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The case study states Mrs BR's is suffering from high blood pressure (BP). This is evident from her Systolic Blood Pressure (SBP) which is 136 mmHg and her Diastolic Blood Pressure (DBP) 84 mmHg. Perindopril is a medicine that is used for treating high BP, that significantly reduces complications such as myocardial infarction, stroke, other kidney-related disorders etc (Mayoclinic.org, 2022). This medicine is used alone or with other medicines as well to reduce the workload on the heart. Mrs BR is already having a 10-year history of hypertension; however, it is currently controlled.
Postmenopausal women have a higher risk of developing osteoporosis disease, where the bones become porous and fragile. Menopause is a natural phenomenon that occurs ages between 45 to 55 years. Female reproductive hormone, oestrogen levels get dropped significantly at menopause. This hormone plays a critical role in maintaining bone health in women starting from menarche at puberty. However, before menarche, ossification is mainly regulated by “Growth hormone” as well as “Insulin-like growth factors (IGF)”. Skeletons are constantly being “Reabsorbed” and “Replaced”. This turnover of bones is controlled by three types of bone cells- osteoblasts, osteoclasts, as well as osteocytes. The osteoblast cells respond to a large number of endocrine glands such as thyroid and parathyroid etc., and among them, the ovary is significant that releases oestrogen hormone (Cannarella et al. 2019). It controls the mineralisation as well and controls the activities of major bone-resorbing cells like osteoclasts.
The bone calcium pool turnover takes place every 5-6 years and bone-resorbing osteoclast cells begin this process. They use lactic acids and citric acids to dissolve the bones and on the other hand, use proteolytic enzymes to digest the organic matrix of bones. Bone formation osteoblast then plays a critical role to synthesise new bone by replacing resorbed bones. The formation exceeds bone resorption during the growth phase which is done under hormonal control. Following puberty, this bone maintenance such as maintaining normal bone density, accelerating osteoblast functions and reducing osteoclast functions are controlled by this oestrogen hormone. Menopause is associated with low levels or completes stoppage of oestrogen hormone that causes increased bone restoration over bone formation, leading to “Osteoporosis” (Emmanuelle et al. 2021). This is why the term postmenopausal is important for Mrs BR for diagnosis of Osteoporosis.
Other than oestrogen hormone, “Parathyroid hormone” (PTH) also plays a crucial role in osteoporosis. This hormone maintains the blood calcium level by increasing calcium absorption by the intestine and stimulating bones to release calcium. Hyperparathyroidism-like condition, where the release of PTH increases in the body enhances bone resorption than bone formation causing osteoporosis. Numerous studies have indicated this hormone helps in bone regeneration and so, doctors recommend one daily injection to patients with bone fractures (Wojda& Donahue, 2018). Moreover, a short-term daily dose of this hormone to osteoporosis patients helps to improve bone strength and bone density. The receptors of this hormone are present in osteoblast, osteoclast-like cells that stimulate bone formation over bone resorption, which is necessary for osteoporotic patients. Therefore, PTH hormone therapies are prescribed to these patients for treating this condition.
Mrs BR can incorporate calcium-rich food in her daily diet that will help her to provide adequate calcium necessary for bone formation and help her to stay healthy. Egg, milk, milk products, fish, chicken, ragi, etc are some of the richest sources of calcium.
Mrs BR can take vitamin D supplements which help in calcium absorption in the body, necessary for bone formation. Moreover, calcium tablets can be incorporated to supply more calcium to the body.
She can have short-term PTH doses to improve bone formation and get relief from this state.
Quiz
These are single-celled…. Bacteria
Generally transmitting through…. Parasite
These can …. Bacterial spore
These microorganisms… Bacteria
Digest food…. Bacteria
These have a hard…. Bacterial spores
These infectious agents …. Virus
A disorder of str…. Disease
Germs that… Colonisation
The invasion and…. Infection
Option b
Answers are- a, c, d
People with infection… Indirect contact
Parasites…. Vector-borne
Skin to skin… Direct contact
Infection can also…. Bloodborne virus transmission
They include…. Standard precautions
b, d, f, g
1 Immediate ….
2 If it is….
3 If policies …..
Used syringe- General rubbish
Used but not visibly soiled- General rubbish
Unused glass blood tube- Sharp container
1. Don gown/apron
2. Don mask
3. Don protective eyewear
4. Hand hygiene
5. Don gloves
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