What is Developmental Dysplasia of the Hip?

Developmental dysplasia of the hip or DDH, is a condition that affects the hip joint in newborns and young children. The hip is like a ball-and-cup, formed by the round top of the thigh bone - called the femur - and a cup-shaped socket in the pelvis. The hip joint is stable in spite of its large range of motion and is kept in place by ligaments and other soft tissue structures. The normal infant hip is not mature at birth but develops into a strong and stable joint as the child grows.

What happens in hip dysplasia?

In DDH, the hip does not develop normally as the cup and ball are either partially or completely out of alignment. DDH can vary from mild to severe depending on whether the cup is shallow, soft tissue structures are lax or a combination of all. These problems may cause the hip to become unstable, and even come out of the joint. This is known as a dislocated hip and is believed to occur in around one in 1000 infants. One or both hips can be affected. DDH isn't painful in babies and young children. Untreated DDH can result in limping in young children. This can progress to hip pain and arthritis at a later date.

How common is it?

DDH is more common in girls and first-born children. It's more likely to occur if there's a family history or if the baby was breech. Swaddling or wrapping a baby's legs too tightly can also lead to DDH. Certain traditional practices like wrapping the children, etc. are known to increase the risk, while carrying them with limbs separated apart is known to decrease the risk of dysplasia. All newborns should have both hips carefully examined by a health professional. 

Treatment options

Treatment depends on the child's age and the severity of the condition. Young babies with confirmed DDH are usually treated in a brace or harness that holds the legs apart. This helps the hip socket to deepen and the hip to become stable with growth. Regular monitoring of the hip position is necessary to ensure good outcomes. Surgery may be necessary if brace treatment is unsuccessful, or if a hip dislocation is first noticed when the child is older.

What is the long-term outlook?

Most infants who are diagnosed and treated early do not have any hip problems in later life. Earlier the diagnosis and treatment, the better the outcome, as late diagnosis often requires surgical treatment and can mean a higher likelihood of ongoing hip problems.

Developmental Dysplasia Of Hip - How Common It Is?

Radiology is a special branch of medical science that uses various techniques of imaging for the diagnosis and the treatment of several types of diseases in the body. The different types of imaging techniques used in radiology are X-rays, Computerised Tomographic scan (CT Scan), ultrasound, Magnetic Resonance Imaging (MRI) and nuclear medicine which includes Positron Emission Tomography(PET).

Role played in evaluating hip replacement
Hip replacement surgeries have become extremely common in the recent times, and radiological evaluation remains the mainstay of the overall hip replacement procedure. Thus, the role played by radiology is quite significant in such situations. All the specific anatomical landmarks and the measurements are used to make sure the placement is perfect during the hip replacement surgery. Radiological imaging helps in the assessment of the following conditions that are as discussed below.

The length of leg
The inequality in the length of the two legs is prevalent after a hip replacement surgery which can create a great deal of discomfort and inconvenience to the patients. A greater difference in the length of the two legs increases the chances of dislocation, and this is a situation where radiological evaluation plays a crucial role. With the help of radiological imaging, the length of the legs can be made almost equal.

The horizontal center of rotation
In this case, horizontal center of rotation helps in the assessment of the acetabular component of the prosthesis. This is calculated by the measurement of the distance between the center of the head of the femur and the acetabular teardrop. This distance should be bilaterally equal, and it is just not possible without the help of the imaging techniques of radiology.

Acetabular inclination
The acetabular inclination is the angle formed between the face of the cup and the transverse axis. If the angle is less, then it results in a stable hip, but the abduction is limited. On the other hand, if the angle increases then there are high chances of dislocation of the hip. Thus, with the help of radiological evaluation, proper and effective angular inclination is given which is optimum for the patient.

The stem positioning of the femur
The main aim of the stem positioning of the femur in a hip replacement surgery is placing the stem in a position which is neutral within the shaft. To get a proper idea of the positioning, the imaging techniques are of utmost importance which cannot be achieved perfectly without the imaging.

Thus, the crucial role the different techniques of radiological imaging plays during the overall procedure of a hip replacement surgery can be perceived. With the use of the different imaging techniques, the results obtained are closer to perfection.

How Radiological Evaluation Can Help In Case Of Hip Replacement?

Siblings are most definitely, the best thing to have ever happened to anyone. We fight, we laugh, we play and we defend. No matter, whether you are the best buddies or you cannot even stand being in the same room, you two (or three or four!) share an inseparable bond, which will last for a lifetime. Siblings are surely in for the long haul, while friends and colleagues may just come and go. But do our sibs really influence us?

The weight issues!
Obesity has been known to run in generations and families, but there have been studies which show that siblings have an influence, especially when we talk of the waistline. Researches&#x2019; conducted from a 2014 based study at Duke University from the Sanford School of Public Policy show that if the older sibling is obese, the chances of the younger one, being the same increase fivefold. This is regardless of the fact that the parents are obese or not.

Character talk
Though there is little evidence supporting the theory of birth order affecting personality, there sure is enough to support that siblings do shape the same for each other. Siblings do develop separate identities for themselves and in the same run, affect and shape the personality and characteristics as well as the behavior of the other, to a major extent. For instance, a person would make more of an effort to become an outgoing person, if his/ her sibling is shy and quiet. In case of families with three kids, this is more likely to happen among siblings of the same gender instead of the opposite genders.

The first teachers!
Navigating social situations are what we first learn from our siblings. A daily practice in understanding foreign minds and getting an insight of the outer world is what we first get from our siblings. Strong bonds between two kids at home have shown better and more successful connections with peers at school.

Saving marriages is their task!
Being a part of a bigger family reduces the chance of divorce due to more chances of being accustomed to adjustment. Ohio State University concluded in a 2013 study that every sibling reduces divorce risk by 2%.

Depression Deal
Squabbling of siblings is as natural as the rain. Yet, the reasons for the fight can have major health implications. Quarrelling about issues like fairness and equality can lead to experiencing higher levels of depression. The same has been concluded by a 2012 study of the University of Missouri. Fighting over personal space can lead to development of low self-esteem and anxiety.

But they are happiness boosters too
You know that already! Having siblings is in itself a joyful experience.

6 Ways Your Siblings Make You Who You Are

MISUNDERSTANDINGS AND ARGUMENTS? CHANGE THEM INTO FLOWING CONVERSATION
Conflicts and misunderstandings occur at all levels of interaction – at work, among friends, within families and between relationship partners. When conflict occurs, the relationship may be weakened or strengthened. Thus, conflict is a critical event in the course of a relationship. Arguments  and misunderstandings  can cause resentment, hostility and perhaps the ending of the relationship. If it is handled well, however, it can be productive – leading to deeper understanding, mutual respect and closeness. The health of any relationship is gauged by how the conflicts are resolved, rather than the number of conflicts between the participants. 
Conflicts run all the way from minor, unimportant differences to disputes which can threaten the existence of a relationship. Conflicts with a loved one or a long-term friend are, of course, different from negotiating with someone who does not care about your needs, like a stranger or a salesperson. 

 Principles that underscores all successful conflict resolution. 
1. Both parties must view their conflict as a problem to be solved together so that both parties have the feeling of winning.
2. Each person must participate actively in the resolution and make an effort and commitment to find answers which are as fair as possible to both. 

We may get so caught up with our own immediate interests that we damage our relationships. If we disregard the position of the other person, if fear and power are used to win, or if we always have to get our own way, the other person will feel hurt and the relationship may be wounded. Similarly, if we always surrender just to avoid conflict, we give the message to the other person that it is acceptable to be bullied and our needs don’t matter. Our feeling of self-worth suffers, resentment surfaces, and we feel frustrated in the relationship. Instead, it is healthier if both parties can remain open, honest, assertive and respectful of the other position. Mutual trust and respect, as well as a positive, constructive attitude, are fundamental necessities in relationships that matter.

SOME EFFECTIVE STRATEGIES TO HOLD EFFECTIVE COMMUNICATIONS:
1. INITIAL AGREEMENT: The other person may be very angry with you and may be having loads of evidence to prove himself right. At that time, instead of arguing your position, simply agree at that time because there will be a grain of truth if nothing else. This doesn’t mean that you are giving up your values and principles. Sometimes its important to diffuse the emotional charge before working out on the differences. Sometimes its ok to “lose” individually in order to “win” together in the end.
2. EMPATHY: Sometimes putting yourself  in the other persons shoes and seeing the problem from their perspective helps build bridges. You could say,” I feel that you must be very upset with me for behaving like that with you, I should have been more considerate”. Half the battle is won and the other participant feels validated and will be more willing to listen to your tale of woes more amicably.
3. ASK QUESTIONS: When you ask questions, it shows that you care and are interested to resolve the problem at hand. Please note that while asking questions, be watchful of your words and tone. Asking exploratory  questions about the other persons thoughts and feelings rather than probing and insulting questions can take you miles on the way to effective resolution. For eg. “Is there anything that you would like me to know about this problem”?
4. USING “I” STATEMENTS: Take responsibility for your own thoughts and feelings rather than blaming the other person for making you feel like that. This decreases the chance that the other person will become defensive. For example, “I feel pretty upset that this thing has come between us.” This statement is much more effective than saying, “You have made me feel very upset.” 
5. COMPLIMENTS: Find something nice and genuine to say about the other person, even if the other is angry with you. Show a respectful attitude. For example, “I genuinely respect you for having the courage to bring this problem to me. I admire your strength and your caring attitude.” 

A RATIONAL APPROACH TO RESOLVING CONFLICTS:
Here is a model that may help in resolving interpersonal conflicts. 
1. Identify the Problem. Have a discussion to understand both sides of the problem. The goal at this initial stage is to say what you want and to listen to what the other person wants. Define the things that you both agree on, as well as the ideas that have caused the disagreement. It is important to listen actively to what the other is saying, use “I” statements and avoid blame. 
2. Come Up With Several Possible Solutions. This is the brainstorming phase. Drawing on the points that you both agree on and your shared goals, generate a list of as many ideas as you can for solving the problem, regardless of how feasible they might be. Aim toward quantity of ideas rather than quality during this phase, and let creativity be your guide.
3. Evaluate These Alternative Solutions. Now go through the list of alternative solutions to the problem, one by one. Consider the pros and cons of the remaining solutions until the list is narrowed down to one or two of the best ways of handling the problem. It is important for each person to be honest in this phase. The solutions might not be ideal for either person and may involve compromise. 
4. Decide on the Best Solution. Select the solution that seems mutually acceptable, even if it is not perfect for either party. As long as it seems fair and there is a mutual commitment to work with the decision, the conflict has a chance for resolution. 
5. Implement the Solution. It is important to agree on the details of what each party must do, who is responsible for implementing various parts of the agreement, and what to do in case the agreement starts to break down. 
6. Continue to Evaluate the Solution. Conflict resolutions should be seen as works in progress. Make it a point to ask the other person from time to time how things are going. Something unexpected might have come up or some aspect of the problem may have been overlooked. Your decisions should be seen as open to revision, as long as the revisions are agreed upon mutually. 

Keep in mind that differences will come up in any relationship just because you two are different individuals with different perspectives, ideologies, attitudes and perceptions. Too much similarity in personality and working styles may be comforting but can be very boring and uninspiring overtime. On the other hand, differences can bring change, novelty and an added spice to the relationship. Two very different people can pool their different strengths and work together as a stronger team. Though, extreme differences may overtime sour the relationship and make living or working together difficult. You also need to look out for an emotionally or physically abusive relationship, which is based on power differential rather than respect and trust. A person may then choose to opt out after an amicable “goodbye” or "agree to disagree".
























A new relationship involves a lot of weighing from both the sides. Learn what really matters to win people over in this post. When you want to build a new relationship, whether it is for work, business, personal, marriage, friendship etc there are several factors that help take off and bloom the relationship. These factors are broadly the same in different age groups as far as psychological impact matters. Some of the most important influential factors from a psychological point of view have been highlighted here. 

1. Presentation- When you want to draw someone into relationship with you for any reason, it is important that you present yourself at you best levels be it physical or mental. Like they say that the first impression is the best impression, your display of you strengths creates an impression that helps people decide what they want to do with you. This doesn't mean you should hide all your weaknesses but highlighting your strengths is as important as making your weaknesses clear. Always learn to put your best foot forward as sometimes that itself may not be enough. You can't really send your neighbour for your job interview!! There are many instances when people send different photographs in their applications and different ones appear for the exams. This is mere cheating and not winning.

2. Plan – Let people know what you want to do with them and what they can they can do with you. No one can say they don’t have a plan. There is always some plan. Knowing it strengthens why you want to have that relationship in the first place. Otherwise it's like something which is there but you can never want to do anything with! When you are honest with your plans and they workout as you described it, it creates confidence in relationship or else it is destroyed forever. You can cheat a person with your plans once, not forever.

3. Possibilities- Will this relationship bring me trouble? Obviously nobody wants to get into a relationship with anybody that brings them trouble be it physical or mental. Next question is whether it will benefit me? Small or big depends on person's needs. Some relationships neither bring us trouble nor benefits us, such relationships are better than the ones which can cause harm.

4. Potential – Question. Does this relationship you are trying to develop have any possibilities of growth a few or many years down the line. Obviously we have a lot of friends who wither by passing of time. Does this relationship have an expiry date irrespective of how well or bad it goes? Like when we join college we know for sure that the friends will be with us till the duration of the course and that's it. We will know that if we study together it will help us achieve great grades in college and hence a great life later. These kind of growth possibilities or possibilities of deterioration are important to be well aware of and will naturally decide the course of relationships.

5. Progress – No matter what our initial assessments are, how the relationships helps us fare in the outside world will ultimately decide the future of any relationship. Loss, sorrow, tragedy, degradation in any aspect of life, insults, injury, loss of health etc will never help any relationship continue or last.

6. Partnerships – When we want to build a relationship with someone, the best way to do it is to obviously partner with that person in as many activities as possible. The more interested a person is the more activities that person will involve you in and try to do it with you. This type of partnership activities, be it spending a few hours in the evening, or a few minutes on phone, or an association of months or years are a foolproof way to show you are interested. Conversely a person who doesn't partner with you in anything is extremely unlikely to ever have any sort of relationship with you. Partnership in activities is the only way to show and know that you are interested or the other person is interested respectively. After all chasing the moon, stars and rainbow are activities of people who don’t realize its out of their reach. Sensible people are busy with what their eyes see, hands feel, ears listen, tongue tastes and thinking perceives as appropriate.

7. Positioning attitudes- As a tree bends with the winds to prevent from cracking, we all have to be flexible with our attitudes towards each other. Being too rigid about our protocol on how relationships should run irrespective of the reality and circumstances of the person we are having a relationship with is naturally going to break relationships. After all a doctor who heals and prevents all illnesses is better than a doctor who abuses his patients for falling ill but never does anything for them. Eg: You get bed and good food in a hotel as well as at your home. A hotel will provide food only on payment of money, but family will provide it whenever your hungry. Hence hotels can never expect the same emotions as family can, and this is as natural as it should be. Hence be careful what you want from a relationship. Whether you want to be treated as a hotel or family is entirely how you play yourself with others. After all only families can expect loyalty not hotels.

8. Politeness- In any relationship, many years down the line, what our long term memory retains is how comfortable we were in that relationship. Even if we profit from a particular relationship, the fact that it shook us mentally and emotionally will never allow us to go back or retain that relationship. Life is short and the only thing that matters is to spend it comfortably. Not destroy our peace for some benefit that destroys our peace of mind.

9. Personation- While sending a representative of your organization for a client meeting may work in business, you cant really send a representative to meet you wife or kids at home. In personal relationship, lack of your physical presence obviously means that you don’t have time for them. In any relationship, individuality matters a lot. Just imagine, if all actors acted exactly the same in movies, why would you prefer any particular one over the other as your favourite? The nuances and differences in our personalities are what makes us all unique. We are not robots from a particular brand to behave exactly the same way. If a person in a relationship doesn't sense your individuality you are wasting their time by trying to have a relationship with them, especially a personal one.

10. Positive reinforcement- When we get into a relationship, it is important that we feel good about ourselves and what we are doing. If you feel like a shoplifter entering a shop, you will not feel good about that relationship. When a shopkeeper welcomes us, shows us his products, tells us their details and provides all the explanations on how we will be well off with the product, provides his guarantee for it, confirms its essence, many people buy it even if they don’t compulsively need it. It’s the same in relationships. On the same side if a shopkeeper is arrogant, avoidant, abusive, insulting etc you are very unlikely to buy anything in that shop because you are not sure that the shopkeeper means any good and will be happy with the shopkeeper s product. The experience of buying is as important as the product we buy. Nobody is happy about something they got when they weren't treated the right way or is interested in retaining it when they don’t get good service for it.

11. Persistence on all Ps – Obviously when we want relationships to last, we need to be persistent on all the above P's. Otherwise it wont take long for a relationship to be counted in “once upon a time”!! A simple conversation even if for a few minutes every now and then when you need it may make it seem that you are still there for a person. Without even that people may even find it hard to remember that they even had something to do with you sometime before keeping in mind the the numerous activities we involve daily to maintain our lifestyles.

“KNOWING IS DOING AND NOT KNOWING IS UNDOING EVEN IF DOING!”

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How To Win Over New Relationships

Damaged hips can cause great distress in carrying out daily activities, such as walking, getting dressed and many more. If you have damaged one or both of your hips, and it causes you great pain, you may require a hip replacement. It is a common form of surgery in which a damaged hip joint gets replaced with an artificial one. This is known as prosthesis.

Conditions which lead to hip replacement

Osteoporosis where the cartilage inside a hip joint gets worn out, and the bones rub with each other as a result
Rheumatoid arthritis, which is caused when the immune system attacks the hip joint lining by mistake
If the hip joint gets damaged severely during an accident or fall
The purpose of a replaced hip joint is to provide pain relief, improve the hip s function, improve your ability to carry out day-to-day activities and improve your overall quality of life.

Procedure
A hip replacement is usually carried out under general anesthesia. An incision is made in the hip by the surgeon and the damaged hip joint is removed through it. It is replaced with an artificial metal alloy or a ceramic joint. The surgery takes approximately 60 to 90 minutes for completion.

Recovery
After the surgery, a walking aid such as crutches is required for up to four to six weeks. You may enroll for an exercise program, which aims at regaining and improving the new hip joint functions. Regular activities can be restored within two to three months. A year is required for utilizing the new hip joint normally.

Risks of hip replacement
There may be several complications as a result of a hip replacement. They include:

Dislocation of the hips
Infection at the surgery wound
Injury to nerves and blood vessels
Difference between the lengths of two legs
Fractures
Alternative
Hip replacement surgery has an alternative type of surgery, which is called hip resurfacing. During this surgery, the damaged surfaces of the bones within the hip joint are removed and replaced with a metal surface. Less bone is removed in this surgery. However, the metal surface may cause complications and health hazards.

Hip replacement is being improved upon with the advent of technology. Stronger and newer materials are being developed for prosthetics, which will allow enhanced joint mobility and a longer wear. New cement-less implants are also being developed. Also surgery assisted by computer is being used for generating an image of the hip joint.

 Hip Replacement - An Overview!

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