While injuries of any form can be painful, burn injuries are one of the worst to suffer from. While cuts and bruises can be temporarily assuaged with a proper dressing, burns are quite different in this regard. With burns, the damaged tissues will stay on the body and may cause continuous pain. Thus, burn injuries are difficult to treat and they require different strategies for pain management as well.

Treatment methods available for treating pain arising due to burn injuries

Apply an anesthetic cream or aloevera gel to soothe the burnt skin. Avoid exposing the skin to air as that will cause painful sensations.
Loose gauze or antibiotic ointment must be used to protect the influenced area.
Soak the burnt area wound in cold water for about five minutes or more.
If the burn escalates or affects a widespread area, seek medical attention immediately.
Pain management factors for burn injuries:

Relaxation: During the phase of recovery, burn injuries put immense stress on your body and continue for a long period. Muscle tension is caused by stress that increases pain. Some relaxation techniques are proven to be beneficial to reduce the stress on body.
Coping with your pain: Different people have different ways to cope with physical discomfort. Look out for situational aspects which are currently under your control and take it positively. The  what ifs  or wishing that the burn didn t occur in the first place will not help with your current situation. You should focus on things what you can control like self-rehabilitation, doing your daily exercises, physical therapy treatment or following a doctor s suggestion of pain management strategies. This will help you cope with your pain to a greater extent.
Sleep medications: If your normal sleep routine is hampered, consult your physician for safe sleep medications. Proper sleep is very important for the healing process and even more so in the case of burn related injuries.
Antidepressants: Some people may not be suffering from depression, but they might still need antidepressants for relief and sound sleep. A health care provider might prescribe antidepressants as a way to deal with acute pain from burn injuries.
Increase the pace of your activities: If you want to rebuild your health and stamina and get back in form soon, focus on the regular physical and mental activities. Exercise regularly, but don t push yourself too much. Increase your physical activities gradually over time. Unless and until you are fully comfortable, don t strain yourself too much. Occupational and physical therapists can help you with an appropriate activity program.

Burn Injuries - 5 Ways to Manage Its Pain

When it comes to a man's physique, enlarged breasts can be quite embarrassing. This is a condition known as gynecomastia or men boobs or  enlarged breast in men and affects more men than you would imagine. It may affect one or both breasts. It can result in terrible embarrassment, teasing, and social trauma. Many will try to hide it with thick loose shirts, avoid bare chest activities like swimming, exercises etc and withdraw from public exposure.Though it does not pose a significant health risk, it can affect a man's psychological health and lower his self-confidence. The good news is that men suffering from this condition do not need to live with it. 

Male breast reduction surgery or gynecomastia surgery, aims at reconfiguring the contours of a man's chest by removing excess breast fat & if needed extra gland tissues. The only permanent solution to this condition is surgery. This is because fat tissues are not solely responsible for enlarged breasts. Often glandular tissue is present in excessive amounts as well. Patients need careful evaluation by Plastic Surgeon & sometimes if needed by endocrinologist to determine the source of their breast enlargement. 

Gynecomastia surgery is usually a daycare procedure. It is performed by Plastic Surgeons under local anesthesia with liposuction being the most preferred procedure. This procedure begins when the surgeon makes a small incision on each side of the chest. These incisions are usually placed along the natural contours of the body, around the edge of the areola or near the armpit so as to reduce the visibility of scars. Excess fat and glandular tissue are then sucked out of this incision. Simultaneously, the surgeon sculpts the other tissues in the chest to redefine chest contours. Patients are usually advised to wear a compression garment after the surgery to support the healing tissues and minimize swelling. 

Results of this procedure are visible almost immediately. Recovery from gynecomastia surgery is usually quick and many men find themselves back to their normal routine within a few days. However, vigorous exercising and heavy lifting should be avoided for a few weeks after the surgery. The patient may also experience slight soreness and minimal pain that can be relieved with over the counter pain killers. 

The results of this procedure are generally permanent if there are no hormonal abnormalities. It is important to maintain a healthy lifestyle and avoid drugs that influence your testosterone levels. Regular exercise can also help tone the chest muscles and maintain the achieved good shape of chest. It is really a very simple but rewarding surgery for the male & it definitely boosts his confidence, body image & self-respect.

Enlarged Breast In Men - Causes And Treatment 

Alternative medicine is fast picking up with its beneficial treatment for several skin disorders. Vitiligo or patchy skin is a common skin problem that can be effectively treated by the ancient Unani system of medicine.

What is vitiligo?
Also referred to as leucoderma, it is a patchy loss of skin colour that occurs due to acquired depigmentation of the skin. The absence of skin cells called melanocytes leads to nonproduction of the melanin pigment and as a result, manifests itself as patchy skin in several parts of the body. It can affect any area of the body including the face, neck, back, hands, and legs.

Unfortunately, conventional medicine has not been able to discover a full-proof treatment for this skin disorder, except for surgical intervention. Thanks to the yesteryear s Unani medicine system, which has its foundations in the ancient Greek, Roman, Persian, and Indian medicine, certain herbal formulations help to treat conditions of vitiligo or leucoderma. The Unani system of medicine aims to create the right balance in the body by stabilizing the four humours   blood, phlegm, yellow bile and black bile, which constitute insulin, hormones and other fluid releases.

Herbal powder and capsules are prescribed for the patient s consumption depending on the severity of the disorder.
Herbal ointment for external application   The affected individual must apply the topical ointment or balm before 10:00 am and then expose it to sunlight for around 10 to 15 minutes. After that, it should be shown back in shade and kept for one hour before washing it off.
Diet for vitiligo
Certain food items like banana, beef, sea food, poultry, citrus foods, pickles and dairy products are to be restricted during treatment. Foods with excessive tamarind and cashew nuts are also to be avoided. Recommended food includes all vegetables, fruits, eggs, and organic chicken.

How effective is Unani in treating vitiligo?
For years together, Unani compound formulations for systemic as well as topical usage are catering to the needs of patients. It helps to treat and induce re-pigmentation. There are several treatment modalities available to control the spreading of the disease and minimize the chances of a relapse of the skin condition.

There have been no reported side effects of Unani medicines and they are well tolerated even after prolonged use. It usually takes about 2 to 3 months to see a visible improvement of the condition. The disease tends to become stable after regaining pigmentation.

The Central Research Institute of Unani Medicine located in Hyderabad, India has taken several measures to eradicate Vitiligo. While conventional medicine does try to offer remedies to treat vitiligo, Unani medicine offers a cost-effective approach that is more promising.

Best Unani Medicine for Vitiligo Treatment

Eczema is something which can really blight the quality of the life of a person. Sometimes, even the most mundane of things can cause our skin to have a reaction, resulting in allergic eczema. However, while it is annoying and painful, there are ways to go about treating it.

It is quite important, though, to understand what exactly eczema is. Simply put, it is a condition which occurs when the skin of the person suffering from it is inflamed.

Among the various groups of people who suffer from eczema, a lot of them are actually babies. However, they thankfully are able to grow out of the issue by the time they become adults. While it is true that eczema can strike any part of a person s body, among the places it strikes most often are the face, the neck and behind the sweat spots of the body i.e. the area behind the knees and around the ankles.

What causes allergic eczema?
Eczema is a lot of the time, a condition which is genetic. That being said, there are certain things which can go a long way into making it worse, which include stress and dry climates as well as external materials which irritate the skin touching it, like soaps which are just too strong.

What are the Treatment Options?
When it comes to things, which have the potential to make the situation a lot better, there is a group of medicines which are part of the antihistamine group which can work wonders. An interesting thing when it comes to the treatment of allergic eczema is the fact that a lot of the treatment for the issue involves a management of the inflammation that occurs along with an attempt to take better control and manage the immune system of the person who has eczema.

Depending on the severity of eczema a person has, a possible course of treatment involves making use of corticosteroids, which are strictly a prescription based way to go about treating eczema. Keeping this in mind, it is of the highest importance to make sure that whenever the steroids are being taken by mouth, there is a full adherence to what the doctor has recommended or directed.

As a last ditch resort, if the condition is really bad, there is a possibility of going for Ultra Violet Therapy in order to make it better. However, if one is looking for ways to reduce the intensity of their eczema sans higher doses of medication, stress management in something that can work well. In addition to this, a humidifier can do a lot to improve the situation.

Allergic Eczema - Ways You Can Contact It!

In today s world, females have advance techniques available for shaping up their breasts. It is a part of their overall persona and beauty. Breast augmentation is one of the greatest plastic surgery operations that is done in hospitals across the globe. 

Gone are the days, when you would sit back at home and blame nature for your saggy breasts. You have the gift of plastic surgery at your rescue. Breast augmentation can enhance the beauty of your breast and uplift its features. In this process, the implant is put under the pectoral muscle so that you can still breastfeed your infant if needed.
The process is executed with the help of a small 4 cm incision. The recovery process takes a week s time. Breast augmentation can be carried out in a surgical centre or in any hospital s outpatient facility. It doesn t require a hospital stay in most cases. In some selected cases only, the procedure is done using local anaesthesia. In those cases, the patient stays awake. The breast region is made numb.

What to expect during the procedure?

The woman opting this must know what all are expected to happen during the procedure. The surgeon will insert the breast implant by making a single cut in one of the following three areas:

1. In the crease under breast 
2. Underarm (axillary)
3. Around the nipple (periareolar)

After the incision is done, the surgeon will try and separate the breast tissue from the patient s muscles and connective tissue. This will lead to the creation of a pocket either behind or in front of the pectoral muscle. After this, the surgeon will put the implant into the newly-created pocket. It will be centred behind the nipple. 

Saline implants are put in an empty form and then filled with sterile salt water. Silicone implants are, however, pre-filled with silicone gel. After the implant is over, the cut is stitched with sutures and the skin is bandaged with adhesive and tape.

What to expect after the procedure?
For a few weeks, the patient might experience Soreness and swelling. It is also possible to develop bruises. Your scars will fade away with time. It is quite possible that the scars will not vanish permanently ever in your lifetime. You must wear a compression or sports bra at the time of healing. You might be required to take painkillers, as advised by the surgeon.

Breast Augmentation - What to Expect from the Procedure?

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.

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