As per the American Osteopathic College of Dermatology, an estimated 10 percent of individuals encounter keloid scarring every year. While women and men are equally prone to have keloid scars, people with darker skin tone are more likely to experience keloids.

What are keloids and why do they occur?
Keloid is widely recognized as keloid scar or keloid disorder. It is caused when the fibrous tissues also known as scar tissues are injured. In specific instances, the scar tissues grow in excess, and they form a hard and smooth growth, which is known as keloid, which could be bigger than the actual wound. They are customarily found in areas like the chest, cheeks, shoulder, and earlobes. Nonetheless, any part of the body could be affected by keloids. Though they do not pose a threat to health, they can be a cause of significant cosmetic concerns. Another factor why they occur is in the case of overgrowth of the scar tissue that develops over the period of weeks.

Are keloids a cause for concern?
Keloids are often itchy and discomforting. Keloids often cause a major cosmetic concern as they are large and easily spotted. Due to this, several patients encounter stress as they become conscious. Exposure to sun must be avoided in case of keloids as the tanning of the affected area may darken the keloid scar and become more prominent. The response of the treatment for keloids depends majorly upon the anatomical location of the scar. An extremely itchy keloid can be quite distracting. Many patients are skeptical of getting treatment as it may leave a permanent scar.

Common Treatment options for Keloids

Laser: The pulsed-dye laser can be helpful in flattening keloids and making them appear less red and intense. The treatment is considered as safe and is almost painless, but many treatment sessions may be required. These may be expensive, as insurance plans do not usually cover laser treatments.
Cryotherapy: This is a method in which the keloid is frozen with the help of liquid nitrogen to flatten the keloid. However, it may result in lightening or darkening of the affected area.
Radiation: Radiation is considered as a safe and effective option by several doctors for the treatment of keloids.
Silicone gel or sheeting: In this method, a sheet of silicone gel has to be worn continuously for months in order to treat the affected area. The outcomes of this treatment may vary. Some doctors claim relative success with compression dressings composed of materials that are not silicone.
Surgery: Treating keloids by surgery may prove to be risky as it may activate the development of a more prominent keloid. Some operations have been successful by applying compression or injecting steroids to the wound after the keloid has been treated. Superficial radiation treatment post-surgical procedure has also been considered to be helpful.
A condition that poses no threat to your health, and is purely of cosmetic concern, Keloids do have several treatment options providing the expected results.

Keloid - 5 Ways It Can Be Treated!

The intervertebral discs are made-up of two concentric layers, the inner gel-like Nucleus Pulposus and the outer fibrous Annulus fibrosus. As a result of advancing age, the nucleus loses fluid, volume and resiliency and the entire disc structure becomes more susceptible to trauma and compression. This condition is called as degeneration of the disc. The disc then is highly vulnerable to tears and as these occur, the inner nucleus pulposus protrudes through the fibrous layer, producing a bulge in the intervertebral disc. This condition is named as herniated disc. This can then cause compression to the spinal cord or the emerging nerve roots and lead to associated problems of Sciatica radiating pain from back to legs in the distribution of the nerve. Other symptoms could be a weakness, tingling or numbness in the areas corresponding to the affected nerve. Sometimes bladder compromise is also present, which is made evident for urine retention and this need to be taken care as an emergency.
Excessive weight, bad postures, undue movements, improper weight lifting and other kinds of traumas may weaken the intervertebral discs. When this occurs the pulpous nucleus will bulge against the annulus, or even be squeezed through it (extruded disc).

The first steps to deal with a herniated or prolapsed lumbar disc are conservative. These include rest, analgesic and anti-inflammatory medication and in some cases physical therapy. At this point, it is convenient to have some plain X-rays done, in search of some indirect evidence of the disc problem, as well as of degenerative changes on the spine.

If in a few days these measures have failed, the diagnosis has to be confirmed by means of examinations that give better detail over the troubled area, as the MRI, CT which will show the disc, the space behind it and in the first case, the nerves. In some instances, the EMG (electromyography) is also of great value, as this will show the functionality of the nerves and muscles.

Once the diagnosis has been confirmed, one of the best alternatives existing today is the Ozone Discolysis as the results obtained are excellent and practically has no complications. This novel treatment avoids the use of surgery in 80% of those who needed it. In most patients left with painkillers as the only treatment, the symptoms eventually disappear, only that this could take weeks to months. Ozone speeds up these developments, see the same result in a few weeks. The problem has to be seen and approached integrally and frequently the combination of therapies has to be used, most frequently physiotherapy. Also, it has to be known that those who had a herniated disc have 10 times more chances of having another herniation than the rest of the population.

If despite the ozone therapy the symptoms persist, Drill Discectomy/ Laser Discectomy are good alternatives before open surgery (Discectomy) which has to be contemplated in those true emergencies, as mentioned above, this is possibly the first choice.

Once the conservative treatment fails:

Early aggressive treatment plan of pain has to be implemented to prevent peripherally induced CNS changes that may intensify or prolong pain making it a complex pain syndrome. Only 5% of total LBP patients would need surgery & 20% of discal rupture or herniation would need surgery. Nonoperative treatment is sufficient in most of the patients, although patient selection is important even then.

Depending upon the diagnosis one can perform & combine properly selected percutaneous fluoroscopic guided procedures with time spacing depending upon pt`s pathology & response to treatment.

Using precision diagnostic & therapeutic blocks in chronic LBP, isolated facet joint pain in 40%, discogenic pain in 25% (95% in L4-5&L5S1), segmental dural or nerve root pain in 14% & sacroiliac joint pain in 15% of the patients. This article describes successful interventions of these common causes of LBP after conservative treatment has failed.

LESI: Lumbar Epidural Steroid Injection

Indicated in   Acute radicular pain due to irritation or inflammation.

Symptomatic herniated disc with failed conservative therapy
Acute exacerbation of discogenic pain or pain of spinal stenosis
Neoplastic infiltration of roots
Epidural fibrosis
Chronic LBP with acute radicular symptoms
Epidural- lumbar injection
ESI Treatment Plan

Compared to interlaminar approach better results are found with a transforaminal approach where drugs (steroid+ LA/saline +/- hyalase) are injected into anterior epidural space & neural foramen area where herniated disc or offending nociceptors are located. Whereas in interlaminar approach most of drug is deposited in posterior epidural space.Drugs are injected total 6-10 ml at lumbar, 3-6 ml at cervical & 20+ ml, if caudal approach is selected. Lumbar ESI is performed close to the level of radiculopathy, often using paramedian approach to target the lateral aspect of the epidural space on involved side. Cervical epidural is performed at C7-T1 level.

SNRB- Selective Nerve Root Block 

Fluoroscopically performed it is a good diagnostic & therapeutic procedure for radiculopathy pain if

There is minimal or no radiological finding.
Multilevel imaging abnormalities
Equivocal neurological examination finding or discrepancy between clinical & radiological signs
Postop patient with unexplainable or recurrent pain
Combined canal & lateral recess stenosis.
To find out the pathological dermatome for more invasive procedures, if needed
Intradiscal Procedures 

Provocative Discography - Coupled with CT

A diagnostic procedure & prognostic indicator for surgical outcome is necessary for the evaluation of patients with suspected discogenic pain, its ability to reproduce pain(even with normal radiological finding), to determine type of disc herniation /tear, finding surgical options & in assessing previously operated spines.

Percutaneous Disc Decompression (PDD)

After diagnosing the level of painful offending disc various percutaneous intradiscal procedures can be employed

Ozone Discolysis: Ozone Discectomy a revolutionary least invasive safe & effective alternative to spine surgery is the treatment of choice for prolapsed disc (PIVD) done under local anaesthesia in a daycare setting. This procedure is ideally suited for cervical & lumbar disc herniation with radiculopathy. The total cost of the procedure is much less than that of surgical discectomy. All these facts have made this procedure very popular at European countries. It is also gaining popularity in our country due to high success rate, less invasiveness, fewer chances of recurrences, remarkably fewer side effects meaning high safety profile, short hospital stay, no postoperative discomfort or morbidity and low cost.

Dekompressor: A mechanical percutaneous nucleosome cuts & drills out the disc material somewhat like morcirator debulking the disc reducing nerve compression.

Epidural Adhenolysis or Percutaneous Decompressive Neuroplasty for Epidural Fibrosis or Adhesions in Failed Back Surgery Syndrome (FBSS)

A catheter is inserted in epidural space via caudal/ interlaminar/ transforaminal approach. After epidurography testing volumetric irrigation with normal saline/ L.A./ hyalase/ steroids/ hypertonic saline in different combinations is then performed along with mechanical adenolysis with spring loaded or stellated catheters or under direct vision with epiduroscope.

Procedures That Can Help Treat Slip Disc & Sciatica!

You must have had an ankle sprain or at least heard of it   it is an injury to the ligaments surrounding and connecting the bones of the leg to the foot. The injury occurs when you accidentally turn or twist the ankle in an awkward way. This can tear or stretch the ligaments that hold together the joint and bones of your ankle.

What Could Possible Lead to a Sprained Ankle? 
A sprain occurs when the ankle joint is forced out of its normal position as a result of the following  

  Awkwardly placing the foot while stepping up and down, jumping or running
  Stepping on an irregular surface
  During a sport or any sort of rigorous physical activity
  An injury while exercising
  Wearing inappropriate footwear

Symptoms of a Sprained Ankle-
A sprained ankle causes pain, swelling, and limited range of motion. You are likely to experience the following symptoms you sprain your ankle  

  Tenderness
  Bruising
  Stiffness
  Discolouration of skin
  Instability in the ankle
  Limping
  A popping sound or sensation at the time of the injury
  Inability to put pressure on the injured ankle

The symptoms of an ankle sprain are usually self-diagnosable and treatable at home. Nevertheless, you never know how severe the sprain could be. Therefore, consider seeing a doctor when you are having problems with your foot or ankle. A specialist can determine whether the injury is just a sprain or something more serious, with the help of X-ray and MRI.

What is the Treatment for Ankle Sprain?
The line of treatment depends on the type of sprain your ankle sustains. Treatment options include  

  RICE   Many people resort to simple home remedies such as RICE and cold compress to treat a sprained ankle. RICE refers to Rest, Ice, Compression, and Elevation. It is a first-aid cure for strains and sprains.
  Cold Compress    Helps reduce inflammation and dulls pain sensation
  Medications   If you visit an orthopaedic, he/she will prescribe the NSAIDs to ease pain and reduce inflammation and fever
  Braces and Splints   These are applied to aid in stabilizing and protecting the injured joint and its movement
  Elastic Bandage   Stretchy bandages are used to wrap strains and sprains. These provide compression and support during recovery.

Apart from medications and devices, the doctor may also recommend stretching, physiotherapy, and massage. Mild physical movement and exercise will help relax your muscles and restore flexibility and muscle strength.

An ankle sprain cannot be prevented; it can happen anytime. What you can do is consult a specialist and seek treatment to get back to your daily activities.

Know More About Ankle Sprain!

Thalassemia is a genetic (which is passed from parents to children through genes) blood disorder. People with Thalassemia disease are not able to make enough hemoglobin, which causes severe anemia. Hemoglobin is found in red blood cells and carries oxygen to all parts of the body. When there is not enough hemoglobin in the red blood cells, oxygen cannot get to all parts of the body. Organs then become starved for oxygen and are unable to function properly.

Symptoms

The symptoms depend on the type of thalassemia:

Thalassemia Minor: Thalassemia minor usually doesn t cause any symptoms. If it does, it causes minor anemia.
Beta-thalassemia: Beta-thalassemia comes in two serious types, which are thalassemia major, or Cooley s anemia, and thalassemia intermedia. The symptoms of thalassemia major generally appear before a child s second birthday. The severe anemia related to this condition can be life-threatening. Other signs and symptoms include:
fussiness
paleness
frequent infections
a poor appetite
failure to thrive
jaundice, which is a yellowing of the skin or the whites of the eyes
enlarged organs
This form of thalassemia is usually so severe that it requires regular blood transfusions.

Alpha-thalassemia: Alpha-thalassemia also has two serious types, which are hemoglobin H disease and hydrops fetalis. Hemoglobin H disease can cause bone issues. The cheeks, forehead, and jaw may all overgrow. Hemoglobin H disease can cause:
jaundice, which is a yellowing of the skin or the whites of the eyes
an extremely enlarged spleen
malnourishment
Hydrops fetalis is an extremely severe form of thalassemia. It occurs before birth. Most individuals with this condition are either stillborn or die shortly after being born.

Thalassemia - Symptoms Based on Types of Thalassemia 

Causes of Hairfall and Solutions to Treat Them

In general, you lose about 50-100 strands of hair each day, but the loss is not visible as new hair grow in their place. However, if you lose more than a 100 strands in a day and more than 200 strands on the day you shampoo, you may be suffering from what is known as excessive hair fall. 

Certain factors or reasons may cause you to lose hair at an alarming rate, which are,

1. Thyroid problems
Your thyroid is responsible for your body?s overall functioning. The hormones (primarily T4 and T3), which it produces help in regulating metabolic activities. Problems with your thyroid gland can cause your hormone levels to rise or fall to unhealthy levels, which can result in hair fall. You can improve the functioning of your thyroid gland through a diet rich in calcium, iodine, magnesium, protein and Vitamins A, B and C.

2. Scalp infections
Infections of the scalp can also be one of the factors that may cause your hair to fall at an alarming rate. Of the different scalp infections, the ringworm scalp infection is the most common. Although this fungal infection can occur in any part of your body, when it develops on your scalp, you end up losing clumps of hair. Alongside the use of anti-fungal medications, even anti-fungal shampoos and creams can provide you with respite from the problem.

3. Poor diet
Gorging on unhealthy foods or going on a crash diet can result in the lack of essential nutrients in your body, which are required to maintain healthy hair. Furthermore, since hair is made of protein, having a balanced diet consisting of proteins and vitamin- rich foods is a must.

4. Stress
Stress gives rise to certain conditions such as alopecia areata, telogen effluvium (hair loss caused post-pregnancy or surgery) and trichotillomania (an impulsive need to pull your hair out), which can cause you to lose significant amount of hair. To avert a hair loss crisis caused by stress, make it a point to do some simple stress-reducing exercises, such as meditation or breathing exercises.

5. Hair styling products
Using hair styling products like hair colours and straighteners can cause you to experience hair fall problems. Your hair not only becomes dull and dry due to their use, but also becomes weak and brittle, leading to a gradual loss of hair. Regular oiling and use of homemade hair masks are some of the ways you can try to counter the negative effects of these hair styling products.

6. Cancer treatment
The drugs that are used in the treatment of cancer not only destroy the fast-growing cancer cells, but also the healthy blood cells in your body. For this reason, consuming foods that possess cancer-fighting properties (like oatmeal, tomato, almonds, garlic etc) is a sure-shot way of fighting the disease as well as averting any side-effects that may arise because of the treatment.

7. Alopecia areata
Lastly, hair fall can also be caused by alopecia areata, which is a kind of hair loss that takes place when your body?s immune system erroneously attacks your hair follicles, and prevents growth of new hair.

8. Genetics
The origin of your severe hair fall or baldness can be traced back to your ancestors. So, your genes can be a factor behind your hair fall problem. If this is the cause, your body then becomes unable to produce new hair.

Apart from the changes that you can make in your lifestyle to address the causes of your hair fall, there are also techniques out there that you can employ to permanently treat your problem, such as platelet rich plasma, mesotherapy, stem cell therapy, ozone activated platelet rich plasma & hair transplant.



8 Common Causes of Hairfall + How To Overcome Them

The onset of winter brings with it chilly and dry winds. For some, it s the time to enjoy the chill weather with hot water baths and soothing drinks, and for others it s time to brave the long persistent cold and flu like symptoms which cause sickness and discomfort.

People who are allergic to the winter season can catch a cold on the slightest exposure to cold air. Sometimes, it s difficult to ascertain whether it is cold or an external allergen. In people prone to winter allergies, the allergies are mainly caused due to the allergens present in the environment. Mostly, winter allergies are also caused by the same allergens that are triggered in the summer season. 

Thus, people who have some or the other form of seasonal allergy is likely to suffer from allergies as the season changes.

Pet dander (flakes of skin in an animal's fur or hair) allergies are believed to escalate in winter since pets are mostly indoors during this season. The best way to deal with this is keeping the pet s area clean and dry, washing and changing of the bedding regularly, and avoiding physical contact as much as possible.
Dampness of clothes, blankets and shoes at home can be an allergy trigger for many people. The best way to control this type of allergy is to keep damp clothes and shoes in sun for some time. However, this may not work in many countries with extreme cold climates, which lack sunshine in their environment.
Decaying leaves and other yard waste can cause allergies due to mould and mildew. Mopping and sweeping the floors and garden can help alleviate the problem to some extent.
Dry climate can cause irritation in the nose and throat. It s important to replenish the body with adequate liquids and water rich fruits and veggies. It s important to choose your drinks wisely. Too much tea or coffee can also dehydrate the body. Go for ginger lemon honey infused in warm water for best results.
Allergy symptoms can also be caused due to too much moisture in the environment. It can give rise to a stuffy or runny nose, sneezing and coughing. Thus it s best to avoid sitting in a moist environment for long.
Sinus congestions are also common during the winter season. Steam inhalation and hot showers can help relieve the symptoms and provide relief.
Whether you are allergic to pets, moisture, dampness, dry weather or chilled winds, the thumb rule is twofold to understand what triggers your allergies and to avoid your exposure to those allergens. As we all know, allergies have no cure and they need to be managed. Drugs also help in controlling the allergy symptoms to some extent. However, it s best to prevent them as far as possible. If you are confused about what triggers your allergy, make sure to consult your doctor.

Allergy - Best Ways Ayurveda Can Help Manage It!

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