Articles on bone

Eat Your Way to Stronger Bones!

Dr. Priyam Sharma, Dietitian/Nutritionist
Old age makes bones weak and brittle. This is MYTH. In fact, poor nutrition and unhealthy food habits are one of the main reasons for bones to lose strength and density. Bones, like all other tissues are made up of protein, calcium phosphate, calcium carbonate and other minerals, and it's importance to get enough nutrients in the body to keep the bones healthy. Here are some foods you must include in your diet.Boost your Calcium consumption You must already know that calcium is an essential component keeping your bones strong and healthy. So, include dairy products like milk and yogurt, fish, leafy greens, broccoli, dried figs and nuts to your diet.Include Vitamin D to your dietMost people are unaware of the benefits of Vitamin D. For your bones to absorb calcium from the food, it is important to consume vitamin-D in the form or food or supplements. Since there is very few food like fish and liver that contain vitamin-D, your doctor might prescribe Vitamin-D supplements to strengthen your bones.Consume lots of fruits and raw vegetablesNutrients like magnesium, potassium, vitamin c and vitamin k are vital in keeping your bones strong. Hence, include vegetables like potatoes, sweet potatoes, red/green peppers, broccoli, leafy veggies and sprouts to your diet. Fruit like grapefruit, apples, strawberries, oranges, papaya, bananas, prunes and pineapples are also very beneficial for bone health.Cut the sodium intakeSodium is known to be bad for the bones. Hence, it is advisable to cut back on salt in food. Sodium is also used as a taste enhancer and a preservative in hotels and restaurants, so it's best to avoid eating out.Better bones make life better, so, stop blaming your age and take control of your life!

Nutrition for Healthy and Strong Bones

Ms. Swati Kapoor, Dietitian/Nutritionist
Strong bones are an essential part of our body’s basic structure. A solid foundation spells lower risk of injury and improved health as we age. A good diet, with sufficient calcium sources and a regular physical activity may ensure healthy bone structure. Due to current fast lifestyle and poor dietary habits, cases with low bone density, osteoporosis and early age arthritis are increasing.While an overall nutritious diet can keep bones, along with the rest of the body, healthy, some specific components of diet contribute directly to bone strength. Including specific vitamins, minerals, macronutrients and phytochemicals in the diet may lead to a lower risk of osteoporosis and other bone disorders and help keep bones protected against fractures.Take (All) Your VitaminsCalcium and vitamin D are well-known heavy hitters for strong bones. While it"s important to focus on these two nutrients, we often disregard other essentials that work together to keep bones strong. Don"t overlook these unsung heroes:- Magnesium: The second most abundant mineral in your skeleton after calcium, magnesium helps to built strong bones.- Vitamin K: This fat-soluble vitamin is essential for strong bones factor. The intestinal tract normally creates adequate vitamin K, but antibiotics and digestive diseases can impair K levels, making dietary sources of the nutrient necessary.- Omega-3 Fatty Acids: A nutrient that's scarce in the standard diet, studies have shown that higher levels of omega-3 fats in the blood correlate with greater bone mineral density and this greater bone density leads to strong bones.Whether you have osteoporosis or just want to build strong bones for the future, there are several things you can do to maintain your bones.Eat Calcium-Rich FoodsFor strong bones, adults should eat at least 700 mg of calcium a day, and 1,200 mg if diagnosed with osteoporosis. You could consume 700 mg in one day by eating a cup of low fat yogurt, a cheese sandwich, a handful of almonds and a spinach salad.Get Your Sunshine QuotaYour body needs vitamin D to help it absorb calcium. Vitamin D is found in oily fish, liver, fortified spreads and cereals, and egg yolks. Your body also makes its own vitamin D when you"re exposed to sunshine. So enough vitamin D can be obtained by spending 15 minutes in the sun i.e. between 9:00 am-10:00 pm at least two to three times a week. Generally, normal levels that are built up in the summer will be enough to last through the winter.Go Easy on The ProteinExcessive amounts of meat, cheese and protein make body acid, which drains the body of calcium and weakens bones. Keep your diet balanced.Your meals should contain protein (meat, fish, eggs, nuts, and seeds), fresh fruits and vegetables, and carbohydrates (bread, pasta, potatoes and rice) in order to built strong bones.Quit SmokingThe more you smoke, the more likely you’ll get osteoporosis. Aim to cut down or, better still, quit smoking altogether.Cut Out The SaltSalt is thought to speed up the body’s loss of calcium. Most of us consume 9 gm of salt a day, but the recommended limit is 6 gm, which is just a teaspoonful. Don’t add top salt to your food, and look at food labels to help you cut down.Avoid foods that contain 1.5 gm of salt per 100 gm (or 0.6 gm of sodium) or more. Crisps, ham, cheese, cooking sauces and processed foods such as pies, pizza and soups are all high in salt.Be ActiveBones get stronger when you use them. The best way to strengthen them is to do exercises at least five times a week. This includes walking, running, dancing, golf, tennis or netball. It doesn't include cycling or swimming (although swimming is good for staying flexible).Bones also benefit if you lift and carry things. Weight training is ideal, but carrying shopping, gardening and housework all count.Drink SensiblyAlcohol, tea, coffee, cola and other fizzy drinks reduce the amount of calcium you absorb, and weaken bones. Stop your alcohol cravings or stick to the recommended amounts of alcohol, swap your caffeine-fueled drinks for water and diluted juice.Maintain a Healthy WeightLosing too much weight too fast under a crash diet can increase your risk of osteoporosis.Weight loss can cut the amount of estrogen (a hormone that helps to protect your bones) in your body. If you need to lose weight, do it sensibly. Gradual and steady weight loss with a healthy planned regime by a professional health expert is what is recommended.Other ConsiderationsPlant chemicals called photochemical, or phytonutrients, may also impact bone strength. Isoflavones, which are found in soy and legumes, have shown a positive effect on bone density in some studies, but others have failed to find a correlation. The Linus Pauling Institute at Oregon State University reports that a few small studies have also found evidence that plant compounds called lignans, found in flax-seed, may help reduce the risk of osteoporosis.If the base of any structure is strong, it is bound to have a long steady life. Same goes with our bodies. Our skeletal system is the basic foundation, of which bones are the major constituents. Stronger skeletal system ensures that your body will go a long way. What needs to be done is to follow a regular healthy lifestyle routine!

Bone Health: Tips to Keep Your Bones Healthy

Dr. Vinay Gupta, Orthopedist
Bones play many roles in the body — providing structure, protecting organs, anchoring muscles and storing calcium. It’s a fact of life: As you age, your bones lose their density & one becomes more prone to injury. While it's important to build strong and healthy bones during childhood and adolescence, you can take steps during adulthood to protect bone health, too.Protecting your bone health is easier than you think.1. Eat calcium-rich foodscalcium rich food productsMilk, yogurt, and cheese are rich natural sources of calcium. In addition to dairy product food rich in calcium are dark leafy green vegetables like broccoli& Collard green, fish with bones such as salmon, sardines or whitebait, almonds, fortified tofu and soy milk.2. Take calcium supplementsThe daily allowance for calcium is 1,000 -1200 mg a day during your 20s, 30s, and 40s. But your need rises as you age. Check with your doctor before starting supplements to find out what amount is right for you.One can calculate individual calcium requirement at http://www.medindia.net/patients/calculators/daily-calcium-chart.aspTable 1: Recommended Dietary Allowances (RDAs) for Calcium     Age                  Male          Female     Pregnant     Lactating0–6 months*       200 mg          200 mg7–12 months*     260 mg         260 mg1–3 years              700 mg          700 mg4–8 years              1,000 mg      1,000 mg9–13 years            1,300 mg      1,300 mg14–18 years         1,300 mg       1,300 mg19–50 years         1,000 mg       1,000 mg      1,000 mg          1,000 mg51–70 years         1,000 mg       1,200 mg71+ years              1,200 mg       1,200 mg3. Add Vit-D to your dayTo help absorb calcium, most adults need 1,000 to 2,000 IU of vitamin D daily. Combined calcium-vitamin D pills usually do not meet this requirement. Taking a vitamin D supplement will ensure you meet your daily needs.4. Start weight-bearing exercisesPeople who are physically inactive have a higher risk of osteoporosis than do their more-active counterparts. To boost your bone strength, try an exercise that “loads” or compresses your bones- Running, jogging, high-impact aerobics, repetitive stair climbing, dancing, tennis, and basketball are best for building bones. Be sure to clear any exercise plans with your doctor first.5. Don’t smoke, and don’t drink excessivelyQuit SmokingResearch suggests that tobacco use contributes to weak bones. Similarly, regularly having more than two alcoholic drinks a day increases the risk of osteoporosis, possibly because alcohol can interfere with the body's ability to absorb calcium6. Get your bone mineral density testedDoctors can get a quick and painless “snapshot” of bone health using a simple X-ray test called DXA. This test measures bone mineral density and helps determine risks of osteoporosis and fracture7. Consider medicationPerimenopausal women may consider hormone therapy to increase waning estrogen levels, which are linked to bone loss. And women and men diagnosed with osteopenia or osteoporosis can take various medications to prevent dangerous hip and spine fractures. Talk to your doctor about options such as bisphosphonates or teriparatide

Strengthen Your Bones With These Tips

Ms. Swati Kapoor, Dietitian/Nutritionist
Bones are always at a risk of Osteoporosis, especially the spine, hip and wrist bones. They get stronger once you use them, so exercise acts as a medicine for people suffering from bone related diseases. If you're not worried about bone loss because you're young, keep in mind that weak bones can strike at any age and occur in both men and women, according to the National Osteoporosis Foundation. Bones are also benefited if you lift and carry things. Weight training is ideal, but even carrying shopping bags, gardening and housework counts.Why exercise?Bones, likes muscles, are living tissues .Young women and men who exercise regularly generally have higher bone density and strength than those who do not. For most people, bone mass peaks during the third decade of life. After that time, we can begin to lose bone density and mass. Women and men older than age 20 can help prevent bone loss with regular exercise. Exercising allows us to maintain muscle strength, coordination, and balance, which in turn helps to prevent bone related issues and other medical conditions. This is especially important for older adults and people who have been diagnosed with osteoporosis.Exercises for healthy bonesAccording to Dr. Jon Tobias, a professor of rheumatology at the University of Bristol who studies bone health, running and jumping are the most effective ways to improve bone health because these exercises create ground forces that move through the bones and stimulate them to reconstruct themselves. It even increases bone density.According to the National Osteoporosis Foundation, the best exercises for building and maintaining bone density are:Weight-bearing exercise, such as walking, that makes you work against gravity while staying upright.Muscle-strengthening exercise, such as weight lifting, that makes you work against gravity in a standing, sitting, or prone position.There are some non -impact activities which are posture related, balancing exercises and might help one get relief from bone related problems. Although these exercises don't build or maintain bone density, they may increase muscle strength and decrease the risk of falls and fractures.If your doctor determines that it's not safe for you to perform high-impact weight-bearing exercises, he or she may recommend low-impact weight-bearing exercises that are less likely to cause fractures and also build and maintain bone density. These include:elliptical training machineslow-impact aerobicsstair-step machineswalking (either outside or on a treadmill machine)If you're new to exercise, or haven't exercised for a while, you should aim to gradually increase your level of weight-bearing exercises to 30 minutes per day on most days of the week.

Alveolar Bone Grafting in Cleft Surgery

Dr. Kamlesh Kothari, Dentist
Alveolar bone grafting surgery is one of the most important parts of treating cleft lip, alveolus, and cleft palate defect. Therefore, it is essential for the patients to get treated at the right point of time to avoid any long term issues. The best time for this surgery is around 9-11 years when the canine is erupting as it provides bone support to the erupting tooth. There are various aspects which are associated with the cleft surgery which ensures that the patients are integrated into a normal functioning and anatomical condition at the earliest. Here are some of the benefits of the alveolar bone graft :Provides bone supportProvides support to the upper jaws which thereby leads to better chewing and aesthetics.Provides better stability to the bone present around it, thereby creating a strong base for the teeth in the later years.Here are some of the important measures to be taken for the during the cleft surgery:Managing the child patientMost children patients do not co-operate with the cleft team due to past trauma and fear. They have to be counselled well by the parents and the child specialists and motivate them to co-operate in the whole procedure. Co-operation from the child is importantChoice of the bone tissue The survival of the bone tissue taken for the alveolar bone surgery needs to suit the patient’s oral cavity to function properly throughout the life. Also, the tissue should not react as a foreign material inside the oral cavity. For this, persons own bone is used. Cancellous bone (rich is cells) is preferred over the cortical bone (hard)  in most of the cases as the former bone has better vascularity and more bone regeneration.The Site of donor's boneVarious parts of the body are kept as options while deciding the source of the alveolar bone in the cleft lip and palate surgeries. The hip bone is rich is bone cells and  is the most chosen  donor bone for the most alveolar bone surgeries. This ensures that the alveolar bone grafting gets the right type of the donor's bone for highest success.  Proper care is taken by the consulting dentists and surgeons regarding the right time of the commencement of the alveolar graft procedure. Most of the children who undergo this treatment are in the age range of seven to eleven years. Here, the important aspect is the consideration of the dental health of the patients. Therefore, the age of the patient is not as important as the teeth condition. Concurrent orthodontic treatment is mandatory to expand the arch and align the teeth into proper position

Do You Have a Bone to Pick With Arthritis ?

Dr. Vishwas Virmani, Physiotherapist
Inflammation of the joints, accompanied by symptoms like stiffness and excruciating pain, is called arthritis. Once called the 'old man's disease,' arthritis generally affects adults over 65. It can affect people of all ages. There are various types of arthritis viz osteoarthritis, rheumatoid arthritis, autoimmune arthritis, infectious arthritis, juvenile arthritis and more. The types vary depending on age and which part of the body is involved. For example, rheumatoid arthritis is common among the old and the injured, while juvenile arthritis affects only children.When do you know you have arthritis?Given that arthritis isn't just an old man's disease, here's a list of symptoms. You could have arthritis if you:Have a sprain or muscle tear that refuses to heal, get your doctor to take a look.Encounter numbness and a tingling sensation in the hands (are caused when inflamed tissues press against nerves in the hand and feet).Experience frequent bouts of foot pain, irritation and swelling of the joint linings (the swelling occurs due to an accumulation of white blood cells in the inflamed area.)Have inordinately stiff muscles when you start moving after a period of inactivity.Can feel firm lump-like nodules under your skin especially near the affected joints.What causes Arthritis?Different types of arthritis occur due to different reasons. Injury, abnormal metabolism, heredity, uric acid crystals, infections such as lyme disease, and an overactive immune system are some common causes.Does it primarily affect men?No. Research actually suggests that it affects women more than it does men, rheumatoid arthritis in particular. However, studies have also shown that the symptoms of this disease decrease when treated at an early stage, particularly among men.TreatmentThere are several treatments for arthritis today, the aim of which is to ease out pain and initiate a comfortable living. There are certain remedies that are commonly applicable, as listed below.Applying ice packs to swollen joints may relieve acute pain, while maintaining a balanced diet and controlling one's weight can help manage pain in the long run.Doctors also prescribe routine exercises as a part of the arthritis treatment, as exercising gives strength to the muscles and keeps the joints flexible.Using neoprene sleeves and other supportive devices can help lessen the wear and tear of joint cartilage, thus reducing pain.PreventionThere is currently no preventive treatment for arthritis. However, if detected at an early stage, arthritis can be cured completely.If you can literally feel it in your bones, don't hesitate to consult a doctor. Remember, even if it can't be prevented, arthritis can definitely still be treated. 

Build Strong Bones and Eliminate Knee Inflammation

Dr. Vishwas Virmani, Physiotherapist
There’s no doubt that remaining active is crucial for building and strengthening your bones. But if any part of your body is in pain – especially weight-bearing joints such as your knees – it’s pretty hard to keep moving.That’s why today we’re going to discuss the importance of avoiding knee problems, and easy ways to prevent and relieve knee pain, including a simple exercise you can do at home.Not All Exercise is the SameIf you’re a “Saver,” you know that not just any exercise will do when it comes to increasing bone density and strength. As I explained in the Save Our Bones Program, to really build bone, you need to engage in weight-bearing exercise that utilizes the effects of gravity on bones and muscles.When your knees hurt, though, doing such exercises is certainly difficult, if not impossible. Even getting in and out of a car or climbing a short flight of stairs becomes a painfully challenging task.The Importance of Healthy Knees for Your Bone HealthAll of your joints and bones are important, of course. But knees have a particular role in bone health because they are so central to weight-bearing exercise.Your thigh muscles are pivotal in maintaining the integrity of your knee joints. Walking, for example, is an excellent overall bone-strengthening activity, but it doesn’t target the specific muscle groups that stabilize the knee.A study from the University of Iowa showed a 50% decrease in knee pain in women who had the strongest thigh muscles in the study. Other muscle groups play a role in maintaining the knee joints as well.General Care of the KneesKnee pain does not have to be an inevitable part of ageing. I want to talk about some general tips for keeping your knees healthy, and then we’ll move on to a special knee-strengthening exercise that you can do right in your home.Keeping your hip and bottom muscles (the “glutes”) strong helps keep the pelvis at the proper angle. Strong bottom muscles align the hips and thigh bones (femurs), which in turn keeps the knee joints in proper alignment.Stretching is also important, because it keeps muscles limber and flexible. Muscles that are rigid can pull joints out of alignment, but supple muscles hold your skeleton in proper form and help absorb shocks.In our modern world, excessive sitting has become quite a health hazard. With regard to the knees, sitting weakens the outer hip and leg muscles while tightening up the inner thighs and groin muscles, creating imbalance. The knee, of course, is one of the main joints that suffer when this happens. Stretching the inner thighs and groin muscles helps even out the imbalance, especially when combined with strengthening the outer hip and leg muscles.Strengthening your core muscles also improves your knees’ integrity. It may seem odd that abdominal muscles would affect your knees, but they do. You see, when your abs are weak, your pelvis tends to tilt forward, creating a “sway back.” Strong abs “tuck” your tummy in and pull the bottom of your pelvis forward. Once again, it’s all about alignment; you can’t have healthy knee joints if the rest of your body knocks them off-balance.And now, I want to share with you an easy exercise to prevent knee aches and pains:The Knee CurlStand and hold onto the back of a chair.Lift your right leg straight out behind you, without pointing your toes.Bring your heel toward your buttocks as far as you can by bending your knee. Don’t move your hips, and keep the leg you’re standing onSlightly bent. Hold for one second, then lower to the floor.Repeat the movement 10 to 15 times.Switch legs and do 10 to 15 curls with the left leg. Then perform another 10 to 15 curls with your right leg. Finish by doing 10 to 15 curls with your left leg.
I chose this exercise not only because it is geared toward the knees, but also because it is typical of the moves you’ll find in the Densercise™ eBook System. You see, Densercise™ is designed with knee pain prevention in mind. You’ll find exercises that strengthen the thighs, core muscles, and knees without hard impact, such as:Step UpSide LungeChair DipsWall SquatsHeel LiftChair Knee LiftMountain Pose to Chair Pose and many more!You can do all these exercises right in your home – no special equipment necessary!

Love Your Bones - Say No to Osteoporosis

Dr. S.Sham , Rheumatologist
World Osteoporosis Day which is being celebrated on October 20th of every year since 1997, is actually a year long campaign to create awareness about the disease. It is important, as the need of the hour for people to understand the immense burden caused by osteoporosis and the ways to overcome it.Osteoporosis is a medical condition which leads to reduced bone mass with micro architectural deterioration and hence increasing the risk of fracture. So such fractures which occur due to trivial trauma (eg: falling from a walking height) are called fragility fractures. The sites more prone are spine, femur andradius. Osteoporosis  is usually known as the "silent killer" as it doesn’t show any prior symptoms and the person comes to know about it only after he sustains a fracture. We have so many diseases in our country so why is this so important? The current population of India is around 1.2 billion. By 2020, there will be around 76 million people with their age greater than 65 years, which is quite a significant number.Worldwide it seems every 3 seconds one sustains an osteoporotic fracture. Approximately one in three women and one in five men aged over 50 years will suffer an osteoporotic fracture in their remaining lifetime. A prior fracture is associated with a 86% increased risk of any fracture. More than 50% of hip fractures in the world will occur in Asia by 2050 and the mortality rate is around 20-24% in the first year. Aren’t these statistics quite alarming?The most sad part is  that we all have accepted this as a natural process of ageing. Whatever be our age, we shouldn’t break our bones with a trivial fall. If we do, then our bones are weak and it is not normal. It can be detected early and a fracture can be prevented with adequate treatment.It’s widely known that osteoporosis usually affects the older people. But it’s actually a disease of the young with consequences in the older age. We usually attain the peak bone mass at 20 – 30 years of age, after which there is a gradual decline in the bone mass. So in the earlier stages of life, with the help of a good diet and healthy lifestyle one can attain the maximum bone mass. If they do so, the chances of them having a low bone mass  later in life will be less.Similarly it’s usually thought as a disease of postmenopausal women. Yes of course the women are at a higher risk but men are no safer and are at a greater risk of getting a prostate cancer. Actually the mortality and morbidity post fracture is more in men. ‘Usually women maintain their health whereas men just go for repairs’. This attitude should change among men and they should also screen for osteoporosis rather than getting medical attention after a fracture. There are a lot of secondary causes for osteoporosis like drugs, various rheumatological,endocrine diseases etc. which have to be thought of particularly in males and those with fragility fractures at a younger age.So it’s high time everybody becomes aware about this disease and its consequences. It can be screened effectively by DEXA scan. After detecting osteoporosis it can be effectively managed with the likes of Calcium, Vitamin D, Bisphosphonates,Parathormone analogues, Monoclonal antibodies etc. As we all know ‘prevention is better than cure’, one should try to maintain a healthy lifestyle by regular exercises, requisite sun exposure, adequate dietary intake of calcium and vitamin D. So let’s promote the caption ‘Love your bones’ i.e. the global symbol of bone health.

Carpal Tunnel Syndrome

Dr. A Mohan Krishna, Orthopedist
Carpal tunnel syndrome:The carpal tunnel is the space between the bones and ligaments of the wrist through which median nerve passes. Carpal tunnel syndrome develops when the nerve becomes compressed. It is common condition of the hand that affects women more frequently than men.The symptoms of carpal tunnel syndrome include:Pins and needles or tingling sensations (Paraesthesias) Pain or numbness in the hand, typically worse at the night.Clumsiness and weakness of the hand.A weak grip and an impaired ability to bring the thumb across the palm to meet the other fingers.Pain in the wrist,forearm or shoulder.Causes:Any condition that narrows the carpal tunnel or produces swelling of or fluid retention by the contents of the tunnel can cause carpal tunnel syndrome. The many possible causes includeHormonal changes.Obesity,Diabetes mellitus,Rheumatoid arthritis,Acromegaly – bone enlargement due to pituitary gland abnormality.Under activity ofthyroid (hypothyroidism)Renal failure,AlcoholismAmyloidosis : rare condition in which abnormal proteins accumulate in tissues and organs.Paget’s disease: a chronic bone disease that affects elderly people. The bones become deformed and thickened.Tumors: such as lipoma (Fatty tumours), ganglions (fluid filled cysts formed in tendon), and deformities of wrist after the fractures.The use of hand held vibrating tools – very rarely causes carpal tunnel syndrome.Diagnosis:The typical history of pain and weakness in the hands usually suggest the diagnosis of carpal tunnel syndrome, but it is important to exclude other conditions that may produce similar symptoms, such as a prolapsed cervical disc or arthritis of thumb joint.Clinical examination:This may reveal disturbances in sensation in the area supplied by the median nerve,wasting of the muscles at the base of thumb and poor grip.Tinel’s sign: tapping the median nerve at the wrist may reproduce the pain and tingling of carpal tunnel syndrome in the affected person. Flexing the wrist against resistance has  a similar effect.Imaging:an x-ray of the wrist may be used to rule out bony abnormalities, while MRI gives a clear picture of the soft tissues. Nerve conduction studies: Nerve conduction studies are conducted to see the conduction and velocity of impulses across the median nerve. This test can be used for documentation of carpal tunnel syndrome.Treatment:Treat the underlying cause: The underlying causes should be treated. For example overweight patients should be encouraged to lose some weight and patients with hypothyroidism should receive thyroid hormone replacement therapy.Some patients recover without treatment, while others respond to rest or simple measures such as the use of wrist splint for week or so. In cases where the condition is persistent however several treatments are available.Anti-inflammatory drugs: may help to relive tendon swelling and pressure on the wrist in rheumatoid arthritis.Wearing night splints at night, which hold the wrist, slightly forward, may help night pain.Diuretics (which increase the volume of urine) are sometimes prescribed to remove excess fluid from the body.Steroid injections into the carpal may provide relief, but must be performed with utmost care. It is particularly important not to inject the median nerve itself any improvement may be temporary.In persistent cases,surgery will be performed in order to reduce pressure on the large media nerve.Surgery:Surgery is usually advisable for persistent or worsening symptoms to prevent permanent loss of sensation and wasting of the muscles in the hand. In such cases without surgery, symptoms are likely to persist. Surgical treatment usually involves dividing transverse carpal ligament in order to relieve the pressure on the median nerve. Freeing the nerve enables normal nerve conduction to resume.Traditionally, median nerve decompression was open surgical procedure, but also new technique of endoscopic carpal tunnel release is also being practiced.Generally, both open and endoscopic techniques have excellent results although it may take few months for grip strength to return to normal.

Not All Fractures Are the Same!!

Dr. N Srinivas, Dentist
When tooth gets chipped or fractured,the first consideration must be whether the pulp- the vital, living portion of the tooth has been damaged. If a fracture is sensitive, painful, or uncomfortable,it may be because the pulp is exposed. Ultimately, the condition of the pulp and the amount of remaining tooth structure will determine the choice of treatment.What kind of fracture do you have?Minor fracture: Minor fractures,such as small chips off the biting edges of the teeth,are usually simple to repair. If the chipped tooth is of sufficient length, it may be cosmetically contoured. Often,the neighbouring teeth are also contoured so that no one tooth stands out from the rest. Or, an acid-etch bonding technique may be used to 'fill out' the defect. Crowning should be avoided in case of minor fracture whenever possible. Remember that it is always best-at least initially-to try simple therapies that preserve the colour, shape, and health of the tooth.Porcelain crown fracture: A porcelain crown fracture may also occur. Keep an eye on your metal bonded crowns to see if dark outlines appear at the gum line. If a dark outline gradually appears, you may have a fracture of the crown or shrinkage of the gum tissue. If a fracture has occurred, the loss of porcelain at the gum line may weaken the remaining restoration,making it susceptible to additional damage. Eventually the entire crown may have to be replaced.Serious fracture: Serious fracture,which is often caused by accidents, are best treated with the least amount of additional stress possible. Your dentist may choose to bond some teeth and crown others,especially when time is needed to determine if the nerves in the teeth can be saved. If you have a fracture see your dentist as soon as possible if you aren't experiencing any pain. Often, the only sign of pulpal damage is tooth discoloration. In such cases,the damaged nerve is replaced with a root canal filling.Vertical root fracture: Tooth removal is only choice left.