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  Subjects -> MEDICAL SCIENCES (Total: 7655 journals)
    - ALLERGOLOGY AND IMMUNOLOGY (196 journals)
    - ANAESTHESIOLOGY (110 journals)
    - CARDIOVASCULAR DISEASES (316 journals)
    - CHIROPRACTIC, HOMEOPATHY, OSTEOPATHY (21 journals)
    - COMMUNICABLE DISEASES, EPIDEMIOLOGY (207 journals)
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    - DERMATOLOGY AND VENEREOLOGY (155 journals)
    - EMERGENCY AND INTENSIVE CRITICAL CARE (112 journals)
    - ENDOCRINOLOGY (143 journals)
    - FORENSIC SCIENCES (38 journals)
    - GASTROENTEROLOGY AND HEPATOLOGY (168 journals)
    - GERONTOLOGY AND GERIATRICS (123 journals)
    - HEMATOLOGY (140 journals)
    - HYPNOSIS (4 journals)
    - INTERNAL MEDICINE (144 journals)
    - LABORATORY AND EXPERIMENTAL MEDICINE (95 journals)
    - MEDICAL GENETICS (59 journals)
    - MEDICAL SCIENCES (1946 journals)
    - NURSES AND NURSING (313 journals)
    - OBSTETRICS AND GYNECOLOGY (189 journals)
    - ONCOLOGY (363 journals)
    - OPHTHALMOLOGY AND OPTOMETRY (126 journals)
    - ORTHOPEDICS AND TRAUMATOLOGY (149 journals)
    - OTORHINOLARYNGOLOGY (80 journals)
    - PATHOLOGY (99 journals)
    - PEDIATRICS (250 journals)
    - PHYSICAL MEDICINE AND REHABILITATION (151 journals)
    - PSYCHIATRY AND NEUROLOGY (772 journals)
    - RADIOLOGY AND NUCLEAR MEDICINE (186 journals)
    - RESPIRATORY DISEASES (96 journals)
    - RHEUMATOLOGY (65 journals)
    - SPORTS MEDICINE (73 journals)
    - SURGERY (370 journals)
    - UROLOGY, NEPHROLOGY AND ANDROLOGY (138 journals)

MEDICAL SCIENCES (1946 journals)                  1 2 3 4 5 6 7 8 | Last

Showing 1 - 200 of 3562 Journals sorted alphabetically
16 de Abril     Open Access  
3D Printing in Medicine     Open Access  
AADE in Practice     Hybrid Journal   (Followers: 5)
ABCS Health Sciences     Open Access   (Followers: 3)
Abia State University Medical Students' Association Journal     Full-text available via subscription  
ACIMED     Open Access   (Followers: 1)
ACS Medicinal Chemistry Letters     Full-text available via subscription   (Followers: 41)
Acta Bio Medica     Full-text available via subscription   (Followers: 2)
Acta Bioethica     Open Access  
Acta Bioquimica Clinica Latinoamericana     Open Access   (Followers: 1)
Acta Facultatis Medicae Naissensis     Open Access  
Acta Informatica Medica     Open Access   (Followers: 1)
Acta Medica (Hradec Králové)     Open Access  
Acta Medica Bulgarica     Open Access  
Acta Medica Colombiana     Open Access   (Followers: 1)
Acta Médica Costarricense     Open Access   (Followers: 2)
Acta Medica Indonesiana     Open Access  
Acta Medica International     Open Access  
Acta medica Lituanica     Open Access  
Acta Medica Marisiensis     Open Access  
Acta Medica Martiniana     Open Access  
Acta Medica Nagasakiensia     Open Access  
Acta Medica Peruana     Open Access   (Followers: 2)
Acta Médica Portuguesa     Open Access  
Acta Medica Saliniana     Open Access  
Acta Scientiarum. Health Sciences     Open Access   (Followers: 1)
Acupuncture & Electro-Therapeutics Research     Full-text available via subscription   (Followers: 4)
Acupuncture and Natural Medicine     Open Access  
Addiction Science & Clinical Practice     Open Access   (Followers: 6)
Addictive Behaviors Reports     Open Access   (Followers: 8)
Adıyaman Üniversitesi Sağlık Bilimleri Dergisi / Health Sciences Journal of Adıyaman University     Open Access  
Adnan Menderes Üniversitesi Sağlık Bilimleri Fakültesi Dergisi     Open Access  
Advanced Biomedical Research     Open Access  
Advanced Health Care Technologies     Open Access   (Followers: 4)
Advanced Science, Engineering and Medicine     Partially Free   (Followers: 7)
Advances in Bioscience and Clinical Medicine     Open Access   (Followers: 5)
Advances in Clinical Chemistry     Full-text available via subscription   (Followers: 28)
Advances in Life Course Research     Hybrid Journal   (Followers: 8)
Advances in Lipobiology     Full-text available via subscription   (Followers: 1)
Advances in Medical Education and Practice     Open Access   (Followers: 25)
Advances in Medical Sciences     Hybrid Journal   (Followers: 6)
Advances in Medicinal Chemistry     Full-text available via subscription   (Followers: 5)
Advances in Medicine     Open Access   (Followers: 2)
Advances in Microbial Physiology     Full-text available via subscription   (Followers: 4)
Advances in Molecular Oncology     Open Access   (Followers: 2)
Advances in Molecular Toxicology     Full-text available via subscription   (Followers: 7)
Advances in Parkinson's Disease     Open Access  
Advances in Phytomedicine     Full-text available via subscription  
Advances in Preventive Medicine     Open Access   (Followers: 5)
Advances in Protein Chemistry and Structural Biology     Full-text available via subscription   (Followers: 19)
Advances in Skeletal Muscle Function Assessment     Open Access  
Advances in Therapy     Hybrid Journal   (Followers: 5)
Advances in Veterinary Science and Comparative Medicine     Full-text available via subscription   (Followers: 13)
Advances in Virus Research     Full-text available via subscription   (Followers: 5)
Advances in Wound Care     Hybrid Journal   (Followers: 10)
African Health Sciences     Open Access   (Followers: 2)
African Journal of Biomedical Research     Open Access  
African Journal of Clinical and Experimental Microbiology     Open Access   (Followers: 1)
African Journal of Laboratory Medicine     Open Access   (Followers: 2)
African Journal of Medical and Health Sciences     Open Access   (Followers: 2)
African Journal of Trauma     Open Access   (Followers: 1)
Afrimedic Journal     Open Access   (Followers: 2)
Aggiornamenti CIO     Hybrid Journal   (Followers: 1)
AIDS Research and Human Retroviruses     Hybrid Journal   (Followers: 8)
AJOB Primary Research     Partially Free   (Followers: 3)
AJSP: Reviews & Reports     Hybrid Journal  
Aktuelle Ernährungsmedizin     Hybrid Journal   (Followers: 4)
Al-Azhar Assiut Medical Journal     Open Access  
Alexandria Journal of Medicine     Open Access   (Followers: 1)
Allgemeine Homöopathische Zeitung     Hybrid Journal   (Followers: 2)
Alpha Omegan     Full-text available via subscription  
ALTEX : Alternatives to Animal Experimentation     Open Access   (Followers: 3)
American Journal of Biomedical Engineering     Open Access   (Followers: 12)
American Journal of Biomedical Research     Open Access   (Followers: 2)
American Journal of Biomedicine     Full-text available via subscription   (Followers: 7)
American Journal of Chinese Medicine, The     Hybrid Journal   (Followers: 4)
American Journal of Clinical Medicine Research     Open Access   (Followers: 6)
American Journal of Family Therapy     Hybrid Journal   (Followers: 11)
American Journal of Law & Medicine     Full-text available via subscription   (Followers: 11)
American Journal of Lifestyle Medicine     Hybrid Journal   (Followers: 5)
American Journal of Managed Care     Full-text available via subscription   (Followers: 11)
American Journal of Medical Case Reports     Open Access   (Followers: 1)
American Journal of Medical Sciences and Medicine     Open Access   (Followers: 3)
American Journal of Medicine     Hybrid Journal   (Followers: 43)
American Journal of Medicine and Medical Sciences     Open Access   (Followers: 1)
American Journal of Medicine Studies     Open Access  
American Journal of Medicine Supplements     Full-text available via subscription   (Followers: 3)
American Journal of the Medical Sciences     Hybrid Journal   (Followers: 12)
American Journal on Addictions     Hybrid Journal   (Followers: 7)
American medical news     Free   (Followers: 3)
American Medical Writers Association Journal     Full-text available via subscription   (Followers: 5)
Amyloid: The Journal of Protein Folding Disorders     Hybrid Journal   (Followers: 5)
Anales de la Facultad de Medicina     Open Access  
Anales de la Facultad de Medicina, Universidad de la República, Uruguay     Open Access  
Anales del Sistema Sanitario de Navarra     Open Access   (Followers: 1)
Analgesia & Resuscitation : Current Research     Hybrid Journal   (Followers: 5)
Anatolian Clinic the Journal of Medical Sciences     Open Access  
Anatomical Science International     Hybrid Journal   (Followers: 2)
Anatomical Sciences Education     Hybrid Journal   (Followers: 1)
Anatomy     Open Access  
Anatomy Research International     Open Access   (Followers: 2)
Angewandte Schmerztherapie und Palliativmedizin     Hybrid Journal  
Angiogenesis     Hybrid Journal   (Followers: 3)
Ankara Medical Journal     Open Access   (Followers: 2)
Ankara Üniversitesi Tıp Fakültesi Mecmuası     Open Access  
Annales de Pathologie     Full-text available via subscription  
Annales françaises d'Oto-rhino-laryngologie et de Pathologie Cervico-faciale     Full-text available via subscription   (Followers: 3)
Annals of African Medicine     Open Access   (Followers: 1)
Annals of Anatomy - Anatomischer Anzeiger     Hybrid Journal   (Followers: 2)
Annals of Bioanthropology     Open Access   (Followers: 4)
Annals of Biomedical Engineering     Hybrid Journal   (Followers: 18)
Annals of Biomedical Sciences     Full-text available via subscription   (Followers: 3)
Annals of Clinical Microbiology and Antimicrobials     Open Access   (Followers: 10)
Annals of Family Medicine     Open Access   (Followers: 12)
Annals of Fundeni Hospital     Open Access   (Followers: 1)
Annals of Ibadan Postgraduate Medicine     Open Access  
Annals of Medical and Health Sciences Research     Open Access   (Followers: 7)
Annals of Medicine     Hybrid Journal   (Followers: 12)
Annals of Medicine and Surgery     Open Access   (Followers: 7)
Annals of Microbiology     Hybrid Journal   (Followers: 10)
Annals of Nigerian Medicine     Open Access   (Followers: 1)
Annals of Saudi Medicine     Open Access  
Annals of the New York Academy of Sciences     Hybrid Journal   (Followers: 5)
Annals of The Royal College of Surgeons of England     Full-text available via subscription   (Followers: 3)
Annual Reports in Medicinal Chemistry     Full-text available via subscription   (Followers: 7)
Annual Reports on NMR Spectroscopy     Full-text available via subscription   (Followers: 4)
Annual Review of Medicine     Full-text available via subscription   (Followers: 17)
Anthropological Review     Open Access   (Followers: 23)
Anthropologie et santé     Open Access   (Followers: 5)
Antibiotics     Open Access   (Followers: 9)
Antibodies     Open Access   (Followers: 2)
Antibody Technology Journal     Open Access   (Followers: 1)
Anuradhapura Medical Journal     Open Access  
Anwer Khan Modern Medical College Journal     Open Access   (Followers: 2)
Apmis     Hybrid Journal   (Followers: 1)
Apparence(s)     Open Access   (Followers: 1)
Applied Clinical Research, Clinical Trials and Regulatory Affairs     Hybrid Journal  
Applied Medical Informatics     Open Access   (Followers: 10)
Arab Journal of Nephrology and Transplantation     Open Access   (Followers: 1)
Arak Medical University Journal     Open Access  
Archive of Clinical Medicine     Open Access   (Followers: 1)
Archive of Community Health     Open Access   (Followers: 1)
Archives Medical Review Journal / Arşiv Kaynak Tarama Dergisi     Open Access  
Archives of Medical and Biomedical Research     Open Access   (Followers: 3)
Archives of Medical Laboratory Sciences     Open Access   (Followers: 1)
Archives of Medicine and Health Sciences     Open Access   (Followers: 3)
Archives of Medicine and Surgery     Open Access  
Archives of Trauma Research     Open Access   (Followers: 3)
Archivos de Medicina (Manizales)     Open Access  
ArgoSpine News & Journal     Hybrid Journal  
Arquivos Brasileiros de Oftalmologia     Open Access  
Arquivos de Ciências da Saúde     Open Access  
Arquivos de Medicina     Open Access  
Ars Medica : Revista de Ciencias Médicas     Open Access  
ARS Medica Tomitana     Open Access   (Followers: 1)
Art Therapy: Journal of the American Art Therapy Association     Full-text available via subscription   (Followers: 11)
Arterial Hypertension     Open Access   (Followers: 1)
Artificial Intelligence in Medicine     Hybrid Journal   (Followers: 12)
Artificial Organs     Hybrid Journal   (Followers: 1)
ASHA Leader     Open Access  
Asia Pacific Family Medicine     Open Access   (Followers: 1)
Asia Pacific Journal of Clinical Nutrition     Full-text available via subscription   (Followers: 10)
Asia Pacific Journal of Clinical Trials : Nervous System Diseases     Open Access  
Asian Bioethics Review     Full-text available via subscription   (Followers: 3)
Asian Journal of Cell Biology     Open Access   (Followers: 5)
Asian Journal of Health     Open Access   (Followers: 3)
Asian Journal of Medical and Biological Research     Open Access   (Followers: 3)
Asian Journal of Medical and Pharmaceutical Researches     Open Access   (Followers: 1)
Asian Journal of Medical Sciences     Open Access   (Followers: 2)
Asian Journal of Scientific Research     Open Access   (Followers: 3)
Asian Journal of Transfusion Science     Open Access   (Followers: 1)
Asian Medicine     Hybrid Journal   (Followers: 5)
Asian Pacific Journal of Cancer Prevention     Open Access  
ASPIRATOR : Journal of Vector-borne Disease Studies     Open Access  
Astrocyte     Open Access  
Atención Familiar     Open Access  
Atención Primaria     Open Access   (Followers: 1)
Atti della Accademia Peloritana dei Pericolanti - Classe di Scienze Medico-Biologiche     Open Access  
Audiology - Communication Research     Open Access   (Followers: 9)
Auris Nasus Larynx     Full-text available via subscription  
Australian Coeliac     Full-text available via subscription   (Followers: 1)
Australian Family Physician     Full-text available via subscription   (Followers: 3)
Australian Journal of Medical Science     Full-text available via subscription   (Followers: 1)
Autopsy and Case Reports     Open Access  
Aviation, Space, and Environmental Medicine     Full-text available via subscription   (Followers: 10)
Avicenna     Open Access   (Followers: 3)
Avicenna Journal of Clinical Medicine     Open Access  
Avicenna Journal of Medicine     Open Access   (Followers: 1)
Bangabandhu Sheikh Mujib Medical University Journal     Open Access   (Followers: 1)
Bangladesh Journal of Anatomy     Open Access   (Followers: 1)
Bangladesh Journal of Bioethics     Open Access  
Bangladesh Journal of Medical Biochemistry     Open Access   (Followers: 3)
Bangladesh Journal of Medical Education     Open Access   (Followers: 2)
Bangladesh Journal of Medical Microbiology     Open Access   (Followers: 3)
Bangladesh Journal of Medical Physics     Open Access  
Bangladesh Journal of Medical Science     Open Access  
Bangladesh Journal of Medicine     Open Access   (Followers: 1)
Bangladesh Journal of Physiology and Pharmacology     Open Access  
Bangladesh Journal of Scientific Research     Open Access   (Followers: 1)
Bangladesh Medical Journal     Open Access  

        1 2 3 4 5 6 7 8 | Last

Journal Cover
Annals of Medicine and Surgery
Journal Prestige (SJR): 0.492
Citation Impact (citeScore): 1
Number of Followers: 7  

  This is an Open Access Journal Open Access journal
ISSN (Print) 2049-0801
Published by Elsevier Homepage  [3163 journals]
  • Mid-term absorbable monofilament is safe and effective for
           gastrointestinal anastomosis – PROMEGAT - A single-arm prospective
           observational study

    • Authors: Petra Baumann; Jongwon Kim; Sang-Hoon Ahn; Hyung-Ho Kim; Hoong-Yin Chong; Moritz N. Wente
      Pages: 1 - 6
      Abstract: Publication date: Available online 6 April 2018
      Source:Annals of Medicine and Surgery
      Author(s): Petra Baumann, Jongwon Kim, Sang-Hoon Ahn, Hyung-Ho Kim, Hoong-Yin Chong, Moritz N. Wente
      Introduction Various suture materials and suture techniques are used to perform gastrointestinal anastomosis after tumour resection, but the best combination is still a matter of debate. Methods This multi-centre, international, single-arm, prospective observational study aimed at demonstrating the non-inferiority of a mid-term absorbable monofilament in comparison to braided sutures in gastrointestinal anastomosis. Monosyn suture was used to create the gastrointestinal anastomosis and the frequency of anastomotic leakage until day of discharge was chosen as the primary parameter. The outcome was compared to the results published for braided sutures in the literature. Secondary parameters were the time to perform the anastomosis, length of hospital stay, costs, and postoperative complications. Results The anastomosis leakage rate was 2.91%, indicating that Monosyn suture was not inferior to braided sutures used in gastrointestinal anastomosis. Of the reported anastomotic suture techniques, the single layer continuous method was the fastest and most economical technique in the present observational study. Conclusion Monosyn suture is safe and effective in gastrointestinal anastomosis and represents a good alternative to other sutures used for gastrointestinal anastomosis. With regard to safety, time and cost-efficiency, the single-layer continuous technique should be considered a preferred method. The transfer of results from clinical studies into daily practice with regard to surgical techniques for gastrointestinal anastomosis should be further evaluated in larger studies or in nationwide registries.

      PubDate: 2018-04-15T07:55:13Z
      DOI: 10.1016/j.amsu.2018.04.003
      Issue No: Vol. 30 (2018)
       
  • Cardiac Hydatid cysts; presentation and management. A case series

    • Authors: Ashur Y. Oraha; Darya A. Faqe; Mahmood Kadoura; Fahmi H. Kakamad; Fitoon F. Yaldo; Sabah Qadir Aziz
      Pages: 18 - 21
      Abstract: Publication date: Available online 7 April 2018
      Source:Annals of Medicine and Surgery
      Author(s): Ashur Y. Oraha, Darya A. Faqe, Mahmood Kadoura, Fahmi H. Kakamad, Fitoon F. Yaldo, Sabah Qadir Aziz
      Introduction Hydatid cyst commonly affects liver and lung. Cardiac Hydatid cyst is an extremely rare disease. The aim of this study is to report the presentation and management of cardiac Hydatid diseases admitted to two major cardiac centers. Method A retrospective, case series study, conducted in two centers during two years. Each case presented separately regarding presentation, diagnosis and management. Results Four cases have been reported, age ranged from 14 to 42 years with mean age of 24.75 years. Three patients (75%) were male, one patient (25%) was female. Three cases (75%) had history of chest pain, 2 cases (50%) had palpitation, and one case (25%) had nausea, vomiting and fever. Echocardiography was the initial diagnostic test in 2 cases (50%), final diagnostic test in two cases (50%). In 3 cases (75%) the cyst was found in the left ventricle and one case (25%) in right ventricle. Median sternotomy was performed for all cases. Conclusion Cardiac Hydatid cyst is a very rare disease. Chest pain is the most common symptom. Surgery is the main modality of treatment.

      PubDate: 2018-04-15T07:55:13Z
      DOI: 10.1016/j.amsu.2018.04.001
      Issue No: Vol. 30 (2018)
       
  • Mesh repair of paraumblical hernia, outcome of 58 cases

    • Authors: Deari Ahmed Ismaeil
      Pages: 28 - 31
      Abstract: Publication date: Available online 13 April 2018
      Source:Annals of Medicine and Surgery
      Author(s): Deari Ahmed Ismaeil
      Background According to the literature, defects in para-umbilical hernias up to 2 cm in diameter could be sutured primarily. For defects larger than 2 cm in dimeters, mesh repair is recommended. The aim of this study is to evaluate the outcome of para-umbilical hernia repair with proline mesh regardless of its size. Methods In this retrospective study, patients with para-umbilical hernia, who were managed by onlay mesh placement were presented, and followed for 1 to 6 years. Several variables were studied including patients' socio-demographic data, post-operative complications, morbidity and mortality. Results The series includes 58 patients, the age ranged from 18– 85 years with median age of 44 years and inter-quartile range of 13.5 years. Mean body mass index was (30.9 ± 4.2). From 49 female patients; 43 (87.8%) were multipara. Forty seven cases (81%) presented for the first time, and 11 cases (19%) had recurrent hernias. Twenty patients (34.5%) had hernia defect ≤2 cm, while 38 patients (65.5%) had hernia size >2 cm. Superficial surgical site infection was found in 6 patients (10.34%). Seroma was found in one female patient (1.72%). One patient (1.72%) had recurrent hernia after 19 months. Conclusion Mesh onlay repair by open surgery can be applied to all sizes of para umbilical hernias, it has low recurrence rate and the rates of morbidity and recurrence are comparable with international standard.

      PubDate: 2018-04-15T07:55:13Z
      DOI: 10.1016/j.amsu.2018.04.028
      Issue No: Vol. 30 (2018)
       
  • How to apply for the academic foundation programme

    • Authors: Mimi R. Borrelli; Reem Farwana; Buket Gundogan; Yasser Al Omran; Thomas Edward Pidgeon; Riaz Agha
      Pages: 5 - 9
      Abstract: Publication date: May 2018
      Source:Annals of Medicine and Surgery, Volume 29
      Author(s): Mimi R. Borrelli, Reem Farwana, Buket Gundogan, Yasser Al Omran, Thomas Edward Pidgeon, Riaz Agha
      The UK Academic Foundation Programme (AFP) is a two-year foundation programme that includes an additional “academic theme” undertaking work in research, management/leadership, or education and teaching activities. The limited number of AFP places makes the AFP application a highly competitive process. This article outlines points to consider when applying for the AFP and successful application strategies. Reviewed by successful AFP applicants, this article provides specific insight into applications to the London Academic Unit of Application (deanery).

      PubDate: 2018-04-15T07:55:13Z
      DOI: 10.1016/j.amsu.2018.01.008
      Issue No: Vol. 29 (2018)
       
  • Management of a postbulbar duodenal ulcer and stricture causing gastric
           outlet obstruction: A case report

    • Authors: Maxwell D. Mirande; Raul A. Mirande
      Pages: 10 - 13
      Abstract: Publication date: May 2018
      Source:Annals of Medicine and Surgery, Volume 29
      Author(s): Maxwell D. Mirande, Raul A. Mirande
      Introduction Peptic ulcer disease has significantly decreased over the past several decades making the need for definitive surgical intervention an infrequent occurrence. Presentation of Case A 44-year-old Caucasian female was sent to the emergency department by her primary care physician for right upper quadrant abdominal pain which had been intermittent for the past two months but acutely worsened over the last five days. During this time, she was unable to tolerate oral intake with intractable nausea and vomiting. Upper GI endoscopy revealed a tight stricture in the second part of the duodenum and antral biopsy was Helicobacter pylori negative. Patient underwent two rounds of balloon dilation with short lived symptomatic relief. An open pylorus-preserving duodenal stricturoplasty using a Heineke-Mikulicz technique was then performed. The operation was successful and the patient has had no reoccurrence of her symptoms. Discussion Gastric outlet obstruction is an uncommon complication of peptic ulcer disease in respect to chronic nonsteroidal anti-inflammatory drug use. The unique location of the patient's stricture and her desire to minimize post-operative GI alterations demanded a review of surgical options and identified the benefits of maintaining the patient's original anatomy versus choosing an extra-anatomic approach. Conclusion This case presented a unique challenge and demonstrated the need for definitive surgical interventions in the treatment of peptic ulcer induced gastric outlet obstruction. This case adds support for the direct anatomic treatment of duodenal strictures when conservative measures fail and perhaps promotes further development of laparoscopic management of gastric outlet obstruction in the future.

      PubDate: 2018-04-15T07:55:13Z
      DOI: 10.1016/j.amsu.2018.03.017
      Issue No: Vol. 29 (2018)
       
  • Osteoporosis and its perspective in Pakistan: A review of evidence and
           issues for addressing fragility fractures

    • Authors: Aysha Habib Khan; Lena Jafri; Sibtain Ahmed; Shahryar Noordin
      Pages: 19 - 25
      Abstract: Publication date: May 2018
      Source:Annals of Medicine and Surgery, Volume 29
      Author(s): Aysha Habib Khan, Lena Jafri, Sibtain Ahmed, Shahryar Noordin
      Despite major advances in osteoporosis diagnosis and treatment, low rates of investigating and treating osteoporosis in patients with fragility fracture are reported in Pakistan. Cost of therapies, time and cost of resources for diagnosis, concerns about medications and lack of clarity regarding the onus of responsibility to undertake this care, are some of the barriers to osteoporosis identification and treatment. Data from our part of the world on osteoporosis as well as on fragility fractures is sparse. This review addresses the current screening and diagnostic strategies for osteoporosis and reviews the existing literature to highlight the issues prevalent in our society on this major public health problem.

      PubDate: 2018-04-15T07:55:13Z
      DOI: 10.1016/j.amsu.2018.03.019
      Issue No: Vol. 29 (2018)
       
  • Management of gastrosplenic fistula in the emergency setting - A case
           report and review of the literature

    • Authors: Amit Frenkel; Yoav Bichovsky; Zvi H. Perry; Jochanan Peiser; Aviel Roy-Shapira; Evgeni Brotfain; Leonid Koyfman; Yair Binyamin; Karen Nalbandyan; Moti Klein
      Pages: 26 - 29
      Abstract: Publication date: May 2018
      Source:Annals of Medicine and Surgery, Volume 29
      Author(s): Amit Frenkel, Yoav Bichovsky, Zvi H. Perry, Jochanan Peiser, Aviel Roy-Shapira, Evgeni Brotfain, Leonid Koyfman, Yair Binyamin, Karen Nalbandyan, Moti Klein
      Introduction A gastrosplenic fistula (GSF) is a very rare complication that arises mainly from a splenic or gastric large cell lymphoma. The proximity of the gastric fundus to the enlarged fragile spleen may facilitate the fistulisation. This complication can lead to massive bleeding, which, though uncommon, may be lethal. We present a patient with massive upper gastrointestinal bleeding secondary to a GSF. Case presentation We present a 48-year-old man with a refractory diffuse large B-cell lymphoma who was admitted to our hospital due to hematemesis. On arrival, he was in hemorrhagic shock, and was taken directly to the intensive care unit. The source of bleeding could not be identified on gastroscopy, the patient remained hemodynamically unstable and a laparotomy was performed. A fistula between a branch of the splenic artery and the stomach was identified. The stomach appeared to be involved in the malignant process. After subtotal gastrectomy and splenectomy, the bleeding was controlled. After stabilization, the patient was admitted to the intensive care unit, and 24 hours later was discharged in stable condition. Discussion We describe a fistula between a branch of the splenic artery and the stomach, which was accompanied by massive bleeding. An emergency laparotomy saved the patient's life. Conclusion The purpose of this report is to alert physicians that surgical intervention can be lifesaving in this rare malignant condition. A literature review focusing on the presenting symptoms and the epidemiology of GSF is presented.

      PubDate: 2018-04-15T07:55:13Z
      DOI: 10.1016/j.amsu.2018.03.025
      Issue No: Vol. 29 (2018)
       
  • Primary total hip Arthroplasty: Staying out of trouble intraoperatively

    • Authors: Shahryar Noordin; Riaz Lakdawala; Bassam A. Masri
      Pages: 30 - 33
      Abstract: Publication date: Available online 4 April 2018
      Source:Annals of Medicine and Surgery
      Author(s): Shahryar Noordin, Riaz Lakdawala, Bassam A. Masri
      Total hip Arthroplasty is one of the most successful and commonly performed procedures in Orthopaedic Surgery. Meticulous preoperative planning allows to surgeon anticipate potential problems to reduce postoperative complications and optimize patient outcomes. Currently, the posterior approach is the most common approach utilized in the United States. In order to prevent errors in stem version, especially with cementless fixation, the entry point should be posterior, and the initial entry point should be aligned in the correct anteversion as this will determine the ultimate version of the stem. Preoperative evaluation should asses for true and apparent lengths. For successful osseointegration of cementless components, bone ingrowth occurs when there is less than 40 μm of motion between the implant and bone. Certain socket conformations such as elliptical versus hemispherical are more prone to generate fractures at the time of impaction.

      PubDate: 2018-04-15T07:55:13Z
      DOI: 10.1016/j.amsu.2018.03.043
      Issue No: Vol. 29 (2018)
       
  • Gastric fundus submucosa as a site for islets transplantation: An
           experimental study

    • Authors: Gustavo Heluani Antunes de Mesquita; Yuri Justi Jardim; Leandro Ryuchi Iuamoto; Fabio Yuji Suguita; Felipe Futema Essu; Lucas Torres Oliveira; Alberto Meyer; Alessandra Crescenzi; Vinícius Rocha-Santos; Flavio H.F. Galvão; Wellington Andraus; Eleazar Chaib; Luiz Augusto Carneiro D'Albuquerque
      Pages: 1 - 5
      Abstract: Publication date: April 2018
      Source:Annals of Medicine and Surgery, Volume 28
      Author(s): Gustavo Heluani Antunes de Mesquita, Yuri Justi Jardim, Leandro Ryuchi Iuamoto, Fabio Yuji Suguita, Felipe Futema Essu, Lucas Torres Oliveira, Alberto Meyer, Alessandra Crescenzi, Vinícius Rocha-Santos, Flavio H.F. Galvão, Wellington Andraus, Eleazar Chaib, Luiz Augusto Carneiro D'Albuquerque
      Background Islets of Langerhans transplantation is a promising alternative for glycemic control in patients with type 1 diabetes. The graft site is a factor that has large impact on the functioning of this transplant, and the stomach appears to be a promising location. Our objective is to describe a new experimental model for the grafting of Islets of Langerhans in rat stomachs. Methodology Islets of Langerhans were extracted from 45 isogenic male rats of the Lewis lineage and transplanted into 9 isogenic rats of the Wistar lineage; 5 in the gastric body submucosa, and 4 in the gastric fundus submucosa. Normoglycemia was defined as two successive measurements of <250 mg/dL. No immunosuppression was used. The two groups glycemia control improvement were compared with t-student test. Results The results obtained following the transplantation of the islets in 9 rats showed between 995 and 2310 islets transplanted (mean of 1367). The rats from the gastric submucosa group had a better glycemic level improvement, with a confidence equal to 83.94%. Conclusion Islets graft into the gastric fundus submucosa is a viable model with potential for adequate glycemic control. This model gives potential for new perspectives and future studies in this area.

      PubDate: 2018-04-15T07:55:13Z
      DOI: 10.1016/j.amsu.2017.12.006
      Issue No: Vol. 28 (2018)
       
  • Irreversible electroporation of locally advanced solid pseudopapillary
           carcinoma of the pancreas: A case report

    • Authors: Luciano Tarantino; Aurelio Nasto; Giuseppina Busto; Vincenzo Iovino; Raffaele Fristachi; Sara Bortone
      Pages: 11 - 15
      Abstract: Publication date: April 2018
      Source:Annals of Medicine and Surgery, Volume 28
      Author(s): Luciano Tarantino, Aurelio Nasto, Giuseppina Busto, Vincenzo Iovino, Raffaele Fristachi, Sara Bortone
      Introduction Solid pseudopapillary Carcinoma (SPC) is a rare pancreatic Tumor with variable, usually low, malignancy potential. Howewer, several SPC are associated with aggressive behavior, local vascular infiltration, organ invasion, distant metastasis, and can be unresectable. Irreversible Electroporation (IRE) is an emerging non-thermal ablation technique for the treatment of locally advanced pancreatic carcinoma. We report the results of four year disease-free follow-up in a case of locally advanced unresectable SPC treated with IRE. Presentation of case A 24-year female patient with SPC of the pancreas underwent IRE during laparotomy under general anesthesia with intubation. Computed Tomography (CT) showed complete tumor thrombosis of splenic vein, encasement of celiac artery and mesenteric vein. Six insertions of 3–4 electrodes per insertion were performed. One month-CT-control showed shrinkage of the tumor. 6 months-post-treatment imaging showed complete regression of the mass, patent Splenic/mesenteric veins, absence of local recurrence or distant metastasis. Post treatment CTs at 12-18-24-30-36-42-48 months follow-up confirmed absence of local or distant recurrence. Discussion Surgery is the first choice curative treatment of SPC. Howewer aggressive surgery (duodeno-pancreasectomy) in unresectable cases, may have a high risk of recurrences, morbidities and death, and bring concerns about endocrine and exocrine insufficiency in a young patient. In these cases, IRE could be a safe and effective alternative treatment and could realize, in selected cases, the condition for a radical surgery, and a bridge to R-0 resection. Conclusions IRE could represent an effective alternative therapy to surgery in local advanced, unresectable SPC.

      PubDate: 2018-04-15T07:55:13Z
      DOI: 10.1016/j.amsu.2018.01.009
      Issue No: Vol. 28 (2018)
       
  • Large hiatal hernia with pancreatic body herniation: Case-report

    • Authors: Elham Sadat Banimostafavi; Maryam Tayebi
      Pages: 20 - 22
      Abstract: Publication date: April 2018
      Source:Annals of Medicine and Surgery, Volume 28
      Author(s): Elham Sadat Banimostafavi, Maryam Tayebi
      Introduction A hiatal hernia can be classified as one of four types according to the position of the gastroesophageal (GE) junction and the extent of herniated stomach. Type IV paraesophageal hiatal hernia (PEHH) is characterized by a large defect in the diaphragmatic hiatus that allows other organs, besides stomach, such as the colon, pancreas, spleen, or small intestine to herniate into the thorax. Herniation of the pancreas through a gastroesophageal hiatus is a rare condition, and only a few cases have been reported in the literature. Case report We present a case of an asymptomatic patient with paraesophageal herniation along with the body and tail of the pancreas. Conclusion However, surgery is optimal choice for symptomatic patients, it is important for surgeons to consider the risks of different approaches and choose the best intervention.

      PubDate: 2018-04-15T07:55:13Z
      DOI: 10.1016/j.amsu.2018.02.006
      Issue No: Vol. 28 (2018)
       
  • Cinemedicine: Using movies to improve students' understanding of
           psychosocial aspects of medicine

    • Authors: Maliheh Kadivar; Mahboobeh Khabaz Mafinejad; Javad Tavakkoly Bazzaz; Azim Mirzazadeh; Zeinab Jannat
      Pages: 23 - 27
      Abstract: Publication date: April 2018
      Source:Annals of Medicine and Surgery, Volume 28
      Author(s): Maliheh Kadivar, Mahboobeh Khabaz Mafinejad, Javad Tavakkoly Bazzaz, Azim Mirzazadeh, Zeinab Jannat
      Background There are rising concerns about how to teach psychosocial aspects of medicine to students. The aim of the study was the use of “cinemedicine” as a tool and technique in teaching psychosocial aspects of medicine to medical students at Tehran University of Medical Sciences (TUMS). Methods This was an educational study with quantitative and qualitative data analysis. Two hundred seventy medical students participated in this study. Nine sessions were held to teach psychosocial subjects in medicine using movies. Each session began with an initial explanation of the program objectives. After the show, medicine related points of the movie were discussed and analyzed by experts and students. In the end, questionnaires were distributed to assess the students' perceptions. Results The results of our study show that most of the students (84%) stated that teaching these subjects through movies was a nice event comparing to usual lectures. 56.5% of the students agreed with the application of points learned in the events in professional performance. The majority of the students (72.8%) agreed that participating in those events was useful for them as a physician and they would advise other students to attend to later sessions. Content analysis of the students' notes uncovered three categories of cinemedicine: “learning by observation”, “creation of a supportive and tangible learning” and “motivation for learning”. Conclusion Cinemedicine provides the opportunity for medical students to learn psychosocial subjects related to medicine through observing and reflecting on movies.

      PubDate: 2018-04-15T07:55:13Z
      DOI: 10.1016/j.amsu.2018.02.005
      Issue No: Vol. 28 (2018)
       
  • ICG easily detects not only the segmental plane, but also the course and
           blood distribution of the bronchial artery“case report”

    • Authors: Hidetaka Uramoto; Nozomu Motono
      Pages: 28 - 29
      Abstract: Publication date: April 2018
      Source:Annals of Medicine and Surgery, Volume 28
      Author(s): Hidetaka Uramoto, Nozomu Motono
      Introduction Sublobar resection has become an acceptable alternative to lobectomy in patients with early-stage lung cancer. Most notable among these approaches is indocyanine green fluorescence (ICG) imaging. Case presentation Operative finding showed clear green staining of the left upper lobe, S6, superior pulmonary vein, and inferior PV under fluorescence navigation. Soon, the bronchial artery of right lower bronchus showed clear green staining. Next, the whole right lower bronchus is deeply colored green. Discussion ICG imaging can lead a planned operation safely in the extreme, especially for situations of special concern for blood supply of the bronchial stump such as pneumonectomy, bronchoplasty and right lower lobectomy. Conclusion This report describes a first case concerning the course and blood distribution of the bronchial artery using ICG injection under fluorescence navigation.

      PubDate: 2018-04-15T07:55:13Z
      DOI: 10.1016/j.amsu.2018.02.004
      Issue No: Vol. 28 (2018)
       
  • Role of biobanks in transplantation

    • Authors: Z. Hanif; N. Sufiyan; M. Patel; M.Z. Akhtar
      Pages: 30 - 33
      Abstract: Publication date: April 2018
      Source:Annals of Medicine and Surgery, Volume 28
      Author(s): Z. Hanif, N. Sufiyan, M. Patel, M.Z. Akhtar
      The establishment of bio-banks together with high throughput technologies, such as genomics, transcriptomics and proteomics has opened new frontiers in biomarker discovery and the development of systems biology approaches to identifying key pathways that could be exploited to improve outcomes of solid organ transplantation. One of the major challenges in organ donation has been the lack of access to large scale well characterised material to facilitate projects that aim to characterise injury to donor organs and identify biomarkers. This may have hampered research in the field of organ donation by not allowing researchers to materials of high quality and lower pre-analytical variability. We describe in this manuscript the need for bio-banks in organ donation, research opportunities and the particular challenges in establishing such an initiative.

      PubDate: 2018-04-15T07:55:13Z
      DOI: 10.1016/j.amsu.2018.02.007
      Issue No: Vol. 28 (2018)
       
  • Iatrogenic nerve lesion following laparoscopic surgery. A case report

    • Authors: Michele Vecchio; Andrea Santamato; Fortunato Geneovese; Giulia Malaguarnera; Vito Emanuele Catania; Saverio Latteri
      Pages: 34 - 37
      Abstract: Publication date: April 2018
      Source:Annals of Medicine and Surgery, Volume 28
      Author(s): Michele Vecchio, Andrea Santamato, Fortunato Geneovese, Giulia Malaguarnera, Vito Emanuele Catania, Saverio Latteri
      Background Peripheral neuropathy after surgical treatment is an under recognized potential untoward event. Pelvic surgery may be associated with nerve lesions by essentially three main mechanisms: transection, entrapment and pressure-stretching; the latter is the modality most frequently linked to patient's positioning on the operating room table. Presentation of the case A 25 years old woman, after undergoing a laparoscopic gynaecologic procedure lasted >3 hours, on postoperative day one presented with numbness over her lateral right leg and dorsum of the foot, right foot drop and gait instability due to compression-stretching of the right superficial peroneal nerve. Discussion Patient's diagnostic work up, treatment and outcome are reported and measures on how to prevent the occurrence of such type of lesion are outlined together with the importance of an early postoperative diagnosis in order to avoid permanent nerve damage. Conclusion Such lesions are sometimes so unexpected that delayed diagnosis leads to damages which are difficult or impossible to repair. Primary prevention plays a key role and it is realized by adhering to specific protocols. In the occurrence of the lesion a prompt diagnosis is highly recommendable and a comprehensive therapeutic plan is necessary to correctly address the specific pathology.

      PubDate: 2018-04-15T07:55:13Z
      DOI: 10.1016/j.amsu.2018.02.002
      Issue No: Vol. 28 (2018)
       
  • Hemosuccus pancreaticus: A mini-review

    • Authors: Peng Yu; Jianping Gong
      Pages: 45 - 48
      Abstract: Publication date: April 2018
      Source:Annals of Medicine and Surgery, Volume 28
      Author(s): Peng Yu, Jianping Gong
      Determining the cause of obscure bleeding in the gastrointestinal tract is the key in treating the disease. Hemosuccus pancreaticus (HP) could be an extremely rare disease. Ordinarily, bleeding in the pancreatic duct is defined as HP. At present, HP is the least frequent cause of upper gastrointestinal bleeding (1/1500), but can lead to massive gastrointestinal bleeding, which is potentially life threatening. Owing to its rarity, HP is difficult to diagnose, and the mortality rate of HP remains high in various studies. The purpose of this study is to expound on the basic symptoms and mechanisms of HP and to describe a potential significant examination method and treatment for usage in clinical practice.

      PubDate: 2018-04-15T07:55:13Z
      DOI: 10.1016/j.amsu.2018.03.002
      Issue No: Vol. 28 (2018)
       
  • Skeletal metastasis in renal cell carcinoma: A review

    • Authors: Masood Umer; Yasir Mohib; Muhammed Atif; Muhammad Nazim
      Pages: 9 - 16
      Abstract: Publication date: March 2018
      Source:Annals of Medicine and Surgery, Volume 27
      Author(s): Masood Umer, Yasir Mohib, Muhammed Atif, Muhammad Nazim
      Background Renal cell carcinoma account for 3% of all cancers, with peak incidence between 60 and 70 years of age predominantly affecting male population. Renal carcinoma is the most common malignancy of kidney constitutes for 80–90% of renal neoplasm with an overall 45% five years survival rate. Majority are diagnosed incidentally during investigation for other disease process of abdomen. Classical triad of gross hematuria, pain and palpable mass in abdomen is rare accounting to only 6–10%. Treatment of early stages of disease i.e. localized disease is partial or radical nephrectomy. Most common metastasis in RCC occurs to lung, followed by bone involvement in 20–35%, lymph nodes, liver, adrenal gland and brain. In metastatic disease median survival rate of patient is about eight months with 50% mortality rate within first year of life, five years survival rate is 10%. Skeletal metastasis are very destructive in patients with renal cell carcinoma compromising bone integrity leading to skeletal related events including pains, impending fractures, nerve compressions, hypercalcemia and even pathological fractures which may require surgical interventions and other therapy. In addition to skeletal complications, presence of bone metastases in RCC has negative impact on progression free survival and overall survival of patients treated with systemic therapies. Objective In this review we discuss pathophysiology of tumor metastasis, diagnosis, management and Case examples of metastatic renal cell carcinoma. Conclusion Incidence of metastatic renal carcinoma is increasing. Overall prognosis of patient with advanced RCC is poor, emphasizing the importance of early detection and prompt treatment of primary lesion in its early stage. Advancement in targeted therapy in recent decades had made some improvement in treatment of SREs and has helped in improving patent's quality of life but still we are in need of further improvement in treatment modalities to cure disease thereby decreasing morbidity and mortality.

      PubDate: 2018-04-15T07:55:13Z
      DOI: 10.1016/j.amsu.2018.01.002
      Issue No: Vol. 27 (2018)
       
  • Pre-hospital National Early Warning Score (NEWS) is associated with
           in-hospital mortality and critical care unit admission: A cohort study

    • Authors: Tom E.F. Abbott; Nicholas Cron; Nidhi Vaid; Dorothy Ip; Hew D.T. Torrance; Julian Emmanuel
      Pages: 17 - 21
      Abstract: Publication date: March 2018
      Source:Annals of Medicine and Surgery, Volume 27
      Author(s): Tom E.F. Abbott, Nicholas Cron, Nidhi Vaid, Dorothy Ip, Hew D.T. Torrance, Julian Emmanuel
      Background National Early Warning Score (NEWS) is increasingly used in UK hospitals. However, there is only limited evidence to support the use of pre-hospital early warning scores. We hypothesised that pre-hospital NEWS was associated with death or critical care escalation within the first 48 h of hospital stay. Methods Planned secondary analysis of a prospective cohort study at a single UK teaching hospital. Consecutive medical ward admissions over a 20-day period were included in the study. Data were collected from ambulance report forms, medical notes and electronic patient records. Pre-hospital NEWS was calculated retrospectively. The primary outcome was a composite of death or critical care unit escalation within 48 h of hospital admission. The secondary outcome was length of hospital stay. Results 189 patients were included in the analysis. The median pre-hospital NEWS was 3 (IQR 1–5). 13 patients (6.9%) died or were escalated to the critical care unit within 48 h of hospital admission. Pre-hospital NEWS was associated with death or critical care unit escalation (OR, 1.25; 95% CI, 1.04–1.51; p = 0.02), but NEWS on admission to hospital was more strongly associated with this outcome (OR, 1.52; 95% CI, 1.18–1.97, p < 0.01). Neither was associated with hospital length of stay. Conclusion Pre-hospital NEWS was associated with death or critical care unit escalation within 48 h of hospital admission. NEWS could be used by ambulance crews to assist in the early triage of patients requiring hospital treatment or rapid transport. Further cohort studies or trials in large samples are required before implementation.

      PubDate: 2018-04-15T07:55:13Z
      DOI: 10.1016/j.amsu.2018.01.006
      Issue No: Vol. 27 (2018)
       
  • A case report of acute pulmonary hypertension after hyperthermic
           intraperitoneal chemotherapy (HIPEC) and review of the literature

    • Authors: Thomas S. Zajonz; Michael Sander; Winfried Padberg; Andreas Hecker; Ruediger Hörbelt; Christian Koch; Emmanuel Schneck
      Pages: 26 - 31
      Abstract: Publication date: March 2018
      Source:Annals of Medicine and Surgery, Volume 27
      Author(s): Thomas S. Zajonz, Michael Sander, Winfried Padberg, Andreas Hecker, Ruediger Hörbelt, Christian Koch, Emmanuel Schneck
      Background Hyperthermic intraperitoneal chemotherapy (HIPEC) poses a widely used and accepted treatment option for patients with peritoneal carcinomatosis of gastrointestinal tumors. In contrast to the well-described risks and complications of intravenous cytostatic drugs, literature offers only scarce information of serious complications following HIPEC. To our knowledge no other description of rapid progressive pulmonary hypertension (PH) and consecutive respiratory failure following HIPEC have been described in current literature. Case presentation A 48-year-old female suffering from a recurrent appendix-carcinoma developed progressive dyspnea and fatigue six weeks after multivisceral abdominal resection and HIPEC. Medical examinations included laboratory-checks, non-invasive imaging, scintigraphy as well as invasive examinations (left-/right-heart-catheterization) and confirmed PH of unknown origin to be the cause of dyspnea. The patient died nine days after admission of respiratory failure and rapid deterioration as a result of aggravating PH. Conclusion Rapid progressive respiratory insufficiency due to PH following HIPEC procedure might represent a rare complication, but must be considered because of the high clinical impact. Further studies are necessary to investigate the correlation between HIPEC and PH.

      PubDate: 2018-04-15T07:55:13Z
      DOI: 10.1016/j.amsu.2018.01.007
      Issue No: Vol. 27 (2018)
       
  • Water in the human body: An anesthesiologist's perspective on the
           connection between physicochemical properties of water and physiologic
           relevance

    • Authors: Efraín Riveros-Perez; Ricardo Riveros
      Pages: 1 - 8
      Abstract: Publication date: February 2018
      Source:Annals of Medicine and Surgery, Volume 26
      Author(s): Efraín Riveros-Perez, Ricardo Riveros
      The unique structure and multifaceted physicochemical properties of the water molecule, in addition to its universal presence in body compartments, make water a key player in multiple biological processes in human physiology. Since anesthesiologists deal with physiologic processes where water molecules are critical at different levels, and administer medications whose pharmacokinetics and pharmacodynamics depend on interaction with water molecules, we consider that exploration of basic science aspects related to water and its role in physiology and pharmacology is relevant to the practice of anesthesiology. The purpose of this paper is to delineate the physicochemical basis of water that are critical in enabling it to support various homeostatic processes. The role of water in the formation of solutions, modulation of surface tension and in homeostasis of body temperature, acid-base status and osmolarity, is analyzed. Relevance of molecular water interactions to the anesthesiologist is not limited to the realm of physiology and pathophysiology. Deep knowledge of the importance of water in volatile anesthetic effects on neurons opens a window to a new comprehensive understanding of complex cellular mechanisms underlying the practice of anesthesiology.

      PubDate: 2018-01-04T19:00:37Z
      DOI: 10.1016/j.amsu.2017.12.007
      Issue No: Vol. 26 (2018)
       
  • Complications during removal of stainless steel versus titanium nails used
           for intramedullary nailing of diaphyseal fractures of the tibia

    • Authors: Mustafa Seyhan; Olcay Guler; Mahir Mahirogullari; Ferdi Donmez; Arel Gereli; Serhat Mutlu
      Pages: 38 - 42
      Abstract: Publication date: Available online 9 January 2018
      Source:Annals of Medicine and Surgery
      Author(s): Mustafa Seyhan, Olcay Guler, Mahir Mahirogullari, Ferdi Donmez, Arel Gereli, Serhat Mutlu
      Objectives Intramedullary nailing is the treatment of choice for fractures of the tibial shaft, which might necessitate the nail removal due to complications in the long-term. Although considered as a low-risk procedure, intramedullary nail removal is also associated with certain complications. Here, we compared the most commonly used stainless steel and titanium nails with respect to the complications during removal and clinical outcome for intramedullary nailing of diaphyseal fractures of the tibia. Patients and Methods Sixty-two patients (26 females, 36 males) were included in this retrospective study. Of the removed nails, 24 were of stainless steel and 38 of titanium. Preoperative and intraoperative parameters, such as implant discomfort, anterior knee pain, operating time and amount of bleeding, and postoperative outcomes were evaluated for each patient. Results Titanium nail group had more, but not statistically significant, intraoperative complications than stainless steel group during the removal of nails (p=0.4498). Operating time and amount of intraoperative bleeding were significantly higher in titanium group than stainless steel group (p=0.0306 and p<0.001, respectively). Preoperative SF-36 physical component and KSS scores were significantly lower in patients who had removal of titanium nails than those of stainless steel nails, whereas there was no difference in terms of postoperative SF-36 and KSS scores. Conclusion In conclusion, although greater bone contact with titanium increases implant stability, nail removal is more difficult, resulting in more longer surgical operation and more intraoperative bleeding. Therefore, we do not recommend titanium nail removal in asymptomatic patients.

      PubDate: 2018-01-09T19:11:36Z
      DOI: 10.1016/j.amsu.2017.12.012
      Issue No: Vol. 26 (2018)
       
  • Retraction notice to "The use of super-selective mesenteric embolisation
           as a first-line management of acute lower gastrointestinal bleeding" [Ann.
           Med. Surg. 17 (2017) 27-32]

    • Authors: Bryan Soh; Steven Chan
      First page: 43
      Abstract: Publication date: February 2018
      Source:Annals of Medicine and Surgery, Volume 26
      Author(s): Bryan Soh, Steven Chan


      PubDate: 2018-04-15T07:55:13Z
      DOI: 10.1016/j.amsu.2018.01.001
      Issue No: Vol. 26 (2018)
       
  • Surgical Site Infection Surveillance Following Total Knee Arthroplasty:
           Tertiary Care Hospital Experience

    • Abstract: Publication date: Available online 10 April 2018
      Source:Annals of Medicine and Surgery
      Author(s): Irfan Ashraf, Yasir Mohib, Obada Hasan, Khabir Ahmad, Amina Malik, Shahryar Noordin
      Introduction Surgical Site Infection (SSI) after knee arthroplasty is a major cause of morbidity and mortality that increases the hospital stay, financial burden and mental anguish of the patient. Infection Control Unit at Aga Khan University Hospital (AKUH) incorporated total knee arthroplasty in its surgical care surveillance program and started collecting data in June 2012. The purpose of this study is to review Surgical Site Infection (SSI) rates in patients undergoing primary total knee replacement (TKR) surgery. Patients and methodology All patients from June 2012 to December 2013 undergoing knee arthroplasty at our hospital were included. Data was acquired from the hospital SSI database for knee arthroplasty surgery. Data was collected by SSI nurses for inpatients a well as post-discharge monitoring in clinics till 90 days post-op follow-up. The work has been reported in line with the PROCESS criteria. Results During this time period a total of 164 patients had primary TKR at AKUH. Out of these, 85 patients (52%) had bilateral TKR while 79 (48%) had unilateral TKR. The overall SSI was in 2 patients (1.2%). Conclusion Identifying SSIs is multidimensional. Since our 2 infected cases after TKR occurred after discharge, this highlights the importance of post-discharge surveillance and not limiting the surveillance for inpatients only. Furthermore, the SSI program may be effective in controlling postoperative wound infections.

      PubDate: 2018-04-15T07:55:13Z
       
  • Clinical pathway after gastrectomy for gastric cancer: a case series of
           laparoscopic gasrectomy and early oral intake with "iEat™"

    • Abstract: Publication date: Available online 3 April 2018
      Source:Annals of Medicine and Surgery
      Author(s): Yuichi Nakaseko, Hironori Ohdaira, Masashi Yoshida, Masaki Kitajima, Yutaka Suzuki
      Introduction We investigated the validity of the clinical pathway of early oral intake using a special type of food "iEat™" for patients after laparoscopic gastric cancer surgery. Methods Fifty-two patients who underwent laparoscopic surgery for gastric cancer between April 2012 and October 2013 were the participants. We provided postoperative care in accordance with a clinical pathway for laparoscopic gastrectomy that begins oral intake with "iEat™ the day after surgery. We examined complications resulting from oral intake, postoperative complications, and the length of postoperative hospital stay. Results Of the 52 patients, 30 underwent distal gastrectomy and 22 underwent total gastrectomy. 50 patients was able to start early oral intake in accordance with our clinical pathway. No anastomotic leak complications were observed, and 9 patients (17.3%) developed complications as results of surgery. there was no comlication related to early oral intake with "iEat™". Re-operation were performed in two cases. Overall mean and median postoperative hospital stays were 8.3 days and 6 days, respectively. There was a single case of hospital re-admission. The completion rate of this early oral intake clinical pathway was 86.5%. Conclusion Clinical pathway of recovery program combined laparoscopic suregry and early oral intake with "iEat™" could be useful for gastric cancer. This study indicates that using non-liquid food like iEat™ can be feasiblel, and water or liquid food don't have to be used in early oral feeding after laparoscopic gastrectomy.

      PubDate: 2018-04-15T07:55:13Z
       
  • Peer review report 1 on "Clinical Use Of Adipose-Derived Stem Cells:
           European Legislative Issues."

    • Abstract: Publication date: January–December 2018
      Source:Annals of Medicine and Surgery, Volume 25, Supplement 1


      PubDate: 2018-04-15T07:55:13Z
       
  • Case Series with Literature Review: Surgical Approach to Megarectum and/or
           Megasigmoid in Children with Unremitting Constipation

    • Authors: James G. Glasser; James M. Nottingham; Martin Durkin; Ret Haney; Sean Christensen; Riley Stroman; Tyler Hammett
      Abstract: Publication date: Available online 27 December 2017
      Source:Annals of Medicine and Surgery
      Author(s): James G. Glasser, James M. Nottingham, Martin Durkin, Ret Haney, Sean Christensen, Riley Stroman, Tyler Hammett
      Background The role of surgery in treating children with functional constipation (FC) is controversial, because of the efficacy of bowel management programs. This case series is comprised of failures: 43 children, spanning 25 years’ practice, who had megarectosigmoid (MRS) and unremitting constipation. Purpose To determine whether these children were helped by surgery, and to contribute to formulating a standard of care for children with megarectum (MR) and/or redundancy of the sigmoid colon (MS) who fail medical management. Method We describe our selection criteria and the procedures we utilized – mucosal proctectomy and endorectal pull-through (MP) or sigmoidectomy (SE) with colorectal anastomosis at the peritoneal reflection. The internet (social media) allowed us to contact most of these patients and obtain extremely long follow-up data. Results 30/43 patients had MP and 13/43 had SE. Follow-up was obtained in 83% MP and 70% SE patients. 60% of MP and 78% of SE patients reported regular evacuations and no soiling. 20% MP patients had occasional urgency or soiling or episodic constipation. 12% MP and 22% SE patients required antegrade continence enemas (ACE) or scheduled cathartics and/or stool softeners. 4% MP had no appreciable benefit, frequent loose stools and soiling, presumably from encopresis. Conclusion MR is characterized by diminished sensation, poor compliance and defective contractility. Patients with MR do better with MP, which effectively removes the entire rectum versus SE, where normal caliber colon is anastomosed to MR at the peritoneal reflection; furthermore, MP reliably preserves continence; whereas total proctectomy (trans-anal or trans-abdominal) may cause incontinence.

      PubDate: 2018-01-04T19:00:37Z
      DOI: 10.1016/j.amsu.2017.12.009
       
  • Violence against doctors, a serious concern for healthcare organizations
           to ponder about

    • Authors: Farah Ahmed; Muhammad Khizar Memon; Sidra Memon
      Pages: 3 - 5
      Abstract: Publication date: January 2018
      Source:Annals of Medicine and Surgery, Volume 25
      Author(s): Farah Ahmed, Muhammad Khizar Memon, Sidra Memon
      Background Aggression and Violence against primary care physicians is reportedly common in Pakistan but there is no any documented study to-date on this burning issue. Methods A formed written questionnaire was distributed among 769 primary care physicians aged 31 ± 7.68 years. Apart from the demographic data, the questionnaire included questions regarding the level of safety that primary care physicians felt during their work setups and on-call duties, along with the experience of aggression against them by the perpetrators & the support provided by the hospital management in such cases. Result Response rate was 68% i.e. 524 physicians agreed to participate in the study. It was found that majority (85%) of the physicians has faced mild events, 62% have faced moderate events and roughly 38% were subjected to severe violence. Some physicians revealed more than one form of aggression being faced by them in 12 months preceding months which makes the collective percentage greater than 100%. Verbal abuse is the most frequent type of mistreatment faced by the doctors from the patients or their attendants. Conclusion A considerable number of physicians participated have faced mild violence in which verbal abuse was commonest; followed by moderate and severe events.

      PubDate: 2017-12-16T17:57:13Z
      DOI: 10.1016/j.amsu.2017.11.003
      Issue No: Vol. 25 (2017)
       
  • Impact of liver volume and liver function on posthepatectomy liver failure
           after portal vein embolization– A multivariable cohort analysis

    • Authors: Patrick H. Alizai; Annabel Haelsig; Philipp Bruners; Florian Ulmer; Christian D. Klink; Cornelis H.C. Dejong; Ulf P. Neumann; Maximilian Schmeding
      Pages: 6 - 11
      Abstract: Publication date: January 2018
      Source:Annals of Medicine and Surgery, Volume 25
      Author(s): Patrick H. Alizai, Annabel Haelsig, Philipp Bruners, Florian Ulmer, Christian D. Klink, Cornelis H.C. Dejong, Ulf P. Neumann, Maximilian Schmeding
      Background Liver failure remains a life-threatening complication after liver resection, and is difficult to predict preoperatively. This retrospective cohort study evaluated different preoperative factors in regard to their impact on posthepatectomy liver failure (PHLF) after extended liver resection and previous portal vein embolization (PVE). Methods Patient characteristics, liver function and liver volumes of patients undergoing PVE and subsequent liver resection were analyzed. Liver function was determined by the LiMAx test (enzymatic capacity of cytochrome P450 1A2). Factors associated with the primary end point PHLF (according to ISGLS definition) were identified through multivariable analysis. Secondary end points were 30-day mortality and morbidity. Results 95 patients received PVE, of which 64 patients underwent major liver resection. PHLF occurred in 7 patients (11%). Calculated postoperative liver function was significantly lower in patients with PHLF than in patients without PHLF (67 vs. 109 μg/kg/h; p = 0.01). Other factors associated with PHLF by univariable analysis were age, future liver remnant, MELD score, ASA score, renal insufficiency and heart insufficiency. By multivariable analysis, future liver remnant was the only factor significantly associated with PHLF (p = 0.03). Mortality and morbidity rates were 4.7% and 29.7% respectively. Conclusion Future liver remnant is the only preoperative factor with a significant impact on PHLF. Assessment of preoperative liver function may additionally help identify patients at risk for PHLF.

      PubDate: 2017-12-16T17:57:13Z
      DOI: 10.1016/j.amsu.2017.12.003
      Issue No: Vol. 25 (2017)
       
  • Endovascular laser treatment of incompetent saphenous veins using the
           1470 nm diode laser and radial fiber

    • Authors: Georgios Vourliotakis; Georgios Sahsamanis; Paschalis Evagelidis; Christina Aivatidi
      Pages: 12 - 16
      Abstract: Publication date: January 2018
      Source:Annals of Medicine and Surgery, Volume 25
      Author(s): Georgios Vourliotakis, Georgios Sahsamanis, Paschalis Evagelidis, Christina Aivatidi
      Objectives To assess the technical success, complications, and patients' quality of life (QoL) after treatment of chronic venous disease (CVD) using the 1470 nm radial fiber laser. Methods A total of 170 patients with chronic venous disease, classified as C2 to C4 according to CEAP classification, were treated for incompetent greater (GSV) and small (SSV) saphenous veins, using the 1470 nm radial fiber laser and application of tumescent anesthesia. Additional phlebectomies were performed through stab microincisions, while 11 patients further underwent sclerotherapy intraoperatively. Patients' QoL was recorded using a CIVIQ-20 questionnaire pre and post-operatively. Results Technical success regarding GSV vein occlusion was recorded at 100% and 98% during 12 and 24 month follow up respectively. SSV occlusion rates were recorded at 100% for the same period. 55% of patients were classified as C2. Mean laser application time was 401.1 ± 92.6 s and 169.4 ± 56.8 s, while an average of 3986.6 ± 934.9 and 1643.5 ± 534.1 J were applied during ablation of GSV and SSV respectively. Three incidents of postoperative pain were recorded. Two patients exhibited partial proximal GSV recanalization, while two patients reported mild post-operative temporal paresthesia. No major complications were observed post-operatively. A significant improvement in patients' QoL was demonstrated through the CIVIQ-20 questionnaires. Mean pre-operative CIVIQ-20 total score was recorded at 77 ± 3.9, with a total score of 32.8 ± 2.8 being observed during 12 month follow-up. Conclusions Endovascular laser treatment using the 1470 nm radial fiber laser constitutes an effective and safe modality for treatment of CVD.

      PubDate: 2017-12-16T17:57:13Z
      DOI: 10.1016/j.amsu.2017.12.002
      Issue No: Vol. 25 (2017)
       
  • Surgical treatment of aggressive vertebral hemangioma causing progressive
           paraparesis

    • Authors: M. Dobran; F. Mancini; D. Nasi; M. Gladi; S. Sisti; M. Scerrati
      Pages: 17 - 20
      Abstract: Publication date: January 2018
      Source:Annals of Medicine and Surgery, Volume 25
      Author(s): M. Dobran, F. Mancini, D. Nasi, M. Gladi, S. Sisti, M. Scerrati
      Vertebral hemangioma is a benign vascular lesion that may onset with neurologic symptoms due to spinal cord compression by epidural extension. Surgical procedure, embolization and radiotherapy are the gold standard for the treatment of this disease. We present a case of a 84 years old woman admitted at our department with worsening paraparesis and urinary retention. Her magnetic resonance images (MRI) showed a lesion involving both anterior and posterior vertebral element of D5, with extension into epidural space and spinal cord compression. The patient was operated for laminectomy and epidural lesion removal. Histological examination confirmed the diagnosis of cavernous hemangioma.

      PubDate: 2017-12-16T17:57:13Z
      DOI: 10.1016/j.amsu.2017.12.001
      Issue No: Vol. 25 (2017)
       
  • Paediatric Dentistry- Novel Evolvement

    • Authors: Saleha Shah
      Abstract: Publication date: Available online 14 December 2017
      Source:Annals of Medicine and Surgery
      Author(s): Saleha Shah


      PubDate: 2017-12-16T17:57:13Z
       
  • ADDRESSING THE RECRUITMENT SHORTFALL IN SURGERY - HOW DO WE INSPIRE THE
           NEXT GENERATION'

    • Authors: Jonathan Bartlett
      Abstract: Publication date: Available online 5 December 2017
      Source:Annals of Medicine and Surgery
      Author(s): Jonathan Bartlett


      PubDate: 2017-12-16T17:57:13Z
      DOI: 10.1016/j.amsu.2017.11.024
       
 
 
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