Andragogy (Adult Learning)

oai:ojs.pkp.sfu.ca:article/1Adult learning is frequently taken as a separate domain having very little connection to learning in childhood and adolescence. Adults have special needs and requirement as learners. In this editorial an attempt has been made to examine critically, how adult learning is different, in the light of Knowles five assumptions of andragogy and various learning theories.1, 2 It also highlights how learning principles derived can be used in actual practice to improve patient outcome. It explores three important issues embedded in Knowles five assumptions; (1) what are important characteristics of an adult learner? (2) What can learning/teaching strategies be used for effective learning in adults? And (3) how an effective teacher can enhance learning in adults

Huge Retroperitoneal Lymphangioma Presenting With Duodenal Obstruction: a case report.

lymphangiomas are benign tumors caused by the congenital proliferation of lymphatic tissue, causing an obstruction in the lymphatic ducts, producing fluid filled cysts (1). Histologically they are polycystic, with cysts divided by thin septas lined with endothelial cells. Most common presentation of cystic lymphangiomas are in the neck (75%) and axillary region (20%) and only 5% are intra-abdominal, while retroperitoneal lymphangiomas account for only 1% of cases (2). It is more common in children with males affected more than women, while women have shown to encounter pancreatic lymphangiomas more than men (3). Often retroperitoneal lypmhangiomas are asymptomatic but due to their large size they might cause a wide variety of symptoms from mild abdominal distention/discomfort and back pain to duodenal obstruction, sepsis and DIC (4). Diagnostic techniques are ultrasound, CT scan and MRI but often it is found accidentally and definitive diagnosis is made post-operatively. Treatment of choice is complete surgical resection with cystectom

Outcomes of post-neurosurgical ventriculostomy-associated infections

Background: Ventriculostomy-associated infection (VAI) is a major concern to physicians. Limited studies have looked at the outcomes of external ventricular drain (EVD) infection and predictors of unfavorable outcomes. In this study, we assessed the outcomes of EVD infection and predictors of unfavorable outcomes.Methods: This was a retrospective medical chart review, conducted at the Aga Khan University Hospital. All the patients irrespective of age and gender, fulfilling the diagnostic criteria of VAI were included. Patients with preexisting bacterial meningitis or ventriculitis were excluded from the study. Outcome assessment was based on Glasgow outcome scale (GOS) at 1 and 3 months after procedure. Other outcomes included 30-day mortality and total length of hospital stay.Results: We included 256 patients in the study. 66 patients (25.8%) developed VAI. EVD was the primary procedure in 21 (31.8%) cases. Most patients, 24 (36.4%), had EVD as a secondary procedure for tumor surgery. Median interval between EVD placement and diagnosis of infection was 3 days. Mean length of stay in VAI patients was 31.85 ± 20.53 days. Seven patients required ICU care. Ten patients (15.2%) expired during hospital stay or within 30 days of discharge and further four had GOS of 2 or 3. A total of 52 patients had a favorable outcome after 6 months.Conclusions: Rate of VAI in this cohort was high. VAI is associated with increased morbidity, mortality, and prolonged hospital stay

Andragogy (Adult Learning)

Adult learning is frequently taken as a separate domain having very little connection to learning in childhood and adolescence. Adults have special needs and requirement as learners. In this editorial an attempt has been made to examine critically, how adult learning is different, in the light of Knowles five assumptions of andragogy and various learning theories.1, 2 It also highlights how learning principles derived can be used in actual practice to improve patient outcome. It explores three important issues embedded in Knowles five assumptions; (1) what are important characteristics of an adult learner? (2) What can learning/teaching strategies be used for effective learning in adults? And (3) how an effective teacher can enhance learning in adults

The accessibility and safety of inserting proximal basilic and axillary veins central lines in neonates

Objectives: to evaluate the accessibility, success rate, and attributable complications and to describe the maneuver for central line insertion via proximal basilic or axillary veins in neonates. Methods: This retrospective study included all infants admitted to the neonatal intensive care unit and had an axillary central line inserted or attempted. Success rate, complications, and outcomes were reviewed. Results: Axillary central line was attempted in 85 infants and was successful in 78 infants with a success rate of 91.7%. The median postnatal age of patients was 8 days (2 days–92 days), and the median weight of patients at the procedure was 2600 g (590 g–3900 g). The median corrected gestational age of patients at the procedure was 36 weeks (23 weeks–46 weeks). No serious complication was observed in any of the 85 infants. Conclusion: This study demonstrated a high success rate for insertion of proximal basilic and axillary veins central lines in neonates with difficult vascular access. This procedure was feasible in very low birth and extremely low birth preterm infants, especially in those who failed previous central line attempts