Am I at Risk of Heart Disease?

Asking if I am at risk of  heart   disease  is somewhat of a loaded question. After all, it is not unusual to see two people who eat the same foods, participate in many of the same activities, but yet have entirely different health concerns.

The most likely explanation for this is genetics, and there seems to be a growing body of evidence suggesting that certain genes can in fact protect a person from many of the common  heart   disease  risk factors such as high cholesterol. But that is a topic for another day. In this article exploring am I at risk of  heart   disease  we I will be focusing more on known facts rather than those that are yet unproven. So if you have few minutes why don’t we get started.

The first thing I would like to talk about is ethnicity. We tend to lump everyone into the same category but for a myriad of different reason certain populations tend to have a higher incidence of death from  heart   disease  than others. Three categories where the risk of heart attack death seem to be the highest are whites (27.5), African Americans (25.8), and Hispanics (22.7). While these are important statistics to take into account they were compiled a few years ago and since that time there has been a spike in the number of heart attack deaths in Asian countries. Many experts attribute this rise in the popularity of cigarette smoking. China is perhaps the best example of this but it is not the only one.

If you are asking yourself am I at risk for  heart   disease  another factor worth considering just might be geographic location as it relates to the types foods you consume. For examples the old style of southern cooking so popular in the Southern United States consisting of fried fatty foods seem to put their citizens at greater risk. To drive home this point the state of Mississippi has the highest death rate due to  heart   disease  of all of the United States. Conversely western states such as Colorado and California have some of the lowest.

One last point of interest that may just help when asking yourself am I at risk for  heart   disease . This is to look at the seven most common risk factors for  heart   disease  and ask yourself whether you have 2 or more of these. They are inactivity, obesity, high blood pressure, cigarette smoking, high cholesterol, and diabetes. If you answered yes to two or more of these you have almost a 40 percent greater chance of having a heart attack than someone who has one or none.

What else? Some individuals have decided to take a proactive approach to heart and artery health by implementing a natural cholesterol reduction supplement, along with daily exercise, and a diet low in saturated fat. This three step approach has proven to be a very effective side effect free way to reduce the risk of  heart   disease  and improve overall  heart  health naturally.

Medical Importance Of Milk

What makes Milk worth taking about? And how is it medically important to the Human health? Well! For the start, it is definitely a food material of special importance. It is almost complete, an ideal food and contains most of the proximate principles of a well balanced diet required for human body. It is thus the nearest approach to perfect food. It forms the only diet for children to the age of a year or so. It is the best source of Calcium in diet both on account of quality and the valuable biological value to the body. Milk contains the following proximate principles:

1. Carbohydrates. The carbohydrate in all Milks is lactose or Milk sugar (4-5%). Human Milk contains more Lactose than cow’s Milk.

2. Fats. Fats contain 3.5% to 4% of fats in emulsified form. Milk fat is a good source of Vitamins A and D when Milk is allowed to stand for sometime, fat rises to the surface as cream, Chemically, milk fat consists of some vital fatty acids.

3. Vitamins. It also contains all the vitamins except Vitamin E. In summer, cows feed on grass, produce Milk containing large amounts of vitamins B, C and D. But in winter, amount of Vitamins A and D in Milk is much reduced.

4. Mineral salts. Phosphates and chlorides of Calcium, potassium and sodium are all constituents of Milk. It is very poor in Iron.

The average composition of Milk from various sources is as follows;

Cow Milk contains 3.2% of proteins; 4.4% of Lactose, 4.1% of Fats; and 87.5% of water.
Goat Milk contains 3.5% of Protein, 4.6% of Lactose, 4.5% of Fats and 86.5% of water.
Human milk contains 1.1% of protein; 7.4% of Lactose; 3.4% of Fats and 88.0% of water.

Milk borne diseases

The Important Milk borne diseases are;

• Directly from the milked animal; Tuberculosis, Brucellosis, streptococcus infection, Malta fever and Anthrax.
• Indirectly from the Human handler or environment; Typhoid and para-typhoid fevers, cholera, Dysentery, Diphtheria and Viral Hepatitis.

Therefore, Milk must be well pasteurized in order to consider it fit for consumption. Everything discussed about Milk here is based on pasteurized Milk and if you are not too sure about the Milk you are taking, please to do not take it.


It is prepared by allowing the Milk to stand for a considerable time in the cold so that butter fat may rise to the top and then removing the top layer. The fat or cream may be separates from Milk mechanically through a centrifuge machine known as cream may contain about 50% fat. Besides Milk fat, cream contains proteins and lactose also.


It is the most nutritious and easily digestible form of all fats. Good butter should neither be varied nor have an unpleasant odor. Its average composition should be; water (12-15%), fat (80-90%), caseinogens (1-3%), Lactose (1%), ash (2-3%), salt and vitamins (very little variable amount).


It is very concentrated protein food and methods of making it vary at different places. It is prepared by coagulating caseinogens of whole milk or skimmed milk with rennet. Cheeses differ by high content of protein (20-25%), fat (25-30%) and what is also important is calcium and phosphorus.

The fat content of different diary products varies a lot and much of this is saturated fat, which can raise cholesterol and is linked to heart diseases. Most cheeses contain between 20 to 40g fat per 100g. If you’re trying to make the healthier choice, you don’t need to avoid cheese, but it’s a good idea to keep a check on how much you eat and how often. If you are using cheese to flavor a dish or a sauce, you could try using a very strong, tasting cheese.

Another option is to choose reduced fat hard cheeses, which usually contain fat (3g fat per 100g or less) including reduced fat cottage cheese and quark. If you are trying to cut down on fat, it is a good idea to go for semi- skimmed or skimmed milk and low fat yogurt. These products contain at least the same amount of protein, B vitamins, calcium, magnesium, phosphorus, potassium and zinc as full fat versions. They just contain less fat. Cream and butter are high in fat, so try to use them sparingly. You can use plain yogurt instead of cream or even sourced creams in recipes. Low fat spreads can be used instead of butter.

It is also worth remembering that some dairy products can be high in salt, and too much salt can cause high blood pressure (hypertension), which is also linked to heart disease. Adults should be eating no more than 6g of salt a day. Some flavored and malted milk products and shakes tend to contain added sugar which can be bad for our teeth. You can check the amount of fat, salt and sugar by looking at the nutrition information on the label. If you compare similar products, you will be able to choose the ones with lower amounts.

Diet and curative property

Milk does not excite gastric secretion enough. It is connected with small content of Nitrogen containing extractive substances. That is why milk is widely used in curative and diet nourishment and almost in all diets. Diuretic effect of Milk is correlation between Potassium and Sodium which is 3:1. Lactic acid stimulates secretory action of stomach, supporting normal and symbiotic microorganisms of intestinal tract and depresses putrefactive microbes. Thanks to that available antibiotic substance and small number of alcohol which appear after fermentation of sour milk products (yogurt and acid-loving yeast) stimulate appetite, regulate motility of intestine (one-day products accelerated and three day products depress) have expressed bactericidal property, slow down fermentation and putrefactive process in intestinal tract.

Yogurt is used in treatment of patients with tuberculosis, because it is made on basis of mare’s albuminous milk whose proteins has much better assimilation, also make better appetite, content specific antibiotic substance to Tuberculosis bacteria, normalize work of intestinal tract and make diuretic influence. Lipid digesting and anti-sclerotic property of milk is caused by available lecithin. Prophylaxis and treatment of Osteoporosis is made by milk calcium with vitamin D. Antibiotic influence of milk and milk products on the Liver is possible due to available protein of full value, sulfur containing amino acid and choline. That property is used in treatment and prophylactic nourishment.

Influence of Milk products on the Organism

1. Sour Milk Stimulates appetite. It stimulates the secretory and mechanical functions of the intestine. Lactic acid improves the development of useful microbes in the intestine. It is a rational nutrition of all population groups but should not be taken when suffering from cases as; Ulcer disease of stomach and duodenum with increased acidity.

2. Kefir Milk stimulates appetite. It influences the secretory and mechanical function of the intestine. It improves the development of symbiotic microbes in the intestine. It is a rational nutrition of all population groups and should not be used in same cases as in sour milk.

3. Greasy Kefir Milk has same qualities as the first two aforementioned milk types only that it can also be recommended for patients with Diabetes.

4. Non greasy Kefir Milk has same qualities as well, but can be recommended for patients with Obesity, diseases of cardiovascular system and Liver problems.

5. Light Kefir (1 day) has same qualities as the previous, but in addition, it can serve as a laxative and hence indicated for constipation and spastic colitis.

6. Middle Kefir (2 days) has exact qualities as the first two milk types.

7. Strong Kefir (3 days) has same qualities as the first two milk types but in addition, it is used as an anti putrid and strengthening agent. It can be recommended for cases of Gastritis with decreased acidity, chronic Colitis and diarrhea.

8. Koumiss is milk with albumins and it is well digested in the organisms. It stimulates appetite, stimulates gastric secretion, activates peristalsis of intestine, decreases putrid processes in intestine, and eliminates mycobacterium tuberculosis, decreased acidity of gastric Juice, intoxication, exhaustion and anemia.

9. Light Koumiss is the same as koumiss only that it is a laxative and hence recommended or indicated for constipation.

10. Acid loving products are as follows; acid-loving milk and acid-loving yeast milk. They stimulate appetite; influence the secretory and mechanical function of stomach and intestine. They have considerable bactericidal properties, slow putrid processes in intestine. They are recommended for inflammation of the Large Intestine, dysentery, tuberculosis, constipation, exhaustion and ray disease. But should not be taken in diseases such as Ulcer disease with increased secretion, gastritis and Inflammation of the Pancreas.

11. Yogurt stimulates appetite, influences the secretory and mechanical function of the intestine. It has middle bacterial-killing properties and slow putrid processes in the intestine. A rational nutrition of all population groups, children’s nutrition, prophylaxis of bacterial diseases caused by imbalance of the normal or symbiotic microbes in our bodies and it is contraindicated in Ulcer disease with increased secretion, gastritis and Inflammation of the Pancreas.

12. Sour Cheese (greasy middle and non greasy) partially fills the organism needs in proteins, essential amino acids, well digested calcium, growth and lipid digesting substances. Especially important for women, children and Old people. It has considerable lipid digesting properties due to the presence of choline and lecithin. It is highly recommended for children, acute and chronic hepatitis, inflammation of the gall bladder, Ischemic heart disease, obesity, diabetes, exhaustion, osteoporosis and fractures. It is contra indicated in a case of high phosphate level in blood.

As earlier stated, to have an idea of how nutritious and fully packaged Milk is, just consider Breast Milk in which the newborn feeds on till some period of time. If it were not complete, or lacks some vital nutrients, the Child will definitely grow up with some deficiencies. Milk is so nutritive to be ignored and medically important to be ignorant of. So therefore, you do not have to be a medical practitioner to know this.

Vitamin E For Hair Growth

Promoting hair  growth  is somewhat similar to promoting the overall health of the human body. There must be adequate nutrients and vitamins to prevent hair loss, and for the hair to grow properly. If you want hair to grow faster, be sure to consume vitamins that will aid in providing more oxygen to the scalp area, and hence promoting  growth .

For the strands to grow long, there are a variety of vitamins that will come in helpful. Some examples of useful substances include vitamin C, Biotin, Niacin, pantothenic acid, vitamin B6 and vitamin B12, as well as vitamin E. Biotin helps to keep hair follicles healthy, and vitamin B helps prevent hair loss and graying.

We usually hear a great deal about vitamins C and B. But what we don’t hear so often, is vitamin E. Vitamin E has been found to be very effective in treating hair. It acts as an antioxidant that encourages blood circulation to the scalp area. This process means that more oxygen can be supplied to the hair cells. The increase in oxygen levels increase the life span of the cells as the cells get more nourishment.

In fact, vitamin E don’t just benefit the hair. It also helps to strengthen the cells in other parts of the body, thereby improving the health of the individual.

This vitamin can be commonly found in many types of foods – soy beans, wheat, ready-to-eat cereals, grains, beans, spinach, nuts, eggs, and many other green leafy vegetables. If you find that your daily diet lacks the above ingredients, you can always consider taking health supplements in the form of pills and capsules to make up for the lack in vitamin E.

Although there are many benefits associated with consuming vitamin E, overeating may present various health problems. For instance, since vitamin E encourages blood to transport more oxygen to various parts of the body, it also means that the blood becomes thinner so that it can fulfill this function. The side effect is that this slows down blood clotting (due to having thinner blood).

Therefore, even though vitamin E helps promotes hair  growth , it is not wise to consume heavy doses of vitamin E deliberately. Take it in moderation to ensure that the balance of the body is not upset by the sudden influx of vitamin E. A perfectly healthy adult should only take between 8 to 10 milligrams of vitamin E on a daily basis. If you feel like consuming more than that dosage, always consult a qualified physician before doing so.

Also, consume vitamins as a means to supplement your daily diet. Don’t be overly dependent on these ingredients. Remember to get plenty of rest, drink plenty of water, and exercise on a regular basis. Have a balanced diet and work on improving your metabolism rate.

Stress can be the root cause of many hair loss problems. So having a healthy lifestyle certainly helps to prevent such problems from arising. A small dosage of vitamins (such as vitamin E) daily to help boost overall health can also be an effective measure.

Normal Cells vs. Tumor Cells

 Tumor  cells vary from normal cells in several basic ways. First, the division of normal cells is tightly regulated by special cell signals. With  tumor  cells, it’s as if the signals are no longer produced or perhaps they are no longer received.

Research involving cells is often accomplished by removing the cells from an individual and growing them in a sterile dish with the nutrients required for their survival. Growing cells for research use is termed “cell culture”. Just by watching normal cells in cell culture it is obvious that their division is regulated by something. Normal cells in culture grow until the bottom of their dish is carpeted with the cell. The layer is only 1 cell thick. Once this density is reached, they stop dividing because there is no more space. If one cell dies, an adjacent one will divide to fill in the space. Additionally, normal cells will divide a certain number of times after which time, the division process halts. There are a certain pre-determined number of generations that may be produced and then there is no more dividing. Eventually, the entire culture will die.

With  tumor  cells, it’s a completely different story.  Tumor  cells will divide over and over, time after time; forever if supplied with nutrients. With enough time,  tumor  cells in culture will become a piled up mess. They lack order to their growth. It is as though  tumor  cells lose have lost the capacity to follow the rules and they divide (proliferate) out of control.

A second major difference between normal cells and  tumor  cells is that normal cells perform a special function or duty for the body. Healthy cells have specialized behaviors and serve a purpose. For example, lung cells have a specialized duty to perform while cells of cardiac tissue have a very different one. Normal cells taken from different tissues even have very different appearances.  Tumor  cells have a different appearance than normal cells taken from the tissue they are derived from. This is due to the fact that they have lost their specialized function.

Differentiation is the term given to describe the specialized function a given cell has. Differentiation and proliferation are closely tied together. In general, a cell that proliferates at a high rate loses some of its specialized function. The problem is, it really doesn’t have time to perform a specific function since its too busy dividing. Cells that perform a highly specific function (i.e. differentiated) have a lower rate of proliferation. Researchers are studying the possibility of making  tumor /cancer cells differentiated so they might lose their ability to proliferate continuously. In theory, this would cause the  tumor  to stop growing.

Pneumonia – Playing Hide and Seek

Here is an important question clinicians need to ask. When can you have a pneumonia and not see it on a chest x-ray? You can have a patient who is clinically sick because of a pneumonia, but when you do an x-ray you just don’t see it there. There are three answers.

One is dehydration. A patient who is dry will not waste water on hydration of a lung that is infected. So, as we talked about under working up a patient who is dehydrated for hyponatremia, when you size up a patient with pneumonia who is dehydrated, it is valid for you to make the diagnosis of pneumonia without seeing it on the x-ray. You would put in your notes that the patient is clinically dehydrated, and I am confident that when hydrated the next day, and we again x-ray, a pneumonia will become apparent.

Chronic obstructive pulmonary disease patients can have pneumonia and not have it readily apparent on the chest radiograph. Remember that the pathology of COPD is that they have air trapping. So, they have disproportionate amount of air in their lungs and because there is more air in the lungs, a pneumonia can be more subtle. COPD patients are treated with antibiotics. If someone comes in with chronic obstructive pulmonary disease exacerbation, we are going to assume that there is indeed an infectious component and automatically treat with antibiotics. Of contrast, in asthma patients we understand the pathophysiology does not include infectious disease. So, when someone comes in with an asthma attack, very rarely would we put them on an antibiotic as opposed to someone with chronic obstructive pulmonary disease who we always place on antibiotics.

Lastly is a retrocardiac (or lingula) pneumonia. This is where behind the heart there is a pneumonia that would not be seen on an AP film. You would need to use a lateral film. It’s extremely difficult to evaluate a patient that has an under penetrated CXR. If they have a well penetrated film and you can see the vertebral bodies, you may be able to make out a lingula pneumonia on the chest x-ray. If not, you really need to get a lateral radiograph. Of concern here is patients with pneumonias that are low in the lungs and very close to the diaphragm, it is classic that their fever could present with a degree of abdominal pain.

So, someone comes in with abdominal pain and a fever, you have to be concerned about whether this could be a pneumonia in the lower fields of the lung. Let’s say you have a child who comes in with a fever and abdominal pain. You think appendicitis. The surgeon takes him into the operating room, removes the appendix and admits him to the hospital. In the postoperative phase, these patients are not placed on antibiotics. This could lead to a life threatening infection/sepsis. So, once again, when can you have a pneumonia and not see it on the chest x-ray? Dehydration, chronic obstructive pulmonary disease, and retrocardiac or lingular pneumonia.

How to Colon Cleanse – 5 Expert Tips

If you’re considering colon cleansing for the first time, the choices can seem overwhelming. Herbal cleanses, oxygen cleanses, fiber programs, specialized diets, fasting and more are all on the colon cleansing market. No matter what kind of cleanse you end up doing, you can improve your results with the advice in these 5 tips.

1. Before you cleanse, first find out how much you really need a colon cleanse. There are several factors including diet, age and overall health that determine how much you need and will benefit from a cleanse. E-mail me for a free health questionnaire that will tell you where you stand.

2. Once you know how much you need a cleanse, you can then choose the appropriate level. All types of colon cleansing can be done slowly and gently or more quickly and intensely. It’s important to know which level is best for you now in order to avoid overburdening your body with toxins as the body cleanses itself.

3. Prepare well for any type of colon cleanse by changing your diet. No matter which kind of colon cleansing you choose, you can get better results by taking 3-5 days to prepare. During this time, it’s best to cut out all processed foods and eat at least 50% of your diet in fresh fruits and vegetables. It’s also helpful to cut out most if not all dairy products, meats and breads as they are mucous forming.

4. During your cleanse be patient and stay with it. Don’t expect to undo years of poor eating habits, stress or lack of exercise with a one time cleanse. You may need to cleanse several times before you achieve all your health goals.

5. Be prepared for changes. After your colon cleanse, don’t expect to want to eat the same things as you did before. Pay attention to how your body feels after you eat and allow your diet to change to foods that make you feel better.

If you have any doubts about colon cleansing, remember these words of Dr. Norman Walker, the inventor of vegetable juicing: “To have a clean colon is the best health insurance we can have.” Dr. Walker seemed to know what he was talking about – he had a healthy and productive life of over 100 years.

Shingles Symptoms – and Treatments

I can remember quite clearly some forty years ago when a friend told me that her husband had Shingles, and how that he was in great pain, and covered in a terrible rash. At this point I thought nothing about it until recently I was reading an article which compared different types of pain, and Shingles was mentioned.

As I write many different articles about medical health I began to check out what caused it, and why it was ranked as one of the most painful things you can get, so I began to investigate what the symptoms were, and what treatment was available.

Shingles comes from the same virus as the well known Chickenpox which lays dormant in anyone that has had chickenpox, or that has had the chickenpox vaccine. It normally affects older people where the dormant virus travels to the nerve endings in the skin area. From there the pain starts, and often patients have described the pain as coming in extreme waves that have been likened to that of an electric shock. After this stage the rash appears, which will blister and become very painful. These blisters can be full of bacteria, and great care should be taken with cleanliness.

What causes Shingles?

Several Doctors have different ideas on the causes of Shingles, but if the truth they don’t know. Some say it can start from stress, while others relate it to Cancer, or HIV. Radiation is another possibility, and also mentioned would be that it could be that part of the skin has been damaged in some way that sets the virus off. The most likely cause in my eyes is that the immune system gets severely run down, and that the virus which is normally kept at bay by our immune system, then breaks out.

Shingles Symptoms.

The things to look out for are extreme sensitivity in the skin, which tend to have a burning sensation, and slight itching. After this stage the skin becomes painful, and if you think that you may have shingles a call to your Doctor must be made, as the sooner an antiviral medication is given the easier for the patient it will be.

Care must also be taken should the patient have a form of rash near the nose, or on any part of the face. This is most important to get immediate medical help, as if the virus reaches the eyes it can lead to impaired vision, or a complete loss of sight.

Medical care.

With Shingles the sooner you get medical care the better for the patient it will be. Pain killers are a must, along with things like Antihistamine can help with the itching. Often the Doctor will recommend creams or oils that can stop the blisters from drying out to fast, and in several articles it is believed that cold water compresses bring great relief, and keep the skin moist.

If possible avoid contact with others that have not had chickenpox, especially if that person is older, and try to wear loose clothing that doesn’t irate the skin.

All About Bronchitis

Bronchitis is a respiratory system disease that is mostly found in the cold seasons. This is mainly because bronchitis is caused by viruses that also give us the flu or the cold. Bronchitis can also be caused by a bacteria, but this is not a very common bronchitis case. The bronchial tubes have linings that get inflated when you develop bronchitis.

This makes it harder from air to travel to the lungs. In bronchitis, mucus is also produced, which is mainly formed in your airway. So as you can see, bronchitis is a disease that affects your ability to breathe properly.

There are two very well known types of bronchitis: the acute form of bronchitis and chronic bronchitis. In people who suffer from asthma, we can find another type of bronchitis, related to asthma. As this is not a very common case of bronchitis, we shall talk less of it. The most common form of bronchitis, the acute one is a short illness. People usually get acute bronchitis after they have had either a cold or the flu. The main characteristic of acute bronchitis is cough together with sputum, colored green.

Another acute bronchitis symptom is soreness in the center of your chest. Fever may also characterize acute bronchitis, but it is usually just a mild one. Shortness of breath can also be found in cases of acute bronchitis because of the narrowing of the airways.

The second type of bronchitis, the chronic bronchitis is a more long lasting disease. It can last up to three years. Chronic bronchitis is also characterized by cough, but a much severe one, unlike in acute bronchitis. If you suffer from chronic bronchitis, problems breathing are also included in the list. Because of the gravity of chronic bronchitis, people who suffer from it may also have infections in their lungs. This as well will make breathing even much worse.

The most common way to get bronchitis is by contacting a virus. This travels into your bronchi, causing infection. Your body will then start to fight the virus that caused bronchitis. As a result, there will be more swelling and the quantity produced will be larger. The most known virus that causes bronchitis is the sams one that causes the cold. There are also cases when a bacteria is responsible for bronchitis, most likely after viral infections, such as a cold. If you are a smoker, you are more at risk of developing chronic bronchitis and you will also recover much slower after acute bronchitis.

Shoulder Injuries in Sportsmen in India

The shoulder joint is one of the five major areas of the body involved in sports injuries. Sportsmen who over use the shoulder in throwing or overhead activities as in cricket bowlers, volleyball, Javelin throw, after a fall, gymnasts are all at risk of developing shoulder injuries. It can be injured to falls on the arm or due to traction as in some contact sports like rugby. In this article I shall discuss the various types of injuries of the shoulder and its neighboring structures.

I present salient feature of its anatomy for a better understanding of the various injuries.


The shoulder is the most mobile joint in the human body, yet is the most insecure. It is a ball and socket joint formed by the upper end of the arm bone (humerus) joining with the shoulder blade (scapula). It is surrounded by a bag like tissue called the capsule. A group of tendons called the rotator cuff are closely related to the shoulder. They serve as dynamic restraints. There is a discrepancy between the radius of curvature of the ball and its socket which renders the shoulder potentially unstable. This is akin to a golf ball perched on a tee. This inherently unstable joint is rendered stable by soft tissue restraints, the bony orientation and a negative suction force between the components. A great deal of movement is possible at the shoulder to allow the arm to be positioned in space.

The price for this great range of movement is instability which is described below. Closely related to the joint are important nerves and blood vessels of the upper limb in their course downwards from the chest to the arm.

Types of shoulder injuries


Shane Warne’s shoulder dislocation a couple of years is one of the most famous in recent memory. The ball shaped upper end of the arm bone slides pops out of its socket either completely (dislocation) or partially (subluxation). This occurs in sports when there is a fall on the outstretched hand. A frank dislocation results and sudden pain is felt when the ball comes out of joint. It predominantly comes out at the front. The arm held as if it is paralyzed, until it is set right by the player or in a hospital. This is a dramatic event. Once the shoulder has   dislocated , there is a tendency for it to recurrently  dislocate  in young sportsmen less than 25 years of age. This tendency for recurrent dislocation merits rehabilitation and surgical treatment.

Arthroscopic stabilization

offers these sportsmen a minimally invasive surgical technique. The results of this mode of surgery are matching the old “gold standard” of Open stabilization. Rehabilitation is faster after an arthroscopic procedure as the amount of pain is less. It is important to bear in mind that instability need not necessarily result only from a fall. It can also occur in sportsmen who use their arm to throw in overhead sports like cricket, Javelin, volley ball. In these sportsmen, the  joint  may not  dislocate  frankly but there is a dead arm feeling or pain. The fielder in cricket, who suffers from pain and has to throw the ball in from the boundary in an overhead manner, avoids this and instead throws it in underarm.

Instability commonly occurs in a front ward direction but can occur to the back or in more than one direction (multi directional). These are less common. Instability towards the front and back needs surgical stabilization by preferably, arthroscopic means. However multidirectional instability (in more than one direction) is best treated by a rehabilitation process.

2) Tendonitis and impingement-

Tendonitis refers to an inflammation of tendons surrounding the shoulder. The rotator cuff or the biceps tendons can get inflamed due to overload/fatigue, trauma and age related degenerative changes. Swelling and crowding of the tendons underneath the bony arch can lead to a condition called impingement. In this condition, pain is felt during overhead activities. Night pain is present in advanced cases by lying on the affected shoulder.

Impingement is a phenomenon in which the rotator cuff (group of tendons) rubs against the undersurface of the bony acromion (crow like) projection of the shoulder blade. Tendons which are weakened by tears do not function efficiently to stabilize the arm bone which migrates upwards to squeeze the already damaged tendons under the overhead bony arch. It can be due to weakness of the rotator cuff as above or be due to instability. In instability the stretching of the capsule permits the ball to migrate upward once again causing impingement. Differentiation between instability and impingement can be difficult and clinical acumen is needed. Internal impingement occurs in baseball pitchers as in the picture where the arm is cocked back for throwing.

3) Rotator cuff tears –

In the young patient tears of the rotator cuff are due to trauma. In the older person, tears are due to degeneration like grey hair. Tears result in weakness and pain during overhead activities. Usually these tears have poor capacity to heal spontaneously and need to be repaired particularly in the young sportsman. In the older patient a trial of conservative treatment with analgesics and one or two cortico-steroid injections may be useful before embarking on surgery.

4) Acromio – clavicular joint injuries-

This joint is formed at the outer end of the collar bone as it joins the shoulder blade. Dislocation results after a fall on the shoulder. It leads to a separation of the collar bone from the shoulder blade and upward prominence of the collar bone. Pain and deformity result. While the minor varieties can be treated conservatively, surgery is necessary for the major types.

5) Labral tears-

The labrum is a circular band of cartilage attached to the glenoid cavity (socket) to make it deeper. It can be torn in sportsmen who use the arm for throwing, serving, smashing; swimming etc. Pain is felt toward the front of the shoulder. The other symptoms may be clicking or locking. There may be associated instability, rotator cuff partial tears. Arthroscopic surgery is the only option. All associated abnormalities should be addressed simultaneously.

6) Muscle ruptures-

These occur due to their sudden contraction against an unexpected resistance. The common muscles ruptured are the Pectoralis major which is located at the front wall of the arm pit and the biceps.

7) Nerve injuries-

They may be associated with a shoulder dislocation, or may occur due to traction on the brachial plexus, leading to complete or partial paralysis of the upper extremity. Brachial plexus injuries in most cases are temporary injuries, however may need investigation by an electromyogram.

Diagnosis and management of shoulder injuries in sportsmen is best done by an Orthopaedic surgeon treating these problems and exposed to arthroscopic surgery. A physiotherapist, rehabilitation expert and sports psychologist also have their important role to play to rehabilitate these sportspersons and make them return to competitive sport. Such skilled manpower and equipment exists in India and vast amounts of money need not be spent on overseas treatment.

Minimally Invasive Hip Replacement Surgery

If you’re considering hip surgery, you can reduce recovery time and pain with minimally invasive hip replacement surgery. The surgery involves an anterior approach to the hip. Traditional hip replacements performed in the U.S. use the posterior or lateral/posterior approach. Over the years, a smaller incision with the traditional approach has been used and is less invasive, but it still requires following strict hip restrictions.

The Minimally Invasive Anterior Approach

The anterior approach to hip replacement has been quite successful with the vast majority of total hip replacement patients, including hip fractures. After the surgery, the patient is free to move his hip without restrictions, and, in most cases, is up and walking later that same day. A patient’s hospital stay is also shortened to 2-5 days.

After traditional hip replacement, patients must strictly follow their hip precautions.

Minimally invasive hip replacement is performed while the patient is lying flat on his back. A small incision (about 4 inches) is made at the front of the hip joint, as opposed to the traditional lateral or posterior incision. During the anterior approach, the hip is replaced without detachment of muscle from the femur or pelvis. The hip is reached through a natural opening between the muscles. This results in a quicker rehab and a shortened hospital stay.

Traditional hip replacement requires a large incision through the gluteal muscles, which are the most important muscles for hip function. This places restrictions on hip movement for a period of time after surgery. Restrictions (referred to as hip precautions) include no internal rotation, no leg crossing, and no bending of the hip beyond 90 degrees. Often times there are also limitations on the amount of weight a patient is allowed to place on his leg while walking. These restrictions are in place to prevent   dislocation  of the new hip.

Minimally invasive hip replacement (anterior approach) eliminates restrictions because muscles and tissue are left intact in the lateral and posterior areas. This provides stability for the hip and greatly reduces the chance of  dislocation .

Minimally invasive surgery doesn’t necessarily refer to the size of the incision. It has more to do with the minimal amount of tissue damage during surgery. The incision can’t be made too small or else the incision area becomes too stretched in an attempt to reach the hip joint.

ProFX Operating Table

The ProFX is a special operating table that positions the patient’s leg for the anterior approach. Not all hospitals have this table. Without it, the anterior approach isn’t performed. For instance, in California there are less than 10 hospitals that perform this minimally invasive procedure. Another reason for the scarcity of this approach lies with surgeons. Most orthopedic surgeons have been trained in the lateral and/or posterior methods only.

Advantages of Minimally Invasive Hip Replacement (anterior approach)

  • No limitations on hip motion
  • No weight bearing restrictions
  • Decreased chance of hip  dislocation 
  • Reduced hospital stay
  • Shorter rehab time
  • Quicker return to functional mobility
  • Quicker return to driving your vehicle
  • Much less pain from surgery
  • Reduces chance of leg length discrepancy


Complications are rare but are similar to complications from traditional lateral and posterior approaches. These include infection, DVT (deep vein thrombosis), nerve damage, femur fracture, and revision surgery.  Dislocation  is a complication, but is much less likely to occur.

Fractured Teeth and Transillumination

Shining the Light on Tooth Fractures

Teeth are strong, and by practicing good home care with regular professional cleanings and check-ups you are working to keep them strong! But, however diligent you may be at using these procedures, thus protecting your teeth cavities and erosion, we still cannot guarantee that accidents won’t happen, and unfortunately accidents can lead to fractured teeth.

Fractured teeth are the second leading cause of tooth loss in adults, with the first being periodontal or gum disease. There are several things that can cause teeth to chip, fracture or break, you may inadvertently bite down on something hard, sports injuries and accidents such as falling, being hit in the mouth or being involved in traumas such as a car accident. These factors can all break and crack teeth. Also large cavities can sometimes lead to ‘more cavity than tooth’ and the resulting thin shell of tooth is vulnerable to cracking and breaking.

For teens and young adults there is a new source of tooth fracture on the horizon – tongue and lip piercing. As this fad spreads, we are seeing more fractures in the front teeth among its followers. One study was conducted in Israel, where as many as 20% of teens have tongue or other oral piercings. Of the pierced teens in the study, researchers found that about 15-20% of them had either fractures or budding gum disease in their front teeth! Since prevention is obviously the best cure, the study’s authors encouraged the parents of teens who are looking at getting pierced to persuade them to change their mind. This may be easier said than done, but consider the hazards of tooth loss, as one author stated, “your kids will thank you for it later in life”.

How Will I Know If I Get A Tooth Fracture?

You’ll know if your tooth breaks severely enough to expose the sensitive inner material and nerve, it will hurt! The pain however, may come and go, it can be extremely sensitive to hot and cold drinks, or just being exposed to the air. The pain increases when you chew and put pressure on the tooth. You can also feel the sharp edge of the broken tooth with your tongue. If you experience any of these unfortunate events, please make an emergency appointment with your dentist to begin the correction and repair process.

Many tooth fractures, however, do not hurt and this is where the trouble comes in. Tiny hairline fractures that don’t enter the sensitive part of the teeth often go undetected. Over time, these fractures can form areas for bacteria to collect and begin the all-too-familiar process of producing acids that lead to tooth decay. Since any fracture is capable of going deeper, the existence of undetected fractures sets you up for a broken tooth waiting to happen. If the situation progresses to ‘more cavity than tooth’, the entire outer structure could fail. So often, these things happen at the worst possible time too. Like the start of a long holiday weekend, or the first night of your honeymoon, well, we surely hope not!

The key then, is to find and correct these little cracks before they become big ones. This is easier said than done. X-rays cannot be used to detect unseen fractures like those in bones, so often they are missed. Fortunately there is a new non-invasive approach called transillumination. This long word literally means ‘shining the light through’, and it is something that should be done with every examination these days.

Light Helps Us Find It, So We Can Fix It

As a kid, did you ever play with a flashlight on an overnight camping trip? Remember how the light could shine through parts of your hands, or produce weird looking shadows and effects (and a nice atmosphere for ghost stories) when angles on your face? In a sense, what you were doing was transilluminating.

The same principle holds in the dentist’s office (but without the ghost stories). A small, high intensity light is used to illuminate the teeth, gums and other mouth parts. Any small undetected fractures, such as the ones we have discussed above can easily be seen with this technique. Once found at this early stage, very often the crack or chip can be repaired with no risk of losing the tooth. This is so much easier than waiting for your tooth to start hurting or fall apart when the risk of losing the tooth becomes very real.

Many other potential problems can be found and corrected by using this transillumination method. These include small cavities, plaque or tartar located beneath the gumline, any hemorrhaging that might occur in injured teeth and any flaws or bubbles in cosmetic applications such as dental veneers. I believe that “a stitch in time saves nine” and examination procedures using on the power of light to find little problems, ensure they can be fixed before they get too big!

Bones, Balance and Cancer

With more birthdays, many women, myself included, struggle with bone loss and loss of balance.

Bone loss is often exacerbated by IV and oral drugs used to treat cancer. Although these drugs may be very effective and necessary they add a twist to the struggle for gaining and maintaining bone health.

Good balance goes hand in hand with bone health because it plays an integral part in the prevention of fractures. With less falls there is less chance of breaking bones – that isn’t rocket science!

So, what will build bone density and improve balance at the same time? According to several published works by K. Sakamoto reported on in a Denver Naturopathic newsletter, dated April 30,2008, a very simple exercise.

‘Unipedal Standing’ is the scientific term for standing on one foot. Research has shown that one-minute long intervals of unipedal standing may be helpful in preventing falls and hip fractures. K. Sakamoto and his colleagues published their work on the effect of unipedal standing as it relates to frequency of falls and hip fractures in the October 2006 issue of the Journal of Orthopedic Science. In the publication K. Sakamoto stated, “this has got to be the least expensive, least intrusive and lowest technological intervention I have ever read about for preventing hip fractures.” The ‘unipedal standing balance exercise’ as the researchers called it, simply involves standing on each leg for one minute three times a day. To help you balance, your eyes should be open while doing this. It you need a little support to keep from falling down to start with, lightly hang onto a chair back or something else that is secure.

The published work used data that was collected from 212 control subjects over a six month period. It was presumed that these control subjects rarely stood on just one foot. The control subjects recorded only 121 falls and one hip fracture while doing the exercise for the study.

From an abstract of the study listed on PubMed, Sakamoto pointed out in another published work in the December 2006 issue of Clinical Calcium that “unipedal standing increases the weight load on the femoral head by a factor of 2.75 over standing on two legs, something I guess would be called bipedal standing”.

Since bone density and bone strength is improved by mild stress to the bone it is worth making a fuss about weight-bearing exercises. This the next couple of sentences should convince each of us to perform this simple exercise religiously. According to Sakamoto’s calculations unipedal standing for just one minute would have an effect on bone density equivalent to walking 53 minutes. That means that if you repeat the exercise three times a day you will get the effect of walking more than 2 1/2 hours per day – in only 6 minutes of actual exercise!

Unipedal standing also appears to decrease spontaneous falls by about one-third because of improved balance. Additionally, the mild strain to the bone seems, at least in theory, to decrease the chance of fracture if a person does fall.

I recently received a diagnosis of osteopenia and I intend to do everything possible to keep it from progressing to osteoporosis. A few minutes each day standing one foot may produce some additional bone mass…and, I for one, am ready to give it a try. An added benefit will be de-stressing for a few minutes…yea!

Cerebral Palsy Exercises – Causes of Cerebral Palsy

Cerebral palsy is a condition that involves a group of disorders affecting the body movement, balance and posture. It is caused by abnormal development or damage in some parts of the brain that is responsible for muscle tone and motor activity. Cerebral palsy usually occurs in infancy or early childhood which results in slower growth rate than a normal child. This also means that they will be slow to reach developmental stages like sitting, crawling, walking or rolling over.

A person with CP will find it difficult to control and coordinate their muscles. Besides, it even makes small and simple movements difficult; this includes postures too. With poor muscle tone that results in uncontrolled movements, problems in walking, speech, swallowing, balance, coordination and other functions will arise. Sometimes, skeletal deformities, eating difficulties, digestive problems, hearing and vision problems, dental problems, seizures and bowel control problems can occur. There are chances of mental retardation too. However, the severity of the problems differs from person to person and magnitude can get better or worse over time.

CP is the result of injuries or damage to the brain. The most important cause for this is because of damage that would have occurred early in pregnancy. Usually, the condition is caused when the child is still in the womb and brain is starting to form or during the birth process when the child passes through the birth canal. It can occur in the first few years of the child’s life too. Many times, the cause itself is unknown!

Among the many problems that occur during birth, inadequate oxygen is the main culprit for CP! Around 10% of the cases for cerebral palsy begin during birth (perinatal). About 70-80% of the cases begin before birth (prenatal) and in some cases begin after birth (postnatal). Hence, most cases of cerebral palsy are the result of a combination of prenatal, perinatal and postnatal factors.

There are many risk factors involved with the cerebral palsy condition and includes seizure disorder, thyroid disorder and medical problems in the mother of the child. Birth defects in the spinal cord, head, face and lungs can also be linked with this condition. Rh factor incompatibility, hereditary and genetic conditions and complications during labor and delivery can also increase the risk of cerebral palsy. Usually, children having premature birth run a higher risk of suffering this condition. After birth, low birth weight, severe jaundice and lack of oxygen can be causes of cerebral palsy. Infections such as meningitis and head injuries or bleeding will also cause cerebral palsy.

Depending on the causes and symptoms, different treatments can be given. The therapies will be based on the condition of the child. However, cerebral palsy exercises remain to be the best treatment that can be given to help the child become independent. Besides, it increases the muscle tone which is the main cause for this condition.

Proper Nutrition With a Hiatal Hernia Diet

It is vital that people with a hiatal hernia eat a proper diet packed with the right nutrition and full of ingredients that do not irritate or upset their condition. A hiatal hernia diet is one that an individual must develop and keep over their entire lives in order to properly treat the condition. It can be very confusing to most, since it is not usually made clear by a doctor or nurse what foods one should, or should not be taking in. Even so, the proper diet for people living with this condition is not just about what one eats, but also how they eat.

The first thing one must know about a proper diet for hiatal hernia is that you must eat small meals. Since you will be consuming smaller portions of food, it is recommended that you eat more often. This generally translates into five or six small meals per day, or one meal every two to three hours. It is also not advised to eat a meal right before bedtime. People who are on a hiatal hernia diet must remember to not eat anything for the last two hours they are awake each day, in order to avoid problems during the night time hours, which can lead to both insomnia and an irritation of the condition.

There are some foods that you must try to avoid when undertaking a diet for a hiatus hernia. It is greatly advised not to consume alcohol. Other foods such as those that contain dairy products, have also been linked to worsen the irritation. This means that you should avoid the consumption of cottage cheese, sour cream and ice cream. Some acidic fruits such as oranges, lemons and grapefruit have also been shown to increase the symptoms. It is very important to avoid all these products, if you are on a hiatal hernia diet.

One type of diet you may choose to undertake if you have a hernia, is the following: it is a diet that is made up of foods that have no irritating effects at all. Seeds, nuts, whole grains, fruit and vegetables are the foods that individuals generally eat when they are on a hiatus hernia diet. Some people who have this condition decide to eat these foods as it is one of the most effective ways to treat their condition and keep it under control.

As you probably can tell it is important to properly plan your hiatal hernia diet. It may be difficult to keep track of all the safe and bad foods, but it is necessary for to stay in good health. If you are having difficulty doing so, do think about keeping a food journal. A food journal will make it easier to keep track of foods that increase the symptoms of hiatus hernia. This can go a long way in keeping you happy and healthy.

Treatments For Osteoporosis

If you are one of the 10 million Americans who has been diagnosed with osteoporosis or one of the 34 million Americans with low bone density, no doubt you have talked to your doctor about treatment options. A spine or hip fracture resulting from osteoporosis can be devastating, so it is important to being treatment as soon as possible.

Osteoporosis is a serious health issue, and although there is no cure, many treatments have been developed in recent years. Luckily, these treatments are effective in slowing or stopping bone loss, actually increasing bone density, managing related pain and preventing fractures.

Studies show that exercise and diet are an important part of treating osteoporosis. Simple lifestyle changes can have a big effect. Getting the recommended amounts of calcium and vitamin D is very important at any age. A dosage of 1200-1500 mg of calcium along with 600-800 IU of vitamin D is recommended. Studies have shown that weight-bearing exercise is key to preventing bone loss. Even walking or jogging can help keep bones strong, retain balance and keep you fit so that you avoid fractures.

For those requiring a more aggressive treatment, there are a number of medications that your doctor can recommend. For menopausal women, estrogen can be an effective treatment for slowing or stopping bone loss. Starting an estrogen patch or pills in menopause can reduce the chance of a hip fracture by up to 50%. Some of the brands of estrogen therapy available are Vivelle, Climara, Estraderm, Esclim and Alora.

Selective estrogen modulators (SERMs) are an alternative treatment that is as effective as estrogen. Evista is a SERM that has been proven effective in slowing bone breakdown. SERMs are appropriate for women who choose not to take estrogen.

Biophosphonates are another treatment option for osteoporosis. These drugs slow down bone loss and can actually increase bone density. Fosomax is one biophosphonate that has been shown to reduce the risk of hip and   spinal   fractures  by 50%. It also contains vitamin D to aid in calcium absorption.

Actonel is another biophosphonate that has been proven extremely successful in preventing fractures. In a recent study, it was shown that new  spinal   fractures  were reduced by 62% in postmenopausal women with osteoporosis.

Boniva is a medication which helps reverse bone loss, that is taken only once a month. It can also be given in an injection at your doctor’s office three times per year.

The newest biophosphonate is Reclast, which is taken intravenously only once a year.

Forteo is a powerful medication that works in a different way. It actually stimulates new bone growth, while other medications prevent further bone loss. This drug is still being studied for long-term effects.

There are clearly many options for the treatment of osteoporosis. If you think you are at risk for osteoporosis, talk to your doctor about testing and treatment. Educate yourself on the benefits and possible side effects of each type of treatment, and discuss the options with your health care provider.

Armed with the knowledge of how to prevent osteoporosis and how to fight it with treatment, there is no reason to put yourself at risk.