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'Is your child complaining of joint pain? It may be juvenile arthritis'

October 17 2017 , Written by Ambika

'Is your child complaining of joint pain? It may be juvenile arthritis'

Juvenile Arthritis (JA) usually affects individuals under 16 years of age; it can affect children at any age although rarely in the first six months post birth. It is a chronic inflammatory condition which may involve one or many joints. It usually manifests in children between 1 to 3 years of age and girls are more prone than male children. Due to the lack of standard diagnostic criteria, determining the exact prevalence becomes difficult. It affects approximately 1 in 1,000 children in any given year with about 1 in 10,000 taking a severe condition.


Diagnosis and test

 The term juvenile arthritis encompasses several types of arthritis that occur in children or young individuals. Diagnosis of the condition is difficult as initial symptoms may not indicate arthritic pathology. Additionally, no diagnostic test is available presently. Individuals may show low red blood cell and elevated white blood cell counts in hematological investigations, but these findings are not characteristic of JA. It is often diagnosed only at advanced stages when joint inflammation becomes visible. Criteria for diagnosis include onset before age of 16, persistent, objective arthritis in 1 or more joints for at least 6 weeks, and exclusion of other potential causes of childhood arthritis.


Symptoms and Causes

Presentation of JA may begin with repeating fever, intermittent rash etc. Apart from these symptoms, typically an individual may complain of stiffness in joints especially in the morning, difficulty performing fine motor activities etc. Joint swelling however, may not be apparent until months or years of onset of symptoms and systemic inflammation. Overtime, disability progresses to the extent that movement is completely restricted. In addition to disability, JA also has an impact on the psychological well being of the child. In mild cases however, symptoms may not progress into adulthood and quality of life may remain unaffected.


 Immune system dysfunction has been implicated as a cause of JA. Genetic predisposition has been suggested as a factor, but the condition develops only after exposure to an infection or other triggers. Synovial membrane, which is the lining of joints is targeted by the malfunctioning immune system. The end result of the pathogenic process is joint inflammation and destruction.



Conventional treatment for JA involves use of anti-inflammatory medications and physiotherapy rehabilitation. These agents aid in temporarily alleviating an individual of symptoms, but do not halt progression of the disease. Disease modifying anti-rheumatoid drugs or agents, steroids may also be advised, however may be associated with adverse effects when used for long durations.


In recent years, regenerative medicine and cellular therapy has been showing promise in treatment of conditions previously thought to be untreatable. Cellular therapy aims to harness the power of the human body’s own reparative mechanisms to treat various conditions. Mesenchymal stem cells have anti-inflammatory, immune-modulatory and tissue repairing properties which are effective in treating arthritic pathology. Source of mesenchymal stem cells may be autologous (from one’s own body) or allogeneic. In addition, T cells which possess the ability to regulate or modulate the immune system may also be effective in treating JA.


This form of therapy is more effective in young individuals owing to better healing ability and general absence of co-morbid health conditions (as seen in older individuals) that may affect overall outcome of therapy.


At StemRx, the overall goal of cellular therapy and rehabilitation (physiotherapy etc.) is to control symptoms, prevent joint damage and maintain function. Being a non/minimally invasive therapy and cells being harvested from the patients’ own body, cellular therapy is a definitive and safe treatment modality for juvenile arthritis.



There is no definite cause that has been implicated in disease pathogenesis. Therefore, prevention of the condition, currently, is not possible. Early identification of symptoms may aid in diagnosing the condition and planning appropriate interventions to limit disability.


Lifestyle and dietary modifications play an important role in autoimmune conditions as these are associated with modulating the core pathology of the disease. Moderate intensity exercises, swimming etc. can aid in maintaining strength of muscle groups and preventing disability. Additionally, maternal or paternal screening for presence of autoimmune antibodies is imperative in identifying possible manifestation of the condition in children.



Arthritis, apart from being an autoimmune condition, is also associated with our way of life. Sedentary lifestyle habits, improper dietary practices cause the condition to progress at a more rapid and severe rate. It is therefore important to follow a disciplined lifestyle along with regular monitoring of health in order to identify the condition at the earliest and plan appropriate interventions.

Inputs By  Dr Pradeep Mahajan, Regenerative medicine researcher, StemRx
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Depressed about not being pregnant

October 10 2017 , Written by Ambika

 Depressed about not being pregnant


"Psychological stress and depression impact one's self-esteem, physical health, and also affect one's social relationships. According to WHO, there has been an increase in stress and depression cases by 18% in last 10 years. One of the reasons why men and women fall prey to mental stress is the inability to conceive a child. When it comes to stress and infertility, people are often caught in a vicious cycle. The stress adds on to the problem by causing hormonal changes to the body, making it even more difficult to conceive. Moreover, it can affect their marital relation also. The 'childless' tag brings social seclusion and frustration to the couple and the family.


The stress levels among infertile couples are extremely high today. About 20-25% of couples go through tremendous mental pressure while undergoing infertility treatment. They get anxious about the treatment, and are often left with uncertainties about the chances of success and in fear of their friends and families getting to know. This World Mental Health Day, we would like to send out a message to all couples that a happy mind and a relaxed body are the key factors for a successful pregnancy, be it natural or through IVF. The success rate for the treatment of any physical ailment is significantly better when one isn't too stressed, and infertility treatment is no different. Hence, we advise all couples seeking treatment to be aware of their limitations, consult their doctors regularly, seek counselling and therapy when necessary, maintain a healthy lifestyle and physical routine, and support each other emotionally."



 Infertility and mental health

Infertility means not being able to get pregnant after one year of trying (or after trying for 6 months if a woman is 35 or older). Women who can get pregnant but are unable to stay pregnant may also be infertile. Infertility affects 10 to 15 percent of couples.

Women who want a child but have not yet conceived often experience the following:

  • Anger
  • Depression
  • Anxiety 
  • Marital problems
  • Sexual dysfunction
  • Social isolation
  • Low self-esteem

Researchers are not sure if mental health can affect fertility, although it is clear that infertility can affect mental health. It's possible, though, that high levels of depression, anxiety, and stress can affect the hormones that regulate ovulation. This could make it difficult for a woman to become pregnant.

Emotional signs:

  • Tension, irritability
  • Feeling of sadness or hopelessness
  • Loss of enjoyment /pleasure
  • Withdrawal from activities that you once enjoyed
  • Inability to make decisions
  • Lack of concentration or focus
  • Self criticism

Difference between being sad and depressed:

If an individual exhibits more than two or three signs then there are chances that he/she may be dealing with depression, if they exhibit one or two signs it indicates that they are sad that which is human.

Being depressed about not being able to conceive is a normal part of infertility treatment and must be dealt with effectively in order to overcome.


Couples with infertility have many treatments available to help them conceive. Most of these treatments cost a lot of money and may not be covered by health insurance. While many couples who seek infertility treatment are already stressed, the process and cost of assisted reproduction itself can also cause anxiety, depression, and stress. If you are trying fertility treatments and they are not working, you may be at risk for further depression and self-esteem problems. Try to keep a positive attitude, and be sure to talk to your doctor about getting help if you feel you need it. A number of research studies show that women who are distressed have lower pregnancy rates among women trying infertility treatments.

Talk therapy, either one-on-one or in a group, can lower stress and mood symptoms. Women who had talk therapy during their infertility treatments were more likely to get pregnant than those who did not.

Researchers are still learning whether drugs like antidepressants can help infertile women. Many women don't want to take medications during infertility treatments because they are afraid it may affect the outcome of a pregnancy. However, there is no data that shows that commonly used antidepressants affect a woman's chances of becoming pregnant.


Inputs by  -       Dr. Manish Banker, Chairman and Medical Director, Nova IVI Fertility

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Stress-free youth can help stay away from cardiac diseases in old age

October 2 2017 , Written by Ambika

Stress-free youth can help stay away from cardiac diseases in old age

Hypertension is one of the most common risk factors of Coronary artery diseases


As per various study and survey conducted in the last few years, the most common risk factor for Coronary Heart Diseases is Hypertension. The prevalence of risk factors in 100 Men suffering from Cardiac Diseases is 25.9%; whereas 24.8% women in 100 also find Hypertension as the risk factor. The second most common risk factor in smoking at 22.8% among Men but for women Hypertension is the foremost cause of Cardiac Diseases. These figures are based on the data published by registrar general of India. Increased stress leads to Hypertension; each stressful situation faced by an individual makes them physiologically older than their chronological age. This leads to Coronary Heart Diseases at a younger age.


The current sedentary lifestyle combined with stress has led to an increase in the number of youngsters with coronary heart diseases. “There are two types of stress, Acute and Chronic stress. Chronic stress leads to hormonal changes, Hypertension, diabetes and heart diseases. If those in their 30’s are under stress for a longer period, are leading a sedentary lifestyle, then can lead to coronary artery diseases at a later stage. Multiple factors collectively cause heart problems. Normal stress experienced during driving, commuting or handling daily activities are manageable. However, acute stress experienced among elderly can cause heart attack while youngsters are capable to handle such situations. If those with pre-existing heart ailment face any stressful situations, mentally or physically, can precipitate heart problems,” said Dr Bipeenchandra Bhamre, Cardio-Thoracic Surgeon, Sir H N Reliance Foundation Hospital and Research Centre.


“Heart diseases are usually considered as Men’s illness; however, women lead an equally stressful life and tend to ignore their health. Heart attacks are now the number one cause of death among women as well. Men between 40 to 60 years of age are 1.5 times more prone to heart attacks than a woman of the same age. A spike in heart attacks among post-menopausal women is noticed as the estrogen levels decrease in the body in this age. Estrogen works as a protection from coronary heart disease,” added Dr Bhamre.


Dr Pradeep Gadge, Diabetologist, Gadge Diabetes centre says,"A rise in the number of youngsters with heart attacks are seen, however, there are not many risk factors like Hypertension or Diabetes but they still face heart attacks. The main cause for this is mental stress and inadequate sleep, this is a common phenomenon among youngsters in their early twenties. I recently had a 23 years old patient who did not have any medical history or hereditary health issues but underwent a Bypass surgery. This was due to his erratic lifestyle and mental stress, it was after the surgery that he got Diabetes. There are a few other similar cases that highlight the rise in youngsters facing heart problems due to increased stress.

Dr. Rahul Gupta,Apollo Hospitals Navi Mumbai, says "Stress increases the adrenergic drive and causes sympathetic overactivity. This causes endothelial dysfunction constricts the arteries raises the blood pressure and heart rate and multiple other deleterious  effects which increases the chances of block formation inside coronary arteries. It also increase the chances of plaque rupture which is the reason for heart attacks in apparently normal looking individuals. 
There are many studies which have shown that stress is an important risk factor for many lifestyle diseases and controlling stress with measures like yoga meditation exercise and proper sleep significantly reduces the chances of heart disease.Youth in our country are living in a highly competitive world and are under constant pressure of performance. They neglect their health badly by overworking, lack of sleep no exercise and improper eating habits. We are seeing lot of young patients with high BP, diabetes and heart disease these days and stress seems to be the number one risk factors. I suggest the youth of our country to take measures which will reduce stress."


How to power your heart?

1.       Brisk Walking for 40minutes, can also run, swim or ride a cycle


2.       Avoid junk, fried foods, excess salt, (excess sugared drinks) or any form of tobacco.

3.       Ensure 7 to 8 hours of undisturbed sleep daily


4.       Pursue yoga or meditation for few minutes in a day  to help keep a relaxed stress free mind


5.       Only up to 30 to 40 gms of oil can be consumed in a day 

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