Types of abdominal and pelvic surgical incision

At the time of a surgical procedure, while making an incision a doctor has to take care of a number of factors before making an incision. Considering a number of factors, different types of incisions have come into fore, such as 

Midline Incision: It s the commonest incision and is done along the linea alba (fibrous structure running through the mid of the abdomen). These are preferred, especially in diagnostic laparotomy as it permits a wide access to the abdomen.
Pfannenstiel Incision: It is transverse in nature, extending from the umbilicus to the pubic-symphysis. It is generally employed for abdominal hysterectomy of benign nature and caesarean section.
Chevron Incision: It is an incision under the rib-cage and is done on the abdomen. It starts from beneath the ribs on the right abdomen and extends till the other mid axillary line. Thus, the entire abdominal width is incised for proper reach into the liver. The incision can be up to 2 feet.
Kustner Incision: It is transverse in nature and extends from the symphysis pubis till the iliac spine (anterior). This type of incision takes time to perform. A Pfannenstiel incision offers more exposure than a Kustner incision.
Lanz Incision: It is a variation of the more common mcburney-incision (also known as Gridiron s incision). It is generally used for open appendectomies. There are quite a few variations for this type of an incision.
Gridiron s incision: It is done for appendectomies. It is an oblique short incision which is done in the lower right quadrant in the abdomen.
Kocher s Incision: It is oblique in nature, extending from the abdominal upper right quadrant and is generally used for performing an open cholecystectomy. Gallbladder, biliary tract and certain liver operations can be suited for a Kocher s incision. This however is different from the same named incision used for the thyroid gland surgery.
Cherney Incision: It is transverse in nature. It allows a great range of exposure for the pelvic sidewall. It is less painful than a midline incision. It allows for the greatest pelvic exposure and hence is a widely preferred and practiced incision.

8 Types Abdominal and Pelvic Surgical Incisions

World Immunization Week is a global public health campaign to raise awareness and increase rates of immunization against vaccine-preventable diseases around the world. It takes place each year during the last week of April. Immunization can protect against 25 different infectious agents or diseases, from infancy to old age, including diphtheria, measles, pertussis, polio and tetanus. The World Health Organization (WHO) estimates active immunization currently averts 2 to 3 million deaths every year. The goal of World Immunization Week is to raise public awareness of how immunization saves lives, and support people everywhere to get the vaccinations needed against deadly diseases for themselves and their children.

The immune system of the body essentially plays two important roles. Firstly, it protects the body from bacteria, viruses and other foreign organisms, thus preventing the onset of infections and diseases. Secondly, it ensures that body cells are functioning properly and are not degenerating. Thus, the immune system of the body is quite effective and is responsible for your overall health.

There are times when the immune system becomes weak and is thus unable to fight foreign organisms invading the body. A direct indication that your immune system is weak is when you catch a seasonal cold or flu. In such a case, you have to take certain steps to give a boost to your immune system, such as-

Live healthily- Living healthy does not only include eating a balanced diet and exercising regularly. Make sure that you get enough sleep on a daily basis and avoid smoking along with consumption of alcohol. It is also essential that you maintain your weight and keep a tab on your blood pressure.

Maintain good hygiene- Hygienic habits such as washing hands before every meal and after using the toilet go a long way when it comes to boosting the immune system.

Reduce sugar intake- As per research, it becomes more difficult for white blood cells to fight bacteria when the sugar level of the body is very high, which is why the immune system gets surpassed, and you are more susceptible to infections.

Consume healthy fats- Omega-3 and Omega-6 fatty acids play an important role in boosting the immune system. These healthy fats help the immune system to make prostaglandins, which effectively destroy germs and viruses that have invaded the body.

Avoid the consumption of toxic food- As far as possible, make sure that you are consuming organic food. This is because food grown on a commercial scale is full of toxic chemicals from the pesticides, insecticides, preservatives and artificial colours added to it. The toxic chemicals have a grave impact on the immune system of the body, which can lead to severe complications in the long run.

Although, you want your immune system to be strong and effective, make sure that it is not highly overactive. A highly overactive immune system can also lead to many health complications, such as the onset of autoimmune conditions. All in all, make sure that you are leading a healthy and balanced lifestyle.

World Immunization Week - Boost Your Immune System!

Hoarseness in the simplest sense means, 'hoarse voice'. It may be defined as an abnormal voice change. It is experienced in the form of strained, rough, thick, harsh and grating voice. Variations can be felt even in the loudness and pitch of the voice.

Hoarseness is a temporary infection associated with the larynx, which is also known as the voice box in animals as well as humans. Vocal cords are present inside the voice box. Depending on the vibration of the vocal cord, different sounds are produced.

What are the general causes of hoarseness?

Hoarseness may be caused by common cold, viral infection, cough, irritation due to screaming, smoking, allergy, thyroid problem, acute laryngitis and benign tumor. In adults, the stomach asset comes up to the throat causing hoarseness. Heartburn can also be one of the causes.

When hoarseness arises due to common cold and cough, it will last for 2 to 3 days and will subside using cough suppressant and home remedies like salt water gargling, drinking hot milk with turmeric and pepper powder. As cough or cold suppress, hoarseness will also reduce.

When to see an Otolaryngologist (ENT specialist)?

ENT stands for ear, nose, throat. Serious infections in these areas are treated by an otolaryngologist. It is very essential to consult this specialist if hoarseness lasts for more than 2 to 3 weeks; pain in ENT is not due to cold or flu, coughing up blood, lump in the neck.

Evaluation

The medical specialist starts his diagnosis by physically examining the vocal cord. Flexible light weight fiber optic tube scope is also used to visually examine the larynx area. Videotaping, acoustic analysis is also done to study voice irregularities, airflow to guide treatment.

How can hoarseness be treated?

The mode of treatments depends on underlying the cause of the problem. The patient may be advised:

In most cases, hoarseness can be treated just by resting your throat or modifying the use of your voice.
To avoid smoking or passive smoking
Referred to a speech therapist to improve sound of voice.
In case of benign tumor the nodule or polyp is removed by surgery.
How can you prevent hoarseness?

We've all heard the phrase, 'prevention is better than cure'. Alas, it is. Preventing hoarse voice and throat is a much better option than treating it. Here are some tips on how to prevent hoarseness:

Avoid smoking
Avoid overconsumption of caffeine and alcohol.
Consume plenty of water
Avoid eating spicy food.
Avoid speaking loudly for long intervals of time.

How Hoarseness Can be Treated

Psoriasis is a long lasting disease characterized by patches of scaly, itchy and red skin. It can be restricted to a small areas or can even spread to the whole of your body. When the underlying infection reaches the surface of your skin, the healthy cells die. This causes red and itchy plaque covered with white scales. It mostly occurs on the elbows, knees and scalp. Sometimes these scales itch and also bleed. In severe cases the red skin grows and merges with another patch.

Conditions of psoriasis:
1. Finger nails get discolored and pitting is noticed. The nails begin to crumble and in severe cases detach from the nail bed.
2. Scales and crust start to develop on the scalp.

Types of psoriasis:
1. Guttate psoriasis- It is characterized by small red spots which occur on the torso and limbs. It usually starts in young childhood or adulthood. It triggers respiratory infection, tonsillitis and strep throat.
2. Inverse psoriasis- In this condition bright red and shiny abrasion occurs in the groin area, in the armpits and under your breasts.
3. Erythrodermic psoriasis- It is characterized by periodic redness of the skin and shedding of the skin. It also causes severe sunburn and infection.

Cause of psoriasis:
Many factors can cause psoriasis. Factors such as, trauma, infection or emotional stress can trigger this condition. Some abnormalities in the system also cause psoriasis. People who have a flare up of psoriasis are usually affected by emotional stress or some trauma like the death of a loved one or loss of a new job. These tensions may intensify because of problems in your internal system.

Ayurvedic treatments for psoriasis:
1. Consuming medicated ghee.
2. Herbal medicines or herbal concoctions can also be consumed.
3. Basthies are medical and herbal enemas which should be taken for 8days.
4. You should avoid having meat and only consume vegetarian dishes to reduce psoriasis. Also avoid yogurt, black gram, salty food products and chilies.
5. You can also remove impurities from your body by means of vomiting and purging.
6. You can also cure psoriasis by covering your entire body in a paste of mud.
7. Consume turmeric and Neem daily to treat psoriasis.

Some medicine like arogya vardhini vati, kutaki, ras manikya, Giloy ghan vati must be taken after consulting an Ayurvedic expert.

7 Best Ayurvedic Medicine for Psoriasis Treatment

HIV: QUICK FACTSIntroductionThe human immunodeficiency virus (HIV) is a subgroup of retrovirus (lentivirus) that causes HIV infection. After a period of time, this infection leads to what is called acquired immunodeficiency syndrome (AIDS).

Epidemiology

According to the Centers for Disease Control and Prevention (CDC), from 2010-2015, the estimated rate of HIV infection in all 50 US states decreased from 14.2 per 100,000 population in 2010 to 12.3 per 100,000 population in 2015. In 2015, 39,513 individuals were diagnosed with HIV infection. From 2010 to 2014, the annual number of new HIV infections decreased by 9%.

Virology HIV-1 and HIV-2 are retroviruses in the Retroviridae family, Lentivirus genus. They are enveloped, diploid, single-stranded RNA viruses with a DNA intermediate.Upon entry into the target cell, the viral RNA genome is converted into double-stranded DNA by an enzyme, reverse transcriptase that is transported along with the viral genome in the virus particle. The resulting viral DNA is then imported into the cell nucleus and integrated into the cellular DNA by a virally encoded enzyme, integrase. HIV contains three retroviral genes, namely gag, pol, and env.

Gag gene: Encodes group-specific antigen; the inner structural proteins
Pol gene: Encodes polymerase; it also contains integrase and protease
Env gene: Encodes the viral envelope, the outer structural proteins responsible for cell-type specificity. Glycoprotein 120, the viral envelope protein, binds to the host CD4+molecule
Pathophysiology

HIV infects vital cells in the human immune system, such as helper T cells (specifically CD4+ T cells), macrophages, and dendritic cells and leads to cellular immune deficiency. This results in the development of opportunistic infections and neoplastic processes.

Mode of Transmission
Sexual intercourse: Unprotected sexual intercourse; especially receptive anal intercourse and different sexual partnersContact with or transfer of blood, pre-ejaculate, semen, and vaginal fluids infected with the virus.Spread from an infected mother to her infant through breast milk. An HIV-positive mother can transmit HIV to her baby both during pregnancy and childbirth due to exposure to her blood or vaginal fluid.

Signs and Symptoms There are 3 categories of infection 

Category A: Asymptomatic HIV infection without a history of symptoms or AIDS-defining conditions
Category B: HIV infection with symptoms that are directly attributable to HIV infection
Category C: HIV infection with AIDS-defining opportunistic infections
Investigation

A high-sensitivity enzyme-linked immunosorbent assay (ELISA) should be used for screening.

Management

Start with antiretroviral therapy (ART) in all HIV-infected adults ready to start therapy. 
CD4 count is no longer a criterion for starting the therapy.
Use of nucleoside reverse transcriptase inhibitors and protease inhibitors.
For refractory cases, during the failing treatment regimen and before switching therapy, use rapid confirmation, perform resistance testing and reevaluate.

HIV - Quick Facts Need To Know!

World Alzheimer s Day is celebrated on the 21st of September each year. A number of organizations, from all over the world concentrate on raising the awareness about Alzheimer s disease and dementia. Alzheimer s disease is a very common type of dementia. It falls under the group of disorders in which mental functioning gets impaired. Life for an Alzheimer s patients is quite difficult, but by following the following tips, you can support yourself and will also help you to cope with it. 

You have to accept the changes and accept that life will continue getting difficult. Instead of trying to cover your difficulties for protection from embarrassment, you should face the fact. You also have to accept the changes in your physical abilities and adapt to skills, which are beneficial.
You should develop some ideal coping strategies. Try to be occupied and involved and respond to the challenges you face in everyday life. By practicing the coping skills you will be able to gain a sense of control in your life.
Try to identify stuff. Make a list of all the tasks which seem challenging to you and try to develop coping strategies for these tasks. Prioritize your tasks and determine whether it is really necessary to overcome certain tasks. You should also strategize solutions and come up with solutions which would suit you best.
You should set realistic goals and expectations for yourself and use the coping skills to deal with difficult tasks. In case of very challenging tasks, do not hesitate to take help.
A daily routine or plan is required for keeping a track of several tasks. A schedule reduces the amount of time you spend to figure out something, simplifying your task and also prevents mistakes.
Always approach one task at a time and take enough time to complete tasks. Do not give up on challenging tasks and take breaks to figure things out.
Always remember that you have more than a single chance to solve problems. If one chance fails, you should adopt new strategies and try again and again with better assessment.
You should identify the triggers which cause anxiety and stress. Knowing the causes will allow you to plan in advance so that you can prevent them.
Keep in mind that your family, friends, pets, will power and prayers are sources of great strength and will help you get past any obstacle.
You should accept help from others and do not hesitate or think about being dependent on others.
You should take the advice from your psychiatrist or from Alzheimer Association National Early-Stage Advisors in order to understand the challenges such as medications, management of schedules and dealing with emotional or relationship changes.

Alzheimer's - 10 Tips to Help Dementia Patients Cope with their Problem

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