Introduction Many countries including Pakistan are currently using face masks in their pandemic control plans. Being highly prevalent, the correct use of these masks is particularly important, as an incorrect use and disposal may actually increase the rate of transmission. The purpose of this study was to investigate the knowledge, attitude, and practices of healthcare workers (HCWs) in wearing a surgical face mask to limit the spread of the new coronavirus disease 2019 (COVID-19). Materials and Methods This survey was conducted by interviewing HCWs using a questionnaire consisting of the basic demographic characteristics, and the knowledge, attitude, and practices regarding the use of surgical face mask to limit the new COVID-19 exposure. Each correct answer was scored 1 and each incorrect answer scored 0. The total number of questions was 16, and the final score was calculated and then labeled according to the percentage (out of 16) of correct responses as good (>80%), moderate (60-80%), and poor (<60%). Results A total of 392 participants with a mean age of 42.37 ± 13.34 years (341 males and 51 females) were included in the study. The overall final results were good in 138 (35.2%), moderate in 178 (45.4%), and poor in 76 (19.3%). Around 43.6% of participants knew about the correct method of wearing the masks, 68.9% knew that there are three layers, 53% stated that the middle layer act as a filter media barrier, and 75.5% knew the recommended maximum duration of wearing it. The majority (88.2%) of participants knew that a cloth face mask is not much effective, around 79.8% knew that used face mask cannot be re-used, and 44.8% knew about the yellowcoded bag for disposal.

Background The coronavirus disease 2019 (COVID-19) since the beginning has been a reason of fear among healthcare workers (HCWs) due to the increased mortality, especially in the HCWs themselves. In this survey study, we aimed to explore the predictive factors associated with fear faced by HCWs during the COVID-19 pandemic and to identify the areas which need to be addressed to reduce it. Methods On May 14, 2020, we conducted an observational, cross-sectional survey using a self-administered questionnaire, consisting of the following two parts: (1) focused on factors associated with HCWs' fear of getting an infection and being a source of carrying the infection to whom they care, and (2) focused on factors associated with HCWs' fear of uncertainty and lack of support from concerned health authorities. Results The mean age of the participants was 40.04 ± 12.92 years with 79.3% being males. More than half (51.1%) of the participants were consultants. The most important factors associated with fear included getting infected (84.8%), quarantined (69.6%), not getting medical treatment (62%), losing a life (56.8%), and infecting family members (94.2%). Another major factor associated with HCWs' fear was lack of support from concerned health authorities, 80.2% thought of solatium, and 71.7% believed that the job should be given to eligible family members of the deceased. More than 82.2% were concerned about health expenses and around 97.6% felt an additional health risk allowance should be given. Conclusion Our results indicate that the risk of getting infection to themselves and their families, along with a lack of support from concerned health authorities, was strongly associated with fear among HCWs. We hope through these findings that the concerned health authorities will take notice and do something in this regard by developing appropriate policies and measures to make sure that HCWs and their families are cared for if they get infected.

No abstract

Metallosis is a very rare condition that poses a diagnostic challenge. Its precise incidence is not known and the condition should be suspected in patients who present with the clinical signs and symptoms discussed below. In particular, physicians and surgeons should pay special attention to whether metal prosthesis has been used for fracture repair or joint function. Here we report the case of a 40-year-old male who presented at an orthopedic surgery outpatient department in a tertiary care hospital with pain in the right distal thigh that had been ongoing for three months and swelling that had been ongoing for two months. According to the patient, he had received an operation for a right-sided distal femur fracture that was fixed with plate at a different hospital one year prior. Despite receiving all the appropriate physical exams and labs, and getting a radiologic workup, the diagnosis was unclear, and ultimately surgical exploration was conducted, which led to the diagnosis of metallosis. Although metallosis is a well-known complication, due to its rarity, physicians and surgeons often forget to keep metallosis as a differential that leads to diagnostic difficulties.

No abstract

BACKGROUND The COVID-19 and its related threat of death have led to significant fears among health care workers (HCWs) and their families around the world. The latest figures show thousands of HCWs have so for been infected with Covid-19 while interacting the patients, with a large percentage of them dying. OBJECTIVE In this survey study, we aimed to explore the predictive factors associated with fear faced by HCWs during covid-19 pandemic and to identify the areas which need to be addressed. METHODS On 14th May 2020, we conducted a descriptive cross-sectional survey using a self-administered questionnaire, which consisted of two parts: (1) focussed on factors associated with HCWs fear of getting infection and being a source of carrying infection to whom they care, and (2) focused on factors associated with HCWs fear of uncertainty and lack of support from concerned health authorities. Finally a total of 329 responses were collected and analyzed RESULTS The mean age of the participants was 40.04 years (SD ± 12.92), and around four-fifths of the participants were males 79.3%, and nearly more than half of the participants were consultants 51.1%. The first important factors associated with fear included, getting infected 84.8%, quarantined 69.6%, not get medical treatment 62%, losing life 56.8%, and infecting family members 94.2%. Another major factor associated with HCWs fear was lack of support from concerned health authorities, 80.2% thought of solatium and 71.7% of Job to deceased family members. More than 82.2% thought of health expenses and almost 97.6% thought of additional health risk allowance. CONCLUSIONS Our survey findings show the main predictive factors associated fear faced by majority of HCWs in Pakistan was getting infected to themselves and their families. Once diseased, majority of them feared that they may not get medical treatment and end up on ventilator. Another important factors associated with fear were uncertainty and lack of support from concerned health authorities. We hope Government of Pakistan should take note of this and make appropriate policies and measures to make sure, that HCWs and their families are cared for if they get infected.

BackgroundCrescent fracture-dislocation of sacroiliac joint is a type of lateral compression pelvic injury associated with instability. These fractures comprise 12% of lateral compression fractures.ObjectiveThe objective of this study is to share the experience and to assess the functional outcome of fixation in crescent fracture-dislocation.MethodsWe analyzed a descriptive case series with clinical data of 15 patients at the Department of Orthopedics Surgery at the Dr. Ruth K.M. Pfau Civil Hospital at Dow University of Health Sciences in Karachi, Pakistan, from January 2016 to August 2018. The patients were treated by closed and open fracture reduction and fixed with percutaneous screws and reconstruction plates.ResultsA total of 15 patients were included in this study with age ranging from 20 to 60 years (11 men [73%]; four women [27%]). According to the mechanism of injury, five (33%) had motorcycle accidents; four (27%) had collision while sitting in a car; three (20%) were pedestrians hit by a vehicle; four (27%) were injured while sitting in van; two (13%) had bus-related injury, and one (6.5%) presented with a history of wall collapse.Five (33%) patients had type I fractures, seven (47%) had type II fractures, and three (20%) had type III fractures Associated injuries were midshaft femur fracture in two patients, contralateral superior and inferior rami fracture in three patients, and open tibia fracture in one patient. All fractures were fixed with reconstruction plates and screws. Patients were kept as non-weight-bearing on the injured joint for three weeks, mobilized non-weight-bearing on the contralateral leg after three weeks, and partial weight-bearing was started at eight weeks; full weight-bearing was started after three months. Nine patients (60%) had excellent outcomes, three (20%) had a good outcome, and three (20%) had a poor outcome.ConclusionCrescent fracture-dislocations are unstable injuries. These fractures should have proper reduction and fixation that will reduce pain, malunion, and shortening.

Objective: We aimed to evaluate the results of using a First and Second Inter-Compartmental Supraretinacular Artery (1,2-ICSRA) based vascularized bone graft (VBG) when performing Herbert screw fixation in scaphoid nonunion. Methodology: This is a retrospective study from January 2017 to August 2020 with a total of 16 patients. All those aged<50 years, fracture <2 yrs old, no previous surgical intervention on the fracture, and stage 1 or 2 degenerative changes at the fracture site were included. Patients with avascular necrosis of the scaphoid were excluded. All patients were radiologically examined. Herbert screw fixation was done under general anesthesia and a wedge-shaped VBG from the radius was placed at the nonunion site. Results: There were 12 males and 4 females with a mean age of 30.25±8.88 years. Chronic wrist pain at rest was completely relieved in all patients while the pain with motion was markedly diminished in 10 and eliminated in two. The average range of motion, pinch, and grip strength of the wrist improved after surgery. Power assessment showed that the mean power before surgery was significantly raised from 67.50±5.83 to 95.06±4.45 Kgs (p=0.001). The mean intensity of pain before surgery i.e. 5.54±1.36 reduced to 2.25±0.78 (p<0.001). Conclusion: We found excellent results when used Herbert screws along with a 1,2-ICSRA based VBG in patients with scaphoid nonunion, where the union was achieved in all and significant improvement was seen when power and pain were assessed.