Sarcopenia refers to the loss of muscle mass caused by the natural process of ageing. Over time, the loss of muscle mass may reduce a person s strength and affect his or her balance and the ability to walk. Sarcopenia can make it difficult for one to carry on with their routine activities, such as walking, lifting objects, or climbing stairs.

The reduction in muscle mass involves both a decrease in their size and the loss of muscle fibres. Sarcopenia becomes noticeable by age 40   and the loss of muscle tissues progress more rapidly by the time you reach the 60s or 70s. Doctors believe that certain hormonal changes due to ageing are the main reason for this condition. 

Apart from that, poor nutrition and a sedentary lifestyle also contribute to muscle loss. Health experts and doctors suggest that following a proper, nutritious diet can help treat or delay sarcopenia.

Diet recommended for sarcopenia patients 

If you are diagnosed with sarcopenia, your dietician or healthcare provider will likely recommend a diet that has an abundance of proteins, omega-3 fatty acids, and vitamins to prevent further muscle loss and boost their growth.

Here is a close look at the nutrients  

Proteins

The protein in your diet signals the muscle tissues to strengthen and build. As your muscles become more resistant to this signal with age, it is important that you consume more protein to increase muscle growth. A study found that people over age 70, who consumed a wholesome meal containing 35gms of protein, saw significant growth in the muscle mass. Leucine, an amino acid, is especially essential for regulating muscle growth. Some of the best sources of leucine include meat, eggs, fish, soy, and whey protein. 

Research has shown that the optimal intake of dietary protein should be somewhere between 0.6-0.9g/pound/d of protein in older adults with chronic or acute diseases. Besides eating more protein with meals, health experts recommend adding other protein-rich foods to their daily diet, including peanuts, almonds, edamame, and chickpeas. 

Vitamin D

Vitamin D is important for maintaining and building healthy bones. This is because the main component responsible for bone health, calcium can be absorbed only when your body has sufficient vitamin D. Milk, soymilk, cheese and other dairy products, egg yolks, and fatty fish like salmon, tuna, and mackerel are some of the foods offering sufficient amounts of vital vitamin D. While natural food sources are the best way to get your daily dose of vitamin D, you can also opt for supplements to increase muscle endurance and lower the risk of falling. However, be sure to discuss with your doctor before taking vitamin supplements. 

Omega-3 fatty acids

Fish oil extracted from fatty fish contains high amounts of omega-3 fatty acids, DHA, and EPA. Due to its anti-inflammatory properties, fish oil is known to boost muscle sensitivity to resistance training and protein, allowing for growth in strength, size, and muscle mass as you age. A study conducted over 16 weeks revealed taking omega-3 supplements regularly witnessed a significant increase in muscle growth. 

Sarcopenia becomes more apparent with age and may affect your quality of life. Eating high-quality protein and enough calories can delay the rate of muscle loss. Consult a dietician and ask for a diet plan comprising these nutrients to improve muscle strength and deter sarcopenia.

What Type Of Diet Should Be Taken In Sarcopenia?

Bone cancer is a rare form of cancer in the cancer family. It affects one of the bones of your body and spreads to other bones. But, more often, it has the tendency to affect the long bone in the legs and the arms. There are many types of bone cancers. While some of them can affect children, the others typically affect the adults. This type of cancer is different than those cancers which get initiated from other parts of the body and spread to the bones.

What are the symptoms of bone cancer?
The typical signs and symptoms of bone cancer include acute pain in the bone, tenderness in the affected area, swelling of certain bones, a tendency of bone breakage, fatigue with little or no effort, unexplained weight loss, shortness of breath etc.

What are the causes of bone cancer?
There is no particular reason for bone cancer. Studies have shown that an error in the structure of the DNA leads to bone cancer. This error leads the bone to grow and divide in an uncontrolled manner leading to non-extinction of cells. These cells keep growing and form a mass invade to other parts of the body, leading to cancer.

What are the different types of bone cancer?
The type of the bone cancer can be distinguished from where cancer originates from. Some of the common bone cancer type includes the following:

Osteosarcoma: This is the form of cancer that originates from the bone cells and is often witnessed in young adults and children. They often attack the arm and the leg.
Chondrosarcoma: This form of cancer begins from the cartilage cells. The exact place of damage appearance includes legs, arm, and pelvis. This is typically observed in middle-aged persons in older adults.
Ewing's sarcoma: Though researchers are yet to find out the location this form of bone cancer originates from, it is mostly considered to affect the legs, arms, and legs of young children.
What are the risk factors?
While doctors are yet to researching for the exact reason of bone cancer, there are certain risk factors which have been associated with the bone cancers.

Inherited genetic syndromes: Certain genetic condition such as the hereditary retinoblastoma and Li-Fraumeni syndrome which are passed on from generations are a prime culprit of bone cancer.
Paget's disease: This is a bone-related disorder that affects the bone and increases the chance of bone cancer.
Radiation: Exposure to a huge amount of radiation increases the chances of bone cancer and other associated cancers.
How is bone cancer detected?
Imaging tests such as the bone scan, x-ray, MRI, PET scan and the CT scan can diagnose bone cancer. Apart from these, oncologists might order a biopsy that includes removing a part of the tissue and test the same in a laboratory can also help to detect bone cancer.

Bone Cancer - Risk Factors Associated With It!

Are you suffering with pins and needles in your hand? You may be suffering with carpal tunnel syndrome. Carpal tunnel is a tunnel made of bones in the wrist. Roof of the the tunnel is made of a ligament. This tunnel contains a nerve and some tendons which help in bending of fingers.

This nerve is called median nerve and it acts as a electrical wire carrying sensation from certain parts of hand. It also functions as a wire carrying power signals from brain to hand. Increased pressure of the tunnel causes compression of the nerve and this condition is called as carpal tunnel syndrome. This syndrome gives symptoms of pins and needles in part of hand and weakness in grip. (Pins and needles in Hindi is commonly known as झुनझुनाहट or झुनझुनी or सुन्न पन). Often patient will wake up in night because of pins and needles and shake their hand to relieve the symptoms. It can also manifest as burning sensation or pain in hand.

Carpal tunnel can be caused due to multiple factors. It is commonly seen in pregnant females. Repeated use of hand in certain postures can also lead to carpal tunnel syndrome. Other causes are thyroid problems, diabetes, rheumatoid arthritis and injury to wrist.

Diagnosis of carpal tunnel is mainly clinical and nerve conduction study is a useful tool in confirming the diagnosis. Special (Neuropathic ) pain killers can help with the symptoms. Physiotherapy and posture training can also reduce pins and needles. Night splints are often helpful. If symptoms fail to improve with non operating measures, surgical decompression of carpal tunnel is indicated. Carpal tunnel surgery is performed as a day case procedure under local anaesthetic. It has very satisfying results and a quick recovery.

This article is for information purpose only and not a substitute for proper medical advise.

Pins & Needles In Hand - Carpal Tunnel Syndrome!

Back pain is a common source of pain and can be acute, sub-acute or chronic in nature. Back pain is classified along the segments of the spine and can be divided into neck pain, middle back pain, lower back pain and coccydynia or tail bone pain. Back pain can be quite troublesome as it disables a person to move about freely due to constant ache.

Here are some procedures for the treatment of back pain.

    Give your back some rest: Most people who get back pain become obsessed with it and end up getting MRI scans and x-rays done. Some even take injections and other such measures without recognizing the intensity of the pain. It is advised not to rush into the matter immediately and the simplest way to cure the pain is by resting. 90% of pains in the back resolve by themselves in 6 weeks and so you must give your back a break instead of taking medical actions and let time do the healing.
    Pills: While you let time treat your back pain, sometimes the pain increases and gives you a bad time. In this case, you can take anti-inflammatory medicinal pills such as ibuprofen or naproxen. These pills will help you ease the pain. However, using such pills for a continued period of time causes side effects such as gastrointestinal disorders. Hence, you should not take them for more than ten days at a stretch.
    Hot and cold compress: Apply a bag of frozen peas or an ice pack to the affected area for 48 hours after the pain appears. Every session should be about 20 minutes, and you should take more than two sessions each day. After two days, repeat the same procedure using a heat pad instead of ice. The cooling procedure shuts down your blood capillaries and reduces the flow of blood to that area. The swelling is eased as a result. The heating, on the other hand, loosens tight muscles and increases the blood circulation, providing extra oxygen.
    Change your mattress: People who sleep on firm mattresses and cushions on their beds are at a higher risk of having a back pain. According to studies, it has been observed that people sleeping on medium-firm mattresses have healthier backs. In case your mattress in sagging or is over 8 years old, you should replace it.
    Acupuncture: When your back pain is very severe, you can resort to acupuncture, which provides efficient pain relief. The procedure changes the way your nerves react and reduces inflammation.

Back pain arises from various reasons and should always be taken care of. Unattended back pain worsens and makes the affected person suffer.

Suffering From Lower Back Pain - 5 Ways You Can Treat it

If you are suffering from a swollen ankle, you can opt for homeopathic treatment. Swollen ankles are commonly caused because of factors such as trauma, ankle injury, ankle sprains, arthritis, steroids, certain medicines, lymphedema, venous insufficiency and many others. There are various homeopathic medicines, which are commonly used for treating swollen ankles occurring due to different reasons.

Here is a list of the top homeopathic medicines for swollen ankles:

Apis Mellifica and Apocynum: These homeopathic medicines are suggested in case of dropsical swelling over the ankles. The swelling occurs because of water retention in your tissues. Apis is used where the patient s ankles are pale, waxy, and swollen. The ankles become sensitive to touch and stinging pain is likely. Apocynum is used in case of dropsical swellings which occur after cardiac diseases. These dropsical swellings may develop on other parts of the body as well, apart from the ankles.
Ledum Pal: This is an efficient homeopathic medicine for swollen ankles, which develop due to arthritis. This medicine is used when the ankles are hot, swollen, and very painful. It is also used for treating swollen ankles due to gouty afflictions. In such patients, warmth worsens the pain while cold applications soothe the pain.
Arnica: Arnica is one of the best homeopathic medicines for swollen ankles, which occur because of an injury. It is a wonderful and fast working medicine, which resolves swelling and attends to other symptoms related to the injury. The ankles of a patient who needs Arnica feel painful, sore, and bruised to touch.
Ruta: This effective homeopathic medicine is used for treating swollen ankles occurring from a sprain, which is an overstretching of the ligaments. This medicine is ideal for sprained ankles along with weakness and pain in the ankle joint.
Hamamelis: This homeopathic medicine is considered to be very effective for the management of swollen ankles, caused due to varicose veins. It works best when used for the treatment of swollen ankles associated with venous insufficiency. The common symptoms which indicate that a patient requires this medicine include swollen, inflamed ankles, which occur because of congested and engorged veins. Cutting pain and soreness in the ankles are also likely. Swelling in the leg is another probable symptom.

Homeopathy is an effective natural remedy for swollen ankles, without having any side effect on the body. For treating swollen ankles, it is recommended for you to consult a licensed homeopathic practitioner before taking homeopathic medicines on your own.


Best Homeopathic Medicines For Swollen Ankles

As life expectancy is increasing so is the incidence of vertebral body (VB) fractures now being the commonest fracture of the body. PVP is an established interventional technique in which bone cement is injected under local anaesthesia via a needle into a fractured VB with imaging guidance providing instant pain relief, increased bone strength, stability, decreasing analgesic medicines, increased mobility with improved quality of life and early return to work in days.

In this era of minimally access surgery replacing open surgeries, PVP is a novel procedure & should be in the first line of management in place of conservatism or major spine surgery for painful uncomplicated compression fracture spine.

Morbidity & consequences of spinal fracture:

Traumatic VB is a painful condition requiring bed rest restricting daily activities markedly
Left untreated it can cause DVT, increase osteoporosis, loss of VB height, respiratory & GI disturbances, emotional & social problems secondary to unremitting pain, loss of independence with high cost of rehabilitation.
High risk of primary or consequential damage to neural, bony or disc element
Increased wedging, deformity & increase incidence of adjacent VB
Chronic pain of altered spine mechanics
Uncomfortable braces & sleep disturbance because of pain & discomfort with its sequels.
Cost of surgery and hospital treatment
Cost of implants
Phobia of surgery
Prolonged recovery period & Extensive rehabilitation
Changed spinal mechanics & transition syndrome
Major surgery & anesthesia with its own complications
Results / Outcome

PVP is a novel procedure with high benefit to risk ratio, which is highly underutilized in relation to the high prevalence of the vertebral.
Different studies show an immediate pain relief in (85   90)% of patients with low complication rate ranging from (1-5)% depending upon the type of lesion.
PVP does augment height of VB but ideal would be kyphoplasty
Patient is either off medicine or on reduced doses.
Patient feels so well that he almost forgets if he had VB

Percutaneous Vertebroplasty (PVP) is an emerging interventional technique in which surgical polymethyl methacrylate bone cement is injected under local anaesthesia via a large bore needle into a vertebral body (VB) under imaging guidance providing increased bone strength, stability, pain relief, decreased analgesics, increased mobility with improved QOL and early return to work. Started in 1984 by Galibert PVP is done in host of indications.

Senile osteoporotic compression remains the commonest Indication. Other indications are Metastatic VB, Multiple myeloma VB, VB haemangioma, Vertebral osteonecrosis & for strengthening VB before major spinal surgery. The benefit has been extended to the traumatic stable uncomplicated VB compression (VCF) which is commoner in younger age group with active life profile and prime of their career where strict bed rest and acute or chronic pain are unacceptable and they are more demanding for proactive treatment approach so as to be back to work ASAP.

Discovering the fact that VB is the commonest of body, its incidence >the hip, it becomes imperative to take it more seriously. With increasing life-span there is more of aged osteoporotic population, more so due to sedentary indoor lifestyle and post menopausal osteoporosis. Diabetics, smokers & alcoholics are at higher risk of developing osteoporosis. I have seen such alcoholic patient developing six spine fractures in just three months time from a single fracture being on complete bed rest.

Quick fix of fracture spine makes patient walk back same day instead of bed rest of months together avoiding morbidity & mortality of prolonged bed rest, making bedridden patient walk, in a way bringing patient back to normal life.

In this era of MAS replacing open surgeries, PVP is a novel procedure & should be in the first line of management in place of conservatism or major spine surgery for painful uncomplicated compression.

Morbidity & consequenses of spinal 

Traumatic VB is a painful condition requiring bed rest restricting daily activities markedly.
Left untreated it can cause DVT, increase osteoporosis, loss of VB height, respiratory &
GI disturbances, emotional & social problems secondary to unremitting pain, loss of independence with high cost of rehabilitation.
High risk of primary or consequential damage to neural, bony or disc elements.
Increased wedging, deformity & increase incidence of adjacent VB
Chronic pain of altered spine mechanics.
Uncomfortable braces & sleep disturbance because of pain & discomfort with its sequels.
Morbidity and complication of spinal surgery 

Cost of surgery and hospital treatment
Cost of implants
Phobia of surgery
Prolonged recovery period & Extensive rehabilitation
Changed spinal mechanics & transition syndrome
Major surgery & anesthesia with its own complications
Preparation & Procedure:
X-ray spine in a/p & lat view. CT is more informative of bone & morphology. MRI is good for soft tissue injuries. Ask for pedicle size in all dimensions and construct a 3D image aiming needle placement and cement filling in scan room itself as rehearsal of PVP. This reduces operative time & gives better results. Conventionally PVP is done by hammering the vertebroplasty needle through the bone. Here we use light weight drill to bore through the vertebra. It is important to set the needle at exact entry site & side with right trajectory aiming the defects.

In lateral view needle should go through middle of the pedicle going up to anterior 1/3 of VB. In P/A view the needle can be in midline or paramedian depending upon & if uni/bipedicular approach is planned. Approach varies as per location of vertebra, anterolateral in cervical, costotransverse/parapedicular in thoracic & transpedicular in lumbar vertebra.

Do bone biopsy if there is any doubt about lession. Do dye test (vertebral venography). Make cement more radiopaque by adding barium /or tungsten. Inject cement with 1or2 ml luerlock syringes strictly under fluoroscope in lateral view & cross checking in P/A view. Stop injecting either there is adequate filling or at the first sight of ectopic cement leak. Keep sample cement to see for hardening. Remove needle with rotational movement before cement hardens.

Pain relief is by virtue of different mechanisms postulated :

Cementing of fragments.
Thermal neurolysis of VB nerve ending due to heat of polymerization.
Washing away of nociceptor chemicals.
Neurolytic action of liquid monomer.
By allowing early ambulation decreasing pains of immobility & bed rest.
Complications 

PVP is generally safe with low risk.
Ectopic cement leak is frequent but generally inconsequential.
Outcome 

PVP is a novel procedure with high benefit to risk ratio, which is highly underutilized in relation to the high prevalence of the vertebral
Different studies show an immediate pain relief in (85   90)% of patients with low complication rate ranging from (1-5)% depending upon the type of lesion.
PVP does augment height of VB but ideal would be kyphoplasty.
Patient is either off medicine or on reduced doses.
Patient feels so well that he almost forgets if he had VB

Vertebroplasty (PVP) / Kyphoplasty - Approach To Management Of Vertebral Body Fractures!

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