Thursday, 26 January 2012

GYMMING-Myths and Realities.

The iron begins to grow within them spreading its tendrils into whole body gently and steadily, taking control of mind and soul.Body building is a passion,worship and dedication towards ones’ own body.They hear whispers all around,”You will grow”.As the iron continues to grow,it spreads its branches all over and people identify them as proud result of salty sweat drops,deserving a fitter tighter and toned body.Others can readily see their shame and find numerous excuses.Whenever the builder looks into mirrors their eyes see only ever growing branches with red hot iron flowing inside them and profound happiness there after.
As more iron is pumped into their bodies,they become rosy,their flash begins to swell,and they swim into sea of strength as wave after wave of sweat is converted into iron.

We live in a society highly poised by Myths and exercises and gym are not spared either,I’ve tried to accommodate important myths-
1.Herniated/bulging disc means no Gym.-This finds no relevance,member has to be just careful by not lifting too much weight and avoid exercises involving undue strain on back,with cautious approach and under supervision of a experienced instructor and by abiding all rules member can achieve desired results,many known Hollywood celebrities and bodybuilders have these problem. Strengthening and stretching of back muscles(extensor) helps in controlling protruding disc towards rear.For anterior bulging flexor muscles needs similar activity.Do not try to do experiment on your own speak to your medical professional(neurosurgeon,if possible) and certified gym instructor .
2.Very obese and cardiac patient means no Gym.-Yes, if you recently had a cardiac surgery otherwise gym is for all from 8 to 80 yr old.Of course you can’t run or sweat like a person in his teens,but certainly by following proper advice from your medical health professional along with tips from certified gym and fitness instructor,you can reach goals. Bariatric surgeons pose a very rosy picture of instant weight loss,what they conceal is restrictions one has to follow there after,believe me restrictions are far much tough then needed to loose weight naturally.I very often see patients in Emergency Department post bariatric surgery ,howling and screaming in pain and other related side effects.Some time will write an article on this surgical intervention.
3.Diabetics should avoid Gym.-In my view,diabetes is one of the medical condition which shows instant results with exercises.Blood sugar levels drop significantly reducing demand doses of insulin or other oral anti-diabetic tablets,During exercises muscles takes up glucose on its own and thereby keeping sugar levels low for hours but don’t do rigorous exercises which may lead to very high blood sugar drop,again you need to consult medical professional.
4.Gym is only for youngsters.-A myth again,as stated above gym is for people from 8 to 80 years,but the sooner the better theory works here.It is easy for adolescents,teenagers to develop and build muscular mass then for a grown up but then never the less,exercise in any form is important for anyone on Earth…
5.Heavy weight training will make you huge and masculine.-Very often one can find someone with huge body and lifting significant quantity of weight,what one does not count, is the immense hard work and gradual approach which made him generate that muscular mass,guys patience is the key word.In general women are not able to generate muscular mass the way man do,for doing so she has to put in lot of efforts involving extensive long term exercises under supervision,genetic mapping,strict and nutritious diet with supplements(legal or otherwise).
6.Steroids and other banned substances have no or practically minimal effect on body.-They create havoc,though they are the shortest,easier way to perfect body but then one has to pay dear,after few years,erectile dysfunction,impotence,kidney,liver failure ,etc.are very often seen.
7.One can change the shape of muscles.-There are lot of noises at the gym about reshaping your muscle mass,or for how to build that super looking Biceps,Triceps and Abs.The response is individual, shape of your muscle is genetic.Even the way muscles are attached to bones and joints is somehow related to genes and vary individually.So no matter what you do,shape cannot be changed.You can ,however make them big and stronger.
8.Fat of certain area can be removed with exercises.-It is not possible to isolate a particular area for fat reduction,our bodies simply cannot react to this approach,it will reduce fat from whole body at the same time,to get maximum results one should schedule exercises involving large muscle groups.
9.Protein shakes and drinks will make gain muscle.-Muscle mass depends upon the way you schedule your exercises and volume of weights.Protein supplements should be used if your weight volume is high otherwise it is always good to take natural protein from products like fish,meat and dairy products.Any extra protein is converted to fat and stored in body the way carbs do.
10.Extra hours in a gym means additional benefit.-Mother of all myths,Over and exhaustive exercises without following a schedule will instead harm the body building process means instead of gaining muscle mass you will loose it , when inside the gym dedicate completely give your best but thereafter allow your muscle to rest so that body can recuperate.Average workout shouldn’t be more then an hour,if it is so either you are taking extra breaks in between or not following schedule properly.
11.Latest and swanky equipment’s need of the hour.-True to some extant,but best bet still remain those inexpensive dumbbells.Latest equipment’s do augment your workout to some extant but proper combination of simple exercises,multiple dumbbell regimes ,is what you need more then those swanky looking expensive giants which are more commercial in nature when weighing benefits.
12.Fat is always bad.-All fat is not bad,extra fat is like store house of body,used in emergency.Problem starts,when accumulation of fat is more then required and it mainly depends upon the area of accumulation..Researches have shown that comparing two overweight people,one might be much healthier than the other.Carrying extra fat around midsection or belly fat has been now associated with high risk factors diabetes,heart disease,hyperlipidemia,erectile dysfunction and what not. Pear shaped pals with fat around thigh,hips and buttocks are considered healthy.
13.People around will laugh if I don’t pump-in hard.-This I sometime call as Gym Ego,I’ve noticed while workouts that many members just try to lift heavy weights to impress even if the exercise is not being carried properly.Remember building muscle mass and gaining strength is a gradual process which needs utter dedication and utmost postural care so that no injuries are suffered.”Shed that false ego inside you “.Do not hurry or try shortcuts you will build your muscle mass one day and will be able to lift desired weights.
14.Pregnancy means no gym.-Abiding few basic rules and advice budding mothers can do exercises and gym,in fact regular exercises helps to improve metabolism,build immunity and de-stress the body.    

Saturday, 17 December 2011

Contact Lenses-Myths and Realities

Contact lenses,these tiny weightless and invisible pieces have changed the way each of us sees the world.Ask an actress,an actor,a model list has become endless for what contact lenses do for them,a thing which was introduced to correct eyesight issues and certain medical ailments has now become one of the major cosmetic tool.Eminent painter Leonardo da Vinci illustrated the concept of contact lenses in fifteenth century,for centuries different people tried to develop them,initial contact lenses were made out of glass which used to cover whole of the eye and were heavy making it cumbersome for use and were worn only for 2-3 hours.It was only in 1970s’ when American company Bausch and Lamb commercially launched soft contact lenses which actually revolutionized the idea of contact lens vision.Latest introduction to the list of available contact lenses are, Custom-manufactured silicone-hydrogel lenses launched in 2010.
There are three types of contact lenses:
  • Hard lenses, the original type of contact lens, now virtually obsolete
  • GP contact lenses or rigid gas permeables,or RGPs
  • Soft lenses, made from gel-like plastic .
      • Conventional-used for months/year.
      • Disposable-used for a day/weeks/months
Contact lenses are like two edged sword,you use them properly –rewarded ,if you don’t –punished.Few years back U.S President injured his eyes while wearing contact lenses,so badly that he was probably hospitalized.
Numerous myths have been surrounding these little oval shaped structures,I’ve taken help from some of my opthal colleagues and contact lens companies websites to formulate this post.
1.Contact Lenses are just waste of money,a marketing gimmick.
  • A myth,Contact lenses today has become the need of the hour,offering one of the most modern,reliable and non-invasive method of vision correction.
  • Contact lenses have numerous advantages to a spectacle wearer and weighing the benefits they are not very expensive. Besides, due to technology enhancements and increased demand they are very much affordable.
  • The advantages that contact lenses offer are:-
    • Contact lenses enhances field of vision and distortion free vision as they move with the eye movements.
    • Contact lenses give your natural looks back
    • Contact lenses are best for people who are in outdoor sports & other physical activities like dancing, jogging.
    • Contact lenses offer an opportunity to a spectacle wearer for sunglasses
    • During temperature changes, contact lenses do not fog up like spectacles do.
    • Contact lenses do not leave tell-tale marks on your nose as spectacles do.
    • Contact lenses helps you to change color of the eye,any shade/color –you name it and it is there.
2.Contact lenses will improve/stabilize eyesight.
  • Contact lenses help only in clearer and better vision with advantages as written above,while offering no solution to refraction error or power no.,which are actually related to medical ailments in body,changes in eyes,etc.
3.Contact lenses are tough to handle
  • No, not at all.Just a teaching of 20-25 min will do.lenses these days are easy to handle and use,you need to take care of sanitation and hygiene issues.
4.Contact lens are uncomfortable to wear.
  • With modern technology and customized lenses ,after a brief adjustments and adaptation period ,they have become very comfortable to use .Yes to certain percentage of people they are troublesome but once cause is notified problem in general is resolved.
5.Contact lens maintenance is cumbersome and tough.
  • Gone are the days when it was, one need to sterile them into sterilizer,dip into tablets,wash them after few hours,etc.,these days one bottle solution has made cleansing,sanitization and maintenance issue so easy. But if you are too lazy for that also opt for daily disposable or a month wear type lenses will do.
6.Contact lens could go inside my eyes.
  • This is termed as wearied thinking ,till date how many times your tears or eyelash or any foreign particles got inside,answer would be no…Mother nature has taken care of this.A very thin invisible layer covers human eye and connect from inside to eyelid making this impossible..
7.Contact lens causes eye diseases/infections.
  • This is a rare possibility these days if you a alert and do’s and don’t follower,but then certain people do get diseases which are mostly reversible after discontinuation of lenses.I’ve mentioned about possible complications at the end of this.Contact lens industry will never highlight this part but this should be kept in mind,after all eyes are most precious…
8.Contact lens – very high power means thickness and discomfort
  • No not at all,with specialized material used and modern technology these days have made all lenses irrespective of power of same thickness.
9.Contact lens-Presbyopia/astigmatism means I can’t wear contact lenses.
  • No,contact lens on the contrary improves astigmatism,a type of refractive error(toric lenses) and there are lenses for presbyopia(mono vision lenses).
10.Contact lens can come(pop) out of my eyes suddenly.
  • Old hard lens had some problem but with the invent of these new lenses this is not a cause of worry any more.
11.Contact lens can’t be worn at night while sleeping.
  • Ideally lenses should be removed after normal usage but these days continues wear category lenses are being introduced by lens companies in the market ,claiming they can be used for 30 days without removal/cleansing,this claim has been challenged by many ophthalmologist ,research paper of Dr.Umang Mathur-says lenses can be worn maximum for 6-7 days.
12.Contact lens –Conventional or Disposable.
  • This is a general question asked , most of the people think that all lenses are same ,no,these days range of lenses have become vast ,so one needs to visit ophthalmologist to find suitable lenses. Here I’m just giving a slight comparison between the commonly asked difference.
      • Conventional are cheap,last longer but are infection prone and ned high maintenance.
      • Disposable are less infection prone,clarity of vision remains same through out as there is less deposition of protein and bacteria.
      • Some claim that disposable lens provide high level of oxygen flow to eye making it healthy.I was unable to find any research paper/article on this issue.
13.Colored contact lens are harmful.
  • No not at all,colored contact lens use FDA/other authorities approved color and material ,after all its all about eyes,but yes you cannot use them as frequently as normal contact lens,colored lenses these days are very common in movies,dramas and even normal parties to give a different look.
N.B;-RGP lenses are best suited for,Keratokones and Post R K Disorder.
  • Lens industry always poses a rosy picture about contact lens usage but they might create some infections and might damage eye/power permanently if one does not adhere to guidelines of lens usage.
        • Keratitis-symptoms.
              • Blurred vision
              • Redness/Itching of eyes.
              • Discharge/tear from eyes.
              • Pain.
              • Feeling of some foreign body inside eye.
        • Corneal Ulcer.
        • Corneal abrasions(scratches).
  • Any quires to this post are welcome.

Friday, 18 November 2011

Gonorrhoea-Sexually Transmitted Disease/A summarized preview

One of the commonest STI ,caused by Neisseria gonorrhoeae.
This infection can spread from any form of sexual habit be it oral or vaginal or anal from the infected person.Prevalence of this infection is same in both genders,but in females particularly this infection severely effects their reproductive system and can even infect eyes.
Clinical Gonorrhoea Symptoms:- MALE
        • Burning,pain and itching while passing urine.
        • Abnormal colored and foul smelling discharge from penis.
        • Swollen or redness over penis opening.
        • Tenderness or swollen testicals.
        • Increased frequency of urination.
        • Sore and painful throat.
 Clinical Gonorrhoea Symptoms:-FEMALE
        • Burning,pain and itching while passing urine.
        • Increased frequency of urination.
        • Abnormal colored and foul smelling vaginal discharge .
        • Fever.
        • Pain abdomen specifically lower abdomen.
        • Painful Intercourse.
        • Sore Throat.
Gonorrhoea leads to:-
        • Infertility.
        • Pelvic Inflammatory Disease.
        • Salpingitis.
        • Infection to fetus during pregnancy or newborn at the time of birth.
        • Joint pain and infections.
        • Infection leading to damage hart valve.
        • Meningitis.
Gonorrhoea Prevention and Treatment :- Please refer this link on PID.

Wednesday, 16 November 2011

Pelvic Inflammatory Disease(P.I.D)-A summarized preview.

What is Pelvic Inflammatory Disease.
PID refers to female diaspora,in general.The usual infection starts from cervix/vagina of females involves female reproductive system(Endometrium and/or fallopian tubes)and may even extend further involving different organs/systems of stomach and near by areas.PID is sometimes caused due to other inflammatory foci,like inflammation in adjacent areas.,eg appendicitis or due to hematological manifestations eg.Tuberculosis or due to some other infections.Intrauterine infections are primarily due to STIs’ or secondary due to surgical procedures.
Pelvic Inflammatory Disease(PID) is caused primarily by N.gonorrhoeae which causes gonorrhea and sometimes by Chlamydia. trachomatis which is linked to be a causative factor for Human T-cell Lymphotropic virus Type-1.There are few other organisms also but I don’t think mentioning them over here is worth as my main intention is to make this blog for general public awareness and discuss about myths and misconceptions and not for medicos for whom tons of medical material can be found everywhere.

Clinical Signs and Symptoms for Pelvic Inflammatory Disease:-
  • Fever.
  • Abdominal tenderness.
  • C reactive protein levels are increased.
  • Abnormal vaginal bleeding.
  • Yellowish vaginal discharge.
  • Ano-rectal pain or bleeding-though rarely..
Main signs and symptoms to remember for PID risk:-
    • Sexually active young females and even other sexually active females with prolonged pain abdomen where no other cause is found.
    • Pelvic tenderness on manual pelvic examination.
    • Cervical motion tenderness.
    • Incidence of lower genital tract infections.
PID leads to:-
    • Infertility.
    • Increased risk of ectopic pregnancy and hysterectomy.
    • Salpingitis,etc…
Prevention of Pelvic Inflammatory Disease:-
    • Regular and periodic screening leads to early detection even in symptom free patient. One should be faithful,avoid multiple partners and casual encounters. 
Treatment of Pelvic Inflammatory Disease:-
    • There are two goals for treatment :first is to treat the patient and secondly taking detailed history of sexual behavior from the patient and than locating each and every partner for treatment and curtailing spread of infections.Health providers in US are bound by the law to inform their respective health boards regarding gonorrhoea and clamydia diagnosed individual,law makes sure that patient turns for regular and prompt follow up and all its partners are located and treated.
    • Regular and prompt Anti-biotic coverage.(Names of Antibiotics are not provided in fear of self-medication).
    • Rarely Surgical intervention.
    I’ve tried to summarize what PID is,avoiding many confusing and difficult terms,for any further clarification either drop a mail to me or meet your local health professional.

Tuesday, 15 November 2011

Sexually Transmitted Diseases/Sexually Transmitted Infections-Myths and Realities.

Recently, I received a mail from one Julia of Florida,age 40 years,asking me some queries regarding Pelvic Inflammatory disease(a kind of a syndrome related to STI).I was surprised  about the nature of questions which were asked,showed the extent of sheer ignorance and myths which may be prevailing in a civilized world like US,prompted me to leave other  posts and concentrate on the much burning and important topic-STD.or better known these days as Sexually Transmitted Infections(STI) or Venereal Disease ,over the next few weeks I will try to write as many possible myths and  realities about different infections .Curiously I tried to search about STI’s on different health and medical sites but most of them seem to have out dated material loaded or techniques which are not used these days.It is invariably not possible for me to write about each and every venereal infection separately but with best of my knowledge and resources available to me I have tried to compile about the most common myths.
STIs’ can be broadly classified into three types,which again are divided into three types,Bacterial,Viral and Others(Fungi,protozoan)
    • Infections primarily through sexual route.
    • Infections but not predominantly through other  routes,but sexual is a possible route.                                              
    • Infections through Oro-fecal  route,In gay communities.                                                                                           
      • SYNDROME
      • AIDS
      • Urethritis: males:-
            • Epididymitis
      • Lower genital tract infections: females:-
            • Cystitis/urethritis
            • Mucopurulent cervicitis
            • Vulvitis
            • Vulvovaginitis
            • Bacterial vaginosis (BV)
            • Acute pelvic inflammatory disease
            • Ulcerative lesions of the genitalia
            • Complications of pregnancy/puerperium
            • Proctitis
            • Proctocolitis or enterocolitis
            • Enteritis
            • Acute arthritis with urogenital
            • infection or viremia
            • Genital and anal warts
            • Mononucleosis syndrome
      • Infertility
      • Intestinal infections
      • Hepatitis
      • Neoplasias
      • Squamous cell dysplasias and
        cancers of the cervix, anus, vulva,
        vagina, or penis
      • Kaposi’s sarcoma, body-cavity
      • T-cell leukemia
      • Hepatocellular carcinoma
      • Tropical spastic paraparesis
      • Scabies
      • Pubic lice
      • I’ve compiled this list to make people understand that what all names are STIs’.
      • With inputs from Harrison's Medicine.

Here I will write about  most common myths pertaining practically to all STIs’ but before doing so pals ,answer the following very nice effective questionnaire,every one should ask oneself.
In order to provide the best care for you today and to
understand your risk for certain infections, it is necessary
for us to talk about your sexual behavior.
Screening Questions:
(1) Do you have any reason to think you might have a
sexually transmitted disease? If so, what reason?
(2) For all adolescents <18 years old: Have you begun
having any kind of sex yet?
STD History:
(3) Have you ever had any sexually transmitted diseases
or any genital infections? If so, which ones?
Sexual Preference:
(4) Have you had sex with men, women, or both?
Injection Drug Use:
(5) Have you ever injected yourself (“shot up”) with
drugs? (If yes, have you ever shared needles or
injection equipment?)
(6) Have you ever had sex with a gay or bisexual man or
with anyone who had ever injected drugs?
Characteristics of Partner(s):
(7) Has your sex partner(s) had any sexually transmitted
infections? If so, which ones?
STD Symptoms Checklist:
(8) Have you recently developed any of these symptoms?
For Men For Women
(a) Discharge of pus (a) Abnormal vaginal discharge
(drip) from the penis (increased amount,
(b) Genital sores (ulcers) abnormal odor, abnormal
or rash yellow color)
(b) Genital sores (ulcers),
rash, or itching
Sexual Practices, Past 2 Months (for patients answering
yes to any of the above questions, to guide examination
and testing):
(9) Now I’d like to ask what parts of your body may have
been sexually exposed to an STD (e.g., your penis,
mouth, vagina, anus)?
Query About Interest in STD Screening Tests (for
patients answering no to all of the above questions):
(10) Would you like to be tested for HIV or any
other STDs today? (If yes, clinician can explore
which STD and why.)
Source: Adapted from JR Curtis, KK Holmes, in KK Holmes et al (eds):
Sexually Transmitted Diseases, 3d ed. New York, McGraw-Hill, 1999.

Myths and Realities.
    1. I will not get infected with occasional change of partner.
      • A myth,sleeping with changed partner even once can infect you even though he /she appears to be a healthy lad,in my clinical experience generally people are reluctant even before medical professionals to accept about STI’s leave aside discussing with partners or many a times people aren’t aware that they are infected due to lack of symptoms,if infection is in early stage .While few infections like HIV have incubation period which may even last for years ,making one just a carrier and  infect others.
    2. I will not get infected with use of condoms.
      • True to some extent that it is the best possible barrier available today but if used with a infected person regularly can give infection in event of a mal function,leakage of bodily fluids,rupture,etc.
    3. I am already infected with one STI so I won’t be infected with other type.
      • This is one of biggest myths about STIs’,as written above STIs’ can be viral ,bacterial ,fungal,etc. meaning different kind of micro organisms are involved,so therefore an individual can suffer from two even three-four STIs’ at the same time.
    4. I am pregnant so won’t get any STI .
      • This is one of the myth, I don’t understand that even highly educated women around believe,beautiful mothers !!!this is a complete non sense,rather any STI can create  havoc to mother as well as fetus, adding to it, many medicine used to treat STI may have a cascading effect on  fetus which may even surface after few years of child birth.
    5. HIV cannot be cured so do other STIs’.
      • Yes HIV cannot be fully cured,but with proper treatment and care can be controlled to give patient a prolonged life span.
      • Regarding other STIs’ bacterial ones can be fully cured if diagnosed early and treated properly,few viral STI’s even have vaccines while other respond to anti-retroviral therapy.
    6. I will not get infected by using oral or anal route.
      • No,any minor injuries or cut on skin will make micro organisms to penetrate into oral cavity or anus or genitals.
      • Few STI’s like Herpes can spread just by  rubbing or skin to skin contact or kissing with the infected person.
    7. Contraceptive pills provide some protection against STIs’.
      • A complete myth,these pills are effective in controlling pregnancies,they have no roll whatsoever regarding STIs’,Condom is the best effective measure against STI.
    8. Circumcision means no STIs’.
      • A myth again ,this notion prevailed so strongly for years especially in African community that even people in Western world circumcised,but lot of studies over the years have proved this absolutely wrong.
      • In fact ,many researches have proved that circumcision should be done when medically justified,otherwise it is like giving yourself pain and agony with no use at all.
      • Please note I am not against religions/ethnic groups practicing circumcision but what ever I have mentioned is quoted from best researches available till date.

Sunday, 6 November 2011

Child abuse myths and realities

Parents/guardian/wardens-this is a burning topic these days,prevalence of child abuse has increased many times,over the years.Data collected from different sources show,in 60-70% cases,people who are near and dear to the child are actually involved.
I've found a very nice video on you tube made by some Indian probably,which should be shown to each and every child.
Click on this link-   child abuse-myths n realities

Headache-Myths and Realities.

“I’ve been getting headache so bad that I cry often.It hurts everywhere on my top,back left side,right side.If this doesn’t improve I will kill myself one day”.This pain generally hurts me in early morning hours,remains their for few hours and then vanishes but it hurts and hurts very badly. Sound’s familiar ,yes this is a fact ,you must have heard people uttering these words……….
Headache or Cephalalgia(medical term)
· Broadly can be divided into three groups.

  • Primary.
  • Secondary.
  • Cranial neuralgias.
  • Primary :-
    • Migraine.
    • Cluster.
    • Tension.
    • Trigeminal Autonomic.
    • Sexual activity related (coital headache).
    • Few others
    • Secondary:-
        • Due to trauma leading to head/neck injury.
        • Some tumor,cyst,etc.
    • Cranial neuralgias.
        • Facial pain and other headache.

    I will try to explain about difference between types of headache in my coming posts.

    Headache-Myths and Realities.
  1. All Headache are same.
    • This is insane,as written above ,headaches are never same ,cause,duration,intensity,onset time may vary amongst individuals,as a result treatment also varies.
  2. Tumors are the main cause for headache.
    • A strange fact that tumors or even many serious disorders of brain rarely causes headaches,every second or third person suffers from headache in US,but only few thousands are diagnosed with Tumors.
  3. Caffeine is the remedy for all types of headache.
    • Low doses of caffeine might help in relieving certain types of headache or decreases intensity in many anecdotal reports but till date has not been subjected to any controlled study,prolonged and continues use of caffeine and related medication can make one dependent.
  4. Botox shots are for beauty treatments only.
    • No not at all,since few years botox shots are being popularly use to treat severe migraine but then like all other medication,Botox shots are not suitable for everyone.
  5. Problem lies where your pain is.
    • This statement does not hold any significance,your problem can be distance away,like severe headache in the frontal area can be attributed to falling eye sight numbers.
    • Brain has no pain receptors,so it has no perception for pain,but ironically it is the brain which make us feel the pain in different part of body,reason behind is that though brain has no receptors,bones,skin other tissues around the brain has pain receptors ,so any disturbance in their area due to any cause leads to headache.
  6. Sleep has no role in Headache.
    • No ,it has.Lack of sleep,fatigue may cause severe headache,moreover excessive sleep can also trigger headache in few.
  7. N.B, Any onset of sudden and severe headache with or without dizziness should be dealt seriously,it may be the beginning of some acute underlying pathology,like,Trans Ischemic attack,Sub Arachnoid Hemorrhage,etc.

Monday, 31 October 2011

Osteoporosis-Myths and Realities

Osteoporosis or commonly called as bone thief,is again a silent killer like many other NCDs'(non contagious disease).
Disease actually causes gradual thinning of bones i.e.,low bone mass and loss of bony tissue over the period of time may be years.It is perhaps one of the most common bone related disease. WHO data suggest significant prevalence of Osteoporosis,which is effecting millions worldwide,without people being aware of it.
Osteoporosis leads to fractures especially in areas like,spine,wrist,hip,skull,etc.if not taken seriously these fractures can make a person invalid or handicap for life.At times,few fractures may be non traumatic or not caused by any injury,these are tough to investigate as patients are not able elicit their condition and just complain of severe unbearable pain and complications depending upon the bone/joint involved.
Bones are formed by minerals-calcium and phosphorus –the most important ones.Calcium is required by the body to run its some very vital organs,eg,heart.Osteoporosis starts when due to some reasons body is unable to maintain daily requirement of calcium intake from unhealthy diet/any other pathological condition, thus it starts using  stored calcium deposits which is found in abundance in bony cage.Over the period of time gradually bones become weaker and thinner,there by a slight trauma may cause fracture..
1.Insignificant number of patients only suffer Osteoporosis.
  • It is again a silent disease effecting millions worldwide and is increasing by leaps and bounces due to lack of awareness and poor understanding of disease.
2.Disease effects only third world countries or poor economies.
  • A myth,every 2 out of 10 American suffer from some kind Osteoporosis,though it is primarily related to nutrition ,other factors also play  significant roles.
3.Osteoporosis effects only white females.
  • Yes,some data suggest a slight increase in white females and Asian racial groups non the less it effects both genders equally and can happen irrespective to age,race and place.
4.Osteoporosis begins after menopause.
  • Yes,condition deteriorates faster after menopause but to say that Osteoporosis begins after menopause is a myth,instead bone mass and density along with your lifestyle and diet at childhood and adolescence are the determinants of developing Osteoporosis in Adults.
  • Osteoporosis develops gradually over years but in certain few illness and side effects of medication like steroids,can develop in weeks or months,though lately such cases are rarely seen.
5.Osteoporosis has a genetic trail.
  • You are not doomed to develop Osteoporosis,just because some blood relation had suffered.With proper diet,alteration in life style and understanding of disease ,genetic risk can be overcome.
6.Osteoporosis has few risk factors.
  • A strong myth,there are many factors causing disease,which include
    • History of non traumatic/stress fractures.
    • Irregular menopause,late starter of menses,history of amenorrhea without pregnancy.
    • Small and thin built.
    • Certain medical conditions-Diabetes,Kidney and liver disease,certain hormonal imbalance,anorexia nervosa,etc.
    • Certain medications-Corticosteroids,steroids,heparin,certain anti-convulsants,furosemide,certain antacids,increased levels of thyroid hormone,etc.
    • Lack of sun exposure.(vitamin D deficiency).
    • Alcohol.
    • Smoking.
    • Inactivity or sedentary lifestyle.
    • list is not exhaustive.
7.Taking milk products daily covers risk of Osteoporosis.
  • A  strong myth,cow milk has certain high quantities of calcium but human body is unable to absorb it fully,secondly high content of phosphorus in milk excrete urinary calcium.
  • It is not that milk products have no use instead,diet rich in calcium supplements,essential amino acids and other nutrients/minerals hold the key of healthy and sturdy bones.
8.Only Calcium supplements are required.
  • Yes,calcium supplementation is required but along with other nutrients and minerals play a vital role in general upkeep of healthy bones.
  • Minerals and Vitamins-Vit.D,Vit-B complex,Vit-C,Vit-K,Magnesium,silica,essential fatty acids.
9.All Calcium supplements are same.
  • No,few forms of calcium are better absorbed and tolerated then others.
  • Watch the labels for calcium citrate and chelates.
  • Avoid calcium carbonate,as poorly absorbed.
10.Only Estrogen hormone therapy increases bone density.
  • A Myth again ,estrogen only decreases bone loss .it in no way increases bony mass or density.
  • Reports have suggested  excess synthetic estrogen has been linked to risk of Bbreast and ovarian cancer.
  • Hormonal therapy should be initiated after conducting related test and after consulting relevant health consultant.
11.Present investigative tools aren't accurate.
  • A Myth again,there are many reliable tools these days,
  • Bone density test-DEXA SCAN(dual energy X-Ray absorptiometery),is the Gold test-informs about density of bones,risk and seriousness of Osteoporosis.
  • Quantitative Computed Tomography is used in certain conditions.
  • Certain Lab.Test have direct and indirect reference to Osteoporosis-
    • Blood Calcium levels.
    • Blood Vit.-D levels.
    • Thyroid Function Test.
    • Parathyroid Function Test.
    • Estradiol levels.
    • Estrogen levels in females.
    • Follicle stimulating hormone in females to establish menopausal status.
    • Testosterone levels in Males.
    • Osteo calcium levels to guess about rate and quality of bone formation.
    • Urine Test-24 hours collection to check 24 hours calcium metabolism