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  1. Book ; Online ; E-Book: Prehabilitation for cancer surgery

    Chakraborty, Arunangshu / Balakrishnan, Ashokka

    2022  

    Author's details Arunangshu Chakraborty, Ashokka Balakrishnan, editors
    MeSH term(s) Neoplasms/surgery. ; Diet Therapy.
    Keywords Cancer/Surgery ; Diet therapy
    Subject code 616.994059
    Language English
    Size 1 online resource (346 pages)
    Publisher Springer
    Publishing place Singapore
    Document type Book ; Online ; E-Book
    Remark Zugriff für angemeldete ZB MED-Nutzerinnen und -Nutzer
    ISBN 981-16-6493-5 ; 981-16-6494-3 ; 978-981-16-6493-9 ; 978-981-16-6494-6
    Database ZB MED Catalogue: Medicine, Health, Nutrition, Environment, Agriculture

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  2. Article ; Online: ‘Exam preparedness’

    Balakrishnan Ashokka / Tat Leang Lee / Daniëlle M.L. Verstegen

    The Asia Pacific Scholar, Vol 6, Iss 4, Pp 80-

    Exploring non-academic predictors of postgraduate exam success

    2021  Volume 91

    Abstract: Introduction: There are certain factors in exam preparedness that are not well studied in the postgraduate medical education context. Non-academic predictors have been extensively researched but usually in isolation. Methods: The study involved a ... ...

    Abstract Introduction: There are certain factors in exam preparedness that are not well studied in the postgraduate medical education context. Non-academic predictors have been extensively researched but usually in isolation. Methods: The study involved a sequential explanatory mixed methods research design. The study was conducted among anaesthesia postgraduates appearing for high-stake nation-wide primary examination. Data obtained by a questionnaire assessing pre-examination attributes were compared with the students’ reflections through focus group discussions (FGD) after the formal declaration of results. The examination had an overall pass rate of 42.9% (18 out of 42). Results: The study showed that pre-examination questionnaire could identify attributes and study behaviours in the postgraduates who passed. Passers procrastinated three times lesser, pursuing a timetable-based study (conscientiousness); had higher metacognitive self-regulation (p value<0.05) applying concentrated self-directed learning & effective group study and higher self-efficacy compared to those who failed. The focus group discussions affirmed of these attributes in candidates who ‘breeze through exams’. Postgraduate success required better ‘work-study’ balance, self & cross regulation and peer and faculty support. Conclusion: Implementing a composite tool to assess ‘exam preparedness’, we propose, would help the learners and teachers to skim for non-academic factors (metacognitive self-regulation, self-efficacy, conscientiousness) that influence the chances of success. Understanding & predicting this would help educators to identify the ‘candidates with difficulty’ and delegate personalised faculty attention. This could guide the exam candidates to have a ‘reality check’ to plan and pace their effort with peer learning, consolidated study and goal orientation.
    Keywords postgraduate exam success ; non-academic predictors ; self-regulation ; Education (General) ; L7-991 ; Medicine (General) ; R5-920
    Subject code 370
    Language English
    Publishing date 2021-10-01T00:00:00Z
    Publisher National University of Singapore
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  3. Article ; Online: Anesthesia for pulmonary veno-occlusive disease: the dilemma and what we should know as anesthesiologists: A case report.

    Foong, Theng Wai / Tan, Pei Shan / Thampi, Swapna / Balakrishnan, Ashokka

    Medicine

    2020  Volume 99, Issue 30, Page(s) e21517

    Abstract: Introduction: Pulmonary veno-occlusive disease (PVOD) is a rare form of pulmonary hypertension. It is often underdiagnosed or misdiagnosed as idiopathic pulmonary arterial hypertension (PAH). Inappropriate treatment may cause worsening of symptoms which ...

    Abstract Introduction: Pulmonary veno-occlusive disease (PVOD) is a rare form of pulmonary hypertension. It is often underdiagnosed or misdiagnosed as idiopathic pulmonary arterial hypertension (PAH). Inappropriate treatment may cause worsening of symptoms which may lead to fatal outcomes. Anesthetic considerations and management for pulmonary hypertension are well described, but few anesthesiologists are aware of the entity of PVOD and its management.
    Patient concerns: We report a case of PVOD in a 73-year-old female who was on concurrent aspirin and anagrelide, requiring emergent open femoral hernia repair.
    Diagnosis: PVOD and incarcerated femoral hernia INTERVENTION:: Combined spinal-epidural (CSE) was performed to enable the surgery.
    Outcome: Surgery was completed successfully under central neuraxial anesthesia and the patient remained stable and comfortable throughout, avoiding the need for general anesthesia. Due to the concurrent aspirin and anagrelide therapy, significant bleeding from the CSE puncture site was observed immediately post-operatively. This was resolved with external manual compression and withholding the aspirin and anagrelide. Patient remained well without neurological deficit and was discharged postoperative day seven.
    Lessons: It is important to differentiate PVOD from PAH due to the controversial use of pulmonary vasodilators in PVOD. Pulmonary vasodilator is commonly used to treat acute pulmonary hypertension in PAH but its usage may lead to pulmonary edema in patients with PVOD. Hence, with no ideal treatment available, the avoidance of general anesthesia is crucial to prevent acute pulmonary hypertensive crisis in patient with PVOD. However, this needs to be weighed against the elevated risk of central neuraxial bleeding when performing a CSE in a patient on concurrent aspirin and anagrelide therapy. Calculated decision-making considering the risks and benefits of all alternatives should be carried out in such a scenario, and measures should be taken in anticipation of the potential consequences of the eventual decision.
    Conclusion: It is important to differentiate PVOD from PAH. PVOD has unique anesthetic considerations due to the controversial use of pulmonary vasodilators. This case also emphasizes the importance of active anticipation of potential issues and adequate follow up.
    MeSH term(s) Aged ; Anesthesia, Epidural ; Anesthesia, Spinal ; Female ; Hernia, Femoral/surgery ; Herniorrhaphy ; Humans ; Intraoperative Complications/etiology ; Intraoperative Complications/prevention & control ; Pulmonary Veno-Occlusive Disease/complications
    Language English
    Publishing date 2020-09-12
    Publishing country United States
    Document type Case Reports ; Journal Article
    ZDB-ID 80184-7
    ISSN 1536-5964 ; 0025-7974
    ISSN (online) 1536-5964
    ISSN 0025-7974
    DOI 10.1097/MD.0000000000021517
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    bis Jg. 2021: Bestellungen von Artikeln über das Online-Bestellformular
    ab Jg. 2022: Lesesaal (EG)

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  4. Article ; Online: Mobile learning in clinical settings: unveiling the paradox.

    Lee, Shuh Shing / Tay, Sook Muay / Balakrishnan, Ashokka / Yeo, Su Ping / Samarasekera, Dujeepa D

    Korean journal of medical education

    2021  Volume 33, Issue 4, Page(s) 349–367

    Abstract: Purpose: The use of mobile devices among medical students and residents to access online material in real-time has become more prevalent. Most literature focused on the technical/functional aspects of mobile use. This study, on the other hands, explored ...

    Abstract Purpose: The use of mobile devices among medical students and residents to access online material in real-time has become more prevalent. Most literature focused on the technical/functional aspects of mobile use. This study, on the other hands, explored students, doctors and patients' preferences and reasons towards the use of mobile devices in clinical settings underpinned by the Technology Acceptance Model 2 (TAM 2).
    Methods: This research employs an exploratory research design using survey and semi-structured interviews. An online survey was administered to clinical year medical students, followed by semi-structured interviews with the doctors and patients. Questions for the online survey and semi-structured interviews were derived from previous literature and was then reviewed by authors and an expert panel. A convenience sampling was used to invite voluntary participants.
    Results: Survey findings showed that most medical students used their devices to find drug information and practice guidelines. The majority of the students accessed UpToDate followed by Google to access medical resources. Key barriers that students often encountered during the use of mobile devices were internet connectivity in the clinical settings, reliability of the information, and technical issues. Thematic analysis of the interviews revealed four themes: general usage by students, receptivity of the use of mobile devices by students, features in selecting resources for mobile learning, and limitation in the current use of mobile devices for learning.
    Conclusion: The findings from this study assist in recommending suitable material using mobile devices to enhance learning in the clinical environment and expand the TAM 2.
    MeSH term(s) Computers, Handheld ; Education, Medical, Undergraduate ; Humans ; Learning ; Reproducibility of Results ; Students, Medical
    Language English
    Publishing date 2021-11-30
    Publishing country Korea (South)
    Document type Journal Article
    ZDB-ID 2846769-3
    ISSN 2005-7288 ; 2005-2367 ; 2005-727X ; 1225-8067
    ISSN (online) 2005-7288 ; 2005-2367
    ISSN 2005-727X ; 1225-8067
    DOI 10.3946/kjme.2021.204
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: In the Extraordinary Times of Coronavirus Disease 2019

    Tan Wei Loong Barry / Tan Sze Lyn Jasmin Jeanette / Balakrishnan Ashokka / Keith Gerard Lopez / Joseph Thambiah / Naresh Kumar

    Asian Spine Journal, Vol 14, Iss 5, Pp 721-

    Clinical Strategies for Performing Spinal Surgery

    2020  Volume 729

    Abstract: The coronavirus disease 2019 (COVID-19) pandemic has caused pronounced strain on global healthcare systems, forcing the streamlining of clinical activities and conservation of health resources. There is a pressing need for institutions to present ... ...

    Abstract The coronavirus disease 2019 (COVID-19) pandemic has caused pronounced strain on global healthcare systems, forcing the streamlining of clinical activities and conservation of health resources. There is a pressing need for institutions to present discipline-specific strategies for the management of COVID-19 patients. We present the comprehensive considerations at the National University Hospital, Singapore from the surgeon’s and anesthetist’s perspectives in the performance of spinal surgery in COVID-19 patients. These are based on national guidelines and overarching principles of protection for the healthcare workers (HCWs) and efficiency in surgical planning. The workflow begins with the emergency department screening that has been adapted to the local epidemiology of COVID-19 in order to identify suspected/confirmed cases. If patient history cannot be obtained, demographic, clinical, and imaging data are used. Designated orthopedic “contaminated teams” are available 24/7 with an activation time of <30 minutes for review. In cases where sub-specialty spine surgeons were required, these professionals were inducted into the “contaminated team” and quarantined until cleared to return to work. Indications for emergency spine surgery were determined pre-emptively. Preoperative surgical considerations included the minimization of manpower, limited dissection, reduced operative time, and judicious use of equipment, leading to reduced aerosolization. Anesthesia considerations include preoperative screening for COVID-19–related concerns that influence surgery, operating room process planning and induction, intraoperative, reversal, recovery, and resuscitation considerations. Focused multi-disciplinary preoperative briefing facilitates familiarization. Surgical, anesthetic, and postoperative workflows were designed to reduce the risk of transmission and protect HCWs while effectively performing spinal surgery. The COVID-19 pandemic has necessitated paradigm shifts in healthcare planning, hospital workflows, and ...
    Keywords covid-19 ; spine surgery ; operative surgical procedures ; perioperative procedures ; anesthesia methods ; hospital planning ; personal protective equipment ; Medicine ; R
    Subject code 610
    Language English
    Publishing date 2020-10-01T00:00:00Z
    Publisher Korean Spine Society
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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