Medical Specialties Commons^™

Negative Appendectomy Rate In Urban Referral Hospitals In Tanzania: A Cross-Sectional Analysis Of Associated Factors, Nyamuryekung'e Klint Masawa, Authar Ali, Miten Ramesh Pate, Aidan Njau, Omar Sherman, Ahmed Jusabani, Ali Akbar Zehri

General Surgery, East Africa

Background: Acute appendicitis (AA) has a lifetime risk of 8.3% with a consequent 23% lifetime risk of emergency appendectomy. In atypical presentation, making a clinical diagnosis is difficult, leading to a high perforation rate (PR) or misdiagnoses and high negative appendectomy rates (NAR). This study aimed to establish NAR and explore the associated factors and possible attainable solutions to reduce it in urban referral hospitals in Tanzania.

Methods: This was a crosssectional study with 91 consecutive patients, aged 10 years and older undergoing appendectomy for suspected AA with histological evaluation of specimens. The study was powered to detect the NAR …

Wet Labs: A Useful Tool In Training Surgical Residents In A Third World Country, Hina Inam, Narmeen Asif, Abdul Ahad Sohail, Saulat Fatimi

Section of Cardiothoracic Surgery

•Wet labs are a useful, cost-effective and safe tool in teaching of Cardiothoracic Surgery residents.•In a third world country where advance real life simulators are not available.•It improves resident's tissue handling and surgical skills.•Allows faculty members to give continuous feedback to their residents.

A Rare Case Of Constrictive Pericarditis As Initial Manifestation Of Paediatric Anaplastic Large Cell Lymphoma Requiring Urgent Pericardiectomy, Sara Iqbal, Abdul Ahad Sohail, Narmeen Asif, Muhammad Rahil Khan, Sabeehuddin Siddique, Saulat Fatimi

Section of Cardiothoracic Surgery

Constrictive pericarditis (CP) is a rare end stage inflammatory disorder affecting both parietal and visceral pericardium leading to a right heart failure. Malignancy is the least common cause of CP. Anaplastic large cell lymphoma (ALCL) accounts for 10-15% of all Non-Hodgkin lymphomas in children. Very few case reports have reported ALCL that is involving the heart and only two have been published involving pericardium but all were managed medically. We present an interesting case of an 11 year old child who presented with an effusive CP that required urgent Pericardiectomy for managing right heart failure. His histopathology was positive for …

Distribution And Correlation Of Ocular Surface Disease Index Scores In A Non-Clinical Population: The Karachi Ocular Surface Disease Study, Nauman Hashmani, Faizan Ghulam Mustafa, Muhammad Ali Tariq, Syed Farjad Ali, Fakiha Bukhari, Abdul Sami Memon, Sharif Hashmani

Section of Ophthalmology

Introduction: There is increasing recognition of dry eye disease (DED) as a significant factor influencing quality of life in seemingly normal individuals. Our goal was to determine the distribution of Ocular Surface Disease Index (OSDI) scores in non-clinical individuals in Karachi, Pakistan.
Methods: We distributed OSDI questionnaires to subjects aged > 18 years with no active ocular complaint. Examiners were selected from various areas of the city to administer questionnaires to students and the general population. The OSDI score was grouped as per the following: normal (0-12 points), mild (13-22 points), moderate (23-32 points), and severe (33-100 points).
Results: We surveyed …

Elective Tracheostomy In Critically Ill Children: A 10-Year Single-Center Experience From A Lower-Middle Income Country, Sidra Ishaque, Anwarul Haque, Saqib Hamid Qazi, Hamdan Mallick, Saad Nasir

Department of Paediatrics and Child Health

Objective: Tracheostomy is a commonly performed procedure amongst critically ill patients, especially in cases of prolonged mechanical ventilation (PMV). This study aimed to describe the indications, clinical characteristics, and outcomes of elective pediatric tracheostomies in critically ill children at our center.
Methods: A retrospective review of medical records of children who underwent elective tracheostomies in our pediatric intensive care unit (PICU) was conducted from January 2009 to June 2018. Data were extracted based on demographics, indications of tracheostomy, and patient outcomes. Results were reported as mean with standard deviation and as frequencies with percentage.
Results: Of the 3,200 patients admitted …

Engaging Patients For Clinical Trials In Africa: Patient-Centered Approaches, Miriam Mutebi, Dicey Scroggins, Virgil Simons, Naomi Ohene Oti, Nazik Hammad

General Surgery, East Africa

Clinical trials in oncology are an emergent field in sub-Saharan Africa. There is a long history of clinical trials in high-income countries (HICs), with increasing attempts to develop patient-centric approaches and to evaluate patient-centered outcomes. The challenge remains as to how these trends could be adopted in low-resource settings and adapted to best fit the different health ecosystems that coexist on the African continent. Models that evaluate patient-related outcomes and measures and that are used in HICs must be modified, adopted, and adapted to suit the diverse populations and the low-resource settings in most of the continent. Patient engagement in …

Innovative Use Of Mhealth And Clinical Technology For Oncology Clinical Trials In Africa, Miriam Mutebi, Rohini Bhatia, Omolola Salako, Fidel Rubagumya, Surbhi Grover, Nazik Hammad

General Surgery, East Africa

Utilization of clinical technology and mobile health (mHealth) is expanding globally. It is important to reflect on how their usage and application could translate in low- and middle-income country (LMIC) settings. With the exponential growth and advancements of mobile and wireless technologies, LMICs are prime to adapt such technologies to potentially democratize and create solutions to health-related challenges. The role of these technologies in oncology clinical trials continues to expand. The lure of mHealth promises disruptive technology that may change the way clinical trials are designed and conducted in many settings. Its applicability in the African context is currently under …

Ruptured Splenic Hemangioma Presenting As Small Bowel Obstruction: A Case Report, Haya S. Raef, Karin L. Cole Md

Journal of Maine Medical Center

Introduction: Splenic hemangioma is a rare vascular tumor of the spleen. Typically asymptomatic, these lesions can present with rupture and hemoperitoneum. Clinical Findings: We report the case of a patient with no previous abdominal surgery that presented with symptoms and imaging consistent with small bowel obstruction (SBO), and an incidental finding of a splenic lesion. Main diagnoses, therapeutic interventions, and outcomes: At diagnostic laparoscopy, a ruptured splenic hemangioma was identified, with obstructive ileus due to hemoperitoneum. The patient subsequently underwent splenectomy to prevent recurrent bleeding. Conclusions: Splenic hemangiomas are rare vascular neoplasms of the spleen, which can be complicated by …

A Primer On Cognitive Errors Illustrated Through The Lens Of A Neurosurgical Practice, Jeffrey Evan Florman, Lisa Almeder, Robert Trowbridge

Journal of Maine Medical Center

Problem Statement:

Diagnostic error is often attributed to cognitive errors, including biased thinking patterns, rather than knowledge or data limitations, and education on cognitive bias deserves review in all spheres of practice.

Background:

The cognitive biases of practitioners create an inherent fallibility in recognizing and treating medical conditions. Awareness of cognitive errors is valuable for mitigating risk of diagnostic error.

The impact of cognitive error is substantial in the management of neurosurgically relevant disease. Remarkably broad differential diagnoses often accompany neurologic symptoms. Both focal and non-focal symptoms lend themselves to diagnostic inertia that contributes to errors. Further, initial diagnostic direction …

Malignant Hyperthermia For The Nurse Anesthetist, Victor Clark

Nursing Student Class Projects (Formerly MSN)

Malignant Hyperthermia (MH) is a rare, autosomal dominant skeletal muscle disorder that can have an insidious onset in susceptible patients exposed to the triggering agents succinylcholine, halothane, desflurane, sevoflurane, and isoflurane. MH can occur in patients who have received anesthesia with these agents in the past (Nagelhout & Plaus, 2018, p 775). Patients with a family history of MH or associated skeletal muscle disorder must be treated as MH-susceptible until proven otherwise. Failure to detect an MH crisis can lead to kidney failure, profound acidosis, coagulopathies, rhabdomyolysis, cardiac dysrhythmias, cardiovascular collapse, and death (Seifert et al., 2015). It is the …

Defining A Research Agenda For Layperson Prehospital Hemorrhage Control: A Consensus Statement, Eric Goralnic, Chibuike Ezeib, Muhammad Ali Chaudhary, Justin Mccarty, Juan P. Herrera-Escobar, Tomas Andriotti, Elzerie De Jager, Daniel Ospina-Delgado, Craig Goolsby, Adil H. Haider

Section of General Surgery

Importance: Trauma is the leading cause of death for US individuals younger than 45 years, and uncontrolled hemorrhage is a major cause of trauma mortality. The US military's medical advancements in the field of prehospital hemorrhage control have reduced battlefield mortality by 44%. However, despite support from many national health care organizations, no integrated approach to research has been made regarding implementation, epidemiology, education, and logistics of prehospital hemorrhage control by layperson immediate responders in the civilian sector.
Objective: To create a national research agenda to help guide future work for prehospital hemorrhage control by laypersons.
Evidence review: The 2-day, …

Acute Syphilitic Posterior Placoid Chorioretinopathy: A Case Report, Rehman Siddiqui, Syed Zohaib Maroof Hussain, Irfan Jeeva, Raeefuddin Ahmed

Section of Ophthalmology

A 25-year-old male presented with a complaint of acute visual loss in his right eye for two days. There was a history of visual loss in the left eye six months ago. Comprehensive eye examination showed evidence of posterior uveitis, and a placoid lesion on the right fundus. Further physical examination showed maculopapular rashes on the upper back which was highly suggestive of syphilis. Blood tests for venereal disease research laboratory (VDRL) test and fluorescent treponemal antibody absorption (FTA-ABS) test were ordered, which were both positive. Ocular syphilis should be suspected in all cases of uveitis. Early diagnosis and prompt …

Significance Of Micro-Rna Expression In Patients With Meningioma, Rida Mitha, Muhammad Shahzad Shamim

Section of Neurosurgery

Recent brain tumour research has shown abnormalities in gene expression as key features for almost all common brain tumours investigated. However, there is increasing evidence that epigenetic abnormalities are also crucial for tumorigenesis. Epigenetic abnormalities are heritable alterations affecting gene expression without changing the primary DNA sequence. Epigenetic abnormalities in meningiomas include abnormal microRNA expression, altered DNA methylation and histone and chromatin modifications. In this review we identify the role of altered expression of microRNA in the development and recurrence of meningioma. Based on the review of current literature, extensive knowledge of micro-RNA expression cannot only determine tumour recurrence and …

Association Of Circulatory Kisspeptin Levels And Hormonal Interplay With Male Infertility: A Cross-Sectional Study In Karachi, Pakistan, Rehana Rehman, Kaleem Ahmed, Nida Zahid, Faiza Alam, Syeda Sadia Fatima

Department of Biological & Biomedical Sciences

Objectives: To determine the impact of Kisspeptin on male reproductive axis in a selected urban population.
Methods: The cross-sectional study was conducted at the Sindh Institute of Reproductive Medicine in collaboration with Aga Khan University, Karachi, from July, 2017, to February, 2018, and comprised infertile males with abnormal sperm parameters who were placed in Group A and fertile males with normal sperm parameters placed in Group B. Serum samples were estimated for Kisspeptin, follicle stimulating hormone, luteinizing hormone, testosterone and sex hormone-binding globulin using enzyme-linked immunosorbent assay. Data was analysed using SPSS 22.
Results: Of the 313 male subjects, 178(57%) …

Perianal Basal Cell Carcinoma: A Common Cancer In An Uncommon Location., Ed Hagen, Nathan Hite, John A Griffin, Rodney Kratz

Articles, Abstracts, and Reports

This is a case of a perianal basal cell carcinoma, a common skin cancer in an unusual location. Our patient is a 67-year-old male with a perianal lesion. He first noticed this painless lesion 5 years prior to presentation and was having fecal incontinence and weight loss. He had a fully encompassing ulcerated lesion involving the entirety of the anal margin. We performed a biopsy that returned on pathology as a basal cell carcinoma. Due to the size of the lesion and his current nutritional status, it was determined to be unresectable. We were able to provide him with a …

Reply: There Are Limits To Autonomy., John W C Entwistle, Kathleen N Fenton

Department of Surgery Faculty Papers

No abstract provided.

A Rare Case Of Three Years Disease Free Survival In A Locally Advanced Parathyroid Carcinoma Successfully Excised By Complete Surgical Resection, Abdul Ahad Sohail, Bushra Ayub, Syed Akbar Abbas, Shafqat Ali Sheikh, Talha Ahmed Qureshi, Muhammad Usman Tariq, Asad Diwan

Department of Surgery Docs

Parathyroid carcinoma (PC) is one of the rarest malignancies making approximately 0.005% of all cancers. It may arise sporadically or less commonly, in conjunction with genetic endocrine syndromes. Due to the rarity of the disease, no general consensus or definitive guidelines exist for its pre-operative diagnosis, management, or follow up. Surgical tumor removal is the gold standard treatment to prevent its recurrence. Parathyroid carcinoma has a high recurrence rate ranging from 40 to 60% in recent literature. We report a case of a seventy-year-old elderly female with locally advanced parathyroid carcinoma successfully surgically excised completely with a 3 year disease …

Aggressive Angiomyxoma In The Ischiorectal Fossa, Asra Wahid, Abdul Hakeem, Sadaf Khan

Medical College Documents

Aggressive Angiomyxoma (AA) is a soft tissue tumour that principally affects women of the reproductive age, primarily involving the pelvis and the perineum. Despite being slow growing, it is classified as aggressive due to its locally infiltrative nature and high recurrence. It is rare, often asymptomatic and is misdiagnosed. However, it has characteristic features on radiographic imaging. Complete surgical resection is the ideal approach to treat AA. We report a case of an aggressive angiomyxoma in a 17 year old female, located in the ischiorectal fossa and diagnosed incidentally on a magnetic resonance imaging (MRI). The lesion was excised without …

Hur/Elavl1 Drives Malignant Peripheral Nerve Sheath Tumor Growth And Metastasis, Marta Palomo-Irigoyen, Encarni Pérez-Andrés, Marta Iruarrizaga-Lejarreta, Adrián Barreira-Manrique, Miguel Tamayo-Caro, Laura Vila-Vecilla, Leire Moreno-Cugnon, Nagore Beitia, Daniela Medrano, David Fernández-Ramos, Juan José Lozano, Satoshi Okawa, José L Lavín, Natalia Martín-Martín, James D Sutherland, Virginia Guitiérez De Juan, Monika Gonzalez-Lopez, Nuria Macías-Cámara, David Mosén-Ansorena, Liyam Laraba, C Oliver Hanemann, Emanuela Ercolano, David B Parkinson, Christopher W. Schultz, Bs, Marcos J Araúzo-Bravo, Alex M Ascensión, Daniela Gerovska, Haizea Iribar, Ander Izeta, Peter Pytel, Philipp Krastel, Alessandro Provenzani, Pierfausto Seneci, Ruben D Carrasco, Antonio Del Sol, María Luz Martinez-Chantar, Rosa Barrio, Eduard Serra, Conxi Lazaro, Adrienne M Flanagan, Myriam Gorospe, Nancy Ratner, Ana M Aransay, Arkaitz Carracedo, Marta Varela-Rey, Ashwin Woodhoo

Department of Surgery Faculty Papers

Cancer cells can develop a strong addiction to discrete molecular regulators, which control the aberrant gene expression programs that drive and maintain the cancer phenotype. Here, we report the identification of the RNA-binding protein HuR/ELAVL1 as a central oncogenic driver for malignant peripheral nerve sheath tumors (MPNSTs), which are highly aggressive sarcomas that originate from cells of the Schwann cell lineage. HuR was found to be highly elevated and bound to a multitude of cancer-associated transcripts in human MPNST samples. Accordingly, genetic and pharmacological inhibition of HuR had potent cytostatic and cytotoxic effects on tumor growth, and strongly suppressed metastatic …

Risk Factors For Nonaccidental Burns In Children, Dalya M Ferguson, Tayler D Parker, Vanessa E Marino, Elisa I Garcia, Seyed A Arshad, Pranali S Kamat, Caroline M Anding, Kuojen Tsao, Rebecca G Girardet, Mary T Austin

Faculty, Staff and Student Publications

BACKGROUND: The relative influences of baseline risk factors for pediatric nonaccidental burns have not been well described. We evaluated baseline characteristics of pediatric nonaccidental burn patients and their primary caretakers.

METHODS: A single-center retrospective cohort study was conducted of pediatric (age < 17) burn patients from July 1, 2013, to June 30, 2018. The primary outcome was nonaccidental burn, defined as burn secondary to abuse or neglect as determined by the inpatient child protection team or Child Protective Services. Univariate and multivariate analyses were performed.

RESULTS: Of 489 burn patients, 47 (9.6%) suffered nonaccidental burns. Nonaccidental burn patients more frequently had a history of Child Protective Services involvement (48.9% vs 9.7%, P < .001), as did their primary caretakers (59.6% vs 10.9%, P < .001). Non-Hispanic black children had higher rates of Child Protective Services referral (50.7% vs 26.7%, P < .001) and nonaccidental burn diagnosis (18.9% vs 5.6%, P < .001) than children of other races/ethnicities. On multivariate analysis, caretaker involvement with CPS (odds ratio 7.53, 95% confidence interval 3.38-16.77) and non-Hispanic black race/ethnicity (odds ratio 3.28, 95% confidence interval 1.29-8.36) were associated with nonaccidental burn.

CONCLUSION: Caretaker history of Child Protective Services involvement and non-Hispanic black race/ethnicity were associated with increased odds of pediatric nonaccidental burn. Prospective research is necessary to determine whether these represent true risk …

Major Septal Defects: Comparative Study Of Down Syndrome And Non-Down Syndrome Infants, Before And After Surgery, Saleha Aziz, Maaha Ayub, Laiba Masood, Muneer Amanullah, Rukhsana Hameed, Shiraz Hashmi, Waris Ahmad

Medical College Documents

Objective: To compare pre-operative, intra-operative, and post-operative parameters in Down syndrome (DS) and non-DS patients with atrioventricular septal defects (AVSD) and inlet ventricular septal defects (VSD) in a tertiary care hospital in Pakistan.
Methods: We conducted a retrospective study at Aga Khan University, Pakistan. All complete atrioventricular septal defect (CAVSD), partial atrioventricular septal defect (PAVSD), and VSD with inlet extension surgical cases from January 2007 to January 2019 were included. Patients with congenital heart diseases other than those listed above were excluded.
Results: In 61 cases, 18 had DS. Median age, mean body surface area (BSA), and height were lower …

Crack Cocaine Induced Upper Airway Injury., N D Vandjelovic, A K Larson, E M Sugihara, N A Stern

Articles, Abstracts, and Reports

The paper describes the presentation and management of patients presenting with crack cocaine induced upper airway injury. The study involved a retrospective clinical series of six patients with crack cocaine induced upper airway injury. Demographics, symptoms, physical exam, flexible laryngoscopy findings, treatment and intervention were recorded. All patients with crack cocaine induced thermal injury presented with mouth or throat pain plus at least one other laryngeal symptom, such as globus sensation, dysphagia or throat tightness. On physical exam, the supraglottis was the most common subsite of endolaryngeal injury. The only statistically significant finding was the number of subsites on initial …

Outcome Of Cranial Firearm Injuries In Civilian Population Based On A Novel Classification System, Farrukh Javeed, Asad Abbas, Lal Rehman, Syed Raza Khairat Rizvi, Ali Afzal, Hafiza Fatima Aziz

Section of Neurosurgery

Background: Cranial firearm injuries (CFAIs) are expected to be frequent during warfare; however, it is becoming increasingly common among civilian population in our part of the world. These injuries are associated with significant morbidity and mortality in addition to financial loss. The objective of our study is to evaluate the pattern of gunshot injuries to cranium and their outcome.
Methods: The study was conducted on 114 patients presenting with CFAIs to Jinnah Postgraduate Medical Centre, Karachi, Pakistan, between June 2015 and January 2019. Patients were evaluated with respect to age, gender, pattern of injury, Glasgow coma scale on arrival, radiological …

Spermine Synthase And Myc Cooperate To Maintain Colorectal Cancer Cell Survival By Repressing Bim Expression, Yubin Guo, Qing Ye, Pan Deng, Yanan Cao, Daheng He, Zhaohe Zhou, Chi Wang, Yekaterina Y. Zaytseva, Charles E. Schwartz, Eun Young Lee, B. Mark Evers, Andrew J. Morris, Side Liu, Qing-Bai She

Markey Cancer Center Faculty Publications

Dysregulation of polyamine metabolism has been linked to the development of colorectal cancer (CRC), but the underlying mechanism is incompletely characterized. Here, we report that spermine synthase (SMS), a polyamine biosynthetic enzyme, is overexpressed in CRC. Targeted disruption of SMS in CRC cells results in spermidine accumulation, which inhibits FOXO3a acetylation and allows subsequent translocation to the nucleus to transcriptionally induce expression of the proapoptotic protein Bim. However, this induction is blunted by MYC-driven expression of miR-19a and miR-19b that repress Bim production. Pharmacological or genetic inhibition of MYC activity in SMS-depleted CRC cells dramatically induces Bim expression and apoptosis …

Effects Of Coronavirus (Covid-19) Pandemic On Orthopedic Residency Program In The Seventh Largest City Of The World: Recommendations From A Resource-Constrained Setting, Marij Zahid, Syed Arif Ali, Naveed Baloch, Shahryar Noordin

Section of Orthopaedic Surgery

The coronavirus (COVID-19) pandemic has hit the entire world hard. Since its inception from Wuhan China the whole world is affected now. Health care facilities and workers are overwhelmed and the situation is changing on daily basis. With the changes in the dynamics of the hospitals, residency and fellowships training programs have also suffered undoubtedly. Due to decreased elective cases and outpatient clinics surgical training gets compromised, however on the other side this physical distancing and isolation have proven to be effective measures in controlling the disease. In this article we share our experience of effect of COVID-19 pandemic on …

Acute Opioid Withdrawal Mimicking Postoperative Joint Infection Following Anterior Cruciate Ligament (Acl) Reconstruction: A Case Report., Qingwu Kong, Martin Griffis, Brandon J Shallop, Amrit S Khalsa, Kyle Brougham, Paul A Marchetto

Department of Orthopaedic Surgery Faculty Papers

BACKGROUND A short course of opioid narcotics is often prescribed for postoperative anterior cruciate ligament (ACL) reconstruction pain management. Unfortunately, there is a well-documented incidence of opioid withdrawal syndrome (OWS) following short-term use of these medications. OWS can present with symptoms such as influenza-like illness. It is important to differentiate OWS from infectious illnesses, especially after surgery. CASE REPORT We present a case of OWS in a patient who underwent ACL reconstruction 7 days prior. The patient's OWS symptoms were similar to symptoms of a postoperative infection. The knee was aspirated, and the analysis of the aspirate was not concerning …

En Bloc Resection Of A Giant Retroperitoneal Liposarcoma: A Surgical Challenge, Talal Almas, Muneeb Ullah, Maryam Ehtesham, Absam Akbar, Muhammad Kashif Khan

Medical College Documents

Liposarcomas are exceedingly rare entities that evoke malignant transformation of connective tissue and fat cells.These tumours occur throughout the soft tissues of the body, afflicting a myriad of regions. In the adult population, liposarcomas represent the most prevalent subtype of sarcomas, and often arise de novo. Retroperitoneal liposarcomas (RLS) are a ubiquitous subset of sarcomas that, due to their deep location in the hollow abdomen, can grow to astronomical proportions before manifesting any noticeable symptoms; a prompt diagnosis of RLS is therefore often rendered dilatory. We hereby delineate the case of a 43-year-old woman who presented with vague left hemiabdominal …

Seasonal Influence On Postoperative Hip Fracture Complications: Retrospective Cohort Of More Than 1000 Patients From A Tertiary-Care University Hospital, Obada Hasan, Mashal Amin, Fatima Mahmood, Amna Rabbani, Umar Rabbani, Shahryar Noordin

Department of Paediatrics and Child Health

Background: Hip fractures account for one of the most debilitating conditions affecting the general population amongst the developed and developing nations. Investigators aimed to study the influence of the ongoing season i.e. whether patients operated upon in summer or winter, on post-operative complications occurring within 30 days of surgical procedure for hip fractures at a tertiary care hospital and level 1 trauma center.
Materials and methods: Investigators conducted a non-funded, non-commercialized retrospective cohort of 1045 patients with hip fractures managed surgically. Primary exposure was surgical procedures undertaken during the summer months (April-September). Our primary outcome was determining post-operative complication rates …

Do New Trainees Pose A Threat To Postoperative Complications After Hip Fracture Surgeries? Retrospective Cohort Of 1045 Patients Over A Decade At A University Hospital, Obada Hasan, Mashal Amin, Umar Rabbani, Amna Rabbani, Fatima Mahmood, Shahryar Noordin

Department of Paediatrics and Child Health

Introduction: Induction of new residents and surgical trainees in most institutes occurs once a year. Fresh residents with no experience, may pose a threat to the surgical procedure outcome and there can be a potential increase in patients' morbidity and mortality as a result of this turnover. Literature is inconclusive about this effect. Our aim was to study the "new residents' induction effect" on postoperative complications after hip fracture surgeries.
Methodology: This is non funded non commercialized study from a university hospital. Investigators studied a retrospective cohort of 1045 adult hip fracture patients who were operated at our tertiary care …

Effectiveness Of Home-Based Rehabilitation Program In Minimizing Disability And Secondary Falls After A Hip Fracture: Protocol For A Randomized Controlled Trial, Anum Sadruddin Pidani, Saniya Sabzwari, Khabir Ahmad, Ata Khan, Shahryar Noordin

Department of Surgery Docs

Introduction: Hip fractures are a major health problem globally and are associated with increased morbidity, mortality, and substantial economic costs. Successful operative treatment of hip fracture patients is necessary for the optimization of post-op mobility and functional recovery of the patient. Rehabilitation after surgical stabilization of a hip fracture is crucial in order to restore pre-fracture function and to avoid long-term institutionalization. In particular ongoing exercise which targets balance can prevent up to 40% of falls. Therefore, we have designed a post-discharge home-based physical rehabilitation intervention program to minimize disability and falls in this high-risk elderly population.
Methods and analysis: …