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Article ; Online: A meta-analysis of the incidence of infections following open tibia fractures and the microorganisms that cause them in high-, middle- and low-income countries.

Chebli, Djenna / Dhaif, Fatema / Ridha, Ali / Schade, Alexander / Khatri, Chetan

2024 , Page(s) 494755241232171

Abstract: Open tibia fractures are devastating, life changing injuries, with infection associated with substantial morbidity to the patient. Reducing infection is a research priority, but before interventional studies can be designed, the incidence of infection ... ...

Abstract	Open tibia fractures are devastating, life changing injuries, with infection associated with substantial morbidity to the patient. Reducing infection is a research priority, but before interventional studies can be designed, the incidence of infection following this injury needs to be better defined. Our aim was to estimate the global incidence of infection following an open tibia fracture. A systematic review was performed of MEDLINE, EMBASE, Central Register of Controlled Trials (CENTRAL), Web of Science and Global Index Medicus. We included randomised controlled trials with more than ten participants which reported infections after open diaphyseal or distal fractures (AO 42 or 43). Primary outcome was deep infection according to the Centres for Disease Control and Prevention criteria. Secondary outcome included causative micro-organisms. A meta-analysis using a random effects model to assess incidence and between-treatment effects was performed. Thirteen studies including 1463 adults from seven middle-income countries, seven high-income countries and one low-income country were included. The incidence of infection was 12.12 person-years (95% CI 7.95-18.47). A subgroup analysis compared external fixation and intramedullary nailing showed no difference between infection rates. There were limited data on organisms, but
Language	English
Publishing date	2024-02-27
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	193169-6
ISSN	1758-1133 ; 0049-4755
ISSN (online)	1758-1133
ISSN	0049-4755
DOI	10.1177/00494755241232171
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Article ; Online: Clinically Meaningful Achievement in Outcomes After Subacromial Balloon Spacer Implantation: Letter to the Editor.

Khatri, Chetan / Ridha, Ali / Ahmed, Imran

The American journal of sports medicine

2023 Volume 51, Issue 12, Page(s) NP43–NP44

MeSH term(s)	Humans ; Rotator Cuff Injuries ; Arthroscopy
Language	English
Publishing date	2023-09-30
Publishing country	United States
Document type	Letter ; Comment
ZDB-ID	197482-8
ISSN	1552-3365 ; 0363-5465
ISSN (online)	1552-3365
ISSN	0363-5465
DOI	10.1177/03635465231184386
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Article ; Online: Robotic trials in arthroplasty surgery.

Khatri, Chetan / Metcalfe, Andrew / Wall, Peter / Underwood, Martin / Haddad, Fares S / Davis, Edward T

The bone & joint journal

2024 Volume 106-B, Issue 2, Page(s) 114–120

Abstract: Total hip and knee arthroplasty (THA, TKA) are largely successful procedures; however, both have variable outcomes, resulting in some patients being dissatisfied with the outcome. Surgeons are turning to technologies such as robotic-assisted surgery in ... ...

Abstract	Total hip and knee arthroplasty (THA, TKA) are largely successful procedures; however, both have variable outcomes, resulting in some patients being dissatisfied with the outcome. Surgeons are turning to technologies such as robotic-assisted surgery in an attempt to improve outcomes. Robust studies are needed to find out if these innovations are really benefitting patients. The Robotic Arthroplasty Clinical and Cost Effectiveness Randomised Controlled Trials (RACER) trials are multicentre, patient-blinded randomized controlled trials. The patients have primary osteoarthritis of the hip or knee. The operation is Mako-assisted THA or TKA and the control groups have operations using conventional instruments. The primary clinical outcome is the Forgotten Joint Score at 12 months, and there is a built-in analysis of cost-effectiveness. Secondary outcomes include early pain, the alignment of the components, and medium- to long-term outcomes. This annotation outlines the need to assess these technologies and discusses the design and challenges when conducting such trials, including surgical workflows, isolating the effect of the operation, blinding, and assessing the learning curve. Finally, the future of robotic surgery is discussed, including the need to contemporaneously introduce and evaluate such technologies.
MeSH term(s)	Humans ; Robotic Surgical Procedures/methods ; Arthroplasty, Replacement, Knee/methods ; Knee Joint/surgery ; Arthroplasty, Replacement, Hip ; Pain/etiology ; Osteoarthritis, Knee/surgery ; Osteoarthritis, Knee/etiology ; Treatment Outcome
Language	English
Publishing date	2024-02-01
Publishing country	England
Document type	Journal Article
ZDB-ID	2697156-2
ISSN	2049-4408 ; 2049-4394
ISSN (online)	2049-4408
ISSN	2049-4394
DOI	10.1302/0301-620X.106B2.BJJ-2023-0711.R1
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Article ; Online: Expanded therapeutic applications of Holarrhena antidysenterica: A review.

Tiwari, Ruchi / Khatri, Charul / Tyagi, Lalit Kumar / Tiwari, Gaurav

Combinatorial chemistry & high throughput screening

2023

Abstract: Background: The use of medicinal plants as a rich resource of therapeutic agents in the treatment and prevention of diseases & ailments has been recognized for millennia and is highly regarded worldwide. Holarrhena antidysenterica (H. antidysenterica), ... ...

Abstract	Background: The use of medicinal plants as a rich resource of therapeutic agents in the treatment and prevention of diseases & ailments has been recognized for millennia and is highly regarded worldwide. Holarrhena antidysenterica (H. antidysenterica), also called kurchi, or kutaj, has been utilized since the dawn of time, Apocynaceae member, also known as H. pubescens, is praised for the medicinal uses of its stem bark, leaves, and seeds in Ayurveda. Objective: The study concentrated on aggregate information regarding H. antidysenterica's therapeutic effects. The purpose of this study was to determine the antidiabetic activity of an extract from H. antidysenterica seeds in diabetic rats induced by streptozotocin. Methods: Regardless of its broad variety of biological and possible therapeutic uses, there has been increasing concern regarding the use of H. antidysenterica. Result: Various phytochemicals have been extracted from H. antidysenterica in recent years and have demonstrated typical pharmacological properties, including antibacterial, anti-diarrhoeal, anti-diabetic, anti-oxidant, anti-urolithic, and anti-inflammatory activity.. Conclusion: This review paper investigated the in-depth description and pharmacological properties of the plant, which produced significant findings on the chemical components present and also verified the traditionally claimed properties associated with the plant.
Language	English
Publishing date	2023-08-21
Publishing country	United Arab Emirates
Document type	Journal Article
ZDB-ID	2064785-2
ISSN	1875-5402 ; 1386-2073
ISSN (online)	1875-5402
ISSN	1386-2073
DOI	10.2174/1386207326666230821102502
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Article: Comparison of the effects of intravenous lignocaine and ketamine on postoperative pain after lower abdominal surgeries under general anaesthesia.

Singariya, Geeta / Sharma, Jyoti / Kumari, Kamlesh / Kamal, Manoj / Khatri, Chanda / Selvin, Caren Candace

Indian journal of anaesthesia

2023 Volume 67, Issue Suppl 1, Page(s) S41–S47

Abstract: Background and aims: As a component of multimodal analgesia, the administration of systemic lignocaine and ketamine is a well-known technique. This study was designed to compare the effect of intravenous lignocaine and ketamine on postoperative pain in ... ...

Abstract	Background and aims: As a component of multimodal analgesia, the administration of systemic lignocaine and ketamine is a well-known technique. This study was designed to compare the effect of intravenous lignocaine and ketamine on postoperative pain in the patients undergoing lower abdominal surgeries under general anaesthesia. Methods: Total 126 patients, aged between18 to 60 years, American Society of Anesthesiologists (ASA) physical status I and II, were randomly allocated into lignocaine (Group L), ketamine (Group K), or control (Group C). We assessed the mean fentanyl consumption 24 hours postoperatively, visual analogue score (VAS), time to first rescue analgesia, haemodynamic parameters, postoperative complications patient satisfaction score, and duration of hospital stay among three groups. Results: The mean fentanyl consumption in first 24 hours postoperatively was higher in group C (194.65 ± 48.48 μg) compared to group L (139.69 ± 46.96 μg) and group K (161.37 ± 46.31 μg) ( Conclusion: The mean fentanyl consumption in 24 hours postoperatively and pain intensity were less with intraoperative lignocaine and ketamine infusion with improved patient satisfaction in patients undergoing lower abdominal surgery under general anaesthesia.
Language	English
Publishing date	2023-02-10
Publishing country	India
Document type	Journal Article
ZDB-ID	412570-8
ISSN	0019-5049
ISSN	0019-5049
DOI	10.4103/ija.ija_691_22
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Article ; Online: Item Response Theory Validation of the Forgotten Joint Score for Persons Undergoing Total Knee Replacement.

Khatri, Chetan / Harrison, Conrad J / Clement, Nick D / Scott, Chloe E H / MacDonald, Deborah / Metcalfe, Andrew J / Rodrigues, Jeremy N

The Journal of bone and joint surgery. American volume

2024

Abstract: Background: The Forgotten Joint Score (FJS), a commonly used patient-reported outcome measure, was developed without fully confirming assumptions such as unidimensionality (all items reflect 1 underlying factor), appropriate weighting of each item in ... ...

Abstract	Background: The Forgotten Joint Score (FJS), a commonly used patient-reported outcome measure, was developed without fully confirming assumptions such as unidimensionality (all items reflect 1 underlying factor), appropriate weighting of each item in scoring, absence of differential item functioning (in which different groups, e.g., men and women, respond differently), local dependence (pairs of items are measuring only 1 underlying factor), and monotonicity (persons with higher function have a higher score). We applied item response theory (IRT) to perform validation of the FJS according to contemporary standards, and thus support its ongoing use. We aimed to confirm that the FJS reflects a single latent trait. In addition, we aimed to determine whether an IRT model could be fitted to the FJS. Methods: Participants undergoing primary total knee replacement provided responses to the FJS items preoperatively and at 6 and 12 months postoperatively. An exploratory factor analysis (EFA), confirmatory factor analysis (CFA), and Mokken analysis were conducted. A graded response model (GRM) was fitted to the data. Results: A total of 1,774 patient responses were analyzed. EFA indicated a 1-factor model (all 12 items reflecting 1 underlying trait). CFA demonstrated an excellent model fit. Items did not have equal weighting. The FJS demonstrated good monotonicity and no differential item functioning by sex, age, or body mass index. GRM parameters are reported in this paper. Conclusions: The FJS meets key validity assumptions, supporting its use in clinical practice and research. The IRT-adapted FJS has potential advantages over the traditional FJS: it provides continuous measurements with finer granularity between health states, includes individual measurement error, and can compute scores despite more missing data (with only 1 response required to estimate a score). It can be applied retrospectively to existing data sets or used to deliver individualized computerized adaptive tests. Level of evidence: Prognostic Level II. See Instructions for Authors for a complete description of levels of evidence.
Language	English
Publishing date	2024-03-19
Publishing country	United States
Document type	Journal Article
ZDB-ID	220625-0
ISSN	1535-1386 ; 0021-9355
ISSN (online)	1535-1386
ISSN	0021-9355
DOI	10.2106/JBJS.23.00814
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Article ; Online: Diagnostic impacts on management of soft tissue injuries associated with tibial plateau fractures: A narrative review.

Stephens, Alastair / Searle, Henry / Carlos, William / Gomindes, Austin / Pilarski, Adam / Syed, Farhan / Smith, Nicholas / Khatri, Chetan

Injury

2024 Volume 55, Issue 6, Page(s) 111546

Abstract: Introduction: Currently there is no consensus on the need for investigating knee ligamentous and meniscal injuries in a patient with a tibial plateau fracture. Consequently, many soft tissue injuries are likely undiagnosed and therefore untreated. The ... ...

Abstract	Introduction: Currently there is no consensus on the need for investigating knee ligamentous and meniscal injuries in a patient with a tibial plateau fracture. Consequently, many soft tissue injuries are likely undiagnosed and therefore untreated. The impact this has on long term knee outcomes is not well defined. We aimed to identify the impacts of various diagnostic methods on the management of meniscal injuries associated with tibial plateau fractures and evaluate the clinical outcomes. Materials and methods: We performed a systematic review using Pubmed, Medline, Embase, CINAHL and Cochrane following Cochrane guidelines. We included studies that operatively managed tibial plateau fractures and soft tissue injuries, which were diagnosed with either preoperative MRI, intra-operative arthroscopy or arthrotomy. Results: 18 articles with 884 people, with a mean age of 46.4 years were included. Soft tissue injuries were detected on MRI (32-73%) and arthroscopy (12-70%), of which the most common were lateral meniscal injuries (7-64% of tibial plateau fractures). When identified by arthroscopy and arthrotomy, these injuries were almost always treated, either by repair or debridement. The clinical outcomes of these patients were poorly reported, with a heterogenous use of patient reported outcome measures, and follow up time points. There were no randomised trials or control groups for comparative analysis, however operative treatment yielded good to excellent outcomes. Conclusion: There is a high incidence of concomitant soft tissue injuries with tibial plateau fractures, particularly lateral meniscal injuries. There are 2 main approaches to meniscal injuries: surgeons who don't investigate, don't treat, whilst surgeons who do investigate often do surgically treat. Although studies that treated these injuries achieved good to excellent results, the currently available evidence doesn't confirm treatment superiority. As there is plausibility for better outcomes, randomised studies are needed to further investigate this clinical question.
Language	English
Publishing date	2024-04-03
Publishing country	Netherlands
Document type	Journal Article ; Review
ZDB-ID	218778-4
ISSN	1879-0267 ; 0020-1383
ISSN (online)	1879-0267
ISSN	0020-1383
DOI	10.1016/j.injury.2024.111546
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Article ; Online: A novel LC-MS/MS method for simultaneous estimation of acalabrutinib and its active metabolite acalabrutinib M

Valluri, Venkat Rao / Katari, Naresh Kumar / Khatri, Chirag / Kasar, Pankaj / Polagani, Srinivasa Rao / Jonnalagadda, Sreekanth Babu

RSC advances

2022 Volume 12, Issue 11, Page(s) 6631–6639

Abstract: A simple, specific, selective and accurate bioanalytical method was developed and validated for simultaneous estimation of acalabrutinib and its active metabolite in human plasma using liquid chromatography-tandem mass spectrometry (LC-MS/MS). Deuterated ...

Abstract	A simple, specific, selective and accurate bioanalytical method was developed and validated for simultaneous estimation of acalabrutinib and its active metabolite in human plasma using liquid chromatography-tandem mass spectrometry (LC-MS/MS). Deuterated analogs of both the analytes were used as internal standards. The extraction of analytes and internal standards were evaluated from the human plasma by liquid-liquid extraction technique using methyl tertiary butyl ether (TBME). The separation of the analytes was carried out on Zorbax Eclipse XDB-C
Language	English
Publishing date	2022-02-25
Publishing country	England
Document type	Journal Article
ISSN	2046-2069
ISSN (online)	2046-2069
DOI	10.1039/d1ra09026g
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Article ; Online: What's important for recovery after a total knee replacement? A systematic review of mixed methods studies.

Khatri, Chetan / Ahmed, Imran / Dhaif, Fatema / Rodrigues, Jeremy / Underwood, Martin / Davis, Edward T / Mitchell, Paul / Metcalfe, Andrew

Archives of orthopaedic and trauma surgery

2023

Abstract: Background: Understanding how patients perceive and prioritise various aspects of recovery following total knee replacement, including pain, function and return to activity, will help clinicians in pre-operative consultations by ensuring they ... ...

Abstract	Background: Understanding how patients perceive and prioritise various aspects of recovery following total knee replacement, including pain, function and return to activity, will help clinicians in pre-operative consultations by ensuring they effectively address patient concerns and managing their expectations. Aims: The aim of this study is to identify aspects of recovery that are important to people after a total knee replacement. Methods: Studies were identified from Medline, Embase, PsycInfo, Cochrane Library and Web of Science. This mixed methods review included all original study types (quantitative, qualitative, discrete choice experiments and mixed methods design). Reviews and non-peer-reviewed publications were excluded. Studies with participants (age ≥ 18 years) who had a primary TKR for osteoarthritis were included. Studies of people with unicompartmental knee, patella-femoral or revision knee replacement were excluded. Recovery attributes were extracted from individual papers and grouped into recovery themes. Results: A total of 23 studies with 8404 participants and 18 recovery themes were developed. The most frequently identified overarching theme was pain, followed by activities of daily living, mobility (walking), recreational activities, specific functional movements of the knee, use of walking aids, sexual activity and range of motion of the knee. Medical complications were an infrequently reported theme, however, was deemed to be high importance. Conclusions: Reducing pain, returning of activities and daily living and mobility are the three most frequently reported recovery domains for people after TKR. Clinicians should be aware of recovery themes, to ensure they are explored sufficiently when consenting for a TKR. Future research should aim to determine the relative importance of these attributes compared to each other. Review Registration: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021253699.
Language	English
Publishing date	2023-12-09
Publishing country	Germany
Document type	Journal Article ; Review
ZDB-ID	80407-1
ISSN	1434-3916 ; 0003-9330 ; 0344-8444
ISSN (online)	1434-3916
ISSN	0003-9330 ; 0344-8444
DOI	10.1007/s00402-023-05136-x
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Article ; Online: The economic burden of open tibia fractures: A systematic review.

Schade, Alexander T / Khatri, Chetan / Nwankwo, Henry / Carlos, William / Harrison, William J / Metcalfe, Andrew J

Injury

2021 Volume 52, Issue 6, Page(s) 1251–1259

Abstract: Background: Open tibia fractures are a common injury following road traffic collisions and place a large economic burden on patients and healthcare systems. Summarising their economic burden is key to inform policy and help prioritise treatment.: ... ...

Abstract	Background: Open tibia fractures are a common injury following road traffic collisions and place a large economic burden on patients and healthcare systems. Summarising their economic burden is key to inform policy and help prioritise treatment. Methods: All studies were identified from a systematic search of Medline, Embase and the Cochrane Central Register of Controlled Trials. We included any human with a diagnosed open tibia fracture, following any intervention. The primary outcome was any costs reported or patient return to work status. Secondary outcomes included average length of stay, wage loss, absenteeism and complications such as infection, amputation and nonunion. Data was extracted and we performed a descriptive narrative summary. Results: We reviewed 1,204 studies from our searches. A total of 34 studies were included from 14 different countries. The average age was 37.7 years old and 76% of the patients were male. 6.5% were Gustilo I, 12% Gustilo II and 82% Gustilo III. Initial direct hospitalisation costs were reported to be between £356 to £126,479 with an average length of stay of 56 days (3.1-244). 89% of participants were working pre-injury, 60% fully returned to work, 17% returned to work part time or changed profession and 22% did not return to work at one-year. The most common complications reported were 22% infection, 11% nonunion and 16% amputation. Mean follow-up duration for the studies was 25 months. Conclusion: The economic burden of open tibia fractures varies greatly, but it is costly for both hospitals and patients. The current evidence is predominantly from high-income countries (HICs), especially the USA. Further research is required to investigate the costs of open tibia fractures using validated costing tools, especially in low-income countries (LICs), to help inform and direct policy.
MeSH term(s)	Accidents, Traffic ; Adult ; Amputation ; Cost of Illness ; Female ; Fractures, Open/surgery ; Humans ; Male ; Tibia ; Tibial Fractures/surgery
Language	English
Publishing date	2021-02-14
Publishing country	Netherlands
Document type	Journal Article ; Review ; Systematic Review
ZDB-ID	218778-4
ISSN	1879-0267 ; 0020-1383
ISSN (online)	1879-0267
ISSN	0020-1383
DOI	10.1016/j.injury.2021.02.022
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