Dr. Kamalini Venkat

Excessive and persistent pain223604 in the feet as well as the ankle joints could point at the existence of a condition known as flat foot pain. This happens due to the difference between a normal foot and a flat foot. While a normal foot will have an upward arch under the foot, right in the middle, the flat foot does not have such a support. This arch is usually formed by the tendons and ligaments that help in rendering support to the foot as well as stabilising the rest of the body. When these tendons and ligaments become weak, the arch begins to diminish before finally disappearing, which leaves the patient with a flat foot.

This can be a painful condition. Let us look at the ways in which it may be cured.

1. Foot Wear: When you are suffering from this condition, it is important to wear comfortable and supportive foot wear like shoes, sandals and slippers which can support the arch and help in giving stability to the rest of the body. Besides looking for shoes that will provide the right amount of comfort, one can also use additional support like insoles that will help in giving comfort while you are walking, standing or running.
2. Orthotics: These are tools that can be recommended by your doctor in order to help in minimising the pressure that one feels in the foot. The orthotics usually distributes this pressure by giving much needed additional support to the arch of the foot. These tools also help in realigning the foot’s ankle with its bones as well as the joints, which can help in successfully treating this condition to a great extent. They are usually customised as per your exact foot shape and size, as well as the problem you are facing, so that you have plenty of support when you are using your feet for varied activities.
3. Arch inserts and wraps: If your normal shoes are lacking the arch support that you require for flat feet, then you can also invest in arch inserts and wraps which will reduce the pain and prevent it from reoccurring. Also, these will help you to remain standing or walking for longer periods of time, as they add that extra bit of support to your feet for normal functioning.
4. Surgery: If the various non surgical treatments do not help you over a period of a few months, then it may be time to speak with your podiatrist or orthopaedic specialist so that you can go in for a surgery that will fix this problem. This kind of surgery will help in stabilising the feet and ankle bones by applying corrective foot support. In case you have a concern or query you can always consult an expert & get answers to your questions!

I am Dr Surekha Jain, I am practicing since last 38 years in Shalimar Bagh Delhi. And I am curtsy consultant to Shalimar Bagh Fortis hospital. Today I am going to talk about a very important hormone which is known as pregnancy hormone or beta HCG. Why it is called pregnancy hormone because this hormone beta HCG is the first hormone to increase and which can diagnose pregnancy very early. Why we should diagnose pregnancy very early, now days in a era of assistant reproductive techniques like IVF, ETSY, IUI etc. We want to know whether our patient is pregnant or not very early so that we can support her and we can give her certain medications which will help her to continue her pregnancy. This is a pregnancy hormone which starts as soon as when embryo is form that is 14 to 15 days after your ovulation or egg pick up. We can detect up to 100mIU’s of Beta HCG on the 14th day after ovulation, if pregnancy is occur. So to know the welfare of the pregnancy or to know first of all whether you are pregnant or not, we do your beta HCG. Anything about 10mIU/ML is taken as positive, it is just positive but to know whether the patient is doing fine or not, we can repeat this hormone every 48 to 72 hours that is every third day and it should almost double up every third day which shows that now the pregnancy is going fine and now we are assured. And we keep on following the patient. When the beta HCG levels they reach around 1000 to 1500 International unit the gynaecologist or your doctor should be able to see by Trans vaginal sonography at least sack. If she cannot see the sack at 1000 to 1500 International unit then there must be something wrong either blighted over or anything else. Now how can you test a beta HCG there are two methods to test beta HCG one is urine and other is blood, urine beta HCG is very simple to test anybody can test it at home. You can buy a simple strip from any chemist and then you can put fresh clean urine in the small socket formed on the slide 3 drops of fresh urine and wait for about 3 to 5 minutes. What you can see on the slide is either a one single line of about red or violet colour which shows that you are not pregnant but you have done your test alright. But if you see 2 parallel lines of equal strength you are happy because indicates that you are pregnant and your pregnancy is fine. But in case you don't see any of the lines, it shows that you have not done that test correctly or you are suffering from some severe urinary tract infection or your urine is very diluted. You have taken it after lot of consumption of water or some liquids. So Urine Pregnancy Test is very easy the drawback with Urine Pregnancy Test is it just tells you that you are pregnant, it doesn't tell you what will happen or what time of the pregnancy it is. Now the second method to test beta HCG is blood, it's very important definitive and very good test to know about the conception and its progress and the time of weeks. So if you get your blood beta HCG done in your blood as I told you anything about 10mIU/ML is positive test and then you follow it every third day to find out that it becomes double or not and then when it is about 1000mIU/ML then it should be seen in the trans vaginal sonography. What is the use of this hormone, why this hormone is there it is with some purpose the purpose of this particular hormone is that when you conceive and after just fertilizations 8 to 10 days after fertilization the embryo goes and implants in the uterus and there it is formed by the plasanta, this sends a message to the ovary that corpus luteum has to keep on working because corpus luteum give the hormone progesterone which is very-very necessary for the pregnancy. Now once the corpus luteum is giving progesterone and gradually the plasanta develops. When the plasnta develops it takes so what the corpus luteum, see the nature's method tell the Corpus luteum to maintain the corpus luteum in pregnancy the beta HCG is keep on increasing till 8 to 10 weeks it is the highest it around 10 weeks its level is about 100, 1000 international unit but as soon as the plasnka takes over the work of making progesterone corpus luteum is no more required. And hence the beta HCG also keeps on reducing and it makes effective Plateau at around 20 weaks its only 20000 then it goes to Plateau and it remains at the same level till full top. Beta HCG other than telling you about the welfare of the pregnancy has certain other many important jobs to do. First of all if your beta HCG is not corresponding with the weeks of pregnancy shown in your lab report, it shows that either your pregnancy is not progressing well or you might be having ectopic pregnancy that is your pregnancy might be other than the in the uterus. It can be it outside the uterus which is very dangerous for the health of the patient. Second it shows if it is very high it shows either you are having multiple pregnancy or some pregnancy related cancers which are known as trophoblastic disease of the pregnancy. Which are also again very dangerous and followed by beta HCG test and thirdly this test is also done to know about the welfare of the foetus in the first trimester of your pregnancy that is known as double marker. So it's a very-very important hormone and is related to all the pregnancy welfares, miscarriages, blighted ovum, ectopic, twins, cancer-related pregnancy that's all, ok.