Authored by Dr. Amit Jhala, Sr. Consultant Spine Surgeon, HCG Hospitals, Ahmedabad

The spine is the backbone of human anatomy. It provides structural support, enables flexibility, and protects the spinal cord, the main communication highway between the brain and the body. However, the spine often faces challenges due to poor posture, sedentary lifestyles, injuries, or age-related degeneration. Of many conditions, chronic pain in the spine tends to cause more discomfort, and conditions like herniated discs, spinal stenosis, or scoliosis can significantly impact mobility and quality of life. Various treatment options are available to manage chronic spinal pain, but spinal fusion stands out as a unique approach that often provides enhanced comfort and stability.

What Is Spinal Fusion?

Spinal fusion involves joining two or more vertebrae using bone grafts, screws, rods, or plates and the goal is to eliminate movement between the affected vertebrae, reducing pain and preventing further damage. Over time, the fused vertebrae grow into a single solid bone, offering enhanced stability.

What are the Common Conditions Requiring Spinal Fusion?

Spinal fusion is not a first-line treatment but is reserved for severe conditions, such as:

• Degenerative Disc Disease: When the cushioning discs between vertebrae break down, it can lead to pain and instability.

• Scoliosis: In cases of severe spinal curvature, spinal fusion helps realign and stabilize the spine.

• Spinal Stenosis: Narrowing of the spinal canal can compress nerves, causing pain, weakness, and numbness.

• Spondylolisthesis: This condition occurs when one vertebra slips over another, causing instability and nerve irritation.

• Fractures or Tumors: Severe trauma or tumors in the spine may necessitate spinal fusion to restore structural integrity.

When Is Spinal Fusion Necessary?

Spinal fusion is considered when:

• Non-surgical treatments Fail: Physical therapy, medications, and injections have not provided sufficient relief.

• Chronic Pain Persists: Pain significantly impacts the quality of life and daily activities.

• Spinal Instability Exists: Movement between vertebrae causes pain or nerve damage.

• Neurological Symptoms Appear: Weakness, numbness, or loss of bowel/bladder control due to nerve compression.

Risks and Considerations

Like any major surgery, spinal fusion poses inherent risks that patients should consider carefully. Potential complications include infection, blood clots, and nerve damage, which could result in numbness, weakness, or chronic pain. Another significant concern is adjacent segment disease, a condition where the vertebrae near the fused segment bear increased stress, potentially leading to degeneration over time. Recovery from spinal fusion is a gradual process, often requiring a prolonged rehabilitation period. Patients may need to undergo physical therapy to restore strength, improve mobility, and adapt to the changes in spinal mechanics. Adherence to post-surgical guidelines is crucial to achieving optimal outcomes and minimizing long-term complications.

What are the Advances in Spinal Fusion?

Modern surgical techniques, such as minimally invasive procedures, have improved outcomes and reduced recovery times. Innovations in imaging and navigation technologies ensure greater precision, enhancing the success rate of the surgery.

Conclusion

Spinal fusion is a highly effective solution for individuals suffering from debilitating spinal conditions. However, it is essential to weigh the benefits against potential risks and consider them only after exhausting non-surgical options. Consulting with a spine specialist is crucial for determining the best course of action based on individual needs and circumstances.

With the advancement in technology, every device has become smart - from smartphones and televisions to wristwatches. Smartwatches today are used across the globe to monitor one’s fitness, sleep habits, and health. We have recently observed how smartwatches are helping in saving peoples’ lives, which reflects on the usefulness of these devices.  Such smartwatches monitor heart rate rates as well and send an alert to the wearer if there is anything out of the ordinary.

Let’s take a look at what a smartwatch notification might indicate about irregular heart rates. While such notifications may sound alarming, it’s important to understand what these notifications mean and when and what action should be taken.

What Does a Smartwatch Detect?

Smartwatch are devices which comes with advanced sensors that monitor heart rates throughout the day. Also, the device analyses a person‘s heart rate when the person is at rest to detect irregularities. An irregular heart rate may signify a potential heart rhythm issue, such as atrial fibrillation (AFib). It also sends a notification to alert the user in case any unusual pattern or irregular beats are detected.

However, it is important to remember that a Smartwatch is not a diagnostic tool. Also, it cannot confirm AFib or any other medical condition. However, it does help identify irregular patterns that may require medical evaluation.

When Should Irregular Heart Rates Cause Concern?

If a smartwatch is repeatedly, sending alerts of is regular heart rate that might be an indication that it is time to consult a doctor. Even if the wearer of the Smartwatch feels fine, such consistent alerts should not be ignored. If there are additional symptoms like chest pain, dizziness, or shortness of breath along with frequent notifications from the Smartwatch device, it is crucial that an individual seek medical attention.

Steps to Take When a Smartwatch Sends an Alert

It is important that a doctor is consulted if there are frequent irregular heart rate notifications from a Smartwatch. One can keep a record of when these notifications occur and the type of activity that was being performed at that time, so as to provide any useful insights to the doctor.

It is important to rely on advice offered by medical experts who might suggest tests like electrocardiogram (ECG) in order to confirm or deny conditions like Atrial fibrillation (Afib).

Additionally, one can adapt lifestyle changes in their daily lives and try to incorporate healthy habits. This can include regular exercise, a balanced diet, and keeping a check on mental health in order to reduce any risk of heart problems.

It is important to remember that a Smartwatch is a helpful and valuable tool to monitor health and heart rate but it cannot have a final say in a person ‘s health. Consulting healthcare providers and medical experts is essential if in case a Smartwatch device sends out frequent notifications regarding one’s health.

By:- Dr Abhishek Singh, Consultant Cardiology, Manipal Hospital, Ghaziabad

Dr. Milind Shetti, Sr.Radiation Oncologist, HCG NMR Cancer Centre, Hubli

Our lifestyle choices play a significant role in determining our overall health and well-being. The food we eat, the exercise we get, and the habits we cultivate can all contribute to our risk of developing various diseases, including cancer. In recent years, research has shed light on the link between certain lifestyle choices and the risk of head and neck cancer. Two substances that have been extensively studied in this context are tobacco and alcohol.

The Role of Tobacco in Head and Neck Cancer

Tobacco is a well-established risk factor for head and neck cancer. Around 50% of all cancer are caused by tobacco and 75% in Head and Neck Cancer. The International Agency for Research on Cancer (IARC) has classified tobacco as a Group 1 carcinogen, meaning that it is considered to be carcinogenic to humans. Tobacco contains more than 70 known carcinogens, including polycyclic aromatic hydrocarbons (PAHs), nitrosamines, and volatile organic compounds (VOCs). When tobacco is smoked or chewed, these carcinogens are absorbed into the bloodstream and can cause damage to the DNA of cells in the head and neck region. This damage can lead to the development of cancerous tumors in the mouth, throat, voice box, and other areas of the head and neck.

The Impact of Alcohol on Head and Neck Cancer Risk

Alcohol is another substance that has been linked to an increased risk of head and neck cancer. The IARC has classified alcohol as a Group 1 carcinogen, and research has shown that drinking alcohol can increase the risk of cancer in the mouth, throat, and voice box. Alcohol can cause cancer in several ways, including by damaging the DNA of cells, increasing the levels of carcinogenic compounds in the body, and altering the way in which the body metabolizes nutrients. Additionally, alcohol can act as a solvent, allowing carcinogens to penetrate more easily into the tissues of the head and neck.

The Synergistic Effect of Tobacco and Alcohol

When tobacco and alcohol are used together, the risk of head and neck cancer increases significantly. This is because the two substances can interact with each other in ways that enhance their individual carcinogenic effects. For example, alcohol can increase the levels of carcinogenic compounds in tobacco smoke, while tobacco can increase the levels of carcinogenic compounds in alcohol. Additionally, the combination of tobacco and alcohol can lead to a greater degree of DNA damage and genetic instability in cells, making it more likely that cancer will develop.

Reducing the Risk of Head and Neck Cancer

While the link between tobacco, alcohol, and head and neck cancer is clear, there are steps that can be taken to reduce the risk of developing this disease. The most effective way to reduce the risk of head and neck cancer is to avoid using tobacco and alcohol altogether. For those who do use these substances, quitting or reducing consumption can significantly lower the risk of cancer. Additionally, eating a healthy diet rich in fruits, vegetables, and whole grains, and getting regular exercise can also help to reduce the risk of head and neck cancer.

The use of tobacco and alcohol is a significant risk factor for head and neck cancer. These substances can cause damage to the DNA of cells, increase the levels of carcinogenic compounds in the body, and alter the way in which the body metabolizes nutrients. By avoiding the use of tobacco and alcohol, quitting or reducing consumption, and adopting a healthy lifestyle, individuals can significantly reduce their risk of developing head and neck cancer.

Dr. R V Raghunandan, Senior Consultant - Radiation Oncology, HCG MNR Cancer Hospital, Ongole

Colorectal cancer, also known as bowel cancer, is one of the most common types of cancer worldwide, affecting millions of people each year. In India, it is estimated that over 50,000 new cases of colorectal cancer are diagnosed annually. While these statistics may seem alarming, the good news is that colorectal cancer is one of the most preventable types of cancer. By incorporating healthy habits into our daily lives, we can significantly reduce our risk of developing this disease.

Maintaining a Healthy Diet

A well-balanced diet plays a crucial role in preventing colorectal cancer. Foods that are high in fiber, such as whole grains, fruits, and vegetables, can help to keep the digestive system healthy and reduce the risk of cancer. It is recommended to consume at least 25-30 grams of fiber per day. A high-fiber diet can help to promote regular bowel movements, prevent constipation, and support the growth of beneficial gut bacteria. In addition to fiber, other essential nutrients that can help to prevent colorectal cancer include omega-3 fatty acids, antioxidants, and vitamin D. It is also essential to limit the intake of red and processed meat, which have been linked to an increased risk of colorectal cancer. The American Cancer Society recommends limiting red meat consumption to no more than 18 ounces per week.

Staying Physically Active

Regular physical activity is another important aspect of preventing colorectal cancer. Exercise can help to improve digestion, boost the immune system, and reduce inflammation in the body. Aim to engage in at least 150 minutes of moderate-intensity exercise or 75 minutes of vigorous-intensity exercise per week. Moderate-intensity exercise includes activities such as brisk walking, swimming, cycling, and dancing. Vigorous-intensity exercise includes activities such as running, jumping rope, boxing or kickboxing, and high-intensity interval training (HIIT). In addition to regular exercise, incorporating physical activity into daily routines can also be beneficial. This can include taking the stairs instead of the elevator, walking to work or school, or doing household chores.

Managing Stress and Getting Enough Sleep

Chronic stress and lack of sleep can weaken the immune system and increase the risk of colorectal cancer. Practicing stress-reducing techniques, such as meditation or yoga, and aiming for 7-8 hours of sleep per night can help to mitigate this risk. Effective stress-reducing techniques also include deep breathing exercises, progressive muscle relaxation, and mindfulness meditation. In addition to stress reduction, getting enough sleep is also essential for overall health and wellbeing. Tips for improving sleep quality include establishing a consistent sleep schedule, creating a relaxing bedtime routine, avoiding caffeine and electronics before bedtime, and creating a dark, quiet sleep environment.

Getting Screened Regularly

Regular screening is essential for detecting colorectal cancer in its early stages, when it is most treatable. The American Cancer Society recommends that adults aged 45 and older undergo regular colorectal cancer screening. Common screening tests for colorectal cancer include fecal occult blood test (FOBT), fecal immunochemical test (FIT), colonoscopy, and computed tomography (CT) colonography. By incorporating healthy habits, such as a balanced diet, regular physical activity, stress management, and regular screening, into our daily lives, we can significantly reduce our risk of developing colorectal cancer.

While colorectal cancer is a serious disease, it is also highly preventable. By taking proactive steps towards a healthier lifestyle, we can reduce our risk of developing this disease. Let us prioritize our health and well-being, and take the necessary steps 

This article highlights the factors behind rising lung cancer incidence in non-smoking women. It is the need of the hour for women to prevent lung cancer by avoiding secondhand smoke, and pollutants, getting screened regularly, and eating a nutritious diet. Read on to learn more about this article. 

Lung cancer is causing higher morbidity and mortality rates not only in India but across the world. This deadly cancer is commonly associated with smoking in men. However, a large number of women who are nonsmokers are now getting diagnosed with lung cancer which is taking a toll on their overall well-being. So, not only in those having a history of tobacco but even lung cancer rates are increasing in nonsmokers. According to reports, even though smoking rates are going down, lung cancer cases are rising at an alarming rate in women too.

Factors causing lung cancer in non-smoking women:  One of the major factors leading to lung cancer is secondhand smoking which involves toxic chemicals such as arsenic ammonia, benzene, and formaldehyde. Estrogen levels among menopausal women with lung cancer are usually higher than those in women without lung cancer. Hence, this also can be the cause of lung cancer. Genetic mutations and hepatitis B and C, human papillomavirus or HPV, and Epstein-Barr virus are also known to cause lung cancer in women.

The warning signs of lung cancer are constant coughing, chest pain, asthma, fatigue, breathlessness, poor appetite, chest pain, and recurrent respiratory infections that women shouldn’t notice and seek accurate diagnosis and treatment without any delay.

The treatment: Of lung cancer is based on the stage and location of the tumor. It will be essential for women to follow the guidelines given by the expert for successful outcomes. The treatment involves a tailor-made approach consisting of surgery, radiation therapy, and chemotherapy. Apart from this, one may also be advised targeted and immunotherapy for cancer management. Just like smokers, nonsmoking women will also have to be proactive when it comes to their lung health.  If you don’t smoke, that doesn’t mean you will not suffer from lung cancer.  Taking preventive measures goes beyond just avoiding smoking. Regular check-ups with experts can lead to earlier detection of potential issues. Women should eat a balanced diet rich in antioxidants, and ensure good indoor air quality through proper ventilation and air purification systems. Women need to stay vigilant regarding their health.

By:- Dr  Shahid Patel, Consultant Pulmonologist, Medicover Hospitals, Kharghar, Navi Mumbai

One of the most critical health issues in our country requires urgent attention to be applied and solved -  addiction to substances. Known for afflicting millions of people, substance abuse has emerged as a grave public health issue. Though tobacco and alcohol often grab headlines, we are globally increasingly facing the problem of drug abuse, which urgently needs attention.

Today, drug addiction in India has crossed alarming levels. As per the National Survey on Magnitude of Substance Use in India (2019), approximately 2.6 crore people (2.1% of the population) use heroin. Additionally, over 8.5 lakh people are estimated to be injecting drug users, with serious health risks including the transmission of HIV and Hepatitis C. These figures depict a worrisome trend, wherein drug use in the erstwhile rural hubs is significantly on the rise but now even more so in the districts. The most vulnerable victims are the youth, exposed to synthetic drugs and opioids that are equally potent and deadly. The social, economic, and health-related effects of drug addiction are severe, calling for intervention in both preventive as well as treatment measures. 

Dr. Swapnil Agrawal, Psychiatrist, Mind Clinic, Napier Town Jabalpur says, “Drug addiction is recognized as a chronic, relapsing disease that alters brain chemistry, making it difficult for individuals to break free from substance dependence. Opioids, in particular, bind to receptors in the brain, creating feelings of euphoria but also leading to tolerance, dependence, and eventually addiction. Heroin, one of the most commonly abused opioids in India, poses a significant risk of overdose and death.”

With addiction being a biological condition, treatment should be based on medical and behavioral interventions rather than morality or punishing the individual. In the recent past, immense advances have been in the treatment of drug addiction through medical therapies. Medications used in the treatment of opioid substitution therapy help people manage withdrawal symptoms and curb cravings without the euphoric effects associated with harmful drugs like heroin. Another critical treatment is through life-saving drugs that reverse opioid overdose, given by first responders and caregivers in time of need. This kind of treatment, accompanied by behavioral support, forms the foundation of advanced, evidence-based treatments of addiction and holds promise for millions fighting against substance dependence in India.

While advanced therapies are essential for those already in battle with addiction, prevention is the bedrock upon which a society free of drug dependency will be erected. The Indian government has made great strides under initiatives such as the National Action Plan on Drug Demand Reduction that serves not only to prevent drug abuse but also offers treatment to those in dire need of it. However, the scale of prevention has to be increased with more public awareness, education, and community outreach investment.

Public awareness campaigns, stricter implementation of existing regulations, and inclusion of addiction education programs are headed to reduce the burden of addiction. Such investments in prevention have been proven to greatly cut through the high healthcare costs and infrastructures that treat addiction and those accompanying health conditions, including cancer, heart disease, and liver cirrhosis. Education should also be directed toward schools, workplaces, and communities to prevent drugs, talk about the hazards of substance abuse, and present healthier alternatives. Furthermore, the stigma surrounding addiction should be lowered and help brought forward when the person who is suffering can be treated effectively, without fear, at an early stage.

Let us recapture the commitment to a drug-free India. By providing support to preventive efforts as well as to evidence-based treatments, we shall take giant leaps forward to eliminate the menace of drug addiction from our society.