Internal Medicine is the branch of medicine that deals with the prevention, diagnosis and non surgical treatment of adults diseases. Internal medicine especially diagonose the diseases which effect the internal organ system but not male or female reproductive organs and neourological diseases.
What is OSTEOPOROSIS
What is this disease?
Does it affect women only?
Do patients know that they are affected with the disease?
Is Calcium alone enough for treatment as thought by lots of women?
What is the role of exercise?
These are all an important questions.
Osteoporosis is a silent disease, a normal bone which is a living tissue that is constantly renewing itself, replacing old bone with a new bone, but with osteoporosis the body loose bone faster than it is replaced. As a result bones weaken, becoming thinner and likely to break. Unfortunately we do not feel this process and osteoporosis can develop without knowing until a fracture can happen.
It affects people over 50 years and gradually increases with age, the most area affected by this disease and cause fractures are hip, spine and wrist. Fractures caused by osteoporosis are more common in women than men with 2-3 fold higher. It affects white Caucasian race higher than other races and is responsible for over a million and a half fractures annually in USA. Of course, there are several risk factors which can predispose for this condition such as smoking, excess alcohol, lack of Calcium and Vitamin D, Thyroid diseases, family history, low weight, chronic steroid use and finally lack of Estrogen either after menopause or after surgical removal of the two ovaries for any reason.
The most important complication of Osteoporosis is different type of fractures and sometimes spontaneous fractures. If fracture happens in the spine it will cause a collapse vertebra and sometimes height loss or curved back or kyphosis. Collapsed vertebra can cause severe back pain but on the other hand pain can be present without obvious fracture on the spine x-ray and this is due to micro fractures and this can lead to the wrong diagnosis like osteoarthritis, so it is very important to think about Osteoporosis and diagnose it early to prevent its complications.
We can diagnose Osteoporosis by doing a test to measure bone density called DEXA scan, which is a radiological test.
The test result can either tell us that the bone is normal with a low risk for fractures or can differentiates between two conditions either the presence of Osteoporosis with a high risk for fractures or a condition called Osteopenia which is the very early stage for osteoporosis and here you have a medium risk for fractures.
DEXA test measure the bone density in two areas, which are the hip and lumbar spine.
As I mentioned, Osteoporosis affects women more than men because the bone density in men is higher than women and the bone loss process in men is much slower with a life time fracture risk in men is about one third that of women. Nonetheless, the incidence of hip fracture in men rises sharply with age, and approaches that in women by age 85 years. It is important to investigate secondary cases of osteoporosis in men which can be treated such as Hypogonadism (low male hormone level), excessive alcohol intake and long term use of steroids used is some type of arthritis.
It is very important to do DEXA scan at the beginning of the steroid treatment and periodically thereafter and even if the bone density was normal, it is accepted practice to start the patients on osteoporosis medication to prevent the development of bone loss with the long term use of steroids.
For the treatment of osteoporosis, it is a wrong practice to use calcium alone to treat this condition as studies showed that calcium alone does not build bone. On the other hand, calcium is important to take in an adequate dose for example women until age 50 are required to take total of 1000 mg daily, this dose should be increased to 1500 mg daily in women over 50 especially if they are not taking hormone replacement. This dose of calcium can be taken partially with food such as milk and dairy products, for example, an 8 oz glass of milk contain 300 mg of calcium, the rest of the daily required dose can be taken as calcium pill. It is also important to combine calcium with vitamin D, which can help absorb calcium from the intestine, it is estimated that the daily requirement of vitamin D is 400 IU if that person exposed to adequate sun light otherwise the dose should be increased to 800 IU daily.
Now, let me speak about a controversial subject, which is Estrogen or hormone replacement therapy. There are conflicting data regarding the benefit of hormone replacement. It is possible now that estrogen alone without progesterone can increase the risk of breast cancer and uterine cancer but on the other hand estrogen can prevents the rapid postmenopausal bone toss and osteoporosis. It is very well recommended that women taking hormone replacement should be under strict medical supervision and doing periodic mammogram and pelvic exam.
It should be mentioned also that Estrogen could cause deep vein thrombosis, increased Triglyceride level and cholecystitis.
There are several medications approved for the prevention and the treatment of osteoporosis and they are not hormone replacement, some of these are easy to take like a weekly pill, but of course, there are some side effects like all other medications and we have to weigh the advantages and the disadvantages for each one.
Finally, I want to remind that osteoporosis is a silent disease, we have to diagnose it early before progressing to its complications like the fractures, so women should seek medical care and screening by doing the DEXA scan as early as 50 years and should the following recommendations to prevent this disease:
- Diet rich in calcium and vitamin D either by food or by tablets as outlined by your doctor.
- Adequate sun exposure without over exposure.
- Regular exercises.
- Avoid smoking and excess alcohol.
- Doing DEXA scan as recommended by your doctor to diagnose osteoporosis early or osteopenia and treat these conditions hopefully to prevent the fractures down the roads.
Nephrology: is a study concerning your kidneys. Being told that you have a kidney disease is a scary thing because many people start thinking about kidney failure and dialysis which is a blood purification process. This might be true if you ignore your kidney disease. Early detection and prevention are very crucial because there are many things can be done at this stage, but once the disease progress to an advanced stage it might be too late to stabilize the kidneys or slow down the progression of the disease. Early detection and prevention are very important especially in patients with high risk factors such those with diabetes mellitus and hypertension. All you need to know if you have a kidney disease is to have a simple inexpensive urine test for albumin and blood test for creatinine.
At Emirates Hospital you will find the best Nephrology Services in Dubai. Our qualified doctors specialize in the management of chronic kidney diseases including diabetic kidney disease. We deal with diagnosis and treatment of hypertension, prevention and treatment of kidney stones, management of electrolytes disturbance such as sodium and potassium. We have the capability of managing patients with end stage kidney disease and arrange for dialysis (blood purification) at different facility where our nephrologists have privileges there. If you are facing any of the above mentioned problems then call us now!
Nephrologists specialize in the management of:
Early detection, prevention and treatment of chronic kidney disease (Kidney failure)
Hemodialysis (blood purification) for patients with end stage kidney disease
Peritoneal Dialysis for patients with end stage kidney disease
Treatment of diabetic kidney disease
Pre-kidney transplant evaluation
Post kidney transplant follow up
Diagnosis and treatment of hypertension
Prevention and treatment of kidney stones
Dialysis vascular access procedures
Insertion of hemodialysis catheters
Treatment of acute kidney failure
Electrolytes disturbance such as sodium and potassium
Emirates Hospital has the best Treatment Of Diabetes Dubai, Abu Dhabi could offer. Patients with Diabetes from all around the United Arab Emirates trust our doctors to give them the best possible treatment for their metabolic diseases.
Diabetes (proper name: diabetes mellitus) is a group of metabolic diseases in which a person has high blood sugar, either due to his/her body not producing enough insulin, or because the cells do not respond to the insulin that is produced. The classical symptoms produced by this high blood sugar include frequent urination (polyuria), increased thirst (polydipsia) and increased hunger (polyphagia).
There are three main types of Diabetes:
- Insulin-Dependent Diabetes Mellitus (IDDM): caused when the body fails to produce insulin, and requires the person to inject insulin.
- Non-Insulin-Dependent Diabetes Mellitus (NIDDM): caused due to insulin resistance, a condition in which cells fail to use insulin properly, sometimes combined with an absolute insulin deficiency.
- Gestational Diabetes: is when pregnant women, who have never had diabetes before, have a high blood glucose level during pregnancy
At Emirates Hospital, our mission is to reduce incidence of diabetes by providing our diabetic patients and their families with specialist medical care and supervision. Our doctors will provide you with the correct information and education on Diabetes, while offering support and empowerment for you to lead an active and healthy life. You will get the most excellent Treatment Of Diabetes Dubai Emirates Hospital.
Liver diseases can be quite difficult to diagnose and treat. Emirates Hospital has the best and the most qualified team of Liver Specialists at your convenience. Our diverse range of Liver Specialists Dubai are here to cater to your needs and treat your lover disorder in the most efficient and successful manner.
Different types of doctors diagnose and treat patients with liver disorders. Emirates Hospital comprises of all such doctors, including primary care physicians (PCPs), and Liver Specialists like gastroenterologists, hepatologists, or infectious disease specialists.
Our Liver Specialists are well aware of the branch of medicine known as Hepatology that incorporates the study of liver, gallbladder, pancreas, and biliary tree, as well as management of their disorders. The most common liver diseases are caused by either alcohol or viral hepatitis, which the main reason for seeking advice from Liver Specialists. Whatever might be the reason or cause for your liver disorder, you can come and consult our Liver Specialists Dubai and get the most reliable treatment for it anytime you like.
Hypertension, or in simple words, high blood pressure, is a common condition found in people these days. Emirates Hospital offers the best Hypertension Treatment Dubai could ever have at your service. Come and visit our hospital and get yourself the most successful Hypertension Treatment in Dubai.
The chronic medical condition in which the blood pressure in the arteries is chronically elevated is known as Hypertension (HTN). Since with every heart beat, the heart pumps blood through the arteries to the rest of the body, and due to Hypertension, the heart needs to work harder than normal to circulate blood through the blood vessels. This could lead to organ damage and several illnesses such as heart attack, heart failure, stroke, aneurysm, or renal failure.
Emirates Hospital offers the best Hypertension Treatment Dubai across the entire United Arab Emirates. Our specialists are skilled and know the finest treatment for your Hypertension. With us, you are in safe hands!