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CEREBRAL PALSY

Cerebral Palsy is a neurological developmental disorder that affects body’s movement. “Cerebral” means brain and “Palsy” means the impairment or loss of motor function.  Cerebral Palsy results from an interference in brain development affecting the person’s ability to control his or her muscles.

It may also be caused due to an impaired blood supply, decreased oxygen, glucose or calcium supply, infections, trauma & preterm birth. It is the most common childhood impairment which may occur during early months of pregnancy, during birth, soon after birth or early childhood.

SYMPTOMS

The signs and symptoms of this disorder vary greatly from person to person as the condition may affect the entire body or a part of it. In general, a person suffering from this disorder will have problems with movement and coordination, speech and eating, development, and various others.

1. The Movement and Coordination Symptoms may include Stiff or tight muscles and exaggerated reflexes (spasticity), Stiff muscles with normal reflexes (rigidity), Lack of balance and muscle coordination (ataxia), Tremors or jerky involuntary movements, Slow, writhing movements, Difficulty walking etc.

2. The Speech and Eating Symptoms may include delays in speech development, Difficulty speaking, Difficulty with sucking, chewing or eating in addition to Excessive drooling or problems with swallowing

3. The Development Symptoms may include Delays in reaching motor skills milestones, such as sitting up or crawling, Learning & Intellectual difficulties, delayed growth, resulting in smaller size than would be expected

TYPES

Cerebral Palsy may be classified as per the main type of movement disorder involved which may be based on the area of the brain which gets affected. The movement disorders can be Stiff muscles (spasticity), Uncontrollable movements (dyskinesia) and Poor balance and coordination (ataxia)

1. Spastic Cerebral Palsy: This is the most common type affecting 80% of CP patients. Muscles may be stiff causing awkward movements and can affect any body part such as legs (Spastic diplegia/diparesis); one side of the body (Spastic hemiplegia/hemiparesis); all four limbs, the trunk, and the face (Spastic quadriplegia/quadriparesis).

2. Dyskinetic Cerebral Palsy: This is characterized by uncontrollable movements of hands, arms, feet, and legs, making it difficult for the patient to sit and walk. It makes it difficult to swallow, suck or talk when face and tongue are affected.

3. Ataxic Cerebral Palsy: This type causes problems with balance and coordination. 

4. Mixed Cerebral Palsy: Having more than one type of CP, for example spastic-dyskinetic CP

CAUSES & RISK FACTORS

There are a certain factors or medical conditions that can happen during any pregnancy or delivery which increase the risk that a baby is born with cerebral palsy. These could be low birthweight (usually less than 5 ½ pounds); premature birth (before 37 weeks); Twins, triplets, and other multiple pregnancies with the death of a baby’s twin or triplet further increasing the risk; Infections such as toxoplasmosis, rubella (German measles), cytomegalovirus, and herpes infecting the womb or placenta may go on to damage the developing nervous system in an unborn baby; Mothers with thyroid abnormalities, intellectual disability, excess protein in the urine, jaundice or seizures are slightly more likely to have a child with cerebral palsy.

PREVENTION

Although, the condition may not be prevented but the risks may be restrained in the following ways:

1. Those who are planning pregnancy can get vaccinated beforehand especially against diseases such as rubella. Doing this may ward off an infection that could cause foetal brain damage.

2. Regular visits to doctor may reduce health risks for both mother and the unborn baby.

3. Avoiding alcohol, tobacco and illegal drugs are a good way to prevent cerebral palsy as they have been linked to it. 

TREATMENT

The condition differs from person to person in terms of type and severity. It’s important for healthcare providers to develop a customized/ individualized plan of treatment. Physical therapies, occupational therapies and Speech & language pathology can be used to address different issues.

Cerebral palsy is a lifelong disorder. There is no cure yet but an individualized plan of treatment can help improve function. Follow us at www.dattmedi.com for more health related blogs.

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Common Wound Care Issues

Advanced Wound Care for the Elderly: Addressing Unique Challenges and Solutions

World Health Day reminds us of the importance of addressing health concerns across all age groups, particularly for the elderly. As people age, they often face unique challenges, including skin fragility and reduced mobility, which make wound care a crucial aspect of their health management. Advanced wound care tailored to elderly needs ensures better healing outcomes and improved quality of life.

Common Wound Issues in Elderly Patients

Skin Fragility & Chronic Wounds

Aging skin becomes thinner, less elastic, and more prone to damage. Studies indicate that skin tears affect up to 20-25% of elderly patients in long-term care facilities globally, highlighting the need for specialized wound management.  Source

Elderly individuals are particularly susceptible to:

  • Tears: Even minor trauma can cause significant skin injuries.
  • Pressure Sores: Prolonged immobility leads to pressure ulcers, especially in bedridden patients. A study in India reported that pressure ulcers affect nearly 8.3% of hospitalized elderly patients. Source
  • Diabetic Ulcers: Poor circulation and nerve damage increase the risk of chronic wounds, with diabetic foot ulcers affecting nearly 25% of diabetes patients in India at some point in their lives. Source
Limited Mobility & Circulation

Reduced physical activity affects blood flow, leading to slower wound healing. A study published in the Indian Journal of Plastic Surgery found that elderly patients with limited mobility take 30-50% longer to heal from wounds. Mobility limitations can also make it challenging to provide adequate care, increasing the risk of infections and complications.  Source

Specialized Dressings for Effective Care

1. Moisture-Retentive and Antimicrobial Dressings

These dressings maintain an optimal healing environment while preventing infections. Products like Velvert® Secure provide antimicrobial protection and promote faster recovery.

2. Non-Adhesive & Waterproof Options

Delicate aging skin requires gentle care. Non-adhesive dressings minimize trauma during changes, while waterproof options allow patients to maintain daily hygiene without compromising wound protection.

Orthopedic Support Products for Recovery

1. Compression Bandages/Stockings

For conditions like venous leg ulcers or swelling, compression products improve circulation and reduce edema, facilitating better healing.

2. Support Braces & Pads

Braces and padding prevent pressure sores and provide stability, especially for patients with mobility challenges.

Tips for Caregivers in Elderly Wound Management

  • Daily Monitoring: Regularly inspect wounds for changes or signs of infection.
  • Hydration, Nutrition & Hygiene: Ensure patients stay hydrated, eat a balanced diet, and maintain clean skin to support healing.
  • Gentle Mobility: Encourage safe physical activity to improve circulation and prevent stiffness.
  • Collaborate with Professionals: Work closely with healthcare providers to develop and follow a tailored care plan.

Advanced wound care plays a vital role in elderly health and well-being. By addressing their unique challenges with specialized solutions and caregiver support, we can improve healing outcomes and enhance their quality of life.

In this World Health Month, let’s advocate for proactive care and ensure our elderly population receives the attention they deserve.

Managing Chronic Wounds

Choosing the Right Dressing for Chronic Wounds

Chronic wounds, such as diabetic ulcers, pressure sores, and venous leg ulcers, present unique challenges in wound care management. These wounds often resist healing due to underlying conditions such as poor circulation, increased infection risks, prolonged or excessive inflammation, and other patient-specific factors.

Selecting appropriate dressings tailored to the needs of chronic wounds is essential to promote healing and prevent complications.

Chronic wounds develop due to systemic issues that delay natural healing. Common types include:

  • Diabetic Ulcers: These ulcers result from reduced blood flow and nerve damage, often occurring on the feet. Proper care involves maintaining a balance between moisture and dryness, ensuring the wound does not become too dry or overly moist.
Stat Spotlight

In India, diabetic foot ulcers account for approximately 20% of all diabetes‑related hospitalizations. ~ Source
  • Pressure Sores: Caused by prolonged pressure on the skin, these wounds are common among bedridden or immobile patients. Managing pressure and ensuring the wound stays clean and protected are vital.
Stat Spotlight

In India, point‑prevalence studies report that approximately 5% of hospitalized patients have pressure ulcers, underscoring the importance of preventive care. ~Source
  • Venous Leg Ulcers: These ulcers result from chronic venous insufficiency, in which impaired venous return causes fluid to accumulate in the lower legs, increasing tissue pressure and leading to skin breakdown. Effective management typically centers on graduated compression therapy to improve circulation, alongside advanced dressings to control exudate, leg elevation, and skin care to protect the periwound area.

Managing these wounds involves addressing infection risks, ensuring patient comfort, and promoting effective healing using evidence-based dressing solutions. Selecting the appropriate dressing depends on the type of wound, its condition, and the specific challenges it presents.

Below are some general guidelines:

Diabetic Ulcers

Dressings should maintain moisture balance and provide effective infection control. Non-adhesive dressings are preferred to minimize skin damage during dressing changes. Velvert®, with its strong antimicrobial properties and excellent moisture management, is ideal for diabetic ulcers and wounds at high risk of infection.

Pressure Sores

These wounds require dressings that redistribute pressure and effectively manage exudate to prevent further tissue damage and support healing. Velfix®-S offers both cushioning and absorption, making it a reliable choice for pressure sores and wounds requiring enhanced comfort and protection.

Venous Leg Ulcers

Advanced dressings used in combination with compression therapy are essential for managing exudate and improving circulation. Velfour®, with its high absorption capacity, is well-suited for heavily exuding wounds, including venous leg ulcers.

Infected Wounds

Antimicrobial dressings are effective in managing bacterial growth and reducing the risk of complications. Silvel™ with its strong silver based antimicrobial action and Velvert™ with their strong silver-based antimicrobial action, are suitable for infected or high-risk wounds such as second-degree burns, necrotizing fasciitis, and traumatic wounds.

Here are some types of advanced dressings that address specific wound care needs:

Antimicrobial Dressings

Designed to manage infection risks, these dressings often contain agents like silver to inhibit bacterial growth. Silvel™ and Velvert™ are widely used for diabetic ulcers and pressure sores prone to infection, owing to their strong antimicrobial properties.

Foam Dressings

Highly absorbent, these dressings are ideal for wounds with significant exudate, such as venous leg ulcers. They also offer cushioning to enhance patient comfort. Velsap™ and Velfix®-S are designed for moderate to heavily exuding wounds, ensuring effective fluid management and reduced dressing change frequency.

Multi-Layer Dressings

These dressings provide both absorption and protection, making them effective for managing pressure sores and heavily exuding wounds. Velfour® is an excellent example, offering essential support for such wound types.

Real-Life Example

A 60-year-old diabetic patient in India developed a non-healing foot ulcer. Initially, traditional gauze dressings were used, leading to frequent infections. After switching to Velvert™ antimicrobial dressing, the wound showed significant improvement within four weeks, with reduced exudate and no further infections. This case highlights the importance of selecting the right dressing for chronic wounds.

Practical Tips for Managing Chronic Wounds

Effective wound care goes beyond dressing selection. Here are additional strategies to optimize healing:

  • Proper Cleaning and Debridement: Regularly cleaning the wound and removing dead tissue helps create an optimal environment for healing.
  • Adjunctive Therapies: Techniques like compression therapy for venous ulcers and offloading for diabetic foot ulcers can significantly improve outcomes.
  • Regular Monitoring: Chronic wounds require consistent evaluation to identify changes in size, depth, or signs of infection, allowing timely adjustments in care.
  • Consulting Professionals: Work with healthcare providers to ensure the care plan addresses the wound’s unique needs and aligns with the patient’s overall health condition.

Selecting the right dressing for chronic wounds can significantly improve healing outcomes and enhance patient comfort. By understanding wound characteristics and tailoring treatments accordingly, healthcare professionals can address even the most challenging cases effectively.

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