Complications of first tarsometatarsal joint arthrodesis

Objective: First tarsometatarsal joint (TMTJ) arthrodesis, also known as Lapidus, is a surgical procedure used to treat severe hallux valgus, associated hypermobility of the first ray, and/or osteoarthritis of the first TMTJ. Despite the high satisfaction rate and high corrective power, this technique is not without complications. This study aimed to report the complications of first TMTJ arthrodesis. Methods: This is a case series of 16 patients treated with first TMTJ arthrodesis. Patients were evaluated based on foot radiographs, clinical alignment of the hallux, and signs and symptoms. Results: Eight patients had either major or minor complications. Three patients had recurrent deformity (1 with associated nonunion), 2 had delayed union, 2 had hardware loosening (1 with associated nonunion), and 1 had wound dehiscence. Conclusion: First TMTJ arthrodesis requires greater care in choosing the surgical technique for the treatment of hallux valgus. In addition, some points should be considered to minimize complications as much as possible. We believe that data are still scarce to provide a concrete basis. Level of Evidence IV; Therapeutic Studies; Case Series.

Fighting COVID-19 Contagion among University Students of Healthcare Professions: An Italian Cross-Sectional Study

During the pandemic, most governments around the world temporarily closed educational institutions to contain the spread of the Coronavirus Disease 2019 (COVID-19). The objective of the present study is to evaluate the efficacy of an e-learning course on COVID-19 transmission for healthcare university students, in order to advance the preparedness of healthcare university students against contracting COVID-19 within the general university population. The e-learning course was run using a free web service for education. Access to the course was limited to participants enrolled in degree courses related to healthcare professions within the Italian university system. A specific and validated questionnaire was administered at two different times (pre-test and post-test). A paired sample t-test was then used to evaluate their knowledge on COVID-19. Furthermore, a questionnaire measuring their satisfaction was distributed. Data were analyzed from a qualitative point of view. The course was made available from March to July 2020. Over 25,000 students from different Italian universities and various backgrounds participated in the course. The analysis of final test scores revealed that approximately 97% of participants acquired new knowledge and skills on COVID-19, with a statistically significant improvement (p < 0.05). Therefore, it is possible to state that most students enrolled in degrees relating to healthcare at Italian universities are adequately trained with respect to COVID-19 knowledge. Furthermore, students declared a high satisfaction rate both with the course content, and with the management of the telematic platform used.

Social and Professional Impact of Learning Communities Within the Alliances for Graduate Education and the Professoriate Program at Michigan State University

At Michigan State University (MSU), the AGEP learning community features the participation of over 70% of the African-American, Latinx, and Native-American under-represented minorities (URM), also referred to as Black, Indigenous, and People of Color (BIPOC) doctoral students in fields sponsored by the National Science Foundation (NSF). Monthly learning community (LC) meetings allow AGEP participants to create dialogues across disciplines through informal oral presentations about current research. The learning communities also offer opportunities to share key information regarding graduate school success and experience; thus providing a social network that extends beyond the academic setting. At MSU, AGEP also provides an interdisciplinary and multigenerational environment that includes graduate students, faculty members, post-docs and prospective graduate students. Using monthly surveys over a 4-year period, we evaluated the impact of this AGEP initiative focusing on the utility of the program, perceptions of departmental climate, career plans and institutional support. Findings indicate that AGEP participants consider their experiences in the program as vital elements in the development of their professional identity, psychological safety, and career readiness. Experiences that were identified included networking across departments, focus on career placement, involvement in minority recruitment and professional development opportunities. Additionally, AGEP community participants resonated with the “sense of community” that is at the core of the MSU AGEP program legacy. In this article, we proposed a variation of Tomlinson’s Graduate Student Capital model to describe the AGEP participants’ perceptions and experiences in MSU AGEP. Within this 4-year period, we report over 70% graduation rate (completing with advanced degrees). More than half of Ph.D. students and almost 30% of master’s degree students decided to pursue academia as their careers. In addition, we found a high satisfaction rate of AGEP among the participants. Our analysis on graduate student capital helped us identify motivating capital development by years spent at MSU and as an AGEP member. These findings may provide some insight into which capitals may be deemed important for students relative to their experiences at MSU and in AGEP and how their priorities change as they transition toward graduation.

Long-term pain relief after groin hernia repair for sports groin: A nationwide cohort study

Background: The groin is a complex anatomical area with multiple structures that can be injured and cause pain. One condition with groin pain is the so-called “sports groin,” which can be treated with a groin hernia repair even though no hernia is present. The aim of this study was to assess the prevalence of chronic groin pain several years after a groin hernia repair performed in patients with a sports groin. Methods: This nationwide cohort study included adults who had a groin hernia repair for a sports groin through the years 1998–2011. The patients were identified through the Danish Hernia Database and in surgical records. Patients were asked to fill out four questionnaires several years after the repair: a visual analogue scale, the Activity Assessment Scale, the Inguinal Pain Questionnaire, and a questionnaire about treatment satisfaction. Results: Of 118 contacted patients, 71 gave informed consent and were included in the study (60%), and of these the response rate was 100%. The questionnaires were filled out median 14 years after surgery. Most of the patients were pain-free in the operated groin (87%), and only a few had physical impairment caused by groin pain (20%). Prior to surgery, 79% had groin pain that they could not ignore. Overall, 90% of the patients were satisfied with the treatment. Conclusions: Most patients were pain-free and without physical impairment several years after groin hernia repair for a sports groin and with high satisfaction rate.

EP.TH.447Simultaneous repair of bilateral Inguinal hernia under Local Anaesthetic - is it feasible?

Introduction Local Anaesthetic repair of unilateral Inguinal hernia is well reported in the literature, as a safe, well tolerated and effective operation. However, there is not much literature on simultaneous repair of bilateral inguinal hernias under local anaesthetic. We are reporting our experience with simultaneous repair of bilateral inguinal hernias under local anaesthetic. Methods We did a retrospective analysis of prospectively collected data of patients, who had bilateral inguinal hernia repaired under local anaesthetic over a period of 2009 - 2019, looking at the patient demographics, patient reported pain score, operating time, volume of local anaesthetic used, patient satisfaction and complication rates.All the patients had Lichtenstein's hernioplasty. The LA mixture was made up of 30ml 0.5% Bupivacaine with adrenaline, 20 ml 2% Lignocaine with adrenaline, 50 ml of 0.9% Saline and 6 ml of 8.6% Sodium Bicarbonate. All these surgeries were performed on a day case basis. Results There were 24 patients, who underwent local anaesthetic repair of bilateral inguinal hernias, 22 Males and 2 Females. Age range was 35 - 81 years. The BMI varied from 18 - 30, with a mean of 24. The average operating time was 66.8 minutes (38 - 120 minutes, median 60 min). The mean pain score was 24, on a 0-100 scale. Patient satisfaction scores varied from 50-100 (Median 90, Mean 88.1) Conclusion We conclude that successful simultaneous repair of bilateral inguinal hernia under local anaesthetic is feasible, with a low level of patient discomfort, high satisfaction rate and using safe quantities of local anaesthetic

Compare the Outcome of Percutaneous Aspiration with Incision Drainage for Management of Breast Abscess

Objective: The aim of this study is to compare the outcome of percutaneous aspiration with incision drainage for management of breast abscess. Study Design: Comparative Study Place and Duration: The study was conducted at Surgery departments of Lady Reading hospital, Peshawar during the period of six months from August 2020 to January 2021. Methods: Total 110 women were presented in this study. Patients were aged between 20-45 years. Patients’ detailed demographics including age, weight, height and body mass index were recorded after taking informed written consent. Women had breast abscess were included. Patients were equally divided into two groups, I and II. Group I had 55 patients and received percutaneous aspiration while in group II 55 patients were underwent for incision drainage. Outcomes among both groups were compared in terms of early restoration of breast feeding, pain score by using VAS and time of healing. Complete data was analyzed by SPSS 24.0 version. Results: Mean age of the patients in group I was 30.11±8.56 years with mean BMI 26.9±3.77 kg/m2 while mean age in group II was 29.17±9.44 years with mean BMI 26.08±3.27 kg/m2. Mean weight of patients in group I was 72.19±17.44 kg and in group II mean weight was 74.35±19.78 kg. Mean height in group I was 154.12±9.55 cm and in group II was 156.08±8.71 cm. Restoration of breast feeding among group I was 47 (85.45%) and in group II 32 (58.2%) patients restored breast feeding. Satisfaction among patients in group I was higher than that of 45 (81.82%) as compared to group II 31 (56.4%). Conclusion: We concluded in this study that percutaneous aspiration in breast abscess was successful and affective as compared to incision drainage with less complications and high satisfaction rate among the women. Keywords: Breast abscess, Percutaneous aspiration, Incision drainage,

Compare the Outcome of Percutaneous Aspiration with Incisional Drainage for Management of Breast Abscess

Objective: To compare the outcome of percutaneous aspiration with incision drainage for management of breast abscess. Study Design: Comparative study Place and Duration of Study: Department of Surgery Unit-1, Sandeman Provincial Hospital Quetta from 1st October 2020 to 31st March 2021. Methodology: One hundred and ten women age aged between 18-65 years of age were enrolled. Patients details demographics age, weight, height and body mass index were recorded after taking informed written consent. Women had breast abscess were included. Patients were equally divided into two groups, I and II. Group I had 55 patients and received percutaneous aspiration while in group II had 55 patients underwent for incision drainage. Results: Mean age of the patients in group I was 30.11±8.56 years with mean BMI 27.9±18.77kg/m2 while mean age in group II was29.17±9.44 years with mean BMI 28.9±55.27kg/m2. Mean weight of patients in group I was 72.19±17.44 kg and in group II mean weight was 74.35+19.78 kg. Mean height in group I was 154.12±9.55 cm and in group II was 156.08+8.71 cm. Restoration of breast feeding among group I was 47 (85.45%) and in group II 32 (58.2%) patients restored breast feeding. Satisfaction among patients in group I was higher than that of 45 (81.82%) as compared to group II, 31 (56.4%). Conclusion: Percutaneous aspiration in breast abscess was successful and affective as compared to incision drainage with less complications and high satisfaction rate among the women. Keywords: Breast abscess, percutaneous aspiration, Incision drainage

Evaluation of efficacy and safety of cryotherapy in benign and premalignant cervical lesion

Background: Cervical cancer ranks 3rd leading cause of cancer in the world. Cervical erosion is mostly asymptomatic in women but when symptoms like postcoital bleeding and vaginal discharge occur in the presence of cervical erosion, it becomes important to identify whether the erosion is a benign lesion or CIN or cancer by means of PAP smear and Biopsy. Treatment for benign and precancerous lesion can be provided by ablative or excisional methods. Cryotherapy was reliably used to treat cervical lesions.Methods: Women among 18 to 60 years of age attending outpatient department who had history of chronic discharge per vaginum, postcoital bleeding, dyspareunia, chronic pelvic pain. Patients were divided in two by PAP smear in erosion with inflammatory changes and presence of low grade squamous intraepithelial lesion. Cryotherapy was performed using double-freeze single session procedure. Each patient was followed up at 2, 6 and at 12 weeks. Complications and patients’ satisfaction were recorded and compared to calculate cure rate of symptoms, healing of lesion.Results: The healing efficacy of cryotherapy at 6th and 12th week was 87.8% and 91.1% respectively. Cryotherapy had high satisfaction rate. The cure rate was not affected by location of lesion and size of lesion in both inflammation and LSIL.Conclusions: Cryotherapy is an effective method for treatment of cervical erosion and effectively eliminates symptoms. Patients were highly satisfied. Cryotherapy is cheap, easy, and safe treatment. It is suitable for both hospital and office-based practice.

PATIENT'S SATISFACTION COME FOR EXAMINATION AND REATMENT AT MEDICAL FACILITIES IN VIETNAM. SYSTEM OVERVIEW STUDY, PERIOD 2010-2020

Background: Patient’s satisfaction is a measure of the health facilities’ reputation and quality of health services. Therefore, determining the satisfaction of the patients in the current context is extremely necessary and meaningful. It provides the evidence for quality improvement of health services.Objective: A systematic review to review research findings on the the satisfaction level and relevant factors, analysis of strengths, weaknesses and deficiencies that need to be supplemented by further studies.Methods: Systematic review.Results: Searched and analyzed 32 national studies related to patient satisfaction. The results show that studies were carried out on many different subjects and locations with different levels of satisfactionConclusion: The satisfaction level of patients is quite high (satisfaction rate is over 70%, average score is over 3.5). Factors with high satisfaction rates include: Information transparency; Behavioralattitude and professional capacity of medical staff. Factors with not high satisfaction rates include: Infrastructure; Accessibility; Service results. Relevant factors: Patient’s satisfaction is not / verylittle related to demographic factors such as: Age, occupation, education level, medical examination target (with health insurance / no health insurance). Factors related to the patient’s satisfaction levelinclude: waiting

Er,Cr:YSGG 2780 nm Laser Treatment of Lip Melanin Hyperpigmentation

Background. In the current research, Er,Cr:YSGG laser been used in ablative mode to peel the pigmentation, and many sessions were done to completely remove the melanin pigmentations. Materials and Methods. 85 patients were selected and Er,Cr : YSGG laser with 2780 nm wavelength in ablative mode (iPlus, Biolase, USA) was used to treat patients with dark lip melanin pigmentation, using gold handpiece and MZ 10 tip (diameter of 1 mm), and the parameters were set as follows: energy density 28.7 J/cm2, frequency 30 Hz, water cooling 100%, and air cooling 60%. Results. The vast majority of the patients (82.4%) had mild adverse effects after the lip depigmentation and 74.1% of patients reported complete improvement of the lip with a high satisfaction rate (84.7%) during the follow-up period with a low level of relapse. Conclusion. Er,Cr:YSGG 2670 nm is an effective tool to achieve excellent esthetic results in the treatment of lip melanin pigmentation; it is very well tolerated by patients with minimal adverse effects.