Assessment and diagnosis of acute limb compartment syndrome: A literature review

Background: Compartment syndrome is a collection of symptoms that signal increased pressure in the muscle compartment and results in compromised tissue perfusion. Failure to diagnose and treat the condition can result in permanent neurovascular deficit, tissue ischaemia, limb amputation and rhabdomyolysis. Aims: The aim of the review was to determine the strength of the evidence regarding risk reduction and early detection of ALCS and to identify the gaps in the evidence. Methods: Following a systematic search, literature about patient risk, risk reduction, clinical observation and compartment monitoring was identified and the methodological quality of studies was considered. Findings: Diaphyseal fractures of the tibia are the most significant risk factor for compartment syndrome followed by fracture of the distal radius. The anterior compartment of the leg and the flexor compartment of the forearm are most affected. Other factors include calcaneal fractures, male gender, age <35 years, high energy trauma, soft tissue injuries (especially in patients with bleeding disorders), open fracture, limb compression due to traction, padding and casts and surgical management of fractures. Males aged below 35 years who sustain a fracture of the lower leg or forearm should be monitored most carefully. Clinical observations, together with compartment pressure monitoring, in patients at risk appears to be the best method of diagnosing the condition. Pain out of proportion to the injury and pain on passive muscle stretch are the most effective clinical observation in conscious patients. Paresis/paralysis, parasthesia and pallor may help in diagnosis but are late signs. The sensitivity and specificity of these symptoms in diagnosing ALCS is unclear and the approach to pain assessment is not considered in detail

Book review: The sociology of South Asian women’s health edited by Sara Rizvi Jafree

In The Sociology of South Asian Women’s Health, Sara Rizvi Jafree brings together contributors to explore gender inequity in health access in South Asia and the inadequacy of cultural and regulatory forces supporting South Asian women’s health and wellbeing. This timely and accessible volume will be a valuable resource for students and researchers working across a range of areas, including sociology, health studies and development, as well as community health workers and social protection officers, writes Parveen Ali. The Sociology of South Asian Women’s Health. Sara Rizvi Jafree (ed.). Springer. 2020

Admission criteria and subsequent academic performance of general nursing diploma students

OBJECTIVE: To determine the relationship between admission criteria used to select students and their subsequent academic performance in general nursing diploma Programme in the province of Sindh. METHODS: Using a descriptive co-relational study design, data was collected retrospectively from records of the entire nursing student population of the batch of 2004. Using multiple linear regression analysis method, three regression models were developed to identify the group of variables that could predict academic performance of the students in the three-year general nursing diploma programme. RESULTS: Results identified a significant relationship between admission criteria and subsequent academic performance of the students in the general nursing diploma programme. Specific factors which were found significant included entry qualification, previous academic performance and gender. CONCLUSION: The study concluded that academic factors considered in the admission criteria were better predictors of students\u27 academic performance than the non academic factors. These factors should be considered in the admission criteria for general nursing diploma programme

A qualitative meta-synthesis of young peoples' experiences of ‘sexting’

Objective: To conduct a meta-synthesis of the qualitative research to explore young people's experiences and use of smart phones to send and receive sexually focused messages and images. Design: A qualitative meta-synthesis was conducted on the retrieved papers following a systematic search of PUBMED, Cumulative Index to Nursing and Allied Health Literature (CINAHL), COCHRANE, Embase, Medline and Psycinfo. The sample included five qualitative studies with a total sample size of 480 participants. Results: The meta-synthesis of the papers resulted in the development of four central themes: gender inequity, popularity with peers, relationship context, and costs and benefits. Conclusions: Drawing the qualitative work together highlights the manner in which ‘sexting’ is more nuanced than traditional ‘cyber-bullying’. The consensual sending of intimate images is a highly gendered activity. The gender issues require work with female students to explore the issue of ‘sexting’ and how it can be harmful. Work with male students around the issues of respect and gender harassment in relation to ‘sexting’ is also required and should contribute to sex and relationships education. The results indicate that school nurses working with young people need to build discussions about the use of technology within relationships into their work with young people

On the Intricacies of Facial Hyperpigmentation and the Use of Herbal Ingredients as a Boon for Its Treatment: Cosmeceutical Significance, Current Challenges and Future Perspectives

Facial hyperpigmentation is the term used to express areas on irregular pigmentation in the skin. It appears as darkened patches on the face that make the facial skin look uneven. Facial hyperpigmentation is not physically debilitating but has been associated with enhanced psychosocial complications including anger, depression and frustration. These psychosocial burdens, in turn, have inference on quality of life and self-esteem. So, the treatment of facial hyperpigmentation seems to be a growing concern to the dermatologists today and they have been practising several treatment modalities including chemical peeling, laser therapy, dermabrasion, etc. But, those are found to be associated with various after-effects. Hence, the use of plants and its products is highly recommended as they are reported with either none or fewer after-effects. The present chapter draws attention to the forms of facial hyperpigmentation with their aetiologies and available treatment options for them with associated side effects. Furthermore, we have discussed about the other side of treatment with herbal ingredients which are safe and have less or no side effects. This chapter will be of value to the dermatologists who are searching for naturally derived ingredients for treating facial hyperpigmentation, in line with consumer expectations and preferences

Understanding of puberty and related health problems among female adolescents in Karachi, Pakistan

Objectives: To understand the level of knowledge, a community based study conducted with the objectives as follows: To estimate the proportion of common facilities available and accessible and frequency of utilizing of it. To estimate the proportion of female adolescent utilizing the availability of facilities. To assess the level of understanding related to puberty and related health problems among female adolescents.Methods: This cross-sectional study was conducted to determine the understanding and level of knowledge related to puberty and related health problems among female adolescents of Karachi, Pakistan. Data was collected from 150 female adolescents between 10-19 years of age. The pre-coded questionnaire was used to collect the data which was double entered and analyzed in SPSS. Results: Sixty six percent (66%) of the participants were aware of the names of reproductive organs. Majority of the participants received information related to sexuality from their mothers. Sixty seven percent (67%) of the participants did not know about self breast examination. Cable and internet were cited as a major source of puberty and sexual health related information. Conclusion: The study concluded that there is a lack of knowledge related to puberty and related health problems among female adolescents. This study recommends that the adolescents should be provided with health education before and during their puberty period to make them confident in dealing with their body changes during puberty effectively (JPMA 56:68;2006)

Parental experiences of raising a child with medium chain Acyl-CoA Dehydrogenase deficiency

Newborn screening enabling early diagnosis of medium chain acyl-CoA dehydrogenase deficiency (MCADD) has dramatically improved health outcomes in children with MCADD. Achieving those outcomes depends on effective management by parents. Understanding parental management strategies and associated anxieties and concerns is needed to inform provision of appropriate care and support. Semi structured interviews were conducted with a purposive sample of parents of children aged two to twelve years. Thematic analysis identified two main themes. Managing dietary intake examined how parents managed day-to-day dietary intake to ensure adequate intake and protection of safe fasting intervals. Managing and preventing illness events explored parental experiences of managing illness events and their approach to preventing these events. Management strategies were characterised by caution and vigilance and influenced by a lack of confidence in others to manage the condition. The study identifies the need for increased awareness of the condition, particularly in relation to emergency treatment

Intravaginal Administration Of Misoprostol Alone Versus Misoprostol And Isosorbidemononitrate For Cervical Ripening And Labour Induction

ABSTRACTOBJECTIVES: To compare the efficacy and safety of intravaginal administration of misoprostol  alone versus misoprostol and  isosorbide mononitrate for cervical ripening and labour induction.MATERIAL AND METHODS: One hundred women with term gestation,  Bishop  score <4 with various indications for labour induction were randomly divided into two groups. In Group I, 50 µg of misoprostol tablet was placed intravaginally, 4 hourly maximum upto 4 doses. In Group II,50 µg of misoprostol tablet with 40mg of isosorbide mononitrate was placed intravaginally in posterior fornix upto 4 doses.RESULTS: Two groups were similar in their clinical characteristics. The induction to delivery interval  was 20.8±2.9 hours vs 14.2±2.7 hours in two groups respectively. Misoprostol and isosorbide mononitrate was associated with a shorter induction to delivery interval, decreased oxytocin requirement higher rate of  vaginal delivery i.e 62.8% Vs 53.9% . Uterine hyperstimulation was more common with misoprostol. Neonatal outcome was similar in both the groups.CONCLUSION: The present study suggests that both intravaginal misoprostol and combination of isosorbide mononitrate and misoprostol are safe and effective modes of labour induction. Isosorbide mononitrate and misoprostol is more effective than misoprostol alone in terms of  shorter induction to active phase interval and induction to delivery interval.