If you think fissure and fistula are the same, you are mistaken. While the term fissure refers to the tear of the skin, fistula refers to the abnormal tube-like passages or connections between organs. Fissures get cured with or without treatment in a few days to few weeks, and do not lead to complications. On the contrary, fistulas when left untreated may lead to complications.

So, read on further to know about the distinction, how to recognize the symptoms and avail treatment.

What is anal fissure?
An anal fissure can occur due to various reason, such as prolonged diarrhea, anal sex, vaginal childbirth, rectum cancer, etc. For majority of the cases, it is usually due to constant constipation or strained bowel movements, that tear down the muscles controlling the sphincters to the inner rectum or the anal canal.

What is anal fistula?
Anal fistulas are not tears but abnormal abscesses near the anus, filled with pus. In fistula, a tunnel is formed under the skin which connects these abscesses to the infected glands. Fistulas are usually the results of present or previous abscesses. If ignored or left untreated, one single fistula can lead to the development of a more complex fistula, where the single fistula tract ends up creating multiple openings.

Symptoms of anal fissure and anal fistula
Some of the common symptoms of an anal fissure are excruciating pain in the anal area every time the bowel movement occurs, constant itching or burning sensation in and around the anus, bloody stool and visible tears and cracks around the anus.

For anal fistula, some of the very common symptoms are a throbbing pain in the anus, which continues to increase, difficulty in sitting down for longer period, swelling and redness around the anus, accompanied by skin irritation, discharge of blood and pus, and at times fever.

Treatment options
To completely cure anal fissure and fistula, it is the various surgical options that are the most effective ones. However, when diagnosed in its earliest form, medications like antibiotics, analgesics, and antipyretics can often help. It is solely depending on the location, type, and size or severity of the fistula or fissure, the treatments may vary from person to person and so does the recovery time.

Though, these conditions cannot be cured with dietary changes or exercise, following a healthy diet can boost healthy bowel movement, reducing chances of constipation or diarrhea that results in fissures.
Prevention is always better than cure. Therefore, it is essential that you visit the nearest medical facilities once you notice any signs of fissure or fistula , to avail the right treatment and get relief from the symptoms quickly.


Don't Confuse Fissure With Fistula!

Tooth eruption is not only a sign that your child is acquiring the ability to tear, bite, and chew food but it also effects the baby's weight gain, immunity strengthening and development of the brain indirectly.
It is observed that most babies get their first tooth at around 6 months after birth, but they may start gnawing as early as 3 months or as late as 14, and may vary from child to child.  This depends on many factors, one of them being as when the parents started sprouting teeth and whether or not your baby was a preemie. In case of premature and low birth weight babies there may be a delay in their first tooth eruption. Children should have a full set of primary teeth by the time they are almost three.
Babies generally undergo the following Teething Timeline:
6 months: lower central incisors
8 months: upper central incisors
10 months: lower and upper lateral incisors
14 months: first molars
18 months: canines
24 months: second molars
 Symptoms of Teething:
Babies start gnawing to relieve the pain of an emerging tooth.
Puffy and red gums
Excessive drooling
Irritation, especially at night
Tugging Ear
A change in eating habits
Methods to Soothe the Pain:
Teething is a physiological process, no major intervention is needed.
Distraction: You can often soothe your child simply by diverting their minds off the pain by any new toy.
You shouldn't use teethers and topical teething gels to soothe the pain as they might be toxic to babies.
Symptoms of teething usually disappear when the tooth breaks through the gum. In case your baby is teething and the pain prevails , the following signs and symptoms are seen - high fever, diarrhea, or vomiting, highly inflamed gums or blue gum (Cysts) or any kind of lesion or bumps on the gums. In such case you should consult the pediatrician for further guidance

When Will My Newborn Start Teething?

Study of the brain has fascinated specialists all over the globe since time immemorial. The brain being the most vital organ for survival and coordination is perhaps the most complex of them all too. This has led to a limited understanding of its working in spite of the available advanced technology. However, with the advent of techniques for diagnosis and treatment, therapeutic strategies are evolving. This is a major step towards rendering Neurosurgery safer than ever in the history of mankind.

Neurosurgery through the 20th Century-

During the beginning of the 20th century, Neurosurgery was considered as a specialty. The clinical-neurologist would draw conclusions related to lesions in the brain through neurological examination and clinical history. It enabled diagnosis of vascular lesions, spinal disorders, and brain tumors. During the second and third decades of the 20th century, vascular pathologies and brain tumors could be diagnosed indirectly through techniques like angiography, ventriculography, and pneumoencephalography. But since the operative techniques were too crude and the lack of skilled professionals were rampant, there were high rates of morbidity and mortality due to neurological conditions. Generally, after diagnosing the nature of brain lesion and its site, surgery was performed with inadequate maintenance and control of intracranial pressure and through not too sophisticated surgical instruments.

During the fifth and sixth decades of the 20th century, chemotherapy and radiation treatment came into the picture for treating malignant brain tumors, thereby reducing mortality to a good extent.

During the seventh decade of the 20th century, Computed Tomography (CT) scan provided a better understanding of the location of lesions in the brain which slightly substantiated the earlier techniques. Then, the procedures for cerebrospinal fluid diversion significantly improved management of intracranial pressure during surgery.

It was only during the last decade of the 20th century that the Neurology saw a giant progressive leap through the introduction of Magnetic Resonance Imaging (MRI) and powerful high magnification microscopes. Combined with Neuroanesthesia and Intracranial Pressure Management, this aided surgeons to work on a relaxed brain. This promoted safe removal of the brain tumor and better management of vascular lesions. Moreover, the understanding of micro-surgical anatomy improved drastically, leading to a boost in confidence levels of the micro-neurosurgeons performing the operation.

Neurosurgery in the 21st Century-

The 21st century is actually a revolutionary era that uses powerful computers in almost all the fields possible. Computer-based applications such as Neuro-imaging, Neuronavigation, Intra-operative Neuro-monitoring, and Neuro-modulation are now used in standard neurosurgical practice as a part of the routine. Extremely powerful CT scans and MRIs are used for diagnosis before surgery. The advent of nanotechnology and its application in Neurosurgery is doing great and has a promising future ahead based on the current study of scenarios. Moreover, there is a possibility of most of the Neurosurgical procedures becoming minimally invasive. Frameless Stereotaxy is another technique that helps in locating the exact position of the tumor, which further helps the neurosurgeon in navigating with great precision the very sensitive, high-risk areas of the brain. Such techniques, to a great extent, have lowered mortality and morbidity, lessened the rate of recovery, and chances of infection related to Neurosurgery.

Take Away-

A number of techniques for diagnosis and precise location of the tumor in the brain have made Neurosurgery much safer today, due to advancement in science and technology, than it ever had been in the history of mankind.

Advancements In Neurosurgery - Know How Safe It Is!

Dengue is caused from the bite of the  Aedes Aegypti  mosquito. This mosquito has been known to breed and survive in tropical and subtropical regions. A waterborne disease, it causes extreme discomfort and pain, even death is a possibility. Statistics suggest that each year, the number of people afflicted with dengue is around 390 million. Out of this huge number, 96 million tend to develop severe illnesses wherein hospitalization becomes mandatory. 


Causes
It is primarily caused due to the bite of the  Aedes aegypti  mosquito.
A mosquito becomes infected with dengue if it bites an already infected person. The disease can be transmitted to any healthy person that this infected mosquito bites next.
Living near a stagnant water body or an open drain makes you the most vulnerable to this disease. Letting water accumulate in open containers or spaces over a period of time makes it the perfect breeding ground for all types of mosquitoes. 


Symptoms
On being infected, the symptoms generally last for around 10 days. Some of the common symptoms are:
Excruciating pain behind the eyes
Severe headache
Sudden high fever with chills
Vomiting
Fatigue
Skin rash which generally appears two to five days after you get infected
Nose bleeding, easy bruising and bleeding gums
Severe muscle and joint pain


It should be noted that these symptoms can be easily mistaken for high fever or any other viral infection. Therefore, getting tested as soon as these symptoms start appearing is very important.


If the dengue is left untreated or not treated on time, it can result in dengue haemorrhagic fever. This condition causes nose bleeding (due to damage to the blood vessels), high fever and failure of the circulatory system as well as the enlargement of liver.


Ways to prevent dengue include
Avoid storing water in containers
Wear clothes that cover your whole body, if possible
Maintain hygiene and clean your immediate surrounding frequently
Use mosquito repellent
Use a mosquito net around your bed 


In worst case scenarios, death is a possibility as a result of dengue haemorrhagic fever or dengue shock. Many countries consider dengue to be an epidemic. You need to be on complete bed rest while drinking adequate amounts of fluids if you need to recuperate from dengue.


Treatment
There is no specific antiviral medication that is available for the treatment of dengue. In general, Acetaminophen (paracetamol) is usually recommended for treating fever and pain associated with dengue. Medications such as Aspirin, other salicylates, and nonsteroidal anti-inflammatory drugs (NSAIDs) must be avoided.

Dengue - Can You Prevent Yourself from it?

Things to do when your child gets flu

Although cold and flu are very common issue it is usually not a very serious condition. However when it affects your child, it is essential to take good care since a child’s immune system is not fully developed. Children tend to get flu very easily and if immediate care is not taken it has the potential to develop into serious conditions. Running nose, headache, nausea, body aches, fever, feeling cold, coughing etc. are some symptoms of common flu.

When to call the doctor?
Flu sometimes comes and goes away all by itself. However, when it is about younger ones, take professional advice if you see the following symptoms

- Difficulty in breathing
- Dehydration
- Extreme loss of appetite
- Difficulty in breathing
- Continuous coughing
- Get a rattling sound while breathing
- Sudden loss of energy, dullness
- High temperatures even after intake of appropriate medicine

How to quickly rid your child of Flu 
Apart from the prescribed medication here are few points you must always take care of, when affected by flu-

1. Good Rest - Complete rest till symptoms vanish
2. Nasal Drops - Use nasal drops to support easy breathing
3. Warm Water - Warm fluids, honey-lemon potion, cough syrup for chest congestion
4. Administer Paracetamol - Fever medicines that are available specially for infants
5. Increase fluids - Abundant intake of fluids in the form of soups, fruit juices or electrolytes in water.
6. Body Sponging - Warm water sponge bath for relieving muscle or body fatigue

If you would like to consult with me privately, please click on 'Consult'.

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Things To Do When Your Child Gets Flu

The outcome and the procedure of an abdominal laparoscopic surgery vary among patients. The extent of the surgery, the length of the procedure, the surgeon, the hospital nursing staff, and a number of other factors vary with each patient.

Moreover, the recovery or the healing time also varies among patients. What applies to one patient may not apply to another. Generally speaking, surgeons will tell you that it takes only a few days to recover from a laparoscopic surgery, but this is not true to specific cases as in many cases, the recovery time has been longer than expected. So, a laparoscopic surgery is subjective to the health of the patient and the extent of the procedure; however, there are some tips that may prove to be helpful for you to deal with a laparoscopic surgery and to improve your healing process.

Here are some useful tips that you can follow before the surgical procedure.

After you have consulted your doctor and made up your mind on the procedure, then it will be useful to watch some surgery videos and read about the procedure to prepare yourself mentally. The videos can be gory and hence discretion must be maintained.
You can read blogs by patients who have undergone laparoscopic surgery to get a better understanding of the procedure and its implications.
Eight hours prior to the procedure, do not drink or eat anything.
Ask someone to accompany you on the day of the procedure.
Make sure that you fix a pre-op appointment with the surgeon to clear any doubts about the surgery, anesthesia or any such concern.
You can shave the part of your body where the surgery will be performed by yourself or be prepared for someone else to do the same at the hospital.
Prepare your hospital bag with the necessary items and inform the person accompanying you about the items in your bag.
Here are some useful tips that you can follow after the surgery.

Keep yourself active after the procedure to enhance the healing process and to relieve any flatulence.
Stick to comfortable clothing and preferably loose clothes.
Avoid taking a bath for a week or as advised by your surgeon.
To avoid constipation and to stay hydrated drink at least 2-3 liters of water a day.
Hold a pillow against your stomach to lessen the pain while sneezing or coughing.
Don t get up straight from your bed. Roll sideways and use the support of your arm to stand up.
Avoid driving for at least 2 weeks.
Go for regular check-ups with your surgeon or doctor to ensure that the incisions are healing properly.

Tips To Deal With Abdominal Laparoscopy!

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