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Hello doctor, i am a 40 years female suffering with adhesive arachnoiditiesis there is any treatment available for this problem ?
Sleep apnea is a disorder which is characterized as interruptions in breathing when you are sleeping. These interruptions or pauses in breathing usually last for about 10 to 20 seconds and may be repeated over 100 times alongside the duration of your sleep. This condition leads to poor sleep resulting in drowsiness, fatigue and poor concentration throughout the day.
Sleep apnea can be classified as:
- Central sleep apnea: Central sleep apnea impairs the central nervous system wherein the brain fails to control muscles which regulate breathing while you sleep.
- Obstructive sleep apnea: This type of sleep apnea occurs when the soft tissues present in the back of the throat block the airway and thus resulting in loud snoring.
Signs and symptoms:
The various signs and symptoms of sleep apnea are
- Loud and chronic snoring during sleeping
- Interruptions in breathing
- Shortness of breath during sleep
- Fatigue during the day
- Choking and gasping during sleep
- Extreme irritability and drowsiness
- Experiencing headaches in the morning
- Impaired concentration and forgetfulness
- Chronic sore throat and dry mouth
The various risk factors for sleep apnea are:
- If you are overweight
- If you are male
- If you are over the age of 40
- If you have a large tongue and tonsils
- If someone in your family has sleep apnea
- Nasal obstruction due to sinus problems
There are certain prevention measures to control sleep apnea, they are:
- Limit smoking: Smoking may cause you to retain fluid in the throat which contributes to sleep apnea.
- Exercise: You should exercise regularly to keep off weight as being overweight increases the chances of getting affected by sleep apnea.
- Schedule your sleep: You should get enough sleep every day so that your body is refreshed and revitalized. Getting enough sleep, thus helps in preventing sleep apnea. If you wish to discuss about any specific problem, you can ask a free question.
Short course radiation therapy is the one of the most talked about subject in recent years and also a fascinating research zone. Hypofractionated radiation therapy is an old concept, but only in recent years with tremendous improvement in radiation therapy delivery technologies there is a significant visible surge in it’s applicability in clinical practice. Modern radiation therapy technology is capable of delivering high dose to the target while sparing majority of the adjacent critical structures. Hence, it is possible to deliver short course of treatment regimen with higher dose per fraction without increasing in toxicity. In brain tumours, radiosurgery with gamma-knife is considered standard of care in many of the clinical indications such as small meningiomas, acaustic schwannomas, residual low grade gliomas, AVMs and solitary/ oligo brain metastasis. Gamma-knife radiosurgery is in clinical practice for more than five decades.
There are several prospective and randomized studies (level I evidence) with long-term follow up data supporting the use of radiosurgery in these clinical indications. Other indications of radiosurgery are pituitary tumour, craniopharyngiomas, glomus tumours, chordomas and others. Robotic radiosurgery (CyberKnife®) is precision radiosurgery delivery system and an extension of gamma-knife system. CyberKnife uses the principle of gamma-knife, but with linear accelerator source instead of multiple cobalt sources. CyberKnife is capable to treating all tumours indicated for gamma-knife with similar accuracy.
This modern tool has some additional advantages from gamma-knife, such as 1) CyberKnife can use fractionated treatment, hence relatively larger tumours can be treated, 2) require only thermoplastic mask, no need for invasive frame, 3) has inverse planning system, can spare critical structure, 4) there is a ‘intra-fraction’ correction technology with imaging, 5) there is no need to change the source, hence may be more cost effective and 6) can be used to treat extra-cranial tumours also. CyberKnife has a linear accelerator attached with a robot and is capable of treatment from various coplanar and non-coplanar field arrangements. CyberKnife has sub-millimeter accuracy and unmatched dose distribution.
The advanced technology behind CyberKnife uses image guidance technology and computer-controlled robotics to deliver and extremely precise dose of radiation to targets, avoiding the surrounding healthy tissue, and adjusting for patient and tumor movement during treatment. In conclusion, CyberKnife is an extension of gammaknife radiosurgery delivery system. This machine has immense promise to treat with short course regimens with high dose and improve local control without increasing toxicities.