Title: An evaluation of morphine use in obstetrics during a national shortage of diamorphine a re-audit highlighting changes in practice over time

Abstract:

Since the national shortage of diamorphine began in late 2018, preservative-free morphine has been used as an alternative adjunct to local anaesthetics in intrathecal blockade in obstetrics. An initial departmental audit following this enforced change to morphine established a statistically significant increased risk of PONV and reduced patient satisfaction compared with previous diamorphine use. A statistically significant link between intrathecal morphine and reduced post-operative oramorph use was also found. These finding correlate with the different pharmacodynamic profiles of the two drugs. The aim of our re-audit was to evaluate the way in which morphine use changed over time, following our initial audit feedback and with increased familiarity, within our department.

Biography:

Hana Damirji is an anaesthetics and intensive care trainee currently working at the Lister Hospital in Stevenage, UK. She completed her medical training in London, graduating from University College London in 2015 with distinction and also obtaining first class honors in Neuroscience iBSc. Previous publications include the initiation of a debriefing session for intensive care trainees, which NHS Improvement listed as one of the top 10 quality improvement measures of 2017. ​

Title: Constellation of rare complications following acute pancreatitis

Abstract:

Acute pancreatitis is characterised by inflammation of pancreas which can be of varying severity depending on the local and systemic complications. An enterovesical fistula is an extremely rare complication of necrotising pancreatitis. Pseudoaneurysms are another rare set of complications associated with pancreatitis that can occur due to the pancratic enzymes eroding the surrounding planes. This case involves the simultaneous presence of these uncommon conditions in a single patient. A chronic alcoholic patient presented to the ED with pain in left lumbar region associated with obstipation, bilious vomiting and fever. A CT scan of abdomen was done which reported necrotic area within body and tail of pancreas involving less than 30% area with multiple hypodense peripherally enhancing collections in anterior pararenal space along with left paracolic gutter and left supramesocolic space. 

Biography:

Avneet Kaur is a general surgery postgraduate resident at VMMC and Safdarjang Hospital, New Delhi. She has an avid interest in the research and enthusiastic about surgical oncology. She is curious about the unusual presentations of the diseases and has been an active member of the conferences organized by the institution.

Title: Keynote Speaker Slots Available

Title: Assessing the burden of abdominal tuberculosis in current scenario

Abstract:

The diagnosis of abdominal tuberculosis poses quite a unique challenge due to its non-specific clinical presentation and can be a significant cause of mortality and morbidity to patients of any age group.  Diagnosis of abdominal tuberculosis can be made by high index  of clinical suspicion and  correlation with radiologic, microbiologic, histopathologic and molecular studies.  While most abdominal TB cases can be treated conservatively with anti-tubercular therapy, still significant number of cases require surgical intervention due to delayed diagnosis and presentation, multi-drug resistant strains and increasing prevalence of HIV infections . The post-operative care is a daunting task for the surgeons in terms of nutritional aspect, as few of these patient may inevitably develop high output fistula, short bowel syndrome and necessity for prolonged TPN with its associated complications. The whole pathophysiology of abdominal tuberculosis is exhaustively discussed in many literatures published so far; however, in this retrospective five-year study of 380 patients ; we attempted to evaluate the burden of this disease from surgical perspective ; the role of surgery in delayed cases with complications and the spectrum of peri-operative challenges to surgeons in an endemic country like India.  Being an otherwise, potentially treatable infectious disease, initiation of anti- tubercular therapy early in the course of the disease process can help to prevent catastrophic consequences and reduce mortality and morbidity.

Biography:

Lira Sangtam is a General and laparoscopic surgeon, at VMMC and Safdarjung Hospital, New Delhi, where she also completed her three-years senior residency programme. She also worked as one of the only two surgeons in a remote Island of Lakshadweep, Union territory of India for a year. She has keen interest in minimal access colorectal surgery and pursuing to upgrade her skills in the field.

Title: A predictor of axillary lymph node metastasis in breast cancer patients?

Abstract:

This study evaluated the relationship between preoperative neutrophil / lymphocyte ratio - platelet / lymphocyte ratio, clinicopathological, radiological factors, and axillary lymph node metastasis in stage I-III breast cancer to determine if axillary surgery can be safely omitted in selected patients.The study included 158 Stage I-III breast cancer patients operated on at Baskent University Zubeyde Hanim Research Center between 2011 and 2018. The incidence of axillary lymph node metastasis was correlated with clinical, radiological, pathological, and laboratory (neutrophil count to lymphocyte count, platelet count to lymphocyte count) findings by univariate and multivariate analyses. Sensitivity and specificity calculations, positive predictive value, negative predictive value, positive and negative Likelihood Ratio (accuracy ratio), and exact accuracy were calculated for neutrophil/lymphocyte ratio cut-off values of 3.5 and 1.

Biography:

Tugba Han Oner works as a General Surgery specialist in Izmir Baskent University Zubeyde Hanım Application and Research Center in Izmir Karsıyaka district.

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