Materials and Methods: This retrospective telephonic structured interview-based study was carried out on all orthopaedic patients taking DAMA during a one-year period from July 2016 to June 2017. They were telephonically interviewed with a structured questionnaire. Hospital and ED records were analysed for demographic as well as temporal characteristics.

Results: A total of 68 orthopaedic patients walked out of casualty against medical advice out of a total 775 (8.77%) orthopaedic patients presenting during the period as against 6.4% overall rate of DAMA for all specialties. The main reasons for DAMA were financial unaffordability of treatment (36.7%), preference for another orthopaedic surgeon (22%) and on advice of the patient's General Practitioner (16.1%).

METHOD: A hyperlink to an online, anonymised questionnaire was distributed to medical students in 3rd, 4th and final year at three RCSI campuses. Basic descriptive statistics were used to describe the responses to individual questions and appropriate statistical tests used to compare male and female responses to questions.

RESULTS: A total of 464 completed questionnaires were analysed. Almost 40% (n=185) were male and 60% (n=279) were female. Males were significantly more influenced by remuneration than females (p<0.001) towards a choice of surgical career. Females were significantly more influenced in their choice of surgical career by part-time work (p<0.001), parental leave (p<0.001), working hours (p<0.001) and length of residency (p=0.003). During surgical attachments, females were significantly more likely to admit feeling intimidated than males (p=0.002) and males more likely to report feeling confident (p<0.001). Ninety-six per cent of students felt they would be more likely to pursue a career in which they had identified a positive role model, with female medical students three times more likely to have identified a female role model than males.

MATERIALS AND METHODS: A cross-sectional study was designed to assess surgeons' and patients' perceptions toward breast reconstruction. Questionnaires were distributed to general and breast surgeons in East Coast Malaysian hospitals and Hospital Kuala Lumpur and to postmastectomy patients with and without breast reconstruction at the Hospital Universiti Sains Malaysia and Hospital Raja Perempuan Zainab II. The response rates were 82.5% for the surgeons (n = 33), 95.4% for the patients with reconstruction (n = 63), and 95.5% for the patients without reconstruction (n = 278).

RESULTS: The median surgeon age and experience was 42 and 6 years, respectively. Each surgeon saw an average of 20 new breast cancer cases annually. Most surgeons (86.7%) discussed reconstruction options with their patients but had only referred an average of 4 patients for reconstruction during a 3-year period. Surgeons' concerns regarding the qualitative outcome increased the likelihood of a breast reconstruction discussion (β = 4.833; P = .044). The women who underwent breast reconstruction were younger (mean age, 42 vs. 50 years), were more often working (69.4% vs. 42.2%), and more often had previous awareness of the option (90.3% vs. 44.3%). The most common reasons for undergoing breast reconstruction were "to feel more balanced" (92.1%) and "surgeon's strong recommendation" (92.1%). Previous knowledge of breast reconstruction increased the likelihood of reconstruction (odds ratio, 5.805; P = .026). Although 70% of surgeons thought that patients would not be interested in reconstruction, only 37.9% of patients with previous awareness reported having no interest.

CASE PRESENTATION: We described a 43 years old male who presented with a right mastoid swelling, nine years after a right retro-sigmoid craniotomy and excision for a cerebellopontine angle meningioma. He also had multiple cranial neuropathies involving trigeminal, facial and vestibulocochlear nerves. Temporal bone CT and MRI showed features suggestive of cholesterol granuloma with extensive bony erosions. He was treated with surgical excision and drainage where bone wax residues were found intraoperatively. Histopathological analysis of the lesion confirmed the diagnosis of cholesterol granuloma. Post-operatively, the mastoid swelling resolved and his recovery was uneventful.

METHODS: A comprehensive search of peer reviewed journals was completed based on the key words, "Circumflex aorta," "Circumflex retro-esophageal aorta" and "circumflex arch" using Google scholar, Scholars Portal Journals and PubMed. The reference section for each article found was searched to obtain additional articles. Literature on the circumflex aorta was reviewed starting from the embryogenesis to the latest management strategies.

RESULTS: Right circumflex aorta is more prevalent compared to left circumflex aorta. It can occur in isolation or in association with other intracardiac lesions. Mainly presents in children, however reported in adults too. The presentation may vary from asymptomatic lesion to acute respiratory distress secondary to airway compression. Computerized tomography (CT) and magnetic resonance imaging (MRI) are important tools in delineating the vascular anatomy. Aortic uncrossing is the definitive procedure. However, the role of concomitant tracheobronchopexy is emerging. Native tissue-to-tissue anastomosis is commonly preferred, but cases of extra-anatomic grafts are reported.