Humanistic Studies and Social Researches

Abstract Introduction: The global healthcare workforce shortage is a critical issue impacting patient care, economic stability, and healthcare access, particularly in specialties like orthopedics, anesthesiology, and nursing. In Iran, this crisis is worsened by economic sanctions, limited training opportunities, and unequal distribution of healthcare workers. This review examines the causes, impacts, and potential solutions to workforce shortages, with a focus on Iran.

Methods: A narrative review was conducted to analyze existing literature on workforce shortages in orthopedics, anesthesiology, and nursing. Sources included peer-reviewed articles, WHO reports, and national surveys. Data were synthesized to identify trends, impacts on patient care, and strategies for addressing these gaps.

Results: The shortage of orthopedic surgeons and anesthesiologists has led to delays in surgeries and worse patient outcomes, especially in underserved regions. Nursing shortages are driven by low wages, poor working conditions, and gender disparities. In Iran, sanctions restrict access to medical equipment, worsening the crisis. Additionally, healthcare workers are concentrated in urban areas, deepening the gap in rural settings. These shortages contribute to higher mortality rates, reduced care quality, and escalating healthcare costs.

Conclusion: The healthcare workforce shortage, particularly in orthopedics, anesthesiology, and nursing, presents a significant global challenge. Solutions include expanding training programs, improving working conditions, providing incentives for rural placements, and fostering international collaboration. These efforts are especially vital in countries like Iran, where external economic pressures exacerbate the issue.

Abstract Background: The social determinants of health (SDOH) significantly shape the prevalence, incidence, and management of diabetes. This review examines the complex relationship between SDOH and diabetes, focusing on economic factors, education, insurance coverage, community context, physical environment, healthcare access, lifestyle factors, and key considerations in orthopedic and anesthesiology care.
Methods: A review of peer-reviewed articles and studies published over the past decade was conducted to explore how SDOH impact diabetes outcomes. The review also addresses orthopedic and anesthesiology concerns, especially related to musculoskeletal complications and anesthesia management for diabetic patients.
Results: Lower economic status, limited education, and insufficient insurance coverage are strongly linked to worse diabetes outcomes. Social and community support, including mental health resources and community programs, is crucial for diabetes self-management. The physical environment—such as access to nutritious food and safe spaces for physical activity—also influences diabetes risk. Additionally, orthopedic issues, such as diabetic neuropathy and musculoskeletal complications, and anesthesiology challenges, such as blood glucose control and cardiovascular concerns during surgery, are vital factors in the care of diabetic individuals.
Conclusion: Addressing diabetes requires a holistic, multidisciplinary approach that incorporates economic, educational, and healthcare factors, along with specialized care for orthopedic and anesthesiology needs. Policy interventions, community-based programs, and healthcare reforms are essential to improving outcomes and reducing disparities. Future research should focus on integrated strategies that incorporate SDOH into diabetes care, particularly for underserved populations.

Abstract Chronic low back pain and sciatica caused by intervertebral disc herniation are among the leading causes of disability and healthcare utilization worldwide. Effective management of lumbar disc herniation is crucial, encompassing medical therapy, physiotherapy, and interventional procedures. Nucleotomy, the gold standard for decades, directly removes herniated disc material but carries risks such as infection and adjacent segment disease. Recently, percutaneous laser disc decompression (PLDD), a minimally invasive technique, has gained prominence due to its favorable safety profile, reduced recovery times, and efficacy in selected cases. PLDD employs laser energy to vaporize the nucleus pulposus, reducing intradiscal pressure and alleviating nerve compression. This review critically compares nucleotomy and PLDD, focusing on their techniques, indications, outcomes, and complications. While nucleotomy is preferred for complex herniations, PLDD is effective for smaller, contained cases, with success heavily reliant on patient selection. The integration of nutraceuticals with PLDD represents a promising innovation, enhancing neuroprotection and pain management. With a growing emphasis on minimally invasive solutions, PLDD offers a cost-effective alternative for patients seeking less invasive options. This discussion aims to guide clinicians and patients in selecting the most appropriate treatment while exploring advancements shaping the future of spinal care.