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Health

The snore should not be ignored.

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Sleeping with a snorer may leave you awake counting sheep

(or fiddling for earplugs). But they aren’t consciously snoring, and it could be a sign of something else.

Most people who snore have obstructive sleep apnea, a medical condition that occurs when the airway at the back of the throat becomes physically blocked.Geisinger otolaryngologist Kevin Stavrides, MD, says breathing can stop for a minute, leading to gasping, snorting, and waking the sleeper.

Carrying a few extra pounds is the most common cause, but heavy smoking, drinking and using sedatives can also contribute to sleep apnea. One of the best ways to avoid sleep apnea is to sleep on your side instead of your back.

In many cases, lifestyle changes can solve the problem, says Dr. Stavrides. If snoring persists, your doctor will likely order a sleep study.

Your doctor may prescribe a continuous positive airway pressure machine (CPAP) or a bi-level positive airway pressure machine (BiPAP) if you have sleep apnea.You wear this mask to bed to keep your airways open while you sleep.

If you have mild sleep apnea triggered by anatomical factors, you may also benefit from a mouthpiece that holds your tongue and jaw in place.

Others may benefit from an implantable hypoglossal nerve stimulator. “The device stimulates your neck before bed to allow your airways to open up,”

A sleep surgeon will determine if surgery is right for you if you need to remove tissue and expand your airway.

Sleep apnea is usually asymptomatic until someone (gently) points it out. After all, most people with it are the ones snoring away.

It will be a win-win for you and them, as you will both sleep better once it’s corrected.


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BLOG&NEWS

How to deal with Scalp Lacerations with this “HAT” trick!

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How many of you have heard of the Hair Apposition Technique, or perhaps even used it on a patient? I figured it existed since 2002, but have only learned about it recently!

Hair Apposition Technique, or HAT trick, is a creative method of approximating the scalp lacing by using the patient’s own hair as sutures.

Let me explain the steps:

  1. Irrigate your wound as usual, inspect for foreign bodies
  2. Pull together 3-7 strands of hair on one side of the wound.
  3. Do the same on the other side of the wound.
  4. Twist these two hair bundles in 360-degree revolutions. Do not tie a knot
  5. Secure the intertwined hair bundles by applying a few drops of Dermabond.
  6. Repeat as needed to close the length of the laceration.

If your patients have short hair, don’t worry, you can still use the HAT trick; all you need is two pairs of clamps.

Traditional staples/sutures have 3 advantages over them : 1) Zero pain (especially useful in kids; just tell them you’re braiding their hair!) 2) No need to anesthetize the wound (forget waiting for your nurses to first apply LET, then waiting more for it to kick in) 3) No need to return to ED for removal! The hair will unravel on its own after a week.

A quick tip for preventing loose hairs from entering your field of repair! When you try to staple Goldberg’s latest scalp lac and his hair keeps falling in, try using petroleum-based ointment instead. Apply ultrasound jelly (or grease) around the area to smooth down the strands, and spread them out to the sides as follows:

Using this method, you will not only be able to visualize the lac more clearly, but you will also be able to avoid trapping hair within the lac, which could cause wound dehiscence, a foreign body reaction, or local cellulitis.


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Health

Booster shots for COVID: what to look for

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Plus, know the difference between a booster shot and a third dose.

In addition to getting vaccinated against COVID, you may have questions. Do you need a booster shot? What is the difference between a booster shot and a third dose?

See how you can protect yourself against COVID-19.

What is the difference between a booster shot and a third dose?

As with the third dose of the vaccine, a booster shot provides additional protection against a virus as well.A third dose is given to people who have moderate to severe immunosuppression and whose immune systems may not have developed enough protection after receiving the first two doses.

Booster shots, on the other hand, are recommended for people with sufficient immunity, but whose immune system has gradually declined with age.

The third dose should not be given to people before 28 days after their second dose, and it should be from the same series as the first and second doses, says Dr. Stanley Martin, infectious diseases specialist at Geisinger.

The booster shot should be given at least six months after the second dose of the COVID vaccine from Pfizer or Moderna.

Is a third dose available to everyone?

People over 12 who are moderately to severely immunocompromised can receive a third dose of the Pfizer or Moderna COVID vaccine. This includes those who have received the full two-doses and have:

  • Been receiving active cancer treatment for tumors or cancers of the blood
  • Received an organ transplant and are taking medicine to suppress the immune system
  • Received a stem cell transplant within the last 2 years or are taking medicine to suppress the immune system
  • Moderate or severe primary immunodeficiency (such as DiGeorge syndrome, Wiskott-Aldrich syndrome)
  • Advanced or untreated HIV infection
  • Active treatment with high-dose steroids or other drugs that may suppress the immune response

Booster shots are available to anyone who needs them.

Individuals who have received two doses of either the Moderna COVID vaccine or the Pfizer vaccine at least six months ago are eligible for booster shots.After receiving a single dose of the Johnson & Johnson COVID vaccine, recipients are also eligible for a booster shot at least two months later.The third dose of a COVID vaccine may also be given to people with moderate or severe immunosuppression age 18 and older,

In what way should I schedule my third or booster dose?

Your third dose or booster shot at Geisinger is still available if you received your first two doses at another location. Simply bring your vaccine card to your appointment.

“It is important to get your third dose to help protect you against COVID-19 and its variants,” Dr. Martin says. “We are starting to see omicron spread across the U.S.This variant is becoming increasingly obvious to us, and these boosters may be able to protect us.”


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BLOG&NEWS

Foot drop can be treated through peroneal or tibial nerve transfer operations

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Patients with foot drop have difficulty lifting the front part of their foot and toes. Despite its debilitating nature, current treatment options are limited. 

The term “foot drop” may seem simple, but it describes an often-complicated condition in which the foot is unable to elevate at the ankle, resulting in difficulty walking and a floppy appearance. Foot drop is caused by a number of factors, but one important factor is damage to the nerves controlling the leg muscles that bend and lift the front part of the foot and toes.As a result, people either drag their feet and toes or walk with high steps referred to as the ‘steppage’ gait.Foot drop often leads to pain or discomfort neurological symptoms, such as tingling or burning. This way of walking requires more effort and in time may lead to other problems, such as back or hip pain.

The peroneal nerve is a group of muscles that runs from the back of the knee around to the front of the shin and provides movement (motor control) and sensation to the lower leg, foot, and toes.Moreover, as this nerve supplies the tibialis anterior muscle (TAM), which lifts the foot, any damage disrupting the motor control pathway between the peroneal nerve and TAM can result in foot drop.Consequently, the peroneal nerve can be damaged by injuries such as sports injuries, gunshot wounds, hip replacements, childbirth, or diabetic complications as it lies close to the surface of the skin.Foot drop can also be caused by multiple sclerosis, a stroke, spinal cord damage, or cerebral palsy.

Handling foot drop ups and downs

Figure 1: The incision at the popliteal fossa.

The extent and cause of foot drop determine the types of treatment available. An orthosis (ankle-foot orthosis) can be fitted to help support the foot and improve walking ability, but many users find them uncomfortable and unhygienic.

Nerve stimulators, which apply small electrical charges to the leg, can help some patients gain more mobility. If the nerve does not recover, surgical treatment may be considered. Peroneal nerve decompression is an option for compressed nerves, or tendons may be transferred from one leg to another.In general, however, foot drop is difficult to treat successfully due to the small size of the nerve that is involved (less than 6cm). Nerve grafting is therefore a limited treatment option.

Exposition of the peroneal nerve at the popliteal fossa. (B) A cross-section showing the direction of the fibers to the tibialis anterior at the popliteal fossa.


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BLOG&NEWS

What is a Neurosurgeon?

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A neurosurgeon specializes in the diagnosis and surgical treatment of disorders of the central and peripheral nervous systems, including congenital anomalies, trauma, tumors, vascular disorders, and infections There are a number of ways to become a neurosurgeon, including surgical training in the brain or spine, stroke, or degenerative diseases of the spine.

  • University or college premedical education for four years
  • Four years of medical school resulting in an M.D. or D.O. degree
  • One year internship in general surgery
  • Five to seven years in a neurosurgery residency program
  • Some neurosurgeons complete a fellowship after residency to specialize in a particular area
  • Continuing education — annual meetings, conferences, scientific journals, research — to keep up with advances made in the complex field of neurosurgery

The Central Nervous System and the Peripheral Nervous System

  • Nerves and cells of the nervous system transmit messages between the brain and spinal cord, as well as to various body parts, including the sensory organs, arms, hands, legs, and feet.

How Do Neurologists Work?

There are several types of neurological disorders that neurologists treat including stroke, multiple sclerosis, Parkinson’s disease, Alzheimer’s disease, Lou Gehrig’s disease, epilepsy, headache disorders, and infections of the brain and peripheral nervous system.The neurosurgeon performs surgery, while the neurosurgeon works closely with neurologists.

How Does Neuromedicine Work?

Neuromedicine describes a practice at Highland Hospital where neurosurgeons, neurologists, and other medical professionals work together to provide comprehensive inpatient care for patients with complex neurological disorders.


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Profile

Dr. VyshanaviBommakanti

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Dr. Vyshanavi Bommakanti

I am an ENT surgeon. I have graduated in 2015 and have done fellowship in advanced rhinology and anterior skull base from University of Graz Austria and Bombay hospital. I head the department of ENT at Maxcure hospital, Hyderabad. I have special interest in rhinology and anterior skullbase surgery and have been performing complex rhinlogical and anterior skullbase procedures independently like invasive fungal sinusitis; CSF rhinorrhea; pituitary macro adenoma ;craniopharyngioma to name a few. Apart from rhinology and anterior skullbase. I have the skill to handle routine ENT cases and manage emergencies too.
I have authored more than 20 articles in national and international journals.
I have extensive experience in teaching ENT to medical students across various institutes in India and on online platform UNACADEMY which is Indias largest learining platform.

Experience

Starting from Nov 2010 to May 2011 he was working as Consultant Neuro and Spine surgeon. From Jun 2011 – April 2012 hea worked as Assistant Professor at Adesh Institute of Medical Science’s and Research, Bathinda, Punjab. He has joined as Lecturer at Nizam’s Institute of Medical Science’s, Hyderabad and worked there from April 2012 to Sep 2012, later continued there are Assistant Professor from Sep 2012 to March 2016. Starting from March 2016 till today, he works as Consultant Neuro Surgeon and Spine Surgeon at Medicover Hospitals, Secretariat.

Awards

> 2nd Prize in Annual conference of AOI Telangana state branch for paper presentation for Smt. SUSHEELA KRISHNA MEMORIAL MEDAL 2016 -Junior consultant Category

> 2nd Prize in Annual conference of AOI Telangana state branch for poster presentation for Smt. AOI NALGONDA BRANCH FOR BEST POSTER MEDAL 2017 -Junior consultant Category.

> 2nd Prize in Annual conference of AOI Telangana state branch for video presentation for LATE DR VENKAT KUMAR MEDAL FOR BEST VIDEO PRESENTATION 2017 -Junior consultant Category.

> 2nd Prize in Annual conference of AOI Telangana state branch for poster presentation for Smt. SUSHEELA KRISHNA MEDAL FOR BEST PAPER PRESENTATION 2017 -Junior consultant Category.

> Best outgoing student in M.B.B.S. 2010

DR. VYSHANAVI

ENT surgeon


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