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 : What are Stretch Marks? Symptoms,Cause,Remedies and Diet

IPHREHAB

What are Stretch Marks? 

Stretch marks are skin lesions that occur when skin is pulled rapidly and the problem is caused by rapid weight gain. Although most of us tend to associate the problem of stretch marks with women, post-pregnancy, the problem is not restricted to women alone. The problem of stretch marks has become increasingly common with many being afflicted with the condition, particularly after resorting to fad diets and medications for rapid weight loss.

Symptoms of Stretch Marks

When skin is excessively pulled it hampers the production of collagen and elastin in the skin, causing them to thin out and weaken. This causes the skin to stretch and discolor. When stretch marks first appear, they take on an angry red color. The skin is stretched so much that it appears transparent and the blood vessels show through; this is what gives the marks the red color. Over time the blood vessels contract and leave the skin looking pale. This whitish color that replaces the red comes from the body fat that is visible through the stretched skin. 

Causes of Stretch Marks

This may be a result of pregnancy, when the skin gets pulled as the belly size increases, as a result of puberty in teens experiencing a growth spurt, a side effect of obesity or of illnesses like diabetes. Stretch marks usually appear on the abdomen and thighs.

Remedies for Stretch Marks

While stretch marks don’t vanish, they do fade with time. The use of over the counter creams and ointments helps the scars fade. One such effective ointment is cocoa butter cream. It is widely available and will help moisturize skin and is effective in smoothing out scars. In extreme cases patients seek laser therapy and surgery to correct the scars left on the body. These are painful and invasive treatments that serves no great cause. So instead of taking such a drastic step, it would be better to opt for simple and effective home remedies for stretch marks. Though the marks won’t vanish over night, they will fade away with proper treatment and dieting.

 Try some the following home remedies and observe the progress:

• Lavender Oil – Lavender oil is a highly recommended home remedy for stretch marks. Rubbing a few drops of lavender oil on the affected area twice a day ensures the scars fade quickly. Applying olive oil is also very effective.

• Sandalwood – A great preventive measure for stretch marks is applying sandalwood on the skin daily. It keeps the skin moisturized and prevents it from stretching.

Diet for Stretch Marks

An important aspect in the treatment of stretch marks is eating right. Eat foods that are good for your skin. These include fresh fruits and vegetables, especially those rich in Vitamin A, C and D. These foods improve skin tone and minimize blemishes. Zinc rich foods like nuts and fish also help diminish scars on skin. It is also of great importance that you drink lots of water through the day.

Suggestions for Stretch Marks

For anyone fighting off stretch marks, it is important to incorporate at least 30 minutes of exercise into your daily schedule. Exercising helps tone and firm up muscles, which in turn firms the skin. Yoga is a good option as it allows you to stretch and tone every muscle in the body.

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 : CEREBRAL ISCHEMIA AND INFARCTION

IPHREHAB :

 CEREBRAL ISCHEMIA AND INFARCTION


Cerebral ischaemia and infarction
Anatomy and pathology
The principal pathological process under consideration here is the occlusion of arteries supplying the brain. The two internal carotid arteries and the basilar artery form the Circle of Willis at the base of the brain, which acts as an efficient anatomotic device in the event of occlusion of arteries proximal to it.

CIRCLE OF WILLIS

Anatomy and pathology

VERTEBRAL ARTERY

Occlusion leads to sudden severe ischaemia in the area of brain tissue supplied by the occluded artery, and recovery depends upon rapid lysis or fragmentation of the occluding material: Reversal of neurological function within minutes or hours gives rise  to the clinical picture of a transient ischaemic attack.

When the neurological deficit lasts longer than 24 hours, it may be called a reversible ischaemic neurological deficit ( RIND ) if it recovers completely in a few days, or a completed stroke if there is a persistent deficit. Sometimes recovery is very slow and incomplete.

Neurological symptoms and signs  

The loss of function that the patient notices, and which may be apparent on examination, entirely depends on the area of brain tissue involved in the ischaemic process.      

 Neurological symptoms and signs

BASIC

The following suggest middle cerebral territory:

Dysphasia; Dyslexia, dysgraphia, dyscalculia; Loss of use of contralateral face and arm; Loss of feeling in contralateral face and arm.

• The following suggests anterior cerebral territory:

Loss of use and/ or feeling in the contralateral leg.

• The following suggests posterior cerebral territory:

Development of a contralateral homonymous hemianopia.

Neurological symptoms and signs

The following suggests a deep-seated lesion affecting the internal capsule which is supplied by small perforating branches of the middle and posterior cerebral arteries close to their origins: Complete loss of motor and sensory function throughout the whole of the contralateral side of the body with a homonymous hemianopia.

Neurological symptoms and signs

The following suggests ophthalmic artery territory (the ophthalmic artery arises from the internal carotid artery just below the Circle of Willis): Monocular loss of vision.

Neurological symptoms and signs

The following suggest vertebro-basilar territory: double vision( 3,4,6);

facial numbness(5);

facial weakness(7);

vertigo (8);

dysphagia (9, 10);

dysarthria ( 9, 10, 12);

ataxia; drop attacks;

motor or sensory loss in both arms or legs.