Articles

Purpose: Sacroiliac joints (SIJ) inflammation and pain is particularly common in patients with Spondyloarthritis. Intraarticular SIJs injections represent a valuable therapeutic option in this condition. In the rheumatological outpatient clinics this procedure is usually done by landmark guidance (LG) or ultrasound guidance (USG). Thus we aimed to compare the short term efficacy of USG vs. LG SIJ injections using five outcome measures: 1. Pain; 2. SIJ status (number of positive provocation tests per symptomatic SIJ on physical examination); 3. Disability; 4. Quality of the night sleep; 5. Patients’ satisfaction. Methods: We enrolled 44 consecutive spondyloarthritis patients with pain in the SIJs that did not respond to NSAIDS and that were otherwise on a stable medical treatment. All patients also had ≥ 3 positive pain provocation tests per SIJ on physical examination. Patients were randomly allocated to receive a single SIJ injection with 7 mg Betamethasone (1 ml) and 1% Lidocaine (1.5 ml) either under USG or with LG. Results: Both groups showed significant improvement in all outcome parameters. However, the USG approach performed significantly better than the LG ones in all parameters. In addition, there was a significant correlation between the improvement in all patient reported outcomes (VAS, RMDQ, JSEQ) and the reduction in the number of positive SIJ pain provocation tests per symptomatic joint. Conclusion: Both USG and LG SIJ injections proved to be an efficient treatment for SIJ pain in SpA patients. However, USG of the intervention led to statistically better results in the present study.

This work aims to evaluate cortical porosity through a high-resolution peripheral quantitative micro-tomography in a group of 47 patients. All patients, in vivo, were subjected to the medical care protocol of the University Hospital Clementino Fraga, 020-213. Patients were women aged from 37 to 82 years old, who did not present fractures in their lower and upper limbs, all of them showing good health. During screening, they were required to have normal BMD (as determined by DXA; T-score ≥ 1.0) and no low-trauma fractures history. The exclusion criteria for all the individuals enrolled in this control study include, for example, alcoholism, chronic drug use, and chronic gastrointestinal disease. Male patients ranging from 42 to 79 years old presented the same health issues as women group. Results showed an increase in the amount of pores on the cortical bone of the evaluated patients over time; however, this increase was also observed in pore diameter, as well as a decrease in the border between the cortical and trabecular bone, indicating a deterioration in cortical bone quality over the years.

Background: Corona virus disease is a highly infectious disease caused by the newly innovated corona virus. An emerging respiratory disease was abbreviated as COVID-19, after it has been first reported in December 2019 in Wuhan city of China. Ethiopia Ministry of health initiated multidisciplinary approach to tackle COVID-19 of which awareness creation is the main. The aim of this study is to assess knowledge, practice and associated factors towards prevention of novel corona virus among clients in Debre Tabor general hospital, Northwest Ethiopia, 2020. Methods: Institution based cross sectional study design was conducted in Debre Tabor General hospital from May 15 to May 30, 2020. A structured questionnaire was used for data collection. The data were entered into epi data version 4.4 and exported to SPSS window version 25 for analysis. Binary and multivariable logistic regression was fitted. Odds Ratios with 95% Confidence interval and p - value ≤ 0.05 were considered to assert significance. Result: A total of 345 clients were analyzed and the response rate was 96.4%. The mean age was 32.95 with S.D ± 13.18 years. Majority of the respondents were male (75.7%). Among the study participants 54.2% with (95% CI: [49.0, 59.2%]) and 49.0% with (95% CI: [43.5, 53.4%]) have good knowledge and god practice on COVID-19 preventions respectively. Sex AOR: 4.33 (2.06, 9.09), family size AOR: 2.49 (1.01, 6.15 and heard from social media AOR: 2.78 (1.21, 6.39) were significantly associated with knowledge of respondents. Knowledge AOR: 3.11 (1.59, 6.10) was significantly associated with practice of clients. Residency and those heard from TV were significant variables for both. Conclusion and recommendation: In this study the overall knowledge and preventive practices of the respondents were found to be low. Sex, family size, residency and sources of information were associated factors for knowledge. In addition to this knowledge was significant factor for practice. Health education programs aimed at mobilizing and improving COVID-19 related knowledge and practice intend to be strengthened.

Osteoarthritis is the most common form of arthritis, affecting millions of people worldwide. Aim of our study was to assess the clinical and the cytogenetic characteristics in longlivers with osteoarthritis from Precarpathian region (Ukraine). Methods: Cytogenetic, Clinical Results: All of the subjects were separated into three groups: І group - 146 longlivers patients who had hypertension and osteoarthritis (ОА); II group - 93 longlivers patients only with ОА. The control (third) group included 130 patients aged 90-102 years without osteoarthritis and hypertension in anamnesis. In the age group more than 95 years, men and women of both groups were significant difference (p<0,05) to be compared with control. Cytogenetic characteristics of the long-livers with on osteoarthritis showed that most there is a tendency for a higher frequency of chromosomal aberrations in male long-livers and tere are significant difference among control (p<0,05). The number of chromosomes associated in a single cell was significantly higher (p<0,05) in both groups compared to control. Conclusion: The importance of this study resides, to the best of our knowledge, in the fact that the largest group of patients in Ukraine was analyzed and assessed.

Physician-patient communication is the most basic element and vital skill of physicians in the diagnosis, treatment, and establishing diagnostic protocols. As the risks of contagion and viral infection are higher in physicians and health workers, front line soldiers inpatient care units, so they should establish strict protective measures. However, patients value greatly face to face and close relationships with their doctors, including facial interviews and physical examinations. So social and physical distancing between physician and their patients can be remarked as a bigger toll than the risk of COVID-19 contagious.

This opinion paper provides a summary of the current reconstructive surgical techniques for the scapholunate interosseous ligament (SLIL) and critically highlights their benefits and shortcomings. Due to limited success with direct repair of the ligament, current practice focuses on achieving biomechanical stabilization and does not allow for tissue regeneration to occur. In addition, the biomechanical behaviour of the ligament is still poorly described and understood, resulting in a very large variation in published mechanical parameters. Therefore, a thorough understanding of the biomechanics of the joint, via both experimental testing and numerical modelling is necessary for enabling the design of the next generation of implants in order to address mechanical stabilisation and regeneration.

Background: The Islamic religion has emphasized the importance of health and well-being, and Muslims have recognized the value of a good and healthy life based on Islamic recommendations. Health-oriented lifestyle is a multi-dimensional phenomenon that is the purpose of this study to investigate the Islamic lifestyle. Methods: In this review study, we tried to explore practical strategies in Islam through access to credible sources in the form of a descriptive article on achieving a healthy lifestyle in nutrition. For this purpose, using keywords and electronic and manual searches in authentic Islamic and medical sources, information was searched and collected to answer the research question. Results: Based on the results of the reviewed studies, the guidelines of Islamic religion and beliefs are mainly based on improving lifestyle factors and dietary habits. It has been emphasized that adherence to the Islamic dietary guidelines and lifestyle, may lead to less risk of diseases. Conclusion: Given the availability of valuable nutritional resources and instructions in Islam to prevent and combat nutrition-related diseases, these theories can be applied and prevent from spreading and creating malnutrition-related diseases; the guidelines of Islam on healthy lifestyles in nutrition can be recommended to the world as a basic strategy

A 34-year-old male patient presented with the complaint of chronic pain in the left groin following left side testicular vein ligation for varicocele. Ilio-inguinal neurectomy and cremaster muscle division was done in another hospital for the pain but with no relief of pain. Patient on examination showed point tenderness in the left groin at the pubic tubercle. Finger Invagination test in the left was painful with severe tenderness. Investigation showed fibrosed contracted left distal inguinal ligament. Percutaneous Ultrasonographic (USG) guided inguinal ligament release and Platelet-Rich Plasma (PRP) injection relieved the pain completely. Post-procedure patient showed significant improvement of pain.

Purpose: The purpose of the study was to examine the health status of rural adolescents and young adults in the United States through a comprehensive review of detailed health information, behavior and health awareness. The disparity in health awareness between rural and non-rural residents compared and evaluated. Methods: Rural-Urban Commuting Area (RUCA) codes were combined with respondent-level data from the Longitudinal Survey of Adolescent to Adult Health (Add Health) to classify individuals as rural/non-rural residents. Health characteristics and perceived health awareness was tested for statistically significant differences using ANOVA. Differences in weight perception accuracy was compared for systematic differences controlling for self-selection into rural areas using a two-stage logistic selection model. Findings: Analysis revealed that rural residents have a higher incidence of major health conditions including epilepsy, high cholesterol, high blood pressure and diabetes. Additionally, they have a higher prevalence of unhealthy behaviors including drinking and drug use. Rural residents are less likely to be insured, but more likely to be overweight or obese. While rural adolescents are more likely to mis-classify their body weight, this misclassification is a result of the higher incidence of overweight rather than the residential location. Conclusion: The higher prevalence of chronic conditions combined with the income and education levels suggests the rural environment is a unique and potentially challenging context for adolescent health. Improving rural adolescent health will require innovative solutions appropriate for rural environments and changes in individual health literacy. Solutions must be multisectoral, engaging education, economic development, and other community perspectives to establish key drivers for health equity.

The Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome is the most severe form of congenital malformation of the inner female reproductive tract. It is diagnosed as such when the uterus, the upper vagina and optionally the Fallopian tubes are absent. It accounts for approximately 1 in 5000 live-born females and has been classified in two subtypes: type 1 in the presence of isolated uterovaginal aplasia and type 2 when associated in various combinations with extragenital malformations of the kidneys, skeleton, heart and auditory system. Most cases of MRKH syndrome are sporadic, although a significant number of many familial cases have been reported to date. Despite numerous studies, the genetics of the syndrome remains largely unknown and appears to be heterogeneous: chromosomal abnormalities and some candidate gene variants appear to be associated with a few cases; others have been suggested but not yet confirmed. To date, mainly the GREB1L gene appears to be a serious candidate. Among the remaining hypotheses, the controversial contribution of partial duplications of the SHOX gene is still puzzling, as the deficiency of this gene is a major cause of skeletal adysplasia syndromes. We have attempted to resolve this controversy in a study of 60 MRKH cases. Our results tend to show that SHOX duplications can be the origin of a genetic mechanism responsible for MRKH syndrome.