Barometric and Spatiotemporal Gait Differences Between Leading and Nonleading Feet of Handball Players.

BACKGROUND: Side-to-side stress imbalance has been suggested as a risk factor for injury in unilateral sports. The leading leg is suggested to be essential in sports rehabilitation for the return of athletes to the playground. The main aim of this study was to evaluate the dynamic pedobarometric and spatiotemporal gait differences between the leading and nonleading feet of male handball players. METHODS: Thirty healthy elite male handball players (mean ± SD: age, 31.7 ± 2.99 years; height, 177.5 ± 6.0 cm; weight, 78.9 ± 6.3 kg; body mass index, 25.0 ± 0.7) participated in this study; all of the participants were backcourt and pivot handball players. The assessments were performed using the Tekscan Walkway pressure sensor to detect and compare the variables of interest between the leading and nonleading feet during normal walking at a self-selected speed. RESULTS: Maximum force, peak pressure (total and forefoot pressure), foot width, single-limb support time, and step velocity were significantly increased in the leading foot compared with the nonleading foot. In addition, maximum force, foot width, and total peak pressure showed moderate positive significant correlations with body mass index. CONCLUSIONS: The differences in the pedobarometric and spatiotemporal gait parameters may result from the physiologic and mechanical demands that are put on the leading foot of handball players, which need more rehabilitation attention and protection to avoid expected injuries.

Recurrent cutaneous basal cell carcinoma after surgical excision: A retrospective clinicopathological study.

Background: Recurrence of basal cell carcinoma (BCC) after complete surgical excision is rarely reported. Risk factors for this negative outcome are not well-studied. We present the clinical and histological features of recurrent BCCs in our institution. Methods: All patients between January 2016 to December 2020 whose primary BCCs were excised with free surgical margins according to the histopathology report, and represented later with local recurrence were included. The medical files were retrieved to record patient's age, sex, sun exposure, tumor site, size, clinical diagnosis, histopathology variant of primary lesion, least free margin distance of the original lesion, and recurrence time. Results: Eighteen patients (11 males and 7 females ranged between 50 and 75 years old) fulfilled the inclusion criteria; all of their lesions were located in head and neck regions. The mean recurrence time was 31.2 months (11-86) and the histological variant was the same of primary in 17/18 patients. Primary tumors showed nodular subtype in 77.8% of patients and 55.6% of the primary tumors were less than 15 mm in diameter. Sun exposure history was given by 77.8% of patients while the rest of patients had non-significant exposure. All recurrent excised lesions were of free margin less than 4 mm. Conclusion: We found that the primary tumors of all studied recurrent BCCs were excised with surgical margins less than 4 mm. We recommend follow up for all excised BCCs either those of low or high risk histological variants. Tumor size does not appear a considerable risk factor for local recurrence.

A comparison of sagittal spine deformities among elementary school students using spinal mouse device.

BACKGROUND: Sagittal spine curvature deformities are common among elementary school students due to long malposition and lack of physical activity. OBJECTIVES: This study aims to compare sagittal spine deformities among first graders (young and elder school students) in elementary schools. METHODS: The sagittal spinal curvatures of 45 young school students aged 5-7 years and 50 elder school students aged 9-11 years were examined by using spinal mouse device. RESULTS: Independent sample t-test shows statistically significant differences in sagittal spinal deformities with increased thoracic kyphosis and spinal flexion in young children than elder children (P = .000, t = 10.72). However, young children show lesser lordosis than elder children (P = .001, t = -4.47). In addition, the young children established a higher significant coefficient of compensation (CC) than elder children (P = .000 t = 12.58). CONCLUSION: The results suggest that the forward flexion of the trunk is more common among young children than elder children. This may be attributed to differences in postural awareness and way of sitting among students of elementary school. So, it is recommended to encourage the proper postures among students of first graders especially young children.

The association between the ICIQ-LUTS and the ICIQ-bladder diary in assessing LUTS.

OBJECTIVES: The bladder diary (BD) provides a non-invasive method of investigating lower urinary tract symptoms (LUTS) while the International Consultation on Incontinence Questionnaires (ICIQ) symptom questionnaires, such as the ICIQ-MLUTS and ICIQ-FLUTS for males and females, respectively, provide a subjective assessment. The association between objective and subjective assessments has not been well established for the ICIQ. MATERIALS AND METHODS: Retrospective analysis of data collected from a urodynamics database was conducted. Only patients who completed both the ICIQ-MLUTS/FLUTS and the ICIQ-BD were included. Assessment of the relationship between the ICIQ-BD and the ICIQ-MLUTS/FLUTS with regards to daytime frequency and nocturia episodes was conducted using descriptive statistics to determine how well they correlate. RESULTS: A total of 3054 patients were on the database with only 529 patients fully completing both the ICIQ-BD and ICIQ-MLUTS/FLUTS from February 2012 until November 2014. Criterion testing showed fair agreement between the nocturia question on the ICIQ-MLUTS/FLUTS and the ICIQ-BD (Kappa = 0.339; P < 0.001; 48.5%). Whereas diary recordings of daytime voiding frequency showed low agreement with questionnaire responses (Kappa = 0.254; P < 0.001; 42.7%). The degree of agreement was higher at lower frequencies. Females had a slightly higher agreement than males during the daytime (43.2% vs 41.6%) and nighttime (49.3% vs 47%). CONCLUSION: The ICIQ-BD is a simple, cheap, valid, and reliable method to assess LUTS in everyday clinical practice. However, an agreement between the ICIQ-BD and the ICIQ-MLUTS/FLUTS with regards to daytime frequency and nocturia episode is weak and therefore both are needed in the assessment of patients with LUTS.

Perineal repair of pelvic fracture urethral injury: in pursuit of a successful outcome.

OBJECTIVE: To determine perioperative factors that may optimize the outcome after delayed perineal repair of a pelvic fracture urethral injury (PFUI). PATIENTS AND METHODS: In all, 86 consecutive patients who underwent perineal repair of a PFUI between 2004 and 2011 were prospectively enrolled in this study. The mean (range) patient age was 23 (5-50) years. The mean (range) follow-up was 5.5 (2-8) years. We examined seven perioperative variables that might influence the outcome including: prior failed treatment, condition of the bulbar urethra, displacement of the prostate, excision of scarred tissues, fixation of the mucosae of the two urethral ends, and the number and size of sutures used for urethral anastomosis. Univariate and multivariate analyses were used to identify factors that influence postoperative outcome. RESULTS: Of the patients, 76 (88%) had successful outcomes and 10 (12%) were considered treatment failures. On univariate analysis, four variables were significant factors influencing the outcome: excision of scarred tissues, prostatic displacement, condition of the bulbar urethra and fixation of the mucosae. On multivariate analysis only two remained strong and independent factors namely complete excision of scarred tissues and prostatic displacement in a lateral direction. CONCLUSIONS: Meticulous and complete excision of scar tissue is critically important to optimise the outcome after perineal urethroplasty. This is particularly emphasised in cases associated with lateral prostatic displacement. Six sutures of 3/0 or 4/0 polyglactin 910 are usually sufficient to create a sound urethral anastomosis. Prior treatment and scarring of the anterior urethra do not affect the outcome.

Impact of lead exposure on health status and scholastic achievement of school pupils in Alexandria.

Lead exposure among children is a serious health problem affecting virtually every system in their bodies. Affection of their cognitive function with its implication of poor school performance, is one of the serious outcomes of such exposure. In an attempt to arrive to an adequate knowledge about the impact of lead exposure on the health status and scholastic achievement in school age, a cross sectional study was carried out on 250 primary school pupils aged from 8 to 10 years in Wassat region in Alexandria. The concentration, visual and hearing acuity and the cognitive function. Moreover, laboratory investigation of blood lead level of the pupils was carried out. Their final scholastic achievement at the end of the year were recorded. The results indicated that the mean blood lead level among the studied pupils was 17.36 +/- 10.67 microg/dl, more than one third of the sample (36.00%) were highly exposed to lead with blood level of 20 microg/dl and more. A significant negative correlation was found between blood lead level and the 50th percentile of weight for height (r = -0.4488), haemoglobin concentration (r = -0.6133) and IQ scores (r = -0.8150) of the pupils. While a significant positive correlation was observed with the functional visual and hearing loss (r = 0.1390 and 0.2189 respectively). Moreover, the multiple regression analysis determined that age, blood lead level, crowding index, IQ score and number of missed school days were the significant contributing variables to the final scholastic achievement of the pupils from all the studied factors.