Rectus sheath hematoma (RSH) is a common entity with no clearly established protocol for management. Existing literature on RSH is outdated and does not incorporate modern technological advances in medicine and imaging. A total of 21 studies were included in this literature review based on PubMed and Google Scholar searches. Modern literature was selected from the last 10 years with the inclusion of three past pieces of literature. We performed a literature review to identify the latest research on RSH management and to consolidate an algorithm to help guide modern RSH treatment. Current RSH classification, scoring system, algorithm, and other predictors for treatment plan are discussed. The best RSH management requires early recognition of RSH followed by the appropriate implementation of conservative management and procedural intervention. The decision on picking the treatment of choice is assisted with the use of predictors, such as hematoma size, rate of hemoglobin drop, and the number of blood transfusions. Further studies are needed to clearly establish predictors among the different types of procedural intervention, and we hope the consolidated algorithm on current literature can help promote the standardization of protocol in the future.
Medical education largely overlooks the sense of smell in clinical training notwithstanding clear evidence that several diseases carry with them pathognomonic scents that can serve as diagnostic clues. We report here an observational cross-sectional study in which we assessed students’ attitudes toward the utility of scent in the process of medical diagnosis as well as their competence and confidence in being able to apply recognition of odor to specific diseases in the clinical setting. We found that nearly 90% of medical students felt that formal incorporation of scent in their medical training would make them more competent physicians. However, approximately 80% of them did not feel confident using scent as a diagnostic aid. Currently, there is a lack of emphasis on the usefulness of the sense of smell in modern medical education, and in the study reported here, we consider the rationale for possible inclusion of olfactory exposure in clinical training.
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