Wishaw General Hospital

About: Wishaw General Hospital is a healthcare organization based out in Wishaw, Scotland, United Kingdom. It is known for research contribution in the topics: Population & Medicine. The organization has 256 authors who have published 222 publications receiving 4324 citations.

Wi-fi is essential for medical education and helps clinicians provide safe and effective patient care

Abstract: We disagree with several of Ingram’s assertions.1 As clinical teaching fellows working primarily in undergraduate medical education, we think that access to wi-fi is a necessity, not a luxury. It is also in keeping with recently published General Medical Council guidance.2 Our students use personal handheld devices to access clinical …

Rectal obliteration following stapled haemorrhoidopexy: a new endoscopic approach to restore luminal continuity

Abstract: Dear Sir, Life threatening complications following stapled haemorrhoidopexy are uncommon and include rectal perforation, sepsis, bleeding and rectal obstruction [1,2]. There are only a few reported cases of rectal obliteration after stapled haemorrhoidopexy, also known as the procedure for prolapse and haemorrhoids (PPH), which is widely accepted for the treatment of haemorrhoids and rectal mucosal prolapse [3–6]. Data from the literature show a complication rate ranging from 5% to 45% with reoperation in 11% [2,6]. We performed stapled haemorrhoidopexy on a 60year-old lady for circumferential haemorrhoids and partial thickness rectal prolapse using an Ethicon PPH03 instrument. The standard technique was followed with the purse string placed circumferentially 4 cm proximal to the dentate line leaving no gaps between the sutures. The suture was tied around the examining digit to ensure the presence of a lumen before insertion, closure and firing of the stapler. After firing, however, complete rectal obliteration was identified on digital examination. The doughnut was examined and a complete disc of mucosa was found (Fig. 1). An attempt to pass a fine probe through the obstructed site was not successful. The only remaining option was to perform a laparoscopic loop colostomy to relieve the obstruction. Following recovery from the operation a radiocontrast study confirmed the presence of luminal obliteration (Fig. 2a). After discussion with the patient, corrective surgery was performed 3 weeks after the initial operation. A gastroscope was inserted down the distal limb of the loop colostomy (Fig. 3) The light of the instrument was seen on inspection by an eisenhammer rectal speculum introduced into the rectum at the site of the obliteration. A cannula from a percutaneous endoscopic gastroscopy pack was then inserted from below through the centre of the obliterated rectal mucosa under direct vision, following which a guide wire was passed (Fig. 4). This was then drawn proximally by the gastroscope in the colostomy. Once exteriorized through the stoma, the guide wire was attached to the anvil of an EEA circular stapler (size 21)

Peroxisomal Disorder-Unusual Presentation as Failure to Thrive in Early Infancy

Abstract: Failure to thrive is not uncommon in Paediatric practice and often leads to multiple investigations to find the underlying cause. We report an infant who presented mainly with mild dysmorphism, failure to thrive and elevated Alanine Transferase (ALT) in early infancy. She was diagnosed to have a peroxisomal biogenesis disorder on further investigation. Peroxisomal disorders represent a spectrum of conditions with absent or abnormal function of intra-cytoplasmic organelles called Peroxisomes. Clinical presentation is quite varied, depending on both the type and severity. We describe the clinical presentation of this case, followed by a brief discussion on Peroxisomal disorders.

Do orthopaedic surgeons practice what they preach

Abstract: Good medical practice predicates a contemporary knowledge of the literature. The British edition of the Journal of Bone and Joint Surgery (JBJS [Br]) is considered one of the leading orthopaedic journals. While seeking guidance on proposed changes to departmental policy, discussion with some high-profile units raised concerns regarding the implementation of their published clinical recommendations. We intended to contact the publishing departments, to establish their routine practice with respect to the topic on which they have written. We reviewed all articles published in JBJS (Br) between January 2005 and December 2006. Target papers were those that recommended a change in practice. The originating department was contacted by telephone and communication sought from an individual not directly involved in the publication, but on whom the change in practice would impact. Seventy-nine papers; representing the work of 87 separate hospitals from 22 different countries, were identified. We found that publishe...

How to write a systematic review: Tips and tricks for surgeons in training

Abstract: Systematic reviews provide high-quality critical appraisal and evidence-based summaries on a topic. They represent a key resource for time-pressured clinicians as they strive to deliver better pati...