Computer Studies Made Simple : Types Of Modems

Types Of Modems

The following are different types of modems:

External Modem

They are connected to the computer externally.

They are more expensive than internal modems.

They are easy to setup and need external power supply.










Internal modems

These are inserted into the main mother board.

They derive their power supply from the main computer.

They are cheaper than external modems.

They are difficult to set up than external modems

Wireless Modems:

They transmit the data signals through air with out the need of a cable.

They are also called as radio-frequency modems.

They are part of wireless local area networks

Endocrinology Made Simple : Medications used for improving BMD : Bone Mineral Density

The following are major risk factors for fragility factors :

Low bone density

History of fragility fractures

Family history of osteoporosis

Smoking

Body weight less than 127 pounds

Medications used for improving BMD : Bone Mineral Density

Following medications are used to improve BMD and hence to reduce risk of fragility fractures.

Calcium and Vitamin D supplementation

Adequate vitamin D supplementation and Calcium is the single most important intervention for prevention of osteoporosis.

Anti-resorptive medications/Alendronate :

These are indicated to prevent risk of fragility fractures.

This is a bisphosphonate.

It improves BMD by reducing bone resorption.

It specifically increases BMD at the hip and lumbar spine.

Another example of bisphosphonates is risedronate which is also used for treatment of osteoporosis but it has more GI side effects.

Calcitonin

This also inhibits bone resorption

It causes improvement in vertebral BMD and hence reduces the incidence of vertebral fractures.

It has slight analgesic effect as well and hence can reduce pain from vertebral fracture.

PTH subcutaneous injections/Parathyroid hormone:

This is very effective in increasing BMD at the lumbar spine and in significantly reducing the incidence of vertebral fractures.

It is an expensive treatment and is used only if a failure by bisphosphonates to improve BMD occurs.

HRT is no longer used for treatment of post menopausal osteoporosis due to it causing increased risk of the following :

Stroke

DVT and Pulmonary embolism

Myocardial infarction

Ca breast

Endocrinology Made Simple : Bone mineral density, T score and Z scores

Bone mineral density, T  score and Z scores

T score is the Bone mineral density BMD of a patient in comparison to young healthy adults around 25 – 30 years of age.

The Z score is the BMD  score of a patient in comparison to age matched normal controls.

The BMD is categorized according to T score as below according to WHO CRITERIA FOR

POSTMENOPAUSAL CAUCASIAM WOMEN :

Normal T score > 1

Osteopenic  T score between – 1.0 and 2.5

Osteoporosis T score of less than – 2.5

As T score decreases,the risk of fracture increases without any threshold effect.

The diagnosis of osteoporosis in men and young premenopausal females by bone densitometry is not clear.

Apart from measuring BMD,some basic workup is needed to rule out secondary causes of osteoporosis.

This includes :

Full / complete blood count.

Routine chemistry profile : Serum calcium and phosphorus levels.

Urinary calcium

Serum protein electrophoresis

PTH

TSH

Bone turnover markers such as N tekopeptide for bone resorption and alkaline phosphatase for bone

formation.