Cureus

BackgroundSacral dysmorphism refers to morphological variations found in the first two sacral segments that limit the safe placement of percutaneous sacral iliac screws. The prevalence is documented in European, North American and some Asian populations. However, studies within the African population including Kenya are lacking. The aim of the study was to describe the patterns of sacral dysmorphism in pelvic computerized tomography (CT) scans at a national referral hospital in Kenya. MethodsA cross-sectional study carried out at the Radiology Department, Kenyatta National Hospital from March 2020 to March 2021 involving the radiographic evaluation of 293 stored abdominal pelvic CT scans of patients. Sacral dysmorphism was identified based on the sacral dysmorphism score >70 and the presence of any of the six morphological features of sacral dysmorphism. ResultsA sacral dysmorphism score of more than 70 was found to in 64% of the population. The prevalence of dysmorphic sacra (based on the presence of at least one qualitative feature) was 100%. The most prevalent feature of sacral dysmorphism was the lack of recession of the S1 segment (82%) followed by an unfused sacral segment (76%). Of note is that some qualitative features of sacral dysmorphism were protective against a high sacral dysmorphism score. There was no statistical significance of gender in sacral dysmorphism. ConclusionThere is a high prevalence of sacral dysmorphism score in this population. There is a need for further studies to revisit the concept of dysmorphic sacra based on the presence of at least one qualitative feature as all our participants had at least one feature.

AbstractionO_ST_ABSBackgroundC_ST_ABSTotal knee arthroplasty (TKA) was the procedure which is preform by orthopedic surgeons in end stage osteoarthritis knee patients who fail conservative treatment. Periarticular analgesia is one of the effective and safe technique used to reduce pain after surgery. However, the location and formula of the mixture have not yet been controversy. Recently, a study compared intraosseous analgesic injection, which provided significant postoperative pain relief compared to the control group. The authors conducted this study to compare periarticular and intraosseous analgesic injection in patients undergoing simultaneous bilateral total knee arthroplasty. MethodThe study is a two-arm, double-blinded, randomized controlled trial with 26 patients (52 knees) who underwent simultaneous bilateral total knee arthroplasty. The primary outcome is postoperative pain at 12, 24, and 48 hours using the Visual Analog Scale for assessment. The secondary outcomes include postoperative range of motion at 24 and 48 hours, postoperative blood loss, and postoperative complications. DiscussionWhile periarticular analgesic is the standard practice, intraosseous analgesic injection is a potential route for controlling postoperative pain after total knee arthroplasty surgery. This study offers a better alternative route for analgesic injection.

BackgroundScientific publications by editorial board members in their own journals raise questions about potential biases in the peer-review process. This study investigates the prevalence of self-publishing in high-impact factor foot and ankle focused journals. MethodsA review was performed of the highest impact factor foot and ankle focused journals/: Foot and Ankle International, Foot and Ankle Surgery y Journal of Foot and Ankle Surgery. In January 2023, the editorial board members were identified, and their names, roles, academic backgrounds, and regions were obtained. For each board member, the number of total published articles listed in PubMed and those for each corresponding journal over their entire history, during the last 5 years and during the last 3 years were compiled. Descriptive statistics analyses were performed using IBM SPSS Statistics v26.0. ResultsThe study included 196 editorial board members from the 3 selected journals. Editorial board members have published 1694 articles in their own journals (9.17% of all the articles published in those 3 journals). Editorial board members published 23.4% (SD 23.6) of their overall production in their affiliated journals. Of that production, 39.0% (SD 38.6) have been published in the last 5 years, considering this 5-year period as the baseline for their role on the editorial board in question. Some 10% of editorial board members have published more than 50% of their scientific production in their own affiliated journal in the last 5 years. European editors (51%) have published more in their own journal over the last 5-year period than North Americans (29%) (p<0.001). Being a surgeon is related to greater publication rates in ones own affiliated journal when compared to other specialist profiles (p=0.003). ConclusionThe publication scientific articles by editorial board members as authors in journals with which they are affiliated is a present-day phenomenon in the highest impact factor journals with a focus on the foot & ankle. Knowledge of this data could be the key to understanding the prevalence of this phenomenon, and lead to making this data more accessible.

IntroductionThyroid Imaging Reporting and Data System (TI-RADS(R)) is a system for classifying thyroid nodules detected at ultrasonography, aiming at a descriptive standardization as well as to classify their risk of malignancy based on sonographic findings. AiumTo present a pictorial essay by composing anatomical, histological, ultrasound and elastography images of the TI-RADS(R) score. MethodUsing software for image composition, based on the ultrasound image of the various types of thyroid nodules, we adapt to the anatomical image, the elastosonography, and histological corresponding TI-RADS(R) and present a pictorial essay. ResultsThe correlation between the sonographic, elastography, anatomical, cytology and histological images corresponding to the TI-RADS(R) score are demonstrated. ConclusionUltrasonographic features, elastosonography, anatomical, and histological in evaluation of thyroid nodules can correlate with features TI-RADS(R) score.

More than half of the fingertip injuries in children are due to door jamming injuries.1)2) There have been several studies on door crush injuries (DCI) but they pertain to either the paediatric age group or form a part of study of fingertip injuries in a large population. This article caters solely to studying the epidemiology, mechanism of injury, associated risk factors and suggests few simple techniques to avoid DCI. MaterialsComparative analysis of the epidemiological data of all the patients with door crush injuries who presented to the Emergencies and the Out Patient Department in the Tertiary care centre was obtained from the MRD. This is a retrospective cohort study between January 2021 to December 2021. Patients with serious concomitant injuries, machine crush injury, heavy falling objects, window crush injury were excluded from the study. ResultsOf the 34 patients, 27 were male and 7 females. In 33 patients DCI was in the hinge side while only 1 had lock-side, entrance door being the commonest. 35% had first-aid done in a local nursing home before arriving at the hospital. 4 patients left against medical advice, 4 were conservatively treated and 2 had double finger injury. DCI was most common in preschool children. Right side and middle finger were most susceptible. 25% of the injuries happened on Mondays. Of the 36 fingers injured, 69% had pulp, 58% had nailbed and 22% had bony involvement. Primary suturing, local flap cover and K-wiring were the main modalities of treatment. Complications included altered sensation, nail deformity and contracture. ConclusionDoor crush injury is a major contributor for finger crush injuries in both children and adults. Awareness among parents, the use of safety appliances to prevent accidental door closing, counselling by doctors and nurses greatly help to bring down the number of door crush injuries.

The Government of India requires all ethics committees (EC) to register themselves with the Department of Health Research (DHR) and the study aimed to analyze the same. Since post-graduation mandates research - necessitating the presence of EC in the institution - we aimed to analyze the status of registrations along with the presence of ECs in National Medical Council(NMC) and Dental Council of India(DCI)-permitted colleges and also to study zone-wise differences in the same. We also studied the impact of COVID-19 on the registration process. The status of ECs was obtained from the DHR website. ECs information was extracted [location, date & type of Approval]. The search terms "College" and "Hospital" were used to locate Institutional ECs (IEC). A list of Medical and Dental colleges was obtained from the NMC and DCI Websites with their location information. Of 931 IECs, 103(11.06%) had final, 728(78.2%) had provisional approval while 100(10.74%) ECs registration had expired. The median delay to file for provisional approval was 857 (IQR=407) days. The expired ECs functioning without registration for 90 (IQR=131) days. 440 of 931 (47.3%) ECs got registered during the COVID-19 period. The IEC to Medical Colleges ratio shows a significant zone-wise difference (Kruskal-Wallis, p=0.019) with the Northern Zone having the highest mean ratio of 0.90(SD=0.63). It is vital to improve DHR compliance and the EC/College Ratio for appropriate ethical governance and improve international acceptance of Indian Research.

Tranexamic acid is a medication typically used to prevent excessive blood loss in the setting of trauma, surgery, and menstrual cycles. Administration of tranexamic acid within the first three hours of trauma has been shown to reduce blood loss and mortality in patients. [1] Tranexamic acid is also commonly used during heavy menstrual bleeding or postpartum hemorrhage cases in which administration has been shown to reduce bleeding in patients. [2] Although there have been studies conducted on the effects of tranexamic acid on blood loss during various surgeries, this systematic review aims to understand the effects specifically on patients undergoing coronary artery bypass grafting (CABG), a common procedure known to have significant blood loss. A systematic review using the PubMed database on the use of tranexamic acid in blood loss for patients undergoing CABG was conducted with the hypothesis that tranexamic acid administration reduces perioperative and postoperative blood loss. This systematic review includes 8 papers from the years 1997-2018 which report on a total of 712 patients. Although significant large, randomized, control studies on the topic are still pending, this systematic review of studies conducted thus far can conclude that tranexamic acid has a positive effect on reducing blood loss in patients undergoing CABG.

Obstructive jaundice is a surgical condition that affects all age groups mostly to the above 18 individuals. This condition can lead to high morbidity and mortality if not early diagnosed and treated. It remains the common cause of surgical consultations globally accounting for 8-10/100,000 and 242/1000 annually in China and Saudi Arabia respectively. Clinicopathological and radiological investigations are the key to the disease diagnosis. Cholelithiasis and cancer head of pancreas are common causes of obstructive jaundice. Although the diagnosis and treatments of obstructive jaundice is advancing; some patients get poor treatment outcome such as SSI, peritonitis and long hospital stay with some of them dying. To determine the clinicopathological, surgical management and early postoperative outcome among obstructive jaundice inpatients at KCMC from March 2020 to March 2023. A hospital-based cross-sectional study was conducted using secondary data from hospital records, EHMS system, surgery admission and theater registry books. All files of patients aged 18 years and above from these registry books with a diagnosis of obstructive jaundice from March 2020 to March 2023 were included. The obtained data were collected using the questionnaire then entered and analyzed using SPSS version 26. A total of 101 patients were studied, with the male to female ratio of 1.2:1. Cancer head of pancreas was the commonest malignant cause of obstructive jaundice where as choledocholithiasis was the commonest benign cause. Most of the clinical presentations were abdominal pain 47.6%, yellowish discoloration of the mucous membrane, eyes and skin by 43.6% and itching by 6.9%. Both laboratory investigations and radiological imaging were done which showed elevated liver enzymes 68.3%, low Hb 46.5%, histopathology 62.4%; benign and malignant obstructive jaundice cause by 33.7% and 46.5% respectively. Among all the patients who were surgically managed 29.7% had palliative triple bypass, 14.8% had laparoscopic cholecystectomy and 14.8% had CBD Exploration. The overall complication rate was 50.5%; Death 16.5% surgical site infections 13.9% and long hospital stay 9.9%. Obstructive jaundice in our setting is more common in males where malignant causes being high in the list

BackgroundWe explored the dynamics of changes in the blood flow velocity in the internal jugular vein (IJV) under conditions of changing intrapulmonary pressure and gravitational influence in healthy volunteers. MethodsColor duplex ultrasonography of the right IJV was performed in 25 healthy volunteers of both genders. The dopplergram of the blood flow spectrum was recorded in the right IJV in the horizontal supine position of the participants, and 3 minutes after the volunteers had attained the new position due to the lifting the bed back section at the 30{degrees}. We recorded the maximum (Max) and minimum (Min) linear of blood flow velocity (cm/s). In each position, the measurements were carried out sequentially at positive end-expiratory pressure (PEEP) values of 0, 5, 10 cmH2O after 3 minutes by process of changing the level of PEEP. Quantitative data were presented as arithmetic mean (M), standard deviation (SD) and compared using the Wilcoxon rank-sum test. ResultsOur data demonstrated that negatively related influence of continuous positive airway pressure on IJV blood flow velocity: Max/Min 57.40{+/-}13.10/20.68{+/-}7.80 cm/s (PEEP 0 cmH2O), 39.00{+/-}18.80/14.63{+/-}4.90 (PEEP 5 cmH2O), 30.83{+/-}7.30/13.25{+/-}2.90 (PEEP 10 cmH2O). The blood flow velocity values are increased after 30{degrees} head elevation in PEEP 5 and 10 cmH2O in comparison to 0{degrees} values. ConclusionsThe constant positive airway pressure 5-10 cmH2O in a person in supine position decreasing blood flow velocity in IJV. The 30{degrees} head elevation eliminates this effect.

I.IntroductionScoliosis is defined as a deviation from midline in the frontal plane, and rotation of the apex of the curve from [&ge;]10{degrees} in AP radiography. Treatment of scoliosis is based in type of scoliosis, region of scoliotic curve, curve magnitude, bone maturity, gender, risk of scoliotic curve progression, other symptoms like and patients opinion about his spine shape. Treatment choices of AIS are observation, physical therapy, corsets and surgical treatment. PurposeResearch of patients with AIS focusing in its characteristics, clinical presentation, diagnosis and a detalized research in non-operative treatment of AIS focusing in treatment choices and criteria of treatment. Material and methodsThe study is based in retrospective research September 2018-March 2019 (7 months) in HUCSK- Specialized outpatient clinics of Orthopaedics. Data is taken with special permission from Personal Data Protection Office and Ethico-Professional Commity from specialized outpatient clinics of Orthopaedics systems archive for patients with AIS of 10-18 years old. ResultsDuring September 2018-March 2019 period in specialized outpatient clinics of Orthopaedics-HUCSK, 250 cases with AIS of 10-18 years old with Cobb angle [&ge;]10{degrees} are diagnosed and treated. The disease has a prevalence 1.40%. Based in gender women are more affected than men in a ratio 2.01:1. Most common form of AIS is the one that affects thoraco-lumbal region of spine with 60.8% of cases. Theres found a correlation between scoliosis and kyphosis in higher levels of spine.About 89.7% of cases are light scoliotic curves according to Cobb angle and the female\male ratio increases at women with increasement of Cobbs angle. Patients are treated with one or more forms of non-operative treatment: observation 10.4% of cases, observation and physical therapy 89.6% of cases and observation, physical treatment and corset TLSO 25.6% of cases. Cases that have undergone three forms of non-operative treatment are with Cobb angle [&ge;]20{degrees}. DiscussionThe results of this study are supported from many studies made in Germany, Singapor, Grece, Turkey and USA, from the earlier and later years, with data exactly or closely to this study results.

IntroductionDemographic disparities in musculoskeletal (MSK) health exist in the US. Racial representation in advertising has been shown to influence buying patterns. By focusing advertising toward majority groups, direct-to-consumer advertising may exacerbate MSK disparities by neglecting underrepresented minorities. To better understand how race is represented across MSK advertisements and how this may influence patterns in MSK health, we reviewed advertisements in popular magazines, using online databases for collection. Methods8 magazine types were chosen. Racial distribution was analyzed using Pearsons chi-squared and chi-squared goodness of fit tests. Fishers exact test was used when >20% of cells had n<5. Significance was set at p<0.05. ResultsOf advertisements that featured a model, white models were overrepresented (p<0.001), and Hispanic and Asian models were underrepresented (p<0.001). Only 7.3% of advertisements featured multiple models of different races or ethnicities, while 92.7% did not. African American models were overrepresented as athletes (p<0.001) and underrepresented in pain relief ads (p<0.001). DiscussionThere is poor representation of minorities in MSK advertisements. Even when controlling for US population demographics, white models were overrepresented, and models of minority races are underrepresented. African American models were typecast as athletes and underrepresented in pain relief ads.

ObjectiveTo investigate sagittal spinal alignment from the perspective of the overall curvature of the "S" curve of the human spine, and explore the roles of pelvic incidence (PI) and maximal thoracolumbar vertebral tilt(TLmax) in the classification of the sagittal spinal aligment. MethodsThe tilt of the sacral, lumbar, and thoracic vertebrae (from Co1, S5, S4... to C7) were measured. The minimal sacral vertebral tilt(Smin), maximal thoracolumbar vertebral tilt(TLmax), and minimal thoracic vertebral tilt (Tmin) were recorded. The concept of lumbosacral lordosis (LSL) was introduced, and the Ferguson method was utilized to measure sagittal spinal parameters both in anatomical segmentation (Ferguson L1-S2, Ferguson T1-T12) and functional segmentation (Ferguson LSLmax, Ferguson TKmax). The subjects were grouped based on pelvic incidence (PI) and TLmax separately, and the mean and standard deviation of each parameter were calculated. Chi-square tests were conducted for statistical analysis. Results1. Based on PI grouping: PI for all subjects was 45.4 {+/-} 9.5{degrees} (21.7-86.4{degrees}). Group A consisted of 117 subjects with a mean PI of 34.7 {+/-} 4.4{degrees}, Group B had 158 subjects with a mean PI of 45.2 {+/-} 2.9{degrees}, and Group C included 113 subjects with a mean PI of 56.7 {+/-} 5.8{degrees}. No statistically significant differences were found in tilt of S2, L1, T1, TLmax, Tmin, and Ferguson L1-S2, Ferguson T1-T12, and Ferguson TKmax among Groups A, B, and C. 2. Based on TLmax grouping: TLmax for all subjects was 110.5 {+/-} 5.5{degrees} (94.4-132.0{degrees}). Group A had 91 subjects with a mean TLmax of 104.0 {+/-} 2.3{degrees}, Group B comprised 216 subjects with a mean TLmax of 110.2 {+/-} 2.1{degrees}, and Group C included 81 subjects with a mean TLmax of 118.6 {+/-} 3.8{degrees}. Significant statistical differences were observed in tilt of S2, L1, T1, Smin, TLmax, Tmin, and Ferguson L1-S2, Ferguson T1-T12, Ferguson LSLmax, and Ferguson TKmax among Groups A, B, and C. ConclusionThere were no differences in the magnitude of LSL and TK among subjects with different PI, indicating that PI does not affect the overall curvature of the "S" curve in the sagittal spinal aligment. In contrast, TLmax effectively distinguishes the overall curvature of the "S" curve.

BackgroundThe impact of age, race, and comorbidities on COVID-19 severity in younger populations is not well understood. This study aimed to identify predictors of hospital admission in young patients with COVID-19. MethodsWe conducted a retrospective analysis of 2658 COVID-19 patients under 36 years old from March 1 to August 6, 2020, using data from HEALTHeLINK, a regional health information system in western New York. Patients were divided into pediatric (0-19 years) and young adult (20-36 years) groups. We evaluated associations between risk factors and hospital admission using recursive partitioning and linear regression. ResultsThe study included 2131 young adults and 527 pediatric patients. In young adults, race was the strongest predictor of admission, followed by BMI. African Americans with BMI > 23 had the highest admission rate (63%, p<0.001). Asian race predicted outpatient management regardless of BMI. Smoking and hypertension were less significant predictors, while gender, diabetes, respiratory conditions, and sickle cell disease were not significant. In the pediatric population, race was also the primary predictor of admission, with African Americans having higher admission rates than Whites and Asians. BMI percentile was not a predictor in pediatric patients. ConclusionsRace strongly predicted hospital admission in young COVID-19 patients, with African Americans most likely to be admitted and Asians least likely. For African American young adults, BMI > 23 was an additional strong predictor. A simple decision tree incorporating age, race, and BMI can help identify young patients least likely to require inpatient management.

PurposeTwo-point discrimination (2PD) is the ability to discern that two nearby objects touching the skin are truly two distinct points, not one. It is often tested with two sharp points during a neurological examination and is assumed to reflect how finely innervated an area of skin is. objective was to find out the normal value of Two Point Discrimination on the Back, Finger, Forehead & Sole and to Correlate values of Two Point Discrimination on Back, Finger, Forehead & Sole with corresponding BMI according to Gender. MethodsTwo point discrimination test is a part of practical course of Physiology Department of the teaching institute. Here, the students perform the practical under strict supervision of professors, the data of the students practical is recorded for departments personal use. This data was collected with the permission from the head of the department and then analyzed to see the normal values of two-point discrimination and also to assess the correlation between Gender, BMI, & Two-point Discrimination(TPD). Pearson Correlation, T-test, SEM, CI95, Scatter diagrams were used to analyze and understand the data. ResultsValues of Two-Point-Discrimination(TPD) Average(in mm), SD, and Pearson Correlation(with BMI) at Back (Males=32.19 {+/-} 4.94,r=0.808 & Females=29.38 {+/-}5.29,r=0.848), Fingertips (Males=3.43 {+/-} 1.52,r=0.0344 & Females=3.47 {+/-} 1.52,r=0.0141), Forehead (Males=13.53 {+/-} 2.36,r=0.0223 & Females=12.25 {+/-} 2.61,r=0.198), Sole (Males=14.69 {+/-} 3.54,r=0.00493 & Females=13.87 {+/-} 3.36, r=0.0234) ConclusionThe results depict the normal values of Two-point discrimination at the respective location. The normal values at a particular location in Males and Females are almost the same Strong Correlation of TPD value at Back with BMI can be justified as fat Accumulation increases in Skin with increasing BMI. Fat mainly accumulates on the abdomen, thighs, and back and neck but not on Forehead, Fingertips & soles. Fat accumulation hypothetically leads to increase skin surface leading to virtually variable per area relative decreased skin innervation resulting in higher TPD values and Strong Positive Correlation. TPD values at Forehead, Fingertips & soles do not correlate with BMI.

PurposeThis study aims to forecast findings showing the difficulty of operation in cholecystectomy through pre-operative examinations and reduce morbidity and mortality with the predictive data obtained.\n\nMaterials and MethodsIn the preoperative period, the followings were measured in patients who will undergo cholecystectomy: C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), WBC, Neutrophil ratio (NR), erythrocyte distribution range (RDW), aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP), gamma glutamyl transferase (GGT), total bilirubin (TB), direct bilirubin (DB). Following the preoperative ultrasound (USG), the patients were recorded in two groups as patients with \"normal\" and \"increased\" gallbladder wall thickness. Also, the patients were asked if they underwent ERCP and whether they received antibiotic treatment in the last 10 days due to their disease in the preoperative period. The appearance of the peroperative gallbladder was recorded in two groups as \"has a normal appearance\" or \"edematous and/or adherent to peripheral tissues\". Whether or not there is a correlation between the preoperative findings and peroperative appearance was evaluated. The recordings and analyzes were made using SPSS statistics program. Correlation between the data were analyzed by Chi-square test. p<0.05 was considered significant.\n\nResultsThe study achieved statistically significant results for the correlation between the \"gallbladder edema and/or adhesion to peripheral tissues\" in the peroperative period and the following five parameters: increased WBC, increased NR, increased gallbladder wall thickness at USG, compulsory ERCP and receipt of antibiotic treatment for the disease in the last 10 days.(p<0,05).\n\nConclusionTaking into consideration the presence, in the preoperative period, of some or all of the five criteria-namely, increased WBC, increased NR, increased gallbladder wall thickness at USG, receiving antibiotic treatment for the disease in the last 10 days and undergoing ERCP-in patients with cholelithiasis for whom cholecystectomy is envisaged would make it easier to estimate the degree of difficulty of the surgery and the possibility of encountering difficult and complicated cases.

BackgroundCarpal tunnel syndrome (CTS) is a chronic focal mono-neuropathy caused by mechanical distortion of the nerve at the carpal tunnel. It is thought to affect between 4 and 5 % of people worldwide, 50 per1000 persons in developed countries, 12.1% in east Africa and 29.2% Ethiopia. The common risk factors include but not limited to, age, sex, inflammatory conditions, pregnancy, diabetes mellitus, and hypertension. Despite this, carpal tunnel syndrome prevalence and its associated factors among patients with musculoskeletal complaints are unaddressed. ObjectivesThis studys aim was to assess the prevalence of carpal tunnel syndrome and its associated factors among patients with musculoskeletal complaints in Dire Dawa, Eastern Ethiopia. MethodologyAn institution-based cross-sectional study was conducted from June 1 to 30, 2022 at Dilchora referral hospital. 265 study participants were selected using the systematic sampling technique. Interviewing techniques and physical examination of the hands and wrists were used to get the data. Epi Data version 3.1 was used to enter, clean up, and edit the data before exporting it for analysis to SPSS version 23.0 software. Bivariable and multivariable logistic regression were carried out with a 95% confidence interval to identify the association of independent and dependent variables. A P-value of 0.05 was considered statistically significant. ResultA total of 260 respondents were included in this study. The prevalence of clinically proven carpal tunnel syndrome among study participants was 10.8%, with a 95 % CI of (6.99 to 14.6). A multivariable analysis found that being female (AOR: 3.26 (95% CI: 1.05, 10.08), being physically inactive (AOR: 6.32 (95% CI: 1.95, 20.52), diabetes mellitus (AOR: 4.23 (95% CI: 1.47, 11.97)), hypertension (AOR: 6.07 (95% CI: 1.70, 21.65)), hand ratio [&le;]2.1 (AOR: 7.31(95% CI: 1.80, 29.66)), and wrist ratio [&ge;] 0.72 (AOR: 5.94 (95% CI: 2.11, 16.72)) were statistically associated factors of carpal tunnel syndrome. But, BMI were not statistically associated with CTS. ConclusionThe prevalence of carpal tunnel syndrome among patients with musculoskeletal compliant was 10.8%. Several risk factors for CTS have been identified.

Osteoporosis, amenorrhea, and low energy with or without disordered eating (the female athlete triad) are frequent clinical outcomes associated with female athletes in constant low energy availability (LEA). The rigorous training demands of the Army and the strict weight limits suggest that female service members may be susceptible to states of LEA, where energy expenditure exceeds dietary energy intake. To understand the prevalence of the female athlete triad among female service members and how restrictive weight requirements influence these symptoms, we compared survey responses measuring symptoms of the female athlete triad between female active-duty service members and female veterans. The results indicated that female veterans had significantly higher female athlete triad and disordered eating scores. Therefore, female veterans are more likely to demonstrate female athlete triad symptoms than active-duty service members. Specifically, female veterans are more likely to demonstrate symptoms of low energy with or without disordered eating. Female veterans unique stressors of no longer being in the military (reintegration into society and losing support system within the military) could be why they are more likely to present with female athlete triad symptoms than active-duty female service members.

Diabetic foot infection (DFI) is a prevalent and severe complication of diabetes mellitus, often leading to lower extremity amputations. This study uses electronic medical records from a tertiary care hospital in Central Malaysia to investigate the predictive factors associated with the type of amputation (major vs minor) in patients with DFI, once the amputation is decided. Methods: This retrospective cohort study analysed data from 434 patients admitted with DFI between January 2010 and December 2019. The information extracted from medical records included demographics, clinical characteristics (inflammatory markers and clinical complications), and amputation details. Binary logistic regression was performed to identify significant major vs minor predictors of amputation. Results: Most amputations were minor (70.7%), with Wagner grade 4 being the most common presentation. Elderly patients and higher Wagner scores are predictors of major (vs minor) amputation. Conclusion: This study underscores the critical role of age and Wagner classification for risk of major (vs minor) amputation among DFI patients. Identifying these underlying risk factors is crucial for developing targeted interventions, improving patient outcomes, and enhancing the quality of care for DFI patients.

ObjectivesTo determine knowledge and acceptance of authorship criteria among residents, PhD scholars and faculty involved in medical research in India. DesignA cross sectional survey was performed via Google forms (a web based platform). ResultsA total of 117 participants responded to the survey, of whom 66 (56%) were faculty/professors, 23 (20%) residents and 28 (24%) PhD scholars. 33% respondents had faced conflicts with their guide, 58% respondents have offered honorary authorship sometime in their careers. Only half of the respondents were aware of the ICMJE guidelines for authorship. ConclusionsGift Authorship and pressure to publish are largely prevalent in bio medical research in India. Journals requiring author-contribution declarations, overlooking the number of publications as the sole source of offering academic promotions among others are possible solutions to curb this problem.

BackgroundRenal cell carcinoma (RCC) comprises cancer originating from the renal epithelium and takes up for >90% of cancers in the kidney. The disease consists of >10 histological and molecular subtypes, of which clear cell RCC (ccRCC) is the most common and is responsible for most cancer-related deaths. In an attempt to ensure an early diagnosis to plan the further course of surgical intervention, pre-operative diagnosis plays an important role. MRI plays a crucial role in the diagnosis of RCC and planning for surgery for presumed RCC, especially for identifying enhanced soft tissue within renal lesions. The purpose of this meta-analysis is to ascertain the accuracy of MRI in diagnosing papillary renal cell carcinoma (pRCC) compared to clear cell carcinoma to reach a definitive diagnosis and thus, help in surgical intervention. MethodsMedical literature was comprehensively searched and reviewed without restrictions to particular study designs, or publication dates using PubMed, Cochrane Library, and Google Scholar databases for all relevant literature. The extraction of necessary data proceeded after specific inclusion and exclusion criteria were applied. In this Meta-Analysis, a total of 5 papers involving 755 lesions were considered for Clear cell carcinoma. A total number of 13 papers regarding 1009 lesions of papillary renal cell carcinoma were considered. wherein two writers independently assessed the caliber of each study as well as the use of the Cochrane tool for bias risk apprehension. The statistical software packages RevMan (Review Manager, version 5.3), SPSS (Statistical Package for the Social Sciences, version 20), and Excel in Stata 14 were used to perform the statistical analyses. ResultsWe calculated the sensitivity and specificity of MRI in diagnosing pRCC and ccRCC in the different papers, For the MRI in ccRCC, The sensitivity is 0.81 with a CI of 95% in a range of 0.77 to 0.86, the mean being 0.049. The Specificity of the MRI is 0.77 with a CI of 95% in a range of 0.68 to 0.86, the mean being 0.091. For the pRCC, The Sensitivity of the MRI in pRCC is 0.66 with a CI of 95% in a range of 0.52 to 0.80; the mean being (0.14). The Specificity of the MRI in pRCC is 0.87 with a CI of 95% in a range of 0.80 to 0.94, the mean being 0.072. ConclusionMagnetic resonance imaging (MRI) offers a thorough evaluation of renal masses that takes in to account both, functional factors and several types of tissue contrast. In light of the above mentioned clinical requirements, these characteristics of MRI have sped up the process of early detection, diagnosis, staging, and evaluation of the aggressiveness and therapeutic r esponse of RCC