Assessment patient satisfaction after total hip replacement in Indian population

Background: We aim to assess the satisfaction of patients after total hip replacement in Indian population. Nоwаdаys tоtаl hiр аrthrорlаsty is the finаl treаtment орtiоn рrоvided tо раtients with unsаlvаgeаble, severely аrthritiс, раinful аnd defоrmed hiрs. Раtient sаtisfасtiоn hаs been meаsured in multiрle оrthораediс рrосedures, inсluding tоtаl hiр аrthrорlаsty. THА is а соmmоn surgiсаl рrосedure thаt imрrоves the lives оf раtients with end-stаge аrthritis by deсreаsing раin, аnd imрrоving mоtоr function and mоbility аs measured by vаlidаted heаlth-relаted оutсоme tооls. Methods: Patients were assessed at OPD visit or with telephonic conversation scores are calculated and mentioned in excel sheet. Post-surgery satisfaction score is the score created to measure the satisfaction after total hip replacement. This score contains different questionnaires. These questions include inquiry about relieve of pain, ability to do daily routine activities, requirement of walking aids etc. Score contains total 7 questions with answers. Results: Out of 95 patients we found through this study that about 92.63% of patients are satisfied after total hip replacement. 7.37% of patients are dissatisfied. Satisfaction rate is more as compared to dissatisfaction rate. Conclusions: In present study we have tried to eliminate other factors responsible for dissatisfaction such as hospital ward cleanliness, hospital administration, patient and hospital staff communication. We recommend total hip replacement surgery for end stage arthritis and is more beneficial to the patients in terms of improvement in post-operative pain and function

Assessment patient satisfaction after total knee replacement in Indian population

Background: We aim to assess the satisfaction of patients after total Knee replacement in Indian population. Tоtаl knee Аrthrорlаsty is most commonly performed for osteoarthritis, and also for other knee diseases such as rheumatoid arthritis and psoriatic arthritis. Knee reрlасement surgeries helрs tо restоre nоrmаl meсhаniсs during level wаlking аs well аs mоre demanding аnd соmрlex асtivities suсh аs stаir negоtiаtiоn. Раtient sаtisfасtiоn rаtes fоr the рrосedure hаve been reроrted between 81-97%. However, this leаves а signifiсаnt роrtiоn оf the TKR рорulаtiоn аs dissаtisfied with the оutсоmes оf the reрlасed knee. Methods: Patients were assessed at opd visit or with telephonic conversation and scores are calculated and mentioned in excel sheet. Post surgery satisfaction (PSS) score is the score created to measure the satisfaction after total hip replacement. This score contains different questionnaires. These questions include inquiry about relief of pain, ability to do daily routine activities, requirement of walking aids etc. Score contains total 7 questions. Results: Out of 55 patients we found through this study that about 92.7% were classified as satisfied while 7.3% patients were dissatisfied. Satisfaction rate is more as compared to dissatisfaction rate. Conclusions: In present study we have tried to eliminate other factors responsible for dissatisfaction such as hospital ward cleanliness, hospital administration, patient and hospital staff communication. we recommend total knee replacement surgery for end stage arthritis and it is more beneficial to the patients in terms of improvement in post-operative pain and function

Radiological and functional outcome of conservatively managed middle one third clavicle fractures

Background: We aim to assess radiological and functional outcome of conservatively managed middle one third clavicle fractures in Indian population. Clavicle fractures represent 2% to 10% of all fractures. In middle third clavicle fractures, conservative management is the commonest approach. In uncomplicated non displaced midshaft fractures, patients treated non operatively with these conservative measures have fewer complications and a timely recovery as those treated operatively. Conservative management is a simpler yet effective mode of management in middle one third clavicle fractures. Methods: Patients managed conservatively for clavicle fractures were assessed on OPD basis with follow up chest X-ray with bilateral shoulder AP view for radiological signs of union and assessing percent shortening and two questionnaires. Constant shoulder score which assess pain, degree of function, range of motion and muscular force and, simple shoulder test, self administered questionnaire defining one or more affirmative answers to find the satisfaction after treatment modality which were tabulated in Microsoft excel sheets. Results: Out of the 55 patients enrolled in the study 52 showed signs of union at 6 months follow up with mean fracture union time of 13.9 weeks. At 6 months follow up Mean Constant Shoulder score was 87.1 with excellent outcome in 67.67 percent patients and using Simple Shoulder Test satisfaction rate was found to be 78.18 percent. Conclusions: Solid evidence in favour of non-operative treatment for fractures with remaining contact of the bone fragments. Non-surgical management of middle third clavicle fractures yield excellent results. Clear indications for conservative treatment versus surgical fixation of displaced midshaft fractures have not finally been established yet. We recommend conservative management for uncomplicated middle one third clavicle fractures

Impact of mutational profiles on response of primary oestrogen receptor-positive breast cancers to oestrogen deprivation

Pre-surgical studies allow study of the relationship between mutations and response of oestrogen receptor-positive (ER+) breast cancer to aromatase inhibitors (AIs) but have been limited to small biopsies. Here in phase I of this study, we perform exome sequencing on baseline, surgical core-cuts and blood from 60 patients (40 AI treated, 20 controls). In poor responders (based on Ki67 change), we find significantly more somatic mutations than good responders. Subclones exclusive to baseline or surgical cores occur in ∼30% of tumours. In phase II, we combine targeted sequencing on another 28 treated patients with phase I. We find six genes frequently mutated: PIK3CA, TP53, CDH1, MLL3, ABCA13 and FLG with 71% concordance between paired cores. TP53 mutations are associated with poor response. We conclude that multiple biopsies are essential for confident mutational profiling of ER+ breast cancer and TP53 mutations are associated with resistance to oestrogen deprivation therapy

Experimental infection in calves with a specific subtype of verocytotoxin-producing Escherichia coli O157:H7 of bovine origin

<p>Abstract</p> <p>Background</p> <p>In Sweden, a particular subtype of verocytotoxin-producing <it>Escherichia coli </it>(VTEC) O157:H7, originally defined as being of phage type 4, and carrying two <it>vtx</it>₂genes, has been found to cause the majority of reported human infections during the past 15 years, including both sporadic cases and outbreaks. One plausible explanation for this could be that this particular subtype is better adapted to colonise cattle, and thereby may be excreted in greater concentrations and for longer periods than other VTEC O157:H7 subtypes.</p> <p>Methods</p> <p>In an experimental study, 4 calves were inoculated with 10⁹colony forming units (cfu) of strain CCUG 53931, representative of the subtype VTEC O157:H7 (PT4;<it>vtx</it>₂;<it>vtx</it>_2c). Two un-inoculated calves were co-housed with the inoculated calves. Initially, the VTEC O157:H7 strain had been isolated from a dairy herd with naturally occurring infection and the farm had previously also been linked to human infection with the same strain. Faecal samples were collected over up to a 2-month period and analysed for VTEC O157 by immuno-magnetic separation (IMS), and IMS positive samples were further analysed by direct plating to elucidate the shedding pattern. Samples were also collected from the pharynx.</p> <p>Results</p> <p>All inoculated calves proved culture-positive in faeces within 24 hours after inoculation and the un-inoculated calves similarly on days 1 and 3 post-inoculation. One calf was persistently culture-positive for 43 days; in the remainder, the VTEC O157:H7 count in faeces decreased over the first 2 weeks. All pharyngeal samples were culture-negative for VTEC O157:H7.</p> <p>Conclusion</p> <p>This study contributes with information concerning the dynamics of a specific subtype of VTEC O157:H7 colonisation in dairy calves. This subtype, VTEC O157:H7 (PT4;<it>vtx</it>_2;<it>vtx</it>_2c), is frequently isolated from Swedish cattle and has also been found to cause the majority of reported human infections in Sweden during the past 15 years. In most calves, inoculated with a representative strain of this specific subtype, the numbers of shed bacteria declined over the first two weeks. One calf could possibly be classified as a high-shedder, excreting high levels of the bacterium for a prolonged period.</p