Search Results (568)

Background/Objectives: Non-specific low back pain (LBP), a highly prevalent musculoskeletal condition, may be associated with overuse of radiological imaging, despite clinical guidelines restricting its use to cases with suspected serious pathology. This study investigated demographic, clinical, and physiotherapy-related factors influencing radiological imaging use in patients with non-specific LBP. Methods: A retrospective cross-sectional study included 179 non-specific LBP patients from an outpatient physiotherapy clinic in Saudi Arabia. Patient data were anonymized and retrieved from electronic health records, including demographic, clinical, physiotherapy and imaging information. Independent variables included patient demographics, non-specific LBP characteristics, physiotherapy engagement, and pain-related outcomes. Descriptive, inferential, and multiple linear regression analyses were conducted to identify predictors of radiological imaging. Results: Among the total study sample (n = 179), 159 (88.8%) patients underwent radiological imaging, primarily X-ray (32.4%) and Magnetic Resonance Imaging (8.4%); 48.0% received multiple imaging modalities. Significant predictors of imaging use included gender (p < 0.001), higher body mass index (BMI) (p = 0.012), greater physiotherapist experience (p = 0.019), and presence of comorbidities (p = 0.023). Non-specific LBP medication use was negatively associated with imaging (p = 0.032). Physiotherapy engagement and pain-related outcomes showed no significant impact on imaging use. Conclusions: Gender, BMI, physiotherapist experience, and comorbidities could influence radiological imaging use in non-specific LBP patients. These findings highlight potential biases in imaging referral patterns and reinforce the need for adherence to evidence-based guidelines to prevent unnecessary imaging, reduce healthcare costs, and enhance patient care. Full article

Background: Upper-extremity morbidity after breast cancer surgery—including pain, lymphedema, and restricted shoulder range of motion—often develops gradually, emerging months after treatment and limiting daily activities. We aimed to characterize morbidity trajectories, physical therapy utilization, and predictors of physical therapy use. Methods: A retrospective multicenter cohort included 1602 women treated with breast surgery 0–36 months earlier. Patient-reported outcomes included Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH), pain, range of motion limitation, axillary web syndrome, and lymphedema. Clinical variables included surgery type and nodal procedure. Outcomes were summarized across four postoperative windows (0–6, 7–12, 13–24, 25–36 months). Logistic and multinomial regression identified predictors of physical therapy uptake and timing (early, ≤3 months vs. late, >3 months; No physical therapy). Results: Anxiety declined across postoperative windows (p < 0.001), and axillary web syndrome decreased from early to later periods (p < 0.001). In contrast, range of motion restriction and decreased function remained common without significant differences between windows (p = 0.145 and p = 0.273). Pain was generally low-to-moderate by median [interquartile range], with a modest rise at 7–12 months (p < 0.001). In adjusted multinomial models (reference: Early physical therapy ≤ 3 months), higher pain was associated with No physical therapy and Late physical therapy (both p < 0.05); lymphedema with No PT and Late physical therapy (both p < 0.05); and axillary web syndrome with Late physical therapy (p = 0.001). Other symptoms (range of motion, function level, anxiety and physical activity) were not independently associated with physical therapy timing. Conclusions: Long-term postoperative morbidity is common. Early assessment and structured follow-up can mitigate its impact and should be embedded as core elements of survivorship health-promotion policy. Full article

Objective: Non-contrast computed tomography (CT) remains the gold standard for diagnosing ureteral stones, with excellent sensitivity and specificity. However, reliance on CT alone raises concerns regarding cumulative radiation exposure, particularly in recurrent stone formers. Clinical scoring systems such as CHOKAI, STONE, and modified STONE have been developed to provide practical bedside tools for diagnostic decision-making. This study prospectively compared these three clinical scores for their ability to predict urinary-stone disease in the emergency department. Study Design: Prospective study. Methods and Duration of the Study: Between 6 August 2024 and 15 February 2025, 130 consecutively enrolled adults with flank pain underwent bedside scoring and reference-standard non-contrast CT. Associations were analysed with Chi-Square Tests and multivariable logistic regression. Model calibration was assessed with the Hosmer–Lemeshow test; overall accuracy was calculated. Results: When the variables used in different stone scoring formulas were compared according to the computer tomography results, there was a statistically significant difference (p < 0.01) between patients with and without a history of stone and hydronephrosis. Patients with nausea, history of stone, and hydronephrosis were 11, 4.2, and 5 times more highly to have a stone on computer tomography than those without, respectively. Conclusions: In this Turkish cohort, CHOKAI and modified STONE demonstrated superior predictive performance compared to the original STONE score. These findings suggest that clinical scoring systems, when incorporating predictors such as nausea, prior stone history, and hydronephrosis, may serve as practical alternatives to CT-first diagnostic approaches. Multicenter validation studies are required before routine clinical adoption. Full article

Study Design: Retrospective Case–Control. Objectives: Sleep disturbances negatively impact quality of life and increase illness susceptibility. Chronic pain is a risk factor for sleep disruption, particularly in patients with degenerative spinal conditions. Existing studies suggest that degenerative cervical myelopathy (DCM) patients often experience sleep disturbances, possibly due to spinal cord compression and pain. However, most research is limited to small, single-center studies, creating a need for broader analyses. Methods: We utilized the Merative Explorys Dataset, focusing on electronic health record data of patients diagnosed with DCM and sleep disorders identified via ICD codes. Comorbidities analyzed included depression/bipolar disorder, chronic pulmonary disease, migraine, osteoarthritis, hypertension, malignancy, diabetes, and cerebrovascular disease. Patient demographic information (age, race, sex, and body mass index (BMI)) was included as covariates. Logistic regression analyses were performed to evaluate the association between each comorbidity and the risk of sleep disturbance. Results: Among 40,551 DCM patients, significant predictors of sleep disturbance included higher BMI (OR: 1.05, 95% CI: 1.05–1.06), depression/bipolar disorder (OR: 1.65, 95% CI: 1.56–1.74), chronic pulmonary disease (OR: 1.26, 95% CI: 1.20–1.33), migraine (OR: 1.32, 95% CI: 1.22–1.43), and hypertension (OR: 1.16, 95% CI: 1.10–1.23). Conclusions: This large-scale analysis demonstrates the multifactorial nature of sleep disturbances in DCM, highlighting strong associations with BMI and respiratory conditions, suggesting a contributory role of sleep-disordered breathing. The identification of migraines as a risk factor highlights the need for multidisciplinary management. Addressing modifiable risk factors such as BMI and mental health may improve sleep quality in DCM patients. Full article

Background/Objectives: Psychoanalytic theories of destructiveness highlight its deep, unconscious origins tied to primal emotional and motivational mechanisms. Traditional psychiatric models of suicidal risk assessment focus on classic risk factors, limiting diagnostic and intervention approaches. This study examines the neuropsychoanalytic foundations of destructive tendencies, integrating sublimation and evolutionary motivational systems, redefining their role in the destruction process. Methods: A total of 480 AI-generated illustrations were assessed for interpretative accuracy. The final set was used in an online projection task with 204 respondents. Analyses included factorial exploration of the structure of the tool, assessment of psychometric properties (Cronbach α, ROC, AUC), logistic regression and analysis of intergroup differences. Results: Factor analysis identified eight subscales. Six of the eight factors showed thematic resemblance to Panksepp’s emotional systems, although this interpretation remains theory-driven and requires empirical validation. The remaining two—pursuit of destruction and its sublimation—extend beyond natural evolutionary mechanisms. Destructiveness was best explained by depression and psychological pain (OR = 1.39, 95% CI [1.26–1.52]), aggression and impulsivity (OR = 1.68, 95% CI [1.36–2.06]), and anxiety and a sense of threat (OR = 1.55, 95% CI [1.27–1.90]). Key predictors of destruction sublimation were curiosity (OR = 3.15, 95% CI [2.43–4.09]), closeness and love (OR = 3.43, 95% CI [2.48–4.76]), and pleasure and fun (OR = 3.08, 95% CI [2.26–4.20]). Analyses showed higher levels of destructiveness in individuals receiving psychological or psychiatric support, those with prior diagnoses, and students compared to employed individuals. Conclusions: Results indicate high reliability (Cronbach’s α > 0.87) and discrimination among internal subscale-defined groups (ROC > 0.7), supporting the tool’s potential in assessing destructive and sublimation tendencies within a neuropsychoanalytic framework. Future studies will explore its external validity and clinical applications. Full article

Background: Globally, uncorrected refractive errors are recognized as the primary cause of visual impairment and blindness. According to a report by the World Health Organization (WHO), providing spectacle lenses at an affordable cost remains a significant challenge, particularly for underprivileged populations in developing countries. This challenge contributes to the low compliance with spectacle wear worldwide. However, the benefits of wearing spectacles are influenced by the perceptions of the population regarding spectacle use. Methods: A quantitative, cross-sectional survey-based study was conducted at a superior educative center in Oman, the University of Buraimi. Participants were recruited from the four major colleges, namely, the College of Health Sciences (COHS), College of Business (COB), College of Engineering (COE), and College of Law (COL), and the Center for Foundation Studies (CFS). This study was conducted over the period from 18 December 2022 to 18 December 2023. Essential data were collected using an electronic questionnaire facilitated by the Google platform. The initial section of the questionnaire outlines this study’s objectives and its benefits to the community. The digital survey comprises three sections: the first section addresses the sociodemographic profile of the participants; the second section explores perceptions related to spectacles; and the third section examines visual symptoms associated with spectacle wear. In this study, a pre-tested survey was administered following consultation with a panel of three subject matter experts who reviewed the clarity and content validity of the test items. Data analyses were performed using descriptive statistics, and linear regression was applied to assess the effect of socioeconomic profile on perceptions of spectacles. Additionally, data entry, processing, and analysis were conducted using SPSS 25 software. The overall mean score for spectacle-related visual symptoms was 2.51 ± 0.75, indicating a moderate level of symptom occurrence. Results: A total of 415 participants (N = 415) were included in this study, comprising 133 males (32.0%) and 282 females (68.0%). The most prominent symptoms related to spectacle perception were “light sensitivity” and “eye pain”, with mean values of 3.03 ± 1.30 and 3.04 ± 1.25, respectively. Additionally, 249 participants (60%) reported moderate concern regarding spectacle-related visual symptoms. Among female participants, 118 (41.8%) exhibited little concern about visual symptoms associated with spectacle wear, whereas this was observed in 25.6% of male participants. Descriptive statistics indicated the mean perceived spectacle-related disadvantages score measured on a scale of 0 to 4 was 2.88 ± 1.16 (57.69% ± 23.15% in percentages), reflecting a moderate perception of such disadvantages. The linear regression model demonstrated statistical significance, as indicated by the likelihood ratio chi-square = 199.194 (df = 15, p < 0.001). The most significant predictor was study major (χ² = 72.922, p < 0.001). Conclusions: The present study indicates that undergraduate students generally exhibit a low perception of the disadvantages associated with wearing spectacles. Randomized sampling should be preferred in future studies to the convenience sampling technique. The most frequently reported visual symptoms include “light sensitivity and eye pain” among spectacle wearers. Therefore, it is imperative to implement health education programs and foundational studies across colleges to address these issues among undergraduate university students. Full article

Background: Musculoskeletal (MSK) pain is a frequent but under-addressed concern during pregnancy. In Bangladesh, challenges such as limited antenatal care (ANC) access and heavy maternal workloads make this issue particularly urgent for maternal health. This study aimed to determine the prevalence and predictors of MSK pain among pregnant women attending government ANC clinics in Bangladesh. Methods: A facility-based cross-sectional study was conducted among 300 pregnant women recruited from two government hospitals in Dhaka Division. Data were collected using structured interviewer-administered questionnaires covering patient characteristics, pain-related characteristics, and pregnancy-related characteristics. Pain was measured using the Numeric Pain Rating Scale (NPRS; mild <4, moderate 4–7, severe >7), and body mass index (BMI) was calculated based on self-reported height and weight. Descriptive statistics, chi-square tests, and multivariable logistic regression were employed to identify factors independently associated with MSK pain. Results: Overall, 67% of women reported MSK pain, most frequently in the lower back and lower abdomen. Women in later trimesters had about twice the odds of experiencing pain, while those with obesity had nearly six times higher odds compared to women with normal body mass index (BMI). Conclusions: MSK pain is common among pregnant women in Bangladesh and shows associations with later gestational stages and obesity. These findings suggest that integrating routine screening and non-pharmacological management into ANC may help support maternal health and reduce preventable complications in resource-limited settings. Full article

Background: This study was a cross-sectional online survey aimed at examining health-related quality of life and the effect of different symptoms and lifestyle factors on health-related quality of life in a sample of women with endometriosis in Hungary. Methodology: A cross-sectional online survey was carried out in a sample of women with endometriosis. Self-edited and Hungarian versions of validated questionnaires were used to assess health-related quality of life (Sf-36-Health Survey—SF-36), pain (Numeric Rating Scale-NRS), effect of pelvic pain on everyday life (Pelvic Pain Impact Questionnaire—PPIQ), perceived stress levels (Perceived Stress Scale—PSS), and physical activity (Global Physical Activity Questionnaire—GPAQ). Data analysis was conducted using IBM SPSS Statistics 28.0, and the level of significance was set at p < 0.05. Multivariate linear regression analysis was performed to examine the effect of different lifestyle factors, pain-related, and physical symptoms on the participants’ health-related quality of life (HrQoL). Results: The health-related quality of life of Hungarian women with endometriosis in our sample was significantly lower than the latest Hungarian normative values. Multiple linear regression analyses revealed that psychological, pain-related, and lifestyle factors significantly predicted HrQoL across SF-36 subscales in women with endometriosis (all models, p < 0.001; Adjusted R² = 0.274–0.654). Pain self-efficacy (PSEQ) was a consistent positive predictor that was significantly associated with better scores in five SF-36 domains, including physical and social functioning. Perceived stress (PSS) is a strong negative predictor that particularly affects emotional well-being, energy/fatigue, and social functioning. Pain interference (PPIQ) was linked to poorer HrQoL in seven out of eight SF-36 domains, while average pain intensity (NRS) negatively predicted Physical Functioning and General Health. Vigorous physical activity was positively associated with Social Functioning, whereas moderate activity had no significant effect. Among the demographic factors, only age was negatively associated with Physical Functioning; BMI and education were not significant predictors. Conclusions: Psychological, lifestyle, and symptom-related factors play key roles in health-related quality of life among women with endometriosis. Self-efficacy was a strong positive predictor, whereas perceived stress and pain interference were linked to poorer outcomes. High-intensity physical activity supported better social functioning. These findings highlight the need for multidisciplinary interventions targeting psychological support, pain management, and physical activity to improve quality of life in this population. Full article

Background: Several prognostic factors, including the early recovery pattern of acute low back pain (ALBP), are related to the chronicity of LBP. However, the association between systemic symptoms and ALBP remains underexplored from a holistic perspective. Hence, this study aimed to investigate this relationship and identify novel clinical prognostic predictors for LBP. Methods: This retrospective cross-sectional study included patients with ALBP admitted to the Department of Korean Medicine Rehabilitation at the Dongguk University Bundang Hospital between 1 January 2021 and 30 April 2025. Data extracted from medical records included demographics, treatment-related information, pain characteristics, past medical history, and systemic symptoms. Statistical analyses included independent t-tests, Mann–Whitney U tests, chi-squared tests, Fisher’s exact tests, correlation analysis, and multiple linear regression models. Results: A total of 194 patients with ALBP were included in the analysis. Among systemic symptoms, dyspepsia was significantly associated with higher pain at discharge and smaller absolute and relative pain changes. Although sleep disturbance and constipation showed associations with higher pain at discharge in univariate analyses, these associations were not statistically significant in regression models. Beyond systemic symptoms, alcohol consumption was significantly associated with lower pain at discharge and greater relative pain change, while hospitalization and symptom duration exhibited non-linear relationships. These findings remained robust in sensitivity and subgroup analyses. Conclusions: Systemic symptoms, especially dyspepsia, may serve as prognostic factors impeding ALBP recovery, representing potential early markers for identifying patients at risk of chronicity. The findings highlight the prospect of multidimensional strategies in reducing pain and enhancing patients’ quality of life in clinical practice. Full article

Background: Despite the high prevalence of anterior cruciate ligament (ACL) surgeries, standardized, evidence-based rehabilitation protocols remain lacking. Digital medical devices (DMDs) like the “Orthelligent” system have gained relevance as adjuncts to traditional physiotherapy, offering continuous, objective monitoring of functional recovery. Methods: A retrospective cohort analysis included 335 patients who underwent ACL reconstruction and used the “Orthelligent home” system between August 2022 and December 2024. In total, 5675 recorded test and exercise events were analyzed. Functional recovery was assessed using the Limb Symmetry Index (LSI) across five defined rehabilitation phases (0–4). All patients followed a structured rehabilitation program aligned with current clinical practice guidelines, supplemented by Orthelligent as a home-based digital tool for daily monitoring. Results: Significant functional improvement was observed during early rehabilitation phases, with the LSI increasing from 0.64 ± 0.02 in phase 0 to 0.81 ± 0.01 in phase 2 (p < 0.001). Time since surgery was a significant positive predictor (p = 0.034), while pain showed a strong negative impact on performance (p < 0.001). Anthropometric factors had no significant effect. Exercises associated with high rates of drop-out, pain, or difficulty were identified and linked to specific rehab phases. Conclusions: This study demonstrates that digital rehabilitation monitoring can reliably reflect patient progress after ACL reconstruction. The early postoperative period (first 3 months) is critical for functional gains, highlighting the need for individualized, pain-sensitive rehabilitation strategies. Full article

Background: Osteoarthritis (OA) is a major global health issue, increasing with aging and obesity. Current therapies mainly address symptoms without modifying disease progression. Platelet-rich growth factor (PRGF) therapy has potential regenerative effects through high cytokines and growth factors, but the outcomes of these therapies remain heterogeneous. This study explores the relationship between patient nutritional status, PRGF characteristics, and clinical outcomes in knee OA treatment. Methods: Baseline anthropometric, metabolic, and nutritional assessments of 41 patients with knee OA who underwent PRGF treatment were conducted. Blood samples were analyzed for metabolic and inflammatory markers. PRGF composition was assessed by protein content and extracellular vesicle (EV) markers. KOOS and VAS pain scores were collected at 2, 6, and 12 months. Responders improved KOOS by ≥10 points. An elastic-net regularized logistic model allowed the identification of the predictors of treatment response. Results: KOOS and VAS scores improved significantly at all follow-ups. At 2 months, the PRGF of responder patients showed higher PRGF G-CSF levels; at 12 months, increased CD49e and HLA-ABC expression. Higher BMI correlated with increased IL-6, IL-1ra, and resistin in PRGF samples. Hypercholesterolemic patients displayed altered EV profiles, with elevated levels of CD8 but reduced CD49e, HLA-ABC, CD42a, and CD31. Multivariate analysis identified BMI, biceps fold, fat percentage, red blood cell, platelet, and neutrophil counts as predictors of early response. Conclusions: Metabolic and immunological factors influence PRGF composition and clinical efficacy in knee OA. Baseline body composition and hematological parameters as key predictors of response, highlighting the potential of personalized PRGF therapy. Full article

Calf disbudding is a routine practice in the dairy industry to prevent horn growth and reduce the risk of injury to animals and handlers. However, growing public concern about animal welfare has raised questions about the acceptability of common disbudding methods. This study explored public perceptions of caustic paste and hot-iron disbudding using a mixed methods approach. Quantitative survey analyses captured measurable trends while iterative qualitative analysis explored the underlying reasons behind participant’s attitudes. A convenience sample with a total of 511 Texas resident participants completed a 44-item online survey that included demographic questions, the Animal Attitude Scale (AAS-10), and image-based evaluations of the two techniques. Quantitative analysis using factor analysis and multiple regression revealed that concern for animal welfare and justification for animal use were the most significant predictors (p < 0.001) of method acceptability, with caustic paste generally viewed as more humane. Qualitative responses reinforced these results, identifying themes of animal suffering, ethical concerns, and a widespread lack of public knowledge. While caustic paste was preferred, skepticism toward hot-iron disbudding was more pronounced among low-income participants. Nonetheless, when properly performed with pain control, hot-iron disbudding is often considered a more controlled and welfare-conscious method due to faster healing times and reduced risk of injury to other animals from paste exposure. These findings underscore the need for consumer education and transparent communication from the dairy industry. Full article

Background: Degenerative lumbar spine disease is a prevalent cause of chronic low back pain that significantly impairs daily function and quality of life. While conservative management is the first line of treatment, many patients ultimately require instrumented lumbar spine surgery. However, postoperative outcomes vary considerably, with emerging evidence suggesting that preoperative psychological factors such as anxiety, depression, and pain catastrophizing may influence recovery. The SAP-LD (Scale for Anxiety and Pain in Lumbar Degeneration) study was designed to assess the prognostic role of these psychological and physical parameters in surgical outcomes. Methods: This prospective observational study enrolled 70 adult patients with degenerative lumbar spine pathology scheduled for instrumented surgical treatment at the University of Brescia and ASST Spedali Civili di Brescia between March and December 2024. Preoperative assessments included demographic, clinical, and radiologic data along with validated scales: the Oswestry Disability Index (ODI), 36-Item Short Form Health Survey (SF-36), Visual Analogue Scale (VAS), Pain Catastrophizing Scale (PCS), and Hospital Anxiety and Depression Scale (HADS). Follow-up evaluations were performed at 45 days and at 6 months, and statistical analyses were conducted using correlation tests, ANOVA, and regression modeling. Results: The demographic analysis of the 70 enrolled patients shows a balanced gender distribution (38 females, 34 males) with a mean age of 61 years (range 23–81). The educational level distribution indicates that the majority of patients (44.29%) have a secondary education level, while 35.71% have a tertiary education level. Regarding employment status, 50% of the patients are retired or not working. Patients with clinically significant anxiety and/or depression showed higher levels of perceived pain, pain catastrophizing, and disability at baseline. These patients reported significantly worse scores on the Visual Analogue Scale (VAS), Pain Catastrophizing Scale (PCS), and Oswestry Disability Index (ODI). The Oswestry Disability Index (ODI) demonstrates a clinically significant improvement (reduction) in disability between the preoperative period (t0) and the 45-day follow-up (t2), with the median decreasing from 39.00 to 13.00. However, there is a partial regression at the 6-month follow-up (t3), with the median increasing to 27.00. For the SF-36 Health Survey, the General Health subscale shows an improvement between t0 and t2 (median increasing from 55.00 to 60.00), followed by a slight decrease at t3 (median 55.00). Similar patterns are observed in most other subscales, with initial improvement followed by partial regression. The Pain Catastrophizing Scale (PCS) shows a substantial reduction in catastrophizing between t0 and t2 (median decreasing from 16.00 to 3.00), followed by an increase at t3 (median 11.00), though still below baseline levels. Pain intensity as measured by the Visual Analogue Scale (VAS) shows a significant reduction at t2 (median decreasing from 5.00 to 3.00), but increases again at t3 (median 6.00), even exceeding the preoperative level. For the Hospital Anxiety and Depression Scale (HADS), no significant differences were observed across time points, with values indicating mild symptoms throughout the study period. Correlation analyses confirmed that higher preoperative anxiety and depression scores were predictive of poorer postoperative outcomes. Specifically, higher HADS scores at baseline are associated with higher ODI scores (increased disability) at all time points (p = 0.002), higher VAS scores (increased pain) at all time points (p = 0.015), and lower scores on SF-36 subscales, particularly Emotional Well-being (p = 0.00023) and Social Functioning (p = 0.002). Higher PCS scores at baseline are associated with higher ODI scores at all time points (p = 0.001), higher VAS scores at all time points (p = 0.008), and lower scores on SF-36 subscales, particularly Pain (p = 0.00023) and Physical Functioning (p = 0.04254). The mixed linear models analysis confirms these findings, showing that the ODI score decreases significantly between t0 and t2 (p = 0.00023) and increases between t2 and t3, though this increase is not statistically significant (p = 0.079). For VAS scores, there is a significant decrease between t0 and t2 (p = 0.00023) and a significant increase between t2 and t3 (p = 0.04254). Patients with elevated preoperative HADS scores tended to have slower recovery trajectories and reported lower satisfaction levels. These findings reinforce the prognostic value of psychological assessments in spine surgery and suggest that targeted psychological interventions could improve patient outcomes. Conclusions: By identifying psychological predictors of postoperative recovery, this study underscores the importance of integrating preoperative psychological screening into routine clinical practice. The results suggest that a multidisciplinary approach, including both surgical and psychological care, could enhance long-term functional outcomes and quality of life for patients undergoing instrumented lumbar spine surgery. Full article

Introduction: Plantar fasciitis (PF), or more recently plantar fasciopathy due to its degenerative nature, is the most common cause of heel pain in adults and is often refractory to conservative care. One alternative conservative intervention involves replacing damaged fascia with homologous tissue, such as Wharton’s jelly (WJ) connective tissue allografts. The purpose of this observational study is to evaluate the efficacy and safety of collagen-rich Wharton’s jelly (WJ) when applied to defects in the plantar fascia. Materials and Methods: From the observational repository, nine patients who had plantar fasciopathy and received a single application of WJ were observed over 90 days. Outcomes were tracked using the Numeric Pain Rating Scale (NPRS), the Western Ontario and McMaster University Arthritis Index (WOMAC), and the Quality-of-Life Scale (QOLS) with no adverse reactions reported. Results: The cohort was 56% male (n = 5) and 44% female (n = 4), with a mean age of 73. From the initial to final visit, patients reported an overall trend of improvement in all scales. Statistically significant Bonferroni-adjusted differences were observed in the WOMAC scale. Age was a significant predictor of the total WOMAC score change from the initial to the final visit. Discussion: Although only a small cohort was observed, the preliminary evidence suggests the safety and efficacy of WJ allografts for plantar fascia degeneration. Key limitations of this study included a small cohort size and a lack of a comparison group with other alternative methods. Conclusions: The favorable results in this study could encourage future research to validate the clinical potential, safety, and dosing protocols of Wharton’s jelly as a primary conservative care method for patients suffering from plantar fasciopathy. Full article

Background: Dentists are at an increased risk of developing musculoskeletal disorders, particularly carpal tunnel syndrome (CTS), due to repetitive hand movements, awkward postures, and sustained grip forces. This study aimed to investigate the prevalence and risk factors of self-reported wrist and hand symptoms and clinically relevant CTS indicators among dentists in Jordan. Methods: A cross-sectional study was conducted among 201 licensed dentists in Jordan. Participants completed demographic questionnaires and the Valid Arabic version Boston Carpal Tunnel Questionnaire (BCTQ) to assess their symptom severity and hand function. Data was analyzed using STATA version 17, applying descriptive statistics, chi-squared tests, t-tests, ANOVA, and multivariable linear regression to evaluate association between sociodemographic factors and BCTQ scores. Results: Of the 201 participants, 64.2% were female and 35.8% were male. Female dentists were significantly younger (median age 31 vs. 39 years, p < 0.001), reported higher symptom severity (median score 18.0 vs. 16.0, p = 0.019), and experienced greater functional limitations (median score 15 vs. 9, p < 0.001) than male dentists. The overall mean symptom severity score was 19.12 (SD = 7.82), and the functional impairment score was 14.20 (SD = 6.37), indicating mild pain and functional limitation. Multivariable regression revealed that male sex was associated with significantly lower symptom scores (β = 0.7, p = 0.001) and better function (β = 0.722, p = 0.002). Geographic location, higher education level (PhD), and full-time employment were associated with higher symptom scores in the study. Conclusions: Wrist and hand symptoms are prevalent among dentists in Jordan, with significant sex differences in symptom severity and functional impairment. Geographic location, academic degree, and working hours were significant predictors of CTS-related symptoms. These findings underscore the need for ergonomic interventions and targeted preventive strategies, especially for high-risk groups, such as female and full-time practitioners. Full article