Effects of medically generated electromagnetic interference from medical devices on cardiac implantable electronic devices: A review

As cardiac implantable electronic devices(CIED)become more prevalent,it is important to acknowledge potential electromagnetic interference(EMI)from other sources,such as internal and external electronic devices and procedures and its effect on these devices.EMI from other sources can potentially inhibit pacing and trigger shocks in permanent pacemakers(PPM)and implantable cardioverter defibrillators(ICD),respectively.This review analyzes potential EMI amongst CIED and left ventricular assist device,deep brain stimulators,spinal cord stimulators,transcutaneous electrical nerve stimulators,and throughout an array of procedures,such as endoscopy,bronchoscopy,and procedures involving electrocautery.Although there is evidence to support EMI from internal and external devices and during procedures,there is a lack of large multicenter studies,and,as a result,current management guidelines are based primarily on expert opinion and anecdotal experience.We aim to provide a general overview of PPM/ICD function,review documented EMI effect on these devices,and acknowledge current management of CIED interference.

Literature Review of Inflammatory Bowel Disease in South Asian Populations

Background: South Asians have been recently identified as having rapidly rising incidence of inflammatory bowel disease (IBD). There is a paucity of data regarding the phenotypic and genotypic associations of IBD among the patients of this region. Due to the rising disease prevalence, a study on South Asian population can disclose more information about the etiopathogenetic causes of the disease. Methods: Here we did a review article of IBD among South Asians. In order to get a correct sense of factors associated with the disease, we have reviewed approximately 150 articles through the PubMed search and google scholar. Results: We attempted to find temporal trends of IBD among south Asian population, compared phenotype and genotype of IBD among South Asians and western patients and looked at the patterns of IBD presentation in different countries of South Asia. We have also reviewed the differences in the incidence of IBD among South Asian immigrants and discussed the treatment challenges of IBD among this special population. Conclusion: We identified that both patients in South Asia as well as South Asian patients living in Western countries are at greater risk for all types of IBD. This geographical region provides an opportunity for revealing possible etiopathogenetic factors. Further population-based studies, comparison of studies in South Asians and immigrants from South Asian countries, and large-scale biologic treatment models need to be accelerated to control the disease burden in South Asians, as well as to achieve reduced burden globally.

A Holistic Approach to Enhance FRCS General Surgery Examination Training Using Adult Learning Model: A Non-Profit Initiative

Objectives: To evaluate the impact of adult learning and simulation-based learning (SBL) on surgical trainees’ learning experiences and Fellowship of the Royal College of Surgeons (FRCS) Section 2 General Surgery examination pass rate. Methods: This was a cross-sequential study involving 148 surgical candidates (72 UK trainees, 75 non-UK trainees) who had attended our revision course (Phoenix FRCS Course) from June 2017 until 2023. Each course comprised a two-day weekend preparation with dedicated sections for clinical, viva, and academic reading, incorporating SBL as its key learning style. We maintained a prospective database of candidate and course details, examination results, and feedback since the course inception. Results: We found that 97% of candidates passed the FRCS examination after their first attempt. The course was attended once by 89% of candidates, and only 3 of the 148 candidates exhausted all four attempts at the examination. Candidate feedback for the course and its style of learning was positive, with simulation-based table viva sessions and virtual clinical sessions proving the most popular learning sessions (95% and 80% of candidates attending courses run in December 2017, April 2018, and May 2021 rated them “Excellent” respectively). Conclusions: The course is centered around shared adult learning and mindfulness tools to encourage candidates to learn from each other and develop confidence and mastery in all domains of surgical practice. These methods have been shown to be effective in achieving high success rates in the Intercollegiate and International FRCS examinations for UK and overseas surgeons.

Takotsubo cardiomyopathy:A comprehensive review

Takotsubo cardiomyopathy(TCM),also known as stress cardiomyopathy,occurs in the setting of catecholamine surge from an acute stressor.This cardiomyopathy mimics acute myocardial infarction in the absence of coronary disease.The classic feature of TCM is regional wall motion abnormalities with characteristic ballooning of the left ventricle.The etiology of the stressor is often physical or emotional stress,however iatrogenic causes of TCM have been reported in the literature.In our review,we discuss medications,primarily the exogenous administration of catecholamines,and a wide array of procedures with subsequent development of iatrogenic cardiomyopathy.TCM is unique in that it is transient and has favorable outcomes in most individuals.Classically,beta-blockers and ACE-inhibitors have been prescribed in individuals with cardiomyopathy;however,unique to TCM,no specific treatment is required other than temporary supportive measures as this process is transient.Additionally,no improvement in mortality or recurrence have been reported in patients on these drugs.The aim of this review is to elucidate on the iatrogenic causes of TCM,allowing for prompt recognition and management by clinicians.