Diagnosis of osteomyelitis presents a formidable challenge. Lack of pathognomonic clinical sign(s) and diagnostic tests that can diagnose osteomyelitis at an early stage contribute to this difficulty. If the diagnosis is not made early, the disease becomes very difficult to eradicate and can lead to limb threatening and potentially life-threatening complications. Staphylococcus aureus is the most common organism causing osteomyelitis. Raman Spectroscopy provides information about molecular vibration that could potentially be harnessed as a spectral signature for cellular changes in specific pathologic conditions. In this study we describe a technique using Raman spectroscopy that could potentially be used to diagnose staphylococcal osteomyelitis. Human bone samples were co-cultured with Staphylococcus aureus (S. aureus) and the effects of bacterial growth on bone quality were then monitored using Raman spectroscopy. A major drop in the bone mineral quality and crystallinity was observed in the infected bones compared to the controls. S. aureus infection was also found to alter the collagen cross-linking. Our study shows that specific spectral signatures are present for the cause as well as the effect of staphylococcal osteomyelitis, opening the possibility of developing a useful diagnostic modality for early and rapid diagnosis of this condition.

Background: Improved chemotherapy and radiotherapy treatment protocols, fortunately, increased the rates of cancer survivors over the years. However, these treatments may result in infertility or subfertility. Oncologists are considered the gateway for knowledge about cancer and its treatments’ effects. Several studies showed that many oncologists do not discuss fertility preservation with their patients. This study aimed to explore the perspective of oncologists in Oman on fertility preservation. Methods: A cross-sectional study of physicians and surgeons dealing with patients with cancer was conducted from June 2021 to December 2021. A standardized and validated questionnaire was used to collect data. Results: Participants reported that they are knowledgeable about sperm cryopreservation and gonadotropin-releasing hormone agonists use but not other methods of fertility preservation. About 94% of the participants reported that they need more knowledge about fertility preservation. More than half of the participants had never encountered cancer patients who used ovarian cryopreservation, testicular tissue cryopreservation, in vitro fertilization with embryo cryopreservation and oocyte cryopreservation. The majority (78%) agreed that discussing fertility preservation with newly diagnosed cancer patients is a high priority. Conclusions: Oncologists in Oman are supportive of fertility preservation. The lack of knowledge and unavailability of well-structured fertility preservation services in Oman hinders the initiation of fertility preservation discussions.

A bstract Background Isolation of the causal microorganisms in osteomyelitis presents a major challenge for treating clinicians. Several methods have been proposed to rapidly and accurately identify microorganisms. There has been an increasing interest in using Raman spectroscopy in the field of microbial detection and characterisation. This paper explores the use of Raman spectroscopy identification as one of the most difficult-to-isolate microorganisms causing osteomyelitis. Methods and results Fresh healthy human bone samples were collected from patients undergoing a total knee replacement. These samples were then inoculated with fresh overnight Pseudomonas aeruginosa (PAO) cultures. Bacteria growth and bone ultrastructural changes were monitored over a period of 6 weeks. The experiment demonstrated ultrastructural bony destruction caused by osteolytic PAO secretions. Raman-specific spectral signatures related to the cellular membranes of PAO structures were spotted indicating survival of bacteria on the bone surface. Conclusion This study showed the promising ability of Raman spectroscopy to identify the presence of bacteria on the surface of inoculated bone samples over time. It was able to detect the osteolytic activity of the bacteria as well as ultrastructure specific to PAO virulence. This method may have a role as an aid to existing diagnostic methods for fast and accurate bacterial identification in bone infection. How to cite this article Al Ghaithi A, Al Bimani A, Al Maskari S. Investigating the Growth of Pseudomonas aeruginosa and Its Influence on Osteolysis in Human Bone: An In Vitro Study. Strategies Trauma Limb Reconstr 2021;16(3):127–131.

Introduction: Bone AVN (avascular necrosis) is a pathological condition which results from hypo-vascularity to the bone tissue. Although it is a poorly understood condition, it can be a consequence of either traumatic or non-traumatic factors compromising the bone's precarious blood flow. Bone hypo-vascularity causes the death of bone marrow, osteocytes and ultimate failure of the necrotic part. Due to the lack of resolution and poor sensitivity of existing diagnostic modalities, the aim of this study was to examine necrotic bones, and map the molecular changes using Raman spectrometry. Materials and Methods: Following institutional permission, femoral heads of patients undergoing total hip arthroplasty for AVN secondary to SCD (sickle cell disease) (n = 7) were obtained, and stored at -20 ºC until further processing. Each head was cut in half and scanned with a Raman spectrometer (I-Raman Ex Bwtek system). Scanned areas were correlated with preoperative magnetic resonance scans. Results: The effect of AVN on bone mineralization, crystallinity of minerals, content of carbonate, collagen cross-linking, mineral and collagen fibril orientation were examined. Results suggest a significant difference (p < 0.05) in bone quality when comparing diseased bone areas to normal controls. Conclusion: Our results show the efficacy of Raman spectroscopy as a tool to analyse the overall biochemical signature of necrotic bone. It can be a potential screening tool for bone AVN, and provide future predication of bone fragility while differentiating it from other bone pathologies.

Nemaline myopathy is a rare genetic disorder caused by a mutation in genes encoding skeletal muscle proteins resulting in generalized hypotonia. It can be associated with neonatal multiple long bone fractures. We present a female neonate who had bilateral humerus and left femur fractures. Due to fetal distress, her delivery was at 37 weeks gestation by emergency cesarean section. The child was splinted and followed up for 8 weeks. She had a good union of fractured bones, callus formation, and no deformity. Muscle biopsy showed nemaline myopathy. Other biochemical and genetic tests were normal. The aim of this case report was to describe the presentation of multiple long bone fractures in neonates as an obstetric complication. Therefore, identifying the potential risk factors and planning the mode of delivery in future pregnancies, is critical in their management.