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Spinal Stenosis – A potential midlife crisis

The Kashmir Monitor

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Do you often search for a chair to sit while attending a social gathering? Do you often experience numbness, weakness or a tingling sensation in any one or all of these areas like your feet, legs, hands and arms; or face problems while walking or with balancing yourself? If yes, then you could be at a risk of having spinal stenosis.
The disease mostly affects people in middle and older age groups, where the space available for the nerves in our backbone becomes narrower than normal and causes a pinching effect on the nerves and spinal cord. Untreated severe spinal stenosis may progress and cause permanent numbness, weakness, balance problems, incontinence or urine/stool and may lead even to paralysis.
What Is Spinal Stenosis?
Dr Arun Bhanot of Columbia Asia Hospital, Gurugram, said, “Our spine is made up of a series of connected bones and shock-absorbing discs. It protects our spinal cord, a key part of the central nervous system that connects the brain to the body. The cord rests in the canal formed by the vertebrae. In spinal stenosis, the spinal canal becomes narrow and the open spaces between the vertebrae may start to get smaller. The stiffness can squeeze the spinal cord or the nerves around it, leading to pain, tingling or numbness in legs, arms or torso.”
Spinal stenosis is a slowly progressive disease that does not cause much pain at rest or while sitting. However, when such patients stand and walk, the spinal cord gets compressed and the patient may feel pain, heaviness, tingling and numbness in the legs accompanied by weakness and a tendency to lose balance. But just after a few minutes of sitting, the symptoms improve and the patient can walk again for a few meters. There are various nonsurgical treatments and exercises to help keep the pain at bay.
What Causes Spinal Stenosis?
“Spinal stenosis is mainly caused by wear and tear of degenerative process that manifests in the form of arthritis, the condition caused by the breakdown of ligament, the cushiony material between bones and the development of bone tissue, and additionally thickening of different ligaments around the spinal cord and nerves. The degenerative procedure can lead to disc changes, thickening of the ligaments of the spine, and bone spurs. This can put weight on the spinal cord and spinal nerves. Cracked herniated plates may allow a portion of the delicate internal material to escape and push on the spinal cord or nerves,” said Dr. Sumit Sinha of Paras Hospitals, Gurugram.
Besides this, the ligaments that hold the bones of spine together can turn out to be hardened and thickened after some time causing swell in the spinal canal. Likewise, any new development inside the spinal segment can encroach on the space accessible for spinal cord, hence leading to secondary spinal canal stenosis. Swelling of nearby tissue immediately after back medical procedure can put weight on the spinal cord or nerves.
Is There a Treatment?
Today, a minimally invasive surgical treatment is available for patients where the ailment can be treated using a small calibre high powered camera (endoscope) that creates a tiny 8 mm hole in the back and removes the pressure from the nerves very safely and effectively.
The benefit of the endoscopic technique is that the patient can avoid getting a big cut in the spine and his recovery is even faster. Some of these patients may require a microscopic decompression and use of metal screws and rods to stabilise their spine. However, in many such cases, the surgeon can avoid putting in any additional metal screws and rods in the spine by using the endoscopic technique, thus reducing the cost of treatment as well.
With advancement in other allied fields like medicine, cardiology and anesthesia, the patients even in their eighties and nineties can avail the benefits of surgery with a fairly good outcome.


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Health

Health Problems from Wearing Heels

The Kashmir Monitor

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Heels are one of those great inventions that make anything look fabulous, but is a torture device at the same time. Podiatrist have a distinct hatred for heels and the health problems it brings to the wearer. We wear heels as part of our professional attire or for fashion, but at the end of the day we all slump up on our sofa saying “my feet is killing me”. Who knows why we still allow ourselves to go through this torture, but wearing heels does make you feel a little bit more powerful.

Human feet are not designed to wear heels all the time. Our feet are designed at a 90 degree angle to fully support our frame, altering it to a 60 or 45 degree angle will alter the foot function and position causing health problems. Below are some of the health problems you will encounter from wearing heels overtime.

Posture

 

Heels will increase the pressure on your forefoot and making you adjust your posture to maintain balance. Your lower body will tend to lean forward as your lower body leans backward. Long period of keeping this position will affect the posture.

Back

The back and spine have a normal S- curve that helps absorb shock and lessen pressure on the spine. Wearing heels will flatten this structure and alter the body’s positioning. This poor alignment will cause you to use more muscles, causing muscle pain and back pain. Posterior displacement can be fixed with the help of a medical professional.

Toe Pain and Ankle Pain

Wearing heels will increase the pressure that your toes and ankle face. Trying to balance out your body structure while wearing heels can wear down the joints in your ankles and cause muscles inflammation and calluses on the feet and toes.

Corns and Keratin Build-up

Corns and Keratin build-up will start to appear on the feet due to the pressure on the skin. Corn usually appears under the balls of the foot where most of the weight is pressed down. This corns will feel like small rocks and can cause discomfort.

Nerves

Pinched nerves or neuromas can cause mild to severe pain to wearers in the future, leaving it untreated can cause severe damage in the future.

Crack on the Bones

Wearing heels for a long period of time will result in cracks in the bones of the feet and stress fractures.

Tips:

Choose low heels that have a slightly thicker heel. This will allow more balance and spread the pressure on your feet.

Wear soft insoles. Wear rubber soled shoes instead of leather, this will absorb pressure better.

Wear heels when there is limited standing or walking. Bring flat shoes when commuting or walking for a long period of time.

Stretch every day, especially leg and calf stretches in the morning and at night.

Take in calcium supplements to make the bones stronger.

Wear heels are seldom as possible.

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Health

Obesity can impair learning, memory: Study

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Obesity can break down our protective blood brain barrier resulting in problems with learning and memory, a study has found. Chronic activation of the receptor Adora2a on the endothelial cells that line this important barrier in our brain can let factors from the blood enter the brain and affect the function of our neurons, scientists said.

The team from Augusta University in the US have shown that when they block Adora2a in a model of diet-induced obesity, this important barrier function is maintained. “We know that obesity and insulin resistance break down the blood brain barrier in humans and animal models, but exactly how has remained a mystery,” said Alexis M Stranahan, neuroscientist at Augusta University and corresponding author of the study published in The Journal of Neuroscience.

In the brain, adenosine is a neurotransmitter that helps us sleep and helps regulate our blood pressure; in the body it’s also a component of the cell fuel adenosine triphosphate, or ATP.Adenosine also activates receptors Adora1a and Adora2a on endothelial cells, which normally supports healthy relationships between brain activity and blood flow.

 

Problems arise with chronic activation, particularly in the brain, which is what happens with obesity, Stranahan said in a statement. People who have obesity and diabetes have higher rates of cognitive impairment as they age and most of the related structural changes are in the hippocampus, a centre of learning and memory.Fat is a source of inflammation and there is evidence that reducing chronic inflammation in the brain helps prevent obesity-related memory loss.

For the study, young mice fed a high-fat diet got fat within two weeks, and by 16 weeks they had increases in fasting glucose and insulin concentrations, all signs that diabetes is in their future. In the minute vasculature of the hippocampus, the researchers saw that obesity first increased permeability of the blood brain barrier to tiny molecules like fluorophore sodium fluorescein, or NaFl. Diet-induced insulin resistance heightened that permeability so that a larger molecule, Evans Blue, which has a high affinity for serum albumin, the most abundant protein in blood, also could get through.

When they looked with electron microscopy, they saw a changed landscape. Resulting diabetes promoted shrinkage of the usually tight junctions between endothelial cells and actual holes in those cells. When they gave a drug to temporarily block Adora2a, it also blocked problems with barrier permeability. Whether that could work in humans and long term as a way to avoid cognitive decline in obese humans, remains to be seen, Stranahan said.

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Health

‘Love hormone’ may help treat alcoholism, says study

The Kashmir Monitor

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A nasal spray of ‘love hormone’ oxytocin may help treat alcohol use disorder, according to a study conducted in mice.

Oxytocin plays a role in social bonding, sexual reproduction, childbirth, and the period after childbirth.

The study, published in the journal PLOS Biology, found that oxytocin blocks enhanced drinking in alcohol-dependent rats.

 

Targeting the oxytocin system may provide novel pharmaceutical interventions for the treatment of alcohol-use disorder, said researchers from the National Institutes of Health and The Scripps Research Institute in the US.

Administering oxytocin can decrease consumption, withdrawal symptoms, and drug-seeking behaviour associated with several drugs of abuse, researchers said in a statement.

This shows promise as a pharmacological approach to treat drug addiction, they said.

Researchers tested the hypothesis that oxytocin administration could normalise the maladaptive brain changes that occur in alcohol dependence and thereby reduce alcohol drinking in an established rat model of alcohol dependence.

They investigated oxytocin’s effects on dependence-induced alcohol consumption and altered signalling of the inhibitory neurotransmitter GABA in the central nucleus of the amygdala (CeA) – a key brain region in the network affected by alcohol dependence.

The experiments demonstrated that oxytocin administered systemically, intranasally or into the brain blocked excess drinking in alcohol-dependent but not in normal rats.

Moreover, oxytocin blocked GABA signalling in the CeA, researchers said.

Taken together, these results provide evidence that oxytocin likely blocks enhanced drinking by altering CeA GABA transmission.

These results provide evidence that aberrations in the oxytocin system may underlie alcohol use disorder, researchers said.

Targeting this system, possibly by intranasal administration, could prove a promising therapy in people who misuse alcohol, they said.

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