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Gender, lifting loads, and flexed trunk postures are three risk factors associated with low back pain. Previous studies have not found gender differences in effective trunk stiffness (intrinsic stiffness plus reflex response) using force perturbations, but these measures may have been confounded by differences in trunk kinematics between males and females. The purpose of this study was to investigate the effects of gender, trunk extensor preload, and trunk flexion angle on intrinsic trunk stiffness using position perturbations, which have the potential to eliminate kinematic differences between research subjects and to separate intrinsic stiffness from reflex responses. A total of 13 males and 12 females were exposed to sudden, small trunk flexion position perturbations with two trunk extension preloads (0 and 30% maximum) and three trunk flexion angles (0, 20, and 40 degrees). Data collected during position perturbations were used along with a two degree of freedom model of the trunk and connecting elements to estimate intrinsic trunk stiffness. Intrinsic stiffness was lower in females compared to males, and increased with increasing preload and trunk flexion angle. Intrinsic stiffness increased more substantially among males with increasing preload and trunk angle, and effects of trunk angle were diminished with a preload. A lower intrinsic stiffness and smaller increases with preload and trunk angle, may contribute to the increased rate of occupational LBP and injury among females.

Background: To study the functional outcome of surgical management in Hoffa’s disease.

Methods: This prospective study was conducted in the Department of Orthopaedics in a tertiary health care centre between 1st January 2020 and 31st December 2021. A total of three patients (2 males and 1 female) with Hoffa’s disease were included in the study.

Results: “Tegner-Lysholm score” was used for evaluation of function, and the mean Tegner–Lysholm score was 93. All the three patients had normal range of motion at 1 year follow-up.

Conclusion: Hoffa’s disease has low incidence, and hence diagnosing the condition correctly is of utmost importance for its proper management.

BACKGROUND: Male infertility is a global health challenge and the prevalence is increasing, particularly in the so-called infertility belt of sub-Saharan Africa, including Nigeria. The etiologies are complex and multifactorial. The impact of thyroid disorders on male reproductive health is often overlooked. This unrecognized link can significantly affect sperm quality, quantity, and overall fertility. The involvement of thyroid dysfunction in male infertility is now increasingly reported, but thyroid hormone evaluation is rarely determined in the laboratory work-up during fertility evaluations. The aim of this review is to highlight the involvement of thyroid hormones in the regulation of reproductive function, how thyroid dysfunction induces male infertility, diagnosis, and future directions for research in thyroid-associated male infertility.

METHODS: Scientific information reviewed for this purpose was obtained from Google Scholar, PubMed, Web of Science, and other search engines.

RESULTS: Studies have indicated that thyroid dysfunction in male infertility is critical to spermatogenesis. Any disruption in the interaction between thyroid hormones and the hypothalamic–pituitary–gonadal (HPG) axis may lead to alterations of the fine hormonal balance needed for optimal reproduction and a spectrum of endocrinopathies. Thyroid dysfunctions have an adverse impact on fertility and male reproductive organs.

CONCLUSION: The need to focus on how specific thyroid-related interventions will improve semen quality and if routine thyroid hormone evaluations be included in the diagnostic workup for male infertility are discussed.

Background: Hyaluronan (HA) sperm selection, utilizing the affinity of mature sperm for HA, has emerged as a technique to enhance the selection of sperm for intracytoplasmic sperm injection (ICSI). However, conflicting evidence exists regarding the impact of HA-ICSI on clinical outcomes including fertilization, embryo utilization, and pregnancy rates. The study aimed to compare clinical outcomes including fertilization, utilization, and pregnancy rates between paired ICSI and HA-ICSI cycles within patients, particularly for male factor and low utilization subgroups.

Methods: A retrospective study from 3,988 ICSI treatment cycles was conducted between January 2018 and March 2022. A HA-ICSI cycle was paired with the preceding ICSI cycle from the same patient. Fertilization, utilization, and clinical pregnancy rates were compared based on infertility diagnosis and utilization rate (UR) from the initial ICSI cycle.

Results: There were no differences in fertilization, utilization, embryo quality, euploidy, or pregnancy rates between ICSI and HA-ICSI in all paired cycles. However, for patients with male factor infertility UR increased from 25.0% to 38.5% in their HA-ICSI cycle ($p=0.014$). There was no difference observed for female factor infertility patients. HA-ICSI use was of particular benefit for male factor infertility patients with low ($<40\%$) embryo utilization in their initial ICSI cycle, evident by an increased utilization from 14.3% to 25.0% in their HA cycle ($p=0.006$).

Conclusions: This is the first study to focus on the impact of HA-ICSI on embryo utilization, particularly in patients with male factor infertility. The efficacy of HA-ICSI as a sperm selection tool appears to be limited to improving UR in patients with male factor infertility, particularly those with low utilization in a previous ICSI cycle, with no significant effect on fertilization or pregnancy rates.

Conclusion: HA-ICSI may be useful for sperm selection at the time of ICSI for a select subgroup of patients. Male factor infertility patients, who have previously undertaken an ICSI cycle with less than 40% utilization, should be considered as candidates for treatment.