Concept of Majja Dhatu of Ayurveda in Perspective of Bone Marrow: A Review

Ayurveda has described three basic physiological constituent dosha, dhatu and mala for the existence of human body. Among them, seven dhatus form the structural units of the body. The functions of dhatus are dharana (to support) and poshan (to nourish). Dhatus undergo continuous construction and degeneration to maintain a state of equilibrium of the body. Majjadhatu is the sixth dhatu to be formed after asthi dhatu in uttrottardhatuposhan cycle. Bone marrow can be considered as a part of majja dhatu playing a significant role in erythropoiesis. Acharya Sushrut has mentioned about saraktameda and majja. Asthi (bone) and sandhi (joints) are the foundation of majjavahasrotas. The quantity of majjadhatu is one anjali. This manuscript is an attempt to explore the physio-anatomy of majja dhatu based on physiological functions described in ayurveda classics. For which the basic material has been collected from the ancient classics with the available commentaries as well as text books of contemporary modern medical science. KEY WORDS: Bone Marrow, Majja, Majjavahasrotas, Medas, Saraktameda.

Pediatric Orthopedic Emergencies

Proper care of orthopedic injuries and emergencies in children and adolescents requires knowledge of the altered bone and ligament characteristics, varying stages of skeletal development, and potential for congenital or developmental abnormalities. Pediatric fractures affecting the growth plate require unique management to maintain optimal growth. Whereas some specific fractures in these skeletally immature patients require urgent surgical repair, other fractures remodel extremely well and can be managed with a simple splint. Particular dislocations are common in this population and may have concomitant fractures. There are several overuse injuries seen primarily in children, and treatment aims to keep the patient active while allowing the injury to heal. Potentially devastating osteoarticular infections occur in the pediatric population and must be differentiated from more benign causes of joint pain, such as transient synovitis or congenital abnormalities. Children are also at risk for abnormalities such as slipped capital femoral epiphysis or Legg-Calvé-Perthes disease, which are rarely diagnosed in the adult population. It is imperative for a clinician to be aware of these and other nuances to optimally care for orthopedic injuries and emergencies in the pediatric population. This review contains 9 figures, 13 tables and 45 references Key words: bone, musculoskeletal, orthopedic, skeletal

Pediatric Orthopedic Emergencies

Proper care of orthopedic injuries and emergencies in children and adolescents requires knowledge of the altered bone and ligament characteristics, varying stages of skeletal development, and potential for congenital or developmental abnormalities. Pediatric fractures affecting the growth plate require unique management to maintain optimal growth. Whereas some specific fractures in these skeletally immature patients require urgent surgical repair, other fractures remodel extremely well and can be managed with a simple splint. Particular dislocations are common in this population and may have concomitant fractures. There are several overuse injuries seen primarily in children, and treatment aims to keep the patient active while allowing the injury to heal. Potentially devastating osteoarticular infections occur in the pediatric population and must be differentiated from more benign causes of joint pain, such as transient synovitis or congenital abnormalities. Children are also at risk for abnormalities such as slipped capital femoral epiphysis or Legg-Calvé-Perthes disease, which are rarely diagnosed in the adult population. It is imperative for a clinician to be aware of these and other nuances to optimally care for orthopedic injuries and emergencies in the pediatric population. This review contains 9 figures, 13 tables and 45 references Key words: bone, musculoskeletal, orthopedic, skeletal

Pediatric Orthopedic Emergencies

Proper care of orthopedic injuries and emergencies in children and adolescents requires knowledge of the altered bone and ligament characteristics, varying stages of skeletal development, and potential for congenital or developmental abnormalities. Pediatric fractures affecting the growth plate require unique management to maintain optimal growth. Whereas some specific fractures in these skeletally immature patients require urgent surgical repair, other fractures remodel extremely well and can be managed with a simple splint. Particular dislocations are common in this population and may have concomitant fractures. There are several overuse injuries seen primarily in children, and treatment aims to keep the patient active while allowing the injury to heal. Potentially devastating osteoarticular infections occur in the pediatric population and must be differentiated from more benign causes of joint pain, such as transient synovitis or congenital abnormalities. Children are also at risk for abnormalities such as slipped capital femoral epiphysis or Legg-Calvé-Perthes disease, which are rarely diagnosed in the adult population. It is imperative for a clinician to be aware of these and other nuances to optimally care for orthopedic injuries and emergencies in the pediatric population. Key words: bone, musculoskeletal, orthopedic, skeletal

BONE MINERAL DENSITY WOMEN AGED 45 AND OLDER WITH OVERWEIGHT AND OBESITY

Objectives: (1) To assess the bone mineral density by dual energy X-ray absorptiometry in women aged 45 and older with overweight, obesity. (2) To approach the relationship between the bone mineral density and osteoporosis risk factors in women aged 45 and older with overweight, obesity. Materials and method: 207 women aged 45 and older receiving treatment at Medic - Binh Duong hospital were divided into 2 groups: 147 women with overweight, obesity and 60 women without overweight, obesity. Research was designed as a cross-sectional descriptive study and comparative control group. Results: The femoral bone mineral density in terms of women with overweight, obesity is (0.795 ± 0.121) and the control group is (0.731± 0.116). The bone mineral density of lumbar spine in women with overweight, obesity is (0.800 ± 0.138) and the control group is (0.757 ± 0.148). Conclusions: The bone mineral of femora in women with overweight, obesity was higher than that of the control group (p<0.05). Between two groups, there were no differences in the bone mineral of lumbar spine (p>0.05). There was a statistically significant relationship between the bone mineral density and age, menopause state, and duration of menopause in women aged 45 and older with overweight, obesity (p<0.01). Key words: Bone mineral density, women aged 45 and older, overweight, obesity

Microsurgical Reconstruction of the Upper Extremity

The advent of free tissue transfer has revolutionized upper extremity reconstruction in the setting of trauma, infection, and oncologic resection. Current microsurgical techniques allow for soft tissue coverage, osseous reconstruction, and free functioning muscle transfer. This review highlights perioperative planning considerations in terms of the timing of reconstruction and flap choice, as well as indications and contraindications, for upper extremity microsurgical reconstruction. Many commonly used fasciocutaneous, muscle, and osseous free flap options are reviewed, with specific emphasis on surgically relevant anatomy, flap variations, and pearls and pitfalls. Many of these free flap options are illustrated using case examples. This review contains 15 figures, 3 tables and 109 references. Key words: bone defect, elbow, free flap, hand, microsurgery, reconstruction, upper extremity, wrist

Pediatric Orthopedic Emergencies

Proper care of orthopedic injuries and emergencies in children and adolescents requires knowledge of the altered bone and ligament characteristics, varying stages of skeletal development, and potential for congenital or developmental abnormalities. Pediatric fractures affecting the growth plate require unique management to maintain optimal growth. Whereas some specific fractures in these skeletally immature patients require urgent surgical repair, other fractures remodel extremely well and can be managed with a simple splint. Particular dislocations are common in this population and may have concomitant fractures. There are several overuse injuries seen primarily in children, and treatment aims to keep the patient active while allowing the injury to heal. Potentially devastating osteoarticular infections occur in the pediatric population and must be differentiated from more benign causes of joint pain, such as transient synovitis or congenital abnormalities. Children are also at risk for abnormalities such as slipped capital femoral epiphysis or Legg-Calvé-Perthes disease, which are rarely diagnosed in the adult population. It is imperative for a clinician to be aware of these and other nuances to optimally care for orthopedic injuries and emergencies in the pediatric population. Key words: bone, musculoskeletal, orthopedic, skeletal