 Thyroid is a small gland situated in front of the neck and secretes hormones like thyroxine (T4) and tri-iodothyronine (T3). These hormones control various functions of our body like heart, blood pressure, digestion, metabolism, growth, blood formation, brain function etc. Any fluctuation in the functioning of the thyroid gland can have a great impact on health. The thyroid gland is primarily responsible for energy and metabolism. This gland triggers the genes that make all the cells in the body conduct their specific jobs. But over a period of time, the optimum functioning of the thyroid may reduce because of specific reasons. The gland may start to under-produce or overproduce the thyroid hormone, which may lead to conditions known as hypothyroidism or hyperthyroidism, respectively. 

Patients with hypothyroidism may feel extreme tiredness and fatigue even though they may be sleeping more than before. An unexplained gain in weight, constipation, inability to stand cold temperatures, and constant pain in muscles and joints are some of the other symptoms of hypothyroidism. 
Hyperthyroidism, or overactive thyroid, is an endocrine disorder. Patients with this disorder may experience excessive sweating, fatigue, and intolerance to heat. They may even experience restlessness, puffy or protruded eyes, hair loss, and muscle weakness. Such patients may lose weight and are unable to sleep properly at night. In some cases, palpitations or abnormal heart rhythm may also be experienced. 
Complications of Thyroid Disorder 

Hypothyroid and hyperthyroid can cause a number of complications if patients don t take medications. It is important for you to not to ignore any of the aforementioned symptoms and speak to your doctor as soon as possible. 

Hypothyroid complications

Myxedema: This condition is characterized by slowed thinking, swelling of tissues, and accumulation of fluid around major organs like brain, lungs and/or heart. This condition may prove life-threatening if not treated on time. 
Enlarged goiter: This is characterized by enlargement of the thyroid gland because of a constant increase in the TSH levels. High cholesterol and triglycerides: This may eventually pave way for heart disease and stroke. 
Sleep apnea: Sleep apnea is a disorder that affects nighttime breathing where the brain that temporarily stops sending signals to the muscles that control breathing, or by an obstruction in the airway. This may prove fatal if left untreated. 
Low blood pressure: This means not enough blood is getting to capillaries and tissues, particularly in your hands, feet, and brain. You may have chronic nail fungal infections and cold hands and feet if so. 
Hyperthyroid complications 

Heart disorders (cardiac arrest): If left untreated, excess thyroid hormones can lead to congestive heart failure and heart rhythm disorders. 
Osteoporosis: Too much thyroid hormones interfere with the body s ability to use calcium to build bone. This may lead to brittle bones and osteoporosis. 
Thyrotoxic crisis: This is a rare yet life-threatening complication characterized by high fever, vomiting, irregular heartbeat, and agitation. 
Hypertension or high blood pressure: It is a condition in which a patient has high blood force striking the walls of the artery An early diagnosis can help make the treatment of this disorder easier. 
Depending on the condition of the thyroid condition, it requires different ways to manage it. The conventional TSH (thyroid-stimulating hormone) and T-4 (thyroxine) blood tests will be advised and the results should provide a reasonable confirmation of the condition. If doubts still persist an ultrasound or scan can also be ordered. In case you have a concern or query you can always consult an expert & get answers to your questions!

Is Your Thyroid Gland Working Against Your Body? 

Laparoscopy surgery is a very vital component of the hernia repair. Studies have shown that many patients have a better outcome when they opt for laparoscopic surgery. Candidates eligible for this mode of surgery include those with bilateral inguinal hernias, ventral hernias, and recurrent hernia. People associated with athletics and other outdoor sports prefer to go for a laparoscopic hernia surgery as it ensures a speedy recovery and minimal tissue invasion (due to small incisions).

Laparoscopic hernia repair- inguinal
A laparoscopic surgery requires an incision of 1-2 cm at the belly (at the lower end). Two small punctures are done near the umbilicus. The punctures are done to make room for the cameras so that the surgeon is able to view the abdomen clearly. The smaller incisions allows the operating instrument to enter into the stomach.

The Procedure:
A balloon is placed in between the abdomen and the overlying muscle so that the peritoneum can be separated. When space is successfully made, the camera comes into the action to view the condition of a hernia. A hernia is pulled from its hole into the abdomen. Once the hole is detected, the defect of a hernia is fixed.

Laparoscopic hernia repair- incisional/ventral: Laparoscopic hernia repair is suitable for all types of a hernia such as an umbilical hernia, ventral hernia, recurrent umbilical hernia, epigastric hernia etc. Just like an inguinal hernia, A camera is placed into the abdomen through the muscles. Two small incisions are made for the operating instruments to get through. This is followed by the cutting of the tissue that is placed between a hernia and the intestine. The hole thus gets exposed. Through one of the laparoscopic ports, the hernia mesh gets rolled and is placed into the abdomen. A hernia is then pulled up and the mesh gets secured with 4 sutures. A special device is used to fix the healthy muscle.

Tension free repair: Tension free  repair is often used to symbolize hernia surgery. A hernia is often triggered by the weakened muscles. Few surgeons endeavors to sew the muscle around the area of a hernia. Since the muscles surrounding the hernia are weak in the first place, they pull apart causing a recurrence of a hernia. To avoid this, most surgeons use a mesh to strengthen the cells around the hernia region. This procedure ensures that the muscles aren t sewn but the mesh placed over the hole can prevent the muscle to push through the walls of the abdomen.

The use of mesh: There are some reservations about using the mesh in a hernia surgery. However, this is the safest and most appropriate way to perform a hernia laparoscopic surgery. The use of a mesh also negates the risk of open incisions and recurrence of a hernia.

Types of Hernia - How Laproscopy Can Help Manage?

Haemorrhoids or piles is a condition where the veins in and around your anus become swollen. This swollen vein sticks out from the anus and can make sitting and moving difficult. Laser haemorrhoidoplasty is one of the best ways to treat advanced forms of the condition. However, before knowing more about the procedure, you should learn more about piles in general.

Causes of piles-
You are likely to develop piles in the following events  
  If you strain excessively during bowel movements
  If you sit for prolonged periods on the toilet
  If you suffer from constipation or chronic cases of diarrhoea
  If you are overweight or obese
  If you are pregnant
  If you engage in anal sexual intercourse
  If your diet lacks proper quantities of fibre
The likelihood of having piles increase with your age. This is because the tissues supporting your veins tend to lose their strength, as you grow old.

Symptoms of piles-
If you suffer from piles, you can easily notice certain symptoms from the condition. Here are the most common signs of haemorrhoids  
  You will notice bleeding during bowel movements. However, you will not feel any pain from the said bleeding.
  Your anal and rectum area will itch throughout the day. You will experience irritation in the region as well.
  You will notice a lump formation near the anus, which will lead to extreme pain and discomfort. Sitting and walking may also become painful due to the presence of the lump
  You may also notice a general swelling in your anus region.
However, the exact symptoms may vary from one affected person to the next, based on the location and type of haemorrhoids.

How does laser haemorroidoplasty help in the treatment of piles?
While most haemorrhoids are treated with medication and lifestyle changes alone, advanced cases require additional procedures. Laser haemorrhoidoplasty is one such procedure used to treat severe piles cases.
This treatment results in the reduction of the size of the haemorrhoid. The laser energy passes through the haemorrhoidal node, destroying it in the process.

Here are some advantages of laser haemorrhoidoplasty  
  Closes the arteries carrying blood inside the haemorrhoid
  Reduction of the haemorrhoidal node tissues
  Preservation of most of the mucosa, anal lining and muscle
  Rectifies the issues with the anatomical structure and restores it to normal
  A minimally invasive procedure, which limits post-operative pain and scarring

If you suffer from an advanced stage of piles, speak to your doctor and see whether laser haemorrhoidoplasty is an option for you.

Laser Haemorrhoidoplasty - What All Should You Know About It?

Anal Fistula is a tunnel like communication structure between anal canal and outer skin. There are certain glands in anus whose secretions keep the anal passage lubricated. If due to any reason infectious agent invades these glands abscess formation occurs which subsequently spreads towards the skin and bursts outside forming an external opening.

So Anal Fistula presents itself as a nodular swelling in area surrounding anal opening. Intermittent pus discharge is seen from this swelling. When pus has accumulated there will be swelling and pain which subsides once the pus has been discharged and this cycle goes on.

Anal Fistula Treatment:

Anal Fistula cannot be treated by oral medicines only - Homeopathic/ Allopathic or Ayurvedic whatever it may be. Continuing oral medicines in hope for fistula treatment only worsens the problem. Different surgical options have been tried to treat Anal Fistula like Fistulectomy/ VAAFT/ Laser/ LIFT etc. but not satisfactory results have been found. A high incidence of recurrence around 20-25 % has been observed with these procedures. 

Besides this other complications like stool incontinence etc. are also seen if there is some damage to sphincter muscles. However Anal Fistula can be completely treated by Graded KsharsutraTM Treatment. Clinical trials conducted by Indian Council of Medical Research (ICMR) at AIIMS new Delhi; PGI Chandigarh and other premier institutes of medical sciences; have proved that Ksharsutra treatment is more convenient and more effective than Surgery in patients suffering from Anal Fistula.

In this treatment; first of all Fistula tract is defined with respect to depth, direction and branching pattern by careful manual probing and MRI Fistulogram. Once the Fistula tract has been defined properly; Graded KsharsutraTM - a specialized medicated thread is placed in Fistula tract. Medicine released from KsharsutraTM debrides the Fistula tract and induces healing. This medicine works for 5-7 days so old Ksharsutra needs to be replaced by a new thread at week or 10 days interval.

No. of Ksharsutra changes required for complete healing of Fistula depends on length of Fistulous tract. It has been observed that a Fistula tract of 3 cm length usually requires 4-5 Graded KsharsutraTM sittings at weekly intervals for complete healing. Thus with this recent concept of Graded Ksharsutra treatment of Anal Fistula has become more easy and more effective.

Anal Fistula - How Non Surgical Treatment Is Better Than VAAFT/Surgery?

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

Gall bladder stones can be painful. Until and unless it is surgically removed and cured from within, the pain continues to hinder daily life. The good news is that there are ways by which pain from gall bladder stones could be managed. 

Here is a list of quick, easy-to-follow remedies to counter the pain.

Heat Pack: Applying a heat pack or hot water bottle on to the stomach making sure that the heat is directly passed on to the gall bladder can give instant relief from the pain. The heat should be applied at an interval of half an hour and a layer of cloth should be placed in between the skin and the heat pack.
Over the counter medicine: In most cases, over the counter pain relief meds can make the pain go away. NSAIDs should be avoided until and unless suggested by the doctor. A pain relief medicine with anti-inflammatory properties will perfectly suit the gall bladder condition.
Try vegetable juice: While gulping vegetable juice might sound a little indifferent, it has instant benefits with no side effect. All it needs is to mix beetroot, cucumber, and carrot in equal proportions and extract the juice from it. The juice extracted from this mixture should be consumed twice in a week to flush out the toxins from the system and ease the gall bladder pain.
Citrus fruits: Citrus fruits such as lemon, orange etc. contains pectin that is believed to be a remover of stones and blockages. This is also believed to be a great agent for countering pain originating from the gall bladder. Consumption of 10-12 tablespoon of lemon juice extracted from fresh lemons followed by a glass of water will wither the pain away in few weeks.
A mixture of honey and turmeric: Honey s antiseptic nature prevents infection and the curcumin found in turmeric makes the bile more soluble in the gall bladder. These two herbs in tandem can ease the gall bladder pain and get relief from the stones too. A tablespoon of honey and 1 tablespoon of turmeric should be consumed daily to get the benefits.
Take the herbal route: There are several herbals that are believed to be extremely effective in treating pain origination from the gall bladder. Some of them include goldenseal, quebrapedra, catnip, fennel seed, yellow dock, rosemary, nettle, peppermint herbal tea etc.
Apple Cider Vinegar: Apple cider vinegar is acidic in nature and consumption of a quarter of a glass followed by a quarter of a glass of apple juice can show instant results. It should be consumed daily after breakfast. There are instances where the pain eases out within a matter of 15 minutes.

Gall Bladder Stone Pain - Tips To Help You Manage It!

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