X-ray Reading
X-ray Reading
Figure 1
The patient in this x-ray image is centred with both lungs apices. The image has also captured the costophrenic angles but some of the bones are invisible in the picture. The reason some of the bone structures are invisible is because of poor reproduction. Additionally, the medial ends of clavicle are invincible thus it is impossible to assess rotation using this image. Another observation is that the trachea is patent and deviated to the right. The image also shows that the heart is deviated to the right. The heart of the patient has a normal cardiac size and shape but there are some differences in radiolucency on either sides of the vertebral column. According to the image, the right side is darker and less dense than the left side of the vertebral column. The left side of the vertebral column has distinct and well-defined cardiac borders whereas the right side has indistinct cardiac borders.
Additionally, the right hemidiaphragm can be distinguished whereas the left hemidiaphragm is indistinguishable. In fact, the left hemidiaphragm has its costophrenic angle blunted revealing signs of a pleural effusion. The image reveals a white region around the left cardiac border, which is a sign of consolidation. The region contains dark patches that are discrete in nature which is a sign of air. The white region extends to the left costophrenic angle of the chest (). The dark patches are distorting the outlines of left atrium, left helium and azygous vein (). However, the right side of the chest shows clear outlines for the left ventricle, left helium and aortic arch. The x-ray image revealed above demonstrates that the patient may be suffering from staphylococcal pneumonia. Since the right cardiac is visible, we can conclude that the patient is suffering from left lower lobe pneumonia rather than the middle lobe pneumonia or right lower lobe pneumonia.
Figure 2
Figure 3
Figure 4
There are varieties of effects of calcium intake in the Bone Mineral Density of human beings (BMD). Based on DXA measurements (Dual-energy X-ray Absorptiometry), the report aims at focusing on Saudi Arabian women and the effects of both calcium and physical exercise on their BMD. It aims to cover all aspects of BMD among the Saudi Arabian women in the region of Riyadh. The choice of location owes to the presence of DXA equipment and easy access to the reassert data. The goal of this project is to report, evaluate, and create a conclusion on the outcomes of bodily activities and calcium intake on the Saudi Arabian women’s BMD, mostly in the postmenopausal stages. It helps generating a conclusion pertaining BMD in regards to calcium intake and physical activity.
In Saudi Arabia, low levels of BMD among women are a public concern in regards to health. Based on the research, women living in the region of Riyadh have a tremendously low BMD, which affects their lives adversely (Al-Maatouq et al. 2004). Lack of sufficient calcium intake affects the BMD by lowering its levels in the body. The report presents data obtained from the location, and thus a conclusive statement of effects of physical activity alongside calcium intake, on Bone Mineral Intensity. The research will consider publications by other authors and researchers and their results.
Literature review
A research by Mohamed A. Al-Maatouq and other assisting authors entitled “Prevalence of Osteoporosis among Postmenopausal Females” has a vast focus on the causes of low BMD among Saudi Arabian women from Riyadh. The research to determine the prevalence happened at King Khalid University Hospital. The major cause of the low BMD levels was poor nutrition, where most of their meals lacked the bone-strengthening mineral, calcium. The constant lack of this vital mineral amounted to low levels of BMD among them. Another reason was the lack of intensive physical activities. Past the menopausal stage, most women, in this case, Saudi Arabian, indulge in fewer physical activities (Al-Maatouq et al. 2004). Lack of exercise amounts to osteoporosis and thus low BMD levels.
Calcium and Vitamin D are key constituents for maintaining high levels of BMD. Therefore, intake of calcium and maximizing physical activity helps improve the Bone Mineral Intensity among women in Saudi Arabia. The research concluded that the lack of calcium intake, vitamin D, and physical activity amounted to Osteoporosis and low BMD levels.
The area of investigation has received an upper hand by other authors, including Nora Abdullah, WHR chair, who has undertaken a similar research in the College of Medicine, King Saud University. Saudi Med J (2004) also acknowledges that the prevalence of low BMD is as a result of low calcium intake and lack of sufficient physical activity. These are thus reliable sources, proving that calcium intake, alongside physical activity, result to increase of BMD levels, reducing the threat of Osteoporosis.
Two-stage cluster sampling was used in a cross-sectional study in Riyadh, 2009. The research took 30 clusters comprised of 300 houses each. The clusters were randomly chosen, to ensure that the obtained results were not compromised or one-sided. During the process women of ages above 40 years were chosen, resulting to 38-40 women who added up to a total of 1150 postmenopausal women (AlQuaiz et al. 2014).
These chosen participants received self-administered questionnaires at the primary center of health care. The total number of women who took the questionnaires constituting calcium intake, health, diet, and physical activity was 1069. Another group of 1008 women underwent low BMD screening. The technique used was the quantitative ultrasound, which screens bones for BMD levels. Five hundred and thirty-five (535) women, whose results were positive, were taken to the King Khalid Hospital for DXA measurements (AlQuaiz et al. 2014).
Findings
The mean age of the women who were participants in the research was 55.26 years, with an age variation of about (+/-) 8.84 years. Out of the 362 women taken to for DXA measurements, 59 percent had low BMD levels. The actual number was 212 women, out of the 362 who undertook the screening (AlQuaiz et al. 2014). Multivariate logistic analysis concluded that low calcium intake and lack of physical activity amounted to low BMD levels among women past the menopausal age. Other associated minor factors were literacy levels, fracture history, not drinking diluted yogurt (Laban), and being of ages above 61 years (AlQuaiz et al. 2014).
Discussions
Low BMD levels result in weak bones in one's body. In this case, most Saudi Arabian women are associated with weak bones resulting from lack of calcium intake, and physical activity, such as exercises. As depicted in the research at Riyadh, women past the menopausal age are at a higher risk of experiencing low levels of BMD. Lack of proper nutrition greatly affects their bone structure, due to the low levels of calcium intake. Calcium is a key nutrient constituent that helps in strengthening bones, giving an individual full support of his or her weight. Lack of appropriate calcium levels in the body affects the strength of bones, especially the backbone. Excessive lack of calcium intake may result in the impairment of the bone structure of an individual, paralyzing him or her.
Lack of physical activity also has a major effect on the bone structure of an individual. The situation amplifies in a woman past her menopause, who is at a higher risk of low BMD levels. It is important to indulge in physical activities that boost the strength of bones and increase the level of BMD.
Conclusion
As depicted in the report, calcium intake is vital for proper development of bones in an individual. Low or no levels of calcium intake results to low BMD levels and osteoporosis. Physical activity is also necessary for the development of bones and structure of an individual. Low BMD levels are dangerous and may result in paralyzing the individual.
The report covers a key aspect of nutrition in Saudi Arabia, where the problem of low BMD levels is a public health concern among women. Aging in women results in weakening of bones, and, therefore, demands the proper nutrient uptake to remain healthy and in shape. The lack of proper nutrition is a major problem in Saudi Arabia, and most of the women have low BMD levels. The remedy to this problem is the improvement in nutrition and a major focus on physical activity. The deficient women may indulge in activities such as jogging, joining a gym, and changing their lifestyle habits. A lot of rest is not good for the body though one should relax after exercising to give the body time to rejuvenate. Ensuring intake of healthier diets and meals is also vital for improvement in the level of BMD. Intake of healthier diets helps the individual to better their health and strengthen bones, making them more active and thus leading a happier and healthier life.
Recommendations
The leadership of Saudi Arabia should bring up initiatives to help eliminate the menace from menopausal women and any other affected population group. It should encourage screening, which will enable victims to discover the unknown ailments from which they are suffering. Through diet improvements, the government can also enable the patients to better their health states and eliminate such ailments.
As seen during the research, illiteracy is also among the major causes of lowering of the level of BMD in the menopausal women. The prevalence of illiteracy in the region is wanting, and thus the government or any other Non-Governmental Organization can devote itself to educating the women on dietary and nutrition. In this way, they will help women avoid such nutritional sicknesses, making them healthier and fit.
Encouraging exercises is also a key approach towards the elimination of osteoporosis among menopausal women. NGOs or even the government may offer physical exercise education to these women. It will enable them tackle any illness or condition resulting from lack of physical activities. With the enactment of these recommendations, the government cases of low Bone Mineral Density levels can be eliminated and put to the past, flourishing healthier lifestyles.
RESEARCH REGARDING BONE MINERAL DENSITY WITH DUAL ENERGY XRAY ABSOPTIOMETRY IN PRE AND POST MENOPAUSAL WOMEN.
M.R. Salamat 1, N. Rostampour 1, S. Shanehsazzadeh, M.B. Tavakoli 1, M. Siavash 3, T. Almasi .Bone Mineral Density with dual energy Xray absorptiometry in pre and post menopausal women.Isfahan university of medical sciences.
The aim of the research was to assess the degree of bone loss on femoral neck and lumbar spine in pre and post-menopausal women referred to the Isfahan Osteoporosis Diagnosis Centre (IODC) since 2005.Osteoporosis is the gradual loss of bone mineral loss due to a variety of factors.174 early post-menopausal women and 174 pre-menopausal women were selected randomly for the research. Researchers conducted the investigation using Norland XR46 system (a type of dual x-ray absorptiometry)..For the study, women who had undergone hysterectomy or had a history of HRT (hormone replacement therapy) or had diseases affecting bone metabolism were excluded.
The findings revealed that postmenopausal Iranian women had a lower bone mineral density than premenopausal Iranian women. From previous investigations in different countries, (e.g. USA, Europe, and Arab countries) FN T-scores were higher than LN T-scores for those nations except for the women from Isfahan in Iran. In contrast to previous findings, there were a significantly lower BMD T-scores for FN in comparison with for both pre and post-menopausal women. This might be due to physiological, lifestyle, poor calcium and low activity factors. Another study was carried out in Isfahan comparing the BMD in lower and upper body between non-athletic and athletic women. The athletes had significantly higher BMD than non-athletic females.
In Iran, foods do not contain enough vitamin D.As a result; there is widespread vitamin D deficiency in the Iranian population (about 80%).
This research provides a platform on which I can compare the relation of bone mineral density with levels of activity in Saudi Arabian population. The results of the correlation between Vitamin D (main source of calcium) in the diet and the bone mineral density also make it integral to my project.
BIBLIOGRAPHY 2
RESEARCH REGARDING EFFECT OF SUPPLEMENTATION OF CALCIUM AND VITAMIN D ON BONE MINERAL DENSITY AND BONE MINERAL CONTENT IN PRE- AND POST MENOPAUSAL WOMEN
Nicola Di Daniele, Maria Grazia Carbonelli, Nicola Candeloro, Leonardo Iacopino, Antonino De Lorenzo∗, Angela Andreolied trial.Effect of calcium supplementation on BMD in women.Human Nutrition Unit, Via Montpellier 1, University of Rome, “Tor Vergata”, 00173 Rome, Italy
The objective of the study was to assess the effects of calcium supplementations combined with vitamin D on Bone Mineral Density (BMD) and its mineral content (BMC) in pre- and post-menopausal women. The trial was such that a group of 120 Italian women aged over 45 participated in a random placebo-controlled double-blind trial over a 30-month period. The researchers took details on their daily dietary intake and assessed their DXA results. The DXA was to measure both the BMD and BMC.
The researchers noted that there was no change in dietary or calcium intake in the significant groups over the 30-month period. The placebo group lost total BMD at a rate higher than the calcium group. The findings also revealed an increase in BMD with lower age groups. The findings also suggested that healthy women with low dietary calcium intake are more likely to benefit from calcium supplements. They revealed that as much as calcium supplementation helps to reduce bone loss, diet-induced weight loss countered these effects. The researcher's conclusion was that there is a positive effect of calcium and Vitamin D supplementation on bone mineral density in both pre- and post-menopausal women.
The study is helpful in my project in that it will help me factor in the relationship between weight changes among women receiving calcium supplements and their combined effect on bone marrow density and bone mineral content. There are great references in original research that I will find and use in my research too.
BIBLIOGRAPHY 3
RESEARCH PAPER FOR PROJECT REGARDING BONE MINERAL DENSITY OF THE SPINE AND FEMUR IN MOROCCAN MEN
El Maghraoui a, ⁎, M. Ghazi a , S. Gassim a , A. Mounach a , I. Ghozlani a , A. Nouijai a , L. Achemlal a, A. Bezza a , M. Dehhaoui b .Rheumatology and Physical Rehabilitation Department, Military Hospital Mohammed V, Rabat, Morocco; Statistics Department, Agronomic and veterinary institute Hassan II, Rabat, Morocco
The purposes of the study were to determine the normal BMD of the Moroccan men.Also, there was need to determine whether the obtained BMD values were different enough from US, European or Arab reference values to warrant separately Moroccan reference data. The researchers used the DXA system to establish reference values for 592 Moroccan men aged between 20 and 79 years that measured BMD of lumbar and femur. Then there was a comparison between this data to values from US, European, Lebanese and Saudi men.The researchers then studied the impact on osteoporosis diagnosis using the personalized curve and US (NHANES), European and Arabian values.
The research indicated that there is a decrease in the BMD with advancement in age with the rate of bone loss varying with the anatomical region. The findings established that there are racial/ethnic differences in BMD values. The reference values for the lumbar spine classified a larger proportion of the US/European men as osteoporotic since they were higher compared to the Arabs’. When compared to other countries, the spine BMD of Moroccan men were lower than the Iranians’, Europeans and Brazilian’s but higher than the Saudi and Lebanese males. The Moroccan BMD values were higher than Saudi and Lebanese young adults (20-39).Moroccan values were higher than Saudis and almost similar to Lebanese for older subjects.
The findings provide a re-analysis of the research findings in my project. The research suggests that population-based variations exist. Thus, there is need to establish local reference values to make the data more comprehensive on the populations I researched on in my project.
BIBLIOGRAPHY 4
RESEARCH PAPER FOR PROJECT REGARDING RELATIONSHIP BETWEEN LIFESTYLE FACTORS AND BONE DENSITY IN WOMEN REFERRING TO BONE DENSITOMETRY RESEARCH CENTRE IN SHIRAZ ,IRAN
Iran Jahangir ; Elham Aflaki ; Haleh Ghaem.Relationship between lifestyle factors and bone density in women.Shiraz University of Medical Sciences, Shiraz, IR Iran 2 Department of Rheumatology.
The aim of the study was to establish the relationship between lifestyle and Bone Mineral Density (BMD) in women going for referral in bone densitometry Research Center.A total of 1170 premenopausal and postmenopausal women participated in the study. It was a cross-sectional study. The researchers obtained details on anthropometric, lifestyle data including physical activities, smoking habits, dairy intake and its consumption pattern. The researchers also included a history of steroid intake and calcium intake .DXA was used to measure the lumbar and femoral BMD.The research also includes demographic data (age, number of pregnancies, number of children, height body mass index).
After age adjustments, the research revealed a correlation between BMD and body weight for women. Low body weight and an advancement in age predisposes one to bone loss according to the findings. Women who had more than four pregnancies were significantly susceptible to the osteoporosis of the lumbar spine and femoral neck. A positive relationship existed between BMD and smoking, drinking plenty of tea and coffee, soft drinks consumption, thyroid disorders and drugs including corticosteroids. BMD was higher for the women that engaged in physical activities though this was more with hip than the spine. Consumption of dairy products correlated well with an increase in BMD.Collectively, increasing age, low calcium intake and poor physical activity were risk factors for a low BMD.
The study explored many factors that I will include in my project that expounds more on osteoporosis in pre- and postmenopausal women. The findings on calcium intake and physical activity provide further material for my project.
BIBLIOGRAPHY 5
RESEARCH PAPER FOR PROJECT REGARDING EFFECTS OF PHYSICAL ACTIVITY AND CALCIUM INTAKE ON BONE MINERAL DENSITY IN WOMEN BASED ON DXA MEASUREMENTS.
Nicola Di Daniele, Maria Grazia Carbonelli, Nicola Candeloro, Leonardo Iacopino, Antonino De Lorenzo∗, Angela Andreoli. Effect of supplementation of calcium and Vitamin D on bone mineral density and bone mineral content in peri- and post-menopause women a double-blind, randomized, controlled trial. Human Nutrition Unit, Via Montpellier 1, University of Rome, “Tor Vergata”, 00173 Rome, Italy
The objective of the study was to assess the effects of calcium supplementations combined with vitamin D on Bone Mineral Density (BMD) and its mineral content (BMC) in pre- and post-menopausal women. The trial was such that a group of 120 Italian women aged over 45 participated in a random placebo-controlled double-blind trial over a 30-month period. The researchers took details on their daily dietary intake and assessed their DXA results. The DXA was to measure both the BMD and BMC.
The researchers noted that there was no change in dietary or calcium intake in the significant groups over the 30-month period. The placebo group lost total BMD at a rate higher than the calcium group. The findings also revealed an increase in BMD with lower age groups. The findings also suggested that healthy women with low dietary calcium intake are more likely to benefit from calcium supplements. They revealed that as much as calcium supplementation helps to reduce bone loss, diet-induced weight loss countered these effects. The researcher's conclusion was that there is a positive effect of calcium and Vitamin D supplementation on bone mineral density in both pre- and post-menopausal women.
The study is helpful in my project in that it will help me factor in the relationship between weight changes among women receiving calcium supplements and their combined effect on bone marrow density and bone mineral content. There are great references in original research that I will find and use in my research too.
Reference List
Al Quaiz A, Kazi A, Sulaimani R, et al. Prevalence and factors associated with low bone mineral density in Saudi women: a community based survey. BMC Musculoskeletal Disorders [serial online]. February 2014;15(1):1-17. Available from: Academic Search Premier, Ipswich, MA. Accessed February 8, 2015.
2 Määttä M, Moilanen P, Timonen J, Pulkkinen P, Korpelainen R, Jämsä T. Association between low-frequency ultrasound and hip fractures - comparison with DXA-based BMD. BMC Musculoskeletal Disorders [serial online]. July 2014; 15(1):2-16. Available from: Academic Search Premier, Ipswich, MA. Accessed February 8, 2015.
3 Bener A, Hammoudeh M, Zirie M. Prevalence and predictors of osteoporosis and the impact of life style factors on bone mineral density. APLAR Journal of Rheumatology [serial online]. September 2007; 10(3):227-233. Available from: Academic Search Premier, Ipswich, MA. Accessed February 8, 2015.
References
Buttaro, T. M., Trybulski, J., Polgar Bailey, P., & Sandberg-Cook, J. (2013). Primary care: A collaborative practice (4th ed.). St. Louis, MO: Mosby.
Ellis, S. M. (2010). Interpreting chest x-rays. Oxford: Scion Pub.
