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.

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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.

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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.

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