This surgery involves the removal of Gallbladder, which is a pear-shaped organ that lies right beneath the right side of the liver. The main function of the gallbladder is to collect and concentrate bile, which is a digestive juice produced by liver after eating, aiding digestion. The most common disorder of the digestive system is presence of Gallstones, which are the stones made up of a mixture consisting of cholesterol, bile pigment and calcium salts.

These Gallstones don t cause any problems in most cases. But prompt treatment is required if stones block ducts and cause infections and inflammation in the pancreas. This may lead to removal of the gallbladder through a surgery, known as cholecystectomy, which further includes techniques such as laparoscopic (keyhole) cholecystectomy or open surgery.
Although it is a less vital organ, the body can cope up even after removal.

Procedure of surgery:

    The surgery involves removal of gallbladder and gallstones through several incisions in the abdomen. In order to see clearly, the surgeon inflates the abdomen with air or carbon dioxide.
    A lighted scope attached to a video camera is inserted into one incision near the belly button. The video monitor is used as a guide for inserting other surgical instruments into the other incisions to remove the gallbladder.
    Intraoperative cholangiography is the X-ray procedure which shows the anatomy of bile ducts. This is done before the surgeon removes the gallbladder.
    Bile flows from the liver through the common bile duct after the surgery into the small intestine. As the gallbladder has been removed, the gallbladder can no longer store bile between meals but has no effect or little effect on digestion.
    In case of open surgery, the surgeon reaches the gallbladder through a large, single incision in the abdominal wall.

Complications after gallbladder surgery:
This surgery carries some degree of risk like any other surgery. Complications such as internal bleeding, infection, injury to nearby digestive organs, injury to the bile duct and injury to blood vessels.

Types of gallstones:
There are three main types of gallstones. They are
1. Mixed stones: They are made up of cholesterol and salts. They tend to develop in batches.
2. Cholesterol stones: Mainly made of cholesterol, which is crucial to many metabolic processes. They can grow large enough to block the bile ducts.
3. Pigment stones: The colour of bile is greenish-brown, due to some particular pigments.

Medical factors to consider before cholecystectomy:
The most important factor is a consideration of your medical history. This is because the pre-existing conditions influence decisions on surgery and anaesthetic and information about any bad reactions or side effects from any medications would be helpful for surgery.

Self-care after the surgery:
Taking rest is the most important thing after surgery. Avoid things such as heavy lifting and physical exertion. The usual recovery period after the surgery is one week. 

Gallstone Surgery - Things You Should Know About It 

AV or arterio-venous fistulas are unusual linkages between arteries and veins. In general, pure blood passes from the arteries to the capillaries to the veins and becomes devoid of nutrients and oxygen (becomes  impure ) by the time it reaches the veins. The capillaries in between absorb the nutrients, to supply them to the tissues and organs lying beneath them. In the case of AV fistulas, the capillaries are bypassed and blood passes directly between the arteries and the veins. Thus, organs are deprived of nutrients.

This can be a severe condition, leading even to heart failure.

AV fistulas and dialysis

Sometimes, AV fistulas have to be deliberately created on the body, to treat for severe kidney ailments requiring dialysis.

What is the surgical procedure for creation of AV fistulas for dialysis?

Following are the steps-

  A vascular specialist checks your arteries and veins to make sure they are sturdy enough to be able to support an AV fistula.
  Then, with the help of wave techniques or an angiogram, the depth of your blood vessels is recorded.
  Anaesthesia is then used on the spot, which is chosen for your AV fistula. Local anaesthesia (anaesthesia of only that spot) is preferred over central anaesthesia (anaesthesia of the whole body).
  With the help of a small cut on the skin surface, the surgeon accesses your blood vessels and makes a connection between arteries and veins.

After this process is completed, dialysis takes usually some weeks to begin.

Why should you go for AV fistula?

Following are the advantages-

  Foreign chemicals or devices, which may cause invasion and damage to vital internal organs, are not introduced in your body.
  As only local anaesthesia is administered, you have to spend significantly less recovery time or  downtime  after surgery.
  There is less chance of the wound becoming infected.
  There is a reduced danger of clotting.

AV fistulas are in essence an unusual connection between your arteries and veins, leading to undernourished organs due to capillaries being bypassed. In some cases like dialysis, AV fistulas need to be created and closely monitored. There are several advantages to this, but you will also need recovery time after the procedure is over.

AV Fistula - Its Surgery & Creation Of AV Fistula For Dialysis!

Sleep is one such time when people usually are expected to lie down still and get rest. However, we have all heard of sleepwalking, a condition where a person walks during the sleep. Though it may sound strange, there is a deeper explanation for it both from a causative point of view and from managing it.

Things you should know?

Sleepwalking happens when a person moves back from a deep sleep to a light sleep or awakening state.
The person who is sleepwalking is usually not aware of it.
Activities may range from simply getting up and sitting up in bed to walking around the room. They could also open the door and walk out to the neighbourhood. Moving furniture, changing dresses or driving a car, may also be some of the actions Most of these activities happens completely without their knowledge.
Mostly happens in children up to the age of 12, but can be seen in adults also, where it assumes a more severe form.
The person who is sleepwalking has a fixed stare with glassy eyes. They may appear dazed and lost when they are awakened.
They may not respond when they are actually sleepwalking, or respond very slowly
They can be brought back to bed and put back to sleep without being disturbed. Most children would go back to sleeping when this is done
Though the parents can be very worried when they see children sleepwalking, reassurance is required, as it usually disappears as they cross teenage.
There could be chances of small injury like tripping or fall during the sleepwalking episode
Sleepwalkers may be more restless compared to other children during their waking hours
Bedwetting is also quite common in children who sleepwalk
Causes

Inappropriate sleep pattern with lack of sleep for prolonged periods is one of the main reasons for sleepwalking
Stress
Excessive drinking
Medical conditions like heart rhythm problems, acidity, gastric reflux, and seizures
Psychiatric conditions like panic attacks and post-traumatic stress disorder can also lead to sleepwalking
Management

For a parent to see their child walking around in their sleep can be quite disturbing.
Reassurance is required stating that it is just a temporary phase and will not stay beyond the teenage years
Most people do not require any intervention unless accompanied by severe symptoms like going out of the house or driving
Once established, it is advisable to avoid by not drinking too much alcohol, avoiding stress and anxiety and taking precautions like extra-secure locks to prevent sleepwalking and/or other side effects.

Sleepwalking - 11 Things You Must Know!

Low levels of testosterone can end up affecting various aspects of a your life. It can affect your libido, your performance in bed along with your motivation and energy. Testosterone replacement therapy can bring the levels back to what they were before and restore his lost confidence, energy and vigour.

Testosterone is a hormone which is mainly produced in the testicles. Testosterone controls bone density, distribution of fat, muscle mass and strength, body and facial hair, red blood cell production, sex drive and production of sperms.

Testosterone levels generally lower with age, especially after 30. Usually, in older men, low levels of testosterone result in androgen deficiency. Androgen deficiency affects the muscle mass, bone density, weight and can drastically change sleep patterns as well. On the other hand, testicle injury, testicular cancer or treatment for it, hormonal disorders, infections, HIV/AIDS, chronic kidney or liver disease, type 2 diabetes and obesity can lead to low testosterone levels as well.

While testosterone replacement therapy (TRT) seems very desirable, there are certain risks and benefits which need to be considered.

Factors to be considered before opting for it

1. Sleep apnea is one of the risk factors of TRT. In this condition, breathing stops and starts repeatedly when you sleep.

2. Acne problems and other skin disorders

3. Swollen breasts. Men with breast cancer should not opt for this treatment.

4. TRT can trigger noncancerous prostate growth.

5. Sperm production is limited or the testicles might shrink

6. Chances of deep vein thrombosis (blood clots in veins) leading to pulmonary embolism (clots burst and lodge into your lungs) are increased.

Benefits of getting a testosterone therapy done

1. Sexual drive, performance and function are improved.

2. Mineral density of the bones gets restored

3. Healthy weight loss, thus improving your body composition

4. Muscle strength and mass improves

5. Mood and energy gets a boost

6. Cognitive functions improve

7. Lessens the risks of type 2 diabetes and cardiovascular diseases

8. Improves metabolism

9. Reduces chances of anaemia or improves the condition if you are already suffering from it

Risks and Benefits of Testosterone Therapy

Acne vulgaris, commonly known as acne is a type of chronic skin condition which occurs when the hair follicles of the skin become clogged with oil and dead skin cells. Characterized by blackheads, pimples, whiteheads and greasy skin, acne can also cause scarring. Typically, acne which cause pimples tend to develop on the back, chest, shoulders but mostly on the face and neck.

Causes and symptoms of pimple scars

Although the actual cause of acne is uncertain, medical professionals have reason to believe that an increase in the level of androgen triggers pimples. On the other hand, scarring due to pimples are a result of the presence of inflamed lesions. Such inflamed lesions when gorged with surplus oil, bacteria and dead skin cells cause swelling and an eventual rupture in the follicle wall which leads to scarring. The extent of the scar has a direct relationship with the rupture. That is to say, the deeper the rupture, the bigger the scar.

In actuality, the formation of scars is involved in the normal healing process of the skin. The skin cells in order to mend the damage caused by the ruptured pimples, forms fresh collagen fibers which are fibrous proteins that impart flexibility and strength to the skin. The resultant repair which are very rarely smooth and unblemished are referred to as scars.

Treatment of pimple scars

1) fractional radiofrequency treatment is a highly effective method of reducing or removing pimple scars from skin. The radio frequency does not cause much damage to upper layers of skin, but effectively breaks down the scar tissue.

2) lasers are alternative and are little less painful. This treatment involves the use of skin resurfacing lasers.

3) fillers are another form of treatment which fill the indentations left remaining from dense pimple scars. Hardly any down time with this but are expensive in the long run.

4) scar reduction surgery is meant to minimize the scar so that it is more consistent with your surrounding skin tone and texture.

Procedures for Removal of Pimple Scars

With age it becomes difficult for many men to achieve an erection and maintain it. This is known as Erectile Dysfunction. This is not necessarily related to a lowered libido. In many cases, a man may desire sex but not be able to have an erection rigid enough for intercourse. Men with a history of obesity, hypertension, diabetes and smoking are at a higher risk of suffering from erectile dysfunction as they get older. However, this condition can be treated. 

Ayurvedic Medicine for Erectile Dysfunction:

Gold Bhasma: Gold Bhasma also known as Swarna Bhasma is prepared from pure gold. Nowadays, the use of technology has mitigated many tedious steps, which one had to undergo during ancient time to prepare it. It is highly effective and is used for the treatment of infertility, sexual weakness, tuberculosis, cancer, asthma and many other fatal diseases.

Silver Bhasma: Silver Bhasma is also know as Rajat Bhasma or Raupya Bhasma is a calcified Ayurvedic medicine used not just for treating erectile dysfunction, but also for a number of diseases such as, jaundice, frequent urination, enlargment of spleen, etc.
Both Gold Silver Bhasma are mixed with other Ayurvedic medicines for effective treatment of erectile dysfunction.

Other Treatments for Erectile Dysfunction:
Erectile dysfunction can be treated in a number of ways. Some of these are:

Viagra: Viagra is usually the first form of treatment for erectile dysfunction. Viagra is a type of drug also known as phosphodiesterase-5 inhibitors. These drugs increase the blood flow into the penis and thus enable an erection. Levitra and cialis are other forms of phosphodiesterase-5 inhibitors. However, Viagra is a temporary treatment and has a side effect that it is a habbit forming drug.
Penile Injection: If a man cannot take oral medication, a penile injection is the best form of treatment. Here, medication is directed into the side of the penis. This dilates the arteries and allows blood to flow in. thus it instantly initiates an erection.

Intraurethral Suppositories: This involves placing a soluble medicated pellet into the urethra. This increases the blood flow into the penis and will create an erection in 10-15 minutes. This form of medication is rarely used.

Vacuum Pump: A vacuum pump is another common form of treatment for this condition. It consists of a plastic cylinder that is placed over the penis and a pump that removes the air within the cylinder thus forcing blood to flow into the penis. An elastic ring is then slid onto the base of the penis to hold the erection. The ring must be removed after a maximum of 30 minutes.
Surgical Implants: There are two types of surgical implants that can be beneficial to men who have not benefitted from medication. The first is an inflatable pump that can manually pump fluid into cylinders within the penis. The second is a malleable prosthesis.

Lifestyle Changes: Obesity, hypertension, high blood pressure, excessive alcohol, smoking and a sedentary lifestyle can also be the reason a man cannot hold an erection. Addressing these factors by making conscious lifestyle changes can improve a man's ability to initiate and maintain an erection. These changes include a healthy diet, regular exercise, lowered consumption of alcohol and losing excessive weight. Living a healthy lifestyle is the only way to lower the risk of suffering from erectile dysfunction in the later years.

5 Best Treatment for Erectile Dysfunction - Effective Methods

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