Ventral Hernia Treatment

What is a Ventral hernia?

A weak spot or hole in the muscles of the abdominal wall leads to looping of the intestine or forces tissue to push through the layer of muscle, manifesting ventral hernia. The location of a ventral hernia can be anywhere across the midline or vertical centre of the abdomen.

Types :

Typically, there are three types of ventral herniations, as described below.

Epigastric

Occurring in the stomach area, below the breastbone and above the belly button or navel, an epigastric hernia can develop both in men and women.

Umbilical

Appearing primarily in the belly button area, umbilical hernias are treatable and seldom serious. Improper closure of the abdominal muscle that allows passage of the umbilical cord leads to hernia.

Incisional hernia

Generally, evolving at the site of a previous abdominal surgery, an incisional hernia appears on the scar. There is no specific time frame identified for its development.

Causes and risk factors for ventral hernia

Surgical

An infection at a previous abdominal surgery site

Weakness at the site of a preceding incision

Failed surgical mesh placement

Unsuccessful surgical repair

Other

Congenital weaknesses of the abdominal wall

Weakness of the abdominal wall due to persistent strain as a result of

Obesity and overweight dispositions

Frequent episodes of coughing

Severe bouts of vomiting

Lifting, pushing heavy objects

Straining while urinating or during bowel movements

Lung diseases

Emphysema: Due to which the patient is unable to breathe leading to a strain on the abdominal wall

Chronic obstructive pulmonary disease or COPD where patient experiences shortness of breath due to poor airflow

Enlargement of the prostate gland or prostatism causing the older male patients to strain while urinating

Loss of elasticity of the abdominal wall due to old age

Signs and Symptoms

In its early stages, ventral hernia seldom causes any discomfort. A visible bulge appears in the abdomen area, right under the skin and is tender to touch. When lying down, or when you push against it, the bulge may even flatten.

Patients may feel increased levels of pain when they lift heavy objects, strain during bowel movements or urination, or sit and stand for prolonged periods.

If the intestine bulges through the abdominal wall and is trapped, then the person might experience severe abdominal pain. The strangled portion of the intestine begins dying as it loses blood supply. This situation requires emergency care.

Diagnosis

Your medical and surgical history is first reviewed by the doctor before a physical examination of the abdominal area is performed. Thereafter, imaging tests are done including ultrasound, MRI or Magnetic Resonance Imaging and a CT or Computed Tomography Scan.

Repair of ventral hernia

Surgical intervention is the only treatment available for ventral herniation because the malformation does not resolve on its own. It can get worse over time. Patients may also experience serious complications when ventral hernias are left untreated for prolonged periods.

What happens during the surgery?

The hole in the abdominal wall is repaired and the muscles are brought back into position. Additionally, the shape of the abdomen along with its tone is restored.

At SIMS Hospital, we primarily perform laparoscopic and open hernia repairs.

Laparoscopic surgery:

About 7 sites are marked for small incisions to be made away from the area where the hernia is present. A laparoscope is inserted through one of the openings and a guided surgery is performed where a mesh material is placed to stabilize and strengthen the weak area. Since only small-sized incisions are involved, the surgery comes with lower risks of infection and better healing rates.

Open hernia repair:

The intestine and abdominal tissue are pushed back into place when a single large open incision is made in the abdomen in the herniated area. This type of surgery has reduced recurrences and quick skin closure due to dissolvable stitches.

At SIMS Hospital, Nungambakkam

Before operating upon you, our doctors will consider several factors such as your age, existing health problems, your medical history, size of the ventral hernia, skin required for repair, and presence of infection.

We tailor every ventral hernia repair according to individual situations, requirements, and the expected outcomes.

Treat your ventral hernia repairs, right here at SIMS Hospital, Nungambakkam.

A Peek Into Central Obesity And Metabolic Syndrome

November 26th has been declared as World Anti-obesity Day for a good reason. Studies performed by the World Health Organisation (WHO) indicate that obesity worldwide has tripled since 1975. In 2016, it was found that 39% of the adults over the age of 18 years were overweight, while 13% were obese. 

Central obesity can kill more people than you think. Increased fat deposition in the abdomen otherwise known as pot belly is one of the most important components of Metabolic Syndrome.

Difference between central obesity and routine obesity :

  • In traditional obesity, individuals usually weight more than 20% over their standard weight, but in central obesity, there is excessive fat accumulation around the stomach or abdomen.
  • Incidences of central obesity are more than that of routine obesity and are seldom addressed due to a lack of awareness among the masses. Central obesity is widespread and more dangerous.
  • The condition is potentially reversible using lifestyle and dietary changes.

What is Metabolic Syndrome ?

Metabolic syndrome (MS) is a clinical name provided for a cluster of health issues encompassing central obesity, diabetes, high blood pressure, and dyslipidaemia or abnormal contents of fat in blood. The crux of MS is due to the build-up of adipose tissue in the viscera or intra-abdominal organs, putting individuals at high risk of stroke and coronary heart disease (heart attack). The term “metabolic syndrome” was only coined sometime in 1988, although the group of health issues have existed before. 

Symptoms :

Metabolic syndrome comes with some visible signs and symptoms. Diagnosis may include:

  • Waist circumferences.
  • South Asian Men: 35.5 inches or 90 cm and greater.
  • South Asian Women: 31.5 inches or 80 cm and more.
  • Low levels of HDL or good cholesterol and high levels of LDL or bad cholesterol and triglycerides in the blood – the fatty substances clog up the arteries leading to atherosclerosis.
  • Blood pressure levels of at least 140/90 mm Hg or higher, consistently .
  • Insulin resistance or uncontrolled blood sugar levels.

Causes :

Central obesity is a part of metabolic syndrome and is associated with the lack of physical activity and consumption of a high-calorie diet, both of which act as triggers for the disease. Especially individuals who possess a family history of type 2 diabetes or have had gestational diabetes are at a higher risk of metabolic syndrome. Besides, one of the critical features of type 2 diabetes is insulin resistance, where too much glucose accumulates into your bloodstream. Other risk factors include your age, ethnicity, and conditions such as NAFLD or non-alcoholic fatty liver disease, cardiovascular disease, and PCOS or Polycystic ovarian syndrome in women. Long term fatty liver can lead to permanent liver damage, which is a severe health condition called cirrhosis. 

Prevent and reverse metabolic syndrome :

There are many lifestyle changes that you can perform to reverse metabolic syndrome. These alterations also help prevent the advent of the disorder.

Begin by losing weight :

The best way to do this is to follow a routine that helps you lose at least 0.5 to 1 kg per week.

Consume a daily calorie allowance to keep your weight in check – Speak to a dietician to regulate your daily intakes. 

Use the BMI calculator to assess your daily / weekly weight loss allowance- Additionally, use the waist to hip ratio, which is more relevant for central obesity.

Regular exercise :

Fitness should be a part and parcel of everyone’s daily routine – exercise for at least 30 minutes per day.

If you wish to increase the activity levels, you can start by walking.

Always ensure that you perform moderate movements regularly to ensure that you burn more energy.

Healthy diet :

Eating a healthy meal is one of the essential practices that will help you control your blood sugar levels, cholesterol, and blood pressure.

A balanced diet should include its fair share of carbohydrates, proteins and other components for nutritional needs.

Habits :

Additionally, you should quit smoking before it becomes unmanageable.

Even quitting alcohol, helps with weight loss.

Adequate sleep is a critical component of anti-obesity.

Speak to our experts for anti-obesity plans and get tips on a healthy lifestyle!

Glaucoma

Glaucoma – The Silent Thief of Sight

Glaucoma is an ailment that affects the eyes. It is one of the leading cause of blindness in the world with 65 million people suffering from this condition. It is also the second major cause of blindness, first one being cataract. The prevalence of Glaucoma is highest in African nations followed by Asia. It is a matter of grave concern that of all the people suffering from Glaucoma, 5% eventually lose their sight. Even with appropriate treatment 10% people still experience significant loss in sight.

What is Glaucoma ?
Glaucoma is a condition of optic nerve damage. Optic nerve is the channel through which the images captured through our eyes are transmitted to the vision centre of our brain. When this nerve deteriorates slowly over a period of time, we gradually lose our sense of sight.

Our eye contains a clear fluid, called aqueous humour, that keeps the eye healthy by nourishing various internal parts like cornea and the lens. This fluid periodically get drained through the drainage system of the eye to maintain the pressure inside the eye cavity. In Glaucoma, pressure inside the eye cavity increases due to fluid build up, usually in the front part. This progressively strains the optic nerve and causes irreversible damage to it. Surprisingly a person loses as much as 40% of vision without even realizing it.

What are the types of Glaucoma ?
There are two major types of Glaucoma, as described below.

  • Primary Open-angle Glaucoma: It is most the common type that is caused due to inadequate drainage of the fluid inside the eye. It is usually painless and detected quite late. So early examination can help detect early signs of optic nerve damage.
  • Primary angle-closure Glaucoma: When the drainage angle is narrow or blocked in eye pressure builds up. This type of Glaucoma may present with an “acute attack”, which is a medical emergency. Many people with angle closure develop slowly. So, if not detected and treated early, can lead to blindness.

What are the risk factor for development of Glaucoma ?
Though Glaucoma can develop in any person, there are certain risk factors associated with this condition.

  • Family history of Glaucoma
  • Age more than 40 years
  • Medical conditions that builds high eye pressure
  • Diabetes, Hypertension
  • Chronic steroid use

What are the symptoms of Glaucoma ?
Most people do not realize any issue in vision until the damage is quite severe. The process of optic nerve damage is irreversible and that’s why Glaucoma is called the “Silent Thief of Sight”.
Only regular eye examination can detect the condition. Sometimes acute angle closure Glaucoma can present with severe headache, blurring of vision, severe pain and redness of eyes.

How can Glaucoma be prevented?
As stated earlier, it is not a preventable condition; buyt, it can be controlled. Regular eye check-up is the best course of action to control Glaucoma. The diagnosis tests generally include:

  • Eye pressure check
  • Visualization of drainage angle
  • Examination of optic nerve
  • Visual field evaluation
  • Photograph of optic nerve
  • Measurement of thickness of Cornea

How is Glaucoma treated / controlled ?

  • Medical treatment like eye drop
  • Surgical treatment if not controlled with drops
  • Laser treatment
Paleo-Diet

PALEO DIET – Should I go for it?

Being a Nutritionist, I am frequently asked by various health-watchers about FAD diets, crash diets and whether to opt for a change over to an entirely different diet plan. And one frequently asked the question is about the Paleo diet.

Hence, today we would explore the do’s and don’ts and the Pros and Cons of this diet so as to throw light on better understanding for the practical implementation of the Paleo diet in the Indian scenario.

You are what you eat – and perhaps surprisingly, you also are what your ancestors ate – Jack Challem

Developed by Loren Cordain, Ph.D., a researcher from Colorado State University in the 1970’s, the Paleo diet is often embraced by few and heavily debated by many. Also called as the stone-age or Caveman’s diet, the concept behind this diet is simple: “If you want to shed your pounds, eat like a caveman!”

The Paleo diet is rich in protein, fibre and the so-called healthy fats, due to which it results in losing weight without losing calories, and with no physical exercises. This diet also claims to safeguard us from diabetes, heart disease, hypertension, cancer and other health problems.

Carefully read through the table below to see the freely permitted foods and those that need to be avoided on a Paleo diet.

The two different food pyramids, one for a balanced diet and the other for the Paleo diet explore the foods allowed under each.

Pyramid

Sunscreens

Summer in Chennai is a time when our shadows are brightly lit by sun rays. The human skin undergoes a vast spectrum of changes when exposed to the sun’s rays. The chronic damage it causes to the skin, manifest on the skin as photo ageing. A classic example being the difference between an individual’s skin on a sun exposed area (hands) and the skin on the covered area (abdomen).

The acute damage that the sun causes on the skin is the infamous “sunburn” or the “suntan”. We all know how it manifests on our skin. It’s time to know the importance of sunscreen and the ways to choose a sunscreen that is the best for your skin.

  • Choose a sunscreen lotion even if you don’t have direct sun exposure.
  • For those who are out in the sun and sweat under it, a sunscreen gel or sunscreen serum is the best.
  • We understand that you feel dull and greasy after applying your sunscreen. Combat it by applying a “finger tip unit” for the entire face and avoid outdoors for 15 minutes after application. It blends well into the skin and neutralises the grease during that period.
  • If you’re blessed with dark skin, you are safer from the sun damage and have the options of using “tinted sunscreens”.
  • Use a sunscreen even if you stay indoors, the ultraviolet radiation from gadget screens and LED lights can damage the skin.
  • Reapply your sunscreen in the afternoon.
  • Please check if your sunscreen has a good SPF factor (Ranging from 25-40) for Indian skin. Higher numbers don’t mean increased efficacy.
  • Verify the booster rating on the package as this denotes the efficacy of the sunscreen for our climatic conditions.
  • Makeup may be applied over the sunscreen after a 15 minute period. Hydrating foundations and powders with SPF factors are preferred. Avoid mousse and creams as make up foundations.
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