PRE-OPERATIVE EXPECTATIONS FOR RETURN TO SPORTS AND OUTCOMES FOLLOWING ACL RECONSTRUCTION: A SURVEY OF ADOLESCENT PATIENTS AND THEIR PARENTS

Background: There is limited data regarding patient and parent expectations regarding return to sport (RTS) and outcomes following anterior cruciate ligament reconstruction (ACLR) in adolescent athletes. Purpose: To investigate RTS and outcome expectations of adolescent patients and their parents before ACLR and determine any differences between groups. Methods: For this cross-sectional study, sets of patients (aged 10 to 18 years) and parents were separately asked to complete the same questionnaire relating to knowledge and expectations regarding the patient’s upcoming ACLR. The custom survey consisted of 12 questions and was administered before being seen by a single sports medicine surgeon in the clinical setting of a tertiary care referral center from June 2019 through June 2020. Statistical analysis was performed to compare differences between patient and parent/guardian responses. Results: 28 sets of patients (53.6% female) and parents (64.3% female) completed the survey with average ages of 14.5 ± 2.0 years and 45.6 ± 7.0 years, respectively. 75% of families were Caucasian and 85.2% had private insurance. The most common sports played were basketball (25%) and soccer (17.9%). Overall, nearly 68% of consults were for a second opinion. 50% of patients and 82.1% of parents researched or read of ACL injuries and/or surgery prior to the visit. Most patients (46.4%) and parents (51.9%) expected the surgeon to consider full, unrestricted RTS/activities at 9 months. Only 7.1% of patients and 3.7% of parents believed full RTS would occur >12 months. 50% of patients and 67.9% of parents expected RTS at the same level. Both patients (53.6%) and parents (64.3%) believed fear of re-injury was the most common reason for not returning to sport or returning at a decreased level. There were no statistically significant differences in RTS expectations between patients and parents ( p>0.05). Most patients (38.5%) believed the risk of graft rupture in adolescent athletes was 5%, whereas most parents (37%) believed the risk to be at 25%, but the difference was not statistically significant ( p>0.05). Both patients and parents believed the risk of graft rupture was highest within the first 6 months (77.8% vs. 50%, respectively). More parents felt the risk of graft rupture was highest within the first year (39.3% vs. 22.2%), but the difference was not statistically significant ( p>0.05). Conclusion: Adolescent patients and their parents had similar knowledge and expectations regarding RTS and outcomes following ACLR. Further study is needed to better understand factors affecting those expectations.

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Telerehabilitation to Address the Rehabilitation Gap in Anterior Cruciate Ligament Care: Survey of Patients

JMIR Formative Research ◽

10.2196/19296 ◽

2020 ◽

Vol 4 (9) ◽

pp. e19296

Author(s):

Emma Dunphy ◽

Elizabeth C Gardner

Keyword(s):

Anterior Cruciate Ligament ◽

Physical Therapy ◽

Acl Reconstruction ◽

Cruciate Ligament ◽

Private Insurance ◽

Return To Sports ◽

Resource Saving ◽

Quality Of Reporting ◽

Cross Sectional ◽

Anterior Cruciate

Background Evidence shows that after anterior cruciate ligament (ACL) reconstruction, patients may have varied access to physical therapy. In particular, physical therapy input may end many months before patients reach full recovery. Telerehabilitation may provide an opportunity to address this rehabilitation gap and improve access to evidence-based rehabilitation alongside physical therapy at all stages of care. Objective This study aims to understand the opinions of patients who have undergone ACL surgery and rehabilitation on the use of telerehabilitation as part of ACL care and define the population and explore their experiences and views on the acceptability of telerehabilitation after ACL reconstruction. Methods This study was a cross-sectional, voluntary, web-based survey combining both closed and open questions. Ethical approval was obtained from the Yale School of Medicine Institutional Review Board. Participants were aged 16 years or older at the time of recruitment and had undergone ACL reconstruction within the past 5 years. A 26-item survey was developed using the Qualtrics survey platform. No items were mandatory. Responses were multiple choice, binary, and qualitative. The CHERRIES (Checklist for Reporting Results of Internet E-Surveys) was used to ensure the quality of reporting of surveys in the medical literature. Data were analyzed using Stata version 15. Qualitative data were analyzed using NVivo 11. The theoretical framework for this analysis is based on the Capability, Opportunity, and Motivation-Behavior model of behavior change. Results A total of 100 participants opened the survey. All completers were unique. The participation and completion rates were each 96% (96/100). Patients reported their physical therapy care ended at an average of 6.4 months and that they felt fully recovered at an average of 13.2 months. Only 26% (25/96) of patients felt fully recovered at the end of physical therapy. Of these 96 patients, 54 (60%) were younger than 30 years, 71 (74%) were recreational athletes, 24 (24%) were competitive athletes, 72 (75%) had private insurance, 74 (77%) were not familiar at all with telerehabilitation, and 89% (85/96) felt capable. They preferred to use telerehabilitation at different stages of care. Reported benefits included resource saving, improved access to care, improved learning, and greater engagement. Concerns included incorrect performance of exercises or unmanaged pain being missed and less access to manual therapy, motivation, and opportunities to ask questions. Participants’ priorities for a future telerehabilitation intervention included its use as an adjunct to physical therapy rather than a replacement, with content available for each stage of care, especially return to sports. Participants stressed that the intervention should be personalized to them and include measures of progress. Conclusions These findings helped understand and define the ACL reconstruction population. Participants found telerehabilitation acceptable in principle and highlighted the key user requirements and scope of future interventions.

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Telerehabilitation to Address the Rehabilitation Gap in Anterior Cruciate Ligament Care: Survey of Patients (Preprint)

10.2196/preprints.19296 ◽

2020 ◽

Author(s):

Emma Dunphy ◽

Elizabeth C Gardner

Keyword(s):

Anterior Cruciate Ligament ◽

Physical Therapy ◽

Acl Reconstruction ◽

Cruciate Ligament ◽

Private Insurance ◽

Return To Sports ◽

Resource Saving ◽

Quality Of Reporting ◽

Cross Sectional ◽

Anterior Cruciate

BACKGROUND Evidence shows that after anterior cruciate ligament (ACL) reconstruction, patients may have varied access to physical therapy. In particular, physical therapy input may end many months before patients reach full recovery. Telerehabilitation may provide an opportunity to address this rehabilitation gap and improve access to evidence-based rehabilitation alongside physical therapy at all stages of care. OBJECTIVE This study aims to understand the opinions of patients who have undergone ACL surgery and rehabilitation on the use of telerehabilitation as part of ACL care and define the population and explore their experiences and views on the acceptability of telerehabilitation after ACL reconstruction. METHODS This study was a cross-sectional, voluntary, web-based survey combining both closed and open questions. Ethical approval was obtained from the Yale School of Medicine Institutional Review Board. Participants were aged 16 years or older at the time of recruitment and had undergone ACL reconstruction within the past 5 years. A 26-item survey was developed using the Qualtrics survey platform. No items were mandatory. Responses were multiple choice, binary, and qualitative. The CHERRIES (Checklist for Reporting Results of Internet E-Surveys) was used to ensure the quality of reporting of surveys in the medical literature. Data were analyzed using Stata version 15. Qualitative data were analyzed using NVivo 11. The theoretical framework for this analysis is based on the Capability, Opportunity, and Motivation-Behavior model of behavior change. RESULTS A total of 100 participants opened the survey. All completers were unique. The participation and completion rates were each 96% (96/100). Patients reported their physical therapy care ended at an average of 6.4 months and that they felt fully recovered at an average of 13.2 months. Only 26% (25/96) of patients felt fully recovered at the end of physical therapy. Of these 96 patients, 54 (60%) were younger than 30 years, 71 (74%) were recreational athletes, 24 (24%) were competitive athletes, 72 (75%) had private insurance, 74 (77%) were not familiar at all with telerehabilitation, and 89% (85/96) felt capable. They preferred to use telerehabilitation at different stages of care. Reported benefits included resource saving, improved access to care, improved learning, and greater engagement. Concerns included incorrect performance of exercises or unmanaged pain being missed and less access to manual therapy, motivation, and opportunities to ask questions. Participants’ priorities for a future telerehabilitation intervention included its use as an adjunct to physical therapy rather than a replacement, with content available for each stage of care, especially return to sports. Participants stressed that the intervention should be personalized to them and include measures of progress. CONCLUSIONS These findings helped understand and define the ACL reconstruction population. Participants found telerehabilitation acceptable in principle and highlighted the key user requirements and scope of future interventions.

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Nutritional Status and Causes of Anterior Cruciate Ligament Injury in Relation with Exercise Habit Among Patients of a Tertiary Care Hospital

Chattagram Maa-O-Shishu Hospital Medical College Journal ◽

10.3329/cmoshmcj.v13i3.21026 ◽

2014 ◽

Vol 13 (3) ◽

pp. 58-61

Author(s):

Khandker Masum Muktadir ◽

Md Monoarul Haque ◽

Shuhana Sultana ◽

Nadira Usmani ◽

Md Nazmus Sakib ◽

...

Keyword(s):

Anterior Cruciate Ligament ◽

Nutritional Status ◽

Cruciate Ligament ◽

Tertiary Care ◽

Regular Exercise ◽

Return To Sports ◽

Care Hospital ◽

Worst Case ◽

Exercise Habit ◽

Anterior Cruciate

Background: ACL injuries, is a serious problem in sports. Treatment of ACL injury is costly and it often takes 12 months or more to return to sports or in worst case and lead to early retirement. The long term outcome is also concerning issue. Objective: The goal of this study was to identify the nutritional status and causes of injury in relation with exercise habit among the patients with anterior cruciate ligament injury.Methods: A cross-sectional descriptive study was carried out in a super specialty modern tertiary care level hospital in Dhaka, Bangladesh. Total 63 samples were collected purposively to conduct this study. Data were collected through face to face interview by pretested semi-structured questionnaire and anthropometry was measured by standard technique. Prior data collection written consent was taken from the respondents. Descriptive as well as inferential statistics were used for data analysis.Results: The mean age (±SD) of the respondents was 27.52 (±7.59) years where 95.3% were male patients and 4.7% were female patients. Regarding their nutritional status, 23.8%, 55.6% and 20.6% were normal, over weight and obese respectively. Moreover 61.9% respondents had regular exercise habit whereas 38.1% respondents had no regular exercise habit. Besides there was no significant association (p>0.05) found between causes of injury and types of injury with exercise habit.Conclusion: Most of the patients were over nourished and no significant association was found between vehicle used and causes of injury. Further large scale study is needed to get actual picture.DOI: http://dx.doi.org/10.3329/cmoshmcj.v13i3.21026

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Impact of Insurance and Practice Type on Access to Orthopaedic Sports Medicine

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967120933696 ◽

2020 ◽

Vol 8 (7) ◽

pp. 232596712093369

Author(s):

Weilong Shi ◽

Albert Anastasio ◽

Ndeye F. Guisse ◽

Razan Faraj ◽

Omolola P. Fakunle ◽

...

Keyword(s):

Sports Medicine ◽

Cruciate Ligament ◽

Private Insurance ◽

Meniscal Tear ◽

The United States ◽

Cross Sectional Study ◽

Cross Sectional ◽

Orthopaedic Practice ◽

Telephone Calls ◽

Appointment Availability

Background: The Patient Protection Affordable Care Act has expanded Medicaid eligibility in recent years. However, the provisions of the act have not translated to improved Medicaid payments for specialists such as orthopaedic surgeons. The number of health care practitioners who accept Medicaid is already decreasing, with low reimbursement rates being cited as the primary reason for the trend. Hypothesis: Private practice orthopaedic groups will see patients with Medicaid or Medicare at lower rates than academic orthopaedic practices, and business days until appointment availability will be higher for patients with Medicaid and Medicare than those with private insurance. Study Design: Cross-sectional study. Methods: Researchers made calls to 2 regular-sized orthopaedic practices, 1 small orthopaedic practice, and 1 academic orthopaedic practice in each of the 50 states in the United States. Callers described a scenario of a recent injury resulting in a bucket-handle meniscal tear and an anterior cruciate ligament tear seen on magnetic resonance imaging at an outside emergency department. For a total of 194 practices, 3 separate telephone calls were made, each with a different insurance type. Data regarding insurance acceptance and business days until appointment were tabulated. Student t tests or analysis of variance for continuous data and χ2 or Fisher exact tests for categorical data were utilized. Results: After completing 582 telephone calls, it was determined that 31.4% (n = 59) did not accept Medicaid, compared with 2.2% (n = 4) not accepting Medicare and 1% (n = 1) not accepting private insurance ( P < .001). There was no significant association between type of practice and Medicaid refusal ( P = 0.12). Mean business days until appointment for Medicaid, Medicare, and private insurance were 5.3, 4.1, and 2.9, respectively ( P < .001). Conclusions: Access to care remains a significant burden for the Medicaid population, given a rate of Medicaid refusal of 32.2% across regular-sized orthopaedic practices. If Medicaid is accepted, time until appointment was significantly longer when compared with private insurance.

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Fixation of Traumatic Chondral-Only Fragments of the Knee in Pediatric and Adolescent Athletes: A Retrospective Multicenter Report

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967117753140 ◽

2018 ◽

Vol 6 (2) ◽

pp. 232596711775314 ◽

Cited By ~ 9

Author(s):

Peter D. Fabricant ◽

Yi-Meng Yen ◽

Dennis E. Kramer ◽

Mininder S. Kocher ◽

Lyle J. Micheli ◽

...

Keyword(s):

Case Reports ◽

Femoral Condyle ◽

Tertiary Care ◽

Case Series ◽

Return To Sports ◽

Adolescent Athletes ◽

Patient Registries ◽

Level Of Evidence ◽

Bioabsorbable Implants ◽

Clinical And Radiological Results

Background: While traditional biological principles have suggested that fragments consisting of cartilage alone cannot be reaffixed to bone with expectable long-term healing, case reports of successful healing after fixation in younger patients indicate that this concept remains incompletely explored. Purpose: To evaluate the presenting features, techniques, healing rates, and clinical and radiological results in a cohort of pediatric and adolescent athletes who underwent fixation of traumatic chondral-only fragments in the knee. Study Design: Case series; Level of evidence, 4. Methods: Patient registries at 2 tertiary care children’s hospitals were reviewed to identify patients ≤18 years old who underwent fixation of a “chondral-only” fragment in the knee, defined as the inability to visualize the fragment on injury radiographs or discern bone on the articular portion of a fragment intraoperatively. The mechanism of injury, fragment features, fixation technique, and postoperative clinical course, including timing of sports clearance, healing on postoperative magnetic resonance imaging (MRI), and any complications or reoperations, were assessed. Results: Fifteen patients with a median age at surgery of 12.7 years (interquartile range [IQR], 11.7-14.2 years) and median follow-up of 12.0 months (IQR, 6.0-19.2 months) were analyzed. All patients sustained an acute knee injury before surgery. The injured sites, as assessed on MRI, were the patella (n = 6), trochlea (n = 5), and lateral femoral condyle (n = 4). The median fragment surface area was 492.0 mm2 (IQR, 400.0-787.5 mm2). Fixation with bioabsorbable implants was performed in all patients at a median of 1.6 weeks (IQR, 1.0-2.6 weeks) after the injury. One patient (7%) sustained a fall 8 weeks postoperatively, requiring secondary surgery for excision of a dislodged fragment, and 1 patient (7%) underwent unrelated patellar stabilization surgery 3.4 years postoperatively, at which time the fragment was found to be stable. MRI was performed in 9 of 14 patients with retained fragments (median, 12.0 months postoperatively), with 5 patients (56%) showing restoration of the cartilage contour and the resolution of subchondral edema; 2 patients showed thinning but intact cartilage, 1 had cartilage thickening, and 1 had subchondral edema, fissuring, and cystic changes. The median time to return to sports for all 15 patients was 26.0 weeks (IQR, 22.8-40.9 weeks), including 2 patients who required second surgery and returned to sports at 26.1 and 191.1 weeks. Conclusion: Fixation of traumatic chondral-only fragments using bioabsorbable implants may result in successful short-term healing in the majority of pediatric and adolescent athletes.

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LIMB SYMMETRY IS NOT ENOUGH: ESTABLISHMENT OF HEIGHT NORMALIZED HOP DISTANCES WITHIN HEALTHY YOUTH ATHLETES

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967120s00190 ◽

2020 ◽

Vol 8 (4_suppl3) ◽

pp. 2325967120S0019

Author(s):

Elliot M. Greenberg ◽

Michael Karl ◽

Anne Leung ◽

J. Todd Lawrence ◽

Theodore Ganley

Keyword(s):

Test Performance ◽

Cruciate Ligament ◽

Body Height ◽

Age Groups ◽

Future Research ◽

Return To Sports ◽

Cross Sectional ◽

Sample Mean ◽

Youth Athletes ◽

Main Effect

Background: Most experts recommend utilizing single leg hop tests to help determine an athlete’s readiness to return to sports after anterior cruciate ligament reconstruction (ACLR). A limb symmetry index (LSI =involved limb/uninvolved limb) of ≥90% is typically required by most contemporary protocols. However, limb symmetry may underestimate continued post-operative deficits due to performance declines within the uninvolved limb after ACLR. Additionally, LSI may not accurately identify those at risk of repeat injury, and doesn’t assist in ensuring maximal patient effort. Comparing height normalized hop distances to uninjured controls has been suggested as an additional criteria to better recognize performance deficits after ACLR. Purpose: To characterize single leg hop test performance in a large group of healthy youth athletes and determine the relationships of sex or age on hop performance. Methods: This was a cross-sectional study of healthy youth athletes aged 8-14 years-old, who were currently participating in organized sports. Using their dominant leg, each subject performed a triple hop (TrH) in which they quickly hopped on one leg three times, achieving maximal linear distance, while holding their balance after the last hop. Distance from starting line to the heel was recorded in centimeters. Each subject’s hop distance was normalized to body height and served as the dependent variable. A two-way ANOVA analyzed any effects of age and sex. A-priori alpha was set at p≤0.05. Results: A total of 340 subjects (Male [n=184], mean age 10.9±1.5 years) were included. Across the entire sample, mean TrH distance was 2.2 times body height. ANOVA demonstrated no differences for main effect of sex (mean TrH/height, Males=2.2, Females=2.1, p=0.212). (Figure 1) Main effect of age was significant (p<0.001) with Bonferroni post-hoc analysis indicating 13 year-olds normalized TrH distance (2.6 times body height) was greater than all other age groups (8 yrs=1.9, 9yrs=2.0, 10yrs=2.1, 11yrs=2.2, 12yrs=2.3). (Figure 2) The 12 year-old performance was significantly greater than 8-9 year-olds only (2.3 vs 1.9-2.0). Conclusions: When normalized to body height, TrH performance increases around the ages of 12-13 years. Regardless of sex, athletes aged 8-11 can be expected to TrH approximately 2 times body height, while athletes near age 13 should have TrH values of 2.6 times body height. Due to post-operative deconditioning within the healthy limb, the use of age-matched hopping norms in addition to LSI may offer better determination of functional recovery or effort. As performance changes with age, future research should focus on establishing normative performance in older subjects. Figures/Tables: [Figure: see text][Figure: see text]

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Functional result of anterior cruciate ligament reconstruction by remnant preservation in a tertiary center in Eastern India

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20212429 ◽

2021 ◽

Vol 7 (4) ◽

pp. 820

Author(s):

Ritwik Ganguli ◽

Swagatam Jash

Keyword(s):

Anterior Cruciate Ligament ◽

Acl Reconstruction ◽

Cruciate Ligament ◽

Pivot Shift Test ◽

Return To Sports ◽

Lachman Test ◽

Remnant Preservation ◽

Graft Rupture ◽

Tertiary Center ◽

Anterior Cruciate

Background: Anterior cruciate ligament (ACL) reconstruction is one of the most common procedures in orthopaedics. Orthopaedic surgery is vastly evolving to give better functional outcome. Apart from stability, proprioception, ligament healing are important factors for return to sports. The presence of remnant containing mechanoreceptors and free neural endings can help reinnervate the ACL auto graft. Aims and objectives were to evaluate clinical outcomes in patients undergoing ACL reconstruction with remnant preservation.Methods: One hundred and six patients who underwent ACL reconstruction between April 2014 and March 2020. Among these 80 patients underwent remnant preservation. Analysis is done based on international knee documentation committee score (IKDC), modified Cincinnati knee rating system (MCKRS) and Tegner-Lysholm scoring system. Other factors are Lachman test, pivot shift test, return to sports and graft rupture rate.Results: Lachman test became negative in 98% at 12 weeks and in all the patients at 24 months post-operatively. 74 patients (92.5%) among 80 patients develop full range of knee movement after ACL surgery. Post-operative scores are 95, 93, and 92 respectively.Conclusions: Remnant preserving ACL reconstruction having excellent clinical outcome with good knee stability, early return to sports activities and no incidence of graft rupture in our series.

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SINGLE-LEG HOP TESTING AFTER ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION IS NOT PREDICTIVE OF GRAFT RUPTURE IN ADOLESCENT PATIENTS

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967120s00153 ◽

2020 ◽

Vol 8 (4_suppl3) ◽

pp. 2325967120S0015

Author(s):

Jie J Yao ◽

Jordan Snetselaar ◽

Gregory A. Schmale ◽

Michael Saper

Keyword(s):

Anterior Cruciate Ligament ◽

Acl Reconstruction ◽

Cruciate Ligament ◽

High Risk Population ◽

Entire Cohort ◽

Hop Tests ◽

Graft Rupture ◽

Adolescent Patients ◽

The Mean ◽

Anterior Cruciate

Background: Safe return to sport (RTS) after anterior cruciate ligament (ACL) reconstruction is difficult to determine in adolescent patients. Return of strength and dynamic knee stability can be assessed with functional single-leg hop testing as part of a formal RTS assessment. However, it is unclear whether performance during single-leg hop testing can predict future ACL graft rupture. Hypothesis/Purpose: To investigate differences in single-leg hop testing between adolescent patients who experienced a graft rupture after ACL reconstruction and those that did not. Methods: A retrospective review of adolescent patients whom underwent primary ACL reconstruction with a hamstring (HS) autograft identified 16 patients (10 girls, 6 boys) with single-leg hop testing data prior to graft failure. A nearest neighbor match algorithm was used to age-, sex-, surgeon-, and graft-match 16 patients without graft rupture. All patients followed a standardized rehabilitation protocol following surgery. As part of a formal RTS test, assessment of function and dynamic strength/stability was performed using 4 different single-leg hop tests: single hop for distance, triple hop for distance, triple crossover hop for distance, and timed hop. The recovery of muscle strength was defined by a limb symmetry index (LSI) ≥ 90%. Bivariate analyses were performed to compare the two groups. Results: The mean age of the entire cohort at the time of surgery was 14.6 ± 1.5 years. Patients completed their RTS test at 29.0 ± 5.4 weeks. There were no statistically significant differences in demographics, graft size, or time to RTS test between groups. There were no statistically significant differences in LSIs on the single hop (p=0.90), triple hop (p=0.36), crossover hop (p=0.41), or timed hop (p=0.48). The mean LSIs on each of the four hop tests were 92.3 ± 14.7, 95.1 ± 6.1, 95.8 ± 7.1, and 98.6 ± 7.9, respectively. Passing rates were similar between groups (p=0.54). Conclusion: Performance on single-leg hop tests 6 months after surgery is not predictive of graft rupture following ACL reconstruction with HS autograft in adolescent patients. Further investigation of alternative RTS measures and different time frames for testing in this high-risk population is needed.

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Clinico-demographic profile of deceased patients with coronavirus disease in a tertiary care centre of central India

International Journal of Community Medicine and Public Health ◽

10.18203/2394-6040.ijcmph20211777 ◽

2021 ◽

Vol 8 (5) ◽

pp. 2474

Author(s):

Rupali A. Patle ◽

Ashok R. Jadhao ◽

Priya B. Dhengre ◽

Manjusha A. Dhoble

Keyword(s):

Clinical Characteristics ◽

Tertiary Care ◽

Case Fatality ◽

Central India ◽

Cross Sectional Study ◽

Common Symptom ◽

Care Hospital ◽

Tertiary Care Centre ◽

Cross Sectional ◽

The Difference

Background: The covid pandemic started from Hubei, Wuhan in December 2020 then covered many other countries including India. Understanding the demographic and clinical characteristics of deceased COVID-19 patients could inform public health interventions focusing on preventing mortality due to COVID-19. The present study was done with the objective of studying the socio-demographic and clinical profile of deceased patients with coronavirus disease.Methods: This is a hospital based cross-sectional study on 1190 deceased patients of coronavirus disease in a tertiary care hospital of central India which is a dedicated covid hospital from 11 March 2020 to 28 February 2021. Socio-demographic and clinical characteristics of deceased patients were recorded.Results: Overall case fatality rate was 13.24%. Maximum number of deaths occurred in the month of August 2020 and September 2020 were 372 (31.26%) and 477 (40.08%). It was higher in the males 791 (66.47%) as compared to females 399 (33.53%), but the difference was not significant. The most common symptom was fever on hospitalization 924 (77.65%), followed by generalized weakness 771 (64.79%). 352 (29.58%) patients died within 24 hours of the admission to hospital. Hypertension and type 2 diabetes mellitus were the most prevalent morbidity in 557 (46.80%) and 357 (30.00%). It was found that 232 (19.50%) deceased patients had oxygen saturation less than 50% on admission.Conclusions: Higher age and presence of co-morbidities at the time of admission were significantly associated with mortality.

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Comparative study of intraocular pressure (IP) in Bangladeshi individuals by contact and non contact technique

Bangabandhu Sheikh Mujib Medical University Journal ◽

10.3329/bsmmuj.v8i1.28922 ◽

2016 ◽

Vol 8 (1) ◽

pp. 56

Author(s):

Sayed Abdul Wadud ◽

Md. Sharfuddin Ahmad ◽

Muntasir Bin Shahid

Keyword(s):

Intraocular Pressure ◽

Tertiary Care ◽

Cross Sectional Study ◽

Contact Method ◽

Tertiary Care Centre ◽

Cross Sectional ◽

Goldmann Applanation Tonometer ◽

Applanation Tonometer ◽

The Mean ◽

The Difference

Background: Intraocular pressure (IOP) is one of the most important parameters in the diagnosis and treatment of glaucoma. Glaucoma has been established as the second leading cause of blindness. The treatment of glaucoma focuses mainly on lowering intraocular pressure (IOP). The target IOP is often set to a level 20% to 30% of IOP reduction, and consequent large IOP reduction beyond 30% or even 40% in cases of advanced glaucoma The different methods of tonometery are: Goldman Applanation tonometery, Noncontact (air-puff) tonometery, Perkins tonometery, Tonopen tonometery, Transpalpebral tonometery.Objective: To determine the frequency of accuracy of intraocular pressure (IOP) measured by non-contact (air puff) tonometer compared with Goldmann applanation tonometer.Methods: This was a non-interventional, cross sectional study conducted at a tertiary care centre of Dhaka, Bangladesh. consecutive subjects attending the BSMMU eye OPD were included in the study. IOP was measured by non-contact (air puff) tonometer and a slit lamp mounted GAT in all the subjects. The study samples were selected by convenience sampling who presented for check-up in the Eye Department of community ophthalmology, Bangabandhu Sheikh Mujib Medical University, Dhaka. Bangladesh. Results:A total of 120 eyes in 60 patients were studied. The mean age of the patients was 41.60 year. study population consisted of 24 (40 %) men and 36 (60 %) women. The mean intraocular pressure was 13.52 &13.72 mmHg for GAT, and 16.64 & 17.44 mmHg for Air puff respectively. The range of measurements by GAT was from 10 to 23 mmHg and by Air puff was 12 to 28mmHg. The difference between IOP measured by two instruments were statistically significant (p=0.000).Conclusion: Airpuff tonometer is quick, a non-contact method to measure intraocular pressure and is useful for screening purposes and postoperative case but the measurements should be confirmed with Goldmann applanation tonometer for accurate labelling of intraocular pressure.

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