Osteoporosis-related vertebral fractures in postmenopausal women: prevalence in a Saudi Arabian sample.

The study aimed to determine hospital-based prevalence of vertebral fractures in postmenopausal Saudi Arabian women. Chest radiographs from consecutive Saudi women over the age of 50 years visiting the emergency room at King Fahd Hospital of the University were evaluated. Of 785 radiographs analysed 159 (20.3%) patients had 198 vertebral fractures. The mean age of the women was 65.7 (SD 8.5) years. In only 37.8% of the radiographs with fractures was a vertebral fracture highlighted in the radiologist's report, and only 13.2% of the women with vertebral fractures were on antiresorptive therapy for osteoporosis.

Influence of pregnancy on bone mass in sickle cell anemia.

BACKGROUND: Sickle cell disease (SCD) causes osteopenia and osteoporosis, This osteopenia may be further influenced by pregnancy. OBJECTIVE: To find out the effect of pregnancy on bone skeleton density in patients with SCD. METHODS: Consecutive adult female SCA patients who were treated at the out-patients clinics of King Fahd University Hospital Al-Khobar, Saudi Arabia, between January and July 2007, were the cases of study. Patient's age, number of pregnancies and duration after pregnancy were documented. Weight and height were recorded to calculate body mass index (BMI). Blood was collected for haematology and biochemistry purposes. Bone mineral density (BMD) measurement was done using dual energy X-ray absorbtiometry (DEXA) at upper femur and lumbar spine. RESULTS: Thirty-eight patients were evaluated. There were 20 (52.6%) patients who were delivered in (Group A) and 18 (47.4%) who were nulliparous in Group B. The average age in group A was 27.55 +/- 4.9 years while group B was 26.30 +/- 2.1 years. Thirteen (65%) of the patients in group A were osteoporotic when compared to five (27.7%) in group B (p=0.01). Osteopenic patients in group B were seven (38.9%) versus four (20%) in group A (p=0.2). Osteoporosis in both groups was highest at lumbar spine compared to the hip region (P=0.001). BMD was lower in parous women when compared to the nulliparous women. There was no significant difference in haematological parameters which included the percentage of sickle hemoglobin, hemoglobin level between normal, osteopenic and osteoporotic patient. CONCLUSION: This study shows that SCA female patients suffer from low bone mass in young age. Pregnancy predisposes the SCA patients to further osteopenia and osteoporosis.

Osteoporosis-related vertebral fractures in postmenopausal women: prevalence in a Saudi Arabian sample

The study aimed to determine hospital-based prevalence of vertebral fractures in postmenopausal Saudi Arabian women. Chest radiographs from consecutive Saudi women over the age of 50 years visiting the emergency room at King Fahd Hospital of the University were evaluated. Of 785 radiographs analysed 159 [20.3%] patients had 198 vertebral fractures. The mean age of the women was 65.7 [SD 8.5] years. In only 37.8% of the radiographs with fractures was a vertebral fracture highlighted in the radiologist's report, and only 13.2% of the women with vertebral fractures were on antiresorptive therapy for osteoporosis

Low bone mass due to sickle cell anemia: is it becoming a real issue?

BACKGROUND: The prevalence of sickle cell anemia in Saudi population was reported to be between 0-5.27%. OBJECTIVE: This cross-sectional study was conducted to assess the prevalence of osteoporosis and osteopenia in patients with sickle cell anemia and to correlate its severity with the hematological parameters. METHODS: A cross-sectional study which included consecutive adult patients with sickle cell anemia attending the outpatient clinics or were admitted with uncomplicated vaso-occlusive crisis to King Fahd University Hospital, Al Khobar, Saudi Arabia, between August 2006 and March 2007 was undertaken. After informed verbal consent to participate, patient's age and sex were documented and body mass index (BMI) calculated. Blood was drawn for heamatological and biochemical parameters. Bone mineral density (BMD) measurement was done using dual energy X-ray absorbtiometry (DEXA) at upper femur and lumbar spine. Osteopenia and osteoporosis were diagnosed as per the WHO criteria. RESULTS: A total of 87 patients were studied. There were 41 male and 46 female patients. The mean age of males was 29.59+/-6.1 years, and females was 32.1+/-7.6 years. Over 65% of the males and 65.2% of the females were either osteopenic or osteoporotic. The prevalence of osteoporosis in both groups was highest at lumbar spine. Other variables like BMI, percentage of sickle hemoglobin and degree of anemia did not affect the bone mass. CONCLUSIONS: This study supports the view that prevalence of osteopenia and osteoporosis among sickle cell anemia patients is high. Sickle cell anemia is becoming the most common cause of secondary osteoporosis and physician's awareness about this issue is essential for early diagnosis and appropriate management.

Ultrasound-guided embryo transfer does not offer any benefit in clinical outcome: a randomized controlled trial.

BACKGROUND: Ultrasound-guided embryo transfer (ET) is widely suggested as a standard clinical practice that improves overall embryo implantation and pregnancy rates. Various studies of this issue suffer from methodological pitfalls, so that a randomized controlled trial, which overcomes these problems, might be valuable. METHODS: Three hundred women aged <40, who underwent fresh ET, were included in this randomized, double-blind controlled trial. The K-J-SPPE echo tip soft catheter was used for the ultrasound-guided ET and the traditional K-Soft catheter for ETs not using ultrasound. One experienced operator performed all ETs. The primary study outcome was overall pregnancy rate (defined as the number of positive hCG results per transfer). RESULTS: No significant differences between groups were found regarding baseline patient and embryological characteristics, except for male factor and unexplained infertility (higher in the blind and ultrasound-guided ET group, respectively, P < 0.05). Overall pregnancy rates were 53.3 and 51.3% in the ultrasound-guided and blind ET group, respectively. Two ectopic pregnancies were reported in each group. Difficulty in cervical negotiation did not differ between the two groups. CONCLUSIONS: In patients undergoing ET by an experienced operator, ultrasound guidance did not provide any benefit in terms of overall clinical pregnancy and embryo implantation rates.

Successful treatment of an aggressive recurrent post-menopausal endometriosis with an aromatase inhibitor.

The current case report describes the development and medical treatment of an aggressive pelvic endometrioma in a post-menopausal patient, who had undergone abdominal hysterectomy and salpingo-oophorectomy a decade earlier. The patient was referred to the authors' centre because of right-sided sciatic pain. Three months before her admission she was hospitalized elsewhere due to subacute bowel obstruction. She was operated on and a resection of a part of sigmoid colon and an endometrioma, which was the cause of the subobstruction, was carried out. During the clinical investigation for the right-sided sciatic pain, an intrapelvic mass was found, which was compressing the lumbo-sacral plexus mimicking sciatica. The diagnosis of recurrent endometrioma was confirmed by a computerized tomography-guided biopsy and the decision was made to treat it with an aromatase inhibitor (letrozole). Eighteen months later, the endometrioma was almost completely regressed and the patient was free of symptoms. Medical management of recurrent post-menopausal endometriosis with aromatase inhibitors seems to be an effective alternative treatment to surgery.