bluuebunny/crossref_metadata_2025 huggingface dataset:
Chronic Kidney Disease and COVID-19 Infection
Authors: Moeinzadeh Firouzeh , Mortazavi Mojgan , Shahidi Shahrzad , Mansourian Marjan , Yazdani Akram , Zamani Zahra , Seirafian Shiva
Published: December 2022

Background:

To organize efforts to manage the coronavirus disease 2019 (COVID-19), it is necessary to understand which groups are at higher risk of infection. Kidney disease seems to be substantial in COVID-19 patients, but there are limited data on COVID-19 incidence and fatality among chronic kidney disease (CKD) patients. In this study, we intend to examine the association between CKD and susceptibility to COVID-19 infection.

Materials and Methods:

Participants were selected from those recruited in a population-based cross-sectional survey of CKD prevalence and associated risk factors in Iranian people 18 years and older. A three-part questionnaire was used for COVID-19 infection clinical symptoms and epidemiologic and hospitalization data.

Results:

A total of 962 individuals including 403 CKD patients and 559 healthy controls were recruited in this study. Healthy controls were suffering more from common cold signs, cough, fever, sore throat, headache, anosmia, dyspnea, and abdominal pain (all P < 0.05). Furthermore, the number of healthy individuals with myalgia was marginally higher compared to the CKD patients (P = 0.057). Data regarding the number of CKD patients with/without COVID-19 infection throughout different CKD stages revealed that there was no significant difference between the two groups in terms of COVID-19 infection in different stages of CKD (P = 0.956).

Conclusion:

We found that some of the clinical presentations of COVID-19 including common cold symptoms, cough, fever, sore throat, headache, anosmia, dyspnea, and abdominal pain were higher among healthy individuals compared to the CKD group. On the other hand, the susceptibility to COVID-19 infection was not significantly different in various early stages of CKD.
Predictors of Mortality for Patients with ST-Elevation Myocardial Infraction after 2-Year Follow-Up
Authors: Jamalian Marjan , Roohafza Hamidreza , Soleimani Azam , Massoumi Gholamreza , Mirmohammadsadeghi Amirhossein , Dorostkar Neda , Yazdekhasti Safoura , Azarm Maedeh , Sadeghi Masoumeh
Published: December 2022

Background:

Mortality of ST-elevation myocardial infarction (STEMI) patients is increasing in world. This study defines predictors of mortality in patients who have STEMI.

Materials and Methods:

This study was a part of the ST-elevated myocardial infarction cohort study in Isfahan conducted on 876 acute myocardial infarction (MI) followed for 2 years that 781 patient entered. The effect of predictors of mortality includes demographic, physiological, and clinical characterizes compared in two groups alive and died patients. MACE was defined as nonfatal MI, nonfatal stroke, and atherosclerosis cardiovascular disease-related death was recorded. Univariate and multiple logistic regression analyses were performed. All analyses performed using SPSS 20.0. P < 0.05 considered statistically significant.

Results:

A total 781 patients, 117 (13%) that 72 (8.5%) was in-hospital died. The mean (standard deviation) age of the patients was 60.92 (12.77) years and 705 (81.3%) patients were males. Significant factors that affected mortality on analysis of demographic and physiological parameters were age (P < 0.001), sex (P = 0.004), transfusion (P = 0.010), STEMI type (P < 0.001), number epicardial territories >50% (P = 0.001), ventilation options (P < 0.001), smoker (P = 0.003), and diabetes (P = 0.026). Significant clinical factors affected mortality were ejection fraction (EF) (P < 0.001), creatinine (P < 0.001), hemoglobin (P < 0.001), low-density lipoprotein-cholesterol (LDL-C) (P = 0.019), and systolic blood pressure (P < 0.001). Multiple logistics regression model definition significant predictors for mortality were age (P < 0.001), heart rate (HR) (P = 0.007), EF (0.039), LDL-C (P = 0.002), and preangia (P = 0.022).

Conclusion:

The set of factors can increase or decrease mortality in these patients. Significant predictors of mortality STEMI patients by 2-year follow up were age, HR, EF, LDL-C, and preangia. It seems that more articles need to be done in different parts of Iran to confirm the results.
Expression Optimizing of Recombinant Oxalyl-CoA Decarboxylase in Escherichia coli
Authors: Kahaki Fatemeh Abarghooi , Dehnavi Seyed Mohsen
Published: December 2022

Background:

One of the most common diseases of the urinary tract is stones of this system, including kidney stones. About 70%–80% of kidney stones are calcium oxalate. Oxalyl-CoA decarboxylase is a single polypeptide included of 568 amino acids which play a key role in oxalate degradation.

Materials and Methods:

The aim of current study is high-level expression of oxalyl-CoA decarboxylase in Escherichia coli BL21 (DE3). To achieve this aim, oxalyl-CoA decarboxylase gene was cloned upon pET-30a (+) with T7 promoter. The vector containing the oxalyl-CoA decarboxylase gene was transformed into E. coli and the expression of the gene was examined on a laboratory scale and fermentor. Atfirst, the effect of temperature, culture medium, and induction time on oxalyl-CoA decarboxylase expression at three levels was examined.

Results:

The obtained data showed that the highest expression was related to the terrific broth culture medium and temperature of 32°C with an inducer concentration of 1 mM. Under this situation the ultimate cells dry weight and the final oxalyl-CoA decarboxylase expression were 2.46 g/l and 36% of total protein, respectively. Then induction time was optimized in a bench bioreactor and productivity of oxalyl-CoA decarboxylase was calculated. Under optimized condition the cell density, biomass productivity and oxalyl-CoA decarboxylase concentration reached 4.02 g/l, 0.22 g/l/h, and 0.7 g/l which are one of the highest reported rates.

Conclusion:

This study demonstrated that high levels of oxalyl-CoA decarboxylase can be achieved by optimizing the expression conditions.
Assessment of Endothelial Function in Iranian Healthy Obese Patients after Bariatric Surgery
Authors: Melali Hamid , Behjati-Najafabadi Hamid , Tabesh Faezeh , Sayadishahraki Masoud , Hasehmi-Jazi Seyed Mohamad
Published: December 2022

Background:

Endothelial function plays a critical role in cardiovascular homeostasis. Morbid obesity is associated with an enhanced risk of atherosclerosis and chronic inflammation. Bariatric surgery (BS) is a promising method used recently for weight loss; however, the number of studies that have examined the effect of BS on endothelial function is limited. This study aimed to investigate the association between endothelial function evaluated by flow-mediated dilation (FMD) and weight loss after BS.

Materials and Methods:

This is a cross-sectional study conducted in Isfahan, Iran, and included 40 healthy obese individuals who underwent BS as an intervention group and 40 healthy obese patients who did not undergo BS as a control group in a 6-month follow-up duration period. FMD as an indicator of endothelial function was evaluated in these participants. FMD <7.1% is considered abnormal.

Results:

There was no significant difference between control and BS groups in terms of age and body mass index (BMI) at baseline. The mean ± standard deviation (SD) of FMD in the BS group pre- and post-intervention were 12.95 ± 6.90 and 37.65 ± 13.52 respectively and the mean ± SD of FMD in the control group were 15.88 ± 6.85 and 15.85 ± 5.83. The association between significant weight loss after BS and FMD was strongly significant (P < 0.001).

Conclusions:

According to the results of this study, it can be concluded that BS has been effective in terms of improving the FMD as an indicator of endothelial function.
Acute Onset of Guillain-Barré Syndrome after Multiple Spine Surgeries
Authors: Komlakh Khalil , Manafi-Rasi Alireza , Mirbolook Ahmadreza , Baroutkoub Mojtaba , Salimi Sohrab , Athari MirBahador
Published: December 2022

Guillain-Barré syndrome is an autoimmune disorder presented by ascending paralysis and areflexia. The condition has been reported after many infections, but Guillain-Barré syndrome after spine surgery is rare. We, herein, present a case of Guillain-Barré syndrome after multiple spine surgeries for degenerative lumbar scoliosis. A 60-year-old woman with degenerative scoliosis underwent surgery for the third time and developed Guillain-Barré syndrome 3 weeks after the final operation. The patient received intravenous immune globulin therapy and needed mechanical ventilation and intensive care. She was discharged in good condition after 5 weeks.
Therapeutic Effect of Kidney Tubular Cells-Derived Conditioned Medium on the Expression of MicroRNA-377, MicroRNA-29a, Aquapurin-1, Biochemical, and Histopathological Parameters Following Diabetic Nephropathy Injury in Rats
Authors: Mansouri Esrafil , Orazizadeh Mahmoud , Mard Seyyed Ali , Gorji Armita Valizadeh , Rashno Mohammad , Fakhredini Fereshtesadat
Published: December 2022

Background:

Diabetic nephropathy (DN) is a critical complication of diabetes mellitus. This study evaluates whether administration of conditioned medium from kidney tubular cells (KTCs-CM) has the ability to be efficacious as an alternative to cell-based therapy for DN.

Materials and Methods:

CM of rabbit kidney tubular cells (RK13; KTCs) has been collected and after centrifugation, filtered with 0.2 filters. Four groups of rats have been utilized, including control, DN, DN treated with CM, and sham group. After diabetes induction by streptozotocin (50 mg/kg body weight) in rats, 0.8 ml of the CM was injected to each rat three times per day for 3 consecutive days. Then, 24-h urine protein, blood urea nitrogen (BUN), and serum creatinine (Scr) have been measured through detection kits. The histopathological effects of CM on kidneys were evaluated by periodic acid–Schiff staining and the expression of microRNAs (miRNAs) 29a and 377 by using the real-time polymerase chain reaction. The expression of aquapurin-1 (AQP1) protein was also examined by Western blotting.

Results:

Intravenous injections of KTCs-CM significantly reduced the urine volume, protein 24-h, BUN, and Scr, decreased the miRNA-377, and increased miRNA-29a and AQP1 in DN treated with CM rats.

Conclusion:

KTCs-CM may have the potential to prevent kidney injury from diabetes by regulating the microRNAs related to DN and improving the expression of AQP1.
Cutaneous Leishmaniasis Based on Climate Regions in Iran (1998-2021)
Authors: Rejali Mehri , Dashtaki Nadia Mohammadi , Ebrahimi Afshin , Heidari Asieh , Maracy Mohammad Reza
Published: December 2022

Background:

Climate change can facilitate the expansion of leishmaniasis and create the suitable habitat for vector and reservoir species. The objective of this study was to estimate the prevalence of cutaneous leishmaniasis (CL) at the climatic regions of Iran.

Materials and Methods:

The literature search was conducted to identify all published studies reporting the prevalence or incidence of CL in humans in Iran. A total of 350 articles that reported leishmaniasis in Iran were retrieved, due to eligibility criteria, only 42 studies were selected to the final systematic review and meta-analysis procedure. Random effects meta-analysis was done with the estimate of heterogeneity being taken from an inverse-variance model. Subgroup analysis was conducted and it stratified the studies according to climatic regions. Between-study heterogeneity was assessed by using I
2 and Cochran's Q method I
2 value of heterogeneity. Meta regression was used to investigate factors potentially contributed the between-study heterogeneity.

Results:

Individual studies showed that prevalence per 100,000 population estimated the range from 1.5 to 318.7 with the overall random pooled prevalence of 83.3 (95% confidence interval 74.5–92.1). Subgroup analysis by climatic regions showed that many studies were conducted in the desert areas and also, it has more prevalent than the other climatic regions.

Conclusions:

Leishmaniasis was more prevalent in regions with dry and desert climates than the other climatic regions. One of the advantages of this work is that the majority of selected studies have been conducted on population-base. However, some of the studies have been designed poorly or have had a lack of internal validity.
Laparoscopic Surgery for Atypical Endometrial Hyperplasia with Awareness Regarding the Possibility of Endometrial Cancer
Authors: Kamii Misato , Nagayoshi Yoko , Ueda Kazu , Saito Motoaki , Takano Hirokuni , Okamoto Aikou
Published: December 2022

Objectives:

Although atypical endometrial hyperplasia (AEH) is considered a precancerous disease, the frequency with which AEH and endometrial cancer (EC) coexist is not low. Broadly, total laparoscopic hysterectomy (TLH) is performed for treating AEH; however, it is unclear what perioperative precautions need to be taken. This study aimed to clarify the points to be considered when performing TLH for AEH.

Materials and Methods:

We retrospectively identified 57 patients who underwent TLH for AEH in our hospitals. We extracted data on clinical characteristics, preoperative examinations (endometrial sampling and diagnostic imaging), surgical procedures, and final pathological diagnoses. Then, we statistically analyzed the difference in clinicopathological features and preoperative examinations between patients postoperatively diagnosed with EC and those diagnosed with AEH.

Results:

Twenty patients (35%) who underwent TLH for AEH were diagnosed with EC postoperatively (16 [28%] with stage IA EC and four [7.0%] with stage IB EC). We found no significant differences in clinical characteristics and preoperative evaluations between patients postoperatively diagnosed with EC and those diagnosed with AEH. The group with stage IB EC had a significantly higher median age and a significantly higher proportion of postmenopausal patients and patients with adenomyosis.

Conclusion:

It is important to recognize the risk of coexisting EC when performing TLH for AEH. High-precision endometrial sampling and contrast-enhanced magnetic resonance imaging are recommended for diagnosing AEH. In addition, surgical procedures for AEH are required to prevent cancer spillage in consideration of its coexistence, such as tubal sealing before manipulator insertion or avoiding using manipulator.
An integrated multidisciplinary model of care for addressing comorbidities beyond reproductive health among women with polycystic ovary syndrome in India
Authors: Patil Anushree Devashish , Vaidya Rama Ashok , Begum Shahina , Chauhan Sanjay L. , Mukherjee Srabani , Kokate Pratibha P. , Joshi Beena Nitin
Published: December 2022

Background & objectives:

Polycystic Ovary Syndrome (PCOS) is becoming an area of global and national health concern. It requires a life cycle approach from adolescence to menopause. To comprehensively address the wide spectrum of this disorder, a multidisciplinary model of care was established for women with PCOS in a government setting in India with an objective to screen and manage multifaceted manifestations of PCOS and to diagnose and treat associated comorbidities such as metabolic syndrome, dermatologic manifestations and psychological issues.

Methods:

A model of integrated multidisciplinary PCOS clinic was implemented for services and research at ICMR-National Institute for Research in Reproductive and Child Health (NIRRCH), Mumbai Maharashtra, India. This is a one-stop holistic centre for managing menstrual, cosmetic, infertility, obesity, metabolic and psychological concerns of women affected with PCOS. Two hundred and twenty six women diagnosed with PCOS using the Rotterdam criteria were screened for metabolic comorbidities with anthropometry, ultrasonography, hormonal and biochemical tests and for psychological problems. Analysis was performed using SPSS version 19.0.

Results:

Mean body mass index (BMI) was 26.1 kg/m2, higher for Asians. Hirsutism was observed in 53.6 per cent of women. Metabolic syndrome was seen among 35.3 per cent and non-alcoholic fatty liver in 18.3 per cent. Psychological issues such as anxiety and depression were identified in majority of the women 31.4 per cent of women could achieve pregnancy at the end of one year of multidisciplinary management.

Interpretation & conclusions:

The results of the present study suggest that an integrated multidisciplinary approach led to the early identification and treatment of comorbidities of PCOS, especially metabolic syndrome. There is hence an urgent need to implement multidisciplinary PCOS clinics in government health facilities.
Cost of delivering primary healthcare services through public sector in India
Authors: Chauhan Akashdeep Singh , Prinja Shankar , Selvaraj Sakthivel , Gupta Aditi , Muraleedharan V.R. , Sundararaman Thiagarajan
Published: December 2022

Background & objectives:

Public health spending on primary healthcare has increased by four times (in real terms) over the last decade and continues to constitute more than half of the total public health expenditure. The present study estimated the cost of providing healthcare services at sub centre (SC) and primary health centre (PHC) level in four selected States of India.

Methods:

A total of 51 SCs and 33 PHCs were selected across the four States (Himachal Pradesh, Odisha, Kerala and Tamil Nadu) of India. The economic cost of delivering health services at these facilities was assessed using bottom-up costing methodology during the reference year of 2014-2015. The cost of capital items was annualized and allocation of shared resources was based on appropriate apportioning statistics.

Results:

The mean annual cost of providing health services at SC and PHC was

JOURNAL/ijmer/04.03/02223309-202209000-00003/372FF01/v/2023-02-02T183910Z/r/image-tiff

0.69 million (US$ 11,392) and

JOURNAL/ijmer/04.03/02223309-202209000-00003/372FF01/v/2023-02-02T183910Z/r/image-tiff

5.1 million (US$ 83,837), respectively. Nearly 3/4th and 2/3rd of this cost at the level of SC (74%) and PHC (63%) were spent on salaries. In terms of unit cost, the costs per antenatal care and postnatal care visit were

JOURNAL/ijmer/04.03/02223309-202209000-00003/372FF01/v/2023-02-02T183910Z/r/image-tiff

221 (173-276) and

JOURNAL/ijmer/04.03/02223309-202209000-00003/372FF01/v/2023-02-02T183910Z/r/image-tiff

333 (244-461), respectively, at SCs. Similarly, the costs of per patient outpatient consultation and per bed day hospitalization at PHC level were

JOURNAL/ijmer/04.03/02223309-202209000-00003/372FF01/v/2023-02-02T183910Z/r/image-tiff

121 (91-155) and

JOURNAL/ijmer/04.03/02223309-202209000-00003/372FF01/v/2023-02-02T183910Z/r/image-tiff

1168 (955-1468), respectively.

Interpretation & conclusions:

The cost estimates from the present study can be used in economic evaluations, assessing technical efficiency and also for providing valuable information during scale-up of health facilities.
Scrub typhus in urban areas of Wardha district in central India
Authors: Narang Rahul , Deshmukh Pradeep , Jain Jyoti , Jain Manish , Raut Abhishek , Deotale Vijayshri , Pote Kiran , Rahi Manju
Published: December 2022

Background & objectives:

Scrub typhus caused by Orientia tsutsugamushi presents as acute undifferentiated fever and can be confused with other infectious causes of fever. We studied scrub typhus as part of a study on hospital-based surveillance of zoonotic and vector-borne zoonotic diseases at a tertiary care hospital located in the Wardha district, Maharashtra, India. We report here descriptive epidemiology and climatic factors affecting scrub typhus.

Methods:

Patients of any age and sex with fever of ≥5 days were enrolled for this study. Data on sociodemographic variables were collected by personal interviews. Blood samples were tested by IgM ELISA to diagnose scrub typhus. Confirmation of scrub typhus was done by indirect immunofluorescence assay for IgM (IgM IFA). The climatic determinants were determined using time-series Poisson regression analysis.

Results:

It was found that 15.9 per cent of the study participants were positive for scrub typhus by IgM ELISA and IgM IFA, both. Positivity was maximum (23.0%) in 41-60 yr of age and more females were affected than males (16.6 vs. 15.5%). Farmworkers were affected more (23.6%) than non-farm workers (12.9%). The disease positivity was found to be high in monsoon and post-monsoon seasons (22.9 and 19.4%) than in summer and winter.

Interpretation & conclusions:

There were three hot spots of scrub typhus in urban areas of Wardha district. Rainfall and relative humidity in the previous month were the significant determinants of the disease.
Causes of Revision after Total Hip Arthroplasty in Patients Undergoing Revision Total Hip Arthroplasty Younger than 50 Years of Age
Authors: Mathur Hemant , Zala Kashyap Laxmanbhai , Chokshi Jimmy Jyotinbhai
Published: December 2022

Background and Aims:

Young patients undergoing revision total hip arthroplasty (THA) have different indications and causes of failure of THA. This retrospective cohort study examines the causes of failure of THA in a patient younger than 50 years.

Subjects and Methods:

Clinical and demographic data of 146 revision THA (130 patients) were gathered from case records of patients who underwent revision THA at our institute between January 1, 2018, and December 31, 2021. Fifty-two hips (46 patients) were younger than 50 years at the time of revision. Baseline characteristics, cause for revision, implants revised, and duration of survival were noted.

Statistical Analysis:

Chi-squared test was implemented to find a correlation, and P < 0.05 was considered statistically significant.

Results:

We had 52 hips, 46 patients (28 females), and the mean age at primary THA was 33.9 years, the mean age at revision THA was 44.5 years, and the mean survival of implants was 10.6 years. The most common diagnosis for primary THA was avascular necrosis of the femoral head (21 hips, 40.38%), followed by inflammatory arthritis. The most common cause of failure was aseptic loosening (27 hips, 51.92%). As compared to the overall population undergoing revision THA (60/146 hips, 41.09%), patients younger than 50 years having more frequency of aseptic loosening as a cause of failure of THA and less frequency of periprosthetic joint infection, instability, and fracture; but statistically significant difference was not found (P = 0.38). No correlation was found between the type of implants used (P = 0.84) and diagnosis at index THA (P = 0.78), with the cause of failure of THA.

Conclusions:

Aseptic loosening of THA is the most common mode of failure in patients younger than 50 years.
Orthogonal Dual Plating
Authors: Nathi Anil Kumar , Shinde Gopal M. , Sista Baladitya Sarma , Pathri Sivananda , Paka Varun Kumar , Shaik Jameer , Nakka Pramoda , Pathri Chandana
Published: December 2022

Background:

Distal humerus fractures are difficult to manage and perfect intra-articular reduction is a prerequisite for a successful outcome. Dual plating is the norm, and this may be in the form of orthogonal or parallel plating. Controversy regarding the choice between these modes of plating is a topic of debate.

Aims and Objectives:

To show that perpendicular or orthogonal plating is an adequate mode of treatment option to handle all patterns of distal humerus fractures compared to later-introduced parallel plating.

Patients and Methods:

We, here, report a case series of 30 cases of AO type C distal humerus fractures, in patients aged between 20 and 60 years, managed by orthogonal plating. All patients were operated between 2015 and 2019 by a single surgeon at our institute.

Results:

A total of 22 (73.33%) patients showed good or excellent results. Six (20%) patients had fair results. Two (6.66%) patients had poor results. About 86% of the total patients were satisfied with their outcomes.

Conclusion:

Orthogonal plating offers a satisfactory outcome in AO type C distal humerus fracture with reasonable functional output through early mobilization due to the inherent stability offered by the construct.
Joshi's External Stabilization System and K-wire Fixation in the Management of Hand Fractures – A Prospective Comparative Study
Authors: Singh Vivek , Ahmad Sabeel , Singh Gobinder , Singh Sukhmin , Gupta Kshitij , Kalia R. B.
Published: December 2022

Background:

Hand fractures can be treated conservatively or surgically, depending on the severity, location, and type of fracture, as in conservative management chance of nonunion, malunion, and stiffness is more if it is displaced or angulated fracture. Various modes of treatment have been used which include K-wire fixation, mini plates, and external fixator application. A modified form of mini-external fixator devised in India is Joshi's External Stabilization System (JESS).

Aim:

This prospective study was conducted to compare the functional and radiological outcomes following metacarpal/phalangeal fracture fixed with either K-wire or JESS.

Materials and Methods:

Forty patients with hand fractures (58 fractures – 18 metacarpal and 40 phalanges) were prospectively studied. Twenty patients underwent K-wire fixation and 20 were fixed with JESS, functional and radiological outcomes were assessed, grip strength using dynamometer, visual analog scale (VAS) score, disabilities of the arm, shoulder, and hand (DASH) score, range of motion (ROM) using the American Society for Surgery of the hand scale, tip pinch strength. Student's t-test, Wilcoxon test, Fisher's exact test, and Chi-squared test were used.

Results:

At 6 months' follow-up, patients fixed with either of the fixation modality showed statistically significant improvement in different outcome variables such as ROM (P < 0.001), quick DASH score (P < 0.001), VAS score (P < 0.001), tip pinch strength (P < 0.001), and hand grip (P < 0.001). All the fractures united at an average 6 weeks. Functional outcomes were excellent in closed fracture fixed with either JESS or K-wire and good to moderate in open injuries. However, overall comparison between K-wire and JESS, no significant difference in these outcome measures was found.

Conclusions:

K-wires as well as JESS both provide adequate stability and satisfactory results in fractures of the metacarpal and phalanges. This study could not find the superiority of JESS over traditional K-wire fixation.
Evaluation of the Effect of Platelet-Rich Plasma in Early Osteoarthritis Knee Using the Oxford Knee Score
Authors: Nitish K. , Kubsad Sandeep , Sharath J. S. , Gadagoli Bharath Shekharappa , Manjunath S. , Suresha B. , Pai Harish S.
Published: December 2022

Introduction:

Osteoarthritis (OA) is classically described as a noninflammatory, degenerative joint disease most commonly occurring in the elderly population. It is characterized by the deterioration of articular cartilage and by the formation of new bone at joint surfaces and margins. Our study aims at evaluating the efficacy of intra-articular platelet-rich plasma (PRP) injections in Grade I and II OA knees.

Materials and Methods:

A total of 46 patients with Grade I and II (Kellgren and Lawrence grading) primary OA knee were enrolled for a prospective study. Prior consent was taken for intra-articular injection of PRP from all patients. The study group was evaluated using the Oxford Knee Score (OKS) at 3 months and 6 months.

Results:

In our study, we found decreasing pain and improvement in activities of daily living with an increase in OKS at 3 and 6 months, follow-up indicating long-term pain relief, improvement in function, and decreased stiffness.

Conclusion:

Our study shows that intra-articular injection of PRP is safe and effective in treating Grade I and Grade II OA knee. We also observed improvement in daily living activities and a reduction in pain in patients with OA of the knee treated with two doses of PRP. PRP therapy is an easy, affordable, and minimally invasive treatment, which is practical to administer for treating degenerative OA of the knee with minimal associated adverse events.
Clinical Effect of Morphological Changes in Bone Tunnels after Anterior Cruciate Ligament Reconstruction
Authors: Subhash Abhijeet , Kashyap Nishant , Kumar Indrajeet , Runu Ritesh
Published: December 2022

Background:

The effect of tunnel widening on clinical outcomes after anterior cruciate ligament (ACL) reconstruction has not been widely investigated. In this study, ACL reconstructions (ACL-Rs) were done by semitendinosus and gracilis tendon grafts and suspensory fixation on the femoral side. The aim was to study tunnel widening at the end of 1 year postoperative and correlate it with clinical outcomes.

Materials and Methods:

Fifty-five consecutive patients enrolled in the study underwent arthroscopic ACL-R. All were evaluated clinically using the Lysholm knee score and Tegner activity level preoperatively as well as during subsequent follow-up. Femoral and tibial tunnels were visualized with computed tomography scan which was performed at a mean duration of 1 year (range: 10–14 months).

Results:

The mean femoral tunnel diameter increased significantly (17.1%) from 8.03 ± 0.05 mm postoperatively to 9.04 ± 0.6 mm at 1 year; the tibial tunnel increased significantly (22.55%) from 9.04 ± 0.04 mm to 11.09 ± 0.8 mm at the same duration. No significant correlation could be established between tunnel widening and clinical evaluation scores. In both clinical evaluation scales, the overall improvement was noticed.

Conclusions:

Within a limit, neither femoral nor tibial tunnel widening affects the clinical outcome at 1 year of follow-up.
Functional Outcome of Intramedullary Interlocking Nailing Versus Minimally Invasive Percutaneous Plate Osteosynthesis in Distal Tibia Fracture
Authors: Jose R. Sahaya , Vivek K. , Bava N. Kattu , Moosa M. Syed
Published: December 2022

Aims:

The aim of the study was to compare the functional outcome of patients with extra-articular distal one-third tibia fracture, treated with intramedullary interlocking nailing (IMILN) with those treated by minimally invasive percutaneous plate osteosynthesis (MIPPO).

Settings and Design:

This is a prospective study and nonprobability sampling technique.

Subjects and Methods:

In this study, 60 patients with distal third tibia fractures of AO classification Type 43 A1, A2, and A3 were selected, in which 30 of them were treated with IMILN and the remaining 30 were managed with MIPPO. The patients were regularly followed up, and functional outcome was measured at 4, 8, 12, and 24 weeks using a modified Klemm and Borner scoring system.

Statistical Analysis Used:

The data collected were subjected to data entry in MS Excel. The data were analyzed using SPSS version 20.0 using Chi-square test.

Results:

In our prospective study, the functional outcome of MIPPO has shown excellent outcome in 13 patients (43.3%) and good outcome in 13 patients (43.3%), fair outcome in three patients (10%), and only one patient had poor outcome (3.3%). However, in the IMILN group, excellent outcome was seen in 7 patients (23.3%) and good outcome in 15 patients (50%), fair in five patients (16.7%), and poor outcome in 3 patients (10%). Alignment of fracture was anatomical in 13 patients of MIPPO and 7 patients of IMILN. Complications such as nonunion and malunion were more in the IMILN group than MIPPO, whereas superficial wound infection and delayed union were comparable in both.

Conclusions:

Distal tibial fractures can be effectively treated by both intramedullary nailing and MIPPO with minimal soft tissue injury providing good-to-excellent results, whereas in our present study, we observed that MIPPO had excellent functional outcome when compared to IMILN. Although interlocking intramedullary nailing allows early weight-bearing in patients, malunion and nonunion were more frequently seen, which affects the functional outcome. Therefore, we recommend that MIPPO is considered a very effective modality of treatment in distal third tibia fractures.
Modified Tension Band Wiring of Transverse Patella Fractures Through Cannulated Cancellous Screws
Authors: Gumaste Abhishek , Baindoor Prasanna , Jeevannavar Santosh , Shenoy Keshav , Gurudev Ranjan
Published: December 2022

Introduction:

The management of transverse patella fractures with modified tension band wiring using Kirschner wires, though routinely used is associated with complications such as implant loosening, wire migration, and infection. We hypothesized that using cannulated cancellous screws with tension band wiring through the screws will overcome these complications.

Objective:

The objective was to assess the functional and radiological outcomes following patellar fracture fixation with modified tension band wiring through cannulated cancellous screws.

Materials and Methods:

Twenty-four patients with transverse patella fractures fixed with modified tension band wiring through cannulated cancellous screws were included in this retrospective study. Surgical technique involved a vertical incision over the knee, reduction of the fracture initial fixation with Kirschner wires, replaced with cannulated cancellous screws. A stainless steel wire was passed through the lumen of the screws, and tension band was applied. Follow-up at 3, 6, and 12 months was done to assess the radiological union. Functional outcome was assessed with the Bostman scoring.

Results:

The study included 13 male and 11 female patients with an average age of 39.6 years, with 8 three-part and 16 two-part fractures. The average follow-up was 14 months, and the average time to union was 8.5 weeks. Twelve patients had an excellent, 11 patients a good, and one patient an unsatisfactory functional outcome as per the Bostman score. No infection or implant loosening was observed.

Conclusion:

The technique of patella fracture fixation with modified tension band through cannulated cancellous screws offers an enhanced stability, minimizing the complications such as implant migration, prominent implant, and refracture. As such, we recommend this technique in all transverse patella fractures.
Open Anatomical Dual Tunnel Reconstruction of Acromiao-Clavicular Joint Using Autogenous Semitendinosus Graft
Authors: Sathwik Matta Sai Venkata , Nathi Anil Kumar , Pathri Sivananda , Sista Baladitya Sarma , Paka Varun Kumar , Shaik Jameer , Pathri Chandana
Published: December 2022

Background:

The primary constraint to the dislocation of an acromioclavicular (AC) joint is its ligaments. They prevent vertical and horizontal translations in the joint. Reconstruction of these ligaments is of prime importance for restoring the AC joint. There is uncertainty regarding the surgical treatment protocol for Rockwood's type III injury.

Patients and Methods:

We report a prospective cohort study on 20 patients aged between 15 and 45 years, presenting with Rockwood type III or higher rank of AC joint dislocation for open double-tunnel anatomical reconstruction of AC joint using autogenous semitendinosus graft. Patients were evaluated at the end of follow-up of 2 years using the Constant–Murley outcome scoring system.

Results:

Clinical and radiological evaluation performed revealed excellent results in 15, good in three, and fair in two, with no poor results recorded.

Conclusion:

Open double-tunnel reconstruction with semitendinosus graft is a vital technique for Rockwood type III or higher grade of AC joint dislocation management to deliver a pain-free shoulder with good strength, well-retained range of movements, and near normal regain of activities.
A Study of Morbidity and Mortality of Surgically Managed Hip Fractures in Elderly Patients in the 1st Year
Authors: Channappa T. S. , Jayaram Manju , Shivakumar H. B. , Karan C. L.
Published: December 2022

Background:

Fractures of hip are one of the most common injuries sustained by the elderly. They occur predominantly in patients aged over 60 years. For many, this fracture is often a terminal event resulting in death due to comorbidities and cardiac, pulmonary, or renal complications. The incidence of morbidity and mortality after hip fractures was evaluated in this study.

Methodology:

We included 102 patients who were divided into two groups; 54 patients with fracture neck treated by hemiarthroplasty as arthroplasty group, and 48 with intertrochanteric fracture treated by internal fixation with proximal femoral nail or with dynamic hip screw as internal fixation (IF) group were followed up for 1 year. The preexisting medical comorbidities, intraoperative findings, and postoperative complications were documented. The final functional results were evaluated using Merle d'Aubigne score at the end of 1 year.

Results:

This is a descriptive cohort study from the local population. The mean age was 74.5 years. We noted a total mortality of 17.6%. Diabetes mellitus and anemia were the most common comorbidities. Binary logistic regression analysis was performed to predict the survival status among the study patients. We found that male patients with anemia to be most associated with mortality. Excellent results were noted in 39% of cases of arthroplasty and 60% of cases of IF. Morbidity experienced was greater in extracapsular fracture type, who were less mobile during the postoperative period.

Conclusion:

Hip fractures are on a rising trend in the elderly population, especially in the Indian subcontinent. Mortality and morbidity in elderly patients in the 1st year are significant. Age and preexisting comorbidities contribute to morbidity. Morbidity leads to loss of independence and requirement of social support. The goal of treatment in fractures of the hip must be the restoration of the patient to their preinjury status at the earliest possible time.
Immediate Effect of Pranava Pranayama on Oxygen Saturation and Heart Rate in Healthy Volunteers: A Single-Blinded, Randomized Controlled Trial
Authors: Ramanathan Meena , Bhavanani Ananda Balayogi
Published: December 2022

Introduction:

Yoga is known to promote health and wellness in all. Pranava Pranayama is a useful sound based yogic breathing technique with reported benefits such as potentiating vagal tone.

Subjects and Methods:

This single blinded randomized self-controlled cross-over study was done with 58 participants. The immediate effect of Pranava Pranayama on saturation of oxygen in the blood (SpO2) and heart rate (HR) was determined before and after intervention using pulse oximeter. To avoid extraneous influences due to recording on different days, one half of the subjects were randomized to perform quiet sitting on day 1 while other half did Pranava Pranayama which was then reversed on day 2.

Results:

Intra group comparison showed significant changes (p < 0.001) in both SpO2 and HR following Pranava Pranayama whereas in the quiet sitting group, there was an insignificant fall in the SpO2 readings but HR was found significant (p < 0.001). Intergroup comparison showed significant differences between groups (p-0.032).

Discussion:

Cardiovascular changes following Pranava Pranayama may be as a result of audible chanting improving baroreflex sensitivity along with increased endogenous nitric oxide production. This promotes vasodilatation resulting in reduction of BP. The decrease in vascular resistance and an increase in capillary perfusion results in increased oxygen saturation with lesser demand on the heart.

Conclusion:

This study provides evidence that Pranava Pranayama is an effective technique in enhancing SpO2 and our findings may have therapeutic applications especially in the current pandemic situation.
Coping Mechanisms as a Predictor of Fear of COVID-19 and Quality of Life: A Malaysian Nationwide Survey
Authors: Chong Siew Koon , Tuan Hadi Tuan Sharipah , Ong Wan Xi , Ali Ruzila , Choy Seng Kit , Kanchan Thandani , Ling Ling Shiao , Theng Yoong Mei , Chew Poh Yih , Shukri Madihah
Published: December 2022

Objective:

The COVID-19 is a major health crisis that has changed the life of millions globally. The purpose of this study was to assess the coping mechanism among the general population of Malaysia as well as its possible correlates such as Fear of COVID-19, quality of life (QOL) and associated sociodemographic background.

Methods:

This is an online cross-sectional study involving a total of 4904 adults across Malaysia from June to December 2021. Brief Coping Orientation to Problems Experienced was used to measure coping mechanisms, while the level of fear toward COVID-19 was assessed by fear of COVID-19 scale. QOL was measured by WHOQOL-BREF.

Results:

Sociodemographic data shows that 59.1% of Malaysians report an overall reduced QOL during the COVID-19 pandemic. 32% of respondents were unemployed during the pandemic and 18% of respondents were working from home. 71% of respondents had at least one or more encounter with COVID-19. We find that problem focused coping mechanism may be effective in face of COVID-19, both, in reducing overall fear toward COVID-19 and improving QOL, while emotional and avoidance coping mechanism has a negative correlation. Other socioeconomic factors such as age, gender, levels of education, income, and employment have a significant positive correlation with QOL and a negative correlation with Fear of COVID-19. Another factor which affects QOL is work from home which has a negative correlation.

Conclusion:

Based on study findings, problem based coping mechanism is beneficial to reduce Fear of COVID-19 and improve QOL.
Psychological First Aid Training in the Community
Authors: Qamruddin Asraf Ahmad Bin
Published: December 2022

Mental health problems in Malaysia have been showing an upward trend, especially due to the effect of the COVID-19 pandemic. Despite good primary, secondary, and tertiary care, and the availability of community-based mental services such as psychosocial rehabilitation, there remains to be a lack of social support for mental health in the Malaysian community. Stigma toward mental health problems remains high in the country. There are existing volunteer programs, such as Komuniti Sihat Perkasa Negara, that could deliver psychological first aid to the community. This allows the mobilization of societal resources and increases universal health coverage for mental health, which is a crucial preparation before the next crisis that could impact the community’s mental health.
Exploring Depression Literacy among Malaysian Secondary School Adolescents Using a Vignette-Based Questionnaire
Authors: Zakaria Rozanizam , Ubaidah Aisyah Nazurah , Rashid Khadijah Abdul , Ramli Rawahah Husna
Published: December 2022

Introduction:

Mental health literacy is an important element for better recognition of illness and early intervention. This study is aimed at exploring the level of literacy on depression among a sample of secondary school adolescents in Malaysia and the factors that determine their level of literacy regarding depression.

Materials and Methods:

A cross-sectional study was carried out among 462 secondary school students. Mental health literacy was assessed using the adapted mental health literacy survey using the case vignette method. The questionnaire consists of a set of open-ended questions designed to elicit information regarding the respondents’ ability to identify depression in the case vignette and their ability to identify the appropriate help-seeking actions.

Results:

About 51.3% of students were able to identify depression, whereas 42.6% and 10.8% were able to identify appropriate help-seeking and medical-related help-seeking actions, respectively. Multivariate analyses show gender and school demographic are predictors for the ability to correctly identify the problem. School demographic is identified as a predictor for the appropriate help-seeking actions, whereas gender, age, and race are predictors for medical-related help-seeking action.

Conclusion:

The ability of adolescents from this sample to identify depression is higher than the general population in Malaysia. However, their ability to identify treatment is still low. Adolescents who are male, younger, Malay, and come from rural areas are the target subpopulation that will require further actions to improve their mental health literacy.
Challenges in the Management of Major Hemorrhage after Hemorrhoidal Banding
Authors: Chen Kabytto , Su Michael , Toh James W. T.
Published: December 2022

Hemorrhoidal banding is considered a safe, low-risk technique for the management of grade-I–III internal hemorrhoids. Furthermore, information in the literature regarding serious complications associated with banding is limited. Bleeding post hemorrhoidal banding is often considered minor and is expected to resolve spontaneously. Therefore, major hemorrhage post hemorrhoidal banding is often unexpected, recognized late, poorly managed, and may become life-threatening. In this case series, we present two unusual cases with rare, major, life-threatening hemorrhage post banding. Although it is rare, banding is shown to be associated with a risk of life-threatening bleeding, as this report highlights. Major hemorrhage is unusual because most bleeding after hemorrhoidal banding resolves spontaneously; however, as shown in this series, bleeding is a potential complication of hemorrhoidal banding. Thus, an appropriate index of suspicion is important to prevent serious morbidity and mortality. In this study, we discuss the factors associated with bleeding risk as well as surgical and management strategies to reduce the risk of major bleeding with hemorrhoidal banding.
Decreased birth weight after prenatal exposure to wildfires on the eastern coast of Korea in 2000
Authors: Jung En-Joo , Lim Ah-Young , Kim Jong-Hun
Published: December 2022

OBJECTIVES: In April 2000, a series of wildfires occurred simultaneously in five adjacent small cities located on the eastern coast of Korea. These wildfires burned approximately 23,794 hectares of forestland over several days. We investigated the effects of prenatal exposure to the by-products generated by wildfire disasters on birth weight.METHODS: Birth weight data were obtained for 1999-2001 from the birth registration database of the Korean National Statistical Office and matched with the zip code and exposed/unexposed pregnancy week for days of the wildfires. Generalized linear models were then used to assess the associations between birth weight and exposure to wildfires after adjusting for fetal sex, gestational age, parity, maternal age, maternal education, paternal education, and average exposed atmospheric temperature.RESULTS: Compared with unexposed pregnancies before and after the wildfires, mean birth weight decreased by 41.4 g (95% confidence interval [CI], -72.4 to -10.4) after wildfire exposure during the first trimester, 23.2 g (95% CI, -59.3 to 13.0) for exposure during the second trimester, and 27.0 g (95% CI, -63.8 to 9.8) during the third trimester. In the adjusted model for infants exposed in utero during any trimester, the mean birth weight decreased by 32.5 g (95% CI, -53.2 to -11.7).CONCLUSIONS: We observed a 1% reduction in birth weight after wildfire exposure. Thus, exposure to by-products generated during a wildfire disaster during pregnancy may slow fetal growth and cause developmental delays.