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Bone density in UAE. Dr. Humeira Badsha

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From Gulf Today, July 25, 2010

Despite the UAE basking in the sun, a “silent killer” is crippling its population from the age 40. The people most affected with this disease are in Dubai.

The silent killer, according to Al Biraa Arthritis & Bone Clinic consultant rheumatologist Dr Humeira Badsha, is the condition of low bone density, which left undiagnosed leads to debilitating fractures and osteoporosis.

“It is scary that one out of four among us of 40 years of age is suffering from low bone density,” Badsha told The Gulf Today.

The rheumatologist quoted the results of the findings she and the clinic’s general manager, Dr Ayman Mofti, had concluded from the review of several collated bone screening results, participated in by 15,000 Dubai residents.

The findings showed that up to 25 per cent or 3,750 of the 15,000 residents about the age of 40 were suffering from low bone density.

“This is an alarming rate and I can call it the silent killer since majority of us are unaware that we are suffering from low bone density unless we get fractured,” she said.

“Unfortunately, when the results are out we find out that the condition is already at its advanced stages,” the rheumatologist added.

Badsha cited the case of a 65-year-old wheelchair-bound Jordanian lady suffering from hip and bone fractures. She added that women patients seeking her advice for bone treatments are between 30 and 40 years of age.

“The Jordanian lady is the most severe case I have,” Badsha said, stressing that the silent killer exists, not because of the “culture of being covered,” but because of the extreme heat people experience when exposed under the sun.

“The climate has led us to live the ‘airconditioned culture,’” she said, claiming that her 65-year-old patient goes for the Western style of fashion.

Suffering from low bone density has nothing to do with the clothes one wears and which was confirmed in a study she conducted on Indian and Arab women. Badsha mentioned the following risk factors: Lack of Vitamin D and calcium, smoking, thyroid gland problem (too much thyroid hormone can cause bone loss), long-term corticosteroid medications which may lead to bone damage unless monitored, excess alcohol intake, and for women, menopause (the lack of estrogen accelerates bone loss).

The findings of the Al Biraa Arthritis & Bone Clinic team, which is conducting free bone screenings until Aug. 15, confirmed the observation of clinical dietician Caroline Kanaan.

Interviewed on Aug. 27 last year, Kanaan said that based on the profile of her patients from the Advanced Nutrition Centre, the majority has been suffering from Hypovitaminosis D or the lack of Vitamin D, linked to low bone density.

She said that she had not encountered any major study or statistics on the prevalence of Hypovitaminosis D. Kanaan then told this reporter: “But, from our clinic, whenever we ask somebody to undergo the Vitamin D blood test, results show that his or her Vitamin D is below the required level.”

Kanaan said one lacks Vitamin D when the required blood test shows that this is below 20 microgrammes per liter (mgl). The required levels must be between 20 and 60 mgl.

“We have too much sunlight here but among the 100 per cent of patients we asked for the Vitamin D blood test in the past three months, 80 to 90 per cent of them are women (from 18 years of age) who lack Vitamin D,” Kanaan then said.

The remaining 10 per cent was spread out among children of both sexes and the men.

The findings of Badsha and Mofti also confirmed the study conducted by Al Noor Hospital-Internal Medicine and Rheumatology consultant Dr. Haider Al Attia had done last year among 140 predominantly Arab patients between 55 and 64 years old.

From a statement: “The research using the Dual Energy X-Ray Absorptiometry, found that between 22 per cent of men aged 55 plus, and 34 per cent of those over the age of 64.5 years were suffering from osteoporosis, which increases the risk of bone fracture and the likelihood of disability and death.”

All medical experts said there is no reason why low bone density will remain a silent killer.

Kanaan mentioned that 10 minutes of daily exposure under the sun will help the skin to produce the Vitamin D levels each one needs.

In an interview last year with Badsha, she said children must be encouraged to spend a lot of time playing as well as to eat lots of daily products, especially between 500 and 800 milligrammes of milk a day.

Saying that every adult must drink as much as two glasses of milk a day apart from eating dairy products, specifically yoghurt, Badsha during the recent interview said: “There is no reason now why low bone density would be a problem since aside from diet and nutrition, we can get a once a year intravenous treatment and take oral medications.”

She also advised that adults must undergo bone screenings every year especially when a previous one has shown the signs of weak bones.

Al Attia said: “Doctors in the UAE have all kinds of medications available within reach. Men and must be benefiting from these.”

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