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Piles or haemorrhoids are swollen veins in the rectum or anus. They can have a lot of possible causes, but the exact reason is still unknown. The one most common reason that researchers cite is the excessive straining during bowel movement and increased pressure on the veins during pregnancy. Some of the common signs of this condition include discomfort, bleeding, and itching. A clot can be witnessed occasionally. There could be swelling around the anus as well.

How is a pile diagnosed?
Doctors often recognize this condition just by doing a physical exam of the rectum. By lubricating the glove and inserting a finger into the rectum, a doctor can gauge any unusual growth around the rectum area. A doctor might also use a sigmoidoscopy or a proctoscopy to witness the lower portion of the colon. Apart from this, a doctor might prescribe a colonoscopy, if he fathoms that there is a possibility of colorectal cancer or a disease related to the digestive system.

Treatment of piles

1. Medication: In case of mild discomfort, a doctor might prescribe over-the-counter pads, ointments, creams or suppositories. Products such as these contain lidocaine, witch hazel or hydrocortisone that can relieve a person from itching and pain. One should stop consuming over-the-counter medicine, if there is no change in the condition.
2. Haemorrhoid thrombectomy: If a clot has appeared along with a pile in the rectum, a doctor can remove it by making an incision and draining the clot. This can fetch instant relief. The best time to do this is within 72 hours of clot formation.
3. Minimally invasive procedures: 
   • Rubber band litigation: This form of surgery involves placing of a couple of rubber band at the base of the piles to cut off blood circulation. In due course, the haemorrhoids fall off. Although this form of treatment works for many people, the patient has the risk of bleeding within few days of placing the rubber band.
   • Sclerotherapy: This form of treatment involves injecting a chemical into the haemorrhoid. The chemical shrinks the piles within few days. There is hardly any pain involved with sclerotherapy.
4. Surgical procedure:
   • Haemorrhoidectomy: This is the process by which a surgeon eradicates the excess tissue that might be causing the piles. The patient is sedated before performing this procedure. Some amount of pain is experienced after the procedure is over. The temporary difficulty of urination can be faced by a patient after this procedure.
   • Stapled hemorrhoidopexy: This surgery is only performed for internal haemorrhoids. The process involves blocking the blood supply. The process of stapling has less pain compared to a Haemorrhoidectomy. On the flip side, studies have shown that this procedure has an increased chance of recurrence of haemorrhoids.

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

Lip augmentation is a restorative (cosmetic) procedure where your lips are reshaped to make them appear fuller. Cosmetic procedures are done for aesthetic improvement, but surgical lip augmentation is performed if the lips are affected by any congenital condition or tissue trauma.

Dermal fillers are mostly used to enlarge the lips. Previously, collagen was the most popular filler, but currently, due to various health reasons, doctors do not use it as often as before. Now, hyaluronic acid fillers are the most popular dermal filler.

Hyaluronic acid is naturally available in your body, especially in your neural, epithelial and connective tissues. The fillers that doctors presently use are chemically similar to hyaluronic acid. It is extremely beneficial in adding volume to your lips.

Applications of Hyaluronic acid

• Hyaluronic acid fillers improve your lips’ appearance by boosting their shape, structure and volume.
• The effects of such fillers last approximately for six months; you would require more injections after that.
• Restylane and Juvederm are the most popular hyaluronic acid fillers used currently. These also contain lidocaine in them, which is a local anaesthetic.

Hyaluronic acid fillers also include the following benefits:

• The amount of filler to be injected is easily controllable, so the doctor can regulate the amount of volume to create.
• The injections are given at a steady pace, so the development can be carefully monitored to achieve the desired result.
• Any bump or lump caused by moving the lips too much is easier to correct.
• In relation to other dermal fillers, there will be reduced swelling and bruising.
• Results last for a longer duration, but they are not permanent.
• Collagen fillers required an allergy test before the procedure could begin, but that is not the case with hyaluronic fillers. Hyaluronic acid fillers are not allergens since they are made from similar substances found in the body.

Risks of lip augmentation
Like every surgical procedure, lip augmentation too has certain risks involved. Some of the contraindications (situational dangers of certain drugs or procedures) include:

• Facial nerve disorders
• Intermittent herpes simplex sores
• Diabetes
• Critical Hypertension
• Allergies
• Autoimmune disorders

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

Dermabrasion is a skin related treatment used by cosmetic surgeons and dermatologists to cure a number of ailments that may leave your skin looking less than healthy. This method basically employs a technique that removes the upper layers of your skin with the help of a rough edged diamond wheel or a wire brush. These edges are called a burr or a fraise.

Here is everything you need to know about the procedure as well as the results that it can yield:

• Areas and Conditions: The most common areas where this procedure is conducted include the face as well as the neck. It is mostly used to treat people who want to remove fine lines that form around the eyes and the mouth, as well as patients who are suffering from acne scars and other inflammation causing skin ailments as well as abrasions due to injuries.
• Preparation: The procedure includes cleaning and marking the area that is being treated. This is the first step that helps in seeing exactly what needs to fixed, the extent of the damage and the intensity of the treatment to be employed. Following this process, the doctor will administer a local anaesthesia such as, Lidocaine that will numb the area before the actual treatment begins so that the patient does not undergo any discomfort. Also, with this purpose in mind, the dermatologist may also apply ice packs on the face and neck of the patient so as to make the skin even more numb and remain like that for a longer period of time. Additionally, the skin may be sprayed with a freezing cryogenic spray in order to retain the numbness and keep the skin firm enough for effective treatment. If the doctor is going to treat deeper abrasions or the entire face, then pain killers and general anaesthesia may be used.
• Procedure: To begin with, a small area is exposed to the treatment at a time, rather than the entire area or face at one time. After the freezing spray is administered, the doctor may run the rotating brush or burr to remove the top layers of the skin. Gauze will be kept handy so as to stem any bleeding that may take place during the process. Finally, the area will be covered with the help of ointment and dressing.
• Results: The recovery time is said to take anywhere between five to eight days. But this also depends on the severity of condition that was treated, as well as the area that was covered. Little or no pain may follow and regular cleaning will be required. To prevent re-occurrence or re-growth of the problem, follow up visits to the dermatologist will be required.

My last article gave insight on the non-medical methods of controlling premature ejaculation.  Now, as a wrap up on this topic, I will highlight the options of medical treatments available for managing P.E. However, take it as a warning that you must consult your doctor before trying out any of these methods and medicines, because more often than not, such drugs and medicines have their side effects that can adversely bother your health.

By now we know that Premature ejaculation (PE) occurs when a man reaches peak of sexual excitement and ejaculates before he actually wants it to happen, thus, leaving his partner deprived of the sexual pleasure that she deserves. Even the most empathetic female partner would not like his man to leave her unsatisfied in bed.  Sooner or later this problem becomes a medical problem, reduces the warmth in their relationship.

Several factors including psychological problems such as anxiety; biological problem like penile hypersensitivity, hormonal imbalance (e.g. thyroid problem); behavioural problem like, habituation of quick sex/masturbation, etc may be held responsible for causing PE.

Medical (Allopathic) therapy for PE treatment:

Drugs used for managing premature ejaculation reduce sensitivity and anxiety, improve blood flow and even affect some chemical mediators present in the brain. These class of drugs include local anaesthetics, antidepressants and phosphodiesterase-5 inhibitors.

Anaesthetic compounds were the first medical treatment proposed for PE management. They were applied topically to the surface of skin. Lidocaine-prilocaine sprays or creams decrease the sensation of the penis and increase the time taken to ejaculate during vaginal penetration. These sprays/ creams are applied 10 to 20 minutes prior to sexual activity. Side effects of topical agents include partial loss of sensation of penis, absorption in vagina resulting in vaginal numbness and irritation.

Earlier agents like Alpha Amino Benzoate and Phenoxybenzamine were used to prolong duration of intercourse, but they were associated with severe side effects.

It has been found that Serotonin (a chemical in brain) levels were deficient in PE patients. Treatment medications include Selective Serotonin Reuptake Inhibitors (SSRIs), which interact with a receptor (5-HT2C) present in brain and increases the production of Serotonin. They also help in reducing anxiety and depression associated with PE. Through this mechanism, they prolong the time to reach ejaculation. Several SSRIs have increasingly become used as 'off-label' for PE.

Among the available SSRIs, Paroxetine-Dapoxetine is more beneficial with lesser side effects as compared to other SSRIs. These medications are associated with sexual side effects including decreased fertility and erectile dysfunction. Dapoxetine is a recent SSRI which acts quickly and cleared rapidly from the body. Adverse effects with SSRIs are usually minor and include fatigue, mild nausea, loose stools and sweating. Other side effects may include decreased sexual urge and increased tendency to suicide, especially with long-term use of Paroxetine.

Another potential medical treatment option for PE are class of medications which increase the blood flow by dilating the blood vessels of penile region and prolong the PE. But headache, dizziness, flushing, body-ache associated with them have limited their use in PE.

At present, clinicians need to consider all treatment modalities when evaluating a man with PE, as each patient may respond differently and experience variable side effects. Additional and more effective therapies need to be developed having least side effects.

Ayurvedic therapy for PE treatment:

Vajikaran in Ayurveda is an important treatment modality which increases sexual capacity and improves health. In Sanskrit, Vaji means horse, the symbol of sexual potency and performance thus Vajikaran means producing a horse's vigour, particularly the animal's great capacity for sexual activity in the individual. Vajikaran therapy reenergizes all the seven dhatus (body elements), and restores equilibrium and health. It also offers a solution to minimize the shukra (sperm and ovum) defects.

There are many formulations which are used in Vajikaran. Some of the commonly used formulations include Vrihani Gutika, Vrishya Gutika, Vajikaranam Ghritam and Upatyakari Shashtikadi Gutika.

Vrihani Gutika is one of the potent formulations while Vrishya Gutika is highly potent aphrodisiac used in treatment of PE. Vajikaranam Ghritam enhances the strength of penis. Upatyakari Shashtikadi Gutika is useful for the enhancement of the fertility.

Also, Chapdraprabha Vati and Kaunch Pak are known to increase sexual vigour and semen consistency helping in increase in sexual timing.

So, with this concluding article, I wrap up my knowledge and experience in treating patients suffering from premature ejaculation. Take care, and stay healthy!

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

Liposuction is a type of cosmetic surgery that removes excess fat from some parts of the body to improve your overall body contour. Essentially, this cosmetic procedure involves insertion of small, thin but blunt-shaped needles under the skin in those areas that have excess fat. Fat is then suctioned out through these needles by moving them from one place to another under the skin. Also called as “lipo”, this type of cosmetic surgery addresses the following body parts;

1. Thighs
2. Hips and buttocks
3. Fat located on abdomen and waist
4. Fat on the upper arms
5. Fat on neck, chin and cheek area
6. Fat deposited on the back, inner knee, chest, calves and ankles

Liposuction can be performed along with other cosmetic surgeries such as facelift, breast reduction, tummy tuck etc. Please note that liposuction cannot be used to reduce obesity, diabetes and other weight-related disorders.

Types of Liposuction
In recent years, this surgical procedure has been made less painful by developing newer techniques. These are:

1. Tumescent Liposuction- This involves applying a local anesthetic on the area where the procedure has to be done. A combination of chemicals e.g. lidocaine and epinephrine is then inserted under the skin. This numbs the precise area where liposuction will be done.
2. Ultrasound liposuction: This procedure involves melting of the undesired fat by ultrasound. This form of liposuction is suited for fat deposited on the neck, upper abdomen, sides and the back area.
3. Laser liposuction: Low-energy waves are sent under the skin to liquefy the fat that is later removed through the cannulas.

Liposuction is not an elaborate procedure and does not require overnight hospitalization most cases. The patient is administered a local anesthetic so that she does not experience any pain. Overnight hospitalisation may be required if the volume of fat to be removed is large.

Post-liposuction care
Post this surgery, expect your body to swell. The parts of your body where liposuction has been carried out will display swellings, bruises etc. You may even experience pain in those areas. To alleviate discomfort, patients are wrapped up in bandages, support hoses, girdles etc. Some patients may report fluids oozing from the areas affected by liposuction. To prevent infection, doctors prescribe antibiotics to such patients.
Swelling and bruises may continue for the next 7- 10 days post this surgery. Patients may have to wear the bandages, girdles, wraps etc. for the next 3-4 days.

Effectiveness
Liposuction results in a better shape if the volume of fat removed is small. If the patient regains weight after liposuction, fat reappears in those areas which have not been treated.

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