Background:Metacarpal and phalangeal fractures are common upper limb injuries that significantly affect hand function. Surgical fixation using Kirschner wires (K-wires) and mini-plates is widely practiced, but their comparative effectiveness in terms of functional recovery and postoperative analgesic requirements remains debated. Aim:To compare functional outcomes and postoperative analgesic requirements in patients undergoing K-wire versus mini-plate fixation for metacarpal and phalangeal fractures. Methodology:A prospective comparative study was conducted on 50 adult patients with unstable metacarpal or phalangeal fractures. Patients were divided into two groups: Group A (K-wire fixation, n = 25) and Group B (mini-plate fixation, n = 25). Outcomes assessed included total active motion (TAM), visual analog scale for pain, time to union, and analgesic requirements. Follow-up was conducted at 1, 3, 6, and 12 months. Results:Both groups showed progressive improvement. K-wire fixation demonstrated significantly better TAM at 12 months (54.70 ± 10.94 vs 28.09 ± 5.62; P < 0.001). Mini-plate fixation showed faster fracture union. Analgesic requirements were higher in the mini-plate group during the early postoperative period. Complication rates were comparable. Conclusion:K-wire fixation offers superior long-term functional outcomes and reduced analgesic requirements, whereas mini-plate fixation provides earlier fracture stability and faster union. Implant selection should be individualized.
Background:Cyberbullying is an emerging public health issue among adolescents, associated with psychological consequences such as anxiety, depression, and sleep disturbances, often requiring clinical and pharmacological management. Preventive educational interventions may improve knowledge, awareness, and sensibility, thereby reducing mental health burden. Aim:To evaluate the effectiveness of a contemplated nursing intervention on knowledge, awareness, and sensibility regarding cyberbullying and its mental health consequences among adolescents. Methods:A true experimental design was conducted among 20 adolescents (13-17 years) in selected schools in Coimbatore, India. Participants were randomly assigned to experimental (n = 10) and control (n = 10) groups, each subdivided to minimize contamination. Pre- and post-tests were administered using standardized tools. The experimental group received an eight-week nursing intervention involving mobile-based modules and vignette discussions. Data were analyzed using descriptive and inferential statistics (P < 0.05). Results:Post-intervention, the experimental group showed significant improvements in knowledge (mean difference 6.3), awareness (16.6), and sensibility (6.3), with all participants achieving adequate or high levels. Control groups showed minimal change. Significant inter-group differences were observed (P < 0.05). No association was found between pre-test scores and demographic variables. Participants also demonstrated improved understanding of psychological consequences and treatment options, including counseling and Selective Serotonin Reuptake Inhibitors (SSRIs). Conclusion:The intervention effectively enhanced adolescents' understanding of cyberbullying and its mental health impact. Such programs may reduce psychological morbidity and future reliance on pharmacological management. Larger studies are recommended.
Background:Diabetic nephropathy (DN) is a leading microvascular complication of diabetes and a major cause of end-stage renal disease. Conventional biomarkers such as albuminuria fail to detect early renal injury. MicroRNA-377 (miRNA-377) has emerged as a potential epigenetic regulator involved in renal fibrosis and extracellular matrix accumulation. Aim:To evaluate circulating miRNA-377 expression across different stages of DN and determine its diagnostic utility. Methods:This analytical cross-sectional study included 132 participants categorized into healthy controls (n = 35), type 2 diabetes mellitus (T2DM) with normoalbuminuria (n = 32), microalbuminuria (n = 32), and macroalbuminuria (n = 33). Plasma miRNA-377 expression was quantified using reverse transcription polymerase chain reaction (RT-PCR) and analyzed by the Livak method. Clinical, biochemical, and renal parameters were assessed. Statistical analysis included ANOVA, Spearman correlation, receiver operating characteristic (ROC) curve, and multinomial regression. Results:miRNA-377 expression showed significant upregulation in microalbuminuria (P = 0.022) and macroalbuminuria (P = 0.014). It demonstrated strong correlation with urinary albumin-to-creatinine ratio (UACR) (r = 0.510, P < 0.001) and moderate correlation with HbA1c (P = 0.04). ROC analysis showed good diagnostic performance (area under the curve [AUC] =0.811). Multinomial regression confirmed miRNA-377 as an independent predictor of DN progression. Conclusion:Circulating miRNA-377 is significantly associated with DN severity and may serve as a promising non-invasive biomarker for early detection and disease stratification.
Background:Pharmacovigilance is crucial in the safety of drugs and it is here that adverse drug reactions (ADRs) are observed, especially in a tertiary care environment where polypharmacy is prevalent. This paper set out to assess the patterns of pharmacovigilance reporting and examine the nature of ADRs in a tertiary care teaching hospital. Methods and Materials:The study was prospective observational and was carried out after 12 months involving 250 patients with suspected ADRs. The sources of data included the spontaneous reporting forms, patient records, and laboratory results. The World Health Organization (WHO) causality assessment scale was used to determine ADRs. Descriptive statistics were presented in the form of mean ± standard deviation and percentages, and Chi-square and t-tests were used in the inferential statistics. Results:The average age of the patients was 47.8 (18.5) years, and the patients were mostly male (58%). The largest percentage of ADRs reported was in the medicine department (42%), then surgery (22) and pediatrics (16). The most commonly involved classes of drugs were antibiotics (36%) and antiepileptics (18%). Type A reactions were found in 64 percent of the cases, whereas Type B reactions were found in 36 percent. WHO causality assessment indicated that 52% of ADRs were possible, 34% probable, and 14% certain. ADRs were serious in 28% of the patients. Underreporting was observed and only 68 percent of ADRs were reported in writing. The incidence of ADRs was significantly greater in patients who were on polypharmacy (five or more drugs) than in those on fewer drugs (P = 0.01). Conclusion:The article identifies some gaps in pharmacovigilance reporting and presents the necessity to involve better awareness, training, and regular reporting systems to improve drug safety in clinical practice.
Postoperative pain following cardiac surgery remains a major challenge that can delay recovery, increase opioid use, and hinder rehabilitation. This systematic review evaluated mixed methods evidence on pharmacological pain management strategies and their integration with nursing care in adult patients undergoing cardiac surgery. A comprehensive search of PubMed, Scopus, Web of Science, CINAHL, and Google Scholar was conducted from database inception to December 2025 following PRISMA 2020 guidelines. Four mixed methods studies met the inclusion criteria. Pharmacological interventions included opioids, paracetamol, nonsteroidal anti-inflammatory drugs, gabapentinoids, ketamine, dexmedetomidine, and multimodal analgesic regimens. These approaches were associated with reduced postoperative pain, 15-38% lower opioid consumption, shorter intensive care unit stays, and improved rehabilitation. Qualitative findings emphasized patients' concerns regarding opioid dependence and sedation while highlighting the importance of nurse-led education and individualized pain assessment. Overall, multimodal opioid-sparing analgesic strategies integrated with patient-centered nursing care appear to enhance postoperative recovery after cardiac surgery, although further high-quality mixed methods research is required to strengthen the evidence.
