Liposuction is a type cosmetic surgery that refers to the removal of excess fats from the body through suction.During liposuction, small, thin, blunt-tipped tubes (cannula) are inserted through tiny cuts in the skin.

Liposuction is used to remove fat deposits from:

Thighs.

Hips and buttocks.

Abdomen and waist.

Upper arms.

Back.

Inner knee.

Chest area.

Cheeks, chin and neck.

Calves and ankles.

Different techniques are adopted in liposuction process. Some of them are:

Traditional Liposuction: In traditional liposuction, the surgeon uses a thin tube called a cannula, connected to a powerful suction pump.

Tumescent Liposuction: Tumescent liposuction is similar to traditional liposuction, but experts often hail its innovative use of medication and reduced risks for complications.

Super-wet Liposuction: Super-wet liposuction is a variation of the tumescent technique that uses less fluid injection.

Ultrasonic Liposuction: This popular form of liposuction uses a specialized cannula that emits ultrasonic sound waves into the fat deposits to liquefy fat cells and make them easier to remove.

Power Assisted Liposuction: By employing a cannula that has a vibrating tip, surgeons are able to break up fat cells for easier removal.

More and more people are turning to liposuction to help achieve their aesthetic goals. Patients benefit both mentally and physically from liposuction. In fact, liposuction has become one of the most popular plastic surgery procedures in the world because it is a safe and effective way to remove fat and cellulite in your body. To add to it s effectiveness, liposuction can be paired with a myriad of complementary procedures such as breast augmentation, tummy tuck, and even facial plastic surgery.

The benefits of liposuction include:

Safe removal of fat

Reduction of cellulite or improvement in the appearance of cellulite

Improved health, usually associated with fat loss

Changes the way you look, and the way others perceive you

Boost in self-esteem

Sculpting areas of body that even exercise and diet don t seem to impact

Liposuction Surgery

Hypothyroidism is a condition in which the thyroid gland is not producing the thyroid hormones adequately. This is a fairly common condition.

What is thyroid gland?

The thyroid gland is a small butterfly-shaped gland located just below Adam s apple. It encircles the windpipe or the trachea. It is about 4 cms in height and weighs about 18 gms. This gland is responsible for the secretion of thyroid hormones. Hormones are chemicals produced by special glands like thyroid, adrenals, ovaries etc. They act as messengers and are carried by the blood to the various target organs.

What are the hormones produced by thyroid gland and what do they do?

The thyroid hormones are of two types   T3 (Tri iodo thyronine) and T4 (Thyroxine). These hormones are mainly responsible for the body s metabolism - a process in which food is converted into energy in the cells. They influence growth and development and regulate various bodily functions which are mentioned below:

Heartbeat
Body temperature
Breathing
Body weight
Metabolism of fat
Menstrual cycles in females
Functioning of Nervous system
Digestion
Burning calories etc.
What is Hypothyroidism?

Inadequate production of hormones by the thyroid gland is termed as hypothyroidism. This is also called Underactive thyroid state. Hypothyroidism can make the body s development to slow down and reduces metabolism rates.

What are the causes of Hypothyroidism?

Hypothyroidism can be caused by a number of factors:

Hashimoto's thyroiditis: This is the commonest cause. This is an autoimmune disorder (normally body s defence system fight against external infections. In autoimmune disorder the defence system attacks the healthy cells of the body by mistake). In Hashimoto s thyroiditis the immune system/defence system produces antibodies that attack the thyroid gland and destroy it.
Iodine deficiency in diet. For the production of thyroid hormones iodine is very important. The body does not produce iodine normally, so it needs to be supplemented from outside. Iodine is mainly present in the food we eat. It is mainly present in shellfish, salt-water fish, eggs, dairy products. If a person does not eat iodine rich foods, he may end up with iodine deficiency leading to hypothyroidism. Currently, this causative factor is on the decline due to government initiative of table salt with iodine.
Surgery: Surgery to remove thyroid gland (for e.g. thyroid cancer treatment, overactive thyroid etc.)
Radiation to the neck (to treat cancer in the neck area): The thyroid gland cells are damaged due to the radiation.
Treatment with radioactive iodine: This treatment is used for managing hyperthyroidism/overactive thyroid, where the thyroid gland produces excessive thyroid hormones. One of the treatment modalities is by radioactive iodine. Sometimes this radiotherapy destroys normal functioning cells which lead to hypothyroidism.
Certain medicines: Certain medicines used to treat heart conditions, cancer, psychiatric conditions etc.   for e.g. amiodarone, lithium, interleukin-2, interferon-alpha.
Pregnancy: Pregnancy (the reason is unclear but it has been noticed that the thyroid may get inflamed after delivery   this is called Postpartum thyroiditis.
Damage to the pituitary gland: Pituitary gland is a gland which is present in the brain. It produces a hormone called TSH (Thyroxine-Stimulating hormone).The TSH tells the thyroid gland how much thyroid hormone it should make. If the levels of thyroid hormone in the blood are low, then the TSH will stimulate the thyroid gland to produce more Thyroid hormone.
Hypothalamus disorders: This is an organ in the brain. This produces a hormone called TRH (Thyrotropin Releasing Hormone) which acts on the Pituitary gland to secrete TSH. So any disorder of Pituitary gland will indirectly effect the production and secretion of Thyroid hormones. These are very rare disorders.
Congenital thyroid defects: Some babies are born with thyroid problems. This is due to the thyroid not being developed normally during pregnancy. Sometimes the thyroid gland does not function normal. This can be identified by screening for thyroid disorders in the first week after delivery. This is usually by a blood test using a small drop of blood from the baby s heel.
What are the different types of hypothyroidism?

One classification is based on whether the defect is with the thyroid gland or not:

Primary hypothyroidism: The problem is in the thyroid gland itself and thus there is reduced production /secretion of thyroid hormones.
Secondary hypothyroidism: Here the problem is with the Pituitary gland or the Hypothalamus. This results in abnormal production of TSH or TRH, which indirectly leads to less production and secretion of thyroid hormones.
Another classification is based on the symptoms and levels of the thyroid hormones and TSH:

Overt hypothyroidism: Here the patient is having the symptoms. Further the T3/T4 are low and TSH is high
Subclinical hypothyroidism: Here patient may or may not have symptoms. The T3/T4 levels are normal but TSH is high. In this situation the patient is at an increased risk of developing overt hypothyroidism in the future especially if he has Thyroid peroxidase antibodies on testing.
Who are at risk of developing Hypothyroidism?

Women have a higher risk of suffering from hypothyroidism than men.
Older people are at increased risk.
People suffering from other autoimmune diseases like Coeliac disease, Type-1 Diabetes Mellitus, Vitiligo, Pernicious anemia, Multiple sclerosis, Rheumatoid arthritis, Addison s disease etc.
People with psychiatric conditions such as bipolar disorder
People with Chromosomal abnormalities like Down syndrome, Turners syndrome also have a high risk of suffering from hypothyroidism.
What are the symptoms of hypothyroidism?

Symptoms vary from person to person. They may also mimic other conditions and hence be difficult to diagnose. Symptoms may also develop very slowly over a span of moths-years. Some of the characteristic symptoms of this disease are:

Depression
Constipation
Hair loss
Dry hair
Dryness of the skin
Tiredness
Body pains
Fluid retention in the body
Irregular menstrual cycle
Increased sensitivity to cold
Reduced heart rate
Increase in size of the thyroid gland   called Goitre. This is due to constant stimulation of the thyroid gland by TSH.
Weight gain
Carpal tunnel syndrome
Hoarse voice
Infertility
Loss of libido/sex drive
Confusion or memory problems especially in the elderly
What are the symptoms to look for in a baby if you suspect hypothyroidism?

Infants suffering from congenital hypothyroidism may show no symptoms or exhibit signs of excessive drowsiness, cold hands, cold feet, constipation, hoarse cry, poor growth or absent growth, poor appetite, bloating of abdomen, puffiness of face, swollen tongue, persistent jaundice.

How to diagnose hypothyroidism?

Blood tests:

TSH: This hormone is made in the pituitary gland and it stimulates the thyroid gland to produce thyroxine. If the thyroxine levels are low in the blood, the pituitary gland produces and secretes more TSH into the blood to act on the thyroid gland to produce more thyroxine. A raised TSH level indicates hypothyroidism. Other tests are not usually necessary unless a rare cause of hypothyroidism.
T4: A low level of thyroxine indicates hypothyroidism.
T3: these levels are generally not needed to diagnose hypothyroidism
Anti-Thyroid peroxidase antibodies (anti-TPO antibodies) or Anti- thyroglobulin antibodies are present in 90-95% of patient with autoimmune thyroiditis.
Other blood tests include Creatinine Kinase, Serum Lipids, Complete blood picture etc.
Ultrasound of the neck is done if the patient presents with a thyroid swelling.
What is the treatment of hypothyroidism?

Overt hypothyroidism is treated by synthetic Thyroxin hormone which should be taken every day on an empty stomach at least 30   45 minutes before breakfast. The treatment is continued for the rest of the patient s life. Regular thyroid function tests are done once every 8 weeks-12 weeks to adjust the dose of the thyroxine in the initial period of diagnosis. Once the thyroxine dose is stabilised, the tests can be done even once a year. This treatment is quite effective.

Sub-clinical hypothyroidism is only treated if the patient is a woman and is contemplating pregnancy, in patients with symptoms or if the TSH is quite high.

What are the side-effects of thyroxine medication?

There are few side effects if any. Most people tolerate these medications quite well. An important consideration before starting medication is to check if the patient has chest pain/angina. These people are started on the least available dose. If these patients are started on a higher dose they notice a worsening of their angina pains.

Side effects mainly occur if the thyroxine dose is high which leads to hyperthyroidism. The symptoms of this could be palpitations 9increased heart beat), weight loss, profuse sweating, anxiety, irritability etc.

There are some tablets which increase with thyroxine tablets. These include carbamazepine, iron supplements, calcium supplements, rifampicin, phenytoin, warfarin etc.

What are the complications of hypothyroidism?

If untreated hypothyroidism can lead to:

heart problems like heart attack due to increased levels of bad cholesterol like LDL, or heart failure due to fluid retention
obesity
infertility
joint pains
depression
A pregnant woman with hypothyroidism is at increased risk of giving birth to a baby with congenital hypothyroidism, also known as cretinism. Further, the woman may have pregnancy related complications like pre-eclampsia, premature delivery, low birth weight baby, anemia, post-partum haemorrhage (bleeding after delivery) etc.
Myxoedema is another complication where the patient has extremely low levels of thyroid hormone. The body temperature drops drastically making the person lose consciousness or go into a coma.
References:

2013 ETA Guideline: Management of Subclinical Hypothyroidism; European Thyroid Association (Nov 2013)
Management of primary hypothyroidism: statement by the British Thyroid Association Executive Committee; British Thyroid Association (2015)
The diagnosis and management of primary hypothyroidism; Royal College of Physicians and others (June 2011)
Suh S, Kim DK; Subclinical Hypothyroidism and Cardiovascular Disease. Endocrinology Metabolism (Seoul). 2015 Aug 4.
UK Guidelines for the Use of Thyroid Function Tests; British Thyroid Association (2006)
Gaitonde DY, Rowley KD, Sweeney LB; Hypothyroidism: an update. American Family Physician. 2012 Aug 1 86(3):244-51.
Bindra A, Braunstein GD; Thyroiditis. American Family Physician. 2006 May 15 73(10):1769-76.
Wilson GR, Curry RW Jr; Subclinical thyroid disease. American Family Physician. 2005 Oct 15 72(8):1517-24.
British National Formulary; NICE Evidence Services (UK access only)
Baumgartner C, Blum MR, Rodondi N; Subclinical hypothyroidism: summary of evidence in 2014. Swiss Medical Weekly. 2014 Dec 23 144:w14058. doi: 10.4414/smw.2014.14058. eCollection 2014.

Know Everything About Hypothyroidism

The skin is the largest external organ as well as the largest organ in general in the human body. There are many types of skin diseases that can afflict your body and they may appear anywhere. Ayurveda is a potent weapon which can be used to treat many skin diseases effectively. The natural remedies of Ayurveda are being increasingly adopted throughout the world. Let's take a look at a few of the skin diseases that can be easily cured by Ayurveda.

Eczema - one of the most common types of skin diseases, eczema is characterized by the reactions that the skin has. These reactions can manifest themselves in many forms. The most common reaction is swelling of the skin with redness. Other forms may also develop blisters, cracking of the skin, scaling or papules.

Scaly rashes - scientifically known as papulosquamous eruptions, scaly rashes are usually the result of itching which in itself is a reaction to some internal or external factors. These rashes can be mild to severely painful depending on what had caused them. Some factors behind these may be eczema, reaction to drugs, psoriasis and others.

Urticaria - these rashes differ from other ones as they persist for a short period of time and usually result in swellings on the skin. These swellings may be very sensitive and itchy. Some common examples of urticaria are nettle rashes and hives that may develop due to an external factor such as bug bites.

Psoriasis - Ayurveda has great treatments for this disease as its incidence within the population is quite high. This is a non-infectious skin condition where inflammation occurs in the affected parts of the skin and reddish scales form on the body. This problem is usually attributed to excessive cells within the body.

Pruritus or itching - another very common skin affliction which can be caused by a variety of factors, it can be a reaction to something external or be caused by internal issues that may be developing. Mostly caused by the reaction of external nerve endings they may become very painful if over stimulated.

Ayurveda has many remedies for all of the ailments mentioned above along with many other skin disorders and has gained popularity as it completely natural and devoid of side effects encountered with conventional medicine.

Common Skin Diseases That Ayurveda Can Easily Cure

Raise a toast to great skin with vodka!

The Russians love their national drink, the vodka, as much as the french love their fine wines. And just like wine, vodka can be easily used in your daily beauty regime to add a much wanted healthy white glow to your skin.

Vodka is a great astringent or toner. Soak a cotton ball in a mix that is equal parts vodka and water and then lightly dab all over your skin. It will cleanse the skin and tighten pores.

You can add a dash of lemon juice to the mixture and freeze it. Rub these beauty cubes onto your face to bring down skin bloat as vodka and lemon juice together tighten pores and brighten the skin.

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


Raise a Toast to Great Skin with Vodka!

Oily skin and summers: what is the ideal way to handle it?

Oily skin is a condition that can be characterized by shine on the skin and a large number of pores. The oil in question is a result of overactive sebaceous glands that produce excessive sebum. This can result in acne and blackheads. Summer is a time of the year where skin problems due to oily skin are worsened by factors such as sweat and dust. So proper skin care is necessary in order to negate the effects of oily skin.

There are multiple ways to handle this condition in summers:

1. Using cleansers - Proper cleaning of skin is a very important step in lessening the effects of oily skin. Harsh cleansers have an opposing effect as they facilitate secretion of oil, so a mild cleanser is usually the best option. Some cleansers may contain ingredients that irritate the skin, so care is advised in selecting a proper one.

2. Hydration and food - Keeping the body well hydrated in summers combined with a diet free of greasy, oily food and less fats can help in reducing the effects of oily skin.

3. Using masks to clear the face - Masks such as clay masks, yogurt, and baking soda can help in cleansing the skin by clearing the oil. It should be noted that these treatments should not be overdone as they can cause the skin to dry up too much and over secrete oil.

4. Skin moisturizers - People often have this notion that oily skin does not require moisturizer application. Selecting a moisturizer that is fit for oily skin and using it will help moisturize the skin and keep it healthy.

5. Sunscreen - Sunscreen is a necessity during summers, and the sunscreen you choose should be specifically for oily skin in order for it to work effectively. Application of sunscreen can help prevent the UV rays of the sun from penetrating the skin and cause complications.

6. Dermatological treatment - In case of severe oiliness, treatments such as chemical peels and creams laced with tretinoin can help.



Oily skin and summers: what is the ideal way to handle it?

Corns and calluses are areas of stumpy skin caused by friction or pressure. They usually hurt when you wear shoes or walk.
Calluses generally develop on your feet or hands, and most of the time, don t require treatment.
Corns have a hard or soft inner core. Soft corns are mostly found between the toes, while hard corns form on the top of the toes. Corns that are caused by ill-fitting shoes often reduce on wearing the right shoes.
Causes-
Repeated friction or pressure causes corns and calluses on areas of skin. The pressure leads to the death of the skin, which develops a protective, hard surface. Soft corns develop in a similar fashion. Corns and calluses are not formed due to viruses and are not harmful. They can be formed due to:
Regular usage of any object that puts strain on the hands, such as sports equipment (badminton racquet) or tools (hammer or gardening hoe), usually leads to calluses on the hands.
Pressure from wearing the wrong footwear usually leads to corns and calluses on the feet. Calluses can also form by walking barefoot.
Abnormal structures on the foot, such as hammertoe or bone spurs, can cause calluses and corns.
Repeated pressure from playing certain sports can also cause calluses on the feet.
Symptoms-
Corns and calluses on the feet are easy to spot. A callus is thick, hard and dry, and may appear yellowish or grey in colour. When touched, it will feel bumpy and more insensitive than the skin around it. A hard corn is thick and firm, while soft corns look like an exposed sore. The hard corn may have a grey centre with a light yellow ring around it.
Corns and calluses don t hurt, but it does become painful when you are wearing shoes or walking. Fitting your feet into shoes gets more difficult due to them. Touching or squeezing the corn or callus can also be painful.
Treatment-
Corns and calluses don t require treatment normally, but if they hurt, here s what you can do:
Wearing well-fitting shoes that are roomy with deep and wide toe boxes (the area covering the toe).
Protective paddings, such as moleskin, toe separator, toe sleeves, etc., can alleviate pain.
Soaking the corn or callus in hot water, and then gently wear down the dead skin by using a pumice stone.
Salicylic acid can be used to soften the corn or callus.


All about Calluses and Corns

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