Spinal fractures caused by trauma represent a serious orthopedic injury. Fractures that occur as a result from a high velocity accident are most commonly in the mid to low back. High velocity accidents are associated with trauma from motor vehicle accidents, a fall from height, or sporting accidents. Patients with high energy trauma or who lose consciousness require urgent emergency evaluation and treatment. The most common symptom of a spinal fracture is moderate to severe pain in the back that is increased with movement.

Fractures of the neck usually occur as a result of high energy trauma and are uncommon in other situations. There are seven bones in the neck and a break in any of those bones may be referred to as a “broken neck.” Any fracture in the neck has serious consequences because the spinal cord runs through the center of the cervical vertebrae. Damage or injury to the spinal cord can result in paralysis or death. All patients with trauma who develop cervical fractures should be evaluated in an emergency room setting.

FRACTURES  :

Low Energy Fractures

People can develop spinal fractures unrelated to trauma; they usually have weakened bones from osteoporosis, tumors, or other medical conditions. Fractures that occur during daily activities are most commonly associated with conditions that may weaken the bone including osteoporosis, spinal tumors or spinal infections. For patients with low energy fractures due to osteoporosis these fractures are called a compression fracture. Treatment options include observation, bracing, and pain management. For some patients a minimally invasive procedure including vertebroplasty and kyphoplasty may improve pain and help to prevent further compression.

Types of Spinal Fractures

There are several types of spinal fractures based on pattern of injury and the extent of spinal cord injury. Below are the more common fractures.

Compression Fracture: This is often caused by osteoporosis or a tumor and rarely has spinal cord or nerve involvement. The front of the vertebra fractures and loses height however the back, posterior, part remains stable. It can be painful or asymptomatic and is usually a stable fracture.

Axial Burst Fraction: This is usually caused from a fall from a significant height, landing on the feet. The vertebra loses height on both the front and back side; depending on the stability of the fracture this may require surgery.

Chance Fracture: This fracture is known as a “seat-belt injury” and is caused by a violent forward flexed injury.  The vertebra is pulled apart, often from a car accident where the upper body is pulled forward while the pelvis is stabilized by a lap only seat belt

PREVENTION

Prevention from high impact accidents can save your life. Always wear a seat belt when riding in a car. Always wear protective equipment when playing sports, riding bicycles, motorcycles or even horses. Obey all regulations in place for your safety. Never dive head first into shallow pool or swimming area.

TREATMENT

Treatment for spinal fractures will depend on the location and type of fracture as well as other the amount of neurologic compression. Minor fractures can be treated with cervical bracing. More complex fractures or fractures with spinal cord compression may require traction, surgery, or some combination of the above. For patients with neurologic compromise or unstable fractures, surgical intervention may be appropriate in order to stabilize the fracture, remove any nerve compression and assist with healing. For most patients, non-operative treatment is appropriate. Rehabilitation is an essential part to the treatment plan once the spinal fracture has healed. Rehabilitation allows patients to reduce pain and minimize disability with a hopeful full return to their functional level before the injury.

 

Strabismus is a failure of the two eyes to maintain proper alignment and work together as a team.

If you have strabismus, one eye looks directly at the object you are viewing, while the other eye is misaligned inward (esotropia, “crossed eyes” or “cross-eyed”), outward (exotropia or “wall-eyed”), upward (hypertropia) or downward (hypotropia).

Strabismus can be constant or intermittent. The misalignment also might always affect the same eye (unilateral strabismus), or the two eyes may take turns being misaligned (alternating strabismus).

To prevent double vision from congenital and early childhood strabismus, the brain ignores the visual input from the misaligned eye, which typically leads to amblyopia or “lazy eye” in that eye.

According to the American Association for Pediatric Ophthalmology and Strabismus, approximately 4 percent of the U.S. population has crossed eyes or some other type of strabismus.

Strabismus Symptoms And Signs

The primary sign of strabismus is a visible misalignment of the eyes, with one eye turning in, out, up, down or at an oblique angle.

When the misalignment of the eyes is large and obvious, the strabismus is called “large-angle,” referring to the angle of deviation between the line of sight of the straight eye and that of the misaligned eye. Less obvious eye turns are called small-angle strabismus.

Typically, constant large-angle strabismus does not cause symptoms such as eye strain and headaches because there is virtually no attempt by the brain to straighten the eyes. Because of this, large-angle strabismus usually causes severe amblyopia in the turned eye if left untreated.

Less noticeable cases of small-angle strabismus are more likely to cause disruptive visual symptoms, especially if the strabismus is intermittent or alternating. In addition to headaches and eye strain, symptoms may include an inability to read comfortably, fatigue when reading and unstable or “jittery” vision. If small-angle strabismus is constant and unilateral, it can lead to significant amblyopia in the misaligned eye.

Both large-angle and small-angle strabismus can be psychologically damaging and affect the self-esteem of children and adults with the condition, as it interferes with normal eye contact with others, often causing embarrassment and awkwardness.

Newborns often have intermittent crossed eyes due to incomplete vision development, but this frequently disappears as the infant grows and the visual system continues to mature. Most types of strabismus, however, do not disappear as a child grows.

Routine children’s eye exams are the best way to detect strabismus. Generally, the earlier strabismus is detected and treated following a child’s eye exam, the more successful the outcome. Without treatment, your child may develop double vision, amblyopia or visual symptoms that could interfere with reading and classroom learning.

What Causes Strabismus?

Each eye has six external muscles (called the extraocular muscles) that control eye position and movement. For normal binocular vision, the position, neurological control and functioning of these muscles for both eyes must be coordinated perfectly.

Strabismus occurs when there are neurological or anatomical problems that interfere with the control and function of the extraocular muscles. The problem may originate in the muscles themselves, or in the nerves or vision centers in the brain that control binocular vision.

Genetics also may play a role: If you or your spouse has strabismus, your children have a greater risk of developing strabismus as well.

Accommodative Esotropia

Occasionally, when a farsighted child tries to focus to compensate for uncorrected farsightedness, he or she will develop a type of strabismus called accommodative esotropia, where the eyes cross due to excessive focusing effort. This condition usually appears before 2 years of age but also can occur later in childhood. Often, accommodative esotropia can be fully corrected with eyeglasses or contact lenses.

Strabismus Surgery

In most cases, the only effective treatment for a constant eye turn is strabismus surgery. If your general eye doctor finds that your child has strabismus, he or she can refer you to an ophthalmologist who specializes in strabismus surgery.

The success of strabismus surgery depends on many factors, including the direction and magnitude of the eye turn. In some cases, more than one surgery may be required. The strabismus surgeon can give you more information about this during a pre-surgical consultation.

Strabismus surgery also can effectively align the eyes of adults with long-standing strabismus. In many cases of adult strabismus, however, a significant degree of amblyopia may remain even after the affected eye is properly aligned. This is why early treatment of strabismus is so important.

The earlier strabismus is treated surgically, the more likely it is that the affected eye will develop normal visual acuity and the two eyes will function together properly as a team.

Non-Surgical Strabismus Treatment

In some cases of intermittent and small-angle strabismus, it may be possible to improve eye alignment non-surgically with vision therapy.

For example, convergence insufficiency (CI) is a specific type of intermittent exotropia in which the eyes usually align properly when viewing a distant object, but fail to achieve or maintain proper alignment when looking at close object, such as when reading, resulting in one eye drifting outward. Convergence insufficiency can interfere with comfortable reading, causing eye strain, blurred vision, double vision and headaches.

There also is some evidence that suggests CI can cause attention problems and affect academic performance in children. A recent study conducted by Mayo Clinic researchers found that children with exotropia (including convergence insufficiency) at an early age were significantly more likely to develop attention deficit hyperactivity disorder (ADHD), adjustment disorder and learning disabilities by early adulthood.

Certain types of strabismus also have been associated with an increased risk of myopia. Another Mayo Clinic study published in 2010 followed 135 children with intermittent exotropia over a 20-year period and found that more than 90 percent of these children became nearsighted by the time they reached their 20s.

On the bright side, it appears non-surgical vision therapy can be an effective treatment for convergence insufficiency. In a study published in Archives of Ophthalmology, 73 percent of 221 children with symptomatic convergence insufficiency had a successful or improved outcome following a 12-week program of office-based vision therapy combined with eye exercises performed at home.

Sometimes, a strabismus surgeon may recommend a program of vision therapy for a period of time after strabismus surgery to treat amblyopia and minor binocular vision problems that might remain after surgery. In these cases, the term “orthoptics” (“ortho” = straight; “optics” = eyes) rather than “vision therapy” might be used to describe this treatment, which may be provided by an orthoptist working closely with the surgeon rather than by an optometrist.

A corneal ulcer is an open sore on the cornea, the thin clear structure overlying the iris (the colored part of the eye).

Corneal Ulcer Causes

Most corneal ulcers are caused by infections.

• Disorders that cause dry eyes can leave your eye without the germ-fighting protection of tears and cause ulcers.
• Disorders that affect the eyelid and prevent your eye from closing completely, such as Bell’s palsy, can dry your cornea and make it more vulnerable to ulcers.
• Chemical burns or other caustic (damaging) solution splashes can injure the cornea.
• People who wear contact lenses are at an increased risk of corneal ulcers. In fact, your risk of corneal ulcerations increases tenfold when using extended-wear (overnight) soft contact lenses. Extended-wear contact lenses are those contact lenses that are worn for several days without removing them at night. Contact lenses can damage your cornea in many ways.
• Scratches on the edge of your contact lens can scrape the cornea’s surface and make it more open to bacterial infections.
• Similarly, tiny particles of dirt trapped underneath the contact lens can scratch the cornea.
• Bacteria may be on the lens or in your cleaning solutions and, thus, get trapped on the undersurface of the lens. If your lenses are left in your eyes for long periods of time, these bacteria can multiply and cause damage to the cornea.
• Wearing lenses for extended periods of time can also block oxygen to the cornea, making it more susceptible to infections.

Corneal Ulcer Symptoms

• Red eye
• Severe pain
• Feeling that something is in your eye
• Tears
• Pus or thick discharge draining from your eye
• Blurry vision
• Pain when looking at bright lights
• Swollen eyelids
• A white round spot on the cornea that is visible with the naked eye if the ulcer is very large

Corneal Ulcer Treatment – Self-Care at Home

• If you wear contact lenses, remove them immediately.
• Apply cool compresses to the affected eye.
• Do not touch or rub your eye with your fingers.
• Limit spread of infection by washing your hands often and drying them with a clean towel.
• Take over-the-counter pain medications, such as acetaminophen(Tylenol) or ibuprofen (Motrin).

Medical Treatment

• Your ophthalmologist will remove your contact lenses if you are wearing them.
• Your ophthalmologist will generally not place a patch over your eye if he or she suspects that you have a bacterial infection. Patching creates a warm dark environment that allows bacterial growth.
• Hospitalization may be required if the ulcer is severe.

• Because infection is a common occurrence in corneal ulcers, your ophthalmologist will prescribe antibiotic eyedrops. If the infection appears very large, you may need to use these drops as often as 1 drop an hour.
• Oral pain medications will be prescribed to control the pain. Pain can also be controlled with special eyedrops that keep your pupil dilated.

Surgery

If the ulcer cannot be controlled with medications or if it threatens to perforate the cornea, you may require an emergency surgical procedure known as corneal transplant.

Abulia, also known as aboulia, is a state of diminished motivation. In general, abulia refers to a type of apathy that develops as a result of disease, specifically disease that affects the brain. Some people who have abulia are aware of the change in level of motivation, but it is particularly noticeable and upsetting for friends and loved ones.

An individual who experiences abulia may show symptoms that range from subtle to overwhelming in levels of severity, with mutism (not speaking) being the most extreme form.

Abulia is most commonly associated with neurologic or psychiatric conditions. It is estimated that about 20-30% of stroke survivors experience apathy or abulia.

When abulia results from a sudden event, such as a stroke, it may become apparent during or after stroke recovery. When abulia results from a progressive disease, such as Alzheimer’s disease or Parkinson’s disease, it may worsen over time.

Symptoms

There are a number of symptoms of abulia.

Typical symptoms may include any combination of the following:

• Apathy- lack of interest or motivation in getting things started or in joining activities. Not enthusiastic about getting things done. Difficulty initiating or completing projects or important tasks.
• Disinterest in things that are going on or in participating in activities or events.
• Passivity
• Lack of opinion or lack of expression of opinion about preferences
• Asocial- lack of interest in other people, lack of interaction with others, limited communication with others, avoiding others.
• Extreme quiet or muteness

• Physical slowness of movement
• Lack of spontaneity
• Emotionally remote
• Difficulty in making decisions or plans, indecisiveness
• Chewing food for long periods of time without swallowing

Causes

Brain damage or dementia can interfere with normal functioning in the brain, resulting in abulia.

Damage to the nerve circuits of the frontal lobes of the brain that impact the dopaminergic system, is thought to be the cause of abulia. The dopaminergic system describes the system of chemicals produced in the brain that provide positive feelings of happiness and satisfaction. Thus, it is possible that once positive feedback is disrupted, there is little incentive to try to attain things that make a person ‘happy.’

Most people who experience and show symptoms of abulia have experienced one of the following conditions:

• Stroke
• Huntington’s disease
• Schizophrenia
• Acquired brain injury- from trauma, cancer or infection
• Alzheimer’s disease
• Vascular dementia
• Lewy body dementia
• Parkinson’s disease
• Frontotemporal dementia

Difference From Depression

While they share some features in common, abulia and depression are not the same. Abulia is clinically distinct from depression in that people living with abulia typically do not exhibit signs of sadness or negative thoughts. Instead, they exhibit a lack of concern about their condition or about the world around them.

Establishing the difference between the two conditions and getting an accurate diagnosis is important because abulia does not improve with antidepressant medications, while people who have depression should generally expect to experience improvement of symptoms with antidepressants.

Diagnosis

You might be wondering whether you have abulia or depression or whether your friend, coworker or loved one has abulia or depression. You should start by seeking medical attention so that the symptoms and signs can be carefully evaluated.

The diagnosis of abulia may take some time. Abulia is diagnosed through a medical history that details the feelings and actions of the person who might have abulia, as well as a history of the observations make by friends and loved ones. Your doctor may ask further questions and make clinical observations during the office visit. In some cases of abulia, diagnostic imaging with a Brain CT scan or Brain MRI scan can reveal localized brain lesions such as stroke, one of the main causes of abulia.

Treatment

There are some medical treatments available for the treatment and management of abulia. Medications that have an effect on the body’s dopaminergic system, which is disrupted in abulia, have shown positive results when it comes to objective symptoms of abulia.

Cognitive rehabilitation can help in optimizing thinking skills, which may improve abulia. Physical therapy can help with initiating physical activity, possibly increasing motivation in people who are affected with this condition. Counseling and family counseling can improve communication and help in dealing with abulia.

CAUSES:

Whiplash occurs when the muscles in your neck suffer a strain because of a rapid movement backward and then forward. The sudden motion causes your neck’s tendons and ligaments to stretch and tear, resulting in whiplash.

Symptoms:

What does whiplash feel like?

How is whiplash diagnosed?

Treatment for whiplash:

Complications associated with whiplash

By the time you sign up for back surgery, your doctor will probably have tried a number of treatments to ease your back pain. While there are no guarantees the operation will provide relief, there are lots of options. Learn as much as you can about back surgery ahead of time. The more you know, the better the choice you’ll make.

What Are the Benefits?

Often, the result is more than just a drop in pain. You may find:

• You can move around better.
• You’re more physically fit.
• Your mood improves.
• You don’t need to take as much pain medicine.
• You can go back to work.
• You’re more productive at work

Risks:

That said, any operation will have some degree of risk, including:

• Reaction to anesthesia or other drugs
• Bleeding
• Infection
• Blood clots, for instance in your legs or lungs
• Heart attack
• Stroke
• Herniated disk
• Nerve damage, which can lead to weakness, paralysis, pain, sexual dysfunction, or loss of bowel or bladder control

The odds that something could go wrong go up for people with certain health conditions. They also vary by type of surgery. Part of your surgeon’s job is to identify potential problems. So talk it over before you head to the OR.

Each type comes with its own risks and benefits.

Spinal fusion. This is the most common surgery for back pain. The doctor will join spinal bones, called vertebrae, together. This limits the motion between them and how far your nerves can stretch. But it probably won’t limit your activity. It’s rare, but the bones don’t always fuse completely. Smoking can make this more likely. If it happens, you may need another operation to fix it.

Laminectomy. In this procedure, a surgeon removes parts of the bone, bone spurs, or ligaments in your back. This relieves pressure on spinal nerves and can ease pain or weakness. It can make your spine less stable. If that happens, you’ll probably need a spinal fusion. Doctors sometimes do the two procedures together.

Foraminotomy. The surgeon cuts away bone at the sides of your vertebrae to widen the space where nerves exit your spine. The extra room may relieve pressure on the nerves and ease your pain. Like a laminectomy, this procedure can also make your spine less stable. So the surgeon may do a spinal fusion at the same time. That’ll increase the amount of time you need for recovery.

Diskectomy. Sometimes a disk, the cushion that separates your vertebrae, can slip out of place, press on a spinal nerve, and cause back pain. In a diskectomy, the surgeon removes all or part of the disk. He may have to make a big cut in your back, or he may be able to do it through a small one. Sometimes it’s part of a larger surgery that includes laminectomy, foraminotomy, or spinal fusion.

Disk replacement. A surgeon removes the damaged spinal disk and inserts an artificial one between your vertebrae. Unlike fusion, this lets you continue to move your spine. Recovery time may be shorter than for a spinal fusion, too. But there is a slight chance the new disk could slip or fall out of place and require repair.

Interlaminar implant. The surgeon implants a U-shaped device between two vertebrae in your lower back. It helps keep the space between them open and eases pressure on your spinal nerves. It can be done at the same time as a laminectomy. Unlike spinal fusion, the implant provides stability and lets you move your back almost like normal. You may not be able to bend backward as easily in that area.

List of Hospitals which is giving treatments for International Patients under Global Treatments Services P. Ltd., Bangalore are given below:

 

Dumping syndrome is common after gastric surgery. It is a group of symptoms that may result from having part of your stomachremoved or from other surgery involving the stomach. The symptoms range from mild to severe and often subside with time. Although you may find dumping syndrome alarming at first, it is not life threatening. You can control it by making changes in what and how you eat. By controlling dumping syndrome, you will also be avoiding the foods that tend to make you gain weight.

Causes of Dumping Syndrome

After gastric surgery, it can be more difficult to regulate movement of food, which dumps too quickly into the small intestine. Eating certain foods makes dumping syndrome more likely. For example, refined sugars rapidly absorb water from the body, causing symptoms. Symptoms may also happen after eating dairy products and certain fats or fried foods.

Dumping Syndrome: Symptoms of the Early Phase

An early dumping phase may happen about 30 to 60 minutes after you eat. Symptoms can last about an hour and may include:

• A feeling of fullness, even after eating just a small amount
• Abdominal cramping or pain
• Nausea or vomiting
• Severe diarrhea
• Sweating, flushing, or light-headedness
• Rapid heartbeat

 

 

Dumping Syndrome: Causes of the Early Phase

Symptoms of an early phase happen because food is rapidly “dumping” into the small intestine. This may be due to factors such as these:

• The small intestine stretches.
• Water pulled out of the bloodstream moves into the small intestine.
• Hormones released from the small intestine into the bloodstream affect blood pressure.

Dumping Syndrome: Symptoms of the Late Phase

A late dumping phase may happen about 1 to 3 hours after eating. Symptoms may include:

• Fatigue or weakness
• Flushing or sweating
• Shakiness, dizziness, fainting, or passing out
• Loss of concentration or mental confusion
• Feelings of hunger
• Rapid heartbeat

Dumping Syndrome: Causes of the Late Phase

The symptoms of this late phase may happen due to a rapid rise and fall in blood sugar levels. The cause of this rapid swing in blood sugar may be worse when eating sweets or other simple carbohydrates.

If you have not already been diagnosed with the dumping syndrome, and you have confusion, dizziness, rapid heartbeat, or fainting, get immediate medical help.

Dumping Syndrome Treatment

Many people find that taking steps like these greatly reduces symptoms of dumping syndrome.

Foods to avoid. Avoid eating sugar and other sweets such as:

• Candy
• Sweet drinks
• Cakes
• Cookies
• Pastries
• Sweetened breads

Also avoid dairy products and alcohol. And avoid eating solids and drinking liquids during the same meal. In fact, don’t drink 30 minutes before and 30 minutes after meals.

Foods to eat. To help with symptoms, also try these tips:

• Use fiber supplements, such as psyllium (Metamucil or Konsyl), methylcellulose (Citrucel), or guar gum (Benefiber).
• Use sugar replacements, such as Splenda, Equal, or Sweet’N Low, instead of sugar.
• Go for complex carbohydrates, such as vegetables and whole-wheat bread, instead of simple carbohydrates, such as sweet rolls and ice cream.
• To prevent dehydration, drink more than 4 cups of water or other sugar-free, decaffeinated, noncarbonated beverages throughout the day.

How to eat. Here are some other ways to lessen symptoms of dumping syndrome:

• Eat five or six small meals or snacks a day.
• Keep portions small, such as 1 ounce of meat or 1/4 cup of vegetables.
• Cut food into very small pieces. Chew well before swallowing.
• Combine proteins or fats along with fruits or starches. (For example, combine fruit with cottage cheese.)
• Stop eating when you first begin to feel full.
• Drink liquids 30 to 45 minutes after meals.
• Reclining after eating may help prevent light-headedness.

When to Call the Doctor About Dumping Syndrome

It is important to manage dumping syndrome so you stay well-nourished and don’t lose too much weight. Talk to your health care provider about any symptoms you have and what else you can do. In some cases, medication or surgery may be needed to help correct the symptoms of dumping syndrome.

If you’ve received the news that your lung contains something “suspicious,” this may be a source of great distress. The first thing that may come to mind is a dreaded word: cancer. In many cases, though, a lung nodule turns out to be benign. This means that it isn’t cancer. A hard part is waiting and not knowing. Here’s information that may make your wait just a little bit easier.

What Are Benign Lung Nodules and Benign Lung Tumors?

A nodule is a “spot on the lung,” seen on an X-ray or computed tomography (CT) scan. In fact, a nodule shows up on about one in every 500 chest X-rays. Normal lung tissue surrounds this small round or oval solid overgrowth of tissue. It may be a single or solitary pulmonary nodule. Or, you may have multiple nodules.

Your lung nodule is more likely to be benign if:

• You are younger than age 40.
• You are a nonsmoker.
• There is calcium in the nodule.
• The nodule is small.

A benign lung tumor is an abnormal growth of tissue that serves no purpose and is found not to be cancerous. Benign lung tumors may grow from many different structures in the lung.

Determining whether a nodule is a benign tumor or an early stage of cancer is very important. That’s because early detection and treatment of lung cancer can greatly enhance your survival.

What Are the Symptoms of Benign Lung Nodules and Tumors?

Benign lung nodules and tumors usually cause no symptoms. This is why they are almost always found accidentally on a chest X-ray or CT scan. However, they may lead to symptoms like these:

• wheezing
• Coughing that lasts or coughing up blood
• Shortness of breath
• Fever, especially if pneumonia is present

What Are the Causes of Benign Lung Nodules and Tumors?

The causes of benign lung tumors and nodules are poorly understood. But in general, they often result from problems like these:

Inflammation from infections such as:

• An infectious fungus (histoplasmosis, coccidioidomycosis, cryptococcosis, or aspergillosis, for example)
• Tuberculosis (TB)
• A lung abscess
• Round pneumonia (rare in adults)

Inflammation from noninfectious causes such as:

• Rheumatoid arthritis
• Wegener granulomatosis
• Sarcoidosis

• Birth defects such as a lung cyst or other lung malformation.

  These are some of the more common types of benign lung tumors:

  • Hamartomas are the most common type of benign lung tumor and the third most common cause of solitary pulmonary nodules. These firm marble-like tumors are made up of tissue from the lung’s lining as well as tissue such as fat and cartilage. They are usually located in the periphery of the lung.
  • Bronchial adenomas make up about half of all benign lung tumors. They are a diverse group of tumors that arise from mucous glands and ducts of the windpipe or large airways of the lung. A mucous gland adenoma is an example of a true benign bronchial adenoma.
  • Rare neoplasms may include chondromas, fibromas, or lipomas — benign tumors made up of connective tissue or fatty tissue.