Muscle sprains and ligament tears are one of the most common injuries that medical practitioners encounter on a regular basis. These injuries are painful and can also limit one s movement, needless to say. However, there are simple things that can be done as soon as the injury happens so that the impact of the injury can be reduced, the symptoms minimised, and recovery improved.

A sprain is a tear of the ligament. The ligament is responsible for connecting the tissue strands that connect the bone to the muscle. When this sprain affects the muscle or even the tendon, it is known as a strain.
Sprains are very common and can occur due to a fall, twist, or impact. Most commonly affected areas are the ankles and wrists. Sprains happen when there is a pull or a twist of the ankle or the joint. This is very common in athletes and can be caused by repetitive motions in the knees, wrists, elbows, etc.

The most common symptom is pain, swelling, limited movement, and sometimes bruising. The degree of these injuries depends on its severity. The most common ways to treat such injuries are as follows.

RICE therapy: RICE is an acronym for rest, ice, compress, and elevate. Rest the affected area immediately by stopping any further activity. Ice the area using an ice wrap, with the ice cubes wrapped in a towel or a cotton cloth. Repeat this exercise if possible for every 20 minutes. This will reduce the swelling and pain. Compress the area using a sling or a wrap. This will help in reducing the swelling. Elevate the affected area if possible above the heart. This will help control the blood flow and thereby reduce the swelling and pain.
Pain control: If there is pain that needs medication, go for the non-steroidal drugs like ibuprofen or acetaminophen. If it is a child that is injured, it is advisable to give non-aspirin ones.
Seek professional help: Most sprains can be self-limiting over a couple of days. However, it is advisable to seek medical help if there is significant pain, swelling, or numbness, open wounds or bruises, or inability to move the joint.
The doctor may decide to do the following.

Scanning or imaging to rule out any internal hard/soft tissue injury like fracture or tear
Immobilise the joint with a splint or a cast
Start physical therapy if there is severe pain and immobility
Surgical repair if there is a ligament injury
A word of caution to athletes or people who are very active physically is to go easy on the joint. In an eagerness to quickly get back to their routine, more and severe damage may be caused. This can be avoided by allowing time for complete healing.

Muscle & Ligament Sprain - Tips To Help You Deal With It!

As life expectancy is increasing so is the incidence of vertebral body (VB) fractures now being the commonest fracture of the body. PVP is an established interventional technique in which bone cement is injected under local anaesthesia via a needle into a fractured VB with imaging guidance providing instant pain relief, increased bone strength, stability, decreasing analgesic medicines, increased mobility with improved quality of life and early return to work in days.

In this era of minimally access surgery replacing open surgeries, PVP is a novel procedure & should be in the first line of management in place of conservatism or major spine surgery for painful uncomplicated compression fracture spine.

Morbidity & consequences of spinal fracture:

Traumatic VB is a painful condition requiring bed rest restricting daily activities markedly
Left untreated it can cause DVT, increase osteoporosis, loss of VB height, respiratory & GI disturbances, emotional & social problems secondary to unremitting pain, loss of independence with high cost of rehabilitation.
High risk of primary or consequential damage to neural, bony or disc element
Increased wedging, deformity & increase incidence of adjacent VB
Chronic pain of altered spine mechanics
Uncomfortable braces & sleep disturbance because of pain & discomfort with its sequels.
Cost of surgery and hospital treatment
Cost of implants
Phobia of surgery
Prolonged recovery period & Extensive rehabilitation
Changed spinal mechanics & transition syndrome
Major surgery & anesthesia with its own complications
Results / Outcome

PVP is a novel procedure with high benefit to risk ratio, which is highly underutilized in relation to the high prevalence of the vertebral.
Different studies show an immediate pain relief in (85   90)% of patients with low complication rate ranging from (1-5)% depending upon the type of lesion.
PVP does augment height of VB but ideal would be kyphoplasty
Patient is either off medicine or on reduced doses.
Patient feels so well that he almost forgets if he had VB

Percutaneous Vertebroplasty (PVP) is an emerging interventional technique in which surgical polymethyl methacrylate bone cement is injected under local anaesthesia via a large bore needle into a vertebral body (VB) under imaging guidance providing increased bone strength, stability, pain relief, decreased analgesics, increased mobility with improved QOL and early return to work. Started in 1984 by Galibert PVP is done in host of indications.

Senile osteoporotic compression remains the commonest Indication. Other indications are Metastatic VB, Multiple myeloma VB, VB haemangioma, Vertebral osteonecrosis & for strengthening VB before major spinal surgery. The benefit has been extended to the traumatic stable uncomplicated VB compression (VCF) which is commoner in younger age group with active life profile and prime of their career where strict bed rest and acute or chronic pain are unacceptable and they are more demanding for proactive treatment approach so as to be back to work ASAP.

Discovering the fact that VB is the commonest of body, its incidence >the hip, it becomes imperative to take it more seriously. With increasing life-span there is more of aged osteoporotic population, more so due to sedentary indoor lifestyle and post menopausal osteoporosis. Diabetics, smokers & alcoholics are at higher risk of developing osteoporosis. I have seen such alcoholic patient developing six spine fractures in just three months time from a single fracture being on complete bed rest.

Quick fix of fracture spine makes patient walk back same day instead of bed rest of months together avoiding morbidity & mortality of prolonged bed rest, making bedridden patient walk, in a way bringing patient back to normal life.

In this era of MAS replacing open surgeries, PVP is a novel procedure & should be in the first line of management in place of conservatism or major spine surgery for painful uncomplicated compression.

Morbidity & consequenses of spinal 

Traumatic VB is a painful condition requiring bed rest restricting daily activities markedly.
Left untreated it can cause DVT, increase osteoporosis, loss of VB height, respiratory &
GI disturbances, emotional & social problems secondary to unremitting pain, loss of independence with high cost of rehabilitation.
High risk of primary or consequential damage to neural, bony or disc elements.
Increased wedging, deformity & increase incidence of adjacent VB
Chronic pain of altered spine mechanics.
Uncomfortable braces & sleep disturbance because of pain & discomfort with its sequels.
Morbidity and complication of spinal surgery 

Cost of surgery and hospital treatment
Cost of implants
Phobia of surgery
Prolonged recovery period & Extensive rehabilitation
Changed spinal mechanics & transition syndrome
Major surgery & anesthesia with its own complications
Preparation & Procedure:
X-ray spine in a/p & lat view. CT is more informative of bone & morphology. MRI is good for soft tissue injuries. Ask for pedicle size in all dimensions and construct a 3D image aiming needle placement and cement filling in scan room itself as rehearsal of PVP. This reduces operative time & gives better results. Conventionally PVP is done by hammering the vertebroplasty needle through the bone. Here we use light weight drill to bore through the vertebra. It is important to set the needle at exact entry site & side with right trajectory aiming the defects.

In lateral view needle should go through middle of the pedicle going up to anterior 1/3 of VB. In P/A view the needle can be in midline or paramedian depending upon & if uni/bipedicular approach is planned. Approach varies as per location of vertebra, anterolateral in cervical, costotransverse/parapedicular in thoracic & transpedicular in lumbar vertebra.

Do bone biopsy if there is any doubt about lession. Do dye test (vertebral venography). Make cement more radiopaque by adding barium /or tungsten. Inject cement with 1or2 ml luerlock syringes strictly under fluoroscope in lateral view & cross checking in P/A view. Stop injecting either there is adequate filling or at the first sight of ectopic cement leak. Keep sample cement to see for hardening. Remove needle with rotational movement before cement hardens.

Pain relief is by virtue of different mechanisms postulated :

Cementing of fragments.
Thermal neurolysis of VB nerve ending due to heat of polymerization.
Washing away of nociceptor chemicals.
Neurolytic action of liquid monomer.
By allowing early ambulation decreasing pains of immobility & bed rest.
Complications 

PVP is generally safe with low risk.
Ectopic cement leak is frequent but generally inconsequential.
Outcome 

PVP is a novel procedure with high benefit to risk ratio, which is highly underutilized in relation to the high prevalence of the vertebral
Different studies show an immediate pain relief in (85   90)% of patients with low complication rate ranging from (1-5)% depending upon the type of lesion.
PVP does augment height of VB but ideal would be kyphoplasty.
Patient is either off medicine or on reduced doses.
Patient feels so well that he almost forgets if he had VB

Vertebroplasty (PVP) / Kyphoplasty - Approach To Management Of Vertebral Body Fractures!

Have you tried one product after another during the dry weather and are still left with dry and itchy skin. Then your skin care product is to be blamed. Creams, lotions and oils all essentially perform the same job of moisturizing your skin. It is how they do it that is different.

There is a wide range of choices available in the market for all three products with individual variations in ingredients including types of oils like coconut, lavender, jojoba, etc., types of value proposition like 24-hour moisture lock, or intense hydrating care and flavors like rose, strawberry and even chocolate that leaves you smelling great.

The main difference between a cream and lotion:
The main difference between the two besides additives is their oil to liquid ratio. Lotions and creams, both contain oils and water. In lotions the proportion of water is more compared to oil. So it is more 'liquid' in nature and is easy to spread on the skin. Creams on the other hand, are thicker because of their higher oil content. They can typically be more 'greasy' in nature because of their consistency.

Choosing between the two:
Lotion and creams, both will do the trick, but it will depend on what you need and when you use it. Give a good thought to your skin. Is it always dry or only during certain times of the year. If your skin dries easily and you can see a white line if you scratch with your nail, you'll need a cream that absorbs more slowly and has benefits that stay longer.

Applying cream then creates a layer of oil that locks the moisture in your skin. The water does not evaporate, and your skin stays hydrated. Lotions are easy to spread on the skin. If your skin is already soft and supple and you simply need a layer to keep the dryness at bay, a lotion is a good choice for you.

Use both lotion and cream:
Morning, before bed, after baths or repeatedly throughout the day? The time you plan on using a moisturizing product will play a part in determining which type you choose. Creams are great to use right after a bath when the skin is soft after absorbing moisture. The cream then creates a protective layer of oil, which allows the skin to stay hydrated longer.

Creams are also great to use during bedtime when you don't have to worry about getting an oily look on your face or body. Lotions are best if you need to reapply during the day, for instance,  you wash your hands and face and need to dab on some quick moisture.

Should I Use A Lotion Or A Cream For Dry Skin?

Proper rest and a sound sleep are prerequisites for keeping the physical and mental health in good shape. Difficulty to fall asleep or having a disturbed and interrupted sleep day after day can be a nightmare. In addition to the immense physical exhaustion and fatigue, insomnia can leave a person stressed out mentally which is bound to have an impact on their professional as well as personal lives and commitments. Over the last few years, incidences of insomnia have been rising at an alarming rate.

Insomnia does not always exhibit similar symptoms in all the affected individuals. In some, the condition may be short-term, lasting for a few days or weeks (Transient Insomnia). In some, the problem may appear on and off (Intermittent Insomnia). In extreme cases, insomnia and the associated discomfort may continue for months (Chronic Insomnia). In some instances, insomnia appears as a symptom associated with health conditions such as diabetes, Alzheimer's disease, Parkinson's disease, heart ailments, GERD, to name a few. Severe stress and anxiety along with unhealthy dietary and lifestyle habits are also known to play a pivotal role resulting in insomnia.

The goodness of Unani in treating Insomnia
Unani is one of the ancient forms of medications that has gained immense worldwide appreciation due to its effectiveness in treating various threatening and complicated health conditions including insomnia. In case of Insomnia, the Unani treatment involves a combination of Dietotherapy, Regimental Therapy, and Pharmacotherapy. The main aim of the Unani treatment is to treat insomnia by restoring the balance between the four humors namely, Blood (Dum), Yellow bile (Safra), Phlegm (Balgham), and Black bile (Sauda). It is these four humors that not only nourish the body and the vital organs but also keeps the various health conditions at bay.

With Dietotherapy or Ilaj Bil Ghiza, the aim is to bring the necessary dietary changes to deal with insomnia. The daily intake of banana, walnuts, kale, lettuce leaves, sweet potatoes, herbal tea (especially Chamomile), grapefruits, turkey and red meat (in moderation), whole grains, go a long way to improve the condition of insomnia. People with insomnia should, however, try and avoid processed foods, cheese, pork, aerated, caffeinated and alcoholic drinks, as much as possible. Unani also suggests that the dinner should be light and taken at least 2-3 hours before going to sleep.

Pharmacotherapy or Ilaj Bil Dawa involves the use of Unani medicine to alleviate the discomfort. Some of the medicines often used in treating insomnia includes:

Rogan Kaddo
Rogan Badaam
Hareera Magaz Badaam
To treat insomnia, a Unani specialist will also carry out a detoxification of the body, known as Regimental Therapy or Ilaj Bil Tadbeer, the detoxification is brought about through

Exercise (Riyazat)
Massages (Dalk)
Leeching (Taleeq-e-Alaq)
Venesection (Fasd)
Turkish bath (Hammam)

Role Of Unani Medication In Insomnia Treatment

Kidneys and Kidney Diseases

The kidneys are organs which aim to filter out huge amounts of blood to produce 1-2 quarts of urine. They also perform the task of filtering out the excessive waste materials from the blood stream.

However, there can be cases when infection enters your bloodstream and affects your kidneys. This can cause serious kidney diseases such as cysts, stones and cancer.

Diabetes: What is it and how does it affect your kidneys?

Diabetes is a condition which is caused when the pancreas does not produce enough insulin (Type 1 Diabetes) or when your body doesn t react to the insulin in a normal way (Type 2 Diabetes). The sugar in your food cannot be broken down effectively which can result in problems in your kidneys.

The glucose content in your blood causes considerable damage to the filters in your kidneys. When the filters in the kidney are damaged, a particular protein called albumin releases into your blood and your urine. The damage in the kidneys can affect the kidney function and obstruct the filtering out of wastes from the blood.

Thus, diabetes could be attributed as a major cause of kidney disease.

Managing Diabetes-

Managing diabetes is crucial to avoid kidney diseases. However, diabetes doesn t have a proper cure which is why it is even more important to take care of your health in such cases.

Here are a few ways in which diabetic patients can aim to be healthy and prevent kidney diseases:

Quit Smoking: Smoking increases diabetic complications such as nerve damage and heart strokes which can in-turn affect your kidneys  functions adversely. Hence, it is advisable to quit smoking to keep diabetes under control.

Healthy Meals: Opt for healthy meals which are balanced and packed with nutrients as they help in increasing the insulin function in your body. Foods such as green leafy vegetables, legumes, fruits and lean meat should be included in your meals.

Engage in Physical Exercise: A diabetic person needs to engage in physical exercise in order to maintain a healthy lifestyle. Obesity can increase your chances of complications and can be detrimental to your kidneys as well.

How Does Managing Diabetes Help Your Kidneys?

Skin rashes are a regular problem in both men and women. These can be caused by a variety of factors, both internal and external to the body. However, rashes on the genitals and the groin area can be very problematic, painful and embarrassing. Some could be caused due to problems within the body while some could be contracted externally such as rashes caused by sexually transmitted diseases.

Types of groin rashes in women
Women tend to be affected by rashes as the genital area along with the innerwear tends to be a fertile breeding ground for microorganisms. Infections can also grow uninhibited if medications or appropriate precautions aren t taken. Some of the common types of groin rashes in women along with their causes are mentioned below.

Chaffing or intertrigo: This is one of the most common forms of rashes, which are both painful and can be unsightly as well; these look like inflamed spots. This is primarily caused by the rubbing of the inner thighs against each other.
Jock itch: Although more commonly associated with men, Jock itch can affect women as well. Medically known as  tinea cruris , jock itch occurs when the moisture from your sweat gets trapped within the folds or creases of skin in the groin area thus, encouraging fungi (dermatophyte fungi) to grow there. It is more common among obese people or if you happen to wear tight clothing during exercise. The rash will look like raised papules, which are red in color and quite itchy.
Infections caused by the imbalance or proliferation of fungi such as yeast: Yeast infections caused by fungi candida usually occur when the pH (the alkaline to acidity) balance of the vagina is disrupted. This will not only result in vaginal discharge, itching pain and discomfort, but will also result in rashes around the vagina along with swelling.
Contact rashes: Dermatitis may be transferred either through skin to skin contact or by using shared utensils and clothing items such as towels. Contact dermatitis or skin infections look like red rashes and can happen anywhere within the body, including the genitals and groin.
Friction rashes: Some rashes occur as a result of adverse reactions to items of clothing rubbing against the skin such as jeans or using razors or the use of nylon thongs. These rashes occur due to the body reacting to these and look more like inflammation of the skin.
Rashes caused by STIs and STDs: Certain rashes may develop on a woman s groin as a manifestation of sexually transmitted diseases and infections. Some examples of these are Chlamydia, gonorrhea or syphilis and herpes; just to mention a few. These are usually accompanied by mild to severe pain and can only be cured after a proper consultation with the doctor.
Get to the doctor: Heat rashes, intertrigo and friction rashes usually go away by themselves. Vaginal yeast infections may require topical creams while other forms of bacterial infections can be treated by creams or oral antibiotics after proper consultation with a physician. If the pain is unusual and the rashes tend to persist along with other symptoms, you should immediately visit your doctor for further analysis and treatment.

6 Types of Groin Rashes in Women

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