Definition

Paraplegia is a spinal cord injury that paralyses the lower limbs. It is a result of severe damage to the spinal cord and the nervous system. Paraplegia mainly affects the trunk, legs, and the pelvic region, resulting in loss of movement.

Causes of Paraplegia :

• Accidents
• Severe spinal cord injury
• Motor neuron disease
• Cancerous cell growth, tumors or blood clots within spinal cord
• Spina bifida
• Prolonged diseases
• Alcohol addiction

Categorization

There are two main categories – complete and incomplete. Complete paraplegia is witnessed when the injury affects the patient at the neurological level and it hinders the movement of limbs, whereas in case of incomplete paraplegia, some of the limbs are still moving.

Symptoms of Paraplegia

• Loss of ability to feel and move
• No control over bowel and bladder activities
• Intense pain or tingling sensation in the trunk, legs, and the pelvic region
• Problems in breathing and coughing
• Sexual function and fertility can be affected

There are no apparent symptoms that could be seen. Moreover, there may be delayed symptoms like numbness and paralyses.

Diagnosis of Paraplegia :

The doctors may diagnose paraplegia with the help of one of the following tests:

• Computerized CT Scan for a better understanding of the severity of the injury
• X-rays to examine any tumors or fractures in the spine
• Magnetic Resonance Imaging (MRI) to test for blood clots or any mass formation that may compress the spinal cord

Treatment of Paraplegia:

In the early stage, treatment is possible through medication and traction for immobilization. Surgery or experimental treatments can also be conducted.

While the patient is undergoing a treatment, doctors focus on preventing secondary problems like bowel and bladder issues, blood clots, pressure ulcers and respiratory infections. Any hospitalization will depend on the patient’s condition.

In the case of complete paraplegia, there are new technologies that may restore movement.

Recovery may start from the first week or it may take up to six months to experience improvement. However, there may be no permanent treatment for this condition.

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Causes

Sweating helps the body stay cool. In most cases, it is perfectly natural. People sweat more in warm temperatures, when they exercise, or in response to situations that make them nervous, angry, embarrassed, or afraid.

Excessive sweating occurs without such triggers. Persons with hyperhidrosis appear to have overactive sweat glands. The uncontrollable sweating can lead to significant discomfort, both physical and emotional.

When excessive sweating affects the hands, feet, and armpits, it is called primary or focal hyperhidrosis. In most cases, no cause can be found. It seems to run in families.

If the sweating occurs as a result of another medical condition, it is called secondary hyperhidrosis. The sweating may be all over the body or it may be in one area. Conditions that cause second hyperhidrosis include:

• Acromegaly
• Anxiety conditions
• Cancer
• Carcinoid syndrome
• Certain medications and substances of abuse
• Glucose control disorders
• Heart disease
• Hyperthyroidism
• Lung disease
• Menopause
• Parkinson disease
• Pheochromocytoma
• Spinal cord injury
• Stroke
• Tuberculosis or other infections

What Are the Symptoms of Cerebral Palsy?

Symptoms of sebaceous cyst :

Diagnosis of a sebaceous cyst

Treatment of sebaceous cyst:

Conductive and mixed conductive/sensory hearing loss

A bone conduction implant (BCI) is used to treat 2 basic problems: conductive and/or mixed hearing loss and deafness in one ear (single-sided deafness). These devices are considered when use of a conventional (air-conduction hearing aid) is not possible. For the case of conductive or mixed hearing loss, they are used most commonly in patients with chronic ear infections, cholesteatoma, and chronic otorrhea in which the diseased eardrum and/or middle ear ossicles are not able to conduct sound to the cochlea and use of a conventional hearing device often is not possible. The other common situation is congenital aural atresia in which absence of the ear canal and eardrum causes conductive hearing loss and a conventional hearing aid cannot be used.

Before Baha, the only device available to treat these situations was a conventional bone conduction hearing aid. This device consists of a bone conduction hearing aid (vibrator) attached to a headband (see the image below). These devices, while very helpful over the years, have several inherent disadvantages that limit their benefit and their acceptance, including the following:

• Discomfort caused by the constant pressure of the vibrator against the scalp
• Poor sound quality and volume caused by the indirect and variable coupling of the vibrator to the skull due to intervening hair and scalp tissues
• Variable and unstable positioning affecting the quality of transduction
• Bilateral use is not possible
• Poor aesthetics

Audiometric Testing

Polycystic Ovary Syndrome :

What is Polycystic Ovary Syndrome?

Polycystic ovary syndrome, or PCOS, is a complex hormone disorder that causes such symptoms as irregular menstrual cycles, infertility, excessive body hair, acne, and obesity.  The syndrome is named for the cysts that may form in the ovaries when the hormone imbalance interrupts the ovulation process.  The term polycystic means “composed of many cysts”.  If the hormone imbalance is left untreated, the syndrome may lead to life-threatening illnesses such as diabetes, heart disease, stroke, and uterine and endometrial cancers.

Symptoms of Polycystic Ovary Syndrome

Because it is a syndrome, PCOS includes a set of symptoms.  Women with PCOS can suffer from any combination of the symptoms listed here.  Some women experience only one of these symptoms, while other women experience all of them.  The severity of PCOS symptoms can vary widely from woman to woman.  Talk to your physician if you suffer from one or more of these symptoms.•

• Chronically irregular menstrual cycles or absent periods
• Infertility or difficulty conceiving (due to not ovulating)
• Obesity (greater than 20 percent over “ideal” weight)
• Sudden, unexplained weight gain (even if you are still of “normal” weight)
• Adult acne
• Excessive hair growth (especially dark hair on the face, chest, or abdomen)
• Male-pattern hair loss or thinning hair
• Type II diabetes or insulin resistance

It is possible to have the above symptoms and not have PCOS.  However, most women with these symptoms, especially irregular menstrual cycles, do have PCOS.  In fact, 80 percent of women with six or fewer periods per year have PCOS.

Researchers have found some variations in the symptoms among different races.  For example, while excessive body hair is found among 70 percent of American women with PCOS, it only occurs in about 10 to 20 percent of Asian women.  Unfortunately, there is not enough evidence to explain why these variations in symptoms occur.

Because the symptoms of PCOS can vary widely, it can be difficult to exclude or include symptoms as a part of the diagnosis.  In face, the World Health Organization tried to determine a comprehensive list of symptoms and couldn’t agree on more than four of them.  Further research is being done at a dozen facilities in the United States alone.  There may be more common symptoms discovered as new studies are completed and women continue reporting their experiences.

Who Is Affected by Polycystic Ovary Syndrome, PCOS?

The most common endocrine disorder, PCOS is estimated to affect anywhere from 5 to 10 percent of all women. That means at least 5 million and as many as 10 million women in the United States suffer from PCOS. The syndrome does not discriminate and can be found in women of all races and ethnic groups throughout the world, although it tends to be more common in women of Mediterranean descent.  PCOS affects women of all ages, from adolescence to menopause.  Once a woman is diagnosed, she will need to manage the symptoms for the rest of her life.

What is Uncemented / Cementless Total Hip Replacement

Total hip replacement is a surgical procedure for replacing the hip joint. This joint is composed of two parts – the hip socket (acetabulum, a cup-shaped bone in the pelvis) and the “ball” or head of the thighbone (femur). During the surgical procedure, these two parts of the hip joint are removed and replaced with smooth artificial surfaces. The artificial socket is made of high-density plastic, while the artificial ball with its stem is made of a strong stainless metal. These artificial pieces are implanted into healthy portions of the pelvis and thighbones and affixed with a bone cement (methyl methacrylate).

An alternative hip prosthesis called a “cementless” total hip replacement has the potential to allow bone to grow into it, and therefore may last longer than the cemented hip. This is an important consideration for the younger patient. In some cases, only one of the two components (socket or stem) may be fixed with cement and the other is cementless and would be called a “hybrid” hip prosthesis.

When is total hip replacement considered ?

Total hip replacements are usually performed for severe arthritic conditions. The operation is sometimes performed for other problems such as hip fractures or avascular necrosis (a condition in which the bone of the hip ball dies). Most patients who have artificial hips are over 55 years of age, but the operation is occasionally performed on younger persons.

Circumstances vary, but generally, patients are considered for total hip replacements if : –

Your pain is severe enough to restrict work, recreation, and the ordinary activities of daily living.
Your pain is not relieved by anti-inflammatory medicine, the use of a cane or walker and restricting activities.
You have significant stiffness of the hip.
Your x-rays show advanced arthritis, or other problems.

The orthopaedic surgeon must be very precise in preparing the femur for a cementless impact. The implant channel must match the shape of the implant itself very closely. New bone growth cannot bridge gaps larger than 1 mm to 2 mm. Your surgeon may recommend a period of protected weight-bearing (using crutches or a walker) to give the bone time to attach itself to the implant. This protected weight bearing helps to ensure there is no movement between the implant and bone so a durable connection can be established.

Cementless femoral components tend to be much larger at the top, with more of a wedge shape. This design enables the strong surface (cortex) of the bone and the dense, hard spongy (cancellous) bone just below it to provide support.

The acetabular component of a cementless total hip replacement also has a coated or textured surface to encourage bone growth into the surface. Depending on the design, these components may also use screws through the cup or spikes, pegs, or fins around the rim to help hold the implant in place until the new bone forms. Usually these components have a metal outer shell and a polyethylene liner.

The pelvis is prepared for a cementless acetabular component using a process similar to that used in a cemented total hip replacement procedure. The intimate contact between the component and bone is crucial to permit bone ingrowth.

Initially, it was hoped that cementless total hip replacement would eliminate the problem of bone resorption or stem loosening caused by cement failure. Although certain cementless stem designs have excellent long-term outcomes, cementless stems can loosen if a strong bond between bone and stem is not achieved.

Patients with large cementless stems may also experience a higher incidence of mild thigh pain. Likewise, polyethylene wear, particulate debris, and the resulting osteolysis (dissolution of bone) remain problems in both cemented and uncemented designs. Improvements in the wear characteristics of newer polyethylene and the advent of hard bearings (metal-on-metal or ceramic) may help resolve some of these problems in the future.

Although some orthopaedic surgeons are now using cementless devices for all patients, cementless total hip replacement is most often recommended for younger, more active patients and patients with good bone quality where bone ingrowth into the components can be predictably achieved. Individuals with juvenile inflammatory arthritis may also be candidates, even though the disease may restrict their activities.

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