If you are experiencing pain in the muscles and joints, an enhanced craving for salt, symptoms of low glucose in the blood or low blood pressure, you could be suffering from adrenal insufficiency (AI). The outer layer or cortex of our adrenal gland produces three forms of steroid hormones. In adrenal insufficiency, the cortex fails to produce enough steroid hormones. Some people do not know that they have been affected with adrenal insufficiency until they experience a sudden worsening of symptoms. This is called an adrenal crisis.

Causes
The different types of adrenal insufficiencies occur because of different reasons. Primary AI is commonly caused by autoimmune diseases in which our body s defence system destroys the body s tissues. Bleeding in glands, genetic diseases and infections are other likely causes.

Secondary AI occurs because of problems with the pituitary gland. The pituitary gland produces a hormone named adrenocorticotrophic hormone (ACTH) because of which the adrenal glands produce cortisol. In the case of secondary AI, the pituitary glands stop sending ACTH to the adrenal glands, and cortisol is hence not produced. This may occur by taking certain prescribed medicines.

Diagnosis
A patients s medical symptoms and medical history are observed. The blood levels of cortisol, sodium, potassium and glucose are checked for the detection of AI. The adrenal glands and the pituitary gland are observed by imaging tests. X-rays, ultrasound, and CT and MRI scans may be required.

Treatment
The treatment of adrenal insufficiency aims at ensuring proper levels of hormones in the body. You may require regular replacement of hormones for life. You have to take glucocorticoids for replacing the cortisol which your body does not provide anymore. Mineralocorticoids should be taken when the body does not produce aldosterone. Extra glucocorticoids may be required during times of intense stress such as a surgery or serious health conditions.

Glucocorticoid helps the body in coping with stress, injury and illness. It helps in the regulation of blood glucose levels and blood pressure levels. It performs the function of cortisol.
Mineralocorticoid helps in maintaining a proper balance of water and salt in our body. This is actually carried out by aldosterone.
Adrenal androgens, which are weak male sex hormones, present in both men and women, help in the regulation of pubic and armpit hair growth in women.
If you experience any symptoms of adrenal insufficiency, it is recommended that you visit a doctor immediately. Early diagnosis will enable early treatment, which is beneficial for you.

Adrenal Insufficiency (AI) - Ways It Can Be Treated!

Ovarian cysts and fertility: Is there a connection?

Having a child is one of the most profound experiences in a woman s life. The joy of being a mother and welcoming a new life is unparalleled. In the midst of such expectation, an inability to conceive can take a serious toll on any woman s health. The mental scars from such an event can never be obliterated.

This does not mean you should give up. Consult a doctor to find the cause and rectify it. With advances in medical science and technologies like IVF in the market, no fertility challenge is insurmountable.

One of the most common cause of infertility is ovarian cysts. According to research conducted by the American Society For Reproductive Medicine, ovarian cysts resulting in ovulation abnormality and infertility has been recorded among 25% of women.

There are two types of cysts that are produced as byproducts of ovulation-

1. Follicular Cysts which does not break open to release the eggs. Rather the follicle stays as a whole while the cyst continues to grow.

2. Corpus Cysts or luteal cysts is a condition when after the egg has bronek free, the follicles seal itself rather than shrinking and the fluid builds up inside.

Causes-

Ovarian cysts are mainly caused due to hormonal imbalance, abnormal cell growth where the cells overgrow and develop into cysts, pelvic infections that spread to the ovaries and fallopian tubes and causes severe harm to them, and endometriosis when the tissue attaches to an ovary and forms cell growth.

Which ovarian cyst affects fertility?

Ovarian cysts that generate complications during pregnancy include-

1. Endometriomas - This is the condition when the tissues lining your uterus or endometrium grows outside the uterus or the fallopian tubes and is largely associated with fertility problems. Endometriomas can differ in sizes from the range of less than an inch to over 6 inches. They are filled with dark coloured blood.

Some studies have demonstrated that women suffering from mild endometriosis develop a lower (2%-4%) chance of getting pregnant each month when compared to women who are healthy and have a 15%-20% chance. Another research states that 40% of unexplained infertility results from endometriosis through anatomical distortion or inflammation.

2. Polycystic Ovary Syndrome - PCOS is the condition where small cysts form inside your ovaries which prompts irregular periods, excessive stomach cramps and large hormonal imbalance. Connected to immature ovaries, they do not assist in ovulation and thus produces complications infertility. The immature follicles with an immature egg cause the ovary to be politic.

This chronic lack of ovulation also alters the hormonal levels in your body that assists in ovulation. Women with PCOS develop high levels of androgen or male hormones in your body, which gets converted to estrogen. As a result, they do not ovulate.

Does the treatment of ovarian cysts also affect fertility?

This usually depends on the kind of treatment you receive. Hormonal birth control doesn t have a long-term effect on fertility. Although surgeries can invariably damage some healthy eggs inside your body, the doctors recommend that the ovaries be removed before you have more complications. However, in both the situations, the egg count in your body decreases significantly.

Ovarian Cysts & Fertility - Is There A Connection?

Bariatric surgery is a surgery performed on the stomach and is usually recommended for people who are obese. If you have a BMI value more than 40, then this surgery is a very good option. Along with those having an obesity problem, this surgery is also said to be ideal for those people who are suffering from type 2 diabetes and having a BMI value between 35 to 40.

There are many studies which show that there is a great improvement in people with type 2 diabetes after bariatric surgery. Even the cholesterol and blood pressure levels can also be controlled with the help of this surgery. Post-surgery, you will have to take fewer medicines or in some cases, you need not have to take medicine at all.

How does the doctor decide if you need bariatric surgery?
Basically, there are two things that will be considered by the doctor. The first one is the BMI value, which should be above 35. And the second parameter to consider is if you have tried any other methods to lose weight but did not succeed. Based on these and if you are ready to face the mental and physical challenges after the surgery, you will be advised to go through this surgery. You should make sure that you are doing regular exercise and also eat less.

Types of bariatric surgeries for type 2 diabetes

Gastric bypass: In this kind of surgery, the stomach is divided into two parts. One small part at the top is separated from the lower part of the stomach. Whatever you eat, will go into this small part of the stomach and that makes you feel full faster. Also, fewer nutrients and calories are absorbed into the body. After this kind of surgery, more than 80 percent of diabetes patients showed no signs of diabetes at all.
Gastric sleeve: In this surgery, a large portion of the stomach is removed and hence you will be able to eat less. This also reduces the amount of ghrelin, the hormone responsible for making you feel hungry, produced. This is successful in 60 percent of people with type 2 diabetes.
Adjustable gastric band: A small inflatable band is placed around the stomach. This will look like a small pouch at the place where the food goes in. This pouch will get full a lot quicker and hence you will not be able to eat too much.
Does it help?
Some surgeries show 80 percent success rate and some show 60 percent success rate, but that is in terms of diabetes levels. Due to less food, the body will not get the required minerals and vitamins, which will result in other health complications. Some surgeries are also irreversible. So, it is your doctor who understands the surgery and your health better and they will always suggest the best option for you.

Bariatric Surgery For Type 2 Diabetes - Does It Help?

Prostate cancer is one of the most common cancers that men are diagnosed with. It is accompanied by a number of difficulties of urination and ejaculation. It can also cause difficulty in achieving and sustaining an erection. If cancer advances and affects the bone structure and the spine, it can cause weakness in the limbs, and also result in urinary and fecal incontinence. If it is diagnosed in its early stages it can be treated quite easily before it spreads.

Treatment for Prostate Cancer-
Prostate cancer generally does not show any symptom in the early stage but progressively degenerates with time. If you suspect having any of the symptoms of prostate cancer such as urination difficulty, erectile dysfunction and discomfort in the pelvic region, then consulting an oncologist is the next step. Your doctor will perform certain diagnostic tests like digital rectal examination (DRE) and prostate-specific antigen (PSA) test. After the diagnosis of prostate cancer, doctors generally check the stage and rate of growth of a tumour by determining its Gleason score.



Once the extent of the prostate cancer is known, a treatment plan is devised by the doctor. If the cancer is localised and small, your doctor will either prescribe active surveillance or surgery. During active surveillance, there is a blood test, rectal examination, and biopsies on a regular basis to monitor the growth of a tumour. However, the tumour can also be deftly removed with surgical intervention in the form of Radical Prostatectomy. There are two types of radical prostatectomy- laparoscopic prostatectomy and robotic laparoscopic prostatectomy

Robotic Radical Prostatectomy-
A radical prostatectomy is one of the most common methods of treating prostate cancer. It involves the surgical removal of the prostate gland along with some of the surrounding tissues. This curtails the spreading of the cancerous cells to other parts of the body. A robotic radical prostatectomy is a minimally invasive procedure that involves the use of a robotic instrument that is controlled by surgeons to make the removal of the gland precise and efficient. The surgeon controls the robot by sitting at a console and makes several small incisions to enter the abdomen. This procedure reduces the risks of blood loss and any possible side-effect that includes erectile dysfunction and urinary difficulties.

Robotic Radical Prostatectomy For Cancer Prostate!

The kidneys are primarily responsible for filtering blood and removing waste from the body. They also regulate the fluid and electrolyte balance. If the kidneys stop functioning, a patient may need to undergo dialysis or have a renal transplant. Many patients prefer undergoing a transplant as it offers a better quality of life in the long run.

A kidney transplant can be described as a procedure to replace one s own kidneys with a donor's kidney. In case of kidney transplant, there are two types of donors. The human body can function with one healthy kidney and hence family members and friends of the patient may choose to donate a kidney. Else, a kidney may be sourced from recently deceased donors who have chosen to donate their organs after death. In both cases, it is important that the donor kidney match the patient s blood and tissue type.

A renal transplant surgery usually takes about 3 hours. The donor kidney is placed in the abdominal cavity and connected to the patient s arteries, veins and bladder. Usually, the donor kidney begins functioning immediately. The patient s own damaged or diseased kidneys may not be removed unless there is a severe infection, cancer or a diagnosis of large polycystic kidneys.

The patient will need to be hospitalized for a few days after the surgery. In some cases, dialysis may be needed if the kidneys are unable to produce urine. In addition diuretics and other medication may be needed to remove excess water and salt from the body. Medication will also be prescribed to suppress the immune system so that the patient s body does not reject the donor kidney. These medications typically need to be taken for the rest of the patient s life.

A renal transplant is considered a relatively safe procedure. Less than 20 out of 100 people reject a donor kidney. However, there are a few other risks involved. These include:
  Bleeding
  Severe infection
  Failure of the donor kidney
  Reaction to anesthesia
  Increased risk of infections due to suppressed immune system

Kidney transplant is not advised for people suffering from diseases such as cancer or any significant lung or heart disease. If the patient is suffering from an infection, he or she may be advised to wait until the infection subsides before undergoing a renal transplant. A renal transplant may seem to be an expensive procedure but in the long run, this can work out to be more budget friendly than dialysis.

Renal Transplant - What Should You Know About It?

Adrenal Glands are endocrine glands located right above the kidneys. They produce important hormones such as adrenaline, aldosterone and cortisol which are involved in a number of biological functions. The dysfunction of the adrenal glands can cause serious endocrine diseases.

Need for Surgery?
The adrenal glands may not function properly due to a number of reasons, including any kind of infection in the glands, kidney disorders, genetic ailments, lesions, tumours on or around the adrenal glands. Due to the irregularity in the release of hormones and enzymes that are essential to the normal functioning of a human body, a number of serious illnesses arise. There is an excess or absolute insufficiency in the release of hormones. This can even turn into a medical emergency. It can lead to uncontrollable obesity, very high or low blood pressure, dermatological problems, menstrual irregularities, blood sugar level irregularities, severe headaches, cramps, fluctuations in potassium levels and so on. That is when surgery is required.

How surgery is performed?
Laparoscopy is the type of surgery which requires minimum invasion. This is fairly a new and successful method of surgery. The patient recovers speedily and is able to go back home within a short span of time after the surgery. Removal of adrenal glands can be performed by making a maximum of three or four-and-a-half inches incision. This results in quicker cosmetic recovery compared to other patients of open surgery.
The surgery is performed under general anaesthesia. A narrow tube-like instrument, known as the cannula is placed into the upper abdominal cavity, below the ribs. Through the cannula, a tiny telescope, known as the laparoscope is inserted. It is connected to a special camera that provides a magnified view of the patient s internal organs on a large monitor. Using such technology, the adrenal glands are dissected free from other organs and removed.

Post Operative Care
In case of a simple laparoscopic surgery, there are hardly any post operative complications. In case of mild pain or discomfort, the doctors may however prescribe some medications. It is important to go for a medical check up after a couple of weeks of the surgery, to make sure you are completely fine.

Laparoscopic Adrenal Gland Removal Surgery - What Is It?

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