Comparison of Singh index accuracy and dual energy X-ray absorptiometry bone mineral density measurement for evaluating osteoporosis

The Singh index is an inexpensive simple method to evaluate bone density, commonly used to assess osteoporosis is based on the radiological appearance of the trabecular bone structure of the proximal femur on a plain antero-posterior [AP] radiograph. The purpose of this study was to compare between Singh index and bone mineral density measurement using dual energy X-ray absorptiometry [DXA]. Three orthopedists evaluated radiographs of 72 patients suspected with osteoporosis. The inter-observer agreements of the Singh index were obtained by using kappa statistics. The bone mineral density [BMD] of proximal femur was measured by DXA in all patients, and then the BMD results were compared with those of Singh index by using reference radiographic charts of the Singh index method. Dual-energy X-ray absorptiometry was used to measure bone mineral density. A Norland XR46 system was used for the investigations. The inter-observer agreement kappa values were 0.01, 0.07 and 0.09 [mean value: 0.05] and the strength of the observer agreements was negligible. The obtained osteoporosis prevalence among the studied patients was 38.9%.The inter-observer variation was large, there was no any correlation between the Singh index and bone densitometry. So, the index cannot be used; for evaluating and osteoporosis diagnosis, because of its low reliability

Evaluation of chronic anterior knee pain in Iranian teenagers

Chronic anterior knee pain is one of the most common complaints, especially in our society. It consists of a large number of patients in orthopedic clinics. This pain might have serious negative effects on students' educations, on the other hand, limits their physical activities that is essential for their age. In contrast to adults, such pain etiologies may vary in many ways for teenagers. Some are easily curable and others not. In time evaluation and diagnosis can lead to a faster and more efficient treatment. The aim of this study was to evaluate chronic anterior knee pain in Iranian teenagers. In this cross-sectional study, among patients referred to Isfahan Hospitals from December 2005 to December 2007, 198 teenagers [8 to 18 years-old] who suffered from untreated chronic anterior knee pain were enrolled. All of them were examined by an orthopedic specialist. The patients' demographic information such as age, sex, physical activity type, underlying diseases if any, knee trauma history if any, pain duration, laboratory and radiological findings, and other diagnostic findings and the final diagnosis were recorded in questionnaires. Then, the relations between disease etiology and these factors were sought. Chronic anterior knee pain was more frequent in boys compare with girls [53.1% vs. 46.9%]. At the ages around puberty, chronic anterior knee pain was more common. The most prevalent etiologies were patella-femoral dysplasia, malalignment of lower limbs, knee menisci and ligaments tearing, osgood-schlatter disease, juvenile rheumatoid arthritis [JRA] and osteochondritis dissecans, respectively. In our study like many other ones, patella-femoral dysplasia and malalignment of lower limbs are the most prevalent causes among other etiologies. Such causes like malalignment of lower limbs and JRA are found more in girls and osgood-schlatter disease and osteochondritis dissecans are more common in boys. JRA and osteochondritis dissecans were considered as rare causes for chronic anterior knee pain; however in our study they played an important role. Finally we can diagnose these causes and treat them properly by this mean, we'll be able to teach the patients how to prevent such diseases

Determinants of plate fracture after osteosynthesis of lower limb fractures in one year

The lower limb fractures are common in young and elderly people. The goal of treatment is to return the patient to normal function as quickly as possible, with minimal complications. Plate and screw is a popular and successful technique in treatment of these patients. This case-control study was conducted on 108 patients [54 with plate fracture as cases and 54 without plate fracture as controls], who have been admitted in Kashani and St Alzahra hospitals affiliated to Isfahan University of Medical Sciences during 2005.A Check list including age, sex, bone fractured, site of initial fracture, use of external support, distance between plate fracture and plating, infection and etc was completed for each patient; and out coming data was analyzed. The most common site of plate fracture was in diaphysis and the least in epiphysis of bones. In the case group, 87% of patients had used no external support [splint, cast, brace], 3/7% of patients had infected surgery site, 44% of patients had had early weight bearing after plating, the most common bone was femur, most initial fracture lines were comminuted, in 33/3% of patients, bone graft had been used, 9/3% of first injuries had been open fracture and 92/6% close fracture, 92/6% of patients were male and 4/7% female, the mean age of patients was 31.6 +/- 15.36 yr, the average time between plating and plate fracture was 5.5 +/- 3.4 months, All plates were broken at the empty hole site against initial fracture line, PH in site of plate fractures was alkaline and 2 patients had an underlying disease [chronic renal failure]. In this study, site of fracture, use of external support, early weight bearing and type of fracture line were contributing factors in plate failure. We didn't find any relation between plate fracture and fracture type [open or close], PH of fracture site, patient's sex or age

[Evaluation of scoliosis screening results in 10-14 years old students of Shahrekord]

Scoliosis is referred to abnormal curvature of spinal column beyond 10 degrees. The most common type of it, is adolescent idiopathic scoliosis. Scoliosis screening test is the most economic and simplest method for diagnosis of the disease. Preferred age of scoliosis screening is 10-14 years old when growth spurt is occurring. This study was performed on 936 students between 10-14 years old in Shahrekord. Diagnosis was based on observation of asymmetric anatomical landmarks [such as spinout process, pelvic and shoulders], Adam's forward bending test and radiographic measurement of Cobb's angle. Eighty-six persons out of 936 were referred to orthopedic clinic. Seven cases had idiopathic scoliosis, 5 females and 2 males. Two persons had thoracic, 4 had thoracolumbar and 1 had lumbar congenital curvature. Two patients had family history of scoliosis and overall prevalence of idiopathic scoliosis was 0.7%. During exercise all 7 patients got tired sooner than their classmates and had higher incidence of back pain. Two girls and one boy needed surgery. Also 3 girls and 1 boy needed Brace treatment. Using this method, the patients can be recognized easier and more rapidly. Therefore, both the curve progression and dysfunction of limb are inhibited leads to decrease need for surgery

Differential sensitivity of male and female neuronal cells may play a role in onset of neuronal diseases

Due to the worldwide increase in the number of older people in both developed and developing countries, there is a public health concern for dealing with age related diseases such as neurodegenerative diseases. There is little known about the difference in neuronal cell responses between genders. Our understanding of the neuronal cell response regarding genders, will be useful for developing more efficient therapies for these diseases such as Alzheimer's disease. To investigate gender differences in neuronal cell response against cell death inducers, we examined the percentage of cell death in male and female mouse primary cortical neuronal cultures. Our findings indicate that there is a difference in cellular response to ethanol [a cell death inducer] that may be the basis of how they behave in vivo of what may be seen in adults, as they age. These observation support this idea that genetic factors, most likely governed by X or Y chromosomes

[Noxious behaviours from injection of formalin and morphine tolerance of addicted male rats]

Background: formalin as a chemical noxious stimulus evokes biphasic pain that its latter phase as a chronic inflammation pain is similar to clinical pain

Objective: assessment of noxious behaviours from subcutaneous injection of formalin and morphine tolerance effects on the responses of addicted male rats

Methods: flinching and licking behaviours scored as quantitative pain. Experiments were carried out in normal and morphine addicted rats. Behaviour scores measured quantitative after injection of formalin in plantar region of hind paw. Assessment of morphine tolerance was carried out by intrapritoneal injection of morphine [10mg/Kg] 10 minute before formalin injection

Findings: in this study, we observed biphasic model of formalin test. Morphine injection in normal animals supressed noxious behaviours. Flinching and licking responses evoked by formalin not affected by morphine injection. Licking scores in addicted rats have significant difference from normal rats [p<0.05]

Conclusion: addicted rats showed tolerance to morphine analgesia after formalin injection. Hyperalgesic effects of formalin injection observed in addicted rats