How Sharp Objects Injuries Impact our Healthcare Workers: Unveiling Perspective and Preventive Imperatives.

Introduction Sharp object injuries in the medical field present a considerable occupational hazard for healthcare workers (HCWs), encompassing a spectrum of consequences from immediate discomfort to enduring health consequences. These injuries may expose HCWs to potential infections. Despite efforts to control sharp object injuries in healthcare environments, they are present at every stage involving using or disposing of medical sharp instruments. In Jordan, limited research has focused on sharp object injuries, with most data included from studies concentrating on practicing nurses or nursing students. Consequently, further research is necessary to comprehend the causes behind the high sharp object injury rate and the insufficient knowledge of safety practices and preventive guidelines. Objectives This study was conducted to investigate the impact of sharp object injuries on HCWs, underlying causes, and potential consequences causes of needlestick injuries. To highlight perspective and preventive imperatives. Methods and patients This retrospective institutional-based cross-sectional chart analysis was conducted by reviewing all sharp object injuries report sheets and extracting data directly from these reports for analysis. The study encompassed all reported cases occurring between 2018 and 2023. All the participants' data handling was accomplished according to the Declaration of Helsinki (2013) and the Health Insurance Portability and Accountability (HIPAA) Acts.  Results A total of 146 self-reported hospital workers were included in the study. Within the final cohort, 52.73% of the participants were male (77/146), with an average age at diagnosis of 38.6±7.87 years (ranging from 20 to 52 years). Conversely, females comprised 47.27% of the cohort population (69/146) and had an average age at diagnosis of 34.73±6.73 years (ranging from 19 to 47 years). The age group 20-29 years was the most prominent age group, statistical analysis of age and gender data revealed significant differences. The overall prevalence of sharp object injuries was 11.83%, indicating that a sizable portion of HCWs is at risk of exposure to bloodborne pathogens. Among the different professional categories, Physicians constituted the majority of sharp object injuries reported victims in 41 cases (28.08%), followed by nurses in 38 cases (26.02%). Statistical analysis of the profession's data revealed significant differences (P<0.001). Notably, sharp object injuries were most reported in wards. The leading procedures that caused sharp object injuries were identified as during needle recapping in 53 instances (36.30%), then followed by medical waste treatment in 32 cases (21.92%). The left hand was the most affected body part, reported in 83 cases (56.84%). All injured individuals reported the incident promptly. No seroconversions were documented within the reviewed cases during the study period. Conclusion Injuries caused by sharp objects persist as a significant danger for hospital employees, posing immediate harm and long-term health risks linked to bloodborne pathogens. The findings stress the continuous responsibility of healthcare institutions to prioritize staff safety by addressing the root causes of sharp object injuries and fostering reporting and prevention cultures. Underreporting reasons are diverse, encompassing factors like time constraints, fear of consequences, and the misconception of injury insignificance.

Exploring the Complex Landscape of Spine Brucellosis.

INTRODUCTION: Brucellosis is an infectious illness contracted by humans through the consumption of unpasteurized milk and dairy items. Brucella organisms are diminutive, gram-negative, non-motile, and non-spore-forming facultative intracellular, aerobic intracellular coccobacilli residing within the reproductive organs of host animals, leading to conditions such as abortions and sterility. Numerous species of Brucella have been identified, with the following four exhibiting varying degrees of pathogenicity in humans: Brucella melitensis (originating from sheep), Brucella suis (associated with pigs), Brucella abortus (linked to cattle), and Brucella canis (found in dogs). B. melitensis and B. suis demonstrate the highest level of pathogenicity, while B. abortus and B. canis exhibit a more moderate degree of pathogenicity. The illness can progress to systemic involvement, with the musculoskeletal system being particularly susceptible to complications. Spinal epidural abscess is an infrequent complication that may occur during spondylitis caused by Brucella species. Epidural abscesses most commonly affect the lumbar vertebrae, while their involvement in the cervical spine is relatively rare. OBJECTIVE: In this review, we explore spine brucellosis, covering its epidemiology, pathogenesis, clinical manifestations, diagnostics, and evolving treatments. We aim to enhance early detection, timely intervention, and patient outcomes. PATIENTS AND METHODS: This retrospective chart analysis was conducted by revising all medical files for patients in whom spinal brucellosis was diagnosed and managed. RESULTS: This study was conducted at King Hussein Medical Center (KHMC), Jordan, and included a total of 20 patients who were diagnosed with spine brucellosis during the study period. Within the final cohort, 65% of the patients were male (13/20), with an average age at diagnosis of 47.53±14.98 years (ranging from 4 to 61 years). The female group, on the other hand, had an average age at diagnosis of 51.12±15.55 years (ranging from 3 to 58 years). Statistical analysis of the data revealed no significant demographic differences between the two groups. Regarding the co-morbidities, no statistical differences were observed between the two groups. Examining the occupational status of the two groups, no differences were observed. Also, no differences were observed between the two groups regarding the residence place, or the spinal segment involved. CONCLUSION: Spine brucellosis, although uncommon, poses a complex clinical challenge. Early diagnosis and a multidisciplinary approach are crucial for effective management. Further research is needed to refine diagnostic tools and treatment guidelines for spine brucellosis.

Spinal, Epidural, and General Anesthesia for Knee Joint Arthroscopy: Diversity, Equity, and Inclusion - Comparison Study.

Background: Knee arthroscopic surgery is a commonly performed procedure for diagnosing and treating knee joint problems. This procedure can be achieved under various types of anesthesia, general; or by applying regional anesthesia or even local. Epidural anesthesia and peripheral nerve blockage have been utilized in short procedures and provided a shorter length of hospital stay than general anesthesia in many former articles; however, spinal anesthesia including bupivacaine infusion has also offered a shorter length of hospital stay compared to general anesthesia. While the literature has not compared optimal techniques for these valid options. Aims: This review was conducted to challenge the hypothesis: What would be of choice for local anesthesia agents (either epidural or spinal anesthesia) that would be comparable to short-acting general anesthesia agents in terms of patient satisfaction and discharge times?! Setting and Design: The review was conducted as a prospective, randomized study. Patients were randomized using a sealed envelope method to be selected to one anesthesia technique (general, epidural, or spinal anesthesia). Materials and Methods: During the period between January 2019 and December 2020, 198 patients underwent unilateral knee joint arthroscopy. Seventy-seven patients refused anesthesia randomization and opted for one option directly. One hundred and twenty-one patients were qualified for the final recruitment stage of this analysis to contribute to the anesthesia randomization and they were assigned into three groups. Results: Demographical analysis showed no significant differences between cohorts. No major surgical or anesthetic adverse effects were reported. Anesthesia reported satisfactory for incision among three groups. For regional anesthesia cohorts, sphincteric control (voiding) considered a mandatory parameter for discharge, was shorter in the epidural group compared to the spinal anesthesia cohort (154 ± 28 vs. 189 ± 47 min, P < 0.0013). Time to discharge for the three cohorts was also significantly shorter for general anesthesia and epidural cohorts as compared to spinal cohort (general, 106 ± 29 min; epidural, 90 ± 18 min; spinal, 151 ± 48 min, P < 0.003). A total of 114 patients stated that they would select the same anesthetic method over again. Conclusion: This review revealed that regional epidural anesthesia using 2-chloroprocaine and general anesthesia using short-acting agents were similarly successful in terms of perioperative conditions and duration of hospital stay in our center. Whereas spinal anesthesia using 10 mg of bupivacaine combined with fentanyl in the same setting lacked behind in terms of extended discharge time and showed a higher prevalence of adverse effects.

The Lead of Direct Adjuvant Intraoperative Foraminal Steroids' Infiltration.

Low back pain generally involves lumbosacral radicular syndrome, nerve root pain, and nerve root entrapment/irritation. Management options for patients are variable and diverging. To the highlight the efficacy of combined early decompressive surgery plus intraoperative steroid injections in terms of postoperative back pain in patients managed by our combined team. A prospective study conducted by reviewing all consecutive patients managed, over a 1-year period (2018-2019). This study showed that adjunct use of intraoperative foraminal and epidural steroids injections to treat back pain in patients with degenerative spine disease could significantly improve the pain score which leads to significant decrease in working days off and the need for pain killer medications or even obviating the usage rate.

Delving Inside the Enigmatic Central Neurocytoma: Electronic Hospital Database Retrieval.

INTRODUCTION: Central neurocytomas (CNCs) appear as a rare benign intraventricular lesions involving <0.5% of primary brain tumors. There are no consensus guidelines for the optimal management strategy, so that this entity still enigmatic. AIM: This review aims to highpoint the entity of central neurocytoma in patients managed by our department and the unique surgical considerations, to review the epidemiology and demographics in patients treated in our institution. METHODS: This retrospective analysis was conducted by reviewing tall patients managed at King Hussein Medical Center (KHMC) and their medical records. Patient reports were retrieved from the electronic hospital database for a 14-year period (2004 _ 2018). The review was permitted by the Royal Medical Services Institutional ethics committee. As this study was a retrospective chart review, the requirement for consent was waived. RESULTS: Study revealed 33- patients who had Central neurocytoma as the underlying cause for admission. Of the final population 42.4% of the patients were males. Mean age at diagnosis was 29.48±9.78 years. Two cases were extra-ventricular, to cases were anaplastc. Only one patient developed recurrence. CONCLUSION: We have one the large series of Central neurocytomas in literature. They are benign and total resection is feasible. New adjuvant therapies are flourishing. Supplementary studies are required clarify the cardinal factors responsible for its pathogenesis; diagnosis; and to consolidate management approaches protocol.

The Scanty Knowledge of Endoscopic Third Ventriculostomy in Infants.

INTRODUCTION: Hydrocephalus (HCP) remains one of the commonest pathologies treated in developing countries. Endoscopic third ventriculostomy (ETV) has become the alternative to shunt-divergen procedures in the treatment of many pathologies of the cerebral fluid in the brain. Age has been considered a limitation to perform the procedure, we started to perform ETV In younger patients earlier than many other units. Objectives: In this study, we demonstrate the overall efficacy of ETV in infants younger than 1-year of age and to subsequently report the outcome of this procedure. METHODS: From 2000 till 2016 we have performed a total of 386 cases of ETV of all ages. 71-cases were infants (below 1-year of age). Our study was undertaken to evaluate these cases. Patients were divided into two subgroups according to the cause of hydrocephalus; obstructive HCP, communicating HCP. RESULTS: Mean time for follow up was 52 months. Mean age at surgery was 137days (7- 351days). The population included 31-females and 40-males, while10 infants were premature. Success rates were; 91.6%, 63.6% correspond to each sub-group with an overall success rate of 73.24%. CONCLUSION: ETV in infants is feasible, technically more demanding. Success rate justifies the procedure to be performed in such age group of patients. ETV can be used, attentively, in cases of hydrocephalus associated with MMC, morbidity and mortality does not differ from the general population.

The Quest of Sagittal Balance Parameters and Clinical Outcome after Short Segment Spinal Fusion.

INTRODUCTION: Sagittal imbalance leads to muscular distress and results in low back pain. OBJECTIVES: This study scrutinize the segmental impact of short spinal fusion on spinopelvic parameters and the global patient's clinical outcome. MATERIALS AND METHODS: A retrospective analysis evaluated 56-patients who underwent lumbar fusion surgery at Klinikum Dortmund, from July 2013 to February 2014. The population was allocated into two groups: (1-level group), (2-levels group). EOS imaging applied for radiological evaluation and measurements of the following spinopelvic parameters: pelvic incidence (PI), sacral slope (SS), pelvic tilt (SS), lumbar lordosis (LL), and sagittal vertical axis (SVA). The radiological measurements were implemented during the preoperative, postoperative, 3 months and 1 year follow-up visits. All patients completed clinical questionnaires. RESULTS: Statistically, the Pearson correlation coefficient revealed in the 1-level group that the clinical parameters correlated with the PT (R=0.40), SSA (R=-0.38) and SVA (R=-0.41) (p<0.05). While clinically, the mean preoperative VAS and mean ODI improved significantly in both groups.There was also a high correspondence between LL and SS (R=0.90); this relationship persisted at the same level even after a year. For the 2-level group, the only parameter that was interrelated with clinical parameters was the SVA (R=0.49) (p<0.05). There was also a high correlation between LL and SS (R=0.88). CONCLUSION: Scrutiny conducted showed: Patient with one level would improve clinically in terms of pain and radiculopathy, with only small alterations in spino-pelvic parameters. Meanwhile, two-level fusions have a statistically substantial clinical improvement interrelated to re-establishment of lumbar lordosis and sagittal vertical axis.