Osteoporosis is a systemic skeletal disease that is a cause of morbidity and mortality. It can affect all ages but most frequently postmenopausal women. It is a silent condition, however, osteoporotic fractures can lead to significant pain and disability. In this review article, we aim to review the clinical approach to the management of postmenopausal osteoporosis. We include risk assessment, investigations, and the various pharmacological and non-pharmacological options used in the treatment of osteoporosis. We have discussed the pharmacological options individually including their mechanism of action, safety profile, effects on bone mineral density and fracture risks, and duration of use. Potential new treatments are also discussed. The importance of sequence in the use of osteoporotic medicine is also highlighted in the article. An understanding of the different treatment options will hopefully help in the management of this very common and debilitating condition.

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Fungal infections are a growing cause of concern in both hospital and non-hospital settings all over the world. Fungal infections are often characterized by the location of the infection. These may be referred to as superficial, subcutaneous, or systemic, which is also referred to as deep-seated. Dermatomycosis are superficial fungal infections of the skin & or its appendages.Aims & Objectives: This study was undertaken to determine: 1) The predominant dermatophytes and non dermatophytes causing dermatomycosis. 2) The clinicomycological profile of dermatomycosis. Materials and Methods: 641 samples from clinically suspected cases of dermatomycosis including the skin, hair, and nail samples were collected. All the relevant clinical, demographic, and epidemiological details were noted. Samples were then subjected to direct microscopy and fungal culture. Results: Of the total 641 cases, 337 (52.6%) were males and 304 (47.4) were females (Table 1). The most commonly affected age group was 20-39 years (51%). Out of total, 340 (53%) were nail samples, 283 (44.1%) were skin samples, and 18 (2.9%) were hair samples. Onychomycosis was the commonest clinical presentation (48.8%) followed by Scaly skin lesions (13.1%). Moreover, Tinea corporis was seen in 10.3%, Tinea cruris in 5.3% cases. KOH wet mount was performed on all 641 samples with 230 (35.9%) showing positive results. Whereas, 312 (48.7%) were positive by culture. the most common Fungi isolated in our study were Dermatophytes n=154 (49.4%), followed by Non-dermatophyte molds (NDMs) n=93 (29.8%) and Yeasts n=65 (20.8%). Conclusion: A combination of direct microscopy and culture was found to be superior than direct microscopy and culture alone. The recovery of NDMs and yeasts from routine dermatological samples in addition to the usual suspects, dermatophytes, also increases the awareness and suspicion among clinicians and mycologists to look beyond dermatophytes as the lone cause of superficial skin infections. Additionally, given the geographical location of Kashmir valley and its temperate climate with extremely cold winters (November to March) and a relatively milder summer with moderate humidity levels, when compared to the rest of northern Indian states doesn't make it a suitable environment for fungal infections, more so the superficial mycosis. That said, people at risk are always vulnerable to develop fungal infections.

Blood cultures are collected from patients with suspected sepsis or bacteremia and are essential in the diagnosis and treatment of the etiologic agent of septicemia. JMS 2014;17(2):76-77

Cutaneous tuberculosis (CTB) is the rarest case of extrapulmonary TB comprising 2% of total cases. It’s often a challenge both clinically and diagnostically. 1) To determine prevalence, age & gender-wise distribution of CTB. 2) To assess various diagnostic, microbiological modalities for the diagnosis of CTB. 76 skin biopsy specimens from suspected CTB lesions were analysed using following methods – Acid-fast Bacilli (AFB) staining (Ziehl-Neelsen method), growth of mycobacteria in culture (Lowenstein-Jensen media), and Gene Xpert MTB/RIF, Histopathological (H&E staining). Of the 76 specimens, 44 were males and 32 were females. The most commonly affected age group was 40–59 years. Infections were least common in 0-19 years age group. AFB was not seen in any of the primary smears. 10 were confirmed as CTB by the recovery of Mycobacterium in solid culture. Of the 10 culture positives, 9 were confirmed as MTB, and 1 was found to be NTM. Staining of 10 culture positive specimens revealed acid fast, beaded rods. Detection of MTB by Gene Xpert gave positive result in 9 cases with all RIF sensitive. All 9 PCR confirmed cases were also culture positive, all 9 were slow growers with a minimum of 5 weeks required for growth on the LJ slant. PCR is the test of choice and should be performed on all specimens of suspected CTB. However when coupled with the “gold standard” culture method, the diagnostic accuracy improves. Also, further, culture helps in identification and isolation of NTM’s.