MY MOTHER IS ABOUT 60 YEARS OLD. SHE IS SUFFERING FROM stiffness of knee joints along with weakness of calf muscles (muscles of legs). We have consulted in orthopaedic surgeon, he advised active exercises. I want to know about the active exercises she can do.
Active exercises may be given for three purposes, to mobilise joints, to strengthen muscles and to improve coordination or balance. In mobilising exercises the patient's active efforts to move the joint may be assisted by gentle pressure by the physiotherapist's hand (assisted active exercises). In muscle strengthening exercises the patient is encouraged to contract the weakened muscles against the resistance of weights or springs, the resistance being increased as the muscles gain power. Exercises to improve coordination are of particular importance in cerebral palsy.
IAM A 27- YEAR- OLD WORKING WOMAN AND TWO MONTHS pregnant. This is my first pregnancy. I want to know the bodily changes during the entire phase of pregnancy. Breast changes (enlargement, vascular engorgement, colostrum), abdominal enlargement, cyanosis of vagina and cervical portion (about the seventh week), softening of the cervix (seventh week), softening of the cervicouterine junction ( eighth week), generalised enlargement and diffuse softening of the corpus (after eighth week). The uterine fundus is palpable above the pubic symphysis by 12- 15 weeks from the last menstrual period ( LMP) and reaches the umblicus by 20-22 weeks. Foeatel heart tones can be heard by Doppler at 10-12 weeks of gestation and at 20 weeks with an ordinary foetoscope.
MY DAUGHTER IS 28 YEARS OLD AND WORKING. RECENTLY she has developed fear of open places and public areas. We have consulted a psychiatrist. He told us that she is suffering from agoraphobia and advised medicine and psychotherapy. I want your opinion about the disease.
Agoraphobia is a phobic disorder. Phobic ideation can be considered a mechanism of displacement in which patients transfer feelings of anxiety from their true object to one that can be avoided. However, since phobias are ineffective defence mechanisms, there tends to be an increase in their scope, intensity and number. Social phobias are global or specific, in the former, all social situations are poorly tolerated, while the latter group includes performance anxiety or well delineated phobias. Agoraphobia ( fear of open places and public areas) is frequently associated with severe panic attacks. Patients often develop the agoraphobia in early adult life, making a normal lifestyle difficult.
MY DAUGHTER IS 6 YEARS OLD AND DEVELOPS Itching and redness of skin when exposed to the sun. We have consulted a skin specialist, who told us that she is suffering from photosensitivity disorders and advised sunscreens. I want to know about photosensitivity disorders and sunscreens.
Protection from ultraviolet light should begin at birth but will reduce the incidence of actinic keratosis and some nonmelanoma skin cancers when initiated at any age. The best protection is shelter, but protective clothing, avoidance of direct sun exposure during the peak hours of the day and the assiduous use of chemical sunscreens are important. Estimates are that if fair children were to use such sunscreens regularly, their lifetime risk of skin cancer might be reduced by 75 per cent. A number of highly effective sunscreens are available in cream, lotion and nongreasy gel and liquid formulations. Fair complexioned persons should use a sunscreens with an sun protective factors of at least 15 and preferably 30- 40, every day. Sunscreens with high sun protective factor values, more than 30 afford some protection against ultraviolet A as well as B light exposure and may be helpful in managing photosensitivity disorders.
Y MOTHER IS ABOUT 70 YEARS OLD AND USUALLY TAKES medicines for anxiety and depression and suffering from constipation. We have consulted a physician, he told us that this is because of medicines of anxiety and depression and advise some diet and prophylactic measures. What is your opinion?
Given the frequent use of opioids (used in anxiety and depression medication), poor dietary intake and physical inactivity, constipation is a common problem among the elderly. Clinicians must inquire about any difficulty with hard or infrequent stools. Constipation is an easily treatable cause of discomfort and distress. Constipation may be prevented or relieved if patients can increase their activity and their intake of dietary fibre and fluids.
Simple considerations such as privacy, undisturbed toilet time and a bedside commode rather than a bedpan may be important for some patients. For patients taking opioids, anticipating and preventing constipation is important. A prophylactic bowel regimen of stool softeners ( docusate) and stimulants should be started when opioid treatment is begun. Lactulose, sorbitol, magnesium citrate and enemas can be added as needed.