Arthritis patients have surgical options other than knee replacement

executive@coastaldigest.com (Agencies)
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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News Network
May 11,2020

Panaji, May 11: Amid the COVID-19 outbreak, most of the people are more concerned about the health of their near and dear ones than their own well-being, says a study conducted by a leading business school in Goa.

People are now more conscious about any bodily changes, and even mild cold, cough and sneezing, it says.

The study, on public's reaction towards COVID-19 outbreak by gauging their psychological response in terms of anxiety and their coping behaviour, was conducted by the Goa Institute of Management's Dr Divya Singhal and Prof Padhmanabhan Vijayaraghavan.

It took into account inputs from 231 respondents residing in various parts of the country.

"Nearly 82.25 per cent of the respondents were more worried about the health of their loved ones than their own well-being," Singhal said.

"Majority of the respondents have become conscious of any bodily changes, sensations, a mild cold, cough, sneezing and experience concern, and attribute those changes to the symptoms of COVID-19," she said.

Besides, more than 50 per cent of the respondents said their social media usage has gone up as well as their time spent on watching movies and shows through online medium, the official said.

The respondents agreed that their technology usage to connect with friends and relatives has gone up, she said.

The study also indicated that a large group of respondents found it "depressing" to read forwarded messages on the deadly disease.

"An overwhelming majority of the respondentsagreed that they discourage unverified forwarded messages about COVID-19 on social media," says the study.

It also found that 41 per centof the respondents were not doing any physical activity, like yoga, during the lockown period, while another 19 per cent were not sure about engaging themselves in physical activities.

Besides, 57 per cent of the respondents were not engaged in any mind-calming practices like meditation, and 18 per cent were not sure about taking up meditative practices, the study said.

The respondents included 145 men and 86 women, aged 18 and above, with nearly 60 per cent of them residing in non- metro cities and rest from metros.

About 47.62 per cent of the respondents were employed in private or government sectors, and the remaining included students, retired persons and homemakers.

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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
February 26,2020

Feb 26: While too much stress can be toxic to your health, a new study suggests that despite its negative side effects, it may also lead to a surprising social benefit.

The research, published in the journal Stress & Health, found that experiencing stress made people both more likely to give and receive emotional support from another person.

This was true on the day they experienced the stressor as well as the following day.

"Our findings suggest that just because we have a bad day, that doesn't mean it has to be completely unhealthy," said study researcher David Almeida from Penn State University in the US.

"If stress can actually connect us with other people, which I think is absolutely vital to the human experience, I think that's a benefit. Stress could potentially help people deal with negative situations by driving them to be with other people," Almeida added.

For the study, the researchers interviewed 1,622 participants every night for eight nights. They asked the participants about their stressors and whether they gave or received emotional support on that day.

Stressors included arguments, stressful events at work or school, and stressful events at home.

The researchers found that on average, participants were more than twice as likely to either give or receive emotional support on days they experienced a stressor.

Additionally, they were 26 per cent more likely to give or receive support the following day.

The researchers said that while this effect, on average, was found across the participants, it differed slightly between men and women.

"Women tended to engage in more giving and receiving emotional support than men," said study researcher Hye Won Chai.

"In our study, men were also more likely to engage in emotional support on days they were stressed, but to a lesser extent than women," Chai added.

The researchers said they were surprised that stress was linked to people not just receiving emotional support, but giving it, as well.

"We saw that someone experiencing a stressor today actually predicted them giving emotional support the next day," Almeida said.

"This made me think that it's actually possible that stress helps to drive you to other people and allows it to be ok to talk about problems -- your problems, my problems," Almeida added.

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