The intervertebral discs are made-up of two concentric layers, the inner gel-like Nucleus Pulposus and the outer fibrous Annulus fibrosus. As a result of advancing age, the nucleus loses fluid, volume and resiliency and the entire disc structure becomes more susceptible to trauma and compression. This condition is called as degeneration of the disc. The disc then is highly vulnerable to tears and as these occur, the inner nucleus pulposus protrudes through the fibrous layer, producing a bulge in the intervertebral disc. This condition is named as herniated disc. This can then cause compression to the spinal cord or the emerging nerve roots and lead to associated problems of Sciatica radiating pain from back to legs in the distribution of the nerve. Other symptoms could be a weakness, tingling or numbness in the areas corresponding to the affected nerve. Sometimes bladder compromise is also present, which is made evident for urine retention and this need to be taken care as an emergency.
Excessive weight, bad postures, undue movements, improper weight lifting and other kinds of traumas may weaken the intervertebral discs. When this occurs the pulpous nucleus will bulge against the annulus, or even be squeezed through it (extruded disc).

The first steps to deal with a herniated or prolapsed lumbar disc are conservative. These include rest, analgesic and anti-inflammatory medication and in some cases physical therapy. At this point, it is convenient to have some plain X-rays done, in search of some indirect evidence of the disc problem, as well as of degenerative changes on the spine.

If in a few days these measures have failed, the diagnosis has to be confirmed by means of examinations that give better detail over the troubled area, as the MRI, CT which will show the disc, the space behind it and in the first case, the nerves. In some instances, the EMG (electromyography) is also of great value, as this will show the functionality of the nerves and muscles.

Once the diagnosis has been confirmed, one of the best alternatives existing today is the Ozone Discolysis as the results obtained are excellent and practically has no complications. This novel treatment avoids the use of surgery in 80% of those who needed it. In most patients left with painkillers as the only treatment, the symptoms eventually disappear, only that this could take weeks to months. Ozone speeds up these developments, see the same result in a few weeks. The problem has to be seen and approached integrally and frequently the combination of therapies has to be used, most frequently physiotherapy. Also, it has to be known that those who had a herniated disc have 10 times more chances of having another herniation than the rest of the population.

If despite the ozone therapy the symptoms persist, Drill Discectomy/ Laser Discectomy are good alternatives before open surgery (Discectomy) which has to be contemplated in those true emergencies, as mentioned above, this is possibly the first choice.

Once the conservative treatment fails:

Early aggressive treatment plan of pain has to be implemented to prevent peripherally induced CNS changes that may intensify or prolong pain making it a complex pain syndrome. Only 5% of total LBP patients would need surgery & 20% of discal rupture or herniation would need surgery. Nonoperative treatment is sufficient in most of the patients, although patient selection is important even then.

Depending upon the diagnosis one can perform & combine properly selected percutaneous fluoroscopic guided procedures with time spacing depending upon pt`s pathology & response to treatment.

Using precision diagnostic & therapeutic blocks in chronic LBP, isolated facet joint pain in 40%, discogenic pain in 25% (95% in L4-5&L5S1), segmental dural or nerve root pain in 14% & sacroiliac joint pain in 15% of the patients. This article describes successful interventions of these common causes of LBP after conservative treatment has failed.

LESI: Lumbar Epidural Steroid Injection

Indicated in   Acute radicular pain due to irritation or inflammation.

Symptomatic herniated disc with failed conservative therapy
Acute exacerbation of discogenic pain or pain of spinal stenosis
Neoplastic infiltration of roots
Epidural fibrosis
Chronic LBP with acute radicular symptoms
Epidural- lumbar injection
ESI Treatment Plan

Compared to interlaminar approach better results are found with a transforaminal approach where drugs (steroid+ LA/saline +/- hyalase) are injected into anterior epidural space & neural foramen area where herniated disc or offending nociceptors are located. Whereas in interlaminar approach most of drug is deposited in posterior epidural space.Drugs are injected total 6-10 ml at lumbar, 3-6 ml at cervical & 20+ ml, if caudal approach is selected. Lumbar ESI is performed close to the level of radiculopathy, often using paramedian approach to target the lateral aspect of the epidural space on involved side. Cervical epidural is performed at C7-T1 level.

SNRB- Selective Nerve Root Block 

Fluoroscopically performed it is a good diagnostic & therapeutic procedure for radiculopathy pain if

There is minimal or no radiological finding.
Multilevel imaging abnormalities
Equivocal neurological examination finding or discrepancy between clinical & radiological signs
Postop patient with unexplainable or recurrent pain
Combined canal & lateral recess stenosis.
To find out the pathological dermatome for more invasive procedures, if needed
Intradiscal Procedures 

Provocative Discography - Coupled with CT

A diagnostic procedure & prognostic indicator for surgical outcome is necessary for the evaluation of patients with suspected discogenic pain, its ability to reproduce pain(even with normal radiological finding), to determine type of disc herniation /tear, finding surgical options & in assessing previously operated spines.

Percutaneous Disc Decompression (PDD)

After diagnosing the level of painful offending disc various percutaneous intradiscal procedures can be employed

Ozone Discolysis: Ozone Discectomy a revolutionary least invasive safe & effective alternative to spine surgery is the treatment of choice for prolapsed disc (PIVD) done under local anaesthesia in a daycare setting. This procedure is ideally suited for cervical & lumbar disc herniation with radiculopathy. The total cost of the procedure is much less than that of surgical discectomy. All these facts have made this procedure very popular at European countries. It is also gaining popularity in our country due to high success rate, less invasiveness, fewer chances of recurrences, remarkably fewer side effects meaning high safety profile, short hospital stay, no postoperative discomfort or morbidity and low cost.

Dekompressor: A mechanical percutaneous nucleosome cuts & drills out the disc material somewhat like morcirator debulking the disc reducing nerve compression.

Epidural Adhenolysis or Percutaneous Decompressive Neuroplasty for Epidural Fibrosis or Adhesions in Failed Back Surgery Syndrome (FBSS)

A catheter is inserted in epidural space via caudal/ interlaminar/ transforaminal approach. After epidurography testing volumetric irrigation with normal saline/ L.A./ hyalase/ steroids/ hypertonic saline in different combinations is then performed along with mechanical adenolysis with spring loaded or stellated catheters or under direct vision with epiduroscope.

Procedures That Can Help Treat Slip Disc & Sciatica!

Irritable bowel syndrome is a disorder that is diagnosed on the basis of its symptoms. It is characterised by intense abdominal pain, discomfort, bloating and change in bowel habits. One of the primary symptoms of IBS is abdominal pain. It may also be accompanied with frequent diarrhoea or constipation. There might also be a feeling of partial or incomplete evacuation. The symptoms are sometimes relieved by the proper bowel movement. Other symptoms, in this case, include depression and anxiety. In rare cases, there is also a possibility of sexual dysfunction and a reduced libido.

Causes of Irritable Bowel Syndrome 

The exact reason behind the occurrence of IBS is not known. It is a disruption of the brain-gut axis that is known to cause the problem. It is also caused due to small intestinal bacterial overgrowth.

Triggering factors 

IBS is intensified or triggered by the following factors:

Foods: Edibles like chocolate, milk and alcohol might lead to constipation or diarrhoea. One must also avoid carbonated beverages and some fruits and vegetables. These might lead to bloating and discomfort.

Stress: The condition gets worse with any type of stress.

Hormones: In women, the symptoms occur as a result of the hormones during menstrual periods.

Complications: It is not associated with any fatal condition. But it can lead to diarrhoea and constipation and aggravate hemorrhoids.

Adverse Impacts of the Disease-

IBS has an adverse impact on your lifestyle. It will limit your ability to get social or carry out your daily professional activities. You will find it difficult to cope up with the symptoms while living away from your comfort zone or home. You will not have a good sex life. You will get depressed and may even feel suicidal in extreme cases.

Treatment of Irritable Bowel Syndrome-

IBS is treated broadly by bringing in certain changes in the lifestyle. To begin with, you are advised to check your diet. Include fibre in your diet, if you are suffering from constipation. Also, avoid oily, spicy and hot food items. Besides, you are prescribed medicines such as stool softeners and laxatives and antispasmodic drugs and proton pump inhibitors.

Homeopathic medicines-IBS requires prolonged treatment. Homoeopathy works best to get you relief from the symptoms and cures it, from the roots. Here are certain homeopathic remedies that are helpful in treating the disorder.

Argentum nitricum

Asafoetida

Colocynthis

Lilium tigrinum

Lycopodium

Natrum carbonicum

Nux vomica

Podophyllum

Sulphur

Aloe

It has to be kept in mind that these are just basic remedies. There are over 150 Homeopathic medicines that can be used for treating IBS. Thus, consult your doctor for the best remedy for you as per the symptoms.  

Treating Irritable Bowel Syndrome With Homeopathy

If you have been that extremely skinny guy in your high school days, never getting picked for the soccer team, then it is time to fix that stubborn weight issue. Worry not, it s fairly easy, all you have to do is make changes in your diet. Diet is the primary component that can help gain weight.

Some tips you can follow and design your diet plan accordingly are mentioned below: 

Increase your appetite by eating more to gain weight. But do it step-by-step and not by stuffing yourself too much at one go. Add one extra chapatti or more rice than you normally consume, or you even start with fruits by eating an extra one every day. Ghee, oil or butter can not only help increase your weight, but it may increase weight by increasing your fat percentage in your body. Rather you can eat a proper well-nourished diet and increase your muscle mass and not only the fat accumulation in the body.

Carbohydrates are needed to gain weight but include healthier options like banana, potato, mango, whole grain, rice, etc. Instead of sugar-rich food items like chocolates and other junk food items. Carbohydrates are classified into simple and complex carbs. Reduce on your simple carbs like sugar and sweets which later on converts to fats. Complex carbs like whole grains, beans or fibre-rich vegetables and fruits can be consumed for a healthy weight gain.

Consume protein-rich food items after your workout to increase your muscle mass. And eat good fats like nuts and seeds in your diet. Eating a handful of pumpkin or flaxseeds is a good way to give your body the fat intake it needs. Though junk food items like vada pav or burgers are loaded with calories, they only increase body fat and not muscle mass. This is not the right way to go around. Every meal should comprise of carbs and protein. Post-workout nutrients and a well-balanced diet with the proper combination of carbohydrates and protein is the most important to maintain your muscle mass and weight gain process.
Sample Meal Plan -

To give you more opportunities to get the calories to gain weight, aim to eat 3 meals and 2-3 snacks a day. For breakfast, enjoy generous servings of whole grains like whole-wheat bread with beans or egg whites, paneer or Cereals and a glass of milk with nuts will be a good combination.

Mid-morning can be fruit juices, fruit milkshakes, 1-2 serving of fruit or granola bars. Lunch and dinner can be incorporated with 3-4 wholegrain chapattis with a serving of pulses, paneer, chicken or fish and a serving of vegetables with a portion of rice OR 1 bowl of khichdi which serves you with good cereal pulse combination. In between meals if you feel hungry you can have sprouts or roasted channa. Evening you can either grab a whole wheat sandwich, a whole wheat roll or a whole wheat sub.

Bedtime you can either have a glass of milk or either banana /mango/strawberry milkshake.

Right Ways To Gain Weight!

The fever itself isn t a disease but a symptom of a disease. It is generally caused when the immune system heats itself to fight the infections that enter our body. One of the most common reasons a person catches a fever is due to Influenza or the common cold.

Though fever is a common symptom, it can aggravate very quickly if not taken care of properly. This article will educate patients how to take care of themselves if they have a fever. The first and foremost step of taking care is to go to a doctor and get a proper diagnosis.

Upon a proper diagnosis, one can determine the kind of fever they are having. If someone has a fever due to diseases like Malaria then the course of action will be quite different. However, following are the common steps for most of the fevers:

Do s: While Having a Fever

  The first step is to keep a proper check of the temperature every 2 hours. For that, it is advisable to keep a thermometer handy. For better accuracy, it is better to carry a digital one.
  The next step is to keep the patient hydrated as fever usually leads to loss of appetite. This can cause dehydration and loss of nutrients.
  Drinking water isn t enough to battle dehydration, which is why the patient will need to take the ORS solution every 15 minutes.
  If the temperature rises, one should soak a cloth in cool water and put it on the forehead for a few minutes.
  If the temperature keeps rising, the patient should take Paracetamol only.
  Get a blood check by calling a local pathology technician and subsequently send the report to the doctor to get a proper diagnosis.

Don'ts: While Having a Fever

  Don t take an Antibiotic unless the doctor prescribes it.
  The fever may cause temporary body pain and stiffness; don t take Ibuprofen and other painkillers to get rid of it.
  Don t take any kind of NSAIDS without doctor s supervision.
  Don t take any kind of dairy products or junk food.
  Don t starve because of the loss of appetite.
  Don t agitate by doing any kind of household work or exercise.
  Don t sleep with the air conditioning on.
  Avoid drinking and smoking while having a fever.
  If the doctor prescribed antibiotics, don t quit halfway. It is important that one must complete the course of antibiotics.
  Don t take a bath while having a fever; it is better to clean the body with a soaked cloth or sponge.

Conclusion:

Though fever is a fairly common disease, the treatment can go haywire if the usage of certain medicines isn t done properly. Following the above instructions will help to take care of when someone has a fever and will help to get better. However, if the fever isn t going down after 2-3 days, one should see a doctor immediately.

What To Do When You Get A Fever?

Kidney stones could be a cause for worry by the time they are not removed causing incessant and regular pains and disrupting normal life. The task is not finished even if you get them removed because what follows is a rigorous and disciplined routine that you must follow to maintain your health after the surgery is done. Diet plays a crucial role in negating the possibility of yet another stone accumulation. Here are a few diet tips that would be handy if you have got a kidney stones removal surgery done. 
 
Do's
1. To stay hydrated is the golden rule that you must abide by at all costs. It is advisable to drink at least 2-3 litres of water on a daily basis. Water prevents the formation of stones and would also help to eliminate any remaining residues of kidney stones existing in the system. 
 
2. Dairy products could be included but in diluted form. 
 
3. A fixed dietary routine is mandatory above all. The patient should be given meals at proper time intervals in small proportions. Heavy meals should be avoided at all costs. 
 
4. Foods rich in high fibre should be included in the diet. They help in bowel movement also. These include whole grain breads and beans. 
 
Don'ts
 1. Foods rich in oxalates and calcium should be kept at bay for at least a period of two months after the stone removal procedure is complete. Oxalates can lead to the formation of yet another stone which is far from desirable. The foods that fall in this category include:
-Green leafy vegetables like spinach, mustard and beet greens
-Cabbage, cauliflower, tomatoes
-Banana, mango, apricot, grapes
-Nuts like almond and cashew
-Alcohol
-Soft drinks
-Soda
-Caffeinated drinks like tea and coffee
 
2. Foods rich in sodium should be kept at bay for at least some time immediately after the surgery. 
 
3. Reducing the food intake that is high on animal protein. 
 
4. Do not eat stale food. 

5. Junk food should not even cross your mind. It is something which should be avoided for best results. 
 
These are generic guidelines that would help you to cope with post surgery care. However, there could be specific requirements depending from patient to patient. Therefore, it is advisable to get the guidelines by a doctor who will take into account the specificities of the case. Diet along with exercise is in most cases, the most effective combat to kidney stones. The trick however, is to not go overboard with either of them.

Diet Plan Tips After Kidney Stones Surgery - Eating Guidelines

Psoriasis is the condition in which the infected skin cells multiply 10 times faster than the normal rate. During this disease, the normal skin tends to get covered by a layer of dead skin cells, not allowing the skin to breathe. People who suffer from psoriasis face an increased likelihood of contracting other serious medical conditions such as cardiovascular diseases, diabetes, and psoriatic arthritis.

Psoriasis can erupt just about anywhere on the body, but it most often occurs on the scalp, chest, back, elbows, knuckles, and knees. If you have a mild case, the patches may hardly be noticeable. The worst cases produce unsightly patches almost everywhere.

Psoriasis can also affect fingernails and toenails, making them appear pitted and discolored. It can even cause significant joint pain, a condition known as psoriatic arthritis. 

Most people who develop psoriasis are initially diagnosed in their teens, twenties, or thirties. The disease follows a very unpredictable course. That first flare-up may also be the last. Or it may signal the start of a lifetime of flare-ups that come and go for no apparent reason. Fortunately, when the lesions disappear, they leave no scars. 

Here's a list of following unsafe health conditions created by psoriasis:

Cancer: People experiencing psoriasis are subjected to an increased risk of contracting certain cancers like lymphoma. A study discovered that people diagnosed with psoriasis have an increased likelihood of 40% to contract cancer than the general population. The reason for this particular risk hasn't been yet understood.
Kidney disease: According to a 2013 study, published in the British Medical journal people with psoriasis have an increased risk of encountering kidney disorders. Severe and mild psoriasis increases the likelihood of kidney diseases by 58% and 36% respectively.
Obesity: People suffering from mild psoriasis are 30% likelier to be obese than those who are not. For people diagnosed with severe psoriasis the chances increase by 80%.
Diabetes and high cholesterol: High levels of triglycerides, total cholesterol and lipoprotein are present in patients with psoriasis, and these patients are 28% likelier to have high cholesterol compared to the general masses. According to a recent study, people with the condition have a 46% increased chance of suffering from Type 2 diabetes.
Peptic ulcers and mood disorders: In some cases, peptic ulcers are also linked with psoriasis. The reason for this is attributed to inflammation. Psoriasis also leads to mood disorders like depression due to the pain and anxiety arising from the condition.

Psoriasis: Vulnerability to Health Conditions

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