The prevalence of fibromyalgia in adults at Al-Karak Jordan: a cross-sectional study.

Introduction: Fibromyalgia is a chronic and intricate musculoskeletal disorder characterized by widespread pain, fatigue, and tenderness in specific anatomical regions. Although its prevalence varies among populations, understanding the prevalence in different geographical areas is crucial for healthcare planning. This cross-sectional study aims to determine the prevalence of fibromyalgia in adults residing in Al-Karak, Jordan. The city's unique demographic and environmental characteristics may influence the occurrence of fibromyalgia among its adult population. The study aims to address gaps in knowledge, provide localized insights, and shed light on fibromyalgia's burden on the community's health. Accurate prevalence data aids healthcare planning and resource allocation. Methods: This research collected data from 965 social media participants using Google Forms. The American College of Rheumatology survey criteria for diagnosing fibromyalgia were used. To investigate the predictive value of various parameters, univariate and multivariate logistic regression analyses were performed. Results: The study found a 26.5% prevalence of fibromyalgia in the studied population. Female gender, mental health illnesses, and comorbidities like irritable bowel syndrome, psychiatric disorders, and rheumatological and neurological diseases were significantly associated with fibromyalgia. Age, BMI, marital status, employment status, and certain comorbidities did not show statistically significant predictive value. Conclusion: This study sheds light on fibromyalgia's prevalence and associated factors in the Al-Karak population. The identified predictors highlight the necessity for comprehensive healthcare strategies and interventions to mitigate the disease burden. These findings aid policymakers and healthcare professionals in planning and implementing effective measures for fibromyalgia management and prevention. Further research is warranted to deepen our understanding of fibromyalgia's complexity and its implications in this region.

The Unseen Strain: Investigating the Awareness of Rhinoplasty Surgeons Regarding Their Spine Health.

BACKGROUND: Musculoskeletal pain is a common occupational health problem among surgeons that can affect work productivity and quality of life. OBJECTIVES: The aim of the study was to investigate the prevalence and causes of back pain among rhinoplasty surgeons, evaluate their routine practice, and identify unique risk factors. A further goal was to measure functional disabilities with the Total Disability Index (TDI) questionnaire. METHODS: A structured online questionnaire was distributed to plastic surgeons performing rhinoplasty internationally. The questionnaire comprised sections on biodata, routine practice posture, length of practice, surgical duration, and the history of surgery or hospitalization related to these issues. In the second part of the survey, participants were asked to complete the TDI questionnaire. RESULTS: The prevalence of back pain was reported by 93.6% of surgeons, with low back pain being the most common (76.7%). The average pain intensity for low back pain was 44.8 ± 26.8. The mean TDI score was calculated as 31 ± 12.1, with 58.2% of surgeons experiencing mild to moderate disability. Significant associations were found between musculoskeletal pain severity and disability index and factors such as BMI, exercise, years of rhinoplasty practice, number of surgeries performed per week, and average procedure length. Interestingly, only 16.4% of rhinoplasty surgeons had previous ergonomic training or education. CONCLUSIONS: Musculoskeletal issues related to the spine are prevalent among rhinoplasty surgeons. It is imperative to educate surgeons about this underestimated health problem, provide proper physical rehabilitation targeting ergonomic concerns, and make changes to current practices to address this issue effectively.

Clinical Outcomes and Osteoarthritis at Very Long-term Follow-up After ACL Reconstruction: A Systematic Review and Meta-analysis.

BACKGROUND: Few studies on outcomes after anterior cruciate ligament (ACL) reconstruction (ACLR) have provided insight into the very long-term effects of this procedure. PURPOSE: To systematically review the outcomes, failure rate, incidence, and predictors of osteoarthritis (OA) for different ACLR techniques at a minimum 20-year follow-up. STUDY DESIGN: Systematic review; Level of evidence, 4. METHODS: A search of the PubMed, SCOPUS, and Cochrane databases was performed on June 2020 for studies of patients who underwent ACLR and had a minimum follow-up of 20 years. We extracted data on patient and surgical characteristics, patient-reported outcomes (Lysholm score, subjective International Knee Documentation Committee [IKDC] score, Knee injury and Osteoarthritis Outcome Score [KOOS], and Tegner score), clinical outcomes (IKDC grade, pivot shift, Lachman, and KT-1000 laxity), degree of OA (Kellgren-Lawrence, Ahlbäck, and IKDC OA grading), revisions, and failures. Relative risk (RR) of OA between the operated and contralateral knees was calculated as well as the pooled rate of revisions, failures, and conversion to total knee arthroplasty (TKA). RESULTS: Included were 16 studies (N = 1771 patients; mean age, 24.8 years; mean follow-up, 22.7 years); 80% of the patients underwent single-bundle bone-patellar tendon-bone (BPTB) reconstruction. The average Lysholm (89.3), IKDC (78.6), and KOOS subscale scores were considered satisfactory. Overall, 33% of patients had "abnormal" or "severely abnormal" objective IKDC grade, 6.7% had KT-1000 laxity difference of ≥5 mm, 9.4% had Lachman ≥2+, and 6.4% had pivot shift ≥2+. Signs of OA were reported in 73.3% of patients, whereas severe OA was reported in 12.8%. The operated knee had a relative OA risk of 2.8 (P < .001) versus the contralateral knee. Identified risk factors for long-term OA were male sex, older age at surgery, delayed ACLR, meniscal or cartilage injuries, BPTB autograft, lateral plasty, nonideal tunnel placement, residual laxity, higher postoperative activity, and postoperative range of motion deficits. Overall, 7.9% of patients underwent revision, and 13.4% of ACLRs were considered failures. TKA was performed in 1.1% of patients. CONCLUSION: Most patients had satisfactory subjective outcomes 20 years after ACLR; however, abnormal anteroposterior or rotatory laxity was found in nearly 10% of cases. The presence of radiographic OA was high (RR 2.8 vs uninjured knee), especially in patients with concomitant meniscal or cartilage injuries, older age, and delayed surgery; however, severe OA was present in only 12.8% of cases, and TKA was required in only 1.1%.

Satisfactory clinical results and low failure rate of medial collagen meniscus implant (CMI) at a minimum 20 years of follow-up.

PURPOSE: The aim of the study was to evaluate the long-term clinical results, reoperations, surgical failure and complications at a minimum of 20 year of follow-up of the first 8 medial CMI scaffolds implanted by a single surgeon during a pilot European Prospective study. METHODS: Seven (88%) out of 8 patients were contacted. The Cincinnati Score, VAS, and Lysholm score were collected. Moreover, magnetic resonance imaging (MRI) was performed on 4 patients at the last follow-up. Complications, reoperations and failures were also investigated. RESULTS: The average follow-up was 21.5 ± 0.5 years. One patient underwent TKA after 13 years from CMI implantation; a second patient underwent valgus high tibial osteotomy 8 years after the index surgery and another patient underwent anterior cruciate ligament hardware removal at 21 years of follow-up. At the final follow-up, 3 patients were rated as "Excellent", 1 as "Good" and 2 as "Fair" according to the Lysholm score. The Cincinnati score and the VAS were substantially stable over time. The MRI showed a mild osteoarthritis progression in 3 out of 4 patients according to the Yulish score, and the CMI signal was similar to the mid-term follow-up revealing 3 cases of myxoid degeneration and 1 case of normal signal with reduced scaffold size. CONCLUSION: The medial CMI is a safe procedure: satisfactory clinical results and a low failure rate could be expected even at a long-term follow-up. For this purpose, the correct indication as well as correcting axial malalignment and addressing knee instability at the time of the index surgery is mandatory. On the other hand, a mild osteoarthritis progression could be expected even after meniscus replacement. LEVEL OF EVIDENCE: IV.

Bifocal Tibial Kaposiform Hemangioendothelioma Responsive to Vincristine Therapy: A Case Report.

BACKGROUND Kaposiform hemangioendothelioma is a rare locally aggressive vascular endothelial-derived spindle cells neoplasm. Herein, we report a rare case of bifocal tibial kaposiform hemangioendothelioma. CASE REPORT A 9-year-old female presented with a 2-year history of pain and swelling in the left leg. The patient had a high plasma level of the D-dimer and fibrinogen. Radiography revealed a centric lytic lesion on the left proximal tibial metaphysis and an eccentric lateral distal tibial metaphyseal. Histopathologic examination of the sample taken from the distal tibia revealed a dense spindle cell tumor with lobular architecture composed of compact spindle cells compressing small slit-like vascular spaces, forming glomeruloid nests. No necrosis was identified. Based on these findings and the positive immunohistochemical staining for CD31, CD34, and D2-40, the patient was diagnosed with kaposiform hemangioendothelioma. Treatment was started by using vincristine chemotherapy, after which the patient developed temporary peroneal neuropathy, which improved over the next 3 months. CONCLUSIONS Bifocal tibial kaposiform hemangioendothelioma lesions are unique in pediatric patients and can be successfully treated with vincristine chemotherapy. In these cases, the treating physician should be aware of peroneal neuropathy as a potential complication of vincristine administration.

Association between mobile phone use and neck pain in university students: A cross-sectional study using numeric rating scale for evaluation of neck pain.

OBJECTIVE: Mobile phones are reliable devices for communication and entertainment. However, their utilization for prolonged periods in flexed neck position is linked to neck and shoulders pain. The main purpose of this study is to investigate the association between neck pain and the duration of device use, taking into consideration gender, age, and the most frequent position in which students use their devices. SUBJECTS AND METHODS: Based on a self-administered online questionnaire, we filled 500 questionnaires between February 15th, 2017 and March 18th, 2017. The study sample included healthy students from health care faculties regardless of their age, gender, or handedness. RESULTS: Analysis of the predictors for pain severity showed that age (p = 0.04) and duration of use (p = 0.001) were significantly associated with the severity of neck pain, while only the duration of use was significantly associated with pain duration (p = 0.036). Subjects were divided into two groups according to the pain score, 75.8% had pain severity equal or less than 4/10 and 24.2% had pain severity more than 4/10. Of those with pain severity >4, 5.8% of students sought medical help at the emergency department and 12.4% visited clinics, compared to only 0.3% seeking medical advice at an emergency department and 4.2% visiting clinics in the group with pain severity of ≤4 (p<0.001). Regarding the use of analgesia in the two groups, 44.6% of subjects with pain severity of >4 used analgesia, compared to only 12.1% in subjects with pain severity of ≤4 (p< 0.001). CONCLUSION: This study demonstrates a significant positive correlation between the duration of mobile phone use and the duration and severity of neck pain. Furthermore, the increased severity of neck pain places a huge burden on the healthcare system.