Inguino-scrotal and Inguino-labial swellings are common in children during infancy. A common cause of an Inguino-scrotal swelling in children is the presence of a patent processus vaginalis. It presents in the form of an inguinal hernia or hydrocele. Male infants are often affected 3 to 6 times more than the female ones. Processus vaginalis is the outpouching of peritoneum that extends through the inguinal canal. It is first seen during the 3rd month of intrauterine life. It follows the gubernaculum and testes through the inguinal canal and reaches the scrotum by the 7th month of gestation. 

Differential diagnosis of inguino-scrotal swelling in children: 

Inguinal hernia and hydrocele 
Torsion testes, epididymorchitis 
Undescended testes 
Varicocele 
Enlarged inguinal lymph node 
Abscess or lipoma 
Normally after the testicular descent, the portion of processus vaginalis surrounding the testis becomes tunica vaginalis. The processus vaginalis gets obliterated, eliminating the communication between peritoneal cavity and scrotum. A patent processus vaginalis is seen up to 20% in adulthood. 

Hernia and Hydrocele: The testicles or ovaries form in the abdomen near the kidneys, between 3 to 4 months of fetal development. Further, they gradually move down into the lower part of the abdomen as the fetus continues to develop. On descending downwards, small part of the peritoneum (a layer of tissue lining the abdomen from inside) that attaches to the testicle is drawn with it into the scrotum. This forms a pouch or sac. A similar process occurs in females as the round ligament of the uterus descends into the groin at the labia. The sac formed is processus vaginalis. Any connection between the abdominal cavity and the scrotum or groin is eliminated. When closure of the processus vaginalis is delayed or incomplete, it may stretch and eventually become a hernia. Stretching of processus vaginalis creates the inguinal sac that allows organs an extension from abdomen and entry into the sac. If fluid, rather than organs, builds up and remains in the sac, the child has a hydrocele. Approximately 80 percent to 90 percent of inguinal hernias appear in boys. They are more common on the right side, but in about 10 percent of cases, they occur on both sides (bilaterally). 

Epididymorchitis: Epididymitis is the pain and swelling of the tube that attaches to each testicle called as the epididymis. Orchitis is pain and swelling of the testicle. Since epididymis and testis lie next to each other, differentiation of the inflamed part is difficult. Hence, the term epididymo-orchitis is often used. Infection with bacteria often causes these problems. Other causes are infections from surgery or from a catheter that drains urine. The mumps virus also can cause orchitis. Analgesics or anti-inflammatory medicines can reduce the pain. Antibiotics are used if the problem is caused by bacteria. 

Torsion testis: It is a painful condition that occurs in the boys. It is a twisting of the testicles and the spermatic cord (the structure extending from the groin to the testes that contains nerves, ducts, and blood vessels). A decreased blood flow to the testes is caused by torsion of the testes. This torsion essentially strangles them of oxygen and nutrients. While it generally occurs in adolescent boys, it may also occur during fetal development or shortly after a baby is born. Urgent surgical procedure is undertaken if testicular torsion is confirmed in a child. The chance of survival for the testicle is best if surgery is completed within six hours of symptom onset.

Know The Types Of Inguinoscrotal Swelling In Children!

Osteoporosis is a condition wherein the bones become brittle and weak; so much so that even mildly stressful activities such as coughing, bending over or even a slight fall (such as the one from a high rise chair) can result in fractures. Osteoporosis-related fractures commonly occur in the spine, hip or the wrist. The human body has a continuous mechanism of bone absorption and removal. In case of osteoporosis, the creation of new bones doesn t happen in accordance with the removal of old bones.

Spinal Fractures:

The bones of the spine get extremely vulnerable to breakage and even cracking open. The fractures in the spine, also known as vertebral compression fractures can cause a sharp stinging pain in the back that may make sitting, standing, or even walking a very tardy task.

Risk Factors:

Increasing age

Abnormally less or high body weight

Smoking

Menopause or low levels of sex hormones

Gender: This disorder is more likely to affect women as compared to men. Also women, who are above 50 are more likely to suffer from this debilitating disorder.

Race is a significant risk factor of osteoporosis. If you are of Asian descent, you are more likely to be affected by it.

Having a family history of osteoporosis will put you at a greater risk of this disorder.

Symptoms:

Fractured or collapsed vertebra causing back pain

A stooped posture

A shrunken appearance (as if one has had loss of height)

Very fragile bones, thus increasing risks of fractures

Severe and sudden pain in the back

Difficulty in twisting or bending the body

Lower spine fractures are way more troublesome as compared to fractures in the upper spine. Fracturing more than a bone in the spine also remains a huge possibility.

Diagnosis and Treatment:

Firstly, an X-ray or a computerized tomography (CT scan) will be done to have a closer look at the bones. A bone density test is another commonly used method of diagnosing osteoporosis. 

Steroids and medications: Some medications may be used to prevent or combat osteoporosis. These include alendronate, ibandronate, risedronate and zoledronic acid.

Physical therapy: Just like muscles, bones get stronger too when you exercise. Weight-bearing and muscle- strengthening exercises are the most helpful in this regard and are considered best for the treatment of osteoporosis. Cardiovascular exercises such as walking, jogging or even swimming can prove to be immensely beneficial.

Diet: Make a diet chart that includes high-calcium food items, dairy products such as yogurt, cheese, and low-fat milk, tofu, green vegetables such as collard greens and broccoli, sea fish such as salmon and sardines.

Salt: Limit salt intake

Therapy: Hormone replacement therapy (treatment method consisting of estrogens to alleviate and treat symptoms of osteoporosis) is another method of treatment that can be recommended by the doctor.

Osteoporosis Spine Fractures: Risks, Symptoms and Treatments

The pain in the lower extremity of the body caused by the irritation of the sciatic nerve (the large nerve running down from the lower back of the body to each one of the legs) is referred to as Sciatica. Sciatica is caused by injury, inflammation or compression of the sciatic nerve and causes pain or numbness spreading to leg, buttocks, and hips. In Ayurveda, Sciatica is known by the name of Gradhrasi. It is believed to be aggravated by the imbalance of Vata Dosha.


Causes -

Sciatica can be caused by strenuous physical activity such as heavy weight lifting, or to exposure to extreme cold. Pressure on buttocks due to sitting or lying continuously for long hours, injury due to a fractured pelvis or trauma to thighs also damages the sciatic nerve.


Symptoms -

Pain in the back and the lower extremity of the body is the primary symptom of Sciatica. Also, there is a burning or tingling sensation in the affected area. It can also become numb. One may even find it difficult to walk. In severe cases, it becomes impossible to bend the knee or move the foot.


Treatment Through Ayurveda -

Through Ayurveda, Sciatica can be treated internally and externally by balancing the energies involved in the doshas:

Internal methods of treatment: Yogaraja Guggulu is the herbal pill consisting of Guggulu resin, twenty-five types of herbs and ghee effectively treats all types of pain associated with the nervous system. Dashamula Arishta, an elixir having sixty-three herbs, jaggery, plums, honey, and water has anti-inflammatory properties which help in toning up the affected nerve.

External methods of treatment: Application of Sarshapadi medicinal oil (made up of camphor, mustard oil, and vegetable turpentine as a base) on the affected area helps in relieving pain.

Panchakarma therapies are very effective in the treatment of this condition. They aim to relieve inflammation and release nerve compressions and spasms for strengthening the entire spine and the surrounding tissue. Generally, treatment through the Panchkarma therapies takes four to five weeks depending upon the severity of the condition. Following are some of the processes involved in treatment through Panchakarma:

Kativasti and Elakizi, Naranga Kizhi, Navarakizhi are very important in the treatment of sciatica.

Sarwang Abhyang is the full body massage with medicated warm oils for lubricating and nurturing the body for the pacification of Vayu.

Swedana refers to steaming the body for detoxification.

Vasti refers to the administration of medicated oils and decoction through anal route for treating the vatic disorder that is Sciatica as per Ayurveda. It pacifies dryness and strengthens intestines and is one of the permanent cures for most of the vatic disorders.

Siravedha is the venous puncture or venesection.

Agnikarma is the Cauterisation or burning the affected part.

Raktamokshan is the process for Blood purification.

Take Away-

Sciatica refers to the pain in the lower body due to an irritated sciatic nerve, caused due to nerve compression or trauma or injury. Through Ayurveda, Sciatica can be treated through internal or external methods as well as through Panchakarma therapies.

Sciatica - Panchakarma Therapy To Heal It!

Breaking a bone is, needless to say, a painful experience. But, when people have their broken bone put in a cast, they tend to forget about it until it comes out. This is quite wrong! A person would want to be up and running but does not find that the hand or the leg as it has been cast up. For weeks, the person's hand or leg barely moves and also shrinks up quite a lot!

There is a lot of pain, not only due to shrinkage when a fracture occurs. The occurrence itself causes what is known as acute pain. Then, for some weeks, the sub-acute pain just seems to persist, to the person having the fracture. The reason for this is the fact that the bone and the soft tissue are in the process of healing.

Chronic pain is a worry as it does not go away even after the healing process has ended. In order to make sure that there is a quick recovery and there is no chronic pain which is experienced at all, some of the proverbial leaves need to be taken out of the book of physiotherapy.

To start with, sometime between a fortnight and a month after the injury or the bone break has taken place, the doctor will wish to see some movement in the soft tissue that has broken around the bone. The great advantage of this is that while it may be a little bit of effort and time involved, there are great benefits by the way of less pain and swelling as the blood flows as normally as is possible.

If such movements are not done, a person can have related soreness, which can be even more of a pain! An example of this would be a broken foot or ankle causing the stiffness of the knee. When a person is already in pain, adding to his or her trouble makes no sense at all, does it?

Post one month mark, the physiotherapist would want to see more functioning so that the normal levels can be attained. A person who has a fracture should not despair as if he or she is willing to stick to the schedule given by the physiotherapist and perform all the exercises that have been set out, he or she will be back at the normal level much sooner than would have been expected!

Also, getting active again will reduce the risk of a repeat injury, and that is enough justification to do so!

What To Expect When Recovering From Broken Bones?

What is Developmental Dysplasia of the Hip?

Developmental dysplasia of the hip or DDH, is a condition that affects the hip joint in newborns and young children. The hip is like a ball-and-cup, formed by the round top of the thigh bone - called the femur - and a cup-shaped socket in the pelvis. The hip joint is stable in spite of its large range of motion and is kept in place by ligaments and other soft tissue structures. The normal infant hip is not mature at birth but develops into a strong and stable joint as the child grows.

What happens in hip dysplasia?

In DDH, the hip does not develop normally as the cup and ball are either partially or completely out of alignment. DDH can vary from mild to severe depending on whether the cup is shallow, soft tissue structures are lax or a combination of all. These problems may cause the hip to become unstable, and even come out of the joint. This is known as a dislocated hip and is believed to occur in around one in 1000 infants. One or both hips can be affected. DDH isn't painful in babies and young children. Untreated DDH can result in limping in young children. This can progress to hip pain and arthritis at a later date.

How common is it?

DDH is more common in girls and first-born children. It's more likely to occur if there's a family history or if the baby was breech. Swaddling or wrapping a baby's legs too tightly can also lead to DDH. Certain traditional practices like wrapping the children, etc. are known to increase the risk, while carrying them with limbs separated apart is known to decrease the risk of dysplasia. All newborns should have both hips carefully examined by a health professional. 

Treatment options

Treatment depends on the child's age and the severity of the condition. Young babies with confirmed DDH are usually treated in a brace or harness that holds the legs apart. This helps the hip socket to deepen and the hip to become stable with growth. Regular monitoring of the hip position is necessary to ensure good outcomes. Surgery may be necessary if brace treatment is unsuccessful, or if a hip dislocation is first noticed when the child is older.

What is the long-term outlook?

Most infants who are diagnosed and treated early do not have any hip problems in later life. Earlier the diagnosis and treatment, the better the outcome, as late diagnosis often requires surgical treatment and can mean a higher likelihood of ongoing hip problems.

Developmental Dysplasia Of Hip - How Common It Is?

Hip replacement is a surgery in which a specialist doctor surgically removes an agonizing hip joint afflicted with arthritis and replaces it with a man-made joint usually produced using metal and plastic elements. It is usually done when all other treatment choices have been tried and have proven unsuccessful in providing satisfactory pain alleviation. The technique is to mitigate the pain in ahip joint, in order to make walking and other physical exercises easier.

The surgical procedure is as follows:

Hip replacement surgery can be performed generally or by utilizing what is called a non-obtrusive method. The primary difference between the two methodologies is the number of entry points needed for the surgery.
During standard hip replacement surgery, you are given general anesthesia to relax your muscles; this will keep you from feeling any pain during the surgery or being awake during the surgery. A spinal sedative might be given to counteract pain as an add-on option.
The specialist will then make a cut at the edge of the hip and move the muscles connected to the highest point of the thighbone to uncover the hip joint.
Next, the ball part of the joint is taken out by cutting the thighbone with a saw. At this point a fake joint is attached to the thighbone using a material that allows them to stay intact.
The specialist then readies the surface of the hipbone - evacuating any harmed ligament - and joins the substituting attachment to the hipbone.
The new ball part of the thighbone is then embedded into the new joint part of the hip. The specialist then reattaches the muscles and shuts the entry point.
There are some things you need to keep in mind and be attentive about, post the surgery. These are as follows:

You will probably remain in the healing facility for four to six days and may need to remain in bed with a pad between your legs to keep the new hip joint set up.
A seepage tube will be set in your bladder to help you urinate without having to walk to the bathroom.
Non-intrusive treatment usually starts the day after surgery and within the days you can go around with a walker or a walking stick.
You will continue with the non-intrusive treatment for quite a long time which could be a number of months post the surgery.
For anywhere in the range of six to twelve months after hip replacement surgery, rotating or putting pressure on the operated leg needs to be limited to a great extent. You need to likewise not cross the operated leg past the midline of the body nor turn it inwards.
You cannot twist the hip past ninety degrees. This includes both twisting forward at the abdomen and crouching.
Your physical advisor will tell you the methods and equipment that will help you comply with the above rules and precautionary measures while performing every day exercises.

Hip Replacement - Things You Must Keep In Mind!

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