Health Wikipedia

Pain in the knees is particularly a serious problem faced by the older people. Sometimes it becomes so severe that it incapacitates people in bed.

Age related wear and tear of the knee — known as Osteoarthritis (OA) is mainly responsible for this. Although common, many people are not aware of the solutions that are currently available. Proper medication, physiotherapy, lifestyle modification and sometimes surgery can help stop or lessen the pain.

In Bangladesh, approximately 10 million people are suffering from Osteoarthritis. Women suffer more — 2 out of 3 women over the age of 65 have osteoarthritis. More than half of all men over the age of 65 have osteoarthritis.

With the increasing longevity of life, the problem will multiply itself within a very short time. Osteo-arthritis occurs when the knee undergoes age-related wear and tear around its joint. Almost every one is affected by it to some extent, as they grow older.

Osteoarthritis can also occur in weight bearing joints mainly hips and ankles. This form of arthritis slowly and gradually breaks down the overlying bony ends which forms the joint.

With osteoarthritis, the smooth surface of bones becomes rough and pitted. In advanced stage it may wear away completely. Without the normal gliding surface the bones, eroded bones grind against one another causing pain, swelling, restricted knee motion, crispy sound inside the joint and sometimes bowing of the knees.

In addition to age related wear and tear, athletes, labourer and highly physically active persons often stress their knee joints that lead to prolong wear and tear, which places them at increase risk of developing arthritis.

Arthritis has been linked with joint injuries and damaging events like fractures and infections that can harm the internal tissues of the joints. Individuals who experience repeated knee injuries are much more likely to develop osteo-arthritis as they get older.

Lack of exercise can weaken the thigh muscles that support the knee joints, eventually making the under-used joint stiff, painful and dysfunctional. Lastly, heavy individuals are at increased risk of developing osteoarthritis, because their knees become strained by excessive weight. Research indicates that people who are overweight as young adults are likely to develop osteoarthritis of the knees as they age.

“When and how would I understand that I have osteoarthritis?” is a common question I face in my clinical practice. People start limping and the knee may become swollen with fluid. There may be a reduction in the range of motion of the affected knee — the knee bends less than normal and may lose the ability to completely straighten out. Finally, as the condition becomes worse, the pain persists all the time and may even keep you awake at night.

Repeated knee pain is the main symptom. It tends to be worse after activity. Knee stiffness occurs after rest, the joint feels stiff and it hurts to get going after sitting for any length of time. In time, the joint gets stiffer and you are unable to fully straighten or bend the joint. Knee swelling is also common especially after excessive activity. Knee bowing is seen if osteoarthritis is severe, your joint may become deformed what we call bowlegged.

Most people suffering from osteoarthritis can be treated by non-surgical means which include pain killer, physiotherapy, life style modification and injection in to the knees. Unfortunately if the medical measures are not successful in relieving pain, surgery may be considered. Among the surgical options, arthroscopic washout of the knees is relatively new method in Bangladesh used to relieve pain for sometimes.

When medical measures and arthroscopic washout fail; knees become progressively worsened both in pain and deformity, total knee joint replacement are the better option which is now being done in state-of-the-art hospitals under skilled care of experienced Knee Consultants.

Dr M Ali

Health is not just absence of disease but it is a state of wellness in which a person enjoys physical, mental, social and spiritual health. Health is connected to the total well being of an individual. Apart form environmental and social factors, there are subtle factors that affect the health of a person. A clean and pure mind is a prerequisite for healthy life. A pure mind enables the use of time, energy and resources in the best way. Stress or negative thinking has been identified as a leading cause of quite a number of major illnesses.

Holistic health encompasses total health of a human being in all four aspects of life — physical health, mental health, social health and spiritual health. Meditation promotes health in all these areas of life. Meditation regulates the physical responses of the body by eliminating stress and stimulating healthy hormones. It creates self-control thus enabling a person to remain free from negative influences and give the best in every role and situation. It empowers a person to deal with challenges in equanimity and positivity. Meditation alters the physiological and psychological response of the body remarkably. Reduction in heart and respiratory rate, and a drop in blood pressure suggest reduction in the level of sympathetic activity. Meditation aids the secretion of ‘healthy’ hormones such as endorphins and encephalon’s, which help, in detaching oneself from various kinds of pains. Meditation helps sustain deep relaxation even during active states of mind. Brain wave recordings of Rajyogis have shown alpha and theta waves even while they performed various mental and intellectual tasks.

The benefits of meditation go beyond relaxation response. A number of studies have critically investigated meditation for effective treatment of hypertension, diabetes, headache, anxiety, depression and heart disease. Meditation reduces the requirement of medication for pain and sleep etc. It is reported to be effective in de-addiction from drugs; alcohol, tobacco and can increase decision-making skills, overcome irrational fears, phobias and expand spiritual life.

One of the most subtle but critical factors that affect health is quality of our actions. The law of action is infallible — you reap what you sow. If we use our body to perform good and right actions then we will enjoy good health. Body is the temple in which the divine self resides. If we treat our body well then it will perform well. The seed of good actions is pure feelings and thoughts; hence, we have to make a conscious choice to nurture only pure thoughts. Everything that we suffer through our body is a debt of bad action that the soul is paying off. To enjoy good health we have to accumulate a stock of good karma by sharing the qualities of peace, love and joy in every thought, word and action.

World Kidney day was observed on 11 March in more than 100 countries of the world. The slogan of World Kidney Day this year was “Protect your kidneys, control Diabetes”. World Kidney Days aims to raise awareness about the heavy burden of chronic kidney disease (CKD) on human lives.

The mission of World Kidney Day is to raise awareness of the importance of our kidneys to overall health and to reduce the frequency and impact of kidney diseases and its associated health problems worldwide. The objectives of the World Kidney Day 2010 were the followings:

* Raise awareness about our “amazing kidneys”

* Highlight that diabetes and high blood pressure are key risk factors for chronic kidney disease (CKD)

* Encourage systematic screening of all patients with diabetes and hypertension for CKD

* Encourage preventive behaviours

* Educate medical professionals about their key role in detecting and reducing the risk of CKD, particularly in high risk population

* Stress the important role of local and national health authorities in controlling CKD epidemics. Health authorities worldwide will have to deal with high and escalating costs if no action is taken to treat the growing number of people with CKD. On World Kidney Day all governments are encouraged to take action and invest in further kidney screening

* If detected early, CKD can be treated by reducing other complications and dramatically reduced the growing burden of deaths and cardiovascular disease worldwide

Kidney diseases are silent killers which largely affect the quality of life. There are, however, several easy ways to reduce the risk of developing this kidney disease.

Seven golden rules:
i) Keep fit and active
ii) Keep regular control of your blood sugar level
iii) Monitor your blood pressure
iv) Eat healthy and keep your weight in check
v) Do not smoke
vi) Do not take over the counter pills on regular basis
vii) Check your kidney function if you have one or more of the high risk factors

Diagnosis of CKD with Diabetes:
People with diabetes should be screened regularly for kidney diseases. The two key markers of kidney diseases are eGFR and urine albumin. Kidney diseases are present when eGFR is less than 60 ml/min.

The Americal Diabetic Association (ADA) and National Institute of Health (NIH) recommend that eGFR can be calculated from serum creatinine at least once a year in all people with diabetes.

Urine albumin is measured by comparing amount of albumin to the amount of creatinine in a single urine sample. When the kidneys are healthy, the urine will contain large amount of creatinine but almost no albumin. Even small increase in ratio of albumin to creatinine is a sign of kidney diseases. Kidney diseases is present when urine contain more than 30 mg of albumin per gram of creatinine, with or without decrease eGFR. The ADA and NIH recommend annual assessment of urine albumin excretion to assess kidney damage in all people with type 2 diabetes and people who have type 1 diabetes for 5 years or more.

Good care makes a differencePeople with diabetes should:
* Measure their HbA1C level at least twice a year which should be kept less than 7%

* Regular insulin injection, intake of other medicines, meal planning, physical activity and blood sugar monitoring

* Blood pressure should be checked several times a year which should be kept <130/80 mmHg

* Regular intake ACEI or ARB medicine for controlling high blood pressure

* To measure effective eGFR yearly

* To estimate urine albumin atleast once a year to check kidney damage

* To take reduce amount of protein in the died at to seek health from the dietitian regarding meal planning

In conclusion early detection and treatment of kidney diseases are the best way to prevent CKD in order to reduced substantial burden of health budget.

Everyday, thousands of people undergoing major surgeries need blood transfusion. Many people suffering from various conditions like haemophilia (genetic disease that impair the body’s ability to control blood clotting), dengue, severe anaemia, blood cancer, thalaessemia need blood transfusion.

On an average, 3 to 3.5 lakh bags of blood are needed in our country every year. There is always strict advice to transfuse safe blood. But from where these amount of blood will come? Blood is not produced in a factory and yet there is no alternative source for blood. The only source of blood is human body.

Usually, blood from relative is encouraged for transfusion. But if a healthy relative of the same blood group is not available, blood from any healthy voluntary donor of that group may be transfused. In our country, people usually depend on the organisations like Sandhani, Redcresent, Badhon, Quantam etc. for safe and fresh blood. We should remember that these organisations or institutions do not manufacture blood. They are only the media to collect blood from healthy voluntary donors to provide it to the needy people. The more the voluntary donor, the more these organisations will make blood available.

Here the question comes — who can donate blood? Any person within the age group of 18-60 years with a body weight as minimum 45 kg for female and 48 kg for male and having a general well-health is an eligible blood donor. Healthy means that you feel well and can perform normal activities; your blood pressure, pulse, body temperature are normal; and you are free from any blood boarn diseases such as malaria, syphilis, gonorrhoea, hepatitis B, C, AIDS, haemophilia etc.

You may have chronic conditions like diabetes or high blood pressure; but in these cases, healthy means — you are being treated and the condition is under control. Such healthy people can donate one bag (350-450 ml) blood safely every 4 months.

After donating blood, the donor should take rest for 15-20 minutes. Routine work is absolutely fine after the initial rest. Rigorous physical work should be avoided for few hours. After resting for a while a donor should be given some liquid (fluid) to drink, such as water, ORS, milk or fruit juice. The donor needs no special diet other than a routine balanced diet. The body replaces blood volume or plasma within 24 hours.

It is very unfortunate that voluntary blood donation is still not so popular in our country. This is due to the lack of proper awareness, social movement, irrational fear and superstitions about donating blood. Some organisations are working in this field but still the number of voluntary blood donor is not keeping pace with the yearly requirement of blood.

In a study conducted by Sandhani, Dhaka Medical College Unit, it was seen that 62 percent of the population were unaware of the blood-transmitted diseases, 53 percent of people did not even know what their blood group was; 66 percent admitted that their knowledge about blood donation was not sufficient.

For the lack of adequate voluntary donors, many patients are being compelled to buy blood from professional blood donors. Such donors are more likely to carry dangerous infections and their blood is more likely to be of lower standard, as they tend to donate, better to say, trade more frequently.

In Bangladesh, mostly drug addicts sell their blood to get money to buy drugs for addiction. Usually they are under-nourished, having less haemoglobin in their blood. They also suffer from various blood transmissible diseases. So, the patient who is getting that blood, though initially may be benefited, is in risk of having many diseases.

In a research conducted in our country, 22 percent of the professional donor was found having Syphilis and 29 percent having Hepatitis-B. A study conducted in BSMMU showed that 60.1 percent of the patients suffered from hepatitis, who got transmitted unscreened blood from professional donors.

Again, many patients fail to get any kind of blood, not from voluntary donors, not from professional donors even. Voluntary donors’ safe blood and professionals’ unsafe blood collectively fail to fulfill the yearly requirements of Bangladesh.

If only 1% of the population donate blood once a year (though a healthy donor can donate blood 3 times a year safely), the yearly collection stands a satisfactory number which may fulfil the requirement smoothly.

Mathematically it is an easy task but it does not happen in reality. We all need come forward to save thousands of lives dying due to the shortage of blood.

With the advent of Valentine’s Day on this Sunday, millions of people are planning to give special gifts to their beloved. People sent flowers, red hearts, anonymous cards and offer a candle-lit dinner to surprise their valentines. On this Valentine’s day, you can make an exception by giving the greatest gift — a healthy heart that lasts forever. With little changes in your lifestyle that keep your heart healthy you can offer the big gift.

Research has shown that the leading cause of heart disease is related to behavioural choices such as eating habits, exercise, tobacco use, alcohol consumption and stress.

Maintaining a healthy body weight is crucial for the prevention of coronary heart diseases. Physical exercise even walking is good for heart. Blood pressure should be checked at regular interval and focus on lowering pressure by decreasing salt and low calorie diet. Alcohol, tobacco products and secondary exposure to tobacco smoke are important driving force behind heart diseases. We should make pledge to avoid it on this very occasion.

Following a heart healthy diet rich in vegetables, fruits and whole-grains are equally important. Consume fish, especially oily fish, at least twice a week. Limit your intake of saturated fat and minimise your intake of beverages and foods with added sugars.

On this Valentine’s Day, you can make the outstanding decision to change your lifestyle to give your beloved one, a healthy heart that creates love for life time.

The recent outbreak of H1N1 influenza epidemic which is better familiar as swine flu is a respiratory disease of pigs caused by type A influenza virus that causes regular outbreaks in pigs.

The human outbreak has created panic in the people due to some fatality. People are in a fix due to some reasons which include the disease is relatively new, healthcare setup is not completely equipped with adequate resources, medical professionals are not quite skilled handling the disease and so on.

When there was first outbreak of dengue haemorrhagic in Bangladesh, people were so worried similarly. But it is no longer a disease of panic.

To deal with the H1N1 influenza, we need keeping in mind several things. The best way to keep from spreading the virus through coughing or sneezing is to limit contact with other people as much as possible. Sick people should avoid work place and children should not go to schools. Concerned authority should be reluctant in this regard.

When coughing or sneezing, mouth and nose should be covered with tissue which should be discard immediately. If tissue is not available, hands are enough which must be washed afterwards. There is serious bad habit spitting and not covering mouth or nose while coughing or sneezing. Use of civic sense and simple courtesy can contribute a great deal here.

Most of the cases are self limiting and personal hygiene is of great value.

People with H1N1 influenza are potentially contagious as long as they are symptomatic with a ceiling of up to seven days following illness onset. Kids, especially younger children, might potentially be contagious for longer periods.

There is a dilemma about using the masks. Usually three types of masks are used — facemask, surgical mask and N95 mask. The N95 mask is effective in protection of H1N1 virus whereas surgical and facemask have almost no contribution for protection. But wearing facemask or surgical mask is of no harm. At least it protects others from spreading the disease. Sometimes, experts opt for double layered mask for resource poor settings.

Since the virus easily spread in crowded places, children are recommended to abstain from their schools where large outbreak occurs. Otherwise, only sick children are recommended to stay home to avoid spreading illness. Children also should not be brought to crowded places unnecessarily like shopping complexes, cinema halls etc.

Treatment is available in Bangladesh now and soon medical professionals will be used to hand H1N1 cases. Suspected cases should stay home and take home management. In case of developing warning signs or complications, individuals should seek emergency medical care in hospitals.

Antiviral drugs (Oseltamivir), which are available in the market can be stored at home for safety purpose, but it should not be readily taken without any clinical judgement or without prescription of physician, as it may develop resistance.

Fatality occurs due to misdiagnosis of the disease and accompanying other serious/chronic medical conditions — not as the disease is virulent too much. Early intervention with medication can cure the disease as usually.