The impact of the COVID-19 pandemic on the well-being, work conditions, and education of early career psychiatrists in the WHO Eastern Mediterranean Region: study protocol.

Background: The COVID-19 pandemic placed great strain on healthcare professionals, leading to a substantial impact and a redistribution of the workforce. Despite the active involvement of the Eastern Mediterranean Region Office (EMRO) and the World Health Organization in managing mental health crises, there is a knowledge gap concerning the working conditions and training opportunities available for early career psychiatrists (ECPs) during the pandemic period. Objectives: This study aims to investigate the impact of the COVID-19 pandemic on ECPs and how it affected their well-being, employment, and educational opportunities. Methods: A mixed methods study has been conducted in Iran, Egypt, and Tunisia, three EMRO member countries. It includes a cross-sectional survey with self-reported questions, and a qualitative study with individual in-depth interviews. Discussion: The findings of this study will raise awareness to the working conditions of ECPs within the EMRO region and its member societies, both during the COVID-19 pandemic and beyond. The results will serve as a basis for encouraging supervisors and policymakers to mitigate the pandemic's impact on psychiatric training, strengthen healthcare systems' preparedness, and equip early career psychiatrists with the necessary skills to deal with the mental health consequences of the COVID-19 pandemic.

Ipsilateral Concurrent Knee Arthroplasty and Tibial Osteotomy with 3D-Printed Patient-Specific Instrumentation: A Case Report.

CASE: A 70-year-old woman presented with knee pain and instability and was diagnosed with advanced knee osteoarthritis and bifocal tibial deformities. The complexity of the case challenged our team to perform a significant sagittal correction (>60°) and restore her ability to walk independently. We performed ipsilateral total knee arthroplasty and anterior closed wedge tibial osteotomy using virtual planning and 3D-printed patient-specific instrumentation. CONCLUSION: Using 2 separate 3D-printed patient-specific cutting guides for this patient with a complex deformity and managing the whole planning process in close collaboration between the surgeons and engineers resulted in a satisfactory postoperative outcome, optimal implant positioning and leg alignment, and minimal soft-tissue damage.

Management of tibial nonunion and osteoarthritis using a 3D-printed titanium cone: A case report.

The use of customized 3D-printed structures has been gaining popularity in non-union management, as it allows for bypassing the defect while promoting osseointegration. Additionally, porous titanium implants minimize stress shielding due to their stiffness and elastic modulus being closer to that of bone. The interconnected channels increase the surface area and provide space for cell adhesion and proliferation. This study presents the case of a 62-year-old female patient with concomitant knee osteoarthritis recalcitrant aseptic atrophic nonunion in the tibial proximal metaphysis. Due to the small distance between the nonunion site and the joint line, nonunion treatment had to be included in the treatment plan, as it would result in a lack of mechanical stability of the tibial component, and techniques such as plating were not an option. A customized 3D-printed porous titanium cone was used to bypass the fracture site and support the stem used with the CCK prosthesis, allowing for simultaneous nonunion and osteoarthritis management.