Mohammed Lafi Al-Otaibi

By Mohammed Lafi Al-Otaibi

Sickle cell disease is a well-known disease with evolving changes in medical as well as surgical management. Recent developments in medical management and the well-adjusted screening protocols for the disease complications toward its anticipation and prevention and all these recent changes have led to more work toward understanding and managing disease orthopedics complications. Many researchers considered the major ones affecting patients’ daily living activity, with the improvement in patients living expectancy. Thanks to the evidence-based medical management and the development of new agents such as L-Glutamate that are recently implemented and help space the vaso-occlusive crises. This phenomenon plays the cornerstone effects on the disease pathology and leads to its harmful effects on many systems, including the muscles and bones. The infarct does occur almost everywhere through the muscle-skeletal system, with predilected site happening to be the hip joints. A vascular necrosis of the femoral head does occur in other conditions, and dealing with the one happening in sickle cell anemia must take into account all issues concerning this disease. There is growing evidence that surgical intervention with the total hip is best when there is a loss of congruency of the femoral head with head subchondral collapse and not in pure infarct with femoral head maintaining its sphere shape.

Part of the book: Sickle Cell Disease

By Zeenat Ara, Shah Walliullah, Mohammed Lafi Al-Otaibi and Rajeshwar Nath Srivastava

Spinal cord injury (SCI) is extremely debilitating disorder. The increasing incidences and persisting poor prognosis in neurological recovery and QoL (SCIM) have severely exposed the limitations of all known management strategies. Recently simple measures like nutritional supplementation in SCI cases have shown promising results. Efforts in augmenting neurological recovery and QoL (SCIM) following SCI are being studied world over. Unfortunately, little success has been achieved and the most promising ones such as corticosteroids, newer pharmaceutical agents, and cellular therapies have conflicting results. Several studies have found significant improvement in recovery following nutritional intervention in acute trauma and critically ill subjects. These were reported to be cost effective and easy to administer. Since most of these studies were on a specific nutritional supplement, the full potential of a set of nutritional supplementation facilitating neurological recovery needs to be explored. In ASCI, the improvement in neurological status and QOL (SCIM) is unpredictable and remains poor with known therapy. It has been reported that injuries heal better with nutritional supplementation. Taurine, vitamins C and E, omega-3 fatty acid, etc. have specifically found to be effective in facilitating recovery in acute trauma.

Part of the book: Spinal Cord Injury