Preparedness,knowledge,and perception of nursing students about climate change and its impact on human health in India

Higher education plays an important role in all aspects of sustainability.Infusing climate change and sustainability into the curriculum is important to prepare future health-care professionals for climate change and sustainability actions to build resilient health systems.In this study,we evaluated the preparedness,knowledge,and perception regarding climate change and its impact on human health among Indian nursing students.A quantitative descriptive survey was conducted among 644 undergraduate nursing students studying in three institutes in the southern,northern,and western parts of India.We used a structured online questionnaire with established validity and reliability to collect data.The data were analyzed using Statistical Package for the Social Sciences version 26 software.The results showed that more than half of the students reported experiencing excessive increase(362;56.2%)and decrease(374;58.1%)in temperature in recent years.Though more than three quarters of the students(494;76.7%)accepted the general truth that climate change is mainly caused by human activities,only less than half of the students(309;48.0%)perceived the impact of climate change to be high.Three quarters of the students(483;75.0%)had a high level of knowledge regarding climate change.The students who had a high level of knowledge about climate change exerted a high perceived impact of climate change(χ^(2)=75.47;P<0.01).More than half of the students(50.9%)felt that they needed information about climate change to be included in the nursing curriculum,and only one sixth of the students(16.1%)were highly confident about engaging in climate change-related conversation with patients.Most of the students who participated in the study had basic knowledge about climate change and its impact on human health.However,there is an observed gap between knowledge and their preparedness and confidence to engage in climate change actions.Hence,we propose to strengthen the nursing curriculum by integrating various curricular and co-curricular activities related to climate change,so that future nurses are empowered to become climate change advocates.

Demographic characteristics of patients who underwent anterior cruciate ligament reconstruction at a tertiary care hospital in India

BACKGROUND Anterior cruciate ligament(ACL)tears are common sports-related injuries.Their incidence is not the same either for all the sports or for the same sport across various nations.This information is maintained by many sports leagues in their registries.However,very few nationwide registries exist for such injuries.This study is carried out to know the demographic characteristics of patients who underwent ACL reconstruction at our hospital in India.AIM To know the demographic characteristics of patients who underwent ACL reconstruction at a tertiary care hospital in India.METHODS All the patients who underwent ACL reconstruction from January 2020 to December 2021 were retrospectively studied.Patients with multi-ligament injuries or a history of previous knee surgery were excluded.The patients’history was obtained from the hospital records,they were interviewed telephonically,and online questionnaires were given.Their demographic data was analyzed and compared to the existing literature.RESULTS A total of 124 patients were operated on for ACL reconstruction during this period.The mean age of the patients was 27.97 years.One hundred and thirteen patients(91.1%)were male and 11(8.9%)were female.The majority of the patients(47.6%)sustained this injury by road traffic accidents(RTA)followed by sportsrelated injuries(39.5%).The commonest presenting complaint was giving way of the knee in 118 patients(95.2%).The mean duration from the injury to the first hospital visit among the patients was 290.1 d.The mean duration from the injury to surgery was 421.8 d.CONCLUSION ACL patients’demography is different in developing nations as compared to the developed world.RTA are the leading cause of ACL injuries and are followed by recreational sports as a cause.There is delayed access to healthcare leading to delayed diagnosis as well as even greater time to surgery.This,in turn,leads to poorer prognosis and longer rehabilitation.National registries for developing nations are the need of the hour due to the different demographics of ACL injuries in developing countries.

Prognostic value of AKT isoforms in non-small cell lung adenocarcinoma

Dear Editor,Lung cancer is one of the most prevalent cancers in the world and has a high mortality rate.Lung cancer patients often have a poor prognosis,with a five-year survival rate of only about 16%.The International Agency for Research on Cancer reports that lung cancer was the main cause of cancer deaths in 2020,accounting for 1.80 million deaths.

Outcome of COVID-19 infection in patients on antihypertensives:A cross-sectional study

BACKGROUND Patients with coronavirus disease 2019(COVID-19)infection frequently have hypertension as a co-morbidity,which is linked to adverse outcomes.Antihypertensives may affect the outcome of COVID-19 infection.AIM To assess the effects of antihypertensive agents on the outcomes of COVID-19 infection.METHODS A total of 260 patients were included,and their demographic data and clinical profile were documented.The patients were categorized into nonhypertensive,angiotensin-converting enzyme inhibitor/angiotensin receptor blocker(ACEI/ARB),calcium channel blocker(CCB),a combination of ACEI/ARB and CCB,and beta-blocker groups.Biochemical,hematological,and inflammatory markers were measured.The severity of infection,intensive care unit(ICU)intervention,and outcome were recorded.RESULTS The mean age of patients was approximately 60-years-old in all groups,except the nonhypertensive group.Men were predominant in all groups.Fever was the most common presenting symptom.Acute respiratory distress syndrome was the most common complication,and was mostly found in the CCB group.Critical cases,ICU intervention,and mortality were also higher in the CCB group.Multivariable logistic regression analysis revealed that age,duration of antihypertensive therapy,erythrocyte sedimentation rate,high-sensitivity C-reactive protein,and interleukin 6 were significantly associated with mortality.The duration of antihypertensive therapy exhibited a sensitivity of 70.8%and specificity of 55.7%,with a cut-off value of 4.5 years and an area under the curve of 0.670(0.574-0.767;95%confidence interval)for COVID-19 outcome.CONCLUSION The type of antihypertensive medication has no impact on the clinical sequence or mortality of patients with COVID-19 infection.However,the duration of antihypertensive therapy is associated with poor outcomes.

Revisiting the morphology of pelvicalyceal system in human cadaveric kidneys with a systematic review of literature

Objective:Renal collecting system macroscopically consists of minor calyx,major calyx,renal pelvis and ureter.Stone in renal collecting system is a common presentation in everyday urological practice.The prevalence of renal calculi ranges from 4%to 20%in different geographical distribution.Anatomical variation in renal collecting system plays a significant role in formation of calculi in its parts.The large extra renal pelvis leads to stagnation of urine for longer durations and formation of stones.The stone free rate after percutaneous nephrolithotomy and extra corporeal shock wave lithotomy is significantly related to anatomical factors,particularly the type of renal pelvis and dimensions(length and width)of lower infundibulum.Previous authors described the morphology of pelvicalyceal system in a highly variable manner and the available anatomical description of pelvicalyceal system is contradictory and incomplete.Hence an attempt has been made to provide the precise anatomy of pelvicalyceal system in adult human kidneys.Methods:We studied 196 formalin embalmed kidneys to note the number of infundibulum,major and minor calyces.The location and shape of pelvis were also studied.Results:The intra-renal pelvis was narrow and had funnel shaped appearance in 95 of total 196(48.5%)specimens,and the extra-renal pelvis was dilated as balloon shaped in 43 of 196(21.9%)specimens.In 41(20.9%)specimens,the renal pelvis was having partially intra-and extra-renal in location.Bilateral symmetry was found in only 27.1%of 196 renal collecting systems.The length of lower infundibulum was more than 22 mm in 19(9.7%)of 196 cases which directly affects the stone clearance rate during open and endoscopic surgeries on pelvicalyceal system.Conclusion:This study provides the accurate morphological details of the shape and dimensions of renal pelvicalyceal system to help the urologists and nephrologists.

An innovative technique of chest wall stabilization and reconstruction in traumatic flail chest:The figure-of-eight suture with polypropylene mesh and musculofascial flap

Surgical stabilization of the flail chest is challenging and has no established guidelines.Chest wall integrity and stability are the main factors that ensure the protection of intrathoracic organs and an adequate respiratory function.Here,we report a novel chest wall reconstruction technique in a 45-year-old man with a traumatic left flail chest and open pneumothorax diagnosed both clinically and radiographically.Rib approximation and chest wall reconstruction was done using intercostal figure-of-eight suture and polypropylene mesh with vascularized musculofascial flap.The patient improved gradually and was discharged after three weeks of total hospital stay.He returned to regular working after a month with no evidence of respiratory distress or paradoxical chest movement.Follow-up visit at one year revealed no lung hernia or paradoxical chest movement.This is a novel,feasible and cost-effective modification of chest wall reconstruction that can be adopted for thoracic wall repair in case of open flail chest,which needs emergency surgical interventions even in resource constraint settings.

Comparison of functional outcomes among subtypes of Fraser’s typeⅡfloating knee

Purpose The poor prognosis in patients with floating knee injuries is mainly contributed to articular involvement(Fraser’s typeⅡ).This study aims to evaluate and compare the functional outcomes among different Fraser’s typeⅡfloating knee injuries after surgical management.Methods Twenty-seven patients with Fraser’s typeⅡfloating knee injuries(54 fractures)between September 2014 and December 2015 were enrolled prospectively in this study and were distributed according to Fraser’s floating knee classification into three different groups as typeⅡA(ipsilateral femoral shaft and tibial intra-articular involvement,n=11),typeⅡB(ipsilateral tibial shaft and femoral intra-articular involvement,n=9)and typeⅡC(both femoral and tibial intra-articular involvement,n=7).The differences among the groups were evaluated and compared.The functional outcomes of these injuries at one year were analyzed using Knee Injury and Osteoarthritis Outcome Score(KOOS)which covers 5 subscales of pain,other symptoms,activities of daily living,sports and recreation,and quality of life.The result was also compared with standardized age-sex matched healthy population using paired samples t-test.Results All the patients were male,and the injury mechanism was solely roadside accident.The mean age was 29.8 years and injury severity score 17.9(comparable in all the three groups).Most injuries were observed on the right side(20 cases,74.1%).Based on paired samples t-test,the KOOS score of patients with Fraser’s typeⅡA was found to be better than that of typeⅡB and typeⅡC.Compared with the reference age-sex matched control group,patients with Fraser’s typeⅡB andⅡC fractures had significantly lower mean score in all KOOS subscales(all p<0.01).However,Fraser’s typeⅡA only revealed significant difference regarding the subscales of activities of daily living(p<0.0001),sports and recreation(p<0.0001),and quality of life(p<0.0001).Conclusion The results of this study show that patients with Fraser’s typeⅡA fractures had a better functional outcome as compared to those with typeⅡB andⅡC fractures.This might be due to the open intra-articular involvement of the distal femur of the latter two fracture types.

Comments on “Intravenous Mannitol reduces intra-compartmental pressure following tibia fractures: A randomized controlled trial”——relevant questions demanding attention related to the study

Dear authors:We would like to congratulate Nesaraj et al.1 for their study.This is an exciting study,but there are few pertinent points which must be clarified.1.It is known that the relative intra-compartmental pressure changes in different compartments of the leg after a tibial fracture.2 The authors have not specified in which of the four compartments the compartment pressure has been measured.Also,the pressure in each compartment depends on the position of the ankle.3 This appears to be a significant flaw of the study methodology,as many cases of compartment syndrome of the leg involve the posterior compartments,and non-measurement of pressure in these compartments might result in a potential failure to detect a compartment syndrome.