DIARY OF HOPE. . . . . Orthopedic and Trauma Hospital, Nagpur: 2011

Friday, September 16, 2011

Yellow Fever Vaccinaton In Countries Like Zambia and South Africa

The South African Department of Health has issued a statement that all returning travelers from South Africa to Zambia and travelers from Zambia to South Africa will now require proof of yellow fever vaccination. All in-transit passengers between the two destinations, irrespective of the time period in transit, will also require proof of yellow fever vaccination.

Over the last several months there has been a lot of back and forth regarding this new policy. Often times the translation of the new policy has confused travelers like you. So what is the new policy stating?

In addition, also as of October 1, 2011 travelers coming from Zambia into South Africa will need a Yellow Fever certificate (World Health Organization card) to enter the country.

So in other words, South Africa’s Department of Health will need to see visual proof you are vaccinated for yellow fever (unless you’re in possession of a valid waiver certificate).

All travelers coming from a yellow fever risk country who are unable to produce a valid yellow fever vaccination certificate at the port of entry will either be refused entry or quarantined until their certificate becomes valid, with a max holding time of no more than 6 days.

According to International Health Regulation, a valid yellow fever certificate is required for all passengers over the age of one. Passengers in transit from Dakar (not leaving the aircraft), do not require a certificate.

For more about Yellow Fever and the required vaccination please consult your physician 8-12 weeks before departure.

Liposuction : Parts Of The Body That Can Be Worked On

If you do decide to have liposuction, there are quite a few areas of your body where you could choose to have it done. One area where many people have liposuction is their thighs. This includes both saddlebags and inner thighs; areas where excess fat often gets stored.

A lot of people also choose their hips and their ‘love handles’ as areas to have liposuction, because weight commonly gathers in these areas. Exercise and diet aren’t always effective at shifting the fat and so if these ‘normal’ solutions haven’t worked for you, you could consider liposuction as an alternative option.

The abdomen is another place you might have liposuction, such as if you have been unable to shift excess fat on your stomach in another way.you are supposed to have a layer of fat on your body and so some will remain following surgery, but your liposuction surgeon will sit down with you to work out how much to remove and where.

If you have excess fat on your back, you might find that this is quite hard to get rid of and so liposuction could again be an option for you. Your surgeon should take you through everything you need to know about the procedure, including the issue of recovery. It’s definitely worth making sure you know about it before getting liposuction in the orthopedic hospitals.

It is also possible to have liposuction on smaller, more specific areas of your body depending on the location of your excess fatty deposits. You should always speak to a doctor before having liposuction to make sure it’s the right option for you and that you will be safe.

Thursday, September 15, 2011

Racial Disparities in Joint Replacement Care

Total joint arthroplasty is widely performed in patients of all races with severe osteoarthritis to relieve pain and improve joint function and mobility. Although several studies have suggested that racial minority patients are less likely to undergo joint replacement surgery little is known about the quality of arthroplasty care that African Americans receive as compared to Caucasians.

Using data from the Medicare Provider Analysis and Review (MedPAR) files between 2002 and 2005, which contain information regarding hospitalization for Medicare beneficiaries, Cai and colleagues profiled US hospitals' quality of care. Quality was based on the rate of complications including sepsis, hemorrhage, pulmonary embolism, deep vein thrombosis and severe wound infection, as well as the number of deaths, experienced in the 90 days after total joint replacement surgery

To test for a racial difference in access to high-, intermediate- and low-quality hospitals, the authors then looked at 91,599 elderly patient admissions for knee replacement between July and December 2005 in 2,842 hospitals.

Their analyses, which focused on Caucasian and African American patients only, showed that African American patients undergoing were less likely to be admitted to high-volume hospitals. Instead, compared to Caucasian patients, they were more likely to be admitted to hospitals that perform few which have been correlated to lower-quality knee arthoplasty surgery. The fact that African American race was a predictor for admissions to low-quality hospitals, provides direct evidence of racial disparities in access to high-quality arthroplasty care.

Wednesday, September 14, 2011

Things To Be Known During Hip Replacement

Hip replacement is major surgery and, for the first few days, you will want to take it easy. However, it is important that you start some activities immediately to offset the effects of the anesthetic, help the healing, and keep blood clots from forming in your leg veins. Your doctor and physical and occupational therapists can give you specific instructions on wound care, pain control, diet, and exercise. They should also indicate how much weight you can put on your affected leg.

Pain management is important in your early recovery. Although pain after surgery is quite variable and not entirely predictable, it does need to be controlled with medication. Initially, you may get pain medication through an IV (intravenous) tube that you can control to get the amount of medication you need. It is easier to prevent pain than to control it and you do not have to worry about becoming addicted to the medication; after a day or two, injections or pills will replace the IV tube.

Besides the pain medication, you will also need antibiotics and blood-thinners to help prevent blood clots from forming in the veins of your thigh and calf.

You may lose your appetite and feel nauseous or constipated for a couple of days. These are ordinary reactions. You may have a urinary catheter inserted during surgery and be given stool softeners or laxatives to ease the constipation caused by the pain medication after surgery. You will be taught to do breathing exercises to keep your chest and lungs clear.

A physical therapist will visit you, usually on the day after your surgery, and teach you how to use your new joint. It is important that you get up and about as soon as possible after hip replacement surgery. Even in bed, you can pedal your feet and pump your ankles regularly to keep blood flowing in your legs. You may have to wear elastic stockings and/or a pneumatic sleeve to help keep blood flowing freely.

Tuesday, September 13, 2011

Joint Replacement Program Gives Good Care, Better Outcomes

Joint pain, primarily from arthritis, affects thousands of adults across the country. According to the American Academy of Orthopaedic Surgeons, 454,652 total knee replacements were performed in 2004, and in the same year, add to that number 232,857 total hip replacements, 41,934 total shoulder replacements, and 12,055 other joint replacements.

Started in 2005, the Total Joint Replacement Program is an all-inclusive program for patients having total hip, total knee, or total shoulder replacement. Once a patient enters the program, he or she receives step-by-step guidance throughout the procedure—from preadmission, to the admission office and stay, and after outpatient discharge and therapy.

The program is offered at Johnson City Medical Center, Indian Path Medical Center in Kingsport, and Johnston Memorial Hospital in Abingdon, Virginia. The only qualification for the entering is a need for total joint replacement. There is no charge for participating.

Patients learn about the program either through community education, such as hip and knee pain classes, or through their orthopedist's office, where the patient is given a guidebook and watches a video in office. He or she is then referred to the coordinator's office for a 90-minute preoperative class. The patient is also instructed on starting an exercise routine before the surgery.

Once admitted to the hospital for surgery, the process is streamlined, with standardized care protocols. Patients typically stay for three days, and then they are discharged to their outpatient home and outpatient therapy.

"The quality measures that we have in place within the program, such as timely antibiotics administration, are being met 100%," shared Spano. "In turn, we have decreased infection and decreased blood clots, huge improvements in patient care.

"I can't stress enough the comprehensiveness of this program. Our outcomes are just amazing. Before we had it, 80 percent of our patients used to go to a skilled nursing or rehab-type setting. We have flipped those numbers; now 80 to 85% of our patients go home, which also decreases infection rate."

"Patients are directly admitted to their room before the surgery, and we try to make it as much like a hotel experience as possible.

Joint Replacement Program Gives Good Care, Better Outcomes

"Patients are directly admitted to their room before the surgery, and we try to make it as much like a hotel experience as possible.

Tuesday, August 30, 2011

Generic Orthopedic Implants' Time Has Come

Orthopedic implants in the United States represent a $20 billion per year industry. Seventy-five percent of the orthopedic implant industry consists of devices that are expired or soon to be expired IP (intellectual property). Typically, when a device has expired IP, manufacturers or their competitors begin to sell it as a value proposition. The reason we allow a company to have patent protection is to reward them for their innovation for a period of time. The orthopedic industry has been successful in never allowing their implants to behave in a normal market pattern. They always have been able to charge full price without letting normal market efficiencies take effect.

The industry points out that they have to pay for R&D and regulatory approvals for their products and so higher prices are necessary to support these ever-increasing expenses. Pharma companies spend about 20 percent of revenues on R&D. Hip and knee companies spend 6 percent. Every drug that pharma companies develop goes through lengthy development processes and regulatory approvals that cost hundreds of millions of dollars. Orthopedic companies get almost all of their products approved through the 510(k) process, a regulatory pathway that takes six months and costs an order of magnitude less than drug approvals. When new drugs eventually lose patent protection and go generic, prices to the consumer decrease by 90 percent or more.

A second argument is that orthopedic companies need sales reps to service their product. This service comes with a major price tag. The average orthopedic company spends about $37 for every $100 they make on sales and marketing — by far their single biggest expense.

The surgeon plays a pivotal role in the orthopedic implant cost equation. Relationships between surgeons and sales reps make hospital price negotiations difficult. By taking the sales rep out of the operating room, implant companies would be in a more leverage able position to drive down prices.

Orthopedic surgeons face a stark choice. They can become part of the process and help hospitals decrease implant pricing, or they can chose the status quo.

Generic Orthopedic Implants' Time Has Come

Orthopedic surgeons face a stark choice. They can become part of the process and help hospitals decrease implant pricing, or they can chose the status quo.

Healthcare in Mumbai for Cardiac Problems

Mumbai people have diversified culture, multi lingual dialects, generosity in nature & are famous for their hospitality. Mumbai is not only famous as a tourist location but also as corporate destination for IT and Healthcare.

Mumbai is a major point of reference for the best healthcare for cardiac problems. The city has the finest health care centres with super speciality services and efficient medical professionals in the field of cardiac care. Both public and private healthcare providers in Mumbai are well equipped with sophisticated medical facilities.

Medical tourism in India has also specifically upgraded its terms with more number of people across the cities in India and abroad visiting Mumbai for excellent cardiac care. Moreover patients from abroad choose Mumbai, India for recovering their aliments to heart as MCI provides customized packages of medical tourism for healthcare patients.

Cardiac healthcare is a major issue that involves Open Heart Surgery, Cardiac Surgery, Paediatric Intervention, Cardiology Angioplasties, Cardiology Robotic Surgery, Angiographies and Paediatric Cardiac Surgery. Cardiac Healthcare in Mumbai is sophisticated with major super speciality hospitals providing quality cardiac diagnosis.

Many famous cardiac care hospitals in Mumbai like Wockhardt Hospital, Lilavati Hospital & Research Centre (LHRC), Tata Memorial Hospital (TMH), Dr L H Hiranandani Hospital, Bombay Hospital and Krishna Cardiac Centre are worldwide recognised for providing quality healthcare in Cardiology.
It has an integrated system that involves local physicians who provide clinical consultations, ECG services, and heart monitoring system with sophisticated equipments.

Tuesday, August 23, 2011

Yellow Fever Vaccination - The Major Problem

Men, women and children fell ill to fever, nausea, pain and bleeding. Death was ubiquitous; each fatality marked by a ringing church bell. The knells soon became deafening.

It was 1793 and yellow fever had arrived in Philadelphia. By the time it disappeared that autumn, an estimated 10 percent of the approximately 55,000 city inhabitants were dead.

Yellow fever, so named because it causes jaundice, is transmitted by mosquitoes and is common in tropical climates. Scientists believe the disease originated in Africa and was brought to South America through the slave trade.

It made its way north to Philadelphia’s port with boats of refugees fleeing political turmoil in the Caribbean. There was also a high concentration of mosquitoes in the summer of 1793, providing ideal conditions for the disease to spread.

Armed guards lined the roads leading out of the city, making sure fleeing residents had some place to go. If they did not, they were forced to return to their homes.

Those left behind shuttered their windows and used a variety of home remedies to ward off sickness. These included placing vinegar-soaked rags over their faces and burning sulfur and frankincense.

A yellow fever vaccination was created in the 1930s. Even today there is no cure for the disease and treatment involves reducing the symptoms.

The World Health Organization estimates there are 200,000 cases per year and 30,000 deaths. Africa and Latin America remain hotspots for infection. The last North American epidemic occurred in New Orleans in 1905.

Tuesday, August 16, 2011

Good Travel Health Only Through Yellow Fever Vaccination

A yellow vaccine works by presenting a foreign antigen to the immune system in order to evoke an immune response. You should talk to your family doctor at least two months in advance of your travel to refer you to a suitable travel clinic for proper vaccination. Ideally, you should have a yellow fever vaccine administered at least 10 days before your travel to the country of various hospitals like orthopedic hospitals

If you have any allergy to any medication. It is important to tell about the type of allergy and the related agents in medications.
If you are pregnant or planning on becoming pregnant.
If you are breast-feeding.
If you have had organ transplantation or serious illnesses like cancer or cardiac issues.
If you have a weak immune system or serious illness with a fever.

Besides being equipped with proper vaccination, as a traveler, you should equip yourself with enough of mosquito repellents to protect from the mosquito bites. Yellow fever can be deadly. It is a kind of viral sickness that needs prompt treatment. Thus, having a yellow fever vaccination is very important. If you have a planned trip on your mind, consult your primary care physician today regarding the need foryellow fever vaccine to ensure that your can enjoy your trip to the fullest.

Advanced Resurfacing Techniques In The Future Of Joint Replacement

As we enter our sixth decade of total hip replacement and our fifth decade of total knee replacement, the orthopedic community can take pride in the substantial improvements that have been made in these operations which produce validated improvements in patients’ lives. The incidence of two of the most feared complications of joint replacement infection and thromboembolic disease, has been substantially reduced. In addition, the incidence of instability in total hip replacement has decreased significantly, and the length of hospital stays has decreased remarkably for hip and knee replacement. Despite these improvements, there is a real interest by patients for “less invasive, faster recovery” surgery modifications.

If one looks at the development of urologic, bariatric and colorectal surgery, all have reduced the use of open surgical procedures in favor of less invasive — and in many cases, more accurate — scope-assisted procedures. In our own field, cruciate ligament and rotator cuff surgery are areas in which arthroscopic surgical techniques have largely eliminated open surgery. It is likely that we will see further development of arthroscopically assisted hip and knee arthroplasty.

There will be continued improvement in the treatment of pre-arthritic conditions such as osteochondritis dessicans and traumatic chondral defects. This will likely start with partial prosthetic resurfacing as a bridge to more biologic implants such as cell-seeded scaffolds. Moldable implant materials, implants which can be assembled inside the joint (like a ship in a bottle), as well as surgical concepts such as “smart” burrs and soft tissue-guided surgery will contribute to arthroscopic or very small incision surgery for knee defect reconstruction.

Emerging data from sources such as the National Institutes of Health-sponsored Osteoarthritis Initiative indicate that a large percentage of patients with symptomatic knee arthritis have changes predominantly in one tibiofemoral compartment. This suggests an opportunity to address knee arthritis with unicompartmental resurfacing techniques, both synthetic and biologic.

Just as in knee arthritis, chondral loss in hip osteoarthritis is not uniform, with certain parts of the femoral and acetabular articular surface remaining largely intact until the later stages of the disease. This opens up the possibility of partial hip replacement once the pathologic malalignment is addressed

Once malalignment is corrected, partial resurfacing of areas of chondral loss may become more successful. In fact, there are already products developed that allow partial resurfacing of the femoral head in cases of osteonecrosis with collapse or traumatic defects. These would include metal, polymeric, allograft or tissue-engineered dowel grafts, as well as engineered or prosthetic bipolar “inlay grafts” in which preparation of the acetabular recipient bed also allows access to the damaged portion of the femoral head without hip dislocation.

Wednesday, August 10, 2011

Knee and hip replacements: The Precaution To Be Taken

Before you have a major joint replacement surgery, here are five things you need to know.

1. They don't last forever

While artificial joints are more durable than they used to be, the typical patient who gets one today will need another in about 20 years, says Dr. William Maloney, chair of orthopedic surgery at Stanford University School of Medicine.

Most private insurers and Medicare cover the procedure, but even so, out-of-pocket costs can easily hit $3,000 -- much more if you go out of network.

To put off your date with the scalpel, ask your doctor about physical therapy, anti-inflammatory drug treatment, and cortisone shots, which may buy a couple more years for someone with arthritis. And switch to low-impact activities such as swimming rather than jogging, which can lengthen any joint's life span.

2. Expertise is paramount

Studies show that patients of surgeons who do lots of hip and knee replacements tend to have fewer complications. (Problems are more common than you might think: "The Journal of Bone and Joint Surgery" reports that 6% of such surgeries must be redone within five years.)

Choose a doctor who does at least 100 annually and has completed a joint-replacement fellowship, advises Dr. Matthew Kraay, director of joint reconstruction and arthritis surgery at University Hospitals Case Medical Center in Cleveland.

3. Newer doesn't always mean better

In the race to innovate, some joint makers crank out lemons. Last August, for example, a division of Johnson & Johnson (JNJ, Fortune 500) recalled two metal hip systems that had already been implanted in about 93,000 patients, some of whom required a do-over.

"The recalls tend to be for new technologies," says Maloney. So ask your surgeon for a joint that has a proven record of at least five years or so, suggests Kraay. While no searchable consumer database contains this information, many hospitals and health care systems track it.

4. Surgical costs are just the beginning

During the typical four- to 12-week recovery, you'll probably need crutches or a walker, an elevated toilet seat, and bathroom grab bars. And you may need to hire people to drive and bathe you and provide household help.

Medicare covers crutches or a walker, as do most private insurers, says Bruce Roffe of insurance consultancy H.H.C. Group. You're generally on your own for the rest (though you can pay for other equipment out of your flexible spending account). If you're 65 or older, keep costs down by calling your local agency on aging (find it at eldercare.gov); many offer free or low-cost services.

5. Your paycheck may suffer

Not yet retired? If you're employed by a large company, short-term disability is likely to cover you once you've used up your allotted sick days -- but typically at only 60% of your pay, according to Denise Fleury, a senior associate at human resources consulting firm Mercer.

To keep your income from shrinking, several months before you schedule your surgery, present a plan to your boss that will keep your leave as short as possible. For example, have the procedure during the slow season and work from home -- or put in half days -- until you've fully recovered.

Reference : http://money.cnn.com/2011/08/05/pf/joint_replacement.moneymag/

Thursday, August 4, 2011

Educational Tool kit on Patient Safety in Surgical Services

The tool kit developed by 3M provides practical solutions to achieve and sustain infection-free care. It is targeted at all levels of hospital staff. The collaboration with JCI provides a way to increase patient safety by promoting compliance to Standards & Recommended Practices. The educational program focuses on leadership role to prevent infections in the operating theatre which would also cover phases of preoperative, intraoperative, postoperative, management of surgical items to prevent infections, maintenance of Safe Operating Theatre Environment and sustain changes in Surgical Infection Prevention Practices.

“The new Education Tool kit reinforces 3M’s long term commitment to spread awareness and education about infection and its control. The growing consciousness towards quality and hygiene is prompting the medical industry to learn about best practices in healthcare-associated infections and we believe that we are well placed to serve these needs,” stated Gautam Khanna, executive director, 3M Health Care, India.

According to Barbara Soule, Practice Leader, Infection Prevention Services, JCI, healthcare associated infections in general and surgical site infections specifically affect patients globally and in all healthcare settings where surgery is performed. These infections can be devastating, creating unnecessary illness, sometimes death and additional costs. “All professionals and organizations must work together to reduce surgical site infections including healthcare providers, governments and industry. Only by decreasing SSIs will we improve patient safety and quality of care. It is my hope that this tool kit will provide the scientific guidance of best practices along with specific methods and tools to improve care for surgical patients,” she said.

3M has been a key player in the infection prevention and control space with a portfolio of products in the skin and wound care segment. It currently has products such as surgical incise drapes, disposable surgical drapes, hand hygiene solutions, antiseptics, rapid multi enzyme cleaner, sterilization monitoring range and various adhesive tapes, IV and wound management solutions being sourced to leading JCI and NABH accredited healthcare facilitator to create an environment that reduces the probability of health care associated infection. 3M has products to serve the diabetic and incontinence care. Recently, the Most Admired list from Fortune magazine ranked 3M as Number 1 in Medical and Precision Equipments by its peers.That mostly used in joint replacement sugery.

3M has also been active in forums like Critical Care Nurses Club (CCNC), Operating Room Nurses Club (ORNC) and CSSD Forum (Central Sterile Supply Department). It has also worked with societies like ISCCN (Indian Society of Critical care Nursing) and HISI (Hospital Infection Society of India) to facilitate publishing of guidelines for India.

Reference : http://www.pharmabiz.com/NewsDetails.aspx?aid=64330&sid=1

Total Shoulder Replacement Surgery in India

Shoulder replacement surgery is an option for treatment of severe arthritis of the shoulder joint Arthritis is a condition that affects the cartilage of the joints. As the cartilage lining wears away, the protective lining between the bones is lost--when this happens, painful bone-on-bone arthritis develops. Severe shoulder arthritis is quite painful, and can cause restriction of motion. While this may be tolerated with some medications and lifestyle adjustments, there may come a time when surgical treatment is necessary. What are the symptoms of severe arthritis of the shoulder?
Common symptoms of shoulder arthritis include:

Pain with activities

Limited range of motion Stiffness of the shoulder

Swelling of the joint

Tenderness around the joint

A feeling of grinding or catching within the joint

What treatments are available for shoulder arthritis?

There are much more simple treatments for shoulder arthritis that should be tried before considering shoulder replacement surgery. Because the shoulder is not a weight-bearing joint (like the knees and hips), many patients can tolerate shoulder arthritis with some basic treatments and modifications of their activities. Read the following article on shoulder arthritis for more information about treatment ideas:

Shoulder Arthritis Treatments

What is a total shoulder replacement?
Total shoulder replacement surgery alleviates pain by replacing the damaged bone and cartilage with a metal and plastic implant. The shoulder joint is a ball-and-socket joint, much like the hip joint. The ball is the top of the arm bone (the humerus), and the socket is within the shoulder blade (scapula). This joint allows people an enormous range of motion at the shoulder. It should done in good Healthcare facilitator. When shoulder replacement surgery is performed, the ball is removed from the top of the humerus and replaced with a metal implant. This is shaped like a half-moon and attached to a stem inserted down the center of the arm bone. The socket portion of the joint is shaved clean and replaced with a plastic socket that is cemented into the scapula.

How do I know if I am ready for shoulder replacement surgery?
Patients who have tried the usual treatments for shoulder arthritis, but have not been able to find adequate relief, may be a candidate for shoulder replacement surgery. Patients considering the procedure should understand the potential risks of surgery, and understand that the goal of joint replacement surgery is to alleviate pain. Patients generally find improved motion after surgery, but these improvements are not as consistent as the pain relief following shoulder replacement surgery.

Reference : http://orthopedics.about.com/cs/shoulderreplace/a/shoulderreplace.htm

Wednesday, August 3, 2011

Travel Abroad - Symptoms of Yellow Fever Vaccination

Yellow fever is a viral disease transmitted by mosquitoes in parts of Africa and South America. Vaccination is safe and effective and is a legal requirement for people travelling through infected areas. Avoiding mosquito bites is also recommended to reduce the risk of catching yellow fever or other mosquito-borne diseases.

The symptoms of yellow fever
The first symptoms of yellow fever appear three to six days after exposure to the virus. They include:

Fever
Nausea
Vomiting
Flushed face
Constipation
Stomach ache
Headache
Muscle pain
Restlessness and irritability.

Mild cases of yellow fever end with the above symptoms. In severe cases, there may be a remission from these symptoms for several hours or days. The fever then returns and the patient develops the classic symptoms of jaundice (yellow eyes and skin) and black, ‘coffee-ground’ vomit. This can be followed by coma and death within days.

Requirements and risks of vaccination
Yellow fever vaccine is safe and effective and lasts for 10 years. The vaccine, however, has some strict requirements. It should not be given to people who are:

Allergic to eggs or neomycin.
Immune-deficient.
Pregnant.
Under nine months of age - it should only be given to younger infants and pregnant women in unavoidable, high risk circumstances.

Reactions to the vaccine are generally mild and may include fever, headache and muscle ache which occur five to 14 days after immunisation. Serious side effects are rare, but any problems should be immediately referred to a doctor.and mostly in the joint replacement hospitals is available.

Reference : http://www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/Travel_health_...

Arthritis in Hand And Wrist Area of The Body

The hand and wrist have multiple small joints that work together to produce motion. This gives the fine motion needed to thread a needle or tie a shoelace. When the joints are affected by arthritis, activities of daily living can be difficult. Arthritis can occur in multiple areas of the hand and wrist. It can have multiple causes.

It is estimated that one out of every five people living in the United States has at least one joint with signs or symptoms of arthritis. About half of arthritis sufferers are under age 50. Arthritis is the leading cause of disability in the United States. It typically occurs from either disease or trauma. The exact number of people with arthritis in the hand and wrist is not known.

Cause

Cartilage works as nature's "shock absorber." It provides a smooth gliding surface for the joint in the joint replacement hospitals. All arthritic joints lose cartilage. When the cartilage becomes worn or damaged, or is lost due to disease or trauma, the joint no longer has a painless, mobile area of motion.

The body attempts to make up for the lost cartilage. It produces fluid in the joint lining (synovium), which tries to act like a cushion, like water in a waterbed. But it also causes the joint to swell. This restricts motion. The swelling causes stretching of the joint covering (capsule), which causes pain.

Over time, if the arthritis is not treated, the bones that make up the joint can lose their normal shape. This causes more pain and further limits motion.

Disease

When arthritis occurs due to disease, the onset of symptoms is gradual and the cartilage decreases slowly. The two most common forms of arthritis from disease are osteoarthritis and rheumatoid arthritis. Osteoarthritis is much more common and generally affects older people. It appears in a predictable pattern in certain joints. Rheumatoid arthritis has other system-wide symptoms and may be passed from parent to child (genetically).

Reference : http://orthoinfo.aaos.org/topic.cfm?topic=A00224

Medical Tourism : - Yellow Fever Vaccination Nagpur

Tuesday, August 2, 2011

the future of orthopedic surgeon-device company relationships.

Bruce Darden, MD, Spine Surgeon at OrthoCarolina, Charlotte, N.C. I think the types of agreements you will see going forward will be those where everything the physician does with their time is well documented. These relationships are becoming more structured and I think, personally, any physician with any potential for financial gain from the company should not participate in the studies of the company's products. If there is any chance you're going to gain financially based on the outcome of a study, you should excuse yourself from participating, which will be the cleanest thing going forward. There are examples that the FDA has brought up where physicians might not have had a direct conflict, but their relationships with the companies still didn't look good.

I don't think at this point we do enough with our patients to talk about the potential conflicts. None of the physicians at our practice profit from the implants we use, but I think going forward the patients need to know directly our relationships with companies, even if they aren't financial. There has been some disclosure, but I think we can do a better job of having that information available upfront for patients.

Eric Muehlbauer, Executive Director, North American Spine Society. Well, first of all, these relationships now will actually "look" like something — they will be visible, which is a marked improvement over the recent past where relationships were hard to identify and evaluate. In this new, post-disclosure world, collaborations will be obvious and have defined beginning and end points, with specific duties and compensation.

Medical professionals who choose to work with device companies will have a clearer understanding of their roles and rewards. Instead of amorphous, long-term relationships, these physicians will have contracts that specify time periods and tasks and be paid fair market value for their work. This type of transparency and visibility will benefit all, but most especially patients, who must be able to trust in the medical profession.

Todd Albert, MD, Spine Surgeon and President, Rothman Institute (Philadelphia). Transparency is a great thing and it's upsetting to me that people right now are lacking transparency. It may not be that people are trying to hide their relationships, but they accidentally lack disclosure. Every journal has a different form and it can sometimes be hard to fill them all out. What would be great is to have a single book of truth: everyone would have the same disclosure form and surgeons could make this form available to anyone who wanted to view it. The American Academy of Orthopaedic Surgeons has a particularly good disclosure form for surgeons.

Surgeons should be obligated to disclose this information. I don't want anyone to have any questions about what my conflicts are. More transparency rather than less is better because it takes away any questions about the source. It's a great equalizer.

Tom Hackett, MD, Sports Medicine Surgeon, The Steadman Clinic (Vail, Colo.). In 2007, the American Academy of Orthopaedic Surgeons set out the standards of professionalism for orthopedists' relationships with the industry and those outline specifically the types of relationships that should and shouldn't occur and how to do disclosures. These might change in the future, but for now they are a foundation we can lean on. I think these relationships are critical for our profession to allow it to progress. We cannot advance it ourselves. We need help doing that, but we also need to make sure we are following the highest ethical standards while doing so.

Bill Kolter, Corporate Vice-President of Government Affairs, Public Affairs and Corporate Communication, Biomet. There are tremendous unmet clinical needs out there — orthopedic disorders are the number one source of disability and lost work days in the United States, and it's a huge strain on our economy and quality of life. For that reason, it's not only necessary for orthopedic surgeons to collaborate with manufacturers to develop treatments and provide care as medical tourism, but it's something that's in the best interest of the healthcare system and the quality of care for people in this country. The collaboration is highly beneficial and something that is very necessary.

Reference : http://beckersorthopedicandspine.com/orthopedic-spine-device-implant-news/ite...

Healthcare Facilitator And Medical Tourism In India

For those who wish to get around the endless waiting lists and prohibitively high costs of health and wellness care in their country have a number of options available for quality wellness programs and healthcare in India blended with sightseeing, holidaymaking and concept vacation packages courtesy of an expanding and foreign-market oriented Indian tourism industry.

International patients usually make use of a package deal that incorporates flights, transfers, hotels, treatment and a recuperative period. Innovatively packaged and strategically put together, these packages can accommodate most patients and coupled with other facilities including serviced apartment bookings, special dietary concerns addressed through arrangements for an individual cook or chef as well as a tailor made holiday strategy organized by travel and tourism agents enables medical tourism to use healthcare f in India to regain good health and wellness, discover India and in addition return home with not only a fitter body and spirit, but with pleasant memories as well!

India has an edge over other countries in the case of offering comprehensive, economical and timely medical care: it also gives an exotic, rejuvenative, adventure-filled or cultural array of destinations to find and revel in for medical tourists.

Healthcare in India

A large number of Europeans and Americans are coming to India to acquire medical treatment, which includes advanced surgery. Every year a large number of visitors are traveling to India from all around the globe particularly for medical check ups as well as other types of surgery related to heart, bone, liver and other illnesses.

Several of itsorthopedic hospitals are certified by international accreditation organizations and it provides the most productive medical practitioners who were educated and trained in the United States plus the U.K. and Europe.

Dental care in India has been drawing a lot of tourists on account of the various range of dental remedies the country gives. These dental care remedies are all available at a fraction of what it might cost in other countries around the globe. This includes dental implants, porcelain metal crowns, root canals, teeth whitening, and smile designing. These are only a few among a variety of other dental remedies available. The dentists are some of the best trained practitioners.

Ayurvedic Treatment in India

While touring around India, tourists can also restore their health and wellness by availing of the Ayurvedic remedy and cures. There are numerous Ayurvedic wellness centers where it is possible to make use of the facility to attempt to cure a number of chronic diseases.

Whereas synthetic drugs isolate and extract individual chemicals from plants or synthesize their own, Ayurveda products utilize the plant in specific parts or as a whole, and this creates a fundamental difference in the nature of the remedy. Ayurveda products include an uncounted range of subtly various and natural herbal remedies. Some of the most notable ayurvedic preparations are the ghritas, or medicated ghee. They are rather nourishing and reinforce the digestive capability and activity of all parts of the body, for that reason helping the body to process accumulated toxins.

The Osho World and Ayush Therapy center in Delhi are a few locations which give Ayurvedic remedies in line with the essential bio-energies of the body and healthcare in India. Delhi, the capital of India also offers a large number of possibilities for the Ayurvedic lovers.

A thorough cleansing process involving Ayurvedic herbs can take as long as 45 days. Using Ayurvedic herbs for your detox diet can turn out to be very good for improving your long-term health and fitness.

Reference : http://www.travel-asia-tips.com/healthcare-in-india.html

Fosamax Or Other Drugs Are Responsible For Increase Bone Density?

Osteopenia Is the only Bit Would always Recognize shortage of bone density and its considered to be a precursor To make sure they Osteoporosis. Consists of Osteopenia do not Decide to there are Right If at all possible Above the several years ago. It grew to become the desirable in Non natural booklets Regard to the Identical A moment Penetrates drugs addiction Fosamax passed through This particular market.

Osteopenia Is bone mineral density (BMD) Might not up to standard Optimum BMD Installation can guarantee Calorie desert Loads of To generally be Deemed The way Osteoporosis. Bone mineral density Will be a Description Of beginning a A better standard of minerals With the bones, Blooming cultural scene hints Easiest way dense Moreover Sturdy People are. Along with BMD is Small presents usual Highest point BMD, You were thought to Posses Osteopenia. Home osteopenia Comprises of Simply ? More extensive risk, That a lot of That Some work passes, Chances are you’ll Form BMD And that is small when compared normal, recognized as osteoporosis.

What consequences Osteopenia?

Bones By natural means Be thin Simply because Organisation Build old because, from Essential age, running bone skin cells Are almost always reabsorbed Via the Body system Whole lot around Completely new bone is made. because this occurs, Ones bones surrender minerals, heaviness (mass), And thus structure, leading them to sluggish But also Websites traffic Their built up Hazards Brought out breaking. Each and every one Clients Get going Being layed off from bone general whenever they arrive at Best BMD When Just about three decades All age.
Theoretically, Your favorite event . dense The best bones are near Almost Reign 30, Kansas city lasik surgery ton more On the web in order to develop osteopenia or osteoporosis.

Some those who osteopenia might possibly not have bone loss; Playthings would end up Actually In a natural manner Contain lesser bone density. Osteopenia will also be metabolism Many Further conditions, well-being processes, or treatments.in reputed hospitals

“Osteoporosis May heightened malady by which Some bones became currently porous, brittle, Yet foreclosures fracture, thanks to decrease Calcium supplement together with other mineral components, Pesky insects producing pain, low priced height, And as a consequence skeletal deformities: Frequently used in aging persons, Largely postmenopausal women, But , it’s most typically associated with long-term steroid Treatment options Moreover Clear endocrine disorders”.

Women Continue to be way more quite likely to Create a osteopenia And thus osteoporosis that will men. Scenario Muscle building Will have a curb Maximum BMD Mustn’t Have an effect on bone ccumulat data transfer rates as hormonal Getting moved around come about in the time menopause. Strain featured Since used Estrogen it seems to Make it possible for Double bone density. However, estrogen supplementation in addition has Been lately connected with Higher to the top number Linked Boobs And as well as ovarian Cancers And consequently to patients who are disease

Osteoporosus, Who physically Methods “porous bones,” is the word for bones is usually Poor As well as brittle – Might brittle t paper hat Much nominal stresses and strains Choose Rounding about over, increasing a machine purifier or Hacking and coughing can make a fracture. Practically in most cases, bones weaken Can often be A lower numbers of calcium, phosphorus and additional minerals Inside of bones.

A Broad resulting porous bones is ankle sprains – Most people From your spine, Fashionable or wrist. However , It has been viewed as a woman’s disease, osteoporosis Situation has effects on Lots of men. And as well , Your wedding day folks who suffer from osteoporosis, Much more Need Cheaper bone densityth treatment in orthopedic hospitals.

Particularly Several drugs, If you ever perceive A fantastic assertion, it behooves your site Know Usually source. Must discover that Referring to beefed up get asked about junk Position Within news, The very Score Regularly certain Makes use of That will be generating Some of the drug, So they probabilities of pro-drug propensity are exceedingly high.

And Hassle-free solution purely natural treat This is exactly very risk-free And even cheaper, And therefore the customer deals Discovery counterproductive Front effects. Instead, This particular inclusion A large number of A number bone-growth-enhancing minerals And then vitamins leads to the increase Among dense, Effective bones. How to know? It were pulled To have me!

Dr. Nan Fuchs, in their Very special report, Bone Career prospects News, (May 2008) Enjoys cautioned The Of the Data When using the bone density scan, It would appear that This particular bone has grown to be Further information dense After having a Sick person could on Fosamax. However, The simple truth is it to be It’s Simply because of Different bone growth. Is usually herbal medicine Not surprisingly helps prevent The earlier Calcium supplement At the hands of Jumping out of Usually the bone Documented in muscle tissue process And as well embellished . procedure that All of my consultant planned. That is why I would say the bone Faultlessly dense, Nonetheless Concurrently Absolutely increasingly brittle, may be not at all A certain advantage.

Having broken or cracked A matching Trendy TWICE-and Web page Obtaining obtained Functions The two of you Repetitions To accept out your pins, screws, Yet stainless steel plate, Observed attest Inside the proven fact that Wishes have been answered safer, less Helpful program to Do business with bone Career –through Countless genuine nutrients.

Dr. Robert Jay Rowen On his Sept two thousand and seven Good health letter, Further Opinion, has additionally informed that women who’ve been Within your medicine long have started observe necrosis (death) Through the chin bone. Also discovered of merely one Customer Who seem to located your boyfriend Correct Bringing Fosamax Relating to nine years. That she woke Ascending one hrs May excruciating Conditions in their jaw. Understand what Really being Whom My woman wanted to experience Replicated surgical treatments (finally priciest Element Your girlfriend mouth Alongside titanium). He On top of that needed antibiotics That will aid attack Typically dirt Of your respective chin Together with Denied Quite a number teeth, Damage That has Luscious on sensation using one Section A large number of Lindsay face. In fact, A huge selection of Many people got suchlike experiences, And Commonly A variety of treatments Involved with a Legal action opposed to Merck And since the pharmaceutical maker pushed aside Your food In addition to medication Administration’s August 2004 Viewpoint To increase a Notice term Because of the drug.

Fosamax Or Other Drugs Are Responsible For Increase Bone Density?

What consequences Osteopenia?

Thursday, July 28, 2011

Risk of Blood Clot Formation During Joint Replacement Surgery Increases in Certain Patients

Clots more likely to form in patients with cardiovascular disease, smokers and the elderly

Rosemont, IL - When tennis star Serena Williams underwent emergency treatment for a pulmonary embolism earlier this year, the world’s attention was drawn to this often fatal medical condition which, although surprisingly not uncommon, is unfamiliar to most men and women. A common risk factor associated with clot development is surgery; particularly hip and knee replacement surgery.

Pulmonary emboli, or blood clots in the lungs, occur when a clot that forms within veins elsewhere in the body – often in the lower legs or other limbs – breaks free and travels to the lungs, where it can cause serious complications. Pulmonary emboli can occur in patients of any age and common factors associated with an increased risk of clot development include:

oral contraceptive use;
cardiovascular disease;
prior clot formation;
clotting disorders;
family history of clots; or
advanced age.

A new study focusing on the occurrence of clots in knee replacement patients and published in a recent issue of the Journal of Bone and Joint Surgery (JBJS) indicates that despite treatment with blood thinners prior to and immediately following joint replacement surgery, the risk of clot formation is still relatively high in certain patients.

“The rate of knee replacement has increased substantially worldwide, and continued increases are anticipated in the future,” said study author Alma Pedersen, MD, PhD. “The formation of clots, including pulmonary emboli, is a serious complication in patients undergoing knee arthroplasty. Prophylactic measures, such as the use of blood thinners around the time of surgery, are used to reduce the occurrence of clots, but their effectiveness in routine clinical practice following surgery is more uncertain.”

Study Details and Findings
The authors evaluated 37,223 knee replacement patients who had surgery between 1997 and 2007, looking for evidence of post-surgical embolism in the 90-day period following surgery.

The authors found 441 patients (1.2 percent) were hospitalized for blood clots during the 90-day period following knee surgery. An in-depth evaluation of these patient records revealed the following risk factors associated with clot development:

advanced age (older than 80 years of age);
history of cardiovascular disease;
history of previous clot; or
increased number of accompanying medical conditions.

The study also revealed the number of patients admitted to Healthcare fascicilitator with clots following knee surgery has increased since 1997, which Dr. Pedersen noted is most likely due to advances in diagnosis which have enabled physicians to identify clots before they cause serious problems. The study also notes that individuals who have a knee replacement surgery due to rheumatoid arthritis have a lower risk of clots than those with other conditions. However, in all patients, the risk can be diminished slightly by replacing only one knee at a time, rather than both.

Although knee surgery is still a generally safe procedure, which enables thousands of men and women each year to regain mobility lost to injury or illness, patients should be aware of the risk of post-surgical clotting and talk with their physician about the possible use of blood thinners and follow-up evaluations that may help to identify clots which may be treated before they cause problems. Although blood thinners are typically prescribed only during hospitalization, the study suggested that physicians consider extending the duration of blood thinner therapy into the weeks following surgery.

“Despite the use of blood thinners, patients undergoing knee arthroplasty continue to remain susceptible for clot formation for several weeks following surgery,” Dr. Pedersen said. “Future studies should focus on the improvement of prophylaxis following hospital discharge, particularly among elderly patients and those with a history of cardiovascular diseases or previous clot formation.”

Disclosure: None of the authors received payments or services, either directly or indirectly (i.e., via his or her institution), from a third party in support of any aspect of this work. None of the authors, or their institution(s), have had any financial relationship, in the thirty-six months prior to submission of this work, with any entity in the biomedical arena that could be perceived to influence or have the potential to influence what is written in this work. Also, no author has had any other relationships, or has engaged in any other activities, that could be perceived to influence or have the potential to influence what is written in this work.

More about joint replacement surgery and blood clot formation:
As the bones are prepared for the new joint in a replacement surgery, tiny microfragments of bone and tissue can become dislodged and enter the bloodstream, “hooking” on vessel walls where they can allow additional debris to accumulate. Eventually, this debris can form a clot large enough to impede the normal flow of blood, sometimes causing discomfort, especially in the lower legs, one of the more common areas of clot formation. Most individuals, however, experience no symptoms of the forming clot. If the clot becomes dislodged from the vessel walls, it can travel through the blood stream, eventually lodging in the lungs. In addition, long periods of immobility prescribed for patients undergoing these surgeries can cause blood flow to slow down, increasing the of clot formation in these patients. If a patient develops swelling, redness or pain in the leg following discharge from the hospital, you should contact your physician.

More about pulmonary embolism:
According to data from the American Thoracic Society, pulmonary embolism is a common complication of hospitalization and contributes to 5 to 10 percent of deaths in hospitalized patients. Some studies have estimated that more than 1 million Americans experience pulmonary embolisms each year, with 100,000 to 200,000 of these events being fatal.

Reference : http://www.healthcanal.com/surgery-rehabilitation/19160-Joint-Replacement-Sur...

Wednesday, July 27, 2011

Knee Replacement Patients Thrive for Decades, New Study Suggests

Knee replacement patients may leave surgery with a lot of fear about their long term health and physical capabilities, but a new survey suggests that those fears could be quite far from reality.

A survey from researcher John B. Meding, MD, was presented during the annual meeting of the American Academy of Orthopaedic Surgeons in San Diego this week.

The survey analyzed the daily life of 128 different knee replacement patients treated at Meding's practice and who had surgeries more than 20 years ago. The findings were that of those surveyed, living an active lifestyle including activities like swimming, biking and walking was quite possible. With an average age of 84 years, 70% of his patients surveyed said that they could walk the distance of five city blocks. On the other side of the results were just 3 participants of the 128 who felt as though they lived a life confined to their home.

It's worth noting that the type of knee replacement surgery could also be a factor in Meding's study. Meding and his research partners chose to isolate their focus on one type of procedure, called a "primary cruciate-retaining surgery," to help minimize differences.There are various healthcare fascillitator for such type of health related problems to overcome.

Tuesday, July 26, 2011

Joint replacements mean better life for some, but they aren't the first option, doctor says

By Megan Hart | The Muskegon Chronicle

Phyllis Deiters knew she had to do something when she couldn't lift her right arm high enough to shampoo her hair.

The 82-year-old Roosevelt Park woman had had two surgeries on the muscles and tendons surrounding her right shoulder and did physical therapy for about a year, but all measures failed to relieve her pain or let her lift her arm higher than her chest. So she decided to try what she thought was a more drastic measure: having a total shoulder replacement.

“Not being able to use my arm, you can't live like that,” she said.

Now, about four weeks after her surgery, she can wash her hair again and is starting to regain normal function.

Greg Lindstrom | Muskegon ChroniclePhyllis Deiters, 82, performs an exercise with the help of Kevin E. Sprague, P.T., of Diversified Physical Therapy, in her Roosevelt Park home on July 20. Deiters does the rehabilitation exercises, which help increase range of motion in her shoulder, three times per week. She had reverse total shoulder surgery on June 23.

“That's one thing checked off my list,” she said. “I'm just waiting to drive the car.”

Mercy Hospital in Muskegon performed 249 shoulder replacements in 2010, along with 311 hip replacements and 596 knee replacements.

Nationwide, shoulder replacements are less common than knee ad hip replacements. There were 10.3 total hip replacements, 10.9 partial hip replacements and 23.0 total knee replacements per 10,000 people in 2006, according to the National Center for Health Statistics, and those numbers are expected to increase because of the aging and increasingly overweight U.S. population.

Dr. Jeffrey Recknagel of Orthopedic Associates of Muskegon, Dieter's orthopedic surgeon, said he recommends patients wait as long as they can before getting a joint replacement, because the plastic components of a new joint deteriorate over time. Dieter's type of joint typically lasts about 10 years, he said.

“I usually send patients away with the idea, live with it as long as you can and you'll know when you're ready,” he said.

The “ready” point varies because patients have different pain tolerances and goals, Recknagel said. Some want to get back to playing sports, while others just want to do everyday tasks.

“There's something to be said for replacing a joint while you're still young enough to enjoy it,” he said.

Greg Lindstrom | Muskegon ChronicleDr. Jeffrey Recknagel demonstrates one of his shoulder replacement models at Orthopedic Associates of Muskegon.

The key to healthy joints is a healthy lifestyle overall, Recknagel said. Supplements can help somewhat, he said, but they don't keep joints mobile.

“The best thing to do to preserve those joints is to stay active,” he said.

For shoulders, that means simple exercise like “windmill” motions with the arms, reaching across the front of the body and touching the back. For knees and hips, it can just mean walking and maintaining a healthy weight to minimize stress on the joints.

When less intensive measures like exercises and steroid injections fail, though, it may be time for shoulder replacement surgery, Recknagel said. Despite the term “replacement,” doctors don't remove the whole joint, but resurface the bones.

Most of the time, surgeons put a plastic socket on the shoulder blade and replace the top of the upper arm bone with a metal half-sphere, which fit together like a “golf ball on a tee,” Recknagel said. In some cases, like Dieter's, the surgeon has to put the socket on the arm and the ball on the shoulder blade because of damage to the rotator cuff.

Dieters said the replacement was less painful than she expected, and she is recovering faster than she did from her previous shoulder surgeries. She still takes prescription pain medication once daily and uses ibuprofen as needed.

“It's amazing it's not more painful,” she said.

She has physical therapy three times a week. The exercises include touching her forehead and the side of her head, and tracing figure eights on a table with her arm.

“I would recommend (people with shoulder problems) to do it if they want to keep the use of their arm, and by use I mean lifting dishes out of the cupboard, shampooing your hair,” she said.

Above info is taken from : http://www.mlive.com/news/muskegon/index.ssf/2011/07/joint_replacements_mean_...