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Article ; Online: Rectal Cancer Metastasis to the Anal Verge

Johnson GGRJ / Yip B / Helewa RM / Shariff F / Hyun E

International Medical Case Reports Journal, Vol Volume 15, Pp 1-

An Unusual Case Presentation and Review of the Literature

2022 Volume 6

Abstract: Garrett GRJ Johnson,1,2 Benson Yip,1 Ramzi M Helewa,1 Farhana Shariff,1 Eric Hyun1 1Department of Surgery, Section of General Surgery, University of Manitoba, Winnipeg, Manitoba, Canada; 2Clinician Investigator Program, University of Manitoba, Winnipeg, ... ...

Abstract	Garrett GRJ Johnson,1,2 Benson Yip,1 Ramzi M Helewa,1 Farhana Shariff,1 Eric Hyun1 1Department of Surgery, Section of General Surgery, University of Manitoba, Winnipeg, Manitoba, Canada; 2Clinician Investigator Program, University of Manitoba, Winnipeg, Manitoba, CanadaCorrespondence: Eric Hyun Email ehyun@sbgh.mb.caBackground: Anal metastasis of colorectal adenocarcinoma is very rare, represented by only a handful of case reports in the literature. Previously, reports of metastasis to this region had occurred following a history of anorectal disease, such as anal fistulae. Antecedent trauma to the area from hemorrhoidectomy, fissures, or perineal retractor injury have also been implicated.Case Presentation: Herein we report the case of 69-year-old man without any history of anal disease presenting with a metachronous metastasis of a colorectal-type adenocarcinoma to the anal verge. He was previously treated for T1N0 rectal adenocarcinoma at the rectosigmoid junction with a low anterior resection 5 years prior, then had a T3N0 local recurrence at the colorectal anastomosis treated with neoadjuvant chemoradiation, and eventually a Hartmann’s procedure 4 years later. Subsequently, on surveillance flexible sigmoidoscopy, a new tumor was identified on the perianal skin extending from the anal verge. Histopathology demonstrated colorectal-type adenocarcinoma. Flexible endoscopy identified no other residual or recurrent disease in the colon or rectal stump. The patient was treated with wide local excision and advancement flap reconstruction.Conclusion: Isolated metastasis to the anus is an extremely rare occurrence for colorectal adenocarcinoma. There exists little evidence to inform management. One option is to treat like a locally recurrent rectal cancer with aggressive tri-modality management consisting of chemoradiation, abdominal perineal resection, and adjuvant chemotherapy. In the absence of metastatic disease, local resection and close surveillance remain an option. As always, patient factors should guide management.Keywords: colorectal cancer, anal metastasis, rectal cancer, anal adenocarcinoma
Keywords	colorectal cancer ; anal metastasis ; rectal cancer ; anal adenocarcinoma ; Medicine (General) ; R5-920
Subject code	610
Language	English
Publishing date	2022-01-01T00:00:00Z
Publisher	Dove Medical Press
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article: Telehealth application in Sudan: requirements and potential benefits.

Elahssan, Rabab / Shariff, Farhana / OGrady, Michael / Yousif, Taha Ibrahim

Sudanese journal of paediatrics

2022 Volume 22, Issue 1, Page(s) 5–9

Abstract: Telehealth (TH) is defined as the entire spectrum of activities used to deliver care remotely. It could either be provider-to-patient or provider-to-provider communications. TH can take place synchronously (via telephone and video), asynchronously (via ... ...

Abstract	Telehealth (TH) is defined as the entire spectrum of activities used to deliver care remotely. It could either be provider-to-patient or provider-to-provider communications. TH can take place synchronously (via telephone and video), asynchronously (via patient portal messages, e-consults), and through virtual agents (chat) and wearable devices. It has been used to support access to specialised medical advice in remote areas in many countries all over the world. We discuss the potential use of TH Clinics in Sudan and propose guidance for establishing such services. The current pandemic of SARS-COVID-19 has increased the pressure on most health systems. This has challenged and urged for significant changes in the way we provide health care for both COVID and non-COVID cases. There is a great potential for improvement in services in many countries including Sudan with the use of TH.
Language	English
Publishing date	2022-08-08
Publishing country	Sudan
Document type	Journal Article ; Review
ZDB-ID	3035197-2
ISSN	1858-8360 ; 0256-4408
ISSN (online)	1858-8360
ISSN	0256-4408
DOI	10.24911/SJP.106-1591278403
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Article ; Online: Satisfaction and attrition in Canadian surgical training program leadership: a survey of program directors.

Shariff, Farhana / Wright, Frances C / Ahmed, Najma / Dossa, Fahima / Nadler, Ashlie / Hallet, Julie

CMAJ open

2023 Volume 11, Issue 2, Page(s) E237–E266

Abstract: Background: Surgical program directors (PDs) play an integral role in the well-being and success of postgraduate trainees. Although studies about medical specialties have documented factors contributing to PD burnout, early attrition rates and ... ...

Abstract	Background: Surgical program directors (PDs) play an integral role in the well-being and success of postgraduate trainees. Although studies about medical specialties have documented factors contributing to PD burnout, early attrition rates and contributory factors among surgical PDs have not yet been described. We aimed to evaluate Canadian surgical PD satisfaction, stressors in the role and areas institutions could target to improve PD support. Methods: We administered a cross-sectional survey of postgraduate Canadian surgical PDs from all Royal College of Physicians and Surgeons of Canada accredited surgical specialties. Domains we assessed included PD demographics and compensation, availability of administrative support, satisfaction with the PD role and factors contributing to PD challenges and burnout. Results: Sixty percent of eligible surgical PDs (81 out of 134) from all 12 surgical specialties responded to the survey. We found significant heterogeneity in PD tenure, compensation models and available administrative support. All respondents reported exceeding their weekly protected time for the PD position, and 66% received less than 0.8 full-time equivalent of administrative support. One-third of respondents were satisfied with overall compensation, whereas 43% were unhappy with compensatory models. Most respondents (70%) enjoyed many aspects of the PD role, including relationships with trainees and shaping the education of future surgeons. Significant stressors included insufficient administrative support, complexities in resident remediation and inadequate compensation, which contributed to 37% of PDs having considered leaving the post prematurely. Interpretation: Most surgical PDs enjoyed the role. However, intersecting factors such as disproportionate time demands, lack of administrative support and inadequate compensation for the role contributed to significant stress and risk of early attrition.
MeSH term(s)	Humans ; Leadership ; Cross-Sectional Studies ; Canada/epidemiology ; Surveys and Questionnaires ; Burnout, Professional/epidemiology ; Personal Satisfaction
Language	English
Publishing date	2023-03-14
Publishing country	Canada
Document type	Journal Article
ZDB-ID	2701622-5
ISSN	2291-0026 ; 2291-0026
ISSN (online)	2291-0026
ISSN	2291-0026
DOI	10.9778/cmajo.20210270
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Article ; Online: Malignant Bowel Obstruction Management Over Time: Are We Doing Anything New? A Current Narrative Review.

Shariff, Farhana / Bogach, Jessica / Guidolin, Keegan / Nadler, Ashlie

Annals of surgical oncology

2021 Volume 29, Issue 3, Page(s) 1995–2005

Abstract: Introduction: Malignant bowel obstruction from peritoneal carcinomatosis affects a significant proportion of luminal gastrointestinal and ovarian oncology patients, and portends poor long-term survival. The management approach for these patients ... ...

Abstract	Introduction: Malignant bowel obstruction from peritoneal carcinomatosis affects a significant proportion of luminal gastrointestinal and ovarian oncology patients, and portends poor long-term survival. The management approach for these patients includes a range of medical therapies and surgical options; however, how to select an optimal treatment strategy remains enigmatic. The goal of this narrative review was to summarize the latest evidence around multimodal malignant bowel obstruction treatment and to establish if and where progress has been made. Methods: A targeted literature search examining articles focused on the management of malignant bowel obstruction from peritoneal carcinomatosis was performed. Following data extraction, a narrative review approach was selected to describe evidence and guidelines for surgical prognostic factors, imaging, tube decompression, medical management, nutrition, and quality of life. Results: Outcomes in the literature to date are summarized for various malignant bowel obstruction treatment strategies, including surgical and non-surgical approaches, as well as a discussion of the role of total parenteral nutrition and chemotherapy in holistic malignant bowel obstruction management. Conclusion: There has been little change in survival outcomes in malignant bowel obstruction in over more than a decade and there remains a paucity of high-level evidence to direct treatment decision making. Healthcare providers treating patients with malignant bowel obstruction should work to establish consensus guidelines, where feasible, to support medical providers in ensuring compassionate care during this often terminal event for this unique patient group.
MeSH term(s)	Humans ; Intestinal Obstruction/etiology ; Intestinal Obstruction/therapy ; Palliative Care ; Peritoneal Neoplasms ; Quality of Life
Language	English
Publishing date	2021-10-18
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	1200469-8
ISSN	1534-4681 ; 1068-9265
ISSN (online)	1534-4681
ISSN	1068-9265
DOI	10.1245/s10434-021-10922-1
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Article ; Online: The nature of learning from simulation: Now I know it, now I'll do it, I'll work on that.

Shariff, Farhana / Hatala, Rose / Regehr, Glenn

Medical education

2020 Volume 54, Issue 7, Page(s) 652–659

Abstract: Context: Ongoing learning in complex clinical environments requires health professionals to assess their own performance, manage their learning, and modify their practices based on self-monitored progress. Self-regulated learning (SRL) theory suggests ... ...

Abstract	Context: Ongoing learning in complex clinical environments requires health professionals to assess their own performance, manage their learning, and modify their practices based on self-monitored progress. Self-regulated learning (SRL) theory suggests that although learners may be capable of such learning, they often need guidance to enact it effectively. Debriefings following simulation may be an ideal time to support learners' use of SRL in targeted areas, but the extent to which they are optimally fostering these practices has not been examined. Methods: A qualitative study informed by grounded theory methodology was conducted in the context of three interprofessional in situ trauma simulations at our level 1 trauma centre. A total of 18 participants were interviewed both immediately and 5-6 weeks after the simulation experience. Transcripts were analysed using an iterative constant comparative approach to explore concepts and themes regarding the nature of learning from and after simulation. Results: During initial interviews, there were many examples of acquired content knowledge and straightforward practice changes that might not require ongoing SRL to enact well in practice. However, even for skills identified as needing to be 'worked on,' SRL strategies were lacking. At follow-up interviews, some participants had evolved more specific learning goals and rudimentary plans for implementation and improvement, but suggested this was prompted by the study interview questions rather than the simulation debriefing itself. Conclusions: Overall, participants did not engage in fulsome development of SRL plans based on the simulation and debriefing; however, there were elements of SRL present, particularly after participants were given time to reflect on the interview questions and their own goals. This suggests that simulation training can support the use of SRL. However, debriefing approaches might be better optimised to take full advantage of the opportunity to encourage and foster SRL in practice after the simulation is over.
MeSH term(s)	Clinical Competence ; Computer Simulation ; Education, Medical ; Health Personnel ; Humans ; Simulation Training
Language	English
Publishing date	2020-04-13
Publishing country	England
Document type	Journal Article
ZDB-ID	195274-2
ISSN	1365-2923 ; 0308-0110
ISSN (online)	1365-2923
ISSN	0308-0110
DOI	10.1111/medu.14153
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Article ; Online: Quality of Colon Cancer Care in Patients Undergoing Emergency Surgery.

Guidolin, Keegan / Withers, Rebecca / Shariff, Farhana / Ashamalla, Shady / Nadler, Ashlie

Current oncology (Toronto, Ont.)

2021 Volume 28, Issue 3, Page(s) 2079–2086

Abstract: Thirty percent of colon cancer diagnoses occur following emergency presentations, often with bowel obstruction or perforation requiring urgent surgery. We sought to compare cancer care quality between patients receiving emergency versus elective surgery. ...

Abstract	Thirty percent of colon cancer diagnoses occur following emergency presentations, often with bowel obstruction or perforation requiring urgent surgery. We sought to compare cancer care quality between patients receiving emergency versus elective surgery. We conducted an institutional retrospective matched (46 elective:23 emergency;
MeSH term(s)	Case-Control Studies ; Colonic Neoplasms/surgery ; Elective Surgical Procedures ; Emergencies ; Humans ; Retrospective Studies
Language	English
Publishing date	2021-06-03
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	1236972-x
ISSN	1718-7729 ; 1198-0052
ISSN (online)	1718-7729
ISSN	1198-0052
DOI	10.3390/curroncol28030192
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Article: Rectal Cancer Metastasis to the Anal Verge: An Unusual Case Presentation and Review of the Literature.

Johnson, Garrett G R J / Yip, Benson / Helewa, Ramzi M / Shariff, Farhana / Hyun, Eric

International medical case reports journal

2022 Volume 15, Page(s) 1–6

Abstract: Background: Anal metastasis of colorectal adenocarcinoma is very rare, represented by only a handful of case reports in the literature. Previously, reports of metastasis to this region had occurred following a history of anorectal disease, such as anal ... ...

Abstract	Background: Anal metastasis of colorectal adenocarcinoma is very rare, represented by only a handful of case reports in the literature. Previously, reports of metastasis to this region had occurred following a history of anorectal disease, such as anal fistulae. Antecedent trauma to the area from hemorrhoidectomy, fissures, or perineal retractor injury have also been implicated. Case presentation: Herein we report the case of 69-year-old man without any history of anal disease presenting with a metachronous metastasis of a colorectal-type adenocarcinoma to the anal verge. He was previously treated for T1N0 rectal adenocarcinoma at the rectosigmoid junction with a low anterior resection 5 years prior, then had a T3N0 local recurrence at the colorectal anastomosis treated with neoadjuvant chemoradiation, and eventually a Hartmann's procedure 4 years later. Subsequently, on surveillance flexible sigmoidoscopy, a new tumor was identified on the perianal skin extending from the anal verge. Histopathology demonstrated colorectal-type adenocarcinoma. Flexible endoscopy identified no other residual or recurrent disease in the colon or rectal stump. The patient was treated with wide local excision and advancement flap reconstruction. Conclusion: Isolated metastasis to the anus is an extremely rare occurrence for colorectal adenocarcinoma. There exists little evidence to inform management. One option is to treat like a locally recurrent rectal cancer with aggressive tri-modality management consisting of chemoradiation, abdominal perineal resection, and adjuvant chemotherapy. In the absence of metastatic disease, local resection and close surveillance remain an option. As always, patient factors should guide management.
Language	English
Publishing date	2022-01-06
Publishing country	New Zealand
Document type	Case Reports
ZDB-ID	2495077-4
ISSN	1179-142X
ISSN	1179-142X
DOI	10.2147/IMCRJ.S350999
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Article ; Online: In silico

Siddiqui, Quratulain / Ali, Mohd Shukuri Mohd / Leow, Adam Thean Chor / Oslan, Siti Nurbaya / Mohd Shariff, Fairolniza

Journal of biomolecular structure & dynamics

2022 Volume 41, Issue 20, Page(s) 10347–10367

Abstract: Leptospirosis is one of the neglected zoonosis, affecting human and animal populations worldwide. Reliable effective therapeutics and concerns to look for more research into the molecular analysis of its genome is therefore needed. In the genomic pool of ...

Abstract	Leptospirosis is one of the neglected zoonosis, affecting human and animal populations worldwide. Reliable effective therapeutics and concerns to look for more research into the molecular analysis of its genome is therefore needed. In the genomic pool of the
MeSH term(s)	Animals ; Humans ; Serogroup ; Leptospira interrogans/genetics ; Leptospira interrogans/metabolism ; Leptospirosis/drug therapy ; Leptospirosis/microbiology ; Bacterial Proteins/genetics ; Bacterial Proteins/metabolism ; Computational Biology ; Leptospira/chemistry ; Leptospira/metabolism
Chemical Substances	Bacterial Proteins
Language	English
Publishing date	2022-12-12
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	49157-3
ISSN	1538-0254 ; 0739-1102
ISSN (online)	1538-0254
ISSN	0739-1102
DOI	10.1080/07391102.2022.2154845
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Article ; Online: Learning After the Simulation Is Over: The Role of Simulation in Supporting Ongoing Self-Regulated Learning in Practice.

Shariff, Farhana / Hatala, Rose / Regehr, Glenn

Academic medicine : journal of the Association of American Medical Colleges

2019 Volume 95, Issue 4, Page(s) 523–526

Abstract: The complex and dynamic nature of the clinical environment often requires health professionals to assess their own performance, manage their learning, and modify their practices based on self-monitored progress. Self-regulated learning studies suggest ... ...

Abstract	The complex and dynamic nature of the clinical environment often requires health professionals to assess their own performance, manage their learning, and modify their practices based on self-monitored progress. Self-regulated learning studies suggest that while learners may be capable of such in situ learning, they often need guidance to enact it effectively. In this Perspective, the authors argue that simulation training may be an ideal venue to prepare learners for self-regulated learning in the clinical setting but may not currently be optimally fostering self-regulated learning practices. They point out that current simulation debriefing models emphasize the need to synthesize a set of identified goals for practice change (what behaviors might be modified) but do not address how learners might self-monitor the success of their implementation efforts and modify their learning plans based on this monitoring when back in the clinical setting. The authors describe the current models of simulation-based learning implied in the simulation literature and suggest potential targets in the simulation training process, which might be optimized to allow medical educators to take full advantage of the opportunity simulation provides to support and promote ongoing self-regulated learning in practice.
MeSH term(s)	Education, Medical ; Goals ; Humans ; Models, Educational ; Self-Directed Learning as Topic ; Simulation Training/methods
Language	English
Publishing date	2019-11-14
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	96192-9
ISSN	1938-808X ; 1040-2446
ISSN (online)	1938-808X
ISSN	1040-2446
DOI	10.1097/ACM.0000000000003078
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Article: Electrocautery burns of genitalia during lumbar spine surgery.

Kumar, Shashi / Bikkasani, Rakesh / Shariff, Fardeen / Jaffar, Jishna

Journal of clinical orthopaedics and trauma

2019 Volume 10, Issue Suppl 1, Page(s) S139–S142

Language	English
Publishing date	2019-02-02
Publishing country	India
Document type	Journal Article
ZDB-ID	2596956-0
ISSN	2213-3445 ; 0976-5662
ISSN (online)	2213-3445
ISSN	0976-5662
DOI	10.1016/j.jcot.2019.01.018
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