Background Patients scheduled for coronary artery bypass graft (CABG) surgery tend to have persistent symptoms of anxiety and depression. Course of hospital stay post-CABG procedure has become increasingly shorter over the last few decades. This pilot study was conducted to develop and test feasibility of MyEducation: CABG application as a learning tool to reduce anxiety and depression levels among patients undergoing CABG Surgery. Methods This study was quasi-experimental in design. Forty-five patients scheduled for CABG surgery were recruited via consecutive sampling from a Tertiary Referral Centre at Kuala Lumpur, Malaysia. MyEducation:CABG application (Web-based education application) was administered among the intervention group (N = 23); while the control group (N = 22) underwent standard care. Web-based education application were implemented by nurses at admission and prior to discharge. Patients were assisted in terms of queries and concerns, upon which corresponding information and support was provided. Sociodemographic data were obtained from patients, prior to administration of Hospital Anxiety and Depression Scale which was used to measure levels of anxiety and depression. The educational application was used to obtain satisfaction rating among intervention group. These measures were administered upon admission, on discharge and one-month post-discharge. Results Mean anxiety and depression scores among the intervention group were lower compared to the control. This was significant for anxiety upon admission, on discharge and one-month post-discharge (p < 0.05). Reduced mean depression scores was only significant at one month post-discharge (p < 0.05). Intervention group were generally satisfied with design, content and usability of the application. Conclusions Utilisation of MyEducation: CABG application as an educational platform were associated with reduced anxiety and depression among CABG patients, which probably explains positive user satisfaction levels reported. Hence, the study recommends implementation of this application among larger sample as a way to support patient scheduled for CABG aside, with further possibility of preventing complications.

Introduction Rapid prototyping is a process by which three-dimensional (3D) computerized surface models are converted into physical models. In this study, a 3D heart bio model was created using the rapid prototyping method and the accuracy of this heart model was assessed by clinicians. Methods The two-dimensional images of normal heart from gated computed tomography scan datasets were used to create a 3D model of the heart. The slices were then processed using the software BioModroid and printed with the 3D printer. The evaluation of the model was performed by a questionnaire answered by four cardiothoracic surgeons, 12 cardiologists, five radiologists, and nine surgical registrars. Results Eighty-six percent of the anatomy structures showed in this model scored 100% accuracy. Structures such as circumflex branch of left coronary artery, great cardiac vein, papillary muscle, and coronary sinus were each rated 77%, 70%, 70%, and 57% accurate. Among 30 clinicians, a total of 93% rated the model accuracy as good and above; 64% of the clinicians evaluated this model as an excellent teaching tool for anatomy class. As a visual aid for surgery or interventional procedures, the model was rated excellent (40%), good (50%), average (23%), and poor (3%); 70% of the clinicians scored the model as above average for training purpose. Overall, this 3D rapid prototyping cardiac model was rated as excellent (33%), good (50%), and average (17%). Conclusion This 3D rapid prototyping heart model will be a valuable source of anatomical education and cardiac interventional management.

Local treatment for hepatocellular carcinoma (HCC) has been widely used in clinical practice due to its minimal invasiveness and high rate of cure. Percutaneous radiofrequency ablation (RFA) is widely used because its treatment effectiveness. However, some serious complications can arise from percutaneous RFA. We present here a rare case of hemorrhagic cardiac tamponade secondary to an anterior cardiac vein (right marginal vein) injury during RFA for treatment of HCC.

ObjectivesRecently a biocompatible bone adhesive was introduced in addition to the sternal wires to expedite sternal union and improve patient recovery. In this study we aim to objectively assess the biomarker of pain in patient who received the biocompatible bone adhesive.MethodsA total of 62 patients who underwent sternotomy were prospectively randomised to receive either conventional wire closure (CWC); 32 patients or adhesive enhanced closure in addition to sternal wire (AEC); 30 patients. Patients were monitored postoperatively at certain time intervals for incisional pain, serum Interleukin-6 (IL-6) level, analgesia used and postoperative complications. All patients were followed up for 4 weeks.ResultsThe post-operative pain scores with coughing were significantly higher in the CWC group at 24 hours and 48 hours. The postoperative IL 6 levels were significantly higher in the CWC group in comparison with the AEC group at 6 hours, 24 hours, and 48 hours. There were no significant differences in term of additional analgesia used. No adverse events from adhesive bone cement were observed during follow up.ConclusionsAdhesive-enhanced sternal closure resulted in modest reduction of pain confirmed by reduction of pain biomarker. Justification of its routine use requires larger multicentre study.

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