جستجوی مقالات مرتبط با کلیدواژه "amputation" در نشریات گروه "پزشکی"

Both diabetes and peripheral arterial disease (PAD) have complex interactions with COVID?19. PAD is one of the most important underlying factors in the development of diabetic foot. The COVID?19 pandemic has also caused an increase in cardiovascularcomplications in those with chronic diseases, including diabetics, due to both the  thrombophilic course of the viral disease and the lockdown measures applied for prevention. Since both COVID?19 and diabetes mellitus predispose to thrombosis, PAD is likely to have a more severe course in diabetic patients with COVID?19. The aim of our study is to discuss the complications, prophylaxis, and treatment of PAD, which is a serious complication of diabetes, during the pandemic period

This preliminary study investigates the effects of adding exergame (EG) training to conventional exercises on the functional activities of newly fitted patients with unilateral transtibial amputation.

A total of 22 newly fitted patients with unilateral transtibial amputation were equally and randomly divided into two groups as follows: the EG group who performed exercises and EG training and the control group who performed exercise only. The 2-min walk test, timed up and go test, amputee mobility predictor with prosthesis test, and physiological cost index were assessed at baseline and after 2 and 4 weeks of the intervention.

Both interventions effectively improved the 2-min walk test distance, timed up-and-go test, and the amputee mobility predictor with prosthesis test scores in patients with newly fitted transtibial amputation (P<0.001). Additionally, a significant improvement was observed in the timed up-and-go test time in the EG group versus the control group after the 4-week intervention (P=0.04, effect size=0.53).

The findings of this preliminary study further support that adding EG to exercises significantly increases movement speed among amputee patients.

The quality of life among amputees is a multifaceted concept influenced by various factors. This study aimed to evaluate the quality of life among amputees and its associated socio-demographic characteristics.

This descriptive correlational study was carried out at the Al-Rusafa Health Directorate in Baghdad City from October 1, 2023, to March 21, 2024. The study sample comprised 200 clients selected through non-probability sampling. The used questionnaire underwent validation by experts, and its reliability was confirmed through a pilot study. Data were collected via interviews and analyzed using descriptive and inferential statistics.

The average age of the participants was 49.68 years, with the majority being male (65.5%), married (63%), and having completed middle school (49.5%). Among the participants, 42.5% were retirees, with most having incomes of 100 to less than 200 dollars per month (47%). Health conditions, particularly in the lower extremities (73%), led to amputation, with an average of 14.71 years since the amputation and 48.5% since the use of prostheses. The simple linear regression analysis showed that increased healthcare services were linked to enhanced physical, psychological, social, and overall quality of life (p=0.0001).

There is a robust and positive correlation between healthcare services for amputees and their comprehensive QOL, encompassing physical, psychological, and social aspects.

This study aimed to determine amputation-related factors that affected the activities of daily living in persons with amputations.

A descriptive cross-sectional study was conducted in Babylon Rehabilitation Centre from August 1st and November 20th, 2023. The study sample consists of 250 amputees using a standardized questionnaire. Data were collected through the interviews and analyzed by applying descriptive and inferential statistical approaches.

A significant portion of amputees (63.6%) exhibited poor activities of daily living, with factors such as age (p=0.0001), gender (p=0.008), amputation reasons (p=0.0001), site (p=0.005), and duration (p=0.0001) being predictive variables according to simple linear regression analysis.

Amputees are poorly able to do the activities of their daily living.

This research investigated the relationships between self-efficacy and social support among users of prostheses post-lower limb amputation. Understanding these relationships is crucial for comprehending how individuals adapt to life post-amputation and how their perceived capabilities and social interactions influence their rehabilitation and overall well-being.

This descriptive correlational study was conducted in Baghdad City at the Rusafa Health Department from October 1, 2023, to March 24, 2024. The study sample comprised 200 patients selected through the non-probability sampling method. The used questionnaire was validated by experts, and its reliability was confirmed through a pilot study. Data were gathered through interviews and analyzed using descriptive and inferential statistics.

A notable percentage of lower limb amputees utilizing prostheses exhibited low self-efficacy (60%) and moderate social support (40.5%). Furthermore, a positive correlation was observed between social support and self-efficacy, particularly in managing fatigue (r=0.133), coping with pain (r=0.198), handling emotional distress (r=0.172), addressing other symptoms (r=0.180) and health issues, and overall self-efficacy (r=0.173).

Interventions focused on enhancing social support networks significantly enhance self-efficacy and overall well-being in this demographic, ultimately fostering improved adjustment and quality of life post-amputation.

This study aims to determine the prevalence of knee osteoarthritis (OA) and associated risk factors in the contralateral limb after lower limb amputation.

This cross-sectional survey included 500 lower limb amputees using prostheses for at least 1 year using convenience sampling from the Pakistan Institute of Prosthetic and Orthotic Sciences (PIPOS), Peshawar City, Pakistan rehabilitation services program (PRSP) and its satellite centers across Khyber Pakhtunkhwa. A sample included either gender aged 20 to 80 years. A basic demographic sheet and risk factors questionnaire and American College of Rheumatology (ACR) guidelines diagnostic knee OA criteria, such as using history, physical examination, and radiographic findings were used to collect data. Data were analyzed using SPSS software, version 21. T-test and analysis of variance (ANOVA) statistics were utilized to observe any relationship with P<0.05 as significant. 

The current study revealed the prevalence of OA in 131 people (26.2%) with a higher prevalence in 86 married men (65.5%) aged 51-80 years (99[75.6%] and 99[75.6%]) with the predominance of 87 trans-tibial amputees (TTA) (66.4%). Sustained knee bending was the most prevalent risk factor in 127 people (96.9%, 31.07), followed by the history of a painful knee injury in 117 people (89.3%, 12.00), sitting on the floor for home activities in 106 people (80.9%, 8.00) and occupation with knee use in 129 people (98.5%, 7.25).

The high prevalence of 26.2% of OA in the sound limb in lower limb amputees is more common in married men aged 51-80 years with trans-tibial amputation on the contralateral side. Common risk factors include sustained knee bending, a history of a painful knee injury, sitting on the floor for home activities, and occupations with knee use.

Disability arising from amputation is intricately shaped by both social factors and rehabilitative care. The efficacy of veterans' self-care emerges as a pivotal factor in effectively managing, controlling, and reducing complications, thereby augmenting and enriching their overall quality of life. This research delves into the creation, execution, and assessment of a comprehensive self-care software tailored for amputees, with a focus on harnessing the practical utility of smartphones and their manifest capabilities in the realm of healthcare.

In 2023, an applied developmental study was conducted, encompassing the evaluation, design, development, implementation, and assessment of a mobile application dedicated to the self-care management of veterans with amputations. The mobile application's conception unfolded within the Android Studio environment, utilizing the Java programming language within the Android operating system. A user interface satisfaction questionnaire was used to gauge the app's usability, with feedback from 20 veterans experiencing amputations.

The needs assessment for a comprehensive self-care software tailored for amputation veterans identified requisites across four distinct sectors. Building upon these insights, a holistic self-care software solution was meticulously designed. Evaluating usability and user satisfaction revealed that veterans rated the app at a "good" level, with an average score of 7.88±1.03 (out of 9).

The mobile application proved apt in content, functionality, and quality, presenting a valuable tool for enhancing the lifestyle, education, and self-care practices of veterans with amputations. This conclusion stems from a thorough usability evaluation from the end-users' perspective.

The diabetic foot is a chronic complication of diabetes. There is a strong relationship between glucose levels, the severity of diabetic foot ulcers (DFUs), and the need for amputation. This study aimed to evaluate the blood sugar (BS) trends before and after surgery in patients with DFU who had been amputated.

The adult patients who had undergone DFU-related amputation surgery between 2017 and 2020 in Imam Khomeini Hospital Complex, Tehran, Iran, were evaluated. The cases whose BS levels were charted at least three days before and after amputation were recruited. The main data, including hypoglycemia (defined as a blood glucose level < 70 mg/dl) and mean BS and fasting BS (FBS) levels, were recorded. The data were then analyzed and compared before and after amputation.

Of 267 patients reviewed for inclusion criteria, 55 patients were included in the study. Twenty-eight patients (50.9%) were men, and the mean age was 60 years. The mean FBS before and after amputation was 229.5 and 181.3 mg/dl, respectively, and the mean BS before and after amputation was 227.3 and 197.8 mg/dl, respectively. The differences were significant (P < 0.001). Twelve patients (21.8%) before and 21 patients (36.4%) after amputation suffered from hypoglycemia (P = 0.057).

DFU-related amputation is associated with a significant decrease in blood glucose levels and inflammatory indexes. However, it can increase the risk of hypoglycemia during the first three days after the surgery.

Amputation refers to removing a limb's defective or useless portion. Although it is an awful solution, amputation may be the only strategy that can save lives. This study was done to identify the causes of amputation and build a database for assessing healthcare.
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This cross-sectional descriptive study, which excluded cases of congenital amputations, included all cases admitted to Ghazi Al-Hariri Hospital for surgical specialties in the center of the medical city of Baghdad from January 2016 to January 2021.

A total of 19744 patients were hospitalized in the orthopedics and trauma department, with 12381 male patients (63%) and 7363 female patients (37%). Also, 748 cases (4% of all cases) had their limbs amputated, of whom 499 cases (67%) were male and 249 cases (33%) were female. For both sexes, the average age was 46 years. The average hospital stay was close to five days. Lower limbs made up 677 cases (91%). However, the difference between these sides was too tiny to be taken into account. Trauma affected 269 patients (36%), complications from diabetes mellitus were found in 232 patients (31%), peripheral vascular ischemia affected 205 patients (27%), malignant tumor cases affected 32 patients (4%), infection was found in only three patients (0.4%), COVID-19 and rheumatologic affected only two patients (0.26%), and burn and chronic ulcers that did not respond to treatment affected just one patient (0.13%).

Male gender and younger ages were found with lower limb disease. Both sides were affected equally. COVID-19 may present as an ischemic limb.

Diabetes mellitus (DM) is the most common metabolic disorder. The improvement of the quality of life (QoL) of people with DM is one of the goals in most health systems. This study was conducted to investigate the relationship between the QoL and social support in these individuals.

Forty people with diabetes with lower limb amputation participated in this descriptive cross-sectional study. For data collection, the multidimensional scale of perceived social support (MSPSS), medical outcome study-social support survey (MOS-SSS), the diabetes quality of life (DQoL), and demographic questionnaires were used.To examine the relationships between the variables, an independent t-test, Pearson correlation coefficient, Spearman’s correlation coefficient, and multivariate analysis were performed by SPSS software, version 22.

In this study, 56% of the participants (22 people) were male and the rest were female. The results of the linear regression analysis showed that there was a significant and direct relationship between QoL and social support resources (P=0.002, β=0.514) and dimensions (P=0.01, β=0.458). QoL was significantly correlated with marital status (P=0.015) and economic status (P=0.046).

Increased social support enhances QoL in people with diabetes with lower limb amputation. Therefore, planning to improve social support is highly important in improving the QoL in these people.

Hand traumas are common in young men and their complications can have negative effects on their occupation and economic activities. On the other hand, most of the hand injuries are related to occupation accidents and thus necessitates preventive measures. The goal of a clinical registry is assisting epidemiologic surveys, quality improvement preventions.

This article explains the first phase of implementing a registry for upper extremity trauma. This phase includes recording of demographic data of patients. A questionnaire was designed. Contents include patients’ characteristics, pattern of injury and past medical history in a minimal data set checklist. This questionnaire was filled in the emergency room by general practitioners. For 2 months the data were collected in paper based manner, then problems and obstacles were evaluated and corrected. During this period a web based software was designed. The registry was then ran for another 4 months using web based software.

From 6.11.2019 to 5.3.2020, 1675 patients were recorded in the registry. Random check of recorded data suggests that accuracy of records was about 95.5%. Most of the missing data was related to associated injuries and job experience. Some mechanisms of injury seems to be related to Iran community and thus warrants special attention for preventive activities.

With a special registry personnel and supervision of plastic surgery faculties, an accurate record of data of upper extremity trauma is possible. The patterns of injury were remarkable and can be used for investigations and policy making for prevention.

Cases of severe lower limb injuries that previously were amenable only to amputation can now, in certain circumstances, be managed with reconstruction. The present systematic review and meta-analysis was designed to compare the results of amputation and reconstruction in severe lower extremity injuries.

PubMed, EMBASE and Cochrane Central Register of Controlled Trails (CENTRAL) were comprehensively searched for studies comparing amputation and reconstruction for severe lower extremity injuries. The search terms used were the following: “amputation”, “reconstruction”, “salvage”, “lower limb”, “lower extremity”, and “mangled limb”, “mangled extremity”, “mangled foot”. Two investigators screened eligible studies, assessed the risk of bias and extracted the data from each study. Meta-analysis was conducted using the Review Manager Software (RevMan, Version 5.4). The I2 index was used to assess heterogeneity.

Fifteen studies with 2,732 patients were included. Amputation is associated with lower rehospitalization rates, lower length of stay in the hospital, lower number of operations and additional surgery and fewer cases of infection and osteomyelitis. Limb reconstruction leads to faster return to work and lower rates of depression. The outcomes with respect to function and pain are variable among the studies. Statistically significance was achieved only with regards to rehospitalization and infection rates.

This meta-analysis suggests that amputation yields better outcomes in variables during the early postoperative period, while reconstruction is associated with improved outcomes in certain long-term parameters. Severe lower limb injuries should be managed on their individual merit. The results of this study may be a useful tool to aid in the decision-making for the treating surgeon. High-quality Randomized Controlled Studies are still required to further our conclusions. Level of evidence: III

Amputation is a procedure in which an unhealthy limb or a part of it is cut because it is dangerous, or useless or disrupts life. This procedure in itself is considered a crippling procedure, yet it is also a life-saving procedure. This study aimed to compare the causes of amputation in Iraqi subjects for five years (2016-2020).
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In this retrospective cross-sectional study, 758 amputated patients were investigated from 1st day of 2016 to the last day of 2020 at Al-Hariri Hospital for Surgical Specialty.

The rate of amputation in 2020, 2019, 2018, 2017, and 2016 was 6%, 6%, 4%, 3%, and 2% of total admitted cases, respectively. The highest cause of amputation in 2020 was diabetes mellitus (18%) and mostly in males. Diabetes mellitus and vascular ischemia in both sexes were 18% of total amputated cases in 2019. Trauma was 23% of total amputated cases in 2018, 57% in 2017, and 64% in 2016.

The rate of amputation is not so high. There is a significant association between amputation and gender, age, occupation, and the cause of amputation. There is no significant relationship between amputation and the hospital stay, the parts are either lower or upper, and the side is either left or right. Regarding the indications of amputation, the highest cause of amputations changes every year.

Suicide by high-speed railway track trauma with complete decapitation is a rare event; however, it is well known and reported in the scientific literature. The authors analyzed 5 cases of suicide with complete decapitation along with upper limb amputation or severe injury by high-speed mainline train subjected to medico-legal autopsies at the Department of Forensic Medicine and Toxicology, Gandhi Medical College, Bhopal between 2019 and 2021. Upper limb injury is considered because of scientific reasons that they have been amputated along with decapitation. Personal, circumstantial, autopsy, and toxicological data and thevictim’s psychical profile were analyzed, and factors like the type of injury, the vital reaction of wound edges, absence of any signs of defense, alcohol, and drug consumption were also considered.

Social support is an essential source of psychological support that a disabled person needs in daily life. Social support and level of satisfaction affect how the patient perceives the various stresses of life. Because of few studies on amputees, it is necessary to study social support and its impact on their quality of life (QoL). This study investigates social support and its relationship to QoL among amputation cases living in Kut City, Iraq.

This correlational study was conducted on 150 participants attending the Prosthetics Center in Kut. We investigated the relationship between social support and the QoL of amputees. The study questionnaire’s reliability was assessed through a pilot study, and it was subsequently presented to experts for validation. The information was collected through interview techniques and evaluated using descriptive and inferential statistical analysis.

The Mean age of the participants was 38 years. They were mostly married males and unemployed with low economic status. Findings show that 68% of the participants expressed poor social support. Their social status, residents, and income had been influenced the social support (Mean±SD: 34.18±14.978), and 62% expressed a poor QoL (Mean±SD: 85.37±21.008). There was a significant correlation between social support and QoL (P=0.000), and social support significantly affected the QoL for amputation cases (P=0.000).

There is a strong significant positive correlation between social support and QoL. The QoL among amputated cases was dependent on their social support. If family, friends, and community members provide embellished social support for amputees, they can face adversity and crises and lead their lives more effectively

Throughout history, people have lived through various situations of security, peace, recovery, and war, as well as the cruelty over the diversity, intensity, duration, or shortness of life. This study aimed to assess the self-esteem of amputees living in Hilla City, Babylon Province, in Center of Iraq.

A descriptive correlational study was conducted to determine the association between body image and self-esteem of amputees. By a purposive sampling method, 200 subjects from both genders and different age groups (25-35, 36-46, 47-57, 58-68, and >69 years) were recruited. The study data were collected through the modified questionnaire of multidimensional body-self relations questionnaire, Rosenberg self-esteem scale, and interviews with the patients individually. The obtained data were collected and analyzed with descriptive and inferential statistics.

Most participants were male patients aged between 58 and 68 years. The lower limbs were the most amputation site caused by the war for less than five years. The majority of amputees had negative responses toward their body image. As well as depicts (39%) as a majority response of amputated patients were never feel with their self-esteem. There was a high reverse association between body image and self-esteem (P<0.01).

Our analysis reflects that amputees see themselves negatively, which leads to a lack of self-esteem. Also, a feeling of negative body image affects their self-esteem. Hospitals should provide specialists in mental health and psychological therapy to increase the chance for early intervention and psychological treatment in these cases. The hospitals must provide programs to guide amputees and reduce their psychological problems.

Buerger's disease (thromboangiitis obliterans) may be a rare peripheral vascular disease that sometimes affects young male smokers. This study presents surgical treatment options for 315 Buerger's patients during a period of 18 years from 2002 to 2020.

In this cross-sectional study, 315 newly diagnosed Buerger patients in a period of 18 years (by Census sampling) were evaluated. Data included age, sex, cigarette smoking status, clinical presentation, the affected limb (right or left, upper or lower extremities), and the performed therapeutic procedures such as angiography of limb arteries, amputation, sympathectomy, and vascular bypass surgery, which were collected in a data sheet. Vascular reconstruction was done if there were suitable inflow and outflow arteries. Sympathectomy was performed for the patients who were unsuitable for revascularization. All analyzes were performed using SPSSV.18 software package (SPSS Inc., Chicago, IL). Data are presented as frequency, mean ± variance (SD).

The mean age of patients was 42.6±9 years old, ranging from (26-75). There were 309 (98.1%) males and 6 (1.9%) females. The most common symptom was ulcer 252 (80%), and the most commonly involved arteries were the dorsal pedis (N=231; 73.4%) and posterior tibialis (N=225; 71.5%). Vascular bypass surgery, sympathectomy, and amputation were performed for patients who met surgical indications. Aortofemoral (N=9) and femoropopliteal (N=24) bypass procedures were done in 2.8% and 7.6% of patients respectively. Of nine patients who underwent aorto-femoral bypass procedure, 6 cases presented with leg claudication, 3 with an ulcer, and 3 with the Raynaud phenomenon. The digital loss rate was 9.6% (N=9) in toes and 1% (N=3) in fingers.

As most of the Buerger patients have multi arterial involvement, bypass surgery or sympathectomy can’t help treat these patients more than cigarette smoking or pharmaceutical therapy.