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Introduction: Osteoporosis (OP) is a major health problem in the older population. The aim of the study was to assess the role of serum osteoprotegerin (OPG) as a diagnostic indicator of primary osteoporosis in peri- and post-menopausal women in an Indian population.Materials and Methods: After ethical approval, 90 cases (45 cases and 45 controls) of peri- and post-menopausal females above 40 years of age presenting to our outpatient department were included in the study. It was a case controlled study conducted between July 2014 to July 2015. Based on the clinical features, t-score and radiological evidence from the DEXA scan, they were equally divided into two groups (cases and controls). Serum osteoprotegerin (OPG) levels were measured amongst cases and controls.Results: The total calcium (mg/dl) level was lower among the cases and the difference was significant (p-Value= <0.001). Similarly, alkaline phosphatase (u/l), osteoprotegerin (u/ml) levels were higher in the cases as compared to controls and the difference was significant (p-Value= <0.001). The mean osteoprotegerin level showed a slight increase with increase in severity of the grading of BMD of spine. The results suggested a cut-off value of ≥10.5 u/ml (86.7% sensitive and 80% specific with accuracy of 84.5%) between normal and osteoporosis.Conclusion: From the present study, we conclude that osteoprotegerin is a valid biomarker to diagnose postmenopausal women with low bone mineral density.

Introduction: Proximal humerus fractures account for 4-5% of all fractures and could be managed both conservatively and surgically. As much as 85% minimally or non-displaced fractures can be managed conservatively. In spite of early union and exercise programme by conservative treatment, the problem of shoulder stiffness is common. To overcome stiffness, early mobilisation is mandatory which is not possible in conservative treatment before three weeks. Therefore, surgical intervention is needed for early mobilisation and early return of function. Aim: To compare the functional outcome between the four common methods of managing proximal humerus fractures namely locking plate, Joshi External Stabilisation System (JESS), percutaneous K-wire fixation and conservative method. Materials and Methods: Patients with proximal humerus fracture above 18 years of age between August 2011 to August 2013 were included in the study. The study population was divided into four groups viz., Group A, B, C, D depending on the mode of treatment by locking plate, external fixator, K-wire fixation and conservative method of treatment, respectively. The patients were followed-up at 3 weeks, 6 weeks, 12 weeks, 18 weeks and thereafter every 6 weeks’ interval till 9 months. After union, cases were evaluated radiologically and clinically for functional results by using the Swanson Shoulder Score and Constant Scoring System (Modified). Results: At the end of the study there were 17 patients in the Group ‘A’, 7 patients in the Group ‘B’, 7 patients in the Group ‘C’ and 11 patients in Group ‘D’. At 9 months of follow-up according to modified constant shoulder score the percentage of excellent score in group A was maximum. Group B and Group D had maximum number of good scores. The mean constant shoulder score increased in all groups at 9 months of follow-up as compared to 3 months of follow-up except in group D. Similarly, according to Swanson’s shoulder score, group A had the maximum number of excellent scores. Conclusion: From the above study it can be concluded locking plates are an excellent modality of treatment of proximal humerus fractures with excellent union rate and early mobilisation.

Osteochondroma is one of the most common benign tumors arising from the ends of the long bones which are characterized by irregular bony growth covered by cartilaginous cap. The tumor mass tends to grow eccentrically more, rather than centrifugally. We are reporting a case of 17 year old female who presented to our Outpatient department with large, hard, painful, irregular swelling over anterolateral aspect of right knee. After a series of radiographic screening and its confirmation through CT the tumor was surgically excised and histopathological reports showed benign nature of the tumor mass excised.

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