scholarly journals Arithmetic hip-knee-ankle angle (aHKA): An algorithm for estimating constitutional lower limb alignment in the arthritic patient population

2021 ◽  
Vol 2 (5) ◽  
pp. 351-358
Author(s):  
William Griffiths-Jones ◽  
Darren B. Chen ◽  
Ian A. Harris ◽  
Johan Bellemans ◽  
Samuel J. MacDessi

Aims Once knee arthritis and deformity have occurred, it is currently not known how to determine a patient’s constitutional (pre-arthritic) limb alignment. The purpose of this study was to describe and validate the arithmetic hip-knee-ankle (aHKA) algorithm as a straightforward method for preoperative planning and intraoperative restoration of the constitutional limb alignment in total knee arthroplasty (TKA). Methods A comparative cross-sectional, radiological study was undertaken of 500 normal knees and 500 arthritic knees undergoing TKA. By definition, the aHKA algorithm subtracts the lateral distal femoral angle (LDFA) from the medial proximal tibial angle (MPTA). The mechanical HKA (mHKA) of the normal group was compared to the mHKA of the arthritic group to examine the difference, specifically related to deformity in the latter. The mHKA and aHKA were then compared in the normal group to assess for differences related to joint line convergence. Lastly, the aHKA of both the normal and arthritic groups were compared to test the hypothesis that the aHKA can estimate the constitutional alignment of the limb by sharing a similar centrality and distribution with the normal population. Results There was a significant difference in means and distributions of the mHKA of the normal group compared to the arthritic group (mean -1.33° (SD 2.34°) vs mean -2.88° (SD 7.39°) respectively; p < 0.001). However, there was no significant difference between normal and arthritic groups using the aHKA (mean -0.87° (SD 2.54°) vs mean -0.77° (SD 2.84°) respectively; p = 0.550). There was no significant difference in the MPTA and LDFA between the normal and arthritic groups. Conclusion The arithmetic HKA effectively estimated the constitutional alignment of the lower limb after the onset of arthritis in this cross-sectional population-based analysis. This finding is of significant importance to surgeons aiming to restore the constitutional alignment of the lower limb during TKA. Cite this article: Bone Jt Open 2021;2(5):351–358.

2011 ◽  
Vol 26 (S2) ◽  
pp. 1417-1417
Author(s):  
A. Kheradmand ◽  
H. Ziaaddini ◽  
M. Vahabi

Introduction & aimsEstimate the prevalence of cigarette smoking and some of the related factors among schizophrenic and other hospitalized psychiatric patients.MethodsThis was a cross-sectional study on 120 patients hospitalized in Shahid Beheshti hospital in Kerman in 2005. Patients were equally devided in two groups of schizophrenia and other psychiatric disorders. Sampling was based on statistical census and data were collected using a questionnaire including 27 questions on demographic data, psychiatric disorder, smoking cigarettes and other substances, and Fagerstrom test. Data were analyzed by Chi-square and ANOVA tests using SPSS software.ResultsPrevalence and severity of cigarette smoking was 71.6% and 6.47% among schizophrenic and 51.6% and 6.40% among other psychiatric patients, respectively and the difference was not significant. History of withdrawal was 25.6% and 58.1% in the schizophrenia and other disorders respectively and the difference was significant (P < 0.05). Addiction to other substances was 51.6% in schizophrenic and 45% in the other patients and the most prevalent substances in both groups were opium and alcohol. The severity of smoking cigarettes was 6.9 along with other drug abuses and 5.1 in cases with just smoking based on Fagerstrom test and the difference was significant (P < 0.05).ConclusionsThe prevalence of cigarette smoking in both schizophrenia and other psychiatric patients is higher than normal population, but there is no significant difference between these two groups. Schizophrenic patients need persistent supportive and supervising programs for cigarette smoking abuse treatment because of their cognitive, motivate and social problems.


2018 ◽  
Vol 1 (2) ◽  
pp. 114
Author(s):  
Wahdaniah Wahdaniah ◽  
Sri Tumpuk

Abstract: Routine blood examination is the earliest blood test or screening test to determine the diagnosis of an abnormality. Blood easily froze if it is outside the body and can be prevented by the addition of anticoagulants, one of which Ethylene Diamine Tetra Acetate (EDTA). Currently available vacuum tubes containing EDTA anticoagulants in the form of K2EDTA and K3EDTA. K3EDTA is usually a salt that has better stability than other EDTA salts because it shows a pH approaching a blood pH of about 6.4. The purpose of this research is to know the difference of erythrocyte index results include MCH, MCV and MCHC using K3EDTA anticoagulant with K2EDTA. This research is a cross sectional design. This study used venous blood samples mixed with K2EDTA anticoagulant and venous blood mixed with K3EDTA anticoagulants, each of 30 samples. Data were collected and analyzed using paired different test. Based on data analysis that has been done on MCH examination, p value <0,05 then there is a significant difference between samples with K3EDTA anticoagulant with K2EDTA to erythrocyte index value. Then on the examination of MCV and MCHC obtained p value <0.05 then there is no significant difference between samples with K3EDTA anticoagulant with K2EDTA to erythrocyte index value.Abstrak: Pemeriksaan darah rutin merupakan pemeriksaan darah yang paling awal atau screening test untuk mengetahui diagnosis suatu kelainan. Darah mudah membeku jika berada diluar tubuh dan bisa dicegah dengan penambahan antikoagulan, salah satunya Ethylene Diamine Tetra Acetate (EDTA). Dewasa ini telah tersedia tabung vakum yang sudah berisi antikoagulan EDTA dalam bentuk  K2EDTA dan  K3EDTA. K3EDTA  biasanya berupa garam yang mempunyai stabilitas yang lebih baik dari garam EDTA yang lain karena menunjukkan pH yang mendekati pH darah yaitu sekitar 6,4. Tujuan dari penelitian ini adalah untuk mengetahui perbedaan hasil indeks eritrosit meliputi MCH, MCV dan MCHC menggunakan antikoagulan K3EDTA dengan K2EDTA. Penelitian ini merupakan penelitian dengan desain cross sectional. Penelitian ini menggunakan sampel darah vena yang dicampur dengan antikoagulan K2EDTA dan darah vena yang dicampur dengan antikoagulan K3EDTA, masing-masing sebanyak 30 sampel. Data dikumpulkan dan dianalisis menggunakan uji beda berpasangan. Berdasarkan analisis data yang telah dilakukan pada pemeriksaan MCH didapatkan nilai p < 0,05 maka ada perbedaan yang signifikan antara sampel dengan antikoagulan K3EDTA dengan K2EDTA terhadap nilai indeks eritrosit. Kemudian pada pemeriksaan MCV dan MCHC didapatkan nilai p < 0,05 maka tidak ada perbedaan yang signifikan antara sampel dengan antikoagulan K3EDTA dengan K2EDTA terhadap nilai indeks eritrosit.


2021 ◽  
Vol 6 (14) ◽  
pp. 1-7
Author(s):  
Emine Serap ÇAĞAN ◽  
Birsen KARACA SAYDAM ◽  
Sinem GÜLÜMSER ATEŞ ◽  
Rabia EKTİ GENÇ ◽  
Esin ÇEBER TURFAN

Introduction: The primary attachment figure is mostly defined as the mother, and studies focus on the mother. However, in many babies, basic attachment is just as good with the father as with the mother. It is seen that there are very few studies in the literature investigating the correlations of father-infant attachment relationships.. The aim of this study is to determine the father-infant attachment status and to determine the factors affecting attachment. Method: The population of the cross-sectional study consisted of the spouses of all puerperant women hospitalized in the Gynecology and Obstetrics Clinic between September 1, 2018 and October 1, 2018. The sample size consisted of 156 fathers who agreed to participate in the study. Father identification form and father-infant attachment scale were used to collect the study data. The analysis of the data obtained from the research was carried out on the computer using the SPSS 16.0 package program. Results: 156 fathers participated in the study. The mean age of the fathers is 33.64±6.49, and 38.5% of them have a bachelor's degree. 91.0% of fathers stated that they felt ready for fatherhood. The fathers' Father-Infant Attachment Scale mean score was 82.60±7.72 In the analysis, the difference between the variables and the total score of the scale was found to be statistically insignificant (p>0.05). Discussion and Conclusion: At the end of the study, the bonding process of fathers participating in the study with their babies and the factors affecting this process were evaluated and it was seen that the father-infant attachment scale mean scores of the fathers participating in the study were high and were similar to other studies. In addition, when the basic factors affecting father-infant attachment were compared with the attachment scale mean score, it was found that there was no statistically significant difference.


Hand ◽  
2016 ◽  
Vol 12 (5) ◽  
pp. 439-445 ◽  
Author(s):  
Paul W. L. ten Berg ◽  
Tessa Drijkoningen ◽  
Thierry G. Guitton ◽  
David Ring

Background: Radiological grading of wrist osteoarthritis associated with scaphoid nonunion advanced collapse (SNAC) can be difficult. A comparison radiograph of the contralateral healthy wrist and an educational training in the various SNAC stages may improve reliability. Our purposes were to evaluate the difference in the reliability: (1) between observers who rate SNAC wrists with and without a comparison radiograph; and (2) between observers who receive training prior to ratings and those who do not. Methods: In this cross-sectional survey study, 82 fully trained orthopedic or hand surgeons rated anteroposterior radiographs of 19 patient wrists following a scaphoid nonunion based on SNAC stages 0 to 4. Observers were randomized online in 4 groups: one group rated unilateral views without training, a second group unilateral views with training, a third group bilateral views without training, and a fourth group bilateral views with training. Training included a 1-page clarification of the SNAC stages. Interobserver agreement was calculated using kappa statistics. Results: There was no significant difference between agreement between observers who rated unilateral radiographs (κ = 0.55) and who rated bilateral radiographs (κ = 0.58) ( P = .14), nor between agreement between observers who received training (κ = 0.59) and who did not (κ = 0.54) ( P = .058). Conclusions: The use of an additional comparison view and/or training does not seem to be clinically relevant in SNAC staging. There is room for improvement in the way we assess patients with SNAC wrists.


Author(s):  
AW Ali ◽  
MZ Hossain

Aim: To investigate the correlation between anterior tooth size discrepancies among Angle's Class l, ll, lll malocclusions and corresponding normal occlusion, as well as their prevalence in Bangladeshi population. This study would act as a reference for diagnosis, treatment planning and assessment of prognosis in some orthodontic cases. Methods: This cross sectional study was conducted in the Department of Orthodontics & Dentofacial Orthopedics, Dhaka Dental College & Hospital. A total number of 200 subjects were selected in Angle's Class l, ll, lll and corresponding normal group. Each group had 50 subjects with males and females. A chi-square test was performed to statistically compare the prevalence of anterior tooth size discrepancies among Angle's Class l, ll, lll malocclusions and corresponding normal occlusion and two genders. Analysis of variance was used to compare the mean Bolton anterior tooth size ratios as a function of angle classification and gender. Statistical differences were determined at the 95% confidence level (p< 0.05). Results: No significant difference was observed in the mean Bolton anterior ratio between normal group and class-I malocclusion group (p = 0.343). Significant differences were observed between Class-II malocclusion and normal group (p=0.001), and also between Class-III malocclusion and normal group (p = 0.001). Individuals with Angle Class lll and Class ll malocclusions showed significantly greater prevalence of tooth size discrepancy than Class l malocclusion and corresponding normal group. Conclusion: The great diversity and ethnic mix of Bangladeshi population should alert our orthodontist to use Bolton analysis as an important diagnostic tool and become aware of the moderate variations that may be present and treated. It may somehow guide planning of this type of study in future. DOI: http://dx.doi.org/10.3329/bjodfo.v1i2.15982 Ban J Orthod & Dentofac Orthop, April 2011; Vol-1, No.2, 1-4


2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0033
Author(s):  
Karan Malhotra ◽  
Oliver Chan ◽  
Nicholas Cullen ◽  
Matthew Welck ◽  
Andrew Goldberg ◽  
...  

Category: Other Introduction/Purpose: Gastrocnemius tightness (GT) is thought to predispose patients to multiple musculoskeletal pathologies including back pain, plantar fasciitis, and metatarsalgia. It is thought to be especially prevalent in patients with foot and ankle pathology (FAP) and consequently there is an emerging trend to perform lengthening / release procedures in this patient group. However, it is not clear what proportion of the normal population has GT and how this differs in patients with FAP. We set out to investigate what the incidence and degree of GT in the foot and ankle population is compared to the normal population. Methods: This was a prospective study comparing GT in a cohort of patients with FAP with GT in controls matched for age, gender, and ethnicity. The control group consisted of healthy adult volunteers and the FAP group consisted of patients presenting to our Foot & Ankle unit. Patients with previous surgery, tendoachilles tightness, or ankle arthritis were excluded. GT was measured using a digital inclinometer and the lunge test. It was calculated as the difference between maximal ankle dorsiflexion with the knee extended and with the knee flexed. Data on the control group was collected first and a power calculation suggested a FAP cohort size of 91 feet was required to detect a 2° difference in GT (a= 0.05, ß = 0.05, Ratio 3:1). Results: After case-matching 97 FAP cases were paired with 291 controls for analysis. Mean GT was 8.0° ±5.7° (range: 0-21°) in FAP patients versus 6.0° ±3.5° (range: 0-16°) in controls (p<0.001). Regression analysis demonstrated demographics including BMI and activity level were not significant determinants of GT in the FAP group (r=0.141, p=0.599). Subgroup analysis of the FAP group revealed a mean GT of 10.3° ±6.0° in patients with forefoot pathology (FoP) versus 6.9° ±5.3° in the other FAP patients (NFoP) (p=0.008). When comparing the NFoP group to the controls, there was no difference in GT (p=0.188). In total 21 FAP patients (21.6%) and 12 FoP patients (37.5%) had GT greater than 2 standard deviations of the control group (Figure 1). Conclusion: This population based study demonstrates increased GT in the FAP population versus the normal population; however, in patients without forefoot pathology, this difference may not be clinically relevant. Over a third of patients with forefoot pathology have GT which is greater than the normal population range. We conclude that not all patients with foot and ankle pathology have inherently increased GT, compared with the normal population, but it is reasonably common in patients with forefoot pathology. Further work is required to define what degree of GT may be considered significant, to determine which patients will benefit from surgical treatment.


2020 ◽  
Vol 5 (2) ◽  
pp. 1027-1030
Author(s):  
Shanti Sunuwar Subedi ◽  
Rakina Bhansakarya ◽  
Sajjan Kumar Sharma

Introduction: To evaluate the maternal and perinatal outcome in booked and unbooked cases. Objectives: To assess the maternal and fetal outcomes in unbooked and booked patients. Methodology: This was a cross-sectional comparative study conducted in the Department of Obstetrics and Gynecology from Augustti2019 to January 2020. Using a convenient sampling technique, 204 samples were taken and cross-sectional study was done. Results: There were total 204 cases in this study;102were booked and 102 were unbooked. In this study, 85(83%) of booked cases were educated up to secondary level as compared toti65 (64%) of unbooked cases. There was no significant difference in Apgar score in 1 and 5 minute between booked and unbooked cases. More babies in the unbooked group were transferred to NICU as compared to the booked group and the difference was significant (9.8%vs 1.9%). Greater proportion of booked cases had spontaneous vaginal delivery (81.3% vs 59.8%) and complications like preterm delivery, anemia, preeclampsia/ eclampsia, complicated labor and puerperal sepsis was also less in the booked group. Conclusions: The study showed that unbooked mothers and their newborns had higher chance of having complications.


e-CliniC ◽  
2016 ◽  
Vol 4 (1) ◽  
Author(s):  
Marianne C. Jacobus ◽  
Max F.J Mantik ◽  
Adrian . Umboh

Abstract: Haemoglobin is the main component of red blood cells that serves as a transporter of oxygen and carbon dioxide in the blood. The normal range of haemoglobin values can be used to determine the degree of anemia according to age and gender. Geographical condition such as altitude influences the haemoglobin value. This study aimed to obtain the difference of haemoglobin levels between teenagers with good nutrition status who live at the highland and those at the seaside. This was an observational analytical study with a cross sectional design. Samples were students with good nutrition status of SMPN 3 Tomohon (living at the highland) and those of SMP Kristen Nazaret Tuminting (living at the seaside). There were 60 students who met the inclusion criteria as follows: adolescent, good nutrition status, healthy, aged 13-15 years, lived at the highland or at the seaside ≥ 6 month, and willing to be performed blood examinations, and had been approved by their parents. The Mann-Whitney test for the difference between haemoglobin levels of the two groups showed a p value < 0,001. Conclusion: There was a very significant difference between haemoglobin levels of good nutrition teenagers who lived at the highland and at the seaside. Keywords: haemoglobin levels, good nutrition, teenagers, highland, seaside  Abstrak: Hemoglobin merupakan komponen utama sel darah merah dan berfungsi sebagai transporter oksigen dan karbon dioksida dalam darah. Batas normal nilai hemoglobin dapat digunakan untuk menetapkan derajat anemia, dengan distribusi usia dan jenis kelamin spesifik didasarkan pada sampel referensi sehat. Kondisi geografis, seperti ketinggian tempat dari permukaan laut menjadi faktor pertimbangan dalam distribusi nilai normal hemoglobin. Penelitian ini bertujuan untuk mendapatkan perbedaan kadar hemoglobin antara remaja gizi baik yang tinggal di pegunungan dengan yang tinggal di tepi pantai. Jenis penelitian ini analitik-observasional dengan desain potong lintang. Sampel penelitian yaitu remaja gizi baik yang tinggal di pegunungan yaitu siswa SMPN 3 Tomohon dan yang di tepi pantai yaitu siswa SMP Kristen Nazaret Tuminting. Subjek penelitian berjumlah 60 remaja yang memenuhi kriteria inklusi yaitu gizi baik, sehat, berumur 13-15 tahun, berdomisili di pegunungan atau tepi pantai ≥6 bulan, bersedia dilakukan pemeriksaan darah, dan telah disetujui oleh orang tua. Data yang diperoleh dianalisis menggunakan uji Mann-Whitney dengan bantuan program SPSS. Hasil uji Mann-Whitney mengenai perbedaan kadar hemoglobin antara kedua kelompok menunjukkan nila p <0,001. Simpulan: Terdapat perbedaan yang sangat bermakna kadar hemoglobin remaja gizi baik yang tinggal di pegunungan dengan di tepi pantai.Kata kunci: kadar hemoglobin, remaja gizi baik, pegunungan, tepi pantai


2020 ◽  
Vol 19 (2) ◽  
pp. 1-5
Author(s):  
Aso Sabir Saeed ◽  
◽  
Osama MohammadAmin Shukr

Background: Several studies have demonstrated an association between obesity and migraine. It’s still unclear whether migraine is the cause or it's the result of obesity. Objective: We investigated the prevalence of migraine among obese and non-obese individuals and analyzed the relationship between migraine prevalence and obesity. Patients and Methods: This is cross-sectional observational study was carried out at the neurology outpatients’ department of the Rizgary Teaching Hospital in Erbil, Iraq, from July 1st , 2018 to September 30, 2019. We interviewed and examined 300 persons, both obese (n=154) and non-obese (n=146), and of both gender. All of them were adults (>18 years old). Each person's weight, height, body mass index (BMI), and waist circumference were measured.The diagnosis of migraine was made according to the International Headache Society’s criteria. Obesity was present if the individual’s BMI is ≥30 and/or waist-to-hip ratio is >0.9 in females and >1.0 in males. Results: Out of the 300 persons, 14 males (8.5%) got migraines while migraine was found in 37 females (27.4%), irrespective of their weight. Out of the 300 persons, the prevalence of migraine among obese individuals was 21.4% (n=33) and while in non-obese individuals was 12.3% (n=18). There was a statistically significant difference between the groups (p-value=0.045). The overall prevalence of migraine was 16.9% of the persons interviewed. Conclusion: The results showed that migraine is more prevalent among obese persons than non-obese persons and the difference was statistically significant. Keywords: Migraine, obesity, BMI, headache


2020 ◽  
Vol 7 (6) ◽  
pp. 997
Author(s):  
Dharmendra Jhavar ◽  
Neha Kirti ◽  
Sumit Kumar Vishwakarma ◽  
Umesh Kumar Chandra ◽  
Vinod Verma

Background: Since a long time ago, the experts have realized that determination of cut-off point for diagnosing diabetes will be revised over time with the lower blood glucose level as the more sensitive diagnosis for detecting the occurring complication and biochemical changes.Methods: This cross sectional study was carried out in the department of medicine, M.G.M. Medical College and M.Y. Hospital Indore from July, 2016 to August, 2017 in 200 individuals and patients having euglycemic status attending General Medicine OPD.Results: In the low and high normal group 2 (2.0%) and 8 (8.0%) were having abnormal total cholesterol (TC) level respectively. The mean total cholesterol in the low normal group was 117.16±26.94mg/dl and it was 154.74±28.38mg/dl in the high normal group. The difference was found to be statistically significant (p value 0.000). In the low and high normal group, 4 (4.0%) and 17 (17.0%) were having abnormal triglyceride (TG) levels respectively. The mean TG levels in the low and high normal group were 96.93±22.64mg/dl and 110.55±32.37mg/dl respectively. The difference was found to be statistically significant (p value 0.001). In the low and high normal group, 6 (6.0%) and 14 (14.0%) patient was having abnormal uric acid levels respectively. The mean uric acid levels in the low and high normal group was 4.88±1.10mg/dl and 5.31±1.31mg/dl respectively. The difference was found to be statistically significant (p value 0.013).Conclusions: Higher levels of Cholesterol and Triglycerides were found more commonly in high normal euglycemic group compared to low normal euglycemic group. Mean cholesterol and mean triglyceride levels were higher in high normal euglycemic group.


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