Burning your skin is a very traumatic experience and can leave behind scars that remind one of the traumatic incident. Scarring caused by burns may fade a little with time but are usually permanent. Apart from affecting your appearance severe burns can also affect the functioning of the body. Burns can make a person withdraw socially by making him or her afraid of how people will accept them with their scars as well as make them depressed about their appearance.

Burn repair surgery can be categorised under two headings: Acute and Reconstructive

Acute repair surgery happens immediately after the burn and deals with large burns and deep burns that affect critical areas. The focus here is to aim for saving of life of burn patient with earliest wound healing with various surgical means.
Reconstructive burn surgery addresses the deformities & scars after the initial burn wounds have healed. The goal here is to improve the appearance of the scars and ensure improvement of functioning. 
There are many types of reconstructive surgeries for burns and the type of surgery best suited to a patient is based on the location of the scar, the extent of scarring and the patient s personal goals.

Skin grafts: This involves the removal of healthy skin from one part of the body and transplanting it to the burn site. This split thickness skin graft include only a few outer layers of skin & full thickness graft involve the entire dermis. This is used in cases of deep burns where full thickness of dermis is affected. Also skin grafts are used for defects following release of burn contracture . 
Flaps: These are thick skin tissues with its own blood supply, used to cover exposed vital structures like vessels , tendons, nerves, bones, etc especially in deep electrical burns of extremities. 
Free flap procedure: In this Microvascular Surgery , muscle, bone or skin is transferred from one part of the body to another to reconstruct huge defects after contracture release or for cosmetic improvement of ugly burn scars. 
Tissue expansion: This involves the insertion of a balloon expander under the skin near the burn scars & deformities. As the balloon is filled with saline, the skin stretches and grows. Once the skin has stretched enough, the expander is removed and the skin can then be used to replace the burn scars & deformities.
This procedure has many advantages as the skin colour and texture are a near perfect match thus reducing scarring to a large extent. However, it is a very slow procedure and can take a few months.

Burn Repair Surgery - How Can It Help To Reduce Deformities & Scars?

A common form of skin inflammation brought about by the fungal infection is called as Athlete's Foot and is most commonly seen among the athletes. In medical terms, this condition is called "tinea pedis". This generally starts in between the toes and gradually moves towards the toe nails, if left untreated. In the later stages, this infection has the tendency to move towards the palm region of the hands and other body surfaces, if left unchecked. Most often, this condition is referred to as the ringworm of the moccasin feet. 

Statistics have shown that about 15% of the population is affected by this condition. It is important to note that men have a higher chance of contracting this contagious condition than women. Young adults or old children are most likely to take the hit for this condition.

After a serious research, the National Health Service has come out with the finding that, Athlete's foot can be transmitted from one person to another either by direct or indirect contact. Any environment that is warm and moist serves as the perfect breeding place for the fungal species to cause this condition.

Getting them treated before the condition spreads to other parts of the body is a very important step that has to be taken by the person who has been diagnosed with this disease. Instead of worrying about the condition after it has set in, a few remedial precautions can be taken to prevent the onset of this disease. 

Some preventive measures are:

1.  Clean shoes and socks: The socks have to be changed at least twice a day and these must be able to absorb the sweat from the feet.

2.  Using a medicated powder: Normal talcum powder or an anti-fungal powder can be applied to the skin where the irritation prevails and this kills the fungi that might form on the surface.

3. Precaution after swimming and going for walk: The region between the toes has to be wiped clean after swimming, bathing or going for a long walk. The basic idea is to remove the excessive moisture from the skin.

4.  Using socks and sandals: The sandals must allow some breathing space for the skin on the legs and when at home, socks without shoes can be worn. 

Preventive measures help a great deal in avoiding the complications that arise out of this Athlete's foot.

Athlete's Foot - How To Prevent It?

Hypothyroidism is a condition in which the thyroid gland is not producing the thyroid hormones adequately. This is a fairly common condition.

What is thyroid gland?

The thyroid gland is a small butterfly-shaped gland located just below Adam s apple. It encircles the windpipe or the trachea. It is about 4 cms in height and weighs about 18 gms. This gland is responsible for the secretion of thyroid hormones. Hormones are chemicals produced by special glands like thyroid, adrenals, ovaries etc. They act as messengers and are carried by the blood to the various target organs.

What are the hormones produced by thyroid gland and what do they do?

The thyroid hormones are of two types   T3 (Tri iodo thyronine) and T4 (Thyroxine). These hormones are mainly responsible for the body s metabolism - a process in which food is converted into energy in the cells. They influence growth and development and regulate various bodily functions which are mentioned below:

Heartbeat
Body temperature
Breathing
Body weight
Metabolism of fat
Menstrual cycles in females
Functioning of Nervous system
Digestion
Burning calories etc.
What is Hypothyroidism?

Inadequate production of hormones by the thyroid gland is termed as hypothyroidism. This is also called Underactive thyroid state. Hypothyroidism can make the body s development to slow down and reduces metabolism rates.

What are the causes of Hypothyroidism?

Hypothyroidism can be caused by a number of factors:

Hashimoto's thyroiditis: This is the commonest cause. This is an autoimmune disorder (normally body s defence system fight against external infections. In autoimmune disorder the defence system attacks the healthy cells of the body by mistake). In Hashimoto s thyroiditis the immune system/defence system produces antibodies that attack the thyroid gland and destroy it.
Iodine deficiency in diet. For the production of thyroid hormones iodine is very important. The body does not produce iodine normally, so it needs to be supplemented from outside. Iodine is mainly present in the food we eat. It is mainly present in shellfish, salt-water fish, eggs, dairy products. If a person does not eat iodine rich foods, he may end up with iodine deficiency leading to hypothyroidism. Currently, this causative factor is on the decline due to government initiative of table salt with iodine.
Surgery: Surgery to remove thyroid gland (for e.g. thyroid cancer treatment, overactive thyroid etc.)
Radiation to the neck (to treat cancer in the neck area): The thyroid gland cells are damaged due to the radiation.
Treatment with radioactive iodine: This treatment is used for managing hyperthyroidism/overactive thyroid, where the thyroid gland produces excessive thyroid hormones. One of the treatment modalities is by radioactive iodine. Sometimes this radiotherapy destroys normal functioning cells which lead to hypothyroidism.
Certain medicines: Certain medicines used to treat heart conditions, cancer, psychiatric conditions etc.   for e.g. amiodarone, lithium, interleukin-2, interferon-alpha.
Pregnancy: Pregnancy (the reason is unclear but it has been noticed that the thyroid may get inflamed after delivery   this is called Postpartum thyroiditis.
Damage to the pituitary gland: Pituitary gland is a gland which is present in the brain. It produces a hormone called TSH (Thyroxine-Stimulating hormone).The TSH tells the thyroid gland how much thyroid hormone it should make. If the levels of thyroid hormone in the blood are low, then the TSH will stimulate the thyroid gland to produce more Thyroid hormone.
Hypothalamus disorders: This is an organ in the brain. This produces a hormone called TRH (Thyrotropin Releasing Hormone) which acts on the Pituitary gland to secrete TSH. So any disorder of Pituitary gland will indirectly effect the production and secretion of Thyroid hormones. These are very rare disorders.
Congenital thyroid defects: Some babies are born with thyroid problems. This is due to the thyroid not being developed normally during pregnancy. Sometimes the thyroid gland does not function normal. This can be identified by screening for thyroid disorders in the first week after delivery. This is usually by a blood test using a small drop of blood from the baby s heel.
What are the different types of hypothyroidism?

One classification is based on whether the defect is with the thyroid gland or not:

Primary hypothyroidism: The problem is in the thyroid gland itself and thus there is reduced production /secretion of thyroid hormones.
Secondary hypothyroidism: Here the problem is with the Pituitary gland or the Hypothalamus. This results in abnormal production of TSH or TRH, which indirectly leads to less production and secretion of thyroid hormones.
Another classification is based on the symptoms and levels of the thyroid hormones and TSH:

Overt hypothyroidism: Here the patient is having the symptoms. Further the T3/T4 are low and TSH is high
Subclinical hypothyroidism: Here patient may or may not have symptoms. The T3/T4 levels are normal but TSH is high. In this situation the patient is at an increased risk of developing overt hypothyroidism in the future especially if he has Thyroid peroxidase antibodies on testing.
Who are at risk of developing Hypothyroidism?

Women have a higher risk of suffering from hypothyroidism than men.
Older people are at increased risk.
People suffering from other autoimmune diseases like Coeliac disease, Type-1 Diabetes Mellitus, Vitiligo, Pernicious anemia, Multiple sclerosis, Rheumatoid arthritis, Addison s disease etc.
People with psychiatric conditions such as bipolar disorder
People with Chromosomal abnormalities like Down syndrome, Turners syndrome also have a high risk of suffering from hypothyroidism.
What are the symptoms of hypothyroidism?

Symptoms vary from person to person. They may also mimic other conditions and hence be difficult to diagnose. Symptoms may also develop very slowly over a span of moths-years. Some of the characteristic symptoms of this disease are:

Depression
Constipation
Hair loss
Dry hair
Dryness of the skin
Tiredness
Body pains
Fluid retention in the body
Irregular menstrual cycle
Increased sensitivity to cold
Reduced heart rate
Increase in size of the thyroid gland   called Goitre. This is due to constant stimulation of the thyroid gland by TSH.
Weight gain
Carpal tunnel syndrome
Hoarse voice
Infertility
Loss of libido/sex drive
Confusion or memory problems especially in the elderly
What are the symptoms to look for in a baby if you suspect hypothyroidism?

Infants suffering from congenital hypothyroidism may show no symptoms or exhibit signs of excessive drowsiness, cold hands, cold feet, constipation, hoarse cry, poor growth or absent growth, poor appetite, bloating of abdomen, puffiness of face, swollen tongue, persistent jaundice.

How to diagnose hypothyroidism?

Blood tests:

TSH: This hormone is made in the pituitary gland and it stimulates the thyroid gland to produce thyroxine. If the thyroxine levels are low in the blood, the pituitary gland produces and secretes more TSH into the blood to act on the thyroid gland to produce more thyroxine. A raised TSH level indicates hypothyroidism. Other tests are not usually necessary unless a rare cause of hypothyroidism.
T4: A low level of thyroxine indicates hypothyroidism.
T3: these levels are generally not needed to diagnose hypothyroidism
Anti-Thyroid peroxidase antibodies (anti-TPO antibodies) or Anti- thyroglobulin antibodies are present in 90-95% of patient with autoimmune thyroiditis.
Other blood tests include Creatinine Kinase, Serum Lipids, Complete blood picture etc.
Ultrasound of the neck is done if the patient presents with a thyroid swelling.
What is the treatment of hypothyroidism?

Overt hypothyroidism is treated by synthetic Thyroxin hormone which should be taken every day on an empty stomach at least 30   45 minutes before breakfast. The treatment is continued for the rest of the patient s life. Regular thyroid function tests are done once every 8 weeks-12 weeks to adjust the dose of the thyroxine in the initial period of diagnosis. Once the thyroxine dose is stabilised, the tests can be done even once a year. This treatment is quite effective.

Sub-clinical hypothyroidism is only treated if the patient is a woman and is contemplating pregnancy, in patients with symptoms or if the TSH is quite high.

What are the side-effects of thyroxine medication?

There are few side effects if any. Most people tolerate these medications quite well. An important consideration before starting medication is to check if the patient has chest pain/angina. These people are started on the least available dose. If these patients are started on a higher dose they notice a worsening of their angina pains.

Side effects mainly occur if the thyroxine dose is high which leads to hyperthyroidism. The symptoms of this could be palpitations 9increased heart beat), weight loss, profuse sweating, anxiety, irritability etc.

There are some tablets which increase with thyroxine tablets. These include carbamazepine, iron supplements, calcium supplements, rifampicin, phenytoin, warfarin etc.

What are the complications of hypothyroidism?

If untreated hypothyroidism can lead to:

heart problems like heart attack due to increased levels of bad cholesterol like LDL, or heart failure due to fluid retention
obesity
infertility
joint pains
depression
A pregnant woman with hypothyroidism is at increased risk of giving birth to a baby with congenital hypothyroidism, also known as cretinism. Further, the woman may have pregnancy related complications like pre-eclampsia, premature delivery, low birth weight baby, anemia, post-partum haemorrhage (bleeding after delivery) etc.
Myxoedema is another complication where the patient has extremely low levels of thyroid hormone. The body temperature drops drastically making the person lose consciousness or go into a coma.
References:

2013 ETA Guideline: Management of Subclinical Hypothyroidism; European Thyroid Association (Nov 2013)
Management of primary hypothyroidism: statement by the British Thyroid Association Executive Committee; British Thyroid Association (2015)
The diagnosis and management of primary hypothyroidism; Royal College of Physicians and others (June 2011)
Suh S, Kim DK; Subclinical Hypothyroidism and Cardiovascular Disease. Endocrinology Metabolism (Seoul). 2015 Aug 4.
UK Guidelines for the Use of Thyroid Function Tests; British Thyroid Association (2006)
Gaitonde DY, Rowley KD, Sweeney LB; Hypothyroidism: an update. American Family Physician. 2012 Aug 1 86(3):244-51.
Bindra A, Braunstein GD; Thyroiditis. American Family Physician. 2006 May 15 73(10):1769-76.
Wilson GR, Curry RW Jr; Subclinical thyroid disease. American Family Physician. 2005 Oct 15 72(8):1517-24.
British National Formulary; NICE Evidence Services (UK access only)
Baumgartner C, Blum MR, Rodondi N; Subclinical hypothyroidism: summary of evidence in 2014. Swiss Medical Weekly. 2014 Dec 23 144:w14058. doi: 10.4414/smw.2014.14058. eCollection 2014.

Know Everything About Hypothyroidism

5 horrible things you do to your hair everyday

Hair today, gone tomorrow. That might be your condition if you are not taking care of your hair properly. There are a lot of things you do almost daily that are adversely impacting your hair health. You might not even be aware of the damage you are doing to your tresses by indulging these activities. Read on to find out about the 5 worst things you do to your hair on a daily basis.

1. Excessive hair brushing: Here’s why brushing your hair excessively is bad for your hair: it causes breakage and strips your hair of its natural nourishing oils. To avoid this, try limiting the use of your hair brush to about just two times in a day. Brushing right after you wake up is a good idea, as it helps in distributing the oils produced by your scalp down your hair shaft, which act as a natural conditioner for your hair.

2. Tying your hair in a ponytail everyday: If you tie your hair in a ponytail everyday then chances are you are applying consistent pressure to on the same hair shafts, resulting in brittle and weaker hair. In fact, doing so continuously can even retard hair growth. Try to leave it open as much as you can, but if you absolutely must tie a pony tail, then tie a loose one. Maybe even use booby pins to keep your hair in place instead of scrunchies. Alternating between high and low ponytails helps too.

3. Using a pre-used hairbrush: Your hairbrush contains a lot of germs, which can severely damage your hair. Using an unclean brush is one of the main reasons of damage hair, as these brushes contain dirt gathered from your hair which you’re giving back to your hair by using. It’s best to clean it once in a while to maintain proper hair health. The same holds true for other styling agents such as combs, curlers, rollers, straighteners etc.

4. Delaying a hair cut: Most of us are guilty of this crime. What with your jam-packed schedule and work overload, you often ignore that much needed trip to the salon. Prolonging a haircut is never a good idea as it can lead to a bad case of split ends, which can result in hair that tangles a lot and causes hair fall. Regular trimming sessions, once every 6 weeks, are a must.

5. Shampooing in excess: Some of you prefer your scalp to be squeaky clean every single day, believing that daily dust and pollution require you to indulge in this unhealthy habit. Well, it’s best to stop right now as you’re harming your hair by shampooing daily. Daily shampoos can completely strip your hair of its natural oils, causing your scalp to become dry, leaving your hair with a dry, messy and rough feel. However. Delaying hair wash is not good either. It is best to shampoo whenever your hair feels greasy and dirty.

Avoid doing these to your hair, and let your tresses breathe so that they look healthy and shine with a natural glow.



5 Worst Things You Should Stop Doing to Your Hair!

Pregnancy is a life-changing phase in a woman s life. In addition to a baby (or babies!), there are a lot of physical and emotional changes also that come with it. The more evident are the physical ones, and in addition to weight changes, the stretch marks are the most obvious.

The uterus or the womb grows to its full extent to accommodate the developing baby, and so there is stretching of the connective tissue in these areas. After delivery, the tension is lost, and these marks become evident.

What are stretch marks?

These marks appear as lines on the skin and are most commonly found in areas such as the buttocks, arms, breasts, thighs and stomach. They are different in appearance in comparison to the normal skin. It may appear pinkish or purplish initially and then it takes a shiny appearance later. When you feel the stretch marks, you may feel a certain indentation or ridge on the skin. It may feel sore or itchy as well sometimes.

They most commonly appear during adolescence when there is rapid growth and stretching of the skin. It is also seen in women pre and post pregnancy. Stretch marks can also appear when there is a sudden change in weight.

How To Treat Them?

Use Moisturisers: People who use moisturisers show an increased elasticity of the skin, which reduces the appearance of stretch marks on the skin. Keeping the skin hydrated stops the skin from tearing and creating stretch marks. Moisturising is not entirely effective on older marks, but it can help with newly formed stretch marks. You can also use it on areas that are prone to stretch marks.

Retin-A: Retin- A is known to boost collagen production that helps the skin to stretch out with ease and not cause tears. When Retin-A is used, it is recommended to limit the sun exposure as the skin becomes more susceptible to sun damage and burning.

Glycolic Acid: This chemical compound falls under the category of an alpha-hydroxy acid which is commonly found as a major ingredient in chemical peels. It is known to amplify the production of collagen and increase the tensile strength of the skin. Go to your dermatologist for a stronger dose for more effective results.

A Combination of Retin-A and Glycolic Acid: A combination of these two potentiates the action of each other and gives better results.

Vitamin E Oil: You can find Vitamin E oil capsules in medical shops that are known as the miracle medication when it comes to curing stretch marks.

Essential Oils: Certain essential oils like rose oil, lavender oil, or geranium oil are known to reduce stretch marks.

Vascular Laser: Pulsed dye laser that is kept at the wavelength of 585 nm is used to remove the stretch marks that are red and newly formed. It may not be effective on the older ones that have turned silver. This process is highly expensive and needs about 6 sittings. The efficacy of this procedure also depends on the complexion of the skin. Much like laser hair removal, vascular laser does not work on darker skin. The colour difference between the marks and the actual skin tone should be prominent.

Fractional Laser Treatment or Laser Resurfacing: This is used to get rid of the older stretch marks that have turned light and are no longer red. This procedure is more expensive than the previous one and is prone to leave scars on the site of application.

Abdominoplasty or Tummy Tuck: The only permanent solution to get rid of stretch marks is to cut them out entirely. If you are tired of the stubborn tiger stripes, then this could be your only way out.

RF Micro-Needling Device: This is a more cost effective alternative to CO2 Laser Resurfacing that could be used on any stretch mark types  new and old . The micro needles are driven directly into the skin to a certain depth (0.2mm-3.0mm) and radiofrequency (RF) energy is then released inside the skin. Minimally invasive RF thermal energy creates fractional electrocoagulation in the dermis which facilitates a natural wound healing process promoting the remodelling of collagen.

10 Tips To Treat Stretch Marks Effectively

One of the most common cosmetic procedures performed in the world today is that of breast augmentation or reduction. This is a fairly common surgery wherein depending on the requirement of the patients; the breasts are either made bigger with the help of implants or reduced in size by excising fat and tissue. Although a majority of these patients are female, there are an increasing number of male patients, who opt for male breast surgery as well.
The need for male breast surgery-
The requirement for male breast surgery arises due to the occurrence of Gynecomastia or the development of male breasts. In this condition, fat and glandular tissues are stored within the male chest in the pattern of female breasts, thus giving it a feminine look. This is a common occurrence among men and can be a cause of social embarrassment for the man as well as affecting his self esteem. Some of the causes for gynecomastia or male breasts would be  
Excessive Weight Gain.
Hormonal changes within the body where testosterone levels drop due to conditions such as  Hypogonadism  (in men, the inability of the testicle s to function correctly) and estrogen levels increase.
Medications used to treat other disorders such as certain anti -depressants, cancer medication, and anti-anxiety medications among others.
Excess consumption of alcohol and certain drugs.
Hyperthyroidism (excess thyroid secretion by the thyroid gland).
It isn t always just fat!
While many people tend to blame male breasts due to the accumulation of fat, this may not be the case always. Even skinny or people with an athletic build may notice misshapen chest that has more of a feminine appearance and thus would like to correct that. This is obviously caused by hormonal factors and genetics of body shape as well rather than just being obese or overweight.
Types of Male Breast Surgery-
Male breast surgery revolves around breast reduction and contouring to give it a more flat and toned look. This can be achieved in either of these ways:
Liposuction   This is a fairly common procedure and is minimally invasive; meant to suck out the fat through a small opening on the skin. With the help of liposuction, doctors can easily contour your chest to have a more masculine look by removing the excess fat. This procedure is a very popular one as it takes less time to recover and also isn t invasive. However, this is used as an option for male breast surgery when the problem isn t acute.
Surgery to remove excess tissues and fat   If the male breasts have excessive glandular tissue and the problem is acute, a more extensive form of surgery wherein the glandular tissue is excised may be required. However, this is also not very invasive and you can get back to your regular routine within a few days after surgery.


Male Breast Surgery

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