bluuebunny/crossref_metadata_2025_split huggingface dataset:
Arthroscopic-assisted mini-open rotator cuff repair outcome measures
Authors: Saleh Mohamed R A 
Published: April 2023

Abstract

Background
Mini-open repair seems to be equivalent to all-arthroscopic repair in multiple nonrandomized comparative studies, and a randomized trial is underway to formally address this question.

Objectives
These include the ability to perform diagnostic arthroscopy, preservation of the origin of the deltoid, rapid hospital discharge, less postoperative pain, and accelerated rehabilitation.

Patients and Methods
A case series study was performed on 20 patients from May 2017 to May 2019. The technique is not technically demanding than all-arthroscopic repair while still having the advantages of arthroscopic repair. A total of 20 patients, 11 (55%) men and nine (45%) women, were included in this study with a mean age of 58.00 Å} 9.17 years.

Results
There was high significant gradual improvement in the modified University of California, Los Angeles (UCLA) shoulder scale among the studied patients at 1, 3, and 6 months postoperative follow-up compared with preoperative. Postoperative complications were found in six patients. Three (15%) cases had stiffness, and the other three (15%) cases had superficial wound infections. There were significant correlations between the modified UCLA shoulder scale with age, operative time, and postoperative complications, while there were no significant correlations with sex or side.

Conclusion
Our study concluded that surgery for rotator cuff tears improves self-reported patient outcomes and has a lasting and durable result at an average of 15 years after surgery. There was a high statistically significant gradual improvement in the modified UCLA shoulder scale among the studied patients at 1, 3, and 6 months postoperative follow-up compared with preoperative. Further studies including a larger sample are required to enhance the current findings.
Comparison of treatment of unstable intertrochanteric fractures by intramedullary and extramedullary implants
Authors: Khairy Mahmoud , Nzayikorera Gratien 
Published: April 2023

Abstract

Background
To achieve union and restore the normal biomechanics of the hip region after unstable trochanteric fractures, surgical intervention is necessary. There are two options for internal fixation: extramedullary and intramedullary. Dynamic hip screw (DHS) as extramedullary fixation was and is still widely used to surgically treat intertrochanteric fractures. However, it sometimes fails to give good results. Intramedullary fixation methods include gamma nail placement, which is considered by some surgeons to be a better choice as it can avoid complications occurring with extramedullary fixation. Our study aimed to conclude which is better to be used to manage unstable intertrochanteric fractures by either DHS or gamma nail regarding the operation requirements (hospital stay, need for blood transfusion, wound complications, and soft tissue damage) and later on evaluate which is better regarding the fracture healing radiologically and functionally.

Patients and methods
This is a retrospective study of 52 patients with recent unstable intertrochanteric fractures between January 2020 and December 2020. A total of 40 patients continued the study till the last follow-up, where 20 of them were fixed by intramedullary gamma nails as a group I and the other 20 patients were fixed by extramedullary DHS as a group II. The mean age for the group I was 50.05 (20–83) years and the mean age for group II was 60.5 (22–91) years. A total of 14 patients from group I were males and 12 from group II were males. All fractures were classified according to Evan’s classification to be unstable (Evan’s types III, IV, and V).

Results
Overall, 19 (95%) patients of group I achieved full union and one patient had nonunion with nail breakage. No patients in group I had malunion. A total of 17 (85%) patients of group II achieved good union with one patient having nonunion with implant failure. Moreover, two (10%) patients of group II had femoral shaft medialization and varus malunion.

Conclusion
This study supported the previous series in the literature, which proved that unstable intertrochanteric fractures can be fixed by intramedullary gamma nails or extramedullary DHS but intramedullary fixation gives better results than extramedullary fixation.
Biological plating for diaphyseal humeral fractures
Authors: Hegazy Mohamed O , Hosny Gamal A , Elbegawi Hossam E A , El-Attar Hesham A , Elnakkadi Nagui S E 
Published: April 2023

Abstract

Background
Diaphyseal humeral fracture is one of the common injuries in orthopedic surgery. The biological plating technique or minimally invasive plate osteosynthesis (MIPO) is the fixation of the fracture with minimal opening, preserving the soft tissue attachment and blood supply to the bone.

Aim
To evaluate the biological plating technique in the management of diaphyseal humeral fractures by comparing MIPO with open reduction and internal fixation (ORIF) techniques.

Patients and methods
This study is a randomized controlled trial. It was performed on 40 adult patients with a humeral diaphyseal fracture. The patients were randomly divided into two groups: 20 MIPO cases and 20 ORIF controls. We compared the two groups.

Results
MIPO is superior to ORIF, as it has a shorter duration of surgery, shorter incision length, and less blood loss. It may minimize to some extent the duration of fracture healing and the risk of deep infection. MIPO and ORIF have excellent shoulder and elbow functional outcomes.

Conclusion
MIPO offers many advantages over the ORIF, but it has some disadvantages.
Clinical outcome of ambulatory anterior cruciate ligament reconstruction compared with the standard in-patient surgery
Authors: Sharaby Mohamed M F , El-Deeb Younes M , Abuheif Mohamed 
Published: April 2023

Abstract

Purpose
There is a current trend toward performing anterior cruciate ligament reconstruction (ACLR) as a day surgery procedure. However, the full evaluation of this process compared with the traditional inpatient ACLR was not accomplished particularly from the perspective of patient satisfaction, pain improvement, and final outcome. Furthermore, several centers described refusal of patients to pass through the day surgery protocol with more preference to admission.
The aim of this study is the evaluation of early/late results of short-term hospital stay following arthroscopic ACLR with regard to patient recovery, complications, patient satisfaction, and return to daily activities through our algorithm.

Patients and methods
Through a prospective randomized study, 284 patients were operated for ACLR through two pathways; G1 is the day surgery pathway and G2 is the traditional inpatient pathway. Patients were evaluated postoperatively for pain severity, satisfaction, the need for additional analgesia, any readmission, complications, and final outcome.

Results
Patients in both groups showed similar pain and satisfaction levels with no difference regarding the amount of extra-analgesia needed and with no readmission from the day surgery group. However, seven patients were recorded as reattending the hospital seeking for pain medication which was given in ER and the patient was satisfied to return home with no need for readmission.

Conclusions
In conclusion, day surgery can be considered as the protocol of choice for patients undergoing ACLR with no difference from the former standard in-patient ACLR.
The prevalence of tuberculosis infection in India: A systematic review and meta-analysis
Authors: Chauhan Arohi , Parmar Malik , Dash Girish Chandra , Solanki Hardik , Chauhan Sandeep , Sharma Jessica , Sahoo Krushna Chandra , Mahapatra Pranab , Rao Raghuram , Kumar Ravinder , Rade Kirankumar , Pati Sanghamitra 
Published: April 2023

Background & objectives:
The National Prevalence Survey of India (2019-2021) estimated 31 per cent tuberculosis infection (TBI) burden among individuals above 15 years of age. However, so far little is known about the TBI burden among the different risk groups in India. Thus, this systematic review and meta-analysis, aimed to estimate the prevalence of TBI in India based on geographies, sociodemographic profile, and risk groups.

Methods:
To identify the prevalence of TBI in India, data sources such as MEDLINE, EMBASE, CINAHL, and Scopus were searched for articles reporting data between 2013-2022, irrespective of the language and study setting. TBI data were extracted from 77 publications and pooled prevalence was estimated from the 15 community-based cohort studies. Articles were reviewed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines and were sourced using a predefined search strategy from different databases.

Results:
Out of 10,521 records, 77 studies (46 cross-sectional and 31 cohort studies) were included. The pooled TBI prevalence for India based on the community-based cohort studies was estimated as 41 per cent [95% confidence interval (CI) 29.5-52.6%] irrespective of the risk of acquiring it, while the estimation was 36 per cent (95% CI 28-45%) prevalence observed among the general population excluding high-risk groups. Regions with high active TB burden were found to have a high TBI prevalence such as Delhi and Tamil Nadu. An increasing trend of TBI was observed with increasing age in India.

Interpretation & conclusions:
This review demonstrated a high prevalence of TBI in India. The burden of TBI was commensurate with active TB prevalence suggesting possible conversion of TBI to active TB. A high burden was recorded among people residing in the northern and southern regions of the country. Such local epidemiologic variation need to be considered to reprioritize and implement-tailored strategies for managing TBI in India.
Heteroresistance to rifampicin & isoniazid in clinical samples of patients with presumptive drug-resistant tuberculosis in Central India
Authors: Desikan Prabha , Panwalkar Nikita , Punde Ram Prakash , Khan Zeba , Pauranik Ankur , Mirza Shaina Beg , Chourey Manju , Anand Sridhar , Sachdeva K.S. 
Published: April 2023

Background & objectives:
A combination of resistant and susceptible Mycobacterium tuberculosis (MTB) isolated from clinical specimens is referred to as heteroresistance. Heteroresistance leads to difficulties in drug resistance testing and may adversely affect treatment outcomes. The present study estimated the proportion of heteroresistance among MTB in clinical samples of presumptive drug-resistant tuberculosis (TB) patients in Central India.

Methods:
A retrospective analysis of data generated from line probe assay (LPA) at a tertiary care hospital in Central India between January 2013 and December 2018 was carried out. A heteroresistant MTB in a sample was indicated by the presence of both wild-type and mutant-type patterns on an LPA strip.

Results:
Data analysis was carried out on interpretable 11,788 LPA results. Heteroresistance in MTB was detected in 637 (5.4%) samples. Of these, heteroresistance in MTB was detected in 413 (64.8%), 163 (25.5%) and 61 (9.5%) samples with respect to rpoB, katG and inhA genes, respectively.

Interpretation & conclusions:
Heteroresistance is considered a preliminary step in the development of drug resistance. Delayed or suboptimal anti-tubercular therapy in patients with heteroresistance of MTB may elicit full clinical resistance and negatively impact the National TB Elimination Programme. Further studies are, however, needed to determine the impact of heteroresistance on treatment outcomes in individual patients.
Sociocultural and drug-related factors associated with adherence to iron–folic acid supplementation among pregnant women – A mixed-methods study
Authors: Muthuraj Lakshmi Prabha , Kandasamy Sunitha , Subbiah Padmavathi , Sibqathulla Maryam Jamila , Velappan Lakshmi Kandhan , Gopal Muthu , Ramya Ezhil J , Jayaraman Yuvaraj , Kalyanaraman Shantaraman 
Published: April 2023

BACKGROUND:
The National Family Health Survey of India (NFHS-5) revealed a lapse in the advancement of mitigating anemia despite free supplementation of iron–folic acid tablets (IFAT) and improvement in IFAT coverage during pregnancy. The local sociocultural beliefs and community perspective toward IFAT are pivotal in reducing the gap between IFAT coverage and consumption. Hence, we proposed the study to assess adherence to IFAT among rural pregnant women and explore the associated factors.

MATERIALS AND METHODS:
The present study was conducted as a mixed-methods study with a sequential exploratory design in a rural setting of the Model Rural Health Research Unit (MRHRU) from October 2020 to May 2021. Ten focus group discussions (FGDs; 8 – antenatal women, 1 – mother/mother-in-law, and 1 – health care worker) were conducted, and framework analysis was done to identify themes followed by a quantitative survey with a semi-structured questionnaire among antenatal women (n = 236). Logistic regression was used to analyze factors associated with adherence.

RESULTS:
The major themes that emerged from FGDs were the sociocultural factors (gender norms, communal fallacies), lack of awareness, and drug-related factors (unpalatability, misperceptions, and experienced side effects). Around 57% were adherent to IFAT. Side effects experienced on IFAT intake (P = 0.001, OR = 2.33), misconceptions regarding IFAT, like weight gain in IFAT use (P = 0.001, OR = 2.86), a big baby with IFAT use (P = 0.000, OR = 5.93) negatively influenced adherence.

CONCLUSIONS:
The significant gaps between IFAT coverage and consumption surrounded the unpleasant odor and stench of IFAT, side effects, lack of individualized counseling, and misperceptions regarding IFAT use.
Reasons for not getting COVID-19 vaccine in Ardabil, a Northwestern province in Iran: Based on an ecological approach
Authors: Moghaddam Hamed Rezakhani , Khan Fatemeh R. , Bazyar Hadi , Aghamohammadi Vahideh 
Published: April 2023

BACKGROUND:Understanding the reasons for not getting the COVID-19 vaccine can help to increase acceptability and tackle vaccine hesitancy and consequently reach high coverage for this new vaccine. Using an ecological approach, the reasons for not getting the vaccine in the Iranian population was investigated.METHODS AND MATERIAL:This study was conducted from October to December 2021 on 426 participants who had not received the COVID-19 vaccine. The following subsets of questions were included in the questionnaire: intrapersonal level factors, interpersonal level factors, group and organization, and society and policy-making. Multivariable logistic regression was used, and the odds ratio (OR) and 95% confidence intervals (CIs) were estimated for vaccine hesitancy (dependent variable) according to the reasons for not getting COVID vaccine scores (independent variable) using multivariable logistic regression in 3 different models, including Model 0: unadjusted, Model 1: adjusted for age, gender, and underlying disease, and Model 2: adjustment for age, gender, underlying disease, education, place of living, income, marital status, and employment.RESULTS:A significant difference was found regarding gender between likely and not likely groups (P= 0.016). A significant association was observed between the vaccine hesitancy and interpersonal (unadjusted model: OR = 0.833 (CI: 0.738–0.942),Pfor trend = 0.003; model 1: OR = 0.820 (CI: 0.724–0.930),Pfor trend = 0.002; model 2: OR = 0.799 (CI: 0.703–0.909),Pfor trend = 0.001) and group and organization (unadjusted model: OR = 0.861 (CI: 0.783–0.948),Pfor trend = 0.002; model 1: OR = 0.864 (CI: 0.784–0.952,Pfor trend = 0.003; model 2:OR = 0.862 (CI: 0.781–0.951,Pfor trend = 0.003). There was no significant association between vaccine hesitancy and intrapersonal and society and policy-making (P> 0.05).CONCLUSIONS:We found that a high score of “interpersonal” and “group and organization” factors were associated with lower intention to COVID vaccine. Moreover, women had higher vaccination intentions than men.
Attitude of nurses caring critically ill patients admitted in the ICUs of AIIMS Hospital, Jodhpur
Authors: Aktar Shoaib , Pandey Vandna , Kumar Ashok 
Published: April 2023

BACKGROUND:
Nurses are internationally recognized to be largest group of registered and regulated practitioner in the health workforce of any country. There is an increase in number of critically ill patients seeking optimal care, and this rapidly increases the demand for the critical care nurses at the end of life. Caring for a critically ill patient creates anxiety and emotional exhaustion and may sometimes lead to burnout. So, it is imperative for the nurses to have an optimistic approach while caring patients in the ICU. The aim of the study was to assess the attitude of the nurses caring critically ill patients and to determine the association of the level of attitude with the selected personal variable. The study was conducted at ICUs of tertiary care hospital by using descriptive research design.

METHODS AND MATERIAL:
A cross-sectional descriptive study was conducted in ICUs of tertiary care hospital from October to December 2018. The sample was selected by total enumeration technique. Data was collected from 60 critical care nurses with the help of self-structured five-point Likert scale to assess the attitude of nurses. Descriptive statistics and inferential statistics were used for data analysis such as mean, frequency, percentage, standard deviation, and Chi-square test.

RESULTS:
Majority (81.7%) of the nurses were having favorable attitude toward caring the critically ill patients, and there was no significant association of the attitude score with the selected personal variable at P < 0.05.

CONCLUSIONS:
Majority of critical care nurses have favorable attitude. If they have supportive environment at workplace, their willingness to work toward quality care will improve further.
Analysis of cognizance and practices of biomedical waste management principle rules among health professional workers in a teaching hospital with special emphasis on COVID-19 pandemic: A critical appraisal on the current state and way forward
Authors: Sri E. S. Keerthika , Vaithy Anandraj K , Shanmugasamy Kathirvelu , Srinivasan Sowmya 
Published: April 2023

BACKGROUND:
Hospital-generated waste materials commonly labeled as “Biomedical waste” (BMW) is a kind of remnant that includes infectious and non-infectious materials and their appropriate disposals are controlled as per the guidelines of Biomedical Waste Management (BMWM) Amendment Rules, 2018, Government of India. Periodic assessment on BMWM among healthcare workers (HCWs) is mandated to ensure quality assurance, which may be helpful during pandemic times.

MATERIALS AND METHODS:
The study was conducted with ethical clearance by using a validated questionnaire (using Cronbach's α) covering knowledge, attitude, and practices (KAP) derived based on recent BMWM 2018 guidelines. The responses in context to KAP were checked by the study conductors, appropriate statistical analysis was done and discussed at end of each session.

RESULTS:
Nearly 279 HCWs participated in the study and cast their responses. Knowledge and attitude domain on BMWM showed statistical significance whereas varied responses were observed with practices among the health professional workers with health professional physicians having an edge over other HCWs involved in the processes with varying attrition factors.

CONCLUSIONS:
The present study proves novelty by extensively analyzing KAP among HCWs on BMWM in general with special emphasis on laboratory biosafety norms. The study emphasizes that BMWM should be a continuous process and that all HCWs handling BMW must undergo regular training and assessment with questionnaire surveys. Multi-tasking and cumulative efforts must be formulated to attain translational synergy in the stream of KAP of BMWM, which could be attained by incorporating BMWM in the health science curriculum.
Validation of a form for assessing the professional performance of residents in cardiology by nurses
Authors: Busch German , Rodríguez Borda María V. , Morales Pablo I. , Weiss Mónica , Ciambrone Graciana , Costabel Juan P. , Durante Eduardo , Gelpi Ricardo , Alves De Lima Alberto E. 
Published: April 2023

BACKGROUND:
There is a strong need for transformation in our assessment systems from one that evaluates performance based on levels of training to another that focuses on professional competence to meet the expected requirements for the practice of the profession. The aim of this study is to validate for the first time a Spanish version of a new tool for assessing the professional performance of residents by nurses newly developed in the Ottawa Hospital (O-RON).

MATERIALS AND METHODS:
After the author's written authorization, the original O-RON form was translated and cross-culturally adapted. Then we conducted a prospective observational study in two cardiology centers in the city of Buenos Aires. The validity of the tools was evaluated by the ability of the instrument to discriminate the level of experience of the residents according to their post-graduate year level. Data is expressed as percentages and frequencies of the qualifications obtained in the different questions. The chi-square test was used to assess the significance of the differences obtained. A generalizability test was used to evaluate reliability. Feasibility was defined as a minimum of 4 assessments per resident per evaluation round. Satisfaction of evaluators was assessed using a survey with a 10-point scale designed by the authors.

RESULTS:
A total of 838 evaluations were performed. Regarding validity, the 15-item form could significantly discriminate the experience of the residents according to their postgraduate year level (P < 0,005). Thirty evaluations per resident are required to obtain reliable results. The tool is feasible to implement and an average of 4.55 assessment per resident per evaluation round were achieved throughout the entire experience. This value remained stable during the 8 rounds (1st: 4.65; 2nd: 4.34; 3rd: 4.47; 4th: 6.17; 5th: 4.56; 6th: 4.08; 7th: 4.36; 8th: 3.91). The levels of satisfaction among the evaluators were acceptable.

CONCLUSION:
The Spanish version of the O-RON form can provide residents with a valuable source of feedback from the eyes of nurses on important aspects of their professional training. This tool, positively assessed by the raters, significantly discriminates residents' experience. Its implementation is feasible in our environment, and it is user-friendly, though it requires a considerable number of assessments to achieve high reliability.