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Treatment of Nerve And Muscle Disorders
Treatment of Paralysis
Cerebral Palsy Treatment
Brain Tumor Surgery
Electroconvulsive Therapy (Ect) Treatment
Surgery Of The Facial Nerve
Radiofrequency Neurotomy Procedure
Spine Surgery Treatment
Traumatic Brain Injury (Tbi) Treatment
Treatment of Traumatic Brain Injury (Tbi)
Assistive Walking Device Training
Vagus Nerve Stimulation ( Epilepsy )
Deep Brain Stimulation Procedure
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A fifty-four years old Marwari patient from Assam presented with progressive jaundice and intermittent episodes of abdominal pain for three months. CT scan of abdomen showed a small (1.5 x 1.5 cm) mass in the bifurcation of common bile duct which is causing biliary tract obstruction and hence jaundice. Portal nodes were not enlarged and there was no lesion in the liver parenchyma. At presentation, serum bilirubin level was high (14.7 mg/dl). Endoscopic biopsy and brushing cytology was adenocarcinoma and clinic-radiological diagnosis was ‘Klatskin tumour’.
- Metallic stenting was done to relieve jaundice and after stenting serum bilirubin level came down rapidly. PET scan showed increased uptake in the biliary duct region mass without any sign of metastasis. He was evaluated and planned for treatment with robotic radiosurgery. He was treated using robotic radiosurgery (CyberKnife) with high precision radiotherapy technique after fiducial placement (gold seeds) near the tumour. After one year, the patient had no obvious complain, liver function (no jaundice) was normal and CT scan evaluation showed completed resolution of the mass.
- Klatskin tumour is an uncommon tumour that arises from the bifurcation of common bile duct in the abdomen (duct that drains bile from liver). Patients usually present with progressive (increasing) persistent jaundice followed by pain in the upper abdomen. Surgical excision is the mainstay of treatment. However, surgery is not possible in majority of the patients owing to the location of the tumour, high jaundice and medical condition. Chemotherapy may not be an optimal option in majority of the patients as they present with high jaundice. Majority of such patients with poor medical condition are treated with only supportive care and prognosis is dismal (survival for a few months only).
- Patients with metallic stent have relief from jaundice but unfortunately in a few weeks time, the stent gets blocked with tumour growth. Patients again present with high jaundice and have severely impaired quality of life. They complain of severe itching of entire body, loss of appetite and succumb due to impaired liver function from high jaundice/obstruction. The treatment is to have a longer ‘jaundice-free period’ which in turn improves quality of life and possibly survival function as well.
- Stereotactic body radiation therapy’s high dose radiation ‘sterilizes’ the metallic stent and bile duct region. It is assumed that with radiation therapy, blockage of bile duct and stent is delayed and patients have longer jaundice-free period.In Klatskin tumour, CyberKnife allows to deliver high dose of radiation in a short duration to the target without significant morbidity. If you wish to discuss about any specific problem, you can consult an Oncologist.
I am 20 yrs old and when I sit continuing few hours my back goes numb. please help me regarding this.
I have multiple scattered calcific foci with healed granulomatous in my parietal lobe of brain as discovered 10 years back. I had 4 major siezures and 4 simple partial focal siezures till date. I am on a eptoin 300mg a day since 5 years. Can I consume alcohol ?
My age is 23. My height is 6 ft. My weight is 78 kg. I also had habit of masturbation since 17-18 .i used to do it daily one time by rubbing penis against bed but. From last three years I was doing 4-5 times daily by rubbing penis against bed for hours. I never felt any type of weakness nor I look thin. I have a strong personality. The only thing I noticed that 70% of my hair are greyed now. 6 month ago I had problem of head pain. Half head pain and on back side of pain .It was migraine. I left masturbation and saturated focussing on yoga. I used yo do yoga daily for 2 hours. Two month after one day I had frequent urination. The same problem goes on for three day so I had check. It was urine infection along with prostate enlarge 22. 6 cc.and my weight was reduced then. 4-5 kg. Buf uric acid was normal. But from that day I used to have more symptom such as penis head pain. A very sharp pain inflammation of legs and whole body. Numbness and tingling in whole body. Pain in whole body even mouth. Stomach pain. noticed.my blood sugar even after eating reaches to less than 70 .from these five month excessive hair growth in my body. Too.much hair all over body. eyebrows are becoming thicker .head hair chest hair. Except I dnt have beard. I have high bp 150/100. All my these symptoms correlate to adrenal gland disease. I have dark coloured urine. I also have very smelly urine these days n.so bad smell. And my chest and abdomen enlargement along with hair growth on body is on increasing frequency these days. Or pituitary tumour as my head pains a lot but stomach too. My belly fat is coming too .i am gaining weight even I have reduced diet. I am in the doubt how can masturbation can cause adrenal gland disease?
I am really suffering from insomnia. So please do help with with few points to get rid of this sickness.
Hello friends, I am Dr Anubhav Gupta. I am a consultant of cosmetic and plastic surgeon. Today I am going to talk about a very common topic, that is Facial injuries. Now this is something which we see very common in our day to day life. Face is comprising of a lot of structures; the skin, there is the subcutaneous tissues, there are muscles, then there is bone underneath it. So when we talk about facial injuries, we can divide them broadly into two types:
- One is the simple injuries and
- The complex facial injuries.
Now the simple injuries are the one, which we see like, our kids, they fall in the house, and they have cuts, and they have continuous lacerated wounds.
The complex facial injuries are seen when there are road traffic accidents, where there are deep cuts right up to the muscle and there are fractures of these bones.
So these are the common types of injuries related to face. Now the question which next comes to our mind is, what to do?
So in case of facial injuries, what is required to be to be done is, whenever such injuries happen, we need to apply some pressure on that, so that the bleeding stops. And if you are concerned about good scars and better looking sutured wounds, then you should consult a plastic surgeon to get it sutured. And in any case, it has to repaired, it has to be stitched. This is how the management of simple injuries is done.
But in case of complex injuries, they require advanced management, wherein not only a plastic surgeon but also a neurosurgeon and many other surgeons are involved because these injuries are usually not isolated injuries. They occur with head injuries also, and many times there are injuries to other parts of the body also. So it is better to take the patient to a better hospital. So in such injuries, what we usually do is, once the patient is stabilised, such injuries, for example a fractures, requires fixation.
Fixation means, is very similar to fracture of the hand or the limb, there is plating and screws and clamps and plasters and related things. The principles are similar for all these things also. So we use very fine, titanium plates for fractures.
The common fractured parts are the upper maxilla, or the lower maxilla or the mandible. The importance in such facial injuries, there are two priorities:-
- One is , the patient should be able to eat, even after these injuries and fractures. Because once these bones are fractured, it becomes very difficult to eat so the main priority is that the patient should be able to eat even after these injuries.
- The second thing is, the lower part of the eye. So, there should be no problem in the vision, as well as the cosmetic outcome. So these bones are put back together anatomically by plating and fixation. So that the patient can lead a normal life, i.e, having a normal vision, and is able to eat properly.
So these are the principles required for practical fixation of complex facial injuries.
Now, to know more about these types of injuries you can get in touch with me on Lybrate. Thank You.