Why osteoporosis and osteopenia are fast turning into diseases of the young

Did you know that osteoporosis causes more than 8.9 million fractures worldwide every year? what is frightening is many of these fractures are now taking place among the youth due to deficit diet and poor lifestyle coupled with genetic predisposition. Both osteoporosis and osteopenia are two forms of bone loss conditions, with the latter being a precursor to the former. To distinguish between the two a bone mineral density test is usually performed.

What is the difference between osteoporosis and osteopenia?

A BMD (bone mineral density) t-score between -1 sd and -2.5 sd indicates osteopenia with a high chance of osteoporosis. On the other hand, a t-score of -2.5 sd and below stands for osteoporosis. A higher bone density (above -1sd) is usually indicative of stronger bones. Fragility index is more accurate way to assess the risk of fractures.

In osteoporosis the bone loss or weakening of bones take place over a long period of time, and results in unexpected fractures and severe bone problems. Disfigurement, fractures in the spine, loss of mobility and independence are usual characteristics of this bone disease once it progresses further.

Prevention is better than cure, always!

To keep bones strong and healthy, calcium and phosphate is continuously absorbed by the body. But after 30, the body?s ability to absorb calcium slows down and there?s a decrease in the production of new bones. In contrast, bone desorption (the process of transferring calcium from the bone to the blood) continues unabated.

When the body starts absorbing the store of calcium in the bones to meets its needs, it leads to calcium depletion and is one of the causes of the weakening of the bone.

At present, the age limit (50-60 years) for osteoporosis has seen a drop with many younger people increasingly suffering from the ailment. Factors like unhealthy lifestyle, late-night shifts, smoking and alcohol consumption have been found to be the culprits behind the rise in osteoporosis cases among the young. Recent studies have identified vitamin d deficiency as a major factor for poor bone health and bone mass density in the young.

How to keep your bones strong and healthy? and manage osteo - penia/porosis complications:

Bone loss can be prevented by adopting these very simple but effective ways:

- exercising can help in building strong bones and muscles, while preventing bone loss.

- maintaining a calcium intake of 1000 mg for pre-menopausal women and 1200 mg for women post menopause.

- staying out in the sun for 20 minutes to produce requisite amount of vitamin d for calcium absorption and using supplements of vitamin d.

- there are many safe medicines available to prevent and treat osteoporosis like alendronates, calcitonin, parathyroid, teriparatide preparation etc.

- in osteoporosis induced /associated fractures we have to to modify implants to negate weak purchase of implants in bone and improve mobility. We have been using these modifications in established osteopenia/porosis case in fractures treatment/joint replacement/ arthroscopic fixations and MIS spine fracture management.


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Are Osteoporosis and Osteopenia fast turning into diseases of the young?

The liver is a vital body organ (the second largest) that helps in detoxification of the harmful substances and chemicals, in addition to participating in various metabolic pathways. It is normal for the liver to contain some amount of fats. The problem arises when there is an excess deposition of fats (accounting to nearly 7- 10% of the total liver weight), a condition referred to as Steatosis or Fatty Liver. Fatty liver often interferes with the normal functioning of the liver triggering serious consequences.

Types of fatty liver

Alcoholic Fatty Liver: As the name suggests, the condition is an outcome of excessive alcohol consumption.
Nonalcoholic Fatty Liver (NAFL): Here the problem or the trigger is not alcohol. The excess fat deposition in NAFL (~10 % of the total liver weight) results from the inability of the liver to break down the fat molecules.
Nonalcoholic Steatohepatitis (NASH): In NASH, the liver tends to swell up due to excess buildup of fats in the liver tissue (alcohol is not the trigger in NASH)
Acute fatty liver of pregnancy: Some pregnant women may suffer from this fatal condition (extremely rare).
Causes of fatty liver
Fatty liver is a common condition that often results from unhealthy diet and lifestyle practices. In this context, it is important to mention that unlimited alcohol consumption plays a pivotal role in various liver disorders, with fatty liver being one of the most common consequences. In fact, steatosis is one of the earliest stages associated with alcohol related Liver disease. However, fatty liver is a reversible condition that can be successfully treated if diagnosed at an early stage.

The excess deposition of fats in the liver cells can be an outcome of medical conditions such as
Besides alcohol, obesity is one of the biggest factors responsible for fatty liver. As per a survey, 1 in every 50 obese people suffers from fatty liver and other related complications (scarring, liver hepatitis or liver cirrhosis).

In addition to obesity, hyperlipidemia (a medical term used to define increased levels of lipids in the blood), high blood pressure, diabetes mellitus may have a significant role in triggering fatty liver.
Rapid weight loss or malnutrition can, more than often, give rise to fatty liver and its related disorders.
The use of certain medications such as carbon tetrachloride, tetracycline, and corticosteroids may be a contributing factor in fatty liver and associated complications.
Genetics can also play a significant role in triggering steatosis in some people.
Though fatty liver can affect children and young adults, people in the age group of 40 - 60 years are more susceptible to the condition.
Symptoms associated with fatty liver
There are no characteristic symptoms associated with fatty liver. However, in general, a person may experience
  Abdominal discomfort
  Extreme tiredness

With time, a person left undiagnosed and untreated, may exhibit the following symptoms
  A changed appetite (there is often a loss of appetite)
  Sudden weight loss (unexplained)
  Weakness
  Abdominal pain

Fatty Liver - 4 Common Types Of It!


Here are some well advertised and well-loved foods that most youngsters cherish. These foods cause far more damage in even small quantities. 

Try to avoid these foods now, to prevent from further damage as you grow older.

1) Frosting- The creamy layer that you lick off from the top of a cake is one of the most unhealthy foods ever. It contains trans-fat, which lowers your good cholesterol and can raise heart rate, increase belly fat and lead to heart diseases or diabetes. Plus, frosting has just too much of sugar.

2) Packaged Fruit Juices- ‘But juices are good for you!’ is something that most people say to defend why they drink packaged fruit juices. It is true that juices are great, but the ones that are packaged aren’t any good. Firstly, the ones available in packed forms have a limited amount of real content (look at the concentrate, which is sometimes lesser than 10% of the total packaging). At the same time, most of these are filled with artificial flavours and a lot of sugar. Do yourself a favour and drink only fresh juices.

3) Artificial Sweeteners- Artificial sweeteners can actually cause diabetes and are as harmful as natural sugar. In fact, they are also responsible for a number of allergies, cancers, seizures, weight gain and obesity.

4) Soda Beverages-   They are the worst! There is absolutely no reason why you should be popping out that bottle of soda or fizzy drinks with so much of caffeine every time. These bottles contain 10 packets of sugar, highly synthetic flavors and have absolutely zero nutritional value. In fact, they promote the ugly fat deposits on all the wrong places. High content of phosphoric acid in sodas can lead to heart and kidney problems, muscle loss, and osteoporosis, as well as trigger accelerated aging.

If you have any further questions on issues related to nutrition or diet, ask me by clicking on 'consult'.

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Avoid These 4 Foods to Stay Healthy

What is a foreign body (FB)?
Foreign body or FB is an object or piece of extraneous matter that has entered the body by accident or design. It is common to see certain items getting stuck in the ear, nose or throat especially, in young children. While most of the time they do not raise an alarm, however, sometimes they can lead to severe consequences like rupture of the eardrum or even choking.

How do FBs affect ear, nose and throat?

Children over 9 months develop an ability to pick up objects. As they explore the environment around them, they tend to put items such as peas, beans, marbles, beads, cotton, paper, etc, in their mouth, nose or ears. Similar trend may be seen in adults with mental disorders.
Trauma/ fall/accident can force FBs like rock, pebbles into the ear, nose or throat.
Adults while riding a bike or sleeping on the ground (campsites) can have insects: flies, ants, roaches fly into the nose or ear.
Choking occurs when FBs block the airway, common reasons are: not chewing the food properly, diseases like Parkinsonism, drinking alcohol or certain drugs that slowdowns the process of swallowing.
Managing FB in the ear, nose and throat

Foreign bodies in the ear
Symptoms: Pain in the ear, discharge or bleeding from the ear, feeling of fullness or pressure in the ear and dizziness and nausea in extreme cases.

Management: 

Make sure the patient is sitting in an upright position, pull the pinna or outer semicircle of the ear towards the back. This can help you see the object clearly and also loosen it to wiggle out. If you can see the object clearly, use a tweezer to grasp the object and gently remove.
In case a live insect gets trapped inside the ear lie down and place few drops of warm vegetable or baby oil. Use oil only if symptoms of eardrum perforation like pain, bleeding/discharge from the ear is absent.
Tilting the head to the affected side can facilitate gravity to dislodge the object.
Foreign bodies in the nose:
Symptoms: Pain and difficulty in breathing from that side of the nose.
Management: Keep the uninvolved nostril closed by pressing a finger against the side of the nose and gently ask the person to blow from the affected nostril.

Foreign bodies in the throat:
Symptoms: Choking, inability to breathe and speak 
Management: Perform Heimlich maneuver: abdominal thrusts, if trained otherwise, it is advised to call for medical help immediately.

How can you prevent foreign bodies from entering your ear, nose, throat?

Discourage talking, playing, laughing when food is in the mouth.
Do not give whole grapes, popcorn, nuts to children below 3 years.
Keep small objects out of reach of small children.
Teach children to avoid placing objects into their nose, ears.

Presence Of Foreign Bodies In Ear/Nose/Throat - How It Can Be Managed?

Most of us are affected by diseases, which spread through physical contact, but most of us do not consider it important to get them checked, due to which they turn into major ailments. Sexually transmitted diseases (stds) are infections, which are transmitted through any kind of sexual contact. The organism that causes the disease is transmitted from one person to the other during sex intercourse. Sometimes stds can be asymptomatic (no symptoms or signs)

Here are some stds that you should be informed about:

1. Gonorrhoea: genital infection caused by bacteria is called gonorrhoea, its symptoms include 

 Bloody vaginal discharge
 Painful urination
 Heavy period bleeding
 Anal itching

2. Chlamydia: bacterial infection in the genital tract is called chlamydia. Chlamydia is usually difficult to diagnose, its symptoms include

 Pain during urination
 Pain in lower abdomen
 Vaginal discharge
 Painful intercourse
 Bleeding between menstrual cycles

3. Syphilis: the bacterium treponema pallidum causes syphilis, its symptoms include

 Rashes
 Sores in the mouth, anus or vagina
 In later stages, it causes nerve and organ damage

4. Genital herpes: the herpes simplex virus (hsv) causes herpes. Signs and symptoms include-

 Small red bumps or ulcers in the anal, genital and other areas
 Itching or pain around the genital area, thighs and buttocks

5. Human papillomavirus (hpv) and genital warts: genital warts are caused by hpv. It infects the genital tract. Hpv has been linked to cervical cancer, its symptoms include

 Small swellings in the genital area
 Itching
 Bleeding during sex

6. Chancroid: chancroid is a bacterial infection. The bacterium haemophilus ducreyi causes chancroid, its symptoms include

 Development of red bumps on the skin folds covering the genitals
 Pain during urination
 Burning sensation during bowel movement

7. Ectoparasitic infections: ectoparasitic infections are caused by small parasitic bugs like mites or lice. The parasites usually affect the hair or skin. Scabies and crabs are common parasites that cause such infections. They both cause intense itching and visible rashes.

8. Human immunodeficiency virus (hiv) and acquired immunodeficiency syndrome (aids): the virus that causes aids is called hiv. It can spread through blood, vaginal fluids, semen and breast milk. Unprotected sex or sharing needles with an infected person is how the disease spreads. It includes symptoms, such as

 Slight fever
 Fatigue
 Muscle aches
 Weight loss.

Most Common STDs in Women

Life can be tough when living with Crohn s disease as it is a chronic condition. Especially with the disease is marked by phases of relapse and remission, it requires a long-term management to keep the symptoms in check. Though the flare-ups can be typically contained using medications, some of the patients with severe symptoms or complications arising from the illness would require surgery.

Before we proceed with the surgical management of the disease, it is essential to understand what Crohn s disease is in case you are not aware of it. It is a chronic illness in which the intestine or the bowel have become inflamed or marked with ulcers and sores and is a part of disorders collectively known as inflammatory bowel disease(IBD).

When does Crohn s disease require surgery?
Typically, patients who are suffering from complications of Crohn s Disease may require surgery. This may include the formation of a scar that is causing the bowel to narrow down and leading to obstructions, extensive bleeding from the intestine, perforation in the bowel wall or the formation of fistula or abscess. The fistula may be formed in the connecting area between two body parts that do not meet. Also, a condition known as toxic megacolon where the large intestine or the colon becomes severely stretched out causing the toxins to spread all through the blood requires surgical intervention.

What are the different surgical options available for Crohn s disease?

The surgery chosen for Crohn s disease is dependent on various factors such as where the disease has affected, how severe the disease is and most importantly what complication will be treated by the surgery. Here are some of the types of surgeries done for treating Crohn s disease:

Strictureplasty: If the small intestine is affected by the disease, it may show up in the alternating areas of the bowel. Strictureplasty is a surgical way of widening the narrow area of the small intestine into a portion which has been affected by the disease. It doesn t involve removal of the intestine.
Resection: This is yet another surgical process where the affected part of the intestine is removed. It may be required when the stricture has become elongated. The removal of the diseased portion of the intestine may be able to offer some relief from the symptoms.
Colectomy: This surgery refers to the removal of the entire colon, and it is done when the disease is severe and extensive.
Proctocolectomy: When both rectum and colon are affected, both these parts are removed by a process called proctocolectomy. When this process becomes necessary, the waste materials drain into the bag which is emptied every day.
Since, the surgical intervention aims to manage the disease, your doctor would be able to recommend the most suitable option as per your condition.

Crohn's Disease - How Surgical Management Can Help?

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