ABSCESS AND SEBACEOUS CYST: WHAT'S THE DIFFERENCE

On a video uploaded by Dr Vikram Singh Yadav, I saw many people asking that what is the difference between abscess and sebaceous cyst. So I thought that I would create this post to explain you the difference between them. Ill come directly to the point here.

An abscess is cavity filled with pus. It occurs due to an unresolvable infection or inflammation which body, macrophages to be specific, cant kill or cant get rid off. So to prevent the spreading of the infection or inflammation our body tries to wall off the inflammation. This creates a cavity which is full of neutrophills and necrotic derbies. These present as painfull red warm swellings over various areas of body or at the injury site. An abscess could accompany with fever, lethargy and other constitutional symptoms.

Treatment of abscess is incision and drainage, betadine packing, noninflammatory drugs and antibiotics.

Cracked Lips

Chapped or cracked lips are a major issue in winters. It causes pain, bleeding and the dryness also causes rough lips which usually doesn't look good. So it becomes not only medical as in risk of increased infections though the cracks in the lips, but also cosmetic problem for many guys and girls. It can be prevented by using few basic and easy methods described below. So what is cause of these cracked or chapped lips.


It is usually due to dry air in winters which causes water to evaporate from not only the lips but also the whole body. This results in cracks

HOMEMADE ORAL REHYDRATION SOLUTION

Sometimes on some bad bad day, if you get diarrhea and also you do not any other help as you are in a remote place, that would be a very bad situation. So here I thought to tell you how to make oral rehydration solution (ORS) at home. I did found the method on rehydrate.org.

You need one litre of clean water preferably boiled and then cooled. Mix in it 6 leveled teaspoon of sugar and 1/2 leveled teaspoon of salt and your ors is ready.

Make sure the mixture almost accurate. Sugar is used in this solution to help intestine absorb the salt (sodium). Too much of sugar might make the diarrhea worse or too much of salt will make your health more bad. So be sure to mix it correctly.

The juices and other such type of products usually do not help so better avoid them. Rather get a orange flavored WHO ORS and drink it over time to make up for the loss of water and electrolytes.

CAULIFLOWER EAR

Cauliflower ear also known as Boxer's Ear is a condition which occurs mainly in boxers, wrestlers and rugby players. This occurs due to repeated blow to the ear pinna following which there occurs a hematoma or blood clot or collection of fluid under the perichondrium. Perichondrium is the structure which supplies nutrients to the underlying cartilage. The hematoma formed separates the perichondrium from the cartilage leading to decreased nutrient supply to the cartilage. This leads to death of cartilage tissue which is later replaced by fibrous tissue causing a permanent swelling in the ear pinna.

Treatment is usually evacuation of hematoma, and antibiotics as it can get infected very often.

Prevention: Ear guard or headgear should be worn at time of these sports.

What Is SURFER'S EAR

Surfer's ear is another name for exosteosis. It is common in people engaged in water sport. This is not the same as swimmers ear which is due to infection. This occurs due to constant irritation of external ear canal by cold water. This disease is usually bilateral and involves the bony part of external auditory canal.

Symptoms include decreased hearing or hearing loss, secondary bacterial infections and impaction of ear debris leading to further hearing loss.

Treatment: Drilling under general anaesthesia.

Prevention: Prevent water from entering the ear canal using ear plugs, or swim caps.

Ways to Check Ovulation

Well during each cycle a female body changes due to the effect of hormones that predominated during each cycle. These changes can be easily monitored with some effort. There are methods to check whether you are ovulating or not without using any ovulation kits. These changes are important to monitor if you are trying to get pregnant as accurately monitoring them will increase the chances of getting pregnant.


Here are a few methods you can use:-

1) Monitor Your Menstrual Cycle: A normal cycle is somewhere between 28days plus minus 7 days. You monitor your periods regularly then you will be ovulating at around 14th day from the beginning of the last menstruation.

2) Check your Basal Body Temperature: You can keep track of your body temperature by using a basal body thermometer. Usually after ovulation a females BBT increases to somewhere around 0.5 degrees. Usually you should measure it in the morning.

3) Cervical Wetness: Some women can feel the cervical wetness which is maximum during the ovulation. You can check it by properly washing the hands and then gently feeling the cervix with one or two fingers. While doing this you can also feel the consistency of the cervix and whether it is open or not.

4) Mittle Schmerz: It is a pain of ovulation which occurs specifically during ovulation. Few women can feel that.

5) You can always use the ovulation kit with your convenience as they are pretty accurate.

Medical Causes of Poor School Performances

All the parents (or many) want to see their kids perform well in school. Sometimes they are so strict that they dont see or they do not want to understand why their child has poor school performance. They forget about some other medical causes that can cause poor school performances not only low attention. Let me list some medical causes of poor school performances here. Be sure to ask your children about some of these problems if they are not getting good marks in the class.



I am listing them according to whatever comes to my mind first...

1. Adenoids: This leads to increase size of tonsills leading to blockage of eustachian tube which in turn leads to glue ear or serous otitis media. These children have problem in hearing. They sit somewhere in the middle benches in the class, have their mouth open and try to listen to teachers. But since they cant listen what they are being taught they cant do well in exams do they...

2. Eye problems like myopia or hypermetropia. Some of these children complain of headache while reading. This happens especially in hypermetropics. Parents think that he is giving just another excuse.

3. Worm infestations and malnutrition also lead to decreases attention in class and low grades.

4. ADHD i.e. attention deficit hyperkinetic disorder

5. Some specific learning disabilities like dyslexia etc...

6. Diabetes and other hormonal problems can also lead to fatigue, memmory loss etc.

If your child is getting persistently low grades and also if he or she is trying hard to improve its time to talk to them about any problem be it medical, mental or stress or any other problem before they loose hope and stop trying.

Thank you for reading the article. Please leave your comments below.

Tomatoes Decrease Risk Of Heart Attcks

 Here is an interesting fact about tomatoes that they help in decreasing the risk of stroke or heart attack. This primarily due to the presence of large amount of lycopene in them. Lycopene is an antioxidant that is also present in other red fruits and vegetables which help in reducing reactive oxygen species also known as singlet oxygen quenching property which according to wiki is 100 times more efficient than vitamine E and 125 times more efficient than that of glutathione.



   A study performed in Finland suggested that diet rich in tomatoes could be helpful in reducing risk of stroke. Lycopene gives tomatoes its red colour and is already linked in lowering the lisk of prostate cancer in men. It also prevents blood clotting. It decreases the amount of reactive oxygen species in blood that injure the walls of artery leading to formation of atherosclerotic plaque. Thus it prevents or atleast delays the onset of a heart attack. It is also known to decrease the wrinkle formation in skin.

So eat a lot of tomatoes and stay healthy.

Reflux Esophagitis and Bad Teeth

Many people have bad teeth, mostly due to bad eating habit, poor oral hygiene etc. etc. But did you know that reflux easophagitis or gastroesophageal reflux disease can cause bad teeth and even it can lead to tooth loss. Well if you think about it, its not surprising. Let me explain you why.

Well from the time our teeth appear, they are in constant state of demineralisation and remineralisation which is usually balanced by many factors. One of such factor is pH of our mouth which is slightly alkaline and it is maintained by saliva. When this balance is disturbed then demineralisation of teeth occur leading to tooth caries.

So in people with severe reflux esophagitis the pH of mouth becomes acidic due to massive acid reflux. This leads to increased demineralisation of teeth leading to caries and ultimately leading to teeth loss if not treated in time.

Treatment of this condition would be to treat your primary condition first i.e. reflux esophagitis. Visit your dentist immediately if you notice such condition.

Hearing Loss and Headphones: Is There a Connection???

Now a days with the invention of portable music players, ipod, it is more sort of became a habit for many to wear headphones while working, walking, cooking, sleeping and sometimes even during pooping. They keep listening to their personalised music play list for hours and after some time they start having ear aches. So they start thinking that may be these headphones are bad and should be changed. Did you ever think that your ears can get fatigued so called listeners fatigue due to long hours of listening to music. Well it is a phenomenon by which your in ear headphones can harm your ears.

How do headphones harm your ear: Well to understand that we need to understand what is stapedial reflex. Stapes is a bone in our middle ear (smallest bone in our body) which transmits the sound via oval window to the inner ear from outside. Now this bone is connected to wall of middle ear by a muscle called stapedial muscle. Whenever we hear a loud noise this muscle contracts and pulls the stapes bone away from inner ear so that amount of sound entering the inner ear is decreased. This is a normal protective mechanism.

Now when we start listening to music via our headphones, specially the in ear ones, which totally clog the external ear canal, the sound seems a bit loud to our inner ear. So it sends a protective signal to muscle, which in turn contracts and thereby decreases the loudness reaching the inner ear. We think that the volume is low and we crank up the volume. This leads to increased workload to the muscle and at last it gets fatigued. Now when it gets fatigued the muscle no more contracts leading to all of the loud noise reaching to inner ear. This causes inner ear cells to die and leads to hearing loss.

What to Do??

• Well 1st of all control the loudness of the device
• Limit the usage of the device
• Buy a good pair of noise cancelling headphones so that you don't have crank up the volume to listen to your songs or play lists. 

Hope you liked the article here. Please do add any other information or suggestion in form of comments to help people live healthier.

Health Effects of Noise Pollution

There are numerous effects of noise on health as it is one of the most influential factor of our life now a days. How much influencial?? Well read on to find out how much noise affects your daily life, your mood, your cardiovascular health, your learning capabilities. It basically affects almost every aspect of your life. Hope that we can understand these effects and do what we can decrease these problems so that we can live happier and healthier.

1. Hearing Loss: Well this is by far the most well known affect of noise on health. It usually causes high frequency hearing loss.

2. Sleep Disturbances: Yes noise can sleep disturbances which in turn leads to increased stress, leading to decreased social and household harmony as youll remain irritated if you cant get enough sleep. And stress is another factor there.

3. Dysgraphia or Learning Impairement: Noise leads to decreased attention and impairs ability to focus. These two have vital role in learning. So if it is impaired your learning ability will be impaired.

4. Cardio-Vascular Problems, like Hypertension

5. Annoyance

6. Vertigo, speech disturbance, fatigue etc...

There are many other effects of noise which can lead to serious health problem.

Noise Induced Hearing Loss: A Major Issue in Modern World

Hi friends, in today's world where science has advanced so much, along with its pros it has given us many cons.One of the major cons is the noised pollution like from cars, aeroplanes, industries with lots of noise. Apart from deafness or hearing loss noise has many other bad affects on our health.

1. Traffic induced noise is the most common form of noise in countries like India ( from where I belong). Most of these people driving cars are so impatient that they cant even stop at the signal and also they do not obey traffic rules. Most of the time they are in hurry because they are late. Anyways these cars are major source of noise pollution along with air pollution. You can avoid these when you obey the traffic rules and may be if leave for work on time (for Indians).

2. Other source of noise pollution is the mills. There are a few mills or industries where there is a lot of noise pollution. For these type of pollutions we have some rules in India like these workers should not work more than 5 days week for max 8 hrs per day.

3. The loudspeakers which we enjoy now a days is now becoming very common source of noise pollution as they are getting better and cheaper. We like to enjoy loud music for hours without having any thoughts of what other people might be experiencing due to this noise. It is our responsibility that we control that noise so that other may live in piece.

Most of these factors are manageable by us. So should try to mange the situation. Because if we don't care for our surrounding nobody will.

Ways to Gain Weight

Now in this era of modern fast foods and obesity there are people who are trying to gain weight. The problems with obesity is so much that we forget to talk about underweight or skinny people. Now here in this article i am trying to mention some of the ways to gain weight.

To gain weight you need to make your eating habbit a bit smarter. Hmm... what do i mean by that... I mean you need to calculate the amount calories you eat, the frequency of your meal, what type of diet you are including in your meal i.e protiens, carbohydrates or fats. Are you exercising or not.

1. Frequency of meals is very important. You can divide your meals in six parts... three large meals each alternating with small meals. You should plan this in such a way that you never remain hungry for more that 4-6 hrs.

2. Exercise particulary the anaerobic ones i.e the resistant exercises help to build muscle mass... so it is very important that you do some exercises. This will help you to become muscular rather than overweight with nothing but fat which would again be a problem and youll start looking for ways to loose weight :D.

3. Do include high protien meal after the exercises which will help the muscles to get the resources to expand. Some of these food include red meat, soya, pulses like dal, fish, low fat dairy products, almonds etc.

4. Doing all these please Do Stay Away From Junk Food as they containg nothing but excess amount of trans fat which are bad for health.


Do give your feedback about the article in form of comments. Thank you for giving your valuable time in this reading this article.

Food That Burn Fat

Now a days obesity is a very big problem, with all those junk fast food around which don't do any good to health but they are certainly rich in high cholesterol and trans fats which are very bad for health and especially for heart. Fast food should certainly be avoided. There are many food that can help you loose weight and keep you fit. Some of these food are listed below:

1. Citrus Fruits and other fruits that are rich in vitamin C. Vit C is an antioxidant that helps in maintaining the lipid profile by decreasing the amount of oxidised LDL in the body. Oxidised LDL tends to get deposited in the blood vessel leading to diseases like atherosclerosis which is the basic foundation for other diseases like myocardial stroke and angina and some other diseases. It also certainly does help to reduce fat in the body. Be sure to include cirtus fruits like oranges, lemon, kiwi in your diet.

2. Vegetables like cabbage, broccoli, spinach are very low in carbohydrate content and thry also stop coversion of glucose to fats in the body.

3. Spices like turmeric, chillies and cardamom. Turmeric with its active component curcumin helps in reducing bad cholesterol and decreases blood clotting on regular intake.
Cardamom is a thermogenic herb that increases metabolism in the body and helps burn fat. It is believed that it also has soothing affect on digestive system and helps in propper digestion of food.
Chillies have capsaicin that increases metablic rate of the body and thus helps in burning fat.

4. Garlic: Garlic has a sulphur containing compound called allicin which has antibacterial actions, and also decreases unhealthy fats.

5. Nonvegetarians should avoid eating red meat as it contains a lot of fat. They should rather eat chicken, which is white meat and contains very less fat.

6. Eggs have dietary cholesterol which are important for the body as it reduces endogenous cholesterol production. It is rather good to eat one or two eggs a day than not having at all.

7. Pulses like dal, jwar, bajra etc are low on fats and highly nutrtious.

8. Honey It is a home remedy for obesity. It mobilises the extra fat deposits in the body allowing it to be utilised as energy for normal functions. One should start with about 10 grams or a tablespoon, taken with hot water early in the morning.


Please do try to add these food items in your diet as they have multiple properties i.e. not only fat lowering but also most of them help in improving circulation in body. Do add suggestions in form of comments what else to added in the list make the list complete.

Stress and Acne: Are They Related???

Here in modern world, stress is the most common problem a person would have because it leads to so many other diseases the list of which would never be complete. It influences health in a large spectrum of ways. Recently in a study it has been found that it can flare up an acne reaction in an already acne prone patient. Although the exact mechanism is not know, it increases the receptors in skin for different stress hormones. These hormones increase the sebum production. Eventually sebum mixes with dead skin and block the pores leading to acne cyst or comedone formation. The study was done on few college students (around 20-22) with acne during exam period and increased acne pimple was noted.

Stress doent lead to new acne formation, but flares up the old ones. These acne cant be treated only with stress relieving unfortunately, but some anti acne cream like benzoyl peroxide etc or isotretinion tablet for resistant cases are used.

Stress: How It Affects Sex Life

Stress is a major problem in this modern era, especially with our hectic work environment. Stress can affect many aspects of our life and cause many illnesses like insomnias, stomach problems, mental problems. Not only these but stress has major effect on sexual life also.

How does stress affect libido:

When we are under stress our body releases different hormones like cortisol, adrenalin which prepare our body for fight or flight reaction. Cortisol has many effects on our body one of which is decreased libido that is decreased desire for sex.

Apart from physical stress there is mental stress which is more common now a days and is increasing more and more. Mental stress can be related to work, money, how to pay your monthly electricity and phone bill and more importantly your Internet and Cable Tv bills :D.These stresses lead to low mood and ultimately to depression. In this case you are not able to concentrate on what you are doing, and also you loose interest in almost everything else which you enjoyed earlier including sex.


What to do??

Hmm... this is a difficult part as there are thousands of solutions available and still remain ineffective as they entirely depend on individual ability to cope with stress. Its only you who can relieve your stress. Others can only give advices. As of me all I can say that you can relieve your stress by doing something which you like, something which cheers you up even in sad mood, whichever activity it is, it will surely make you stress free. Rest all those yoga, excercises and everything else depends on you, if you wanna do it... do it, if dont then no harm done. I hope i helped. Enjoy life..:)

Earwax: A Common Problem

Excessive earwax production is a fairly common problem in day today life. It may cause some hearing loss if it gets impacted, may cause infections, irritation in ear.

Ear wax is made up of secretions from sebaceous gland ( which are present in the outer 1/3 rd of external auditory canal), cerumin, hair, dird, desquamated cellular debris. It plays a protective barrier role in ear canal. It lubricates the ear canal and entrapes any foreign material that happens to enter the ear canal.

 Normally a small amount of ear wax is produced which later dries up and is expelled out of ear due to movements of jaw. But in some people there is higher production of wax than normal which forms a plug. It may later dry up and form a hard impacted mass.

These people may complain of decreased hearing (as impacted wax causes a hearing loss of 30db), ringing in ear. They might develope some sort of infection.

Dont use ear buds to clean these impacted wax ( infacted ear buds should usually be avoided in general) as it may push the wax further inside the canal.

Do consult your doctor. He may advice to go through a procedure called Syringing in which luke warm water is injected in the canal an when water comes out it takes the wax plug out with it.

In case of hard impacted wax plug which is hard to remove by syringing it is softened by sodabicarbonate ear drops, hydrogen peroxide, liquid paraffin, or olive oil. Paradichlorobenzene 2% ear drop is available commercially.

Gastroesophageal Reflux Disease: Dos and Donts

GERD gastroesophageal reflux disease, this disease is fairly common in the population particularly in obese people. This disease usually occurs when the lower esophageal sphincter tone is decreased leading to reflux of acid from stomach to esophagus. Few symptoms of this disease are heartburn, belching, asthma, acid reflux in mouth, bad teeth. I am not going to discuss about the whole disease here i am going to give a few lifestyle modification advices which will help you to reduce the symptoms.

Dos:-

• Elevate the head end of your bed to around 20-30 degrees. This helps to keep the food in the stomach due to gravity during sleeping.
• Divide your meals in several small parts during the whole day rather than taking one large meal. E.g. youcan divide your lunch into four separate meals 2hrs apart.

Donts:-

• Dont go to bed immdiately after a meal.
• Dont eat a heavy meal as it will not allow the lower esophageal shincter to close properly.
• Dont drink tea, coffee or eat chocolates too much as these affect the normal physiology of lower esophageal sphincter and reduce its force of contraction.
• Dont drink lots of water just after the meal. You should wait for atleast 45 mins to drink water after meals.
• Do not smoke or atleast try to quit as nicotine also decreases lower esophageal shincter tone.

Hope this information helps you keep yourself  heathy . Do read some other articles on the blog.

Dos and Donts in Kidney Stones

While many patients suffer from kidney stones in the world and are prescribed for medications no dietary advices are given to these patients like which food will increase the process of stone formation and will lead to recurrence of kidney stones after their removal and which diet leads to decreased stone formation even spontaneous dissolution of the stones. So here is an advice on dietary modifications in kidney stones.

Dos:-

• Drink plenty of water around 8-10 glasses per day
• Eat fruits and vegetables rich in citrate (vit C) as they lead to decrease precipitation of calcium oxalate like orange juice and coconut water rich in potassium and other electrolytes
• Drink Cranberry Juice as it decreases the chances of urinary infections due to stones which can be disastrous
• Eat fruits rich in vit B6 like banannas

Donts:-

• Avoid soyabeans and nuts
• Avoid vegetables like cauliflower, brinjal, tomatoes, beatroots, dark leafy vegetables
• Avoid nonvegetarian food like red meat, fish
• Avoid dairy products
•  Avoid carbonated drinks like coca cola, pepsi etc as they are rich in oxalates leading to stone formation

This dietery modification usually helps to reduce kidney stone formation i  patients who are prone recurrent stone formation. Also after the removal of kidney stones the contents of stones are analyzed and dietary modifications are adviced according to that.

WHAT ARE THYROGLOSSAL CYSTS

Thyroglossal cysts are fibrous cysts that forms due to a persistent thyroglossal duct. The thyroid gland usually develops in the oropharynx and then it descends to its final position through tongue, hyoid bone and neck muscles making a thyroglossal duct which usually closes before birth. If it remains open it is called persistent thyroglossal duct which can lead to a thyroglosssal cyst formation.

Symptoms:

Usually patients present with palpable lump in the midline of neck between thyroid and hyoid bone which moves swallowing and upward with protrusion of neck. Usually the patients are asymptomatic but a few of them might complain of dysphagia i.e. difficulty in swallowing or he can present with difficulty in breathing. Sometimes cysts can get infected.

Treatment:

Surgical removal is the mainstay. Sistrunk operation is performed in which hyoid bone is also removed to ensure the complete thyroglossal tract removal to prevent recurrence.

TUNING FORK TESTS

These tests are use for assessment of hearing in an individual, hearing loss. We can also differentiate between conductive hearing loss and sensory hearing loss using these tests.

Hearing Pathway: The sound first reaches the tympanic membrane via external auditory canal then via auditory ossicles (Malleus, Incus, Stapes) reaches the cochlea from where VIIIth nerve takes the impulse and take to brain in the temporal lobe. The pathway till cochlea is the conductive pathway.

So now for the test we need tuning fork, 512hz frequency is ideal as lesser frequencies produce more vibration on the bone and the tone of higher frequencies decay faster.

Air Conduction: It the conduction via normal pathway as described above. It is usually better than bone conduction.

Bone Conduction: When we put the base of tuning fork on the mastoid, or middle of forehead the sound waves travel directly via cranial bones to the cochlea bypassing the normal pathway. This is called bone conduction.

Below is a video showing how to do a Rinne Test.

Now there are usually three tests that we use in Tuning Fork Test

1. Rinne Test: It is done using a 512hz tuning fork. 1st we check the bone conduction by ringing the tuning fork and then placing the base of the tuning for on mastoid process. Ask the patient whether he can hear a sound or not and if he can hear the sound then ask him to raise his hand or simply tell you when the ringing stops. Note that time. Then again hit the tuning fork and place it near his ears and repeat the same procedure.

• Rinnes test is positive in normal people as Air Conduction > Bone conduction. 
• Rinnes Test is negetive In conductive hearing loss the BC>AC as there is problem in conductive pathway leading to decreased conduction but when we bypass the pathway via bone conduction the soun is percieved normally as cochlea is healthy. 
• Rinnes is positive in sensory neural hearing loss i.e. AC>BC but the duration of the ringing is reduced for both AC and BC, as cochleae is damaged so there is no bypass pathway left to carry sound energy to brain.

   2.   Webers Test: It is done by placing the tuning fork in the middle of the forehead of the patient. Then ask the patient on which side he can hear the sond better. In conductive hearing loss the sound lateralises to bad ear while in sensory neaural hearing loss sound goes to better ear

WHAT IS PARONYCHIA

Paronychia is a bacterial or fungal infection of hand where nail meets the skin. It could start suddenly called acute paronychia or it gradually called chronic paronychia.. It is usually common in diabetics. Acute paronychia usually occurs in bacterial infection whereas fungal infection causes chronic paronychia.

Symptoms: Usually the first symptom is painful, red swelling around the nail, often at the cuticle or at the site of hangnail or other injuries. Pus filled blisters can also be found specially in bacterial infection.

Treatment: Paronychia can effectively be treated with antibiotics like cephalexin or dicloxacillin. Topical antibiotics can also be used. When there is pus in loculi we need to drain it. Sometimes partial nail is also removed.

                    Fungal infection tends to heal slowly taking a period of around 4-6 weeks.

Prevention: 

• Care for nail and and skin around the nail properly.
• Do not bite or pich the nai
• Protect nails from damage
• Bring your manicure tools.
• Avoid gatting damage to flaps.

DIABETES COMPLICATIONS: THE DIABETIC FOOT

The diabetic foot occurs due to decreased blood supply to lower limbs due to accelerated arterial hardening also called atherosclerosis, nerve damage which leads to decreased sensation in foot, tight fitting shoes etc. Since there is poor blood and nerve supply, even a small trauma or infection can cause a very serious damage which can lead to even amputation of limbs. Below is a video of diabetic foot in an uncontrolled diabetic patient.

Treatment includes antibiotics, daily dressing of the wound with vitE, trental ointments (which increase blood flow in lower limbs) can be used. 

Surgical management includes debridement of the infected area and then dressing and antibiotics. If that doesnt help then amputation is the last resort.

DIABETES MELLITUS

Diabetes mellitus is a group of metabolic disease in which patient cant utilize glucose present in the body either due to decreased insulin or due to insulin resistance in body. There are basically two types of diabetes:

• Diabetes Mellitus Type I: It occurs due to destruction of insulin producing cells ( beta-cells) in the islet of Langerhans of pancreas. This occurs due to some autoimmune disorders, pancreatitis, infections. Destruction of beta-cells leads to decreased production of insulin. Insulin is required by muscle cells to draw the sugar in blood into themselves. But in absence of insulin they cant do it and sugar remains circulating in blood leading to a rise in blood sugar level i.e. Diabetes.

• Diabetes Mellitus Type II: This type usually occurs in obese people in whom resistance to insulin developes. So there is insulin but muscle cant use them for glucose uptake as insulin cant attach to its receptors because the receptors becomes defective. Pancreas tries to overcome to this situation by producing increased amount of insulin, which leads to increased weight in turn. But after some period of time the pancreas gets exhausted of overwork and the insulin levels start to decline.

Symptoms: The patient usually feels lethargic, due to decreased amount of glucose in muscle. Thirst, Polyuria occur when kidneys no longer can retain the sugar lost in urine leading to increased osmotic outflow. Increased appetite is also a symptom.

Usually in type I diabetes the symptoms lead to diagnosis at once but there is no hidden disease while in type II patient develops symptoms very late and is diagnosed late or accidentally during regular check up.

Treatment:

Type I can be treated by using insulin, combination of insulins.

Type II: Here diet and lifestyle modification along with oral hypogycemics like metformin is prescribed. Exercise usually helps to decrease the insulin resistance. But after a few years when beta cell get exhausted of producing excess insulin, recombinant  insulin injections are required.

WHAT IS STUDENTS ELBOW

Olecranon bursitis also known as student elbow is a condition in which there is pain, redness, swelling around the olecranon due to inflammation of the elbow bursa. The bursa is located on the extensor surface near the extreme proximal end of ulna.

CAUSES: It is usually caused by trauma to to the elbow like a hard blow to the elbow or repeated minor injuries to the elbow for example while studying. Due to the injury the bursa starts producing larger amount of fluid than normal exceeding the normal rate and gets accumulated in the bursa leading to swelling and pain.

Infection of bursa is also one of the cause.

TREATMENT: Usually the 1st treatment is rest and avoiding further injuries to the elbow.

Aspiration of the fluid and injecting steroid into the bursa to reduce inflammation is also one of the practices.

Antibiotics can be prescribed if inection is suspected.

Surgical resection of bursa can also be done if medical management fails.

Here is a video by Dr Vikram Singh Yadav of aspiration and steroid injection into the bursa.

PERCUTANEOUS NEPHROSTOMY VIDEO

Here is a video showing how PCN is done. Dr Vikram has explained it in the video very well. 

Indications for PCN are:

• Pelvi-Ureteric Junction Obstruction
• Renal abscesses, urinomas
• PUJ obstruction secondary to stone
• Urine diversion in obstruction during pregnancy
• Treatment regarding any fistulas due to iatrogenic or traumatic injuries, malignant or inflammatory fistulas.

Contra-Indications include:

• Bleeding diathesis
• Unco-operative patient
• Severe hyperkalemia (>7) -- Do dialysis first then the procedure

Urethral Stricture

It is abnormal narrowing of urethra due to trauma, STDs or urethritis.

Causes:-

• Inflammation or scar tissue formation due surgery, disease or injury
• Pressure from enlarging tumor
• instrumentation of urethra eg. cystoscopy
• STDs
• H/O repeated urethritis

Symptoms:-

• Decreased stream of urine
• Incomplete emptying of bladder with terminal dribling of urine
• Urinary intermittency
• Frequent micturition
• Acute or chronic retention of urine

Complications:-

• Urinary retention
• Bilateral hydronephrosis
• • Urinary infections
  • Urinary calculi

  Diagnosis:-
  
  
  • Urine routine examination with microscopy
  • Urine culture
  • Retrograde Urogram (RGU)
  • Post void residual urine
  • Cystoscopy

  Treatment:-
  
  
  • Instrumentation with bougies or catheter depending on severitySurgery eg urethrostomy or urethroplasty can be done

WHAT ARE SEBACEOUS CYSTS

A sebaceous cyst is closed sac under the skin filled with sebum which in a cheesy or oil like material. These cysts are sometimes called epidermal cysts. They are basically caused by blocked sebaceous gland, trauma, swollen sebaceous glands, excessive amounts of testosterone. Usually they present as painless nodule under the skin, can occur anywhere in the body. If they get infected, redness, pain, warm skin and tenderness appear around the area and cheesy like material may drain from the area.


How To Remove A Sebaceous Cyst by VideojugBeautyandStyle
 
Treatment usually include surgical removal of the cyst. If properly removed along with the wall and sac, cyst will not recur. If it gets infected, the cyst is 1st drained and patient is kept on antibiotic treatment. When infection gets settled the cyst is then excised.

This is a sebaceous cyst excised from back of patient

ASPIRATION OF GANGLION CYST AND INJECTING STEROID INJECTION INTO IT

O.k few days earlier I discussed about ganglion cysts, what are they, their treatment modalities. Here is a video showing how to aspirate and then inject kenacort into the cyst.

1st we clean the area and then apply some local anesthetic. When the area becomes numb we insert a wide bore needle into it and then aspirate the fluid. Then keeping the needle in place we replace the syringe with the kenacort (steroid) loaded syringe and then inject it into the cyst.

What Are Ganglion Cysts

Ganglion cysts are found most commonly at the dorsum of hand near the wrist joint or fingers. The can also be found near other joint. They are hard, somtimes painfull swellings, which on applying pressure move away, the movement is restricted on flexion/ extension of wrist, and on applying light the light is transmitted through the cyst as it contains clear fluid i.e. transillumination is positive.

Cyst usually resolves itself

Treatment options include aspiration and then injection with steroid e.g. triamcinolone (kenakort) or surgical excision. Although there is higher rate of recurrence.

DIABETIC FOOT

Diabetic foot usually occurs in patients with uncontrolled diabetes. It is one of the most serious complications of diabetes mellitus. It usually occurs due to blood supply problems in lower limbs, and peripheral neuropathy both occuring due to high levels of blood sugar. Many patients with ulcer result in lower limp amputation if not treated early with good diabetic controll and antibiotics.

Here is a video of a patient with diabetic foot. He had an unctrolled diabetes for 3-4 yrs.

ACNE VULGARIS

O.k, first of all vulgaris doesnt mean that it is vulgar or dirty, it means most common type e.g. icthyosis vulgaris, acne vulgaris. Acne is a very common problem in world. It is caused as a result of blockages of follicles which are called microcomedone, which later become enlarged and result in comedones if open and milia if closed. The comedones contain sebum and dead skin which can become infected by propionibacterium acne leading to inflammation and pustule ( pimple) formation. Other causes include hormonal changes during puberty, anabolic steroid intake, diet.

Symptoms include comedones, seborrhea, pustules, nodules, scars, pigmentations.

TREATMENT includes ointments like benzoyl peroxide, clyndamycin cream, if they dont help then isotretinoin gel/cream. If all these treatments fail then oral isotretinoin is prescribed which usually given for 4-6 months and can cause long term resolution of symptoms. It is teratogenic ( causes developement problem in fetus) so is contraindicated in pregnancy.


Some other modalities are Dermabrasion, phototherapy, photodynamic therapy, laser.


Home remedies... aloe vera oil, egg oil and tea tree oil.


Also Watch: Blackhead Removal Video Collection by Dr Vikram Singh Yadav