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Kale A, Khandelwal N, Sirohi B, Shaki O, Rai S. Knowledge, Attitudes, Practices, and Awareness Levels Among Indian Postmenopausal Women About Osteoporosis and Its Relationship With Sociodemographic Factors: A Cross-Sectional Study From Northern India. Cureus 2024; 16:e59606. [PMID: 38832210 PMCID: PMC11146440 DOI: 10.7759/cureus.59606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/02/2024] [Indexed: 06/05/2024] Open
Abstract
Background Osteoporosis is a silent disease and can be prevented by providing correct and appropriate information to the individuals at risk. Therefore, we aim to find out the levels of knowledge, attitudes, and behaviors of postmenopausal women, the highest-risk group. Methods Between May 2021 and December 2023, a cross-sectional study was done in the Military Hospital in Ambala, India, in 1326 postmenopausal women of age between 45 and 70 years who visited the outpatient department of orthopedics and who previously had a measure of bone mineral density (BMD) or estimation of BMD. All patients participating in the study received a questionnaire that assessed the level of knowledge, attitudes, and behaviors related to osteoporosis. The Osteoporosis Knowledge Assessment Tool (OKAT) was used to assess these parameters. Results The mean age was 60±3.1 years. The mean score for osteoporosis awareness was 6/20 points. A total of 983 (73.13%) had no knowledge about osteoporosis, and 221 (16.66%) had higher knowledge. Knowledge about osteoporosis was low with a mean knowledge score of 7.44±3.16 and a median of 7.2. It was found that those who graduated had some knowledge regarding osteoporosis with the help of either a hospital staff or a family member who had a history of osteoporosis. Conclusions Even among postmenopausal women who know they are at risk and should have BMD, knowledge, attitudes, and behaviors about osteoporosis were found to be quite low. In addition, education and mass communications are needed to increase awareness among women of this age about improving bone health.
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Affiliation(s)
- Amit Kale
- Orthopaedics, Military Hospital, Jammu, IND
| | | | - Bhavya Sirohi
- Orthopaedics, Military Hospital, Agra, IND
- Orthopaedics, Command Hospital, Udhampur, IND
| | - Omna Shaki
- Trauma and Emergency, Military Hospital, Ambala, IND
| | - Sanjay Rai
- Orthopaedics, Military Hospital, Ambala, IND
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Ahmed S, Farooqui AJ, Pradhan NA, Zehra N, Majid H, Jafri L, Khan AH. Assessing the knowledge, attitude and practice of osteoporosis among Pakistani women: A national social-media based survey. PLoS One 2023; 18:e0288057. [PMID: 37948412 PMCID: PMC10637646 DOI: 10.1371/journal.pone.0288057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 06/18/2023] [Indexed: 11/12/2023] Open
Abstract
BACKGROUND There are numerous risk factors for osteoporosis and understanding and recognizing these risk factors is critical when deciding whether to take preventive measures. It is critical to reduce the healthcare expenditure burden of the Pakistani population by raising awareness and implementing osteoporosis-preventable measures. This survey aims to assess the knowledge, attitudes, and practices (KAP) of Pakistani women as well as their misconceptions about osteoporosis. METHODS A cross-sectional survey was conducted from August 2021 to January 2022 by the Bone & Mineral Disease research group at Section of Chemical Pathology, Department of Pathology and Laboratory Medicine, Aga Khan University, Karachi, with exemption from the ethical review committee. Using snowball sampling, a validated Osteoporosis Prevention and Awareness Tool (OPAAT) was disseminated online via social media. With informed consent, 400 Pakistani women aged ≥ 18 years were included in the study. SPSS Statistics version 25.0 was used for data analysis. Chi-square test for association and Fisher-exact test were applied, and significance level was α<0.05. RESULTS Based on the OPAAT scores of all (n = 400) participants, 22% (n = 88) had low knowledge, 44% (n = 176) had average knowledge, while 34% (n = 136) had good knowledge of osteoporosis. The most common misconceptions were about age-related risk, presentation of symptoms, radiation risk, associated risk factors like tooth loss, osteoarthritis, and knowledge about predictors of bone health. CONCLUSION Adult Pakistani women have a fair understanding of osteoporosis, but the OPAAT tool clarifies some common misconceptions. There is a need to develop educational strategies to increase the knowledge of osteoporosis among Pakistani adults and to promote a bone-healthy lifestyle.
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Affiliation(s)
- Sibtain Ahmed
- Section of Chemical Pathology, Department of Pathology and Laboratory Medicine, Aga Khan University (AKU), Karachi City, Sindh, Pakistan
| | - Arsala Jameel Farooqui
- Section of Chemical Pathology, Department of Pathology and Laboratory Medicine, Aga Khan University (AKU), Karachi City, Sindh, Pakistan
| | - Nousheen Akber Pradhan
- Department of Community Health Sciences, Aga Khan University (AKU), Karachi City, Sindh, Pakistan
| | - Nawazish Zehra
- Section of Chemical Pathology, Department of Pathology and Laboratory Medicine, Aga Khan University (AKU), Karachi City, Sindh, Pakistan
| | - Hafsa Majid
- Section of Chemical Pathology, Department of Pathology and Laboratory Medicine, Aga Khan University (AKU), Karachi City, Sindh, Pakistan
| | - Lena Jafri
- Section of Chemical Pathology, Department of Pathology and Laboratory Medicine, Aga Khan University (AKU), Karachi City, Sindh, Pakistan
| | - Aysha Habib Khan
- Section of Chemical Pathology, Department of Pathology and Laboratory Medicine, Aga Khan University (AKU), Karachi City, Sindh, Pakistan
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El Miedany Y, El Gaafary M, Gadallah N, Mahran S, Fathi N, Abu Zaid MH, Tabra SAH, Hassan W, Elwakil W. Osteoporosis treatment gap in patients at risk of fracture in Egypt: a multi-center, cross-sectional observational study. Arch Osteoporos 2023; 18:58. [PMID: 37127804 DOI: 10.1007/s11657-023-01252-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Accepted: 04/19/2023] [Indexed: 05/03/2023]
Abstract
Despite the wide availability of a wide variety of approved osteoporosis medications and DXA scan centers in Egypt, only a minority of patients at high risk of sustaining a fragility fracture receive treatment, even after their first fracture. Such big "treatment gap" leaves the most high-risk individuals unprotected against fragility fractures. This study provides a benchmark to monitor national trends in osteoporosis management and service uptake. PURPOSE To assess the treatment gap among men and postmenopausal women presenting with a fragility fracture, and to analyze the characteristics and fracture risks of the patients presenting with an index fragility fracture. METHODS This was a multi-center, cross-sectional, observational study. Both men and postmenopausal women, admitted with an osteoporotic fracture (whether major osteoporosis or hip fracture), were consecutively recruited for this work. The fracture risk was assessed based on their FRAX calculation prior to the index fracture. All the patients were assessed for their falls and sarcopenia risks. Blood tests for bone profile as well as DXA scan were offered to all the patients. RESULTS Two hundred and thirty-six patients presenting with fragility fractures were included in this work. 70.8% were women and 29.2% were men. Mean age was 70.1 (SD = 9.2) years. Ten-year probability of fracture (without BMD) was high in 65.9% of the postmenopausal women and 40.3% of the men. 82.1% of the postmenopausal women and 100% in men identified to be eligible for osteoporosis therapy did not receive any form of osteoporosis therapy. FRAX score correlated significantly with bone mineral density assessment at both hip and spine. Falls, sarcopenia, and functional disability showed significant relation to the fracture risk. CONCLUSIONS There is a large treatment gap in Egyptian older adults. The recent guidelines for osteoporosis management in Egypt endorsed fracture centric approach to identify people at risk. The gap appears to be related to a low rate of osteoporosis diagnosis and lack of patient education.
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Affiliation(s)
- Yasser El Miedany
- Institute of Medical Sciences, Canterbury Christ Church University, Canterbury, England.
| | - Maha El Gaafary
- Community and Public Health, Ain Shams University, Cairo, Egypt
| | - Naglaa Gadallah
- Rheumatology and Rehabilitation, Ain Shams University, Cairo, Egypt
| | - Safaa Mahran
- Rheumatology and Rehabilitation, Assiut University, Assiut, Egypt
| | - Nihal Fathi
- Rheumatology and Rehabilitation, Assiut University, Assiut, Egypt
| | | | | | - Waleed Hassan
- Rheumatology and Rehabilitation, Benha University, Benha, Egypt
| | - Walaa Elwakil
- Rheumatology, Physcial Medicine and Rehabilitation, Alexandria University, Alexandria, Egypt
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Thomas T, Paul S. A Study to Assess the Osteoporosis Knowledge and Preventive Practice among Menopausal Women: A Community Based Survey. JOURNAL OF HEALTH AND ALLIED SCIENCES NU 2022. [DOI: 10.1055/s-0042-1757968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Abstract
Background and Objectives Osteoporosis is a multifactorial and slowly emerging global health problem. Along with menopause, one out of three women between the age group of 50 to 60 years in India suffers from osteoporosis. Indian women have an early age onset of osteoporosis as compared to their Western counterparts. The current study assessed osteoporosis knowledge and preventive practice among menopausal women. The study's objectives were to 1) assess the osteoporosis knowledge and preventive practice among women, 2) find the correlation between the knowledge and preventive practice among menopausal women, and 3) find the association of knowledge and preventive practice with selected demographic variables.
Methods A quantitative nonexperimental research approach with a descriptive correlational survey design was adopted in the study. A total of 100 samples between the ages of 45 and 56 years were the participants. Data were collected using demographic proforma, a self-structured knowledge questionnaire, and a preventive practice checklist. Descriptive and inferential statistics were used to analyze the data.
Results The majority of the menopausal women (65%) were between the age group of 53 and 56 years and 79% of menopausal women were having primary education, 77% of them were unskilled workers. Fifty percent of the participants had shown adequate knowledge with a median score of 12 and the remaining half of the participants had a knowledge score < 12. The knowledge score among women was 11.47 ± 2.4 with a maximum score of 17 and the minimum score of 5. With regard to the preventive practice, the participants were 20.12 ± 2.22.
Conclusion The study showed a gross deficit in osteoporosis knowledge among menopausal women and they were following unhealthy practices in their lifetime. There is a need to prioritize designing appropriate awareness campaigns regarding osteoporosis among subjects who are at risk, according to their level of literacy.
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Affiliation(s)
- Timi Thomas
- Department of Obstetrics and Gynaecological Nursing, Nitte Usha Institute of Nursing Sciences, NITTE (Deemed to be University), Mangalore, Karnataka, India
| | - Shynee Paul
- Department of Obstetrics and Gynaecological Nursing, PVS College of Nursing, Calicut, Kerala, India
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Hanafy NM, Elsehaimy LA, Alzokm SM, Abd El-Raheem SI. Bone mineral density and risk factors of osteoporosis in children. THE EGYPTIAN RHEUMATOLOGIST 2022; 44:257-260. [DOI: 10.1016/j.ejr.2022.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
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Evaluation of Bone Mineral Density, Serum Osteocalcin, and Osteopontin Levels in Postmenopausal Women with Type 2 Diabetes Mellitus, with/without Osteoporosis. J Osteoporos 2022; 2022:1437061. [PMID: 35198139 PMCID: PMC8860540 DOI: 10.1155/2022/1437061] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2021] [Revised: 01/16/2022] [Accepted: 01/29/2022] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVE Osteoporosis (OP) is a worldwide ailment; we aim to establish new biomarkers in diagnosis by determining the levels of serum osteocalcin and osteopontin along with bone mineral density (BMD) and lumbar T-score, in postmenopausal women with type 2 diabetes mellitus (T2DM) with or without OP. METHODS This observational study included 160 postmenopausal women who were an attendee at outpatient clinics in Al-Hussein Hospital, Thi-Qar province; subdivided into 3 groups based on their T-score testing: Group I (n = 40) comprised postmenopausal women without T2DM as controls, Group II (n = 60) comprised postmenopausal women with T2DM but without OP, and Group III (n = 60) comprised postmenopausal women with T2DM with OP. The dual-energy X-ray absorptiometry was used to measure the BMD (total body, lumbar spine, and femoral) and T-score for lumbar spine and femoral. Glycosylated hemoglobin (HbA1c), fasting blood glucose (FBG), osteocalcin, and osteopontin levels were assessed in all three groups. RESULTS Compared with controls, Group III demonstrated significantly lower BMD (total body, lumbar spine, and femoral), T-score for lumbar spine and femoral, serum osteocalcin, and osteopontin levels than Group II and Group I (P < 0.001). FBG and HbA1c levels were significantly higher in Group III than in Groups I and II (P < 0.001). A negative correlation was proved between HbA1c levels with BMD, osteocalcin levels, and osteopontin levels in the three groups. CONCLUSIONS Iraqi postmenopausal women with T2DM had a significantly lower bone mineral density, serum osteocalcin, and osteopontin levels. These results may serve as adjuvants in screening for OP, particularly among diabetic patients.
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Rundasa DT, Ayisa AA, Mekonen EG. Knowledge, health belief, and associated factors towards the prevention of osteoporosis among post-menopausal women in Metu Town, southwest Ethiopia: A community-based cross-sectional study. Int J Orthop Trauma Nurs 2021; 45:100905. [PMID: 34799291 DOI: 10.1016/j.ijotn.2021.100905] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Revised: 09/23/2021] [Accepted: 09/24/2021] [Indexed: 12/01/2022]
Abstract
INTRODUCTION Osteoporosis is a condition where bones lose mass and strength. It is a common cause of morbidity and mortality in women, especially those of post-menopausal age. It is estimated that 30% of postmenopausal women globally suffer from osteoporosis. This study aimed to assess knowledge, health beliefs, and associated factors towards the prevention of osteoporosis among post-menopausal women in Metu Town, southwest Ethiopia, 2021. METHODS A community-based cross-sectional study was conducted among 422 post-menopause women. A simple random sampling technique was employed to select study participants. Data was collected using a structured interviewer-administered questionnaire. Bivariate and multivariate analyses were condcuted to identify factors significantly associated with the outcome variable. RESULTS The results showed that 38.4% and 44.5% of participants had adequate knowledge and positive health beliefs towards the prevention of osteoporosis. Age, marital status, educational status, employment status, and self and family history of osteoporosis were significantly associated with knowledge. Age, educational status, self and family history of osteoporosis, and sources of information were significantly associated with health beliefs. CONCLUSION More than 40% of participants had adequate knowledge and positive health beliefs. Being younger, better educated, and having a personal and family history of osteoporosis increased the odds of having adequate knowledge and positive health beliefs. Being employed and getting information from families and friends had a significant association with higher odds of adequate knowledge and positive health beliefs.
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Affiliation(s)
- Dawit Tesfaye Rundasa
- Institute of Health Science, College of Nursing and Midwifery, Surgical Nursing Department, Wollega University, Nekemte, Ethiopia.
| | - Aynalem Adu Ayisa
- Department of Surgical Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
| | - Enyew Getaneh Mekonen
- Department of Surgical Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
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El Miedany Y, Abu-Zaid MH, El Gaafary M, El Naby MMH, Fathi N, Saber HG, Hassan W, Eissa M, Mohannad N, Khaled H, Mortada M, Nasef SI, Galal S, Ghaleb R, Tabra SAA, Mohamed SS, Medhat BM, Aly HM, Elolemy G, Fouad NA, Ganeb SS, Adel Y, Ibrahim MME, Farouk O, Gadallah N. Egyptian consensus on treat-to-target approach for osteoporosis: a clinical practice guideline from the Egyptian Academy of bone health and metabolic bone diseases. EGYPTIAN RHEUMATOLOGY AND REHABILITATION 2021. [DOI: 10.1186/s43166-020-00056-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Abstract
Background
This study was carried out to achieve an Egyptian expert consensus on a treat-to-target management strategy for osteoporosis using Delphi technique. A scientific committee identified researchers and clinicians with expertise in osteoporosis in Egypt. Delphi process was implemented (2 rounds) to establish a consensus on 15 clinical standards: (1) concept, (2) diagnosis, (3) case identification, (4) whom to treat, (5) who should treat?, (6) case stratification and intervention thresholds, (7) falls risk, (8) investigations, (9) treatment target, (10) management, (11) optimum treatment duration, (12) monitoring, (13) drug holiday, (14) osteoporosis in men, and (15) post-fracture care and fracture liaison service.
Results
The surveys were sent to an expert panel (n = 25), of whom 24 participated in the two rounds. Respondents were drawn from different governorates and health centres across Egypt including the Ministry of Health. Most of the participants were rheumatologists (76%), followed by internists (8%), orthopaedic doctors (4%), rehabilitation doctors (4%), primary care (4%), and ortho-geriatrics (4%) physicians. Seventy-two recommendations, categorised into 15 sections, were obtained. Agreement with the recommendations (rank 7–9) ranged from 83.4 to 100%. Consensus was reached (i.e. ≥ 75% of respondents strongly agreed or agreed) on the wording of all 15 clinical standards identified by the scientific committee. An algorithm for the management of postmenopausal osteoporosis has been suggested.
Conclusion
A wide and representative panel of experts established a consensus regarding the management of osteoporosis in Egypt. The developed guidelines provide a comprehensive approach to the assessment and management of osteoporosis for all Egyptian healthcare professionals who are involved in its management.
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Paruk F, Tsabasvi M, Kalla AA. Osteoporosis in Africa-where are we now. Clin Rheumatol 2020; 40:3419-3428. [PMID: 32797362 DOI: 10.1007/s10067-020-05335-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 07/20/2020] [Accepted: 08/08/2020] [Indexed: 02/07/2023]
Abstract
Africa is experiencing an exponential increase in the number of older persons. The number of persons surviving with human immunodeficiency virus is simultaneously increasing due to improved availability of anti-retroviral therapy. The burden of non-communicable diseases, in particular, osteoporosis and its consequent fragility fractures, is also predicted to increase. Osteoporosis, however, remains a neglected disease and there are no age-standardized reference data available to accurately screen and diagnose individuals with osteoporosis. Epidemiological studies reporting the incidence of hip fracture or vertebral fractures are limited from Africa, especially Sub-Saharan Africa. The studies are usually limited as they are based on a retrospective data and small study numbers and often from a single study site. However, compared with early initial studies, the more recent studies show that osteoporosis and fractures are increasing across the continent. The overall incidence rates for osteoporosis and fractures still vary greatly between different regions in Africa and ethnic groups. Predisposing factors are similar with those in developed countries, but awareness of osteoporosis is sorely lacking. There is a lack of awareness among the population as well as health authorities, making it extremely difficult to quantify the burden of disease. There is great potential for research into the need and availability of preventive strategies. The FRAX® tool needs to be developed for African populations and may circumvent the shortage of bone densitometry.
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Affiliation(s)
- F Paruk
- Department of Rheumatology, Inkosi Albert Luthuli Central Hospital, School of Clinical Medicine, College of Health Science, University of KwaZulu-Natal, 719 Umbilo Road, eThekwini, Congella, Durban, 4001, South Africa.
| | - M Tsabasvi
- Department of Surgery-Orthopaedics and Traumatology, Harare Central Hospital, Harare, Zimbabwe
| | - A A Kalla
- Department of Medicine, University of Cape Town, Cape Town, South Africa
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E Hassan N, El Shebini SM, Ahmed NH, A El-Masry S, Y El Sherity S, Rasheed EA, S El-Saeed G, Kamal AN. Dietary Pattern and Bone Health in Pre and Post-menopausal Obese Women. Pak J Biol Sci 2020; 23:602-611. [PMID: 32363816 DOI: 10.3923/pjbs.2020.602.611] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND AND OBJECTIVE Obesity and osteoporosis are worldwide health problems that interact with each other. There are also affected by the menopause and dietary pattern. So, this study aimed to find the relation between osteoporosis, body weight and intake of protein, calcium and vitamin D in obese pre and post-menopausal women. MATERIALS AND METHODS One hundred and sixteen shared as volunteers in a cross-section study lasted for 2 years. They were divided into 2 groups, pre and post-menopausal women. All women were subjected to, clinical examination, anthropometric measurements and 24 dietary recalls. They were evaluated for bone mass density, biochemical analysis for serum lipids, calcium and vitamin D. RESULTS Osteopenia and osteoporosis were higher among normal-weight and overweight (non-obese) women compared to obese as well weakly associated with their serum lipids. The mean daily protein consumption was high as compared to recommended daily allowances (RDAs), especially among osteoporotic women. The mean daily intake of vitamin D and calcium was low as the lower level was noticed among the osteoporotic premenopausal patients. The means serum concentration of calcium and vitamin D were adequate. CONCLUSION Data revealed that the prevalence of osteoporosis was lower among obese patients compared to non-obese women. Inadequate daily dietary intake of calcium and vitamin D was reported, however, physiological compensation maintained their optimal normal serum levels.
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Panahi R, Dehghankar L, Hosseini N, Hasania E. Factors Related to Adoption of Osteoporosis Preventive Behaviors among Females' High School Students; a Case Study of Qazvin City. JOURNAL OF EDUCATION AND COMMUNITY HEALTH 2020. [DOI: 10.29252/jech.7.2.105] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
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Mahmoud NS, Mohamed MR, Ali MAM, Aglan HA, Amr KS, Ahmed HH. Osteoblast-Based Therapy-A New Approach for Bone Repair in Osteoporosis: Pre-Clinical Setting. Tissue Eng Regen Med 2020; 17:363-373. [PMID: 32347454 DOI: 10.1007/s13770-020-00249-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Revised: 03/02/2020] [Accepted: 03/04/2020] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Osteoporosis is a metabolic bone disease characterized by low bone density resulting in increased fracture susceptibility. This research was constructed to uncover the potential therapeutic application of osteoblasts transplantation, generated upon culturing male rat bone marrow-derived mesenchymal stem cells (BM-MSCs) in osteogenic medium (OM), OM containing gold (Au-NPs) or gold/hydroxyapatite (Au/HA-NPs) nanoparticles, in ovariectomized rats to counteract osteoporosis. METHODS Forty rats were randomized into: (1) negative control, (2) osteoporotic rats, whereas groups (3), (4) and (5) constituted osteoporotic rats treated with osteoblasts yielded from culturing BM-MSCs in OM, OM plus Au-NPs or Au/HA-NPs, respectively. After 3 months, osterix (OSX), bone alkaline phosphatase (BALP), sclerostin (SOST) and bone sialoprotein (BSP) serum levels were assessed. In addition, gene expression levels of cathepsin K, receptor activator of nuclear factor-κb ligand (RANKL), osteoprotegerin (OPG) and RANKL/OPG ratio were evaluated using real-time PCR. Moreover, histological investigation of femur bone tissues in different groups was performed. The homing of implanted osteoblasts to the osteoporotic femur bone of rats was documented by Sex determining region Y gene detection in bone tissue. RESULTS Our results indicated that osteoblasts infusion significantly blunted serum BALP, BSP and SOST levels, while significantly elevated OSX level. Also, they brought about significant down-regulation in gene expression levels of cathepsin K, RANKL and RANKL/OPG ratio versus untreated osteoporotic rats. Additionally, osteoblasts nidation could restore bone histoarchitecture. CONCLUSION These findings offer scientific evidence that transplanting osteoblasts in osteoporotic rats regains the homeostasis of the bone remodeling cycle, thus providing a promising treatment strategy for primary osteoporosis.
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Affiliation(s)
- Nadia Samy Mahmoud
- Hormones Department, Medical Research Division, National Research Centre, 33 EL Bohouth St. (former EL -Tahrir st.)-Dokki, Giza, 12622, Egypt.
- Stem Cells Lab, Center of Excellence for Advanced Sciences, National Research Centre, 33 EL Bohouth St. (former EL -Tahrir st.)-Dokki, Giza, 12622, Egypt.
| | - Mohamed Ragaa Mohamed
- Biochemistry Department, Faculty of Science, Ain Shams University, El-Khalyfa El-Ma'moun St., Abbasya, Cairo, 11566, Egypt
| | - Mohamed Ahmed Mohamed Ali
- Biochemistry Department, Faculty of Science, Ain Shams University, El-Khalyfa El-Ma'moun St., Abbasya, Cairo, 11566, Egypt
| | - Hadeer Ahmed Aglan
- Hormones Department, Medical Research Division, National Research Centre, 33 EL Bohouth St. (former EL -Tahrir st.)-Dokki, Giza, 12622, Egypt
- Stem Cells Lab, Center of Excellence for Advanced Sciences, National Research Centre, 33 EL Bohouth St. (former EL -Tahrir st.)-Dokki, Giza, 12622, Egypt
| | - Khalda Sayed Amr
- Medical Molecular Genetics Department, Human Genetics and Genome Researches Division, National Research Centre, 33 EL Bohouth St. (former EL -Tahrir St.)-Dokki, Giza, 12622, Egypt
| | - Hanaa Hamdy Ahmed
- Hormones Department, Medical Research Division, National Research Centre, 33 EL Bohouth St. (former EL -Tahrir st.)-Dokki, Giza, 12622, Egypt
- Stem Cells Lab, Center of Excellence for Advanced Sciences, National Research Centre, 33 EL Bohouth St. (former EL -Tahrir st.)-Dokki, Giza, 12622, Egypt
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Chan CY, Subramaniam S, Chin KY, Ima-Nirwana S, Muhammad N, Fairus A, Ng PY, Jamil NA, Abd Aziz N, Mohamed N. Levels of Knowledge, Beliefs, and Practices Regarding Osteoporosis and the Associations with Bone Mineral Density among Populations More Than 40 Years Old in Malaysia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E4115. [PMID: 31731507 PMCID: PMC6861980 DOI: 10.3390/ijerph16214115] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Revised: 10/23/2019] [Accepted: 10/23/2019] [Indexed: 12/16/2022]
Abstract
Osteoporosis is a skeletal disorder commonly found among the elderly, in which the bones become weak, brittle, and more susceptible to fracture. Adequate knowledge and positive attitude towards the disease and osteoprotective activities may prevent osteoporosis, but comprehensive studies to verify this hypothesis are limited in Malaysia. This study aims to bridge the research gap by determining the levels of knowledge, beliefs, and practices regarding osteoporosis and their associations with bone mineral density (BMD) among men and women ≥ 40 years in Klang Valley, Malaysia. In this cross-sectional study, 786 Malaysians (382 men, 404 women) completed a questionnaire on knowledge, beliefs, and osteoprotective practices, and underwent BMD scan using a dual-energy X-ray absorptiometry device. The current study found moderate levels of knowledge and beliefs regarding osteoporosis but poor osteoprotective practices. Osteoporosis knowledge, beliefs, and practices were significantly different based on subjects' demographic characteristics (p < 0.05). Osteoporosis knowledge and beliefs were correlated significantly with osteoprotective practices (p < 0.05). Bone health status of the subjects was associated positively with calcium supplement intake, and negatively with exercise barriers and smoking status of the subjects (p < 0.05). However, no significant correlation was noted between osteoporosis knowledge and bone health (p > 0.05). Conclusively, despite some correlations between individual components, the detachment between bone health knowledge and beliefs, and osteoprotective practices among Malaysians is apparent. Integrating all three components into a comprehensive osteoporosis prevention program is warranted.
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Affiliation(s)
- Chin Yi Chan
- Department of Pharmacology, Universiti Kebangsaan Malaysia Medical Centre, Cheras 56000, Malaysia; (C.Y.C.); (S.S.); (K.-Y.C.); (S.I.-N.); (N.M.)
| | - Shaanthana Subramaniam
- Department of Pharmacology, Universiti Kebangsaan Malaysia Medical Centre, Cheras 56000, Malaysia; (C.Y.C.); (S.S.); (K.-Y.C.); (S.I.-N.); (N.M.)
| | - Kok-Yong Chin
- Department of Pharmacology, Universiti Kebangsaan Malaysia Medical Centre, Cheras 56000, Malaysia; (C.Y.C.); (S.S.); (K.-Y.C.); (S.I.-N.); (N.M.)
| | - Soelaiman Ima-Nirwana
- Department of Pharmacology, Universiti Kebangsaan Malaysia Medical Centre, Cheras 56000, Malaysia; (C.Y.C.); (S.S.); (K.-Y.C.); (S.I.-N.); (N.M.)
| | - Norliza Muhammad
- Department of Pharmacology, Universiti Kebangsaan Malaysia Medical Centre, Cheras 56000, Malaysia; (C.Y.C.); (S.S.); (K.-Y.C.); (S.I.-N.); (N.M.)
| | - Ahmad Fairus
- Department of Anatomy, Universiti Kebangsaan Malaysia Medical Centre, Cheras 56000, Malaysia;
| | - Pei Yuen Ng
- Faculty of Pharmacy, Universiti Kebangsaan Malaysia Kuala Lumpur Campus, Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia;
| | - Nor Aini Jamil
- Faculty of Health Science, Universiti Kebangsaan Malaysia Kuala Lumpur Campus, Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia;
| | - Noorazah Abd Aziz
- Department of Family Medicine, Universiti Kebangsaan Malaysia Medical Centre, Cheras 56000, Malaysia;
| | - Norazlina Mohamed
- Department of Pharmacology, Universiti Kebangsaan Malaysia Medical Centre, Cheras 56000, Malaysia; (C.Y.C.); (S.S.); (K.-Y.C.); (S.I.-N.); (N.M.)
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El Hage C, Hallit S, Akel M, Dagher E. Osteoporosis awareness and health beliefs among Lebanese women aged 40 years and above. Osteoporos Int 2019; 30:771-786. [PMID: 30840113 DOI: 10.1007/s00198-019-04901-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2018] [Accepted: 02/12/2019] [Indexed: 10/27/2022]
Abstract
UNLABELLED Our study investigated the characteristics of Lebanese women population groups with the poorest knowledge of osteoporosis definition, risk factors, and preventive measures in order to identify categories that should be targeted in future campaigns and educational programs. Higher knowledge scores were reached in women who already heard about the disease and had a formal education. As a result, osteoporosis awareness campaigns and educational programs are mostly needed in populations with lower educational levels. INTRODUCTION Our study investigated the characteristics of Lebanese women population groups with the poorest knowledge of osteoporosis definition, risk factors, and preventive measures. METHODS A cross-sectional study, conducted between March and June 2018, enrolled 560 community dwelling women aged 40 years and above. A questionnaire was used to collect data. A proportionate random sample from all Lebanese Mohafazat was used. Data collection was performed through personal interviews. The median was used as a cutoff point for both the Knowledge and Health Belief scales. RESULTS The study results showed that 47.3% of participants had a poor knowledge score. Women who received no education, compared to a higher education and have not previously heard about the disease, had lower knowledge scores. In addition, women not taking calcium and vitamin D supplements and not exercising or exercising less than 20 min per day compared to those having these characteristics had lower osteoporosis knowledge levels. A lower knowledge score was associated with less recognized benefits of adequate calcium intake and regular physical activity, more perceived barriers towards their practice, and a less important health motivation. A lower level of education correlated to the same results. CONCLUSION Lower knowledge scores were reached in women who have never heard of osteoporosis and had a lower level of education. As a result, osteoporosis awareness campaigns and educational programs need to target population categories with lower educational levels.
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Affiliation(s)
- C El Hage
- Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon.
- Notre Dame des Secours Hospital University Hospital Center, Byblos City, Lebanon.
- , Building Carole El-Boustany, Holy Virgin Street, 1st Floor, Damour, Lebanon.
| | - S Hallit
- Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon.
- INSPECT-LB: Institut National de Sante Publique, Epidemiologie Clinique et Toxicologie, Beirut, Lebanon.
| | - M Akel
- INSPECT-LB: Institut National de Sante Publique, Epidemiologie Clinique et Toxicologie, Beirut, Lebanon
- School of Pharmacy, Lebanese International University, Beirut, Lebanon
| | - E Dagher
- Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon
- Notre Dame des Secours Hospital University Hospital Center, Byblos City, Lebanon
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15
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Khashayar P, Taheri E, Adib G, Zakraoui L, Larijani B. Osteoporosis strategic plan for the Middle East and North Africa region. Arch Osteoporos 2019; 14:20. [PMID: 30761432 DOI: 10.1007/s11657-019-0567-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Accepted: 01/21/2019] [Indexed: 02/03/2023]
Abstract
UNLABELLED The first step to achieve a world without fragility fractures is to devise a strategic plan to improve research and planning, and assisting member states to acquire the required financial, technical, and other resources. This article aims to outline the first strategic plan devised for the Middle East and North Africa region proposed by the International Osteoporosis Foundation's (IOF) Middle East and North Africa (MENA) Regional Advisory Council (RAC). PURPOSE Osteoporosis is no exception in this rising tide of non-communicable diseases, not only sharing common risk factors but also contributing substantially to a heavy social and economic burden on society. During the past decade and after the establishment of the International Osteoporosis Foundation (IOF), a goal-directed movement has started to achieve a world without fragility fractures. In order to achieve this goal, regional councils were formed to maximize the effectiveness of national osteoporosis societies in raising awareness of effective prevention, diagnosis, and treatment strategies. METHODS AND RESULTS The first step to achieve this goal is to devise a strategic plan to improve the research and planning, assisting all member states to acquire the financial, technical, and other resources needed in order to achieve a world-class program in the fight against osteoporosis. CONCLUSION This article therefore aims to outline the first strategic plan devised by the IOF's MENA RAC for the Middle East and North Africa region.
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Affiliation(s)
- Patricia Khashayar
- Center for Microsystems Technology, imec and Ghent University, -Zwijnaarde, Ghent, Belgium.,Osteoporosis Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Eghbal Taheri
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Shariati Hospital, Tehran University of Medical Sciences, Kargar st., Tehran, Iran
| | - Gemma Adib
- Syrian Council of Osteoporosis, Damascus, Syria
| | - Leith Zakraoui
- Rheumatology Department, Mongi Slim Hospital, La Marsa, Tunisia
| | - Bagher Larijani
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Shariati Hospital, Tehran University of Medical Sciences, Kargar st., Tehran, Iran.
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Gheita TA, Eesa NN. Rheumatology in Egypt: back to the future. Rheumatol Int 2018; 39:1-12. [PMID: 30406299 DOI: 10.1007/s00296-018-4192-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Accepted: 10/29/2018] [Indexed: 12/17/2022]
Abstract
Medical knowledge in ancient Egypt had a remarkable reputation since rulers of other empires used to request the pharaoh to send them their best physician to treat their beloved ones. Many rheumatologic conditions as giant-cell arteritis, reactive arthritis and other forms of spondyloarthritis have been identified in ancient Egyptian materials. Rheumatologists in Egypt are enormously expanding and mastering the tools that aid them in enhancing the management of rheumatic diseases. More Egyptian rheumatologists are actively participating in the annual European League Against Rheumatism (EULAR) and American College of Rheumatology conferences and those attached to well known state of the art centers are increasing. EULAR certified Egyptian MSUS trainers are effectively performing regionally. This review throws light on the rheumatology practice in Egypt, its progress from ancient times passing through Egyptian medical healthcare services, education systems for rheumatologists, rheumatology associations, an overview on the spectrum of rheumatic diseases through publications in the field till future perspectives. Rheumatology in Egypt is an actively growing and dynamic specialty of medicine with considerable contributions to the world's literature. These days, persistent efforts are mandatory to raise the standard of clinical and basic research, to optimize clinical practice with regard to new biologics, to develop tailored and targeted therapies for the rheumatic diseases, and to meet the medical demands of the exponentially increasing Egyptian population. Opportunities and challenges discussed high-lighten future perspectives needed to boost the rheumatology practice in Egypt.
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Affiliation(s)
- Tamer A Gheita
- Rheumatology Department, Faculty of Medicine, Cairo University, Cairo, Egypt.
| | - Nahla N Eesa
- Rheumatology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
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Senosy SA, Elareed HR. Impact of educational intervention on osteoporosis knowledge among university students in Beni-Suef, Egypt. J Public Health (Oxf) 2018. [DOI: 10.1007/s10389-017-0847-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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18
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Association of bone mineral density and body mass index in a cohort of Pakistanis: Relation to gender, menopause and ethnicity. EGYPTIAN RHEUMATOLOGIST 2017. [DOI: 10.1016/j.ejr.2016.05.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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