Role of the Whole Body Vibration Machine in the Prevention and Management of Osteoporosis in Old Age: A Systematic Review

A literature search of related articles was carried out in electronic data sources. Initially, 276 randomised controlled trials related to the title were collected, after which 44 were selected using the keywords. Overlapping articles, articles with a study duration of less than six months, and studies involving young participants were removed from the list. The remaining 20 articles were checked for entitlement using the PEDro scale. A total of nine eligible articles with 1486 participants were analysed. Seven trials used dual-energy x-ray absorptiometry (DXA) to measure bone mineral density (BMD). The six trials published from 2005 to 2013 found a significant increase in BMD. In the remaining one trial, there was no significant increase in BMD. One study published in 2013 reported a significant increase in BMD measured with peripheral qualitative computed tomography, whereas another trial published in 2014 stated that there was a reduction in calcaneal bone density measured by peripheral qualitative ultrasound. From these findings it can be concluded that the whole body vibration machine is a good adjunctive therapy for the prevention and management of osteoporosis in postmenopausal women. However, further investigations are necessary before the same can be recommended for elderly men.

Review on the comparison of effectiveness between denosumab and bisphosphonates in post-menopausal osteoporosis

OBJECTIVE: Osteoporosis is a rapidly rising cause of concern for elderly patients. Various classes of drugs are available in the market. Bisphosphonates are considered as a first-line therapy for the prevention and treatment. Denosumab is an antiresorptive agent which is a RANK ligand inhibitor. There is a scarcity of comparison between these two classes of drugs. The aim of this study is to compare efficacy of Bisphosphonates and Denosumab in various parameters. MATERIALS AND METHODS: Literature search was done for randomized controlled trials (RCTs) comparing bisphosphonates with denosumab. RCTs with a treatment period of at least one year with a baseline bone mineral density (BMD) and bone turnover markers (BTM) and follow up values at one year were included in the study. All included studies were also analysed for complications. The study has also been registered in PROSPERO International prospective register of systematic reviews. RESULTS: A total of five RCTs were identified providing data on 3751 participants. In all five studies, the BMD changes at both hip and spine were statistically significant in favour of denosumab. Result was similar in three studies that studied BMD changes at the wrist. Denosumab also produced significant reduction in BTM as early as one month, but at one year there was no difference compared to the bisphosphonates. There was no statistically significant differences in the complication rates. CONCLUSION: Though both bisphosphonates and denosumab were effective with similar side effects, the latter was statistically superior in increasing the BMD and reducing the BTM.

Post-mortem histological and dissecting microscopic appearance of the proximal jejunum of Myanmar children

A comparative morphological study of jejunal villi under the dissecting microscope and their histological changes under the light microscope was performed on 100 childhood necropsies from Yangon Children Hospital. they were from a-day-old meonate to twelve-year-old children. Four patterns of villi morphology were observed under the dissecting microscope: finger-like, tongue-like, leave-like and ridge villi. Histologically, inflammatory cells infiltration in the lamina propria and submucosa with vascular congestion of graded severity were observed. There is no correlation between villi morphology and histological changes. Tongue-like and leave-like villi could be regarded as normal for our children. Although histological examination of the post-mortem jejunal materials yields limited value, it could be of supportive or additive value if studied simultaneously with the dissecting microscopy.

Repeat caesarean section

A report of 376 cases of Repeat C.S. is submitted and analysed with respect to maternal mortality, morbidity, rupture uterus, and perinatal mortality. Most of the cases were booked cases i.e. 88.58 per cent Total no: of elective C.S. was 210 and total no: of elective C.S. was 166. Blood transfusion was given in 64 cases and total 155 units of blood was used. There were 7 respiratory tract infection, 9 wound sepsis, 2 lleus cases. And one case of foocal fistula which needed resection anastomosis. There was no maternal death due to repeat section. Perinatal mortality was 2.17 per cent and corrected perinatal mortality was 1.06 per cent which is not higher than the results of other studies. Rupture of the uterus was seen in 3 cases with previous scar, admitted as an emergency. 2 were in-complete and one was complete rupture.