10th Annual Conference of ISBMR

The Department of Endocrinology TN Medical College and BYL Nair Ch hospital hosted the 10th Annual Conference of the Indian society of Bone and Mineral Research The conference was conducted over 2 days i.e. on the 20th and 21st if September 2014 in the Auditorium of the TNMedical College & BYL Nair Ch. Hospital.

This was preceded by a “Meet the expert session” on 19th September 2014. This session featured 3 lectures : Recent Advances in Osteoporosis : Controversies and management Issues : (Dr.Mone Zaidi); The Investigation & Management Of Renal Osteodystrophy And Role Of Histomorphometry In Managing Same: (Dr D.Sudhakar Rao) and Epidemiology of Osteoporosis: (Dr.Peter Ebeling). These were extremely insightful presentations and clarified several clinical dilemmas that even the experienced physicians in the audience were faced with in day to day clinical practice.

This was followed by case presentations by consultants and post graduates working in training institutes at Mumbai and Bangalore.

The cases ranged from the exotic (Mafucci Syndrome, Neurofibromatosis with primary HPT ; multiple myeloma with primary HPT) to the difficult (unlocalized tumours in hypophosphatemic osteomalacia) and to the day to day clinical dilemmas (glucorticoid induced osteoporosis in juvenile RA; X linked hypophosphatemia; End stage renal disease with primary hyperparathyroidism)

The conference proper was graced by Delegates from all over India along with international faculty from Australia and the U.S. The ISBMR President Dr. Nikhil Tandon , the executive committee and the CEO Brigadier Satish Kukreja were present for the event

It began with a workshop on DXA with presentations on :Introduction and Technical aspects of BMD( Dr Nikhil Bhagwat) Indications and Interpretation of BMD(Dr Pratibha Pawal) Going Beyond BMD; (Dr Ameya Joshi) Decision making and Troubleshooting (Dr Manoj Chadha) DXA being an important investigative modality in Metabolic Bone disease this session saw an enthusiastic audience.

The Scientific committee had envisaged that the conference should have a good mix of basic sciences, difficult topics in metabolic disease and problems that various representative specialties encounter in day to day practice

Dr.Raman Marwaha flagged off the scientific sessions with an erudite presentation on “Assessment Of Lean Mass And Its Distribution And Correlation With BMD By Dual Energy X-Ray Absorbtiometry (DXA) In Healthy Indian Females” His study on lean mass measured by dual-energy X-ray absorptiometry (DXA) showed that peak muscle mass among Indian females is achieved in the fourth decade, and that they have lower total and regional lean mass than other ethnic groups. In the era of obesity and metabolic syndrome and osteoporosis sarcopenia. has a special relevance – and the clinical implications of this study elicited an animated discussion

Hypovitaminosis D is now universally recognized… and is prevalent across age groups Strategies to supplement Vitamin D – sunlight exposure, food fortification and supplementation were discussed. The talk on the “Growing Menace Of Vitamin D Toxicity” by Dr.Ambrish Mithal highlighted the iatrogenic complications of the overzealous attempts to correct hypovitaminosis D. The Guidelines of the Endocrine society on supplemental strategies and the need to use discretion in supplementation especially in the vulnerable population were the take home messages on these two talks. This session also brought to the fore the problems in the fortification of foods with Vitamin D.. The good news is that soya bean oil is now being fortified in Indian states such as MP, Rajasthan and Gujarat.

The Presidential Oration on “Bone Health in Indian children” presented by Dr Nikhil Tandon – was an erudite exposition on his work on the various determinants of Bone health in Indian children from the prevalence of hypovitaminosis D in this population to its impact on bone mineral density.

The talk on “ Extensive Clinical Experience In Rickets’ highlighted the extent of this problem in our country, its clinical manifestations and therapeutic approaches to this problem

The theme of World Osteoporosis Day 2014 is Osteoporosis in Men and Dr.Peter Ebeling addressed this subject very articulately. Osteoporosis affects one in five men over the age of 50 ; one thirds of the worlds hip fractures occur in men … however it is post menopausal osteoporosis that gets highlighted. This talk emphasized that osteoporotic fractures are more common than prostatic cancer and need to be taken seriously because men are twice as likely to die follow a hip fracture than women
Dr Usha Shriram spoke on Bisphosphonate Therapy For Osteoporosis-Current Consensus- and covered extensively all the available literature on the subject. All the Official Positions of the ISCD that were introduced or revised since 2007 were discussed threadbare by Dr Shashank Joshi –

Tumour Induced osteomalacia is now being increasingly recognized thanks to the newer investigative modalities. Some tumors are in surgically unreachable locations and the experience with Radiofrequency ablation in these situations was highlighted by Dr. Tusshar Bandgar

It was left to the stalwarts in the field of Bone and Mineral Research to teach the audience the nuances of investigative modalities that can be applied in the management of Bone disease. Dr.D.S.Rao spoke on the Application Of Bone Turnover Markers In The Monitoring Of Therapy For Osteoporosis; Dr.Subhash Kukreja presented the state of the art information on FGF23/ PTHrp In Bone And Utility and Dr.S.K.Bhadada covered Bone Histomorphometry And Its Application In Clinical Practice.
Dr.Mone Zaidi covered Pituitary Bone Axis and Genetics and Bone Diseases in which therapeutic implications of genetics as well as various hormonal receptors in possible treatment of Osteoporosis.

Dr.Ritu Trivedi introduced the audience to the concept of adipomyokines in a talk that explained the effect of skeletal muscle and adipose tissue on the acquisition of bone mass

The impact of systemic illness on bone health was brought to the fore by scholarly presentations on Rheumatology and Bone disorders- emphasis on GIOP (Dr Balakrishnan) Impact of Liver disease on Bone and Mineral metabolism (Dr Thomas Paul) and Post Transplant Osteoporosis (Dr Sushil Gupta )

Last but not the least the surgeon’s perspective on the use of PTH in osteoporotic fracture was an eye opener to the physicians in the audience.

The quality of the free papers submitted for the conference was of a high standard and it was only paucity of time that we could short list 6 papers for oral presentation. The posters also were of an excellent standard. The Prize winning papers were :

Oral Presentation:

1st Prize: Dr Sahana Shetty, CMC Vellore “Bone mineral density and bone turnover markers in healthy postmenopausal women and their daughters from South India”
2nd Prize: Dr Bhavna Daswani, National Institute for Research in Reproductive Health :”Phosphorylated HSP27: A novel marker for low BMD”

Poster presentation:

1st Prize: Dr Nitin Kapoor, CMC Vellore” The manifestations of Wilson’s Disease (WD) with respect to renal tubular dysfunction, bone health and body composition”& Dr. Vandana Dhiman PGI Chandigarh “Functional characterization of a novel mutation in type 1 collagen and Hsp47 gene in Osteogenesis Imperfecta patients”
2nd Prize: Dr Manjunath Goroshi: Study of Hyperparathyroidism in MEN 1 syndrome & Dr Soham Mukherjee, PGI Chandigarh: “Weekly Teriparitide Therapy In Post Menopausal Osteoporosis: Anabolic Window “

250 delegates registered for this conference and took active part in the scientific deliberations.