Knee replacement can be extremely painful. Previously, opioids or narcotics were administered for pain relief. But excessive addition of opioids is not exactly effective for controlling pain. 

Multimodal pain management has become an important part of the perioperative care of patients undergoing total joint replacement. The principle of multimodal therapy is to use interventions that target several different steps of the pain pathway, allowing more effective pain control with fewer side effects. Many different protocols have shown clinical benefit. The goal of this review is to provide a concise overview of the principles and results of multimodal pain management regimens as a practical guide for the management of joint arthroplasty patients.

Multimodal denotes administering two or more than two types of medications that work with different mechanisms. The following are the techniques used:

Pre-operative Femoral Nerve Block: Prior to the surgery, a catheter is placed beside the femoral nerve for blocking it. This nerve is located in the upper thigh. Medication is delivered through the catheter for the nerve to be numbed for 24 hours. Thus, pain signals to the brain are blocked. This method reduces the use of narcotics and the consequent side effects.

Patient Controlled Analgesia (PCA): This method is also known as  Pain Pump . An intravenous pump is used to administer pain relief medications, such as oxymorphone or morphine, after the surgery. The control button of the machine could be pressed, by the patient for 6 to 10 times per hour. The machine is used for two post-operative days.

Oral Medications: The oral medications include Non-Steroidal Anti-Inflammatory drugs or NSAID; such as Celebrex which is similar to aspirin, structurally. Alternatively, acetaminophen, such as Tylenol or its equivalent composition, can also be used.

Acetaminophen: It acts on the Central Prostaglandin Synthesis and relieves the patient of pain through multiple mechanisms.

Epidural Analgesia: It produces lower pain scores and involves less time for achieving physical therapy goals. However, this is subject to side effects such as dizziness, urinary retention and itchiness.

Gabapentinoids: These medications include membrane stabilizers such as Gabapentin and Pregabalin.

The objective of multimodal treatments is to provide quick relief to the patient and immediately so. Earlier the rehabilitation, more successful will be the knee replacement surgery.

Multimodal Pain Relief After Total Knee Replacement

The human lungs are an intricate and a vital organ of the body. This organ is responsible for filtering the air you breathe, separating the oxygen and infusing it in the blood to be used by the body. The lungs have multiple tube-like structures within it, known as the bronchial tubes. The lining of these tubes may become inflamed due to a bacterial or viral infection and thus result in bronchitis. However, a significant percentage of bronchial inflammation or bronchitis is also caused by allergies. Inflammation causes swelling which not only results in breathing difficulties, but also causes other problems as well such as excess production of mucus, painful coughing and heaviness in the chest area, etc.

Homeopathic approach towards curing allergic bronchitis
Homeopathy is a form of medication which is symptom based and takes into account the general disposition of the person along with the apparent symptoms. Thus, prescribing medications also differs according to the differences in each patient. Some of the more well-known homeopathic medications usually prescribed are mentioned below. However, you should consult a homeopathic doctor first as they would be able to evaluate your condition best and then prescribe the correct medications accordingly.

Arsenica Album: This medication is usually prescribed for people who have general weakness in the body that accompanies bronchitis. Some of the other indications wherein Arsenica Album may be prescribed may include restlessness and increased coughing after midnight and wheezing.
Antimonium Tartaricum: This is another very effective medication when there is rattling in the chest. However, although you can feel a lot of mucus within, very little of it tends to come out. Antimonium Tartaricum is very effective in such cases. Another indication for this medication is the worsening of the coughing after eating.
Pulsatilla: If you have a lot of mucosal discharge after coughing which is yellow to greenish in color, then Pulsatilla may be prescribed for you. Some of the other indications wherein Pulsatilla is usually prescribed are a lack of thirst and the cough worsening while lying down which may force you to sit up. Cough also tends to be loose in the morning and becomes drier in the evening.
Bryonia: Another allrounder medication very effective in treating multiple disorders, Bryonia is very effective in treating Bronchitis as well. Some of the indications where this medication is prescribed would be   extreme thirst, dry cough, dryness of the mucosal membranes in general, pain in the head and chest while coughing and the cough starting when getting into a warmer room.
Hepar Sulph: An overtly increased sensitivity to cold air or coldness, in general, is the prime indicator for this homeopathic medication. Any exposure to coldness immediately triggers a cough and the coughing tends to be worse in the morning. You may also rattle excessively from cold and wheezing may also be present.

Allergic Bronchitis - Homeopathic Remedies That Can Help!

LASIK stands for Laser In-situ Keratomileusis. This is a common eye surgery that helps in correcting vision problems. During this procedure, the cornea of the eye is cut across by a medical expert to raise the tissues and reshape them to correct vision. LASIK is suitable for patients who have shortsightedness, long sightedness or who suffer from astigmatism.

Here are the 5 benefits that a LASIK surgery offers:

1. Improved vision

A study reveals that 95% of the people who underwent this surgery achieved uncorrected visual acuity of 20/40 and 85% of the people achieved 20/20 vision. This procedure ensures that a patient achieves enhanced vision.

2. Quick results and recovery

This surgery enables you to return to your normal schedule immediately the day after the surgery. You can have clear and improved vision within a day.

3. Long- lasting outcomes

A minimum timeframe of 3 months is required for the eyes to adjust, after which LASIK results are permanently noticeable in a patient. No follow up procedures are required unless something wrong went with the surgery. The patient will continue to have improved vision unless there is any normal loss due to illness or aging.

4. No need of glasses

You no longer require glasses as your vision turns to normal post-LASIK surgery.

5. Goodbye contact lenses

LASIK surgery will help eliminate the need for contacts. You will be able to avoid all the problems pertaining to wearing a contact lens, including lens solution.

5 Benefits of Lasik Surgery

Heart attack, also known as myocardial infarction, is a severe condition where death of the heart muscle occurs because of the loss of blood supply. The blood loss usually happens because of the blockage of a coronary artery. Due to electrical instability, ventricular fibrillation is caused. Heart attacks may result in permanent brain damage or even death.

Symptoms of heart attack
There are many early symptoms and signs of heart attack, which should be recognized. Symptoms of heart attack vary from person to person. Here is a list of the primary heart attack symptoms:

Chest pain and discomfort:
Chest pain is the basic symptom of a heart attack and occurs in different forms. The chest pain has a pressure, fullness and squeezing sensation and starts from the center of the chest. The pain may go away and re-occur and may spread down to other limbs of the body.
Headache, toothache:
The chest pain occurring due to a heart attack spreads all over the body and the jaw. Even the back and head are affected. Sometimes pain in these regions is present while chest pain is absent.
Shortness of breath:
A gasping sensation or feeling shortness of breath is another common sign of a heart attack. Such breathing difficulty is called dyspnea. The shortness of breath occurs before or during the chest pain.
Nausea and vomiting:
The feeling of nausea or sickness in the stomach is another possible symptom. It is accompanied by belching or burping and sometimes, the heart attack is associated with a feeling of indigestion. Nausea is more common in women. Vomiting also occurs alongside nausea.
General epigastric discomfort:
In several cases, patients describe the pain of a heart attack as stomach pain. The pain is heavy and uncomfortable and persists for several minutes.
Sweating:
Perspiration or sweating occurs during a heart attack and the patient experiences cold sweat in avid amounts.

Emergency treatment for heart attack-
A person who has a heart attack should be rushed to a hospital.
Several tests are carried out to detect the cause of the attack. A 12 lead ekg is carried out to supervise electrical activity within the heart and detect the damaged areas.
Blood tests are undertaken to check enzymes and in certain cases, cardiac catheterization is required where pictures of the blood vessels are examined.
Emergency medicines are given to the patient to stop the formation of blood clots and include aspirin, heparin and other drugs. Other medicines are given for thrombolytic therapy, which dissolve already formed blood clots. They work to reduce the heart damage. Nitrates are also used.

A heart attack is a severe condition and must be attended to immediately. Emergency treatment procedures are essential to save the life of an affected person.

Heart Attack - Signs, Symptoms and Emergency Treatment

Body fat or adipose tissue is a constituent of the human body. Its primary function is to provide energy to the body. Body fat builds up differently in men and women. Recent studies explore the health consequences ensuing from these differences. 

Usually, men have an  apple-shaped  body. This is because men accumulate visceral fat   fat that is stored in the abdominal cavity   around the belly. Women, on the other hand, depict a  pear-shaped  body because they have more fat deposits around the hips. Visceral fat is extremely dangerous because it affects the internal organs of your body, including the liver, intestines, and pancreas. 

Body Fat Percentage in Men and Women 

To evaluate your health, it is essential that you know your body fat percentage (BFP). A healthy body fat percentage depends on a number of variables such as age, body type, gender etc. For example, BFP range tends to be higher in women than in men because women require more body fat. The average BFP of females falls in between 25% and 31%. 

What is a good body fat percentage?

Ideally, for men between ages 20-40, healthy BFP ranges from 8%-19%; between ages 41-60, normal BFP ranges from 11%-22%; between ages 61-79, the normal should be between 13%-25%. For women aged between 20-40 years, healthy BFP ranges from 21%-33%; between ages 41-60, normal BFP ranges from 23%-25%; between ages 61-79, the normal should be between 24%-36%. 

What body fat percentage is unhealthy?

Body fat percentage below or above the normal range (as stated above) is considered unhealthy. For instance, if the BFP of a woman aged between 20-40 years is more than 30%, then it is considered overweight. Similarly, if a 50-year-old man has BFP below 11%, he is deemed underweight. Nevertheless, there are several ways to maintain a good body fat percentage.

How to Lose Body Fat Percentage?

Many people come up with questions like   Is it hard to lose body fat percentage? Certainly not, unless you have a serious underlying condition (obesity or PCOD). You can reduce your BFP by following the pointers below- 

  Follow a protein-rich diet   It will decrease your appetite, reduce calorie intake, and preserve muscle mass. Good protein sources include dairy products, meat, eggs, legumes, seafood etc.   Add vinegar to your diet   Induces a sense of feeling full, lowers body fat, and reduces calorie intake 

  Eat more healthy fats   Helps you burn fat quickly. Coconut oil, olive oil, and avocados are good sources. 

  Reduce carb intake   Cutting down on refined carbohydrates like white bread/rice, pasta, snacks, cereals etc. can help you shed that extra flab. 

Besides following a healthy diet, you should also engage in physical activities to bring down your body fat percentage to its normal range. Exercise more often   begin strength training to get rid of belly fat and build muscle mass. You can also lose fat by consuming these natural fat burners:

  Caffeine   boosts metabolism and helps you burn more fat as fuel

  Green tea extracts

  Protein powder/supplements   boosts metabolism and reduces appetite 

  Soluble fibre 

Having a healthy body fat percentage is the key to staying fit and steering away from a host of ailments. Therefore, maintaining a balanced diet along with moderate exercise and routine check-ups is extremely important. 

How Body Fat Affects Men's & Women's Health Differently?

Choosing homeopathy to cure bronchitis

Bronchitis is a respiratory disease where people cough up thick mucus. Bronchitis can either be acute or chronic, with the most common cause of bronchitis being either viral or bacterial infection. Acute bronchitis improves within a few days with proper medications. On the other hand, chronic bronchitis is a serious condition causing constant irritation in the linings of bronchial tubes. The most commonly visible signs of bronchitis are a cough, fatigue, shortness of breath, chest discomfort and slight fever and chills. Exposure to excessive pollutants and smoking can cause chronic bronchitis.

How homeopathy can help you in treating bronchitis

Bronchitis can be treated with the help of homeopathy, which can be instrumental in providing relief, thereby improving your quality of life. In fact, homeopathy can be your best option for treating both the forms of bronchitis, as it offers significant relief from the symptoms as well as helps in improving your health in totality.

In the case of acute bronchitis, homeopathy can shorten the duration of the illness to a great extent. When a patient is on the homeopathic treatment he/she experiences a marked reduction in toxicity as well. For the management of an acute attack of bronchitis, the prescribed homeopathic medicines may have to be taken at shorter intervals, after every few hours.

Chronic bronchitis, though contagious, can be treated by homeopathy as well. The symptoms of chronic bronchitis can be significantly improved by homeopathic remedies. It can even aid the patient in quitting smoking.

The most important aspect of homeopathy treatment in the management of bronchitis is that the medicine works very fast and does not leave you weak and drained at the end of the infection. Homeopathic treatment can also help to prevent complications such as pneumonia, respiratory failure, right sided heart failure (the one that affects the right side of your heart), emphysema, etc.

Homeopathic medicines come without any side effects and are non-addictive. Also, there is no problem in administering the medicines to any patient irrespective of age; therefore, it's a safer choice to opt for homeopathy for the treatment of bronchitis.

If you would like to consult with me privately, please click on 'consult'.
Related Tip: Did You Know: Every 7th Urban Indian Is Prone To Bronchitis

Here's a Reason for Choosing Homeopathic Treatment for Bronchitis

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