bluuebunny/crossref_metadata_2025_split huggingface dataset:
FTP8.5 Patients Named Consultant: Who is the patient under?
Authors: Shah Saumil , Richardson Tom , Ahmad Adil , Kamal Mona , Datta Uttaran , Waraich Naseem 
Published: August 2023

Abstract

Aims
As per the Francis report patients must have a named clinician assigned to them. Knowledge of named consultant prevents confusion for medical staff and patient’s alike.
This study assessed named consultant discrepancies between in patient lists (nursing/medical), electronic patient record (EPR) and patient knowledge.

Methods
Data was collected from doctors/nursing list, EPR and patients themselves on general surgical wards. Patients lacking capacity were excluded and reasonable adjustments made for those with difficulty communicating.
The following interventions were implemented: results emailed to relevant staff, findings presented at doctor's teaching, posters in the ward office and marker pens made available. Interventions were re-audited at 12 days.

Results
Round 1: 52 patients. 63% had the correct consultant name on EPR, nursing and medical lists. 19% had named consultant over their bed space. 44% could name and a further 10% could describe their named consultant.
Round 2: 38 patients. 68% had the correct consultant name on EPR, nursing and medical lists. 37% had named consultant over their bed space. 50% could name and a further 8% could describe their named consultant.

Conclusions
Despite improvement; only 1:2 patients could name their consultant, 1:3 have consultant name over their bed and 1:3 have some discrepancy in named consultant on EPR or medical/nursing list.
Elective patients were most likely to know their consultant so future interventions should focus on emergency admissions. Other interventions should involve clerical staff, formal introduction of consultant to patients and ensuring on call consultant is known to the nursing team on ward.
FTP8.6 Informed Written Consent for General Surgery in Tertiary Care Center: A Closed Loop Audit
Authors: Oh Ke En , O'Leary Stephen , Anwar Afiq , Meshkat Babak 
Published: August 2023

Abstract

Aim
The aim of the study was to perform an audit of standard consent form in which patients sign prior surgical intervention in our institute. This audit is compared to ‘Code of Practice for Surgeons’ standard developed by Royal College of Surgeons in Ireland.

Methods
A pre-interventional cycle was conducted to evaluate the standard of consent of patients underwent surgery obtained using electronic records in the Department of General Surgery. This was performed over a period of one week. Following the analysis of collected data, teaching sessions was given to non-consultant hospital doctors (NCHDs) obtaining consent for patients underwent surgical procedure which include colorectal surgery, upper gastrointestinal surgery, breast and endocrine surgery. A post-intervention cycle was conducted to assess for any improvement in the standard of consent.

Results
A total of 50 consents forms were obtained in the pre-intervention cycle. Patient’s name, date of birth (DOB), patient’s identifier (PID) was correctly labelled in all the consent forms (100%). However, only 38 (76%) consents forms were correctly documented without using abbreviations or acronyms. In the post-interventional cycle, 75 consents forms were obtained. All (100%) consent forms were correctly labelled included patient’s name, DOB and PID. A total of 65 (87%) consents forms were correctly labelled without using abbreviations or acronyms.

Conclusion
This audit demonstrated that standard of consent can be significantly improved by general surgery NCHDs with virtual education sessions. Intervention like education sessions can be informative and improve the documentation of consent forms to optimise patient safety.
FTP8.13 Validation of a definition of Major Abdominal Surgery (MAS)
Authors: Courtney Alona , Dorudi Yasmin , Cosentino Daria , Cross Tim , Moonesinghe Suneetha Ramani , Dorudi Sina 
Published: August 2023

Abstract

Aims
To validate a previously derived definition for major abdominal surgery that has potential for widespread adoption and use in patient-driven outcome studies.

Methods
We codified our narrative definition for MAS using CCSD and OPCS-4 schedules. Data was extracted from electronic health records over a 5-year period to validate this definition by comparing relevant proxy measurements between MAS and non-MAS groups. Unsupervised machine learning, using the Partitioning Around Medoids algorithm, was used to cross-validate the definition by clustering all procedure codes into MAS and non-MAS groups based on these proxy measures.

Results
337 CCSD codes and 214 OPCS-4 codes were reviewed. Of these, 84 CCSD and 45 OPCS-4 codes were considered to be MAS, while 195 CCSD and 111 OPCS-4 codes were considered to be non-MAS. The remaining codes were excluded as they involved non-operative procedures. We extracted data on 16,353 procedures, covering 214 CCSD procedure codes over a 5 year period. There was statistically significant difference between MAS and non-MAS operations, when comparing patient age, procedure duration, length of hospital stay, percentage of ICU admissions (p&lt;0.001 for all values). Unsupervised machine learning allocated 127 CCSD codes, that contained data on more than 10 patients, into 2 distinct clusters with percentage agreement being 87.4% and Cohen’s kappa of 0.736 between narrative definition and machine learning analysis.

Conclusions
We have arrived at a validated definition of major abdominal surgery, which can now be confirmed using a larger data set. We propose that this will prove useful in the development of comparative patient-driven outcome data.
85 The SSSLOT study: Surgery, Stent (SEMS), Stoma for Left Obstructive colonic Tumours
Authors: Kwan Jing Yi , McClean Adam , Harper Alex , Jiminez Anna , Lockwood Sonia , Yiasemidou Marina 
Published: August 2023

Abstract

Aim
There is no clear consensus on the optimal management of obstructed left colonic malignancy. Although SEMS as a bridge to elective surgery is considered an alternative to primary surgery, comparisons of defunctioning stoma versus stent versus surgery has yet to be explored. This is a pilot study on the management of acute left malignant colonic obstruction (LMCO) in our trust.

Methods
This is a retrospective review of the management and outcomes of LMCO in our trust from 2019-2021.

Results
19 patients were identified (72 y.o., M:F 10:9). T3:4 (8:11). 3 were rectal, 11 sigmoid, 4 were descending, and 1 transverse colon cancer. 7 had SEMS, 7 defunctioning stoma, and 5 emergency resection.
All 7 cases of SEMS were clinically and technically successful. Mean time from SEMS to definitive surgery was 49.5 days with one case not leading to surgery. There was one 30-day complication reported which was not SEMS related; 3 year mortality (3YM) was 4/7.
In the defunctioning stoma group, 2 did not proceed to surgery; 6 patients experienced complications; 3YM was 3/7. For the straight to surgery group, 5/14 of patients who had bridging-to-surgery procedure had neoadjuvant treatment; 4 complications were reported; 3YM was 1/6.

Conclusion
Although the results are limited by small numbers, a bridge-to-surgery technique is used approximately 3 times more frequently than emergency surgery, and neoadjuvant treatment is rarely employed. There would appear to be a lower 3YM with emergency surgery compared to the other interventions. Multicenter data collection will assess these preliminary findings.
92 Closed loop audit: Improving virtual clinic practice in Royal Sussex County Hospital
Authors: Nour Hussameldin Mohamed , Saleem Mohamed , Peristeri Dimitra V , Abogabal Sameh , Sajid Muhammad S 
Published: August 2023

Abstract

Aims
The aim of this study is to assess virtual clinics practice in Royal Sussex County Hospital comparing it to the RCS guidelines as standard as well as improving the current practice.

Methods
We undertook two cycles studying twelve consecutive clinics each cycle. These cycles aimed to assess the virtual clinics and comparing them with RCS guidelines using check-lists. A teaching session was conducted between the two cycles. In addition, RCS guidelines were handed over to surgical consultants aiding them in conduction their virtual clinic.

Results
We sampled a total of 444 patients from 24 virtual clinics (first cycle: 216, second cycle 228). Following conduction of teaching sessions and handing over guidelines , there was a significant improvement in some parameters such as obtain consent of the patient for the virtual consultation (from 70% to 100 %), explain what will happen in the virtual appointment and how long it will last (from 30% to 100 %) and If further contact is needed, confirm the patient’s agreement to be contacted remotely and explain how the patient can contact them if they have further questions (from 70% to 100 %). Introduction, history taking, management plan, conclusion and follow-up letter or email to patient and GP were satisfactory in both cycles.

Conclusion
Virtual consultations offer potential tools through which we may still be able to offer care remotely and also identify those patients who need urgent intervention, with proper education sessions Virtual clinic can be conducted safely according to RCS guidelines

Acknowledgment
First cycle presented in ASGBI 2022.
100 Utilisation of Dissections vs Prosections in Anatomical Education and its Relevance in Pursuing Surgical Training: A Comparative Study on Students' Perspectives at a Northern Irish Medical School
Authors: Roy Sakshi , Ahluwalia Arjun , Shah Muhammad Hamza 
Published: August 2023

Abstract

Aim
This study investigates medical students’ opinions regarding their memorisation, retention and implementation of anatomical learning by comparing prosection and dissection studies offered at the university. Furthermore, we also investigated its significance in students considering the surgical training pathway in the future.

Method
Medical students at QUB were sent a 10-item survey weighing their preference for dissection and prosection in the retention and application of anatomical knowledge along with its relevance in pursuing surgery. The survey was distributed amongst Year 1 - 5 medical students in an online format, with answers recorded over the span of two weeks.

Results
26 QUB medical students across preclinical/clinical years answered the survey, 53.85% of whom preferred dissections for identification, memorisation and employment of information regarding anatomical structures. Students who chose dissection agreed that the process offered more interaction, with deeper knowledge about spatial organ recognition. Meanwhile, prosections were chosen by students who believed focusing on isolated organs helped in mapping their knowledge to relevant learning outcomes.
Moreover, 42.11% of respondents found both learning methods helped visualise anatomical concepts outside a medical environment. However, dissection helped most students draw links between pathology and its anatomical basis. Finally, 84.21% considered dissection to play a major role in viewing surgery as a future career.

Conclusions
While there is an observable difference in respondents' perspectives, the survey indicates an overall preference for dissection in anatomical lab practices. The practice appealed to students better due to its greater interactive experience and tactile approach, with respondents agreeing that dissection mimics true surgical craftsmanship.
146 Percutaneous Cholecystostomy Management: A Quality Improvement Project
Authors: White Annabelle , Harman Holly , Worthington Tess , Wu Fiona , Klimovskij Michail 
Published: August 2023

Abstract

Introduction
Percutaneous Cholecystostomy (PC) drainage is used in acute calculous cholecystitis management for draining a septic source as an adjunct to antibiotic therapy, and frequently a temporising measure to interval cholecystectomy. Despite various guidelines surrounding PC insertion, there is little consensus on their subsequent management and removal – including optimal duration, investigations prior to removal, and timing of cholecystectomy.

Method
Retrospective review of all patients undergoing radiologically guided PC insertion between 1/22/21 and 2/10/22. Data collected included patient demographics, time from diagnosis to PC, duration of admission and PC in situ, investigations prior to removal, cholecystectomy, and complications.

Results
25 patients, with median 2 days from diagnosis to PC (0-25), and admission duration 6.5 days (1-25). 22 patients were discharged with PC in situ, 2 removed prior to discharge, and 1 in-hospital mortality. 33 days (1-68) median duration of PC in situ, with 11 having LFTs and 10 having cholecystogram prior to removal. 5 patients have subsequently undergone cholecystectomy, with another 5 awaiting operation date. 2 patients were readmitted following initial PC removal– both requiring further PC insertion.

Conclusion
We demonstrated considerable heterogeneity in PC management at ESHT, and subsequently introduced a consultant-body approved “Cholecystostomy Pathway” and “Cholecystostomy Passport”. This pathway outlines the journey for patients through outpatient investigations and removal – complete with ideal timeline and clinic appointments. Accompanied by the “Cholecystostomy Passport” given to patients outlining the above and providing safety netting information, we aim to standardise PC management and subsequently improve patient outcomes and experience.
147 Walled- off pancreatic necrosis mimicking a pancreatic cancer
Authors: Nawaz Ibia , Rauf Fatima , Khan Huma Sabir , Malik Naveed Akhtar , Hanif Muhammad 
Published: August 2023

Abstract

Introduction
Walled-off pancreatic necrosis is a late complication of acute pancreatitis and can mimic a pancreatic cancer.

Case Summary
A 20 years old male patient was referred to us with a suspicion of pancreatic mass. He gave an inconsistent history of pain epigastrium and jaundice about 3 months back. An ultrasound abdomen showed a solid mass measuring about 47 x 52mm in head of pancreas having enhanced vascularity on doppler. Computed tomography scan done showed a mass lesion of 5cm in head of páncreas, solid and enhancing in nature with no separation from duodenum. Based on radiological findings and a history of weight loss of 5 kg in 2 months, patient was referred to us with suspicion of pancreatic mass. Current admission baseline investigations were normal. CA 19-9 levels were 6.23 U/ml. Dynamic three phase CT scan of abdomen showed diffuse smooth circumferential gall bladder wall thickening without any fat stranding and preserved pericholecystic fluid planes suggestive of chronic cholecystitis. There was a hypodensity along the body of pancreas measuring 11mm in size. MRCP was done which also showed a small pancreatic cyst. After thorough discussion, a presumptive diagnosis of walled off necrosis of páncreas was made that has now regressed. Patient was assured and follow up was advised to monitor the cystic lesión.

Conclusion
Infected pancreatic necrosis may be present and can be confused with pancreatic malignancy in an early stage of development. This case highlights that awareness of the natural course of pancreatitis and infected pancreatic necrosis is important.
187 Improving adherence to anaesthetic room preoperative shaving: A surgical site infection quality improvement project
Authors: Muir Duncan , Dejsupa Chaninda , Ghani Anum , Thompson Anna , Bridegman Joseph 
Published: August 2023

Abstract

Introduction
The correlation between hair removal and surgical site infection (SSI) remains debated but the limited guidance suggests when hair removal is necessary it should take place in the anaesthetic room. Our local policy is for preoperative hair removal to be performed in the anaesthetic room. We completed a quality improvement project after auditing our practice.

Methods
Location of preoperative shaving in emergency and trauma theatres were recorded for 7 days. Results were presented to surgical leadership teams and SSI steering groups, and information was disseminated to surgical and anaesthetic teams. Posters specifying the appropriate location of hair removal were created. Results were re-audited after six weeks.

Results
Pre-intervention, 15 cases required preoperative hair removal. This included 9 general surgery cases, 2 urology, 1 gynaecology and 4 trauma and orthopaedics. Overall, 6/15 (40%) cases were shaved in the anaesthetic room. The rates of hair shaving in the anaesthetic room were 2/9 (22%) general surgery, 1/2 (50%) urology, 1/1 (100%) gynaecology, and 2/4 (50%) trauma. Post-intervention, 9/12 (75%) cases were shaved in the anaesthetic room. This included 7/9 (78%) general surgery, 1/2 (50%) urology, 0/0 gynaecology and 1/1 (100%) trauma and orthopaedics.

Conclusion
The rate of appropriate preoperative hair shaving in the anaesthetic room increased as a result of initial audit and intervention. Notable change was observed in general surgery in emergency theatres. Future studies should record the rate of surgical site infection, to determine the overall effect this can have on patients and should extend the assessment to elective theatre.
192 Percutaneous cholecystostomy as a definitive treatment versus bridging treatment before cholecystectomy for acute cholecystitis: a retrospective observational study
Authors: Lau Joshua , Sinha Surajit , Srinivas Gandrapu , Andrews Stuart , Bowling Kirk , Platt Timothy 
Published: August 2023

Abstract

Aims
In this study, we aimed to investigate the mortality and predictors of mortality of patients receiving percutaneous cholecystostomy (PC) as definitive treatment versus patients receiving PC followed by laparoscopic cholecystectomy (LC) for acute cholecystitis (AC)

Methods
The study population consisted of 48 patients receiving PC for AC (mean age 76, 68.8% male), with a median follow-up period of 22 months. Data was collected on 1,3 and 12-month mortality, Charlson Comorbidity Index (CCI) and American Society of Anaesthesiology (ASA) score, admission bilirubin and respiratory function, and conversion to LC rates.

Results
22 patients (46.8%) received LC following PC treatment, and 26 patients (54.2%) had PC as their definitive treatment. All 22 LC patients (100%) survived at 30 days, 3 months, and 12 months. Definitive PC patients had a 30-day mortality of 30.8% (8 patients), and a 3-month and 12-month mortality of 46.2% (12 patients). The alive cohort of patients had a lower CCI (4.66 vs 5.86, p&lt;0.094), lower ASA (2.71 vs 3.25, p&lt;0.05), and fewer patients with respiratory dysfunction or jaundice (27.8% vs 62%) than the 30-day and 3-month mortality cohort. The LC cohort had significantly lower CCI (4.39 vs 5.57, p&lt;0.05), lower ASA (2.61 vs 3.04, p&lt;0.05), but more jaundice/respiratory dysfunction (50% vs 38.4%) than the PC cohort.

Conclusions
Our results suggest that patient CCI score, ASA score, admission jaundice, and respiratory dysfunction can be used as effective predictors for 30-day and 3-month mortality for patients receiving PC for AC, as well as effective adjuncts in deciding which PC patients should be considered for surgery.
227 Never reported Complication of open Right hemicolectomy -Right external iliac artery pseudoaneurysm with arterio colonic fistulae presenting as delayed postoperative anastomotic bleeding – a case report and review of Literature
Authors: Elhassan Ali Mohamed 
Published: August 2023

Abstract
Anastomotic bleeding is well known complication after gastrointestinal resection and anastomosis procedures. The percentage of patients experiencing this complication is between 0.5% to 9.6%. Delayed postoperative anastomotic bleeding is even more rare, herein, we report a case of pseudoaneurysm of right external iliac artery with arteriocolonic fistulae in a patient who underwent open right hemicolectomy and presented as delayed postoperative anastomotic bleeding-a complication never reported before related to this procedure.
248 Master Students' Perception and Attitude on Methods of Anatomy Teaching and Assessment, Khartoum, Sudan 2014-2020
Authors: Hassan Rawan , Awad Khalid , Hassan Razan 
Published: August 2023

Abstract

Aim
Anatomy is the cornerstone of medical education; anatomical knowledge is undoubtedly essential for doctors regardless of their specialty. Teaching and learning anatomy are one of the most important and challenging subjects for both teachers and students. This study aimed at improving the postgraduate teaching and assessment methodologies by eliciting the perception and attitude toward anatomy teaching approaches among anatomy master students.

Methods
A descriptive cross-sectional study was conducted among three consecutive batches of anatomy master students. A structured questionnaire was used as a tool of data collection and data was analysed using IBM statistical package for social sciences version 24 (SPSS 24).

Results
44 candidates responded to the questionnaire. Among them, 90.9% chose dissection room sessions as the best tool in attaining the intended learning outcomes. Practical dissection was the best teaching method with regards to interest 81.1%, enjoyment 70.5%, retention of information 65.9% and satisfaction 59.1%. 72.7% of the respondents think that practical dissection test was the best assessment method in fulfilling the intended learning objectives. Multiple choice questions were the most helpful in learning anatomy effectively and was the best tool for assessing knowledge.

Conclusions
The results have shown a strong positive perception towards the use of cadaveric dissection in teaching and learning anatomy. However, many did not seem to prefer lectures as a tool in anatomy teaching and learning. In addition, practical dissection test and multiple-choice questions were the best assessment methods in attaining the intended learning objectives and learning anatomy effectively respectively.
251 Trachoma in Sudan: Case Series from Two Eye Care Hospitals and a Review of the Literature
Authors: Hassan Rawan , Hassan Razan , Mohamed Sagad , Saad Fadwa , Mohamed Haidar 
Published: August 2023

Abstract

Background
Trachoma is a common infectious cause of blindness worldwide. Although it has largely now disappeared from developed countries, it is still endemic in many developing countries. We aimed to highlight clinical stages and common related socio-demographic and household characteristics among patients with trachoma in Sudan.

Methods
A hospital-based case series descriptive study was conducted at Makah Eye Complex and Abdalfadeel-Almaz hospital in Khartoum, Sudan. We included all Trachoma patients from all age groups attending the two eye care hospitals March-May 2015. Data was collected through clinical examination, hospital records, and face to face interview using a structured questionnaire. Also, we conducted a review of the literature to highlight the epidemiological aspect of trachoma in Sudan, using the databases of MEDLINE (PubMed) and Google Scholar.

Results
In this case series, we identified 125 patients with trachoma in the study period. Most of them were aged more than 50 years old (78.4%). Half of the participants (56%) were positive for active trachoma, 40.8% of them were having Trachomatous Trichiasis (TT), and 56% of them have Trachoma Follicles (TF). Majority of the patients have low socioeconomic status and poor personal and environmental hygiene (88%), (44%) and (74.4%), respectively.

Conclusions
Low socioeconomic status and poor personal and environmental hygiene are common socio-demographic and household characteristics among patients with trachoma. Despite the progress that has been made towards disease elimination, trachoma is still a public health problem in Sudan. Our review highlights the magnitude of trachoma and the progress towards its elimination in Sudan.