Assessment of Tamarind Seed Polysaccharide (TSP) and Hyaluronic Acid (HA) Containing Ophthalmic Solution to Maintain Tear Osmolarity, Ocular Surface Temperature (OST) and Tear Production

Background: The enhancement of ocular drug delivery is achieved by using biopolymer carriers in liquid ophthalmic preparations. Using natural polysaccharides to formulate ocular medications is attractive because they are economical and readily available. The primary goal of the study was to assess the safety and effectiveness of Tamarind seed polysaccharide (TSP)/Hyaluronic acid (HA) containing Rohto eye drops (TSP/HA drops) in alleviating the signs and symptoms of dry eye disease (DED) under dry environmental conditions using controlled environmental chamber (CEC). Methods: 12 participants were subjected to harsh environmental conditions in a CEC with a relative humidity (RH) of 5% and an ambient temperature of 21°C. TSP/HA drops were used in the two treatment modalities, protection (drops instilled before exposure to the dry environment and relief (drops instilled after exposure to the dry environment. Before and after administering drops, patients undergo screening for ocular symptoms, tear osmolarity, ocular surface temperature (OST), and tear production using the ocular Surface Disease Index questionnaire (OSDI), OcuSense TearLab Osmometer, FLIR System ThermaCAM P620, and phenol red test (PRT) respectively. Tear production was calculated by the Tear Function Index test (TFI). Results: Before (protection) and after (relief) exposure to the dry environment, TSP/HA resulted in a mean tear osmolarity of 296.0 mOsm/L and 292.0 mOsm/L, with no significant statistical difference. The presence of TSP/HA in both protection and relief modes led to an increase in tear production. TSP/HA drops did not significantly affect OST compared to the absence of TSP/HA drops at 5% RH. There was a significant increase in mean symptom score from 14 at 40% RH to 128 at 5% RH (p=0.003). A substantial reduction in symptoms was found in both protection (before exposure) (35) (p=0.003) and relief (after exposure) (50) (p=0.005) compared to when no drop was used. Conclusion: It was apparent that using TSP/HA for protection was superior to relief for osmolarity and eye comfort. To optimise the therapeutic efficacy of TSP/HA, it is advisable to instruct patients to administer it before exposure to dry atmospheric conditions. The small sample size limits the ability to generalize the findings. Future studies should evaluate the tear supplement with a larger sample to improve statistical power.</p

Comparison of Demographics and Oxford Knee Score in Total Knee Arthroplasty Patients Between the United Kingdom and Saudi Arabia: A Cohort Study

Background/Objectives: Total knee arthroplasty (TKA) is considered as important final line of treatment for several conditions such as knee osteoarthritis. Interestingly, culture, demographics, and health care systems may differ between countries, leading to different outcomes. Understanding this variation can help in enhancing patient care and rehabilitation therapy. This study aimed to compare primary TKA patients from the Kingdom of Saudi Arabia (KSA) and the United Kingdom (UK) pre- and post-surgery, representing two different populations and cultural backgrounds. Methods: A retrospective cohort sample was collected from the UK and one prospective cohort sample was collected in the KSA. Demographic characteristics and the Oxford knee score (OKS) were compared preoperatively and 6 and 12 months postoperatively. Results: A total of 259 patients were included in the study. Significant differences were observed in demographic characteristics. Patients in the UK cohort were five years older and 7 kg/m2 lower in body mass index (BMI) than those in the KSA cohort. The proportion of male patients was higher in the UK cohort (37%) compared to the KSA cohort (17%). Preoperatively, the OKS was significantly (p = 0.001) worse in the Saudi cohort (15 ± 4) compared to the UK cohort (19 ± 6). After 6 months postoperatively, both groups improved; however, there was a significant difference, with a higher value for the KSA cohort compared to the UK cohort. By 12 months post-TKA, the difference in OKS between the populations no longer existed. Conclusions: Although there are notable differences in demographics and preoperative OKS, the functional outcomes at 12 months post-TKA were comparable between the two populations. These findings suggest that while cultural and demographic factors may influence early postoperative recovery, 12-month outcomes tend to converge across different populations

Biomechanical Analysis After Anterior Cruciate Ligament Reconstruction at the Return-to-Sport Time Point

Background: Biomechanical alterations after anterior cruciate ligament reconstruction (ACLR) may increase the risk of knee reinjury. Furthermore, individuals may experience persistent biomechanical differences in the lower limbs after finishing the rehabilitation program and being ready to return to sport, which may lead to an increase in the risk of reinjury. Limited data exist on individuals after ACLR and biomechanical alterations during running in elite athletes. Purpose: To measure kinetic and kinematic data during overground running 6 to 8 months after ACLR in an elite sports cohort. Study Design: Controlled laboratory study. Methods: Three-dimensional motion capture tested the running gait of the participants. A total of 34 elite sports professionals who underwent ACLR and were cleared to return to sport and 34 noninjured high-level athlete participants matched by age and sex participated as the control group in this study. Results: A significant reduction was identified in internal knee extensor moment and knee flexion angles between the ACLR limb and the contralateral side (P = .01, .02) and between the ACLR limb and the control limb (P = .01, .01). The external knee adduction moment was increased significantly between the ACLR and control limbs (P = .01). No other differences were seen in the knee or hip kinetics and kinematics. Conclusion: After ACLR, the elite participants demonstrated altered knee joint kinematics and kinetics at the time of being cleared to return to sport. These biomechanical deficits suggest that, despite being cleared, the athletes may not have been fully prepared for a safe return to sport, potentially increasing the risk of knee reinjury. Clinical Relevance: Alterations in kinematics and kinetics in the sagittal plane of the ACLR knee observed during running may predispose participants to joint-related issues, such as patellofemoral pain. Similarly, increased knee adduction moments in the affected limb may indicate unresolved biomechanical deficits. These findings suggest that the elite population may not be fully prepared to resume high-level activity within the 6-month time frame outlined in current rehabilitation protocols. A longer recovery period may be necessary to restore joint kinematics and kinetics to levels more consistent with a safe return to sport

Reliability of the Star Excursion Balance Test with End-Stage Knee Osteoarthritis Patients and Its Responsiveness Following Total Knee Arthroplasty

AbstractBackground/Objectives: The Star Excursion Balance Test (SEBT) is a simple and feasible tool for assessing dynamic balance in individuals with knee osteoarthritis (KOA). It has an advantage as it replicates dynamic balance better than other static balance tools. This study aims to determine how reliable SEBT is among people with end-stage KOA, as well as how responsive it is and how well it correlates with performance-based outcome measures after TKA. Methods: Patients on the waiting list for TKA performed SEBT in the anterior, posteromedial and posteriorlateral directions twice within 7 days. The measurements were repeated 6 and 12 months after TKA. The participants completed performance-based outcome measurements (PBOMs) and the Oxford Knee Score (OKS) before and after TKA to estimate correlation. Results: In all directions, the intraclass correlation coefficient range (ICC) was 0.998–0.993, and there were no significant differences between the test and re-test mean SEBT scores. The standard error of measurement (SEM) ranged from 0.37% to 0.68%, and the minimum detectable change (MDC) ranged from 1.02% to 1.89%. The post TKA SEBT results show significant improvement, with a large effect size. There were large-to-medium correlations between SEBT and PBOMs before and after TKA, while OKS correlated only before surgery. The magnitude of change in SEBT, PBOMs and OKS did not correlate. Conclusions: SEBT is an extremely reliable tool for assessing dynamic balance in all three directions of severe KOA patients. It is sensitive enough to detect balance changes at 6 and 12 months post TKA. SEBT cannot be used to reflect the change in functional outcome improvement after TKA

Enhancing water treatment with polyvinylidene fluoride (PVDF)/cellulose composite membranes : a comprehensive review

This study delves into the critical examination of prior research on PVDF/cellulose membranes and their applicability in water treatment contexts. Raw water sources are typically laden with contaminants, organic compounds, soil particulates, and humic substances, all of which contribute to membrane fouling. The challenge escalates when membranes lack adequate hydrophilicity, resulting in heightened costs for water treatment, notably in regions with swampy or peaty water sources. Despite the potential of hydrophilic biopolymers like cellulose as a solution, their complex and crystalline structure poses handling difficulties. This review aims to deepen our understanding of the significant potential of PVDF/cellulose membranes as sustainable and effective solutions for water treatment. These membranes showcase promising attributes such as high water flux and straightforward production processes. Our goal is to promote the broader utilization of this widely available biopolymer to enhance the performance and sustainability of PVDF membrane filtration in water treatment applications

Combining Ultrasound Pulse-Echo and Transmission Computed Tomography for Quantitative Imaging the Cortical Shell of Long-Bone Replicas

We demonstrate a simple technique for quantitative ultrasound imaging of the cortical shell of long-bone replicas. Traditional ultrasound computed tomography instruments use the transmitted or reflected waves for separate reconstructions but suffer from strong refraction artifacts in highly heterogeneous samples such as bones in soft tissue. The technique described here simplifies the long bone to a two-component composite and uses both the transmitted and reflected waves for reconstructions, allowing the speed of sound and thickness of the cortical shell to be calculated accurately. The technique is simple to implement, computationally inexpensive, and sample positioning errors are minimal