Bilateral Symmetrical Humeral Fracture on a Background of Multiple Myeloma and Humeral Capillary Hemangioma

A 59-year-old female who was managed for multiple myeloma presented with spontaneous bilateral pathologic fracture of the distal third of both humeri. She had associated renal impairment and background diabetes mellitus. Biopsy of her bone specimen from surgery shows features in keeping with capillary hemangioma. The patient was properly optimized for surgery; she was reviewed by a nephrologist and endocrinologist before surgery. Her blood investigations showed that she was anemic. She was transfused with fresh whole blood and also had renal dialysis. She subsequently was offered bilateral retrograde locked intramedullary nailing of both humeri, which was done 2 weeks apart under regional anesthesia (brachial plexus block). There was profuse intraoperative bleeding, which was controlled with bone wax and electrocautery. Biopsy of her bone specimen from surgery shows that she also has osseous capillary hemangioma rather than the provisional diagnosis of bilateral pathological fracture of the humerus following extramedullary manifestation of multiple myeloma. There have been suggestions in the literature that extra manifestations of multiple myeloma simulating hemangioma may be due to neoangiogenesis propagated by myeloma cells secreting vascular endothelial growth factor. We present a case of multiple myeloma with renal failure that presented to us with bilateral humeral fracture with a histological report of capillary hemangioma. We suggest that tumor‑neoangiogenesis may be responsible for this type of manifestation. This case is a rare coincidental finding which has not been reported in literature, hence the objective of this presentation. Keywords: Bilateral humeral fracture, capillary hemangioma, multiple myeloma, neoangiogenesis, vascular endothelial growth facto

Does Load Position on the Trunk Affect Cardiopulmonary Responses of the Bearer during Simulated Front and Back Infant Carrying Methods?

Background: The position of the infant on the trunk during back and front infant carrying methods (ICMs) may be a potential factor of maternal physiological changes. Related information is necessary for the establishment of guiding principles for infant carrying tasks. Thus, this study was carried out to evaluate cardiopulmonary responses to infant‑load positions on the trunk during simulated back and front ICMs. Materials and Methods: Twenty‑three nulliparous females completed four trials while walking with a 6 kg simulated infant, being carried in four trunk positions (upper back, lower back, upper front, and lower front). Cardiopulmonary indices (systolic blood pressure, diastolic blood pressure, respiratory rate, and heart rate) and rating of perceived exertion were assessed pre‑ and post‑trials. Results: All the cardiopulmonary indices did not change significantly (P > 0.05) as the infant load moved from upper to lower trunk positions during the back and front ICMs. However, marginal differences were observed. Participants perceived the lower back and upper front ICMs as less exerting than the upper back and lower front ICMs. Conclusions: Infant‑load position on the trunk is not an important factor in the cardiopulmonary responses to back and front infant carrying tasks, although the lower back and upper front ICMs were perceived to be more comfortable. Keywords: Back, cardiopulmonary indices, front, infant carrying, infant‑load positions, perceived exertio

Relationship between physical activity level and flexibility profile of Nigerian postpartum women

Flexibility is an essential component of musculoskeletal health and is usually associated with physical activity levels. Pregnancy and its aftermath may influence physical activity participation and musculoskeletal flexibility in women, which warrants this study. Thus, this study aimed to assess the physical activity level and musculoskeletal flexibility profile of Nigerian Postpartum women. In this cross-sectional study, 462 postpartum women were conveniently sampled from Healthcare Facilities in Anambra State, Nigeria. Physical Activity was assessed using Global Physical Activity Questionnaire while flexibility profile was assessed using modified sit-and-reach (for the lower back and limb components), total body rotation (for trunk component) and shoulder rotation tests (for upper limb components). Relevant inferential statistics were used to compare variables between the two groups of women. The results showed that 42.0% of the women were fairly flexible and 51.1% of them had high Physical Activity level. Majority (77.6%) of their daily physical activities were from work. Statistically, there was no significant relationship between their physical activity levels and flexibility profile of the participants (p = 0.066). The postpartum physical activity level of the respondents is not a determinant of their musculoskeletal flexibility. Recommendation of structured physical exercises, particularly flexibility trainings to postpartum women in Nigeria is necessary for optimum maintenance of their general postpartum and musculoskeletal health

Comparative Analysis of the Effects of Abdominal Crunch Exercise and Dead Bug Exercise on Core Stability of Young Adults

Background: Poor core stability is a known risk factor for musculoskeletal injuries. The utilization of abdominal crunch exercises for improving core stability has been discouraged by some authorities considering its risks for low back pain. Evaluating the efficacy of other core exercises is necessary for implementing them as safe alternatives. Aims: This study compared the effects of abdominal crunch and dead bug exercises on core strength, endurance, and flexibility of young adults. Materials and Methods: Twenty‑nine untrained young adults participated in this study, comprising of three exercise groups [abdominal crunch group (ABG), dead bug group (DBG) and a control group (CG)]. Pre‑ and post‑intervention (at 6 weeks) core strength, endurance, and flexibility were measured. ANOVA and ANCOVA were used to test for differences at baseline and between groups, respectively. Sidak’s multiple‑comparison test was used for post hoc analysis between groups. The effect size was reported using partial Eta‑squared (η2p). Alpha level was set at 0.05. Results: The highest mean differences were observed within DBG (5.3 [1.67], 63.6 [23.10], and 2 [0.5] for core strength, endurance, and flexibility, respectively). Core strength, endurance, and flexibility varied significantly across groups (P = 0.0111, 0.000, and 0.0090, respectively). Estimated marginal mean (EMM) for core strength for DBG (EMM [ Standard error (SE)], 25.31 [1.38] ) was significantly higher than ABG (20.57 [1.24]) and CG (19.37 [1.30]). For core endurance (EMM [SE], DBG (4.62 [0.12]) and ABG (4.2 [0.11]) were significantly higher than CG (3.8 [0.12]). EMM for core flexibility for the DBG (EMM [SE], 9.47 [0.48]) was significantly higher than the CG (7.28 [0.45]) and not ABG (8.27 [0.44]). Conclusions: The efficacy of dead bug exercise in improving core stability was revealed in this study. It is biomechanically efficient and suggested as an alternative to abdominal crunch exercise. Keywords: Abdominal crunches, core, dead bug exercise, endurance, flexibility, stability, strengt