International Journal of Medicine and Biomedical Sciences

Acute Acromioclavicular Dislocations Treated with Kirschner wire and Polyester suture at B.P Koirala Institute of Health Sciences: A Retrospective Review of Records.

2023-02-03T06:08:59+00:00

Introduction: Acromioclavicular (AC) dislocations are relatively rare injuries often seen in athletes who are involved in high-impact sports. The aim of management is to restore the coracoclavicular interspace to maintain stability and prevent chronic pain. Many fixation methods have been described for managing these injuries. To the best of our knowledge, only a few studies have reported regarding the functional outcome of AC joint dislocation using bifocal fixation using K wire and Polyester suture. This study aimed to evaluate the functional outcome of AC joint dislocation managed using a bifocal fixation.

Method: This retrospective review of records was conducted between January 19th to January 30th, 2023 after obtaining clearance from the institutional ethics committee. All patients aged between 18-45 years with AC joint dislocations meeting the inclusion criteria were included in the study. The information was recorded in a data extraction form. The University of California, Los Angeles (UCLA) Shoulder Rating Score was evaluated at 6 months follow-up.

Results: A total of 34 patients of which there were 30 male and 4 female patients included in this review of records. The average age was 37.69 ± 7.21 years, then the average time of surgery from injury was 2.34 ± 0.5 days and the average duration of surgery was 58.45 ± 5. 14 mins. The mean UCLA shoulder rating scale was 28.26 ± 4.1 for all patients at the final follow-up. Complications like hardware prominence, implant back out, and superficial skin infection were also recorded in the patients.

Conclusion: Bifocal fixation is an acceptable method of fixation for Grade III, IV and V acromioclavicular joint dislocations due to their good functional outcomes, mechanical stability and low cost.However more studies with increased sample size and better designed studies are required to assess their long term outcomes.

Health related quality of life among people receiving highly active antiretroviral therapy at Bharatpur Hospital, Chitwan, Nepal.

2022-06-17T04:59:15+00:00

Background: Health-related quality of life (HRQoL) is one of the most important outcome measures among HIV-infected patients receiving highly active antiretroviral therapy (HAART). Likewise, improved quality of life (QoL) is one prominent goal of patient treatment. This study was conducted to investigate the QoL of people living with HIV/AIDS (PLWHA) receiving HAART at the antiretroviral therapy (ART) center of the Bharatpur Hospital in Chitwan, Nepal.

Methods: This was a cross-sectional study conducted among 271 PLWHA receiving HAART at the ART center of Bharatpur Hospital in the Chitwan district in April, 2016. Participants were recruited purposely and interviewed with a structured questionnaire. Quality of life was assessed using the World Health Organization Quality of Life HIV- BREF (WHOQOL-HIV-BREF) standard tool. Data was entered to Epi-Info version 3.5.3 and analyzed using SPSS version 21 for windows. A bivariate analysis was fitted to identify factors associated with QoL.

Result: A total of 271 participants, with a mean age of 36.86 (SD = 9.62), were included in the study. This study found that the majority of participants had moderate general QoL, except for the spiritual domain, which contains information about personal beliefs, forgiveness and blame, and concerns about future, death, and dying. Younger patients, religious minorities, literate patients, unmarried patients, those on ART for more than three years, and those who adhered to ART were associated with good general QoL across all domains.

Conclusion: The participants’ self-reported HRQoL was generally satisfactory except for Spiritual domains. Since HIV is a chronic illness, the spiritual need of patients requires attention, including religious coping or support to find a sense of meaning/support in life, to cope with issues of guilt and shame, and to deal with the grief and bereavement associated with the disease.