Dr M K Mam
Bone and Joint day – an opportunity to introspect Bone and Joint day is celebrated all over India by the Indian Orthopaedic Association (IOA) on 4th of August every year since 2012.The primary aim is to create awareness among people about the various orthopaedic illnesses which can be prevented or treated and be useful to the society. It was on this day in 2012, the President of IOA asked members to have at least one free surgery for poor patient and that activity is taken care of every year on this day .We also have other public awareness programs at state chapters to sensitize the society about the importance of bone health and an increasing impact of bone and joint conditions, how to prevent and treat them.
Celebration is fine, but more than that the day certainly gives us the orthopeadic fraternity an opportunity to reassess and evaluate our performance as regards the achievement of improved bone health of the people and our usefulness to the society. It certainly gives an opportunity to introspect and think about our role in the society. Are we fulfilling the social obligations? What we are today is of course because of our hard work and efforts, but all this could not have been possible without the support and the help from the society. The society has certainly contributed in our making in lot many ways and all of us are well aware of that. We all owe to it and we just cannot forget that. Doctor’s profession has been a noble one, but somehow or other the things have changed to the worse over the years. It is true that the doctor does not command the same respect which he used to command in earlier times and I feel we the doctors are also partly if not fully responsible for it. It is a fact that there have been over all degradation of moral values and the principles in the society in general. The doctor being part of the same society, it is hard to think that he could have escaped from it. Somehow or other there has also been commercialization of the medical education and the profession to a large extent. In recent past lot of talks have been going on in the community and the media regarding the allegations of corruption in the medical profession. It is a fact that the society is aware of many of the doctors doing lot of good work and it does recognize them. But there are also black sheep in the doctor fraternity and it is but for their misdeeds that the profession as a whole is put to shame. Before pointing finger at others, it is appropriate that we honestly look within our selves, do an introspection and try to find why, where, when, how and what has gone wrong and then do the necessary corrections.
Coming to bone health, it is important that we sensitize and educate the people, administrators and the health planners about the importance of bone health. Bones, joints and muscles along with ligaments and tendons form the musculoskeletal system. The bones along with the joints and muscle provide shape, form, support, stability, movements and enable us to do our day today physical activities. Bones do provide protection to many of our delicate internal organs like brain, spinal cord, heart, lungs etc. Bones also serves as the main store house of the minerals – calcium and phosphorus. The marrow present in the bones produces the blood cells. In short, the musculoskeletal system is very important for the body and must take care of its health. It is well known that the poor bone health causes loss of work days and the workplace productivity which affects the economy of the person, the family and the nation as a whole. It is certainly associated with disability and restriction of social activities. It is all the more important that due attention is given to bone health in children and the teen agers as about 40?60% of peak bone mass is built during teen age.
What all has to be done to have a optimum bone health—-
i) Regular physical activity is of utmost important for maintaining the bone health. Bone is a living tissue and it responds to exercise by becoming stronger. According to Wolf’s law bone becomes stronger with loading. Insufficient physical activity certainly leads to osteoporosis. Simple walking, running, jogging, jumping, stair climbing, dancing and playing games are some of the weight-bearing exercises which one can easily do. The most essential thing is that exercise has to be regular. It is most important that the children and the teenagers regularly participate in the physical exercise, outdoor games and sports activities, spend less time on mobile phones, computers and other gadgets. There are evidences to suggest that regular physical activity, especially started in childhood and adolescence is a cheap and safe way of improving bone strength.
ii) Calcium rich diet is essential as calcium is the most important mineral for the bones, so a diet rich in calcium is very essential. It needs to be emphasized that adequate calcium intake in childhood is very important as bone is developing and growing. Children and young people certainly need more calcium than an adult.
iii) Adequate supply of vitamins especially vitamin D is important for calcium absorption and mineralization of bone. An intake of 800 to 1000 international units of vitamin D per day for adults is recommended. Chief dietary sources of vitamin D include vitamin fortified milk .Exposure to sun light does provide vitamin D by way of skin, however because of the life style changes of mostly staying indoors ,most of us are not are able to make use of this free source of vitamin D. Also there is a fear of skin cancer caused by overexposure to sun.
Malnutrition and under nutrition is one of the major problems, seen more often in rural population that too in children. The people do not get a balanced diet, it lacks in important nutrients including vitamin D, calcium etc., thus affecting the overall health. Although lot of work is being done to tackle it, much more needs to be done and it has be done on a war footing that too with the active involvement of the people.
iv) High alcohol intake has to be avoided as it is harmful for the bones. Alcohol damages bone cells directly, inhibits calcium absorption and damages the liver – the organ where activation of vitamin D occurs.
To summarize, there is an utmost need to introspect, assess and evaluate our selves as regards how useful and relevant we are to the society and then have required necessary measures. There has to be an action plan for maintaining the bone health. The people must follow a bone healthy life style which includes enough of physical activity, intake of diet rich in calcium and vitamin D, avoid smoking and excess intake of alcohol.
(The author is Senior consultant orthopaedics, Jammu, formerly, Vice Principal, Prof. & Head of Orthopaedics, Christian Medical College, Ludhiana)
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