ABSTRACT
Objective: To explore the qualities of brilliant surgeons that makes them distinctive
Study Design: A qualitative exploratory study
Place and Duration of Study: The study was conducted in Armed Forces Hospitals, Rawalpindi, from Jan to Jul 2017
Material and Methods: A purposive sampling technique was applied for in-depth, semi-structured interviews of 19 members [ten surgeons, six anesthesiologists and three operation room assistants] having experience of surgical environment for more than 20 years in different institutions. Computer Assisted Qualitative Data Analysis Software [CAQDAS] was employed for thematic data anal ysis using software NVIVO 11 Pro
Results: Study participants reported observation of distinctive personality characteristics of a few surgeonshitherto termed as [brilliant]. Multifaceted aspects of their personality were identified and categorized into five major themes: mental, psychological and emotional, social, mechanical, and structural strength. The first three themes were found to be common among brilliant achievers in all other professions as well, however, the mechanical and structural strength domains were considered to have unique and substantial bearing on the achievement of brilliance in surgery
Conclusion: A category amongst the surgeon has been identified and termed as [brilliant]. These brilliant surgeons were gifted in five domains of their personality with a distinct set of qualities which made them outclass their contemporaries
ABSTRACT
Evasion of apoptosis is one of the hall marks of cancer. The overwhelming ability of tumor cells to increase in number is influenced not only by un-limited replicative potential but also to a great degree by their ability to evade apoptosis. Apoptosis is the programmed cell death that ensures the removal of old and genetically altered cells that can not be repaired. So the process is very important for continued preservation of genetic information in all body cells. Cancer cells acquire the overwhelming ability to evade apoptosis, thereby the genetic mutations necessary for carcinogenic phenotype start accumulating. The cancer cell thus becomes immortalized, this genetically mutated, immortalized cell then divides and reproduces genetically mutated daughter cells, and thus tumorogensis develops. Apoptosis is brought about by a family of proteases, called as caspases. The principal function of caspases is proteolysis of specific substrates which facilitates the occurrence of various morphological and biochemical characteristics of apoptosis. They also act as critical signaling molecules in the apoptotic pathway and serve to amplify the signal during caspase cascade. There are a variety of ways by which cells can evade apoptosis. This article looks at a variety of strategies acquired by the cells to evade apoptosis and to become immortalized. A thorough and complete understanding of these strategies can enable us to maximize the benefits of the apoptosis inducing agents, which are often included in the chemotherapeutics of carcinomas. Infact many of the conventional combination therapies utilize apoptosis inducing agents along with radiotherapy