Bone mineral density measurement in a medical camp to identify osteopenic and osteoporotic subjects

To identify osteopenic and osteoporotic subjects through bone mineral density measurement. Design: An observational, cross sectional study, carried out in a relatively affluent community, both below and above 40 years of age, in both sexes. Settings: In a medical camp held under the supervision of the medical specialists. Main outcome measures: Bone Mineral Density [BMD] was assessed on all the subjects by SAHARA ultrasound bone densitometer on right calcaneus. Sixty subjects were studied, out of these 35[58.3%] were females and 25[41.7%] were males. The age range was 16 - 80 years with the mean of 46.95 +/- 18.61. Out of sixty subjects 17 were below 40 years and 43 were above the age of 40. Daily milk intake was in the range of 25-750 ml/day with the mean of 166.82 +/- 137.10. Symptoms of difficulty in getting up from floor, bone pains, cramps, body aches and pains were more prominent amongst subjects above the age of 40 years. BMD, in males below 40 years was in the Range of -3.20 +/- 2.80 with the mean of 0.125 +/- 1.66 and in females was in the Range of -2.80 +/- 2.00, with the mean of 0.266 +/- 1.34. In subjects above 40 years, amongst males it was in the Range of -3.00 +/- 3.00, and mean of -0.1720 +/- 1.532 and females in the Range of -3.50 +/- 1.70 with the mean -0.8057 +/- 1.364. In subjects understudy 30/60 [50%] had normal BMD, 20/ 60 [33.4%] were osteopenic and 10/60 [16.6%] were osteoporotic. In patients over 40 years of age 29/43[67.44%] were either osteopenic or osteoporotic. BMD is a simple noninvasive but expensive tool which can help in identifying osteopenic and osteoporotic subjects in both genders. It is expected that the problem is much more in the poor and malnourished community. Early detection of potential and at risk individuals and their timely and appropriate treatment can reduce the stresses of mental, physical and financial nature. Strategies need to be developed to encourage modifications of all risk factors for osteoporosis early in life

Dyslipidemias in type II diabetes mellitus patients in a teaching hospital of Lahore, Pakistan

To know the pattern of dyslipidemias amongst type II diabetic patients. Design: Observational study. Setting: Hospital based study on type II diabetic patients, who were either admitted or reported to outpatient department/diabetic clinic on take days of Unit-I of Sir Ganga Ram Hospital, Lahore, Pakistan. Subjects: One hundred consecutive type II diabetics between the age of 40-70 years. Those who had hyperlipidemia due to other causes e.g. nephrotic syndrome, hypothyroidism and type-I diabetes mellitus were excluded. Main Outcome Measures: Dyslipidemias One hundred patients suffering from type II diabetes mellitus were included in the study. Out of these 64% were females and 36% were males. The age range was 41-70 years with mean of 56.1 +/- 9.38. Out of these 100 patients, duration of diabetes mellitus of less than 10 years was noted in 43% of patients and more than 10 years in 57%. Random blood sugar was 229.34 +/- 6.23 and fasting blood sugar was 153.5 +/- 4.45 when it was seen in the total study subjects, random blood sugar 210.51 +/- 7.68 and fasting blood sugar 143.83 +/- 5.35 in sub group whose duration of illness was less than 10 years. In sub group whose DM was for more than 10 years random blood sugar was 257.91 +/- 12.81 and fasting blood sugar was 171.21 +/- 8.14. Serum cholesterol was 226.88 +/- 18.48 in the patients as one group, in illness of less than 10 years, it was 191.72 +/- 5.72 and in illness of more than 10 years duration it was 213.11 +/- 6.70. Serum triglyceride in illness of less than 10 years duration was 191.83 +/- 8.05 and where it was more than 10 years, it was 210.04 +/- 8.90. Serum HDL-C was 36.25 +/- 0.45 in patients illness of less than 10 years and 35.57 +/- 0.60 in more than 10 years. Serum LDL - C was 127.1 +/- 3.99 in patients with less than 10 years of diabetes mellitus and 147.5 +/- 5.20 in patients with more than 10 years of illness. Fifty-eight patients were hypertensive, 43% of the male patients were smokers. Conclusions: Diabetic dyslipidemia is an important cause of morbidity. Duration of diabetes is associated with higher incidence of dyslipidemia. Type II DM is associated with a marked increase in the risk of CHD. Dyslipidemia is believed to be a major cause of increased risk. In this study we found elevated total serum cholesterol, LDL-C but normal HDL-C. Patients should be educated to get checked regularly for lipid abnormalities and if found to be abnormal, should control blood sugar and lipids very effectively

Outcome in lower cervical spine injuries [treated surgically]

Fracture dislocation of the cervical spine is amongst the most serious injuries that can result from fall, industrial accident, automobile accidents and athletic activities. They cause a broad spectrum of disabling conditions ranging from minor pains to quadriplegia and even death. Cervical spine injuries are usually treated by skeletal traction for 3-6 weeks. By this method proper decompression, bony fusion and stabilization of the injured cervical spine is not possible. It also results in many complications i.e. bed sores, infection etc. Surgical management of the cervical spine injuries provides proper decompression, and enhances bony fusion and stabilization of the spine thus allowing early mobilization of the patient. With early mobilization the complications are tremendously reduced It also reduces the hospital stay of the patient and offers ideal circumstances for recovering the neurological deficit. A study was conducted in the department of Neurosurgery Lahore General Hospital, Lahore comprising of 20 consecutive patients of lower cervical spine injuries which were treated surgically. Excluding the three patients who were in Grade E [Frankel grading], 75% of patients improved as regard of their grading. At the end of follow up of 6 months, only 20% of patients were in the non useful grades i.e. A, B and C. There were no complications like bed sore, thromboembolic phenomena, UTI and non union of the spine producing chronic instability. It was concluded that patients of lower cervical spine injuries treated surgically with early mobilization results in dramatic improvement in outcome with negligible rate of complications

Incidence of medical problems at high terrestrial altitudes: a retrospective study

Data covering the 3 year period, 1 986-88 from the forward area hospitals [60 CCS and 50 CCS] receiving patients from units operating in high altitude areas reveal an average admission per year of 202 cases due to high altitude medical problems. Frost bite was the commonest [49.8%] high altitude medical problem followed by acute mountain sickness [AMS] [30.7%], high altitude pulmonary edema [HAPE] [13.9%], high altitude cerebral oedema [HACE] [3.1%] snow blindness [1.7%] and hypothermia [0.8%] respectively. More than 90% patients were in 20-39 years age group. Maximum number [84.4%] of high altitude cases occurred between 12000 to 20000 feet height. More [59.2%] high altitude cases occurred among lowlanders as compared to high landers [40.8%]. The disease was mild in 32% cases and severe in 63.3% cases