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Objective To evaluate the operative outcomes when trainees first perform caesarean sections independently. Design A retrospective study in a tertiary obstetric unit. Population Five hundred caesarean sections, which represented the first 50 caesarean sections performed independently by each of ten trainees, were studied. Methods The effect of learning curve on outcome was analysed. Main outcome measures Total operative time, incision-to-delivery interval, operative blood loss, Apgar score, cord arterial pH, incidence of neonatal intensive care unit admission, postoperative complication rates and duration of hospitalisation. Results The mean operative time for the first five cases by trainees was 52.2 ± 11.4 minutes. It progressively decreased and reached 39.6 ± 8.4 minutes for the 46th to 50th cases. The operative time was significantly longer in the first 15 caesarean sections ( P < 0.05). Moreover, the incision-to-delivery interval was also longer during the first five cases ( P= 0.02). Besides the time of the operation, the trend for operative blood loss stabilised after the first ten caesarean sections ( P < 0.05). Otherwise, there were no significant differences among other outcome variables. Conclusion This study shows that trainees need to perform 10–15 caesarean sections before their skills become more proficient. Senior obstetricians may need to provide guidance to the trainees during their first independent 15 caesarean sections. [ABSTRACT FROM AUTHOR]

Musculoskeletal allotransplantion is the most common form of human tissue transplantation. Unlike solid organ transplants, bone allotransplants undergo rigorous processing and are considered non-viable tissue. In this study, we propose that donor genetic material may exist in circulation after bone allotransplantation. Fifty-one female patients who received bone allotransplants from male donors were assessed. Blood plasma samples were analyzed using real-time quantitative polymerase chain reaction (PCR) with dual labeled fluorogenic probes for the presence of the SRY gene on the Y chromosome. Of the total 51 patients, the SRY sequence was detected in 6 patients. Five were positive at day 1 postoperatively and negative thereafter, with the remaining patient positive at 3 months post-transplantation. Our results document, for the first time, the presence of donor DNA in the circulation of recipients after bone allotransplantation. Our findings suggest a potential new investigative tool to assess the postoperative status of bone allotransplants.