Very useful Post doctor thank you
Very nice post sir, thanks for sharing
Best information, dr.
Valuable post@Dr. Rajesh Gupta Thanks fr sharing
Informative & helpful post Sir....
Very good collective information thanks for sharing
Excellent post sir Thank you for sharing@Dr. Rajesh Gupta sir
Dr Ranjit Poriya. Homeopathy. Nice Imformative &Educated Help Post Doctor. Rajesh Gupta Ji. Very Very Thanks.
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Complicated Anorectal case *Chief Complaints* 26 Years old male patient C/o severe pain & burning while defecating and hours after that. On proctoscope examination reveal swelling in anal canal ( piles ? ) and TRUS report attached which suggest the same. No h/o constipation as such. However, irregular lifestyle with no fix times for meals or excretory activities. Eating outside because travelling job. *History* Patient took below prescription from a general surgeon for 10 days Cap. RBSON D BD Tab. Oflox Oz BD Tab. Xymoheal D BD replaced by SignoFlam in later 5 days Anobliss ( Nifedipine + Lignocaine ) Cream for LA Syrup. Cremafinn Plus 15 ML at bed time Tab. Hilo ( Ayurvedic Preparation ) But no improvement. Urine retention also there. Was admitted with Foley's catheter for 4 days since 5 days following the same. *Investigations* Blood reports including infective etiology including HIV 1 &2, HBSAG, HSV, VDRL Negative. Apart from creat 1.2 ( possibly due to urine retention ) Urine RM findings negative. Please suggest the diagnosis and best line of treatment. *Management* EDIT - I got USG abdomen done to rule out high Creatinine. USG is normal. Moreover Urine CS shows E COLI growth 40,000 CFU/ml after 10 days of Oflox Oz and other symptomatic course. It showed sensitive to Amoxyclav so have started augmentin BD for the last few days and urine retention complaint has improved. But lately he has developed blood drops ( clotted & liquid form ) while defecating which aren't that painful. Is there any agressive which needs to be done?Dr. Vikas Thakkar2 Likes25 Answers
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Friends today I am discussing about the problem known as Piles or Hemorrhoids. Piles is another term for hemorrhoids. Hemorrhoids are collections of inflamed tissue in the anal canal. They contain blood vessels, support tissue, muscle, and elastic fibers. Facts on piles: Here are some key points about piles. More detail and supporting information is in the main article. Piles are collections of tissue and vein that become inflamed and swollen. The size of piles can vary, and they are found inside or outside the anus. Piles occur due to chronic constipation, chronic diarrhea, lifting heavy weights, pregnancy, or straining when passing a stool. A doctor can usually diagnose piles on examination. Hemorrhoids are graded on a scale from I to IV. At grades III or IV, surgery may be necessary. What are piles? Hemorrhoids and piles demonstrated in diagram or rectum. Image credit: Mikael Häggström, (2012, September 17) Internal piles occur more frequently than external piles. Image credit: Mikael Häggström, 2012, own work Piles are inflamed and swollen collections of tissue in the anal area. They can have a range of sizes, and they may be internal or external. Internal piles are normally located between 2 and 4 centimeters (cm) above the opening of the anus, and they are the more common type. External piles occur on the outside edge of the anus. Symptoms In most cases, the symptoms of piles are not serious. They normally resolve on their own after a few days. An individual with piles may experience the following symptoms: A hard, possibly painful lump may be felt around the anus. It may contain coagulated blood. Piles that contain blood are called thrombosed external hemorrhoids. After passing a stool, a person with piles may experience the feeling that the bowels are still full. Bright red blood is visible after a bowel movement. The area around the anus is itchy, red, and sore. Pain occurs during the passing of a stool. Piles can escalate into a more severe condition. This can include: excessive anal bleeding, also possibly leading to anemia infection fecal incontinence, or an inability to control bowel movements anal fistula, in which a new channel is created between the surface of the skin near the anus and the inside of the anus a strangulated hemorrhoid, in which the blood supply to the hemorrhoid is cut off, causing complications including infection or a blood clot Piles is classified into four grades: Grade I: There are small inflammations, usually inside the lining of the anus. They are not visible. Grade II: Grade II piles are larger than grade I piles, but also remain inside the anus. They may get pushed out during the passing of stool, but they will return unaided. Grade III: These are also known as prolapsed hemorrhoids, and appear outside the anus. The individual may feel them hanging from the rectum, but they can be easily re-inserted. Grade IV: These cannot be pushed back in and need treatment. They are large and remain outside of the anus. External piles form small lumps on the outside edge of the anus. They are very itchy and can become painful if a blood clot develops, as the blood clot can block the flow of blood. Thrombosed external piles, or hemorrhoids that have clotted, require immediate medical treatment. Everything you need to know about colon cancer Everything you need to know about colon cancer Be sure to rule out the symptoms of colon cancer. Click here to learn more. Causes Pregnant woman in doctors office. Pregnancy may increase the risk of developing piles, as it causes increased pressure in the body. Piles are caused by increased pressure in the lower rectum. The blood vessels around the anus and in the rectum will stretch under pressure and may swell or bulge, forming piles. This may be due to: chronic constipation chronic diarrhea lifting heavy weights pregnancy straining when passing a stool The tendency to develop piless may also be inherited and increases with age. Diagnosis A doctor can usually diagnose piles after carrying out a physical examination. They will examine the anus of the person with suspected piles. The doctor may ask the following questions: Do any close relatives have piles? Has there been any blood or mucus in the stools? Has there been any recent weight loss? Have bowel movements changed recently? What color are the stools? For internal piles, the doctor may perform a digital rectal examination (DRE) or use a proctoscope. A proctoscope is a hollow tube fitted with a light. It allows the doctor to see the anal canal up close. They can take a small tissue sample from inside the rectum. This can then be sent to the lab for analysis. The physician may recommend a colonoscopy if the person with piles presents signs and symptoms that suggest another digestive system diseases, or they are demonstrating any risk factors for colorectal cancer. Treatments In the majority of cases, piles resolve on their own without the need for any treatment. However, some treatments can help significantly reduce the discomfort and itching that many people experience with piles. Lifestyle changes Woman standing on weighing scales. Diet and body weight may affect the risk of developing piles. Eating a high fiber diet and managing weight may help to prevent and treat the condition. A doctor will initially recommend some lifestyle changes to manage piles. Diet: Piles can occur due to straining during bowel movements. Excessive straining is the result of constipation. A change in diet can help keep the stools regular and soft. This involves eating more fiber, such as fruit and vegetables, or primarily eating bran-based breakfast cereals. A doctor may also advise the person with piles to increase their water consumption. It is best to avoid caffeine. Body weight: Losing weight may help reduce the incidence and severity of piles. To prevent piles, doctors also advise exercising and avoiding straining to pass stools. Exercising is one of the main therapies for piles. Medications Several medicinal options are available to make symptoms more manageable for an individual with piles. Over-the-counter (OTC) medications: These are available over-the counter or online. Medications include painkillers, ointments, creams, and pads, and can help soothe redness and swelling around the anus. OTC remedies do not cure piles but can help the symptoms. Do not use them for more than 7 days in a row, as they can cause further irritation of the area and thinning of the skin. Do not use two or more medications at the same time unless advised to by a medical professional. Corticosteroids: These can reduce inflammation and pain. Laxatives: The doctor may prescribe laxatives if a person with piles suffers from constipation. These can help the person pass stools more easily and reduce pressure on the lower colon. Surgical options Around 1 in 10 people with piles will end up needing surgery. Banding: The doctor places an elastic band around the base of the pile, cutting off its blood supply. After a few days, the hemorrhoid falls off. This is effective for treating all hemorrhoids of less than grade IV status. Sclerotherapy: Medicine is injected to make the hemorrhoid shrink. The hemorrhoid eventually shrivels up. This is effective for grade II and III hemorrhoids and is an alternative to banding. Infrared coagulation: Also referred to as infrared light coagulation, a device is used to burn the hemorrhoid tissue. This technique is used to treat grade I and II hemorrhoids. Hemorrhoidectomy: The excess tissue that is causing the bleeding is surgically removed. This can be done in various ways and may involve a combination of a local anesthetic and sedation, a spinal anesthetic, or a general anesthetic. This type of surgery is the most effective for completely removing piles, but there is a risk of complications, including difficulties with passing stools, as well as urinary tract infections. Hemorrhoid stapling: Blood flow is blocked to the hemorrhoid tissue. This procedure is usually less painful than hemorrhoidectomy. However, this procedure can lead to an increased risk of hemorrhoid recurrence and rectal prolapse, in which part of the rectum pushes out of the anus. Outlook While they can be painful and debilitating, piles do not usually pose any ongoing threat to health and can be self-managed up to grades III or IV. If a complication develops, such as a fistula, this can become serious. Homoeopathic Remedy Options Aesculus hippocastanum. When this remedy is needed, hemorrhoids are sore and aching, with a swollen feeling. ... Aloe. ... Graphites. ... Nux vomica. ... Pulsatilla. ... Sulphur. ... Arnica montana. ... Calcarea fluorica. Others can also be on the basis of totality of symptoms.Dr. Rajesh Gupta8 Likes9 Answers
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A 28yrs old female pt having lesson like this in anal canal , associated with pain while passing stools and difficulty in siting, also complaint of constipation since 10days ..plz dx and rx ,Dr. Md Ansari6 Likes25 Answers
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32 year old female is brought in by her family with several months history of anal pain, pruritus and difficulty passing stool. Comorbid HIV infection receiving treatment. What would your concerns be? Treatment options?Dr. Arun Bali6 Likes24 Answers
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Goldenseal: A Natural Antibiotic & Cancer Fighter Goldenseal is one of the five top-selling herbal products in the U.S. Native Americans historically used goldenseal for various health concerns including skin diseases, ulcer symptoms and gonorrhea. Today’s traditional uses of goldenseal have broadened to include the natural treatment and prevention of colds , respiratory tract infections, allergies , eye infections, digestive issues, canker sores, vaginitis, urinary tract infections and even cancer. Goldenseal contains berberine , which has been been proven to be antimicrobial , anti-tumor , anti-inflammatory and blood glucose–lowering . Goldenseal has also gained popularity after a rumor spread that taking the herb can help block a positive test for illegal drugs. However, there is no scientific evidence that has proven this rumor to be correct. Yet fortunately there is research to support the medicinal use of goldenseal. What Is Goldenseal? Goldenseal ( Hydrastis canadensis), also known as orange root, yellow root or yellow puccoon, is a perennial herb belonging to the buttercup family, Ranunculaceae . It is a low, sprawling plant native to the rich, shady soil of the deciduous forests of North America growing from southern Quebec to northern Georgia and west to Missouri. Due to overharvesting, goldenseal is now mostly commercially grown on farms in the U.S. Goldenseal plants have hairy stems with jagged five to seven lobed leaves and small white flowers that turn into raspberry-like red berries. The bitter tasting roots of the goldenseal plant are bright yellow or brown, twisted and wrinkled. The dried underground stems (rhizomes) and roots of the goldenseal plant are used to make teas, liquid extracts, tablets, and capsules as well as natural skin care products. Goldenseal’s potent properties are primarily due to the alkaloids berberine , canadine and hydrastine. These phytochemical alkaloids produce a powerful astringent effect on mucous membranes, reduce disease-causing inflammation and have antiseptic effects. 5 Health Benefits of Goldenseal 1. Improves Digestive Issues Goldenseal is an excellent digestive aid since it is very bitter, which stimulates the appetite, aids digestion and encourages bile secretion. Goldenseal contains berberine, which has been used in Traditional Chinese Medicine (TCM) and Ayurvedic medicine for thousands of years to treat dysentery and infectious diarrhea. This is not surprising since the berberine in goldenseal has shown antimicrobial activity against certain pathogens that cause bacterial diarrhea, including E. coli and V. cholera . Goldenseal can also be helpful to people experiencing small intestine bacterial overgrowth (SIBO) symptoms . Current conventional treatment of SIBO is limited to oral antibiotics with inconsistent success. The objective of a study published by Global Advances in Health and Medicine was to determine the remission rate of SIBO using an antibiotic versus an herbal remedy. It found that the herbal treatment, which included berberine, worked just as well as antibiotic treatment and was equally safe. Some people also use goldenseal for stomach swelling (gastritis), peptic ulcers, ulcerative colitis , diarrhea, constipation, hemorrhoids and intestinal gas. Another impressive study found that among several herbs tested in vitro, goldenseal extract was the most active in inhibiting the growth of H. pylori, a type of bacteria which can lead to gastritis, ulcers and even stomach cancer. Goldenseal truly treats a wide range of problems when it comes to the gastrointestinal system. 2. Natural Antibiotic & Immune System Booster Goldenseal is often found in herbal remedies for allergies, colds, and the flu because of its natural antibiotic and immune-boosting capabilities. One study found that goldenseal might help boost white blood cells, which is a measure of the infection-fighting ability of the immune system. Scientific research also suggests that medicinal plants like goldenseal and echinacea may enhance immune function by increasing antigen-specific antibody production. A product containing goldenseal and echinacea is an awesome natural bronchitis remedy . Additionally, research at the University of Texas-Houston Medical School has shown goldenseal’s medicinal effectiveness as an immune stimulant may be due to its ability to reduce the pro-inflammatory response, which indirectly leads to the limiting of clinical symptoms during infection. Goldenseal is also recommended to treat urinary tract infections (UTIs) , which are caused by bacterial overgrowth in the bladder’s interior walls. The berberine in goldenseal actually prevents the E. coli from binding to urinary tract walls. 3. Fights Cancer According to Memorial Sloan Kettering Cancer Center , the berberine in goldenseal has been found to induces cell cycle arrest and apoptosis (programmed cell death) in cancer cells in multiple studies . One in vitro study found that berberine inhibited the growth of breast cancer cells to a greater extent than doxorubicin (a chemotherapy drug). In another study, berberine alkaloids produced an average of 91% tumor inhibition against 6 malignant brain tumor cell lines both in vivo in mice and in vitro against human brain tumors. Berberine alkaloids were also shown to have potent cancer cell killing activity against tumor cells. Research has also been performed on a series of human malignant brain tumor cells and rat brain tumor cells in which berberine was used alone at a dose of 150 mcg/ml and had an average cancer cell kill rate of 91% . In contrast, the chemotherapy drug carmustine had a cell kill rate of only 43%. The rats treated with berberine at 10 mg/kg had an 81% kill rate. Research will continue, but so far goldenseal is being shown to hold some serious anti-cancer abilities. 4. Aids Eye & Mouth Problems Goldenseal is also commonly used as a mouthwash for sore throats, gum complaints, and canker sores (small ulcers in the mouth). For any of these concerns, goldenseal mouth rinse can help by reducing inflammation and getting rid of any nasty bacteria. You can purchase a mouthwash that already contains goldenseal or you can easily make some goldenseal mouthwash at home. Simply make a cup of goldenseal tea and let it cool down before using it to rinse your mouth. Or you can add five drops of liquid goldenseal extract to eight ounces of warm water with a teaspoon of salt and mix well. Goldenseal has been utilized as an eyewash for eye inflammation and eye infections like conjunctivitis or “pink eye.” Since the use of goldenseal in the eyes is somewhat controversial, consult a health practitioner before using goldenseal in this way. 5. Boosts Heart Health The cardiovascular effects of the berberine found in goldenseal suggest its possible clinical usefulness in the treatment of arrhythmias and/or heart failure . For this reason, goldenseal is believed to possibly be helpful for chronic congestive heart failure (CHF) and heart function in general. A 2006 study demonstrated that the root extract of goldenseal is highly effective in regulation of the liver’s LDL (“bad cholesterol) receptors and in reducing plasma cholesterol. Overall, the findings identified goldenseal as a natural LDL-lowering agent . In combination with a healthy diet and lifestyle, goldenseal can help to lower cholesterol naturally . Berberine also helps heart health by helping to keep blood sugar levels under control and obesity in check, both of which can raise the risk of coronary heart disease . Berberine also stimulates the release of nitric oxide, a signaling molecule that relaxes the arteries, increases blood flow, reduces blood pressure and protects against arteriosclerosis. Goldenseal History & Interesting Facts Goldenseal gets its name from the golden-yellow scars that form on the base of the stem when it is broken. The scars resemble a gold wax letter seal hence the name goldenseal. It has been said that the powers of goldenseal were first introduced to European settlers by Native Americans, who harvested its rhizomes and roots to treat a variety of health complaints including eye, skin and digestive issues. Native Americans also mixed goldenseal with bear grease for use as an insect repellent and they used the color-rich roots to dye clothing. Goldenseal has become one of the top selling herbs of North America. In Canada, there are currently around 40 over-the-counter drugs containing goldenseal or its active ingredients in the form of elixirs, tablets, capsules, or suppositories. Health products combining goldenseal and echinacea are very common and are created with immune system enhancement in mind. Despite rumors, goldenseal will not cause a false-negative result for marijuana, cocaine, amphetamines, or any other illegal drugs. The idea of using goldenseal to alter drug test results came from the novel Stringtown on the Pike , by the pharmacist John Uri Lloyd. However, in this book, goldenseal caused a false-positive for strychnine (a poison), not illegal drugs, in a murder case. Possible Side Effects of Goldenseal Goldenseal is considered safe for short-term use in adults at recommended dosages. Rare side effects may include nausea and/or vomiting. Discontinue use of goldenseal if any negative reactions like these occur. Goldenseal is not meant for long-term use. If you are currently taking any prescription or over-the-counter medications or have any health issues, check with your doctor before taking goldenseal. People with high blood pressure, liver disease, or heart disease should consult their healthcare provider before taking goldenseal. Goldenseal is not suggested for use in children or infants. Pregnant or breastfeeding women should also avoid using goldenseal. Recommended Use of Goldenseal Goldenseal can easily be found in tea or supplement form at your local health store or online. Depending on which goldenseal product you purchase, make sure to read the label for each brand’s recommended dosage. For powdered goldenseal root and rhizome, 4–6 grams per day in tablet or capsule form is sometimes recommended. For liquid herbal extracts, a typical recommended dosage is 2 milliliters (40 drops) in 2 ounces of water or juice 3-5 times per day. Continuous use of goldenseal should not exceed three weeks, with a break of at least two weeks between each use. You can also talk to your health practitioner about what amount of goldenseal would be best for you and your particular health concern(s). Goldenseal is best taken internally between meals. For external use of goldenseal, there is no standard recommended dosage, but read the label of the topical goldenseal product for instructions. Most likely, it will recommend that you use the product on the area of concern at least once a day.Dr. Tapan Kumar Sau12 Likes14 Answers