CITY DENTAL CLINIC, Madiwala

Overview - INGUINAL HERNIA

An inguinal hernia occurs when tissue, such as part of the intestine, protrudes through a weak spot in the abdominal muscles. The resulting bulge can be painful, especially when you cough, bend over or lift a heavy object.An inguinal hernia isn't necessarily dangerous, however, it can lead to life-threatening complications. Inguinal hernia repair is a common surgical procedure.    

Symptoms

• A bulge in the area on either side of your pubic bone, which becomes more obvious when you're upright, especially if you cough or strain .
• A burning or aching sensation at the bulge   
• Pain or discomfort in your groin, especially when bending over, coughing or lifting    
• A heavy or dragging sensation in your groin    
• Occasionally, pain and swelling around the testicles when the protruding intestine descends into the scrotum
• You should be able to gently push the hernia back into your abdomen when you're lying down.

Incarcerated hernia

If you aren't able to push the hernia in, the contents of the hernia can be trapped (incarcerated) in the abdominal wall. An incarcerated hernia can become strangulated, which cuts off the blood flow to the tissue that's trapped. A strangulated hernia can be life-threatening if it isn't treated.

Signs and symptoms of a strangulated hernia 

• Nausea, vomiting 
• Fever    
• Sudden pain that quickly intensifies    
• A hernia bulge that turns red, purple or dark
• Inability to move your bowels or pass gas

Signs and symptoms in children

• Inguinal hernias in newborns and children result from a weakness in the abdominal wall that's present at birth. Sometimes the hernia will be visible only when an infant is crying, coughing or straining. 
• In an older child, a hernia is likely to be more apparent when the child coughs, strains during a bowel movement or stands for a long period.
• Seek immediate medical care if a hernia bulge turns red, purple or dark.

Causes

• Some inguinal hernias have no apparent cause. 
• Increased pressure within the abdomen    
• A pre-existing weak spot in the abdominal wall
• Straining during bowel movements or urination    
• Strenuous activity    
• Pregnancy    
• Smoking
• Inguinal hernias develop later in life when muscles weaken or deteriorate due to aging, strenuous physical activity or coughing that accompanies smoking.

Risk factors

• Male. Men are eight times more likely to develop an inguinal hernia than are women.   
• Old age
• Family history.
• Chronic cough, such as from smoking.    
• Chronic constipation.
• Pregnancy.

Complications

1. Pressure on surrounding tissues

Most inguinal hernias enlarge over time if not repaired surgically. In men, large hernias can extend into the scrotum, causing pain and swelling.    

2. Incarcerated hernia

If the contents of the hernia become trapped in the weak point in the abdominal wall, it can obstruct the bowel, leading to severe pain, nausea, vomiting, and the inability to have a bowel movement or pass gas.    

3. Strangulation

An incarcerated hernia can cut off blood flow to part of your intestine. Strangulation can lead to the death of the affected bowel tissue. A strangulated hernia is life-threatening and requires immediate surgery.           

Diagnosis

A physical exam is usually all that's needed to diagnose an inguinal hernia. Your doctor will check for a bulge in the groin area. 

.If the diagnosis isn't readily apparent, your doctor might order an imaging test, such as an abdominal ultrasound, CT scan or MRI.                                

Treatment

If your hernia is small and isn't bothering you, your doctor might recommend watchful waiting. 

Enlarging or painful hernias usually require surgery to relieve discomfort and prevent serious complications.

There are two general types of hernia operations — open hernia repair and laparoscopic repair.                Open hernia repair - In this procedure, which might be done with spinal anesthesia or general anesthesia, the surgeon makes an incision in your groin and pushes the protruding tissue back into your abdomen. The surgeon then sews the weakened area, often reinforcing it with a synthetic mesh (hernioplasty). The opening is then closed with stitches, staples or surgical glue.After the surgery, you'll be encouraged to move about as soon as possible, but it might be several weeks before you're able to resume normal activities.  

COMPARISON OF OPEN AND LAPAROSCOPIC SURGERY

Laparoscopy

In this minimally invasive procedure, which requires general anesthesia, the surgeon operates through several small incisions in your abdomen. Gas is used to inflate your abdomen to make the internal organs easier to see.A tiny camera (laparoscope) is inserted into one incision. Guided by the camera, the surgeon inserts tiny instruments through other incisions to repair the hernia using synthetic mesh.People who have laparoscopic repair might have less discomfort and scarring after surgery and a quicker return to normal activities.

It also might be a good choice for people with hernias on both sides of the body (bilateral).

In Ayurveda, joint pain is known as 'Sandhigata Vata'. Arthritis and Joint pain are among the most prevalent problems faced by adults, mostly old people. As per ayurveda, 'vata Dosha' Is responsible for joint pains and other discomforts associated with it. Natural remedies and proper lifestyle techniques can be utilized to balance the 'vata' to lessen the occurrence and severity of joint pain. Factors including,old age, obesity, injury and strenuous physical activities (that require a lot of joint movements) are responsible for disturbing the balance of your 'vata'.

The following are some ayurvedic home remedies that can be utilized to treat joint pain:

1. Massage therapy - Warm coconut, castor, mustard, olive or garlic oil can be utilized to massage the affected areas to lessen the intensity of pain. If you massage the affected joints with natural oils, it improves blood circulation and relaxes the swelling and stiffness in the region.

2. Hot And Cold Compress - Cold and hot compresses can be utilized to ease your joint pain effectively. Heat compression decreases the pain, increases the blood circulation and relaxes the swollen joints and muscles. On the other hand, cold therapy lessens the inflammation of the affected joint. Place hot and cold towel alternatively on the affected area to achieve immediate relief from persistent pain.

3. Fenugreek - Ingest a teaspoon of ground fenugreek seeds and drink a glass of lukewarm water. Fenugreek has anti inflammatory and antioxidant properties that make it effective for joint pains.Follow this remedy every morning on a regular basis to achieve optimal results.

4. Turmeric - Add a pinch of turmeric and a teaspoon of honey in a glass of lukewarm water and drink this solution on a regular basis for a week. Turmeric contains anti-inflammatory and antioxidant properties, which makes it an excellent remedy for treating joint pains.
5. Apple cider vinegar - Add 2 teaspoons of apple cider vinegar and a little honey to a cup of lukewarm water. Drink this solution twice daily, before your meals. Apple cider vinegar has alkalizing effect, which makes it an effective remedy to remove the toxins that are responsible for causing joint pain.

6. Healthy diet - A balanced diet that comprises a lot of green leafy vegetables and fresh seasonal fruits is good for your joints. The uncontrolled intake of fatty food, dairy products, and high sodium diet must be avoided in order to avoid arthritis and joint pain.

A fracture separates a single solid object into two or more pieces due to pressure. In medical terms, a fracture refers to a broken bone due to some kind of external trauma. A crack in the bone, on the other hand, does not cause a clean break in the bone - there is only a separation or discontinuity in the bone material. A crack in the bone caused due to repeated stress is often called a 'hairline fracture'.

Here are the basic differences between a crack and a fracture in the bone and how to treat them:

1.        A crack or hairline fracture is rarely caused by a single injury. It is usually the result of bone fatigue which may be caused due to repeated concentrated stress over a long period of time and thus it is also called a stress fracture. Other bone fractures are almost always the result of sudden and severe force on the bones.

2.        The skeletal system constantly remodels itself. The cells called osteoblasts absorb calcium and secrete bone connective tissue. If a particular site is exposed to recurrent bouts of force (which are individually not impactful enough to cause a crack), over time the osteoblasts in that region malfunction and the crack appears. Muscular exhaustion can also cause cracks in the bones. Fractures are caused due to sudden external single force trauma to the bone. Nutritional problems like deficiencies of calcium, phosphorus and vitamin D and excessive smoking decrease the bone mineral density and increase the chances of both cracks and fractures.

3.        The symptoms of a crack are swelling, tenderness and sharp pain in the injured region. The symptoms worsen over time. A fracture has similar symptoms and might also exhibit an external physical distortion and makes it impossible to move the part of the body that where the broken bone is.

4.        An MRI is better for the detection of cracks or crack-prone areas because an X-ray can only detect the crack after it widens somewhat or the bone starts paining because the rays cannot pass through the tiny gap in bone material. A fracture is easily detectable by an X-ray because the rays pass right through the break.

5.        Complete rest for six to eight weeks is the most effective way of healing a crack. Using a walking boot in case of cracks in the leg bones in also helpful. Healing fractures requires extensive medical intervention. Surgical techniques like bone grafting and insertion of metal plates are used to reposition the broken bone.
 

A shoulder dislocation is a shoulder injury which is characterized by the upper arm bone popping out of the socket of your shoulder blade. The shoulder joint is the most mobile among all the joints in the body, making it the most prone to dislocation. The dislocation of the shoulder joint can either be partial or complete depending on the injury. In a partial dislocation, the head of the upper arm is partially shifted out of the socket whereas in a complete dislocation, the head comes out of the socket in its entirety.

Symptoms-

The symptoms of shoulder dislocation are:

1. Swelling or bruising of the affected area.

2. Deformed shoulder.

3. Excruciating pain in the shoulder region.

4. Mobility of the joint is greatly reduced.

Apart from these symptoms, there may be tingling, numbness and weakness in the affected region.

Causes-

There can be multiple ways in which a shoulder can be dislocated because of its ability to move and swing in all the directions. The fibrous tissues that connect the bones of your shoulder may also get stretched or torn. These injuries occur due to a sudden blow or a strong force exerted on the shoulder joint.

It is caused by:

1. Trauma to the Shoulder Joint: Hard blows to the shoulder joint such as one suffered from a vehicle accident can lead to shoulder dislocation.

2. Sports Injuries: In contact sports such as hockey and football, the sudden forceful contractions of the shoulder region may lead to dislocation of the shoulder.

3. Falls: Tripping or falling from an elevated place and landing on the shoulder can cause shoulder joint dislocation.

Treatment-

The treatments for shoulder dislocation are –

1. Medication: Medications such as pain relievers can be prescribed by the doctor to reduce pain.

2. Surgery: Surgery of the shoulder joint can help in treating chronic shoulder dislocations. Surgery is also required if the blood vessels or the nerves along the shoulder joint are damaged.

3. Immobilization: This process involves attaching a sling or a splint to the affected area to prevent it from moving. This allows the shoulder joint to heal and recuperate faster.