Apollo Spectra Hospital - Chennai

If a survey is done for the most common male sexual problem, the outcome would be erectile dysfunction. Commonly referred to as ED, it is a major problem for the male but it can be treated in simple ways.
By definition, ED is the repeated inability of a male to achieve and/or maintain an erection for a healthy and satisfying sexual relationship. The key word here is “repeated” as a quicker erection or softer erection is very common in many men, which could be a one-off instance and caused by transient factors like stress or lack of sleep. When this happens repeatedly, then it needs attention.

Symtoms: Erectile dysfunction is when:

1. Erection is too soft, not allowing for sufficient penetration and prolonged intercourse
2. Erection duration is very short
3. There is difficulty in arousal

Risk factors: ED has been noted to be commonly seen in people, who have following behaviours:

1. Smoking
2. Obesity
3. Advanced age (>60 years)
4. Excessive alcohol abuse
5. Sedentary lifestyle with no exercise
6. History of diabetes
7. Hypertension
8. Atherosclerosis
9. History of groin surgical procedures for prostate, bladder, etc.

Causes: ED has both physiological and psychological reasons.

• Most common psychological reasons are strained relationships, performance anxiety, and other life stressors.
• Physical causes include reduced hormone levels and other chronic medical conditions like obesity, diabetes, and hypertension.

Diagnosis: While ED is easy to diagnose medically, the truth is that not many would be forthcoming for a diagnosis. Given that this issue could be a jolt to the “manhood,” it is often not brought out in the open for discussion. Once that is done, the following steps can help in diagnosis.

1. Medical history and specifically sexual history
2. Check for genital abnormalities
3. Blood testosterone levels
4. Other vitals including blood pressure, sugar, and cholesterol levels to identify overall health

Management:

1. Sexual counseling involving the couple. Once they open up and get comfortable, the problem vanishes. Performance anxiety which is a major cause is taken care of, and ED is no longer an issue. Aligning the couple’s expectations also is very essential.
2. Hormone supplements, both locally applied and taken into the system, help to a great extent
3. Lifestyle changes like quitting smoking, moderating alcohol abuse, healthy eating habits, and moving away from sedentary lifestyle helps treat ED
4. Medicines like Viagra are very useful for occasional cases of erectile dysfunction

As a last resort, there are advanced options like pumps, vacuum devices, implants, and surgical options, and implants. These are often not required, as in most cases, sexual counseling and hormone therapy help in managing ED.

Be it frequent urination, painful urination, or change in color of urine, you must not hesitate to visit a urologist, especially when the symptoms persist for more than two days. Typically, an abnormal urge to urinate is directly affected by any infection in the bladder or due to any underlying medical condition. A urologist who is specialized in the study and treatment of disorders related to the urinary system is the right person to diagnose the problem and put you on the right treatment. Read on to have an insight into symptoms that would necessitate a urologist visit.

Inability to urinate: Many people tend to have calcium depositions in their urinary tract. This is what is known as a stone. When this stone grows big in dimension, it can block the ureters or the urethra. In both these situations, the total urine output reduces to a great extent or can stop completely. The first symptom, in this case, will be an intolerable pain in the back or lower abdomen. This is also a common sign in males with an enlarged prostate.

As the prostate grows in size, it pushes onto the bladder, thus again making it difficult to release urine.

1. Pain in the lower abdomen: Pain in the lower abdomen is also a symptom of various kinds of urinary problems. If the pain is accompanied by urinary frequency or a burning sensation during urination, it inevitably prompts a visit to the urologist to check for bladder cancer or prostate.
2. Blood in urine: Irrespective of the gender of the sufferer, blood in the urine is never a good sign. An immediate visit to the urologist is suggested as he can order tests which can highlight an infection or a disease or in extreme cases, even the early signs of cancer in kidney or bladder.
3. Repeated urinary tract infections: Cases might arise, when a particular person is suffering from two or more infections in a span of 6 months. This situation should never be ignored, and immediately a doctor should be visited as this can be a serious health problem in both men and women. Prophylactic or some antibiotic treatments will be prescribed in this case.
4. Chronic pain in the pelvic region: This is again another urinary condition which can affect both sexes. This condition is characterized by increased frequency of urination and nocturia and pain in the lower abdomen are also reported. Nocturia is severe nighttime urination. The treatment for this condition depends on the reason. A series of tests and examinations have to be carried out to find out the reason, and accordingly, a treatment plan has to be charted out.

Apart from the symptoms mentioned above, if you experience uncontrolled urine leakage or any sediments in urine or if you sense any abnormality concerning the lower abdominal area a urologist visit is warranted. No need to shy away from reporting even such minor discomfort as it could help avoid dire consequences. In case you have a concern or query you can always consult an expert & get answers to your questions!

There is a prevalent misconception that gynecologists are for women what urologists are for men. But urologists also deal with certain women-related health issues. These include overactive bladder, pelvic organ prolapse, and urinary incontinence.

Following are the 5 points which every female should know:

1. Women sometimes pee in their pants too: A majority of the female population between 40 and 60 suffer from either stress incontinence (when you cough, sneeze or laugh) or urgency incontinence (leaking when you want to go badly). Urologists want you to know that there are less invasive options and medications available to treat this problem.
2. Recognize pelvic organ prolapse: This condition is defined by a bit of bladder, rectal, or uterine tissue bulging into your vagina. An urologist can provide non invasive options to deal with this.
3. Age related factors affect both men and women: Right around the time when menopause and andropause strike, changing hormone levels affect the pelvic floor, bladder, urethra and vagina in women causing problems like urinary tract infection and incontinence. These conditions are effectively treated by an urologist who can also probe for underlying conditions like kidney stone, polyp, or tumor in severe cases.
4. An overactive bladder is more common than you think: Around 40% women have to hit the bathroom every hour or so owing to this. Simple lifestyle changes like lowering the intake of caffeine and alcohol, in combination with pelvic floor exercises can solve the problem.
5. Pelvic pain: If it is not gynecology then it is urology. A general pain in the pelvic region triggers a visit to the gynecologist first for most women.From menstrual cramps to ovarian cysts, all of this may well be taken care of by your gynecologist too. But when the usual culprits are not the cause for your discomfort, it's time you get the urology aspect examined thoroughly too.

In case you have a concern or query you can always consult an expert & get answers to your questions!

Kidney stones are one of the most common urinary tract disorders. These stones are the result of an abnormal concentration of urine. The stones might get unnoticed, till it moves around the kidney or passes into the ureter. The stones are basically small deposits of calcium that can cause excruciating pain.

Here is a list of signs that can indicate that a person might be suffering from kidney stone disorder:

1. Painful Urination: The most common sign of kidney stones is a sudden urge to urinate. The urination occurs even though an individual has maintained the normal rate of fluid intake. When an individual does try to urinate, the amount of urine expelled is less than normal. In case of a normal volume of urine, an individual might experience extreme pain. The pain is the result of kidney stones travelling from the bladder to the urethra.
2. Back Pain: People suffering from kidney stones often suffer from localized back pain in the early stages. The pain initiates at the side and back, just near the kidney area. As the condition worsens, the pain might spread to the groin, lower abdomen and lower back area. The waves of pain might last from a few minutes to few hours, depending on the number and size of the stones. For men, the pain might also be felt in the testicles and scrotum area.
3. Blood In Urine: Apart from pain and discoloration, visible signs of blood in the urine are seen in patients who have kidney stones. The color of urine might vary from brown, pink to slightly red with stains of blood. With kidney stones increasing in size, it blocks the urethra, thereby ticking blood along with urine. This condition is referred to as hematuria.
4. Vomiting and Nausea: People suffering from kidney stones often complain of nausea. It can become so severe that can lead to vomiting. Some other complications related to this condition include dehydration, nutritional deficiency etc. Another theory suggests that, throwing up is the result of body’s endeavor of clearing the toxic material from the body.
5. Pungent Smell: It is quite common among patients suffering from kidney stones to have a pungent smelling urine. The smell is foul and sticks for a long time. The smell is the result of creatinine waste being accumulated and slowly passing through the urine from time to time.
6. Difficulty in Sitting: Once the kidney stones gain in size, it becomes increasingly difficult for a patient to sit or lie down for a longer duration. Sitting or lying down puts pressure in the kidney area thereby causing intense pain. People try to combat this condition, by frequently standing up or by having a small walk.

In case you have a concern or query you can always consult an expert & get answers to your questions!

When it comes to the brain and IQ, is bigger better? Does size really matter? Is there really a connection between the size of your brain and intelligence? With the help of findings by neurologists and scientists, we seek to find out!

1. Ailments and the brain: Scientists have found that children with autism have a brain that has grown in a disproportionate manner in the very first year of their life. This prevents the child from making connection in a normal manner. On the other hand, children and adolescents who suffer from Attention Deficit Hyperactivity Disorder or ADHD show sign of having a much smaller brain size. Many scientists have shown that the size of the brain shrinks as we age and this does not have any visible effect on our cognitive abilities.
2. It’s all relative: The size of the brain does not really have a bearing on the way a person’s cognition gets shaped. Even large mammals like elephants and whales are finally hunted and tamed by humans who have smaller brains in comparison. The brain is made up of billions of neurons, which need to function properly. It may be seen that scientists consider the brain mass in relation with the rest of the body so as to speculate about the cognitive abilities of the person. Why is this required? Large animals need a well functioning and proportionate brain size to control and run their organs with proper cognition for satisfactory results, which is what we humans seem to have done.
3. Neanderthal brain: Historically, the earliest man or the Neanderthals are said to have had larger brains than we do. These people are believed to have brains that are at least 10% larger than the brains that we have in our modern times. The shape of their brain was different too. They were also heavily muscled people which had a bearing on the size and shape of the brain and bodies as well as the lean tissue within the brain. They also survived very successfully for a period of over 200,000 years, which obviously points to some form of elevated cognition, as per many scientists.
4. Animals: While animals with small brains like lizards and reptiles do not perform too well on IQ tests, the animals with bigger brains like elephants and dolphins perform much better. But the medium sized brain of monkeys, lemurs and other animals are said to perform in the best manner. The correlation between the body size and the brain does not seem to hold good here, as per various researches.

So the verdict as per medical science and research stands divided!

Headaches and migraines can vary drastically depending on their duration, specific symptoms and the person they are affecting. The more you know about your specific type of headache or migraine, the better prepared you will be to treat them—and possibly even prevent them. The two types of migraine are- 

1. Migraine without aura: The majority of migraine sufferers have Migraine without Aura. 
2. Migraine with aura: Migraine with Aura refers to a range of neurological disturbances that occur before the headache begins, usually lasting about 20-60 minutes.

Symptoms of migraine vary and also depend on the type of migraine. A migraine has four stages: prodrome, aura, headache and postdrome. But it is not necessary that all the migraine sufferers experience all the four stages.

Prodrome: The signs of this begin to appear a day or two days before the headache starts. The signs include depression, constipation, food cravings, irritability, uncontrollable yawning, neck stiffness and hyperactivity.
Migraine Aura: Auras are a range of symptoms of the central nervous system. These might occur much before or during the migraine, but most people get a migraine without an aura. Auras usually begin gradually and increase in intensity. They last for an hour or even longer and are 

• Visual: Seeing bright spots, various shapes, experiencing vision loss, and flashes of light
• Sensory: Present in the form of touch sensations like feeling of pins and needles in the arms and legs
• Motor: Usually related with the movement problems like the limb weakness
• Verbal: It is related with the speech problems

Headache: In case of a migraine attack one might experience:

• Pain on both sides or one side of the head
• Pain is throbbing in nature
• Vomiting and nausea
• Sensitivity to smells, sound and light
• Vision is blurred
• Fainting and lightheadedness

Postdrome: This is the final phase of the migraine. During this phase one might feel fatigued, though some people feel euphoric.

Red flags that the patient may be having underlying serious disorder not migraine

1. Onset of headaches >50 years 
2. Thunderclap headache - subarachnoid haemorrhage 
3. Neurological symptoms or signs 
4. Meningism 
5. Immunosuppression or malignancy 
6. Red eye and haloes around lights - acute angle closure glaucoma 
7. Worsening symptoms 
8. Symptoms of temporal arteritis

These patients require CT scan / MRI or CSF examination. Most Migraine patients do not need these tests. 

Diagnosis of Migraine: Usually migraines go undiagnosed and thus are untreated. In case you experience the symptoms regularly then talk to the doctor, who evaluates the symptoms and can start a treatment. You can also be referred to a neurologist who is trained to treat the migraines and other conditions. During the appointment the neurologist usually asks about the family history of headaches and migraines along with your symptoms and medical history.

The doctor might advise for some tests like:

1. Blood Tests: These reveal problems with the blood vessel like an infection in the spinal cord and brain.
2. CT scan: Used to diagnose the infections, tumors, brain damage, and bleeding that cause the migraines.
3. MRI: This helps to diagnose the tumors bleeding infections, neurological conditions, and strokes.
4. Lumbar Puncture: For analyzing infections and neurological damages. In lumbar puncture a thin needle is inserted between the two vertebrae to remove a sample of the cerebrospinal fluid for analysis.

Treatments

Migraine treatments can help stop symptoms and prevent future attacks.

Many medications have been designed to treat migraines. Some drugs often used to treat other conditions also may help relieve or prevent migraines. Medications used to combat migraines fall into two broad categories:

• Pain-relieving medications. Also known as acute or abortive treatment, these types of drugs are taken during migraine attacks and are designed to stop symptoms.
• Preventive medications. These types of drugs are taken regularly, often on a daily basis, to reduce the severity or frequency of migraines.

Your treatment strategy depends on the frequency and severity of your headaches, the degree of disability your headaches cause, and your other medical conditions.

Some medications aren't recommended if you're pregnant or breast-feeding. Some medications aren't given to children. Your doctor can help find the right medication for you.

A brain stroke can affect anyone at any point of time when the supply of blood to the brain is interrupted. It can threaten major physical functions and can prove to be fatally dangerous at times. The brain stem which is placed right above the spinal cord controls the breathing, heartbeat and levels of blood pressure. It is also in charge of controlling some elementary functions such as swallowing, hearing, speech and eye movements.

What are the different types of strokes?
There are three main kinds of stroke: ischemic strokes, hemorrhagic strokes and transient ischemic attacks. The most common type of brain stroke is the ischemic stroke is caused by narrowing or blocking of arteries to the brain, which prevents the proper supply of blood to the brain. Sometimes it so happens that the blood clot that has formed elsewhere in the body have travelled via the blood vessels and has been trapped in the blood vessel which provides blood to the brain. When the supply of blood to a part of the brain is hindered, the tissue in that area dies off owing to lack of oxygen. The other variant of brain stroke is termed as hemorrhagic stroke is caused when the blood vessels in and around the brain burst or leak. Strokes need to be diagnosed and treated as quickly as possible in order to minimize brain damage.  Remembering the F.A.S.T. acronym can help with recognizing the onset of stroke (Face, Arms, Speed, Time - explained below). 

What are the common symptoms of a brain stroke?
The symptoms of the brain stroke are largely dependent on the area of the brain that has been affected. It can interfere with normal functioning, such as breathing and talking and other functions which human beings can perform without thinking such as eye movements or swallowing. Since all the signals from the brain as well as other parts of the body traverse through the brain stem, the interruption of blood flow often leads to numbness or paralysis in different parts of the body.

Who is likely to have a stroke?
Anyone is at a risk of developing brain stroke although ageing is directly proportional to the risk of having a stroke. Not only that an individual with a family history of brain stroke or transient ischemic attack is at a higher risk of developing stroke. People who have aged over 65 accounts for about 33 percent of all brain strokes. It is important to point here that individuals with high blood pressure, high blood sugar, cholesterol, cancer, autoimmune diseases and some blood disorders are at a higher risk of developing brain stroke.

There are a few factors which can increase the risk of developing stroke beyond any control. But there are certain lifestyle choices as well which aids in controlling the chances of being affected by stroke. It is crucial to refrain from long-term hormone replacement therapies as well as birth control pills, smoking, lack of physical activity, excessive use of alcohol and drug addiction. A brain stroke is a life-threatening medical condition, and when an individual has symptoms that resemble that of stroke, it is crucial to seek immediate medical help.

Treatment for stroke

1. Treatment depends on the type of stroke.
2. Ischemic strokes can be treated with 'clot-busting' drugs.
3. Hemorrhagic strokes can be treated with surgery to repair or block blood vessel weaknesses.
4. The most effective way to prevent strokes is through maintaining a healthy lifestyle.

What is TPA?
TPA is a thrombolytic or a “Clot Buster” drug. This clot buster is used to break-up the clot that is causing a blockage or disruption in the flow of blood to the brain and helps restore the blood flow to the area of the brain. It is given by intravenous (IV). This can be given only within 4.5 hrs of the onset of symptoms

Time is brain

1. Remember Every second Loss means brain cells die.
2. Rush to the nearest Stroke Centre whenever you experience such symptoms.
3. U can save the brain cells dying if you reach within 4.5 hrs by the CLOT BUSTER. 

Endovascular procedures 
Another treatment option is an endovascular procedure* called mechanical thrombectomy, strongly recommended, in which  trained doctors try  removing a large blood clot by  sending a wired-caged device called a stent retriever, to the site of the blocked blood vessel in the brain

Stroke prevention
The good news is that 80 percent of all strokes are preventable. It starts with managing key risk factors, including 

1. High blood pressure,
2. Cigarette smoking,
3. Diabetes
4. Atrial fibrillation and
5. Physical inactivity.
6. More than half of all strokes are caused by uncontrolled hypertension or high blood pressure, making it the most important risk factor to control. 

Rehabilitation
The best way to get better after a stroke is to start stroke rehabilitation ("rehab"). In stroke rehab, a team of health professionals works with you to regain skills you lost as the result of a stroke.

There is no trustworthy evidence regarding what causes brain tumors, but there are a few risk factors that have been substantiated through research. Children and young people who receive radiation around the head are susceptible to developing tumors in the brain once they grow up. Also, people with a certain kind of rare genetic condition like neurofibromatosis may develop a brain tumor though such cases are very few in number. Age is also an important factor as people aged over 65 years are diagnosed with brain tumors at quadruple times higher than children and younger people.

Types of Brain Tumours:

A primary brain tumor originates in the brain, and they may or may not be cancerous. Some tumors can be benign, which do not spread in the surrounding tissues and are not very malicious. However, that does not signify that they will not cause any harm over time. Sometimes these tumors can be severe and cause a threat to the life of the sufferer. The National Cancer Institute reports that approximately there were 23, 380 fresh cases of brain tumors in 2014.

Identifying the Symptoms of Brain Tumors:

The symptoms of the brain tumor are dependent on various factors such as the size, type as well as the exact location of the tumor. These symptoms are triggered when any tumor is pressed or clashed against a nerve or disturbs a part of the brain. Symptoms are also felt when any tumor particle blocks the fluid flowing around the brain or when there is a swelling in the brain owing to the build-up of fluid.

Common symptoms include: headaches that get worse in the morning, nausea along with vomiting, an alteration in the speech, hearing and imbalances in walking and movement, mood swings, change in personality and ability to concentrate or remember things and seizures or convulsions.

Treatment for Brain Tumor:

Surgery is normally the most usual treatment for brain tumors, and the patient is given anesthesia, and the scalp is shaved before the surgery. Then, craniotomy is performed to open the skull, and the surgeon removes a bone piece out of the skull. Then the tumor is removed as much as possible. The bone is then restored back, and the incision on the scalp is closed. Sometimes surgery is not viable in case the tumor has developed in the brain stem or some other complex parts.

Neurosurgeons can surgically remove some tumors completely (called resection or complete removal). If the tumor is near sensitive areas of the brain, neurosurgeons will only be able to remove part of it (called partial removal). Even partial removals can relieve symptoms and facilitate or increase the effectiveness of other treatments.

The role of surgery in treating brain tumors:

Surgery can provide:

• The complete removal of some brain tumors
• A sample to enable doctors to diagnosis the tumor and recommend the most appropriate treatment
• Better quality of life:
  • Reduced symptoms and improved ability to function (e.g., to think, speak or see better)
  • Less pressure within the skull from the tumor
  • A longer life

In case you or any of your near ones is affected with brain tumor, you should visit the doctor to know the possible treatments other than surgery and other important questions related to brain tumor.

When it comes to the brain and the IQ, is bigger the better? Does size really matter? Is there really a connection between the size of your brain and intelligence? With the help of findings by neurologists 
and scientists, we seek to find out!

1. Ailments and the Brain: Scientists have found that children with autism have a brain that has grown in a disproportionate manner in the very first year of their life. This prevents the child from making connections with normal behaviour. On the other hand, children and adolescents who suffer from Attention Deficit Hyperactivity Disorder or ADHD have shown signs of having a much smaller brain size. Many scientists have shown that the size of the brain shrinks as we age, and this does not have any visible effect on our cognitive abilities.
2. It's all Relative: The size of the brain does not really have a bearing on the way a person's cognition gets shaped. Even large mammals like elephants and whales are finally hunted and tamed by humans who have smaller brains in comparison. The brain is made up of billions of neurons which need to function properly. It may be seen that scientists consider the brain mass in relation with the rest of the body so as to speculate about the cognitive abilities of the person. Why is this required? Large animals need a well functioning and proportionate brain size to control and run their organs with proper cognition for satisfactory results, which is what we humans seem to have done.
3. Neanderthal Brains: Historically, the earliest man or the Neanderthals are said to have had larger brains than we do. These people are believed to have brains that are at least 10% larger than the brains that we have in our modern times. The shape of their brain was different too. They were also heavily muscled people which had a bearing on the size and shape of the brain and bodies as well as the lean tissue within the brain. They also survived very successfully for a period of over 200,000 years, which obviously points to some form of elevated cognition, as per many scientists.
4. Animals: While animals with small brains like lizards and reptiles do not perform too well on IQ tests, the animals with bigger brains like elephants and dolphins perform much better. But the medium sized brains of monkeys, lemurs and other animals are said to perform in the best manner. The correlation between the body size and the brain does not seem to hold good here, as per various researches.

So the verdict as per medical science and research stands divided!

Ear discharge is the phenomenon of fluids being expelled from the ear. This condition is also known as otorrhea.

The kinds of fluids that can be discharged from the ear range from blood to pus and other forms of bodily secretions. It is caused by a number of factors, which determine the exact nature of the condition and the diagnosis for treatment.

What are the causes of ear discharge?

Some forms of ear discharge are natural, such as ear wax which is produced by the body as a form of defense against external particles that may enter the ears. Other forms are unnatural and result from anomalies in the health system.

The causes of these include the following:

• Infections: This is the most common cause of ear discharge and occurs when bacteria and viruses infest the inside of the ear and lead to the secretion of fluids, which builds up in the middle ear or at the eardrum
• Swimmer’s Ear: This condition is also known as otitis externa and is caused by staying in water for prolonged periods. It results from excessive exposure to moisture that makes the walls of the ear canal to break down allowing bacteria and fungi to enter and infect the ear.
• Trauma: Excess pressure on the eardrum can cause it to rupture and discharge fluids. This happens due to a number of reasons such as exposure to loud explosive sounds or pressure from flying in aircrafts and scuba diving.
• Skull Injury: Damage to the bones behind the ear as a result of injury can also lead to ear discharge due to infection.
• Acute Rhinosinusitis: Any sort of infection in Sinuses or nasal secretions may lead to infection in middle ear which may cause perforation in ear drum leading to ear discharge.

What are the symptoms associated with ear discharge?

Some of the symptoms of otorrhea are as follows:

• Abnormal and unusual secretion of fluids from the ear
• Swelling of the ear
• Partial or complete loss of hearing
• Pain and throbbing in the ear
• Accompanying signs such as fever and migraine

Diagnosis and treatment of the problem depend on the exact cause and nature of the condition, which also determines treatment and recovery time. In case you have a concern or query you can always consult an expert & get answers to your questions!