Epidemiološki pokazatelji i sprečavanje trauma s posljedicom amputacije prsta: studija bolničkih podataka

Traumatic finger amputation is a widespread preventable public health problem. This study aimed to define the epidemiology of finger amputations to identify important related factors in order to suggest pertinent prevention strategies. A cross-sectional study was conducted in 2015 at the main orthopedic referral university hospital of Shiraz. All patients with any type of traumatic finger amputation were included. For each patient a questionnaire including demographic and injury characteristics was filled and analyzed. One hundred patients (92 men and 8 women, mean age: 32.5 ± 18 years) were enrolled. The vast majority of subjects were young men, more than half (53 cases) sustained occupation-related injuries during working time. Finger amputation following severe jammed finger in door was the second most frequent damage (18 %). Approximately 59% of victims labeled inattention during work as the reason of injury. Finger amputations in right hand were equal in frequency to the left one. Amputation of the index and middle fingers were seen as the most common amputated fingers in hands, 27% and 26% respectively. It was found that young beginner worker man with low educational level is at the highest risk of traumatic finger amputation especially with positive history of drug abusing. So, effective interventions such as closer supervision, more training programs, detection of drug addiction, and using safe engineering machines are urgently needed.Amputacija prsta čest je javnozdravstveni problem koji je moguće spriječiti. Studija definira epidemiologiju amputacije prsta kako bi se utvrdili najvažniji čimbenici i predložila strategija prevencije. Studija je provedena 2015. u glavnoj sveučilišnoj ortopedskoj bolnici u Shirazu. U studiju su bili uključeni svi bolesnici s bilo kojom vrstom amputacije prsta. Za svakog bolesnika je popunjen i analiziran upitnik s demografskim podacima i tipom ozljede. Sudjelovalo je 100 bolesnika (92 muškarca i 9 žena, prosječne dobi 32.5 ± 18 godina). Najveći broj bolesnika bili su mlađi muškarci. Više od polovice (53 slučaja) pretrpjeli su ozljede na radu u vezi s radom. Amputacija prsta zbog nagnječenja u vratima bila je drugi najčešći uzrok amputacije (18 %). Približno 59 % ozlijeđenih navelo je nepažnju pri radu kao uzrok nezgode. Amputacije prsta desne ruke bile su brojčano jednake amputacijama na lijevoj ruci. Najviše je bilo amputacija kažiprsta (27 %) i srednjeg prsta (2 %). Utvrđeno je da su mlađi, slabije obrazovani muškarci te početnici na poslu podložni najvećem riziku od amputacije prstiju, naročito ako imaju povijest zlouporabe droga. Hitno je potrebno provesti sljedeće učinkovite mjere: veći nadzor, više programa osposobljavanja, otkrivanje ovisnosti o drogama i korištenje sigurnijih strojeva

Author’s Reply to Prevalence of Visual Impairment in School Children

This is a Reply Letter and does not have an abstract

Visual Impairment Prevalence, Causes, and Role of Healthcare Access: A Systematic Review and Meta-Analysis in Iran

Purpose. Healthcare access is one of the determinants of visual impairment (VI), as a public health problem. The objective of this study was to estimate VI prevalence, related causes, and its correlation with access to physicians in Iran. Methods: This systematic review and meta-analysis include observational studies published in Iran. PubMed, Web of Science, Scopus, Google Scholar, and local databases were systematically searched by using the MeSH headings. Data on the provincial distribution of physicians, as an index of access to healthcare, was retrieved. A random-effect meta-analysis was performed to assess. Results. Eight articles were included. The pooled prevalence of blindness, low vision, and VI was 0.80% (95% CI: 0.61–0.99%), 2.92% (95% CI: 2.40–3.44%), and 5.57% (95% CI: 4.71–6.43%). Refractive errors were the most common causes of VI based on PVA with the pooled prevalence of 54.6% (95% CI: 43.4–65.8%). Based on BCVA, we found that the pooled prevalence of cataracts was 37.4% (95% CI: 29.5–45.3%) as the most common cause of VI. The results of metaregression showed that the greater number of general practitioners (GPs) (P value=0.01) and pharmacists (P value=0.024) per population were associated with a lower prevalence of blindness. Conclusion. Some of the main causes of visual impairment in Iran are preventable. Access to healthcare services may lead to early diagnosis of preventable causes of VI. Further well-designed studies and national surveys should be conducted to provide accurate data from different regions of Iran

Osteoporosis guideline awareness among Iranian nurses: results of a knowledge and attitudes surveyIntroduction: Osteoporosis is a chronic and progressive disease associated with gradual bone loss and elevated risk of fracture. Role of health care profess

Introduction: Osteoporosis is a chronic and progressive disease associated with gradual bone loss and elevated risk of fracture. Role of health care professional especially nurses in lowering burden of osteoporosis via patients and public education is critical. Current study conducted to evaluate knowledge and belief regarding osteoporosis among the nurses in orthopedic wards and their experience with national clinical osteoporosis guideline. Methods: A cross-sectional study was conducted from August to December 2016 among all nurses in orthopedic ward of hospitals affiliated to Shiraz University of Medical Sciences. The 23- item self-administered scale consisted of knowledge and belief questions was used. Moreover, data regarding participation in osteoporosis training courses and awareness of the national osteoporosis clinical guideline were collected. The gathered data were analyzed using SPSS (V. 16), p-value < 0.05 was considered statistically significant.  Results: From total of 160 nurses, 143 of them completed the questionnaire (response rate: 89.3%). Six nurses (4.2%) had participated in osteoporosis training courses after graduation, and 39 (27.3%) had been aware of the national osteoporosis clinical guideline. The median total knowledge score was 11 out of the maximum of 18 points, and 35.0% of the participants scored above this value. In belief, most of nurses had positive attitude about necessity of osteoporosis screening and patient education.  However, only 29 (20.3%) of them confident in giving counselling to public and patients.    Conclusion: Our findings reveal that we need more empowered nurses to lowering burden of osteoporosis and its consequences in the future

MORTALITY AND FUNCTION AFTER SURGICALLY-TREATED HIP FRACTURE IN ADULTS YOUNGER THAN AGE 60

<div><p>ABSTRACT Objective: Hip fractures in young adults can cause poor functional capacity throughout life because of several complications. The purpose of this study was to prospectively evaluate 1-year mortality and functional outcomes for patients aged 60 years or younger with hip fracture . Methods: We prospectively obtained data for all consecutive patients aged 60 or younger with any type of hip fracture who were treated operatively between 2008 and 2014. After one year, patient outcomes were evaluated according to changes in pain severity, functional status (modified Barthel index), and mortality rate . Results: Of the total of 201 patients, 132 (65.7%) were men (mean age: 41.8 years) and 69 (34.3%) were women (mean age: 50.2 years) (p<0.001). Reduced pain severity was reported in 91.5% of the patients. The mean modified Barthel index was 22.3 in men and 18.6 in women (p<0.001). At the one-year follow-up, 39 cases (19.4%) were dependent on walking aids while only 17 patients (8.5%) used walking aids preoperatively (p<0.001). Seven patients (4 men and 3 women) died during the one-year follow-up period; 2 died in the hospital after surgery . Conclusion: Hip fractures in young adults have a low mortality rate, reduction in pain severity, and acceptable functional outcomes one year after surgery. Level of Evidence II, Prospective Comparative Study.</p></div