Medicine and Health Sciences Commons^™

Psychometric Properties Of The Urdu Version Of The Eortc Qlq-H&N35 (European Organization For Research And Treatment Of Cancer Head And Neck Module) Quality Of Life Tool, Nida Zahid, Russell Seth Martins, Wajeeha Zahid, Iqbal Azam Syed, Mubasher Ikram, Aneesa Hassan, Shireen Shehzad Bhamani, Adnan Abdul Jabbar, Nargis Asad, Shabbir Akhtar, Moghira Iqbaluddin Siddiqui, Mohammad Sohail Awan, Khabir Ahmad

Department of Surgery

Background: We translated and validated the Urdu version of the European Organization for Research and Treatment of Cancer Quality of Life (QoL) Questionnaire's Head and Neck (H&N) Cancer Module (EORTC QLQ-H&N35) and assessed its convergent and discriminant validity by examining correlations of QoL with depression, anxiety, and resilience.
Methods: We translated the EORTC QLQ-H&N35 according to EORTC instructions. Patients at a tertiary care hospital in Pakistan completed a survey consisting of Urdu versions of EORTC QLQ-C30 (core QoL tool), QLQ-H&N35, Hospital Anxiety and Depression Scale, and Wagnild and Young Resilience Scale (RS-14). Content validity, convergent validity, discriminant validity, and reliability …

Surgical Management Of Subclavian And Proximal Axillary Artery Injuries, Zia Ur Rehman, Suleman Yousaf, Tehmeed Ahmad

Department of Surgery

Subclavian and proximal axillary arterial injuries are rare and difficult to manage. Eight patients were managed from January 2008 to December 2018 at The Aga Khan University Hospital, Karachi, Pakistan with mean age of 36.13 ± 14.48 years. All patients had penetrating injuries, from gunshot in 5 (62.5%), bomb blast in 2 (25%), and stab wound in 1 (12.5%) case. Six (75%) patients presented in haemodynamically stable condition. The mean time between the injury and patient presentation was 28 ± 8.39 hours. The injuries were approached via supraclavicular incision in 3 (37.5%) patients, infraclavicular incisions in 2 (25%) patients and …

Abdominal Vascular Injuries- What General/ Trauma Surgeons Should Know?, Zia Ur Rehman

Department of Surgery

Abdominal vascular injuries are the common cause of death post-trauma. These are challenging injuries to manage due to severe haemodynamic instability, other associated injuries and difficulty in accessing and controlling these deep-seated vessels. Early control of bleeding can decrease mortality in these patients. Abdominal vasculature is divided into three zones, each requiring different operative strategy for exposure. Standard vascular surgery principles of achieving proximal and distal control before exploring any haematoma are followed when managing these injuries. Resuscitative endovascular balloon occlusion of aorta is a minimally invasive method of achieving proximal aortic occlusion. This also acts as bridge for definitive …

Inferior Vena Cava Injuries - A Clinical Review, Zia Ur Rehman

Department of Surgery

Inferior vena caval (IVC) injuries are uncommon and challenging to treat. Less than 5% of patients with penetrating abdominal trauma and less than 0.5% of patients with blunt abdominal trauma have this injury. Patient can present with intraperitoneal haemorrhage or with a contained retroperitoneal haematoma. Mostly it is associated with other abdominal structures injuries. Most commonly injured segment is infrarenal IVC. Operative strategy is different for each segment of injured vein. Infrahepatic injuries are exposed by medial visceral rotation. Retrohepatic and suprahepatic injuries need infrequent exposures. Mortality remains high and range between 31-51% for the patient brought alive to the …

The National Burden Of Orthopedic Injury: Cross-Sectional Estimates For Trauma System Planning And Optimization, Molly P. Jarman, Michael J. Weaver, Adil H. Haider, Ali Saleem, Mitchel B. Harris

Department of Surgery

Background: Management of orthopedic injuries is a critical component of comprehensive trauma care. As patterns of injury incidence and recovery change in the face of emerging injury prevention efforts and technologies and an aging US population, assessment of the burden of orthopedic injury is essential to optimize trauma system planning. We sought to estimate the incidence of orthopedic injury requiring emergency orthopedic surgery in the United States.
Methods: Using nationally representative samples from the Agency for Healthcare Research and Quality Healthcare Cost and Utilization Project, we estimated the incidence of orthopedic injury, polytrauma with orthopedic injury, and emergency operative orthopedic …

Psychological Distress And Its Associated Factors Among Informal Care Givers Of Disabled Young Adults With Traumatic Brain Injuries, Samera Punjwani, Yasmin Parpio, Rubina Barolia, Muhammad Shahzad Shamim, Nargis Asad

Department of Surgery

Objective: To measure the psychological distress among the informal caregivers of disabled young adults with traumatic brain injuries (TBI) and to identify its associated factors.
Methods: An analytical cross sectional study was conducted with 76 informal caregivers of young adults (19 - 50 years) with TBI, using admission records of one of the tertiary care hospitals in Karachi, Pakistan from 2015 to 2016. Data were collected using a structured questionnaire comprising a general demographic questionnaire and the General Health Questionnaire- 28. The effect of the predictors on the psychological distress was determined by applying multiple linear regression analysis.
Results: The …

Outcome Of Traumatic Inferior Vena Caval Injuries: A Case Series, Zia Ur Rehman, Rimsha Farooq

Department of Surgery

Inferior vena caval (IVC) injuries are uncommon and challenging. The objective of the study is to evaluate outcomes of patients operated for inferior vena caval injuries at a university hospital. This is a retrospective case series of all adult patients aged >18 years who had been operated for traumatic IVC injuries at a university hospital between Jan 1998 to December 2018. During the study period, 9 patients with IVC injuries were operated with mean age of 26±10.3 years and all were males. Five (55.5%) patients had penetrating injuries while 4 (44.4%) had blunt trauma. Four (44.4%) patients had infra-renal while …

Knowledge Gain Of The Non-Vascular Surgeons After Attending A Course On Traumatic Vascular Emergencies, Zia Ur Rehman, Muhammad Asad Moosa, Qamar Riaz

Department of Surgery

Objective: To measure the effectiveness of the workshop in enhancing the knowledge and skills of the non-vascular surgeons in dealing with traumatic vascular emergencies.
Methodology: It was a Quasi-experimental pre-post design study conducted at Section of Vascular Surgery, Aga Khan University Hospital, Karachi (Pakistan) in February 2019. One-day workshop was conducted to enhance the knowledge and operative skills of the non-vascular surgeons in managing traumatic vascular emergencies. A written test and course evaluation survey were used to evaluate the effectiveness of the course in achieving the desired objectives.
Results: Total of 21 participants attended the workshop with mean age of …

Free Flap Reconstruction After Lower Limb Trauma - Outcome Analysis Using National Surgical Quality Improvement Programme (Nsqip) Parameters, Muhammad Mehmood Alam Atiq, Shayan Shahid, Muhammad Ubaid, Mohammad Fazlur Rahman, Safdar Ali Shaikh

Department of Surgery

Objective: To assess the outcomes of free flap reconstructions performed for the management of lower limb trauma.
Methods: This retrospective study was conducted at Aga Khan University Hospital (AKUH), Karachi and included data from June 2017 to May 2019 of patients who underwent free flap reconstruction as part of management of lower limb trauma.
Results: The mean age of the 8 adult patients was 34±11 years. Also included were two paediatric patients aged 7 and 8 years. Nine of the total 10 patients were male. Road traffic accidents were the most common mechanism of injury, occurring in 5(50%), followed by …

Changing Face Of Trauma And Surgical Training In A Developing Country: A Literature Review, Qamar Riaz, Sabah Uddin Saqib, Rehan Nasir Khan, Nadeem Ahmed Siddiqui

Department of Surgery

Trauma continues to be the major cause of disability and death globally and surgeons are often involved in immediate care. However there has been an exponential decrease in the number of the trained trauma surgeons. The purpose of the current review article is to summarize the published literature pertaining to trauma education in postgraduate surgical training programmes internationally and in a developing country as Pakistan. Several electronic databases like MEDLINE, PubMed, Google scholar and PakMediNet were searched using the keywords 'trauma education' or 'trauma training' AND 'postgraduate medical education', 'surgery residency training', 'surgery residents' and 'surgeons'. The current training in …

Peripheral Vascular Injuries - Not To Miss Or Mess Them!, Zia Ur Rehman

Department of Surgery

No abstract provided.

Driving Simulators – More Than A Video Game!, William D. Mcquilken B.A., Judith M. Schultz B.A.

Department of Surgery

Background: This study aimed to investigate teenager, young adult, and adult knowledge levels on distracted and impaired driving through the use of educational driving simulators. The distracted and impaired driving simulators were customized to instruct participants on the dangers of driving distracted or impaired utilizing consequence videos. The simulators were taken to high schools, colleges/universities, and businesses over a four year period where we hypothesized that they would play a significant role in raising knowledge about the dangers and penalties of these risky driving behaviors and would also help to increase seat belt usage.

Setting: High schools, colleges / universities, …

Challenging Cases In Pediatric Trauma: Management Of The Open Abdomen, Firas Madbak Md, William D. Hardin Jr, Md, Facs, Faap

Department of Surgery

No abstract provided.

Use Of Geocoding And Us Census Data To Assess Determinants Of Outcome In Trauma Patients, Krista M. Goodman Md, John J. Hong Md, Sherrine Eid Mph, Leslie Baga Bsn, Ccrc, Michael M. Badellino Md, Mph, Facs, Michael D. Pasquale Md, Facs

Department of Surgery

No abstract provided.

Effect Of Preinjury Use Of Antiplatelet Agents In Patients With Isolated Traumatic Brain Injury, Danielle Cheeseman Md, David Milia Md, David Kashmer Md, Farheen Hussain Ms, John J. Hong Md, Robert D. Barraco Md

Department of Surgery

No abstract provided.

Utilization Of Smartphones For The Enhancement Of Trauma Division Of Education, Ryan A. Lawless Md, Dale A. Dangleben Md, Rovinder S. Sandhu Md

Department of Surgery

No abstract provided.

Caval Agenesis With Hypoplastic Left Kidney In A Trauma Patient On Warfarin For Deep Vein Thrombosis (Poster), Ryan A. Lawless Md, Dale A. Dangleben Md

Department of Surgery

No abstract provided.

Hemoptysis From Retained Intrapulmonary Foreign Body In Pediatric Trauma, Shawn Travis Greathouse Md, William D. Hardin Md, Facs, Faap

Department of Surgery

No abstract provided.