A Review of Corporate Social Responsibility Programmes Conducted in a Large Public Hospital in a Metropolitan City

Background: Through Corporate Social Responsibility (CSR), a company achieves a balance of economic, environmental andsocial objectives and is also mandated by Indian law. CSR can help in strengthening healthcare in public hospitals catering to theneedy population. Aims: This study documents the various CSR activities going on in a large tertiary care teaching and publichospital in a metropolitan city, challenges in their implementation and effectiveness of such activities. Materials and Methods:Cross sectional questionnaire based descriptive study in a large public hospital in Mumbai, India. A questionnaire was distributedto nine departments which had received CSR support in the year 2017-18. Details recorded were the kind of initiatives andamount received, difficulties faced in implementation, mode of implementation, its effectiveness and number of people benefittedby the activity. Results: In all, companies have provided a total funding of Rs.10,18,24,940 in a year. Difficulties were faced dueto lack of knowledge of the procedure and clear guidelines for CSR implementation. Approximately 84,251 indoor patients and20,77,146 OPD patients were directly or indirectly benefited by these activities. Conclusions: Public hospitals are best settingswhere companies can implement their CSR activities for healthcare of the poorer sections of society, thus fulfilling their socialobligations in a fruitful way. In view of the advantages of CSR, a dedicated CSR department and guidelines for CSR utilisationneed to be set up with adequate expertise and responsibilities.

Laparoscopic training in India: Need for criterion-based training and objective assessment of surgical skills.

Over the past 2 decades, laparoscopic techniques have evolved from diagnostic laparoscopy to more complex procedures. Minimally invasive techniques are routinely used for bariatric, colonic and advanced gastrointestinal surgical procedures. These new techniques require highly developed psychomotor skills and place an extra demand upon surgeons to acquire, maintain and develop a wide range of operative skills in the middle of their careers. In developed countries, training is imparted in skills centres, which use various models not only to teach a skill, but also as a means of assessment, both of technical competence and of decision-making. In addition, these centres are playing an expanding role in providing credentials to surgeons and maintaining the standards of skills. In India, laparoscopic training for community surgeons is unstructured and opportunistic, while resident’s training is not uniform. There is a need for structured training programmes that include giving residents and community surgeons experience in skills laboratories, along with an objective assessment of acquired skills.

Networking in medical education: Creating and connecting.

Social networking is being increasingly used as a tool of choice for communications and collaborations in business and higher education. Learning and practice become inseparable when professionals work in communities of practice that create interpersonal bonds and promote collective learning. Individual learning that arises from the critical reconstruction of practice, in the presence of peers and other health professionals, enhances a physician's capability of clinical judgment and evidence-based practice. As such, it would be wise for medical schools, whose responsibility it is to prepare students to make a transition to adult life with the skills they need to succeed in both arenas, to reckon with it.

Spectrum and outcome of pancreatic trauma.

BACKGROUND AND AIMS: Pancreatic trauma is associated with high morbidity and mortality. Diagnosis is often difficult and surgery poses a formidable challenge. METHOD: Data from 17 patients of pancreatic trauma gathered from a prospectively maintained database were analysed and the following parameters were considered: mode of injury, diagnostic modalities, associated injury, grade of pancreatic trauma and management. Pancreatic trauma was graded from I through IV, as per Modified Lucas Classification. RESULTS: The median age was 39 years (range 19-61). The aetiology of pancreatic trauma was blunt abdominal trauma in 14 patients and penetrating injury in 3. Associated bowel injury was present in 4 cases (3 penetrating injury and 1 blunt trauma) and 1 case had associated vascular injury. 5 patients had grade I, 3 had grade II, 7 had grade III and 2 had grade IV pancreatic trauma. Contrast enhanced computed tomography scan was used to diagnose pancreatic trauma in all patients with blunt abdominal injury. Immediate diagnosis could be reached in only 4 (28.5%) patients. 7 patients responded to conservative treatment. Of the 10 patients who underwent surgery, 6 required it for the pancreas and the duodenum. (distal pancreatectomy with splenectomy-3, pylorus preserving pancreatoduodenectomy-1, debridement with external drainage-1, associated injuries-duodenum-1). Pancreatic fistula, recurrent pancreatitis and pseudocyst formation were seen in 3 (17.05%), 2 (11.7%) and 1 (5.4%) patient respectively. Death occurred in 4 cases (23.5%), 2 each in grades III and IV pancreatic trauma. CONCLUSIONS: Contrast enhanced computed tomography scan is a useful modality for diagnosing, grading and following up patients with pancreatic trauma. Although a majority of cases with pancreatic trauma respond to conservative treatment, patients with penetrating trauma, and associated bowel injury and higher grade pancreatic trauma require surgical intervention and are also associated with higher morbidity and mortality.

Mucormycosis of the bile duct: a case report.

A case of isolated localised mucormycosis of the bile duct in an immuno-competent 54 year old female patient is described. Mucormycosis is rare in immuno-competent patients. Isolated localised mucormycosis of the bile duct has not yet been described in the literature.