Online resources for information on shoulder arthroplasty: an assessment of quality and readability

Background@#Many patients use online resources to educate themselves on surgical procedures and make well-informed healthcare decisions. The aim of our study was to evaluate the quality and readability of online resources exploring shoulder arthroplasty. @*Methods@#An internet search pertaining to shoulder arthroplasty (partial, anatomic, and reverse) was conducted using the three most popular online search engines. The top 25 results generated from each term in each search engine were included. Webpages were excluded if they were duplicates, advertised by search engines, subpages of other pages, required payments or subscription, or were irrelevant to our scope. Webpages were classified into different source categories. Quality of information was assessed by HONcode certification, Journal of the American Medical Association (JAMA) criteria, and DISCERN benchmark criteria. Webpage readability was assessed using the Flesch reading ease score (FRES). @*Results@#Our final dataset included 125 web pages. Academic sources were the most common with 45 web pages (36.0%) followed by physician/private practice with 39 web pages (31.2%). The mean JAMA and DISCERN scores for all web pages were 1.96±1.31 and 51.4±10.7, respectively. The total mean FRES score was 44.0±11.0. Only nine web pages (7.2%) were HONcode certified. Websites specified for healthcare professionals had the highest JAMA and DISCERN scores with means of 2.92±0.90 and 57.96±8.91, respectively (P<0.001). HONcode-certified webpages had higher quality and readability scores than other web pages. @*Conclusions@#Web-based patient resources for shoulder arthroplasty information did not show high-quality scores and easy readability. When presenting medical information, sources should maintain a balance between readability and quality and should seek HONcode certification as it helps establish the reliability and accessibility of the presented information.Level of evidence: IV.

Evaluation of online video content related to reverse shoulder arthroplasty: a YouTube-based study

Reverse shoulder arthroplasty (RSA) has evolved continuously over recent years, with expanded indications and better outcomes. YouTube is one of the most popular sources globally for health-related information available to patients. Evaluating the reliability of YouTube videos concerning RSA is important to ensure proper patient education. Methods: YouTube was queried for the term “reverse shoulder replacement.” The first 50 videos were evaluated using three different scores: Journal of the American Medical Association (JAMA) benchmark criteria, the global quality score (GQS), and the reverse shoulder arthroplasty-specific score (RSAS). Multivariate linear regression analyses were conducted to determine the presence of a relationship between video characteristics and quality scores. Results: The average number of views was 64,645.78±264,160.9 per video, and the average number of likes was 414 per video. Mean JAMA, GQS, and RSAS scores were 2.32±0.64, 2.31±0.82, and 5.53±2.43, respectively. Academic centers uploaded the highest number of videos, and surgical techniques/approach videos was the most common video content. Videos with lecture content predicted higher JAMA scores whereas videos uploaded by industry predicted lower RSAS scores. Conclusions: Despite its massive popularity, YouTube videos provide a low quality of information on RSA. Introducing a new editorial review process or developing a new platform for patients’ medical education may be necessary. Level of evidence: Not applicable.

Study Of Clinical Outcomes In Patients With Severe Hepatic Injury: Experience At A Tertiary Care Centre.

Background: Management of liver trauma earlier used to be primarily surgical. With advancement in diagnostic modalities it has gradually shifted to non operative management. Methods: The present study was conducted on 40 patients with severe hepatic injuries (grade 3 onwards). All the patients were compared in terms of various methods adopted for their management and their clinical outcomes Results: Out of a total of 40 patients, maximum numbers of patients were in age group 18-24 years. 82.50 % patients had grade IV and rest had Grade V. 12 patients presented with shock on admission. Failure of NOM (non operative management) was seen in 25% of cases . The average requirement of blood transfusion in our study was 2.157 1.74 units. Average hospital stay in successful NOM cases was lower than in failed NOM. A total of 6 patients had to be operated upon in our study. Active bleed was seen on laparotomy in four patients with no evidence of any injury causing peritonitis. Conclusion: The success rates of non-operative management were significantly higher than the failures rates of non-operative management, without any significant incidence of complications and delayed laparotomies. Grade of liver injury or the amount of hemoperitoneum as detected on CT scan did not influence the outcome of non-operative management. Non-operative management is thus the gold standard in hemo-dynamically stable patients.

Anthropometric Profile in Relation to Playing Position of Elite Indian Soccer Players.

Background: Previous literature has demonstrated that each specialized playing position may have unique physical and physiological requirements. Body fat is highly related to playing position of football players. Purpose: The purpose of the study was to examine differences among positions in body size and percent body fat of elite football players prior to the start of regular season. Subjects: The subjects of this study were 34 (10 forwards, 10 midfielders, 10 defenders, 4 goalkeepers) normal, healthy elite football players without any orthopedic, respiratory or cardiovascular problems. Methods: Anthropometric profiles of the subjects were determined by measuring height, weight, body mass index (BMI) and percent body fat. The prediction formula used to calculate percent body fat using BMI was: body fat % = (1.20 × BMI) + (0.23 × age) - (10.8 × gender) - 5.4 (R2 0.79, standard error estimate = 4.1% BF%), taking age and gender (male = 1, female = 0) into account. Results: The results demonstrated significant differences (p < 0.005) in the percent body fat among the players of different playing positions. Goalkeepers possessed highest values for body fat percentage followed by defenders and forwards while midfielders had the least body fat percentage. Conclusion: The study suggests that anthropometric characteristics differ in players of different playing positions. The differences found despite similar training protocol might be due to the physiological adaptations in the players.

Effect of exercise program and calcium supplements on low bone mass among young Indian women- A comparative study

Low bone mass is a major health concern among young women nowadays due to sedentary lifestyle and lack of calcium rich food intake. Therefore there is an increase in the incidence of LBM among young university women so our main purpose of study was to compare effects of exercise program and calcium supplements on bone mass in young women. This single blinded, cross sectional study included data collection in the form of SOS T-scores at distal radius for 104 young university women of mean age 22.3 years using Sunlight Omnisense Bone Sonometer 7000S. Of these, 62 women with low bone mass were included in a 3 month study but 60 subjects completed the study. They were randomly divided into 3 groups: exercise group [n=21], calcium supplementation group [n=21] and control group [n=20]. All participants were evaluated pre and post protocol for T-score distal radius and midshaft tibia. After measuring SOS T-score of 104 subjects; we found that 60.57% had low bone mass and remaining 39.43% had normal bone mass. After 3 months, the exercise group showed significant improvement in distal radius SOS T-score [t=5.10, P<0.001], at midshaft tibia [t=3.71, P<0.001] followed by improvement in calcium group at distal radius [t=6.28, P<0.001], midshaft tibia [t=2.33, P<0.05] as compared to control group which showed a marginal increase. Exercise group showed more improvement in T-scores than calcium and control group. Exercise is important modifiable factor to improve bone accretion at this age and reduce risk of developing osteoporosis related debilitating conditions later in life

Role of biofeedback in optimizing psychomotor performance in sports

Biofeedback is an emerging tool to acquire and facilitate physiological and psychological domains of the human body like response time and concentration. Thus, the present study aims at determining the reconstitution of psychomotor and performance skills in basketball players through biofeedback training. Basketball players [N=30] with different levels of expertise [university, state and national] aged 18-28 years [both male and female] were randomly divided into 3 equal groups - Experimental group, Placebo group and Control group. The experimental group received Heart Rate Variability Biofeedback training for 10 consecutive days for 20 minutes that included breathing at individual's resonant frequency through a pacing stimulus; Placebo group was shown motivational video clips for 10 consecutive days for 10 minutes, whereas Control group was not given any intervention. At session 1, 10 and 1 month follow up, heart rate variability, respiration rate, response time [reaction and movement time], concentration and shooting performance were assessed. Two way repeated measure ANOVA was used to simultaneously compare within and between group differences. Response time, concentration, heart rate variability, respiration rate and shooting differences were statistically significant in each group along with interaction of group and time [P<0.001]. Also, all the measures showed statistically significant inter group difference [P<0.05]. The results of the study suggest that biofeedback training may help to train stressed athletes to acquire a control over their psychophysiological processes, thus helping an athlete to perform maximally

Blastoschizomyces Capitatus Pneumonia in an immunocompetent female.

Pulmonary infection due to Blastoschizomyces capitatus is less common. It is an emerging fungal pathogen. We describe a case of Blastoschizomyces capitatus pneumonia in an otherwise healthy female and review the clinical presentation, microbiological characteristics, and treatment for B .capitatus infection.

Functional performance testing in athletes with functional ankle instability

To determine if functional performance deficits are present in athletes with functional ankle instability [FAI] compared to healthy athletes using various functional performance tests. Sixty two athletes [mean age-21.7 +/- 1.8years; height-168.2 +/- 9.1cm; weight-63.8 +/- l 1.0kg] participated in this case control study. Athletes were divided into two groups: athletes with FAI [FAI group, n=31] and healthy athletes [Non-FAI group, n=31]. The FAI group was further divided into two subgroups: FAI with giving way [FAI-GW], FAI with no giving way [FAI-NGW]. Functional performance was assessed with the single-limb hopping test, figure-of-8 hop test, side-hop test, single-limb hurdle test, square hop test and single hop test. Significant differences [P<0.05] were observed for all the functional performance tests [FPTs] except the single hop test between FAI and Non-FAI groups; between FAI-GW, FAI-NGW and Non-FAI groups. Additionally, the involved limb performed significantly worse [P<0.05] than the contra-lateral uninvolved limb of the FAI-GW group for the above-mentioned FPTs. Significant functional performance deficits were observed in the FAI group in all tests except single hop test with greater deficits observed in the FAI-GW group. Hence, these tests can be used to determine the presence of FAI. However no deficits were identified for the test involving sagittal plane functional activities suggesting that this test can not be used as a criterion to discriminate individuals with FAI. It was further ascertained that functional performance was not affected by limb dominance

Prediction equation for calculating fat mass in young Indian adults

Accurate measurement or prediction of fat mass is useful in physiology, nutrition and clinical medicine. Most predictive equations currently used to assess percentage of body fat or fat mass, using simple anthropometric measurements were derived from people in western societies and they many not be appropriate for individuals with other genotypic and phenotypic characteristics. We developed equations to predict fat mass from anthropometric measurements in young Indian adults. Fat amass was measured in 60 females and 58 males, aged 20 to 29 yrs by using hydrostatic weighing and by simultaneous measurement of residual lung volume. Anthropometric measure included weight [kg], height [m] and 4 skinfold thickness [STs [mm]]. Sex specific linear regression model was developed with fat mass as the dependent variable and all anthropometric measures as independent variables. The prediction equation obtained for fat mass [kg] for males was 8.46+0.32 [weight] - 15.16 [height] +9.54 [log of sum of 4 STs] [R2=0.54, SEE=3.42 kg] and -20.22 +0.33 [weight] + 3.44 [height] + 7.66 [log of sum of 4 STs] [R2+0.72, SEE=3.01 kg] for females. A new prediction equation for the measurement of fat mass was derived and internally validated in young Indian adults using simple anthropometric measurements

effects of aerobic versus resistance training on cardiovascular fitness in obese sedentary females

The present study was designed to evaluate the effects of aerobic and strength training on cardiac variables such as blood pressure, heart rate [HR], and metabolic parameters like cholesterol, high density lipoprotein [HDL], triglycerides and anthropometric parameters of obese women of Punjab. This study was performed as an experimental study, in which subjects were randomly selected. There were thirty obese women, aged between 35-45yrs with body mass index [BMI] of above 30. Subjects were grouped into control [n=10], aerobic training [n=10] and resistance training [n=10]. Aerobic training was given for three days a week at 60-70% of maximum HR for 6 weeks. Resistance training [Delorme and Watkins Technique] was given for alternate days for 6 weeks. HR and blood pressure were measured before and after the exercise. Recovery HR was also measured. The findings of the study indicate statistically significant differences in recovery heart rate [Pre-exercise: 97.40 +/- 5.378 [mean +/- standard deviation [SD]], post-exercise: 90.70 +/- 4.599, t=8.066, P<0.001] and in post-diastolic blood pressure [Pre-exercise: 85 +/- 3.265, post-exercise: 86.20 +/- 2.820, P<0.001] in aerobic training and in systolic blood pressure [Pre- and post-exercise] in both training groups [P<0.001]. Significant differences were observed in very low-density lipoprotein [pre-exercise: 28.10 +/- 1.415, post-exercise: 26.86 +/- 0.760, t=6.318] and HDL [pre-exercise:45.40 +/- 3.533, post-exercise:53.60 +/- 3.134, t=6.318] levels in aerobic training group with P<0.001. BMI and body fat percentage showed significant improvements in both training groups. Aerobic training is more beneficial and can be used as a preventive measure in patients who are at risk of developing cardiovascular diseases due to obesity

Endoscopic removal of unusual foreign bodies from maxillary sinus

Maxillary antrum is a site for unusual and unexpected foreign bodies [FB]. Among them, the dental originated foreign bodies are the most commonly seen. We came across two foreign bodies of non dental origin in maxillary sinus, which were removed endoscopically. These cases presented in the ENT department of Dayanand Medical College and Hospital, Ludhiana, India. One of the foreign bodies was a silastic sheet lying in the floor of maxillary sinus causing subperiosteal abscess. The other one was a bullet lodged in maxillary sinus following firearm injury. X-rays and CT scan are essential for making diagnosis in such cases

Tuberculous paraplegia in pregnancy treated by surgery

Tuberculous paraplegia in pregnancy is reported to be rare. Paraplegia due to tuberculosis has a good prognosis if surgical decompression and stabilisation are done early together with chemotherapy. Vaginal delivery is not contraindicated in pregnancy complicated by paraplegia, but is associated with problems related to the initiation and progression of labour. Performing spinal nursing on an unstable spine with a rapidly enlarging gravid uterus in the third trimester of pregnancy poses a significant challenge. We report successful simultaneous Caesarean section and surgical treatment of a paraplegic spine due to tuberculosis.