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The risk factors identified worldwide for development of osteoporosis are female sex, old age, small thin build or ABSTRACT Background: Osteoporosis is a silent, often found late, underdiagnosed disease characterized by low bone mass leading to increased susceptibility to fractures. With an increasingly aging population, the proportion of patients with osteopenia and osteoporosis are increasing in both developed and developing countries. The available data on osteoporosis is scanty from India. Methods: The objective was to measure the bone mineral density (BMD) of the patients using calcaneal Quantitative Ultrasound (QUS) and determine the risk factors along with the FRAX score. This was a hospital based cross sectional study conducted in a tertiary care hospital done on 183 out patients. BMD was measured using calcaneal QUS & T scores were calculated along with the FRAX score. Results: The prevalence of osteoporosis was 29.5% and osteopenia was 42.1%.The age wise analysis of BMD revealed males have the tendency to lose their bone mass after the age of 40 years while in females, the trend begins a decade earlier. The mean BMD of post-menopausal females was significantly lower compared to pre-menopausal females (-2.72 ± 1.33 vs-1.63 ± 1.06, P < 0.0001).Linear regression analysis revealed a complex linear relationship between the FRAX score and the BMD and it was statistically significant. Conclusions: Calcaneal QUS can be used as a screening tool to screen for and detect osteoporosis. It is economical, portable and easily available in many parts of the country. DEXA scan, the gold standard test to diagnose osteoporosis can be used to confirm the diagnosis in selected cases.

Background: Proteinuria is a condition in which urine contains an excess amount of proteins. The gold standard test for evaluation of proteinuria is 24 hour urinary protein estimation which is a cumbersome process. The rate of urinary protein excretion remains variable and no standard values have been established for timed samples. However since it remains a very simple procedure to perform, evaluation of the predictive nature of the test in comparison to the 24 hour method is necessary. The aim of the study was to compare the 24 hour urinary protein excretion expected from 7 am and 7 pm spot urine protein creatinine ratio with the estimated urine protein from a 24 hours urinary sample collection. Methods: 55 patients with persistent dipstick positive proteinuria with varying degrees of renal dysfunction were included in this study. Two urine samples were collected, one in the early morning (around 7 am) and other in the evening (around 7 pm). Both samples were used to estimate proteincreatinine ratio and calculate expected 24 hours urinary protein excretion. 24 hours urine protein estimation was done simultaneously and compared. Results: There was significant positive correlation with both the samples though the better correlation was seen in early morning urine sample than evening sample (r = 0.931 for 7am sample & r = 0.872 in 7 pm sample; p <0.01). The maximum correlation was seen in patients with normal/mild renal dysfunction and non nephrotic range proteinuria while it was lesser in patients with moderate/severe renal dysfunction and nephrotic range proteinuria. Conclusions: Spot Urine Protein Creatinine Ratio may be used as an alternative for the 24 hour urinary protein excretion as it has a good correlation with the longer method. The early morning sample may be a preferable one.

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Lower Gastro intestinal (LGIB) bleeding is one of the most important clinical symptoms which have significant morbidity and mortality. It has an annual admission rate of 0.15% with mortality rate of 5-10%. LGIB can be caused by a number of causes, including both neoplastic and non-neoplastic lesions. Colonoscopy is the gold standard diagnostic measure which is a simple, convenient and cost-effective procedure. The present study aimed to assess the Colonoscopic profile of LGIB presented to our tertiary care centre. This is a cross-sectional observational study conducted in a tertiary health care centre. A total number of 58 adult subjects with LGIB aged above 18 years were recruited over a period of six months after obtaining written informed consent. All included patients underwent detailed history, clinical examination, blood tests and colonoscopic evaluation. Results were analysed. In our study among the 58 subjects (n=33) were males, which were equal to 57%. The majority of our patients were between the mean age of 31-40 years. Most colonoscopic findings were suggestive of ulcerative colitis, which equalled to 31%. Other different aetiologies of LGIB were as following: carcinoma of the colon (15%), haemorrhoids (15%), colonic polyps (14%) carcinoma of anal canal (5%) and so on. The majority of our patients had moderate anaemia, which was equal to 45% and this was due to persistent LGIB. The incidence of lower GI bleeding increased with increasing age among our patients. The leading cause of lower GI bleeding was found to be ulcerative colitis. The prevalence of colon cancer increases with increase in age. It was followed by CA colon, haemorrhoids, and colonic polyps; hence colonoscopy is recommended in all patients with chronic LGIB.