Arthritis patients have surgical options other than knee replacement

March 23, 2017

New Delhi, Mar 23: For those suffering with age-related (degenerative) arthritis of the knee, a stage comes when all the reasonable non-operative options stops working. Here's when the option of surgery comes into the picture.

KneeDr J Maheshwari, Director and Chief of Knee & Shoulder Service and Head, Max Smart Super Specialty Hospital, Saket said that one common option suggested is knee replacement, and it being as intimidating as it sounds, it is natural that patients look for an alternative. Other non operative options such as stem cell treatment, oil messages etc. with large claims and no scientific backing also come into consideration.

Scared of the so called 'Total Knee Replacement', the patients often fall for alternative treatment modalities with tall claims and no scientific validity, and ultimately land up in a situation where knee replacement, like it or not, remains the only option.

Sometimes the surgery is delayed so much that even the best of surgeons cannot give a good result, and the fear of the patient actually 'comes true', said Dr Maheshwari.

There is a recent advance in medicine, where the scientific community is focusing on 'joint preservation' and not 'replacement' options. Some of these are non surgical - such as physiotherapy, weight reduction, modification in life-style etc, but others are surgical, where effort is to keep the original joint going. Some of these options may be surgical, aimed at corrective surgery in early stages of the arthritis, where one can see that if left to itself that particular joint is going to the path of damage, and hence future knee replacement.

These options could be key-hole surgery (arthroscopic surgery), which, if done at the right time, can halt the progress of the disease and may save one from knee replacement. Unfortunately, most patients do not have significant complaints at this stage, and may ignore their problem.

Dr Maheshwari further stated, in some patients with deformed legs (bow legs), the progress of arthritis can be halted by correcting the alignment, what is called high tibial osteotomy (HTO). Best approach, therefore would be to see a specialist to get yourself evaluated whether you have some such issue which may be the reason for your knee to take downhill course, and whether some intervention can prevent it from reaching knee replacement stage.

Even in cases, where joint is damaged beyond a certain level, it is not necessary that total replacement is the only option. There are options where only the damaged part of the knee is capped (partial replacement).

Knee, as we know it today, is made up of three distinct compartments. Often the damage is limited to only one of the three compartments, and in such cases, a limited surgery on that compartment can produce good results, without changing the whole joint. These operations are more recent in the armamentarium of knee surgeons, and have been shown to be effective. These options are not applicable in every patient of advanced knee arthritis, but in some, selected by careful investigations and special X rays. These are good joint preserving options.

As a last resort, knee replacement is always an option in case it is ascertained that all compartments of the knee are damaged. Also knee replacement remains a potent back up option in any case where partial replacement has been done in the past, and for some reason it has not given desired results.

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Agencies
April 21,2020

The Lockdown is not a cure but a critical strategy to prevent the geographical spread of COVID-19.

While pandemics at this level involves actual life threatening situations for individual's or significant others in one's immediate circle, it envisages a marked disruption in routine life. Even after the pandemic has been contained and will come to pass; it's aftermath will leave a trailblazer which demands planning and implementation of a post pandemic reconstruction of society with potentially traumatic experiences varying in intensity, multiplicity and duration.

Degree of Trauma

It would do well for each one of us to realise that the pandemic is "potentially traumatic", since not everyone will experience COVID -19 as a traumatic event in their lives. Yet, there will be those who may develop post pandemic stress reactions, depression and related dysfunction and pathological reactions while still other exhibit healthy reactions to the same set of circumstances.

"Psychological reactions to the pandemic can be distilled into four distinct prototypical patterns, namely, Resilience, Recovery, Chronic and Delayed patterns which may vary in intensity, multiplicity, and duration. Resilient individual have an ability to bounce back from adversity and experience modest or little disruption in normal functioning and are able to maintain a relatively stable, healthy levels of psychological functioning even after enduring the pandemic. Recovery pattern is characterised by relatively rapid reduction in symptoms and return to normal functioning whereas chronic pattern is characterised by symptoms and dysfunction of a long duration," says Pune-based military psychologist Lt Col Dr Samir Rawat.

Challenges at the Individual and Community Levels

From a psychological perspective, post pandemic reconstruction would entail catering to the problems, concerns and needs of those adversely impacted by the COVID -19 with stress symptoms typically characterised by individual's experiencing an overwhelming trauma of the pandemic (for example, recurring nightmares/ breaking into a cold sweat, flashback of stressful events, increasing irritability, low frustration tolerance or emotional numbing).

It could also manifest in depressive symptoms which may result in lack of interest or diminished pleasure in activities and things which you earlier liked to do, feelings of worthlessness or even survivor guilt in case of a loss of a loved one due to COVID-19, fleeting thoughts of death and suicidal ideation. Physical symptoms, on the other hand could be a decrease in appetite, weight and sleep problems, inability to focus and lack of concentration.

Undoubtedly, the pandemic will cause a financial loss of varying magnitude to many, especially the marginalised and economically disadvantaged strata of daily wage earners; it will also lead to loss of jobs (already beginning to show), homelessness, occupational difficulties and new challenges in interpersonal relations at work and on the home front, besides physical health problems and psychological barriers with new norms of accepted social behaviour (social distancing, handshakes, an obsession for cleanliness to name a few).

Emotional battles

Many factors may influence whether individuals come out stronger and more resilient or surrender to the pandemic. Emotion Regulation is one such long term critical factor that can play an important role in contributing to varying degrees of adaptation with negative or positive outcomes. While we know that primary emotions are fear, anger, disgust, joy, anticipation, acceptance, sadness and surprise, other basic emotions include wonder, love, desire, joy, hatred, sadness, attachment, disgust, rage and even expectancy .

To be able to regulate these emotions and avoid negativity , especially on social media platforms is likely to increase efforts in emotion regulation which involves initiating, increasing or maintaining an emotional response.

This means by regulating or on the other hand by stopping, decreasing or avoiding an emotional response, that is, by down-regulating, depending on the individual's objectives and goals or his /her ability to regulate emotions in the valued and given direction.

"One of the best ways to regulate emotions is through cognitive restructuring wherein we change the way we think; after all it is not the event but the interpretation of the event which is perceived as stressful and finding meaning promotes resilience and reduces risk and vulnerability to stress," advises Dr Rawat.

Adding, "Clearly, we need to have a psychological plan to prevent, mitigate and minimise negative outcomes by post pandemic reconstruction of society at an individual and community level all over the country; this has to be integrated by all leaders across verticals in diverse domains."

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News Network
January 31,2020

Jan 31: Cervical cancer could be eliminated worldwide as a public health issue within the next 100 years, according to two studies which may lead to better strategies for screening and vaccination against the malignant disease.

According to the studies, published in the journal The Lancet, more than 74 million cervical cancer cases, and 60 million deaths could be averted, and the disease eliminated in the 78 countries which have the highest disease burden.

The researchers, including those from Laval University in Canada, said cervical cancer is the second most frequent cancer among women in low-income and lower-middle-income countries (LMICs) with 2,90,000 (51 per cent) of the 5,70,000 new cases worldwide reported in women living in LMICs.

In the current studies, the scientists used the WHO draft strategy of cervical cancer elimination which defines plans for vaccination against the disease's causative agent, the human papillomavirus (HPV).

These plans, they explained, call for 90 per cent of girls to be vaccinated against HPV by 2030, and for 70 per cent of women to be screened for cervical cancer once or twice in their lifetime.

About 90 per cent of women with precancerous lesions, or cervical cancer are also advised to receive appropriate treatment, according to the WHO draft strategy, the scientists said.

In the second study, the research team analysed the impact of three elements of the WHO strategy on deaths from cervical cancer -- modelling the impact of scaling up cancer treatment, as well as vaccination and screening

"Our findings emphasise the importance of acting immediately to combat cervical cancer on all three fronts," said Karen Canfell from the University of Sydney in Australia, who co-led both the studies.

"In just 10 years, it's possible to reduce deaths from the disease by a third and, over the next century, more than 60 million women's lives could be saved. This would represent an enormous gain in terms of both quality of life, and lives saved," Canfell said.

By adding the two screening tests, and with the treatment of precancerous cervical lesions, cases of the cancer may drop by 97 per cent, and 72 million cervical cancer cases could be averted over the next century, the researchers said.

Scaling-up of appropriate cancer treatment could avert 62 million cervical cancer deaths, the study noted.

"For the first time, we've estimated how many cases of cervical cancer could be averted if WHO's strategy is rolled out and when elimination might occur," said Marc Brisson, study co-author from Laval University.

"Our results suggest that to eliminate cervical cancer it will be necessary to achieve both high vaccination coverage, and a high uptake of screening and treatment, especially in countries with the highest burden of the disease," Brisson added.

Based on the results of the studies, WHO's cervical cancer elimination strategy has been updated which will be presented for adoption at the World Health Assembly in May 2020, the scientists noted.

"If the strategy is adopted and applied by member states, cervical cancer could be eliminated in high income countries by 2040, and across the globe within the next century, which would be a phenomenal victory for women's health," Brisson said.

"However, this can only be achieved with considerable international financial and political commitment, in order to scale-up prevention and treatment," he added.

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Agencies
April 25,2020

An uncertain prognosis, severe shortage of resources and the imposition of unfamiliar public health measures that infringe on personal freedoms along with large and growing financial losses are undoubtedly contributing to the widespread psychological and emotional distress associated with COVID-19.

The COVID-19 pandemic has forced millions of people to work from home world-wide. Today, due to constant exposure to increasing numbers, an intense fear of contamination have a massive psychological impact on people who are working from home.

Kuhoo Gupta, Healer and Founder of The K Junction talks about wellness during work from home as the situation is resulting in people being vulnerable to severe mental illnesses. Staying positive and optimistic while working from home during pandemic can be heavily challenging.

Gupta states its critical to maintain your mental well-being and immune system, as people with mental upheavals are prone and susceptible to various flu or inflammations. Your bodies immune system reacts abnormally which diminishes the capability of it's function.

The only key to manifesting a wonderful well-being is to try and calm one's mind and focus on constructive and wellness activities, to find a path towards making ourselves more resilient while working from home. Gupta shares 5 tips you can start doing today to improve and enhance your positive outlook.

Remember! Your workplace should be a sacred space where you are able to find a sense of comfort in your work environment. It should help you feel positive, healthier and happier, more like a protective zone.

Fabricating a Positive Workstation

There should be a separate workstation so that one can concentrate while working from home. It would be great if the work desk is stationed somewhere near a window or a balcony door so that one can welcome sunlight, fresh air and a view of plants & birds during the day. Try to have an ergonomic setting of your table and chair so that you keep your posture right while working the whole day. Keeping one or two indoor plants near your work desk will help to make it interesting.

Keep your laptop charger wires and other stuff neatly on your desk to avoid overwhelming yourself. Motivation quotes around you will help to make you overall positive. Keep your notes diary and pen handy at your desk. It will always helps to keep some colorful artifacts around you to make the atmosphere a little cheerful.

Declutter Your Workstation

Avoid the pilling up files and unnecessary stationery at your workstation. Clutter is responsible for the confusion and problems all around and it leads to distraction; thus, a clean desk reflects power which enhances positivity and creates a tranquil workspace that will help your mind focus on productivity. It is important to declutter your work desk once in a few days because physical clutter translates to mental clutter.

Gratitude Notes in workstation and how to manifest

It is a great morning practice to write at least five things you are grateful for. It helps to shift the focus from negative to positive, from scarcity to abundance. One can write gratitude statements on Post it notes and put them at the work daily. This will raise the vibrations and help you stay grounded and positive. You can also compile affirmations and prayers that you resonate. Whenever you take work breaks, it is a good idea to read these.

Crystals to imbibe positivity at workstation

Selenite is a great crystal to spread light and positivity around. Black tourmaline absorbs negativity and is great to shield you from it during lockdown. Shungite is a great crystal to reduce the effects of electromagnetic radiations around you. You can place it near your wifi router, laptop and other devices to reduce the EMF pollution effects on you and your family. Clear quartz is great for energizing you after a tiring meeting. Just hold it in your left hand with eyes closed for five minutes and visualise beautiful energy entering your body and soul.

You can combine this exercise by holding black tourmaline in your right hand and visualize all the tiredness and unwanted energy draining into the black tourmaline. Tiger eye is very effective in eliminating the scattered brain and it allows us to make confident decisions. Green Aventurine neutralizes stress and anxiety from work, allowing us to keep calm.

Lepidolite is known as the Peace Stone, making it one of the best crystals for peace. It improves our overall mood, calms us, soothes us, and reduces our anxiety with a peaceful sense of happiness.

Sodalite is a great crystal for peace because it turns fear and stress into peaceful feelings. It also helps in better communication and can help while making crucial presentations & meetings.

Fluorite is great for healing and rejuvenating the mind and body. You can close your eyes and sit quietly with Fluorite while imagining your body being filled with an incredible energy that puts you at ease with yourself and the world.

Pyrite, also known as abundance stone, is great to put over your business card to manifest abundance at work.

Don't forget to clean your crystals regularly to harness their maximum energy.

Meditate, Do Pranayam and Stay Hydrated!

It is important to take short breaks to maintain productivity at work. Being summer, it is a good idea to get up for a water break once in 30 minutes at least. Even if you keep a water bottle alongside you, walking to the kitchen for water will help your physical body get some much needed movement.

Few iterations of square breathing once in two hours is a great way to boost your mind and body. Square breathing is basically the sequence of inhalation - holding breath - exhalation - holding breath - all for equal time spans. So you can count mentally 1 to 4 in inhalations, then again counting 1 to 4 as you hold your breath, and so on and so forth.

You can also chant any mantra while taking a work break for 1 or 2 minutes. While attending online meetings, where there is nothing much your hands are doing, you can utilize that time to do Yoga Hast/Hand Mudras and harness their energies. Pran Mudra is one of the best options to practice while attending meetings or reading articles, where your hands are free essentially.

You can Also -

Dress up like you would do while going to office so as to feel good in general

Go out on your terrace/balcony once or twice a day to get some fresh air, sunlight and hear birds chirping

Say yes to distractions rather than getting irritated from them, because you cannot avoid them while working from home, like the kids, TV sounds, kitchen sounds etc.

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