No abstract

Colonic submucosal lipomas are rare benign tumours of the colon, which may be discovered incidentally at colonoscopy, through imaging such as CT or at autopsy. These tumours can cause complications such as bleeding, intussusception and bowel obstruction. We describe the case of a patient in whom a small submucosal lipoma was identified at the time of colonoscopy and who did not receive follow-up treatment. The patient presented 1 year later with intussusception and obstruction resulting from this polyp and required urgent surgery. With the increasing use of colonoscopy and CT, such lesions are likely to be discovered more often. As complications can ensue, guidelines should be developed to advise on the management of such polyps in order to prevent consequent complications.

Background:There are little data on the incidence and patterns of injuries seen on magnetic resonance imaging (MRI) in acute inversion ankle sprains. This study may help in the understanding of the pathomechanics, natural history, and outcomes of this common injury.Study Design:Case series; Level of evidence, 4.Methods:From June 2011 to June 2013, a total of 64 consecutive patients had MRI of the ankle performed for acute inversion injury to the ankle. All injuries/pathologies reported were recorded.Results:Only 22% of patients had isolated lateral ligament complex injuries. Twenty-two percent of patients had other pathologies but no lateral ligament injury, and 53% had lateral ligament injuries in combination with other pathologies or injuries. The most common associated finding with lateral ligament injuries was bone bruising (76%) followed by deltoid ligament injury (50%). The overall incidence of bone bruising was 50%. Thirty percent of ankles had tendon pathology, 27% had deltoid ligament injury, and 22% had occult fractures.Conclusion:Isolated lateral ligament ankle injury is not as common as is believed. The pattern of injury seems complex, and most patients appear to have more injuries than expected. MRI reveals additional information that may have significance in terms of diagnosis, treatment, and prognosis in this common injury.

Burnout is common among physicians and affects the quality of patient care. 1,2 Preliminary studies have shown that the COVID-19 pandemic has negatively impacted the emotional and mental wellness of healthcare workers. 3,4 Our original study aims to analyse the effect this pandemic has on burnout rates and possible reasons among all members of the orthopaedic department in Ng Teng Fong General Hospital, Singapore. This is an anonymous, questionnaire-based, crosssectional study conducted prospectively in an orthopaedic department of a tertiary hospital during the COVID-19 pandemic. From 1 to 10 April 2020, all healthcare workers within the orthopaedic department were invited via an email blast to participate in a self-administered questionnaire. The primary objective of this study is to discover the prevalence of burnout before and after the hospital's implementation of measures countering the COVID-19 pandemic. Our secondary objectives are to correlate demographic data with burnout, as well as identify the reasons for burnout. Our selection of participants consisted of the entire orthopaedic department, including 58 doctors, 70 nurses, 24 administrative staff and 4 allied healthcare staff. The questionnaires were then distributed electronically. Responses to each questionnaire item were collected in Google forms and tabulated using Microsoft Excel 2016. The questionnaire was divided into 3 sections that recorded: (1) participant demographics, (2) the Maslach Burnout Inventory (MBI) designed for Medical Personnel and (3) questions on factors influencing burnout. The MBI is the most common validated tool used to measure physician burnout in the last 20 years. 5,6 It is a 22-item survey that measures burnout on 3 separate subscales: depersonalisation (score range of 0-30), emotional exhaustion (score range of 0-54) and low personal accomplishment (score range of 0-48). As for the reasons influencing burnout, we provided a list of possible reasons influencing burnout as well as a free response section. Participants were required to rate each reason from "not influencing burnout" to "significantly influencing burnout".