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| 1 | Bone mineral density and disorders of mineral metabolism in chronic liver disease显示文摘AIM:To estimate the prevalence and identify the risk factors for metabolic bone disease in patients with cirrhosis.METHODS:The study was performed on 72 Indian patients with cirrhosis(63 male, 9 female;aged < 50 years).Etiology of cirrhosis was alcoholism(n = 37), hepatitis B(n = 25) and hepatitis C(n = 10).Twenty-three patients belonged to Child class A, while 39 were in class B and 10 in class C.Secondary causes for metabolic bone disease and osteoporosis were ruled out.Sunlight exposure, physical activity and dietary constituents were calculated.Complete metabolic profiles were derived, and bone mineral density(BMD) was measured using dual energy X ray absorptiometry.Low BMD was defined as a Z score below-2.RESULTS:Low BMD was found in 68% of patients.Lumbar spine was the most frequently and severely affected site.Risk factors for low BMD included low physical activity, decreased sunlight exposure, and low lean body mass.Calcium intake was adequate, with unfavorable calcium:protein ratio and calcium:phosphorus ratio.Vitamin D deficiency was highly prevalent(92%).There was a high incidence of hypogonadism(41%).Serum estradiol level was elevated significantly in patients with normal BMD.Insulin-like growth factor(IGF) 1 and IGF binding protein 3 levels were below the age-related normal range in both groups.IGF-1 was signiflcantly lower in patients with low BMD.Serum osteocalcin level was low(68%) and urinary deoxypyridinoline to creatinine ratio was high(79%), which demonstrated low bone formation with high resorption.CONCLUSION:Patients with cirrhosis have low BMD.Contributory factors are reduced physical activity, low lean body mass, vitamin D def iciency and hypogonadism and low IGF-1 level. | Joe George Hosahithlu K Ganesh Shrikrishna Acharya Tushar R Bandgar Vyankatesh Shivane Anjana Karvat Shobna J Bhatia Samir Shah Padmavathy S Menon Nalini Shah | 2009 | World Journal of Gastroenterology2009，15，28： | 15 |
| 2 | Unique Homologous siRNA Blocks Hypoxia-indueed VEGF upregulation in human corneal cells and inhibits and regresses murine corneal neovascularization 显示文摘 | Nirbhai S Eric H Shivan A | 2007 | Basic Invest2007，26，1： | 1 |
| 3 | Digital templating facilitates accurate leg length correction in total hip arthro- plasty显示文摘 | Shivan S Christopher I Matthew K | 2012 | Acta Orthop Belg2012，78，3： | 1 |
| 4 | HER2 expression in gastric cancer:Rare,heterogeneous and of no prognostic value conclusions from 924 cases of two independent series显示文摘 | Heike G Shivan S Sally G | | 0，，1： | 1 |
| 5 | Bone mineraldensity and factors influencing it in Asian Indian population withtype 2 diabetes mellitus 显示文摘 | Kamalanathan S Nambiar V Shivane V | 2014 | Indian J Endocrinol Metab2014，18，6： | 1 |
| 6 | Return to sport after lower limb arthroplasty-why not for all?显示文摘BACKGROUND Total hip and knee replacements are being performed in increasing numbers in progressively younger patients with higher activity demands. Many such patients have expectations of returning to athletic activity post-operatively yet are not always able to do so and the reasons behind this have not been extensively examined. We hypothesise that any reasons for a failure to return to athletic activity post-operatively are multi-factorial.AIM To quantify the return to athletic activity following lower limb joint arthroplasty and understand qualitative reasons for altered activity participation.METHODS A single centre, single surgeon retrospective questionnaire for hip and knee arthroplasty patients under age 60 years, minimum two years post-surgery with exclusion criteria of multiple degenerative joint involvement and multiple medical co-morbidities. Outcomes were validated joint-specific(Oxford hip and knee) and lifestyle questionnaires [short form 12(SF-12) and University of California, Los Angeles(UCLA)] and an activity questionnaire assessing ability participation in athletic activity post-operatively. Statistical analysis was performed on the validated outcome data, including comparison between hip and knee replacements. Frequency tables were produced to quantify the different athletic activities participated in by patients.RESULTS Responses were received from 64 patients(80% response rate). There was a statistically significant improvement in Oxford hip and knee scores following surgery. SF-12 scores also improved for all patients, but no statistically significant difference was seen between joints(P = 0.88). Mean UCLA scores pre-operatively were 7.67 and at two years post-operatively were 7.69, with no statistically significant change(P = 0.91). All patients reported high satisfaction and improved ability to perform athletic activity at a higher frequency compared to pre-operatively. The most common reasons for changing activity participation were not wanting to stress their joint replacement or instructions by other doctors or the lead surgeon. There was no difference in the responses to the questionnaire based on type of joint replacement(P = 0.995).CONCLUSION Patients receiving a joint replacement are able to participate in athletic activity to high levels and are satisfied with their outcomes. Reasons for non-participation are multi-factorial. | Shivan S Jassim Jenni Tahmassebi Fares S Haddad Angus Robertson | 2019 | World Journal of Orthopedics2019，10，2： | 0 |
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