Subject: Risk Factors, Strategy Prevention and Treatment of Anterior Cruciate Ligament Injuries in Female Athletes

Studies your target reviews of risk factors and preventive maintenance and also treatment for harm reduction anterior cruciate ligament (ACL) assigned to  help women's sports society. Female athletes with ACL injury such as psychological and emotional problems, social and medical costs high and physical is confronted. So the purpose of the article understand risk factors of ACL injury among women suggested therapy for determining women  with risk of ACL injury high. Review  search databases Scopus, Pubmed, Cochran, Elsevier, Pedro and google scholar for Assigning Articles  performed on the injury anterior cruciate ligament particularly studies conducted on prevalence of the pathology in women  that has case studies  of ACL injury, especially women, as well as of risk factors and treatment of ligament injury was detected in women. A total of 14 articles in field of check the network among which, six articles various ligament of the anterior cruciate The damaged reviews 3 article with risk high ACL women of  the 2 article alone factor risk , 1 Original is also prevention and first article examines of risk factors and treatment only 1 article reviews the epidemiology  of  ACL injury in women, men.The results showed that ACL injuries in female athletes are more likely than men due to differences in neuromuscular. So we have discussed the difference evaluating the Risk Factors and Treatment Studies previous risk of internal and external. According to this study nonsurgical treatments surgical treatment including strength training, plyometric, weight bearing and proprioception whose activities the patient to return to the damage

Evaluation of Delayed Diagnosis of Neck Masses and Related Factors

Background: Due to the importance of time in diagnosis and treatment and, as a result, the prognosis of patients with neck malignancies, we decided to evaluate the causes of delay in diagnosis of neck masses and their associated factors. Aim: In this study, we have evaluated the delay in diagnosing neck masses and the related factors. Methods: This descriptive-analytical study was performed on 500 patients with a neck mass who were referred to Loghman Hakim Hospital in 2019. Demographic data were recorded. The time of the delay to visit a doctor and the time of the delay to diagnosis were recorded. Factors related to the delay in the patient and physician's diagnosis, including the patient's socioeconomic status, literacy and income level, associated symptoms, history of smoking, infections and underlying diseases, were evaluated. Results: the mean age of patients was 46.04 years. 50.4% were female. The mean time interval between feeling neck mass and visiting a doctor was 34.72 days. This time interval between feeling neck mass and visiting a doctor in patients with higher education levels was less than in illiterate patients with low education levels (p = 0.046). This interval time in patients with higher income levels was less than in patients with lower income levels (p = 0.009). This interval was significantly increased with increasing age (p<0.001). Conclusion: Based on our findings, some factors such as age, income and education level significantly influence the process of diagnosis and treatment. On the other side, the presence of some signs and symptoms like dysphagia, sore throat, weight loss, etc., can remarkably reduce delay in that process. Ultimately it seems helpful to make an application which provides essential training for elderly, low-income or unlearned patients and facilitates consulting and referring to doctors for them

Evaluation of the Relation between Tuning Fork Tests, Glue ear Presence, and Conductive Hearing Loss in Patients with Otitis Media with Effusion

Background: In the middle ear inflammation, otitis media with effusion (OME) leads to a sterile effusion. Although most OME resolves without any complications, long-lasting OME may cause conductive hearing loss (CHL). Aim: In this article, we investigate the validity of the Rinne and Weber tests in different frequencies of tuning forks in predicting the conductive hearing loss secondary to OME as diagnosed by more modern audiometric tests. Methods: A case series of 25 consecutive patients visited the Loqman Hakim Hospital clinic. Each patient was evaluated by tuning fork tests (256, 512, 1024, 2048 Hz), audiometry, tympanometry, and tympanocentesis. Results: In evaluation of the hearing status in OME patients, there was no significant association between the Weber test, audiometry, and tympanometry. The 256 Hz Rinne test correlated with the level of hearing loss in patients with OME. Results revealed no relationship between the presence of glue ear, audiometric, tympanometric, and tuning fork tests. Conclusion: 256 Hz Rinne test can predict the presence of CHL in cases suffering from OME. Adhesive otitis does not worsen the hearing condition of patients

Evaluation of the Association between Serum Levels of Vitamin D and Benign Paroxysmal Positional Vertigo (BPPV): A Case-Control Study

Background: Benign paroxysmal positional vertigo (BPV) is the most common cause of the high prevalence of vertigo. Today, BPV is caused by the separation of autochthonous particles from the macular atrial. As a result, these particles float in a semicircular canal and change position by gravity. The majority of vertigo causes arise from the inner ear. Aim: This study aims to measure the vitamin D level in patients with BPPV who visited Loghman Hakim Hospital clinics and compare the results with controls. Methods: This comparative study evaluated the effect of vitamin D on reducing BPV. Demographic information of patients was collected through interviews. The physical examinations were recorded through a questionnaire. For the group with BPPV, we did the Epley maneuver and measured the vitamin D level. We compared the vitamin D levels of these patients with the matched control group. Results: In this study, 148 patients were evaluated. Sixty-three patients were male, and 85 patients were female. All case and control patients were tested for vitamin D levels. Of 93 patients with benign vertigo, 39 (41.9%) patients had normal vitamin D levels, and 54(58.1%) patients had below normal. In the control group, 43 (78.2%) patients had normal vitamin D, and 12 (21.8%) patients had less than normal. There was a statistically significant difference between the two groups. Conclusion: The present study indicated that BPV was more prevalent in people with vitamin D deficiency, and vitamin D treatment could effectively control and reduce the prevalence of this disease

A Young Case with Endolymphatic Sac Tumors Presented with Right-sided Hearing Loss and Facial Hemi-paralysis

Background: Endolymphatic sac tumors (ELSTs) are uncommon low-grade, locally invasive epithelial tumor that originates from the endolymphatic sac of the inner ear and temporal bone. It is a rare event with less than 300 cases worldwide. In this article, we present a case of ELTS who presented with facial asymmetry and hearing loss. In this article, we present a case of ELTS who presented with facial asymmetry and hearing loss.                    Case presentation: A 15-year-old female was admitted to our hospital with right-sided facial hemiplegia and hearing loss in her right ear which was started and progressed within two years. Except for facial hemiparalysis, other physical examinations were normal. In her audiological investigations, severe hearing loss of her right ear was evident. Imaging studies were indicative of ELSTs. This diagnosis was confirmed by histopathological investigations. Discussion: ELST is an aggressive papillary tumor that arises from the endolymphatic sac. In most cases, this tumor presents as a solitary growth. It usually presents with hearing loss but can be associated with other symptoms like tinnitus, vertigo and nerve VII paralysis. Imaging studies play a crucial role in the diagnosis of ELST, as it can reveal a characteristic soft-tissue mass involving the temporal bone, with bony erosion and extension into adjacent structures. Surgery is considered as the main form of treatment for ELSTs. Conclusion: ELSTs are exceedingly rare events. Here we presented a case of ESLT with right facial hemiplegia and right ear deafness

Prevalence of Cerebrospinal Fluid Rhinorrhea Following Trans-Sphenoidal Surgery for Pituitary Adenoma in Patients Referred to Loghman Hakim Hospital from 2016 to 2020

Background: Endoscopic endonasal transsphenoidal surgery is commonly used to remove pituitary adenomas. However, it can lead to cerebrospinal fluid (CSF) leakage, with an incidence of around 5% in sphenoid transnasal procedures and up to 20% in extended endonasal approaches. A retrospective study was conducted on 160 pituitary adenoma patients admitted to Loghman Hakim Hospital from 2016 to 2020 to evaluate the factors influencing CSF leak. Aim: The aim of this study was evaluating the occurrence of cerebrospinal fluid leakage and analyzing the factors involved. Methods: This is a retrospective analysis of patients diagnosed with pituitary adenoma at Loghman-Hakim hospital over a four-year period. Demographic information, tumor characteristics, surgical procedures, and complications were collected. All patients gave their consent, and the study was approved by the ethics committee. Surgical procedures were conducted using a direct endonasal trans-sphenoidal approach under general anesthesia, and antibiotics were given. Statistical analysis was conducted using SPSS to evaluate the relation between measured variables and the occurrence of CSF leak. Results: The study found that 19.4% of the patients developed CSF leak during their hospital stay. Age and body mass index (BMI) of patients with CSF leak significantly differed from those without. The size of the tumor did not differ significantly between patients with and without CSF leak. The only variable associated with CSF leak was sphenoid sinus anatomy. Conclusion: The study concluded that older patients with a lower BMI and a larger defect size are more prone to CSF leak, but no significant difference was found in tumor size between the groups with and without CSF leak. Sphenoid sinus anatomy correlated with CSF leak, while other factors did not show any correlation with the incidence of CSF leak

Surface rupture of multiple crustal faults in the 2016 Mw 7.8 Kaikōura, New Zealand, earthquake

Multiple (>20 >20 ) crustal faults ruptured to the ground surface and seafloor in the 14 November 2016 M w Mw 7.8 Kaikōura earthquake, and many have been documented in detail, providing an opportunity to understand the factors controlling multifault ruptures, including the role of the subduction interface. We present a summary of the surface ruptures, as well as previous knowledge including paleoseismic data, and use these data and a 3D geological model to calculate cumulative geological moment magnitudes (M G w MwG ) and seismic moments for comparison with those from geophysical datasets. The earthquake ruptured faults with a wide range of orientations, sense of movement, slip rates, and recurrence intervals, and crossed a tectonic domain boundary, the Hope fault. The maximum net surface displacement was ∼12  m ∼12  m on the Kekerengu and the Papatea faults, and average displacements for the major faults were 0.7–1.5 m south of the Hope fault, and 5.5–6.4 m to the north. M G w MwG using two different methods are M G w MwG 7.7 +0.3 −0.2 7.7−0.2+0.3 and the seismic moment is 33%–67% of geophysical datasets. However, these are minimum values and a best estimate M G w MwG incorporating probable larger slip at depth, a 20 km seismogenic depth, and likely listric geometry is M G w MwG 7.8±0.2 7.8±0.2 , suggests ≤32% ≤32% of the moment may be attributed to slip on the subduction interface and/or a midcrustal detachment. Likely factors contributing to multifault rupture in the Kaikōura earthquake include (1) the presence of the subduction interface, (2) physical linkages between faults, (3) rupture of geologically immature faults in the south, and (4) inherited geological structure. The estimated recurrence interval for the Kaikōura earthquake is ≥5,000–10,000  yrs ≥5,000–10,000  yrs , and so it is a relatively rare event. Nevertheless, these findings support the need for continued advances in seismic hazard modeling to ensure that they incorporate multifault ruptures that cross tectonic domain boundaries

Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017.

The Global Burden of Diseases, Injuries and Risk Factors 2017 includes a comprehensive assessment of incidence, prevalence, and years lived with disability (YLDs) for 354 causes in 195 countries and territories from 1990 to 2017. Previous GBD studies have shown how the decline of mortality rates from 1990 to 2016 has led to an increase in life expectancy, an ageing global population, and an expansion of the non-fatal burden of disease and injury. These studies have also shown how a substantial portion of the world's population experiences non-fatal health loss with considerable heterogeneity among different causes, locations, ages, and sexes. Ongoing objectives of the GBD study include increasing the level of estimation detail, improving analytical strategies, and increasing the amount of high-quality data. METHODS: We estimated incidence and prevalence for 354 diseases and injuries and 3484 sequelae. We used an updated and extensive body of literature studies, survey data, surveillance data, inpatient admission records, outpatient visit records, and health insurance claims, and additionally used results from cause of death models to inform estimates using a total of 68 781 data sources. Newly available clinical data from India, Iran, Japan, Jordan, Nepal, China, Brazil, Norway, and Italy were incorporated, as well as updated claims data from the USA and new claims data from Taiwan (province of China) and Singapore. We used DisMod-MR 2.1, a Bayesian meta-regression tool, as the main method of estimation, ensuring consistency between rates of incidence, prevalence, remission, and cause of death for each condition. YLDs were estimated as the product of a prevalence estimate and a disability weight for health states of each mutually exclusive sequela, adjusted for comorbidity. We updated the Socio-demographic Index (SDI), a summary development indicator of income per capita, years of schooling, and total fertility rate. Additionally, we calculated differences between male and female YLDs to identify divergent trends across sexes. GBD 2017 complies with the Guidelines for Accurate and Transparent Health Estimates Reporting

Global, regional, and national disability-adjusted life-years (DALYs) for 359 diseases and injuries and healthy life expectancy (HALE) for 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017.

How long one lives, how many years of life are spent in good and poor health, and how the population's state of health and leading causes of disability change over time all have implications for policy, planning, and provision of services. We comparatively assessed the patterns and trends of healthy life expectancy (HALE), which quantifies the number of years of life expected to be lived in good health, and the complementary measure of disability-adjusted life-years (DALYs), a composite measure of disease burden capturing both premature mortality and prevalence and severity of ill health, for 359 diseases and injuries for 195 countries and territories over the past 28 years. Methods We used data for age-specific mortality rates, years of life lost (YLLs) due to premature mortality, and years lived with disability (YLDs) from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017 to calculate HALE and DALYs from 1990 to 2017. We calculated HALE using age-specific mortality rates and YLDs per capita for each location, age, sex, and year. We calculated DALYs for 359 causes as the sum of YLLs and YLDs. We assessed how observed HALE and DALYs differed by country and sex from expected trends based on Socio-demographic Index (SDI). We also analysed HALE by decomposing years of life gained into years spent in good health and in poor health, between 1990 and 2017, and extra years lived by females compared with males. Findings Globally, from 1990 to 2017, life expectancy at birth increased by 7·4 years (95% uncertainty interval 7·1-7·8), from 65·6 years (65·3-65·8) in 1990 to 73·0 years (72·7-73·3) in 2017. The increase in years of life varied from 5·1 years (5·0-5·3) in high SDI countries to 12·0 years (11·3-12·8) in low SDI countries. Of the additional years of life expected at birth, 26·3% (20·1-33·1) were expected to be spent in poor health in high SDI countries compared with 11·7% (8·8-15·1) in low-middle SDI countries. HALE at birth increased by 6·3 years (5·9-6·7), from 57·0 years (54·6-59·1) in 1990 to 63·3 years (60·5-65·7) in 2017. The increase varied from 3·8 years (3·4-4·1) in high SDI countries to 10·5 years (9·8-11·2) in low SDI countries. Even larger variations in HALE than these were observed between countries, ranging from 1·0 year (0·4-1·7) in Saint Vincent and the Grenadines (62·4 years [59·9-64·7] in 1990 to 63·5 years [60·9-65·8] in 2017) to 23·7 years (21·9-25·6) in Eritrea (30·7 years [28·9-32·2] in 1990 to 54·4 years [51·5-57·1] in 2017). In most countries, the increase in HALE was smaller than the increase in overall life expectancy, indicating more years lived in poor health. In 180 of 195 countries and territories, females were expected to live longer than males in 2017, with extra years lived varying from 1·4 years (0·6-2·3) in Algeria to 11·9 years (10·9-12·9) in Ukraine. Of the extra years gained, the proportion spent in poor health varied largely across countries, with less than 20% of additional years spent in poor health in Bosnia and Herzegovina, Burundi, and Slovakia, whereas in Bahrain all the extra years were spent in poor health. In 2017, the highest estimate of HALE at birth was in Singapore for both females (75·8 years [72·4-78·7]) and males (72·6 years [69·8-75·0]) and the lowest estimates were in Central African Republic (47·0 years [43·7-50·2] for females and 42·8 years [40·1-45·6] for males). Globally, in 2017, the five leading causes of DALYs were neonatal disorders, ischaemic heart disease, stroke, lower respiratory infections, and chronic obstructive pulmonary disease. Between 1990 and 2017, age-standardised DALY rates decreased by 41·3% (38·8-43·5) for communicable diseases and by 49·8% (47·9-51·6) for neonatal disorders. For non-communicable diseases, global DALYs increased by 40·1% (36·8-43·0), although age-standardised DALY rates decreased by 18·1% (16·0-20·2)