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Diagnostic Cardiac Procedures
Treatment of Endoscopic Sinus Surgery
Treatment of Lumbar Radiculopathy
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Hiv Prophylaxis Post Exposure
Restylane Vital Procedure
Treatment of Shin Splints
Treatment of Shin Splits
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In the duration of iui time can go for intercourse. If go then what will happen. I am waiting for success. Please tell me?
When I eat something heavy something started happening in my stomach and I feel to go for toilet? Why this happening to me.
Sir my mother is suffering from dysentery with blood and pus she is taking medicine but not improving she goes at least 6 times for focus stool and blood comes with pain.
When I look down in front and back. My neck pains. On myback I feel a stress like aome muscle is stretching.
My head and sweat a lot I can't get daily 7 hrs sleep this is happening in night and pimples are coming up on my head and facial what is the cause want to treat soon I also have hair loss problem please guide me on same I think I have hyperhidrosis problem can any one help me on same also I feel tired after going in sun light.
I am 28 years old male but since last 3 years I am getting attracted towards boys also. I do not wish to be a gay. Please guide me about how to remove this feeling from mind. Please guide me But.
Many people are hesitant to see a doctor for incontinence as they feel embarrassed or believe it can't be treated or that the problem will eventually go away by itself. This may be true in a few cases, but many cases can be successfully treated or managed. The treatment of incontinence will vary according to whether it is faecal or urinary incontinence and will depend on the cause, type and severity of the problem.
1. Stress incontinence
• Weight loss
• Cessation of smoking
• Pelvic floor exercises
• Vaginal weights
• Electrical stimulation
Non-medical treatment can be very effective in motivated patients with minor degrees of stress incontinence. The short-term results are often very good, but this isn't always maintained in the long term. Published studies quote cure/improvement rates of 50-80% for pelvic-floor exercises.
• Combination of the above
Medical treatment doesn't have a great role in stress incontinence. Postmenopausal atrophy affects the closure of the urethra. Oestrogens, which can be taken orally or applied locally, restores the bulk of urethral tissue leading to more effective closure. Alpha-agonist s increase the tone in the bladder neck, thereby increasing outflow resistance. Some studies indicate a beneficial effect using a combination of oestrogen and an alpha-agonist in older post-menopausal women.
• Periurethral injections of bulking agents
• Suspension operations
• Sling operations
• Artificial urinary sphincters
Periurethral injections involve the injection of bulking agents into the urethra to improve effective urethral closure. Commonly used agents include fat, collagen, Teflon paste and silicon particles. Injection therapy is suitable for women with intrinsic sphincter deficiency rather than hyper mobility, as well as for men with post-prostatectomy incontinence. The major advantage of injection therapy is that it's a minor procedure. Short-term results are good, but often not maintained long-term.
The various suspension operations restore the normal anatomy in patients with hyper mobility and improve the support of the urethra and the bladder neck. Open suspension operations like the Burch copo suspension provide the best long-term results. The various needle suspensions have fallen into disuse due to high failure rates.
Urethral slings can be used in people with intrinsic sphincter deficiency as well as those with hyper mobility. It involves the placement of a strip of tissue or artificial substance that supports the urethra and bladder neck like a hammock. It increases outflow resistance and improves urethral closure by supporting the mid urethra. The vast majority of patients can be rendered dry in this way, but the operation does carry the risk of difficulty with passing urine afterwards. Other complications include infection or erosion of the synthetic sling material which then has to be removed.
An artificial urinary sphincter (AUS) made of silicone can be used in someone with total incontinence resulting from irreparable damage to the sphincter. The AUS consists of a small cuff that is placed around the urethra (bladder tube), with a reservoir (balloon) that is placed in the lower belly next to the bladder. Both of these are connected with a small tube to a valve placed in the scrotum, which the person then uses to inflate or deflate the cuff. An AUS is very effective, but it is quite expensive, and there is a risk of infection or erosion of the synthetic material.
2. Urge incontinence
• Bladder training
• Pelvic floor exercises
Voiding by the clock and progressively increasing the time between voids can improve the symptoms of patients with urge incontinence and otherwise normal bladders. This can be combined with biofeedback and pelvic floor exercises.
Drug therapy forms the mainstay of treatment for patients with urge incontinence due to bladder instability. These anti cholinergic agents relax the bladder muscle and increase bladder capacity. Side effects include a dry mouth, constipation and blurred vision.
Injection of botulinum A toxin (Botox) into the bladder muscle (detrusor) can be used if the urge incontinence is due to a neurological disease causing overactive bladder contractions.
Tiny bladders due to radiation or tuberculosis can be enlarged surgically. A segment of intestine is patched onto the opened bladder, thereby increasing the capacity. Patients with intractable bladder instability who have failed medical treatment can also be treated in this way.
3. Overflow incontinence
Overflow incontinence due to bladder outflow obstruction is treated by surgically alleviating the obstruction. The most common example would be a man with prostatic enlargement treated by resection of the prostate gland. If the incontinence is due to failure of the bladder to contract then intermittent clean self-catheterisation is the most appropriate treatment. Permanent indwelling catheters should be avoided if at all possible.
4. Total incontinence
Total incontinence due to a vesico vaginal fistula or auretero vaginal fistula is treated by surgical repair of the defect.
Treating faecal incontinence
Once your doctor has established the underlying cause of faecal incontinence, they will decide on the most suitable treatment, which could involve a combination of medication, exercise and other methods.
Let’s look at some of the treatment options available for FI:
Dietary changes: If your FI is caused by diarrhoea or constipation, making changes to your diet may sometimes help to normalize and regulate bowel movements. Your doctor may ask you to keep a food diary to monitor the impact of dietary changes. For example, he or she may suggest increasing your intake of high-fibre foods and fluids, or to eliminate foods that may exacerbate the problem.
Medications: Your doctor may recommend specific medication or bulking agents such as fibre supplements to change stool consistency, depending on whether you suffer from diarrhoea or constipation. Another option is Solesta, an injectable FDA-approved gel that's injected into the anus and effectively reduces or completely treats FI in some people. This gel narrows the anal opening by increasing the growth of rectal tissue and helping it to remain tightly closed.
Bowel retraining: This routine encourages normal bowel movements and helps you achieve greater control by becoming more aware of the need to use the toilet. It may incorporate various aspects such as making a conscious effort to have a bowel movement at a specific time of day and using suppositories to stimulate bowel movements.
Biofeedback: This improves the strength and coordination of the anal muscles that help control bowel movements, and heightens the sensation related to the rectum filling with stool. It usually involves a specially trained physiotherapist teaching you simple exercises to strengthen your pelvic-floor muscles, sense when stool is ready to be released and contract the muscles if it's not appropriate to have a bowel movement at a specific time.
Kegel exercises: Also called pelvic-floor exercises, these focus on strengthening the muscles of the anus, buttocks and pelvis. When done correctly, they can be effective in improving or resolving FI. They involve a routine of repeatedly contracting muscles used when making a bowel movement. Hold these muscles as if you're trying to stop the flow of stool or passing gas for a slow count of five, and then relax. Kegel exercises should be done in a series of 30 contractions three times a day. They usually strengthen the pelvic-floor muscles within a few weeks.
Surgery: In some cases, surgery may help people with severe FI who haven't responded to other treatments or people with an underlying condition causing incontinence that need surgery to regain control. There are various surgical options and your doctor will probably refer you to a specialist.
Hiatal hernia takes place when the upper portion of the stomach pushes itself through an opening in the diaphragm, into the chest cavity. The diaphragm is a wall of thin muscles, which separates the chest cavity and the abdomen. In most cases, a small Hiatal hernia doesn't cause problems and you may never know you have a Hiatal hernia unless your doctor discovers it when checking for another condition.
But a large Hiatal hernia can allow food and acid to back up into your oesophagus, leading to heartburn. Self-care measures or medications can usually relieve these symptoms, although a very large Hiatal hernia sometimes requires surgery.
Hiatal hernia is primarily or most commonly caused due to the increase in pressure in the abdominal cavity. Sometimes, a lot of pressure may be felt around the stomach accompanied by coughing, vomiting, strain during bowel movements. For people born with an abnormal hiatus, the chance of getting Hiatal hernia is more.
The two common types of Hiatal hernia are:
- Sliding Hiatal hernia, which occurs during the sliding out of the stomach and oesophagus into and out of the chest through the hiatus. This type of Hiatal hernia is less intense and has no symptoms.
- Fixed Hiatal hernia or Paraoesophageal Hernia is an uncommon type of hernia where a part of the stomach pushes through the diaphragm and stays there.
Usually, no symptoms are experienced during Hiatal Hernia. Some symptoms are experienced that happen due to stomach acids, bile or air, which enters the oesophagus. Some common symptoms include:
- Heartburns which become worse when a person lies down
- Chest pain, better called epigastric pain
- Problem in swallowing food
Tests for Diagnosis
Several tests can be carried out for the diagnosis of Hiatal hernia. They include:
- Barium X-ray, where a person is made to drink a liquid filled with barium before the x-ray. The x-ray provides a clear image of the upper digestive tract region and the location of the stomach can be seen. If it is protruded out, Hiatal hernia is signified.
- Endoscopy is another test for detection of Hiatal hernia. A thin tube slides down the throat, which reaches up to the oesophagus and stomach. This will determine whether the stomach is pushing through the diaphragm or not.
Medicines, which are used to cure a Hiatal hernia may include antacids for neutralizing stomach acid, H2 receptor blockers to lower acid production and proton pump inhibitors. Sometimes fundoplication surgery is required for the treatment of Hiatal hernia, although it is rare. Some common surgical techniques are rebuilding of oesophageal muscles or a surgery to put the stomach back in its actual place. Laparoscopic surgery methods are used. Hiatal hernia may reoccur even after surgery; so general precautions should be taken. You should:
- Exercise regularly and maintain a healthy weight
- Avoid lifting heavy objects and ask for help
- Avoid any kind of strain on the abdominal muscles
Hiatal hernia is a disorder, which is more common among people over the age of fifty. Necessary precautions and treatment should be adopted in case of Hiatal hernia.