Disc Changes Research Articles

Epidemiological and Clinical Aspects of Primary Open Angle Glaucoma in Fianarantsoa Madagascar

Introduction : Primary open-angle glaucoma (POAG) is a chronic, progressive, bilateral optic neuropathy corresponding to a loss of retinal ganglion cells and characterised by morphological changes in the optic disc associated with typical visual field damage. Methods : This was a prospective, cross-sectional, descriptive, monocentric study conducted over a 5-month period from September 2020 to February 2021 in the ophthalmology department of the university hospital of Tambohobe Fianarantsoa Madagascar. The purpose of this study was to evaluate the prevalence of primary open-angle glaucoma and to describe its epidemiological and clinical aspects. Results: The prevalence of primary open-angle glaucoma in our study was 21.25% with a female predominance of 68.63%. The mean age was 50 ± 15 years. The majority of patients (80.39% ) with POAG in our study had visual acuity greater than or equal to 20/63. 49 eyes or 48.94% of the 102 eyes had ocular hypertoni greater than 21 mm Hg. The Cup/Disc ratio greater than 0.5 was found in 99 eyes (97.06%). In our study, 61 of 102 eyes had a slightly altered visual field (59.80%), 30 eyes had a moderately altered visual field (29.41%) and 11 eyes had a severely altered visual field (10.78%). Conclusion : Primary open-angle glaucoma is a chronic progressive bilateral optic neuropathy corresponding to a loss of retinal ganglion cells and characterised by morphological changes in the optic disc associated with typical visual field damage. This pathalogy is very common in Fianarantsoa.

Planet formation around intermediate-mass stars

Context. The study of protoplanetary disc evolution and theories of planet formation has predominantly concentrated on solar- (and low-) mass stars since they host the majority of confirmed exoplanets. Nevertheless, the confirmation of numerous planets orbiting stars more massive than the Sun (up to ~3 M⊙) has sparked considerable interest in understanding the mechanisms involved in their formation, and thus in the evolution of their hosting protoplanetary discs. Aims. We aim to improve our knowledge of the evolution of the gaseous component of protoplanetary discs around intermediate-mass stars and to set the stage for future studies of planet formation around them. Methods. We study the long-term evolution of protoplanetary discs affected by viscous accretion and photoevaporation by X-ray and far-ultraviolet (FUV) photons from the central star around stars in the range of 1–3 M⊙, considering the effects of stellar evolution and solving the vertical structure equations of the disc. We explore the effect of different values of the viscosity parameter and the initial mass of the disc. Results. We find that the evolutionary pathway of protoplanetary disc dispersal due to photoevaporation depends on the stellar mass. Our simulations reveal four distinct evolutionary pathways for the gas component not reported before that are a consequence of stellar evolution and that likely have a substantial impact on the dust evolution, and thus on planet formation. As the stellar mass increases from one solar mass to ~1.5–2 M⊙, the evolution of the disc changes from the conventional inside-out clearing, in which X-ray photoevaporation generates inner holes, to a homogeneous disc evolution scenario where both inner and outer discs formed after a gap is opened by photoevaporation vanish over a similar timescale. As the stellar mass continues to increase, reaching ~2–3 M⊙, we identify a distinct pathway that we refer to as revenant disc evolution. In this scenario, the inner and outer discs reconnect after the gap opened. For the largest masses, we observe outside-in disc dispersal, in which the outer disc dissipates first due to a stronger FUV photoevaporation rate. Revenant disc evolution stands out as it is capable of extending the disc lifespan. Otherwise, the disc dispersal timescale decreases with increasing stellar mass except for low-viscosity discs.

Efficacy of Cervical Thoracic Spine Correction Exercise in Reducing Pain and Improving Neck Posture in People with Cervical Spondylitis

Background: The development of osteophytes and the involvement of adjacent soft tissue structures are the initialindications of degenerative changes in the intervertebral discs in cervical spondylitis. Forward head posture alsohas an effect on the muscles at the head and shoulders, which aggravates postural deformity.Purpose: The purpose is to determine Efficacy of cervical thoracic spine correction exercises in reducing pain andimproving neck posture in people with cervical spondylitis.Methods: This experimental study has been conducted from December 2022 to April 2023. Patients willing toparticipate in the study were screened for inclusion and exclusion criteria. The total number of subjects (30) weretaken from Sai charan physio clinic and they are divided into 15 subjects for the experimental group, they aregiven cervical thoracic spine correction exercises with ultrasound. The control group consisting of 15 subjects,are isometric exercises with ultrasound. NPRS and Neck disability index are used as outcome measures. Thetreatments were given for 5 days per week and continued for 2 weeks.Results: From statistical analysis made with the quantitative data revealed statistically significant differencesbetween the Group A and Group B, with the P value of <0.0001. Thus, the experimental group has higher statisticaldifferences than the conventional group.Conclusion: According to the findings of this study, Cervical thoracic spine correction exercises in the experimentalgroup were found to be more beneficial than isometric exercises in conventional groups in lowering pain andleading to faster recovery in participants with forward neck posture.

Numerical evaluation of acoustic emission (AE) sensors by lead-zirconate-titanate (PZT) geometric design

The effect of geometric variation of lead zirconate titanate (PZT) layers on the impedance performance of cylindrical acoustic emission (AE) sensors is investigated through numerical simulations. The finite element numerical models are developed with the use of the simulation program ANSYS and verified by comparing the impedance–frequency responses of the numerical simulations with those of the experiments. The effect of the dimensional changes of the individual PZT disk and ring on the impedance performance is investigated. We devise a total of 13 sensor designs consisting of a disk and either a ring or two rings with varying dimensions, and their impedance-based performances are quantitatively evaluated by counting the number of impedance resonant frequencies nr and average impedance at the resonant frequencies Zr,avg. As a result, it is discovered that the performance of the AE sensors is dominantly influenced by the total area of piezoelectric material At and the area ratio of the disk to ring Rdr. These two geometric indicators might be useful to enhance the performance of the AE sensors in various applications.

The relationship between structural changes in paraspinal muscles and intervertebral disc and facet joint degeneration in the lumbar spine of rats

BackgroundDegenerative spine disease is one of the largest causes of disability worldwide and has a multifactorial aetiology. Determining the leading causes of this multifactorial disease could help create new treatment approaches.PurposeStudy the impact of degenerative changes in the paraspinal muscles caused by local (prolonged compression) or systemic (high-fat diet) factors on the structure of the intervertebral discs (IVDs) and facet joints of the lumbar spine in rats.MethodsThe study was conducted using two animal models to create degenerative changes in the paraspinal muscles of 10 white laboratory rats for 90 days and five control rats: 1) high-fat diet model (model 1) involved keeping the rats on a high calorie diet; 2) compression model (model 2) involved binding the paraspinal muscles from L2 to S1 using non-absorbable sutures. Histological analysis for the facet joints and IVDs of rats (at the L1–L4 level) with semi-quantitative analysis of the structure conducted used by degeneration grading system for IVDs and cartilage degeneration score (OARSI) for facet joint.ResultsIn both models, 90 days after the experiment, the degenerative changes observed in the rats’ IVDs were more severe in the annulus fibrosus than in the nucleus pulposus. The height of the IVD in model 1 did not differ from the control group, but in the model 2 was 1.3 times greater (p < 0.001) compared with control. Degenerative changes in the IVD were scored out 5.3 ± 1.7 in model 1 and 5.32 ± 2.1 in model 2 of a possible 16. The height of the articular cartilage of the facet joints was smaller by 1.5 times (p < 0.001) and 1.4 times (p < 0.001) in model 1 and model 2, respectively, compared to the control. Degenerative changes of facet joint were scored out 3.7 ± 0.6 in model 1 and 3.8 ± 0.6 in model 2 of five points according to the cartilage degeneration score.ConclusionsIt was determined that rats who had structural changes in the lumbar paraspinal muscles as a result of being kept on a high-fat diet or subjected to prolonged compression for 90 days, showed degenerative changes in intervertebral discs and osteoarthritis in facet joints of lumbar spine.

Deep learning-based optic disc classification is affected by optic-disc tilt

We aimed to determine the effect of optic disc tilt on deep learning-based optic disc classification. A total of 2507 fundus photographs were acquired from 2236 eyes of 1809 subjects (mean age of 46 years; 53% men). Among all photographs, 1010 (40.3%) had tilted optic discs. Image annotation was performed to label pathologic changes of the optic disc (normal, glaucomatous optic disc changes, disc swelling, and disc pallor). Deep learning-based classification modeling was implemented to develop optic-disc appearance classification models with the photographs of all subjects and those with and without tilted optic discs. Regardless of deep learning algorithms, the classification models showed better overall performance when developed based on data from subjects with non-tilted discs (AUC, 0.988 ± 0.002, 0.991 ± 0.003, and 0.986 ± 0.003 for VGG16, VGG19, and DenseNet121, respectively) than when developed based on data with tilted discs (AUC, 0.924 ± 0.046, 0.928 ± 0.017, and 0.935 ± 0.008). In classification of each pathologic change, non-tilted disc models had better sensitivity and specificity than the tilted disc models. The optic disc appearance classification models developed based all-subject data demonstrated lower accuracy in patients with the appearance of tilted discs than in those with non-tilted discs. Our findings suggested the need to identify and adjust for the effect of optic disc tilt on the optic disc classification algorithm in future development.

Changes in Intervertebral Disc Properties after Intradiscal Injection of Condoliase for Painful Lumbar Disc Herniation.

The detailed changes in disc properties after intradiscal injection of condoliase remain controversial. At 3 and 9 months after administration, radiographic changes in discs were investigated. A total of 41 patients (men, 25; median age, 46 years) who underwent regular follow-up magnetic resonance imaging at 3 and 9 months after administration without additional invasive therapy were retrospectively investigated. The intensity changes of the nucleus pulposus based on the Pfirrmann disc grading system, midsagittal disc height, and maximum protrusion length of herniation were assessed. In addition, disc height changes were compared between 24 patients aged <50 years (young group) and 17 patients aged ≥50 years (over 50s group). The overall mean disc heights were 9.1, 7.5, and 7.6 mm preoperatively, at 3 months, and at 9 months, respectively, with a significant reduction at 3 months (P < 0.001) and no significant changes thereafter. The mean maximum protrusion length of herniation significantly and gradually decreased. The overall proportions of Pfirrmann disc grades after administration were equivalent between 3 and 9 months. However, the recovery from Pfirrmann disc grades IV to III was confirmed in 8 of 17 cases (47.1%) between 3 and 9 months, whereas 6 of 20 cases (30.0%) showed a decline from III to IV. Patients in the young group with pretreatment disc height >11 mm had the greatest reduction in disc height than the over 50s group. In conclusion, the clinical outcomes in the over 50s group were comparable to those in the young group after injection of condoliase, whereas young patients with higher disc were more susceptible to disc height reduction.

Glaucoma screening: How and why?

Purpose: To assess the results of glaucoma screening in the population over age 40.Methods: A population‐based glaucoma screening was performed at Habib Thameur Hospital, Tunis TUNISIA on March 12, 2023. Screening included intraocular pressure (IOP) measurement with Goldmann applanation tonometry, visual acuity measurement (VA) with the Snellen chart, fundus examination to detect characteristic optic disc changes, and questions regarding systemic diseases, family history of glaucoma, and current medications.Results: A total of 280 subjects were examined. Forty‐six had ocular hypertension, including 12 glaucomatous. All these patients were referred to the ophthalmology department for a complete ophthalmological examination, explorations (pachymetry, OCT of the optic nerve, visual field), treatment and regular follow‐up. Twenty‐two had unilateral or bilateral cataracts which we scheduled for surgery and fifteen had diabetic retinopathy at various stages which were referred to our specialist consultation for treatment.Conclusions: The need for effective and early detection and management of glaucoma may reduce the prevalence of glaucoma‐induced blindness.

Characterization of a unique attachment organelle: Single-cell force spectroscopy of Giardia duodenalis trophozoites.

The unicellular parasite Giardia duodenalis is the causative agent of giardiasis, a gastrointestinal disease with global spread. In its trophozoite form, G. duodenalis can adhere to the human intestinal epithelium and a variety of other, artificial surfaces. Its attachment is facilitated by a unique microtubule-based attachment organelle, the so-called ventral disc. The mechanical function of the ventral disc, however, is still debated. Earlier studies postulated that a dynamic negative pressure under the ventral disc, generated by persistently beating flagella, mediates the attachment. Later studies suggested a suction model based on structural changes of the ventral discs, substrate clutching or grasping, or unspecific contact forces. In this study, we aim to contribute to the understanding of G. duodenalis attachment by investigating detachment characteristics and determining adhesion forces of single trophozoites on a smooth glass surface (RMS = 1.1 ± 0.2 nm) by fluidic force microscopy (FluidFM)-based single-cell force spectroscopy (SCFS). Briefly, viable adherent trophozoites were approached with a FluidFM micropipette, immobilized to the micropipette aperture by negative pressure, and detached from the surface by micropipette retraction while retract force curves were recorded. These force curves displayed novel and so far undescribed characteristics for a microorganism, namely, gradual force increase on the pulled trophozoite, with localization of adhesion force shortly before cell detachment length. Respective adhesion forces reached 7.7 ± 4.2 nN at 1 μm s-1 pulling speed. Importantly, this unique force pattern was different from that of other eukaryotic cells such as Candida albicans or oral keratinocytes, considered for comparison in this study. The latter both displayed a force pattern with force peaks of different values or force plateaus (for keratinocytes) indicative of breakage of molecular bonds of cell-anchored classes of adhesion molecules or membrane components. Furthermore, the attachment mode of G. duodenalis trophozoites was mechanically resilient to tensile forces, when the pulling speeds were raised up to 10 μm s-1 and adhesion forces increased to 28.7 ± 10.5 nN. Taken together, comparative SCSF revealed novel and unique retract force curve characteristics for attached G. duodenalis, suggesting a ligand-independent suction mechanism, that differ from those of other well described eukaryotes.

Peripapillary and macular vessel density changes after trabeculectomy

Aims/Purpose: to evaluate peripapillary, optic disc and macular microvascular changes in glocomatous eyes after trabeculectomy using optical coherence tomography angiography (OCTA).Methods: 90 eyes of 52 patients with primary open angle (20%), pseudoexfoliative (71%) and angle closure glaucoma (9%), and were included. 24 eyes (Group 1) underwent trabeculectomy during the study, 34 eyes (Group 2) had previous trabeculectomy three years more ago and 37 eyes (Group 3) had no trabeculectomy trabeculectomy. The AngioVue OCTA (Optovue Inc., Fremont, CA, USA) was performed at baseline (within one week before trabeculectomy for Group 1), one week and one month following baseline examination. The main outcomes of interest were changes in the superficial and deep macular vessel density (VD) as well as whole image and inside optic disc.Results: The mean IOP at baseline was 25.3 ± 5.0 mmHg, 14.4 ± 3.7 mmHg and 14.7 ± 3.6 mmHg for the Group 1, Group 2 and Group 3 respectively. No significant differences in baseline characteristics were found between three groups, except for Group 3 group had milder glaucoma (it would be good to put the VF MD values of the groups). A reduction of IOP was observed in Group 1 one week and one month after trabeculectomy (14 ± 6.0 mmHg and 10 ± 6.2 mmHg respectively, p &lt; 0.001). There were no significant IOP changes in Group 2 and 3. In all groups the changes in macular vessel density were nonsignificant. In Group 1 the mean inside disc small vessel density increased one week postoperatively (p = 0.04) and peripapillary vessel density increased one month postoperatively(p = 0.03) when compared with the baseline values. There was no significant difference in mean peripapillary or macular vessel densities between groups.Conclusions: IOP reduction causes mild microvascular changes of optic disc and peripapillary regions in early postoperative period, however, does not affect macula.

In vitro effect of Er: YAG laser irradiation in caries cavity preparation on biobehaviors of adjacent human dental pulp cells in the pulp chamber.

The erbium-doped yttrium aluminum garnet (Er: YAG) laser has been successfully applied in caries removal; however, little is known about proper parameters of Er: YAG laser on different conditions of caries removal, especially the influence of Er: YAG irradiation on human dental pulp cells (hDPCs). Here, we tested the effects of Er: YAG laser at different output energy levels (100, 200, 300, 400, and 500 mJ) on biobehaviors of hDPCs. To simulate clinical deep caries conditions, hDPCs were cultured on the pulpal side of 500-μm-thick dentin disks in an in vitro pulp chamber model. Temperature change, structural change, and ablation depth of dentin disk were also recorded. The findings suggested that the biological behaviors of hDPCs are strongly correlated with the energy output of the Er: YAG laser. Er: YAG laser irradiation at 100 mJ may be proper and safe for deep caries removal since it would not cause any adverse effect on hDPCs biobehaviors.

Prevalence of degenerative vertebral disc changes in elite female Crossfit athletes – a cross-sectional study

BackgroundCrossfit athletes consistently recruit or transfer high levels of repetitive forces through the spine, and MRI has documented a higher rate of intervertebral disc degeneration in athletes compared with matched controls. The aim of this study was to evaluate early degenerative spinal disc changes in elite female CrossFit athletes quantified by 3.0 Tesla magnetic resonance imaging (MRI) matched with female none-athletes.MethodsIn a cross-sectional single-center study 19 asymptomatic adult participants, nine German female elite Crossfit athletes and ten female participants underwent spinal MRI (3.0T). Demographic data, spinal clinical examination results and sport-specific performance parameters were collected prior to the MRI. The primary outcome was the prevalence of degenerative spinal disc changes. The secondary outcome was the grade of degeneration using Pfirrmann grading.ResultsA total of 437 discs underwent spinal MRI (3.0T). The prevalence of early degenerative disc disease was not increased. Pfirrmann degenerative grade did not show significant differences among groups.ConclusionAsymptomatic female elite Crossfit athletes do not show an increased prevalence of degenerative disc disease. Compared to a sex-matched control group, high training volume in Crossfit does not correlate to a higher incidence of degenerative disc changes in young females.

Optic Disc and Retinal Architecture Changes in Patients with Spinocerebellar Ataxia Type 2.

ATXN2 is the causative gene of spinocerebellar ataxia type 2 (SCA2) and has been implicated in glaucoma pathogenesis. Therefore, studying ocular changes in SCA2 could uncover clinically relevant changes. The aim was to investigate optic disc and retinal architecture in SCA2. We evaluated 14 patients with SCA2 and 26 controls who underwent intraocular pressure measurement, fundoscopy, and macular and peripapillary spectral domain optical coherence tomography (SD-OCT). We compared SD-OCT measurements in SCA2 and controls, and the frequency of glaucomatous changes among SCA2, controls, and 76 patients with other SCAs (types 1, 3, 6, and 7). The macula, peripapillary retinal nerve fiber and inner plexiform layers were thinner in SCA2 than in controls. Increased cup-to-disc ratio was more frequent in SCA2 than in controls and other SCAs. Ocular changes are part of SCA2 phenotype. Future studies should further investigate retinal and optic nerve architecture in this disorder.

Coexistence of Vertebral and Intervertebral Disc Changes in Low Back Pain Patients—In Depth Characterization with Same Day MRI and CT Discography

The aim of this study was to investigate to what extent annular fissures, vertebral and endplate changes, and Modic changes (MCs), coexist in low back pain (LBP) patients by using multiple imaging modalities. Sixty-two LBP patients (mean age 45 years, range 24–63, 53% men) were examined with same-day CT-discography and MRI. Intervertebral discs punctured for discography (n = 204) were evaluated on MRI [Pfirrmann grade, High-Intensity Zone (HIZ)] and on CT-discograms [Modified Dallas Discogram Score (DDS)]. DDS≥ 1, i.e., disc fissures involving the outer annulus were further digitomized into delimitable fissuring (&lt;50% of annulus affected) or non-delimitable annular fissuring. Using both MRI and CT, adjacent vertebrae and endplates were assessed for MC, vertebral sclerosis, and a modified endplate defect score (EPS). In 194 discs the contrast agent was adequately injected during discography, of which 160 (83%) displayed outer annular fissures, with 91 (47%) of the latter being delimitable fissures. Most discs with delimitable fissures were moderately degenerated; 68% Pfirrmann grade ≤3, 71% EPS ≤ 2, and 12% displayed MC. The majority (76%) of MCs were associated with advanced adjacent disc degeneration; 84% Pfirrmann grade ≥4, 76% with non-delimitable annular fissuring, 59% EPS≥ 4, and 34% EPS of 3. A total 95 HIZ (47%) were found, of which 54 had delimitable fissuring, while the remainder displayed non-delimitable fissuring. Vertebral sclerosis was commonly observed (26%), both with MCs (73%) and without MCs (27%), and not specifically linked to MC type 3. A total of 97% of segments with vertebral sclerosis displayed outer annular fissures. These findings were significant (0.046 &gt; p &gt; 0.0001), except between HIZ and adjacent sclerosis (p = 0.303). To conclude, the present study confirmed a close interplay between the disc and adjacent vertebra and endplates. The fact that a majority of discs with delimitable annular fissures did not coexist with pronounced endplate changes and/or MCs, however, supports the theory that disc fissuring is an early event in the degenerative cascade. This was further supported by the fact that MCs were strongly linked to extensive disc fissuring and to advanced endplate damage. Further, vertebral sclerosis was common also in vertebra without MCs and strongly associated to annular fissuring, indicating that sclerosis is a previously underestimated feature of a general degenerative process.

Quantitative analysis of optic disc changes in school-age children with ametropia based on artificial intelligence.

To explore changes in the optic disc and peripapillary atrophy (PPA) in school-age children with ametropia using color fundus photography combined with artificial intelligence (AI) technology. Based on the retrospective case-controlled study, 226 eyes of 113 children aged aged 6-12y were enrolled from October 2021 to May 2022. According to the results of spherical equivalent (SE), the children were divided into four groups: low myopia group (66 eyes), moderate myopia group (60 eyes), high myopia group (50 eyes) and emmetropia control group (50 eyes). All subjects underwent un-aided visual acuity, dilated pupil optometry, best-corrected visual acuity (BCVA), intraocular pressure, ocular axis measurement and color fundus photography. The width of PPA, horizontal diameter ratio of PPA to the optic disc and area ratio of PPA to the optic disc were significantly different among the four groups (P<0.05). The width of the nasal and temporal neuroretinal rim, the roundness of the optic disc, the height of PPA, the vertical diameter ratio of PPA to the optic disc, and the average density of PPA in the high myopia group were significantly different compared with the other three groups (P<0.05). There were strong negative correlations between SE and area ratio of PPA to the optic disc (r=-0.812, P<0.001) and strong positive correlation between axial length (AL) and area ratio of PPA to the optic disc (r=0.736, P<0.001). In school-age children with high myopia, the nasal and temporal neuroretinal rims are narrowed and even lost, which have high sensitivity. The area ratio of the PPA to the optic disc could be used as an early predictor of myopia progression, which is of great significance for the development prevention and management of myopia.

Histopathological spectrum of lumbar disc changes in obesity: analysis of intervertebral discs in lumbar hernia patients in Zenica-Doboj Canton, Bosnia and Herzegovina

&amp;lt;p&amp;gt;&amp;lt;strong&amp;gt;Aim&amp;lt;/strong&amp;gt; &amp;lt;br /&amp;gt;To investigate the correlation of body mass index (BMI) with severity of intervertebral disc degeneration.&amp;lt;br /&amp;gt;&amp;lt;strong&amp;gt;Methods &amp;lt;br /&amp;gt;&amp;lt;/strong&amp;gt;The study enrolled patients who had undergone surgical intervention for a herniated disc at the Department of Neurosurgery of the Cantonal Hospital Zenica. Patients underwent thorough preoperative evaluation, including medical history, neurological and physical assessments, and radiological analysis. The surgical intervention consisted of a posterior lumbar discectomy, and the excised disc material was preserved and subjected to histopathological analysis based on Histopathologic Degeneration Score (HDS). Patients were divided in two groups according to Body Mass Index (BMI): study group with BMI&amp;amp;ge;25 and control group with BMI&amp;amp;lt;25.&amp;lt;br /&amp;gt;&amp;lt;strong&amp;gt;Results&amp;lt;/strong&amp;gt; &amp;lt;br /&amp;gt;Among 69 patients with herniated IVD, 26 (37.7%) were with BMI&amp;amp;ge;25 (study group), and 43 (62.3%) were with BMI&amp;amp;lt;25&amp;lt;br /&amp;gt;(controls). The study group displayed substantial increase in height, 1.80&amp;amp;plusmn;0.06 m compared to controls, 1.74&amp;amp;plusmn;0.06 m (p=0.001). Weight and BMI were significantly higher in the study group of patients (weight: 91.60&amp;amp;plusmn;10.22 vs. 67.37&amp;amp;plusmn;9.20 kg, BMI: 28&amp;amp;plusmn;2 vs. 22&amp;amp;plusmn;2; p&amp;amp;lt;0.001). Differences were confirmed in HDS values in the study group comparing to the control group (p&amp;amp;lt;0.001). The study group exhibited significant differences in chondrocyte proliferation, tears and clefts, granular changes, and mucous degeneration (p&amp;amp;lt;0.05), and positive correlations were found between BMI and&amp;lt;br /&amp;gt;these alterations found in the herniated discs (p&amp;amp;lt;0.05). Therefore, HDS showed positive correlations with BMI (R=0.599; p&amp;amp;lt;0.001) and weight (R=0.696; p&amp;amp;lt;0.001).&amp;lt;br /&amp;gt;&amp;lt;strong&amp;gt;Conclusion&amp;lt;/strong&amp;gt; &amp;lt;br /&amp;gt;The study&amp;#039;s findings confirmed that BMI has a significant impact on intervertebral disc degeneration, emphasizing the&amp;lt;br /&amp;gt;importance of weight management in preventing disc degeneration.&amp;lt;/p&amp;gt;

Effect of TMJ disc position on condylar bone remodeling after arthroscopic disc repositioning surgery

PurposeThe objective of this study was to analyze the effect of TMJ disc position on condylar bone remodeling after arthroscopic disc repositioning surgery. MethodsNine patients with anterior disc displacement without reduction (ADDWoR, 15 sides) who underwent arthroscopic disc repositioning surgery were included. Three-dimensional (3D) reconstruction of the articular disc and the condyle in the closed-mouth position was performed using cone-beam computed tomography (CBCT) and magnetic resonance imaging (MRI) data. Then, the CBCT and MRI images were fused and displayed together by multimodal image registration techniques. Morphological changes in the articular disc and condyle, as well as changes in their spatial relationship, were studied by comparing preoperative and 3-month postoperative CBCT-MRI fused images. ResultsThe volume and superficial area of the articular disc, as well as the area of the articular disc surface in the subarticular cavity, were significantly increased compared to that before the surgical treatment（P < 0.01）. There was also a significant increase in the volume of the condyle (P < 0.001). All condyles showed bone remodeling after surgery that could be categorized as one of two types depending on the position of the articular disc, suggesting that the location of the articular disc was related to the new bone formation. ConclusionsThe morphology of the articular disc and condyle were significantly changed after arthroscopic disc repositioning surgery. The 3D changes in the position of the articular disc after surgery tended to have an effect on condylar bone remodeling and the location of new bone formation.

A Dragon Out of Breath? Monitoring High-velocity Outflows from the High-mass Gamma-Ray Binary LS 2883/PSR B1259–63 During the 2017–2021 Binary Cycle

Observations of the high-mass gamma-ray binary LS 2883/PSR B1259–63 with the Chandra X-ray Observatory during the 2011–2014 and 2014–2017 binary cycles have shown X-ray-emitting clumps, presumably ejected from the binary during periastron passages. These clumps traveled at projected velocities of ∼0.1c and have shown evidence of being accelerated. The clumps also evolved in shape, size, and flux. We monitored this binary with Chandra during the 2017–2021 binary cycle to search for additional X-ray-emitting ejections. While we find evidence of extended emission in two of the six observations, it is unlike the clumps observed in the previous three binary cycles. More specifically, the extended emission is not well localized, and no bright clump is observed moving away from the binary. It is still unclear what caused the lack of X-ray-emitting clump in this orbital cycle, but it may be due to changes in the decretion disk of the Be star.

CLINICAL ASSESSMENT OF DASHAMOOL KWATH WITH HINGU AND PUSHKARMOOL CHURNA IN THE MANAGEMENT OF JHINJHINI VATA WITH SPECIAL REFERENCE TO SCIATIC NEURALGIA.

Introduction: Chakradatta has explained the use of Dashamool kwath, Pushkarmool, and Hingu in Jhinjhini Vata. The word Jhinjhini is the best example of onomatopoeia meaning the formation or use of words that indi-cate the sounds associated with the objects or actions they refer to. In Sanskrit, the word Jhinjhini is taken from the colloquial language that was in existence at the time of the writer. It is the influence of dialects which was commonly used at that time. This type of word is known as Prakrut (original) words without any specific Nirukti, which has been taken directly from colloquial language. Such words are being accepted in Sanskrit as they are. Therefore, we do not find its original root in any Sanskrit dictionary. So, we assumed that the word Jhinjhini resembled the tingling numbness in sciatic neuralgia. By this assumption, we have studied the effect of the said combination on Jhinjhini Vata w.r.t. tingling and numbness in Sciatic neuralgia. Sciatica is a set of symptoms that includes pain caused by general compression or irritation of one of five spinal nerve roots of each sciatic nerve or by compression or irritation of the left, right, or both sciatic nerves. There is often a history of trauma such as twisting of the spine, lifting heavy objects, or exposure to cold. Herniation or degenerative changes in the intervertebral disc is the most common cause. Symptoms include lower back pain, buttock pain, numbness or weakness, and pain in various parts of the leg and foot. Other symptoms include a “pins and Nee-dles” sensation or tingling and difficulty in moving the leg. Mostly, symptoms only manifest on one side of the body and pain may radiate below the knee, but not always. Sciatica is a set of symptoms where irritation of the root of the nerve is a cause of the pain. This disease is now becoming a major threat to the working population. Methodology: The study aimed to observe the effect of Dashamool kwath, Pushkarmool, and Hingu in Jhinjhini Vata with spe-cial reference to sciatic neuralgia. The subjective assessment of dependent variables such as Sphikshula (Buttock pain), Katishula (Low back pain), Urushula (Pain in the back of thigh), Jamgha shula (Pain in calf), Pada shula (Pain in the foot), Graha (Pulling pain), Spandan (Twitching), Stambha (Stiffness), Supti (Numbness), Toda (Pricking pain) was done. A total of 30 patients were studied. Appropriate statistical tests were applied to find out the significance of the treatment. Results: The Results showed that 2 patients got excellent results (&gt; 75%), 25 patients got good relief (&gt; 50%), and 3 pa-tients got moderate relief (&gt;25%) after treatment of 21 days. The percentage of relief on symptoms score of Sphikshula was 57.33%, Katishula 53%, Urushula 50%, Jamghashula 51.11%, Padashula 64.13%, Graha 67.36%, Stambha 64.8%, Supti 61.61% and Toda 64.42% re-spectively. An average relief of 59.3% was observed for the above-said symptoms. Conclusion: This study revealed that the treatment of Jhinjhini Vata with Dashamool kwath, Pushkarmool, and Hingu as ex-plained by Chakradatta is statistically significant, effective, and complication-free.

Effects of Severe Lumbar Spine Structural Artifact on Trabecular Bone Score (TBS): The Manitoba BMD Registry

Trabecular bone score (TBS) is a bone mineral density (BMD)-independent risk factor for fracture. During DXA analysis and BMD reporting, it is standard practice to exclude lumbar vertebral levels affected by structural artifact. Although TBS is relatively insensitive to degenerative artifact, it is uncertain whether TBS is still useful in the presence extreme structural artifact that precludes reliable spine BMD measurement even after vertebral exclusions. Among individuals aged 40 years and older undergoing baseline DXA assessment from September 2012 to March 2018 we identified three mutually exclusive groups: spine BMD reporting performed without exclusions (Group 1, N=12,865), spine BMD reporting performed with vertebral exclusions (Group 2, N=4867), and spine BMD reporting not performed due to severe structural artifact (Group 3, N=1541). No significant TBS difference was seen for Group 2 versus Group 1 (referent), whereas TBS was significantly greater in Group 3 (+0.041 partially adjusted, +0.043 fully adjusted). When analyzed by the reason for vertebral exclusion, multilevel degenerative changes significantly increased TBS (+0.041 partially adjusted, +0.042 fully adjusted), while instrumentation significantly reduced TBS (-0.059 partially adjusted, -0.051 fully adjusted). Similar results were seen when analyses were restricted to those in Group 3 with a single reason for vertebral exclusions, and when follow up scans were also included. During mean follow-up of 2.5 years there were 802 (4.2 %) individuals with one or more incident fractures. L1-L4 TBS showed significant fracture risk stratification in all groups including Group 3 (P-interaction >0.4). In conclusion, lumbar spine TBS can be reliably measured in the majority of lumbar spine DXA scans, including those with artifact affecting up to two vertebral levels. However, TBS is significantly affected by the presence of extreme structural artifact in the lumbar spine, especially those with multilevel degenerative disc changes and/or instrumentation that precludes reliable BMD reporting.