Osteoporosis, yani haddiyan kamzor hona

Women's Health Concern, jo British Menopause Society ka mareezon ke liye hissa hai, osteoporosis ko haddiyon ke patla hone ki beemari kehta hai jis se haddiyan zyada naazuk ho jati hain aur aasaani se toot sakti hain. Is se hone wale fracture ko doctor fragility fracture kehte hain.

NHS ki website kehti hai ke aam taur par jab tak haddi na toote is mein dard nahin hota, aur reerh ki haddi mein fracture se kamar jhuk sakti hai aur jism aage ko mur sakta hai.

Haddiyon ki sehat mein hai ke menopause (mahwari ka band hona) ke aas paas ke saalon mein haddiyon ke saath kya hota hai.

Women's Health Concern kehta hai ke auraton mein haddiyon ka bara nuqsan menopause par estrogen khatam hone ke saath aata hai. NHS ki website mazeed kehti hai ke agar menopause jaldi, 45 saal se pehle, ho jaye, ya ande daniyan nikali ja chuki hon, to khatra zyada hai.

Pakistan Menopause Society aakhri mahwari ke baad ke pehle paanch chhe saalon ko haddiyon ke tezi se kamzor hone ka waqt kehti hai (1.2.7.1). British Menopause Society mazeed kehti hai ke jin Junoobi Asiai auraton ki mahwari 40 se pehle band ho jaye, woh shayad madad na lein, aur woh ise baad mein osteoporosis ke zyada khatre se jorti hai.

NHS jin doosre khatraat ka naam leta hai un mein teen maheene se zyada zyada dose wali steroid goliyan lena, khandan mein osteoporosis (khaas taur par agar maan ya baap ka koolha toota ho), zyada sharaab peena aur cigarette peena shamil hain.

Doctor kaise check karte hain:

• Pichhli baatein. PMS ki sifarishaat doctoron se kehti hain ke pehle tooti haddiyan, qad kam hona, girna, steroid ka istemaal aur khandan mein osteoporosis, sab likhein (Table 2).
• Khatre ka score. NHS ki website FRAX jaise online tools ka naam leti hai, jin se PMS ki sifarishaat auraton ko kam, zyada aur bohat zyada khatre mein baanti hain (6.4).
• Scan. NHS haddiyon ki mazbooti ke scan ko, jise aksar DEXA ya DXA scan kaha jata hai, aik chhota aur baghair dard ka test batata hai jo haddiyon ki mazbooti naapta hai. PMS ki sifarishaat zyada khatre wali auraton ke liye, jahan mumkin ho, yeh scan tajweez karti hain: kisi fragility fracture ke baad, waqt se bohat pehle ya waqt se pehle menopause mein, lambe arse tak steroid lene ke baad, baar baar girne par ya qad wazeh kam hone par (Table 4). Pakistan mein yeh jahan mumkin ho wali baat aham hai: yeh scan har jagah nahin milta.

Haddiyon ko kya bachata hai, mukhtasir mein: PMS ki sifarishaat chalne jaisi warzish ko, jis mein jism apna wazan khud uthata hai, haddiyon ki sehat ke liye zaroori kehti hain, aur saath wazan uthana ginti hain (Table 6). The Menopause Society do ehtiyaatein batati hai: warzish se osteoporosis ulat nahin jata, aur jin auraton ko yeh ho, khaas taur par reerh ki haddi ke fracture ke baad, woh aage jhuk kar ya mur kar kuch uthane ya khainchne se bachein. Girne se bachne ke liye woh tawazun, chalne aur taaqat ki warzish, jaise tai chi, ka naam leti hai, aur doctor ke saath mil kar un dawaon ko kam karne ka jin se girne ka imkaan barhta hai, jaise neend ki kuch goliyan. Vitamin D aur calcium ke liye vitamin D aur calcium dekhein.

Dawaein do tarah ki hain.

Aik HRT (hormone ki dawa) hai. NICE NG23 ki fawaid aur khatraat ki table kehti hai ke HRT lete hue haddi tootne ka khatra (fragility fracture) kam hota hai, ke yeh faida ilaaj ke dauran rehta hai, aur band karne ke baad khatam hota jata hai. PMS ki sifarishaat haddiyon ko sehat mand rakhne ko MHT, jo HRT ke liye un ka lafz hai, ki bari wajoohaat mein ginti hain (5.1). Woh yeh bhi kehti hain ke 60 saal ya zyada umar ki auraton mein MHT ko osteoporosis ke ilaaj ya bachao ka pehla raasta na banaya jaye.

Doosri baghair hormone ki dawaein hain. PMS ki sifarishaat kai qismon ka naam leti hain, un mein bisphosphonates aur denosumab, jo haddiyon ka kamzor hona dheema karti hain, aur woh dawaein jo nayi haddi banane mein madad karti hain. NICE ki osteoporosis wali hidayat NG259 doctoron se kehti hain ke menopause ke baad ki auraton mein ilaaj par haddi tootne ke khatre ke hisaab se ghaur karein, maslan jab kulhe ya reerh ki haddi toot chuki ho ya scan mein haddiyon ki mazbooti kam nikle (1.7.3). Kaun si dawa, kitne arse ke liye, aur kya yeh aap ke gurdon aur dil ke liye theek hai, yeh aap ke saath mil kar aap ke doctor ka faisla hai.

Aik hifazati baat The Menopause Society aur European Menopause and Andropause Society (EMAS) donon kehti hain: denosumab ko is ke baad koi aur dawa shuru kiye baghair na band kiya jaye, na is mein der ki jaye, kyunke is ke rukne par haddi tezi se kam ho sakti hai.

Apni haddiyon ke baare mein poochein agar mamooli girne par koi haddi toot gayi ho, agar qad kam ho gaya ho ya kamar jhukti mehsoos ho, ya agar mahwari 45 se pehle band ho gayi ho. Pehli tooti haddi ko bas badqismati na samjhein: The Menopause Society pehle hue fracture ko agle fracture ki sab se bari nishaniyon mein ginti hai, aur is ke baad ke do saalon mein khatra sab se zyada hota hai.

NICE NG23 doctoron se kehta hai ke menopause ke jaize ki mulaqaton mein haddiyon ki sehat par baat karein. Agar kisi ne yeh baat nahin chheri, to aap chher sakti hain.

PMS ki sifarishaat ghar ke andar rehne wali zindagi aur parde ko un wajoohaat mein ginti hain jin ki wajah se Pakistan mein vitamin D itna aham hai (Table 5). Parda imaan se jura aap ka apna intikhab hai, aur yahan kuch bhi aap se ise badalne ko nahin kehta. Haan, doctor ko zaroor batayen, kyunke is se farq parta hai ke kaun se muaine bante hain.

Kisi buzurg ammi ya nani dadi ka koolha toot jaye to aksar poora ghar badal jata hai. Agar aap ke khandan mein aisa hua ho to zikr karein: khandan ki beemariyan is ka hissa hain ke khatra kaise nikala jata hai.