Muzzafar ZAMAN, Aliya SHAH, Rikki SINGAL, Altaf KIRMANI, Abdul Rashid BHAT and Rajinder Pal SINGAL

ABSTRACT

Objectives: Osteoporosis is a skeletal disorder characterized by a decrease in bone mass, with accompanying microarchitectural damage that increases the risk of bone fracture. The aim of this study is to evaluate various risk factors for osteoporosis and the role of DEXA scan in diagnosing the problem in an earlier stage.
Materials and methods: About 100 patients who presented with complaint of low back pain in our outpatient department were studied and subjected to a DEXA scan.
Results: The age range of patients included in this study was between 35 and 70 years. Of all subjects, 85.10% (n=57) were females and 78.80% (n=26) males. The number of those with significant medical or surgical history was 31% (n=31). The anthropometric characteristics of the studied group included weight, height, and also BMI in kg/m2, which was 20.23, 21.06 in male subjects and 19.343, 20.42 in female ones.
Regarding DEXA measurements, the bone mineral density was 0.97±0.27 (0.48, 1.96) for males and 0.83±0.21(0.01, 1.60) for females, with a total of 0.88±0.24 (0.01, 1.96).
Conclusion: Low back pain is highly prevalent in postmenopausal women. DEXA is a widely accepted radiological tool used to detect osteoporotic changes in bones earlier, with a higher accuracy than plain radiographs of skeletal system. It is relatively cheap, needs no special preparation and involves less radiation hazard.
Keywords: osteoporosis, DEXA scan, fracture, low back pain

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Muzzafar ZAMAN, Kunal CHOWDHARY, Gurinder KAUR and Aliya SHAH

ABSTRACT

Objectives: Amoebiasisis a common parasitic infection and fulminant amoebic colitis remains a very rare complication of this disease. The objective of the present study was to find the incidence and outcome of perforation peritonitis due to amoebic colitis in MMIMSR, Mullana, Ambala, India.
Material and methods: 200 patients with perforation peritonitis were studied retrospectively, out of which 22 cases had colonic perforation, were selected over a period of five years, between 2012 to 2017, at MMIMSR Mullana. All patients had undergone emergency laparotomy and cases with amoebic colonic perforation established on histopathology were studied in terms of incidence, clinical presentation and outcomes.
Results: Out of 200 emergency exploratory laparotomies carried out during 2012-2017 at MMIMSR, Mullana, 22 (11%) patients had amoebic colonic perforation. The disease was more common among men as compared to women (21:1). The mean age of patients was 60±10 years. Symptom duration ranged from 1 to 8 days. 15 (68%) patients had historyof chronic alcohol intake and 2 (9%) had a recent episode of loose stools. Chest X-ray showed free gas under the diaphragm in 45% (10/22) of patients. Ultrasonography whole abdomen showing associated liver abscess was seen in 8/22 (36%) patients. Intraoperatively caecal perforation was seen in 20 cases, out of which 16 had concomitant ascending colon perforation and 2 sigmoid colon perforation. Bowel resection was performed depending upon the site and extent of the colon involved—right hemicolectomy (16), limited ileocolic resection (4) and sigmoidectomy (2). Proximal diversion stoma was made in all cases. Postoperative complications encountered were wound infection in 20 (91%) cases, followed by burst abdomen in 8 (36%) cases, stoma related complication in 6 (27%) cases. The overall mortality rate due to sepsis was 54% (12/22).
Conclusion: Although amoebiasis is a common parasitic infection, fulminant amoebic colitis remains a very rare complication with a reported incidence of 1%. Even with aggressive management of this entity, patients have got a poor prognosis. Resection with exteriorization of bowel is the current gold standard treatment in such cases.
Keywords: colonic perforation, amoebic colitis, faecal peritonitis.

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