Dr Panchamiyas Hi Tech Orthopaedic And Surgical Hospital

Heat treatment or thermotherapy is an effective process of healing from a sports injury. Understanding the when and how to use heat treatment is essential since it can even prolong the process of healing.

The Process Of Healing-

There are three stages of healing. The first phase is called the inflammatory phase. The goal for this phase is to ensure that no further damage happens to the affected area. It is during this phase that the swelling and the buildup of fluid happens. Heat treatment is not applicable here since it increases the blood circulation and can lengthen the healing process. The second phase is called proliferation. This is the phase where the introduction of scarring and new tissue takes place. This is the post-injury phase and heat treatment greatly helps during this time. The third phase is known as remodelling. It is the time when the new tissue matures and settles down. Thermotherapy can be applied in this phase as well.

Injuries that are treatable through thermotherapy-

Heat treatments are extremely effective in injuries such as muscle spasms along with back strains. It can also be applied to joint injuries related to a thumb, turf toe, elbow, wrist sprains and sprained ankles. The reason why heat treatment is effective in joint injuries is because heating significantly heats the bone and improves the range of motion. The idea behind any heat treatment is to make the tissue more extensible by warming it up. Exercises related to a range of motion should be performed for 15-20 minutes post the heat treatment.

How heat treatment helps in treating sports injuries?

1. Heat treatment significantly increases the blood circulation and help to eradicate dead skin and other toxic bodies from the origin of the injury.

2. It assists in metabolism of the cells.

3. It increases the capillary permeability.

4. It increases the number of nutrients and oxygen to the source of injury and speeds up the process of healing.

5. Heat treatments can cut down muscle spasms.

Types of Heat Treatments Available:

For heating deep tissues, ultrasound is the best form of treatment. It can penetrate up to 1.5 inches inside the skin. Basic strain injuries such as hamstring and rotator cuff are instantly treatable with ultrasound. This being said it is one of the most expensive methods of heat treatment. Then there is superficial heat therapy. This is convenient and readily available. They directly transfer heat from the source to the injury location. Common examples of these are a hot tub, paraffin bath and hot bags. The third type of heating mechanism is known as dry hot packs. They produce a steady source of heat and are run by either microwave or electricity. Caution should be taken in order to ensure that the heat does not burn the upper layer of the skin.

During the natural course of events, a women's body starts its reproductive phase with menarche and at about 50 years of age, attains menopause. This is when the reproductive function ceases and the ovaries stop producing the hormone estrogen and progesterone. In some cases, for various reasons including medical, the ovaries stop functioning earlier, and this is medically termed early or premature menopause. Menopause that occurs before 40 years of age is termed premature menopause; it is due to primary ovarian insufficiency and occurs in 1% of the women.  If it occurs between 45 to 50 years, it is termed early menopause.
Causes: Normal ageing, family history, genetic disorders, autoimmune disorders, toxins, and surgery are some reasons that could lead to premature menopause.
Effects: Estrogen and progesterone have a lot of beneficial effects on a women's body. Reduction in their levels leads to some of the below changes:
- Emotional changes like mood swings, irritability, and in some cases depression, especially in premature menopause.
- Irregular cycles before complete cessation of the menstrual cycles.
- General mucosal dryness leading to vaginal dryness, dry skin, dry eyes.
- There also would be urinary incontinence and reduced sex drive due to reduced hormone levels.
- For women who still would want to have children, infertility would be a big cause for concern. This could lead to other emotional issues, worsening the depression.
- Osteoporosis - Bones lose their density and get weak and are more prone to fracture.
- Cardiovascular health - Post menopause, women are more prone to heart attacks and stroke. Though not fully proven, this is believed to be true as the good role that estrogen plays on blood vessels is negated with menopause.
- Accelerated ageing - Menopause leads to accelerated damage of genetic structures, thereby leading to faster ageing. This also leaves a feeling in the women of being less attractive and less desirable.
There is also a good news, that after menopause women are at lesser risk of cancer - especially breast and ovarian. 
It is not easy for women to handle premature menopause. The body undergoes some changes much earlier than expected, and it requires a lot of support and caring and comforting to come to terms with it - especially if associated with infertility or chemotherapy for cancer. Emotional issues of not being able to have children and feeling less attractive require frank talks to boost the person's confidence and increase self-worthiness.
It is easier said than done, but one of the key ways to handle premature menopause is an open discussion.

Have you undergone cartilage damage recently and are seeking ideal treatment measures? Cartilage damage is a common form of injury that involves your knees. Other joints such as the ankles, elbows and hips may also be affected by cartilage damage. Cartilage, the tough and flexible tissues covering the surface of your joints, acts as a shock absorber, allowing the bones to slide over each other. Cartilage damage may occur because of injuries such as a gradual wear, sports injuries and osteoarthritis. While acute cartilage damage may heal on its own, severe damage may need treatment via surgical measures.

Treatment

Physiotherapy

• Physiotherapy is effective when you experience difficulty in moving your affected joint.
• It is also an important part of recovery if you have to undergo surgical procedures for treating cartilage damage.
• A physiotherapist will teach you certain exercises that are effective for strengthening the muscles that surround and support your affected joint.
• This helps in reducing pain and pressure on the joint.

Surgery

• Severe and serious cartilage damage does not heal effectively on its own, and a surgery may be required for treatment.
• Usually, surgery is performed by using Arthroscopy. This is a form of keyhole surgery in which certain instruments are inserted into your affected joint via incisions or small cuts.
• In some cases, larger incisions have to be made.
• Such surgeries are carried out after giving general anesthesia to the patient.

The most common surgeries that are undertaken in cases of cartilage damage include the following:

Lavage and debridement

• In this form of surgery, your joint is cleaned for the removal of any loose tissues.
• The damaged edges are trimmed to be made smooth. Sometimes, the damage may also be repaired during the same time.

Marrow stimulation

• In this procedure, tiny holes are made on the bone beneath your damaged cartilage that releases the bone marrow in it.
• The marrow cells stimulate the production of new cartilage.

Mosaicplasty

• In this procedure, small plugs of healthy cartilage from areas of a joint that are non-weight bearing are removed and used for replacing areas of the affected cartilage.

Osteotomy

• This procedure involves the alteration of the alignment of your leg for reducing pressure on the damaged area.
• It is effective in improving pain.
• A wedge of bone may be removed or added from your thigh bone or shin bone.
• The bone gets fixed with a plate till it gets healed.

In some cases, a joint replacement surgery has to be carried out. In this procedure, the entire affected joint is removed and replaced with an artificial joint. Hip replacement and knee replacement are common examples of this kind of surgery.

The sunscreen acts as a layer of defense against sun radiation and keeps it from causing any damage. It is tremendously important to stress upon the importance of using sunscreen. Using a sunscreen every time you step outdoors and using it correctly is of vital importance to have healthy skin. No sunscreen provides absolute protection from the harmful rays of the sun, but using the right product in the right way will take you far in shielding yourself from their harshness.

Two important facts about sunscreen are:

1. You don't need to apply sunscreen if your makeup contains SPF - If any of your makeup products like foundation or powder contains SPF, do not assume that it can replace your sunscreen. Makeup containing SPF cannot protect your skin entirely as cosmetics are generally applied lightly and mostly doesn't cover places like T-zones, earlobes or hairline. To fully shield your skin from the sunrays, it's necessary to apply sunscreen or moisturizer with at least SPF 30 before putting makeup on. It is advisable to apply the sunscreen half an hour before stepping out for maximum benefit.
2. You do not need to apply sunscreen in winters or when you are indoors - Winter skin is relatively more sensitive than summer skin which is tanned. If one is in hilly areas or snow covered regions there is reflection of UV light from the snow that causes more skin damage. Also glass can allow UV rays to pass through and indoor lighting can also be a source of UV exposure, therefore you should apply sunscreen even when you are indoors.

Following are the do's and don'ts you need to follow before you apply sunscreen:

1. Do: Choose a sunscreen that is, at least, SPF 30+: That is the minimum protection that your skin requires. And if you must stay outdoors for an extended period of time, opt for a product with a higher SPF rating.
2. Do: Apply sunscreen 15-30 minutes before going outdoors: For the product to be most effective, it needs to be fully absorbed by the skin before exposure to the sun; the reason why applying approximately 30 minutes before you step out of home is a must.
3. Don't: Apply sunscreen only on the face: Make sure you apply it to every part of your body, especially the hands, forearms, thighs and ears, which are commonly exposed to the sun. Not only are these more prone to skin ageing, but the risk of melanoma (skin cancer) is also tremendously high in these portions of the body.

Sinusitis or sinus infections can be quite a debilitating ailment when it becomes recurrent. Sinuses are cavities within our head just behind the nose which extends up to our forehead and to certain areas of the cheeks. These cavities are filled with a mucosal lining which helps you breathe and also filters the air which goes to the lungs. When the mucosal lining gets inflamed, it blocks the normal drainage of the mucus into the nose. This results in headaches, nasal polyps and general discomfort. Homeopathy offers some great remedies for this condition, without side effects. Some of these are discussed below.

Homeopathic remedies for sinus problems

1. Belladonna: This medication is very effective when the sinusitis has resulted in a suppressed discharge from the nose which occurs intermittently. If you have a splitting headache which feels unbearable, Belladonna can help relieve the symptoms quickly. If the infection of the sinus has spread to the throat and results in cough, Belladonna can be equally effective in those circumstances as well.
2. Pulsatilla: If you are experiencing a greenish mucosal discharge from your nose without a painful burning sensation within it, Pulsatilla can be a very effective cure. Another indication where this medication is very effective is when you have headaches centered just above your eyes rather than over the forehead or other parts of your face.
3. Kali Bichrome: This is another commonly prescribed medication to deal with the symptoms of sinusitis as well as to reduce inflammation and cure sinusitis altogether. If you have a lot of mucosal discharge that drops into your throat along with discharges through the nose, Kali Bichrome is the drug to go to. Other indications where it is effective are pain and heaviness in the nose and the inability to breathe with headaches in and around the eyes.
4. Silicea: If you are feeling cold and constantly chilly along with nasal stuffiness, Silicea is the medication to go to. Along with discharges, your nose may form hard mucous crusts within it. Trying to manually remove these crusts may also cause bleeding. Silicea will reduce these symptoms and is also effective in reducing a headache which occurs mostly on the left side of your face.
5. Merc Sol: If you are experiencing a yellowish green discharge from the nose along with a burning sensation and increased saliva secretion in your mouth, Merc Sol is the remedy to turn to. It is also effective wherein the headache has spread all around the head.

Pregnancy brings with it a new set of additional responsibilities. The mother has to be extra vigilant about monitoring and caring for her health. This ensures that sufficient nutrition is being provided to the growing infant, at the same time, ensuring no harm comes through you. Listed below are some simple ways to do the same.

1. Prenatal care: As soon as you realize that you are pregnant, it is advisable to talk to a doctor or a midwife about proper prenatal care. This could include anything and everything from prenatal vitamins to food habits to exercise to sleeping habits to periodic scanning – the whole hog.
2. Diet: You need to ensure two things: that you are eating enough for two people, and also that everything is healthy and not harmful for the little one that gets all its nutrition through you. The diet should be healthy, nutritious, wholesome, and of course free of junk. Some pointers to a healthy diet include:
   • Include a good amount of fruits and vegetables every day; break it into five small portions.
   • Sufficient amount of carbohydrates should be the basis of each meal.
   • Whole grains are preferred to white grains, which also give good amount of fiber.
   • A good amount of proteins including fish, eggs, meat, nuts, pulses, milk, and other dairy products.
   • Ensure adequate amount of iron, calcium, and other minerals are included in the diet.
   • Avoid eating non-pasteurized dairy products, uncooked or undercooked food, and smoked seafood.
   • Folic acid is compulsory for the first trimester as it helps to protect your unborn baby from developing neural tube defects such as spina bifida. Also, it helps to prevent other birth defects, such as a cleft palate . 
3. Weight gain: If your weight was normal for your age and height before pregnancy, expect to add about 12 to 15 kg during your pregnancy. Consult with your doctor on weight changes and nutritional aspects to monitor weight throughout pregnancy. This could change based on if it is twins, your weight before pregnancy, and body type.
4. Exercise: There are specific exercises designed to benefit the pregnant women. Whether it is walking or swimming aimed at improving overall health or Kegel exercises aimed at improving vaginal and perineal muscles, your doctor should be able to draw up a routine. Exercising while pregnancy is being increasingly encouraged for the following reasons:
   • Improved energy levels
   • Controls back pain
   • Improved sleep pattern
   • Improves constipation
   • Improves muscles strength and endurance
5. Lifestyle changes: With pregnancy setting in, it is time to bid goodbye to smoking and drinking alcohol. Continued smoking after onset of pregnancy has many serious complications, including growth retardation, low birth weight. Alcohol can lead to miscarriage, stillbirth, and premature delivery.

These are simple ways to monitor and care for your and of course, the baby’s health throughout pregnancy.

Foot problems are common among all people. Some foot problems are minor while some are severe and require immediate medical attention or surgery for treatment.

Here are some common foot problems, which require surgery:

1. Bunions: These are bony lumps, which develop on the side of a foot and also at the base of the big toe. Bunions occur due to a condition called hallux valgus. This causes the big toe joint to bend in the direction of the other toes, resulting in deformity. This condition requires surgical correction. The surgery required is known as osteotomy, and it involves the straightening of the big toe and metatarsals.
2. Hammertoes: Hallux valgus may result in your other toes being clawed or bent permanently. This condition is called hammer toes.

The damage can be eased by:

1. Arthroplasty: It involves the removal of a deformed joint between the toe bones, resulting in joint flexibility.
2. Arthrodesis: This process fuses the phalange and makes the toe stable.
3. Metatarsal surgery: In some cases, the forefoot joints may get damaged due to the inflammation of the joint lining or synovitis, which results in arthritis. These joints are called metatarsophalangeal joints and they can get dislocated due to arthritis damage. Pain and discomfort are felt. Surgery is required when the symptoms are very severe and other treatments fail. The nature of surgery depends on the severity. The most common surgery is done on the big toe to remove the heads of the metatarsophalangeal joints.
4. Ankle arthritis: This condition occurs because of osteoarthritis. The cartilages, which cover the ends of the bones roughen and get thin, which further thicken the bone underneath. It also results because of other rheumatic conditions. Pain and swelling is caused with an occasional joint deformity. Surgery may be required when the symptoms are very severe. The three major surgical options for treating ankle arthritis are ankle fusion, triple fusion and ankle replacement.
5. Achilles tendon disorders: The Achilles tendon accounts for being the largest body tendon and great force is put through it when moving the lower leg muscles. This wears down with old age and causes swellings within the tendon accompanied by pain. Sometimes, surgery is required for fixing this condition.
6. Morton's neuroma: This is a painful condition in which a nerve that gives sensation or feelings to the nearby toes is affected. The nerves are affected in the third and fourth toes. In case the symptoms are severe, a surgery is required.

Foot problems are prevalent in many people and they may occur due to various conditions or reasons. In case of severe symptoms, some foot problems require surgery for treatment. The most appropriate surgical method should be undertaken.

Heel pain is a common problem in the body where the affected person experiences pain radiating from the heel bone. Heel pain usually progresses slowly over time, it is recommended to consult a medical professional, if heel pain turns severe. The pain tends to be most severe after one has been inactive for some time such as after waking up in the morning. 

Causes 

Heel pain is usually caused when tissues present in the bottom of the heel (Plantar fascia) is inflammed. These tissues connect the heel bone with the bones of the feet and acts as a shock absorber. Tears form in these tissues when they are damaged or when they get thicker. These tissues are at an increased risk of wear and tear for those who are over 45 years old. The risks also tend to increase if the person is obese or whose occupation requires standing for lengthy periods of time. 

Among other causes of heel pain are heel bone fractures, fat pad atrophy (a condition where a layer of fat present under the heel bone is reduced) and bursitis (inflammation of the fluid filled sacs present around the joints). Peripheral neuropathy is a condition where damage occurs in the peripheral nerves (that transmits signals between the central nervous system and the rest of the body), this can cause pain in the heel. 

Symptoms 

The symptoms of heel pain include: 

1. Experiencing pain while jogging or walking 
2. A feeling of pins pricking the heels after waking up in the morning 
3. Inability to put weight on the heel 
4. Painful swelling 
5. Pain in the heel accompanied by fever 

Heel pain can be prevented by taking certain preventive measures such as restricting usage of high heeled shoes without proper support and stretching the heel regularly. Medications such as painkillers are used to treat symptoms of heel pain. Consult a doctor for accurate medicines !!

Menopause is a natural change in a female body that occurs after or around the age of 45, when the ability to bear children stops permanently. The fertility diminishes and the menstrual cycle stops. A decrease in hormone production, especially in the levels of estrogen, happens after the onset of menopausal years.

During this time, there are a number of physical changes that take place inside the woman’s body. The noticeable changes happen in the female breasts.

Some visible changes to breasts during menopause

1. Non-cyclical breast pain is mostly not related to menstrual cycle and slowly stops with time.

2. Loss of glandular tissues is common and causes shrinkage in size.

3. With age, the connective tissues also lose elasticity and causes sagging

4. Breast pain could also be due to fibrocystic breast changes

5. There could be a chance of developing breast cancer

6. Density of the glands decreases inside the breasts and fat develops.

It is advisable to get any kind of discomfort examined by the doctor to make sure you are in the safe zone. Hormone replacement therapy (HRT) is not generally advised as it may create hormonal issues in the long run.

It is also important to follow a healthy diet comprising of protein, calcium , magnesium and other vital nutrients as advised by your doctor. Reduction in smoking and alcohol intake is highly beneficial and cuts down risk of major diseases. It is also necessary to exercise, remain physically active and maintain a healthy body weight during this time.

Regular check-ups, mammograms and self-examination of breasts help to diagnose and detect early signs of breast tumours and cancer and are highly recommended, especially for women who are in the perimenopausal and menopausal years. If you wish to discuss about any specific problem, you can consult a Gynaecologist.

A Gastroenterologist is a physician with dedicated training and unique experience in the management of diseases of the gastrointestinal tract and liver. If you are planning to visit one, you most likely have a problem in one or many organs like esophagus, stomach, small intestine, colon and rectum, pancreas, gallbladder, bile ducts and liver. 

Visit your doctor to understand the severity of your condition and the course of treatment, as it is obvious that during this time you must be suffering from anxiety and you may not ask the questions arising in your mind. That is why you need to prepare in advance for your first visit with a gastroenterologist.

Being an active partner in the doctor patient relationship is bound to have its benefits. Here are some handy tips:

1. Come mentally prepared: Don't let the anxiety get to you. If you need some extra help calming down, try yoga or meditation. You can simply go out on a walk alone to help you focus your thoughts. This is just like any other doctor visit. The good part is that you are taking the first step in easing your discomfort and starting treatment, so go with a positive mind.
2. Maintain a diary of symptoms: It is likely that you are experiencing discomfort from past few days or weeks before you finally realize the need to seek out a specialist. Try to remember as much as possible about the symptoms you experienced in a chronological order. Write down any over the counter medicines you've tried or anything unusual that you may have consumed in the past week. 
3. Take stock of your medical history: It is likely that your doctor may want to know about any historic conditions you've suffered that may or may not relate to your present condition. Many ask you to fill out forms during your first time patient registration which includes many minor details about your medical past. List down any allergies, especially food allergies you have. 
4. Take stock of your recent medical tests: Bring your latest blood tests and imaging tests (X-rays, ultrasounds, MRIs, and CT scans) with you for the doctor's visit. If you have a pre-existing condition like diabetes, thyroid or you suffer from other chronic conditions like increased uric acid, carry your most recent medical reports with you. 
5. Make a list of questions for the doctor: In most cases, the first visit is a crucial factor in determining whether you want to continue the course of treatment with a particular doctor. This comes out of your ability to trust the doctor, his knowledge and diagnosis and an overall comfort level that comes with how well he handles your questions. Start by making a list of questions you want to ask about your specific condition and course of treatment and see if you get satisfactory answers. 
6. Brace yourself: If you want to suggest a treatment option, make sure you read up all about it before you tell the doctor. If you wish to discuss about any specific problem, you can consult a Gastroenterologist.

The menstrual cycle is a natural part of a woman’s life. Most of the times, it has been seen that women have periods that have a standard or perfect timing. However, some women may have extremely unpredictable or irregular periods. There are numerous reasons that can cause these irregular periods. In such cases, there are some that are more serious than the others.

At the point when a woman stops getting her period, it is called amenorrhea. It is a strong sign that something is not right. Primary amenorrhea is the point at which a teenager never got her period in the first place during adolescence. Secondary amenorrhea on the other hand, is when a woman has had her period in the past, yet stops getting her monthly period for at least three months.

Irregular periods, missed periods, or exceptionally painful and serious PMS (post menstrual syndrome) symptoms are an indication that the levels of one or more hormones are either missing or are too high. Whether it is a basic health condition, constant stress levels, a bad eating routine, an excess of exercise or less body weight, frequently missed periods is not something that should be ignored, especially when you are sure that you are not pregnant.

1. In case your irregular periods are consistent, you need to be assessed for PCOS. PCOS or polycystic ovary syndrome influences up to 10 percent of the women who are in their conceiving age. Apart from causing infertility, PCOS can expand the danger of diabetes and many heart diseases.
2. You need to likewise be screened for thyroid problems and other diseases and conditions that might be connected to irregular periods. For example, an overactive or an underactive thyroid can aggravate ovulation, which may cause a lot of hormone imbalance in your body.
3. An irregular cycle can also make it more difficult to get pregnant naturally, particularly in case you are not ovulating each month. Your specialist can run tests to check whether you are ovulating. Women with sporadic periods who are attempting to have a child are at times prescribed fertility medications to improve ovulation.
4. Women with irregular menstrual cycles may have a double danger of ovarian cancer as compared to the women who have standard month-to-month period cycles.
5. Untimely ovarian failure (otherwise called untimely menopause) is the point at which a woman’s ovaries quit working before she turns 40, making her stop ovulating.
6. Irregular periods can result in a thick coating of the uterus, which can be a hazard for creating uterine cancer.
7. Irregular periods that are very heavy can result in issues like a low blood count, weakness or anemia.

Hence, if you feel your periods might not be regular and are causing you a lot of problems along with being untimely, you need to consult a gynaecologist immediately.