Effectiveness of home based intervention program in reducing mortality of hip fracture patients: A non-randomized controlled trial.

PURPOSE: The study was done to investigate whether a postoperative intervention program is effective in reducing mortality and improving mobility in two comparative hip fracture patients over one year postoperatively. METHODS: A non-randomized controlled trial study with an intervention group of hip fracture patients and historical control group with 12 months follow up. One hundred twenty four admitted hip fracture patients to the Trauma Unit of Assiut University Hospitals, aged 50 years and older were included from 1st July to 31st December 2014. They were divided into 64 and 60 patients as intervention and control groups respectively. Weight, height and bone mineral density were measured and baseline characteristics were taken. The intervention was a postoperative care program in the form of education sessions with an explanatory leaflet on discharge for nutrition and physical exercise program at home. Follow up phone calls were done at 3 months, 6 months and one year postoperatively by one assessor. Physical mobility was assessed by 24 items Western Ontario And McMaster Universities Osteoarthritis Index (WOMAC). RESULTS: Mortality was significantly higher in the control group, WOMAC score was significantly better among intervention group through follow up. By multivariate Cox survival analysis, advancing age, no intervention, osteoporosis, postoperative complications, chest infections and heart attacks were significant predictors for mortality. CONCLUSION: A significant improvement in mobility and reduction of mortality was achieved by application of a postoperative care program that could be incorporated into the hip fracture patients' care pathway.

Prevalence of metabolic syndrome and insulin resistance among Egyptian adolescents 10 to 18 years of age.

BACKGROUND: The prevalence and magnitude of childhood obesity are increasing dramatically. OBJECTIVES: To examine the effect of varying social, demographic, dietary, and activity factors on the prevalence of metabolic syndrome and its relation to insulin resistance, C-reactive protein, and homocysteine levels in a large, representative sample of Egyptian adolescents. METHODS: Our survey included 4250 adolescents (from 10 to 18 years of age; male subjects comprised 42.5% of participants) from 7 governorates representing Egypt. Baseline measurements included blood pressure, fasting blood glucose, plasma lipids, C-reactive protein, and homocysteine levels. Because the body mass index varies according to age, we standardized the value for age and sex with the use of conversion to percentiles. RESULTS: The overall prevalence of the metabolic syndrome was 7.4% with no sex or area of residence predilection. Results showed that adolescents with the full criteria of metabolic syndrome (ie, three criterion or more) constituted nearly one fourth of those exhibiting high values of different components, except for systolic blood pressure, where they were 42%, and TG, where they were 31%. Family history of obesity and diabetes mellitus increase the odds for metabolic syndrome significantly (1.68 and 1.3, respectively) as well as inactivity. A high level of C-reactive protein was reported among affected adolescents. Homocysteine level did not have an influence. CONCLUSIONS: The prevalence of the metabolic syndrome is considerable among obese adolescents. Proinflammatory markers associated with an increased risk of adverse cardiovascular outcomes are already present in these youth.