Gastrointestinal lipomas are a rare benign non-epithelial neoplasms derived from mature adipocytes. The colon is the commonest organ involved in the entire digestive tract and has an incidence rate ~4.4% in autopsy series. Most of the colonic lipomas are asymptomatic and incidentally detected. Lipomas need to be distinguished from true neoplasia, because in most cases they do not need to be resected unless when they cause a clear symptom or they are large in size. Surgical rather than endoscopic resection is preferred for lipomas > 2 cm to avoid complications such as bleeding and perforation. We report a case of a 56-year-old female, a known case of locally advanced breast cancer and positive adenomatous polyposis coli mutation, who was found to have 4 cm ascending colon lipoma by imaging and confirmed by colonoscopy and histopathology.

AM careers were unpopular by students. Curricular, extracurricular and institutional measures should be implemented to rectify this dilemma.

Objectives: Our study aims to assess the effect of implementing direct verbal communication between the triage nurse and Emergency Department (ED) physician and providing Rapid Assessment and Treatment of Canadian Triage and Acuity Scale (CTAS) category 2 (RAT2) patients presenting to a tertiary care ED.Methods: This is a retrospective, pre and post RAT2 intervention study of periods in our ED using the Enterprise Reporting System and records from ED quality section. The data collected consisted of patient demographics, length of stay, waiting time (Door to Doctor Time), door to triage time, and triage to doctor time (physician initial assessment time) for CTAS category 2 patients, and any sentinel events reported during the study periods.Results: The total number of patients included in this study was 97,472 from which 10,024 were CTAS category 2 and 4,825 were post-RAT2 intervention. Using the T-Test, our results showed pre-RAT mean door-to-doctor time of 61.8 minutes (median: 61.5) and post-RAT time of 31.6 minutes (median: 32). This reduction was statistically significant (p<0.001). There was no significant difference in patient demographics, length of stay, door to triage time, or the door-to-doctor time for other category patients. There were no sentinel events reported during the RAT2 intervention period.Conclusion: Direct verbal nurse-physician communication with early physician assessment and treatment of category 2 patients reduces patient door-to-doctor time without delaying care of other patients or causing any sentinel events.

In 1673, the first case of lung agenesis was reported during an autopsy. Since then many more similar cases were reported and a classification of these cases developed for better medical management. Those cases ranged from hypoplasia to aplasia or agenesis of the lung tissue, with a survival rate of less than 50% by the age of 5 years in cases of agenesis. More commonly affecting the left side than the right, here we present a case of a late presentation of right lung agenesis in a young 24-year-old female. Who presented with multiple episodes of shortness of breath over a year. When examined she had an asymmetric chest and dull right sided auscultation. The x-ray done showed a homogeneous opacity in the right upper, middle and lower zone with shift of the mediastinum to the right side, making the heart in dextroposition. Watchfulness need to be maintained when encountering patients with simple complaint, as sometimes, it is not just the normal anatomy.