Surgery Commons^™

Utility Of Clinical Examination And Ct Scan In Assessment Of Penetrating Neck Trauma, Maliha Kazi, Montasir Junaid, Mumtaz Jamshed Khan, Naeem Sultan Ali, Aria Masoom

Section of Otolaryngology, Head & Neck Surgery

Managing penetrating injuries adequately and effectively depends a great deal on proper assessment of the injury. This study carried out was done at The Aga Khan University Hospital to assess the role of clinical examination and CT scan imaging in evaluation of penetrating neck injuries. A total of 68 students were included, with ages ranging from 3 to 74 years. The involved zones and the injured structures were noted. Results showed a high sensitivity of clinical examination in assessing vascular (81%) and airway trauma (77%), with a low sensitivity for esophageal trauma (34%). For CT scan the sensitivity was 90% …

Burn Disaster Management Planning: A Preparedness Toolkit (Poster), Brian S. Joho Msn, Rn, Daniel D. Lozano Md, Patrick Pagella Msn, Arnp, Michael Wargo Mba, Rn, Hamed Amani Md, Facs

Patient Care Services / Nursing

No abstract provided.

Lasik In Hyperopic Eyes With Congenital Nystagmus: A Case Report, Sharmeen Akram, Zarksis H, Khabir Ahmad

Department of Surgery Docs

Patients with nystagmus are considered to be poor candidates for laser in situ keratomileusis (LASIK), because they are unable to fixate. This case report presents the first reported use of LASIK surgery with a solid-state laser in hypermetropia and congenital nystagmus. A 23 year old woman with congenital nystagmus had LASIK surgery to correct a refractive error of +2.25/+1.75 90º in the right eye and + 2.00 / +1.75 90º in the left one. Baseline uncorrected visual acuity (UCVA) was 20/200 in both eyes, and best spectacle corrected visual acuity was 20/40 in both the eyes. The procedure was performed …

Development And Pilot Implementation Of A Locally Developed Trauma Registry: Lessons Learnt In A Low-Income Country, Amber Mehmood, Junaid Abdul Razzak, Sarah Kabir, Ellen J. Mackenzie, Adnan A. Hyder

Department of Emergency Medicine

Background

Trauma registries (TRs) play an integral role in the assessment of trauma care quality. TRs are still uncommon in developing countries owing to awareness and cost. We present a case study of development and pilot implementation of “Karachi Trauma Registry” (KITR), using existing medical records at a tertiary-care hospital of Karachi, Pakistan to present results of initial data and describe its process of implementation.

Methods

KITR is a locally developed, customized, electronic trauma registry based on open source software designed by local software developers in Karachi. Data for KITR was collected from November 2010 to January 2011. All patients …

Causes Of Death In Surgically Treated Patients With Type A Aortic Dissection - A Ten Year Review, James K. Wu Md, Eilizabeth Depaolo Bs, Theodore G. Phillips Md, Timothy S. Misselbeck

Department of Surgery

No abstract provided.

De-Branching Of The Aortic Arch During Thoracic Endovascular Aortic Repair, James K. Wu Md, Caitlin O'Connor Bs, Timothy S. Misselbeck, Theodore G. Phillips Md

Department of Surgery

No abstract provided.

The Community As A Learner Group, Cathyann Feher Rn,Msn, Karen L. Kutner Mba, Robert Ruhf, Charles Scagliotti Md,Facs, Michael M. Badellino Md

Department of Surgery

No abstract provided.

The Value Of Bleeding Scans In The Evaluation Of Acute Lower Gastrointestinal Bleeding, K Beiermeister, L Smith, Robert J. Sinnott, John S. Park Md

Department of Surgery

No abstract provided.

The Perfect Fit

Colby Magazine

From the classrooms and laboratories of Mayflower Hill, they found their niche in science. Microbiologist Carrie Harwood ’73, transplant surgeon Patrick Wood ’75, and marine biologist Paul Wade ’80 have passion for their professions.

Supporting Rebuilding Efforts In Afghanistan, Dialogue

Data and Test Instruments

The Royal College has been quietly assisting in the reconstruction of Afghanistan’s residency education system, devastated by years of war, by supplying members of the NATO Training Mission-Afghanistan (NTM-A) with educational materials and advice to appropriately modernize the country’s training programs.“These efforts are essential for the training of Afghan physicians in medical and surgical specialties, to ensure a healthy future for the people of Afghanistan,” says Major Vivian McAlister, MD, FRCSC, member of Royal College Council and NTM-A participant.The capacity-building initiative is supported on the ground by the NTM-A team, which includes numerous Fellows of the Royal College, who advise …

Focused Abdominal Sonography For Trauma (Fast) In Blunt Paediatric Abdominal Trauma, Ahmad Vaqas Faruque, Saqib Hamid Qazi, Muhammad Arif Mateen Khan, Wassem Akhtar, Amina Majeed

Section of Paediatric Surgery

Objective: To evaluate the role of focussed abdominal sonography for trauma in blunt paediatric abdominal trauma patients, and to see if the role of computed tomography scan could be limited to only those cases in which sonography was positive.
Methods: The retrospective study covered 10 years, from January 1,2000 to December 31,2009, and was conducted at the Department of Radiology and Department of Emergency Medicine, Aga Khan University Hospital, Karachi. It comprised cases of 174 children from birth to 14 years who had presented with blunt abdominal trauma and had focussed abdominal sonography for trauma done at the hospital. The …

John Chalmers Dacosta (1863-1933): Restoration Of The Old Operating Table., Madalyn G. Peters, Md, Adam C. Berger, Md, Gordon Schwartz, Md, Mba, Facs, Charles J. Yeo, Md, Scott W. Cowan, Md

Department of Surgery Gibbon Society Historical Profiles

John Chalmers DaCosta was an influential chairman and the first Samuel D. Gross Professor of Surgery at Jefferson Medical College in Philadelphia. He was well known throughout the field as a skilled surgeon, passionate speaker, and exceptional writer. In addition to countless accomplishments during his career, DaCosta was deeply dedicated to the preservation and commemoration of surgical history. This ideology was exemplified when he set out on a mission to recover the old wooden operating table used by many of his iconic mentors including Samuel D. Gross, Joseph Pancoast, and William W. Keen. This table was originally used for surgical …

Faculty And Staff Updates, Department Of Surgery, March 2013, Wright State University Department Of Surgery

Department of Surgery Updates

A one page newsletter created by the Department of Surgery documenting changes to the department. This issue contains a message from the chair, a list of important dates, committee meetings, scholarly activity and more.

Preparation And Technical Considerations For Percutaneous Cannulation For Veno-Arterial Extracorporeal Membrane Oxygenation., Kathleen Lamb, Hitoshi Hirose, Nicholas C. Cavarocchi

Department of Surgery Faculty Papers

BACKGROUND: The most frequent limb complications from peripheral veno-arterial extracorporeal membrane oxygenation (VA-ECMO) are limb ischemia and localized bleeding. To minimize these risks, perfusion of the distal limb with peripheral percutaneous cannulation was done.

TECHNIQUE: Percutaneous cannulation with a distal perfusion port was performed in all patients. During the VA-ECMO, distal limb perfusion was monitored using near-infrared spectroscopy to assess tissue oxygenation. At the decannulation, patch angioplasty was performed to prevent the development of narrowing of the artery at the cannulation site.

CONCLUSIONS: Using our standard technique, we have not experienced any limb loss related to ischemia or bleeding.

Comparison Of Vaginal Cuff Closure Outcomes In Patients Having Robotic-Assisted Total Laparoscopic Hysterectomy: V-Loc Vs. Vicryl (Poster), Martin A. Martino Md, R Melody Reynolds Md, A Ei Haraki Md, Rachel Morcrette Pa-C, Kyle M. Langston Pa-C, Gregory F. Kainz Md, Richard Boulay Md, M Bijoy Thomas Md

Department of Obstetrics & Gynecology

No abstract provided.

Hemodialysis Access: Initial Considerations And The Difficult Patient, Laura Peterson, Maria Litzendorf, Hooman Khabiri, Stanislaw P. Stawicki

Department of Surgery Faculty Publications

The population requiring hemodialysis (HD) in the United States continues to grow, with recent studies reporting over 370,000 Americans with end stage renal disease (ESRD) who are HD-dependent. The creation of functional HD access is often the limiting step in utilization of renal replacement therapy (RRT). Since the 1960s, the creation of hemodialysis access has become one of the most commonly performed procedures in the United States with over 500,000 vascular access procedures performed per year. This represents approximately 8% of the annual Medicare budget allocated to patients with ESRD. The magnitude of the associated economic and human costs is …

Management Of Upper Aerodigestive Tract Bleeding On Extracorporeal Membrane Oxygenation., Hitoshi Hirose, Md, Phd

Department of Surgery Faculty Papers

Introduction: Bleeding complications on extracorporeal membrane oxygenation (ECMO) are often encountered. In a review of our own series, it was found that upper aero digestive tract bleeding was common and management was often difficult. We propose an algorithm to help manage upper aero digestive tract bleeding in the anticoagulated, ECMO patient.

Methods: A retrospective chart review was performed of the patients who underwent veno-venous or veno-arterial ECMO at our institution between July 2010 and July 2012. The patients that had upper aero digestive tract bleeding that required an otolaryngology consultation were identified. They were further investigated to determine location …

Faculty And Staff Updates, Department Of Surgery, February 2013, Wright State University Department Of Surgery

Department of Surgery Updates

A two page newsletter created by the Department of Surgery documenting changes to the department. This issue contains a message from the chair, a list of important dates, committee meetings, scholarly activity and more.

Morbidity Meetings: What Makes It To; What Stays Out Of The Forum, Khawaja Muhammad Inam Pal, Amyn Pardhan, Junaid Haroon

Section of General Surgery

Objectives: To review the utility of morbidity and mortality forum in General Surgery at a tertiary care hospital in Karachi, Pakistan.
Methods: The retrospective study was conducted at the Aga Khan University Hospital and reviewed morbidity data from March to May 2009. Case notes of all patients admitted to the General Surgical service during the study period were reviewed to identify in-hospital morbidities.
Results: There were a total of 340 inpatients during this period. Case notes identified 61 (17.94%) patients with morbidities; 35 (57.37%) males and 26 (42.62%) females. The morbidity record for the same period identified 32 (52.5%) patients, …

Assessment Of Nutritional Adequacy In Patients On Extracorporeal Membrane Oxygenation., Hitoshi Hirose, Md, Phd, Joseph Miessau, Pa-C, Evanthia Foliou, Rd, Pawel Karbowski, Pa-C, Ms, Melanie K. Sion, Md, Christine Feldmeier, Md

Department of Surgery Faculty Papers

Introduction: Nutrition is a key element of recovery from the state of critical illness. Little is known about nutritional adequacy in patients supported on extracorporeal membrane oxygenation (ECMO) for severe cardio-respiratory dysfunction. A study was performed whether or not early nutrition support improve outcomes of the patients on ECMO.

Methods: A retrospective IRB approved review was conducted of all patients supported on ECMO from 7/10 to 6/12. The patients were divided into 2 groups, survivors and non-survivors. Age, sex, preoperative comorbidities, type and duration of ECMO, day to initiation and goal feeding, caloric intake, weekly biomarkers (pre-albumin, albumin, …