My Green Corner

Degree of risk involved with Osteoporosis used to be a big puzzle and it was a major issue among the doctors and clinicians around the world. “Until now there is no way to determine which orthopedic patient is at low risk and which one is at the high risk” said Ethel Siris, a Professor of Clinical Medicine at ‘Columbia University of Physicians and Surgeons’ in New York City.Some of the people with low bone mass will have a fracture but most of them never have fracture. This fact though known but was a main point of worry as it was not possible to differentiate between the two probabilities.

“FRAX algorithms” have solved this long pending puzzle now and to point out the people who need treatment can be find out using the FRAX algorithms. To calculate an individual’s 10-year risk of fracture ‘World Health Organization (WHO)’ has developed a new algorithm to complete this calculation.

For the prevention and treatment of osteoporosis that includes the algorithm is the new guide for a clinician. Osteoporosis can be diagnosed by a low impact fracture or a bone density score of -2.5 as a measure by “Dual-Energy X-Ray Absorptiometry or a DXA Scan”. According to the statistics, in the United States alone about 10 million people are suffering from some kind of osteoporosis.  To strengthen the bones this group needs to be treated with one of the several pharmaceutical products. In absence of a definite measurement of bone fracture susceptibility and degree of risk involved with the level of severity of osteoporosis it becomes extremely difficult to select the most appropriate medication and treatment.

The people whose bone density scores range between minus1.0 and minus2.5 are known to have “Osteopenia”.  The treatment of people with osteopenia is more of a puzzle as the number of people suffering from this disorder has reached to almost 34 million. The risks for fracture are high in this group of people but it is not clear that who among group needs the treatment and which particular treatment should be prescribed. By keeping this population in mind the new tools were developed.

According to the ‘National Institutes of Health’, one in two women and one in four men above the age of 50 has an osteoporosis related fracture. The cost is very high for such fractures. For those at high risk many groups have worked to improve educational efforts on ways to prevent bone loss and to gain insurance coverage for bone density screening.

According to Dr. Siris evidence based direction to help doctors and others to identify patients of age above 50 who are at a risk of breaking a bone is provided by the new clinician’s guide. Richard Hellman, President of the ‘American Association of Endocrinologists’ said that the guidelines that represent an important improvement in the risk evaluation quality and treatment of osteoporosis will assist clinicians in treating osteoporosis. The focus is shifted from bone density scores to fracture risk by the new guidelines. New algorithm based calculation would further facilitate clinicians and doctors around the world to define and select the most suitable treatment for an osteoporosis patient.

Laura Tosi who is an orthopedic surgeon at Children’s National Center in Washington D.C welcomed the new development and also stressed that the fractures are the issue, not the osteoporosis because the people without osteoporosis will also have fractures.

Dr. Kanis, the Director of ‘WHO Collaborating Center for Metabolic Bone Diseases’ and the professor emeritus at the ‘Sheffield University’ developed “FRAX” which is known by clinicians and researchers for several years. Edward Leib, a professor of medicine at the ‘University of Vermont ‘said that using the data published by Dr. Kanis he began calculating 10-year fracture risk about five years ago and results obtained with this new system have been extremely satisfactory.

“FRAX” is an online calculator which determines the patient’s risk of fracture over the next 10 years when the physicians give answers to the questions such as patient’s height, weight, bone density scores at the hip, history of fracture, smoking status, whether a patient had a fractured hip and how many drinks imbibed per day. The calculator can be used in several countries and also in countries where DXA scanners are not available. To determine whether the treatment is cost effective the resulting score can be used. Multiuser interface of this algorithm based fracture calculator is an extended advantageous tool for everyone since it is available online.

When the 01-year risk of a hip fracture reached above 3% as determined by FRAX it was found cost effective to treat a person in the United States. When the risk for any fracture over the next 10 years reached 20% was also considered cost effective to treat.

By including the men above 50 and postmenopausal women for the first time when the population needs an evaluation for fracture risk, the new guide breaks the ground. An important risk for low bone mass in people of all background has found by the recent research.

 Basics of Prostate Glands

A walnut-sized gland in the male reproductive system is the “Prostate Gland”. Changes occur in this gland as the man ages can cause disruptions in his life. The change may be from annoying urinal symptoms to the dangerous prostate cancer. Although younger persons can be affected by the prostate problems, mostly the prostate problems come to the surface after 50 years of age. The causes are exactly not known but studies show that a combination of genetic, hormonal and environmental factors such as diet also plays a role.

Prostate inflammation with painful or difficulty in passing urine is “Prostatitis”. The erectile function is not affected by ‘Prostatitis’. “Prostatitis” frequently strikes younger men unlike other prostrate diseases and treatment can be difficult.

Non-cancerous enlargement of the prostrate that can interfere with urination is “Benign Prostatic Hyperplasia (BPH)”. Erectile function is not altered by this disease called “Prostatitis”. Prostrate cancer is common in older men. About 70% of the men aged over 65 are diagnosed with prostate cancer. It is more common in African American men than any other group and tends to hereditary.

Location of prostate is in front of the rectum and just below the bladder. The tube that carries urine from the bladder out of the body wraps around the upper part of the urethra. The connective and glandular tissues found in the prostrate glands produces a thick milky-white fluid that forms part of the semen that is a liquid ejaculated during sexual activity. The prostate gland requires adequate amount of certain hormones for functioning properly such as testosterone that is produced by the testicles as well as other hormones from the pituitary and adrenal glands.

Prostate Disorder Diagnosis

Digital Rectal Examination (DRE)

DRE is used to determine whether the prostate is swollen or has any lumps or abnormally textured area in which the doctor inserts a lubricated, gloved finger in to the rectum and feels the surface of the prostate glands. DRE also helps doctors to screen diseases of the rectum such as rectal cancer. All men ages 50 or older have to take a yearly DRE, advises the ‘American Cancer Society’.

Conflicting results are produced by the studies and the study conducted by ‘Mayo Clinic’ demonstrated that men who get DREs are less likely to develop prostate cancer.  DRE is a useful screening test. The accuracy of DRE depends on the skill of the doctor and interpreting the test. DRE cannot detect early cancerous tumors as they are too small and cannot be located by the doctor’s fingers also. Because of this DRE sometimes miss the smallest and most treatable tumors. Tumors which cannot be felt by the physicians are less likely to be dangerous.

PSA Test

PSA is a blood test which measure the level of a protein called “Prostate-Specific Antigen (PSA)” which is produced by the prostate. This is used to detect prostrate cancer but cannot provide a correct diagnosis. Because an above normal PSA level does not always shows the presence of cancer i.e. more than 4 nanograms per milliliter of blood and the levels of 4 ng/ml or less than that does not mean that the person is completely prostate cancer free.

The clues besides cancer also can provide by the PSA test. The mildly elevated PSA levels do not have cancer. The non-cancerous conditions such as “Benign Prostatic Hyperplasia” and “Prostatitis” are accompanied by elevated PSA levels. An elevated PSA also means that prostate glands naturally release more protein in to the blood. According to some studies the ejaculation can elevate PSA levels for up to 48 hours. Doctors also use PSA test for follow-up after prostate cancer treatment and also to predict which patients with BPH are likely to develop troublesome symptoms.

PSA Screening

Prostate cancer is more common but only 3%-4% of men die of prostrate cancer.

Screening increases the chance of finding prostate cancer but does not decrease of having it.

It can detect early stage cancers.

A normal PSA level does not mean that the person is cancer free.

Higher PSA level may force the person to seek treatment resulting in possible urinary and sexual side effects.

BPH and Prostatitis are also the conditions that can elevate the PSA level.

Yes, according to the American Cancer Society, virtual colonoscopy can prove a boon to patients hitherto undergoing the conventional and not-so-pleasant colonoscopy. If this becomes successful, millions would be benefited. The ‘EBT Heart and Body Imaging’ at Detroit seemed to have passed the advance test supported by the 5-year colon screening guidelines.”March being the month of awareness for colon cancer awareness, the including of ‘Virtual Colonoscopy’ in the colonoscopy guidelines in the month of March can send smiles across the cancer patients that need to undergo frequent colonoscopies,” remarks a physician based in Detroit.

‘The American Cancer Society’ in association with the ‘American College of Radiology’ as well as a group of multitask force on colorectal cancer which has representatives from various groups of gastroenterology released the unanimously approved colon screening guidelines for screening colorectal cancer. Thankfully the virtual colonoscopy passed the ACS screening tests.

According to the ‘American Cancer Society’, colorectal cancer is the third commonest of cancers amongst the Americans and second in leading to cancer death in the country. Colorectal cancer mostly is common after the age of 50 and caused death of about 75k people in the year 2007 alone with almost double that number of new cancer cases. In spite these alarming numbers less than half of these only get tested.

“Unfortunately several deaths happen for the simple reason of people waiting for the compensation for this colonoscopy which is quite expensive,” says the Director of EBT Heart & Body Imaging, Detroit. “In this context the virtual colonoscopy proves boon to them and additionally, it satisfies all criteria of a regular colonoscopy screening and therefore it can incorporated into the screening. The third parties that pay compensations, doctors and medical institutions can also avail the information for expediting compensations as well as training the doctors,” remarks the director of the Imaging institute.

‘Virtual colonoscopy’ procedure which is also known as ‘CT colonography’ will soon be covered by insurance opines the director of the institute and in the interim it can be availed by US and Canadian residents.

Virtual colonoscopy procedure is less invasive and uses CT scan technology to give a 3-D view of the colon without any sedation required. Once the procedure is complete, the person can resume back to normal routine. This procedure is a recommended screening test for colon cancer.

Spring time brings green cheerfulness everywhere. It is time for families to take care of their gardens and the green grass often needs proper dressing with lawn mowers.

The “Power Lawn Mower” is one of the most unsafe tools around the home. The unsafe use of lawn mowers poses a serious public health threat and it results in more than 55,000 injuries every year due to that.

In such accidents, a significant proportion of the victims either lose a part of their toes or fingers or could face dislocated bones, burns or it might even prove to be fatal. According to the medical data, in almost 95 percent of such injury cases amputation and extensive reconstructive surgery was found to be inevitable.

The types of injuries caused by unsafe and improper use of power lawn mowers could include lacerations, fractures and amputations of the fingers, hands, toes, feet and legs. Thousands of unfortunate children not only suffer the physical injuries but also have to undergo the emotional and social problems associated with these kinds of injuries. Other type of injuries include being run over by a riding mower, any object being flung and striking the child, or the burns due to the gasoline or by touching the hot metal parts.

Most of the ‘lawn mower injuries’ occur on slopes, particularly when the ground is damp, in poor lighting conditions and among inexperienced mowers. Among the victims are usually the innocent bystanders, often children, injured or killed by someone else operating the mower. Fatalities usually occur during the following situations:

• When adults while moving the mower, allow children to stand on it or sit at the back of riding mowers while moving lawn mower.
• Children try to operate the mower themselves, when they are too young to do so.
• Sometimes even rocks or stones can be thrown by the mowers and they can hit the head or eyes of the children.
• Injuries also occur when the lawn mowers are placed into reverse and children moving behind them are not aware of it.

Lawn mowing experts and other health professionals including some medical societies recommend that virtually all of these injuries could be prevented if some necessary precautions are taken. An initial training would always be more beneficial because it will help in understanding the working of power lawn mowing machine and its operational guidelines. According to the expert’s recommendations, individuals and families should observe following precautions:

• It is important for one to familiarize oneself with the equipment before operating it and after checking that it is in proper working condition. It is always safe to go through the manufacturer precautions.
• It is recommended to use lawn mowers with guards and a cutoff switch and be certain that the cutoff switches should not be disconnected. All electrical connections must be checked properly prior to operating the machine. Any negligence could give you a shock.
• One should be extra ordinarily careful while operating the mowers on slopes and avoid mowing when the ground is damp.
• Other people, especially the children under the age of 6, should not be allowed inside the yard when operating a lawn mower.
• Kids should not be allowed to ride as passengers on mowers or let them be towed behind mowers. They should not be allowed to play on or around stored mowers.
• Children should not be allowed to operate the equipment unless they have strength and are totally aware of the know how of it. It is always better to keep them off instead of making them participative in this ‘adventurous activity’.
• It is dangerous to go barefoot while mowing. Sturdy shoes should be worn. Use your legs in movements with caution and more attention.
• Always wear protective eye gear, hand gear and footwear such as goggles, gloves and heavy rubber sole boots.
• It is advisable to pick up stones, toys, and debris from the mowing area. These objects can act as potential projectiles from the lawn and could hit back affect head, eyes and other parts of your body.
• It could be dangerous while pulling backward on a mower or mow in reverse. This should be done while looking carefully behind you before backing up a mower.
• It is advisable to start and refuel mowers outdoors, not in a garage or shed. Refueling should be done with the motor turned off and cool.
• While removing any objects from the blade, one should be extra careful as any negligence could result in to severe cuts and injuries.

In addition to the above precautionary steps adopted by the consumers, it should be made necessary for the lawn mower manufacturers to include a safety manual with every lawn mower sold and imprinting safety instructions on all machines. There should also be awareness campaigns among the public so that such injuries could be prevented, contributing to a decline in costs on health care as well as eliminate suffering to the injured.

“Lawn mowers severely injure thousands of children every year. So many of these tragic injuries could have been prevented with just a few precautions”, says AAP President Dr Jay. E. Berkelhamer.

Lawn mower injuries are a seasonal threat to children and the leading cause of amputations in adolescents, say specialists from the ‘Johns Hopkins Children’s Center’, Maryland’s designated pediatric trauma center where the most severe injuries are treated.

Ardent lovers and frequent mobile phone users are at 50% more risk of developing the “Parotid Gland Tumor” compared to those who either do not use mobile phone devices or use it quite less frequently.The “parotid gland” is located near our jaw and ear, the place where we normally place the mobile phone devices while communicating. It is the largest human salivary gland in our body.

Mark Kidd in an article published in the year 2006 in the “Ear Nose and Throat Journal “reported that approximately one to three per hundred thousand people is the rate of occurrence of ‘salivary gland tumors’ on an annual basis. Projecting the same rate ahead, if the rate is increased by 50% would raise the theoretical risk of developing a brain tumor from its rate of 0.003% to 0.0045% per year.

Presently, the rate of deaths caused by the car accidents in the United States alone is nearly 14 per hundred thousand people per year. A close comparison with this ratio can easily make a perspective of dangers posed by the frequent use of cell phones to the common people.

The debate is constantly on as the use of cell phone is dangerous or not. The possible outcomes and resulting health effects are among the focus of several of the studies that are still underway. But one aspect is clear which concerns the radiation impacts on human beings. Researchers around the world will have to work with all available data but since the number of mobile phone devices users is growing exponentially they should opt for more comprehensive studies involving large populations. Some experts feel that this may be a time taking exercise but to derive conclusive findings it is required in the interest of people’s health concerns.

Risk of cancer is also one such debatable issue as scientists across the world seem to be divided on this issue. Some favor such health effects like cancer and some of course do not. However, there appears to be a consensus emerging in favor of a risk of cancer though very small but real. More specific research studies are required to obtain conclusive proof.

It is clear from the findings of the ‘U.K. Mobile Telecommunications and Health Research Programme’ which remarked that they “found no association between short term mobile phone use and brain cancer”. At the same time they also expressed that “the situation for longer term exposure is less clear”.

Findings of another study conducted by professor Kjell Mild of Sweden’s ‘Orebro University’ revealed that prolonged use of mobile phone devices for a period of over ten years definitely enhances the probability of brain cancer and children in particular are far more susceptible to this great risk as the radiations are more likely to affect their developing skulls. Researchers feel that probably it is the prolonged use of devices that causes adverse effects on health and this is perhaps the reason that researches conducted with a short term focus have not been able to find out such results.

On the contrary, findings of a Swedish research conducted last year and published in the “American Journal of Epidemiology” said that an analysis was made for possible risks of using mobile phones related to the parotid gland tumours but the researchers could observe no direct relation between the two.

Both these specific studies focussed on ‘parotid tumour risks’ differ in their approach and methodologies. The study conducted in year 2006 involved 172 people who were having Benin and malignant tumours along with the 691 health control subjects. On the other hand the present study conducted by an Israeli scientist, Dr. Siegal Sadetzki at the ‘Gertner Institute for Epidemiology and Health Policy Research’ at the ‘Sheba Medical Center’ included almost 500 people with benin and malignant tumours and nearly 1,300 healthy controls.   

Israeli people were among the early cell phone adaptors and they are heavy technology users, according to Sadetzki. This tendency, she says, exposes them to higher radio frequencies compared to any other populations. In rural areas, her study reveals, the risk of cancer is increased considerably among the frequent cell phone users. Presence of fewer antennas the radiation output is also increased and this affects the rural people while communicating with the mobile phone devices. She expressed her concern that the frequent users and specifically the children are at greater risk of various health effects.

Precaution is the best way, Sadetzki says, in order to diminish the exposure and lower down the risk. She strongly recommends use of hands free devices and holding the phone away from body. She also calls for reducing the talk time on phones making them shorter calls and less frequent use. Parents must impose a limitation on their children to follow a controlled routine with mobile phone devices.