Avascular Necrosis, also termed as Ischemic Bone Necrosis or Osteonecrosis is a medical condition characterized by the bone death on being deprived of blood. The condition is known to occur in the shoulder, ankles, and knees. However, the part of the body most affected by Avascular Necrosis is the hip. In this article, we will describe the conditions that contribute towards Avascular Necrosis of the hip along with the associated symptoms.

Factors that lead to Avascular Necrosis of the hip
The supply of blood to the bones may be interrupted by a myriad of factors some of which include

1. Certain medical conditions and health disorders such as

Gaucher's disease: A genetic disorder resulting from glucocerebrosidase enzyme deficiency. As a result, glucocerebroside gets deposited in the cells of the macrophage-monocyte system.
Sickle cell anemia: A genetic disorder which results in the RBC's appearing like a sickle cell instead of being round shaped.
Both of these conditions bring about a significant reduction in the supply of blood to the bones resulting in Avascular Necrosis.

Certain inflammatory conditions that may damage the arteries and trigger Avascular Necrosis of the hip include autoimmune diseases, pancreatitis or HIV infection.

2. Extensive and prolonged use of corticosteroids: Often used as non-inflammatory drugs, corticosteroids can play a contributing role, resulting in Avascular Necrosis (non-traumatic). The fatty substances are usually broken down by the body. However, the use of corticosteroids may affect this breakdown as a result of which the fatty substances start piling up in the blood vessels, constricting their size. The constricted blood vessels, in turn, reduces the supply of blood to the bones to a great extent.

3. An injury or a fracture affecting the femur: A hip fracture or a dislocation that affects the upper half of the thigh bone or the femur acts as a potential threat, triggering a traumatic Avascular Necrosis (AVN) of the hip.

In some case, radiation therapy or chemotherapy for cancer can go a long way in interfering with the ability of the bone (weakens the bone) to receive blood, causing bone death.

People who are into heavy drinking stand a greater risk of suffering from AVN. An increased consumption of alcohol causing constriction and narrowing of the blood vessels interfering with the flow of blood to the bones.

Symptoms characteristic of AVN of the hip

Unfortunately, the initial stages of AVN are asymptomatic. However, as the condition progresses into later stages, a person may experience pain and discomfort, particularly while exerting pressure on the bone affected by the condition.
As the bone and the adjacent joints deteriorate and collapse further, a person may experience great difficulty in using the joint altogether.
In some cases, the condition may progress and affect both the hips (Avascular Necrosis Bilateral).

Causes and Symptoms of Avascular Necrosis of the Hip

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!

Lower back pain can be one of the most physically debilitating things that can affect you and limit your mobility. Even if the pain isn t that acute, it could still signal something deteriorating in your lower back. While oral medications, topical creams or sprays can help in reducing pain, there are other effective remedies you can try on your own. These will be handy when you have no medications at hand. One of these is the hot and cold therapy.

Heat therapy for lower back pain

Heat works well with lower back pain as it can dilate blood vessels and improve circulation within the tissue. This will help in circulation and also result in lowering the pain. Heat therapy will also loosen up other muscles in the area and help soothe sore areas which have been taking the burden along with the lower back muscles. Some of the techniques that can be applied are:

1. All day heat wraps: These are specially manufactured belts or wraps which wrap around your abdomen and keep tightness and pressure on your lower back as well as supplying heat.

2. Electric heating pads: These are mechanized heating pads which generate heat with electricity. You can place them under you back and then either sit or sleep with it positioned behind you. However, ensure that you don t keep these for too long as they could burn your skin.

3. Hot Compress with towels or hot water bags: Use a clean towel and heat it over a conductive surface and apply it on your lower back. You can also use hot water bags for the same purpose.

Cold therapy for lower back pain

Cold therapy uses the principle of constriction of blood vessels as well as slowing circulation. This will help numb the area and thus help relieve the pain. Some of the ways these can be administered are mentioned below.

1. Ice towel: In this method, soak a towel in ice cold water, wring it to dry it and then apply on your lower back. This will numb the pain without transferring the sting of the cold or damaging your skin.

2. Ice packs: Put about half a kg of ice in a plastic Ziploc bag and pour water over the ice to just about cover it. Push out the air out of the bag and then lock it. Use this ice pack with a towel to ensure that you back doesn't get wet.

3. Ice gel packs: These are ready made packs, which can be bought from medical stores and kept frozen to be used whenever you need it in order to relieve lower back pain.

Treating Lower Back Pain Using Hot and Cold Therapy

The Anterior cruciate ligament (ACL) is an important ligament that gives stability to the knees. An injury to this ligament can result in a host of complications and discomfort. Children or adults who are into sports such as gymnastics, volleyball, tennis, basketball, soccer, football, often injure this ligament. As per various studies and surveys, ACL injury is more likely to affect female athletes as compared to their male counterparts.

Depending on the severity and extent of the damage, an Anterior Cruciate Ligament Injury may be ranked on a grade of 3.

Grade 1 sprains indicate a mild injury or stretching of the ligament, seldom affecting the stability of the knees.
Grade 2 sprains are indicative of a partial ligament tear (the ligament loosen up). The damage is still under control.
Grade 3 sprains are extensive and severe, indicating a complete ligament tear (the ligament often breaks in two pieces). With a complete ligament tear, the stability of the knee is also affected (the knee becomes highly unstable).
What causes Anterior Cruciate Ligament (ACL) Injury?
While a host of sports activities mentioned above increases the risk of the injury, a person may also suffer a partial or a complete anterior cruciate ligament tear under the following situations.

A jump down a ladder, a tree, or a wall. An incorrect jump or a landing may be equally responsible for the ligament tear.
A collision or a hit, especially on the knee (while playing football).
Slowing down suddenly while still in running motion. A person suddenly stopping or missing a step can also injure the ligament.
Symptoms associated with ACL injury

An excruciating pain (especially in the back and outside of the knee) is often seen in people with a complete ligament tear (the movement is yet not affected). However, within a few hours, there may a swelling around the knee, indicating the severity of the injury with internal bleeding within the knee joints.
There may be restricted knee movement. The knee also feels unstable, further limiting the movement.
Sometimes a pop in the knee can be heard just at the time of the ACL injury.
Prolonged ACL injury left unattended can result in a painful complication such as knee osteoarthritis.
Diagnosis
To diagnose the extent of the damage, the doctor may suggest

Physical examination, including a quick brief about the case history.
Imaging tests such as X-rays and MRI can go a long way to analyze the ligament injury.
In the case of extensive swelling of the knees, the doctor may carry out an arthroscopy to have a closer look inside of the knee.
An accurate and timely diagnosis is important to avoid the aggravation of the injury. In the case of swelling and knee pain, consult a doctor, and get yourself thoroughly examined.

Anterior Cruciate Ligament Injury- Causes, Symptoms, and Diagnosis

Indigestion spares nobody. No matter how healthy you are, at some point or the other, everyone suffers from acidity, bloating and gas. On its own these problems are rarely serious but they can leave you feeling quite uncomfortable and can be embarrassing as well.

Homeopathy can be very effective when fighting against indigestion of any kind. This form of treatment has negligible side effects and hence can be given to both children and adults. Homeopathy does not address only the symptoms but goes to the root of the problem. Thus it also stops the problem from recurring. Here are few common homeopathic medicines that can help ease indigestion.

1. Nux vomica
Nux vomica is known as the remedy for overindulgence. This homeopathic medicine can be used to treat stomach problems of all kinds. It is very effective against bloating and gas and is also often used to treat constipation. Nux vomica is also known as the best homeopathic remedy for heartburn associated with excessive alcohol or caffeine.

2. Pulsatilla
This is often used to treat gastric problems that follow eating heavy food like pastries, ice cream and food fried in ghee or butter. It can also be used to treat loose motions.

3. China
China is an effective form of treatment against bloating and build up of gas. Abdominal pain caused by gas can also be treated with china. This homeopathic remedy can also be used to treat diarrhea that is accompanied by extreme weakness.

4. Arsenic album
Gastric troubles that are triggered by food poisoning can be effectively treated with arsenic album. Some of the symptoms it treats are nausea, loose motions, abdominal pain and vomiting. Acidity and a burning sensation in the stomach can also be eased with this medicine. Arsenic album is also used in cases of chronic vomiting where the stomach does not retain any food.

5. Lycopodium
Sometimes even eating a light meal can leave you feeling bloated and with a heavy feeling in your abdomen. This bloating and excessive gaseousness accompanied by burning burps can be treated with lycopodium. It also treats acidity triggered by starchy and flatulent food.
Along with taking homeopathic medicine, making a few changes to your eating habits can also help treat chronic gastric problems. Chew your food and eat slowly. Avoid eating anything that is too hot or too cold and drink plenty of water. Ideally you should hydrate your stomach half n hour before eating a meal.

Remedies for Stomach Acid, Bloating and Gas

The appendix is a small, finger-shaped pouch attached to the large intestine in the right belly area. It is a vestigial organ as it has no specific role to play in humans, but the organ is still seen, though in a very small size compared to the earlier living beings in the evolutionary chain. Acutely inflamed appendix is the most common cause leading to it removal, often seen in the ages of 10 to 19.

Causes: the appendix gets infected by two main reasons - general infection in the abdomen that reaches the appendix or blockage of the appendix leading to inflammation and swelling within it. The appendix is a blind pouch, and there is a good chance for its blockage from food particles, lymphatic tissue, or even sometimes feces. Some of the potential risk factors for appendicitis include a diet low in fiber, high in sugar, gut flora, and family history.

Symptoms/diagnosis: in adults, the appendicitis has very characteristic symptoms including acute pain in the right upper part of the belly associated with fever and vomiting. However, in children, the pain may not be as tell-tale a sign but is still quite diagnostic of appendicitis. However, presence of the following symptoms together is surely indicative of appendicitis.
1. Right abdominal pain, especially rebound tenderness, where pressure placed in the right upper part of the belly and released leads to excruciating pain.
2. Fever, nausea, and vomiting
3. Abdominal fullness or bloating
4. Elevated white blood count (as with most infections)
Additionally, the younger the child, the symptoms are not very clear, but ultrasound will confirm the diagnosis. The inflamed, enlarged appendix will be visible on the images and could be surrounded by free fluid. Ct scan also can be considered if required to confirm the diagnosis.

Treatment: as noted above, children present with symptoms that do not pinpoint to appendicitis. Treatment usually takes two routes:

If diagnosed as appendicitis before rupture, then surgical removal is the best method to contain its symptoms. Other symptoms like fever and nausea and vomiting usually subside a couple of days after the surgery.
If the appendicitis goes unnoticed and ruptures, then the intestinal cavity can get infected, which is called peritonitis. Earlier, the preferred approach was to control the infection and then go for removal. However, lately, removing the appendix followed by antibiotics to control the infection is the preferred approach.
The prognosis and recovery from appendicitis is very good. Deaths have occurred only in very small infants, where they are not able to pinpoint the area and therefore it can go undiagnosed, leading to rupture and subsequent death.

Early identification is the key to proper identification, immediate treatment, and complete recovery from appendicitis.

Appendicitis in Children

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