Corporate Social Responsibility in Sri Lanka: A case for Peacebuilding

Violent conflict has plagued Sri Lanka for much of the last half-century. There have been several axes of conflict, some of which became militarised (the Janatha Vimukthi Peramuna insurgencies in the 1970s and 1980s, and the current war with the Liberation Tigers of Tamil Eelam, or LTTE), and some that remained latent (the grievances of the Malayaga or ‘Hill Country’ Tamils, for example). A legacy of militarised violence, assassinations, state repression and ‘party political’ violence has impacted on all aspects of Sri Lankan society. As a consequence, the socio-political and, to some degree, the economic fabric of the country is fragile at best

The relationship between maternal characteristics and carotid intima-media thickness using an automated ultrasound technique

Objective: To investigate CIMT and its relationship with maternal demographic characteristics in healthy pregnancy. Methods: CIMT was measured using an au. Results: CIMT showed no relationship with gestational age (rho=−0.124, p=0.335), parity (Z=−0.055, p=0.960) and MAP (rho=0.110, p=0.393). A relationship was found between CIMT and maternal age (rho=0.277, p=0.028), booking BMI (rho=0.278, p=0.027), and BMI at time of study (rho=0.287, p=0.023). CIMT ranged from 0.30-0.80mm, the 97.5th percentile was 0.63 mm. Conclusion: In healthy pregnancy, we reported CIMT was related to BMI and maternal age but not parity or gestational age

Maintaining safe lung cancer surgery during the COVID-19 pandemic in a global city.

Background: SARS-CoV-2 has challenged health service provision worldwide. This work evaluates safe surgical pathways and standard operating procedures implemented in the high volume, global city of London during the first wave of SARS-CoV-2 infection. We also assess the safety of minimally invasive surgery(MIS) for anatomical lung resection. Methods: This multicentre cohort study was conducted across all London thoracic surgical units, covering a catchment area of approximately 14.8 Million. A Pan-London Collaborative was created for data sharing and dissemination of protocols. All patients undergoing anatomical lung resection 1st March-1st June 2020 were included. Primary outcomes were SARS-CoV-2 infection, access to minimally invasive surgery, post-operative complication, length of intensive care and hospital stay (LOS), and death during follow up. Findings: 352 patients underwent anatomical lung resection with a median age of 69 (IQR: 35-86) years. Self-isolation and pre-operative screening were implemented following the UK national lockdown. Pre-operative SARS-CoV-2 swabs were performed in 63.1% and CT imaging in 54.8%. 61.7% of cases were performed minimally invasively (MIS), compared to 59.9% pre pandemic. Median LOS was 6 days with a 30-day survival of 98.3% (comparable to a median LOS of 6 days and 30-day survival of 98.4% pre-pandemic). Significant complications developed in 7.3% of patients (Clavien-Dindo Grade 3-4) and 12 there were re-admissions(3.4%). Seven patients(2.0%) were diagnosed with SARS-CoV-2 infection, two of whom died (28.5%). Interpretation: SARS-CoV-2 infection significantly increases morbidity and mortality in patients undergoing elective anatomical pulmonary resection. However, surgery can be safely undertaken via open and MIS approaches at the peak of a viral pandemic if precautionary measures are implemented. High volume surgery should continue during further viral peaks to minimise health service burden and potential harm to cancer patients. Funding: This work did not receive funding

Corporate Social Responsibility in Sri Lanka: A case for Peacebuilding

Violent conflict has plagued Sri Lanka for much of the last half-century. There have been several axes of conflict, some of which became militarised (the Janatha Vimukthi Peramuna insurgencies in the 1970s and 1980s, and the current war with the Liberation Tigers of Tamil Eelam, or LTTE), and some that remained latent (the grievances of the Malayaga or ‘Hill Country’ Tamils, for example). A legacy of militarised violence, assassinations, state repression and ‘party political’ violence has impacted on all aspects of Sri Lankan society. As a consequence, the socio-political and, to some degree, the economic fabric of the country is fragile at best

Pelvic floor examination performed by medical students: a model to obtain consent

Swina Santhirakumaran, Harkaran Singh Kalkat, Vinay Jamnadas Sonagara Department of Undergraduate Medicine, Faculty of Medicine, Imperial College London, London, UK Abstract: Student-led clinical examinations, including pelvic floor examinations, are an integral part of clinical training and can be beneficial to both students and patients alike. However, our experience and previous literature catalog numerous obstacles in obtaining consent for student-led pelvic floor examinations. Although some of these factors may not be modifiable, it is evident that efforts can be made to overcome those that are. An examination of these obstacles can help to provide a clear and succinct template to overcoming them: we propose a “5-Rs” framework that may bridge the apparent gap between the students’ need to practice and obtain valid consent. Keywords: consent, teaching, pelvic floor examinatio

The value of near-peer teaching in the medical curriculum

Vinay Jamnadas Sonagara, Swina Santhirakumaran, Harkaran Singh Kalkat Department of Undergraduate Medicine, Faculty of Medicine, Imperial College London, London, UK According to the General Medical Council’s guide for “Good Medical Practice”, doctors are expected to partake in active mentoring roles and contribute to the education of other training doctors.1 This reflects the fact that medical education is an apprenticeship where the vertical transmission of knowledge from peers and colleagues contributes to a large proportion of the necessary clinical training. Therefore, peer teaching skills should be inculcated from an early stage. At Imperial College London, student-led societies encourage the cohort to take on mentoring and teaching roles to students in earlier years, in the form of near-peer teaching. However, this near-peer teaching largely remains a voluntary undertaking. Given the importance of these skills, there is an argument to be made that such tutoring schemes ought to form a more extensive and mandatory part of the medical syllabus

The use of distractors in multiple-choice questions: a medical student perspective

Harkaran Singh Kalkat, Vinay Jamnadas Sonagara, Swina Santhirakumaran  Department of Undergraduate Medicine, Faculty of Medicine, Imperial College London, London, UK We read with considerable interest the study by Rahma et al that aimed to assess the impact of varying the number of distractors in multiple-choice questions (MCQs).1 It was noticeable that in reducing the number of distractors from four to three, the discriminatory power of the examination increased, while the number of nonfunctional distractors was reduced. In demonstrating this, the group sheds an important light on the need for higher-quality distractors in making assessments adequately discriminatory and reliable. Indeed, as fourth-year medical students who have undertaken many diverse formats of MCQs, we concur that the quality of distractors, as opposed to their quantity, has a greater bearing on the depth of knowledge required to arrive at an answer. View the original paper by Rahma and colleagues.&nbsp