Hemorrhoids can be very painful and are impossible to ignore. They can be defined as internal or external swollen veins. In some cases, making a few lifestyle changes such as eating fiber-rich foods and drinking plenty of water may be enough to relieve the problem. In other cases, surgery may be required. Surgery for hemorrhoids depends on the severity of the case. There are many different types of surgeries that may be performed.

Banding
Banding or rubber band ligation is a surgical process used to treat internal hemorrhoids. This involves placing a tight band around the hemorrhoid base to cut off its blood supply. This procedure does not involve the use of anesthesia.

Sclerotherapy
This is also used to treat internal hemorrhoids. It involves injecting a particular chemical into the hemorrhoid that makes the hemorrhoid shrink and keeps it from bleeding. This procedure does not involve the use of anesthesia.

Coagulation therapy
Coagulation therapy is also referred to as infrared photocoagulation. The procedure involves the use of infrared light and extreme heat and cold. The aim here is to help the hemorrhoid shrink and retract. It may be performed with an anoscopy. An anoscopy is a procedure that allows the doctor to look inside the rectum with the help of a scope. This procedure does not involve the use of anesthesia.

Hemorrhoidal artery ligation
Hemorrhoidal artery ligation (HAL) or transanal hemorrhoidal dearterialization (THD) is often used to remove hemorrhoids. It involves using an ultrasound to locate the swollen blood vessels and then closing these off. This procedure does not involve the use of anesthesia.

Hemorrhoidectomy
Large external hemorrhoids can be treated with a hemorrhoidectomy. Internal hemorrhoids that have prolapsed and are not responding to other forms of treatment can also be treated with this procedure. The procedure is performed while the patient is under general anesthesia or local anesthesia. The hemorrhoids are then cut off surgically. Hospitalization may be required for a few days after this procedure.

Hemorrhoidopexy
This procedure is also known as stapling and may be performed while the patient is under local or general anesthesia. It is typically used to treat prolapsed hemorrhoids. During the procedure, the doctor staples the prolapsed hemorrhoid to the walls of the rectum and cuts of the blood supply to the affected vein. By doing this, the tissue is allowed to shrink and be reabsorbed into the body. As compared to a hemorrhoidectomy, stapling is less painful and has a quicker recovery time. 

Surgical Treatment Of Hemorrhoids!

6 Bodily Pains You Must Never Ignore

Any pain in the body is an indication and demands attention. Some pains go away by themselves or by home treatment, while few need medical attention. 

Here are 6 types of pains which should never be ignored.

Chest Pain - Chest pain that doesn't go away and is accompanied by shortness of breath can prove to be fatal if not treated at the earliest. Do not wait for it to subside, nor should you try self medication. Consult the doctor immediately.
Abdominal Pain - While abdominal pain could be because of various smaller reasons, if it is unbearable, consult a doctor at the earliest. This pain could be because of ruptured appendix, stomach ulcer, problems in your pancreas or gallbladder or even intestinal blockages.
Severe Headache - Normally we tend to take headaches lightly, believing that all we need to do is pop a medicine or rest it out. However, if the pain is excruciating, consult the doctor as soon as possible.
Prolonged Backache - If you are experiencing pain in the back with tingling in your toes, this could be associated with your discs. Give it medical attention at the earliest, as it could turn fatal.
Lower Abdomen  - Appendicitis' indicator is sharp pain on the side. If you feel a sharp pain in your lower abdomen on the right side along with symptoms like nausea, vomiting, fever, shaking, constipation and diarrhea, reach out for medical assistance as soon as possible.
Leg Pain - Yet another pain one should not ignore is deep vein thrombosis which is blood clots in the legs? deep veins.

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

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6 Bodily Pains You Must Never Ever Ignore


- hiv testing in pregnancy should be done early so as standard care can be taken for the pregnant women.


- this hiv testing must be repeated in the third trimester, usually before 36 weeks of gestation. This should be done in women with hiv-seronegative and also in pregnant women who are at a high risk of developing hiv infection.


- expedited hiv tests should be performed at the time of delivery and labor and this is a must in women who have not been documented for hiv. The results of the test should be available in one hour of the test and the testing should be available 24 hours. In case the results are positive then, infant postnatal antiretroviral and intrapartum drug prophylaxis should be started immediately.


- women who have not been able to be tested for hiv at the time of labor and delivery are suggested expedited screening for hiv. Their screening can be done immediately postpartum or their babies should undergo screening. In case the infant and mother, both are positive, then infant antiretroviral drug prophylaxis should be started immediately. These mothers should avoid breastfeeding their babies, until the supplemental hiv tests are negative. In infants with positive hiv, prophylaxis should be discontinued and antiretroviral drug therapy should be started.


- in case of acute hiv infection during pregnancy, that is in the intrapartum period, or during breast feeding, initial testing can be performed with an antigen/antibody combination immunoassay. If the supplemental test is negative, then an additional test which is the virologic test (dna, rna) are necessary for the diagnosis of the hiv infection.
- if the mother is hiv positive then this information must be documented in the infant's medical record and also communicated to the infants care provider.
The knowledge of an antenatal maternal hiv infection allows the:
- women with hiv infection to get the correct antiretroviral therapy along with prophylaxis for the infections which might occur due to the immunocompromised state of the body. This also prevents and decreases the risk of transmission to their partners.
- when there is provision for antiretroviral therapy for the mother during pregnancy and labor along with antiretroviral drug prophylaxis for the baby there is less risk of perinatal transmission of the hiv.
- the hiv infected women should be counseled for a cesarean delivery. The option of an elective cesarean reduces the perinatal transmission of the hiv.
- the hiv women should be counseled about the risk of breastfeeding.

Identification and Management of Perinatal HIV Treatment

Erectile dysfunction (ed) occurs when the man is unable to achieve or maintain his erection of penis to meet his or his partner's sexual satisfaction. 
The problem is often faced by newly married men. Fortunately with experience, most of them are able to overcome this problem. Again it is increasingly common with increased age. 

So, what are the causes. In some male, it is psychological, caused by anxiety, depression, stress, marital disharmony etc. Use of alcohol and smoking will aggravate the problem. Psychological causes can happen at any age but more common at younger age. But in some cases, it is associated with serious diseases, especially at old age. It has been seen that in apparently healthy male ed is the first sign of heart disease. So, if you have ed, make sure that i's not caused by your heart problem. Again diabetes is another important cause. Excessive weight gain will also cause hormonal imbalance and thus problems in erection. Some hormone may also cause ed like thyroid, prolactin and even testosterone (male sex hormone). If you have chronic diseases like liver or kidney disease, it may also lead to ed. Diseases of nerves and spines should also be kept in mind. Sometimes, infections or tumour in private parts (prostate, testis etc) will also add to ed. Other diseases of penis like abnormalities in blood vessels can also be responsible, especially in young guys. Apart from these, some surgeries in abdomen and some drugs (like drugs to lower blood pressure, antidepressants, hormonal drugs etc) will also cause ed.

Now, what you can do? if you want to suffer silently, you will land up in other problems like problem in sexual life, problem in family relationships, depression and even inability to make your partner pregnant. But do all men with ed have to go to doctor? initially, the men should try life style modifications like avoiding smoking and alcohol; avoiding stress and anxiety; making good understanding with partner and also reducing weight. The partner should also have sympathetic attitude to the husband who is having ed.

But if still the issue is not resolved you have to consult doctor. It's not a mater of hesitation or embarrassment, as you may think. Rather it is needed to ensure that you are healthy. So, your doctor will talk to you, will check you and try to find out if any cause is there or not (like heart disease, diabetes, hormones etc). He may order some basic tests to ensure that everything is alright. After that he will advise you the treatment. If the cause is found, treatment of the cause (like diabetes) may cure ed. Even if no cause is found, ed can be treated by various ways.

But should you try the drugs shown in television or newspaper? remember, drugs used in ed have important side effects and we advise drugs only when it is absolutely necessary. In most cases simple measures like stress reduction, exercise help. Sex counseling of both the partners helps a lot. And if still ed persists, we advise drugs. There are variety of drugs, all are having own advantages and disadvantages. Particularly sildenafil group of drugs can affect heart and retina. So, we always practice caution before prescribing such drugs. And when patients are advised such drugs we advise to inform us when he feels eye problems, chest pain, fainting or even painful persistent erection of penis (" priapism").

There are other drugs that can be applied directly over penis. Testosterone group of drugs are prescribed only in selective cases as they have serious side effects and even they can reduce the size of your testes. In some cases where drugs cannot be given or drugs fail, we advise penile implants or artiificial pump to maintain erection. Finally in very few cases, where blood vessels of penis is blocked, we can cure it by some operations. 

So, if you feel ed, don't get depressed. At the same time don't feel embarrassed to take medical help. Today's embarrassment may harm you in future. So, get cured and enjoy your personal life.

Erectile Dysfunction

Season is changing and kids are very susceptible to cold and flu these days. Here are 5 ways you can keep your kids safe -

1. Blow their Noses: Frequently and Right: Blow their noses often and don't let them gulp the mucus. Don't ask them to exert too much pressure as it might hurt their ears.
2. Gargle Daily: Make your kids gargle with lukewarm water everyday. It moistens the sore throat and gives relief.
3. Give them a Steamy Bath: Make sure they always take bath with warm water. It relieves nasal congestion and makes them feel good
4. Hygiene is a must: Inculcate good personal hygiene.
5. Hand Wash: Ensure frequent Hand Wash with antiseptic lotion and lukewarm water.

Click on consult privately to ask me any questions regarding your kid's health.

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Avoid Cold & Flu in Toddlers in 5 easy ways

The shoulder is one of the most intricate joints in the body and given that it is subjected to a lot of lifting and movements, there are chances for it to tear or dislocate. The shoulder is a ball-and-socket joint with the socket in the shoulder, and the ball in the upper arm. The joint space between the two bones is surrounded by cartilage, and the space between the two is filled with fluid. Especially in athletes, due to forceful movement, this joint could get dislocated or the cartilage could tear.

The Bankart lesion is when there is a tear of the cartilage in the central anterior shoulder. This causes the cartilage to be damaged, allowing the humeral head to slip down from the socket. When the arm is extended down or to the side, it is commonly dislocated. This can happen posteriorly also, but this movement and so the injury is less likely than an anterior dislocation. If there is also a fracture of the shoulder bone with this dislocation, then it is known as bony or osseous Bankart lesion.

Causes: Bankart lesions can be acute or chronic. Acute is when there is sudden dislocation due to sports activity or accidents. Repetitive use of the shoulder can also lead to chronic Bankart lesions. This is usually seen in sportspersons like swimmers, tennis players, and weightlifters.

Signs and Symptoms:

Pain: The most common symptom with Bankart is shoulder pain that restricts any kind of movement. One may find it difficult pick up things or lifting your hands and in some cases, it is difficult to even sit straight.
Weakness: The shoulder feels weak and one is unable to perform normal activities
Instability: One may lose the grip and strength.
Limited movement: The range of motion of the shoulder may be reduced compared to before the injury.
Crackling: The damage to the fibrous cartilage produces a crackling sound, which can be heard during the movement of the shoulder.
Diagnosis: A combination of symptoms, physical examination, X-ray, and MRI can help in confirming the diagnosis.

The course of treatment depends on the cause and condition of the patient. An exercise regimen is prescribed as the first step in the treatment process. If there is inadequate progress, or if the pain seems to be recurrent, open or closed shoulder surgery may be recommended to include the following:

Arthroscopy (closed surgery) to repair the cartilage damage
Ligament re-attachment
Bone reshaping
Cartilage build up and reshaping
Ligament repair to improve stability
Any of these shoulder surgeries would be followed up with measures to reduce further injury. It is therefore advised to visit a doctor in case of any such discomfort as he/she will be able to find out the severity of the situation and devise a treatment plan accordingly.

Bankart's Lesion - What Exactly Is It?

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