Best treatment for fistula

40 Yrs old male pt. having this type of condition on both hands from 5 years taken many allopathy medicines and herbal medicines also but no relief... Please help in diagnose nd Rx also.... Thanks in advance.....@Dr. P. G. Shah @Dr. Akshay Ingole @Dr. Hemant Adhikari @Dr. Md Shahbaz Ali @Dr. Yashpal Chadha

Dear Friends, A BEAUTIFUL case of traumatic pneumothorax left side (partial) with fracture rib posteriorly.. Should be USEFUL to us Thanks Dr K N Poddar

Dear Friends, I have posted in my earlier case… two pictures of a classical case of MASSIVE SUBCUTANEOUS EMPHYSEMA… I thought a discussion on it will be helpful… SUBCUTANEOUS EMPHYSEMA It is a condition that occurs if air or gas is trapped in the subcutaneous layer of the skin. The term “Subcutaneous” denotes the tissue located underneath the cutis of skin while “Emphysema” denotes trapped air. CAUSES… The main causes for this condition include seepage of small amounts of air through lesions on the skin caused by some blunt trauma, stabbing or bullet wound. The air is immediately drawn in because of the muscular movements and Spreads quickly into the chest and neck cavity. It can also occur following a Laparoscopic surgery. Other causes (1)Pneumothorax (2)Tracheal rupture   (3)Bronchial Rupture (4)Esophageal Rupture (5)Necrotizing infections like gangrene (a late symptom of Gas Gangrene) (6)Dental Procedures It can occur due to certain dental procedures that uses compressed air equipments. Root canal is considered to be one of its possible causes. (7)Forceful vomiting due to Boerhaave’s syndrome can also cause this condition. SIGNS AND SYMPTOMS include: It gives rise to a characteristic crackling sensation that is described to resemble the feeling of touching Rice Krispies. This feeling of air trapped under the skin is called subcutaneous crepitation. SEVERE CASES of SE: Swelling of the entire face Swelling of the neck Change in the voice of an individual In extremely serious conditions, the air can spread in various body parts like the abdomen and the limbs. TREATMENT AND MANAGEMENT….. Generally, occurs as a benign condition. and does not require any treatment… although the diseases causing the condition should be treated properly. However, if large amount of air is present in the Subcutaneous Emphysema, it may cause breathing problems and discomfort. called… “Massive Subcutaneous Emphysema”, It is a very uncomfortable form which needs surgical drainage. it causes the swollen eyelids of the patient to obstruct the eye sight. The air pressure may also block the blood-flow to areolae of the skin and breast and of the labia or scrotum. This can cause necrosis in these skin areas. It is important to perform adequate decompression immediately if the air is causing necrosis. In severe cases, the trachea can be compressed. If the Subcutaneous Emphysema turns severe, catheters can be placed in the subcutaneous layer for releasing the air. “Blow holes” or small cuts can be made in the affected skin for eliminating the air. If the condition is being caused by Pneumothorax, its treatment involves placing a chest tube. Placing a chest tube eliminates the source through which the air enters the subcutaneous tissue. Thanks Dr K N Poddar

No any type of pain.Patient eats tobacco.Pungent things aversion. Suggest dx and Rx.

This patients age is28 yrs. His mouth is opened with very difficulty and pain.There is a history of tobacco chewing.Tobacco chewing is stopped from last 2years.No patches in mouth, colour and condigion of mouth is normal. I diagnose this condition i.e. Submucous fibrosis.Please suggest curable remedy for this condition,both allopath,homoeopath,ayurved