Tinnitus is when you think that there is noise when there really is no sound. It is very common and is not very serious either. It affects about 1/5th of the population. It is worth note that tinnitus is not a condition. Instead, it is a symptom of having a condition. These conditions range from hearing loss, an ear injury or even a circulatory system disorder. Even though tinnitus does worsen with age however it can also improve with treatment. If you know the cause of tinnitus, it does help treat it. Here is everything you need to know about tinnitus.

Symptoms of Tinnitus
As mentioned earlier, tinnitus is a ringing, hissing, clicking or buzzing sound which only you can hear and no one else.

Causes of Tinnitus
There are many common causes of tinnitus including:
1. Age-related hearing loss: Tinnitus is commonly caused due to hearing loss.
2. Meniere's disease: Meniere's disease is a type of inner ear disorder. It is when there are abnormalities in the fluid pressure of your inner ear.
3. Medications: Many medications have a side effect of tinnitus as well including certain antibiotics, antidepressants, cancer medications and even aspirin.
4. Loud noise exposure: Exposure to loud noise once in a while will not cause tinnitus. However, constant exposure to loud noise might cause tinnitus.
5. Changes in the shape of your ear bone: Otosclerosis is an abnormal bone growth which results in the bones in your middle ear stiffening.
6. Acoustic neuroma: There is a nerve, which goes from the brain straight to the inner ear. When this nerve develops a tumor, it is known as acoustic neuroma which is a common cause of tinnitus.

Treatment of Tinnitus
Tinnitus can be only be stopped if the underlying condition is treated. However, there are certain electronic devices, which help suppress the noise including:
1. Hearing aids: Hearing aids are already helpful for people who have hearing loss; however they can also help reduce tinnitus.
2. Masking device: Wearing a masking device which continuously emits a low-level noise helps stop the buzzing, clicking, hissing or ringing sound which comes with tinnitus.

Causes and Treatment of Tinnitus

A number of factors, such as physical ailments, stress, anxiety and even relationship problems can cause sexual problems. Relationship concerns where intimacy and the culmination of the various phases of sexual activity from stimulation to excitement and peak, cannot be possible in a satisfactory manner. So what are the routine sexual problems recognised and treated as per ayurveda? read on to know more.

1. Erectile dysfunction: this condition is also known as impotence and it usually occurs when male patients cannot muster up and retain an erection for long enough to enjoy sexual intercourse. This problem can be fixed with various herbs and condiments including sanda oil massage on the testicles and nearby areas in order to increase the blood flow. Also, one can have ginger, honey, drumsticks, milk and other such ingredients for better achievement and retention of an erection for a prolonged period of time during sexual intercourse.

Sanda oil is not available in its pure form and simple branding of this name is not useful. Sanda is a wild reptile, which was boiled in ancient times and fats taken out to make sanda oil. This is not possible now a days. Instead various'tilas' (penis massage oils) prepared by valuable herbs and vegetable oils such as sesame oil should be used. Tila using mall (purified arsenic) and egg are also effective. Preparation and use should be as per instructions in classic ayurveda. Tila is selected as per history, present condition and duration of specific problem

Otc or advertisement products are general products, which do not benefit all. Post application directions are also important otherwise there may be adverse effect of tila application

2. Premature ejaculation: premature ejaculation is a condition when the male patient may face ejaculation as soon as the intercourse begins, or upon insertion. This happens in an unplanned way and is a sudden occurrence that usually puts a damper on the sexual mood and activity. In ayurveda, there are various herbs including ashwagandha and a variety of oil massages that can help in treating this problem.

3. Sexual weakness: sexual weakness is a condition when the female or male patient may not have the energy to go through with sexual intercourse and may even complain of pain during intercourse. This problem is especially common among women, and may be caused due to fatigue, stress or even low pelvic strength following childbirth or miscarriage. The best way to treat this issue is with the help of proper counselling and therapy that will help in introducing yogic poses that can strengthen the pelvic area so as to have better sexual strength.

4. Infertility: this problem may be found in both men and women. Ashwagandha, vasant kusumakar ras, shilajit and labub kabir are some of the herbs and concoctions that can help in increasing virility and the chances of conception by creating better sperm quality and quantity, as well as more effective ovulation.

Most of the sexual problems in ayurveda are recognised as factors that arise from stress and anxiety. These are recognised as temporary issues that can be fixed with the help of a proper routine of eating, resting and exercising, as well as a healthy diet where the patient stays away from smoking, excessive drinking as well as drug abuse. Before taking any herbal medicines, one will have to consult the doctor and find out about side effects for patients suffering from chronic ailments like diabetes, cardiovascular diseases and others.

Solving Routine Sexual Problems Through Ayurveda

Ulcer pain can be uneasy and unbearable at times. It is caused by a bacterium known as the H. Pylori. Pain medication, lifestyle changes, and healthy eating habits can ensure pain relief from this condition. Here is a list of 4 best ways to get instant pain relief from an ulcer:

Medication - H. Pylori is often found in the digestive tract. Doctors suggest various combinations of antibiotics kill this bacterium. Some of those include tetracycline, levofloxacin, metronidazole, and tinidazole. These are prescribed as per the resistance rate of the bacteria. There are other sets of medication that blocks acid production in the body. These drugs which commonly go by the name of PPIs include esomeprazole, lansoprazole, and pantoprazole. The third set of medications reduces acidity in the stomach and gives instant relief. They are readily available over the counter and goes by the name antacid. The final line of medicines that are often prescribed by doctors includes Cytotec and Carafate. They protect the tissue lining of the intestine and the stomach.
Consumption of cranberry - Cranberry has multiple health benefits. One of those includes the ability to fight against bacteria of the urinary tract. They also do not allow the bacteria to settle on the surface of the bladder. Cranberry in the form of juice, supplement and as a whole can be consumed daily to get relief from the stomach ulcer. It should be taken in specific quantity as too much of cranberry consumption can upset the stomach. Packaged cranberry juice from the market can be avoided as they contain high level of fructose which can unsettle the stomach.
Flavonoids - A compound known as bioflavonoids are known to be extremely helpful for pain relief from an ulcer. These compounds naturally occur in many vegetables and fruits such as soybeans, berries, apples, legumes, green tea, broccoli and berries. Bioflavonoids available in red wine and citrus food should be strictly avoided as they can trigger ulcer pain. Bioflavonoids should be taken in measured quantities as too much consumption of it can cause harm in blood clotting. It can be consumed in the form of supplements if the body doesn t receive the same from the daily diet.
Deglycyrrhizinated licorice - This compound is nothing but licorice with the sweet flavour pulled out of it. A study showed that they are capable of completing curing the ulcer containing bacteria by inhibiting their growth. Deglycyrrhizinated Licorice is available in the form of candy and can be consumed once the pain starts. Supplements too are available in the market. Not more than 2 ounces of Deglycyrrhizinated Licorice should be consumed in a day as they can cause fluctuation in blood pressure and lead to heart diseases.



Stomach Ulcer - 4 Best Ways To Get Pain Relief!

As life expectancy is increasing so is the incidence of vertebral body (VB) fractures now being the commonest fracture of the body. PVP is an established interventional technique in which bone cement is injected under local anaesthesia via a needle into a fractured VB with imaging guidance providing instant pain relief, increased bone strength, stability, decreasing analgesic medicines, increased mobility with improved quality of life and early return to work in days.

In this era of minimally access surgery replacing open surgeries, PVP is a novel procedure & should be in the first line of management in place of conservatism or major spine surgery for painful uncomplicated compression fracture spine.

Morbidity & consequences of spinal fracture:

Traumatic VB is a painful condition requiring bed rest restricting daily activities markedly
Left untreated it can cause DVT, increase osteoporosis, loss of VB height, respiratory & GI disturbances, emotional & social problems secondary to unremitting pain, loss of independence with high cost of rehabilitation.
High risk of primary or consequential damage to neural, bony or disc element
Increased wedging, deformity & increase incidence of adjacent VB
Chronic pain of altered spine mechanics
Uncomfortable braces & sleep disturbance because of pain & discomfort with its sequels.
Cost of surgery and hospital treatment
Cost of implants
Phobia of surgery
Prolonged recovery period & Extensive rehabilitation
Changed spinal mechanics & transition syndrome
Major surgery & anesthesia with its own complications
Results / Outcome

PVP is a novel procedure with high benefit to risk ratio, which is highly underutilized in relation to the high prevalence of the vertebral.
Different studies show an immediate pain relief in (85   90)% of patients with low complication rate ranging from (1-5)% depending upon the type of lesion.
PVP does augment height of VB but ideal would be kyphoplasty
Patient is either off medicine or on reduced doses.
Patient feels so well that he almost forgets if he had VB

Percutaneous Vertebroplasty (PVP) is an emerging interventional technique in which surgical polymethyl methacrylate bone cement is injected under local anaesthesia via a large bore needle into a vertebral body (VB) under imaging guidance providing increased bone strength, stability, pain relief, decreased analgesics, increased mobility with improved QOL and early return to work. Started in 1984 by Galibert PVP is done in host of indications.

Senile osteoporotic compression remains the commonest Indication. Other indications are Metastatic VB, Multiple myeloma VB, VB haemangioma, Vertebral osteonecrosis & for strengthening VB before major spinal surgery. The benefit has been extended to the traumatic stable uncomplicated VB compression (VCF) which is commoner in younger age group with active life profile and prime of their career where strict bed rest and acute or chronic pain are unacceptable and they are more demanding for proactive treatment approach so as to be back to work ASAP.

Discovering the fact that VB is the commonest of body, its incidence >the hip, it becomes imperative to take it more seriously. With increasing life-span there is more of aged osteoporotic population, more so due to sedentary indoor lifestyle and post menopausal osteoporosis. Diabetics, smokers & alcoholics are at higher risk of developing osteoporosis. I have seen such alcoholic patient developing six spine fractures in just three months time from a single fracture being on complete bed rest.

Quick fix of fracture spine makes patient walk back same day instead of bed rest of months together avoiding morbidity & mortality of prolonged bed rest, making bedridden patient walk, in a way bringing patient back to normal life.

In this era of MAS replacing open surgeries, PVP is a novel procedure & should be in the first line of management in place of conservatism or major spine surgery for painful uncomplicated compression.

Morbidity & consequenses of spinal 

Traumatic VB is a painful condition requiring bed rest restricting daily activities markedly.
Left untreated it can cause DVT, increase osteoporosis, loss of VB height, respiratory &
GI disturbances, emotional & social problems secondary to unremitting pain, loss of independence with high cost of rehabilitation.
High risk of primary or consequential damage to neural, bony or disc elements.
Increased wedging, deformity & increase incidence of adjacent VB
Chronic pain of altered spine mechanics.
Uncomfortable braces & sleep disturbance because of pain & discomfort with its sequels.
Morbidity and complication of spinal surgery 

Cost of surgery and hospital treatment
Cost of implants
Phobia of surgery
Prolonged recovery period & Extensive rehabilitation
Changed spinal mechanics & transition syndrome
Major surgery & anesthesia with its own complications
Preparation & Procedure:
X-ray spine in a/p & lat view. CT is more informative of bone & morphology. MRI is good for soft tissue injuries. Ask for pedicle size in all dimensions and construct a 3D image aiming needle placement and cement filling in scan room itself as rehearsal of PVP. This reduces operative time & gives better results. Conventionally PVP is done by hammering the vertebroplasty needle through the bone. Here we use light weight drill to bore through the vertebra. It is important to set the needle at exact entry site & side with right trajectory aiming the defects.

In lateral view needle should go through middle of the pedicle going up to anterior 1/3 of VB. In P/A view the needle can be in midline or paramedian depending upon & if uni/bipedicular approach is planned. Approach varies as per location of vertebra, anterolateral in cervical, costotransverse/parapedicular in thoracic & transpedicular in lumbar vertebra.

Do bone biopsy if there is any doubt about lession. Do dye test (vertebral venography). Make cement more radiopaque by adding barium /or tungsten. Inject cement with 1or2 ml luerlock syringes strictly under fluoroscope in lateral view & cross checking in P/A view. Stop injecting either there is adequate filling or at the first sight of ectopic cement leak. Keep sample cement to see for hardening. Remove needle with rotational movement before cement hardens.

Pain relief is by virtue of different mechanisms postulated :

Cementing of fragments.
Thermal neurolysis of VB nerve ending due to heat of polymerization.
Washing away of nociceptor chemicals.
Neurolytic action of liquid monomer.
By allowing early ambulation decreasing pains of immobility & bed rest.
Complications 

PVP is generally safe with low risk.
Ectopic cement leak is frequent but generally inconsequential.
Outcome 

PVP is a novel procedure with high benefit to risk ratio, which is highly underutilized in relation to the high prevalence of the vertebral
Different studies show an immediate pain relief in (85   90)% of patients with low complication rate ranging from (1-5)% depending upon the type of lesion.
PVP does augment height of VB but ideal would be kyphoplasty.
Patient is either off medicine or on reduced doses.
Patient feels so well that he almost forgets if he had VB

Vertebroplasty (PVP) / Kyphoplasty - Approach To Management Of Vertebral Body Fractures!

Sleep is known to most as a period of rest and relaxation, but there are multiple disorders which are associated with sleep too. Hypersomnolence or hypersomnia is one of the most common sleep disorders. This is characterised by excessive daytime sleepiness and prolonged periods of sleep at night. They wake up fresh in the morning, but can easily go back to sleep any time of the day without feeling strained or tired. There is again no freshness associated upon waking up. Funny as it may sound, they can doze off even during a meal or in the middle of a conversation.

Causes: This condition is most common in men and in the early adolescent days.

There is no underlying cause that has been identified, though there is a genetic predisposition.
People with history of head trauma are more affected
People with anxiety, depression, bipolar disorders, epilepsy, and other mental disorders are also more likely to be affected
People with sleep apnea often are hypersomnolence
Restless legs syndrome, narcolepsy
Neurodegenerative disorders like Parkinson s and Alzheimer s tend to sleep more.
Symptoms:

Sleeping for longer hours at night time
Excessively sleepy during daytime
Able to doze off anytime during the day
Inappropriate and involuntary sleeping pattern
Having difficulty getting out of bed after waking up, even after prolonged sleep
Feeling of disorientation
Feeling agitated, anxious, lethargic, and irritated
Impaired cognition and memory
All these lead to extreme state of drowsiness
Increased tendency for hallucinations
Reduced appetite and even weight loss in some people
There is restlessness, reduced pace of thinking and speaking
Overall reduced energy levels
Social interactions are affected including work life, social functions, etc.
Diagnostic criteria:

If a person happens to sleep more at night or falls asleep during the day easily for more than 3 times a week, it is usually concerning.
The added feature of no tiring physical activity can also lead to suspicion
In acute cases, these symptoms are present for at least a month and in chronic cases, it could be seen for up to 3 months
It cannot be explained by lack of sleep on a regular basis
One or more of the above conditions could be present, which can help in making the diagnosis
Treatment:
Most cases of hypersomnia would need treatment only to improve their energy levels and improve the quality of life. Very often, treating the underlying condition can lead to improvement of hypersomnia. The tired, lethargic, restless feeling affects the overall performance of a person, leaving them with a lowered self-esteem. Brain stimulating drugs like amphetamines are used to improve daytime alertness and also reduce sleepy feeling during the day.


Hypersomnolence - How It Can Be Managed?

The onset of winter brings with it chilly and dry winds. For some, it s the time to enjoy the chill weather with hot water baths and soothing drinks, and for others it s time to brave the long persistent cold and flu like symptoms which cause sickness and discomfort.

People who are allergic to the winter season can catch a cold on the slightest exposure to cold air. Sometimes, it s difficult to ascertain whether it is cold or an external allergen. In people prone to winter allergies, the allergies are mainly caused due to the allergens present in the environment. Mostly, winter allergies are also caused by the same allergens that are triggered in the summer season. 

Thus, people who have some or the other form of seasonal allergy is likely to suffer from allergies as the season changes.

Pet dander (flakes of skin in an animal's fur or hair) allergies are believed to escalate in winter since pets are mostly indoors during this season. The best way to deal with this is keeping the pet s area clean and dry, washing and changing of the bedding regularly, and avoiding physical contact as much as possible.
Dampness of clothes, blankets and shoes at home can be an allergy trigger for many people. The best way to control this type of allergy is to keep damp clothes and shoes in sun for some time. However, this may not work in many countries with extreme cold climates, which lack sunshine in their environment.
Decaying leaves and other yard waste can cause allergies due to mould and mildew. Mopping and sweeping the floors and garden can help alleviate the problem to some extent.
Dry climate can cause irritation in the nose and throat. It s important to replenish the body with adequate liquids and water rich fruits and veggies. It s important to choose your drinks wisely. Too much tea or coffee can also dehydrate the body. Go for ginger lemon honey infused in warm water for best results.
Allergy symptoms can also be caused due to too much moisture in the environment. It can give rise to a stuffy or runny nose, sneezing and coughing. Thus it s best to avoid sitting in a moist environment for long.
Sinus congestions are also common during the winter season. Steam inhalation and hot showers can help relieve the symptoms and provide relief.
Whether you are allergic to pets, moisture, dampness, dry weather or chilled winds, the thumb rule is twofold to understand what triggers your allergies and to avoid your exposure to those allergens. As we all know, allergies have no cure and they need to be managed. Drugs also help in controlling the allergy symptoms to some extent. However, it s best to prevent them as far as possible. If you are confused about what triggers your allergy, make sure to consult your doctor.

Allergy - Best Ways Ayurveda Can Help Manage It!

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