Article


Best Health Care Center – Noble Hospital, Pune

Research in science and technology has brought about great change in our daily comforts in this 21st century. Along with that we have also been given ill health as our physical activities have drastically reduced. All work and no play is taking a heavy toll on people irrespective of their age and gender.
We have been invaded with new diseases and health problems caused due to pollution, changes to the environment, unhealthy food habits, very less or no physical activities and undue stress by long and irregular working hours. Due to all these reasons our visit to the doctor have become frequent. Research in the field of medicine is so advanced that many diseases which were considered fatal are now curable. The long suffering patients are seeing a new dawn of hope.
Noble Hospital, Pune is one such hospital dedicated to provide health services to one and all at an affordable price. A multi specialty tertiary hospital, it was established in the year 2007. This 250 bed hospital sprawls over an area of 1, 85,000 sq ft. This modern hospital is a state-of-the-art health care facility with the best doctors and advanced technological setup. The competent doctors of Noble Hospital are a boon to people of Pune who are in need of health care.
From the time of establishment the hospital has progressed to reach the new heights in the field of medicine through its services. It is more like a one stop shop for people as the hospital is one of the best diagnostic services in Pune. From the stage of diagnosis to treatment the hospital is self reliant with its own top-notch modern laboratory and radiology facilities.
Noble Hospital is capable of handling any kind of emergencies and provides 24hour services in its emergency and trauma unit. Being home for doctors with a great number of years of experience, the hospital provides services in the following areas: Cardiac & Cardiothoracic Surgery, Acupuncture, Ayurveda & Panchakarma, Chest Medicine, Dermatology, Cosmetology, ENT, Diabetology, Dentistry, Endocrinology, General & Laparoscopic Surgery, Gastroenterology, Homoeopathy, Infectious Disease, Nephrology, Neurology, Neurosurgery, Obstetrics & Gynecology, Onco Surgery, Obesity & Metabolic Surgery, Ophthalmology, Psychiatry, Pediatrics and Pediatric Surgery, Urology and Plastic & Reconstructive Surgery.
Providing all these services Noble Hospital is an ideal place for solutions to your health problems.
 

Beautiful Smile – Dentistry at Noble Hospital

People would kill for a beautiful smile. Beautiful smile enhances a person’s beauty and personality. To get that beautiful smile, a little bit of prompt, regular and hard work is required. Boosting your confidence is a set of beautiful teeth which gives a very strong first impression. But that comes only with hard work and dedication towards your dental and oral health.
Dental or Oral health, an extremely important part of your daily chore is the basic part of your well being. People may not even realize the magnitude of need of oral health involved in public health and wellness. Your dental and oral health is deeply connected to your overall health.
Dental health is not limited to having beautiful set of teeth, it is much more than that. Your teeth may problems like caries, decaying of roots, crooked teeth etc. Dentistry is divided into many branches like orthodontist, periodontist, pedodontists etc.
Selecting a dentist is a tedious and responsible work, as a dentist should simply not treat you for your current problem. He/She should be able to solve the problem, and also analyze and help you to make a future plan to maintain your oral and dental health.
At Noble Hospital Pune, we have a well equipped and advanced dental facility to cater to the needs of people with dental problems. With the intention of serving people better with good health care, we create a rather informal atmosphere with a team of highly competent dentists with very modern facilities.
Dental clinic at Noble Hospital covers the areas of Oral & Maxillofacial Surgery, Periodontists, Pedodontist, Orthodontist, Prosthodontist and Implatntologist. Known as one of the most competent center for Dental Transplant in Pune, we also specialize in procedures like:
  • Root Canal Treatment
  • Cosmetic fillings
  • Prophylaxis and Crown & Bridge work
  • Cosmetic treatments like enhancing smile by treating crowded teeth
  • Emergencies like fracture of teeth or bones or loosened teeth due to trauma
  • Perio-surgeries for stabilizing loosened teeth
  • Restorative procedures
  • Painless and single sitting root canal
  • Pediatric Dentistry
  • Imported teeth set with fibre dentures
 

Thyroid

What is a thyroid gland?
A thyroid gland is an endocrine gland; this means that it manufactures hormones that are released into the bloodstream, which then act as messengers to affect cells and tissues in other parts of the body.
 
Where is the thyroid gland?
The thyroid gland lies on either side of your windpipe, with the gland as a whole lying just below your Adam's apple.
 
What does the thyroid gland do?
The thyroid gland produces thyroid hormones which it secretes into the bloodstream. If hormone production is insufficient, it can easily be replaced with medication.
 
What do the thyroid hormones do?
Thyroid hormones regulate the speed at which your body cells work. If too much of the thyroid hormones are secreted, the body cells work faster than normal, and you have thyroid overactivity or 'hyperthyroidism' (also referred to as "thyrotoxicosis"). However if too little of the thyroid hormones are secreted then the body cells work slower than normal and you have underactivity or 'hypothyroidism'.
 
How is the thyroid gland controlled?
Thyroid gland works in conjunction with pituitary, which lies underneath your brain in your skull and senses the levels of thyroid hormones in your bloodstream. If the levels drop below normal, the pituitary reacts by secreting a hormone called the 'thyroid stimulating hormone' which is often called TSH. TSH stimulates the thyroid gland to make more thyroid hormones. Should the thyroid hormone levels rise above normal for example in Graves' disease), the pituitary senses this and slows down or stops making TSH.
 
How is thyroid activity measured?
Your doctor will be able to get a good assessment of your thyroid gland activity by taking a history of your symptoms and by a physical examination. However, to gain an exact level of the thyroid hormones, it is necessary to take a small sample of blood, which when analysed in the laboratory will show how much T4 is being made, and how active your pituitary is, by measuring the level of TSH. These tests are sometimes called thyroid function tests or TFTs.
 
How is thyroid disease diagnosed?
Thyroid disease can fall under numerous disease entities. Your illness may be due to under or over functioning of the gland or even you could be having a disease where the function of the gland is normal. Treatment depends on the particular disease of thyroid you are suffering from. Your doctor will order necessary investigations as to pin point the diagnosis (TFT, thyroid antibody profile, Ultrasound scanning of neck, FNAC, Nuclear imaging) and then decide on the treatment.
 
How do I suspect hypothyroidism (under functioning of thyroid)?
Common complaints include fatigue and lethargy, cold sensitivity, dry skin and lifeless hair, impaired concentration and memory, increased weight with poor appetite and constipation. Patients may also fairly often experience a hoarse voice, tingling of the hands (carpal tunnel syndrome), heavy and later, absent periods, deafness and joint aches. In childhood there may be delayed development and in the adolescent early onset of puberty.
The elderly may develop memory disturbances, an impaired mental state or depression, and in rare cases coma can occur, resulting in death if left untreated. Signs include slow movements, face looks puffy due to the accumulation of subcutaneous fluid, cool dry skin, slow pulse rate, thinning of the hair including the eyebrows, slow tendon reflex relaxation time, slow pulse rate and hoarse voice. The thyroid may be enlarged (causing a goitre) in some patients due to accumulation of lymphocytes (Hashimoto's thyroiditis), but in others the thyroid is destroyed by the time of diagnosis and there is no goitre.
Nowadays patients often are diagnosed at an early stage of disease, due to increased awareness and improved biochemical testing. Therefore many patients have relatively few of the classical signs or symptoms just listed. In addition, none of the symptoms or signs are sufficiently sensitive or specific for the diagnosis of hypothyroidism, even when combined together.
 
How do I suspect hyperthyroidism (over functioning of thyroid)?
Common complaints include fatigue, heat intolerance, sweating, weight loss despite good appetite, shakiness, inappropriate anxiety, palpitations of the heart, shortness of breath, tetchiness and agitation, poor sleep, thirst, nausea and increased frequency of defecation. The elderly may complain predominantly of heart problems with a fast or irregular heart beat, breathlessness and ankle swelling, whereas children tend to have hyperactivity, with a short attention span. Signs include shaky and hot hands, fast or irregular heart beat, inability to sit still, flushing of the face, an enlarged thyroid gland and prominent or bulging eyes.
Nowadays patients often are diagnosed at an early stage of disease, owing to increased awareness and improved biochemical testing. Therefore some patients have relatively few of the classical signs or symptoms. In addition, none of the symptoms or signs just listed is sufficiently sensitive or specific for the diagnosis of hyperthyroidism, even when combined together. It is not uncommon for people to worry that they have cancer, because of the associated weight loss.
 
How is thyroid disease important in Pregnancy?
For the first 10-12 weeks of pregnancy, the baby is completely dependent on the mother for the production of thyroid hormone. By the end of the first trimester, the baby's thyroid begins to produce thyroid hormone on its own. The baby, however, remains dependent on the mother for ingestion of adequate amounts of iodine, which is essential to make the thyroid hormones. Untreated or inadequately treated, hypothyroidism has been associated with maternal anemia (low red blood cell count), myopathy (muscle pain, weakness), congestive heart failure, pre-eclampsia, placental abnormalities, low birth weight infants, and postpartum hemorrhage (bleeding).
Recent studies have also suggested that mild brain developmental abnormalities may be present in children born to women who had mild untreated hypothyroidism during pregnancy on the other hand, uncontrolled maternal hyperthyroidism has been associated with fetal tachycardia (fast heart rate), small for gestational age babies, prematurity, stillbirths and possibly congenital malformations. So, if you have thyroid disease, it is advisable to get an endocrinology opinion prior to planning pregnancy and to monitor thyroid function regularly through gestational period.
 

Heart attack

What are the common cardiac/heart diseases?
  • Heart attack  (this is the commonest cause of death in India)
  • Heart failure
  • Arrhythmias
  • Valvular heart diseases
  • Congenital heart disease

What are the risk factors for cardiac diseases?

Non-modifiable risk factors:

  • Hereditary (risk is increased by 2 times)
  • Gender (males> females)
  • Age (increases with age)

Modifiable risk factors:

  • Smoking/ Tobacco chewing
  • High blood pressure
  • Diabetes
  • High blood cholesterol
  • Obesity
  • Physical inactivity
  • Stress and behavior

Lifestyle: Dos and Don'ts for a healthy heart Dos :

  • Avoid smoking
  • Avoid excessive alcohol intake
  • Stress and behavioural modification (meditation, yoga, etc.)
  • Stay active (regular exercise), loose weight, if needed.
  • Regular health check-ups. Take prescribed medications for high blood pressure, diabetes and cholesterol.

Don'ts

  • Smoking, tobacco chewing
  • Excessive alcohol intake
  • Stressful lifestyle
  • High cholesterol diet
  • Physical inactivity, continue to be overweight.
  • Avoid visiting the doctor. Let diabetes, high blood pressure and high cholesterol remain untreated.

What is a heart attack?

  • Heart attack (this is the commonest cause of death in India)
  • Heart failure
  • Arrhythmias
  • Valvular heart diseases
  • Congenital heart diseases

What are the symptoms of a heart attack?

Heart attacks can cause a wide range of symptoms, from mild to intense. Women, the elderly, and people with diabetes are more likely to have subtle or unusual symptoms. Symptoms in adults may include:

  • Chest pain
  • Usually in the center of the chest
  • Lasts for a few minutes, or comes and goes
  • May feel like pressure, squeezing, fullness
  • Pain may be felt in other areas of the upper body, such as the jaw, shoulder, one or both arms, back, and stomach area
  • Cold sweat
  • Light-headedness
  • Nausea
  • Heartburn 
  • Abdominal pain
  • Numbness, aching, or tingling in the arm (usually the left arm)
  • Shortness of breath
  • Weakness or fatigue, particularly in the elderly
  • Women are more likely than men to have symptoms of nausea, vomiting, fatigue, back or jaw pain, and shortness of breath, either alone or with chest pain

Dos and Don'ts when dealing with a heart attack

  • Have the person sit down, rest, and try to keep calm
  • Loosen any tight clothing
  • Ask if the person takes any chest pain medication for a known heart condition
  • Help the person take the medication (usually nitroglycerin, which is placed under the tongue)
  • Call for emergency medical help
  • If the person is unconscious and unresponsive, call for medical help immediately and then begin CPR
  • Do not leave the person alone except to call for help, if necessary
  • Do not allow the person to deny the symptoms and convince you not to  call for emergency help
  • Do not wait to see if the symptoms go away
  • Do not give the person anything by mouth unless a heart medication (such as nitroglycerin) has been prescribed
 

H1N1

What is Influenza A (H1N1)?
2009 Influenza A (H1N1) (previously referred to as 'new strain of swine flu') is a new strain of the influenza virus that spreads from human to human. Influenza A (H1N1) is a viral respiratory disease that presents flu-like symptoms.
 
What are the signs and symptoms of infection?
The symptoms of Influenza A (H1N1) are similar to the symptoms of the seasonal flu. These symptoms can vary in severity from mild to severe, and include the following:
  • High fever (>38C)
  • Sore throat
  • Cough
  • Body aches
  • Runny nose
  • Headaches
  • Tiredness

What can I do to protect myself and others against the Influenza A (H1N1)?

Practice good personal hygiene and be socially responsible by:

  • Washing your hands regularly and thoroughly with soap and water, especially before touching your eyes, nose or mouth
  • Turning quickly away from anyone near you if you are about to cough or sneeze, and do not cough or sneeze at him/her
  • Covering your nose and mouth with a tissue when coughing or sneezing. Dispose of the tissue properly in the dust bin after use
  • Avoiding crowded places if you are unwell and wear a surgical mask to cover your nose and mouth
  • Staying home from work or school when you are sick
  • Using a serving spoon when sharing food at meal times. Also, leading a healthy lifestyle helps to build up your immunity and protects you against infection.
  • Eat a balanced diet, including plenty of fruit and vegetables
  • Be active. Do 30 minutes of physical activity at least 5 days a week
  • Learn to relax and get enough sleep and rest
  • Do not smoke

Treatment

There are antiviral medications available to treat Influenza A (H1N1), such as oseltamivir (Tamiflu) and zanamivir (Relenza). They fight against the Influenza A (H1N1) virus reproducing itself in the body. When taken early (within 2 days of the appearance of symptoms), these medicines may:

  • Reduce the severity of the infection with faster recovery from the illness
  • Prevent serious complications

If you have travelled to any Influenza A (H1N1) affected areas or have come in close contact with a person with Influenza A (H1N1) and have developed a fever (temperature >38oC) with either cough, runny nose or sore throat within 7 days after your return, please contact your doctor.

How does Influenza A (H1N1) spread among humans?

The spread of Influenza A (H1N1) is similar to the seasonal flu. It can be spread when an infected person coughs, sneezes or speaks. It can also be spread when a person touches a contaminated surface and then touches his or her nose or mouth.

Is Influenza A (H1N1) infection serious?

Influenza A (H1N1) in humans can range from mild illness to a serious, life-threatening illness. Deaths from pneumonia and respiratory failure have been reported with Influenza A (H1N1) infection.

 

 

Donate blood

Why should you donate blood?

Blood donation leaves us with a proud feeling of saving someone's life in a beautiful way. It's an experience that no words can define.

Is donating blood painful?

Donating blood is not painful and is completely safe for the donor. It takes approximately 5 -8 minutes to donate blood.

Is it safe to donate blood?

Donating blood is very safe and simple. We only use sterile disposable blood collection bags and needles.

How much blood can I donate?

Each individual can donate up to 350/450 ml. of blood. Your body can replenish this volume within 24 to 36 hours. This depends on the weight of the individual. 350 ml – 45-60 kg. 450 > 60 kg & above.

How often can I donate blood?

Whole blood donors can give blood once every 90 days. Aphaeresis platelet donors can donate more frequently, as much as twice in one week, and up to 24 times a year.

Who is eligible to donate blood?

In India, you can start donating blood at the age of 18 yrs and up to the age of 60 yrs, if you weigh at least 45 kg. and if you are in good health.

Can I get any disease like AIDS or hepatitis or any other disease by donating blood?

No. Only sterile disposable bags and needles are used to collect your blood. These disposable items are for one-time-use only.

What should I eat before making a blood donation?

Eating light snacks and a drink (non-alcoholic) before blood donation makes you psychologically more comfortable.

What should I eat after making a blood donation?

Drink some liquid like tea, coffee, a cold drink, juice, etc. to replenish fluid and eat some snacks like 3-4 biscuits. All this will be available for you at the blood donation site.

Will I be asked any questions before I give blood?

Yes. In order to make this process safe for both the donor, and for the patient receiving blood from our blood bank, we require to ask a number of questions. All details given during this process are treated as confidential.

I've just had a tattoo and am dismayed that I can't donate for 6 months. Why?

There is always an infection risk whenever the skin is pierced. In order to avoid unconsciously passing on such infections, donating blood after a tattoo is not advisable for at least 6 months.

I am a vegetarian, can I give blood?

There is no problem with vegetarians giving blood. The red blood cells, which require iron from the stores in your body, will need to be replaced after the donation. Provided you eat a well-balanced diet, you should be able to replenish your iron supply within a month. However, this may take longer because you are a vegetarian.

I have started taking 75 mg. of aspirin a day to thin my blood and help prevent heart attacks. Will this affect my ability to donate blood?

You can donate blood but, because aspirin may affect platelet function, your donation will not be used for preparing platelets. That is why it is always important to let us know if you are taking any over the counter medication on a regular basis.

Can I go back to work on the same day?

Yes. However, it's unwise to give blood just before undertaking a hazardous hobby or job, such as driving a crane or working for emergency services. It’s better to avoid strenuous / laborious work.

What happens during a blood donation?

  • You will complete a donor registration form that includes your name, address and a few other details.
  • You will be asked a few questions about your health.
  • You will go through a simple medical check-up, including checking blood pressure and pulse.
  • A drop of blood will be obtained from your fingertip to check your haemoglobin percentage.
  • You will proceed to a donor chair where your arm will be cleaned with antiseptic.
  • During the donation process, you will donate 350 ml. or 450ml., depending on your weight.
  • After the process is over, you will need to rest for about 5-10 minutes.
  • Following your donation, you will be given refreshments.
  • Please remember to collect your donor card before you leave.

How soon after donating can I practice sports?

Sports can be resumed the day after the donation.

What are the components of the blood?

Blood has the following components and each one takes care of specific needs.

Red Blood Cells: RBCs are administered to replenish blood loss and is usually used to treat trauma and surgery patients. Fresh

Frozen Plasma: Plasma is the liquid part of the blood. It is administered to patients with liver problems, burn cases etc.

Platelets: Platelets help in clotting and are used in treatment when cuts or other open wounds occur. Leukemia, dengue and transplant patients often need platelet transfusions.

How long can the blood be stored at the Blood Bank?

Whole blood can be stored for up to 35 days. The various blood components can be stored as under:

Platelet Concentrate - 5 days

Platelet Aphaerises - 5 days

Packed Cells - 42 days

Fresh Frozen Plasma - 1 year

Cryo Antihaemophilic Factor - 1 year

What are the laboratory tests performed on the collected blood?

  • Hepatitis B & C
  • Malarial parasite
  • HIV I & II (AIDS)
  • Venereal disease (Syphilis)
  • Blood group
  • Before issuing blood, compatibility tests (cross-matching) is done

Do you charge for issuing blood?

All blood received by you is through voluntary donation.

We don't. The blood itself is free. A processing fee is charged by the blood centre to the patient to cover the cost of collecting, blood typing, testing, storing and distributing the blood. Yes. Voluntary blood donation is the only source of blood.

Points to Remember

  • Eat and drink something before leaving
  • Increase your fluid intake during the next 24 hours
  • Avoid consuming alcohol until you have eaten something
  • Don't smoke or chew tobacco for the next 30 minutes to 4 hours
  • Avoid climbing steps for the next 30 minutes
  • Avoid strenuous physical exertion, heavy lifting or pulling using the arm used for donation for at least 24 hrs
  • If there is bleeding from the phlebotomy site (puncture site), raise the arm and apply pressure or use ice pack.
  • If you feel faint or dizzy, either lie down or sit for some time.
  • Resume all normal activities if no symptoms occur
  • Remove bandage after 4 hours.
  • Do not hesitate to contact the blood bank if you have any problems or queries
 

Alcohol

What happens when a person has a drink?
Alcohol affects everyone. When a person has a drink, the alcohol is absorbed directly through the wall of the stomach and intestine into the bloodstream, where it is distributed rapidly throughout the body. Alcohol changes the function of each cell that it enters.
The liver is the sole organ involved in processing alcohol and only a certain quantity of alcohol can be detoxified over a period of time. In the meantime, excess alcohol affects the brain, heart, muscles and other tissues of the body.

How does alcohol affect the liver?
When the liver has too much alcohol to handle, normal liver function may be interrupted, leading to a chemical imbalance. If the liver is required to detoxify alcohol hour after hour, it can lead to a fatty liver and more seriously, alcoholic hepatitis and cirrhosis.

How much alcohol is safe?
This depends on the individual's body weight, gender, etc.; for example, women are more susceptible to alcohol-related liver damage. Recommendations are that alcohol consumption be limited to less than two drinks a day.

If a person's total weekly consumption of alcohol exceeds 14 drinks, serious damage may be done to the liver.

Mixing alcohol and medication may damage the liver. A person should check with his/her doctor about taking essential medication and drinking alcohol. However, alcohol should not be taken with drugs such as paracetamol.
 
With respect to different types of alcohol, is one safer than another?
No. It is the amount of alcohol present in a drink that matters, not the type of drink. One "drink" is the equivalent of either;
  • 12 oz. (341 ml) beer
  • 5 oz. (142 ml) wine
  • 3 oz. (86 ml) sherry or port
  • 1½ oz. (43 ml) spirits (Whisky, Rum, Vodka, Brandy, etc.)
Each of the above has the same effect on the liver, whether taken alone or diluted.

How does a person know if his/her liver has been damaged by alcohol?
More than three-quarters of liver cells may be non-functioning before a person notices any symptoms. But, by then it may be too late to do anything about it. So, it's important to have regular check-ups with a hepatologist (liver specialist), who will be able to detect early signs of liver disease through physical examination and blood tests.

What are the symptoms of alcohol-related liver damage?
If the liver is not performing its functions properly, the rest of the body will soon be affected by the lack of nutrients and excess waste products present in the blood.

Complications arising from liver damage include fatigue, loss of appetite, lowered resistance, jaundice (yellowing of the skin and eyes), swelling of the abdomen, intestinal bleeding, brain dysfunction and kidney failure.

Can alcohol-related liver damage be reversed or cured?
If caught early, minimal liver damage can be reversed if a person abstains from drinking alcohol. When there is no alcohol in the bloodstream, the liver cells will be able to return to normal because the liver has a tremendous capacity to regenerate.

Alcohol-related diseases vary in severity. Fatty liver and mild alcoholic hepatitis can be cured. However, advanced alcoholic hepatitis can result in serious illness. When cirrhosis develops, the structure of the liver is permanently damaged. The symptoms, signs and outcome of cirrhosis depends upon the associated hepatitis and also at which stage the patient has stopped alcohol abuse. If there is severe hepatitis, or the patient has been too late in stopping alcohol abuse, then it eventually leads to liver failure and death.

Abstaining from alcohol can be associated with a slow, but marked, improvement in liver function. If necessary, a hepatologist may also suggest that a person be treated with new drug therapies. In many cases, these treatments allow people to live normal lives.

 

Back Pain

MUSCULOSKELETAL HEALTH CARE IN INDUSTRY


DR S S DUMBRE
PATIL NOBLE HOSPITAL,
MAGARPATTA,PUNE.

Our Back

Spine is made up of a series of 33 vertebrae (bone) and disks (elastic tissue).

chronic back pain managementPain management consultantspinal back pain management

First three sections of the spine:

  • Cervical Spine: Neck – C1 through C7
  • Thoracic Spine: Upper and mid back – T1 through T12
  • Lumbar Spine: Lower back - L1 through L5

Why to talk of BACK PAIN?

  • No 1 reason in < 45 yrs to limit activity
  • 2nd highest complaint in OPD
  • 5th most common cause of Hospitalisation
  • 3rd leading cause of Surgery
  • Commonest cause of absenteeism in work.
  • Common in young people < 45yrs
  • Only 1/3rd of total expenditure of Back pain is on Medications, rest all is on disability payments.
  • Treatable.
  • PREVENTABLE.

BACK PAIN

back pain management techniques

Classification anatomical

  • Neck pain
  • Upper back pain
  • Lower back pain

Classification- duration

  • Acute (less than 4 weeks)
  • Sub acute ( 4 to 12 weeks)
  • Chronic ( greater than 12 weeks)

Classification – cause

  • Musculoskeletal
  • Infection
  • Malignancy
  • Traumatic
  • Metabolic

Etiology

  • Mechanical / non specific 98% has no serious underlying pathology
  • Secondary 2% caused by underlying pathology like infection, malignancy

LOW BACK PAIN

  • Symptoms
  • Predisposing factors
  • Complications PID ( slipped disc)
  • Prevention - Ergonomics

Symptoms / complaints

  • Acute / sudden low backache -catch
  • Leg pain - SCIATICA
  • Backache with leg pain
  • Tingling numbness in leg
  • Weakness in leg

Predisposing factors for Back Pain

  • Lack of Exercises
  • Sitting for long time
  • Occasional Lifting weights
  • Travelling

Exercises

  • Regular exercises
  • At least 5 days a week
  • Walking 30 min is basic salary.
  • Gym exercises is bonus.
  • Games like Lon tennis / badminton are to be played if you are FIT not for FITNESS.

Sitting for long time

  • Common in IT industry
  • Work station should be properly designed acc to ergonomic standards.
  • Frequent breaks in between are needed But sitting for 12 to 16 hrs a day is UNNATURAL

Lifting weights

  • A 60 yr farmer can lift a bag (60 kg) 35 yr doctor can’t lift his son (20kg)

WHY

  • Proper training – how to lift weight
  • Tone of muscles- regular exercises
  • Regularity in lifting
  • Occasional lifting of wt with improper tech & muscle tone – slipped disc.

Travelling

For 40km Car better than bike

100km Bus better than car

150km Volvo better than bus

300km Train better than volvo

1500km Plane better than train

Less travelling better than Back pain.

Worst combination for Back Pain

  • Two wheeler riding
  • Sitting for long time
  • Lack of regular exercises
  • Occasional lifting of weight.

Other Predisposing factors

  • Obesity – lack of anterior abd. wall support
  • Stressful working conditions
  • Smoking
  • Anxiety / depression

Complications

  • Physical-
  1. leg pain
  2. Weakness in leg
  3. Paralysis of muscles of leg
  4. Chronic backache
  • Socioeconomic-

  • Billions of dollars are spent on the backache problems.
pain management for lower back pain

Slipped disc / herniated disc

  • Most common neurological impairment associated with Back pain
  • 95% of PIDs occur in last two lumbar levels

PID (prolapsed intervertebral disc)

  • Common 15 to 45 yrs because of maximum intrahydrolic pressure in matrix.

 

Intradiscal pressure in diff postures

pain management for lower back pain

HERNIATED DISC

HENCE lifting wt in bending position with knees straight predisposes to slipped disc.

pain management for lower back pain

Treatment of Acute lumbago Non operative

  • STRICT BED REST for initial 7 days.
  • Not to sit up
  • Can stand up
  • No bending
  • No travelling
  • No exercises during acute phase
  • Traction/SWD/IFT/Injections & medicines

Treatment Operative

  • Conventional/standard discectomy operation
  • Microlumbar discectomy
  • Endoscopic discectomy

Prevention

PREVENTION IS BETTER THAN CURE

Regular exercises –

  • At least 5 days a week
  • Exercises during pain free period.
  • Proper posture at working place.
  • Decreased stresses at working place.

Exercises for the office

  • One of the biggest injury risk factors is static posture.
  • Try to spend at least 5 minutes every hour away from your computer.
  • Remember to ONLY stretch to the point of mild tension.
  • Try to incorporate the stretches into your daily routine. This slide provides some illustrations of simple active stretches to perform at the office.

Hand Exercises

  • Tightly clench your hand into a fist and release, fanning out the fingers. Repeat 3 times

pain management backlow back pain managementpain management back

Back and Shoulder Exercises

management of back pain
  • Stand up straight, place your right hand on your left shoulder and move your head back gently.  Do the same thing for the right shoulder
  • Move head sideways from left to right and back to left
  • Move head backwards and then forward

management of back painmanagement of back pain

Computer and Desk Stretches

  • Sitting at a computer for long periods often cause neck and shoulder stiffness and occasionally lower back pain. Do these stretches every hour or so throughout the day or whenever you feel still. Also be sure to get up and walk around the office whenever you think of it. You’ll feel better.

pain management for chronic back pain

pain management for chronic back pain

pain management for chronic back pain

MYTH: Advise of hot fomentation on

MYTHS AND FACTS

  • MYTH: Advise of hot fomentation on day1
  • FACT: Heat aggravates inflammation while cold helps decrease. Hence first 48 hrs use ice.
  • MYTH: Complete rest to neck & use of collar
  • FACT: Rest or no movement, increases spasm, thereby increasing pain. Hence continue pain free movement.
  • MYTH: No pillow
  • FACT: Proper pillow helps support the contour of spine. Without a pillow there is excessive strain on the muscle which in turn aggregates the problem.

Workstation Ergonomics

low back pain management guidelines

Make your work area more comfortable & productive

Ergonomics
“Ergon”(Gr): Work and strength
“Nomos” (Gr): The study of,
Defined: The study and principles of work

Purpose of Ergonomics

  • The improvement of human health, safety, and performance through the application of sound people and workplace principles

Purpose of Ergonomics
To Make the job fit the person instead of the person  fit  the  job.

Disciplines Involved with Ergonomics

  • Engineering Sciences
  • Physical Sciences
  • Biological Sciences
  • Social and Behavioral Sciences
  • Sub-areas: mechanics, physics, chemistry, biomechanics, anatomy, physiology, anthropology, sociology, psychology.

Benefits of Ergonomics

  • Improved Health and Safety for Workers
  • Higher morale
  • Improved quality
  • Improved productivity & competitiveness

Benefits of Ergonomics

  • Lower absenteeism and turnover
  • Fewer workplace injuries & health problems
  • Reduced Workman’s Compensation rates

Why Implement Ergonomic Principles?

  • Injuries and illness can be avoided or minimized
  • Costs can be curtailed
  • Companies can remain competitive
  • Productivity can be improved

Office Of Horrors

pain management for back pain

Ideal Office

lower back pain management

THE PERFECT SETUP

pain management for lower back pain

Workstation Essentials

pain management for back pain
Office furniture
  • Adjustable and supportive chair
  • A fixed height desk with a height adjustable footrest, or, an adjustable desk

Monitor

  • Top of screen is at or below eye level
  • Monitor positioned to reduce glare and reflections

Sufficient area to enter and move about the work area and allow for frequent changes in posture Storage for personal items and work requirements Work Environment

  • satisfactory temperature
  • not too noisy
  • appropriate lighting
  • good air quality

pain management for back pain

 

Incorrect

Correct

pain management for back pain pain management for chronic back pain
chronic low back pain evaluation and management pain management for chronic back pain
back pain management techniques chronic low back pain evaluation and management
low back pain management back pain management techniques
 
Summary of BACK PAIN & ERGONOMICS
  • Lack of Exercises,
  • Sitting for long time,
  • Occasional Lifting weights
  • Travelling are common causes of Back Pain.
 
Summary
  • Regular exercises, proper ergonomic advise will decrease chances of Back Pain and CTDs
TAKE HOME MESSAGE
WE are responsible for musculoskeletal health in INDUSTRY
 

Neck Pain

NECK PAIN
( NECK TENSION SYNDROME )
CAUSES OF NECK PAIN
  1. Wrong posture during ADLs: Sleeping; eg: improper pillow Sitting; eg: with shoulder shrugged/ neck forward attitude Standing; eg: holding phone between the ear and shrugged shoulder
  2. Heavy bag on shoulder
  3. Infection: incase of flu; sudden jerks to the neck during very forceful sneezing
  4. Sudden recreational activity: sport/ gym
  5. Stress, anxiety

SYMPTOMS AND SIGNS OF TRAPEZITIS

  • Pain in the neck; either on 1 side or both the side
  • Reduced movement of the neck
  • Extension of the neck will be more painful
  • Swelling along with tautness of that part and sometimes redness

INVESTIGATIONS AND DIAGNOSIS

  • History
  • On observation: increased contour indicating swelling; posture
  • On examination: spasm
  • cervical ROM restricted
  • Investigations: X ray, MRI etc.

TREATMENT- MEDICAL

  • Anti-inflammatory drugs
  • Muscle relaxants

PHYSIOTHERAPY TREATMENT

  • To reduce pain
  1. Hot packs
  2. Pain relieving modalities
  • To relieve myofascial pain:
  1. Myofascial release (MFR)
  • To release trigger point:
  1. Cyriax deep friction
  2. Local Ultrasound massage
  • To reduce muscle tightness & increase ROM-
  • Stretching exs to pectorals, trapezius,  levator scapulae, subocipital muscles Mobilization of facetal joints
  • To increase muscle strength:
  • Strengthening exs with theraband
  • With free weights
  • Postural correction
  • Ergonomic advice:
  • Desk modification
  • Computer n accessories modification

Exercises for the office

  • One of the biggest injury risk factors is static posture.
  • Try to spend at least 5 minutes every hour away from your computer.
  • Remember to ONLY stretch to the point of mild tension.
  • Try to incorporate the stretches into your daily routine.

This slide provides some illustrations of simple active stretches to perform at the office.


Hand Exercises

  • Tightly clench your hand into a fist and release, fanning out the fingers. Repeat 3 times

neck pain reliefneck pain treatmentsevere neck pain

Back and Shoulder Exercises

back and neck pain
  • Stand up straight, place your right hand on your left shoulder and move your head back  gently.  Do the same thing for the right shoulder
  • Move head sideways from left to right and back to left
  • Move head backwards and then forward

back and neck painupper neck pain

Computer and Desk Stretches

  • Sitting at a computer for long periods often cause neck and shoulder stiffness and occasionally lower back pain. Do these stretches every hour or so throughout the day or whenever you feel still. Also be sure to get up and walk around the office whenever you think of it. You’ll feel better.

Computer and Desk Stretches …

back of head and neck painneck and shoulder pain reliefbad neck pain

MYTHS AND FACTS
MYTH: Advise of hot fomentation on

Ideal Office

cause of neck pain

TAKE HOME MESSAGE
WE are responsible for musculoskeletal health in INDUSTRY

 

Press Release


Surgeons Fix Severed Hand

 

Heading a 'noble' cause

Press release

Press release
 

Academics


Academics

Courses Conducted :

PGDEMS
Course Duration - 6 months
PGDHHCM
Course Duration - 1 Year

 

Post Graduate Diploma in Emergency Medical Services

 

  • 6 months Course

ELIGIBILITY CRITERIA

  • MBBS / BAMS / BHMS /  BUMS / B.Sc. Nursing

ADMISSION PROCEDURE

  • Admissions are open  for PGDEMS in January / June
  • Candidate should submit the prescribed application form duly completed along with 3 passport sized photographs and an attested copy of the degree / REGISTRATION certificate at the time of admission

TEACHING PATTERN OF THE COURSE

  • Course duration - 9 academic months
  • Theory & Practical - 6 months Supervised Internship - 3 months
  • Weekend course, teaching will be conducted for 8 hours every weekend. i.e. on Sunday’s (9 am – 6 pm) for the first 6 months
  • 85% attendance mandatory

Post Graduate Diploma in Hospital and Healthcare Management

  • 1 Year Course launched in association with Yashwantrao Chavan Maharashtra Open University

ELIGIBILITY CRITERIA

  • Graduates in Engineering, Science, Medical Science,  Pharmaceuticals etc

ADMISSION PROCEDURE

  • Admissions are open for PGHHCM in June
  • Candidate should submit the prescribed application form duly completed along with 3 passport sized photographs and an attested copy of the degree / REGISTRATION certificate at the time of admission.

TEACHING PATTERN OF THE COURSE

  • Course duration – 1 year
  • Weekend course, teaching will be conducted for 8 hours every weekend. i.e. on Saturday’s (9 am – 6 pm)
  • 85% attendance mandatory

For further details please contact Course Coordinator :
Dr. Pankaj Bhise – 9764042247 / 66285000 – Extn 5466

 

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Call:
020 66285000, 020 43285000

Fax No:
020 66285199

Email:
care@noblehospitalspune.com

Website:
www.noblehospitalspune.com

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Noble Hospital
153, Magarpatta City Road
Hadapsar
Pune 411013