4 ways to put off joint replacement

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  • Lose weight: For every extra pound you carry, you put about three pounds of additional pressure on your knees and multiply the pressure on your hips by six. If you have arthritis, losing just 15 pounds can cut your knee pain in half. If you do eventually need a joint replaced, losing weight beforehand can reduce your risk of having complications from surgery. Swimming, walking, or riding a stationary bike are the way to go.
  • Take care when using your joints: By standing up straight instead of slouching you can protect the joints in your neck, hips, and knees. Also use the proper technique when lifting or carrying anything heavy. If any activity hurts, stop doing it right away.
  • Try nonsurgical approaches before turning to surgery: Treatment with steroid injections is one approach. Benefits can last anywhere from 4 to 6 months — however, it doesn’t work for everyone. Viscosupplementation involves injecting a lubricating fluid into damaged knee joints to treat osteoarthritis.
  • Get pain relief: Use NSAIDS. There is also some evidence that the dietary supplement glucosamine chondroitin can lead to subtle improvements in arthritis pain. “It doesn’t rebuild joints, but it does seem to help with the pain.
  • If you can’t escape from joint pain even while at rest, your pain is only relieved by narcotic medications, or your function is severely compromised, it’s time to consider a joint replacement.

All about depression

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Depression is a major public health problem as a leading predictor of functional disability and mortality.
Optimal depression treatment improves outcome for most patients.
Most adults with clinical significant depression never see a mental health professional but they often see a primary care physician.
A non–psychiatrist physician misses the diagnosis of the depression 50% of times.
All depressed patients must be enquired specifically about suicidal ideations.
Suicidal ideation is a medical emergency
Risk factors for suicide are psychiatric known disorders, medical illness, prior history of suicidal attempts, or family history of attempted suicide.
Demographic reasons include older age, male gender, marital status (widowed or separated) and living alone.
World over about 1 million people commit suicide every year.
Seventy–nine percent of patients who commit suicide contact their primary care provider in the last one year before their death and only one–third contact their mental health service provider.
Twice as many suicidal victims had contacted with their primary care provider as against the mental health provider in the last month before suicide.
Suicide is the 10th leading cause of death worldwide and account for 1.2% of all deaths.
In US suicidal rate is 10.5 per 100,000 people.
In America suicide is increasing in middle aged adults.
There are 10–40 non–fatal suicide attempts for every one completed suicide.
The majority of suicides completed in US are accomplished with fire arm (57%); the second leading method of suicide in US is hanging for men and poisoning in women.
Patients with prior history of attempted suicide are 5–6 times more likely to make another attempt.
Fifty percent of successful victims have made prior attempts.
One of every 100 suicidal attempt survivors will die by suicide within one year of the first attempt.
The risk of suicide increases with increase in age; however, younger and adolescents attempt suicide more than the older.
Females attempt suicide more frequently than males but males are successful three times more often.
The highest suicidal rate is amongst those individuals who are unmarried followed by widowed, separated, divorced, married without children and married with children in descending order.
Living alone increases the risk of suicide.
Unemployed and unskilled patients are at higher risk of suicide than those who are employed.
A recent sense of failure may lead to higher risk.
Clinicians are at higher risk of suicide.
The suicidal rate in male clinicians is 1.41 and in female clinicians it is 2.27.
Adverse childhood abuse and adverse childhood experiences increase the risk of suicidal attempts.
The first step in evaluating suicidal risk is to determine presence of suicidal thoughts including their concerns and duration.
Management of suicidal individual includes reducing mortality risk, underlying factors and monitoring and follow up.
Major risk for suicidal attempts is in psychiatric disorders, hopelessness and prior suicidal attempts or threats.
High impulsivity or alcohol or other substance abuse increase the risk.

Most uncontrolled asthmatics think they are controlled

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Two–thirds of patients with uncontrolled asthma think their disease is well under control,

Asthmatics on proper medicines can not only lead a normal life but also reduce their future complications. Drugs include those medicines that keep the disease at bay as well as those that are used when a flareY–up occurs. Uncontrolled asthmatics will invariably end up with right heart complications due to persistent lack of oxygenation in the blood.

Most asthmatics fail to perceive their level of disease control and with an uncontrolled state they often feel that their asthma is under control.

Dr. Eric van Ganse, of University of Lyon, France, in a study published in the Annals of Allergy, Asthma, and Immunology, examined 1,048 subjects with inadequate asthma control. When asked how they would rate their asthma control over the past 14 days, nearly 69 percent considered themselves to be completely or well controlled. Failure to perceive inadequate asthma control was more likely to be found in patients between the ages of 41 and 50 years.

In severe asthma, low blood oxygen levels might impair a person’s ability to assess their own breathing difficulty.

Another reason is that the notion of asthma control seems poorly understood by asthmatic patients. Also, mild to moderate asthma limits the activities of a person and they over a period of time take that as their normal limits.

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