Prashanthi Ortho & Maternity Hospital

Apart from the skin on your face, the skin on your elbows and knees needs special attention as well. Whether you’re fair skinned or dark skinned, with age you may notice your skin on the elbows and knees becoming darker than usual. This happens because the skin in these areas is thicker than the rest of the body and has more folds than usual. It also has no oil glands and very little blood supply that makes this area rough and dry.

Genetics, exposure to the sun, improper hygiene, hormonal imbalances and certain medications are some of the factors that play a role in the darkening of the skin in these areas. Resting your elbows on the tables or kneeling puts the skin on your elbows and knees in contact with other surfaces and causes friction that can also make the skin darker. Luckily this is not a condition that requires medical attention and can be treated with simple home remedies. Here are a few-

1. Lemon and Honey Scrub: Lemon and honey are excellent for the skin. Lemon juice has natural bleaching properties and honey is a great moisturiser. When combined together, they lighten the skin and make it softer simultaneously. Mix 1 lemon juice and 1 tablespoon of honey and apply on the affected areas. Leave on for at least 20 minutes and then rinse.

2. Vinegar and Yogurt Mask: The combination of vinegar and yoghurt helps remove black spots and moisturises the skin. To use, mix a few tablespoons of vinegar with yoghurt and apply on the skin. Once dry, rub the mixture in a circular motion to scrub the dead cells off and then wash off.

3. Aloe Vera Gel: Along with all its other health benefits, aloe vera gel is also very good for the skin. In particular, it addresses damage caused by sun exposure and moisturises the skin. Ideally, use the gel from a plant directly. Apply aloe vera gel on the elbows and knees and leave to dry for at least half an hour before rinsing it off.

4. Turmeric, Milk, and Honey: Turmeric is well known as an antiseptic and when combined with the moisturising properties of honey and the bleaching properties of milk can do wonders for darkened elbows and knees. To use, mix equal proportions of all the three elements into a paste and apply to the affected areas. Leave on for 20 minutes and scrub in a circular motion before washing off.

Blisters can be a very major inconvenience. Though it seems to be a good idea to pop a blister yourself as it can otherwise cause distraction or may be uncomfortable and unsightly, puncturing it often does more harm than good. Here are a few ways mentioned about how to treat blisters. Read on more to find out all about it.

1. For a Blister which has not popped

• Try not to pop the blister as the pus if spread can affect other areas
• Leave the blister uncovered or cover it with a loose bandage
• Avoid putting pressure on the area of the blister. If the blister has appeared in areas where applying pressure is unavoidable like for example at the bottom of the foot, put mole skin around the blister in a circular fashion such that the mole skin gets the shape of a donut.

2. For a blister which has been popped

• Wash the area where the blister appeared gently with warm water. Apply gentle soap in the area as well to disinfect the region. Do not by any chance use alcohol, hydrogen peroxide or iodine in the area as it would cause complications.
• Smooth down the skin flap which remains after the blister pops. 
• Apply antibiotic ointment in the affected area to prevent infections
• Cover the region loosely with help of a sterile bandage or gauge.

3. When to drain a blister

• For blisters which are painful, large or in awkward spots, it is better to drain them. Be careful and cautious while draining the blister and follow the below mentioned tips.
• Wash the area where the blister has appeared.
• Take a needle and sterilize it with alcohol and water.
• Make an incision at the edge of the blister and carefully squeeze out the pus.
• Wash the blister again and pat dry. Do not remove the skin flap which remains there after draining.
• Smoothen the skin flap and apply antibiotic ointment in the region.
• Wrap it up with a loose sterile bandage or gauge.

4. Follow up

• Change the bandage on a regular basis, whenever it is wet or dirty.
• Consult a doctor immediately if signs of infections like red streaks around the affected region, fever, or accumulation of more pus occur.

However for blisters which have formed due to spider bites, chicken pox or such consult a doctor first.

The ear is made up of three parts that is outer, middle and the inner part. Infections, disorders and ailments in the ear can occur across all age groups and in any part of the ear. Ear ailments are more common in children than in adults as the Eustachian tubes (tubes which drain out ear fluid) are smaller in children.

Here are a few common ailments which occur in children:

1. Acute otitis media: AOM is the most common ear infection in children. Some parts of the middle ear are infected, resulting in swelling and blockage of fluid behind the eardrum. This condition is characterised by earache in children and in graver conditions, can also cause fever.
2. Otitis media with effusion: This condition usually occurs due to the infestation of an infection when the fluid gets restricted behind the ear drum. This condition doesn’t exhibit too many symptoms except mild earache. You should visit an ENT specialist who can diagnose this condition by checking the concentration of fluid behind the eardrum using special instruments.
3. Chronic otitis media with effusion: This condition occurs in children when the fluid remains trapped behind the eardrum for a long period of time. It can lead to serious infection and cause problems in hearing in children.
4. Barotrauma: Barotrauma occurs due to changes in atmospheric pressure changes. It can cause problems in the Eustachian tube and causes trapping of air in the middle ear. Middle ear problems can become severe if left untreated and result in a burst in the eardrum, causing excessive bleeding.
5. Meniere's disease: This is a disorder, which comes in bouts and is characterised by vertigo and fluctuating hearing loss. This condition usually affects one ear. It can result in tinnitus (ringing in the ear) or permanent loss of hearing if left untreated.
6. Swimmer’s ear: Swimmer’s ear, also known as otitis externa, is a common condition which is caused in the outer area of the ear. This condition is caused due to remnants of chlorine water in the ear or because of inserting swabs too deep inside the canal. This condition is characterised by earache, discomfort and itching of the ear.

A fracture separates a single solid object into two or more pieces due to pressure. In medical terms, a fracture refers to a broken bone due to some kind of external trauma. A crack in the bone, on the other hand, does not cause a clean break in the bone - there is only a separation or discontinuity in the bone material. A crack in the bone caused due to repeated stress is often called a 'hairline fracture'.

Here are the basic differences between a crack and a fracture in the bone and how to treat them:

1. A crack or hairline fracture is rarely caused by a single injury. It is usually the result of bone fatigue which may be caused due to repeated concentrated stress over a long period of time and thus it is also called a stress fracture. Other bone fractures are almost always the result of sudden and severe force on the bones.
2. The skeletal system constantly remodels itself. The cells called osteoblasts absorb calcium and secrete bone connective tissue. If a particular site is exposed to recurrent bouts of force (which are individually not impactful enough to cause a crack), over time the osteoblasts in that region malfunction and the crack appears. Muscular exhaustion can also cause cracks in the bones. Fractures are caused due to sudden external single force trauma to the bone. Nutritional problems like deficiencies of calcium, phosphorus and vitamin D and excessive smoking decrease the bone mineral density and increase the chances of both cracks and fractures.
3. The symptoms of a crack are swelling, tenderness and sharp pain in the injured region. The symptoms worsen over time. A fracture has similar symptoms and might also exhibit an external physical distortion and makes it impossible to move the part of the body that where the broken bone is.
4. An MRI is better for the detection of cracks or crack-prone areas because an X-ray can only detect the crack after it widens somewhat or the bone starts paining because the rays cannot pass through the tiny gap in bone material. A fracture is easily detectable by an X-ray because the rays pass right through the break.
5. Complete rest for six to eight weeks is the most effective way of healing a crack. Using a walking boot in case of cracks in the leg bones in also helpful. Healing fractures requires extensive medical intervention. Surgical techniques like bone grafting and insertion of metal plates are used to reposition the broken bone.
    

Toxic shock syndrome (TSS) is a potentially life-threatening condition that causes a steep drop in blood pressure, resulting in deprivation of oxygen to the organs, which in severe cases leads to death. This disease has been associated with menstruating women who use superabsorbent tampons. It was first recognized in the 1970s and 80s when women using tampons of certain brands were affected by this syndrome and those brands were immediately taken off the market. This disease primarily affects tampon wearers and harmful effects of cervical caps, diaphragms, and menstrual sponges have surfaced.

New mothers are susceptible to TSS as well as those who are recovering from a surgery, are wounded or are using prosthetics. It is important to know about its symptoms so that you can identify the disease and seek professional help at the earliest.

Symptoms

Warning signs of TSS include:
-Seizure
-Headaches
-Muscle aches
-Diarrhea
-High fever
-Nausea

Causes
An overgrowth of bacteria called staphylococcus aureus (staph) causes this disease. It can be found primarily in female bodies. This is one of the many staph bacteria that lead to skin infections in burn victims and patients recovering from surgical wounds. Group a streptococcus (strep) bacteria is another cause of this syndrome.

Siblings are most definitely, the best thing to have ever happened to anyone. We fight, we laugh, we play and we defend. No matter, whether you are the best buddies or you cannot even stand being in the same room, you two (or three or four!) share an inseparable bond, which will last for a lifetime. Siblings are surely in for the long haul, while friends and colleagues may just come and go. But do our sibs really influence us?

The weight issues!
Obesity has been known to run in generations and families, but there have been studies which show that siblings have an influence, especially when we talk of the waistline. Researches’ conducted from a 2014 based study at Duke University from the Sanford School of Public Policy show that if the older sibling is obese, the chances of the younger one, being the same increase fivefold. This is regardless of the fact that the parents are obese or not.

Character talk
Though there is little evidence supporting the theory of birth order affecting personality, there sure is enough to support that siblings do shape the same for each other. Siblings do develop separate identities for themselves and in the same run, affect and shape the personality and characteristics as well as the behavior of the other, to a major extent. For instance, a person would make more of an effort to become an outgoing person, if his/ her sibling is shy and quiet. In case of families with three kids, this is more likely to happen among siblings of the same gender instead of the opposite genders.

The first teachers!
Navigating social situations are what we first learn from our siblings. A daily practice in understanding foreign minds and getting an insight of the outer world is what we first get from our siblings. Strong bonds between two kids at home have shown better and more successful connections with peers at school.

Saving marriages is their task!
Being a part of a bigger family reduces the chance of divorce due to more chances of being accustomed to adjustment. Ohio State University concluded in a 2013 study that every sibling reduces divorce risk by 2%.

Depression Deal
Squabbling of siblings is as natural as the rain. Yet, the reasons for the fight can have major health implications. Quarrelling about issues like fairness and equality can lead to experiencing higher levels of depression. The same has been concluded by a 2012 study of the University of Missouri. Fighting over personal space can lead to development of low self-esteem and anxiety.

But they are happiness boosters too
You know that already! Having siblings is in itself a joyful experience.

An abnormal junction or connection between two organs or tissues is referred to as a “fistula”. It targets two hollow organs, vessels, or tissue structures. It occurs mostly in the rectum, vagina, however can affect the intestines and the eyes too. It results in extreme pain, discomfort and should be treated as immediately as possible to prevent infection.

It can induce sensations of:

1. Extreme irritation or itching
2. Discharge with unusual odor (if the fistula is located near the anus/vagina)
3. Irritable bowel syndrome
4. Excess pus
5. High body temperature
6. Blood discharge

Diagnosis
In case or prolonged tension and pain in these areas, a proctoscopy should be conducted for diagnosis. It most commonly occurs in women who have sustained prolonged labor (over 2-3 days). However, other causes include:

1. Digestive malfunction
2. Abscesses(formation of pus in hollow organs)
3. An unhealthy lifestyle which includes excessive indulgence in alcohol and tobacco

Ayurvedic treatment for fistulas are available which aim to sooth the inflammation by slowly remedying the wound through natural and safe measures. Since Ayurvedic practices are non-toxic, non invasive and completely safe, one can avoid the drastic measures that surgery consists of, and also avoid the side effects of medicines.

Ayurvedic remedies of fistulas include
Ayurvedic doctors have developed several oils, ointments and medications that are readily available in the market. The medications usually consist of a mixture of herbs, roots and plants that aim to restore the physical systems and also soothe the affected area.

1. The importance of buttermilk added with rock salt and black pepper also allows the enzymes of our body to multiply and thereby cure the fistulas internally.
2. Radish juice with a pinch of cumin is also recommended to be consumed after meals to improve digestion and empower the immune system.
3. A healthy lifestyle and fitness routine consisting of yoga and exercises also contribute to improve conditions in the patient by facilitating blood circulation and metabolism.