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5 Signs You Might Be Hallucinating!

Dr. Sushil Kumar Sompur 93% (2856 ratings)
MB BS, MD - Psychiatry, MBA - Healthcare
Psychiatrist, Davanagere
5 Signs You Might Be Hallucinating!

Serious mental disorders and side effects to varied medicines may cause hallucinations in many individuals. Psychosis and Schizophrenia are the most commonly known causes that may cause this condition. Hallucinations are sensations and feelings that may appear as real to the patient, convincing him or her of the occurrence of things that are not really happening in reality. Hearing voices, seeing people, and experiencing things that no one else can, are some of the ways in which hallucinations work.

Let us find out the varied signs and symptoms of this condition.

  1. Hearing Voices: One of the most common signs of hallucinations includes hearing voices. You may hear voices from people who cannot be seen or heard by other people around you. In such cases, you may have the distinct feeling of hearing these voices from within or from a source outside your own mind and body. In many cases, you may feel like these voices are trying to talk to you or give you a certain message. Ringing of the ears on a persistent basis may also be experienced in such cases.

  2. Visual Hallucinations: These hallucinations will make the patient see things. In such cases, the patient may be witness to a scene that cannot be seen by anyone else – a scene that may not be happening in reality. In visual hallucinations, the patient may also see people that other people in the room or the area cannot see. The patient may also see objects and other creatures like insects crawling across his or her hand, and may react with fear or anxiety, when in reality, no such scene may be happening. These kind of hallucinations also cause occipital seizures where the patient will see spots, shapes and rings of brightly coloured lights that may be coming towards him or her, or even encircle him or her.

  3. Feeling Things: These kinds of hallucinations will make the patient feel things that may not really be happening. For example, these hallucinations will make the patient feel hot during winters or feel a blast of air even when there has been none.

  4. Taste Hallucinations: In these hallucinations, the patient may get a salty taste from sweet food, or vice versa. These hallucinations make the patient imagine that he or she tastes a certain flavor when in reality, this may not be true. These are also called gustatory hallucination.

  5. Olfactory Hallucinations: These hallucinations have to do with odd smells that the patient may get a whiff of. In these hallucinations, the patient imagines certain smells like burning, or other odours. Patients may also feel that their own bodies are letting out certain odours which may not be the actual case.  

Delusion vs. Hallucination

A delusion is a false belief based on incorrect inference about external reality that is firmly sustained despite what almost everybody else believes and despite what constitutes incontrovertible and obvious proof or evidence to the contrary. The belief is not one ordinarily accepted by other members of the person's culture or subculture (e.g., it is not an article of religious faith).

A hallucination occurs when environmental, emotional, or physical factors such as stress, medication, extreme fatigue, or mental illness cause the mechanism within the brain that helps to distinguish conscious perceptions from internal, memory-based perceptions to misfire. As a result, hallucinations occur during periods of consciousness. They can appear in the form of visions, voices or sounds, tactile feelings (known as haptic hallucinations), smells, or tastes.

Delusions are a common symptom of several mood and personality-related mental illnesses, including schizoaffective disorder, schizophrenia, shared psychotic disorder, major depressive disorder, and bipolar disorder. They are also the major feature of delusional disorder. Individuals with delusional disorder suffer from long-term, complex delusions that fall into one of six categories: persecutory, grandiose, jealousy, erotomanic, somatic, or mixed.

In case you have a concern or query you can always consult an expert & get answers to your questions!

2857 people found this helpful

Urinary Tract Infection in Childhood - What Parents Need To Know?

Dr. Amit Agarwal 92% (825 ratings)
MD - Paediatrics, MBBS, FISPN & FISPN - Pediatric Nephrology
Pediatrician, Noida
Urinary Tract Infection in Childhood - What Parents Need To Know?

Many children all over the world are affected by urinary tract infections or UTIs that can be resolved with simple antibiotics, but might also lead to complications at times. Most often, kids under 2 years of age are affected by it, and either the bladder or the kidney might be infected leading to cystitis or pyelonephritis , in smaller children kidneys are presumed to be infected unless proved otherwise.

Causes of UTIs

Though bacterial infections are the most common cause, viral or fungal infections might occur in some cases as well. Most UTI in infants are caused by structural abnormalities of urinary tract. Uncircumcised male infants or children with poor toilet habits, or female children with poor toilet hygiene are susceptible to this disease. Children suffering from a weak immune system might also be at a risk.

Symptoms and signs

Symptoms of UTI are very difficult to differentiate from any other illness in small kids under 2 years of age, symptoms include high fever, diarrhea vomiting, and dehydration. Basically any fever for which no cause is apparent must be evaluated for UTI. UTIs in older children beyond 5 years of age come with different signs including pain during urinating (dysuria), frequent urination, abnormal urge for urination, or bedwetting. Sometimes, fever, abdominal pain, blood in urine or vomiting might be signs as well.

Which doctor to consult?

In most cases, UTIs in children are treated by pediatricians, but if kidney function is troubled then a pediatric nephrologist needs to be contacted immediately. Pediatric Nephrologist to be consulted once the fever is over to look for cause of UTI.

  1. Tests carried out: To understand the underlying cause of the infection and any anatomical or functional risk factors, several examinations or tests are carried out. Vital signs like blood pressure, body temperature, and breathing rate are checked. The abdomen is palpated to find tenderness near the kidneys. Genital areas are also examined for signs of trauma, redness, discharge and such. Urine cultures are essential for diagnosing UTIs finally and this helps in assessing the antibiotic sensitivity profile too.
  2. Good to know: Right after an antibiotic is administered, UTI in children starts getting resolved. But recurrent UTIs might lead to urinary tract abnormalities like kidney malformation. Also note that UTI is not contagious, and cannot be passed on if children share a bath or if you sit on an infected toilet seat.

Treatment

In most cases, UTIs respond well to oral antibiotics, though Pyelonephritis may require hospitalization and intravenous drip. Some studies are also carried out to check if the child is susceptible to renal scarring or kidney failure. These are as below:

  1. Renal ultrasound: Defines the location of the kidneys and their size and shape clearly.
  2. Voiding cysto-urethrogram: The bladder is filled with a dye through a catheter in this method. Then the catheter is removed to study if the bladder is getting emptied without any reflux or obstruction.
  3. Renal scan: To test the functioning of the kidneys and the risk of renal scarring, a bit of radioactive material is used.
  4. Intravenous pyelogram: Though rarely used, in this method, a dye is injected into the bloodstream and X-ray images are obtained.

Prevention

  1. Maintaining proper hygiene: Girls should wipe from front to back and uncircumcised boys should be able to gently retract the foreskin to reveal the urethral opening.
  2. Complete voiding of bladder: Encourage kids to urinate every two to three hours, since they often ignore a full bladder to carry on playing.
  3. Consumption of fluids: Drink plenty of fluids and avoid constipation. If you wish to discuss about any specific problem, you can consult a Pediatrician.
3752 people found this helpful

Causes Of Impotence In Young Males - This Is What Really Causes It!

Dr. Vinod Raina 91% (6502 ratings)
MD - General Medicine
Sexologist, Delhi
Causes Of Impotence In Young Males - This Is What Really Causes It!

Many young men have tried Viagra and similar medications but found they do not help very much. Causes of impotence in young males can be varied and an embarrassing problem. However the problem affects millions of men of all age groups and there are many treatment options available. This article will talk about obesity, smoking and lack of exercise which can all result in narrowing of the blood vessels, which is the cause of impotence. Losing weight if necessary, giving up smoking and getting fitter may help reverse the problem.

Why Do So Many Younger Men Suffer From Impotence?

Impotence is a recurring and persistent issue where a man is unable to get or maintain an erection. It may be worth consulting your doctor if a persistent problem as impotence is caused by a variety of conditions.

Causes Of Impotence In Young Males And Solutions

1. Obesity 
There is a strong connection between obesity and impotence. Men that are obese are far more likely to experience erection issues than those of normal weight. Men who are overweight have a higher risk of developing heart disease, diabetes and high cholesterol. Clogged arteries and high blood pressure will worsen with excess weight and this is what contributes to erection issues. Men who return to their normal weight usually regain their sex life.

2. Smoking 
Men who smoke are more likely to develop problems with achieving or maintaining an erection. This is due to blood flow and smoking can cause damage to the blood vessels of the penis. Smokers tend to have reduced or abnormal semen quality and sperm count compared to men that do not smoke.

3. Exercise 
Aerobic exercise and this includes walking, jogging and swimming is helpful for your blood vessels. Studies have found that men who exercised the most were the most likely to have better performance in the bedroom. Exercise can help improve cardiovascular risk factors and will also reduce stress related issues. It is also easy to get started on an exercise program. Exercise can also help your impotence treatment work better.

4. Medicines for Impotence 
There are 3 main prescription medicines which are used to treat impotence in young men: Viagra Cialis and Levitra. You can purchase all of these medicines through an online website but a prescription from your doctor is advised. They all work in the same way, by enlarging the arteries which supply blood to the manhood. This allows enhanced blood flow to the erectile tissue in the penis. An erection can then be achieved and maintained.

5. Other Treatments 
The two main other treatments are vacuum pumps and erection rings. A vacuum pump is a cylinder a man places over the penis. Air is pumped out of the device and this can create an erection. Rings are used to maintain an erection as they restrict blood flow from the penis. The ring is placed around the base of the manhood and can give some men stronger erections and better orgasms. Side effects of using a penis pump can include pain and bruising. The ring should be removed right away if you feel any pain, numbness, or a cold sensation.

6. Psychological treatment 
Counselling or therapy can sometimes tackle stress, depression or performance anxiety issues and can be combined with medication to treat the impotence in the short-term.

Natural Remedies For Impotence 
Whatever the cause of impotence in young males, there are numerous natural remedies for impotence that can help treat this condition. There are many alternative therapies and these can include natural herbs and remedies. Derived from plants and herbs, cultures have used these treatments for many years to treat impotence and other related erection issues.

 

9 people found this helpful

7 Causes Of Vitiligo And Its Treatment!

Dr. Ramya M N 91% (1057 ratings)
MBBS, MD - Dermatology , Venereology & Leprosy
Dermatologist, Bangalore
7 Causes Of Vitiligo And Its Treatment!

Vitiligo is a skin disorder where white patches of depigmentation develop on the skin and keep enlarging. This disorder is long term and continuous in nature. The patches appear due to the death of melanocytes within the skin. Melanocytes are skin pigment producing cells, which produce melanin. Vitiligo can affect the skin of several areas, including the eyes, hair and the portion inside the mouth.

Causes:
The causes of this disease are as follows:

  1. Autoimmune disorders in which the immune system of a patient becomes over reactive and the melanocytes are destroyed.
  2. This disease may also occur due to genetic oxidative stress imbalance.
  3. Stressful events may also lead to vitiligo.
  4. Harm or damage to the skin from sunburns or cuts also leads to vitiligo.
  5. Exposure of the skin to several harmful chemicals may be a cause.
  6. Neural disorders are also responsible for vitiligo.
  7. Vitiligo may also happen from viral causes or may be hereditary and passed on from family members.

Symptoms:
Vitiligo has only one major symptom. White, flat spots and patches develop on the surface of the skin. The earliest of these white patches appear on the parts of the body which are exposed to the sun continuously.
It starts off as a simple spot in the beginning and gradually, the spot starts getting pale and finally turns white. The patches have irregular shapes, and in some cases the edges get inflamed and are red in color. Itchiness is experienced in the affected areas. Symmetrical patches signify slow development of vitiligo.

The two major types of vitiligo are:

  1. Non segmental vitiligo, which affects the back of the hand, the arms, knees, elbows, feet, mouth.
  2. Segmental vitiligo, which is more stable than non segmental vitiligo, but spreads faster. It usually affects areas of the skin, which are attached to nerves.

Treatment:
The different methods of treatment for vitiligo are:

  1. Phototherapy with UVB and UVA light: Exposing the affected area of the skin to UVB lamps is a popular cure for vitiligo. This treatment can be performed easily at home. UVA treatment incorporates taking of a drug which makes the skin more sensitive to ultraviolet light and then the skin is exposed to high doses of UVA light.
  2. Skin Camouflage: Cosmetic creams and makeup can be used to camouflage affected areas of the skin. These topical creams are waterproof.
  3. Depigmentation: Depigmentation is used to treat widespread areas affected by vitiligo. The skin color of the unaffected areas is reduced in order to match the affected areas. It is done using topical ointments.
  4. Medicinal creams containing tacrolimus, steroids, calcopotriol can be used. Phototherapy should not be taken at home. A variety of surgeries also available. Skin grafting, melanocyte transfer, melanocyte culture.

Vitiligo is a skin disease, the major causes of which are still to be discovered. Proper care and treatment should be taken for skin areas affected by vitiligo. In case you have a concern or query you can always consult an expert & get answers to your questions!

2756 people found this helpful

5 Most Common Problems That People Face In Their Sex Life!

Dr. A. Kumar 93% (6871 ratings)
B.A.M.S., M.D.(A.M), EX-M.R.C.G.P., EX-M.R.S.H., EX-M.S.I.E.C.U.S, EX-M.S.S.S.S.
Sexologist, Mumbai
5 Most Common Problems That People Face In Their Sex Life!

Discrepancy in desire between partners is the most common type of issue that becomes the first reason for an unhealthy sex life. Generally with females the same could be because of four reasons as follows:

  • Fatigue or Stress
  • Physical Issue
  • A Severe Lifestyle Change
  • Financial Stress

Though as per the experts the sexual drive is a result of how attracted you find yourself towards your partner.

Here are top 5 reasons why your sex life can be disturbed:

  • Having “No time for Sex”: The biggest reason behind a hampered sex life could be having no time for sex. Generally people with busy lives claim that they love each other a lot, on the other hand they do accept they hardly get time to get intimate. Actually the reason behind the same is the lack of desire because of mental stress which they undergo for the whole day. Other than that erectile dysfunction, painful intercourse, negative body image, premature ejaculation and interpersonal conflict could be some of the other reasons which can create issues. The solution for the same is to confront the situation and discuss the problem openly with your partner.
  • Medical Illness: One of the most common problems is low desire. But there are many ways to approach the problem. This is exceptionally disappointing for the two patients and clinicians on the grounds that there is no 'little blue pill' for want. The issue of low want regularly sits comfortable crossing point between brain, body and relationship, and this isn't generally simple to hear in our convenient solution culture.  In my opinion one should definitely sit back and let the body undergo the repairing part all by itself.
  • Erectile Difficulty: The most common sexual issue that generally people face is erectile difficulty. In the event that there is no restorative premise or commitment to the erectile trouble, for the most part uneasiness is meddling with the man's ability to end up and stay excited. On the off chance that the man is in a conferred relationship, treatment for this as a rule includes having the man and his accomplice complete a graduated arrangement of touching activities, which are intended to help men physically interface with their accomplices with no strain to perform sexually.
  • Decreased sex-drive: The most serious issue which a couple can confront is either troubled with the decreased sex-drive in their sexual recurrence or the way that they have ceased all sexual movement. The arrangement isn't a one-assess fits-all model, in light of the way that there are different reasons that couples pertain from taking part in sexual relations can be erectile brokenness, severe pain in the midst of intercourse, weakness with the sexual timetable, loss of orgasm on account of sickness, pharmaceuticals or stress in the relationship. 
  • Lack of Emotional Intimacy: Sex is not at all centered to have intercourse rather; the main factor which drives sex is love and intimacy. People generally don’t know how to make love to each other. There had been many chances wherein the partners are too quick to enjoy the feeling of intercourse, and sometimes it becomes so slow that one actually gets irritated because of the same. In both the cases the solution is to get attached to the emotional sensitivity of your partner. In certain cases Dr.s do advise such couples to undergo certain sexual touch exercises which help them perform better between the sheets.
6228 people found this helpful

Hallucinations - 5 Signs of it

Dr. Prashant 92% (48 ratings)
MD - Psychiatry, MBBS
Psychiatrist, Delhi
Hallucinations - 5 Signs of it

Serious mental disorders and side effects to varied medicines may cause hallucinations in many individuals. Psychosis and Schizophrenia are the most commonly known causes that may cause this condition. Hallucinations are sensations and feelings that may appear as real to the patient, convincing him or her of the occurrence of things that are not really happening in reality. Hearing voices, seeing people, and experiencing things that no one else can, are some of the ways in which hallucinations work.

Let us find out the varied signs and symptoms of this condition.

  1. Hearing Voices: One of the most common signs of hallucinations includes hearing voices. You may hear voices from people who cannot be seen or heard by other people around you. In such cases, you may have the distinct feeling of hearing these voices from within or from a source outside your own mind and body. In many cases, you may feel like these voices are trying to talk to you or give you a certain message. Ringing of the ears on a persistent basis may also be experienced in such cases.

  2. Visual Hallucinations: These hallucinations will make the patient see things. In such cases, the patient may be witness to a scene that cannot be seen by anyone else – a scene that may not be happening in reality. In visual hallucinations, the patient may also see people that other people in the room or the area cannot see. The patient may also see objects and other creatures like insects crawling across his or her hand, and may react with fear or anxiety, when in reality, no such scene may be happening. These kind of hallucinations also cause occipital seizures where the patient will see spots, shapes and rings of brightly coloured lights that may be coming towards him or her, or even encircle him or her.

  3. Feeling Things: These kinds of hallucinations will make the patient feel things that may not really be happening. For example, these hallucinations will make the patient feel hot during winters or feel a blast of air even when there has been none.

  4. Taste Hallucinations: In these hallucinations, the patient may get a salty taste from sweet food, or vice versa. These hallucinations make the patient imagine that he or she tastes a certain flavor when in reality, this may not be true. These are also called gustatory hallucination.

  5. Olfactory Hallucinations: These hallucinations have to do with odd smells that the patient may get a whiff of. In these hallucinations, the patient imagines certain smells like burning, or other odours. Patients may also feel that their own bodies are letting out certain odours which may not be the actual case.  

Delusion vs. Hallucination

A delusion is a false belief based on incorrect inference about external reality that is firmly sustained despite what almost everybody else believes and despite what constitutes incontrovertible and obvious proof or evidence to the contrary. The belief is not one ordinarily accepted by other members of the person's culture or subculture (e.g., it is not an article of religious faith).

A hallucination occurs when environmental, emotional, or physical factors such as stress, medication, extreme fatigue, or mental illness cause the mechanism within the brain that helps to distinguish conscious perceptions from internal, memory-based perceptions to misfire. As a result, hallucinations occur during periods of consciousness. They can appear in the form of visions, voices or sounds, tactile feelings (known as haptic hallucinations), smells, or tastes.

Delusions are a common symptom of several mood and personality-related mental illnesses, including schizoaffective disorder, schizophrenia, shared psychotic disorder, major depressive disorder, and bipolar disorder. They are also the major feature of delusional disorder. Individuals with delusional disorder suffer from long-term, complex delusions that fall into one of six categories: persecutory, grandiose, jealousy, erotomanic, somatic, or mixed.

2435 people found this helpful

Obesity and Small Penis - How They Relate Each Other

Dr. Vinod Raina 91% (6502 ratings)
MD - General Medicine
Sexologist, Delhi
Obesity and Small Penis - How They Relate Each Other

Even in today's health-conscious culture, obesity continues to be a major problem. According to a National Health and Nutrition Examination Survey, 1 in 3 adults in America is considered obese. Clearly, obesity is a general health concern, but for men, it can also be a penis health issue. And beyond health, there's another factor to consider: men who are obese tend to present with a small penis.

Obesity & Small Penis - How They Relate Each Other?

Does this mean that obesity causes a man's penis to shrink? Not exactly. Instead, being overweight causes the penis to appear smaller than it actually is. Part of this is an illusion and has to do with seeing things in comparison. For example, imagine two men standing naked next to each other, each with an erection measuring six inches long and having the same girth.

Assume they are the same height, but that one has a waist measuring 34 inches and one a waist measuring 44 inches. Because there is so much more mass "framing" the erection in the second instance, it is going to appear smaller than the erection on the first, leaner man.

But there are other, more insidious ways that obesity contributes to the appearance of a small penis. As stated, being overweight does not make the penis actually shrink. However, as a man's belly grows, so does his pubic pad. This area at the base of the penis grows out over the penis, hiding that portion underneath a layer of fat.

It's estimated that every 40-50 extra pounds a man gain hides about an inch of his penis in this way. So his penis may still technically be six inches long - but with an inch hidden away, it appears to be only five inches.

How else does a small penis result from obesity? Well, obesity is associated with erectile dysfunction. Blood vessels are weakened by excess fat, so erections are not as full and strong, thus when the penis becomes erect, it often is not as long as it was in the past.

Tips to Fight with Obesity Problem

Fear of a small penis may cause some obese men to take steps to lose some of that extra weight - and that's definitely a good idea. Maintaining a healthy weight can pay off in many ways beyond just making a man proud of his penis. But it's important that a man, especially one who has been overweight for a long period of time, checks in with a doctor before beginning a new diet or strenuous next exercise routines. That said, here are a few things a man can consider to help him fight his obesity.

  • Eat Good Food: Many men eat too much of certain foods, such as fatty meats or sugary foods, and not enough of healthier items like fruits and vegetables. By expanding the kinds of food he eats, a guy can eat healthier and lose weight at the same time.
  • Smaller Portions: It's not always necessary to "clean the plate" when eating. Men can try taking smaller portions or just eating until their hunger is satisfied, rather than feeling obligated to "eat it all."
  • Exercise Wisely: Not every guy can jump right into spending two hours working out or running ten miles a day. It's good to know limits and to start slow. Even just walking 30 minutes a day can be beneficial to a guy who is mostly sedentary.
  • Penis Health: More than just creating the appearance of a small penis, obesity can make it difficult for a man to properly tend to his penis health. This can more easily be accomplished through the daily application of a superior penis health crème (health professionals recommend Man1 Man Oil, which is clinically proven mild and safe for skin).
  • Creams: The best crème contains both L-carnitine and L-arginine. The former is a neuroprotective ingredient that is excellent at keeping sensation alive in the penis. The latter is an amino acid that helps produce nitric oxide, which in turn helps keep penile blood vessels healthy.

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In case you have a concern or query regarding sexual health ask a doctor online, you can consult the best sexologist doctor online, & get the answers to your questions.

 

10 people found this helpful

Gangrene - Cause, Symptoms, Diagoniss & Treatment

Dr. Radhika Amulraj 89% (13 ratings)
MD - Acupuncture, Diploma In Accupuncture, Advanced Diploma In Accupuncture
Acupuncturist, Delhi
Gangrene - Cause, Symptoms, Diagoniss & Treatment

What is Gangrene

Gangrene is a serious condition where the body’s tissue begins to decay and die due to a lack of blood flow or bacterial infection. It most commonly affects the toes, fingers, and limbs, but it can also occur in your muscles and internal organs.

Symptoms of Gangrene

  1. Skin discoloration
  2. Severe pain
  3. Swelling
  4. Feeling of numbness
  5. A foul-smelling discharge leaking from a sore
  6. Rapid heart rate
  7. Lightheadedness
  8. Shortness of breath
  9. Fever

Causes of Gangrene

  1. Lack of blood supply
  2. Infection

Risk factors of Gangrene

  1. Older people
  2. Severe injury or surgery
  3. Blood vessel disease
  4. Diabetes
  5. Obesity
  6. Immunosuppressant

Complications of Gangrene

  1. Need for reconstructive surgery
  2. A body part may need to be removed 

Diagnosis of Gangrene

Diagnosis of Gangrene involves the following tests: 

  1. Blood tests
  2. X-Ray, CT scan and MRI
  3. Fluid or tissue culture
  4. Surgery to determine the extent to which gangrene has spread within your body

Precautions & Prevention of Gangrene

  1. Lose weight
  2. Help prevent infections
  3. Avoid tobacco
  4. Care for your diabetes

Homeopathic Treatment of Gangrene Foot

Homeopathy can both prevent and cure gangrene. Several homeopathic remedies are available to treat gangrene that can be selected on the basis of cause, sensations and modalities of the complaints. Some of the homeopathic medicines help in the treatment of gangrene are:

  1. Arsenic album
  2. Bromium
  3. Carbo veg
  4. Lachesis
  5. Antrhacinum
  6. Cantharis
  7.  

Conventional / Allopathic Treatment of Gangrene Foot

In the allopathic treatment of gangrene, antibiotics are given through a vein.

Surgical Treatment of Gangrene

The following surgical methods are used to treat gangrene:

  1. The dead tissue is removed which helps stop gangrene from spreading and allows healthy tissue to heal.
  2. A skin graft is a type of reconstructive surgery that may be used to repair damage to your skin caused by gangrene.
  3. An affected body part, such as a toe, finger, or limb, may need to be surgically removed.

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3 people found this helpful

Labiaplasty

Dr. Abhishek Vijayakumar 91% (2318 ratings)
MCh Plastic Surgery, MS - General Surgery
Cosmetic/Plastic Surgeon, Bangalore
Labiaplasty

What is a Labiaplasty?

Labiaplasty is a surgical procedure that corrects excessively long, enlarged or redundant labia minora tissue and can make the external genitalia (the “vulva”) more cosmetically appealing. Women with enlarged or elongated labia may feel very conscious when wearing tight clothing or swimwear, as the outline of the labia may be visible through the clothing. Enlarged labia may also cause women to feel self-conscious during intimate contact.  Some are concerned about asymmetry of their labias, or they may have pain or discomfort during sex or with exercise. Occasionally, redundant labia tissue predisposes to yeast infections or creates friction tears of the tissue.

During a labiaplasty, excess or stretched-out labia minora tissue is excised to create a more neat and tidy appearance to this region and to treat associated physical concerns. Occasionally excess tissue around the clitoral hood is also carefully trimmed as part of the procedure.

Who is a Good Candidate for Labiaplasty?

Labiaplasty is a personal procedure that should certainly not be associated with embarrassment or shame. Women of all backgrounds, shapes, sizes and cultures seek labiaplasty. Sometimes after childbearing, labial tissue can become stretched out or redundant, and following menopause the vulvar lips can droop with loss of collagen and elastin. Many women are congenitally born with asymmetric or excess labial tissue.

Women who experience awkwardness, pain with intercourse, or discomfort when walking or with exercise due to excess labia tissue are candidates for a labiaplasty. Other women are simply looking to improve the appearance of this part of their body to look as youthful as they feel. Rejuvenation of the labia area can be an empowering experience, potentially improving a woman’s body image, self-esteem and comfort during intimacy.

Can Labiaplasty Be Done Before Pregnancy?

A labiaplasty can certainly be performed at any time in a woman’s life. Labiaplasty is considered a “quality of life” procedure, and is a personal decision. Having surgery will in no way influence future pregnancies or childbirth delivery options.

What Are the Different Types of Labiaplasty?

Labia Minora Reduction

A labiaplasty usually involves trimming the inner lips of the labia, known as the “labia minora”. Only the inner or outer lips of the vulva are treated; the vagina is not normally addressed during a labiaplasty.

 

Labia Majora Reduction

Occasionally, the outer lips of the genitalia (“labia majora”) are trimmed to additionally reduce their prominence. This procedure involves incisions in the skin of the labia majora and is associated with-potentially additional scars and post-surgical swelling during healing.

Clitoral Hood Reduction

For women with redundant clitoral hood tissue, a reduction of the clitoral hood can also be performed as part of a labiaplasty. Clitoral hood reduction involves careful trimming of excess skin that hangs over the clitoris. The overlying skin is then rearranged without risking nerve injury or affecting sexual sensation or stimulation.

Labiaplasty procedure

In order to ensure complete comfort and relaxation, we perform labiaplasty as an Day care procedure in the operating room, under a short and safe general anesthesia or under local anesthesia. Local anesthetic is used to prevent bleeding and bruising during surgery, and to keep the area numb for many hours after surgery. Excess labial tissue is trimmed, the clitoral hood is reduced if appropriate, and a neat and tidy closure is performed in multiple layers using dissolving (absorbable) sutures. Antibiotic ointment is applied, and an absorbable pad is placed over the incisions. Surgery takes around 1-2 hours to complete, and women are allowed to return home a few hours after awakening.

Types of Labiaplasty

Wedge Labiaplasty

Many surgeons these days are performing wedge labiaplasty, for two main reasons:

A wedge of tissue is removed from the middle area of the labia, preserving the natural labial edge for a less obviously surgical look.

The wedge method leaves a shorter scar that’s harder to see because it runs across the labia rather than along the edge.

However, there are some potential drawbacks to this approach. The wedge technique generally only addresses the middle one third of the labia and does not treat the irregular dark hyperpigmented edge of the posterior parts of the labia. It also does not treat excessive clitoral hood tissues which commonly accompany prominent labia minora.

In addition, the wedge technique creates a condition where the amount of tissue resected must be balanced against creating wound tension with closure. Excising too much tissue may result in a potential for wound separation, whereas conservative resection may produce insufficient reduction. It takes an experienced surgeon to advise you on the anticipated results.

 

Trim Labiaplasty

Until recently, trim labiaplasty was the go-to choice for women who wanted to improve the appearance of their labia. This method, as the name implies, involves trimming the excess labia tissue to a more proportionate size and shape relative to the rest of the vaginal area. Many women appreciate that the trim method removes the existing edges of the inner labia, which can darken with age or following pregnancy.

The tissue is typically excised from the clitoral hood and along the edge of the labia minora to the vaginal forchette. In this manner, excess tissue from the upper, middle and lower one/thirds of the inner lips can be removed.

The trim technique leaves a longer scar but it is tension free and commonly is barely visible. Unlike the wedge, wound separation is less likely.

An irregular, thickened and darkened edge is what leads so many of our patients to choose trim labiaplasty as their preferred approach. For those with excess tissue limited to the mid portions of the labia only, the wedge method is an excellent option.

Wedge vs. Trim: Which Is Best?

Both procedures accomplish the primary goal of labia reduction just fine. The question of which labiaplasty technique will give you better results depends on your unique anatomy and your personal goals for surgery.

What is the Recovery After Labiaplasty?

Mild discomfort is treated with oral pain medication for a few days. Swelling and bruising of the genital region can develop over the first few days. You may shower the next day, and will apply antibiotic ointment daily. If you start your menstrual cycle, it is recommended you avoid using tampons for your next 1-2 cycles to avoid irritation of the incisions while they are healing.

At least couple of days should be taken off work or arrange to work from home during this time. Aggressive physical activity should be avoided for at least a week or two after surgery. Sexual intercourse should be avoided for approximately 6 weeks after a labiaplasty. By week 6 to 8, the healing is complete, and no restrictions are needed.

Like any surgery, it takes at least 6 weeks for the initial swelling to recede, and 6 months up to a year for the results to be absolutely complete. Incisions are hidden in the natural crease of the labia region. There is usually very little scarring, as incisions are made in the labial “mucosa” (similar to the inside of the mouth or the gums) rather than the skin.

Possible Complications of Surgery

Some complications associated with labiaplasty are specific to this procedure, while others are complications that could be encountered as a result of any cosmetic surgery, or any surgical procedure in general. Complications common to nearly all surgical procedures include bleeding, bruising, swelling, infection, and scarring. Since labiaplasty is often performed under local anesthetic and sedation rather than general anesthetic, the risks are somewhat less than with more invasive surgical procedures.

Procedure specific complications include Loss of sensation, Spotting, Difficulty urinating ,Change in pigmentation, Asymmetrical results after full healing has occurred ,Separation of the incision site; this occurs in roughly five percent of wedge labiaplasty patients, but is easily to correct. The majority of these symptoms will also be temporary, and resolve within a few days to a few weeks depending on the individual symptom and how quickly your healing progresses.

Will the procedure affect my fertility?

No, the procedure will have no affect on your ability to have children. However, you should use contraception to avoid pregnancy before and after the procedure. Your surgeon will cancel your procedure if you are pregnant on the appointed day. After surgery, you should avoid giving birth for one year following the procedure. As a normal delivery would stretch the tissue and damage the results achieved.

Will there be scarring?

There is usually evidence of scarring following surgical incisions. Your surgeon will try to make the incisions in the least conspicuous areas so that the scarring may be virtually invisible. Even visible scarring will tend to fade over time.

Will labiaplasty affect my sensitivity?

Sensitivity typically stays the same after labiaplasty when done right. After recovery, sexual intercourse is often more enjoyable, because patients feel more confident without the excess skin.

AntiBiotic Resistance on the rise very fast

Dr. Himanshu Shekhar 93% (522 ratings)
Post Graduate Diploma in Hospital and Healthcare Management, MD - Consultant Physician, Fellowship Critical Care Management
Internal Medicine Specialist, Faridabad
AntiBiotic Resistance on the rise very fast

In 5 Years, Threat Of Drug-Resistant Superbugs Doubles


A 72-year-old woman in Bengaluru consulted a hospital physician about a severe skin infection and fever. She had previously consulted a couple of general practitioners, who prescribed a course of penicillin for three days and fluoroquinolones—both antibiotics—for two days.

There was no relief.

So, the consultant ordered a culture sensitivity test of pus from the skin lesions to identify what was causing her ailment and figure out what antibiotics it would respond to.

Here’s what the report said:
Pathogen: Klebsiella pneumoniae
Susceptible to: No antibiotic
Resistant to: All antibiotics, including advanced drugs like fluoroquinolones, carbapenems and even the last resort combination usually reserved for severe cases of ICU infection, colistin-tigecycline.

With nothing to offer the patient, save a prescription for paracetamol to keep her fever in check, the doctor sent the patient home, and asked her to return after a week.

In such cases, sometimes, the body’s immunity kicks in and throws off the infection, the physician, Sheela Chakravarthy, consultant (internal medicine) at Fortis Hospital, Bengaluru, told IndiaSpend.

Sometimes, resistance to one or more drugs abates, allowing treatment to be resumed. Chances of that happening are greater at home, not in the hospital, which is a more infectious space where sepsis—a disproportionate and potentially life-threatening immune response by your body to an infection—could set in, she explained.

Most patients, however, succumb to the infection.

Chakravarthy faces situations where she has nothing to offer patients, not because they are suffering from terminal illnesses, such as some forms of cancer, but even when they present with what should be curable infections, “almost every day”, she said.

What Chakravarthy described is the consequence of rampant, inappropriate consumption of antibiotics, spurring the development of superbugs, as the recently released State of the World’s Antibiotics Report 2015 affirms.


India is fast becoming home to superbugs

Escherichia coli, Klebsiella pneumoniae and Staphylococcus aureus are three of the deadliest pathogens facing humanity, according to the World Health Organisation (WHO). And India is gradually but increasingly becoming home to multi-drug resistant strains of these pathogens, according to the State of the World’s Antibiotics Report 2015.

Escherichia coli is notorious for causing food poisoning and urinary tract infections.

In 2010, 5% of Escherichia coli samples in India were resistant to carbapenems, last-resort antibiotics for bacteria that are resistant to first-, second- and third-line drugs. By 2014, 12% of E. coli samples were similarly resistant.


Klebsiella pneumoniae causes pneumonia, septicaemia and infections in the urinary tract, lower biliary tract and at surgical wound sites, to name a few.

While 29% of Klebsiella pneumonia isolates were resistant to carbapenems in 2008, this increased to 57% in 2014.

For comparison, fewer than 10% of Klebsiella pneumoniae infections in Europe are carbapenem-resistant.

Staphylococcus aureus can cause skin and soft tissue infections, bloodstream infections, pneumonia and surgical site infections. A particularly nasty strain of, methicillin-resistant Staphylococcus aureus (MRSA), is common in India and increasingly hard to treat.

MRSA was responsible for 40% of post-surgical site infections, according to a 2013 study by the Jawaharlal Nehru Medical College and Hospital, Aligarh.

Between 2009 and 2014, the incidence of MRSA in India has risen from 29% to 47%.

People with MRSA are 64% more likely to die than people with a non-resistant form of the infection, according to the WHO.

How ignorance is spurring the development of superbugs

“My understanding of antibiotic is that it stops bacteria growing in body…I think amoxicillin is for throat infection.”

–An urban participant of a study of perceptions about antibiotic use and resistance among urban and rural doctors, pharmacists and public in Vellore.

Mox, short for amoxicillin, has become a household word across India.

A little knowledge, however, is a dangerous thing. It encourages self-medication, even when medicine is unnecessary, such as when people suffer viral infections—against which drugs are ineffective. Most viral fevers dissipate on their own after a few days with rest, hot fluids and a check on the fever.

Consuming too many antibiotics contributes to pathogen drug resistance.

“Resistance is an outcome of accumulated use,” said Ramanan Laxminarayan, vice president, Research and Policy, Public Health Foundation of India, and director and senior fellow, Centre for Disease Dynamics, Economics & Policy, US, and co-author of the State of the World’s Antibiotic Report 2015.

Indians often rely on corner pharmacists, whose knowledge of dosages may be limited.

Here’s what a rural pharmacist participant of the aforementioned Vellore study said: “Amoxicillin, 6 tablets is to be taken [for full course].”

Amoxicillin’s full course depends on the kind and severity of bacterial infection.

When an antibiotic of lower strength or fewer pills than needed is prescribed, the body cannot fully eradicate the pathogen. Sensing it has come under attack, the bacterium responds by evolving into more resilient, antibiotic-resistant strains.

But with a course of antibiotics, say generic Amoxicillin, costing about Rs 160, close to a day’s wage in many states, and a doctor’s consultation costing anywhere between Rs 100 and Rs 1,000, more than a day’s wage in most places, patients are bound to cut corners.

Another Vellore study participant summed up the situation thus: “If I have money I go to hospital. If not, I get medicine from pharmacy shop. If I get better, I stop and keep for future use.”

Stopping a course of drugs mid-way also contributes to antibiotic microbial resistance.

In a 2015 study in Chennai, 70% respondents confessed to stopping the medication when they felt better. Only 57% completed the antibiotic course.

“Less is more”: the key to preserving antibiotic efficiency

Educate health professionals, policy makers and the public on sustainable antibiotic use, says the State of the World’s Antibiotics Report 2015.

That is sensible advice.

Denmark and Sweden boast of low rates of antibiotic use and near-zero rates of antibiotic resistance because the risks of antibiotic overuse are widely known.

Instituting regulations on antibiotic use has reduced the proportion of MRSA in Europe and the US by about a fifth over the last eight years.

India requires more stringent regulations for antibiotic use.

It isn’t enough to tell physicians that they should prescribe antibiotics only when essential to cure bacterial infections. The right way is to order a culture sensitivity test, which costs money, and the patience to wait for the result.

“Patients want instant and cheap relief, and are willing to shop around for a doctor who obliges,” said Dr Himanshu Shekhar, medical director, SCI International Hospital, New Delhi.

“Some judge doctors on how fast the prescribed medicine cures. Practice pressures lead many doctors to prescribe advanced drugs, without getting a culture-sensitivity test done.”

So, it’s also not enough to have 24 advanced antibiotics, including third- and fourth-generation cephalosporins, carbapenems, and newer fluoroquinolones, under the ambit of Schedule H1 of the Drugs & Cosmetic Rules, 1945, with effect from March 1, 2014.

That means these drugs cannot be sold over-the-counter, but they are still freely prescribed.

Chakravarthy’s suggestion: “Make Schedule H antibiotics available only through hospitals and health centres.”

“Changing antibiotic usage behaviours is critical to preserve the efficacy of existing and new drugs,” proposed Laxminarayan.

India also sorely needs regulations to check antibiotic use in animals raised for human consumption, to meet the State of the World’s Antibiotic Report 2015 recommendation to reduce and eventually phase out sub-therapeutic antibiotic use in agriculture.

Sub-therapeutic use implies mixing antibiotics in animal feed to make them grow faster and to prevent infections from devastating the herd or flock.

India is among the world’s five biggest consumers of antibiotics for livestock. IndiaSpend has earlier reported increasing evidence of antibiotic-resistant bacteria in animals in India, and how this impacts humans.

“Using antibiotics to make animals fatter faster is a waste of a precious resource,” said Laxminarayan.

How surgeons contribute to antibiotic resistance

Surgical antibiotic prophylaxis refers to the prescribing of antibiotics before, during and after operations to prevent infection.

Between 19% and 86% of patients in hospitals in India receive “inappropriate antibiotic prophylaxis”, according to the State of the World’s Antibiotics Report 2015. A prophylactic is preventive treatment for a disease.

Ideally, antibiotic prophylaxis should be administered as a single dose within 60 minutes of the skin incision. However, a 2013 Mangalore-based study found timing adhered to in 22% of cases in a government hospital, 64.9% cases in a medical-college teaching hospital and 80.7% of patients in a tertiary care corporate hospital.

“Smart antibiotic prophylaxis also includes choosing narrow-spectrum antibiotics to target the organism most likely to present concerns based on the kind of surgery being performed, this avoids needless exposure to antibiotics for the other microbes and helps prevent resistance,” said Vimesh Mistry, assistant professor, Pharmacology, Baroda Medical College.

Staphylococcus aureus, which lives on the skin, is most likely to cause infection during surgery. But surgeons frequently make poor antibiotic choices.

“We found appropriateness of choice of antibiotic in 68% cases and 52% compliance with the in-house prophylaxis guidelines,” said Tanu Singhal, infectious diseases specialist, Mumbai, and co-author of another study on antibiotic prophylaxis conducted in PD Hinduja Hospital, Mumbai.

Other prophylaxis inaccuracies include the unnecessary prescribing of antibiotics, inaccurate dose and inaccurate duration of prescription.

“We logged 63% accuracy in prescription duration. Surgeons tend to prescribe antibiotics for too long fearing post-surgery infection,” said Singhal.

In the trade off between protecting the patient better and increasing the risk to society of a pathogen developing resistance, surgeons are choosing the former.

Needed: A back-to-the-basics approach to health

Reducing the need for antibiotics through improved water, sanitation and immunisation is another strategy recommended in the State of the World’s Antibiotics Report 2015.

“Vaccination against pathogens such as the diarrhoea-causing rotavirus and pneumonia-causing Klebsiella pneumoniae helps curtail antibiotic demand, thereby reducing the chances of resistant strains developing,” said Laxminarayan.

In Canada, the widespread use of pneumococcal conjugate vaccines for pneumonia in children has reduced the incidence of pneumonia caused by strains the vaccine covers.

However, just as antibiotic usage spurs the development of superbugs, vaccination is a double-edged sword.

Canada is seeing a rapid increase in the incidence of other strains of pneumonia not protected against by the vaccine.

So, it is better to focus on the basic constituents of health.

Making available clean drinking water and improving sanitation would prevent people from getting sick in the first place. India still has a lot to do on both these fronts.

Improving individual immunity is the best bet to ward off infections, and that is also achievable by healthier eating, exercising, healthier living and the better management of chronic conditions like diabetes and asthma that increase vulnerability to infections when they are not kept in check.


Dr Himanshu Shekhar
MD,Medicine
New Delhi
+919818433208
( Above Article , with My Inputs was published in a leading Health Magazine)
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