Osteoporosis

Literally meaning 'porous bones', osteoporosis is a medical condition that is characterized by fragile skeletal structure. Osteoporosis threatens nearly 34 million women in the US alone and many more worldwide. Osteoporosis is commonly noticed in post-menopausal women. But actual loss of bone mass happens in the 30s. This occurs due to loss of lose an excessive amount of their protein and mineral content, particularly calcium from the bones. Over time it leads to reduced bone mass and decreased bone strength. Normal bone marrow has small holes within it, but a bone with osteoporosis will have much larger holes. Osteoporosis can be classified into two categories - primary and secondary. Primary osteoporosis is associated with bone loss, which is prevalent in older persons and post menopause women. Secondary osteoporosis results from chronic conditions that contribute significantly to accelerated bone loss.

Most often osteoporosis is caused by a combination of lifestyle, genetic and hormonal factors. Slender, small-framed women are particularly at risk. Typical symptoms of osteoporosis are severe back pain, curvature of the spine and loss of height. A woman suffering from osteoporosis suffers from joint aches and muscle aches. There is an increased tendency to fractures on account of brittle and thin bones. Osteoporosis can be hereditary. Women with very thin body frames can be at increased risk of osteoporosis on account of lesser bone mass. Prolonged use of corticosteroids can put a woman at increased risk of osteoporosis since drugs such as prednisone, cortisone, prednisolone and dexamethasone damage bone mass. Other medications that can lead to bone loss are diuretics, anti-seizure drugs and anticoagulants. Hyperthyroidism is another contributory factor to developing osteoporosis. Chronic conditions such as renal failure, malnutrition and connective tissue diseases contribute towards development of osteoporosis.

Diagnosis of osteoporosis may include a series of tests such as bone densitometry (a bone density scan) performed by your physician. There are three types of bone density scans: dual-energy x-ray absorptiometry (DEXA), single photon absorptiometry (SPA), and quantitative computed tomography (QCT). The most common bone density scan is the DEXA - a test that measures bone density based on how bone absorbs two sets of photons (atomic particles with no electrical charge) generated by an x-ray tube. A bone density test is recommended by physicians to post menopausal women, especially those with a higher risk factor.

It is essential to build on your bone mass during the ages of 25 - 35 so as to keep osteoporosis at bay. This can be done by maintaining a balanced diet, with plenty of calcium and following a regular exercise regimen. Weight-bearing exercises are of special importance in strengthening the bones. Running, skipping, aerobics, tennis and weight training are ideal osteoporosis exercises that can be undertaken thrice a week for at least 30 minutes. Apart from bone density, these exercises also increase the strength, co-ordination and balance, thereby reducing the risk of falls. A sedentary lifestyle can put you at increased risk of developing osteoporosis in latter years.

• Consuming a balanced diet, rich in calcium
  
• Eating green leafy vegetables, citrus fruits, dairy products, nuts and shellfish
  
• Calcium supplements
  
• Avoid smoking and excess alcohol intake
  

Panoramic X ray

The Panoramic x-ray or Panorex as it was initially called is considered the 'work horse' of dentistry. The Panorex is a large single x ray film that shows the entire bony structure of the teeth and the face. It covers a much wider area than a traditional intra oral film showing structures outside of their range including sinuses, temperomandibular joints as well as the position of the wisdom teeth. The panoramic x ray has the ability to scan the region of oral pharynx and surrounding tissues thereby increasing the dentist's diagnostic capabilities. The uninterrupted panoramic film is the most commonly used for obtaining clearly portrayed image of orofacial structures in dentistry. Other dental X-rays include:

Bitewing x ray uses the least amount of radiation. It shows the upper and lower back teeth in a single view. They are used to detect decay between the teeth and to show how well the upper and lower teeth line up. Bitewing also indicates bone loss and the presence of severe gum disease or dental infection.

Periapical x rays show the entire supportive system of the tooth from the exposed crown to the end of the root and bones. They are used to detect dental problems below the gum line or the jaw. They also help to detect impacted teeth.

Panoramic x rays belong to the broad category of x rays called tomographs. The amount of radiation needed to expose a panoramic film is about the same as the radiation needed to expose two intra oral films. It is advised to use lead apron during panoramic x ray. In panoramic x ray, the x ray source passes around the patient and behind their head at a slight upward angle. Use of a lead apron helps in optimal prevention of the patient's body from scatter radiation of the panoramic x ray beam. Special panoramic lead aprons are available that cover both the back and front of the patient without interfering with the path of the X ray beam.

• Cysts, tumors, bone irregularities are also revealed in panoramic x ray.
  
  
• Impacted teeth that may be buried deep inside the jaw bone are shown in panoramic x ray.
  
  
• Panoramic x ray is usually taken when the wisdom teeth (third molars) are being evaluated.
  
  
• Panoramic x ray is used in dental implant surgery as it clearly reveals the possible complications in mandibular nerves.
  
  
• Panoramic x ray can also identify some not so common problems such as calcification within the carotid artery that may be indicative of a potential stroke.
  
  
• Panoramic films are especially good for forensic purposes in the identification of otherwise unrecognizable bodies after plane crashes or mishaps.

Hysterectomy

Hysterectomy is the surgical removal of the uterus that can sometimes save the life of a woman. Hysterectomies are usually performed abdominally or vaginally. Laparoscopic hysterectomy is also performed in some cases.

Reasons for hysterectomy

Gynecological cancer: Cancer of the uterus or cervix usually necessitates removal of the uterus and cervix. Endometrial cancer, cancer of the uterus or cervix or fallopian tubes usually requires hysterectomy surgery.

Endometriosis: In some cases of severe bleeding following endometriosis, a hysterectomy surgery is advised. This is the second leading reason for hysterectomies.

Fibroids: While most fibroid tumors can be treated by non-surgical methods, hysterectomy surgery may be the only permanent solution.

Uterine prolapse: When the uterus moves from its usual place down into the vagina, it can affect other organs such as the bladder. This can happen due to childbirth, obesity, loss of estrogen after menopause and weak pelvic ligaments and tissues.

Other reasons for going for a hysterectomy surgery range from heavy or irregular menstrual periods to dysmenorrhea. Severe pelvic inflammatory disease can sometimes necessitate a hysterectomy.

Types of hysterectomy surgery

Total hysterectomy involves removal of the cervix and uterus. It is known as Oopherectomy. Partial hysterectomy is a surgical procedure to remove only the upper part of the uterus, leaving the cervix in place. This type of hysterectomy is referred to as supra cervical hysterectomy or subtotal hysterectomy. Radical hysterectomy involves removal of the uterus, cervix, upper part of the vagina and the supporting tissues.

Hysterectomy surgery performed prior to menopause can bring about severe and prolonged symptoms as compared to natural menopause. A woman can experience bone loss, loss of libido, depression and anxiety. Many women may need hormone replacement therapy (HRT) following total hysterectomy where the ovaries are removed before menopause.