Osteoporosis: A Step-by-Step Case-Based Study

Coexistence of Biopsychosocial Factors With Lumbopelvic Pain in Indian Women: A Systematic Review

In general, women appear to report lumbopelvic pain (LPP) more frequently. In addition to the biomechanical risks, this systematic review aimed to identify the add-on biopsychosocial implications of LPP among women in the Indian community. PubMed, ScienceDirect, Web of Science, PEDro, and Google Scholar were searched twice from inception to a final systematic literature search in December 2022. All studies addressing Indian women with LPP were selected. Studies on non-musculoskeletal LPP were excluded. Qualities of non-experimental and experimental research articles were assessed through the Critical Appraisal Skills Programme (CASP) checklist and Cochrane risk of bias criteria for Effective Practice and Organization of Care reviewsrespectively. Data synthesis was narrative as the selected studies differed substantially. Habitual squatting, kneeling, and continuous sitting were identified as ergonomic risks to LPP. Menopause, cesarean, and multiple deliveries influence the onset of LPP among women. There is a severe deficit in data about the musculoskeletal implications of LPP. There are insufficient data present to summarize the biopsychosocial risks of LPP. Even the exact anatomical sites of LPP were not described in most articles. Due to the severe scarcity of data, there is an alarming need to explore the musculoskeletal as well as psychosocial consequences of LPP in Indian women. Among rural women, LPP was common in those working as laborers; which are physically robust jobs with respect to strength and anthropometrics of women. Domestic chores in India involve a lot of manual work; placing unequal loads on the lumbar spine, eventually resulting in LPP. Therefore ergonomic strategies for women should be designed to meet the needs and demands of their respective occupations as well as domestic chores.

A Prospective Study Correlating Preoperative Modified Frailty Index With One-Year Mortality in the Elderly With Hip Fractures

Background Hip fractures occur frequently in the elderly population over the age of 60 years following low-energy domestic falls. The postoperative mortality after hip fracture surgery depends on numerous factors like comorbidities, pre-fall ambulatory status, nutritional status, cognition, and overall physical health. In this context, the physiological age and reserve play a vital role in mortality after hip fracture surgeries. This physiological reserve is measured in terms of "frailty." There are many frailty indices that assess the physiological reserves of an elderly patient. The modified frailty index (MFI) is one of the validated indexes predicting postoperative complications and mortality. So we concluded there is a need to assess the patients with MFI preoperatively, based on which mortality and postoperative complications could be predicted in our patients. Materials and methods We included 100 patients aged more than 60 years with intertrochanteric and neck of the femur fractures, who were managed surgically. We followed the patients for one year and observed the immediate and late complications and mortality at the end of one year. To reduce bias, patients with pathological fractures, revision surgeries, contralateral fractures, high-energy trauma, younger than 60 years of age, and previous proximal femur fracture surgery on the side of injury were excluded from the study. Results The primary objective was to study the correlation between the MFI with one-year mortality. We observe that the MFI score had a significant effect on mortality at one year (p-value = 0.0316). With a unit increase in the MFI score, the odds of death increase by a factor of 1.52. Conclusion There is a strong correlation between MFI with one-year mortality and postoperative complications after hip fracture surgeries in the elderly. This MFI can be used as a preoperative predictive model to predict the mortality and postoperative complications after hip fractures in the elderly. It will also help patients and their caretakers in decision-making and elucidating surgery choices.

Osteoporosis in Childhood Cancer Survivors: Physiopathology, Prevention, Therapy and Future Perspectives

Simple Summary

Anti-cancer treatments induced an increase in the childhood cancer survival rate. However, they are responsible for several long-term side effects in childhood cancer survivors, including osteoporosis. Cancer itself, a sedentary lifestyle, and an unhealthy diet might adversely affect bone health. Early identification and adequate management of bone fragility in childhood cancer survivors could be useful to prevent osteoporosis onset and consequently fragility fractures.

Abstract

The improvement of chemotherapy, radiotherapy, and surgical interventions, together with hematopoietic stem cell transplantation, increased childhood cancer survival rate in the last decades, reaching 80% in Europe. Nevertheless, anti-cancer treatments are mainly responsible for the onset of long-term side effects in childhood cancer survivors (CCS), including alterations of the endocrine system function and activity. In particular, the most frequent dysfunction in CCS is a metabolic bone disorder characterized by low bone mineral density (BMD) with increased skeletal fragility. BMD loss is also a consequence of a sedentary lifestyle, malnutrition, and cancer itself could affect BMD, thus inducing osteopenia and osteoporosis. In this paper, we provide an overview of possible causes of bone impairment in CCS in order to propose management strategies for early identification and treatment of skeletal fragility in this population.