The ketogenic diet or keto diet was developed and used prominently throughout the 1920s and 30s to treat epilepsy. Epilepsy is a common chronic noncommunicable disease that results in habitual seizures occurring within diagnosed patients. More than 50 million people worldwide have epilepsy, making it the most common neurological disease throughout the world.
The body processes the metabolic activity of the diet comparatively to fasting, which has health benefits that can be traced back to ancient Greece, where early treatise in the Hippocratic Corpus explain how changes in diet can aid in managing epilepsy. While having epilepsy may seem like a persistent burden to one’s life, changes to a person’s lifestyle and routine could reduce the possibility of a seizure from occurring. Research has shown that ketogenic diets aid in the prevention of epileptic episodes. Following the dietary guidance of keto could prove to both improve one’s resistance to seizures as well as their general health.
How It Works
Based on the understanding that fasting helps reduce the frequency of seizures, the ketogenic diet consists of consuming foods that are high in fat, low in carbohydrates, and focused on protein. Through the metabolic process of ketosis, chemicals known as ketones are produced from fat that is processed by the body for energy. As opposed to glucose, which is produced from carbohydrates, ketones are mostly used as an energy source by the body when a ketogenic diet is being practiced. This diet has recently seen a surge in popularity for its effectiveness in weight loss, however its initial conception was for the relief of seizures among patients with epilepsy. Up to 70% of people with epilepsy are able to control their seizures with anti-epileptic drugs, but for those still prone to episodes, the keto diet could prove to be beneficial.
Monitoring a Keto Diet
Ketogenic diets are specialized per person based on their own dietary needs. An experienced dietitian is required in order to create a guide for the type of food a patient is able to eat. Due to the diet’s restrictive nature, vitamins and mineral supplements are recommended by the dietitian. It’s important to monitor the rate at which the body is producing keto electrolytes; an amount above 1.5 millimoles per liter means the patient is at the risk of developing ketoacidosis. If this occurs, a healthcare specialist should be sought out immediately.
Reduced Frequency of Seizures
Despite advancements in medicine and the continued production of anti-epileptic drugs, the keto diet still proves to benefit those who suffer from chronic seizures. Studies conducted on children with epilepsy have shown that 4 in 10 children who start the diet had their seizures reduced by over half in frequency. They also experienced an increase in their ability to predict when an episode was about to occur. Those who discontinued the diet after its prescribed duration also reported a significant decrease to the frequency of seizures, or to have stopped experiencing them entirely.
The ketogenic diet remains a viable way for individuals diagnosed with epilepsy to regulate the frequency at which they experience seizures. Effective in both children and adults, the keto diet can be adopted by most individuals as a beneficial means to regulate one’s medical conditions and lifestyle.
Do you pay any attention to the car seats when deciding to buy a car? Experts will tell you that you should. In fact, that should be among your top considerations when purchasing a vehicle.
Seats are as important as the engine, particularly if you are driving a fast car. A good seat helps improve safety, makes us better drivers and can even increase a car’s fuel efficiency, say experts.
Whether buyers take car seats seriously or not, manufacturers are certainly doing so. It’s not just cushion, fabric and leather that goes into making a car seat. Seat making has become a specialised field now, with automakers contracting dedicated firms, such as Adient, Faurecia and Lear, to get the job done.
Just consider this: A typical car seat design and manufacture involves the following areas — designers, chemists, ergonomic specialists, metallurgists, artisans, biomedical and software engineers. Every one of them has a definitive role to play in the final reality of the car seat.
Having the right sitting position is very important for safety… and back comfort. In a good driving position, you can reach the pedals and steering wheel easily without moving in your seat.
– Carl-Johan Ramberg, Consultant Neurologist, German Neuroscience Centre Dubai
According to a recent study by Harvard Health Watch, a typical driver spends nearly 38,000 hours behind the wheel in a lifetime, covering some 1.2million kilometres.
Car companies know an uncomfortable perch can mean a lost sale, no matter how exceptional the car is. Rarely offered in sizes, the same seat that supports a five-foot frame must please a six-foot-four rugby player. No wonder, most carmakers these days are allocating a high chunk of their budget for seating, second only to the engine […]
The full original article was published in Gulf News
‘Hi, Sleep has never been a problem for me – usually I fall asleep a few minutes after I get into bed. But since I downloaded a sleep-tracking app, I’ve been unable to get a good night’s rest. I thought maybe I was anxious because of the app, but even after deleting it, my issue persists. I’m not under any unusual stress but still it’s bothering me. Can you recommend something that may help?’ -From a reader who wishes to remain anonymous.
Answered by Dr Harry Horgan, Clinical Psychologist, German Neuroscience Center
Dear Reader, I am sorry to hear that sleep has been a problem for you recently. It is difficult to overstate the importance of adequate sleep for our physical and mental health.
When sleep difficulties arise, particularly problems with getting to sleep, it is always a good idea to review our ‘sleep hygiene’; a term that covers implementing good sleep habits.
What are good sleep habits?
• A regular sleeping time;
• Avoiding daytime napping;
• Restricting caffeine consumption for at least 6 hours before sleep;
• Avoiding large meals or vigorous exercise one hour before sleeping; and
• Ensuring a dark, quiet room with a comfortable temperature.
With your case specifically, I wonder whether the disruption of your usual sleep pattern with a sleep-tracking app might an unhelpful ‘conditioned response’. Behavioural psychology shows us that we can develop associations between experiences and environments that can help or hinder us.
It is very common for people who experience insomnia to understandably associate their bed with frustration and anxiety.
A useful way of correcting this association is to keep the bedroom only for the final stage of our getting-to-sleep-routine. This can be achieved by waiting until we are feeling very sleepy before getting into bed e.g. by reading a book in the living room until we reach this point. Then retiring to bed immediately.
If sleep does not come within 20 minutes, return to the living room and try again. Over a period of days and weeks, we can more firmly establish the association between sleepiness and our bed.
The full original article was published in Gulf News
The German Neuroscience Center is a leading Neurology clinic in Dubai, United Arab Emirates. Our Department of Neurology offers comprehensive healthcare services in the diagnosis and treatment of neurological diseases.
Neurology is a branch of medicine that deals with diagnosis and treatment of disorders of the nervous system. The nervous system consists of a complex collection of nerves and specialized cells referred to as neurons that transmit signals to other parts of the body. Neurological diseases or disorders include:
Headaches and Migraines
Vertigo and Dizziness
Dementia and Alzheimer’s
Neuro-inflammatory and Neuro infective conditions
Our neurology doctors in Dubai are internationally recognized experts fully capable of providing a range of health care services for the conditions mentioned above. We offer a variety of diagnostic options for both adult and paediatric neurology cases in Dubai, which include:
EEG examines brain activity. The procedure involves placing electrodes made up of small metal discs on the scalp. These electrodes identify minor electrical charges that are a result of activity in the brain cells, which are then amplified and displayed.
NCV tests include measuring the swiftness of conduction of electrical impulses through the nerve. During this examination, numerous metal disc electrodes are positioned on the skin, and a shock-emitting electrode is put directly on top of the nerve area. Multiple rapid electrical pulses are passed through the nerve, and the muscle contraction response time is recorded. This is done on both sides of the body for comparison.
EMG tests examine the electrical activity of muscles. This examination is usually correlated with the results of an NCV test to determine muscle weakness or problems with nerves that activate the muscles.
These are non-invasive ultrasound methods used to examine blood circulation and blood vessels in the brain. These tests may include:
Duplex sonography: A duplex ultrasound involves the combination of the traditional ultrasound and Doppler ultrasound which sounds waves to measure the speed of blood and so on.
Evoked potential tests determine electrical activity in the brain in response to sight, sound, light, or touch stimulation. The stimuli conveyed to the brain from these senses induce minor electrical signals. These signals travel through the nerves to a particular region of the brain where they are received by electrodes, amplified, and displayed for interpretation. These include:
The spine is one of the most essential structures in the human body. It is divided into three sections the lumbar, thoracic, and cervical regions. The spine or backbone serves as a support system for the body’s weight and protection for the spinal cord. Besides the natural ‘S’ curve of the backbone which helps it to endure great extents of stress, it is also made up of a series of bones, stacked on top of each other and cushioned by cartilage-like pads called discs. Spine pain in the lower back, thoracic, and middle back is a widespread problem that requires medical attention and can affect anyone.
Causes of spine pain
Muscle strains and sprains in the lumbar region are the most common causes of spine pain in the middle back, lower back and neck regions. However, the thoracic spine, which is the area between the cervical (neck area) and lumbar spines, is also susceptible to spinal pain although in very rare cases because of its rigidity. Mostly, pain on the spine mainly occurs due to injury on the lumbar and cervical regions and very rarely on the thoracic region. The cervical and lumbar spines are predisposed to strain and sprain because of the weight-bearing and flexibility (bending, twisting, moving) function.
Spine pain results from:
Lumbar muscle sprain or strain, which causes inflammation of the soft tissues.
Scoliosis: pain on the backbone may result from an abnormal curvature of the spine usually to the side.
Osteoporosis: This condition affects bones, including the vertebrae of the spine, causing them to be brittle and porous, which leads to compression fractures and pain.
Cauda equina syndrome: This syndrome affects the bundle of spinal nerve roots that stem from the lower end of the spinal cord.
Spine cancer: A tumor can compress nearby nerves, which can result in pain.
Spinal stenosis: Narrowing of the space in the spine because of injuries, herniated disks or bone overgrowth.
Spondylolisthesis: a condition which occurs when spinal bones push forward and apply pressure on the bone below it.
Sciatica: this condition occurs when the sciatic nerve becomes inflamed due to a bone spur, herniated disc, among other issues that pinch the nerve.
Although spine pain is usually a result of a sprain or strain, there could be a more severe underlying condition which requires the expertise of a physician. Severe spine problems often involve discomfort that radiates into the arms, around the chest or down the legs. Other symptoms include:
Stiffness in the lumbar region
Inability to retain a normal posture
Consistent pain that persists for two weeks
Loss of motor functions
Spine pain diagnostics and treatment
Typically, diagnostic testing becomes necessary if the discomfort has persisted for more than two weeks without any improvement. Additionally, if the pain radiates into other parts of the body, a diagnosis is done to rule out any underlying conditions. These tests may include:
Rest and reduced activity: Pain on the backbone can be relieved by rest or reduced activity for a short period, preferably one to three days, to ensure muscles retain their strength.
Medicine: Mild to moderate pain can be treated by medications such as nonsteroidal anti-inflammatory drugs, muscle relaxants, narcotics, among others. However, be sure to check with your doctor before taking any medicines to avoid further complications.
Physical therapy: This spine pain treatment process involves an evaluation by a therapist to determine a personalized treatment method for the patient depending on their symptoms. The treatments can include stretching exercises, ice and heat therapy, gentle massage, ultrasound, pelvic traction, electrical muscle stimulation, and so on.
Spine surgery: If the pain does not respond well to non-surgical treatment methods, surgery may help.
If your spine pain persists without any improvements, please see a doctor.
I am a hoarder. It began with little knick-knacks and has gotten worse over time. Of late, I’ve not been able to throw out even clothes that are old and torn. Everywhere I go is a mess and I can barely find anything. And while I want to be organised, I am unable to junk anything. What can I do to get clutter-free? A reader who wishes to remain anonymous asks.
Answered by Dr Fabian Saarloos, Clinical Psychologist, German Neuroscience Center
Hoarding, according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), is defined by the persistent difficulty [in] discarding or parting with possessions, regardless of their value, due to a perceived need to save the items and to [perceived] distress [in] discarding them. It is not clear what causes hoarding disorder, but genetics, brain functioning, and stressful life events are implied in the development of the disorder. The difficulty results in the accumulation of possessions that clutter and congest living areas and substantially compromises their intended use.
What can go wrong?
Hoarding can result in excessive cluttering, disorganised piles and stacks of items which make living space unusable (e.g. no room for walking/sitting), and the buildup of organic products can also lead to unsanitary and/or unsafe conditions.
In addition, important and usable items may get lost in the clutter, leading to other problems.
Frequently, hoarders get into conflict with people who try to reduce or remove the clutter as the anxiety about parting with it may lead to fight-or-flight reactions. This frequently results in isolation, which then increases the hoarding behavior in order to reduce the anxiety/sadness.
Despite frequently being related to psychological conditions such as depressive disorder, obsessive-compulsive disorder, or post-traumatic stress disorder, hoarders have a tendency to indecisiveness, perfectionism, avoidance, procrastination, and problems with planning and organising.
Hoarding versus collecting
Hoarding is different from collecting items as collectors tend to pay more attention to their possessions and their organisation, and do not experience the distress and impairment that the hoarder does, but rather joy.
Because hoarding has only recently been recognised as a mental disorder, little is understood about what causes it and how to prevent it. However, psychological treatment of the underlying disorder, e.g. depression or post-traumatic stress, and focusing on the anxiety about parting from the hoarded items seems to be effective in reducing and/or coping with hoarding disorder.
In therapy, clients learn what factors or life situations have taught them that the accumulation of items reduced anxiety.
They also learn about the negative impact of their disorder, and how the resultant anxiety maintains the hoarding behavior, making them aware of the vicious cycle they are in.
Depending on the conceptualisation of the problem and the degree of suffering, psychotropic medication may be considered.
As with most psychological disorders, Cognitive Behaviour Therapy (CBT) is the treatment of choice. In CBT, clients learn how their thinking (e.g. throwing away items) affect their feelings (e.g. anxiety), and how that interaction affects their behavior in certain situations (e.g. avoidance). In CBT, clients are tought different ways of thinking about their problem behavior and situations, which then results in more functional emotions and better feelings, which in turn lead to a change in behavior and improvement of situations.
Other psychotherapeutic models such psychodynamic and psychoanalytic therapy, focus on the development of the hoarding behavior, like, how early factors such as upbringing and parents may have created the hoarding disorder (for instance, accumulating items to compensate the void of having felt unloved by mother).
More modern psychotherapeutic modes such as Eye Movement Desensitization Reprocessing (EMDR), focus on desensitising the anxiety related to the hoarding experience, by improving the brain’s processing of (conscious/unconscious) memory processes implied in the anxiety and behavior.
The full original article was published in Gulf News
refers to back pain that radiates from the lower back to the leg. The pain is a result of a problem with the sciatic nerve, a nerve that branches from the lower back down to your buttocks, hips and the back of both legs.
Sciatica commonly results when a bone spur, herniated disk or narrowing of the spine (spinal stenosis) compresses part of the nerve leading to discomfort, inflammation, and often numbness in the affected leg. Naturally, sciatica will only affect one side of your body.
Although the discomfort resulting from this condition can be severe, most cases can be treated without surgery. In fact, 90% of people get pain relief from sciatica after a few weeks with non-operative treatments.
Signs and symptoms
One of the most common symptoms is lower back pain that radiates down to the affected leg. While the discomfort can be felt anywhere along the nerve canal, sciatica pain radiates explicitly from your lower back to your buttock, hip, and calf.
Sciatica pain varies greatly, from mild to excruciating or a sharp, burning sensation which tends to worsen after prolonged sitting or even just sneezing. Other symptoms include muscle weakness, tingling, numbness in the affected leg and in severe cases, problems controlling your bowels.
The most common cause of sciatica results from a lumbar disc herniation directly pushing against the sciatic nerve, but any form of irritation or inflammation can cause discomfort resulting in symptoms of sciatica.
Besides a pinched nerve from a disc or irritation of the sciatic nerve due to pregnancy, other causes include:
Cauda equina syndrome
Infections in or around the lumbar spine
Nerve irritation caused by adjacent bones, tumors or muscles
Typically, sciatica is diagnosed through physical exams and medical history. The symptoms and tests done will help the health care professional to diagnose the condition. In some cases, X-rays, CT scans, MRI scans, Nerve Conduction Velocity and electromyogram are done to rule out some underlying conditions such as tumors.
Treatment varies depending on the intensity of the problem (acute or chronic) and the underlying condition.
Acute sciatica treatment responds well to self-care procedures such as:
Over the counter (OTC) medication such as painkillers, muscle relaxants, anti-depressant, and anti-inflammatories. Individuals should seek medical advice and review options with their doctor before taking any medicines to avoid severe effects.
Regular exercise, such as light stretching or walking. Sciatic nerve targeting exercises alleviate pressure on the nerve, provide pain relief, and reduces the need to take medications.
Hot or cold compression provide pain relief and should be used interchangeably.
Chronic sciatica treatment consists of a combination of self-care and medical treatment procedures, which include:
Cognitive-behavioral therapy (CBT) which trains individuals on pain management and coping mechanisms, enabling them to react differently to pain.
Surgery may be considered if symptoms fail to respond to other treatments. Depending on the cause, the surgeon will guide you through the risks and benefits of surgery and suggest the best option.
Depending on the causes of sciatica and duration of the symptoms, the recovery outlook ranges from positive to lasting chronic symptoms. Although, the sooner the treatment process begins, the better the outcome.
is among the most common medical problem in modern society. It can be caused by anything from an injury, activity, or even an underlying medical problem. This condition can affect anyone regardless of age, but, the older people get the higher the risks of developing back-related problems. However, unlike the conventional healing process associated with most injuries, back pain tends to diminish with time regardless of an underlying medical problem such as Arthritis or Sciatica.
Symptoms and complications associated with back pain vary depending on intensity, from mild to severe, and whether the pain is on the upper, middle, or lower back. Fortunately, there are several preventive or relief measures you can take to make the discomfort bearable as your back heals. Surgery is rarely the go-to treatment for these cases, unless otherwise.
Spine degeneration is natural to aging. Both men and women are affected, approximately 80% of adults globally complain of low, middle or upper back pain at one point in their lifetime notes the National Institute of Neurological Disorders and Stroke (NINDS). Your spine is your body’s primary structural support, meaning a lot is riding on the spinal column from being stable for you to maintain an upright position to being flexible for movement. It’s no surprise the high numbers of people suffering from back problems.
Lower back pain (lumbago) is particularly the most common and is mostly associated with spinal cord and nerves, the bony lumbar spine, lower back muscles, discs, internal abdominal and pelvic organs, among others. While upper back pain may be linked to complications in the aorta, spine inflammation, and tumors in the chest.
Signs and Symptoms
The main symptom of back pain is an ache or strain on the upper, middle, or lower back. The pain can either be acute, meaning it strikes suddenly and lasts for a few days or weeks or chronic, meaning it lasts for more than three months and is usually caused by trauma or other medical conditions.
Other signs and symptoms of back pain can include:
Pain down your leg
Stabbing or shooting pain
Restricted flexibility and range of motion
Pain in the back, buttocks or legs
Inability to stand upright
The back of a human being consists of a complex structure of bones, muscles, tendons, ligaments, and discs that function together to support the body as well as allow for flexibility. The spine, for instance, is made up of several segments each cushioned with cartilage-like pads referred to as discs.
Problems with any of these segments can result in back pain. Although in some cases causes of back problems remain unclear. Commonly, back injuries stem from strains, underlying medical issues, poor posture, among others. However, contrary to popular belief, rarely do back injuries strike when somebody is lifting a heavy object or doing an intensive activity notes research from Harvard Health Publishing. In fact, only 5% of cases of new-onset disc herniation are a result of heavy-lifting activities, the rest are from simple tasks, like sneezing or reaching out for something, notes the research. Conditions commonly associated with back pain include:
Strains or sprains on muscles and ligaments, muscle tension, fractures, falls or injuries.
Ruptured or bulging discs. As mentioned earlier, discs act as cushions between vertebrae along your spine. In some cases, the contents within your disk may rupture or bulge which puts pressure on your nerve and results in discomfort.
Arthritis. Osteoarthritis, arthritis in the spine, affects the lower back causing the space around the spinal cord, referred to as the nerve root canal or the spinal canal to become narrow. This condition is referred to as spinal stenosis.
Osteoporosis: If your bones are or become brittle, your spine’s vertebrae can develop compression fractures.
Sciatica: This refers to back pain caused by compression of the Sciatic nerve and is characterized by a sharp and shooting pain that radiates through the buttocks, hips and down the leg.
Spine cancer: A tumor on the spine can exert pressure on the nerve, resulting in back problems.
Infections: Kidney or bladder infections, pelvic inflammatory diseases can lead to back problems.
Intervertebral disc degeneration: as people age, discs deteriorate and lose their cushioning ability.
Cauda equina syndrome: This is a rare but severe problem of a ruptured disc. This condition occurs when disc material press into the spinal canal compressing the nerve roots.
The diagnostic procedures used depend on the patient’s complete medical history and physical examinations which determine if there is any serious underlying condition that could be causing the pain. Only after a thorough back examination and neurological tests can a healthcare provider establish the cause of back pain and the appropriate treatment.
In most cases, imaging is not necessary, but in some instances, it may be required to rule out specific causes of pain in the lower, middle or upper back, including spinal stenosis and tumors. Some of these medical tests may include:
Treatment for back pain depends on the intensity of the pain. Surgery is only necessary for back problems causing progressive nerve damage or involves structural changes that require corrective surgery. Some of the treatment and preventive measures include:
Activity: Although bed rest seems like the logical thing to do, it should be limited. Individuals should remain active, do light stretching exercises, and resume daily activities while avoiding movements that strain the back.
Physical therapy programs help to strengthen core muscles that support your back, promote proper posture and positioning, and enhance mobility and flexibility.
Medications: A wide range of drugs such as painkillers, antidepressants, narcotics, and muscle relaxants are available for treating both acute and chronic pain. Some are available over the counter (OTC) while others require a physician’s prescription. However, some of these drugs may be unsafe for use with other medications, during pregnancy, can cause serious side effects, or have adverse side effects. Individuals should seek medical advice and review options with their doctor before taking any medicines.