8^th International Conference on Surgery and Anaesthesia April 05-06, 2023 Barcelona, Spain

Biography:

Mamta Arora graduated (MBBS) from Sir JJ Medical College, Mumbai with distinction. Thereafter she pursued Masters in General Surgery (MS) from TNMC and B.Y.L Nair Hospital, Mumbai, India in 1999. She has had a brilliant post-graduate career and has been working in the Middle East for the last fifteen years. She is also a member of the prestigious Royal College of Surgeons of England (MRCS-England). She has taken special training in Varicose Vein treatment from UK and has been offering Radio-Frequency Ablation (RFA) in NMC Healthcare since 2013 with commendable outcomes. She practices all general and laparoscopic surgeries. Her special areas of interest are RFA–varicose vein treatment, thyroid and breast surgeries, gall bladder and hernia surgeries. Being a female doctor, she can ably manage and is very sensitive to the detection and management of breast diseases including breast cancer.

Abstract:

Breast inflammation is usually associated with lactation and treatable easily with antibiotics and surgical drainage. The other important well known entity though less common is inflammatory breast carcinoma has clear international guidelines on treatment. There are many gray areas in the inflammatory non infective categories which are less commonly known, not recognized most of the time and very difficult to treat. I would like to discuss some of these Nonbacterial Inflammatory breast disorders that mimic malignancy:
1. Fat necrosis
2. Post traumatic breast inflammation
3. Post COVID breast inflammation
4. Idiopathic granulomatous mastitis.

These disorders are great masqueraders of malignancy, difficult to treat, debilitating to the patient and cause a lot of anxiety. I would like to discuss these disorders and present a statistical analysis of 100 patients with these uncommon non-infective disorders of the breast in a private hospital in the Middle East along with the management plan and suggested guidelines.

Biography:

Graduate in Medicine from the Catolic University of Valencia, Spain. General and Digestive Surgeon. Master University in General and Digestive Surgery. Master University in trauma and bullhorn injuries. Master University in Obesity Surgery. Training Fellowship in Trauma and Acute Care Surgery at Sotero del Rio Hospital, Santiago de Chile. Consultant Endocrine, Bariatric and Metabolic Surgery at University General Hospital of Castellon, Spain. The scientific research was in line with this addressing various areas of investigation, including general surgery and emergency trauma care, specifically to trauma and bullhorn injuries studies.

Abstract:

Background: Although bullfighting festivals were traditionally attributed to the cultural idiosyncrasies of the Ibero-American people, they also exist world-wide. The province of Castellon (Valencian Community, Spain) is considered one of the regions with the most bull-related activities worldwide, with more than 5,000 popular events held every year. The objective of this study was to present our experience in the integral care of patients injured by bull horns, describing the characteristics of this type of injury and its possible complications.
Methods: A retrospective study was conducted, reviewing the medical records of patients treated on our service for bull horn injuries between January 1978 and December 2019. Results: There were 572 admissions due to bull horn injuries. 54 of these patients had multiple injuries. The average annual admission was 13.6 patients. The most frequent injuries were located in the lower extremities, perineum, and abdomen. Forty-seven laparotomies were performed, revealing intra-abdominal visceral impairment on 39 occasions. The most frequently injured organs were the intestine and liver. The most frequent complications were skin devitalisation, infection and post-operative eventration. The recorded mortality was 0.87%.
Conclusion: We wish to highlight the importance of injuries caused by bull horns worldwide. These are highimpact injuries with specific intrinsic characteristics that require regulated medical and surgical care.

Biography:

Mamta Arora graduated (MBBS) from Sir JJ Medical College, Mumbai with distinction. Thereafter she pursued Masters in General Surgery (MS) from TNMC and B.Y.L Nair Hospital, Mumbai, India in 1999. She has had a brilliant post-graduate career and has been working in the Middle East for the last fifteen years. She is also a member of the prestigious Royal College of Surgeons of England (MRCS-England). She has taken special training in Varicose Vein treatment from UK and has been offering Radio-Frequency Ablation (RFA) in NMC Healthcare since 2013 with commendable outcomes. She practices all general and laparoscopic surgeries. Her special areas of interest are RFA–varicose vein treatment, thyroid and breast surgeries, gall bladder and hernia surgeries. Being a female doctor, she can ably manage and is very sensitive to the detection and management of breast diseases including breast cancer.

Abstract:

Introduction: The last decade has been like a crusade in the treatment of varicose veins, one after the other new development, advances in techniques each method claiming to be better than the other. I wish to present a report on comparison of all the methods of treatment for a patient population of around 1500, cases ranging from CEAP 3 to CEAP 6 all treated by various endovenous ablation methods.
Objective: To determine the best method of treatment of varicose veins by doing a retrospective analysis of around 1500 patients of varicose veins treated in a private hospital in the UAE.
Methods: 1500 patients who underwent treatment of varicose veins in this hospital by various methods were studied over a period of 8 years from 2015 to 2023. The age group is 25 to 55 years, 60 percent males and 40 percent females. The various treatment methods were laser ablation, radio-frequency ablation, microwave ablation, venaseal ablation and stab avulsions with injection sclerotherapy. Patients were assessed by venous Doppler examination, CEAP scores and venous clinical severity scores. Mean CEAP score was 4-5. Reflux time was above 0.5 milliseconds and vein size was above 4.5 mm. Results: A comparative study showed that all methods produced a reasonably effective means of closure of axial veins long and short saphenous with minimal complications in the long and short term. Methods varied in the ease of procedure, patient comfort, versatility of use in different areas and in recurrence.

Biography:

Brandon Lucke-Wold was born and raised in Colorado Springs, Colorado. He graduated magna cum laude with a BS in Neuroscience and distinction in honors from Baylor University. He completed his MD/PhD, Master's in Clinical and Translational Research and the Global Health Track at West Virginia University School of Medicine. His research focus was on traumatic brain injury, neurosurgical simulation and stroke. At West Virginia University, he also served as a health coach for the Diabetes Prevention and Management program in Morgantown and Charleston, WV, which significantly improved health outcomes for participants. In addition to his research and public health projects, he is a co-founder of the biotechnology company Wright-Wold Scientific, the pharmaceutical company CTE cure and was a science advocate on Capitol Hill through the Washington Fellow's program. He has also served as president of the WVU chapters of the American Association of Pharmaceutical Scientists, Neurosurgery Interest group and Erlenmeyer Initiative Entrepreneur group. In addition, he has served as vice president for the graduate student neuroscience interest group, Nu Rho Psi Honor Society and medical students for global health. He was an active member of the Gold Humanism Honor Society and Alpha Omega Alpha Honor Society. He is currently a member of the UF House Staff Council and Positive Culture Committee.

Abstract:

Aim: Conventional techniques to share and archive spinal imaging data raise issues with trust and security, with novel approaches being more greatly considered. Ethereum smart contracts present one such novel approach. Ethereum is an open-source platform that allows for the use of smart contracts. Smart contracts are packages of code that are self-executing and reside in the Ethereum state, defining conditions for programmed transactions. Though powerful, limited attempts have been made to showcase the clinical utility of such technologies, especially in the pre and post-operative imaging arenas. Herein, we therefore aim to propose a proof-of-concept smart contract that stores intraoperative Three-Dimensional (3D) Augmented Reality Surgical Navigation (ARSN) data and was tested on a private, proof-of-authority network. To the author's best knowledge, the present study represents a first-use case of the Inter-Planetary File Storage protocol for storing and retrieving spine imaging smart contracts.
Methods: The content identifier hashes were stored inside the smart contracts while the Inter-Planetary File System (IPFS) was used to efficiently store the image files. Insertion was achieved with four storage mappings, one for each of the following: fictitious patient data, specific diagnosis, patient Identity Document (ID) and Gertzbein grade. Inserted patient observations were then queried with wildcards. Insertion and retrieval times for different record volumes were collected.
Results: It took 276 milliseconds to insert 50 records and 713 milliseconds to insert 350 records. Inserting 50 records required 934 Megabyte (MB) of memory per insertion with patient data and imaging, while inserting 350 records required almost the same amount of memory per insertion. In a database of 350 records, the retrieval function needs about 1,026 MB to query a record with all three fields left blank, but only 970 MB to obtain the same observation from a database of 50 records.
Conclusions: The concept presented in this study exemplifies the clinical utility of smart contracts and off-chain data storage for efficient retrieval/insertion of ARSN data.

Biography:

Shuting Guan is affiliated to the Royal Preston Hospital, UK. His research interests reflect in his wide range in various national and international journals.

Abstract:

Aim: This audit aims to assess adherence to the Enhanced Recovery After Surgery (ERAS) pathway in the Intensive Care Unit (ICU) at Royal Preston Hospital (RPH). Results are compared to the standards set by the ERAS Society and the National Institute for Health and Care Excellence (NICE) regarding early mobilisation, oral intake, and cessation of Intravenous (IV) fluids. Further investigation of barriers preventing compliance was also explored and discussed in the recommendations for improvement.
Methods: Retrospective data collection of elective surgical patients during March and April 2022 were analysed and compared. A re-audit was performed to assess effectiveness following a week of re-education of nursing staff and doctors. An additional survey was also conducted amongst healthcare professionals to evaluate adherence and identification of difficulties for ERAS implementation.
Results: Numerous barriers to adherence were identified including patient, structural, cultural, and technical. Staff shortage, inadequate pain management, ambiguous plans, and lack of equipment are the main obstacles identified. Although improvements were seen in early mobilisation and oral intake, fluid prescription compliance remains poor. Staff re-education had minor improvement in ERAS pathway documentation (0% to 33%). However, there is limited data and further audits are required.
Conclusion: Overall, a minimal increase in compliance was noted. However, the small sample size and time limit prevented significant improvement in adherence. Further work including the Implementation of recommendations, on-going re-education, and reaudits is required to fully appreciate the benefits of postoperative ERAS for ICU.

Biography:

Onyekachi Ekowo is affiliated to Darent Valley Hospital, United Kingdom. He is a recipient of many awards and grants for his valuable contributions and discoveries in major area of subject research. His international experience includes various programs, contributions and participation in different countries for diverse fields of study. His research interests reflect in his wide range of publications in various national and international journals.

Abstract:

Aim: A study to investigate the tumour behaviour in the management of locally advanced rectal cancer (LARC) treated with neoadjuvant chemo-radiotherapy (NACRT) and definitive surgery to help guide decision on watchful wait versus surgery post NACRT.
Methods: T3 &T4 and/or positive nodal rectal cancer Patients treated for locally advanced low rectal cancer between the periods of 2017 – 2019 at our district general hospital were studied.
Results: A total of 30 patients met the criteria. The median age was 67 years (11 females and 19 males). All patients had neoadjuvant chemotherapy & surgery. 2 patients had complete clinical response on MRI post neoadjuvant chemotherapy. When the histological sample was analysed, we found cure in the same 2 patients (8.7%), down stage in 12(52%) and no effect in 9(39.1). These 2 patients who had cure before surgery had pathological complete response (pCR) post op. MRI (performed about 42 days post neoadjuvant chemotherapy) showed a concordance with histology of 12(70%).
Conclusion: MRI done as close to surgery as possible and about 6 to 8 weeks post NACRT could potentially pick those cancers showing complete response and would have obviated the need for surgery in 2 of the patients. MRI pre-op showed good concordance with pathology report post op and so can be relied upon for follow up with no surgery done.

Biography:

Doaa Lotfy Abd El Baky is affiliated to Fayoum university, Egypt. He is a recipient of many awards and grants for his valuable contributions and discoveries in major area of subject research. His international experience includes various programs, contributions and participation in different countries for diverse fields of study. His research interests reflect in his wide range of publications in various national and international journals.

Abstract:

Background: The quadratus lumborum (QL) block is a recently introduced abdominal truncal block, used for somatic and visceral analgesia in abdomen surgeries.
Aim of the work: To compare between caudal block and ultrasound guided quadratus lumborum block as regard degree of pain relief, accuracy of block, effect on hemodynamic stability and incidence of complications in lower abdominal surgeries.
Patients and methods: Fifty two patients ranging from one to seven years of age of both genders, scheduled for unilateral lower abdominal surgery were randomized into 2 study groups. Group QL — Unilateral quadratus lumborum block (n= 26) Group C — Caudal block (n= 26). Inhalational induction of general anesthesia (GA) was performed . Group C: Children received caudal block with 1 ml/kg of bupivacaine 0.25%. Group QL: Ultrasound guided quadratus lumborum block was done. The local anesthetic was injected as a bolus of 0.5 ml/Kg bupivacaine 0.25%. Quality of analgesia was assessed using a FLACC scale at 30 minutes and at 1, 2, 4, 6, 12, and 24 hours postoperatively . Hemodynamic parameters (heart rate, systolic and diastolic arterial blood pressure) were recorded preoperatively and every 15 min till the end of surgery. Incidence of complications in the form of hemodynamic instability, injury to the underlying structures (injury to the liver or a viscous), and hematoma formation as recorded under ultrasound guidance, and signs of local anesthetics toxicity The general satisfaction of parents were also recorded.
Results: As regards hemodynamic parameters ,there was no statistically significant difference between the two groups (p value > 0.05) ,there was no statistically difference in the severity of postoperative pain between both study groups up to 24 hours postoperatively. The time till first request for analgesia postoperatively was statistically longer in the QL group compared to C group. Parents of the QL block group showed a higher level of satisfaction than the caudal block group. No intraoperative complications were detected. Conclusion: the QL block provided longer and more effective postoperative analgesia compared with the caudal block.

Biography:

Doaa Lotfy Abd El Baky is affiliated to Fayoum university, Egypt. He is a recipient of many awards and grants for his valuable contributions and discoveries in major area of subject research. His international experience includes various programs, contributions and participation in different countries for diverse fields of study. His research interests reflect in his wide range of publications in various national and international journals.

Abstract:

Background: The quadratus lumborum (QL) block is a recently introduced abdominal truncal block, used for somatic and visceral analgesia in abdomen surgeries. Aim of the work: To compare between caudal block and ultrasound guided quadratus lumborum block as regard degree of pain relief, accuracy of block, effect on hemodynamic stability and incidence of complications in lower abdominal surgeries.
Patients and methods: Fifty two patients ranging from one to seven years of age of both genders, scheduled for unilateral lower abdominal surgery were randomized into 2 study groups. Group QL — Unilateral quadratus lumborum block (n= 26) Group C — Caudal block (n= 26). Inhalational induction of general anesthesia (GA) was performed . Group C: Children received caudal block with 1 ml/kg of bupivacaine 0.25%. Group QL: Ultrasound guided quadratus lumborum block was done. The local anesthetic was injected as a bolus of 0.5 ml/Kg bupivacaine 0.25%. Quality of analgesia was assessed using a FLACC scale at 30 minutes and at 1, 2, 4, 6, 12, and 24 hours postoperatively. Hemodynamic parameters (heart rate, systolic and diastolic arterial blood pressure) were recorded preoperatively and every 15 min till the end of surgery. Incidence of complications in the form of hemodynamic instability, injury to the underlying structures (injury to the liver or a viscous), and hematoma formation as recorded under ultrasound guidance, and signs of local anesthetics toxicity The general satisfaction of parents were also recorded. Results: As regards hemodynamic parameters ,there was no statistically significant difference between the two groups (p value > 0.05) ,there was no statistically difference in the severity of postoperative pain between both study groups up to 24 hours postoperatively. The time till first request for analgesia postoperatively was statistically longer in the QL group compared to C group. Parents of the QL block group showed a higher level of satisfaction than the caudal block group. No intraoperative complications were detected.
Conclusion: the QL block provided longer and more effective postoperative analgesia compared with the caudal block.