bluuebunny/crossref_metadata_2025 huggingface dataset:
Fear of Childbirth and Its Contributing Factor – An Exploratory Study at a Tertiary Care Hospital
Authors: Sharma Kanchan , Vyas Himanshu , Gothwal Meenakshi , Arumugam Gomathi
Published: September 2023

Background:

Motherhood and pregnancy are cherished moments in a life and considered one of the most important events in a women's life. So, she does the best to maintain good health to bring into this world a healthy baby. The fear of pregnancy is called tocophobia and it is defined as an intense state of anxiety which leads to fear of childbirth. Fear of childbirth result in increased number of visits to the obstetrician and in frequent request for cesarean delivery. The study aimed to assess the fear of childbirth and factors contributing to fear of childbirth among primigravidae at a tertiary care teaching hospital.

Methodology:

Descriptive design with Quantitative approach was used and a sample of 269 primigravidae women by using consecutive sampling. Data was collected at Antenatal OPD, by using standardized tool Wijma delivery expectancy questionnaire Version – A and a checklist for factors contributing to fear of childbirth.

Results:

Level of fear of childbirth among primigravidae (24.4%) having severe level, (44.8%) high level and 24.1% having moderate level, 6.7% low level of fear of childbirth. Major contributing factor for fear of childbirth was Fear of labor pain (80.7%), and least common was disturbed self image and feeling of insecurity (27.9%).

Conclusion:

Majority of the primigravidae women face fear of childbirth, as contributed by various factors that affect fear of childbirth. Primigravidae women were counseled on one to one basis and they were made aware about the physiology of labor and what to expect during labor to alleviate their fear after the completion of the data collection process.
COVID-19-Related Anxiety and Coping Strategies Among Nursing Professionals Working in COVID Intensive Care Unit
Authors: Choudhary Mamta , Gopichandran L. , Jyotishana KP
Published: September 2023

Background:

During the COVID-19 pandemic, nursing professionals along with other health-care workers worked as the pillars of the health-care system. There have been difficult times when nursing professionals have overworked despite shortage of resources, continuously wearing PPE over hours, and overfilled intensive care units (ICUs). Thus, while confronting the numerous COVID-19-related challenges, nursing professionals might have experienced anxiety and utilized various coping strategies to reduce their anxiety.

Methods:

The cross-sectional survey was conducted using a web-based questionnaire. Information was collected from 200 nursing personnel's working in the COVID ICU of a selected tertiary care hospital. The questionnaire used for data collection comprised three sections: the first section focused on sociodemographic profile of subjects, the second section included the Self-Rating Anxiety Scale, and the third included Brief COPE.

Results:

The result revealed that majority, 61%, of the subjects had no COVID-19-related anxiety, whereas 33.5% of subjects had mild-to-moderate COVID-19-related anxiety. However, only 5.5% of the subject reported marked-to-severe form of COVID-19-related anxiety. The highest anxiety scores were identified for items: (1) I get feelings of numbness and tingling in my fingers and toes, (2) I feel weak and get tired easily, and (3) I have nightmares. To cope up with anxiety, majority of nursing professionals' approach “praying or meditating” coping style mechanism followed by positive reframing and planning.

Conclusions:

COVID-19 is causing mild-to-moderate anxiety in a significant number of nursing professionals. Thus, the hospital administration and nurse managers should focus on early screening for anxiety, providing psychological support to nurses, and training ineffective coping strategies.
SocioDemographic Variables and Social Connectedness as Predictors of Coping Mechanisms in College Students during COVID-19 Pandemic
Authors: Bano Samina , Deka Tanushree
Published: September 2023

Purpose:

The outbreak of the COVID-19 pandemic has left the student community in distress. They have had to vacate their hostels and go home, which has restyled their enjoyable campus life into virtual online classes. The technical glitches and uncertainty of the future kept them in the doldrum. Our study explored the subgroups of socio-demographic variables (gender, educational qualifications, history of mental health condition, current experience of mental health condition, and current accommodation) and Social Connectedness as predictors of coping strategies during the pandemic in university students of Delhi-NCR.

Method and Materials:

A cross-sectional research design was implemented. Through purposive sampling, 248 students were recruited. The sample consisted of males and females aged 18-34 years (Mean=21, SD=2.86). Data was collected using Google forms consisting of the Sociodemographic Form, The Brief Cope and Social Connectedness Scale. Online informed consent was taken from the participants.

Results:

Regression results suggested that the current experience of mental health conditions predicted active emotional and avoidant emotional coping strategies. Social Connectedness positively predicted avoidant emotional coping strategy and negatively predicting problem focus strategies in the COVID-19 pandemic. Significant differences were found in active emotional and avoidant emotional coping strategies between students having a past and current history of mental health conditions (anxiety/depression) vs. those who were in sound mental health. Students with past experience of mental health issue were reported to be significantly more socially connected than who did not have any mental health issue.

Conclusions:

The potential effects of Social Connectedness, a history of the mental health condition on coping strategies during COVID-19, were found to be necessary.
Perceived Stress and Level of Coping Strategies Adopted by Working Women during Current COVID-19 Pandemic Situation
Authors: Banik Monica , Jacob Jyotsna , Maheshwari Sushil Kumar
Published: September 2023

Background:

The outbreak of COVID-19 has created a global health crisis that has had a deep impact on the way we perceive our world and our everyday lives and hence causing a significant negative impact on mental health. The uncertainty and low predictability of COVID-19 not only threaten people's physical health, but also affect people's mental health, especially in terms of emotions and cognition.

Aim:

The aim of this study is to assess the level of perceived stress and coping strategies adopted by working women during COVID-19 outbreak.

Materials and Methods:

An online survey was conducted with a semi-structured questionnaire using nonprobability snowball sampling technique that surveyed 219 individuals through social networking platform.

Results:

The level of stress was found out to be in severe level but it is also revealed that majority of the women (90.4%) were preoccupied with the thoughts of COVID-19 and reported that they are uncertain about their current situation and about the future. Maximum number of sample (97.7%) revealed that they are unable to cope with the current uncertainty. There was significant association of perceived stress with educational, marital status, and area of living.

Conclusion:

The study concluded that working women had lot of stress and inadequate coping strategies while dealing with Covid-19 situation. Women should be taught to adapt more coping strategies to deal with this situation.
The Efficacy of Educational Intervention in Enhancing Person's Ability to Manage their Epilepsy Well
Authors: Ghosh Rinki , Baruah Arunjyoti
Published: September 2023

Epilepsy is one of the most common chronic neurological conditions, with the potential to generate significant morbidity, impaired quality of life, socioeconomic decline, and high health care costs. Self-management is essential for patients who live with a chronic disease. In addition to standard therapeutic options, patients are also urged to engage in epilepsy self-management which is best achieved by delivering educational intervention to enhance their self-management skills. A good self-management enhances self-efficacy and improves overall quality of life. The purpose of the current review was to identify the evidence on the efficacy of educational intervention in enhancing person's ability to manage their epilepsy to improve their quality of life. Various online databases were searched to obtain the literature using appropriate search terms/keywords. Only Randomized controlled studies were included in the review because of their high evidence level and to avoid subject to bias. Databases searched were ScienceDirect, Wiley online library, and Google Scholar. A total of 41 articles with full texts were reviewed, out of which 7 articles met the criteria. The methodological quality of the studies was assessed by using the Jadad scoring system. The outcome measurement of self-management, self-efficacy, drug adherence, quality of life was observed among patients with epilepsy (PWE) and found effective after delivering educational intervention. In the entire studies, the control group received routine care. This systematic review of randomized controlled trial studies emphasized the positive impact of educational interventions for patients diagnosed with epilepsy concerning various outcome measures. Hence, It was concluded that the planned educational intervention empower PWE to engage in good self-management practices and it enhances their self-efficacy, quality of life by improving their sleep quality, decreasing stress, concern, and fears related to epilepsy.
Lived Experiences of the Wives of Alcohol Use Disorder Partners
Authors: Devi Naorem Bijyarani , George Mini
Published: September 2023

Introduction:

Alcoholism, a “family disease,” is on the rise in India. Individuals who abuse alcohol affect themselves and family, especially their spouses. This study explored the lived experiences of wives of alcohol use disorder (AUD) partners within the context of phenomenology. This was essential to understand their life as they experienced it, from their perspective and the coping resources adopted by them.

Materials and Methods:

Interpretive phenomenology was used with a purposive sampling of wives of AUD partners attending the de-addiction clinic. After explaining the study and written consent, in-depth interviews were conducted with 11 participants, which led to data saturation.

Results:

Data were explicated by thematic analysis. Significant statements and meaning units were identified, and codes were assigned. Three categories namely impact on self, effect on life, and coping strategies were emerged. Two major themes namely “faced innumerable challenges and used adaptive and maladaptive coping” were generated.

Conclusion:

Wives faced innumerable problems of poor health, physical misery, social relations, emotional disturbances, marital discord, and financial burden. In terms of coping, most wives relied on either avoidance or tolerance which was not productive for them or their partners. The wives covered up partners' alcohol dependence, took on their responsibilities, withdrew or distanced themselves from friends and family. Many of them put on a brave front and continued to live with the constant stress.
Relationship between Emotionally Unstable Personality Disorder and Remembered Parenting Style - A Pilot Study from Private Tertiary Care Center
Authors: Srivastava Prerna , Shetty Kannappa V. , Anjanappa Jagadish
Published: September 2023

Introduction:

Emotionally unstable personality disorder (EUPD) is a type of personality disorder which is characterized by symptoms, such as highly volatile mood, high impulsivity, unstable relationships, and self-harming behavior. Studies indicate that an individual's personality is an outcome of various factors, their parental upbringing being one of the major factors.

Materials and Methods:

The study aimed at exploring remembered parental style in patients diagnosed with EUPD. Ten patients were recruited from a tertiary care psychiatric hospital, and parental bonding instrument and clinical global impressions scale were administered.

Results:

The mean age of the patients with EUPD was 28.8 ± 7.77 years, and the mean years of education was found to be 15.4 ± 1.66. Mean age of onset of illness was 23.71 years, and the mean severity score was found to be 4.8. The mean mother's care score was found to be 25.6 ± 7.17 and mother's overprotection score was found to be 11.2 ± 5.53. The mean father's care score was found to be 20 ± 11.28 and father's overprotection score was 12.1 ± 6.38.

Conclusions:

The study findings reveal involvement of authoritarian parenting style in fathers and neglectful parenting style in mothers in the development of EUPD. However, a more comprehensive study with larger sample size is needed to throw more light over this finding.
Prevalence of Bronchial Asthma Among Students of 16–20 Years' Age Group in a South Indian City
Authors: Sheik Irfan A. , Sharma M. Vishnu
Published: September 2023

Background:

The prevalence of asthma has been increasing worldwide in recent years. There is a wide variation in the prevalence of asthma in various countries, varying between 1.2% and 6.3% among adults in most countries. There is a scarcity of data on the prevalence of asthma in the age group 16–20 years in India.

Objective:

The aim is to study the prevalence of asthma among students of 16–20 years' age group in our city.

Methodology:

This was a questionnaire-based cross-sectional study. A standardized questionnaire was prepared and distributed to 4600 college students. Among the students who had symptoms suggestive of asthma by the questionnaire method, 10% of them were selected for spirometry to confirm the diagnosis by a systemic random sampling method. Statistical analysis was performed using frequency and percentage method to calculate the prevalence. Chi-square test, odds ratio, and 95% confidence interval were used to measure the association between the variables, and a value of P < 0.05 was considered to be significant.

Results:

Out of 4600 students, 1539 (33.5%) were boys and 3061 (66.5%) were girls. 230 (5.0%) students had symptoms suggestive of bronchial asthma, of which 115 (7.5%) were boys and 115 (3.8%) were girls. 336 (7.3%) students had a family history of asthma. Out of 230 students having symptoms suggestive of asthma, only 57 (24.78%) students were taking regular medications, in which 34 (59.64%) students had symptomatic relief. The prevalence of bronchial asthma among college students (16–20) years of age was 5.0%. A family history of asthma was associated with significantly higher odds of having bronchial asthma.

Conclusions:

The prevalence of asthma among students of 16–20 years ago was 5.0%. A family history of asthma was associated with significantly higher odds of having bronchial asthma.
Rapidly Progressive Dyspnea in an Elderly Diabetic
Authors: Bhandary Nithish M. , Sharma Vishnu , Megha S. N.
Published: September 2023

Breathlessness is a common presenting symptom in the emergency room. Focused history, clinical examination, and proper stepwise evaluations are essential for early diagnosis and treatment. The most common presenting feature of nCovid19 pneumonia is rapidly progressive breathlessness. During this pandemic, we need to differentiate nCovid19 pneumonia from other causes for breathlessness. Here, we discuss the differential diagnosis for rapidly progressive breathlessness, how to evaluate a patient with suspected nCovid19 pneumonia and the role of chest computed tomography scan in nCovid19.
Assessment of Outcome of Uncemented Total Hip Arthroplasty
Authors: Shakunt Rajendra Kumar , Sharma Brijesh , Sharma Sohan Swaroop , Pal Chandra Prakash , Sadana Ashwani , Patel Jaydeep
Published: September 2023

Introduction:

Uncemented total hip arthroplasty is a time-tested remarkable surgical procedure that provides mobility, stability, and better quality of life for thousands of patients, especially young patients throughout the world. Thus, uncemented total hip arthroplasty today has become the main mode of hip replacement, especially in young patients. However, uncemented total hip arthroplasty has its own drawbacks such as inadequate initial fixation, excessive wear, and periprosthetic bone loss due to particle-induced lysis.

Materials and Methods:

This prospective study was conducted between September 2018 and August 2020. A total of 30 patients were selected from patients attending emergency department and outpatient department of orthopedics. For all prospective cases, a detailed history regarding mode and mechanism of injury (in case of trauma) was taken followed by clinical examination, and the patient was documented. Follow-up visits were made at 3 months, 6 months, 1 year, and periodically thereafter.

Results:

In our study, functional outcomes after uncemented total hip replacement were excellent in 30% of cases, good in 53.33% of cases, fair in 13.33% of cases, and poor in 3.33% of cases by using Harris Hip Score. No patients showed any radiographic signs of loosening. No patients showed any complications during follow-up.

Conclusion:

In our study, the results are fair to poor in noncompliant young patients with high functional demands. The results are fair to poor in patients with bilateral affections such as chronic arthritis and avascular necrosis in which the patient undergoes only unilateral total hip arthroplasty.
Retrieval of Broken Guide Wire in Femoral Neck
Authors: Jaiswal Atin , Tanwar Yashwant Singh , Chatterji Gautam
Published: September 2023

Perioperative breakage of implant or instrument in the hip joint is a nightmare for an orthopedic surgeon. Location of the broken metallic part near neurovascular bundle or joint surfaces necessitates its removal. In this article, we report a case of retrieval of broken guide wire from femoral neck during proximal femoral nailing for pertrochanteric fracture by engaging it in rigid cannulated reamer without causing any further iatrogenic injury. This is a novel and simple technique not described previously in literature and has its own unique advantages over other methods. Large core diameter of rigid cannulated reamer engages broken guide wire easily, is better than any other cannulated instrument, and can be a simple solution to a difficult problem. Regular checking and replacement of used instruments along with cautious use may prevent iatrogenic complications of instruments and implant breakage. However, if the situation arises, the surgeon must be familiar with all the techniques of removal of broken instruments and should choose the technique which is more convenient and less traumatic.
Conservative Management of a Lesser Trochanter Avulsion Fracture
Authors: Saraf Amit , Bishnoi Sandeep , Habib Hamza , Aggarwal Shubham
Published: September 2023

A 12-year-old male patient came to our outpatient department with a complaint of pain in the left hip region after he slipped and fell on a wet floor while playing at school. The symptoms were pain left the hip region with functional impairment, difficulty in walking, tenderness on inguinal region palpation, and restricted hip movements. The X-ray and computed tomography scan showed an avulsion fracture of the left lesser trochanter. The treatment included rest, immobilization, analgesia, and non-weight bearing. After a 9-month follow-up, the patient had a completely normal range of motion and was fully able to do all his daily activities
Comparison between Outcomes of Small Head and Large Head Prosthesis Use in Total Hip Arthroplasty
Authors: Mittal Vivek , Pal Chandra Prakash , Chahar Hemant Singh , Sadana Ashwani , Verma Ashutosh , Patel Jaydeep
Published: September 2023

Introduction:

Total hip replacement (THR) currently uses a various size of head and bearing. These days the most common head diameter used in the THR is 32 mm. The purpose of our study is to compare the functional and radiographic evaluation of outcomes of two groups of patients undergoing the THR, received either small diameter (≤28 mm) or large diameter (≥32 mm) femoral head prosthesis.

Materials and Methods:

This was an interventional prospective study done between September 2018 and August 2020. The diameter of femoral head sizes 32 mm and 28 mm was used in this study. At definite intervals, patients were regularly followed and specifically assessed for functional and radiographic evaluation.

Results:

During follow-up of patients with 32-mm femoral head diameter excellent functional results were achieved as graded by Harris hip score (P< 0.0001). No patients showed any complications in the large diameter femoral head group.

Conclusions:

Large femoral head diameter prosthesis may lead to more stability, range of motion, wear rate, and reducing the complications of revision surgery, but with small diameter femoral head, there is an increased chance of dislocation, impingement, and more complications.
Can PFLP be the Implant of Choice for Unstable Trochanteric Fractures? Outcomes and Complications
Authors: Singh Chanchal Kumar , Deshpande Juhi , Shah Awanish , Agarwal Prabhanjan
Published: September 2023

Background:

Intertrochanteric fracture is a common orthopedic injury sustained in the elderly population because of osteoporosis and trivial fall. Life-threatening systemic complications occur mainly due to immobility.

Materials and Methods:

We included 62 patients (40 males and 22 females) of unstable intertrochanteric fracture (AO 31 A2 and A3) attending Department of Orthopedics. They were all subjected to surgical treatment with proximal femoral locking plate (PFLP). Patients were followed up at 3rd, 6th, and 12th month for outcome variables, i.e., functional (Harris hip score, Palmer and Parker mobility score) and radiological outcomes (neck shaft angle, loss of reduction, union, and implant-related complications). Statistical analysis was done using Friedman’s test after calculating the data in terms of mean and median using SPSS 20 software.

Results:

Mean age of our patients was 64 years; 40 were males and 22 females. Fifty patients sustained fracture due to trivial fall and 12 due to road traffic accidents. Thirty-five out of 62 patients had medical comorbidities. Twenty-six patients needed open reduction of fracture and 36 were close reduced. Twenty-two patients had severe comminution (AO A3 III type). Mean degree of loss of reduction was 5° in 6th month and 4° in 12th month. Union was achieved in 48 out of 50 patients at 12th month. Most of the patients achieved fair-to-good functional outcome scores at 12th month of follow-up. We noticed difficulties in fracture reduction as well as complications related to implant.

Conclusion:

PFLP is an effective implant in comminuted intertrochanteric fractures with broken lateral wall. Complications can be minimized by following the principles of locking plate meticulously.
Clinical Presentation of Congenital Talipes Equinovarus via Detailed Case Scenarios
Authors: Pandey Vaishnavi , Singh Ajai , Gond Amit Kumar , Raikwar Archana , Siddiqui Salma , Ali Sabir
Published: September 2023

Background:

Clubfoot is a developmental deformity stirring at ankle, sub-taloid, and metatarsal joints. This deformity includes three elements: the foot inversion; forefoot-adduction relative to the hindfoot; and equinus position. The need for this case study was to understand the effectiveness of various treatment/management programs.

Methodology:

The study was performed for relating the severity of congenital talipes equinovarus (CTEV) with the need of Achilles tendon tenotomy (ATT) in the management along with demographic parameters. Overall, 95 patients of both sexes having 159 clubfeet were included. Clinicodemographic data were recorded, and the severity of CTEV was analyzed (Pirani scoring). Patients only presented at the tertiary hospital King George’s Medical University (KGMU), Lucknow for the first time, were included in the study, were provided with the facilities including casting, taping, and in extreme scenarios were projected for surgical interventions. Cases who had already registered under the Rastriya Bal Swastha Karyakram (RBSK) program were projected to the non-government organization “CURE” within the O.P.D. of the Paediatric Orthopaedics Department, KGMU, Lucknow. Via “CURE” the treatment facilities offered to the cases were completely free.

Result:

The mean age of the included cases was 102.44 days. Out of the 95 included cases with 159 clubfeet, 67.37% were males, and 32.63% were females. The mean of the presenting Pirani score was 3.17, the mean of the pre-ATT Pirani score was 2.72, and the mean of the Pirani score at the completion of management was 0.043. From these 159 clubfeet, 73 feet were subjected to ATT, and the remaining 86 feet were managed via casts only. The mean duration of correction was 6.1 weeks, and the mean of the required number of casts was 4.68. The total relapse observed was 32.70%. These were further managed by re-casting 44.23% and re-ATT, along with re-casting 55.77%. We found that out of 95 cases, 70.53% were rural rest, and 29.47% were urban. Similarly, 64.21% were literate, and 35.79% were illiterate Tables 1 and 2.

Special Case Scenarios:

The present clinical article is a type of an observational-descriptive case series, with the focus on two different but similar anomaly-based cases. The first case is based on the simple idiopathic CTEV; however, the second one represents the case of complex clubfoot, that s, the patient is suffering from the clubfoot along with other deformities as a secondary anomaly.

Conclusion:

Clubfoot is a genetic deformity targeting the lower limb, with an effectively high rate of incidence in live births.
Joshi's External Stabilization System Versus Locked Compression Plating in the Management of Tibial Plateau Fractures
Authors: Huda Najmul , Bishnoi Sandeep , Shahid Mir , Keshav Kumar , Altaf Danish , Kumar Kapil
Published: September 2023

Context:

Among the myriad treatment options available for tibial plateau fractures, Joshi's external stabilization system (JESS) is one of the established treatment modalities as an external fixation device. Closed reduction has the advantage of biological fixation and preservation of the already jeopardized local blood supply to the bone.

Aim:

This study was conducted to compare the functional results between locked compression plate and JESS as a fixation method for tibial plateau fractures.

Setting and Design:

This is a prospective, single-center, and nonrandomized study.

Materials and Methods:

Fifty patients with tibial plateau fractures were included in the study, who presented to our hospital between January 2016 and December 2018 and were treated alternatively by either plating (Group P) or JESS (Group J). Modified Rasmussen functional score (MRFS) was used for assessing the functional outcomes.

Statistical Analysis Used:

Microsoft Excel and Statistical software SPSS version 21.0.

Results:

The mean age in Group J and P was 39.52 ± 9.27 years and 39.00 ± 10.82 years, respectively. The mean follow-up period was 12 months (range: 9–24 months). Schatzker Type II was the most common fracture pattern (n = 15). The average union time was 12.3 weeks in Group J and 14 weeks in Group P (P = 0.036). The mean MRFS at 3, 6, and 9 months of follow-up was significantly better in the J group (P value at 3 months was 0.0204, at 6 months was 0.0226, and at 9 months was 0.0048).

Conclusion:

The study shows that the functional outcome of JESS for the management of tibial plateau fractures is better than plating.
Minimally Invasive Percutaneous Plate Osteosynthesis in Distal Femur Fractures Using Locking Compression Plate (LCP)
Authors: Choubisa Raghvendra , Agarwal Saumya , Meena Dinesh Kumar , Sharma Anamendra , Prakash Shivank
Published: September 2023

Background:

Distal femoral fractures are frequently seen in high-velocity road traffic accidents. The introduction of locking compression plates with option of locked screws has provided the means to increase the rigidity of fixation in osteoporotic bone or in the presence of periarticular fractures.

Materials and Methods:

Fifty patients within the span of 3 years underwent internal fixation of distal end femur by LCP using minimal invasive percutaneous plate osteosynthesis (MIPPO) technique. All the patients were assessed using Modified Neer's criteria which assign points for pain, function, working ability, joint movements, gross, and radiological appearance.

Results:

Out of 50 patients, 48 patients (96%) showed radiological union within 20 weeks. Average time for union was 16.4 weeks. Average knee flexion was 120° with more than 60% of patients having knee range of motion more than 115°. Modified Neer's score was excellent in 32 (64%), good in 12 (24%), fair in 4 (8%), and poor in 2 (4%). There had been one patient each who developed nonunion, deep infection, and valgus malalignment.

Conclusion:

Locking compression plate used through MIPPO technique is an optimal tool for distal fractures of femur. It provides rigid fixation, where a widening canal, thin cortices, and frequently poor bone stock make fixation difficult.
Palmaris Longus Tendon for Distal Radio-Ulnar Ligament Reconstruction – A Novel Technique
Authors: Mohan Amitabh , Nagamahendran R. , Singh Sanjay , Shankaran R.
Published: September 2023

Isolated Distal Radioulnar Joint (DRUJ) Instability is a rare phenomenon. It is usually associated with fractures of either the radius or ulna, and the treatment is not uniform. We present the case of a traumatic DRUJ instability presented to our centre with complaints of abnormal clicking sound in wrist during rotatory movements. During surgery, the stabilization of DRUJ was done using distal radioulnar ligament. Postoperative radiography showed proper alignment, with good stability of DRUJ. Correction of DRUJ instability is facilitated by distal radioulnar ligament reconstruction. The treatment is found to be effective with good outcome as compared to the conservative management and other surgical modalities widely practiced.
Solitary Tuberculous Lesion Involving the Spinous Process of the Cervical Vertebra
Authors: Agarwal Sanchit , Huda Najmul , Islam Mir Shahid Ul , Agarwal Saurabh
Published: September 2023

The higher incidence and prevalence of tuberculosis (TB) is a common health problem particularly in developing countries like ours. The most common site of TB is the pulmonary region followed by lymph nodes and osteoarticular TB. In the spine, the dorsal spine is the most commonly affected region and the paradiscal being the most common type, posterior elements being the least involved, particularly in isolation. Of the posterior elements, the most common to be involved are the laminae. Here, we are presenting the case of the tubercular osteomyelitis involving the spinous process of the C6 vertebra in isolation. A young female presented to our outpatient department with pain and swelling on the posterior side of the neck. The swelling was nontender, without any signs of acute inflammation, cystic in consistency, and lying deep to the muscles. X-ray of the cervical spine and contrast enhanced magnetic resonance imaging (MRI) suggested the diagnosis of tubercular osteomyelitis. Pus was aspirated. Cartridge-based nucleic acid amplification test revealed Mycobacterium tuberculosis. The patient was given anti-tubercular drugs as per the index TB guidelines of the WHO and was cured. This, to the best of our knowledge, is the only case reported from India. Though the TB of the spinous process is extremely rare, still the diagnosis should be kept in mind when examining a posterior neck swelling, especially in country like ours, where the incidence of TB is high. X-ray and MRI are good tools to reach a diagnosis. Antitubercular regimen should be started for treatment.
A Rare Case of Comminuted Fracture Shaft Humerus with Intercondylar Extension with Monteggia Dislocation and Its Management
Authors: Nallakumarasamy Arulkumar , Manjhi Birju , Sinha Shivam , Arya Rajkumar , Singh Lalit Pratap
Published: September 2023

Background:

Monteggia fracture-dislocation is a rare entity in adults with an incidence of less than 1%. However, a combination of fracture shaft humerus with distal intraarticular extension along with monteggia fracture-dislocation in an ipsilateral upper limb is very hard to find and manage, owing to its rare presentation.

Materials and Methods:

In this report, we detailed the surgical management of comminuted fracture(splinter) of shaft humerus with intercondylar extension AO C2 with typeII monteggia fracture-dislocation with the usage of proper implants in a 25year old male with a 3 year follow-up.

Result:

It shows that the fracture united well at the appropriate period and the elbow range of movements was satisfactorily ranging from 20° to 130° with no limitation in supination and pronation.

Conclusion:

Such complex elbow injuries are difficult to find in the literature. This study addresses the proper surgical management in terms of approach and usage of appropriate implants to improve the long-term functional outcome when dealing with such injuries.
Experiences of what influences physical activity adherence in Iranian patients with heart failure: A qualitative study
Authors: Ahrari Shahnaz , Karimi Moonaghi Hossein , Mahdizadeh Seyed Mousa , Heidari Bakavoli Alireza
Published: September 2023

BACKGROUND:

Heart failure (HF) is becoming one of the important health care problems around the world. Physical activity as the foundation of the cardiac rehabilitation program is poorly adhered by patients with HF. This study aimed to understand the experiences of patients with HF in terms of adherence to physical activity.

MATERIALS AND METHODS:

This study was conducted using conventional qualitative content analysis. Data were collected by semistructured telephone interviews with 25 patients with HF through open-ended questions. Data were collected from patients with HF in Birjand and Mashhad hospitals and heart departments from December 2021 to March 2022. Data were analyzed using Max-QDA10 and data analysis was continuous, comparative, and simultaneous with data collection.

RESULTS:

After data analysis, three main categories were identified: (1) patient-related barriers and facilitators, (2) support system-related barriers and facilitators, and (3) environmental barriers and facilitators. These categories were subdivided into two main themes: (1) threatening disease and (2) challenging disease.

CONCLUSION:

The results showed that beyond patient-related, support system-related, and environmental categories, perceiving the disease as a challenge or a threat is crucial in the activity of patients with HF. Nurses and other health care providers can train problem-solving behaviors to patients with HF to improve their physical and mental well-being. It is suggested that theoretical–behavioral approaches can be used in future clinical trials to improve adherence to physical activity.
Health-related quality of life variation by socioeconomic status: Evidence from an Iranian population-based study
Authors: Ghahramani Sulmaz , Hadipour Maryam , Peymani Payam , Ghahramani Sahar , Lankarani Kamran B.
Published: September 2023

BACKGROUND:

Health-Related Quality of Life (HRQoL) values based on the accurate and reliable European Quality of Life Five Dimension (EQ-5D) questionnaire gives health-state utilities as a helpful data set for studying socio-demographic and socio-economic inequalities in health status in the general population. We aimed to do a population-based study to see how HRQoL varies by socio-demographics and socioeconomic status (SES).

MATERIALS AND METHODS:

The study was a cross-sectional population-based study in Shiraz, Iran's southwest. Data was gathered utilizing a personal digital assistant (PDA). A trained interviewer administered the EQ-5D questionnaire to a representative sample of 1036 inhabitants. Principal component analysis (PCA) was used to create SES indices. Because of the skewed distribution, quantile regression was utilized to model the quartiles of HRQoL values. STATA 12.0 was used to perform all statistical analyses. P <0.05 was considered statistically significant.

RESULTS:

In 1036 study respondents, women had a mean HRQoL of 0.67 ± 0.28, whereas men had a mean HRQoL of 0.78 ± 0.25. Gender and age remained significant in all quartiles of HRQoL value. Participants with insurance showed 0.14 and 0.08 higher HRQoL values in the first and second HRQoL quartiles than those without coverage, respectively. Education [95% CI: 0.034, 0.111)], economy [95% CI: 0.013, 0.077], and assets [95% CI: 0.003, 0.069] all had an impact on HRQoL value in the lowest quintile.

CONCLUSION:

In all quartiles of HRQoL value, women had lower reported HRQoL than men. Insurance programs aimed at more disadvantaged groups with poorer HRQoL may help to minimize inequity. Education, economics, and assets all had an impact on the lower quartiles of HRQoL value, emphasizing the importance of general policies in determining public health status.
Identifying the challenges of holding comprehensive exams in the Ph.D. programs of Iranian medical universities: A protocol for qualitative research
Authors: Ashrafi-rizi Hasan , Samouei Rahele , Soleymani Mohammad Reza , Yamani Nikoo
Published: September 2023

BACKGROUND:

The purpose of Ph.D. education is to train students equipped with science in a particular area and familiar with research methods and the most recent foundations of education and research to apply their knowledge, creativity, and innovation in research and scientific areas to meet the needs of the society, extending the frontiers of knowledge in their special field, and reach undetected areas in the world of science, especially health. One component of evaluating Ph.D. students in medical universities is the comprehensive exam that aims to assess Ph.D. students' skills, knowledge, and experiences in both educational and research areas. However, the process sometimes encounters substantial administrative challenges and problems.

MATERIALS AND METHODS:

In this study protocol, we will interview. Ph.D. students, members of the examining committees of comprehensive exams, and educational practitioners involved in the administration of the comprehensive exam in District 7 of Iran's medical universities (Isfahan, Kashan, Yazd, and Shaherekord)) as one of the 10 major districts of medical education in the country (Iran).

RESULTS:

Thus, the present study will identify the challenges of the comprehensive exam to find ways to eliminate them and offer suitable solutions to increase the effectiveness of the exam.

CONCLUSION:

Indeed, what is expected from this study is to help educational practitioners and policymakers in medical universities detect the strengths and weaknesses of administering the comprehensive exam and help educational practitioners and policymakers detect potential alternatives for the present comprehensive exam.
Information-seeking behavior of reproductive health based on socio-demographic among adolescents in Jakarta, Indonesia
Authors: Karima Ulya Q. , Pristya Terry Y.R. , Herbawani Chahya K.
Published: September 2023

BACKGROUND:

The main characteristic of today's adolescents in seeking information is through online media. The pattern of their information-seeking behavior is diversified based on socio-demographic factors. The objective of this study is to describe the information-seeking behavior of reproductive health based on socio-demographics among adolescents.

MATERIALS AND METHODS:

This online-based survey was conducted with a cross-sectional study in 2021 among 438 adolescents 18–24 years of age in Jakarta, Indonesia, by purposive sampling technique. Data were collected by distributing Google forms and analyzed using the Chi-square test.

RESULTS:

The main source of information media used by adolescents in their daily lives was online media (97.3%), with Instagram being the highest proportion (66.0%). Based on education, there were significant differences in preference topics on Human Immunodeficiency Virus-Acquired Immuno Deficiency Syndrome (HIV-AIDS) and other sexually transmitted diseases (P = 0.012), reproductive system and puberty (P = 0.045), source of information from Facebook (P = 0.034), and source of information from mother (P = 0.045). Based on parents' income, there was a significant difference in preference topics on child marriage, prevention of pregnancy, and abortion (P = 0.015).

CONCLUSION:

There is a need to improve reproductive health promotion by maximizing online media and certain figures along with promotion target mapping based on socio-demographic characteristics.
Investigating the level of respect for human dignity and its related factors in providing care for the elderly with COVID-19 in shahid Beheshti Hospital, Kashan, 2021
Authors: Hoseinian Masoumeh , Majidi Bidgoli Azam , Sadat Zohre , Mirbagher Ajorpaz Neda
Published: September 2023

BACKGROUND:

Patients' dignity includes the feelings of being valuable, maintaining their respect, and respecting their physical and spiritual privacy. Coronavirus disease of 2019 (COVID-19) is one of the life-threatening diseases that affect the dignity of the elderly. Therefore, the aim of this study was to investigate the level of respect for human dignity and its related factors in providing care for the elderly with COVID-19 in Shahid Beheshti Hospital in Kashan, 2021.

MATERIALS AND METHODS:

This cross-sectional study investigated 250 nurses caring for the elderly with COVID-19 and 300 elderly with COVID-19 in Shahid Beheshti Hospital of Kashan in 2021. A sampling of the elderly with COVID-19 was performed continuously based on the inclusion criteria and sampling of nurses by census method. The research tools included the questionnaire on background variables of nurses and the elderly, the questionnaire on respect for human dignity from the perspective of nurse and patient, and the job stress questionnaire. Then, the results were analyzed using Pearson's correlation coefficient tests, t-tests, and multiple regression in SPSS 21 software.

RESULTS:

Based on the results, the mean and standard deviation of patient dignity was 132.13 ± 71.52 and 129.14 ± 06.44 from the perspective of the nurses and the elderly, respectively. The results revealed that the level of respect for human dignity from the nurses' perspective was significantly related to gender and job stress (P < 0.05). Moreover, a significant relationship was found between the human dignity score from the elderly's perspective and the elderly's marital status and education (P < 0.05). According to the results of regression, the variables of nurses' gender and job stress explained about 8.7% of the variance of the patient's dignity observed by the nurses (Adjusted R-Square = 0.087). Finally, the variables of marriage and education of the elderly explained about 4% of the variance of their dignity observed by the nurses (Adjusted R-Square = 0.040).

CONCLUSION:

The results showed that with the increase of job stress in female nurses, their human dignity toward the patient decreases. Elderly people who are married and have a high school diploma have a better understanding of respect for human dignity. Since respect for human dignity is important from the point of view of nurses and the elderly, it is suggested to teach nurses how to respect patient dignity.
Role of demographic variables in investigating occupational stress of disaster and emergency medical management center
Authors: Yazdi Fateme , Chaboksavar Fakhreddin , Malekzadeh Roya , Ziapour Arash , Yoosefi Lebni Javad , Janjani Parisa , Hamidipour Nasim , Fard Azar Amir Ali Ebadi , Darabi Fatemeh , Garosi Vahid Hatami , Kianipour Neda
Published: September 2023

BACKGROUND:

Emergency medical services face stressful environments such as departments dealing with injuries and sick patients that pose challenging situations for the healthcare staff. This present study investigates the role of demographic variables in investigating occupational stress of disaster and emergency medical management center in 2021.

MATERIALS AND METHODS:

This present descriptive study selected a sample size of 200 medical personnel associated with disaster and emergency medical management center in Iran, according to the inclusion chosen criteria. The study used a tool consisting of two parts, including demographic information and a job stress Health and Safety Executive (HSE) standard questionnaire. The study selected respondents through Cochran's sample size formula using stratified random sampling with a cross-sectional research design for data collection. This present study has analyzed received data using performed the descriptive and inferential information (t-test and one-way ANOVA) at a significance level P < 0.05. The participants of the survey were males only.

RESULTS:

The study results specified that the mean age of respondents was 30.14 ± 5.96. The study results exhibited that the mean score of total occupational stress was 3.41 ± 0.26. The results showed the highest (4.34 ± 0.35) and the lowest (2.72 ± 0.86) stress levels were related to role dimensions.

CONCLUSIONS:

The study findings revealed a significant relationship between stress level and participants' age, marital status, educational level, type of base, workplace, and the number of work hours per month. Emergency medical personnel experience a high level of occupational stress. Senior managers can use similar studies to implement measures to reduce the experience of employees' stress.
Development and implementation of an intraoperative documentation protocol for enhancing patient safety in the operating room: A mixed methods protocol study
Authors: Akbari Leila , Bahrami Masoud , Aarabi Akram
Published: September 2023

BACKGROUND:

Documentation is an important part of the patient care process; however, there is no regular program for documenting intraoperative care in Iran. This study was conducted to design an intraoperative documentation for enhancing patient safety in the operating room (OR).

MATERIALS AND METHODS:

This exploratory, mixed-methods, qualitative-quantitative study (in 2021) consists of four phases. The first phase involves a conventional content analysis of healthcare providers in the OR to identify the needs, strategies, and content of a pertinent documentation. In this phase, purposeful sampling will be used to collect data through semi-structured interviews. In the second phase, a literature review will be carried out to extract the documentation procedures in the intraoperative period in many other countries. In the third phase, a panel of experts is recruited and the classic Delphi (RAND) technique is run to validate the initial draft of the designed program and, the protocol is then finalized. In the last phase, the designed protocol will be implemented through a quasi-experimental study in one group (before and after intervention), and the effectiveness of the intervention will be evaluated.

DISCUSSION:

To design a protocol for intraoperative documentation, healthcare providers' experiences during surgery in the Iranian healthcare setting, where the lack of documentation might forensically harm both the healthcare providers and the patients, will be explored. This information alongside some universal standards developed in other countries should help improve patients' safety in ORs.