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Dr K K Aggarwal

Use painkillers with caution in the elderly

By Dr K K Aggarwal
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Painkillers can cause stroke via irregular heart rhythm. Non selective non steroidal anti inflammatory drugs NSAIDs and new generation selective COX 2 inhibitors commonly used to treat inflammation are now linked to an increased risk of irregular heart rhythm called atrial fibrillation AF as per a Danish Research of 32602 patients led by Professor Henrik Toft Sorensen at Aarhus University Hospital in Denmark. These drugs are already linked to increased risk of heart attacks and strokes. And now through AF the risk gets intensified for stroke and new risk added of heart failure and death. In the study compared with non users new users first drug within 60 days of diagnosis showed 40 increased risk of AF with non selective NSAIDS and 70 increased risk with COX 2 inhibitors. This means four extra cases of AF per year per 1000 new users of non selective NSAIDS and seven extra cases of AF per 1000 new users of COX 2 inhibitors. The risk was highest in the elderly patients with chronic kidney disease or rheumatoid arthritis especially on COX 2 inhibitors. NSAIDs should be used very cautiously in older patients with a history of hypertension or heart failure.

Every arthritis is not same

By Dr K K Aggarwal
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Every arthritis is not the same. While osteoarthritis, also called as green arthritis, may require only painkillers and rehabilitation exercises, the red inflammation arthritis called rheumatoid arthritis, if not treated early and aggressively can end up with serious deforming complications Any arthritis in young women of child-bearing age should not be ignored, especially if it is worse in the morning and improves by movement. Most of them will have high platelet count on blood examination. These patients require aggressive treatment with disease-modifying drugs within days of the onset of symptoms and diagnosis. Approximately 1-2% of population may have this type of disease. Osteoarthritis, on the other hand, is a disease of age 50+ and is due to wear and tear of various joints in the body and break down of the cartilage cushion in the joints. It mainly affects the weight-bearing joints like the knees, hips, neck and lower back joints. Inflammation is not a major feature of osteoarthritis. Another form of joint disorder is gout, which is never seen in children and in people below 40 years of age and is almost never seen in young women before the onset of menopause unless there is a known underlying kidney disease. The progression of osteoarthritis can be arrested with appropriate exercises, weight reduction and preventing posture and movement that worsen the disease. Typical wear and tear of osteoarthritis is caused by sitting crosslegged, doing Padmasana, squatting, other non physiological postures, sitting on low level surface like floor and low chairs, doing push ups, going up and down on stairs, etc. Most yoga postures should be done under medical supervision and should follow with a counter yoga exercise. Most patients of serious arthritis end up with treatment with other systems of medicines or with quacks.

Every arthritis is not same

By Dr K K Aggarwal
Filed Under Wellness | Tagged With: , , , , | | Comments Off on Every arthritis is not same

Every arthritis is not the same. While osteoarthritis, also called as green arthritis, may require only painkillers and rehabilitation exercises, the red inflammation arthritis called rheumatoid arthritis, if not treated early and aggressively can end up with serious deforming complications

Any arthritis in young women of child-bearing age should not be ignored, especially if it is worse in the morning and improves by movement. Most of them will have high platelet count on blood examination. These patients require aggressive treatment with disease-modifying drugs within days of the onset of symptoms and diagnosis. Approximately 1-2% of population may have this type of disease.

Osteoarthritis, on the other hand, is a disease of age 50+ and is due to wear and tear of various joints in the body and break down of the cartilage cushion in the joints. It mainly affects the weight-bearing joints like the knees, hips, neck and lower back joints. Inflammation is not a major feature of osteoarthritis.

Another form of joint disorder is gout, which is never seen in children and in people below 40 years of age and is almost never seen in young women before the onset of menopause unless there is a known underlying kidney disease.

The progression of osteoarthritis can be arrested with appropriate exercises, weight reduction and preventing posture and movement that worsen the disease.

Typical wear and tear of osteoarthritis is caused by sitting cross legged, doing Padmasana, squatting, other non physiological postures, sitting on low level surface like floor and low chairs, doing push ups, going up and down on stairs, etc.

Most yoga postures should be done under medical supervision and should follow with a counter yoga exercise.

Most patients of serious arthritis end up with treatment with other systems of medicines or with quacks.

The benefits of exercise are enhanced by hydrotherapy.

Hydrotherapy is used in rheumatoid arthritis, ankylosing spondylitis, and fibromyalgia. All of them have severe pain and impairment.

Hydrotherapy involves submersion of a small or large body surface area in a small tank or tub. The water temperature usually does not exceed 40 C.

It provides a reduced-gravity environment that facilitates benefit from physical therapy. It also facilitates muscle relaxation and improves overall emotional state.

Patients may experience a decrease in the typical pain experienced with movement.