Comparision of Effect of Teriparatide and Alendronate Sodium on the Bone Mineral Density in Post-Menopausal Women

Aim: Purpose of this study was to know which one is better modality of treatment for osteoporosis in postmenopausal women – enhancing bone formation or reducing bone resorption. Methods: Total 120 patients were included in this study and randomly divided in two groups. Group A patients were given teriparatide injection and Group B patients were given alendronate sodium tablet. Both groups were given Calcium supplement, and vitamin D supplement along with therapy. Bone mineral density (BMD) at the spine and hip was assessed by dual-energy x-ray absorptiometry (DEXA) scan before and after the therapy. Results: Average Bone mineral density (BMD) in teriparatide group was - 2.77 in pretreatment and – 1.8767 after one year follow up. Average BMD in alendronate sodium group was -2.78 in pretreatment and – 2.00 after one year follow up. Avearage gain in BMD in Group A was – 0.8933 and in group B was –0.78. Conclusion: Teriparatide seems to be better treatment for oeteoporosis as compared to alendronate therapy.

Solitary Osteochondroma: Rare Occurrence A Report of Two Cases.

Solitary Osteochondroma is the most common benign bone tumor, and occurs most frequently in the proximal humerus, tibia, and distal femur. It rarely affects proximal femur and talus. Therefore, we report two cases of solitary osteochondroma, which were found at these rare sites (one at lesser trochanter and another at talus) with a brief review of literature and discussion of clinical features and management..

Comparison between Intraarticular Triamcinolone Acetonide and Methyl prednisolone Acetate Injections in Treatment of Frozen Shoulder.

Background: This study is aimed to compare the effectiveness of intra-articular injections of 2 corticosteroid preparations; triamcinolone acetonide (40 mg) and methyl prednisolone acetate (40 mg) in patients with frozen shoulder. Methods: 100 patients were enrolled randomly in our study and randomly divided into two groups. Diagnosis of frozen shoulder was made using the guidelines for shoulder complaint issued by the Dutch College of General Practitioners. The assessment of pain was by using scores of; 0 (no pain); 1 (mild); 2 (moderate); 3 (severe); 4 (severe night pain that interferes with night sleep).The outcome of intervention was assessed at 8 weeks and after that at 3 months, at 6 months and at 1 year. Results: Right side was found to be more involved than the left. Male &Female ratio was 1:3. 51% patients belong to age group 55–65. We got 62.7% satisfactory result in Group A as compared to 51.8% in Group B. Conclusion: We conclude that triamcinolone acetonide is a good rescue for painful stiff shoulder particularly for resistant cases as with diabetes mellitus, and with long duration of illness.

A Comparative Evaluation of Techniques in Interscalene Brachial Plexus Block: Conventional blind, Nerve Stimulator Guided and Ultrasound Guided.

Background: This study was conducted to compare the three technique Conventional blind, Nerve stimulator guided and Ultrasound guided for Interscalene brachial plexus block in surgeries of upper limb. Methods: Total 60 patients were included in our study which were randomly allotted by closed envelope technique into either of the three groups namely Conventional blind (group CB), US-guided (group US) or NS-guided (group NS). The drug bupivacaine 0.5% (2 mg/kg) was used and diluted with normal saline to make a total volume of 30 ml. Results: Comparison between the Conventional blind (CB), Nerve Stimulator (NS) and Ultrasound guided (US) technique of interscalene brachial plexus block revealed that the block execution time, time of onset of sensory and motor block was significantly less in ultrasound group as compare to other groups. The mean duration of analgesia too, was significantly higher in both NS and US group (3 hr & 23 min ,3 hrs 30 min respectively), while it was 2 hr 47 min in CB group. The incidence of patchy effect (3 cases) and blockade failure requiring general anesthesia (4 cases) were significantly higher in CB group compared to NS group (2 cases each) and US group (1 case each). Conclusion: The success rate and effective quality of the block were more satisfactory with ultrasound technique than the nerve stimulator or conventional blind technique.

Comparison of Fixation Techniques in Young Patients with Fracture Neck of Femur: Multiple Hip Screws with Fibular Graft or Multiple Hip Screws Alone.

Background: Fracture neck of femur occurs infrequently in young patients compared to geriatric age groups. The occurrence in the younger age group is associated with high-energy trauma and more complications. The study was conducted to compare the results of two fixation techniques in management of fracture neck of femur in young age group patients. Methods: A total of 60 patients included in this prospective randomized trial were divided into two groups. Group I includes patients managed by multiple hip screws with fibular graft and group II includes patients managed by multiple hip screws alone. Assessment of fixation was done on basis of Harris Hip score at 6 week and 3 monthly intervals. Results: According to Garden's classification, a total of 40 (66.67%) cases were of type III, out of which 24 patients were in group I and 16 were in group II. The rest 20 (33.33%) patients were of type IV with 6 cases ingroup I and 14 cases in group II. In our study, functional outcome was calculated according to Harris hip score. In Group I we got 21 patients (70%) with excellent result, 7 patients (23.33%) with good result and 2 patients were failure cases. In Group II 17 patients (56.67%) got excellent outcome, 9 patients (30%) good outcome and 4 were failure cases.Conclusion: The study showed that there was no significant difference in any of the procedures and either of the technique could be employed depending on user experience and skills.