Merit Research Journal of Medicine and Medical Sciences

029-040

Authors: Rapheeporn Khwanchuea

According to WHO criteria, Osteoporosis is defined as bone mineral density (BMD) that is reduced by more than 2.5 standard deviations below the young adult mean. This leads to bone fragility and an increased risk of fractures. Bone mass rapidly accelerates in adolescents until peak bone mass (PBM) is achieved by the end of adolescence between the age of 20–25 and levels remain relatively static until the age of 45 when bone density starts to fall. Bone loss is positively associated with age and aging contributes to the development of osteoporosis. Genetic, hormonal and environmental factors such as low estrogen, low dietary calcium intake, vitamin D deficiency, current cigarette smoking, chronic alcohol consumption, and low physical activity or exercise also contribute to low bone density and skeletal fragility. Mechanical stress has long been recognized to have important effects on bone. Activities or exercises that are weight bearing or involve impact are most useful for increasing or maintaining bone mass. The development of PBM during the growing years is an important determinant for risk of osteoporosis in later life. Adequate nutrition and sufficient activity are critical factors in maximizing bone growth potential. Replacing milk intake by soft drinks appears to be detrimental to bone gain. The association between bone fractures and carbonated beverage consumption, in particular, is found in adolescences. Caffeine-containing beverage consumption has been reported to be associated with reduced bone mass due to its effects on a mild diuretic and short-term increased in urinary calcium excretion. This consumption with more milk may distribute effects of caffeine on body bone gain. Current greater cigarette consumption is at increased risk of hip fracture, and the decline in risk is observed until 10 years after smoking cessation. A small amount of alcohol has benefit to BMD, whereas high alcohol consumption increases risk of fractures that is relative to low body mass index. Keywords: Bone mass, Peak bone mass, Exercise, Calcium intake, Beverages

019-028

Authors: Cihan Solak, Bozkurt Gulek, Gokhan Soker, Omer Kaya, Mehmet Sirik and Eda Soker

The purpose of this study was to investigate the diagnostic efficiency of 0.2 Tesla (T) low field-strength open MRI imaging in the diagnosis of meniscal tears of the knee. 44 knees of 44 patients who had applied to the Orthopedics department with several clinical complaints and physical findings regarding their knees were imaged by a low-field open MR scanner. The results were compared with those obtained from the arthroscopic examinations of the same patients, performed during the first week following their MRI examinations. MRI studies revealed medial meniscal tears in 33 (75 %), and lateral meniscal tears in 10 (22.70 %) cases. Arthroscopy proved medial meniscal tears in 32 (72.70 %), and lateral meniscal tears in 10 (22.70 %) of the cases, respectively. 3 false-positives and 2 false-negatives in the medial meniscal, and 2 false-positives and 2 false-negatives in the lateral meniscal series were detected. The sensitivity values were 93.75 % and 80 %, the specificity values were 75 % and 94.12 %, the accuracy values were 88.63 % and 90.90 %, the positive predictive values were 90.90 % and 80.80 %, and the negative predictive values were 81.81 % and 94.12 %, for the medial and lateral menisci, respectively. Our results have confirmed that low-field open MR scanners may be used effectively and reliably in the diagnosis and evaluation of meniscal tears of the knee. Keywords: Meniscopathy, meniscal tear, MRI, low-field MRI

012-018

Authors: Yassin Mustafa M. D., Heib Aysha MPH, Garti Avraham M. D. and Prof. Dr. Bowirrat Abdalla M. D., Ph.D

Elderly patients with Alzheimer’s disease (AD) are subject to high incidence of hip fracture, especially in elderly female patients. The devastating and progressive consequences of AD are numerous and have unconstructive impacts in the whole body function; Psychological problems such as memory impairments; judgment deficiency; failure of the topographical orientation – characterized by the inability to orient oneself in one’s surroundings as a result of dementia which lead to the disability or inability to make use of selective spatial information (e.g., environmental landmarks) or to orient by means of specific cognitive strategies such as the ability to form a mental representation of the environment (visuospatial dysgnosia) – other vital penalties are observed among AD patients such as the loss of activity of daily living, the failure of adequate motor function which cause together with other symptoms to movement instability (falls), orthopedic injuries and instigate a state of mental incapacity and motor unsteadiness among AD patients. Many other metabolic factors such as Hypovitaminosis D and K due to malnutrition or sunlight deprivation, increased bone reabsorption due to immobilization, and low bone mineral density (BMD) can increase the risk of falls and may contribute to an increase risk of hip fractures in patients with neurological diseases in general and especially AD patients. The purpose of this study is to shed light on this quandary, and to evaluate the risk of hip fracture in patients with AD by looking for prevention strategies capable to reduce the risk of hip fractures in patients with such neurological disease. Keywords: Alzheimer’s disease, Hip fracture, Risk factors, Prevention strategies.

007-011

Authors: Isaac I. Z., John R. T., Suleiman A. S., Erhabor O. and Ahmed Yakubu

It has been figured that sometime this fall, the world’s population will reach 7 billion people. Experts now forecast that by 2050, the population could be 10 billion. The need to control the increasing world population has triggered the implementation of policy to make family planning including the use of hormonal contraceptives much more widely available in the developing world. Forty three women on hormonal contraceptive for three months and above duration constituted the subjects for this case-control study. Twenty age- matched women who were not on any contraceptives were monitored as controls. The mean age and range of the subjects and was 28 ± 1.76 years and 18-45 years respectively. EDTA anticoagulated blood samples were collected from subjects and control participants and analysed using the SWELAB 3-part-differential haematology analyzer (Medonic, Sweden) for platelet count. Although the mean platelet count was marginally higher among subjects on hormonal contraceptives compared to controls, this difference however was not statistically significant (t = 190.0, p = 0.851). The mean and standard deviation of platelet count was 300.50 ± 63.60; 258.00 ± 94.10; 247.60 ± 61.20 and 244.00 ± 49.90 respectively among the age groups 20 – 24; 25 – 29; 30 – 34 and 35 – 40 years respectively. We observed a negative correlation between age of HCs users and platelet count (r=-0.56, p=0.03). The mean platelet count was significantly lower among long-term (>1 year) hormonal contraceptives users compared to short-term users (297.50 ± 56.40 versus 268.10 ± 89.00, p=0.05). This study indicates that early introduction of third generation hormonal contraception can produce an initial increase in the platelet count and that long-term use of hormonal contraceptives is associated with a reduction in platelets count. Keywords: Hormonal contraception, Platelet count, Sokoto, Nigeria.

001-006

Authors: Prasant MC, Anuroop Singhai, Ashutosh Dutt Pathak and Fareedi Mukram Ali

Various types of pathological conditions can be seen in the oral cavity. Oral lesions like oral malignancy can be fatal, but its fatality can be decreased if it is diagnosed properly and at the proper time. Biopsy is an important tool for the accurate diagnosis and thereby giving the patient its proper way of treatment. This can be achieved with the help of biopsy procedures performed by the dental surgeons with clinical judgment and appropriate methods. For which accurate knowledge of the principles of the biopsy procedures are essential. This review article focuses on the basic principles of the biopsy. Keywords: Biopsy, Oral Lesions, Specimen.