ABSTRACT
Background: The present study was conducted to find the association between tuberculosis and vitamin D levels and assess severe vitamin D deficiency (VDD) as a risk factor for developing tuberculosis at high-altitude regions. Methods: This cross-sectional study was carried out at a tertiary care hospital situated at an average altitude of 5,412 feet above sea level. Newly diagnosed active cases of tuberculosis (Group A) and unmatched healthy individuals (Group B) were recruited in the study. Serum samples were analyzed for Vitamin 25(OH) D levels and correlated between the groups. Results: The study included 54 newly diagnosed tuberculosis patients (Group A) (47 pulmonary and 7 extrapulmonary tuberculosis) and 87 healthy controls (Group B). Of the total 141 participants, 69 (49%) had severe VDD and 44 (31%) had VDD. The mean (SD) vitamin D level was significantly lower in patients having tuberculosis (12.6 ± 7 ng/mL) as compared to Group B (15.9 ± 7 ng/mL). The risk of tuberculosis infection was 2.13 times higher among those who had VDD (odds ratio = 2.13) (P-0.106), whereas those with severe VDD were at 3.2 times higher risk of developing tuberculosis (crude odds ratio = 3.2) (P = 0.001) and severe VDD independently contributed to being diagnosed with tuberculosis (adjusted odds ratio = 3.1) (P = 0.002). Conclusions: Vitamin D levels are significantly low in tuberculosis patients and severe VDD independently contributes to developing tuberculosis infection.
ABSTRACT
BACKGROUND: Musculoskeletal pain (MSP) is common among medical students across the world. The present study was done to estimate the prevalence of MSP among medical students in the state of Sikkim, India, and to assess perceived stress levels among medical students and its association with MSP. MATERIALS AND METHOD: A cross-sectional study was carried out at a private medical college in the state of Sikkim, India. Fifty students each from the third, fifth, seventh, and ninth semesters were included in the study. Students were asked to complete a questionnaire that included data regarding lifestyle habits and activities, the modified Nordic scale for MSP, perceived stress score (PSS-10), and Oswestry disability index (ODI) questionnaire. RESULTS: The majority (73%) of the participants reported one or more episodes of MSP in the past 12 months and 50% of them had pain in the past 7 days. No significant association was found between MSP and lifestyle habits, mean time spent on physical activities and sedentary behavior. The perceived stress level was significantly higher among those with MSP in the past 12 months (19.7 ± 5.6) (P-0.021), as well as in those who had MSP in the past 7 days (20.8 ± 5.5) (P-0.001). Severe pain was significantly associated with a higher perceived stress score (23 ± 5) (P-0.003). Students who had MSP in the past 12 months as well as in past 7 days had a higher quality of life score (9.8 ± 10.6, P-0.039 and 13 ± 10.9, P-0.000, respectively). CONCLUSION: The majority of our medical students have experienced musculoskeletal pain in the past 12 months, which is significantly associated with perceived stress and quality of life.
ABSTRACT
Introduction: Osteoporosis could be viewed as a metabolic disease. The WHO guidelines for diagnosing osteoporosis reflect structural damage only and not the metabolic imbalance that leads to it. Biochemical markers of bone turnover have been shown to provide valuable information for diagnosing and monitoring metabolic bone disease. The present study analyzed bone-specific alkaline phosphatase (BALP) and urinary hydroxyproline in pre- and postmenopausal women and correlated them with changes in bone mineral density (BMD) in the state of Sikkim. The study also intended to know the ethnicity-based disease burden in Sikkim. Materials and Methods: A hospital-based cross-sectional study was done at a tertiary hospital in Sikkim. Blood and 24-h urine samples from 50 premenopausal and 50 postmenopausal women were analyzed for total alkaline phosphatase (ALP), BALP, and Urine Hydroxyproline. BMD was measured using the quantitative ultrasound technique by Achilles densitometer. Results: There was a statistically significant increase in serum calcium (P = 0.01), ALP (P = 0.01), and urine hydroxyproline (P = 0.03) levels in postmenopausal women as compared to premenopausal women. Although ALP was higher in postmenopausal women, BALP isoform was more elevated in premenopausal women (P = 0.001). BMD was significantly lower in postmenopausal women (P < 0.001). It was also noted that there was a significant difference in BMD between tribal and nontribal populations (P = 0.003). Total ALP and BALP as the bone formation marker and urine hydroxyproline as a bone resorption marker added statistically significant r to BMD prediction (P < 0.05). Conclusion: In this study, BALP combined with Urine Hydroxyproline was helpful as a screening biomarker to predict osteoporosis in postmenopausal women.
ABSTRACT
Giant cell tumour is a benign aggressive bone tumour. Most commonly, it is seen in epiphysiometaphyseal region around knee and distal radius. Proximal ulna is a rare location for giant cell tumour. According to reports, only 4 such cases have been reported in English literature. We report one such case of giant cell tumour of proximal ulna. Patient presented with painless, progressive swelling around right elbow since 4 months. Proximal ulna along with tumour was resected and elbow was reconstructed using nonvascularized free fibular graft. At two years of follow-up, patient is tumour-free and has functional range of movement in elbow. We are reporting the case because of its rare location and for the indigenous treatment modality of using free fibular graft for elbow reconstruction.
