Everything You Need To Know About Your Foot Surgery

Foot surgery needs to be carried out if a person’s bone has been dislocated or if the injury is quite serious. Gordon Slater is an orthopedic surgeon who specializes in Minimally Invasive Foot Surgery, primarily in the correction of bunions. He has extensive experience in orthopedic trauma. His special interests include ankle surgery, arthroscopy, and sports injuries, and foot surgery. If you have to go in for surgery, here are a few things that you should know.

By whom should I get surgery?

The best person to judge surgical results is your doctor, who regularly sees the patient’s surgery and has a clear idea about the surgeon. Many patients also come “by word of mouth” advised by a satisfied friend.

How much will it cost me?

The operation is fully supported with regard to social security. Nevertheless, the majority of the surgeons are in free fees and can ask you an overflow of fees, possibly refunded by your mutual, with an invoice. This should be clearly stated before the intervention.

Do I have to see the anesthetist?

The consultation is mandatory even if the patient leaves the same day, even if the anesthesia is not general. It must be between one month before and three days before the operation. Anesthesia can be general, locoregional by epidural, see local by a gesture behind the knee. The anesthesiologist will offer the patient the choice, as long as his medical record allows it.

What should I bring for the procedure?

Apart from the usual toiletries, in the case of hallux valgus and claw toe, think of bringing crutches and a special walking shoe if the surgeon has prescribed it, as well as X-rays.

For Morton’s syndrome, however, special walking shoes are not useful.

What is the duration of hospitalization?

Depending on the planned surgical procedure, the surgeon’s habits, the patient’s social context, the duration can range from a few hours to 2 to 3 days for the hallux valgus. For claw toe and Morton syndrome, it is most often a few hours as part of outpatient surgery.

When are you going to walk?

In principle, from the intervention, walking is possible with or without special shoe depending on the type of intervention, the habits of the surgeon, and the resistance of the bone. It is essential in all cases to raise the limb well to fight against edema when you are not standing. Crutches can be helpful.

Reference Blog: https://beforeitsnews.com/healthcare/2020/02/everything-you-need-to-know-about-surgery-2539320.html

Common Types of Foot Surgeries

Image Credits: Google.com

Common Types Of Foot Surgeries Out There

Foot surgeries are very intricate, and not many people know that there are different types of them. In fact, this is one of the most complex areas of the human body. It is easy to imagine that a lot of gut and stability of the hand is required for these surgeries. There are different types of surgeries that accomplished doctors like Gordon Slater perform. This Australian orthopedic surgeon is an MBBS FRACS AOrthoA, and an expert in the field of Minimally Invasive Foot Surgery. This is specifically linked to the correction of bunions and orthopedic trauma. His interests include ankle surgery, arthroscopy, foot surgery, and sports injuries. He has been active since 1988 and has his own private clinical practice in Sydney and Albury.

Let’s dive into the types of foot surgeries that orthopedics perform.

Metatarsal foot surgery
The metatarsal bones are a collection of five long bones present in the foot. You will find them in between the tarsal bones, and the toes’ phalanges. The reason why you would need this surgery would be when the small joints in your forefoot have become arthritic. Arthritis will then lead to inflammation of the joint lining. This results in the MTPJ joint dislocation and turns into pain and discomfort. A lot of people who have suffered from this have reported that it feels like they are walking on pebbles.

Bunions foot surgery
Bunions usually affect women because of their choices in footwear. High heels are usually the major reason for this sort of problem. Bunions occur at the base of the big toe. They are bony lumps, which result from hallux valgus. The hallux valgus causes the big toe joint to become deformed as it leans towards the other toes. This is what really causes bunions. Though the surgery for bunions is not all that complicated, it is still worth operating on immediately.

Hammer foot surgery

Hallux valgus does not only cause issues like bunions. They also give way to hammertoes. The toes become permanently bent and also become clawed and deformed. We call this hammertoe, and as evident by the description, they are extremely painful when the individual tries to walk. Surgeries like arthroplasty or arthrodesis are usually used to repair this condition. This requires the deformed joint to be removed from between the toes.

Plantar fasciitis foot surgery

This is when the tissue from the heel to toe, becomes inflamed. This tissue is presently exactly where the toes join the heel. Usually, this situation does not require any surgery, but in worse cases, the doctor will release the plantar fascia from the heel bone.

These foot conditions are pretty common in individuals, as our daily lifestyle starts to take a toll on us. This is why it is always best to head to the doctor as soon as you can when you discover the first symptoms of these issues.

Reference Blog: https://ello.co/georgianabrown/post/aw6hnnpbjybqinf2ogamng

Clear Signs of a Knee Injury

Image Credits: Jewett Orthopaedic Clinic

Knee injuries are among the most common when playing sports. Fortunately, most patients consulting for knee injuries do not need surgery. If you have knee pain, what are the signs that should alert you? Is it necessary to consult an orthopedic surgeon? The list is far from complete, but here are a few symptoms that will help. Gordon Slater is an Australian surgeon who is an expert in the field of Minimally Invasive Foot Surgery, especially in the correction of bunions. His special interests include treating ankle surgeries, arthroscopy, foot surgery, and sports injuries. If the pain persists, you might want to contact him. Here are some other signs that will help you identify a knee injury.

Your knee is “swelling”

It may not be much if you only have a small effusion. However, if your knee is as large as a rugby ball in the hours following the trauma, it may be suggestive of anterior cruciate ligament rupture or fracture.

You heard a crackle

This does not mean a little crunch like when you crack your fingers or when the knee cracks when getting up from a prolonged sitting position. A crisp, sharp crack, accompanied by a sudden pain during a trauma, a movement in torsion of the knee, or the reception of a jump is in favor of a meniscal ligamentous lesion or bone. Many athletes explain that on the field, their teammates heard a crack when they broke the anterior cruciate ligament.

It is impossible to lean on the leg

Although this is a fairly general sign, intense pain that prevents you from stepping on the ground and putting body weight on it is a call sign that should lead to consultation. Especially if it persists for several hours after the trauma.

Your knee is unstable, loose, has a “painful jump”

If your knee does not respond to a jump or a violent change of direction, you may have a ligament injury such as anterior cruciate ligament rupture. If you have not consulted initially and this sensation persists over the months, you should consult. It is important to see an orthopedic surgeon because this instability can create and aggravate cartilage and meniscal lesions. If it is a rupture of the anterior cruciate ligament, a ligamentoplasty will then restore the necessary stability to your knee.

You cannot fully bend your knee

Pain, effusion, and inflammation after knee trauma are often responsible for a decrease in joint range. However, having the feeling of a real mechanical blocking to stretch the knee fully is often linked to a torn meniscus tongue that gets stuck in the joint. A dislocation of the patella, cartilaginous fragments can also block the joint. It is important to consult because the treatment will often be surgical in semi-emergency in order to be able to suture a damaged meniscus.

Reference Article: https://www.launchora.com/story/clear-signs-of-a-knee-injury

Everything You Need to Know About Ankle Fusion

Everything You Need to Know About Ankle Fusion

An ankle fusion (ankle arthrodesis) is a type of surgery used to join two or more bones in your ankle. This surgery is performed to treat ankle arthritis or a severe deformity in it.

What to tell your health care provider?

Tell your healthcare provider all the medications you take. This includes over-the-counter medications, such as ibuprofen and aspirin. It also includes herbs and vitamins, among other supplements. Also, notify your doctor if:

*You have had recent changes in your health, such as an infection or fever

*You have sensitivity or allergy to any medication, latex, tape or anesthetic medications (either for local anesthesia or general anesthesia)

*You are pregnant or unsure if you are or not.

Ankle fusion is surgery carried out be exceptional orthopedic surgeons, and one good example remains the Australian, Gordon Slater. He's an expert in orthopedics, specializing in MIC, bunion corrections, ankle fusion, arthroscopy, foot surgeries, sports-related surgeries, etc. He holds an MBBS (Bachelors of Medicine) from New South Wales and today holds special importance in the media. He has references in M2 Magazine and GQ Magazine.

The day of surgery

An orthopedic surgeon will conduct your ankle fusion. He is a surgeon who specializes in treating problems with bones, muscles, joints, and tendons. Surgery can be done in different ways. Consult your surgeon about the details of your surgery. Preparation and surgery can take a couple of hours.

During your surgery:

You may be given general anesthesia. It is a medicine that will make you sleep during surgery. You may also be given spinal anesthesia. Thus, you will not feel anything from the waist down. They will probably sedate it too. That will help you relax and sleep during surgery.

A health care provider will monitor your vital signs, such as your heart rate and blood pressure during surgery.

The surgeon will make an incision (a cut) in the skin and muscle of your ankle. You may also have a cut in your foot. If you have minimally invasive surgery, the cuts will be small. Then, a device with a small camera with light will be used to help during surgery.

The cartilage from the affected joint will be removed by your surgeon. Then, you will join the bones of the joint in the correct position. Screws or other elements will be used to join them. A bone graft may be used to help the bones weld together.

They can make other repairs in the area as needed. The surgeon will close the muscle and skin layers of your ankle and foot with stitches (stitches), staples, or a combination of both.

Control visits

After your surgery, you will probably need to wear a splint for a couple of weeks. You may also need to use crutches for several weeks. You will be instructed by your surgeon to move your ankle and foot while recovering. You will not be able to support your full weight on that foot for several months. You may need help at home at this stage.

You may have a splint replaced by a cast a couple of weeks after surgery. You may have to do physical therapy for a few months. That is to help you regain strength and range of movement in your ankle.

To achieve optimal recovery, be sure to follow all the instructions your surgeon gives you about your medications, how to take care of your wound, and the exercises you should do. That will help ensure that the merger is a success. If you have any questions or concerns, call your surgeon's office.

Call your healthcare provider immediately if you notice any of the following symptoms:

*Chest pain or trouble breathing

*Fever of 100.4 ° F or higher, as directed by the health care provider

*The splint or cast appears too tight or too loose

*The splint, cast, or ankle bandage becomes wet or pasty

*Discoloration or pale skin color

* Numbness or tingling near or under the cast or foot

*The foot or toes look pale or bluish or feel cold when touched

*Pain that worsens with or without activity

*Calf pain that feels warm to the touch and tender if pressed

*Increased redness, tenderness, bleeding or swelling of the wound

*Suppuration leaving the wound, or opening the wound

*Swelling of the foot, ankle or calf that is not relieved by raising the foot

*Other signs or symptoms as directed by your health care provider 

Boosting Your Immune System Naturally

Image Credit: Active.com

“Doctors won’t make you healthy. Nutritionists won’t make you slim. Teachers won’t make you smart. Gurus won’t make you calm. Mentors won’t make you rich. Trainers won’t make you fit. Ultimately, you have to take responsibility. Save yourself.”- Naval Ravikant

Your health is your wealth. The current state of medical innovation is healing from within. With the advent of stem cell therapy and orthobiologics, mechanisms are in place to enable the body to heal itself in instances of immunocompromise, or any damage due to physical stresses like cuts. A normal healthy body, will naturally be resistant to diseases. Studies have shown that a balanced diet , or a predominantly plant based diet has led to the utmost in health. With respect to the current global pandemic, one way to ease the mind and protect ourselves is to ensure that we are a state where our immunities are at peak. Let us delve into a few superfoods that are proven to be effective in healing the body. As a start, juicing daily is one way to boost your health. A recipe is included in this article for a reference. You will notice considerable skin clarity, and resistance to colds and flus. At best, daily vitamins can help you to maintain peak health. 

Increasing your Vitamin Intake 

Vitamin C is often the first resort once people think of reducing the effects of a pending cold. Taken in either the fizzy pill form, tablets or via natural methods such as orange juice and cherry juice, the effects will definitely be noticeable. Where possible drink cherry juice instead of orange juice. Cherry juice is scientifically proven to have up to five times the Vitamin C of Orange juice. With the ability to significantly boost your immune system, your white blood cell count will increase with the presence of Vitamin C. As one of the body's health enablers, the white blood cells will be able to facilitate the healing process in the instance of any pending illness. Where possible, plant your own citrus trees and enjoy the fruit year round, or purchase from your local grocery store grapefruit, oranges, tangerines, lemons, limes and clementines. 

To start your day, you can drink one glass of lime water. Fill your glass with half warm, half cold water and then squeeze in some limes. This will instantly wake up your immune system and keep you boosted across the day. 

Vegetable Intake 

Greens are the key to a multitude of health benefits. From the ability to maintain a healthy digestive system to immunity boosts, there are many vegetable superfoods that are able to facilitate the healing of the body. Ingesting vegetables such as red bell peppers, which have twice as much Vitamin C as citrus fruits will enable you to boost your immunity and stay healthy and well. Ingesting superfoods such as broccoli, spinach and even celery will ensure that your body is supercharged with vitamins and minerals. 

Broccoli is rich in vitamins A, C and E and is known to have antioxidant properties. Eaten raw or parboiled, you will achieve the maximum health benefits from this vegetable. 

Another best kept secret...is garlic. You can incorporate this into your diet. As an anti-fungal, when ingested, garlic will be able to maintain your internal pH. Garlic also can improve the health of your arteries. 

Many of us utilize ginger when we have a stomach ache or nausea. Whether it's in the form of a processed food like a ginger ale, or boiled as a tea, ginger is the ultimate healer. As an anti-inflammatory agent, ginger soothes the internal digestive system, and also helps to boost immunity in the process.

IMMUNITY BOOSTING  SMOOTHIE

CARROT JUICE

• 2 cups carrots

• 1 1/2 cups filtered water

SMOOTHIE

• 1 large ripe banana (previously peeled, sliced and frozen // more for a sweeter smoothie)

• 1 cup frozen or fresh pineapple

• 1/2 Tbsp fresh ginger (peeled // 1 small knob yields ~1/2 Tbsp)

• 1/4 tsp ground turmeric (or sub cinnamon)

• 1/2 cup carrot juice

• 1 Tbsp lemon juice (1/2 small lemon yields ~1 Tbsp or 15 ml)

• 1 cup unsweetened almond milk

Instructions

1. Make carrot juice by adding carrots and filtered water to a high speed blender and blending on high until completely pureed and smooth. Add more water if it has trouble blending / scrape down sides as needed.

2. Drape a large, thin dish towel over a mixing bowl and pour over the juice. Then lift up on the corners of the towel and begin twisting and squeezing the juice out until all of the liquid is extracted. Set aside pulp for smoothies, or baked goods (such as carrot muffins).

3. Transfer carrot juice to a mason jar - will keep for several days, though best when fresh.

4. To the blender add smoothie ingredients and blend on high until creamy and smooth. Add more carrot juice or almond milk if it has trouble blending. Scrape down sides as needed.

5. Taste and adjust flavors as needed, adding more banana or pineapple for sweetness, lemon for acidity, ginger for bite, and turmeric for warmth.

6. Divide between two glasses (as original recipe is written // adjust if altering batch size) and serve. Best when fresh.

There are a variety of smoothie options that are able to meet your health needs. With a little research, you can identify combinations that will work well for your dietary needs. If you’re just getting started, don’t be intimidated. Via utilizing what you already have in your refrigerator and blending it, you will be in a good position to keep your body and immunity up. Don’t be surprised if you have much more energy than before too. As you eat foods that are naturally based, your body will be better able to manage them and it will respond much more favorably. 

Reference Article: https://www.healthline.com/health/food-nutrition/foods-that-boost-the-immune-system#other-options

Smoothie Reference: https://minimalistbaker.com/carrot-ginger-turmeric-smoothie/

Medical E-Health Apps and You

Image Credit: HIT Consultant 

“When health is absent, wisdom cannot reveal itself, art cannot manifest, strength cannot fight, wealth becomes useless, and intelligence cannot be applied.” -Herophilus

The entire world is going digital, and so too is your healthcare system. For the past two decades, digital disruption is aiming to save lives via the introduction of applications that will facilitate tracking of critical parameters. These days, with devices like the smartphone, there are apps that track your sleep, track your mood, track your steps, track your heartbeat, track anything that you can think of. With the right applications, many lives can be saved. As a consumer, one of the key things that you’ll have to fit into your routine at some point, is the key decision making point: What is the best healthcare app for my health condition. In many instances, you can ask your doctor to recommend an app. In other instances, you can empower yourself as an individual and decide that you want to do your research, and download apps according to your personal decision matrix. Here are a few pointers that you can factor into your research, in order to choose the best app for your needs. 

As a starting disclaimer, an app is best used as a guide to your body’s operational activities. It is not intended to replace any doctor’s visits. It is actually intended to even assist in the discussion with your specialists, when you go into the office for a consultation. Apps that you utilize: 

1. Must be compliant with the healthcare system’s abiding laws. Depending on your region, in your research process, you can go through the process of identifying the key regional bodies that set the mandate for healthcare in the region, and enquire if the app is compliant with that system. If yes, you can download the app with assurance. If not, you are better off either not downloading that app, or utilizing extra caution in the process of using the app. 

2. Seek the recommendation of other patients. Studies have shown that only 2% of healthcare apps are being utilized by patients. Research into why this is so, tends to identify root causes such as the patients thought the app was too complicated to use on a daily basis. Additionally, patients were under the impression that if their vital signs were barely changing, why would they have to keep checking them every day. With root causes like this, the pool of health care app innovators is realizing that they need to make the tools more appealing to the customer base. There are some apps that have high acclaim, so just ensure that when you are purchasing, you seek the ratings of other users who have tested the product before. 

3. Decide what type of medical app you are going to download. In the application realm, the medical apps have been classified to be in one of four main categories: Diagnosis chatbots, Mobile medication alerts, Phone-to-text capabilities, Geolocation or geofencing. The apps are then designed to provide features like clinical assistance - and will enable you to access your medical records, laboratory results and charts, as well as to check your symptoms. These act like assistants to your doctor as your final conditions are being diagnosed. Scheduling and reminder apps will help you to stay on top of your appointments and your medicine intake. Health and lifestyle apps will help you to track your vital signs and ensure that you are on top of your diet and general fitness. Knowing what you’ll need, will help to guide you as you decide what you want to do. 

With these features, you are now competent enough to start doing your due diligence. With the advent of the internet, you can now take the time to determine what options will work best for you. Health is your wealth, and taking the time each week to look after yourself, and ensure that you are well is critical to ensuring that you are the best version of yourself. 

With medical devices and applications, you are well on your way to ensuring that you are staying at peak. Imagine a world, where your smart home will be linked to your smart phone or watch, which then is linked to your baseline health tracking. All of these systems will then be in a position to determine when your next doctor’s appointments should be, and even find a slot in your schedule to ensure that you can have your check up. 

Reference: 

App Development: https://themanifest.com/app-development/how-develop-healthcare-app

Sever's Disease In Adults and Children

Image Credits: OrthoInfo - AAOS

“I have chosen to be happy because it is good for my health.” -Voltaire

While orthopaedic conditions in children tend to be more severe in adults than in children, there are a few ailments that tend to plague children as they are growing and developing. One such condition is known as Sever’s Disease, a painful condition that affects the heels of children and adolescents. Also known as calcaneal apophysitis, Sever’s Disease occurs when there’s an inflammation of the heel’s growth plate. The image above gives a visual view of the heel anatomy, with the heel bone plated by the growth plate. With increased physical activity and even during growth spurts, children can experience pain in this region of the foot. 

As a disease that has the tendency to be induced by stress to the heel, if the stress is prolonged, the growth plate will be susceptible to the impact. Rapid changes to the heel anatomy will also induce damage to the growth plate. If your children are very active and in sports that have a lot of vertical motions that can cause stress to the heel, there will be an increased possibility of Sever’s Disease. At best, it will be in the best interest of the sufferer to minimize activities such as jumping and running, so that the heel itself can recover from the inflamed growth plate.

The growth plate is a growing area of bone in the foot anatomy. During the development process, the plate consists of cartilage, which then eventually develops into bone. The process continues until the child is fully formed as an adult. Growth plates then, are very soft compared to solid bone and with movements, will be impacted by the stresses of physical activity. Due to the proximity of the growth plate to the Achilles tendon, tendon stress can also impact the growth plate and induce inflammation. 

Heel pain, painful walking, heel swelling and general area tenderness is observed during an assessment of the area. Your orthopaedic specialist, will be able to relate the symptoms to the root cause during an examination. 

How Is Sever’s Disease Treated? 

Sever’s disease is usually treated by rest, rest and more rest. Based on the above root causes of physical stresses to the area, your child will be advised to minimize physical activity for a few weeks, depending on the severity of the condition. Once the growth plate has been restored, physical therapy will be utilized to ensure that the site is operating normally and to facilitate strength of the area. Foot inserts such as orthotics will be prescribed in order to ensure that the tender heel area is supported during the restorative process. 

Elevating the legs, as well as a routine stretching exercise can accelerate the healing process and prescribe a walking boot to protect the feet. Where necessary, your orthopaedic surgeon will prescribe anti-inflammatory drugs. These will include Nonsteroidal anti-inflammatory medication. Over the counter drugs like ibuprofen and naproxen can also be purchased to help reduce pain and swelling.

Reference Article: 

Sever’s Disease:https://orthoinfo.aaos.org/en/diseases--conditions/severs-disease/

Orthobiologics and Internal Healing

Image Credits: Bone and Spine

Orthobiologics is a theme that will be relevant in 2020 and beyond. The healing arts are evolving from a symptom based treatment, to an internal root cause treatment. The transition is warranted because many of the current therapies in medicine often have adverse effects,  that are avoidable via natural methods. All fields are evolving, and as medicine advances, so too does the final healing result. When it comes to the human bone structures, healing is a process that is still being studied, and often takes a long time to facilitate if there is a serious injury or fracture to a bone in particular.

In the current health regime, with a renewed understanding of the healing mechanisms of the body, there are natural and artificial substances which orthopaedic surgeons are using to accelerate the rate of healing. These substances, are known as Orthobiologics. With their abilities to heal bones, muscles, tendons and ligaments, orthobiologics is the path forward to a life of accelerated healing. Consult with your orthopaedic surgeon, to identify if you’ll be a suitable candidate for this cutting edge medical innovation. 

How do our bodies heal? 

Designed to self heal, our body’s healing mechanisms are facilitated by healing agents that attend to an injury site. Blood is the agent that facilitates the healing process. Additionally, there are three orthobiologic substances which research has identified is key to aid the healing process. 

These three agents are: 

1. the cell matrix which helps to heal bone gaps

2. proteins for regulation of the healing process

3. and stem cells for regeneration of the relevant cells that will heal the injury

While all three elements are critical, stem cells are the very versatile agents that are finding their relevance in global healing of the body. They have the ability to generate a multitude of cells, and facilitate healing. The integration of all these elements will ensure that injuries are able to restore to normalcy. 

Types of Orthobiologic Materials: 

As orthobiologics evolves, there are various natural and synthetically derived materials that are used in the orthobiologic process. When there is an injury, often the site must be protected by a special scaffolding that provides support and mobility. Injected into the scaffolding site will be the relevant healing agent such as stem cells. Materials such as Bone Grafts (autograft/allograft), involve the use of bone fragments to support the injured bones. Bone fragment sources vary, and in some instances are harvested from cadavers, or even 3D printed. Alternatively, with the advent of materials science, there are compounds such as calcium phosphate which can be used to fill gaps in bone fragments.  

How do the growth elements help to heal? 

As medicine advances via fields such as genetic engineering, the body’s healing processes can be accelerated with increased knowledge. On its own, the body takes a very long time to heal structures such as bones. This is often why healing fractures requires minimal mobility via casting and arthroplasty. Via science and technology, mechanisms of healing are now much more easily understood, and the levers that facilitate healing are now being manipulated. While not one hundred percent effective, research has shown favorable adaptation of the body to the injection of healing agents such as stem cells and growth factor proteins. With good blood circulation in the area, the two agents work in tandem with each other to repair the injured site. Via innate intelligence, the cells will regenerate the relevant cells needed to heal bones, muscles and ligaments. 

The future of orthobiologics is still unfolding, and from the current vantage point, the possibilities look endless. Consult with your orthopaedic surgeon to identify if you are a suitable candidate for this new wave of medical treatment. Your health is your wealth, if there are new and better methods, take advantage of them. 

JUVENILE ARTHRITIS - CAUSES AND TREATMENTS

Image Credits: OrthoInfo - AAOS

While children are statistically healthier than adults, one in every thousand children is diagnosed with juvenile idiopathic arthritis. As a treatable health condition, juvenile arthritis is the most common form of arthritis identified in children. Children experiencing this condition will have joint pain and general stiffness, and studies have shown that the extent of the condition is variable across childhood. In some instances, cases of juvenile arthritis have been found to last for a few months, to traversing an entire lifespan. 

As with all cases of arthritis, careful care must be taken in treatment of juvenile arthritis, as peripheral downstream health conditions such as eye problems, and additional skeletal problems may occur. 

What symptoms do children experience? 

The first sign of juvenile arthritis is usually pain and stiffness in the joints. As a parent, you may or may not observe your children either limping, or having difficulty holding things. This symptom is attributed to the fact that joints tend to swell during the moments of minimal activity, and the initial movements upon waking often bring shock to the body’s joints. Autoimmune responses are taking place within the body, and it will be important to ensure that they are being balanced in order to restore the appropriate mobility. In some severe cases, children may experience fever, swelling in the lymph nodes, and a rash on the trunk of the body. The rash is often aggravated during sleep, as the body is undergoing its healing mechanisms. 

The severity of juvenile arthritis is variable, with several classifications noted in the orthopaedic realm. A consultation with your child’s orthopaedic surgeon will facilitate identification of the appropriate case, and also facilitate the development of an appropriate treatment plan that will bring healing. As an initial observation, it will be helpful for you to track your child’s reactions. 

Keep a journal or utilize a health application, and note your child’s diet, temperature, level of activity, sleeping patterns and identify any key triggers to the arthritic flares. Taking these observations to your child’s doctor, will ensure that the appropriate root cause of the flare ups is observed and identified, and the right treatment plan be prescribed.

Arthritis is an autoimmune condition, and is an instilled self attack by the body. The immune system, when triggered by the appropriate internal condition, can in some instances attack its own cells and tissues. Scientific studies are identifying the root causes of why this attack takes place. In some instances, internal chemistry is a key trigger to the autoimmune attacks, and avoidance of inflammation inducing agents in the body often keeps the flare ups at bay. In some instances, external triggers such as environmental pollutants, can cause the body to react. Carefully monitor water sources, and filter where possible.

What to expect after your consultation

With your child’s juvenile arthritis, the journey to the final diagnosis will be variable. A series of baseline organic tests will be taken. These tests will be part of an assessment series, and the collective results will determine what the classification of arthritis is in the patient. As part of the process, your child may have to undergo a series of blood tests such as tests for Erythrocyte sedimentation rate (ESR) to test red blood cell activity, C-reactive protein and anti-nuclear antibody tests for inflammation levels in the body. Additional tests may or may not be necessary depending on the severity of the case.

Once the body chemistry is thoroughly assessed, the internal imaging scans can then be analysed by your doctor. These include X-rays or MRI scans to enable a visualization of the internal bone structure. 

What are the appropriate treatment plans? 

With all conditions, it is important to ensure that there is a sufficient level of physical activity that is sustained by the body. Movement facilitates health, and enables social activity of your children. In the treatment process, your orthopaedic surgeon will utilize a program of medication, diet and physical therapy in order to ensure restoration of the joints to their peak. 

Medical treatments for juvenile arthritis include anti-inflammatory drugs. These can be either over the counter or prescribed. At the higher level, Disease-modifying antirheumatic drugs (DMARDs) will be prescribed by your doctor. For children, methotrexate (Trexall) is the number one choice. 

In the newer health sphere, biologics and corticosteroids are prescribed to assist with healing. Stem cell therapy, known to help with healing is a potential that can be investigated. Young children do adapt, and they are most likely to benefit from stem cell treatments. 

To facilitate joint integrity restoration, a program with a physical therapist will also be advised. 

Article References: 

1. Mayo Clinic: https://www.mayoclinic.org/diseases-conditions/juvenile-idiopathic-arthritis/symptoms-causes/syc-20374082

What Will Clinical Trials Look Like In the Future?

Image Credit: The Doctor Weighs In 

“Future clinical trials that make full use of digital technologies will look very different at each stage of development – and may have a much higher chance of approval at lower cost.”- ICON Digital Disruption Whitepaper

The future of medicine looks bright! With the advent of various advances in computer based research, future clinical trials will be increasingly successful. With increasing odds in the pre-clinical phases, the downstream effects will be as desired. In a previous blog article, we had expanded on the advents of Organ-On-A-Chip Technology, Blockchain Technology and Quantum Computing as core technologies used in synchrony with statistical tools and mathematical algorithms, in order to filter through data and generate the appropriate models that represented the desired systems accordingly. 

Technologies such as quantum computing have processed significant amounts of process data in the genomic and proteomic realms and have identified new silos of heart failure. Such details would have taken conventional computers years to compute. Quantum modelling and the background algorithms enables drug molecule prediction, as well as their mechanisms of action to be clearly identified and predicted. Artificial Intelligence then facilitates determining the best candidates for actual synthesis. AI utilizes algorithms such as empirical physiology models in order to determine how the lock and key mechanism of the drug and its active site will be matched. 

With the Organ-On-A-Chip technology that was previously discussed, there is a way that organ simulations can be facilitated on silicon chips. With the desired pathways for action able to be simulated in a chemical laboratory, the drugs can then be tested in situ. How the drug will operate in the critical organs can then be determined. In trials, usually the top five drug candidates will be assessed in order to determine the right combination for final drug manufacture. 

With the global nature of industrial and scientific data, global medical records can be assessed by a research entity. With the available data from sources like block chain data, insurance data and electronic health records, clinical trial coordinators can then identify the appropriate candidates for a human trial. 

In a world where data is king, there are several ways that data can be acquired. From a real-time perspective, utilizing real time data generators such as heart monitors linked to an app will be able to facilitate more real-time data that can help researchers identify trends that can assist with improved care. The interesting thing about data, is that the more of it that a research organization collects, the more that human trials can be reduced, in terms of the number of patients to be tested. The ideal candidate can be predicted from preliminary data, and then the actual patients be assessed for site specific reactions to the synthesized test drug. 

Progressing through each stage of the research and development process will be a process that will become seamless with time. With increases in automation, the forecasted success rate for new drug approval will be 60 percent, a six time increase from the current success rate. Drug companies are keen to improve their returns on investment, and look forward to harnessing the best of Industry 4.0 where medical innovation is concerned. Changes in clinical trials will change the entire industry for the best. R&D as a field still has a lot of potential to tap into. From a consulting perspective, the four key advantages for improving the drug development process include: 

1. Determine the technology needed. In a problem solving methodology frame of mind, an assessment of the existing research system and identifying what operational, IT and AI tools will be needed to optimize the existing operations. Additionally, it will help to identify the current condition for successful product launch. If the current success rate is 6%, what tools will push the organization to 20%. Even a threefold increase will significantly increase the returns. 

2. Statistical Knowledge - Data is the new oil. Ensure that organization quants are ready and on hand for data processing and model generation. 

3. Global Network - Data sources and data availability are more valuable with time. Pre-clinical trials will work best if all the pre-work is facilitated. Partnering with global research firms provides the expertise and resources needed to accomplish the task.

4. Embrace Change - The only thing constant is change! Embrace the fact that new developments are taking place in the field that will help your organization to advance. Early investments will lead to the appropriate outcome in the long term. 

Medical Research Innovations: Organ-On-A-Chip, Blockchain And Quantum Computing

Image Credits: BBVAOpen4U

Digital technology, pervasively, is getting embedded in every place: every thing, every person, every walk of life is being fundamentally shaped by digital technology — it is happening in our homes, our work, our places of entertainment. It’s amazing to think of a world as a computer. I think that’s the right metaphor for us as we go forward. – Satya Nadella, CEO of Microsoft

Industry 4.0 is an emerging global phenomenon that is changing the way that all industries are operating in the current decade and beyond. Essentially, all industries are in a position where they cannot ignore technology and its various aspects, be it cloud computing, 3-D printing, internet of things, location technology or even big data analysis. In every system, there will be an application for each element of the industry 4.0 portfolio, in the optimization of process systems operations, and patient satisfaction. 

In the research realm, Big Data in conjunction with artificial intelligence and even detailed and advanced statistical modelling, will be key assets in the progression of the success of R&D efforts. As digital technology advances, it is always a good idea to welcome the change, and allow for industrial transformation for the better. When it comes to three technologies that can facilitate medical innovation, Organ-On-A-Chip, Blockchain and Quantum Computing will help in that regard. This article will take the time to dissect the different elements, and enable the viewership to visualize what is to come in the years and even months ahead in terms of patient care: 

Organ-On-A-Chip: In a previous blog article, it was indicated that clinical trial success is at a low. To optimize the research process, we will need to strengthen the success of the pre-clinical phase of the research process. During clinical trials, what will be key is the ability to gauge critical parameters such as potential efficacy, general safety and toxicity of a drug, before it is administered to patients. 

In previous generations, animals were used to simulate humans, but studies have shown that there is often no direct correlation between the two. Research alternatives such as human cells, also didn’t achieve the desired objectives because they are not representative of the organs and their functions in a human body. How else then, could scientists actually simulate the internal experience? 

This is the advent of the Organ-On-A-Chip methodology. Via techniques such as photolithography, organ simulations on a silicon chip can be re-created. In research studies, elements such as artificial livers have been created, facilitating viable active sites for the testing of drugs in the renal system. Additional research on areas such as the lungs, kidneys and even the gut have been developed. With improved internal replication, improved pre-clinical trials can be facilitated, enabling the odds of appropriate drugs to be synthesized for a chosen condition. 

Blockchain Technology: 

As a distributed, public ledger of information linked in a peer-to-peer network of computers blockchain technology is key to healthcare data processing. Blockchain technology has various advantages including: decentralized management, immutable audit trail, data provenance, robustness, and improved security and privacy. 

Technically, a blockchain consists of ordered records. These are organized in an array, resembling that of a block. Each data block has a unique identifier that enables it to be traced. With this identifier, the history of transactions that the data block is involved in, can be tracked. Block connection is facilitated in a sequential fashion, and the resulting technology then derives its name. The beauty of blockchain technology is that connected blocks of data make it difficult to modify data in part of a sequence without modifying the entire block. 

The immutability of data, the phenomenon described above, is expected to improve patient care, by improving the current state of medical record management. From a peripheral perspective, organizations such as insurance companies that are linked to the hospital, can optimize their insurance claim process. Within the medical entities themselves, inhouse clinical and biomedical research can be accelerated. 

Quantum Computing 

Computers are a central theme in Industry 4.0. Many details in medical research require the use of computing technology in order to solve critical problems. Quantum computing is a technology that assists with solving very detailed mathematical calculations in various realms. Within the medical realm for instance, many computers have been looped together in order to assist with predicting things like the human genome. 

Quantum computing is a high powered computing technology that utilizes background algorithms such as linear algebra, to solve the mathematical representations of a critical topic. With the ability to complex problems due to the increased computing power, can solve multiple problems simultaneously, compared to conventional computers that can solve problems in a linear and sequential fashion. On a scale level, quantum computers solve detailed problems in a matter of weeks. 

Healthcare will benefit immensely from the improvements described above! 

Article Reference: 

1. ICONS: https://pages.questexweb.com/rs/294-MQF-056/images/ICON%20Digital%20Disruption%20Whitepaper.pdf

Morton's Neuroma

“Health is a large word. It embraces not the body only, but the mind and spirit as well; …and not today’s pain or pleasure alone, but the whole being and outlook of a man.” - James H. West

Foot and ankle conditions come in various formats. Some aspects of the pain can be due to structural damage to bones in the ankle joint, or due to pain the ligaments. There is also the possibility of developing nerve damage in the feet. Morton’s neuroma, develops when there is a non-cancerous growth between the third and fourth toes. The nerve tissue expands and becomes swollen, as outlined in the image above, and the resultant sensation is a painful sensation, often experienced by patients as “feeling as if there’s a marble” in the sole of the feet. Consult with your orthopaedic specialist if you experience any prolonged pain in the feet. With the appropriate diagnostic tools, your specialist will be able to diagnose your condition. 

Women are more prone to Morton’s neuroma, and the primary root cause is tied to the wearing of high heeled shoes. Take caution with your shoe design. Wearing high heels induces the conditions that develop the condition - the ability to induce stress to the nerves since the feet are not in positions that they are comfortable in, but remain elevated and stretched for prolonged periods of time. The nerves respond by thickening, causing neuroma. Additionally, some sporting activities which stress the feet, are also capable of inducing the condition. 

What happens in your consultation? 

During your consultation, your orthopaedic surgeon will usually ask detailed questions about the symptoms that you are experiencing. Your medical history and lifestyle will be assessed. A thorough medical examination will follow, with an X-ray, Ultrasound scan or MRI used to get a closer look at the internals of the feet. What these tools will do, is eliminate other possibilities such as stress fractures and other orthopaedic conditions, and facilitate a clear view of the internals of the feet. 

Treatment

After your consultation, your orthopaedic surgeon will determine the path that you will take to recovery. For acute conditions, treatments such as corticosteroid injections, and alcohol sclerosing injections are used. These treatments are done in series, and eventually facilitate the healing of the area. If the instance of severe Morton’s neuroma, your orthopaedic surgeon will recommend a surgical option. Minimally invasive treatments are used to remove the painful growth. The adverse effect of surgery is numbness, so attempt the acute treatments for up to 6 months, before deciding with your surgeon’s help, that surgery is the path for you. 

Recommended with your treatment are the following lifestyle changes: 

1. Footwear changes 

2. Pain treatment - painkillers or injection 

As with all conditions, early treatments will ensure that drastic medical action will not have to be taken. Along with your treatments, there are series of physical therapy exercises that you can do, to ensure that you are improving the flexibility of the area. Additionally, insoles and orthotic devices can be applied to the area, in order to protect the area and facilitate healing. 

Reference Articles: 

1. Morton’s Neuroma: https://www.mayoclinic.org/diseases-conditions/mortons-neuroma/symptoms-causes/syc-20351935

2. Medical News Today: https://www.medicalnewstoday.com/articles/179773.php

BLOCK CHAIN TECHNOLOGY AND THE MEDICAL FIELD

Image Credits: Inter-American Development 

Healthcare research initiatives are embracing industry 4.0 tools, facilitating more computer usage in their research efforts, and enabling better decision making processes to take place as discoveries are being made. In the computing realm, the blockchain technology, which facilitates decentralized data processing. How then, can the data be processed in order to facilitate these outcomes? 

Science is well known for cross functional uses. Many modern technologies that we rely on, such as GPS were developed by scientists and engineers in either army labs or NASA labs. If a discovery doesn’t make it on sphere, it can be repurposed for use in another realm. Interestingly, blockchain technology still has its origins in its original realm - Bitcoin and the financial sector. The underlying framework however, has usage in the medical realm in the facilitation of data transfer and processing. 

The medical industry prides itself on patient confidentiality. When it comes to general research, it is important for data to be properly interpreted and analysed. For patient data that is collected and analyzed for a cause, it will be important for critical information to be cleansed from the original data pool. With data sources ranging from healthcare institutions, insurance companies and third party sources, care must be taken to protect original patient data.  

As a decentralised ledger system, blockchain technology is a web-based framework that allows both patients and researchers to access a pool of information. Based on the system design and access, it will be possible to facilitate both user confidentiality and data exchange as transactions are processed.  With data transparency, it will be possible to facilitate the desired data pooling during clinical trials. With data traceability, data audits and information validity can be facilitated. With open data in systems, studies such as patient feasibility analysis and population studies can be conducted. 

Blockchain Technology 

As a distributed, public ledger of information linked in a peer-to-peer network of computers blockchain technology is key to healthcare data processing. Blockchain technology has various advantages including: decentralized management, immutable audit trail, data provenance, robustness, and improved security and privacy. 

Technically, a blockchain consists of ordered records. These are organized in an array, resembling that of a block. Each data block has a unique identifier that enables it to be traced. With this identifier, the history of transactions that the data block is involved in, can be tracked. Block connection is facilitated in a sequential fashion, and the resultant technology then derives its name. The beauty of blockchain technology is that connected blocks of data make it difficult to modify data in part of a sequence without modifying the entire block. 

The immutability of data, the phenomenon described above, is expected to improve patient care, by improving the current state of medical record management. From a peripheral perspective, organizations such as insurance companies that are linked to the hospital, can optimize their insurance claim process. Within the medical entities themselves, inhouse clinical and biomedical research can be accelerated. 

Additional Advantages of Blockchain Technology

While institution research, and medical innovation is key, with patients having the right to assign access rules to their medical data for a time that they determine, the patients can also log into the systems and collect their own medical data. This information will be critical in those instances where they feel like they might want a second opinion on their particular cases. Having the ability to access and utilize data will be a win for all. Dissecting the medical data, certain fields in the patient data will be tagged and stored in data blocks. Private data will be kept on internal files, while critical data such as patient allergy data, will be published on a public domain. 

With blockchain technology currently evolving, there are challenges to be met and overcome, before the technology can be readily accessible for mainstream or organizational healthcare applications. Once privacy, sharing access, network speed and other inherent challenges are dealt with, blockchain technology will become more widespread. As with all things that are new, there will be an initial phase of introduction, after which tweaking will facilitate the desired outcomes. 

Reference Articles: 

1. ICON : https://pages.questexweb.com/rs/294-MQF-056/images/ICON%20Digital%20Disruption%20Whitepaper.pdf

2. Blockchain Technology and Healthcare: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6517629/pdf/hir-25-59.pdf

Ankle Reconstruction Surgery - Lateral Ankle Ligament Reconstruction

Image Credit: Patient Education Videos 

“Keeping your body healthy is an expression of gratitude to the whole cosmos – the trees, the clouds, everything.” - Thich Nhat Hanh

Lateral Ankle Ligament Reconstruction

There are some orthopaedic ailments that require surgery to restore. In the process of healing loose ankle ligaments, your orthopaedic surgeon may opt to perform a lateral ankle ligament reconstruction. This process, aims to tighten loose ligaments and allow them to maintain the tension that is necessary to maintain optimum ankle flexibility and movement. The good news about the lateral ankle ligament reconstruction surgery or Brostrum procedure is that patients are free to return to their homes post procedure.  As a hinge joint, the ankle facilitates rotation, as well as up and down and side to side motion of the feet. The critical ankle ligaments are what enable the critical motion to be facilitated and for the appropriate foot support to be enabled. For those individuals who are prone to repeated ankle sprains, the ligaments are likely to be stretched in the process. Loose ligaments lead to ankle instability. To correct the procedure, your orthopaedic surgeon will make a small incision right outside the ankle, which then facilitate access to the ligaments for treatments. This incision is part of that advent of medicine known as minimally invasive surgery. Done under general anaesthesia, you will feel minimal pain and a fast recovery.  

How do you know if you need Lateral Ankle Ligament Reconstruction Surgery? 

After an orthopaedic consultation, your doctor will be able to determine if you will be a recipient of the surgery. Via a series of assessments such as X-rays that permit internal imaging of your ankle, your doctor will be able to analyze your ankle and determine the path forward. Initially, you’ll experience chronic ankle pain, and the propensity for your ankle to “slip” when you are doing something strenuous such as walking for exercise or participating in sports activities. All of these activities eventually lead to a stretching of the ankle ligaments, and may also partially tear the ligaments. There are also a myriad of root causes of an unstable ankle, which are not limited to, but inclusive of the following [ ref 3]: 

• Hindfoot varus

• Plantar flexion of the first ray

• Midfoot cavus (high arches)

• General looseness of your ligaments. For example, from a health condition such as Ehlers-Danlos.

When physical therapy and orthotics aren’t helping you to advance your healing, surgery is often recommended as the next best option for treatment. As a preventative measure, if you just experienced your first ankle sprain, your orthopaedic surgeon may recommend lateral ankle ligament reconstruction as a preliminary healing procedure. This will prevent further damage down the line. 

According to the University of Rochester’s Medical Dictionary, the surgical risks associated with lateral ankle ligament surgery include:

• Excess bleeding

• Nerve damage

• Infection

• Stiffness in your ankle joint

• Blood clot

• Complications from anesthesia

• No improvement in your ankle stability

Having discussions with your orthopaedic surgeon will prepare you for the surgery, and enable you to be mentally and physically ready for the procedure. 

ANKLE LIGAMENT RECONSTRUCTION SURGERY

Within the ankle reconstruction sphere, there are various iterations of the Brostrum procedure which is a type of keyhole surgery that facilitates the tightening of the ankle ligaments. With time, the expansion of the treatment options also includes an option to repurpose a tendon, in order to facilitate the internal tension restoration in the hinge. Statistically, up to 85% of all ankle injuries involve the lateral ankle ligament complex. With the two aforementioned procedures, the prevention of downstream problems such as degenerative arthritis will be the ultimate advantage. With life expectancies increasing, mobility will be critical and maintaining the ankle joint will facilitate that desire. Orthopaedic surgeons will be the key to ensuring that your feet are in good health. 

Within your ankle, there are three main ligaments: 

-the anterior talofibular ligament (ATFL)

-the calcaneofibular ligament (CFL) 

-the posterior talofibular ligament (PTFL) 

The most commonly affected during sprains is the ATFL. Using a little physics and engineering, your orthopaedic surgeon will assess in detail, the extent of damage that has been experienced by the injury in question. Based on the dimensions of the feet, detailed calculations will be done, identifying what the restored dimensions of the feet should be. If there is adequate tissue to reconstruct the foot, the surgical procedures will be executed by your foot and ankle surgeon. 

Advances in orthopaedic surgery have identified reconstructive techniques to be quite efficient. The ultimate results indicated by both the patient experience and their x-rays, have indicated that ankle instability is generally restored. The majority of athletes who underwent the treatment were able to return to their sport within a few months of the procedure. Treatment takes approximately three months. During this interim, there are plenty of activities that you can use to keep yourself engaged in the healing process. Gentle exercises will be prescribed by your foot and ankle surgeon that will facilitate your peak joint restoration. 

POST OPERATION

As an outpatient procedure, it is possible for you to return home after your surgery. You will typically be monitored by your medical team for a few hours after your surgery. You will be under general anaesthesia, and will awaken after a few hours. Post surgery treatment includes the wrapping of the ankle with a splint. As a patient, you won’t be able to drive, so arrange to have a friend or family member pick you up after the procedure. Pain management will also be critical once the anaesthetic wears away. Your orthopaedic surgeon will prescribe appropriate treatments for you. These may include prescription pain medications or the use of over the counter pain medications such as Ibuprofen or Acetaminophen. Keep your movement to a minimum and keep your leg elevated to minimize healing. 

In order to facilitate your movement, you will need crutches as part of your post surgery tools. During your surgical plan, all of these items will be organized and arranged. You will require these items for a few weeks, before you are cleared for natural mobility. 

Article References: 

Results of Anatomic Lateral Ankle Ligament Reconstruction with Tendon Allograft

 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3145865/

Ankle Reconstruction Surgery: https://www.mymosh.com/services/ankle/ankle-ligament-reconstruction/

Lateral Ankle Ligament Reconstruction Surgery: 

https://www.urmc.rochester.edu/encyclopedia/content.aspx?contenttypeid=135&contentid=343

Data Analytics And Its Impact on Medical Research

Image Credit: Galvanize.com

1. “In 10 years the electronic medical record will be the minor player, in terms of where a person’s health history lives. Most of that information will be kept on the phone or in a secure cloud, and the patient will be highly engaged with collecting, curating and sharing that data. Most doctor visits will be like calling up a YouTube meets virtual human docs and there will also be an aspect of virtual reality.”- Leslie Saxon

The future of all fields is under the influence of an emerging phenomenon known as Industry 4.0. Depending on your profession, you may have encountered concepts such as the Internet of Things, and Big Data Analytics, in facilitating the gathering, filtering and processing of data. 

Regardless of realm, Big Data utilization in the medical sphere is the collation of large volumes of health based data collected predominantly by health care providers, insurers, the government, researchers and industry professionals such as management consultants. As data access increases, statistics have shown that the volume of available information doubles every 12 to 14 months. In the year 2020 alone, studies have indicated that an anticipated 2,314 exabytes of data will be generated globally. For those of you who love to practice your physics conversions, one exabyte = one billion gigabytes. As more and more devices become connected to the internet, the number is only expected to become larger and larger with time. 

With data generation, the matching storage sources must be facilitated by the network, as well as the appropriate means to transmit the data once its called for by the relevant computer functions. Internet infrastructure will have to be upgraded in order to facilitate the anticipated changes. Processing and analytic infrastructure changes will be tackled by today’s computer scientists and network engineers. 

The purpose of having data, is to ensure that it can be processed into critical information for medical innovation decision making. In order to have information, data must be sourced from somewhere. Before the medical implant you probably have in your body is developed for the mass market, critical research and data analysis was done on it. Let us assess where this data will come from. If your orthopaedic surgeon is involved in medical research, some of your patient data may be extracted for the purposes of research. 

SOURCES OF BIG DATA

Big Data is an accumulation of large amounts of data, and volume often results in a diverse number of feed sources. Once the data itself is received, it is then filtered, normalized, and formatted so that it can be organized into critical process correlations that can be applied in scientific experiments. As with all systems, reliable data sources will result in reliable medical information for decision making. When it comes to R&D data, the two main sources are: 

Structured Clinical Data

Major sources of clinical data includes current and past clinical trials and registries. Data collection is ongoing, and having a means to access this data will ensure that appropriate correlations are reached. Statistically, the more data available, the better the research models developed will be. Peer-reviewed studies will also be suitable sources of data, since the required data from these studies can also be pooled into research in order to ensure that collective data can be accessed. 

The data is used to determine the appropriate safety, efficacy and performance issues, inform clinical trial design, and determine promising leads in the research process. Once the preliminary data is collated, controlled trials will then be facilitated and real-world trial performance can then be monitored. 

Once the trial phase approaches, the potential impact of the trial can then be assessed. Critical medical innovation requirements include safety and efficacy for the protection of the patients, who are the end users. Knowing ahead of time how patients will react to the drug or medical innovation will be key to ensuring that the appropriate ones go to the market. The aim right now is to ensure that the items themselves are effective, and research ROI will be maximized once there’s a successful product ready for the market. There’s only room for innovative winners in the field, and successful research will ensure that this is the outcome. With readily available data, appropriate approval of products and services will be facilitated by entities such as the FDA. 

Traditional Clinical Data 

The second predominant source of Big Data information includes traditional clinical data. The sources for this type of data include clinical Electronic Health Records or EHRs, medical labs, imaging data, pharmacy data collected via prescription processing and insurance claims.

Once the data is collected, the data can be filtered to identify patient needs and identify trends that could be location based or age based. The available data will help in the development of trial design, and then pave the way for implementing the trial. Additionally, if there’s a need to make amendments to the trial as it progresses, the shift will be easy to make. Since the data collected from this source is live, it can be an appropriate feedback loop of real world evidence of medical need. Current demand of a product or service for instance, may be grounds for researchers to determine if there’s a market for new products to be developed in that particular field. 

The future impact of the product or service can then be realistically determined and applied in the development process. With a more patient centered approach to research and development, it will ensure that products and services are targeting the right audiences. 

Big Data is here for you! Welcome the advents of better research and development processes and trust that the innovations that develop from these activities will be in your favor as a patient. What you can also anticipate is the advent of customizable innovations based on your own medical history. 

These sources of data are not exhaustive, and there are additional sources that can be pooled if necessary to make the research process more detailed. The key is to have as much data as possible in order to minimize the available errors in the research process. 

In the clinical realm, there will be variation in data sources, but the final intention will be the same. As the technology advances, predictive analytics will be able to forecast patient medical conditions in advance, and facilitate appropriate treatments. This is a great time to be involved in medical research, and also an ideal time to be a patient. Educating yourself on what’s possible, you can consult with your orthopaedic surgeon to identify what is possible for your medical treatment. 

Treating Achilles Conditions - Honoring a Legend

“When you make a choice, and say “Come hell or high water, I’m going to be this…then you shouldn’t be surprised when you are that.” It should not be something that is intoxicating or out of character because you have seen this moment for so long, that when the moment comes, of course it is here because…it has been in your mind the whole time” - Kobe Bryant

On January 26, 2020 the entire world was shocked by the untimely passing of the young, yet legendary Kobe Bean Bryant. He was only 41 years old. Kobe Bryant spent his entire twenty year basketball career with the Los Angeles Lakers, and under his helm, the team was able to secure with their hard work and their talents five NBA Championships. Kobe was truly a talent to be seen in the sports realm. Even if you never watched the sport, you knew of him and his charismatic and powerful presence. His energy just drew you to him, the instant he stepped unto the court and started playing. As an athlete, he inspired millions with hard work and passion, and we would like to honor him briefly on our blog. Nothing great was ever achieved without hard work, and the Mamba mentality that he instilled in people, is one that we all should embody. Passion and dedication to the craft is warranted in all realms of life. If we all gave as much as he did, the entire world would operate like a well oiled machine.

Off the court however, Kobe was a loving husband, father, brother and friend. Kobe’s kindness led him to start a sports academy, dedicated to empowering the women of the basketball field. In much the same way that Kobe’s father before him was an NBA player, Kobe was training his daughter Gianna, and several other promising young women, to one day be the helm of their sports professions once they became professionals. Impact is something that goes beyond an individual and we are all truly blessed to have been graced by a legend in this current era of our existence.

As an athlete, one of Kobe’s most debilitating injuries, was a torn Achilles. Let us delve into the nuances of this condition, and see how you can arrange with your orthopaedic surgeon to have your condition treated, should you find yourself in a similar position.

ACHILLES TENDON RUPTURE

Image Credit: Mayo Clinic

What is Achilles Tendon Rupture? 

Achilles Tendon Rupture is a condition  that occurs when the Achilles tendon separates into two separate parts after the introduction to a stress, that causes the tendon to shear then break! It is usually associated with hearing a loud “pop” in the feet once there’s a vigorous blow to the heel area. The variation in ankle conditions is expansive from minor conditions to debilitating conditions where patients cannot walk. Not all ankle pain sufferers are the same!

The symptoms list can be numerous! The symptoms of Achilles tendon rupture can be mistaken for additional ailments, so consult with your foot and ankle surgeon in order to determine what the root cause of your ankle pain is! 

What are the symptoms of Achilles Tendon Rupture? 

As an injury of the lower leg, the statistics have proven that the condition occurs when a blow is received to the back of the lower leg. As a ligament, the Achilles tendon facilitates the flexibility of the ankle joint. Athletes are the number one suffers from Achilles tendon rupture. Additionally, risk factors such as age, gender, antibiotic usage, obesity, and steroid usage have proven to increase the odds of Achilles Tendon Rupture. 

As a strong fibrous cord, via the laws of physics, if stretched to the limit...the Achilles Heel will definitely break. Orthopaedics has identified two different types of rupture of the Achilles Tendon: 

1. Complete Rupture: This results in the tearing of the tendon into two segments, as outlined in the image above. 

2. Partial Rupture: This results in the partial tearing of the tendon. There will still be a joining of the tendon at one phase of the defect, but a separation at one stage. 

What are the treatment options for Achilles Tendon Rupture

With an excruciating pain that affects your ability to walk, the most common treatment for Achilles Tendon rupture is a minimally invasive surgical procedure. Surgery is the ideal way to engineer the tendon back to its former glory. As with all surgery, your orthopaedic surgeon will assess the area, usually with a scan like an X-ray in order to determine where the problem is. Post surgery, you will be prescribed a recovery plan, to facilitate your healing. 

While there are non-surgical treatments for Achilles tendon rupture, minimally invasive procedures have proven effective for healing the root cause, particularly for a internal tear. For maintenance of the ankle, stretching exercises have proven effective in facilitating the healing of the ankle regions. An appropriate physiotherapy will aid in the restoration. 

Reference: 

https://www.mayoclinic.org/diseases-conditions/achilles-tendon-rupture/symptoms-causes/syc-20353234

Avoiding Common Orthopedic Problems

Image Credits: Muir Orthopaedic Specialists

Avoiding Common Orthopedic Problems

Every day more and more people start a physical activity to improve their health and well-being. Therefore, it is important to be careful to reduce the possibility of injury. Orthopedic injuries can be very damaging to health and make it difficult to perform sports or even simple daily tasks.

To avoid orthopedic injuries, first of all, you need to know the most common ones. That's why we select the problems that most affect people and what the ways you can do prevention are. Continue reading and learn more.

What are the most common?

There are several types of orthopedic injuries that are known and treatable. Therefore, we selected the most common cases among people. Remembering that they can come from physical activities and everyday crafts such as climbing stairs or taking a walk, Dr. Gordon Slater, an orthopedic surgeon advises people to take effective measures in order to prevent these complications from developing in their adult life.

Dr. Slater highlights some of the most painful problems that are far too common among adults and that he has seen in his professional practice as a surgeon.

Sprain

It is very common that after stepping on the wrong side, there is a swelling that causes a lot of pain and discomfort. In some more severe cases, this comes from a sprain which is when the joint is stretched, and the joint ligaments can be ruptured. This injury occurs after an unexpected sudden movement, in simple cases, can be resolved with ice and anti-inflammatory, in more difficult situations with surgery.

How to Avoid: Stretch before physical activity, wear walking-friendly shoes, and avoid walking on uneven ground. Another tip is to try to avoid sudden movements, especially changes of direction.

Muscle Sprain

Muscle distension is a very common problem in orthopedics in hospitals. This injury occurs because a muscle or tendon is too stretched and ruptures. This occurs after excessive force movement or action. Symptoms may vary. Usually, the first is severe pain, then swelling and difficulty moving. Treatment may be surgical in more severe cases or rest and compress in mild injuries.

How to avoid: Stretching before physical activity or long walks. It is always important to have the guidance of a professional before playing sports, so it is possible to avoid excessive strain causing the strain.

Dislocation

Another problem that also occurs a lot with people around the world is dislocation. This orthopedic injury occurs when two bones that are joined by a joint separate. It can occur after some trauma, fall, fracture or even chronic illness. The treatment is done with the replacement of the bone in its proper place, after which rest and immobilization of the affected part are necessary.

How to avoid: Do physical activities accompanied by a professional. In hazardous sports, it may be necessary to wear protective equipment.

Article Author: Sean Smith

Foot Problems And Care

“Health is a large word. It embraces not the body only, but the mind and spirit as well; …and not today’s pain or pleasure alone, but the whole being and outlook of a man.” - James H. West

Image Credits: Medical News Today

Foot Problems and Care – What You Need to Know 

As with all medical conditions, from time to time, there may be an ailment of your feet. When foot problems occur, working with your orthopaedic surgeon will be an ideal way to ensure that you have a clearly mapped solution for your treatment. Foot problems often have a solution to improvement, no matter the age to be treated. The constancy in the treatments is reflected in their results. Dr Gordon Slater is a trained orthopedic surgeon who specializes in foot surgery, particularly in the treatment of bunions. To start off the 2020 foot care season, here are some things you should know about different foot problems and the care needed. Awareness is the key to effective prevention. 

Pain

While the myriad of ailments have varying root causes, one of the primary symptoms that you’ll experience when you discover a foot condition is pain. The pain may either be at the site of the root cause of the site, or alternately you may feel pain in auxiliary parts of the body.  The body skeletal components are connected to each other...and pain in the knees, hips and spine can have their origin in the feet, although they do not hurt.                                       

Sport

A statistically high category patient of foot and ankle specialists is the athlete. Athletes stress their bodies to extremes and are prone to the twists and turns that will more than likely result in injury. The best advice for the care of your feet if you do sports is prudence and moderation. Wear the footwear indicated for each sport discipline, paying special attention to the correct choice of size, both in length and width, the American size includes these factors. The key to finding the right shoe is comfort, not price or brand. Do not wait for a shoe adaptation period to start feeling comfortable: you must have it from day one. In the shower wear flip flops to avoid fungal and papilloma infections, if you have fungi and papillomas, remember that both are highly infectious and can infect those who live with you.

Warmer weather induces outdoor activities. From strains to fractures to arthritis, the root causes of the majority of the cases received are linked to athletic activity. Depending on where you take your exercises, you may or may not have access to an athletic trainer, who can access you and treat you on the spot if you have an injury. Many individuals self train after a while, thinking that they know their bodies. Under those circumstances, it will be best to have a toolkit on hand, to treat any immediate ailments that may crop up, until you are able to access an orthopaedic surgeon for treatment. 

An athlete’s toolkit is a kit, much like your home medical kit, that you keep on hand on the periphery as you are exercising. Equipped with your critical medical supplies and auxiliary equipment, you can create for yourself a kit that can range in side from a small case the size of a cosmetics bag to one that is about the size of a backpack. The key is to have your kit be something that you will welcome in your routine, and will be easily accessible and light enough to be mobile. 

A light sweater is always recommended in the lower ranges, as cooler weather contributes to conditions that can weaken the immune system. Carry a light sports jacket that you can keep on hand to keep you covered as you work out, if you’ll be outdoors. 

The convenience of having your athlete’s tool kit will benefit you once the relevant moment arises. According to the Henry Ford Livewell program, the following is what an athletic trainer keeps in his sports bag. You can modify your personal list according to your activity. You will need: 

1. Athletic tape (in several versions) : Athletic tape is a pressure sensitive tape that resembles surgical tape. It adheres itself to the skin, and is utilized to keep muscles and bones in a set position. Depending on your activity, taping can help to prevent injuries to critical areas such as ankle joints. 

2.  Band-aids: In everyday living, it is not uncommon to receive a scrape. In physical activity, the odds of injury are significantly increased. If you’re out jogging for instance, you may be prone to cuts from anything from the bark of a tree, to a scrape against a concrete wall or even exercise equipment that may have sharp edges or screw exposed. If you’re cut in such a manner that you are bleeding, a band-aid is an ideal way to cover your wound. 

3.  Bandages: For larger cuts and scrapes that standard band-aids will be able to cover. 

4. Antiseptic wipes: Depending on where you are, you may not always have access to clean water. If you’re in a gym and get an injury, you’ll be fine with respect to accessing your restroom facilities and cleaning your wound there. If you decide to go hiking for instance and get cut against the bark of a tree, a moist towelette like an antiseptic wipe will help you to clean the wound, while soothing it with healing agents. 

5. Wipes: Wipes are always advised for gym use. Since some pieces of equipment are shared by multiple individuals, it will be important to clean the equipment between uses. Well equipped gyms have wipes in stock in an open area. If you don’t see any, you can ensure you have your own, and wipe down your equipment prior to, and after use. You will minimize the occurrence of communicable diseases. Additionally wipes are great for outdoor usage to cleanse prior to eating, if you’re in a remote location. Antibacterial gel also works well. 

6.  Antacids: These will settle stomach during those instances where you may have upset your stomach, or involved in physical activity that involves excessive motion that can induce dizziness and impact your stomach as a result. Keeping antacids on hand will help you to stabilize your stomach. Additionally, you can keep a can of a drink containing ginger to help you settle your stomach. The active ingredient in ginger is a natural antiseptic and antacid.

7. Petroleum Jelly: To soothe your skin after irritation.  

8. Scissors: To cut various items in your list such as your tape and bandages to size. 

9. Specialized Tools : These vary according to your sport. If you’re a runner for instance, you may keep extra spikes in your bag, along with a screwdriver to affix them to your boots if you lose any. 

10. EpiPen for treating allergic reactions, If you’re allergy prone, buy generic allergy tablets like Loratadine, and keep them on hand. If you’re prone to headaches, either keep tabs with two tablets of Advil/Tylenol or a full box of their generic equivalents of ibuprofen/acetaminophen. 

11.  A resistance band for rehab and ankle taping

12. Elastic wraps and extra padding for injuries.

It is better to be prepared! In some instances, you’ll find that having your safety kit will enable you walk with a sense of assurance as you progress through your workout. When you have a cushion, you act more confidently as an athlete, than in instances when you don’t. Take good precautions. Injuries often appear when you least expect them, so ensure that you are able to manage them when they do. There’s no such thing as a risk free life! Take good care of your health! 

In Town

Urban footwear should be comfortable, weigh little, of noble materials and subject to the instep or heel. Avoid flip flops for continued use.

Barefoot

It is beneficial to walk barefoot on beach sand, so it is recommended in a generic way (except for diabetic people) to strengthen all the intrinsic and extrinsic foot muscles and improve circulation.

Protection

If you have recent scars, defend yourself from the sun with high-protection sun creams so that they do not suffer pigmentation variations.

Reference: 

1. Inside An Athletic Trainer's Toolkit: https://www.henryford.com/blog/2018/10/inside-athletic-trainers-toolkit

2. Tourism Australia: https://www.australia.com/en/facts-and-planning/weather-in-australia.html

Research and Development In 2020 - Clinical Trial Optimization

Image Credit: Investopedia 

Scientific and medical innovations are continuously evolving with time. With a new decade upon us, not only will drug development be an innovation that will be a focus of medical innovation, but the advent of technologies such as stem cell therapies and biologic adaptations. The research and development path is not as straightforward as one can imagine. The drug development process is a series of combinatorial explosions of possibilities that determine the best path to synthesize a drug. Studies by the consulting firm Deloitte, have indicated that returns on research and development in various biopharma firms is falling. With an average return of 1.9 percent in a 2018 study, the incentive for pharmaceutical companies to want to delve into new ventures will be lessened. 

Drug development is a feedback loop, and with time progressions there will be a push for new innovations that are lucrative to emerge in a field that is seeming to decline. The limiting factor to research and development is the cost, and researchers are challenging themselves to bring R&D costs to a controllable level, and maximize the returns on the investments that are attained if a project is to be tackled. 

CLINICAL TRIAL OPTIMIZATION

With the current state of the drug development cycles, industry experts have identified that one way to keep innovating and developing products that will be lucrative will be focus on optimization of the clinical trial process. As an interesting design project, clinical trials have standard components that are critical to their success. A deep dive into each of the critical stages will determine where the bottlenecks are. With an identification of the limiting factors, the solution and optimization of the process will be possible. With the advent of the digital age, the transformation process will rely on computing technology to propel the process forward. These digital waves include the internet, which can do things like harness the computing power of computer networks. Social media can assist the research process by facilitating the process of interviewing the target market. Data access via tools like applications (Fitbits and similar technologies) will enable data mining and trend identification. The advent of data access is a disruptive force in the medical industry. Where there is data, there will be the ability for individuals to access critical health trends. From these trends the appropriate solutions in the form of a drug or natural product will be the key to the need. 

Once the power of digital technologies is harnessed, the transformation of the drug development process will be facilitated. With the appropriate models, there will be the ability for an organization to forecast various aspects of the drug development process. The disruption of the existing business operating models, will drive the ability for organizations to improve their R&D productivity. The areas of impact will include: 

Automation of Processes: With the drug development process, one of the keys to ensuring success in the final stages and even during the pilot stages, is appropriate replication of the manufacturing of the product. Quality management is key to the success of any pharmaceutical product. Process automation is the key to facilitating this outcome. 

Data Sets: Data is the new gold. It takes a multitude of steps to synthesize a drug. Thankfully, with the advent of computer technologies, molecular models can be converted into mathematical models, and the pathway for target drugs that will match the desired active sites of their target proteins will be better optimized. Many times during drug development processes, the chemists will synthesize then test, but with the advent of computer simulations, there will be a means via which the mechanism of action and even success can be predetermined, before money is expended on physical synthesis. Predictive analytics is the key to success in the current state of events. The vision will be deciding factor in the drug development process. 

The utilization of all of these methodologies will be the key to progress. Optimizing the drug development process via the utilization of Robotic Process Automation as well as Big Data optimization will be the key to reducing the odds of error in the existings research methods. With the advent of Artificial Intelligence, process data at various stages of the process will simply be filtered, processed into suitable process models and then translated into their suitable operating process. 

Advanced Statistical Modelling

How does statistical modelling affect you as a patient. More than likely, advanced statistics is a theme that you thought you’d left behind in graduate school. In the medical realm however, as a researcher, advanced statistical models are key to clinical R&D productivity. Statistical models today are centered predominantly around models and simulations, and delves into analytics with methods such as Bayesian techniques. With time, data will be accumulated which can be assessed via these methodologies. Bayesian techniques are applicable even to smaller sample sizes for conditions such as sickle cell anaemia and paediatric studies. Utilizing the appropriate complimentary mathematical tools through each stages of the  research, tools such as MCPMod (or Multiple Comparisons & Modelling) can optimize research methodologies and drive critical conclusion. 

This article is an introduction to the possibilities that exist in the current statistical modelling methodologies that are helping to change the drug development process. As a start, AI and Big Data will be the key to changing the current state of the decision making process in early stages of the clinical trial. With better decision making, will be better drug development, and the facilitation of successful studies that will be favorable in the sites of regulators.

Article Reference: 

1. ICONS: https://pages.questexweb.com/rs/294-MQF-056/images/ICON%20Digital%20Disruption%20Whitepaper.pdf

How to Treat A Bunion Of The Foot

Image Credits: Kansas City Foot Specialists

How to Treat a Bunion of the foot (hallux valgus)

Does a distortion in the big toe area make your foot difficult to put on? Do you experience joint and inflammatory pain? If so you probably have a bunion (hallux valgus).

To learn more about the causes and treatments of bunion foot, download our fact sheet here.

Symptoms of a  bunion

Even if, at first, the bunion is painless, do not be fooled. Hallux valgus can quickly cause uncomfortable symptoms, ranging from simple local pain to ingrown toenail and mobility disorders.

Here is an overview of the symptoms caused by the foot bunion:

• Appearance of a lump at the base of the big toe created by a characteristic deflection of the joint

• Beginning of the movement of the big toe towards the 2nd toe

• Appearance of joint stiffness and pain when moving straight

• Second toe that deforms and becomes claw or hammer

• Pain in the joint (osteoarthritis)

• Bursitis

• Ingrown nails

Possible complications

While the foot bunion is usually easy to treat when taken early, it can also lead to more severe symptoms without adequate treatment.

Here is a list of complications that may occur in response to a bunion.

• A hallux limitus, then a hallux rigidus

• The disarticulation of the second toe

• Skin infections that appear because of calluses

• A change in posture in response to muscle compensation

What causes a bunion?

There are several causes that can explain the appearance of a bunion foot. These may include family history, inappropriate footwear, age of the person, etc. Here are some of the causes often observed in practice.

• Flat foot

• Hereditary factors

• Wearing shoes too narrow

• Big toe too long (Egyptian foot)

• Ligamentous hyperlaxity (ligaments more flexible than normal)

• Hypermobile hollow foot (foot with a high arch, but which collapses when walking)

• Pregnancy or menopause that can lead to sagging foot and forefoot enlargement

• Some mechanical factors such as hyperpronation, hypermobility of the foot, raised or low arch

We asked Dr. Gordon Slater an orthopedic surgeon who specializes in minimally invasive foot surgery. He has vast experience in treating trauma and bunions and specializes in treating sports injuries as well.

Keyhole surgery can address many of these problems and is an emerging technique compared to traditional “open” techniques. 

Minimally Invasive Bunion Surgery 

When bony accumulations or growths develop on the exterior of the big toe joint, a bunion is the final outcome. The toe eventually loses its alignment with the rest of the toes, and it becomes painful to carry out general activities such as walking and running. Many persons avoid treatment till it’s too late. With minimally invasive surgeries, normal activities can be restored within a short turnaround time. Minimally invasive bunion surgery or bunionectomy, is the solution to removal of painful bunions. Contact your foot and ankle surgeon today for a consultation. 

Usually in the progression of a bunion, patients believe that they can ignore the condition, and use painkillers as a means via which to “forget” the pain. This process is a temporary fix, and surgery is the best way for the pain to be permanently relieved. The condition is internally generated, and the best way to relieve it is from internal treatment. If left untreated, bunions will naturally progress, and in the most severe conditions the second toe will overlap the big toe. The shift will cause a realignment of the foot and can lead to even more problems down the line. Walking will be a challenge. Your orthopeadic surgeon will prescribe surgery when the pain experienced is becoming unbearable, and the onset of alignment challenges is on the verge of developing. 

TRADITIONAL SURGERY VERSUS MINIMALLY INVASIVE BUNION TREATMENT

The image to the left is a visual of a patient with a bunion. The protrusion to the left is eventually painful. Wearing shoes, becomes a challenge because the width of the foot is wider than normal. With the width to length ratio affected, finding appropriate shoes becomes a challenge.The minimally invasive bunion surgery procedure used to remove the bunion is a significant change to previous traditional procedures which treated the bunion via large incisions during the surgery. These incisions were in the regions of approximately 5 cm. With minimally invasive bunion surgery, incisions less than 3 mm are created on the site. The operation, with less impact on the area, facilitates faster recovery, and more flexibility in the big toe. For persons with bunions, the procedure is best for mild to moderately painful bunions. Any condition more severe will require more traditional open surgery. 

Post Surgery Results: 

The image to the left, is the the foot of the same patients, six months post operatively. With less scarring and minimal pain, normal activity resumption is an advantage of minimally invasive bunion surgery. 

Temporary Treatments for Bunions: 

If your condition is very mild, you can ease your pain with mild anti-inflammatory treatments. Recommended painkillers include over the counter drugs like ibuprofen and acetaminophen. Adjusting your shoes in the interim will also help. Wear flatter shoes until the foot has been treated. Inserts such as gels will help you. In severe cases, you might need a foot brace. Your foot and ankle surgeon will advise, but there are treatments you can use until you get a final opinion. 

Reference Article: 

1. Minimally Invasive Surgery Article: https://www.healthxchange.sg/news/new-minimally-invasive-bunion-surgery