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Chest postgraduate

Mariyah Anwer, Shahneela Manzoor, Nadeem Muneer, Shamim Qureshi
OBJECTIVE: To assess World Health Organization (WHO) Surgical Safety Checklist (SSC), compliance and its effectiveness in reducing complications and final outcome of patients. METHODS: This was a prospective study done in Department of General Surgery (Ward 02), Jinnah Postgraduate Medical Centre (JPMC), Karachi. The study included Total 3638 patients who underwent surgical procedure in elective theatre in four years from November 2011 to October 2015 since the SSC was included as part of history sheets in ward...
July 2016: Pakistan Journal of Medical Sciences Quarterly
Amanullah Abbasi, Abdul Rabb Bhutto, Mohammad Tanveer Alam, Muhammad Aurangzaib, Mohammad Masroor
OBJECTIVE: To determine the frequency of hepatic hydrothorax and its association with Child Pugh Class in patients with liver cirrhosis. STUDY DESIGN: Descriptive, analytical study. PLACE AND DURATION OF STUDY: Jinnah Postgraduate Medical Centre, Karachi, Medical Unit-III, (Ward- 7), from June 2012 to May 2013. METHODOLOGY: All patients with established diagnosis of decompensated chronic liver disease were included. Detailed history, thorough physical examination, routine laboratory investigations, chest X-ray and abdominal ultrasound were carried out in all patients to find out the presence of pleural effusion and ascites, respectively...
July 2016: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
Arvind Vijayasarathi, Richard Duszak, Rondi B Gelbard, Mark E Mullins
PURPOSE: To study the awareness of postgraduate physician trainees across a variety of specialties regarding the costs of common imaging examinations. METHODS: During early 2016, we conducted an online survey of all 1,238 physicians enrolled in internships, residencies, and fellowships at a large academic medical center. Respondents were asked to estimate Medicare national average total allowable fees for five commonly performed examinations: two-view chest radiograph, contrast-enhanced CT abdomen and pelvis, unenhanced MRI lumbar spine, complete abdominal ultrasound, and unenhanced CT brain...
July 27, 2016: Journal of the American College of Radiology: JACR
Richard Amini, Lori A Stolz, Parisa P Javedani, Kevin Gaskin, Nicola Baker, Vivienne Ng, Srikar Adhikari
BACKGROUND: Emergency medicine milestones released by the Accreditation Council for Graduate Medical Education require residents to demonstrate competency in bedside ultrasound (US). The acquisition of these skills necessitates a combination of exposure to clinical pathology, hands-on US training, and feedback. OBJECTIVES: We describe a novel simulation-based educational and assessment tool designed to evaluate emergency medicine residents' competency in point-of-care echocardiography for evaluation of a hypotensive patient with chest pain using bedside US...
2016: Advances in Medical Education and Practice
Richard Amini, Lori A Stolz, Jeffrey Z Kartchner, Matthew Thompson, Nicholas Stea, Nicolaus Hawbaker, Raj Joshi, Srikar Adhikari
BACKGROUND: Goal-directed ultrasound protocols have been developed to facilitate efficiency, throughput, and patient care. Hands-on instruction and training workshops have been shown to positively impact ultrasound training. OBJECTIVES: We describe a novel undifferentiated chest pain goal-directed ultrasound algorithm-focused education workshop for the purpose of enhancing emergency medicine resident training in ultrasound milestones competencies. METHODS: This was a cross-sectional study performed at an academic medical center...
2016: Advances in Medical Education and Practice
Dustin Smith, Daniel G Miller, Jeffrey Cukor
INTRODUCTION: Work interruptions during patient care have been correlated with error. Task-switching is identified by the Accreditation Council for Graduate Medical Education (ACGME) as a core competency for emergency medicine (EM). Simulation has been suggested as a means of assessing EM core competencies. We assumed that senior EM residents had better task-switching abilities than junior EM residents. We hypothesized that this difference could be measured by observing the execution of patient care tasks in the simulation environment when a patient with a ST-elevation myocardial infarction (STEMI) interrupted the ongoing management of a septic shock case...
March 2016: Western Journal of Emergency Medicine
Maurits Graafland, Olle Ten Cate, Jan-Pieter van Seventer, Jan Maarten C Schraagen, Marlies P Schijven
OBJECTIVE: Serious games are potentially powerful tools for residency training and increasingly attract attention from medical educators. At present, serious games have little evidence-based relations with competency-based medical education, which may impede their incorporation into residency training programs. The aim of this study was to identify highly valued entrustable professional activities (EPAs) to support designers in the development of new, serious games built on a valid needs-assessment...
October 2015: Games for Health
Muhammad Saeed Minhas, Kashif Mahmood Khan, Jahanzeb Effendi, Anisuddin Bhatti, Seemi Jamali
OBJECTIVE: To understand the different types of blast injuries, their mechanisms, patho-physiology of wounds and clinical consequences caused by improvised explosive device detonation, and their early management. METHODS: The retrospective study related to 70 Special Security Unit personnel of police travelling on duty in a bus that was struck with an Improvised Explosive Device on February 13, 2014, at 7:48am.The data of triage, primary survey and resuscitation and secondary survey on arrival at the Accident and Emergency section of Jinnah Postgraduate Medical Centre, Karachi, were noted and later analysed...
December 2014: JPMA. the Journal of the Pakistan Medical Association
Edward W Carlton, Martin Than, Louise Cullen, Ahmed Khattab, Kim Greaves
BACKGROUND: Physicians rely upon chest pain history to make management decisions in patients with suspected acute coronary syndromes, particularly where the diagnosis is not immediately apparent through electrocardiography and troponin testing. The objective of this study was to establish the discriminatory value of "typicality of chest pain" and the effect of clinician experience, for the prediction of acute myocardial infarction and presence of significant coronary artery disease. METHODS: This prospective single-center observational study was undertaken in a UK General Hospital emergency department...
October 2015: American Journal of Medicine
Michael C Soult, Leonard J Weireter, Rebecca C Britt, Jay N Collins, Timothy J Novosel, Scott F Reed, L D Britt
The objective of this study was to investigate the feasibility of using ultrasound (US) in place of portable chest x-ray (CXR) for the rapid detection of a traumatic pneumothorax (PTX) requiring urgent decompression in the trauma bay. All patients who presented as a trauma alert to a single institution from August 2011 to May 2012 underwent an extended focused assessment with sonography for trauma (FAST). The thoracic cavity was examined using four-view US imaging and were interpreted by a chief resident (Postgraduate Year 4) or attending staff...
April 2015: American Surgeon
Vishal R Tandon, Vivek Mahajan, Vijay Khajuria, Zahid Gillani
AIM: The aim was to evaluate the extent and factors responsible for underreporting (UR) of adverse drug reactions (ADRs) in India. MATERIALS AND METHODS: A retrospective observational, cross-sectional prospective questionnaire-based analysis was undertaken to evaluate the extent and factors for UR of ADRs in pharmacovigilance. RESULTS: At the time, this report was prepared, 90 ADR Monitoring Centers (AMC) were operational in India. Indian AMC functional rate was 56...
January 2015: Indian Journal of Pharmacology
Victor Y Kong, George V Oosthuizen, Benn Sartorius, Claire M Keene, Damian L Clarke
OBJECTIVE: To review the ability of junior doctors (JDs) in identifying the correct anatomical site for intercostal chest drain insertion and whether prior Advanced Trauma Life Support (ATLS) training influences this. DESIGN: We performed a prospective, observational study using a structured survey and asked a group of JDs (postgraduate year 1 [PGY1] or year 2 [PGY2]) to indicate on a photograph the exact preferred site for intercostal chest drain insertion. SETTING: This study was conducted in a large metropolitan university hospital in South Africa...
July 2015: Journal of Surgical Education
Gelareh Sadigh, Ramsha Khan, Michael T Kassin, Kimberly E Applegate
RATIONALE AND OBJECTIVES: To investigate residents' knowledge of adverse effects of ionizing radiation, frequency of their education on radiation safety, and their use of radioprotective equipment. MATERIALS AND METHODS: Residents from 15/16 residency programs at Emory University were asked to complete a resident radiation safety survey through SurveyMonkey(®). The associations between the residents' knowledge and use of radioprotective equipment with residents' specialty and year of training were investigated...
July 2014: Academic Radiology
Karim Hamaoui, Hazim Sadideen, Munir Saadeddin, Sarah Onida, Andrew W Hoey, John Rees
PURPOSE: Changes in undergraduate medical curricula, combined with reforms in postgraduate education, have training implications for surgical skills acquisition in a climate of reduced clinical exposure. Confidence and prior experience influences the educational impact of learning. Currently there is no basic surgical skills (BSS) programme integrated into undergraduate curricula in the United Kingdom. We explored the role of a dedicated BSS programme for undergraduates in improving confidence and influencing careers in King's College London School of Medicine, and the programme was evaluated...
2013: Journal of Educational Evaluation for Health Professions
M Szkorupa, T Bohanes
INTRODUCTION: The mastering of the chest drainage technique should be among the basic skills of any surgeon, pneumologist or critical care specialist. What is essential is the knowledge of the anatomy of the chest, the basic radiologic interpretation of pathological findings in the pleural cavity, and some manual skill. The possibility of complications occurring and the method of their treatment are also important. OBJECTIVE: The aim of the article is to give an outline of the time aspect of the indication, necessary material equipment, the technique of chest drainage itself, differences in the drainage of pneumothorax, free and circumscribed effusion, caring for the chest drain following drainage and also of possible errors and mistakes that may occur...
November 2013: Rozhledy V Chirurgii: Měsíčník Československé Chirurgické Společnosti
Taraneh Movahhed, Behjatalmolook Ajami, Mostafa Soltani, Mohammad Taghi Shakeri, Mahboobe Dehghani
Dental practitioners are susceptible to Musculoskeletal Disorders (MSDs). The symptoms may begin from education courses. The aim of this study was to assess prevalence of musculoskeletal pain reports and correlated factors among the Mashhad Dental School students, Iran. A total of 177 undergraduate and postgraduate dental students, who were involved in educational clinical training, completed a questionnaire focusing on pain reports of different body anatomical regions. Variables such as gender, academic grade, academic year, clinical working hour, regular exercise times and also pain characteristics including pain duration intensity and frequency were evaluated...
January 15, 2013: Pakistan Journal of Biological Sciences: PJBS
Farhat Hussain Mirza, Qudsia Hassan, Nadia Jajja
OBJECTIVE: To study the demographic distribution of the victims of road traffic accidents that were presented for medico-legal autopsy in Karachi, identify fatal injuries, the identity of road users autopsied and the month-wise variation in performing autopsies. METHODS: Descriptive cross-sectional study of autopsies conducted at the mortuaries of Civil Hospital Karachi, Jinnah Postgraduate Medical Centre and Abbasi Shaheed Hospital between March 1,2008 and February 28, 2009...
February 2013: JPMA. the Journal of the Pakistan Medical Association
Ramesh-K Sen, Nirmal-Raj Gopinathan, Tajir Tamuk, Rajesh Kumar, Vibhu Krishnan, Radheshyam Sament
OBJECTIVE: To define the preoperative and intraoperative variables which may affect the immediate postoperative outcome in surgically managed patients with unstable pelvic fractures. METHODS: This study was performed prospectively from January 2009 to June 2011 on 36 consecutive patients admitted to the trauma ward of Postgraduate Institute of Medical Education and Research, Chandigarh, with unstable pelvic injuries. RESULTS: In the present study of 36 patients, 29 were managed surgically...
2013: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
Thea C Moran, Alan D Kaye, Andrew H Mai, Leonard R Bok
Radiologists, like other physicians, need to know how to use sedatives, analgesics, and local anesthetics; however, their exposure to patients requiring discomfort control is limited, not just during residency but also in postgraduate practice. The purpose of this article is to provide a reference guide for radiologists who need pertinent and ready information on discomfort control. The authors discuss policies and standards that the Joint Commission has established for sedation providers; also discussed are the clinical pharmacology and dosage recommendations for the sedative, analgesic, anesthetic, and reversal agents that radiologists are most likely to use...
March 2013: Radiographics: a Review Publication of the Radiological Society of North America, Inc
Tanveer Ahmad, Syed Waqar Ahmed, Niaz Hussain Soomro, Khalil Ahmed Sheikh
Post-traumatic retained hemothorax is a major risk factor for empyema thoracis leading to prolonged hospitalization, entrapped lung and a need for decortication. VATS (Video Assisted Thoracoscopy) for retained hemothorax shortens the duration of chest tube drainage and length of stay. From December 2004 to July 2009, 110 consecutive patients underwent VATS for retained or clotted hemothoraces at the Department of Thoracic Surgery, Jinnah Postgraduate Medical Centre, Karachi. Majority of the patients were males (n = 91; 82...
March 2013: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
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