Microdermabrasion- Deparment of Dermatology

Microdermabrasion is used to treat. Enlarged pores. Hyperpigmentation. Superficial creases. Mild non-inflammatory acne scarring, sun damaged skin, dull and blemished skin, Stretch marks, Scar revision, face and body peeling.

During Microdermabrasion, aluminiumoxide crystals are blown into the skin through a sterile tipped tube at half to one atmosphere, pressure and vacuumed out under the same pressure through an adjoining aperture. The crystals remove a very superficial layer of the upper half of the skin called epidermis.

This is an outpatient training, and is best done by trained dermatologists. Each session lasts from 5 to 15 minutes, and one can go back to work after the treatment session.

Article by apollo Hospitals
Bangalore

Abrasion Arthroplasty with High Tibial Osteotomy

Abrasion Arthroplasty with High Tibial Osteotomy for
treatment of sever osteoarthritis – a follow up subjective
study.
Since 1980 we have started treatment of advanced osteoarthritis knee
by abrasion under arthroscopic guidance. But since 1985 we have started the
combination of Arthroscopic Abrasion Arthroplasty (AAA) and High Tibial
Osteotomy (HTO).
Aim of the study
To present the follow up results of AAA and HTO performed to patients
with advanced varus osteoarthritis knee; who are candidates for Total Knee
Replacement (TKR) or Unicompartmental Knee Replacement (UKR)
Materials and methods
All patients in this study were those suffering from advanced (severe)
knee joint varus osteoarthritis. The patients were of any age, any gender, and
the most important point is that the patient must accept the 6-8 weeks nonweight
bearing rehabilitation program. The patient also my be obese (mild) but
not morbid obesity. All our patient were candidate for artificial prosthesis (they
mentioned they had already date for TKR & UTKR), they search about an alternative
to prosthesis.
Since 1985 till 2006 more than 1.500 patients with advanced osteoarthritis
of medial knee compartment; underwent AAA with HTO at the clinic of Dr
Witwity, and Oxford score was sent to 946 patients till 2003 as we are concerning
with patients more than three years follow up-also some patient come for
metal removal and second look also was included. The Oxford 12 points questionnaire
is reliable and used by many surgeons to evaluate the patients with
TKR &UKR.509 patients sent their answers, 246 females and 263 males, 260
Lt knee, 249 Rt knee and 19 were bilateral. Average age 60 years (29 – 84
year).

Technique of the operation
Arthroscopic Abrasion Arthroplasty with High Tibial Osteotomy done
for all patients with grade IV chodromalacia and sclerotic lesion medial compartmental
knee osteoarthritis (bare bone).
AAA is multiple tissue debridement procedure and it is consisted of
Abrasion, which must be strictly intra-cortical, preserving the tide mark as a
vital bearing zone for the expected newly formed fibrocartlige. Only 1-3 mm is
abraded till the appearance of the superficial blood vessels which take the salt
and pepper appearance (minute dark red tinny vessels against pale white background
of abraded bone). In few number patients Micro-fracture technique is
done using special sharp knife to reach the deep cortical layers without disturbing
the tide-mark line

Hypospadias Repair

We feel that parents should be involved in decision making at every stage. This is an overview of the pathophysiology of hypospadias and possible treatment options.
What is hypospadias?

Hypospadias is abnormal growth and development of the tissues on the ventral (under-surface) aspect of the penis. This may cause abnormal opening of the urine tube anywhere from the scrotum up to the penile tip, curvature of the penis and problems while passing urine in standing position.
Why does it happen?

The exact cause is not known but many factors including genetic factors may contribute.

When the penis is being formed the urine tube initially is open sulcus that later on closes to form a tube. This closure begins from the base of the penis and progresses to its normal location at the tip. If this process gets interrupted in-between then the opening may remain at an abnormal place.
What are the types of hypospadias?

Hypospadias can be of various types depending on the location of this opening of urine tube (urethra). It can be glanular (on glans), coronal (at the sulcus between the glans and the body of penis), on the penile shaft (this type is divided in to 2 subgroups proximal and distal shaft) and peno-scrotal at the junction of penis and scrotum. Very rarely the scrotal halves remain separate and it opens directly on the perineum (perineal)
Can there be other associated problems?

This condition is rarely associated with malformations of kidney and other parts of genitourinary system
What is correct age for surgery?

Surgery can be performed at any age after 6 months of age. When it is corrected early, child will have no memory of it. Even older boys usually do not have problems with the surgery. After complete healing there are little noticeable marks of the operation. A successful repair lasts lifetime; including periods of rapid penile growth.
What operation will correct the problem?

Hypospadias repair transfers the location of urine tube from more proximal one (abnormal) to its normal position at the tip. It is done under general anaesthesia, meaning that he will be sound asleep during the surgery. This surgery takes between 1 to 2 hours.
What Is Hypospadias Repair?

Penis acts as a conduit for the urine and sperms while they leave the body. Both these are expelled out through a tube called urethra (referred as urine tube elsewhere for understanding) which opens at the end of the penis. Most of the children will also have ventral bending of the penis (when erect). The hypospadias repair surgery will reposition the opening and correct the bending to give the penis a more normal appearance.

The surgery will deal with following things

Creating the urine tube that has failed to form
Relocating its opening to the tip of the penis
Straightening the penile shaft if curved
Removal/ reshaping the abnormal foreskin
In complicated cases more extensive or stages repair may be necessary.

Which anaesthesia will be used?

This operation is usually performed under general anaesthesia. General anaesthesia will make the child go into deep sleep. General anaesthesia makes the surgery easier and safer as the child will not feel any pain or have any memory of it.

Caudal block is given along with general anaesthesia. It has two advantages; it blocks pain in the low back and trunk during and following the surgery and will reduce the requirements of GA medicines.
After the operation

Child can start eating and drinking a little at a time within 2 hours of surgery and can resume normal eating and drinking as early as he feels.

There will be a tube coming out from the tip of the penis connected to urine bag. Staff will teach you regarding empting the bag. Child carries the bag to home and it will be removed after a week or 10 days.

If a dressing was used, you will be told how to care for it. An ointment may be recommended or prescribed for you to use with the dressing.

If you notice a fever higher than 101.4˚F, bleeding or foul smelling drainage from the area around the repair, call the hospital.
Special needs

If your child has any special needs or health issues you feel the doctor needs to know about, please call your doctor’s office before the surgery and ask to speak with a nurse. It is important to notify us in advance about any special needs your child might have.

Article by
Sparsh Hospirals,
Bangalore

Salivary gland cancer surgery hospitals in India

A salivary gland tumor is an uncontrolled growth of cells that originates in one of the many saliva-producing glands in the mouth. Salivary gland cancer surgery in India is now days performed in most prominent cities of India at Hyderabad, Mumbai, Delhi and Bangalore. Salivary gland cancer surgery hospitals in India are highly equipped with best treatment facilities. Salivary gland cancer is a cancer that occurs in one of the salivary glands in your mouth, neck or throat. Salivary gland cancer may not cause any symptoms and is found during a regular dental check-up or physical exam. Symptoms caused by salivary gland cancer also may be caused by other conditions. Because of most advanced treatment facilities and most expert cancer surgeons, the success rate of surgical treatment in salivary gland cancer surgery in HCG Cancer centre, Bangalore in India is very good.

Treatment Facilities.

Now it is possible to cure salivary gland cancer with a surgical treatment, as most advanced cancer surgery techniques are available in salivary gland cancer surgery hospitals in India and are being successfully used for patients’ treatment. Surgery is not a solution of all cancers; it always depends on the stage of cancer, requirements, and health. But if surgery is required then it is very important to get it done as early as possible because any delay in getting treatment spreads cancer. In most cases, surgery is done to remove the cancer and some of the nearby tissue. If the cancer is a high grade or if it has spread to the lymph nodes, the doctor may suggest removing the nodes as well. Since salivary gland tumors often start in the parotid gland, that operation will be described first. The facial nerve, which controls movement of the face, passes through the parotid gland. This makes the surgery complicated. If it looks like the surgeon will need to remove the facial nerve, ask about ways to repair the nerve and ways to treat the side effects. If your cancer is in the submandibular or sublingual glands, the surgeon will remove the entire gland and perhaps some of the nearby tissue or bone. Several important nerves pass through or near these glands. These nerves control tongue movement, as well as feeling and taste. The surgeon may need to remove some of these nerves. If your cancer is in the minor salivary glands, the surgeon usually removes some tissue around the cancer along with the cancer. The exact details depend on the size and place of the cancer. There can be side effects from each of the different kinds of surgery, especially if facial nerves or other nerves need to be removed. Talk to your doctor about what to expect after your surgery and what measures you can take to help reduce any side effects.

Medical tourism in India would make your travel and medical stay in India more comfortable by providing you the best medical hospitalization and patient care during your salivary gland cancer surgery in India. Indian cancer surgeons are reliable persons that would provide you health recovery within the shortest span of time at an affordable cost.

Epistaxis is an important otorhinolaryngological emergency, which usually has an apparent etiology, frequently local trauma in children. Here we present a case report wherein the epistaxis was recalcitrant, and proved to have a psychiatric disorder as an underlying basis. The child was diagnosed with Attention Deficit/Hyperactivity Disorder, hyperactive type, which led to trauma to nasal mucosa due to frequent and uncontrolled nose picking. Treatment with atomoxetine controlled the patient’s symptoms and led to a remission of epistaxis.

Introduction

Children commonly present with nosebleed and these episodes are rarely life threatening. The majority of nosebleeds are mild, spontaneous and self-limited. However some children suffer from repeated nosebleeds or, to use its clinical name, ‘recurrent idiopathic epistaxis’. These nosebleeds often cause significant parental concerns and remain a challenging problem to patients and physicians alike [1,2].

Initiating factors include local inflammation, mucosal drying, and local trauma (including nose picking). Most of the studies have emphasized the fact that there are no apparent causes in habitual nose bleeders. However, there may be some underappreciated factors that place many children at risk for injury [3]. One of these factors may be the presence of attention-deficit/hyperactivity disorder (ADHD), which is now believed to be the most common neurobehavioral disorder in children[4]. The purpose of this case report is to describe the case of the child with a diagnosis of ADHD who suffered severe recurrent epistaxis, and to highlight the possible importance of this co-morbidity and its treatment in the context of paediatric trauma.

History:

A 12 year old boy presented with a 2 month history of recurrent epistaxis to the emergency department for his fourth episode. The first episode had occurred 2 months back and was treated by local pressure and a haemostatic drug. The second episode occurred 2 weeks later and was treated similarly. A week later, the patient had another bout of nose bleed, heavier this time, which had to be treated with an anterior nasal pack, and silver nitrate cauterization of the wound later on. The current episode was from the same site and needed nasal packing again.

On all occasions there was no history of an apparent physical trauma to the nose, nor were there any symptoms to suggest an upper respiratory infection or allergic rhinitis. There was no bleeding from any other site in the body. The patient was not using any medicines. The patient was not suffering from any diagnosed medical condition. There was no family history of a similar illness.
Physical Examination

On arrival the patient was awake, alert and fully oriented. He was bleeding moderately from left nostril. On physical examination his vital signs were stable. ENT examination showed active bleeding from left anterior nares. Rest of physical examination was normal. All through the examination, the child acted fussy and had difficulty remaining focused on a given task. He continuously rocked and fidgeted in the examination chair. Even frequent reprimanding couldn’t discipline the child. This prompted the attending resident to seek a psychiatric consultation.

Psychiatric Screening
History:

A detailed evaluation revealed a child who had no problems in preschool. In kindergarten, he seemed to learn alphabets and numbers normally. The parents had noticed that he seemed more disorganized and inattentive than his older brother was at the same age. They often had to repeat instructions, and he left tasks half-finished. In primary school the patient had mild difficulty with mathematics, and the teacher use to be concerned about his not listening much of the time. The patients’ school work was inconsistent and he often failed to finish his assignments. The parents also admitted a frequent nose picking behavior of the patient, which they couldn’t correct with even punitive methods.
Mental Status Examination

When the patient was seen in the child and adolescent psychiatry department, he appeared as an attractive teenager who looked his stated age and was of average build but he showed grossly conspicuous behaviour. During interview he constantly shifted position, folded arms behind his head or leaned over the table in front of him and at times fiddled with his nose. He also got out of his seat frequently, played with buttons on clothes and couldn’t sit still. His attitude was over familiar, pushy, demanding and lacking distance. He showed difficulty in sustaining attention and concentration which was elicited in writing and reading task given to him in interview. He was oriented in time, place and person. Intelligence was normal

Diagnostic Inventory:

A diagnosis of Attention Deficit/Hyperactivity Disorder, hyperactive type was suggested.

Investigation:

The patients hemoglobin was decreased at 10.2 gm/dl (11-13 gm/dl), platelet count was normal at 230,000 per microliter (150,000 to 400,000 per microliter). The coagulation profile was normal. TLC & DLC, ESR, RBC indexes were normal. Serum chemistry, TFT, urine exam and X-ray chest were also normal. ECG only showed sinus tachycardia (HR: 108/min).

Management and Course:

The patient was started on atomoxetine at 9 mg/bd, and weekly behavioral therapy sessions (including habit-reversal therapy), aimed at decreasing the nose picking behavior. The dose of atomoxetine was raised two weeks later to 18 mg/bd (calculated @ 0.5 mg/kg/d), while the behavior therapy was continued. The patient was sent for ENT follow-up as well, who after evaluation referred the patient the back, with no alteration in the treatment. The patient was followed up at weekly intervals. At 4 (Four) weeks, the patient’s hyperactive behavior, including nose picking, was much controlled. ENT checkup confirmed healing of the nasal wound. The drug treatment was continued at the same dose and patient continues to follow up on a monthly basis with no further episode of nosebleed.

Narcolepsy is a condition that causes patients to fall asleep uncontrollably throughout the day for periods lasting less than a minute to more than half an hour. These “sleep attacks” occur even after getting enough sleep at night. The unusual sleep pattern that people with narcolepsy have can affect their schooling, work, and social life. Falling asleep during activities like walking; driving, cooking, or talking can have dangerous results, both professionally and personally.

People with narcolepsy may also have one or more of the following signs and symptoms : –

Sudden loss of muscle tone and control (muscle weakness) over parts or all of the body while awake (cataplexy)
Sudden inability to move or speak while falling asleep or waking up (sleep paralysis)
Vivid dreams while falling asleep or waking up (hallucinations

Narcolepsy can occur in both men and women at any age, although its symptoms are usually first noticed in teenagers or young adults. There is strong evidence that narcolepsy may run in families; 8 to 12 percent of people with narcolepsy have a close relative with the disease.

Narcolepsy usually is a genetic (inherited) disorder, although it may be associated with brain damage or neurological disease

Diagnosis of Narcoplepsy

Epworth Sleepiness Scale : – During the test, you will be asked to answer 8 questions using a scale from 0 (not at all likely to fall asleep) to 3 (very likely to fall asleep). The resulting total score is between 0 and 24. Scores of 0 to 10 are normal. Total scores above 10 generally warrant further investigation.

Nocturnal polysomnogram : – This test will measure the electrical activity of your brain (electroencephalogram) and heart (electrocardiogram), and the movement of your muscles (electromyogram) and eyes (electro-oculogram), and usually requires an overnight stay at a sleep clinic for observation purposes.

Multiple sleep latency test (MSLT) This test measures how long it takes for you to fall asleep during the day, plus the kind of sleep you get during such a nap. Sleep specialists analyze your brain waves (EEG), heart rate (EKG), muscle activity, and eye movements

Spinal fluid analysis : – The lack of hypocretin in the cerebrospinal fluid may be a marker for narcolepsy. Examining spinal fluid is a new diagnostic test for narcolepsy

Narcolepsy is usually treated with amphetamine or amphetamine-like stimulants and a couple new pharmacologically different drugs. The most common amphetamine-like drugs are dextroamphetamine, pemoline methamphetamine, and methylphenidate.

In addition to drug therapy, an important part of treatment is scheduling short naps (10 to 15 minutes) two to three times per day to help control excessive daytime sleepiness and help the person stay as alert as possible. Daytime naps are not a replacement for nighttime sleep
Article by
BGS Hospitals

What is a Laryngectomy ?

The surgical procedure is performed to remove the voice box (larynx) and the separation of the airway from the esophagus, nose and the mouth. A part or all of the larynx can be removed. Owing to its location, larynx (voice box) plays a crucial role in swallowing, speaking and breathing. The larynx is located in the front of the esophagus (food pipe) and above on the trachea (windpipe). Larynx consists of two small bands of muscle (vocal cords) that helps in preventing the food from entering into the lungs and it vibrates to generate the voice. Laryngectomy is performed to remove the cancerous or tumor tissues.
Throat Cancer Symptoms

Location and size of the tumors are the two important factors for determining the symptoms-

While coughing the blood comes out
Constant cough
A mass or lump either in the throat or in the neck
Persistent or constant sore throat
Difficulty in breathing
The pain from the throat can result in ear pain

Laryngectomy Procedure

The surgical procedure is performed under general or local anesthesia. The surgeon in total laryngectomy will make cuts in the neck in order to open up the area. The crucial parts of the surgery

The first step is the removal of lymph nodes
The surgeon then removes the tissues and the larynx around it.
An opening is made in the patient’s trachea along with a hole in front of the neck.
The patient’s trachea is brought up and is then attached to stoma (hole)
After the surgical procedure, the patient will breathe from the stoma and the stoma is never removed.
Clips or stitches are used to thoroughly close the skin and the muscles.
Tracheoesophageal puncture (TEP) is a little hole in the trachea (windpipe) and the tube which is responsible for sending food from the throat into the stomach (esophagus).
Prosthesis (a little man-made part) will be placed into the opening. With the help of Prosthesis, the patient is able to speak after the removal of the voice box.

Minimally Invasive Surgery for Laryngectomy

The less invasive surgeries works for specific people and largely depends upon the type of the cancer and also on how much the cancer has spread. Some of the procedures are vertical partial laryngectomy, supracricoid partial laryngectomy, supraglotticor horizontal partial laryngectomy and endoscopic surgery.
Partial Laryngectomy

The procedure of removing a part of larynx instead of the whole is a very rare case. In this, a part of the voice box is left in order to be able to speak. But this results in the hoarse and weak voice. A temporary tracheotomy may be present that enables one to breathe.

Treatments for Laryngeal Cancer
What is a Laryngectomy ?

The surgical procedure is performed to remove the voice box (larynx) and the separation of the airway from the esophagus, nose and the mouth. A part or all of the larynx can be removed. Owing to its location, larynx (voice box) plays a crucial role in swallowing, speaking and breathing. The larynx is located in the front of the esophagus (food pipe) and above on the trachea (windpipe). Larynx consists of two small bands of muscle (vocal cords) that helps in preventing the food from entering into the lungs and it vibrates to generate the voice. Laryngectomy is performed to remove the cancerous or tumor tissues.
Throat Cancer Symptoms

Location and size of the tumors are the two important factors for determining the symptoms-

While coughing the blood comes out
Constant cough
A mass or lump either in the throat or in the neck
Persistent or constant sore throat
Difficulty in breathing
The pain from the throat can result in ear pain

Laryngectomy Procedure

The surgical procedure is performed under general or local anesthesia. The surgeon in total laryngectomy will make cuts in the neck in order to open up the area. The crucial parts of the surgery

The first step is the removal of lymph nodes
The surgeon then removes the tissues and the larynx around it.
An opening is made in the patient’s trachea along with a hole in front of the neck.
The patient’s trachea is brought up and is then attached to stoma (hole)
After the surgical procedure, the patient will breathe from the stoma and the stoma is never removed.
Clips or stitches are used to thoroughly close the skin and the muscles.
Tracheoesophageal puncture (TEP) is a little hole in the trachea (windpipe) and the tube which is responsible for sending food from the throat into the stomach (esophagus).
Prosthesis (a little man-made part) will be placed into the opening. With the help of Prosthesis, the patient is able to speak after the removal of the voice box.

Minimally Invasive Surgery for Laryngectomy

The less invasive surgeries works for specific people and largely depends upon the type of the cancer and also on how much the cancer has spread. Some of the procedures are vertical partial laryngectomy, supracricoid partial laryngectomy, supraglotticor horizontal partial laryngectomy and endoscopic surgery.
Partial Laryngectomy

The procedure of removing a part of larynx instead of the whole is a very rare case. In this, a part of the voice box is left in order to be able to speak. But this results in the hoarse and weak voice. A temporary tracheotomy may be present that enables one to breathe.

Treatments for Laryngeal Cancer

Radiotherapy : It is the most common treatment and is used for treating early stage cancers. The therapy helps in shrinking a large tumor of the larynx that makes it easy to remove.
Chemotherapy : Both radiotherapy and chemotherapy can be performed simultaneously to treat the cancer. Chemotherapy is also used when the cancer of the larynx again occurred after radiotherapy. The advanced cancer can be treated before with the help of chemotherapy (induction therapy).
Biological Therapy : This type of treatment is made up of natural body substances. The patient may opt for biological therapy which is also called as cetuximab. In this, radiotherapy can also perform for locally advanced squamous cell laryngeal cancer.

What is Throat Cancer ?

The throat (pharynx) is a cancer that develops in the throat. The throat is a five inch long tube that connects from the nose to the neck. The two major places of the throat cancer forms are pharynx and larynx. Head and neck cancer is the type of throat cancer that includes the salivary glands, nose, neck lymph nodes, mouth, tonsils and sinuses. Throat cancer is of two types –

Adenocarcinoma : This type of cancer starts in the glandular cells of the throat.
Squamous Cell Carcinoma : This type of cancer occurs in the flat and thin cells which lines the throat.

Pharyngeal cancer and Laryngeal cancer are the two most common forms of throat cancer.
Throat Polyps

The condition where there is an abnormal growth of the tissue which grows in the throat is known as throat polyps. Throat polyps may become cancerous and that is why a biopsy is performed. The symptoms include a feeling of having something at the back of the throat or can also be a feeling of sensation while swallowing.
Head and Neck Cancer

The cancers of head and neck usually starts in the squamous cells which lines the moist and mucosal surfaces in the head and neck. They are referred to as Squamous cell carcinomas of the head and neck. The cancers can also start in the salivary glands and that is a very uncommon situation. Salivary glands consist of a large number of cells which can become cancerous and ultimately leads to many types of salivary gland cancer.

To know more about Laryngectomyy cost in India keep browsing our site Medical India Tourism and to book a medical tour to India please fill the given form.

Radiotherapy : It is the most common treatment and is used for treating early stage cancers. The therapy helps in shrinking a large tumor of the larynx that makes it easy to remove.
Chemotherapy : Both radiotherapy and chemotherapy can be performed simultaneously to treat the cancer. Chemotherapy is also used when the cancer of the larynx again occurred after radiotherapy. The advanced cancer can be treated before with the help of chemotherapy (induction therapy).
Biological Therapy : This type of treatment is made up of natural body substances. The patient may opt for biological therapy which is also called as cetuximab. In this, radiotherapy can also perform for locally advanced squamous cell laryngeal cancer.

What is Throat Cancer ?

The throat (pharynx) is a cancer that develops in the throat. The throat is a five inch long tube that connects from the nose to the neck. The two major places of the throat cancer forms are pharynx and larynx. Head and neck cancer is the type of throat cancer that includes the salivary glands, nose, neck lymph nodes, mouth, tonsils and sinuses. Throat cancer is of two types –

Adenocarcinoma : This type of cancer starts in the glandular cells of the throat.
Squamous Cell Carcinoma : This type of cancer occurs in the flat and thin cells which lines the throat.

Pharyngeal cancer and Laryngeal cancer are the two most common forms of throat cancer.
Throat Polyps

The condition where there is an abnormal growth of the tissue which grows in the throat is known as throat polyps. Throat polyps may become cancerous and that is why a biopsy is performed. The symptoms include a feeling of having something at the back of the throat or can also be a feeling of sensation while swallowing.
Head and Neck Cancer

The cancers of head and neck usually starts in the squamous cells which lines the moist and mucosal surfaces in the head and neck. They are referred to as Squamous cell carcinomas of the head and neck. The cancers can also start in the salivary glands and that is a very uncommon situation. Salivary glands consist of a large number of cells which can become cancerous and ultimately leads to many types of salivary gland cancer

Procedure Details

This is an operation to remove part of the tongue and adjacent tissues. At the same time,reconstructive surgery is performed to restore normal appearance and speech. A tracheostomy may be performed to assist breathing postoperatively, and a skin graft may be needed to replace removed tissue. Carried out under general anesthesia, the procedure may take several hours. A lengthy hospital stay is usually necessary.Hemiglossectomy and subsequent reconstructive surgery are major procedures and as such entail risk. At present, this operation is the treatment of choice for some types of tongue cancer.Hemiglossectomy may be performed when a malignant growth is found in the tongue.Diagnosis depends on microscopic examination of cells obtained at biopsy (tissue sampling).Important decision on treatment are based on staging, a process to determine the extent of the primary growth in the tongue and whether it has metastasized (spread) to another part of the body.A graft may be needed to replace tissue removed during surgery. If skin cover only is needed, a thin layer of skin (split-skin graft) may be taken from the thigh and placed over the wound. When tissue loss is greater, a full-thickness graft of skin, underlying muscle, and blood vessels, may be taken from the chest, back or forehead and used to reconstruct the tongue and mouth.

Article by
Dr. Balabhai, Nanavati Hospital
Mumbai

Loop Electrosurgical Excision Procedure (LEEP) for Abnormal Cervical Cell Changes:

The loop electrosurgical excision procedure (LEEP) uses a thin, low-voltage electrified wire loop to cut out abnormal tissue. LEEP can:

Cut away abnormal cervical tissue that can be seen during colposcopy camera.gif.
Remove abnormal tissue high in the cervical canal that cannot be seen during colposcopy. In this situation, LEEP may be done instead of a cone biopsy.

LEEP is also known as large loop excision of the transformation zone (LLETZ).

A vinegar (acetic acid) or iodine solution, which makes abnormal cells more visible, may be applied to the cervix before the procedure is done.
How it is done

LEEP is usually done at your doctor’s office, a clinic, or a hospital as an outpatient procedure. You do not have to spend a night in the hospital.

You will need to take off your clothes below the waist and drape a paper or cloth covering around your waist. You will then lie on your back on an exam table with your feet raised and supported by footrests (stirrups). Your doctor will insert a lubricated tool called a speculum camera.gif into your vagina. The speculum gently spreads apart the vaginal walls, allowing the inside of the vagina and the cervix to be examined.

Medicine is injected to numb the cervix (cervical block). If a cervical block is used, an oral pain medicine or pain medicine given into a vein (intravenous, or IV) may be used along with the local anesthetic.
What To Expect After Surgery

Most women are able to return to normal activities within 1 to 3 days after LEEP is performed. Recovery time depends on how much was done during the procedure.
After LEEP

Mild cramping may occur for several hours after the procedure.
A dark brown vaginal discharge during the first week is normal.
Vaginal discharge or spotting may occur for about 3 weeks.
Pads should be used instead of tampons for about 3 weeks.
Sexual intercourse should be avoided for about 3 weeks.
Douching should not be done.

When to call your doctor

Call your doctor now or seek immediate medical care if:

You have severe vaginal bleeding. You are passing clots of blood and soaking through your usual pads each hour for 2 or more hours.
You have pain that does not get better after you take pain medicine.
You have signs of infection, such as:
Increased pain.
Vaginal discharge that smells bad.
A fever.

Why It Is Done

LEEP is done after abnormal Pap test results have been confirmed by colposcopy and cervical biopsy. LEEP may be used to treat cell changes on the cervix. These include:

Minor cell changes called low-grade squamous intraepithelial lesions (LSIL) that may be precancerous and that persist after a period of watchful waiting.
Moderate to severe cell changes that can be removed.

How Well It Works

LEEP is a very effective treatment for abnormal cervical cell changes. During LEEP, only a small amount of normal tissue is removed at the edge of the abnormal tissue area.

After LEEP, the tissue that is removed (specimen) can be examined for cancer that has grown deep into the cervical tissue (invasive cancer). In this way, LEEP can help further diagnosis as well as treat the abnormal cells.

LEEP is as effective as cryotherapy or laser treatment. If all of the abnormal cervical tissue is removed, no further surgery is needed, though abnormal cells may recur in the future. In some studies, all the abnormal cells were removed in as many as 98% of cases.1
Risks

Infection of the cervix or uterus may develop (rare).
Narrowing of the cervix (cervical stenosis) that can cause infertility may occur (rare).
After a woman has had LEEP, she has a higher risk of delivering a baby early

Psoriasis and Eczema
Treatment & Cure

Psoriasis & Eczema are non-infectious skin diseases that cause red, scaly rashes and patches on the skin. Though they are similar, the symptoms for psoriasis and eczema are usually different. Both Eczema and psoriasis cause painful swelling, bleeding cracks, severe scaling, itching, burning and plaques. Both psoriasis plaques and eczema rashes affect any part of the skin including scalp, palms, elbows, and knees, nape of the neck, genitals and soles of feet. Psoriasis is found in all age groups and most commonly it appears between 15 and 35. It is considered as a hereditary disease that passes down to the next generation whereas eczema is considered as allergic reaction that leads to long-standing irritation.
Herbal Treatment for Psoriasis and Eczema

Padanjali is an Ayurvedic psoriasis treatment centre that provides the best treatment for psoriasis and eczema. We provide herbal treatment for psoriasis especially hand psoriasis treatment, baby eczema treatments, eczema face treatment, infant eczema treatment, treatment for scalp psoriasis, skin psoriasis, guttate psoriasis, plaque psoriasis, genital psoriasis, eczema scalp treatment, severe eczema treatment, hand eczema treatment, eczema in children and infant eczema treatments. Treatment for eczema and psoriasis requires utmost care and therefore we recommend beginning your treatment program after the consultation with our Physician- Dr. Parameswaran Nair.

The treatment for psoriasis can start after initial consultation with doctor through phone or internet. A complete cure for psoriasis and eczema requires certain precautions before and during the period of medication