Cross-sectional study.
To evaluate the prevalence and various risk factors for low back pain (LBP) in young adults in India.
LBP is an emerging problem in adolescents, with an incidence that is the ...highest in the third decade of life worldwide. Various risk factors such as obesity, smoking, family history, stress, and exercise have been described in the literature. This study was conducted because of paucity of data in the Indian literature.
A total of 1,355 (741 males and 641 females) young Indian Administrative Service aspirants and medical postgraduate aspirants aged 18-35 years were enrolled in the study. The subjects completed a detailed, semi-structured questionnaire that gathered data regarding their sociodemographic profile and factors considered to be risk factors for LBP. Anthropometric measurements, including height and weight, were measured and body mass index was calculated.
Most subjects (90.6%) were aged 20-29 years (mean, 24.49; range, 18-35 years). Results indicated that the following factors were associated with LBP in young adults: marital status, previous history of spine problems, strenuous exercise, job satisfaction, monotony, stress, daily number of studying hours, and family history of spine problems (
<0.05). However, age, sex, smoking, alcoholism, coffee intake, mode and duration of travel, diet, frequency of weightlifting, wearing heels, studying posture, and frequency and type of sports activities were not associated with LBP.
The study identified various modifiable and non-modifiable risk factors that precipitated LBP in young adult Indians. Identifying these risk factors at an early stage will prevent LBP progression to a chronic disease state, thereby improving an individual's quality of life and increasing productivity.
This is a retrospective cohort study.
This study aimed to identify the clinicoradiological risk factors associated with the inability to achieve minimum clinically important difference (MCID) on the ...modified Japanese Orthopaedic Association (mJOA) Scale in operated cases of cervical spondylotic myelopathy (CSM).
Only a few studies have evaluated the outcomes of surgery performed for CSM using MCID on the mJOA scale.
We analyzed 124 operated CSM cases from March 2019 to April 2021 for preoperative clinical features, cervical sagittal radiographic parameters, and magnetic resonance imaging (MRI) signal intensities (SI). The risk factors associated with missing the MCID (poor outcome) on mJOA at the final follow-up were identified using binary logistic regression. Multivariate analysis was used to find significant risk factors, and odds ratios (OR) were computed.
A total of 110 men (89.2%) and 14 women (10.8%) with an average age of 53.5±13.2 years were included in the analysis. During the last follow-up, 89 cases (72.1%) achieved MCID (meaningful gains following surgery) while 35 (27.9%) could not. The final model identified the following parameters as significant risk factors for poor outcome: increased duration of symptoms (OR, 6.77; p=0.001), lower preoperative mJOA scale (OR, 0.75; p=0.029), the presence of multilevel T2-weighted (T2W) MRI SI (OR, 4.79; p=0.004), and larger change in cervical sagittal vertical axis (ΔcSVA) (OR, 1.06; p=0.013). Also, an increase in cSVA postoperatively correlated with a reduced functional recovery rate (r=-0.4, p<0.001).
Surgery for CSM leads to significant functional benefits. However, poorer outcomes are observed in cases of greater duration of symptoms, higher preoperative severity with multilevel T2W MRI SI, and a larger increase in the postoperative cSVA (sagittal imbalance).
Land-use land-cover (LULC) changes are occurring rapidly in Southeast Asia (SEA), generally associated with population growth, economic development and competing demands for land. Land cover change ...is one of the vital factors affecting carbon dynamics and emissions. SEA is an important region to study urban-caused LULC emissions and the potential for nature-based solutions (NBS) and nature climate solutions (NCS), as it is home to nearly 15% of the world’s tropical forests and has some of the world’s fastest rates of urban growth. We present a fine-scale urban cluster level assessment for SEA of current (2015) and future (2050) scenarios for carbon sequestration service and climate mitigation potential. We identified 956 urban clusters distributed across 11 countries of SEA. Considering the urban expansion projected and decline in forests, this region could see a carbon loss of up to 0.11 Gigatonnes (Scenario SSP4 RCP 3.4). Comparing carbon change values to urban emissions, we found that the average offset value ranging from −2% (Scenario SSP1 RCP 2.6) to −21%. We also found that a few medium and large urban clusters could add to more than double the existing carbon emissions in 2050 in the SSP3 and SSP4 RCP 3.4 scenarios, while a minority of clusters could offset their emissions under SSP1. Our study confirms that NCS, and particularly reforestation, are in many cases able to offset the direct emissions from land cover conversion from SEA urban clusters. Hence, documenting the plausible LULC transitions and the associated impacts gains significance in the SEA region as the results can be useful for informing policy and sustainable land management.
Evaluating the submarine groundwater discharge (SGD) derived strontium (Sr) flux from the Bengal Basin to the Bay of Bengal (BoB) and determining its isotopic composition is crucial for understanding ...the marine Sr isotopic evolution over time. Measurements of spatially and temporally distributed water samples collected from the BoB show radiogenic
Sr/
Sr, high Sr, calcium (Ca) concentrations and high salinity in samples collected dominantly from 100-120 m depth, which can be explained only by the contribution of saline groundwater from the Bengal Basin. These results provide a direct evidence of the SGD-Sr flux to the BoB. This SGD-Sr flux is however, spatially heterogeneous and using conservative hydrological estimates of the SGD flux to the BoB, we suggest a SGD Sr flux of 13.5-40.5 × 10
mol/yr to the BoB. Mass balance calculations using Sr concentrations and
Sr/
Sr suggest up to 7% contribution of SGD to the 100-120 m BoB water samples. The identification of SGD at 100-120 m depth also provides an explanation for the anomalous variations in barium (Ba) concentrations and the δ
O-salinity relationship in intermediate depths of the BoB.
Retrospective case series review.
To determine the recovery and prevalence of myelopathic signs and their resolution in cervical spondylotic myelopathy after treatment by laminoplasty.
Myelopathic ...signs are an integral component of diagnosis of cervical myelopathy. Effect of surgical intervention (laminoplasty) on recovery of these reflexes has not been studied and remains undetermined. Their recovery and its rate remain unclear. This may be important because resolution may affect recovery, and reappearance may mark relapse.
Patients diagnosed as having cervical spondylotic myelopathy based on symptoms, corroborative imaging, and improvement of at least 1 grade in Nurick score were part of study. The patients were evaluated for a period of 1 year from surgery. Hyperreflexia and provocative signs (Hoffman, inverted brachioradialis reflex, clonus, and Babinski) and recovery (Nurick and mJOA) were noted at subsequent follow-up, and improvement was analyzed.
Twenty-one patients had severe spondylotic myelopathy with Nurick score ≥ 3. Myelopathic signs were highly sensitive in diagnosing the presence of severe SCM, because 100% of the SCM patients revealed at least 1 sign on examination. The recovery of these signs was maximum within the first 6 months, with lesser than half of total occurring in immediate and major half in the subsequent 6 months. Beyond this, plateau was seen in recovery, with marginal improvement of these signs. Patients with adverse cord signal changes (t2 hyper/T1 low) had higher prevalence and persistence of individual myelopathic signs compared with patients with only T1 hyperintensity/normal cord in preoperative period and follow-up at the end of 1 year.
At least 1 myelopathic sign is universal in severe SCM patients. However, individual myelopathic signs cannot alone diagnose disease in all patients. The benefit of laminoplasty is apparent in immediate postoperative period (<7 days), but it is maximum in first 6 months after which the recovery stabilized or these are a marginal improvement. Similarly, the resolution of signs is maximum in period of first 6 months, which parallels recovery. Babinski and inverted brachioradialis reflex revert to normal in most patients and can serve as markers of relapse in long follow-up. Hoffman is not a sensitive test and is likely to persist in patient with severe cord changes.
Cervical spondylotic myelopathy (CSM) is a common presentation in the middle-aged to elderly population. The cause of myelopathy is multifactorial, and cervical spondylosis is the most common cause. ...This review looks into the treatment options, timing of the surgery, and the advantages and disadvantages of the various posterior approaches for multilevel spondylotic myelopathy. CSM is a disabling disorder that should be addressed in its early phases. There are limited surgical options available, and each procedure has its advantages and disadvantages. Since the neurological and functional outcomes are the same for all well-performed decompressions, the choice of surgical approach depends on various other factors. Posterior approaches are good for multilevel disease as they make the surgery simpler, shorter and with reduced complications in comparison to multilevel anterior surgeries.
Sensorineural hearing loss (SNHL) is a known but rare complication of non-otological surgeries. SNHL after spinal decompression also remains a rare occurrence with a handful of reports in the ...literature. The exact mechanism is not clearly understood. Cerebrospinal fluid leak, barotrauma, microemboli, hypoperfusion, vasospasm, traumatic event, and anesthetic agents are some of the proposed etiologies. Early diagnosis and prompt intervention have shown benefits though management lacks consensus. We report a case of profound SNHL post-lumbar decompression and fixation surgery, who showed significant recovery at 4-week follow-up, and we review the literature for hearing loss after spine surgeries.
Steady improvement in quality of life has led to increased survival time of elderly, especially of those with noncommunicable diseases. A study about their health-seeking behavior (HSB) and its ...determinants is essential for provision of comprehensive care and facilitate policy development. A cross-sectional study was conducted among 350 elderly participants over 60 years of age in an urbanized village of Delhi. Data was collected using a semi-structured questionnaire, and detailed general and systemic examination was done. Tests of significance were applied to assess the HSB with various demographic, clinico-social, and economic variables. A total of 87.4% of the study population was suffering from at least one noncommunicable disease (NCD). Majority of the study subjects' NCDs (72.66%) were diagnosed while getting treatment for a symptom of the disease. Also, 52.94% of the participants had inappropriate HSB. HSB was significantly associated with gender, age, duration of illness, and importantly with modifiable variables like the level of literacy, distance of preferred health facility, and presence of multimorbidity. HSB was found to be inappropriate in over half of the participants. Policymaking should focus on modifiable variables like education, distance of health facility, and multimorbidity, especially for commonly ignored diseases like osteoarthritis and diabetes.
The common causes of vertebral body lesion are metastasis, infection, primary malignancies or osteoporotic fractures. Histopathological examination is necessary to confirm the diagnosis. There are ...different approaches to collect the biopsy samples and they have different adequacy and accuracy rates and also possible complications. This study aims to determine adequacy, accuracy and safety of the fluoroscopy guided percutaneous transpedicular biopsy of the vertebral body lesion.
This is retrospective review of all the patients who underwent fluoroscopy guided percutaneous transpedicular biopsy from January 2013 to October 2016. We reviewed medical records and biopsy reports, plain radiographs, Computed Tomography Scan and Magnetic Resonance Imaging and additional necessary investigations required to confirm the diagnosis.
Fifty two patients underwent fluoroscopy guided percutaneous transpedicular biopsy of vertebral body lesion in 55 different levels. Thirty six patients were male and 16 were female with mean age of 54.17 years (range 2-87 years). This procedure was performed in 55 levels from D3 to S1. The adequate sample was retrieved from 50 samples in 47 cases (90.9%). The diagnosis was confirmed by histopathological examination from41 samples in 38 cases (82%). In three cases the histopathology was inconclusive but microbiological investigation of tissue sample confirmed the diagnosis. So in total 44 samples from 41 cases (80%), the diagnosis was confirmed by the procedure. We did not encounter any complications during the procedure.
Fluoroscopy guided percutaneous transpedicular biopsy is a safe minimally invasive procedure with high adequacy and accuracy rate.
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