Medicurio

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Diarrhoea is when your bowel movements become loose or watery. The definition of diarrhoea is passing loose or watery bowel movements 3 or more times in a day (or more frequently than usual).

Many cases of diarrhoea are self-limiting and don’t need specific treatment. However, it’s important in any case of diarrhoea to stay hydrated by drinking plenty of liquids.

Diarrhoea occurs when the lining of the intestine is unable to absorb fluid, or it actively secretes fluid. There are many causes, including infection and inflammation.

Severe diarrhoea leads to fluid loss, and may be life-threatening, particularly in young children and people who are malnourished or have impaired immunity.

Fast facts on diarrhea

Here are some key points about diarrhea. More detail and supporting information is in the body of this article.

1. Most cases of diarrhea are caused by bacteria, viruses, or parasites
2. Inflammatory bowel diseases (IBD) including crohn’s disease and ulcerative colitis can cause chronic diarrhea
3. Antidiarrheal medications can reduce diarrheal output and zinc supplement is effective in children
4. Some nutritional and probiotic intervention may help prevent diarrhea.

causes–

Most cases of diarrhea are caused by an infection in the gastrointestinal tract. The microbes responsible for this infection include:

• bacteria
• viruses
• parasitic organisms

The most commonly identified causes of acute diarrhea in the United States are the bacteria Salmonella, Campylobacter, Shigella, and Shiga-toxin-producing Escherichia coli.

Some cases of chronic diarrhea are called “functional” because a clear cause cannot be found. In the developed world, irritable bowel syndrome (IBS) is the most common cause of functional diarrhea.

IBS is a complex of symptoms. There is cramping abdominal pain and altered bowel habits, including diarrhea, constipation, or both.

Inflammatory bowel disease (IBD) is another cause of chronic diarrhea. It is a term used to describe either ulcerative colitis or Crohn’s disease. There is often blood in the stool in both conditions.

Other major causes of chronic diarrhea include:

1. Microscopic colitis: This is a persistent diarrhea that usually affects older adults, often during the night.
2. Malabsorptive and maldigestive diarrhea: The first is caused by impaired nutrient absorption, the second by impaired digestive function. Celiac disease is one example.
3. Chronic infections: A history of travel or antibiotic use can be clues to chronic diarrhea. Various bacteria and parasites can be the cause.
4. Drug-induced diarrhea: Laxatives and other drugs, including antibiotics, can trigger diarrhea.
5. Endocrine causes: Sometimes hormonal factors cause diarrhea, for example, in the case of Addison disease and carcinoid tumors.
6. Cancer causes: Neoplastic diarrhea is associated with a number of gut cancers.

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Treatment

Mild cases of acute diarrhea may resolve without treatment. Persistent or chronic diarrhea will be diagnosed and any underlying causes will be treated in addition to the symptoms of diarrhea.

Dehydration

For all cases of diarrhea, rehydration is key:

1. Fluids can be replaced by simply drinking more fluids, or they can be received intravenously in severe cases. Children and older people are more vulnerable to dehydration.
2. Oral rehydration solution or salts (ORS) refers to water that contains salt and glucose. It is absorbed by the small intestine to replace the water and electrolytes lost in the stool. In developing countries, ORS costs just a few cents. The World Health Organization (WHO) says ORS can safely and effectively treat over 90 percent of non-severe diarrhea cases.
3. Oral rehydration products, such as Oralyte and Rehydralyte, are available commercially. Zinc supplementation may reduce the severity and duration of diarrhea in children. Various products are available to purchase online.

Antidiarrheal medication

Over-the-counter (OTC) antidiarrheal medicines are also available:

1. Loperamide, or Imodium, is an antimotility drug that reduces stool passage. Loperamide and Imodium are both available to purchase over-the-counter or online.
2. Bismuth subsalicylate, for example, Pepto-Bismol, reduces diarrheal stool output in adults and children. It can also be used to prevent traveler’s diarrhea. The can be bought online as well as over-the-counter.

There is some concern that antidiarrheal medications could prolong bacterial infection by reducing the removal of pathogens through stools.

Antibiotics

Antibiotics are only used to treat diarrhea caused by a bacterial infection. If the cause is a certain medication, switching to another drug might be possible.

Symptoms-

Diarrhea refers to watery stools, but it may be accompanied by other symptoms.

These include:

1. stomach pain
2. abdominal cramps
3. bloating
4. thirst
5. weight loss
6. fever

Diarrhea is a symptom of other conditions, some of which can be serious.

Other possible symptoms are:

1. blood or pus in the stools
2. persistent vomiting
3. dehydration

If these accompany diarrhea, or if the diarrhea is chronic, it may indicate a more serious illness.

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Tennis elbow, also known as lateral epicondylitis, is a condition in which the outer part of the elbow becomes painful and tender. The pain may also extend into the back of the forearm and grip strenght may be weak. Onset of symptoms is generally gradual. golfer’s elbow is a similar condition that affects inside the elbow.

Tennis elbow, or lateral epicondylitis, is a painful condition of the elbow caused by overuse. Not surprisingly, playing tennis or other racquet sports can cause this condition. However, several other sports and activities can also put you at risk.

Tennis elbow is an inflammation of the tendons that join the forearm muscles on the outside of the elbow. The forearm muscles and tendons become damaged from overuse — repeating the same motions again and again. This leads to pain and tenderness on the outside of the elbow.

There are many treatment options for tennis elbow. In most cases, treatment involves a team approach. Primary doctors, physical therapists, and, in some cases, surgeons work together to provide the most effective care.

Anatomy

Your elbow joint is a joint made up of three bones: your upper arm bone (humerus) and the two bones in your forearm (radius and ulna). There are bony bumps at the bottom of the humerus called epicondyles. The bony bump on the outside (lateral side) of the elbow is called the lateral epicondyle.

Muscles, ligaments, and tendons hold the elbow joint together.

Lateral epicondylitis, or tennis elbow, involves the muscles and tendons of your forearm. Your forearm muscles extend your wrist and fingers. Your forearm tendons — often called extensors — attach the muscles to bone. They attach on the lateral epicondyle. The tendon usually involved in tennis elbow is called the Extensor Carpi Radialis Brevis (ECRB).

Symptoms

The symptoms of tennis elbow develop gradually. In most cases, the pain begins as mild and slowly worsens over weeks and months. There is usually no specific injury associated with the start of symptoms.

Common signs and symptoms of tennis elbow include:

• Pain or burning on the outer part of your elbow
• Weak grip strength

The symptoms are often worsened with forearm activity, such as holding a racquet, turning a wrench, or shaking hands. Your dominant arm is most often affected; however both arms can be affected.

Cause

Overuse

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Recent studies show that tennis elbow is often due to damage to a specific forearm muscle. The extensor carpi radialis brevis (ECRB) muscle helps stabilize the wrist when the elbow is straight. This occurs during a tennis groundstroke, for example. When the ECRB is weakened from overuse, microscopic tears form in the tendon where it attaches to the lateral epicondyle. This leads to inflammation and pain.

The ECRB may also be at increased risk for damage because of its position. As the elbow bends and straightens, the muscle rubs against bony bumps. This can cause gradual wear and tear of the muscle over time.

Activities

Athletes are not the only people who get tennis elbow. Many people with tennis elbow participate in work or recreational activities that require repetitive and vigorous use of the forearm muscle.

Painters, plumbers, and carpenters are particularly prone to developing tennis elbow. Studies have shown that auto workers, cooks, and even butchers get tennis elbow more often than the rest of the population. It is thought that the repetition and weight lifting required in these occupations leads to injury.

Age

Most people who get tennis elbow are between the ages of 30 and 50, although anyone can get tennis elbow if they have the risk factors. In racquet sports like tennis, improper stroke technique and improper equipment may be risk factors.

Unknown

Lateral epicondylitis can occur without any recognized repetitive injury. This occurence is called “insidious” or of an unknown cause.

Tests

Your doctor may recommend additional tests to rule out other causes of your problem.

1. X-rays. These tests provide clear images of dense structures like bone. They may be taken to rule out arthritis of the elbow.
2. Magnetic resonance imaging (MRI) scan. If your doctor thinks your symptoms are related to a neck problem, an MRI scan may be ordered. MRIs scans show details of soft tissues, and will help your doctor see if you have a possible herniated disk or arthritis in your neck. Both of these conditions often produce arm pain.
3. Electromyography (EMG). Your doctor may order an EMG to rule out nerve compression. Many nerves travel around the elbow, and the symptoms of nerve compression are similar to those of tennis elbow.

treatment-

f simple treatments can help alleviate the pain of tennis elbow. The most important thing you can do is rest your injured arm and stop doing the activity that caused the problem (see below).

Holding a cold compress, such as a bag of frozen peas wrapped in a towel, against your elbow for a few minutes several times a day can help ease the pain.

Invasive treatments, such as surgery, will usually only be considered in severe and persistent cases of tennis elbow, where non-surgical approaches have not been effective.

Avoiding or modifying activities

If you have tennis elbow, you should stop doing activities that strain affected muscles and tendons.

If you use your arms at work to carry out manual tasks, such as lifting, you may need to avoid these activities until the pain in your arm improves.

Alternatively, you may be able to modify the way you perform these types of movements so they do not place strain on your arm.

Talk to your employer about avoiding or modifying activities that could aggravate your arm and make the pain worse.

Painkillers and NSAIDs

Taking painkillers, such as paracetamol, and non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, may help ease mild pain and inflammation caused by tennis elbow.

As well as tablets, NSAIDs are also available as creams and gels (topical NSAIDs). They are applied directly to a specific area of your body, such as your elbow and forearm.

Topical NSAIDs are often recommended for musculoskeletal conditions, such as tennis elbow, rather than anti-inflammatory tablets. This is because they can reduce inflammation and pain without causing side effects, such as nausea and diarrhoea.

Some NSAIDs are available over the counter without a prescription, while others are only available on prescription. Your GP or pharmacist will be able to recommend a suitable NSAID.  

Read more about non-prescription and prescription-only medicines.

Physiotherapy

Your GP may refer you to a physiotherapist if your tennis elbow is causing more severe or persistent pain. Physiotherapists are healthcare professionals who use a variety of methods to restore movement to injured areas of the body.

Your physiotherapist may use manual therapy techniques, such as massage and manipulation, to relieve pain and stiffness, and encourage blood flow to your arm. They can also show you exercises you can do to keep your arm mobile and strengthen your forearm muscles. 

The use of an orthoses – such as a brace, strapping, support bandage or splint – may also be recommended in the short term.

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Steroid injections

Steroids are a type of medication that contain manmade versions of the hormone cortisol, and are sometimes used to treat particularly painful musculoskeletal problems.

Some people with tennis elbow may be offered steroid injections when other treatments haven’t worked.

The injection will be made directly into the painful area around your elbow. You may be given a local anaesthetic first to numb the area and reduce the pain.

Steroid injections are only likely to provide short-term relief and their long-term effectiveness has been shown to be poor. If they are helping, you may be offered up to 3 injections in the same area, with at least a 3 to 6 month gap between them.

Shockwave therapy

Shockwave therapy is a non-invasive treatment, where high-energy shockwaves are passed through the skin to help relieve pain and promote movement in the affected area.

How many sessions you will need depends on the severity of your pain. You may have a local anaesthetic to reduce any pain or discomfort during the procedure.

The National Institute for Health and Care Excellence (NICE) states that shockwave therapy is safe, although it can cause minor side effects, including bruising and reddening of skin in the area being treated.

Research shows that shockwave therapy can help improve the pain of tennis elbow in some cases. However, it may not work in all cases, and further research is needed.

PRP injections

Platelet rich plasma (PRP) is a newer treatment that may be offered by a surgeon in hospital to treat tennis elbow.

PRP is blood plasma containing concentrated platelets that your body uses to repair damaged tissue. Injections of PRP have been shown to speed up the healing process in some people but their long-term effectiveness is not yet known.

The surgeon will take a blood sample from you and place it in a machine. This separates the healing platelets so they can be taken from the blood sample and injected into the affected joints. The procedure usually takes about 15 minutes.

Surgery

Surgery may be recommended as a last resort treatment in cases where tennis elbow is causing severe and persistent pain. The damaged part of the tendon will be removed to relieve the painful symptoms.

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Peptic ulcers are open sores that develop on the inside lining of your stomach and the upper portion of your small intestine. The most common symptom of a peptic ulcer is stomach pain.

Ulcers occur when stomach acid damages the lining of the digestive tract. Common causes include the bacteria H. Pylori and anti-inflammatory pain relievers including aspirin.Upper abdominal pain is a common symptom.Treatment usually includes medication to decrease stomach acid production. If it is caused by bacteria, antibiotics may be required.

ulcers include:

1. Gastric ulcers that occur on the inside of the stomach
2. Duodenal ulcers that occur on the inside of the upper portion of your small intestine (duodenum)

Causes—

igestive tract is coated with a mucous layer that normally protects against acid. But if the amount of acid is increased or the amount of mucus is decreased, you could develop an ulcer. eptic ulcers occur when acid in the digestive tract eats away at the inner surface of the stomach or small intestine. The acid can create a painful open sore that may bleed.

Common causes include:—

1. A bacterium. Helicobacter pylori bacteria commonly live in the mucous layer that covers and protects tissues that line the stomach and small intestine. Often, the H. pylori bacterium causes no problems, but it can cause inflammation of the stomach’s inner layer, producing an ulcer. It’s not clear how H. pylori infection spreads. It may be transmitted from person to person by close contact, such as kissing. People may also contract H. pylori through food and water.
2. Regular use of certain pain relievers. Taking aspirin, as well as certain over-the-counter and prescription pain medications called nonsteroidal anti-inflammatory drugs (NSAIDs) can irritate or inflame the lining of your stomach and small intestine. These medications include ibuprofen (Advil, Motrin IB, others), naproxen sodium (Aleve, Anaprox, others), ketoprofen and others. They do not include acetaminophen (Tylenol). Peptic ulcers are more common in older adults who take these pain medications frequently or in people who take these medications for osteoarthritis.
3. Other medications. Taking certain other medications along with NSAIDs, such as steroids, anticoagulants, low-dose aspirin, selective serotonin reuptake inhibitors (SSRIs), alendronate (Fosamax) and risedronate (Actonel), can greatly increase the chance of developing ulcers.

symptoms –

The most common symptom of a peptic ulcer is burning abdominal pain that extends from the navel to the chest, which can range from mild to severe. In some cases, the pain may wake you up at night. Small peptic ulcers may not produce any symptoms in the early phases.

Other common signs of a peptic ulcer include:

1. changes in appetite
2. nausia
3. bloody or dark stool
4. unexplained weight loss
5. indigestion
6. vomitting
7. chest pain
8. Burning stomach pain
9. Feeling of fullness,
10. bloating or belching
11. Fatty food intolerance
12. Heartburn

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Risk factors

In addition to taking NSAIDs, you may have an increased risk of peptic ulcers if you:

1. Smoke. Smoking may increase the risk of peptic ulcers in people who are infected with H. pylori.
2. Drink alcohol. Alcohol can irritate and erode the mucous lining of your stomach, and it increases the amount of stomach acid that’s produced.
3. Have untreated stress.
4. Eat spicy foods.

Prevention

You may reduce your risk of peptic ulcer if you follow the same strategies recommended as home remedies to treat ulcers. It may also be helpful to:

1. Protect yourself from infections. It’s not clear just how H. pylori spreads, but there’s some evidence that it could be transmitted from person to person or through food and water. You can take steps to protect yourself from infections, such as H. pylori, by frequently washing your hands with soap and water and by eating foods that have been cooked completely.
2. Use caution with pain relievers. If you regularly use pain relievers that increase your risk of peptic ulcer, take steps to reduce your risk of stomach problems. For instance, take your medication with meals. Work with your doctor to find the lowest dose possible that still gives you pain relief. Avoid drinking alcohol when taking your medication, since the two can combine to increase your risk of stomach upset. If you need an NSAID, you may need to also take additional medications such as an antacid, a PPI, an acid blocker or cytoprotective agent. A class of NSAIDs called COX-2 inhibitors may be less likely to cause peptic ulcers, but may increase the risk of heart attack.

Complications

Left untreated, peptic ulcers can result in:

1. Internal bleeding. Bleeding can occur as slow blood loss that leads to anemia or as severe blood loss that may require hospitalization or a blood transfusion. Severe blood loss may cause black or bloody vomit or black or bloody stools.
2. Infection. Peptic ulcers can eat a hole through (perforate) the wall of your stomach or small intestine, putting you at risk of serious infection of your abdominal cavity (peritonitis).
3. Obstruction. Peptic ulcers can block passage of food through the digestive tract, causing you to become full easily, to vomit and to lose weight through either swelling from inflammation or scarring.

Treatment—

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Physiotherapy focuses on function, movement, and optimal use of the child’s potential and uses physical approaches to promote, maintain and restore physical, psychological and social well-being within all environments of the child including home, school, recreation, and community environments

gross motor skills, functional mobility in the management for the motor deficits, positioning, sitting, transition from sitting to standing, walking with or without assistive devices and orthoses, wheelchair use and transfers, are all areas that the physiotherapist works on using a wide range of physiotherapeutic approaches to influence functional ability of the child, which we will review.

Physical therapy implements strength and flexibility exercises, heat treatment, massages and special equipment to give children with cerebral palsy more independence.

In more severe cases, it may be used alongside other treatments or medications. Beginning physical therapy as early as possible usually gives children the best chances at improvement.

benifits of physiotherapy treatment —The main goal of physical therapy is to make everyday movements easier for children with cerebral palsy.

There are many benefits of physical therapy, from improving mobility to preventing future issues such as contractures and joint dislocations by keeping the body strong and flexible. Many children with CP increase their level of self-reliance through physical therapy

According to Patel (2005) a wide range of therapeutic interventions have been used in the treatment and management of children with cerebral palsy. They show that there is evidence to support the use and effectiveness of neuromuscular electrical stimulation, while evidence in support of the effectiveness of the neurodevelopmental treatment is equivocal at best. The effectiveness of many other interventions, including include: sensory integration, body-weight support treadmill training, conductive education, constraint-induced therapy, hyperbaric oxygen therapy used in the treatment of cerebral palsy have not been clearly established based on well-controlled trials. We provides an overview of salient aspects of popular approaches and interventions used in the management of children with Cerebral Palsy.

Physical therapy can improve:

1. Coordination
2. Balance
3. Strength
4. Flexibility
5. Endurance
6. Pain management
7. Posture
8. Gait
9. Overall health

How is physical therapy performed?

Physical therapy is carried out by licensed physical therapists and physical therapy assistants, often by using means such as:

1. soft tissue mobilization (kneading of the muscles)
2. joint mobilization
3. specialized exercises
4. stretching
5. endurance exercises designed to meet therapeutic goals

Physical therapy is hands-on: a therapist, or an assistant, will guide the child through exercises.

Exercises often include the use of equipment, such as:

1. Weights
2. Exercise machines
   1. Bands
   2. Rollers
3. Balance balls
4. Heat and cold packs
5. Ultrasound technology

At some centers, sports or recreation like swimming, dancing and playing games such as throwing and catching a ball, may be used to help children develop muscles, balance, coordination and range of motion.

types—

The types of exercises used vary and have specific benefits for each types of cerebral palsy Some of the benefits by cerebral palsy type include:

1. spastic – Physical therapy can reduce the muscle tension and jerky movements associated with spastic cerebral palsy. Exercises such as stretching can even relieve stiffness over time.
2. athetoid – People with athetoid cerebral palsy use physical therapy to increase muscle tone and gain more control over their movements.
3. ataxic – There are exercises that can improve balance problems faced by those with ataxic cerebral palsy.

physical therapy used—

Exercises

Exercises for cerebral palsy are geared toward treating either high or low muscle tone. High muscle tone causes stiffness and spasticity, whereas low muscle tone causes too much flexibility and weakness.

Improving muscle tone

Flexibility exercises and massages are often used for children with spastic cerebral palsy; these exercises not only help improve mobility, but also can prevent painful muscle tightening that could require surgical correction. Strength training exercises are used to increase muscle tone in children with athetoid cerebral palsy.

Assisting posture and walking

Special exercises are also used to help with walking, posture, transitional movements and sensory impairments like touch and balance. Posture is improved through exercises that emphasize sitting, kneeling and standing. Transitional movements are those used by infants that lead to walking, such as rolling over and sitting up.

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toys for kids with celebral palsy science behind this —

Recent studies using commercially available VR products like the Smart Kids as a supplement to traditional approaches for children with CP have reported statistically significant improvements in:

*Cortical reorganisation: Brain changes! Targeted, sustained interaction between the brain and the nerves of the isolated muscle systems has been shown to create neuroplastic changes in the central and peripheral nervous systems particularly in cortical areas related to motor learning and control.

*Motor control: Use it or lose it!
Repetition of muscle use over time leads to improved strength, manual dexterity, motor planning skills as well as increased ability to generalize this strength increase into use of the arm during daily tasks.

*Motivation and confidence: I’m winning!
When abilities are challenged appropriately kids can become motivated to keep playing in order to achieve game goals. Through the achievement of small wins in the game, kids are secretly performing prescribed exercises while building the confidence needed to attempt novel tasks outside of the VR experience.

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Compliance: Time flies when you’re having fun!
VR use can increase home exercise compliance levels in children who feel like they are gaming and not exercising which enhances conventional physiotherapy effectiveness.

*Cognition: Get your head in the game! Improved concentration and levels of participation have been reported when using VR intervention. The games provide feedback which enables kids to improve their performance while giving them a measurable sense of achievement through persistence and control over their actions.

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Sickle cell anemia is a genetic disorder characterized by irregularly shaped red blood cells due to an abnormal form of hemoglobin within the RBC’s. The hemoglobin is able to transport Oxygen in a normal fashion, but once the Oxygen is released, the diseased molecules stick to one another and form abnormally shaped rods in the RBC’s. This, in turn, causes the erythrocytes to become sickle-shaped and unable to squeeze through the small diameter capillaries, leading to occlusion of these vessels.

characterstics—

Individuals with this disorder may vary in their presentation of symptoms. Occlusion of the capillaries by the sickle-shaped erythrocytes leads to acute and chronic tissue damage. Clinically, this can lead to widespread pain throughout the body, termed painful episodes, that may last 5 or 6 days.

As the name suggests, these patients are anemic, resulting in a presentation of fatigue, pallor, and irritability. Acute episodes of symptoms are typical and may be brought on by physical exertion, extreme temperatures, fatigue or recent infections.

as a result of occlusion of the blood vessels. The sickled RBC’s may adhere to the lung endothelium and cause inflammation resulting in acute chest syndrome.

role of physiotherapist:–

Therapists could play a large role in education, treatment and possible prevention.Patient education is extremely important for individuals with sickle cell. They should be educated on the importance of physical activity and remaining mobile in order to combat serious pulmonary and other systemic complications.

The patient should be taught breathing techniques and incentive spirometry to also prevent acute chest syndrome and atelectasis, as well as retain adequate lung capacity Wound care to stasis ulcers that often occur on the hands, legs, and feet may also be indicated for PT managem.

Patients with sickle cell disease may have an intolerance to exercise and may fatigue quickly due to anemia. PT’s should be mindful of this and gradually work up to moderate levels of exercise with frequent rest breaks.

Aquatic therapy may be beneficial for some individuals with sickle cell anemia. A recent case study found that two aquatic sessions a week for five weeks resulted in decreased frequency of painful episodes and increased strength of the respiratory muscles.

During painful episodes, therapists should avoid overexerting the patient, and should look out for stressors that may include dehydration or cold.

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Torticollis is a condition causing asymmetrical head or neck position due to a problem in the neck muscles.Torticollis, also known as wry neck, is a dystonic condition defined by an abnormal, asymmetrical head or neck position, which may be due to a variety of causes. The term torticollis is derived from the Latin words tortus for twisted and collum for neck.

causes:-

1. The cause is likely from the baby’s position in the uterus which leads to injury to the neck muscles.

2. Acquired torticollis may be caused by irritation to the cervical ligaments from a viral infection,

3.injury, or vigorous movement.Osseous

4.Additional causes may include:

1.Sleeping in an awkward position.Osseous

2.Traumatic

3.CNS/PNS

4.Ocular

5.Non-muscular soft tissue

6.Spasmodic

7.Drug induced

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types-

1.laterocollis : the head is tipped toward the shoulder,

2.rotational torticollis : the head rotates along the longitudinal axis,

3.anterocollis : forward flexion of the head and neck,

4.retrocollis : hyperextension of head and neck backward.

sign and symptom—

1. Neck pain
2. Occasional formation of a mass
3. Thickened or tight sternocleidomastoid muscle
4. Tenderness on the cervical spine
5. Tremor in head
6. Unequal shoulder heights
7. Decreased neck movement

Anatomy of torticollis —

The underlying anatomical distortion causing torticollis is a shortened sternocleidomastoid muscle. This is the muscle of the neck that originates at the sternum and clavicle and inserts on the mastoid process of the temporal bone on the same side.There are two sternocleidomastoid muscles in the human body and when they both contract, the neck is flexed. The main blood supply for these muscles come from the occipital artery, superior thyroid artery, transverse scapular artery and transverse cervical artery. The main innervation to these muscles is from cranial nerve XI (the accessory nerve) but the second, third and fourth cervical nerves are also involved. Pathologies in these blood and nerve supplies can lead to torticollis.

treatment—

physiotherapy:–

Physical therapy is an option for treating torticollis in a non-invasive and cost-effective manner.

1. Stretching the neck and trunk muscles actively. Parents can help promote this stretching at home with infant positioning. For example, prone positioning will encourage the child to lift their chin off the ground, thereby strengthening their bilateral neck and spine extensor muscles, and stretching their neck flexor muscles. Active rotation exercises in supine, sitting or prone position by using toys, lights and sounds to attract infant’s attention to turn neck and look toward the non-affected side.
2. Stretching the muscle in a prone position passively.passive stretching is manual, and does not include infant involvement. Two people can be involved in these stretches, one person stabilizing the infant while the other holds the head and slowly brings it through the available range of motion. Passive stretching should not be painful to the child, and should be stopped if the child resists. Also, discontinue the stretch if changes in breathing or circulation are seen or felt.
3. Stretching the muscle in a lateral position supported by a pillow (have infant lie on the side with the neck supported by pillow). Affected side should be against the pillow to deviate the neck towards the non-affected side.
4. Environmental adaptations can control posture in strollers, car seats and swings (using U-shaped neck pillow or blankets to hold neck in neutral position)
5. Passive cervical rotation (much like stretching when being supported by a pillow, have affected side down)
6. Position infant in the crib with affected side by the wall so they must turn to the non-affected side to face out

Other treatments include:—

1. Rest and analgesics for acute cases
2. Diazepam or other muscle relaxants
3. Botulinum toxin
4. Encouraging active movements for children 6–8 months of age
5. Ultrasound diathermy

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containt:- 1)defination
2)origin of junk food
3)history
4)national junk food day
5)junkfood vs health

defination:– food that is high in calories but low in nutritional content food that is high in calories but low in nutritional content.
It is something that is appealing or enjoyable but of little or no real value
origin of junk food:-
the term junk was originated in1950s , although its coinage has been credited to Michael F. Jacobson of the Center for Science in the Public Interest, in 1972s Dr. bready in an article called “mrs.H named it as cheat food“.he term cheat food can be traced back in newspaper mentions to at least 1916.
history:-
The history of junk food is a largely American tale: It has been around for hundreds of years, in many parts of the world, but no one has done a better job inventing so many varieties of it, branding it, mass-producing it, making people rich off it and, of course, eating it.

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national junk food day :-
America also celebrates an annual National Junk Food Day on July 21. Origins are unclear; it is one of around 175 US food and drink days, most created by “people who want to sell more food”, at times aided by elected officials at the request of a trade association or commodity group.] “In honor of the day,” Time in 2014 published, “5 Crazy Junk Food Combinations”. Headlines from other national and local media coverage include: “Celebrate National Junk Food Day With… Beer-Flavored Oreos?” “National Junk Food Day: Pick your favorite unhealthy treats in this poll” (Baltimore);[32] “Celebrities’ favorite junk food” (Los Angeles”A Nutritionist’s Guide to National Junk Food Day” with “Rules for Splurgin
in develping countary like India also stared following this trend .

junkfood vs health :-
The health problems that junk food can cause affect every part of your body. It can lead to brain damage in children and cause serious conditions like fatty liver syndrome in adults. So saying no to junk food is not a choice anymore. It is something you should do if you want to live a healthy life.

Here are some of the serious health problems of junk food that you should be aware of.
obesity- Junk food contains trans fats that is almost impossible to lose without extensive work out. Most of us do not work out and thus never lose the permanent trans fats that we accumulate while enjoying junk food.

Fatigue Junk food may make you feel full but you will always be tired. This is because fast food has no nutrients in it. Your body is getting empty calories but no nutrition. This makes you fatigued and lazy.

Unhealthy For Heart Trans fats present in junk food clog up your arteries and cause heart diseases. It is not unheard of for 30-year-olds to have heart attacks these days. This is because of eating junk food.

Affects Your Kidneys Junk food is often salty and high on sodium. This extra sodium affects the sodium-potassium balance in your body and in turn damages your kidneys.

Chances Of Diabetes Eating junk food causes sudden fluctuations in your blood sugar level. That is why junk food is one of the bad lifestyle choices that pushes you towards getting diabetes type 2.

Makes Your Brain Slow The bad fats from junk food get stored in your brain. This insulates your brain to the nerve signals, thus making you slow. This is one of the reasons for obese children being slow learners.

Causes Fatty Liver The extra fat that you gain from eating junk food gets deposited over your liver. This is called the fatty liver syndrome. You are unable to digest anything as your liver function gets affected.

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Thanks for joining me!

Good company in a journey makes the way seem shorter. — Izaak Walton

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