SUMMARY

Cushing’s syndrome is a pathological condition associated with excessive cortisol production, the commonest etiology being Cushing’s disease. Corticosteroids in high doses have been used in the management of Steven Johnson Syndrome (SJS) with favourable outcome. We describe a patient with Cushing’s disease who developed SJS, one week after taking sperulina a product from sea-weed while waiting for transphenoidal surgery. KEY WORDS

The Importance of Theory to Inform Practice – Theorizing the Current Trends of Clinical Teaching: A Narrative Review

Clinical teaching lies at the heart of physicians’ training; however, it is often opportunistic, haphazard, and lacks a theoretical foundation. Medical education is a profession that requires robust scientific methods and an evidence-based approach driven by accountability and patient safety concerns in the healthcare provision nowadays. Learning theories are increasingly applied in the realm of medicine with implications to the quality of teaching and learning in the clinical environment and the professional growth of medical graduates. These theories elucidate the basic tenets ambient to the intricate process of learning and answer some basic questions of how people learn. Educational theories provide a myriad of benefits to the teaching and learning approaches in the clinical environment. It arms teachers with a repertoire of educational tools and sets out principles to justify their use and predict the conditions under which they may likely work. It enables clinicians to design their teaching based on well-developed objectives and robust methods for their evaluation. As such, learners’ capacity to achieve clinical competence is enhanced and their identity formation and other essential attributes of clinical expertise are potentiated. However, it has been reported that learning theories are neither well-articulated in clinical teaching nor educators and clinicians are formally trained on their application in the clinical context. Continuous professional development and faculty training about learning theories are essential to lift their capability to teach effectively in the clinical environment. This article revisited the main learning theories and discusses their application to enhance teaching and learning in the clinical context.  Key words: clinical teaching, educational perspectives, learning theorie

Mentorship Compact Between Cancer Diseases Hospital Registrars and Their Mentors

https://openworks.mdanderson.org/mozart/1016/thumbnail.jp

Empyema thoracis presented as giant back abscess

Empyema thoracis (ET) is defined as pus in the pleural space, either localized or involving the entire pleural cavity, due to diverse etiologies. In severe form, it may infiltrate the extra- pulmonary region. Clinical guideline describes 3 stages of parapneumonic effusion before developing into an ET, namely the exudative stage, the fibrinopurulent stage, and the orga- nizing/late stage. We highlight a 59-year-old gentleman who presented a back swelling masquerading as a deep-seated abscess, in which the diagnosis of ET had not been established early. The principles of treatment are treating the underlying condition such as pneumonia, pleural drainage and debridement, full re-expansion of the collapsed lung by performing chest physiotherapy, and improving nutrition. ET is a condition with a dynamic process due to diverse etiologies, either localized or involving the entire pleural cavity. The gold standard in diagnosing ET is the pleural aspiration of fluid from the pleural space, whereas the management of ET may include non-surgical and/or surgical treatments based on the basic principles of ET treatment

Intraocular pressure changes in patients undergoing cataract extraction and lens implantation: laryngeal mask airway versus endotracheal tube

ABSTRACT Objectives: To investigate the influence on intraocular pressure (IOP) of airway management with a laryngeal mask airway (LMA) or tracheal tube (ETT), and secondly to compare the devices with regard to their impact on IOP. Results: There was a small increase in mean IOP in the LMA group, which was statistically insignificant. However there was a significant rise in mean IOP in the ETT group (p = 0.0001) which returned to almost pre-insertion levels at 2 minutes. Conclusions: The LMA causes minimal changes in intraocular pressure when used to secure the airway during cataract surgery. The rise in IOP following tracheal intubation is significant, yet transient and probably clinically insignificant

Renal Cell Carcinoma in Young Patients is Associated with Poorer Prognosis

Abstract Introduction: Renal cell carcinoma (RCC) in young patients is uncommon but thought to represent a distinctive clinical entity from older patients with different clinico-pathologic features and outcomes. We evaluated the association of age at the time of diagnosis with pathological staging, histological parameters, disease recurrence and overall survival (OS) following radical or partial nephrectomy for non-metastatic RCC in native kidneys. Materials and Methods: A retrospective review of 316 patients with RCC after nephrectomy at a single institution between January 2001 and June 2008 was performed. Eligible patients included all histologically proven primary non-metastatic RCC treated by radical or partial nephrectomy. They were categorised into group A (≤40 years at diagnosis) and B (>40 years). Differences in clinical parameters were analysed using the Mann Whitney U test. The prognostic potential of age at diagnosis was evaluated using Cox proportional hazards regression. Survival was estimated using the Kaplan Meier method. Results: There were 33 patients in group A and 283 patients in group B. There were more non-clear cell tumours in the younger group (30% vs 14%, P <0.05). No statistical differences were found in the stage and grade of both groups. At a median follow-up time of 41 months, the younger group had a higher metastatic rate (18% vs 10.5%, P <0.05), lower 5-year cancer-specifi c survival (82% vs 98%, P <0.05) and lower 5-year OS (82 % vs 95%, P <0.05). Conclusion: Younger patients were more likely to have non-clear cell RCC with higher disease recurrence and lower OS. They should not be assumed to have similar features and outcomes as screen-detected early RCC in older patients

How to Make Epidemiological Training Infectious

In this fun, interactive exercise, students simulate an infectious disease outbreak among themselves that conceptually integrates two historically distinct fields in epidemiology