Lymphedema is a condition that typically affects the arms and legs. The most common cause of this condition is damage to the lymph nodes or their removal as part of a cancer treatment program. There is no known cure for this condition. However, surgeries such as Vascularized lymph node transfer surgery may help deal with it better.

Vascularized lymph node transfer surgery involves replacing the affected lymph nodes with healthy lymph nodes from other parts of the body. This allows blood to flow more easily and restores or augments the lymphatic drainage system. In most cases, the healthy lymph nodes are harvested from the patient s groin. This procedure is relatively new, and its limits are still being explored by doctors. In cases of breast cancer that causes lymphedema in the upper limbs, this procedure may be performed along with breast reconstruction.

To be a viable candidate for this procedure the patient must have maximized control over lymphedema through other forms of lymphedema therapy. This therapy will need to be restarted after the surgery to ensure good results. The lymphedema diagnosis should also be less than 5 years old such that the patient s lymphedema is in its early stages.

As with any other surgical procedure, there are certain risks associated with this procedure. These can include

Reaction to anesthesia
Bleeding
Infection
Scarring at the site and poor healing
Damage to adjacent blood vessels
Nerve damage that can cause a temporary loss of sensation
Muscle weakness
Numbness ta the sites from where healthy lymph nodes were harvested
Risk of Lymphedema in the area where the lymph nodes were harvested from
After the surgery, the patient will need to keep pressure off the site where the lymph nodes have been transferred. The surgery site may be bandaged but compression garments will not need to be worn. On being discharged the patient may resume normal activities such as driving and work. High-intensity exercises that involve the use of the operated limb should be avoided for at least a month after the surgery. Compression garments should not be used until recommended by the doctor or a minimum of 2 weeks post-surgery. They will also need to schedule review consultations with the doctor. The schedule followed usually involves check-ups after 2 weeks, 1 month, 3 months, 6 months, 9 months and 1 year. 

Lymphedema - Vascularized Lymph Node Transfer Surgery!

Gastric (stomach) cancer occurs when malignant cells form in the lining of the stomach. By far, it is known to be the second most common cause of cancer-related deaths not only in Asia but also worldwide. Though it can affect both male and female populace, it is seen more commonly in men and in people aged 50 years or older.

Type: Gastric cancers can present as one of the following types - 

Adenocarcinoma: Begins in the glandular cells lining the inside of the stomach. This forms a majority of the stomach cancers.
Lymphoma: Begins in immune system cells present in the walls of the stomach. Occurrence of lymphoma, in the stomach, is rare.
Carcinoid Tumor: Begins in hormone producing cells of the stomach.  Occurrence of carcinoid cancer, in the stomach, is rare.
Gastrointestinal Stromal Tumor (GIST): begins in nervous system cells of the stomach. Occurrence of GIST, in the stomach, is rare.
Gender: It affects both male and female populace.

Etiology: The factors that are associated with increased risk of gastric cancer include the following mostly  

 Helicobacter Pylori  bacterial infection in the stomach is a common cause of gastric cancer of both the intestinal (expanding) & diffuse (infiltrative) type. Furthermore, studies indicate that high salt intake is synergistic with H. Pylori infection in the manner that it is likely to increase the risk of gastric cancer that is induced by H. Pylori bacteria.
Smoking, consuming alcohol, red meat, salty/ smoked/ processed foods, low intake of fruits and vegetables, diets rich in nitroso compounds, eating foods contaminated with aflatoxin fungus etc all.
Atrophic gastritis characterized by chronic stomach inflammation is known to increase the risk multi-fold. Chronic gastric inflammation can lead to atrophy of the gastric mucosa, metaplasia, dysplasia and finally carcinoma.
History of pernicious anaemia, gastric ulcers, adenomatous gastric polyp etc all.
Family history of gastric cancer. Several familial syndromes that have been associated with a pre-disposition to gastric cancer include familial adenomatous polyposis, Lynch syndrome, Peutz-Jeghers syndrome and e-cadherin mutation (diffuse type)
Blood group A, Obesity etc all are known to be associated with diffuse or cardia gastric cancer.
Low socioeconomic status - persistent lifestyle issues/ irregularities including high stress coupled with an improper diet/ dietary pattern.
Epidemiological evidence is indicative of a risk or pre-disposition to gastric/ stomach cancer for people suffering from diabetes mellitus (DM).
Very high dose ionizing radiation exposure is an uncommon risk for gastric cancer.
Features: There are often no early stage symptoms. Early stage symptoms, if any, are non-specific and are likely to be ignored, thus delaying the diagnosis most often. Hence, gastric/ stomach cancer is often detected at an advanced stage where the disease is either locally advanced or metastatic. The various presentations (of signs & symptoms), by stage (early or advanced), of gastric cancer are as enumerated below:

Early Stage   can present with one or more of the following non-specific symptoms/ signs -

Dyspepsia (Indigestion),
Stomach/ Epigastric discomfort,
Bloated feeling after eating,
Mild Nausea/ Vomiting,
Blood in Vomit (Haematemesis),
Heartburn,
Weight loss (Cachexia)
Anaemia,
Occult blood in stool/ Melaena,
Advanced Stage   presents with one or more of the following symptoms/ signs -
GI Bleeding with black tarry stools (Melaena),
Persistent Nausea/ Vomiting,
Blood in Vomit (Haematemesis),
Early Satiety,
Anaemia,
Loss of Appetite (Anorexia),
Weight loss (Cachexia),
Persistent pain in the abdomen,
Fluid build-up in the peritoneal cavity (Ascites),
Edema of the lower extremities,
Liver Enlargement (Hepatomegaly)/ Jaundice,
Difficulty swallowing food (Dysphagia)
Screening: Is generally recommended for asymptomatic populations in high incidence areas or as surveillance for high risk individuals. The goal of screening, as usual, is to be able to detect & diagnose gastric cancer at an early stage which is potentially curable. It is mostly endoscopic/ radiologic.
Diagnosis: Following are the diagnostics employed in gastic cancer - 

Physical Examination: May be remarkable for palpable abdominal mass, weight loss (cachexia), abdominal distension, ascites, hepatomegaly, lower extremities edema and lymphadenopathy for gastric cancers in the advanced stage. For early gastric cancers, however, physical examination is largely uninformative.
Blood: Hb- may be low, ESR   raised, tumor markers CEA & CA-19-9 could be raised sometimes in adenocarcinoma but are not frequently elevated. Abnormal blood test results may be indicative of malignancy, but a follow-up gastroscopy/ biopsy is always the gold standard for accurate diagnosis.
Stool: Occult blood may be +ve
Barium Meal X-Ray: Could show a filling defect at the site of the carcinoma/ cancer growth.
Gastroscopy/ Biopsy: Clinches the diagnosis.
Endoscopic Ultrasound: Maximizes tumor staging as it helps determine the depth of invasion of the tumor.
CT Scan: Of chest, abdomen & pelvis helps detect metastatic disease, if any, and also helps stage the disease (TNM) appropriately.
Bone Scan: Helps detect osseous metastasis (bone mets), if any.
Treatment: Conventional treatment includes surgery, chemotherapy and radiotherapy as contextually appropriate. Surgery (i.e. gastrectomy either sub-total or total), with an adjuvant chemotherapy and/ or radiotherapy as contextually relevant, is the only treatment that is known to cure the disease in light of the prognostic indicators as briefly enumerated in the section below. Chemptherapy and/ or radiation alone cannot be curative. Mostly, it can improve symptoms, and may prolong survival. Simultaneously, an adjunctive or integrative naturopathic treatment with suitable complementary & alternative medicines (CAM) too can help improve clinical outcomes and facilitate recovery as feasible contextually.
Prognosis: For gastric cancer is variable. Preventive measures, earlier diagnosis and right early treatment is key for an effective therapeutic management & better prognosis. Like most other cancers, the chances of cure for an early stage gastric cancer are more. The cure/ recovery chances are influenced by the grade, stage of cancer, recurrence and the patient s general health & vitality etc all. Distal tumors are known to be cured more often than the proximal ones. Again, intestinal-type gastric cancers are known to have a better treatment outlook in comparison to the diffuse-type gastric cancers.

Prevention: Rightly said, prevention is always a better choice. Although genetic risks are difficult to modify, still an adherence to a relative Mediterranean diet, maintaining an ideal body weight and an active lifestyle with due emphasis on regular exercising, de-stressing and relaxation is highly recommended for reducing the risks of many cancers including gastric cancer. A healthy eating plate comprises essentially a low fat diet, fibre rich foods including whole grain cereals, green leafy vegetables cooked using healthy vegetable oils, fresh fruits of all colours as seasonally available and healthy proteins/ fats including fresh fish, poultry, beans, nuts etc all. The consumption of alcohol, if any, has to be strictly in moderation, and is best avoided in a high risk scenario. Smoking is to be avoided too. Again, red meat, butter, refined grains, sweets, sugary drinks including carbonated beverages and other high calorie foods etc all, if any, are to be taken sparingly. Not only it is important to eat healthy, but also it is equally important to eat properly. Insufficient chewing, eating until full, eating meals within a short time etc all are best avoided so as to ease off digestive burden on the stomach/ other organs in the GI tract. Last but not the least, consumption of clean and filtered water, natural probiotics like freshly prepared yogurt/ butter milk, maintenance of cleanliness & hygiene including oral hygiene etc. all can help guard against H. Pylori infections. Breastfeeding is known to be protective against H. Pylori infections too.

Gastric Cancer - In a Nutshell!

Most of us suffer from lower back pain at some point in our lives; be it from a sedentary lifestyle, spending hours at the office desk or from strenuous physical exercises. In most cases, a little bit of rest does the trick. However, if the lower back pain persists for 3-6 weeks, physiotherapy is recommended.

How does physiotherapy help?

The main purpose behind physiotherapy is reducing lower back pain and increasing muscle and bone function, so that such instances are avoided in the future. Physiotherapy is the first line of defence against lower back pain. More drastic measures such as surgery are undertaken once physiotherapy fails to do is job.

Physiotherapy is often recommended when the back pain is caused due to lifestyle factors, a minor injury like a fall or other moderate factors. For more severe back injuries, doctors recommend surgery straight away when there is no scope of performing physiotherapy.

Low-intensity back pain can be cured using a combination of heat packs, ultrasound wave therapy and Iontophoresis (using a localized current source to introduce medical ionic compounds to the body).

A physical therapy program for back pain usually has two components:

Passive physical therapy to help reduce the patient's pain to a more manageable level

Active exercises

Passive Physical Therapy - Modalities

The physical therapist may focus on decreasing pain with passive physical therapy (modalities). These therapies are considered passive because they are done to the patient. Examples include:

Heat/ice packs

TENS units

Iontophoresis

Ultrasound

Active Physical Therapy - Back Pain Exercises

In addition to passive therapies, active physical therapy (exercise) is also necessary to rehabilitate the spine. Here are some of the common exercises for back pain:

Back Stretch: Put your hands underneath your head while lying back. Bend your knees but put your feet on the ground. Roll your legs to one side and hold them there for 10 seconds. Repeat three times for each side.

Deep Lunge: For this, you need to kneel on one knee with the other foot pointed towards the front. Lift the back knee up and hold it there for five seconds and then bring it down. Repeat this exercise three times for each side.

One Leg Stand: This is the simplest of exercises. Hold on to a wall for support while standing and face towards it. Then slowly hold one leg and bend it behind you. Hold in the same position for five seconds before bringing it down. Repeat the process three times for each leg in five second gaps.

Physiotherapy for Back Pain

Both natural and homeopathic remedies can efficiently deal with lactose intolerance and thus you should check the reports of the patient for finding the best solution. You can choose any of these remedies or else can continue with both.

List of homeopathic medicines for treating lactose intolerance

    Aethusa Cynapium: The medicine helps in the digestion of milk so that unwanted stomach aches can be easily avoided. On the other hand, health condition of the kids can also be improved to a great extent using this medicine. Loose tools or green colour diarrhea due to dairy products can be prevented with care.
    Apis Mellifica: Milk allergies can be easily cured with this medicine and thus kids are often prescribed the drug by a homeopathic expert. A few symptoms are found in kids due to lactose intolerance like breathing difficulty, body itchiness, redness, swelling, skin rashes and others. All these symptoms can be treated by this homeopathy medicine.
    China Officinalis: This medicine is mainly prescribed to those kids for whom Apis Mellifica is not the suitable one. Flatulence, belching and bloating can be properly controlled or regulated by taking this drug regularly.  Excessive mucus formation, chest's rattling sound and excessive coughing might occur with dairy intolerance and these symptoms might get severe. This is the reason the doctors often prescribe this medicine as the best option. 

A few natural remedies for treating lactose intolerance

    Probiotics: These are specialized bacteria that not only help in improving digestion, but proper nourishment can also be gained. 
    Coconut milk: This is now considered as one of the leading substitutes for different dairy products. 
    Apple cider vinegar: Lactose intolerance signs can be completely eradicated along with the maintenance of body balance by consuming apple cider vinegar regularly. This is a natural product, and thus you can take the same regularly without taking a doctor's permission. 
    Fermented products: Kimchi and Sauerkraut are those fermented foods that can create helpful bacteria as a result of which the gut can be re-populated and digestive system can be regulated. The symptoms will get reduced slowly with the consistent intake of these foods.
    Yogurt: This can be taken with meals as it is enriched with beneficial bacteria that can help in digesting different other dairy products. With the consumption of yoghurt, Lactose can be broken down naturally, and on the other hand, digestion can be improved.

Homeopathic and Natural Remedies for Lactose Intolerance

Growth hormone or somatropin is responsible for cell growth as well as reproduction. But insufficient somatropin production by the pituitary gland may result in lack in height. It is mostly caused by a serious brain injury, any prevalent medical condition or might occur as a birth defect.

Types
1. Congenital ghd - this form of ghd appears from at the time of birth itself.
2. Acquired ghd- ghd can be acquired during later life as a result of trauma, infection, tumor growth within the brain or radiation therapy.
3. Idiopathic ghd- idiopathic ghd is the third, and comparatively worst kind of ghd since it has no treatment.

Ghd is mostly permanent, but can also be transient. Read on to know how to detect whether you or your child is suffering from growth hormone deficiency (ghd).

Symptoms
Childhood onset
1. Restricted height- compared to other children of your child's age, he/she may be of shorter height, which is a rather conclusive sign to detect somatropin deficiency.
2. Chubby and comparatively younger appearance- your child may have a proportionate body, but if he/she is unnaturally chubby and has a baby-face compared to other children, he/she may be suffering from ghd.
3. Late puberty- your child's puberty maybe later than usual or even not appear at all, depending upon the gravity of the ghd.
4. Hypoglycemia and exaggerated jaundice- low blood sugar is amongst the most primary manifestations of ghd, along with extended duration of jaundice.
5. Micro-penis- micro penis condition is one of the incident signs of ghd, which later escalates to growth deficit as the infant gets older.

Adult onset
1. Fatigue- adults with ghd may experience extreme tiredness throughout the day, with reduced muscle strength.
2. Osteoporosis- osteoporosis, along with bodily deformities, is a common sign in adults with ghd.
3. Lipid abnormalities- a test of your lipid profile may reveal abnormalities in ldl cholesterol, insulin resistance, and impaired cardiac functions.

Tests to determine ghd
1. Physical test- a chart is drawn to determine the proportion of height and weight with respect to your age to detect anomalies.
2. Hand x-ray- a hand x-ray can determine whether the age of bones are at par with your age.
3. Mri-mri scan can determine the health of your brain and pituitary gland.
4. Test for other hormones- growth hormone may not be solely responsible for your health condition, so it is important to determine if other hormone levels are all normal.

Treatment
1. Hormone supplements- hormone supplements like corticosteroids (hydrocortisone or prednisone), levothyroxine (levoxyl, synthroid, etc), and others work to replenish the deficiency of pituitary hormones.
2. Growth hormone injection- gh is injected beneath your skin, to cure gdh. This is a long-term treatment and requires constant monitoring.

All About Growth Hormone Deficiency

For nearly 30 years, HIV (human immunodeficiency virus) and AIDS (acquired immunodeficiency syndrome) have been shrouded in myths and misconceptions. In some cases, these mistaken ideas have prompted the very behavior that cause more people to become HIV positive. Here are the top five myths about HIV, along with the facts to dispute them.

Myth No. 1: I can get HIV by being around people who are HIV-positive.

The evidence shows that HIV is non communicable and does not spread through touch, tears, sweat or saliva. You cannot catch HIV by:

    Breathing the same air as someone who is HIV-positive
    Touching a toilet seat or doorknob handle after an HIV-positive person
    Drinking from a water fountain
    Hugging, kissing, or shaking hands with someone who is HIV-positive
    Sharing eating utensils with an HIV-positive person
    Using exercise equipment at a gym

You can get it from infected blood, semen, vaginal fluid, or mother's milk.

Myth No. 2: I can get HIV from mosquitoes.

Because HIV is spread through blood, people have worried that biting or bloodsucking insects might spread HIV. Several studies, however, show no evidence to support this, even in areas with lots of mosquitoes and cases of HIV. When insects bite, they do not inject the blood of the person or animal they have last bitten. Also, HIV lives for only a short time inside an insect.

Myth No. 3: I'm HIV positive, my life is over.

In the early years of the disease epidemic, the death rate from AIDS was extremely high. But today, antiretroviral drugs allow HIV positive people and even those with AIDS to live much longer, normal and productive lives.

Myth No. 4: My partner and I are both HIV positive there's no reason for us to practice safer sex.

Practising safer sex, wearing condoms or using dental dams can protect you both from becoming exposed to other (potentially drug resistant) strains of HIV.

Myth No. 5: You can't get HIV from oral sex.

It's true that oral sex is less risky than some other types of sex. But you can get HIV by having oral sex with either a man or a woman who is HIV positive. Always use a latex barrier during oral sex.

Top 5 Myths & Misconceptions About HIV & AIDS!

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