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Asthma: Allergen management and the use of anti-inflammatory drugs

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A Life with Asthma

Life has been a struggle for Karen ever since she was a little girl.  She was very allergic to dust mites, pollen coming from trees, and other allergens that seemed to surround her everywhere she went.  Growing up did not only mean getting braces for her teeth, growing her hair long, or moving up several sizes.  It also meant the daily battle with her own immune system that over-reacted to almost anything microscopic.  He body’s anti-allergic response included the secretion of above-normal amounts of fluid in her nostrils and mucus inside her chest.  The moment she gets an allergic reaction, her chest would suddenly feel as if a block of cement had been hurled at her.  He difficulty of breathing was so severe that should would almost turn blue from lack of oxygen.  For most of her childhood and teenage years, she felt miserable about the repeated asthma attacks that almost always happened in public.  The difficulty of having asthma was made worse by the embarrassment she had to endure whenever she desperately gasped for air in front of people.

Like Karen, millions of people around the world suffer from asthma.  In the United States alone, about 20 million people have been diagnosed with this chronic disease. Of this number of asthma sufferers, nearly nine million are children. An asthma attack affects and produces a constriction of the airways. The airways are the tubes through which air flows in and out of our lungs. The inside walls of these airways are become swollen during an asthma attack.  The inflammation of the airways is actually an allergic reaction to microscopic particles Once the inflammation occurs, an asthma sufferer may produce wheezing sounds or may experience excessive coughing.

To date, there is still no cure for asthma but it can be prevented or its symptoms can be managed.    One simple way to help prevent asthma is to prevent pollutants and other allergens from proliferating in  your home or work environment.  Hygiene at home and at the office can help control the spread of viruses and bacteria that may also trigger allergies and other more serious ailments.  While there are varying degrees of severity of asthma attacks and sensitivity to “triggering elements”, keeping the surroundings as allergen-free as possible would benefit all asthmatics.

Anti-Inflammatory Drugs To The Rescue

Aside from environmental sanitation, another option to control asthma and its debilitating symptoms is the use of medications.  Anti inflammatory drugs are now prescribed for patients who need immediate help in controlling asthma. These anti inflammatory drugs help reduce the swelling of swelling of air passageways and, as a result, prevent wheezing and coughing.

The main types of anti-inflammatory drugs are:

1. Inhaled corticosteroids – Considered as one of the most effective medications to reduce airway inflammation. This drug helps reduces the need for hospitalization and provides better asthma control.

2. Mast cell stabilizers – It works by preventing the release of irritating and inflammatory substances from immune cells called mast cells.

3. Dry powder inhaler –  A medication in the form of a dry powder that is administered through a small device called a dry powder inhaler or DPI. This inhaler delivers the medication to the lungs as you inhale through the device. It does not contain propellants and it can be used by young asthmatics starting at age five and up.

4. Nebulizer – This is a device used to administer medication in the form of liquid mist to the air ways.  Also known as “atomizers”, the nebulizer is used to pumps air or liquid medicine in vapor form. By inhaling the medicine through the nebulizer, an asthmatic is able to reduce the symptoms of the disease.

Managing your Asthma

To help a patient manage the symptoms of this condition, doctors usually use a tool called Spirometry to diagnose asthma.  The tool is also used to evaluate the pulmonary functions of a patient.  It also helps the doctor obtain valuable information about the lung condition of an asthma patient.   Optimal medication, continuation of normal activities, and the reduction of trips to the hospital are only some of the goals that every doctor want to achieve in treating an asthma patient.  Depending on the severity of the condition, the doctor may opt to prescribe anti inflammatory drugs that would prevent attacks that constrict a patient’s breathing.

Asthma is a very uncomfortable condition to deal with, especially on a daily basis.  But it should not rob someone out of the joys and happiness of life.  Even asthmatics can live relatively normal lives.  Through proper medication and allergen management, asthmatics can pursue active, fulfilling lives.

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The most frequently touted anti-aging techniques

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Aging will definitely come to all of us. As we live our everyday lives, we also grow old. We all know what aging does to us. The process of growing old makes us frail, slower, and more likely to fall ill. Everyday, as we live, we become older and there is no denying the fact that our skin will give out the most inconvenient evidence that indeed, we are aging.

When a person is younger, the skin is elastic, bouncy and self-moisturizing. However, with age, it loses a little of its elasticity. The skin becomes thinner, and loses its capacity to rejuvenate itself. This happens when collagen is produced less and less which results in wrinkle formation and skin sagging especially around the eyes, the mouth, or in places where the skin is thinner. Other signs of aging skin are the appearance of dark spots due to sudden dryness of skin and loss of oil content of the skin on the face. The dryness is due the shutting down of the sebaceous glands which stop producing oil.

Although one cannot stop the process of aging, there are actually a lot a person can do to help fight wrinkles and look younger. If one aims to be lively and robust in their “senior” years, one needs to learn some anti-aging skin care secrets. Here are some anti-aging skin care tips that are the most frequently touted anti-aging techniques.

  • Eat a low-fat diet that contains complex carbohydrates. The standard advice from the US government is to consume 5 fruits and vegetables and 3 servings of whole grains daily for vitamins and minerals and the other healthful micro-nutrients in plants. Drink five to eight glasses of water. Get no more than about 30-35 percent of daily calories from fat, with about 20 percent of that from unsaturated fat (e.g., 1 percent milk, olive and canola oil); 15 percent from protein; and the remaining calories from carbohydrates, with an emphasis on complex carbohydrates like oatmeal, whole wheat bread and wild rice.
  • Exercise regularly. Build endurance and strength with exercise. Regular aerobic exercise is a “must-do” for anyone committed to slowing the aging process. Hundreds of studies show that exercise combats the loss of stamina, muscle strength, balance, and bone density that increases with age. The American Heart Association advises doing a single set of eight to 15 repetitions, using eight to 10 exercises, two to three times a week for a comprehensive strength-building program. If you are not a beginner, that’s about a 10-minute routine.
  • Maximize antioxidants intake. Free radicals contribute to the onset of age-related diseases and antioxidants “neutralize” free radicals. Everyone should take a combination of antioxidants through diet and supplementation. Eat dark-colored vegetables like tomatoes, carrots, squash, and spinach for carotenoids and blue and purple berries for flavonoids. Because foods contain many classes of antioxidants that work synergistically, they are the superior source of antioxidants. But because we don’t always eat as we should, experts advocate the daily intake of supplements and antioxidants including 200-250 mg of vitamin C; 100-400 IU of vitamin E; and a mixed carotenoid supplement of 6-10 mg.

With some care and pampering, and living a happy life, one can have an excellent skin even in their golden years. Some are lucky and have a natural resistance to aging. Those who have not, depend on proper anti aging skin care treatment to keep their skin glowing and young.

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Anti aging skin care treatments that will keep your skin young and healthy

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As we get on in years, who isn’t trying to stay young, to hold the line on aging? And where do we see our age and fret our age more, than in our skin? I’d like to share with you some general anti aging skin care treatment that will keep your skin young and healthy, and recommend some natural anti aging skin products that make a big difference as well.

The health of our skin reflects many factors. Some we can’t control, but others we can and should. Heredity and environment, for example, might be working against you. But you’re not going to leave the city just to get clean, dewy skin. And if a certain swarthiness is in your genes, there’s not much you can do about it. But let’s look at the anti aging skin care that you CAN do – and there’s a lot – to bring your skin to a whole new level.

Water

Water – yes water – is your best anti aging medicine. You need to drink at least 8 full glasses of spring or well water daily. Your body is 75% water, and your skin is a moist, elastic medium that needs to be kept hydrated naturally – from within. Your skin’s thirst for this inner hydration can’t be satisfied by just rubbing in creams or lotions on the outside. You need to follow this “first commandment of skin care” if you want to get the super benefits that anti aging creams and other products also offer.

Natural Creams

Many anti aging creams – even the most expensive ones – have a base of mineral oil, and are loaded with artificial preservatives and coloring. Just look at the labels. You need bifocals and a lab coat just to read them! Need I say more? I get many compliments on my soft skin, and always the same question: what do you use on it? First I tell people about water, lots of fresh air and exercise, and moderate exposure to sunlight. Then I get down to specific anti aging solutions.

Real Aloe Vera

Lots of products boast that they contain aloe vera – so why do we think we can improve upon nature? I go right to the source, and keep an aloe vera plant growing in my bathroom. It’s a pretty plant, it’s easy to care for, and you just cut off a section of leaf and out gushes the wonderful fresh gel. My friends and nursing colleagues all report the same excitement the first time they rub in a gel directly from their plants. And they report that it’s the best anti aging product they’ve ever used – and one that you just can’t get from a store-bought jar or tube.

Aloe vera is truly potent. It’s filled with moisture, protein, vitamins and minerals – antiaging nutrients that give your skin deep, thorough hydration. Cleopatra is known to have used aloe vera on her skin, and if you overlook her little snake bite, you must admit: she was quite a success story!

Olive Oil

When my skin is very dry I also apply olive oil, and use olive oil soap over my entire body. In fact, such were the excellent results I got from olive oil, that I created my own anti aging personal care cosmetic – a soap which is 90% olive oil, and smooth beyond belief. (Aloe vera, oddly enough, can sometimes create a superficial drying effect, which olive oil quickly smoothes out.) Besides anti aging effects, aloe vera adds proteins, minerals and water to your skin.

Application of Creams

I always tell friends not to rub in their oils and creams in a bored hum-drum way. You need to really massage it in, giving yourself pleasure and stimulating your circulation. Indeed – it’s best to make all your health practices emotional. It’s this zest that makes the magic connection between body, mind, heart and soul. So – when we’re working to make ourselves younger and prettier, please ladies – let’s make it an anti aging exercise – not act as if we’re ironing socks!

Natural Progesterone Cream

We mention this last, but definitely not least, for it is really the “Queen” of anti aging products. This all-natural cream suffuses your body with progesterone, the anti aging hormone that turns girls into women and gives that beautiful glow to pregnant women. A natural progesterone hormone cream, such as Prosperine, delivers the right dosage of progesterone derived from the Mexican wild yam. Besides providing a protective quality against breast cancer, it wonderfully tones your skin and retards the aging process. As with drinking water, this is an approach that works from the inside out – the right way, the natural way.

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The development of anti-aging products for good women’s health

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Anti aging products have been around for years, from creams to pills to bath oils – they’re all designed to make women look and feel younger. What many women don’t realize is that the aging process begins right after we’re born! Each time the skin is exposed to the rays of the sun, some slight aging occurs. Unfortunately, it takes years for the evidence of aging to show up for most women.

Ten or twenty years of sun bathing can equal lots of wrinkles and skin discoloration once a woman reaches her 40s or 50s. The anti aging products on the store shelves then become very attractive, but many will not work after reaching a certain age. That’s why a new cutting edge science in Genomics is getting noticed in the anti-aging market. It’s a new natural discovery that defies aging through cell rejuvenation.

What is Genomics?

Genomics is the study and experimentation of genomes, or an organism’s complete DNA makeup, that is found in virtually every cell of the human body. In studying genomics, scientists have discovered ways to encourage cell repair and healthy cell development as the body produces new cells every day. This process is ongoing so having healthy cells is pertinent to good women’s health.

Through cutting edge science in genomics and a devotion to help women with anti-aging, natural products have been developed to help prevent aging and maintain beauty for many years. Through cell rejuvenation, the body is capable of healthy aging.

Food and Aging

If we need natural ingredients found in foods to have healthy cells, why not just eat a more healthy diet? Eating healthy is important in slowing the aging process, but it’s usually not enough unless you eat raw vegetables from your own garden! Many fruits and vegetables are grown in nutritionally-depleted soil, shipped to the grocery, cooked in oil and served on the platter. Through this entire process, the foods are losing important minerals and nutrients women need for healthy living. Taking an anti-aging supplement provides nutrients and minerals needed to replace those lost in foods.

Good Bone and Joint Health

Another area of concern for women is bone and joint health. Proteins help to keep bone and joint tissue healthy and strong. With arthritis and osteoporosis being so prevalent among older women, it’s wise to start working on good bone and joint health at a young age. Products are available to help restore minerals that are lost in the bones and joints during the aging process.

Anti-aging research through genomics is still fairly new, but many women are already seeing results when using natural, genomics-based anti-aging products.

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Five common questions about getting health insurance in Texas

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Although Texas ranks the highest among U.S. states in the number of uninsured residents, obtaining affordable Texas medical insurance is easier and more affordable than you think. Here are answers to five common questions about getting health insurance in Texas.

1. I’m young and healthy. Why should I spend money for medical insurance that I’ll never use?

Having insurance is like carrying an umbrella. You may not need it most of the time, but when there’s a torrential downpour you’ll be glad you have it. Even young and healthy people have accidents, seasonal illnesses, and sometimes tragic health issues. If you wind up having a serious medical condition, it can become very difficult to obtain Texas medical insurance, or your preexisting condition may be excluded from your coverage. In addition, you can get much lower premiums when you’re young and healthy, so health insurance provides excellent protection at very little cost.

2. Is there a benefit to using a health insurance agency, as opposed to getting quotes for policies on my own or going through a single agent?

A health insurance agency provides a number of benefits. First, they have established relationships with many, many insurance companies. This means that they have access to all of the best Texas medical insurance plans in the marketplace, while not having a bias toward any single insurer. This is in contrast to some individual agents, who work on behalf of one or two companies, and who will try and push you to sign up with their company. While you can research various plans on your own, a health insurance agency will do the legwork for you and present you will all available options, at no charge to you.

3. What’s the most important feature to consider when buying health insurance?

There are two important features that people often overlook: the lifetime maximum coverage and the maximum out-of-pocket expense. Although your more immediate concerns might be co-payments for doctors’ visits and prescription coverage, if you or a family member experiences a catastrophic illness, your overall coverage and out-of-pocket costs are much more crucial. Look for a policy that offers lifetime maximum coverage of $3 million or more, and a yearly out-of-pocket maximum in the $2,000 to $3,000 range.

4. Can I trust online comparisons for Texas health insurance?

Yes. The law requires that identical plans have identical pricing, regardless of whether you go directly through the insurer or use a health insurance agency. In other words, if you’re looking at the XYZ company’s Plan A, you will receive the same quote whether you get it online, place a phone call, or visit an insurance agency or company. Keep in mind though, that the price you pay may depend upon a number of variables, including your age, your gender, whether or not you smoke, and any pre-existing medical conditions that you may have. The final price is in large part determined by your medical history.

5. What’s the difference between an HMO and a PPO?

When it comes to Texas medical insurance, a health maintenance organization (HMO) requires that, for non-emergency services, you use their physicians and hospitals. A preferred provider organization (PPO) allows you to visit any health care provider, but gives you more benefits if you use health care professionals and services within their network.

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The trend of increasing costs of health care

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The health industry’s main lobbying group, America’s Health Insurance Plans, reports that medical premiums increased 8.8% between 2004 and 2005. The lobbying group claims this is good news since the actual premium rate of growth has continued to slow from a rate of more than 13% in 2002. The increase in health premiums is reportedly most likely due to the increased use of doctor and hospital services.

The accounting firm, PriceWaterhouseCoopers, reports that just 14% of the increase had to do with administration or marketing costs or higher insurance profits. According to the Kaiser Family Foundation, an average health care plan obtained through an employer in 2005 approached $11,000. The average annual cost for the worker was approximately $3,500 plus deductibles and co-pays.

Employers are currently shifting more and more of the health care costs to their employees. Studies show that employers decreased health care spending by 1.3%, while employees increased spending by 5.5%. “What we’re aware of is that health care costs,” says Judy Feder, PhD, dean of the Public Policy Institute at Georgetown University, “even when they slow down, are still outpacing peoples’ income and ability to pay.”

The trend of increasing costs of health care does not seem to be slowing down. With baby boomers now into their sixties, these costs will certainly continue to rise. Health care costs are taking a larger chunk out of everyone’s budget.

Prescription drugs price increases are outpacing the growing medical premiums by almost two-fold. Controlling drug costs is one of the simplest ways to lower overall health care spending. Using generics as often as possible, utilizing less expensive over the counter medication, and shopping around for lower prices are three quick and easy ways to lower these costs. Even small savings, done over and over, will soon add up to a significant reduction in your expenses at the pharmacy.

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How to deal with people who suffer from anorexia?

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Anorexia is an eating disorder characterized by a pronounced fear of gaining weight and being fat. People confronted with this condition become obsessed with food and engage in exaggerated acts of preventing weight gain. It is very important to understand that anorexia doesn’t involve loss of appetite. Anorexics willingly refuse to eat properly, continuously pursuing their goal of having a slim body. People who suffer from anorexia keep very strict diets and often over-exercise in an attempt to become thin.

The main problem of anorexics is that they are never satisfied with their efforts and regardless of how much weight they may lose, they continue to indulge in self-restrictive food behaviors. In many cases, people affected by anorexia develop an altered perception of their bodies. They always complain about their physical appearance, referring to themselves as fat. People who suffer from anorexia often try to suppress their hunger by taking diet pills or they even try to replace food with energy drinks. Due to their very scarce diet and the poor intake of nutrients, anorexics often develop serious illnesses. Many people with anorexia eventually develop anemia, gastrointestinal disorders, or osteoporosis (deterioration of bones).

Anorexia has a very high incidence among teenagers worldwide. Statistics indicate that in the United States alone, anorexia affects more than 10 million people. Although anorexia can occur in both sexes, the disorder is very common in the female gender. Research results indicate that more than 90 percent of people diagnosed with anorexia are women. Anorexia is mostly common in teenagers and young adults, rarely affecting people at more advanced stages of life.

The actual causes of anorexia haven’t yet been clarified. The disorder seems to occur on the background of inherited genetic abnormalities, and the main triggers for anorexia are suspected to be various environmental factors Anorexia is more prevalent in well-developed societies, which suggests a pronounced environmental feature of the disorder. However, this type of eating disorder has been identified in virtually any ethnical group and culture, hence contradicting existing environmental theories.

Anorexia affects people on multiple levels and there are various signs that can point to this type of disorder. Physical signs of anorexia are: pronounced weight loss, body weakness, fatigue and anemia. Recidivating menstrual problems are clear indicators of anorexia in the female gender. From a behavioral perspective, the signs of anorexia are: strict dieting, refusal to eat in the company of others, excessive exercise, abusive use of diet pills and diuretics, refusal of social interactions. The emotional aspect of anorexia can involve depression, low self-esteem, inaccurate perception of body image and sudden changes in mood.

In time, people affected by anorexia become the victims of their own actions. Although they may not realize it, anorexics actually engage themselves in self-destructive behaviors. It is very important to pay attention to any signs that may suggest the presence of anorexia in your friends or family members. Anorexia can be treated and people can recover completely from the disorder if they receive appropriate encouragement and support.

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How Anorexia Nervosa affects the body system?

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Anorexia Nervosa can be translated “nervous loss of appetite”. This type of eating disorder has been affecting the female gender for centuries, occurring in various cultural and ethnical groups around the world. The unusual behavior of people affected by the disease attracted the attention of various medical scientists throughout the course of history. Early data related to Anorexia Nervosa can be found in manuscripts written many centuries ago. Although they are very inaccurate, the first studies on this form of disease date back since the end of the 17th century. These early studies describe Anorexia Nervosa as a purely physiological disease, developed on the premises of physical dysfunctions. More substantial data on Anorexia Nervosa has been collected towards the end of the 19th century, when the neuropsychological nature of the disease has been described for the first time.

The disease has been called “Anorexia Nervosa” at the beginning of the 20th century. In spite of its name, Anorexia Nervosa doesn’t involve loss of appetite at all! This inappropriate definition suggests a poor understanding of the disease in the past. People who suffer from anorexia don’t just “lose” their appetite; they simply refuse to eat properly. Anorexics are overwhelmed by the fear of being fat and therefore they struggle to prevent this from happening. They become obsessed with food and they engage in unusual behaviors in order to lose weight. People who suffer from anorexia in time develop an altered perception of their body image, seeing themselves as “fat”. Regardless of their efforts to lose weight, anorexics constantly complain about their physical appearance and they are never satisfied with their achievements.

In present, anorexia is very common in the young population. It mostly affects girls and young women, although the disease is also known to affect men. Actually, nowadays anorexia seems to affect both sexes equally. While anorexia was a rare disease in the past, nowadays it has an overwhelmingly high incidence in the young population. Although there are some genetic and acquired physiological factors involved in the development of Anorexia Nervosa, the disease appears to be triggered by environmental and neuropsychological factors.

In modern society, the high incidence of anorexia in the young population is interrelated with the increased influence of the media over the masses. The ideal of beauty promoted by the society we live in has a great influence on teenagers and children. Being fit and having a slim body is the ideal of beauty promoted by modern society and due to a pronounced pressure exercised by the media and modern culture, many young people engage in unhealthy food behaviors in an attempt to achieve an image that closely resembles the topical ideal of beauty. Nowadays, anorexia is obviously a phenomenon induced by modern society, which latently manipulates the young. In fact, the diminished acceptance of modern society for “average-looking people” is the main catalyst of Anorexia Nervosa in present. Due to the exaggerated ideals of beauty promoted these days, and the increased pressure exercised by our culture upon the young, anorexia can only become an even more prevalent phenomenon in future.

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How to checkup your water supply?

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What if your doctor never did an examination or test until you became critically ill?

That may sound crazy but in much the same way, many water well owners rarely, if ever, have their wells checked until something goes wrong-even though occasional maintenance might prevent problems.

The National Ground Water Association (NGWA) recommends that well owners get an annual maintenance checkup and water test. By checking your well system and water quality each year, you can often detect and fix small problems before they become big ones.

If you haven’t gotten a well maintenance checkup and water test in the past 12 months, now would be a good time to do so.

A well checkup should include:

  • A flow test to determine well output.
  • A water-level check before and during pumping, if possible.
  • A pump motor performance check including amp load, grounding and voltage.
  • A pressure tank and pressure switch contact check.
  • A well equipment inspection to ensure it is sanitary and meets local codes.
  • A water test for coliform bacteria, nitrates and anything else of local concern.
  • A clearly written report that explains results and recommendations, and includes all laboratory and other test results.

Your water should be tested any time there is a sudden change in its appearance, taste or odor.

To further protect your water supply, keep hazardous substances properly stored and away from the well. To learn more about this, check with your local health or environmental health department.

“We take care of the things we value. When you stop to think how important good drinking water is to our well-being, it makes sense to check your well system and water quality each year,” said Kevin McCray, National Ground Water Association executive director.

You can arrange a checkup by contacting a water well contractor who performs the type of maintenance recommended by NGWA.

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What treatment is undertaken to get ankle sprain corrected?

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It is very common to find the ankle joint afflicted by injuries and the most common form is sprain. Anatomically, various ligaments that are stretched or torn surround the ankle joint when it is forced to land in varied unnatural positions. This is of common occurrence during exercises, playing certain sports or accidentally.

The usual presentation could be an individual landing his foot forcefully on an uneven surface or the foot is turned inwards suddenly with force. This force in-turn stresses the ligaments that normally help stabilize the outer part of the joint. There might be a history of sudden snap/pop when this type of injury happens.

The ankle sprain ranges in severity from grade-I to grade-III, depending on the extent of injury to the ligament. An examination of the ankle reveals swelling and discoloration due to the accumulation of blood and fluid. The X-ray is an integral part of diagnosis as it rules out the possibility of fracture. An MRI examination provides a conclusive picture of injuries to various ligaments.

Prolonged immobilization in cases of ankle sprain is a common treatment error. Early mobilization stimulates collagen bundle orientation thereby promoting healing and regaining the range of motion.

Improper rehabilitation may result in instability vis-à-vis a balance deficit that increases the risk of re-injury. Returning to activity without proper healing or inadequate rehabilitation can also lead to instability. Patients can be declared fit to return to normal activity only after taking into consideration the following points:

1. When there is a full range of motion of the ankle.
2. Ability to walk without a limp.
3. 80-90 per cent strength when compared to normal ankle.
4. Pain-free hopping possible on the affected limb.

The patients not treated adequately experience a feeling of “giving away” of the ankle. On an uneven surface, while climbing stairs, such individuals are good candidates for recurrent ankle sprain.

Treatment at the initial stage aims at reducing post-injury swelling, bleeding and pain especially during the first 24 hours. Hot fomentation should be avoided as it increases swelling. Avoid Aspirin intake (as it prolongs the blood clotting time thereby increasing bleeding).

Give rest to the affected joint. Keep the leg and foot elevated by placing a pillow. This will reduce pain and swelling. Give ice treatment for 15-20 minutes every one or two hours.

PROTECTION OF THE ANKLE during the initial healing phase is extremely important. Taping, ankle stir-up, brace/crepe bandage and in severe cases leg cast is applied. In some cases crutches are used until pain-free weight bearing is achieved.

Once pain-free motion is attained, strengthening exercises are advised with a stretch band. Sitting on the floor/ chair, looping band over the foot with the heel on the floor ankle is moved outwards/ inward, upward and downward.

Heel/toe raises: Standing on a step with heels slightly off the step, slowly rise up on toes and then slowly bring the heel down. When this is easily done, exercise only the injured ankle in a pain-free motion.

Balance exercises: While standing, raise one foot off the floor and balance on the other foot for a count of 15. Increase the count gradually to 30. Start this exercise with your eyes open, and later on close the eyes also.

Return to activity is advised when the distance travelled by patient is no longer limited by pain then patient can progress to 50 per cent walking and 50 per cent jogging.

Chronic ankle laxity treatment becomes more tedious as it requires proper rehabilitation exercises over a period of time in order to improve the range of motion, to enhance strength and bring stability. If ankle pain is managed properly and well in time the incidence of chronic pain can be effectively reduced.