Premier Hospital

Knee pain or injuries are very common and have numerous causes. Knee pain can emerge from delicate tissue wounds like ligament sprains and muscle strains. Bone conditions like knee joint pain, Osgood Schlatters, and biomechanical dysfunction can also cause knee pain. Treatment can include basic knee mobilization techniques, taping, massages or knee strengthening exercises completely through a careful recovery method after knee replacement or reconstruction.

Physiotherapy can help you overcome the pain and increase your strength and flexibility. A physiotherapist can suggest you a number of treatments and also help you understand your issue and get you back to your everyday routine. Physiotherapists are said to be successful in getting rid of the source of the knee pain by diagnosing a cause. This includes tightness around the knee and treating it with stretching and exercises.

Following are some of the exercises a physiotherapist might generally recommend for knee pain:

1. Hamstring stretch: Stretching keeps you flexible and increases your scope of movement, or how far you can move your joints in different directions. It additionally helps you reduce your chances of injuries and pain. Continuously warm up with a five minute walk first. Lie down when you are prepared to stretch your hamstring. Circle a bed sheet around your right foot, use the sheet to pull the leg up and hold for twenty seconds and then lower the leg. Repeat twice and switch legs.
2. Calf stretch: Use a chair for balance. Bend your left leg. Step back with your right leg and gradually straighten it behind you. Press your left heel toward the floor. You should feel the stretch in the calf of your back leg. Hold for 20 seconds. Repeat twice and then switch legs.
3. Straight leg raise: It helps build muscle strength to give support to the weak joints. Lie on the floor. Twist your left knee, foot on the floor. Keep the right leg straight, toes pointed up. Tighten your thigh muscles and raise your right leg.
4. Quad set: With these, you don't raise your leg. Just tighten the thigh muscles, also called the quadriceps, of one leg at once. Begin by lying on the floor. Keep both legs on the ground, loose. Flex and hold the left leg tense for five seconds and then relax. Do three sets of ten repetitions. Switch legs after every set.
5. Cushion squeeze: This move strengthens your legs from the inside so that they can support the knees. Lie on your back, both knees facing inwards. Place a cushion or a pillow between the knees. Press your knees together, squishing the cushion between them. Hold for five seconds and then relax. Do three sets of ten repetitions. Switch legs after every set.
6. Heel raise: Stand tall and hold the back of a seat for support. Lift your heels off the ground and rise on the toes of both feet. Hold for three seconds. Gradually lower both heels to the ground. Do three sets of ten repetitions.

Knee replacement is a surgery wherein an artificial joint is used to replace a diseased, damaged or worn out knee. This surgery is common among people who fall in the age group of 60-80, but recent trends seem to suggest that younger people are opting for this surgery as well. The lifetime of the artificial knee joint is around 20 years, provided the knee is well cared for.

Why do you need knee replacement?

Most common reason is “high grade osteoarthritis” due to wear and tear of the knee joint. The pre-hospital study of the Knee joint is mandatory and would decide what kind of Replacement is suitable to the patient. If there is diabetes or hypertension associated with this, then it should be controlled well before undergoing surgery. Hemoglobin of at least 10 gm% is required.

If the mobility in your knee joint is reduced leading to impaired functioning of the knee joint, then you might need a knee replacement surgery. You may experience pain while walking, sitting and, in some cases, resting as well.

Some of the common reasons why you may opt for this particular surgery are:

1. Gout, where, small crystals are formed inside the joint.
2. Rheumatoid Arthritis, an autoimmune disorder, wherein the immune system of the body attacks the body’s healthy tissues.
3. Hemophilia, wherein, the blood ceases to clot normally.
4. Injuries to the knee.
5. Disorders that cause unusual bone growth (bone dysplasias).
6. Death of bone in the knee joint following blood supply problems (avascular necrosis).
7. Knee deformity with pain and loss of cartilage.
8. Unusual growth of bones in the knee joint.

Knee replacement surgery is classified into:

1. Partial Knee Replacement: In this surgery, only one part of the joint is replaced.
2. Total Knee Replacement: Total knee replacement surgery involves replacement of both sides of the knee joint.

The usual hospital stay period is around 2-3 days after the surgery is completed. Initially, you will require the help of crutches to walk for at least 2 months. You may also be asked to do gentle knee strengthening exercises. It may take up to 3 months to recover completely from a knee replacement surgery.

Epilepsy is a neurological disease which is characterised by recurring epileptic seizures. These seizures can be brief or can persist for prolonged periods. Vigorous episodes which last long can result in physical injuries such as broken bones. Mention that 6th February is International epilepsy day.

Causes of Epilepsy
The cause of this condition isn’t very evident; however, most medical practitioners attribute epileptic seizures to brain injury, tumours, infections in the brain or birth defects. Some doctors believe that epilepsy is caused due to genetic mutations and is an outcome of abnormal activity of cells in the brain. Other causes for this condition can be alcohol or narcotics withdrawal and electrolyte problems.

Symptoms

1. Repeated seizures
2. Impaired memory
3. Bouts of fainting
4. Short spans of blackout
5. Sudden bouts of blinking and chewing
6. Panic
7. Inappropriate repetitive movements

Types of Seizures
A seizure, also known as fit, is usually a brief episode characterised by uncontrollable jerking movement and loss of awareness due to abnormal neuronal activity in your brain. A collective occurrence of these seizures causes epilepsy.

There are three types of seizures an epileptic person usually encounters.

1. Idiopathic: This kind of seizure has no apparent cause
2. Cryptogenic: The doctors believe that there is a cause for the seizure but cannot detect it
3. Symptomatic: These seizures occur due to a reason.

Treatments

1. Medication: Medication is the most common treatment in case of epilepsy. Drugs taken on a regular basis can stop the seizure partially. But in very severe cases, they seem to have no effect at all.
2. Surgery: For symptomatic seizures which are caused due to abnormal brain function, surgery can be a way to get rid of seizures. In some minor cases, nerve stimulation in the brain and special diets can be prescribed to control the epileptic seizures.

Five facts about epilepsy you need to know:

• Epilepsy is not psychosis or madness and can be treated easily 
• Popular celebraties with epilepsy include Aristotle, Alfred Nobel, Alexander the great, Sir Isaacs Newton, Martin Luther and Julius Caesar etc. 
• Woman with epilepsy can have a normal pregnancy 
• Newer medicines for epilepsy are effective and very safe 
• Surgery can cure epilepsy in some patients.

HIV or the human immunodeficiency virus is the lentivirus which causes HIV infection and leads to acquired immunodeficiency syndrome or AIDS.

The symptoms of HIV vary from person to person. There are three main stages of HIV infections, where each stage has different symptoms.

Here are some facts about the three stages of HIV infections along with the accompanying symptoms.

Acute HIV Infection Stage: This is the first stage of HIV infection and after three to four weeks of becoming HIV infected, people experience symptoms, which are similar to flu. This flu usually does not last more than two weeks.

Symptoms include:

1. Fever
2. Rashes on the body
3. A sore throat
4. Swelling of different glands
5. Headache
6. Joint and muscle pain
7. Improper digestion

These symptoms appear and indicate that the body is reacting to the HIV. Infected cells circulate throughout the blood, and the immune system produces HIV antibodies in order to attack the viruses. This process is termed as seroconversion, and it takes place within 45 days of getting infected. The levels of virus in your blood are quite high during this stage.

Clinical Latency Stage: This is the second stage of HIV infection, which follows the early stage. This stage is also known as chronic HIV stage. During this stage, HIV is active, but is reproduced at a very low level. People in this stage may not receive symptoms related to HIV or may get mild indications.

In case of people who do not take medicines for HIV treatment, this stage lasts for a long period. Some people, however, progress faster through this stage. Medicines should be taken to keep the virus in check. During this stage, people can transmit HIV to others very easily in spite of not experiencing any symptoms. People who are on medication stay suppressed virally and have a low level of HIV in their blood, and the risk of transmission is less.

Symptomic HIV infection or AIDS stage: This is the third stage of HIV infection, which is characterized by severe damage to the immune system of an HIV-virus affected person. A patient is likely to have serious infections and gets bacterial or fungal diseases. The infections are termed as opportunistic infections. The patient is now said to be having AIDS.

The symptoms of this stage are:

1. Loss of weight
2. Diarrhoea
3. Sweating at night
4. Fevers and persistent coughing
5. Problems in the mouth and skin
6. Infections on a regular basis
7. Illness and development of other diseases.

HIV infection affects the body via three stages and leads to AIDS in the third stage. Each stage is accompanied by several symptoms.

What is salt and sodium?

Salt is made of sodium (40% by weight) and chloride (60% by weight). Sodium is a crucial electrolyte in the body. Sodium is an essential nutrient necessary for maintenance of plasma volume and blood pressure, acid-base balance, transmission of nerve impulses and normal cell function.

Different types of salt?

• Table salt or common salt
• Sea salt
• Himalayan rock salt (sendha namak and black salt)

The primary advantages of various types of salts other than common salt is having trace minerals (in very small amounts) and lack of processing and additives.

How salt intake normally?

WHO recommends that adults consume less than 5 g (just under a teaspoon) of salt per day. This goes around 2300mg of sodium per day. But, most Indian people consume too much salt - on average 9-12 grams per day.

What are health hazards of high salt intake?

• Hypertension
• Stroke
• Heart disease
• Kidney disease
• Obesity

How high intake of sodium cause kidney disease?

High salt intake is associated with kidney disease by two mechanisms:

Causing hypertension, vascular injury and proteinuria.

FOOD containing high salts?

Fast foods, preserved and packaged foods like:

• Prickles
• Anchovies
• Soups
• Bread products
• Prawns
• Salted and dry-roasted nuts
• Salt fish
• Smoked meat and fish
• Soy sauce
• Stock cubes

Many snack foods - chips, crackers, and pretzels - contain several hundred milligrams of sodium per serving.

Conditions where low salt is beneficial?

Hypertension, Heart Failure, Kidney disease, Nephrotic syndrome, Kidney stones and Patient on diuretics or ACEi or ARB.

How to reduce sodium (salt) intake?

• Not adding salt during the preparation of food
• Not having a salt shaker on the table
• Limiting the consumption of salty snacks
• Choosing products with lower sodium content
• Remove salt from recipes whenever possible
• Use salt substitutes wisely
• Eat more fresh fruits and vegetables and low-fat dairy
• Use onions, garlic, herbs, spices, citrus juices and vinegars in place of some or all of the salt to add flavour
• Drain and rinse canned beans (like chickpeas, kidney beans, etc.) and vegetables
• Combine lower-sodium versions of food with regular versions. This will not differ much in taste. This works especially well for broths, soups and tomato-based pasta sauces.
• Cook pasta, rice and hot cereal without salt
• Cook by grilling, braising, roasting, searing and sautéing to bring out natural flavors. This will reduce the need to add salt
• Incorporate foods with potassium like sweet potatoes, potatoes, greens, tomatoes.

Influenza is more commonly known as the flu. It is an infection that affects the respiratory system and is caused by the influenza virus. This injection is recommended for kids who are under the age of 6 months. It ensures that the baby is safeguarded from the virus during an influenza outbreak. Since the nature of virus changes year on year, the immunity doesn’t last for more than 1 year. This vaccination is ideally taken during the month of October and November. The effect of the vaccination typically lasts for 6-8 months.

Ideally, kids who have never had a flu vaccination should take 2 vaccinations within 4 weeks. Kids who have received a shot of flu should undertake this vaccination once in a year. This arrangement is ideal up to 9 years of age. Flu shot is extremely important for a kid due to the following reasons:

• It saves a kid from chronic lung and heart disorders such as asthma and cystic fibrosis
• Kids suffering from immune deficiency, cancer, and HIV should take this vaccination to avoid further complication of the existing disease
• Kids suffering from diabetes, kidney diseases, and metabolic disorders should go for this vaccination without a second thought
• Kids suffering from a neurological disorder, haemoglobin deficiency, and anaemia should take this vaccination to refrain from the risk of aggravation of the present disease
• Pregnant women should ideally take it for the safeguarding the fetus

Flu shot should not be taken be taken if:
1. A baby is under the age of 6 months.
2. The baby has thimerosal allergy.

Is flu shot safe?
The flu shot is considered to be very safe. It does not result in flu. Few side effects include:
a. Soreness of the place where the needle is injected. This doesn’t last for more than a couple of day.
b. Body ache and mild fever for the first couple of days after the vaccination is done.
c. There is little to no pain in the place where the injection is injected by the doctor.

What is nasal flu vaccine?
This is an influenza dose that is not injected into the body, but given in the form of nasal spray. Healthy kids above the age of 2 years are fit to get this injection. For those kids who have a history of chronic illness should check with their doctor to go ahead with nasal spray. Each dose is given in each nostril. Like the influenza vaccine, nasal flu vaccine should be undertaken once for those who have already taken this dose once. Kids who have not undergone this vaccination are eligible for 2 dosages each 4 weeks apart from each other.