Sunday, 4 March 2012

IPHREHAB: Spinal Cord Injury : Quadriplegic and Paraplegic Injuries

IPHREHAB

Spinal Cord Injury : Quadriplegic and Paraplegic Injuries
Paraplegic and quadriplegic (tetraplegic) are terms used to describe the medical condition, for a person who has been paralysed due to a spinal cord injury. This classification depends on the level and severity of a persons paralysis, and how it affects their limbs.
This  provides patient information about acute spinal cord injuries, as well as treatment, symptoms, information on long term rehabilitation issues and peer support, to help improve the quality of life of those affected by a spinal cord injury.

What is a Spinal Cord Injury ?
A spinal cord injury (SCI) is typically defined as damage or trauma to the spinal cord that in turn results in a loss or impaired function resulting in reduced mobility or feeling.
Typical common causes of damage to the spinal cord, are trauma (car/motorcycle accident, gunshot, falls, sports injuries, etc), or disease (Transverse Myelitis, Polio, Spina Bifida, Friedreich's Ataxia, etc.). The resulting damage to the spinal cord is known as a lesion, and the paralysis is known as quadriplegia or quadraplegia / tetraplegia if the injury is in the cervical (neck) region, or asparaplegia if the injury is in the thoracic, lumbar or sacral region.
The spinal cord injury level is usually refered to alpha numerically, relating to the affected segment in the spinal cord, ie, C4, T5, L5 etc.
It is possible for someone to suffer a broken neck,or a broken back without becoming paralysed. This occurs when there is a fracture or dislocation of the vertebrae, but the spinal cord has not been damaged.

What is a Complete and Incomplete Spinal Cord Injury
There are typically two types of lesions associated with a spinal cord injury, these are known as a complete spinal cord injury and an incomplete spinal cord injury. A complete type of injury means the person is completely paralysed below their lesion. Whereas an incomplete injury, means only part of the spinal cord is damaged. A person with an incomplete injury may have sensation below their lesion but no movement, or visa versa. There are many types in incomplete spinal cord injuries, and no two are the same.
Such injuries are known as Brown Sequard Syndrome, Central Cord Syndrome, Anterior Cord Syndrome and Posterior Cord Syndrome.

What is Spinal Cord Injury Rehabilitation
Someone with a spinal cord injury will have a long road of rehabilitation ahead of them, usually at a spinal cord injury rehabilitation centre or spinal injury unit, and it is important that they keep their sense of humor on their bad days to help them maintain a positive attitude.
Generally, paraplegics will be in hospital for around 5 months, where as quadriplegics can be in hospital for around 6 - 8 months, whilst they undergo rehabilitation. Both paraplegics and quadriplegics should have some kind of rehabilitation and physiotherapy before they are discharged from hospital, to help maximise their potential, or help them get used to life in a wheelchair, and to help teach techniques which make everyday life easier.
Disabled sports, and wheelchair based sports can be an excellent way to build stamina, and help in rehabilitation by giving confidence and better social skills. The ultimate reward for many disabled sportsmen and women, is to win at the paralympic games, which will be coming to London in 2012.

Spinal Cord Injury Cure and Treatment
A cure for long term paralysis is still some years in the future, but clinical trials are taking place with Olfactory Ensheathing Glial (OEG) cells and Embryonic Stem Cell based Therapy.
and conservative treatment via physiotherapy and rehabilitation approaches.

Paraplegic and Quadriplegic Discussion Forum
If you have any spinal cord injury related questions, please visit our discussion forums and join in on the many topics there. We will do our best to help you, or at the very least, put you in contact with someone who can if we can't. The discussion forum is intended to be a free flow of information between spinally injured people, carers, and their friends, and everyone is welcome.
Even if you don't have any questions, take a look at the forum anyway, as you may be able offer help and advice to others who have questions.

Quadriplegic, Tetraplegic, Paraplegic and it's Definition
Quadraplegic is derived from two separate words from two different languages, Latin and Greek. The word “Quadra”, meaning “four” which is derived from latin, relates to the number of limbs. “Plegic”, is derived from the Greek word “Plegia”, meaning paralysis.
Put the two together, and you have “Quadraplegia”.
“Tetra” is derived from the Greek word for “Four”. “Para” is derived from the Greek word for "two" Hence: Tetraplegic and Paraplegic.
In Europe, the term for 4 limb paralysis has always been tetraplegia. The Europeans would never dream of combining a Latin and Greek root in one word.
In 1991, when the American Spinal Cord Injury Classification system was being revised, the definition of names was discussed. The British are more aware of Greek versus Latin names. Since Plegia is a greek word and quadri is Latin, the term quadriplegia mixes language sources. Upon review of the literature, it was recommended that the term tetraplegia be used by the American Spinal Cord Association so that there are not two different words in English referring to the same thing.

Saturday, 3 March 2012

IPHREHAB : OSTEOMALACIA & RICKETS WITH TREATMENT

IPHREHAB


OSTEOMALACIA & RICKETS

DEFINITION
It is a condition characterised  by defective bone mineralisation.
There is increased bone turnover.
It is usually due to Calcium & Vitamin D deficiency.
Condition is rare in USA, UK..
More common in Arab countries

DEFINITION
Rickets is seen in children before Puberty..
Osteomalacia is adult counterpart of Rickets..

Both have same aetiology :
There is failure or defective mineralisation of newly formed matrix

AETIOLOGY
Diet poor in calcium & Vitamin D
Malabsorption Syndromes Chronic Diarrhoea, Sprue,    Steatorrohoea, 
Tuberculosis of Intestines
Chronic  Renal Failure  

AETIOLOGY
Lack of Sunlight Exposure- Reduced Vit. D Conversion 
Hypophophatemia
Vitamin D Resistance Rickets
There is increased thickness of Osteoid Seams, reduces calcification –mineralisation is defective

VITAMIN D METABOLISM
Ultraviolet Rays 
Skin 7-DHC (dehydrocholesterol)
Vitamin D3
Liver  - converts into 25-hydroxylase
Inactive 25(OH) D3
Kidney- 25(OH) Vitamin D 1-a hydroylase
Biological Active 1,25 (OH)2 D3  
Increases absorption of calcium from gut

CLINICAL PICTURE
Delayed DEVELOPMENT-Short Stature
Decreased Muscular Tone (Hypotonia)
Craniotabes  6-12 years 
Frontal Bossing
Delayed Frontallae Closing
Enlargement of Epiphysis (Rickets Rosary)

CLINICAL PICTURE
Teeth are pitted Caries common
Pot-belly Abdomen
Carpopedal Spasms
Laryngeal Stridor
Tetany may be seen
Bone Pains – Defective spine
Waddling Gait

INVESTIGATIONS
Complete Blood Anaemia Common
Serum Calcium Low
Phosphates usually low 
Alkaline Phosphatase raised
X-ray of bones characterstic changes in children Epiphysis thined & distal end of bone widened SAUCER deformity

INVESTIGATIONS
In Adults bone X-ray may be normal or shows osteoporosis
In Children Pseudofractures & Looser’s zones (Radiolucent bands)  may be seen It affects the ribs, Axilliary border of Scapula, Pubic rami

X-Ray of Rickets
BOWED  LEGS
MANAGEMENT
Calcium 1-2 gm daily
Diet- 1 litre of milk
Vitamin D 60,000 IU (1.5 mg of D3) Daily Orally
For tetany IV Calcium gluconate is given
Response to treatment is excellent

Conservative Management
1.Dietary supplement:
2.Physiotherapy treatment :
 .Gentle range of motion exercise.
 .Gradual weaght bearing training.
 .Prevention from fall and injury.
 .Coordination and reconditioning.
 .Light endurance training.

IPHREHAB : INDIAN EXPERIMENT WITH SPIRITUAL AND ENVIRONMENTAL WELL BEING AND HEALTH

IPHREHAB
WE NEED EMPHASIS ON:
  • DIET
  • LIFE STYLES
  • ENVIROMNTAL POLLUTION
  • ENVIRONMENTAL POLLUTION
  • CALCUTTA TRAGEDY
  • MEHSANA WATER PROBLEM
  • OZONE DEPLETION Please remember both earth summits have failed
INDIAN EXPERIMENT : Kurichioas of Wayanad-an illiterate Tribal Community of Kerala
  • HAVE NO MEDICAL FACILITIES
  • STILL ENJOYS HEALTHY LIFE
  • NO   DIABETES, CANCER OR HYPERTENSION
  • AND THERE ARE MANY CENTENARIANS
INDIAN EXPERIMENT :RURAL AND NUMEROUS URBAN AREA
  • HAVE POSITIVE LIFE STYLE
  • CLEAN  ENVIRONMENTS -  NO POLLUTION
  • SALUBRIOUS CLIMATE
  • HIGH  SECURITY
  • HEALTHY JOINT FAMILY SYSTEM.
INDIAN EXPERIMENT
  • FOOD CONSIST OF RAGI, FRESH VEGETABLES, FRUITS & MEAT
  • THEY DO HARD MANUAL WORK 10 HOURS A DAY
  • HIGHLY RELIGIOUS
  • FOND OF MUSIC & SINGING.
SOME ONE HAS NICELY SAID
NO GOVERNMENT  IS REALLY INTERESTED IN HEALTH & WELFARE OF SOCIETY
RICH & HEALTHY PEOPLE ARE THREAT TO GOVERNMENT
MODERN MEDICINE CAN NOT ACHIEVE HEALTH FOR ALL EVEN BY 3000 AD.

WE   NEED
  • AFFORDABLE MEDICAL CARE MODEL
  • GOOD DRUG POLICY
  • STRICT MEDICAL AUDITING REGARDING ADMISSIONS & INVESTIGATIONS
  • MODIFICATION OF CPA
  • IF YOU DON’T DO ANYTHING
  • OUR MEDICINE WILL DIE LIKE BIG DINOSAURS OF OLD DARWIN TIME
  • IF YOU HAVE ANY TEARS IN YOUR EYES ,SHED THEM NOW
THANK YOU

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.