HEALTH & FITNESS

Pain after ankle sprain
Dr Ravinder Chadha

It is very common to find the ankle joint afflicted by injuries and the most common form is sprain. Anatomically, various ligaments that are stretched or torn surround the ankle joint when it is forced to land in varied unnatural positions.

Banned drug can reverse Alzheimer’s disease
LONDON:
A drug that has been banned from the UK’s National Health Scheme (NHS) can reverse the effects of Alzheimer’s disease in the worst-affected patients, researchers have discovered.

  • Grape seed extract can lower blood pressure

  • Too little or too much sleep is harmful

  • Pop a mint before you drive

Enlarged prostate —family connection
Dr Rakesh Khullar
It is interesting to note that the aging dog (like his master) is also prone to prostatic enlargement, but (unlike his master) does not often develop retention of urine. However, due to the bulging upwards of the enlarged prostate the dog’s rectum is compressed.

Homoeopathy & you
Beware of white patches on the skin
Dr Vikas Sharma

Vitiligo (often called as leucoderma) is a disorder where the skin loses its colour in patches of irregular shapes and sizes. This is a pigmentation disorder which means that melanocytes (the pigment-producing cells) in the skin get destroyed.
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Pain after ankle sprain
Dr Ravinder Chadha

It is very common to find the ankle joint afflicted by injuries and the most common form is sprain. Anatomically, various ligaments that are stretched or torn surround the ankle joint when it is forced to land in varied unnatural positions. This is of common occurrence during exercises, playing certain sports or accidentally.

The usual presentation could be an individual landing his foot forcefully on an uneven surface or the foot is turned inwards suddenly with force. This force in-turn stresses the ligaments that normally help stabilise the outer part of the joint. There might be a history of sudden snap/pop when this type of injury happens.

The ankle sprain ranges in severity from grade-I to grade-III, depending on the extent of injury to the ligament. An examination of the ankle reveals swelling and discoloration (due to the accumulation of blood and fluid. The X-ray is an integral part of diagnosis as it rules out the possibility of fracture. An MRI examination provides a conclusive picture of injuries to various ligaments.

Prolonged immobilisation in cases of ankle sprain is a common treatment error. Early mobilisation stimulates collagen bundle orientation thereby promoting healing and regaining the range of motion.

Improper rehabilitation may result in instability vis-à-vis a balance deficit that increases the risk of re-injury. Returning to activity without proper healing or inadequate rehabilitation can also lead to instability. Patients can be declared fit to return to normal activity only after taking into consideration the following points:

* When there is a full range of motion of the ankle.
* Ability to walk without a limp.
* 80-90 per cent strength when compared to normal ankle.
* Pain-free hopping possible on the affected limb.

The patients not treated adequately experience a feeling of “giving away” of the ankle. On an uneven surface, while climbing stairs, such individuals are good candidates for recurrent ankle sprain. Recurrence causes chronic ankle laxity that is manifested as pain or soreness. recurrent swelling, loosening of ankle, and general disability and locking or giving away.

Treatment at the initial stage aims at reducing post-injury swelling, bleeding and pain especially during the first 24 hours. Hot fomentation should be avoided as it increases swelling. Avoid Aspirin intake (as it prolongs the blood clotting time thereby increasing bleeding).

Give rest to the affected joint. Keep the leg and foot elevated by placing a pillow. This will reduce pain and swelling. Give ice treatment for 15-20 minutes every one or two hours.

PROTECTION OF THE ANKLE during the initial healing phase is extremely important. Taping, ankle stir-up, brace/crepe bandage and in severe cases leg cast is applied. In some cases crutches are used until pain-free weight bearing is achieved.

In the next stage, priority is given to increasing the motion and strength that help in facilitating circulation and inhibit swelling.

* Start with upward/ downward movement of the ankle progressing to an inward/ outward movement up to the point of pain.
* Toe curls with the help of a towel and marble picking with the toes should also be done.

Once pain-free motion is attained, strengthening exercises are advised with a stretch band. Sitting on the floor/ chair, looping band over the foot with the heel on the floor ankle is moved outwards/ inward, upward and downward.

Heel/toe raises: Standing on a step with heels slightly off the step, slowly rise up on toes and then slowly bring the heel down. When this is easily done, exercise only the injured ankle in a pain-free motion.

Balance exercises: While standing, raise one foot off the floor and balance on the other foot for a count of 15. Increase the count gradually to 30. Start this exercise with your eyes open, and later on close the eyes also.

Wobble board exercises: When the patient achieves full weight-bearing without pain, proprioceptive exercises are started for the recovery of balance and postural control. The Wobble Board is a small platform attached to a hemispheric base. The patient is instructed to stand on the board on both feet and later on one foot.

Return to activity is advised when the distance travelled by patient is no longer limited by pain then patient can progress to 50 per cent walking and 50 per cent jogging.

Chronic ankle laxity treatment becomes more tedious as it requires proper rehabilitation exercises over a period of time in order to improve the range of motion, to enhance strength and bring stability. If ankle pain is managed properly and well in time the incidence of chronic pain can be effectively reduced.

The writer is a former doctor/ physiotherapist, Indian cricket team.

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Banned drug can reverse Alzheimer’s disease

LONDON: A drug that has been banned from the UK’s National Health Scheme (NHS) can reverse the effects of Alzheimer’s disease in the worst-affected patients, researchers have discovered.

In the first trial of the drug, donepezil, in the treatment of severe dementia, doctors found it improved cognition and the ability to carry out daily activities among patients cared for in nursing homes.

The finding, published in the online edition of The Lancet, will increase pressure on the National Institute of Health and Clinical Excellence (Nice) to revise its decision to ban the drug.

Nice, the government watchdog that monitors the cost and effectiveness of medicines and treatments, has been reviewing drugs that combat Alzheimer’s disease since 2004.

The disease affects an estimated 500,000 people in the UK and is a degenerative condition that erodes sufferers’ ability to think and function and strips them of their personality.

Three drugs known as cholinesterase inhibitors, including donepezil, whose brand name is Aricept, has been shown by research to slow the progression of disease in some patients.

However, in preliminary guidance issued in March 2005 that caused a storm of protest, Nice concluded that the drugs were not cost-effective and should be banned on the NHS.

Donepezil and its sister drugs cost about £2.50 a day, but only one in five patients benefit and it is impossible to tell in advance which patients these will be, researchers say. — The Independent

Grape seed extract can lower blood pressure

Washington: Researchers have revealed that grape seed extract may be effective in reducing blood pressure.

Grape seed extract lowered the blood pressure of patients who participated in a University of California Davis study of the benefits of the supplement on people with high blood pressure.

Conducted by UC Davis cardiovascular researchers, the study was the first human clinical trial to assess the effect of grape seed extract on people with metabolic syndrome, a combination of risk factors that increase the risk for heart disease, including high blood pressure, excess abdominal body weight, high blood cholesterol fats and high blood sugar.

The one-month study involved 24 male and female patients diagnosed with metabolic syndrome. — ANI

Too little or too much sleep is harmful

Washington: A new study by the researchers at the New England Research Institutes in collaboration with those at Yale School of Medicine shows that men who indulge in either excessive sleeping or sleep less are more likely to develop Type 2 diabetes. The data, published in the March issue of Diabetes Care, were obtained from 1,709 men, 40 to 70 years old.

Since six to eight hours of sleep was considered to be most healthy, men who reported they slept between five and six hours per night were twice as likely to develop diabetes. Men who slept more than eight hours per night were three times as likely to develop diabetes, said the lead author, H. Klar Yaggi, professor in Yale’s Department of Internal Medicine, Pulmonary Section. — ANI

Pop a mint before you drive

Washington: Next time when you’re behind the wheel, don’t forget to take some peppermint or cinnamon-flavoured chewing gum, for a new study suggests that the odours of mint and cinnamon may keep you more alert and awake while driving.

According to the results of a recent study led by Wheeling Jesuit University undergraduate student Will Esgro, both cinnamon and peppermint enhance performance and alertness, decrease fatigue and frustration.

The student, who worked with Dr Bryan Raudenbush, Director of Undergraduate Research and Associate Professor of Psychology at Wheeling Jesuit University in Wheeling, WV, will present the study during the university’s Seventh Annual Student Research and Scholarship Symposium, April 4, 2006. — ANI

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Enlarged prostate — family connection
Dr Rakesh Khullar

It is interesting to note that the aging dog (like his master) is also prone to prostatic enlargement, but (unlike his master) does not often develop retention of urine. However, due to the bulging upwards of the enlarged prostate the dog’s rectum is compressed. This engenders a feeling of continuous fullness in the rectum and induces straining. The prostates of eunuchs are small and underdeveloped, and enlargement of the prostate is unknown.

Benign prostatic hyperplasia (BPH) is one of the most common diseases to affect men beyond the middle age. The prevalence goes up with age, and thus the total number of patients is increasing as a result of aging population. A majority of these people suffer gradual progression of symptoms and the concomitant discomfort, and require either medical or surgical treatment. The growth and development of the prostate is under the influence of male hormone “testosterone”.

Rather surprisingly, there is no close correlation between the size of the prostate and the extent of outflow obstruction. However, the larger the prostate, the greater is the risk of BPH complications such as acute urinary retention and the need for surgery.

BPH is usually a slowly progressive condition. An average increase in the prostate is 1-2 cm per year. BPH is the most common condition affecting the prostate accounting for over 80 per cent of prostate disease. The defined risk factor for BPH is age. Clinical BPH seems to run in families.

In the early stages of the disease, the patient complains of hesitancy, a reduced stream and incomplete bladder emptying and then frequency, urgency and nocturia. Later on, prolonged micturition, acute urinary retention, urge incontinence, etc, can have a negative effect on the quality of life and may be associated with sexual dysfunction like erectile dysfunction and disorders of ejaculation.

The treatment of BPH can be with the help of drugs or by going in for surgery. Some of the drugs used are Finasteride, Duatasteride, Terazosin, Alfuzosin and Tamsulosin. Adverse side- effects of these drugs can be erectile dysfunction, decreased libido, reduced ejaculation, drowsiness, headache, dizziness, postural hypotention, etc.

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Homoeopathy & you
Beware of white patches on the skin
Dr Vikas Sharma

Vitiligo (often called as leucoderma) is a disorder where the skin loses its colour in patches of irregular shapes and sizes. This is a pigmentation disorder which means that melanocytes (the pigment-producing cells) in the skin get destroyed. This results in the development of white patches on the skin. The hairs which are growing in that area may lose their colour and turn grey.

The causes: The cause for vitiligo is not very clear, but doctors and researchers are beginning to believe that vitiligo resembles an autoimmune disorder. Which means that the pigment (the matter that gives colour to our skin) producing cells of the skin are destroyed by the body’s own antibodies (defense cells).

In some cases, it has been observed that the onset of vitiligo is related to a psychologically stressful event in the patient’s life. People with a family history of vitiligo are more prone to developing these white patches. Ninety-five per cent of all those who develop vitiligo start developing symptoms before the 40th year of their life.

The symptoms: People with vitiligo develop white patches on their skin of irregular shapes and sizes. Vitiligo is more common on the exposed areas, for example, hands, face, neck and arms. It also occurs on covered areas too like genitals, breast and legs. In some patients, the hair may also turn grey early and in the inside of the mouth, white discoloration may occur.

The spread of vitiligo cannot be determined. It may stop completely after the first patch, but often these patches do spread. For some patients, further development may take years and for others the large areas can be covered in months. In some patients, mental stress has been seen to increase the growth of these white patches.

According to homoeopathic philosophy, vitiligo is not a disease in itself but an expression of an inner disturbed state of the body. Thus, the cure should occur at a level where things have gone wrong. In order to achieve this, the problem is analysed keeping in view various aspects of mental, physical and familial attributes, and also a complete study is done on the psychological environment of the patient. The prescription is then based at the deepest level of understanding of the patient’s disturbed inner force.

Although many homoeopathic medicines like Arsenic Sulph Falvus, Arsenic Album, Baryta Mur and Baryta Carb are known to give good results in vitiligo, the fact is that the real cure of vitiligo occurs when the prescription is made according to the true principles of homoeopathic philosophy — treating that “deep causative factor” behind this inner disturbance. Also remember that vitiligo is a chronic disorder and can take considerable time, even with the best of the homoeopathic treatment, to be completely cured.

The writer is a Chandigarh-based homoeopath.

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