EVALUATION OF EFFICACY OF DIFFERENT MODALITIES IN TREATMENT OF FRACTURE METATARSAL

Objectives: This study mainly aims to evaluate the efficacy of three different modalities in treatment of fracture metatarsal. Methods: A hospital-based prospective comparative study was conducted in Mahatma Gandhi Medical College, Jaipur, from December 2018 to June 2020, involving 50 patients above 16 years of age presented with isolated metatarsal fractures and grade I open fractures were included in the study. Patients fulfilling the inclusion criteria were then allocated to one of three groups. Group A – Conservative management, Group B – K-wire fixation, and Group C – external Fixator. Outcome measurement was done using AOFAS MID FOOT SCALE (100 points total). Results: Majority of 29 patients belong to 35–60 years of age group followed by 18 patients in 26–35 years. Maximum number of cases is reported in male category that was 45 cases. Majority of the cases falls under the category of road traffic accidents that are 28 cases which is about 56% of the total cases. In 37 cases right foot was involved, whereas 13 cases are on the left side, suggesting the right was the dominant side. About 48% of the second metatarsal and 30% of the third metatarsal showed the maximum involvement. Maximum number of cases were designated as excellent having score between 90 and 100 that was about 38 cases which are 76% of total cases suggesting every treatment modality was good in its own right. There was a significant difference between the different treatment modalities at final follow-up p<0.05. Conclusion: All treatment modalities equally good, achieving good fracture union, decreased incidence of pain, and achieve a good range of movements, but complications rate was more in the conservative group as compared to other groups.

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DeVega versus ring annuloplasty in severe functional tricuspid insufficiency and their impact on the right ventricle

The Egyptian Cardiothoracic Surgeon ◽

10.35810/ects.v1i4.89 ◽

2019 ◽

Vol 1 (4) ◽

pp. 133-139

Author(s):

Yasser Hamdy ◽

Mohammed Mahmoud Mostafa ◽

Ahmed Elminshawy

Keyword(s):

Right Ventricular ◽

Tricuspid Valve ◽

Tricuspid Regurgitation ◽

Early Postoperative Period ◽

Tricuspid Valve Repair ◽

Ring Annuloplasty ◽

Significant Difference ◽

Group A ◽

Group B ◽

The Right

Background: Functional tricuspid valve regurgitation secondary to left-sided valve disease is common. DeVega repair is simple, but residual regurgitation with subsequent impairment of the right ventricular function is a concern. This study aims to compare tricuspid valve repair using DeVega vs. ring annuloplasty and their impact on the right ventricle in the early postoperative period and after six months. Methods: This is a prospective cohort study of 51 patients with rheumatic heart disease who underwent tricuspid valve repair for secondary severe tricuspid regurgitation. Patients were divided into two groups: group A; DeVega repair (n=34) and group B; ring annuloplasty repair (n=17). Patients were assessed clinically and by echocardiography before discharge and after six months for the degree of tricuspid regurgitation, right ventricular diameter and tricuspid annular plane systolic excursion (TAPSE). Results: Preoperative echocardiographic assessment showed no difference in left ventricular end-systolic diameter, end-diastolic diameter, ejection fraction and right ventricular diameter, however; group A had significantly better preoperative right ventricular function measured by TAPSE (1.96 ± 0.27 vs1.75 ± 0.31 cm; p=0.02). Group B had significantly longer cardiopulmonary bypass time (127.65 ± 13.56 vs. 111.74 ± 18.74 minutes; p= 0.003) and ischemic time (99.06 ± 11.80 vs. 87.15 ± 16.01 minutes; p= 0.009). Pre-discharge, there was no statistically significant difference in the degree of tricuspid regurgitation, but the right ventricular diameter was significantly lower in group B (2.66 ± 0.41 and 2.40 ± 0.48 cm; p=0.049). After six months of follow up, the degree of tricuspid regurgitation (p= 0.029) and the right ventricular diameter were significantly lower in the ring annuloplasty group (2.56 ± 0.39 and 2.29 ± 0.44 cm; p=0.029). Although there was a statistically significant difference in preoperative TAPSE, this difference disappeared after six months. Conclusion: Both DeVega and ring annuloplasty techniques were effective in the early postoperative period, ring annuloplasty was associated with lesser residual regurgitation and better right ventricular remodeling in severe functional tricuspid regurgitation than DeVega procedure after 6-months of follow up.

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A COMPARATIVE STUDY TO DETERMINE THE KNEE JOINT FUNCTIONAL OUTCOME IN PATIENTS WITH FEMUR SHAFT FRACTURES MANAGED OPERATIVELY OR CONSEVATELY AT NDOLA HOSPITAL:complete enumeration (Preprint)

10.2196/preprints.16905 ◽

2019 ◽

Author(s):

Ripedah Nakana

Keyword(s):

Knee Joint ◽

Functional Outcome ◽

Road Traffic ◽

Femur Fracture ◽

Conservative Group ◽

Femur Fractures ◽

Shaft Fractures ◽

Significant Difference ◽

Femur Shaft ◽

Femur Shaft Fractures

BACKGROUND According to WHO, It has been reported that there has been a rise in road traffic accidents globally due to many factors. Consequently this has contributed to an increase in fracture of the femur in hospitals. The annual incidence of these Fractures has been estimated to be 10 per 100,000 persons and this incidence has been noticed to be higher among the youths decreasing after the age of 40 and then increasing in the elderly. These fractures are either managed conservatively or operatively. OBJECTIVE the aim of this study was to determine if there is a significant difference in knee joint functional outcome in patients with femur shaft fractures managed operatively and conservatively at Ndola Teaching Hospital at the orthopedics clinic and physiotherapy. This in future might help to place emphasis on government to sensitize the right measures needed to improve on the functional outcome of a knee joint in patients with femur fracture who are treated operatively or conservatively METHODS the method used for the study was a complete enumeration of all patients with femur fractures that were admitted at orthopedic ward, visited the orthopedic clinic and physiotherapy sessions at NTH between the period of July 2019 to September 2019. Data collected will be analyzed using a statistical data software called Statistical Package of Social Sciences (SPSS). The independent variable that will be considered in the study are age, DOI, DOA, femur shaft fractures, treatment and others that that will meet the selection Criteria. The dependent variable will be “Knee Joint Functional Outcome”. RESULTS Results did not show statistically significant difference in knee functional outcome for two methods (conservative or operative). In the current study it was noted that there was much reduction in swelling in the operative in comparison to the conservative group. We may therefore conclude that the operative management promises a better outcome especially when done on time. However it seemed the operative procedure was not preferred for any conservative approach however the study has shown an in depth feasibility study to affirm such findings in order to inform on policy or management paradigim shift. CONCLUSIONS There is need for further intervention in the management of femur fracture which complicates to poor knee joint function

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A Comparative Study of Epidemiology, Clinicopathologic Features and Outcome of Colorectal Cancer Patients between Ain Shams University Hospitals and Luxor International Hospital

QJM ◽

10.1093/qjmed/hcab103.005 ◽

2021 ◽

Vol 114 (Supplement_1) ◽

Author(s):

Tarek Hussein Kamel ◽

Amr Lotfy Farag ◽

Dr/Sherif Hassanin Ahmed ◽

Chresteen Talaat Samy Hanna

Keyword(s):

Colorectal Cancer ◽

Comparative Study ◽

Disease Free Survival ◽

University Hospital ◽

Treatment Modalities ◽

Clinicopathologic Features ◽

Free Survival ◽

Significant Difference ◽

Group A ◽

Group B

Abstract Background Colorectal cancer (CRC) is one of the leading causes of mortality and morbidity in the world. It is the third most common malignancy after lung & breast and the fourth leading cause of cancer-related deaths worldwide, accounting for approximately 1,400,000 new cases and about 700,000 deaths worldwide. Objectives The aim of this retrospective study is to compare the epidemiology, clinicopathologic features, different treatment modalities and outcomes regarding disease free survival (DFS), progression free survival (PFS) & overall survival (OS) of colorectal cancer disease between cases presented to Ain shams university hospital & to Luxor international hospital in 3 consecutive years. Patients and Methods The study is retrospective comparative study. Clinical oncology department in Ain Shams University Hospital and Luxor International Hospital. The data Collected from January 2013 to December 2015. This study analyzed hospital records of patients who diagnosed with colorectal cancer (CRC) and allocated into two groups: Group A: CRC patients presented to Ain-Shams University Hospital from January 2013 to December 2015, group B: CRC patients presented to Luxor International Hospital from January 2013 to December 2015. Results There was no statistically significant difference regarding age parameter in LIH when compared to ASU, but the study was consistent with higher incidence in patients who were aged more than forty- accounted about 70.5% in all CRC cases. Cases less than 40 years old, in group A were 35.2%, while in Group B were 23.5%. Even there was no statistically significant difference but it may be attributable to more westernization in Lower Egypt. Other explanation may be due to decreased low socioeconomic status and different lifestyle factors in more developing region what increase risk of colorectal cancer. Among our cases, there is no statistically significant difference regarding gender between the two hospitals. Both sexes almost were affected equally, females appeared to be at a slightly higher risk of developing CRC cancer with current prevalence 1.3:1 in ASU group, and 1.1:1 in LIH group. Conclusion The need to increase awareness about CRC in Egypt especially upper Egypt, is recommended. An awareness campaign should be performed to promote detection of CRC at its earliest and most curable stage by recognizing early symptoms and enabling early referrals for colonoscopy. Those at higher risk should be offered more intensive surveillance. Similarity of the data from different centers suggests that this is the picture of colorectal cancer typical of Egypt.

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Surgery for primary intracerebral haemorrhage: is it safe and effective?

Bangladesh Medical Research Council Bulletin ◽

10.3329/bmrcb.v38i3.14328 ◽

2013 ◽

Vol 38 (3) ◽

pp. 74-78

Author(s):

MMH Talukder ◽

KMT Islam ◽

M Hossain ◽

MU Jahan ◽

F Mahmood ◽

...

Keyword(s):

Intracerebral Haemorrhage ◽

Glasgow Outcome Scale ◽

Control Group ◽

Intracerebral Haematoma ◽

College Hospital ◽

Conservative Group ◽

Best Medical Treatment ◽

Significant Difference ◽

Group A ◽

Group B

This prospective study was conducted to compare the outcome between medical and surgical treatment of primary intracerebral haemorrhage at the department of Neurosurgery, Dhaka Medical College Hospital from January 2006 to October 2007. All patients with primary intracerebral haematoma with Glasgow Coma Scale (GCS) 5-15 (on admission) and heamatoma volume 30 cc or above admitted at Neurosurgery department managed conservatively or surgically were included in this study. Total 60 patients were selected, of them 30 patients managed conservatively and 30 patients managed surgically. Conservatively managed patients regarded as control group (Group-A) and surgically managed patients regarded as experimental group (Group-B). Patients or attendants refused to operate were included in the conservative group. All the selected patients were evaluated on the basis of detailed history, clinical examination (general and neurological examination) and CT scan findings. Outcome was evaluated in term of Glasgow Outcome Scale (GOS). Best medical treatment was given for conservative group and operations were done for surgical group and followed up after surgery till discharge by observing GCS and GOS at discharge. Number of death were 15 (50%) patients in group- A and 13 (43%) patients in group-B. There was no significant difference in mortality rate between two groups but outcome was relatively better in group-B. According to Glasgow Outcome Scale, dependency in group-A and group-B was 26.6% and 23.4% respectively. So dependency were more in group-A. But there was no significant difference statistically. Seven (23.4%) patients were independent in group-A but 10(43.3%) patients were independent in group-B. However in relative terms of outcome of group-B was better than that of group-A. In our study we found no statistically significant difference in outcome between medical and surgical management of primary intracerebral haemorrhage. DOI: http://dx.doi.org/10.3329/bmrcb.v38i3.14328 Bangladesh Med Res Counc Bull 2012; 38(3): 74-78 (December)

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TRAFFIC-RELATED MORTALITY IN MOLDOVA

Economy and sociology ◽

10.36004/nier.es.2020.2-12 ◽

2020 ◽

pp. 140-147

Keyword(s):

Life Expectancy ◽

Traffic Accident ◽

Traffic Accidents ◽

Road Traffic ◽

Road Accident ◽

Road Accidents ◽

Continuous Increase ◽

Risk Of Death ◽

Significant Difference ◽

Related Mortality

This article analyses the mortality caused by road accidents in Moldova depending on the degree of involvement of pedestrians, cyclists, motorcyclists, drivers and passengers of transport units, depending on age and sex. Results suggest that traffic-related mortality in Moldova has shown an increased incidence among the young and working-age population, where a significant difference between males and females is observed. Among the youth, traffic-related deaths register between 10-27% of the overall mortality in both sexes. The risk exposure of dying in a traffic accident decreases with age and is less significant in the retired ages. During the years 1998-2015, avoidance of trafficrelated deaths would have assured an increase in life expectancy between 0.40-0.56 years in males, and 0.09-0.23 years in females. The continuous increase in the number of transport units on public roads, as well as in the number of hours spent in traffic, influences the degree of exposure to the risk of death or injury as a result of road traffic accidents. Trauma resulting from road accidents increases the incidence of premature mortality and disability among the population, which is reflected by the decrease of healthy life expectancy. It is ascertained that the road accident mortality requires a detailed and comprehensive analysis given the multitude of factors influencing deaths and injuries related to a traffic accident among the population. Thus, in order to improve road safety and reduce mortality incidence among traffic participants, a range of actions has to be implemented by the liable actors, including through the international experience.

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The Victims of Road Traffic in the Territory of Kosovo and the Way of Their Compensation-Indemnity

ILIRIA International Review ◽

10.21113/iir.v4i2.38 ◽

2016 ◽

Vol 4 (2) ◽

pp. 163

Author(s):

MSc. Halim Kuliqi

Keyword(s):

Traffic Accident ◽

Traffic Accidents ◽

Road Traffic ◽

Comparative Method ◽

Theory And Practice ◽

Road Traffic Accidents ◽

The Road ◽

Large Numbers ◽

The Right

Taking into account the fact that in the world the road traffic accidents happen very often and go up to very large numbers, which often are also very disturbing, then there is an indispensable need to study this problem, because without identifying the problem and its causes then it can neither be fought nor prevented.The significance of this paper lays on the presentation of some data regarding the number of accidents and their victims, the ways of compensation for the damage and the presentation of some measures in order to protect the victims of accidents from secondary victimization.This paper fills a scientific gap for victims of accidents and their way of compensation, which until now for the case of Kosovo has been not addressed significantly in terms of theory and practice also. For the presentation and the development of this issue have been used statistical method, comparative method and among others also the case study methods.In other words, the main purpose of this paper is to present data that expose the difficulties for the realization of the right of victims after suffering accidents and also to propose some norms that would protect the victims from secondary victimization, as victims after suffering a traffic accident may be hurt again until the realization of their demand for compensation according to the law.

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Evidence-based treatment of osteoporotic vertebral compression fracture

Journal of Korean Medical Association ◽

10.5124/jkma.2021.64.3.200 ◽

2021 ◽

Vol 64 (3) ◽

pp. 200-207

Author(s):

Subum Lee ◽

Dae-Chul Cho ◽

Kyong-Tae Kim ◽

Young-Seok Lee

Keyword(s):

Surgical Treatment ◽

Outcome Measurement ◽

Treatment Guideline ◽

Treatment Modalities ◽

Vertebral Compression Fractures ◽

Controlled Trials ◽

Evidence Based ◽

Evidence Based Treatment ◽

Significant Difference ◽

Non Surgical Treatment

The prevalence and medical costs of osteoporotic vertebral compression fractures (OVCFs) are on the rise. However, a concrete evidence-based treatment guideline has not yet been established. Despite that numerous randomized controlled trials (RCTs) were performed, the study design and outcome measurement were heterogeneous, and the results were not unified. The purpose of this review is to compare the results of high level-evidence studies to provide a background for evidence-based OVCF treatment. Many reports showed that vertebroplasty has better clinical outcomes than non-surgical treatment for OVCF, but the results of three double-blinded RCTs with the highest level of evidence did not show a significant difference between vertebroplasty and sham procedure. Whether undergoing surgical or non-surgical treatment, OVCF patient management should be started by managing osteoporosis first. Meanwhile, in the results of RCTs related to the comparison of conservative treatment modalities, the benefit of braces and a specific analgesic prescription protocol was also unclear. The presented results of each clinical trial were generally inconsistent and may not be appropriate in all situations. Any decision by clinicians to apply this evidence must be made considering individual patients and available resources. At present, controversy remains about the best treatment modality for OVCF. Large, multicenter, placebo/sham-controlled trials are needed to address this gap and establish strong evidence-based guidelines.

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40 days and 40 nights: Clinical characteristics of major trauma and orthopaedic injury comparing the incubation and lockdown phases of COVID-19 infection

Bone & Joint Open ◽

10.1302/2046-3758.17.bjo-2020-0068.r1 ◽

2020 ◽

Vol 1 (7) ◽

pp. 330-338 ◽

Cited By ~ 1

Author(s):

Bisola Ajayi ◽

Alex Trompeter ◽

Magnus Arnander ◽

Philip Sedgwick ◽

Darren F. Lui

Keyword(s):

Clinical Characteristics ◽

Traffic Accidents ◽

Major Trauma ◽

Road Traffic ◽

Trauma Centre ◽

Orthopaedic Patients ◽

Major Trauma Centre ◽

Group A ◽

Group B ◽

The Uk

Aims The first death in the UK caused by COVID-19 occurred on 5 March 2020. We aim to describe the clinical characteristics and outcomes of major trauma and orthopaedic patients admitted in the early COVID-19 era. Methods A prospective trauma registry was reviewed at a Level 1 Major Trauma Centre. We divided patients into Group A, 40 days prior to 5 March 2020, and into Group B, 40 days after. Results A total of 657 consecutive trauma and orthopaedic patients were identified with a mean age of 55 years (8 to 98; standard deviation (SD) 22.52) and 393 (59.8%) were males. In all, 344 (approximately 50%) of admissions were major trauma. Group A had 421 patients, decreasing to 236 patients in Group B (36%). Mechanism of injury (MOI) was commonly a fall in 351 (52.4%) patients, but road traffic accidents (RTAs) increased from 56 (13.3%) in group A to 51 (21.6%) in group B (p = 0.030). ICU admissions decreased from 26 (6.2%) in group A to 5 (2.1%) in group B. Overall, 39 patients tested positive for COVID-19 with mean age of 73 years (28 to 98; SD 17.99) and 22 (56.4%) males. Common symptoms were dyspnoea, dry cough, and pyrexia. Of these patients, 27 (69.2%) were nosocomial infections and two (5.1%) of these patients required intensive care unit (ICU) admission with 8/39 mortality (20.5%). Of the patients who died, 50% were older and had underlying comorbidities (hypertension and cardiovascular disease, dementia, arthritis). Conclusion Trauma admissions decreased in the lockdown phase with an increased incidence of RTAs. Nosocomial infection was common in 27 (69.2%) of those with COVID-19. Symptoms and comorbidities were consistent with previous reports with noted inclusion of dementia and arthritis. The mortality rate of trauma and COVID-19 was 20.5%, mainly in octogenarians, and COVID-19 surgical mortality was 15.4%. Cite this article: Bone Joint Open 2020;1-7:330–338.

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Most Frequently Affected Body parts in Road Traffic Accidents Reporting to the Accident and Emergency Department of the Largest Tertiary Care hospital of Karachi in 2019

Journal of Community Health Research ◽

10.18502/jchr.v10i3.7279 ◽

2021 ◽

Author(s):

Zaeema Ahmer ◽

Aisha Siddiqui

Keyword(s):

Traffic Accidents ◽

Road Traffic ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Care Hospital ◽

Body Parts ◽

Road Traffic Accidents ◽

Accident And Emergency ◽

Significant Difference ◽

Study Participants

Introduction Injuries sustained during Road Traffic Accidents (RTAs) amounts to a serious public health crisis. The aim of the study was to determine the body parts most likely affected in an RTA in patients brought to Accident and Emergency (A&E) department of Jinnah Postgraduate Medical Centre (JPMC), the largest tertiary care hospital of Karachi. Method A descriptive cross-sectional study was done in January-March 2019 among 371 respondents aged 15-65 years. Study participants were recruited through non-probability convenience sampling. A structured questionnaire was used to collect data on sociodemographic variables and type, severity and nature of injury. Chi Square test was used to determine the significant difference between using safety precautions with body parts affected. All analysis was performed on SPSS version 20. Results Out of 371 study participants, 64.4% (n=239) were between 15-35 years with 91.9% (n=338) males. In 77.1% (n=286) cases, emergency medical services responded in less than one hour and first aid was provided by doctor to 95.7% (n=355) at hospital. In 82.5% (n=306) cases, private vehicles were involved, with 46.1% (n=171) motorcycles. In 79.8% (n=296) cases, bone injury was prevalent, with 57.1% (n=212) leg injuries, which was the most frequently affected body part. Majority, 56.2% of the study participants who did not wear seat belts had chest area affected (p=0.006). Conclusion It is concluded that males of 15-35 years who were motorcyclists were more prone to RTAs with lower limbs more frequently being affected. Safety precautions like wearing seatbelts provide protection against RTAs.

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