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Osteoporosis: early detection is difficult
Flat feet cause problems with aging EYESIGHT
Health Notes
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Osteoporosis: early detection is difficult
THE human skeletal bones with a reduced mass and increased porosity are observed as osteoporotic bones and the condition is called osteoporosis. The milder condition is known as osteopenia when the process of reduction in bone mass starts. Osteoporosis is a major health problem, affecting an estimated 200 million people worldwide. The fragility in the bone matrix starts when the dietary intake of calcium, protein and vitamins is deficient and not taken in the required quantity. The common factor of hormonal changes affects mostly women in their post-menopausal period (50 to 60 years) when dietary absorption is affected. The senile osteoporosis due to the ageing process is common in the old age, which depends upon the intake of good diet along with a minimum schedule of exercise. The majority of osteoporotic cases involve women above 50 years with post-menopausal hormonal change. The fragile bones with a moderate fall or bump sustain fractures and the risk goes up with an increase in porosity. The fractures need early fixation because prolonged lying down in bed also increases osteoporosis. The quality of bone is very important for every fracture fixation. Despite the availability of good fracture treatment, osteoporosis is associated with significant morbidity and mortality, which places a heavy burden on the individual pockets and society at large. The patients suffer from disability and pain, which are common consequences of osteporotic fractures while the hip fractures are associated with an approximately 20 per cent reduction in survival. An early diagnosis of osteoporosis is difficult, as the patient does not have any obvious symptoms. Only one sign can lead to diagnosis — the feeling of fatigue after only two hours of domestic work and the other sign is prolonged backache not responding to conservative treatment. Osteoporotic patients normally present with a vertebral fracture or a fracture at the hip. The assessment of bone mineral density (BMD) is the only reliable parameter to diagnose osteopenia or osteoporosis. Dual energy X-ray absorptiometry (DEXA) scanning is considered the gold standard for the determination of BMD. The hip and the lumber spine are the preferred sites for BMD measurements. One must start getting ones bones checked every three to five years after 40 years of age. Although BMD is reliable, overall assessment of the patient suffering from osteoporosis should be done in relation to the risk of fracture and clinical treatment effective for the individual patient. BMD assessment should become mandatory in the preventive health check-up in persons above the age of 40 years. Sedentary lifestyle also affects the bones to preserve the bone matrix, and if it continues the bones will definitely show loss of bone mass and become osteoporotic in the early forties. If the BMD test shows T-score -1.5 it is a warning sign and one must start bothering about the body structure. To manage this early osteoporosis, a balanced intake of proteins, vitamins and calcium with a minimum schedule of exercise will help in improving the lifestyle. The treatment guidelines are to prevent the development of osteoporosis and strengthen the bone matrix, which will reduce the risk of bone fracture. The most effective anti-resoptive drugs are bisphosphonates, which are currently considered the treatment of choice. Alendronate is the leading bisphosphonate, which is taken as a weekly morning dose with an empty stomach to overcome the loss of bone. There are many proprietary names of Alendronate but take the advice of your doctor before consuming it. There is no use of taking only calcium just to build up bone mass when osteoclast cells are eating up the bone. It is the combination of alendronates and calcium products, which are most effective to combat the metabolic enigma of osteoporosis. Pharmaceutical companies have come out with convenient oral doses of these products like weekly kits or monthly packs. Some prefer the nasal route in the spray form. The writer is Senior Consultant in Orthopaedics, Fortis City
Centre, Chandigarh.
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Flat feet cause problems with aging OVER the years there has been an all-round increase in awareness regarding the benefits of yoga and remaining fit. However, biomechanics of the body is still a neglected area wherein the feet shape takes the lead. The feet are the most neglected parts of our body. Flat/high-arched feet with a small great toe are a source of many problems, not only for the feet but also the ankles, knee, hip and back. The space on the inner side of the foot is the arch of the foot. The arch of the foot is formed by the tightening of the muscles and ligaments present in the foot. These muscles and ligaments support the bones of the foot. The size of the arch varies from person to person. Individuals with a low arch or no arch are labelled as having flat feet. The arch helps to create the optimum foot/leg position that allows an even distribution of the weight of body across the feet and legs. Flatter the feet, the more seriously is the posture affected. Flat feet could be flexible and inflexible, the former being the more common type. The foot appears flat in a normal standing posture. This condition is usually painless. However, while aging, increased physical activity, etc, could trigger secondary conditions leading to pain. The reason is an incorrect posture triggered by flat feet. During younger days a person’s body is strong and is capable of repairing wear and tear. The damaged / inflamed tissue is regenerated quickly. Aging/obesity exerts excessive stress on the lower limb while performing day-to-day physical activities. An incorrect posture causes wear and tear in the joints and an imbalance of strength occurs in the muscles exaggerating the misery. The physique, when well balanced, exerts the least pressure on the joints and muscles alleviating pain. Inflexible flat feet denote bone abnormality due to disease/ injury. In such cases, two bones in the foot fuse together and
render the foot inflexible and painful. Causes
Diagnosis There are certain self-diagnostic techniques such as taking a wet footprint. Usually more the sole of the foot makes contact the flatter the foot. Treatment: Flat feet as such don’t cause any discomfort. However, enhanced physical activity, aging(due to osteoporosis), sudden increase of aerobic activity, wearing high heels, worn-out shoes, etc, cause pain/ discomfort in the foot, ankle, knee, hip and lower back. Knock knees with flat feet is a common condition usually overlooked by parents. Constant complaining of tiredness/pain while running or playing some sport calls for medical consultation and supervision. In such instances, children should be encouraged to do cycling or swimming to remain active and not become obese.
The children who exhibit flat feet and complain of foot/leg pain should be evaluated before the age of 12 years (i.e. ossification of the bones) in order to achieve complete recovery. The writer runs a pain management clinic in Chandigarh.
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EYESIGHT CATARACT surgery has continuously evolved to reduce the incision size with the use of ever improving technology. The early cataract surgeries involved the removal of the entire lens of the eye, along with the lens capsule. This procedure was known as Intracapsular Cataract Extraction (ICE) and required an incision of 12mm. Patients had to undergo stitches and patching of the eye. ICCE was followed by a technique called Extracapsular Cataract Extraction (ECC), which entailed the removal of the lens while leaving the majority of the lens capsule intact. This procedure brought down the incision size to 7-8mm. Then in 1967, a major breakthrough was made with the introduction of the Phacoemulsification. This technique used ultrasonic waves to remove cataracts and the incision size was brought down a step further to 2.8 to 3.4mm. Phaco was performed using local anaesthesia. This continuous endeavour to reduce incision size and improve the life and safety of the cataract patients finally led to the advent of the Microincision Cataract Surgery. The breakthrough cataract removal technology has radically brought down the incision size to a mere 1.6 to 1.8mm. With this technique, the cataract (opaque lens of the eye) is removed and replaced with a third generation ultra-thin foldable Intra-Ocular Lens (IOL) called Akreos® AO Micro Incision Lens. This lens has been given the Medical Design Excellence Award. The new IOL offers advantages not only in terms of correcting spherical power but also the cylindrical power and aberrations, which translates into a sharp and crisp vision and the smaller incision also leads to faster vision recovery. The path-breaking treatment is quick and virtually painless and is performed as an outpatient procedure that is sure to change the way people look at cataract in the future. Hard facts
The writer is Chairman and Medical Director, Centre for Sight, New Delhi.
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Health Notes Washington:
Researchers have developed a programme that offers a more comprehensive approach to tackle childhood obesity and encourage kids to live healthier lives. They found that a family, school and community intervention programme helps children live healthier lives and could be a new tool in the fight against the nation’s childhood obesity epidemic. In the study, children who participated in The Switch programme developed by the Minneapolis-based National Institute on Media and the Family (NIMF) - watched an average of two fewer hours of television and also consumed two more servings of fruits and vegetables per week than those who weren’t in the programme.
— ANI How to make flu shots
easier for kids
Washington:
Kids often cry or scream when they are about to get an injection. Now, experts from Mattel Children’s Hospital UCLA have offered certain tips to minimise the pain associated with the needlestick. “The good news is that there are several techniques that parents can use to positively impact their child’s experience when getting a needlestick — whether it’s a flu shot, a childhood vaccine, or blood work,” said Dr Lonnie Zeltzer, director of the Paediatric Pain Program at Mattel Children’s Hospital UCLA. “The key is to be creative and use the right combination of tactics depending on your child’s age, the particular procedure being done and the child’s fear level,” Zeltzer added.
— ANI Mind really does matter when it comes to health
Washington:
A new research has suggested that Hippocrates’ opinion on health and illness, that mind is significant in health and healing, is actually true. Nurse researchers and clinicians at the Johns Hopkins University School of Nursing and the Johns Hopkins Hospital are looking at ways to prevent the damage excessive stress does to a young child’s development. They are also looking at how the mind can help speed or slow healing and help control pain.
— ANI Devices that will provide good night’s sleep
Washington: Many people have sleep related problems — some cannot catch sleep, some cannot wake up, and others are troubled because they get less sleep. But here’s some good news for the sleep-deprived: Dr Carol Ash, a sleep expert, a board-certified sleep and pulmonary specialist with the Sleep For Life programme of the Somerset Medical Center in New Jersey, has highlighted many options for the troubled souls on “The Early Show Saturday Edition,” reports CBS News. One of the gadgets pointed out by Ash to help people with sleep problems is: Good Nite Sleep Lite — priced at 35 dollars, this night light is especially meant for kids, just learning to sleep properly. A blue, smiling moon indicates the time for sleeping and a bright, smiling sun replaces it when it is time to get up. Parents can adjust the sun and the moon timings according to the sleep pattern of the child or to improve it.
— ANI |
