Study on prevalence of obesity using different scales and its association with hypertension among the elderly in a district of Gujarat.

Introduction: In older adults, excess weight is associated with a higher prevalence of cardiovascular disease, metabolic disease, several important cancers, and numerous other medical conditions. Several indices such as body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), and waist-to-height ratio (WHtR) are used to classify general. Some studies also reported that WC and WHR is a better indicator of cardiovascular disease (CVD) risk than BMI and WHR. Aims and Objective: 1. To estimate the prevalence of obesity among the elderly using three scale viz. BMI, WHR, and WHtR 2. To compare the results of these three-scale used for assessment of obesity 3. To determine the presence of association between obesity and hypertension if any. Material and Methods: For selection of the area, in both the urban and rural areas, the sampling units were enumerated and samples were collected from them. The estimated geriatric population combined in both Urban and Rural areas amounted to 12,220 (7% of geriatric population as per Census 2001), out of which 5% was selected as sample. This came out to be 611 elderly subjects which were selected equally from both urban and rural areas. For assessment of obesity BMI, WHR, and WHtR were measured. Assessment of hypertension was as per JNC classification. Result: Prevalence of obesity as per BMI in the urban area was found to be 40%, whereas that in rural areas was found to be 47.4%. WHR and WHtR showed higher prevalence in rural areas (70%) and also in urban areas (60%). BMI and WHR were significantly associated with hypertensive status of elderly. Conclusion: Anthropometric assessments of obesity like WHR and WHTR are more sensitive indicators of obesity among the elderly. BMI is found to be significantly associated with hypertension as well in the present study. Logistic regression showed that the association of BMI with hypertension was higher than other obesity assessments.

Cemented Hemiarthroplasty of the Hip in a Patient with Ipsilateral Knee Arthrodesis: Surgical Difficulties and Techniques.

INTRODUCTION: Standard references such as knee and lower leg position cannot be used in patients with knee arthrodesis with destroyed distal femur anatomy. The resulting component malposition can culminate in dislocation, decreased range of motion, impingement, and wear. To our knowledge, no cases on surgical techniques have been reported in such patients. We describe a simple technique that guides a surgeon in assessing the femoral stem version in such cases. CASE REPORT: A 80-year-old female sustained right sided neck of femur fracture. She had a history of bone tumor, which was treated with resection and arthrodesis. Subsequently, the patient developed osteomyelitis which healed gradually. The difficulties, in this case, were inability to flex the knee, to determine the trans-epicondylar axis and to use the ankle as a reference. Using lesser trochanter as reference neutral rotation of the limb was determined and K wire was inserted in distal femur of the patient. A post-operative computed tomography (CT) was done to assess the stem version. CONCLUSION: Our main aim in presenting this case was to emphasize on the surgical technique. A pre-operative CT scan should be done to evaluate the distal femur anatomy and calculate the lesser trochanter versions of the normal limb. We recommend the use of K wire inserted into the distal femur after determining the neutral version of the limb and comparing the lesser trochanter profile with the normal side.