Injuries are very common, especially head injuries are one of the leading causes of death and disability in adults. As per surveys conducted, 1.7 million people suffer from head injuries every year and this estimation is increasing day by day.

Head Injury is any trauma to head other than superficial injuries to face. It results in high morbidity & mortality. Head injuries are an important cause of loss of young people at their productive age.

Causes of Head Injury-

A head injury can occur due to many reasons. Some common causes of these head injuries are:

Vehicle accidents

Street fights

Fall from height

Child abuse

Symptoms of Head Injury-

A head injury is followed by various symptoms depending upon the intensity of the injury. Here is a list of the possible symptoms of brain injuries:  

Nausea and vomiting, fatigue or sleepiness, severe headache, confusion, amnesia,  loss of consciousness, seizures, loss of muscle control or paralysis in the part of the body controlled by the part of the brain that is affected, coma, dilation of the pupils and disturbance of vision, Cerebrospinal fluids might come out of the ears and nose, sometimes accompanied by blood, difficulty in breathing, low pulse rate, increase in blood pressure, difficulty in swallowing, loss of hearing, problems in cognitive functions.

Brain damage is a process, not an event. 80% are minor head injuries, 10% are moderate head injuries and 10% are major head injuries.

Management of Head Injury-

Diagnosis of a brain injury has to be detailed and very quick at the same time. It always comes under emergency cases. Some of the steps involved are:

Glasgow Coma Scale

Pupillary reaction to light

Brain stem reflex tests

Head to toe examination

CT scan of head is the initial study of choice. MRI Brain is helpful in cases of non-haemorrhagic contusions, diffuse axonal injury and deep lesions.

Surgical Indications

Head injuries with intracranial hematomas causing significant mass effect

Massive cerebral edema

Hydrocephalus

Infection

Precautions for Head Injury

Use Helmets- both riders

Use Seat Belts

Keep vehicle speed under control

Follow traffic rules

Take adequate precautions during trekking, diving

Take Away-

No head injury is minor enough to be neglected nor severe enough to be given up.

Head injuries take time to heal, but medical treatment along with neurosurgery can aid the process of recovery and also help a person to lead a healthy life in the future. Most young patients recover fully, while some older patients or patients with preexisting neurological conditions live with a degree of disability.



Head Injuries - All You Must Know!

Our skeletal structure is truly a work of art however, when we are faced with bone related disorders, our lives is no less than a roller coaster ride. Arthritis is one such ailment which can really alter the quality of life of a person who suffers from it. Taking into account the impact, would it not be good to know the symptoms of early arthritis, so it can be detected before it gets too bad?

There are a few symptoms of the condition, but it is to be noted that the intensity of the symptoms even in the earlier stages of the issue do vary widely. As a matter of fact, the problem can be developing for months on end without a person even knowing that he or she has arthritis while on the other hand, there are quite a few cases in which a person is provided with an almost instant  notification  that arthritis has started having its degenerative impact on his or her joints.

What signs to watch out for?
There are three areas that need attention if trying to detect arthritis:

Knees: When a person is in the process of developing arthritis, the signs he or she should be aware of include his or her knees being shaped like an outward curve; if he or she is developing the condition in the knee. Apart from this, a limp can also be seen for a lot of people who develop arthritis which affects the joints which bear the weight of the body. The best example of this is a case of arthritis affecting the ankle or the knee.
Neck: If a person has a near constant pain in the lower back or also of the neck, he or she should be aware of the fact that there could be arthritis developing and it is important for a doctor to be consulted about the same.
Fingers: In some cases, the signs of arthritis may not even be the cause of pain to a person. This is true when a person begins to develop something such as Bouchard s node; which affects the fingers when arthritis begins to set in on the digits. These nodes are not painful, in most cases, but, it is to be kept in mind, that they have the ability to limit the motion of the fingers which are affected.
Arthritis is something that can and should be limited to as far an extent as possible, rather than being allowed to worsen a person s condition and not allow him or her to have the freedom he or she is used to having in life. When in doubt, a quick consultation with a doctor can really save the person a lot of pain later on!

If You Have These Symptoms Check For Arthritis!

Knee replacement can be extremely painful. Previously, opioids or narcotics were administered for pain relief. But excessive addition of opioids is not exactly effective for controlling pain. 

Multimodal pain management has become an important part of the perioperative care of patients undergoing total joint replacement. The principle of multimodal therapy is to use interventions that target several different steps of the pain pathway, allowing more effective pain control with fewer side effects. Many different protocols have shown clinical benefit. The goal of this review is to provide a concise overview of the principles and results of multimodal pain management regimens as a practical guide for the management of joint arthroplasty patients.

Multimodal denotes administering two or more than two types of medications that work with different mechanisms. The following are the techniques used:

Pre-operative Femoral Nerve Block: Prior to the surgery, a catheter is placed beside the femoral nerve for blocking it. This nerve is located in the upper thigh. Medication is delivered through the catheter for the nerve to be numbed for 24 hours. Thus, pain signals to the brain are blocked. This method reduces the use of narcotics and the consequent side effects.

Patient Controlled Analgesia (PCA): This method is also known as  Pain Pump . An intravenous pump is used to administer pain relief medications, such as oxymorphone or morphine, after the surgery. The control button of the machine could be pressed, by the patient for 6 to 10 times per hour. The machine is used for two post-operative days.

Oral Medications: The oral medications include Non-Steroidal Anti-Inflammatory drugs or NSAID; such as Celebrex which is similar to aspirin, structurally. Alternatively, acetaminophen, such as Tylenol or its equivalent composition, can also be used.

Acetaminophen: It acts on the Central Prostaglandin Synthesis and relieves the patient of pain through multiple mechanisms.

Epidural Analgesia: It produces lower pain scores and involves less time for achieving physical therapy goals. However, this is subject to side effects such as dizziness, urinary retention and itchiness.

Gabapentinoids: These medications include membrane stabilizers such as Gabapentin and Pregabalin.

The objective of multimodal treatments is to provide quick relief to the patient and immediately so. Earlier the rehabilitation, more successful will be the knee replacement surgery.

Multimodal Pain Relief After Total Knee Replacement

A slipped disc is a condition which is characterized by a damaged disc in your spinal cord. The disc is a soft substance present in the spinal cord that cushions the vertebra in the spine. A slipped disc occurs when the soft substance in the disk pops out causing pain in the area. 

There are various preventive measures that you can adopt to prevent a slipped disc from occurring; they are

Keep a check on weight: Being overweight increases the risk of a slipped disc as the pressure on the lower back will be immense. In order to reduce the pressure, maintain optimal levels of bodyweight.
Exercise regularly: Do strength training exercises such as the plank and squats to strengthen the core muscles. This helps in strengthening your lower back strong and prevents slipped disc from occurring.
Maintain a good form while exercising or lifting anything heavy: If you are exercising or simply lifting something heavy, make sure to keep your lower back straight. Lifting heavy weights without proper form may lead to slipped disc as the spine may not be able to bear the stress.
Quit smoking: It is advised to quit smoking as smoking impairs the ability of the disc to absorb nutrients and thus, prevents it from remaining healthy. It may also cause the discs to become brittle and dry.
Maintain a good posture: Remember to keep an uptight posture while walking; keep the spine straight to prevent slouching. Maintain a proper neutral posture while sitting as well. Hunching over your desk while working with your computer may also cause problems in your spine.
Do not sit for prolonged periods: Sitting for extended periods of time may cause problems in your lower back and posture. It may weaken the lower back muscles and lead to complications such as a slipped disc.

Slipped Disc - Things You Must Do To Prevent It!

Causes and symptoms of knee pain

Knee pain is characterized by a feeling of pain in the knee joint caused by injury or overuse. The knee joint consists of small bone structures, the kneecap, supporting ligaments and cartilage of the knee. This joint bears the full weight of the body, which makes it very vulnerable to injury.

Causes of knee pain

Knee pain is usually caused by injuries to the knee such as exposure to a direct force on the knee, abnormal twisting of the knee or falling on your knees. Some causes of knee pain are -

Knee strains and sprains - Overworking the knee joints can damage the tissues of the knee joint resulting in knee sprains and strains

Osteoarthritis - it is condition where the protective cartilage around the kneecap is damaged, resulting in knee pain

Bursitis - Excessive movement of the knee or kneeling down for extended periods can irritate the bursa (a fluid sac below the skin above the knee joint) that causes swelling and pain, thereby giving rise to this condition

Gout - This condition is characterized by the accumulation of uric acid in crystal form around the knee joint, causing inflammation and pain

Tendon disorders - Tendons connect the muscles to the bones, and overworking the knee can cause the tendons around the knee to become sore and painful

Kneecap dislocation - Injuries may cause the kneecap to shift out of its position, this causes swelling and pain in the knee joint

Symptoms of knee pain

Severe knee pain can restrict movements such as walking or standing. The symptoms vary according to the extent of the damage suffered by the knee. Most common symptoms of knee pain are problems in climbing stairs, inability to extend the knees, limping and swelling of the knee joint. In some cases, knee pain may also cause fever.

Causes and Symptoms of Knee Pain

A stinging pain in the neck that makes you feel broken from the neck joint could be a reason to worry. It is often accompanied by an aching head or a throbbing shoulder joint. Neck pain, such as this occurs due to an injury in the area resulting from sudden back and forth movement of the neck. It is referred to as whiplash as the nature of the pain and subsequent discomfort resembles the snapping of a whip. The pain is more like a sprain, but not exactly so. This can affect athletes or even any person in general who has faced an accident in recent past. Whiplash is characterized by a tearing of ligaments and tendons that connect one bone to another.

Causes of whiplash:

1. Sports that involve contact- any extracurricular activity involving collisions or other forms of physical contact can cause neck injuries. Football and rugby players frequently suffer from whiplash.

2. Road accidents- public transport has a host of disadvantages. Reckless driving can make the tendons of your neck tear. Auto accidents cause immense strain on your neck; it can also lead to whiplash.

3. Any kind of physical abuse- if you have gotten into a violent fight with someone your neck could suffer from a whiplash. Instances of physical abuse where the neck is jerked or punched at can also result in neck strains. Domestic violence often leads to instances of neck strains.

Symptoms related to this condition:

1. You may or may not suffer from tinnitus. Tinnitus is a physical disorder where you hear ringing sounds. It is quite distracting.
2. Your vision might get blurry.
3. You can experience irregular sleep patterns.
4. You can find it hard to concentrate on any one thing for more than a while.
5. You can grow irritable at the drop of a hat.
6. Your memory may fail you. You might find it next to impossible to trace back a day's activity.

Some of the other direct symptoms are:

1. Your neck might turn stiff preventing you from moving it left, right, up or down.
2. Pangs of pain can be felt in and around your shoulders.
3. Your upper arms can grow numb and tender.
4. Your head can spin repeatedly or you could feel dizzy.
5. Whiplash can also result in serious fatigue.

All About Whiplash

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