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  1. Article ; Online: Emergency single-incision laparoscopic cholecystectomy for acute cholecystitis: A multi-center study.

    Cawich, Shamir O / Dapri, Giovanni

    Medicine international

    2022  Volume 2, Issue 4, Page(s) 21

    Abstract: Single-incision laparoscopy is accepted as a safe alternative to multiple port laparoscopy for elective cholecystectomy; however, there are limited data on its use in patients with acute cholecystitis. The present multi-center study evaluated the ... ...

    Abstract Single-incision laparoscopy is accepted as a safe alternative to multiple port laparoscopy for elective cholecystectomy; however, there are limited data on its use in patients with acute cholecystitis. The present multi-center study evaluated the outcomes of emergency single-incision surgeries for acute cholecystitis in hospitals in Belgium, Jamaica, and Trinidad and Tobago over a 5-year period. Standardized definitions of uncomplicated and complicated acute cholecystitis were used and the data were compared using SPSS software. The results revealed that over the 5-year period, 108 patients with a mean age of 48±15 years and a mean body mass index of 27±4.2 kg/m
    Language English
    Publishing date 2022-06-20
    Publishing country England
    Document type Journal Article
    ISSN 2754-1304
    ISSN (online) 2754-1304
    DOI 10.3892/mi.2022.46
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: Colorectal resections for malignancy: A pilot study comparing conventional

    Cawich, Shamir O / Plummer, Joseph Martin / Griffith, Sahle / Naraynsingh, Vijay

    World journal of clinical cases

    2024  Volume 12, Issue 3, Page(s) 488–494

    Abstract: Background: Laparoscopic colectomy is widely accepted as a safe operation for colorectal cancer, but we have experienced resistance to the introduction of the FreeHand: Aim: To compare the initial results between conventional and FreeHand: Methods!# ...

    Abstract Background: Laparoscopic colectomy is widely accepted as a safe operation for colorectal cancer, but we have experienced resistance to the introduction of the FreeHand
    Aim: To compare the initial results between conventional and FreeHand
    Methods: This was a prospective study of outcomes from all laparoscopic colectomies performed for colorectal carcinoma from November 29, 2021 to May 30, 2022. The following data were recorded: Operating time, conversions, estimated blood loss, hospitalization, morbidity, surgical resection margins and number of nodes harvested. All data were entered into an excel database and the data were analyzed using SPSS ver 20.0.
    Results: There were 23 patients undergoing colectomies for malignant disease: 8 (35%) FreeHand
    Conclusion: The FreeHand
    Language English
    Publishing date 2024-02-05
    Publishing country United States
    Document type Journal Article
    ISSN 2307-8960
    ISSN 2307-8960
    DOI 10.12998/wjcc.v12.i3.488
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article: Allergic Dermatitis Following Bilateral Oxidized Zirconium Total Knee Replacements.

    Mencia, Marlon M / Cawich, Shamir O

    Journal of orthopaedic case reports

    2021  Volume 11, Issue 2, Page(s) 67–70

    Abstract: Introduction: Total knee replacement (TKR) utilization is expected to increase by 673% in 2030, with patients between the ages of 45 to and 64 years representing the fastest-growingfastest growing age group requiring joint replacement. This group not ... ...

    Abstract Introduction: Total knee replacement (TKR) utilization is expected to increase by 673% in 2030, with patients between the ages of 45 to and 64 years representing the fastest-growingfastest growing age group requiring joint replacement. This group not only demands a higher- performinghigher performing, durable prosthesis but are is also the most likely to be dissatisfied if their expectations are not met. Hypo-allergenic implants have been developed by some implant manufacturers to fill this need, so the occurrence of allergic skin reactions after surgery is unanticipated and can have unwanted consequences if not recognized and managed appropriately.
    Case report: We present the case of a 55-year-old woman who underwent bilateral staged TKR using oxidized zirconium implants and subsequently developed eczematous skin reactions. In both instances, she presented with a peri-incisional erythematous blistering skin reaction that was successfully treated with topical corticosteroids. Investigations revealed no evidence of infection or allergic-typeallergic type reactions to the metals contained in the knee replacements.
    Conclusion: Allergic skin reactions following TKR are very rare, and are not necessarily due to a metal hypersensitivity. Infection must be excluded in all cases and a trial of topical corticosteroids is useful before prior to more aggressive treatment, with the removal of the implant reserved as a last resort. To the best of our knowledge, this is the first case in the literature that reports the occurrence of allergic skin reactions following oxidized zirconium TKRs, and highlights the fact that allergic skin reactions can occur when using hypo-allergenic implants. Surgeons should be aware of this possibility and counsel their patients appropriately during the informed consent process.
    Language English
    Publishing date 2021-06-01
    Publishing country India
    Document type Case Reports
    ZDB-ID 2658169-3
    ISSN 2250-0685
    ISSN 2250-0685
    DOI 10.13107/jocr.2021.v11.i02.2030
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article: Laparoscopic Release for Median Arcuate Ligament Compression Syndrome Associated with a Celiac-Mesenteric Trunk.

    Cawich, Shamir O / Harnanan, Dave / Pran, Lemuel

    Case reports in vascular medicine

    2022  Volume 2022, Page(s) 3595603

    Abstract: The median arcuate ligament compression syndrome is a rare entity that occurs in 2 per 100,000 unselected individuals. We present a case where the median arcuate ligament compression syndrome was associated with an equally uncommon anatomic variation-a ... ...

    Abstract The median arcuate ligament compression syndrome is a rare entity that occurs in 2 per 100,000 unselected individuals. We present a case where the median arcuate ligament compression syndrome was associated with an equally uncommon anatomic variation-a celiac-mesenteric trunk, which occurs in 0.42-2.7% of unselected individuals. We could find no prior report of a celiac-mesenteric trunk being associated with the median arcuate ligament compression syndrome. This report also adds to the literature to show that a laparoscopic approach to median arcuate ligament release is feasible.
    Language English
    Publishing date 2022-04-22
    Publishing country United States
    Document type Case Reports
    ZDB-ID 2629916-1
    ISSN 2090-6994 ; 2090-6986
    ISSN (online) 2090-6994
    ISSN 2090-6986
    DOI 10.1155/2022/3595603
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Epidemiology of neoplastic colorectal polyps in a Caribbean country.

    Cawich, Shamir O / Mahabir, Avidesh / Arthurs, Milton

    Medicine international

    2021  Volume 1, Issue 4, Page(s) 10

    Abstract: Screening is practiced to identify and remove neoplastic colorectal polyps prior to their transformation into colorectal cancer (CRC). The aim of the present study was to document the epidemiology of neoplastic colorectal polyps in order to obtain ... ...

    Abstract Screening is practiced to identify and remove neoplastic colorectal polyps prior to their transformation into colorectal cancer (CRC). The aim of the present study was to document the epidemiology of neoplastic colorectal polyps in order to obtain important data that may then be used to guide screening protocols in Jamaica. For this purpose, an audit was performed to identify all consecutive patients who had neoplastic polyps detected at a screening colonoscopy at a facility in Jamaica from January 1, 2015 to December 30, 2018. The following data were collected: Patient demographics, polyp location, polyp synchronicity and histopathological information. The results revealed that a total of 480 colonoscopies were performed over the study period. With the exclusion of 2 patients with innumerable polyps as a part of polyposis syndrome, there were a total of 92 neoplastic polyps in 68 patients. Polyps were most commonly located in the right colon (55.6%), followed by the left colon (38%) and rectum (6.5%). Upon the histological evaluation, 63 polyps were found to be benign adenomas with mild to moderate dysplastic alterations, 15 were adenomas with severe dysplasia and/or carcinoma
    Language English
    Publishing date 2021-07-29
    Publishing country England
    Document type Journal Article
    ISSN 2754-1304
    ISSN (online) 2754-1304
    DOI 10.3892/mi.2021.10
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  6. Article: Laparoscopic Hepatectomy via Remote Mentoring From Jamaica to Trinidad.

    Cawich, Shamir O / Simpson, Lindberg / Josephs, Andrew

    Cureus

    2021  Volume 13, Issue 12, Page(s) e20177

    Abstract: Laparoscopic hepatectomy brings many physiologic advantages over open hepatectomy and adheres to all oncologic principles. It is currently considered the standard of care. However, these are technically difficult operations to perform. Consequently, the ... ...

    Abstract Laparoscopic hepatectomy brings many physiologic advantages over open hepatectomy and adheres to all oncologic principles. It is currently considered the standard of care. However, these are technically difficult operations to perform. Consequently, the expertise may not be universally available for all patients to benefit from laparoscopic hepatectomy. We report a unique situation where remote mentoring was used to guide bariatric surgeons in Jamaica to complete a laparoscopic hepatectomy.
    Language English
    Publishing date 2021-12-05
    Publishing country United States
    Document type Case Reports
    ZDB-ID 2747273-5
    ISSN 2168-8184
    ISSN 2168-8184
    DOI 10.7759/cureus.20177
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article: Greater Gender Diversity Observed at Orthopaedic Conferences in the Caribbean Than in the United States or England.

    Mencia, Marlon M / Bidaisee, Shanta / Quan Soon, Camille / Cawich, Shamir O

    Cureus

    2022  Volume 14, Issue 8, Page(s) e28224

    Abstract: Introduction Women are underrepresented in orthopaedics. Recent studies have shown that women comprise only a very small proportion of all practising orthopaedic surgeons in the United States. One theory that seeks to explain this disparity is the lack ... ...

    Abstract Introduction Women are underrepresented in orthopaedics. Recent studies have shown that women comprise only a very small proportion of all practising orthopaedic surgeons in the United States. One theory that seeks to explain this disparity is the lack of female mentors in orthopaedic surgery. Women are particularly influenced by same-sex mentors, and the paucity of mentors sets up a negative feedback loop that further reduces applications to residency programs. Presentation of scholarly work at conferences increases the visibility of women and represents important opportunities to encourage young female doctors to the speciality. The annual meeting of The Caribbean Association of Orthopaedic Surgeons (TCOS) is a forum that allows regional exposure to young doctors. In the present work, we aim to analyse the gender diversity among presenters at the annual TCOS meetings. Methods A retrospective analysis of the final programs of TCOS meetings over five years was conducted to determine the sex of the presenter, their roles, and topics. The first author listed on the program was taken as the presenter unless it was otherwise stated. Gender was determined using conventional naming taxonomy. Presenters were classified as podium presenters or moderators and presentations as clinical or non-clinical. We subdivided clinical presentations into seven subspecialty areas. A Chi-squared test was used to calculate differences between groups, with a p-value of < 0.05 representing significance. Statistical tests were performed using Analyse-it for Microsoft Excel 5.40 (Analyse-it Software Ltd). Results There was a total of 195 podium presentations over the study period. During this time, there was a steady increase in the number of presentations by women, with a mean value of 19.5%. Compared with men, women presented fewer clinical papers (52.6%vs 73.9%, p=0.037), presented on more general topics (63.2% vs 31.2%, p=0.007) and were less likely to moderate a session (2.7% vs 97.3%, p=0.014). Presentations by female residents were marginally higher than the mean rate for women overall and were representative of the gender distribution in the resident pool. Conclusions There are significantly fewer presentations by women than men at the annual TCOS meetings. Encouragingly, however, there is a positive trend towards greater female presentations over the study period. Our results show that despite being underrepresented, more women are presenting at orthopaedic conferences in the Caribbean than in the United States or England.
    Language English
    Publishing date 2022-08-21
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2747273-5
    ISSN 2168-8184
    ISSN 2168-8184
    DOI 10.7759/cureus.28224
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article: Whipple's pancreaticoduodenectomy at a resource-poor, low-volume center in Trinidad and Tobago.

    Cawich, Shamir O / Thomas, Dexter A / Pearce, Neil W / Naraynsingh, Vijay

    World journal of clinical oncology

    2022  Volume 13, Issue 9, Page(s) 738–747

    Abstract: Background: Many authorities advocate for Whipple's procedures to be performed in high-volume centers, but many patients in poor developing nations cannot access these centers. We sought to determine whether clinical outcomes were acceptable when ... ...

    Abstract Background: Many authorities advocate for Whipple's procedures to be performed in high-volume centers, but many patients in poor developing nations cannot access these centers. We sought to determine whether clinical outcomes were acceptable when Whipple's procedures were performed in a low-volume, resource-poor setting in the West Indies.
    Aim: To study outcomes of Whipple's procedures in a pancreatic unit in the West Indies over an eight-year period from June 1, 2013 to June 30, 2021.
    Methods: This was a retrospective study of all patients undergoing Whipple's procedures in a pancreatic unit in the West Indies over an eight-year period from June 1, 2013 to June 30, 2021.
    Results: This center performed an average of 11.25 procedures per annum. There were 72 patients in the final study population at a mean age of 60.2 years, with 52.7% having American Society of Anesthesiologists scores ≥ III and 54.1% with Eastern Cooperative Oncology Group scores ≥ 2. Open Whipple's procedures were performed in 70 patients and laparoscopic assisted procedures in 2. Portal vein resection/reconstruction was performed in 19 (26.4%) patients. In patients undergoing open procedures there was 367 ± 54.1 min mean operating time, 1394 ± 656.8 mL mean blood loss, 5.24 ± 7.22 d mean intensive care unit stay and 15.1 ± 9.53 d hospitalization. Six (8.3%) patients experienced minor morbidity, 10 (14%) major morbidity and there were 4 (5.5%) deaths.
    Conclusion: This paper adds to the growing body of evidence that volume alone should not be used as a marker of quality for patients requiring Whipple's procedures. Low volume centers in resource poor nations can achieve good short-term outcomes. This is largely due to the process of continuous, adaptive learning by the entire hospital.
    Language English
    Publishing date 2022-07-07
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2587357-X
    ISSN 2218-4333
    ISSN 2218-4333
    DOI 10.5306/wjco.v13.i9.738
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article: Robot-Assisted Common Bile Duct Exploration in Trinidad & Tobago.

    Cawich, Shamir O / Spence, Richard / Senasi, Ramdas / Naraynsingh, Vijay

    Cureus

    2022  Volume 14, Issue 11, Page(s) e30965

    Abstract: Although laparoscopic common bile duct exploration is a feasible and safe option for the operative management of choledocholithiasis, there has been a general reluctance to perform this procedure in Caribbean practice. This is largely because duct ... ...

    Abstract Although laparoscopic common bile duct exploration is a feasible and safe option for the operative management of choledocholithiasis, there has been a general reluctance to perform this procedure in Caribbean practice. This is largely because duct exploration is perceived to be difficult with laparoscopic instruments, and endoscopic retrograde cholangiopancreatography (ERCP) has become increasingly available. We report a case in which stones were extracted laparoscopically from the common bile duct, aided by the FreeHand® (Freehand 2010 Ltd., Guildford, Surrey, UK) robot, to show that the procedure is feasible and safe in the Caribbean environment.
    Language English
    Publishing date 2022-11-01
    Publishing country United States
    Document type Case Reports
    ZDB-ID 2747273-5
    ISSN 2168-8184
    ISSN 2168-8184
    DOI 10.7759/cureus.30965
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article: Aggressive Resection for a Primary Leiomyosarcoma of the Vena Cava Masquerading as a Pancreatic Head Tumor.

    Cawich, Shamir O / Harnanan, Dave / Coye, Adrian / Johnson, Lisa J / Sanchez, Hugh E / Nicholas, Tracey

    Cureus

    2023  Volume 15, Issue 10, Page(s) e46634

    Abstract: Smooth muscle is a normal component of the inferior vena cava (IVC) wall. Although uncommon, the smooth muscle component may undergo neoplastic change. Benign neoplasms are termed leiomyomas, and when there is a malignant change, the nomenclature is ... ...

    Abstract Smooth muscle is a normal component of the inferior vena cava (IVC) wall. Although uncommon, the smooth muscle component may undergo neoplastic change. Benign neoplasms are termed leiomyomas, and when there is a malignant change, the nomenclature is changed to an IVC leiomyosarcoma. Leiomyosarcomas of the IVC are rare, with less than 150 cases reported in medical literature. Unfortunately, the majority of IVC leiomyosarcomas are diagnosed at advanced disease stages. Surgical resection of locally advanced lesions is technically challenging, but complete resection is the mainstay of treatment as leiomyosarcomas respond poorly to chemo-radiotherapy. Due to the advanced disease stage at diagnosis and the technical complexity of IVC resection and reconstruction, most patients are transferred to high-volume centers in developed nations. We report a case of a patient with a locally advanced leiomyosarcoma masquerading as a pancreatic head tumor. This patient could not access care in a high-volume center and required aggressive maneuvers to resect the IVC leiomyosarcoma in a resource-poor, low-volume center. We present this case to highlight the steps in operative management and also to show that these procedures can be carried out in resource-poor environments once there is meticulous planning, appropriate equipment, and multidisciplinary care.
    Language English
    Publishing date 2023-10-07
    Publishing country United States
    Document type Case Reports
    ZDB-ID 2747273-5
    ISSN 2168-8184
    ISSN 2168-8184
    DOI 10.7759/cureus.46634
    Database MEDical Literature Analysis and Retrieval System OnLINE

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