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Hernia

Understanding Postpartum Hernia: A Comprehensive Guide

Introduction

Motherhood is the most sacred feeling of every woman who brings and nurtures a new life with unconditional love. Women undergo transformative changes, not just emotionally or psychologically but physically as well, during and after pregnancy. Giving birth to a new life is a blessed moment for every woman and her near and dear ones. Still, one must not overlook the health concerns and complications often faced and experienced by them. These health issues could range from high blood pressure, gestational diabetes, excessive bleeding, anemia, and infection, including conditions like postpartum bodily changes, emotional stress and depression, fatigue, anxiety, or hernia.

Understanding the postpartum emotional, physical, and psychological health of women during and after pregnancy is of paramount importance for addressing the underlying causes and treating the symptoms of any such complications timely and adequate.

This blog discusses one such postpartum medical condition, hernia, along with its types, symptoms, and treatment for general awareness and information.

What is Postpartum Hernia?

The term ‘postpartum’ refers to the medical condition of a woman after childbirth. Postpartum hernia is when the abdomen muscles get stretched due to weight gain, and a growing baby increases pressure on the abdominal wall. The belly fat, or the abdomen’s interior, pushes against the weak muscles, or the belly button protrudes through the weak muscles. In short, any hernia post-delivery is known as a postpartum hernia.

Causes of Postpartum Hernia

Physical changes that result in weight gain or obesity, excessive pressure or fluid buildup in the abdomen, multiple pregnancies, the birth of twins or triplets, heavy coughing, and c-section surgery are some of the common causes of postpartum hernia.

Types of Postpartum Hernia

Hernia, post-delivery, could be of various types. These types include-

  • Umbilical hernia- The fetus is connected to the mother in the womb through an umbilical cord. This cord passes through the opening in the baby’s abdomen, which generally closes after birth. However, when this umbilical cord does not close completely, it leaves a weak spot in the baby’s abdomen, which may lead to a hernia anytime in the future. These hernias are commonly seen in infants but are also seen in women when the spot where the umbilical cord detached at birth does not heal.
  • Inguinal hernia- During pregnancy, there can be pressure near the groin. Inguinal hernia occurs when the abdomen or intestine tissue bulges out through the opening in the lower abdominal wall. Inguinal hernia is caused in the inguinal canal.
  • Ventral hernia- Ventral hernia occurs above the belly button, in the middle of the stomach. Also known as incisional hernia, it occurs at the previous surgical incision site, as in the case of c-section surgery that is not healed. The tissue protrudes from the weakened part of the abdominal wall, resulting in a bulge.

Symptoms of postpartum hernia

Hernias cause pain and discomfort. Though not a severe medical condition, it must be treated properly to prevent its severity. Some of the common symptoms of postpartum hernia are-

  • Pain in the abdomen
  • Bulge in the abdominal area or near the c-section site
  • Vomiting or constipation due to strangulation of hernia
  • Tenderness in the abdominal area
  • Heightened pain and bulge due to pressure, coughing, lifting, or any physical activity

Treatment for postpartum hernia

In cases of small or minor hernia with no discomfort or pain, there is no need for urgency for its treatment. One may wait for it to grow in size to be treated surgically or laparoscopically. In cases of severe discomfort and pain, hernia needs to be treated timely and properly. However, one may avoid postpartum hernia by observing specific precautionary measures of avoiding heavy lifting, rigorous exercise, or physical exertion, ensuring support to the abdomen in case of severe coughing or sneezing to reduce pressure. Postpartum workout for strengthening the core muscles also helps in preventing hernia occurrence. It may be noted that postpartum hernia is treated through open hernia surgery or laparoscopic procedure.

  • Open surgery- In the case of open surgery, the surgeon cuts open the abdomen with a large incision to access the hernia site, pushes the hernia back to place, and closes the incision with stitches.
  • Laparoscopic procedure- Also known as a keyhole procedure, the hernia is placed back into its position using tiny instruments inserted through smaller incisions on the abdomen. Once put in place, it is supported by a mesh attached to the surrounding tissues, thus reducing the chance of hernia reoccurrence. Hernia treatment involves pushing the protrusion back to its place and supporting it by placing a mesh.

The doctor often recommends using an abdominal binder (a wide belt worn around the abdomen) to support the treated hernia.
Recovery from hernia treatment requires nearly a few weeks of rest from physical activities that exert pressure on the abdomen.

Conclusion

Though hernias are not severe, they often become painful and cause discomfort if not treated promptly. Postpartum hernia can be prevented through adequate rest and avoiding activities that would exert pressure on the abdomen. The likelihood of hernia occurrence is high if one becomes pregnant again. Resorting to non-surgical techniques of workouts to strengthen the core muscles may help in preventing postpartum hernia. However, in cases of large and painful hernia symptoms, hernia repair is the only effective treatment option.

References

https://medlineplus.gov/ency/article/000987.html
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Piles

Anal Fistula: Symptoms, Causes, Diagnosis, Treatment

Introduction

When two body cavities or a body cavity and skin connect abnormally, they form a fistula. A fistula can be formed in many parts of the body, namely between the cervix and vagina, the neck and the throat, an artery, and a vein, the bowel and vagina, stomach and skin surface, anus and skin surface, skull space, and nasal sinus. These fistulas could be open (one end open), complete (both ends open), incomplete (closed inside), or horseshoe (connecting the anus to the skin surface). Some fistulas may heal on their own, while some may not. The treatment depends on the type, location, cause, and severity of the condition.

An anal fistula is one such types of fistula that most commonly affect men. Following an infected anal gland that does not heal, it needs surgical treatment for its cure.

The present blog provides insight into the meaning, causes, symptoms, diagnosis, and treatment of anal fistula for a better understanding of the condition.

What is an Anal Fistula?

An anal fistula, also known as a Fistula-in-Ano, is an abnormal connection between the surface of the skin of the bullock and the anal canal in the colon. It is a tunnel running from inside the anus to the skin surface around it. An anus is an opening at the end of the digestive tract that gets rid of the solid waste of the body. Anal fistula affects the internal and/or external anal sphincters (muscles).

What Causes Anal Fistula?

An infection in the anal gland is the primary cause of anal fistula. This infection causes an abscess. An abscess is a tender mass over skin filled with pus and bacteria, painful and warm to feel.

The other cause of anal fistula includes –

  • an injury or surgery in the anus,
  • radiation therapy in the pelvic region,
  • tuberculosis (infection in the lungs),
  • Crohn’s disease (inflammation of the digestive tract),
  • ulcerative colitis (inflammation of the large intestine) or
  • sexually transmitted diseases.

Symptoms of Anal Fistula?

Anal fistula symptoms require immediate medical consultation and intervention for its treatment. Some of the symptoms of anal fistula are-

  • Fever
  • Swelling and redness around the anus,
  • Pain during bowel movement or urination
  • Fowl smelling pus or watery discharge from the abscess
  • Bleeding

How is Anal Fistula Diagnosed?

The diagnosis of anal fistula starts with medical history and physical examination of the patient. Some fistulas can be easily spotted, and the doctor may examine through the oozing blood fluid.

For those that are closed, the doctor may need to find the inside source of the fistula. For this, they may use an anoscope or a proctoscope to examine the anal canal. The patient is put on anesthesia during the examination. 

The use of special dye to find the internal source of the anal fistula is also resorted to by the doctor. For this, the doctor injects a special dye that would react with the infection, creating bubbles at the injection site.

Ultrasound and MRI are some of the imaging studies that the healthcare provider may conduct for the diagnosis of anal fistula.

Treating Anal Fistula

The treatment for anal fistula depends on the severity of the condition and the type of fistula. Before arriving at the decision for anal fistula surgery, the healthcare provider may try to treat it with medications. However, spontaneous healing may cause the fistulas to reopen if there is infection again. The treatment varies depending on whether the fistula is simple or complex. Simple fistula has less muscle involved that needs to be treated. Complex fistula treatment requires addressing more muscle damage. The treatment options for fistula are-

  • Fistulotomy– Fistulotomy is the most common one-time surgery for simple fistulas. The surgeon cuts through the fistula, opens the infected area, and removes the damaged muscle.
  • Seton drain– For complex fistulas, the surgeon uses a surgical thread called the seton that keeps the fistula open and helps drain the infection. The seton is passed from the opening of the fistula through its track out to the anus with a loop at the end. It acts as a wick to drain the infection and heal the fistulas. Later, it may be closed with a fistulotomy. A seton is generally required to be removed; however, in some cases, it might be placed for an indefinite time.
  • Endorectal advancement flap– The infection is accessed through the inside opening of the fistula and cut out. The opening is then covered with healthy tissue from the inside of the rectum above it. This flap of the healthy tissue is pulled down from the rectum to fill the opening. The infection drains out from the outside of the fistula opening. In some cases, there are chances of reoccurrence of infection and fistula, along with the risk of damaging the muscles.
  • LIFT- The procedure is known as the Ligation of the Intersphinteric Fistula Tract. It avoids cutting the sphincter muscles. The surgeon accesses the fistula between the internal and external muscles through an incision at the anal track opening and treats the infection, and then closes the incision with stitches.

Conclusion

Fistulas are not life-threatening; however, they may become life-challenging, affecting the patient’s quality of life. Anal fistulas usually need to be treated surgically depending on the severity and location of the fistula. A timely address requires an informed decision based on the risk assessment and successful surgical outcomes of the various treatment options. Living with a fistula is challenging, and its treatment varies depending on its severity and complexity. Immediate and timely medical intervention is the only way to treat it, enabling quality and healthy living.

References

https://my.clevelandclinic.org/health/diseases/14466-anal-fistula
https://www.mayoclinic.org/diseases-conditions/anal-fistula/symptoms-causes/syc-20352871
https://www.webmd.com/digestive-disorders/anal-fistula-overview
https://www.hopkinsmedicine.org/health/conditions-and-diseases/anal-fistula
https://www.pennmedicine.org/for-patients-and-visitors/patient-information/conditions-treated-a-to-z/fistula

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Peripheral Vascular

How Diabetes and Peripheral Vascular Disease are Interlinked

In India, diabetes is a widespread health issue affecting millions. According to WHO, about 77 million adults have type 2 diabetes [1]. But did you know that diabetes affects more than just your blood sugar? Many are unaware of its link to other conditions, like peripheral vascular disease (PVD). PVD impacts blood vessels outside the heart and brain, and when combined with diabetes, it can lead to severe complications. Find out how diabetes and PVD are connected and how you can manage both conditions effectively.

What is Peripheral Vascular Disease? [2]

Peripheral vascular disease (PVD) affects the blood vessels, especially in the legs and feet. In PVD, arteries narrow or get blocked due to fatty deposits, reducing blood flow to the limbs. This can cause pain, cramps, and sores that take longer to heal. If not treated, PVD can lead to serious problems like infections, tissue damage, or even amputation in severe cases. PVD is more common in people with other health conditions, including diabetes.

The Connection Between Diabetes and PVD [3]

Diabetes and peripheral vascular disease (PVD) are closely connected because diabetes also affects blood vessels. High blood sugar can damage the blood vessel lining, making it easier for fatty deposits to form and block the arteries, especially in the legs and feet. This is a key feature of PVD. People with diabetes are more likely to develop PVD since their blood vessels are more vulnerable to damage. High blood sugar also slows down the body’s ability to heal wounds, increasing the risk of complications from PVD.
Both diabetes and PVD get worse over time if not properly managed. The reduced blood flow caused by PVD can make it harder for diabetes-related foot problems, like ulcers, to heal. This can lead to infections. In severe cases, surgery may be needed.

Common Symptoms Linking Diabetes and PVD [3]

People with both diabetes and peripheral vascular disease often experience similar symptoms, especially in the legs and feet. Some common signs to watch out for include:

  • Leg pain or cramping – This can happen during activities like walking and is called claudication. It occurs because the muscles are not getting enough blood flow.
  • Numbness or tingling in the legs or feet – This may result from nerve damage caused by both diabetes and PVD, making it harder to feel injuries or infections.
  • Slow-healing sores – Wounds, especially on the feet, may take longer to heal due to poor blood flow and high blood sugar levels.
  • Coldness in the lower legs or feet – This is a sign of poor circulation caused by peripheral vascular disease.
  • Shiny or discoloured skin – Poor blood flow can change the appearance of the skin, especially in the lower legs and feet.

If any of these symptoms are present, it is always recommended to seek medical advice early to prevent further complications.

Risk Factors & Complications [3]

Several factors can raise the chances of developing both diabetes and peripheral vascular disease. These include:

  • High blood pressure – It puts extra pressure on blood vessels, making them more likely to get damaged.
  • High cholesterol – Too much cholesterol can cause fatty deposits in the arteries, leading to PVD.
  • Smoking – Smoking harms blood vessels and greatly increases the risk of PVD, especially in people with diabetes.
  • Obesity – Being overweight adds strain on blood vessels, raising the risk of both diabetes and PVD.
  • Sedentary lifestyle – Not being physically active can lead to poor circulation, making it harder to control blood sugar levels. This also increases the risk of PVD.

If not managed properly, complications from diabetes and PVD can be serious. Poor circulation from PVD can cause infections, slow-healing wounds, and, in severe cases, gangrene, which might require amputation. Additionally, people with both conditions have a higher risk of heart attacks and strokes.

Preventive Measures for Diabetes and PVD [3]

  • Blood sugar control – Keeping your blood sugar at a healthy level is crucial to avoiding complications from diabetes, including peripheral vascular disease.
  • Regular exercise – Being physically active helps improve blood circulation and lowers the risk of PVD by promoting healthy blood vessels.
  • Healthy diet – Eating a balanced diet that is low in saturated fats, salt, and sugar can help stop fatty deposits from building up in the arteries.
  • Quit smoking – Smoking is a big risk factor for both diabetes and PVD. Quitting can greatly reduce the chances of complications.
  • Foot care – For diabetics, taking care of your feet is important. Checking your feet regularly for wounds or sores and getting treatment quickly can prevent serious problems.

Conclusion

It’s clear that diabetes and peripheral vascular disease (PVD) are more connected than many realise. But here’s the good news—by staying informed and taking proactive steps, you can manage both conditions effectively. Remember, the key is catching the signs early and taking control.

Reference Links:

[1] https://www.who.int/india/health-topics/mobile-technology-for-preventing-ncds
[2] https://www.hopkinsmedicine.org/health/conditions-and-diseases/peripheral-vascular-disease
[3] https://www.medicalnewstoday.com/articles/diabetes-peripheral-vascular-disease#treatments

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Suture

How to Care for and Manage Absorbable Stitches

Have you ever wondered how to ensure your wound heals properly without needing to remove the stitches? Absorbable sutures are the key. Taking care of absorbable stitchec might seem overwhelming, but with the right guidance, it can be simple and stress-free. In this blog, we’ll walk you through everything you need to know about absorbable sutures, from immediate care tips to recognizing signs of healing and preventing complications.

What are Absorbable Sutures?[1]

Absorbable sutures are used to close wounds or surgical incisions. Unlike non-absorbable sutures, which need to be removed after the wound heals, absorbable sutures break down and are absorbed by the body over time. This eliminates the need for a follow-up procedure to remove the stitches.

Care Tips for Absorbable Sutures[2]

Immediate Post-Procedure Care

You should start caring for absorbable sutures immediately after the procedure. Below are some general care guidelines you can follow:

Keeping the Area Clean and Dry: In the initial days following the procedure, it’s essential to keep the area with absorbable sutures clean and dry. Avoid submerging the area completely in water, such as taking baths or swimming.

Instructions on Changing Dressings: Your healthcare provider will instruct you on how to change the dressings of your absorbable sutures. Some general instructions include –

  • Always wash your hands thoroughly before touching the sutured area
  • Remove the old dressing, gently clean the area, and apply a new, sterile dressing
  • Ensure the new dressing is secure but not too tight, because this can restrict blood flow and impede healing.

Daily Care Routine[3]

Gentle Cleaning with Mild Soap and Water: This is important to maintain the hygiene of absorbable sutures. Use mild soap and lukewarm water to clean the area around the sutures. Avoid using harsh chemicals unless recommended by your healthcare provider. Gently pat the area dry with a clean towel instead of rubbing, which can cause irritation or disturb the sutures.
Avoiding Strenuous Activities: Avoid activities that may cause strain or pull at the sutures. This includes heavy lifting, vigorous exercise, or any movement that places stress on the wound. Follow your healthcare provider’s advice on when it is safe to resume normal activities.

Monitoring the Healing Process of Absorbable Sutures[4]

  • Signs of Proper Healing: Reduced redness, minimal swelling, and the gradual closure of the wound. Over time, you may notice the sutures becoming less visible as they begin to dissolve.
  • Warning Signs to Watch For: Excessive redness, increasing pain, swelling that does not subside, or any discharge from the wound. Infections can cause these symptoms. If you notice any of these signs, contact your healthcare provider immediately.

Regular follow-up appointments with your healthcare provider are important for monitoring the progress of your healing. During these visits, your provider can assess the wound, ensure the absorbable sutures are dissolving as expected, and address any concerns you may have.

Conclusion

Caring for and managing absorbable stitches involves a combination of proper hygiene, monitoring the healing process, and taking steps to prevent complications. By following the guidelines outlined in this blog, you can ensure that your absorbable stitches heal effectively and minimize the risk of infections or other issues. Always consult with your healthcare provider if you have any questions or concerns about your sutures or the healing process.

Reference Links:

[1] https://www.webmd.com/a-to-z-guides/what-to-know-absorbable-sutures
[2] https://www.medicalnewstoday.com/articles/325297#care-tips
[3] https://www.drugs.com/cg/care-for-your-absorbable-stitches.html
[4] https://www.verywellhealth.com/what-are-absorbable-sutures-3156838

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Contraception

A Comparison Between Pregnancy Kits vs. Clinical Tests

You’re eagerly waiting for that one piece of news that could change your life forever. The anticipation is building, and you need to know if you’re pregnant. But what’s the best way to find out? Should you grab a pregnancy kit from the nearest pharmacy or schedule an appointment for a clinical test? Both options have their merits, and the choice can be difficult. This article will compare the two and help you decide which method suits you best. Let’s get started!

Pregnancy Kits

Pregnancy kits are a popular choice for many due to their convenience and ease of use. These kits are designed to detect the presence of human chorionic gonadotropin (hCG) in urine, a hormone produced during pregnancy[1].

How do Pregnancy Kits Work?

Pregnancy kits typically come with a test strip or a stick that needs to be placed in a urine sample. The strip contains antibodies that react with hCG. If hCG is present, a line or symbol appears on the strip, indicating a positive result. The instructions are straightforward, making these kits user-friendly.

Pros of Pregnancy Kits

Convenience: They can be used in the comfort of your home, allowing you to avoid a visit to the clinic. This aspect is particularly beneficial for those with busy schedules or limited access to healthcare facilities.
Privacy: You can perform the test without anyone knowing, which can be crucial for those who prefer to keep their potential pregnancy confidential until they are ready to share the news.
Cost: Pregnancy kits are generally affordable, making them accessible to a wide range of individuals. This affordability allows for multiple tests, which can be reassuring for those seeking confirmation over time.
Speed: Pregnancy kits provide quick results, typically within a few minutes. This immediate feedback can be essential for those eager to know their status without the anxiety of waiting for lab results.

Clinical Tests

Clinical tests for pregnancy involve a visit to a healthcare facility where blood or urine samples are analyzed by professionals. These tests are conducted in a more controlled environment, ensuring higher accuracy[2].

How The Clinical Tests Work[2]

Clinical pregnancy tests can be either urine or blood tests. Blood tests are more common and can be qualitative (detecting the presence of hCG) or quantitative (measuring the exact amount of hCG). These tests are performed in a laboratory setting, and the results are interpreted by medical professionals.

Advantages of Clinical Tests

Accuracy: Blood tests, in particular, can detect lower levels of hCG, making them more reliable than home pregnancy kits. This accuracy is crucial for confirming pregnancy, especially in its early stages.
Early Detection: Clinical tests can detect pregnancy earlier than home kits[2]. Blood tests can identify hCG levels even before a missed period, providing an earlier confirmation of pregnancy. This early detection can be vital for individuals needing to make timely healthcare decisions.
Professional Guidance: One of the important benefits of clinical tests is the access to professional healthcare guidance. When you visit a clinic, you can receive expert advice, discuss any concerns, and plan the next steps with a healthcare provider. This support can be invaluable, especially for first-time parents or those with health complications.

Comparison Between Pregnancy Kits and Clinical Tests

Comparison FactorsPregnancy KitsClinical Tests
Accuracy and SensitivityConvenient but may give false negatives if used too early.Higher accuracy and can detect pregnancy earlier.
Cost and AccessibilityGenerally more affordable and accessible, available over-the-counter without a prescription.May require an appointment and the availability of healthcare services.
Privacy and ConvenienceOffers unparalleled privacy and convenience for home testing.Less private but provides professional support and accurate results.

Conclusion

Both pregnancy kits and clinical tests have their unique advantages. Choosing between a pregnancy kit and a clinical test depends on your specific needs, circumstances, and preferences.

[1] https://www.medicalnewstoday.com/articles/316463
[2] https://my.clevelandclinic.org/health/diagnostics/9703-pregnancy-tests.
https://medlineplus.gov/lab-tests/pregnancy-test/
https://www.plannedparenthood.org/learn/pregnancy/pregnancy-tests
https://www.webmd.com/baby/pregnancy-tests
https://www.mayoclinic.org/healthy-lifestyle/getting-pregnant/in-depth/home-pregnancy-tests/art-20047940
https://www.nhs.uk/pregnancy/trying-for-a-baby/doing-a-pregnancy-test/#:~:text=How%20does%20a%20pregnancy%20test,stick%20after%20a%20few%20minutes.

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