Introduction
The bone is a living organ that continues in growth before and after the puberty. Osteoporosis (OP) is characterized by deterioration in the micro-architecture of bone tissue that leads to increased bone frailty and susceptibility to fragility (low trauma) fractures. Preventive measures including patient education and exercise can reduce hip fractures related to osteoporosis.
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Background
No disease has attracted attention in the last 2 decades all over the world, such as osteoporosis. [1]During childhood and adolescence bone formation is dominant. In adulthood the bone goes through a process of removal and replacement through life.'' Most of the adult skeleton is replaced about every 10 years [2]
The limited awareness by physicians and the public about how to effectively predict fracture is a major contributory factor for the occurrence of OP-related fractures. [3] Secondly, early detection of OP remains largely opportunistic, and its confirmation is dependent on clinician referral for objective assessment of bone health, [4] Bone density is best assessed by dual energy x-ray absorptiometry (DEXA) at the hip. [5]
More than half of all women and one-third of all men will experience osteoporotic fractures if they live long enough. [7]And people who created greater reserves of calcium during their youth have more bone mass to be destructed in the osteoporosis-endangered age. [8]The most suitable activities regarding osteoporosis prevention are rather weight-bearing activities or activities using some sports tools when there are created a burden upon the bones. [9] Higher intake of alcohol, caffeine and cola beverages associated with OP and Drinks like Coca Cola contain a lot of phosphorus which leads to hypocalcemia and osteoporosis. [10] Caffeine consumption may increase urinary excretion calcium and subsequently reduce bone mineral density among postmenopausal women but not in young adult women. [11]
Prynne et al [12] report revealed association between fruit and vegetable consumption and bone mineral status in 5 age and sex cohorts. Intriguingly, the results indicate significant positive associations.
The lack of vitamin D also contributes to osteoporosis. [12]Sunshine exposure is a natural source of vitamin D with about 10 to 15 minutes of sunlight several days a week is enough for human body produces adequate quantities of Vitamin D. [13] Lack of exercise makes bone deteriorated. [14] Physical activities regularly play a role as a glue to keep calcium stay in to keep bone, a strong bone. [15]
The aim of study was to determine the knowledge and attitude of osteoporosis among female patients attending Najran university hospital during May & June 2018.
Material and Methods
A cross sectional study conducted in Najran city situatedin Southwestern Saudi Arabia,
Najran University hospital located at the Prince Masha’al discrete area. It serves more than 30000 people around this hospital. It contains more than 17 specialized clinics with a fast growing in different medical health services.The study population included adult female patients attending Najran University Hospitals. A validated questionnaire after extensive literature review & revised by professors of Endocrinology, Family Medicine Doctors & statistician.Any female known to have osteoporosis & female attending orthopedic clinicswere included in the study.Total coverage of all female attending during May & June 2019. A well-trained female nurse distributed the questionnaire to the target population. They have been asked to fill the questionnaire and submit it on the same day.
The data analyzed by using SPSS software version 17 with most appropriate statistical tests (e.g. Chi square test, ANOVA, or student t test). P. value is considered significantly if its value found < 0.05.
Discussion
In order to prevent osteoporosis effectively it is necessary to have the knowledge about the lifestyle risk factors, the positive attitudes towards them and to practice in a corresponding, suitable way.
Our study evaluated the general perception of osteoporosis among patients attending University Hospital in Najran, as well as their knowledge of lifestyle, risk factors, and preventive measures. The results of our study, which are consistent with those of other reports, indicate that several aspects of patients' knowledge and life style could be improved. [16-18, 19]
The results of the current study showed that media sources, such as television and radio were used more often than healthcare professionals to obtain disease related information. This is in agreement with the study by Al Attia et al., which identified magazines, newspapers, and television as the major source of information among patients. [18]
Thus, we recommend that media outlets should be used to deliver disease specific information, as Logsdon et al., have shown such to be effective. [20, 21]
Primary osteoporosis is observed mainly in postmenopausal women and in elderly people. Secondary osteoporosis, on the other hand, is related to predisposing conditions such as genetic diseased, immobilization, use of medicine (medical treatment). [22]
Postmenopausal osteoporosis and osteoporosis of ageing are the commonest forms of the disorder. Of the study women aware of menopause as a risk factor and they accounted for 55.9%. Postmenopausal osteoporosis expresses itself clinically as a fracture. In a study by Sujic et al., that included 1735 fragility fracture patients, 93% of the participants did not think that their fracture was caused by osteoporosis. [23]
Fractures of the hip are more common in women. [24] Of the study women 71.3% were aware of this and 38.9 % aware that male is less susceptible to osteoporosis. Within the first year after hip fracture, there is a death rate of 2-20%. [34] Age is known to be a major factor, affecting both male and female osteoporosis. [25] It is also well known that bone mass decline with age and the reduction is more marked among women than men. [25]
The disease has a strong genetic component. [26] And current study shows 47.3% of the study women aware heredity may be a risk of osteoporosis. A calcium-rich diet is considered important in the prevention of osteoporosis. [27] Most prospective intervention studies have shown a significant effect of high intake of calcium in women after the menopause. [28]
The protective nature of calcium rich diet to osteoporosis known to 69.2 % study women and 88.8 % thought it is essential to use calcium-rich diet for the prevention of osteoporosis. Protein malnutrition and starvation have marked detrimental effects on bone. On the other hand, a high protein intake may result in high rates of cortical bone loss. [27, 28] Meat is main source of high protein. Of the study 53.5% women aware meat is a risk for osteoporosis.
Coffee is risk for osteoporosis known to 84.6%. Whereas tea protective against it known to 24.5% of the study women. Several studies have suggested that the consumption of coffee is associated with a significant increase in risk of fracture. [29, 30, 31] The consumption of tea was found to be a protective factor in some studies. [29, 31] The current study results shows 24.5% of the study women aware of this.
Physical activity is also an important aspect in prevention of osteoporosis. [32]The knowledge about the physical activity (physical exercise) is quite good 32.9% among the study women.
In the current study lack of exercise as a risk factor for osteoporosis was known to 64.7% of the study women. According to a study carried out in north-east England, [33] lack of exercise as a risk factor for osteoporosis was known to 29% of the participants which is less than the finding of this study. Oestrogen appears to be the most important sex steroid in preventing osteoporosis in women. [34] In current study, the role of oestrogens in preventing osteoporosis was known to 48.3 % of the study women whereas in north-east England study [34], the role of oestrogens in preventing osteoporosis was known to 74.9% of study participants which is more than the finding of the current study. Smoking seems to be a very important risk factor according to the literature. [35] Current study shows 54.9% of the study women aware smoking is a risk factor of osteoporosis.Some medications may cause osteoporosis, especially with long-term use. [36] In current study more than half of study women were aware of this. Excess salt (sodium) intake is considered to be one of the causes of calcium loss. [37] Of the study women 38.1% aware of this.
Conclusions
In conclusion, the overall prevention knowledge of osteoporosis among participants was moderate (76.74%); however, a considerable number of surveyed women in our study are unaware of the risk factors and the consequences of osteoporosis. The overall risk knowledge of osteoporosis among participants was 45.7%.Television and radio should be targeted in efforts to raise awareness and provide health education. Future research should examine perceptions in a larger sample of patients, as well as in the general population. This should aid in building and directing future modalities for the prevention and treatment of osteoporosis.
A superficial familiarity with osteoporosis may be giving women a false sense of security about the disease, its severity and its potential impact on their lives. Therefore, we have to conduct public seminars and design leaflets on osteoporosis in addition to making personal efforts in order to make them aware of the disease while there is a chance of changing the risks.
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