RESULTSOf the nine patients who presented with ED, nearly two-thirds were infants (age range 3 months-5 years). Seven (77.8%) were male and two (22.2%) were female. The presenting symptoms were varied, with the most common being abdominal mass and bleeding per rectum. Descriptions of the patients' age and gender, clinical features, main investigations, types and sites of cysts, surgical procedures performed and complications observed are RESULTS A total of nine patients were managed during the study period. The patients' ages ranged from three months to five years. Four out of nine EDs were rectal duplications. Three EDs were of the cystic type, five were of the tubular type and one was a complex mixed anomaly. Patients presented with varied symptoms, with the two most common being the presence of an abdominal mass and bleeding per rectum. Diagnosis was mainly achieved based on magnetic resonance imaging and computed tomography, although Meckel's scan provided accurate diagnosis in three of the nine patients. All the cysts were resected without any major complications, and patients were event-free during the five-year follow-up. Table I. A total of four out of nine patients had rectal duplications, and a perineal mass was noted in one (11.1%) patient. One patient had infected wound discharge following drainage of a perineal abscess, while penoscrotal hypospadias was present in another. (2) Although ED may present at any age, a majority are also why EDs may pose as a diagnostic challenge. In the present study, none of the patients were diagnosed antenatally. CONCLUSIONSome patients, however, had unusual symptoms -one patient presented with a nonhealing wound in the perineum that had previously been incised and drained due to suspicions of it being a perineal abscess, although a closer look at the surface would have revealed the presence of mucosa in the deeper part of the wound. Only one patient in our series had associated penoscrotal hypospadias. Such anomalies have been reported in up to 50% of patients, with vertebral defects being the most common.(1)EDs may be cystic, tubular or mixed (cystic and/or tubular).Although EDs usually communicate with adjacent parts of the gut, instances of completely isolated duplication cysts have also been reported. (6) We found various types of duplication cysts in our patients, including the cystic, tubular and complex mixed varieties. According to the literature, the ileum is the most common site of ED, whereas gastric and colonic duplications are rare, (4) and thoracoabdominal duplications are the most challenging. (7)(8)(9) In our series, the ileum was the most commonly involved site (n = 5), presenting as either an isolated lesion or a combination. However, contrary to the literature, which does not describe a high incidence of rectal involvement, (7,9,10) our series saw four cases (out of a total of nine) of rectal involvement. Also, there was a higher incidence of tubular ED (n = 5) in our study. Interestingly, one patient had a rare, complex duplication cyst that s...

Waardenburg-Shah syndrome is a rare autosomal recessive [AR] inherited disorder characterized by the presence of Hirschsprung's disease with a high likelihood of aganglionic megacolon, due to which the mortality is high. The management of the condition involves surgical intervention for the removal of the aganglionic segment of the colon. Here, we report a neonate that presented with a white forelock, white eyelashes, iris hypopigmentation, and sensorineural deafness associated with bilious vomiting, refusal to feed, and failure to pass meconium indicating intestinal obstruction.

doi: https://doi.org/10.12669/pjms.37.5.4794 How to cite this:Safdar CA, Qayyum R. Moral Injury, Emotional Labor and Burnout: An Unbearable Burden for Health Professionals. Pak J Med Sci. 2021;37(5):1256-1258. doi: https://doi.org/10.12669/pjms.37.5.4794 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Background & Objectives: Feedback brings a fresh perspective and improvement in any organization. Health professionals (HPs) lose insight of the gaps in medical care. The views of student nurses can help improve systems. The objective of this study was to assess the views of our student nurses and how they perceive the way the doctors and HPs work in our hospital and comment on training, attitudes, care pathways, teamwork, and what needed to be improved. Methods: A proforma based qualitative study was carried out at the Nurses’ Training Centre of PAF Hospital and Fazaia Medical College, Islamabad, from January to March 2020. After approval, a semi-structured proforma with open and closed ended questions was administered, in English and Urdu. The results were analyzed by comparative numbers and percentages for each question and descriptive responses were grouped in recurring themes and analyzed for content and their constructive value. Results: Out of 85 nursing cadets, the proforma could be administered to 61(M=38(62.3%) and F=23(37.7%). Most were FSc with 26% graduates. Majority of the female students’ main reason for joining was to serve humanity, unlike most males. According to gender many responses were interestingly different. Majority of females thought male doctors were better (86%). Only 36% said the doctors were sincere in care of patients. Most thought that we needed to improve patient counseling. Most thought the seniors treated them unfairly, but bullying was negligible. They wanted the senior HPs to improve their attitudes and ensure adequate equipment in the wards. They were worried about personal security from patients and relatives. Dedicated mental health services to deal with stress of witnessing every day misery and death was suggested. Conclusions: Doctors need to improve their counseling skills and should talk more to the patients and their relatives. They should acknowledge the nursing students and improve teamwork. Belittling them in front of others harms their self-efficacy. Simple corrections like punctuality, ownership of their patients and improvement of equipment and systems can improve patient care. doi: https://doi.org/10.12669/pjms.36.7.3110 How to cite this:Safdar SA, Zafar H, Ahmad J, Qayyum R, Naseem S, Safdar CA. Pakistani Student Nurses’ perceptions of their hospital’s health professionals’ attitudes and suggested ways to improve patient care – An untainted view. Pak J Med Sci. 2020;36(7):---------.  doi: https://doi.org/10.12669/pjms.36.7.3110 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

doi: https://doi.org/10.12669/pjms.36.4.2628 How to cite this:Safdar CA. How to get most out of a Medical Conference, and Love it too!. Pak J Med Sci. 2020;36(4):589-592. doi: https://doi.org/10.12669/pjms.36.4.2628 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.