Related Injuries Research Articles

Prevalence, characteristics and clinical impact of work-related musculoskeletal pain in echocardiography

BackgroundWork-related musculoskeletal pain (WRMSP) is increasingly recognised in cardiac ultrasound practice. WRMSP can impact workforce health, productivity and sustainability. We sought to investigate the prevalence, characteristics and clinical impact of WRMSP.MethodsProspective electronic survey of 157 echocardiographers in 10 institutions. Data acquired on demographics, experience, working environment/pattern, WRMSP location, severity and pattern, the impact on professional, personal life and career.Results129/157 (82%) echocardiographers completed the survey, of whom 109 (85%) reported WRMSP and 55 (43%) reported work taking longer due to WRMSP. 40/129 (31%) required time off work. 78/109 (60%) reported sleep disturbance with 26/78 (33%) of moderate or severe severity. 56/129 (45%) required medical evaluation of their WRMSP and 25/129 (19%) received a formal diagnosis of musculoskeletal injury. Those with 11+ years of experience were significantly more likely to receive a formal diagnosis of WRMSP (p = 0.002) and require medication (p = 0.006) compared to those with 10 years or less experience.ConclusionWRMSP is very common amongst echocardiographers, with a fifth having a related musculoskeletal injury. WRMSP has considerable on impact on personal, social and work-related activities. Strategies to reduce the burden of WRMSP are urgently required to ensure sustainability of the workforce and patient access to imaging.

The relationship between blast-related mild traumatic brain injury and executive function is moderated by white matter integrity.

Blast-related mild traumatic brain injury (BR mTBI) is a critical research area in recent combat veterans due to increased prevalence of survived blasts. Post-BR mTBI outcomes are highly heterogeneous and defining neurological differences may help in discrimination and prediction of cognitive outcomes. This study investigates whether white matter integrity, measured with diffusion tensor imaging (DTI), could influence how remote BR mTBI history is associated with executive control. The sample included 151 Veterans from the Minneapolis Veterans Affairs Medical Center who were administered a clinical/TBI assessment, neuropsychological battery, and DTI scan as part of a larger battery. From previous research, six white matter tracts were identified as having a putative relationship with blast severity: the cingulum, hippocampal cingulum, corticospinal tract, inferior fronto-occipital fasciculus, superior longitudinal fasciculus and uncinate. Fractional anisotropy (FA) of the a priori selected white matter tracts and report of BR mTBI were used as predictors of Trail-Making Test B (TMT-B) performance in a multiple linear regression model. Statistical analysis revealed that FA of the hippocampal cingulum moderated the association between report of at least one BR mTBI and poorer TMT-B performance (p < 0.008), such that lower FA value was associated with worse TMT-B outcomes in individuals with BR mTBI. No significant moderation existed for other selected tracts, and the effect was not observed with predictors aside from history of BR mTBI. Investigation at the individual-tract level may lead to a deeper understanding of neurological differences between blast-related and non-blast related injuries.

Unravelling the synergistic interaction of Thrips tabaci and newly recorded, Thrips parvispinus with Alternaria porri (Ellis.) Cif., inciting onion purple blotch.

Onion purple blotch is the most indispensable foliar disease of crop and has become a major concern for farmers and research fraternity. An attempt to investigate the role of injury in parasitism by Alternaria porri indicated that disease incidence and severity enhance considerably with injury. Thrips injured plants inoculated with A. porri presented 100% incidence and 52-72% severity while mechanically injured plants inoculated with A. porri showed 60-70% incidence and 28-34% severity. The uninjured plants showed considerably less disease incidence (30-40%) and severity (10-16%). Injured inoculated plants presented reduced leaf length and leaf area while the leaf diameter remained unaffected. The lesion number, lesion length and size was substantially enhanced with concomitant infestation of pest and pathogen. Thrips tabaci injury led to more pronounced symptoms of purple blotch compared to Thrips parvispinus injury. There was substantial decrease in photosynthetic rate and chlorophyll content with stress imposed on plant whilst the relative stress injury was enhanced. The induction of injury and inoculation of A. porri had an impact on the concentration of total phenolics, total soluble sugars, total proteins and hydrogen peroxide in onion leaves. A. porri combined with injury caused a more pronounced decrease in total soluble sugars and total protein content while enhancement in total phenolics and hydrogen peroxide content compared to uninjured plants. The dynamic nature of morpho-physiological and biochemical changes owing to stress conditions imposed on onion plant adds an extra layer of complexity in understanding the onion plant physiology and their ability to work out in response to challenging environment conditions.

Collecting behavioral evidence from a highly mobile and seasonal population: A protocol for a survey on quad bike injuries.

Quad bikes are popular recreational, four-wheeled bikes in the Middle East. Injury prevention programs targeting quad bike crashes in the United Arab Emirates (UAE) need evidence about the risk factors and behaviours associated with these crashes in the target population. This is a protocol for a study aiming to investigate quad bike rider behaviours and to assess the risk factors associated with related injuries in the UAE. This is a cross-sectional observational study aiming to describe a seasonal sport in a desert environment. With an estimated sample size of 451, the survey will follow a three-stage, location-based sampling strategy using the line-transect method. A sampling frame of desert locations with high injury incidences was developed, using Dubai ambulance injury records. Further expansion of the sampling frame was participatory, involving police, enthusiasts, emergency responders and gas station employees. The data collection will be limited to the winter months in fifteen high-injury desert locations across three major Emirates in the UAE. Trained researchers will observe the riders directly in the desert to note their riding habits, followed by a researcher-administered interview on riding and injury history. The interviews will be administered in Arabic and English using Qualtrics software on handheld tablets with offline and online entry mode. In addition, paper-based entry with the same format will be used as a contingency in busy quad bike locations. The objective of this study protocol is to develop a comprehensive survey that will furnish substantial evidence for the formulation of effective injury prevention strategies. To enhance the credibility of the recorded riding behaviors, field observations will be employed. The uniqueness of this study lies in its innovative sampling strategy, custom-tailored to accommodate the highly mobile and transient population of desert bikers in the UAE.

Elevation of astrocyte-derived extracellular vesicles over the first month post-stroke in humans

We sought to identify alterations in the quantity of plasma brain-derived extracellular vesicles (EV) over the first month post-stroke to shed light on related injury and repair mechanisms. We assessed plasma levels of presumed neuron-derived EVs (NDEs), astrocyte-derived EVs (ADEs), and oligodendrocyte-derived EVs (ODEs) in 58 patients 5, 15, and 30 days post-ischemic stroke and 46 controls matched for cardiovascular risk factors using sandwich immunoassays. Subsets of brain-derived EVs were identified by co-expression of the general EV marker CD9 and markers for neurons (L1CAM, CD171), astrocytes (EAAT1), and oligodendrocytes (MOG) respectively. Clinical MRIs assessed lesion volume and presence of hemorrhagic transformation. ADE levels were elevated 5, 15, and 30 days post-stroke compared to controls (p = 0.002, p = 0.002, and p = 0.005 respectively) with no significant change for NDE or ODE. ADEs were increased 15 days post-stroke in patients with hemorrhagic transformation (p = 0.04) compared to patients with no hemorrhage. We conclude that ADE levels are preferentially increased over the first month post-stroke in humans, possibly to provide trophic support to injured neurons following ischemia. ADEs hold potential as biomarkers of blood–brain barrier breakdown and hemorrhagic transformation, but this requires further study at earlier time points post-stroke.

Iatrogenic skin injuries in infants admitted to neonatal intensive care units: An investigation in 22 Chinese units

ObjectiveTo investigate the incidence of iatrogenic skin injuries in neonates across 22 neonatal intensive care units (NICUs) in China. DesignProspective study. Setting22 NICUs in China. PatientsInfants admitted to NICU. InterventionsNone. MeasurementsThe “Iatrogenic Skin Injuries Data Collection Form of infants” were used to collect the data during hospitalization. Main resultsA total of 8126 neonates who were hospitalized in 22 tertiary hospitals across 15 provinces, cities, and autonomous regions of China between December 1, 2019 and January 31, 2020 were analyzed. Five hundred and twenty-one infants had iatrogenic skin injuries, including 250 with diaper dermatitis (47.98%), 70 with physicochemical factor–related skin lesions (PCFRSIs) (13.44%), 81 with medical device–related pressure injuries (MDRPIs) (15.55%), and 69 with medical adhesive–related skin injuries (MARSIs) (13.24%), accounting for 91% of the total number of iatrogenic injuries. Among these, diaper dermatitis was closely related to the skin and feeding status. Furthermore, the risk was higher among neonates who had skin damage upon admission or were already fully fed orally. The influencing factors of MDRPIs and MARSIs were similar. They were negatively associated with gestational age and birth weight, and were closely related to the presence of various tubes. ConclusionsDiaper dermatitis, PCFRSIs, MDRPIs, and MARSIs were the four common types of iatrogenic skin injuries in newborns. The various types of iatrogenic skin injuries were influenced by varying factors. Specialized nursing measurements can reduce the likelihood of these injuries.

Frequency of concomitant injuries in maxillofacial trauma in a tertiary health care centre in India: A 5-year retrospective study

PurposeRoad traffic accidents (RTA), assaults, falls, and sports-related injuries are the leading causes of maxillofacial trauma. Due to quite different geographical environment and fast urbanization, the use of various protective equipment is restricted in India. Thus, compared to other countries, there might be a significant difference in the pattern and frequency of associated injuries among subjects with maxillofacial trauma. The present study was conducted to identify the causes and pattern of various maxillofacial fractures and the frequency of other related injuries among subjects with maxillofacial trauma. MethodsThis is a cross-sectional retrospective study recording 2617 subjects with maxillofacial trauma. The patient demographics, causes of trauma, types of maxillofacial injury, and associated soft and hard tissue injuries were recorded. The types of maxillofacial and associated injuries were diagnosed from details of clinical examinations and the interpretation of various radiographs available in the file. The associated injuries were divided into head injury, other bony injuries, and soft tissue and vital structure injuries. Descriptive statistics and the test of proportion were used. A p value < 0.05 was considered as a level of significance. ResultsThe maxillofacial injuries were significantly common in patients aged 16 – 45 years (66.7%) than in patients aged ≤ 15 and > 46 years (33.3%) (p < 0.001). The RTA was the most common cause of maxillofacial injury (n = 2139, 81.7%), followed by fall (n = 206, 7.9%), other causes of injury (n = 178, 6.8%), and assaults (n = 94, 3.6%). The maxillofacial injury by 2-wheel vehicle accidents was significantly higher than that by 4-wheel vehicle and other vehicle accidents (p < 0.001). There was a significant correlation between alcohol and RTA (p < 0.001). The head injury (n = 931, 61.1%) was the most common associated injury, followed by soft tissue and vital structures injuries (n = 328, 21.5%) and other bone injuries (n = 264, 17.3%). DiscussionHead injury was the most common associated injury followed by soft tissue and vital structures and bone injuries among subjects with maxillofacial trauma. Clavicle fracture and injury to the lower extremities were the most common hard and soft tissue-associated injuries.

Age-specific Patterns of Intimate Partner Violence Related Injuries in US Emergency Departments

PurposeTo identify intimate partner violence (IPV)-related injury patterns of U.S. patients of three age groups: <18 years (adolescents), 18–25 years (emerging adults), and >25 years (adults). MethodsWe performed a nationally representative retrospective review of all patients presenting to U.S. Emergency Department for IPV-related injuries from 2005 through 2020. Demographics and injury patterns were calculated using statistical methods accounting for the weighted stratified data. Main outcomes were injury morphology, mechanism, severity, location, and temporal associations of IPV-related injuries among the three age groups. ResultsThere was a higher proportion of female victims, sexual assault cases, and lower trunk injuries among adolescents compared to emerging adults and adults. There was increasing injury severity, fractures, and hospital admissions with increasing age. Adolescents experienced a greater prevalence of fractures of the head, neck, hands, fingers, and distal lower extremity, while trunk fractures increased with age. The peak prevalence of violence-related Emergency Department visits among adolescents was in June and September, with the peak day as Tuesday. DiscussionInjurious forms of IPV are prevalent across all age groups, with sexual assault cases demonstrably higher among adolescents and increasing severity of injuries as victims age. Identification of age-specific injury patterns will aid health-care professionals and policymakers in developing targeted interventions for adolescents who experience IPV.

Vascular Complications Secondary to REBOA Placement at a Level 1 Trauma Center

IntroductionResuscitative endovascular balloon occlusion of the aorta (REBOA) is designed to manage severe hemorrhagic shock. Popularized in medical care during military conflicts, the concept has emerged as a lifesaving technique that is utilized around the United States. Literature on risks of REBOA placement, especially vascular injuries, are not well reported. Our goal was to assess the incidence of vascular injury from REBOA placement and the risk factors associated with injury and death among these patients at our institution. MethodsWe performed a retrospective cohort study of all patients who underwent REBOA placement between September 2017 and June 2022 at our Level 1 Trauma Center. The primary outcome variable was the presence of an injury related to REBOA insertion or use. Secondary outcomes studied were limb loss, the need for dialysis, and mortality. Data were analyzed using descriptive statistics, Chi-square, and t-tests as appropriate for the variable type. ResultsWe identified 99 patients who underwent REBOA placement during the study period. The mean age of patients was 43.1 ± 17.2 years, and 67.7% (67/99) were males. The majority of injuries were from blunt trauma (79.8%, 79/99). Twelve of the patients (12.1%, 12/99) had a vascular injury related to REBOA placement. All but one required intervention. The complications included local vessel injury 58.3% (7/12), distal embolization 16.7% (2/12), excessive bleeding requiring vascular consult 8.3% (1/12), pseudoaneurysm requiring intervention 8.3% (1/12), and one incident of inability to remove the REBOA device (8.3%, 1/12). The repairs were performed by vascular surgery (75%, 9/12), interventional radiology (16.7%, 2/12) and trauma surgery (8.3%, 1/12). There was no association of age, gender, race, and blunt versus penetrating injury to REBOA related complications. Mortality in this patient population was high (40.4%), but there was no association with REBOA related complications. Ipsilateral limb loss occurred in two patients with REBOA related injuries, but both were due to their injuries and not to REBOA related ischemia. ConclusionWhile vascular complications are not unusual in REBOA placement, there does not appear to be an association with limb loss, dialysis, or mortality if they are addressed promptly. Close coordination between vascular surgeons and trauma surgeons is essential in patients undergoing REBOA placement.

What do we know about beach soccer injuries? Systematic video analysis of four consecutive years with 580 match injuries

ABSTRACT The aim of the present study was to evaluate the characteristics of match injury in male beach soccer players. Video recordings of all official beach soccer tournaments in which the European national male beach soccer teams participated from 2018 to 2021 were analysed by two sports medicine specialists retrospectively. Regarding each injury, data including the mechanism, location of the injury, whether the injury led to time-loss, and the relationship of the injury to the bicycle kick (BK), etc. were documented. A total of 632 injuries were documented, corresponding to 234.9 injuries/1000 player hours. Video footage was available for 580 injuries. Whilst 79.8% of medical attention injuries occurred due to opponent contact, 19.5% of time-loss injuries occurred due to non-contact, and 12.2% of indirect opponent contact (p < 0.01). The most common location of the BK related injury was the head/neck (68.7%), whereas most common location of the BK unrelated injury was the lower extremity (54.1%) (p < 0.01). The findings demonstrated that beach soccer injury incidence was quite high; the most common injury location was head/neck and head/neck injuries were associated with BK. In light of these results, some rule regulations, particularly those associated with BK, and the use of protective equipment should be considered to prevent these injuries.

Complex stab related injuries involving the diaphragm, bowel and cystic duct: a case report

Penetrating abdominal trauma is a major killer worldwide. Biliary duct injuries resulting from penetrating stab wounds are rare but potentially life-threatening occurrences. This case report outlines a rare case, diagnosis, surgical management, and postoperative outcomes of a patient who sustained a cystic duct injury due to a penetrating stab wound. There is paucity of such cases in the literature. A 55-year-old man sustained a penetrating wound and was found to have cystic duct injury intra-operatively along with other multi-visceral injury. The patient underwent a cholecystectomy with the management of associated injuries. The report aims to highlight the rarity yet the possibility of such injuries and emphasize the importance of a high index of suspicion.

Amiodarone and Dronedarone Causes Liver Injury with Distinctly Different Clinical Presentations

ObjectiveTo describe hepatotoxicity due to amiodarone and dronedarone from the DILIN and the US FDA’s surveillance database.MethodsHepatotoxicity due to amiodarone and dronedarone enrolled in the U.S. Drug Induced Liver Injury Network (DILIN) from 2004 to 2020 are described. Dronedarone hepatotoxicity cases associated with liver biopsy results were obtained from the FDA Adverse Event Reporting System (FAERS) from 2009 to 2020.ResultsAmong DILIN’s 10 amiodarone and 3 dronedarone DILIN cases, the latency for amiodarone was longer than with dronedarone (388 vs 119 days, p = 0.50) and the median ALT at DILI onset was significantly lower with amiodarone (118 vs 1191 U/L, p = 0.05). Liver biopsies in five amiodarone cases showed fibrosis, steatosis, and numerous Mallory-Denk bodies. Five patients died although only one from liver failure. One patient with dronedarone induced liver injury died of a non-liver related cause.Nine additional cases of DILI due to dronedarone requiring hospitalization were identified in the FAERS database. Three patients developed liver injury within a month of starting the medication. Two developed acute liver failure and underwent urgent liver transplant, one was evaluated for liver transplant but then recovered spontaneously, while one patient with cirrhosis died of liver related causes.ConclusionAmiodarone hepatotoxicity resembles that seen in alcohol related liver injury, with fatty infiltration and inflammation. Dronedarone is less predictable, typically without fat and with a shorter latency of use before presentation. These differences may be explained, in part, by the differing pharmacokinetics of the two drugs leading to different mechanisms of hepatotoxicity.

Combined metabolomic and proteomic analysis of sepsis related acute liver injury and its pathogenesis research

BackgroundSepsis-induced acute liver injury is common in patients in intensive care units. However, the exact mechanism of this condition remains unclear. The purpose of this study was to investigate the roles and mechanisms of proteins and metabolites in the liver tissue of mice after sepsis and elucidate the molecular biological mechanisms of sepsis-related liver injury. MethodsFirst, a lipopolysaccharide (LPS)-induced sepsis mouse model was established. Then, according to alanine aminotransferase (ALT) and aspartate aminotransferase (AST) detection in mouse serum and liver histopathological examination (HE) staining, the septic mice were divided into two groups: acute liver injury after sepsis and nonacute liver injury after sepsis. Metabolomics and proteomic analyses were performed on the liver tissues of the two groups of mice to identify significantly different metabolites and proteins. The metabolomics and proteomics results were further analysed to identify the biological indicators and pathogenesis related to the occurrence and development of sepsis-related acute liver injury at the protein and metabolite levels. ResultsA total of 14 differentially expressed proteins and 46 differentially expressed metabolites were identified. Recombinant Erythrocyte Membrane Protein Band 4.2 (Epb42) and adenosine diphosphate (ADP) may be the key proteins and metabolites responsible for sepsis-related acute liver injury, according to the correlation analysis of proteomics and metabolomics. The expression of the differential protein Epb42 was further verified by western blot (WB) detection. ConclusionsOur study suggests that the differential protein Epb42 may be key proteins causing sepsis-associated acute liver injury, providing new and valuable information on the possible mechanism of sepsis-associated acute liver injury.

Moonless night sky increases Isistius species (cookiecutter shark) and live human contact.

The nocturnal feeding behavior and zoogeographical habitat of cookiecutter sharks Isistius brasiliensis and Isistius plutodus (Isistius spp.) greatly reduces interaction of this species with live humans. Attacks on live humans are exceedingly rare with 7 cases reported worldwide, 6 of them in Hawai'i, and 5 of these occuring among channel swimmers. Published research suggests that periods of bright moonlight may increase Isistius spp. contact with live humans and does not otherwise identify significant trends or risk factors. Yet 5 of the 6 Isistius spp. bites on live humans in Hawai'ian waters occurred with the moon set and after nautical twilight end and before nautical twilight start. From 1961-2023 in Hawai'i, 129 successful solo channel crosses and 5 Isistius spp. related injuries in the habitat of cookiecutter sharks were analyzed across two groups: one where both the moon and sun were set (dark group) and one where the moon and/or sun was in the sky (light group). There was a significant difference for swimmers bitten by Isistius spp. in the dark 4 (12%) versus light groups 1 (1%), p = 0.012, RR 12.6 (95% confidence interval: 1.5-108.9). Swim start time and year was also significant (Pearson correlation 0.566, p <0.001). Swimmer gender and use of shark deterrent devices and artificial illumination were not significant. The growing popularity of channel swimming in Hawai'i and swim start times have contributed to an increasing likelihood of live human and Isistius spp. contact and a moonless night sky is a significant risk factor for this interaction.

Comparing forceps and self-assembled intraocular rare earth magnet in removing metallic intraocular foreign bodies in 25-guage vitrectomy

PurposeTo compare the efficacy and efficiency of self-assembled intraocular rare earth magnet and forceps in removing intraocular foreign bodies(IOFBs) undergoing 25-gauge(G) pars plana vitrectomy.MethodsA total of 30 patients with metallic IOFB underwent 25-G PPV were enrolled into this study. Self-assembled intraocular rare earth magnet were used in 15 patients(bar group), and forceps were used in 15 patients(forceps group). Success rate of removing IOFB, time taken to remove IOFB, incidence of IOFB slippage and fall, iatrogenic retinal damages were compared between the two groups.ResultsThere was no significant difference in success rate of removing IOFBs between the groups(93.3% and 100%, P > 0.99). The median time taken of removing FB was significantly shorter in bar group than in forceps group(112 and 295 s, P = 0.001). None of the patients in bar group had IOFB slippage and fall, or related iatrogenic retinal damage in the process of removal. In forceps group, IOFB slippage and fall during removal were observed in 7 of 15(47.6%) patients, related iatrogenic retinal injuries were recorded in 6 of 15(40.0%) patients, both were significantly higher than bar group(P = 0.003 and P = 0.017, respectively).ConclusionsCompared with forceps, the assembled intraocular magnet can greatly reduce the possibility of IOFB slippage and fall, prevent related iatrogenic retinal damage, and shorten the time taken to remove IOFB. The assembled intraocular magnet can be an useful tool in removing metallic IOFBs in PPV.

Prognostic Power of Foot Mobility in Identifying the Risk of Musculoskeletal Injuries: A Cross-Sectional Study of Male Volleyball Players at Different Competitive Levels.

(1) Background: The arch structure and mobility of the foot are considered injury risk factors in volleyball. However, there are limited studies presenting differences in injury prevalence and the risk of lower limb injuries in relation to the competitive level in male volleyball. Therefore, the main aim of the current study was to evaluate foot mobility (through navicular drop test) as an injury risk factor in volleyball players from different competitive levels. (2) Methods: The reliability and usefulness of navicular drop testing were initially assessed in test-retest procedures (based on a sample of eight participants and 16 feet measurements), with primary analyses conducted using foot measurements of the twelve top-level volleyball players (24 feet) and eighteen academic-level volleyball players (36 feet). The modified navicular drop test was conducted, and the feet were classified based on arch height, and injury prevalence was retrospectively assessed with a previously validated questionnaire. Chi-squared tests, receiver operating curves, and logistic regression were used as statistical methods. The navicular drop test was verified as a reliable tool by intraclass correlation coefficient (ICC) (3.1) analysis. (3) Results: There were no significant differences in injury prevalence between academic- and top-level volleyball players, though there was a significant relationship between pronated foot and injury risk independent of competitive level. Generally, for both groups, thresholds above 10 mm of the navicular drop were predictors of lower limb injuries. The risk of injury if the foot was pronated ranged from 70% (academic level) to over 90% (top-level players). However, no statistically significant effect of competitive level on the chance of injury was observed. (4) Conclusions: Our study found a high prevalence of foot injuries independently of competitive level. There was a relationship between pronation of the foot and the risk of injury. However, the risk of lower limb injury was higher in pronated top-level players. Also, a navicular drop greater than 10 mm was an excellent predictor of injuries at both competitive levels.

Unraveling the influence of salinity on physiological and biochemical parameters in citrus (Citrus spp.) rootstocks

The present study was carried out during 2018–19 and 2019–20 at Chaudhary Charan Singh Haryana Agricultural University, Hisar, Haryana to examine the impact of salt stress on physiological parameters of 9 distinct rootstocks of citrus (Citrus spp.) The experimental design followed a completely randomized design (CRD) accompanied with 3 replications, enclosing 45 combinations with 9 citrus rootstocks (Pectinifera, Cleopatra mandarin, Rangpur lime, Alemow, Rough lemon, NRCC-4, Volkamer lemon, CRH-12 and NRCC-3) exposed to 5 NaCl salt stress levels, viz. control (0.07), 2.5, 4.0, 5.5 and 7.0 dS/m. Among the different rootstocks, Rangpur lime exhibited the highest leaf (12.65 mg/g DW) and root (12.42 mg/g DW) total soluble carbohydrates at the 7.0 dS/m salinity level. Additionally, Rangpur lime showcased minimal reduction in chlorophyll stability index (17.2%), leaf and root relative water content (18.7 and 18.9%, respectively), relative stress injury (32.0 and 33.0%, respectively) and leaf and root (Malondialdehyde) MDA content (8.46 and 8.12 µmoles/g DW, respectively) at the same salinity level. Overall, Rangpur lime, Volkamer lemon and CRH-12 demonstrated superior performance by exhibiting relatively higher buildup of total soluble carbohydrates and less drop in CSI, RWC, RSI and MDA content at 7.0 dS/m as compared to control. Conversely, Cleopatra mandarin, Rough lemon and NRCC-3 displayed a relative moderate response, while Pectinifera, Alemow, and NRCC-4 showcased substandard performance, exhibiting contrasting behaviour at 7.0 dS/m as compared to control, particularly concerning physiological parameters at the seedling stage.

Superiority of a Silk Surgical Site Wound Closure Device Over Synthetic Dressings

Background: Silk fibroin is an emerging biomaterial with enhanced properties of cellular regeneration, growth and proliferation. The use of a silk fibroin wound dressing has the potential to decrease the incidence of wound healing complications and to improve patient outcomes compared to synthetic dressing alternatives. Methods: A prospective, randomized, single-blinded clinical trial was conducted on 50 patients who were dressed with a silk fibroin dressing on one side of their body and on the contralateral side with 3M Steri-Strips® after undergoing abdominoplasty, reduction mammaplasty, or brachioplasty procedures. Data was collected over 5 postoperative visits using photographs and an investigator administered questionnaire to monitor erythema, skin irritation, skin discomfort, the need for pharmaceutical intervention, wound dehiscence and mechanical skin injury. A comprehensive 75 patient statistical analysis was conducted combining the results with a previously published study comparing Dermabond® Prineo® to the silk dressing. Results: 20.8% (10/48) of patients were assessed by surgeons as having skin erythema (7-10) on the Steri-Strip® control side and 0% (0/48) on the silk dressing side (p=0.002). The frequency of breast triple point separation in 43 cases was 30.2% (13/43) on the Steri-Strip® side and 9.3% (4/43) on the silk side (p=0.012). 75% (36/48) of patients had partial or total detachment of Steri-Strips® while 0% (0/48) had total detachment of the silk dressing and 18.8% (9/48) had partial detachment of the silk dressing within the first two weeks (p&lt;0.001). Conclusion: A silk fibroin wound dressing significantly reduces the incidence of wound healing complications throughout the postoperative period. Clinical Relevance Statement: The adoption of a silk fibroin wound dressing into clinical practice has the potential to improve patient outcomes, decrease medical adhesive related skin injuries and reduce the rate of wound healing complications.

Usage of blood components in obstetric practice

Transfusion of blood and its components form an important component in obstetric care. Almost 5% of pregnant mothers require some sort of red cell and/or component transfusion as part of their obstetric management. Although red cell usage in large parts of developed countries are coming down, its usage in obstetric care is increasing. About 27% of maternal deaths in the world are due to hemorrhage. There are many causes where transfusion with different blood components is required in obstetric practice; to name a few are – accidental hemorrhage, placenta previa, hemoglobinopathies, pre-eclamptic toxemia, postpartum hemorrhage, amniotic fluid embolism, disseminated intravascular coagulation, malaria, etc. Certain complications and challenges of transfusion such as transfusion related acute lung injury, microangiopathy, Thrombotic thrombocytopenic purpura, isoimmunization, and transfusion-associated cardiac overload occur with increased frequency in pregnant mothers. Transfusion requirement around peripartum period is uncertain and sometimes could be massive. Hence, both obstetrician and transfusion experts should remain prepared for this eventuality. Transfusion of blood products even though has never been safer than it is today; yet, this procedure carries with it many immunological, infectious, and other complications, hence, should be used judiciously and very cautiously. Several procedures such as apheresis and intraoperative cell salvage are being increasingly used nowadays for various facets of management and obstetric care. Present review condenses on the knowledge of usage of blood and blood products in obstetric care.

Biomechanical effects of foot orthoses on jump landing performance: A systematic review

Jumping is involved in a wide range of sports and activities, and foot orthoses (FO) are suggested to enhance performance and prevent injury. The aim of this systematic review was to investigate whether using FO with different modifications affects jump landing biomechanics and improves performance in healthy individuals. The search strategy included 7 databases that identified 19 studies. The study quality was evaluated using a modified Downs and Black index. The primary outcome measures were joint kinematics, kinetics, muscle activity, vertical jump height, and horizontal jump distance. Our findings indicated that incorporating arch support with a rearfoot post and softer forefoot region into FO may improve several biomechanical variables during jump landing activities. Improvements in vertical ground reaction force loading rates, knee and ankle kinematics, and muscle cocontraction during jumping with FO could enhance jumping performance. In addition, improvements in hip, knee, ankle, and tibial kinematics and vertical ground reaction force loading rates during landing could reduce impact forces and related injuries. Although a limited number of studies have addressed the effects of FO on vertical jump height and horizontal jump distance, inserting such FO inside shoes with optimum bending stiffness could facilitate jumping performance. A rigorous exploration of the effect and mechanism of FO designs on jumping performance could benefit jumping-related activities and prevent ankle and knee injuries.