Integrating artificial intelligence techniques for advancements in colorectal cancer management: navigating past and predicting future direction.

Artificial Intelligence (AI) in the last few years has emerged as a valuable tool in managing colorectal cancer, revolutionizing its management at different stages. In early detection and diagnosis, AI leverages its prowess in imaging analysis, scrutinizing CT scans, MRI, and colonoscopy views to identify polyps and tumors. This ability enables timely and accurate diagnoses, initiating treatment at earlier stages.

Transforming surgical landscapes: obstacles in the integration of robotic surgery in Pakistan -is cost the only limiting factor?

The advantages of Robotic Assisted Surgery (RAS) over laparoscopic surgery encompass enhanced precision, improved ergonomics, shorter learning curves, versatility in complex procedures, and the potential for remote surgery. These benefits contribute to improved patient outcomes which have led to a paradigm shift in robotic surgery worldwide and it is now being hailed as the future of surgery. Robotic surgery was introduced in Pakistan in 2011, but widespread adoption has been limited.

Feasibility of robotic platform to perform R0 resection for locally advanced multi-visceral pelvic malignancy: an institutional experience on outcomes of robotic pelvic exenteration.

Background: Exenteration surgery for multi-visceral pelvic malignancy is a complex life-changing operation with high perioperative morbidity and mortality. Traditional open surgery has long been the standard approach for pelvic exenteration for achieving Ro resection which is the main aim of surgery. In the current era of minimally invasive surgery, robotic-assisted pelvic exenteration has provided a promising alternative, offering potential advantages in terms of improved oncological outcomes and enhanced postoperative recovery.

The role of Da Vinci Xi robotic simulation curriculum in enhancing skills in robotic colorectal surgery.

Robotic surgery in comparison to open and laparoscopic surgery allows better ergonomics, three-dimensional vision, and seven-degree freedom of movement. This ensures fast recovery, fewer postoperative complications, and safe oncological resections. Robotic surgery has revolutionized the field of colorectal surgery, providing surgeons with enhanced precision, dexterity, and visualization.

Return to Work in Patients With Unilateral Inguinal Hernia Surgery: A Comparative Study Between Laparoscopic Transabdominal Preperitoneal Approach and Lichtenstein Tension-Free Mesh Repair.

Objective The objective of this prospective cohort study was to compare the time to return to work between patients who underwent laparoscopic transabdominal preperitoneal (TAPP) hernia repair and those who underwent Lichtenstein tension-free hernia repair with mesh for unilateral inguinal hernia. Methodology Patients were registered for unilateral inguinal hernia review at Aga Khan University Hospital, Karachi, Pakistan, from May 2016 to April 2017 and followed till April 2020. All patients aged 16-65 planned for unilateral transabdominal preperitoneal hernia repair or Lichtenstein tension-free hernia mesh repair were included.

Strongyloides colitis, a rare but important mimic of Crohn's disease, resulting in coma and multi-organ failure: a case report.

Background: Strongyloides colitis is a severe form of strongyloidiasis that carries a high mortality rate if untreated. There is an overlapping clinical presentation between Strongyloides colitis and Crohn's disease. Here, we present a case of a patient who was diagnosed with Crohn's disease and was treated with immunosuppressant therapy which resulted in a poor outcome.

Collision versus loss-of-control motorcycle accidents: Comparing injuries and outcomes.

Objective: Motorcycles are a common mode of transport, especially in low-middle-income countries like Pakistan. The pattern and severity of injuries in motorcycle trauma depends on the mechanism of accident, which may be classified as collision accidents (CAs) or loss-of-control accidents (LOCAs). In this study, we aimed to investigate patterns of trauma due to motorcycle CAs and LOCAs, with a focus on injuries, management, complications, and outcomes.

The robotic learning curve for a newly appointed colorectal surgeon.

Robotic colorectal surgery allows for better ergonomics, superior retraction, and fine movements in the narrow anatomy of the pelvis. Recent years have seen the uptake of robotic surgery in all pelvic surgeries specifically in low rectal malignancies. However, the learning curve of robotic surgery in this cohort is unclear as established training pathways are not formalized.

In a digitally connected world through Likes, Hashtags and Followers - Advancing surgical research through a social media: A narrative review.

In this era of modern information technology, the world is now digitally connected through various platforms on social media, which has changed the way medical professionals work, communicate and learn. The use of social media in surgery is expanding, and it is now becoming an essential tool for surgical training, research and networking. Articles, journal clubs and surgical conferences are within reach of everyone regardless of geographical location worldwide.

Changes in patterns and outcomes of trauma patients after betterment in law and order situation of the city.

Objective: To assess the impact of the law and order situation of a city on the pattern of traumatic injuries and the overall outcomes of trauma victims.

Methods: The retrospective study of prospective trauma surgery data was done at Aga Khan University Hospital, Karachi, and comprised data of patients with torso injuries before the improvement of law and order situation from January 2012 to March 2013 in Group A, and of those with similar injuries after the law and order situation improved in the city from January 2018 to March 2019 in Group B. The required data was collected by a single researcher using a predesigned questionnaire.

Disclosing bad news of cancer diagnosis: Patients' preference for communication.

The majority of relatives of cancer patients in Pakistan request their clinicians to adopt a "do not tell approach" while counselling the patients regarding their disease. The current study aimed to assess patients' understanding of their disease and how they would prefer the physicians to deliver news about cancer diagnosis and its management plan. This was a cross-sectional study in which both patients and their immediate relatives were interviewed.

Acute presentation of cocoon abdomen as septic peritonitis mimicking with strangulated internal herniation: a case report.

Background: Abdominal cocoon syndrome is a rare cause of intestinal obstruction in which loops of small bowel get entrapped inside a fibro-collagenous membrane. Condition is also known in the literature as sclerosing peritonitis and in the majority of cases, it has no known cause. Although the majority of patients exhibit long-standing signs and symptoms of partial bowel obstruction in an out-patient clinic, its acute presentation in the emergency room with features of sepsis is extremely rare.

Current standards of postgraduate surgical education and training in Pakistan: Time to bridge the gaps in lieu of national necessity.

The provision of good-quality surgical care is a salient feature of every public health system. Pakistan is ranked among low and middle-income countries where the burden of surgical disease is rapidly increasing, but the capacity of the health system has not expanded at the same pace to cater current needs. One of the key components is the dearth of trained surgical specialists and lack of easy access to surgical care.

Impact of a global pandemic on surgical education and training- review, response, and reflection.

The catastrophic effects of the coronavirus disease-2019 global pandemic have revolutionised human society. The unprecedented impact on surgical training needs to be analysed in detail to achieve an understanding of how to deal with similar situations arising in the foreseeable future. The challenges faced by the surgical community initiated with the suspension of clinical activities and elective practice, and included the lack of appropriate personal protective equipment, and the self-isolation of trainees and reassignment to coronavirus patient-care regions.

Patterns of traumatic injuries and outcomes to motorcyclists in a developing country: A cross-sectional study.

Objective: Motorcyclists are frequently involved in road traffic accidents and may suffer polytraumatic injuries, contributing a substantial burden on healthcare systems particularly in lower-middle-income countries. This study aimed to describe patterns of injury, in-hospital course, and outcomes of road accident trauma in motorcyclists, including polytrauma, at a Trauma Facility in Pakistan.

Methods: A retrospective review was conducted by using relevant trauma codes to extract data from records for all victims presenting with motorcycle trauma between January 2018 and June 2019, to a tertiary care hospital in Pakistan.

Congenital Morgagni hernia presenting as complete small bowel obstruction in the adult - A case report.

Introduction: Congenital Diaphragmatic hernia (CDH) is a condition in which there is a defect in the diaphragm present at the time of birth. Morgagni hernia is one of the two most common types of CDH which constitutes 2%-4% of diaphragmatic hernias. They mostly remain silent or discovered as an incidental finding on radiological studies.

Gastrointestinal anastomosis (GIA) stapler as a safe and efficacious damage control tool for high-grade liver injury in hemodynamically unstable patient- A case report.

Introduction: Liver injury occurs in approximately 5% of all trauma admissions. There are many traditional ways of controlling hemorrhage from the liver and here we report a case in which a GIA 75 stapler was successfully used to manage Grade IV liver injury in a hemodynamically unstable patient.

Presentation Of Case: 45 years old policeman presented in the emergency, after sustaining a gunshot injury to his abdomen.

Changing face of trauma and surgical training in a developing country: A literature review.

Trauma continues to be the major cause of disability and death globally and surgeons are often involved in immediate care. However there has been an exponential decrease in the number of the trained trauma surgeons. The purpose of the current review article is to summarize the published literature pertaining to trauma education in postgraduate surgical training programmes internationally and in a developing country as Pakistan.

Impact of time of arrival in emergency unit on estimation of injuries and overall care of trauma victims.

Background: Outcomes of trauma victims largely depends upon available resources, not only in terms of location of high level trauma center near the area where incident takes place but also on staff and equipment available at that particular center at that particular time. This study used retrospective charts review to ascertain whether trauma patients presenting during the night time would have delayed in establishing injuries after necessary investigations and higher in-hospital mortality than those trauma patients arriving during the day time at our hospital.

Methods: This was a cross sectional study, conducted in department of Surgery, Aga Khan University Hospital, Karachi.

Sclerosing peritonitis presenting as complete mechanical bowel obstruction: a case report.

Introduction: Sclerosing peritonitis or abdominal cocoon syndrome is characterized by small bowel loops completely encapsulated by a fibrocollagenous membrane in the center of the abdomen. Although cocooning of the abdomen is mostly seen in patients on peritoneal dialysis, it can occur de novo; it very rarely manifests as complete mechanical bowel obstruction.

Case Presentation: A 46-year-old Asian man presented with complete mechanical bowel obstruction.

Better outcome of splenectomy in younger patients suffering from chronic immune thrombocytopenia (ITP).

Immune thrombocytopenia purpura (ITP) may need splenectomy after failure of medical treatment. The aim of this study was to explore the outcome of splenectomy in chronic ITP and to point out factors which can predict better response to splenectomy. This retrospective chart review was conducted at the Aga Khan University Hospital, Karachi, and comprised adult patients who underwent splenectomy for ITP from October 2005 to December 2015.