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| Sunday, 26 October 2003 |
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Features |  |
| News Business Features Editorial
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Compiled by Carol Aloysius When bones become brittle by Carol Aloysius Osteoporosis is mainly seen in elderly women. it affects six out of 10 Sri Lankan women causing their bones to become brittle and weak over the years. Also known as 'Brittle Bone Disease', osteoporosis has no cure . Preventing the condition can only be done by a sufficiently high calcium intake in your daily diet.
The doctors who included Doctors Sarath Lekamwasam, Lalith Wijayaratne and Udul Hewage, explained the causes, symptoms and most importantly how the disease could be prevented with slides. a number of posters illustrating the onset of the disease and preventive measures lining the foyer outside the conference rooms, attracted the attention of a large number of school girls who were present. They also answered several questions from the audience relating to the disease.
As the three medical specialists explained, osteoporosis means a loss of bone tissue or bone mass density which in turn leads to the impairment of the bone structure. Most people imagine the bone to be like a concrete column. But in reality bone is a living tissue which is constantly being shed and replaced, they pointed out. Who is most at risk? Upto the age of 30 years this bone mass density is at its peak in women. From then onwards there is a decline especially in women who have less bone mass density than men. Women after menopause are most at risk due to the loss of oestrogen in their bodies. Women who have had their ovaries removed are at a greater risk since oestrogen levels fall drastically when the womb is removed. The highest risk age group is persons over 65 years. This last category of elderly patients who can be male or female usually suffer from senile osteoporosis. What are the other causes of osteoporosis? Large doses of steroids and drugs such as prednisolone for a long period of time, those who are underweight and those suffering from other bone related diseases such as arthritis. So how does one prevent the disease? by promoting bone formation. how? Bone formation, could be promoted by a high calcium diet, intake of phosphate and Vitamin. What kind of foods contain these essential vitamins? Dairy foods especially milk contain high levels of calcium which is good for bone and teeth formation as well. Sprats and kathurumurunga too have a high calcium content and help to absorb calcium quickly. Are there any recommended doses for the intake of calcium? A child of six months would need about 400 grams while an adult of over 65 would need much more - at least 1500 gram for women and a 1000 grams for men because of the loss of bone mass. How important a part does exercise play? A very important part. To have strong bones, use them. Eighty percent of patients usually don't exercise their legs, hands adequately and end up with osteoporosis. Walking, running, lifting weights can help to increase the bone density much more than swimming or cycling. If you are doing a sedentary job are you at risk of getting osteoporosis? Certainly. If you are seated in front of a type writer or computer machine, then for heaven's sake get out and exercise. Even half an hour a day will ward off osteoporosis which can cause your bones to break, keep you bed ridden for a long period of time and lead to other complications that could be fatal if you are an elderly person. Can too much exercise be bad? Just as too much calcium is bad, too much exercise can also be bad. For example an olympic runner who practises for five hours at a stretch can end up with loss of bone density. Osteoporosis, according to the medical experts, is now a growing problem in Sri Lanka compounded by the rise in the elderly population. As Dr. Lalith Lekamwasam pointed out, 99 percent of women suffering with bent backs (a common sight in most villages today) have osteoporosis. By the year 2020 when the percentage of elderly persons will rise to 20 percent at least one in four women are likely to suffer from this debilitating disease, he added. Exercising everyday for at least half an hour and taking adequate calcium are the only means of preventing the onset as well as the progression of the disease. A novel feature of the seminar was the presence of a stall giving the public an opportunity for a free bone scan that could measure their bone density. ############### Good posture Good posture means the correct use of the body all the time. For the body to function in the best of health it must be used in such a way that no strain is put on muscles, joints, bones and ligaments. The common complaint of low back pain also can be prevented by avoiding strain on back. Avoiding strain has to be a way of life and has to be practised in all the positions such as lying, sitting, standing, walking. This should not be ignored while doing your work and also while exercising. It is possible to strain the muscles of neck, back even while lying on the bed, so particular attention should be given to the correct resting positions. By learning to live with good posture at every time you will improve the strength of the muscles needed to protect and support your hard working back. Try to remember the following important facts if you want to avoid strain. In lying position both knees should be supported properly for the back to rest. (Figure A) In side-lying position both knees should be bend well to keep the back flat and comfortable. Flat pillow can be used to support the neck. For proper bed posture a firm mattress is essential. While sitting on a chair use of a foot rest to keep knees higher than hips relieves sway back. This position is good for the people who have to sit long time for the type of work they do. When you watch TV avoid forward slump in the chair which strains neck and shoulders. Sit well back in the chair. When you drive adjust the seat closer and use it. For proper sitting the best is a straight hard chair. Standing tall with head up, chin in, back flattened pelvis held straight is the correct way to do it. If your upper back is stooped lower back is arched and abdominal sag you need to strengthen the weak muscles. If you have good posture in standing a line dropped from the ear will pass through the tip of the shoulder, middle of the lap, back of the kneecap and in front of the ankle bone. Here are some simple exercises you can do at spare time of the day to help you to relax tension and improve the tone of some important muscles group. Turn head side to side slowly. Rotate shoulders forward and backward. Rotate neck both ways.Touch left ear to left shoulder, right ear to right shoulder. Raise both shoulders to touch ears and drop them down as far as possible. Pull in abdominal muscles tighten and hold to a count of eight without breathing in. Then relax slowly. Increase the count gradually after the first week. Repeat each exercise four to six times.Practise breathing normally with abdomen flat and then contracted. This can be done while sitting, standing, or walking. Check yourself and try to improve the correct posture. When you maintain good posture internal organs have enough room to function normally and blood circulates more freely keeping you healthy. lP. J. S. Herath, Senior Physiotherapist. ############ Why urine testing is important Urine testing is an essential part of any medical examination. Urine passed into a clean vessel is suitable for routine urine testing. Special methods of collection have been designed to reduce contamination, which is essential for bacteriological examination. It is rarely necessary to catheterize a patient for the purpose of obtaining urine for culture. A mid-stream urine specimen collected after the vulva penis has been cleaned with tap water is the most suitable method of collecting urine for most bacteriological testing. Antiseptic solutions should not be used for cleaning, because it will interfere with the growth of bacteria. In women the labia are separated by the patient or nurse if done in a hospital and the vulva is cleaned twice in an anteroposterian direction with swab soaked in pure water and then finally with a dry swab. The most satisfactory specimen for culture is the one that is collected just after awakening from sleep. This is because the bacteria in the bladder are able to multiply undisturbed for several hours. The urine sample should be cultured as soon as possible (and certainly within two hours of collection) or refrigerated at 4 degrees C immediately in order to prevent contaminant bacteria from multiplying so much that they may be misinterpreted as pathogens. The urine should be examined physically, chemically, micro scopically and bacteriologically. physical examination When examining the patient physically, attention must be paid to the following points: quantity, colour, and transparency, specific gravity and naked-eye characteristics of the deposit. Quantity - the normal quantity of urine passed daily varies widely from 700 - to 2500 ml. Depending on the fluid intake. Normally very much more urine is excreted during the day than during the night. An increased excretion of urine occurs physiologically after food or drink, and after exposure to cold. Conversely, diminished excretion occurs when little food or drink has been taken, and after heat induced sweating. A pathological increase (Polyuria) occurs in diabetes mellitus and sometimes in renal failure. Nocturnal polyuria (nocturia) is often the first clinical indication of failure of the concentrating power of the kidney and therefore is often the first symptom of chronic renal failure. Abnormal reduction of urine output may be due to salt and water depletion from such factors as diarrhoea, vomiting, fever, extensive sweating, sudden lowering of blood pressure, severe heart failure or acute diffuse disease of the kidney tissue (acute glomerulo nephritis). Complete cessation of urine output (anuria) is uncommon and most often results from an obstruction in the urine tract itself. Colour and transparencies Urochropie and uroerythrin are pigments which give normal urine its characteristic colour. Urine will get darker as standing due to the oxidation of colourless urobilinogen to coloured urobilin. The concentration of urine cannot be reliably estimated from its appearance. Small quantities of blood give urine a smoky appearance, large quantities make it brownish or red haemoglobin large among as in black water fever given it a colour varying from dark red to black bile pigments causes the urine to appear brown. The urine is abnormally pale when it is very dilute with specific gravity of about 1002 and in renal failure. The taking of drugs may also lead to discolouration of the urine. Eg. Tetracycline (yellow) Vitamin B yellow anthracene purgatives (orange) Normal urine is quite transparent when freshly passed, but it may be opalscent from the presence of various substances in suspension of which the most important are pus, bacteric phosphates and urates. A.D.T. Maithripala, Medical Lab Technologist ##################### Cancer update : Some reassuring facts on breast cancer Having read your article "Cancer Guidelines for Children" which appeared in the Sunday Observer (14 Sept), I wish to share a few facts about breast cancer which I gleaned from a "Reader's Digest". Women presume that breast cancer mainly affects younger women. According to the US National Cancer Institute however one of the strong factors is age. The others are early menstruation, bearing a first child after 30 years and late onset of menopause. The institute also states that the chance of developing breast cancer by age 50 is actually LOW compared to women of that age who ail with heart disease. There are many forms of breast cancer. Unfortunately the rare, malignant type spreads and invades killing the person even though a mammogram has identified it at an early stage. The other slow-growing type which has been diagnosed for a long time will surprisingly not cause death. Consult a doctor regarding tumours. They are treatable but can become dangerous as they continue to develop and turn malignant. Ductal carcinoma occurs in the milk ducts. It is considered as "pre-cancer" but unlike other cancer cells it is not invasive remaining only in the milk ducts. There is a possibility of the pre-cancer cells erupting from the milk ducts and eventually becoming cancerous. To prevent this, doctors perform a lumpectomy or mastectomy. Some doctors seem to think that a lumpectomy and radiation therapy treatment is a better choice than mastectomy, when considering the physical and emotional trauma the woman experiences after mastectomy. To prevent breast cancer women should exercise regularly. Take vitamin D daily, the amount in two cups of vitamin D fortified milk will suffice. Eat a good share of fresh, green vegetables, fruit juice and simple but nourishing meals. Vegetables which have a carotene content (highly coloured) lowers one's breast cancer risk. Examine the breasts now and again. Do not be afraid or reluctant to consult your physician if you have any fear or doubts. Consider these reassuring facts. Sent by Caryl Nugara. |
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| Editorial | Security Produced by Lake House |
Osteoporosis, like glaucoma which we featured on this page last week,
has been described as a 'silent disease'. "It creeps upon you
gradually without you being aware of it. There are no specific symptoms
because most of the symptoms are similar to other diseases as well",
a group of specialists in the field told a large gathering of mixed
audience at a seminar held at the BMICH to mark World Osteoporosis Day on
Monday, October 20. The seminar was sponsored by New Zealand Milk Lanka ,
the makers of Anlene High Calcium milk powder, a product designed to
prevent bone loss.
What is Osteoporosis?
