What do we mean by a hiatal hernia?

The hiatus is an opening in the diaphragm (the muscular wall) which separates the chest cavity from the abdomen. Normally, the esophagus (food pipe) goes through the hiatus and attaches to the stomach. In a hiatal hernia, the stomach bulges up into the chest through that opening.

What does statistical data say about a hiatal hernia?

Statistically, approximately 60% of individuals who are above age 50 or older have a hiatal hernia.

In which age group is hiatal hernia very common?

The incidence of hiatal hernias increases with age. It is commonly seen in the older age people specifically in people who are above 50. 

What are the causes of hiatal hernia?

The most common risk factors are as follows: 

Obesity Congenital deformities, such as scoliosis
Certain types of surgery
Major trauma
Conditions which causes an increase in abdominal pressure within the abdomen, such as heavy lifting, or bending over, frequent or violent coughing, violent sneezing, violent vomiting, and straining during bowel movements
What are the types of a hiatal hernia?

There are four types of a hiatal hernia and they are as follows:

Sliding hiatal hernia: This is the most common variant of a hiatal hernia. It occurs when your stomach and esophagus slide into and out of your chest through the hiatus. It is usually asymptomatic.
Fixed hiatal hernia: It is also known as a paraesophageal hernia. In a fixed hernia, part of the stomach pushes through diaphragm and stays there.
Type III hiatal hernia: In this type, as a hernia goes on increasing, the phrenoesophageal ligament stretches and displaces the gastroesophageal junction above the diaphragm
Type IV hiatal hernia: Type IV hiatal hernia includes a large defect in the phrenoesophageal ligament causing other organs, such as colon, spleen, pancreas and small intestine to enter the hernia sac.
What are the sign and symptoms of hiatal hernia?

Common symptoms include:

Heartburn
Chest pain or epigastric pain, coughing
Difficulty in swallowing
Belching, eructation, and hiccups
How to diagnose the condition?

To diagnose this condition following tests or procedures are included:

X-ray of the chest and abdomen Barium follow-through examination of gastrointestinal tract (GI) to visualize GI tract.
Upper endoscopy for examining the esophagus and stomach from inside Esophageal manometry for measuring the rhythmic muscular contractions of esophagus while swallowing, and also, measuring the force exerted by the muscles of esophagus.
What is the treatment available for it?

It includes medications and surgery which are as follows:

Antacids to neutralize stomach acid and to reduce acid production
Medications that heal the esophagus 
Surgery of opening of diaphragm to make it smaller and for reconstruction of an esophageal sphincter

Hiatal Hernia - How Is it Diagnosed?

Treatment of frozen shoulder varies depending on the stage it is at, and how severe is the pain and stiffness. There is no outright cure and the aim of treatment is to keep the joint as mobile as possible. The most effective treatment is that which maintains a good range of movement until the shoulder starts to heal. 

Treatment may Include the following:

1. Shoulder exercises: Regular, gentle exercise can help to keep the shoulder joint mobile. If your shoulder is very stiff, exercise may hurt, and it should only be carried out with the guidance of your doctor or physiotherapist. If you are able to, continue using your shoulder as normal saving' the shoulder can cause the muscle to waste and may make stiffness worse.
2. Painkillers: Over-the-counter painkillers such as paracetamol or prescription-only drugs such as codeine may be taken to ease pain and you should discuss this with your general physician or pharmacist.
3. Anti-inflammatory painkillers: Such as ibuprofen and diclofenac, are often prescribed to ease pain and inflammation. Any medication that you take should be discussed with your general physician or pharmacist.
4. Steroid injections into or near the shoulder joint may be effective at relieving pain and inflammation for a few weeks. However, injections are not a cure, and symptoms may return.


Treatment of frozen shoulder

SSHL is not like any other normal hear-loss trouble. Rather it is quite a severe condition. Sudden deafness can occur at any time due to several reasons. This trouble does not affect both the ears rather only one specific ear is usually affected, and thus this is one of the prominent signs that can help the doctors to understand that SSHL has occurred. 


What are the leading causes of this hearing loss?

    Head injury: If you have faced any severe kind of head injury ever, then it might bring SSHL. This is why you are suggested to get necessary treatment on time so that this kind of hearing loss can be avoided.
    Loud-noise exposure: If your ears are exposed to louder noises or sounds in a consistent manner, then there is a greater possibility of the occurrence of this hearing loss. Thus, you should stay away from unwanted noises. 
    Ageing: With the increase in age, hearing power slowly decreases. However, if you take proper precautions from the very beginning, then SSHL can be definitely avoided. 
    Blood-circulation troubles: Interrupted blood-circulation creates different physical troubles out of which hearing loos is one of the most prominent one. And if timely treatment is not provided, then it might get converted into SSHL. 
    Ototoxic medication: This kind of medication should not be continued for long without doctor's prescription otherwise SSHL might occur. 
    Lyme disease: This is a kind of disease, which occurs due to tick bites and this is pretty infectious in nature. Apart from that, this disease is now considered as one of the main sources of SSHL. 

How to evaluate this hearing loss? 

    History analysis: The history of the patient needs to be known first otherwise SSHL cannot be perfectly treated. If the history shows that the patient already has an existing trouble of ear loss for which SSHL has been proven, then in accordance with the same the treatment can be prescribed. 
    Laboratory and imaging: Laboratory analysis is one of the main methods for evaluating SSHL and necessary images of the ears boost the potentiality and importance of this kind of analysis to a great extent. 
    Quick evaluation: This kind of medical evaluation is mainly made on the basis of the symptoms. The doctors often follow the signs thoroughly in order to determine as to whether the patients have SSHL or not. This evaluation is highly supported by different medical tests that are prescribed by the doctor.

Sudden Sensorineural Hearing Loss: Causes and Evaluation

Hernia refers to the condition when an organ or fatty tissue inside the body begins to protrude from its location. Hernias are mostly detected in the groin, belly, or the stomach region. They occur because of muscle weakness in the said region where it is detected but they can be treated with surgery. In most cases, a surgery is prescribed and laparoscopic hernia repair is a very popular surgical procedure that has proven to be successful in most of the cases. This is why a growing number of patients decide to go for it.

Laparoscopic hernia repair: procedure: In this surgical procedure, a laparoscope (an instrument with a high-resolution camera and high-intensity light) is passed inside the abdomen through small incisions that varies between 0.5 and 1.5 inches in length. When the laparoscope moves inside the abdomen, it sheds light on the hernia and sends the images to the monitor connected to it. The surgeon views the hernia on the monitor and then the abdominal cavity is made to swell with carbon dioxide so that the surgeon can find enough space to operate the hernia. Once this is done, the surgeons operate the hernia with tiny surgical instruments. Once the hernia is removed, space or the hole is covered with a mesh from inside the abdomen.

Advantages of laparoscopic hernia repair: The laparoscopic procedure is popular because it is comfortable for the patient in many ways. They have to endure lesser post-operative pain as compared to open surgery, which means the recovery is quicker. They require lesser drugs for healing and the patient can get back to work in fewer days. It is an advanced form of surgery and thus, gives better results.

Disadvantages of laparoscopic hernia repair: While the non-invasive laparoscopic surgery has several advantages, it also comes with some drawbacks. It is lengthier in comparison to open surgery and also costs more. It cannot be performed by all the surgeons and only those who are skilled in this type of surgery can do justice to the different cases of a hernia. 

Recovery after laparoscopic hernia repair: The patient takes one to two weeks after the surgery to return to light activity and daily routine. Nevertheless, heavy exercise and strenuous activity should be avoided until four weeks after the surgery. The full recovery time differs from patient to patient depending on their age, gender, and health condition but one month is the average time for full recovery.

555 Manish Technique for inguinal hernia repair:

Totally extra-peritoneal (TEP) repair of inguinal hernia is now a standard surgical technique. A 12 mm incision in infra-umbilical region for Hasson trocar is must for TEP repair of inguinal hernia. This is the only technique known to laparoscopic surgeons. We have innovated a "555 Technique" for completing Mini TEP repair of inguinal hernia by using all three 5 mm ports.

555 Technique" is a feasible option without compromising the principles of TEP repair for inguinal hernia. Innovation of simple "Manish Retractor" is the key in completing Mini TEP repair. This technique is simple, less invasive, less morbid, and cost effective as it avoids dependence over costly Hasson trocar with better cosmetic results.

Laparoscopic Hernia Repair - What Should You Know

A deaf child is the one who suffers from hearing loss. Children with deafness may also fail to develop speech. Such children might have no defect in their speech but they cannot speak anything. The main reason is deafness. They do not hear a speech, therefore, cannot develop it. Deafness may not be hereditary, but it occurs due to several other causes. 

The period of 5 years is crucial in a child s life. During this period, they develop their speech and language. Therefore, parents need to take the utmost care for the early identification of hearing loss and treat the child accordingly. 

Causes of Deafness in Children

There are several causes of deafness in children.

Otitis Media: In young children, if the eustachian tube is not fully formed, it forms fluid behind the eardrum. This fluid can get infected and affect the hearing. The fluid may not cause any pain or infection but still, it can harm and cause hearing loss even if it stays for a short time. 

Problems by Birth: Some children have hearing problems by birth. Sometimes, the problem lies in the genes. But, other times during pregnancy or prenatal care, the problem arises. If a mother, while pregnancy, has diabetes or preeclampsia, she is likely to deliver a deaf child. A prematurely born baby also has a high risk of deafness.

Illness or Injury: Some young children suffer hearing loss due to some injury in the ear or some other illness. Illness includes meningitis, measles, chickenpox, and flu. Head injury or listening to loud music for a long time can also be a reason.

Symptoms of a Deaf Child

A deaf child shows no reaction to the loud noises.

He/she doesn t respond to the voices.

The sound of the child is simple that taper off.

The child may pull or rub the ear several times, which is noticeable.

The child is continuously cranky for no particular reason.

He/she does not pay any attention when anyone is talking.

He/she has very little energy to do anything. 

He/she fails to understand the direction.

Often asks to raise the volume of TV or radio.

Have fever and ear pain.

Treatment of the Problem

Hearing loss affects a child s learning ability. So, the problem must be diagnosed and treated immediately. Here are some treatment approaches: 

Treatment for Otitis Media: The very first thing parents and doctors can do is watchful waiting because sometimes the problem cures itself. Some pediatricians might prescribe some antibiotics. If the problems continue, then the doctor will suggest getting an ear tube to the child that will allow the fluid to drain. For this, the child will have to visit an ENT doctor also called Otolaryngologist. 

Treatment for other causes: The child may use a hearing aid. Some can get cochlear implants. 

Conclusion
It is necessary for parents to accept the child with deformity and stay by his/her side. They must get themselves educated and communicate the problem with others to get help. It is essential to stay in touch with the child and take care of him.

Deaf Child - What Should You Know?

5 Ways to Stop Muscle Cramps

Muscle cramps are feared and loathed by all of us alike – they hurt, they slow us down and they just give us a helpless feeling! The most common cause of these cramps is premature fatigue which affects the reflex control of muscles. Here are 5 ways guaranteed to beat these troublesome muscle cramps:

1. Take rest
The most easy and sure-shot way to kill a muscle cramp is to take rest. Just rest your body, be at one place and the cramp will not last more than 3-4 minutes. Moving around will only cause the pain to be aggravated and eventually affect other areas as well.

2. Consume solutions rich in salt
Whenever you encounter a troublesome cramp, the first instinct is to reach for water. However, studies have shown that salt solutions are far more effective in countering cramps as compared to plain water. You can have pickle juice and similar drinks which have a high salt concentration.

3. Be physically active
The most common reason for muscle cramps is over-straining of the body. If you are planning to indulge in an extremely intensive physical activity, make sure to train well in advance. Also, keep the duration and intensity of the training at a similar level to that of the actual activity.

4. Keep your body hydrated
Dehydration is the root of a number of troublesome conditions, muscle cramps being one of them. Make sure to always carry a water bottle with you and drink a minimum of 7-8 glasses of water on a daily basis.

5. Indulge in light passive muscle stretching
When faced with a muscle cramp, in addition to resting, try and gently stretch the affected muscle. This continuous and light passive stretching lets the brain know that it can relax the muscle and help it return to normal.




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5 Winning Ways to Stop those Nasty Muscle Cramps

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