What is the best time to sleep?
This is one of those questions which bother many and sundry. Considering the different sleep schedules which different people might develop as a result of their work or other reasons, the correct answer is roughly around 10 p. M. It is good to follow a proper sleeping schedule so that you go to bed and wake up at the same time almost every single day. The body's internal clock or the circadian rhythm is linked to the cycle of the sun. Technically, it is better to wake up with the sun as it has a number of benefits for the human body.

The quality of sleep is known to be influenced by how late you retire for the night. The quality of rem (rapid eye movement) sleep tends to decrease if you go to sleep late. There is another type of sleep which is known as non rem sleep; this is a deeper state of sleep. The non rem sleep helps in revitalizing the body and leaves you energized once you wake up. Sleeping late at night is linked to higher levels of rem sleep, which might not be very beneficial for your physical or mental health.

If you go to bed late at night, you will experience more of the lighter rem sleep. This may lead to fatigue and restlessness the following day. It is also been shown that going to bed late and sleeping less than the usual eight hours is linked with problems in blood sugar levels and decline in cognitive function. It also raises your risks of high blood pressure.

Exposure to radiation from your cellphones or the glare from your computer screen before going to sleep may also affect the quantity and quality of your sleep. Make sure you eat a light dinner consisting of salads. Eating a heavy dinner before going to bed may cause digestive problems, thus impairing your sleep. Also make sure to exercise on a regular basis as it releases various hormones in the body that help in improving your overall wellbeing.

Just What Is the Best Time to Go to Sleep?

The carpal tunnel is the passageway for the median nerve to pass through on the inner side of your hand, when your palms are facing down. For example, while typing, there is a lot of movement of the fingers and this puts a lot of pressure on this tunnel. In fact, people who are involved in a lot of typing are one of the most prone people for carpal tunnel syndrome (CTS). Other causes would include trauma, fractures, etc., where the tunnel is injured.

Conventional measures to treat CTS included a combination of exercise and pain killers in mild to moderate cases. In moderate (sometimes) to severe cases, surgery was also done. However, with advancements in medical technology, endoscopic surgical procedure is gaining popularity.

What is done?
In endoscopic surgery, a small incision is made in the wrist or one each in the palm and the wrist. Through this, a flexible tube with a camera and minute cutting tools are inserted into the wrist. Another ligament known as transverse carpal ligament is cut. This reduces the pressure on the median nerve, which provides relief from the CTS symptoms.

What to expect as benefits?
The intention behind the surgery remains the same in both traditional and endoscopic procedures. The pressure on the median nerve is released, restoring movement and reducing pain in the joints. In addition, the endoscopic procedure has the following benefits.

Less invasive: Needless to say, there are only one or two small incisions done for this procedure, so less surrounding tissue is damaged.
Same day surgery: No hospitalization is required, and unless required, the patient can return home on the same day of surgery.
Reduced recovery time: The recovery period is usually substantially less compared to the traditional surgical approach.
Back to work: Depending on which is your dominant hand, you would be able to return to your regular work earlier than with regular surgery. If your non-dominant hand is involved, a day or two of rest is required. If your dominant hand was involved, give it up to four weeks for complete recovery.
Reduced chances of nerve injury: The area of operation has many nerves and blood vessels, and endoscopic surgery reduces the chances of damaging adjacent nerves.
Anesthesia: This is done under local anesthesia. Therefore, complications arising out of general anesthesia are completely avoided.
Indications
While these sound promising, your doctor will decide if you are a candidate for endoscopic procedure depending on the following:

Nonsurgical treatment including exercise and pain killers have not provided relief, even after several months.
Severe symptoms including those of nerve damage, like loss of sensation, altered coordination, etc., is affecting your normal daily routine.
Person requiring bilateral surgery like severe trauma, wheelchair dependent, etc.

Carpal Tunnel - How Endoscopic Surgery is Beneficial?

Cerebral palsy is the term for a group of neurological disorders that affects one s muscle movement and motor skills.

In most cases, the condition is caused due to a brain impairment that develops while the baby is still in the womb. Cerebral palsy may also occur shortly after or during birth.

Symptoms of Cerebral Palsy:

The signs and symptoms of the condition vary from one individual to another, ranging from mild to severe. The commonly observed ones in children are-

  Difficulty walking
  Difficulty holding on to objects
  Delay in developing motor skills- sitting up straight, rolling over, crawling
  Variation in the muscle tone- too stiff or too floppy
  Delay in development of speech
  Spasticity
  Lack of coordination of the muscles
  Difficulty swallowing and excessive drooling
  Functioning of only one side of the body
  Neurological ailments such as intellectual disabilities, seizures, and others

Types of Cerebral Palsy:

Cerebral palsy can occur in the following forms-

  Spastic cerebral palsy - Causes exaggerated reflexes and muscle stiffness. This is the most common type of cerebral palsy, affecting nearly 80% of the population.
  Dyskinetic cerebral palsy - Causes abnormal, involuntary movement of the legs, arms, and hands. It may also affect the movement of the tongue and face, thereby making it difficult to talk or swallow.
  Hypotonic cerebral palsy - Causes overly relaxed muscles and reduces muscle tone. The legs and arms are easily moveable and appear saggy.
  Ataxic cerebral palsy - This is the least common type. People living with this form of the condition have problems with coordination and balance.

Diagnosis and treatment of cerebral palsy

Cerebral palsy can be diagnosed with the help of the following-

  CT scan
  MRI
  Ultrasound
  Electroencephalogram

Treatment of the condition depends on its severity. Long-term treatment includes physiotherapy, medications and surgery.

  Physiotherapy and occupational therapy helps restore muscle strength and improves muscle tone. You can try stretching exercises to improve flexibility.
  Usually, the doctor prescribes medications in the form of muscle relaxants and sedatives. Muscle relaxants reduce muscle tension, helps relieve discomfort and muscle pain.
  You may need to undergo an orthopaedic surgery in case medications and therapy does not yield positive results. The surgery will aim to release tight muscles and repair bone abnormalities caused due to spasticity.

The specialist as a last resort may recommend SDR or Selective Dorsal Rhizotomy to reduce spasticity and chronic pain. This involves operating the nerves at the base of your spinal column.

There is no permanent cure for cerebral palsy. However, the condition is manageable with the help of drugs, therapy and surgery. The kind of treatment required depends on your overall condition. While some may be able to live with the condition without much assistance, others may require immediate medical intervention. Therefore, it is best to consult an orthopaedic and get help if the symptoms deteriorate over time.

Cerebral Palsy - Symptoms, Types & Treatment Of It!

Gallbladder removal, termed as cholecystectomy, is regarded as one of the most commonly opted surgical procedures. Laparoscopic surgery for cholecystectomy is the process of removing the gallbladder with laparoscopic techniques. It is a minimally invasive surgery where the surgical procedures are performed with the assistance of different minute instruments and a video camera.

Advantages of Laparoscopic surgery for cholecystectomy
The most commendable reason why people favour laparoscopic surgery is that in place of having to undergo a five to seven-inch incision, this surgical process requires only four small incisions in the abdomen. Moreover, there is minimal post-operative pain and the patients are able to recover faster than patients who have undergone open gallbladder surgery. Most patients can go home the same day as the surgery and can have a quick return to day to day activity.

Determining whether you are a good candidate for laparoscopic surgery
Even though there are numerous benefits of laparoscopic gallbladder surgery, the process may not be suitable for all candidates as it is generally not suggested for patients who suffer from severe and complicated gallbladder disease or have a history of undergoing upper abdominal surgery. A comprehensive medical evaluation by the physician and subsequent consultation with the surgeon is essential in determining whether a patient is a suitable candidate for laparoscopic removal of the gallbladder.

Undergoing the laparoscopic surgery for gallbladder removal
Once you are recommended to undergo laparoscopic gallbladder removal, your doctor will advise you certain preoperative measures that you must follow before the surgery. It is suggested to take a shower the night before the operation and not to eat anything from the night before the operation. Also, drugs such as anticoagulants, arthritis medicines, and Vitamin E medications must also be stopped temporarily for several weeks before the surgery.

The surgery is performed under general anaesthesia. Therefore, the patient is asleep all through the process. The surgeon first inserts the cannula into the abdomen and then a laparoscope is connected to a specific camera through the cannula. Subsequently, other cannulas are also inserted which help the surgeon to separate the gallbladder from the attachments and then remove it completely through one of the apertures. Once the surgeon removes the gallbladder successfully, the small incisions are closed with dissolvable surgical tape or glue.

It is an overall safe procedure, and the rate of complications is much lower which makes it the most effective and popular treatment option.

Laparoscopic Surgery For Cholecystectomy - Who Should Go For It?

Hypertension is a killer disease whose symptoms develop late when the damage is in advanced stages. Hypertensive Retinopathy is one such disease.

It damages the retina of eyes. Since retina is responsible for vision formation, Hypertensive Retinopathy can result in loss of vision. It is of grave concern that in most cases, Hypertensive Retinopathy is diagnosed later.

This is due to the fact that there are often no symptoms in the early stages of the disease. In some cases, where symptoms do manifest, patients may experience pain in the eyes, reduced vision, or headache.

What Happens in Hypertensive Retinopathy

People suffering from long term hypertension are susceptible to Hypertensive Retinopathy. Long-term hypertension affects the small and narrow blood vessels that join arteries to capillary blood vessels taking blood to different parts of the eye. These blood vessels become narrow with time if hypertension in the eyes continues unabated. This narrowing is more common in young adults compared to older people. Such unabated systemic hypertension also leads to leakage of fluid. This is why in some cases of Hypertensive Retinopathy, patients may experience exudation. Ultimately, Hypertensive Retinopathy may lead to damage to retinal blood vessels.

Risk Factors

Long standing hypertension is the number one risk factor for Hypertensive Retinopathy. People who are suffering from longer hypertension become most susceptible for this ailment.

However, studies have shown that hypertension for more than 5 years can even make people susceptible to this ailment.

Diagnosis

Diagnosis is done by Funduscopic Examination. The doctor would look at the eyes of the patient through an Ophthalmoscope which has different lenses. The Ophthalmoscope illuminates the retina and the doctor looks at the retina with different lenses. He can get a view of the retina, including blood vessels and optic nerve disks.

Findings of Diagnosis

For a person suffering from Hypertensive Retinopathy, this examination is likely to show:

Constriction of the arterioles.

Changes in the walls of retinal blood vessels.

Flame-shaped hemorrhages in the retina.

Yellow and hard exudates.

Spots in the shape of cotton wool.

Swelling of the optic disc.

Treatment

The primary treatment for Hypertensive Retinopathy is controlling blood pressure of the eyes. Some lifestyle changes like reducing the intake of salt, avoiding tobacco, etc., may bring down or control systemic hypertension in the eyes. In many cases, doctors may just recommend lifestyle modifications. Nevertheless, it completely depends on the extent of the damage and whether or not there is any fluid accumulation.

If the doctor feels that lifestyle modification is not enough, he may go for medicines that help the patients to control blood pressure effectively.

If the problem is in advanced stages and there is fluid accumulation behind the retina, the doctor may go for Intravitreal injection or Laser Therapy to control the edema.

Conclusion

Eyes are one of the most significant part of the body, this is why it is important for people to take care of it. In case of disease like Hypertensive Retinopathy, one must consult a doctor before opting any treatment or medicines.

Hypertensive Retinopathy - Everything About It!

Vitiligo is a skin condition that causes loss of pigmentation of the skin. Melanocytes, the pigment cells, within the skin are destroyed. This causes these parts of the skin to lose color and turn pale. It might affect different parts of the body including the arms, legs, face and even genitalia. It can affect a person of any age, ethnicity or gender.

Causes
The exact cause of vitiligo is not definitively known. However, there are a number of risk factors that might contribute towards the condition. These include-

Autoimmune disorders- Vitiligo might be a result of an autoimmune disorder where the overactive immune system destroys the pigment cells of the skin.
Exposure to Chemicals- Exposure to certain chemicals can increase the risk of vitiligo by causing depigmentation.
Hereditary factors- There might be a genetic pre-disposition towards vitiligo. Though a person can exhibit symptoms of the condition at any age, it is most commonly found to manifest itself around the age of 20 years.
Symptoms
Vitiligo may start with a simple spot of pale skin but over time, this spot expands and turns paler until it is white in color. Irregular in shape, the edges of these spots may inflame and cause itchiness.

Treatment
The treatment of vitiligo will be determined by a number of factors such as the number and the extent of the white patches and where they are located. Vitiligo treatment includes cosmetic, medical and surgical methods.

Cosmetic Treatment- Cosmetic and skincare products such as sunscreens, dye or makeup can help relieve and hide signs of the condition.
Medical Treatment- Oral medication or medicated ointments may be prescribed to treat Vitiligo. Photochemotherapy which involves the use of PUVA rays to induce re-pigmentation may also be prescribed. If the condition has spread to a considerable extent then the physician might advise that the color from the remaining areas of the skin also be removed in order to match the affected areas.
Surgical Treatment- Surgical treatments are at times prescribed which involve skin grafting or tattooing. This is usually prescribed for those with small patches of affected areas.
With ongoing and extensive research being conducted on this skin condition, we will in the near future be able to both understand and treat it better.

Vitiligo - What Causes It and How Can It Be Treated?

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