Background Snakehead fish (Channa striatus) is a fresh water fish indigenous to many Asia countries and believed to have medical value. Studies showed that it contains all the essential amino acids and fatty acids able to accelerate wound healing and it has antinociceptive effect. However, little human study has been done to assess the effectiveness of Channa striatus in wound healing. A prospective RCT has been conducted on the effect of Channa striatus spray versus placebo on clean wound to assess its pain control effect and cosmetic outcome. Methodology One hundred and two patients (102) underwent clean elective surgery; postoperatively they were randomized into two group. One group received Channa striatus extract spray (n=51) another group received placebo (n=51) on daily basis for 2 weeks. They were followed up on 2nd, 4th, and 6th weeks. Pain control effect was assessed based on Visual Analog Pain Score (VAPS) and cosmetic outcome based on Visual Analog Cosmetic Scale (VACS), Wound Evaluation Scale (WES), and Vancouver Scar Scale (VSS). Result The patient treated with Channa striatus spray displayed a better outcome in terms of pain control compared to placebo. During analysis using repeated measure ANOVA, there was significant difference of patient's pain score based on VAPS between Channa striatus spray and placebo (F-stat (df) = 4.80 (2), p-value = 0.010). For cosmetic outcome it showed a better result in Channa striatus spray group for all the 3-scoring system, VACS, (F-stat (df) = 2.68 (2) , p-value <0.001), WES (F-stat (df) = 3.09 (2), p-value = 0.048), and VSS (F-stat (df) = 1.72 (2) , p-value = 0.011). Conclusion Our study suggest that application of Channa striatus extract spray on clean wound has shown a significant better pain score result and cosmetic outcome on week 2, week 4, and week 6 comparatively with placebo.
PurposePatients with secondary hyperparathyroidism are at high risk for developing postoperative hypocalcemia. However, there are limited data regarding predictors of postoperative hypocalcemia in renal failure patient with secondary hyperparathyroidism. This study aimed to determine the clinical presentations of renal hyperparathyroidism and the predictors of early postoperative hypocalcemia after total parathyroidectomy.MethodsData of patients with renal hyperparathyroidism who underwent total parathyroidectomy between January 2007 to December 2014 were reviewed retrospectively. Patients were divided into 2 cohort groups according to their serum calcium levels within 24 hours of parathyroidectomy: the hypocalcemia group (calcium levels of 2 mmol/L or less), and the normocalcemia group (calcium levels more than 2 mmol/L). With the use of multivariable logistic regression analyses, the predictors of early postoperative hypocalcemia after total parathyroidectomy in patients with renal hyperparathyroidism were investigated.ResultsAmong 68 patients, 56 patients (82.4%) were symptomatic preoperatively. Fifty patients (73.5%) presented with bone pain and 14 patients (20.6%) had muscle weakness. Early postoperative hypocalcemia occurred in 25 patients (36.8%). Preoperative alkaline phosphatase level was the predictor of early postoperative hypocalcemia (adjusted odds ratio, 1.004; 95% confidence interval, 1.001–1.006; P = 0.002).ConclusionResults from our study show that most of the patients with renal hyperparathyroidism were symptomatic preoperatively and the most common clinical presentations were bone pain and muscle weakness. The significant predictor of early postoperative hypocalcemia after total parathyroidectomy was the preoperative alkaline phosphatase levels.
Background Artificial intelligence (AI) is gaining traction in medicine and surgery. AI-based applications can offer tools to examine high-volume data to inform predictive analytics that supports complex decision-making processes. Time-sensitive trauma and emergency contexts are often challenging. The study aims to investigate trauma and emergency surgeons’ knowledge and perception of using AI-based tools in clinical decision-making processes. Methods An online survey grounded on literature regarding AI-enabled surgical decision-making aids was created by a multidisciplinary committee and endorsed by the World Society of Emergency Surgery (WSES). The survey was advertised to 917 WSES members through the society’s website and Twitter profile. Results 650 surgeons from 71 countries in five continents participated in the survey. Results depict the presence of technology enthusiasts and skeptics and surgeons' preference toward more classical decision-making aids like clinical guidelines, traditional training, and the support of their multidisciplinary colleagues. A lack of knowledge about several AI-related aspects emerges and is associated with mistrust. Discussion The trauma and emergency surgical community is divided into those who firmly believe in the potential of AI and those who do not understand or trust AI-enabled surgical decision-making aids. Academic societies and surgical training programs should promote a foundational, working knowledge of clinical AI.
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