Traumatic Injury and Complete Ligation of the Inferior Vena Cava: A Case Report

This case report describes an occurrence of a traumatic injury to the inferior vena cava (IVC) secondary to penetrating trauma. A 37-year-old male patient presented to the emergency department (ED) after sustaining a stab wound to the mid back. The patient was transferred directly to the operating theatre (OT) and underwent an emergency exploratory laparotomy. A through-and-through IVC injury at the level of the entry to the liver bed was identified. Surgical repair was attempted but failed, followed by eventual IVC ligation. The patient was shifted to the intensive care unit postoperatively for damage control resuscitation while the abdomen was temporarily closed. He later required a re-look procedure for definitive treatment, after which he could mobilize without assistance and return home. This case highlights the different surgical approaches to an IVC injury and examines postoperative complications and their management.

Evaluating the knowledge, attitudes, and uptake of the influenza vaccine in healthcare professionals: A cross-sectional study from the United Arab Emirates

Background:

Influenza, a yearly epidemic, can present with a wide array of symptoms ranging from mild rhinorrhoea and cough to life-threatening superadded bacterial infections. It affects the lives of around 12.5% of the world’s population every year and accounts for almost half a billion deaths. With growing populations, these numbers will follow a similar growth resulting in increased morbidity and mortality. Currently, the recommended method to prevent influenza is through the administration of a yearly vaccine that entails the suspected strains of the virus for the year and region.

Objective:

This study aims to explore the knowledge, attitudes, and practices of the health care professionals in the United Arab Emirates (UAE) regarding Influenza vaccination.

Methods:

A cross-sectional study, utilizing a self-administered questionnaire, was distributed amongst health care professionals in the four largest emirates in the UAE, via convenience sampling. 417 responses were completed and analysed using SPSS-24.

Results:

54.1% (n=225) of participants continue going to work while being sick despite 67.6% (n=282) reporting they are aware of the recommendations published by the Centers for Disease Control and Prevention (CDC). Multiple linear regression showed that age and profession were the only significant predictor of influenza vaccine knowledge. 54.2% (n=226) of the participants reported receiving the vaccine; of those, only 38.9% (n=88) receive it annually. One of the most commonly reported barriers to taking the vaccine was the uncertainty of its effectiveness. Those using a reminder system were 2.044 times more likely to take the vaccine regularly.

Conclusion:

This study demonstrates that the attitudes and practices towards taking the influenza vaccine as recommended are suboptimal. Campaigns targeting health care professionals regarding the influenza vaccine and the CDC recommendations would perhaps positively skew the results in the future.

Plastic and aesthetic surgery among medical students: A cross-sectional study

Objectives

The wide variety of operations that a plastic surgeon can deal with creates confusion regarding its proper scope. This confusion was observed in primary physicians as well as medical students. Increasing the perception of medical students toward plastic surgery can aid in career decision-making and early referral patterns. The aim of this study is to gauge a holistic overview of how medical students and interns perceive the plastic and aesthetic surgical specialty in King Faisal University and to suggest a recommended plan.

Methods

An online questionnaire was distributed equally to male and female medical students and interns in a local medical institute. The questionnaire constituted three sections; the first included the biographical data. The second is concerned with the different case scenarios and specialties to be chosen. The third is concerned with the previous clinical exposures. The data were analyzed by SPSS version 21. Between comparison, chi-square tests, Mann-Whitney U-test, and Kruskal-Wallis tests were applied. Normality tests were conducted using the Shapiro-Wilk's test.

Results

Two hundred ninety-two students and interns have participated and completed the questionnaire. There were 189 males and 103 females. Plastic surgery was most commonly chosen in the following case scenarios; burn of the hand (74%), broken nose (64.7%), and cosmetic nose reshaping (80.8%). However, plastic surgery was infrequently chosen (selected by <30% of students) in many areas of hands and peripheral neuropathies (severed finger extensor tendon (26.4%), fractured scaphoid (12.7%), carpal tunnel syndrome (14.4%), brachial plexus injury (16.1%)). The most common source of information was the social media, and the least one is meeting with doctors and professors.

Conclusion

Medical students and interns lack a full view of plastic and reconstructive surgery, especially in hand and peripheral neuropathies. Improving the education of medical students and interns is recommended and needed.

Brugada Syndrome and Anesthesia

Brugada Syndrome is a distinct form of an arrhythmic disease characterized by right bundle branch block an ST segment elevation in the right pericardial leads (VI - V3) of the electrocardiogram (ECG). This syndrome is clinically important because of the high incidence of sudden death by ventricular fibrillation (VF) without any structural heart disease, and is seen especially in the Asian population including Japanese people. Recently, it has been demonstrated that Brugada Syndrome is generally linked to the mutation of the alpha subunit of the sodium channel gene, SCNSA, and the use of certain anti-arrhythmic sodium channel blockers (Class IA au IC) is the sole the Medical intervention which effectively protects patients with Brugada Syndrome from sudden cardiac death.