Online ISSN: 2515-8260

Keywords : impact


Floating knee injuries: Associated injuries and clinical outcome

Dr. Himanshu Agrahari, Dr. Chethan MH, Dr. Siddharth Dubey, Dr. Bhaskar Sarkar, MD Quamar Azama

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 2, Pages 258-266

Background: Floating knee injuries are frequently part of polytrauma. The outcome of this injury
pattern when compared to only femur or tibia fracture is less satisfactory. The outcome is even worse
when there is presence of other associated injuries. We hypothesized that not all associated injuries
have similar bearing on the outcome thus tried to find out the impact of commonly associated injuries
on the final outcome of these complex fractures.
Methods: Study was conducted including the patients of floating knee injury operated between
September 2016 and January 2019. Total of 42 eligible patients were operated, 4 patients were
excluded to due to lack of adequate follow-up. Data relating to demography, Fraser subtype,
compounding, associated injuries and clinical outcome were collected. Statistical analysis was
performed to see the association of associated injury, Fraser subtype and presence of compounding
with clinical outcome.
Results: Mean age was 33.5 years (17-63 years) with a male preponderance. Mean follow up was 1.6
years. Twenty-seven patients (71.1%) had excellent/good outcome while outcome of 11 patients
(28.9%) was acceptable/poor. Seventeen patients (44.7%) had compound fractures. Injuries which were
significantly associated with Acceptable/Poor outcome were ligament injuries, popliteal artery injury,
abdominal injury and patella fracture. Chest injury with a p value of 0.05 was also very close to being
statistically significant.
Conclusion: The clinical outcome of these patients not only depend on proactive and optimum
management of tibial and femoral fractures but also on the management of associated injuries.

A comparative study to find out/ assess the impact of lockdown on the mental health of the general population and covid-19 frontline health care workers

Nandkishor Tak, Aditya Soni, Abhilasha Suwalka, Rujul Modi, Manju bhasker .

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 3019-3029

Background: Lockdown is an emergency situation which has confined people to their homes, states and country. Individuals felt insecure and worried about their financial matters and their mental health was affected at some point of time during the corona virus pandemic lockdown.
Aim: The study aimed to assess the effect of lockdown on mental health between the general population and covid-19 frontline health care workers.
Material and Methods: The survey was conducted from July to October 2020 using DSM -5 Self-Rated level 1 cross-cutting symptom measure -Adult scale, circulated through social media platform (Google forms). In this study, 180 participants were enrolled. Hindi version of the measure was used to assess the psychological impact on the participants and a score of 0 was considered as NO and was taken as a Negative response and scores 1 to 4, were considered as YES and were taken as a positive responses.
Result: A total of 180 responses were obtained during the survey, amongst them 36.67% were male and 63.33%were female. Frontline healthcare workers were 51.67% and among the Non-health care workers, unemployed were 10%, Student were 17.78%, and the remaining working were 56.67%. As per DSM 5 Crosscutting symptoms scores, the most common reported psychological symptoms were Anxiety  81.11%, Depression  52.78%, Sleep problems  29.44%, and Substance use 25%,. The comparison between both the groups was not statistically significant (p>0.001). However, non-healthcare workers experienced more psychological symptoms.
conclusion: The covid-19 lockdown was associated with poor mental health across individuals .the lockdown was observed  to be a stressful situation that could have precipitated psychological symptoms like anxiety, stress, depression, and sleep disturbance in the individuals.
 

Assessment of Risk Factors For Stroke In The Vertebrobasilar System And Their Impact On Rehabilitation

Bakhadirova Munisa Anvarovna; Mirjuraev Elbek Mirshavkatovich; Shadmanova Lola Abdudjalilovna; Bakhadirova Madina Olimkhanovna

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 3, Pages 3100-3115

Relevance: The high prevalence, high risk of social maladjustment as a result of the consequences of acute cerebrovascular accident and, accordingly, one of the main causes of mortality gives cerebrovascular pathology a special status, as evidenced by numerous publications. the task was to identify in the studied patients the entire spectrum of clinical manifestations corresponding to the lesions of the brain structures supplied by the blood vessels of VBD and to determine the presence of a statistically significant dependence of clinical manifestations of COPD. As well as the identification of risk factors and their influence on the rehabilitation of patients with stroke in the vertebrobasilar system.
Patients with IS in VBD and COPD - 62 people (group I) - 29 men and 33 women aged 50 to 74 years (59.8 ± 5.8). Patients with IS in VBD - 64 people (group II). Of these, 31 were men and 33 were women aged 51 to 80 years (62.4 ± 5.4). All patients received traditional treatment in the most acute and acute periods of IS, patients with COPD received COPD treatment in parallel with traditional IS therapy. in group I, BMI averaged 29.3 ± 5.8 kg / m2, in men - 28.9 ± 6.3 kg / m2, in women - 29.9 ± 5.1 kg / m2 (the difference is not significant, p = 0.58), while 11 patients (17.7%) had a normal BMI, 1 patient (1.6%) had a body weight deficit, 26 patients (41.9%) had preobesity, 15 patients (24, 2%) had first degree obesity, 9 patients (14.5%) had second degree obesity. Accordingly, preobesity or obesity was recorded in 50 patients of group I (80.65%) (Figure 3.3)
And in group II, BMI averaged 28.7 ± 6.1 kg / m2, in men - 27.8 ± 5.7 kg / m2, in women - 30.1 ± 5.6 kg / m2 (the difference is not significant, p = 0.6), while 17 patients (26.6%) had a normal BMI, 3 patients (4.7%) were found to be underweight, 29 patients (45.3%) had preobesity, 8 patients (12 , 5%) had first degree obesity, 7 patients (10.9%) had second degree obesity. Accordingly, preobesity or obesity was recorded in 44 patients of group II (68.8%). In patients of group I, among the clinical manifestations of IS in PBS, ataxia prevailed, which occurred in 35 patients (56.5%), including hemiataxia, which occurred in 20 patients (31.3%). Paresis and paralysis of the limbs were detected in 31 patients (50%). Complaints about a subjective feeling of unsteadiness, instability in an upright position, and imbalance occurred in 25 patients (40.3%). Dysarthria also occurred in 25 cases (40.3%). Nystagmus was detected in 22 cases (35.5%), rotational dizziness (vertigo) - in 20 cases (32.3%), depression of consciousness - in 21 cases (33.9%). Symptoms such as hemianopsia and ophthalmoparesis occurred each in 14 cases (22.6%). Sensory disorders were detected in 12 patients (19.4%), autonomic disorders - in 8 patients (12.9%), diplopia - in 8 patients (12.9%), dysphagia - in 7 patients (11.3%) , aphasia and headache - 6 patients each (9.7% each), dysphonia - 7 patients (11.3%), confusion and visual agnosia - 4 patients each (6.5% each), respiratory failure - 3 patients (4.8%). There were also 2 cases (3.2% each) of amnesia, ignorance syndrome and a feeling of generalized weakness.

Challenges Of Policy Implementation In Government Of Malawi

Dr. Manvendra Singh; Bertha Pidini

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 7, Pages 5881-5884

Decisions are what shape actions, if decisions remain unimplemented it means that there can be no change. A decision is a best choice chosen among the alternatives. To be able to come up with a good decision, scholars have come up with a well-defined process which guides the steps that need to be taken for individuals and organisations to make the optimum decision possible. Decision making reduces uncertainty. Many decisions made by the organisations, most of the times become policies but not all decisions are policies. In Malawi, a landlocked country in south eastern region of Africa, many decisions in form of policies that are made by the department of human resource management and development never yield the results they intended and most of the policies remain unimplemented or partially implemented as shown by the persistence of the problems which were supposed to be addressed by these policies. This paper is an attempt to answer these relevant questions about the decisions made by the Malawian government over the period of time and their real grassroots level of execution in which many elements have been shown to impact the decision-making process from the will of the people to the availability of resources.

THE ASSESSMENT OF THE IMPACT OF QUALITY ON THE SAUDI HEATH CARE SYSTEM IN PRIMARY HEALTH CARE CENTERS IN MAKKAH

Nawar Hamad Mohammad Alfahmi, Khaled Fawzan gazi Alholaife, Abdulmohsen masraj Alfahmi, Faisal Mohammed Al-Nofaie, Hassan Fuad Labban, Fayez Abdul Rahman Fayez Al-Shehri,Abduljalil Ahmed Nojoom, Majed Faraj Alharthi, Majed Mohammedeid Almihmadi, Youssef Dakhilallah Nafea Aljehani

European Journal of Molecular & Clinical Medicine, 2019, Volume 6, Issue 1, Pages 170-181

Background:
Primary health care, the basis of universal health coverage, needs to be assessed on its performance through Saudi health care quality system and future opportunities to serve the Saudi Arabian population increase the chance of desired health outcomes. Saudi Arabia has invested heavily in its health care system by establishing health care infrastructures to improve health of the nation. However, it remains to be seen whether it is efficient and effective in providing health care services needed. In spite of substantial improvements in the Saudi Arabian health services sector in the past few decades, the country is facing a number of challenges in its primary health care system. These challenges include increased demand because of rapid population growth, high costs of health care services, inequitable access, concerns about the quality and safety of care, a growing burden of chronic diseases, a less than effective electronic health system, poor cooperation and coordination between other sectors of care, and a highly centralized structure.
Aim of the study: This study aims to determine the impact of quality on the Saudi Heath care system in primary health care centers in Makkah on satisfaction of Saudi people.
 Method:A cross-sectional studydesign. The current study was conducted male and female in primary health care centers in Makkah.the study randomly sampled. The total sample size will be (300) participated. female and male.
Results:Regarding Patient satisfaction about study results showed that the majority of participants were high satisfaction proportions (65.7%) while average satisfaction were (31%) While The Range (50 – 113) Mean +SD (89.913±11.636). Regarding Patients satisfaction about Patients satisfaction about social and behavioral characteristics results show that the majority of participants were high satisfaction proportions (64.3%) while average satisfaction were (33.3%) While the Range (28 –56)Mean+SD(46.796±5.9636)
Conclusion:The Saudi Arabian health care system needs comprehensive reform with a focus on primary health care.There is substantial variation in the quality of Saudi primary care services. In order to improve quality, there is a need to improve the management and organization of primary care services. Professional development 
strategies are also needed to improve the knowledge and skills of staff.