bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluation of Radiological and Clinical Outcome of Minimally Invasive Plate Osteosynthesis (MIPO) for Metaphyseal Fracture of Distal Femur and Proximal Tibia
Authors: Verma Ajeet Kumar , Agarwal Saumya , Garg Apoorv Mohan , Prakash Shivank , Choubisa Raghvendra 
Published: September 2023

Background:
Metaphyseal fracture of distal femur and proximal tibia results from high-velocity road traffic accidents. Using minimally invasive plate osteosynthesis (MIPO), the complex fracture zone is left untouched and length, alignment, and rotation are restored. As the fracture site is not explored, the osteogenic tissues surrounding the fracture are well protected and their blood supply is well preserved. This accelerates fracture healing.

Materials and Methods:
Thirty-five patients within the span of 3 years underwent internal fixation of distal end femur and proximal tibia by locking compression plate (LCP) using MIPPO technique. All the patients were assessed using Johner–Wruhs’ criteria and lower extremity functional scale (LEFS).

Results:
The mean time of partial weight bearing in fractures of distal femur was 10.14 weeks and proximal tibia was 9.71 weeks, respectively. The mean time of full weight bearing in fractures of distal femur was 16 weeks and in proximal tibia was 15.28 weeks. The mean time of bone union in fractures of distal femur was 18.14 weeks and in proximal tibia it was 18.57 weeks. The overall average LEFS score comes out to be 67 out of 80 points. According to Johner Wruhs’ criteria, results were excellent in 14 (40%), good in 16 (45.7%), fair in 4 (11.4%), and poor in 1 patient.

Conclusion:
MIPO techniques represent a fascinating new armamentarium in fracture fixation, which is made easier with the LCP technology and the different available minimally invasive surgical instruments, which were developed to cause less additional damage to the soft tissue and the bone.
Study of Early Infection in Open Fractures of Long Bones
Authors: Maheshwari Rajesh , Agarwal Digvijay , Ratra Rohan 
Published: September 2023

Introduction:
The complications associated with open fracture make the task of a surgeon difficult and also increase the financial burden. Underlying bone is exposed to contaminating agents due to breakdown of the tissue barrier between the fracture zone and the environment. It leads to an increased risk of complications such as wound infections and nonunion.

Materials and Methods:
We performed a prospective observational study on 82 patients presenting with open fractures of long bones treated in the year 2019 in the Department of Orthopedics, Himalayan Institute of Medical Sciences. Patients presenting with long bone open fractures within 72 h from injury to the Emergency were included in the study. All patients were clinically and radiologically followed for a period of 6 weeks.

Results:
Of the 82 cases, 26 developed an infection (31.70%). Fracture classified as Type IIIa had the highest infection rate (50%), whereas Type 1 had the lowest infection rate (14.3%). Infection rate in patients presenting 24 h after injury was higher than those presenting within 24 h from injury but a significant association could not be established between infection rate and late presentation from injury. Enterococcus species were the most commonly identified organism in both intraop and postop swabs (31.57%).

Discussion:
Trauma patients can present with chest, abdomen, or head injury, which may require emergency intervention precludes early debridement for open fracture. In our study, no significant decrease in infection rate was observed in patients undergoing debridement within 6 h from injury. However, it was also observed that open fractures presenting 24 h after injury had a higher infection rate than those presenting before it, which is in accordance with previous literature. Organisms finally causing established infection in bone were isolated mostly from postop swabs and were gram negative, which further strengthens the fact that most infections are nosocomial in origin.

Conclusion:
This paper furnishes the literature by validating facts, theories, and guidelines given in the past to manage open fractures. The study has limitation that the numbers of patients presenting with open fractures were less, and especially patients having common risk factors such as diabetes and anemia due to which correlation with infection rate could not be assessed effectively.
To Evaluate the Efficacy of Antibiotic-coated Intramedullary Locking Nail in the Compound Fracture of Tibia
Authors: Pal Chandra Prakash , Dinkar Karuna Shankar , Kapoor Rajat , Kumar Shailesh , Verma Ashutosh , Patel Jaydeep 
Published: September 2023

Introduction:
Soft tissue with skeletal infections remains a big problem for orthopaedic surgeons. Bone provides a unique milieu for bacteria, with low vascularity and turnover rate. Biofilm-forming bacteria cause most orthopaedic trauma infections. When biofilm is formed, it protects the microorganism from antimicrobial treatment thus leading to chronic infections. Antibiotic-coated interlocking nail locally releases gentamycin + PDLLA at initial high concentrations followed by a period of constant release. The biodegradable polymer (PDLLA) is excreted from the body through the tricorboxylic acid cycle cycle, combined with gentamycin for sustained release.

Materials and Methods:
This was a prospective interventional study conducted between September 2018 and August 2020. In this period, we analyzed the hospital records to find out the cases treated by antibiotic-coated intramedullary locking nails. A total of 30 cases of compound tibia fracture were included in our study. Patients were routinely followed at definite intervals and specifically assessed for radiographic and functional evaluation by using the RUST score.

Results:
Out of 30 patients, radiological union at 6 months using the RUST score was 4 in 10.00% patients, 8 in 13.33% patients, 10 in 23.33% patients and 12 in 53.33% patients and final functional outcome was “excellent” in 53.33% patients, “good” in 23.33% patients, “fair” in13.33 % patients and “poor” in 10.00% patients.

Conclusion:
Antibiotic-coated tibia interlocking nail yields good functional outcomes with fewer complications in these fractures. Antibiotic tibia interlocking nail is a good treatment option and should be used whenever indicated.
Changing practices of delivering orthopedic and coronavirus disease 2019 care
Authors: Keshav Kumar , Sharma Pulak , Kumar Amit , Baghel Anurag , Kaustubh Kumar , Huda Najmul , Mishra Prabhaker 
Published: September 2023

Purpose:
Coronavirus disease 2019 (COVID-19) pandemic has caused severe disruption of services for other health-related ailments. This study was done to assess change in practices of orthopedic surgeons, availability of proper training and personal protective equipment (PPEs), and changes in hospital setup/preparedness for the management of COVID-19 patients.

Materials and Methods:
A pan-India online survey was done among practicing orthopedic surgeons. Orthopedicians not practicing in India, trainees, and those who had left their practice before the pandemic were excluded from the study. Survey MonkeyR questionnaire and Google FormsR were sent to 10,055 orthopedicians, during the 7th week of nationwide lockdown in the month of May, 2020. Complete responses were received from 407 participants who were included in the final analysis.

Results:
Only a quarter (n = 100/407, 24.6%) of the doctors were visiting hospitals at a frequency similar to that before the pandemic. Onus of orthopedic care among COVID-19 suspected/diagnosed cases and routine COVID-19 patients were mainly borne by the government sector. Only 38.8% (n = 158/407) doctors felt that they received adequate training while 64.9% (n = 264/407) of the doctors had adequate supply of PPE kits. “Designation of specific areas of their hospitals exclusively for COVID-19 patients” was opined by 43.7% (n = 178/407), urgent diagnostic facilities by 52.8% (n = 215/407), and exclusive operation theaters by only 28.3% (n = 115/407) of the respondents.

Conclusion:
This study has shown a drastic fall in the frequency of hospital visits by orthopedic surgeons, predominant involvement of government sector orthopedicians, inadequate training of doctors and inadequate availability of PPE kits, lack of proper designated areas, operation theaters, and urgent diagnostic facilities for the management of COVID-19 patients.
Role of Needle Aponeurotomy and Buddy Taping as a Natural Continuous Passive Mobilization Machine in Dupuytren’s Contracture
Authors: Lal Hitesh , Kumar Jaswant , Goyal Rakesh , Mehta Nitin 
Published: September 2023

Purpose:
Needle aponeurotomy (NA) for Dupuytren’s contracture is gaining popularity and is becoming the standard primary treatment. We present a short series of patients with Dupuytren’s contracture managed by NA and elucidate the augmenting role of buddy taping as a natural anatomic continuous passive motion machine in maintaining the improvement in DASH (Disabilities of the Arm, Shoulder and Hand) scores.

Materials and Methods:
Four patients (five hands) with Dupuytren’s contracture all of whom were diabetic are included in the short case series. All patients had their contracture released by NA and the operated finger was buddy taped to adjacent finger.

Results:
The mean age of the patients was 48.75 years. Out of four patients, three had unilateral involvement and one had bilateral involvement of ring finger. The mean flexion contracture at the metacarpophalangeal (MCP) joint was 61°(50°–70°), whereas at PIP joint it was 36° (30°–40°) which improved to mean of 0° and 2° immediately after release and 0° and <5°, respectively, at the final follow-up. The mean DASH score improved from 16.25 to 3.77 at the final follow-up. We did not encounter any neurovascular injury in any of our patients related to the procedure though one patient complained of tingling sensation in all fingers and one patient had 1–2 mm of skin rupture. There was no relapse and no patient required secondary release.

Conclusion:
Patients with Dupuytren’s contracture released by NA have good clinical results. The mobilization of the taped buddy finger allows early, superior, cost-efficient rehabilitation and prevents relapse.

Type of Study/Level of Evidence:
Therapeutic IV
To Assess the Functional and Radiological Outcomes in Patients of Medial Compartment Osteoarthritis of Knee Undergoing Medial Open-Wedge High Tibial Osteotomy
Authors: Huda Najmul , Islam Mir Shahid Ul , Aggarwal Shubham , Bishnoi Sandeep , Beri Sudhir , Dholariya Ravi 
Published: September 2023

Background:
Varus malalignment at the knee can lead to medial compartment overload and progression of ipsilateral compartment osteoarthritis (OA). In such cases, a valgus-producing medial open-wedge high tibial osteotomy (MOWHTO) has been proposed to restore neutral mechanical alignment and alleviate excess load on the medial compartment. One distinct advantage of this procedure is the ability to correct deformities in the sagittal and coronal planes. The present study was conducted with the aim to analyze the difference in the pre- and postoperative functional scores and to estimate the changes in the pre- and postoperative radiological alignment in the patients managed by MOWHTO for uni/medial compartmental OA knee.

Materials and Methods:
Fifteen patients with medial compartment OA knee Kellgren–Lawrence Grade II and III with a mean age of 54.46 years were managed with MOWHTO. Clinical assessment was done using the Knee Society Score (KSS) preoperatively and postoperatively at 3, 6, and 9 months. Radiological assessment was done using the Puddu technique on the load-bearing lower limb antero-posterior X-ray extending from the hip joint up to the ankle preoperatively at postoperatively at 3 and 9 months.

Results:
All patients had pain relief and improvement in walking ability after the procedure. The mean KSS significantly improved from 35.50 ± 9.78 preoperatively to 55.07 ± 9.13, 67.14 ± 10.06, and 74.14 ± 4.09 at 3, 6, and 9 months postoperatively, respectively (P < 0.01). The mean varus angle significantly improved from 9.06° preoperatively to 1.43° varus at 3 months postoperatively (P = 0.001) and 1.64° varus at 9 months postoperatively and was found to be significant.

Conclusion:
After a follow-up of 9 months, we found that the MOWHTO of the tibia is an effective method to treat the medial compartment OA knees. It leads to significant improvement in both the clinical and radiological outcomes.
Comparitive Study of Functional and Radiological Outcome of Open-Wedge High Tibial Osteotomy Versus Proximal Fibular Osteotomy in Patients with Osteoarthritis Knee
Authors: Jaiswal Sparsh , Mangal Parit , Swarup Arunim , Rastogi Avinash 
Published: September 2023

Aim:
Proximal fibular osteotomy (PFO) and valgus high tibial osteotomy (HTO) are the well-established treatment options for patients with K-L grade 2, 3 medial compartment knee osteoarthritis where replacement may not be the treatment of choice. The aim of the present study was to compare the radiological and clinical outcomes following HTO and PFO.

Materials and Methods:
During the duration of 2 years, two groups of 30 patients each undergoing PFO with a mean age of 53.9 years (range 40–65 years) and HTO with a mean age of 54.7 years (range 40–65 years) were compared and followed up for 1 year. They were compared on the basis of preoperative and postoperative range of walking distance, Numerical Pain Rating Score, American Knee Society Score, Knee Injury and Osteoarthritis Outcome Score, femorotibial angle, and medial joint space narrowing.

Results:
In PFO group, immediate postoperative functional scores improved and maintained for 3 months during follow-up. Following which there was the decline in the functional score up to 1-year follow-up, whereas in the HTO group, the improvement is seen with a gradual increase in postoperative functional scores that progressed positively for the entire follow-up period of 1 year.

Conclusion:
Both PFO and HTO lead to good and comparable radiological and functional results. However, HTO provided slow but long-term success in terms of functional and radiological scores after the follow-up period of 1 year.
Psychological impacts of the COVID-19 on health care providers
Authors: Alizadeh Azizeh , Barati Mohammad , Hadian Arash , Almasi Reza , Salehi Safora , Javanmard Yavar , Azizi Maryam 
Published: September 2023

BACKGROUND:
Psychological distress, functional impairment, reduced quality of life, and subjective well-being were the most common negative psychological effects during the COVID-19 outbreak. The present study was to investigate the impact of job stress, hospital resources, and fear of infection on job burnout of medical staff in Iran during the Covid-19 pandemic.

MATERIALS AND METHODS:
In this cross-sectional study, 223 hospital staff from several public and private hospitals in Tehran and Mazandaran provinces, selected through convenience sampling. The questionnaire included the validated “Maslach Burnout Inventory (MBI)”, “job stress scale (Parker and DeCotiis, 1983)”, and the questions about “hospital resources”, and “fear of infection” developed by the researcher wereused to collect data. Data were analyzed by correlation and regression methods using SPSS software.

RESULTS:
The results revealed that there was a significant difference in the scores on the burnout scale, in the dimension of emotional exhaustion, but the differences were not significant in the dimensions of depersonalization and self-accomplishment. Also, job stress and fear of infection significantly correlated with job burnout in the dimensions of emotional exhaustion and personal-accomplishment. However, the correlation between the adequacy of hospital resources and job burnout in these two dimensions was not significant. None of the three variables of the study showed a significant correlation with the dimension of depersonalization.

CONCLUSION:
It is essential to consider the package of psychological interventions which, primarily includes finding the sources of stress to resolve them through stress management programs, based on education and training in stress coping and management strategies.
An exploratory study of the experiences of emergency medical care (EMC) students transitioning through the COVID-19 pandemic in South Africa
Authors: Bhagwan Raisuyah , Rowkith Shannal 
Published: September 2023

BACKGROUND:
The COVID-19 pandemic coalesced into increased mental health problems, particularly anxiety, stress, and depression for university students. Students from the emergency medical care (EMC) department encountered these difficulties, more intensely, particularly those in WIL or clinical placements, as they worked at the interface of illness, trauma, and grief during the pandemic. While empirical research has burgeoned in relation to healthcare practitioners within this context, little exists on EMC students at South African higher education institutions (HEIs), within the context of the COVID-19 pandemic. This qualitative study aimed to explore the academic and psychosocial challenges experienced by EMC students, as they transitioned through the COVID-19 pandemic and the ensuing lockdown during 2021.

MATERIALS AND METHODS:
A qualitative approach with an exploratory descriptive design was used to guide the study. A sample of students from all levels of the EMC Department in the Faculty of Health Sciences was recruited. This was done using non-probability sampling techniques, which includes purposive sampling. Data saturation was reached after interviewing 15 participants using a virtual platform. Interviews were recorded, transcribed, and analyzed using thematic analysis.

RESULTS:
Our results revealed five broad themes and six subthemes which reflected the psychosocial experiences that EMC students faced. The themes and (subthemes) included encountering COVID-19 during WIL or clinical, infection or loss of loved ones, psychological effects of living and working at the interface of COVID-19 (negative emotional toll of the pandemic, misinformation, isolation and social disconnectedness, and sense of responsibility/duty to work) and disruption to academic life (online learning challenges and challenges related to clinical training experiences) and financial impact of the pandemic.

CONCLUSIONS:
The findings suggested that there is a critical need for HEIs to develop strategies that ensure EMC students' well-being amidst their academic journey within the context of the pandemic. This study will therefore assist EMC departments at higher education institutions to formulate strategies in relation to the pandemic.
Effectiveness of behavioral activation therapy and acceptance and commitment therapy on depression and rumination as a tool for health promotion on mothers with cerebral palsy children
Authors: Alirahmi Mostafa , Aibod Sehat , Azizifar Akbar , Kikhavani Sattar 
Published: September 2023

BACKGROUND:
Since in most families, mothers are more responsible for taking care of children and they have more responsibility than fathers for monitoring the child; taking care of a disabled child can have a more negative effect on the psychological state of mothers. The purpose of the present study is to investigate the effectiveness of behavioral activation therapy (BAT) and acceptance and commitment therapy (ACT) on depression and rumination on mothers with children with cerebral palsy in the city of Ilam.

MATERIALS AND METHODS:
The design of this research was pretest and post-test quasi-experimental with a control group. The research sample was 60 mothers who referred to occupational therapy centers in the city of Ilam in 2022, who were randomly divided into two experimental groups (N = 40 for each) and a control group (N = 20). One of the experimental groups, received behavioral activation group therapy method; and the other received the group therapy method based on acceptance and commitment for eight sessions lasted for 90 minutes in week. Data were collected using the Beck depression questionnaire (BDI-II) and the rumination questionnaire in two stages before the intervention and after the intervention. In this research, covariance analysis was used for data analysis.

RESULTS:
The results of covariance analysis showed that behavioral activation therapy and acceptance and commitment-based therapy reduced depression (P < 0.01) and rumination (P < 0.01), and the two experimental groups were compared with the control group in the post-test phase.

CONCLUSION:
It seems that behavioral activation therapy and acceptance and commitment therapy are effective in reducing depression and rumination in the subjects of the present study. Therefore, these treatments are suggested as complementary treatments along with drug treatments to improve psychological symptoms.
Lived experiences of post-mastectomy women: A qualitative study of Western Rajasthan
Authors: Patiyal Neha , Pandey Vandna , Kumar Ashok 
Published: September 2023

BACKGROUND:
Women's breasts have biological functions to lactate, socially and culturally seen as sensual, and the essence of her femininity. In the world, breast cancer is the most constantly occurring non-cutaneous cancer among women. The qualitative phenomenological study aimed to explore the lived experiences of post-mastectomy women.

MATERIAL AND METHODS:
A total of 14 post-mastectomy women were recruited through non-probability convenience sampling based on data saturation, at the radiation unit of a tertiary care hospital, in Basni, Jodhpur, Rajasthan, from September to November 2020. The data was collected using an in-depth interview schedule. It was firstly audio-recorded and transcribed, and then themes and subthemes were extracted. Experiences of women were recorded and analyzed using Colaizzi”s framework (1978) and ATLAS ti. 9 scientific software.

RESULT:
This revealed five main themes and their subthemes: Body image changes, physical impacts, emotional impacts, treatment impacts, and coping and support sources.

CONCLUSION:
In India, the lack of exploration regarding this topic is due to the stigmatization of very private parts, i.e., breast involvement and people rarely discuss it. Thus, there is a need for more such studies to be done, and more attention is required on the role of nurses to assist post-mastectomy women psychologically, spiritually, and physically to cope with their conditions. Findings highlight that mastectomy as a surgical treatment may negatively affect a woman's body image. It's highly recommended to address individual women's psychosocial needs and preferences before undergoing mastectomy in educational sessions by physicians involving nurses with them. Also, proper knowledge about reconstructive procedures should be provided to improve their body image. The counseling sessions can be conducted pre and post-mastectomy by a professional counselor.