Anger is one of the most common negative emotions, in that when a person is upset or frustrated over somebody or something, it manifests as anger. Though we may not notice on a routine basis, there are various forms of anger and it has a lot of negative effect on the overall physical and emotional health. Some people also are more prone to feel angry and manifest it openly, who is known as  short-tempered.  Read on to know more about anger and how to manage anger effectively.

In today s world though, you cannot throw a fit of rage and say it is because of your short-tempered nature. There are extreme instances of violence triggered by anger, so it is necessary to learn to conquer your anger. 

DIFFERENT PEOPLE RESPOND TO ANGER IN DIFFERENT WAYS, COMMONLY AS:

Verbal anger: The person who is angry, abuses the other person or sometimes throws rage at a totally different person to vent out the anger. 
Passive anger: Though these people are less expressive when angry, they show their anger through sarcasm directed at the person who induced anger. 
Self-inflicted Anger: These people inflict anger on themselves through self-harm acts like minor cuts, bruises, beating oneself, digging nails into their flesh or burns to release their anger.
SYMPTOMS OF ANGER AND AGGRESSION 
We may respond to anger in physical and psychological ways such as those listed below:

Anger   physical responses: increased heart rate and blood pressure, sweating, muscle tension, clenched jaw 
Anger   psychological responses: feelings of frustration, feelings of rejection, feelings of mistreatment, hostility towards some people 
Aggression: shouting at people (e.g. family, colleagues, strangers, physical violence (e.g. hitting, punching people or slamming doors), ignoring or socially excluding others (passive aggression)
WHY ARE SOME PEOPLE SHORT-TEMPERED
Some people really are more impetuous than others. They get aggressive more easily and more intensely as compared to others. There are also those who don't show their anger in loud ways but are chronically irritable and grumpy. People who are easily angered don't always curse and throw things; sometimes they get off socially, sulk, drink/smoke or get physically ill.

Easily angered people generally have what we call as "A low tolerance for frustration, aggravations and hassles of daily living" and sometimes overreact to the many common problems of daily living. They feel that they should not be subjected to frustration, annoyance, or inconvenience. They can't take things in stride, and are particularly infuriated if the situation in some way seems illogical: for example, such people might be miffed on being corrected for even a minor blunder. 

HOW ANGER AFFECTS OUR LIVES

Physical effects of anger: Anger triggers the body s  fight or flight  response. Other emotions that trigger this response include anxiety, fear and excitement. The adrenal glands flood the body with stress hormones, such as adrenaline and cortisol. The brain shunts blood away from the gut and towards the muscles, in preparation for physical exertion. Heart rate, blood pressure and respiration increase, the body temperature rises and the skin perspires. The mind is sharpened and focused.

Health problems with anger: The constant flood of stress chemicals and associated metabolic changes that go with recurrent unmanaged anger can eventually cause harm to many different systems of the body. Some of the short and long-term health problems that have been linked to unmanaged anger include: 

Headache 
Insomnia 
Digestion problems, such as abdominal pain 
Increased anxiety 
High blood pressure 
Depression 
Heart attack 
Stroke 
Skin problems, such as eczema
IMPACT OF ANGER ON OUR RELATIONS

Anger at home: Anger is a normal emotion but not being able to control your anger at home can damage your personal relationships. When you get angry, it stresses your partner out and breaks the trust in your relationship. When it comes to children, shouting at them can confuse them and make them afraid of you. In the long run, this can affect their social skills.
Anger at the workplace: Getting angry at your workplace can reduce your productivity and harm your relationships with your colleagues. The angrier you get in the office, the more your colleagues and clients will avoid you. Thus, you may risk missing out on crucial teamwork projects that can affect your career growth. A reputation for anger can also make you a target for revenge and lawsuits.
Anger in society: Nobody wants to interact with a person who has a reputation for getting easily offended and angered. Thus the angrier you get, the more your friends will keep away from you. This can be quite frustrating and can make you an even angrier person. Uncontrolled anger can also lead to physical outbursts that can put you in trouble with the law.
Anger is a strong and powerful emotion. If it isn t handled appropriately, it may have destructive results for you and those closest to you. Uncontrolled anger can lead to arguments, physical abuse, physical fights, self-harm and assault. On the other hand, well-managed anger can be a useful emotion that motivates you to make positive changes

ANGER MANAGEMENT - SUGGESTIONS FOR LONG-TERM ANGER MANAGMENT 
The way you typically express anger may take some time to modify. Suggestions include:

Keep a diary of your anger outbursts, to try and understand how and why you get mad. 
Learn relaxation techniques, such as meditation or yoga. 
Consider assertiveness training, or learning about techniques of conflict resolution. 
See a counsellor or psychologist if you still feel angry about events that occurred in your past. 
Exercise regularly.
BENEFITS OF REGULAR EXERCISE IN MOOD MANAGEMENT
People who are stressed are more likely to experience anger. Studies have documented that regular exercise can reduce stress levels and improve one's mood. This may be because physical exertion burns up stress chemicals, and it also boosts production of mood-regulating neurotransmitters in the brain, including endorphins and catecholamines.

TEACHING CHILDREN HOW TO EXPRESS ANGER
Expressing anger appropriately is a learned behaviour. Suggestions on helping your child to deal with strong feelings include:

Lead by example. 
Treat your child s feelings with respect. 
Let them know that anger is natural and should be expressed appropriately. 
Teach practical problem-solving skills. 
Encourage open and honest communication in the home. 
Explain the difference between aggression and anger. 
Teach your child different ways of calming and soothing themselves. 
Punish aggression or violence, but not appropriately expressed anger.

Kill The Anger Before It Kills You!

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!

You must have often heard about sports person, especially those associated with tennis or baseball (that involves continuous arm movement) suffer from rotator cuff injury. But what exactly is this injury? To understand the condition better, you need to know what is a rotator cuff. A rotator cuff is a group of tendons and muscles that keep the shoulder joints stable enabling a person to rotate or lift their shoulders freely.

With time, certain activities may cause a wear and tear of the rotator cuff injuring them. The injury sustained can result from a partial or a complete tear.
A partial tear of the rotator cuff may damage the tendons, but it will remain attached to the bones. However, in the case of a complete tear, the injury is more severe that penetrates deep within detaching the tendons off the bone (humerus).

Who can suffer from a Rotator Cuff Injury?
While the condition can affect anyone, people under the following situations stand a greater chance of injuring their rotator cuff.

People in their old age may suffer from the Rotator Cuff injury as with age the tendons and muscles may undergo a degeneration.
The injury may also be genetically linked.
The problem is found to be common among tennis and baseball players.
Painters, as well as carpenters who need to move their arms and shoulders continuously in a particular direction, stand at a risk of injuring the rotator cuff.
Symptoms associated with a Rotator Cuff Injury
People with a Rotator Cuff Injury may exhibit the following symptoms and associated discomfort.

The rotator cuff ensures the free and comfortable rotation of the arm and the shoulder. An injury will limit this rotation. As a result, a person may experience great difficulty and pain in lifting and moving the arm.
Lying on the affected shoulder can be a painful experience.
There is instability of the shoulder joints followed by weakness.
A person finds it difficult to carry out the basic activities such as bringing a glass of water close to the mouth or combing the hair.
Treatment

Anti-inflammatory drugs and painkillers (Acetaminophen) may be used to reduce the pain and swelling associated with the injury.
Physiotherapy and various strengthening exercise can go a long way to deal with shoulder weakness, stiffness, and restricted movement. However, one needs to have patience as the treatment may take time to produce the desired results.
In extreme cases, the doctor may opt for a surgery.
Arthroscopic surgery: The procedure is simple and involves a small incision on the affected shoulder to place an arthroscope (that comes fitted with a camera and the surgical instruments) to treat the condition.
The doctor may also carry out an open surgery or a mini-open surgery (an amalgamation of open and arthroscopic surgery) to fix the tear.

Rotator Cuff Injury - Symptoms Associated With It!

Arthritis is a painful joint condition that leads to pain and stiffness as well as lack of proper mobility due to inflammation and swelling. Usually, an orthopaedic specialist will prescribe anti-inflammatory and pain relieving medication for this condition, but there are various things that you can do to ensure that this condition does not become a debilitating one in the long run. One of the best ways of doing this is by limiting your diet in certain ways when it comes to inflammation producing food. 

Here are a few types of food to avoid if you are suffering from arthritis.

Fried food: Fried and processed food is packed with too much of salt in order to better preserve it so that it has longer shelf life. Also, the use of oil in order to deep fry can have a detrimental effect on the inflammation that is already causing problems for your joints. Therefore, it is best to avoid fried, fatty and processed or packaged food that has been frozen for too long.
AGEs: When we speak of AGEs, we are not talking about the number of birthdays that you have celebrated. AGEs are actually Advanced Glycation End products that are a toxin released by food when it is heated, grilled, fried or pasteurised. These toxins can render damage to the proteins in your body. Once this process starts, the body retaliates by sending forth cytokines which are basically inflammatory messengers. This can lead to inflammation and arthritis.
Sugar: Sugar and other refined carbs also have a large amount of AGEs as discussed above. These types of food should also be avoided by patients suffering from arthritis. Also, artificially sweetened drinks and too many baked goodies should be avoided by these patients.
Dairy products: Owing to a certain kind of protein that most dairy products contain, these kinds of food are considered harmful for patients of arthritis. These proteins can encourage inflammation and irritation of the tissue that surrounds your joints. Switching to a vegan diet is considered helpful for arthritis patients.
Alcohol: Excessive drinking is a major problem that can aggravate your arthritis situation. Smoking and drug abuse also leads to such problems. Drinking excessively can lead to the development of gout.
Corn oil: This kind of oil is a part of most packaged, processed and fried food. It also leads to inflammation. Arthritis patients should switch to omega fatty three oils which can be found in fish.
Taking care of your body is a matter of maintaining a good diet with lots of activity that will be congenial for your condition. This will also help in keeping the painful symptoms of arthritis away.

Arthritis - 6 Foods You Must Avoid!

Being fit is a matter of striking the right balance between one s diet as well as exercise. There are many kinds of problems that we all face when we do not strike a balance between the two. A flat stomach is a sought after feature in one s figure. One usually ends up losing a flat stomach when you have weight gain due to pregnancy and the onset of age. 

When one wants to get back a flat stomach, there are many measures that one can take because this is a very difficult thing to get back once you have put on weight because you will usually lose weight from the abdomen at the very end. Yet, one does not need to spend many hours in the gym for a flat stomach. You can also do exercises at home in order to get a flat stomach. Read on to know the secret!

Squats: One can do squats every morning as a part of a warm up before getting into the exercises. Ensure that you hold it for a while before you release and straighten up. You can also do squats while you are standing at the kitchen counter so that you get plenty of exercise with just a few moments of hard work through various times during the day.
Sit Ups: Sit ups are also a good form of exercise that one can do at home. Along with lunges and squats, you can also do sit ups so that you get a more toned torso with good exercise for your muscles in that area.
Pike and Stretch: This is another very well known exercise that can easily be done at home. The pike and stretch requires you to lie on a mat, facing upwards. Then, you will have to crunch up and try and touch your toes. The next step is to bring your arms behind your head and keep them straight while you crush up one leg at a time. This should be done at least ten times so that your abs and hips are well worked out.
The Standing Side Crunch: This crunch can be done with a chair. You need to stand on your left leg and then extend the left arm so that the right foot gets lifted off of the ground level by a few inches. Then, place the right hand behind your head with the elbow bent. After this, you will need to lift the left knee towards the right shoulder. Repeat this at least 15 times for it to show any results on your abs and abdomen area.
The Plank: This is a very well known move that many people take to. You will have to lie down on a mat and elevate yourself on your elbows. This position will have to be held for as long as possible for maximum effect on the abs, torso, hips and the thighs and legs as well. This exercise is recommended for a flat stomach, more than any other.

Want a Flat Stomach - 5 Must Do Exercises!

Allergic rhinitis is also known as hay fever. This is a seasonal cold allergy condition that comes with many symptoms like reddening and watering of eyes, blocked and runny nose, flu, headaches and many others. The causes of hay fever include exposure to dust, nettle, pollen, pet hair and even pollution. While most doctors prescribe anti allergies to deal with this problem, it can also be cured and treated with the help of alternative treatments. Let us find out about five such treatments.

1. Chinese medicine: traditional chinese medicine is also known as tcm, and it usually works by incorporating eight essential herbs along with massages, acupuncture and dietary tweaks in order to create a basis for treatment. These methods aim at creating a more congenial environment within the body of the patient so that the patient is more equipped to deal with the problem causing allergens that come in from the environment outside.

2. Acupuncture and acupressure: this is also a chinese form of treatment that aims at redistributing the qi or chi, which is the life giving energy within us. With the help of this needle based treatment, the various points in the body are activated so that the chi quotient is more favourable and fights these allergens and symptoms with greater gusto.

3. Ayurveda: this is an ancient life science that originated india. With the use of herbs, condiments and spices in one's everyday life, ayurveda brings in other methods of treatment including yogic postures and poses, dietary changes, massages and more in order to treat conditions such as allergic rhinitis. The problem of hay fever or allergic rhinitis may be cured with the use of seven herbs including piper nigrum, terminalia bellerica, piper longum, and others which can help in soothing the symptoms and creating resistance towards the allergens in the long run. Along with this, jal neti can also be practised so as to clear the nasal tracts and airways. One should also avoid food that is cold and can give rise to an aggravation of the dosha in question.

4. Ointment: the use of herbal allergy absorbing creams and ointments can also help in averting the onset of conditions like allergic rhinitis. These ointments or creams may contain long chain hydrocarbons which can get absorbed into the nasal mucosa. It can be applied three times in a day.

5. Capsaicin: extracted from red peppers, this wonder ingredient can help in desensitising the nerve fibres in thenasal tract which create hyperresponsiveness of the nose. In this way, this ingredient can curb the allergic reaction.

6. Gavyamrut grut: gavyamrut grut is made by mixing pure cow ghee with certain herbs. It should be used as nasal drops and is a very effective and time tested remedy for allergic rhinitis.

As a part of the treatment, one must also take care to avoid allergens that cause the allergic rhinitis.

5 Alternative Treatments for Allergic Rhinitis

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