Ligament sprain and Tendon injuries

The connective tissue muscles with a bone is called as a tendon where as a ligament is the connective tissue between bones .

Sprains : Sudden over stretching of the ligament cause sprains. Basing on the intensity of the strain, ligament injuries are classified as four different types . The first degree being requiring conservative management and the the fourth requiring surgical intervention .

• first degree: caused by over stretching usually associated with a minor tear.
• second degree : these usually present with a severe pain and swelling.
• third degree : these is a complete rupture of the ligament
• fourth degree :complete damage of the ligament along with a fracture of the bone .

Usually ligament injuries require Magnetic resource imaging( MRI )for accurate diagnosis .

Treatment : (RICE : rest , ice , compression , elevation )

Rest : the best initial step in the management of the ligament injuries .
Ice :applying ice locally will help in protecting the swelling to increase and further decrease the pain
Compression : wrap the swelling with a creep bandage to reduce the already present swelling
Elevation : keep the injured region at an elevated level

Tendons

Tendons transmits the force from the muscle to the bone. Tendons have much more tensile strength and much more resistant to injuries involving over stretching . More common pathologies of tendons are tendinitis and tenosynovitis.

1.Tendinitis:
Chronic use of the tendons results in chronic stress which results in the breakdown of the collagen.Swelling of the tendon due to chronic overuse results in the decrease in the collagen.Treatment involves use of anti inflammatory drugs and rest . Resting the effected tendon will help in regeneration of the collagen .Rehabilitation, in many cases, continues to focus on anti-inflammatory treatment strategies, rather than collagen rebuilding. In some cases, the use of anti-inflammatory medication, such as corticosteroid injections or oral anti-inflammatory medications, can be detrimental for healing collagen degeneration. Overuse tendon disorders can take a long time to heal due to the slow rebuilding of collagen. Collagen rebuilding is a slow process.

2.Tenosynovitis : Tendons in the extremities , usually in the arms and the legs will have protective covering called as synovial sheath . chronic overuse and the friction in the synovial sheath results in the inflammation of the synovial sheath . It usually presents with pain and swelling on movement . It is treated with Anti inflammatory drugs .

3.Avulsion :

It results from an acute tendon injury resulting from high tensile loads, in which a tendon is forcibly torn away from its attachment site on the bone. In some other cases these fibers remains intact and the tendon pulls away from its bony attachment site.Avulsion injuries occur in regions where a large muscle attaches at a relatively small site on the bone, such as the hamstring attachment. These injuries requires surgical management.

Schizophrenia symptoms

The symptoms are broadly divided into 2 types .Positive symptoms and negative symptoms  

Positive symptoms : These are the symptoms present in only schizophrenic individuals and not in normal persons Ex : delusions , hallucinations , bizarre behaviour  

Negative symptoms : These are present in normal individuals and absent in schizophrenic individuals ex : lack of interest , decreased motor activity , lack of normal feelings like joy & sorrow Basing on the specific symptoms schizophrenia  are further divided into four types

1. Paranoid: these persons have less negative symptoms These persons constantly think of conspiracy against them and hence constantly involved in conflicts with all other persons around them . Some may have some abnormal and bizarre thoughts  like

• “He thinks like he is the president of the country ( delusions of grandeur )
•  “The friends and   family members are  conspiring to kill him .( delusions of persecution )”
•  “Constantly doubts the spouse thinking that they might be involved in some extramarital relationship” .
• “Then often hears voices like the god is speaking to them or some extra terrestrial organisms are sending encrypted messages to him” .

2. Catatonic : these persons presents with  more negative symptoms .  They will show the following symptoms automatic obedience,  negativism ,

• these people  sit or stand continuously for hours with out any movement and sometimes  even in awkward positions
• they may have brief outbursts of  violent and destructive behaviours and even hurt themselves in that process

3.Disorganized : these persons completely neglect themselves either in their appearance They will have unorganized speech and sometime unorganized speech . There behaviour is completely unpredictable . In a way they will be doing all the wrong things at the wrong places.

Identify Autism

Autism is a disease of the central nervous system that hampers social interaction and communication. It is  genetically inherited disorder  . Even-though it does not have any treatment early detection can help the child the child immensely . Early intervention may help children gain self-care and social skillsMost of the symptoms appear before the age of 3 years .

If you find any of the following symptomsin your child , check with your doctor immeadeatly . He may have  

•  No babbling by 12 months. 

• No gesturing (pointing, waving goodbye, etc.) by 12 months. 

•  No single words by 16 months. 

•  No two-word spontaneous phrases by 24 months. 

•  Any loss of any language or social skills, at any age.

Take this  AUTISM QUIZ  if you are not sure of the identifying symptoms .

Most of the children end up with very low IQ or rarely an abnormally high IQ . Some say that Albert Einstein is an autistic child .    

Treatment Goals:

1. Decrease associated deficits and family distress.
2. To improve the  quality of life  helping the child in attaining  functional independence. 

Eventhough none of the treatment is specifically made for a child , it involves several intensive special education programs

Behavioural therapy: It helps in decreasing the behavious which inhibit learning . this enables the child  to learn language  and  develop socially.

Mesothelioma

Mesothelioma is a form of cancer that is almost always caused by previous exposure to asbestos . Most people who develop mesothelioma have worked on jobs where they inhaled asbestos particles, or have been exposed to asbestos dust and fibre in other ways, such as by washing the clothes of a family member who worked with asbestos, or by home renovation using asbestos cement products.

SYMPTOMS

Symptoms of mesothelioma may not appear until 20 to 50 years after exposure to asbestos. Shortness of breath, cough, and pain in the chest due to an accumulation of fluid in the pleural space are often symptoms of pleural mesothelioma

1. chest wall pain

2. pleural effusion, or fluid surrounding the lung

3. shortness of breath

4. fatigue or anemia

5. wheezing, hoarseness, or cough

6. blood in the sputum (fluid) coughed up

 

RISK FACTORS

Working with asbestos is the major risk factor for mesothelioma. A history of asbestos exposure exists in almost all cases. However, mesothelioma has been reported in some individuals without any known exposure to asbestos. In rare cases, mesothelioma has also been associated with irradiation, intrapleural thorium dioxide (Thorotrast), and inhalation of other fibrous silicates, such as erionite.

WHAT TO DO ?

PREVENTION OF THE DISEASE

Replace asbestos with an alternative .There are two major types of asbestos: chrysotile and amphibole. It is thought that exposure to the amphibole form is more likely to cause mesothelioma. However, chrysotile has been used more frequently, hence many mesotheliomas are caused by chrysotile.

LONG TERM EFFECTS OF THE DISEASE

A mesothelioma is a highly aggressive tumor that is generally deadly. Current treatment of malignant mesothelioma is palliative .(to make the person with cancer comfortable.)

WHAT ARE THE RISKS TO OTHERS?

Mesothelioma is not contagious and cannot be passed from one person to another. The exposure to the asbestos that caused the cancer occurred many years to several decades before the disease appeared. People who live with asbestos workers have a higher risk of getting this cancer.

TREATMENT

Treatment for mesothelioma depends on the location of the cancer, the stage of the disease, and the patient’s age and general health. Standard treatment options include surgery, radiation therapy, and chemotherapy. Sometimes, these treatments are combined.

Surgery is a common treatment for mesothelioma. The doctor may remove part of the lining of the chest or abdomen and some of the tissue around it. For cancer of the pleura (pleural mesothelioma), a lung may be removed in an operation called a pneumonectomy. Sometimes part of the diaphragm, the muscle below the lungs that helps with breathing, is also removed.

Radiation therapy, also called radiotherapy, involves the use of high-energy rays to kill cancer cells and shrink tumors. Radiation therapy affects the cancer cells only in the treated area. The radiation may come from a machine (external radiation) or from putting materials that produce radiation through thin plastic tubes into the area where the cancer cells are found (internal radiation therapy).

Chemotherapy is the use of anticancer drugs to kill cancer cells. Most drugs used to treat mesothelioma are given by injection into a vein.

Palliative Measures ( symptomatic relief ):

To relieve symptoms and control pain, the doctor may use a needle or a thin tube to drain fluid that has built up in the chest or abdomen (thoracentesis). Drugs may be given through a tube in the chest to prevent more fluid from accumulating. Radiation therapy and surgery may also be helpful in relieving symptoms.

LONG TERM MANAGEMENT

Although mesothelioma is very unpleasant it’s still important for person after treatment is over to keep up all follow-up appointments and that’s vital because further testing is always needed to check whether cancer is coming back or to examine possible side effects that could be rather unpleasant and what’s even worse permanent.

Aim at a Healthy Weight

 Assessing Your Risk
Assessment of overweight involves using three key measures:

1. body mass index (BMI)

2. waist circumference, and

3. risk factors for diseases and conditions associated with obesity.

The BMI is a measure of your weight relative to your height and waist circumference measures abdominal fat. Combining these with information about your additional risk factors yields your risk for developing obesity-associated diseases.

What is Your Risk?
1. Body Mass Index (BMI): BMI is a reliable indicator of total body fat, which is related to the risk of disease and death. The score is valid for both men and women but it does have some limits.

The limits are:
It may overestimate body fat in athletes and others who have a muscular build.
It may underestimate body fat in older persons and others who have lost muscle mass.
Use the BMIcalculator calculator or tablescharts to estimate your total body fat. The BMI score means the following:

BMI
Underweight Below 18.5
Normal 18.5 – 24.9
Overweight25.0 – 29.9
Obesity 30.0 and Above

2. Waist Circumference

Determine your waist circumference by placing a measuring tape snugly around your waist. It is a good indicator of your abdominal fat which is another predictor of your risk for developing risk factors for heart disease and other diseases. This risk increases with a waist measurement of over 40 inches in men and over 35 inches in women

3. Other Risk Factors

Besides being overweight or obese, there are additional risk factors to consider.
RISK FACTORS
high blood pressure (hypertension)
high LDL-cholesterol (“bad” cholesterol)
low HDL-cholesterol (“good” cholesterol)
high triglycerides
high blood glucose (sugar)
family history of premature heart disease
physical inactivity
cigarette smoking

4. Assessment
For people who are considered obese (BMI greater than or equal to 30) or those who are overweight (BMI of 25 to 29.9) and have two or more risk factors, the guidelines recommend weight loss. Even a small weight loss (just 10 percent of your current weight) will help to lower your risk of developing diseases associated with obesity. Patients who are overweight, do not have a high waist measurement, and have less than 2 risk factors may need to prevent further weight gain rather than lose weight.
Talk to your doctor to see if you are at an increased risk and if you should lose weight. Your doctor will evaluate your BMI, waist measurement, and others risk factors for heart disease. People who are overweight or obese have a greater chance of developing high blood pressure, high blood cholesterol or other lipid disorders, type 2 diabetes, heart disease, stroke, and certain cancers, and even a small weight loss (just 10 percent of your current weight) will help to lower your risk of developing those diseases

Facts about Lipitor(anti cholesterol drugs )

Lipitor ( Atrovostatin ) is from a class of pharmaceutical agents to lower cholesterol levels in people with or at risk of cardiovascular diseases. They lower cholesterol by inhibiting the enzyme HMG-CoA reductase, which is the rate-limiting enzyme in cholesterol synthesis. Inhibition of this enzyme in the liver stimulates LDL receptors, resulting in an increased clearance of low-density lipoprotein (LDL) from the bloodstream and a decrease in blood cholesterol levels. The first results can be seen after one week of use and the effect is maximal after four to six weeks.

Cholesterol metabolism:

Most circulating cholesterol is manufactured internally through the HMG-CoA reductase pathway. Cholesterol, both from dietary intake and secreted into the duodenum as bile from the liver, is typically absorbed at a rate of 50% by the small intestines.

Cholesterol is not water-soluble, and is therefore carried in the blood in the form of lipoproteins, the type being determined by the apoprotein, a protein coating that acts as an emulsifier. The relative balance between these lipoproteins is determined by various factors, including genetics, diet, and insulin resistance. Low density lipoprotein (LDL) and very low density lipoprotein (VLDL) carry cholesterol toward tissues, and elevated levels of these lipoproteins are associated with atheroma formation (fat-containing deposits in the arterial wall) and cardiovascular disease. High density lipoprotein, in contrast, carries cholesterol back to the liver and is associated with protection against cardiovascular disease.

Lipitor( Statins) act by competitively inhibiting HMG-CoA reductase, the first committed enzyme of the HMG-CoA reductase pathway. By reducing intracellular cholesterol levels, they cause liver cells to make more LDL receptors, leading to increased clearance of low-density lipoprotein from the bloodstream. Lipitor is the most potent cholesterol-lowering agents available, lower LDL cholesterol (so-called “bad cholesterol”) by 3050%. However, they have less effect in raising HDL-cholesterol (“good cholesterol”). Lipitor is recommended for patients who do not meet their lipid-lowering goals through diet and lifestyle approaches.

Indications of Lipitor:

It plays an important role in both the primary and secondary prevention of coronary heart disease, myocardial infarction, stroke and peripheral artery disease.

Adverse effects of Lipitor:

Lipitor can cause a condition that results in the breakdown of skeletal muscle tissue. This condition can lead to kidney failure. This medication can cause birth defects in an unborn baby. Do not use if you are pregnant if you are pregnant or breast-feeding, or if you have liver disease.
Before taking Lipitor, tell your doctor if you have diabetes, under active thyroid, kidney disease, a muscle disorder, or a blood disorder.Avoid eating foods that are high in fat or cholesterol. Lipitor will not be as effective in lowering your cholesterol if you do not follow a cholesterol-lowering diet plan.Avoid drinking alcohol while taking Lipitor. Alcohol can raise triglyceride levels, and may also damage your liver while you are taking Lipitor.