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Treatment of Child and Adolescent Problems
Thyroid Problems Treatment
Thyroid Disorder Treatment
Paediatric Critical Care
Treatment of Childhood Infections
Child Nutrition Management
Growth And Development Including General Paediatri
Management of New Born Care
Preimplantation Genetic Diagnosis (Pgd)
Congenital Ear Problem Treatment
Treatment of Polycystic Ovary Syndrome In Adolesce
Treatment of Thyroid Disease in Children
Cleft Lip Treatment
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Q1. What exactly is Laparoscopy?
Laparoscopy is an alternative to 'Open' surgery wherein the abdomen is opened by tiny 'key hole' incisions and surgery is done. 'Scopy' means the use of an endoscope or telescope to see inside the abdomen. This is attached to a camera and a light source and the inside of the abdomen is projected on to a monitor. The surgeon performs surgery looking at this screen. The surgeon makes a total of 2-4 small cuts on the abdomen ranging from half to 1 cm through which the telescope and other thin surgical instruments are passed into the abdomen. When the uterus is removed , known as hysterectomy, there is also a cut at the top of the vagina where the uterus is attached.
Q2. What kind of gynaecological surgeries can be performed by Laparoscopy?
Most surgeries done in gynaecology can now be performed by Laparoscopy and do not require the large incision as for open surgery. Laparoscopy can be done sometimes only for diagnosis and is called Diagnostic Laparoscopy, as in checking whether the tubes are open or not and to look for any causes of infertility or pain outside the uterus. In women who are unable to conceive, Diagnostic Laparoscopy is often combined with Hysteroscopy (endoscope inside the uterus, inserted from below, via the vagina). When laparoscopy is done to perform some surgical procedure inside the abdomen it is called Operative Laparoscopy. This may be for simple procedures like sterilization, minor adhesions, drilling ovaries; or for intermediate or major reasons like fibroids, endometriosis, removal of ovaries or tubes or both or removal of uterus, for staging of cancers or radical surgeries for cancer. However, about 5% of all surgeries including those for cancer or very large tumours may benefit from open surgery.
Q3. Why does an expert surgeon recommend Laparoscopy over Open Surgery?
Laparoscopic surgery has many advantages above open surgery: the incisions are much smaller (open surgery incisions are 8-10 cms long), therefore pain is much less; requirement for pain killers (which can have side-effects like sleepiness, impaired judgement) is lesser; hospital stay is shorter; complications fewer; requirement for blood transfusions infrequent; recovery in terms of physical, emotional and mental state is much better and quicker; return to work is faster with consequent lesser loss of working and earning days. Surgery with laparoscope is more precise because it is magnified view. Further vision is much better because it's like having your eye behind the structure because you can see with the telescope at places where the surgeon's eye cannot reach.
Q4. If the cuts on the abdomen are so small in Laparoscopic surgery, how do you remove the uterus or a large tumour from inside the abdomen?
Quite often if the tumour is not malignant and contains fluid, it is punctured to collapse it into a smaller size. If it is solid, it can be cut into smaller pieces inside the abdomen using a special instrument. The collapsed or cut structures can be removed gently through the 1 cm cut on the abdomen which may be increased a bit if required. After hysterectomy, the uterus can be removed easily from below, through the vagina.
Q5. Will there be much pain or discomfort after Laparoscopic Surgery?
There may be some pain and discomfort in lower abdomen for one day to few days after Laparoscopic surgery but this is much less as compared to open surgery because the incisions on the abdomen are much smaller and there is much less tissue handling inside the abdomen by fine instruments instead of rough, big, gloved hands which can cause tissue injury in open surgery. There may be some pain in the shoulder following laparoscopy. This is not serious and is due to the gas used in the surgery to make space for instruments.
Q6. When can I be discharged from hospital?
Following Diagnostic Laparoscopy or with simple Operative Laparoscopy you can expect to be discharged from hospital latest by the morning after surgery. In most other cases of intermediate or even major surgery, discharge is generally 1-2 days following the surgery unless there is some health issues prior to the surgery or any complication during the surgery. The complication rates for Laparoscopic surgery are not more than for open surgery and depend upon patient factors like anaemia, diabetes, obesity and skill of the surgeon.
Q7. When can I perform routine household activities or return to work after Laparoscopic Surgery?
Recovery after surgery depends upon many factors: presence of health problems before surgery; why the surgery is required; what surgery is being done; problems or complications of surgery, anaesthesia or blood transfusions. If all is well, one can perform routine household activities by 1 week, provided one doesn't feel tired. Although there may not be any harm, it may be unwise to be normally active within 48 hours of procedure. Following Diagnostic Laparoscopy or Operative Laparoscopy for simple procedures, one can return to work in 1 week. For other procedures, a 2-3 week off from work is reasonable. It depends on the type of work you are returning to. Avoid too rapid return to work if it is manually hard or requires standing for long durations of time. Sometimes a surgical procedure brings on a well needed rest and break from a lifetime of work. Mostly, when you return to work depends upon your own body and its signals of tiredness. You need to listen to those signals.
Upper respiratory infection (URI) is a condition, which involves illness, mainly caused by critical infection in the upper respiratory tract. This region includes the pharynx, larynx, nose and sinus. This infection causes diseases, such as tonsillitis (tonsils get inflamed), pharyngitis (causes sore throat) sinusitis (nasal passage becomes inflamed), laryngitis (voice box in your throat gets inflamed) and common cold.
Causes of upper respiratory infection (URI):
- Both virus and bacteria cause upper respiratory infection (URI). The most common form of virus causing this infection is known as 'rhinovirus.'
- The immune system of young adults and children are often very vulnerable. Hence, they are more likely to develop upper respiratory tract infection.
- URI is also contagious and airborne in nature. So if a person comes in contact with an infected person suffering from URI, he/she is likely to develop this infection.
- Not washing hands before meals can also cause upper respiratory infection because the virus can be transferred easily to the mouth and can travel into your system.
- If you have any lung problem or heart disease, you are more likely to be susceptible to upper respiratory infection.
- Those who already have inflamed tonsils can trigger tonsillitis by drinking any cold or spicy beverage like ice-creams or cold milkshakes.
- Exposure to some flu or cold can cause pharyngitis. It can also be caused by second hand smoking.
- Birth defects or structural defects in the nasal cavity or nasal polyps can cause sinusitis. Sometimes the inside part of the nose may get swollen due to common cold and block your ducts. This is a common cause for sinusitis.
Symptoms of acute upper respiratory infection:
- Congestion in the lungs or nasal area.
- Whooping cough
- Running nose due to common cold.
- Feelings of fatigue and lethargy throughout the day.
- Your body will start aching without engaging in any physical exercise.
- You can also lose consciousness in severe respiratory tract infections.
- Difficulty in breathing.
- Oxygen levels in blood drop down drastically.
Sometimes in worse cases, acute upper respiratory tract infection (URI) can also cause respiratory failure, respiratory arrest and congestive heart failure. Therefore, it is necessary to book an appointment with a doctor as soon as you start experiencing the above symptoms. If you wish to discuss about any specific problem, you can consult a pulmonologist.
While india is racing towards the no 1 country having the most number of diabetic patients, though the knowledge regarding the general guidelines about diabetes care, or dos and dont's to follow is lacking on a very large scale patients and that includes the most literate persons also.
There are a few things that matters the most which are as follows:
1) diet: most patients are in knowledge that the diet should be restricted in sweets. But rarely anybody knows that only restriction of food that taste sweet will not do the needed.
The food high in carbohydrates also must be included in the list as carbohydrates are the first line source of the body's energy store to convert them in to sugar.
E. G. Rice, potatos, bananas, or over ripen fruits.
And advice is to take them in minimum quantity instead of completely banning them.
Again how to eat? the advise is to divide your large meals in to smaller meals at the interval of 3-4 hours. Avoid eating too much at a time. Diabetes patients also should not indulge in fasting too much.
2) exercise: now many knows that diabetes is having two types: insulin dependent and insulin independent.
In the first type there is actual lack of effective circulating insulin, while the second types does have most of the time considerable amount of insulin to be used but the effectiveness is reduced. Because of the increased amount of fat deposition around cells. In that case doing prescribed exercise will not only help build the general health but by reducing the fat layer around the cells it helps the insulin to reach its effector cells and do its functions normally. Thats why exercise is one of the crucial key points in the diabetic regime.
3) regular investigation: this a very major dilema in many patients that I have observed throughout my practice. Many of the patients don't go for investigation in the fear that what if the blood sugar level comes abnormal. At that point I could remember a saying" if a cat drinks milk with the eyes closed, it doesn't mean that world does not see it.
If its already abnormal then by going for the investigation will make you aware and you can take proper preventive steps to by pass any complications that might have fall upon you.
So advise isto go for the regular blood sugar checkup at least once every two months for those whose levels remains under the normal range and often if it is uncontrolled.
And one should also think of investigated for hba1c every 3-4 months as it will give general idea of the glycemic control.
4) general prevention of complication and specific cares:
By following the above mentioned points you could easily prevent the major complications. But there are also some specific cares you should not ingnore:
Like get examined for any underlying heart condition, or opthalmic conditions, or the like, or kidney problems, or neurological involvement.
Out of these one that I care the most and patients ingnore the most is foot care:&nbsp;
Why is this important: as our feet not being a vital organ we usually ignore but it can be a reason for a very major complication and even can be fatal.
Because of diabetes there are very chances that any injury will not heal at a normal pace and if not taken a due care then it can turn into gangrene. Which we all know that leads to amputation and life long being a handicap.&nbsp;
Because of poor supply and other vascular degeneration it can cause deep vein thrombosis means the veins in you leg gets obstructed by clotts and if such clott dislodges from there and gets in to the circulation then whenever it gets deposited it causes a grave complication like myocardial infarction (heart attack), stroke (paralysis), or other organs can also get affected.
These were some important topics that I thought the general population should know so that they can educate themselves and minimize their emergency visits to the doctors.
Being a homeopath I cannot restrain myself to propogate homeopathy because it is as a true notion that a harmless and gentle treatment, less costly than any other mode of treatment (directly or indirectly), very easy to follow (just few white sugar pills and drops of medicines), prevents the above mentioned complications, and not only that also improves the general health.
There are some homeopathic medicines well proved to be very effective and unquestionable positive effects:
E. G:- syzigium jambolanum, cephalendra, abroma augusta, uranium nitricum, phosphoric acid etc.
Note: above mentioned medicines are very useful and anybody can try but the advise is to consult the specialist as the doses and the repititions needs to be regulated case specifically.
Breast reduction, or reduction mammoplasty, is for a woman experiencing health problems and/or extreme self-consciousness associated with very large, heavy breasts. The main complains are backache, neck pain and skin rashes or itching along with difficulty in carrying large breasts. The goal is to give the woman a more attractive contour with smaller, better-shaped breasts in proportion with the rest of her body. She will then benefit from freedom of health problems associated with large breasts and an improved self-image.
Medical problems associated with very large breasts include back and neck pain caused by the excessive weight, skin irritation, skeletal deformities and breathing problems. Bra straps may leave shoulder indentations. Large, heavy breasts also contribute to poor posture, and can interfere with normal daily activities such as exercise. Excessive breast size may also lead to a decreased sense of attractiveness and self-confidence.
Breast reduction is done under general anesthesia on an outpatient basis or in the hospital. The surgery removes fat, glandular tissue, and skin from the breasts, making them smaller, lighter, and firmer. It can also reduce the size of the areola, the darker skin surrounding the nipple.
Incisions are made around the pigmented nipple-areolar complex and extend vertically below the nipple and in the fold under the breast. The nipple-areolar complex is moved upward to the desired location. The incisions are covered with a light dressing.
Afterward, the breasts are placed in a surgical bra that will hold them symmetrically during initial healing. Initial discomfort subsides daily and can be controlled with oral medications. Scars will fade in 6-18 months. Surgery will likely reduce, but not eliminate the ability to breast-feed.
RECOVERY: WHAT TO EXPECT
When performed by a qualified plastic surgeon, breast reduction is a safe procedure. Nevertheless, as with any surgery, there is always a possibility of complications, including bleeding, infection, or reaction to the anesthesia. Some patients develop small sores around their nipples after surgery; these can be treated with antibiotic creams. You can reduce your risks by closely following your physician’s advice both before and after surgery.
Much of the swelling and bruising disappears in the first few weeks following the surgery. Breasts may appear slightly mismatched, or have unevenly positioned nipples. Their new shape will be apparent within 6 months to a year, and will depend on hormonal fluctuations, weight changes and pregnancy.
Although your surgeon will make your scars as inconspicuous as possible, some permanent scarring is inevitable. Smokers are more likely to experience poor healing and wider scars. The scars will be red and lumpy in the months following the surgery, but the redness will fade and in time the scars will be less obvious.
ABILITY TO BREASTFEED
Because the surgery removes many of the milk ducts leading to the nipples, breast-feeding may no longer be an option.
Some patients may experience a permanent loss of feeling in their nipples or breasts. Rarely, the nipple and areola may lose their blood supply and the tissue will die. (The nipple and areola can usually be rebuilt, however, using skin grafts from elsewhere on the body.)
THE END RESULT
Breast reduction produces the most dramatic results of all plastic surgeries. It ends the physical discomfort or large breasts and makes your body appear more evenly proportioned, and clothes fit better. Your new image will take some getting used to, as much as you desired the change. Give yourself—and your family and friends—time to adjust to the new you and, like most women, you will enjoy the benefits.