Have you ever come across a person with usual toes, toes that are mysteriously curled or bend upwards, downwards or inwards? As strange and intriguing as it may appear, the condition can be quite painful and is known as toe deformity. In toe deformity, the foot bone is unusually and abnormally positioned, resulting in pain and discomfort.

Toe deformity in a person can be of different types. It can be:

Hammer toe: This is one of the most commonly observed toe deformity. A hammer toe is characterized by the curling or bending down of the second toe at the proximal interphalangeal joint (the middle toe joint). The toe may further bend up at the distal interphalangeal joint (joint adjacent to the toe tip) or the metatarsophalangeal joint (meeting point of the foot and the toe) as well. In hammer toe, the awkward alignment results in a slight elevation in the joint of the middle toe. A hammer toe is often seen accompanied by a bunion (a bony bump or a deformity formed at the joint that links the foot with the big toe).
Mallet toe: Mallet toe mostly affects the second toe (other toes may be affected). The deformity results in bending down of the toe at the distal interphalangeal joint (appears like a mallet).
Claw toe: The deformity affects all the toes, with the big toe being an exception. Here, the toes bend up at the metatarsophalangeal joint and bend down at the distal interphalangeal joint. The deformity results in the toes curling down towards the floor (appears claw-like).
What causes Toe Deformity?
There can be many factors responsible for toe deformities.

Toe deformity in a person may be congenital (present from birth).
It can also be an outcome of medical conditions such as arthritis (osteoarthritis, rheumatoid arthritis), stroke, heart attack, diabetes, an injury, an accident, or wearing wrong footwear.
Toe deformity can also be hereditary.
Signs and symptoms:
The symptoms for Toe Deformity (hammer toe, claw toe, and mallet toe) include

There is redness, pain, and swelling in the affected part of the toe. In claw toe, however, there may or may not be pain associated with the condition.
A person faces difficulties in straightening the toe.
In hammer toe, corns, and calluses appear on the middle joint (top) of the affected toe.
In mallet toe, ulcers may occur on the toe (in diabetic patients).
Treatment:
Initially, toe deformity appears flexible, where movement around the affected joint is possible. However, if left unattended, the condition can become severe and rigid, thereby restricting the movement (in the affected area). Treatment for toe deformity depends on how severe the condition is.

In most cases, the treatment involves wearing custom-made shoes, fitted with supports (cushions or pads) and wider toe box.
Using of tapes and splints may be helpful in correcting and repositioning the deformed toe.
Patients with excruciating pain benefit immensely from cortisone injections.
Corn pads can be used to deal with corns and calluses better.
Toe stretching exercises are highly effective.
If severe cases or extreme rigidity, doctors may opt for surgical treatments like arthrodesis, tendon transfer, arthroplasty, to name a few.

Toe Deformity- What Causes It And What Are Its Treatment Options?

Did you know that Thalassemia is a common blood disorder in India, that?s passed through families (just the way it was passed to Abhishek Bachchan because megastar Amitabh Bachchan is a carrier). It is characterized by excessive destruction of red blood cells or genetic mutation, leading to anaemia. Today is World Thalassemia Day, lets understand about the disease.

Thalassemia can be classified into alpha and beta, depending on the globin genes that are affected.

1. Thalassemia Minor - Usually doesn?t have any symptoms, except for minor anaemia.

2. Beta Thalassemia - Has two serious types.

2.A) Thalassemia Major: This type usually happens before a child?s second birthday and requires regular blood transfusions. The condition is life-threatening. Symptoms include anaemia, fussiness, frequent infections, paleness of the skin, poor appetite, enlarged organs and jaundice.

2.B) Thalassemia Intermedia: It is a less severe form and doesn?t require blood transfusions. The symptoms include anemia, jaundice, extremely large spleen and malnourishment.

3. Alpha Thalassemia: Only in rare cases this severe form of Thalassemia may be present. Known as Hydrops Fetalis, this condition usually occurs before birth and children are either stillborn or die soon afterwards.

How to live with Thalassemia:

Take steps to be as healthy as possible. Follow a balanced diet eating plan as per the recommendation of your doctor. Take iron supplement only if prescribed. It is recommended that patients get themselves vaccinated whenever needed, especially if their spleen has been removed. Meanwhile, always be on a lookout for the signs of infections (such as fever) and lower your risk of infections. Thalassemia can spark fear, anxiety, depression and stress. That?s why, doctors recommend that patients receive adequate emotional support.

Treatment:

The treatments depend on the kind of Thalassemia an individual has. Usually, treatment procedures include blood transfusions, bone marrow transplants, removal of spleen or gallbladder specific medications and supplements.

If you have any more questions on this topic, click on consult privately to ask me.

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Read Dr. Jatin Soni's Health Tip on The Occasion of World Thalassemia Day

A loss of tooth or teeth is one of the biggest dental problems that someone can face. The irony is that people consider loss of teeth to be very insignificant. But in reality loss of teeth can lead to not only cosmetic problems, but also functional problems and an unstable chewing mechanism.

Loss of teeth can lead to many problems. Some of them are:
1. Supra eruption of opposing teeth
2. Compromised efficiency of chewing
3. Adjacent teeth might drift into the space created by missing teeth
4. Food tend to accumulate between teeth, which have moved
5. Food accumulation also leads to periodontal disease and caries
6. A lopsided chewing pattern as there is loss of equilibrium in the mechanism of chewing
7. The extracted area might reveal a loss of bone height
8. Problems of the temporomandibular joints, like closed bite and tmj osteoarthritis
9. The existing functional teeth might lead to problems due to overload
10. There are increased chances of cheek biting due to collapse of the cheek in the missing space, thus leading to functional and cosmetic problems
11. The frequency of tongue biting and ulceration might increase in the area of missing teeth or tooth
When missing teeth are replaced, one can easily restore the healthy look of the teeth and also prevent any other dental problems which are due to the missing teeth.

While replacement of the missing teeth it is of utmost importance that the equilibrium is maintained with the distribution of the forces caused by chewing. Care is also taken that the cosmetic outlook is also maintained in the treatment. 

Ideally the teeth when extracted or lost should be immediately replaced. This is because the replacement prevents the bone resorption or bone loss in the area and also retains the good bone. But a drawback is that such an immediate replacement might lead to limitation. Immediate treatment is usually done with the help of implants which easily fit in the sockets created by extraction. But even for this an analysis of the bone and gum health is necessary, thus leading to only a few instances for such replacements. Other alternative is that immediate removable dentures can be prepared and these can be replaced once the gums of the area have healed. The time period for this is usually 3 months. If these need to be fixed permanently then a waiting period of 3 months is mandatory for the settling and healing of the gums and bone of the area.

The 3 basic ways of fixing missing teeth are through implants, fixed bridgework (bridges and crowns) and dentures, which can be removed.

Missing Teeth and Problems Associated With It

Having a foreign object stuck inside a child s ear or nose is an issue many parents encounter, especially while their child is a toddler. At the early developmental stages, it s natural for children to be curious and attempt such things. It is also quite common for children as well as adults to get insects caught inside their nose or ear. In situations such as this, it s best not to worry, as people tend to aggravate the situation when they panic.
The first thing you should try if you have any foreign object stuck inside your nose is to blow your nose. Be careful not to push too hard so as to not risk injury. Often children will be able to expel foreign objects from their nose only when asked to blow their nose.

If the foreign object in question is not stuck up the nose, but up the ear, or if blowing your nose has not helped, you should try and remove the object with a pair of clean tweezers. Do not try to use household items other than tweezers, as they might push the object further up the cavity. Do keep in mind to have someone help you while removing foreign objects from your own ear as well as to keep in mind to be extra careful not to be too harsh as you might puncture your ear drum. If the foreign object is stuck up your child s nose or ear and they refuse to keep still, it s best to take them to a professional.

What can an ENT specialist do?
If you have a foreign object stuck in your nose or ear and can t get it out easily, it s safest to go to the doctor rather than risk hurting yourself or your child. An Ear-Nose-Throat Specialist can use a local anesthetic to numb the area and use their expertise to better navigate the cavity and remove the object from the ear or nose. If the object is too far up the nose to reach, the ENT Specialist can administer medication to induce a nosebleed which will naturally dislodge the object from the cavity without having to insert anything into it.

When faced with problems such as a foreign object stuck in the ear or nasal cavity, it s best to consult a professional as soon as possible instead of leaving the problem untouched for a long duration of time, as activities such as sniffing or scratching may further aggravate the issue.

Foreign Body Inside Ear, Nose Or Throat - What To Do And What Not To?

The inflammation of your pancreas over a short period of time indicates acute pancreatitis, which is a serious health condition. You may experience symptoms such as severe abdomen pain all of a sudden, diarrhoea and feeling of being sick. Acute pancreatitis occurs when there are some problems with certain enzymes in the pancreas. This condition is often associated with gallstones and alcohol consumption.


Treatment
Acute pancreatitis can be cured in a hospital, where you will get monitored for signs of serious issues. In some cases, supportive things like oxygen and fluids are required. Here are the various ways by which the condition can be treated:


1. Fluids: The body may get dehydrated during acute pancreatitis. Fluids are provided via a tube connected to one of the veins of the patient. This is known as intravenous or IV fluid. These fluids may help in the prevention of a problem called hypovolemic shock, which occurs when the amount of blood in your body gets lowered due to a drop in fluids. 
2. Nutrition: Diet is usually not restricted for people with acute pancreatitis, but some patients are recommended not to consume solid food for some time. Attempting to digest solid food may cause a strain on the pancreas. You may need to avoid solid food for some days. You should use a feeding tube to get essential nutrients. This process is called enteral feeding and it may involve the insertion of a tube into your stomach via the nose. 
3. Oxygen: For ensuring sufficient oxygen supply to your vital organs, you will be supplied with oxygen through the tubes on your nose. The tube may be removed when your condition improves. In some cases, ventilation equipment may be required for assistance to breathe.
4. Painkillers: Acute pancreatitis causes severe abdominal pain and strong painkillers such as morphine may be given to the patient. These may make the patient feel drowsy. 


Treatment of underlying cause
After controlling the symptoms, the underlying cause must be treated. They are as follows:
1. Gallstone: When pancreatitis occurs because of a gallstone, you may require a process known as endoscopic retrograde cholangiopancreatography or ERCP. The gallbladder may have to be removed, if necessary. 


2. Alcohol consumption: After getting treated for acute pancreatitis and you have recovered from this condition, you should try to avoid alcohol completely. Alcohol may spoil your recovery and the condition might reoccur or the symptoms may reappear. For freedom from alcohol, you may try counselling, joining self-help groups such as Alcoholics Anonymous (AA) or take a medicine which reduces your craving for alcohol. 


It is recommended that you visit a doctor immediately after experiencing any slight or severe symptoms of acute pancreatitis. This will help in early diagnosis and the chances of the symptoms getting worse are prevented.

Acute Pancreatitis - Can it be Cured?

Myofascial pain syndrome refers to a chronic condition that affects a person s musculoskeletal system. With this disorder, pressure on the sensitive points (known as trigger points) in the muscle induces pain in various parts of the body.

Myofascial pain syndrome mostly affects people in the age group 40-60 years.

What causes myofascial pain?

Typically, myofascial pain syndrome occurs because of repetitive muscle contraction or overuse, or due to an injury. Sensitive areas of the tight muscle fibres can develop following an injury/trauma, and ultimately lead to pain and strain throughout the muscle.

Symptoms to watch out for-

Common signs and symptoms of myofascial pain syndrome include-

  Severe pain in localized muscle areas
  Pain that worsens when you stretch or strain the affected muscle
  Muscle pain that persists for longer than usual, or worsens with time
  Painful, tender knots in the muscles that lead to severe pain when pressed
  Weakness and stiffness in the muscles
  Inflexibility or a reduced range of motion

Although muscle pain is temporary in most cases, and usually subside on its own, you should visit a doctor immediately if the pain becomes intense and severe. Otherwise, the symptoms of myofascial pain syndrome can aggravate and impede your daily routine.

What is the treatment for myofascial pain syndrome?

Treatment for myofascial pain syndrome include a range of pain management options such as the following-

  Medications
Your doctor will likely prescribe medications that include anticonvulsants, analgesics, and over-the-counter Non-steroidal Anti-inflammatory Drugs (NSAIDs). These work as painkillers and help relieve pain and reduce muscle spasms.

  Dry-needling
Dry-needling is a quicker way of getting rid of myofascial pain symptoms. The doctor inactivates the trigger points by directly inserting a needle into it. He/she will then slowly move the needle around and poke it inside and out. The initial process can be a little painful, but it certainly helps manage the pain in your muscles. Alternatively, acupuncture needles can be used for the same procedure since they are small and are less painful.

  Local injections
Local injections, also known as trigger point injections, are similar to dry-needling. The only difference is that local injections involve injecting a solution (saline/steroid/or a local anaesthetic) into the trigger points. The method yield similar results as does dry-needling.

  Therapy
Different types of therapies can be used to ease the pain associated with this chronic pain disorder.

Ultrasound therapy where sound waves are transmitted into the muscle tissues through a sound-conducting gel applied on the skin. The sound waves heat up and relax the muscles, thereby improving blood circulation and removing the scar tissues. Ultrasound therapy is also effective in reducing muscle stiffness and increasing one s mobility.
Massage therapy also is very effective in treating myofascial pain syndrome. The therapist usually uses his/her fingers or some sort of equipment to induce pressure on the various trigger points. When performed, this procedure may first aggravate the muscle pain and then release muscle tension.
Apart from these, the doctor may prescribe regular exercising or physiotherapy treatment for patients suffering from chronic muscle pain.

Myofascial pain syndrome can be managed well using the techniques mentioned above. In addition, it is very important that you stick to some sort of physical activity. Talk to your doctor and incorporate these pain management techniques to live a pain-free healthy life.

Myofascial Pain - Causes, Symptoms & Treatment Of It!

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