Predictors of Acute Compartment Syndrome in Patients With Forearm Fractures: A Systematic Review.

Acute compartment syndrome (ACS) is a critical orthopedic and traumatology emergency arising from elevated pressure within a confined osteofascial compartment, leading to compromised blood circulation and tissue ischemia. This systematic review aims to comprehensively identify and analyze the most predictable risk factors associated with ACS development in patients with forearm fractures. Published articles on ACS were meticulously searched and evaluated on reputable medical databases such as PubMed. The keywords "risk factors associated with the ACS in patients who have sustained forearm fractures"were used to create the search syntax on various databases. Data were gathered on raw prevalence, population under study, and methodology. A total of 10 articles that met the search criteria were identified and included in this review with a total of more than 300,000 patients across the studies. Fracture-related ACS was the most common, followed by soft tissue damage among patients with forearm fractures. This review underscores fractures as primary ACS catalysts, along with the role of soft tissue trauma. Meticulous consideration of these risk factors can enhance clinical decision-making, early detection, and intervention, improving patient outcomes and care quality.

Work-Related Shoulder Pain Among Saudi Orthopedic Surgeons: A Cross-Sectional Study.

INTRODUCTION: Shoulder pain is one of the most frequently reported musculoskeletal conditions that approximately 6.9 to 26% of people experience. Numerous etiologies have been linked to causing shoulder pain, with the most frequent one being rotator cuff tendinopathy. Work-related musculoskeletal pain is prevalent in the medical field in general, but orthopaedic surgeons account for the majority of cases overall. The pain experienced is usually caused by many attributing factors that all relate to either the long hours and physically intensive procedures or the unnatural positions orthopaedic surgeons are put in during their surgeries. This study seeks to shed light on the prevalence, contributing factors, and effect of the complications of shoulder pain among orthopaedic surgeons, a topic unexpectedly understudied, particularly in Saudi Arabia. METHODS: A survey has been developed to ask orthopaedic surgeons at various levels of their careers. The study was conducted in Saudi Arabia, Riyadh. It was a multi-centered study that included both governmental and private hospitals in Riyadh. The collected data included age, gender, BMI, sub-specialty, position, number of surgeries performed per week, and the average time per surgery. In our survey, we used the Shoulder Pain and Disability Index (SPADI) to assess shoulder pain. Ethical approval was obtained for this study by the Institutional Review Board of King Abdullah International Medical Research Center, Ministry of National Guard Health Affairs, Riyadh, Kingdom of Saudi Arabia (IRB/1484/23). RESULTS: Fifty orthopaedic surgeons participated in this study most of whom were male (88%) and fell within the age range of 31-40 years (36%). Regarding their positions, a significant proportion were consultants (54%). In terms of workload, approximately (38%) of the surgeons performed three to four surgeries per week. As for the duration of surgeries, almost half of the participants spent between three and five hours per surgery (48%). When it comes to experiencing pain or difficulties during shoulder activities, a considerable number reported occasional occurrences (36%). Moreover, a substantial majority did not have a history of specific shoulder-related disorders, as (88%) of the participants had none of the mentioned conditions, such as shoulder trauma or disorders like adhesive capsulitis and impingement. Most participants reported difficulties in performing daily activities due to their work-related shoulder pain. Mild pain was the most common reported severity level in all assessed activities. CONCLUSION: The present study showed that orthopaedic surgeons in Riyadh, Saudi Arabia, occasionally experience shoulder pain from their jobs. Most of our sample stated that mild shoulder discomfort made it difficult to conduct daily tasks. This study is limited by a relatively low response rate, which may be attributed to the demanding nature of orthopaedic surgery. To promote health among caregivers throughout the kingdom, more studies should be conducted about shoulder pain.

Unexpected Benefits of Coronavirus Disease 2019: Impact of Coronavirus Disease 2019 Pandemic on Surgical Site Infection: A Systematic Review and Meta-Analysis.

Background: We aimed to summarize and synthesize the current evidence regarding the indirect impact of the coronavirus disease 2019 (COVID-19) pandemic and its associated measures on the surgical site infection (SSI) rate compared with the pre-pandemic period. Methods: A computerized search was conducted on MEDLINE via PubMed, Web of Science, and Scopus using the relevant keywords. Two-stage screening and data extraction were done. The National Institutes of Health (NIH) tools were used for the quality assessment. The Review Manager 5.4.1 program was used for the analysis. Results: Sixteen articles (n = 157,426 patients) were included. The COVID-19 pandemic and lockdown were associated with reduced risk of SSIs after surgery (odds ratio [OR], 0.65; 95% confidence interval [CI], 0.56-0.75; p < 0.00001) and (OR, 0.49; 95% CI, 0.29-0.84; p = 0.009), respectively. There was no significant reduction in the SSIs rate after applying the extended use of masks (OR, 0.73; 95% CI, 0.30-1.73; p = 0.47). A reduction in the superficial SSI rate during the COVID-19 pandemic compared with the pre-COVID-19 pandemic period was observed (OR, 0.58; 95% CI, 0.45-0.75; p < 0.0001). Conclusions: The current evidence suggests that the COVID-19 pandemic may have some unexpected benefits, including improved infection control protocols, which resulted in reduced SSI rates, especially superficial SSIs. In contrast to extended mask use, the lockdown was associated with reduced rates of SSIs.

The Prevalence of Acceptance Between General Anesthesia and Spinal Anesthesia Among Pregnant Women Undergoing Elective Caesarean Sections in Saudi Arabia.

Background The choice of anesthesia for an elective cesarean section should be based on an individual benefit-risk assessment, considering the pregnant woman's preferences, concerns, and the available medical expertise. This study aimed to determine the preferences for general and spinal anesthesia among women undergoing elective cesarean sections and the factors affecting their choice. Methods The study design is a cross-sectional study, and it was conducted on pregnant women to measure the acceptance of general anesthesia and spinal anesthesia in patients with elective cesarean sections in Saudi Arabia. Random pregnant women were invited to participate in this study across Saudi Arabia after fulfilling the inclusion criteria. A digital questionnaire was distributed across Saudi Arabia to be filled out by female residents. A Microsoft Excel (Microsoft Corporation, Redmond, Washington, USA) sheet was used for data entry, while IBM SPSS software version 27.0.1 (IBM Corp., Armonk, New York, USA) was used for statistical analysis. Results The study included 813 participants; most (28%) of them were 25-30 years old. Of the study participants, 54% had chosen spinal anesthesia before, 22% had chosen general anesthesia, and 24% had chosen neither. Reasons to choose general anesthesia were reported as follows: 21.6% feared pain during surgery, 24.2% feared watching the surgical procedures on their bodies, 16.6% feared back pain, 12.8% feared being paralyzed, and 15.1% feared needles used to administer anesthesia in the lower back. Reasons for choosing spinal anesthesia were reported as follows: 26.3% had back pain concerns; 13% feared prolonged unconsciousness; 9.6% feared having a headache after surgery; 17% had post-surgery pain concerns; 30.1% wanted to be alert at the time of the birth of the baby; 10.6% feared the chances of experiencing nausea and vomiting; and 7.4% feared not being able to breastfeed. Conclusion Spinal anesthesia was chosen by more participants than general anesthesia. There was a statistically significant association between choosing spinal anesthesia and the number of previous pregnancies, parity, history of preterm labor, and recommendation to undergo general or spinal anesthesia by non-medical staff. It was also significant with the older age and higher educational level of participants. This decision may be influenced by a number of variables, the most significant of which are prior experience with general anesthesia or spinal anesthesia, educational attainment, and non-medical advice.

Management of Lumbar Disc Herniation: A Systematic Review.

A herniated disc in the spine is a condition during which a nucleus pulposus is displaced from intervertebral space. It is a common cause of back pain. The patients who experience pain related to a herniated disc often remember an inciting event that caused their pain. This activity reviews the evaluation and management of lumbar disc herniation and discusses the role of the healthcare team in evaluating and improving care for patients with this condition. Data sources were PubMed/Medline and Embase. Our review investigated English-language articles (from 2010 to 2023) according to the PRISMA guidelines. Overall, there were seven articles. Surveys and analyses of national databases were the most widely used methods (n=7). The search identified 777 studies; 7 were eligible for inclusion in the analysis. Further understanding of spinal disc herniation and treatment protocols may help improve evaluation and management in the future. Our research covered a range of management options. Disc herniation is a frequent problem for internists, emergency department doctors, nurse practitioners, and primary care physicians. To manage efficiently, an interprofessional team is needed. The first course of treatment is conservative, with paracetamol and anti-inflammatories being frequently used to relieve pain. A chemist must supervise the use of opioid analgesics in certain situations. Although surgery is sometimes the final option, patients frequently have neurological damage and lingering discomfort. In circumstances where physical treatment is not working, MRI interpretation becomes necessary. Primary care physicians or mental health professionals should handle back pain as it is frequently linked to mental health issues. Results can be enhanced by regular exercise and preserving a healthy body weight.