Reflections and Lessons Learnt from an International Medical Camp in Kazakhstan

This is the final version of the article. It first appeared from SciDoc Publishers via http://scidoc.org/IJOES-2332-290X-03-601.php#As a member of a team of 84 medical volunteers from the UK, USA, Canada and Russia, I travelled to Kazakhstan in August 2013 to take part in an international medical camp covering the town of Saran and nearby villages. Based in the Ophthalmology and Optometry clinics, I was able to gain a better understanding not only of ocular pathology, but also of the attributes needed for a successful medical camp. In this article, I reflect upon the role of the ophthalmologist, medical student and general volunteer in forming a shared collaboration with local doctors and patients, and consider lessons that can be implemented in daily clinical practice

COGNITIVE IMPAIRMENT FOLLOWING USE OF ANAESTHETIC AGENTS: A REVIEW OF THE LITERATURE, AND IMPLICATIONS FOR FUTURE PRACTICE

Emerging data suggest that both inhalational and intravenous anaesthetics are associated with cognitive decline, particularly in the elderly. Of particular concern, is the phenomenon known as post-operative cognitive decline (POCD), characterised by a transient impairment of memory, concentration, language comprehension and social integration. Implicated in the pathophysiology of POCD is the accumulation of Aβ peptide, and inhibition of cholinergic neurotransmission. Currently used anaesthetic agents differ in their propensity for causing POCD as a result of their differing pharmacological profiles. Coupled with increasing knowledge of patient susceptibility factors, this information allows for modification of clinical practice to minimise the long-term disability that may otherwise accompany POCD

COGNITIVE IMPAIRMENT FOLLOWING USE OF ANAESTHETIC AGENTS: A REVIEW OF THE LITERATURE, AND IMPLICATIONS FOR FUTURE PRACTICE

Emerging data suggest that both inhalational and intravenous anaesthetics are associated with cognitive decline, particularly in the elderly. Of particular concern, is the phenomenon known as post-operative cognitive decline (POCD), characterised by a transient impairment of memory, concentration, language comprehension and social integration. Implicated in the pathophysiology of POCD is the accumulation of Aβ peptide, and inhibition of cholinergic neurotransmission. Currently used anaesthetic agents differ in their propensity for causing POCD as a result of their differing pharmacological profiles. Coupled with increasing knowledge of patient susceptibility factors, this information allows for modification of clinical practice to minimise the long-term disability that may otherwise accompany POCD

Tablets at the bedside - iPad-based visual field test used in the diagnosis of Intrasellar Haemangiopericytoma: a case report

BACKGROUND: In the assessment of a pituitary mass, objective visual field testing represents a valuable means of evaluating mass effect, and thus in deciding whether surgical management is warranted. CASE PRESENTATION: In this vignette, we describe a 73 year-old lady who presented with a three-week history of frontal headache, and 'blurriness' in the left side of her vision, due to a WHO grade III anaplastic haemangiopericytoma compressing the optic chiasm. We report how timely investigations, including an iPad-based visual field test (Melbourne Rapid Field, (MRF)) conducted at the bedside aided swift and appropriate management of the patient. CONCLUSIONS: We envisage such a test having a role in assessing bed-bound patients in hospital where access to formal visual field testing is difficult, or indeed in rapid testing of visual fields at the bedside to screen for post-operative complications, such as haematoma

Color vision deficiency among doctors: Can we make useful adaptations to the color codes used in the clinical environment?

Color vision deficiency (formerly known as color blindness) is common as a congenital and as an acquired condition. Some professions, most famously commercial aviation, require their members to demonstrate normal color vision. In the USA and UK, no restriction is placed on the ability of the color-deficient doctor to practice medicine, though there is evidence that certain clinical discriminations are harder for such doctors. Generally ignored has been the difficulty, and the potential for error, that arises from the use of color codes in clinical equipment. In this review, we introduce the basic concepts of color deficiency, summarize evidence for the challenges it poses to the doctor, examine global variation in policy, show the potential for confusion among clinical color codes, and suggest how the current situation could be improved to enhance both patient safety and the wellbeing of the color-deficient doctor