Burning your skin is a very traumatic experience and can leave behind scars that remind one of the traumatic incident. Scarring caused by burns may fade a little with time but are usually permanent. Apart from affecting your appearance severe burns can also affect the functioning of the body. Burns can make a person withdraw socially by making him or her afraid of how people will accept them with their scars as well as make them depressed about their appearance.

Burn repair surgery can be categorised under two headings: Acute and Reconstructive

Acute repair surgery happens immediately after the burn and deals with large burns and deep burns that affect critical areas. The focus here is to aim for saving of life of burn patient with earliest wound healing with various surgical means.
Reconstructive burn surgery addresses the deformities & scars after the initial burn wounds have healed. The goal here is to improve the appearance of the scars and ensure improvement of functioning. 
There are many types of reconstructive surgeries for burns and the type of surgery best suited to a patient is based on the location of the scar, the extent of scarring and the patient s personal goals.

Skin grafts: This involves the removal of healthy skin from one part of the body and transplanting it to the burn site. This split thickness skin graft include only a few outer layers of skin & full thickness graft involve the entire dermis. This is used in cases of deep burns where full thickness of dermis is affected. Also skin grafts are used for defects following release of burn contracture . 
Flaps: These are thick skin tissues with its own blood supply, used to cover exposed vital structures like vessels , tendons, nerves, bones, etc especially in deep electrical burns of extremities. 
Free flap procedure: In this Microvascular Surgery , muscle, bone or skin is transferred from one part of the body to another to reconstruct huge defects after contracture release or for cosmetic improvement of ugly burn scars. 
Tissue expansion: This involves the insertion of a balloon expander under the skin near the burn scars & deformities. As the balloon is filled with saline, the skin stretches and grows. Once the skin has stretched enough, the expander is removed and the skin can then be used to replace the burn scars & deformities.
This procedure has many advantages as the skin colour and texture are a near perfect match thus reducing scarring to a large extent. However, it is a very slow procedure and can take a few months.

Burn Repair Surgery - How Can It Help To Reduce Deformities & Scars?

Cold sores are typically caused by the herpes simplex virus and are characterized by small blisters that develop around the lips and mouth. However, some people do not showcase any symptoms at all. The mouth is the most affected area as the skin in this area is not as resistant to the virus as skin on other parts of the body. It can also occur on the chin, nose or cheeks. Cold sores are communicable through skin contact. This condition can also be triggered by stress. 

The first time this virus affects is a person is known as the primary infection. Some of the symptoms of cold sores are 
- Blisters on the mouth, lips, tongue, throat or gums. These blisters may be dry or oozing. 
- Pain while swallowing or eating due to ulcers and blisters.
- Swollen neck glands.
- High fever accompanied by body ache.

An outbreak of cold sores usually lasts about a week. Once the primary infection is over the virus is not eliminated from the body, but remains dormant in a nerve sheath. Recurrent cold sores may not cause severe mouth infections as with primary infections, but can be quite unpleasant. In most cases, recurrent cold sores erupt in the same area as the primary infection. 

Some of the ways to treat primary infections are:
- Painkillers: Over the counter painkillers such as ibuprofen or paracetamol can help ease the pain.
- Chlorhexidine mouthwash: This can be used in place or brushing in case of painful sores inside the mouth. It can also prevent plaque buildup and secondary gum infection. 
- Antiviral medication: If taken at the onset of a cold sore infection, this can reduce the pain associated with it and shorten the duration of the infection. This also prevents the virus from multiplying. 

As cold sores are communicable, it is important to prevent it from spreading. Some ways of containing this infection are:
- Wash your hands with soap and water after touching your mouth or the sores.
- Avoid touching the cold sores
- Abstain from oral sex
- Do not share items that come in contact with the infected area like lip balms, towels, cutlery etc. 

If the symptoms do not subside within 5 days, visit a doctor immediately. Consult a doctor if you have frequent bouts of cold sores or suffer from a severe case of the disease. Pregnant women and mothers with young babies who suffer from the disease should also seek prompt medical attention.

What You Must Know About Cold Sores + Treatment

Improvements in medical technology and surgery techniques have made so much possible. With organ transplants becoming relatively simpler and less risky, many critical health conditions can now be resolved. Liver transplants are one of the most common and patients going through the agony of life-threatening liver diseases now have hope.

What is a Liver Transplant?

When the patient s liver is damaged to the extent that functioning is severely impaired and regeneration is not possible, a liver transplant is advised. In the transplant surgery, the diseased liver is removed and replaced by whole or part of healthy liver from the donor.

Types of Liver Transplants

Based on the type of donor, liver transplant can be classified as deceased donor and live donor transplantation.

Deceased Donor Transplants (DDLT): A "brain dead" person can be a liver donor if they had pledged their organs previously or if their relatives consent for organ donation. The healthy liver can give a new lease of life for an ailing patient.
Live Donor Liver Transplants (LDLT): A blood relative or spouse may donate a part of their liver to the patient (subject to compatibility). As the liver is a regenerative organ, the donor's liver will function normally and the recipient will have a completely new liver. At Kauvery Hospital, a detailed evaluation of the prospective donor is done to ensure that the health risks are minimized and complete recovery is achieved.
Donor Safety

Donor can lead a normal and physically active life with no restrictions. Lifelong medications are not required and women can enjoy pregnancy and motherhood.

Who Needs A Liver Transplant?

A person with end-stage liver disease is a candidate for a liver transplant. The failure can happen over a period of time or be a sudden occurrence, due medical conditions or reactions to drugs (ALF). Following are some of the common reasons for liver failure.
Alcoholism: Long term drinking can lead to end stage liver disease.
Biliary Atresia: Absence of bile ducts since birth.
Chronic viral Hepatitis: (Hepatitis B & C)
Haemochromatosis: An inherited disorder that overwhelms the body with abnormal levels of iron deposits including liver.
Liver Cancer: (Hepatocellular carcinoma) Cirrhosis increases risk of liver cancer. Transplantation early would offer potential cure.
Primary Biliary Cirrhosis: (PBC) An unusual condition with immune mediated destruction of the bile ducts resulting in failure of the liver.
Non Alcoholic SteatoHepatitis (NASH): It is a common cause of liver disease seen in those with metabolic syndrome (Obesity, Diabetes Mellitus, Hypothyroidism and Dyslipidemia with or without Hypertension). Unlike alcoholic or viral hepatitis, it occurs in people with no inherent liver problem.Primary Sclerosing Cholangitis: (PSC) The bile duct gets scarred and narrowed, which blocks bile drainage, ultimately leading to failure of the liver.
Wilson's disease: A very rare inherited disease that causes abnormal levels of copper deposition throughout the body including liver, ultimately causing liver failure.
What does a Liver Transplant Involve?

First stage: Evaluation: A team of specialists will evaluate the patient to determine if transplant is the best option or if any other course of action will be better. This includes review of the patient's medical history and a number of investigations.

If a patient is found to be a suitable candidate to undergo transplant, we proceed to the second stage where his or her name is placed on the waiting list if he or she opts for cadaveric liver transplant.

A scoring system based on medical criteria determines the priority. In general, sicker the patient, greater is the necessity for transplant.

Third stage: Donor becomes available. When a suitable donor has been identified, the patient is contacted and informed about donor's medical condition. If the patient consents, he or she will have to come to the hospital. Some basic tests will be repeated to ensure that the current condition is safe for surgery. Surgeons and anesthetists involved in the transplant will meet the patient and brief him or her about what to expect. Once all the test results are found to be satisfactory, we proceed for surgery.

 The Procedure

While aspects of the surgery vary from patient to patient, the procedure typically takes between 8 to 12 hours to complete. Once the surgery is over, the patient is shifted to the ICU where he or she will stay for 3 to 7 days. At this stage, various tubes are connected to the body to enable it to carry out its natural functions. These are gradually removed as and when deemed appropriate. From the ICU the patient is shifted to a room for 2-3 weeks. In total, patient spends about 3-4 weeks in the hospital while undergoing transplant.

Discharge & Recovery

Once the doctors deem that the patient can return home, he or she is discharged from the hospital.
A follow up schedule is given to the patient so that complete recovery is monitored. Before discharge, patient and family will be trained on how to take medicines and what precautions to take. The number of medications will reduce over time as the recovery progresses.
The pace of recovery depends upon several factors. In general, a patient may be able to resume daily activities by 1 month and resume work by about 3 months after the surgery.

The Liver Transplant Process!

An abnormal junction or connection between two organs or tissues is referred to as a  fistula . It targets two hollow organs, vessels, or tissue structures. It occurs mostly in the rectum, vagina, however can affect the intestines and the eyes too. It results in extreme pain, discomfort and should be treated as immediately as possible to prevent infection.

It can induce sensations of:

Extreme irritation or itching
Discharge with unusual odor (if the fistula is located near the anus/vagina)
Irritable bowel syndrome
Excess pus
High body temperature
Blood discharge
Diagnosis
In case or prolonged tension and pain in these areas, a proctoscopy should be conducted for diagnosis. It most commonly occurs in women who have sustained prolonged labor (over 2-3 days). However, other causes include:

Digestive malfunction
Abscesses(formation of pus in hollow organs)
An unhealthy lifestyle which includes excessive indulgence in alcohol and tobacco

Ayurvedic treatment for fistulas are available which aim to sooth the inflammation by slowly remedying the wound through natural and safe measures. Since Ayurvedic practices are non-toxic, non invasive and completely safe, one can avoid the drastic measures that surgery consists of, and also avoid the side effects of medicines.

Ayurvedic remedies of fistulas include
Ayurvedic doctors have developed several oils, ointments and medications that are readily available in the market. The medications usually consist of a mixture of herbs, roots and plants that aim to restore the physical systems and also soothe the affected area.

The importance of buttermilk added with rock salt and black pepper also allows the enzymes of our body to multiply and thereby cure the fistulas internally.
Radish juice with a pinch of cumin is also recommended to be consumed after meals to improve digestion and empower the immune system.
A healthy lifestyle and fitness routine consisting of yoga and exercises also contribute to improve conditions in the patient by facilitating blood circulation and metabolism.

Fistula - Treating It With Ayurveda!

Pulmonary Function Tests or PFTs are a set of tests that are used to determine, measure or observe the functioning of the lungs. The most common pulmonary function tests used are spirometry, gas diffusion, and lung plethysmography. 

Highlights of pulmonary function tests

A spirometry test is used to measure the amount of air inhaled and exhaled. It also measures the amount of time taken to complete a respiration cycle.
A lung plethysmography measures the amount of air in the lungs after the patient has taken a deep breath. It also measures the amount of air that remains in the lungs after the patient has exhaled as much air as possible.
What does a Pulmonary Function Test measure?
Pulmonary function tests would not only check how well the person is breathing but also how effectively the lungs are able to conduct oxygen to the rest of the body. In addition to air flow, these tests would measure the size and volume of the lung and lung diffusion.

These tests can also be used to measure

Total Lung Capacity   the amount of air present in the lungs after breathing in deeply
Forced Vital Capacity   the amount of air that can be exhaled after breathing in deeply
Minute Volume   the amount of air exhaled per minute
Vital Capacity   the total volume of air that can be breathed out after inhaling as much as possible
Tidal Volume   the amount of air inhaled or exhaled when breathing normally
Maximum voluntary ventilation   the amount of air that can be inhaled and exhaled in one minute
Functional Residual Capacity   the amount of air that remains in the lungs when breathing normally
Forced Expiratory Flow   the flow or volume of air during an exhalation
Peak Expiratory Flow Rate   the rate at which a person can exhale
When are Pulmonary Function Tests recommended?
A physician might recommend a patient undergo a PFT as part of a routine physical check-up. This test would be advised if the patient is experiencing any symptoms associated with lung problems or disorders such as asthma, respiratory infections, chronic obstructive pulmonary disease, COPD. A doctor would also use these tests to monitor and check whether a certain treatment prescribed for a lung disease or condition is working effectively.

Pulmonary function tests are safe as they are non-invasive but it is important to follow the instructions of the doctor or technician before, after and during the test. It is important to make your doctor aware of any surgeries, respiratory infections, chest pains or heart attacks that you might have experienced before the test. If you are taking any medications you might need to follow the advice of the doctor as to whether you can take them before the test.

Your doctor would also advice you on how to prepare for the test such as not eating a large meal, avoiding caffeine and wearing loose-fitting clothes. If you have any doubts, concerns or queries discuss them with your doctor.

Pulmonary Function Tests - Why Is It Required?

Treatment of frozen shoulder varies depending on the stage it is at, and how severe is the pain and stiffness. There is no outright cure and the aim of treatment is to keep the joint as mobile as possible. The most effective treatment is that which maintains a good range of movement until the shoulder starts to heal. 

Treatment may Include the following:

1. Shoulder exercises: Regular, gentle exercise can help to keep the shoulder joint mobile. If your shoulder is very stiff, exercise may hurt, and it should only be carried out with the guidance of your doctor or physiotherapist. If you are able to, continue using your shoulder as normal saving' the shoulder can cause the muscle to waste and may make stiffness worse.
2. Painkillers: Over-the-counter painkillers such as paracetamol or prescription-only drugs such as codeine may be taken to ease pain and you should discuss this with your general physician or pharmacist.
3. Anti-inflammatory painkillers: Such as ibuprofen and diclofenac, are often prescribed to ease pain and inflammation. Any medication that you take should be discussed with your general physician or pharmacist.
4. Steroid injections into or near the shoulder joint may be effective at relieving pain and inflammation for a few weeks. However, injections are not a cure, and symptoms may return.


Treatment of frozen shoulder

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