The Gargaar Multi-speciality Hospital was founded in 2009. It is a multi-speciality private hospital, located in Hargeisa.
Acute-on-chronic liver failure (ACLF) is a condition associated with high mortality in the absence of liver transplantation. There have been various definitions proposed worldwide. The first consensus report of the working party of the Asian Pacific Association for the Study of the Liver (APASL) set in 2004 on ACLF was published in 2009, and the "APASL ACLF Research Consortium (AARC)" was formed in 2012. The AARC database has prospectively collected nearly 10,500 cases of ACLF from various countries in the Asia-Pacific region. This database has been instrumental in developing the AARC score and grade of ACLF, the concept of the 'Golden Therapeutic Window', the 'transplant window', and plasmapheresis as a treatment modality. Also, the data has been key to identifying pediatric ACLF. The European Association for the Study of Liver-Chronic Liver Failure (EASL CLIF) and the North American Association for the Study of the End Stage Liver Disease (NACSELD) from the West added the concepts of organ failure and infection as precipitants for the development of ACLF and CLIF-Sequential Organ Failure Assessment (SOFA) and NACSELD scores for prognostication. The Chinese Group on the Study of Severe Hepatitis B (COSSH) added COSSH-ACLF criteria to manage hepatitis b virus-ACLF with and without cirrhosis. The literature supports these definitions to be equally effective in their respective cohorts in identifying patients with high mortality. To overcome the differences and to develop a global consensus, APASL took the initiative and invited the global stakeholders, including opinion leaders from Asia, EASL and AASLD, and other researchers in the field of ACLF to identify the key issues and develop an evidence-based consensus document. The consensus document was presented in a hybrid format at the APASL annual meeting in Kyoto in March 2024. The 'Kyoto APASL Consensus' presented below carries the final recommendations along with the relevant background information and areas requiring future studies.
Pancreatic cancer (PanCa) is one of the most lethal cancers (survival 12
The digital transformation of medical education, accelerated by the COVID-19 pandemic, has redefined how students engage with content and how educators deliver instruction. This review focuses on the cognitive dimensions of this shift, analyzing how technology affects attention, memory, spatial reasoning, and gratification patterns in learners. While interactive tools and global content access enhance learning flexibility and engagement, concerns arise regarding shrinking attention spans, reduced memory reliance, and overdependence on digital aids. Drawing on current research and cognitive theory, this review emphasizes the need for mindful technology use in medical education. Educators must strike a balance, leveraging digital tools to boost cognition while preserving the fundamental mental skills essential to clinical reasoning and decision-making. Ultimately, technology should function as a cognitive enhancer, not a replacement-to cultivate sharp, adaptable, and lifelong learners in the field of medicine.
Suicidal ideation among surgeons is a critical issue, with prevalence rates significantly higher than the general population. This review was conducted with the objectives to find the magnitude and gravity of suicidal ideations among surgeons and its risk correlates that are linked to human and workplace stress issues. Factors, viz., triggering thoughts related to toxic work culture, perfectionism, financial instability, retirement blues, and substance abuse, further exacerbate mental health challenges. The stigma surrounding mental health in the surgical profession prevents many from seeking timely support. A comprehensive prevention strategy must include confidential mental health programs, structured work-life balance initiatives, peer support networks, and educational interventions on resilience and stress management. Institutional policies should actively combat bullying, harassment, and excessive workload while promoting a culture of psychological safety. Addressing financial burdens and ensuring access to counseling can mitigate key stressors. Prioritizing surgeon well-being through systemic reforms is essential to reducing suicide risk and enhancing professional fulfillment.
It is believed that delayed perseveration on a semantic verbal fluency (SVF) test may occur due to impaired working memory (WM). However, the relation between perseveration and switching, and the self-generated interference one has to overcome when switching back to a previously visited subcategory has not been explored. In this study we wanted to see: 1) if perseverative errors in SVF test require switching and subsequent switch back to a previously explored subcategory; (2) if this trend would parallel cognitive decline. We studied three groups, amnestic mild cognitive impairment (aMCI) (n = 30), Alzheimer’s disease (AD) (n = 30) and healthy controls (HC) (n = 60) based on their performance on an SVF task along with tests of executive function. Our primary analysis, focussed on the association of switching and switch back with the first perseverative error. Perseveration was significantly associated with switch back for individuals with cognitive decline and healthy controls (χ 2 = 24.88, p = .000359). Fewer switches and switchbacks were needed to trigger a perseveration as we moved along the continuum of cognitively healthy to cognitively impaired (HC>aMCI>AD). Finally, across all groups, perseverations were a result of more switchbacks (Wald chi-square = 8.909, p = .003) rather than other factors. These findings suggest that it is switching and eventual switch back to a previous subcategory, and not the distance from the index word alone, that trigger perseverative errors in SVF tasks.
