Wearable Device Hackathon 2018

Just concluded the biggest, baddest Wearable Device Hackathon evah, organized by the Innovation Center Manipal and the Kasturba Medical College Manipal.

We had over 150 participants from ten different institutions, 25 mentors, 17 volunteers and five judges. What an amazing event that was.

A Patient Guide to Total Shoulder Replacement


cross-posted from Aches & Joints.org


Patients with severe shoulder arthritis are unable to move their arms through the full range of motion and thus are unable to perform many activities of daily living. For these patients, total shoulder replacement is a proven surgical procedure relieving their pain, recovering their range of motion and allowing them to return to their active lifestyles.

In this video, Dr JP Warner from the Massachusetts General Hospital, Boston, MA, goes through the necessary examination and the surgical technique.


See these related posts:

Hands-only CPR: Save a Life

post on Hand only CPR on Arun Shanbhag

How To:

  1. Call 911
  2. Push hard and fast in the center of the chest, without interrupting
  3. Push deeply, about 100 times per minute. That’s faster than three times every two seconds
  4. Do NOT be afraid, your actions can only help
  5. Look around and invite your friends or other onlookers to help
  6. Continue until trained Emergency Personnel arrive

Continue reading “Hands-only CPR: Save a Life”

What to do with Bunions?

cross-posted from Aches & Joints


What to do with Bunions? Better to leave them alone.

A bunion is a characteristically large bony bump at the base of the big toe. This alters the alignment of the bones, causing the base of the big toe to angle out and crowding the tops towards the smaller toes. Bunions can often be painful and cause swelling, making it difficult to find comfortably fitting shoes. The big toe pushing against the smaller toes can result in irritation of the skin, forming painful calluses.

Bunions occur more frequently in women and can occur in children as well. Although some footwear can contribute to the deformity, it is not the sole cause. “People who develop bunions often have an underlying predisposition to acquire them, such as a family member who may have them, overly mobile joints, or a disease such as rheumatoid arthritis,” explains Dr A Holly Johnson, Foot & Ankle Surgeon at the Massachusetts General Hospital and Instructor at Harvard Medical School, Boston, MA. Traumatic injuries to feet or toes can also result in bunions. Bunions can occur in people with flatfeet (or over pronation) and may involve deformities of the smaller toes, such as hammer toes.

xray of normal foot (left) and a foot with a bunion (right) hallux valgus
Left: X-ray of normal foot while standing. Right: Foot with a bunion, also called hallux valgus. Notice the bony protuberance and the large angle at the base of the big toe. The top of the big toe is seen crowding towards the smaller toes. Continue reading “What to do with Bunions?”

Vitamin D Prevents Fractures

A recent clinical review reported in the NY Times provides great news for older adults. A meta-analysis of 12 randomized clinical trials, together representing over 65,000 subjects suggests that Vitamin D reduces the risk for non-vertebral fractures by 20 % and hip fractures by 18%.
Continue reading “Vitamin D Prevents Fractures”

Scapular Exercises for Stronger Shoulders

Exercises for Strong and Healthy Shoulders
Shoulders permit our arms to move in a wide arc and perform elaborate activities. This mobility is due to superb coordination of muscles and soft tissues around the shoulder and shoulder blades (scapula, SKA-pew-la), and is essential for performing activities in a pain- and injury-free manner. See related article on Rotator Cuff complications impairing shoulder movement.

Conventional shoulder exercises strengthen the larger muscles but tend to overlook the mid-back muscles that stabilize the scapulas. This can often result in muscle imbalance and consequently, bad posture. Even non-shoulder exercises like running on a treadmill with shoulders slouched can lead to stiffness and pain. These conditions increase injury potential and thus the need for corrective exercises.

Michael Bento, personal trainer at the Clubs at Charles River Park, Boston, demonstrates simple exercises you can do at home to develop shoulder strength and protect them from injury. As an added bonus, these exercises also tone the all-important core muscles.

These exercises can be performed on a stability ball as shown, or on a work bench. Dumbbells or additional weights are not required. And as I surprisingly found out last week, you can do these scapular exercises while standing, starting with the arms in front! Yaay!


Common Starting Position for Shoulder-Scapula Exercises
scapular exercises for stronger shoulders

  • Anchor heels to a wall, toes on the floor and slowly roll out on a stability ball.
  • Rest upper abdomen on the ball and straighten body forming a line from ears to ankles.
  • Pull your shoulder blades down, tuck your chin and look at the floor.
  • Start with arms straight, hands in front of the ball (or bench), fingers lightly curled, palms facing each other and thumbs pointing forward.
  • In this position, your core muscles including abdominal and gluteus muscles are engaged in stabilizing your body.
  • For a challenging core-muscle workout, move your heels away from the wall as demonstrated above and use as starting position.

Continue reading “Scapular Exercises for Stronger Shoulders”

Rotator Cuff Disease

A drawback of traveling is carrying your suitcase everywhere, particularly lifting it into overhead compartments on planes, trains and buses. This really hurts my shoulder. Apparently, I am straining my rotator cuff muscles and tendons. As we age, these soft tissues surrounding the shoulder tend to weaken and are easily injured.

Here is short summary on Rotator Cuff Disease, published in Aches & Joints.



Primary Cause of Shoulder Pain and Treatment Options.

There are several causes of shoulder pain. In the elderly, shoulder pain is commonly associated with aging and can be traced to rotator cuff disease. In younger people, it is associated with throwing or overhead sporting activities that result in injury to the rotator cuff.

shoulder rotator cuff anatomy disease

The rotator cuff is a band of four muscles and tendons at the shoulder joint, which grasp the end of the upper arm or humerus (HYU-mer-us, see figure), much like four fingers holding a baseball. The rotator cuff thus stabilizes the shoulder joint and provides exceptional mobility to the arm. Pinching, irritation, or tears of the rotator cuff are common causes of shoulder pain.

shoulder rotator cuff anatomy holding baseball

Continue reading “Rotator Cuff Disease”

Marine Corps Marathon 2008: The Long Slog!

Marine Corps Marathon 2008
time: 4:33:10
My Slowest Marathon!


Its been two weeks and now I can write about my slowest marathon.

The Course and the Run:
I loved the first ten miles of this course. Leaving the Pentagon, the course works its way through the narrow streets of Arlington, VA. The mass of runners then worms their way over the George Washington Parkway and through the forests of Georgetown. It was a nice incline and the heavy breathing of runners filled the cool air. As we worked uphill, sunlight filtered through fall trees and only a few feet ahead, runners disappeared in fog mingling with mist from their breath. It was a beautiful slog. Then we raced down to the center of Georgetown to a large and raucous crowd. At that point, it was only mile Ten, and I was ahead of my expected 4:00 h pace!
Continue reading “Marine Corps Marathon 2008: The Long Slog!”

Yoga for Arthritis

Yoga can provide immense physical benefits for women with arthritis.

For arthritis patients, aerobic exercises, muscle conditioning and increased physical activity can keep you strong and agile, improve heart fitness and reduce your weight. Yoga provides an effective alternative to the traditional strengthening and aerobic exercises, and offers other benefits as well.

While yoga may bring visions of complex body contortions, most yoga classes provide simple, gentle movements that gradually build muscular strength, promote balance and improve flexibility. Its meditative nature soothes and relaxes the mind, and is associated with increased mental alertness and enthusiasm. Scientific studies have shown that practicing yoga is a safe and effective way to increase physical activity, which is strongly recommended for arthritis patients. Yoga does not increase pain or worsen arthritis.

Picture of Padmasana Yoga Pose
Continue reading “Yoga for Arthritis”

PiPi Unbound

Growing up, even a thimble full of these squiggly bits was a treat It still is. I found this in a desi store here. Now I get my stash from Mumbai on every visit. (Chikki was my other treat.)


Continue reading “PiPi Unbound”

Repetitive Strain Injury

Cross-posted from Aches & Joints


Repetitive Strain Injury or RSI describes a group of conditions associated with overuse of soft tissues such as muscles, tendons and nerves. RSI causing pain can affect the upper back, arms, hands, wrists, or fingers. Continuous and prolonged use of a computer keyboard, strumming a guitar, or wielding tools on an assembly line, have all been associated with RSI.


Continue reading “Repetitive Strain Injury”

Five Easy Steps to an Exceptionally Long life!

Good genes certainly help in living a long life. But alas, we don’t get to control them. A recent study (Original Article; NYT article) tracked more than 2000 elderly men (ave 72 years) for up to 25 years. Based on those who survived to age 90, the authors identified five factors that we can control.

Five Easy Steps to an Exceptionally Long life:

  1. Abstain from smoking
  2. Weight management
  3. Control blood pressure
  4. Regular exercise, and
  5. Avoid diabetes

Not very surprising! It’s not that those long-lifers got less ill, but they became ill a little later in life, and were better able to deal with the diseases and survive.

Not only did survivors enjoy healthier lifestyles, more than two-thirds described their health as “excellent” or “very good;” and they were mentally with-it! And sadly, smokers had worse physical function coupled with a decrease in mental function as they aged. Don’t expect the tobacco industry to put this in their cool ads! Interestingly, low cholesterol levels and social drinking of alcohol were not associated with increased life span. Even though they studied men, these finding certainly hold for women as well.

So stub out and join me for a run!

BTW, did I mention that survivors in their 90s had a higher incidence of arthritis? This may be partly related to their vigorous activity. So those knee aches may be with me for a while! 😦

Foot and Toe Extension

Continues the Heel Pain and Plantar Fasciitis Series.


For most of the day, our feet are bound within stiff shoes and many of the soft tissues within the feet are infrequently used. This is a simple yet very effective exercise to stretch the heel and underlying plantar fascia … and bring life to those toes!

If you have heel pain, perform this stretch as you wake up and place your feet on the floor. This can also be performed while sitting in the office chair or on the couch.

  • Sit on a chair and place your ankle over the opposite knee.
  • Grip toes and gently pull them back towards the knee, while holding the ankle to prevent it from moving.
  • Feel the stretch in the sole of the foot all the way to the heel.
  • Hold the stretch for 30 seconds.
  • Repeat three times for each foot.

See related articles:
Treating Heel Pain or Plantar Fasciitis
Heel and Achilles Tendon Stretch
This article and archives are available at achesandjoints.org

Heel & Achilles Tendon Stretch

Continuing my Health & Fitness Series, as published in our patient newsletter, Aches & Joints.

Following up on the Heel Pain (Plantar Fasciitis) article from a few weeks earlier, here is the first of a series of exercises that can help recovery from heel pain.

This is a wonderfully effective warm-up before running, going for a walk, or participating in any sports. Or just do this stretch because you want to. This stretches the Achilles tendon as well as the calf muscles. Runners especially need to do stretch these before heading out and after returning from a run too.

You don’t need to go to a health club or gym to do this. Stretch in your office or waiting in the coffee line, or even during a walk in the park.

Enjoy and Share with others. Live well!
heel achilles tendon stretch, Meg Vitter

  • When out for a walk, find a wall to lean against. Even a tree will do.
  • Stand an arms length from the wall.
  • Place the leg to be stretched about 12-18 inches behind you.
  • Keep your toes pointed forward and slightly inward.
  • Bend your arms and gradually lean towards the wall.
  • Make sure your leg is straight and the heel of your back leg is pressed to the floor.
  • Feel the stretch in the calf and heel of the back leg.
  • Hold this position for 30 seconds and return to starting position.
  • Repeat three times for each leg.

Stretches demonstrated by Meg Vitter of Boston, MA.


Also read:
Treating Heel Pain or Plantar Fasciitis
Precautions to Take Before Starting New Exercises
Article archives are available at www.AchesAndJoints.org

Man Who Moved a Mountain

Every morning, for 22 long years, a frail, diminutive man, barefoot and clad in a loin cloth, would trudge two kilometres to a hillock of solid rock and chip away at it with a hammer and chisel. Bemused onlookers thought he had lost his mind, and he was an object of great fun for village urchins. But the women of the village, young and old, admired him, for his was a labour of love.

Dasrath Manjhi was trying to clear this mountain so a road could be built leading to the nearby village with a hospital. His wife had died because he couldn’t get her to the hospital in time. This was a memorial to his wife.

Read the story from Outlook India: here

Introducing Aches & Joints: A health blog

Subscribe and stay abreast of the latest in Orthopaedic knowledge, with exercise tips to keep you healthy and moving. And all this while blogging! Really! Not Kidding!

While there is no dearth of blogs on travel (guilty), photography (guilty), food (guilty) and other less than ennobling interests (guilty, again), there is a severe paucity of good health care related information.

With my Orthopaedic knowledge base, I started a work-related Newsletter with a mission to, “distill, interpret and translate the latest orthopaedic knowledge for the general reader.” Its appropriately called, Aches & Joints.

For accurate information, we recruited Orthopaedic Surgeons at the front lines of clinical medicine, to contribute on the latest topics of interest. We recruited certified trainers to demonstrate exercises to overcome our aches and keep us going.

For a reputable founding based on oversight and peer-review, we brought together an Editorial Board. After everyone’s blessings, we published the first issue in early May (2007). These were placed in our Orthopaedic Clinical Waiting areas. The Newsletter has been a big hit, and is flying off the racks. Sidebar – About 60,000 patients visit our busy clinics each year!

Here is a sneak preview of a blog I developed, populated by articles from the Newsletter: Aches & Joints www.achesandjoints.com We will announce this to our patients in about 2 weeks when we release the second issue of A&J. It is still called “beta” as I plan on tweaking the overall design. Check out the features and exercises. Leave comments and let me know what you think of the articles and the style.

Yoga: For the everyday stress of life

The Financial Times (London) reports that yoga is gaining acceptance beyond India's middle class. The physical and mental benefits of yoga are no longer exclusive to the well off, but are now being enjoyed by the aam janta.

Ashok Leyland has included yoga in the training curriculum for truck drivers, helping them better cope with the stress of driving on India's roads. Also makes for safer driving for the rest of us.

According to the FT, the Indian Armed Services offers yoga training to soldiers posted at high altitudes in the mountains of Kashmir and naval officers who man submarines.

The Army’s 10-year research program concluded “that soldiers who did yoga along with conventional physical training showed better physiological responses than those receiving only routine training. Participants with yoga training maintained stability under stress and quickly returned to an equilibrium state.”

I started yoga about a month ago and it has definitely helped me better control my emotions and take things in stride. Of course, while I don't have to deal with road rage, or the stress of keeping our borders safe, dealing with the PC at work and e-mails is plenty stressful.

Yoga should be made mandatory in all schools, if it isn't already! As a bonus, it could get kids off their gameboys, inculcate healthy lifestyles, and tackle weight gain and its associated pathologies of heart disease and diabetes!

Oommmmmmmm!

First Book! First Look!

This was five years in the making! Lots of ups and downs! There were times I thought it would never see the light of day. But my co-editors were always there to pick me up, dust my knees and pat my shoulder. “You can do it!” M always reminded me. And so I persevered, and finally it is here.

When I saw the package from the Publisher, it was actually anticlimactic. Yes! I was glad to finally hold the tome. But it represented the culmination, the end of one project; and an opportunity to focus on another. I celebrate the confidence I gained, from assembling nearly 30 leading groups from around the world to contribute. The confidence of bringing such an undertaking to completion. I celebrate the friendships I nurtured, the friends I did not let down. A time to celebrate the long journey ahead, time to energize myself for the next push.

I don't expect you to rush out and buy a copy. It's expensive! At 783 pages, it will weigh your bag down considerably, but will look impressive on your book shelf. If you are trying to impress your boyfriend/girlfriend, this can certainly be an ice-breaker. If you are considering curling up with this book and a blanket, well … I strongly recommend against it. The first page will put you to sleep and the book falling on our face can hurt you! I suggest propping it up on a heavy table and resting your chin on a pillow. A particularly safe posture, especially when falling asleep is assured. There is no plot really, and the characters are lifeless. The writing is esoteric and dense. Very few pictures and importantly, there is no sex! So, there you go! Ask your doctor or a engineering/medical school library to get a copy!

Find more details at this random site.

High Cholesterol: The curse of doing well!

A couple of friends have recently had their blood cholesterol levels tested. To aid in deciphering the numbers, I am including a link to the guidelines developed by the US's National Institutes of Health. It is well written and gives guidance on how to interpret the results.

Click here to start a heart healthy lifestyle
The 6-page PDF guide will address the following:

  • What do the cholesterol numbers mean?
  • What affects cholesterol levels?
  • Includes a brief questionnaire to determine your risk of developing heart disease, or getting a heart attack.
  • Treating high cholesterol.
  • Therapeutic lifestyle changes to lower cholesterol.

    More Background

    Per guidelines, if you are over the age of 20, you need to get your blood cholesterol tested every five years. If you are over 30, make it every 2 years! Ask your doctor for a “Lipid Profile” (or cholesterol profile, or lipoprotein profile). In the US, just ask your primary care physician. In India I was told, most hospitals and clinics offer this service. It only requires a simple fasting blood draw. You should not have eaten any food or drinks 10-12 hours before the blood is taken. In most instances, this is not a problem. After an early, normal dinner, get the blood drawn first thing in the morning. You should get your results within a day.

    There appears to be a big discrepancy in the way the lipid profile results are interpreted. There is also confusion regarding what should be the optimal levels of the various types of cholesterol. The interpretation of the results, and the 'advise' given by doctors varies, depending upon the skill of the doctor, and how well he or she is up to date on the latest health guidelines.

    The United States' National Institutes of Health (NIH) is the leader in driving all basic science and clinical research, and develops various guidelines for all health related concerns. Thus the NIH is the “go-to” place for the most up to date health information.

    The NIH's National Heart, Lung and Blood Institute (NHLBI) manages all cardiovascular research. And the NHLBI develops the guidelines for blood cholesterol levels. The NHLBI's guidelines are in-turn adopted by the various non-governmental doctors groups and organizations such as the American Heart Association. If your doctor is a member of this or other such organization, or reads any of their literature, then he or she is made aware of the latest updates. Please don't go by 'average' population data. It only informs how a group of people (by city, country, gender, disease, etc) are doing, and not what you should be aiming for.

    A long way of saying: Follow the NHLBI Guidelines

    It is a handy guide. Read it and keep it with your medical records – so you know where to look for it the next time you have a blood test. And, share it with your friends.

    Live long and prosper!

Sunday Cuisine: A berry beautiful meal!


Its July and the peak season for fruits at the local farm stall – berries in particular. Blueberries are my favorite, with raspberries, cherries and strawberries close behind. Theres something about blueberries. Bluish-black tinged, tiny, no seeds, tangy and barely sweet, and my tongue turns blue! When I wrap handfuls in a napkin and toss in my bag, they don't get squishy either.

Many recipes call for smothering the blueberries in pancakes, choking them in muffins, preserving them in jam, pickling them in a lemony cheese tart, freezing them, whipping them in a smoothie, or covering them in chocolate. I ask, why this obsession with messing up something so delicious to start with? I love my blueberries just plain – no recipes needed, thank you!

And if taste doesn't convince you, they have the highest anti-oxidant activity which protects from the detrimental effects of aging (I should know), prevents cancer and heart disease!

After a satisfying run, my dinner on Sunday was a bowl full of blueberries, a handful of cherries, papayas and a strawberry-mango lassi, which you needed to spoon out. Burp! Aaaaah! Life!

Notes: Unwashed blueberries shot in natural light of the setting sun, with my Olympus C4040

What apples were they?

From my previous post on apples.

The apples shown were (from left): Royal Gala, Golden Delicious, Granny Smith, Braeburn, Fuji and Red Delicious.

As many of you promised, grab a few apples (or any other fruit) on your next outing to the grocery store. They are so much better than the junk snacks the MNCs want us to eat.

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