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I am a man of 55 years of age and could not have a sound sleep at night felling anxiety and the negative thoughts remains in mind. I am taking sleeping pills for the last about 10 years, what should I do.
I have pain in right leg and small very light whight color patch on my right leg and have pain and pain right feet down siden, I got this after hole body itching from 10 months, please do sir.
I am a 24 year male I am married but I use to masturbate daily is it ia harmfull for health I am having hyper thyroid. High blood pressure.
I am 25 year old male from india ,had a condom protected oral sex with a female sex worker .she looked ok did not have any visible lesions or sores on skin or on lips .she put condom on my penis and rolled back till the base ,held the base from her grip and performed oral on me for about 3-4 min after that she removed it easily and we did not indulge in any other for of sex ,the condom remained intact and ok as far a I remember also I did not have any cut or open wound on my penis neither did I have any std bcoz that was my first and last time I did it so far. After this act roughly in the midst of seventh month I had sore throat after eating junk food outside one day followed by high fewer all of this lasted for a day or two I do not remember having any diarrhea. Now 20 days ago I noticed 3-4 white lesions under my tongue got them checked by physician who prescribed me bifilac which took for two days also I was having constipation for past 3-4 days before going to doctor then I felt some problem the third day with my throat so I visited a ent who prescribed me becelac fort after which I had two small rashes on four day I continue taking the same medicine for a week the rashes grew a little and turned dark brown and purplish and started to fade away eventually soon after I stopped taking it meanwhile I went to another ent he did endoscopy of my throat and told me my throat was fine and that he did not see any palpable LAP only a slight effect of tonsils I took the medicine but did not continue after one day and went back to my physician coz I was more worried about the rash on my elbow he prescribed me bifilac and b -complex again even my mouth ulcers had not gone completely so he gave one ointment to apply also soon after starting to tak bifilac I has a itchy rash on abdomen next day the redness around it shrinked a lil ans a white head bump in the center next 2 days I had two more rashes in similar fashion each on one day gap one on my rib area and another one on my thigh .today I noticed multiple tiny bumps with white center raise suddenly on my rib area near shoulder and neck after a pinch feeling got terrified but soon they started settling down in 2-3 hours .i also have a history of nasal allergies severe sneezing had sneezing problem thrice for 1-2 days ech time in last twenty days following cold due to sitting under ac also had my cbc blood work done twice in same twenty days both seem normal to my physician also tlc count did drop between the two from 11000 to 4900 but remained in reference range doc says report is normal he also asked me for a gi endoscopy .constipation still there though not severe. I did not tell any of the docs about the sexual act .been also to a skin and vd doc she examined and said the skin issues are possible drug reaction I did tell her about my encounter with CSW .been under lot of stress and anxiety for last 20 days do not know what to do really scared .i had protected oral , am I at any possible hiv or any other sti risk .do I need to worry about taking a test or am I worrying for no reason and I should just move on .i would appreciate expert notions from related doctors.
I am suffering from psoriasis for the past 10 years. No relief from so many medications. Problems of scalp and getting lesions on hands and balck marks on fingers. Please advise.
PHYSIOTHERAPY TREATMENT OF HEAD INJURY
The treatment may comprise of the following measures:
IMPROVES ALERTNESS OR AROUSAL THROUGH SENSORY STIMULATION:
The patient who is drowsy or confused need to be stimulated by makes them more alert and awake. The therapist should encourage the patient’s cooperation during the treatment. The main aim is to stimulate the reticular activating system by making the patient sit or even stand in the tilt table.
The therapist should provide tactile, visual, auditory and Proprioceptive stimulation to the patient that will send facilitatory signals to the brain and will enable the alert response to be provoked. Auditory stimulation can be given by speaking to the patient during the course of treatment. Visual stimulation is given by showing familiar faces, objects or movement in the visual field of the patient.
Proprioceptive stimulation by giving traction and approximation at joint structures is very helpful in stimulating the arousal response in the patient.
PREVENTION OF SPASTICITY:
As hyper tonicity generally sets in almost all head injury cases various measures need to be taken to keep them under control. Gentle passive movement, gradual rhythmic sustained stretch, prolonged icing for 20 minutes over the muscles, biofeedback, proper positioning are certain measures that needs to be employed for controlling spasticity.
MAXIMISE THE PATIENT’S FUNCTIONAL CAPACITY:
The main aim of this management is to improve the ROM, improve the control of voluntary movement, strengthening paretic muscles, improve the coordination, balance and teach various safety measures.
The treatment should be wide spread over the periods of time as the patient’s attention span and endurance is very less.
NEUROMUSCULAR TRAINING can be given through the development sequence by inhibiting abnormal movement pattern and by facilitating normal movement pattern.
The patient may give activities like bridging, prone on elbow, on all fours, side lying to sitting, sitting, kneeling, half kneeling, standing and walking.
PROPER DOCUMENTATION is necessary of the entire event through- out the day. Infact the routine of the patient should be maintained in the register and the patient need to be reminded of various activities especially if the patient has memory problems. The patient may be given register with photo and names of various health professional visiting him so that each day’s program can be entered. This will benefit both the patient and his acquaintance to know regarding the activities given to the patient.
USE OF VESTIBULAR BALL while training the patient for crawling, bridging, sitting, balance helps in building the Proprioceptive stimulation and teaches proper control to the patient.
Each task has various subtasks which need to be mastered by the patient so that he learns the actual activity using normal movement combination and performs it with precision. Like for training the patient to get up from bed, he may be taught to do asymmetrical push up with the trunk in partial rotation, then lower leg patterns are incorporated and finally the whole task of get up from sidelying is practiced.
REPETITION ACTIVITIES is key like any other neurological disorders. Ambulation training should always be done in upright position training the patient in each and every phase of the gait cycle. If the patient’s balance is poor then assistance may be used.
FUNCTIONAL ELECTRICAL STIMULATION has been shown more effective than kinetic joint training in certain types of cases. The upper extremity also appeared to use specific synergies for hand use in different positions. Clients often can opens hand in out stretched arm position but will be unable to perform the same action when the elbow is flexed. Some patient with minimal functional deficit in th upeer limb may be given some assistive devices or support for the hand so that they can perform some basic activity like eating, combing, writing, etc. this technique helps the shoulder and other proximal structures to produce appropriate movement sequences for hand use but does not facilitate hand function. The treatment however does provide whole task practice even though some basic component of the function is substituted by other means.
REVERSING TASKS in some patients helps in developing increased control by modifying a task or synergy as well as making the muscle work both eccentrically and concentrically. For instance lowering a glass of water on the table may help the patient in getting th glass close to the mouth by improving motor control of biceps during eccentric contraction.