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Dr. Sayalee Karve is one of the most esteemed doctor in Pune.

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  • Clinical Pharmacologist

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Questions Answered By Dr. Sayalee Karve (10)

Female | 70

I am 20 year grand daughter who is taking care of my 70+age grandmother who has ankle fracture a month ago.We are not allowed to have surgery because operation won't be success.She has tight bandage in first week,after 15 days.What is the best steps to be taken now?And the second question is I am helping her with bedpan for excretion.But at night, She expects to use bedpan.But I suggest adult tape briefs.What should I use at night?

Answered on 27th May '22

  • Older individuals are more prone to falls and fractures. The incidence of ankle fractures in older patients is high and severe in some cases. The treatment is difficult and complicated in nature due to presence of comorbidities such as diabetes, obesity, hypertension and poor bone quality.
  • Treatment goals include: Stability of the joint, ability of the patient to perform daily activities independently and minimizing complications associated with fracture and other comorbid conditions.

RICE is a part of the Non-operative management of ankle fracture in older patients which includes:

R: The importance of rest cannot be overstated. In order for the fracture to heal faster limit yourself from further pressure on the foot. 

A cast will most likely be worn to keep the foot and ankle immobile.  In case of severe soft tissue swelling, a cast may be required for the first three to five days. The brace must be worn for six weeks in order to allow the fracture to heal. Cast fixation with off-loading is advised for poor bone quality depending on the radiography report.  

Ice: For reducing the swelling and inflammation, apply ice to the region for 20 minutes at a time.

 And continue further for every 40 minutes.

Compression: Wrapping the area in a bandage helps to reduce swelling.

Elevation: To assist reduce inflammation, lift your foot and ankle slightly above the level of your heart.

Female | 30

I am 30 years old. My knee is paining since 3 months. I did MRI...... Discoid lateral meniscus showing grade 2 signal intensity. -mild intra substance hypertensity in the distal fibres of anterior cruciate ligament with no obvious tear -likely sprain. Mild joints space narrowing, subchondral marrow edema and tiny bony spur in anterior aspect of lateral tibial plateau. Mild joint effusion extending along the supra patellar recess. Jyadader khade hone Mein pain jyada ho rha hai.washer jahan hota hai Vahan jyada pain hota hai. Ye treat ment se tik ho jaega kya?

Answered on 13th Jan '22

Sacroiliac joint dysfunction is frequently assumed to be a source of lower back and/or leg discomfort, however it is sometimes difficult to diagnose. The sacroiliac joint, which connects the triangle bone at the bottom of the spine (the sacrum) to the pelvis, can cause discomfort if its natural mobility is disrupted. More precisely, sacroiliac joint discomfort can be caused by excessive or insufficient movement.

• Leg pain produced by sacroiliac joint dysfunction can be difficult to distinguish from radiating leg pain caused by lumbar disc herniation (sciatica) since they can feel quite similar.

• The major reasons of SI joint dysfunction include - Too much or lack of movement.

• Too much movement in the sacroiliac joint (hypermobility or instability) can cause the pelvis to feel unstable and produce discomfort. Excessive mobility causes pain in the lower back and/or hip, which can extend into the groin, whereas lack of movement (hypomobility or fixation) can result in muscular tension, discomfort, and a reduction in mobility.

• Sacroiliac joint inflammation (sacroiliitis) can also cause pelvic discomfort and stiffness. Inflammation may arise as a result of sacroiliac joint dysfunction or as a result of an infection, rheumatoid disease, or other cause.

• There is no one-size-fits-all solution for controlling SI joint discomfort. For successful pain management, a combination of non-surgical therapies is frequently required.

• Treatment includes – resting for 1 to 2 days, applying ice or heat (applying it to lower back reduces inflammation and alleviates pain and discomfort; applying around the joint provides relief from pain), pain relievers like paracetamol and inflammation treating agents such as NSAID’s are recommended in case of mild or moderate pain relief. Muscle relaxants or high-end pain killers can be prescribed in case of episodes of severe and acute pain, Manual manipulation can be effective if sacroiliac joint pain is caused due to too little movement, Support or braces can be used to stabilize the pelvic area and sacroiliac joint injections such as anaesthetics such as lidocaine along with anti-inflammatory medicine like corticosteroids are given to reduce inflammation and pain.

Consult an Orthopedics for further investigations and customised treatment.

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Education

  1. Doctor of Pharmacy

    Gulf Medical University

    2015

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