A fistula is an abnormal, tube-like connection, a passage or hole that forms between two organs or an organ in your body and your skin. There are various types of fistulas that can develop in different parts of your body but the most common types are-

1. Obstetric Fistulas: This is the name given to a hole between the vagina and rectum or bladder. A vaginal fistula that opens into the urinary tract is called a vesicovaginal fistula and one that opens into the rectum is called a rectovaginal fistula. 

A woman with obstructed labour or labour that is not attended by a doctor or a midwife, can suffer labour pain for up to six or seven days. And as the labour produces contractions that push the baby s head against the mother s pelvic, the soft tissues between the baby s head and the pelvic bone are compressed and do not receive adequate blood flow between the mother s bladder and vagina and/or between the rectum and vagina.
This means that a hole forms on the vaginal wall between the urinary tract and her rectum. The urine and faeces thus start to leak from the vaginal opening causing soiling and foul smell.

Apart from labour, hysterectomies that damage the vaginal wall can also cause such types of fistulas.

Enterovaginal   A woman may have gas and foul smelling fluids leaking out of her vagina due to an enterovaginal fistula which is a hole between the vagina and the digestive tract. It s usually caused due to inflammatory bowel disease or IBD and ulcerative colitis.

2. Anal fistula

These are fistulas that form between the end of the bowel and skin near the anus.

An anal fistula usually develops due to a previous or current anal abscess. An anal abscess is an infected cavity filled with pus found near the anus due to an acute infection in the internal glands of the anus.

Common symptoms are:

Pain in the anorectal area
Swelling
Redness
Fever
Rectal bleeding
Urinary symptoms, such as trouble initiating urination or painful urination
Causes:

Inflammatory bowel disease   a chronic condition of the GI track which causes inflammation
Diverticulitis   An infection in the large intestine
Tuberculosis, HIV
Surgery near the anus
Anal abscess and likewise anal fistula are treated by surgical drainage in which an incision is made in the skin near the anus to drain the infection causing an anal abscess. Hospitalization may be required for patients who have impaired immunity like diabetics.

Anal fistula though has no medical treatment and surgery is almost always necessary to cure it.

If the fistula is straightforward which means one that involves minimal sphincter muscle, a fistulotomy may be performed. This involves cutting open the whole length of the fistula so it heals.
Seton is another procedure in which a surgical thread called a seton is placed in the fistula and left there to help it heal.

Different Types of Fistula and Treatments!

Varicose veins are a painful swelling of the veins of the legs. The raised veins just under the top layer of the skin appear to be purplish blue. It is a common affliction and affects nearly 25% of the adult population all across the world and 10 million people in India are diagnosed with it every year.

What are varicose veins?

Varicose veins are enlarged veins that typically develop in the legs and the feet. This condition is triggered when there is something wrong with the valves of the veins. When the valves do not function properly, blood flow to all parts of the body is disrupted. Since the legs are the farthest part of the body from the heart, gravity makes it difficult for blood to flow up to the heart.

Varicose veins are common in people who are:

  Above 50 years of age
  Lead a lifestyle that requires them to be on their feet for long stretches of time
  Pregnant
  Menopausal
  Obese

If someone in your family has a history of varicose veins, you are quite likely to get it too.

What are the symptoms of varicose veins?

Varicose veins are characterized by the following symptoms-

  The most obvious symptom is the large twisty veins
  Pain all down the length of your legs
  Discolouration of the skin of the legs and feet

Diagnosis of varicose veins:

The doctor usually diagnoses varicose veins by a physical examination. She/he may also suggest an ultrasound to determine if your flow of blood is affected. It is a non-invasive procedure and is done with the help of high-frequency sound waves.

You may even have to undergo a venogram. The doctor injects a coloured dye into your veins and X-rays them. The dye gives an indication of how well your blood is flowing through the veins.

Treatment of varicose veins:

There are several treatment options for varicose veins-

  Compression socks: these socks exert pressure on the swollen veins and make it easy for blood to flow upwards. They also bring down the swelling.

Vascular surgery:

When the other methods do not work, doctors prescribe vascular surgery.

  Ligation and stripping: Through this surgery, the surgeon ties up the vein to prevent pooling of blood in the veins and sometimes the vein itself is removed.
  Sclerotherapy: The doctor injects a chemical right into the varicose vein which closes it.
  Radiofrequency ablation: The doctor uses radiofrequency to heat the varicose vein up, which makes the walls collapse

Lifestyle changes:

A few changes to your lifestyle can help you avoid the menace of varicose veins-

  If your job requires you to stand for extended periods, squeeze out a few minutes so that you can sit down, that allows blood to flow normally up to your legs.

  If you are overweight, lose weight immediately.

  Exercise regularly because that keeps your heart healthy and improves blood circulation.

Varicose veins are a painful condition that can be avoided if you implemented a few changes to how you live your life and even if you do get them, there are ways to cure them.

Varicose Veins - How Does Vascular Surgery Help?

A broken bone or a crack in the commonly known as a fracture. Any bone in the arm can be broken, but common areas for fractures in the arm is wrist, specifically the distal radius, forearm bones (radius and ulna), elbow, humerus and shoulder. 

What causes fracture in bones?

Fall: Falling an outstretched hand or elbow is the most common cause of a broken arm.
Sports injuries: Direct blows and injuries on the field or court are a common cause of all types of arm fractures.
Significant trauma: Any of your arm bones can break during a car accident, bike accident or other direct trauma.
Abuse: In children, a broken arm may be the result of child abuse.
How to identify?

An audible snap or cracking sound may be your first indication you've broken an arm.

Signs and symptoms include:

Severe pain, which may increase with movement
Swelling
Bruising
Deformity, such as a bent arm or wrist
Inability to turn your arm from palm up to palm down or vice versa
When to see a doctor?

If you have enough pain in your arm that you can't use it normally, see a doctor right away and do the same for your child. Delay in diagnosis and treatment of a broken arm, especially for children who heal faster than adults do, can lead to poor healing and deformity.

Fracture In Upper Limb Bones - 4 Things That Can Cause It

Tuberculosis or TB as it is commonly known in medical circles is a bacterial infection commonly affecting the lungs. While there are some countries in the world, where TB is more common, anybody can develop TB if they are not very healthy. The TB bacteria spreads through the air. While some people's immune system would be able to fight the disease back; some people who have risk factors, the disease may continue to develop and present with symptoms. 

So, a person can develop TB in two circumstances:

Exposure to TB
Visited a country where TB is very common
Spent time with a person who is infected with TB
Exposure to crowded places like a market or a healthcare facility where TB virus is present
Weakened immune system
Be HIV infected
Weak immune system due to long-term use of steroids
Chronic diseases like diabetes, malnutrition, end-stage kidney or liver disease, cancer, etc.
Extremes of age (children whose immune system is not fully developed, elderly whose immunity is weakened)
Chronic smoker, IV drug abuse, and/or alcohol user
Repeatedly exposed to TB bacteria in the last two years
Had TB bacteria, but not identified or treated
Drug therapy like chemotherapy, long-term use of steroids, auto-immune disease treatments, etc.
Signs and symptoms of TB: 

If you are at risk, it is also suggested that you know the early warning signs and symptoms of TB. TB most commonly affects the lungs and is known as pulmonary tuberculosis. Watching out for these helps in early diagnosis which can both help arrest the condition in the early stages and improve prognosis.

A persistent cough which lasts for more than 3 weeks
Pain in the chest worsened with coughing
Presence of blood in the sputum
Generalized and extreme weakness or fatigue
Unexplained weight loss
Loss of appetite
Fever and chills
Profuse sweating at night
If a person has TB bacteria in the system but does not feel sick and does not have the above systems, then it means that the person is not actively infected. This person also cannot spread the disease to another person. However, when immunity is weak, this can develop into an infection. In a country like India where tuberculosis is quite prevalent, it is best to get yourself screened for active tuberculosis infection if you display any such symptoms.

Tuberculosis (TB) - When A Person Can Develop It?

If you are experiencing heartburn during pregnancy, it is important for you to know about the ways of dealing with it. Heartburn, which is a fiery, painful sensation, occurs when the lower esophageal sphincter (LES) starts leaking or relaxing. This makes your stomach acids to flow up into the esophagus, resulting in acidity or heartburn. Pregnant women are more susceptible to heartburns because the relaxing hormone slows down the rate of digestion, thereby keeping food in the stomach for longer duration and triggering acidity.

Here are the various measures you should take for dealing with acidity during pregnancy:

Follow regular eating patterns: Overeating triggers heart burns, and hence, you should eat less. During pregnancy, there is much less space in the stomach for it to expand. Maintaining a healthy diet in lesser quantities will help you in eliminating the heartburn throughout your pregnancy. You should eat several small meals a day instead of having two or three large meals. It is easier for your body to digest smaller meals.
Avoid trigger foods: You need to identify the common foods, which trigger your heartburn, and eliminate them from your diet. You should abstain from consuming acidic food items like tomatoes, citrus fruits, fried and spicy food, coffee, carbonated drinks, and alcohol.
Focus on fluids: A liquid diet causes much lesser problems compared to solid food products as they can move through your stomach quickly. You should consume milkshakes, soups, yoghurt, smoothies, puddings, and protein shakes. Try to take liquids, which are rich in protein like dairy products. While having solid foods, ensure that you chew them very well.
Sleep properly: In order to avoid heartburn during the night, you must not eat anything three hours before going to sleep. You should make the head of your bed elevated by placing books or any solid object under the bed s legs. You should sleep on your left side, which will make it difficult for stomach acids to travel up to your esophagus.
Sit or stand up right after a meal: After taking any meal, you should take a short walk, undertake some housework, or sit down for a while. Avoid lying down, and abstain from doing anything for which you have to bend over.
Wear comfortable clothes: You should wear loose-fitting clothes for dealing with acidity or heartburn during pregnancy. Tight clothing puts extra pressure on your abdomen, which is already crammed. This is capable of worsening acid reflux. Therefore, you should choose loose fitting maternity wear for eliminating acidity and heartburn.


Acidity During Pregnancy - How It Can Be Dealt With?

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