Cell Transplantation Therapies to Reverse Type 1 Diabetes: A review

Stem cell technology is demonstrating promising advancements in cure of diseases due its differentiation ability. Type 1 diabetes is mainly caused by autoimmune β cells destruction. In this review, we focus on treatment procedures of Type 1 Diabetes (T1D) with numerous stem cells (SCs) i.e hPSCs, MSCs, hESCs, BMSCs, AFSCs, HSCs and islet cells (that are not stem cells but they are approved worldwide and are being successfully used to permanently reverse T1D). A brief overview of this disease along with the advancements in treatment of T1D with stem cells is discussed. Biomaterial encapsulation to avoid immune rejection and improved immunomodulation and immune tolerance via drugs /bioengineering techniques makes the outcomes of SC therapies more efficient and productive, hence, proving to be another future milestone of completely reversing type 1 diabetes especially in those patients who got clinically diagnosed at an early stage and then received prompt treatment of either restoration of already available β cells functionality or transplantation of purified and functional SCs differentiated insulin producing cells to normalize the glycemic control and homeostasis

Harassment and mental health in surgical training: A pilot survey of surgical trainees in Pakistan

Objective: To assess harassment among surgical trainees and its effects on mental health, and to explore its association with gender.Methods: The nationwide cross-sectional pilot study was conducted by the Association of Women Surgeons of Pakistan from July to September 2019, and included surgical trainees of either gender working in both public and private hospitals. Data was collected using an anonymous online survey form to assess harassment and self-perceived burnout and depression. Data was analysed using SPSS 22.Results: Of the 147 respondents, 49(33.3%) were males; 98(66.6%) were females; and 118(80.3%) were residents. Workplace harassment was reported by 80(54.4%) trainees. Among the males it was reported by 24(49%) and among the females by 56(57%) (p=0.349). Of those having faced harassment, 9(11.3%) reported it to the administration. Severe self-perceived burnout was reported by 102(69.4%) respondents, and severe self-perceived depression by 69(46.9%). Respondents experiencing bullying were more likely to report severe self-perceived burnout than those not experiencing bullying (p=0.02). Multivariable logistic regression showed female gender to be significantly associated with sexual harassment (odds ratio: 4.261 [95% confidence interval: 1.067-17.019]) and severe self-perceived depression (odds ratio: 5.052 [95% confidence interval: 1.187-21.503]). Need for a support group was identified by 134(91.2%) trainees.Conclusions: An overwhelming need was found for trainee surgeon support groups and other interventions targeted at improving the workplace environment for surgical trainees in Pakistan

Reducing post-operative length of stay, is it worth the effort?

Background: Studies show that reducing the length of hospital stay (LOS) for surgical patients leads to cost savings. We hypothesize that LOS has a nonlinear relationship to cost of care and reduction may not have a meaningful impact on it. We have attempted to define the relationship of LOS to cost of care. We utilized the itemized bill, generated in real time, for hospital services.Materials: Adult patients admitted under General, Neuro, and Orthopedic surgery over a 3-month period, with an LOS between 4 and 14 days, were the study population. Itemized bill details were analyzed. Charges in Pakistani rupees were converted to US dollar. Ethical exemption for study was obtained.Results: Of the 853 patients, 38% were admitted to General Surgery, 27% to Neurosurgery, and 35% to Orthopedics. A total of 64% of the patients had an LOS between 4 and 6 days; 36% had an LOS between 7 and 14 days. Operated and conservatively managed constituted 82% and 18%, respectively. Mean total charge for operated patients was higher $3387 versus$1347 for non-operated ones. LOS was seen to have a nonlinear relationship to in-hospital cost of care. The bulk of cost was centered on the day of surgery. This was consistent across all services. The last day of stay contributed 2.4%-3.2% of total charge.Conclusions: For surgical patients, the cost implications rapidly taper in the postoperative period. The contribution of the last day of stay cost to total cost is small. For meaningful cost containment, focus needs to be on the immediate perioperative period

Cultural barriers for women in surgery: How thick is the glass ceiling? An analysis from a low middle-income country

Background: This study aimed to highlight cultural barriers faced by surgeons pursuing a surgical career faced by surgeons at a tertiary care hospital in Pakistan. As more females opt for a surgical career, barriers faced by female surgeons are becoming increasingly evident, many of which are rooted in cultural norms. In Pakistan, a predominantly Muslim-majority, low middle-income country, certain societal expectations add additionally complexity and challenges to existing cultural barriers.Methods: A cross-sectional survey was administered via e-mail to the full-time faculty and trainees in the Department of Surgery at the Aga Khan University Hospital, Karachi, Pakistan, from July 2019 to November 2019.Results: In total, 100 participants were included in this study, with the majority being residents (55.6%) and consultants (33.3%). 71.9% of female surgeons felt that cultural barriers towards a surgical career existed for their gender, as compared to 25.4% of male surgeons (p \u3c 0.001). 40.6% of females reported having been discouraged by family/close friends from pursuing surgery, as compared to only 9.0% of males (p \u3c 0.001). Moreover, a greater percentage of females surgeons were responsible for household cooking, cleaning and laundry, as compared to male surgeons (all p \u3c 0.001). Lastly, 71.4% of female surgeons felt that having children had hindered their surgical career, as compared to 4.8% of males (p \u3c 0001).Conclusion: Our study shows that significant cultural barriers exist for females pursuing a surgical career in our setting. Findings such as these emphasize the need for policy makers to work towards overcoming cultural barriers