Background: In the absence of significant pleural effusion, conventional medical thoracoscopy (MT) is often not feasible due to the risk of lung injury. Dry MT mitigates these risks by inducing artificial pneumothorax through needle insufflation or blunt dissection. Although the Veress needle is commonly used by surgeons to create pneumoperitoneum before laparoscopic surgeries, its application in dry MT has not been widely reported in recent times. Methods: We report on a series of 31 patients who underwent dry MT with artificial pneumothorax induction using Veress needle under thoracic ultrasonography (TUS) guidance. A procedure was considered technically successful if it met all the following criteria: successful pneumothorax induction, allowing smooth insertion of the semi-rigid thoracoscope; absence of immediate significant procedural-related complications; and no delayed complications such as persistent air leaks, defined as leakage lasting more than 5 days necessitating extended chest tube placement. Results: Complete pneumothorax induction was achieved in 25 cases, resulting in an 80.6% technical success rate; however, biopsies were successfully performed in all cases. The most frequent histopathological diagnoses were malignancy (n=9, 29.0%), followed by inflammatory pleuritis (n=8, 25.8%) and tuberculosis (n=8, 25.8%). No procedural complications were reported. Conclusion These results indicate that TUS-guided dry MT utilizing a Veress needle is technically feasible and secure when performed by experienced MT practitioners in TUS.

Background: Fasting guidelines have long recommended that patients can have clear fluids until 2 h prior to surgery. Multiple audits in our institution showed that patients had prolonged fluid fasting duration, despite being given preoperative instructions. This paper presents the results of audits in our institution relating to fasting since 2004 and the outcome of interventions undertaken. Methods: Audits conducted in 2004, 2008, 2018, 2021, and 2022 were reviewed, with a focus on fasting duration for clear fluids. Interventions that led to significant improvements were identified. Results: The median fasting duration for clear fluids was 8 h, 8 h 42 min, and 7 h 42 min in 2004, 2008, and January 2018, respectively. The approach of giving patients a ‘welcome drink’ of water and allowing sips of water up to the time of being called upon to the theater was introduced in 2018 (Think Drink). This resulted in dramatic reduction of fasting duration to 2 h 15 min. However, repeat audit in 2021 showed slippage requiring additional interventions in the form of staff education for newcomers and reinforcement at staff huddles that reduced the fasting duration down to 2 h. There were no instances of aspiration or regurgitation after the introduction of Think Drink. Conclusions Allowing sips of water until being called to the theater with a Think Drink approach successfully reduced unnecessary fasting by patients. Staff and patient education were also required to sustain success. Fasting duration should be considered a ‘Quality of Service Indicator’ and periodic audit should be mandated.

Background: In the absence of significant pleural effusion, conventional medical thoracoscopy (MT) is often not feasible due to the risk of lung injury. Dry MT mitigates these risks by inducing artificial pneumothorax through needle insufflation or blunt dissection. Although the Veress needle is commonly used by surgeons to create pneumoperitoneum before laparoscopic surgeries, its application in dry MT has not been widely reported in recent times. Methods: We report on a series of 31 patients who underwent dry MT with artificial pneumothorax induction using Veress needle under thoracic ultrasonography (TUS) guidance. A procedure was considered technically successful if it met all the following criteria: successful pneumothorax induction, allowing smooth insertion of the semi-rigid thoracoscope; absence of immediate significant procedural-related complications; and no delayed complications such as persistent air leaks, defined as leakage lasting more than 5 days necessitating extended chest tube placement. Results: Complete pneumothorax induction was achieved in 25 cases, resulting in an 80.6% technical success rate; however, biopsies were successfully performed in all cases. The most frequent histopathological diagnoses were malignancy (n=9, 29.0%), followed by inflammatory pleuritis (n=8, 25.8%) and tuberculosis (n=8, 25.8%). No procedural complications were reported. Conclusion These results indicate that TUS-guided dry MT utilizing a Veress needle is technically feasible and secure when performed by experienced MT practitioners in TUS.

Background: In the absence of significant pleural effusion, conventional medical thoracoscopy (MT) is often not feasible due to the risk of lung injury. Dry MT mitigates these risks by inducing artificial pneumothorax through needle insufflation or blunt dissection. Although the Veress needle is commonly used by surgeons to create pneumoperitoneum before laparoscopic surgeries, its application in dry MT has not been widely reported in recent times. Methods: We report on a series of 31 patients who underwent dry MT with artificial pneumothorax induction using Veress needle under thoracic ultrasonography (TUS) guidance. A procedure was considered technically successful if it met all the following criteria: successful pneumothorax induction, allowing smooth insertion of the semi-rigid thoracoscope; absence of immediate significant procedural-related complications; and no delayed complications such as persistent air leaks, defined as leakage lasting more than 5 days necessitating extended chest tube placement. Results: Complete pneumothorax induction was achieved in 25 cases, resulting in an 80.6% technical success rate; however, biopsies were successfully performed in all cases. The most frequent histopathological diagnoses were malignancy (n=9, 29.0%), followed by inflammatory pleuritis (n=8, 25.8%) and tuberculosis (n=8, 25.8%). No procedural complications were reported. Conclusion These results indicate that TUS-guided dry MT utilizing a Veress needle is technically feasible and secure when performed by experienced MT practitioners in TUS.

Background: Fasting guidelines have long recommended that patients can have clear fluids until 2 h prior to surgery. Multiple audits in our institution showed that patients had prolonged fluid fasting duration, despite being given preoperative instructions. This paper presents the results of audits in our institution relating to fasting since 2004 and the outcome of interventions undertaken. Methods: Audits conducted in 2004, 2008, 2018, 2021, and 2022 were reviewed, with a focus on fasting duration for clear fluids. Interventions that led to significant improvements were identified. Results: The median fasting duration for clear fluids was 8 h, 8 h 42 min, and 7 h 42 min in 2004, 2008, and January 2018, respectively. The approach of giving patients a ‘welcome drink’ of water and allowing sips of water up to the time of being called upon to the theater was introduced in 2018 (Think Drink). This resulted in dramatic reduction of fasting duration to 2 h 15 min. However, repeat audit in 2021 showed slippage requiring additional interventions in the form of staff education for newcomers and reinforcement at staff huddles that reduced the fasting duration down to 2 h. There were no instances of aspiration or regurgitation after the introduction of Think Drink. Conclusions Allowing sips of water until being called to the theater with a Think Drink approach successfully reduced unnecessary fasting by patients. Staff and patient education were also required to sustain success. Fasting duration should be considered a ‘Quality of Service Indicator’ and periodic audit should be mandated.

Background: Fasting guidelines have long recommended that patients can have clear fluids until 2 h prior to surgery. Multiple audits in our institution showed that patients had prolonged fluid fasting duration, despite being given preoperative instructions. This paper presents the results of audits in our institution relating to fasting since 2004 and the outcome of interventions undertaken. Methods: Audits conducted in 2004, 2008, 2018, 2021, and 2022 were reviewed, with a focus on fasting duration for clear fluids. Interventions that led to significant improvements were identified. Results: The median fasting duration for clear fluids was 8 h, 8 h 42 min, and 7 h 42 min in 2004, 2008, and January 2018, respectively. The approach of giving patients a ‘welcome drink’ of water and allowing sips of water up to the time of being called upon to the theater was introduced in 2018 (Think Drink). This resulted in dramatic reduction of fasting duration to 2 h 15 min. However, repeat audit in 2021 showed slippage requiring additional interventions in the form of staff education for newcomers and reinforcement at staff huddles that reduced the fasting duration down to 2 h. There were no instances of aspiration or regurgitation after the introduction of Think Drink. Conclusions Allowing sips of water until being called to the theater with a Think Drink approach successfully reduced unnecessary fasting by patients. Staff and patient education were also required to sustain success. Fasting duration should be considered a ‘Quality of Service Indicator’ and periodic audit should be mandated.

Background: In the absence of significant pleural effusion, conventional medical thoracoscopy (MT) is often not feasible due to the risk of lung injury. Dry MT mitigates these risks by inducing artificial pneumothorax through needle insufflation or blunt dissection. Although the Veress needle is commonly used by surgeons to create pneumoperitoneum before laparoscopic surgeries, its application in dry MT has not been widely reported in recent times. Methods: We report on a series of 31 patients who underwent dry MT with artificial pneumothorax induction using Veress needle under thoracic ultrasonography (TUS) guidance. A procedure was considered technically successful if it met all the following criteria: successful pneumothorax induction, allowing smooth insertion of the semi-rigid thoracoscope; absence of immediate significant procedural-related complications; and no delayed complications such as persistent air leaks, defined as leakage lasting more than 5 days necessitating extended chest tube placement. Results: Complete pneumothorax induction was achieved in 25 cases, resulting in an 80.6% technical success rate; however, biopsies were successfully performed in all cases. The most frequent histopathological diagnoses were malignancy (n=9, 29.0%), followed by inflammatory pleuritis (n=8, 25.8%) and tuberculosis (n=8, 25.8%). No procedural complications were reported. Conclusion These results indicate that TUS-guided dry MT utilizing a Veress needle is technically feasible and secure when performed by experienced MT practitioners in TUS.

Background: Fasting guidelines have long recommended that patients can have clear fluids until 2 h prior to surgery. Multiple audits in our institution showed that patients had prolonged fluid fasting duration, despite being given preoperative instructions. This paper presents the results of audits in our institution relating to fasting since 2004 and the outcome of interventions undertaken. Methods: Audits conducted in 2004, 2008, 2018, 2021, and 2022 were reviewed, with a focus on fasting duration for clear fluids. Interventions that led to significant improvements were identified. Results: The median fasting duration for clear fluids was 8 h, 8 h 42 min, and 7 h 42 min in 2004, 2008, and January 2018, respectively. The approach of giving patients a ‘welcome drink’ of water and allowing sips of water up to the time of being called upon to the theater was introduced in 2018 (Think Drink). This resulted in dramatic reduction of fasting duration to 2 h 15 min. However, repeat audit in 2021 showed slippage requiring additional interventions in the form of staff education for newcomers and reinforcement at staff huddles that reduced the fasting duration down to 2 h. There were no instances of aspiration or regurgitation after the introduction of Think Drink. Conclusions Allowing sips of water until being called to the theater with a Think Drink approach successfully reduced unnecessary fasting by patients. Staff and patient education were also required to sustain success. Fasting duration should be considered a ‘Quality of Service Indicator’ and periodic audit should be mandated.

Background: In the absence of significant pleural effusion, conventional medical thoracoscopy (MT) is often not feasible due to the risk of lung injury. Dry MT mitigates these risks by inducing artificial pneumothorax through needle insufflation or blunt dissection. Although the Veress needle is commonly used by surgeons to create pneumoperitoneum before laparoscopic surgeries, its application in dry MT has not been widely reported in recent times. Methods: We report on a series of 31 patients who underwent dry MT with artificial pneumothorax induction using Veress needle under thoracic ultrasonography (TUS) guidance. A procedure was considered technically successful if it met all the following criteria: successful pneumothorax induction, allowing smooth insertion of the semi-rigid thoracoscope; absence of immediate significant procedural-related complications; and no delayed complications such as persistent air leaks, defined as leakage lasting more than 5 days necessitating extended chest tube placement. Results: Complete pneumothorax induction was achieved in 25 cases, resulting in an 80.6% technical success rate; however, biopsies were successfully performed in all cases. The most frequent histopathological diagnoses were malignancy (n=9, 29.0%), followed by inflammatory pleuritis (n=8, 25.8%) and tuberculosis (n=8, 25.8%). No procedural complications were reported. Conclusion These results indicate that TUS-guided dry MT utilizing a Veress needle is technically feasible and secure when performed by experienced MT practitioners in TUS.

The prevalence of smartphone addiction among university students has raised concerns about its potential implications on their mental health, academic performance, and interpersonal relationships. This review aims to address the existing gap in the literature and shed light on the psychosocial impact of smartphone addiction in this crucial phase of young adults’ lives. A systematic approach was employed to identify and analyse relevant studies from reputable databases. The selection criteria encompassed studies published between January 2009 and December 2022, in university students. The review synthesises findings from 32 selected studies to present a comprehensive analysis of the psychosocial impacts of smartphone addiction. The results indicated significant associations between excessive smartphone use and adverse mental health outcomes, including increased levels of anxiety, depression, and stress among university students. Furthermore, smartphone addiction negatively influences academic performance, decreasing face-to-face communication and social isolation.