Publications by authors named "Sameer Badarudeen"

9 Publications

  • Page 1 of 1

A new interventional home care model for COVID management: Virtual Covid IP.

Diabetes Metab Syndr 2021 Jul 23;15(5):102228. Epub 2021 Jul 23.

Department of Diabetology, Jothydev's Diabetes Research Centers, Kerala, India.

Aim: Amidst COVID-19 pandemic, the health care delivery in India faces major challenges owing to the overwhelming hospitals, exhausted healthcare workers, and shortage of crucial medical supplies such as ventilators and oxygen. The study aims to propose a novel successful interventional home care model, the Virtual COVID In-Patient (VCIP) care for effective COVID management.

Methods: The Covid-19 positive patients enrolled in VCIP were chosen for the study. A 24/7 active multidisciplinary WhatsApp group was created for each patient, for remote monitoring of temperature, blood pressure, blood glucose, respiratory and pulse rate along with the symptoms. Advice on sleep and exercises were given along with the medication via video-audio consultations. Lab facility was provided at the doorstep. Training on various devices, medications including steroids, delivering subcutaneous injections etc were given via video platforms.

Results: Among the 220 patients who availed the VCIP facility, only two were hospitalized, yielding a 99.5 % success rate in preventing hospitalizations and patients enrolled have been immensely satisfied with their experience.

Conclusions: With similar pandemics anticipated in near future, VCIP model may be considered for successful domiciliary treatment and overcoming the challenges.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.dsx.2021.102228DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8299213PMC
July 2021

Complications After Revision Total Hip Arthroplasty in the Medicare Population.

J Arthroplasty 2017 06 1;32(6):1954-1958. Epub 2017 Feb 1.

Adult Reconstruction Program, Department of Orthopedic Surgery, University of Louisville, KentuckyOne Health, Louisville, Kentucky.

Background: The purpose of this study was to identify the incidence and types of complications after revision total hip arthroplasty (THA) within the first year, and determine the relative risk factors for these complications and of re-revision.

Methods: The sample size of 5% Medicare claims data from 1998-2011 was studied. Primary THA patients who underwent subsequent revision were identified using ICD-9-CM codes. Outcomes and complications after revision THA were assessed. Multivariate Cox regression was used to evaluate the effect of patient demographic characteristics on the adjusted complication risk for revision THA patients.

Results: Of the 64,260 primary THA patients identified between 1998 and 2011, 3555 patients (5.71%) underwent revision THA. Etiology of primary hip failure included mechanical complications such as loosening and wear (40.7%), dislocation (14.0%), and infection (11.3%). Complications after revision THA included infection and redo revision, 17.3% and 15.8% followed by venous thromboembolic disease (VTE) at 11.1%, dislocation at 5.43%, PE at 3.24%, and death at 2.11%. The rate of "new" infections after an aseptic revision was 8.13%. Patients in the 85+-year-old age group had a 100% greater adjusted risk of VTE (P < .001) and 406% higher adjusted risk of death (P < .001) than those in the 65-69 years-old age group. Patients with higher Charlson scores had higher adjusted risks of VTE (P < .001), infection (P < .001), death (P = .002), and re-revision THA (P = .011).

Conclusion: Advanced age is a clear risk factor for VTE and mortality, but not for dislocation, infection, or re-revision. Higher Charlson index was found to be a risk factor for every complication after revision except dislocation. Greater attention is required to address the high rate of infection and re-do revision after revision THA (17.3% and 15.8%).
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.arth.2017.01.037DOI Listing
June 2017

The Difficult Primary Total Knee Arthroplasty.

Instr Course Lect 2016 ;65:243-65

Professor, Chief of Adult Reconstruction, Department of Orthopaedic Surgery, University of Louisville, Louisville, Kentucky.

Primary total knee arthroplasty (TKA) for the treatment of knee arthritis has substantially increased over the past decade. Because of its success, the indications for primary TKA have expanded to include younger patients who are more active, elderly patients who have multiple comorbidities, and patients who have more complex issues, such as posttraumatic arthritis and severe deformity. TKA also has been used to salvage failed unicondylar arthroplasty and osteotomies about the knee. Exposure may be challenging and outcomes may not be as successful in patients with soft-tissue contractures, such as a stiff knee, who undergo TKA. Bone graft or augments may be required to correct deformity and attain proper knee alignment in patients who have a substantial varus or valgus deformity. TKA is somewhat challenging in patients who have deformity, bone loss, contracture, or multiple comorbidities, or have had prior surgery; therefore, it is necessary for surgeons to be aware of some general principles that may help minimize complications and improve outcomes.
View Article and Find Full Text PDF

Download full-text PDF

Source
July 2016

Definitive plates overlapping provisional external fixator pin sites: is the infection risk increased?

J Orthop Trauma 2014 Sep;28(9):518-22

*Department of Orthopaedic Surgery, Washington University School of Medicine, St Louis, MO; and †Department of Orthopaedic Surgery, Boston University, Boston Medical Center, Boston, MA.

Objectives: The purpose of this study was to compare the infection risk when internal fixation plates either overlap or did not overlap previous external fixator pin sites in patients with bicondylar tibial plateau fractures and pilon fractures treated with a 2-staged protocol of acute spanning external fixation and later definitive internal fixation.

Design: Retrospective comparison study.

Setting: Two level I trauma centers.

Patients/participants: A total of 85 OTA 41C bicondylar tibial plateau fractures and 97 OTA 43C pilon fractures treated between 2005 and 2010. Radiographs were evaluated to determine the positions of definitive plates in relation to external fixator pin sites and patients were grouped into an "overlapping" group and a "nonoverlapping" group.

Intervention: Fifty patients had overlapping pin sites and 132 did not.

Main Outcome Measure: Presence of a deep wound infection.

Results: Overall, 25 patients developed a deep wound infection. Of the 50 patients in the "overlapping" group, 12 (24%) developed a deep infection compared with 13 (10%) of the 132 patients in the "nonoverlapping" group (P = 0.033).

Conclusions: Placement of definitive plate fixation overlapping previous external fixator pin sites significantly increases the risk of deep infection in the 2-staged treatment of bicondylar tibial plateau and pilon fractures. Surgeons must make a conscious effort to place external fixator pins outside of future definitive fixation sites to reduce the overall incidence of deep wound infections. Additionally, consideration must be given to the relative benefit of a spanning external fixator in light of the potential for infection associated with their use.

Level Of Evidence: Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1097/BOT.0000000000000077DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4133273PMC
September 2014

Assessing readability of patient education materials: current role in orthopaedics.

Clin Orthop Relat Res 2010 Oct;468(10):2572-80

Cedars-Sinai Medical Center, Los Angeles, CA, USA.

Background: Health literacy is the single best predictor of an individual's health status. It is important to customize health-related education material to the individual patient's level of reading skills. Readability of a given text is the objective measurement of the reading skills one should possess to understand the written material.

Questions/purposes: In this article, some of the commonly used readability assessment tools are discussed and guidelines to improve the comprehension of patient education handouts are provided. Where are we now? Several healthcare organizations have recommended the readability of patient education materials be no higher than sixth- to eighth-grade level. However, most of the patient education materials currently available on major orthopaedic Web sites are written at a reading level that may be too advanced for comprehension by a substantial proportion of the population. WHERE DO WE NEED TO GO?: There are several readily available and validated tools for assessing the readability of written materials. While use of audiovisual aids such as video clips, line drawings, models, and charts can enhance the comprehension of a health-related topic, standard readability tools cannot construe such enhancements. HOW DO WE GET THERE?: Given the variability in the capacity to comprehend health-related materials among individuals seeking orthopaedic care, stratifying the contents of patient education materials at different levels of complexity will likely improve health literacy and enhance patient-centered communication.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s11999-010-1380-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3049622PMC
October 2010

Impact of obesity in patients with congestive heart failure.

Rev Cardiovasc Med 2009 ;10(3):142-51

Cedars-Sinai Heart Institute, Division of Cardiology, Cedars-Sinai Medical Center, Los Angeles, CA, USA.

Obesity is a known risk factor for developing cardiovascular disease, including heart failure. However, the impact of obesity on patients with heart failure is unclear. Weight reduction is a recommended method of prevention of cardiovascular disease. However, the phenomenon of the "obesity paradox" (or "reverse epidemiology") revealed that overweight and mild to moderate obesity are associated with better outcomes in patients with heart failure compared with patients at normal or ideal weight. Even more, increases of weight in cachectic heart failure patients might improve survival, although patients with heart failure who are overweight or mildly to moderately obese have better outcomes than patients with heart failure who are at ideal or normal weight. In heart failure patients, weight reduction through diet regulation, moderate exercise, and bariatric surgery can improve quality of life and New York Heart Association functional class, but it is yet unclear if these measures will improve survival.
View Article and Find Full Text PDF

Download full-text PDF

Source
December 2009

The effect of circular external fixation on limb alignment.

J Pediatr Orthop 2008 Apr-May;28(3):314-9

Department of Orthopedics, UMDNJ-New Jersey Medical School, Doctor's Office Center, 90 Bergen St, Suite 7300, Newark, NJ 07103, USA.

Introduction: A full-length standing radiograph of the entire lower extremity is the standard imaging modality for assessing lower limb alignment. However, the effect of an overlying circular external fixator on the radiographic alignment of the lower extremity is not well documented.

Methods: After correction of angular deformity using a circular external fixator, 29 patients (31 limbs) underwent 2 sets of full-length standing radiographs, one done before, and the other, after removal of the fixator. The difference in the measurement of frontal plane alignment, limb lengths, and rotation between the 2 radiographs was analyzed.

Results: The mean absolute difference in the measurement of mechanical axis deviation (MAD) between the 2 radiographs was 11.5 mm (P < 0.0001) for the ipsilateral limb (with the external fixator) and 8.9 mm (P < 0.0001) for the contralateral limb. The mean difference in the radiographic measurement of limb lengths was 20 mm (P < 0.0001) for the ipsilateral and 20.2 mm (P < 0.0001) for the contralateral limb. As the magnitude of MAD and external rotation of the ipsilateral limb increased, a progressive increase in the magnitude of discrepancy in the measurement of MAD between the 2 sets of radiographs was noted. There was no significant effect (P > 0.05) of the patient's age, sex, body mass index, primary diagnosis, duration between the 2 radiographs, and the direction of malalignment found on the discrepancy in the measurement of MAD for both limbs.

Conclusions: The standing full-length radiograph with an overlying circular external fixator may not be a reliable indicator of limb alignment and length of the operated extremity. Moreover, the presence of the circular external fixator on the lower extremity can affect the alignment and length of the opposite limb. Clinicians using circular external fixators for lower extremity trauma and reconstruction should be aware of the pitfalls of using a full-length standing radiograph for assessing limb alignment and length during osseous healing.

Level Of Evidence: Diagnostic level II.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1097/BPO.0b013e3181653ba2DOI Listing
August 2008

Readability of online patient education materials from the AAOS web site.

Clin Orthop Relat Res 2008 May 7;466(5):1245-50. Epub 2008 Mar 7.

Department of Orthopedics, University of Medicine and Dentistry of New Jersey-New Jersey Medical School, Doctor's Office Center, 90 Bergen Street, Newark, NJ 07103, USA.

One of the goals of the American Academy of Orthopaedic Surgeons (AAOS) is to disseminate patient education materials that suit the readability skills of the patient population. According to standard guidelines from healthcare organizations, the readability of patient education materials should be no higher than the sixth-grade level. We hypothesized the readability level of patient education materials available on the AAOS Web site would be higher than the recommended grade level, regardless when the material was available online. Readability scores of all articles from the AAOS Internet-based patient information Web site, "Your Orthopaedic Connection," were determined using the Flesch-Kincaid grade formula. The mean Flesch-Kincaid grade level of the 426 unique articles was 10.43. Only 10 (2%) of the articles had the recommended readability level of sixth grade or lower. The readability of the articles did not change with time. Our findings suggest the majority of the patient education materials available on the AAOS Web site had readability scores that may be too difficult for comprehension by a substantial portion of the patient population.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s11999-008-0193-8DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2311488PMC
May 2008

Readability of patient education materials from the American Academy of Orthopaedic Surgeons and Pediatric Orthopaedic Society of North America web sites.

J Bone Joint Surg Am 2008 Jan;90(1):199-204

University of Medicine and Dentistry of New Jersey, New Jersey Medical School, Doctor's Office Center, 90 Bergen Street, Suite 7300, Newark, NJ 07103, USA.

Background: While experts recommend that the readability of patient education materials should be less than the sixth grade level, the available information pertaining to orthopaedic diseases may be excessively complex for some to read and comprehend. The Flesch-Kincaid grade level is the most widely used tool to evaluate the readability score of a given text, with a lower grade level suggesting easier readability. The goal of our study was to assess the readability of pediatric orthopaedic patient education materials that were developed by the American Academy of Orthopaedic Surgeons (AAOS) and the Pediatric Orthopaedic Society of North America (POSNA) and were accessible to the general public through the Internet.

Materials And Methods: All articles from the "Children" section of the patient education library, "Your Orthopaedic Connection," on the AAOS web site and the "Parent/Patient" section on the POSNA web site were identified. The Flesch-Kincaid grade level of each article was determined with use of Microsoft Office Word software. The mean grade levels of articles that were available in 2001 were compared with those accessible in 2007.

Results: Fifty-seven unique articles were available in 2007 on both web sites compared with twenty-five articles available in 2001. The readability score of only one (2%) of the currently available articles was less than sixth grade level. The mean Flesch-Kincaid grade level of the currently available articles was 8.9 compared with 8.7 for the articles available in 2001 (p = 0.71).

Conclusions: Our findings suggest that most of the pediatric orthopaedic patient education materials available on the AAOS and POSNA web sites have readability scores that may be too high, making comprehension difficult for a substantial portion of the United States population.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.2106/JBJS.G.00347DOI Listing
January 2008
-->