People suffering from pneumonia, postoperative partial or complete collapse of the lungs, chronic respiratory conditions like Chronic Obstructive Pulmonary Disease, Cystic Fibrosis etc as well as people suffering from neuromuscular diseases can get partial relief by respiratory physiotherapy. If a person is suffering from retained secretions, increased effort to breathe or volume loss, he or she may be referred to Respiratory Physiotherapy.

Respiratory Assessment Of The Patient

A Respiratory Physiotherapist will assess the condition of the patient with the help of Respiratory Assessment or Respiratory Examination. It includes:

Auscultation and review chest X-Ray

Interpreting arterial blood gasses test and blood tests

History of present illness

History of past illnesses

Details of cough, breathlessness, sputum, chest pain  

Other symptoms like headache, fever, CO2 retention, heart failure, peripheral oedema, shivering, palpitations, weight loss, Gastrointestinal Reflux Disease, vomiting and nausea etc.

Respiratory Physiotherapy Techniques -

After the Respiratory Assessment the doctor may prescribe the following:

Breathing Exercises

Exercises like Active Cycle Of Breathing Techniques can help in clearing phlegm. Since people in respiratory distress often produce more phlegm than normal, it is essential that this excess phlegm be removed. This can help the person breathe more freely. Removing the phlegm can also help prevent infections in the chest and reduce coughing. It is a set of exercises that together help in establishing breathing control, huffing and deep breathing.

Mobilisation

Early mobilization is one of the most important aspects of chest physiotherapy. It includes positioning, active and passive turning, cycling pedals, standing, stepping etc. 

Manual Techniques

The Physiotherapist may apply pressure on the chest to facilitate airway clearance while keeping the patient in gravity assisted phlegm drainage position. 

IPPB

It employs a device that helps patients take a deep breath, cough and clear lungs. The device offers short-term and intermittent mechanical ventilation of a positive pressure set by a physiotherapist. The device pushes a mixture of oxygen through a facemask.

Suction

Here too the physiotherapist uses a device to suck out excess mucus from the chest and facilitate breathing. Here the cough is stimulated by a catheter and phlegm is sucked out using another catheter.

MHI

It is the acronym for Manual Hyperinflation. This procedure is carried out by a Respiratory Physiotherapist to give volume to partially or completely collapsed lungs.

BiPAP or CPAP

The device delivers pressurized air into the patient's airways through a facemask. The pressure of air prevents collapse of the throat muscles and reduces airway obstructions. In essence, they allow patients to breathe more freely and regularly. 

Conclusion

Right Respiratory Assessment or Respiratory Examination is crucial to applying the right physiotherapy techniques. Right techniques may help patients breathe more freely and avoid respiratory infections. 

Know More About Respiratory Examination!

When you run your hands over the soles of your feet, the surface should be smooth to touch. However, sometimes, the surface may not be so smooth. Piezogenic pedal papules are papules on the medial, posterior or lateral aspects of both heels and result from herniation of fat. These papules are usually asymptomatic and can range from a size of 2mm to 10mm. In some cases, they can be a little painful. This is seen commonly in large lesions. They become apparent when the patient stands with his full weight on his feet and disappear or shrink when the weight is removed. Piezogenic papules can also occur on the wrists. This is a fairly common condition that affects women more than men. Piezogenic pedal papules can occur at any age including infancy.

There is no known cause for the herniation of fat that causes this condition. However, there are a few factors that could increase your risk of suffering from this condition. These factors are:

Obesity
Orthopedic problems
Flat feet
Collagen disorders such as EDS
Jobs which entail standing for long hours
Excessive weight bearing
This condition can also affect newborn babies with no predisposition. The diagnosis of this condition is often confused with infantile pedal papules, xanthoma and tophi. Since they are prominently visible only when pressure is applied, it is essential for a doctor to physically examine the patient while he or she is standing. This condition does not affect the health of a person and is largely only a cosmetic issue. Thus treatment is not usually necessary but some of the things you could do to relieve the discomfort are:

In cases where Ehlers-Danlos syndrome triggers the condition, patients may be recommended betamethasone and bupivacaine injections. These injections need to be administered repeatedly for complete pain relief.
Orthotic soles or custom made inserts for shoes can help relieve the pain and distribute pressure equally.
Heel taping
Compression stockings
Avoid excessive or prolonged weight bearing
Avoid standing for extended periods and try not to run too much
Rest the feet and keep them elevated to help alleviate the symptoms
Lose weight if you are on the heavier side
Electro acupuncture
Piezogenic pedal papules are benign and are no reason to worry. If they begin to affect the quality of your life, you could consult a podiatrist. 

What are Piezogenic Pedal Papules?

A Simple Guide to Arthritis

One of the most common ailments the elderly suffer from is arthritis. However, arthritis can affect people of all ages. It is a rheumatic disease as in, it affects joints and bones. It can be of many types and the term covers a number of inflammatory and non-inflammatory joint diseases. Some of the most well-known types of arthritis are rheumatoid arthritis, bone spurs, gout, and osteoarthritis.

The causes of arthritis have not been defined but there are a number of factors that increase a person's chances of getting it. Foremost amongst these is increasing age and excess weight. Arthritic conditions such as rheumatoid arthritis, ankylosing spondylitis, and lupus are said to be hereditary and linked to certain genes. Sometimes, injuries can also cause arthritic conditions. Misuse of steroids can also result in arthritis.

Here is a look at the most common symptoms of the disease :-

Pain around the joints is the most well-known symptom of arthritis. Along with pain, you may also notice swollen or stiff joints.
Increased body temperature around the affected joints and redness in the area is also a symptom of arthritis. These symptoms range from mild to severe, and can be constant or may come and go.
Everybody suffers from occasional joint pains but if any of the above symptoms persist for a long duration, it is best to consult a doctor. The sooner you seek treatment, the easier it becomes to deal with arthritis. If left untreated for too long, arthritis can result in permanent joint damage.

While there is no single cure for arthritis, it can be effectively controlled if treated in time. Since the type and severity of arthritis differ from person to person, treatment for the same must also be tailored to the needs of the individual.

Drugs for arthritis can be categorized as those that treat symptoms such as pain and stiffness, and those that suppress inflammatory conditions.

In some cases, surgery may be advisable. 

Physical therapy and regular exercise are very important when dealing with arthritis.

It is equally important to eat a healthy, nutritious and well-balanced diet. If you are overweight, try and lose the excess kilos.

You must also look after your joints to ensure that there is no further degradation of bone or muscle tissue. Avoid staying in one position for a long time, and try and maintain a good posture. These simple techniques can be very effective when dealing with all types of arthritis.

A Simple Guide to Arthritis

The liver is a vital body organ (the second largest) that helps in detoxification of the harmful substances and chemicals, in addition to participating in various metabolic pathways. It is normal for the liver to contain some amount of fats. The problem arises when there is an excess deposition of fats (accounting to nearly 7- 10% of the total liver weight), a condition referred to as Steatosis or Fatty Liver. Fatty liver often interferes with the normal functioning of the liver triggering serious consequences.

Types of fatty liver

Alcoholic Fatty Liver: As the name suggests, the condition is an outcome of excessive alcohol consumption.
Nonalcoholic Fatty Liver (NAFL): Here the problem or the trigger is not alcohol. The excess fat deposition in NAFL (~10 % of the total liver weight) results from the inability of the liver to break down the fat molecules.
Nonalcoholic Steatohepatitis (NASH): In NASH, the liver tends to swell up due to excess buildup of fats in the liver tissue (alcohol is not the trigger in NASH)
Acute fatty liver of pregnancy: Some pregnant women may suffer from this fatal condition (extremely rare).
Causes of fatty liver
Fatty liver is a common condition that often results from unhealthy diet and lifestyle practices. In this context, it is important to mention that unlimited alcohol consumption plays a pivotal role in various liver disorders, with fatty liver being one of the most common consequences. In fact, steatosis is one of the earliest stages associated with alcohol related Liver disease. However, fatty liver is a reversible condition that can be successfully treated if diagnosed at an early stage.

The excess deposition of fats in the liver cells can be an outcome of medical conditions such as
Besides alcohol, obesity is one of the biggest factors responsible for fatty liver. As per a survey, 1 in every 50 obese people suffers from fatty liver and other related complications (scarring, liver hepatitis or liver cirrhosis).

In addition to obesity, hyperlipidemia (a medical term used to define increased levels of lipids in the blood), high blood pressure, diabetes mellitus may have a significant role in triggering fatty liver.
Rapid weight loss or malnutrition can, more than often, give rise to fatty liver and its related disorders.
The use of certain medications such as carbon tetrachloride, tetracycline, and corticosteroids may be a contributing factor in fatty liver and associated complications.
Genetics can also play a significant role in triggering steatosis in some people.
Though fatty liver can affect children and young adults, people in the age group of 40 - 60 years are more susceptible to the condition.
Symptoms associated with fatty liver
There are no characteristic symptoms associated with fatty liver. However, in general, a person may experience
  Abdominal discomfort
  Extreme tiredness

With time, a person left undiagnosed and untreated, may exhibit the following symptoms
  A changed appetite (there is often a loss of appetite)
  Sudden weight loss (unexplained)
  Weakness
  Abdominal pain

Fatty Liver - 4 Common Types Of It!

Most families refer to their newborn baby as their 'bundle of joy'. The news of a child being born brings immense joy to the entire family. However, due to various reasons, a child could be born with some medical abnormalities, which would be known as congenital abnormalities. There are several different types of heart defects that can be congenital. These usually manifest themselves either immediately after birth or in the early years of life. In some cases, the abnormality could be detected on prenatal ultrasounds. In others, it may not be and the family could be caught off guard about the condition. This causes a lot of stress, both for the child, who does not receive regular postnatal care and for the parents immediately after the delivery process.

If the baby has the following symptoms within the first few hours of life, there could be a serious underlying condition, which requires medical attention. The presence and severity of the symptoms would depend on the actual abnormality.

The skin is pale gray or blue in color due to excessive venous flow in the system
Excessive sweating
The child is exerting to breathe regularly
Rapid breathing causes added load on the heart accompanied by a grunting noise
Flared nostrils i.e. the baby attempts to take in more oxygen with each breath causes flared nostrils
Swollen legs, eyes, and abdomen: Fluid retention in the legs and abdomen is quite common, and this could be characteristic of newborns with congenital heart disease
Shortness of breath, even during feeding
Clubbed fingernails
Lethargy and low energy, even with feeding, therefore very poor feeding pattern
Chest pain, which may cause the newborn to cry incessantly
Low weight gain, as they feed less
In some children, symptoms manifest only during the teenage years or early adulthood. These conditions are not very severe and the symptoms include:

Swelling of the hands, feet, and ankles due to fluid accumulation
Lowered energy levels, leading to easy fatigue
Shortness of breath with even minimal physical activity
Inability to exercise
Developmental delays and changes in growth milestones
Recurrent respiratory tract infections including sinus infections, bronchitis, and pneumonia
Endocarditis
Pulmonary hypertension
Heart failure, where the heart is not able to effectively function and pump blood to all parts of the body.
Some or more of these symptoms should trigger a warning to get the child tested for congenital heart disease. While some would just require a monitoring until severe symptoms develop, severe conditions like holes, abnormal valves, narrowed arteries, and blood vessel abnormalities might require immediate intervention.

Congenital Heart Disease - Signs Your Kid is Suffering from It!

The main task of the kidneys is to balance the electrolytes in the blood and maintain the pH homeostasis. The kidneys also remove waste products from the blood. Infections in the kidney aren t uncommon and affect women (majorly pregnant women) and children below the age of two in most conditions.

Kidney infections are of two types:

Uncomplicated kidney infection: The infections in this condition are minor and can be cured with minimal medication.
Complicated kidney infection: These infections are more complex and serious as compared to the uncomplicated ones.
If not treated on time, kidney infection can prove to become a serious condition and lead to various complications including kidney damage and blood poisoning (sepsis).

The most common causes of kidney infections are:

Weak immune system: If you have a weak immune system, you are prone to getting a bacterial or fungal infection on the surface of your skin which eventually enters the bloodstream. The infection might right reach the kidneys and cause an infection there.
Bacteria entering from the urethra: The pathogen which causes an infection can enter the body through the urethra and multiply in the bladder. The infection spreads to the kidneys and causes renal infection.
Kidney stones: People diagnosed with kidney stones are at a very high risk of developing kidney infections. Kidney stones are caused because of a build-up of dissolved minerals in the inner lining of the kidneys.
Enlarged prostate: Men with an excessively enlarged prostate are prone to developing kidney infections as compared to men with a normal-sized prostate.
Intercourse: Engaging in sexual (anal or vaginal) intercourse with an infected person can be a major reason for kidney infection as the bacteria can enter the body through the anus or the vagina and affect the kidneys.
It is not difficult to detect infection in the kidneys as they have very visible symptoms. A few symptoms of kidney infection are:

Excessive back pain
Sudden chills or fever
Nausea and puking
Blood in the urine
Pain while urinating

Kidney Infections - Factors That Put You At Risk!

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