Rheumatic Diseases

                            RHUMATOID  ARTHRITIS

    DEFINATION :Rheumatoid arthritis  (Described in detail for the first time at the end of 18th century)is the most common infflammatory disease of the  joints. It is a systemic disease of young and middle-aged adults characterised by proliferative and destructive change in synovial memberane ,periarticular sheaths. Evenntually joints are destroyed ,fibrosed or ankylosed.It is a widespread vasculitis of the small arterioles.

The Ten Self -help Techniques

1. positive mental attiude: Patient is told to focus on things other than pain and their own body. They are encouresed to think positively.
2. Regular medication:Patient is told the value of regular and correct medication.
3. Regular exercise: Patient should follow a regular and apporopriate execrise programme,most suited for themselves.To imporve the range of motion in arthritic joint, patients are instructed to perform exercise .
4. Use of joints: Patient is told the value of correct posture and the methods of using the joints wisely to reduced stress on the painful joints.
5. Energy connservation: Patient are instructed to listen to the body's "inner signals" for the rest. Slowing down and avoiding too many activities reduces the stress and strain on the joints.
6. Assistive devices: Devices like splints ,braces and walking sticks can help stabilise the joints,provided strength and reduce  pain and inflammation.
7. Adequate sleep: A good adequate sleep provides rest to the ailling joints and reduces the pain and sweling.
8. Relaxation Massage: A good moderate massage bring warmth and relives pain due  to arthritis.
9. Relaxation techniques: It is like Yoga meditation , etc.help to relax the muscles, mind and control of pain.
10. Modification in the daily activities

• Bath aids and railings.
• Using western toilets.
• Long handle broomsticks and mop to clean the floors.
• Use of walking sticks while walking climbing ,etc.
• High chairs.
• Avoid squatting on the ground for food ,etc
  Use of dinning table and chairs are recommended.
  To avoid squeezing clothes after washing and just rinsing them dry.

• To avoid walking on hard and uneven and rough surfaces.
• To sleep on a hard surface.

DEVELOPMENTAL DISORDER

ACHONDROPLASIA-It is melancholic at heart as he weeps at his stature but gives the greatest gift to mankind that is laughter, as he dispells the gloom on the weary faces of the people,by his clowning antics at the circus. Definition- It is a defect in the enchondral ossification of the bone,with the membranous ossification being normal. This is the most common type of dwarfism one enconters in clinical practice.The limbs are short and the head is big,because,along with the growth of the limbs,growth of the base of the skull is affected but the membranous bones of the vault escape.

FINGER- NOSE TEST

HOLD YOUR FINGER ABOUT AN ARM'S  LENGTH FROM THE PATIENT. ASK THE PATIENT TO TOUCH YOUR FINGER WITH THEIR INDEX FINGER & THEN TOUCH THEIR NOSE, REPEATING THE MOVEMENTS BACK & FORTH. PATIENTS MAY DEMONSTRATE PAST POINTING (MISSING YOUR FINGER) OR INTENTION TREMOR.

LOW BACKACHE FLEX ION EXERCISES

FLEXION EXERCISES

Flexion exercises are advocated the following goals:

1.  To open the inter vertebral foraminae.
2. To unlock the facet joints.
3. To stretch the hip flexors.
4. To mobilise the posterior fixation of the lumbosacral articulation.
5. To strengthen the abdominal muscles.
6. To stretch the back extensors.
7. To increase the intra-abdominal pressure by contracting the internal& external oblique abdominal muscles.       

Indication of flexion exercises.See below.

 Indication Flexion exercises Extension exercises

• Pain relief on Sitting Lying

Forward bending walking

Lumber lordosis Repeated back bending

Fixed lumber lordosis Decreased lumber lordosis

with bending

• Pain increased on Sitting

                                          Standing                             Driving                      

                                     Sustained forward                   Arising from chain          

                                        bending                                                                            

                                    Repeated backward                 Stooping                              

                                        bending                               Bending                                    

                                        Extreme range of                  Forward bending                

                                      backward bending                                                                

                                                                                    Repeated forward bending                                           

                                    

LOW BACKACHE EXTENSION EXERCISES

TREATMENT  OF LOW BACKACHE DUE TO LUMBAR DISC DISEASE:MUSCLE STRAIN, & LIGAMENT SPRAIN (Common LBA)

The principles of treating common low backache are explained by three R's.

• Relieve pain in acute cases.
• Restore normal movements in chronic cases.
• Recurrence is to be prevented.

The following are the treatment exercises

in low backache.

Extension Exercises

These exercise aim to achieve the following goals:

1. They maintain the normal lumber lordosis
2. They improve the strength of the extensor  muscles of back & hip.
3. In patients with posterior or posterolateral disc prolapse it relieves the pressure on the disc.
4. The improve the mobility of the spine.

Type of Extension Exercises 

1. Extension to neutral
2. Hyper extension exercises

 Contraindication

1. Acute disc prolapse
2. Multiple back operations.
3. Spinal stenosis
4. Spondylolisthesis

Rotational Exercise

1. These exercises provide overall relaxation of the spinal muscles.
2. The external & internal oblique abdominal muscles help in the development of intra-abdominal pressure & help in the maintenance of anterior & posterior trunk balance.

They also provide anterior stability to the spine.

Exercises for Stretching the Side Muscles

Patient lies on the back, keeping the backflat & feet together, the knees are rotated on either side for a count of ten.

Other Forms of Exercises

• Mobility exercises 

1. Pelvic rotation
2. Chest roll on either side in sitting or supine.

• Stretching exercises
• Aerobics 

 

WHAT IS AUTISM?

  Autism Spectrum Disorder (ASD) & autism are both general terms for a group of complex disorders of brain development. These disorders are characterized in varying degrees, by difficulties in social interaction, verbal & nonverbal communication & repetitive behaviours.They include autistic disorder, Rett syndrome, childhood dis-integrative disorder, pervasive developmental disorder -not otherwhttp://drchetanparasar.blogspot.com/2012/09/what-is-autism.htmlAUSTIMise specified (PDD-NOS) & Asperger   syndrome.

ASD can be associated with intellectual disability, difficulties in motor co-ordination & attention & physical health issues such as sleep & gastrointestinal disturbances, some persons with ASD excel in visual skills, music, math & art.http://drchetanparasar.blogspot.com/2012/09/what-is-autism.html Done

Autism appears to have its roots in very early brain development.

However the most obvious signs of autism & symptoms of autism tend to emerge between 2 & 3 years of age. Autism speaks continues to fund research on effective methods for earlier diagnosis as early intervention with proven behavioral therapies can improve outcomes.

Increasing autism awareness is a a key aspect of this work & our families & volunteers play an invaluable role.     

    

  

WHAT ARE THE SYMPTOMS OF AUTISM?

WHAT ARE THE SIGN AND SYMPTOMS OF AUTISM?

http://drchetanparasar.blogspot.com/2012/09/what-are-symptoms-of-autism.html

1. 

AUTISM SPECTRUM DISORDERS(ASD) are characterized by social interaction difficulties, communication challenges and a tendency to engage in repetitive behaviors.However,symptoms& their severity vary widely across these three core areas.Take together,they may result in relatively mild challenges for someone on the high functioning end of the autism spectrum.For others, symptoms may be more severe as when repetitive behaviour s &lack of spoken language interfere with everyday life.

1. Social Communication Deficits
2. Repetitive Behaviours 
3. Language Disability
4. Associated medical conditions

• Genetic Disorders
• Seizure Disorders
• Sleep Dysfunction
• Sensory processing problems
• Pica (tendency to eat things that aren't food)