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Journal articles on the topic 'College of Physicians and Surgeons (Pakistan)'

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Published: 4 June 2021

Last updated: 1 February 2022

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1

Chaudhry, Zafar Ullah. "Establishing a System of Postgraduate Medical Education in Pakistan." Journal of Medical Regulation 101, no. 3 (September 1, 2015): 37–40. http://dx.doi.org/10.30770/2572-1852-101.3.37.

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Postgraduate Medical Education (PGME) and specialist care made a late beginning in developing countries and has progressed quite slowly, compared to the developed world. Historically, medical graduates in developing countries desiring to pursue PGME had to travel to Western centers to acquire specialist qualifications; and after having spent a significant time period it became difficult for them to return from those settings, resulting in “brain drain” from the developing nations and a loss of national resources. The status of overall medical education in Pakistan was dismal at the time of its independence in 1947. Pakistan inherited only a few undergraduate medical colleges, and none offered any postgraduate qualification. The majority of doctors seeking postgraduate education preferred to go to England and the United States. In this situation, the College of Physicians and Surgeons, Pakistan (CPSP) was established in 1962 as an autonomous corporate body to cater to the needs of PGME and to provide specialists for the health care needs of the country. The college started offering fellowship and membership programs in different fields of medicine and dentistry — a hallmark of the College System of PGME, which focuses primarily upon rigorous clinical training. It has succeeded in achieving high standards in PGME and specialization, making its qualifications at par with the institutions of the developed world. This paper describes the policies and strategies adopted by the College to earn recognition for its qualifications, both within the country and in the international community.

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2

ZAREEN, NUSRAT. "TESTICULAR MORPHOLOGY." Professional Medical Journal 16, no. 02 (June 10, 2009): 289–92. http://dx.doi.org/10.29309/tpmj/2009.16.02.2945.

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Objective: To study the effects of mobile phone induced Electromagnetic fields (EMFs) on testis of young mice. Settings: Department of Anatomy, College of Physicians and Surgeons Pakistan, Regional Centre, Islamabad. Period: January to June, 2008. Study Design: Experimental animal study. Materials & Methods: This study was conducted on two groups of young BALB-c (6 weeks of age) purchased from National Institute of Health Islamabad. These animals were divided into two groups control and treated, each consisting of twenty animals. The treated group was exposed for one month to mobile phone induced EMFs by placing a mobile phone in the floor of the cage. This phone was rung upon from any other line or cell phone twice daily for 15 minutes. The control group was kept under identical conditions except for mobile phone on the cage floor. Results and observations: Histological comparison of testis of the both group animals showed a significant increase, in the number of tubules with sperms in the lumen, increased sub capsular congestion of vessels, presence of vacuolation and giant cells in germinal epithelium and abnormal cells in the lumen of seminiferous tubules of the treated group. Conclusion: The results indicate altered testicular morphology of the EMFs exposed mice.

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Aslam, Uzma, Nausheen Henna, Aman-ur Rehman, Saniyah Ali, Shireen Hamid, and Saroash Iqbal. "Frequency of fungal infections in nasal polypi." Professional Medical Journal 26, no. 12 (December 10, 2019): 2231–34. http://dx.doi.org/10.29309/tpmj/2019.26.12.4203.

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Objectives: Determine the frequency of fungal infections in nasal polypi. Study Design: Cross sectional study. Setting: Histopathology Department at Shaikh Zayed Hospital Lahore. Period: Six months from 12/2/2015 to 12/8/2015. Material & Methods: Two hundred surgical resections/biopsies using 95% confidence level, with 7% margin of error were collected. Formalin fixed specimens of patients of both genders and 10- 60 years of age with nasal polyps received after surgical procedure in department of ENT. Grossing and processing was done. Hematoxyin & Eosin stained sections were examined by two consultant Histopathologists independently. The presence of fungal hyphae was confirmed by PAS and Silver stains. The study was approved by College of Physicians & Surgeons Pakistan. All the data was entered and analyzed by using SPSS version 20. Results: Out of 200 patients all the patients showed the prescence of inflammatory cells in polyps (100%) with predominantly eosinophils in their submucosa (82%). Fungus was present in 48 cases (24%) most of them were in the age group of 42-57 years (13%) and 31(15.5%) patients having BMI <30 and 17(8.5%) having BMI >30 were positive for fungus.30 cases were of Aspergillus (62.5%) and rest 8 were of Mucor (37.5%). The fungus positive cases were more in males (13.5%). 160 of the cases were of unilateral polyps (80%) and 40 were of bilateral polypi (20%). Only 8% of the patients having diabetes had fungal infection. Conclusion: Hence, the frequency of fungal infection in nasal polypi is low with Aspergillus being the commonest pathogen affecting males predominantly.

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4

Ashraf, Tariq, and Muhammad Ishaq. "ORAL ANTICOAGULANTS: CHALLENGES IN PAKISTAN. DO WE HAVE A SOLUTION?" Pakistan Heart Journal 54, no. 2 (June 24, 2021): 124–25. http://dx.doi.org/10.47144/phj.v54i2.2085.

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The common public health problem in thromboembolic disorders (TED) are venous thromboembolism (VTE) and stroke caused by Atrial Fibrillation (AF).1 The main stay of treatment among oral anticoagulants are Vit K antagonist (VKAs) like warfarin and acenocoumarin, warfarin has been the most commonly used drug particularly in Pakistan. However now Non Vitamin K dependent oral anticoagulants (NOACs) such as dabigatrin, rivaroxaban and apixaban have come in to use.2 Till now VKAs are most extensively used in developing countries like India3 & Pakistan because of their effects can easily be reversed, and they are safe in impaired renal function besides being cost effective. The problems encountered with VKAs relate to dietary patterns in the region resulting in drug interaction, over usage of non-steroidal anti-inflammatory drugs (NSAIDs) and most important the lack of lab facilities to monitor international normalized ratio (INR), and finally the lack of awareness of target INR levels by physicians & patients. Oral anticoagulants are the main stay in the prevention of stroke in patients with valvular and non valvular Atrial Fibrillation.4 The preferred oral anticoagulants with mechanical heart valves and severe mitral stenosis are the VKAs while for others stroke risk stratification is done by CHADS2-VASC score.5 If CHADS2-VASC score is of 3 in non valvular AF NOACS can be initiated. The main challenge for stroke prevention is in pregnant women with AF who have either mechanical valve or severe valvular disease (Mitral Valve disease) in adjusting VKAs dose. Low molecular weight Heparin (LMWH) is considered to be safe option6 in first trimester and before delivery. The recommended dose of warfarin in women with or without mechanical valves is ≤ 5 mg/day throughout pregnancy, however during the first trimester dose adjusted LMWH is given to avoid teratogenic effects. Warfarin is continued in second and third trimesters and I/V unfractionated Heparin / LMWH in the peripartum period.7 The gynecologists being primary care givers should be trained in this respect to avoid any kind of complications. Another problem is to bridge antithrombin therapy in VHD patient schedule for surgery. The clinicians deciding factor for temporary stoppage of VKAs therapy is the type of heart valve prosthesis.8 Surgeon and anesthetist posted in rural health center in Pakistan should be provided management guidelines in the form of small printed cards in simple language. Knowledge of management of prosthetic valve complication9 and stroke management10 needs to be addressed especially in public hospitals. In conclusion vitamin K antagonists such as warfarin is most commonly used in the Pakistan for valid reasons as mentioned. Awareness of PT/INR level to a therapeutic range to be made to patients and physicians by establishing anticoagulation clinics in all public hospitals throughout the country. NOACs to be initiated with appropriate use of CHADS2-VASC score with their appropriate indication and contraindication. Information leaflets on Anticogulation benefits, complications and interactions should be provided in local languages to the patients and they should keep a record of their INR values. Efforts should be made by various agencies in particular Ministry of NHS TO ensure uninterrupted availability of anticoagulants and cheap lab tests. Although international evidence based guidelines do exist, they do not address specific goals required by ours patients. To enhance knowledge of our clinician regarding Vit K antagonist and NOACS its important to set local guidelines for various case-based scenarios. References Amin A, Marrs JC. Direct oral anticoagulants for the management of thromboembolic disorders: the importance of adherence and persistence in achieving beneficial outcomes. Clin Appl Thromb Hemost. 2016;22(7):605-16. Mekaj YH, Mekaj AY, Duci SB, Miftari EI. New oral anticoagulants: their advantages and disadvantages compared with vitamin K antagonists in the prevention and treatment of patients with thromboembolic events. Ther Clin Risk Manag. 2015;11:967. Menon A, Thomas J, Ichaporia NR, Sahoo PK, Unni TG. Oral anticoagulation therapy: current challenges in Indian scenario. Int J Adv Med 2020;7:1044-52. Asinger RW, Shroff GR, Simegn MA, Herzog CA. Anticoagulation for Nonvalvular atrial fibrillation: influence of epidemiologic trends and clinical practice patterns on risk stratification and net clinical benefit. Circ Cardiovasc Qual Outcom. 2017;10(9):e003669. Alshawabkeh L, Economy KE, Valente AM. Anticoagulation during pregnancy: evolving strategies with a focus on mechanical valves. J Am Coll Cardiol. 2016;68(16):1804-13. Kirchhof P, Benussi S, Kotecha D, Ahlsson A, Atar D, Casadei B, et al. 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS. Eur Heart J. 2016;50(5):e1-88. Nishimura RA, Otto CM, Bonow RO, Carabello BA, Erwin JP, Fleisher LA, et al. 2017 AHA/ACC focused update of the 2014 AHA/ACC guideline for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. J Am Coll Cardiol. 2017;70(2):252-89. Saksena D, Muralidharan S, Mishra YK, Kanhere V, Mohanty BB, Srivastava CP, et al. Anticoagulation Management in Patients with Valve Replacement. J Assoc Physicians India. 2018;66(1):59-74. Powers WJ, Rabinstein AA, Ackerson T, Adeoye OM, Bambakidis NC, Becker K, et al. 2018 guidelines for the early management of patients with acute ischemic stroke: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2018;49(3):e46-99. Morgenstern LB, Hemphill III JC, Anderson C, Becker K, Broderick JP, Connolly Jr ES, et al. Guidelines for the management of spontaneous intracerebral hemorrhage: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2010;41(9):2108-29.

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5

DRUSIN, RONALD E., PAT MOLHOLT, and HILARY J. SCHMIDT. "Columbia University College of Physicians and Surgeons." Academic Medicine 75, Supplement (September 2000): S232—S234. http://dx.doi.org/10.1097/00001888-200009001-00068.

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6

Page, Kerrianne P., and Ronald E. Drusin. "Columbia University College of Physicians and Surgeons." Academic Medicine 79, Supplement (July 2004): S28—S29. http://dx.doi.org/10.1097/00001888-200407001-00011.

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7

Goldman, Lee. "Columbia University College of Physicians & Surgeons." Academic Medicine 82, no. 12 (December 2007): 1171. http://dx.doi.org/10.1097/acm.0b013e318159e4e0.

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8

Balmer, Dorene F., Boyd F. Richards, and Ronald E. Drusin. "Columbia University College of Physicians and Surgeons." Academic Medicine 85 (September 2010): S365—S369. http://dx.doi.org/10.1097/acm.0b013e3181ea2105.

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9

Baron, J. H. "Book: The History of the Royal College of Physicians and Surgeons of Glasgow: Physicians and Surgeons in Glasgow, 1599-1858 The History of the Royal College of Physicians and Surgeons of Glasgow: Physicians and Surgeons in Glasgow, 1858-1999." BMJ 321, no. 7260 (September 2, 2000): 577. http://dx.doi.org/10.1136/bmj.321.7260.577.

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10

Dyrbye, Liselotte N., Tait D. Shanafelt, Charles M. Balch, Daniel Satele, and Julie Freischlag. "Physicians Married or Partnered to Physicians: A Comparative Study in the American College of Surgeons." Journal of the American College of Surgeons 211, no. 5 (November 2010): 663–71. http://dx.doi.org/10.1016/j.jamcollsurg.2010.03.032.

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11

Bodley, Steven C. "The College of Physicians and Surgeons of Ontario on MAiD referrals." Canadian Medical Association Journal 190, no. 23 (June 11, 2018): E724. http://dx.doi.org/10.1503/cmaj.69469.

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12

Amiel, Jonathan, Aubrie Swan Sein, and Ronald Drusin. "Columbia University Roy and Diana Vagelos College of Physicians and Surgeons." Academic Medicine 95, no. 9S (September 2020): S335—S338. http://dx.doi.org/10.1097/acm.0000000000003461.

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13

Islam, MN. "Rethinking Stable Ischemic Heart Disease: Time for a Copernican Revision." Journal of Bangladesh College of Physicians and Surgeons 31, no. 4 (November 29, 2014): 179–80. http://dx.doi.org/10.3329/jbcps.v31i4.21000.

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14

Pilkey, Jana, James Downar, Deborah Dudgeon, Leonie Herx, Doreen Oneschuk, Cori Schroder, and Valerie Schulz. "Palliative Medicine—Becoming a Subspecialty of the Royal College of Physicians and Surgeons of Canada." Journal of Palliative Care 32, no. 3-4 (July 2017): 113–20. http://dx.doi.org/10.1177/0825859717741027.

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The discipline of palliative medicine in Canada started in 1975 with the coining of the term “palliative care.” Shortly thereafter, the provision of clinical palliative medicine services started, although the education of the discipline lagged behind. In 1993, the Canadian Society of Palliative Care Physicians (CSPCP) started to explore the option of creating an accredited training program in palliative medicine. This article outlines the process by which, over the course of 20 years, palliative medicine training in Canada went from a mission statement of the CSPCP, to a 1 year of added competence jointly accredited by both the Royal College of Physicians and Surgeons of Canada (Royal College) and the College of Family Physicians of Canada, to a 2-year subspecialty of the Royal College with access from multiple entry routes and a formalized accrediting examination.

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15

Mulder, David S. "The 64th Annual Meeting of the Royal College of Physicians and Surgeons." Archives of Surgery 131, no. 2 (February 1, 1996): 121. http://dx.doi.org/10.1001/archsurg.1996.01430140011001.

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16

Gallagher, R., P. Hawley, and W. Yeomans. "A Survey of Cancer Pain Management Knowledge and Attitudes of British Columbian Physicians." Pain Research and Management 9, no. 4 (2004): 188–94. http://dx.doi.org/10.1155/2004/748685.

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INTRODUCTION:There are many potential barriers to adequate cancer pain management, including lack of physician education and prescription monitoring programs. The authors surveyed physicians about their specific knowledge of pain management and the effects of the regulation of opioids on their prescribing practices.METHODS:A questionnaire was mailed out to British Columbia physicians who were likely to encounter cancer patients. The survey asked for physicians' opinions about College of Physicians and Surgeons of British Columbia regulation and other issues related to their prescribing practices, and assessed basic knowledge of cancer pain management.RESULTS:There was a 69% return rate with a total of 4618 evaluable responses. There was a significant difference among medical disciplines, years in practice, number of chronic pain patients seen and size of community of practice. The highest knowledge scores were achieved by oncologists and the lowest scores were from surgeons. Those who practiced in smaller communities had a higher average knowledge score. Those who felt their knowledge about cancer pain was inadequate scored lower than those who felt their knowledge was adequate. The questions most frequently answered incorrectly (or by 'don't know') were those about equianalgesic dosing (68%) and adequate breakthrough dosing (45%), revealing knowledge deficiencies that would significantly impair a physician's ability to manage cancer pain.CONCLUSIONS:The details of opioid prescribing are crucial areas to target education for cancer pain management. The surveyed physicians accepted the need for regulation of opioid prescribing with very few being fearful of scrutiny from the College of Physicians and Surgeons of British Columbia. However, the inconvenience of the triplicate prescription pad was more of a barrier to prescribing, it being of concern to 20% of respondents, particularly surgeons and medical specialists.

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17

Beuran, M. "TRAUMA CARE: HIGHLY DEMANDING, TREMENDOUS BENEFITS." Journal of Surgical Sciences 2, no. 3 (July 1, 2015): 111–14. http://dx.doi.org/10.33695/jss.v2i3.117.

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From its beginning, mankind suffered injuries through falling, fire, drowning and human aggression [1]. Although the frequency and the kinetics modifiy over millennia, trauma continues to represent an important cause of morbidity and mortality even in the modern society [1]. Significant progresses in the trauma surgery were due to military conflicts, which next to social sufferance came with important steps in injuries’ management, further applied in civilian hospitals. The foundation of modern trauma systems was started by Dominique Jean Larrey (1766-1842) during the Napoleonic Rin military campaign from 1792. The wounded who remained on the battlefield till the end of the battle to receive medical care, usually more than 24 hours, from that moment were transported during the conflict with flying ambulances to mobile hospitals. Starting with the First World War, through the usage of antiseptics, blood transfusions, and fracture management, the mortality decreased from 39% in the Crimean War (1853–1856) to 10%. One of the most preeminent figures of the Second World War was Michael DeBakey, who created the Mobile Army Surgical Hospitals (MASH), concept very similar to the Larrey’s unit. In 1941, in England, Birmingham Accident Hospital was opened, specially designed for injured people, this being the first trauma center worldwide. During the Golf War (1990–1991) the MASH were used for the last time, being replaced by Forward Surgical Teams, very mobile units satisfying the necessities of the nowadays infantry [1]. Nowadays, trauma meets the pandemic criteria, everyday 16,000 people worldwide are dying, injuries representing one of the first five causes of mortality for all the age groups below 60 [2]. A recent 12-month analysis of trauma pattern in the Emergency Hospital of Bucharest revealed 141 patients, 72.3% males, with a mean age of 43.52 ± 19 years, and a mean New Injury Severity Score (NISS) of 27.58 ± 11.32 [3]. The etiology was traffic related in 101 (71.6%), falls in 28 (19.9%) and crushing in 7 (5%) cases. The overall mortality was as high as 30%, for patients with a mean NISS of 37.63 [3]. At the scene, early recognition of severe injuries and a high index of suspicion according to trauma kinetics may allow a correct triage of patients [4]. A functional trauma system should continuously evaluate the rate of over- and under-triage [5]. The over-triage represents the transfer to a very severe patient to a center without necessary resources, while under-triage means a low injured patient referred to a highly specialized center. If under-triage generates preventable deaths, the over-triage comes with a high financial and personal burden for the already overloaded tertiary centers [5]. To maximize the chance for survival, the major trauma patients should be transported as rapid as possible to a trauma center [6]. The initial resuscitation of trauma patients was divided into two time intervals: ten platinum minutes and golden hour [6]. During the ten platinum minutes the airways should be managed, the exsanguinating bleeding should be stopped, and the critical patients should be transported from the scene. During the golden hour all the life-threatening lesions should be addressed, but unfortunately many patients spend this time in the prehospital setting [6]. These time intervals came from Trunkey’s concept of trimodal distribution of mortality secondary to trauma, proposed in 1983 [7]. This trimodal distribution of mortality remains a milestone in the trauma education and research, and is still actual for development but inconsistent for efficient trauma systems [8]. The concept of patients’ management in the prehospital setting covered a continuous interval, with two extremities: stay and play/treat then transfer or scoop and run/ load and go. Stay and play, usually used in Europe, implies airways securing and endotracheal intubation, pleurostomy tube insertion, and intravenous lines with volemic replacement therapy. During scoop and run, used in the Unites States, the patient is immediately transported to a trauma center, addressing the immediate life-threating injuries during transportation. In the emergency department of the corresponding trauma center, the resuscitation of the injured patients should be done by a trauma team, after an orchestrated protocol based on Advanced Trauma Life Support (ATLS). The modern trauma teams include five to ten specialists: general surgeons trained in trauma care, emergency medicine physicians, intensive care physicians, orthopedic surgeons, neurosurgeons, radiologists, interventional radiologists, and nurses. In the specially designed trauma centers, the leader of the trauma team should be the general surgeon, while in the lower level centers this role may be taken over by the emergency physicians. The implementation of a trauma system is a very difficult task, and should be tailored to the needs of the local population. For example, in Europe the majority of injuries are by blunt trauma, while in the United States or South Africa they are secondary to penetrating injuries. In an effort to analyse at a national level the performance of trauma care, we have proposed a national registry of major trauma patients [9]. For this registry we have defined major trauma as a New Injury Severity Score higher than 15. The maintenance of such registry requires significant human and financial resources, while only a permanent audit may decrease the rate of preventable deaths in the Romanian trauma care (Figure 1) [10]. Figure 1 - The website of Romanian Major Trauma Registry (http://www.registrutraume.ro). USA - In the United States of America there are 203 level I centers, 265 level II centers, 205 level III or II centers and only 32 level I or II pediatric centers, according to the 2014 report of National Trauma Databank [11]. USA were the first which recognized trauma as a public health problem, and proceeded to a national strategy for injury prevention, emergency medical care and trauma research. In 1966, the US National Academy of Sciences and the National Research Council noted that ‘’public apathy to the mounting toll from accidents must be transformed into an action program under strong leadership’’ [12]. Considerable national efforts were made in 1970s, when standards of trauma care were released and in 1990s when ‘’The model trauma care system plan’’[13] was generated. The American College of Surgeons introduced the concept of a national trauma registry in 1989. The National Trauma Databank became functional seven years later, in 2006 being registered over 1 million patients from 600 trauma centers [14]. Mortality from unintentional injury in the United States decreased from 55 to 37.7 per 100,000 population, in 1965 and 2004, respectively [15]. Due to this national efforts, 84.1% of all Americans have access within one hour from injury to a dedicated trauma care [16]. Canada - A survey from 2010 revealed that 32 trauma centers across Canada, 16 Level I and 16 Level II, provide definitive trauma care [18]. All these centers have provincial designation, and funding to serve as definitive or referral hospital. Only 18 (56%) centers were accredited by an external agency, such as the Trauma Association of Canada. The three busiest centers in Canada had between 798–1103 admissions with an Injury Severity Score over 12 in 2008 [18]. Australia - Australia is an island continent, the fifth largest country in the world, with over 23 million people distributed on this large area, a little less than the United States. With the majority of these citizens concentrated in large urban areas, access to the medical care for the minority of inhabitants distributed through the territory is quite difficult. The widespread citizens cannot be reached by helicopter, restricted to near-urban regions, but with the fixed wing aircraft of the Royal Flying Doctor Service, within two hours [13]. In urban centers, the trauma care is similar to the most developed countries, while for people sparse on large territories the trauma care is far from being managed in the ‘’golden hour’’, often extending to the ‘’Golden day’’ [19]. Germany - One of the most efficient European trauma system is in Germany. Created in 1975 on the basis of the Austrian trauma care, this system allowed an over 50% decreasing of mortality, despite the increased number of injuries. According to the 2014 annual report of the Trauma Register of German Trauma Society (DGU), there are 614 hospitals submitting data, with 34.878 patients registered in 2013 [20]. The total number of cases documented in the Trauma Register DGU is now 159.449, of which 93% were collected since 2002. In the 2014 report, from 26.444 patients with a mean age of 49.5% and a mean ISS of 16.9, the observed mortality was 10% [20]. The United Kingdom - In 1988, a report of the Royal College of Surgeons of England, analyzing major injuries concluded that one third of deaths were preventable [21]. In 2000, a joint report from the Royal College of Surgeons of England and of the British Orthopedic Association was very suggestive entitled "Better Care for the Severely Injured" [22]. Nowadays the Trauma Audit Research network (TARN) is an independent monitor of trauma care in England and Wales [23]. TARN collects data from hospitals for all major trauma patients, defined as those with a hospital stay longer than 72 hours, those who require intensive care, or in-hospital death. A recent analysis of TARN data, looking at the cost of major trauma patients revealed that the total cost of initial hospital inpatient care was £19.770 per patient, of which 62% was attributable to ventilation, intensive care and wards stays, 16% to surgery, and 12% to blood transfusions [24]. Global health care models Countries where is applied Functioning concept Total healthcare costs from GDP Bismarck model Germany Privatized insurance companies (approx. 180 nonprofit sickness funds). Half of the national trauma beds are publicly funded trauma centers; the remaining are non-profit and for-profit private centers. 11.1% Beveridge model United Kingdom Insurance companies are non-existent. All hospitals are nationalized. 9.3% National health insurance Canada, Australia, Taiwan Fusion of Bismarck and Beveridge models. Hospitals are privatized, but the insurance program is single and government-run. 11.2% for Canada The out-of-pocket model India, Pakistan, Cambodia The poorest countries, with undeveloped health care payment systems. Patients are paying for more than 75% of medical costs. 3.9% for India GDP – gross domestic product Table 1 - Global health care models with major consequences on trauma care [17]. Traumas continue to be a major healthcare problem, and no less important than cancer and cardiovascular diseases, and access to dedicated and timely intervention maximizes the patients’ chance for survival and minimizes the long-term morbidities. We should remember that one size does not fit in all trauma care. The Romanian National Trauma Program should tailor its resources to the matched demands of the specific Romanian urban and rural areas.

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18

Jayawardena, Sanasi, and Alexandra A. Majerski. "Response to: “The College of Physicians and Surgeons of Ontario on MAiD referrals”." Canadian Medical Association Journal 190, no. 23 (June 11, 2018): E725. http://dx.doi.org/10.1503/cmaj.69570.

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19

Bentley, Ronald. "The use of stable isotopes at Columbia University's College of physicians and surgeons." Trends in Biochemical Sciences 10, no. 4 (April 1985): 171–74. http://dx.doi.org/10.1016/0968-0004(85)90161-6.

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20

Avery, Brian, and Mike Mulcahy. "Towards a College of Dentistry…" Bulletin of the Royal College of Surgeons of England 88, no. 3 (March 1, 2006): 80–81. http://dx.doi.org/10.1308/147363506x100338.

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There are royal colleges of surgeons, physicians, psychiatrists, general practitioners, nursing, and speech and language therapists but not a college of dentistry. Why not? Admittedly, dentistry is a relatively small profession with a total of around 30,000 dentists registered within the UK; however, a single recognised academic home for the whole profession is overdue. Indeed, there are many 'academic homes', including the two faculties within this College (the Faculty of Dental Surgery and the Faculty of General Dental Practice (UK)) and the faculties of dental surgery at the colleges of Edinburgh, Glasgow and Ireland. Perhaps this fragmentation is one reason why the concept has not been developed.

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21

Spaulding, W. B. "David A.E. Shephard, The Royal College of Physicians and Surgeons of Canada 1960-1980: The Pursuit of UnityDavid A.E. Shephard, The Royal College of Physicians and Surgeons of Canada 1960-1980: The Pursuit of Unity (Ottawa: Royal College of Physicians and Surgeons of Canada, 1985), 551 pp. $20.00." Canadian Bulletin of Medical History 3, no. 2 (October 1986): 277–79. http://dx.doi.org/10.3138/cbmh.3.2.277.

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22

Kain, Nicole Allison, Kathryn Hodwitz, Wendy Yen, and Nigel Ashworth. "Experiential knowledge of risk and support factors for physician performance in Canada: a qualitative study." BMJ Open 9, no. 2 (February 2019): e023511. http://dx.doi.org/10.1136/bmjopen-2018-023511.

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ObjectiveTo identify, understand and explain potential risk and protective factors that may influence individual and physician group performance, by accessing the experiential knowledge of physician-assessors at three medical regulatory authorities (MRAs) in Canada.DesignQualitative analysis of physician-assessors’ interview transcripts. Telephone or in-person interviews were audio-recorded on consent, and transcribed verbatim. Interview questions related to four topics: Definition/discussion of what makes a ‘high-quality physician;’ factors for individual physician performance; factors for group physician performance; and recommendations on how to support high-quality medical practice. A grounded-theory approach was used to analyse the data.SettingThree provinces (Alberta, Manitoba, Ontario) in Canada.ParticipantsTwenty-three (11 female, 12 male) physician-assessors from three MRAs in Canada (the College of Physicians & Surgeons of Alberta, the College of Physicians and Surgeons of Manitoba and the College of Physicians and Surgeons of Ontario).ResultsParticipants outlined various protective factors for individual physician performance, including: being engaged in continuous quality improvement; having a support network of colleagues; working in a defined scope of practice; maintaining engagement in medicine; receiving regular feedback; and maintaining work-life balance. Individual risk factors included being money-oriented; having a high-volume practice; and practising in isolation. Group protective factors incorporated having regular communication among the group; effective collaboration; a shared philosophy of care; a diversity of physician perspectives; and appropriate practice management procedures. Group risk factors included: a lack of or ineffective communication/collaboration among the group; a group that doesn’t empower change; or having one disruptive or ‘risky’ physician in the group.ConclusionsThis is the first qualitative inquiry to explore the experiential knowledge of physician-assessors related to physician performance. By understanding the risk and support factors for both individual physicians and groups, MRAs will be better-equipped to tailor physician assessments and limited resources to support competence and enhance physician performance.

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Howieson, W. B. "Education in the Royal College of Physicians and Surgeons of Glasgow: The Way Forward." Scottish Medical Journal 51, no. 2 (May 2006): 36. http://dx.doi.org/10.1258/rsmsmj.51.2.36.

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Loudon, Irvine. "The History of the Royal College of Physicians and Surgeons of Glasgow. Vol. 1: Physicians and Surgeons in Glasgow, 1599-1858, and: The History of the Royal College of Physicians and Surgeons of Glasgow. Vol. 2: The Shaping of the Medical Profession, 1858-1999 (review)." Bulletin of the History of Medicine 75, no. 1 (2001): 134–36. http://dx.doi.org/10.1353/bhm.2001.0043.

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Mitura, Kryspin, Sławomir Kozieł, and Klaudiusz Komor. "Can the surgeon live his whole life? Analysis of the risk of death related to the profession." Polish Journal of Surgery 90, no. 1 (February 28, 2018): 18–24. http://dx.doi.org/10.5604/01.3001.0011.5955.

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More than half of physicians in Poland are over 50 years old. This raises concerns about the risk of lack of continuity of health care services due to the generational gap, particularly marked among interventional specialties. The physical and mental burden of general surgery affects those doctors in particular. The aim of the study is to assess whether the type of the profession pursued influences the average lifetime of a physician in Poland and the impact of the surgeon’s occupation on life expectancy compared to the rest of the population according to gender. Demographic data was obtained from official publications of the Central Statistical Office. Data on 189,459 physicians in Poland were obtained from the Central Register of Doctors. A total of 6,496 physicians and dentists deaths in the period from January 1st, 2010 to June 30th, 2014, including 722 surgeons, were analyzed. In general, both male physicians and dentists died at an older age than the mean population (74.9 years and 74.7 years vs. 68.9 years; p <0.05). Among women, only dentists lived longer (78.5 years) p <0.05), while women physicians died at a younger age than the average in the general population (76.4 vs. 77.2 years; p <0.05). The average lifetime of both male and female surgeons was 74.2 and 77.5 years, respectively. The average life expectancy of people aged 25 years with college/university education is 80.3 years for men and 86.6 years for women. Male surgeons live significantly longer than the average life expectancy in the general population of men. The average length of life of women surgeons is significantly lower than the average lifespan of women in the general population. The actual lifetime of surgeons in Poland is significantly lower than the expected average life expectancy for other people aged 25 with tertiary education. The average lifespan of surgeons in Poland does not differ significantly from the average life expectancy of other Polish physicians.

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Becker, W. J. "MOCOMP: An Idea Whose Time Has Come for Canadian Neurology." Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques 21, no. 3 (August 1994): 285–86. http://dx.doi.org/10.1017/s0317167100041305.

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In June 1993, the Canadian Neurological Society (CNS) at its annual meeting passed a motion to join the Royal College of Physicians and Surgeons of Canada (Royal College) MOCOMP program. A MOCOMP (Maintenance of Competence) Sub-Committee of the CNS Education and Manpower Committee has also been established to deal with implementation issues, and to liaise with the Royal College. These are important milestones, and it is important that the momentum which has brought our national specialty society to full participation in the Royal College MOCOMP program be maintained.

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Elyas, R. "31. The birth of a new specialty: The history of emergency medicine in Canada." Clinical & Investigative Medicine 30, no. 4 (August 1, 2007): 44. http://dx.doi.org/10.25011/cim.v30i4.2791.

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Modern day emergency rooms across Canada have almost completely transformed over the past 30 years; perhaps more so than any other specialty. Before the 1970’s, it was primarily general practitioners working on a part-time basis who ran our emergency departments. Some hospitals used interns and residents as first-line emergency care providers, often under the direction of a surgeon or internist. Emergency Medicine has evolved into a highly sophisticated and respected medical specialty that extends beyond clinical medicine, into both research and academia. The appeal of Emergency Medicine is so great that it is now one of the most sought after specialties in the annual CaRMS match. The success story of Emergency Medicine is characterized by the tireless efforts and determination of its founders across the country. They fought for adequate and supervised care of the acutely ill or traumatized patient, believing in a special body of knowledge that should be available to physicians who spend most, if not all, their time in Emergency Departments. In 1977, these founders formally united and The Canadian Association of Emergency Physicians was born. A few years later, in 1980, Emergency Medicine was finally designated as a free-standing specialty by the Royal College of Physicians and Surgeons of Canada. Meanwhile, the College of Family Physicians of Canada also sought to establish a parallel route for Emergency Training of Family Physicians, feeling that Emergency Medicine lay within the realm of Family Medicine. The result was that both colleges established Emergency Medicine training programs that exist until this day. Using journals, archives, a survey, and interviews, the paper will trace the history of the professionalization of Emergency Medicine in Canada. Johnson R. The Canadian Association of Emergency Physicians. The Journal of Emergency Medicine 1993; 11:362-364. Reudy J, Seaton T, Walker D, Rowat B, Cassie J. Report of the Task Force on Emergency Medicine: RCPSC Accreditation Section, 1988. Walker DMC. History and Development of the Royal College Specialty of Emergency Medicine. Annals Royal College of Physicians and Surgeons of Canada 1987; 20:349-352.

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Parboosingh, J. T. "The Maintenance of Competence Program of the Royal College of Physicians and Surgeons of Canada." JAMA: The Journal of the American Medical Association 270, no. 9 (September 1, 1993): 1093. http://dx.doi.org/10.1001/jama.270.9.1093.

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Parboosingh, John T. "The Maintenance of Competence Program of the Royal College of Physicians and Surgeons of Canada." JAMA: The Journal of the American Medical Association 270, no. 9 (September 1, 1993): 1093. http://dx.doi.org/10.1001/jama.1993.03510090077016.

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Parboosingh, John. "CPD and maintenance of certification in the Royal College of Physicians and Surgeons of Canada." Obstetrician & Gynaecologist 5, no. 1 (January 2003): 43–49. http://dx.doi.org/10.1576/toag.5.1.43.

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Ellis, Harold. "Peter Lowe: a father figure of the Royal College of Physicians and Surgeons of Glasgow." British Journal of Hospital Medicine 71, no. 8 (August 2010): 474. http://dx.doi.org/10.12968/hmed.2010.71.8.77674.

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Aluwihare, Arjuna. "The Nora and Noel Bartholomeusz Centre." Bulletin of the Royal College of Surgeons of England 92, no. 10 (November 1, 2010): 1–3. http://dx.doi.org/10.1308/147363510x533775.

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The College of Surgeons of Sri Lanka (CSSL) has long wanted a headquarters of its own. This need was compounded by Colombo being chosen to house the office of the South Asian Association for Regional Cooperation (SAARC) Surgical Care Society – the apex surgical body of the SAARC countries: Bangladesh, Bhutan, India, the Maldives, Nepal, Pakistan and Sri Lanka.

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Stafford, Renae E., Elizabeth B. Dreesen, Anthony Charles, Harry Marshall, Michele Rudisill, and Eithiel Estes. "Free and Local Continuing Medical Education Does Not Guarantee Surgeon Participation in Maintenance of Certification Learning Activities." American Surgeon 76, no. 7 (July 2010): 692–96. http://dx.doi.org/10.1177/000313481007600721.

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The American Board of Surgery has adopted the Maintenance of Certification requirement for surgeons. It requires continuous professional development (CPD) using active and passive learning modalities in contrast to traditional continuing medical education (CME). The Rural Trauma Team Development Course developed by the American College of Surgeons Committee on Trauma is a CPD learning activity. We provided 22 free courses between May 2007 and June 2009 to trauma care providers at 11 affiliated community and critical access hospitals. The course was taught on-site by an interdisciplinary group and at least one trauma surgeon was faculty. Free Category I CME credits and continuing education units were provided. Two hundred thirty-four providers attended and the majority were RNs (60%) and emergency medical technicians (21.8%). Only 18 were physicians (7.7%) and none were surgeons. The majority felt that they would change their practice as a result of the course but cited the lack of attendance at the course by emergency physicians and surgeons as a deficit. It may be that surgeons have barriers such as time away from a practice to attending these newer types of educational opportunities. Those who develop and offer these courses may need to develop different strategies to reach this target audience.

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Rubin, Lewis J., Robyn Barst, and Nazzareno Galiè. "Inside the New Era in Treatment: Three Experts Analyze the Growing Spectrum of Therapy and Future Strategies." Advances in Pulmonary Hypertension 1, no. 1 (January 1, 2002): bmi—7. http://dx.doi.org/10.21693/1933-088x-1.1.1.

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Three physicians addressed key concerns in the treatment of pulmonary hypertension in a discussion that ranged from special considerations in tailoring therapy to the role of new agents dramatically changing the algorithm for managing this disease. The roundtable discussion was moderated by Lewis J. Rubin, MD, Professor of Medicine, University of California, San Diego, School of Medicine, and included Robyn Barst, MD, Professor of Pediatrics, Columbia University College of Physicians and Surgeons, New York, New York, and Nazzareno Galiè MD, Professor at the Postgraduate School of Cardiology, University of Bologna, Italy.

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Tuhan, Isolda. "Mastering CanMEDS Roles in Psychiatric Residency: A Resident's Perspective." Canadian Journal of Psychiatry 48, no. 4 (May 2003): 222–24. http://dx.doi.org/10.1177/070674370304800404.

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Postgraduate trainees in psychiatry are being evaluated on their proficiency at competencies that comprise the physician roles identified by the CanMEDS 2000 Project. This paper provides an overview of each CanMEDS role and its associated competencies and suggests strategies to help residents prepare for the new format of the Royal College of Physicians and Surgeons (RCPSC) certification examination in psychiatry.

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Lewis, Aaron M., Salvador Sordo, Leonard J. Weireter, Michelle A. Price, Leopoldo Cancio, Rachelle B. Jonas, Daniel L. Dent, Mark T. Muir, and Jayson D. Aydelotte. "Mass Casualty Incident Management Preparedness: A Survey of the American College of Surgeons Committee on Trauma." American Surgeon 82, no. 12 (December 2016): 1227–31. http://dx.doi.org/10.1177/000313481608201231.

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Mass casualty incidents (MCIs) are events resulting in more injured patients than hospital systems can handle with standard protocols. Several studies have assessed hospital preparedness during MCIs. However, physicians and trauma surgeons need to be familiar with their hospital's MCI Plan. The purpose of this survey was to assess hospitals’ and trauma surgeon's preparedness for MCIs. Online surveys were e-mailed to members of the American College of Surgeons committee on Trauma Ad Hoc Committee on Disaster and Mass Casualty Management before the March 2012 meeting. Eighty surveys were analyzed (of 258). About 76 per cent were American College of Surgeons Level I trauma centers, 18 per cent were Level II trauma centers. Fifty-seven per cent of Level I and 21 per cent of Level II trauma centers had experienced an MCI. A total of 98 per cent of respondents thought it was likely their hospital would see a future MCI. Severe weather storm was the most likely event (95%), followed by public transportation incident (86%), then explosion (85%). About 83 per cent of hospitals had mechanisms to request additional physician/surgeons, and 80 per cent reported plans for operative triage. The majority of trauma surgeons felt prepared for an MCI and believed an event was likely to occur in the future. The survey was limited by the highly select group of respondents and future surveys will be necessary.

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Frank, J., J. Nagle, R. Ramsarin, D. Danoff, and P. Rainsberry. "18. The future of Canadian residency education: The core competency project." Clinical & Investigative Medicine 30, no. 4 (August 1, 2007): 37. http://dx.doi.org/10.25011/cim.v30i4.2778.

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The Core Competency Project (CCP) is an initiative to reexamine fundamental recurring issues in Canadian medical education, including: (1) premature career decision making by medical students, (2) barriers to changing career disciplines by residents and practicing physicians, (3) lack of clarity on the role of “generalism” in medical training, and (4) the optimal structure and function of the PGME system. The CCP is a collaborative national endeavour of The Royal College of Physicians and Surgeons of Canada and the College of Family Physicians of Canada. From 2005 to 2007, the CCP employed four primary methods, including: (1) a systematic review of relevant literature, (2) a series of commentary papers by leaders in medicine and medical education, (3) a series of focus groups across Canada involving medical students, residents, and practicing physicians, and (4) a national survey of stakeholders. This was supplemented by consultations with key groups in the medical profession. We describe the findings of these studies and the implications for medical education policy in Canada and around the world. The CCP is an unprecedented national medical education policy initiative.

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Bulger, Eileen M., Debra G. Perina, Zaffer Qasim, Brian Beldowicz, Megan Brenner, Frances Guyette, Dennis Rowe, et al. "Clinical use of resuscitative endovascular balloon occlusion of the aorta (REBOA) in civilian trauma systems in the USA, 2019: a joint statement from the American College of Surgeons Committee on Trauma, the American College of Emergency Physicians, the National Association of Emergency Medical Services Physicians and the National Association of Emergency Medical Technicians." Trauma Surgery & Acute Care Open 4, no. 1 (September 2019): e000376. http://dx.doi.org/10.1136/tsaco-2019-000376.

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This is a joint statement from the American College of Surgeons Committee on Trauma, the American College of Emergency Physicians, the National Association of Emergency Medical Services Physicians and the National Association of Emergency Medical Technicians regarding the clinical use of resuscitative endovascular balloon occlusion of the aorta (REBOA) in civilian trauma systems in the USA. This statement addresses the system of care needed to manage trauma patients requiring the use of REBOA, in light of the current evidence available in this patient population. This statement was developed by an expert panel following a comprehensive review of the literature with representation from all sponsoring organizations and the US Military. This is an update to the previous statement published in 2018. It has been formally endorsed by the four sponsoring organizations.

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Bloch, Konrad. "The origins of intermediary metabolism at Columbia College of Physicians and Surgeons (P&S) 1." FASEB Journal 10, no. 7 (May 1996): 802–5. http://dx.doi.org/10.1096/fasebj.10.7.8635699.

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40

Blackman, J. "The History of the Royal College of Physicians and Surgeons of Glasgow. Vol. I: Physicians and Surgeons, 1599-1858; Vol. II: The Shaping of the Medical Profession, 1858-1999." English Historical Review 119, no. 480 (February 1, 2004): 210–12. http://dx.doi.org/10.1093/ehr/119.480.210.

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41

Hoffenberg, Raymond, IanP Todd, and George Pinker. "Joint Statement from the Presidents of the Royal College of Physicians, the Royal College of Surgeons, and the Royal College of Obstetricians and Gynaecologists." Lancet 330, no. 8572 (December 1987): 1411. http://dx.doi.org/10.1016/s0140-6736(87)91312-2.

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42

Sinclair, Douglas, Peter Toth, Alecs Chochinov, John Foote, Kirsten Johnson, Jill McEwen, David Messenger, et al. "Health human resources for emergency medicine: a framework for the future." CJEM 22, no. 1 (November 26, 2019): 40–44. http://dx.doi.org/10.1017/cem.2019.446.

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ABSTRACTIn June of 2016, the Collaborative Working Group (CWG) on the Future of Emergency Medicine presented its final report at the Canadian Association of Emergency Physicians (CAEP) annual meeting in Quebec City. The CWG report made a number of recommendations concerning physician Human Health Resource (HHR) shortfalls in emergency medicine, specific changes for both the Royal College of Physicians and Surgeons of Canada (FRCPC) and the College of Family Physicians of Canada (CCFP-EM) training programs, HHR needs in rural and remote hospitals, future collaboration of the CCFP-EM and FRCPC programs, and directions for future research. All recommendations were endorsed by CAEP, the Royal College of Physicians and Surgeons of Canada (RCPSC), and the College of Family Physicians of Canada (CFPC). The CWG report was published in CJEM and has served as a basis for ongoing discussion in the emergency medicine community in Canada. The CWG identified an estimated shortfall of 478 emergency physicians in Canada in 2016, rising to 1071 by 2020 and 1518 by 2025 assuming no expansion of EM residency training capacity. In 2017, the CAEP board struck a new committee, The Future of Emergency Medicine in Canada (FEMC), to advocate with appropriate stakeholders to implement the CWG recommendations and to continue with this important work. FEMC led a workshop at CAEP 2018 in Calgary to develop a regional approach to HHR advocacy, recognizing different realities in each province and region. There was wide representation at this workshop and a rich and passionate discussion among those present. This paper represents the output of the workshop and will guide subsequent deliberations by FEMC. FEMC has set the following three goals as we work toward the overarching purpose to improve timely access to high quality emergency care: (1) to define and describe categories of emergency departments (EDs) in Canada, (2) define the full time equivalents required by category of ED in Canada, and (3) recommend the ideal combination of training and certification for emergency physicians in Canada. A fourth goal supports the other three goals: (4) urge further consideration and implementation of the CWG-EM recommendations related to coordination and optimization of the current two training programs. We believe that goals 1 and 2 can largely be accomplished by the CAEP annual meeting in 2020, and goal 3 by the CAEP annual meeting in 2021. Goal 4 is ongoing with both the RCPSC and the CFPC. We urge the EM community across Canada to engage with our committee to support improved access and EM care for all Canadians.

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Harrison, Jon, Michael J. Pucci, Scott W. Cowan, and Charles J. Yeo. "A Brief Overview of the Life and Work of Lyon Henry Appleby, M.D. (1895–1970)." American Surgeon 82, no. 12 (December 2016): 1151–54. http://dx.doi.org/10.1177/000313481608201218.

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The life and work of Dr. Lyon Henry Appleby, M.D., portrays the essence of a devoted clinician committed to scholarly excellence. Born in Deseronto, Ontario, in 1895 and passing in 1970, Dr. Appleby influenced all areas of general surgery, most notably popularizing a procedure that bears his name today. After a tour in World War I, he quickly proved himself to be a dedicated clinician with roots in academia, which translated into excellence within the Department of Surgery at St. Paul's Hospital in Vancouver, Canada. He served in various leadership roles including Chair of the Department of Surgery, President of the International College of Surgeons, and Fellow of the Royal College of Physicians and Surgeons. The Appleby procedure, or en bloc removal of the celiac axis, at the time of gastrectomy, is the technical focus of this paper, although reference is made to Appleby's extensive contributions to historical medicine.

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Smith, Lord. "Book Review: The Royal College of Physicians and Surgeons of Canada 1960–1980: The Pursuit of Unity." Journal of the Royal Society of Medicine 79, no. 10 (October 1986): 623–24. http://dx.doi.org/10.1177/014107688607901024.

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Morley-Forster, Patricia. "Perspectives on the Royal College of Physicians and Surgeons of Canada new subspecialty program in pain medicine." Canadian Journal of Anesthesia/Journal canadien d'anesthésie 61, no. 2 (December 7, 2013): 188–94. http://dx.doi.org/10.1007/s12630-013-0068-7.

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46

Dingwall, Helen. "JOHANNA GEYER-KORDESCH and FIONA MACDONALD, Physicians and Surgeons in Glasgow: The History of the Royal College of Physicians and Surgeons of Glasgow 1599–1858 and ANDREW HULL and JOHANNA GEYER-KORDESCH, The Shaping of the Medical Profession: The History of the Royal College of Physicians and Surgeons of Glasgow, 1858–1999." Journal of Scottish Historical Studies 22, no. 1 (May 1, 2002): 85–88. http://dx.doi.org/10.3366/jshs.2002.22.1.85.

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Chan, Teresa, Serena Sennik, Amna Zaki, and Brendon Trotter. "Studying with the cloud: the use of online Web-based resources to augment a traditional study group format." CJEM 17, no. 2 (March 2015): 192–95. http://dx.doi.org/10.2310/8000.2014.141425.

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AbstractCloud-based applications such as Google Docs, Skype, Dropbox, and SugarSync are revolutionizing the way that we interact with the world. Members of the millennial generation (those born after 1980) are now becoming senior residents and junior attending physicians. We describe a novel technique combining Internet- and cloud-based methods to digitally augment the classic study group used by final-year residents studying for the Royal College of Physicians and Surgeons of Canada examination. This material was developed by residents and improved over the course of 18 months. This is an innovation report about a process for enhanced communication and collaboration as there has been little research to date regarding the augmentation of learner-driven initiatives with virtual resources.

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Slabaugh, Alexander D., John W. Belk, Jonathan C. Jackson, Richard J. Robins, Eric C. McCarty, Lance E. LeClere, and Mark A. Slabaugh. "Managing the Return to Football During the COVID-19 Pandemic: A Survey of the Head Team Physicians of the Football Bowl Subdivision Programs." Orthopaedic Journal of Sports Medicine 9, no. 1 (January 1, 2021): 232596712199204. http://dx.doi.org/10.1177/2325967121992045.

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Background: COVID-19 is a severe respiratory virus that spreads via person-to-person contact through respiratory droplets. Since being declared a pandemic in early March 2020, the World Health Organization had yet to release guidelines regarding the return of college or professional sports for the 2020-2021 season. Purpose: To survey the head orthopedic surgeons and primary care team physicians for the National Collegiate Athletic Association (NCAA) Football Bowl Subdivision (FBS) football teams so as to gauge the management of common COVID-19 issues for the fall 2020 college football season. Study Design: Cross-sectional study. Methods: The head team orthopaedic surgeons and primary care physicians for all 130 FBS football teams were surveyed regarding their opinions on the management of college football during the COVID-19 pandemic. A total of 30 questions regarding testing, return-to-play protocol, isolating athletes, and other management issues were posed via email survey sent on June 5, 2020. Results: Of the 210 team physicians surveyed, 103 (49%) completed the questionnaire. Overall, 36.9% of respondents felt that it was unsafe for college athletes to return to playing football during fall 2020. While the majority of football programs (96.1%) were testing athletes for COVID-19 as they returned to campus, only 78.6% of programs required athletes to undergo a mandatory quarantine period before resuming involvement in athletic department activities. Of the programs that were quarantining their players upon return to campus, 20% did so for 1 week, 20% for 2 weeks, and 32.9% quarantined their athletes until they had a negative COVID-19 test. Conclusion: While US Centers for Disease Control and Prevention guidelines evolve and geographic regions experience a range of COVID-19 infections, determining a universal strategy for return to socialization and participation in sports remains a challenge. The current study highlighted areas of consensus and strong agreement, but the results also demonstrated a need for clarity and consistency in operations, leadership, and guidance for medical professionals in multiple areas as they attempt to safely mitigate risk for college football players amid the COVID-19 pandemic.

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Shrestha, S., GB Pradhan, K. Bhoomi, BL Shrestha, and CL Bhattachan. "Abdominal Tuberculosis in Nepal Medical College Teaching Hospital, Kathmandu." SAARC Journal of Tuberculosis, Lung Diseases and HIV/AIDS 5, no. 1 (May 7, 2010): 39–42. http://dx.doi.org/10.3126/saarctb.v5i1.3083.

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Abdominal Tuberculosis is a common extra pulmonary manifestation of tuberculosis. The wide spectrum of presentation makes abdominal tuberculosis difficult to diagnose and treat. Retrospective review of cases with abdominal tuberculosis presenting to the Surgery Department of Nepal Medical College Teaching Hospital from January 2002- June 2007 was done to describe our experience of abdominal tuberculosis over a 5 year period. We found total 32 patients with abdominal tuberculosis, among which 13 had concurrent pulmonary tuberculosis. The most common clinical presentation, i.e. a triad of abdominal pain, fever and weight loss was present in 13 who had symptoms of pulmonary tuberculosis presented to physicians and the remaining 19 presented acutely to surgeons with symptoms of pain and obstruction. Chest X ray, abdominal ultrasound and barium meal follow through done to find associated abnormalities. Diagnostic Laparoscopy was performed in 10 and 3 patients with peritonitis underwent emergency laparotomy which revealed multiple ileal perforations in 2 cases and one had multiple strictures with small bowel perforation. Diagnosis of tuberculosis, attended at surgeons was confirmed by demonstrating caseating granulomas in histology and Acid Fast Bacilli Positive, culture for M. tuberculosis from peritoneal fluid. All patients were started anti tuberculosis treatment. Abdominal tuberculosis is a relatively common finding and should always be considered in the differential diagnosis of abdominal pain, fever and weight loss. Key Words: Tuberculosis; abdominal tuberculosis; Acid Fast Bacilli; ileocaecal disease DOI: 10.3126/saarctb.v5i1.3083 SAARC J. Tuber. Lung Dis. HIV/AIDS 2008 Vol.5(1) 39-42

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Ofori-Adjei, David. "Professor Jacob Plange-Rhule." Ghana Medical Journal 54, no. 2 (June 30, 2020): 75. http://dx.doi.org/10.4314/gmj.v54i2.3.

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The usual quiet morning of Good Friday, April 10, 2020, was shattered by the spreading news of the death of Professor Jacob Plange-Rhule. For many persons the news elicited sentiments of grief and outpouring of statements on the good natureof the third Rector of the Ghana College of Physicians and Surgeons. Even though he died at the age of 62 years, his footprints will remain in several places where his feet hath trod in academia, medical education, medical ‘politics’, golf andfamily life.

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