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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.
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Background One of the most often damaged ligaments in the knee is the anterior cruciate ligament (ACL). With the increased occurrence of ACL injuries, there is a greater need for clinical diagnostics to rule in or rule out a suspected rupture. The Lever Test, a novel clinical tool for diagnosing ACL rupture, has been presented, with preliminary trials indicating encouraging results. Methods This is a prospective, blinded, diagnostic accuracy study. The aim of this study was to evaluate the accuracy of the Lever Test and other common clinical tests (Anterior Drawer Test, Lachman Test, Pivot Shift Test) for diagnosing ACL injuries. The study enrolled 23 patients who had knee pain, instability, and locking symptoms. The clinical tests were performed on the patients in supine position before, during, and after anesthesia. The results of the clinical tests were compared with MRI findings to determine the sensitivity of each test. Results The patients consisted of 17 men and six women, with a mean age of 30.4±9.95 years. 18 patients had complete tears, four had partial tears, and one had intact ACL damage. 10 (44%) complained in the right knee, 13 (56%) in the left knee, and two (9%) had a generalized ligamentous laxity. 21 (91%) complained of giving away, 22 (96%) complained of knee pain, and 10 (43%) complained of locking of the knee. On the ipsilateral leg examination, pre-operative positivity of Lever Sign was 44%, Lachman 83%, and Anterior Drawer 67%. After being given anesthesia, test positivity rates were 44% for Lever Sign and 56% for Pivot Shift. Post-operative positivity of Lever Sign was 17%, Lachman 39%, and Anterior Drawer 35%. Mcnemar test p values were significant for the difference of positivity anterior drawer test (p=0.002) and were not significant on Lever Sign (p=0.7) and Lachman tests (p=0.13). Correlation analysis showed a weak but not statistically significant interrater reliability between MRI findings and Lever Sign (p=0.846) (Kappa= 0.2). On the contralateral leg examination, the pre-operative positivity of Lever Sign was 9%, Lachman 17%, and Anterior Drawer 22% Conclusion The study suggests that the Lever Test has lower accuracy than other clinical tests when comparing the results of tests with MRI findings. As a result, Lever Test should be used in combination with other clinical tests to accurately rule out suspected ACL injuries.
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Diffuse idiopathic skeletal hyperostosis (DISH) is a condition that causes abnormal bone growth at the sites of ligament insertion, mainly in the spine. It is of unknown etiology and usually affects older males. It is often asymptomatic, but it can sometimes cause dysphagia if it affects the anterior cervical spine. We report the case of a 50-year-old male patient with DISH who presented with chronic dysphagia and was diagnosed with a large cervical osteophyte compressing the esophagus. The patient had a history of several comorbidities, including diabetes, hypertension, stroke, and gout. He underwent surgical removal of the osteophyte and recovered well. We discuss the clinical features, diagnosis, and treatment options for this rare complication of DISH.
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Diabetic retinopathy (DR) is a microvascular complication associated with vascular endothelial growth factor (VEGF) overexpression. Therapeutic delivery to the retina is a challenging phenomenon due to ocular biological barriers. Sorafenib tosylate (ST) is a lipophilic drug with low molecular weight, making it ineffective at bypassing the blood-retinal barrier (BRB) to reach the target site. Cubosomes are potential nanocarriers for encapsulating and releasing such drugs in a sustained manner. The present research aimed to compare the effects of sorafenib-tosylate-loaded cubosome nanocarriers (ST-CUBs) and a sorafenib tosylate suspension (ST-Suspension) via subconjunctival route in an experimental DR model. In this research, ST-CUBs were prepared using the melt dispersion emulsification technique. The distribution of prepared nanoparticles into the posterior eye segments was studied with confocal microscopy. The ST-CUBs were introduced into rats' left eye via subconjunctival injection (SCJ) and compared with ST-Suspension to estimate the single-dose pharmacokinetic profile. Streptozotocin (STZ)-induced diabetic albino rats were treated with ST-CUBs and ST-Suspension through the SCJ route once a week for 28 days to measure the inhibitory effect of ST on the diabetic retina using histopathology and immunohistochemistry (IHC) examinations. Confocal microscopy and pharmacokinetic studies showed an improved concentration of ST from ST-CUBs in the retina. In the DR model, ST-CUB treatment using the SCJ route exhibited decreased expression levels of VEGF, pro-inflammatory cytokines, and adhesion molecules compared to ST-Suspension. From the noted research findings, it was concluded that the CUBs potentially enhanced the ST bioavailability. The study outcomes established that the developed nanocarriers were ideal for delivering the ST-CUBs via the SCJ route to target the retina for facilitated DR management.
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Background Post-acute COVID-19 syndrome (PACS) is a syndrome characterized by a wide spectrum of symptoms emerging after clearance of coronavirus 2019 (COVID-19) infection. These symptoms include fatigue, myalgia, arthralgia, cognitive dysfunction, and many other psychiatric symptoms. Given that fibromyalgia patients have similar symptoms, we conducted a web-based cross-sectional study to investigate the prevalence and predictors of fibromyalgia patients who recovered from COVID-19. Methods Data were collected between the 9th and 19th of March 2022 using a web-based survey. The questionnaire consisted of 25 questions gathering sociodemographic information, comorbid diseases and features of acute COVID-19 infection. Lastly, the American College of Rheumatology (ACR) survey criteria completed the questionnaire. Results A final sample of 404 individuals (75% women) filled out the form. Of these, 80 (19.8%) satisfied the ACR survey criteria for fibromyalgia (93.8% women). A multivariate logistic regression model including demographic and clinical factors showed that female gender (OR: 6.557, 95% CI: 2.376 - 18.093, p = 0.001) and dyspnea (OR: 1.980, 95% CI: 1.146 - 3.420, p = 0.014) were the strongest predictors of being classified as having post-COVID-19 fibromyalgia. Bivariate correlation revealed that age (r = 0.200, p = 0.001) and duration of COVID-19 infection (r = 0.121, p = 0.015) were directly correlated with fibromyalgia symptom (FS) score. Conclusion Our data suggest that clinical features of fibromyalgia are common in patients who recovered from COVID-19 and that dyspnea and female gender increase the risk of developing post-COVID-19 fibromyalgia.