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Bariatric surgery

Date: 2020-01-01

Bariatric surgery is a surgical operation that contributes to losing weight by making alterations in the digestive system. Some types of bariatric surgeries work to lose weight by reducing the size of the stomach, which makes the patient eat and drink at every meal and feel full sooner. Bariatric Surgery includes Gastric bypass and other weight-loss surgeries that effectively make changes in your digestive system to help you lose extra calories. Obesity can be understood by our body mass index. If one’s body mass index (BMI) exceeds 30 or more, then he is considered obese. BMI is a measure of one's weight-related to his height. •    Class 1obesity indicates a BMI of 30 to 35, •    Class 2 obesity shows a BMI of 35 to 40, •    Class 3 obesity to a BMI of 40 or more.   Classes 2 and 3, are considered as severe obesity, and it becomes hard to treat with diet and exercise alone. Candidates for Bariatric Surgery 1.    If one is overweight (BMI is 40 or more) and when diet and exercise haven't worked. 2.    If one has serious health problems, such as type 2 diabetes or sleep apnea, related to obesity.  (BMI is above 35 or more) 3.    If one has BMI is 30 or more, serious health problem related to gastric band is accompanied by obesity The obese teenager needs this surgery if he has- •    Severe obesity-related health problems like type 2 diabetes or severe sleep apnea with  BMI equal to or above 35 •    Less serious health problems like high blood pressure or high cholesterol with BMI equal to or above 40 Potentially life-threatening weight-related health problems includes: •    Heart disease and stroke •    High blood pressure or hypertension •    Nonalcoholic fatty liver disease (NAFLD) or nonalcoholic steatohepatitis (NASH) •    Sleep apnea •    Type 2 diabetes   Surgical Procedures: 1.    Roux-en-Y (roo-en-wy) gastric bypass-  It is the most common method of gastric bypass. It cannot be reversible. It reduces the amount of food one can eat in one meal and the absorption of nutrients. In this procedure, the surgeon cuts the upper portion of your stomach, sealing it off from the rest of your stomach, reducing its size. Then, the small intestine is cut and sewn directly onto the pouch to bypass the food directly into its middle part. 2.    Sleeve gastrectomy- In this procedure, about 80% of the stomach is removed. A long, tube-like pouch is left to hold less food. It also leads to reduced secretion of the appetite-regulating hormone ghrelin, reducing one’s desire to eat. 3.    Biliopancreatic diversion with duodenal switch- It has two-parts which the first step involves performing a procedure similar to sleeve gastrectomy, and another one connects the end portion of the intestine to the duodenum near the stomach (duodenal switch and biliopancreatic diversion), bypassing the majority of the pipe.   Advantages •    It reduces one's appetite and urges to eat much. •    It causes significant long term weight-loss. •    It reduces the absorption of the nutrients. Recovery Hospital stay depends on the type of bariatric surgery performed.  Post-surgery, the patient is not allowed to eat for one or two days, and a specific diet plan is given to them to follow for a few weeks. He is advised to switch to a healthy lifestyle to fetch good outcomes of the surgery. Side effects Short term Risks associated with the surgical procedure can include: •    Excessive bleeding •    Adverse reactions to anesthesia •    Blood clots •    Infection •    Breathing problems •    Leakage in your gastrointestinal system •    Death (rare) Longer-term risks and complications of weight-loss surgery may vary and depends on the type of surgery. It includes: •    Malnutrition •    Bowel obstruction •    Vomiting •    Gallstones •    Hernias •    Low blood sugar (hypoglycemia) •    Dumping syndrome, which leads to diarrhea, flushing, lightheadedness, nausea or vomiting •    Ulcers •    Acid reflux •    The need for a second, or revision, surgery or procedure •    Death (rare)  

Facial Plastic Surgery

Date: 2019-12-31

Facial plastic surgery is a surgical operation done to reshape structures in the head and neck like the nose, ears, chin, cheekbones, and neckline. It is performed to reconstruct the face after a disease, injury, or birth defect or to change the signs of aging, remove contour irregularities or deformities, or improve the features of the facial appearance, to make it look more young, natural & more in proportion with one another. It is also performed to improve specific congenital facial abnormalities such as a birthmark, cleft lip, or other birth defects. Many conditions, such as sun damage, the effects of aging,  or previous facial trauma, are also resolved through its procedures performed by a skilled surgeon. ENT (ear, nose, and throat) doctors/otolaryngologists are trained surgeons to diagnose and treat a wide range of conditions that require plastic surgery for the whole face, nose, lips, ears, and neck. Facial Plastic Surgery Types: Facial plastic surgery is included in otolaryngology (the study of Ear, Nose & throat) that is divided into two types: 1.    Reconstructive plastic surgery- It is performed for patients who have conditions present from birth, like birthmarks on the face, protruding ears, cleft lip and palate, and a crooked smile affecting their normal function. It is also selected for conditions arising from accidents, burns, trauma, or previous surgery. Besides, some reconstructive procedures are done to treat existing diseases like skin cancer. 2.    Cosmetic facial plastic surgery- It is surgery performed to improve the visual appearance of the facial structures and features. It involves procedures like facelifts, eye lifts, rhinoplasty, chin and cheek implants, liposuction, and methods to remove facial wrinkles. Surgical Facial Plastic Treatments- 1.    Rhinoplasty/Septoplasty/ nose surgery—in this procedure, internal and external structures of the nose i.e., cartilage and bone, are reconstructed and reshaped to improve the appearance and function of the nose. It is done for both functional (correction of a deviated septum) and cosmetic purposes. 2.    Blepharoplasty or eyelid Surgery—it involves surgery of the upper or lower eyelids to correct the conditions like drooping eyelids, impaired vision, and enhance the appearance of the eyes. 3.    Browlift — It is the surgery to improve wrinkles and deep lines in the forehead and droopy or furrowed eyebrows. 4.    Rhytidectomy —Surgery of the skin on the face and neck is performed to tighten the skin and remove excess wrinkles. 5.    Liposuction—It is done to remove excess fat under the chin or in the neck 6.    Facial Implants—it is used to make specific structures of the face (cheek, lips, chin) more attractive, prominent, and well defined. 7.    Otoplasty or ear surgery- It is performed to reshape the cartilage of the protruding ears. Recovery and Expectations: Most of the facial surgery will not require an extended stay in the hospital. It depends on the extent of the operation and procedures performed on an outpatient basis. Some procedures may need a hospital stay overnight, or it may extend to a day or two. Before discharge, the surgeon will instruct the patient any special care required for easy recovery at home. Most patients may resume work in one to two weeks after their surgery, probably when swelling and bruising subside, and there is an improvement in their appearance. Risks or Side Effects: Facial surgery has risks of nausea, numbness, infection, blood clots, bleeding, and adverse reactions to the anesthesia.  

Stem cells Therapy

Date: 2019-12-09

Stem cell therapy is a therapy that regenerates new cells from the specialized cells, called stem cells, for specific functions. These cells can replace damaged or defective cells in the body. This therapy is considered as a miracle cure for most of the diseases ranging from wrinkles to spinal repair. It is also called regenerative medicine that boosts the repair of nonfunctional or injured or diseased tissues with the help of stem cells or their derivatives. It has excellent future therapeutic potential that needs to be researched more. In this therapy, stem cells are grown in the laboratory and implanted into specific types of cells like heart muscle cells, bone cells, blood cells, or nerve cells of the patient. The stem cells then enhance the repair of the damaged or defective cells in the injected part. For instance, if it is inserted into the heart muscle, it can repair the defective muscle cells in the heart. This therapy is successfully utilized to perform bone marrow transplants in current medical practice. It is the most widely practiced stem cell therapy nowadays. What are Stem cells? Stem cells are the raw cells in a human body specialized in building any tissue. Owing to various researches, these cells are known to enhance tissue regeneration and repair. Stem cells have two specific properties- Unlimited renewal-these cells have a property to produce infinite progeny similar to an originating cell in a highly controlled manner. Ability to differentiate- these cells can differentiate into all types of cells in the body. Stem cells are derived from embryonic cells (blastocysts, when the embryo has nearly 150 cells), Adult stem cells (present in the adult tissues such as fat, bone marrow, etc.) Perinatal stem cells (cells taken from amniotic fluid and umbilical cord blood). In recent research studies, genetic programming is used to produce healthy adult cells from stem cells successfully. However, several scientific experiments are still required to discover their therapeutic values for the treatment of various diseases. Advantages Currently, stem cell therapy is used for bone marrow transplantation as stem cell transplants. Stem cell transplants can be used to replace damaged or diseased cells to treat many blood-related diseases and cancer diseases like leukemia, neuroblastoma, lymphoma, and multiple myeloma. Scientists are experimenting with the efficacy of stem cells in the treatment of degenerative diseases such as heart failure, renal disorders, etc. Potential disadvantages The research related to stem cell therapy is performed on the mice whose outcomes are different in humans. The feature of unlimited cell division by stem cells is quite similar to that of cancer cells so that there is a constant risk of conversion of stem cells into cancer cells. The scientists haven’t yet mastered to control the production of the stem cells in a large number of right healthy cells at the correct stage of differentiation. Specific protocols are still missing that can control the survival, production, and integration of the transplanted cells. Clinical trials are still not accomplished that can assure the safety and efficacy of stem cell therapy. Conclusion Stem cell therapy is an advanced and widely used therapy used for regeneration and repair of the diseased and defective cells in the body. It possesses the potential to treat degenerative diseases, cancer, blood-related disorders, and many more. Currently, bone marrow transplantation is the most effective treatment conducted with the aid of stem cell transplant. However, conclusive research that can confirm the benefits and efficacy of this therapy is yet to come.

Lung Transplant

Date: 2020-01-09

Lung Transplant A lung transplant is a surgical operation performed to remove and replace a diseased or poorly functional lung with a healthy human lung from a donor. A donor is usually a person whose lung is transplanted. He is a generally recently died person with functional lungs. In rare cases, a section of the lung is taken from a living donor for lung transplantation. A lung transplant is recommended for those people whose lung is severely damaged and cannot perform the normal function, and the affected person cannot live longer enjoy life. Types There are three types of lung transplant: •    Single lung transplant – where a single donor lung is used to replace diseased or damaged lungs, then it is termed as a single lung from the recipient and replaced with a lung from the donor, then it is called a single lung transplant. It is considered to treat pulmonary fibrosis, but it's never recommended for people with cystic fibrosis as infection will go from the remaining lung to the donated lung •    Double lung transplant – in this type, both the lungs are removed and replaced with two donated lungs. It is needed in people with cystic fibrosis or COPD. •    Heart-lung transplant – it is a more complicated surgery in which the heart and both lungs are removed, followed by replacement with a donated heart and lungs.  It is often recommended to treat severe pulmonary hypertension. Candidates The potential candidates for lung transplantation are those who have •    Advanced lung disease has not responded to other methods of treatment. •    a life expectancy less than 2 to 3 years without a transplant •    chronic obstructive pulmonary disease (COPD), •    cystic fibrosis •    pulmonary hypertension •    emphysema •    sarcoidosis •    idiopathic pulmonary fibrosis Procedure When a perfect matched donor’s lung is available, the patient is taken to the operation theater. This operation takes between 4 and 12 hours to complete, depending on the complexity of the procedure and the condition of the patient. It is performed when the patient is entirely unconscious under general anesthesia. A large incision is made in the chest to reach the lungs. The incision depends on the type of lung transplant: •    An incision on a single side of the chest only (for a single lung transplant) •    An incision across the entire width of the front of the chest, or an incision on either side (for a double lung transplant) The patient is kept on a heart and lung bypass machine to keep your blood circulating during the operation. It is selected according to the condition of the individual. Then, the surgeon will connect the donated lungs to the relevant airways and blood vessels, and the chest is then closed. Advantages Although lung transplants are risky and complex surgeries, they can have substantial benefits. Depending on the condition and health status of the patient, a lung transplant may increase the life expectancy of the patient. It will improve the quality of life, making breathing comfortable for the recipient. About 5 out of 10 people will have life expectancy for at least five years after a lung transplant. In a few cases, people may survive for at least ten years. Recovery A lung transplant is a complex operation in which the recipient would take at least three months to recover. He may have to remain in the ICU for a few days after the surgery. Risks or Side Effects- The side effects of lung transplant include •    Organ rejection when the recipient's body does not accept  donated lung and consider it as foreign lungs •    Infections •    Bleeding and blood clots •    Stomach problems •    Thinning of your bones (osteoporosis) •    Cancer and malignancies due to consumption of immunosuppressants •    Diabetes •    Kidney damage  

Melanomas

Date: 2020-01-10

Melanoma is a cancer of melanocytes present in the skin that produces the pigment melanin. Most melanomas appear on the skin, but it may also develop in almost any organ of the body, including the eye, brain, and lymph nodes. It is a type of skin cancer that can spread to other organs in the body. It rarely appears in internal organs, such as intestines. It is more serious forms of skin cancer because it tends to spread to other organs of the body that may lead to serious illness and even death. The most common forms of melanoma involve- superficial spreading melanoma  nodular melanoma  lentigo maligna. The stages of Melanoma depend on the thickness, ulceration, lymph node involvement, and the presence of distant metastasis.  Stages 1 and 2 – the cancerous growth is limited to the skin only. Stage 3- the skin cancer is spread to the local areas through the lymphatic drainage. Stage 4- the cancerous cells have traveled to distant areas to other organs, usually through the bloodstream. Symptoms The typical sign of melanoma is the presence of a new mole or a change in an existing mole that can appear anywhere on the body. Its commonest site is back in males and the legs in females. It rarely appears in sun-protected areas such as the buttocks and the scalp. In most cases, its characteristic features can be understood by following ABCDE criteria- A stands for asymmetrical shape- moles are irregular in shapes, such as two very different-looking halves. B stands for irregular border-moles have irregular, notched, or scalloped border. C stands for changes in color- they have many colors with an uneven distribution of color. D stands for diameter- the mole has a diameter of more than 1/4 inch (about 6 millimeters). E stands for evolving- the moles may exhibit new signs and symptoms, like new itchiness or bleeding. Causes DNA damage in the skin cells causes out of control growth of these cells. It can eventually grow to form a mass of cancerous cells. Other causes of melanomas are- Combination of environmental and genetic factors Exposure to ultraviolet (UV) radiation from the sun From tanning lamps and beds Risk factors Factors that may increase the risk of melanoma are Caucasian (white) race Fair skin, light complexion, light hair, and light-colored eyes A history of sun exposure, especially in childhood A large number of moles (more than 100) Large, irregular shaped or "funny looking" moles History of melanoma in Close blood relatives Weak immune system Diagnosis In most cases, melanoma is diagnosed with the help of the biopsy. In this procedure, the suspicious mole is removed and is studied in the laboratory to examine its cancerous nature under a microscope. Another test is recommended when there is doubt that melanoma is spread to the lymph nodes. It is called a sentinel node biopsy. Treatment The primary treatment for melanoma is the surgical excision of the mole.  But it depends depend on age, shape & size, the stage during diagnosis and extent of its spread. If it is detected in the early stage, it is treated successfully with surgery. If it has spread to lymph nodes, then surgical removal of nearby lymph nodes is recommended. If melanoma is diagnosed after it has progressed to an advanced stage, then treatment is focused on slowing down the spread of cancer and reduce symptoms. More in-depth and more advanced cancers may require more extensive surgery to get treated.  The treatment focuses on the reduction of symptoms, usually involves medicines that target specific genetic alterations in melanoma, like BRAF inhibitors, etc. Medicines are selected that can boost the immune responses of the body to the cancerous growths (so-called checkpoint therapies). Some treatments using immunotherapy or chemotherapy are often selected.

Eye Cancer

Date: 2020-01-15

Eye Cancer Eye cancer is an uncommon type of cancer that develops due to the uncontrolled multiplication of the cells in or around the eyeball. This cancer tends to grow in the tissues surrounding the eyeball or had spread to the eye from distant parts of the body, like breasts or the lungs. Types •    Eye melanoma •    Squamous cell carcinoma •    Lymphoma •    Retinoblastoma – a childhood cancer If the cancerous growth begins inside the eyeball, it's called intraocular cancer. The most common eye cancer is melanoma. Hence, it is discussed more in this article. Retinoblastoma is the most common eye cancer that affects children, which originates from the cells of the retina. In adults, the common eye cancer is melanoma and lymphoma. Symptoms Symptoms of eye cancer include: •    The patient sees shadows, flashes of light, or wiggly lines •    He may have blurred vision •    He may feel a dark patch in the eye that grows bigger in size •    There is a partial or complete loss of vision •    Another symptom is bulging of one of the eyes •    A lump is felt in the eyelid or in the eye that increases in size •    Rarely, pain may be felt in or around the eye Causes The exact cause is not clearly understood. •    Age.-People of age 50 or more are more at risk of developing primary intraocular melanoma. It is rarely seen in children and people over age 70. •    Race- Primary intraocular melanoma affects white or fair-skinned people more than black people. •    Gender-Intraocular melanoma affects both men and women. •    Individual history-People with the following medical conditions have a higher risk of developing primary intraocular melanoma: •    Family history- melanoma can run in families, due to a mutation or change in a gene called BAP1. •    Other factors- Exposure to sunlight or tanning beds or certain chemicals may trigger intraocular melanoma. Diagnosis The tests that can detect eye cancer are following- 1.    Eye Exam- the eye specialists examine the structures of the eyes in more detail and check for abnormalities 2.    Ultrasound scan- a small probe is used to find out more about the position of the tumor and its size. It is kept on the closed eye and uses high-frequency sound waves are passed to develop an image of the internal parts of the eye. 3.     Fluorescein angiogram-  a special camera is used to take pictures of suspected tumor after injecting a dye into the blood vessels of eyes to highlight the tumor 4.    Biopsy- in rare cases, a small sample of tissue is removed from the tumor of eye tissues. Treatment The treatment of eye cancer is dependent on the size and exact location of the tumor. The main treatments of eye melanoma are- •    Brachytherapy – tiny plates lined with a radioactive material called plaques are inserted near the tumor and kept in place for up to a week to kill the cancerous cells •    External radiotherapy – in this technique,  beams of radiation are focussed on the tumor to destroy the cancerous cells •    Surgery- it is selected when the eye has some scope of vision. In this procedure,  the tumor or part of the eye is removed.   •    Removal of the eye (enucleation) – this may be necessary if the tumor is too large or the patient has lost vision; the eye will eventually be replaced with an artificial eye that matches your other eye •    Chemotherapy- It is rarely recommended for eye melanoma, but it can be used for different types of eye cancer. Outlook The outlook of the eye cancer depends on the size of the tumor, its time of diagnosis and parts of the eye affected •    Nearly 80% of patients diagnosed with a small eye melanoma will survive up to minimum five years after detection •    Almost 70% of the patients diagnosed with a medium-sized eye melanoma will survive up to minimum five years after detection •    Nearly 50% of the patients diagnosed with a large eye melanoma will survive up to minimum five years after detection  

Neuro Cancer

Date: 2019-11-05

Neurological Cancer Neurological cancer is the abnormal and uncontrollable growth of cells in the brain or spine. Sometimes, it develops in both areas of the body at the same time. Brain cancer appears when the cells inside the brain reproduce uncontrollably, forming a mass. This mass is also known as a tumor. It is categorized into three types- •    Noncancerous (low grade, benign)- Benign tumors are limited to the affected area, but they can still cause neurological cancer symptoms, especially if they grow to be quite large. •    Cancerous (high grade, malignant) -Malignant neurological tumors can invade nearby tissue and spread to other parts of your brain. •    Metastatic cancers- this cancer has developed in some other part of the body and has invaded the brain or spine to form tumors. In children, brain and spine cancer appear before the age of 10 years. In adults, it usually occurs in the ages between 30 and 50 years. Symptoms The Symptoms of Neurological cancer vary from person to person. Brain Cancer represents the following common symptoms: •    Headaches •    Weakness •    Seizures or convulsions •    Problems related to speech or vision •    Nausea and vomiting •    Difficulty in walking •    Alterations in one’s alertness, memory or concentration •    Changes in personality Spinal Cord Tumors are represented by symptoms such as- 1.    Pain in the back 2.    Pain that extends from the back to the arms or legs 3.    Weakness felt in the legs 4.    Trouble in walking 5.    Bowel or urinary incontinence Diagnosis The tests that can help to diagnose the neuro cancer are- 1.    Neuropsychological exam: neurological evaluations help to assess memory, learning, concentration, attention,  verbal comprehension, visual perception, processing speed, basic motor, and sensory functions, reasoning, etc. 2.    MRI (magnetic resonance imaging): MRI scan utilizes a strong magnetic field and radio waves to develop a clear image of soft tissues in the brain and spine. 3.    3T MRI: This high-tech MRI scanner gives detailed scans of the brain and spine with accuracy. 4.    Open MRI: in this test, the neurologist treats the tumors during the scan, like performing a real-time neurological tumor biopsy during the MRI. 5.    Functional MRI: A functional MRI (fMRI) is the diagnostic test that accurately maps the brain. Accurate mapping is necessary to plan surgery, radiation therapy, and other interventional treatments as brain tumors may shift the locations of the centers responsible for memory, speech, sensation, and other functions. 6.    16-slice CT (computed tomography): A 16-slice CT shows precise cross-sectional images of the brain than a conventional CT. 7.    PET/CT: These scans give anatomical data by a CT scan along with the metabolic information from a PET scan that tracks smaller tumors and the extent of brain cancer. Treatment One or more of the following procedures are advised for neuro cancer: 1.    Surgery: In some cases, Neuro tumors can be removed surgically. However, surgery is many times are performed in combination with chemotherapy, radiation, or immunotherapy. 2.    Radiation therapy: it is used to destroy cancer cells or cease them from growing. 3.    Chemotherapy: These medicines are used to fight cancer, usually in combination with other therapies, such as radiation therapy and surgery. 4.    Autologous stem cell treatment (ASCT): Autologous stem cell treatment (ASCT): The word “Autologous” means that the stem cells are derived from the patient before performing chemo/radiation therapy. This procedure is used to rebuild the bone marrow after an extremely high dose of chemo, as it might have destroyed healthy stem cells (immature blood cells) along with brain cancer cells. 5.    Cancer immunotherapy: The immune system of the body can be used to treat cancer without damage to healthy tissue. Cellular cancer vaccines, prepared from the patient's healthy cells, help to trigger his immune system to fight cancer and prohibit it from spreading, that eventually prevent returning of the tumor. 6.    Rehabilitation therapy: It includes •    Physical therapy to help the patient  restart walking, maintain balance and rebuild strength •    Occupational therapy to perform life skills, such as dressing, drinking, eating and going to the bathroom •    Speech therapy to deal with difficulties related to talking and swallowing.  

Test

Date: 2020-01-09

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