bluuebunny/crossref_metadata_2025_split huggingface dataset:
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.