The SCARE Statement: Consensus-based surgical case report guidelines

AbstractIntroductionCase reports have been a long held tradition within the surgical literature. Reporting guidelines can improve transparency and reporting quality. However, recent consensus-based guidelines for case reports (CARE) are not surgically focused. Our objective was to develop surgical case report guidelines.MethodsThe CARE statement was used as the basis for a Delphi consensus. The Delphi questionnaire was administered via Google Forms and conducted using standard Delphi methodology. A multidisciplinary group of surgeons and others with expertise in the reporting of case reports were invited to participate. In round one, participants stated how each item of the CARE statement should be changed and what additional items were needed. Revised and additional items from round one were put forward into a further round, where participants voted on the extent of their agreement with each item, using a nine-point Likert scale, as proposed by the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) working group.ResultsIn round one, there was a 64% (38/59) response rate. Following adjustment of the guideline with the incorporation of recommended changes, round two commenced and there was an 83% (49/59) response rate. All but one of the items were approved by the participants, with Likert scores 7–9 awarded by >70% of respondents. The final guideline consists of a 14-item checklist.ConclusionWe present the SCARE Guideline, consisting of a 14-item checklist that will improve the reporting quality of surgical case reports

The SCARE Statement: Consensus-based surgical case report guidelines

Introduction: Case reports have been a long held tradition within the surgical literature. Reporting guidelines can improve transparency and reporting quality. However, recent consensus-based guidelines for case reports (CARE) are not surgically focused. Our objective was to develop surgical case report guidelines.Methods: The CARE statement was used as the basis for a Delphi consensus. The Delphi questionnaire was administered via Google Forms and conducted using standard Delphi methodology. A multidisciplinary group of surgeons and others with expertise in the reporting of case reports were invited to participate. In round one, participants stated how each item of the CARE statement should be changed and what additional items were needed. Revised and additional items from round one were put forward into a further round, where participants voted on the extent of their agreement with each item, using a nine-point Likert scale, as proposed by the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) working group.Results: In round one, there was a 64% (38/59) response rate. Following adjustment of the guideline with the incorporation of recommended changes, round two commenced and there was an 83% (49/59) response rate. All but one of the items were approved by the participants, with Likert scores 7–9 awarded by >70% of respondents. The final guideline consists of a 14-item checklist.Conclusion: We present the SCARE Guideline, consisting of a 14-item checklist that will improve the reporting quality of surgical case reports.</p

Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study

Background Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide.Methods A multimethods analysis was performed as part of the GlobalSurg 3 study-a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital.Findings Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3.85 [95% CI 2.58-5.75]; p&lt;0.0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63.0% vs 82.7%; OR 0.35 [0.23-0.53]; p&lt;0.0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer.Interpretation Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised

Blunt abdominal trauma: Back to clinical judgement in the era of modern technology

AbstractBackground and methodsAbdominal trauma poses a diagnostic challenge to most trauma surgeons. This study evaluates a clinical scoring system in 476 blunt abdominal trauma patients treated by the author over a period of 92 months. Patients were sorted into three groups according to the score results. Priority I group (160 patients) was subjected to an immediate laparotomy. Priority II group (200 patients) was treated according to the results of auxiliary investigations. Priority III group (116 patients) was kept under observation. The treatment outcome was used as a gold standard for the evaluation of the results.ResultsIn priority I and III groups (276 cases) the management was only dependent on the proposed clinical score with a 100% specificity, 88% sensitivity, 90% positive predictive value, 100% negative predictive value and an overall accuracy of 94%.ConclusionsThis scoring system (CASS) is helpful in ensuring rapid diagnosis and treatment, reduces time, costs and mortality that may result from improper and/or delayed diagnosis

Biomedical research ethics: An Islamic view – part I

AbstractMost of the currently accepted western basic principles of ethics in research are consistent with the instructions of Islam. This statement may come as a surprise to some western researchers. In this article, I will discuss why Islam rejects secularization and this is not because the ethical principles embedded in Islam's teachings are archaic and out of touch with current realities. In addition, I will point out the agreement between general broad principles of research ethics and Islamic teachings concerning life; this would show clearly that Islam has addressed the regulation of ethics in research more than 14 centuries ago

Supporting Sustainable selection for lubricants in automotive industry : Constant velocity joint grease as a case study

Sustainability within automotive industry has been an important topic that is covered in several studies. Due to the multi-aspect nature of sustainability and the variety of the factors need to be taken in consideration when choosing a material, the decision-making process could be challenging. This study focuses on lubricants within the automotive industry and proposes a framework consisted of three milestones that aspire to assist automotive manufacturers in sustainable lubricant selection. The study uses LCA as an environmental assessment tool for fully formulated lubricants and multicriteria decision matrix to include other criteria indicators in the decision-making process quantitively. The study also contributes to the literature by performing LCA for fully formulated lubricants. The framework was applied on well-established case company within the automotive industry (Volvo Cars Corporation) in Sweden. The results showthe importance and significant impacts of the inclusion of the additives in LCA studies done on lubricants using CV joint grease as a case study. It also shows the effect of the organisational preferences on the final results of the framework

Supporting Sustainable selection for lubricants in automotive industry : Constant velocity joint grease as a case study

Sustainability within automotive industry has been an important topic that is covered in several studies. Due to the multi-aspect nature of sustainability and the variety of the factors need to be taken in consideration when choosing a material, the decision-making process could be challenging. This study focuses on lubricants within the automotive industry and proposes a framework consisted of three milestones that aspire to assist automotive manufacturers in sustainable lubricant selection. The study uses LCA as an environmental assessment tool for fully formulated lubricants and multicriteria decision matrix to include other criteria indicators in the decision-making process quantitively. The study also contributes to the literature by performing LCA for fully formulated lubricants. The framework was applied on well-established case company within the automotive industry (Volvo Cars Corporation) in Sweden. The results showthe importance and significant impacts of the inclusion of the additives in LCA studies done on lubricants using CV joint grease as a case study. It also shows the effect of the organisational preferences on the final results of the framework

SPE and HPLC monitoring of 17-β-estradiol in Egyptian aquatic ecosysetms

Solid-phase extraction and HPLC methods are described for monitoring of 17-β-estradiol residues in Egyptian aquatic ecosystems (water, fish, mollusks, sediment, and drinking water) at the Nile River, Suez Canal region, and northeast of Egypt. Molecular imprinted polymer was prepared and used in extraction. High performance liquid chromatography (HPLC) columns used were Supelcosil C18 and Nucleosil C18. The mobile phases used were different combinations of water and acetonitrile. The concentration of 17-β-estradiol in water, aquatic animals, and sediment samples were of 265.13–7988.12 µg/L, 0.503–96.167, and 0.775–11.884 µg/kg, respectively. Marine lake was contained with high levels of 17-β-estradiol (P < 0.05). Similarly, the Nile River downstream showed high levels of 17-β-estradiol. The detected concentrations in mollusks were significantly higher than those detected in fish. Tilapia fish did not show 17-β-estradiol. Contrarily, low concentrations were detected in the rivulet streams supplied by the Nile River. Besides, 17-β-estradiol was also detected in the sediments at low levels. Detection of 17-β-estradiol in the Egyptian ecosystems attracted attention toward heavy reliance on some esterogenic medicinal products in Egypt. The monitoring of 17-β-estradiol in other water bodies was recommended. Besides, the development of methodologies of bioremediation to eliminate 17-β-estradiol from the Egyptian and other water resources of the world was also suggested