Juniper Publishers-Open Access Journal of Surgery

Abstract Background: The current work describes a surgery technique where the autograft of hamstring tendon (semitendinosus and gracilis) was used as adjuvant in the transfer of the lower trapezius for the treatment of massive or irreparable rotator cuff tear. There is a theoretical advantage that the graft takes a greater footprint area in the greater tuberosity of the humerus corresponding to the infraspinatus, thus recreating the native anatomy more accurately. Methods: The autograft of hamstring tendon was attached to the lower trapezius through an incision of 4cm in the middle third of the scapular spine and transferred to the footprint of the infraspinatus in the greater tuberosity of the humerus, where it is attached through the second incision under the lateral acromial margin. Result: The patient was examined preoperatively and after 6 months of follow-up, and his pain, according to the Visual Analogue Scale, varied from 8 to 3, the range of motion improved...

  Journal of Surgery -  JuniperPublishers Dear Editor, Communication, especially delivery of difficult news (DDN), remains a key part of clinical practice. Despite its importance, many medical providers lack the skill and ability to effectively DDN to their patients. Due to lack of data specific to sub-Saharan Africa and to help us develop an appropriate training tool for this geographical area, we sought to explore what challenges and barriers residents at our institution faced when they deliver difficult news to their patients. Methodology A qualitative approach using thematic analysis was adopted and a self-administered open ended survey was administered amongst residents currently doing their Masters in Medicine at the Aga Khan University Hospital in Nairobi and Dar es Salaam. The survey was emailed to all the residents within the two campuses using the REDCap software. Two independent researchers identified rec...

  Journal of Surgery -  JuniperPublishers Emergency Medical Service (EMS) is one of the health professions that society requires. EMS involves the use of certain emergency medications to save lives. Therefore, EMS providers (paramedic) should acquire sufficient training in medication administration. A part of the training focuses on the knowledge of medications, indications for use, contraindications (side effects), and dosing skills considering the type of disease, concentration of medication, age, or weight of the patient. A student who is trained to be a paramedic should be adequately skilled to properly calculate the dosage of medications. This study aims to determine the paramedic students’ ability and its progress in medication calculation while studying in EMS program in Prince Sultan Bin Abdulaziz College for EMS (PSCEMS), King Saud University (KSU), Riyadh, Saudi Arabia. Literature Review A few research art...

  Journal of Surgery -  JuniperPublishers  In breast cancer great endeavors are going on to find new markers in determining the prognosis. In addition to well-known prognostic factors such as tumour size, grade, nodal status, molecular subtype, proliferation index, gene-expression based recurrence score, recently there is increasing evidence that tumor-infiltrating lymphocytes (TILs) are of important role as an immune biomarker in breast carcinoma [1-3]. TILs might be a reflection of host immune response which plays an important role in cancer control and patient’s clinical outcome. TILs are mononuclear immune cells that infiltrate tumour tissue and mainly comprised of cytotoxic (CD8+) T cells as well as macrophages, helper (CD4+) T cells, B cells, and NK cells [4,5]. There are two types of TILs: Stromal TILs (sTILs) are defined as the percentage of tumour stromal field in which lymphocytes are located without direct connection to tumour cells. In contrast, i...

  Journal of Surgery -  JuniperPublishers  One in a thousand people have an acute gastrointestinal (GI) hemorrhage per year [1]. There are around 300,000 hospitalizations for GI bleeds, costing an estimated $2 billion per year [2-4]. Compared to lower gastrointestinal bleeding (LGIB), upper gastrointestinal bleeding (UGIB) is associated with a much higher mortality rate, with some studies suggesting a 30-day mortality rate of up to 14% [2,3]. A majority of these UGIB (67 - 80%) are attributed to gastric erosions/ulcers 6,17,18. However, of this morbid group of bleeds, a rare (1% or less), yet more serious cause is a Dieulafoy’s lesion (DFL). DFL, is an obscure type of bleeding that can cause life threatening hemorrhages with a mortality rate ranging from 28-67% [5,6]. DFL was first described by MT Gallard [7] in 1884 as a type of aneurysm and later clarified by P. G. Dieulafoy in 1898 who believed this was an early stage of ulceration [7-9]. DFL’s are a col...

  Journal of Surgery -  JuniperPublishers Pheochromocytomas are neuroendocrine tumors developed at the expense of cells derived from the neural crest. They occur sporadically in 50-55% of cases, but they can be familial in 5 to 10% of cases and then be isolated or integrated into an inherited syndrome of multiple neuroendocrinopathy. The properly operated pheochromocytoma is radically and definitively cured as long as it is benign and sporadic. Renal anomalies have been reported rarely in this disease. Here we report a rare case of pheochromocytoma associated with renal agenesis. Patient was a female presented with headache and hypertension. In radiologic examinations, an adrenal mass was detected in the right side, with no renal tissue on that side. It was reported an adrenal pheochromocytoma in histopathology. Renal agenesis confirmed during surgery. All of the patient’s symptoms alleviated after the resection of tumor. Considering association of renal abnormali...

  Journal of Surgery -  JuniperPublishers  Breast cancer is the most common cancer among women counting about 125 per 100000 per year new case in United States and about 1.4 million new cases worldwide [1,2]. In the last twenty years early diagnosis, neoadjuvant and adjuvant systemic treatment that targeted to specific molecular targets have significantly reduced the mortality from breast cancer. However ,the increase in survival has allowed to observe the cardiotoxic effects of anticancer therapy and increase mortality from cardiovascular causes, resulting in a large literature where experts try to identify the correct management of critical problem. Cardiotoxicity is potential complication of anticancer therapy; anthracycline therapy is a mainstay for breast cancer and other cancer, but it associated with rate of incidence heart failure more than five time the average, is a well-known problem in the treatment of cancer and limits the therapeutic use of thi...