Healthy Joints For a Healthy Living

A joint also called an articulation, is any place where adjacent bones come together (articulate with each other) to form a connection.  The joint allows the bones to move freely but within controlled limits.

There are various types of joints in the body but among them, the synovial joints are the most common joint.

A key structural characteristic for a synovial joint is its joint cavity. This fluid-filled space is the site at which the articulating surfaces of the bones come into contact with each other. This gives the bones of a synovial joint the ability to move smoothly against each other, allowing for increased joint mobility.

Some joints, such as the knee, elbow, and shoulder, are self-lubricating, almost frictionless, and are able to withstand compression and maintain heavy loads while still executing smooth and precise movements. Other joints such as sutures between the bones of the skull permit very little movement (only during birth) in order to protect the brain and the sense organs.

In a joint, bones do not directly come into contact with each other. They are cushioned by cartilage that lines your joints (articular cartilage), synovial membranes around the joint and a lubricating fluid inside your joints (synovial fluid).

Muscles provide the force and strength to move the body. Coordination is directed by the brain but is affected by changes in the muscles and joints. Changes in the muscles, joints, and bones affect the posture and walk, and lead to weakness and slowed movement.

AGING CHANGES ON JOINTS AND MUSCLES

From about age 30, the density of bones begins to diminish in men and women. This loss of bone density accelerates in women after menopause. As a result, bones become more fragile and are more likely to break, especially in old age.

As people age, their joints are affected by changes in cartilage and in connective tissue. The cartilage inside a joint becomes thinner, and components of the cartilage (the proteoglycans—substances that help provide the cartilage’s resilience) become altered, which may make the joint less resilient and more susceptible to damage. Thus, in some people, the surfaces of the joint do not slide as well over each other as they used to. This process may lead to osteoarthritis or osteoarthrosis. Additionally, joints become stiffer because the connective tissue within ligaments and tendons becomes more rigid and brittle. This change also limits the range of motion of joints.

Loss of muscle (sarcopenia) is a process that starts around age 30 and progresses throughout life. In this process, the amount of muscle tissue and the number and size of muscle fibres gradually decrease. The result of sarcopenia is a gradual loss of muscle mass and muscle strength. This mild loss of muscle strength places increased stress on certain joints (such as the knees) and may predispose a person to arthritis or falling.

Symptoms of osteoarthritis can include:

  • Painstiffnessa grating or grinding sensation (crepitus) when the joint movesswelling (either hard or soft)not being able to use the affected

Joint normally, which can make it difficult to do certain activities

(For example climbing stairs).

PREVENTION

Exercise is one of the best ways to slow or prevent problems with the muscles, joints, and bones. A moderate exercise program can help you maintain strength, balance, and flexibility. Exercise helps the bones stay strong.

A Harvard Alumni Study has published a report that a caloric expenditure of >2000 kcal/day associated with 25% reduction in mortality, they even suggested that physical activity levels must be maintained THROUGHOUT life

Research shows that:

  • Exercise can make bones stronger and help slow the rate of bone loss.
  • Older people can increase muscle mass and strength through muscle-strengthening activities.
  • Balance and coordination exercises, such as tai chi, can help reduce the risk of falls.
  • Physical activity in later life may delay the progression of osteoporosis as it slows down the rate at which bone mineral density is reduced.
  • Weight-bearing exercise, such as walking or weight training, is the best type of exercise for maintenance of bone mass. There is a suggestion that twisting or rotational movements, where the muscle attachments pull on the bone, are also beneficial.
  • Older people who exercise in water (which is not weight bearing) may still experience increases in bone and muscle mass compared to sedentary older people.

Aerobic exercise is any exercise that increases your pulse rate and makes you short of breath (for example a brisk walk, swimming or using an exercise bike). Regular aerobic exercise should help you sleep better, is good for your general health and well-being, and can also reduce pain by raising the levels of pain-relieving hormones called endorphins.

  • Stretching is another excellent way to help maintain joint flexibility.

See your doctor before you start any new physical activity program. If you haven’t exercised for a long time, are elderly or have a chronic disease (such as arthritis), your doctor, physiotherapist or exercise physiologist can help tailor an appropriate and safe exercise program for you.

To summarize

Older adults are the fastest-growing segment of the population

  • As the older adult population increases in number, there is considerable impact on health care and economic aspects of society
  • Observational studies suggest that physical activity may increase the quantity and quality of life

It’s never too late to start living an active lifestyle and enjoying the benefits.

Dr. Ashwin Narasimhaprasad 

Specialist in Orthopaedics  

Aster Clinic, Muteena (DMPC)

Dr. Ashwin - Muteena

http://asterclinic.ae/doctor/dr-ashwin-narasimhaprasad/

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Paediatric Influenza Infections

Viral flu or Influenza is one of the most common and significant causes of respiratory infections worldwide. As many as 1 in 3 children, seeking treatment for flu – like illnesses, at the peak of flu season ( December to February), are at the risk of complications like pneumonia and bronchitis.

 

SIGNS AND SYMPTOMS

High fever, chills, myalgia, headache, fatigue, nasal congestion, non-productive cough, conjunctivitis and sometimes diarrhoea.

 

MODE OF SPREAD

The Influenza virus spreads through coughing, sneezing or touching objects used by infected person.eg: Handkerchief or towels

 

DIAGNOSIS

Mostly clinical, based on examination findings. In some cases, your Paediatrician may recommend a complete blood count or a nasal swab test to confirm it.

 

TREATMENT

It is mostly supportive, in the form of

  • Acetaminophen for fever
  • Expectorants
  • Steam Inhalation
  • Saline nebulization
  • Oral or IV Fluids, if oral intake is reduced.
  • Anti-viral therapy with Oseltamivir, in severe cases
  • Antibiotics – don’t have a role in most cases.

 

PREVENTION

Regular handwashing and personal hygiene help prevent infections from spreading. It is difficult though to prevent infections from spreading amongst family members and in school.

The flu vaccine can help reduce or prevent viral influenza. It can be given to children over 6 months of age. It is effective for up to 1 year after vaccination. It is recommended for children with recurrent viral respiratory infections, especially when they start school or daycare.

It is an inactivated vaccine and may cause fever up to 2 days after vaccination. It is to be avoided for children with an egg allergy.

 

Dr.Brindha BalaSubramanian

Specialist Paediatrician & Neonatologist 

Aster Clinic, Al Muteena (DMPC)

Dr.-Brinda-60x60

 

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Prostate Cancer – It’s Causes and Symptoms.

The prostate gland is part of the male reproductive system and is located below the bladder and in front of the rectum. The size of the gland changes with age, being smaller in young men and larger in older men. Being a part of the male reproductive system, the prostate gland functions to produce and release a fluid that forms part of the semen.

Cancer is a condition in which the cells in a particular part of the body start growing uncontrollably and crowd out the normal cells. Cells in any part of the body can become cancer cells and spread to the other parts of the body. Prostate cancer begins when cells in the prostate gland, in men, start to multiply uncontrollably. Prostate cancer is one of the most common types of cancer in men. Prostate cancer usually grows slowly and initially remains confined to the prostate gland itself, where it may not cause serious harm. While some types of prostate cancer grow slowly and may need minimal or no treatment, other types are aggressive and can spread quickly. Unlike other forms of cancer, however, if detected early, prostate cancer has a very high rate of survival attached to it.

Despite the high rate of diagnosis for prostate cancer in older men, doctors have not been able to pinpoint one or more exact causes as to why prostate cancer presents itself in some men. What doctors do know is how the process of prostate cancer begins and spreads. Cancer begins when cells in the prostate become abnormal. Mutations present in the DNA of the cells cause them to grow and multiply more rapidly than normal cells would. These mutated cells continue surviving while the normal cells around them perish. The accumulating mutated cells form a tumour that can grow to invade the nearby tissue. These abnormal cells can also break off (metastasize) and spread to other parts of the body.

Although doctors have not identified a direct cause for the advent of prostate cancer in men, they have been able to identify risk factors that increase the chances of getting prostate cancer. These risk factors include:

  • Age: Statistics show that the older a person is, the more likely they are to be diagnosed with prostate cancer. The rate of diagnosis for men under 40 is 1 in 10,000. However, this rate shoots up considerably as the age bracket increases. The rate of diagnosis for men between the ages of 40 and 59 is 1 in 38, while the rate of diagnosis for men above the age of 60 is 1 in 14.
  • Family history/ Genetics: Another risk factor is the presence of prostate cancer in the family. If men in a family have a history of prostate cancer, then it is likely to be passed down onto the successive generations. Furthermore, if the women have a family history of containing the gene that increases the risk for breast cancer (BRCA 1 or BRCA2), then to the risk of prostate cancer increases for the offspring.
  • Obesity: Although there is no direct linkage between a high BMI and the risk of getting prostate cancer, it has been observed that obese men that have been diagnosed with prostate cancer usually suffer from the aggressive form of the disease.

One of the standout features of prostate cancer is also the reason why doctors strongly suggest that men over 40 get regularly screened for the disease, namely, that has no overt symptoms. Since prostate cancer starts in a relatively small gland, located in a relatively obscure position in the body, the disease stays silent for many years. In some cases, it has been seen in autopsies in patients that have died from other causes that they were suffering from prostate cancer as well, without having shown any physical symptoms for the same. However, in more aggressive forms of the disease, there are certain physical discomforts that can arise, these include:

  • A need to urinate frequently, especially at night; sometimes urgently
  • Difficulty starting or holding back urination
  • Weak, dribbling, or interrupted flow of urine
  • Painful or burning urination
  • A decrease in the amount of fluid ejaculated
  • Blood in the urine or semen
  • Pain or stiffness in the lower back, hips, pelvis, or thighs

However, these symptoms may also be indicative of the presence of other diseases such as Benign Prostatic Hyperplasia (BPH) or prostatitis.

Almost all forms of prostate cancer are adenocarcinomas, and they might vary between gestating slowly and gestating rapidly. Due to the lack of symptoms, until very late into the disease, physicians and doctors are usually adamant about their male patients above 40 getting checked for prostate cancer. Despite the widespread nature of the disease, there is still a lot of misinformation about it and a general lack of knowledge about it, amongst the general public. In the UAE itself, 20% of all cancer cases were those of the prostate kind. As men get older it is imperative that they get themselves checked for any signs of prostate cancer, because as mentioned earlier, early detection of the disease can go a long way in eliminating it from the body completely.

Dr.Nazeer Ahamed

Specialist Urologist 

Aster Clinic, Bur Dubai (AJMC)

Dr.-Nazeer-Ahamed

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Are you feeling SAD this season?

Have you ever experienced being sad, irritable, moody or have you lost interest in your usual activities all at the same time every year? We have all heard about seasonal changes, even in areas that have only two seasons, but have you heard of seasonal changes in a person?

As surprising as it may sound, some people experience a serious mood change with the change in weather, some people feel down and experience seasonal depression during the winter months particularly. This is a psychological condition known as Seasonal Affective Disorder or SAD.

When the temperature levels drop and winter begins to set in, we all begin to function a little slower. We feel like staying at home and cuddling in a blanket to stay cosy. For some people, this feeling gets critical to an extent that it begins interfering with their lives. It is normal to feel irritable or tired during the winter months because of reduced light and shorter days but if this becomes a recurring issue every year during the winter months, making it difficult to function normally, chances are that you may be suffering from Seasonal Affective Disorder. SAD is a sub-type of depression that comes and goes during seasons.

Feeling slightly down every now and then is normal as everybody goes through this feeling at some point in time. However feeling sad and depressed can sometimes become incapacitate and have severe consequences to the extent of the person feeling suicidal.

Symptoms of Seasonal Affective Disorder vary from feeling depressed throughout the day for almost every day, having very low energy, no interest in things you generally like to do, to feeling irritated, having difficulty in concentrating, sleeping etc. Symptoms also vary depending on seasons. The winter specific symptoms of SAD include tiredness, changes in appetite, weight gain, feeling lethargic, feeling of heaviness in the limbs, hypersensitivity to rejection, withdrawal symptoms etc.  However, the symptoms of depression aren’t always as obvious, as they manifest themselves in many other ways. Sometimes the changes may be very subtle and the person undergoing the changes may fail to realise it, although people surrounding will surely notice the changes.

Melatonin is a hormone produced in our body to regulate sleep and wakefulness. Light affects the amount of melatonin produced in the body. Normally melatonin levels remain high throughout the night and drop in the morning. This may differ with seasonal changes, during the shorter days the body may produce melatonin either earlier or later than usual, hence leading to symptoms of SAD. This causes a disruption in the normal functioning of the body’s internal system because melatonin slows down the nervous system and induces sleep and low levels of energy.

Seasonal depression in the winter is linked to excess production of melatonin, however, SAD may affect people even in the summer months. Research shows that people in the UAE suffer from the inverted form of SAD where people feel that they are trapped indoors because of the scorching heat in this region during the summer months. The study also established a link between depressive symptoms and decreasing levels of Vitamin D.

SAD, however, is a treatable disorder and the awareness among people about the condition is rather less. There are some ailments that can be resolved without medical help, however certain symptoms, particular symptoms of SAD when appears all together is an indication that urgent medical attention is required.  Consulting a specialist on noticing any of the visible and obvious symptoms of depression is recommended. At an individual level, on noticing symptoms of SAD, one can undertake a few steps like;

  • Soaking up some sun even in the winter months. Sitting by the window, opening all the blinds or curtains during the day will help absorb as much sunlight as possible. Even the smallest amount of sunlight counts.
  • Regular physical activity is a must to keep the body from feeling lethargic and to keep the blood flowing. Simple exercises like stretching or yoga can be done indoors.
  • Photo therapy, the practice of light treatment can be used to mimic sunlight, the feeling of being in the sun indoors. It can also be used even during the dark hours.

Despite all this, medication and therapy may be required if the symptoms get too extreme. Getting over the symptoms of SAD may not be as easy as it may seem. Sometimes people require extra help because if the symptoms get severe, people may resort to activities like excess alcohol intake, drug abuse and even suicide. There are a number of treatment options for SAD and it is best to visit a doctor sooner than later when new symptoms develop.

Dr.Mohammed Yousef

Specialist Psychiatrist

Aster Clinic, Al Muteena (DMPC)

Dr.-Mohammed-Yousaf- muteena

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GERD – Symptoms and Prevention

GERD is a condition in which the stomach acid or contents from the stomach flow back into the food pipe (esophagus). The backwash (reflux) irritates the lining of the esophagus and causes GERD. Gastroesophageal refers to the stomach and the esophagus. While reflux refers to the back-flow of acidic or non-acidic stomach contents into the esophagus. A band of muscles at the junction of the stomach and esophagus called the lower esophageal sphincter (LES) normally act, in conjunction with the diaphragm, as a barrier to prevent the reflux of stomach contents into the esophagus. It is when that barrier is relaxed at inappropriate times or is otherwise compromised that reflux occurs.

GERD is characterized by symptoms and/or tissue damage that results from repeated or prolonged exposure of the lining of the esophagus to contents from the stomach. If tissue damage is present, the individual is said to have esophagitis or erosive GERD. The presence of symptoms with no evident tissue damage is referred to as non-erosive GERD.

GERD symptoms are often persistent, such as chronic heartburn and the regurgitation of acid. But sometimes there are no apparent symptoms, and the presence of GERD is revealed only when complications become evident. While the symptoms of GERD vary from person to person, the majority of people with GERD have mild symptoms, with no visible evidence of tissue damage and little risk of developing complications.

Periodic heartburn is a symptom that many people experience. If it occurs occasionally just after a meal and less than once per week, it is likely a “benign” condition. However heartburn that occurs more frequently than once a week, becomes more severe, or occurs at night and wakes a person from sleep, may be a sign of a more serious condition and consultation with a physician is advised. Even occasional heartburn – if it has occurred for a period of 5 years or more, or is associated with difficulty in swallowing– may signal a more serious condition. People with long standing chronic heartburn are at greater risk for complications including stricture or a potentially pre-cancerous disease that involves a cellular change in the esophagus called Barrett’s esophagus.

Persistent chronic heartburn and acid regurgitation are the most common symptom of GERD. But there are numerous less common symptoms that also may be associated with GERD. These may include:

  • Belching
  • Difficulty or pain when swallowing
  • Water brash (sudden excess of saliva)
  • Dysphagia (the sensation of food sticking in the esophagus)
  • Chronic sore throat
  • Laryngitis
  • Inflammation of the gums
  • Erosion of the enamel of the teeth
  • Chronic irritation in the throat
  • Hoarseness in the morning
  • A sour taste
  • Bad breath

Chest pain may also indicate acid reflux. Nevertheless, this kind of pain or discomfort should prompt urgent medical evaluation in order to exclude possible heart conditions. Relief of symptoms after a two-week trial therapy with a proton pump inhibitor (a prescription medication that inhibits gastric acid secretion) is an indication that GERD is the cause. This can also be confirmed with pH monitoring, which measures the level of acid refluxing into the esophagus and as high as the larynx.

On the positive side, since GERD is a lifestyle disorder, making significant changes in your lifestyle and eating habits can greatly reduce the impact of GERD or even prevent its onset to begin with. Here are 10 tips you can try to prevent GERD.

  1. Lose weight. Obesity is the leading cause of GERD because the extra stomach fat places pressure on your abdomen, pushing gastric juices up into your esophagus.
  2. Avoid foods known to cause reflux.If you’re at risk for GERD, avoid:
    • Fatty foods
    • Spicy foods
    • Acidic foods, like tomatoes and citrus
    • Mint
    • Chocolate
    • Onions
    • Coffee or any caffeinated beverage
    • Carbonated beverages
  3. Eat smaller meals.Large meals fill the stomach and put pressure on the LES, making reflux and GERD more likely.
  4. Don’t lie down after eating.Wait at least three hours before you lie down after a meal. Gravity normally helps keep acid reflux from developing. When you eat a meal and then stretch out for a nap, you’re taking gravity out of the equation. As a result, acid more easily presses against the LES and flows into the esophagus.
  5. Elevate your bed.Raising the head of your bed six to eight inches can help gravity keep gastric acid down in your stomach. You could also use a wedge-shaped support. Don’t use extra pillows, as they only raise your head and will not help with GERD. You need your entire upper body elevated to get relief.
  6. Review your medications.There are a number of medications that can increase your risk of GERD, either by relaxing the LES, interfering with the digestive process, or further irritating an already inflamed esophagus. These medications include:
    • Non-steroidal anti-inflammatory drugs, or NSAIDs
    • Calcium channel blockers (often used to treat high blood pressure)
    • Certain asthma medications, including beta-agonists like albuterol
    • Anticholinergics, medications used to treat conditions such as seasonal allergies and glaucoma
    • Bisphosphonates, used to boost bone density
    • Sedatives and painkillers
    • Some antibiotics
    • Potassium
    • Iron tablets

If you are taking any of these medications, talk to your doctor about switching to another drug that does not have the same effect on the upper digestive tract. However, never stop taking a prescribed medication without first consulting your doctor.

  1. Quit smoking.Some studies have found that nicotine can relax the muscles of the LES and can also interfere with your saliva’s ability to clear acid out of the esophagus.
  2. Cut back on alcohol.As with smoking, alcohol can cause the LES to relax. Alcohol can also cause the esophageal muscles to spasm.
  3. Wear loose-fitting clothes.Do not wear tight clothing or belts that can constrict your stomach.

In the UAE itself, there has been a rise in the incidents of patients suffering from some degree of GERD. Specialists at Aster Hospital and Clinic often receive 2 to 3 patients a day with GERD. In the last 1.8 years, they have treated around 320 patients with the condition. Aster Hospital and Clinic has initiated a “GERD Awareness Campaign” to educate the residents of UAE on alarming symptoms or critical symptoms associated with the disease which, if noted, should prompt medical attention. Through dedicated programmes for the general population, Aster aims to encourage early diagnosis and proper treatment in order to improve the quality of life of people suffering from the condition.

 

Dr. Sabu Antony

Specialist Gastroenterologist

Aster Clinic, Bur Dubai (AJMC)

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