Ankle ap and foot oblique xrays needed Otherwise check the following for pain and tenderness Both malleoli Base of 5th metatarsal Anterior talofibular ligament Deltoid ligament Anterior inferior tibiofibular ligament If nothing, give below knee pop for three weeks and check xray after that Serious soft tissue injury heal faster with immobilisation
Ligament. Tearing..?? Edema... Swelling.. ADVISABLE... 1. Avoid. pressure. on. Heel 2. Apply. Pad. over. Heel 3. Antibiotics.. 4. Serratiopeptidase + Aceclofenac...+ P C M 5. ZEVIT.. 6. Splintage..
Type of trauma¿ where is swelling and tenderness.How is ankle movements.Then comes role of X rays. No bony injury seen.Tt can not be advised hypothetically.
No bony injury detected. ?Ligament tear.
Soft tissue injury
Well lateral view looks good and foot is also fine. Ankle ap with internal rotation gives better idea.
Suspected fracture base of 5th metatarsal
Sprain and strain. If very painful rest to the part ,analgesics. Or immobilize
Xray Lt Ankle Jt : NBI. Suspected Ankle Sprain--Tt by immobilization & NSAIDs.
Scan is normal sesamoid bones are seen
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Friends today I am discusing about Piles (Hemorrhoids) . Homeopathic medicine for piles Piles or hemorrhoids refer to swollen, dilated, engorged veins in and around the anus. In this condition, the veins around the anus or lower rectum become swollen and inflamed. Hemorrhoids are a problem in both men and women. Homeopathy medicine for piles is prescribed according to individual symptoms to treat the condition on a long-term basis. The leading causes of piles include a sedentary lifestyle, prolonged sitting, chronic constipation, chronic diarrhea, low fiber content in the diet, excessive use of alcohol, obesity and increased straining during defecation. Pregnancy and genetics also play an essential role in the development of piles. The top homeopathic medicines for piles are Aloe Socotrina, Muriatic Acid, Ratanhia Peruviana, Hamamelis and Collinsonia Canadensis. Why Choose Homeopathy for Treatment of Piles? Conventional treatment for piles involves the use of medicines that make the condition more manageable but do not help treat it. These medicines offer temporary relief from the symptoms, and continuous use is often necessary. Over-the-counter (OTC) medications for piles include ointments, pads, creams and, painkillers. In case of grade 4 piles (or hemorrhoids) cases, surgery is the only option given to most people. Homeopathy offers comprehensive treatment options that help treat the condition and ease the symptoms of piles. Some significant benefits of homeopathy regarding piles/hemorrhoids treatment include: 1. No Side-Effects Homeopathy does not cause any side effects because of these are made of natural substances that are highly diluted. Over-the-counter remedies for piles only help relieve the symptoms, and certain side-effects come with their usage. For example, creams containing corticosteroids are recommended for reducing pain and inflammation for piles, but prolonged usage of these cause skin reactions, increased sweating and growth of body hair, inflammation of hair follicles and increased vulnerability to infections. 2. Natural Remedies to Treat Piles As an ancient 200-year-old medical science, homeopathy uses cures found in nature that help restore the natural healing processes of the body. Homeopathy treatment for piles involves a comprehensive treatment plan that works in harmony with the system. In conventional treatment, use of stimulant laxatives to relieve constipation as a result of piles may cause side effects like abdominal cramps, bloating, rectal irritation, weakness and, pain. 3. Holistic Approach to Treat Piles Homeopathy aims to treat the problem internally, by understanding the cause of different symptoms instead of suppressing them. OTC drugs, ointments and other symptom-relieving options only provide temporary relief. Out of ten people, at least one person is recommended for a piles-related surgery. This invasive treatment has a host of complications, like difficulty passing stools and urinary tract infections post-surgery. Surgeries like hemorrhoid stapling may cause complications like rectal prolapse (part of the rectum pushes out of the anus) and hemorrhoid recurrence. 4. 4. Individual Treatment Homeopathy works by analyzing the individual symptoms of the disease in a person. There is no blanket treatment provided for a particular illness since every individual is treated according to their specific symptoms. For example, for a person dealing with piles with painful defecation, the medicine Muriatic Acid is prescribed. In case a person suffering from piles complains of bleeding along with stools, the medicine Hamamelis Virginiana is prescribed. 5. Simple and Effective A single dose of the correct medicine can help relieve the symptoms and also treat piles to a large degree. By restoring the internal processes of the body, these medications help address the condition naturally and effectively. Invasive procedures like surgery can be held-off with the help of homeopathy. 6. These are Safe Medicines for piles treat the problem by reducing the engorgement of blood in the rectal veins as well as improving blood circulation. Unlike conventional drugs for piles that are usually not recommended to be taken for more than seven days in a row, these medicines are taken in small doses over a continuous period. This helps improve the efficacy of the natural substances in the medicines, which in turn thereby helping reduce the severity of the symptoms and treats the problem on a long-term basis. Homeopathic Medicines for Piles Depending on the grade, severity, and symptoms of piles, different medicines are recommended to decrease the severity of the symptoms and treat the condition on a long-term basis. 1. For External Piles Aloe Socotrina is a medicine used to treat for external piles that are sore and tender. Sharp or burning pain in the rectum and a constant feeling of bearing down in the rectum may be felt. Application of a cold compress may help relieve the pain or burning sensation. This medicine is also used to treat anal fistulas. 2. For Painful/Protruding Piles Muriatic Acid is a medicine used to treat conditions of piles that are intensely painful, sore and protrude outside the anus. The hemorrhoids are very swollen and look bluish. The pain may get worse while passing stools. Stitching pain that gets worse on touch is present, and it gets better from warm-washing. This medicine is also used to treat cases where the soreness in the hemorrhoids worsens during menses in females. 3. For Piles with Burning Sensation Ratanhia Peruviana is a medicine used to treat piles where a burning sensation after defecation is present in the rectum. The person may have to strain to pass stool. Knife-like stitching pains in the anus or the feeling of a sharp splinter of glass in the rectum may be present. 4. For Piles with Bleeding Hamamelis Virginiana is a medicine used to treat piles with profuse bleeding. Weakness due to bleeding, soreness at the anus, hard stool and anal-itching are other symptoms that indicate the need for this medicine. 5. For Piles with Constipation Collinsonia Canadensis is a medicine used to treat piles accompanied by constipation. The stool in such cases is lumpy, dry and is passed with a lot of strain. Other symptoms include aching and burning at the anus, a sensation of sharp sticks in the rectum, anal-itching and a constricted sensation in the anus. 6. For Piles with Shooting Pain Aesculus Hippocastanum is a medicine used to treat piles with sharp, shooting pains where the stools are knotty, dry and hard. This medicine is used to treat external, blind and bleeding piles. 7. For Blind Piles Nux Vomica is a medicine used to treat blind piles where there is pronounced burning and itching around the anus. A constant desire to pass stools may be there, but constipation and passing of scanty stool is the main symptom. Pulsatilla Nigricans is a medicine used to treat blind piles with a cutting, sticking or burning pain. The pain gets worse during lying down. Itching in piles and constipation with a backache and pressure in the rectum is another symptom. 8. For Piles caused by Childbirth Sepia Succus is the medicine used to treat piles that develop after the delivery of a child. It is also used in cases of constipation where the stools are very hard. Kali Carb is a medicine used to treat piles in females that develop post childbirth. The piles are extremely tender to touch. There may be stitching, smarting, pricking and tingling sensation at the anus along with sharp pain. Constipation lasting for days along with hard stool, and white mucus after bleeding from piles may also be present. 9. For Piles and Anal Fistula Silicea is a medicine used to treat piles and anal fistula. The piles tend to protrude during the passage of stool. The stool is hard and tends to recede into rectum several times during defecation. Burning in anus after passing hard stools, and a foul-smelling discharge of pus or serum from the anal fistula may also be present. 10. For piles with Chronic Diarrhea Merc Sol is a medicine used to treat piles in people suffering from diarrhea. There is an urge to pass stool, more frequently during the night. The stools in most cases smell sour and are undigested bits of food. Burning at the anus while passing stools, protrusion of piles during defecation, exhaustion, and chilliness with shivering and a feeling of nausea is also present. 11. For Piles Protruding during Urination Baryta Carb is a medicine used to treat piles which protrude during urination. Other symptoms that indicate the need for this medicine include an urgent need to pass stools, and an itching, burning, soreness and shooting pain in piles. 12. For Piles Protruding during Cough/Sneeze Lachesis Muta is a medicine used to treat piles that protrude during a cough or sneeze. In most cases, a stitching pain and a throbbing sensation in the piles is present. Piles in females during menopause are also treated with this medicine. 13. For Piles during Pregnancy Sepia Succus is a medicine used to treat piles that develop during pregnancy in females. The piles may be bleeding or non-bleeding, and a protrusion of piles during stool occurs. Itching at the anus and rectum, constipation and the presence of hard and large stools also indicate the need for this medicine. 14. For Piles during Menses Ammonium Carb is a medicine used to treat piles that get worse during the menses in a female. The piles tend to bleed during menses, and the affected person feels better upon lying down. 15. For Piles with Rectal Prolapse Lycopodium Clavatum is a medicine used to treat piles in cases where there is a rectal prolapse. The piles may be swollen and painful, and the pain gets worse upon touching and sitting. Chronic constipation with a scanty stool, painful constriction at the anus and excessive flatulence and bloating in the abdomen may also be present. 16. For Internal Piles Phosphorus is a medicine used to treat internal piles where there is bleeding during stool. Excessive exhaustion, an urgent need to empty bowels and rectal tenesmus (desire to evacuate the bowels) are some other symptoms. 17. For Large, Swollen Piles Causticum is a medicine used to treat large, swollen piles that hinder the passage of stool from the anus. The person needs to pass stool by straining hard in a standing position. The piles are hard, painful and constant and get worse upon sitting, standing and walking. There may be a pressing and sticking pain in the anus along with a burning, stinging sensation. 18. For Piles and Anal Fissure Nitricum Acidum is a medicine used to treat piles and anal fissure when there are tearing pains in the anus while passing stools. The stool can be hard or soft but is passed with difficulty and may also bleed. There may be splinter-like pains in the anus. 19. For Itching Piles Sulphur is a medicine used to treat piles when there is a soreness and tenderness at the anus along with a hard, knotty stool. Weakness after passing stool, excessive rectal pain, and a biting sensation at the anus that gets better upon lying down are some other symptoms that indicate the need for this medicine. 20. For Piles with Pain after Stool Sedum Acre is a medicine used to treat painful piles that feel worse after a few hours of passing stool. In a majority of cases, the pain is constricting. Sedum Acre is also useful for treatment of anal fissure with pain that worsens a few hours after passing stool. For Piles that get Worse during Sitting Graphites Naturalis is a medicine used to treat painful piles that get worse during sitting. Cutting pains and swelling with cracks at the anus are present. The stool tends to be hard, knotty and scanty. The Different Types of Piles Piles are of different types, classified according to their location and whether they bleed or not. External piles, internal piles, protruding/prolapsed piles and blind piles are the most common types. External piles are present on the skin around the anus and can be seen or felt from the outside. The main symptoms of external piles include painful swelling and hard lumps around the anus. If these hemorrhoids get irritated, they may cause itching or bleeding. Internal piles lie deep inside the rectum and cannot be felt or seen from the outside. They are mostly painless since there are no pain receptors in the region where they tend to appear. The only symptom of internal piles is bleeding through the anus while straining during a motion of the stools. Protruding or prolapsed piles are hemorrhoids that get pushed out towards the anus when a strain is applied to pass stools. They look like pink, moist pads of skin. Prolapsed or protruding hemorrhoids tend to hurt since the anus area is dense with pain-sensitive nerves. The typical symptoms of hemorrhoids are mucus discharge, itching, and pain. Blind Piles are those hemorrhoids that do not bleed. They feel like protruding masses, usually detectable after passing stools, at the opening of the anus. The Different Grades of Piles according to Severity Piles can also be classified into grades, according to their severity. Grade 1 piles are small inflammations that are usually found inside the lining of the anus and are not visible. Grade 2 piles are larger than the grade 1 piles, but they too remain inside the anus. These protrude outside the anus while passing stools and go back into the rectum after defecation. Grade 3 piles protrude during defecation and need to be manually pushed back inside the anus. Grade 4 piles are a severe case. These cannot be pushed back inside and need immediate medical attention. Causes and Risk Factors of Piles Primarily, the swollen veins that are seen in piles develop due to increased pressure in the rectum. This pressure may cause disintegration of the tissues supporting the anal walls, leading to hemorrhoids. Various factors contribute to causing this kind of pressure: Irregular Bowel Movements Factors like constipation, straining to pass stools, overuse of edemas or laxatives, chronic diarrhea, spending too much time on the toilet add to the strain on the rectum and anus, leading to the development of piles. Diet Lack of a fiber-rich diet, low water intake, excessive intake of alcohol, consumption of over-spicy food and junk food also contribute towards this condition. Pregnancy There is increased pressure on the abdomen and pelvic area during pregnancy, which is a leading cause of piles during pregnancy. In some cases, hemorrhoids develop as a result of childbirth due to the excessive pressure on the rectum and anus. Age and Heredity Other factors like age and heredity can contribute towards the development of piles due to the weakening of the tissues supporting the rectum and anus. Portal Hypertension Portal hypertension refers to a condition where there is an increase in the blood pressure within the veins of the portal venous system. The veins coming from the spleen, stomach, pancreas, and intestines merge into the portal vein, which travels through the liver. In case of any complication due to which blood cannot flow properly through the liver, a high pressure develops in the portal system. This pressure can cause the development of large, swollen veins in the stomach, esophagus, and rectum. As a result, hemorrhoids may develop in the anal area. Symptoms of Piles Pain in the rectal region is one of the first signs of piles. Pain experienced while passing stools, painful lumps in or around the anal area, swelling and blood in the stools are the most common symptoms of piles. A small mass of skin may protrude out of the anus upon defecation. The area around the anus may feel sore, red and itchy. In some cases, a feeling of fullness may remain, despite having passed stools. Larger piles can cause discomfort in the form of pain, itching, and mucus discharge. All these symptoms need a clinical diagnosis to rule out the presence of any other rectal problems. A visual rectal examination, anoscopy, and colonoscopy may be required. Piles or hemorrhoids can sometimes lead to further complication escalate into a more severe condition. These include excessive anal bleeding that may lead to anemia, incontinence, anal fistulas, and infections or clots within the hemorrhoids. Q. I am passing blood with stools, is it indicative of piles? Bleeding with stool is one of the primary symptoms of piles. However, blood in the stool may appear from many other conditions like anal fissures and severe conditions like ulcerative colitis or any malignancy of the GIT. Further investigation by a physician may be required to determine the exact cause of bleeding. Q. Is anal itching indicative of piles? While anal itching is one of the symptoms of piles, it may also be present due to other conditions like worm infestation, anal fissures, anal fistula or a skin complaint around the anal area. Other symptoms like painful defecation, bleeding with stools, burning/soreness at the anus or swelling are also indicative of piles. A physical examination of the anal region may be required to pinpoint the exact problem. Q. If I feel a mass protruding out of the rectum while passing stools, is it piles? A mass protruding from rectum while passing stools can be indicative of two conditions – piles and rectal prolapse. A rectal examination is required to know the exact cause. Q. I have piles with excessive swelling around the anus and painful defecation. Will applying ointments solve my problem? Ointments may help in temporarily reducing the discomfort and soothe the symptoms of piles. To cure piles, a proper treatment that helps reduce the engorgement of the rectal veins and ensures adequate blood circulation in the veins is required. Q. I am suffering from piles with constipation; can I take a laxative? A laxative is a short-term solution for the management of constipation, but proper treatment is required for long-term treatment to improve the bowel motility and reduce engorgement of blood in the rectal veins. Q. Can I avoid piles surgery with the help of medicines? Yes, natural medicines work to stimulate the internal healing processes of the body, and with long-term use, they can help manage piles without surgery. It should be noted that the results vary from case to case, depending upon the severity of the problem. Q. For how long do I need to take medicines to treat piles? The length of treatment for piles depends upon the duration of the symptoms, their intensity, and how quickly a person responds to personalized medicines. The treatment period can range from a few weeks to a few months. Q. Is surgery a permanent solution for piles or do piles recur after surgery? Surgery for piles is not a permanent solution since in most cases, chances of recurrence are high. It does not treat the cause behind piles. For a permanent solution, the cause of increased rectal pressure and poor blood circulation in the rectal veins needs to be identified and treated. Managing Piles in Everyday Life Foods that Help Treat Piles High-fiber foods like figs, flaxseeds, quinoa, beans, lentils and fresh fruits and vegetables help keep the system healthy and aid in maintaining proper bowel movements. Fresh plant-based food eaten with the skin intact provides a decent amount of fiber. Some also contain a lot of water; watermelons, celery, and cucumbers are made up of almost 90% water. The aim is to ensure that the stools do not become hard and constipation is avoided. Clinical research shows that in case of non-prolapsing hemorrhoids, taking a fiber supplement helped reduce the risk of persisting symptoms and bleeding by almost 50%. Foods to Avoid During Piles Foods with little or no fiber can cause constipation, or worsen the condition, indirectly leading to hemorrhoids. Foods like milk, cheese, and other dairy products should be avoided, as should meat, processed and frozen food. Alcohol, caffeine, excessive salt and spicy food can also worsen the condition. Certain supplements like Iron can lead to digestive problems and should only be taken on the recommendation of a doctor. Staying Hydrated to Prevent Dehydration Dehydration leads to constipation because water is required for the fiber to be able to travel smoothly through the digestive tract. Dehydration and constipation can worsen the symptoms of hemorrhoids. Eating water-based fruits and ensuring an adequate amount of water intake are simple measures to prevent dehydration. homeopathic piles exercisePracticing Healthy Toilet Habits It is essential to understand that the toilet habits practiced on an everyday basis are directly linked to piles. Over-straining during defecation can increase the pressure on the hemorrhoids and worsen the condition. An urge to pass stool should not be ignored, since delaying it can cause the stool to harden. Regular physical activity, consumption of adequate amounts of water and fiber and healthy toilet habits can help prevent constipation naturally, and stop the hemorrhoids from getting worse. For those who like to sit and browse their phone on the toilet – prolonged sitting on the toilet causes unnecessary strain on the body and can make the condition worse. It is important to clean up properly after defecation to prevent infections and worsening of the condition. Cleaning should be done gently, not roughly. A warm bath where the person sits in warm water for 10-15 minutes can help relieve itching, burning and aching, while also cleaning the area. Apart from these, factors like obesity and chronic digestive issues also play an important role. Simple lifestyle modifications can help a lot, and regular exercise is key in weight management and maintaining a healthy bowel movement. A holistic approach towards piles can help manage and treat the condition naturally. A physician can identify the underlying causes of the symptoms of piles and help a person transition into natural, safe treatment options with adequate lifestyle changes to treat the problem.Dr. Rajesh Gupta20 Likes17 Answers
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Dear doctors Female patient with k/c/o delayed cycles with slight duscomfort in lower abdomen since 6months. The flow also has reduced. Before this her cycles were regular and she has a child of 4 years. no H/O any other systemic problem. H/o ectopic pregnency got aborted 2 years back. Is it a case of PCOD or infection please share your views Dx and Rx gave her Varunadi quatha Kanchanara guggulu Chitrakadi vati AshokaristaDr. Savitha Nagendra4 Likes11 Answers
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Friends today I am discussing about female problem Uterine fibroids. Uterine fibroids are non-cancerous tumors that grow from the muscle layers of the womb. These benign growths of smooth muscle can vary from the size of a bean to being as large as a melon. They are also known as leiomyomas and myomas. Fibroids affect around 30 percent of all women by the age of 35 years, and from 20 to 80 percent by the age of 50 years. They usually develop between the ages of 16 to 50 years. These are the reproductive years during which estrogen levels are higher. Fast facts on fibroids: Here are some key points about fibroids. More information is in the main article. Fibroids are most common during the reproductive years. It is unclear exactly why they form, but they appear to develop when estrogen levels are higher. Most people experience no symptoms, but they can include lower backache, constipation, and excessive or painful uterine bleeding leading to anemia. Complications are rare, but they can be serious. Types Fibroids Fibroids are non-cancerous tumors that appear in the tissues around the womb. There are four types of fibroid: Intramural: This is the most common type. An intramural fibroid is embedded in the muscular wall of the womb. Subserosal fibroids: These extend beyond the wall of the womb and grow within the surrounding outer uterine tissue layer. They can develop into pedunculated fibroids, where the fibroid has a stalk and can become quite large. Submucosal fibroids: This type can push into the cavity of the womb. It is usually found in the muscle beneath the inner lining of the wall. Cervical fibroids: Cervical fibroids take root in the neck of the womb, known as the cervix. The classification of a fibroid depends on its location in the womb. Symptoms Around 1 in 3 women with fibroids will experience symptoms. These may include: heavy, painful periods, also known as menorrhagia anemia from heavy periods lower backache or leg pain constipation discomfort in the lower abdomen, especially in the case of large fibroids frequent urination pain during intercourse, known as dyspareunia Other possible symptoms include: labor problems pregnancy problems fertility problems repeated miscarriages If fibroids are large, there may also be weight gain and swelling in the lower abdomen. Once a fibroid develops, it can continue to grow until menopause. As estrogen levels fall after menopause, the fibroid will usually shrink. Causes It remains unclear exactly what causes fibroids. They may be related to estrogen levels. During the reproductive years, estrogen and progesterone levels are higher. When estrogen levels are high, especially during pregnancy, fibroids tend to swell. They are also more likely to develop when a woman is taking birth control pills that contain estrogen. Low estrogen levels can cause fibroids may shrink, such during and after menopause. Genetic factors are thought to impact the development of fibroids. Having a close relative with fibroids increases the chance of developing them. There is also evidence that red meat, alcohol, and caffeine could increase the risk of fibroids, and that an increased intake of fruit and vegetables might reduce it. Being overweight or obese increases the risk of fibroids. Childbearing lowers the risk of developing fibroids. The risk reduces each time a woman gives birth. Diagnosis As fibroids often do not show symptoms, they are usually diagnosed during routine pelvic examinations. The following diagnostic tests can detect fibroids and rule out other conditions: A doctor can create ultrasound images by scanning over the abdomen or by inserting a small ultrasound probe into the vagina. Both approaches may be needed. An MRI can determine the size and quantity of fibroids. A hysteroscopy uses a small device with a camera attached to the end to examine the inside of the womb. The device is inserted through the vagina and into the womb through the cervix. If necessary, the doctor can take a biopsy at the same time to identify potentially cancerous cells in the area. A laparoscopy may also be performed. In a laparoscopy, the doctor makes a small opening in the skin of the abdomen and inserts a small tube with a lighted camera attached through the layers of abdominal wall. The camera reaches into the abdominopelvic cavity to examine the outside of the womb and its surrounding structures. If necessary, a biopsy can be taken from the outer layer of the womb. Treatment Birth control medication an be used to shrink fibroids. Birth control medication can be used to shrink fibroids. Treatment is only recommended for those women experiencing symptoms as a result of fibroids. If the fibroids are not affecting quality of life, treatment may not be necessary. Fibroids can lead to heavy periods, but if these do not cause major problems, one may choose not to have treatment. During menopause, fibroids often shrink, and symptoms often become less apparent or even resolve completely. When treatment is necessary, it can take the form of medication or surgery. The location of the fibroids, the severity of symptoms, and any future childbearing plans can all affect the decision. Medication The first line of treatment for fibroids is medication. A drug known as a gonadotropin-releasing hormone agonist (GnRHa) causes the body to produce less estrogen and progesterone. This shrinks fibroids. GnRHa stops the menstrual cycle without affecting fertility after the end of treatment. GnRH agonists can cause menopause-like symptoms, including hot flashes, a tendency to sweat more, vaginal dryness, and, in some cases, a higher risk of osteoporosis. They may be given before surgery to shrink the fibroids. GnRH agonists are for short-term use only. Other drugs may be used, but they may be less effective when treating larger fibroids. These include: Non-steroidal anti-inflammatory drugs (NSAIDs): These include mefenamic and ibuprofen, which is available to buy online. Anti-inflammatory medications reduce the production of hormone-like lipid compounds called prostaglandins. Prostaglandins are associated with crampy periods, and they are thought to be associated with heavy menstrual periods. For those with fibroids, an NSAID may be effective at reducing fibroid pain, does not reduce bleeding from fibroids, and does not affect fertility. Birth control pills: Oral contraceptives help regulate the ovulation cycle, and they may help reduce the amount of pain or bleeding during periods. Levonorgestrel intrauterine system (LNG-IUS): This plastic device is placed inside the womb. It then releases a hormone called levonorgestrel over an extended timeframe. The hormone stops the inside lining of the womb from growing too fast, which reduces menstrual bleeding. Adverse effects include irregular bleeding for up to 6 months or longer, headaches, breast tenderness, and acne. In some cases, it can stop periods. Surgery Severe fibroids may not respond to more conservative treatment options, and surgery may be necessary. The treating doctor may consider the following procedures: Hysterectomy: A hysterectomy is the partial or total removal of the womb. This is considered for treating extremely large fibroids or excessive bleeding. A total hysterectomy can prevent the return of fibroids. If a surgeon also removes the ovaries and fallopian tubes, side effects can include reduced libido and early menopause. Myomectomy: This is the removal of fibroids from the muscular wall of the womb. It can help women who still want to have children. Women with large fibroids, or fibroids located in particular parts of the womb, may not benefit from this surgery. Endometrial ablation: Removing the lining inside of the womb may help if fibroids are near the inner surface of the womb. Endometrial ablation may be an effective alternative to a hysterectomy for some women with fibroids. Uterine artery embolization (UAE), more specifically uterine fibroid embolization (UFE): Cutting off the blood supply to the area shrinks the fibroid. Guided by fluoroscopic X-ray imaging, a chemical is injected through a catheter into the arteries supplying blood to any fibroids. This procedure reduces or removes symptoms in up to 90 percent of people with fibroids but is not suitable for women who are pregnant and typically not for those who still wish to have children. MRI-guided percutaneous laser ablation: An MRI scan is used to locate the fibroids. Fine needles are then inserted through the skin and body tissues of the patient and pushed until they reach the targeted fibroids. A laser fiber device is inserted through the needles. A laser light is sent through the device to shrink the fibroids. MRI-guided focused ultrasound surgery: An MRI scan locates the fibroids, and high energy ultrasound waves are delivered to shrink them. Natural treatments There is no proven natural treatment for fibroids. However, keeping weight down through exercise and a healthful diet may help to moderate estrogen levels. Complications In severe cases, fibroids can lead to infertility Fibroids do not normally result in complications, but if they occur, they can be serious and even life-threatening. Complications may include: Menorrhagia, also called heavy periods: This can sometimes prevent a woman from functioning normally during menstruation, leading to depression, anemia, and fatigue. Abdominal pain: If fibroids are large, swelling and discomfort may occur in the lower abdomen. They may also cause constipation with painful bowel movements. Pregnancy problems: Preterm birth, labor problems, and miscarriages may occur as estrogen levels rise significantly during pregnancy. Infertility: In some cases, fibroids can make it harder for the fertilized egg to attach itself to the lining of the womb. A submucosal fibroid growing on the inside of the uterine cavity may change the shape of the womb, making conception more difficult. Leiomyosarcoma: This is a rare form of cancer that is thought by some to be able to develop inside of a fibroid in very rare cases. Other serious complications include acute thromboembolism, deep vein thrombosis (DVT), acute renal failure, and internal bleeding. Homeopathic Medicines for Uterine Fibroids Thlaspi Bursa Pastoris, Calcarea Carb, Belladonna, Sepia Officinalis, Ustilago Maydis, Sabina Officinalis, Trillium Pendulum, Kali Carbonicum, Erigeron Canadensis and China Officinalis and Ferrum Met are the top remedies used in the treatment of uterine fibroids. 1. Thlaspi Bursa Pastoris – For Uterine Fibroids with Prolonged Menses Thlaspi Bursa is one of the top grade medicines for treating uterine fibroids with prolonged menses. The menses continue for 10-15 days. Menses appear very frequently as well. The next menstrual cycle appears even before recovery from the periods has occurred. Menstrual bleeding is profuse, with the presence of large clots. Violent uterine colic during menses may also arise. Cramping pain in the uterus during menstruation in uterine fibroids cases is also suggestive of use of Thlaspi Bursa Pastoris. 2. Calcarea Carb – For Heavy Periods from Uterine Fibroids Calcarea Carb is a very useful medicine for treating heavy periods from uterine fibroids. Menses continue for long and may even appear early. Vertigo during menses may arise. Leucorrhea of thick, milky or yellow color is another complaint that may attend. 3. Belladonna and Sepia Officinalis – For Uterine Fibroids where Menses are Painful Belladonna and Sepia Officinalis are well-indicated medicines for uterine fibroids where the menses are painful. Belladonna is best prescribed where there is cramping pain in the uterus during menses, the menses are bright red in colour and profuse. Use of Sepia Officinalis is recommended in case of griping, burning or bearing down pains during menses. Menses start early and are quite copious. Fainting and chilliness during menses may attend. Sepia Officinalis is also indicated for treating painful intercourse in uterine fibroids cases. 4. Ustilago Maydis – For Uterine Fibroids with Dark Menstrual Bleeding Ustilago Maydis is a highly suitable medicine for uterine fibroids where menstrual bleeding is dark. Clots may also be present in menstrual blood. Uterine bleeding may be stringy in nature. 5. Sabina Officinalis – For Uterine Fibroids where Clots Pass with Menstrual Blood In the case of menstrual bleeding with clots in uterine fibroid cases, Sabina Officinalis is a significant medicine. The slightest motion increases menstrual bleeding. Pain from sacrum to pubis is another attending feature. During menses, pain in the uterus may be present that gets better by lying on the back. Uterine pain may extend to the thighs. Other symptoms include foul, acrid, corrosive, yellow leucorrhoea. 6. Fraxinus Americana – Excellent Homeopathic medicine for uterine fibroids with bearing down sensation Fraxinus Americana is a top grade medicine for uterine fibroids which is mostly recommended when the major indicating feature is a bearing down sensation in the pelvis from uterine fibroid. 7. Trillium Pendulum and Kali Carbonicum – For Uterine Fibroids with Back Pain during Menses In uterine fibroid cases with back pain during the menstrual cycle, Trillium Pendulum comes highly recommended. The pain may radiate to the hips from the back during menses. Tight binding of the back and hips provides relief. Menstrual bleeding is bright red and gushing. The slightest movement worsens uterine bleeding. Trillium Pendulum is also indicated for inter-menstrual bleeding every two weeks. Another attending feature is faintness from uterine bleeding. Kali Carbonicum is selected when there is violent back pain during menses. The pain gets better from sitting and pressure. The menstrual flow is also copious. 8. Erigeron Canadensis – For Frequent Urination in case of Uterine Fibroids Erigeron Canadensis is a beneficial medicine for treating frequent urination in case of uterine fibroids. In some cases, painful urination may also arise. The attending features are excessive menstrual bleeding which is bright red in colour. Erigeron Canadensis is also used for inter-menstrual bleeding from slight exertion. 9. China Officinalis and Ferrum Met – For Uterine Fibroids with Heavy Bleeding and Anaemia Both China Officinalis and Ferrum Met are effective medicines for treating uterine fibroids with heavy bleeding and anaemia. Among them, China Officinalis works best when there is profuse, dark menstrual bleeding, clots in menstrual blood, exhaustion and anaemia. Fainting spells may also arise. Ferrum Met is best used where the symptoms include pale, watery, heavy and prolonged menses leading to anaemia. Menstrual flow worsens from the slightest movement. Lower back pain or abdomen pain during menses may be observed.Dr. Rajesh Gupta8 Likes6 Answers
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A 50-year-old male known case of HTN on regular medication, presented to internal medicin clinic with 2-week history of these painful swelling&redness of right leg associated with fever. No Hx of dyspnea, and no chest pain. On Examination:_The swelling is unilateral, pitting, tenderness. Laboratory investigations:_WBC 12600, CRP positive, ESR 25mmol/hour. What's your diagnosis?Dr. Nihal Ahmad7 Likes3 Answers
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Goodmorning curofians... Here is a case for discussion. 54 year old female presented with obstipation for 3 days. pain and distension for the same duration . Hx of vomiting multiple episodes, fever. Past medical and surgical hx unremarkable. O/e vitals hemodynamically stable Afebrile No signs of dehydration No pallor, edema or LaP P/A...Tender, mildly distended, guarding present. BS sluggish Other systemic examination reveal no significant abnormality. P/R prolapsed pile mass, Anal tone increased. Greyish soft fleshy mass protruding per urethra. Foley's in situ.Dr. Nyemwang W Konyak12 Likes28 Answers