Evaluation of Patient Perception and Satisfaction Toward the Use of Telemedicine During Pandemic of Novel Coronavirus in Pakistan.

Background:The trend of telemedicine is exponentially increasing worldwide due to the coronavirus disease (COVID-19) pandemic. However, patient satisfaction is always a concern regarding the use of telemedicine.Introduction:The aim of this study is to evaluate the perception and satisfaction level of patients toward the use of telemedicine during the pandemic of COVID-19 among Pakistani population.Materials and Methods:The survey questionnaires were distributed to 251 patients who received telemedicine consultation in any of three specializations: orthopedic, ophthalmology, and general medicine. The questionnaire contains 15 questions that covered four categories of patient satisfaction: interpersonal communication, caring, care delivery, and proficiency. Descriptive and analytical statistics were obtained by analyzing data using SPSS software version 20.Results:A total of 251 patients responded to the telemedicine questionnaire. Overall, 61.35% patients reported that they did not need any support for using technology during consultation and 96.41% of the patient population reported that telemedicine saved their travel time. It was found that gender, education, and age were significantly associated with the ease in technology with the p-value 0.012, 0.004 and <0.001, respectively, whereas the use of telemedicine again in future is found to be significantly associated with only education and age p-value <0.001. The statistically significant difference was found in three specialized consultation regarding the overall satisfaction, χ2 = 5.83, p-value = 0.05, with a mean rank in orthopedic is 133.6, 134.4 in ophthalmology, and 113.6 in internal medicine.Conclusion:Telemedicine is convenient and satisfactory way to provide health care services during pandemic. Although a considerable number of participants reported good response for telemedicine, there is a need of establishing local telemedicine guidelines, training of consultants and advancement in technology.

Dynamic Hip Screw Fixation Vs. Proximal Femur Nail For Unstable Per-Trochanteric Fractures: A Comparative Analysis Of Outcomes And Complications.

BACKGROUND: There are various implant choices to fix unstable per- trochanteric fractures. The aim of this study was to compare the outcomes of dynamic hip screw and proximal femur nail for unstable per-trochanteric fractures including complications associated with both fixations. METHODS: A retrospective analysis done on pertrochanteric fractures of femur who were treated with Dynamic hip Screw (DHS) and Proximal Femur Nail (PFN). The data was taken from our hospital hip data base for the past two years from January 2017 to January 2019. Data of 174 patients was analysed, divided in to Group A with DHS (n=122) and Group B with PFN (n=52). Follow up included X-ray (anteroposterior and lateral) views for fracture union and collapse, femur neck shortening, implant position and identification of mode of failure or collapse (cut out risk) by using tip-apex distance. The Harris hip score used to evaluate mobility status and other functional outcomes. RESULTS: The mean age in years of patients treated with PFN and DHS were 55.9 and 59.8, ranging from 39-83 years. The mean of Harris hip score at 2 year was 69.28±9.99 in DHS group and 72.12±9.71 in PFN group with the p-value 0.31. The mean of limb shortening was 12mm in DHS and 9 mm in PFN group. In DHS group, four cases had tip-apex distance of 39 mm and reported implant cut out that needs revision of surgery. CONCLUSIONS: Proximal Femur Nail group demonstrated no implant cut out and less mean limb length shortening where as other parameter like functional outcomes, fracture union, rate of infection, hospital stay and postoperative pain are not significantly different in two groups.