Gym supplements protein

India is getting muscular in more ways than one!

We are seeing modern gyms in all neighbourhoods now.
Our cricketeers and bollywood icons looks fitter, brawnier with sculpted muscles to envy of most men.
we think why not me?
we start gymming and find that months of pumping iron does not get us anywhere near rhitik or salman.
we start thinking.........should we take supplements?

protein supplements are perhaps one of the common ones available. as long as there are no other additives in it they may be safe.
\those come in various forms ranging from simple protein bars and shakes to specialist products which contain not only proteins but also creatine or testosterone boosters.

proteins are building blocks of human body. Our muscles are mainly made of protein. Thats the simple logic of needing protein to build up protein.
our body undergoes constant turnover. all our body tissues are constantly being renewed and refreshed. waste products of protein metabolism are removed from the body via kidneys.

so we need strong kidneys in able to cope up with increased turnover of protein metabolism.

if you are planning to resort to any supplements to enhance your gymming, simply reading on the tin of the supplements may not be enough.

you must consult your physician whether it is safe for you.

protein shakes can be loaded with calories which are fine for fit youngsters but not if you have tendency for diabetes. read about the carbohydrate content.

shakes purely consisting of protein may be fine in recommended doses provided your kidneys work well. But then drink plenty water when you are on such regime. plenty water keeps kidneys flushed.

occassionally there may be steroids or hormones added into these formulations. for a lay individual this is a strict no no. these will do damage in long term.

bottomline...pure protein shakes are safe as long as you are fit and well hydrated. happy gymming

--
Dr Sachin Bhonsle MS(orth) ; FRCS(Glasg, UK)
Senior Consultant Orthopaedic Surgeon
Fortis Hospitals

Mulund, Mumbai, 400076
INDIA

simple backpain in youngsters

Everyone sufferes from backpain at some stage in their life. On day to day basis this common orthopaedic condition can be a cause of loss of livelihood as well as earnings.

What is important to know is that correct approach can help us to get a much better quality of life and almost avoid the aches and pain.

In today’s fast moving life backpain has not only become more common but I am also seeing young and fit individuals coming up with problems. I really feel bad about this and as a doctor I feel my role lies in educating masses in addition to treating the back problems.

Classically the causes of backpain have been age related wear and tear also known as spondylosis; problems with back cushion which we call slipped disc; instability in the vertebral joints ; certain diseases like infections (TB) and cancers.

What is more worrying is the new trend for back pain caused by lack of sunlight resulting into vitamin D deficiency ; poor posture ; lack of exercise; being overweight; junk food and nutritional deficiencies; poor lifestyle with alcohol and tobacco usage.

In the good old days youngsters would have plenty of sporting and outdoor activities during student days.

Foundations of the body with good bone structure would be laid down by healthy balanced diet, sunlight exposure topping up vitamin D and exercise building solid bone stock as well as strong muscles.

Today young guys working long hours neither get sunlight nor any exercise.

Constant usage of smartphones with flexed neck leads to neck and back strain.

Poor sitting positioning and standing position in kitchen will lead to muscle fatigue and backpain.

Watching TV sleeping in crooked posture cause problems.

Poor diet, alcohol and tobacco contributes to above posture by draining valuable resources.

My message to everyone.

Have balanced diet and sunlight exposure. If sunlight exposure is not possible talk to me about Vitamin D.
You MUST exercise! If difficult park your vehicle one km away and walk to work. (Get off one bus stop before)
Look after your posture while working, driving, using phone and at home.

Cut out bad habits.

arthritis in india

1.      Prevalence of arthritis in India - 

roughly 20% adults in India have some type of arthritis. thats 1 in 5 adults.

arthritis includes osteoarthritis, rheumatoid arthritis, gout, SLE, Lupus, sero-negative arthritis and other miscellaneous types.

the prevalence is more or less the same in general compared to western countries but there are differences in presentation. differences as follows.

Indians mostly have bowed (varus) tibiae. This leads to predominantly a medial osteoarthritis causing exaggerated bowing. Such patients are commonly seen to be walking with a waddling gait with enormous bow legs. Its defined as a "varus thrust gait"

In spite of such bad deformities indians tend to have well preserved bending of their knees. In general Indians have very flexible knees compared to Caucasians.

primary Osteoarthritis of hips is virtually unheard of in native Indians. 

rheumatoid arthritis of poly articular variety is less common than in western countries.

also rheumatoid arthritis with juvenile onset and systemic involvement is less common.

certain rarer forms of arthritis like "ochranosis" is virtually non existant in India

but certain rarer forms like "sickle cell disease related arthritis" are more common

2.      Projections of prevalence in next ten years

the arthritis will be on rise in the coming decade because of multiple reasons.

mainly increasing life expectancy, increasing obesity and alcohol abuse.

sedentary habits in cities may see earlier onset of arthritis.

3.      What are the main diagnostic tools used for diagnosis in India

diagnostic tools are standard.

clinical examination and history taking is gold standard.

xrays, scans and lab tests are useful tools.

management of trauma

success in management of trauma is not easy to achieve.

having highly trained and experienced trauma surgeon is the pivotal part.

the jig saw puzzle is complete with all the pieces in right place with precision.

in trauma the term "golden hour" is very important. the first hour after injury if well managed saves lives. well trained ambulance staff and attending paramedics are vital.

once stabilised patient is transferred to "accident and emergency" department the trauma team consisting of orthopaedic surgeon, general surgeon, casualty specialist and anaesthetist awaits. the equipment in A&E department and trained nurses make world of a difference.

readiness of emergency operating theatres with appropriate life and limb saving equipment is paramount.

when i returned from england to fortis hospitals this is one of the first things i checked out.

I had been an "advanced trauma life support" provider in England and i adhere to the principles here.

we can quote lots of examples how we made a difference to many lives at fortis.

1. 15 year old girl lost her balance and fell down 9 storeys. i received a call from her doctor. it was sunday morning and i could just drive down to fortis in minutes. this beautiful girl was brought to A&E in a state of shock with multiple limb fractures.

advanced trauma life support protocol was followed. her airway (A) was secured first. Breathing (B) was ensures normal. Circulation (C) i.e blood pressure stabilized with adequate fluid resuscitation.

After above A,B,C were stabilized she was moved to CT scan where the whole body was scanned to check internal organ damage.

When she was shifted back she was reexamined.

this girl was taken to operating theatre after fully stabilizing and she went home smiling in just over a week since this horrendous fall.

2. 23 year old factory worker got his right hand cut off in a machine. he went from pillar to post so seek help. he did not succeed in finding anyone who would agree to repair his hand back to his body.

by the time he arrived in fortis it was almost ten hours since the injury.

i was not very hopeful about the prospects especially because so much time had lapsed. the had tissues may well have started to decompose.

in any case i decided to go by the book and put the machinery into motion.

i requested my esteemed plastic surgeon colleague to come over to do microvascular work to repair his blood vessels.

in the meanwhile i cleaned up all the dirt and provided stabilization to the bones.

this created a stable bed for repair of blood vessels. 

after the repair the blood gushed back into his hand after eleven hours.

in a couple of days it was heartening to see that his hand had survived.

we reconstructed his nerves in subsequent weeks and freed up his tendons.

today he can move and feels his fingers and is back to work.

3. 18 years old student was riding pillion on a motorcycle. the bike had an accident and he was ejected off the eastern experss  highway mulund flyover.

this boy fell 25 or 30 feet on hard road. he was rushed to fortis hospital where we followed ATLS protocol and resuscitated and stabilized him.

he underwent several surgeries and was finally restored to a completely normal young man.

4. 25 years old junior doctor working as a houseman was knocked down and run over by a truck.

he was taken to a local hospital where he was given initial treatment for a massive soft tissue swelling of his shoulder.

actually the wheel had passed over his shoulder causing rupture of main artery to his arm.

to make the matters worse muscles and nerves in that area had got bruised and stretched out too.

it was five hours since the accident when he was shifted to fortis.

initial stabilization in casualty was really fast tracked. I had to take him to theatre to restore circulation of his limb but he had to be stabilized too. luckily the young man was strong like a bull and stabilized fast.

we operated on him within three hours of him arriving in hospital. his artery was repaired.

he required further reconstructive surgeries to treat shoulder dislocation and nerve injuries. today the young doctor has fully functioning hand and wants to be a surgeon.