THE THREE KEY PLAYERS IN OSTEOIMMUNOLOGY: RANK, RANKL AND OSTEOPROTEGERIN.

The RANK, RANKL and OPG interaction plays a major role in bone resorption and remodelling. The history dates back to mid 1990s when the RANK/ RANKL interaction was found to mediate osteoblastic stromal cells to stimulate osteoclastic bone resorption. This interaction was found to induce several cytokines including the TNF superfamily, thereby activating the pathways of bone remodelling. The Osteoprotegerin (OPG) prevents the binding of RANKL to RANK, thereby preventing the excessive bone resorption. When there is an imbalance in the levels of RANK/RANKL/OPG, the metabolic activity of the bone cells gets altered and thus there is loss of balance between bone formation and resorption. Thus, studying the inter – relationship between RANK, RANKL and OPG becomes critical for assessing the osteoblastic and osteoclastic activity

THE ASSOCIATION IN SERUM VITAMIN D3 LEVELS IN PATIENTS WITH EARLY PREGNANCY LOSS

AIM: To find out the association between vitamin D levels in normal pregnancy and pregnancy loss in the first trimester. METHODOLOGY: -The present study was a hospital based comparative study conducted in 40 pregnant (7-9 weeks) women having pregnancy loss (Group I) and 40 pregnant (7-9 weeks) women having normal pregnancy coming to department of Obstetrics and Gynaecology, SMS medical college and associated hospitals, Jaipur, Rajasthan. The mean Vitamin D3 level in pregnancy loss cases RESULTS: was 17.77±6.56 ng/ml and in normal pregnancy group was 24.85±7.55 ng/ml. So the results showed that the mean Vitamin D3 level was significantly higher in normal pregnancy group compare to early pregnancy loss cases. Pre CONCLUSION: sent study concluded that vitamin D has a significant role during pregnancy started from early implantation and decidulization phase till late pregnancy.

A PROSPECTIVE STUDY COMPARING ULTRASONOGRAPHIC FINDINGS AND INFLAMMATORY MARKERS AS A PREDICTOR OF JOINT EROSIONS IN RHEUMATOID ARTHRITIS.

Rheumatoid arthritis is chronic infiammatory disease that affects the joints. This results in painful joints, swelling and stiffness in the joints. The present prospective comparative study aimed to compare the USG Doppler findings with the infiammatory marker levels in being a better predictor of joint erosions in rheumatoid arthritis. Total 50 patients coming rheumatology and medicine OPD were studied for infiammatory markers and ultrasonography findings. Radiological investigations such as High resolution USG power Doppler (4-12 MHz) and x-ray of the affected joints were carried out. Majority of participants (60%) belonged to 31-50 years of age group and female gender (86%). The change in infiammatory markers were found to be poorly correlated to joint erosions, while that of USG erosions was found to be strongly positively correlated with the same. Multivariate regression analysis showed that in presence all others also only delta USG erosion significantly impacts delta VDH, or the gold standard(X Ray) for evaluation joint erosion This strongly proves that USG erosion is a better predictor of joint erosions than the other independent variables(infiammatory markers)

EFFICACY AND SAFETY OF AZILSARTAN IN PATIENTS OF HYPERTENSION WITH DIABETES IN GWALIOR DISTRICT.

Background: Angiotensin receptor blockers are well established drugs for the treatment of hypertension with or without renal disease. Azilsartan is a new angiotensin receptor blocker being used in the treatment of hypertension. Present study is done to evaluate efficacy and safety of azilsartan in patients of hypertension with diabetes mellitus in Gwalior district. Methods: The study was conducted in department of pharmacology, Gajra raja medical college, Gwalior Madhya Pradesh during February 2018 to march 2019. It is a longitudinal, prospective, randomized study and total 90 patients of hypertension with diabetes were enrolled out of which 83 patients completed study with a follow up of 1 year period and were divided equally into two groups. Group I received Azilsartan 40- 80 mg once daily and group II received another drug once daily for 12 weeks. Baseline Systolic blood Pressure and diastolic blood pressure were recorded at the start and then at 4th, 8thand 12th weeks after therapy. Fasting and post prandial blood sugar, HDL, LDL-C , total cholesterol values were recorded at start and after 12 weeks of therapy. All the patients were screened for any adverse drug reactions on each visit. Result: Azilsartan effectively lowered the levels of systolic and diastolic blood pressure from baseline (p=0.00001) confirming the antihypertensive efficacy also there was overall significant improvement in HDL values from baseline (p=0.000) and also significant improvement was shown in LDL Total cholesterol levels from baseline (p =0.005). There was significant improvement in FBS and PPBS from baseline (p value 0.00). Conclusion: Azilsartan effectively lowered the levels of systolic and diastolic blood pressure in patients of hypertension with diabetes and the difference was significant. Azilsartan showed overall improvement in HDL, LDL, TC values with significant difference in hypertensive with diabetes patients.

COMPARATIVE STUDY OF CASE BASED LEARNING WITH TRADITIONAL TEACHING METHODS IN BIOCHEMISTRY FOR FIRST YEAR MEDICAL STUDENTS

Background: Case based learning (CBL), is a learning method aids learner to reorganize, elaborate their information and provide connection between current and new information. Moreover CBL is student centered, taken in small groups where teacher acts as facilitator or guide. This study was planned to perceive the need for initiating CBL, this study aimed to compare the biochemistry teaching among first year medical students with that of traditional teaching. Methods This is an observational study conducted from August 2021 to December 2021. This research study was conducted on 99 students of First year MBBS students. Ten ideal case scenarios on the topic of protein energy malnutrition(PEM) in children and acid base balance were prepared, and pre validated by the faculty of Biochemistry, Paediatrics and Surgery medical education department in our institution. CBL was introduced and total three sessions were conducted and compared with traditional teaching. Results The mean (±SD) value of the score of gain in knowledge was 3.90±1.86 (n=99) for the batch of students who attended case based learning while the mean (±SD) gain in knowledge for the batch who underwent, traditional learning ( TL) was 2.60±2.29 (n=99). A paired t-test comparing didactic lectures with self-directed learning showed that the scores following didactic lectures were more compared to SDL and the results were statistically significant. An unpaired t-test comparing case based learning to SDL also showed statistically significant gain in knowledge following didactic lectures. Conclusion This study clearly showed that CBL is more effective over traditional teaching for our first year MBBS students and for covering a wider area.

Efficacy Of Dhanyamla Sarvanga Dhara In The Management Of Obesity: An Analytical Review

Obesity consist a major nutritional health problem in developed and developing countries, which has reached epidemic proportions. It is a medical condition of excessive fat accumulation to the extent that it may have negative effect on health. Obesity are major causes of co-morbidities, including type 2 diabetes, cardiovascular disease, various cancer and other health problem like obstructive sleep apnea, osteoarthritis and depression. Obesity is most commonly caused by a combination of excessive food intake, lack of physical activity. Leptin enzyme is responsible for controlling appetite through its action on CNS, TNF alpha is also link factor between fat accumulation and metabolic disorders. The body mass index (BMI) is an internationally accepted index to estimate body weight. Taking medication like Sibutramine, Orlistat as an option for treatment of obesity can be given, because it is associated with many side effects. Bariatric surgery may be performed to reduce weight, but it is not very useful treatment. Diet, life style modification, physical activity can achieve the desired loss of body fat. In Ayurveda best treatment for Sthaulya defined by Acharyacharak and Sushruta and Vagbhatt. Dhanyamalasarvangadhara is highly effective in Vata associated with Ama and Kapha. Dhanyamla sarvanga dhara eliminates the body toxins, establishes health and tones up the joints and soft tissues. The drug will act soon as the medicine touches the skin surface. Due to Vasodilation property blood flow will increase through the area, increasing metabolism further eliminating the toxins, which will help in reducing the obesity. Dhanyamala sarvanga dhara controls the disease process and may cause long lasting relief.