Port of Spain General Hospital is a public hospital in Port of Spain, Trinidad and Tobago. The main building was once a Colonial hospital that began construction in 1854, using local stone and imported brick facing to provide a Classical style facade. The official opening of the hospital was in 1858. The exterior has been maintained while the interior has been adapted for modern medical practice, mostly in work around 1960 directed by the UK architects Devereux and Davies and including murals by the Trinidadian artist Althea McNish.The hospital is located on Upper Charlotte Street in the city and serves as the main hospital for the North West Region of Trinidad, the most densely populated region in the island. Among its services are obstetric and gynecological care, outpatient medical care, surgical specialties such as orthopaedics and plastic surgery, therapeutic support and emergency care. It also serves as a teaching hospital to medical students from the University of the West Indies, St. Augustine campus.This Institution falls under the North West Regional Health Authority (NWRHA)..
Perioperative hypothermia remains common during anesthesia and surgery. It is associated with higher rates of surgical site infection, blood loss, transfusion, cardiac events, postanesthetic shivering, delayed recovery, and longer hospital stay. Temperature monitoring is therefore an important part of safe anesthesia care when it is linked to thermal management. This article is a narrative review of perioperative temperature monitoring in anesthesia. The aim was to review the physiology of perioperative heat loss, the clinical effects of hypothermia, the performance of common monitoring sites and devices, and the practical role of monitoring in prevention and management. A structured literature review was performed using PubMed. Search terms included combinations of "perioperative temperature monitoring," "anesthesia," "hypothermia," "core temperature," "esophageal temperature," "nasopharyngeal temperature," "bladder temperature," "zero-heat-flux," "warming," and "prewarming." Boolean operators were used to refine the search. English-language articles relevant to adult perioperative anesthesia care were reviewed. The final manuscript included 43 references, comprising randomized trials, observational studies, reviews, meta-analyses, and guideline-based articles. The evidence shows that core temperature monitoring is more reliable than peripheral or skin-based methods for detecting perioperative hypothermia. Esophageal and nasopharyngeal probes remain practical and accurate during general anesthesia. Bladder temperature is useful in selected patients, especially during longer procedures, but may be less reliable when urine flow is low. Newer zero-heat-flux forehead systems offer a useful noninvasive option across different perioperative phases, although agreement with invasive core sites is good rather than perfect. Evidence also shows that measured temperature can support timely warming or adjustment of warming, better maintenance of normothermia, and lower rates of temperature-related complications. Perioperative temperature should be measured routinely in patients at risk and interpreted together with active thermal management. The method should be chosen according to the patient, the type of anesthesia, and the stage of care. Monitoring is most useful when started early and paired with active warming and clear institutional protocols. More high-quality studies are still needed to compare newer devices, define acceptable accuracy thresholds in different settings, and determine the best monitoring pathway from the preoperative area to recovery.
Precoccygeal tumors are an uncommon group of heterogenous lesions ranging from benign simple cysts to complex malignant masses. Their nonspecific clinical presentations often make diagnosis difficult. Cross-sectional imaging, including computed tomography (CT) and magnetic resonance imaging (MRI), plays a critical role in their detection and characterization. Magnetic resonance imaging is considered the gold standard owing to its superior soft tissue resolution and detailed anatomical evaluation. Surgical excision remains the treatment of choice. Prognosis depends on the tumor’s nature and completeness of resection. Herein, we present the case of a precoccygeal leiomyoma in a premenopausal female patient with episodic, deep-seated pelvic and anal pain that worsened during ovulation.
INTRODUCTION:Multiple publications have shown that there is gender-based discrimination in surgery, aimed against surgeons who are women. The authors theorize that it was not due to a difference in clinical competence, but due to implicit bias: a subconscious prejudice that traditionally assigned women to homemaker roles. The authors designed this study to determine whether gender discrimination was due to implicit bias or a quantifiable difference in clinical competence. METHODS:This questionnaire study investigated prevailing attitudes among a professional association of surgeons in the Anglophone Caribbean. The authors collected data on gender discrimination and 4 parameters as proxies for clinical competence: judgment, thoroughness, surgical skill, and task completion. The SPSS version 20 was used to perform statistical analyses. RESULTS:A total of 140 questionnaires were distributed and 95 (68%) respondents observed gender discrimination in the workplace, with surgeons who are women significantly more likely to be victims of discrimination (64.2% vs 4.2%; z -8.7165; P < .0001). There was no difference between genders in clinical judgment nor surgical skill. There was a significant difference in thoroughness (47.4% vs 2.1%; P < .0001) and task completion (60% vs 24.2%; P < .0001), favoring surgeons who are women. CONCLUSION:Gender discrimination is still prevalent in surgical disciplines as the second quarter of the 21st century begins. The authors have demonstrated that surgeons who are women are substantially more likely to be the victims, likely due to implicit gender bias. The surgical community must address this urgently, because impeding full participation by women creates the chance for undermining the expansion of the workforce needed for the next generations' surgical care.
We carried out a survey of surgical residents in the Caribbean to quantify the prevalence of gender discrimination. In this setting, up to 85% of surgical residents were exposed to gender based discrimination, especially young women who are junior-level surgical residents.
Background:Acute exertional compartment syndrome (AECS) is a rare but limb-threatening condition that typically occurs in athletes or military recruits in the absence of trauma. Although the anterior compartment of the leg is most commonly affected, isolated lateral compartment involvement is distinctly uncommon. Delayed recognition is frequent and may result in serious complications, including acute kidney injury (AKI) and amputation. Case Presentation:We report the case of a 37-year-old previously healthy man who presented with severe lateral leg pain, progressive swelling and acute foot drop approximately 12 h after a high-intensity interval training (HIIT) session. Initial investigations revealed markedly elevated creatine phosphokinase, myoglobin and creatinine levels, and he was admitted with a provisional diagnosis of rhabdomyolysis-induced AKI. Despite aggressive intravenous hydration, his biochemical parameters worsened and leg pain intensified. Clinical assessment demonstrated a tense lateral compartment and a diagnosis of acute exertional lateral compartment syndrome was made, and urgent fasciotomy was performed. Postoperatively, pain rapidly improved and renal function normalised over several days. At 2-year follow-up, the patient had residual weakness of ankle dorsiflexion (MRC Grade 4) but had returned to moderate physical activity. Conclusion:Acute exertional lateral compartment syndrome is an exceptionally rare diagnosis and may present atypically, leading to delayed treatment. Clinicians should maintain a high index of suspicion in patients presenting with severe leg pain and neurological deficit following exercise. Early diagnosis and prompt fasciotomy remain critical to optimising functional outcomes.
