Fissure in Ano, also known as Anal Fissure, is basically a small longitudinal cut in skin that lines the opening of the anus. Fissures cause bleeding and severe pain in the bowel movements. These are very common in the general public, but often confused with other pain. A fissure can happen at any point in your lifetime and can have equal general distribution.

Types of Fissure in Ano:

  Acute Fissure: Fissure in Ano less than 6 weeks of duration is known as Acute Fissure.

  Chronic Fissure: Anal Fissure with more than 6 weeks of duration is known as Chronic Fissure. 

Causes of Fissures in Ano:

  Anal fissures are basically caused by stretching of the anal muscles beyond its capability.

  In adults, it is caused by the passing of large stools, constipation or by prolonged diarrhea.   In older adults it is caused by the less flow of blood to that area.

  It is also caused by sexually transmitted infections (syphilis, chlamydia, herpes) and it results in fissures.

  Anal sex can also be the cause of fissures.

Symptoms of Fissures in Ano:

  Tear in the skin around the anus

  Small lump of skin, or skin tag next to the tear

  Pain during bowel movement

  Stools with blood or pus

  Itching and burning in the anal area 

Preventions During Fissures in Ano:

  One should drink enough water.

  One should have high fibre diet so that one does not suffer from constipation.

  Be careful and hygienic after anal defecation.

  In case of suspected fissure or any kind of pain, use a lubricating ointment.

  Sit in lukewarm water

Treatment for Fissures in Ano

Surgical treatments are not recommended, but there are some other measures that can be taken and are listed as follows:

  Some prescribed medication to lower the severity of pain.

  Nitroglycerin ointment may help heal the fissure.

  Having a rich fiber diet as a lifestyle change.

  Drink enough water as that helps in softening the stool.

  Sometimes Stool softeners may be required to soften the bowel movement.

When Anal Fissure does not heal with all of the above listed things, then a surgery may be required:

  Lower most part of the internal anal sphincter is divided laterally. With this acute fissure heals of its own. In chronic cases one may require to undergo fissurectomy.

  The surgery decreases the anal pain and spasm, allowing the fissure to heal.

  If a sentinel pile is present, it is removed to heal the fissure. 

It is important to note that any kind of treatment requires 6-10 weeks to recover. However, the pain may disappear just after 2-4 days after the surgery. One must consult a doctor before going for any treatment. This surgery can also be performed with LASER,where there is less trauma and early recovery is posssible.

Fissure In Ano

Vertebroplasty means shaping the backbone i.e. vertebra for backbone and plasty is related to shape. This is an outpatient procedure done to treat compression fractures of the spinal cord. The backbone is made up of multiple small bones which are stacked one on top of the other with a filling material in between that is known as vertebrae. The stack of bones are held in place by the soft, elastic vertebral material. 

Vertebroplasty & similar procedure called kyphoplasty is a non-surgical procedure where collapsed vertebrae is brought back to shape by injecting medical bone cement under fluroscopy / image intensifier in OT, thereby relieving pressure on the spinal cord or spinal nerves with special canula directed to the core of vertebral body. Indicated in osteoporotic vertebrae, spinal fracture, metastatic tumour or primary tumour of spine. This technique has replaced major surgery done earlier to reshape & fix vertabrae.

Technique: Bone cement, in a semisolid state, is injected into the weakened or fractured bone space. Once this solidifies, it provides additional support to the spine, enabling normal movement. It also helps in reducing the pain significantly and improves the overall mobility.

Procedure:

In what takes about an hour, the following steps are done. Earlier, a few decades ago, this would be an open surgical procedure. However, with advance technology, now it is done using a small incision

Local anesthesia is given in the area that needs to be operated
A biopsy needle is inserted into the fractured space with the help of an X-ray
The acrylic bone cement is injected into the bone space with a needle to fill up the space, once it solidifies, it stabilizes the vertebral space
The needle is removed and the incision is covered with a bandage
Usually the patient is sent home in an hour s time unless the overall condition is really bad
There could be some soreness at the site where injection is given, but one can notice a significant reduction in pain from the day of the procedure
There is also improvement in mobility while doing daily chores
The pain relief can last up to 3 years after the procedure
Returning back to normal activities takes about 3 to 4 days after the procedure
When to use this procedure?

Vertebroplasty is usually done in case of non-radicular pain that is intractable. In most cases, they do not respond to traditional therapies including physiotherapy, pain medications and even surgery. The pain could be due to:

Osteoporosis
Cancer metastasis
Myeloma
Spinal hemangiomas
Traumatic fractures
Benefits of using vertebroplasty for managing pain 

Minimally invasive
Effective way to get relief
Improves mobility
Cost-effective
Reduces need for long-term use of painkillers
Stabilizes the spine and prevents further collapse

Vertebroplasty - How It Can Help Manage Pain?

When Should You Use Viagra?

Viagra is a very common drug prescribed for treating erectile dysfunction. It works by enhancing the flow of blood to the penis during sexual intercourse to bring about erection. Viagra actually contains the active ingredient Sildenafil Citrate which is a selective inhibitor of Cyclic Guanosine Monophosphate (cGMP)-specific phosphodiesterase type 5 (PDE5).

This drug works efficiently with sexual stimulation. Erectile dysfunction is very common among older men whose sexual function tends to fall after they reach their 50s. But these days even younger men in their 30's and 40's are experiencing an increased incidence of erectile dysfunction.

Doctors can even recommend the drug to both younger and elder men who suffer from erection problems.

Solidification of the arteries, the blood vessels that supply blood to the penis, can occur during the teen years. The problem then develops by the time they reach the age of 20-30 years and more, hindering their ability to get and maintain an erection. Men suffering from diabetes and facing the problem of Erectile dysfunction can be assisted by this drug.

The drug should be ideally taken an hour before the sexual intercourse.

On the other hand, you can also take Viagra half an hour to 4 hours before the sexual intercourse. You don't require having food in order to take the drug. But you need to keep in mind that if you take it after a meal high in fats, it can take a little bit longer for you to experience its effects.

Most importantly, the misuse of Viagra should be avoided. It should be taken only under medical supervision. The drug doesn't have the power to help you ejaculate easily if you suffer from problems related to orgasm or even enhance your sexual appetite. It does not enhance sexual timing, so should not be used to treat premature ejaculation. Men also shouldn't expect the drug to take the erections to unexpected heights.

Word of Caution:

One should never take the drug for recreational purposes. One can end up suffering from minor erectile dysfunction due such abuse.



When Should You Use Viagra?

People who have healthy sex life are not only happier but also healthier than those who don't. Here are 9 health benefits you never knew sex can provide -

1) Rocking Immune System: Regular sex ensures higher levels of what defends your body against germs, viruses, and other intruders.

2) Lowers Blood Pressure: One landmark study found that sexual intercourse specifically (not masturbation) lowered systolic blood pressure.

3) Great Exercise: Sex is a really great form of exercise. It is a muscular exercise that burns calories and increases your heart rate.

4) Lowers Heart Attack Risk: Great sex life is good for your heart. It not just raises your heart rate, sex helps keep your estrogen and testosterone levels in balance.

5) Reduces Pain: Getting an orgasm can block pain. Vaginal stimulation can block chronic back and leg pain, and can reduce menstrual cramps, arthritic pain, and in some cases even headache.

6) Improves Sleep:  People usually dose of quickly after sex and tend to get a sound sleep.

7) Relieves Stress: Sexual arousal releases a brain chemical that revs up your brain's pleasure and reward system. Sex and intimacy relieve you of stress and boost your self-esteem and happiness too.

8)  Reduces Risk Of Prostate Cancer: A study, published in the Journal of the American Medical Association revealed that men who ejaculated frequently (at least 21 times a month) were less likely to get prostate cancer.

9) Helps Women's Bladder Control: Incontinence, a problem that affects about 30% of women at some point in their lives is helped with a regular sex. Good sex is like a workout for their pelvic floor muscles. An orgasm causes contractions in those muscles thus strengthening them

Click on consult privately to ask me any follow-up questions on this.

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Having Sex - 9 Health Benefits


- 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

Vaccines are not just for kids; the human body can be vulnerable to viruses during any time period of life. It is important for an adult to get vaccinated regularly, else there are always chances that some virus or infection may attack you in a severe way.

Let's look at some of the vaccines adults should get for a healthy and ensured life:Pneumococcal Vaccine -

This vaccine protects the human body from diseases like Pneumonia and Meningitis.

Who should get this vaccine?

Adults who smoke regularly are vulnerable to Pneumonia and should get this vaccine.
Elderly people over the age of 60 are also vulnerable to pneumonia and should get this vaccine shot as soon as possible.
How many vaccine shots should I get?

PCV 13 and PPSV23 is prescribed to the elderly over the age of 60. PCV13 is to be taken at first and PPSV23 to be taken one year after the first shot.

Hepatitis Vaccine -

Strains of Hepatitis Viruses like A, B and C attack the Liver and can cause Liver failure in adults. There are vaccines to prevent the human body from Type A and Type B. However, there s no vaccine for hepatitis C yet.

Who can get it?

Hepatitis B vaccine can be administered to people of all age groups, be it children or adults.
Hepatitis A vaccine is mostly prescribed to people working in the healthcare sector or going abroad to a tropical country.
When to get it?

Hepatitis vaccine can be taken during any time of the year.

Vaccine options for Flu:

Inactivated Influenza Vaccine (IIV)
Recombinant Influenza Vaccine (RIV)
Live Attenuated Influenza Vaccine (LAIV)
Vaccine options for Typhoid:

Inactivated (killed) vaccine
Live, Attenuated (Weakened) Vaccine
Vaccine options for Pneumococcal:

Pneumococcal Conjugate Vaccine (PCV13 or Prevnar 13)
Pneumococcal Polysaccharide Vaccine (PPSV23 or Pneumovax23)
Vaccine option for Hepatitis A:

Inactivated (Killed) Vaccine
Vaccine for Hepatitis B:

It is made from the parts of Hepatitis B virus but it cannot cause Hepatitis B infection.
Human body is vulnerable throughout its life. Deadly viruses can attack our body anytime, and we must stay prepared and ahead of them. The vaccines mentioned above would help in avoiding some of the common but dangerous diseases.

Adult Immunisation - Vaccines That Are Of Great Help!

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Consult for Nipple Problems - Online and Easy!

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