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New Discovery – Alendronate In The Treatment Of Avascular Necrosis Of Bone

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In a ground breaking discovery Dr. Sanjay Agarwala & Dr. V.R. Joshi along with their teams have established new hope for painful joints stricken by Avascular Necrosis.

Avascular necrosis (AVN) of bone is a painful, progressively disabling disorder. The hip (femoral head) is the most common site. Untreated, it progresses to frank hip arthritis needing surgical intervention (surface replacement arthroplasty or total hip replacement).

Till date both medical (total bed rest and supportive measures) and surgical treatment like core decompression carried no more than 50% success rate.

 

Our group has been using Alendronate, a Bisphosphonate, to treat AVN of the hip for the last five years with great success. Alendronate is most commonly used to treat osteoporosis. It prevents bone resorption. An initial report appeared as a letter in the Journal of Association of Physicians of India (Vo. 49, Dec’01 issue) and was awarded the Patel-Mehta Prize. Then we reported our experience of treating over 70 cases of AVN observed over 3-5 years. Most were referred for surgical treatment. In 80% of these surgical intervention was avoided. The relief from past was seen within a few weeks. Most become freely ambulant. We are now in the process of publishing our 8 year long term results which show sustained benefit with alendronate. Today it is not possible to say how long the benefit will persist, nor how long the Bisphosphonates should be taken. Presently, patients are advised to take the drug for three years.

Those that needed surgery had advanced disease with hip joint damage already set in. In advanced stages of AVN there is resultant osteoarthritis of the joint. This requires the management of the joint arthritis and may need hip replacement or surface replacement as surgical remedies.

Concurrent animal experiments done elsewhere, independent of our studies have also confirmed the scientific efficacy of this study, and are quoted in the original papers published in scientific journals.

INSTRUCTIONS ON HOW TO USE ALENDRONATE

The tablet is to be taken on an empty stomach with one, preferably two glasses of water only (tea, coffee or juice WILL NOT do) and dissolves to become acidic.

While the stomach lining can withstand this acidity, bending forwards, or lying down, brings the acid to the mouth and food-pipe (esophagus). Hence, after taking the tablet please do not bend forward or lie down for a period of half an hour.

Likewise eating or drinking for up to half an hour will change the acidity of the stomach and prevent the activity of the tablet. Hence, do not take anything to eat or drink for up to half an hour. Therefore, I recommend you take it before you brush your teeth in the morning and continue with the rest of your daily morning rituals like bathing / shaving etc.

Alendronate is available as

Osteophos from M/s. Cipla Limited or

Restophos from M/s. Sun Pharmaceuticals in 10 mg everyday dose and 70 mg weekly dose.

In our experience once a week drug preparations are not as efficacious in the treatment of this disease and the daily regimen is recommended. In India the cost of this treatment works out to approx. Rs. 150/- a month and considering that it prevents a 1 lakh rupee operation this is a panacea in the management of these cases.

Dr. Sanjay Agarwala, Chief of Surgery, Head of Orthopaedics & Traumatology, P.D. Hinduja National Hospital.


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Health

These Nutritious Breakfasts Can Give A Kick Start To Your Day: Do Try Them!

The Kashmir Monitor

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Breakfast is undoubtedly the most important meal of the day. It is the meal which kick-starts your metabolism and helps you burn calories throughout the day. Not only is it important for people who are trying to lose weight, it is simply important for a person to stay fit and healthy. Breakfast is the one meal which can give you the energy to do things and focus at your work and school. WebMD says that including breakfast in your diet can have positive effects on your memory and concentration.

Following are some breakfast options suggested by Delhi-based nutritionist Pooja Malhotra, which can give a boost your energy and also keep you warm during the chilly winter months.

Try these healthy breakfast options right now!

 

1. Stuffed rotis

Winter is the time when a variety of vegetables are in season. Stuffed rotis or paranthas made from methi (fenugreek), mooli (radish), gobi (cauliflower), matar (peas) or gajar (carrots) can all make for a delicious and wholesome winter breakfast. You can cook them with ghee (make sure you use it in the right quantity) and eat them with pickle and curd. Stuffed rotis are essentially the traditional Indian breakfast which people have been having for years. Prepare them as your grandmother used to prepare and enjoy them throughout winter.

2. Palak or beetroot roti with mint raita

Palak or spinach is a leafy geen veggie with more health benefits than you can count in your fingers. Similar is the case with beetroot, which is a root vegetable which is incredibly low in calories and is a great source of essential nutrients like fibre, folate and Vitamin C. Beetroot also contains nitrates and pigments which can help in controlling your blood pressure and may improve your overall athletic performance.

3. Egg parantha or scrambled eggs with chapati

Now that is a protein-rich breakfast which can help you keep full for longer. Prepare egg paranthas or eat scrambled eggs with roti for the perfect blend of protein, fat and carbs in your breakfast. Also, do not separate the yolk from egg white. A whole egg will provide you with all essential nutrients.

4. Bajra roti with beetroot raita/bajra khichdi

Bajra is a healthy grain which can be included a weight loss diet as well. You can either make a dough of bajra flour or prepare bajra khichdi as a healthy breakfast option. Bajra or millets has properties that can help in stabilising cholesterol levels in the body. Being rich in fibre, the grain is great for digestion and makes for a healthy breakfast option during winter.

(Pooja Malhotra is a nutritionist based in Delhi)

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5 Super Healthy And Warm Drinks To Keep You Hydrated During Winter

The Kashmir Monitor

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Are the teas and coffees failing to keep you warm during the chilly winter? Then need not worry as we are right here with multiple options for warm and comforting drinks during winter. Warm drinking options are important to keep you hydrated during winter. Staying hydrated during summer seems to be way easier as cold and healthy drinks are aplenty. The easiest way to stay hydrated during summer is to simply gulp down a bottle of water. But in winter, the body is usually in need of something which keeps us warm and on-the-go. Keep reading if you want some alternative warm drinks instead of sipping on a third our fourth cup of coffee.

Drinks to keep you warm and hydrated during winter

Turmeric latte:

 

Well, this is nothing but our very own haldi doodh. It is the traditional drink which is taken when a person is suffering from cold or fever. It is a healing drink which can naturally detox your body and even strengthen your bones.

Ginger, honey, lemon tea:

Yes, this is another traditional drink which can be taken in warm form as well. You can create a tea concoction by adding ginger, honey and lemon to water and bring to a boil. It can make for a refreshing and warming drink during the chilly winter months.

Hot mulled cider:

All you need to do is add cardamom, peppercorns, star anise, ginger, lemon and cloves to apple cider vinegar. Add a tinge of all these ingredients in a cup of ACV and heat it in low flame. The drink is going to make for a flavourful companion to you and your favourite book by the fireplace.

Vegetable/chicken/bone broth or soup:

Soups or broths are filling and extremely warming during the cold winter months. You can either prepare steaming hot vegetable soup or broth or chicken soup or bone breath. Broths and soups are fluids which can help you hydrated during winter while also boosting your immunity and protecting your from catching a cold or infection. Just make sure that their preparation is light and healthy.

Vanilla-almond steamer:

Now this is a toasty treat you all have been craving! All you need is some warm milk, cinnamon, vanilla and some almonds. This velvety winter drink is going to be your all time favourite! What’s more is that you can prepare it beforehand and have it when you’re ready for a warm treat for yourself.

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Fasting can improve overall health, study suggests

The Kashmir Monitor

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Fasting influences the circadian clock and fasting-driven cellular responses, which together work to achieve fasting-specific temporal gene regulation.

Fasting can lead to improved health and provide protection against ageing-associated diseases, a recent study suggests.

According to the research, fasting affects circadian clocks in the liver and skeletal muscle, causing them to rewire their metabolism, which can ultimately lead to improved health and protection against ageing-associated diseases. The study was published recently in Cell Reports.

 

The circadian clock operates within the body and its organs as intrinsic time-keeping machinery to preserve homeostasis in response to the changing environment. And, while food is known to influence clocks in peripheral tissues, it was unclear, until now, how the lack of food influences clock function and ultimately affects the body.

“We discovered fasting influences the circadian clock and fasting-driven cellular responses, which together work to achieve fasting-specific temporal gene regulation,” said lead author Paolo Sassone-Corsi.

“Skeletal muscle, for example, appears to be twice as responsive to fasting as the liver,” Paolo asserted.

According to the researchers, fasting is able to essentially reprogram a variety of cellular responses. Therefore, optimal fasting in a timed manner would be strategic to positively affect cellular functions and ultimately benefiting health and protecting against ageing-associated diseases.

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