Follow-up study of bone mineral density and C-terminal telopeptide marker as predicators of fracture risk

Osteoporosis is a major health problem in many countries. Osteoporotic fractures are the main consequence of osteoporosis. Our aim was to identify the usefulness of bone mineral density and C-terminal telopeptide of type 1 collagen as predictors of fracture risk. We evaluated both BMD and serum carboxy-terminal pyridinoline cross-linked telopeptide of type I collagen [ICTP] in 212 subjects recruited from the community. This included healthy postmenopausal women and males over 60 years. Subjects were followed up for the occurrence of fractures jar one year. X-ray radio graphs of thoracic and lumber regions were done to detect silent vertebral fractures at baseline, and at the end of 1 year. Male gender was associated with a higher level of serum ICTP. BMD was insignificantly higher in males compared with females. Age, weight, BMI were significantly correlated with BMD. Age was significantly correlated with ICTP levels. BMD proved to be a strong predictor of incident fracture specially vertebral and hip fractures. Serum levels of ICTP were also predictors of incident fracture and this observation was more evident in females compared to males. Advancing age and low weight were predictors of increased incidence of fractures. Coffee was found to increases bone resorption, accordingly has a detrimental effect on bone strength. Other caffeine containing beverages [tea, cola] were not fond to have a significant effect on bone resorption

Malnutrition and growth status in patients with congenital heart diseae

Different congenital heart diseases could affect children growth. To assess the growth [Weight, height and head circumference] in patients with different types of congenital heart disease [CHD]. The growth of one hundred ninety six patients with CHD, attending the out patient department of the Central Teaching Hospital of Pediatrics and Ibn Al Betaar Center for Cardiac Surgery, aged 0-24 months, between February and June 2002 was assessed. They were grouped according to cardiac diagnosis: Group I: Acyanotic CHD without heart failure [HF] or pulmonary hypertension[PH]; Group II: Acyanotic CHD with HF; Group III: Acyanotic CHD with PH; Group IV: cyanotic CHD. It was found that 29.6% of patients with CHD had acute malnutrition [AM] and 21.9% had chronic malnutrition [CM]. The acute malnutrition was more in group I of CHD [39.2%] while chronic malnutrition was more in group III of CHD [26.3%]. The acute malnutrition was more obvious in infants [31.7%] than in those in the second year, while chronic malnutrition was more obvious in second year of life [34.7%]. In all patients with congenital heart disease [cyanotic and a cyanotic], the growth is affected. Because of the delay in surgical correction in our patients, so we suggest a better nutritional counseling and possible earlier surgical correction to optimize the growth in our patients

Testicular tumours: Does color doppler has a role?

The aim of this work was to assess the role of high-resolution ultrasonography [US] and color Doppler ultrasonography [CDS] in the diagnosis and evaluation of testicular tumors and the ability of each modality to add important information aiming to reach a precise diagnosis and hence a prompt management. The study was conducted on six patients with painless testicular swellings. It was concluded that gray scale along with the clinical and physical findings help to establish a specific diagnosis in almost all cases. CDS does not add any clinically important information and does not help in establishing a definite diagnosis of testicular tumors due to the great overlap between the findings in cases of testicular tumors and those of inflamed and normal tests. However, CDS seems to be more helpful in depicting the infiltrative lesions, such as lymphoma and leukemia, which increases the diagnostic confidence of the examiner

Autogenous bone marrow grafting for treatment of nonunited fractures

A prospective study on fifty eight patients with establish nonunion of different bone segments was carried out. Patients were treated by autogenous bone marrow aspiration and re injection at the site of nonunion. Eight of those patients were lost on follow-up. Some cases had other associated problems as infection, gaping, negligence, hyper mobile fracture, or systemic compromise. It was intended that non of the cases have an associated rigid immobilization. Few of them received minimal external or internal splinting, which,is not expected to disseminate union in normal circumstances. On final assessment 34 cases [68%] gained excellent or good results, with 16 [32%] having poor results. Factors affecting the final results were analyzed, and a conclusion was reached, to which cases would be expected to get maximal benefit of this technique

Simultaneous versus staged bilateral total knee arthroplasty

Eleven patients had bilateral simultaneous total knee arthroplasty [done under single anesthetic]. Operative, as well as one year follow up data were compared to those of similar number of patients, who had bilateral knee arthroplasty done on two stages, with an average of 6 months interval. Simultaneous bilateral arthroplasty consumed an average of 86 minutes more than each stage of the staged procedures. There was no significant difference between both procedures regarding the rate of peri-operative as well as the follow-up complications. Rehabilitation period was the same [average of 6 weeks] for both procedures. The mean hospital stay for both procedures was 18 days for the bilateral procedure compared to 33 days for the sum of the stages of the staged procedure. Accordingly, bilateral procedure is considered to be more economic. This is added to its advantage of rapid full functional recovery by avoiding time lage in staged arthroplasty. We think that it may be beneficial to offer both procedures to the patient for choice

Limb lengthening by subperiosteal diaphyseal oblique corticotomy

Twenty two patients underwent twenty two limb lengthening procedure, This was done through subperiosteal diaphyseal oblique corticotomy, distracted by specially designed distractor to give a daily distraction rate of 0.7 to 0.8 mm. Cases included 6 femurs and 16 tibias. The mean preoperative length discrepancy was 6.4 cm. In all cases, the planned lengthening was achieved with non of the cases left with impaired function. The mean gain in length was 5.75 cm with a range of 3 to 12 cm. 37 complications were encountered [154.5%]. The mean D/C ratio was 1.8/1. The mean healing index was 25 days/cm. Although high complication rate was encountered, yet non of the cases needed bone grafting or internal fixation. High efficacy of the method is supported by the low healing index, and inverted distraction - consolidation [DIC] ratio