Yield of Coronary Assessment in Sustained Monomorphic Ventricular Tachycardia.

Background: Coronary assessment is frequently conducted in patients with sustained monomorphic ventricular tachycardia (SMVT); however, its yield and subsequent treatment implications remain unclear. This study aimed to determine the prevalence of coronary artery disease (CAD) in patients presenting with SMVT, factors influencing clinician referral for coronary assessment, and clinical outcomes based on revascularisation or medical management of CAD.

Method: Consecutive patients presenting with acute SMVT requiring inpatient admission between 2017 and 2022 were identified.

The synergistic role of virtual coaching with simulation-based mastery learning for upper endoscopy.

Introduction: Our simulation-based mastery learning (SBML) curriculum, delivered in person, has been shown to successfully train novices in structured esophagogastroduodenoscopy (EGD). SBML with virtual coaching (VC) has the potential to improve the effectiveness and efficiency of endoscopy training and expand access to trainees from around the world. We share our observations conducting an EGD training course using SBML with VC.

Protocolised Management of Cardiogenic Shock and Shock Teams: A Narrative Review.

Despite advances in therapy, the incidence of cardiogenic shock continues to increase, with significant mortality that has improved minimally over time. Treatment options for cardiogenic shock are complex and time-, resource-, and case volume-dependent, and involve multiple medical specialties. To provide early, more equitable, and standardised access to cardiogenic shock expertise with advanced therapies, cardiogenic shock teams with a protocolised treatment approach have been proposed.

Effects of Ramadan fasting on fetal health: A systematic review.

Background: Ramadan fasting (RF) is mandatory for all healthy Muslims in the ninth month of the Islamic calendar. Although pregnant women are exempt from fasting, many make the decision to practise it. Concerns that fasting during pregnancy harms the fetus remain, as there are no firm recommendations regarding its safety.

Trends in Modifiable Risk Factors Amongst First Presentation ST Elevation Myocardial Infarction Patients in a Large Longitudinal Registry.

Background: Recent studies suggest that the risk factor profile of patients presenting with ST elevation myocardial infarction (STEMI) is changing.

Aim: The aim is to determine if there has been a shift of cardiovascular risk factors to cardiometabolic causes in the first presentation STEMI population.

Method: We analysed data from a STEMI registry from a large tertiary referral percutaneous coronary intervention centre to determine the prevalence and trends of the modifiable risk factors of hypertension, diabetes, smoking and hypercholesterolaemia.

Entrust Me: Embedding Entrustable Professional Activities in a Gastroenterology Residency Program.

Entrustable Professional Activities (EPAs) are defined as a process of gradually entrusting key tasks to specialty fellows during their training. EPAs are an important component of competency-based medical education; the concept of entrustment is also familiar and intuitive to clinical faculty, even inexperienced evaluators even if not termed as such. In this paper, we describe the process of how the authors adopted an established EPA framework for gastroenterology training, using EPAs to guide curriculum and faculty development and assessment in ten steps: (1) adopting an established framework, (2) mapping EPAs to relevant competencies, (3) specifying expected behaviors for competency of each EPA, (4) training faculty and fellows to have a shared mental model, (5) designing the training curriculum and educational strategies based on EPAs, (6) determining the assessment strategy, (7) designing the assessment tool, (8) ensuring clarity in how assessment data are used to make summative decisions, (9) changing feedback culture of fellows, and (10) using a longitudinal coaching system to improve EPA performance.

Medical Education Blog and Podcast Utilization During the COVID-19 Pandemic.

Introduction The coronavirus disease 2019 (COVID-19) pandemic disrupted traditional in-person learning models. Free Open Access Medical (FOAM) education resources naturally filled this void, so we evaluated how medical blog and podcast utilization changed during the early months of the pandemic. Methods Academic medical podcast and blog producers were surveyed on blog and podcast utilization immediately before (January-March 2020) and after (April-May 2020) the COVID-19 pandemic declaration and subsequent lockdown.

Value of a Growth Mindset: Improving Endoscopy Coaching and Mentoring.

The teaching of endoscopic procedures to trainees has radically changed from the previous "see one, do one, teach one" approach to the method termed "competency-based medical education" (CBME), which has transformed endoscopic training. Successful implementation of a CBME program requires learners to direct their own learning. Learners with a growth approach are more likely to thrive in such a system since they are learning-oriented and not performance-oriented.

Guidance on performance and reporting of high-resolution oesophageal manometry and ambulatory pH monitoring in Singapore.

Introduction: We aimed to provide a practical and evidence-based guide on the indications, performance and reporting of high-resolution oesophageal manometry (HRM) and ambulatory pH monitoring (PHM) in adult patients in Singapore.

Methods: The guideline committee comprised local gastroenterologists from public and private sectors with particular expertise in aspects of HRM and PHM, and it was tasked to produce evidence-based statements on the indications, performance and reporting of these tests. Each committee member performed literature searches to retrieve relevant articles within the context of domains to which they were assigned.

Low Incidence of Ischemic Stroke Associated With Thrombus Aspiration in STEMI Patients Undergoing Primary PCI.

Background: Thrombus aspiration (TA) during primary percutaneous coronary intervention (PPCI) for ST-segment elevation myocardial infarction (STEMI) was recommended to minimize distal embolization and to reduce thrombus burden prior to PPCI. Subsequent randomized trials showed no mortality benefit from TA and suggested an increased risk of stroke up to 180 days following TA, although it was not obvious that the procedure alone caused the strokes.

Methods And Results: This study retrospectively analyzed the periprocedural stroke rate in a series of STEMI patients treated with TA and PPCI at a single, large, tertiary hospital, where a rigorous uniform protocol of aspiration was used in all patients.

The impact of the coronavirus disease 2019 pandemic on gastroenterologists in Southeast Asia: A mixed-methods study.

Background And Aim: The coronavirus disease 2019 pandemic has impacted gastroenterology practices worldwide; however, its protracted effects within Southeast Asia were unknown. The primary aim of the study was to determine the impact of the pandemic on clinical demands including burnout among gastroenterologists within the region. The secondary aim was to identify risk factors for burnout and determine regional stressors.

Pondering the Pandemic's Problems: A Program Director's Perspective.

The year 2020 was challenging for many fellowship programs with regard to training or even burnouts. In this article, I will reflect on being a new program director having to deal with new responsibilities amidst an evolving pandemic. I highlight ten takeaway reflections with the hope that others may find these relevant to their current situation as training program leaders and mentors.

Image-guided Procedure Versus 2-year Follow-up for a BI-RADS 3 Probably Benign Lesion: A Cost Comparison Analysis.

Objective: Perform a comparison between the costs of image-guided breast procedures versus 2-year imaging follow-up for findings classified as BI-RADS assessment category 3-probably benign.

Methods: The national payment amount costs at non-facility locations were obtained from the Centers for Medicare and Medicaid Services physician fee schedule for breast imaging-related Current Procedural Terminology codes. Total costs were calculated and compared for management algorithms of 2-year imaging follow-up of a BI-RADS 3 lesion from 2018 through 2019 versus performing an image-guided procedure of the lesion in 2018 after the initial diagnostic imaging.

Mindfulness-based cognitive therapy in functional dyspepsia: A pilot randomized trial.

Background And Aim: Patients with functional dyspepsia (FD) often have concomitant anxiety and depression. Mindfulness-based cognitive therapy (MBCT) combines the principles of cognitive behavioral therapy and mindfulness. It is a group-based therapy and has been shown to be efficacious in functional gastrointestinal disorders.

Burnout and work-related stressors in gastroenterology: a protocol for a multinational observational study in the ASEAN region.

Background: Clinician burnout is an important occupational hazard that may be exacerbated by the novel COVID-19 pandemic. Within Southeast Asia, burnout in gastroenterology is understudied. The primary objective of this study is to estimate the prevalence of burnout symptoms within gastroenterology, in member states of the Associations of Southeast Asian Nations (ASEAN), during and after the COVID-19 pandemic.

Conducting of Web-Based Workshops for Final Year Medical Students Preparing to Enter the Workforce During the COVID-19 Pandemic.

Medical students were temporarily removed from direct patient contact activities during the COVID-19 pandemic, shortening the duration of ward-based attachment programs. Web-based workshops were organized to equip final year medical students with necessary skills to start work in a general medicine setting. Topics included case-based scenarios reviewing patients with new complaints, medical documentation, and inter-professional communication.

Nonepithelial Tumors of the Larynx: Single-Institution 13-Year Review with Radiologic-Pathologic Correlation.

Nonepithelial tumors of the larynx are rare and represent a minority of all laryngeal neoplasms. Imaging has an important role in the diagnosis, treatment planning, and surveillance of these entities. However, unfamiliarity with these neoplasms can cause diagnostic difficulties for radiologists, especially because many of the imaging findings are nonspecific.

The Practice of Gastrointestinal Motility Laboratory During COVID-19 Pandemic: Position Statements of the Asian Neurogastroenterology and Motility Association (ANMA-GML-COVID-19 Position Statements).

During the Coronavirus Disease 2019 (COVID-19) pandemic, practices of gastrointestinal procedures within the digestive tract require special precautions due to the risk of contraction of severe acute respiratoy syndrome coronavirus-2 (SARS-CoV-2) infection. Many procedures in the gastrointestinal motility laboratory may be considered moderate to high-risk for viral transmission. Healthcare staff working in gastrointestinal motility laboratories are frequently exposed to splashes, air droplets, mucus, or saliva during the procedures.

Outrunning Burnout in a GI Fellowship Program During the COVID-19 Pandemic.

Many GI training programs have needed to adjust to the serious disruption to the training and education of fellows worldwide due to the COVID-19 pandemic. A silent problem that has arisen within programs is the issue of burnout among their trainees. Burnout is common among gastroenterologists, especially in fellows (Keswani et al.