France – Revolting Against Muslim

In a multicultural multi religious secular country, should we practice faith in privacy?

Remember, if we decide to do so, it becomes a universal policy applicable to all, several religious ceremonies may have to be banned in public including Hindus, Muslims, Sikh and other religion.

More so, it is through public expression that we understand others faith. We will lose that opportunity to learn too.

Irrespective of what you choose, your choice becomes universally applicable to all.

Awaiting your reply.

French politicians protest over Muslim street prayers in Paris
http://www.bbc.co.uk/news/world-europe-41950826

Time for collective responsibility, not partisan bickering

Delhi and other metropolitan places are an eye opener. Gradually, with uncontrolled automobile proliferation, lack of awareness (Only Chai time talk) and political fights over the spoils (even before the winners are declared) will extend this pollution to second and third tier cities. We don’t have to wait for a decade, it is hardly a matter of few more years, and you will be surprise to see that smaller cities too are in the fray of pollution.

delhi-pollution759

In the western world, pollution from car is the biggest contributor towards environmental pollution. However, In India (as in this case of Delhi and other metropolitan places in India), we see other contributors such as organic and nonorganic pollutants.

In Delhi and other major metropolis in India, the contributing factors are many fold. Inorganic particulate matter, Volatile Organic Compounds and dust are major contributors to such menace. Even if major factors are corrected, (partial control works too), that would help reduce the VOC’s significantly. However, is there a way to look at these factors as isolated contributors and work upon each in helping reduce the pollution?

EPA’s Tier 3 standards? While Europe has significantly reduced vehicular pollution by adopting this standards, US has been away from implementing. India can revisit the EPA standards and implement those across the country.

Car pulling, rationing, allowing cars with advanced environmental standards are immediate way out. However, in the immediate period, petroleum guzzlers should be completely banned plus mid-long term strategy should revisit how best to eliminate the use as f fossil fuel.

crop-burning

Crop burning: While it is hard to change the deep rooted cultural practices, time has come to bury the crop rather than burn and create smog.

In US countryside, we can burn crop when certain environmental conditions exist. Patterns which indicate conducive burning can be identified and crop burning can still be allowed while such conditions exist.

Greening the environment – India has been on the fore front in plantation and replacing trees, additional measures need to be taken to clear environmental pollution.

In India, as in other democratic countries, the major bottleneck is one up man-ship, partisan bickering and political blame game. However, all these politicians should form a nonpartisan committee comprising of each party and stakeholders and be given the credit for reducing pollution.

 

Managing Osteoarthritis of Knee

Obesity is the biggest risk factor for osteoarthritis of knee. Next is sedentary habits and disuse of certain muscle groups and eventual imbalance. Sedentary lifestyle is another contributory factor. Dietary factors also contribute towards accentuated knee pain.

As far as possible, try avoiding aggressive surgical options. This blog was written in response to a friend approaching for resolving dilemma on management of osteoarthritis of knee.

Note: Never be your doctor, always discuss with professionals before initiating any medical plan.

Osteoarthritis is a disease of ageing, a normal wear and tear process. Contrary to mainstream views, I trust, body has enough resilience to recover and bounce back. However, tailoring to age specific and relevant activities help significantly in avoiding any aggressive surgical options. Currently, there is significant impetus towards minimally invasive surgery and if possible, one should explore those.

Knee Joint

Agreed, Osteoarthritis of knee is a disease of ageing but ‘Obesity’ is the single most important risk factor. Other contributing factors are sedentary habits and disuse of certain muscle groups and eventual imbalance.

Evaluating the stage of osteoarthritis is important and management depends upon the stage of destruction.

Loss of Joint Space

stage-of-knee-osteoarthritis

A comprehensive plan will include working on below options –

  • Exercise
  • Physical Therapy
  • Modify Your Activities
  • Weight Control
  • Self-Help/Assistive Devices
  • Heat and Cold Treatments
  • Nutritional Supplements
  • Over-The-Counter Medications
  • Injections

Summarily –

Weight reduction –

  1. Salt sugar restriction, and
  2. Accentuated calorie burning from active exercise

Physiotherapy:

To evaluate Consistent or Progressive Foot Progression Angle.

  1. Identify muscles that are in disuse atrophy. This creates imbalance and accentuates arthritis. Start fixing those muscles with proper advice from Physiotherapist.
  2. Postural training.
  3. Gait training

Heat Application

    Nutritional supplements such as

  1. Glucosamine-chondroitin supplements
  2. Turmeric, Ginger (oral when low grade to moderate, topical when severe)
  3. Babul ka goond
  4. Vitamin C
  5. Krill Oil

Arthroscopy is invasive

Evaluating knee joint fluid helps. Since arthroscopy is considered, also discuss injecting Glucosamine in the joint fluid and possible steroids if inflammation is exuberant.

Avoid NSAID’s:

As best as possible, avoid taking NSAID’s. If you have pain, take Tylenol (Paracetamol).

Additional Reading:

(Click the link for additional reading)

When Bones Collide

Treatment of Osteoarthritis: Stanford University

18 ways to keep your joints healthy (https://www.webmd.com/rheumatoid-arthritis/better-living-ra-17/active/slideshow-keep-joints-healthy)

https://stanfordhealthcare.org/medical-conditions/bones-joints-and-muscles/osteoarthritis/treatments.html

https://drsarahbrewer.com/the-9-best-supplements-for-knee-pain

https://www.mayoclinic.org/diseases-conditions/swollen-knee/basics/treatment/con-20026072

http://www.synviscone.com/what-is-synvisc-one.aspx

https://med.stanford.edu/clinicaltrials/trials/NCT01397981

https://med.stanford.edu/clinicaltrials/trials/NCT02767570