Inguino-scrotal and Inguino-labial swellings are common in children during infancy. A common cause of an Inguino-scrotal swelling in children is the presence of a patent processus vaginalis. It presents in the form of an inguinal hernia or hydrocele. Male infants are often affected 3 to 6 times more than the female ones. Processus vaginalis is the outpouching of peritoneum that extends through the inguinal canal. It is first seen during the 3rd month of intrauterine life. It follows the gubernaculum and testes through the inguinal canal and reaches the scrotum by the 7th month of gestation. 

Differential diagnosis of inguino-scrotal swelling in children: 

Inguinal hernia and hydrocele 
Torsion testes, epididymorchitis 
Undescended testes 
Varicocele 
Enlarged inguinal lymph node 
Abscess or lipoma 
Normally after the testicular descent, the portion of processus vaginalis surrounding the testis becomes tunica vaginalis. The processus vaginalis gets obliterated, eliminating the communication between peritoneal cavity and scrotum. A patent processus vaginalis is seen up to 20% in adulthood. 

Hernia and Hydrocele: The testicles or ovaries form in the abdomen near the kidneys, between 3 to 4 months of fetal development. Further, they gradually move down into the lower part of the abdomen as the fetus continues to develop. On descending downwards, small part of the peritoneum (a layer of tissue lining the abdomen from inside) that attaches to the testicle is drawn with it into the scrotum. This forms a pouch or sac. A similar process occurs in females as the round ligament of the uterus descends into the groin at the labia. The sac formed is processus vaginalis. Any connection between the abdominal cavity and the scrotum or groin is eliminated. When closure of the processus vaginalis is delayed or incomplete, it may stretch and eventually become a hernia. Stretching of processus vaginalis creates the inguinal sac that allows organs an extension from abdomen and entry into the sac. If fluid, rather than organs, builds up and remains in the sac, the child has a hydrocele. Approximately 80 percent to 90 percent of inguinal hernias appear in boys. They are more common on the right side, but in about 10 percent of cases, they occur on both sides (bilaterally). 

Epididymorchitis: Epididymitis is the pain and swelling of the tube that attaches to each testicle called as the epididymis. Orchitis is pain and swelling of the testicle. Since epididymis and testis lie next to each other, differentiation of the inflamed part is difficult. Hence, the term epididymo-orchitis is often used. Infection with bacteria often causes these problems. Other causes are infections from surgery or from a catheter that drains urine. The mumps virus also can cause orchitis. Analgesics or anti-inflammatory medicines can reduce the pain. Antibiotics are used if the problem is caused by bacteria. 

Torsion testis: It is a painful condition that occurs in the boys. It is a twisting of the testicles and the spermatic cord (the structure extending from the groin to the testes that contains nerves, ducts, and blood vessels). A decreased blood flow to the testes is caused by torsion of the testes. This torsion essentially strangles them of oxygen and nutrients. While it generally occurs in adolescent boys, it may also occur during fetal development or shortly after a baby is born. Urgent surgical procedure is undertaken if testicular torsion is confirmed in a child. The chance of survival for the testicle is best if surgery is completed within six hours of symptom onset.

Know The Types Of Inguinoscrotal Swelling In Children!

Myths about and treatments for arthritis

Arthritis is a medical condition which causes stiffness and inflammation in the joints. It can be extremely painful and should be cared for on daily basis.
 
However there are many myths surrounding arthritis that need to be busted.

1. Myth: every knee pain is arthritis.
Truth: the condition in which joints pain a lot, it is assumed that every type of knee pain is arthritis and there is only one type of arthritis. From gout to virus caused arthritis, to autoimmune arthritis, there are numerous different types of arthritis.

2. Myth: stop exercising to avoid straining your knee.
Truth: with the joints paining a lot, a lot of patients believe that they cannot exercise any more. The truth is that there are specific low-impact workouts designed for people with arthritis so that staying fit is never a problem.

3. Myth: arthritis makes you immobile.
Truth: arthritis does change your life since it affects your joints. But remember, it doesn't make you a handicap. It is false to believe that nothing can be done about the disease.

4. Myth: diet has no impact on the disease.
Truth: since it is a joints related problem, many people believe that dietary changes are not required if you are suffering from arthritis. It is in fact crucial since those suffering from arthritis are at higher risk of being obese, and in turn getting heart diseases and type2 diabetes.

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Busting The Myths Surrounding Arthritis

Knee pain or injuries are very common and have numerous causes. Knee pain can emerge from delicate tissue wounds like ligament sprains and muscle strains. Bone conditions like knee joint pain, Osgood Schlatters, and biomechanical dysfunction can also cause knee pain. Treatment can include basic knee mobilization techniques, taping, massages or knee strengthening exercises completely through a careful recovery method after knee replacement or reconstruction.

Physiotherapy can help you overcome the pain and increase your strength and flexibility. A physiotherapist can suggest you a number of treatments and also help you understand your issue and get you back to your everyday routine. Physiotherapists are said to be successful in getting rid of the source of the knee pain by diagnosing a cause. This includes tightness around the knee and treating it with stretching and exercises.

Following are some of the exercises a physiotherapist might generally recommend for knee pain:

Hamstring stretch: Stretching keeps you flexible and increases your scope of movement, or how far you can move your joints in different directions. It additionally helps you reduce your chances of injuries and pain. Continuously warm up with a five minute walk first. Lie down when you are prepared to stretch your hamstring. Circle a bed sheet around your right foot, use the sheet to pull the leg up and hold for twenty seconds and then lower the leg. Repeat twice and switch legs.
Calf stretch: Use a chair for balance. Bend your left leg. Step back with your right leg and gradually straighten it behind you. Press your left heel toward the floor. You should feel the stretch in the calf of your back leg. Hold for 20 seconds. Repeat twice and then switch legs.
Straight leg raise: It helps build muscle strength to give support to the weak joints. Lie on the floor. Twist your left knee, foot on the floor. Keep the right leg straight, toes pointed up. Tighten your thigh muscles and raise your right leg.
Quad set: With these, you don't raise your leg. Just tighten the thigh muscles, also called the quadriceps, of one leg at once. Begin by lying on the floor. Keep both legs on the ground, loose. Flex and hold the left leg tense for five seconds and then relax. Do three sets of ten repetitions. Switch legs after every set.
Cushion squeeze: This move strengthens your legs from the inside so that they can support the knees. Lie on your back, both knees facing inwards. Place a cushion or a pillow between the knees. Press your knees together, squishing the cushion between them. Hold for five seconds and then relax. Do three sets of ten repetitions. Switch legs after every set.
Heel raise: Stand tall and hold the back of a seat for support. Lift your heels off the ground and rise on the toes of both feet. Hold for three seconds. Gradually lower both heels to the ground. Do three sets of ten repetitions. 

Knee Pain - How Physiotherapy Can Heal Knee Pain?

Osteoporosis is an age-related condition characterized by low bone density and fragile bones. Lack of calcium and vitamin D are the most common triggers of this condition. These are vital elements for healthy teeth as well. Osteoporosis has a direct relationship with oral health and can trigger a number of issues such as loss of teeth, gum and can cause periodontal disease. The effects of osteoporosis on oral health and affect more women. This risk increases when talking of menopausal women.

The jawbone is one of the areas that bear the brunt of osteoporosis. The loss of bone density in this area can cause tooth loss and make teeth lose. It can also affect the gum ridges that hold dentures in their place. This can result in ill-fitting dentures that need to be frequently changed.
Medication for osteoporosis is also linked to dental health. In rare cases, antiresorptive medicines that are prescribed to strengthen the bones can lead to a condition known as osteonecrosis. This refers to the death of a bone due to poor blood supply. Antiresorptive medication can be administered orally or intravenously with the latter having a higher risk of triggering osteonecrosis. Though it affects the hips and shoulder bones in most cases, it can also affect the jaw bone. It is marked by pain, swelling, infection and exposed bone. Loose teeth, gum infections and numbness or heaviness of the jaw are also symptoms of osteonecrosis of the jaw bone.
The risk of suffering from osteonecrosis cannot be determined beforehand. Hence it is a good idea to see your dentist before or just after starting antiresorptive treatment for osteoporosis and to schedule regular checkups for the duration of your treatment. Dental problems if any should be treated before starting medication for osteoporosis. Osteonecrosis of the jaw bone is most commonly seen after undergoing a dental procedure that affects the jawbone and associated tissues such as a tooth extraction. Ideally, invasive dental procedures should be avoided if you are taking antiresorptive medicines. However, it can also occur spontaneously.
Bisphosphonates are also commonly prescribed to treat osteoporosis. This type of medication slows down the breakdown of bone tissue. However, this can lead to the development of new bones. This is not a troublesome issue when it comes to bones like the hip, leg or arm bones but can be very disruptive if it affects the jawbone. This is because the jaw bone is constantly reforming and reshaping itself.

Osteoporosis - Can It Impact Your Oral Health?

Pain related sleep disruption has affected a large number of people around the globe. Statistics has it that, in India, about 25% of the population suffers from pain-related sleep deprivation. Studies call it  the vicious cycle of pain and sleep  as pain affects your ability to sleep and lack of sleep makes the pain even worse.

Back pain and arthritis are examples of some common pain-related medical disorders. People with these types of chronic pains have reported persistent sleeplessness or have had immense trouble falling asleep.

The following are the primary sleep disorders associated with chronic pain:

Insomnia: It is a medical condition that is characterized by an inability to fall asleep no matter how physically exhausted you are. Insomnia can be acute (lasting for one night to a week) or chronic (that lasts for more than 3 weeks).
Hypersomnia: It is a condition wherein you tend to sleep excessively; in this condition, you will have trouble being awake throughout the day or can fall asleep at any point of time.
Sleep Apnoea: This is a sleep disorder wherein breathing pauses and resumes repeatedly. Risk factors include obesity, age and gender; it is more commonly observed in men. This condition can be chronic with symptoms such as snoring loudly or feeling very tired even after one has had a night s sleep.
Restless leg syndrome: It is a sleep disorder wherein you continuously move your legs while sleeping. However, this condition can also cause you to move your legs even if you aren t sleeping.
Some of the causes of sleep disorders due to chronic pain are:

Pain
Worry and anxiety
Sweating at night
Depression and other mental disorders
Treatment

A pain and sleep disorder should be simultaneous as both the components of it, pain and sleep, are interrelated. Some of the ways people with chronic pain can still have a good night s sleep are:

Limiting caffeine intake
Abstaining from alcohol and smoking, as these disrupt the sleep cycles, thus aggravating the existing pain.
Practicing meditation and other relaxation techniques
Pain killers or sleeping pills can be administered, but only with the doctor s advice.
Hot water fomentation over painful area during night, for better sleep.

Back Pain and Bad Sleep

Spine deformity refers to an abnormality of the shape, alignment, or formation of the vertebral column. The spine in the human body is composed of small bones or vertebrae, stacked on top of another. A healthy spine, typically, has gentle curvatures. A displacement or exaggeration of the spine leads to deformities.

Types of spine deformities:

The three major forms of spine curvature deformity are-

  Lordosis - Causes the lower back to turn inward
  Kyphosis - Leads to forward rounding of the back
  Scoliosis - Causes the spine to curve sideways

What are the causes of spine deformity?

The following conditions may cause the spine to be misaligned-

  Achondroplasia - A disorder, which impedes the normal growth of the bones, thereby resulting in short stature or dwarfism
  Spondylolisthesis - When the vertebrae in the lower back slip forward
  Osteoporosis - When the vertebrae become fragile and prone to fractures
  Scheuermann s disease - A developmental disorder of the spine that leads to abnormal growth of the upper back
  Spina bifida - A congenital disorder where the spinal column does not close completely while inside the womb

Symptoms associated with deformed spine:

Signs and symptoms of a deformed spine include-

  Uneven/misalignment of the shoulder and hips
  Uneven shoulder blades (one side is slightly higher than the other)
  Slight bending of the head over the body
  Difficulty in movement
  Discomfort and back pain

How is the condition treated?

The treatment of the condition depends on the severity of your spine deformity. Anti-inflammatory medications and drugs are prescribed to manage pain and discomfort associated with spine deformity/curvature. However, these cannot correct the deformity completely.

Severe cases of spine deformity need another line of treatment.

  Bracing - Back braces are recommended for children and adults alike, depending on the degree of curvature. This can help prevent the condition of your back from worsening.
  Body casting - The doctor places a cast that starts from the shoulders and goes all the way down to the lower trunk. This provides adequate support to the spine and strengthens the back.
  Spinal instrumentation - The surgeon will attach instruments like rods, hooks, and wires to the spine to keep the bones aligned following a spinal fusion.
  Artificial disc replacement - The surgeon replaces degenerated discs in the spine with artificial devices.
  Kyphoplasty - The surgeon inserts a balloon into the spine to stabilize and realign the deformed spine and relieve you from the pain.

Following the treatment, patients with spine deformity are usually advised to go for physiotherapy sessions. Physical therapy and exercise can help you build muscle strength and increase flexibility.

Deformity of the spine is a difficult condition to live with. Not only does it restricts your normal movement but also places you at risk of other musculoskeletal disorders. Therefore, it is imperative that you get the condition treated by a specialist.

Spine Deformity - Everything You Should Know!

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