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  1. 1. OSTEOPOROSIS Submitted By:Akanksha Jayesh Rathore
  2. 2.  Osteoporosis means “porous bones”, causes bones to become weak and brittle- so brittle that even mild stresses like bending over ,lifting a vacuum cleaner or coughing can cause a fracture.  In most cases , bones weakens when low levels of calcium , phosphorous and other minerals in the bones and results as low bone density.  A common result of osteoporosis is fractures of the spine , wrist and hip.  Although its often thought of as a women’s disease , osteoporosis also affects many men .
  3. 3. SYMPTOMS  Back pain , which can be severe if fractured or collapsed vertebra.  Loss of height over time , with an accompanying stooped posture.  Fracture of the vertebrae , wrists , hips or other bones.
  4. 4. Normal has appearance of a honeycomb matrix (left) .Under a microscope , osteoporotic bone looks more porous.
  5. 5. CAUSES  The strength of bone depends on their size and density : bone density depends in part on the amount of calcium , phosphorous and other minerals bones contains.  When the bones contains fewer minerals than normal , they are less strong and eventually lose their internal supporting structure.
  6. 6. The process of bone remodeling: Scientists have yet to learn all the reasons why this occurs, but the process involves how the bone is made . Bone is continuously changing – new bone is made and old bone is broken down - a process called remodeling or bone turnover.  A full cycle of bone remodeling takes 2-3 months.  In young – the body makes new bone faster than it breaks down old bone , and the bone mass increases.
  7. 7.  Reaches the peak bone mass in mid- 30’s  After that , bone remodeling continues, but loses slightly more than it gains.  At menopause, when estrogen level drop, bone loss increases dramatically.  Many factors contribute to bone loss, the leading cause in women is decreased estrogen production during menopause.
  8. 8.  Risk of developing osteoporosis depends on How much bone mass attained during ages 25-35 (peak bone mass) and how rapidly loses it rapidly, The higher peak bone mass , the more bones “in the bank” and less likely to develop osteoporosis as ages .  Not getting enough vitamin D and calcium in the diet may lead to a lower peak bone mass and accelerated bone loss later.
  9. 9. What keeps bones healthy?  Regular exercise.  Adequate amount of calcium  Adequate amount of vitamin D , which is very essential for absorbing calcium.
  10. 10. RISK FACTORS: SEX:- Fractures from osteoporosis are about twice more in women than in men . Risk in women at menopause(45yrs) that accelerates bone loss. Risk in men is greater than age 75  AGE:-The older, The higher risk of osteoporosis . Bones become weaker as ages.  RACE:-Greatest risk – White or of South-East Asian descent . Black men and women have less risk.
  11. 11.  FAMILY HISTORY:-Osteoporosis runs in families. Parent or siblings with osteoporosis puts at greater risk , especially if having a family history of fractures.  FRAME SIZE :- Men and women who are exceptionally thin or have small body frames tend to have higher risk because they may have higher risk because they may have less bone mass to draw from as they age.  LIFETIME EXPOSURE TO ESTROGEN:-The greater a woman’s lifetime exposure to estrogen , the lower her risk of osteoporosis.
  12. 12.  EATING DISORDERS:-Women and Men with anorexia nervosa or bulimia are at higher risk of lower bone density in their lower backs and hips.  THYROID HORMONE :-Too much of thyroid hormone can cause bone loss.  OTHER MEDICATIONS :- Long term use of the blood thinning medication, the cancer treatment drug , some anti-seizure medications and aluminum containing antacids also can cause bone loss.
  13. 13.  BREAT CANCER:- Postmenopausal women who have had breast cancer are at increased risk of osteoporosis , especially if they were treated with chemotherapy( which suppresses estrogen)  LOW CALCIUM INTAKE :-A lifelong lack of calcium plays a major role in the development of osteoporosis.  MEDICAL PROCEDURES THAT DECREASES CALCIUM ABSORPTION:-Stomach surgery can affect the body’s ability to absorb calcium.
  14. 14.  SEDENTRY LIFESTYLE :-Bone health begins in childhood . Children who are physically active and consume adequate amount of calciumcontaining foods have the greatest bone density . Exercise throughout life is important , but can increase bone density at any age.  EXCESS SODA CONSUMPTION:-The link between osteoporosis and caffeinated soda isn’t clear , but caffeine may interfere with calcium absorption and its diuretic effect may increase mineral loss.
  15. 15.  CHRONIC ALCOHOLISM:-For men, alcoholism is one of the leading factors for osteoporosis . Excess consumption of alcohol reduces bone formation and interferes with body’s ability to absorb calcium  DEPRESSION:-People who experience serious depression have increased rate of bone loss.
  16. 16. TESTS AND DIAGNOSIS  Osteopenia refers to mild bone loss that isn’t severe enough to be called osteoporosis , but that increases the risk of osteoporosis.  Ultrasound  Quantitative CT scanning  The best screening test is dual energy X-ray absorptiometry (DEXA)- measures the density of bone in the spine, wrist , hip , and is used to accurately follow changes in these bones over time .
  17. 17. TEST SHOULD: Older than age 65, regardless of risk factors.  Postmenopausal and have at least one risk factor, including having fractured a bone.  Having vertebral abnormality.  Type 1 diabetes, liver disease, kidney disease , thyroid disease or a family history of osteoporosis.  Experienced early menopause.
  18. 18. COMPLICATIONS: Fractures are most frequent and serious complications of osteoporosis.  Often occurs in spine and hips – bones that directly support your weight.  Hip fractures and wrist fractures from fall are common.  Compression fractures can cause severe pain and require a long recovery
  19. 19. Treatments and Drugs  Hormone therapy (HT)  Prescription Medications:- Bisphosphonates, selective estrogen receptor modulators (SERM’S) , Calcitonin  Emerging therapies:-New physical therapy program combines the use of a device called a spinal weighted kypho-orthosis (wko) , a harness with a light weight attached and a specific back extension exercises.
  20. 20. ESTROGEN AND BONE PROTECTION  Estrogen is essential for healthy bone, and that when the production of estrogen is reduced (in postmenopausal women and exposure to radiation or chemotherapeutic drugs )bones become brittle and break easily . However the mechanisms involved aren't clearly understood.
  21. 21. The new study observed that one way estradiol helps to maintain bone density is by stopping the activation of an enzyme , known as caspase-3, the central player in initiating the process of programmed cell death of osteoblasts, the bone cell that aid in the growth of new bone and teeth.
  22. 22. PREVENTION  Do exercise such as walking , running , skipping rope , jogging regularly.  Add soy in diet – plant estrogen found in soy helps to maintain bone density and reduce the risk of fracture.  Avoid smoking , it can reduce the level of estrogen and increases bone loss.  Avoid excessive alcohol.  Avoid caffeine , which is very harmful.  Consider hormone therapy.
  23. 23. Lifestyle and home remedies  Prevent falls.  Manage  Maintain pain . Don’t ignore chronic pain. good posture – keeping the head held high , chin in, shoulders back , upper back flat and lower spine arched – helps to avoid stress on spine .when sit or drive , place a rolled towel in back . Don’t lean while writing or doing handwork . When lifting bend at knees , not at waist , and lift with legs , keeping the upper back straight .