Somebody in the world suffers a stroke every two seconds. Stroke affects physical as well as mental health gravely. It can be a life- altering situation leading to new limitations overnight. Such limitations can be physical or mental, affecting mobility and cognition. According to psychologists, cognitive functions of the brain encompass speech, language, functional memory, spatial- motor systems, ability to switch between tasks, executive functions like task organization, attention, and being able to employ tools and symbols.

When the stroke strikes, it irreversibly damages a part of the brain. It happens due to hemorrhage or blocked supply of blood. However, the brain can be trained and taught compensatory strategies. These compensatory strategies consist of attention increasing activities that require neurological utilities. These activities and exercises are formed in a way to improve the memory. Both pictorial and hearing skills are engaged in these activities.

Memory, attention span, and executive activities are dependent on each other and any problem regarding these affects an individual s daily life. That is why to improve the complete mental capacity, exercises are required. These exercises help to improve memory and attention span. In cognitive rehabilitation, goals are set as per the requirements of the patient and treatment is then followed. This requires some plans and strategies to carry out daily activities. These plans may consist of planning and analysis of the task.

The recovery varies from individual to individual depending upon the restoration of the damaged neurological functions supporting specific cognitive area. However, there are very limited types of treatments for cognitive rehabilitation, mostly generic treatments which depends on doctor s experience.

Evidence is found by researchers which supports the cognitive rehabilitation after stroke, in which the areas discussed are smaller than the issues faced by the stroke survivors. The studies fail to talk about the long-term results and common treatments for daily tasks. It is now really important for us to have a serious innovation in the field of cognitive rehabilitation with the amount of stroke patients increasing day by day.

Before one going for rehabilitation, he/ she should ensure that why they need it and what are their needs that are to be fulfilled through rehabilitation. Experts recommend rehabilitation so that patients are able to lead as normal lifestyle as possible post stroke strikes them.

Who are more prone to stroke?

Old age people, alcoholics, people with high cholesterol levels, active smokers, Diabetic patients, people who consume drugs, people suffering from Hypertension, patients going through transient ischemic attack (TIA) are all very much prone to a stroke.

It is also very important to consult a doctor after stroke. He will advise you the best possible way to treat the problem. 

Take away

Stroke these days can happen to anyone which although largely depends upon the age factor, but one's lifestyle can also make him/her the target of stroke. There is cognitive rehabilitation which can help a person to recover post stroke through activities and exercises and change in lifestyle. It is important for an individual to consult a doctor if he/she finds any difficulty in carrying out daily activities with one side of the body.

Cognitive Rehabilitation Post Brain Stroke!

For a long time cholesterol in totality was seen as a bad thing for your body although the truth was a little more complicated than that. Cholesterol primarily is divided into two types, one of which can be categorized as bad cholesterol and the other as good cholesterol. Let's have an in-depth look at both the categories.

Ldl or low density lipoprotein aka bad cholesterol: cholesterol is a wax like chemical which is found all over the body and it has important functions to perform. Cholesterol is carried all over the body by lipoproteins. The low density lipoproteins are denoted as bad cholesterol as they can accumulate on the walls of the blood vessels and cause blockages resulting in many ailments. Ldl levels of 190 and above are considered dangerous. 

Some of the risks associated with it are:
1. Heart disease
2. Stroke
3. Atherosclerosis
4. Peripheral artery disease among many others

Hdl or high density lipoprotein aka good cholesterol - this is a form of cholesterol which is usually desired in higher quantities as it removes ldl from the system by dislodging it from the arteries and then carrying it through the bloodstream into the liver. The liver then breaks it down and removes it from the body. Thus, higher number of hdl cholesterol is always desirable. Some of the ideal numbers for hdl cholesterol within the body are:

For women - ideal: 60 mg/dl, dangerous: 50 mg/dl or lower
For men - ideal: 60 mg/dl, dangerous: 50 mg/dl lower

The role of triglycerides
Good and bad cholesterol levels also depend on the levels of triglycerides within the body and not just ldl or hdl cholesterol. Triglycerides are another type of fat which are used to store energy within the body, but can also affect your health. It is most associated with atherosclerosis when the levels of triglycerides are high within the body. 

Some habits that contribute to high levels of it are
A. Lack of physical activity
B. Obesity or being overweight
C. Excesses in alcohol consumption
D. Smoking
E. Bad diet and others

Thus the good cholesterol vs bad cholesterol war also includes other factors, most of which can be easily changed by making subtle changes in lifestyle and incorporating healthier habits. This will increase the good cholesterol and the other relevant elements and reduce the bad.

Good Cholesterol Vs Bad Cholesterol

A heart attack does not always have obvious symptoms, such as pain in your chest, shortness of breath and cold sweats. In fact, a heart attack can actually happen without a person knowing it. This condition is known as a  silent heart attack , medically known as  silent ischemia , occurring due to the shortage of oxygen supply to the heart muscle. The causes of a silent heart attack are similar to that of a heart attack. 

They include- 

Conditions like: 
Obesity or excess weight 
Diabetes 
High Blood pressure 
High cholesterol 
Heart Diseases 
Lack of exercise 
Age, usually above 65 
Consumption of tobacco or smoking 
High consumption of alcohol 
A silent cardiac arrest makes one more vulnerable to another heart attack that could be fatal. Diagnosis: The only method to diagnose if you had a silent heart attack is through imaging tests, such as echocardiogram, electrocardiogram, Holter Monitoring or others. These tests can show certain changes which might be indicative of a heart attack. An analysis of one s overall health and the symptoms can aid in deciding whether few more tests are required. 

How would you prevent a silent heart attack? 
1.   Get your cholesterol and blood pressure count tested regularly. 
2.   Refrain from smoking. 
3.   Get your VO2 max checked regularly. 
4.   Live a healthy lifestyle: Refrain from smoking and excessive alcohol consumption; exercise daily, eat healthy. 
5.   Control high blood pressure, cholesterol, and diabetes 
6.   Be aware of your body and call on a doctor if you feel there s anything which is bothering you. 

If you wish to discuss about any specific problem, you can consult a doctor and ask a free question.

Know Everything About Silent Heart Attacks

Stroke is a medical condition in which the flow of blood towards the brain is poor and causes the death of certain cells. There are two common types of stroke: 

1. Ischemic- due to lack of blood flow
2. Hemorrhagic- due to bleeding

Signs and symptoms of stroke 

Problems with movement
Inability to feel  on one side of the body
Problems understanding or in speech
Vertigo
Loss of vision
Difficulty in carrying out everyday activities
Role of Physiotherapy for Patients with Stroke

The main focus of physiotherapy is to help you use your arms and legs to regain as much strength and movement as possible. 
If you have one-sided paralysis, correct positioning is important to prevent spasm or injury.
It helps you to sit up as this will help you avoid blood clots in your legs, improve your breathing and help you recover quickly.
If you are unable to move, you may be given chest physiotherapy to keep your lungs free of infection.
What does a Physiotherapist do?

A physiotherapist advises you on how you should be positioned when lying or sitting, and how often you need to be moved.
Motivates you to be actively involved in your physiotherapy sessions to help you relearn normal patterns of movement
Decides when you should begin to start walking and what equipment is needed to move or support you
Provides therapy to strengthen your limbs and teach you how to move again as independently as possible
Takes care of the fact that no complications should arise and you have a smooth recovery.
Treatment Techniques:

Strength Training: It is evident that strength training can improve upper-limb strength and function without increasing tone or pain in individuals with stroke.
Gaming: Goal orientated computer gaming has proven to significantly reduce upper limb impairment in stroke survivors.
Virtual Reality: Virtual reality training has been shown to be effective in restoring upper limb motor impairments and motor-related functional abilities.
Mirror Therapy: Mirror therapy has been shown to have a beneficial effect on motor control and function compared to conventional therapy.
Robot-Assisted Therapy: It has been shown to have a beneficial effect on motor recovery and function.
In the upper extremity with severe impairment and/or poor prognosis for recovery, Chedoke McMaster Stroke Assessment (CMSA) of Arm and Hand < Stage 4) treatment should focus on maintaining a comfortable, pain-free, mobile arm and hand. Engage in repetitive and intense use of novel tasks that challenge the stroke survivor to acquire necessary motor skills to use the involved upper limb during functional tasks and activities. Engage in motor-learning training including the use of imagery.

Stroke - How Physiotherapy Can Help With It?

Cholesterol is either ingested in the food (about 25% ) we eat and some of it is produced by our body (remaining 75%). Cholesterol is needed by the body to produce steroid hormones and bile acids. It is an aspect that is required by the body and if in too much quantity, the same can cause havoc in the body. The best is to maintain the right balance of cholesterol in our diet. The same requires lifestyle and dietary modifications.

The first step in creating your low cholesterol diet plan is to eliminate foods high in saturated fat and bad cholesterol.

Low cholesterol foods diet mainly includes:

1. High-Fiber Diet- Soluble fiber reduces bad cholesterol. Good food sources are oatmeal, fruits and vegetables.

2. Cooking oil- Fats makes about 30 % of your days intake. A combination of oils works the best. Foods rich in saturated fats are butter, ghee, cream, and cheese. These need to be taken in moderation or avoided. Avoid fried foods. Not more than 10% of total calories should be from Polyunsaturated Fatty Acids (PUFA) and the remaining should be from Monounsaturated Fatty Acids (MUFA). The best sources of PUFA are plant based oils, sunflower, corn, soybean, cottonseed and safflower. MUFA are found in the largest amounts in olive, canola, mustard, almond and peanut oils.

3. Avoid Trans fats- Read labels carefully and do not reuse oil used for frying.

4. Go lean- Choose lean meat and fish. Fish is a good source of omega-3 fatty acids. Foods high in omega 3 help you lower down the risk of cardiovascular disease. Tuna and salmon are a good source of omega-3 to name a few.

5. Eat a wide range of fruits and vegetables- This will help ensure that your body meets all the vitamins and nutrient requirement. Fruits and vegetables are relatively low in calories. Apples and pears are known for soluble fiber, which reduces bad cholesterol levels. It is best that you eat good quantities of the same.

6. Include low-fat dairy products- avoid ghee, cheese, cream, paneer and butter. Opt for lighter and healthier options.

7. Exercise well - Exercise at least 30 mins per day. Workout will help you burn extra fat resulting in lowering cholesterol levels.

Cholesterol - How To Manage It?

Angioplasty is the procedure of opening a coronary artery blockage with the help of wire balloon and stent. This procedure is done to open the blocked coronary arteries if they are causing symptoms or acute heart attacks.

HOW IT IS DONE?

The procedure is usually done in local anaesthesia. A wrist artery (radial) or a groin artery (femoral) is used to gain access to the coronary artery as is done in angiography. A hollow tube called a catheter is passed upto heart artery and through this, a guidewire is passed across the blockage and over this wire balloon is passed and blockage dilated.

After this balloon is removed and the metallic stent is passed over this wire. The stent is then inflated and it takes its shape of the hollow tube so that the flow in the coronary artery is restored.

WHAT ARE INDICATIONS OF ANGIOPLASTY AND STENTING:

An acute Heart attack is the most definite indication of angioplasty and stenting. At the time of the heart attack, there is an urgent need to restore the blood flow of block coronary artery which is usually not possible with medicines alone. Angioplasty is the most effective and definite way of opening the artery urgently in such situation.

SHOULD ALL BLOCKAGES BE OPENED UP BY ANGIOPLASTY AND STENTING?

NO, all blockages do not warrant this procedure. There is some amount of risk involved in the angioplasty procedure itself. When the risk of blockage is considered more than the risk of opening the artery then the procedure is indicated. Patients who are doing good on medicines may be followed up without angioplasty.

All About Angioplasty!

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