Nevin Manimala

Arthrosc Sports Med Rehabil. 2024 Sep 27;7(1):101014. doi: 10.1016/j.asmr.2024.101014. eCollection 2025 Feb.

ABSTRACT

PURPOSE: To analyze the etiology, diagnosis, and incidence of head and neck (HN) injuries among ocean surfers.

METHODS: The National Electronic Injury Surveillance System database was queried for surfing HN injuries presenting to United States emergency departments (EDs) between January 2003 and December 2022. Date of presentation, age, sex, race, injured body part, injury diagnosis, and disposition, as well as a brief injury narrative, were included in the data. National estimates (NEs) were calculated using the associated statistical weight of the reporting hospital.

RESULTS: A total of 1,359 surfing-related HN injuries (NE, 90,872) were included in this study. The average age at presentation was 29.2 ± 13.8 years (range, 3 to 81 years). The most commonly specified mechanisms of injury were impact with board (NE, 48,360 [53%]) and impact with ocean floor (NE, 8,690 [10%]). Concussions represented 5% of surfing HN injuries and occurred at a higher rate (8%) in the age group younger than 20 years. There were statistically significant decreases in overall HN injuries (P < .01) (coefficient, -270; 95% confidence interval [CI], -355 to -206), lacerations (P < .01) (coefficient, -208; 95% CI, -258 to -158), and impact-with-board injuries (P < .01) (coefficient, -177; 95% CI, -327 to -117) presenting to United States EDs from 2003 to 2022.

CONCLUSIONS: Although surfing HN injury ED presentations decreased from 2003 to 2022, the rate of surfing-related concussions presenting to EDs remained steady. Concussions therefore remain a significant concern in surfing, especially among surfers under 20 years of age.

CLINICAL RELEVANCE: As the sport of surfing has increased in popularity, it is important to understand the range of surfing injuries seen in EDs. HN injuries, especially concussions, should be thoroughly investigated to better understand the risks of ocean surfing, to advise athletes, and to develop effective injury prevention strategies.

PMID:40041821 | PMC:PMC11873521 | DOI:10.1016/j.asmr.2024.101014

Arthrosc Sports Med Rehabil. 2024 Sep 26;7(1):101010. doi: 10.1016/j.asmr.2024.101010. eCollection 2025 Feb.

ABSTRACT

PURPOSE: To examine a method to visualize a 3-dimensional (3D) rendered distal femur using 3D curvature analysis and to compare models of patellofemoral instability (PFI) with controls to study the reliability of the entry point to trochlear groove angle (EPTG) metric.

METHODS: The 3D models of patients with recurrent patellar instability, defined by at least 2 reported patellar dislocation events, and age- and sex-matched controls were created from computed tomography scans. Curvature was calculated to highlight the proximal trochlear ridges and the trochlear groove by overlaying them on the 3D models. Anteroposterior views with and without curvature visualization were created and used for qualitative comparison and to measure the EPTG. The EPTG was measured by 2 raters with and without the aid of the curvature maps. Significant differences between patients with PFI and controls were compared with a Mann-Whitney U test. Inter-rater reliability was calculated using interclass correlation coefficients, classified according to literature and compared using a permutation test. Significance was assumed at .05.

RESULTS: Qualitive analysis between 30 PFI patient knees (age: 23.9 ± 8.4 years, female/male: 24/6) and 30 control knees (age: 21.8 ± 5.6 years, female/male: 22/8) showed that in general, patients with PFI have a lateralized medial ridge and trochlear groove, with the trochlear groove being shorter and shallower. Qualitatively, differences between patients with PFI and controls were significant for measurements both with and without the aid of the curvature maps. Inter-rater reliability was significantly (P = .0349) better when using the curvature visualization.

CONCLUSIONS: Curvature-based visualization aids overlain on a 3D model have the power to increase the information gained from 3D imaging and corresponding 3D models, amplifying their potential value in clinical decision-making. Such visualizations facilitate both the identification of qualitative differences between patient and control morphology and improve the reliability of the EPTG trochlear dysplasia metric.

LEVEL OF EVIDENCE: Level III, retrospective cohort study.

PMID:40041820 | PMC:PMC11873473 | DOI:10.1016/j.asmr.2024.101010

Arthrosc Sports Med Rehabil. 2024 Oct 15;7(1):101008. doi: 10.1016/j.asmr.2024.101008. eCollection 2025 Feb.

ABSTRACT

PURPOSE: To investigate the changes in minimum joint space width (mJSW) caused by superficial medial collateral ligament (sMCL) transection during open-wedge high tibial osteotomy (OWHTO).

METHODS: This study included consecutive patients with a diagnosis of medial unicompartmental knee osteoarthritis who were scheduled for OWHTO between September 2020 and August 2022. Intraoperative fluoroscopic evaluations of mJSW were performed under neutral, valgus stress, and varus stress positions in knee extension and 20° of flexion before sMCL transection, after transection, and after plate fixation. Changes in mJSW and increases in valgus stress were calculated and compared using analysis of variance. Linear regression analysis was performed to investigate the related factors for increased mJSW after transection.

RESULTS: We included 44 knees in 43 patients in the final statistical analysis. The maximum mJSW occurred during valgus stress after sMCL transection at 20° of flexion and returned to baseline after plate fixation. Under the valgus stress condition, mean mJSW before transection was 5.1 ± 0.9 mm in extension and 5.5 ± 1.1 mm at 20° of flexion. It increased significantly after transection to 7.8 ± 1.4 mm (P < .001) and 9.2 ± 2.1 mm (P < .001), respectively. Regression analysis showed that increased mJSW after transection in extension positively correlated with the knee extension angle (P = .032). Overall, mJSW increased with sMCL transection regardless of the preoperative condition.

CONCLUSIONS: Transection of the sMCL in OWHTO effectively enlarged the mJSW to 9.2 mm, which was 3.8 mm greater than that before transection, facilitating medial meniscal procedures. After plate fixation, the mJSW returned to pre-transection levels.

LEVEL OF EVIDENCE: Level Ⅳ, therapeutic case series.

PMID:40041818 | PMC:PMC11873491 | DOI:10.1016/j.asmr.2024.101008

J Orthop. 2025 Feb 7;68:96-104. doi: 10.1016/j.jor.2025.01.039. eCollection 2025 Oct.

ABSTRACT

PURPOSE: Computer-assisted technology offers better component alignment and surgical precision than conventional TKA. However, whether robotic-assisted total knee arthroplasty (RA-TKA) shows clear benefits over navigation-assisted total knee arthroplasty (NA-TKA) is still contentious. Therefore, we aimed to perform a meta-analysis exploring the accuracy and safety of RA-TKA compared to NA-TKA in patients with knee osteoarthritis.

METHODS: We systematically searched PubMed, Scopus, Web of Science, and Cochrane Library for studies comparing RA-TKA with NA-TKA. We assessed radiological alignment outliers, polyethylene (PE) insert thickness, surgical time, and safety outcomes. Statistical analyses were performed using RevMan Web. Odds ratios (ORs) and mean differences (MDs) with 95 % confidence intervals (CIs) were pooled for dichotomous and continuous endpoints, respectively. A random-effects model was used due to anticipated heterogeneity and measured with the I² test.

RESULTS: We included 19,209 patients from sixteen studies, of whom 3764 (19.6 %) were assigned to the RA-TKA. We found no statistically significant difference between RA-TKA and NA-TKA in terms of hip-knee-ankle angle outliers (OR 0.91; 95 % CI 0.56 to 1.48; p = 0.71; I² = 25 %), femoral coronal angle outliers (OR 0.46; 95 % CI 0.16 to 1.38; p = 0.17; I² = 60 %), tibial coronal angle outliers (OR 0.51; 95 % CI 0.13 to 2.08; p = 0.09; I² = 58 %), periprosthetic joint infection (OR 0.76; 95 % CI 0.27 to 2.15; p = 0.61; I² = 0 %), and length of stay MD -0.17 days; 95 % CI -1.08 to 0.74; p = 0.72; I² = 98 %). RA-TKA used 1.03 mm thinner PE inserts compared with NA-TKA (MD -1.03 mm; 95 % CI -1.60 to -0.46; p = 0.71; I² = 98 %), whereas surgical time was 9.87 min shorter with NA-TKA (MD 9.87 min; 95 % CI 0.62 to 19.11; p = 0.04; I² = 99 %).

CONCLUSIONS: RA-TKA and NA-TKA had comparable radiological alignment. While RA-TKA allows for thinner polyethylene inserts, it requires longer surgical time than NA-TKA. These findings suggest that both techniques are adequate, with specific differences that may influence surgical decision-making.

PMID:40041811 | PMC:PMC11875737 | DOI:10.1016/j.jor.2025.01.039

J Parasitol Res. 2025 Feb 25;2025:4950793. doi: 10.1155/japr/4950793. eCollection 2025.

ABSTRACT

Background: Malaria is a deadly vector-borne parasitic disease spread by the bite of an infective female Anopheles mosquito. In routine malaria diagnosis, microscopic examination is generally regarded as the gold standard. Our study sought to evaluate the diagnostic precision of two commercially accessible quantitative PCR (qPCR) kits, in contrast to light microscopy and nested multiplex PCR (NM-PCR). Methods: This cross-sectional study in southwest Saudi Arabia included 92 febrile patients meeting the inclusion criteria. Detection of Plasmodium species used light microscopy, NM-PCR, and qPCR kits (RealStar and Viasure). Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and receiver operating characteristic (ROC) curves were calculated. Statistical analysis was performed using SPSS v25, with significance set at p ≤ 0.05. Results: Light microscopy detected 92.4% of cases, NM-PCR detected 73.9%, and RealStar and Viasure detected 92.4% and 95.7%, respectively. Viasure showed the highest sensitivity (97.6%) and NPV (50%), while NM-PCR had superior specificity (71.4%). For species identification, Plasmodium falciparum detection was highest with RealStar (85%). Mixed infections were better identified by Viasure (34.6%). RealStar excelled in Plasmodium vivax detection (area under the curve [AUC] = 90%). qPCR detected low parasitemia levels missed by microscopy. Conclusions: The qPCR kits, particularly Viasure, demonstrated superior sensitivity for detecting Plasmodium species and identifying mixed infections compared to light microscopy and NM-PCR. While light microscopy showed higher specificity and PPV, qPCR effectively detected low parasitemia levels missed by microscopy, highlighting its value in improving malaria diagnostics.

PMID:40041801 | PMC:PMC11879595 | DOI:10.1155/japr/4950793

J Parasitol Res. 2025 Feb 24;2025:1655679. doi: 10.1155/japr/1655679. eCollection 2025.

ABSTRACT

Cystic echinococcosis (CE) is a neglected parasitic infection with a particular impact in humans and livestock. The current investigation was undertaken to design and evaluate a DNA vaccine encoding Echinococcus granulosus Eg95-1 to EG95-6, P29, and GST against hydatid cyst infection in BALB/c mice. Initially, B-cell, cytotoxic T-lymphocyte, and helper T-lymphocyte epitopes were forecasted using B-cell epitope prediction server (BCPREDS) and Immune Epitope Database (IEDB) server, respectively, and a vaccine construct incorporating multiple epitopes was rationally designed and comprehensively analyzed through in silico modeling and simulation studies. Next, Escherichia coli TOP10 was transformed by the recombinant pcDNA 3.1 plasmid and mass production, followed by plasmid extraction, was done. The BALB/c mouse immunization was done with 50 and 100 μg concentrations of plasmid combined with IL-12 adjuvant or alone. Mouse sera and splenic lymphocytes were used for the measurement of specific humoral and cellular responses. The candidate vaccine model weighed 37.49 kDa with 338 residues antigenic, while nonallergenic, soluble, stable, highly thermotolerant, and hydrophilic in nature. Expression in HEK-293 cells was successfully achieved, as evidenced by the detection of a 37 kDa protein band in the western blot analysis. Vaccine doses, especially the 100 μg concentration, alone or in combination with an adjuvant, induced a T-helper 1 (Th1)-type immune response. This was evidenced by higher levels of IgG2a antibody and interferon gamma (IFN-γ) along with lower levels of interleukin 4 (IL-4). Although the groups that received the 50-μg dose of vaccine alone or with adjuvant showed a lower immune response, overall, the vaccinated groups showed statistically significant differences compared to the control groups (phosphate-buffered saline (PBS) and pcDNA). The promising results of this vaccine candidate can be further examined using challenges with various parasite genotypes.

PMID:40041800 | PMC:PMC11876539 | DOI:10.1155/japr/1655679

Health Sci Rep. 2025 Mar 2;8(3):e70500. doi: 10.1002/hsr2.70500. eCollection 2025 Mar.

ABSTRACT

BACKGROUND AND AIMS: The study’s goal was to assess the global prevalence of HIV/AIDS infection in transgender people and to provide light on regional variances.

METHODS: A systematic search was conducted across multiple databases, including PubMed (Medline), Scopus, Web of Science, Embase, Ovid, and PsycINFO, from inception until September 2023. Studies were selected based on predefined inclusion and exclusion criteria, and quality was assessed using the Newcastle-Ottawa Scale (NOS). Heterogeneity was evaluated using Cochran’s Q and I-squared statistics. A meta-analysis was performed using the random-effects model in Stata 17.0 (StataCorp, Texas, USA). A total of 3125 articles were identified, of which 37 studies met the inclusion criteria and were included in the systematic review and meta-analysis.

RESULTS: The global prevalence of HIV/AIDS among transgender populations was 24% (CI: 12%-39%). Regional analysis revealed higher rates of HIV/AIDS among male-to-female (MTF) transgender individuals in Asia (30%, CI: 5%-54%) and Africa (35%, CI: 13%-57%) compared to other regions. In contrast, female-to-male (FTM) transgender individuals in Asia had a higher prevalence (23%, CI: 9%-31%) than those in the Americas (11%, CI: 3%-23%).

CONCLUSION: Given the high prevalence of HIV/AIDS in the TG community worldwide and the significant variance within communities, it is critical to execute a comprehensive set of interventions to successfully prevent HIV/AIDS in transgender people.

PMID:40041791 | PMC:PMC11872686 | DOI:10.1002/hsr2.70500

BMC Oral Health. 2025 Mar 4;25(1):332. doi: 10.1186/s12903-025-05600-7.

ABSTRACT

BACKGROUND: For more than 80% of patients with head and neck cancer, radiation therapy (RT) is a crucial component of their treatment plane which causes impairment for the masticatory apparatus functions leading to trismus. The study objective was to compare the efficacy of different treatment modalities for patients with RT-induced trismus on maximum mouth opening (MMO), visual analogue scale (VAS) (primary outcomes) patient satisfaction (secondary outcome).

METHODS: Thirty-six patients with trismus after radiation therapy were classified equally and randomly into three groups (n = 12 per group): Group A was given threaded tapered screw appliance therapy (TTSA), Group B was given low-level laser therapy (LLLT), and Group C was given both threaded tapered screw appliance and low-level laser therapy (LLLT + TTSA). Maximum mouth opening (MMO), visual analogue scale (VAS) and Gothenburg Trismus Questionnaire (GTQ) scores and time required to achieve normal state were evaluated at baseline, 1, 2, 4 weeks, 3 and 6 months after the intervention. Data were collected and analysed using SPSS software.

RESULTS: Regarding VAS and MMO, there was a statistically significant difference at different times of evaluation within all groups where (P <.0001). Regarding GTQ, group C recorded the least values for GTQ symptoms followed by group B followed by group A. Between groups A, B, and C at six months, there was a statistically significant difference for VAS. At three and six months, there was a statistically significant difference between all groups for MMO. At three and six months, there was a statistically significant difference between groups for all GTQ domains.

CONCLUSION: All available therapy modalities have the potential to effectively improve radiation induced trismus; however, the combination of TTSA and LLLT group appears to yield the most rapid and optimal enhancement.

CLINICAL TRIAL REGISTRY NUMBER: (NCT06413628) (05/12/2024) Retrospectively registered.

PMID:40038715 | DOI:10.1186/s12903-025-05600-7

BMC Oral Health. 2025 Mar 4;25(1):334. doi: 10.1186/s12903-025-05670-7.

ABSTRACT

BACKGROUND: To assess the effectiveness of low-dose amitriptyline in reducing pain and improving oral health-related quality of life in individuals with chronic temporomandibular disorders (TMD) over a 2-month period, compared to placebo.

METHODS: Forty participants were randomly assigned to receive either 25 mg of amitriptyline or a placebo pill for 2 months. The primary outcome was pain intensity, measured using a visual analogue scale (VAS). The secondary outcome was the impact of pain on oral health-related quality of life, assessed by the Oral Health Impact Profile questionnaire (OHIP-14). Evaluations were conducted at baseline and after the 1st and 2nd months of treatment.

RESULTS: No statistically significant differences were observed between the treatment groups at baseline (p > 0.05). After 2 months of treatment participants in amitriptyline group experienced a significantly greater reduction in spontaneous pain, with a 63.3% decrease in VAS scores. Participants in placebo group showed a much smaller reduction in spontaneous pain, with only a 16.2% decrease in VAS scores. Additionally, the amitriptyline group demonstrated a significant improvement in OHIP-14 scores (p < 0.001), whereas the placebo group showed no significant change in oral health-related quality of life (p = 0.184).

CONCLUSION: This study highlights low-dose amitriptyline as an effective treatment for chronic TMD, showing significant pain reduction and improved quality of life, underscoring its value in a multimodal approach despite the need for further research to personalize care.

TRIAL REGISTRATION: This study was registered retrospectively in ISRCTNregistry under the number ISRCTN17622685, on 01/10/2024.

PMID:40038711 | DOI:10.1186/s12903-025-05670-7

BMC Health Serv Res. 2025 Mar 4;25(1):336. doi: 10.1186/s12913-025-12348-x.

ABSTRACT

BACKGROUND: Infertility affects more than 50 million couples worldwide, resulting in a significant burden on individuals and society. Its prevalence ranges from 8-12% among developed countries. The growing number of patients poses an increasing challenge to the healthcare system and its funding. Our quantitative, descriptive, and cross-sectional study aimed to analyze the prevalence and annual nationwide health insurance treatment cost of female infertility in Hungary in 2019.

METHODS: We used claims data obtained from the Hungarian National Health Insurance Fund Administration (NHFIA). The number of patients, total and age-specific prevalence, annual health insurance expenditure, and the distribution of costs by age group were evaluated. Infertility was determined according to the World Health Organization International Classification of Diseases codes (N.97.0, N97.1, N97.2, N97.3, N97.4, N97.8, and N97.9) and the utilization of each healthcare service type. During the study descriptive statistics, correlation analysis and t-test were used.

RESULTS: In 2019, the NHIFA spent a total of 7.2 billion HUF (22.2 million EUR) on female infertility treatment in Hungary (33,151 women in outpatient care). The most significant costs were related to inpatient care (4.1 billion HUF, 12.7 million EUR). The highest number of patients and prevalence (650.4 per 100,000 women) were found in outpatient care. In inpatient care, the prevalence is substantially lower (206.7 per 100,000 women). Regardless of its type, female infertility mainly affects patients in the 30-39 years age group (number of patients: 18,156 women). The average annual health insurance expenditure per capita was 1,083 EUR.

CONCLUSIONS: Reproductive health education, prevention, and medical screening play inevitable roles in the early stages of reproductive life to reduce the risk of infertility and decrease treatment costs.

PMID:40038705 | DOI:10.1186/s12913-025-12348-x