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Patient Review Highlights
Cleft palate or palatoschisis is a common genetic abnormality that leads to a horde of problems and is presently a growing challenge to medicine practitioners. The major developmental stages affected due to this particular irregularity include feeding, speech development, dentition and maxillofacial growth which are rather important to the normal overall developmental pace of an individual. Even though the cleft palate deformity was defined centuries ago, no fixed management algorithm exists for patients suffering from the condition in the present day scenario
Cleft palate may be successfully fixed using reconstructive surgery. Multiple specialists are involved in the reconstruction surgery includingplastic surgeons, otolaryngologists, nutritionists, oromaxillofacial surgeons and speech pathologists. Some hospitals also consider psychological therapy for the patient and the family to help get through the emotional trauma and the issues faced due to developmental backlogs
The treatment for cleft palate usually begins around 9 to 12 months of age. If left untreated, it may cause major deformities. It takes about some years before the whole procedure is completed although it depends on the type and severity of the deformity
The process involves the administration of anaesthesia after which the palate repair closes the inner, middle and final layers and at the same time realigning of the palatal muscles in a technique called anintravelarveloplasty is conducted. This ensures that the muscles are adjusted in a normal position which facilitates the best functioning of the palate during feeding, swallowing and speaking. It is possible that the child might require more than one surgery to completely close the palate.
Some of the risks involved during the process include:
1. Abnormal reactions to the medications
3.Problems in breathing
4. Need for more surgery
Although complicated and time consuming, cleft palate must be given immediate attention to avoid serious developmental issues. The reconstruction surgery and therapy combined ensures a normal development for the child in the longer run, given the surgery was done at the correct time. The child would be required to remain at the hospital for about 5-7 days. Complete recovery takes a time period of 4 weeks. Keeping the wound of the surgery clean is of the utmost importance and it should not be strained. If you wish to discuss about any specific problem, you can consult a General Surgeon.
I was told by a doctor that I have a dead pile (but considerable in size) in my anus which some times obstructs stool passage but rarely with blood. I am a diabetic person will this dead pile be a problem in future? I am 40 years old. Please suggest treatment preferably in homeopathy. I also heard about laser treatment for pile removal please throw some light on that too. Thanks Ravi.
I am 25 years old I am suffering from fissures from last year September and I got operated in the month of December but still I am not yet cured properly used medicine but still the same conditions. What to do?
Hi. My mother is age of 56 years she suffering from breast cancer. Can tell you y it occurs to her. What was the treatment should be done. And what are possibility of doses in future. For cure.
Adverse respiratory events (AREs) are leading causes of post-operative morbidity and mortality. Anesthesia is the use of medicine to prevent or reduce the feeling of pain or sensation during surgery or other painful procedures (such as getting stitches). Giving as an injection or through inhaled gases or vapours, different types of anesthesia affect the nervous system in various ways by blocking nerve impulses and, therefore, pain.
Anesthesia can help control your breathing, blood pressure, blood flow, and heart rate. It may be used to:
- Relax you,
- Block pain,
- Make you sleepy or forgetful,
- Make you unconscious for your surgery.
Adverse Respiratory Events (ARE)
Adverse outcomes of such events are fatal and lead to Death & Brain Damage. Three mechanisms of injury are reported to account for highest adverse respiratory events:
Inadequate Ventilation: Insufficient Gas Exchange can produce the adverse outcome. Esophageal Intubation: Incubation between the two sides of the esophagus inadvertently.
Difficult tracheal intubation: Tracheal Intubation is the placement of a flexible plastic tube into the trachea (windpipe) to maintain an open airway. It is performed facilitate ventilation of lungs in severely ill, anesthetized patients.
Other’s are as listed below:
- Airway Obstruction
- Inadequate inspired oxygen delivery
- Endobronchial Intubation
- Premature Extubation
Residual neuromuscular blockade is an important postoperative complication associated to the use of neuromuscular blocking drugs and is commonly observed in the post-anesthesia care unit (PACU) after non-depolarizing neuromuscular blocking agents (NMBAs) are administered intra-operatively. Incomplete neuromuscular recovery can be minimized with acceleromyography monitoring. The risk of adverse respiratory events during early recovery from anesthesia can be reduced by intra-operative acceleromyography use.
Reintubation is a serious adverse respiratory event and the consequences include increased cardiac and respiratory complications, prolonged length of stay at the PACU, intensive care unit (ICU) and hospital, prolonged mechanical ventilator support, higher costs, and increased mortality. Overweight and obesity have also been identified as risk factors for postoperative respiratory complications. Most adverse respiratory events are considered preventable with improved monitoring such as:
- Pulse Oximetry
- Combination of Both
Closed observation of the clinical factors and appropriate monitoring by well trained people are factors necessary to prevent adverse outcome. If you wish to discuss about any specific problem, you can consult a general surgeon.
Light fluid secreting from my left breast nipple after one rubbing, start over 1 year but now more. I.e. Means infection in breast nipple? I can't discus with any one, so please solved with medicine. I am unmarried. Tell me what is the problem?
Sir my girlfriend's breasts leaks fluid like something of light colour slightly sticking when touch. Neither she is breastfeeding nor pregnant, we enjoyed on 20/2/17 and when I squeeze her breasts something sticky fluid sticks my hand and when I kiss it tastes sweet. Later she informed me that fluid comes out when she squeeze her breasts both but in single little droplet. She have no tumour or burn or pain. Her menstrual period ends on 18/2/17. Pliz acknowledge the symptom. Is she suffering from breasts cancer? I fear sir.
I am 30 years old married women. Now I have a 11 days baby girl. I am getting pain when she is sucking milk like some one is pinning to my breast. May I know the reason for this pain? What should I do to cure this pain?
Hello All, My father's prostate gland got enlarged also his sodium level became down so doctors put foley catheter as he has become so weak, and did medication for sodium level increase. After discharge they said to keep catheter for two weeks as he has become weak, when we took my father to home he was getting few drops of blood in insertion area of catheter and few amount of blood through pipe also, but next day it was all OK, but after six to ten days he started bleeding from catheter like continuous blood was flowing and that catheter bag was full of blood, we took him again to doctor and it's been two days the flow of blood is now reduced but it's still coming. Also as he was having cholesterol problem so doctor has given tablets which will thin blood, please can someone help me out with how many days it will be fine and why this issue can be occurred. Is this normal because doctors has hospitalized him but blood flow is still there. Thanks so much in advance!
My relative is 32 year old n he is suffering from anal fistula from 2 years n getting severe pain so what treatment should done to cure it.
I am facing with anal fissure for nearly a year .but now my pain become severe. This is my last sem .i have to travel more to complete my project. What should I do for reducing pain atlest till the completion of this semester. I am feeling pain even if I used pain killer. What is the best remedy to avoid pain after bowel movement.
I am 26 years old I have a problem in my anus, it itches and while scratching it bLeeds sometimes it get swollen when scratched constantly. Facing this problem for quite long now Please help I am scared.
1. Is Water Lumps in Breast required urgent operation? 2. How much days Rest is required? 3.Is it Big operation or normal? 4. Can it be cure through Medicine (Tablets & Capsule or any other) or Operation is must?
Sir I'm 26 year old, pichhle 20 dino se mai toilet jate time anus me halki khujlahat or dard feel kr raha hu. Baithne PR v dard hta h.ek funsi c ho gai h Jo thik nai ho rai. please suggest me what can I do? Kon c tblt khau? Or any cream?
Colorectal cancer, also known as colon cancer or bowel cancer; is the occurrence of cancer in the colon and the rectum region. Colorectal cancer may either be malignant or benign, the former spreads to other areas of the body whereas, the latter stays confined to its place. It is characterized by an abnormal growth of cells in the rectum or the colon.
The various surgical treatment options for colorectal cancer are:
1. Right colectomy: This procedure involves removal of the right part of the colon. A part of the small intestine, which is attached to the right side of the colon, known as ileum, is also removed.
2. Partial colectomy: In partial colectomy, only a portion of the colon that has been affected by cancer is removed. The remaining parts are fused together in a process called ‘Anastomosis’. This procedure does not cause much change in your bowel habits.
3. Total abdominal colectomy: In this procedure, the large intestine is removed from the body.
4. Abdominoperineal resection: Abdominoperineal resection involves removing the rectum, anus and the sigmoid colon (part of the intestine that leads to the rectum).
5. Total proctocolectomy: This is an extensive procedure wherein, both the colon and the rectum are removed. If the anus is weak or damaged, then it needs to be removed as well.
Apart from these procedures, there are other surgical procedures that complement the above procedures, they are:
1. Fecal diversion: This is a procedure where an opening is formed between the small intestine and the skin’s surface so that it facilitates the healing process.
2. K pouch: The K pouch also called continent ileostomy is a pouch, which is attached to the anus so that feces can be passed normally. The K pouch contains nipple valve that prevents leakage; it is emptied by inserting a catheter in the stoma.
3. Stomas: A stoma is an opening on the skin of the bowel. This is done when the normal route of bowel is disturbed after a surgery. If you wish to discuss any specific problem, you can consult a general surgeon.
Hi I am married just one month back and I think that my breast shape is very small. And I feel lump in my breast. I am really worried is that a sign of cancer. Also I want to increase my beast size .pls help me how do I do it?
What is an Appendectomy?
An appendectomy (which is sometimes referred to ‘appendicectomy’) is the surgical elimination of the organ known as the appendix. Appendectomy is mostly performed as an emergency surgical procedure, when patients suffer from appendicitis.
How is Appendectomy Performed?
Appendectomy can be performed both as an open operation as well as laparoscopically. An appendectomy is most often performed laparoscopically, if the diagnosis is in doubt, or if the patients feel that they need to hide their telltale surgical scars near their umbilicus or in the pubic hair line.
However, although laparoscopic appendectomy has its cosmetic advantages, and its recovery time is a little quicker, this procedure is more expensive than conventional open surgery.
Conventional Open Appendectomy-
In the conventional open surgery, the surgeon makes an incision which is less than 3 inches in length in the lower right section of the abdomen. Once the infected appendix is identified, the surgeon separates the infected appendix from its surrounding tissues and removes it surgically from the cecum (an intraperitoneal pouch that forms the junction of the small and large intestine). After that, the cecum is closed and is returned back into the abdomen. In the end, the muscle layers and the skin are sewn together and the incision is closed.
Laparoscopic Appendectomy (LA)-
While performing appendectomy laparoscopically, which is also known as LA, four incisions of 1 inch in length are made in the abdomen. One incision is made near the umbilicus, while another one is made in an appropriate region between the umbilicus and the pubis. The other two incisions, which are even smaller in size, are made in the right side of the lower abdomen. The surgeon then passes the camera and special laparoscopy instruments through these openings and after identifying, frees the appendix from its surrounding tissues. Next, the appendix is removed from the cecum and the site of its former attachment is sewed. The infected appendix is removed from the body of the patient through any one of the two 1 inch incisions. In the end, the laparoscopic instruments are removed and the incisions are sutured and closed. During this whole procedure, the intraperitoneal space is filled with medical grade carbon dioxide gas, to inflate the abdomen, which is released after the surgery.
Recovery Time For Appendectomy-
The recovery time for appendectomy depends on and varies with the type of procedure and anesthesia used during the surgery. While laparoscopic appendectomy can be done on an outpatient basis so that the patients can recover back at home, an open surgical procedure will require an overnight or even longer hospital stay.
Normally patients after appendectomy can resume their normal daily activities within a few days. However, for full recovery, it may take four to six weeks. Patients are advised to avoid strenuous activities during this period of time.
Risk and Long Term Consequences of Removing the Appendix-
While wound infections are the most common complications of this surgery, formation of an abscess in the area of the surgical incision and also in the area close to the removed appendix has also been noticed as an aftermath of appendectomy.
Other rare complications may include lack of intestinal peristalsis (ileus), gangrene of the bowel, injuries to the internal organs and infections in the peritoneal cavity (peritonitis).
Major long-term consequences of appendectomy include increased risks of bowel obstruction, stump appendicitis (infection in the retained portion of the appendix still stuck with the cecum) and development of incisional hernia at the site of the scar. If you wish to discuss about any specific problem, you can consult a doctor and ask a free question.