introduction of diclofenic sodium by sp new instrument

" trans ionnic ''' for pain relief in shoulder tendinitis

results are promising.

This is the case of Mr. S. P (Patient Ref. No. PS - 396), a 29 years old male patient who reported to the clinic with complaints of pain in the anal region since 5 -6years. He would get shooting pains in the anal region that would last the whole day long. The pain would get worst during stools. He would also experience increased intensity of pain while sitting, traveling, at night and early morning. Application of hot water would relieve the pain to some extent. There would also be some amount of bleeding during the passage of stools. There was no history of passage of mucus with the stools. Bowels would be chronically constipated and he would have to strain much to pass stools.
Patient was taking homoeopathic treatment without improvement then he started allopathic treatment but no improvement. At last patient was ready for operation but last moment he refused operation & again start homoeopathic treatment.
His appetite is normal and he is very fond of sault, sweets. Thirst is excessive. He would be comfortable in the cold weather and could not tolerate sun heat, warm atmosphere. Constitutionally he is stoky & average height. Recurrent apthe in mouth especially when suppressed anger. White spot in nails, profuse perspiration over upper lips, saulty in test.
Mr. S is coming from well settle nuclear family of Brahmin. He is only son of parents. His father is engineer in GEB, irritable by nature. He was often irritated over patient in matter of study. Patient also irritate in front of him. Mother is house wife, good by nature. Younger sister is also good in nature.
Good in study. He took part in sport & cultural activities. He completed Msc & doing job as a teacher in higher Secondary school. He had habit of cigarette smoking, take much spicy food & irregular in diet during the Msc. This the time when complaint started. He had iften fight in collage time. He is irritable by nature. Irritate very easily. He is can not tolerate any opposition, indignation. He is reserved kind of person. Revengeful. He is particular in work. He did not like if anybody cheat. Sentimental. Never see the pain of others. He told that now he is control his anger after death of his close friend. He wept lots when his friend dies. Still remember.


He does not like authority but working as a teacher with own principal. He never accept all the things of trusty. Many times disput occur with management.
4 weeks was all that was required to give him more than 80-90% relief in his symptoms of painful defecation and he was back to his work. He was prescribed a remedy named Nat. Mur as a constitutional remedy & Nitricum Acidum along with another one called Aesculus as a acute remedy. He continued the treatment for some more time and his symptoms were under good control now. He would not have any bleeding or pain now and his complaint of chronic constipation was also effectively taken care of with the medicines. At the end of one year the patient stated that he had completely forgotten the fissure now.
Remark: Homoeopathic medicine do miracal work in surgical cases if right medicine, right potency & frequency.

Kumar�s Hospital
( Jodhamal Road, Hoshiarpur)

DIABETES MELLITUS- How to stay healthy.

Do you know that Diabetes mellitus or commonly known as �sugar� is spreading very fast in India. According to one estimate at present rate by 2050 every Indian will be diabetic. Reasons are many but more important ones are stressful life, fast food habits, sedentary lifestyle, and may be genetic predisposition.

If you are diabetic follow these tips.
Diet modification:
Avoid;
1. Sugar in all forms, sweets, fried food,
2. Potatoes, rice, sweet potatoes, refined wheat flour (Maida)
3. Mangoes, grapes, litchi, banana,
4. Cold drinks, alcoholic drinks, smoking
5. Fast foods, deep fried foods, canned juices, canned fruits, ice creams, non veg. foods
Take;
1. Lots of salads,
2. Vegetables cooked in refined oils
3. Chapattis made from whole-wheat flour preferably mixed with gram and Soya flour.
4. Fruits: - oranges, mossumbies, papaya, plumes,
5. Nimbu paani without sugar, tea/coffee without sugar, fresh fruit juices (oranges/mossumbies) without sugar and lots of plain water.
6. Roasted or plain Nuts like almonds/ground nuts/cashew can be taken in moderation.
(For further details contact your doctor)
Life Style modification:
Since Diabetes mellitus is a life style disease it is very important to modify it.

� Do light aerobic exercise daily
� Like walking briskly for about 5 kms daily
� Do pranayam for one hour or yoga
� Cycling/Swimming
� Reduce weight � attain your ideal weight i.e- 23 x Height2 (in meters)
� Don�t over work and over stretch yourself. � Find time to relax, spend time with family. Free your mind from daily tensions. Try meditation for 15-20 minutes daily
� Do get up from your chair and move around in office from time to time.
� Take a walk to neighborhood groceries or vegetable market instead of going in a car.
� Dispense with peon and do small menial jobs-like taking out / putting back files from cabinet yourself.

Medical Consultation;
� Consult your doctor for medical check ups at regular intervals and follow the instructions.
� Keep your blood sugar level, blood pressure and weight in control with or without medicines.
� Always keep your drug record /blood sugar level record /contact number of your home and doctor with you.
� Take your medicines regularly

Tips for Special Care of Body
You should take special care of your body because you know that in a diabetic wounds and infections take longer than usual to heal Some times there is loss of sensation in hands and feet due to the damage to the nerves, and any minor injury goes unnoticed until it is too late. Diabetes also leads to restricted blood supply to body parts thus causing delayed healing and infection.
Report to your doctor:
� Any numbness or tingling sensation in hands, arms feet or legs...
� Any blurring of vision or diminishing of vision
� Any skin infection or injury.


Do the following:
� Daily check your feet and hands for any minor cuts, scratches, blisters, swelling and discoloration, at the time of taking bath.

� If you find any of above then rinses the area with clean tap water, apply some antiseptic cream or band-aid etc. Consult your doctor at the earliest. Don�t ignore it can be dangerous.
� Wash your feet daily with lukewarm water and soap, and dry them taking special care of area between the toes. Apply some moisturizing cream to feet but don�t apply in between the toes. Keep the inter digital spaces dry or sprinkle some anti fungal powder. (Candid)
� Choose your footwear carefully _ these should be neither tight fitting nor very loose and insides should be soft smooth and well cushioned. Don�t wear new shoes for longer periods continuously. - Always examine your feet afterwards for blisters, ulcers or discoloration
� If your feet remain numb then be extra cautious:
o Don�t wear open shoes/sandals etc. Always wear nice fitting shoes with soft inside with cotton socks. In summers and rainy seasons, sprinkle some anti fungal talcum powder (Candid powder) on your feet before putting on socks. If possible do remove shoes and socks for some time during day so that moisture dries up and massage your feet for some time.
o Never walk bare foot even in your home. Use slippers made of soft rubber.
o Ensure that inside of your footwear is smooth and there are no sharp edges.
o Don�t sit near the heaters in winters. Never put up your feet in front of heaters. It can seriously burn your feet because you will not feel pain due to numbness. Similarly do check the temperature of water before immersing your feet in it. It will be better if you ask some one else to do it for you.
o Don�t keep hot water bottles in direct contact with your legs or feet -always wrap these in cotton sheet and keep away from your body.
o Don�t cut your nails too short � it can cause unnoticed injury to your fingers and toes.
� Don�t smoke: it further causes decrease in blood supply to legs and feet and worsens the condition.


Some Final Tips: 5 A�s
� Avoid unnecessary medications �
� Always consult you doctor regularly
� Allow yourself some relaxation in between busy schedule.
� Adhere to the guidelines/instructions of your doctor
� Always be happy.


Prevention: of Diabetes mellitus.

There are no definite methods to prevent the onset of Diabetes mellitus but following steps, will definitely delay its onset and decrease its severity.


� Keep your weight in ideal range.
� Avoid junk food/fast food
� Take natural, healthy food with lots of fruits/ vegetables/salads. And less of oils.
� Avoid alcoholic drinks/canned juices/canned fruits/sugary syrups.
� Do daily exercise.
� Follow life style and diet modification as advised earlier.

We can�t cure diabetes but can definitely help you to live a meaningful, healthy and complete life.
________________________________________________
Issued in public interest by: Dr. Rajender Kumar Sharma, Consultant surgeon, Kumar�s Hospital, Jodhamal Road, Hoshiarpur
Ph. 01882-220092,
________________________________________________

How The Tooth Pierces The Heart!!!



Heart Attacks:

The most common strain of bacteria in dental plaque
can cause blood clots that induce heart attacks when
they escape into the bloodstream.

Studies have found the incidences of heart disease are
about twice as high in people with periodontal (gum)
disease.

Periodontal disease is an infection that destroys the
gum surrounding your teeth and also destroys the
supporting bone that holds your teeth in place.



Incidence of Periodontal Disease: Unlike most diseases
that give us early warning signs, gum disease
progresses silently, often without pain. It may
develop slowly or progress quite rapidly. More than
half of all people over 18 have at least the early
stages of periodontal disease. Even more frightening,
after the age of 35, three out of four people are
affected to some degree.



Determining Periodontal Disease:

Early Warning Signs of Periodontal Disease are

The Gums bleed when you brush your teeth.
Gums become red, swollen, or tender.
Gums are pulled away from the teeth.
Pus oozes between teeth and gums when gums are
pressed.
Permanent teeth get loose or separate.
Persistent bad breathe.


Your dentist can help you better understand
periodontal disease and how you can prevent it. He can
quickly and painlessly check and monitor the condition
of your gums during your recare appointments.

Evidence is mounting relating gum disease to a
variety of health concerns, some that are life
threatening

Plaque bacteria threatens your teeth, gums,
restorative and cosmetic work; possibly even your life


By keeping regular re-care appointments with your
dentist, you help increase your chances for a long and
happy life.


Dr. Amjadali.Y. Budguzar
camp, pune.
+91-9822000805

Varicose Veins

What are varicose veins?

Veins are vessels which are designed to carry de-oxygenated blood back to the heart from the tissues of the body. Varicose veins, however, are abnormally dilated veins that cannot perform their function.
Varicose veins are larger veins that bulge above the skin surface which are commonly found in association with larger and deeper vein problems. If there is a deeper vein problem can be detected at an initial examination.
Dilated blood vessels often cause aching especially after prolonged standing. Although dilated blood vessels do carry blood they are not very efficient and are often not necessary to the circulatory system. The body has an already established alternative route for the blood to travel back more efficiently to the heart (deep venous system). Thus they can be treated without damaging the circulation. In fact, treatment actually improves venous circulation. The probability of a greatly improved appearance following treatment is about 90 per cent depending on the severity of the problem. Treatment will also usually relieve any symptoms caused by the veins.

What causes varicose veins?

Since our ancestors decided to stand upright, our leg veins have been faced with the difficult task of taking the blood up to the heart against the pulling force of gravity. To do this the leg veins depend on the contraction of the calf and thigh muscles to pump the blood. This is why walking is good for your circulation.
So when you walk, the contraction of your leg muscles pumps the blood up. However, as the saying goes "what goes up must come down" which is what happens to blood in the leg veins. Therefore, to prevent the blood from falling back down, nature has designed valves in the leg veins which open in only one direction: upwards. So the valves allow the blood to get through but when it comes back down, the valves shut and stop the blood going all the way down. The next contraction sends the blood even higher until it eventually reaches the heart.
In venous disease, the underlying problem appears to be damage to the valves. The abnormal reticular veins, for instance, act as "feeders" of the spider veins. The blood flow in these feeder veins can compared to a "two-way" street. In other words, blood in the feeder veins can go back and forth. This backward flow through the incompetent valves dilates up the smaller veins (medically called "post-capillary venules"). These dilated post-capillary venules are commonly referred to as "spider veins".
The same principle applies to varicose veins. The abnormal valve cannot stop the blood from rushing back down. The blood in these veins is oxygen low and in fact carries a lot of toxins. In the case of varicose veins, this "toxic" blood pools in the legs and cannot be returned to the circulation. This is why patients with varicose veins suffer from night cramps and their legs feel heavy at the end of the day.
Varicose veins occur in both men and women. A definitive cause is not known, however a strong family history suggests that some people inherit veins that are more likely to deteriorate. In women, oestrogen may play a role as the onset of puberty, pregnancy and taking oral contraceptives can give rise to vein abnormalities. In pregnancy, the enlarged uterus can restrict blood flow from the legs and promote the development of varicose veins. Spider veins and varicose veins are also associated with obesity. Occupations involving prolonged standing tend to increase the likelihood of veins to develop. Bone fractures and soft tissue trauma can cause localized vein abnormalities.

How to treat Varicose Vein?

The aim of varicose vein treatment by any method (surgical or non-surgical) is to close or remove the diseased and incompetent superficial varicose vein. Since most of the blood in the legs is returned to heart by the deep veins, and the superficial veins only return about 10 per cent, they can be sacrificed without serious harm.
Elevating the legs provides relief. Regular exercise has not shown to cure varicose vein. The wearing of graduated compression stockings with a pressure of 30-40 mmHg has been shown to provide temporary relief from the leg swelling. Anti-inflammatory medication such as ibuprofen or aspirin can be used as part of treatment for superficial thrombophlebitis along with graduated compression stockings.

1. Open Surgery

Traditionally, open surgery was the only choice for treatment of varicose vein till few years. It involved stripping the diseased varicose vein from the body. This operation is done under general or spinal anesthesia as an inpatient procedure. Multiple cuts are made on the legs at various places starting from the groin till the ankle. The vein is stripped through the open cuts. This usually is a prolonged surgery with blood transfusion. Patient is admitted in the hospital for about five days. The post-operative period is often painful with risk of bleeding from the incision sites. Multiple surgical scars on the legs are produced due to surgery. The patient is advised rest for a period of six weeks following surgery.
The higher rate of deep vein thrombosis, pulmonary embolism, and wound complications including infection and bleeding are discouraging for a patient to undergo open surgery for varicose vein.
The open surgery has a high recurrence rate (five to 60 per cent), and a risk of nerve damage up to 15 per cent. Hence now open surgery for varicose vein is less commonly performed worldwide.

2. Endovenous Laser Ablation (EVLA)

Recent advances have improved lasers, making laser surgery a preferred method of treatment for varicose vein. By LASER, the whole lining of the diseased superficial varicose vein is destroyed, and hence a chance for new collateral veins to grow is almost zero.
The Endovenous Laser ablation for varicose vein is done under local anesthesia from a single pinhole in the leg. There is no need for any cutting or stitching on the leg. The patients walk out of the Laser suite after the procedure. Normally EVLA is done as an out patient procedure or 6 to 8 hour hospitalization may be recommended.
The Laser energy seals the abnormal vein completely and permanently. The most modern 1470 nm diode laser system produces the highly wavelength, which safely passes through the skin and is selectively absorbed by the targeted blood vessel. The vein will gradually disappear, leaving the skin intact. A crepe bandage is applied on the leg for 48 hours continuously. The patient will be advised oral pain killer for five days following the procedure. Crepe bandage or stockings are worn for a couple of weeks on the calf from morning to evening. A monthly follow-up twice with Doppler scan following the LASER ablation of varicose vein is recommended.

I. Advantages of EVLA
The advantages of Endovenous LASER ablation are many. Due to the optimal absorption spectrum of 1470 nm, the veins get closed in without affecting the neighboring tissue. The closed vein remains in its natural position in the body, which reduces the invasiveness of surgery to a minimum.
The procedure is done under local anesthesia, and there is no risk of blood transfusion. The patient does not require postoperative rest, and can resume routine activities on the next day of the procedure. The treatment duration is just about half an hour. Also, there is reduced risk of infection.

II. Side-Effects
The Laser Ablation for varicose vein is well tolerated and has few side-effects. Some patients may experience a slight ache along the shrunken veins, for which local cooling and anti-inflammatory drugs will provide quick relief. Some patients may experience bruising or paraesthesia, which are self-limiting in a few days time.

3. Radio Frequency Ablation

Radio frequency ablation of varicose vein is less invasive than open surgery, but more invasive than LASER ablation and recurrence rates are lower than open surgery but higher than LASER ablation. Not many centers across the world are now practicing RF ablation for varicose vein treatment after the advent of LASER as a modality to treat varicose vein.

4. Sclerotherapy

Sclerotherapy is a non-surgical approach in the treatment of varicose and spider veins of the legs. A sclerosing solution is injected directly into the vein, causing it to quickly disappear. It has a recurrence rate as high as 70 per cent. It is never used as a sole method of treatment for varicose vein. It can be an added therapy with other mainstay treatment.

Prevention

Varicose vein is prevented by avoiding prolonged standing. Sitting for a few minutes during prolonged standing helps prevent the disease. A good compression stocking (pressure gradient of 30 to 40 mm Hg) should be worn by persons who stands for a prolonged period routinely. Maintaining a normal weight, regular exercise, avoiding constipation and avoiding wearing high heeled shoes may also be helpful.