International Research Journal of Medicine and Medical Sciences

34-39

Authors: Joshi B. and Chaudhary R.

Meniscus extrusion can be considered as a serious and relatively frequent clinical problem and can be also considered as a risk factor for osteoarthritis progression and knee pain symptom. Previous studies have shown a strong association between degenerative radial meniscal tears and extrusion. The aim of this study was to correlate the shape of lateral meniscus and the risk of its extrusion based on MRI examination of the knee joint. A prospective study was done in 75 patients of age group between 18 years and 50 years of age who were referred for MRI of knee joint in a tertiary hospital. The MRI was performed on a Magnetom Amira 1.5 Tesla MRI scanner following TUTH MRI routine protocol of Knee joint. All the cases who met the inclusion criteria were included in the study. After the procedure, images were evaluated. The measurements for the parameters used for this study were done in T1 Coronal image at the level of inter-condylar eminence and Proton density(PD) fat saturated sagittal image at the mid bow tie level where the morphology of the lateral meniscus were clearly delineated. Then the recorded data for each patient was correlated with the extrusion of the lateral meniscus along with body mass index (BMI) of the patient. The study showed a strong positive linear correlation of BMI and lateral meniscus-bone angle [LMBA] with meniscus extrusion, where (r=0.94; p=0.000) and (r=0.857; p=0.000) respectively. However, lateral meniscus-cartilage angle [LMCA] and lateral meniscus-cartilage height [LMCH] showed a moderate positive linear correlation with meniscus extrusion (r=0.564; p=0.000) and (r=0.305; p=0.26) respectively. The height of the anterior and posterior horns of the lateral meniscus showed the mean dimension of about 6.13(SD±0.62) mm and 6.30 (SD±0.58) mm respectively in our study. Similarly, the mean antero-posterior diameter of the anterior and posterior horns of the lateral meniscus were found to be 11.3(SD±1.06) mm and 11.4(SD±1.02) mm, respectively. Finally, the mean meniscus extrusion of the lateral meniscus observed beyond the tibial margin were about 2.57 (SD±0.93) mm whereas, the maximum meniscus extrusion was found to be 4.7 mm. In conclusion, increased BMI and LMBA showed significant increased risk of lateral meniscus extrusion beyond the tibial margin. However, LMCA and LMCH showed statistically moderate relation with the risk of lateral meniscus extrusion.

48-52

Authors: Beatriz Cepeda De Romero, Diana Carolina Cañon Guarnizo, Lina Marcela Orozco Herrera, Sofìa Cepeda Tarazona and Maria Alexandra Polo Pacheco

The ratio Deoxypyridinoline / Creatinine measured in urine (DPD/Cr) is the most sensitive and specific marker of early metabolic breakdown of collagen I, and therefore, of osteopenia and bone resorption. The normal values change with age and gender; in male adults the normal range is 2.3 to 5.4 nmol/mmol and in women is 3.0 to 7.4 nmol/mmol. It has been shown that osteopenia can lead to osteoporosis and to failure of implant osseointegration. The objective of this study was to associate levels of DPD/Cr in urine with bone height measured by tomography before surgery and three months after oral implant surgery in menopausal women. 20 healthy or systemically controlled postmenopausal women who underwent surgery implants, were selected by convenience for the study. All implants were: Titanium SIS® Implants (CIEO Foundation, Colombia) customized according to the patient requirements indicated in the CBCT. The implant length varied in the range 5 to 15 mm, internal diameter: 3 to 5 mm, internal hexagon: 2.4 mm, and screw: 1.85 × 0.35 mm. DPD values in urine were measured by a Chemical Luminescence Immune test and bone height in mm was measured in a tomography on implant zone before the surgery and 3 months after implant surgery. The average age of the patients was 61.2 ± 17.31 years and the number of implants 1-4/patient. The ratio DPD/ Cr showed a high average of 9.594 ± 0.475 nmol/mmol. Average pre-surgery bone height was 15.23 ± 1.41 mm and post-surgery decreased to 13.78 ± 1.16 mm. This difference was significant (t paired, p = 0.001). The Pearson correlation test showed a high association (p = 1) between the elevation of DPD/Cr and the decrease in bone height. There is a significant association between the change in concentrations of urinary creatinine-corrected deoxypyridinoline and bone resorption in menopausal women, three months after oral implant surgery.

60-67

Authors: R. S. Omotayo, O. Akadiri, A. L. Akintan and S. E. Omotayo

The health sector occupies an enormously important position in ensuring sustainable overall socio-economic advancement in developing countries. Healthy people make a healthy nation and also contribute to economic growth. Satisfaction is the contentment one feels when one has fulfilled a desire, need, or expectation. Poor quality is costly - to clients, to programmes and to the society overall. People's perception about quality of care often determines whether they seek and continue to use services. This study evaluated the level of patient’s satisfaction in gynaecological practice at the state specialist hospital Akure. This study is a descriptive cross-sectional study. Questionnaires of the Likert-like form was used to obtain information from consenting patients on various factors that determines or have effect on their level of satisfaction while accessing gynaecological care services at the gynaecology clinic of State Specialist Hospital, Akure. Systematic sampling method was used to recruit patients by selecting every second patient serially as they present . Three hundred and eight consenting gynaecological patients were recruited into the study. Data was analysed with the Statistical Package for Social sciences (SPSS) 20.0. Majority of the respondents 295 (95.7%) were satisfied with the morning time clinic schedule. More percentage of respondents were very satisfied with attending doctor being male (52.9%) than if the attending doctor was female (26.3%). Most patients (53.3%) were not satisfied with having to go outside the hospital to get some of their investigations done. Most patients (44.6%) were not satisfied with the level of availability of drugs in the hospital as they still go out to buy drugs. Vast majority of the respondents (89.2%) were either satisfied or very satisfied with the behavior and competence of the attending doctors and nurses. In conclusion, client's satisfaction is reflected by their happy expression about the care they receive, where and how they access the care. There is need for health care givers to continue and improve on aspects of care that gives patients satisfaction and discourage those that make the patients dissatisfied.