Viscosupplementation for Knee Arthritis

Hyaluronan injections are a treatment option for osteoarthritis of the knee. In osteoarthritis, as cartilage wears away, synovial fluid changes and loses its ability to lubricate the joint. Pain, stiffness, and limited range of motion for the affected joint are the result of the deterioration. The treatment which injects hyaluronan into the knee, known as viscosupplementation, is an effort to improve the lubrication of the knee, reduce pain, and improve range of motion. Here are some things you should know about hyaluronan injections.
Hyaluronan is usually not a first line treatment for knee osteoarthritis.
Typically, hyaluronan injections (also sometimes called viscosupplements) are recommended for patients who have not found adequate pain relief from more conservative treatment options:
• Medications
• Exercise / Physical Therapy
• Weight loss if patient is overweight
• Heat and cold
• Assistive mobility devices (e.g., cane)
Although, hyaluronan injections are not usually recommended before trying other treatment options, the best result usually occurs if the patient is in the early stages of osteoarthritis. Patients in the later stages of osteoarthritis, who may be waiting for knee replacement surgery, are considered good candidates for hyaluronan injections so they hopefully can get some relief while waiting.
How well hyaluronan injections work has been debated.
Clinical studies have concluded that hyaluronan injections can decrease pain and improve function in patients with mild to moderate osteoarthritis of the knee. There is no evidence that suggests hyaluronan injections affect the underlying disease course. It is clear that the injections are not a cure.
Among patients who were helped by hyaluronan injections, when pain relief occurred was variable.
The most significant pain relief occurred 8 to 12 weeks after the first injection for most patients. Studies have shown that Synvisc and Hyalgan provide pain relief from knee osteoarthritis for up to six months, with some patients getting relief for an even longer duration. Patients may be able to repeat the course of treatment with hyaluronan injections. For example, a patient who has experienced up to six months of pain relief from Synvisc but has had pain return may be a candidate for another course of Synvisc injections.
To minimize potential side effects, after an injection patients should avoid strenuous activities for 48 hours.
The most common side effects around the injected joint, which are usually mild, include:
• temporary injection site pain
• swelling
• redness and warmth
• itching
• bruising
The patient does not have to stop other medications they are taking when getting hyaluronan injections.
There should be no adverse interaction with other pain medications or anti-inflammatory medications that a patient is taking.
Dr. Harinder Batth
Orthopedic & Joint Replacement Surgeon

Zerona Low level non invasive laser liposuction (http://erchonia.asia/index.htm) , used for body slimming also emerges as an innovative weight loss program (http://erchonia.asia/index.htm) and ideal way to balance appetite hormones. AVI Pharma recently gained the rights for the program in Southeast Asia, including India, Malaysia, Thailand, Indonesia, Pakistan and Sri Lanka. The procedure is US FDA approved.

(PRWEB) October 16, 2010

Zerona is a low-level non invasive laser liposuction for body slimming that also emerges as an innovative weight loss program. Together with or independent of very low calorie VLCD Diet, HCG injections or other weight loss programs. It rotates around the waist, hips and thighs, forcing the fat cells to empty in a matter of weeks. There are no incisions, no downtime and no need for anesthesia. The fat is reabsorbed by the body through natural detoxification channel via liver and lymphatic system. But there is no substitute of eating right and healthy life style. This liposuction laser mechanism has to work hand in hand with lifestyle modification.

Good news is that Food and Drug Administration just cleared Zerona for "body slimming" in doctors' offices to reveal a thinner body with no incisions or needles. The Zerona is the first non-invasive aesthetic device to receive FDA market clearance for circumferential reduction of the waist, hips, and thighs.

The obesity epidemic continues unabated with no cure in sight. This is adversely affecting social harmony and economic productivity in developing as well as developed countries. Since obesity is mainly dependent on the size of the fat cell not just the number of fat cells .It is important to see the good side of the adipocytes too. Usually thought to be a poisonous inflammatory reservoir of fat and toxins the good side of adipocytes is missed or misinformed not only to the population but also the medical fraternity. Destroying the fat cells can be dangerous.

For long we have been trying to reveal the real mystery around adipocytes. Now fat cells are not just considered as inactive storage form for excess calories. We can consider adipose tissue as one of the largest endocrine gland in the body responsible for release of multiple hormones and sending signals to target tissues all over the body to regulate fatty acid metabolism, growth, puberty, healing, temperature control, disease-fighting ,aging and hunger mechanism. More than 20 hormones, both orexigenic and anorexigenic, have been identified. After crossing the blood-brain barrier, they reach their main site of action located in several hypothalamic areas and interact to balance satiety and hunger. One of the most significant advances in this matter has been the discovery of Leptin. This hormone plays fundamental roles in the control of appetite and in regulating energy expenditure.

The metabolism of adipocytes and gastric epithelial cells is closely linked to food intake and energy storage. The coordinated secretion of adipose and gastric leptins ensures proper management of food processing and energy storage. Leptin also regulates the activities of enzymes involved in lipid metabolism, e.g., AMP-activated protein kinase and stearoyl-CoA desaturase-1, and also interacts with insulin signaling in the brain. Low levels of leptin indicating food deprivation and depleted fat stores have been identified as the strongest signals to induce adaptive biological actions such as increased energy intake and reduced energy expenditure. The fall in leptin during fasting mediates hyperphagia and suppresses thermogenesis, thyroid and reproductive hormones, and immune system. On the other hand, rising leptin levels in the fed state stimulate fatty acid oxidation, decrease appetite, and limit weight gain. Because of this LEPTIN, is often known as the fat switch.

Similar changes can be observed when the adipocytes are damaged or destroyed by various invasive and non invasive slimming techniques. Most protocols for slimming and aesthetics involves destruction or removal of the adipocytes. This destruction of fat cells without diet control or exercise can stimulate the adipocytes elsewhere in body to get bigger and store more fat and ultimately non aesthetic results. Another danger is that losing fat cells may lower leptin levels and increase leptin resistance, signaling to the brain to eat more. In concert with other signals from the gut and metabolically active tissues, low leptin levels trigger powerful activation of multiple peripheral and brain systems to restore energy balance. It is not just neurons in the arcuate nucleus, but many other brain systems involved in finding potential food sources, smelling and tasting food, and learning to maximize rewarding effects of foods, that are affected by low leptin. Food restriction and fat depletion thus lead to a "hungry" brain, preoccupied with food.

Among multiple hormones that fat cells secrete another example is ADIPONECTIN, which helps manage metabolism. It enhances fatty acid oxidation and insulin sensitivity, in part by stimulating AMP-activated protein kinase phosphorylation and activity in liver and muscle. Moreover, Adiponectin decreases body fat by increasing energy expenditure and lipid catabolism. It is also known that Adiponectin release decreases when the fat cells are oversize. On the other hand oversize fat cells also become resistant to Leptin itself explaining why very obese individuals may have high leptin but are resistant to it,very similar to insulin resistance.
Ideally the best slimming & weight loss program to get maximum advantage from the endocrine fat cells is to shrink the fat cells without damaging them. This not only will increase leptin sensitivity but will also increase production of Adiponectin. This goal can be achieved by a non invasive protocol using low level laser liposuction which deflates/shrinks the fat cells without damaging the adipocytes and maintaining the endocrine function.
www.erchonia.in

– Thu Nov 18, 12:30 am ET
AMAR India is proud to be an Integral Sponsor of the Microsoft Alumni Foundation 2010 Celebration, supporting non-profit organization SeeYourImpact.org’s innovative approach to charity, by showing donors the direct impact of their donations on people’s lives.

Seattle, WA (PRWEB) November 17, 2010

Age Management Medicine and Research (AMAR India) is proud to be an Integral Sponsor of the Microsoft Alumni Foundation 2010 Celebration, supporting non-profit organization SeeYourImpact.org’s (http://SeeYourImpact.org) innovative approach to charity, by showing donors the direct impact of their donations on people’s lives.

On November 18th in Seattle, the Microsoft Alumni Foundation will host its second annual celebration honoring the Microsoft community’s accomplishments in philanthropy. Bill and Melinda Gates will recognize award winners and nominees of the Integral Fellows for their commitment to changing lives through philanthropic service. The winners of the Integral Fellows Award will each receive a $25,000 unrestricted grant for their nonprofit organization, as well as support from their fellow alumni to help continue in their efforts to leverage resources and scale solutions for their initiatives.

The panel of judges includes: Tom Brokaw, journalist and author, Bill Drayton, chair and CEO, Ashoka, William H. Gates Sr., co-Chair, Bill & Melinda Gates Foundation, Pierre Omidyar, Founding partner, Omidyar Network and Founder and Chairman, eBay Inc., Judith Rodin, President, Rockefeller Foundation, Thomas J. Tierney, Chairman and Co-founder, Bridgespan Group.

AMAR India is proud to support the work of the Integral Awards Program, including its chosen charity, SeeYourImpact.org. “We are honored to provide support for the philanthropic accomplishments of the Microsoft Community,” said Dr. Anoop Chaturvedi, Founder, AMAR India.

“We are very happy to announce that Mark Shanks, COO of Erchonia Corporation USA, world leader in low level laser technology, has agreed to donate its latest wound-healing lasers with the support of Scott Oki and Digvijay Chauhan, Co-founders, of SeeYourImpact.org to medical institutes in India. These lasers will greatly aid burn victims, diabetic patients with non-healing wounds, and patients struggling with mobility who are suffering with bed sores in hospitals and retirement homes. This will change the way we look at the healing process from healing wounds to healing life.” said Rowland Hanson, Chairman Erchonia India.

The Microsoft Alumni Foundation brings together Microsoft alumni to positively affect the world's challenges. "We've been fortunate to play a significant part in the information revolution. Now we have a chance to change the world in a different way. Microsoft alumni are making it happen every day in our local communities and around the world," said Jeff Raikes, chairman of the board of the Microsoft Alumni Foundation. "Some very unique individuals were nominated by their peers as Integral Fellows for their work deeply rooted in service and making a difference in people's everyday lives.”

About SeeYourImpact.org: SeeYourImpact.org (http://SeeYourImpact.org) is a revolutionary way to help those in need around the world and next door. Give a small gift. In about two weeks, you’ll receive a photo and story of the person you helped. By showing donors who and how their gift changed someone’s life, SeeYourImpact.org transforms charitable giving into a fun, transparent experience. SeeYourImpact.org offers over 70 charitable innovations in more than 15 countries spanning 3 continents.

About the Foundation: The Microsoft Alumni Foundation was established to catalyze the collective power of the Microsoft alumni family and leverage our resources on innovative, scalable and transformative solutions to our world's challenges. Launched in 2007, the Foundation is a 501(c)(3) public nonprofit organization with its worldwide headquarters based in Bellevue, Washington, USA. Board members include: Jeff Raikes (chair); Chuck Hirsch (president); Scott Oki (co-founder and vice president); Paul Shoemaker (treasurer); Tony Audino (co-founder); Sharon Maghie (co-founder and secretary) and Brad Smith (Microsoft representative).

About AMAR India: The mission of Age Management Medicine and Research India is to introduce the concept of graceful and healthy aging. It helps establish complete businesses for those who have the same goals. It brings the latest science and technology for improvement of the quality of life of patients through age management and anti-aging conferences and courses for physicians. It promotes a unique social platform where like minded physicians dealing with aging and age-related diseases can come together to connect, learn and collaborate with each other. AMAR India together with Erchonia USA and SeeYourImpact.org is dedicated to changing lives at the grassroots-level from suffering to healing. AMAR India is a private company, based in Mumbai India. Learn more at http://www.antiagingindia.net.

TUKARM CHAITANYA: DR. SHRINIWAS KASHALIKAR

Tukaram Chaitanya is a name given to Tukaram of Yehelgaon (born on Kartiki Ekadashi of shaka 1745 i.e. roughly 1823 AD); by Swami Chinmayananda of Umarkhed. Yehelgaon is about 16 kosas from Nanded (A city in the state of Maharashtra in India)

Tukaram Chaitanya later became the spiritual guru of Brahmachaitanya Maharaj Gondavalekar approximately in 1860. The Samadhi of Tukaram Chaitanya is in Yehelgaon and that Of Chinmayananda is in Umarkhed.

India’s real strength and true identity is hidden in these places and I think it would prove extremely beneficial for people of world to visit these places; at least in holidays.



Dr. Shriniwas Janardan Kashalikar

CULTURE AND VULTURE
Do we need to reassess the merits and demerits of drainage system, rapid and controlled urbanization and disposal of dead bodies? Are the prevalent cultural practices responsible for the extinction of the natural scavengers viz. the vultures? Can this be harmful to life cycle and hence the life?

Dr. Shriniwas Janardan Kashalikar