Background With the emergence of the COVID-19 pandemic and lockdown approach that was adopted all over the world, conducting assessments while maintaining integrity became a big challenge. This article aims at sharing the experience of conducting an online assessment with the academic community and to assess its effectiveness from both examiners’ and students’ perspectives. Methods An online assessment was carried out for the final year medical students of Hawler Medical University/Iraq during the lockdown period of the COVID-19 pandemic, June 2020. Then, an online questionnaire was sent to a sample of 61 examiners and 108 students who have been involved in evaluating the mentioned assessment process. Mann-Whitney and Kruskal-Wallis tests were used to compare the mean ranks of the overall satisfaction scores between categories of the students and examiners. Categorical data were summarized and presented as frequencies and percentages. Results The response rates among examiners and students were 69.4% and 88.5% respectively. The majority of the examiners were generally satisfied with the online examination process compared to only around a third of the students. However, both examiners and students agreed that online examination was not suitable for assessing the physical examination skills. Conclusion The online assessment can be considered a good alternative and acceptable method for medical students’ assessment in unpredicted emergencies, yet it was not applicable in testing physical examination skills.

Background Anaplastic thyroid carcinoma is a rare and lethal disease that accounts for 1–2% of thyroid malignancies. It is an aggressive locoregional disease with a high rate of distant metastasis, a poor prognosis, and a mean survival rate of 3–6 months after diagnosis. This retrospective study aimed to analyse the clinical and pathological features of ATC to assess treatment procedures and its outcome. Methods We analysed data from 22 patients diagnosed with ATC from 2018 to 2021, using the Kaplan-Meier method and log-rank test to determine overall survival. Results Patients’ median age was 64.3 ± 17.1 years. Females were more affected (male/female ratio: 1:1.7); 14 cases occurred in females (63.6.4%), and eight in males (36.4%). The most common manifestations were neck enlargement (81.8%) and dyspnoea (72.27%), and the tumour size was > 4 cm in 17 (77.3%) patients. The percentage of cases that presented in clinical-stage IVA was 36.4%, with 31.8% presenting in clinical-stage IVB and 31.8% presenting in clinical-stage VIB. Among 22 cases, 14 (63.6%) were operable, and 8 (36.4) were inoperable (p = 0.015). Multimodal therapies were associated with better survival (surgery plus radiotherapy without systemic treatment, P = 0.063). The median overall survival was three months (IC 95%, 0.078–5.922). One-year and two-year survival rates were 9% and 4.5%, respectively. Conclusion ATC is a rapidly growing cancer that, fortunately, is rare. Early diagnosis and multimodality treatment may provide a better quality of life and survival time for this group of patients.

Background and objectives: Acute appendicitis is one of the most common surgical emergency conditions. This study was done to clarify the effect of antibiotics in reducing post appendectomy complications after open and laparoscopic appendectomy in patients with non-perforated appendicitis. Methods: This is a randomized controlled trial. Three hundred and twenty one patients, who underwent appendectomy for non-perforated appendicitis and fulfilled the selection criteria, were randomly divided into two groups. The patients in group A received double dose of pre-operative and postoperative antibi- otics (third generation cephalosporin and metronidazole), while the group B patients received one dose of the same antibiotics pre-operatively. Patients of both groups were followed-up for 30 days to assess postoperative infective complications. Results: Group A had 133, while group B comprised of 188 patients. The groups were comparable in the baseline characteristics. Statistically, there was no significant difference in rates of localized wound complications between both groups (p = 0.4713). Mean hospital stay was 2.1 ± 0.73 and 2 ± 0.48 days for group A and B respectively Conclusions: Single dose of pre or post-operative antibiotics (third generation cephalosporin and metronidazole) was sufficient in reducing the wound related complications after appendectomy for non-perforated appendicitis.

Background and objectives: Acute appendicitis is the most common and challenging surgical emergencies. The diagnosis is still based on the clinical examination. The modified alvarado score system isa safe diagnostic modality without extra expense and complications. Efficacy ofantibiotic treatment was often considered as a bridge to surgery inselectedpatients with acute appendicitis aided by using of Modified Alvarado scoring system. Methods: A prospective clinical trial comparing antibiotics with appendectomy, a total of 424 consecutive patients were enrolled, according to Modified Alvarado Scoring Systemwere divided into three groups: Group A: score between 8-10 (emergency surgery group),Group B: score between 5-7 (conservative group): these patients were subjected to repeated clinical examinations for 24 hours. Group C: scorebetween 1-4, the choice of antibiotic regimen was made by using an intravenous injection of (ceftriaxon 1g x2 and metronidazo l500mg x 3). Results: out of 424 patients, 206(48.6%) female and 218(51.4%) male. 156(36.8%) patients group A,148 (34.9%) group B, histopathology confirmed appendicitis in 128(82%). patients nine (5.8%) patient in group A revisiting hospital due to complications. Mean hospital stay in group A was lesser than group B. The antibiotic response rate was 91.3%, In group A 12(7.7%) patients had wound infection,while in group B and C seven (4.7%) had complications. Out Of 13 patients in the antibiotic group, nine (6%) underwent appendectomy during the initial hospitalization. Conclusions: Modified Alvaro Scoring System as a diagnostic tool,can be usedsafely for conservative treatment of patients with acute uncomplicated appendicitis by giving antibiotics only.

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