bluuebunny/crossref_metadata_2025_split huggingface dataset:
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.
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.
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.