Keloids

Keloids are noncancerous, fibrous skin tumors. It rises above the skin and has a smooth appearance on the top. It is usually pink in color with irregular shape and the size increases gradually. It starts due to any injuries and will extend beyond the injuries and do not get subsided like ordinary scars. It can also spread to the surrounding areas of the wound.

Causes :

Keloids can occur in both men and women. It is usually caused due to certain damages in the skin. The skin damages that can cause keloids are

  • Chicken pox
  • Acne
  • Burns
  • Cuts
  • Chicken pox
  • Body piercing
  • Surgery
  • Insect bites
  • Vaccinations
  • Tattoos

It can occur spontaneously in some people and even minor abrasions can cause the keloid to develop on the skin.

Symptoms:

It occurs mainly on the chest, back, shoulders and earlobes.

The color of the scar ranges from pink to red.

Raised, shiny, dome-shaped appearance

Some scars will be itchy and also painful to touch

Diagnosis:

Keloids can be diagnosed by the doctor or dermatologist. It is based on the location and appearance of the scar and its progressive time. A skin biopsy can be done for diagnosing and ruling out any malignant tumor.

Keloids Treatment

Treatment:

Currently, there is no effective treatment to treat keloids. But there is a chance in regrowth of keloids after the removal. Sometimes, it can grow larger than before. Some of the treatments for Keloids are listed below

  • Inflammations can be reduced by corticosteroid injections.
  • The tissues can be softened with moisturizing oils.
  • The skin cells can be killed by freezing the tissues.
  • The scar tissue can be reduced by laser treatment.
  • Radiations can be done to shrink the keloids.

Initially, less invasive treatments will be recommended to shrink and flatten the keloids. In the case of larger keloids, surgical removal is done by using steroid injections.

Appendicitis

Appendicitis is a condition due to inflammation of the appendix, a three and a half inches long tube of tissue. It extends from the large intestine and produces antibodies. If it becomes inflamed, then the person has to undergo a surgery to remove the appendix immediately. If it is not treated properly, then it will burst or spill out the infectious materials to the abdominal cavity. This may lead to peritonitis. Peritonitis is a condition in which there is an inflammation of the lining of the abdominal cavity. It may become fatal and should be treated quickly with antibiotics.

Causes of Appendicitis:

Appendicitis occurs when there is a block in the appendix due to stool or a foreign body. The block may be due to infections and it causes swelling in response to any infection in the body.

Symptoms of Appendicitis

Symptoms of Appendicitis:

  • The classic symptoms of appendicitis are as follows
  • A feel of dull pain near the upper abdomen or naval area which becomes sharp and moves to the lower right abdomen. This is the first sign of appendicitis.
  • Nausea or vomiting
  • Loss of appetite
  • Abdominal swelling
  • Fever with 99-102 degree Fahrenheit
  • Inability to pass gas
  • Severe cramps
  • Pain in passing urine
  • Constipation with gas

Diagnosis of Appendicitis:

  • The following tests are usually made to diagnose appendicitis. They are
  • Rectal exam
  • Abdominal exam to detect inflammation
  • Urine test
  • Blood test
  • CT scans / ultrasound

Appendicitis Home Remedies

Treatment for Appendicitis:

The condition is treated with the surgery named appendectomy. It is a standard treatment for treating appendicitis. Most of the surgeries are aimed at removing the appendix so that there will be no fear of rupture. If there is a chance of rupture, then immediate surgery is essential to treat it.

Home Remedies:

Some of the home remedies for treating appendicitis are listed below

  • Consumption of fruits and vegetables helps to pass out the mucus and other toxins.
  • One teaspoon of green gram regularly cleanses the system effectively.
  • Garlic prevents the swelling of appendix
  • Plenty of water helps to flush out the system by maintaining a healthy appendix
  • Intake beet and cucumber juices.

Floating Kidney

Floating kidney is a condition in which the kidney moves down from its normal position when a person stands straight or lies flat. This is medically known as nephroptosis. If a kidney moves downwards, then it is suggested that it is not fixed fully by the tissues surrounding it. It is also known as kidney prolapse condition.

Floating kidney can occur in both men and women but it is far common in women. It is estimated that 20% of the women have floating kidney but only a few experience its symptoms. It tends to affect the right kidney more than the left.

Causes of Floating Kidney:

The causes of floating kidney are listed below

  1. Kidneys are supported by a soft connective tissue called perirenal fascia. When this tissue is damaged or not present in abundance, then it will cause floating kidney.
  2. If anyone receives a blow to the kidney or the area above or below the kidney, then there may be a chance of floating kidney. This is not due to congenital defect.
  3. Young women who have thin and long waists can be affected.

Symptoms of Floating Kidney:

When a person experiences the following symptoms, it should be treated. It can occur rarely in some people.

  1. If the kidney is displaced, it can cause ureter to kink.
  2. Can cause pain during urination.
  3. May suffer from nausea, chills and high blood pressure.
  4. If there is a pain in the flank area, then it may cause discomfort.

Diagnosis of Floating Kidney:

Diagnosis can be done through a series of X-rays in the supine or the standing position if the person has any symptoms related to it. If the person has no pain or discomfort, then there is no need of diagnosis.

Treatment For Floating kidney

Treatment for Floating Kidney:

When a person has floating kidney and does not suffer from any symptoms, then there is no need of any treatment.

If the ureter becomes kinked and causes pain along with nausea, vomiting, and constipation, then the following home remedies are suggested

⦁    Make the patient lie in bed and keep them warm.

⦁    Warm bottles can be applied to the side abdomen area.

⦁    Diet with fattening substances should be given to increase the fat around the kidney.

⦁    To provide support and get relief from discomfort, a belt with rubber padding is suggested to wear around the area.

If these home remedies do not fix the problem, then a surgery called nephropexy is suggested. This surgery is done through laparoscopic techniques. It will make the kidney to place in correct position and the pain also eventually disappears.

Reduce The Risk Of Lung Cancer With Garlic

Lung cancer is one of the deadly diseases and about 1.2 million people die due to lung cancer all over the world. The main cause of lung cancer is smoking. But a research says that one fifth of the lung cancer occurs in people who never smokes in their life. Lung cancer is often diagnosed at the later stage where the risk increases and it becomes not curable.
A VEGETABLE THAT REDUCES THE RISK OF LUNG CANCER:
Most of the people hear that garlic is a healthy vegetable. A study reveals that garlic helps to treat lung cancer effectively. Consuming raw garlic regularly reduces the risk of lung cancer and it is found effective on regular smokers. Garlic is rich in medicinal properties and it is widely used as a home remedy for curing many diseases. Recently, researchers revealed that garlic reduces the risk of lung cancer.

Reduce The Risk Of Lung Cancer with Garlic
RESEARCHES ON GARLIC:
Researchers tested patients suffering from lung cancer with the healthy people. At the end of the research, it is proved that people who consumed fresh garlic for at least two times per week have a lower risk of lung cancer by 44 percent. People with smoking habit also has 30 percent lower risk of lung cancer. These researches are made on fresh raw garlic and it is not known on the preserved or dried garlic.

HEALTH BENEFITS OF GARLIC:
Garlic has a chemical called ‘allicin’, a sulfur compound that is formed when it is crushed or chopped. This Allicin has many medicinal values and the health benefits of garlic are listed below
• Allicin is an anti-oxidant that prevents the formation of free radicals in the body.
• Reduces the inflammations.
• Used as a natural remedy to treat colds and infections.
• Lowers the blood pressure and increases the production of insulin.
• Blocks the formation of cancer-causing substances.
• Enhances DNS repair.
• Reduces cell proliferation or induce cell death.
• Reduces the risk of several forms of cancer such as stomach, lung, esophageal, breast, colorectal and bladder.

Common Fractures In Children

Fractures in children are common in the age group between 1 year to 15 years.  More common in boys than in girls because they are more naughty. The left upper extremity fracture seems to be common, as the left assumes the role of protection during the fall. In the lower limbs, fracture of the thigh bone  (femur) and leg bone (Tibia and fibula) are common.

In children, the fracture management is simple with plaster cast (recently the fiberglass) immobilization. The healing and remodeling potential is very high. However, whenever the child is brought to us with the fracture in the upper limb or lower limb, the first question the parents ask is, whether my child will become normal as before, whether there will be any deformity and any shortening etc. The answer is very simple, if it is treated by a well-trained  Orthopaedic surgeon, complications will not occur. In our village setup, many parents take their children to native bone setter and then get into complications like deformity, shortening, neurological and vascular problems.

Very commonly when the child falls from a cycle or while playing, he or she falls with the outstretched hand on the left side or right side. When this happens, the impact will be transmitted to the wrist, forearm bones, elbow,  shoulder, and clavicle.

Common Bone Fractures In Children

The commonest fractures which we see are the “Greenstick” fracture of forearm bones and supracondylar fracture of the humerus above the elbow joint.

Greenstick Fracture:

Child’s bones are like a thin branch of a tree (Green Stick), hence it breaks on one side of the cortex and the other side bends. The treatment here is straightening the bone under anesthesia and giving a plaster cast for 3 weeks is sufficient. Taking care of the plaster by the parents is important. Otherwise, the bone will deform again. Very often the parents tend to take the child to the bone setter and we see a lot of complications because of the native splints.  Another important factor in children fracture healing is that deformities gradually gets corrected. This may take 2 years.

Supracondylar Fracture Humerus:

This is the commonest of all elbow injuries. Whenever the child complains of pain and swelling of the elbow, X-ray must be taken to rule out any fracture. An undisplaced fracture can be treated with a plaster cast for 3 weeks. After 3 weeks, physiotherapy is important to get back the normal range of movements.

In displaced fracture, the modern method is to reduce the fracture under anesthesia and under fluoroscopic control and fix with 2 criss-cross Kirschner wires, for 3 weeks and above elbow plaster cast. After 3 weeks, the wires are removed and one more week plaster is given and exercises are started.

The physiotherapeutic measures must be done well. Otherwise, the child will develop post-traumatic stiffness.

Fractures in children are common. Parents must take all efforts to take them to the correct orthopedic surgeon who can treat better without any complications.

Infant Feeding Practice

Breast Feeding is essential up to first 6 months of age group. Initiate breastfeeding within one hour of normal delivery birth, within four hours of caesarean delivery. No food or drink other than breast milk should be given. Practice rooming in and allow mothers and infants to remain together 24  hours a day. Encourage breastfeeding on demand. No artificial teats or pacifiers for breastfeeding infants.

Complementary Feeding:

The systemic process of introduction of suitable food substances in the right time in addition to mother’s milk in order to provide needed nutrients to the baby. Baby become biologically fit to accept semi-solids after 4 months of age.

Breastfeeding should continue for as long as feasible preferably, till two years of age. This is important for first two years because it is a period of rapid brain growth and breast milk contains taurine amino acid factors which are essential for brain growth and development.

What are Complementary Feeds?

It can be homemade. It is better to start with mono cereals followed by multi cereals. Cereal like rice is the best choice to start weaning as it is gluten-free and easily digestible. Tubers, Fruits, Biscuits and Banana powder are also popular weaning foods. The addition of oil for calories can make homemade food more nutrient dense.

Family Pot Feeding:

Around 6 months:

  1. Cereals based porridge (ragi, suji, rice).
  2. Cereals can be enriched with jaggery, sugar, oil, and ghee.
  3. Start with the 1-2 spoon and gradually increase to 1 cup per day in 1-2 servings in addition to breastfeeding.
  4. Fruit Juice also can also be added.

Around 6-9 months:

  1. Mashed rice with pulses.
  2. Mashed tubers.
  3. Vegetable soups mashed fruits.
  4. Biscuits and egg yolk can be given.

Around 9-12 months:

  1. Introduce soft food that can be chewed, avoiding hot spices.
  2. Chappathi and other hard items can be made soft by adding a little milk.
  3. It can be given 4-6 times a day gradually increasing the quantity.
  4. By one year of age, the baby should be taking everything cooked at home.

Infant Feeding Practices

Food Items Enhancing Calories:

Oil, Ghee, Sugar, Egg, Fish, Meat, Green leafy vegetables, Curd, and Sprouting pulses enhance the calories.

Texture, Preparation, and Storage of Weaning Food:

It is essential to advise the mother to differentiate the texture through preparation and cooking methods. A soft to coarser to bigger bite texture will be a positive approach towards developing the baby for acceptance.

Careful hygiene preparation such as hand washing with soap and water should be practiced before cooking and also during feeding is essential. Food stuff should be freshly prepared. Cooked food should be stored in airtight container.

Complementary Bridge and Safety Net to Prevent Malnutrition:

Most of the children fall into the pit of malnutrition during weaning and postweaning phase. Some even succumb to it. Mothers are expected to make the weaning bridge to carry children across the pits.

The three Planks include

  1. Continuous breastfeeding.
  2. Introducing Vegetable protein.
  3. Animal Protein.

Exercises For Knee Arthritis

Knee Arthritis usually develops after the age of 40 but it occurs earlier in some cases. It occurs commonly in obese people and regular exercise can lessen the pain. Exercising an arthritic knee may be seen wrong but it can relieve arthritis pain and also other symptoms such as stiffness and swelling of joints.

Benefits of exercises:

Exercising regularly provides the following benefits to get relief from knee arthritis.

⦁    Strengthen the muscles that support the joint.

⦁    Helps to maintain the joint’s full range of motion.

⦁    Strong muscles help the joint to absorb shock.

⦁    Gentle, low-impact exercises minimize the stress on the joint by increasing its flexibility and strength.

Types of exercises for Knee Arthritis:

Walking:

Walking is an excellent form of exercise that helps to strengthen the muscles and build bone. It has a low-impact as it is a weight-bearing exercise. Prepare yourself for a walk with good shoes and gradually increase the speed and distance for best results.

Exercising at Home or Work:

Knee exercises can be done at home or even during a short break at the office. These exercises can be convenient, effective and easily done without any special equipment. Do slowly and gradually increase the number of repetitions to strengthen the muscles.

Isometric exercises:

Isometric exercise is one of the basic therapeutic exercises that help to strengthen the knee area. These exercises rapidly improve the strength and cause less inflammation and pressure. To perform this exercise, place a roll of the towel under the knee and push it down by holding it for 5 seconds. Repeat this on both legs for approximately 10 minutes.

Water exercise:

Water exercise is nothing but walking in the knee immersed water. It helps to improve the muscle strength, endurance and the flexibility of knee. The body is buoyant in water and it lessens the impact to nearly zero as it makes to work a little harder to move. Nowadays, some gym has a trend to keep hydrotherapy tubs.

Stretching Exercises For Knee Arthritis

Gentle stretching exercises:

Gentle stretching exercises has a positive effect on the muscles of the knee joint and soft tissues. Some gentle stretching exercises help to maintain the circulation and also prevents the tightening of muscles.

Tip before doing the Exercises:

If you can, put a moist heat pack on the arthritic knee for 20 minutes before starting an exercise. Because the heat brings blood up to the surface and decreases the stiffness and soothing.

Patient on medication:

If you take medications for pain, take them 45 minutes before the exercise for controlling pain during workouts.

Tip after doing the Exercises:

After exercises, put an ice pack on the sore knee for 10 to 15 minutes. It helps to reduce the swelling caused due to exercise and also relieves pain.

Tips To Lose Weight After Pregnancy

Weight gain during pregnancy is normal but it is important to lose weight after pregnancy. In the first month after the delivery, don’t worry about losing weight. After 6-8 months of delivery, extra weight gained during pregnancy should be reduced. If extra weight is not reduced during this period, it will retain that extra fat for longer.

Tips to Lose weight after Pregnancy:

There are three tips that will help to reduce weight tremendously. They are

  1. Diet
  2. Exercise or physical activity
  3. Breastfeeding

The first two tips are common for reducing the weight and the third tip is specific for weight gain during pregnancy.

Diet Remedies to Lose Weight after Pregnancy:

It is not necessary to go for extreme diet for losing weight but small changes in your daily food habits are enough to lose weight.  Some tips that are should be followed are listed below

Losing Weight After Pregnancy Naturally by Drinking Water

⦁    Should not skip breakfast and choose healthier options for breakfast such as whole grain cereals, whole wheat bread, eggs, fruits, etc

⦁    Stay energetic by consuming regular meals to take care of yourself and also your baby.

⦁    Intake more fruits and vegetables and consume less amount of junk foods and sweets.

⦁    Consume nutritious foods that are high in nutrients and less in calories which help to reduce weight.

⦁    Take boiled, baked, steamed foods and avoid fried foods.

⦁    Drink lots of water so that it flushes out toxins from the body and prepares your body to get ready for maximum health.

⦁    Take healthy natural drinks like fruit juices, coconut water and avoid sodas and colas.

⦁    Limit the intake of caffeinated drinks like tea and coffee and instead take herbal tea without sugar or
artificial sweeteners.

Exercises to lose weight after Pregnancy:

If you want to lose weight after pregnancy, should be physically active. If there are any complications during pregnancy, consult your doctor whether you can or cannot move your body after delivery. Here are some tips to do exercise after delivery.

⦁    Start to walk after 4 weeks of delivery and initially walk lesser and gradually increase for 45 minutes a day for 5 days per week.

⦁    If unable to walk for a longer time, take a break and walk for 10-15 minutes for 3-4 times a day.

⦁    Move your body frequently and don’t sit at a place for more than half an hour.

⦁    Apart from exercise, dance a little to make your baby happy and also play with your baby.

Breastfeed to lose weight after Pregnancy:

Breastfeeding helps to burn calories so that it helps to reduce weight. Women who breastfeed their babies burns 500 calories per day approximately when compared to women who are not breastfeeding their babies.

Lose Post Pregnancy Weight Naturally

 

However, it is not essential to reduce weight but it can boost the rate of fat loss. And, it also ensures the best nutrition for the baby.

 

Sleep a little more to reduce weight:

A study says that mothers to newborns who sleep for less than six hours faces difficulties in reducing weight but those who slept for seven hours can reduce their weight easily after pregnancy.

Hormones such as cortisol and other stress hormones can be released inside the body when your body does not get enough sleep and rest. These hormones can cause weight gain as a side effect. So, sleep a little more to reduce weight after pregnancy.

Losing weight after pregnancy is not that much difficult. All that you need to reduce weight are a healthy diet, exercise, and a good sleep.

Breastfeeding Technique and It’s Common Problems

Sign of Good Attachment:

  1. Baby’s chin is close to the breast
  2. Baby’s tongue is under the lactiferous sinuses and nipple on the palate
  3. Baby’s mouth is wide open and lower lip turned outwards
  4. More areola is visible above the baby’s mouth than below it
  5. No pain while breastfeeding
  6. Baby’s cheek are full, not hollow
  7. Regular, Slow, deep sucks

Sign of Poor Attachment:

  1. Baby sucks only at the nipple
  2. Mouth is not wide open and much of the areola and thus lactiferous sinuses are outside the mouth
  3. Baby’s tongue is also inside the mouth and does not cup over the breast tissue.
  4. Chin is away from the breast.
  5. It is painful while breastfeeding.

Flat or Inverted Nipple:

Normally, the nipple corrects itself as the child suckles. But in few cases, the problem persists even after that, the following technique can be tried.

  1. Cut the nozzle end of a disposable syringe.
  2. Introduce the piston from the ragged cut end side.
  3. Ask the mother to apply the smooth side of the syringe on the nipple and gently pull out the piston and let her wait for a minute.
  4. Nipple would then protrude into the syringe. Ask the mother to slowly release the suction and put the baby to breast, at this time it helps the nipple to erect out and the baby is able to suckle in the proper position.
  5. After feeding, the nipple may retract back, but doing it each time before feeding over a period of few days will help to solve the problem.

Fullness and Engorgement of the Breast:

  1. Applying moist heat to the breast 3 to 5 minutes before a feed, followed by a gentle massage and stroking the breast towards the nipple.
  2. Expressing enough milk to soften the areola.
  3. Feeding frequently, every 2 – 2.5 hours or sooner at least for 15 – 20 minutes each side after milk let-down has occurred.
  4. Feeding the baby in a quiet relaxing phase.
  5. Paracetamol needed to relieve the pain in the breast.

Breastfeeding Technique New Born Babies - Inverted Nipples

Sore Nipple and Cracked Nipple:

  1. Feeding in a correct position.
  2. Washing the nipple once daily only with water.
  3. Exposure of nipple to air.
  4. Application of hindmilk drop on the nipple after each feed.
  5. If infants have oral thrush, 1% gentian violet should be applied to the nipple.

Blocked Duct:

  1. Feeding in the correct position.
  2. Avoid wearing tight clothes.
  3. A warm compress or warm shower.
  4. Massage the breast using the firm movement of the thumb over the lump towards the nipple.
  5. Antibiotic therapy.
  6. Analgesics.
  7. Applications of warm packs.

Burping and Position after feeding:

Babies tend to take in a lot of air during feeding, this will lead to abdominal distension, colics, regurgitation, for that baby can be put on the left shoulder. The hand has to support with mothers left hand and then with right arm supporting the buttocks and pat gently on the baby’s back with the right hand. Slowly air will escape.

The prone position should be avoided as it found to be associated with higher incidence of sudden infant death syndrome.

Reattachment of Amputated Body Part

What is meant by Replantation?

Replantation is reattachment of a part that has been completely amputated from the body – there is no connection exists between the severed part and the patient.

What are the indications for Replantation?

Those with the following amputation are listed below

  • Thumb
  • Multiple digits
  • Partial hand
  • Any part of upper extremity of a child
  • Wrist or forearm
  • Elbow and above elbow level

What should be done at the site of the accident?

  • The injured victim should be assessed for other major injuries.
  • The victim should be removed from the accident site and place him/her in a safe area.
  • Make the victim lay down and keep the injured hand in elevated position.
  • Direct compression should be applied over the bleeding spot to control the active bleeding.
  • The tourniquet should not be applied to control bleeding.

How to preserve the amputated Part?

Gently clean the amputated part with sterile water, cover it with gauze wrap. Put it in a watertight bag, and place that bag on ice. But don’t put the amputated part directly on ice.

How early should the replantation surgery be done?

As early as possible. The reattachment of the amputated part should be done within 4-6 hrs from the time of the accident.

How to preserve the partially amputated hand?

The sterile dressing should be applied over the injury site. Then place the ice cube containing plastic bag over the injured part.

What is the effect of cooling of the amputated part?

Cooling reduces the metabolic demand of the amputated part. The victim can be transferred from the accidental site to replant center for replantation surgery. The cooling can extend the replant surgery time quite considerably.

surgical reattachment of a body part

What is the role of the microscope in replantation Surgery?

The size of Blood vessels in the amputated fingers are around 1mm in diameter. Reattachment of small blood vessels can be done by very fine sutures, that needs magnification. The operative microscope provides up to 20 times magnification. The operative microscope is essential for suturing the fine blood vessels to reestablish the blood flow to the severed part.

What are the unfavorable conditions for replantation?

  • Severely crushed or mangled parts
  • Amputation at multiple levels
  • Amputations in patients with other serious injuries or disease
  • Amputation in which severe atherosclerotic vessels
  • Amputations with mentally unstable patients

Other than finger and hand replant, any other amputated body parts can be replanted?

  • Avulsion of the scalp – complete detachment of hair-bearing scalp skin
  • Amputation of the foot and leg
  • Amputation of male genital organ

If the amputated body part are preserved well and the patient’s general condition is fit to undergo major replantation surgery, above mentioned amputated body part can be replanted.