Background The principles of global surgery should be taught as a part of the core curriculum in medical schools. The need for medical students to be familiar with the topic is increasing in acceptance. There is, however, a paucity of data on how medical students are exposed to global surgery. This study aims to evaluate exposure of medical students to global surgery, awareness of the key messages of the Lancet Commission on Global Surgery, global surgery career aspirations and barriers to said aspirations. Methods ISOMERS was a multi-centre, online, cross-sectional survey of final year medical students globally. The questionnaire utilised a combination of Likert-scale, multiple-choice, and free text questions. Results In this study, 1593 final year medical students from 144 medical schools in 20 countries participated. The majority (n = 869/1496, 58.1%) believed global surgery to be relevant, despite 17.7% (n = 271/1535) having any exposure to global surgery. Most participants (n = 1187/1476, 80.4%) wanted additional resources on global surgery. Difficulty in providing appropriate care for patients living abroad (n = 854/1242, 68.8%) was the most common perceived barrier to a career in global surgery. Conclusions Participants believed global surgery was a relevant topic for medical students and wanted additional resources that they could access on global surgery. It is critical for medical students to become aware that global surgery is a field that aims to address inequity in surgical care not just internationally, but nationally and locally as well.

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Jenunoileal atresia is a congenital defect that causes small bowel obstruction in newborns. They are classified into 5 types and simple abdominal x-ray can aid in the diagnosis and with prompt resuscitation and surgery provides positive outcome. We present a 5-day-old newborn male baby was presented with features of intestinal obstruction since birth. Diagnosis of atresia of the small bowel was made through plain abdominal x-ray and was successfully operated. During the recovery, the baby developed surgical site infection which was managed promptly.

Introduction and importance The natural history of metastatic melanoma in the absence of a known primary site has been poorly defined. The disease usually presents a significant cause of morbidity and mortality. Around 90% of melanomas have cutaneous origin, but still there are melanomas that could be found in visceral organs or lymph nodes with unknown primary site. Spontaneous regression of the primary site could be an explanation. The disease is frequently diagnosed after treatment for known extracranial metastases and has a poor outcome despite various local and systemic therapeutic approaches. Case presentation Herein, we present a case of a 43-year old female presented with history of headaches and enlarged a left inguinal lymph node. Notably, no cutaneous lesions could be identified by history or on physical examination. CT-scan of the brain revealed a space occupying lesion and the inguinal lymph node biopsy confirmed the diagnosis of metastatic malignant melanoma. The patient succumbed shortly after establishment of diagnosis. Clinical discussion Most patients with brain metastases from malignant melanoma are diagnosed after treatment for known extracranial metastases and have a poor outcome despite various local and systemic therapeutic approaches. Conclusion Metastatic melanomas of brain with unknown primary present a significant morbidity and mortality and confer a poor prognosis. Delay in diagnosis and treatment is of serious concern when it comes to improve the prognosis of patients with this disease. The optimal treatment depends on the objective situation, often surgery, radiosurgery, whole brain radiotherapy and chemotherapy can be used in combination to obtain longer remissions and optimal symptom relieve.

Introduction Medical students around the world have been showing an increasing interest in Global Surgery as evident by their participation in various organizations on local and international levels. We set out to evaluate exposure of medical students to global surgery, modes of exposure, whether the exposure meets the needs of students, awareness of the key messages of the Lancet Commission on Global Surgery, global surgery career aspirations and barriers to said aspirations. Methods We developed the International Survey Of Medical students Exposure to Relevant global Surgery (ISOMERS) study, an online, international, questionnaire-based study. This survey will collect data from final year medical students across the world. The questionnaire utilises a combination of the Likert scale, multiple choice options and free text questions and will be disseminated by email and social media through the International Student Surgical Network, a global surgery student interest group with more than 5,000 members. Results Primary outcomes will include exposure to global surgery research, advocacy and education among medical students. We will generate simple descriptive statistics and identify determinants of exposure among medical students and subgroups (country income class and geographic region). Also, we will use multinomial regression analysis to identify confounders and significant dependent variables. Conclusion The ISOMERS study will identify the level of exposure to global surgery among students during medical education. An understanding of this exposure will be crucial in developing the foundation for global surgery education at the level of undergraduate medical curriculum and furthered in addressing perceived barriers to joining the global surgery workforce.