Evaluation of relationship between bone mineral density and fragility fracture in perimenopausal women between 40-58 years of age: a hospital based prospective observational study

Background: At present the risk assessment for osteoporosis using low bone mineral density (BMD) is based on data obtained from elderly females, largely ≥ 65 years of age. The risk factors for low peak bone mass or accelerated bone loss that occurs during perimenopausal phase is ignored in this risk assessment. Osteoporosis is found to occur at a relatively younger age in the Indian population. Although lower BMD values have an established identity as a major risk factor for fractures in postmenopausal women, we endeavour to evaluate relationship between bone mineral density and fragility fracture in perimenopausal women.Methods: 65 Patients were recruited for the study. After X-ray of involved part, patients were divided into cases (with fracture, n=33) and control (no bony injury, n=32). All patients underwent dual energy X-ray absorptiometry (DEXA) scan. Results of DEXA scans were evaluated in both the groups. BMD was expressed in g/cm2.Results: 33 patients (50.77%) were diagnosed as fracture, 32(49.23%) had no bony injury. Threshold bone mineral density (BMD) for fragility fracture found out asfor L1, cut off ≤0.767. For L2, cut off ≤0.829. For L3, cut off ≤0.811. L4, cut off ≤0.798. For L1-L4, cut off ≤0.845. For left femur total hip, cut off ≤0.918. For left forearm-total, cut off ≤0.411. For right femur total hip-cut off ≤0.795. For right forearm-total, cut-off≤0.382.Conclusions: Perimenopausal women having BMD below threshold for involved site are at risk of fragility fracture and should be given prophylactic treatment to improve bone mineral density

pH responsive cross-linked polymeric matrices based on natural polymers: effect of process variables on swelling characterization and drug delivery properties

Introduction: The current work was aimed to design and synthesize novel crosslinked pH-sensitive gelatin/pectin (Ge/Pec) hydrogels using different polymeric ratios and to explore the effect of polymers and degree of crosslinking on dynamic, equilibrium swelling and in vitro release behavior of the model drug (Mannitol). Methods: The Ge/Pec based hydrogels were prepared using glutaraldehyde as the crosslinker. Various structural parameters that affect their release behavior were determined, including swelling study, porosity, sol-gel analysis, average molecular weight between crosslinks (Mc), volume fraction of polymer (V2,s), solvent interaction parameter (χ) and diffusion coefficient. The synthesized hydrogels were subjected to various characterization tools like Fourier transform infrared spectroscopy (FTIR), X-ray diffraction (XRD) and DSC differential scanning calorimetry (DSC) and scanning electron microscopy (SEM). Results: The hydrogels show highest water uptake and release at lower pH values. The FTIR spectra showed an interaction between Ge and Pec, and the drug-loaded samples also showed the drug-related peaks, indicating proper loading of the drug. DSC and TGA studies confirmed the thermal stability of hydrogel samples, while SEM showed the porous nature of hydrogels. The drug release followed non-Fickian diffusion or anomalous mechanism. Conclusion: Aforementioned characterizations reveal the successful formation of copolymer hydrogels. The pH-sensitive swelling ability and drug release behavior suggest that the rate of polymer chain relaxation and drug diffusion from these hydrogels are comparable which also predicts their possible use for site-specific drug delivery