ABSTRACT
Introduction Generalized ligamentous laxity (GLL) is defined as an increased range of motion across multiple joints in an individual beyond the mean range of motion in the general population, with a reported prevalence between 5% and 15%. It becomes less common with age and is more common in females and in the lower limbs. Musculoskeletal injury (MSI) is damage to musculoskeletal systems, usually due to strenuous activity. There is conflicting literature regarding whether the risk of MSI during strenuous activity is higher in individuals with GLL and a dearth of evidence from the Indian subcontinent regarding GLL. This study determines if GLL predisposes to musculoskeletal injuries among patients. Materials and methods One hundred eighty patients each were selected as cases and controls after obtaining informed consent, a Beighton score assessment, and a questionnaire regarding injury-filled in all participants with GLL. Result Thirty-three participants (18.33%) in the case group and 16 participants (8.89%) in the control group were found to have GLL. An odds ratio of 2.30 (using a 2x2 RC table) was calculated between participants with GLL among the cases and controls with a Beighton score of 4/9, and a significantly higher mean Beighton score (p=0.018) was found among participants presenting with MSI (cases) than participants without MSI (controls). Discussion The study found that there was a significant prevalence of GLL in the adult population, especially in females compared to males. The younger age group was also comparatively much more involved. It also proved that GLL was more common in patients with MSI and that hyper-mobile people had a twofold chance of injury compared to the general population. The joints of the lower limb were more frequently involved, probably the weight-bearing joints, the most common being the ankle and knee. People with GLL also had higher chances of repeating injuries. Conclusion This study has implications for the prevention of injuries in people with GLL. Screening such individuals to identify those with GLL using the Beighton score could be beneficial. Though orthopedic surgeons primarily manage people with MSI, they rarely identify individuals with GLL, and making a diagnosis regarding the same definitely helps these individuals live pain-free lives.
ABSTRACT
An integrated life cycle assessment (LCA) and quantitative microbial risk assessment (QMRA) were conducted to assess microalgae-mediated wastewater disinfection (M-WWD). M-WWD was achieved by replacing ultraviolet disinfection with a microalgal open raceway pond in an existing sewage treatment plant (STP) in India. Regarding impacts on human health, both M-WWD and STP yielded comparable life cycle impacts, around 0.01 disability-adjusted life years (DALYs) per person per year. However, QMRA impacts for M-WWD (0.053 DALYs per person per year) were slightly lower than that for STP while considering exposure to E. coli O157:H7 and adenovirus. Additionally, a comparative LCA resolved the dilemma about the appropriate utilization of microalgal biomass. Among biodiesel, biocrude, and biogas production, the lowest impacts of 0.015 DALYs per person per year were obtained for biocrude for 1 m3 water treated by M-WWD. Electricity consumption in microalgae cultivation was a major environmental hotspot. Overall, M-WWD, followed by production of microalgal biocrude, emerged as a sustainable alternative from environmental and public health perspectives. These findings set the foundation for pilot-scale M-WWD system development, testing, and economic evaluation. Such comprehensive investigations, encompassing LCA, QMRA, and resource recovery scenarios, offer crucial insights for stakeholders and decision-makers in wastewater treatment and environmental management.
Subject(s)
Microalgae , Wastewater , Humans , Escherichia coli , Sewage , Ponds , Biofuels , BiomassABSTRACT
Background and objective Total knee arthroplasty (TKA) is a highly successful surgical procedure. However, there is a lack of consensus about whether to resurface the patella or not. This study was aimed at evaluating the outcome of patellar resurfacing in terms of a decrease in the incidence of anterior knee pain after TKA and assessing whether patellar resurfacing is beneficial in improving functional outcomes. Materials and methods This prospective comparative study included 100 patients undergoing TKA who were randomly allotted to the patellar resurfacing or non-resurfacing group. Functional evaluation was done based on the Knee Society Score, and the pain was evaluated by the visual analogue scale (VAS) preoperatively and after one year. Results There was a significant improvement in the Knee Society scores as well as the pain scores in both groups postoperatively. The patellar resurfacing group showed statistically significant improvement as compared to the non-resurfacing group in the Knee Society clinical and functional scores as well as the VAS at the end of one year. Conclusion Patellar resurfacing during TKA provides better clinical and functional outcomes as well as more relief from anterior knee pain as compared to non-resurfacing of the patella.
