Quality of information available over internet on laparoscopic cholecystectomy

Background: The purpose of this study was to evaluate the quality of information available on the internet to patients undergoing laparoscopic cholecystectomy. Materials and Methods: The sources of information were obtained the keyword 'laparoscopic cholecystectomy', from internet searches using Google, Bing, Yahoo!, Ask and AOL search engines with default settings. The first 50 web links were evaluated for their accessibility, usability and reliability using the LIDA tool (validation instrument for healthcare websites by Minervation).The readability of the websites was assessed by using the Flesch Reading Ease Score (FRES) and the Gunning Fog Index (GFI). Results: Of the 250 links, 90 were new links. Others were repetitions, restricted access sites or inactive links. The websites had an average accessibility score of 52/63 (83.2%; range 40-62), a usability score of 39/54 (73.1%; range 23-49) and a reliability score of 14/27 (51.6%; range 5-24). Average FRES was 41.07 (4.3-86.4) and average GFI was 11.2 (0.6-86.4). Discussion and Conclusion: Today, most people use the internet as a convenient source of information. With regard to health issues, the information available on the internet varies greatly in accessibility, usability and reliability. Websites appearing at the top of the search results page may not be the most appropriate sites for the target audience. Generally, the websites scored low on reliability with low scores on content production and conflict-of-interest declaration. Therefore, previously evaluated references on the World Wide Web should be given to patients and caregivers to prevent them from being exposed to commercially motivated or inaccurate information

Surgical Implications of COVID-19

At present, the world is in the midst of a COVID-19 pandemic. However, the incidence of surgically treated disorders remains the same. In many countries resources, which were otherwise available to surgical patients, have been allocated to COVID-19 patients. Therefore, surgical resources need to be prioritized for the most-needy surgical patients. Surgical and obstetric emergencies need to be attended to without delay. Urgent operations also need to be performed to save life or limb. Semi-elective operations including oncological surgeries need to be performed within 4 weeks, whilst many elective surgeries can be safely delayed. Regional anaesthesia is preferable to general anaesthesia during the epidemic as it carries a lower risk of disease transmission. Strict infection control measures should be adopted in the operating theatre. Although there were initial concerns about the safety of minimal access surgery, recent evidence indicates that it is safe during this epidemic. Lung transplantation has been preformed successfully in a few patients with severe COVID-19 pneumonia but there is insufficient evidence to justify its more widespread use. Most pregnant COVID-19 women who delivered, did so successfully by caesarian section under spinal anaesthesia. Surgical care during this epidemic has to be customized to suit the individual setting

A Large Dengue Epidemic Affects Sri Lanka In 2017

Sri Lanka experienced its largest dengue epidemic in 2017 with 110,372 reported cases and 301 deaths during the first seven months. Several factors including a change in the dengue virus serotype, unusually heavy monsoon rains and failure to control mosquito breeding sites may have contributed to the magnitude of this epidemic. We describe aspects relating to this large dengue epidemic and the control measures taken to combat it

Favipiravir in Covid-19

The SARS-Cov-2 virus, emerged in December 2019 in Wuhan, China and has now spread to all parts of the world. Many research groups are carrying out intense research on drugs and vaccines to treat or prevent Covid-19. We have outlined aspects relating to Favipiravir, in treating RNA viral infections and its potential role in controlling SARS-Cov-2 infections

Molecular Diagnosis of COVID-19

The SARS-CoV-2 coronavirus causes COVID-19. Nucleic acid amplification tests (NAAT), could be used to detect the presence of SARS-CoV-2 viral RNA in clinical samples. Several real-time reverse transcriptase-polymerase chain reaction (rRT-PCR) assays are being used by many laboratories for confirming COVID-19. We have outlined the characteristics of the available SARS-Cov-2 rRT-PCR assays and discussed its clinical utility

False Gastric Diverticulum Arising from the Pylorus Associated with Gastric Outlet Obstruction

A gastric diverticulum is an outpouching from the stomach wall. It is usually seen in the posterior gastric wall and the gastric antrum. Diverticula arising from the pyloric region are extremely rare. A 59-year-old female presented with progressively worsening symptoms of gastric outlet obstruction associated with dyspepsia and vague abdominal pain for 5 years. A large, thin-walled, wide-mouthed, false gastric diverticulum (filled with undigested food) arising from the pylorus associated with gastric outlet stenosis was found by endoscopy and CT imaging. Multiple biopsies from the region excluded a gastric malignancy. A gastrojejunostomy and jejunojejunostomy were performed to bypass the obstruction which successfully relieved the symptoms. This is an unusual site for gastric diverticula, and when associated with gastric outlet obstruction, further distention of the diverticulum may cause more obstruction with worsening symptoms

Crohn’s Disease in South Asia

Crohn’s disease (CD) is a highly complex disease of unknown aetiology. We analysed the epidemiology, clinical characteristics, diagnosis, treatment and pathogenesis of Crohn’s disease in South Asia compared to the rest of the world.The PubMed database and Google scholar were searched till March 2016 for articles on CD. Articles dealing with CD in South Asians were reviewed by the authors, critically analyzed and then summarized.There is a lower incidence of CD in South Asia compared to the West and disease characteristics differ. Although novel genetic factors associated with CD have been identified, significant gaps exist in relation to disease pathogenesis, molecular genetic mechanisms and the use of evidence based treatment modalities.Our review provides a comprehensive overview of existing knowledge on CD in South Asia and identifies gaps in knowledge for future research 

Epidemiology, Pathogenesis and Treatment of Ulcerative Colitis in South Asia

Ulcerative colitis (UC) is a chronic inflammatory disorder of the colon and rectum. Its prevalence is on the rise in many non-Western countries and several factors such as changes in lifestyle and improvements in hygiene may account for this. The cultural and ethnic background of South Asia is different from Western countries and other parts of Asia. We have reviewed the scientific literature on UC in South Asia and describe its epidemiology, clinical characteristics, molecular mechanisms, diagnosis and treatment.