Evaluation of bone resorption in male patients with bilharzial periportal hepatic fibrosis

To evaluate bone resorption and bone mineral metabolism in male patients suffering from bilharzial periportal hepatic fibrosis by assessment of liver function tests and factors that regulate bone resorption and formation and correlate these factors to bone mineral density assessing bone mineral metabolism. This study was carried out on 50 male patients suffering from bilharzial periportal hepatic fibrosis; their mean age was 38.6 +/- 8.14. Also 40 age matched healthy males were included in this study as a control group. Both patients and control groups were subjected to the following investigations [parathyroid hormone [PTH], testosterone, vitamin D3 [1-25 hydroxycholecalciferol], serum calcium and phosphorus, total alkaline phosphatase and liver function tests including [SGOT, SGPT, total protein, albumin, total and direct bilirubin] in addition to dual energy X-ray absorbtiometry [DEXA] and abdominal ultrasonography. patients suffering from bilharzial periportal hepatic fibrosis showed highly significant reduction of serum testosterone and bone mineral density [BMD] in comparison to control group [p<0.001] and the testosterone is highly correlated with BMD [p<0.001] parathyroid hormone, vitamin D3, serum calcium and phosphorus showed non significant difference between both studied groups [p>0.05] and not correlated with BMD [p>0.05]. However, liver function tests were significantly higher in patients than control group [p<0.01]. Our results demonstrate that the liver is an important organ responsible for bone integrity and any chronic liver disease like bilharzial periportal liver fibrosis can directly affect the bone and causing osteoporosis which indicated by diminished BMD and this osteoporosis was accompanied with gonadal dysfunction indicated by reduced testosterone so it is called [Andropausal osteoporosis]

Musculoskeletal profile due to obesity and risk factors

This study was designed to estimate musculoskeletal complication due to obesity and which of them is directly related to it. This study was carried out on fifty [50] obese female patients, after exclusion of diabetes mellitus, liver and kidney disease. Twenty [20] normal weight by BMI assessment and age matched female as a control. All persons were fulfilled for: 1- Full history and complete clinical examination and locomotor estimation, 2- CBP, 3- ESR, 4- Serum RF, 5- Serum uric acid, 6- Lipid profile [blood cholesterol, triglycerides, LDL and HDL], 7- Plain X-ray of lumbosecral, knee and heels, 8- EMG and nerve conduction study of median, Ulner, common pronial and medial poplitial nerves for the patients complaining of numbnes. [66%] of patients had oestioarthritis of the knee, twenty of them had pattelofemoral OA [40%], [56%] of patients had back pain due to muscle strain, [36%] of patients had planter fasciitis, [8%] of patients had carpal tunnel syndrome, [4%] of patients had fibromyalgia syndrome. There was a significant correlation between the musculoskeletal problems and BMI of patients. All laboratories parameters are within normal range except the lipid profile, which were high in 32 patients and had the significant correlation with musculoskeletal problems. OA of knees, LBP, Planter fasciitis, CT syndrome and Fibromyalgia syndrome are the most common musculoskeletal complications of obesity. The high level of lipid profile in blood may be due to obesity per sea or disability due to musculoskeletal problems and leads to serious cardiovascular and heart complications