A Qualitative Study of Decision-making (DM) in Surgery and Cancer Care: an Indian Perspective.

Unlabelled: Cancer psychology is a vitally important part of cancer management. Qualitative research is a gateway to exploring this. Weighing the treatment options in terms of quality of life and survival is important.

All-Male Groups in Asian Elephants: A Novel, Adaptive Social Strategy in Increasingly Anthropogenic Landscapes of Southern India.

Male Asian elephants are known to adopt a high-risk high-gain foraging strategy by venturing into agricultural areas and feeding on nutritious crops in order to improve their reproductive fitness. We hypothesised that the high risks to survival posed by increasingly urbanising and often unpredictable production landscapes may necessitate the emergence of behavioural strategies that allow male elephants to persist in such landscapes. Using 1445 photographic records of 248 uniquely identified male Asian elephants over a 23-month period, we show that male Asian elephants display striking emergent behaviour, particularly the formation of stable, long-term all-male groups, typically in non-forested or human-modified and highly fragmented areas.

Right colic artery anatomy: a systematic review of cadaveric studies.

Background: Complete mesocolic excision for right-sided colon cancer may offer an oncologically superior excision compared to traditional right hemicolectomy through high vascular tie and adherence to embryonic planes during dissection, supported by preoperative scanning to accurately define the tumour lymphovascular supply and drainage. The authors support and recommend precision oncosurgery based on these principles, with an emphasis on the importance of understanding the vascular anatomy. However, the anatomical variability of the right colic artery (RCA) has resulted in significant discord in the literature regarding its precise arrangement.

The right colic artery: An anatomical demonstration and its relevance in the laparoscopic era.

INTRODUCTION Hemicolectomies are not tailored in right-sided colon cancer resections, despite significant variation in the incidence and origin of the right colic artery (RCA). Early evidence suggests that removal of the relevant lymphovascular package and associated cancer as part of complete mesocolic excision (CME), rather than the entire right colon, may produce better outcomes. Advancing laparoscopic techniques are making this possible, and so it is increasingly important to more precisely define the anatomy of the RCA.

Risk factors for complications following breast reduction: results from a randomized control trial.

Reduction mammoplasty has been shown to benefit physical, physiological, and psycho-social health. However, there are some recognized complications. It would be beneficial if one could identify and modify the factors which increase the rate of complications.

Usual populations, unusual individuals: insights into the behavior and management of Asian elephants in fragmented landscapes.

Background: A dearth in understanding the behavior of Asian elephants (Elephas maximus) at the scale of populations and individuals has left important management issues, particularly related to human-elephant conflict (HEC), unresolved. Evaluation of differences in behavior and decision-making among individual elephants across groups in response to changing local ecological settings is essential to fill this gap in knowledge and to improve our approaches towards the management and conservation of elephants.

Methodology/principal Findings: We hypothesized certain behavioral decisions that would be made by Asian elephants as reflected in their residence time and movement rates, time-activity budgets, social interactions and group dynamics in response to resource availability and human disturbance in their habitat.

Thrombo-prophylaxis in colorectal surgery: a National Questionnaire Survey of the members of the Association of Coloproctology of Great Britain and Ireland.

Aim: Available guidelines from the National Institute for Health and Clinical Excellence (NICE) and the Association of Coloproctology of Great Britain and Ireland (ACPGBI) recommend combined (medical + mechanical) thrombo- prophylaxis. A Cochrane Library review recommends self-administered low-molecular-weight heparin (LMWH) for 2-3 weeks following surgery. In the light of the recent guidelines from the ACPGBI and NICE, we undertook a National Questionnaire Survey to assess current thrombo-prophylaxis practice among colorectal surgeons in the UK.

Peritonitis in myelofibrosis: a cautionary tale.

Background: Primary myelofibrosis (PMF) is a myeloproliferative disorder characterized by bone marrow fibrosis. Extra-medullary hematopoiesis sometimes occurs even in the peritoneal cavity, apart from organs such as the liver, spleen, and lymph nodes. This may sometimes be complicated by spontaneous infection and complications.

Quality of life issues in aesthetic breast surgery.

Health is multi-dimensional. Mortality, morbidity and cost are traditional health indicators, whereas outcomes research relates to quality of life and health-related quality of life. This article reviews the literature on quality of life issues in aesthetic breast surgery, highlighting the concepts of health and health outcome measures.

Biliary cast syndrome: literature review and a single centre experience in liver transplant recipients.

Background: Biliary cast syndrome (BCS) is an unusual complication of orthotopic liver transplantation (OLTx), and its management is difficult. Limited success using endoscopic retrograde cholangiopancreatography (ERCP) or open exploration to clear casts has been reported, but failure usually results in re-transplantation. We aimed to review our experience with BCS and highlight a novel combined percutaneous and endoscopic approach for duct clearance.

Vascular emergencies in cholelithiasis and cholecystectomy: our experience with two cases and literature review.

Background: Complications from gallstones and laparoscopic cholecystectomy can be serious and fatal if there is a delay in recognition and treatment. We aim to present two unusual, life threatening vascular complications as a result of gallstones and laparoscopic cholecystectomy. Their management is highlighted with a brief review of literature.

Pseudomyxoma peritonei: a rare presentation as an umbilical nodule.

Background: Umbilical nodules are rare and may be the sole presenting sign of an advanced intra-abdominal malignancy associated with poor prognosis. Metastatic involvement of umbilicus was first described in 1846 by Sister Mary Joseph, who established the correlation between carcinomas and umbilical nodes.

Aim: We aim to describe a case report of Pseudo Myxoma Peritonei in a 31-year-old man who presented with subcutaneous non tender umbilical nodule.

Venae comitantes fistulae: an option in patients with difficult hemodialysis access.

Objectives: To evaluate the outcome of use of venae comitantes vessels in the formation of arterio-venous fistulae as vascular access for hemodialysis, in patients with limited venous anatomy.

Methods: Twenty patients who underwent arterio-venous anastomosis between brachial artery and venae comitantes were identified (2002 - 2005) and the notes reviewed.

Results: There was early failure in two (10%) patients (immediate postoperative period) and a further four (20%) failed late (mean 26 weeks, range 7-60).

A point prevalence survey of wounds in north-east England.

Objective: To review current wound-care practice and the standard of wound care in Hull and East Yorkshire; obtain information on prevalence, treatment and outcomes; provide a basis for estimating the extent of the problem, treatment modalities used, service provision and future needs; highlight areas of care in need of improvement; highlight areas with excellent wound practices and gain information for future research projects within the population of the region.

Method: Point prevalence interface audit of community and acute trusts.

Results: The cumulative wound prevalence for the region was 12%.

How do we manage early rectal cancer? A national questionnaire survey among members of the ACPGBI after the preliminary results of the MRC CR07/NCIC CO16 randomized trial.

Objective: The role of neoadjuvant radiotherapy in the management of rectal cancers has not reached a consensus in colorectal surgical practice. In the light of the preliminary results of the CRO7 trial, we undertook a national questionnaire survey to assess the current pattern of practice in the UK. The aim of this study was to assess the correlation between CRO7 trial results and current practice amongst consultant members of the Association of Coloproctology of Great Britain and Ireland (ACPGBI).