Cardiomyopathy includes diseases involving the heart muscle. These diseases have various causes, types, symptoms and modes of treatment.

The heart muscle gets enlarged, thick or rigid. In several cases, the heart muscle tissue is replaced with a scar tissue. As this condition worsens, the heart gets weaker and the ability to pump blood is disrupted, which can cause heart failure or irregular beating of the heart. The weakened state of the heart can lead to valvar diseases.

The different types of cardiomyopathy are:

 Hypertrophic cardiomyopathy-
This is a common form and affects people of all ages. Men and women are affected equally. This condition arises due to the enlargement and thickening of the heart muscle. The ventricles, the septum and the lower heart chamber usually thicken, which causes obstruction in pumping of blood by the heart. This disease also causes stiffness in the ventricles, and cellular changes in the tissue.
 Dilated cardiomyopathy-
This form of cardiomyopathy develops due to the enlargement and weakening of the ventricles. The issue arises from the left ventricle and develops over time. It may even affect the right ventricle. More effort is put in by the heart muscles for pumping blood and slowly the heart is unable to pump blood effectively. This condition may lead to heart failure, valve diseases or blood clots in the heart.
 Restrictive cardiomyopathy-
This disease occurs due to the stiffening of the ventricles, without thickening of the walls of the heart. The ventricles are not allowed to relax and do not receive a sufficient volume of blood supply. This condition causes heart failure and valvar problems over time.
 Arrhythmogenic right ventricular dysplasia-
This rare form of cardiomyopathy occurs when fat or fibrous tissues replace the muscle tissue of the right ventricle. This causes arrhythmias and disruption in the electrical signals of the heart. It generally affects teens and may cause cardiac arrest in athletes.
 Unclassified cardiomyopathy-
Some types of cardiomyopathy of this category include left ventricular non compaction where the ventricles develop trabeculations. Takotsubo cardiomyopathy is another disease where immense stress causes failure of the heart muscles.

Treatment-
Many cases of cardiomyopathy come and go away on their own. Treatment for other cases depends on the severity and symptoms. The major treatment methods are:
Lifestyle changes meant for a healthier heart.
Medication.
Nonsurgical methods.
Surgery and implants

Modes of surgery for treatment of cardiomyopathy include:
Septal myectomy
Heart transplant
Implant devices such as cardiac resynchronization therapy (crt) device, implantable cardioverter defibrillator (icd), left ventricular assist device and pacemakers are fitted into the heart for better performance.

Cardiomyopathy can be of many different types, each arising from different situations and conditions. The mode of treatment depends on the severity of the complication or on the basis of symptoms.

Types and Treatments of Cardiomyopathy

A hernia is a condition where fatty tissue or an organ in your body might bulge through a muscle or an abnormal opening in the body. It is caused mainly due to pressure in the muscle area or weakening in the spot. This may occur due to heavy lifting or weakness that was present since birth.

The different types of hernia are inguinal, incisional, hiatal, umbilical and femoral. For inguinal hernias, surgical methods are used. The most common method is laparoscopic repair.

What is laparoscopic hernia surgery?

In this process, you will be given general anaesthesia before the surgeon performs the surgery. Before undergoing the operation, you will have an evaluation of your complete health that will include an analysis of your past medical history and a physical examination. An electrocardiogram or ECG will also be conducted. 

Then a small cut or incision is made in the lower part of your abdomen below the navel. The laparoscope that is a small telescope-like instrument is inserted to view your internal organs. A video camera is attached to the device that projects the internal view of your body on to a screen. This is viewed by the surgeon in the operating room.

During the process, your abdomen is inflated with carbon dioxide, to create some space for the doctor to look inside easily. The inner abdomen lining called peritoneum is cut open to observe the weakness of the abdominal wall or the location of the hernia sac. After locating it, the surgeon will remove the hernia sac from the wall and use a prosthetic mesh to cover the defect. Then the small incisions are closed with surgical tapes or stitches.

Furthermore, if hernias are found on both sides, they can be operated without making a second incision. The mesh can be placed on all the abdominal areas that are weak. This prevents the hernia to occur in the same spot again or spreading to other areas.

However, laparoscopic surgery is not performed for children. It is also not suitable for some cases such as if you are pregnant, or cannot tolerate general anaesthesia or are obese. 

Aftercare

You will be able to go back home on the same day of the surgery after laparoscopic hernia repair. The recovery time lasts for about 1 to 2 weeks. After that period you can return to light activity like walking. However, you must not engage in any kind of strenuous activity like working out or lifting heavy objects.

You might observe soreness after the first 2 days of the surgery. In some cases, bruising is found in your groin area. But if you observe significant swelling in the groin region, contact the doctor immediately.

It is recommended that you maintain a diet that is rich in fibre. This is because if you suffer from constipation, the straining during your bowel movements might put pressure on the area that is repaired.

People prefer laparoscopic hernia repair as they suffer lesser pain and can get back to their normal lives faster than open repair surgeries. It is advised that you take the medications and follow the instruction of your surgeon properly after the procedure. 

 



 Laparoscopic Hernia Repair - What Should You Know?

What is an ovarian cyst?
If a follicle present in the ovaries grows beyond 2cm in size, it is called an ovarian cyst. In an ovarian cyst, fluid accumulates inside a thin wall in the ovaries. The size of the ovarian cyst varies in size from person to person. It is most common in women during their fertile period, but it can happen anytime.

What is the cause of an ovarian cyst?
Follicles are produced in the ovaries under normal conditions. One of these follicles matures into an egg every month. It is a very normal process and happens spontaneously in most cases. However, under certain circumstances and conditions, these follicles fail to rupture and turn into a fluid filled cyst. In rare cases, dermoid reactions caused by entrapment of sebum follicle or hair follicle can cause ovarian cysts as well. It is common for most women to have at least one cyst in their lifetime.

What are the symptoms of an ovarian cyst?
Sometimes, an ovarian cyst does not present many symptoms. The most common symptoms include:

Increase in weight
Painful intercourse
Headache and fatigue
Pain in the abdomen
Heaviness and fullness in the stomach
An increase in the frequency of urination
Increase in bowel movements as a result of pressure
Back pain
Ayurvedic treatment for ovarian cyst

Shilajit: It is the most common herb for enhancing male libido and induces strength and vigour. Hence, this herb is indicated in women to increase agility so that they are able to get on with their daily schedule without much interference due to the fatigue.
Commiphora mukul: It is a very potent drug and has immense rejuvenating properties. The cells of the body are revitalised and rejuvenated by these. It is also effective in people who are anaemic or have low haemoglobin levels in the blood.
Emblica Officalis (Amlaki): Amlaki  is known for its rejuvenating properties as well. It has great anti oxidant properties and helps to neutralise the free radicals in the body. It is also effective in increasing immunity in the body and enhancing metabolism.

Ovarian Cysts - Ways Ayurveda Can Help You Treat It!

GERD is a digestive disorder that affects the lower esophageal sphincter, which is the ring of muscle between the esophagus and stomach. Gastroesophageal reflux is the backward flow of acids from the stomach into the esophagus. Doctors believe that some people usually suffer due to a condition called hiatal hernia. Pregnant women usually suffer from heartburn or acid indigestion caused by Gastroesophageal Reflux Disease.

The primary goals in the treatment of this disease are relief from symptoms, healing of erosive esophagitis and prevention of complications of esophagitis. The symptoms include heartburn and regurgitation. The setting includes a proton pump inhibitor (PPI). Patients suspected due to GERD with non-cardiac chest pain are recommended to have diagnostic evaluation before institution of therapy. For diagnosing GERD, barium radiographs should not be used.

The other points that must be remembered to diagnose GERD are
1. Endoscopy is recommended only in case of alarming symptoms. Even in typical symptoms, the upper endoscopy is not recommended.
2. For preoperative evaluation, esophageal manometry is recommended, but it has no role in diagnosing GERD.
3. Ambulatory reflux monitoring is a test that can assess association of reflux symptoms.

Management:
The suggested lifestyle modifications for the patients with GERD are

    Weight loss is recommended for patients who are overweight. So, avoid large meals and decrease dietary fat intake.
    Avoid alcohol, chocolate, onions, garlic, acidic foods and peppermint.
    Do not lie down within 3 to 4 hours after meal (recommended for nocturnal GERD patients).
    For symptom relief and to heal erosive esophagitis, a 8-week course of PPIs is the therapy of choice.
    Medications that help in potentiating GERD symptoms, including alpha-adrenergic agonists, nitrates, calcium channel blockers and theophylline should be avoided.
    For patients without diagnostic evaluation, therapy for GERD other than acid suppression, including prokinetic therapy should not be used.
    For patients with partial response to PPI therapy, additional symptom relief can be achieved by increasing the dose twice daily or switching to a different PPI.
    It is recommended to elevate the head of the bed 10 to 20 cm.
    Avoid wearing clothes which are tight around the waist.
    If patients experience heartburn relief, Histamine-receptor antagonists (H2RA) therapy can be used as a maintenance option in patients without erosive disease.

Some surgical options
1. For long-term therapy for patients suffering with GERD, surgical therapy is the best treatment option.
2. In patients who have no evidence of erosive esophagitis, preoperative ambulatory pH monitoring in mandatory.
3. Gastric bypass is the preferred operation for patients who are suffering with obesity and are contemplating surgical therapy for GERD.

Apart from these, there are potential risks that are associated with PPIs such as switching them can be considered in setting of side effects and the therapy can be a risk factor for Clostridium difficile infection.

Management of Gastroesphageal Reflux Disease (GERD)

The bladder is a hollow storage organ that collects urine from the kidneys and stores it until it can be passed out of the body through the urethra during the process of micturition or urination. It has a thin inner lining of cells called urothelial cells and a thick muscular wall, which exerts pressure to push the urine out of the body.

Causes of Bladder Tumors

In most cases, the bladder tumor develops on the inner layer due to a combination of some of the following factors.

1. Hereditary: A strong family history of cancer predisposes a person to cancer.
2. Gender: Men are 3 times more prone for bladder cancer than women.
3. Ethnicity: White people are more prone for bladder cancer black people.
4. Smoking: Smokers develop bladder cancer 2-6 times more frequently than non-smokers. cigarettes contain toxic, carcinogenic substances which reach the kidney and are stored in the bladder, leading to their damage.
5. Occupational hazards: Some workplaces have a higher likelihood of causing bladder cancers, especially dye and rubber industries. The effects can be damaging, and the person may develop cancers years after the exposure has happened.
6. Recurrent bladder infections: In some people, this can also lead to bladder cancer in the long run.

Types of Bladder Tumor

Depending on the extent of the cancerous spread, it can be of two types:

1. Non-muscle-invasive bladder tumors: The tumor spread is limited to the inner part of the bladder (urothelial cells)
2. Muscle-invasive bladder tumor: The tumor has spread to the thick muscular outer layer. This is more advanced and prognosis is poor compared to the noninvasive type.

The most common and diagnostic symptom of bladder cancer is the presence of blood in the urine, known as hematuria. This will be intermittent and happens whenever the tumor bleeding happens. Other symptoms include pain in the lower abdomen and frequent urination.

Diagnosis

From the most noninvasive to the most invasive diagnostic test, these include:

1. Urine microscopy to detect cancer cells in the urine
2. Cystoscopy A tube inserted into the urethra to look into the inner wall of the bladder is highly diagnostic
3. Ultrasound, CT Scan, and biopsy can also be further used to identify severity of the tumor.

Treatment

Once the tumor is diagnosed, treatment would depend on the severity of the tumor. For both invasive and noninvasive tumors, definitive therapy is surgery, known as transurethral resection of the bladder tumor (TURBT). The cancerous bladder tissue is removed through a cystoscope as done for diagnosis. The bladder is then flushed with chemotherapy agent to kill any residual cancer cells in the bladder. This is then followed by BCG vaccine, which is again done 1 to 4 weeks for several months to avoid recurrence. In some cases, radiotherapy may also be included.

Bladder Tumor and Its Common Causes

Colon polyps are growths that are typically found in the large intestine. Although the causes behind the occurrence of colon polyps are not known, this condition is usually seen to affect adults.
These colon polyps might turn into colon cancer over a period of time; the development of cancer can happen over a number of years.
Colon polyps are usually symptomless; hence it becomes difficult to diagnose the condition. They are commonly found as additional results of screening tests for colon cancers. Screening tests are conducted when there is a suspicion of a disease but it displays no significant symptoms. The symptoms can only be visible if the polyps are enlarged. Typical symptoms include:
Rectal bleeding.
Changes in bowel conditions such as diarrhoea and constipation.
Changes in urination patterns.
Change in appearance of stool.
As the presence of most polyps becomes evident only during colon cancer tests, it is recommended that regular tests for colon cancer be conducted for adults over the age of 50. Some of these tests include:
Colonoscopy: This is highly recommended for detecting colon polyps. A small tube used for viewing is inserted into the colon by the doctor.
Flexible Sigmoidoscopy: It is similar to colonoscopy with the only difference being that the tube is smaller.
Computed Tomographic Colonography (CTC): Also known as virtual colonoscopy, various computer systems and X-rays are used to create a detailed picture of the colon so that the doctor can search for polyps.
The size of the colon polyps helps to identify if the polyp is cancerous or not. Chances of the polyp being cancerous are high if the size of the polyp is higher than 1 cm or 0.4 inches. Hyperplastic polyps (smaller polyps) do not become cancerous and hence, do not need to undergo a colonoscopy. Another form of polyp is the sessile polyp which is usually a flat growth without a stalk and grows on the inner wall of the colon. Similar to other polyps, these polyps can be found and removed using a colonoscopy or a sigmoidoscopy.

Causes and Symptoms of Colonic Polyps

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