{"title":"Pancreaticojejunostomy versus pancreaticogastrostomy after pancreaticoduodenectomy: A review article and meta-analysis of randomized controlled trials","authors":"N. Shahzad, T. Chawla, S. Begum, Fareed Shaikh","doi":"10.4103/ijssr.ijssr_8_18","DOIUrl":"https://doi.org/10.4103/ijssr.ijssr_8_18","url":null,"abstract":"Pancreatic fistula is one of the most feared complications after pancreaticoduodenectomy (PD). Results of randomized controlled trials comparing pancreaticogastric anastomosis with pancreaticojejunal anastomosis are not consistent. Furthermore, soft texture of pancreas is an established risk factor for postoperative pancreatic fistula (POPF). There has been no meta-analysis to date to compare pancreaticogastrostomy versus pancreaticojejunostomy in patients with intraoperative soft texture of pancreas. Hence, our primary objective was to determine the role of pancreaticogastrostomy compared to pancreaticojejunostomy after PD in prevention of POPF, especially in patients with soft pancreatic texture. We conducted meta-analysis of randomized controlled trials that had compared pancreaticojejunal anastomosis with pancreaticogastric anastomosis after PD, and pancreatic fistula was among the outcome variables. Ten randomized controlled trials were included in the meta-analysis which comprised of a total of 1629 patients, of which 803 underwent pancreaticojejunostomy, whereas 826 were in the pancreaticogastrostomy group. There was no difference in clinically relevant POPF (CR-POPF) rate in pancreaticojejunostomy versus pancreaticogastrostomy (19.8% vs. 12.8%, P = 0.09) group. POPF rate in patients with soft pancreas was significantly more in pancreaticojejunostomy group as compared to pancreaticogastrostomy group (25.4% vs. 17.3%, odds ratio = 1.71, 95% confidence interval = 1.15–2.53, P = 0.008). Although there is no difference in pancreaticogastrostomy as compared to pancreaticojejunostomy after PD to prevent CR POPF, in a subgroup of high-risk patients with soft pancreatic texture pancreaticogastrostomy has favorable results.","PeriodicalId":331041,"journal":{"name":"IJS Short Reports","volume":"3 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133501639","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Prevention and management of hard- and soft-tissue complication in patient undergoing radiotherapy and chemotherapy: Literature review","authors":"M. Gul, S. Badar, Robia Ghafoor","doi":"10.4103/ijssr.ijssr_7_18","DOIUrl":"https://doi.org/10.4103/ijssr.ijssr_7_18","url":null,"abstract":"Head and neck cancer is among the leading causes of death globally. Its treatment includes surgical resection, radiotherapy, chemotherapy, or the combination of these therapies depending on the extent of disease. Radiotherapy and chemotherapy have a pivotal role in minimizing the morbidity and mortality; however, they also bring about many adverse effects. Both hard and soft tissues of the oral cavity are affected by these therapies ranging from oral mucositis to osteoradionecrosis of jaw thus affecting the quality of life of patients. Prevention and timely management of these complications are essential for better treatment outcomes. The present literature review, therefore, focuses on the prevention and management of hard- and soft-tissue complications associated with patients undergoing radiotherapy and chemotherapy. Comprehensive oral and dental examination of the patient should be performed and all the potential sources of infection should be electively treated appropriately before initiation of the radiotherapy and chemotherapy to reduce the risk of complications associated with the cancer treatment. Management of complication that arises during radiation and chemotherapy is also essential which requires thorough knowledge and skills. Mutual participation of oncology team and dental surgeon is the key to reduce these complications.","PeriodicalId":331041,"journal":{"name":"IJS Short Reports","volume":"58 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133555966","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Perspectives on large bowel obstruction","authors":"E. Weledji","doi":"10.4103/2468-7332.200556","DOIUrl":"https://doi.org/10.4103/2468-7332.200556","url":null,"abstract":"Large bowel obstruction (LBO) is a serious and costly medical condition, indicating often emergency surgery. The main clinical issue is to determine whether the obstruction affects the small bowel or the colon since the causes and treatments are different. Delay in operative intervention may lead to an unnecessary bowel resection, increased risk of perforation, and overall worsening of patient morbidity and mortality. With the advent of colonic endoluminal stent, the treatment of distal colonic obstruction should be individually tailored to each patient. This article discussed LBO and emphasized the importance of history taking, examination, and basic imaging in the early diagnosis of its cause, thus facilitating appropriate management.","PeriodicalId":331041,"journal":{"name":"IJS Short Reports","volume":"22 3-4","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114012237","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
IJS Short ReportsPub Date : 1900-01-01DOI: 10.4103/ijssr.ijssr_12_17
M. Borrelli, R. Farwana, R. Agha
{"title":"Stress management in a medical career","authors":"M. Borrelli, R. Farwana, R. Agha","doi":"10.4103/ijssr.ijssr_12_17","DOIUrl":"https://doi.org/10.4103/ijssr.ijssr_12_17","url":null,"abstract":"Stress is both the psychological and physical experienced when an individual perceives their resources as insufficient to cope with the demands of a situation. A medical career can be stressful. The work of health-care professionals involves taking responsibility for other individuals' lives and mistakes can have detrimental consequences. Work can involve long hours, night shifts, and high-risk situations. High levels of stress among doctors contribute to job dissatisfaction, emotional burnout, and clinical depression, and can undermine the achievement of goals, both for individuals and for organizations. Stress management is therefore a fundamental skill for all medical professionals. This article discusses strategies for managing stress, starting with self-analysis and outlining two main stress management techniques that can be taken at an individual level.","PeriodicalId":331041,"journal":{"name":"IJS Short Reports","volume":"9 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127626756","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Hepatocellular adenoma: Review of contemporary diagnostic and therapeutic options","authors":"S. Begum, M. Khan","doi":"10.4103/ijssr.ijssr_4_18","DOIUrl":"https://doi.org/10.4103/ijssr.ijssr_4_18","url":null,"abstract":"Hepatocellular adenoma (HCA) is a rare benign lesion most often seen in young women with a history of oral contraceptive use. It is typically a solitary lesion located in the right hepatic lobe although multiple lesions have been reported. Diagnosis of HCA is important for prompt treatment because of risk of hemorrhage and malignant transformation. Adenomas are not specifically diagnosed at ultrasonography, and further evaluation with computerized tomography and magnetic resonance imaging is required to differentiate from other hepatic lesions such as focal nodular hyperplasia. The gold standard for diagnosis is excision biopsy. Better understanding of clinical history and imaging appearance is important to avoid misdiagnosis and facilitate effective treatment.","PeriodicalId":331041,"journal":{"name":"IJS Short Reports","volume":"50 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125217903","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Awake craniotomy in developing countries: review of hurdles","authors":"S. Khan, K. Nathani, S. Enam, F. Shafiq","doi":"10.4103/2468-7332.200557","DOIUrl":"https://doi.org/10.4103/2468-7332.200557","url":null,"abstract":"Awake craniotomy is a neurosurgical approach, in which patient is operated under local anesthesia to assess his neurological function intraoperatively. It has multiple advantages over craniotomy under general anesthesia, mainly including improved postoperative neurological status, lower length of hospital, and lower overall cost of hospital stay. Awake craniotomy is commonly practiced in the developed world; however, its role in developing country is limited. Considering the benefits that awake craniotomy offers, it can contribute significant socioeconomic benefits to a developing country, especially with reduce expenditure on health care as well as maintenance of functional capacity of patients to continue work. Development of awake craniotomy in a developing country is a challenge. Multiple hurdles must be overcome before considering the possibility of the procedure. One of the key hurdles is limitation of resources. Others include neuroanesthesia training, extent of disease, and patient selection. Patient's awareness or literacy rate is also a factor to be considered, especially in developing countries where it can be difficult to explain the procedure to the patient. The authors have successfully implemented awake craniotomy in Pakistan recently and have shared how they managed to overcome the hurdles in their case. The hurdles are considerable, but they can be overcome with efforts. The program will be highly beneficial to a developing country and should be attempted for betterment of health-care facilities available to the population.","PeriodicalId":331041,"journal":{"name":"IJS Short Reports","volume":"61 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129204950","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Management of oral complications in irradiated head and neck cancer patients: Literature review","authors":"M. Hameed, K. Zafar, Robia Ghafoor","doi":"10.4103/ijssr.ijssr_6_18","DOIUrl":"https://doi.org/10.4103/ijssr.ijssr_6_18","url":null,"abstract":"The incidence of head and neck cancer is increasing and it is regarded as one of the leading causes of morbidity and mortality. The treatment of head and neck carcinoma is very challenging and depends on the stage of the disease. Radiotherapy is largely employed as primary therapy, adjuvant to surgery, or in combination with chemotherapy for the treatment of head and neck carcinomas. Patients undergoing radiotherapy are prone to a range of short- and long-term complications which adversely affects their health and quality of life. Management of these complications is complex and based on early detection, prevention, and oral care before, during, and after the treatment, to establish the best oral care pathway for these patients. Dental management of these patients is especially important to maintain oral hygiene, overall health, and nutrition status. Management involves multidisciplinary team approach which includes dental practitioners and the oncology team not only in the primary treatment but also in the long-term care and maintenance. It is, therefore, essential for clinicians involved in cancer treatment and cancer survivors to be aware of prevention and management these complications. The aim of this review is to highlight importance of postoperative complications associated with radiotherapy and to draw attention of multidisciplinary teams involved in cancer management toward dental needs of patients treated with radiation therapy, to ensure good quality care and better quality of life in irradiated head and neck cancer patients.","PeriodicalId":331041,"journal":{"name":"IJS Short Reports","volume":"5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132708549","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
IJS Short ReportsPub Date : 1900-01-01DOI: 10.4103/ijssr.ijssr_20_17
O. Hasan, H. A. Rahim Khan, S. Mustafa, Z. A. Muhammad, T. Ahmad
{"title":"Use of bacterial cultures in open wound fractures: A prospective cohort study","authors":"O. Hasan, H. A. Rahim Khan, S. Mustafa, Z. A. Muhammad, T. Ahmad","doi":"10.4103/ijssr.ijssr_20_17","DOIUrl":"https://doi.org/10.4103/ijssr.ijssr_20_17","url":null,"abstract":"Introduction: Open fractures are a big challenge for surgeons to treat due to wound contamination leading to infection is a well established complication. To overcome this complication, prophylactic antibiotic therapy is routinely recommended for open fractures. Methods: A single center, prospective cohort study was conducted on patients at a tertiary care academic center to assess surgical site infection following fixation of upper and lower limb open fractures. In this study, we aimed to identify the utility of postdebridement cultures for predicting postoperative wound infection with the identification of association between the incidence of infection and factors such as age, gender, fracture site, cause of injury, and the time between injury and presentation at hospital. Results: Postdebridement cultures of 46 patients were collected, of which 28.3% showed microbial growth. During the hospital stay, three patients developed clinically deep wound infection. Postdebridement culture growth was not significantly associated with the development of clinical infection within the hospital stay (P = 0.188). Out of 43 remaining patients, 11 patients develop wound infection on follow up. Four out of 11 had positive growth on initial cultures. Conclusion: In this study, we evaluated that postdebridement wound cultures were not useful in predicting wound infection in the postoperative period.","PeriodicalId":331041,"journal":{"name":"IJS Short Reports","volume":"110 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127115618","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
IJS Short ReportsPub Date : 1900-01-01DOI: 10.4103/ijssr.ijssr_13_17
M. Borrelli, R. Farwana, R. Agha
{"title":"Career building starts in the mind","authors":"M. Borrelli, R. Farwana, R. Agha","doi":"10.4103/ijssr.ijssr_13_17","DOIUrl":"https://doi.org/10.4103/ijssr.ijssr_13_17","url":null,"abstract":"There is enormous flexibility in the careers of medical professionals. Careers can be defining, motivating, and inspiring. Careers require continual and active engagement in their construction, and constantly evolve as new experiences and knowledge is gained. Career building starts with the development and identification of ideas, aims, and values, which alter attitudes, habits, and ultimately shape behaviors to achieve aspirations. This article discusses the ideas and strategic approaches to optimizing experiences and building a career within medicine.","PeriodicalId":331041,"journal":{"name":"IJS Short Reports","volume":"59 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128435663","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}