Tinnitus is the ringing in the ears in the absence of any external sound and the ringing heard is not related to any external source. Tinnitus is a symptom due to underlying ear disease.

Epidemiology

Worldwide 10%-15% of the population suffer from tinnitus and those suffering from ear-related problems are 85% of the population.

How do we know whether it is subjective or objective tinnitus?

Subjective tinnitus is the sound which only the patient hears and objective tinnitus is the sound which others can hear as well along with the patient. Ninety-five percent of the people suffer from subjective tinnitus due to problems in the inner, middle, and outer ear whereas rest 5% suffer from objective tinnitus which is due to any structural defect in the ear, neuromuscular condition, or a tumor in the head, neck, and brain.

Causes

Prolonged exposure to loud sound for a long duration can cause permanent damage to the ear, whereas exposure to a sound for short duration may restore hearing back.
Middle ear infection.
Injury to ear.
Age-related hearing loss: Hearing gets hampered with age which starts around 60 years of age. Hearing loss can lead to tinnitus.
Meniere s disease: It is an inner ear disease; tinnitus is an early symptom
Earwax: Normally earwax protects ear canal from dirt. When it accumulates, wax gets built up causing blockage leading to hearing loss.
Emotional stress Diseases of the heart
Drugs, such as aspirin, antidepressants, quinine, cancer medications, and diuretics.
Temporomandibular joint disorder
Acoustic neuroma
How to deal with it?

First, treat the underlying cause.A patient suffering from tinnitus should be counseled every 15 days. It reduces the stress onto those who are suffering from tinnitus and will boost up the patient.Tinnitus maskers/hearing aid is helpful in ignoring tinnitus frequency. Maintain your cardiovascular health with regular exercise, yoga, meditation, and medicines which control blood pressure. All these factors can help prevent tinnitus.

Can tinnitus be fatal?

It can vary from mild to severe which can cause distress such as interference with sleep and normal day to day routine activities. It can affect patient psychologically so much that patient goes into depression and can commit suicide.

How to evaluate tinnitus?

It can include an audiogram (hearing test), measurement of acoustic parameters and some of the imaging studies to be performed.

A pure tone hearing test is to be performed to find out the cause. Acoustic measurement of tinnitus includes measuring several parameters like frequency, the range of frequency, bandwidth, and loudness in dB above hearing threshold.
Residual inhibition helps indicate how useful tinnitus maskers would be.
Imaging studies like magnetic resonance angiography and Transcranial Doppler are to be performed to find out the underlying cause.

Tinnitus - What Causes It?

Pilonidal Sinus/ Cyst is Characterized By 
   Small nodular swelling in the lower spinal region with occasional discharges that may stain undergarments. Sometimes mild pain may also be noticed. 
   It is usually seen in adults of college/ school going age & with hairy skin. 

Pilonidal Sinus/ Cyst seldom heal with medicinal treatment. Any medication whether allopathic, Ayurvedic or homeopathic may show some temporary relief but do not eradicate the problem. In most of the patients having pilonidal sinus/ cyst, surgeons usually recommend surgical procedures like Z-plasty etc. Even after surgery the chances of recurrences are always there. Post operative pain, hospitalization and chances of recurrence are the factors which suggest that surgery is not the appropriate method of treating pilonidal sinus/ cyst. 

TREATMENT OF CHOICE (AYURVEDA) - 
In Ayurveda, a parasurgical treatment known as Ksharsutra therapy is an effective treatment for pilonidal sinus/ cyst. Treatment method includes proper identification of sinus tract wrt. to its depth, direction and branching pattern. This could be achieved via sinogram or skilled probing. Once the sinus tract has been properly identified, a super specialized medicated thread i.e. Graded ksharsutra  is placed in the tract. The medicine from the medicated thread is gradually released which leads to debridement of the sinus tract which means unhealthy tissue, pus, hairs are expelled out from the tract. The proper and complete debridement of the tract induces healing of the sinus which subsequently heals. The medicine coated thread remains effective for 7-10 days after which it has to be replaced by a new thread. 

Usually, in a sinus of approx. 5 cm length, 6-8 sittings of medicated thread replacement are required at a weekly interval. Ksharsutra therapy being a non surgical opd procedure doesn't involve any hospitalization or bed rest and patients can resume their routine work immediately after treatment. Graded ksharsutra  treatment is the treatment of choice for Pilonidal Sinus as chances of recurrence are seldom seen. The facility of Graded ksharasutra  is available only at Sushruta Anorectal Institute. 

Pilonidal Sinus/ Cyst Treatment FAQs 

Question 1 - What is Pilonidal Sinus/ Cyst Disease? 

Answer - Pilonidal Sinus disease is seen as a small nodular swelling in the lower spinal region with occasional discharges of pus & blood. It is most commonly found in people with hairy skin. Some times mild pain may also be noticed. The main problem is that it keeps on developing again and again after short period of remission. As the problem aggravates, the size of the swelling & pus discharges also increase. It is usually not noticeable in the beginning till it keeps recurring again and again. It is advisable not to get it operated as the chances of recurrence after surgery are pretty high, where as in Ayurveda with the help of Graded ksharsutra , this problem can be completely cured without surgery. *(There is no guarantee of specific results and the results can vary.) 

Question 2 - What are the Causes of Pilonidal Sinus Disease? 

Answer -Pilonidal sinus is also known as the jeep riders back problem. The problem was first recorded on a large scale during world war II in the soldiers who rode jeeps and motorbikes on a frequent basis. Though, the reason behind the occurrence of the issue is really not known it is believed that in growing hairs and hairs penetrating the skin are main cause. The problem is more common in people who have hairy skin. Home remedies for Pilonidal Sinus? Answer - Pilonidal Sinus is an infective condition usually seen in hairy skin individuals. As such there is no home remedy for Pilonidal Sinus. So instead of wasting time in searching for home remedies; you should plan for complete treatment i.e. Ksharsutra Treatment for Pilonidal Sinus as soon as possible. 

Question 3 - What are the ways of identifying a Pilonidal Sinus and Recognizing Signs of Infection? 

Answer -The main problem with identifying Pilonidal Sinus Infection is; it cannot be done till it grows to a certain extent. At first, it appears like a normal boil on the skin. When it does not go away with time; pus starts discharging out of it. We have demarcated a few of the signs that may help you in detecting the problem. 

Sensation of pain while sitting or standing in the low back region. 
The cyst appears swollen 
Pus and blood mixed watery discharge from the cyst 
eddened skin near the cyst 
Cyst forming again and again

Pilonidal Sinus - Say No to Surgery!

An inflammation of the pancreas is known as pancreatitis. The pancreas is an organ that produces digestive enzymes. Pancreatitis might start any day and continue for long period and it requires immediate medical attention. It is of two types- acute pancreatitis and chronic pancreatitis. Although the treatment usually requires hospitalization, pancreatitis can be easily stabilized and the underlying cause can be treated thereafter.

Causes
Pancreatitis may be caused due to various reasons:
1. Gall bladder stone: The pancreatic duct lies next to the bile duct. The gallstones enter the small intestine after passing through the common bile duct. Often the stones that remain in the common bile duct have a negative effect on the pancreas, which causes a hindrance to the normal flow of the pancreatic fluids, causing pancreatitis. Also a back flow of the bile into the pancreas can cause pancreatitis. 
2. Alcohol: Long time alcohol use also causes pancreatitis. Alcohol can damage the pancreas tremendously causing it to get inflamed.
3. Other causes: Hereditary disorders in the pancreas, cystic fibrosis, high level of triglycerides, and a few medicines may also cause pancreatitis.

Symptoms: 
1. The first symptom of pancreatitis is abdominal pain: The pain may be sudden or gradually increasing, but is usually aggravated after eating. It is severe and constant, and may continue for a few days. If you are suffering from pancreatitis, you will feel very sick after a sudden attack and you might require medical assistance immediately.
2. Swollen abdomen: Pancreatitis may cause your abdominal area to swell up and become tender.
3. Nausea: If your abdomen suddenly starts paining due to the onset of pancreatitis, you tend to feel extremely nauseous. You might end up vomiting and may also have violent heaves.
4. Fever: The inflammation will cause you to run a temperature, along with a searing pain in your stomach, which will make you feel extremely uncomfortable.
5. Rapid pulse: Pancreatitis affects the rate, at which the heart beats, causing a rapid increase in the pulse rate.

Causes and Symptoms of Pancreatitis

Almost all of us have experienced bloating, gas or an upset stomach. Yet some people experience this problem at a chronic level. Gas occurs in the stomach and intestines due to breakdown of food into energy. All of us pass gas, however some people do more than others. An average person passes gas 5-20 times a day.

An upset stomach can often cause problems and can be a difficult battle for many people. Although the symptoms of gas problems often relate to an improper diet, yet other factors may be also responsible.

Causes and Symptoms of Gas Problems

Swallowing air: The swallowed air which is not burped out, passes through the digestive system and is released through the opening of the anus. Hiccups can also occur if you have swallowed excessive air.
Diet: The reaction of different foods varies from one person to another. Also foods that lead to odorous gas may also vary from person to person. Yet, spicy foods and dairy products are the most common causes of gas. Example - Beans, cabbage, onions, radishes, eggs, carbonated drinks, sugar, packaged foods etc.
Medications: Certain medicines and supplements, including prescription drugs, can lead to gas problems and bloating. Further, medications which change the hormonal balance in the body can also cause bloating.
Medical problems: Certain medical conditions such as Irritable bowel syndrome or bowel obstruction can also lead to an upset stomach.
Common symptoms of gas problems include gas pain, cramping, bloating, diarrhoea and constipation. In the worst of cases, gas and bloating indicate colon cancer. Such people experience rapid weight loss, anaemia and blood in stools.

Treatment
Modifying your lifestyle, in particular your dietary practices, is essential to a healthy recovery.

Avoiding foods such as spaghetti, oats, bran, barley, banana, bread etc. which contain high fibre content is important.
You can opt for over the counter medications after consulting your physician. Homeopathy and Ayurveda can be also opted as alternative forms of treatment.

Chronic Gas Problem - Facts You Should Know About it

The diagnosis as well as management of pancreatic cystic lesions is a general problem. Nearly 1% of the patients in the chief medical centers have been observed to have pancreatic cystic lesions on cross sectional imaging. It has also been observed that a quarter of all pancreas scanned in an autopsy series contain pancreatic cysts. Earlier, these cystic lesions were regarded benign but with increasing evidence made available from the cystic lesions, they are regarded as origin of pancreatic malignancies.


Information on asymptomatic neoplastic pancreatic cysts
The most vital medical tools that are used in the diagnosis and management of pancreatic cystic lesions include the endoscopic ultrasound and cross sectional imaging. These are used to distinguish non-mucinous cysts from mucinous cysts. The identification of pancreatic cysts creates a lot of anxiety for the clinicians as well as the patients related to the probable presence of a fatal tumor. The findings of a macro cystic lesion that enclose viscous fluid loaded in cea are helpful in the analysis of a mucinous lesion. 


The most common pancreatic cysts are the non-neoplastic inflammatory pseudo cysts, and they can be detected easily by imaging. The identification of pancreatic irregularity with probable association with malignant cells is a vital source of referral for the specialist. The set of guidelines that have been proposed for the management and diagnosis of patients with asymptomatic neoplastic pancreatic cysts are based specifically on the analysis of the quality of the data. It is also designed to address the most important and frequent clinical scenarios. The diagnostic suggestions are provided based on the clinical problem as well as the risk of malignancy.


Imperative guidelines to follow
To achieve accurate diagnosis of asymptomatic neoplastic pancreatic cysts is indeed a great challenge. It is all the more important to find the reproducible methods that can be used to stratify threat of cancer for the patients. The main guidelines include a two year screening interval of cysts that can be of any size as well as stopping observation after 5 years, in case there is no change. The new guidelines, for the most part, recommend surgery if more than one concerning feature is confirmed on the mri by use of endoscopic ultrasound. The new guidelines even suggest discontinuation of inspection after the surgery if no dysplasia or invasive cancer is identified. The guidelines have mainly been developed by use of grading of recomendations assessment, development and evaluation.

Diagnosis and Management of Asymptomatic Neoplastic Pancreatic Cysts

Hepatitis A is an infectious disease caused by the Hepatitis A Virus (HAV), which affects the liver. It leads to inflammation of the liver. Even though it does not cause any severe harm in the initial stages, it can become acute or chronic later if not treated or managed on time. If it becomes chronic, it can lead to cirrhosis of the liver and permanent liver failure too. 

Hepatitis A is caused by ingestion of contaminated food or water and it can also result due to anal or oral contact during sex. This infectious disease results in specific signs and symptoms, including fatigue, nausea, vomiting, fever, jaundice, anorexia, and rashes on the body. There are many allopathic medicines to cure Hepatitis A but they can be harsh on the body. If one wants to avoid the possible side effects of these medications, then Ayurvedic remedies offer to be a better choice as they do not have any side effects and also cure the infection completely, giving permanent and full relief. 

So, here are some Ayurvedic remedies for Hepatitis A.

Virechana: A part of the Panchakarma process, it is a detoxification therapy that flushes out the toxins from the body. In Ayurveda, it is believed that any disorder of the liver is caused by pitta imbalance and this imbalance is rectified by a purgation technique. In the first step, the patient is made to vomit and then is kept on a light diet for a few days and watched over. In the last step, the patient is administered virechana drugs such as sweet herbs to cleanse the toxins and purify the blood. After cleansing, the patient is given a warm bath to calm the senses.
Echinacea: This herb is a natural immunizing agent that helps fight the infection caused by HAV. It is an antibiotic and anti-inflammatory in nature and thus, provides relief to the liver. It also stimulates the secretion of enzymes in the body and improves blood circulation as well. Lastly, it prevents auto-immune diseases.
Phyllanthus niruri: Also known as Bhumi Amla, it is very effective in fighting infections of the liver and can cure all forms of liver diseases. It possesses analgesic, antibacterial, and anti-spasmodic properties. It cures the liver inflammation and corrects the pitta imbalance.
Triphala: A mixture of bibhataki, haritaki and amlaki, triphala is a very effective cleansing herb. It carries laxative properties and thus, helps remove toxins from the intestines.
Katuki: This Ayurvedic herb is very effective in the treatment of different liver diseases and is known as a strong laxative. It helps in the detoxification of the intestines and also kills the intestinal worms.
These Ayurvedic remedies are known to provide lasting relief in Hepatitis A, no matter what the stage of the infection is. The herbal medicines can be consumed in the form of tablets, capsules, mixture (churna), or even taken as a tea. Nevertheless, it is advised to consult an Ayurvedic doctor before resorting to any of these remedies. Proper diagnosis and accurate dosage is a must in the treatment of Hepatitis A.

Ayurvedic Remedies For Hepatitis A!

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