Anti-reflux surgery (Fundoplication) is a procedure for treating gastroesophageal reflux disease (GERD) incorporated in hiatus hernia operation. GERD occurs when stomach contents reflux and enter the lower end of the esophagus (LES) due to a relaxed or weakened sphincter or a hiatus hernia. GERD is very much treatable and can cause serious complications if left untreated. 

GERD symptoms
The main symptom of GERD is heartburn or indigestion, along with other symptoms, such as 

Acidic sour taste in the mouth
Burning pain in the throat
Difficulty in eating
Bloating and belching
Stomach pains
Regurgitating food
Nausea
Vomiting blood
Dark tarry stools
Laparoscopic Anti-Reflux Surgery
Laparoscopic surgery reinforces the lower oesophageal sphincter s ability to prevent gastroesophageal reflux from occurring. The surgery involves wrapping the top part of the stomach around the lower end of the esophagus and suturing it in place. Since the esophagus passes through the hiatus, suturing is done to narrow the hiatus as it helps in the prevention and treatment of concurrent hiatal hernia.

Laparoscopic Surgery Procedure
A laparoscope, a long, narrow telescope with a light source and a video camera at the end, is inserted through a tiny incision into the abdomen. Images from the camera are projected onto a large high definition monitor for the surgeon to view enlarged images as it helps the surgeon perform surgery with precision.

The patient is placed under general anesthesia
The surgeon makes a small incision in the upper abdomen and inserts the laparoscope into the abdomen.
The surgeon introduces carbon dioxide into the abdominal cavity near the belly button to expand the viewing area of the abdomen giving the surgeon a clear view and room to work.
Additional small incisions are made for a variety of surgical instruments to be used during the procedure.
After the identification of critical structure, the hole in the diaphragm, through which the esophagus passes, is then tightened with sutures.
The surgeon wraps the upper part of the stomach around the lower esophagus guided by the images on the laparoscope, then creates a valve which is precisely sutured in its place.
The laparoscope and other instruments are removed and the gas is released.
The tiny incisions are closed and covered with waterproof dressings to avoid any kind of infections.
The patient is usually discharged within 1-2 days of the surgery.
Post-surgery, hospitalization is required just for one day - no bed rest is required after that. The patient can quickly return to all normal activities and immediate relief from symptoms also happen. 

Laparoscopic Surgery - How It Can Help With Anti-Reflux and Hernia?

High blood pressure and sex

High blood pressure is a condition in which the pressure of the blood against the artery wall is high enough to cause health problems, including heart disease. No symptoms may be noticed in a person for years but the damage to the blood vessels and to your heart continues. High blood pressure can have an impact on your sex life. Although sexual activity does not lead to any possible threats to your health but high blood pressure can affect the pleasure you would have otherwise derived from sex.

In Men

High blood pressure leads to the wearing out of the lining of blood vessels and causes arteries to narrow and harden that decreases the blood flow. This results in decreased blood flow to the penis. In case of some men, this decreased blood flow makes it difficult for them to achieve and maintain an erection. This problem is called erectile dysfunction.

High blood pressure may also interfere with ejaculation and be a cause for low libido. The medications that are prescribed for treating high blood pressure may lead to this condition.

In Women

Just as in the case of men, high blood pressure results in the decreased flow of blood to the vagina in case of women. This may cause problems like low libido, vaginal dryness, or complexities in achieving orgasm. Sexual dysfunction in women results in stress, anxiety and even relationship issues.



High Blood Pressure and Sex

Menopause is the time in a woman's life when the menstruation ceases, bringing an end to a woman's childbearing years. There are a number of symptoms that mark this stage, including hot flashes, which are very commonly experienced in such cases. Hot flashes are like a feeling of a red hot flush that may wash over the body and lead to excessive sweating. It occurs in the blood vessels that are closest to the surface of the skin. Yet, menopause is not the only reason why one may experience these hot flashes.

Here are some of the reasons that may trigger these hot flashes:

1. Carcinoid syndrome: This is a disease that may cause hot flashes as a symptom. In this condition, a tumour will usually release varied chemicals into the body, which can create varied symptoms that seem like hot flashes.

2. Hyperthyroidism: Overheating of the body and the system from within is something that many patients suffering from hyperthyroidism may experience. This usually happens when the thyroid glands end up producing too much of the thyroid hormone that brings about many symptoms ranging from depression to weight loss and even hot flashes. In hyperthyroidism, the body goes into a hyper mode, which usually leads to overheating of the same. This gives rise to frequent and often severe hot flashes.

3. Hormonal changes: There are many hormonal changes that may affect various men and women from time to time. A drop in the level of the estrogen hormone is something that many women go through on a regular basis. This may happen due to pregnancy as well. Also, this condition usually brings about symptoms like hot flashes.

4. Eating disorders: The way we eat and nurture our body is the way the body reacts. When there is a case of an eating disorder like dyslexia or bulimia, it may lead to varied symptoms, including hot flashes. This is due to the fact that the body's hormonal levels as well as the nutritional level plunge to an all-time low. In many such cases, hot flashes are the body's way of demanding better nutrition. These disorders can also give rise to related conditions like the hypothalamus disorder.

5. Hypothalamus disorder: Hypothalamus disorder may also cause hot flashes. This is a condition that is caused due to poor eating habits. This disorder is characterised by a major drop in one's nutrition levels and also leads to many hormonal changes. These changes often lead to symptoms like hot flashes and other related complications.

Hot Flashes: Is it Due to Menopause or Something Else

Are you experiencing skin itchiness and development of dry, scaly rashes on your skin? This indicates you have eczema, which is a group of skin diseases occurring due to the inflammation and irritation of skin. Atopic dermatitis is the most common form of eczema. The disease can be controlled if proper treatment is undertaken.

Symptoms
Itchy skin is the most common symptom of eczema. In some cases, the itching starts before the development of the rash. The rash appears most commonly on the back of the knees, face, hands, wrists and feet. The affected areas become dry and thickened and in people with a fair complexion, the areas may turn reddish initially and then become brown.

Causes
The specific cause of eczema is yet to be determined. However, the condition is associated with an overactive response by the immune system to an external irritant. This response leads to eczema. The condition is more common in people who have a family history of allergies or asthma.

Treatment

As the condition turns the skin dry and itchy, certain creams and lotions are recommended to be used in order to keep the skin moist. You should apply these products when your skin is damp, ideally after taking a shower. This helps the skin in retaining moisture. You can use a cold compress to ease the itching.
Several creams such as hydrocortisone cream and ointments which contain corticosteroids are prescribed in order to reduce inflammation.
In case the affected area becomes infected, antibiotics should be taken to eliminate the infection-causing bacteria.
Antihistamines are used for reducing the severity of the itching. 
Prevention of Eczema Flare-ups

Moisturize your skin frequently
Avoid sudden changes in humidity or temperature
Abstain from overheating and sweating
Try to reduce stress
Avoid starchy material
Avoid soaps, detergents and solvents, which are harsh
Be aware of food items which trigger eczema flare-ups
It is recommended for you to consult a dermatologist if you experience any symptom of eczema. This will help you with a quick diagnosis so that you can start the treatment without further worsening of the symptoms.

Eczema - How You Can Prevent Its Flare-ups?

Types of abdominal and pelvic surgical incision

At the time of a surgical procedure, while making an incision a doctor has to take care of a number of factors before making an incision. Considering a number of factors, different types of incisions have come into fore, such as 

Midline Incision: It s the commonest incision and is done along the linea alba (fibrous structure running through the mid of the abdomen). These are preferred, especially in diagnostic laparotomy as it permits a wide access to the abdomen.
Pfannenstiel Incision: It is transverse in nature, extending from the umbilicus to the pubic-symphysis. It is generally employed for abdominal hysterectomy of benign nature and caesarean section.
Chevron Incision: It is an incision under the rib-cage and is done on the abdomen. It starts from beneath the ribs on the right abdomen and extends till the other mid axillary line. Thus, the entire abdominal width is incised for proper reach into the liver. The incision can be up to 2 feet.
Kustner Incision: It is transverse in nature and extends from the symphysis pubis till the iliac spine (anterior). This type of incision takes time to perform. A Pfannenstiel incision offers more exposure than a Kustner incision.
Lanz Incision: It is a variation of the more common mcburney-incision (also known as Gridiron s incision). It is generally used for open appendectomies. There are quite a few variations for this type of an incision.
Gridiron s incision: It is done for appendectomies. It is an oblique short incision which is done in the lower right quadrant in the abdomen.
Kocher s Incision: It is oblique in nature, extending from the abdominal upper right quadrant and is generally used for performing an open cholecystectomy. Gallbladder, biliary tract and certain liver operations can be suited for a Kocher s incision. This however is different from the same named incision used for the thyroid gland surgery.
Cherney Incision: It is transverse in nature. It allows a great range of exposure for the pelvic sidewall. It is less painful than a midline incision. It allows for the greatest pelvic exposure and hence is a widely preferred and practiced incision.

8 Types Abdominal and Pelvic Surgical Incisions

Diabetes is a lifestyle disease that is very prevalent in the current generation. According to a report by the World Health Organisation (WHO), the number of people with diabetes has risen from 108 million in 1980 to 422 million in 2014. The global prevalence of diabetes among adults over 18 years of age has risen from 4.7% to 8.5% from 1980 to 2014. Diabetes should not be taken lightly as it can affect other body organs besides the pancreas, such as the kidneys. Diabetic nephropathy refers to damage to your kidneys caused by diabetes, and may also lead to kidney failure in various cases.

Causes of diabetic nephropathy
Not everyone who suffers from diabetes will suffer from diabetic nephropathy. The main function of the kidneys is to filter waste from your blood. However, this is not always the case. Due to high a concentration of blood sugar caused by diabetes, several blood vessels in the kidney are destroyed, thereby, preventing the kidneys from carrying out its job. Over time, the kidneys may stop working altogether, resulting in kidney failure. If you are diabetic, the probability of you suffering from diabetic nephropathy will increase if you smoke or have high blood pressure or high cholesterol.

Catching it early
Today, diabetic nephropathy is the leading cause of chronic kidney disease in the US and other western countries. Since the symptoms of this condition aren t visible in its early stages, you need to undergo urine tests on a regular basis. If detected early, the effects of diabetic nephropathy can be reversed. Common symptoms of this disease include the following:

Swelling in legs and feet
Detection of albumin in urine
Decline in glomerular filtration rate (GFR)
Elevated arterial blood pressure
What are the treatment options?
Medication to lower the blood pressure is the most commonly prescribed form of treatment suggested by doctors to prevent or slow the damage to your kidneys. There are other lifestyle changes that you may have to undertake in order to keep a check on the condition:

Limit sugar intake and keep blood sugar levels within the target range
Exercise regularly and work towards keeping your heart healthy
Limit protein intake, as it could put extra pressure on your kidneys
Limit salt intake to control blood pressure
Quit smoking and drinking
Diabetes is an unfortunate condition to have to live with. But don t let it bog you down! With these simple lifestyle changes and taking care of your general well-being, you can beat the disease and emerge a winner!

Diabetic Nephropathy - Who is at Risk of Acquiring it?

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