There is a Minimal Difference in Ankle Functional Outcomes After Peroneus Longus Harvest: Systematic Review and Meta-analysis

Importance

Recently, peroneus longus (PL) autograft as a graft choice for ligament surgeries have attracted interest due to studies showing good clinical outcomes and minimal donor site morbidity. There remain concerns related to these grafts, especially the potential impact on ankle functions.

Aims/Objective

The purpose of this review and meta-analysis is to summarize the available evidence for ankle functional outcomes after PL harvest. This will provide objective clinical evidence for surgical decision making.

Evidence Review

Cochrane, Embase, Medline, and Google Scholar were all searched for articles published between January 2001 and May 2021. For the aim of a systematic review, certain inclusion and exclusion criteria were adopted in accordance with PRISMA recommendations. The primary outcome measure was the assessment of ankle functional outcomes using validated instruments (such as AOFAS score, FADI score etc.).

Findings

A total of twelve studies representing pooled patient populations of 537 patients were included in this review. The average follow-up duration was 17 months (range; 6-32 months) across all studies. All twelve studies assessed AOFAS score and six studies also additionally assessed FADI score. The pooled mean outcomes measured showed a slight decrease in post-operative as compared to pre-operative AOFAS and FADI score (mean difference of AOFAS 1.92, 95% CI 1.021-3.123, p value < 0.05 and mean difference for FADI 1.50, 95% CI 0.561-2.445, p value < 0.05). Though statistically significant the magnitude of variance implies minimal clinical impact.

Conclusion and Relevance

This review and meta-analysis found that PL autograft harvest leads to statistically significant but minimal impact on ankle functional outcomes. This, in conjunction with various studies on ankle parameters after PL harvest, shows that PL harvest leads to minimal impact on ankle outcomes and function.

Level of Evidence

Systematic review Level III.

Spousal Violence among Reproductive Age Group Women - A Community-Based Cross-Sectional Study

Background

Spousal or intimate partner violence is the most common form of domestic violence and is a preventable cause of morbidity and mortality in women. The aim of this study was to estimate the prevalence of spousal violence, various types of spousal violence, and the factors associated with it among reproductive age group women.

Materials and Methods

This was an analytical cross-sectional study conducted in the Urban Health Training Center area of a tertiary care teaching hospital in Nagpur, India, among married women between 15 and 49 years of age who were selected using systematic random sampling. The data was collected from a sample of 373 women by face-to-face interview and analyzed using Statistical Package for the Social Sciences (SPSS) v21.

Results

The prevalence of spousal violence among reproductive age group (15-49 years) women was found to be 59.7%, with emotional violence (54.1%) being the most common, followed by physical (51.2%) and sexual (43.4%) violence in that order. Regular alcohol consumption of husband had the highest odds of spousal violence among women (odds ratio [OR] 12.51, 95% confidence interval [CI] 6.51-24.03). Other factors associated with spousal violence among reproductive age group women were early age at marriage, literacy and employment of women and husband, lack of emotional support from the family members, and dowry-related problems in the family.

Conclusion

A multifaceted approach including legal measures, empowerment of women, and sociocultural factors involving families, institutions, governmental, nongovernmental, and civil society organizations is the need of the hour.

Development, evaluation and validation of a financial stress scale for traders working in financial market

Background: Stress due to financial aspects in life is increasingly common in today's world. It can lead to psychological consequences such as anxiety, depression and can also lead to other non-communicable disorders. Previous scales to measure stress; which are generalized and does not necessarily include the financial aspects of stress. Aims & Objectives The purpose of this research is to develop a valid and reliable instrument that can be used to assess stress among day-traders of stock market. Material & Methods: In a cross-sectional survey a questionnaire was prepared based on in-depth interviews with day-traders of stock market. Construct validity, test-retest reliability and inter-rater reliability were carried out. Cronbach's alpha ( ) was 0.85 for the 11 short-listed items, with item-total correlations of 0.2--0.8. Multidimensional scaling determined 2 dimensions -- work related and non-work related. Result: Results from this first study among day-traders in India indicate that traders are not immune to financial stress, with (78.9%) reporting high work related stress, (7.7%) reporting moderate work related and (13.4%) reporting low work related stress. Conclusion: this study identified a set of psychosocial stressors among day-traders and a stress scale (The Financial Stress Scale) was developed in the South Asian context.

Profile of modifiable and non-modifiable risk factors in stroke in a rural based tertiary care hospital - a case control study

Background:

Stroke, a major public health problem in India and worldwide, is associated with many risk factors. The modification of risk factors, an important public health strategy, has been shown to reduce the risk of stroke. Hence the present study was carried out to document the risk factor profile of stroke.

Methods:

It was a case-control study. Patients with stroke admitted in a tertiary care centre in central India and age and sex matched controls were included. Detail history and clinical examination was done in all cases and controls. The risk factors studied were education, socioeconomic status (according to Kuppuswamy’s classification), level of physical activity, alcohol intake, and smoking, tobacco chewing, family history of stroke and history of systemic hypertension, transient ischemic attack or ischemic heart disease. Anthropometric (weight, height, body mass index and waist circumference) measurements were done in all patients. Electrocardiogram was done in cases as well as controls and abnormalities noted.

Statistical Analysis:

The data was analyzed using Epi info version 3.4.1 software. Chi-square test was used as test of significance and p value less than 0.05 was considered as significant.

Results:

On comparing the cases with controls, sedentary life-style (p=0.02), history of transient ischemic attack (p=0.002), coronary artery disease (p=0.014), family history of stroke (p=0.001), systemic hypertension (p<0.001) and ECG abnormalities (p=0.04) were significant risk factors whereas low socio-economic status (p=0.40), smoking (p=0.12), tobacco chewing (p=0.35), alcohol consumption (p=0.22), obesity [both central and generalized as assessed by waist circumference (p=0.33) and BMI respectively (p=0.43)] and Diabetes mellitus (p=0.07) were not found to be statistically significant risk factors. The most significant risk factor was systemic hypertension (OR= 15.92, 95% CI, 1.78-6.85) followed by coronary artery disease (OR=3.86, 95% CI, 1.13-14.50), abnormal ECG (OR=2.49, 95% CI, 0.97-6.96) and sedentary life-style (OR=2.41, 95% CI, 1.07-5.49).

Conclusions:

In the present hospital based case control study in patients with stroke, sedentary life-style, history of transient ischemic attack, family history of stroke, coronary artery disease, systemic hypertension and abnormal ECG were significant risk factors. This could be helpful in early identification of subjects at risk for stroke and formulating public health strategy, if proven by larger population based studies.

Prevalence of overweight in high school students with special reference to cardiovascular efficiency

Background:

In India, malnutrition has two ends. Under nutrition attracted the focus of health workers, as it is more prevalent. But over the past few years, childhood obesity is increasingly being observed with the changing lifestyle of families with increased purchasing power, increasing hours of inactivity due to television, video games and computers have replaced outdoor games and other social activities. Globally, an estimated 10% of school-aged children, between 5 and 17 years of age, are overweight and obese. Obesity can be seen as first wave of a defined cluster of non-communicable diseases called “New World Syndrome” creating an enormous socio-economic and public health burden in poorer countries. The most important consequence of childhood obesity is its persistence into adulthood with all its health risks like dyslipidemia, hyper-insulinemia, cardiovascular diseases, type 2 diabetes, osteoarthritis, gall bladder disease, hypertension and some sex hormone- sensitive cancers. The present study was, therefore, undertaken to determine the prevalence of overweight in high school students and to study the association between Body Mass Index (BMI) and cardiovascular efficiency.

Methodology:

A school based cross sectional study was conducted in 2 schools of Nagpur. The total number of students included in the study was 565. Student’s complete information regarding profile was taken in pretested questionnaire format after taking informed consent of parents. The anthropometric measurements of the students were done. Student’s height and weight were measured and BMI was calculated. The student’s cardiovascular efficiency was assessed with the help of Harvard step test.

Statistical Analysis:

The data was analyzed using Epi info version 3.4.1 software. Chi-square test was used as test of significance and p value less than 0.05 was considered as significant.

Results:

90.97% students belonged to 13, 14 and 15 years of age group. majority of the students belong to 14 years (33.81), followed by 13 years (33.27) and 15 years (23.89) of age group respectively. The prevalence of overweight in students was 5.84% and obesity was 0.35%. The combined prevalence of overweight and obesity was 6.19%. The prevalence of overweight in boys is 5.31% and obesity was 0.63% and that in girls is 6.53% and 0% respectively. The association between Harvard step test and overweight was found to be statistically significant (p< 0.000001).

Conclusion:

The total prevalence of overweight and obesity was 6.19%. The association between Harvard step test and overweight was found to be statistically significant (p< 0.000001).

Supplementation of vitamin C with atypical antipsychotics reduces oxidative stress and improves the outcome of schizophrenia

RATIONALE

Several investigators implicated role of free radical-mediated pathology in schizophrenia. No study has ever examined the effect of vitamin C with atypical antipsychotics in the treatment of schizophrenia.

OBJECTIVE

The aim of this study was to examine the effect of oral vitamin C with atypical antipsychotics on serum malondialdehyde (MDA), plasma ascorbic acid levels, and brief psychiatric rating scale (BPRS) score in schizophrenic patients.

METHOD

Forty schizophrenic patients participated in a prospective, double-blind, placebo-controlled, noncrossover, 8-week study. The patients with schizophrenia were divided randomly into placebo and vitamin C group of 20 each. Serum MDA and plasma ascorbic acid were estimated by methods of Nischal and Aye, respectively.

RESULT

Increased serum MDA and decreased plasma ascorbic acid levels were found in schizophrenic patients. These levels were reversed significantly after treatment with vitamin C along with atypical antipsychotics compared to placebo with atypical antipsychotics. BPRS change scores at 8 weeks improved statistically significant with vitamin C as compared to placebo.

CONCLUSION

Oral supplementation of vitamin C with atypical antipsychotic reverses ascorbic acid levels, reduces oxidative stress, and improves BPRS score, hence both the drugs in combination can be used in the treatment of schizophrenia.

Electrophoresis and immuno electrophoresis in leprosy

50 cases of leprosy belonging to various subgroups i.e. 10 tuberculoid, 25 lepromatous leprosy, 10 lepra reaction, 5 dimorphic leprosy, and 25 cases or normal individuals were subjected to agar gel electrophoresis. The slides were scanned by densitometry. It showed profound departure from normal in various fractions of electrophoretic patterns. All of them showed rise of gamma globulin. Albumin was markedly decreased in lepromotous leprosy and lepra reaction. In dimorphic leprosy Alfa-1 was decreased. Qualitative immuno electrophoresis was done by using antihuman serum raised in the laboratory, by immunising rabbits. It revealed changes in IgM and IgG arcs. Results are discussed and tried to explain on immunological derangement.