THE EFFECT OF PRE-OPERATION BASED EDUCATION ON ANXIETY REDUCTION AMONG PATIENTS WITH POST OPEN REDUCTION INTERNAL FIXATION

Open Reduction Internal Fixation (ORIF) is one ofthe management among patients who have a fracture.The study aimed at examining the effect of health education pre operation anxiety reduction among fracturing patients curries post open reduction internal fixation. A quasi-experimental, pre-test and post-test with non-equivalent control group was applied in this study. Thirty-four samples were recruited by using total sampling and divided into two intervention and control groups.Data analysis was performed and presented in descriptive statistics,and significant findings were computed using the paired t-test. Results: The results showethat the mean anxious level intervention group downhill from 28,76+4,603 to 16,61+2,487 after the intervention. Meanwhile,in the control group, the mean anxious level slightly downhill from 28,18+4,066 to 23,82+4,362. The paired t-test obtained a p-value of 0.000, indicating that there were significant differences in the decrease in anxiety level between the intervention and the control group. Conclusion: Preoperative health education interventions based on the health belief model can reduce the level of anxiety in patients with cruris fractures after ORIF surgery.The nurse profession is expected to be able to use preoperative health education actions based on the health belief model to become one of the independent nursing interventions

Combination of bone marrow aspirate, cancellous bone allograft, and platelet-rich plasma as an alternative solution to critical-sized diaphyseal bone defect: A case series

Introduction: Nonunion due to a critical-sized bone defect is a complicated problem. The healing process must fulfill three mandatory elements of osteogenesis, osteoinduction, and osteoconduction. One ideal source to provide an abundant number of osteogenic cells is from the process of the culture of bone marrow stem cells which demands the availability of processing facility. Unfortunately, this sophisticated option is not always feasible in every hospital in low-income to middle-income countries. We tried to fulfill the requirement of osteogenic cells by using simple and cost-effective bone marrow aspirate. We presented two cases of critical-sized diaphyseal bone defect treated with the combination of bone marrow aspirate, cancellous bone allograft, and platelet-rich plasma (PRP). Presentation of cases: The defect sizes were five and six centimeters in humerus and tibia respectively. We applied a combination of bone marrow aspirate, cancellous bone allograft, and PRP to promote bone healing in the defect sites. Both patients have achieved the good clinical and radiological outcome. Discussion: Critical-sized bone defects require the application of tissue engineering. Aspirated bone marrow can be used as a more affordable option to provide the element of osteogenic cells in bone healing. Combined with cancellous bone allograft and PRP, they fulfill the required ingredients to promote bone regeneration. Conclusion: Bone defects remain one of the most challenging conditions to treat in orthopedic. There are many options to treat the defect but the fundamental prerequisites of cells, scaffolds and growth factors for healing have developed into the concept of tissue engineering: osteogenesis, osteoinduction, and osteoconduction

Effect of Decellularized Cartilage Bovine Scaffold and Hypoxic Condition on Stem Cell Differentiation to Chondrocyte: An In Vitro Study

Autologous Chondrocyte Implantation (ACI) has been established for years to treat cartilage defect. Application of tissue engineering has advantages over ACI as tissue engineering requires simpler procedures without leaving morbidity at the donor site. Decellularized bovine cartilage scaffold and hypoxic stem cell differentiation were used in this in vitro experimental study. Comparative test was done between three study groups using bone marrow mesenchymal stem cells treated in three different conditions: growth factor-rich chondrogenic medium, scaffold without growth factor, and combination of both. Each group was given two oxygen tension conditions of normoxia and hypoxic within phase of stem cell differentiation. Immunohistochemical examinations on SOX9, RUNX2, and collagen type II were done for evaluation. After 5-week treatment, the result showed that the highest expression SOX9 and collagen type II were found within the group that used the combination of both scaffold and chondrogenic medium in hypoxic condition. Collagen type II expression in scaffold without additional growth factor showed no statistically significant difference compared with the combination group in hypoxic condition. Cartilage tissue engineering has proven its effectiveness for cartilage regeneration. Decellularized biomaterial scaffold limited the use of growth factor resulting in better cost and resource efficiency

Influence of Thermal Cycling Temperature on the Recrystallization of Cold Rolled Stainless Steel 316L

Investment casting of an orthopedic implant plate based on stainless steel 316L was considered an economical process. Nevertheless, the mechanical properties of the investment casting product were found to be inferior as compared to the implant plate fabricated with other methods such as forging due to their differences in the microstructure. Investment casting mostly produced coarser grain as compared to those with forging or rolled process. In order to improve their mechanical properties, cold-rolling followed by a repetitive thermal cycling process is proposed. The goal is to generate finer grain size through recrystallization process leading to nucleation of new grain during the thermal cycling process thus increasing their strength. Stainless steel 316L was cold-rolled to 52% reduction in thickness and this process generate stored strain energy in the form of dislocation density in the material. The thermal cycling treatment performed within several cycles after cold rolling enabling gradual disperse of stored strain energy that facilitates the recrystallization process that initiates new grain formation. The short holding time within several cycles limits the grain growth that normally occurs during annealing. It was found that thermal cycling treatment at a temperature of 950 °C for 35 seconds within four cycles led to the formation of finer grain size of 22 µm on average as compared to the initial investment casting average grain size of 290 µm. The hardness also increases to 253 HV0.3 in this condition as compared to 155 HV0.3 of investment casting products. Lower thermal cycling temperature than 950 °C during the test did not result in grain refinement thus indicating that strain energy relieves were not enough to aid the recrystallization process