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Introduction: Needlestick and sharps injuries (NSSIs) represent an existential occupational hazard risk to orthopaedic surgeons during their career due to the interaction with various devices, instruments and bone fragments. Consequently, NSSIs have the potential to transmit infections such as Hepatitis B (HBV), Hepatitis C (HCV) and Human Immunodeficiency Virus (HIV) leading to serious illness. The purpose of this cross-sectional study was to identify the clinical settings predisposing orthopaedic surgeons to NSSIs and assess their adherence to safety protocols in the Indian context. Materials and Methods: An online cross-sectional survey of 618 orthopaedic surgeons in India, stratified by experience into two groups: under five years and with 5 years or more was undertaken. The data were collected via an expert-validated online questionnaire to evaluate demographic distribution, injury characteristics, knowledge of safety protocols, and adherence to these protocols. Descriptive statistics summarized the data, Chi-square tests assessed variable associations, and odds ratios were computed for significant variables. Ethical integrity was maintained via electronic informed consent and for confidentiality assurances. Results: The study revealed that orthopaedic surgeons with less than 5 years of clinical experience had higher risks for NSSIs as compared to those with 5 or more years of clinical practice. Conversely, the latter group was more susceptible to bone spike injuries and viral positive needlestick incidents. The analysis shows that whilst the more experienced practitioners displayed greater proficiency in the application of universal precautions and NSSI prevention, they were also less likely to report injuries, often due to discomfiture. Risk profiles were consistent across different practice settings and affiliations, regardless of experience level. Conclusion: This cross-sectional study reveals less experienced orthopaedic surgeons face higher risks of NSSIs, possibly due to inadequate education or awareness. More experienced practitioners encounter distinct risks, likely owing to long-term exposure and traditional practices. There is an immediate need to raise awareness of the potential risks of NSSIs, enhanced education, appropriate training, collaboration with the hospital risk management team and developing a culture of transparent reporting to mitigate these risks. The emphasis should be on reducing the incidence and fostering open reporting of NSSIs to protect clinicians and promote health safety.

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Background: It is well known that the implementation of the WHO surgical safety checklist (SSC) leads to improved operating room team coordination and reduced perioperative complication and mortality rates. Although it is proven to be beneficial worldwide, its awareness and usage need to be evaluated in a diverse country like India. As orthopaedic surgeries involve implants and tourniquet usage, it is important to evaluate the applicability of WHO SSC specifically to orthopaedic surgeries, and whether any modifications are needed. Materials and Methods: A web-based cross-sectional survey was conducted among Indian Orthopaedic Surgeons with a pre-defined questionnaire regarding awareness, usage and suggestions to modify the existing WHO SSC (2009) for orthopaedic surgeries. Results: 513 responses were included for final analysis. 90.3% of surgeons were aware of the surgical safety checklist; however, only 55.8% used it routinely in their practice. The awareness of SSC availability was 1.85 times more among younger surgeons (< 20 years of experience) than among those with > 20 years of experience. 17% of surgeons thought the usage of SSC was time-consuming and 52.4% of participants felt a need to modify the existing WHO SSC (2009) for orthopaedic surgeries. 34.5% recommended the inclusion of the patient blood group in the "Sign-in" section, 62.77% proposed the inclusion of details about the tourniquet, whereas only 6.63% suggested adding about surgical implant readiness in the "Time-out" section and 72.7% suggested including a check to make sure the tourniquet was deflated, removed and also recording of the total usage time during the "Sign-out" section. Conclusion: Despite high (90%) awareness among Indian Orthopaedic surgeons, they have limited usage of the WHO SSC in their practice. Identifying barriers and considering modifications for orthopaedic surgeries, like details about tourniquet usage during the "Time-out" section and a check to ensure it was removed during the "Sign-out" section, will improve patient safety and outcomes. Supplementary Information: The online version contains supplementary material available at 10.1007/s43465-024-01096-5.

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PURPOSE: In academic publishing, research metrics play a crucial role in assessing the scientific impact and performance of the published literature, as well as of the journals in which they are published. Several journal-level metrics (JLM) such as the h-index of the analysed journals, total citations, total documents, citable documents, references and external citations per document are considered crucial indicators of the importance and reputation of the journals. We hypothesize that journals in the field of Medicine receive more citations than those in Surgical journals like Orthopaedic surgery, and hence have better JLM. This study aims to to assess and compare the JLM of Medical and Surgical journals between two time zones 2017-2019 vs. 2020-2022, i.e., pre and post-COVID-19 pandemic period. METHODS: A cross-sectional bibliometric analysis of the top-ranked Orthopaedic, Medical, and Surgical journals was undertaken based on traditional JLM, using the SCImago database from 2017 to 2022. Our analysis focused on identifying trends in the h-index of the analysed journals, total citations, total documents, citable documents, references and external citations per document. RESULTS: Overall Medical journals were found to have higher JLM than the Surgical and Orthopaedic journals. The h-index of Surgical journals, Medical journals and Orthopaedic journals were comparable between the two periods (pre and -post-COVID-19 pandemic); Total Cites (3 years), total documents (2017), total documents (3 years), total references, and citable documents (3 years) of Surgical journals, Medical journals and Orthopaedic journals were significantly higher in the period 2020-2022. CONCLUSION: There has been a steady increase in the number of publications from post COVID-19 period. Medical journals have higher JLM than Surgical and Orthopaedic journals. Journal of Bone and Joint Surgery (Am), Annals of Surgery and Diabetes Care were the most published journals in Orthopaedics, General Surgery and Medicine-related topics respectively.

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BACKGROUND: Nearly 70.1 million individuals have been infected by the pandemic viral disease known as coronavirus disease 2019 (COVID-19), which was first discovered in China and is caused by a novel coronavirus known as severe acute respiratory syndrome coronavirus 2 (SARS­CoV­2). This disease is responsible for the deaths of 6 million people. India ranks third in the total number of cases. The purpose of this study was to classify COVID-19 patients according to several criteria and to determine which clinical, hematological, and radiological indicators were most important in their care. MATERIALS AND METHODS: An analytical cross-sectional study was conducted on a total of 70 symptomatic patients who tested positive for COVID-19 reverse transcription polymerase chain reaction (RT-PCR) and were hospitalized at the Saveetha Medical College and Hospital in Chennai, Tamil Nadu, India, for the duration of the study. Comorbidities and oxygen reliance were taken into consideration while classifying patients into one of three categories. Initial symptoms, as well as hematological (interleukin-6 (IL-6), erythrocyte sedimentation rate (ESR), c-reactive protein (CRP), D-dimer, serum ferritin, and total cell counts) and radiographic (X-ray and computed tomography (CT) of the thorax) characteristics, were taken and analyzed among the different groups. RESULTS: According to our research, the symptom of fever was the most common, accounting for 84.3% of all cases. This was followed by breathlessness (55.7%), myalgia (31.4%), dry cough (27.1%), sore throat (24.3%), cough with expectoration (20%), loose stools (12.9%), loss of taste (12.9%), and smell (11.4%). Although there was a large amount of variation in D-dimer, with Category C having the highest values, there was only a minor amount of variation in ESR and CRP. The X-ray and CT scans of the chest showed substantial differences between the groups, with CT findings such as COVID-19 Reporting and Data System (CO-RADS) and CT severity score, consolidation, crazy paving pattern, and vascular dilatation showing a wide range of differences between the groups. CONCLUSIONS: To facilitate easier treatment and place more attention on radiological characteristics using D-dimer, treating physicians are required to categorize COVID-19 patients into several groups. Patients who need oxygen support were included in this category.

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Social media, leveraging Web 2.0 technologies, plays a vital role in healthcare, medical education, and research by fostering collaboration and enabling research dissemination. Healthcare professionals use these platforms to improve public health literacy, but concerns about misinformation and content accuracy persist. In 2023, platforms like Facebook (Meta Platforms, Inc., Menlo Park, California, United States), YouTube (Google LLC, Mountain View, California, United States), Instagram (Meta Platforms, Inc.), TikTok (ByteDance Ltd, Beijing, China), and Twitter (X Corp., Carson City, Nevada, United States) have become essential in healthcare, offering patient communication, professional development, and knowledge-sharing opportunities. However, challenges such as breaches of patient confidentiality and unprofessional conduct remain. Social media has transformed medical education, providing unique networking and professional development opportunities. Further studies are needed to determine its educational value. Healthcare professionals must follow ethical and professional guidelines, particularly regarding patient privacy, confidentiality, disclosure rules, and copyright laws. Social media significantly impacts patient education and healthcare research. Platforms like WhatsApp (Meta Platforms, Inc.) effectively improve patient compliance and outcomes. Yet, the rapid dissemination of false news and misinformation on social media platforms presents risks. Researchers must consider potential biases and content quality when extracting data. Quality control and regulation are crucial in addressing potential dangers and misinformation in social media and healthcare. Stricter regulations and monitoring are needed due to cases of deaths resulting from social media trends and false news spread. Ethical frameworks, informed consent practices, risk assessments, and appropriate data management strategies are essential for responsible research using social media technologies. Healthcare professionals and researchers must judiciously use social media, considering its risks to maximize benefits and mitigate potential drawbacks. By striking the right balance, healthcare professionals can enhance patient outcomes, medical education, research, and the overall healthcare experience.

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Corticosteroids (CS) have been used in the management regimens for COVID-19 disease to mitigate the cytokine storm and ill effects of the pulmonary inflammatory cascade. With the rampant use of CS, clinicians started reporting the occurrence of osteonecrosis of the femoral head (OFH). In this systematic review, we aim to analyze the literature and identify the definitive cumulative dose and duration of CS needed for the development of OFH based on the SARS model and generate a risk-based screening recommendation for OFH in convalescent COVID-19 patients to facilitate early identification and management. An electronic database search was conducted until December 2022 in PubMed, Web of Science, Embase, and CNKI (China Knowledge Resource Integrated Database). Studies involving CS therapy and osteonecrosis data in SARS patients were included. Three authors independently extracted the data from the included studies and a dose-response meta-analysis was performed for various doses and duration of CS utilized in the included studies. We selected 12 articles with 1728 patients in the analysis. The mean age was 33.41 (±4.93) years. The mean dosage of CS administered was 4.64 (±4.7) g which was administered for a mean duration of 29.91 (±12.3) days. The risk of osteonecrosis increases at pooled OR of 1.16 (95% CI 1.09-1.23, p < 0.001) per 2.0 g increase in the cumulative dose of CS usage. Similarly, the risk increases at pooled OR of 1.02 (95% CI 1.01-1.03, p < 0.001) per 5 days of increase in the cumulative duration of CS usage. A cumulative dosage of 4 g and a duration of 15 days were determined as the critical cut-off for the non-linear dose-response relationship observed. Appropriate and frequent screening of these individuals at regular intervals would help in the identification of the disease at an early stage in order to treat them appropriately.

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The virus causing monkeypox, a rare zoonotic viral disease, belongs to the Poxviridae family and the Orthopoxvirus genus. On 23 July 2022, the World Health Organization (WHO) declared the monkeypox outbreak as a Public Health Emergency of International Concern (PHEIC). From May to July 2022, a multi-country outbreak of monkeypox was reported in both endemic and non-endemic regions. Major goals of managing monkeypox are to identify the suspected cases, detect generic orthopoxvirus DNA at a state or commercial laboratory, and establish the Centers for Disease Control and Prevention real-time polymerase chain reaction testing. Currently, there are no approved treatments for monkeypox virus infection. However, a variety of antiviral medications originally designed for the treatment of smallpox and other viral infections could be considered. Pre-exposure prophylaxis for laboratory and health care employees and post-exposure prophylaxis for individuals with high-risk or intermediate-risk exposures are to be considered. The CDC Emergency Operations Center is available for advice on the appropriate use of medical countermeasures, and can help in obtaining antiviral drugs and vaccines from the National Strategic Stockpile. This review gives an overview of the global scenario, clinical presentation, and management of monkeypox in the light of a global public health emergency.

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Introduction: Musculoskeletal manifestations of COVID-19, post COVID-19, and post COVID-19 vaccination include arthralgia, myalgia, new-onset backache, fatigue, inflammatory arthritis either symmetrical or polyarticular, reactive arthritis, osteoporosis, osteonecrosis of the femoral head, neuropathies, myositis, and myopathies. Almost 15% and 44% of post-COVID-19 patients reported arthralgia and myalgia. We aim to analyze the musculoskeletal manifestations of COVID-19 infection and the factors determining their severity. Methodology: This is a retrospective multicentric cross-sectional study conducted from all the four regions (northern, southern, eastern, and western regions) in India. The recruitment period was from June 1st, 2021, to September 30th, 2021. All patients with COVID-19 positivity in the past were classified into three groups (mild, moderate, and severe). The primary outcome is to find the correlation of musculoskeletal symptoms with disease positivity, severity, and demographic variables. We focused at clinical characteristics and symptoms at the time of admission, as well as comorbidities, laboratory findings, immunological findings, treatments, and outcomes. Results: The study was conducted among 2334 subjects across all the regions of India. Out of which 719 were COVID-19 positive individuals. Non-vaccinated were about 62.6% compared to 37.4% vaccinated among COVID-19 positive individuals. The total average musculoskeletal scores calculated were about 15.94 ± 54.86. MSK scores were significantly higher (p < 0.001) among males, uneducated, those with co-morbidities, and non-vaccinated individuals. Multivariate regression analysis showed a 1.63 times higher risk of having COVID-19 infection among smokers, those who don't exercise regularly are 1.25 times at risk of having COVID-19 infection. Similarly, those who have comorbidities are 1.93 times at risk of having COVID-19 infection. Non-vaccinated individuals were 2.33 times at risk of having COVID-19 infection. Conclusion: Factors such as male sex, non-vaccination, and associated co-morbidities increased the risk of developing severe MSK manifestations upon infection with COVID-19 and needs extended monitoring to control the morbidity due to the same.

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INTRODUCTION: Several sociodemographic variables, including ethnic inequality, have been identified as potentially influencing the uptake of COVID-19 vaccinations. To develop herd immunity against COVID-19, at least 70-85% of the population must be vaccinated. As the situation with COVID-19 changes, the public's perception keeps fluctuating. We designed a survey to determine the prevalence of vaccinated individuals and the rate of infectivity post-vaccination. We also aimed to study the clinical manifestations and infectivity of the SARS-CoV-2 virus post-vaccination. MATERIALS AND METHODS: A cross-sectional study was conducted from May 10, 2021 to July 10, 2021 across India through a pre-tested validated semi-structured self-administered electronic questionnaire, to the study subjects with objectives explained and the confidentiality of the data and results had been assured. The questionnaires were prepared using Google forms and the link was sent across social media platforms such as WhatsApp, Facebook, and various social platforms where people are actively engaged following the restrictions and protocols of social distancing. General demographic data, followed by their lifestyle and comorbid conditions, and data on their vaccination, infectivity, and side effects were collected. RESULTS: We included 2334 participants in the study, of which the majority of the study participants were in the age group of 25-34 years (38.6%). 1729 were vaccinated individuals of which 80.7% had received Covishield and 17.8% had received Covaxin. Around 61.1% have received both doses among 1729 vaccinated individuals and 38.9% had received only one dose of vaccine. The majority of the fully vaccinated individuals had a gap of 4-5 weeks for the second dose (37.1%) followed by 5-6 weeks (11.2%). Post-vaccination 50.8% had experienced muscle pain, 46% had experienced fatigue, 36.5% weakness, and 12.3% back pain. Among vaccinated 26% turned out to be COVID-19 positive and 44.5% non-vaccinated got infected. The odds of infection among non -vaccinated individuals was 2.27 times higher than vaccinated individuals. Individuals who encountered the viral antigen for the second time experienced either through vaccination or infection demonstrated exaggerated inflammatory response which is explained by the antibody-dependent enhancement phenomenon without life-threatening complications. CONCLUSION: Although more than 50% of the vaccinated individuals experienced some form of musculoskeletal side effects, we noted a high acceptance rate (74%) of vaccination among the participants. The vaccinated individuals were two times safer from infection compared to the non-vaccinated individuals.

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STUDY DESIGN: Systematic Review & Meta-analysis. OBJECTIVES: We aim to comparatively analyse the efficacy and safety of using leucocyte-poor platelet rich plasma (LP-PRP) against leucocyte-rich platelet rich plasma (LR-PRP) in the management of lateral epicondylitis. MATERIALS AND METHODS: We conducted independent and duplicate electronic database searches including PubMed, Embase, Web of Science and Cochrane Library till September 2020 for randomised controlled trials analyzing the efficacy and safety of LP-PRP and LR-PRP in the management of lateral epicondylitis. Visual Analog Score(VAS) for pain, Disabilities of the Arm, Shoulder and Hand (DASH) Score, Patient Reported Tennis-Elbow Evaluation (PRETEE) Score, Mayo Elbow Performance Score(MEPS) and adverse events were the outcomes analyzed. Analysis was performed in R-platform using OpenMeta[Analyst] software. RESULTS: We performed a single arm meta-analysis of 26 studies involving 2034 patients. On analysis it was noted that significant improvement was noted in the VAS for pain (p < 0.001), DASH score (p < 0.001), PRETEE score (p < 0.001) and MEPS (p < 0.027) compared to their pre-operative state. No significant increase in adverse events were noted compared to the control group (p = 0.170). While stratifying the results based on the type of PRP used, no significant difference was noted between the use of LP-PRP or LR-PRP in any of the above-mentioned outcome measures. CONCLUSION: PRP is a safe and effective treatment option for lateral epicondylitis with clinical improvements in pain and functional scores and both types of PRP (LR-PRP & LP-PRP) offer similar results.