Category: Publication

IMMUNOLOGY SERIES- PART 7- TYPES OF IMMUNOGLOBULIN

The previous article dealt in detail with immunoglobulin and how they help in phagocytosis. This article is about the types of immunoglobulins, their functions.

The types of immunoglobulins are based on the types of light and heavy chains. There are two types of light chains namely the kappa and the lambda. An immunoglobulin contains either kappa (K-K) or lambda (L-L) but does not have a mixture of both (K-L not possible). About 60% of the immunoglobulins in humans have kappa chains.

So, the classes of immunoglobulins are based on the heavy chain. So based on this condition, there are five classes of immunoglobulins namely:-

  • Immunoglobulin G (IgG) – gamma
  • Immunoglobulin M (IgM) – mu
  • Immunoglobulin A (IgA) – alpha
  • Immunoglobulin D (IgD) – delta
  • Immunoglobulin E (IgE) – epsilon

These immunoglobulins have certain configurations and play different roles in the human body. The immunoglobulin G is present the most. It constitutes about 80% of the total immunoglobulin. These are mostly present in the blood, plasma, and other body fluids. This immunoglobulin has the lowest carbohydrate content when compared to the rest. This immunoglobulin has a half-life of 23 days which is the longest of all. Some of the unique features and functions of this immunoglobulin:-

  • This is the only immunoglobulin which can cross the placenta (this is a unique feature because this immunoglobulin provides immunity to the foetus inside the womb and also after birth for some months. Presence of others may indicate infection)
  • This helps in killing bacteria and viruses by opsonisation (the process of covering the pathogen with a protein coat such that the pathogens become more presentable to the immune cells)
  • Neutralize toxins
  • Activate complement by classical pathway (The complement system, also known as complement cascade, is a part of the immune system that enhances the ability of antibodies and phagocytic cells to clear microbes and damaged cells from an organism, promote inflammation, and attack the pathogen’s cell membrane)
  • Unique catabolism (breaking down of molecules) based on concentration
  • There are four sub classes (G1, G2, G3 and G4) out of which 1,3 and 4 cross the placenta and offer immunity
  • Also involves in the Rh immunization (there are two types’ Rh+ve and Rh-ve based on the presence of Rh factor in blood). The mother being Rh+ve and child the opposite is not a problem in the first pregnancy but can be fatal in second, killing the foetus.

The immunoglobulin M constitutes about 5-10% of total proteins. This is a pentamer structure with a J chain. This weighs about 900000-1000000 and is the heaviest of all. They have 5 days of half-life. Some of its features-

  • Presence in newborn indicate congenital infection as they don’t cross placenta
  • Short lived, so their presence indicates recent infection
  • First Ig to participate in primary response
  • Opsonisation
  • classical pathway
  • bacteria agglutination
  • Play an important role in ABO blood grouping (discovered by Landsteiner). There are 8 types of blood groups based on antigen, antibody and Rh factor

Immunoglobulin A is also known as the secretory immunoglobulin and is mostly present in body secretions (tear, saliva, sebum, mucous, and milk) in which they are dimer and are monomer in blood. They constitute 10-15% of the proteins. They also have a J chain and secretory piece. Their half-life is 6-8 days.

  • The secretory piece protects the Ig from enzymes and juices
  • Complement activation by alternate pathway
  • Promote phagocytosis
  • Intracellular microorganism killing
  • First line of defense against some microbes

Immunoglobulin E is a dimer similar to IgG. This is present in low concentrations (about 0.3) and has the weight of about 1,90,000. These have a half-life of about 2 days and can become inactivated at 56 C.

  • Present extra-cellularly
  • Associated with allergic reactions like asthma, hay fever and anaphylactic shock
  • Bind with the Fc of mast cells and basophils resulting in degranulation and release histamine which causes allergy
  • Mediate the some immunity reactions
  • No complement activation
  • Provide immunity against helminthes

The last is immunoglobulin D.  It is present in low concentrations and on the surface of B lymphocytes. They constitute 0.2% of proteins. They have a half-life of 3 days. The IgM and IgD bind on the B lymphocyte to help in antigen identification.

Hence these were the different types of immunoglobulins and the mechanisms by which they help with immunity. The next article is about the process of inflammation.

HAPPY READING!!

IMMUNOLOGY SERIES- PART 6- IMMUNOGLOBULIN

The previous article was about the different types of immune cells. This article is about a special molecule in immunity known as immunoglobulin.

There might be a question that what is so special about this immunoglobulin. There is a reason for this. These molecules play an important and inevitable role in the phagocytosis of pathogens. To understand this, it is essential to know about immunoglobulins.

The immunoglobulin is a gamma globulin, a specialized group of proteins (glycoprotein) produced in response to pathogens. It is produced by the plasma cells (a globulin protein present in the plasma). These constitute 25-30% of the blood proteins.

There are two important terms that are more commonly known by the most, they are the antigen and the antibody. The antigen is the molecule present on the surface of the pathogen and can stimulate an immune response. There is a small part of the antigen called the epitope which interacts with the antibody.  The epitope is known as the antigen determinant site. An antigen can have unlimited epitopes.

On the contrary, the antibody is the molecule produced in response to the antigen in order to kick it away. The part of the antibody which interacts with the antigen is called a paratope. An antibody must have at least 2 paratopes. These antibodies belong to the immunoglobulins. All antibodies are immunoglobulins but not immunoglobulins are antibodies. To understand how the antibody helps in immunity, it is essential to understand the structure of an antibody/immunoglobulin. The image below shows the general structure of an immunoglobulin:-

There are two chains in an immunoglobulin namely the light chain and heavy chain. The light chain has 212 amino acids (the building block of protein) and the heavy chain has 450 amino acids. Each chain has two types namely the constant and variable. These regions are based on the amino acid sequences. Half of the light chain (1 out of 2) is constant and the rest is variable. A quarter of the heavy chain (1 out of 4) is variable and the rest is constant. These are linked by two types of sulfide bonds namely the intra (H-H AND L-L) and inter (H-L). These molecules contain carbohydrates (CHO) hence these are called as glycoproteins.

The tip of the variable regions of the heavy and light chain is hypervariable in nature and these constitute the antigen-binding site (Fab). These are hyper-variable because they have to produce amino acid sequences complementary to that of the antigen so that they can interact together. The other site is called a crystallizable region (Fc).

Having known all this, now it will be convenient to explain the process by which the antibody plays in the prevention of infections.

There are millions of substances that pass through the blood every day. So there must be a criterion/substance to identify them whether they are pathogenic. This is where antigen comes to play. These antigens present on the surface of the pathogens alert the immune system which then identifies this as a pathogen. So in response to the antigen, a suitable antibody is secreted and deployed to the target site. On reaching the antigen, the Fab region binds with the antigen.

The ultimate aim of the immune system is to abolish the pathogen and one way is by phagocytosing them. This is done by the macrophages. But it is essential for them to identify the substance before engulfing it. This is where the antibody comes to play. The Fc region of the antibody combines with the receptor of the macrophage. This facilitates the process of phagocytosis.

Hence the antibody acts like a bridge between the source (antigen) and the destination (macrophage) aiding in phagocytosis. This is essential because in most of the cases the macrophages, it is difficult to identify the non-self-objects and this is where antibody helps.

In the case of the new pathogen, the antigen is new, and therefore their might not be a suitable antibody. In that case, the macrophage cannot phagocytocise the pathogen and it reigns in the body causing infection and disease.

The next article is about the types of immunoglobulins.

HAPPY LEARNING!!

TIPS TO STAY FOCUSED

“Always remember, your focus determines your reality.” — George Lucas

Unless you have a strong desire to learn the information or develop a skill, it can be hard to focus all of your attention in one place. If you are impatient to learn or master anything, it wouldn’t benefit you more. If you are restless, you will make more mistakes and you will be more distracted as your whole focus will be on result, not on your action.

Instead, remain calm and be devoted to your work.

A mind which is calmer helps you to concentrate better, attaining undivided focus and it makes you proactive.

Television, smart phones, social media, friends, and family can all distract you from your goal of doing well in school. Create an environment that helps you focus. Set a schedule that maximized your study time. Try different study techniques and take breaks so you don’t become too overwhelmed. Here are some of the best tricks that scientists have come up with to help you increase your focus in studying.

  1. Get rid of distractions. Choose the right spot. In order to concentrate, you must eliminate those things that you know will distract you. Put up mobile devices. Turn off the TV. Close other pages in your web browser. Sit away from people making loud noises.
  2. Play music without lyrics. Some people cannot stand silence. They need to have background noise to help keep themselves motivated. Consider playing classical music softly. For some people, music helps them concentrate. For some, it doesn’t. Try it out and see what works best for you. A little something in the background can make you forget that you’re studying instead of out having fun.
  3. Come prepared. Be sure to have all the materials needed to work. Have pencils, pens, highlighters, paper, textbooks, calculators, or whatever else will help you finish the task. Organize the area. A clean space will mean less distractions too. Your goal should be to take care of everything outside of studying before you sit down to focus. If not, you’ll just end up getting up repeatedly. Having to stop and start takes more time than continuously working.
  4. Find a place where you can “unplug”. One of the biggest complaints that teachers have about their students is their inability to concentrate on a subject. Our constant use of social media and personal devices like cell phones divides our attention and makes it more difficult to concentrate.
  5. Learn when to say no. Often times, people find it difficult to concentrate on their studies because they are overextended with other obligations. If this is you, don’t be afraid to tell people no. Just explain that you need to study and won’t have the time or energy to do so, if you help them out.

    Ultimately, there’s no quick, one-size-fits-all solution to staying focused while studying. Different methods and tools will work better for some than others. However, with a little trial and error and the tools and techniques above, you can create a routine of focused studying that works best for you.

    IMMUNOLOGY SERIES-PART 5- INTRODUCTION TO THE IMMUNE CELLS

    The previous article was about the acquired immunity. This article is all about the immune cells, the warriors of the human body.

    These cells play a major role in protecting the body from infections. Some of them contribute directly and some contribute indirectly. Despite the methods, all of them are required in optimum amounts so as to live a healthy life.

    All of these cells are derived from a specific type of cell found in the blood. The blood is a freely flowing interstitial fluid that transports oxygen, nutrients, etc. to the cells of the body. There are two components in the blood in which the first one is called plasma. The plasma is the liquid carrying water, salts, enzymes, and proteins. There are three specialized proteins in the plasma-

    Albumin- to maintain water balance

    Globulin- for immunity (it is a part of immunoglobulin)

    Fibrinogen- for clotting

    Hence the plasma also contributes to immunity. This plasma constitutes about 55% of the blood. The rest 45% of the blood is constituted by the formed elements or corpuscles. There are three elements in it namely-

    Erythrocyte or Red Blood Corpuscle- transport of oxygen

    Leucocyte or White Blood Corpuscle- fight infections

    Thrombocyte or platelets- for clotting

    Out of these, the WBC is the one primarily contributing to immunity. A healthy person must have a WBC count from 4000-11000. Count less than 4000 means leukopenia meaning that the immune system is weak. If the count is more than 11000 then it means the condition of autoimmunity known as leucocytosis. There are some further classifications in the WBC which are displayed through the flowchart below.

    There are two types of cells in the WBC namely the granulocytes and agranulocytes.

    The granulocytes, as the name specifies have granules in their cytoplasm. There are three different cells in this.

    The neutrophil constitutes to about 55-70% of the total WBC and they are ones involved in most of the fights against the infections. These defend against bacterial and fungal infections. These cells are mostly found in the epidermal regions and are in the first line of defense.  These cells engulf the pathogens by the process of phagocytosis. These cells have multiple nuclei hence these are also known as PMN (Poly Morpho Neutrophils). Neutrophils help prevent infections by blocking, disabling, and digesting off invading particles and microorganisms. They also communicate with other cells to help them repair cells and mount a proper immune response. The death of these cells often results in the formation of pus (suppuration).

    neutrophil

    The eosinophil constitutes about 2-4% of the total WBC. These cells are very little in the body but can increase in the case of allergic reactions, parasite infection, and so on. The functions of the eosinophil include movement to inflamed areas, trapping substances, killing cells, anti-parasitic and bactericidal activity, participating in immediate allergic reactions, and modulating inflammatory responses.

    eosinophil

    The basophil is present in the least concentration of all (0.2%) in total WBC. These cells play an important role in allergic reactions in which their count can increase. The basophil contains inflammatory mediators like histamine and heparin. The release of the compounds results in dilation of the blood vessels. Hence these cells regulate the inflammation process.

    The agranulocytes are those which lack granules in their cytoplasm. There are two types in this. The lymphocyte can be called as the memory of the immune system. There are two types of lymphocytes namely T and B lymphocytes. These lymphocytes recognize the incoming pathogens and based on their memory it produces a suitable response in a short amount of time. These cells are involved in the secondary response in the acquired immunity.

    B cells make antibodies that can bind to pathogens, block pathogen invasion, activate the complement system, and enhance pathogen destruction. The T cells mostly known as CD4+ T helper cells produce the cytokines (proteins in cell signaling) and coordinate with the immune system. There is another form called CD8+ cytotoxic T cells which is opposite to the previous type, they help in the destruction of tumors and pathogens.

    The monocyte is the largest of all the cells in WBC. They function similarly to that of the neutrophils (phagocytosis of the pathogens). These cells present the pathogen to the memory cells upon which a response is generated. Once they leave the blood, they turn into macrophages which help in clearing cell debris and killing pathogens. These are known as the vacuum cleaners of immunity.

    Hence all these cells work in different mechanisms and they coordinate together to make sure that we do not fall prey to the disease-causing microorganisms.

    HAPPY LEARNING!!

    DEBATE CONCEPTS IN OSTEOARTHRITIS

    This article deals with some of the concepts related to the progression of osteoarthritis. These statements were given by prominent researchers and resulted in a debate between two prominent groups of researchers against each other. All of these took place actively in the 19th century where the publications of research scholars were opposed to that of the scholars in the other group.

    William Bauer told that mechanical trauma can result in OA directly or indirectly. By the 20th century ideologies were majorly split into two ‘inflammation’ and ‘no inflammation’. Henry Fuller and Robert Todd suggested that OA occurred due to disruption to nutrients required for knee development and doesn’t occur through inflammation. On the other hand, Garrod and others stated that OA is partly degenerative and partly inflammative. Hence the study for OA continued under these two domains and each group of scientists trying to prove the other is false. But this situation can be compared to two sides of a coin where both the situations cannot be neglected. Hence both the domains of OA cannot be neglected.

    Some others say that OA is a neurogenic immune homeostatic disorder. Garrod in 1988 stated that OA is associated with lesions in CNS in a peculiar manner. CNS refers to the central nervous system which constitutes the brain and spinal cord. The brain is the mastermind of the body which generates electrochemical signals to simulate several neurons in the body. The spinal cord is known as a warehouse of reflexes. Reflex is an involuntary (cannot be controlled by conscience) rapid sequence of actions. Reflex can be best explained by several experiments.

    When someone comes to hit you; you will either duck or catch his hand spontaneously and this is known as a reflex and the spinal cord or vertebral column is responsible for this.

    The reflex of the knee is tested by the doctor who takes a rubber mallet and taps it on the knee and what interestingly happens is that the knee starts to retract and the patient can feel the pain. In case of OA or any knee-related diseases, the patient cannot experience any pain and hence the doctor understands that there is some abnormality in the knee. Hence we can understand that there is a connection between the knee’s ability and CNS and an interruption in this connection can lead to knee diseases.

    We have to understand that this is a basic relation and there are other complex associations between them and require more complex methods like electrophysiology and pharmacology to understand them. Later it was proposed that changes in the sympathetic nervous system can also lead to OA.

    The sympathetic nervous system is a part of the autonomic nervous system. This can be correlated to the word ‘increase’. The sympathetic nervous system works in response to stimuli like emotions and increases some parameters of the human body like heart rate, eye dilation, blood sugar, blood pressure, etc. this proposal paved the way for using micro-circuitry to correct it.

    There is also another field on which the world is divided into two namely ‘nociceptive’ and ‘neuropathic’ where nociceptive refers to pain resulted due to receptors. These are present at target and send signals to the brain via the spine more or less like the reflex. On the other hand neuropathic refers to the condition where pain occurs due to nerves. The following table shows the difference between these two. 

    NociceptiveNeuropathic
    Receptor-mediated painNerve mediated pain
    Doesn’t affect nervesAffects the nerves
    Due to painful stimuliDue to inflammation

    However, some of the debate topics have not been resolved even till now but a lot of research articles about the progression of the disease and its underlying phenomena have been published. This is one of the cases in which a debate has done some good to the field of science!

    HAPPY READING!!

    How to become A Leader

    Photo by Rebrand Cities on Pexels.com

    Transformational leaders are positive, empowering, and inspiring. They value followers and inspire them to perform better. So what can you do to embrace these valued leadership qualities and become a stronger and more effective leader?

    Understand Your Leadership Style: Understanding your current leadership style is essential. What are your strengths? Which areas need some improvement? One way to start assessing your skills is to take this leadership style quiz to get a general idea of how you lead.

    Once you have completed the quiz, read about the major characteristics of your dominant style. Are these qualities helping or hindering your leadership? Once you’ve determined which areas need some work, you can begin looking for ways to improve your leadership abilities.

    Encourage Creativity: One way to foster creativity is to offer challenges to group members, making sure that the goals are within the grasp of their abilities. The purpose of this type of exercise is to get people to stretch their limits but not become discouraged by barriers to success.

    Show Passion: You can develop this leadership quality by thinking of different ways that you can express your zeal. Let people know that you care about their progress. When one person shares something with the rest of the group, be sure to tell them how much you appreciate such contributions.

    Communicate Effectively: Another important quality of transformational leadership involves a focus on providing one-on-one communication with group members. Transformational leadership is effective when leaders are able to communicate their vision to followers, who then feel inspired and motivated by this vision.

    Part of the trust-building process is creating an environment where it’s safe to take risks and allows you and your employees to comfortably exchange candid, honest and direct feedback without the fear of being punished.

    It’s important you provide ample channels for two-way communication between employees and managers, and also solicit and reward them for their ideas and contributions. This facilitates progress toward reaching organizational goals. As a leader, you should foster trust and cooperation. Leaders can paint a vision of the future that inspires the team to do whatever it takes to get there.

    And as a coach, you have to inspire action that will help execute that goal. Reinforce an honest and candid environment without taking information personally. Equally treat everyone like you would want to be treated.

    Give credit where credit is due. Say “thank you,” be encouraging, and try to put yourself in their shoes to better understand their everyday challenges.

    You have to support and assist your team. Give them the confidence to take risks and speak up without being punished.

    When the mistake is yours, take ownership. Don’t try to blame someone else, the situation or a circumstance.

    Be credible – people want to follow an honest leader. Be candid about why things didn’t work out, learn from the mistake and move on. People will trust someone who actively displays honesty. As you work toward developing some of these leadership qualities, don’t forget to look to your followers for feedback and inspiration. Pay attention to the things that have been effective in the past and always be on the lookout for new ways to inspire, motivate, and reward group members.

    OSTEOARTHRITIS GRADING SYSTEM

    Osteoarthritis can be mainly classified into two. They are primary and secondary. The criterion for this classification is based on the different types of risk factors. Primary OA is mainly due to age where the reason for cartilage breakdown is not known or maybe due to genetics. Secondary OA is due to direct injury through sports or trauma, stress, inflammation, or other metabolic diseases. In this case, the cause may localize.

    OA grading

    Grading is the process of classifying the disease based on its extent or severity. OA has been graded into 5 from grade 0 to grade 4

    Stage numberCondition
     0Normal
    1Minor
    2Mild
    3Moderate
    4Severe

    This was proposed by Kellgren and Lawrence and it is known as KL grading. The five grades have been proposed based on radiographic analysis of subjects. This was accepted as a standard measure by WHO in 1961. The grading has been done based on the narrowing of joint space and the formation of osteophytes.

    • grade 0 (normal): no changes in knee x-ray
    • grade 1 (minor): minimalistic joint space narrowing with possible osteophyte lipping
    • grade 2 (mild): definite osteophytes and  joint space narrowing
    • grade 3 (moderate): multiple osteophytes, definite narrowing of joint space and some sclerosis and possible deformity of bone ends
    • grade 4 (severe): large osteophytes, marked narrowing of joint space, severe sclerosis and definite deformity of bone ends

    Grade 0

    Grade 0 is considered normal. The subject will not exhibit any features for OA. The x-ray image from this grade is taken as a standard and the other grades are compared with this grade.

    Credit:- Häggström, M (2014). “Medical gallery of Mikael Häggström 2014“. WikiJournal of Medicine 1 (2). doi:10.15347/wjm/2014.008. ISSN 2002-4436. Creative Commons CC0 1.0 Universal Public Domain Dedication
    X-ray of a healthy knee 
    Credit:- Häggström, M (2014). “Medical gallery of Mikael Häggström 2014“. WikiJournal of Medicine 1 (2). doi:10.15347/wjm/2014.008. ISSN 2002-4436. Creative Commons CC0 1.0 Universal Public Domain Dedication
    This is the joint space which is observed in healthy patients.

    Grade 1

    Grade 1 is known as the minor. It can be considered as the initial grade. The joint space has just started to decrease. Osteophyte refers to excess bone growth. It is also known as bone spurs since spur refers to kind to sharp material. This bone growth can be observed as sharp spikes. Here there is very minimal growth of excess bone. Bone spurs occur only at the bones adjacent to the joint. There will be very minor loss of cartilage but this does not contribute to the narrowing of the joint space. Subject in this stage is not confirmed with osteoarthritis. However, subjects having any of the risk factors become more prone to the disease

    Grade 2

    Grade 2 is known as mild. In this grade, the narrowing of the joint space is more and is visible through the x-ray. There will be also more formation of osteophytes. This grade can be considered as the precursor to many complications like bone dislocation and rubbing. None of these complications are seen in this grade but these complications are soon to occur. The subject in this grade is confirmed with osteoarthritis. Special care has to be taken by those in this grade and through proper medications, they can prevent those further complications.

    Grade 3

    Grade 3 is known as moderate. Obvious damage occurs to the cartilage and the joint space narrows even at a faster rate. Swelling of the joints starts to occur in this stage. Erosion of cartilage becomes prominent in this stage. The joints become rougher due to spurs leading to stiffness. Inflammation occurs at regular intervals. Subjects can experience popping sounds from the knee.

    Grade 4

    Grade 4 is known as severe. It is the worst and highest grade of all. The changes become prominent and occur at larger scales. There will be no gap literally meaning the joint is absent. The bones start to rub over each other causing pain. The joint becomes stiff like a rock. The cartilage wears down and maximum growth of osteophyte is seen. Various cytokines are released at cartilage resulting in further death. Life would be dreadful for those in this grade. The arrow in the given X-ray indicates the bones are touching each other and there is no gap in between them.

    Grade 4 osteoarthritis
    Courtesy: – James Heilman, MD Osteoarthritis of the left knee. Note the osteophytes, narrowing of
     the joint space (arrow), and increased subchondral bone density (arrow). the joint space (arrow), and increased subchondral bone density (arrow). Creative Commons Attribution-Share Alike 3.0

    HAPPY READING!!

    THE DREADFUL DISEASE FOR THE AGED- THE OSTEOARTHRITIS

    Osteoarthritis is the most well-known type of joint pain, influencing a huge number of individuals in the world. It occurs as a result of the wearing down of the cartilage that cushions the ends of your bone over time. It is a complex disease that integrates biomechanics and biochemistry associated with the knee. This is the standard way of defining OA which will be difficult to understand. Hence let us try to understand what OA is. The best way is by splitting the word and analyzing it part by part

    Osteo- bone

    Arth- joint                        

    It is- inflammation    

    Knee, Old, Care, Injury, Pain, Knee Pain
    x-ray of the osteoarthritic knee joint

                          

    As mentioned earlier, the unit of bone is called osteon and any word ending with itis refers to inflammation. Also, arthro term refers to joints in general. Hence the combination of the terms corresponds to inflammation of bones in the joint. This rather sounds simplified. The previous definition had complex terms like biomechanics and biochemistry. Biomechanics refers to the study of movement in living beings. Biochemistry refers to the study of the reactions occurring in living things. So in short, osteoarthritis is such a disease that results in inflammation of joints that occur due to wearing down of the bones surrounding the joint hence affecting the movement and chemical reactions which used to occur properly during normal conditions.

    Osteoarthritis can occur in any joint in the human body like elbows, hips, knees, etc. Since our primary focus is on the knee, we will take a deep dive into it. In view of its expectancy and the tolerance that goes with sickness in the knee osteoarthritis represents more prevalence with daily activities like climbing steps and walking when compared to other diseases. Osteoarthritis is the most standardized reason for total knee replacement. As a result of the frequency of this disease especially in middle-aged people, osteoarthritis can act as an extensive barrier towards work and can lead to early retirement.

    Coining of OA

    Many say that the term osteoarthritis was coined by the British physician John Kent Spender but it was Richard Von Volkmann who tried to separate it from rheumatoid arthritis. The other names which were offered to this disease were ‘chronical rheumatism’

    ‘senile arthritis’

    ‘hypertrophic arthritis’

    ‘arthritis deformans’.

    Effect of age

    Osteoarthritis can affect people of any age group but it majorly affects old age people. National Library of Medicine suggests that people with an age greater than 70 have more risk to get osteoarthritis. The reason lies in the definition of osteoarthritis. The definition says that disease occurs due to the wearing down of bones. So the bones don’t get worn down the next instant a baby is born. Every process requires time to occur. A mother has to wait for a minimum of 9 months to give birth to a healthy baby. A student must wait for 4 years to get a degree from college. Similarly, it takes time for the bones in the knee to get worn down.

    This disease has always troubled old aged people in their lives. Living with osteoarthritis is dreadful. Even climbing the stairs will be a difficult task for them. Hence it is worth knowing about the disease.

    HAPPY READING!!

    USAGE OF BOTTLED WATER

    SHOULD WE AVOID IT?

    For a long time now, bottled water has become a trend amongst people all around the world. Mostly, it is cheap and advertised as healthy. Unfortunately, the water is actually not always as healthy as it might seem. Many companies use tap water sealed into bottles, sometimes purified, sometimes not. Many people who buy water bottles never reuse them and the plastic ends up polluting the environment. The cost for transporting millions of empty bottles each month is huge, and ultimately pollutes the air. Therefore, harming the environment, polluting the air and wasting plastic and fuel are strong arguments that why should not sell bottle water.

    “Drinking water is like washing out your insides. The water will cleanse the system, fill you up, decrease your caloric load and improve the function of all your tissues.” – Kevin R. Stone

    Even though recycling is something everyone should be doing, many people still throw away their water bottles. Millions use plastic bottles each month, causing transport to waste lands costing great amounts of money for fuel. The wastelands pollute the air, and so does the fuel when used. If our school sells and uses these plastic bottles normally, that demonstrates that we are helping to pollute the environment.

    I believe that bottled water should be banned, because of the environmental impact & the health effects they cause. Bottled water is obviously not a healthier or cleaner option to normal tap water. Also, bottled water is despicably expensive when you compare it to the cost per gallon of tap water.

    Almost all bottled water sold is tap water, which is put in plastic bottles and sold at huge profits. So pretty much what you’re doing is buying the same water that you could drink at your house for FREE. Also, if a person is choosing between tap water and bottled water, tap water is clearly the more economical and the healthier option.

    According to a 2001 report of the World-Wide Fund for Nature, approximately 1.5 million tons of plastic are used in the bottling of 89 billion liters of water each year. Other than the amount of plastic bottles produced each year, the energy essential to produce and transfer these bottles to the market uncontrollably drains limited fossil fuels.

    Did you know that each year the making of the plastic water bottles takes sufficient oil and energy to fuel a million cars? Millions of gallons of fuel are wasted daily transporting filtered tap water around the world and across countries. All the energy to make the bottle, even more to ship it around the planet and then we drink it in about two minutes? And do you know what happens when you’re finished with that bottle?

    Ninety percent of water bottles end up in landfills where they sit for thousands of years or in incinerators where they’re burned releasing toxic pollution. I don’t see this as being recycling; real recycling would be turning the bottles back into bottles, which happens to only ten percent of the water bottles.

    Pretty much what the government is doing, is wasting so much money and energy to pollute our earth. Bottled water companies have made a momentous strain on the environment, due to their tolerant use of precious resources and their manufacturing of billions of plastic bottles.

    Around the globe, a billion people don’t have access to clean water. However cities all over the world are spending millions of dollars to deal with all the plastic bottles thrown out. What if we spent that money improving our water systems or even better, developing better water systems in third world countries?

    Just remember it could be the beginning of this change, but after cities would be banning water bottles and maybe even countries.

    IS RECONSTRUCTING OUR PAST MORE IMPORTANT THAN BUILDING OUR FUTURE?

    “There are times in our lives when we have to realize our past is precisely what it is, and we cannot change it. But we can change the story we tell ourselves about it, and by doing that, we can change the future.”
    ― Eleanor Brown

    We often hear that ‘the past is past, don’t bother about it’. But actually, the past is not only the past, but also it is the foundation of our future. Every moment is going to be past. It is the only reality that we can know. Future and present are related. Everything is being examined on the basis of past, future and present. Past is a set of experiences, events and beliefs that someone or something confronted with. Everything has a past and that past constitutes the essence of its present and future. It can be said that history is the collection of recorded past events in the form of written documents, monuments, oral discourses etc. But the past is beyond these historical remains.

    The things and deeds we did in past are now to give us fruit in present and also in the future. And our present which is going to be our past will give us its fruit in the future. Some think it is essential to study history in order to make their future bright but some think past has no concern with the future. Other thinks that future is related to present, the things they have in present remain same as in future. Different people have different believe on the same the topic. Why is it so? Due to the different experiences, they have in their past life. In some way or another experience is second name of past.

    What actually affect the future?

    Experience affects the future. Future can never be predicted but we can strive to make it better by mean of the past experiences. Without knowing the past, we repeat mistakes made in the past, and destroy our future.

    We can’t say that we are guessing future upon the past, but in some way, we can perk up our future by relating it to the events take place in past, and work to make it enhanced. No one knows what will happen in the future but the past lends us a hand and lead us to our destiny.

    There must be some reasons why past contribute a lot in building future. It is vitally important to study history and keeping the past in mind to avoid repeating the mistakes of the past and understand why things are as they are!

    We study history to learn where we were in the past and where we are now, to learn what worked for people in the past. We study history to know what is the right thing to do and what is wrong so that we can understand what to do in life and how the wrong things happen and how we can be prevented.

    New thoughts and systems cannot be formed overnight. It is subject to change and reconstruction over the centuries and generations. We cannot say that the past is always constructive and beneficial. Progress is being made by identifying faulty systems. Many things that were once considered right and socially good are now considered as reactionary and unprogressively.

    For example, once untouchability was a prevailing practice in our society which was considered as a normal thing. But later, the practice of untouchability is abolished and now we know how ridiculous it is. This realization is the product of reconstruction. This sort of change can be seen in all areas of life such as culture, cinema, environment, caste, religion, gender, language etc. What we firmly believe to be right and wrong today may not be like that tomorrow. Reconstruction aims at deconstruction also.

    Future is created through rectifying the mistakes of our past by maintaining its positive aspects. It is determined by the realizations gained through the past experiences. Therefore, it is essential to have a proper sense of past and history.

    Here lies the relevance of the reconstruction of the past. The future can only be built by a proper understanding of the past. We must be able to embrace what is progressive and reject what is irrational and biased. Thus, it would be better to say that reconstructing our past is the foundation for building our future instead of reconstructing our past is more important than building our future.

    Yes, the past is past, but it continues.

    HOW TO MAKE BETTER NOTES IN CLASS

    “The more content you try to capture during a lecture or a meeting, the less you’re thinking about what’s being said. You burn through most of your attention parroting the source.”

    Do you sometimes struggle to determine what to write down during lectures? Have you ever found yourself wishing you could take better or more effective notes? Whether you are sitting in a lecture hall or watching a lecture online, note-taking in class can be intimidating, but with a few strategic practices, anyone can take clear, effective notes. This handout will discuss the importance of note-taking, qualities of good notes, and tips for becoming a better note-taker.

    In-class benefits

    Taking good notes in class is an important part of academic success in college. Actively taking notes during class can help you focus and better understand main concepts. In many classes, you may be asked to watch an instructional video before a class discussion. Good note-taking will improve your active listening, comprehension of material, and retention. Taking notes on both synchronous and asynchronous material will help you better remember what you hear and see.

    Post-class benefits

    After class, good notes are crucial for reviewing and studying class material so that you better understand it and can prepare appropriately for exams. Efficient and concise notes can save you time, energy, and confusion that often results from trying to make sense of disorganized, overwhelming, insufficient, or wordy notes. When watching a video, taking good notes can save you from the hassle of pausing, rewinding, and re watching large chunks of a lecture. Good notes can provide a great resource for creating outlines and studying.

    1. Gather your note-taking materials. It may sound pretty basic, but it’s important to have all of your note-taking materials organized and ready to go before the start of any class, meeting or lecture.
    2. Come prepared. Before you come to a class, lecture, or meeting, make sure to review your notes from the last time round. This will bring you fully up to speed and ready to pick up where you left off.
    3. Be an active listener. When note-taking, many people make the mistake of mindlessly taking down every word, without really comprehending what is being said. Instead, make an effort to understand the topic while you’re in class. Focus on what’s really being said, then ask questions if you don’t understand
    4. Take notes by hand. Although taking notes on your laptop is convenient, research shows note takers actually retain information better when they take notes by hand. This may be because people typing on a laptop tend to transcribe every word without understanding the meaning, while people writing by hand are forced to pick out relevant information in order to keep up
    5. Don’t be afraid to ask questions. When you come across something you don’t understand, don’t just jot it down and tell yourself that you’ll worry about it later — ask the teacher/lecturer for clarification.

    FINALLY

    Follow up after class

    Part of good note-taking includes revisiting your notes a day or so after class. During this time, check for clarity, fill in definitions of key terms, organize, and figure out any concepts you may have missed or not fully understood in class. Figure out what may be missing and what you may need to add or even ask about. If your lecture is recorded, you may be able to take advantage of the captions to review.

    REFERENCES

    https://learningcenter.unc.edu/tips-and-tools/effective-note-taking-in-classes

    https://www.wikihow.com/Take-Better-Notes

    INTRODUCTION TO THE KNEE DISORDERS

    When there are some imbalances within the knee then it can lead to disorders which can be indicated by deviation of the knee in terms of function. Most of these disorders occur due to some conditions imposed onto the structures present inside the knee.

    BURSITIS: – inflammation (burning sensation) of the bursa causes pain.

    (TIP- a word ending with itis refers to inflammation)

    FAT PAD IMPINGEMENT: – the fat pad gets swollen heavily and can burst due to over-expansion.

    TENDINITIS: – inflammation of a tendon

    TORN MENISCUS: – a sudden twist of the knee can tear the rubbery cartilage leading to serious issues.

    FRACTURE: – the bones surrounding the joint may get broken especially the patella is viable to damage in the case of accidents.

    DISLOCATION: – the knee bone slips and comes out from its original location leading to excruciating pain.

    ACL AND PCL INJURY: – the anterior and posterior cruciate ligament gets torn which may occur when there are a lot of instantaneous turns. However, this occurs rarely since these are very strong ligaments naturally. 

    OSGOOD-SCHLATTER DISEASE: – this is the swelling of the tendon between the tibia and patellar muscles.

    STRAIN AND SPRAIN: – both are injuries but strain occurs in ligaments whereas sprain occurs in tendons.

    These are some of the common disorders occurring to the knee. All of these disorders have something in common….PAIN but the intensity can vary based on time and severity of the disorder

    ARTHRITIS                                                      

    Arthritis is a commonly used word referring to the inflammation of joints. In fact, many people have an intuition that severe pain in the knee corresponds to arthritis mainly in old age groups. This is potentially a dreadful disease and can mainly affect the old aged. Most arthritis occurs over time but some can occur suddenly. Old-aged persons are more prone to this disease. This disease is likely to affect all age groups. This disease is more prevalent in women rather than men since their joints are weaker and more susceptible to motion when compared to men.

    differences between normal and arthritic knee joint

      

    In the case of arthritis, the bones start to wear down, the ligaments can tear, inflammation and swelling can occur, and also lead to internal bleeding (hematoma). There are about 100+ types of arthritis with different causes and symptoms.

    comparisons between some of the arthritis

    The different types of arthritis have symptoms different from each other. But arthritis, in general, shows some symptoms irrespective of the type.

    Joint pain, stiffness in joints, red swollen mass, deranged and irregular motion is some of the common symptoms exhibited during arthritis. These symptoms are easy to identify by a common man and hence one can consult a medical practitioner known as a rheumatologist. The study of joints is known as arthrology and it is recommended to consult such a person.

    As mentioned earlier cartilage is the one that protects the bones and also acts as a shock absorber. In the case of Osteoarthritis, this cartilage starts to vanish slowly. In the case of rheumatoid arthritis, the synovial fluid gets attacked by its own antibodies!!! This phenomenon in medicine is known as autoimmune disease and occurs due to error in the programming of these cells leading to the attack on their own cells.

    In the case of gouty arthritis, there is a deposition of sodium urate crystals in the joints. It can lead to redness, pain, and heat around the joint. Uric acid which is generated in our body gets converted to purines (an essential component in DNA). Increased uric acid levels can lead to its deposition in the form of crystals. The best way is to remove the synovial fluid.

    So these are the different types of disorders that can be seen in the knee. Proper diet and exercise and a healthy lifestyle can prevent most of them. So it is essential to be healthy to prevent the occurrence of these diseases.

    HAPPY READING!!

    INTRODUCTION TO THE BONES AND JOINTS

    Our human body can be compared to a machine in terms of its functioning, but the magnanimous human can perform extremely better than a machine. As there are many nuts and bolts to connect many parts in a machine, there are too some bolts and nuts in our body which join several parts of the body like arms and legs. The so-called nuts and bolts of the human body are known as JOINTS. A joint in general is the articulation that is present in between two bones. This sounds a bit complex. So joint in the English language refers to the association. So the joints in the human body associate something. The something defined previously is bones. In order to understand this, we have to know about the structure of bone in detail.

    Fig 1.1- structure of a bone 

                         

    The above image depicts the structure of a bone in general. Important information to be known is that the unit of a bone is called an osteon. Many osteons combine together to form a bone. Bone-destroying cells are known as osteoclasts and bone-forming cells are known as osteoblasts. The external structure of a bone has two parts namely epiphysis and diaphysis. Physis refers to the growing plate. An increase in the bone’s height corresponding to bone growth. Epi means above and dia means through. Hence diaphysis is found in between two epiphysis which acts as the head and tail to the bone. The point of attachment of muscle in this bone is known as the trochanter. Everything present in the human body has some kind of protection. In the case of bone, that protection is offered by the periosteum. The inner layers can be visualized by peeling off those previous layers hindering them. Next, we have the cartilage which is a rubbery kind of protection to the bone. Hyaline cartilage present in bone is rather glassy in nature. The bone also has nerves and blood vessels since the bone requires nourishment and a proper message for its functioning. Bone marrow is the spongy tissue inside the bones. It contains stem cells. The stem cells can develop into the red blood cells that carry oxygen through your body, the white blood cells that fight infections, and the platelets that help with blood clotting. Bone marrow can be considered the mother of blood cells. This table provides insights on the types.

    Type namePrevalenceContent
    RedChildrenBlood
    YellowAdultsFat

    So now we move onto how a joint connects two bones. Consider this situation where there are two pipes and we want to connect them. The best way to connect so as to minimize their loss is by using a junction. There may be other options also, but there is no need to make a fuss about it.

    Fig 1.2- the structure of a healthy joint

    Hence from all these, we can come to an understanding of the importance of joints in the human body. To be short, the human body is meaningless and fragmented as the face, trunk, hands, and legs are separated without the joints.

    HAPPY READING!!

    SLEEP HYGIENE

    “Sleep’s what we need. It produces an emptiness in us into which sooner or later energies flow.”
    ― John Cage.

    Almost everyone has encountered a zombie-like feeling after a night of minimal or no sleep. Even after just one night without enough rest, we can feel drowsy during the day with slowed thinking, lack of energy, and an irritable mood.

    Sleep deprivation is when you don’t get the sleep you need, and it is It’s estimated to affect most of the students, a problem that has only worsened in recent years.

    Lack of sleep directly affects how we think and feel. While the short-term impacts are more noticeable, chronic sleep deprivation can heighten the long-term risk of physical and mental health problems.

    If you eat well and exercise regularly, but don’t get at least seven hours of sleep every night, you may be undermining all of your other efforts.

    How much sleep do you actually need?

    Everyone feels better after a good night’s rest.  But now, thanks to a report from the National Sleep Foundation, you can aim for a targeted sleep number tailored to your age.

    • Older adults, 65+ years: 7 to 8 hours.
    • Adults, 26 to 64 years: 7 to 9 hours.
    • Young adults, 18 to 25 years: 7 to 9 hours.
    • Teenagers, 14 to 17 years: 8 to 10 hours.
    • School-age children, 6 to 13 years: 9 to 11 hours.
    • Preschool children, 3 to 5 years: 10 to 13 hours.
    • Toddlers, 1 to 2 years: 11 to 14 hours.
    • Infants, 4 to 11 months: 12 to 15 hours.
    • New-born, 0 to 3 months: 14 to 17 hours.

    But a minimum of seven hours of sleep is a step in the right direction to improve your health.

    What happens when you don’t get enough sleep?

    Short-term problems can include:

    • Lack of alertness. Even missing as little as 1.5 hours can have an impact on how you feel.
    • Excessive daytime sleepiness. It can make you very sleepy and tired during the day.
    • Impaired memory. Lack of sleep can affect your ability to think, remember and process information.
    • Relationship stress. It can make you feel moody and you can become more likely to have conflicts with others.
    • Quality of life. You may become less likely to participate in normal daily activities or to exercise.
    • Greater likelihood for car accidents. Drowsy driving accounts for thousands of crashes, injuries and fatalities each year, according to the National Highway Traffic Safety Administration.

    Chronic sleep deprivation can even affect your appearance. Over time, it can lead to premature wrinkling and dark circles under the eyes. There’s also a link between lack of sleep and an increase in the stress hormone, cortisol, in the body. Cortisol can break down collagen, the protein that keeps skin smooth.

    So lack of sleep could mean more wrinkles! Understand why sleep is so important yet?

    How to Sleep Better

    If you’re experiencing mild, occasional problems with sleep, try these simple strategies to make you better.

    1. Treat getting enough sleep as if it is as important as taking medicine.

    With all the demands on our time every day, you might put a good night’s rest at the bottom of your priority list.

    2. Keep a consistent wake time.

    Wake up at the same time every day, including weekends or days off.  Waking at the same time every day will actually help you to sleep better at night. A fixed wake time helps to build a strong desire for sleep throughout wakefulness. This sleep drive gradually builds, and shortening it by sleeping in will make it harder to fall asleep the next night. Sleeping in on the weekend makes it much more difficult to wake up earlier on Monday morning.  

    It also is important to do some relaxing activity such as taking a warm bath or reading a book before bedtime. By making these activities part of your bedtime ritual, you can train yourself to associate these activities with sleep. This association will help you to move more easily into slumber.

    3. Put away the smart phones and tablets.

    Electronic devices keep your mind humming — and far from the relaxed state you need to achieve before bedtime. So, keep away the gadgets at least an hour ago before sleep.

    BOTTOM LINE

    Getting frequent sunlight exposure during the day supports a healthy circadian rhythm that helps you be alert during the day and sleepy at night. Regular physical activity can also contribute to a normal sleep schedule, so try to engage in at least moderate exercise every day.

    REFERENCES https://health.clevelandclinic.org/happens-body-dont-get-enough-sleep

    WEIGHT BEARERS OF THE BODY- THE KNEE JOINT

    The knee joint is one of the biggest and most important joints in the lower part of the body. The knee plays an important role in distributing the body weight throughout the body. It is worth studying about this joint.

    The knee joint is the tibiofemoral synovial hinge joint. This seems a bit complex. This can be easily understood by splitting each term.

    • Tibio- tibia bone
    • Femoral- femur bone
    • Synovial- freely movable joint
    • Hinge- swinging motion

    We can consider the knee joint as a castle with the patellar bone as a castle wall protecting it from the front, the femur from top, tibia and fibula from bottom and muscles aiding these bones. In general, the massive structures protect the joint from mechanical damage like banging the knee onto a hard surface etc…

                          the detailed structure of knee joint.
                       Credit:- OpenStax College Anatomy & Physiology, Connexions Web site. http://cnx.org/content/col11496/1.6/, Jun 19, 2013

    The above diagram shows the complete parts of the knee joint. There are some terms that were not explained earlier. Bursa can be compared to a tin of oil or any other lubricant and structurally is like a sac containing fluid to reduce friction. Friction is      

    A physical quantity develops when two things come in contact and the lubricant is the one that provides a medium between the two objects thus reducing friction.

    Here are the anatomical terms and their meaning:-

    • Anterior-front
    • Posterior-back
    • Supra-upper
    • Infra-lower
    • Cruciate-cross shape
    • Pre-before

    The fat pad is the one present beneath the knee bone and acts as a cushion for the joint. Ligaments are the primary elements of the knee joint which connect bone to bone.

    There are two types of ligaments namely ACL and PCL. They connect the tibia to the femur as mentioned earlier through the term tibiofemoral. ACL is medial (present more close to centre) than PCL and PCL are lateral (present far from the centre).

    NOTE:-Understanding these structures are very important as an imbalance in each structure can lead to a disorder.

    The knee is the largest known joint in the human body which performs very complex functions. The various functions are:-

    1. It bears the weight load and prevents the lower legs to take in all the weight.
    2. Acts as a supportive agent to the body.
    3. Provides motion but is limited.
    4. Coordination of the movement of upper and lower legs
    5. Fat present in knee acts as thermal insulator
    6. Bursa reduces friction between the bones
    7. Synovial fluid acts as medium for bones to articulate with.

    As mentioned earlier motion is a key aspect amongst the functions of the knee. The following table shows the various movements exhibited directly or indirectly using the knee.

    Knee movements are of two types- primary and secondary.

    NameMeaning
    FlexionDecreasing the angle
    ExtensionIncreasing the angle
    Medial rotationRotating towards centre
    Lateral rotationRotating away from centre
    AdductionMoving towards middle
    AbductionMoving away from the middle
    Anterio-posterior displacementFront and back movement

    Flexion, extension, medial and lateral rotations constitute the primary movements. Adduction, abduction and anterio-posterior displacement constitute secondary movements. Hence all these movements can be offered by the knee. In addition to that knee joint also has sensory receptors and produce proprioreceptic information about the position of knee.

    The ligaments contribute more towards the stability of the joint as compared to other elements.  The several structures inside the knee must perform perfectly so that the knee functions properly as a whole. The knee joint is hinge type and hence it is more vulnerable to injury (stretching beyond the limit leads to injury). In case of injury, the damaged cells start to heal when the stress is removed but there is a chance of losing their functions as there is a chance of them getting replaced with scars.

    It is absolutely worth knowing about the structure and function of the knee joint and how they help to carry ourselves on.

    HAPPY LEARNING!!