Minal Malik

A herniated disc or slipped disc is a medical condition that affects the spine in which the fibrous outer portion of the intervertebral disc ruptures or tears allowing the soft jellylike central portion to squeeze or bulge out.

The spinal column is made up of 33 bones known as vertebra stacked on to each other, accordingly, the column includes seven bones in the cervical spine followed by twelve bones in a thoracic spine and five in the lumbar spine followed by five fused vertebrae in the sacrum and four fused vertebrae in the coccyx at the base.

Each vertebra is separated from the adjacent vertebra and cushioned by an intervertebral disc. The disc helps to protect the bones by minimizing the impact on the spinal column. A herniated disc can occur in any part of the spinal column however, they are more common in the lumbar spine just above the hips. A herniated disc can compress nearby nerves resulting in pain, numbness, or weakness in the arm or leg.

Causes of herniated (slipped) disc: 

Disc degeneration can often be the result of gradual, age-related wear and tear termed degenerative disc disease. As people age, the intervertebral discloses its water content as well as the ability to cushion the vertebrae. This reduction in fluid makes the discs less flexible and more prone to rupture even with a little twist or bend.

In some cases, a disc herniation may occur in young and healthy people as a result of injury or tear from lifting large heavy objects, this injury may occur after twisting while lifting a heavy item or using back muscle instead of a leg muscle while lifting heavy objects.

Certain factors that may increase the risk of a herniated disc may include :

Excess body weight  

Genetics 

An occupation that is physically demanding 

Sedentary lifestyle 

Symptoms of herniated (slipped) disc: A cervical herniated disc symptoms may include pain in the neck, shoulder, or arms, numbness, or weakness in the neck, shoulders, or arms. If the disc herniation is large and compresses the nerves in the spinal column, there may be numbness, weakness stiffness in the legs, loss of bowel control, difficulty with bladder control.

A thoracic herniated disc symptoms may include pain in the mid-back, pain or numbness that travels from the back to the front of the chest or upper abdomen.

A lumbar herniated disc symptoms may include persistent or continuous back pain that is worsened by movement, sneezing, coughing, or standing for long periods of time, unexplained muscle weakness in the leg, difficulty in walking and coordination, changes in bowel or bladder function, pain that starts near the back or bottom and makes it’s way all down the leg and to the foot, decreased reflexes at the knees and ankles.

Diagnosis of the herniated (slipped) disc: 

Diagnosis is based on the history, symptoms, and physical examination may aim to check reflexes, walking ability, muscle strength, range of motion, sensitivity to touch, and the possibility of tender regions in the back. If any other medical condition is suspected or the doctor needs to find the location of the herniated disc and see which nerve is affected, the doctor may order MRI imaging, CT scan, or myelogram.

Available treatment for herniated (slipped) disc in Pakistan: 

Treatment options of medication for herniated (slipped) disc in Pakistan includes :

Medication

Therapy

Surgery

Medication: Medication include over-the-counter pain medications such as ibuprofen or naproxen, doctors may also prescribe narcotics such as codeine or oxycodone, acetaminophen combination if OTC medication doesn’t improve pain. If muscle spasm is present muscle relaxants may also be prescribed, cortisone injections that are injected directly into the area of the herniation to help reduce pain and inflammation.

Therapy: Physical therapy may be suggested if the pain doesn’t resolve within a few weeks physical therapists may show patients positions and exercises designed to help relieve the pain.

Surgery: In very few cases surgery may be required, surgery is suggested if other treatment options fail to improve the patient’s symptoms after a period of six weeks. Surgery may include either removing just the protruding portion of the disc or removing the entire disc. In cases where the entire disc is removed metal hardware may be used to fuse the vertebrae together to provide spinal stability, in very rare cases surgeons may suggest an artificial disc replacement.

Stem cell therapy for herniated (slipped) disc: 

Stem cell therapy has been in use for the last few years and resulted in highly successful procedures for the treatment of herniated or slipped disc. The main function of stem cell therapy is to regenerate a dysfunctional disc that is compressed or bulged out of the spinal canal due to any type of injury or age-related wear and tear of the spine.

Stem cell injections are directly injected into the spine and regrow and regenerate disc that was causing pain and inflammation. As the pain and inflammation are mediated by pressing of the nerves, therefore, stem cell therapy influences reduction and pain management by regenerating the affected disc.

Enriched with growth factors and healing properties of stem cells that are undifferentiated cells and can take the shape of any type of cells that are either inflamed or dysfunctional in the body, is the natural mechanism for self-healing.

Lumbar spinal stenosis is the loss of space inside the spinal canal, it can occur anywhere in the spine but is most common in the lumbar spine or lower back. Lumbar spinal stenosis is very common in people over the age of 60 approximately 1 in 3 people. However symptomatic lumbar spinal stenosis is quite uncommon and it is only present in 5-10% of those people with lumbar spinal stenosis .

Causes of lumbar spinal stenosis: Degeneration or normal age-related wear and tear on the parts of the spine can result in bulging discs, bone spurs, thickened spinal ligaments, and enlarged joints near the spinal canal.

These changes take up space inside the canal and the resulting narrowed space puts pressure on the spinal nerves which cause irritation and inflammation. People usually do not begin experiencing age-related symptoms from stenosis until later in life, however, it can occur in younger people who were born with abnormally small canals.

Symptoms of lumbar spinal stenosis: Symptoms of spinal stenosis are caused by a squeezing of the nerve root. These symptoms occur most often in the legs with people experiencing heaviness, weakness, and pain while walking or during the prolonged periods of standing.

Standing or walking makes the symptoms worse due to pressure and stretching of the irritated nerves, after rest symptoms often disappear due to pressure taken off the nerve roots. 

Available treatment for lumbar spinal stenosis: In many cases, mild pain medication and rest relieve the pain of stenosis. Physical therapy or steroid injections are other possible treatment options. If symptoms become severe the doctor may recommend a surgical procedure to free up or decompress the nerves, two or more vertebrae may also be fused together or connected to stop motion at the painful area.

How stem cell therapy treats lumbar spinal stenosis: Stem cell therapy is part of medical science and termed “regenerative therapy” that harness the body’s own defense mechanism to heal and regrow damaged and inflamed tissue and especially in the case of lumbar spinal stenosis inflamed disc tissue regeneration that is causing nerve root compression.

Stem cells are injected into the spinal canal that regenerates degenerated disc and thus results in the opening of the spinal canal directly influencing the compression on the nerve root that was compressed or pinched before treatment. Stem cell-mediated disc and joint regeneration reduce inflammation and pain by regenerating bulging of the disc and provide quicker onset of relief to patients without the need for an invasive surgical procedure that is high risk and even one small error can result in paralysis of the body either on a temporary or permanent basis. Stem cell therapy not only regenerates but also halts the progression of the disease therefore symptoms experienced by the patient are lessened at once.

Cost of stem cell therapy vs traditional treatment for lumbar spinal stenosis: 

The cost of stem cell therapy vs available traditional therapy is quite significant both in comparison of economical terms in consumption of time for treatment as traditional treatment is a multi-disciplinary approach involving consultation with orthopedic surgeons and neurosurgeon along with any other medical branch that is treating the underlying condition.

Furthermore, after a successful surgical procedure patient has to go through a physical therapist and exercise for many months and sometimes up to 14 months that burdens the patient in both ways of financial and time-wise.

The rotator cuff is a set of four muscles and tendons that attach the shoulder blade to the proximal part of the arm or the proximal humerus, it serves to stabilize the shoulder and socket and also helps to lift and rotate the arm.

Rotator cuff common injuries and causes: common injuries to the rotator cuff include inflammation of the tendon itself or the surrounding tissue called the rotator cuff tendonitis or subacromial bursitis or more significant injuries such as tears.

These tears can be small or partial in size or they can involve the entire tendon’s full thickness and be quite large, they occur because of wear and tear as we age or from acute traumatic injuries. 

Symptoms: Symptoms of rotator cuff injury are following such as 

Pain on the outside of the shoulder down the arm and up to the neck.

Inability to raise one’s arm above shoulder level 

Continuous pain in the shoulder regardless of night or day but more if resting on the affected shoulder.

Difficulty in rotating and weakness in lifting the arms.

Treatment for rotator cuff injury: Treatment for rotator cuff can involve simple measures such as rest and activity modification to avoiding activities that are painful for your shoulder, to things like physical therapy and icing the shoulder, and pain medication such as anti-inflammatory medications like ibuprofen and aspirin.

Surgical treatment for rotator cuff injury: Surgery is a good option for the treatment of rotator cuff injury or tears when non-surgical measures such as physical therapy and pain medications have failed to provide symptomatic relief over a period of time.

Other reasons for surgery include a large tear or tears that are resulted from an acute traumatic injury, finally, if someone has a high demand occupation that requires a lot of overhead shoulder activity, this may be another reason to consider surgical fixation.

Surgery is typically performed arthroscopically although an open incision may be needed in rare cases. The arthroscopic approach uses small incisions around the shoulder to insert a camera and arthroscopic equipment to perform the work.

The goals of surgery are to remove inflammation, remove the diseased portion of the rotator cuff and repair the rotator cuff tendon back into the bone.

For more information visit https://shifarejuvenation.com/ 

The recovery period of surgery: Recovery after surgery can be lengthy and can progress over several months, typically the patient will be in a sling for four to six weeks after surgery and continues for five and six months.

Physical therapy for rotator cuff injury: Physical therapy is usually individualized and prescribed by the surgeon after surgery is performed, in general, however, the patient starts with passive range of motion exercise where motion is generated by the therapist and later towards the active range of motion where the patient performs the range of motion exercises. After a range of motion has returned, strengthening exercises can begin.

The prognosis for rotator cuff repairs is excellent, particularly in terms of pain relief, functional results can continue to improve even out to one year. The majority of the patient will return to a high portion of their activities within four to six months including sports. 

Stem cell treatment/injections for rotator cuff injury: Stem cell therapy helps repair rotator cuff injury and tears using minimally invasive and ultrasound-guided injection precisely into the torn areas of the muscle and tendons.

The results from the stem cell therapy have resulted in more than 70% of patients who received groundbreaking stem cell therapy for rotator cuff injury noted improvements in range and of motion and inflammation reduction of 80% on average.

Further clinical trials have also shown that patients benefited from quicker recovery and can get back to things they love faster than those who undergo traditional surgery and treatments.

Sadly 6 out of 10 patients of rotator cuff injury surgery don’t heal afterward, in fact, a US government-sponsored investigation into healthcare quality recently reviewed more than 150 published studies and concluded that there was no solid evidence that rotator cuff surgery benefited patients any more than no surgery at all.

The rotator cuff is a set of four muscles and tendons that attach the shoulder blade to the proximal part of the arm or the proximal humerus, it serves to stabilize the shoulder and socket and also helps to lift and rotate the arm.

Rotator cuff common injuries and causes: common injuries to the rotator cuff include inflammation of the tendon itself or the surrounding tissue called the rotator cuff tendonitis or subacromial bursitis or more significant injuries such as tears.

These tears can be small or partial in size or they can involve the entire tendon’s full thickness and be quite large, they occur because of wear and tear as we age or from acute traumatic injuries. 

Symptoms: Symptoms of rotator cuff injury are following such as 

Pain on the outside of the shoulder down the arm and up to the neck.

Inability to raise one’s arm above shoulder level 

Continuous pain in the shoulder regardless of night or day but more if resting on the affected shoulder.

Difficulty in rotating and weakness in lifting the arms.

Treatment for rotator cuff injury: Treatment for rotator cuff can involve simple measures such as rest and activity modification to avoiding activities that are painful for your shoulder, to things like physical therapy and icing the shoulder, and pain medication such as anti-inflammatory medications like ibuprofen and aspirin.

Surgical treatment for rotator cuff injury: Surgery is a good option for the treatment of rotator cuff injury or tears when non-surgical measures such as physical therapy and pain medications have failed to provide symptomatic relief over a period of time.

Other reasons for surgery include a large tear or tears that are resulted from an acute traumatic injury, finally, if someone has a high demand occupation that requires a lot of overhead shoulder activity, this may be another reason to consider surgical fixation.

Surgery is typically performed arthroscopically although an open incision may be needed in rare cases. The arthroscopic approach uses small incisions around the shoulder to insert a camera and arthroscopic equipment to perform the work.

The goals of surgery are to remove inflammation, remove the diseased portion of the rotator cuff and repair the rotator cuff tendon back into the bone.

For more information visit https://shifarejuvenation.com/ 

The recovery period of surgery: Recovery after surgery can be lengthy and can progress over several months, typically the patient will be in a sling for four to six weeks after surgery and continues for five and six months.

Physical therapy for rotator cuff injury: Physical therapy is usually individualized and prescribed by the surgeon after surgery is performed, in general, however, the patient starts with passive range of motion exercise where motion is generated by the therapist and later towards the active range of motion where the patient performs the range of motion exercises. After a range of motion has returned, strengthening exercises can begin.

The prognosis for rotator cuff repairs is excellent, particularly in terms of pain relief, functional results can continue to improve even out to one year. The majority of the patient will return to a high portion of their activities within four to six months including sports. 

Stem cell treatment/injections for rotator cuff injury: Stem cell therapy helps repair rotator cuff injury and tears using minimally invasive and ultrasound-guided injection precisely into the torn areas of the muscle and tendons.

The results from the stem cell therapy have resulted in more than 70% of patients who received groundbreaking stem cell therapy for rotator cuff injury noted improvements in range and of motion and inflammation reduction of 80% on average.

Further clinical trials have also shown that patients benefited from quicker recovery and can get back to things they love faster than those who undergo traditional surgery and treatments.

Sadly 6 out of 10 patients of rotator cuff injury surgery don’t heal afterward, in fact, a US government-sponsored investigation into healthcare quality recently reviewed more than 150 published studies and concluded that there was no solid evidence that rotator cuff surgery benefited patients any more than no surgery at all.

Shoulder trauma is a broad term used to define fractures and dislocation of the shoulder. Fracture and dislocation both are different conditions as used also to define the severity of the trauma.

A fracture involving a significant trauma such as falling onto your outstretched arm or maybe being involved in a car accident. These injuries are extremely painful and can limit your function immediately after the injury and can be confirmed with an x-ray.

A dislocation is a total displacement of the articular end of the bone from the joint cavity, in dislocation normal alignment of the bone is altered. Various factors are attributed to the bone and joint dislocations.

Types of dislocation: dislocation of the bones and joints are divided into the following types such as:

Congenital

Traumatic

Pathological

Paralytic 

Congenital dislocation: Congenital deformities are due to genetic factors or factors operating on the developing fetus. These are also called a teratogenic or teratologic disorder.

Traumatic dislocation: It is due to serious violence, it occurs in the shoulder, elbow, and hip.

Pathological dislocation: pathological dislocation can occur due to some disease.

Paralytic dislocation: Paralytic dislocation occurs when a remarkable imbalance occurs in the muscle power 

Types of fractures: Fractures can involve different portions of the shoulder. The fracture can involve the proximal part of the arm or proximal humerus or can involve the socket of the shoulder, called the glenoid.

Fractures also vary in severity, some are simple breaks where the two bone pieces do not move relative to each other, these are called minimally displaced or non-displaced fractures. Other fractures can be more severe and bone can be broken into several pieces.

How are fractures and dislocation treated? As both of the conditions are different and require a different approach to treat each, therefore, treatment method is also different according to the severity of the disease.

For dislocation, if an individual is under the age of 20 years then surgery is a good option for earlier recovery and healing time. Healing time takes about 10-12 weeks. There are two procedures for shoulder dislocation such as “Arthroscopy”  or “Bankart repair” and the second procedure is called “Open surgery” or “Latarjet procedure”.

Surgical repair of the shoulder fracture involves an open surgery generally under general anesthesia and also with the nerve block.

The surgery is an open surgery and is a ten to twelve-centimeter incision Infront of the shoulder, the pieces of bone are carefully realigned and fixed with the metal plate and screws.

In some cases, the fracture may be so severe, or the bone quality so poor that the metal fixation cannot hold, in these cases a metal prosthesis will be used to reconstruct the shoulder.

Recovery from a shoulder fracture involves a 1-2 day hospital admission followed by outpatient physical therapy, depending on the type of surgery an individual has, physical therapy will start with gentle range of motion exercises initially performed by the therapist or passive range of motion, followed by active range of motion exercise performed by the patient. When the range of motion is restored, strengthening exercises will begin which typically occurs after the bone has healed in three to four months.

Cost of fracture and dislocation by traditional treatment vs stem cell therapy: The cost of fracture and dislocation is very high in Pakistan as not only the patient has to pay for the surgical procedure but also for one week of hospitalization that is the minimum requirement.

Medication and physical therapy cost as much as the surgical procedure itself, therefore, rendering multiple financial burdens on the patient which is already suffering from a poor economic climate at the moment.

Stem cell therapy offers no such additional cost in terms of continuous treatment and afterward physical therapy cost on the patient, therefore it is the most logical and conclusive therapy for shoulder fracture and dislocation.

Common types of bone and joint injuries and their treatment through stem cell therapy: 

In common bone and joint fracture and dislocation stem cell therapy is also used as stem cell therapy contains several growth factors, cytokine, and acts as an immunomodulator, and therefore promotes early recovery and bone regeneration at the site of fracture.

With conventional treatment bone, fracture, and dislocation injuries take too much time, and in severe cases decrease in the quality of life of the patient is inevitable. 

Visit https://shifarejuvenation.com/ for more information regarding stem cell therapy.

Stem cell therapy initiates osteoblast activity which is natural bone builders in the body. By activating osteoblast activity bone formation is much faster and recovery is 3 folds early than traditional therapy and surgical procedures.

What Is Plantar Fasciitis? Plantar fasciitis is foot pain caused by a problem with the plantar fascia, the band of tissue that connects the heel and ball of the foot, it’s sometimes called plantar fasciosis.

Plantar fasciitis is the most common cause of adult heel pain, and pain associated with plantar fasciitis generally tends to be worse when a patient gets out of bed in the morning or sitting for a while.

Causes: plantar fasciitis is caused by strain, tearing, or wearing out of the tough band of tissue in the feet, causes varies according to the individual’s activity such as :

Wearing high heels

Being a runner or dancer

Sitting all the time 

Spend a lot of time on feet on hard surfaces

Having tight calf muscles

Having flat feet or very high arches 

Being overweight or having rheumatoid arthritis

Precaution: To lessen the pain and lower the stress on your foot there few precautions that need to adhere to in order to get better results from medications and reduction of inflammation such as:

Take smaller steps

Don’t walk barefoot

Avoid jogging and other high-impact activities

Lose weight especially if an individual is overweight

Do stretches of calves and feet

Rest and put ice on feet

Taking NSAID’s (non-steroidal anti-inflammatory drugs)

Wear a splint at night to stretch the muscle

Symptoms: Symptoms of plantar fasciitis are as followed :

Stabbing or pinching pain in the foot or heal

Unable to walk after few steps 

Unable to move the foot after standing or sitting for a long time (due to pain)

Plantar Fasciitis traditional treatment in Pakistan: Traditional treatment for plantar fasciitis in Pakistan is quite limited but consist of the following protocols such as:

Anti-inflammatory medication (ibuprofen etc)

Ice once or twice a day (5-10 min)

Cortisone injections

Shoe and orthotic therapy

Putting a cast on feet if there’s a fracture

Formal physical therapy

Activity modification

Surgery

Stem cell therapy for plantar fasciitis: recently stem cell therapy has been in use for the treatment of plantar fasciitis as a mediator for quick recovery and promotes an anti-inflammatory response which is usually lack by traditional medications.

Does stem cell therapy work for plantar fasciitis? Stem cell therapy is enriched with cytokines and anti-inflammatory properties that accurately target inflamed areas in the feet such as plantar fasciitis and reduces inflammation and promote recovery with quick onset.

As stem cell therapy include growth factors that stimulate the body’s natural healing process making way for fast recovery on a priority basis therefore stem cell not only works better than traditional therapy but also promotes recovery.

Cost of plantar fasciitis treatment in Pakistan: cost of plantar fasciitis is different in each region in Pakistan especially for orthopedic surgeons and rheumatologist consultation costing very high to visit the clinic and further surgical options and medication put an extra financial burden on the patient.

For a country like Pakistan treatment for diseases such as Plantar fasciitis is not economical where 80% of the population is living under the line of poverty and cannot afford continuous visits to physician clinics and treatments that prolong to several years. 

Stem cell therapy offers the best option for plantar fasciitis as it’s not only the body’s natural healing process but it also doesn’t offer severe side effects of steroid and pain killer medication that further increases the cost and decreases in quality of life.

Whiplash Injury: A whiplash injury is the sudden jerking motion of the head that results in stiffness of the neck inflammation as well as rigidity and tightening of muscles. Not only that patients are complaining of neck pain that happens within the first 24 to 48 hours after injury but they are also complaining of headaches. What happens is when muscles tighten down it causes impingement of a nerve, this can result in radiating hand pain as well as the headaches.

Causes: motor vehicle accidents are the most common cause of whiplash injury but other causes of whiplash injury vary according to the individual’s action at that particular time such as :

Horse riding falls 

Sporting accidents

Minor knocks and falls 

Road accident

Direct impact on the front or back of the head

Symptoms: 95% of symptoms complaints are resolved within one year but there are 5% of chronic symptoms complaints. The most common symptoms of whiplash injury are:

Neck pain

Neck tightness

Decrease range of motion 

Sometimes headache in the back 

Backache

Numbness or tingling in the shoulders or arm

Nausea

Vomiting

Fatigue 

Amnesia 

Poor concentration 

Ringing in ears

Blurred vision

Oversensitivity to the light 

Heaviness both in arms and shoulders 

Available Treatment: Treatment for whiplash injury involves repairing and healing injured ligaments in the neck leading to a realignment of the affected joints and decreasing inflammation and pain. Treatment options that are being utilized are :

Pain killer injections

Low-key exercises

Ice-compress the affected area 

Physical therapy

Rest

Muscle relaxant

Over-the-counter anti-inflammatory medications

Cervical collar

Acupuncture

Chiropractic care

Massage 

Stem cell therapy for Whiplash injury: Stem cell therapy offers a non-invasive treatment for whiplash injury and quick onset of healing and anti-inflammatory response to heal the affected joints and ligaments.

Recently there has been a huge increase in regenerative medicine usage in treating muscle injuries such as whiplash injury, cartilage regeneration, arthritis, and neuropathy.

Cost of stem cell therapy for whiplash injury: cost of stem cell therapy is between 3000-6000$ for treatment of whiplash injury. As stem cell works better and lasts longer and required rigorous check-up, therefore, stem cell therapy is way more economical than conventional therapy.

Conventional Therapy and stem cell therapy comparison: Conventional therapy is very expensive as it continues for many months up until 1 year or more.

A rough estimate of conventional therapy is around 30,000$ in the first 3-4 months and puts a huge amount on an individual’s suffering from an injury. 

Stem cell therapy cost around 3000-6000$ for maximum therapy and lasts for years and even permanent in many cases, stem cell is less time consuming, non-invasive, non-surgical, no side-effects therapy that provides relief to the suffering individuals.

One of the most interesting comparisons between conventional and stem cell therapy is that conventional therapy usually moves from the first to the last option in many phases such as first patient is given pain killers than injections, physical therapy, acupuncture, and many more therapies and lastly surgical option for correction in the alignment of joints and repairing torn and inflamed ligaments.

Stem cell doesn’t get into much longer and time taking procedures and offer regenerative and anti-inflammatory properties in one or two therapies and results are seen evidently in first two weeks, where conventional therapies results are visible in minimum 60-90 days.

Whiplash injury treatment in Pakistan with stem cell therapy works by injecting anti-inflammatory and highly enriched cellular regenerative stem cells into the affected joints and ligaments promoting the body’s natural response to self-healing and reduction of inflammation.

Sciatica is the name given to the pain caused by the irritation of the “sciatic nerve”, anything that irritates this nerve can cause pain ranging from mild to severe. Sciatica is usually caused by a compressed nerve in the lower spine  

Causes: Sciatica occurs when the sciatic nerve becomes pinched usually by a herniated disc in the spine or overgrowth of the bone as in bone spur on the vertebra, more rarely the nerve can be compressed by a “tumor” or damaged by a disease such as diabetes.

Risk factors: Risk factors for developing sciatica includes:

Age 

Obesity

Occupation

Prolonged sitting

Diabetes

Symptoms: the main symptom of sciatica is shooting pain anywhere along the sciatic nerve from the lower back through the buttock and down the back of either leg.

Other common symptoms of sciatica include numbness in the leg along the nerve, tingling sensation as in pins and needles in the feet and toes. This pain can range in severity and may be aggravated by sitting for long periods.

Treatment: If the pain doesn’t improve with self-care measures than the physician recommends the following treatments such as:

Anti-inflammatory medications

Muscle-relaxants

Narcotic painkiller medication

Trycyclic anti-depressants

Anti-seizure medications

Physical therapy

Corticosteroid injection 

Surgery: This option is usually reserved for when the compressed nerve causes significant weakness, loss of bowel and bladder control, or when the pain progressively worsens or doesn’t improve with other therapies.

Surgeons can remove the bone spur or the portion of the herniated disc that’s pressing on the pinched nerve.

Can stem cell play a big role in sciatica treatment? Over the years many research related to an out of the box complete treatment for sciatica has been circling around the medical community and biotechnology specialist resulted in stem cell therapy or regenerative medicine for a possible solution.

In October 2013 a research article published in the “National Library Of Medicine” showed amazing results of the application of stem cell injections in animal models for treatment of sciatic nerve and reduction of inflammation in the spinal canal.

The results showed not the inflammation was reduced but stem cell therapy has regenerated more than 50% of nerve cells or axons in the spinal cord which has improved the outcome even more in favor of stem cell therapy.

After the publication of this study application of stem cell therapy in humans has started and given even more conclusive results and most of the patients who had chosen stem cell therapy didn’t need surgery at all.

Sciatica pain treatment through stem cell therapy in Pakistan is widely used for the management of sciatica and have satisfied thousands of patients over many years and continues to serve many more patients for years to come.  

Neck and back disease is a broad term used to describe multiple conditions that cause a wide range of symptoms and include conditions such as cervical stenosis, tendon of the shoulder and arms, and spondylosis of the spine.

Cervical Spinal Stenosis: Cervical spinal stenosis is the narrowing of the cervical spinal canal that causes compression either on the spinal cord which would cause a disorder called “Myelopathy” or compression on the nerve roots.

Symptoms: Problems with “Radiculopathy” or compression on the nerve roots will cause symptoms such as pain that radiates down the arm into the hand and also numbness and tingling that can occur in the hand as well.

Causes: Cervical spinal stenosis is caused by multiple factors into the neck and its compression on the nerve from the ligaments posteriorly that causes compression on the spinal cord anteriorly, or in the front of the neck, it’s from the disc herniation that causes spinal stenosis.

The joints that we have in the neck can get osteophytes that grow and causes compression out laterally on to the spinal cord and on to the nerve roots.

Non-Surgical Treatment for cervical spinal stenosis: Non-surgical options are physical therapy which can help decrease some of the inflammation around the nerves, also treatment options include anti-inflammatory medications or trial of injections.

These injections decrease the inflammation around the nerve root and as a result, decrease the symptoms that are occurring.

Surgical Treatment: By using the surgical option it can be treated anteriorly or in the front of the neck by doing a decompression with removal of any object or structure that is causing compression on the spinal cord. 

It might be a discectomy or moving the disc or corpectomy, removing any portion of the arterial body that is causing compression.

Also, it could be treated posteriorly which is from the back of the neck by removing the posterior structures that are causing compression on the nerve root or spinal cord, be it the facet joints or the ligaments that are causing compression.

Tendonitis of the shoulder: Shoulder tendonitis is technically an inflammation of the tendon of the shoulder’s rotator cuff and biceps,

These tendons are inflamed as a result of direct impact or, stretching injury, where there’s micro ripping and tearing even micro-tearing inside and that causes pain.

Some times the pain goes away in few days but people with some sort of arthritis and their tendons are aged, tendons usually don’t have a great blood supply that’s why they take more time to heal and decrease in inflammation takes more time than usual injury or inflammation in any other part of the body.

Treatment: Usually doctors recommend anti-inflammatory medications, use ice packs to reduce inflammation, and advise to not lift or carry heavy objects or try to relax as much as possible to give time to heal tendons. 

https://shifarejuvenation.com/

If the pain medication is not working then they move on to injection therapy along with physical therapy, exercise to strengthen the shoulder muscles, reduces friction and stress on the particular tendon, and help in healing. The last option is a surgical procedure where surgeons shave off the portion of tendons that’s either frayed or inflamed or completely cut out the tendons completely and reattach them to the joint.

Spondylosis: Spondylosis is a term simply refers to aging of the spine, as the spine ages the changes occur with dehydration of the disc causing the disc to lose some of their shock-absorbing function so they collapse down and then the back part of the disc bulges into the canal.

Due to these changes connector joints which are called facets becomes arthritic therefore bone spurs form and that can also contribute to spinal stenosis.

Spondylosis can happen throughout the spine as we age it happens in the neck or mid-back, low back. 

Symptoms: Symptoms mostly occur in the upper and lower parts of the spine such as:

Stiffness and pain in the neck

Soreness in neck

Spasm in the muscle 

Clicking sound when the neck is moved

Headaches

Dizziness

Treatment: Aging of the spine does not imply that the patient needs treatment at all, in fact for the majority of the patient’s pain comes and goes away. 

Mostly conventional treatment is enough for pain relief but in chronic and persistent cases pain reliever medication and injections are not enough then the only option of treatment is a surgical procedure also known as “decompression surgery” where inflamed tissue or part is removed from the spine which is contributing in pain and inflammation.

Can Stem Cell Therapy treat Cervical stenosis, shoulder tendonitis, and spondylosis?

The options are limited in treating neck and back diseases such as cervical stenosis, shoulder tendonitis, and spinal spondylosis with over-the-counter (OTC) medications and even with opioid pain killer injections and oral medications, stem cell therapy has proven itself as an alternative way of pain management of these diseases.

Stem cell therapy for spinal spondylosis in Pakistan is highly enriched with anti-inflammatory properties that are found naturally in the body, and our body’s natural response for healing inflammation and pain. Stem cell therapy works by reducing inflammation on the site of spinal stenosis or spinal injury and quickly reduce inflammation thus directly influencing pain reduction.

In surgical procedures, patients needed to be hospitalized for a minimum of 10-14 days and physical therapy takes another 6-9 months of time duration for showing even minimum results.

Spinal surgery itself presents the danger of complication with the latest research till 2015 showing about 52% had experienced post-operative complications which in turn causes further time delay added to recovery as the formation of blood clots, infection and spinal fluid leakage are one of the most experienced complications leaving millions if not thousands of patients with temporary or permanent disability and severity of symptoms.

Menopause is a time in a women’s life when her period stops, it usually occurs naturally most often after age 45 as a result of a natural decline in her reproductive hormones. Menopause happens because the women’s ovaries stop producing the hormones “Estrogen” and “Progesterone”. It can even happen in the early 40s or late 50s.

About 1% of women begin menopause before 40, about 5% between the ages of 40 and 45. The menopause process does not occur overnight, but rather is a gradual process and is called “Perimenopausal Transition”.

The perimenopausal period is the time around menopause, perimenopausal transition varies among different women, usually begins about 4 years before the last period, a small number of women starts their perimenopausal transition 10 years before their menopause.

The perimenopausal transition is characterized by an irregular menstrual period, the period will skip a month and then return or may skip for several months, and then the regular cycle starts for a few months.

Symptoms: A woman has reached menopause when she has not had a period for one year, changes and symptoms can start several years earlier, they include such as:

A change in periods (shorter or longer, lighter or heavier, with more or less time in between).

Hot Flashes and/or night sweats.

Trouble sleeping.

Vaginal dryness.

Mood swings.

Trouble focusing.

Less hair on the head, more on the face

Weight gain in some women

Reduced sex drive 

Causes: The major cause of menopause is the decline in a woman’s reproductive hormone, at this time the function of the ovaries ceases, and there’s no chance of pregnancy. The aging of the ovaries leads to less production of the reproductive hormones.

Removal of ovaries or injury can also result in menopause, cancer chemotherapy, and radiation therapy can also lead to an early onset of menopause or “premature menopause”.

Premature Ovarian condition: This is characterized by an early occurrence of menopause before the age of 40, this may be related to auto-immune diseases or genes.

Treatment For Menopause: there are multiple treatments for menopause depending on the age and cause of menopause such as:

Hormone therapy may be an effective way of treatment in women under 60 years of age and helps in the reduction and management of some symptoms like hot flashes, night sweating, 

Some medications are used in treating some other symptoms such as hair thinning, insomnia, and vaginal dryness.

Sleeping medication or inducers for insomnia.

Topical minoxidil for hair thinning.

Non-hormonal vaginal moisturizer and lubricants.

Ospemifene for vaginal dryness and painful intercourse.

Regular exercise for 20-30 minutes per day, helps in increasing energy, well being and improves mood.

Selective serotonin reuptake inhibitors (SSRIs) for depression, hot flashes, and anxiety.

Regular intake of sodium, magnesium, and vitamin D supplements

How to treat Premature ovarian condition with stem cell therapy: in early 2016 a study was presented to the European society of human reproduction and embryology meeting in Helsinki, Finland that PRP and stem cell therapy can reverse menopause by restoring the menstruation cycle.

The study was conducted on 8 womens aged above 45-50 and they have been without a menstrual cycle for about four months and given Stem cell injections infusion into the ovaries. The study further claims to achieve ovarian rejuvenation and all women had recovered their menstrual cycle within 1-3 months time.

Infertility in the female is defined as the inability to conceive or carry a pregnancy to term after 12 months of regular and unprotected sexual intercourse.

Types: There are two types of infertility such as:

The failure of a couple to have any children at all is termed “Primary Infertility”.

Couples who have already conceived have produced a first child but have great difficulty in adding more or another to their family termed “Secondary Infertility”.

Some doctors prefer the term “Sub Fertility” to describe any form of reduced fertility with prolonged time. Infertility can arise from female factors, male factors, or a combination of both.

Fertilization is the term used to describe the successful fusion of a female egg and male sperm to form the new organism that is the baby.

Female Factors: Female factors affecting fertility include :

Hormone 

Oogenesis

Implantation 

Potential for pregnancy

Causes: Potential causes of sub-fertility or infertility are thought that male factors account for 30% of causes, female factors about 30%, a mix of female and male factors for 30%, and the remaining 10% is idiopathic or of unknown origin.

Causes of female infertility can be broken down into five main groups such as:

Pituitary Disorders 

Ovulation Disorder

Ovarian failure

Hypogonadism 

Hypothalamic pituitary failure 

Hyperprolactinemia 

Hypothyroidism 

Polycystic ovarian syndrome 

Premature ovarian failure

Destruction of ovaries by radiation or chemotherapy, surgery, or toxins

Luteal phase defects 

Pelvic, tubule, or uterine disorders 

Damage to the fallopian tube

Prevention of infertility: infertility can be prevented by:

Having regular sexual intercourse

Maintaining healthy personal habits

Maintaining healthy body weight

Exercise regularly

Avoiding exposure to toxins

Avoiding smoking and alcoholic drinks

Limiting caffeine intake

Conventional Treatment for female infertility: Fertility drugs are the most commonly used infertility treatment for women. Fertility drugs treat infertility by working on three purposes:

To get women to ovulate, who don’t ovulate on their own.

Increase the number of eggs released in women who do ovulate.

In preparation for IVF

For inducing ovulation, oral medications are usually used since they are less expensive, easier to use, and don’t require as much monitoring. Clomid (clomiphene citrate) is the most commonly used medication for female infertility.

Typically the doctor will start with a lower dose such as 1-2 pills a day for five days, after monitoring if the doctor determines that you did not ovulate then the dose can be increased by 1 pill per day.

So if two pills a day for five days didn’t work then the dose goes up to three pills a day and so on. Treatment can no longer be exceeded to more than five days but in some cases, Clomid can be given for 7-10 days.

Injectable medications are a more potent infertility treatment for women with a typically higher percentage of women who will ovulate and more will get pregnant. Commonly used brands of these medications are Follistim or Gonal-F.

Like the Clomid, if you are trying to induce ovulation, the doctor will usually start on a lower dose and increase only if necessary. The exact dose is determined by a number of factors such as age, results of hormone testing, and the response of any previous treatment.

Because they are more potent, the injections require closer monitoring with blood tests and ultrasounds in the doctor’s office every few days. When being used to get multiple eggs in women who already ovulate, or for IVF, the dose of medications may be higher than when it’s used to induce ovulation. 

Autism is a lifelong developmental disability that affects how we communicate with, and to others and it affects how we make sense of the world around us. 

Autism is a spectrum condition so whilst they all share certain difficulties, their autism will affect them in different ways.

Some of the affected patients have been to universities and hold down jobs whilst others need a lifetime of specialist support.

Types Of ASD: there are different conditions that are considered in Autism spectrum disorder such as :

Asperger’s Syndrome

Pervasive Developmental Disorder, not otherwise specified (PDD-NOS)

Autistic Disorder

Childhood Disintegrative Disorder

Rett Syndrome (now excluded from ASD type)

Cost of treatment In Pakistan: The autism consultation fee in Pakistan is around 3000-7000 PKR for just one visit to a specialist doctor and mostly recommended visits are 4/month to assess and further treat the child by different techniques and therapies.

As most of the therapies and consultation is continues for many years until the patient will show some sign of improvement, therefore, it cost roughly about 336,000 PKR to treat one child for one year in Pakistan. 

Cost Of stem cell therapy in Pakistan: The cost of stem cell therapy in Pakistan is very economical starting from 2500$. In the united states stem cell therapy cost about 8000-25000$ therefore stem cell therapy is quite economical considering the cost in other countries.

Stem cell therapy application in Autism, Top 5 benefits of stem cell therapy for Autism :

Stem cell therapy is a new approach to mitigate symptoms of autism and overall improvement of autism. As stem cells are not specialized cells, therefore, plays important role in the brain developing new cells.

As autism is a brain developmental disease therefore by stem cell therapy new cells can be generated in the brain.

Umbilical cord mesenchymal stem cell (MSC) has been used in multiple studies and are generally considered as safe and effective in treating autism and improvement by most of the patients.

Top 5 Benefits Of Stem Cell Therapy In Autism: There are multiple benefits of stem cell therapy in treating autism such as:

Quick results than years and years of therapies such as speech therapy, occupational, behavioral, and cognitive therapy, etc.

Stem cell therapy as being cost-effective as only costing between 400,000-600,000 PKR where only one-year of consultation only costs about 336,000 PKR and therapies cost another 300,000-400,000 PKR.

Stem cell therapy lasts longer but conventional therapies could take at least 2-4 years to show some results and a maximum of a lifetime period to continue the therapy for living a normal life which is a big financial burden on the individual’s family.

Chances of relapse are possible with conventional therapies where stem cells are enriched with the proliferation of neural cells which only show progression, not regression.

Conventional treatments are falling behind in most of the treatment of the disease as the new technological era has shaped medical science into a world of possibilities for treatment for untreatable diseases. Time consumption and inefficient results put conventional therapies as an obsolete way of treatment.

Stem cell therapy in pakistan for autism is the best solution for long-term treatment of autism where conventional treatment is lagging behind in quick response and effectiveness. 

The heart is a very important organ in the body responsible for blood circulation throughout the body and providing much needed oxygenated and glucose-rich blood to every part of the body to survive. The heart is a hollow muscular organ consisting of four parts, divided into two chambers upper and lower, the upper part is called “Atrium” and the lower part as being “ventricle” divided by a septum.

The upper chamber has two parts, one is “right atrium” other is “left atrium”. Similarly in lower chambers have two parts “right ventricle” and “left ventricle”. In heart diseases either there is a problem with the heart muscles or vessels supplying blood to the heart gets narrower which in both cases results in an inefficient supply of blood to the body and also to the heart.

Types of heart diseases: 

There are multiple conditions that are considered in heart disease or part of it, most commonly are :

Coronary Heart Disease

Arrhythmias 

Congenital Heart Disease

Heart Valve disease 

Cardiomyopathy

Coronary Heart Disease (CHD): 

In coronary heart disease, the artery that supplies blood to the heart has occlusion, therefore, the heart is deprived of blood causing ischemia (lack of oxygen) in the heart cells resulting in infarction, and if not treated on time results in cardiac cells death. Coronary heart disease is the reason for heart attack and the number one cause for death in heart diseases.

Arrhythmias: Arrhythmias is a condition with an irregular heartbeat that results in either heart beating too fast known as “Tachycardia” or beating too slow “Bradycardia”. Arrhythmias can result in the formation of blood clots which in turn give rise to heart attacks and also stroke if the blood clot travels to the brain. 

Congenital Heart Disease: Congenital heart disease exists in patients from birth and can be characterized as defects in heart structure that can affect blood flow or circulation to or from the heart. Congenital Heart disease patients are at greater risk of developing CVD later in life and have a higher percentage of mortality in heart disease patients.

Heart Valve Disease: Heart valve disease involves defects in valves that control blood flow and due to these defects in valves backflow of blood can be experienced by individuals suffering from this condition that can result in flow disruption.

This condition can be fatal if not treated properly therefore needs proper cardiac surgery to be performed for the correction of valve defects.

Cardiomyopathy: Cardiomyopathy can be classified as heart muscle inability to pump sufficient blood to the body therefore due to cardiac muscles inability there’s a higher chance of developing heart failure which is the biggest and complicated disease itself and leads to pulmonary and pedal edema.

Causes Of Heart Disease In Pakistan: 

Pakistan has a higher percentage of cardiac patients and in total deaths, heart diseases contribute to 29%. Due to less knowledge of disease and education prevalence is increasing day by day. 

As heart diseases is a broad term used for multiple conditions, therefore, causes are different for each condition but most commonly are as followed:

Sedentary lifestyle

Lack of exercise

Family history

Diabetes

Hypertension

Chronic kidney disease

Stress 

Higher cholesterol intake

Trauma induced cardiac injury/ blunt cardiac injury.

Symptoms: some of the most common symptoms of heart disease are:

Shortness of breath

Chest pain 

Weakness 

Cold hands and feet

Numbness in arms especially left arm

Pain in the back, abdomen, jaw, and throat

Tightness in chest

Unable to walk, exercise.

Treatment For Heart Disease In Pakistan: some of the common treatments after an individual is diagnosed are :

Lifestyle modification (diet and exercise)

Quitting smoking

Aspirin

Anti-hypertensive medication

Anti-diabetic medication

Anti-coagulants

Anti-platelet medication

Ace Inhibitors

Statins

Beta-blockers

Diuretics 

Vasodilators

Conventional Treatment in Pakistan vs stem cell therapy: 

Conventional treatment in Pakistan is usually considered as primary care for cardiac patients and varies differently according to the severity and locality of the healthcare providers. CHD (coronary heart disease) or heart attack which is very common now in even young adults in Pakistan, an average cost for a single “cardiac stent” cost between 200,000 to 350,000 in government and later in private hospitals.   

Cost of “Cardiac Bypass Grafting” or open-heart surgery cost between 425000-650,000. The cost of the conventional pacemaker procedure cost between 100,000-250,000 and varies according to the type of pacemaker selected for the patient.

Stem cell therapy to repair damaged heart in Pakistan is a new approach for treating heart diseases and preventing further progression of other diseases. Stem cell therapy has resulted in the regeneration of cardiac cells that have gone through infarction and have become malfunction. As the heart has a slow rate of cellular regeneration, therefore, the stem cells can be injected into the heart resulting in the regeneration of myocardium cells and angiogenesis.

Our bodies can form a major hurdle when developing therapeutics. Many types of sophisticated therapies are either too fragile or too big to get into the cells and not easily targeted to specific sites of disease. To address this issue scientist are using the body’s own natural delivery and messaging system “the exosome”

What are exosomes? Exosomes are small, extracellular vesicles that can stably transport cargo between cells across great distances. Scientists are able to pack exosomes safely with all kinds of delicate, but effective treatments.

How Exosome Works? In order for the exosomes to deliver these drugs with accuracy, they need to find the site of the disease in the body. Scientists have covered the outside of exosomes with targeting molecules which means that exosomes can get to their destination more easily and can even cross the tissue barrier like the blood-brain barrier which is a big hindrance in delivering drugs to the brain.

The exosomes then bind to their target cells and get internalized, inside the cells specialized machinery delivers the drugs cargo and help treat the disease. With the innovation in biotechnology, scientists are opening up an exciting new way to treat severe diseases where few or no treatments are available today. Exosomes are very powerful mediators they carry all the signaling and the machinery necessary to go and change the behavior of a neighboring cell.

Exosome Therapy For Diagnosis And Treatment Cancer And Other Diseases:

Exosome therapy has been in use since early 2013 for diagnostic tools for prostate cancer, brain cancer, neurodegenerative disease, and other solid tumors. A lot of patients are diagnosed with a certain disease they are treated all alike but not all patients are similar. Exosome therapy can say something about how the treatment worked, was it good, did it worked efficiently or not. 

Exosome potential can be used to directly target cancer cells and kill the cancer cells without killing the healthy cells. Currently, there is a program that’s being run in France to use exosome from patients with cancer so to purify the exosome from their immune cells and to reinject them into these patients with the hope to boost their immune responses against their own cancer so the scientists could load these little vesicles with very specific targeted molecules that are only damaging to cancer cells and not to normal cells. Exosomes used this way would be a sort of personalized therapy.

Exosomes carry cytoplasmic proteins, messenger RNA, and micro RNA and transfer signals and contents to other cells important for biological processes such as immune response, intercellular communication and transport, metastasis, angiogenesis,  and cellular survival.

It has been established fact that exosomes can’t be used for diagnosis alone but also for the treatment of untreatable diseases like cancers and neurodegenerative diseases as exosomes transfers the signal relating to invoking immune response and healing mechanism, therefore, can treat and send necrosis signals for cancer cells to be eliminated from the body.

Exosome-based chemotherapy is 2-3 fold more effective as exosome-based therapy is targeted and destroys more cancer cells at the right time and location in the body and this been demonstrated in a study published in August 2020 in “Signal Transduction And Targeted Therapy”.

Other than cancer, exosomes have shown substantial potential in treating neurodegenerative diseases such as multiple sclerosis and arthritis by initiating nerve cells to start repairing through nerve stem cells. Future medications are now being developing based on exosome-mediated targeted site of action which not only provides an accurate amount of drug unchanged by the metabolism of the body but also on the right targeted organ/part of the body to treat the disease.

Overview: Multiple sclerosis (MS) is a demyelinating disease of the central nervous system, which includes the brain and the spinal cord. Myelin is the protective sheet that surrounds the axons of neurons. Allowing them to quickly send electrical impulses. This myelin is produced by oligodendrocytes, which are the group of cells that supports neurons.

What Happens In MS: In multiple sclerosis, demyelination happens when the immune system inappropriately attacks and destroys myelin, which makes communication between neurons break down, ultimately leading to all sorts of sensory, motor, and cognitive problems.

The brain including the neurons is protected by the things in the blood by the blood-brain barrier, which only lets certain molecules and cells through from the blood. For immune cells like T and B-cells that means having the right ligard or surface molecule to get through the blood-brain barrier, this is kind of like having the VIP pass to get through.

Once a T-cell makes its way in, it can get activated by something it encounters. In the case of multiple sclerosis, it’s activated by myelin. Once the T-cell gets activated, it changes the blood-brain barrier cells to express more receptors and this allows the immune cells to more easily bind and get in.

Role Of Immune Cells In Damage: Multiple sclerosis is a type 4 hypersensitivity reaction or cell-mediated hypersensitivity. This means those myelin-specific T-cells release cytokines like IL-1, IL-6, TNF-alpha, and interferon-gamma which together dilate the blood vessels, which allows more immune cells to get in as well as directly cause damage to the oligodendrocytes.

These cytokines also attract B-cells and macrophages as part of the inflammatory reaction. Those B-cells start to make anti-bodies that mark the myelin sheath proteins and then the macrophages use those antibody markers to engulf and destroy the oligodendrocytes. Without oligodendrocytes, there’s no myelin to cover the neurons, and this leaves behind areas of scar tissue, also called plaques or sclera.

In multiple sclerosis, these immune attacks typically happen in bouts, in other words, an autoimmune attack on the oligodendrocytes might happen, and then regulatory T-cells will come in to inhibit or calm down the other immune cells, leading to a reduction in the inflammation.    

Early on in multiple sclerosis, the oligodendrocytes will heal and extend out new myelin to cover the neurons, which is a process called remyelinating. Unfortunately though over time as the oligodendrocytes die off the remyelination stops and the damage becomes irreversible with the loss of axons.

Causes: Just like other auto-immune diseases, the exact cause of MS is unknown but is linked to both genetic and environmental factors such as:

Genetic Risk Factors: include being a woman and having genes that encode a specific type of immune molecule called HLA-DR2 which is used to identify and bind to foreign molecules

Environmental Risk Factors: includes infections as well as a vitamin-D deficiency which help explain why the rates of multiple sclerosis are higher at the northern and southern poles compared to the equator where there’s a lot more sunlight. Together these genetic and environmental influences might lead to the body not killing off immune cells that target myelin.

Types: there are four main types of MS based on the pattern of symptoms over time.

Relapse and remitting MS or RRMS (most common): The first and by far most common pattern is called relapse and remitting MS, this condition is described as bouts of auto-immune attacks happening months or years apart causing an increase in the level of disability for example during about a person might lose some vision, but then it might be followed by an improvement if there’s remyelination. 

Unfortunately, the remyelination process is not complete so there is often some residual disability that remains and that means with each attack, more and more of the central nervous system gets irreversibly damaged. In RRMS there’s typically no increase in disability between bouts so the line stays flat during that time 

Secondary Progressive Multiple Sclerosis (SPMS): The second type is called secondary progressive multiple sclerosis which initially is pretty similar to the relapse-remitting type, but over time the immune attacks become constant which causes a steady progression of disability.

Primary Progressive Multiple Sclerosis (PPMS): The third type is primary-progressive multiple sclerosis, which is basically one constant attack on myelin that causes a steady progression of disability over a person’s lifetime. 

Progressive Relapsing Multiple Sclerosis (PRMS): The final type is progressive relapsing multiple sclerosis or PRMS, which is also one constant but this time there are bouts superimposed during which the disability increases even faster.

Symptoms: Specific symptoms vary a lot from person to person and largely depend on the location of the plaques, and multiple sclerosis typically affects individuals between the age of 20 and 40. Symptoms related to bouts can typically worsen over weeks and can linger for months without treatment.

One common trio of multiple sclerosis symptoms is called “Charcot’s Neurologic Triad” and it includes “Dysarthria”, which is difficult or unclear speech, “Nystagmus” which is involuntary rapid eye movement and intention tremor.

Dysarthria is due to plaque in the brainstem that affects nerve fibers that control muscles of the mouth and throat, and this can interfere with conscious movements like eating and talking and can lead to things like a new stutter as well as unconscious movement like swallowing.

Nystagmus is due to plaques around the nerves controlling eye movements. Plaques around the optic nerve cause loss of vision in one or both of the eyes because of damage to the optic nerve which is called optic neuritis.

Sometimes there’s blurring or graying of the vision or alternatively, there might be a dark point in the center of vision. Additionally, if there’s damage to the nerves controlling eye movement, then eye movements can be painful and there can even be double vision If the eyes can no longer move in a coordinated way.

Intention Tremors can be caused by plaques along the motor pathway in the spinal cord which can affect outbound signals like skeletal muscle control. Motor symptoms can include muscle weakness, muscle spasms, tremors, and ataxia which is a loss of balance and coordination.

In serious cases this can lead to paralysis, in addition, plaques in the sensory pathways can affect inbound signals like sensations from the skin which causes symptoms like numbness, pins and needles, and paresthesias which are often tingling feelings but may also be a painful itching or burning sensation.

Occasionally there can be very specific sensory symptoms like Lhermitte’s sign, which is when an electric shock runs down the back and radiates to the limbs when a person bends their neck forward.

Plaques can also involve the autonomic nervous system which can lead to bowel and bladder symptoms like constipation and urinary incontinence, as well as sexual symptoms like sexual dysfunction. Multiple sclerosis can also affect higher-order activities of the brain causing poor concentration and critical thinking, as well as depression and anxiety.

Multiple sclerosis is typically suspected when there are multiple neurologic symptoms separated in space, which is attributable to damage in different locations in the nervous system as well as time, meaning separate bouts or flare-ups as well as remission.

Diagnosis of MS: Diagnosis of MS is supported by an MRI which shows multiple central nervous system lesions called white matter plaques. Since these regions tend to have lots of myelin, also in the cerebrospinal fluid there might be high levels of antibodies which indicates an auto-immune process. A visual evoked potential can be helpful as well which measures the nervous system’s response to visual stimuli.

Treatment For MS: There is no cure for multiple sclerosis, but there are medications that are particularly effective for the relapsing-remitting type because they lessen the severity of relapses and make them happen less frequently.

Medications like corticosteroids, cyclophosphamide which is a cell cycle inhibitor, and intravenous immunoglobulin can all be used to help blunt the auto-immune process. In addition, plasmapheresis can be effective as well, which is when the plasma is filtered to remove disease-causing autoantibodies.

Chronic treatment for multiple sclerosis includes immunosuppressants like recombinant beta-IFN which decreases the levels of inflammatory cytokines in the brain and increases the function of T-regulatory cells.

Other immunosuppressants block T-cells from getting into the brain by interfering with the cell surface molecules they use to gain passage through the blood-brain barrier.

Unfortunately, there are fewer treatment options available for progressive MS. Instead, treatments are often targeted at managing specific symptoms, everything ranging from depression to bladder dysfunction. Physical therapy and cognitive rehabilitation therapy can be particularly helpful with sensory, motor, and cognitive symptoms. Finally, there’s also increasing interest in the role of vitamin-D as an effective treatment.

How to control MS through stem cell therapy: Stem cells are part of the body’s normal repair system. Their main function is to replace damaged or dying cells in the body. Stem cells have the ability to grow into other cells type so the stem cell can become nerve cell or red blood cells or a muscle cell.

In multiple sclerosis, it is often thought that there are two processes at work. One is inflammation and the other is neurodegeneration.

In stem cell treatment the transplantation of stem cells could potentially replace any damaged cells. What stem cell therapy hopes to achieve is to replace or reboot the body’s immune system so it no longer causes inflammation in the brain and spinal cord.

This is a lengthy process where the existing immune system is completely or partially destroyed and then rebuilt with stem cells.

Stem cells are injected into the body through drip and they start making new blood and rebuilding the immune system within 10-30 days time period. With the entire new immune system in place, the neurodegeneration process is reversed and almost 60-70% of symptoms are gone gradually and higher activities of neurogenesis.

The human skeleton is made up of bones, which provide support and shape to the body. They provide soft internal organs, such as the brain, and heart from injury. Together with muscles, strong bones enable the body to move freely. 

Bones have a solid outer surface, called compact bone, inner bone is called spongy bone because it is less dense than compact bone and has many small holes like a sponge.

Bones contain cells called osteoclasts that breakdown bone tissue. Other cells osteoblasts, make new bone tissue using minerals such as calcium and phosphate, from the blood. Hormones such as estrogen, growth hormone, testosterone help keep the number and activity of osteoblasts higher than osteoclasts so that more bone is made than removed.

Physical forces and pressure during exercise also help bones to grow stronger and denser. These processes allow bones to grow strong in children and adults. People have their strongest, most dense bones called “peak bones” in their thirties. After this age, osteoclasts gradually remove more bones than the osteoblasts make.

Osteoporosis is a condition that leads to weakened bones, causing them to break more easily. Healthy bone is dense enough to support and protect the body and to handle the stress of movement and minor injuries, however, people with osteoporosis have abnormally thin bones with larger holes in the spongy bones.

Types: There are two types of osteoporosis such as:

Primary Osteoporosis is usually related to an older age as well as a reduced amount of estrogen in women.

Secondary osteoporosis affects both children and adults. it is related to other diseases or conditions such as cancer, hormone problems, or the use of certain medications.

A person has a greater risk of either type of osteoporosis if they don’t develop enough bone mass when they are growing from childhood to adulthood.

Risk Factors: Risk factors that can lead to low peak bone mass include:

Family history of osteoporosis

Being white or Asian

 Female

Poor diet

Certain medicines such as steroid, or seizures medicines

 Lack of exercise Lifestyle behaviors such as smoking, excessive alcohol consumption 

An abnormal amount of bone loss after 30 years of age

 Women’s going through menopause

Bones may break or fracture easily because they are unable to withstand the physical strain and pressure from even normal activities. 

Common fracture location in people with osteoporosis includes the wrist, spine, and hips.

Prevention & Treatment: Building strong, healthy bones through a diet rich in calcium and vitamins and getting regular exercise can help prevent as well as treat osteoporosis. Common medications include:

Biophosphonates

 Denosumab

 Selective estrogen receptor modulator (SERM)

Calcitonin

Calcium and vitamin D supplement

 Vitamin D3 injection

How Stem Cell Therapy can treat osteoporosis: Stem cell therapy has been in use for many years in bone disease and treating bone necrosis specifically in bone cancer. Mayo Clinic has started such treatment in 2012 and resulted in many patients avoiding surgery and complete joint replacement by more than 80% of total patients.

As the stem cells are enriched in growth factors and regenerative qualities, therefore, offers complete treatment for osteoporosis and bone diseases. Surgical options present many challenges and long recovery and physical therapy to be utilized therefore stem cell therapy delays the need for many years and for some patients no need at all. 

Erectile dysfunction (ED) is described as difficulty or inability to obtain or maintain an erection suitable for sexual intercourse.

Erectile dysfunction is most likely to affect older men, over half of the men aged over 40 but it is been easily seen in younger men too as ED is increasingly affecting men for mental health reasons, even as young as men in their late teens and early twenties.

Symptoms: Other than age-related ED happen due to mental stress in younger people due to reasons such as:

Stress

Anxiety

Depression 

Porn

Causes: Erectile dysfunction in terms of a diagnosis can be challenging because it can be multifactorial and sometimes we don’t even ever really find the true cause but there are some certainly known causes or increased risk factors for erectile dysfunction.

Medication often causes problems with erectile function, specifically medication that treats blood pressure or medication that can affect mood disorders are linked very often to these side effects of the medication.

An individual might find that they’d have no issues with erectile function until they started the new medication to manage their blood pressure or to help with their depression and all of a sudden now erectile dysfunction has appeared in their life. 

Other causes for erectile dysfunction can be disease states most commonly diabetes, diabetes often will lead to erectile dysfunction, as well as a whole host of other potential problems. Neurological diseases, spinal cord injury can lead or at least contribute to erectile dysfunction.

Obesity is very prevalent due to excessive use of junk food has been linked to a higher incidence of erectile dysfunction, there’s definitely a link between heart diseases and erectile dysfunction but as they begin to go through the evaluation, it could uncover some underlying heart disease that needs attention.

In terms of other risks or other lifestyle things that can lead to it such as drug abuse, marijuana use specifically, alcoholism, all of these things have shown to increase erectile dysfunction.

Stem Cell Therapy For ED: New clinical trials results show that stem cell can restore erectile functions in impotent men according to Odense University Hospital Denmark where 21 men with ED, its first trail involving direct usage of stem cell therapy for ED in men, and results show that erectile dysfunction is treatable with stem cell therapy.

Within a few weeks, those patients have normal erection levels and satisfactory levels of sexual arousal and intercourse.

Erectile dysfunction treatment in Pakistan by stem cell therapy is provided by Shifa Regenerative and Rejuvenation clinic utilizing stem cell therapy for the long term and effective treatment of erectile dysfunction.