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Patient-reported outcome measures (PROMs) are metrics that assess physical health, mental health, pain, and satisfaction. However, PROM collection in orthopaedic clinics presents numerous logistical and financial challenges. These challenges are reduced when PROMs are completed before clinic encounters, relieving the workflow constraints of in-office PROM collection. The purpose of this study was to determine the efficacy of 3 different methods with respect to pre-visit electronic PROM completion.Consecutive adult orthopaedic patients with no previous PROM participation were enrolled. Patients who registered with the electronic medical record (EMR) patient portal (MyChart) and with active e-mail addresses were randomly assigned to 1 of 3 arms: control (no pre-visit messages), MyChart (EMR patient portal pre-visit messages), and e-mail (e-mail pre-visit messages). The primary outcome measure was pre-visit PROM completion rates in orthopaedic patients, and the secondary outcome measures were time to pre-visit PROM form completion and PROM form completion rates according to patient demographic characteristics. By default, the Patient-Reported Outcomes Measurement Information System (PROMIS) forms were available for completion through the portal by 7 days before scheduled visits. Pre-visit messages were sent 7 days prior to the scheduled visit except in the control group, with reminders sent 3 days prior if still not completed. The patients in each arm who completed all assigned forms were labeled as having total PROM completion, and those who completed at least 1 completed form were considered as having partial PROM completion. Multivariable logistic regression models were used to assess differences in PROM completion rates between study arms. Kruskal-Wallis tests were performed to compare the date of the form completion.A total of 291 patients were included. The pre-visit total completion rates for assigned PROMs were higher in the MyChart arm (49% of 97 patients; p = 0.005) and the e-mail arm (52% of 100 patients; p = 0.002) in comparison with the control arm (30% of 94 patients). Male patients were more likely than female patients to have partial pre-visit PROM completion (odds ratio [OR], 1.74; p = 0.03), and Caucasian patients were more likely to have partial pre-visit PROM completion than African American patients (OR, 2.28; p = 0.01).Orthopaedic patients receiving either e-mail or patient portal messages demonstrated higher pre-visit PROM completion rates. Pre-visit messaging appears to be a useful strategy for increasing PROM completion rates and limiting the clinical workflow strain imposed by in-clinic PROM administration.Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.

Background/purpose of study No study has evaluated the perception of medical undergraduate students to the electronic objective structured practical examination (e-OSPE) in orthopaedics. The aim of the present study is to evaluate the feasibility and perception of the medical undergraduate students to e-OSPE conducted by the department of Orthopaedics to assess problem-solving and clinical decision-making skills of medical undergraduate students. Methods Medical undergraduate students of second and third year at our medical college who completed the orthopaedic clinical posting and appeared for the orthopaedic practical examination during the second wave of the COVID-19 pandemic were included in this prospective observational study. Students appearing for the exams from 20th March 2021 to 26th June 2021 were invited to complete the questionnaire immediately after the e-OSPE. Internal consistency of the survey questions was assessed using Cronbach’s alpha. Results 272 out of 312 eligible students completed the survey and the survey response rate was 87.2%. Nine groups of medical undergraduate students gave the orthopaedic practical exams from 20th March 2021 to 26th June 2021. 91.2% students felt that the e-OSPE represented a valid modality of evaluation of essential orthopaedic practical knowledge during the COVID-19 pandemic. The overall reliability of the 19 questions included in our survey was very high (Internal consistency: Cronbach’s alpha = 0.88). Conclusion The e-OSPE was well received by the medical undergraduate students at our institute and the students had a positive perception about the new examination technique used in orthopaedics during the COVID-19 pandemic.

Ivermectin, composed of at least 80% 22,23 dihydroavermectin B1a and < 20% 22, 23 – dihydroavermectin B1b was the first avermectin to be commercialized and was approved for use in animals in 1981(Chabala et al., 1980). Its unprecedented potency and new mode of action quickly made ivermevtin the treatment of choice for nematode and arthropod parasitism in cattle, sheep, goats, swine and horses (Campbell and Benz, 1984). Monitoring of haemato-biochemical alteration during parasitic infections in several host-parasite systems is an essential criterion for precisely assessing the drug’s efficacy at pre and post anthelmintics treatment (Bhat and Sharma, 1990). The purpose of the study reported here was to evaluate the haemato-biochemical alteration after ivermectin (Neomac inj. INTAS) in helminths infected donkeys.

A number of lice, mites, flea and ticks infect to birds and cause severe irritation which leads to loss of feathers, loss of weight and low numbers of eggs. Small ticks feed on the blood of birds and can carry germs which will cause other diseases. Other external parasites will hide in the walls, floors and bedding of the cages and houses where birds are kept. In order to control the parasites, it is necessary to keep these places clean and kill any parasites there.

Dipteran species (two-winged insects, or true flies) are well known for its consequences when they bite host to have blood meal, also known as hematophagous, cause nuisance to the animals during the adult stage, and myiasis at the immature stages or larvae by feeding on the living soft tissue and act as a vector either mechanically or cyclically transmitting innumerous deadly pathogens which result in production losses and some are even prone to human death. Common ectoparasites which affect cattle health and in turn cause drastic reduction in production level causing havoc in economic downfall of the country.

YouTube proves to be a source of health information for patients. This is the first study to analyze the source reliability and educational value of YouTube videos on facial filler treatments. On August 12, 2020, YouTube.com was queried using the keywords “facial filler” or “dermal filler” or “fillers.” A total of 100 were initially reviewed in which 74 videos met the inclusion criteria and were included in the final analysis. Video characteristics were recorded, and each video was graded for source reliability and educational value by using the Journal of the American Medical Association (JAMA) benchmark criteria and the Global Quality Score (GQS), respectively. Furthermore, each video was assessed to determine whether there was discussion of 5 different topics that were deemed to be useful to patients prior to undergoing a facial filler treatment. A total of 74 videos met the inclusion criteria and had an average length of 436 seconds (7 minutes and 16 seconds), 146 805 views, 1906 likes, 73 dislikes, and 241 comments. Forty-five videos (61%) were posted with an intention to educate patients, whereas 29 videos (39%) were posted with an intention to describe a patient’s experience with facial filler treatment. Patient education videos were found to have a significantly higher educational value ( PGQS < .001). Patient experience videos showed no difference in reliability score ( PJAMA > .05) to patient education videos, but patient experience videos were found to have lower educational value compared with patient education videos ( PGQS < .001). In addition, both categories are not providing sufficient information for informed decision-making prior to treatment deemed by the 5 selected categories we found most informative. As patients will continue to seek educational material online, clinicians should use this information to help primarily educate patients with standardized and accurate information about their treatment.

YouTube is a common source of medical information for patients. This is the first study to assess the reliability and educational value of YouTube videos on neurotoxin procedures. YouTube.com was searched on June 15, 2020 using the keyword “Botox” or “neurotoxin.” A total of 100 videos were reviewed. Sixty-one videos met the inclusion criteria and were included in the final analysis. Video characteristics were noted, and a score was assigned to each video using the Journal of the American Medical Association (JAMA) benchmark criteria and the Global Quality Score (GQS) to measure source reliability and educational value, respectively. A total of 61 videos that met the inclusion criteria had an average length of 589 seconds (9 minutes and 49 seconds), 210,673 views, 5,295 likes, 318 dislikes, and 478 comments. A total of 30 videos (49%) were posted with an intention to educate patients while 31 videos (51%) were posted with the intention to detail a personal experience with neurotoxin. Patient education videos were significantly more reliable (P JAMA< 0.001) and had more educational value (P GQS Key Points

OBJECTIVEPatient satisfaction is a new and important metric in the American healthcare system. The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) is a common modality used to assess patient satisfaction in inpatient settings. Despite the existence of data, neurosurgical literature on patient satisfaction following spinal surgery is scarce.METHODSA total of 17,853 patients who underwent spinal procedures at the authors’ institution were analyzed retrospectively for HCAHPS survey participation. Appropriate demographic, surgical, comorbidity, and complication data were collected; 1118 patients had patient satisfaction survey data, and further survey metrics were collected for this subset of patients.RESULTSMale patients, patients with urgent/emergency procedures, and patients with a longer length of stay were less likely to complete an HCAHPS survey (OR 0.820, p < 0.001; OR 0.818, p = 0.042; and OR 0.983, p < 0.001, respectively). Posterior approach was negatively associated with HCAHPS survey participation (OR 0.868, p = 0.007). Patients undergoing fusion procedures were more likely to participate in HCAHPS surveys (OR 1.440, p < 0.001). Of the completed HCAHPS surveys, there were no positive predictors associated with perfect scores. High Charlson Comorbidity Index (OR 0.931, p = 0.007), increasing elapsed time since surgery or discharge (OR 0.992, p = 0.004), and increasing length of stay (OR 0.928, p < 0.001) were all negatively associated with a perfect score. Finally, patient sex and race did not influence the likelihood of a perfect or low survey score.CONCLUSIONSParticipation in HCAHPS surveys was correlated with preoperative and postoperative factors. Among these, procedure approach and type, length of stay, and complications seemed to influence participation the most. No factors were associated with an increased likelihood of receiving a perfect score. Similarly, length of stay and time elapsed since surgery to survey completion were significant negative predictors of receiving perfect HCAHPS survey scores. Increasing comorbid burden was also found to be a negative predictor for high scores. Further study on predictors of inpatient satisfaction within spine surgery is needed.

OBJECTIVEPress Ganey surveys are common modalities used to assess patient satisfaction scores in an outpatient setting. Despite the existence of data, neurosurgical and orthopedic literature on patient satisfaction following spinal surgery is scarce.METHODSA total of 17,853 patients who underwent spinal procedures at the authors’ institution were analyzed retrospectively for Press Ganey survey participation. Appropriate demographic, surgical, comorbidity, and complication data were collected; 1936 patients had patient satisfaction survey data, and further survey metrics were collected for this subset of patients.RESULTSMale patients, patients with urgent/emergency procedures, and patients with longer length of stay (LOS) were less likely to fill out Press Ganey surveys (OR 0.822, p < 0.001; OR 0.781, p = 0.010; and OR 0.983, p < 0.001, respectively). Posterior approach was negatively associated with Press Ganey participation (OR 0.907, p = 0.055). Patients undergoing fusion procedures were more likely to participate in Press Ganey surveys (OR 1.419, p < 0.001). Of the patients who filled out surveys, there were no positive predictors associated with receiving perfect scores on Press Ganey surveys. High Charlson Comorbidity Index (OR 0.959, p = 0.02), increasing elapsed time since surgery or discharge (OR 0.996, p = 0.03), and increasing LOS (OR 0.965, p = 0.009) were all negatively associated with receiving a perfect score. Patients who underwent a posterior-approach procedure compared with other approaches were less likely to report a low Press Ganey score (OR 0.297, p = 0.046). Patient sex and race did not influence the likelihood of receiving perfect or low Press Ganey scores. Finally, the perceived skill of the surgeon was not a significant predictor for perfect (p > 0.99) or low (p = 0.828) Press Ganey scores.CONCLUSIONSPatient participation in Press Ganey surveys strongly correlated with preoperative factors such as procedure approach and type, as well as postoperative factors such as LOS and complications. No factors were associated with an increased likelihood of receiving a perfect Press Ganey score. Similarly, LOS and time elapsed since surgery to survey completion were significant negative predictors of perfect Press Ganey scores. Skill of surgeon, sex, and race did not correlate with a predictive value for Press Ganey outcomes. In addition, overall comorbid disease burden was found to be a significant negative predictor for high patient satisfaction scores. Further study on predictors of patient satisfaction within spine surgery is needed to better assist physicians in improving the surgical experience for patients.

Design of Data Acquisition (DAQ) system is always remains topic of research and development for custom requirements from the environments. This paper represents exploratory analysis of the various system components and their performance parameters. The baseline performance parameters are power requirement, computing capabilities, interface data rates, miniaturization requirements and others. Based on the baseline performance requirements of DAQ system, major system components are quantified and proposed design has adopted Xilinx Zynq 7000 based System on Chip(SoC) which consists of dual-Cortex A9 CPU and an Artix-7 family Field Programmable Gate Arrays(FPGA). At the end of paper, the design of compact instrument based on Zynq7000 SoC is finalized, which satisfies the functional needs and specifications of data acquisition, storage, processing and communication for high speed data acquisition system in a compact package.

Treatment options for patients with severe attrition resulting in reduced occlusal vertical dimension are often limited to fixed prosthesis to reestablish proper occlusal vertical dimension and functional occlusion. In some cases such as when there are limited finances, minimal esthetic concerns, and medical considerations fixed prosthesis may not be the ideal treatment option. Overlay removable partial dentures (ORPDs) can be used as a provisional or interim prosthesis as well as permanent prosthesis in these cases. While ORPDs can provide a reversible and relatively inexpensive treatment for patients with a significantly compromised dental status, there is not much scientific evidence in the literature on ORPDs. Most studies published on ORPDs to date are primarily reviews and clinical reports. In this article, literatures on ORPDs are summarized and a patient treated with interim and permanent ORPDs is presented. This article reviews previously published literatures on the use of ORPDs. Indications, advantages and disadvantages are discussed. Treatment protocol with an example of the prosthodontic treatment of a patient with severely worn dentition with an interim ORPD and later a permanent ORPD are discussed in details.

A reversed-phase liquid chromatographic (RP-HPLC) method was developed for the simultaneous determination of tolperisone hydrochloride (TOLP) and etodolac (ETD) in a combined fixed dose oral formulation. The analysis was carried out using a phenomenax C-18, pre-packed column. A mobile phase containing a phosphate buffer (pH 5.5) : Methanol : Acetonitrile : Tri-ethylamine (40 : 40 : 20 : 1.5), with the pH adjusted to orthophosphoric acid, was pumped at a flow rate of 1.0 ml min 1 with a UV-detector and PDA detection at 257 nm. Retention time was 3.91 minutes and 6.89 minutes for TOLP and ETD, respectively. The method was validated for linearity, accuracy, precision, sensitivity, and specificity. The method showed good linearity in the range of 3 – 21 μg ml for TOLP μg / ml and 8 – 56 μg / ml for ETD. The detection limit of the proposed method was 0.16 μg / ml and 0.58 μg / ml for TOLP and ETD, respectively. The quantification limit of the proposed method was 0.51 μg / ml and 1.7 μg / ml for TOLP and ETD, respectively. The % recovery was within the range of 99.42 – 101.15 for TOLP and 98.63 – 100.94 for ETD. The percentage RSD for precision of the method was found to be less than 2%. The method was validated as per the International Conference on Harmonization (ICH) guidelines. The developed method could be applied for routine analysis of TOLP and ETD in tablet dosage form. Key words: Etodolac, high performance liquid chromatography, tolperisone, validation.