BLOGS

By Pace Hospitals 15 Nov, 2017
If you have blood in urine, vomiting, or painful when urinate, you may have kidney stone. Technically, kidney stone is a solid piece of material that occurs in the urinary tract. It is normal if there is a small stone in your kidney. A small stone may pass and leave the body in the urine stream without causing symptoms. But if the stone grows to more than 5 millimeters, it definitely can cause blockage of the ureter.

Here are 5 best steps in preventing kidney stone you should follow.

  1. Drink Extra Water:  This first step is not a secret anymore. The fact, water can dilute the substances in urine that lead to stone. So, make sure that you drink enough fluids to pass 2 liters of urine a day. Another fact said that citrus beverages such as lemonade and orange juice are also beneficial to help kidney stone.

  2. Don’t Do Some Heavy Exercises:  Exercise seems as a healing of every disease, but the heavy one may worsen your condition. Some other activities such as sauna, hot yoga are not good either. Those activities can make you loss of water through sweating and it will leads to less urine production.

  3. Get the Calcium:  Having enough calcium is good as a prevention of kidney stone. Getting too little calcium can cause oxalate levels to rise and cause kidney stone. So, make sure that you take enough calcium appropriate to your age. Men 50 and older should get 1000 mg of calcium per day.

  4. Avoid the Trigger Foods:  A number of foods such as beets, chocolate, spinach, tea and most nuts are rich in oxalate. Those can lead you to kidney stone. Avoiding these foods are vital.

  5. Reduce Sodium:  High-sodium diet may increase the amount of calcium in your urine so it can trigger kidney stone. You are highly recommended to do a low-sodium diet. This diet is also good for your blood pressure and heart.

If you have kidney stone, book an appointment with:

Dr Shyam Varma
Advanced Laser & Laparoscopic Urologist,
Andrologist and Renal Transplant Surgeon
By Pace Hospitals 13 Nov, 2017
The University of Southampton has revealed their findings after a 15 year study of liver cirrhosis in more than 4,00,000 patients, and coffee has come out as the top antidote to heavy drinking. It took multiple scientists and doctors to come up with their best solution to reduce liver damage, and all were shocked that a few simple cups of coffee had the most significant healing power.

“Cirrhosis is potentially fatal and there is no cure as such. Therefore, it is significant that the risk of developing cirrhosis may be reduced by the consumption of coffee: a cheap, ubiquitous and well-tolerated beverage.”  

There are slightly more fatal cases of liver cirrhosis in males than females, and most prominent in individuals aged between 25-34, according to the National Institute of Alcohol and Alcohol Abuse. In the United States approximately 24% of the population engages in binge drinking, which causes 88000 deaths per year. Of that, almost half are liver-damage related.

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Does More Coffee Make Your Liver Merrier?
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One cup of coffee per day reduces the risk by 22%, two cups by 44%, 3 cups by 56% and 4 cups by 65%, showing that the compound effect declines slightly, but that the percentage is still remarkable per extra cup.

It was thereafter suggested that 2-4 cups of pure, filtered coffee per day would produce the maximum results, and that any additional cups would have a negative effect on the rest of the body due to the caffeine and acidity load.

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How Do I Know if I am Drinking Too Much?
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While there is no global consensus of how much alcohol exceeds the health limit, an average of governmental recommendations show that the benchmark sits at 14 units per week, which equates to about two glasses of wine taken daily or 8-10 grams of pure alcohol. Binge drinking has proven to have detrimental and compound damaging effects on your body, with your liver taking the biggest knock.

The major symptoms of liver cirrhosis include:

  • Fatigue
  • Weight Loss
  • Loss of Appetite
  • Frequent Nose Bleeds
  • Visible Spider-shaped Arteries Under the Skin
  • Swollen legs
  • Severe Itching
  • Abdominal Swelling
  • Jaundice/Yellowing of the Skin
The Good News is that your liver is an organ which regenerates cells annually, and can recover from the effects of heavy drinking, which cause liver cirrhosis.

The scar tissue caused by alcohol damage can be reduced and healed back into health, and coffee is the perfect beverage to support its path to a healthy condition. Up to 69% of Americans are undiagnosed with this condition, and up to one million people die per year from it.

Diagnosis involves observing symptoms, and completing a liver scan at your local medical centre. By cutting down the consumption of alcoholic beverages and adding a few cups of coffee to your day, you reduce the risk of fatality dramatically.

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Why Coffee?
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Studies are still ongoing, but the previous nine extensive studies have revealed that the powerful antioxidants, the caffeine and the excellent anti-inflammatory properties contained in coffee, such as chlorogenic acid, kahweol and cafestol are the reason behind its remarkable effect on damaged livers. By reducing inflammation, healing oxidative and corrosive stress and giving your body a healthy dose of circulation-inducing caffeine, your liver has the chance to recover from poor lifestyle choices made over a number of years.


References:  http://www.getholistichealth.com
By Pace Hospitals 26 Oct, 2017
Kidney stones have many causes and can affect any part of your urinary tract — from your kidneys to your bladder. Often, stones form when the urine becomes concentrated, allowing minerals to crystallize and stick together.

Passing kidney stones can be quite painful, but the stones usually cause no permanent damage if they're recognized in a timely fashion. Depending on your situation, you may need nothing more than to take pain medication and drink lots of water to pass a kidney stone. In other instances — for example, if stones become lodged in the urinary tract, are associated with a urinary infection or cause complications — surgery may be needed.

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Symptoms
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A kidney stone may not cause symptoms until it moves around within your kidney or passes into your ureter — the tube connecting the kidney and bladder. At that point, you may experience these signs and symptoms:

  • Severe pain in the side and back, below the ribs
  • Pain that radiates to the lower abdomen and groin
  • Pain that comes in waves and fluctuates in intensity
  • Pain on urination
  • Pink, red or brown urine
  • Cloudy or foul-smelling urine
  • Nausea and vomiting
  • Persistent need to urinate
  • Urinating more often than usual
  • Fever and chills if an infection is present
  • Urinating small amounts

Pain caused by a kidney stone may change — for instance, shifting to a different location or increasing in intensity — as the stone moves through your urinary tract.

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Causes
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Kidney stones often have no definite, single cause, although several factors may increase your risk.

Kidney stones form when your urine contains more crystal-forming substances — such as calcium, oxalate and uric acid than the fluid in your urine can dilute. At the same time, your urine may lack substances that prevent crystals from sticking together, creating an ideal environment for kidney stones to form.

Types of kidney stones include:

  • Calcium stones. Most kidney stones are calcium stones, usually in the form of calcium oxalate. Oxalate is a naturally occurring substance found in food and is also made daily by your liver. Some fruits and vegetables, as well as nuts and chocolate, have high oxalate content.

    Dietary factors, high doses of vitamin D, intestinal bypass surgery and several metabolic disorders can increase the concentration of calcium or oxalate in urine.

    Calcium stones may also occur in the form of calcium phosphate. This type of stone is more common in metabolic conditions, such as renal tubular acidosis. It may also be associated with certain migraine headaches or with taking certain seizure medications, such as topiramate (Topamax).
  • Struvite stones. Struvite stones form in response to an infection, such as a urinary tract infection. These stones can grow quickly and become quite large, sometimes with few symptoms or little warning.

  • Uric acid stones. Uric acid stones can form in people who don't drink enough fluids or who lose too much fluid, those who eat a high-protein diet, and those who have gout. Certain genetic factors also may increase your risk of uric acid stones.

  • Cystine stones. These stones form in people with a hereditary disorder that causes the kidneys to excrete too much of certain amino acids (cystinuria).
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Risk factors
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Factors that increase your risk of developing kidney stones include:

  • Family or personal history . If someone in your family has kidney stones, you're more likely to develop stones, too. And if you've already had one or more kidney stones, you're at increased risk of developing another.

  • Dehydration. Not drinking enough water each day can increase your risk of kidney stones. People who live in warm climates and those who sweat a lot may be at higher risk than others.

  • Certain diets. Eating a diet that's high in protein, sodium (salt) and sugar may increase your risk of some types of kidney stones. This is especially true with a high-sodium diet. Too much salt in your diet increases the amount of calcium your kidneys must filter and significantly increases your risk of kidney stones.

  • Being obese. High body mass index (BMI), large waist size and weight gain have been linked to an increased risk of kidney stones.

  • Digestive diseases and surgery. Gastric bypass surgery, inflammatory bowel disease or chronic diarrhea can cause changes in the digestive process that affect your absorption of calcium and water, increasing the levels of stone-forming substances in your urine.

  • Other medical conditions. Diseases and conditions that may increase your risk of kidney stones include renal tubular acidosis, cystinuria, hyperparathyroidism, certain medications and some urinary tract infections.

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Diagnosis

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If urologist suspects you have a kidney stone, you may have diagnostic tests and procedures, such as:

  • Blood testing. Blood tests may reveal too much calcium or uric acid in your blood. Blood test results help monitor the health of your kidneys and may lead your doctor to check for other medical conditions.
  • Urine testing. The 24-hour urine collection test may show that you're excreting too many stone-forming minerals or too few stone-preventing substances. For this test, your doctor may request that you perform two urine collections over two consecutive days.
  • Imaging. Imaging tests may show kidney stones in your urinary tract. Options range from simple abdominal X-rays, which can miss small kidney stones, to high-speed or dual energy computerized tomography (CT) that may reveal even tiny stones.
  • Other imaging options include an ultrasound, a noninvasive test, and intravenous urography, which involves injecting dye into an arm vein and taking X-rays (intravenous pyelogram) or obtaining CT images (CT urogram) as the dye travels through your kidneys and bladder.
  • Analysis of passed stones. You may be asked to urinate through a strainer to catch stones that you pass. Lab analysis will reveal the makeup of your kidney stones. Your doctor uses this information to determine what's causing your kidney stones and to form a plan to prevent more kidney stones.
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Treatment
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Certain medications have been shown to improve the chance that a stone will pass. The most common medication prescribed for this reason is tamsulosin. Tamsulosin (Flomax) relaxes the ureter, making it easier for the stone to pass. You may also need pain and anti-nausea medicine as you wait to pass the stone.

Kidney stones that can't be treated with conservative measures — either because they're too large to pass on their own or because they cause bleeding, kidney damage or ongoing urinary tract infections — may require more-extensive treatment. 

Surgery may be needed to remove a stone from the ureter or kidney if:

  • The stone fails to pass.
  • The pain is too great to wait for the stone to pass.
  • The stone is affecting kidney function. Small stones in the kidney may be left alone if they are not causing pain or infection. Some people choose to have their small stones removed. They do this because they are afraid the stone will unexpectedly start to pass and cause pain.
Kidney stones should be removed by surgery if they cause repeated infections in the urine or because they are blocking the flow of urine from the kidney. Today, surgery usually involves small or no incisions (cuts), minor pain and minimal time off work. Surgeries to remove stones in the kidneys or ureters are:

  • Shock wave lithotripsy (SWL):  Shock Wave Lithotripsy (SWL) is used to treat stones in the kidney and ureter. Shock waves are focused on the stone using X-rays or ultrasound to pinpoint the stone. Repeated firing of shock waves on the stone usually causes the stone to break into small pieces. These smaller pieces of stones pass out in the urine over a few weeks.
  • Ureteroscopy (URS):  Ureteroscopy (URS) is used to treat stones in the kidney and ureter. URS involves passing a very small telescope, called an ureteroscope, into the bladder, up the ureter and into the kidney. Rigid telescopes are used for stones in the lower part of the ureter near the bladder. Flexible telescopes are used to treat stones in the upper ureter and kidney.
  • Percutaneous nephrolithotomy (PCNL):  Percutaneous Lithotripsy (PCNL) is the best treatment for large stones in the kidney. General anesthesia is needed to do a PCNL. PCNL involves making a half-inch incision (cut) in the back or side, just large enough to allow a rigid telescope (nephroscope) to be passed into the hollow center part of the kidney where the stone is located.
  • Other surgery:  Other kidney surgery is rarely used to remove stones. 

Open, Laser, Laparoscopic or robotic surgery may be used only if all other less invasive procedures fail.  If you have Kidney stone better to consult with Urologist before going for surgery or medication.


Book an appointment :

Dr Shyam Varma
Consultant Laser, Laparoscopic Urologist, Andrologist and Kidney Transplant Surgeon

By Pace Hospitals 20 Oct, 2017

Osteoporosis is a occurs due to decrease in the density of bone, decreasing its strength and resulting in fragile bones. Osteoporosis leads to abnormally porous bone that is compressible, like a sponge. This weakens the bone and results in frequent fractures (breaks) in the bones.

Normal bone is composed of protein, collagen, and calcium, all of which give bone its strength. Bones that are affected by osteoporosis can break (fracture) with relatively minor injury that normally would not cause a bone to fracture. The fracture can be either in the form of cracking (as in a hip fracture) or collapsing (as in a compression fracture of the vertebrae of the spine). The spine, hips, ribs, and wrists are common areas of bone fractures from osteoporosis although osteoporosis-related fractures can occur in almost any skeletal bone.

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Factors that will help developing osteoporosis: 
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  • Family history of osteoporosis
  • Thin and small body frame
  • Caucasian or Asian race
  • Thin and small body frame
  • Personal history of fracture as an adult
  • Smoking Cigarette
  • Alcohol consumption
  • Lack of exercise
  • Diet low in calcium
  • Poor nutrition and poor general health, especially associated with chronic inflammation or bowel disease
  • Gastrointestinal disorder
  • Early menopause or with early surgical removal of both ovaries
  • Low testosterone levels in men
  • Chemotherapy that can cause early menopause due to its toxic effects on the ovaries
  • Chronic inflammation, due to chronic inflammatory arthritis or diseases, such as rheumatoid arthritis or liver diseases
  • Immobility, such as after a stroke, or from any condition that interferes with walking
  • Hyperthyroidism, a condition wherein too much thyroid hormone is produced by the thyroid gland
  • When vitamin D is lacking, the body cannot absorb adequate amounts of calcium from the diet to prevent osteoporosis.
  • Certain medications can cause osteoporosis.

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Symptoms and signs
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Osteoporosis can be present without any symptoms for decades because osteoporosis doesn't cause symptoms until bone breaks (fractures). Moreover, some osteoporotic fractures may escape detection for years when they do not cause symptoms. Therefore, patients may not be aware of their osteoporosis until they suffer a painful fracture. The symptom associated with osteoporotic fractures usually is pain; the location of the pain depends on the location of the fracture. The symptoms of osteoporosis in men are similar to the symptoms of osteoporosis in women.

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Osteoporosis consequences
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  • Osteoporotic bone fractures are responsible for considerable pain, decreased quality of life, lost workdays, and disability.
  • Up to 30% of patients suffering a hip fracture will require long-term nursing-home care. Elderly patients can develop pneumonia and blood clots in the leg veins that can travel to the lungs (pulmonary embolism) due to prolonged bed rest after the hip fracture.
  • Osteoporosis has even been linked with an increased risk of death. Some 20% of women with a hip fracture will die in the subsequent year as an indirect result of the fracture.
  • In addition, once a person has experienced a spine fracture due to osteoporosis, he or she is at very high risk of suffering another such fracture in the near future (next few years).
  • About 20% of postmenopausal women who experience a vertebral fracture will suffer a new vertebral fracture of bone in the following year.

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How to determine bone strength
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Bone mass (bone density) is determined by the amount of bone present in the skeletal structure. Generally, the higher the bone density, the stronger the bones. Bone density is greatly influenced by genetic factors, which in turn are sometimes modified by environmental factors and medications.

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Person should go for bone density testing
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  • All postmenopausal women below age 65 who have risk factors for osteoporosis
  • All women aged 65 and older
  • Postmenopausal women with fractures, although this is not mandatory because treatment may well be started regardless of bone density
  • Women with any of more than 50 medical conditions associated with osteoporosis; a primary care physician can scan a patient's list of medical illnesses to determine if one of these conditions is present (see causes above)
  • Women whose decision to begin treatment for osteoporosis might be aided by bone density testing to determine the presence or absence of osteoporosis or osteopenia

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Treatment for osteoporosis
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Although early detection and timely treatment of osteoporosis can substantially decrease the risk of future fractures, none of the available treatments for osteoporosis are complete cures. Therefore, prevention of osteoporosis is as important as treatment.

  • Quitting cigarette smoking
  • Curtailing excessive alcohol intake
  • Exercising regularly
  • Consuming a balanced diet with adequate calcium and vitamin D
  • Medications that stop bone loss and increase bone strength

The outlook for patients with osteoporosis depends greatly on where fractures occur. Additionally, if treatment is begun when the bone disease is detected early, the outcome is better. Get the expert consultation before going for treatment.


Book an appointment:

Dr Jayini P Rammohen
Consultant Orthopedics, Sports Medicine Specialist and Joint Replacement Surgeon

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Dr Anand V Agroya
Consultant Orthopedics & Trauma Surgeon, Specialist in Joint Replacement

 

By Pace Hospitals 18 Oct, 2017

Quitting smoking may be one of the best things you can do for your health and for your fertility.

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Smoking can cause infertility.
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Smokers are more likely to have fertility problems . If you smoke for many years, or smoke many cigarettes per day, your risk for fertility is increased.

When you smoke, more than 7000 chemicals spread throughout your entire body simultaneously all of your organs. This can lead to fertility problems, including the following:

  • Genetic issues
  • Ovulation problems
  • Damage to your reproductive organs
  • Damage to your eggs or premature menopause.
  • Increased risk of cancer and increased risk of miscarriage

In addition, smokers that try fertility treatments tend to take longer to get pregnant. Smokers are also more likely to give birth to babies with health problems.

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Passive smoking can also affect your fertility.
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  • If you live with a smoker or surrounded by smoker, Passive smoking exposes you to poisonous chemicals, affecting your fertility. In fact, experts say that passive smoking is almost as damaging to your fertility as if you were smoking yourself! Exposure to cigarette smoke for even just a few days can affect your health and your fertility.
  • Passive smoking is also a known cause of Sudden Infant Death Syndrome (SIDS). If you do become pregnant, you and your partner must stop smoking to protect the health of your baby.

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Smoking increases the chance of miscarriage
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  • The pain of miscarriage can be devastating. Due to the toxins from smoking, smokers are more likely to suffer from miscarriage. In addition, smoking increases several health risks during pregnancy, such as preterm labor and ectopic pregnancy.
  • Despite these warnings, millions of women of childbearing age still continue to smoke. By doing so, they risk their own health and the health of their babies.

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Smoking causes fertility problems for men.
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Men that smoke cigarettes are at an increased risk for the following male fertility problems:

  • Hormonal issues
  • Erectile dysfunction - trouble getting or maintaining an erection
  • Lower sperm count and sperm motility problems (motility is the ability of sperm to swim towards and penetrate the egg)

If you are trying to get pregnant without success and your partner smokes, encourage him to quit. The sooner he quits, the sooner you may be able to conceive.

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Stop smoking to increase your chances of getting pregnant.
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Fertility often improves for women after they stop smoking. Studies show that female smokers can increase their chances of conceiving by quitting at least two months before trying to get pregnant. Quit smoking and you may just find it easier to get pregnant.

Make an appointment with your doctor today and find out how to kick the habit for good.

Book an appointment with:

Dr. Shyam Varma
Laser, Laparoscopic Urologist and
Kidney Transplant Surgeon


By Pace Hospitals 14 Oct, 2017
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What is swine flu?
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Influenza, commonly known as the “flu”, is an acute infection of the respiratory tract caused by influenza viruses. There are three types of seasonal influenza viruses – A, B and C. Influenza A viruses are further categorized into subtypes. Seasonal influenza epidemics can be caused by new virus strains that are antigenically distinct from previously circulating virus strains to which a population has immunity; this is known as antigenic drift.

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How it transmit?
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Influenza viruses are spread from person-to-person. They can be transmitted by exposure to infectious droplets expelled by coughing or sneezing that are then inhaled, or can contaminate hands or other surfaces. Most persons ill with influenza shed virus (i.e. may be infectious) from a few days before symptoms begin through 5-7 days after illness onset.

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Clinical features
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Infection with influenza viruses can give rise to a wide range of clinical presentations, ranging from asymptomatic infection to severe illness and death depending on the characteristics of both the virus and the infected person. In the majority of people, influenza is an uncomplicated illness which is characterised by sudden onset of constitutional and respiratory symptoms such as fever, myalgia, cough, sore throat, rhinitis and headache. Uncomplicated influenza illness resolves after 3-7 days although cough and malaise can persist for >2 weeks.
  • Uncomplicated influenza: ILI (Influenza-like illness) may present with fever, cough, sore throat, coryza, headache, malaise, myalgia, arthralgia and sometimes gastrointestinal symptoms, but without any features of complicated influenza.
  • Complicated/severe influenza: Influenza requiring hospital admission and/or with symptoms and signs of lower respiratory tract infection (hypoxaemia, dyspnoea, tacchypnoea, lower chest wall indrawing and inability to feed), central nervous system involvement and/or a significant exacerbation of an underlying medical condition. 
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Risk factors for complicated/severe influenza:
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  • Pregnant women (including the post-partum period)
  • HIV–infected individuals
  • Individuals with tuberculosis
  • Persons of any age with chronic disease, including:
  • Pulmonary diseases (e.g. asthma, COPD)
  • Immunosuppression (e.g. persons on immunosuppressive medication, malignancy)
  • Cardiac diseases (e.g. congestive cardiac failure)
  • Metabolic disorders (e.g. diabetes)
  • Renal disease
  • Hepatic disease
  • Certain neurologic and neurodevelopmental conditions, including: disorders of the brain, spinal cord, peripheral nerve, and muscle such as cerebral palsy; epilepsy (seizure disorders); stroke; mental retardation; moderate to severe developmental delay; muscular dystrophy; or spinal cord injury.
  • Haemoglobinopathies (e.g. sickle cell disease)
  • Persons aged ≥65 years
  • Persons ≤18 years receiving chronic aspirin therapy
  • Persons who are morbidly obese (i.e. BMI ≥40)[23]
  • Young children (particularly <2 years of age)
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Prevention of influenza 
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Influenza vaccination is the most effective method for prevention and control of influenza infection available currently. In general, influenza vaccines are most effective among children ≥ 2 years and healthy adults.

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Influenza vaccination 
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Because of the changing nature of influenza viruses, WHO monitors the epidemiology of influenza viruses throughout the world. Each year recommendations about strains to be included in the vaccine for the following influenza season are made. Separate recommendations are made for the Southern and Northern Hemisphere vaccines each year.


Consult for medical advise. Book an appointment with 

Dr Sudhaker Barla
Consultant Physician, Diabetologist and Intensivist

By Pace Hospitals 13 Oct, 2017
Thrombosis is a serious condition that occurs when a blood clot forms in a vein. Other names for this condition include thromboembolism, post-thrombotic syndrome, and post-phlebitic syndrome.
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Risk factors for thrombosis?
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Certain conditions that alter how your blood moves through your veins can raise your risk of developing clots. These include:

  • having an injury that damages your veins
  • being overweight, which puts more pressure on the veins in your legs and pelvis
  • having a family history of thrombosis
  • having a catheter placed in a vein
  • taking birth control pills or undergoing hormone therapy
  • smoking (especially heavy)
  • staying seated for a long time while you’re in a car or on a plane, especially if you already have at least one other risk factor
Some diseases and disorders can increase your risk of having blood clots. These include hereditary blood clotting disorders, especially when you have at least one other risk factor. Cancer and inflammatory bowel disease can also increase the risk of developing a blood clot. Heart failure, a condition that makes it more difficult for your heart to pump blood, also occurs with an increased risk of clots.

Surgery:  Thrombosis is a major risk associated with surgery. This is especially true if you’re having a surgery in the lower extremities, such as joint replacement surgery. Your doctor will discuss the risk of Thrombosis if you need joint replacement surgery.

Pregnancy:  Being pregnant increases your risk of Thrombosis. Increased hormone levels, and a slower blood flow as your uterus expands and restricts blood flowing back from your lower extremities, contribute to this risk. This elevated risk continues until about six weeks after giving birth. Being on bed rest or having a C-section also increases your risk of having Thrombosis.

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Symptoms of thrombosis?
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Common symptoms include:

  • swelling in your foot, ankle, or leg, usually on one side
  • cramping pain in your affected leg that usually begins in your calf
  • severe, unexplained pain in your foot and ankle
  • an area of skin that feels warmer than the skin on the surrounding areas
  • skin over the affected area turning pale or a reddish or bluish color

People may not find out that they have thrombosis until they’ve gone through emergency treatment for a pulmonary embolism. A pulmonary embolism is a life-threatening complication ofthrombosisin which an artery in the lung becomes blocked.

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Treatment options for thrombosis?
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Treatment will attempt to prevent a pulmonary embolism and lower your risk of having more clots.

  • Medication: doctor might prescribe medications that thin your blood
  • Compression stockings: Wearing compression stockings can prevent swelling and lower your chance of developing clots. They reach just below your knee or right above it.
  • Filters: You might need to have a filter put inside the large abdominal vein, it helps prevent pulmonary embolisms by stopping clots from entering your lungs.
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Complications associated with thrombosis?
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You can develop a pulmonary embolism if a blood clot moves to your lungs and blocks a blood vessel. This can cause serious damage to your lungs and other parts of your body. You should get immediate medical help if you have signs of a pulmonary embolism. These signs include:

  • rapid breathing
  • dizziness
  • rapid heart rate  
  • sweating 
  • coughing up blood
  • chest pain that gets worse with coughing or inhaling deeply

By Pace Hospitals 12 Oct, 2017

Arthritis is very common but is not well understood. Actually, “arthritis” is not a single disease; it is an informal way of referring to joint pain or joint disease. There are more than 100 different types of arthritis and related conditions. People of all ages, sexes and races can and do have arthritis

More than 50 million adults and 300,000 children have some type of arthritis. It is most common among women and occurs more frequently as people get older.

Common arthritis joint symptoms include:

  • Swelling and pain
  • Stiffness
  • Decreased range of motion.

Symptoms may come and go. They can be mild, moderate or severe. They may stay about the same for years, but may progress or get worse over time. Severe arthritis can result in chronic pain, inability to do daily activities and make it difficult to walk or climb stairs. Arthritis can cause permanent joint changes. These changes may be visible, such as knobby finger joints, but often the damage can only be seen on X-ray. Some types of arthritis also affect the heart, eyes, lungs, kidneys and skin as well as the joints.

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There are different types of arthritis:

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Osteoarthritis:

Osteoarthritis is the most common type of arthritis. When the cartilage – the slick, cushioning surface on the ends of bones – wears away, bone rubs against bone, causing pain, swelling and stiffness. Over time, joints can lose strength and pain may become chronic. Risk factors include excess weight, family history, age and previous injury (an anterior cruciate ligament, or ACL, tear, for example).

When the joint symptoms of osteoarthritis are mild or moderate, they can be managed by:

  • Balancing activity with rest
  • Using hot and cold therapies 
  • Regular physical activity 
  • Maintaining a healthy weight 
  • Strengthening the muscles around the joint for added support 
  • Using assistive devices 
  • Taking over-the-counter (OTC) pain relievers or anti-inflammatory medicines 
  • Avoiding excessive repetitive movements

If joint symptoms are severe, causing limited mobility and affecting quality of life, some of the above management strategies may be helpful, but joint replacement may be necessary.

"Osteoarthritis can prevented by staying active, maintaining a healthy weight, and avoiding injury and repetitive movements."

 Inflammatory Arthritis:

A healthy immune system is protective. It generates internal inflammation to get rid of infection and prevent disease. But the immune system can go awry, mistakenly attacking the joints with uncontrolled inflammation, potentially causing joint erosion and may damage internal organs, eyes and other parts of the body. Rheumatoid arthritis and psoriatic arthritis are examples of inflammatory arthritis. Researchers believe that a combination of genetics and environmental factors can trigger autoimmunity. Smoking is an example of an environmental risk factor that can trigger rheumatoid arthritis in people with certain genes. 

With autoimmune and inflammatory types of arthritis, early diagnosis and aggressive treatment is critical. Slowing disease activity can help minimize or even prevent permanent joint damage. Remission is the goal and may be achieved through the use of one or more medications known as disease-modifying antirheumatic drugs (DMARDs). The goal of treatment is to reduce pain, improve function, and prevent further joint damage.

Infectious Arthritis:

A bacterium, virus or fungus can enter the joint and trigger inflammation. Examples of organisms that can infect joints are:

  • Salmonella and shigella (food poisoning or contamination)
  • Chlamydia and gonorrhea (sexually transmitted diseases)
  • Hepatitis C (a blood-to-blood infection, often through shared needles or transfusions).

In many cases, timely treatment with antibiotics may clear the joint infection, but sometimes the arthritis becomes chronic. 

Metabolic Arthritis:

Uric acid is formed as the body breaks down purines, a substance found in human cells and in many foods. Some people have high levels of uric acid because they naturally produce more than is needed or the body can’t get rid of the uric acid quickly enough. In some people the uric acid builds up and forms needle-like crystals in the joint, resulting in sudden spikes of extreme joint pain, or a gout attack. Gout can come and go in episodes or, if uric acid levels aren’t reduced, it can become chronic, causing ongoing pain and disability.

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How is arthritis diagnosed?

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Orthopaedist will perform a physical exam to check for fluid around the joints, warm or red joints, and limited range of motion in the joints.  

Through extracting and analyzing inflammation levels in blood and joint fluids can help to determine the kind of arthritis. Blood tests that check for specific types of antibodies like anti-CCP (anti-cyclic citrullinated peptide), RF (rheumatoid factor), and ANA (antinuclear antibody) are also common diagnostic tests.

Commonly use imaging scans such as X-ray, MRI, and CT scans to produce an image of your bones and cartilage. This is so they can rule out other causes of your symptoms, such as bone spurs.

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Arthritis treatment

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The main goal of treatment is to reduce the amount of pain you’re experiencing and prevent additional damage to the joints. You’ll learn what works best for you in terms of controlling pain. Some people find heating pads and ice packs to be soothing. Others use mobility assistance devices, like canes or walkers, to help take pressure off sore joints. Improving joint function is also important.

  • Medication:  A number of different types of medication treat arthritis. Consult orthopaedist.
  • Surgery:  Surgery to replace your joint with an artificial one may be an option. This form of surgery is most commonly performed to replace hips and knees. If your arthritis is most severe in your fingers or wrists, your doctor may perform a joint fusion. In this procedure, the ends of your bones are locked together until they heal and become one.
  • Physical therapy:  Physical therapy involving exercises that help strengthen the muscles around the affected joint is a core component of arthritis treatment.

By Pace Hospitals 11 Oct, 2017

Alcoholism – one step to danger.

Those individuals who consume an excessive amount of alcohol can cause a great deal of damage to their mental and physical health. This chemical can act as a toxin in the body and can start to destroy ever organ. The other problem with alcohol abuse is that it often leads to obesity and this creates further health problems for the individual. It is therefore vital that people learn to moderate their alcoholic intake or quit altogether.

The Dangers of Obesity

Obesity is viewed as one of the most preventable causes of death in the modern world. The dangers of carrying too much body fat include:

  • It increases the likelihood of suffering from type II diabetes.
  • Those individuals who are obese are far more likely to suffer from heart problems.
  • It is a key symptom of metabolic syndrome and therefore increases the risk of developing cardiovascular problems, insulin resistance, and stroke.
  • Obesity puts added pressure on the skeleton and this can lead to chronic conditions such as osteoarthritis.
  • When people are carrying around a great deal of excess body weight it reduces their tolerance for physical activity. This is likely to mean that their life is less enjoyable than what it could be.
  • People who are obese tend to suffer from low self-esteem.
  • If people feel bad about themselves as a result of being obese it can lead to symptoms of depression. It could also encourage the individual to turn to alcohol for comfort.
  • Many people who are obese suffer from sleep apnea. This means that they are not getting a good night sleep as a result.
  • Those individuals who are obese are more likely to develop certain cancers – in particular breast and colon cancer.

Obesity and Alcoholic Drinks

Alcoholic drinks are usually said to contain an excessive amount of empty calories with no real nutritional value.

  • One 12 ounce standard beer contains about 160 calories
  • A glass of white wine can have as much as 300 calories.
  • One gin and tonic can also have as much as 300 calories.

If people consume a few alcoholic drinks per week on top of their regular diet it can quickly put them on the path to obesity. One problem is that the calories in these alcoholic drinks do not satisfy hunger. In fact they can stimulate hunger so that the individual ends up eating more than normal on top of the calories consumed in these drinks. Those people who regularly go to the bar might also be missing out on healthier activities where they would be burning calories.

Obesity and Alcohol Abuse

  • Alcohol can certainly lead to obesity. A alcohol drinker may be consuming an extra 1000 to 3000 calories per day on top of their diet. They are also likely to be engaged in a lifestyle that does not involve a great deal of physical activity. It is even possible for alcoholic people to be obese and still suffer from malnutrition. This is because although they are consuming plenty of calories they are not getting the right mix of nutrients that their body needs to stay healthy.
  • Obesity can be used as a justification to abuse alcohol. Those who are overweight like this tend to suffer from low self esteem and this can lead to symptoms of depression. Alcohol offers a temporary reprieve from uncomfortable thoughts and emotions. This temporary comfort comes with a high price because it is likely to lead to further misery. Alcohol abuse can take people on a trip to alcoholism and further weight gain. They may lose everything they cherish along the way.

Avoid Alcohol Related Obesity but how?

There are things that people can do to avoid alcohol related obesity such as:

  • Understand the calorific content of different alcoholic drinks.
  • Keep to the recommended levels for safe alcohol consumptions. This is one drink per day for adult women and two drinks per day for adult men. For the purpose of these recommendations a drink would be considered a standard beer, a glass of wine, or a shot of spirits.
  • If people are unable to keep to the safe levels for alcohol consumption it is advisable that they quit altogether. Inability to moderate is one of the symptoms of alcohol abuse.
  • Keeping active can help people burn off some of the extra calories they consume while drinking alcohol.
  • It is important to realize that just because an alcoholic is labeled as ‘lite’ or ‘low calorie’ does not that it is safe to drink in high qualities.
  • Those people who drink need to pay special attention to their diet to make sure that the empty calories they are consuming with alcohol do not replace needed nutrients.
  • If people with alcohol problems do enter recovery they need to be aware of turning to food for comfort. It is not uncommon for individuals to experience obesity in recovery if they are not careful.

By Pace Hospitals 11 Oct, 2017

Obesity is a epidemic defined by the World Health Organisation (WHO) as an abnormal or excessive fat accumulation that can have a negative impact on health.

does junk food really play a role in this problem?

Junk food is high in calories but low in nutritional value. It often contains high amounts of sugar and fat without providing many minerals, vitamins or nutrients that are essential to good health.

In order to reduce your risk of obesity, it is essential to reduce your intake of these unhealthy processed foods and replace them with fruit, vegetables, legumes, whole grains and nuts.

However, more and more people are opting to eat junk food as it appeals to our base needs. Why? Junk food is able to stimulate the reward system in our brain, which means we are primed to consume more of it. Your body releases “feel-good” chemicals when you eat these foods, so it’s no wonder they have increased in popularity!

Excess sugar and fat can accumulate in your body causing weight gain. This has other affects on your body – it can increase your risk of developing type 2 diabetes, heart disease and arthritis.

Doing a 28 day detox program can help get you on the right path towards leading a better lifestyle. You may lose weight afterwards and feel generally happier and healthier. Plus, you can learn to get pleasure from eating healthier treats and wean your body from its sugar and fat addiction.

In addition to this, it is important to exercise if you want to reach or maintain a healthy body mass index (BMI). You must work off the energy you have eaten in order to maintain a steady and healthy weight. BMI is the measurement generally used to calculate obesity and it calculated by dividing your weight in kilograms by your height in metres squared. A BMI between 18.5 to 24.9 is healthy.

More Posts
By Pace Hospitals 15 Nov, 2017
If you have blood in urine, vomiting, or painful when urinate, you may have kidney stone. Technically, kidney stone is a solid piece of material that occurs in the urinary tract. It is normal if there is a small stone in your kidney. A small stone may pass and leave the body in the urine stream without causing symptoms. But if the stone grows to more than 5 millimeters, it definitely can cause blockage of the ureter.

Here are 5 best steps in preventing kidney stone you should follow.

  1. Drink Extra Water:  This first step is not a secret anymore. The fact, water can dilute the substances in urine that lead to stone. So, make sure that you drink enough fluids to pass 2 liters of urine a day. Another fact said that citrus beverages such as lemonade and orange juice are also beneficial to help kidney stone.

  2. Don’t Do Some Heavy Exercises:  Exercise seems as a healing of every disease, but the heavy one may worsen your condition. Some other activities such as sauna, hot yoga are not good either. Those activities can make you loss of water through sweating and it will leads to less urine production.

  3. Get the Calcium:  Having enough calcium is good as a prevention of kidney stone. Getting too little calcium can cause oxalate levels to rise and cause kidney stone. So, make sure that you take enough calcium appropriate to your age. Men 50 and older should get 1000 mg of calcium per day.

  4. Avoid the Trigger Foods:  A number of foods such as beets, chocolate, spinach, tea and most nuts are rich in oxalate. Those can lead you to kidney stone. Avoiding these foods are vital.

  5. Reduce Sodium:  High-sodium diet may increase the amount of calcium in your urine so it can trigger kidney stone. You are highly recommended to do a low-sodium diet. This diet is also good for your blood pressure and heart.

If you have kidney stone, book an appointment with:

Dr Shyam Varma
Advanced Laser & Laparoscopic Urologist,
Andrologist and Renal Transplant Surgeon
By Pace Hospitals 13 Nov, 2017
The University of Southampton has revealed their findings after a 15 year study of liver cirrhosis in more than 4,00,000 patients, and coffee has come out as the top antidote to heavy drinking. It took multiple scientists and doctors to come up with their best solution to reduce liver damage, and all were shocked that a few simple cups of coffee had the most significant healing power.

“Cirrhosis is potentially fatal and there is no cure as such. Therefore, it is significant that the risk of developing cirrhosis may be reduced by the consumption of coffee: a cheap, ubiquitous and well-tolerated beverage.”  

There are slightly more fatal cases of liver cirrhosis in males than females, and most prominent in individuals aged between 25-34, according to the National Institute of Alcohol and Alcohol Abuse. In the United States approximately 24% of the population engages in binge drinking, which causes 88000 deaths per year. Of that, almost half are liver-damage related.

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Does More Coffee Make Your Liver Merrier?
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One cup of coffee per day reduces the risk by 22%, two cups by 44%, 3 cups by 56% and 4 cups by 65%, showing that the compound effect declines slightly, but that the percentage is still remarkable per extra cup.

It was thereafter suggested that 2-4 cups of pure, filtered coffee per day would produce the maximum results, and that any additional cups would have a negative effect on the rest of the body due to the caffeine and acidity load.

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How Do I Know if I am Drinking Too Much?
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While there is no global consensus of how much alcohol exceeds the health limit, an average of governmental recommendations show that the benchmark sits at 14 units per week, which equates to about two glasses of wine taken daily or 8-10 grams of pure alcohol. Binge drinking has proven to have detrimental and compound damaging effects on your body, with your liver taking the biggest knock.

The major symptoms of liver cirrhosis include:

  • Fatigue
  • Weight Loss
  • Loss of Appetite
  • Frequent Nose Bleeds
  • Visible Spider-shaped Arteries Under the Skin
  • Swollen legs
  • Severe Itching
  • Abdominal Swelling
  • Jaundice/Yellowing of the Skin
The Good News is that your liver is an organ which regenerates cells annually, and can recover from the effects of heavy drinking, which cause liver cirrhosis.

The scar tissue caused by alcohol damage can be reduced and healed back into health, and coffee is the perfect beverage to support its path to a healthy condition. Up to 69% of Americans are undiagnosed with this condition, and up to one million people die per year from it.

Diagnosis involves observing symptoms, and completing a liver scan at your local medical centre. By cutting down the consumption of alcoholic beverages and adding a few cups of coffee to your day, you reduce the risk of fatality dramatically.

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Why Coffee?
-------------------------------------

Studies are still ongoing, but the previous nine extensive studies have revealed that the powerful antioxidants, the caffeine and the excellent anti-inflammatory properties contained in coffee, such as chlorogenic acid, kahweol and cafestol are the reason behind its remarkable effect on damaged livers. By reducing inflammation, healing oxidative and corrosive stress and giving your body a healthy dose of circulation-inducing caffeine, your liver has the chance to recover from poor lifestyle choices made over a number of years.


References:  http://www.getholistichealth.com
By Pace Hospitals 26 Oct, 2017
Kidney stones have many causes and can affect any part of your urinary tract — from your kidneys to your bladder. Often, stones form when the urine becomes concentrated, allowing minerals to crystallize and stick together.

Passing kidney stones can be quite painful, but the stones usually cause no permanent damage if they're recognized in a timely fashion. Depending on your situation, you may need nothing more than to take pain medication and drink lots of water to pass a kidney stone. In other instances — for example, if stones become lodged in the urinary tract, are associated with a urinary infection or cause complications — surgery may be needed.

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Symptoms
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A kidney stone may not cause symptoms until it moves around within your kidney or passes into your ureter — the tube connecting the kidney and bladder. At that point, you may experience these signs and symptoms:

  • Severe pain in the side and back, below the ribs
  • Pain that radiates to the lower abdomen and groin
  • Pain that comes in waves and fluctuates in intensity
  • Pain on urination
  • Pink, red or brown urine
  • Cloudy or foul-smelling urine
  • Nausea and vomiting
  • Persistent need to urinate
  • Urinating more often than usual
  • Fever and chills if an infection is present
  • Urinating small amounts

Pain caused by a kidney stone may change — for instance, shifting to a different location or increasing in intensity — as the stone moves through your urinary tract.

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Causes
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Kidney stones often have no definite, single cause, although several factors may increase your risk.

Kidney stones form when your urine contains more crystal-forming substances — such as calcium, oxalate and uric acid than the fluid in your urine can dilute. At the same time, your urine may lack substances that prevent crystals from sticking together, creating an ideal environment for kidney stones to form.

Types of kidney stones include:

  • Calcium stones. Most kidney stones are calcium stones, usually in the form of calcium oxalate. Oxalate is a naturally occurring substance found in food and is also made daily by your liver. Some fruits and vegetables, as well as nuts and chocolate, have high oxalate content.

    Dietary factors, high doses of vitamin D, intestinal bypass surgery and several metabolic disorders can increase the concentration of calcium or oxalate in urine.

    Calcium stones may also occur in the form of calcium phosphate. This type of stone is more common in metabolic conditions, such as renal tubular acidosis. It may also be associated with certain migraine headaches or with taking certain seizure medications, such as topiramate (Topamax).
  • Struvite stones. Struvite stones form in response to an infection, such as a urinary tract infection. These stones can grow quickly and become quite large, sometimes with few symptoms or little warning.

  • Uric acid stones. Uric acid stones can form in people who don't drink enough fluids or who lose too much fluid, those who eat a high-protein diet, and those who have gout. Certain genetic factors also may increase your risk of uric acid stones.

  • Cystine stones. These stones form in people with a hereditary disorder that causes the kidneys to excrete too much of certain amino acids (cystinuria).
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Risk factors
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Factors that increase your risk of developing kidney stones include:

  • Family or personal history . If someone in your family has kidney stones, you're more likely to develop stones, too. And if you've already had one or more kidney stones, you're at increased risk of developing another.

  • Dehydration. Not drinking enough water each day can increase your risk of kidney stones. People who live in warm climates and those who sweat a lot may be at higher risk than others.

  • Certain diets. Eating a diet that's high in protein, sodium (salt) and sugar may increase your risk of some types of kidney stones. This is especially true with a high-sodium diet. Too much salt in your diet increases the amount of calcium your kidneys must filter and significantly increases your risk of kidney stones.

  • Being obese. High body mass index (BMI), large waist size and weight gain have been linked to an increased risk of kidney stones.

  • Digestive diseases and surgery. Gastric bypass surgery, inflammatory bowel disease or chronic diarrhea can cause changes in the digestive process that affect your absorption of calcium and water, increasing the levels of stone-forming substances in your urine.

  • Other medical conditions. Diseases and conditions that may increase your risk of kidney stones include renal tubular acidosis, cystinuria, hyperparathyroidism, certain medications and some urinary tract infections.

----------------------------  
Diagnosis

----------------------------

If urologist suspects you have a kidney stone, you may have diagnostic tests and procedures, such as:

  • Blood testing. Blood tests may reveal too much calcium or uric acid in your blood. Blood test results help monitor the health of your kidneys and may lead your doctor to check for other medical conditions.
  • Urine testing. The 24-hour urine collection test may show that you're excreting too many stone-forming minerals or too few stone-preventing substances. For this test, your doctor may request that you perform two urine collections over two consecutive days.
  • Imaging. Imaging tests may show kidney stones in your urinary tract. Options range from simple abdominal X-rays, which can miss small kidney stones, to high-speed or dual energy computerized tomography (CT) that may reveal even tiny stones.
  • Other imaging options include an ultrasound, a noninvasive test, and intravenous urography, which involves injecting dye into an arm vein and taking X-rays (intravenous pyelogram) or obtaining CT images (CT urogram) as the dye travels through your kidneys and bladder.
  • Analysis of passed stones. You may be asked to urinate through a strainer to catch stones that you pass. Lab analysis will reveal the makeup of your kidney stones. Your doctor uses this information to determine what's causing your kidney stones and to form a plan to prevent more kidney stones.
----------------------------  

Treatment
----------------------------  

Certain medications have been shown to improve the chance that a stone will pass. The most common medication prescribed for this reason is tamsulosin. Tamsulosin (Flomax) relaxes the ureter, making it easier for the stone to pass. You may also need pain and anti-nausea medicine as you wait to pass the stone.

Kidney stones that can't be treated with conservative measures — either because they're too large to pass on their own or because they cause bleeding, kidney damage or ongoing urinary tract infections — may require more-extensive treatment. 

Surgery may be needed to remove a stone from the ureter or kidney if:

  • The stone fails to pass.
  • The pain is too great to wait for the stone to pass.
  • The stone is affecting kidney function. Small stones in the kidney may be left alone if they are not causing pain or infection. Some people choose to have their small stones removed. They do this because they are afraid the stone will unexpectedly start to pass and cause pain.
Kidney stones should be removed by surgery if they cause repeated infections in the urine or because they are blocking the flow of urine from the kidney. Today, surgery usually involves small or no incisions (cuts), minor pain and minimal time off work. Surgeries to remove stones in the kidneys or ureters are:

  • Shock wave lithotripsy (SWL):  Shock Wave Lithotripsy (SWL) is used to treat stones in the kidney and ureter. Shock waves are focused on the stone using X-rays or ultrasound to pinpoint the stone. Repeated firing of shock waves on the stone usually causes the stone to break into small pieces. These smaller pieces of stones pass out in the urine over a few weeks.
  • Ureteroscopy (URS):  Ureteroscopy (URS) is used to treat stones in the kidney and ureter. URS involves passing a very small telescope, called an ureteroscope, into the bladder, up the ureter and into the kidney. Rigid telescopes are used for stones in the lower part of the ureter near the bladder. Flexible telescopes are used to treat stones in the upper ureter and kidney.
  • Percutaneous nephrolithotomy (PCNL):  Percutaneous Lithotripsy (PCNL) is the best treatment for large stones in the kidney. General anesthesia is needed to do a PCNL. PCNL involves making a half-inch incision (cut) in the back or side, just large enough to allow a rigid telescope (nephroscope) to be passed into the hollow center part of the kidney where the stone is located.
  • Other surgery:  Other kidney surgery is rarely used to remove stones. 

Open, Laser, Laparoscopic or robotic surgery may be used only if all other less invasive procedures fail.  If you have Kidney stone better to consult with Urologist before going for surgery or medication.


Book an appointment :

Dr Shyam Varma
Consultant Laser, Laparoscopic Urologist, Andrologist and Kidney Transplant Surgeon

By Pace Hospitals 20 Oct, 2017

Osteoporosis is a occurs due to decrease in the density of bone, decreasing its strength and resulting in fragile bones. Osteoporosis leads to abnormally porous bone that is compressible, like a sponge. This weakens the bone and results in frequent fractures (breaks) in the bones.

Normal bone is composed of protein, collagen, and calcium, all of which give bone its strength. Bones that are affected by osteoporosis can break (fracture) with relatively minor injury that normally would not cause a bone to fracture. The fracture can be either in the form of cracking (as in a hip fracture) or collapsing (as in a compression fracture of the vertebrae of the spine). The spine, hips, ribs, and wrists are common areas of bone fractures from osteoporosis although osteoporosis-related fractures can occur in almost any skeletal bone.

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Factors that will help developing osteoporosis: 
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  • Family history of osteoporosis
  • Thin and small body frame
  • Caucasian or Asian race
  • Thin and small body frame
  • Personal history of fracture as an adult
  • Smoking Cigarette
  • Alcohol consumption
  • Lack of exercise
  • Diet low in calcium
  • Poor nutrition and poor general health, especially associated with chronic inflammation or bowel disease
  • Gastrointestinal disorder
  • Early menopause or with early surgical removal of both ovaries
  • Low testosterone levels in men
  • Chemotherapy that can cause early menopause due to its toxic effects on the ovaries
  • Chronic inflammation, due to chronic inflammatory arthritis or diseases, such as rheumatoid arthritis or liver diseases
  • Immobility, such as after a stroke, or from any condition that interferes with walking
  • Hyperthyroidism, a condition wherein too much thyroid hormone is produced by the thyroid gland
  • When vitamin D is lacking, the body cannot absorb adequate amounts of calcium from the diet to prevent osteoporosis.
  • Certain medications can cause osteoporosis.

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Symptoms and signs
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Osteoporosis can be present without any symptoms for decades because osteoporosis doesn't cause symptoms until bone breaks (fractures). Moreover, some osteoporotic fractures may escape detection for years when they do not cause symptoms. Therefore, patients may not be aware of their osteoporosis until they suffer a painful fracture. The symptom associated with osteoporotic fractures usually is pain; the location of the pain depends on the location of the fracture. The symptoms of osteoporosis in men are similar to the symptoms of osteoporosis in women.

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Osteoporosis consequences
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  • Osteoporotic bone fractures are responsible for considerable pain, decreased quality of life, lost workdays, and disability.
  • Up to 30% of patients suffering a hip fracture will require long-term nursing-home care. Elderly patients can develop pneumonia and blood clots in the leg veins that can travel to the lungs (pulmonary embolism) due to prolonged bed rest after the hip fracture.
  • Osteoporosis has even been linked with an increased risk of death. Some 20% of women with a hip fracture will die in the subsequent year as an indirect result of the fracture.
  • In addition, once a person has experienced a spine fracture due to osteoporosis, he or she is at very high risk of suffering another such fracture in the near future (next few years).
  • About 20% of postmenopausal women who experience a vertebral fracture will suffer a new vertebral fracture of bone in the following year.

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How to determine bone strength
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Bone mass (bone density) is determined by the amount of bone present in the skeletal structure. Generally, the higher the bone density, the stronger the bones. Bone density is greatly influenced by genetic factors, which in turn are sometimes modified by environmental factors and medications.

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Person should go for bone density testing
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  • All postmenopausal women below age 65 who have risk factors for osteoporosis
  • All women aged 65 and older
  • Postmenopausal women with fractures, although this is not mandatory because treatment may well be started regardless of bone density
  • Women with any of more than 50 medical conditions associated with osteoporosis; a primary care physician can scan a patient's list of medical illnesses to determine if one of these conditions is present (see causes above)
  • Women whose decision to begin treatment for osteoporosis might be aided by bone density testing to determine the presence or absence of osteoporosis or osteopenia

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Treatment for osteoporosis
-------------------------------------------------

Although early detection and timely treatment of osteoporosis can substantially decrease the risk of future fractures, none of the available treatments for osteoporosis are complete cures. Therefore, prevention of osteoporosis is as important as treatment.

  • Quitting cigarette smoking
  • Curtailing excessive alcohol intake
  • Exercising regularly
  • Consuming a balanced diet with adequate calcium and vitamin D
  • Medications that stop bone loss and increase bone strength

The outlook for patients with osteoporosis depends greatly on where fractures occur. Additionally, if treatment is begun when the bone disease is detected early, the outcome is better. Get the expert consultation before going for treatment.


Book an appointment:

Dr Jayini P Rammohen
Consultant Orthopedics, Sports Medicine Specialist and Joint Replacement Surgeon

-------------------------------------------------------

Dr Anand V Agroya
Consultant Orthopedics & Trauma Surgeon, Specialist in Joint Replacement

 

By Pace Hospitals 18 Oct, 2017

Quitting smoking may be one of the best things you can do for your health and for your fertility.

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Smoking can cause infertility.
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Smokers are more likely to have fertility problems . If you smoke for many years, or smoke many cigarettes per day, your risk for fertility is increased.

When you smoke, more than 7000 chemicals spread throughout your entire body simultaneously all of your organs. This can lead to fertility problems, including the following:

  • Genetic issues
  • Ovulation problems
  • Damage to your reproductive organs
  • Damage to your eggs or premature menopause.
  • Increased risk of cancer and increased risk of miscarriage

In addition, smokers that try fertility treatments tend to take longer to get pregnant. Smokers are also more likely to give birth to babies with health problems.

--------------------------------------- 
Passive smoking can also affect your fertility.
--------------------------------------- 

  • If you live with a smoker or surrounded by smoker, Passive smoking exposes you to poisonous chemicals, affecting your fertility. In fact, experts say that passive smoking is almost as damaging to your fertility as if you were smoking yourself! Exposure to cigarette smoke for even just a few days can affect your health and your fertility.
  • Passive smoking is also a known cause of Sudden Infant Death Syndrome (SIDS). If you do become pregnant, you and your partner must stop smoking to protect the health of your baby.

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Smoking increases the chance of miscarriage
--------------------------------------- 

  • The pain of miscarriage can be devastating. Due to the toxins from smoking, smokers are more likely to suffer from miscarriage. In addition, smoking increases several health risks during pregnancy, such as preterm labor and ectopic pregnancy.
  • Despite these warnings, millions of women of childbearing age still continue to smoke. By doing so, they risk their own health and the health of their babies.

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Smoking causes fertility problems for men.
---------------------------------------

Men that smoke cigarettes are at an increased risk for the following male fertility problems:

  • Hormonal issues
  • Erectile dysfunction - trouble getting or maintaining an erection
  • Lower sperm count and sperm motility problems (motility is the ability of sperm to swim towards and penetrate the egg)

If you are trying to get pregnant without success and your partner smokes, encourage him to quit. The sooner he quits, the sooner you may be able to conceive.

---------------------------------------
Stop smoking to increase your chances of getting pregnant.
---------------------------------------

Fertility often improves for women after they stop smoking. Studies show that female smokers can increase their chances of conceiving by quitting at least two months before trying to get pregnant. Quit smoking and you may just find it easier to get pregnant.

Make an appointment with your doctor today and find out how to kick the habit for good.

Book an appointment with:

Dr. Shyam Varma
Laser, Laparoscopic Urologist and
Kidney Transplant Surgeon


By Pace Hospitals 14 Oct, 2017
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What is swine flu?
-------------------------------
Influenza, commonly known as the “flu”, is an acute infection of the respiratory tract caused by influenza viruses. There are three types of seasonal influenza viruses – A, B and C. Influenza A viruses are further categorized into subtypes. Seasonal influenza epidemics can be caused by new virus strains that are antigenically distinct from previously circulating virus strains to which a population has immunity; this is known as antigenic drift.

-------------------------------
How it transmit?
-------------------------------
Influenza viruses are spread from person-to-person. They can be transmitted by exposure to infectious droplets expelled by coughing or sneezing that are then inhaled, or can contaminate hands or other surfaces. Most persons ill with influenza shed virus (i.e. may be infectious) from a few days before symptoms begin through 5-7 days after illness onset.

-------------------------------
Clinical features
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Infection with influenza viruses can give rise to a wide range of clinical presentations, ranging from asymptomatic infection to severe illness and death depending on the characteristics of both the virus and the infected person. In the majority of people, influenza is an uncomplicated illness which is characterised by sudden onset of constitutional and respiratory symptoms such as fever, myalgia, cough, sore throat, rhinitis and headache. Uncomplicated influenza illness resolves after 3-7 days although cough and malaise can persist for >2 weeks.
  • Uncomplicated influenza: ILI (Influenza-like illness) may present with fever, cough, sore throat, coryza, headache, malaise, myalgia, arthralgia and sometimes gastrointestinal symptoms, but without any features of complicated influenza.
  • Complicated/severe influenza: Influenza requiring hospital admission and/or with symptoms and signs of lower respiratory tract infection (hypoxaemia, dyspnoea, tacchypnoea, lower chest wall indrawing and inability to feed), central nervous system involvement and/or a significant exacerbation of an underlying medical condition. 
-------------------------------
Risk factors for complicated/severe influenza:
-------------------------------

  • Pregnant women (including the post-partum period)
  • HIV–infected individuals
  • Individuals with tuberculosis
  • Persons of any age with chronic disease, including:
  • Pulmonary diseases (e.g. asthma, COPD)
  • Immunosuppression (e.g. persons on immunosuppressive medication, malignancy)
  • Cardiac diseases (e.g. congestive cardiac failure)
  • Metabolic disorders (e.g. diabetes)
  • Renal disease
  • Hepatic disease
  • Certain neurologic and neurodevelopmental conditions, including: disorders of the brain, spinal cord, peripheral nerve, and muscle such as cerebral palsy; epilepsy (seizure disorders); stroke; mental retardation; moderate to severe developmental delay; muscular dystrophy; or spinal cord injury.
  • Haemoglobinopathies (e.g. sickle cell disease)
  • Persons aged ≥65 years
  • Persons ≤18 years receiving chronic aspirin therapy
  • Persons who are morbidly obese (i.e. BMI ≥40)[23]
  • Young children (particularly <2 years of age)
------------------------------- 
Prevention of influenza 
-------------------------------

Influenza vaccination is the most effective method for prevention and control of influenza infection available currently. In general, influenza vaccines are most effective among children ≥ 2 years and healthy adults.

------------------------------- 
Influenza vaccination 
-------------------------------

Because of the changing nature of influenza viruses, WHO monitors the epidemiology of influenza viruses throughout the world. Each year recommendations about strains to be included in the vaccine for the following influenza season are made. Separate recommendations are made for the Southern and Northern Hemisphere vaccines each year.


Consult for medical advise. Book an appointment with 

Dr Sudhaker Barla
Consultant Physician, Diabetologist and Intensivist

By Pace Hospitals 13 Oct, 2017
Thrombosis is a serious condition that occurs when a blood clot forms in a vein. Other names for this condition include thromboembolism, post-thrombotic syndrome, and post-phlebitic syndrome.
---------------------------------------------
Risk factors for thrombosis?
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Certain conditions that alter how your blood moves through your veins can raise your risk of developing clots. These include:

  • having an injury that damages your veins
  • being overweight, which puts more pressure on the veins in your legs and pelvis
  • having a family history of thrombosis
  • having a catheter placed in a vein
  • taking birth control pills or undergoing hormone therapy
  • smoking (especially heavy)
  • staying seated for a long time while you’re in a car or on a plane, especially if you already have at least one other risk factor
Some diseases and disorders can increase your risk of having blood clots. These include hereditary blood clotting disorders, especially when you have at least one other risk factor. Cancer and inflammatory bowel disease can also increase the risk of developing a blood clot. Heart failure, a condition that makes it more difficult for your heart to pump blood, also occurs with an increased risk of clots.

Surgery:  Thrombosis is a major risk associated with surgery. This is especially true if you’re having a surgery in the lower extremities, such as joint replacement surgery. Your doctor will discuss the risk of Thrombosis if you need joint replacement surgery.

Pregnancy:  Being pregnant increases your risk of Thrombosis. Increased hormone levels, and a slower blood flow as your uterus expands and restricts blood flowing back from your lower extremities, contribute to this risk. This elevated risk continues until about six weeks after giving birth. Being on bed rest or having a C-section also increases your risk of having Thrombosis.

---------------------------------------------
Symptoms of thrombosis?
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Common symptoms include:

  • swelling in your foot, ankle, or leg, usually on one side
  • cramping pain in your affected leg that usually begins in your calf
  • severe, unexplained pain in your foot and ankle
  • an area of skin that feels warmer than the skin on the surrounding areas
  • skin over the affected area turning pale or a reddish or bluish color

People may not find out that they have thrombosis until they’ve gone through emergency treatment for a pulmonary embolism. A pulmonary embolism is a life-threatening complication ofthrombosisin which an artery in the lung becomes blocked.

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Treatment options for thrombosis?
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Treatment will attempt to prevent a pulmonary embolism and lower your risk of having more clots.

  • Medication: doctor might prescribe medications that thin your blood
  • Compression stockings: Wearing compression stockings can prevent swelling and lower your chance of developing clots. They reach just below your knee or right above it.
  • Filters: You might need to have a filter put inside the large abdominal vein, it helps prevent pulmonary embolisms by stopping clots from entering your lungs.
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Complications associated with thrombosis?
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You can develop a pulmonary embolism if a blood clot moves to your lungs and blocks a blood vessel. This can cause serious damage to your lungs and other parts of your body. You should get immediate medical help if you have signs of a pulmonary embolism. These signs include:

  • rapid breathing
  • dizziness
  • rapid heart rate  
  • sweating 
  • coughing up blood
  • chest pain that gets worse with coughing or inhaling deeply

By Pace Hospitals 12 Oct, 2017

Arthritis is very common but is not well understood. Actually, “arthritis” is not a single disease; it is an informal way of referring to joint pain or joint disease. There are more than 100 different types of arthritis and related conditions. People of all ages, sexes and races can and do have arthritis

More than 50 million adults and 300,000 children have some type of arthritis. It is most common among women and occurs more frequently as people get older.

Common arthritis joint symptoms include:

  • Swelling and pain
  • Stiffness
  • Decreased range of motion.

Symptoms may come and go. They can be mild, moderate or severe. They may stay about the same for years, but may progress or get worse over time. Severe arthritis can result in chronic pain, inability to do daily activities and make it difficult to walk or climb stairs. Arthritis can cause permanent joint changes. These changes may be visible, such as knobby finger joints, but often the damage can only be seen on X-ray. Some types of arthritis also affect the heart, eyes, lungs, kidneys and skin as well as the joints.

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There are different types of arthritis:

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Osteoarthritis:

Osteoarthritis is the most common type of arthritis. When the cartilage – the slick, cushioning surface on the ends of bones – wears away, bone rubs against bone, causing pain, swelling and stiffness. Over time, joints can lose strength and pain may become chronic. Risk factors include excess weight, family history, age and previous injury (an anterior cruciate ligament, or ACL, tear, for example).

When the joint symptoms of osteoarthritis are mild or moderate, they can be managed by:

  • Balancing activity with rest
  • Using hot and cold therapies 
  • Regular physical activity 
  • Maintaining a healthy weight 
  • Strengthening the muscles around the joint for added support 
  • Using assistive devices 
  • Taking over-the-counter (OTC) pain relievers or anti-inflammatory medicines 
  • Avoiding excessive repetitive movements

If joint symptoms are severe, causing limited mobility and affecting quality of life, some of the above management strategies may be helpful, but joint replacement may be necessary.

"Osteoarthritis can prevented by staying active, maintaining a healthy weight, and avoiding injury and repetitive movements."

 Inflammatory Arthritis:

A healthy immune system is protective. It generates internal inflammation to get rid of infection and prevent disease. But the immune system can go awry, mistakenly attacking the joints with uncontrolled inflammation, potentially causing joint erosion and may damage internal organs, eyes and other parts of the body. Rheumatoid arthritis and psoriatic arthritis are examples of inflammatory arthritis. Researchers believe that a combination of genetics and environmental factors can trigger autoimmunity. Smoking is an example of an environmental risk factor that can trigger rheumatoid arthritis in people with certain genes. 

With autoimmune and inflammatory types of arthritis, early diagnosis and aggressive treatment is critical. Slowing disease activity can help minimize or even prevent permanent joint damage. Remission is the goal and may be achieved through the use of one or more medications known as disease-modifying antirheumatic drugs (DMARDs). The goal of treatment is to reduce pain, improve function, and prevent further joint damage.

Infectious Arthritis:

A bacterium, virus or fungus can enter the joint and trigger inflammation. Examples of organisms that can infect joints are:

  • Salmonella and shigella (food poisoning or contamination)
  • Chlamydia and gonorrhea (sexually transmitted diseases)
  • Hepatitis C (a blood-to-blood infection, often through shared needles or transfusions).

In many cases, timely treatment with antibiotics may clear the joint infection, but sometimes the arthritis becomes chronic. 

Metabolic Arthritis:

Uric acid is formed as the body breaks down purines, a substance found in human cells and in many foods. Some people have high levels of uric acid because they naturally produce more than is needed or the body can’t get rid of the uric acid quickly enough. In some people the uric acid builds up and forms needle-like crystals in the joint, resulting in sudden spikes of extreme joint pain, or a gout attack. Gout can come and go in episodes or, if uric acid levels aren’t reduced, it can become chronic, causing ongoing pain and disability.

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How is arthritis diagnosed?

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Orthopaedist will perform a physical exam to check for fluid around the joints, warm or red joints, and limited range of motion in the joints.  

Through extracting and analyzing inflammation levels in blood and joint fluids can help to determine the kind of arthritis. Blood tests that check for specific types of antibodies like anti-CCP (anti-cyclic citrullinated peptide), RF (rheumatoid factor), and ANA (antinuclear antibody) are also common diagnostic tests.

Commonly use imaging scans such as X-ray, MRI, and CT scans to produce an image of your bones and cartilage. This is so they can rule out other causes of your symptoms, such as bone spurs.

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Arthritis treatment

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The main goal of treatment is to reduce the amount of pain you’re experiencing and prevent additional damage to the joints. You’ll learn what works best for you in terms of controlling pain. Some people find heating pads and ice packs to be soothing. Others use mobility assistance devices, like canes or walkers, to help take pressure off sore joints. Improving joint function is also important.

  • Medication:  A number of different types of medication treat arthritis. Consult orthopaedist.
  • Surgery:  Surgery to replace your joint with an artificial one may be an option. This form of surgery is most commonly performed to replace hips and knees. If your arthritis is most severe in your fingers or wrists, your doctor may perform a joint fusion. In this procedure, the ends of your bones are locked together until they heal and become one.
  • Physical therapy:  Physical therapy involving exercises that help strengthen the muscles around the affected joint is a core component of arthritis treatment.

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