Thyroid disorders are conditions that affect the thyroid gland, which is a butterfly-shaped gland in front of the neck. There are specific kinds of thyroid disorders that include:

Hypothyroidism
Hyperthyroidism
Goiter
Thyroid Nodules
Thyroid Cancer
Epidemiology, Incidence, and Prevalence
It has been estimated that about 42 million people in India suffer from thyroid diseases.

Hypothyroidism

Hypothyroidism occurs when the thyroid gland produces an insufficient amount of thyroid hormone. It can develop from problems within the thyroid gland, pituitary gland, or hypothalamus. 

Symptoms of hypothyroidism can include:

Fatigue
Poor concentration or feeling mentally "foggy"
Dry skin
Constipation
Feeling cold
Fluid retention
Muscle and joint aches
Depression
Prolonged or excessive menstrual bleeding in women
Common Causes of Hypothyroidism

Hashimoto's thyroiditis (an autoimmune condition that causes inflammation of the thyroid gland)
Thyroid hormone resistance
Other types involving inflammation of the thyroid, such as acute thyroiditis and postpartum thyroiditis
Hyperthyroidism

Hyperthyroidism refers to the excessive production of thyroid hormone, a less common condition than hypothyroidism. Symptoms of hyperthyroidism are usually related to increased metabolism. In mild cases, there may not be apparent symptoms.

Signs and symptoms of hyperthyroidism can include:

Tremors
Nervousness
Fast heart rate
Fatigue
Intolerance for heat
Increase in bowel movements
Increased sweating 
Concentration problems
Unintentional weight loss
Common causes of hyperthyroidism

Graves' disease
Toxic multinodular goiter
Thyroid nodules that overexpress thyroid hormone (known as "hot" nodules) 
Abnormal secretion of TSH
Thyroiditis (inflammation of the thyroid gland)
Excessive iodine intake
Goiter: A goiter is an enlargement of the thyroid gland, regardless of cause. A goiter may be associated with hypothyroidism, hyperthyroidism, or a normal thyroid function. 

Thyroid Nodules: Nodules are lumps or abnormal masses in the thyroid. Nodules can be caused by benign cysts, benign tumors, or less commonly, by cancers of the thyroid. If nodules are excessively large, they may cause symptoms related to compression of nearby structures. 

Thyroid Cancer: Thyroid cancer is more common among adult women than men or youth. About 2/3rd of cases occur in people under age 55. There are different kinds of thyroid cancers depending upon the specific cell type within the thyroid that has become cancerous. Most cases of thyroid cancer have a good prognosis and high survival rates, especially when diagnosed in its early stages.

Investigations

Blood tests are done to measure levels of thyroid hormones. Blood tests are also done to identify antibodies against thyroid tissue, such as titers of antithyroglobulin, antithyroperoxidase, or TSH receptor-stimulating antibodies.

Treatment

Thyroid disorders can be treated with medications or, in some cases, surgery. The treatment will depend on the particular disease of the thyroid.Medications can be given to replace the missing thyroid hormone in hypothyroidism. Synthetic thyroid hormone is given in pill form by mouth. When hyperthyroidism is present, medications can be used to decrease the production of thyroid hormone or prevent its release from the gland. 

Thyroid Disorder - What All Should You Know 

Hiatal hernia takes place when the upper portion of the stomach pushes itself through an opening in the diaphragm, into the chest cavity. The diaphragm is a wall of thin muscles, which separates the chest cavity and the abdomen. In most cases, a small hiatal hernia doesn't cause problems and you may never know you have a hiatal hernia unless your doctor discovers it when checking for another condition.

But a large hiatal hernia can allow food and acid to back up into your oesophagus, leading to heartburn. Self-care measures or medications can usually relieve these symptoms, although a very large hiatal hernia sometimes requires surgery.

Causes

Hiatal hernia is primarily or most commonly caused due to the increase in pressure in the abdominal cavity. Sometimes, a lot of pressure may be felt around the stomach accompanied by coughing, vomiting, strain during bowel movements. For people born with an abnormal hiatus, the chance of getting hiatal hernia is more.

The two common types of hiatal hernia are:

 Sliding hiatal hernia, which occurs during the sliding out of the stomach and oesophagus into and out of the chest through the hiatus. This type of hiatal hernia is less intense and has no symptoms.
 Fixed hiatal hernia or paraoesophageal hernia is an uncommon type of hernia where a part of the stomach pushes through the diaphragm and stays there.

Symptoms

Usually, no symptoms are experienced during hiatal hernia. Some symptoms are experienced that happen due to stomach acids, bile or air, which enters the oesophagus. Some common symptoms include:

 Heartburns which become worse when a person lies down
 Chest pain, better called epigastric pain
 Problem in swallowing food
 Belching

Tests for diagnosis

Several tests can be carried out for the diagnosis of hiatal hernia. They include:

 Barium x-ray, where a person is made to drink a liquid filled with barium before the x-ray. The x-ray provides a clear image of the upper digestive tract region and the location of the stomach can be seen. If it is protruded out, hiatal hernia is signified.
 Endoscopy is another test for detection of hiatal hernia. A thin tube slides down the throat, which reaches up to the oesophagus and stomach. This will determine whether the stomach is pushing through the diaphragm or not.

Treatment

Medicines, which are used to cure a hiatal hernia may include antacids for neutralizing stomach acid, h2 receptor blockers to lower acid production and proton pump inhibitors. Sometimes fundoplication surgery is required for the treatment of hiatal hernia, although it is rare. Some common surgical techniques are rebuilding of oesophageal muscles or a surgery to put the stomach back in its actual place. Laparoscopic surgery methods are used. Hiatal hernia may reoccur even after surgery; so general precautions should be taken. You should:

 Exercise regularly and maintain a healthy weight
 Avoid lifting heavy objects and ask for help
 Avoid any kind of strain on the abdominal muscles

Hiatal hernia is a disorder, which is more common among people over the age of fifty. Necessary precautions and treatment should be adopted in case of hiatal hernia.


All About Hiatal Hernia

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

Surgery using a laparoscope is the most common way to remove the gallbladder. A laparoscope is a thin, lighted tube that lets the doctor see inside our belly. It is a minimally invasive surgery in which small incisions and specialized tools are used to remove a diseased or infected gallbladder.

The gallbladder is a small organ that sits right under the liver and is credited with bile storage, which can help the body in breaking down various kinds of fats that enter it. So, what all do you need to know about this operation? read this list.

Reasons for gallbladder operation
The gallbladder is not a very efficient organ. It can lead to blockages and choking as the bile it stores can become very thick and difficult to handle. Also, this bile can harbour deposits that are hard ball like substances, usually known as gallbladder stones. The size of these stones can vary from the size of a grain to the size of a golf ball. 

Further, these gallbladder stones can cause infections, which can lead to symptoms like nausea, vomiting, bloating and more. Another reason can also be the gallbladder disease known as chloelithiasis, which can cause abdominal pain. Inflammation in the pancreas, also known as pancreatitis, can lead to gallbladder open removal surgery.

Risk
While the gallbladder removal surgery is usually considered a safe one, with little or no complications, there are risks attached to this surgery too. These include sudden and excessive bleeding and the creation of blood clots, allergic reactions to the drugs used as well as anaesthesia, blood vessel damage, accelerated heart rate which leads to an increased risk of contracting a heart attack or heart disease, infections, inflammation or swelling in the pancreas, and injuries caused to the bile duct during surgery.

You might also need this type of surgery if you have the following:
1. Biliary dyskinesia, which occurs when the gallbladder doesn't fill or empty correctly due to a defect
2. Choledocholithiasis, which occurs when gallstones move to the bile duct and potentially cause a blockage that prevents the gallbladder from draining
3. Cholecystitis, which is an inflammation of the gallbladder
4. Pancreatitis, which is an inflammation of the pancreas

Laparoscopic surgery is preferred over open cholecystectomy surgery because the smaller incisions that are made reduce your risk of infection, bleeding, and recovery time.

Preparation
To prepare for your gallbladder removal surgery, the doctor may ask you to have a prescription fluid so that your bowels are flushed clean. You may also be asked to fast for at least six hours before the surgery so that there is no hindrance to the same. Also, the use of an antibacterial soap to bathe is usually prescribed so that the risk of contracting infections decreases.

While this surgery can be a simple one, you will have to take due care after the surgery to ensure that the recovery is fast and virtually pain free.

All About Gallbladder Surgery

Cow urine therapy has been in practice for many health problems in india for centuries. In india, cow is a symbol of spirituality and cow urine is not only used in devotional practices, but also comes packed with a bunch of health benefits.

'kamadhenu' is worshipped for thousands of years as the goddess who fulfils desire. In ayurveda, cow is considered as the mother of all entities as the products obtained from cow are beneficial to all mankind in many ways. The milk, urine, curd, ghee and dung obtained from cow are beneficial in different ways as food supplement and medicine. Cow urine or gomutra destroys the poisonous effects of residues and makes body disease free. The medicinal usage of panchgavya, especially cow urine is practiced in ayurveda which is classified as complementary and alternative medicine.

The two indian epics, shushruta samhita and charaka samhita, have described that the consumption of cow urine produces body warmth. In modern medical science, it has been well established that the thyroid hormones are responsible for producing body warmth. The oral administration of cow urine has thyroid stimulating effect and therapeutic value of urinary iodine present in the cow urine is immense. Cow urine or gomutra contains iodine, which is easily absorbable from the gastrointestinal tract. The mean urinary iodine levels in dairy cows may vary from 79.2 to 94.8 micrograms of iodine per litre of urine depending upon their physiological conditions. Iodine is an essential element to produce thyroid hormones such as triiodothyronine and thyroxine. These are catabolic hormones that generate heat and cause body warmth. It has been proven that the cow urine contains iodine in required level for normal functioning of thyroid gland.

Urinary iodine concentration in cow urine varies depending upon its biological status and it could stimulate the patient's thyroid gland activity on oral administration of iodine. Thyroxine stimulates more oxygen utilization and heat production by many different cells of the body.

During iodine deficiency, the pituitary gland secretes enhanced amounts of thyroid stimulating hormone (tsh), which causes compensatory adjustment. This leads in the production of more extensive secretory epithelium which in turn will result in enlargement of the thyroid gland and loss of colloid material in the thyroid follicles. In this scenario, exogenous supplementation of iodine brings back the normal thyroid status.

The administration of cow urine, which contain good levels of iodine, can keep the thyroid gland activity on a better footing. We now have the support of scientific validation for the experience of warming up of the human body after consumption of cow urine or gomutra.

Cow Urine Therapy for Thyroid

An anal fistula, is also called as fistula- in -ano, it is a small channel that develops between the end of the large intestine called the anal canal and the skin near the anus. This is a painful condition, especially when the patient is passing stools. It can also cause bleeding and discharge during defecation.

Genesis of fistula-in-ano
Almost all anal fistulae occur due to an anorectal abscess that begins as an infection in one of the anal glands. This infection spreads down to the skin around the anus causing fistula-in -ano. The anorectal abscess usually leads to pain and swelling around the anus, along with fever. Treatment for anorectal abscess involves incising the skin over the abscess to drain the pus. This is done usually under local anesthesia. A fistula-in-ano happens when there is failure of the anorectal abscess wound to heal completely. Almost 50% of patients with an abscess go on to develop a chronic fistula-in-ano.

Symptoms

Pain- Constant pain which gets worse when sitting down
Irritation around the anus, like swelling, redness and tenderness
Discharge of blood or pus
Constipation or pain while evacuation
Fever
Diagnosis
A clinical evaluation, including a digital rectal examination under anesthesia, is carried out to diagnose anal fistula. However, few patients may be advised screening for rectal cancer, sexually transmitted diseases and diverticular disease.

Treatment
The only cure for an anal fistula is surgery. The type of surgery will depend on the position of the anal fistula. Most patients are treated by simply laying open the fistula tract to flush out pus, called Fistulotomy. This type is used in 85-95% of cases and the fistula tract heals after one to two months.

Seton techniques: A seton is a piece of thread (silk, plastic) which is left in the fistula tract to treat anal fissures. This is used if a patient is at high risk of developing incontinence after fistulotomy.
Advancement flap procedures: When the fistula is considered complex, carrying a high risk of incontinence, then this advanced technique is used.
Other techniques like Fibrin glue and Bioprosthetic plug are also used to surgically treat anal fistulas. In the Fibrin glue technique, glue is injected into the fistula to seal the tract, after which the opening is stitch closed. Bioprosthetic plug is a cone shaped plug made from human tissue, which is used to block the internal opening of the fistula. After this stitches are used to keep the plug in place. 

Whatever the surgical technique, one can experience minor changes in continence. Patients usually don t require antibiotics after surgery but have to take pain medication. They may also have to use gauze to soak up drainage from anus. After surgery, patients should seek help if they have increased pain or swelling, heavy bleeding, difficulty in urination, high temperature, nausea or constipation.

Fistula-in-Ano or Anal Fistula - How It Can Be Treated?

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