Pilonidal Sinus is the small channel in your skin near the tailbone that may sometimes be filled with pus or fluid. This accumulated pus leads to the formation of abscess or cyst. Pilonidal cysts occur near the coccyx or tailbone, right at the top of the buttock crease. Pilonidal sinus consists of dirt, hair and debris that penetrates your skin, becomes embedded and thereby causes infection. Once the cyst gets infected, you may see blood or pus oozing out of the channel, which causes severe pain.
Pilonidal sinus usually affects men and young adults (after puberty). This type of skin disease is mostly observed in people who sit for a prolonged period, such as desk-job workers, truck drivers etc.

What are the causes and symptoms? 
Doctors suggest pilonidal sinus or cysts is caused due to factors such as - hormonal changes during puberty, friction resulting from wearing tight clothes, prolonged sitting, hair growth etc. The hair growing in the region is forced to burrow back beneath your skin. In certain cases, the patient may develop multiple sinuses which connect under the skin.

The signs and symptoms of pilonidal sinus include-

  Pain when standing or sitting for long
  Swelling of the cyst
  Redness and soreness around the affected skin
  Formation of multiple holes (sinus tracts) in the skin
  Foul odor
  Blood or pus oozing out of the abscess
  Hair sticking out of the lesion
Pilonidal sinus can be embarrassing and painful if left untreated for long.

What is the treatment for this condition?
Pilonidal sinus usually goes away on its own, without medical intervention. However, if the cyst becomes infected, it may have to be operated or drained. The commonly used treatment procedures are-

  Conservative treatment - if the condition is diagnosed at an early stage, your doctor will prescribe a broad-spectrum antibiotic to treat a broad range of bacterial infection. This will relieve you from the pain and discomfort resulting from infection.

  Lancing - this procedure involves using a scalpel to open the abscess. Your doctor will give you an anaesthetic prior to the operation. The channel is then cleaned properly to drain out blood, pus or hair. The wound is packed with a sterile dressing and left to heal. It usually takes about a month for the wound to heal, after which no further treatment is required.

  Phenol injections - for this procedure, first and foremost, your doctor will give you anaesthetic so that you don t feel any pain. A chemical compound known as Phenol is injected into the cyst. Phenol acts as an antiseptic and is used to harden and eventually close the lesion. This procedure needs to be repeated multiple times to achieve the desired result.

  Surgery - if the pilonidal sinus tends to recur, or if you develop multiple sinus tracts, the most preferred choice of treatment is surgery. The surgeon will open the lesion, remove the debris and pus, and then suture the wound. You will be given an anaesthetic prior to the surgery, and once the treatment is done, you will need to change the dressing more often.
If you suffer from pilonidal sinus, you will also need to maintain good hygiene. Make sure you clean and wash the area with a mild soap, and rinse properly. If your job requires you to sit for a prolonged period, take a break in between your work. Avoid wearing skin tight clothes. Adopting these measures will help prevent the occurrence of pilonidal sinus.

Treatment For Pilonidal Sinus!

When you run your hands over the soles of your feet, the surface should be smooth to touch. However, sometimes, the surface may not be so smooth. Piezogenic pedal papules are papules on the medial, posterior or lateral aspects of both heels and result from herniation of fat. These papules are usually asymptomatic and can range from a size of 2mm to 10mm. In some cases, they can be a little painful. This is seen commonly in large lesions. They become apparent when the patient stands with his full weight on his feet and disappear or shrink when the weight is removed. Piezogenic papules can also occur on the wrists. This is a fairly common condition that affects women more than men. Piezogenic pedal papules can occur at any age including infancy.

There is no known cause for the herniation of fat that causes this condition. However, there are a few factors that could increase your risk of suffering from this condition. These factors are:

Obesity
Orthopedic problems
Flat feet
Collagen disorders such as EDS
Jobs which entail standing for long hours
Excessive weight bearing
This condition can also affect newborn babies with no predisposition. The diagnosis of this condition is often confused with infantile pedal papules, xanthoma and tophi. Since they are prominently visible only when pressure is applied, it is essential for a doctor to physically examine the patient while he or she is standing. This condition does not affect the health of a person and is largely only a cosmetic issue. Thus treatment is not usually necessary but some of the things you could do to relieve the discomfort are:

In cases where Ehlers-Danlos syndrome triggers the condition, patients may be recommended betamethasone and bupivacaine injections. These injections need to be administered repeatedly for complete pain relief.
Orthotic soles or custom made inserts for shoes can help relieve the pain and distribute pressure equally.
Heel taping
Compression stockings
Avoid excessive or prolonged weight bearing
Avoid standing for extended periods and try not to run too much
Rest the feet and keep them elevated to help alleviate the symptoms
Lose weight if you are on the heavier side
Electro acupuncture
Piezogenic pedal papules are benign and are no reason to worry. If they begin to affect the quality of your life, you could consult a podiatrist. 

What are Piezogenic Pedal Papules?

What is the best time to sleep?
This is one of those questions which bother many and sundry. Considering the different sleep schedules which different people might develop as a result of their work or other reasons, the correct answer is roughly around 10 p. M. It is good to follow a proper sleeping schedule so that you go to bed and wake up at the same time almost every single day. The body's internal clock or the circadian rhythm is linked to the cycle of the sun. Technically, it is better to wake up with the sun as it has a number of benefits for the human body.

The quality of sleep is known to be influenced by how late you retire for the night. The quality of rem (rapid eye movement) sleep tends to decrease if you go to sleep late. There is another type of sleep which is known as non rem sleep; this is a deeper state of sleep. The non rem sleep helps in revitalizing the body and leaves you energized once you wake up. Sleeping late at night is linked to higher levels of rem sleep, which might not be very beneficial for your physical or mental health.

If you go to bed late at night, you will experience more of the lighter rem sleep. This may lead to fatigue and restlessness the following day. It is also been shown that going to bed late and sleeping less than the usual eight hours is linked with problems in blood sugar levels and decline in cognitive function. It also raises your risks of high blood pressure.

Exposure to radiation from your cellphones or the glare from your computer screen before going to sleep may also affect the quantity and quality of your sleep. Make sure you eat a light dinner consisting of salads. Eating a heavy dinner before going to bed may cause digestive problems, thus impairing your sleep. Also make sure to exercise on a regular basis as it releases various hormones in the body that help in improving your overall wellbeing.

Just What Is the Best Time to Go to Sleep?

Your spine or backbone is composed of 26 bone discs, known as vertebrae. The vertebra shields your spinal cord and allows you to bend forwards and backwards, and stand. However, a number of problems, such as the following can change the structure or cause the vertebrae and its surrounding tissues to become damaged  

  Injuries
  Infections
  Tumours
  Changes in bone formation due to ageing   herniated disks, spinal stenosis
  Conditions like scoliosis and ankylosing spondylitis

Spinal disorders often lead to pain and discomfort when bony projections put pressure on the spinal nerves or cord. Over time, spinal disorders limit movement and reduce flexibility.
Treatment varies depending on the disease, ranging from medications and therapy to bracing and surgery.

Endoscopic Spine Surgery: what is it?

Contradictory to traditional open surgery, the new age endoscopic surgery is a minimally invasive procedure used to detect and treat a disorder. Unlike open surgery, minimally invasive endoscopic surgery does not require the patient to undergo general anaesthesia. The procedure is possible under local anaesthesia, considering the fact that it can be performed without cutting open the portion of the surgery site.

How does surgery work?

During the procedure, the surgeon first administers local anaesthesia to numb the site of the operation. You will be awake during the entire procedure but will not feel any pain. Then, he/she will make a small incision and insert a slender, tubular instrument   known as an endoscope   with a camera attached on one end through the soft tissues and skin, down to the spinal column. This allows the surgeon to get a clear view of the spinal tissues and understand where the problem exists. The endoscope holds the muscles open, allowing the surgeon to remove the damaged tissues or disk.

Endoscopic spine surgery preserves normal mobility, as the spine is not fused with rods and crews. When performed under an experienced surgeon, the procedure takes less than an hour.

Benefits of the Procedure

The advantages of going for an endoscopic surgery are the following  
  Local anaesthesia
  Surgery and discharge on the same day
  Microscopic incisions
  No removal of bone or muscles
  Zero or minimal blood loss
  Preserves spinal mobility
  Immediate recovery
  Reduced intake of pain medicines
  The high rate of success
  Improved quality of life

Minimally invasive endoscopic surgery has made it possible to rectify spinal problems and disorders without having to go under the knife. With less pain and quicker recovery, you can improve your spine health and get back to your usual activities in a day or two.

Consult a specialist and discuss the procedure in detail before opting for the same.


Endoscopic Spine Surgery Under Local Anaesthesia!

Pneumonia is an inflammation and infection of the lungs. This is a condition where the alveoli or the air sacs located in the lungs fill up with fluid and pus. It is because of this that oxygen cannot reach the infected individual s bloodstream. People with pneumonia generally have cough, fever, and breathing problems. At times, it can also result in chest pain.

This is a condition that can affect one or both the lungs. There are different forms of this disease. Pulmonary infection is considered one of the most common causes of this disease. It is a kind of infection related to gram-negative or gram-positive bacteria and viruses. Certain infectious agents sharing the similarities of bacteria and viruses might also result in pneumonia.

Symptoms of pneumonia in adults
The symptoms of pneumonia in adults include:

Fatigue
Fever
Coughing up slightly bloody, brown or green mucus
Weakness
Vomiting
Nausea
Headaches
Loss of appetite
Diarrhoea
Wheezing
Chills
Rapid breathing
Shortness of breath
Chest pain
The milder forms of this disease do not disturb the regular functions of the affected individual and are called  walking  pneumonia.

Signs of pneumonia in children
Unlike adults, kids suffering from pneumonia might not experience a fever or a nagging cough. They might have more subtle signs of this infection. However, children have relatively higher chances of being infected because they do not have fully-developed immune systems. Overall, the signs of pneumonia vary according to the age of an individual.

Pneumonia caused by bacteria like Chlamydophila pneumoniae and Mycoplasma pneumoniae generally result in milder signs of the disease in kids. This kind of pneumonia is called walking or atypical pneumonia and is generally found among school-going children. Children suffering from mild pneumonia might not feel very sick, but they can have one or more of the following symptoms:

Low-grade fever
Dry cough
Tiredness
Headache
Irrespective of the age of an individual, it is always important to consult a specialist after determining the symptoms of pneumonia. Remember, it is a deadly disease and needs timely treatment.

How To Recognize The Symptoms Of Pneumonia?

You might have a wonderful morning routine to keep you healthy. However, do you know what really determines health is also your bed time routine? Each night you end one day and stand at the brink of starting a new one. It is therefore crucial how you organize your bed time.

Here are 7 things to adopt for your bed time- 

1) Plan for next day: Preparing in advance always gives you more time and leaves you stress free. Things like looking for keys, deciding what to wear etc make you late and add to your morning stress. Prepare also for breakfast or what to cook the next day. Planning at night doesnt take much time and makes your next day start on a good note.

2) Shut out the buzz: Most of us say goodnight to family and head to bed only to spend the next hour checking Facebook and social media. Or you end up watching a funny video or movie late into the night. If you keep yourself distracted, you can't go off to sleep early or get quality sleep. The light from your gadget's screen can be harmful and stress inducing. It is best to give yourself an hour away from your mobile phone or other gadgets before you sleep.

3) Write a 'Thank-You' Diary: There are many ways to become a more positive person and the best is to have appreciation. Try finding out that 1 thing (more is better) that you are thankful for. Do it everyday. This practice right ahead of your sleep time calms you down, makes you feel happy, satisfied and goes on a long way in contributing to a heathy lifestyle.

4) Stretch it out: Like most people do you also have a job where you keep sitting for long hours? Stretching really works, it helps lengthen tendons and muscles and can reduce the frequency and severity of cramps ensuring you get a better night's sleep.

5) Try meditating: Our work life has become ever so demanding, we are constantly bombarded with information via the television, social media, the internet, friends and work which results in stress and anxiety! Few minutes of meditation before bed, slows down your brain activity which results in a deeper and more peaceful sleep. You will wake up feeling well-rested, energized and ready to take on the day!

6) Book by your side: Reading before bed is has amazing benefits. Firstly, it calms the nerves by eliminating excess sound and vision stimulus (exactly the opposite of what you get from watching television!). It helps you to wind down and sleep better, it also improves brain function, your memory and the thinking process overall.

7) Sleep is crucial: Foremost is to simply make sleep a priority. It is not as simple as it sounds. Sleep deficiency directly relates to increased stress, weight gain and productivity loss. Going to bed late and managing with 5 or 6 hours sleep sets a bad tone for your day.

Your happiness and general wellbeing is controlled by how relaxing you make your bed time.

Click on Consult Privately to ask me a private question on this topic or a related one.

From Lybrate: If you found this tip useful, please thank the doctor by clicking on the heart icon below. Also, spread good health by sharing this tip with your loved ones.

Dr. Sapna Zarwal Tells You How To Improve Your Bed-time Routine

Don't wait any longer, manage your Somnologist online with a Lybrate doctor today

Consult for Somnologist - Online and Easy!

FilterClear All

COMMON SPECIALITIES

COMMON ISSUES