Ca defecancy syndrom

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Lecture By:Dr.Ehab Abusinnah
Ortho-surgeon
Meeqat hospital,Madina.KSA

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Ca defecancy syndrom

  1. 1. By Ehab Abusinna OSTEOMALACIA OSTEOPOROSIS RICKETS
  2. 2. OSTEOPOROSIS - WHO Systemic skeletal disease characterized by low bone mass and micro architectural deterioration of bone tissue with a consequent increase in bone fragility and susceptibility to fracture which usually involves the wrist ,spine, hip, pelvis, ribs or humerus.
  3. 3.  Most common of all metabolic bone disorders  Significant morbidity(50% for hip fractures) and mortality(20% for hip fractures in 1 year)  Lifetime Osteoporotic Fracture Risk(Caucasian) Woman- 40% Men - 20%  Preventive therapies available. Osteoporosis
  4. 4.  Low bone density  Micro architectural deterioration  Fractures Osteoporosis
  5. 5. Target Sites for Osteomalacia
  6. 6. TYPES OF OSTEOPOROSIS  Primary Osteoporosis  Postmenopausal Osteoporosis  Senile Osteoporosis  Secondary Osteoporosis  Diet  Drug Endocrine disease Other Systemic Disorders.
  7. 7. Senile or post-menopausal – 95% Indiopathic Primary Osteoporosis
  8. 8. SECONDARY OSTEOPOROSIS Endocrine: cushing + exog steroids Hyperthyroidism Hypogonadism Hyperparathyroidism Dm Proclatinoma Acromegaly Preg & lactation
  9. 9. RENAL C R F
  10. 10. Malabsorption, Celiac Gastrectomy T P N Hepatobiliary disease Chronic hypophosphatemia NUTRITION AND GIT
  11. 11. DRUGS Heparin Steroids Anti-convulsants
  12. 12.  Diet  Low calcium intake  Low vitamin D intake  Excessive intake of protein, sodium and caffeine  Inactive lifestyle  Smoking , Alcohol abuse Risk factors…
  13. 13. RISK INCREASED BY: F – sex Menopause Decreased Ca Smoking Alcohol Inactivity White Race (↓ black)
  14. 14. • Osteoporosis, the "silent disease," has bone loss without symptoms. • Onset only occurs with sudden strains, bumps, or fall causes a fracture or a vertebra to collapse. • Collapsed vertebrae may initially be felt or seen in the form of severe back pain, loss of height, or spinal deformities such as kyphosis or stooped posture. SYMPTOMS
  15. 15. RICKETS
  16. 16. RICKETS
  17. 17. RICKETS
  18. 18. RICKETS
  19. 19. OSTEOMALACIA – LOOSER ZONE
  20. 20. OSTEOMALACIA – LOOSER ZONE
  21. 21. CHEMISTRY: NORMAL WHY ↑ALK, BUT NOT PERSISTENT
  22. 22. PREVENTION: Exercise Good Ca intake Non-smoking
  23. 23. LIFESTYLE ISSUES  Tobacco- eliminate it Food – eat it  Exercise – do it  Fall Prevention – work on it
  24. 24. Avoid smoking, alcohol and excess soft drink and coffee
  25. 25. Eat a health diet lean meat, fish, green leafy vegetables, and oranges and Off course Plenty Milk
  26. 26. Healthy bone balance
  27. 27. • Prevent further bone loss • Increase or at least stabilize bone density. • Relieve pain and prevent fracture. • Increase level of physical functioning • Increase quality of life Goals of management
  28. 28. TREATMENT Ca 1200 mg/day Vitamin D:- 400-2000 IU / day HRT Biphosphonates Calcintonin S E R M S Parathyroid hormone
  29. 29. Vertebral Fracture Cascade
  30. 30. COMPLICATIONS FRACTURE , The most serious complication of Osteoporosis that leads to  Increased morbidity  Increased mortality  Decreased quality of life
  31. 31. THE TIP OF THE ICEBERG ASSESSMENT MANAGEMENT
  32. 32. Each year, one in three Ontarians over the age of 65 will take a serious tumble that may land them in hospital with a broken hip. One in three of those who do break their hip will die within a year. Two thirds will experience dementia-like symptoms. Most will never see home again.
  33. 33. Osteoporosis, is it only for women??
  34. 34. OSTEOPOROSIS IN MEN HAS ITS TIME COME?
  35. 35. Osteoporosis, only for older people ??

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