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Vesicostomy Definition, Procedure, Complications, Care, Reversal

Vesicostomy is a surgery, in which an opening is made from bladder to directly outside the body i.e. lower belly area. This opening helps in draining urine to prevent urinary tract infection UTI. It is kind of temporary treatment. Vesicostomy can be performed in infants and children under five years of age and only eligible in following conditions.


  • If child is born with bladder outlet obstruction, Vesicostomy helps to drain urine in to diaper.
  • If child is suffering from neurogenic bladder, Vesicostomy is recommended.


In adults, Vesicostomy is performed on temporary basis and is removed when infection is completely treated.


Vesicostomy Procedure


Patient have to stay overnight in hospital, and a drip line is injected to maintain fluid replacement and management of pain. A cut is made in lower belly preferably below belly button. A catheter is placed in the opening of bladder which drains urine directly in to diaper or nappy (in children). After Vesicostomy, there may be blood in urine due to cut freshly made. If Vesicostomy is performed in adults, a clear urine collection bag/ system is attached with catheter to collect urine. It is a removable plastic bag which can be removed after it fills up.

Vesicostomy Definition, Procedure, Complications, Care, Reversal

Vesicostomy Complications

         
Vesicostomy is a simple and reversible surgical operation. But it also have some unusual complications associated like:
  • Opening made in Vesicostomy may become narrow and results in poor drainage of urine. It is normal that Vesicostomy may become narrow due to natural healing process of skin.
  • Stenosis may occur due to poor drainage and then dilation or periodic catheterization is performed.
  • Bladder tissue may get prolapse due to skin opening made in Vesicostomy. Prolapse may occur due to straining (when child cries or have a bowel movement). Prolapse may extend up to 1 inch and is reversible.


Vesicostomy Care



  • Vesicostomy require special care regarding hygiene. Vesicostomy drains urine directly in to diaper and diaper should be changed regularly.
  • Poor hygiene may lead to diaper rash to skin in contact with diaper. Ointments and creams are recommended for these rashes.
  • The abdominal cut should be avoided from water contact, as excess water contact can cause infection in Vesicostomy. Patent is recommended to take complete rest and avoid walking around.
  • If any obstruction occurs in Vesicostomy, it should be replaced because obstructed Vesicostomy will lead to accumulation of urine inside bladder and cause infection.

All these steps should be followed regularly.


Vesicostomy Reversal


Vesicostomy is a temporary surgical operation which is performed when other treatment options regarding urinary tract infections get failed. It is kind of bypass surgery to drain urine directly outside body from bladder. It is performed in children below 5 years of age when they are born with any urinary tract abnormality. These children can have Vesicostomy again and again reversibly whenever they got urinary tract infection. There are many cases of children having Vesicostomy every year reversibly to avoid infections in urinary tract. Any kind of injury may lead to Vesicostomy in adults and can be repeated.
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Cervicobrachial Syndrome Definition, Symptoms, Causes, Treatment

Cervicobrachial syndrome is also known as cervicobrachalgia. In this condition there is pain and stiffness in the cervical spine region. The term cervicobrachial syndrome is not commonly used now a days but in some parts of the world. Pain and stiffness of the cervicobrachial syndrome is also associated with symptoms of shoulder girdle and upper extremity like tingling, headache, discomfort, and numbness in the arm. Pain in cervicobrachial syndrome radiates into the upper limb i.e. arm. It is a radicular pain pattern which is distributed via ventral branch of a spinal nerve. Cervical radiculopathy can be diagnosed with frank sensorimotor deficits and connected with nerve root territory.


Main reason behind cervicobrachial syndrome is cervical radiculopathy which is caused by lesions produced and effecting the c5/6 and c6/7 motion segments of vertebrae. The most effected muscles are located in the upper portion of trunk because this area is mainly supplied with cervical nerve roots. Common muscles involved in cervicobrachial syndrome are rhomboids, supraspinatus muscles, infraspinatus muscle, serratus anterior, deltoid and latissimus dorsi muscles. Cervicobrachial syndrome can also occur due to neurogenic and vascular compression in the thoracic outlet. Nerves involved are subclavian vein and subclavian artery.


Cervicobrachial Syndrome Definition, Symptoms, Causes, Treatment

Cervicobrachial syndrome Symptoms

     
Symptoms of cervicobrachial syndrome are associated with upper part of the trunk i.e. arm, chest region, neck and back. There are some of the common symptoms stated below.

  • Patient may feel numbness in shoulder and upper arm region.
  • There may be stiffness and pain which originates from neck region and extend towards arm.
  • Sometimes swelling occurs in upper trunk region.
  • Patient feel itching and pins and needle sensation in both neck and shoulder region.
  • Movement of effected limbs may initiate pain and laterally can intriguer pain in one side of head (migraine) and can cause trouble in sleeping.

Cervicobrachial syndrome Causes


Some of the main causes are described below:

Common root cause reported is traumatic injuries which may occur while playing a sport and injuries happen due to accidents.

  • Dislocated joints and fractures also lead to cervicobrachial syndrome.
  • Sprains and muscle tear are usual causes.
  • Long term stress periods and anxiety periods are considered associated causes.
  • This syndrome may be secondary to diseases related to bones and muscles like rheumatism.
  • Some degenerative diseases like arthritis are also responsible as these diseases can in time cause cervicobrachial syndrome.
  • Some infectious diseases such as tuberculosis are also responsible.


Cervicobrachial syndrome Treatment

     
Cervicobrachial syndrome involves muscles of upper portion of trunk. So, it demands a highly personalized treatment. Choice of drugs should be accurate and according to condition. Physiotherapy helps in reducing pain of muscles and enables patient to move easily around. Hot and cold therapy is also performed in which patient gets massage with hot water and with hot bags. Sometimes alcohol and rosemary oil massage also helps a lot. Bed rest is recommended along with proper posture. Patient is asked to lie down and rest on his back and rest the effected arm experiencing pain on back side.
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Sensory ataxia Symptoms, Causes, Test, Treatment

Ataxia is a term means dis-coordination and the term sensory ataxia means dis-coordination in senses. This coordination is not caused due to dysfunction of cerebral region but it occurs when there is problem in sensory input towards control center of movement. Sensory ataxia is a different condition from cerebellar ataxia. As in sensory ataxia, normal coordination of nearside is present and is observed visually by the patient himself. Shutting of eyes indicates worsening of sensory ataxia. Associated features like pendular tendon and broken pursuit eye movements are not present in sensory ataxia which differentiate it from cerebellar ataxia.


Sensory ataxia Symptoms

       
There is loss of sensation in sensory ataxia so patient is not able to move his limbs according to his will and as a result patient have unsteady gait and posture. Sometimes stomping gait also occurs. When patient tries to walk around, there are chances of striking foot hard on ground and this state is sometimes known as “walking on pillows”. Pain may also occur in limbs. With these states mentioned above, patient is more closely dependent on visual information he gets to move around in environment. As a result of unsteadiness and imbalance body becomes more pronounced.


Sensory ataxia Symptoms, Causes, Test, Treatment

Sensory ataxia Causes

     
Sensory ataxia is the loss of coordination due to problem in nerves providing information to control center of movement. Nerves which are present in spinal cord or nerves which supply information to limbs i.e. hands and feet may get damaged and as a result sensory ataxia occurs. This damage in nerves may also occur due to systemic diseases like multiple sclerosis, diabetes and compression in spinal cord. Damage may also occur due to increased exposure to toxins which include mercury, lead and arsenic. But causes behind sensory ataxia do not end here, there are many other reason along with these mentioned above.

Sensory ataxia Test

     
Before starting any treatment plan, it should be the 1st priority to confirm disease and its level of severity. For diagnosis of sensory ataxia, past medical history of patient is important. A complete conversation about disease is also of help in diagnosing disease and its root cause. Physical examination is also performed to check the functioning of limbs i.e. hands and feet. A blood test and a nerve conduction study is performed and it is checked that how well these nerves carry signals from limbs to brain and from brain to limbs and conduct them.

Sensory ataxia Treatment

     
Every treatment plan is designed to lower the symptoms of regarding disease, increasing chances of independence, stop progression of damage to nerves and reduce the associated risks. Sometimes treatment is required to treat the root cause behind disease. For treatment of sensory ataxia a specialist or occupation related therapist is needed. Routine life of patient is made better with some life style modifications and physical therapy. Physiotherapy helps in increasing mobility of limbs i.e. hands and foot according to patients will. Some medications are also prescribed to reduce the pain occurring in nerves (damaged nerves).
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Perineal raphe in Female and male, Irritation, Bump, Cyst

Perineal raphe is a tissue line or ridge which originates from anus through the perineum. It is basically the fusion point of urogenital folds and present in both males and females. This tissue line continues through the center portion of scrotum and runs upward through the posterior side of penis right from midline aspect. Perineal raphe develops during fetal development inside mother’s womb. Starting stages of fetal development looks same but at 7th week of pregnancy, fetal genital tissues change and form male reproductive organs i.e. penis and scrotum. At this point, perineal raphe is formed.It is completely common and normal physiological tissue line.


Perineal raphe in Male and Female

       
Perineal raphe is present in both males and females. In females, perineal raphe originates from anus and continues running upward to female genitalia i.e. passing through vagina till clitoris. In males, perineal raphe originates from anus and extends in upward direction to scrotum and then through posterior side of penis. Perineal raphe on scrotum, also divides it into two portions from inside which is known as scrotum raphe and when this line of tissues runs through midline aspect of penis posteriorly, it is known as penile raphe.

Perineal raphe in Female and male, Irritation, Bump, Cyst

Perineal raphe Irritation


Perineal raphe itching is most common in men than women and the reason behind this difference is unknown. Person feels itching and discomfort. It occurs occasionally due to sweating and cause burning and soreness along with irritation. This irritation and burning may extend up to anus and is called as pruritus ani. Person overwhelmed to scratch raphe and over scratching may lead to injury due to removal of upper protective layers of skin. Moisture, clothing, sweating and pressure upon sitting are other causative factors. Usually perineal raphe itching increases at night time and after every bowel movement.

Perineal raphe Bump

     
Perineal raphe bump is a lump formation on the line of tissues i.e. perineal raphe. These bumps can occur anywhere on perineal raphe most commonly around anus. These bumps are present inside skin and are not visible on surface. Person can feel it on touching and it hurts on wiping the area, sitting or moving around. These bumps may be 1 or 2 to 3 in number. Sometimes these bumps are painful. Pain is not unbearable, it’s tolerable. Sometimes it is itchy if it occurs due to an infection. Perineal raphe bumps most commonly occur in females.

Perineal raphe Cyst


Cyst may form anywhere on perineal raphe and genital organs i.e. penis and scrotum in males. Main structures involved are glans penis, penile shaft, scrotum or perineum. These cyst are common benign lesions. These lesions most commonly form in adolescence and childhood. In childhood, these cyst are asymptomatic and are unrecognized. These cyst only show symptoms when these get worse due to trauma and infection. Perineal cyst have an epithelial lining which may be urethral type, epidermoid type, mixed type and glandular type epithelium. The most rarely found cyst are median raphe cyst with ciliated epithelium.
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Uterine synechiae Meaning, Symptoms, Causes, Treatment

Uterine synechiae is a condition related to uterus in which adhesions are formed. The word synechiae means adhesion. These adhesions are like fibrous scars which are formed inside the cavity of uterus. Adhesions in uterus may occur due to uterine trauma like curettage and is also known as Asher man syndrome. Other causative factors involve caesarian section and myomectomy. Uterine adhesions during pregnancy are also referred as amniotic sheets and amniotic folds. These adhesions during pregnancy may lead to amenorrhea, hypo menorrhea, habitual abortion and secondary infertility. The diagnosis of these uterine synechiae is incidental during normal ultrasound evaluation during pregnancy.


Uterine synechiae do not cause any complications and also do not interfere in development and growth of fetus. These adhesions appear as thick bands attached to walls of uterus. A single synechiae have 2 parts i.e. 1 attached base and 1 free end. It is a combination of fibrous adhesions. Fetal membranes wrap the synechiae completely. Uterine synechiae have a complete classification according to its location and extension. Sometimes these lesions become worse and covers the whole cavity inside uterus causing the walls to stick together. Diagnosing the frequency of synechiae is not easy because it is asymptomatic in most cases.

Uterine synechiae Meaning, Symptoms, Causes, Treatment

Uterine synechiae Symptoms


Uterine synechiae are asymptomatic and only show symptoms when it gets worse with passing time because with every passing week, these adhesions covers the whole cavity inside uterus containing fetus. It often diagnosed during routine ultrasound checkup during pregnancy. These lesions may lead to various abnormal conditions like amenorrhea or really opposite condition i.e. loss of menstruation. Hypomenorrhea or scanty menstruation may also occur. Sometimes these uterine adhesions may cause infertility. Worse condition of uterine synechiae may cause recurrent abortion of fetus. All these conditions are secondary to adhesions in uterine walls.


Uterine synechiae Causes

         
There may be many causes behind formation of uterine synechiae. Some of the main causative factors are listed below.

  • Any kind of infection which may lead to fibrous adhesion in uterine walls.
  • Long term use of intra uterine devices lead to infections due to aseptic conditions and these infections cause synechiae formation.
  • These may be secondary to caesarian delivery of fetus and myomectomy.
  • Surgical removal of myomas and polyps also lead to formation of adhesions in uterus.
  • Any kind of trauma in uterus like curettage is the leading cause of uterine synechiae in females during pregnancy or after delivery.

Uterine synechiae Treatment

       
Uterine synechiae can be treated with some surgical processes. Hysteroscopy is a diagnostic as well as surgical procedure with a camera placed ahead and used rarely to treat these uterine synechiae. Fertility is rarely effected by uterine synechiae but women are advised to take treatment option of in vitro fertilization. Especially after the age of 35. Uterine adhesions may alter transit of sperms during sexual intercourse and these will be no or abnormal pregnancy that’s why in vitro fertilization is recommended. Hysteroscopy should be performed as a minor surgery to continue with in vitro fertilization.
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Heliophobia Definition, Symptoms, Causes, Test, Treatment

Heliophobia is a specific phobia towards light. Light means sunlight or any bright light. It is an irrational phobia towards sunlight and should not be mix with photophobia. People having heliophobia are also obsessed with anxiety disorder intriguer intense fear to sunlight or bright light. There may be various causative factors behind the origin of heliophobia. Some patients have a strange psyche of having skin cancer in response to direct contact with sunlight. There are many information awareness programs to educate patients about skin cancer and its main reasons behind it leading to increase fear in person.


Heliophobia Causes

     
Heliophobia causes vary according to the type of anxiety disorder. Scientists reveal that there may be three possibilities behind the origin of phobia i.e. classical conditioning, vicarious acquisition and instructional/informational acquisition. Sometimes some negative events in life intriguer this phobia. Sunburns may also lead to fear towards sunlight. The most common reason is informative seminars regarding skin disease and cancer and blindness. Obsessive compulsive disorder along with intensive fear towards sunlight can also cause heliophobia. It may be secondary to some medical conditions like keratoconus, migraine (which originates mostly from bright light) and polyphyria cutanea tarda (makes skin sensitive to bright light).

Heliophobia Definition, Symptoms, Causes, Test, Treatment

Heliophobia Symptoms

         
Heliophobia is a phobia (fear) to direct light i.e. sunlight or any bright light. So the symptoms totally depends upon severity and person suffering from it. Mild fear shows following symptoms:

  • Patient may feel uncomfortable, may have nauseatic feeling, be shaky, and sometimes numb.
  • Patients with severe heliophobia may have extreme panic attacks and feel anxious all the time. 
  • Increase in sensitivity i.e. heightened senses, patient may have lack of focus, trapped feeling, patient may experience tachycardia or irregular heartbeat, air hunger is common, rapid breathing, excess sweating and muscle cramps.


Heliophobia Test

       
Heliophobia is a phobia which can be self-tested or via checking behavioral changes of patient. There are some online tests available on internet which consist of a questionnaire regarding phobia. Patient have to fill it as he feel about going out in sunlight. There are also some behavioral observational test. Some tests can be performed at home via ADHD home test kit and concentration home testing. These are some home based test for children. Adults also have some home based test for heliophobia named adult ADHD home testing. All the above mentioned tests help in accurate diagnosis of heliophobia.


Heliophobia Treatment

       
As heliophobia is totally a psychological state so it need some talking therapy to recover. Sideways exposure therapy is also needed, some self-help techniques can help in recovering patient from heliophobia. Support groups therapy which involve some members who support patients courage help him to go through this phobia. Cognitive behavioral therapy is most commonly used therapy for heliophobia. Relaxation techniques are required to make patient relaxed by body and mind. Meditation is another way of treatment i.e. anxiety meditation is used to treat severe heliophobic patient. Along with all these therapies, patient response really matters a lot.
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keratoderma blennorrhagica Pictures, Symptoms, Causes, Treatment

Keratoderma blennorrhagicum K.B is also known as keratoderma blennorrhagica. As the name indicates, kerato means keratinized, derma means skin, blenno means mucousy and rrhagia means discharge. Skin lesions are formed on palms and soles of feet which may further spread to the scrotum, scalp and trunk. Psoriasis is a condition resembling keratoderma blennorrhagicum. It is a main symptom of reactive arthritis occurring in 15 % of patients. Lesions on palms and soles of feet appears as a waxy vesico-pustular of brownish yellow in color. These small sized lesions are may join together to form larger crusty plaques.

These lesions can spread to other parts of body on contact. These can be diagnosed with complete diagnostic test of reactive arthritis. Sometimes it does not require any diagnosis because it is a visible skin condition. Keratoderma blennorrhagicum appears differently in males and females with reiter syndrome. Abdominal discharge from the urethra indicates presence of keratoderma blennorrhagicum. Complete blood count CBC test is performed to detect presence of keratoderma blennorrhagicum in the form of inflammation in body. In advanced stages of this condition X-rays are recommended for diagnosis. Clinical examination is considered most important method used to confirm the diagnosis.


keratoderma blennorrhagica Pictures

keratoderma blennorrhagica Pictures, Symptoms, Causes, Treatment

keratoderma blennorrhagica Pictures, Symptoms, Causes, Treatment


keratoderma blennorrhagica Symptoms

           
Keratoderma blennorrhagicum is a skin disease so its signs and symptoms are visible. Some of the main symptoms are as follows:

  • Lesions appear as a waxy texture.
  • Lesions have a great tendency to spread other parts of body on contact.
  • Color of these lesions can be yellowish brown.
  • It appears as pustules or vesicles on the surface of the skin.
  • Upon clustering the patches may become crusted or scaly.
  • In some cases, these lesions may transform into nodules.
  • These nodules are hard and tender on touch.
Sometimes these lesions may be painful and may make patient uncomfortable.


keratoderma blennorrhagica Causes

         
The exact cause behind keratoderma blennorrhagicum is unknown. But some scientist state that it occurs due to genetic predisposition. It appears in the genito urinary variant of the reiter syndrome or reactive arthritis. Main cause stated is infection in urethra which may occur due to a microorganism named chlamydia trachomatis. This biological agent may transfer from one person to another through sexual contact. Basically it is a reaction to the infection caused by chlamydia trachomatis. This reaction is named as reactive arthritis. Keratoderma blennorrhagicum is a primary symptom of reactive arthritis diagnosis appear along with other symptoms.

keratoderma blennorrhagica Treatment


Keratoderma blennorrhagicum is the primary symptom of reactive arthritis or reiter syndrome. There isn’t any treatment of reiter syndrome but its symptoms can be treated with success. If the patient is active, he can be treated with course of antibiotics. It is considered primary course of treatment for this skin disease. Antibiotics are preferred because the urethral infection requires treatment 1st to treat keratoderma blennorrhagicum. Other medicines that are prescribed may involve anti-inflammatory drugs to reduce other related symptoms of disease i.e. pain and inflammation. Treatment of psoriasis is also effective which includes topical corticosteroids and other creams.
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