At some point in life most people experience acute pain in their lower back which is extremely painful. Pain in the spine causes a lot of discomfort and disruption in the life of an individual and hence, it is always better to get it checked on time. There are patients who even wonder when they should consult a neurosurgeon or a spine surgeon for their back pain. It is advisable that a physical examination is done by a primary care physician for low back pain before consulting a spine surgeon.

Why consult a Physical care Physician First?
The main reason to consult a primary care physician at first is that he would prescribe medications for severe lower back pain. The medications could include non-narcotic pain medications such as Ultram or non-steroidal anti-inflammatory drugs such as Motrin. The physician can even refer you to a chiropractor or for physical therapy to get relief from the back pain. Mechanical means are made use of by a chiropractor mainly to alleviate the back pain of the patient.

If the patient feels better with the physical therapy or the medications prescribed by the family doctor and is able to resume normal activities, then there is no need to see a spine surgeon. It is often recommended to take good care of the back and to exercise. A combination of ergonomics, regular stretching and improved everyday posture is beneficial as it reduces the chance of causing pain in the lower back. Exercise plays a very important role and it provides the possibility of reducing the pain.

Conservative Care for Treating Lower back Pain
It is best for patients to consult a conservative care specialist if after consulting a chiropractor they do not find any reduction in their pain and they do not want to undergo spine surgery. The conservative care specialists are well-trained in rehabilitation of musculoskeletal disorders and specialize in spine care. The role of the conservative care specialist is similar to a cardiologist who specializes in treating neurological disorders.

The specialist for spine care works along with the surgeon in a spine center to treat the lower back pain. The specialist is trained in diagnostic techniques and is capable of making use of a combination of diagnostic tests as well as injection techniques such as epidural steroid injections to diagnose the source of the lower back pain in a patient. They can even advise patients whether it is appropriate to consult a spine surgeon for surgery. Surgery is done to correct the anatomical conditions and it is performed only when non-surgical treatments are not successful in alleviating the pain of the patient.

When Is The Right Time To See A Spine Surgeon?

Typhoid fever is a bacterial disease caused by a bacteria Salmonella typhi. It spreads through consuming food or water that has been contaminated by stool of an infected person. The bacteria spread rapidly through your blood and causes a range of ailments.

It can cause bleeding in the intestine and perforations. This results in stomach pains, nausea, vomiting, and sepsis. Repair of intestinal damage may require surgery. In less frequent cases, typhoid can result in inflammation of muscles, linings, and valves of the heart. It can also cause pneumonia, meningitis, kidney infection, bladder infection, and inflammation of the pancreas. It may also result in delirium.



Symptoms-

The symptoms of typhoid infection start appearing within 1 to 3 weeks depending upon the virulence of the infection. The common symptoms are-

  High fever
  A headache
  Weakness
  Confusion
  Agitation
  Loss of appetite
  Red spotting on skin

Vaccination-

Vaccination is the most effective measure to prevent typhoid. There are two methods of vaccination- inactivated typhoid vaccine shot and an oral dose of live typhoid vaccine. One dose of inactivated typhoid vaccine is enough to protect you against the infection. A booster dose may be required every 2 years. You must consume four doses of live vaccine every alternate day. The capsule must be consumed orally, at least one hour before a meal. A booster may be required every 5 years.

What to know before immunisation-

  The inactivated vaccine should not be used in children below 2 years. The live vaccine is not recommended for use in children below 6 years.
  You should wait to get live typhoid vaccine if you are suffering from a pre-existing fever or infection. If you are on antibiotics, you must not take the oral vaccine until 3 days of discontinuing the medicine.
  People with immunodeficiency diseases such as AIDS should take inactivated typhoid vaccine shots instead of the live vaccine.
  Anti-malarial medicines should not be used until 10 days of a typhoid shot.
  Extremely serious side effects resulting from typhoid fever vaccine are very rare. It is generally safe for use.
  The inactivated vaccine may cause fever in 1 person in 100. It can also cause a mild headache, stomach pain, rashes in a person. Although serious allergic reactions are extremely rare, notify the doctor as soon as possible.

Typhoid affects 21 million people worldwide and causes 2,20,000 deaths annually. It can be fatal if it goes untreated. Therefore, it is crucial for people living in a typhoid prone zone to be immunised.

Typhoid Fever Vaccine - All You Should Be Aware Of!

It is an extremely embarrassing situation to have a bladder leakage. Social life could be altered, with reduced socialising for fear of losing control in the presence of others. Though not discussed frankly, it is an extremely common issue and about 25 million people in the United States suffer from this, with 75% of these being women.

Treatment depends on the type of incontinence, such as stress, urge, overflow, functional, or mixed. It starts with least invasive methods like lifestyle changes moving over to surgical approaches.

Ways to manage it

With trips to the toilet increasing considerably when you have urinary incontinence, simple measures can help manage leakage.

Bladder training: Train your bladder to control the urge for another 10 minutes. This happens by voluntarily contracting the muscles and holding up the urge to go to the toilet. Gradually, it will help increase the frequency of the visit to 4 to 6 hours.
Scheduled toilet trips: Whether or not there is an urge, visit the toilet every 4 to 6 hours.
Double emptying: Even after you have voided, force yourself to void one more time. The residual urine, which is almost always present in the bladder, also gets emptied.
Food/diet modifications: Stress incontinence is worsened by alcohol, spicy foods, acidic foods, and caffeine. Avoiding these can help reduce bladder leakage.
Kegel exercises: The simple repetition of contracting the pelvic floor muscles, holding it in place, and releasing it can do wonders for strengthening the pelvic floor. This can be done anywhere and any time of the day and is very effective for improving bladder control.
Catheters: These can be used if the incontinence is short-lived; the person would need to learn how to safely insert and remove it.
Absorbent pads and medical devices: The absorbent pads are helpful in preventing embarrassment during social situations. On the other hand, medical devices like pessary are inserted into the vagina to support the bladder neck and thereby prevent leakage from the bladder.
Drugs: Anticholinergics/antimuscarinics are useful to control a leaking bladder. Botox injections can help paralyse the overactive bladder muscles and provide a solution. Topical oestrogen may be used in small amounts to improve tone and reduce incontinence. Alpha blockers are also used in some people with good results. There are muscles that relax the bladder and increase the amount of urine it can contain.
Surgery: In the event that all these measures are not useful, surgical correction is possible. Sling procedure where an artificial mesh is used to support the urethra. Bladder neck suspension is where the bladder neck is given support to prevent leakage. If there is a pelvic organ prolapse, that is corrected to rectify the bladder leakage.

 Bladder Leakage - Solutions To Help You Manage It!

Also called gluten-sensitive enteropathy and celiac sprue, celiac disease is an autoimmune digestive disorder, wherein the consumption of gluten-based foods leads to damage of the tissues that line the small intestine. This hinders the ability of your body to absorb the essential nutrients from the foods you eat.

Causes
Under normal conditions, the immune system of the body offers protection against external intruders. When individuals diagnosed with celiac disease consume gluten-based foods, gluten resistant antibodies are formed by the immune system. This causes them to attack the linings around the intestines, thus causing irritation in the digestive tract and harming the villi (hair-like structures on the covering of the small intestine which absorb nutrients from the food). This impairs the nutrient absorbing capacity of the individual, thus increasing chances of malnourishment.

Symptoms
Celiac disease has symptoms that vary from patient to patient. Some of the common symptoms include:

A severe skin rash called dermatitis herpetiformis.
Digestive problems such as:
Pain
Gas
Abdominal Bloating
Diarrhoea
Weight loss
Pale stools
Musculoskeletal problems such as bone and joint pain as well as muscle cramps
Seizures
Aphthous ulcers which are basically sores occurring in the mouth
Tingling sensation in the legs which are caused by low calcium and nerve damage
Growth issues in children since they cannot absorb the required amount of nutrients
Irregular menstrual cycles
Other complications associated with celiac disease

Miscarriage or Infertility
Osteoporosis. This is a disease which weakens the bones and causes fractures. It is caused because of a deficiency of Vitamin D and calcium.
Intestinal Cancer
Other birth defects: Such as irregular spinal shape because of the deficiency of certain nutrients, especially folic acid.

Celiac Disease - Signs You Are Suffering From It!

The bowel is a very important part of your body within the digestive system as it plays a vital role in the absorption of nutrients and minerals within your body as well as excreting toxic matter. The bowel contains the small bowel or small intestine as well as the large bowel or the large intestine. However, parts of the bowel may be infected or damaged in such a manner that they may need to be removed in order to save further worsening. Thus, the removal of sections of the bowels is known as bowel resection surgery.

How is bowel resection surgery performed?

In this procedure, sections of either the large intestine or the small intestine are removed which have either become diseased, infected or have malignant growths within them. The doctors and surgeons first identify the sections that need to be removed and then perform the surgery wherein a section of the tissue is excised and then two ends of the bowel are stitched together to form a new section of continuous small intestine or large intestine.

Types of bowel resection
There are two types of bowel resection, namely small bowel resection performed on the small intestine and large bowel resection performed on the large intestine. The indications for both of them are mentioned below:
Small Bowel resection: Some of the cases wherein small bowel resection may be required are as follows:

Cancerous or benign polyps or growth
Precancerous growths and polyps
Damage to the small intestine due to injuries
Congenital defects in the small intestine
Blockages in the intestine
Growth of ulcers, bleeding, and infection within the small intestine
Infections within the intestines
Other disorders of the small intestine
Large bowel resection: Large bowel resection is also carried out due to many of the same reasons as mentioned above. However, some of the specific reasons for large bowel resection are mentioned below:

Colon cancer
Diverticulitis, disorder that specifically affects the large intestine
Bowel inflammation or ulcerative colitis
Abnormal twisting of the bowel also known as volvulus
Intestines which slide into another section of the intestine; also known as intussusception
Risks of the bowel resection
Like any other surgery, bowel resection also carries its own risks just as any other form of surgery. Some of the common risks of bowel resection are  

Adverse reaction to anesthesia
Infections
Heart attacks or strokes during the operation
Infections
Excessive bleeding among others
Specific risks for large and small bowel resections are mentioned as follows:

Small bowel resection: Certain common risks include accumulation of pus in the abdomen, internal bleeding within the intestine after surgery, diarrhea, infection of the incision area and the stitched area breaking open among others
Large bowel resection: In this case, tissues protruding through the cut causing an incisional hernia is the most common element of risk. Nearby organs may be damaged as well; scar tissue, problems with the passage of material within the colon among others are some of the other complications.
However, these issues occur rarely and resections are performed very successfully and quite regularly by surgeons.

Bowel Resection Surgery - Facts You Should be Aware of 

Causes and symptoms of Catatonic depression

Catatonic depression is a kind of depression which is characterized by prolonged periods of speechlessness and motionlessness. It is described as a state of mind that is caused by neurogenic and motor inabilities caused due to dysfunction of various neurotransmitters like glutamate and dopamine. People who suffer from a severe case of this condition, even have difficulty in performing simple regular tasks. For example, the act of eating breakfast may take a span of hours.

Some of the common symptoms of this condition are:

- Feelings of sadness
- A change in appetite causing gain or loss of weight
- Difficulty in concentrating and thinking
- Feelings of restlessness, worthlessness, and guilt
- Fatigue
- Irritability
- A loss of interest in any activity
- Trouble sleeping
- Attempts at suicide
- Cynicism and negativism
- Agitation
- Unusual and abnormal movements
- An inability to move and difficulty in speaking
- A refusal to eat or drink due to extreme anxiety

The major causes of catatonic depression are:

1. Abnormal neurotransmitter production

Irregularities in the production of neurotransmitters are believed to be one of the major causative factors of this type of depression. These neurotransmitters present in the brain help cells to communicate with each other. Serotonin and norepinephrine are the neurotransmitters which are mostly associated with this type of depression.

2. Dopamine irregularities

Another reason for this condition is believed to be the irregularities in dopamine, glutamate, and gamma-aminobutyric acid neurotransmitter systems. Underlying neurological, physical, psychiatric or psychological conditions are accompanying issues.

Administering antidepressants or using electroconvulsive therapy are some of the known ways of treatment which have proved effective for getting relief from catatonic depression.



What Makes Catatonic Depression so Impairing?

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