The human skull is composed of several plates and pieces of bones. The roof of the skull is the top of your head. The base of the skull is, however, a complex area. It consists of 5 bones. These bones are also linked to your eye socket, the cavity of the nose, the sinuses and the bones of the inner ear. Surgery through the skull base can be quite complicated as quite a few nerves, blood vessels and opening of the spinal cord pass through this region.

When does Endoscopic Skull Based Surgery become necessary?
An endoscopic skull based surgery is performed to remove tumours of the brain. The tumour might be benign or malignant - this procedure is effective against both. This surgery can also be performed to cure any abnormality on the underside of the brain, the upper vertebrae of the spinal cord or the base of the skull.

Other conditions that may necessitate an endoscopic skull base surgery are -
  Cysts in the brain
  Swelling caused by infections
  Pituitary tumours
  Meningioma
  Chordomas
  Trigeminal neuralgia
  Cerebrospinal fluid fistulas
  Cerebral aneurysm

What to expect during this Surgery?
Since the base of the skull is a complicated region, surgery requires a delicate approach. That is why endoscopy is used. It is a minimally invasive procedure.
Right before the surgery, you will be put under general anaesthesia. Your skull has two natural openings- the nose and the mouth. Usually, the surgeon inserts the minute surgical instruments through the nose or the mouth. Sometimes, a tiny hole is drilled right above the eyebrows. A tiny camera mounted on a lighted tube will be led into your brain through the cavity that will send a live feed from the inside. This will direct the surgeons who will gently remove the growth or fix the abnormalities.
A team of doctors with different specializations such as ENT, radiology, neurosurgery come together to perform this surgery.

Complementary Procedures -
Depending on the kind of tumour being removed or the stage it was detected in, you might have to undergo any of the following in addition to endoscopic surgery-
  Chemotherapy
  Radiation
  Particle Therapy
  Proton Beam Therapy

Post Surgery Care -
After the surgery, you will have to stay in the clinic or hospital for a number of days where your progress will be constantly monitored. You will require therapy and undergo MRI scans.
Endoscopic skull base surgery is very effective in dealing with tumours and abnormalities of the brain or the upper spinal cord. Keep your family and friends around you during the recovery phase as their love and support will help you get back to your normal lifestyle in no time.

Know More About Endoscopic Skull Base Surgery Through Brain!

Rubbery cushions (discs) between the bones (vertebrae) stack up to form the spine. When a nerve between the disc and vertebrae is pressed and inflamed, that condition is called herniated disc. The herniated disc is also referred to as the ruptured disc or the slipped disc. This is caused when the soft jelly is pushed out due to a tear in the exterior. Herniated discs can lead to an irritation of the nerves and result in tremendous pain. It may also cause the arms and legs to become numb and weak. However, some people suffering from this condition may not display any symptoms at all.

Herniated disc generally occur in the lower part of the vertebral column. The herniated disc may also be seen in the thoracic spine or cervical spine. The symptoms of a herniated disc include pain in the legs, feet, or the buttocks, pain in the shoulder blade, tingling of the feet, numbness of the feet and hands, muscle weakness, neck pain or muscle spasm in the neck. Most common causes of herniated discs are aging, excessive weight or lifting of heavy weight.

Prevention of herniated disc

Herniated discs are very commonly found in people who are aged between 35 or 55 years. They are seen more commonly in the men in comparison to the women.
A herniated disc cannot be prevented easily, but there certain things that you can do to reduce the risks. Maintaining the proper techniques of lifting is important. You should not be bending at your waist. You should always bend the knees and keep the back straight. This helps you to use your leg muscles which are very strong to support the weight.
As the saying goes, precaution is better than cure, so here are few precautions that can be taken to avoid herniated discs. Practicing a proper posture can help in reducing the risk of a herniated disc. It is extremely important for an individual to maintain a healthy posture while standing, sitting, walking, and even sleeping. It is imperative that you stretch your muscles when you are sitting in one position for a long time.
Another important thing to avoid is high-heeled shoes, as they are few of the most common causes of a herniated disc. It would be a good idea to go for flat and well cushioned comfortable footwear as they can go a long way in reducing the risk of the herniated disc.
Exercising regularly can go a long way in keeping the muscles of the legs, stomach, and back very strong. You should try to balance your flexibility and strength by exercising regularly. The best form of exercise to avoid herniated disc or ruptured disc is aerobic exercise.
It is true that as you start to age, the chances of getting a herniated disc increase significantly. However, if proper precautions are taken, the stress put on the spine can be effectively reduced, thereby eliminating the risk of a herniated disc. 

Herniated Disc - Is There A Way It Can Be Prevented?

Fibroid tumour is the abnormal cell growth in the uterus and they are mostly benign. Fibroids usually affect women in the age bracket of 30 - 40. Fibroid tumours are of three types, depending on their location:

Submucosal fibroids: The tumour develops under the lining of the uterus
Intramural fibroids: The growth is found amongst the muscles in the wall of the uterus
Subserosal fibroids: The growth develops on the wall of the uterus right in the pelvic cavity
Causes behind it
The exact cause of fibroids in not known clearly. But certain factors have been discovered that might influence their formation. These factors include:

Hormones: Progesterone and estrogen are the hormones responsible for recreating the uterine lining during every menstrual cycle. These hormones might trigger the formation of tumour.
Family history: If any member in your family; your mother, grandmother or sister has/had fibroids in their uterus, you may also develop it.
Pregnancy: Your body produces excessive progesterone and estrogen when you are pregnant, which may cause an increase in the size of a pre-existing small fibroid. Myomectomy can be done by giving incision on the abdomen or by laparoscopy depending on the size and location of the fibroids.
Signs You are suffering from it

Heavy bleeding along with blood clots during or between your periods
Lower back or pelvic pain
Elevated menstrual cramping
Frequent urination
Pain during sex
Longer than normal periods
Bloating or pressure in lower abdomen
Enlargement or swelling of the abdomen
How it can be treated?
Your doctor will formulate the right treatment depending on your age, the mass of the fibroids and your overall health. Your doctor may choose a combination of treatment to cure your fibroids, and they include:

Medication: Gonadotropin releasing hormones (GnRH) agonists, birth control pills and ibuprofen (anti-inflammatory medicine) are prescribed. GnRH agonists reduce the level of progesterone and estrogen in your uterus.
Surgery: Myomectomy and hysterectomy are two common surgical procedures to treat fibroids. Myomectomy is performed by removing the fibroids only by making an incision on the abdomen. But hysterectomy completely removes the uterus. The latter is reserved for serious cases.
Non-invasive surgery: Forced ultrasound surgery, myolysis (shrinking fibroids with laser or electric current), cryomyolysis (fibroids are frozen) and endometrial ablation (an instrument uses heat, hot water, microwaves or electric current to destroy fibroids) are some non-invasive surgical procedures.

Fibroid Tumours - 8 Signs You are Suffering From it

A fracture requires quick and careful medical attention to ensure proper healing and alignment of the bone. Most fractures usually recover within six weeks but that is only half the problem. A lot of other tissues get damaged in the process when there is enough stress placed in the body to fracture a bone. Additionally, when you are unable to move that bone, you will have joint stiffness and significant muscle weakness.

After a fracture, physiotherapy might be recommended to guarantee that you come back to your ideal capacity. You might have to go for regular appointments to your physiotherapist in order to achieve full recovery. Usually, your physiotherapist will try to prevent your post-fracture stiffness in the nearby joints and muscles after the initial six weeks while you are recovering from your fracture. After six weeks or later, if x-rays show that the bone has not been fully healed, your physiotherapist can take a shot at recovering full movement of the joints and muscles near the affected area. 

Here are five ways in which physiotherapy helps heal post-fracture:

Physiotherapy after a fracture can help you enhance your muscle movement. In case you have fractured your leg, your physiotherapist can help you improve your walk and help you decide whether you need to take the support of a walking stick, crutches or a cane. In case you have broken an arm or shoulder, exercises focused on reaching and grasping are included.
Modalities might be used to help with the pain and swelling. Your physiotherapist may choose to use ice, heat or whirlpool baths.
Electrical stimulation can also be used to improve your muscle movement. You need to keep in mind that while inactive treatments like electrical stimulation or ultrasound might be used, you also need to keep your muscles physically active to better your movement and strengthen your bones.
If you have had surgery to join the fractured bone, you may have surgical scar tissue. Scar massage can decrease scar attachments and increase movement around the scar.
Exercise to improve the scope of movement and strength can also be started. Particular focus points need to be treated in the joints around the fractured area. If you have fractured a bone close to your elbow, exercises need to be included for your elbow, wrist, and shoulder. Moreover, a fracture in the shin needs to include exercises for the knee, lower leg, and hip. Exercise can guarantee that your bone can endure the load during daily routine work. Make sure to consult with your physiotherapist to learn the correct exercises for your condition.
A fracture can be very painful and might lead to a disability or problem in movement. Depending on the seriousness of the damage, the loss may be temporary or permanent. Physiotherapy can help you come back to your optimum function as quickly as possible.

Physiotherapy - 5 Ways It Can Help Post Fracture!

Q1. What exactly is Laparoscopy?
Laparoscopy is an alternative to 'Open' surgery wherein the abdomen is opened by tiny 'key hole' incisions and surgery is done. 'Scopy' means the use of an endoscope or telescope to see inside the abdomen. This is attached to a camera and a light source and the inside of the abdomen is projected on to a monitor. The surgeon performs surgery looking at this screen. The surgeon makes a total of 2-4 small cuts on the abdomen ranging from half to 1 cm through which the telescope and other thin surgical instruments are passed into the abdomen. When the uterus is removed , known as hysterectomy, there is also a cut at the top of the vagina where the uterus is attached.
Q2. What kind of gynaecological surgeries can be performed by Laparoscopy?
Most surgeries done in gynaecology can now be performed by Laparoscopy and do not require the large incision as for open surgery. Laparoscopy can be done sometimes only for diagnosis and is called Diagnostic Laparoscopy, as in checking whether the tubes are open or not and to look for any causes of infertility or pain outside the uterus. In women who are unable to conceive, Diagnostic Laparoscopy is often combined with Hysteroscopy (endoscope inside the uterus, inserted from below, via the vagina). When laparoscopy is done to perform some surgical procedure inside the abdomen it is called Operative Laparoscopy. This may be for simple procedures like sterilization, minor adhesions, drilling ovaries; or for intermediate or major reasons like fibroids, endometriosis, removal of ovaries or tubes or both or removal of uterus, for staging of cancers or radical surgeries for cancer. However, about 5% of all surgeries including those for cancer or very large tumours may benefit from open surgery.
Q3. Why does an expert surgeon recommend Laparoscopy over Open Surgery?
Laparoscopic surgery has many advantages above open surgery: the incisions are much smaller (open surgery incisions are 8-10 cms long), therefore pain is much less; requirement for pain killers (which can have side-effects like sleepiness, impaired judgement) is lesser; hospital stay is shorter; complications fewer; requirement for blood transfusions infrequent; recovery in terms of physical, emotional and mental state is much better and quicker; return to work is faster with consequent lesser loss of working and earning days. Surgery with laparoscope is more precise because it is magnified view. Further vision is much better because it's like having your eye behind the structure because you can see with the telescope at places where the surgeon's eye cannot reach.
Q4. If the cuts on the abdomen are so small in Laparoscopic surgery, how do you remove the uterus or a large tumour from inside the abdomen?
Quite often if the tumour is not malignant and contains fluid, it is punctured to collapse it into a smaller size. If it is solid, it can be cut into smaller pieces inside the abdomen using a special instrument. The collapsed or cut structures can be removed gently through the 1 cm cut on the abdomen which may be increased a bit if required. After hysterectomy, the uterus can be removed easily from below, through the vagina.
Q5. Will there be much pain or discomfort after Laparoscopic Surgery?
There may be some pain and discomfort in lower abdomen for one day to few days after Laparoscopic surgery but this is much less as compared to open surgery because the incisions on the abdomen are much smaller and there is much less tissue handling inside the abdomen by fine instruments instead of rough, big, gloved hands which can cause tissue injury in open surgery. There may be some pain in the shoulder following laparoscopy. This is not serious and is due to the gas used in the surgery to make space for instruments.
Q6. When can I be discharged from hospital?
Following Diagnostic Laparoscopy or with simple Operative Laparoscopy you can expect to be discharged from hospital latest by the morning after surgery. In most other cases of intermediate or even major surgery, discharge is generally 1-2 days following the surgery unless there is some health issues prior to the surgery or any complication during the surgery. The complication rates for Laparoscopic surgery are not more than for open surgery and depend upon patient factors like anaemia, diabetes, obesity and skill of the surgeon.
Q7. When can I perform routine household activities or return to work after Laparoscopic Surgery?
Recovery after surgery depends upon many factors: presence of health problems before surgery; why the surgery is required; what surgery is being done; problems or complications of surgery, anaesthesia or blood transfusions. If all is well, one can perform routine household activities by 1 week, provided one doesn't feel tired. Although there may not be any harm, it may be unwise to be normally active within 48 hours of procedure. Following Diagnostic Laparoscopy or Operative Laparoscopy for simple procedures, one can return to work in 1 week. For other procedures, a 2-3 week off from work is reasonable. It depends on the type of work you are returning to. Avoid too rapid return to work if it is manually hard or requires standing for long durations of time. Sometimes a surgical procedure brings on a well needed rest and break from a lifetime of work. Mostly, when you return to work depends upon your own body and its signals of tiredness. You need to listen to those signals.


Know All About Gynae Laparoscopy Surgery

Breast cancer begins when the cells that are present in the breast start to go out of control. These cells generally form a tumor which can be seen on mammogram or one can feel it as a lump. The tumor is threatening if the cells can grow into the tissues that surround it or spread to other areas of the body. Breast cancer happens mostly in ladies. Here are a few methods with which you can prevent breast cancer-

Keep your weight in check: Maintaining a healthy weight is important for everyone although, it is easy to tune it out since it is said so often. Being overweight can expand the danger of a wide range of cancers, including breast cancer, particularly after menopause.
Be physically active: Women who are physically active for almost or at least 30 minutes a day have a lower danger of breast cancer. Normal activity is additionally one of the ideal approaches to keep weight under control.
Eat Your Fruits and Vegetables and Avoid Too Much Alcohol: A balanced and healthy diet can bring down the danger of breast cancer. Attempt to eat a considerable measure of fruits and vegetables and keep liquor at moderate levels or lower. While moderate drinking can be useful for the heart in most grown-ups, even low levels of intake can build the danger of breast cancer. If you do not drink, don't feel you have to begin. In case you drink modestly, there is less risk.
Try not to Smoke: Smokers and non-smokers alike know how undesirable smoking is. It brings down a person s quality of life and expands the danger of heart and lung diseases, stroke, and no less than 15 types of cancer, including breast cancer. It additionally causes bad breath, awful teeth, and wrinkles.
Breastfeed, If Possible: Breastfeeding for almost one year or more brings down the danger of breast cancer. It additionally has extraordinary medical advantages for the baby as well, especially in terms of immunity.
Keep away from Birth Control Pills: Contraceptive pills have both dangers and advantages. In many cases, the more young a lady is, the lower the danger is. While ladies are taking birth control pills, they have more chances of falling prey to breast cancer as per various medical studies. This danger leaves rapidly in the wake of stopping the pill. The danger of stroke and heart attack is increased while on the pill, especially if the woman smokes. Long term use can likewise have essential advantages, such as bringing down the danger of ovarian cancer, colon tumor and uterine cancer and undesirable pregnancy. In case you are exceptionally worried about breast cancer, staying away from birth control pills is also an alternative to lower the risk.

Breast Cancer - 6 Ways You Can Prevent It!

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