Health related information and news from around the world.

ELM remedy is very uncommon remedy, as it usually caters to very uncommon people—people who hold very responsible positions in life: Presidents, Ministers, Mayors, Principals of educational institutions, General Managers and Chief Engineers of big factories, Managing Directors of big houses and institutions, secretaries of labour unions etc. whose decisions affect thousands of persons. They are very capable people, always ready to shoulder the great responsibilities attached to their office, and work ceaselessly to do their best.

Occasionally, even the most indefatiguable and over-ambitious person is led to identify so strongly with the current role of his personality that he ignores the guidance of his higher self that is calling for moderation. That is the time of weak moments of the Elm person. That is the time when he feels overwhelmed and a fear assails him “How is it humanly possible to do this job alone. No, I am finished. I am dead tired. I won’t be able to do it”.

It is a temporary phase, though. The ELM person is self-reliant and has inner conviction that he is quite capable of discharging his responsibilities.

But till the weak moments last, he feels despondent and exhausted. At that time ELM helps him to overcome the feeling of inadequacy and despondency quickly.

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Surgery

Kneecap alignment problems can be diagnosed by X ray, which will clearly show a patella that is off track. Depending on the cause of the problem, the following types of surgery may be performed.

Lateral Release. In some cases, the patella is being pulled off track by tight lateral bands, or retinaculum, which the physician can feel when she palpates the area. In a lateral release, which is done arthroscopically, the surgeon simply cuts the lateral bands, reducing the lateral pull on the patella, thus the patella moves back into place.

As with any arthroscopic procedure, possible risks include a small chance of developing an infection (under 1 percent), nerve damage, skin numbness, and other problems that are described on your patient consent form, which all patients should read carefully.

Patellar Realignment. There are two types of surgical procedures for patellar realignment: proximal realignment or distal realignment.

In a proximal realignment, an open-knee procedure, the surgeon must first perform a lateral release. After the lateral release, he cuts a piece of the quadriceps tendon (all the way down around the medial side of the patella to the medial border of the patellar tendon) and resutures the quadriceps tendon to a more medial position.

In a distal realignment (which may also include a proximal realignment), the surgeon moves the patellar tendon insertion at the tibia tubercle over to a more medial position and sometimes distal and elevated.

Exercise

Rehabilitation is crucial after patellar surgery. Keep in mind that surgery is not a cure-all. Even after surgery, it is imperative that you continue with a good strengthening program tailored your particular problem.

Bracing

Some people may find that a functional brace worn during activity may offer some relief for patellar problems. Frankly, there is no specific evidence that it does; however, it may have a subtle effect on the tracking of the kneecap, which could relieve discomfort. A patellar femoral workout brace is primarily a sleeve made of cloth or neoprene (rubber). This brace has a hole or pad around the kneecap to stress-relieve the area. A different variety of the patella brace has single straps around the distal (lower) part of the extensor mechanism around the patellar tendon. Either brace is fine if it works for you. Avoid braces that are too tight around the kneecap or an Ace bandage that compresses the knee too tightly—both can cause further discomfort. Braces can be purchased at surgical supply stores and some sporting good stores.

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In the 1930s, people with diabetes could only measure the amount of sugar spilled from the bloodstream through the kidneys and into the urine. To do this measurement they had of use a Bunsen burner and liquid chemicals that made them appear to be laboratory scientists.

In the 1940s, a tablet test for sugar in the urine became the standard for diabetes self-monitoring. The procedure uses a urine sample, a test tube and a tablet that reacts with the urine sample by changing the colour of the solution, depending on the concentration of sugar.

Throughout the world, many people with diabetes still use this test as their sole means of monitoring. Although it has some value in detecting above-normal blood glucose levels during the past few hours, it does not provide information about current levels, nor can it disclose low blood glucose levels.

By the 1950s, urine sugar tests were available on “dip and read” strips and tapes. These, too, were widely used. Improved versions of the strips provided reasonably accurate readings of glucose in the urine. These more precise and convenient strip tests provided information about glucose levels and still are used by persons who are unwilling or unable to do blood glucose tests.

The technology used to produce urine tests for glucose also was used to develop urine tests for ketones. These tests, in tablet or “dip and read” strip form, are widely used by people with diabetes who are at risk for developing the conditions called ketosis and ketoacidosis.

Most people with Type II diabetes are not prone to develop these complications, although some are. If you are at risk, your doctor will advise you to test for ketones in your urine, using a tablet or strip test, when your blood glucose levels are above normal or when you have an illness or are under stress.

There is another monitoring procedure valuable for people with diabetes. It’s called the glycosylated hemoglobin test and is done primarily at the physician’s office or in a laboratory (although an at-home test may be available in the near future). The glycosylated hemoglobin test, also called the hemoglobin A1C test, tells where your glucose levels have been, on the average, for up to eight weeks preceding the measurement.

The results of this test give you and your doctor a much more accurate view of how your overall efforts at good control have been working. Your self-measurements provide daily information. The glycosylated hemoglobin test shows the overall degree of control by averaging out the occasional highs and lows.

The goal of your diabetes management programme is to bring your blood glucose level down into the normal range and to keep them there. The glycosylated hemoglobin test shows how well you’re doing. Your self-monitoring records provide data on specific events – a heavy meal, a skipped exercise session – in relation to a single measurement. Your self-monitoring and your glycosylated hemoglobin test work as partners in helping you gain the best possible control of your diabetes.

To help you keep track of when to monitor, we’ve prepared the following chart. If you have complications, such as high blood pressure, you will want to check that more frequently. Be sure to ask your own doctor about how often you should have checkups and what other things you might be doing to maintain optimal health.

Monitoring schedule

Daily

Blood glucose

Feet

Weekly

Weight

Every three months

Glycosylated hemoglobin A1C

Blood pressure (more often if you have high blood pressure)

Yearly

Eye examination

Kidney function tests

Dental checkup

Liver function tests

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