Background Medical education in this era has been disturbed by coronavirus disease. Our faculty has quickly adapted the curricula to online formats. The online format seems to be more advantageous in terms of content material and virtual activities, but the results of these adjustments will require subsequent evaluation. The aim of this study was to evaluate medical student expectations of online orthopedics learning that was created based on social constructivism theory. Materials and methods A cross-sectional survey was carried out to assess the fifth-year medical student expectations of our newly developed online orthopedics course during the outbreak. Constructivist Online Learning Environment Survey (COLLES) was applied for evaluating the expectations during orthopedic rotation. The survey contains six aspects based on social constructivist principles: relevance, reflection, interactivity, tutor support, peer support, and interpretation. All students responded to the preferred COLLES before starting the online course, and the actual COLLES was filled out when the online course was completed. Before and after attending the online course, the scores were compared and interpreted to assess student expectations. Results A total of 126 fifth-year medical students studied the online orthopedic course. The preferred COLLES were completed by 125 students, while 120 students replied to the actual COLLES. The overall scores from the post-course survey in all aspects were significantly higher than scores from the pre-course with P -value < 0.01. The comparison between the preferred and actual scores showed this online course fulfilled student expectations. Conclusion The outbreak of coronavirus disease 19 has disrupted medical student education. The online orthopedic learning course in our department has been developed to deal with the current situation. Using the various activities based on social constructivism theory in the online platform was able to fulfill medical student expectations.
Summary Fragility hip fracture (FHF) is a serious complication of osteoporosis. A fracture liaison service (FLS) is crucial in preventing FHF. Our retrospective data of 489 patients with FHF and 3-year follow-ups demonstrated that the FLS improved functional outcomes. Our study’s mortality rates were lower than in other published series. Purpose This study assessed the 3-year outcomes after fragility hip fracture (FHF) treatment by a multidisciplinary team from the Siriraj Fracture Liaison Service (Si–FLS). The review investigated the administration rates of anti-osteoporosis medication, refracture, and mortality; activities of daily living; mobility; and health-related quality of life. Methods A retrospective review was performed of the records of Si-FLS patients given FHF treatment between June 2016 and October 2018. The outcomes were evaluated at 3 time points: before discharge, and 1 and 3 years after treatment. Results The study enrolled 489 patients (average age, 78). The mortality and refracture rates at 1 year after hip fracture were 13.9% and 1.6%, respectively. At the 3-year follow-up, both rates were higher (20.4% and 5.7%, respectively). The Barthel Index and EuroQoL Visual Analogue Scale had risen to a plateau at the 1-year follow-up and remained stable to the 3-year follow-up. One year after treatment, approximately 60% of the patients could ambulate outdoors, and the proportion remained steady until the 3-year follow-up. There was no difference in the 1- and 3-year follow-up anti-osteoporosis medication administration rates (approximately 40%). Conclusions This study confirms the benefits of having a multidisciplinary FLS care team to manage older people with FHF. An FLS improves the care of patients with FHF and the social support of caregivers and relatives. The FLS maintained the functional outcomes of the patients through 3 years of postfracture treatment.
Purpose Vitamin D deficiency is related to carpal tunnel syndrome symptoms. Correcting vitamin D levels by supplementation was supposed to improve carpel tunnel symptoms, though there is a lack of aggregated data about treatment outcomes. This study aimed to examine whether vitamin D supplementation could improve the treatment outcomes in carpal tunnel syndrome patients. Methods A comprehensive search of the PubMed, Cochrane Library, Scopus, and Web of Science databases for articles on vitamin D and carpel tunnel syndrome from January 2000 to March 2021 was performed. The article screening and data extraction were performed by two investigators independently with blinding to decisions on selected studies. All included studies had assessed the quality of evidence using the Methodological Index for Non-Randomized Studies (MINORS) scoring system. Results We retrieved four studies that met the eligibility criteria. The treatment outcomes were evaluated by visual analog scale (124 wrists), functional scores (176 patients), muscle strength (84 patients), and nerve conduction velocity (216 wrists). After vitamin D supplementation, two studies reported improved pain scores and nerve conduction velocity, and three studies showed enhancement of functional status. Conclusion Vitamin D administration could offer favorable outcomes in pain improvement, better functional status, and increased sensory conduction velocity in carpal tunnel syndrome. However, there is to date no recommendations concerning a standardized dose or duration of vitamin D administration in carpal tunnel syndrome; prescribing vitamin D at the usual appropriate dose is suggested as an additional treatment in patients with mild to moderate carpel tunnel symptoms. Level of Evidence Level IV, therapeutic study
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