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BACKGROUND: For many years now, inguinal hernia repair in children has been done either by the open approach or laparoscopically with laparoscopy having the edge in terms of cosmesis and postoperative pain. However, recent studies have called for a return of the open approach as it had a comparable result to laparoscopy with lesser cost. This study aims to compare the outcomes of the two approaches at our institution. METHODS: This is a retrospective analysis of the prospectively collected data of all patients aged between 6 months and 13 years who underwent open or laparoscopic inguinal hernia repair in the period between January 2017 and July 2019 at our institution. RESULTS: 155 patients were included in the study. 100 (64.5%) underwent open inguinal repair while 55 (35.5%) were done laparoscopically. There was no significant difference in the postoperative complications between the open and laparoscopic groups (P = 0.66). The overall mean operative time for the laparoscopic group and the open group is (45.7 ± 15.2, 45.5 ± 15.4 min, P = 0.83) respectively. However, a subgroup analysis showed a statistical difference in the operative time in bilateral hernias favoring the laparoscopic approach, (44 ± 13.2, 63.2 ± 26.4 min respectively, P = 0.049). Laparoscopy was also associated with shorter times to full recovery compared to the open group (4.7 days, 7.5 days, P = 0.013). Surprisingly, there was no difference in the cosmetic outcome between the two groups which is contrary to the published literature. CONCLUSIONS: Laparoscopic inguinal hernia repair in children is a feasible and reproducible procedure. It permits the evaluation of the contralateral groin without further incisions. In our study, laparoscopy was superior in terms of operative time in bilateral hernias and the time to recovery. Finally, an added benefit to laparoscopy is that it offers more training opportunities for fellows and residents to improve their laparoscopic skills.
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INTRODUCTION: Obesity is a major cause of metabolic and health disorders like diabetes mellitus (DM) and gastro esophageal reflux disease (GERD). Patients usually offered a professional preoperative consultation and objective information regarding the bariatric surgery type and the advantages and disadvantages of each type for best outcome and satisfaction. PURPOSE: To study the patient response to preoperative advice and recommendation and the patient's decision to undergo the recommended bariatric surgery. OBJECTIVE: To determine the statistical significance of preoperative recommendation and the patient personal choice of the type of bariatric surgery. MATERIALS AND METHODS: This original article is a cross-sectional survey of 188 patients underwent bariatric surgery between February 2015 and December 2018 in the General Surgery Departments - Bariatric Surgery Clinics in Jordan University Hospital affiliated to the College of Medicine in the University of Jordan and Al Karak Governmental Hospital affiliated to the College of Medicine in Mutah University. 144 patients underwent longitudinal sleeve gastrectomy (LSG) and 44 patients underwent Roux en-Y gastric bypass (RYGB) as the recommended type of surgery for the selected comorbidities diabetes, gastroesophageal reflux disease, or both. RESULTS: Of 188 patients data collected, 54 patients who should had undergone RYGB as the recommended type of surgery, preoperative counseling did not have a significant effect on their decision to undergo the appropriate type of bariatric surgery. The number of patients who had pre-operative recommendation = 37 (68.5%). Out of these, only 15 patients choose the surgical team recommended surgery; p-value 0.183, odds ratio 2.22, (95% confidence interval (CI) = 0.6-8.12). CONCLUSION: Preoperative surgical procedure type advice did not have a significant effect on patients' choice of the recommended bariatric procedure.
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BACKGROUND AND OBJECTIVES: Coronavirus disease-2019 (COVID-19) is an emerging disease threatening the world with a rapid increase in cases and deaths since it was first identified in December 2019. Adequate knowledge, practice, and attitudes (KPA) toward COVID-19 among physicians at the frontline defense against the COVID-19 pandemic may enhance their ability to avoid the risk of self-infection, decrease mortality, and provide adequate medical care service in this pandemic. This study aimed to assess KPA toward COVID-19 among physicians in Jordan and Palestine. METHODS: This is a cross-sectional study using an online survey conducted from 10 April to 26 April 2020 among Jordan and Palestine physicians. Invitations were sent to physician groups on Facebook and WhatsApp. This survey contains 36-items, divided into four main sections to assess the participants' socio-demographic characteristics, knowledge, practice, and attitude about COVID-19. RESULTS: A total of 454 physicians participated in this study. The mean score of basic knowledge was 4.4 ± 0.8 (range 2-4). There were significant differences between basic knowledge mean scores among physicians in different professional degrees and physicians in various health sectors (P=0.0315, P=0.0137, respectively). The mean scores of self-protection measures, were 6.1 ± 1.1 (range 3-7) and measures if physician self-suspected of COVID-19 were 9.9± 1.1 (range 5-11). The mean score of attitudes toward COVID-19 was 41.5 ± 3.3 (range 21-45) and significantly related to the age and different experience years (P=0.0022, P=0.0077, respectively). CONCLUSION: As the global threat of COVID-19 continues to emerge, physicians from Jordan and Palestine showed adequate KPA toward COVID-19. There was a significant difference in knowledge level and attitude between physicians. Policymakers and physicians should keep continuous educational activities, training, and follow-up updates during this pandemic.
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SUMMARY: Postgraduate refresher courses may address deficiencies in the gross anatomy preparedness of medical graduates. However, the literature does not offer a method to identify such deficiencies. Our aim is to develop and validate a scale to measure the gross anatomy preparedness of medical graduates. First, we defined gross anatomy preparedness (the construct) as "the benchmark of personal ability in gross anatomy against the standard required for clinical practice." Next, we conducted a literature search for extant items related to our definition. To develop our scale, we grouped the items under three headings: proficiency, preference, and pertinence. Finally, we constructed item-specific response anchors to "Likertize" the items. We recruited experts to validate the content and conducted cognitive interviews to validate the response process. To evaluate the internal structure and reliability of the scale, we invited a purposive sample of 120 surgery residents to complete the scale and explored the results of the pilot test using data reduction and reliability analysis. A total of 77 surgery residents completed the scale. Varimax-rotated principal components analysis revealed three components with eigenvalues greater than one, and the components explained 64 % of the total variance. The rotated solution was consistent with the original structure of the questionnaire. The components, which represented the proficiency, preference, and pertinence item sets, explained 25 %, 23 %, and 16 %, respectively, of the total variance. Cronbach's α coefficients for the item sets were 0.72, 0.71, and 0.61, respectively. We developed and validated a scale to measure the gross anatomy preparedness of medical graduates. In addition, we offer conceptual guidelines to help users interpret the results of the scale. Outcome data are required to substantiate the predictive validity of the scale.
RESUMEN: Los cursos de actualización de posgrado pueden abordar las deficiencias en la preparación de la anatomía macroscópica de los graduados médicos. Sin embargo, la literatura no ofrece un método para identificar tales deficiencias. Nuestro objetivo fue desarrollar y validar una escala para medir la preparación anatómica general de los graduados médicos. Primero, definimos la preparación para la anatomía macroscópica (el constructo) como "el punto de referencia de la capacidad personal en anatomía macroscópica frente al estándar requerido para la práctica clínica". A continuación, realizamos una búsqueda bibliográfica de elementos existentes relacionados con nuestra definición. Para desarrollar nuestra escala, agrupamos los ítems bajo tres encabezados: competencia, preferencia y pertinencia. Finalmente, construimos anclas de respuesta específicas del ítem para "dar me gusta" a los ítems. Reclutamos expertos para validar el contenido y realizamos entrevistas cognitivas para validar el proceso de respuesta. Para evaluar la estructura interna y la confiabilidad de la escala, invitamos a una muestra intencional de 120 residentes de cirugía a completar la escala y exploramos los resultados de la prueba piloto utilizando la reducción de datos y el análisis de confiabilidad. Un total de 77 residentes de cirugía completaron la escala. El análisis de componentes principales rotados con Varimax reveló tres componentes con valores propios mayores que uno, y los componentes explicaron el 64 % de la varianza total. La solución rotada fue consistente con la estructura original del cuestionario. Los componentes, que representaban los conjuntos de ítems de competencia, preferencia y pertinencia, explicaban el 25 %, el 23 % y el 16 %, respectivamente, de la varianza total. Los coeficientes de Cronbach para los conjuntos de elementos fueron 0,72, 0,71 y 0,61, respectivamente. Desarrollamos y validamos una escala para medir la preparación anatómica general de los graduados médicos. Además, ofrecemos pautas conceptuales para ayudar a los usuarios a interpretar los resultados de la escala. Se requieren datos de resultados para corroborar la validez predictiva de la escala.
