Foot problems can occur due to a number of causes that, in most cases, are easily diagnosed. An orthopedic is a specialized doctor whose advice you should seek if you have any kind of discomfort in one or both of your feet. Discomfort may include chronic or regular pain, difficulty in movement and/or disfigurement. These are generally a result of arthritis, physical injury or a genetic or hereditary condition. In some of the cases, the pain and discomfort can be treated without any surgery, by using medications. However, in extreme cases, where medication, physical therapy, and other such non-surgical methods fail to have any impact, surgery is the only way to go.

These surgeries are less invasive and require a limited recovery time. They are also one of the most successful types of surgery. The surgical procedure is successful in dealing with the main complaints of a foot problem. It successfully treats a foot by,

Relieving pain: The pain in your feet interferes with your work, making it difficult to carry on with your daily life, affecting your personal and social relationships. Pain often indicates an underlying problem, and it is easier and effective to treat the problem with a surgery, as it relieves you from the chronic pain.
Restoring function: If your feet do not function properly, it will be impossible for you to move, as they are necessary for mobility. When a simple stride becomes a problem, your whole lifestyle is affected. Accepting defeat is not an option. A good orthopedic can help you to get back to your normal daily life by surgically treating your feet thus ensuring they function properly.
Improving appearances: Foot deformity, due to a number of reasons such as polio or bone spurs, can lead to a restricted lifestyle. Movement is hampered and so is freedom. Surgically it can be treated and the appearance of your feet can be improved.
Arthritis is also a cause of a number of foot problems. In more cases than not, surgery becomes a necessity to treat your foot. Here are some of the surgeries that cater to arthritis-related foot problems:

Repairing Fracture: If the fracture is beyond repair by non-surgical methods, surgery is the last refuge for an orthopedic surgeon. Surgery will include repositioning of the bone and the use of supports to keep them in position.
Arthroscopic debridement: This surgical procedure helps to remove inflamed tissues or spurs from the joint.
Arthrodesis: Also known as joint fusion, it involves the removal of the ends of the bones at the joint and replacing them with metal pins or screws.
Osteotomy: The surgical procedure involves realignment of a joint by cutting the bone.

Foot Problems - Can They Be Treated By Surgery?

Gallstones are bits of solid material that may be formed in the gallbladder. The gallbladder is a little organ located under the liver. You won't know you have them until they've blocked your bile duct, causing pain that will need immediate medical intervention and even hospitalization in some cases.

They may comprise of cholesterol, salt, or bilirubin, which consists of red platelets. Gallstones vary in size. They can be as little as a grain of sand or as even the size of an apricot in many cases. Women are more likely to develop gallstones than men. Here we discuss ayurvedic medicine & treatment to remove gallbladder stones.

Most Common Causes of Gallstones
Here we found out the reason behind the gallstone problem. There is a number of reason which creates gallstone conditions, especially in women.

Intake of anti-conception medication pills, hormone trade treatment for menopause side effects, or pregnancy.
Fasting.
Malfunctioning of the gall bladder.
High cholesterol levels.
Gallstones may be created when there is an excessive amount of cholesterol in the bile discharged by the liver. This bile normally separates the cholesterol and helps in the normal functioning of the liver and other digestive organs of the body.
Bilirubin: Bilirubin is a substance created when your liver wrecks old red platelets. A few conditions, like cirrhosis of the liver and certain blood issues, causes the liver to create more bilirubin than it ought to. This can lead to complicated conditions like gallstones.
Bile: Your gallbladder needs to exhaust bile to be sound. In the event that it discharges its bile content, the bile turns out to be excessively thick which causes stones to shape.
Weight: Being overweight or underweight can also cause a malfunction which can lead to the appearance of such gallstones. The gallstones diet also has a bearing in such cases.
Symptoms of Gallstones Problem
Fever
A yellowish tint in your skin or eyes, which can demonstrate jaundice
Sickness or retching
Clay coloured stools
Pain in the right upper quadrant of your stomach area
Nausea
Vomiting
Other digestive issues
How do you Dissolve Gallstones in Ayurveda?
Ayurveda is a holistic system of medicine that gets to the root cause of the gallstone disorder instead of just treating the symptoms. Ayurvedic remedies improve your overall wellbeing, in addition to treating the symptoms. The various Ayurvedic remedies for gallstone removal are:



Diet: Following a healthy diet is one of the key measures to prevent gallstones problem. Eat a well-balanced diet that has plenty of fruits and vegetables; avoid eating foods that contain saturated fats. Fat rich foods such as nuts and seeds should be consumed in moderation.
Exercise: Exercising regularly helps in keeping your weight in check. Cardio exercises such as swimming and running are good for your heart and overall health. Remember that obesity is a risk factor for gallbladder stones.
Keep Diabetes in check: If you are diabetic, make sure your blood sugar levels are in check. High blood sugar may cause high-fat levels in the blood which may result in gallstones.
Limit Stress: Stress may be a direct or an indirect cause for the formation of gallstones. Hence practice relaxation techniques such as meditation to deal with stress in an effective manner.
Ayurvedic Herbs: Numerous ayurvedic medicine for dissolving gallstones known as cholagogues and choleretics have been found useful in preventing gallstones in traditional ayurvedic medicine. Cholagogues are herbs that stimulate the gallbladder to contract, while choleretics stimulate the liver to secrete more bile. Both these actions could help reduce the risk of developing gallstones. Turmeric, citrus fruits, dried ginger, black pepper, long pepper, hing, etc., fall under these categories.
Table Salt Remedy: Before breakfast, on an empty stomach, take a tsp of Saindhava lavanam or ordinary table salt in a glass of hot water. After drinking this, lie down for about 45 minutes on your right side. Do this once or twice a week.
Castor Oil: Apply castor oil pack over the gallbladder area.
Therapeutic Procedures: Apatarpana (fasting), langhana (light diet), and virechana (mild purgation) are some of the ayurvedic therapeutic procedures that are usually advised as a part of the gallbladder stone removal treatment.
Ayurvedic Remedies: Various ayurvedic treatment use to remove gallbladder stones and some specific Ayurvedic remedies such as Shankavati, Sootasekar ras, Pravaalpanchaamrit, Hingwaashtak choorna, Avipattikar choorna, etc., are generally prescribed to dissolve gallbladder stone. The duration of the ayurvedic treatment and dosage of these ayurvedic medicines depends on the severity of the gallstone condition. If you wish to discuss any specific problem, you can consult an Ayurveda.
Update From Lybrate: Stay fit and strong by consuming Health Drinks for Gallstone, available at Lybrate. Being a blend of natural ingredients, these products give a vitalizing boost of freshness.

Ayurvedic Treatment of Gallstones Removal - Cause & Symptoms

Sometimes, when it comes to problems in the abdominal area, an ultrasound is not clear enough for a diagnosis. In such cases, an Endoscopic Retrograde Cholangiopancreatography (ERCP) may be performed. This procedure gives the doctor a clear view of the duodenum, bile duct, pancreatic ducts, gallbladder and papilla of Vater.

This procedure is usually performed under intravenous sedation without general anesthesia. This procedure involves the use of a duodenoscope, which can be described as a thin, long, flexible tube with a camera at one end. It also has a fiber optic bundle that transmits lights to the camera and a chip to transmit video images to a TV screen.

This is inserted through the patient s mouth and sent down the throat through the food pipe to the stomach and duodenum while the patient is lying on his or her back. The air pipe is left undisturbed so as to not interfere with the patient s breathing. Since the patient is not under general anesthesia, he or she can move and turn according to the doctor s needs. The papilla of Vater is a small nipple like structure with an opening to the bile duct and pancreatic duct. Once this has been identified, a small plastic catheter is passed through the duodenoscope into the bile duct or pancreatic duct through the papilla. Dye is then injected into the area and X-rays are taken of the bile ducts and pancreatic duct. In cases where a biopsy is needed, other instruments can also be passed through the endoscope. Plastic or metal stents can also be passed through this to relieve obstructions in the bile ducts and pancreatic ducts.

ERCP can be used to diagnose and treat a number of conditions in the liver, bile ducts, gall bladder, pancreas and papilla of Vater. These include:

  Blockage of the bile duct by gallstones, cancer, scars, tumors or compression from adjacent organs.

  Jaundice due to an obstructed bile duct. This can also cause light stools and dark urine.

  Persistent upper abdominal pain

  Unexplained weight loss and loss of appetite

  Diagnosing a Dysfunctioning Sphincter of Oddi within the Papilla of Vater

ERCP can also be used to confirm pancreatic cancer and cancer of the bile duct. Once the diagnosis is confirmed, the doctors can customize treatment according to the patient s needs.

Endoscopic Retrograde Cholangiopancreatography - Procedure and Results

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

Sitting or standing slouched does not only look bad but also has a bad effect on your spine. If not addressed in time, bad posture can become a person s second nature. Over time bad posture can change the natural curvature of your spine and lead to a number of health issues. Here are a few tips that could help:

1. Follow the structure of the chair
We spend a lot of time on office chairs. A well-designed chair will follow ergonomic guidelines to support your body. However, this can help only if you sit on the chair properly. Distribute your weight evenly on the chair. Try to align your body to the center of the chair. To do this try keeping your ears, shoulder, and hips in a straight line. Alternate between sitting at the edge of your seat and against the backrest to relieve your back muscles.

2. Change Positions
Though you can t change your desk every few hours, you can change how you sit. Tiredness is one of the leading causes for slumping and bad posture. Thus, to maintain a good posture try changing positions frequently. Stretch every half hour or so. Getting up from your table and walking over to a colleague to tell them something instead of calling them can give your muscles a break.

3. Use posture-friendly props
Along with ergonomic chairs, there are a number of other ergonomic props that could help maintain good posture. This includes footrests, pillows to support the lower back and lumbar back supports. These props can help ease the strain on the back muscles. Using a chair with an adjustable back is also a good idea. While walking, invest in bags and backpacks that are ergonomically designed to distribute their weight evenly over the entire back.

4. Exercise right
Improved posture is one of the many benefits of regular exercise. Cardiovascular exercises such as walking, running, and swimming help condition the body and maintain a good balance. Exercises that strengthen the back muscles are also great for posture. These exercises support the muscles of the upper body and relieve stress on the back muscles.

5. Wear the right footwear
Wear shoes that fit right and support the arches of your foot. This can help you maintain your balance and improve posture. Avoid wearing high heels for extended periods of time as they could have a negative effect on your center of gravity. In case you have a concern or query you can always consult an expert & get answers to your questions!

Tips For Improving Posture And Ergonomics!

Gallstones are small stones that form in the gallbladder as a result of the deposits caused by the bile, a type of digestive fluid. Actually, the gallbladder stores bile and releases it into the duodenum (part of the small intestine) for the digestion of fats. However, when the gallbladder is unable to release the bile properly, the bile deposits start building up and manifest in the form of stones. These stones vary in size, ranging from tiny sand-like grains to big golf ball-like stones.

Symptoms of gallstones: Many times, individuals have stones in their gallbladder and yet they do not experience any discomfort. These stones are very small in size and therefore, do not cause trouble. This is why they are called silent stones and for such individuals, treatment is not needed. But if an individual experiences discomfort, it is a signal for treatment. The signals come in the form of specific symptoms such as pain in the upper right side of the abdomen, pain between the shoulder blades, nausea, vomiting, fever, and even jaundice.

Causes of gallstones: Gallstones may result due to common. Excess bilirubin produced by the liver causes hard, dark brown stones called pigment gallstones. Even when the gallbladder cannot empty the bile, stones are formed due to the concentration of bile.

Treatment: Once gallstones are detected through a CT scan or ultrasound, the doctor begins the course of treatment. Gallstones can be removed only through surgery. In surgery, the gallbladder is removed to help the bile flow directly into the duodenum from the liver. This surgery is called cholecystectomy and it is a safe procedure. The removal of gallbladder does not affect the digestive system in any way. 

Prevention: Gallstones can form in any individual s gallbladder but some people are more susceptible to the condition. Such individuals include women over 40, those who lead a sedentary lifestyle, obese/overweight individuals, and those with a family history of gallstones. Therefore, such people should be aware of the risk they face. If such individuals report any symptoms related to gallbladder stones, they should get it diagnosed immediately. Apart from this, one should also keep a check on the diet. A high-fat or high-cholesterol diet should be replaced with a high-fiber diet and one should also take meals on time. Not eating anything for long hours and fasting increases the risk of gallstones. Regular exercise also helps in this matter. Last but not the least, one should drink plenty of water as it regulates the functioning of the liver and prevents the formation of stones. Gallstones are a common disorder but they cause difficulties for the patient and hence, one should get it treated on time. If surgery is recommended, one should not delay it and get it done as soon as possible. Delay only aggravates the problem.

Gallstones - What All Should You Know About It?

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