These Gallstones don t cause any problems in most cases. But prompt treatment is required if stones block ducts and cause infections and inflammation in the pancreas. This may lead to the removal of the gallbladder through a surgery, known as cholecystectomy, which further includes techniques such as laparoscopic (keyhole) cholecystectomy or open surgery.

Although it is a less vital organ, the body can cope up even after removal.

Procedure of surgery:

The surgery involves removal of gallbladder and gallstones through several incisions in the abdomen. In order to see clearly, the surgeon inflates the abdomen with air or carbon dioxide.
A lighted scope attached to a video camera is inserted into one incision near the belly button. The video monitor is used as a guide for inserting other surgical instruments into the other incisions to remove the gallbladder.
Intraoperative cholangiography is the X-ray procedure which shows the anatomy of bile ducts. This is done before the surgeon removes the gallbladder.
Bile flows from the liver through the common bile duct after the surgery into the small intestine. As the gallbladder has been removed, the gallbladder can no longer store bile between meals but has no effect or little effect on digestion.
In case of open surgery, the surgeon reaches the gallbladder through a large, single incision in the abdominal wall.
Complications after gallbladder surgery:

This surgery carries some degree of risk like any other surgery. Complications such as internal bleeding, infection, injury to nearby digestive organs, injury to the bile duct and injury to blood vessels.

Types of gallstones:

There are three main types of gallstones. They are

Mixed stones: They are made up of cholesterol and salts. They tend to develop in batches.
Cholesterol stones: Mainly made of cholesterol, which is crucial to many metabolic processes. They can grow large enough to block the bile ducts.
Pigment stones: The colour of bile is greenish-brown, due to some particular pigments.
Medical factors to consider before cholecystectomy:

The most important factor is a consideration of your medical history. This is because the pre-existing conditions influence decisions on surgery and anaesthetic and information about any bad reactions or side effects from any medications would be helpful for surgery.

Self-care after the surgery:

Taking rest is the most important thing after surgery. Avoid things such as heavy lifting and physical exertion. The usual recovery period after the surgery is one week.

Know Everything About Gallstone Surgery!

Are you experiencing skin itchiness and development of dry, scaly rashes on your skin? This indicates you have eczema, which is a group of skin diseases occurring due to the inflammation and irritation of skin. Atopic dermatitis is the most common form of eczema. The disease can be controlled if proper treatment is undertaken.

Symptoms
Itchy skin is the most common symptom of eczema. In some cases, the itching starts before the development of the rash. The rash appears most commonly on the back of the knees, face, hands, wrists and feet. The affected areas become dry and thickened and in people with a fair complexion, the areas may turn reddish initially and then become brown.

Causes
The specific cause of eczema is yet to be determined. However, the condition is associated with an overactive response by the immune system to an external irritant. This response leads to eczema. The condition is more common in people who have a family history of allergies or asthma.

Treatment

As the condition turns the skin dry and itchy, certain creams and lotions are recommended to be used in order to keep the skin moist. You should apply these products when your skin is damp, ideally after taking a shower. This helps the skin in retaining moisture. You can use a cold compress to ease the itching.
Several creams such as hydrocortisone cream and ointments which contain corticosteroids are prescribed in order to reduce inflammation.
In case the affected area becomes infected, antibiotics should be taken to eliminate the infection-causing bacteria.
Antihistamines are used for reducing the severity of the itching. 
Prevention of Eczema Flare-ups

Moisturize your skin frequently
Avoid sudden changes in humidity or temperature
Abstain from overheating and sweating
Try to reduce stress
Avoid starchy material
Avoid soaps, detergents and solvents, which are harsh
Be aware of food items which trigger eczema flare-ups
It is recommended for you to consult a dermatologist if you experience any symptom of eczema. This will help you with a quick diagnosis so that you can start the treatment without further worsening of the symptoms.

Eczema - How You Can Prevent Its Flare-ups?

Eczema is a skin condition which is characterized by rough, cracked, red, itchy and inflamed skin. Sometimes it can also cause blisters. Eczema is also known as atopic dermatitis. It is a severe condition which starts during infancy and can go on throughout childhood. While some people may outgrow this condition, the rest might have it till adulthood.

Causes of Eczema:
1. Irritants- Certain irritants found in vegetables, meats, juices extracted from fresh fruits, disinfectants, shampoos, detergents and soaps can cause eczema.
2. Allergens- Dandruff, mold, pollens, pets and dust mites can also contribute to Eczema.
3. Microbes- Certain bacteria such as Staphylococcus Aureus, fungi and viruses can also cause eczema
4. Food products- Many people are allergic to food products such as wheat, soy products, seeds, nuts, eggs and dairy products. This might contribute to Eczema.
5. Stress- This doesn t cause eczema but can aggravate the symptoms of it.
6. Hormones- Women usually experience worsening of Eczema during certain stages of their menstrual cycle or during pregnancy.

Symptoms of eczema in infants and children:
1. Rashes appearing on the cheeks and scalp
2. Rashes which bubble up before fluid discharge
3. Rashes which cause itchiness and lead to disturbed sleeping; continuous scratching and rubbing can result in skin infections
4. Rashes which can appear behind the creases of the knees and the elbows; these rashes are also common on the legs, creases of the buttocks, ankles, wrists and neck.

Symptoms of Eczema in adults:
1. Rashes on the nape of the neck
2. Rashes on the eyes, face and neck
3. Rashes that can cause extremely dry skin
4. Extreme discomfort caused due to itching
5. Scaly skin caused due to rashes
6. Rashes which can result in skin infections
7. Lichenification, a condition wherein the rashes thicken and develop knots, is also a possibility.

How is Eczema treated?
1. Topical ointments and corticosteroid creams- These are anti-inflammatory medications which relieve symptoms of eczema such as itchiness and skin inflammation.
2. Antibiotics- These are usually prescribed if there is any underlying bacterial skin infection.
3. Antihistamines- These mainly reduce scratching at night. In some cases, it can also cause drowsiness.
4. Topical calcineurin inhibitors- This is a drug that suppresses activities of the immune system. It helps to prevent flare-ups and decrease inflammation.
5. Barrier repair moisturizers- These types of moisturizers repair the skin and reduce water loss from the skin.

Eczema - 5 Ways It Can Be Treated!

The gallbladder is a small organ in the abdomen that rarely gets any attention. When it does draw attention to itself, it is usually not for the right reasons. People think of their gallbladder only when they start feeling abdominal pain associated with gallstones. Gallstones aren t stones like we see in river beds but crystallized deposits of digestive fluids. They can be as small a grain of sand or as large as a golf ball. Stones can occur singularly or many stones may develop simultaneously. It can cause pain in the center or upper right part of the abdomen. Though the pain may be bad, it is not a reason to worry as homeopathy has a number of ways to treat this condition.

Homeopathy is a holistic form of healing that addresses the patient as a whole instead of merely looking at the symptoms exhibited. In this way, it attacks the root cause of the problem. Homeopathic remedies may be given to infants, children and adults of all ages. One of the many benefits of this form of medication is that it has negligible side effects. However, self-medication is not advisable. This is because a remedy that suits one person may not be as effective for another. When prescribing homeopathic remedies, a doctor will look into the patient s medical history, family history, overall physical and mental health, as well as the symptoms, were seen. Thus, homeopathy does not follow a one size fits all approach. For example, an obese person will require a specific type of homeopathic medicine. At the same time, a patient complaining of acidity and a bloated abdomen will require a completely different remedy.

There are many different types of homeopathic remedies. These can be prescribed in the form of sugar-coated pills or liquids. In some cases, powders may also be prescribed. Homeopathic medicines may be prescribed singularly or in a combination of two to three medicines. The main aim of these homeopathic remedies is to reduce the size of the gallstone so that it can pass through the digestive system and be expelled from the body. It also helps relieve pain and reduce flatulence associated with gallstones.

When it comes to homeopathic remedies, one must not expect an immediate solution. It is important to be patient and to take your medication regularly for it to be effective. It is also important not to eat or drink anything half an hour before or after taking the medicines. 

Treating Gallstones With Homeopathic Approach!

Atopic dermatitis or as it is commonly known as, eczema, is one of the most common and recurring form of skin disease. Some of the common symptoms of eczema are redness, swelling of skin, temporary discoloration and dryness among others. It not only causes a significant amount of irritation, but is extremely persistent in its occurrence. Combating atopic dermatitis is a rather cumbersome task, often leading to anxiety and depression. It is indeed one of the most problematic skin hindrances. Dermatitis usually occurs due to the inflammation of the epidermis. 

Some of the more obvious causes are exposure to ultraviolet rays, familial predisposition, prolonged exposure to the offending allergen, latent infection, indigestion, hormonal imbalance among others. Occurrence of eczema considerably lowers the skin resistance and makes you vulnerable to various other skin troubles. Atopic dermatitis is especially congenital in nature. It has reported greater frequency in individuals whose family has some record of eczema or the other. Past incidents of asthma, hay fever may also act as triggers. Signs of eczema are usually manifested in itchy patches in the neck, scalp and palms. 

Given the commonness of the disease, there are numerous remedies for it as well. However, many vouch for the efficacy of homeopathy in curing such skin ailments. Homeopathy not only offers natural solutions to eczema but also detoxifies the system from within to curtail the frequency of such outbursts. Homeopathy also averts any kind of side effects. After closely scrutinizing the symptoms and their possible effects, homeopathy recommends a wide range of medicines to cure eczema. 

1. Sulphur: Sulphur is endowed with medicinal qualities. Used either as an ointment or in form of tablets, sulphur is used as arguably the best remedy for eczema.

2. Graphites: Graphites are extremely helpful in abating sticky oozes as well as eyelids. Graphites help in curing gelatinous discharges. 

3. Rhus Tox: Rhus Tox is an ideal therapy for dermatitis with itching and redness. It curtails the flare-ups and breakouts on skin. 

4. Mezereum: It is extremely helpful for weeping eruptions. It soothes intolerable itching and skin irritation.

5. Natrum Mur: Natrum Mur is extremely effective in curing hairline eczema.

Homeopathy and Atopic Dermatitis

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

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