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PRESENTATION TOPIC Osteoporosis

What is Osteoporosis? The word osteoporosis literally means "porous bones." It occurs when bones lose an excessive amount of their protein and mineral content, particularly calcium, therefore bone mass, and bone strength, is decreased. As a result, bones become fragile and break easily.. It occurs most commonly in women after menopause as a result of estrogen deficiency.

Pathogenesis of osteoporosis: The underlying mechanism in all cases of osteoporosis is an imbalance between bone resorption and bone formation. In normal bone, matrix remodeling of bone is constant; up to 10% of all bone mass may be undergoing remodeling at any point in time. The process takes place in bone multicellular units (BMUs Bone is resorbed by osteoclast cells which derive from the bone marrow, after which new bone is deposited by osteoblast cells.

Pathogen with mechanism: There three main mechanisms by which osteoporosis develops. 1. Inadequate peak bone mass. 2. Excessive bone resorption. 3. Inadequate formation of new bone during remodeling.

Inadequate peak bone mass When bones have reached their maximum strength and density, known as peak bone mass.But Inadequate peak bone mass causes osteoporosis.

Excessive bone resorption Bone resorption is the process by which osteoclasts break down bone and release the minerals, resulting in a transfer of calcium from bone fluid to the blood. Hormonal factors strongly determine the rate of bone resorption; lack of estrogen (e.g. as a result of menopause) increases bone resorption. Deficiency of calcium and vitamin D leads to impaired bone deposition The parathyroid glands react to low calcium levels by secreting parathyroid hormone (parathormone, PTH), which increases bone resorption

Inadequate formation of new bone during remodeling Cancellous bone has a greater surface area & it is much important for bone remodeling. When osteoblasts and osteoclasts inhabit the surface of trabecular bone bone density decreased and disrupted or break down and also replaced by weaker bone. Women may lose as much as 50%, while men lose about 30%.

Signs and Symptoms Joint pain Low back pain Neck pain Backache. A gradual loss of height and an accompanying stooped posture. Fractures of the spine, wrist,or hip.

Risk factors Getting older. Being small and thin. Having a family history of osteoporosis. Taking certain medicines. Being a white or Asian woman. Having osteopenia, which is low bone density. Having Type 1 diabetes. Having a liver disease. Having a kidney disease. Having a thyroid disease.

Diagnosis  DEXA scan: The DEXA scan measures bone densities. Normal range: 0,-1 Range: (-1 to -2.5). Osteopenia (not osteoporosis) Below (-2.5) : The patient has osteoporosis.

OtherMethod includes-  CT (computerized tomography) scan  Measuring calcium intake in men  Dental X-rays

Treatment & Care Osteoporosis treatments come in several forms. Many should be started during childhood; others include drugs or physical treatment. Physical treatment: Diet: Young adults should be achieve normal peak bone mass by getting enough calcium (1,000 mg daily) in their diet. Exercise: Regular exercise can reduce the likelihood of bone fractures associated with osteoporosis.

Medicinal Treatment: HRT (Hormone replacement therapy) : HRT helps to prevent bone density loss during the women going through the mid-age like after the age of 40, thus reducing the risk of fractures during treatment. Testosterone treatment: Low testosterone level can cause osteoporosis for this reason administration of testosterone can be a useful treatment. Stem cell therapy : Promote bone growth - and new pathways that controls bone remodeling.

Other Treatment : Bisphosphonates :Helps to prevent bone density loss. Calcitonin: Inhibits the cells that is responsible for the break down of bone. Calcium and vitamin D supplements: Lower the risk of hip fractures. SERMs (Selective estrogen receptor modulators): These drugs(raloxifene ) help prevent bone density loss.This drug is only approved for women with osteoporosis, not men.

Medicinal Complications Corticosteroids - long term use of corticosteroids damages bones. Selective serotonin reuptake inhibitors (SSRIs) - these are types of antidepressants. They have been found to lower bone density. Blood thinning medications - long term use may lower bone density. Methotrexate - a drug used for cancer treatment.

Prevention There are four steps to prevent osteoporosis. No one step alone is enough to prevent osteoporosis. Eat a balanced diet rich in calcium and vitamin D. Engage in weight-bearing exercise. Adopt a healthy lifestyle with no smoking or excessive alcohol intake. Take medication to improve bone density when appropriate.

Prevention:

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