Background: The US (including Doppler & 4D) is a simple method for early detection of amniotic fluid abnormalities to evaluate the fetal wellbeing and congenital lethal and non lethal anomalies. Our results demonstrate that there are different etiologies causing amniotic fluid abnormalities. Aim of work: The ultrasonographic early diagnosis and follow up of amniotic fluid abnormalities for evaluation the fetal wellbeing, fetal growth and early warning signs of fetal distress to determine the suitable time for delivery. Patient and methods: This study was performed between November 2019 and July 2020 at Obied Hospital-KSA. The study was carried on 80 cases …

Feasibility Of Conservative Breast Surgery In Retroareolar Breast Cancer, Amr Samak, Hosam Elfol, Soliman Elshakhs

Al-Azhar International Medical Journal

Objective: The study aimed to evaluate the feasibility of breast conservative surgery in patients with retro-areolar breast cancer Background: Centrally located tumors have long been thought to vave high incidence of multi-centricity and multi-focality and classically treated with mastectomy Methods: Eighteen female patients with Stage I or IIa retro-areolar breast cancer that were ≥ 1 cm away from nipple-areolar complex, were enrolled for our study at General Surgery Department, Menoufia University, from January 2014 to December 2015. Patients were fully assessed preoperatively. After patients’ counseling and consent, all patients were subjected to lumpectomy with nipple-areola complex preservation. All patients were …

Value Of Ipack Block (Interspace Between The Popliteal Artery And The Capsule Of The Posterior Knee) With Adductor Canal Block In Total Knee Arthroplasty, Mohamed Amin, Usama Abotaleb

Al-Azhar International Medical Journal

Background: Acute postoperative pain after total knee arthroplasty (TKA) is so severe to the degree that necessitates proper analgesia which is one of the patients' human rights and prevents the drawbacks of pain on various body systems. Local anesthetic Infiltration between the Popliteal Artery and the Capsule of the Knee (IPACK) can represent a promising technique for management of postoperative pain in combination with adductor canal block (ACB) after TKA. Methods: Patients received an ACB (Group I) or ACB plus IPACK (Group II) as a component of a multimodal analgesic for TKA. Visual analogue scale (VAS) for postoperative pain assessment …

Severity Of Maternal Iron Deficiency Anemia And Risk For Low Birth Weight Babies, Al-Hasan Gomaa, Mohamed Mohamed, Mohamed Radwan, Ahmed El Sheikh

Al-Azhar International Medical Journal

Background: Anemia is one of the most common diseases in the world, affecting patients of all ages and races. Anemia is one of the most common diseases in the world, affecting patients of all ages and races. Anemia is one of the most prevalent diseases in the world affecting all ages and races of patients. Root causes and prevalence vary by age group and socio-economic context. Objective: Therefore, the aim of this study is to evaluate maternal hemoglobin before birth and to know its effect on fetal weight at birth. Patients and Methods: This is a cross-sectional study which included …

Melanotic Neuroectodermal Tumor Of Infancy, Mohammad H. Almomani, Rebecca M. Rentea

Manuscripts, Articles, Book Chapters and Other Papers

Melanotic neuroectodermal tumor of infancy (MNTI) is a rapidly growing benign tumor that arises from the neural crest. It typically occurs in infants in the head and neck region. It was described for the first time in 1918 by Krompecher, and since the origin was unknown, it was described as congenital melanocarcinoma. Until 1966, this tumor was characterized by variable names (e.g., retinal anlage tumor, pigmented congenital epulis, melanotic progonoma, pigmented teratoma, atypical melanoblastoma, etc.). However, Borello and Gorlin found that the tumor produces vanillylmandelic acid (VMA), which is produced by other types of tumors that arise from the neural …

Posterior Urethral Valve, George Bingham, Rebecca M. Rentea

Manuscripts, Articles, Book Chapters and Other Papers

Posterior urethral valves are one of the most common causes of urinary tract obstruction in the pediatric population. They are obstructing membranous folds in the lumen of the posterior part of the urethra and are exclusive to male patients. Posterior urethral valves were first described by Morgagni in 1717 and then by Langenbeck in 1802, who reported valve-like folds in dissected cadavers. Posterior urethral valves can lead to a spectrum of pathology both inside and outside the urinary system. This includes acute retention, chronic kidney disease, and in severe cases, pulmonary hypoplasia secondary to low amniotic fluid levels.

Posterior urethral …

Problems In Scientific Research, Mostafa Abd El-Nasser

Al-Azhar International Medical Journal

Scientific research faces many problems and obstacles especially in developing countries. So, from the early beginning, if we start with a problem, then ways and methods will also be accompanied by obstacles which may lead to more complications. The aim of this study was to clarify some of the most important problems in the field of scientific research in our organization and to suggest solutions for them. Some of these research problems are addressed as follows: 1) is there a difficulty in choosing the research topic? 2) is the topic common or rare? 3) is the research proposal approved from …

Outcomes And Complications Of Scfe Surgery, Tyler Sanda

Scholarship in Medicine - All Papers

Objective: Slipped capital femoral epiphysis (SCFE) is a common hip disorder affecting children and adolescents. There is much debate concerning best treatment with regards to adverse outcomes, specifically avascular necrosis (AVN). This study analyzed the rates of adverse outcomes after the surgical treatment of SCFEs. It examined risk factors which may lead to the development adverse outcomes. This research will aid clinical decision-making, helping determine optimal surgical treatment of SCFEs and adding to external datasets of SCFE treatment.

Methods: This was a retrospective review of patient health records at a level 2 pediatric trauma hospital. The study included all SCFE …

Assessment Of Serum Level Of Interferon Gamma In Patients Of Lupus Nephritis And Without Nephritis, Abdelwahab Bayoumy, Medhat Shalaby, Mostafa Eldahan, Ahmed Abdelaziz, Ibrahim Metwaly

Al-Azhar International Medical Journal

Background: One of the major immunological problems is SLE (systemic lupus erythematosus)and lupus nephritis is one of the main complications, INF (interferon) plays an important role in disease pathogenesis Aim of the work: The aim of this work to assess the level of INF gamma in sufferers with lupus nephritis in comparison to patients with non-nephritis lupus and their correlation to the disease activity. Patients and methods: This research was conducted on 60 persons divided into two groups: group I (group SLE) comprising 40 patients, 20 patients with nephritis and 20 patients without nephritis, and group II (control group) comprising …

Accuracy Of Second Trimester Prediction Of Preterm Preeclampsia By Three Different Screening Algorithms, Mostafa Hegab, Osama Ali, Wael Amin

Al-Azhar International Medical Journal

ABSTRACT Background: Preeclampsia is a condition unique to pregnancy, which can lead to significant maternal and fetal morbidity and death. Early detection of women at greater risk of preeclampsia helps avoid and treat early illness. Aim of the work: current study aimed to compare the performance of the NICE guidelines, the ACOG recommendations and (FMF) algorithm, for the early detection of preeclampsia. Patient & Methods: Current study was a cohort prospective study included 400 women who attended for their routine antenatal care during the second trimester. All demographic and clinical data and follow up cases collected. Result: The incidence of …

Nursing Management Of The Bloodless Surgery Patient, Tiffany Achenbach Msn, Rn, Cmsrn

Posters

No abstract provided.

Early Outcome Of Transannular Patch Repair Of Tetralogy Of Fallot With Or Without Pericardial Monocusp In Pulmonary Position, Ahmed Aboufandoud, Elhusseiny Gamil, Monir Amin, Mohamed Sharaa, Al Sayed Salem, Mohamed Mosa

Al-Azhar International Medical Journal

Background: In repair of tetralogy of Fallot (TOF), the use of monocusp to protect the right ventricle from volume overload is debatable. Aim of work: Evaluates early outcome of pericardial monocusp in pulmonary position in transannular patch repair (TAP). Patients and Methods: 60 patients underwent TOF repair with TAP from June 2016 to December 2018 in Al-Azhar University Hospital and National Heart Institute, group I thirty patients without pericardial monocusp and group II thirty patients received it in pulmonary position. Results: We had Thirty-four male patients representing (56.66%). The mean age of our patients was 14.983±6.533 months. The mean aortic …