Bedridden Research Articles

Effect of Exercise Program in Reducing Risk of Fall in Elderly People

Objective: To study the Effect of Exercise Program in reducing risk of fall in elderly subject. Materials and Method: Total 30 elderly subjects(10 males and 20 females) aged above 60 years were having problem with flexibility, balance and high risk of fall were selected for the assessment of their flexibility, gait and balance. Subjects who are bed ridden, having neurological conditions, Psychiatry condition and visual deficit were excluded from the study. Outcome measures used were Morse fall risk assessment tool, Timed up and go test, Functional reach test, Functional gait assessment. Conclusion: The present study provided evidence to conclude that the exercise programme was significantly effective in improving strength, flexibility and balance along with reducing risk of fall in elderly population.

Biomarkers of chronic nonspecific pain syndrome: A cross-sectional hospital-based pilot study

Background: More than 50 million American have chronic pain and 41% of them have poor response to the treatment. One large survey on Chronic Pain “Pain in Europe” reported it as 12%–30% in the European countries and 19.3% in a study from west India. Objective: We aimed to look for bio-psycho-social biomarkers for chronic nonspecific pain. Methods: Patients of chronic non-specific pain syndrome (CNPS) defined as “patients presenting with multiple site pain or widespread body pain for more than three days per week for more than 3 months duration without any specific medical, neurological, orthopedic or rheumatologic cause”. All patients were subjected to clinical severity scale (visual analogue score), chronic pain related quality of life (QOL) score (ranges from 0 (Bed ridden stage) to 10 (normal functioning). Then patients were subjected for complete Hemogram, serum ferritin level, serum vitamin B12 level and Vitamin D level and psycho-social screening. Psycho-social assessment done by psychologists for psychometric analysis and tools for central sensitization inventory (CSI) to find out sensitization index, Pittsburg sleep quality index (PSQI) for sleep quality, Hospital anxiety and depression scale (HADS), and Somatic symptom scale – 8 (SSS – 8) to know somatization index. Results: Among 120 patients absolute deficiency of ferritin, vitamin B12 and Vitamin D was found in 51 (42.5%), 40 (33.3%) and 60 (50%) patients respectively. High sensitization index (CSI > 50) and high somatization index (SSS-8 of > 12) was found in 22 (17.5%) and 27 (23.3%) patients respectively. Patients with low ferritin had better outcome. Conclusion: This bio-psycho-social model for chronic pain will help the clinicians and patients for better understanding of the problem and better prediction for outcome.

Automated Fluid Transfuser

In hospitals, Saline/Fluids is/are injected into the patient’s body to treat dehydration/diseases in order to improve their health. Monitoring the fluid level and regulating its flow manually has always been a typical problem as it involves much attention by nurse constantly. Any kind of negligence or preoccupied states might invoke a possibility of backflow of blood (and swelling) from the concerned patient. Also blood transfusion using traditional method has a drawback regarding the accuracy in transfusing blood from one patient’s body to another. Considering all these affordable health monitoring systems should be made available to every hospital in the days to come. AUTOMATED FLUID TRANSFUSER deals with these problems. This will accurately assimilate the advised portion of saline/fluid/blood into the patient’s body. It alerts the nurse by sending notifications regarding the status of fluid level and in parallel regulates the flow, thereby averting the chance of backflow of blood and reducing the swelling. Automated fluid transfuser can be used in hospitals and homes for the bed ridden patients. It is not complex in operating to nurse or guardians.

Non-Surgical Management of Degenerative Disc Disease by Reversing the Pathophysiology with Sit Up Exercise

Background: Millions of people all over the world are living with degenerative disc disease, some bed ridden, others with crippling pains, while some have intermittent pains that reduce their productivity. Appropriate treatment that will be preventive, curative, and cost-effective is still being sought for. Objective: To find out the treatment outcome of patients who were managed with sit up exercise for degenerative disc disease over a five year period. Methods: It was a prospective study of patients managed in our center for degenerative disc disease using sit up exercise from January 1, 2014 to December 31, 2018. Patients were clerked and physically examined in the clinic noting the site(s) of pain and muscle weaknesses. Sit up exercise and passive muscle movement (for those with muscle weakness) were done. Paracetamol and Diclofenac were given for pains. Results: Thirty five patients qualified for the study. Males were twenty. The average age was 57·14 years. Sixteen patients had pain and muscle weaknesses. In 96·97% of patients with pain and 83·33% of patients with muscle weakness, the symptoms/signs resolved within six months. Age played significant role in region involved P = 0·01, duration of symptoms P =0·00, and time for pain to resolve P = 0·00. There was significant relationship between gender and symptoms P = 0·04, and time for pain to resolve P = 0·01 Conclusion: Thirty four patients recovered with sit up exercise, while the 35th patient is still improving. Age and gender played significant roles in the disease. Funding Statement: There was no sponsorship. Declaration of Interests: There was no conflict of interest. Ethics Approval Statement: The study was component of our prospective data bank that was approved by our hospital research and ethics committee.

POEMS Syndrome - Rare Paraneoplastic Syndrome in a Young Female

POEMS syndrome is defined by the presence of peripheral neuropathy (P), organomegaly (O), endocrinopathy (E), a monoclonal plasma cell disorder (M) and skin changes (S). We report a case of POEMS syndrome in a 34-year-old female who presented with three month history of back pain, pain in lower limbs, weakness, numbness and edema in both lower limbs. Patient was unable to walk and bed ridden with worsening general condition, shortness of breath and fever for three days. Further clinical examinations (hyperpigmentation), systemic examination (hepato-splenomegaly), laboratory investigation (hypothyroidism), CT showed sclerosis in sacral bone and left acetabular lytic lesion, which on biopsy and immunohistochemistry showed plasma cell dyscrasia and confirmed by increased plasma cells in bone marrow biopsy and presence of M band in immunofixation study. Here we describe, in detail, an unusual clinical presentation of this rare paraneoplastic syndrome with multisystemic involvement which needs multidisciplinary approach with strong clinico-pathological & radiological correlation to diagnose this rare entity.
 J MEDICINE JAN 2020; 21 (1) : 55-58

Validation of SUSPEKT Score in Predicting One-month Mortality of Patients with Hemorrhagic Stroke; a Diagnostic Accuracy Study.

Predicting the outcome of patients with intracranial hemorrhage (ICH) is the area of interest for in charge physicians as well as patients and their associates. This study aimed to evaluate the accuracy of SUSPEKT score in predicting one-month outcome of patients with hemorrhagic stroke. This prospective cross sectional study was conducted on > 18 years old patients with non-traumatic supra-tentorial ICH admitted to emergency department, from February 2017 to January 2018. SUSPEKT score was measured for each patient and its screening performance characteristics in prediction of one-month mortality were calculated. 169 cases with the mean age of 63.09± 15.45 (21 - 96) years were studied (56.8% male). After one month follow up 47 (27.8%) cases had died, 30 (17.7%) cases were bed ridden, and 72 (42.6%) could walk without help or with a cane. Non-survived patients had significantly larger intra-ventricular hemorrhage (IVH) (p < 0.001) and hematoma (p < 0.001) volume, higher serum glucose (p < 0.001) and blood pressure (p = 0.028), higher frequency of IVH (p < 0.001), and higher WBC count (p = 0.037). Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of SUSPEKT score at the 65 cut point were 82.97% (95% CI: 68.65% - 91.86%), 74.59% (95% CI: 65.76% - 81.84%), 55.71% (95% CI: 43.38% - 67.40%), and 91.91% (95% CI: 84.23% - 96.16%), respectively. Total accuracy of SUSPEKT score in predicting one-month mortality of non- traumatic ICH patients is in good range and it has 82% sensitivity and 92% NPV in this regard. It seems that we need further studies before applying the score in routine practice.

Analysis of effect by different air pressure treatment time on prevention of deep venous thrombosis of the lower extremity in severe chronic bedridden patients

Objective To explore the effect of different air pressure treatment time on preventing deep vein thrombosis in severe chronic bedridden patients. Methods This is a prospectie, randomized and controlled study. A total of 120 patients with severe chronic bedridden were randomly divided into normal group and experimental group 1, group 2, with 40 cases in each group. The normal group received 30 min every time, and group 1 received 1h,and group 2 received 2h. To observe the incidence of DVT within 15 days, the blood flow velocity of deep femoral vein before and after the first treatment, and the incidence of deep tissue injury. Results There was no significant difference in the incidence of DVT among the three groups (P> 0.05), but the incidence of DVT in test group 1 was 5.0% (2/40), 2.5% (1/40) and 12.5% (5/40) compared with the conventional group. Compared with before treatment, the blood flow velocity of deep femoral vein in the three groups increased significantly after treatment (t=1.475、t=2.881、t=4.027, all P < 0.05), but after treatment, the blood flow velocity of deep femoral vein in the conventional group (20.41±1.37) ml/s, the experimental group 1 and the experimental group 2 were (22.39±2.22) ml/s and (22.51±1.73) ml/s, respectively, which were significantly faster than that of the conventional group. There were significant differences (t= 3.086、t= 3.662, all P < 0.05).(3) The incidence of deep tissue injury in experimental group 2 was 20.0% (8/40), which was 2.5% (1/40) and 5.0% (2/40) higher than that in conventional group and experimental group 1 respectively (χ2=6.135、χ2=4.114, all P<0.05). Conlousion On the basis of conventional barometric therapy, it can be extended to 1 h/time, 3 times/d, which can significantly increase the blood flow velocity of deep femoral vein, reduce the incidence of DVT, and do not increase the incidence of skin pressure injury in patients with chronic bed-rest. It is worth popularizing and applying in clinic. Key words: Air pressure treatment; Severe chronic bedridden; Deep vein thrombosis

Effectiveness of pressure ulcer prevention strategies on pressure ulcer formation among bed ridden patients at NIMS hospital, Jaipur

Effectiveness of pressure ulcer prevention strategies on pressure ulcer formation among bed ridden patients at NIMS hospital, Jaipur

Comparative study of PFNA vs PFNA 2 in unstable intertrochanteric fractures: A randomised control study of 50 cases

Intertrochanteric fractures management in elderly pose a serious challenge to the new age orthopaedic surgeons. The implants have evolved from extramedullary implants like dynamic hip screw to the intramedullary types of PFNA2 nail. The main goal of fixing such fractures which hardly complicate with non-union are early mobilization of patient in order to prevent complications of prolonged bed ridden status. 50 patients were included in our study from July 2017 to June 2019. 25 patients were treated with PFNA and PFNA2 Nails. We recorded age, sex, mode of injury, associated injuries and comorbidities of patients. Fracture patterns were classified. We found that PFNA2 had less blood loss intraoperatively and better results with respect to nonunion rates, compared to PFNA implant.

Readmission within 30-Day as a Key Indicator for Academic Hospital Performance: Rate and Risk Factors

Background: Unplanned hospital readmission is concerning health care providers and is frequently used as a quality indicator for hospital care.&#x0D; Objectives: This study was conducted in order to examine the rate and associated factors for 30-day readmission in internal medicine units at King Abdulaziz University Hospital, Jeddah.&#x0D; Methods: We retrospectively collected data for patients who had readmission within 30 days of hospital discharge from January 2010 to December 2013. We obtained the following information for all patients: patient demographics, admitting medical service, diagnosis at the first admission, presence of hypoxia, sepsis, and hospital length of stay at the first admission. We then compared the data for patients with 30-day readmissions to those who did not have readmission within 30 days&#x0D; Results: Of the 3838 patients who had hospital admission within the study period, 678 (17.7%) had readmission within 30 days. The mean patient age was 52 years (SD, 21.2 years). Patients who had readmission within 30 days were more likely to be female; older than 65 years of age; diabetic; hypertensive; bed ridden; and to have a history of stroke, bed sores and/or sepsis (all P values ≤0.001, except for stroke, P=0.003).&#x0D; Conclusion: Our study showed that about 18% of patients had readmission within 30 days. Those patients were of older age, with comorbidities like, diabetes or stroke or were bedridden.

Early efficacy of endoscopic laminectomy and traditional hemilaminectomy for lumbar spinal stenosis

Objective To compare the clinical effects of endoscopic laminectomy with traditional hemilaminectomy for lumbar spinal stenosis. Methods From January 2016 to April 2017, 61 patients with lumbar spinal stenosis were treated surgi-cally. Percutaneous endoscopic laminectomy was performed in 32 patients (minimally invasive group), including 13 males and 19 females, aged 38-76 years, with an average age of 58.47±7.51 years. Twenty-nine patients (open group) underwent hemilaminecto-my, including 11 males and 18 females, aged 38-75 years, with an average age of 57.17±9.99 years. The operation time, bleeding, incision length, bedridden time and hospitalization time were recorded. Visual analogue scale(VAS), Oswestry disability index (ODI), dural sac cross-sectional area (DSCA), ventral intervertebral space height (VH), dorsal intervertebral space height (DH) and lumbar mobility (range of motion, ROM) were compared between the two groups. Results All of 61 patients were followed up for 14 to 27 months, with an average of 19.2±2.95 months. The operation time was 60.88±6.49 min in the minimally invasive group, and 52.07±9.45 min in the open group (t=4.277, P=0.000). The blood loss of minimally invasive group was 55.63±10.14 ml, and that of open group was 78.79±12.58 ml (t=7.952, P=0.000). The incision length of minimally invasive group was 23.31±4.56 mm, and open group 82.59±7.66 mm (t=12.047, P=0.000). Bed rest time was 21.97±6.42 h in minimally invasive group and 78.79±12.58 h in open group (t=12.047, P=0.000). The hospitalization time of the minimally invasive group was 8.53±2.75 d and the open group 11.34±3.12 d (t=3.745, P=0.000). All these parameters had statistical significance (P<0.05). At the last follow-up, the VAS score of minimally invasive group was 1.06±0.56, and the open group was 1.14±0.74 (t=0.469, P=0.634). ROM of open group was 5.66±1.12 degree, and ROM of minimally invasive group was 5.56±1.13 degree (t=0.140, P=0.710), VH of minimally invasive group was 14.75±2.81 mm, and open group was 14.44±2.89 mm (t=0.181, P=0.672). There was no significant difference between the two groups for these parameters. At the last follow-up, ODI score was 13.25%±1.08% in the minimally invasive group and 14.28%±2.10% in open group (t=5.911, P=0.018). DSCA score was 108.56±8.69 mm2 in the minimally invasive group, and 117.28±11.09 mm2 in open group (t=11.774, P=0.001). There were significant differences between the two groups for ODI and DS-CA. Conclusion Both endoscopic and open laminectomy have excellent clinical effects on lumbar spinal stenosis. Endoscop-ic laminectomy has the advantages of less local trauma, less damage to the stability of the lumbar spine and faster recovery. However, there's a higher technical requirement for endoscopic spine surgery. Key words: Lumbar vertebrae; Spinal stenosis; Laminectomy; Video-assisted surgery; Surgical procedures, minimally in-vasive

Screening for Deep Vein thrombosis and pulmonary embolism in bed ridden patients in a tertiary care hospital in Central India

Screening for Deep Vein thrombosis and pulmonary embolism in bed ridden patients in a tertiary care hospital in Central India

Prevalence of Cognitive Impairment and Its Predictors among HIV/AIDS Patients on Antiretroviral Therapy in Jimma University Medical Center, Southwest Ethiopia.

Background Cognitive impairment among human immunodeficiency virus (HIV) infected patients can lead to treatment nonadherence, faster progression of the illness, disability, and bed ridden state if we fail to detect it early. However, there is scarcity of previous published studies in Ethiopia on the assessment of cognitive impairment among HIV-positive patients. Hence, this study aimed to determine the prevalence and associated factors of cognitive impairment among HIV-positive patients receiving antiretroviral therapy (ART) at Jimma University Medical Center, Ethiopia. Methods Hospital-based cross-sectional study was conducted among 328 HIV-positive patients attending Jimma University Medical Center, Ethiopia. Data were collected from a face-to-face interview and review of medical records using semistructured questionnaire. Validated International HIV Dementia Scale (IHDS) was used to screen for cognitive impairment. Data was analyzed using SPSS version 20. Results A total of 328 (191 females and 137 males) HIV-positive patients were included in the study with a response rate of 97.04%. The prevalence of cognitive impairment among HIV-positive patients was 35.7%. Factors significantly associated with cognitive impairment were age group of 41−64 years (adjusted odds ratio [AOR] = 3.1, 95% confidence interval [CI] (1.3, 7.4)], plasma HIV-1 RNA load between 1.7log10 and 3log10 copies/ml [AOR = 2.2, 95% CI (1.1,4.3)] and ≥ 3log10 copies/ml [AOR = 7.5, 95% CI (2.6, 21.5)], khat chewing [AOR = 4.4, 95% CI (2.3, 8.3)], and clinical stage III of the disease [AOR = 5.6, 95% CI (1.7, 19.2)]. Conclusion Despite the use of ART, the burden of cognitive impairment among HIV patients was high. Older age, khat chewing, advanced stage of the disease, and higher viral load were the independent factors associated with cognitive impairment. Thus, continuous screening of cognitive impairment, identification of the possible risk factors, and proper management strategy should be designed.

Acute venous thromboembolism in Indian patients of isolated proximal femur fractures

IntroductionVenous Thromboembolism (VTE) has a variable incidence in trauma patients and fatal embolism can be the very first manifestation. Proximal femur fractures result from high velocity trauma in younger age groups and could require prolonged immobilisation, which is associated with increased risk of VTE. Therefore we sought to determine the occurrance of VTE in patients with proximal femur fractures. ObjectivesThe present study was initiated to assess the occurrance of deep vein thrombosis (DVT) or pulmonary embolism in isolated proximal femur fractures and identify the requirement of routine thromboprophylaxis in such patients. MethodsIt was a prospective study conducted over a period of one and a half years. All patients, presenting with isolated proximal femur fractures were included. Patients having any other known risk factors for DVT were excluded, so that the proximal femur fracture remained their only acquired risk for DVT. All the patients were evaluated clinically and with help of diagnostic modalities like Color Doppler with compression ultrasound, D-dimer assays and CT venogram, if indicated. Patients were followed up till 8 weeks post-operatively. ResultsA total of 66 patients with fractures of proximal femur were assessed, out of which there were 42 males with mean age of 48.1 years and 24 females with mean age of 58.3 years. A total of 9 cases of radiologically proved DVT were observed. Clinical DVT was seen in 5 of these cases (54%). Complete resolution of thrombus was noted in all the patients, evaluated by Color Doppler at 6 weeks, post diagnosis. Although the majority of the cases (6) occurred in patients beyond 50 years of age, this was not statistically significant. ConclusionDVT is common in patients with proximal femur fractures and the provision for screening both clinically and radiologically, should be made routine in all such patients. In case of delay in surgery and patient being bed ridden, we recommend thromboprophylaxis in this subset of trauma patients.

The Role of Enhanced Cognition to Counteract Detrimental Effects of Prolonged Bed Rest: Current Evidence and Perspectives.

Prolonged periods of physical inactivity or bed rest can lead to a significant decline of functional and cognitive functions. Different kinds of countermeasures (e.g., centrifugation, nutritional, and aerobic interventions) have been developed to attempt to mitigate negative effects related to bed rest confinement. The aim of this report is to provide an overview of the current evidence related to the effectiveness of computerized cognitive training (CCT) intervention during a period of complete physical inactivity in older adults. CCT, using a virtual maze navigation task, appears to be effective and has long-lasting benefits (up to 1.5 years after the study). Moreover, enhanced cognition (executive control) reduces decline in the ability to perform complex motor-cognitive dual-tasks after prolonged period of bed rest. It has been demonstrated that CCT administration in older adults also prevents bed rest stress-related physiological changes [these groups showed minimal changes in vascular function and an unchanged level of brain-derived neurotrophic factor (BDNF)] while control subjects showed decreased peripheral vascularization and increased plasma level of the neurotrophin BDNF during a 14-day bed rest. In addition, the effects of CCT are evident also from the brain electrocortical findings: CCT group revealed a decreased power in lower delta and theta bands while significant increases in the same EEG spectral bands power were found in control subjects. If we consider an increase of power in delta band as a marker of cortical aging, then the lack of shift of EEG power to lower band indicates a preventive role of CCT on the cortical level during physiological deconditioning induced by 2-week bed rest immobilization. However, replication on a larger sample is required to confirm the observed findings. Applications derived from these findings could be appropriate for implementation of hospital treatment for bed ridden patients as well as for fall prevention programs.

Study of Atrial Fibrillation and Venous Thromboembolism in Critically Ill Patients in Intensive Care Unit

Bachground: atrial fibrillation (AF) is the most common arrhythmia in patient hospitalized in ICU and is associated with increased morbidity and mortality. Venous Thromboembolism (VTE), including deep venous thrombosis (DVT) and pulmonary Embolism (PE), is recognized as a common complication in critically ill patients. Risk factors including critical illness, mechanical ventilation, sedative medications and central venous catheter insertion are major contributing factors to the high risk of VTE. Objective: it was to evaluate the causes and outcomes of AF and VTE in patients admitted to intensive care unit due to non-cardiac causes. We studied 143 consecutive patients admitted to ICU for non-cardiac emergencies. Results: only 48 (33.5 %) patients were complicated. AF is the most common complication happened in 27 patients (56 %) of complicated cases; pulmonary embolism comes next with 13 patients (27.1%) of complicated cases, DVT in the third place with 8 patients (16.6 %) of complicated cases. The age of patients admitted to ICU was directly related to complication happened in ICU, the older the patient is the more he is vulnerable to complications, the increased body mass index and increased weight was directly related to complications, the hemoglobin level is strongly related to cardiac complications . There was increased risk of DVT and pulmonary embolism due to prolonged bed ridden state. Conclusion: patients of ICU who have a higher risk than other for adverse cardiac complications, the most common cardiac complications are AF, DVT and pulmonary embolism and finally cardiac complications leads to increased rate of mortality and morbidity.

Association of Sex Steroid Priming on Growth Hormone Stimulation Test in Tertiary Care Hospital Settings Rawalpindi

Objective: To determine association of Sex steroid priming on Growth hormone stimulation test in tertiary care hospital settings Rawalpindi. Study design: Cross sectional study. Place and duration of study: Department of Chemical Pathology and Endocrinology, Armed Forces Institute of Pathology (AFIP) Rawalpindi from January 2018 to June 2018. Methodology: This study was a cross-sectional study conducted after the Institutional Review Board (IRB) approval at AFIP from January 2018 to June 2018. Data was collected from 149 children of 9-13 year of age reported to endocrinology clinic AFIP, after informed consent. Inclusion criteria included healthy adults with age of 9-13 years with no minor or subclinical illness or endocrinology disorders like hypothyroid, Cushing syndrome or Addison disease. Patients with comorbidity like cancer, tuberculosis and bed ridden patients were excluded from study. Sampling technique was non probability convenience sampling which was done in endocrine clinic of AFIP. Results: A total of 149 patients were inducted in study who visited Endocrine clinic in AFIP. Mean age of participants was 9.9 ± 3.9 year while 96 (64.4%) were male and 52 (34.9%) were female. Total of 149 patients there were 100 (67.1%) patients were below 3rd percentile, while 44 (29.5%) were above 3rd percentile but below 50th percentile and 4 (2.7%) were at 50th percentile. Independent T test was applied for Priming and response level after growth hormone stimulation test and it gives significant level (P value=0.00) which is considered significant (P value <0.05). Conclusion: This study concluded that priming after sex steroids can effect on growth hormone level in pre pubertal children’s and it will help in appropriate diagnosis of growth hormone deficiency.

Design of a multifunctional instrument for bedridden patients with automatic water control

Design of a multifunctional instrument for bedridden patients with automatic water control

Causes and therapeutic effects of conservative treatment for hip fracture in the elderly

Objective To investigate the causes and prognosis of conservative treatment for hip fracture in the elderly. Methods The 47 elderly patients undergoing conservative treatment for hip fracture were recruited and retrospectively analyzed in our hospital from July 2014 to June 2017.The causes of conservative treatment and corresponding therapeutic methods were analyzed, and hip joint function, complications, survival situation at 12-36 months after fracture were followed up. Results A total of 47 hip fracture patients aged(80.0±7.2)years(range, 63-92 years)with 25 females and 22 males included 30 cases with femoral neck fractures and 17 cases with intertrochanteric fractures.Details of prognosis of treatments in all(100%)patients followed for 12-36 months after fracture were as follows: (1)In treatment methods, 43 patients were treated with bed-rest immobilization after discharge from hospital and 4 patients were rehospitalized for surgery due to pain and intolerance of long-term bedridden.(2)There were 40 patients with three comorbidities or more, accounting for 85.1% of the total.11 cases had surgical contraindications.27 cases choose conservative treatment due to the high risk of surgery.9 cases gave up surgery due to psychological or economic reasons.(3)In complications and death, complications were found in 43(91.5%, 43/47)patients with conservative treatment, including pneumonia(37.2%, 16/43 cases, )and bedsore(51.2%, 22/43 cases). (4)In fracture healing and hip joint function, among the 43 patients receiving conservative treatment, hip fractures were not healed in 31 patients, and fractures were malunited in 12 patients.Hip Harris score was poor in 31 cases and fair in 12 cases.The mortality rate within 1 year after fracture is high in the elderly hip fracture patients with conservative treatment and complication incidence rates are also high.Most of them have poor function recovery of hip joint, and clinical results are not good. Conclusions The elderly hip fracture patients with conservative treatment have a high rate of complications and mortality within 1 year after fracture.Most of them have poor hip joint function recovery. Key words: Fracture hip; Conservative treatment; Prognosis

The Use of Arm Span and Knee Height for Estimation of Stature among Nepalese Medical Students

Introduction: Height is a significant parameter for growth and development of an individual. Arm span and knee height measurement are useful when accurate measurement for stature is unobtainable. Studies have shown that the relationship between stature and arm span varies with age and population. Thus, the aim of the present study was to analyze the correlation between stature and two measurements; the arms span and knee height of medical students of Kathmandu Medical College Public Limited, Kathmandu, Nepal.&#x0D; Materials and methods: This is a descriptive study. A total two hundred medical students, presently studying at Kathmandu Medical College, aged between eighteen and twenty eight years were randomly selected as the subjects for the present study. Among them, seventy six were females and one hundred twenty four were males. Arm span and knee height was measured by flexible steel tape and height was taken by stadiometer. The collected data were tabulated and SPSS 20 was used to perform analysis.&#x0D; Results: There is statistically strong correlation (r) between height and arm span (r=0.858, =0.736; r=0.849,=0.720, p&lt;0.01 for males and females respectively) while knee height too has shown a similar relationship (r=0.882, =0.778, r=0.819,=0.670, p&lt;0.01 for males and females respectively).&#x0D; Conclusion: This present study revealed that both arm-span and knee height can be used in estimation of the height of both males and females. The regression equations so derived can be used in cadavers or an amputee or bed ridden patients with fairly accurate results. This can be helpful in medico- legal cases as well as in study of anthropology.