Relationship among hypovitaminosis D, maternal periodontal disease, and low birth weight

Objective: To determine if low birth weight is associated with hypovitaminosis D and periodontal disease among a sample of Pakistani women residing in district Jhelum, Punjab. Study Design: Cross-sectional study nested in a large community-based longitudinal study. Place and Duration of Study: Tehsil Pind Dadan Khan, District Jhelum, Pakistan from August 2012 to October 2015

Methodology: Women during 12-16th week of pregnancy were selected. Dental examination was performed. Probing depth >3 mm was labeled as periodontal disease, whereas serum level 2500 g] babies. Odds ratio was applied to measure the strength of association of low birth weight with maternal hypovitaminosis D and also for maternal periodontal disease

Results: There were 62 participants in the study. The mean age of mothers was 26.7 +/- 4.5 years. It was alarming to observe that 53 [85%] participants had vitamin D deficiency. However, periodontal disease was only seen in four participants [6%]. Out of the 62 mothers, eighteen [29%] gave birth to low birth weight babies. None of the variables were found to be associated with the low birth weight

Conclusion: The present study did not find any significant association of low birth weight with hypovitaminosis D or maternal periodontal disease in the studied sample

Osteochondral grafting of knee joint using mosaicplasty

Focal cartilage defects of articular surface-traumatic and degenerative are difficult to treat, thus a variety of surgical techniques have been developed and reported for treatment of such defects. Procedures such as Priddies perforations, microfracture, abrasion chondroplasty have shown long-term results which are often less than adequate. One of the reasons is that all these techniques lead to the formation of fibrocartilage which has inferior mechanical properties as compared to the native hyaline cartilage. Mosaicplasty is a procedure which aims at replacing the lost articular cartilage with hyaline cartilage including underlying bone support, thus providing adequate stability to the cartilage and better cartilage/bone integration. A young man underwent this procedure for recalcitrant knee pain at our institution. At 2 years follow-up, his knee pain has significantly improved. We hereby present medium term results [2 years] of this first case report in local literature

Shoulder impingement syndrome: outcome of arthroscopic subacromial decompression

To describe the outcome of cases with subacromial impingement syndrome managed with arthroscopic subacromial decompression. Quasi-experimental study. Section of Orthopaedics, Department of Surgery, The Aga Khan University Hospital, Karachi from April 2005 to March 2006. Thirty patients with impingement syndrome who underwent arthroscopic subacromial decompression after failed conservative treatment were included. The Constant and Murley shoulder scoring system was used for the clinical assessment of pain and function pre-operatively and 1, 6 and 24 weeks postoperatively. The postoperatively significant improvement was observed in the Constant and Murley scores in all the patients [by mean 40 points, p < 0.01], which was progressive over six months. Lower scores were noted in patients over 40 years of age, with advanced stage of impingement and partial tears of the rotator cuff. Arthroscopic subacromial decompression was effective in reducing pain and improving function in the studied patients with subacromial impingement syndrome

First Successful autologous chondrocyte implantation in Pakistan

Osteochondritis dissecans entails a hyaline cartilage defect of the articular surface causing pain and functional restriction in young adults, sometimes resulting in early degenerative arthritis. Conventional treatment methods such as abrasion chondroplasty and mosaicplasty have limitations in terms of quality of the resultant cartilage and donor site morbidity. A more recent technique, autologous chondrocyte implantation [ACI] results in hyaline cartilage formation and gives good long-term outcome, but requires a high-level cell culture facility and two surgical procedures. The patient was a young female with knee pain, intermittent locking and feeling of "joint mouse". MRI scan and arthroscopy showed a 2x2 cm full thickness osteochondral defect in the medial femoral condyle. A free fragment of articular cartilage was found, which was extracted arthroscopically, and chondrocytes were cultured from it in the Juma laboratory. Subsequently, patient underwent surgery whereby the chondrocytes were injected under a periosteal patch sewn over the defect. Over six months, patient's symptoms completely resolved and she returned to full function. A repeat arthroscopy after one year revealed complete filling of the previous defect with normal appearing cartilage indicating success of the procedure. This technology can be utilized for treating patients with a variety of conditions affecting hyaline cartilage of joints