IPHREHAB: HEALTH IS PHYSICAL, MENTAL, SOCIAL & SPIRITUAL WELL BEING

IPHREHAB
HEALTH IS PHYSICAL, MENTAL, SOCIAL & SPIRITUAL WELL BEING

HEALTH IS NOT MERELY THE BODY FREE FROM DISEASE HEALTH IS PHYSICAL, MENTAL, SOCIAL & SPIRITUAL WELL BEING

• WE HAVE COMPLETELY FORGOTTEN THE SPIRITUAL PART OF HEALTH
• WE FEEL THAT ONLY DISEASES ARE TO BE TREATED (TERTIARY CARE) MEDICAL  & SURGICAL

PLEASE REMEMBER

• PUBLIC HAS LOST FAITH IN DOCTORS
• DOCTORS BEHAVIOUR IS HIGHLY APPAULING
• DOCTORS ARE VERY BUSY HAVE NO TIME FOR PATIENTS
• DOCTORS DON’T TALK  ABOUT PREVENTION OF DISEASE
• BILLIONS ARE SPENT ON TERTIARY CARE HOSPITAL
• BUT NOT A SINGLE PENNY ON PRIMARY HOSPITAL

DOCTORS DON’T EXAMINE THEIR PATIENT

• CLINICAL EXAMINATION HAS BECOME  OBSOLETE
• INVESTIGATIONS ARE  KING OR MASTER
• DOCTORS ARE TECHNICIAN         
• NO MORE PHYSICIANS
• DOCTORS DO NOT GIVE SERVICE THEY HAVE BECOME BUSINESS PERSON
• INVESTIGATIONS HAVE ATTENDED ROYAL STATUS
• TREATMENT IS STARTED ON RESULT OF INVESTIGATIONS
• NO BODY KNOWS THAT MACHINES CAN BE WRONG
• ECG’s ARE INTERPRETED BY COMPUTER
• TMT & ECHO ARE ORDERED WHETHER NEEDED OR NOT

INVESTIGATIONS

• X-RAYS ARE NOT TO BE DONE. 
• CT SCAN  ARE ORDERED FOR CLEAR CUT CASE OF TUBERCULOSIS
• Dr. SAYS THAT EVERY ONE COMES TO THEIR CHAMBER IS ALWAYS  WITH CT SCAN

I FEEL IN ANY CASE DIAGNOSIS DEPEND ON

• HISTORY:-  IT  FORMS FOUNDATION OF DIAGNOSIS
• CLINICAL EXAMINATION IS LIKE CONSTRUCTION OF BUILDING
• INVESTIGATIONS ARE LIKE DECORATIVE PIECES

INVESTIGATIONS

• DAILY NEW TESTS ARE BEING  ADDED SUPPOSED  TO BE SUPERIOR THAN PREVIOUS ONE.
• NEW EQUIPMENTS  ARE ADDED IN GEOMETRICAL PROPORTION.
• THEY ARE ALL DUMPED IN THIRD WORLD COUNTRIES - SOUTH EAST ASIA
• INVESTIGATIONS  ARE GLORIFIED.

THERE  IS NO DRUG POLICY

• SPURIOUS DRUGS  MARKET IS WORTH MORE THEN  4000 CRORES
• ANTIBIOTICS ARE MISUSED
• SO ARE STEROIDS
• QUACKS ARE FLOURISHING UNDER NAME OF ALTERNATIVE MEDICINE

(DR.ANANT PHODKE THESIS Excellent Study Of Drug Supply & Use

50% of drugs prescribed are irrational or have no connection to disease

He short listed 27 Essential Drugs for 90% of General Diseases)

I BELIEVE IN OLD SAYING

• IF YOU THROW ALL THE  MEDICINES INTO THE THE SEA 
• IT WILL BE GOOD FOR HUMAN BEINGS AND BAD FOR FISH.

IPHREHAB : ANKLE SPRAIN CAUSE AND TREATMENT

IPHREHAB

ANKLE SPRAIN:

An ankle sprain is a common injury and usually results when the ankle is twisted, or inverted. The term sprain signifies injury to the soft tissues, usually the ligaments, of the ankle. On the lateral side of the ankle, there are three ligaments that make up the lateral ligament complex. These include the anterior talofibular ligament (ATF), the calcaneo–fibular ligament (CF) and the posterior talofibular ligament (PTF). The very common inversion injury to the ankle usually injures the anterior talofibular ligament and the calcaneo–fibular ligament. The ATF ligament keeps the ankle from sliding forward and the CF ligament keeps the ankle from rolling over on its side.

Causes of Ankle Sprain

ANKLE SPRAIN

A ligament is made up of multiple strands of tissue–similar to a nylon rope. A sprain results in tearing of the ligaments. The tear can be a complete tear of all the strands of the ligament or a partial tear, where a portion of the strands of the ligament are torn. The ligament is weakened by the injury which depends on the degree of the tear. The lateral ligaments are by far the most commonly injured ligaments in a typical inversion injury of the ankle. An inversion injury simply means that the ankle tilts over to the inside (towards the other foot), and the pressure of all your body weight is forced onto the outside edge of the foot. This causes the ligaments on the outside of the ankle to stretch and possibly tear.

Symptoms of Ankle Sprain

Initially the ankle is swollen, becomes painful, and may turn eccyhmotic (bruised). The bruising, and the initial swelling, is due to ruptured blood vessels from the tearing of the soft tissues. Most of the initial swelling is actually bleeding into the surrounding tissues. This initial swelling due to bleeding then increases due to edema fluid leaking into the tissues as well over the next 24 hours.

Diagnosis of Ankle Sprain

The diagnosis of an ankle sprain is usually made by examination of the ankle and x–rays to make sure that there is no fracture of the ankle. If there is a complete rupture of the ligaments suspected, your doctor may order stress x–rays as well. These x–rays are taken while someone twists or stresses the ligaments.

Treatment of Ankle Sprain

Elevation will help control the swelling.

Gentle compression and ice will control swelling.

Mild pain relievers will help with the pain.

Crutches will prevent weight bearing.

Healing of the ligaments usually takes about six weeks. The swelling may be present for several months. A physical therapist may be suggested to help you regain full function of your injured ankle.

Treatment may vary depending on how bad your ankle sprain is.

 In each case, the first line of treatment is to calm the inflammation and halt the swelling. 

The RICE (Rest, Ice, Compression, Elevation) principle can help address each of these needs.

Rest: 

A brace or splint will keep the ankle in a safe position, helping you avoid more strain to the sore area. In severe cases, you may require a pair of crutches to limit weight through the foot.

Ice:

Cold therapy, in the form of an ice pack, can aid in slowing the inflammatory process and in limiting pain.

Compression:

An elastic wrap can compress the sore area, keeping the swelling to a minimum.

Elevation:

Keeping the ankle elevated above the level of your heart will help drain the extra fluid (edema) back into the blood system and reduce swelling.

Range of motion exercises:

As healing gets underway, it is important to begin a series of movement exercises for the range of motion (ROM). At first, you’ll work on simply bending and straightening the ankle. These exercises will keep the ankle from becoming stiff.

Strength progression: 

Next, you’ll begin strengthening the muscles around the ankle. Isometrics may be chosen in the early stages of rehabilitation. These are strengthening exercises in which the muscles are working but the joint stays still. Isometrics allow you to exercise with the ankle at different angles, helping you stay away from painful positions of the ankle. These exercises provide the benefit of reducing overall pain and swelling.

Balance exercises:

Balance exercises are especially important following an ankle ligament injury. Remember, healthy ligaments send information to the brain about the position of a joint. Once a ligament has been injured, these nerves are unable to receive and send the needed information to the brain. Balance exercises help retrain the new nerves and help you regain your proprioceptive sense around the joint.

IPHREHAB : Mental retardation Signs and Symptoms

IPHREHAB
Mental retardation

• Mental retardation (MR) is a generalized disorder, characterized by significantly impaired cognitive functioning and deficits in two or more adaptive behaviors with onset before the age of 18.
• Mental retardation refers to sub-average general intellectual functioning which originates during the development period and is associated with impairment in adaptive behavior
• It has historically been defined as an Intelligence Quotient score under 70.
• The mentally retarded from childhood experiences unusual difficulties in learning which affects his capacities for adjustment in day to day living.
• General intellectual functioning means the results obtained by administration of standardized general intelligence tests for the purpose.

Signs and symptoms
•    Delays in oral language development
•    Deficits in memory skills
•    Difficulty learning social rules
•    Difficulty with problem solving skills
•    Delays in the development of adaptive behaviors such as self-help or self-care skills
•    Lack of social inhibitors


Diagnosis
• According to the latest edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), three criteria must be met for a diagnosis of mental retardation:
–  An IQ below 70,
Significant limitations in two or more areas of adaptive behavior (as 
–  Measured by an adaptive behavior rating scale, i.e. communication, self-help skills, interpersonal skills, and more), and
–  Evidence that the limitations became apparent before the age of 18.


Class IQ

• •       Profound mental retardation                     Below 20
• •       Severe mental retardation                           20–34
• •       Moderate mental retardation                      35–49
• •       Mild mental retardation                                50–69
• •       Borderline intellectual functioning           70–84

•  Services needed by the mentally handicapped are discussed-medical, educational, vocational training, employment opportunities, residential facilities, legislation, insurance, community involvement and orientation, and adequate training of personnel.
•  Aim must be recognition and development of their potential abilities in order to enable them to develop into full integrated members of the community, living as full, happy and productive lives as possible, should be the aim of all services for the handicapped.

IPHREHAB : HYPOTONIA MANIFESTATION

IPHREHAB :

HYPOTONIA MANIFESTATION


Signs and objective manifestations
Hypotonic patients may display a variety of objective manifestations that indicate decreased muscle tone.
Motor skills delay is often observed, along with hypermobile or hyperflexible joints, drooling and speech difficulties, poor reflexes, decreased strength, decreased activity tolerance, rounded shoulder posture, with leaning onto supports, and poor attention and motivation.
The extent and occurrence of specific objective manifestations depends upon the age of the patient, the severity of the hypotonia, the specific muscles affected, and sometimes the underlying cause. For instance, some hypotonics may experience constipation, while others have no bowel problems.

§Since hypotonia is most often diagnosed during infancy, it is also known as "floppy infant syndrome" or "infantile hypotonia." Infants who suffer from hypotonia are often described as feeling and appearing as though they are "rag dolls" or a "sack of jello," easily slipping through one's hands.

§They are unable to maintain flexed ligaments, and are able to extend them beyond normal lengths. Often, the movement of the head is uncontrollable.

§Hypotonic infants often have difficulty feeding, as their mouth muscles cannot maintain a proper suck-swallow pattern, or a good breastfeeding latch.

Developmental delay

Most low-tone infants have delayed developmental milestones, but the length of delay can vary widely. Motor skills are particularly susceptible to the low-tone disability.

Gross motor skills, and fine motor skills, both are affected. 

Hypotonic infants are late in lifting their heads while lying on their stomachs, rolling over, lifting themselves into a sitting position, remaining seated without falling over, balancing, crawling, and walking. Fine motor skills delays occur in grasping a toy or finger, transferring a small object from hand to hand, pointing out objects, following movement with the eyes, and self feeding.  

§Speech difficulties can result from hypotonia. Low-tone children learn to speak later than their peers, even if they appear to understand a large vocabulary, or can obey simple commands.

§ Difficulties with muscles in the mouth and jaw can inhibit proper pronunciation, and discourage experimentation with word combination and sentence-forming.

Diagnosis

Diagnosing a patient includes obtaining family medical history and a physical examination, and may include such additional tests as computerized tomography (CT) scans, magnetic resonance imaging (MRI) scans, electroencephalogram (EEG), blood tests, genetic testing (such as chromosome karyotyping and tests for specific gene abnormalities), spinal taps, electromyography muscle tests, or muscle and nerve biopsy.

Mild or benign hypotonia is often diagnosed by physical and occupational therapists through a series of exercises designed to assess developmental progress, or observation of physical interactions.

§Since a hypotonic child has difficulty deciphering his spatial location, he may have some recognizable coping mechanisms, such as locking the knees while attempting to walk.

§ A common sign of low-tone infants is a tendency to observe the physical activity of those around them for a long time before attempting to imitate, due to frustration over early failures.

§ Developmental delay can indicate hypotonia

Prognosis and treatment

There is currently no known treatment or cure for most (or perhaps all) causes of hypotonia, and objective manifestations can be life long. 

In some cases, muscle tone improves over time, or the patient may learn or devise coping mechanisms that enable him to overcome the most disabling aspects of the disorder. However, hypotonia caused by cerebellar dysfunction or motor neuron diseases can be progressive and life-threatening. 

Along with normal pediatric care, specialists who may be involved in the care of a child with hypotonia include developmental pediatricians (specialize in child development), neurologists, neonatologists (specialize in the care of newborns), geneticists, occupational therapists, physical therapists, speech therapists, orthopedists, pathologists (conduct and interpret biochemical tests and tissue analysis), and specialized nursing care. 

If the underlying cause is known, treatment is tailored to the specific disease, followed by symptomatic and supportive therapy for the hypotonia. 

In very severe cases, treatment may be primarily supportive, such as mechanical assistance with basic life functions like breathing and feeding, physical therapy to prevent muscle atrophy and maintain joint mobility, and measures to try and prevent opportunistic infections such as pneumonia. 

Treatments to improve neurological status might involve such things as medication for a seizure disorder, medicines or supplements to stabilize a metabolic disorder, or surgery to help relieve the pressure from hydrocephalus (increased fluid in the brain). 

Breast Feeding

Low-tone infants often have difficulty feeding, especially coordinating the suck-swallow reflex required for proper breastfeeding.

Take longer to breastfeed because of the poor timing of sucking bursts and the need for long rests. 

They will also require greater feeding frequency

A baby with low muscle tone may suck better when the head and bottom are level, indicating pillow support in the lap.

If nursing is too frustrating and stressful for mother and child, breast milk can be expressed by use of a breast pump and fed through a bottle.