Hepatitis Prevention and Protection Tips

Viral Hepatitis can invade the body and attack the liver systems. It has five different types, Hepatitis A, B, C, D and E. While hepatitis can be treated, it is best to prevent it in the first place. 
Here are some simple, easy to follow tips that can prevent hepatitis from spreading.
1) Know how it spreads - Hepatitis can pass from individual to individual or through blood, body fluids, infected faeces.  Contaminated food and water can also cause hepatitis. Hepatitis B, C and D in particular spread through contact with infected blood.

2) Get Vaccinations - Immunization can help you protect yourself against Hepatitis A and B. Vaccinations for Hepatitis C, D or E aren’t available. But Hepatitis C can be cured with anti-viral medications. For Hepatitis D, the infected person needs to get Hepatitis B to survive.

3) Avoid Sharing Personal Items - Don’t share as it is a high-risk behaviour for Hepatitis. Be sure that needles for body piercings, acupuncture and tattooing are safe and disposable to avoid the risk of contamination.

4) Avoid Sharing Grooming Items- If you are living with someone who has or is at risk of Hepatitis, make sure that you avoid sharing grooming items as undetectable quantities of blood or other bodily fluids on razors and toothbrushes can lead to spread of virus.

5) Alcohol and Drugs - Hepatitis is a high risk among people who use excessive alcohol and over the counter medications. Liver inflammation and liver damage puts individual at risk of contracting Hepatitis and therefore, alcohol or prescription drugs and herbal supplements must be avoided and taken only after physician’s consultation.

6) When Travelling- Avoid eating raw fruits, vegetables and raw shellfish, avoid eating at unhygienic places, brush teeth and rinse mouth with clean water, avoid iced drinks or adding ice to the drinks while traveling to avoid contracting the condition. 

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Hepatitis Prevention and Protection Guide: World Hepatitis Day

Link between Erectile Dysfunction and Premature Ejaculation

Erectile Dysfunction is the inability of a man to achieve a penetrable erection while premature ejaculation is a man's inability to take control of his ejaculations during or before sexual intercourse. These conditions are two of the most common sexual dysfunctions observed among men. The prevalence of these two conditions can be found among all socioeconomic groups and among men of varying ages.

The incidence of premature ejaculation is higher and hence more common among both young and old men. Studies show that an estimated 40% of men suffer from the condition of premature ejaculation. On the other end, research also reveals that erectile dysfunction is associated with advancing age though a host of other factors like diabetes, kidney and heart diseases and certain medications can also be responsible.

How are these two conditions actually related?

It is found that in most men who have been primarily diagnosed with erectile dysfunction, the secondary concern has been premature ejaculation. The reason for both the problems is more or less the inadequate flow of blood to the penis required for a penetrable erection.

Moreover, in some cases, it was found that premature ejaculation occurred when a person was diagnosed with both mild and acute erectile dysfunction. In a similar manner, it was found that among men who suffered from ED and required constant stimulation to maintain a penetrable erection found out the instances of occurrence of premature ejaculation was high.

In some cases, it was found that the chief cause of erectile dysfunction was premature ejaculation. Because of these reasons, the two conditions are often found to co-exist and overlap one another.

In cases where both the conditions exist, treatment for ED is recommended to be sought first.

If you would like to consult with me privately, please click on 'Consult'.

What is the Link between Erectile Dysfunction and Premature Ejaculation?

The intervertebral discs are made-up of two concentric layers, the inner gel-like Nucleus Pulposus and the outer fibrous Annulus fibrosus. As a result of advancing age, the nucleus loses fluid, volume and resiliency and the entire disc structure becomes more susceptible to trauma and compression. This condition is called as degeneration of the disc. The disc then is highly vulnerable to tears and as these occur, the inner nucleus pulposus protrudes through the fibrous layer, producing a bulge in the intervertebral disc. This condition is named as herniated disc. This can then cause compression to the spinal cord or the emerging nerve roots and lead to associated problems of Sciatica radiating pain from back to legs in the distribution of the nerve. Other symptoms could be a weakness, tingling or numbness in the areas corresponding to the affected nerve. Sometimes bladder compromise is also present, which is made evident for urine retention and this need to be taken care as an emergency.
Excessive weight, bad postures, undue movements, improper weight lifting and other kinds of traumas may weaken the intervertebral discs. When this occurs the pulpous nucleus will bulge against the annulus, or even be squeezed through it (extruded disc).

The first steps to deal with a herniated or prolapsed lumbar disc are conservative. These include rest, analgesic and anti-inflammatory medication and in some cases physical therapy. At this point, it is convenient to have some plain X-rays done, in search of some indirect evidence of the disc problem, as well as of degenerative changes on the spine.

If in a few days these measures have failed, the diagnosis has to be confirmed by means of examinations that give better detail over the troubled area, as the MRI, CT which will show the disc, the space behind it and in the first case, the nerves. In some instances, the EMG (electromyography) is also of great value, as this will show the functionality of the nerves and muscles.

Once the diagnosis has been confirmed, one of the best alternatives existing today is the Ozone Discolysis as the results obtained are excellent and practically has no complications. This novel treatment avoids the use of surgery in 80% of those who needed it. In most patients left with painkillers as the only treatment, the symptoms eventually disappear, only that this could take weeks to months. Ozone speeds up these developments, see the same result in a few weeks. The problem has to be seen and approached integrally and frequently the combination of therapies has to be used, most frequently physiotherapy. Also, it has to be known that those who had a herniated disc have 10 times more chances of having another herniation than the rest of the population.

If despite the ozone therapy the symptoms persist, Drill Discectomy/ Laser Discectomy are good alternatives before open surgery (Discectomy) which has to be contemplated in those true emergencies, as mentioned above, this is possibly the first choice.

Once the conservative treatment fails:

Early aggressive treatment plan of pain has to be implemented to prevent peripherally induced CNS changes that may intensify or prolong pain making it a complex pain syndrome. Only 5% of total LBP patients would need surgery & 20% of discal rupture or herniation would need surgery. Nonoperative treatment is sufficient in most of the patients, although patient selection is important even then.

Depending upon the diagnosis one can perform & combine properly selected percutaneous fluoroscopic guided procedures with time spacing depending upon pt`s pathology & response to treatment.

Using precision diagnostic & therapeutic blocks in chronic LBP, isolated facet joint pain in 40%, discogenic pain in 25% (95% in L4-5&L5S1), segmental dural or nerve root pain in 14% & sacroiliac joint pain in 15% of the patients. This article describes successful interventions of these common causes of LBP after conservative treatment has failed.

LESI: Lumbar Epidural Steroid Injection

Indicated in   Acute radicular pain due to irritation or inflammation.

Symptomatic herniated disc with failed conservative therapy
Acute exacerbation of discogenic pain or pain of spinal stenosis
Neoplastic infiltration of roots
Epidural fibrosis
Chronic LBP with acute radicular symptoms
Epidural- lumbar injection
ESI Treatment Plan

Compared to interlaminar approach better results are found with a transforaminal approach where drugs (steroid+ LA/saline +/- hyalase) are injected into anterior epidural space & neural foramen area where herniated disc or offending nociceptors are located. Whereas in interlaminar approach most of drug is deposited in posterior epidural space.Drugs are injected total 6-10 ml at lumbar, 3-6 ml at cervical & 20+ ml, if caudal approach is selected. Lumbar ESI is performed close to the level of radiculopathy, often using paramedian approach to target the lateral aspect of the epidural space on involved side. Cervical epidural is performed at C7-T1 level.

SNRB- Selective Nerve Root Block 

Fluoroscopically performed it is a good diagnostic & therapeutic procedure for radiculopathy pain if

There is minimal or no radiological finding.
Multilevel imaging abnormalities
Equivocal neurological examination finding or discrepancy between clinical & radiological signs
Postop patient with unexplainable or recurrent pain
Combined canal & lateral recess stenosis.
To find out the pathological dermatome for more invasive procedures, if needed
Intradiscal Procedures 

Provocative Discography - Coupled with CT

A diagnostic procedure & prognostic indicator for surgical outcome is necessary for the evaluation of patients with suspected discogenic pain, its ability to reproduce pain(even with normal radiological finding), to determine type of disc herniation /tear, finding surgical options & in assessing previously operated spines.

Percutaneous Disc Decompression (PDD)

After diagnosing the level of painful offending disc various percutaneous intradiscal procedures can be employed

Ozone Discolysis: Ozone Discectomy a revolutionary least invasive safe & effective alternative to spine surgery is the treatment of choice for prolapsed disc (PIVD) done under local anaesthesia in a daycare setting. This procedure is ideally suited for cervical & lumbar disc herniation with radiculopathy. The total cost of the procedure is much less than that of surgical discectomy. All these facts have made this procedure very popular at European countries. It is also gaining popularity in our country due to high success rate, less invasiveness, fewer chances of recurrences, remarkably fewer side effects meaning high safety profile, short hospital stay, no postoperative discomfort or morbidity and low cost.

Dekompressor: A mechanical percutaneous nucleosome cuts & drills out the disc material somewhat like morcirator debulking the disc reducing nerve compression.

Epidural Adhenolysis or Percutaneous Decompressive Neuroplasty for Epidural Fibrosis or Adhesions in Failed Back Surgery Syndrome (FBSS)

A catheter is inserted in epidural space via caudal/ interlaminar/ transforaminal approach. After epidurography testing volumetric irrigation with normal saline/ L.A./ hyalase/ steroids/ hypertonic saline in different combinations is then performed along with mechanical adenolysis with spring loaded or stellated catheters or under direct vision with epiduroscope.

Procedures That Can Help Treat Slip Disc & Sciatica!

People who suffer from human immunodeficiency virus, commonly known as'hiv, are known as hiv positive people. The virus is the agent of aids that is currently incurable. Hiv is known to alter the human immune system and makes people much more susceptible and vulnerable to diseases and infections. 

Body fluids such as semen, blood, breast milk, vaginal fluids etc. Of an infected individual contains the virus, which can be passed from one person to another during blood-to-blood and/or sexual contact. Hiv positive women may even pass on this virus to their children during pregnancy, delivery or by breast feeding them. Hiv is also transmitted during oral, anal or vaginal sex, by contaminated hypodermic needles and by blood transfusion. 

Mentioned below are a few issues that a hiv positive woman have to face apart from discrimination and stigma, fear of infecting their children or partners, violence and abandonment. 

1. Menstrual disorders: changes in menstrual cycles are frequently reported by hiv infected women. However, menstrual dysfunctions are due to varied reasons that aren't directly related to the disease. Although most of the hiv positive women suffer from amenorrhea i. E. The unusual absence of periods, it is not just due to hiv but also because of weight loss or immunosuppression. 
 
2. Contraception: it is very important that the contraception a hiv positive woman chooses not only acts as birth control, but also to prevent the transmission of sexually transmitted diseases and hiv. Although condoms do not provide exceptional pregnancy prevention, they are excellent at preventing transmission of the hiv virus. Permanent sterilization is usually the most chosen contraceptive method for hiv serodiscordant couples.

3. Surgical complications: hiv positive women are at a higher risk of undergoing gynecologic surgery. This is because they are more vulnerable to pelvic infectious disease that requires surgical intervention. There is also a greater risk of developing vulvar cancer in hiv positive women. 

4. Fertility: there has been an increase in the number of seropositive women contemplating pregnancy and childbirth. Most couples resort to assisted reproduction to lower the risk of horizontal hiv transmission. Studies show that undergoing hiv treatment and having an undetectable viral load is helpful in preventing the transmission of hiv. It is important to consult a medical expert if you are unable to get pregnant after at least 6 months of trying. Fertility problems are more common in hiv positive women than hiv negative women.

Issues for HIV Positive Women

What is allergic rhinitis?
Allergic rhinitis is defined as allergic symptoms in the nasal passage. Allergic rhinitis can be seasonal (occurring during specific seasons) or perennial (occurring year round). The allergens that most commonly cause seasonal allergic rhinitis include pollens from trees, grasses and weeds, as well as spores from fungi and moulds. The allergens that most commonly cause perennial allergic rhinitis are house dust mites, cockroaches, animal dander and fungi or moulds. Perennial allergic rhinitis tends to be more difficult to treat.

How does allergic rhinitis occur ?
This condition occurs when allergens (allergy- causing substances) come into contact with the nose, and usually also the ears, sinuses, and the throat. When allergens come in contact with the lining of the nose and sinuses, they trigger the cells to release the chemical histamine, which causes the allergy symptoms described below.

What are the symptoms?
Nasal congestion 
Sneezing 
Watery " runny nose" 
Itchy eyes,nose,or throat 
Puffy eyes or 'allergic shiners'
Post nasal drip 
Tears 
These symptoms may occur during a certain season or year long. They can occur at any age. 

Risk factors for allergic rhinitis?
Allergies can affect anyone, but you re more likely to develop allergic rhinitis if your family has a history of allergies. Some external factors can trigger or worsen this condition, including:

cigarette smoke
chemicals
cold temperatures
humidity
wind
air pollution
hairspray
perfumes
colognes
wood smoke
fumes
Ayurvedic concept of rhinitis
As per Ayurveda, Allergic rhinitis is compared with Vata- Kaphaja pratishaya. The concept of Ama, Asatmya and virudh aahara also predict the allergic conditions.

Ama is the product of impaired digestion and metabolism. It affects Rasa and Rakta Dhatu leading to manifestation of Pratishyaya. Wrong food combinations (Virudh aahar) having antagonist properties like fish with milk, fruit juice with milk, clarified butter with honey, ice cream after night meals, etc. leads to allergy.

Ayurveda believes in balancing the three doshas present in the human body, thus treating the disease on the whole. Treatment involves clearing the sinuses and expelling phlegm, alleviating the relevant dosha and detoxification. To permanently resolve this disorder, dietary and lifestyle adjustments may be necessary in addition to the strengthening of the immune system. Panchakarma is an effective means of treating Allergic Rhinitis.



Ayurvedic treatment for allergic rhinitis:
If the symptoms are severe and in chronic conditions, Vamana Panchakarma treatment, followed by Virechana is administered. This helps to relieve Ama and balance Tridosha.
In some cases, where the patient has normal digestion strength, Nasya treatment (nasal drops therapy) is administered with herbal oils such as Anu taila or Shadbindu Taila. 
After the above Panchakarma treatments, Ayurvedic medicines are administered to improve respiratory immunity and strength of upper respiratory tract.
Useful Ayurvedic medicines in treating allergic rhinitis:

Nimbarajanyadi tablet   Contains neem and turmeric as main ingredients.
Chavikasavam   Fermented Ayurvedic liquid, also used in urinary tract disorders.
Mahalaxmi Vilas Ras   Also useful in the treatment of skin diseases, diabetes, Sinus, non healing wounds, etc.
Other medicines: Narada lakshmi vilas rasa, Anand bhairava rasa, tribhuvan kirti rasa, shringarabharaka rasa, Mayur shringa bhasma, Abhraka bhasma, Lavangadi pills, Sitopaladi choorna, Marichayadi yoga, vyoshadi pills, Khadiradi pills are suggested.

Diet management:

Take  Light food, lukewarm water, Kapha nashaka foods like little spicy food, saindhav salt, legumes, soups etc.
Avoid heavy food, fermented food, congestive food, too hot or too cold food, soar food, non vegetarian food, sweets, banana, curd, yogurt, ice creams, deserts, cakes, yellow grams, etc.
Avoid Alcohol and cold beverages. 
If you wish to discuss about any specific problem, you can consult an ayurveda.

Allergic Rhinitis - Signs That You are Suffering from it

The sciatic nerve is the longest nerve in the human body. It runs from the lower back, through the buttocks, your hamstrings and into the lower leg. Sciatica means pain in the leg, numbness or any kind of weakness in the lower back. There can be many reasons for a leg pain such as an injury to the leg or it can be due to the main nerve which travels in the lower back. Many times, it is not diagnosed properly and hence it will take a lot of time to respond to the treatment or in some cases, it may not respond at all. 

Symptoms of Sciatica: 

You will experience pain in the lower back only on one side of the body. 
The pain continues from the lower back to the sciatic nerve. 
Rarely, you will see the pain on both sides of the body or buttocks. 
The pain is very sharp. 
In some cases, the patient may experience a needles or pins sensation in the leg and in some cases, it is weakness or numbness in the lower back. 
The pain gets so severe that you will not be able to walk or even stand. 
If you have lower back pain combined with leg pain, then lower back pain is not going to be as severe as the leg pain. With the help of the symptoms, your doctor will be able to diagnose sciatica but in order to know the exact cause and origin of this pain, you will have to undergo other tests and examinations. 
Physiotherapy for Sciatica: 
There are many surgical treatments available for sciatica, but it is always good to go for non-surgical treatments. So you can opt for physiotherapy. You will be able to see better and long lasting results with this treatment. As it involves a thorough assessment of it on which the treatment protocol is laid. 

Physiotherapy involves four phases: 

Pain relief 
Restoration of normal flexibility 
Restoration of full functionality 
Prevention of recurrence 
In sciatica, it is due to unbearable pain, you seek treatment. So that has to be treated initially. When you can see that the pain is under control, then the physiotherapist will start working on the range of motion for your joints. The muscle tension will be reduced and muscle strength will be improved. In the third stage, your physiotherapist will start working on restoring the normal function of your body, especially your legs and your lower back. In the last stage, the physiotherapist will help you with some exercises that will stop its recurrence. Usually, sciatica will return after some time but taking a little care at the early stage can prevent it.

Physiotherapy For Sciatica - Why Is It The Best Treatment Option?

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