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  • Transcript

    • 1. Osteoporosis Slide show
    • 2. The Osteoporosis Landscape In India, an estimated 43 million women suffer from osteoporosis
    • 3. India: Some Hard Facts
      • Over 61 Million Indians have osteoporosis.
      • 80% are women.
      • On a global basis, Indians have the highest prevalence of osteopenia.
      • Compared to Caucasians, osteoporotic fractures in the Indian population occur 10-12 years earlier in age.
      • Osteoporotic fractures are more common in Indian men than in the West.
    • 4. India: Some more hard facts
      • Over 45 Lakhs Indian women above 60 have a fractured spine.
      • Over 2.5 Lakhs Indians suffer osteoporotic hip fractures every year.
      • Most of these fractures are never investigated for osteoporosis - and therefore never treated for the cause.
      Gupta et al, Indian Journal of Medical Research 1967:55:1341-8
    • 5. Incidence of Hip fractures Asia will emerge as the largest sufferer of osteoporosis related fractures
    • 6. Osteoporosis vs other diseases Total incidence of osteoporosis related fractures far exceeds other diseases
    • 7. What makes us more prone?
      • Indians have a poor calcium intake
        • We don’t drink enough milk as children
        • We have a higher incidence of varied degrees of lactose intolerance
        • Rice is a poor source of calcium
        • Vegetarian diets and cereals have low bio-availability of calcium (<30%)
      • Vit D deficiency is common
      • Protein intake is poor
      • Excess salt intake – may increase urinary loss of calcium
      • Healthy exercise is neglected
      • Significantly lower BMD : mean spinal BMD by DEXA is 2SD below the American-European population between 20 to 59 yrs population*
      • Lower BMI : osteoporosis is more common in thin women
      • Late menarche’ in girls - low estrogen exposure
      • Awareness is low
      *Nangia et al, ESICON 1977
    • 8. Why is osteoporosis serious?
      • It affects many more women than heart attacks, strokes and breast cancer together
      • Osteoporosis kills by its complications-An osteoporotic fracture reduces the sufferer’s life expectancy by a decade.
      • In addition, it seriously compromises quality of life
      • Fractures are very expensive to treat-the economic burden of osteoporotic fractures is immense.
    • 9. Common Fracture/BMD measurement Sites
    • 10. World Health Organization (WHO) guidelines for osteoporosis Osteoporosis Osteopenia Normal Peak Bone Mass T-Score -1 -2.5 -2 0
    • 11. Who to Treat?
      • Therapy Decision
        • High Risk
        • Treat
        • Moderate Risk
        • Treat if other risk factors
        • Low Risk
        • Check again in 1-2 years
      T-Score* Below -2.5 -1.0 to -2.5 Above -1.0 International Osteoporosis Foundation. 1998.
    • 12. Osteoporosis: a team work Patient & Family Dietitian Physio. Govt. NGO Sp. Doctor Orthotist Fm. Doctor Sp. Nurse Orthopaedic Surgeon