No abstract

Individuals with glucocorticoid-induced osteoporosis experience vertebral fractures at an increased rate and at higher vertebral areal bone mineral density (aBMD) than individuals with primary osteoporosis. Standard posteroanterior- (PA-) projection dual energy X-ray absorptiometry (DXA) lacks the diagnostic sensitivity required for reliable estimation of vertebral fracture risk in individuals. Assessment of subregional vertebral aBMD using lateral-projection DXA may improve the predictive value of DXA parameters for fracture. One hundred and four individuals were recruited and grouped for this study: primary osteoporosis with no history of vertebral fracture (n = 43), glucocorticoid-induced bone loss (n = 13), and healthy controls (n = 48). Standard PA-projection and supine-lateral scans were performed, and lateral scans were analysed according to an established protocol to measure aBMD within 6 subregions. Main effects for subregion and group were assessed and observed, by ANCOVA. Ratios were calculated between subregions and compared between groups, to overcome the potentially confounding influence of variability in subregional geometry. Significantly lower values were observed in the glucocorticoid group for the ratios of (i) anterior subregion: whole vertebral body and (ii) posterior: whole vertebral body when compared to the primary osteoporosis and control groups (P < 0.05). Lower anterior subregional aBMD in individuals on glucocorticoid therapy may help to explain the increased vertebral fracture risk in this patient group.

Background: Present study was a randomised prospective observational study carried out at Ashakiran Hospital and IVF centre Pune, Maharashtra, India to evaluate the efficacy, safety, and quality of life by using Ulipristal acetate 10 mg and Mifepristone 25 mg daily doses to treat uterine fibroids of two subgroups involving fibroids <3 cm and fibroids 3 to 5 cm all are in reproductive age group with symptomatic in nature over 3 months. Methods: A total number of 40 patients were recruited in the study of which they were divided into two groups according to the size of the fibroid as <3cm and 3-5cm as seen on transvaginal as well as transabdominal ultrasound. Further they were randomly assigned to either mifepristone or ulipristal orally with each category having 10 patients each to assess changes in fibroid size, in symptomatic pain reduction, menorrhagia and in quality of life. Results: The 25-mg dosage of Mifepristone is shown to be a good and effective way of treatment in fibroids less than 3 cm in achieving 40% reduction in size and 50% reduction in menorrhagia as compared to Ulipristal 10 mg which acts better in other subgroup of size 3-5 cm of fibroids. Conclusions: Still larger RCTs are needed to study the long-term benefits of these drugs.