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Overview

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Our fully functional Gastroenterology unit is led by a team of expert gastroenterologists who are dedicated to the diagnosis and alleviation of symptoms of discomforts you may be facing in your gastrointestinal system.

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Our fully functional Gastroenterology unit is led by a team of expert gastroenterologists who are dedicated to the diagnosis and alleviation of symptoms of discomforts you may be facing in your gastrointestinal system.

Test Title 1

Our fully functional Gastroenterology unit is led by a team of expert gastroenterologists who are dedicated to the diagnosis and alleviation of symptoms of discomforts you may be facing in your gastrointestinal system.

Causes of Ureteric Strictures

Ureteral stricture may be caused by external trauma or may develop after treatment for another condition. Ureteral stricture may be inflammatory due to gonorrhea, tuberculous uretritis, or schistosomiasis, or a rare complication of cancer.

Non-anastomotic ureteral stricture may develop after stone impaction or upper urinary tract endoscopy, as well as following pelvic radiation therapy and a variety of open and laparoscopic surgical procedure or other trauma. Anastomotic ureteral stricture may develop as a result of urinary diversion surgery.

Symptoms

Symptoms of ureteral stricture may include pain, loin lump , flank tenderness, and/or urinary tract infection.

Diagnosis of ureteric strictures

It is diagnosed by IVU (Intraveneous Urogram) or retrograde urethrogram to determine the site and degree of stricture.

Treatment for ureteric strictures

There are a variety of minimally invasive treatments for patients with ureteral strictures. A doctor may perform balloon dilation as a first step in treatment, particularly in patients who have nonanastomotic strictures.

For ureteral strictures that do not respond favorably to dilation alone, endoscopic incision is the procedure of choice for most patients. Endoscopic incision of the stricture can be performed or a laser may be used with a rigid or flexible ureteroscope. A stent may be left in place to keep the ducts open for approximately 6 weeks.

New technique called Holmium Laser Endoureterotomy is now available that may allow long-term relief from ureteral stricture if other techniques are unsuccessful.

Signs and Symptoms

Symptoms are often similar to those of benign prostatic hyperplasia (BPH). Men observing the following signs and/or symptoms should see their physician for a thorough examination:

  • Blood in urine or semen
  • Frequent urination, especially at night
  • Inability to urinate
  • Nagging pain or stiffness in the back, hips, upper thighs, or pelvis
  • Painful ejaculation
  • Pain or burning during urination (dysuria)
  • Weak or interrupted urine flow

Treatment For Prostate Cancer

Treatment of prostate cancer depends upon the stage of the disease and patient's age and overall health. Elderly patients with minor symptoms, early stage of cancer, or coexisting illnesses may be treated conservatively.
Watchful waiting is a reasonable course of action for patients who are elderly, in poor health, or in early cancer stage. Untreated prostate cancer may take years to become problematic. During this time, the physician monitors the patient's condition for any marked or sudden progression of the disease, which may signal the need for more aggressive treatment. 

  • Radical Prostatectomy
  • Bilateral Orchidectomy

Preparing for Prostate Cancer Treatment

Radical prostatectomy is the surgical removal of the prostate gland and surrounding tissues including seminal vesicles and pelvic lymph nodes. Surgeons use one of two surgical techniques, retropubic prostatectomy or perineal prostatectomy. General anesthesia is used in both procedures. In retropubic prostatectomy, an incision is made in the lower abdomen. This gives the surgeon access to prostate gland, seminal vesicles, and pelvic lymph nodes. In perineal prostatectomy, the incision is made in the perineum (space between scrotum and rectum). With perineal prostatectomy, a second procedure is required to remove the pelvic lymph nodes, lymphadenectomy.

Sperm Retrieval Techniques

When obstruction is the problem:

When the release of sperm is prevented by a blockage in the vas deferens, or by a vasectomy, several techniques can be used to retrieve the large numbers of sperm that remain inside the testes. The first three involve aspirating sperm using needles or tubes placed through the skin of the testis and are carried out under local anaesthetic. The fourth requires open surgical sperm retrieval and is usually carried out under general anaesthetic.

  • TESA: testicular sperm aspiration. This involves placing a needle attached to a syringe through the skin of the scrotum and simply sucking out the fluid inside the testicle.
  •  
  • PESA: percutaneous epididymal sperm aspiration. This involves the same needle and syringe technique but the needle is placed directly into the epididymis.
  • Perc biopsy: percutaneous biopsy of the testis. This is similar to TESA, but a larger needle is used. This is a 14 gauge needle usually used to biopsy testicular tissue and it usually extracts a larger number of sperm.
  • MESA: microsurgical epididymal sperm aspiration. An open surgical sperm retrieval procedure that uses an operating microscopy to locate the tubules of the epididymis precisely, so that large numbers of sperm can be extracted.

Some small studies have been done to compare success rates after the different types of surgical sperm retrieval. These concluded that MESA gives the highest number of sperm, with a hundred times more sperm being recovered compared to TESA and perc biopsy. MESA also produced sperm that were better swimmers and therefore more useful for infertility treatments, including IVF and ICSI.

When there is no obstruction :

Men who have no sperm in their semen, despite having clear tubes in their testicles, usually have a problem with the process of sperm production. It is unlikely that sperm are present in large numbers, so the surgical sperm retrieval techniques required are more invasive.

  • TESE: testicular sperm extraction. This involves opening up the scrotum and taking a large volume of testicular tissue, perhaps from several regions of the testicle. Sperm are then retrieved using a microscope to identify individual sperm.
  • Microdissection TESE. A similar technique but a microdissecting microscope is used to pinpoint the tissue to be removed. This aims to cause less damage to the structure inside the testicle, and to therefore have fewer after effects such as blood supply problems caused by tiny blood vessels being cut. It also appears to increase the number of sperm that can be retrieved.

A Quick Glance on How We Can Help

·      Understand each other much better

·      Identify root cause of conflicts and ways to fix them

·      Learn effective strategies for problem-solving

·      Teach you effective ways of communication

·      Understand the possible implications of separation

·      Overcome your anger

·      Learn ways to move on from marital disappointments

We make every effort to make you feel at ease. When you come to us, be assured of your privacy. We work on ethics and maintain our patient’s dignity at all times.

 

TREATMENT

NOSE SHAPING (RHINOPLASTY)

It's a surgery to reshape the nose by altering its size, angle, curves or proportions. Can address problems related to the nostrils and the nasal tip.

Baldness Treatment in Delhi

Baldness Treatments include Hair Restoration Surgery- a surgical procedure in which hair is removed from a donor site, sectioned into micro-grafts and transplanted into a balding or thinning area on the scalp. Other grafting techniques include flaps, tissue expansion and scalp reduction.

Baldness Treatment in Delhi

The procedure for hair transplant provides treatment for hair loss and balding. In this technique, the dermatologists first take out a small section of the hair-bearing scalp from the back of the head. The surgeon next cuts the removed scalp into small segments with varying amounts of hair in each graft. These segments are then transplanted into the hairless areas, producing slight thickening and giving "natural" look. The procedure of implantation of grafts is quite a delicate one as the grafts must be handled very gently and inserted into holes formed in the bald area. It is critical to place the grafts closely without damaging the tissue, requiring great skill and expertise. It is therefore recommended to get such a procedure done at the best hair transplant hospital in Delhi.

  1. Follicular Unit Transplantation (FUT):
    A technique that provides permanent results is the FUT hair restoration technique. FUT involves extraction of a bit of tissue containing numerous follicular units from usually the back of your head. The strip is then dissected into individual follicular units, or grafts, for transplantation to your thinning areas.
    With the help of this surgery, a large area can be covered but its only drawback is that this surgery leaves behind a linear scar at the back of the head, which heals relatively slowly.

  2. Follicular Unit Extraction (FUE):
    FUE or Follicular Unit Extraction is another method of hair transplant surgery. It is considered minimally invasive because a small punch is used to yield single hair grafts one at a time. Amongst methods of hair transplant in hospitals in Delhi, the FUE procedure is more popular and successful than FUT as it involves minimum discomfort and fast recovery, its only shortcoming being its multiple lengthy sessions.

  3. Robotic FUE Hair Transplant:
    One of the most advanced forms of Hair Transplant treatment in Delhi is the Robotic Follicular Unit Extraction. It handles the process of hair unit extraction with absolute accuracy in a shorter period than that required for a manual hair transplant procedure.

  4. Mesotherapy:
    Another effective hair loss treatment is through Mesotherapy. It strengthens the hair follicles, stimulates collagen, increases follicle size and improves blood circulation to the scalp. Mesotherapy involves the use of an injection which injects the essential nutrients into the mesoderm of the scalp. This treatment is absolutely safe, painless, does not require anesthesia, ensures quick recovery and has a high success rate of 92%. It is available as a popular method of hair transplant in hospitals in Delhi.

  5. Platelet Rich Plasma (PRP)
    PRP is the latest hair-loss treatment for women used to treat hair thinning. It helps to heal wounds and improves hair growth. It ensures quick recovery.

  6. Direct Hair Implantation (DHI):
    One of the most advanced and latest revolutionary techniques for Hair transplant is the Direct Hair Implantation Method. The main objective of this technique is to raise the survival and growth of the follicle. This technique involves extraction of the hair follicles one by one and placing them in a solution at a specific temperature which increases their growth after placement. The hair is implanted straight into the thinning area using specifically designed tools. For best and natural results with increased density, the follicles are then placed at a specified angle, depth and direction.

  7. Body Hair Transplantation (BHT)
    Usually, in any hair transplant treatment in hospitals, scalp hair is used for transplant. But in such cases where the patients do not have a good donor area, the body hair is used to overcome the unsatisfactory level of head hair. Though there is always some difference in thickness of the hair taken from other parts it gives the distinct advantage in many cases and extraction process might take a bit of time.

TREATMENT

ARM LIFT (BRACHIOPLASTY)

Surgical procedure to reshape the upper arm by reducing loose skin and fat deposits. This may be performed in conjunction with liposuction.

BODY LIFT

Surgical procedure performed to reshape the lower torso and upper legs, the belly, hips, back, buttocks and/or thighs. May be performed in stages rather than in one surgical session.

BUTTOCK / THIGH LIFT

Surgical procedure performed to reshape the buttock/thighs. Removes excess skin and reduces/redistributes fat.

TREATMENT

ARM LIFT (BRACHIOPLASTY)

Surgical procedure to reshape the upper arm by reducing loose skin and fat deposits. This may be performed in conjunction with liposuction.

BODY LIFT

Surgical procedure performed to reshape the lower torso and upper legs, the belly, hips, back, buttocks and/or thighs. May be performed in stages rather than in one surgical session.

BUTTOCK/THIGH LIFT

Surgical procedure performed to reshape the buttock/thighs. Removes excess skin and reduces/redistributes fat.

EYELID (BLEPHAROPLASTY)

A surgical procedure done on your eyelids that:

·       Removes fat and excess skin from the upper and/or lower eyelids

·       Repositions and tightens lower eyelid muscles

·       Makes eye area appear more youthful and less jaded

BROW LIFT / FOREHEAD LIFT

A surgical procedure done on your brow/forehead that:

·       Smoothens furrows

·       Repositions hooded or lowered eyebrows

·       Restores youthful look to upper part of face

FACE LIFT (RHYTIDECTOMY)

A surgical procedure for your face that:

·       Redistributes and/or reduces facial fat

·       Repositions and tightens facial muscles and tissue

·       Re-drapes and reduces excess sagging skin of the face, jaws and neck

·       Produces a more youthful appearance

FACIAL IMPLANT (CHIN, CHEEK AND JAW)

Chin, jaw or cheek implants are designed to improve/enhance facial contours. These are usually made of porous/solid artificial implants.

BOTULINUM TOXIN TYPE A INJECTION (BOTOX)

Injection of botox into facial muscles inhibits muscle action, thereby decreasing:

·       Frown lines

·       Forehead furrowing

·       Wrinkles around the eyes

INJECTABLE WRINKLE FILLERS

These can be temporary hyalouronic acid-based injections, or longer-lasting injectables with microscopic particles that stimulate collagen deeper in the skin.

Soft tissue filler is injected to:

·       Enhance soft tissue volume

·       Re-contour the face

·       Diminish wrinkles

·       Fill in depressed areas as well as cellulite dimples

LIP AUGMENTATION

A cosmetic surgery to improve the appearance of the lips by increasing their fullness through enlargement.

 

HOW IS BMI CALCULATED ?

BMI is calculated by using following formula:

BMI = Weight (in kilograms) / Height (m) X Height (m)

BMI Range-kg/m2

Category

<18.5

Underweight

18.5 - 23.5

Normal

23.5 - 27.5

Overweight

27.5 - 37.5

Obese

>37.5

Morbidly Obese

>50

Super Obese

>60

Super Super Obese

 

CAUSES OF OBESITY

Genetics: Genetics are responsible for affecting hormones in fat regulation. A person is more likely to be obese if one or both parents are obese. 

Lack of Caloric Balance: If you are eating more calories than your body is using, there is a possibility that the extra calories get stored and you can gain weight.  

An Inactive Lifestyle: Lack of physical exercise and involvement in leisure activites like television and computers as well as mechanization of jobs is also developing obesity.

Our environment: Easily available processed and unhealthy foods, and oversized food portions increases the chances of obesity.

Medications: Few medications associated with weight gain include antidepressants,anticonvulsants, diabetes medications, steroids, and some high blood pressure medications and antihistamines. 

Psychological factors: Factors like emotional stress, anger, sadness can also lead to weight gain, as people tend to eat more during such conditions.

Diseases: Conditions like hypothyroidism, insulin resistance, polycystic ovary syndrome, and Cushing's syndrome also contribute to obesity.

MORBID OBESITY

Those people who are morbidly obese are at a greater risk of illnesses like diabetes, high blood pressure, sleep apnea, gastroesophageal reflux disease (GERD), gallstones, osteoarthritis, heart disease, infertility and cancer. Morbid obesity is a state of severe obesity and is defined by the following condition:

  • If a person has a BMI above 37.5 with or without associated illness or BMI above 32.5 with diseases like diabetes, hypertension are considered to be morbidly obese. 

COMMON OBESITY RELATED CONDITIONS

  • Type 2 diabetes
  • High blood pressure
  • Heart disease
  • Joint pains/ Osteoarthritis
  • Stroke
  • Gastroesophageal reflux disease
  • Gallstone disease
  • Increased chances of developing cancer of breast, prostate ,colon, uterus and ovaries.
  • Sleeping disorders like Obstructive sleep apnea
  • Infertility/Polycystic ovarian disease (PCOD)
  • Depression/Anxiety/low self esteem

TREATMENT OPTIONS

The various treatment options available for obesity are as follows:

Diet and Exercise: If BMI > 23.5, certain lifestyle modifications, changes in diet, increase in physical activities, and practicing healthy eating habits can reduce obesity. 

Weight loss drugs: If BMI > 27.5 with co-morbidities or > 30 with or without co-morbidities, pharmacotherapy with weight loss drugs is reecommended. Close medical monitoring is required while taking a prescribed weight-loss medications. 

Surgery: If BMI > 32.5 with co-morbidities or > 37.5 with or without co-morbidities, bariatric surgery is the right choice of treatment. Weight loss surgery for obesity may be considered if other methods to lose weight have not worked. 

DIABETES AND OBESITY (DIABESITY: DUAL EPIDEMIC OF MODERN ERA)

Indians are genetically susceptible to weight accumulation, especially around the waist. An obese individual is much more susceptible to diseases like diabetes, hypertension, osteoarthritis and obstructive sleep apnoea. Studies have shown that:

  • In MALES, Compared with a healthy weight man, an obese man is 5 times more likely to develop type 2 diabetes.
  • In FEMALES, An obese woman, compared with a healthy weight woman, is almost 13 times more likely to develop type 2 diabetes.

The traditional approach to treat TYPE 2 DM (Diabetes Mellitus) has been step wise introduction of lifestyle changes with or without oral medications, saving the insulin therapy for last. Treatment should focus equally on remission of both diabetes and obesity and needs to be widely understood. In the light of escalating global diabetes crisis, the need of the hour is to identify interventions that provide a long term metabolic outcome (obesity and associated diseases remission). There are several methods for treating obesity, such as lifestyle changes encompassing behaviour modification, physical activity, diet modification and medical management. It has been seen that the sustained weight loss is achieved by only 10% of the population.

Bariatric surgery (Obesity surgery) is the most effective long-term treatment for obesity with the greatest chances for amelioration and even resolution of obesity-associated diseases. In the given scenario of increasing morbidity and mortality due to Type II Diabetes Mellitus and obesity, bariatric surgeries emerged as a promising treatment. It provides exceptional sustained weight loss and remission of type II diabetes in addition to improvement in other co-morbidities and quality of life.

TYPES OF BARIATRIC AND METABOLIC SURGERY

Bariatric surgery is considered to be the most effective treatment for obesity. The bariatric surgical procedures causes weight loss by restricting the amount of food, causing mal-absorption of nutrients, or a combination of gastric restriction and mal-absorption. Most weight loss surgeries are performed using minimal invasive techniques (laparoscopic surgery).

The choice of the surgical procedure depends on the treating surgeon and the team after evaluation and counselling. Common Bariatric surgery options which are available are:

  • Gastric Bypass
  • Sleeve Gastrectomy
  • Minigastric bypass
  • Gastric bands
  • Others

WHAT IS GASTRIC BYPASS SURGERY ?

Gastric bypass is one of the most common and successful weight loss procedures. The long term outcomes of this procedure are well researched and documented and today it is one of the most common and successful weight loss procedures.It is called as “The Roux-en-Y Gastric Bypass (RYGB)” and is considered as the ‘gold standard’ of weight loss surgery. It should not be confused with other types of bypasses. The gastric bypass works by creating a small stomach pouch which restricts high intake of food and facilitates significantly smaller meals, which translates into less calories consumed. A major portion of the stomach and a part of the small intestine is bypassed( i.e. food does not enter this portion) which causes malabsorption of food thus leading to lesser calories absorption.

  • Gastric by pass surgery results in sustained (long-term) weight loss.
  • Restricts the amount of food that can be consumed and thus helps in weight loss.
  • Produces favourable changes in gut hormones that causes improvement in metabolism and diabetic status.
  • Bypass surgery is associated with minimal pain and early recovery of patients as most of the patients start walking on the same day of surgery.
  • It is the “gold standard” weight loss procedure.
  • Helps in significant improvement of associated illness like diabetes, blood pressure, joint pains, sleeping disorders, infertility issues etc.
  • The procedure is reversible
  • No part of the stomach / intestine is removed from the body. 

What are the Risks Associated with Weight Loss Surgeries ?

  • The surgery may cause a dumping syndrome, which primarily occurs when the food moves quickly through the stomach and intestines. The common symptoms that can occur are sweating, nausea, diarrhea and dizziness. This syndrome occurs due to carbohydrate rich diet; however, this can be easily avoided if one follows small dietary modifications as suggested by the nutritionist.
  • Staple line leak – It is best to discuss this with your surgeon
  • There are chances of slight weight regain after the surgery if the patient is non compliant in terms of the diet and exercise regime.
  • Long term nutritional deficiencies may be seen in patients who are not compliant with the advised post operative nutritional supplements.

Advantages of Surgery

  • Results in sustained (long-term) weight loss
  • Restricts the amount of food that can be consumed 
  • Produces favourable changes in gut hormones that normalises blood sugar level in diabetics.
  • Bypass surgery is associated with minimal pain and early recovery of patients. Normally patients start walking on the same day of surgery.
  • It is the “gold standard” weight loss procedure.
  • Helps in resolution or improvement of associated illness like diabetes, blood pressure, joint pains, sleeping disorders, infertility issues etc.

Points to Remember Before Surgery is Planned 

  • Patients are usually admitted one day prior to the surgery after all the pre operative investigations including a pre anaesthesia check and clearance has been sought.
  • Patients are hospitalized for 3-4 days and their first-follow up appointment is scheduled on 10th day from the surgery when the clips are removed. 
  • Post-surgery, patients are given a written diet plan for initial few weeks and they are required to be in touch with the nutritionist on a regular basis.
  • Patients must eat food in small amounts and chew it well and slowly.
  • Follow up is necessary in the first year after surgery as advised by the surgeon and nutritionist.
  • The patient is expected to lose on an average 70 % of their excess body weight after a bariatric surgery at a pace of 6- 8 kgs (average) every month.
  • Significant improvements are seen in obesity related medical conditions like type 2 diabetes, hypertension and others and most patients require a medication adjustment which must be done by their physician.
  • There is an enhanced quality of life with improved stamina, mood, self esteem and body image.
  • Obesity surgery is a life altering surgery and must not be confused with cosmetic procedures like liposuction.

Pre and post surgery instructions

Pre surgery instructions:

  • Restriction of alcohol and tobacco is advised as it helps in pre and post operative period.
  • Follow your surgeon’s instructions for any prescribed medications.
  • Comply with the instructions provided by your surgeon for any vital tests required before surgery.
  • On the day of surgery, ensure an empty stomach at the start of the procedure to avoid the risk of aspiration.
  • Patients are usually admitted one day prior to the surgery after all the pre operative investigations including the pre anaesthesia check has been done and clearance has been sought.

Post surgery instructions:

  • Patients are walking around on the same day of the surgery
  • Patients are hospitalized for 3- 4 days and are discharged when their oral intake of fluids reaches 1.5 - 2 liters per day.
  • Dressings should be removed during the first follow up that is scheduled on the 7th to 10th day of the surgery.
  • Patients can resume their normal activities as and when they feel comfortable. They need to follow and respond to their body language. Infact, the physical activity helps  them in early recovery and sense of well being
  • Carefully follow the diet instructions provided by your nutritionist.
  • Ensure regular follow up with your surgeon.

Procedure

It is a laparoscopic surgery, which is carried out using laparoscopic staplers. In this procedure, more than half of the stomach is removed from the body, leaving a thin vertical tube or sleeve. The thin sleeve is about the size of a banana. 

What are the Risks Associated with Weight Loss Surgeries ?

  • The surgery may cause a dumping syndrome, which primarily occurs when the food moves quickly through the stomach and intestines. The common symptoms that can occur are sweating, nausea, diarrhea and dizziness. This syndrome occurs due to carbohydrate rich diet; however, this can be easily avoided if one follows small dietary modifications as suggested by the nutritionist.
  • Staple line leak – It is best to discuss this with your surgeon
  • There are chances of slight weight regain after the surgery if the patient is non compliant in terms of the diet and exercise regime.
  • Long term nutritional deficiencies may be seen in patients who are not compliant with the advised post operative nutritional supplements.

Advantages

  • Sleeve gastrectomy causes favourable changes in gut hormones that suppress hunger, eliminates the portion of the stomach that produces the hunger stimulating hormone (Gherlin).
  • It restricts the amount of food the stomach can hold, thus helping in weight loss.
  • The procedure is not reversible as one past of the stomach is removed from the body.
  • The remaining stomach pouch can dilate on overeating in the longer run.
  • Causes favourable changes in gut hormones that suppress hunger by eliminating portion of stomach that produces the hunger stimulating hormone (Gherlin).
  • Restricts amount of food the stomach can hold, thus helping in weight loss.

Points to Remember Before Surgery is Planned 

  • Patients are usually admitted one day prior to the surgery after all the pre operative investigations including a pre anaesthesia check and clearance has been sought.
  • Patients are hospitalized for 3-4 days and their first-follow up appointment is scheduled on 10th day from the surgery when the clips are removed. 
  • Post-surgery, patients are given a written diet plan for initial few weeks and they are required to be in touch with the nutritionist on a regular basis.
  • Patients must eat food in small amounts and chew it well and slowly.
  • Follow up is necessary in the first year after surgery as advised by the surgeon and nutritionist.
  • The patient is expected to lose on an average 70 % of their excess body weight after a bariatric surgery at a pace of 6- 8 kgs (average) every month.
  • Significant improvements are seen in obesity related medical conditions like type 2 diabetes, hypertension and others and most patients require a medication adjustment which must be done by their physician.
  • There is an enhanced quality of life with improved stamina, mood, self esteem and body image.
  • Obesity surgery is a life altering surgery and must not be confused with cosmetic procedures like liposuction.

Pre and post surgery instructions

Pre surgery instructions:

  • Restriction of alcohol and tobacco is advised as it helps in pre and post operative period.
  • Follow your surgeon’s instructions for any prescribed medications.
  • Comply with the instructions provided by your surgeon for any vital tests required before surgery.
  • On the day of surgery, ensure an empty stomach at the start of the procedure to avoid the risk of aspiration.
  • Patients are usually admitted one day prior to the surgery after all the pre operative investigations including the pre anaesthesia check has been done and clearance has been sought.

Post surgery instructions:

  • Patients are walking around on the same day of the surgery
  • Patients are hospitalized for 3- 4 days and are discharged when their oral intake of fluids reaches 1.5 - 2 liters per day.
  • Dressings should be removed during the first follow up that is scheduled on the 7th to 10th day of the surgery.
  • Patients can resume their normal activities as and when they feel comfortable. They need to follow and respond to their body language. Infact, the physical activity helps  them in early recovery and sense of well being
  • Carefully follow the diet instructions provided by your nutritionist.
  • Ensure regular follow up with your surgeon.

TREATMENT

TUMMY TUCK (ABDOMINOPLASTY)

Flattening of the abdomen by removal of excess fat and/or skin . May include tightening of abdominal muscles.

LIPOSUCTION

Body sculpting through removal of fat from localised areas of the body.

Techniques include:

  • Ultrasound-assisted lipoplasty (UAL)
  • Power-assisted lipoplasty (PAL)
  • Superwet and tumescent techniques

VASER LipoSelection is a minimally invasive procedure that precisely and efficiently removes unwanted body fat. An alternative to the harsh techniques of traditional liposuction, VASER LipoSelection uses state-of-the-art ultrasound technology designed to gently reshape your body. What distinguishes the LipoSelection procedure is its ability to differentiate targeted fat from other important tissues - such as nerves, blood vessels and connective tissue.

 

TREATMENT

Enlarged male breasts can be surgically treated by removing excess fat, glandular tissue and/or skin. Better proportioned, more masculine-contoured upper body can be achieved. Liposuction done in combination with minimal scar approach gives the best results.

TREATMENT FOR URETERIC STRICTURES

There are a variety of minimally invasive treatments for patients with ureteral strictures. A doctor may perform balloon dilation as a first step in treatment, particularly in patients who have nonanastomotic strictures.

For ureteral strictures that do not respond favorably to dilation alone, endoscopic incision is the procedure of choice for most patients. Endoscopic incision of the stricture can be performed or a laser may be used with a rigid or flexible ureteroscope. A stent may be left in place to keep the ducts open for approximately 6 weeks.

New technique called Holmium Laser Endoureterotomy is now available that may allow long-term relief from ureteral stricture if other techniques are unsuccessful.

TREATMENT FOR URETERIC STRICTURES

There are a variety of minimally invasive treatments for patients with ureteral strictures. A doctor may perform balloon dilation as a first step in treatment, particularly in patients who have nonanastomotic strictures.

For ureteral strictures that do not respond favorably to dilation alone, endoscopic incision is the procedure of choice for most patients. Endoscopic incision of the stricture can be performed or a laser may be used with a rigid or flexible ureteroscope. A stent may be left in place to keep the ducts open for approximately 6 weeks.

New technique called Holmium Laser Endoureterotomy is now available that may allow long-term relief from ureteral stricture if other techniques are unsuccessful.

SIGNS & SYMPTOMS

The most common symptoms of arthritis are:

  • Joint pain
  • Joint swelling
  • Redness of skin around a joint
  • Stiffness, especially in the morning
  • Limited movement

SIGNS AND SYMPTOMS

The symptoms of swollen adenoids include:

  • Difficulty in breathing through nose
  • Noisy breathing
  • Snoring
  • Stopped breathing for a few seconds during sleep
  • Frequent sinus symptoms

CAUSES

There could be several reasons behind swollen adenoid gland including:

  • Child born with an enlarged adenoid
  • Respiratory infection
  • Tonsils

TREATMENT

In its initial stage, adenoids are treated using various antibiotics. However, they do not provide much relief if the infection is very serious and chronic. The doctors are then left with the option of removal of adenoid glands. This procedure is known as adenoidectomy.

  • Adenoidectomy – Adenoidectomy is the surgical removal of the adenoids, which helps get rid of the symptoms permanently, while antibiotics provide temporary relief and cannot be used for long-term treatment.

Signs and symptoms

The most common symptom of acute sinusitis is a cold that doesn’t go away. Other symptoms are:

  • Bad breath or loss of smell
  • Cough, often worse at night
  • Fatigue
  • Fever
  • Nausea
  • Headache

Sore throat

Causes

Sinusitis can be caused due to following reasons:

  • Small hair in the sinuses
  • Cold and allergies
  • A deviated nasal septum
  • Smoking
  • Weakened immune system from HIV or chemotherapy

Treatment

  • Generally doctors suggest antibiotics or decongestants for several weeks. Pain killers can also be given to provide relief.
  • Antihistamines or nasal sprays are prescribed to treat the allergies that cause chronic (recurrent) sinus infections.
  • If medicines do not result in positive outcomes, surgery is done to treat chronic and severe sinusitis. During the surgery, surgeons create an extra or enlarged passageway in the wall of the sinus cavity. It allows the sinuses to get more air easily and free from infection.
  • Functional Endoscopic Sinus Surgery (FESS) – This surgery is done to treat chronic symptoms of sinusitis.

 

Signs and symptoms

  • Hearing a sound that no one else can hear
  • Ringing, buzzing, or any other sound

Causes

The causes of tinnitus are:

  • Ear infection
  • Excess wax in the ear
  • A pierced eardrum
  • High blood pressure
  • A benign tumor on the acoustic nerve

Treatment

Different treatment options include:

  • Use of hearing aid, if hearing is impaired
  • Use of a tinnitus masker which masks the tinnitus with ‘white noise’
  • In some cases, tinnitus goes away without any treatment

Signs and symptoms

  • Difficulty in breathing, eating, and sleeping
  • Frequent nasal congestion
  • Headach
  • Nose bleeding

Causes

There are many causes of nasal airway obstruction including:

  • A deviated septum
  • Hormonal changes
  • Allergies
  • Environmental irritants

Treatment

Traditional medical therapy, including allergen/irritant avoidance and/or use of nasal medications, may be enough to treat turbinate enlargement. However, following treatment options are possible:

  • Septoplasty – This is a surgical procedure carried out to correct the shape of the septum of the nose.

Signs and symptoms

Below are the symptoms of tonsillitis:

  • Difficulty in swallowing
  • Ear pain
  • Fever, chills
  • Headache
  • Sore throat
  • Tenderness of the jaw and throat

Causes

The causes of tonsillitis are:

  • Bacterial infection
  • Viral infection
  • Strep throat

Treatment

Following treatment options are available for tonsillitis:

  • Doctors generally give antibiotics to treat tonsillitis as they are not serious and do not cause other problems.
  • Tonsillectomy – If infection goes severe, your doctor would suggest tonsillectomy. It is an operation done to remove tonsils. This option is recommended for people who get repeated or extremely severe bouts of tonsillitis. The surgery is suggested only for people who have had:
    • at least five bouts of tonsillitis in the past year
    • frequent ear infections because of swollen tonsils
    • swollen tonsils that make it harder to breathe or swallow
    • sore throats that stop you, or your child, getting on with everyday life (such as finding it hard to sleep or your child missing school)

Signs and symptoms

There are several signs and symptoms of a perforated eardrum including:

  • Ear pain
  • Hearing change or loss
  • Fluid or blood draining from the ear
  • Vertigo (spinning sensation)

Causes

Following reasons are responsible for the onset of eardrum perforation including:

  • Infections caused by viruses, bacteria, or fungi
  • Infections causing pressure on eardrum
  • Accident
  • Blast waves
  • Falls
  • Sports injuries
  • Lightning blasts

Treatment

Following treatment options are available for eardrum perforation:

  • As most perforated eardrum injuries heal on their own within few weeks, treatment may include analgesics to reduce pain and antibiotics to prevent infection
  • Myringoplasty – This is a surgical procedure done to treat a perforated eardrum when it fails to heal on its own. It involves using a piece of grafted skin taken from another part of the anatomy and placing and securing it over the hole.

Who can they help?

The cochlear implant technology can help people who:

  • Have moderate to profound hearing loss in both ears
  • Receive little or no benefit from hearing aids
  • Score 50% or less on sentence recognition tests done by hearing professionals in the ear to be implanted
  • Score 60% or less on sentence recognition tests done by hearing professionals in the non-implanted ear or in both ears with hearing aids.

Many people have cochlear devices in both ears (bilateral). Listening with two ears can improve your ability to identify the direction of sound and separate the sounds you want to hear from those you don’t.

Many people suffer hearing loss because their hair cells in the inner ear or (or cochlea) are damaged. The cochlear implant enables the sound to be transferred to your hearing nerve and enables you to hear. The process is described below:

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  1. A sound processor worn behind the ear or on the body, captures sound and turns it into digital code. The sound processor has a battery that powers the entire system.
  2. The sound processor transmits the digitally-coded sound through the coil on the outside of your head to the implant.
  3. The cochlear implant converts the digitally-coded sound into electrical impulses and sends them along the electrode array placed in the cochlea (the inner ear).
  4. The implant's electrodes stimulate the cochlea's hearing nerve, which then sends the impulses to the brain where they are interpreted as sound.

Benefits of a cochlear implant

Many adults with cochlear implants report that they:

  • Hear better with a cochlear implant than with a hearing aid
  • A previous study has shown that people with a cochlear implant achieve an average of 80% sentence understanding, compared with 10% sentence understanding for hearing aids1.
  • Can focus better when in noisy environments.
  • Find it easier to have conversations with people across meeting tables, in restaurants and other crowded places.
  • Reconnect with missed sounds that they could not hear before their cochlear implant.
  • Feel safer in the world as they can hear alarms, people calling out and approaching vehicles.
  • Talk and hear on the phone.
  • Enjoy music.

What are gallbladder stones?

Gall bladder stones or gallstones are crystalline masses shaped usually in the gall bladder or bile ducts from bile pigments, cholesterol, and calcium salts. gall bladder stones can cause severe pain and blockage of the bile duct. At the point when the wall of the gall bladder is diseased then it produces the gall bladder stone and polyps and so forth.

What is cholecystitis?

Cholecystitis is characterized by irritation of the gallbladder. Most usually this happens when the flow of bile is halted or hindered because of gallbladder stone (90%) or if the infection of biliary tract happens.

The casual symptoms of cholecystitis are:

  • Serious stomach pain
  • Fever
  • Disquietude
  • Queasiness
  • Retching
  • The attack may take place after a large fatty meal.
  • Pigment stones: These stones are smaller and darker and are comprised of bilirubin.

Symptoms of gallstones

Side effects of gallbladder stones are extreme stomach torment frequently called as gallbladder stones 'attack' (colic) since they happen all of a sudden. gallbladder stones attacks often take place after fatty meals, and they may happen amid the night. Despite the fact that numerous patients with gallbladder stones have no manifestations and they are to be asymptomatic and the stones are called 'Silent stones'. However, a typical attack can cause the following:

  • Severe pain in the right upper abdomen that increases rapidly and lasts from few minutes to a few hours
  • Pain in the back of the shoulder blades
  • Pain in the right shoulder
  • Nausea or vomiting

Other insignificant symptoms of gallbladder stones include:

  • Stomach swelling (gas formation)
  • Recurring intolerance to fatty foods
  • Burping
  • Acid reflux

Who is at risk for gallstones?

  • Women are more prone than men
  • People in their 30's and 40's
  • Overweight men and women
  • People with rapid/ sudden weight loss
  • Pregnant women, women on hormone therapy and those who use birth control pills for a prolonged period

Complications caused by stones

  • Repetitive extreme stomach pain or vomiting.
  • Jaundice because of blockage of the normal bile duct because of gallbladder stones.
  • Intense pancreatitis (swelling of the pancreas) which can have a catastrophic sequel of multi-organ failure and different serious complications. It might be deadly if serious.
  • Pus formation in the gallbladder (Empyema)
  • Gangrene and perforation of the gallbladder.
  • Cholangitis (a life-threatening infection of biliary system).
  • Related to Cancer of the gallbladder in a long time.

Diagnosis for gall stones

• Blood tests
• Complete blood count
• Liver function test
• Coagulation profile
• Abdominal ultrasound
• Cholescintigraphy (HIDA scan)
• Endoscopic retrograde cholangiopancreatography (ERCP)
• Magnetic resonance cholangiopancreatography (MRCP)

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Treatment options for gallstones or cholecystitis

The ailing gall bladder ought to be evacuated by a surgical methodology called Laparoscopic Cholecystectomy. In this procedure, the gallbladder is removed using long narrow instruments through small incisions in the abdomen.

Gallbladder Surgery

Surgery to remove the gallbladder (cholecystectomy) is the only way to cure gallbladder stones. This should be possible by regular (open) technique or a settled endoscopic (laparoscopic) strategy which is currently the 'Gold Standard'. The surgery is called "Laparoscopic Cholecystectomy" (Lap. Chole). The surgeon makes few tiny punctures in the abdomen and inserts surgical instruments and a miniature telescope with an amounted video camera into the abdomen. The camera sends an amplified picture from inside the body to a video screen, giving the specialist a nearby perspective of the organs and tissues. While watching the monitor, the surgeon uses the instruments to carefully separate the gallbladder from the liver, ducts and vessels. The gallbladder is then removed through one of the small incisions. Recovery usually occurs within few hours in most of the cases in the hospital, followed by few days of rest at home. As there is no damage to the muscle (muscles are not cut) during laparoscopic surgery, patients have less pain and negligible wound complications.

If the surgeon finds any difficulty in the laparoscopic procedure, the operating team may decide to switch over to open surgery. It is called open surgery in light of the fact that the specialist needs to influence a 5 to 8-to inch entry point in the stomach area to expel the gallbladder. Open surgery has blurred out of the spotlight with the laparoscopic method giving critical points of interest and ease to the patient.

Non-surgical treatment

Non-surgical approaches are used only in special situations such as when a patient's condition is not fit for anaesthesia and surgery. This does not cure the patients as it only provides symptomatic relief.

Advantages of laparoscopic cholecystectomy

  • Patients usually have minimal post-operative pain.

  • Patients experience faster recovery than patients undergoing open gallbladder surgery.

  • Excellent cosmetic outcomes

  • Minimal discomfort and early recovery

  • Early resumption of normal and routine activities

What are pre-surgery and post-surgery instructions?

 

Pre-surgery instructions

 

  • Some preoperative investigations like blood tests, X-ray or ECG and ultrasound of the gall bladder are required before surgery.
  • Follow your surgeon instructions for any prescribed medications.

Post surgery instructions

 

  • The patient is kept under observation for few hours and then shifted to the room.
  • The patient is allowed to drink oral liquids on the same day of gall bladder surgery.
  • The patient is allowed to move on its own as soon as possible after the gall bladder surgery.
  • Generally, the patient is discharged on the same or next day of the gall bladder surgery depending on the clinical condition.
  • Waterproof dressings are applied on the port sites and the patient may bathe when comfortable.
  • The patient is advised to visit again after 5 days when the dressings are removed. On discharge, a discharge summary with the advised medication is handed over to the patient along with the date of the first follow up an appointment.
  • Round the clock helpline is available for any query or any other emergency.

 

Diet after gall bladder surgery

  • The patient is generally allowed to sip water immediately after the operation and liquids on the day of operation. The liquids may include water/ clear soups/ tea/ coffee/ salted lassi as advised by the dieticians.
  • Next day onwards, a normal diet is given and there are no specific restrictions on diet

 

Exercise/ Movement

  • As soon as the patient is out of anaesthesia and is shifted to the room, the patient is can start moving on his/her own and attend to toilet needs. In fact, movements are encouraged in most patients because this causes a dramatic reduction in pain and increase the sense of wellbeing. The patient is allowed to walk as soon as he/she recovers from sleep. There is no restriction on climbing stairs, lifting the weight.
  • The patient can resume his/her daily routine/ activities as he/she feels comfortable as there are no specific restrictions.
  • Medication chart is provided to the patient to ensure proper compliance with prescribed medications. Ensure compliance with pain and other medications prescribed by your doctor.
  • Regular follow up is advised

Symptoms

  • Abdominal pain – pain may begin around the belly button and then get localized in right lower abdomen
  • Nausea
  • Vomiting
  • Abdominal pain may be worse when walking or coughing
  • Loss of appetite
  • Fever usually occurs within several hours
  • Constipation
  • Rectal tenderness
  • Chills and rigours

Diagnosis of appendicitis

The conclusion of an infected appendix starts with an intensive history and physical examination. As patients usually have an elevated temperature, there is moderate to severe tenderness in the right lower abdomen, when the doctor physically examines it. On the off chance that, inflammation has spread to the peritoneum, there can be a

frequently rebound tenderness. Rebound tenderness is pain that is worse when the doctor quickly releases his or her hand after gently pressing on the abdomen over the area of tenderness.

The following tests are usually used to make the diagnosis:

Blood test to look for signs of infection

Urine test to rule out other conditions, such as a bladder infection

Computerised tomography (CT) scan or an ultrasound scan to see if the appendix is swollen.

Treatment options available for appendicitis

  • ??Laparoscopic technique - The appendix is taken out with instruments put into small abdominal incisions.

Laparoscopic Appendectomy

Procedure

  • After administering anaesthesia the abdomen is prepared with an antibacterial solution.
  • The peritoneal cavity is inflated with gas (usually carbon dioxide).
  • The surgery starts with a small abdominal incision beneath the belly button in the skin crease, which allows the insertion of the laparoscope. Another two or three small incisions may be necessary to insert the laparoscopic instruments to dissect and remove the appendix.
  • Using the laparoscopic surgical tools, the tissues and vessels encompassing the appendix are cut and tied.
  • The appendix is put in a plastic bag before being removed through the small incision to prevent infection of the wound.
  • The abdominal cuts are all closed with clips, which are probably going to leave insignificant scars.
  • The removed appendix is sent to a pathology lab for biopsy

Advantages of laparoscopic appendectomy

The main advantages are:

  • Less post-operative pain
  • Faster recovery
  • Short hospital stay
  • Less post-operative complications like wound infection and adhesion

To treat your appendix related problems you can visit Diyos as we have state of the art infrastructure and we are also known as the best hospital for appendix treatment in Delhi.

Anal fistula

An anal fistula, commonly known as fistula-in-ano, is a small channel that can develop between the end of the rectum/anal canal and the skin near the anus. It can pain and cause bleeding when passing stools. A fistula usually occurs after surgery to drain a perianal abscess.

CAUSES OF ANAL FISTULA

The most common cause of an anal fissure is injury to the skin at the anal opening primarily due to a hard, dry bowel movement. Other causes include Digital insertion (during examination), Foreign body insertion or Anal intercourse. Pregnant women may also develop a fissure during childbirth.

TREATMENT OPTIONS FOR FISTULA

To manage an anal fistula, surgery is performed by a specialist to assess the depth and extent of fistula tract. The following types of surgery are commonly used for the treatment:

Minimally Invasive Fistula Treatment (MAFT): It is a  minimally invasive laparoscopic  technique.

Fistulotomy/Fistulectomy: Most fistulas are treated with a fistulotomy, in which the skin and muscle over the tunnel are cut open,converting it into an open groove. This allows the fistula tract to heal from inside out.

WHAT IS MINIMALLY INVASIVE ANAL FISTULA TREATMENT (MAFT)?

MAFT (VAAFT) is a major breakthrough treatment option for complex fistulas. VAAFT (The Video assisted Anal Fistula Treatment) or MAFT (Minimally Invasive Fistula Treatment) are alternatively used terms.

Procedure

This technique involves examination of fistula path using an endoscope to determine the point of internal opening of fistula. This is followed by closing the internal opening of the fistula using a stapler and the entire fistula tract is destroyed under direct telescopic vision by electrocautery.

ADVANTAGES OF MAFT(VAAFT) 

  • No surgical wounds on the buttocks or in the perianal region
  • No damage to the anal sphincters
  • Less pre-operative investigations to ascertain type of fistula
  • Early recovery and return to work and normal actions.
  • Can be done as a Day-Care procedure
  • Possibilities of localization of the internal fistula opening (key point in all fistula surgical treatments) is much higher
  • Fistulous tract can be completely destroyed from within, without damaging any other tissues

Piles

Piles are also called haemorrhoids. Hemorrhoids are masses, clumps, cushions of tissue in the anal canal and are full of blood vessels, support tissue, muscle and elastic fibers. They are classified into two general categories: Internal and External.

Internal Haemorrhoids lie far deep inside the rectum where you can't see or feel them. Due to the pain-sensing nerves in the rectum, they usually do not hurt. However, bleeding is the only sign of their existence.  

External Haemorrhoids lie within the anus and are often uncomfortable. If an external haemorrhoid prolapses outside (usually in the course of passing a stool), you can see and feel it.

CAUSES OF PILES

Piles develop due to chronic constipation that leads to excessive straining, resulting in swelling of veins in the rectal area. Pregnant women may also develop piles due to increased pressure on the veins in the pelvic area.

TREATMENT OPTIONS FOR PILES

Physical examination and proctoscopy are done to diagnose piles. In the early stages, piles resolve on their own and do not require any treatment. However, right treatment can significantly reduce the discomfort and itching that many patients experience. The treatment options available are as follows:

  • Depending on the diagnosis, the doctor advises whether you require home treatment or further intervention. Lifestyle and dietary modifications such as regular physical exercise, plenty of fluids and a high fibre diet can provide symptomatic relief.
  • Surgery: Surgery is used for particularly large piles. Generally, surgery is used when conservative treatment/management is not effective. Sometimes surgery is done on an outpatient basis - the patient goes home after the procedure.

DIFFERENT SURGERIES FOR PILES

Haemorrhoidectomy (open surgery of the piles): In this procedure, the excess tissue that is causing bleeding is surgically removed. It may involve a combination of a local anesthetic and sedation, a spinal anesthetic, or a general anesthetic. This type of surgery is effective in completely removing piles, but can cause pain for few days.

Minimally Invasive Procedure for Hemorrhoids (MIPH): This technique uses stapler for performing surgery. It is relatively painless and be done as a day care surgery.

WHAT IS MINIMALLY INVASIVE PROCEDURE FOR HEMORRHOIDS (MIPH)?

In this procedure, the vessels at the base of hemorrhoids or piles are stapled and divided high up in the anal canal. The external piles get pulled inside. Few of its advantages are:

  • Minimal postoperative pain
  • Shorter hospital stay
  • Quicker recovery and return to normal activities
  • Excellent cosmetic outcomes

Fissures

An anal fissure is a small tear in the skin lining on opening of anus. They are developed by hard or difficult bowel movements, causing severe pain or bleeding. Your doctor may recommend few changes in diet for soft stools, and topical anesthetics to reduce pain. In case, surgery is required, your surgeon will work to relax the anal area so that there is less anal pain.

CAUSES OF FISSURES

The most common cause of an anal fissure is injury to the skin at the anal opening due to a hard, dry bowel movement. Other causes include Digital insertion (during examination), Foreign body insertion or Anal intercourse. Pregnant women may also develop a fissure during childbirth. They may be acute (recent onset) or chronic. Chronic fissures recur frequently or are present for a long time and are often associated with a small external lump called a skin tag or sentinel pile.

TREATMENT OPTIONS FOR FISSURES

Anal fissures often heal within a few weeks if you take steps to keep your stool soft, such as increasing your intake of fiber and fluids. Bathing in warm water for 10 to 20 minutes several times a day, especially after bowel movements, can help relax the sphincter and promote healing.

Conservative management : Atleast 50% of anal fissures are healed by medical management, which includes topical ointments, sitz baths, dietary modifications (i.e. incorporating a high fibre diet and avoiding foods that are not well digested like maida, popcorn, chips), drinking plenty of fluids, and using stool softeners/ laxatives.

Surgery :  Surgery is used for treatment when fissures do not respond to other treatment. The two options available are:

Chemical Internal Sphincterotomy : A minimally invasive approach to relax the anal muscle by injecting chemicals in the anal sphincter muscle and partially paralyzing it. 

Lateral Internal Sphincterotomy : In this surgery, a portion of the anal sphincter muscle is divided which helps the fissure to heal and decrease the pain and spasm. If a sentinel pile is present, it is removed to promote healing. It is a quick surgical process and can also be performed as a short outpatient procedure. The chances of recurrence are almost nil. It is the most effective treatment option for non healing fissures.

Prolapse

A rectal prolapse occurs when the rectum protrudes out of the anal opening primarily due to stretching or disruption of its attachments to the abdominal wall.

CAUSES OF PROLAPSE

The exact cause remains unclear. However, the predisposing factors include: 

  • Prolonged straining during bowel movement,
  • Multiple pregnancies,
  • Neurological illnesses causing muscular weakness or connective tissue disorders. 
  • Weakness of the anal sphincter muscle is often associated with rectal prolapse, resulting in leakage of stool and mucus discharge. This condition is more common in the elderly

TREATMENT OPTIONS OF PROLAPSE

The treatment of prolapse depends on the history of symptoms and physical examination. In case of an internal rectal prolapse, defecography is required. In some cases of very minor, early prolapse, treatment can begin at home with the use of stool softeners and by pushing the fallen tissue back into the anus by hand. There are several surgical approaches to repair prolapse. The surgeon will decide surgery depending on patient’s age, other existing health problems, extent of the prolapse, results of the examination and other tests, and his experience with certain techniques.

1. Rectal (perineal) Repair Approaches

It includes three different methods that are used depending on the nature of the prolapse.

Minimally Invasive Procedure for Hemorrhoids (MIPH) : This process is indicated only in cases of partial or mucosal prolapse.

Altemeier procedure (also called a proctosigmoidectomy): This involves removal of the prolapsed part of the rectum and suturing together the cut edges.

Thiersch wiring: It is a temporary procedure wherein the anal verge is wired to narrow the opening. The procedure is poorly tolerated.

The perineal approach being minimally invasive has various advantages such as: 

  • Decreased operative time 
  • Less blood loss
  • Faster recovery 
  • Less post-operative pain

2Abdominal repair approaches

Abdominal procedure requires making an incision in the abdominal muscles to view and operate in abdominal cavity. This approach is performed under general anesthesia most often on healthy adults. The two most common types of abdominal repair are:

Rectopexy (fixation [reattachment] of the rectum). Rectopexy can also be performed laparoscopically through small key-hole incisions.

Resection (removal of a segment of intestine) is followed by rectopexy and is preferred for patients with severe constipation. This can be performed laparoscopically as well.

Strictures

Strictures are narrowing of a section of intestines, which causes problems by slowing or blocking the movement of food through that area. They are caused by recurrent inflammation and can hospitalize a person due to partial obstruction. Strictures can also cause intestinal obstruction further leading to perforation of bowel. This perforation can result in severe infection of abdominal cavity (peritonitis), abscesses (collections of infection and pus), and fistulae (tubular passageways originating from the bowel wall and connecting to other organs or the skin). In addition, strictures of small bowel can lead to bacterial overgrowth, which is another intestinal complication of Inflammatory Bowel Disease (IBD). 

CAUSES AND SYMPTOMS OF STRICTURES:

Strictures are formed primarily because of inflammatory bowel diseases like Tuberculosis, Ulcerative colitis and Crohns disease. They may also develop due to tumors, adhesions and radiation therapy. The common symptoms that can occur are:

  • Crampy abdominal pain
  • Nausea
  • Vomiting
  • Bloating
  • Inability to pass flatus or stools

HOW ARE STRICTURES DIAGNOSED?

The below mentioned tests are used for diagnosis of strictures:

  • Plain abdominal X-RAY, erect and supine
  • CT Scan

TREATMENT OPTIONS FOR STRICTURES

There are two ways to perform the surgery:

Laparoscopic surgery: Two to three small incisions are made in the abdomen and laparoscope is used for performing the surgery.

Open surgery: A large surgical cut is made across the left or middle of the abdomen.

LAPAROSCOPIC SURGERY FOR STRICTURES

  • The surgeon makes two-three small incisions in the abdomen and inserts laparoscope and other surgical instruments through these incisions.
  • The surgeon locates the stricture and treats it surgically.
  • Compromised section of the intestine is removed and the healthy ends are rejoined with staples or stitches. 

Benign tumors

Tumors can be benign and malignant, however, some benign tumors can progress and become malignant. The tumors of small intestine are rare, they are usually single but can multiply particularly in certain syndromes (i.e intestinal polyposis syndrome). It is observed that most small intestines are clinically silent for long periods, which means that nealry 50% of all benign small intestine tumors are incidentally located either during an operation or investigation of small intestine for other reasons. 

DIFFERENT TYPES OF BENIGN TUMORS

The types of benign tumors include:

Leiomyoma: These are tumors are present in one of the muscle layers of bowel wall. Some tumors grow in the lumen of bowel and become ulcerated, causing bleeding and anemia. In case they grow in small intestine, it can be very difficult to diagnose them,so biopsy sampling and surgery is recommended. 

Adenomas: They are benign tumors and cannot be malignant. If they arise in the region of papilla or duodenum, where bile ducts and pancreas drain, they can cause jaundice. Adenomas are usually removed by surgery or endoscopy because of the risk of malignant degeneration. 

Lipomas: They are formed due to the accumulation of fatty tissues within the wall of intestine, and appear yellow in color when viewed endoscopically. These are completely benign tumors with no malignant potential. 

Hemangiomas: When the blood vessels get collected, they form a benign vascular tumor in the wall of stomach or intestine. These tumors can cause gastrointestinal bleeding and anemia. 

Neurogenic Tumors: They are formed due to an abnoramlgrowtth of nerve tissue. The most common type of Neurogenic tumors are Neurofibroma. 

LAPAROSCOPIC SURGERY FOR BENIGN TUMORS

Procedure

  • Two-three tiny incisions are made in the abdomen
  • The surgeon then enters laparoscope and other surgical instruments through these incisions.
  • The surgeon locates the tumor and removes it.

Meckel’s diverticulum

It is present as a pouch on the wall of lower part of small intestine. It is approximately 2 feet proximal to its junction with large intestine and is usually present at the time of birth (congenital). The diverticulum may contain tissues similar to that present in stomach or pancreas. 

CAUSES AND SYMPTOMS OF MECKEL’S DIVERTICULUM :

It occurs in the fetus during early pregnancy. The vitelline duct connects the growing fetus with the yolk sac and is absorbed into the fetus by 7th week of pregnancy. In case, the vitelline duct is not fully absorbed, a Meckel's diverticulum is formed. It may contain cells from pancreas and stomach. If stomach secretes acid, it can cause ulcers and bleeding. The common symptoms usually occur during the first year of child's life, and can reoccur in adulthood. They are: 

  • Gastrointestinal bleeding (which can be seen in the stool)
  • Abdominal pain and cramping
  • Tenderness near the navel (belly button)
  • Obstruction of the bowels, a blockage that keeps the contents of the intestines from passing. This can cause pain, bloating, diarrhoea, constipation, and vomiting.
  • Diverticulitis (swelling of the intestinal wall)
  • Symptoms may mimic Acute Appendicitis

LAPAROSCOPIC SURGERY FOR MECKEL'S DIVERTICULUM 

Procedure

  • Two to three tiny incisions are made in the abdomen and a laparoscope is inserted through one of the incisions which enables the surgeon to view the abdomen on a video monitor.
  • Surgical instruments are inserted through the other incisions.
  • The surgeon removes the Meckel's diverticulum along with the surrounding compromised portions of the small intestine. 
  • The healthy ends of the remaining small intestine are joined back using staples or stitches.

ADVANTAGES OF LAPAROSCOPIC SURGERY

  • Minimal postoperative pain
  • Shorter hospital stay and quick return to work and normal activities.
  • Excellent cosmetic results

Causes

Its major causes are:

  • Infection, usually by bacteria or virus
  • Broken bone
  • An autoimmune disease
  • General “wear and tear” on joints

Treatment

Arthritis in initial stages can be managed by medications. Anti-inflammatory drugs often suppress the pain and limit swelling. Once the joint cartilage has been damaged to an extent that any attempt to use it is very painful and X-rays confirm the severe destruction, surgical options need to be considered.

Surgery should be advised after a thorough general check-up of the patient. And peri-operative care is highly co-ordinate between surgeon, anesthetist, physician, physiotherapist or any other specialty depending on patient’s health status.

Various Surgical interventions are available for arthritis depending on the severity of patient's condition and the doctor's assessment. These include:

ARTHROSCOPIC DEBRIDEMENT

A telescope is inserted into the knee and products of wear and tear are removed.

HIGH TIBIAL OSTEOTOMY

The shin bone (tibia) is cut at the upper end and realigned to distribute the loads in a knee which is only partially arthritic.

TOTAL KNEE REPLACEMENT

Total knee replacement or 'Arthroplasty' is relining of the joint (bone end surfaces) with artificial parts called Prostheses. This has a new design called High Flexion Knees permitting near complete range of movement.

UNICONDYLAR KNEE REPLACEMENT

In some patients only one half of the knee joint is worn out. In these situations only one side of the knee is replaced. It can be done in specific conditions, which only the surgeon can judge and advice. Unicondylar Knee Replacement is comparatively economical and since the operation is less extensive, the post-operative recovery is faster.

 

TOTAL HIP REPLACEMENT

There are two major types of Total Hip Replacements: a cemented prosthesis and an un-cemented prosthesis. Both are widely used.

Patients must give a detailed account of their medical history to the Surgeon as it may have a bearing on their operation and its result.

Signs and symptoms

The most common symptoms of arthritis are:

  • Joint pain
  • Joint swelling
  • Redness of skin around a joint
  • Stiffness, especially in the morning
  • Limited movement

Causes

Its major causes are:

  • Infection, usually by bacteria or virus
  • Broken bone
  • An autoimmune disease
  • General “wear and tear” on joints

Treatment

Arthritis in initial stages can be managed by medications. Anti-inflammatory drugs often suppress the pain and limit swelling. Once the joint cartilage has been damaged to an extent that any attempt to use it is very painful and X-rays confirm the severe destruction, surgical options need to be considered.

Surgery should be advised after a thorough general check-up of the patient. And peri-operative care is highly co-ordinate between surgeon, anesthetist, physician, physiotherapist or any other specialty depending on patient’s health status.

Various Surgical interventions are available for arthritis depending on the severity of patient's condition and the doctor's assessment. These include:

ARTHROSCOPIC DEBRIDEMENT

A telescope is inserted into the knee and products of wear and tear are removed.

HIGH TIBIAL OSTEOTOMY

The shin bone (tibia) is cut at the upper end and realigned to distribute the loads in a knee which is only partially arthritic.

TOTAL KNEE REPLACEMENT

Total knee replacement  or 'Arthroplasty' is relining of the joint (bone end surfaces) with artificial parts called Prostheses. This has a new design called High Flexion Knees permitting near complete range of movement.

UNICONDYLAR KNEE REPLACEMENT

In some patients only one half of the knee joint is worn out. In these situations only one side of the knee is replaced. It can be done in specific conditions, which only the surgeon can judge and advice. Unicondylar Knee Replacement is comparatively economical and since the operation is less extensive, the post-operative recovery is faster.

TOTAL HIP REPLACEMENT

There are two major types of Total Hip Replacements: a cemented prosthesis and an un-cemented prosthesis. Both are widely used.

Patients must give a detailed account of their medical history to the Surgeon as it may have a bearing on their operation and its result.

Treatment

A comprehensive treatment plan includes medication and exercise that can help in maintaining a normal upright posture and spinal mobility minimize the impact of hip and other joint manifestations, and reduce pain and stiffness.

Exercise

Stretching exercises and spinal exercise can improve mobility and posture and minimize the long-term impact.

Medications

Your doctor will prescribe the best medication option which will usually vary from case to case. Following are the medication categories:

  • Non-steroidal anti-inflammatory drugs
  • Corticosteroid injections
  • Oral corticosteroids
  • Tumor necrosis factor inhibitors

Surgery

Total hip, shoulder or  knee replacement  are options for restoring mobility in those joints when they have become severely damaged. Corrective spinal surgery has become a safer prospect since the advent of magnetic resonance imaging and may be necessary if your spine fuses into a severely bent position.

Treatment

A comprehensive treatment plan includes medication and exercise that can help in maintaining a normal upright posture and spinal mobility minimize the impact of hip and other joint manifestations, and reduce pain and stiffness.

Treatment

  • Physiotherapy
  • Medications - Short term usage, medications prove effective
  • Exercises - Primarily back strengthening exercises under the guidance of a certified trainer, but always started once acute pain is controlled
  • Acupuncture
  • Surgery - Highly specialised orthopaedic surgeons, rheumatologists and physiotherapists use computer assisted orthopaedic surgery techniques which are as follows:
    • Joint Replacement Surgeries - The joint replacement team provides state-of-the-art surgical care employing up-to-date techniques for the treatment.
    • Spine Surgery - Our dedicated spine clinic offers conservative and operative management for a wide range of spinal disorders, making use of state-of-the-art equipment like operating microscopes, computer-navigation, etc.
    • Traumatic Orthopaedic Management - We are equipped with:
      • Three-dimensional digitised fluoroscopic intra-operative imaging, coupled with professional software support services
      • Multi-functional multi-optional fracture tables (permitting minimal incision technique fixation for all possible fractures)
      • The latest orthopaedic implant and instrumentation, including biodegradable implants

Causes of Low Testosterone :

As a man ages, the amount of testosterone in his body naturally gradually declines. This decline starts after age 30 and continues throughout life. Some causes of low testosterone levels are due to:

 

  • Injury, infection, or loss of the testicles
  • Chemotherapy or radiation treatment for cancer
  • Genetic abnormalities such as Klinefelter's Syndrome (extra X chromosome)
  • Hemochromatosis (too much iron in the body)
  • Dysfunction of the pituitary gland (a gland in the brain that produces many important hormones) or hypothalamus
  • Inflammatory diseases such as sarcoidosis (a condition that causes inflammation of the lungs)
  • Medications, especially hormones used to treat prostate cancer and corticosteroid drugs
  • Chronic illness
  • Chronic kidney failure
  • Cirrhosis of the liver
  • Stress
  • Alcoholism
  • Obesity (especially abdominal)

 

Symptoms of Low Testosterone

Without satisfactory testosterone, a man may lose his sex drive, encounter erectile dysfunction, feel discouraged, have a diminished feeling of well - being, and experience issues concentrating.

To know the symptoms in detail one should always go to a Testosterone Therapy Hospital for consultation. There

What Changes Occur in the Body Due to Low Testosterone?

Low testosterone can cause the following physical changes:

  • Decrease in muscle mass, with an increase in body fat
  • Changes in cholesterol levels
  • Decrease in haemoglobin and possibly mild anaemia
  • Fragile bones (osteoporosis)
  • Decrease in body hair
  • Changes in cholesterol and lipid levels

When in doubt one should always visit a Testosterone Men’s Health Hospital to get help from the specialists in order to tackle such situations.

Diyos is a Testosterone Therapy Hospital situated in the lush green part of South Delhi where you get advice and suggestive methods to deal with Male Testosterone Deficiency.

Low Testosterone Treatment

Testosterone Replacement Therapy

Low testosterone treatment is designed to boost testosterone levels. Studies suggest this increase in testosterone can strengthen muscles, protect bones, and improve sex drive. Testosterone replacement therapy is only recommended for men who have blood levels that show low testosterone. Such treatments can have different effects from one man to another so it is difficult to predict the treatment outcomes for any one individual.

Methods of Testosterone Delivery

  • Intramuscular shots
  • Topical gels and patches

  • Buccal patches

  • Implanted pellets

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ABOUT THE APPENDIX

The appendix is a narrow, small, finger-shaped portion of the large intestine that is generally situated near junction of small and the Cecum or the large intestine on lower right side of the abdomen.

ABOUT APPENDICITIS

When the appendix gets suddenly inflamed, it results in Appendicitis.  Although the appendix has no function, but if an inflamed appendix is left untreated, it can burst, or cause infection. This occurs when the interior of the appendix becomes filled with something like mucus, bacteria, foreign materials, parasites or hard stools which cause swelling in the appendix, thereafter leading to irritation and inflammation. Appendix may perforate, allowing stool, mucus, and other substances to leak through and get inside the abdomen causing localized abscess or generalized infection of abdomen (peritonitis). This might require immediate appendix surgery.

SYMPTOMS

  • Pain in the abdomen- Pain may begin around the belly button and then get localized in right lower abdomen
  • Nausea/Vomiting
  • Loss of appetite
  • Fever usually occurs within several hours
  • Constipation
  • Abdominal pain which may worsen while walking or coughing
  • Rectal tenderness
  • Chills and rigours 

DIAGNOSIS

A thorough history and physical examination is required to diagnose appendicitis and begin appendix treatment. As patients usually have an elevated temperature, there is moderate to severe tenderness in the right lower abdomen, when the doctor physically examines it. In cases where inflammation has spread to the peritoneum, there can be frequent rebound tenderness. Rebound tenderness is pain that worsens when the doctor quickly releases his or her hand after gently pressing on the abdomen over the area of tenderness. 

These tests help in confirming the diagnosis of appendicitis:

  • Blood test to look for signs of infection
  • Urine test to rule out other conditions, such as a bladder infection
  • Computerized tomography (CT) scan or an ultrasound scan to see if the appendix is swollen

TREATMENT

In a laparoscopic appendix treatment, the appendix is removed in uncomplicated cases through Appendectomy. In case a CT scan shows that there is a swelling from a ruptured appendix, patient is treated for infection and appendix is removed after the infection and inflammation have gone away. The appendix is removed with instruments placed into small abdominal incisions. After anesthesia is administered, the abdomen is lined with an antibacterial solution and the peritoneal cavity is inflated with carbon dioxide. A small abdominal incision below to the belly button is made in the skin crease to allow the insertion of the laparoscope. Two or three small incisions more may be necessary to insert the laparoscopic instruments to dissect and remove the appendix. Next, the tissues and vessels surrounding the appendix are cut and tied. The appendix is put as a precautionary measure, to prevent infection, in a plastic bag before being removed.

Finally all the abdominal cuts are closed with clips, which are likely to leave insignificant scars. As a routine procedure the removed appendix is sent to the path lab for biopsy.

A laparoscopic appendix treatment in Delhi is available at all leading hospitals.

ADVANTAGES

  • Least post-operative pain
  • quicker recovery
  • Short hospital stay
  • Least post-operative complications

Treatment Process

 The treatment offered at Diyos is customized to the body type of every patient, targeting different body parts where fat accumulation has taken place, therefore helping the person to lose weight in a systematic way. Adequate care is taken to make sure that the weight loss is gradual and not sudden, so that the body adjusts to the reducing weight slowly and timely. Treatment at Diyos is not just a weight loss treatment, but it is about adopting a new way of life.

When a patient enrols for a weight loss program at Diyos, patient is given complete orientation about a balanced diet with fruits and vegetables, exercises such as brisk walk and yoga, information about likely ailments due to obesity, their prevention and treatment, and a comprehensive goal based schedule is designed, so that the patient can lose weight in a systematic and methodical way. The treatment also increases oxidation, releases fat and accelerates lymphatic drainage.

When a person comes to our centre for weight loss treatment in Delhi, we offer a combination of treatments for body contouring, tightening and reshaping using latest technology, integrated with a tailormade diet program. Our expert dietician works with the patient to create a complete diet plan suited to the body type and daily schedule of the person, with a focus his profession and usual physical activity level.

We train our patients in a way that they maintain their weight and manage weight fluctuations, their entire life. The success of any weight loss program depends on commitment and dedication from the client, and following dietary and exercise instructions of experts at the clinic. Our aim is to offer the best weight loss treatment in Delhi to our clients.

Advantages of Treatment at Diyos

The advantages of taking treatment at our clinic are

  1. Our team of dieticians and doctors are highly experienced and have helped a large number of clients achieve their weight loss and health goals.
  2. We use the latest tools, technologies and trends to treat our patients. We are at par with international standards in weight loss treatment.
  3. Our program focuses on lifestyle changes, and sustainable weight management. It is holistic in nature, and includes therapies, body contouring and developing emotional well-being.
  4. We provide nutritionally balanced diets with options and combinations, customized to the patient’s body type and occupation.
  5. Our anti-cellulite program is non-invasive, yet effective.
  6. We regularly follow up with our clients, and motivate them to achieve their goals.
  7. Our rates are competitive and affordable.

We have a feedback system, where our clients review our services and provide suggestions on ways to improve. We take feedback very seriously, and make changes to our programs and processes on a continuous basis. So if you are looking for weight loss treatment in Delhi, get free consultation from our experts now!

Causes

Stones can be due to excessive cholesterol, bilirubin, bile salts or deposits of digestive fluid, and can be of any size, ranging from the size of a sand particle to the size of a golf ball. People can have one gallstone or several gallstones at a time. A person who develops gallstones needs to seek help from a clinic or hospital providing gallbladder stone treatment in Delhi.

Factors that can increase gallbladder stone risk are being over 40 years of age, being overweight, sedentary lifestyle, pregnancy, eating a high fat and high cholesterol diet, family history of gallstones, diabetes, liver problems etc. It is believed that gallbladder stones are more common in North India as compared to other regions.

Symptoms

Gallstones usually do not cause any symptoms.However, if a gallstone blocks a bile duct, it can cause severe pain in the centre of your abdomen, just below your breastbone, known in medical terms as biliary colic. It can also cause pain between your shoulder blades, nausea or vomiting.

Prevention of Gallstones

The risk of gallstones can be reduced if you take precautions such as

  1. Maintaining a healthy body weight by taking a balanced diet alongwith fruits and vegetables, adequate fibre and less oil and cholesterol, and doing physical exercise.
  2. Take meals on time and do not skip meals.
  3. If you want to lose weight, lose it slowly, not more than 1 kg a week.
  4. Avoid excessive alcohol intake, junk food and processed food.
  5. Those with family history should be extra cautious and go for checkups regularly.

For more information, you can visit Diyos Men’s Health Center, which is one of the best centers for gallbladder stone treatment in Delhi.

Detection and Diagnosis

Gallbladder tests can diagnose gallstones. Some of the tests are

  1. Ultrasound: Abdominal ultrasound is an excellent test to check for stones
  2. Endoscopic Retrograde Cholangiopancreatography (ERCP): A flexible tube is inserted into the small intestine via the mouth and stomach. The doctor can see into the tube and inject dye into the bile system ducts. Small surgical tools can be used to treat certain gallstone conditions during the procedure.
  3. Magnetic resonance Cholangiopancreatography (MRCP): An MRI scanner produces high-resolution images of the bile ducts, pancreas, and gallbladder.
  4. X-ray: X-rays may be able to detect gallstones.

If you notice any symptom of gallstone, you should get yourself checked for diagnosis at a clinic that provides gallbladder stone treatment in Delhi.

Treatment

The only way to get rid of gall stones is to go under a key hole surgery, wherein the entire gall bladder is removed through minimally invasive procedure, known as Laparoscopic Cholecystectomy

  • Surgery (Laparoscopic Cholecystectomy): A surgeon removes the gallbladder using laparoscopy.  It requires a hospitalisation stay of one day and the patient recovers very soon.  This is most preferred line of treatment to deal with gall bladder stones worldwide.
  • You can get discuss treatment options with a doctor at Diyos, and go for gallbladder stone treatment in Delhi.
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