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OBJECTIVE This prospective study was carried out to assess trabecular bone score, bone mineral density (BMD), and bone biochemistry in Indian subjects with symptomatic primary hyperparathyroidism (PHPT), and to study the influence of baseline parathyroid hormone (PTH) on recovery of these parameters following curative surgery. METHODS This was a 2-year prospective study conducted at a tertiary care centre in southern India. Baseline assessment included demographic details, mode of presentation, bone mineral biochemistry, BMD, trabecular bone score (TBS), and bone turnover markers (BTMs). These parameters were reassessed at the end of the first and second years following curative parathyroid surgery. RESULTS Fifty-one subjects (32 men and 19 women) with PHPT who had undergone curative parathyroidectomy were included in this study. The mean (SD) age was 44.6 (13.7) years. The TBS, BTMs, and BMD at lumbar spine and forearm were significantly worse at baseline in subjects with higher baseline PTH (≥250 pg/mL) when compared to the group with lower baseline PTH (

The measurement of bone mineral density by dual-energy X-ray absorptiometry scan is the "gold standard" for the diagnosis of osteoporosis, which has limited availability in many parts of India. This study was done to assess the diagnostic performance of 6 internationally validated tools (Simple Calculated Osteoporosis Risk Estimation [SCORE], age, bulk, one or never estrogen [ABONE], Osteoporosis Risk Assessment Instrument [ORAI] and Osteoporosis Self-Assessment Tool for Asians [OSTA], Fracture Risk Assessment Tool [FRAX®], and calcaneal quantitative ultrasound [QUS]) for the diagnosis of osteoporosis at the femoral neck (FN). This was a cross-sectional study conducted in 2108 ambulatory South Indian rural postmenopausal women who were assessed with SCORE, ABONE, ORAI, OSTA, and FRAX® tools. QUS was performed in 850 subjects. Bone mineral density was estimated by dual-energy X-ray absorptiometry scan at the FN, and sensitivity and specificity were calculated for all tools for predicting FN osteoporosis. The receiver operating characteristic curve was constructed for each tool and the area under the curve (AUC) was calculated. FN osteoporosis was seen in 27%. The sensitivities of SCORE, ABONE, OSTA, ORAI, FRAX®, and QUS were 91.3%, 91.0%, 88.5%, 81.0%, 72.7%, and 81.9%, and the specificities were 36.0%, 33.5%, 41.7%, 52.0%, 60.5%, and 50.3%, respectively, for the FN osteoporosis. When the receiver operating characteristics were constructed, the AUC was good only for SCORE (0.806), and the performance of the rest was under fair category (0.713-0.766). In our large cohort of rural postmenopausal women, the SCORE screening tool was found to be useful with good sensitivity and good AUC for predicting FN osteoporosis. Thus, this tool may be used in resource-limited countries to screen the population at risk and to enable treating physicians to make appropriate management decisions.

Background: We continue to experience an inexorable transition from communicable to chronic non-communicable diseases (NCD), worldwide. This is especially true in India, where it appears that metabolic syndrome (MetS) is increasing in prevalence due to rapid economic growth, change in food intake and physical inactivity have lead to increase in MetS. However access to health service is poor in India and proper assessment for metabolic disease is often lacking. Accredited Social Health Activists(ASHA) are available throughout India for doing house to house assessment and providing health care, a potential solution for identifying people with abnormal metabolic factors. The aim of this study was to conduct capacity building of ASHA workers for screening of metabolic syndrome in rural India and identify people in rural India with features of MetS. Methods: After obtaining approval from institutional ethics committee 300 ASHAs were trained under World Diabetes Foundation fundedproject (WDF15-941) about aspects ofMetS, diabetes mellitus and diabetic foot. Hand holding training activities were held for each ASHA intheir respective area of practice. This was conducted by project staffs. Participants over the ageof 30 years were screened for the presence of MetS. Random blood glucose (RBS), blood pressure, body mass index (BMI) and waist circumference were measured. Results: A total of 38,346 people were screened for the presence of metabolic syndrome,of which13,911(36.3%) were found to have MetS of which 4200(35.9%) were male and 9,711(37.2%) were female. Those with type 2 diabetes mellitus(T2DM) 1,555(36.7%) also had MetS. Among 3 diagnostic criteria, waist circumference was the highest with 34.1%. Individual with impaired random glucose levels have 1.5 times more risk of developing metabolic syndrome adjusted for age and gender. Conclusion: In conclusion, MetS was present in 36.3% participants residing in rural part of Indiai.e one third of the population. Amongst people with T2DM 36.7% had MetS. The result suggest better screening and early identification of these people will help in proper treatment which might reduce the risk of cardiovascular diseases. Funding: The field screening was conducted as a part of ongoing project funded by World Diabetes Foundation WDF 15-941 “Diabetic Foot care: Stepping Ahead”. Declaration of Interest: The author(s) declare no potential conflict of interest with respect to the research, authorship, and/or publication of this article. Ethical Approval: The study was initiated after obtaining the approval from institutional research committee and institutional ethics committee (IEC 700/2015).