Category: English

Alzheimer’s disease is a brain disease that gradually deteriorates thinking and memory abilities and the ability to perform even the most basic tasks. The majority of Alzheimer’s patients have their initial symptoms later in life. According to experts, around 55 million people in the world who are 65 or older have dementia, according to various estimates. 

The most prevalent type of dementia, Alzheimer’s, maybe a factor in 60–70% of cases. In today’s world, it is one of the primary causes of disability and dependency among older people and the seventh most significant cause of death among all diseases.

For those living with dementia, their caregivers, families, and society, dementia has physical, psychological, social, and economic effects.

How is the Brain Affected by Alzheimer’s Disease?

Scientists fully understand the intricate brain alterations associated with Alzheimer’s disease. Before symptoms show, changes in the brain may start ten years or earlier. The brain experiences harmful alterations at this early stage of Alzheimer’s, including aberrant protein buildups that result in amyloid plaques and tau tangles. 

Formerly healthy neurons stop working, lose connections to neighboring neurons, and eventually die. Numerous other intricate brain alterations also influence Alzheimer’s disease.

The hippocampus and the entorhinal cortex, two brain regions crucial for memory formation, appear to be the first areas of the brain to sustain injury. Additional brain regions are damaged and start to shrink as more neurons die. When Alzheimer’s reaches its most advanced stage, the damage is extensive, and the brain tissue has greatly diminished.

What are the Warning Signs and Symptoms of Alzheimer’s?

One of the initial indications of Alzheimer’s-related cognitive decline is frequent memory issues. Some individuals with memory issues experience minor cognitive impairment (MCI). 

People with MCI experience more memory issues than is typical for their age. Nevertheless, their symptoms do not impact how they conduct their daily lives. MCI has also been associated with problems with movement and the sense of smell. Alzheimer’s disease is more likely to affect older MCI patients, but not all of them do. Some people might even resume their regular thinking. Individuals with Alzheimer’s experience different initial symptoms. 

Many people believe that the very early stages of the disease may be indicated by a deterioration in non-memory components of cognition, such as word finding, vision/spatial problems, and impaired thinking or judgment. 

To identify early abnormalities in the brains of persons with MCI and cognitively healthy individuals, researchers are examining biomarkers, which are biochemical indications of disease discovered in blood, cerebrospinal fluid, and brain imaging. They might be more susceptible to Alzheimer’s. Before these methods can be widely and regularly used to diagnose Alzheimer’s in a physician’s office, more study is required.

What are the Different Stages of Alzheimer’s Disease?

Mild Alzheimer’s Disease

Memory loss and other cognitive problems get worse as Alzheimer’s gets worse. Wandering and getting lost can be a problem, as can having difficulties managing money and paying bills, asking questions repeatedly, taking longer to do everyday duties, and changing their personality and conduct. In this period, patients are frequently diagnosed.

Moderate Alzheimer’s Disease

This stage of the disease involves brain damage to the regions responsible for language, cognition, conscious thought, and sensory processing, including the capacity to recognize sounds and scents. 

As disorientation and memory loss worsens, it gets harder for people to identify their loved ones. They might be unable to adapt to new circumstances, learn new things, or perform complex chores like getting dressed. At this stage, individuals may act impulsively and have hallucinations, delusions, and paranoia.

Severe Alzheimer’s Disease

Plaques and tangles eventually cover the entire brain, and the brain’s tissue begins to diminish dramatically. People with advanced Alzheimer’s cannot communicate and rely on others to care for them. As the body slows down at the end of life, the person may spend most of the time in bed.

What Causes Alzheimer’s Disease?

Scientists have made enormous strides toward understanding Alzheimer’s disease in recent years, and the impetus is still building. Even still, researchers are unsure of the exact causation of Alzheimer’s in most cases. A genetic mutation might be the root cause of early-onset Alzheimer’s in affected individuals.

A complicated succession of brain alterations may occur over many years, leading to late-onset Alzheimer’s disease. Genetic, environmental, and lifestyle factors are likely the root causes. Depending on the individual, each of these characteristics may play a different role in elevating or lowering the chance of developing Alzheimer’s.

How is Alzheimer’s Diagnosed?

Doctors employ various techniques and instruments to assess whether a patient with memory issues has Alzheimer’s. For an Alzheimer’s diagnosis, clinicians may:

• Inquire about the person’s general health, prescription and over-the-counter medications, food, previous medical issues, capacity to carry out daily tasks, and any changes in behavior or personality, together with a family member or friend.
• Tests for language, counting, problem-solving, and memory should be conducted.
• Perform standard medical examinations, such as blood and urine testing, to look for further potential reasons for the issue.
• To confirm an Alzheimer’s diagnosis or rule out other potential causes of symptoms, conduct brain scans using computed tomography (CT), magnetic resonance imaging (MRI), or positron emission tomography (PET).
• These tests may be repeated to inform clinicians about how the patient’s memory and other cognitive abilities evolve.

People who experience difficulties with memory and thinking should consult their neurology doctor to determine whether the symptoms are caused by Alzheimer’s disease or something else, such as a stroke, tumor, Parkinson’s disease, sleep disturbances, medication side effects, an infection, or another form of dementia. Some of these ailments might be treatable and even curable.

If Alzheimer’s disease has been identified, starting treatment as soon as feasible in the disease course may assist in maintaining everyday functioning for a while. A timely diagnosis aids families in making plans. 

They can deal with monetary and legal issues and potential safety concerns, learn about living situations, and create support networks.

How is Alzheimer’s Treated?

Due to the complexity of the disease, it is doubtful that any medication or other treatment would completely cure everyone with Alzheimer’s. 

Alzheimer’s disease is currently being treated with an emphasis on managing behavioral symptoms, treating the underlying disease process, and assisting patients in maintaining mental function. 

What are the Medications to Maintain Mental Function in Alzheimer’s Disease?

The US Food and Drug Administration (FDA) has approved several drugs to treat Alzheimer’s symptoms. The signs of mild to moderate Alzheimer’s disease are managed using donepezil, rivastigmine, and galantamine. 

The rivastigmine patch, memantine, donepezil, and medicine that combines the two are all used to treat mild to severe Alzheimer’s symptoms. All these medications function by controlling neurotransmitters, substances that communicate between neurons. 

They might aid in treating some behavioral issues and symptom reduction. However, the underlying illness process is unaffected by these medications. They may be helpful for a brief period and are successful for some people but not everyone.

What are the Medications to Treat the Underlying Alzheimer’s Disease Process?

The FDA has approved aducanumab as the first Alzheimer’s disease disease-modifying medication. The medication helps to reduce the brain’s amyloid buildup. It might slow the disease’s course. It has not yet been demonstrated that it influences clinical outcomes, such as the development of dementia or cognitive decline.

A physician or neurologist would probably run tests, such as a PET scan or a cerebrospinal fluid analysis, to check for signs of amyloid plaques and determine if the patient is a good candidate for the proposed course of treatment.

How to Manage the Alzheimer’s Disease Behaviour?

Sleeplessness, wandering, agitation, anxiety, and hostility are typical behavioural signs of Alzheimer’s disease. Scientists are discovering the causes of these symptoms and researching new drug and non-drug management strategies.

According to research, addressing behavioural symptoms can help caregivers, and patients with Alzheimer’s disease feel more comfortable. Family and caregiver support for those with Alzheimer’s illness

Alzheimer’s care can be physically, emotionally, and financially expensive. 

It can be challenging to balance daily care responsibilities, family dynamics shifts, and choices regarding placement in a care facility.

One crucial long-term approach is to educate yourself on the illness. 

Programs that instruct families on how to handle complex behaviours and other caregiving issues, as well as the many stages of Alzheimer’s, might be helpful.

The expert Neurologists at Burjeel Hospital provide strategies to help carers manage the stress of caring for a loved one with Alzheimer’s, including effective coping mechanisms, solid support systems, and respite care.

For instance, maintaining an active lifestyle has both psychological and physical advantages. For some carers, finding a support group to join is a crucial lifeline. These support groups give caregivers a place to obtain emotional support, voice worries, share experiences, and acquire ideas.

Our Expert Neurologist

What is a Hand Fracture?

A hand fracture is a break in one or more of the bones that make up your hand. Hand fractures are most commonly caused by direct trauma to the hand, such as when you fall on your outstretched hand or catch yourself with your hands after tripping.

Hand fractures can be either open (where the bone breaks through the skin) or closed (where the bone does not break through the skin). Hand fractures are typically treated with a cast to immobilize and protect the injured area while it heals.

What are the Most Common Types of Hand Fractures?

The most common types of hand fractures are:

Colles’ Fracture: This is a break in your forearm’s lower end of the radius bone. It can happen when you fall on an outstretched hand or have an elbow injury and try to catch yourself by putting out your hand.

Scaphoid Fracture: This is a break in the scaphoid bone located just above your wrist. It usually happens from falling on an outstretched arm or twisting your wrist too far while lifting something heavy.

Monteggia Fracture: refers to dislocation of the radial head (proximal radioulnar joint) with fracture of the ulna.

What are the Symptoms of a Hand Fracture?

The symptoms of a hand fracture can vary depending on the severity of the injury. In general, if you experience any of the following signs and believe you may have suffered a fracture, contact your physician immediately:

• Pain and swelling in the hand
• Difficulty moving or using the hand
• Deformity of the hand and/or fingers

How is a Hand Fracture Diagnosed?

A doctor diagnoses a hand fracture through a physical examination and X-rays. The doctor will examine your hand for tenderness, swelling, deformity, and bruising. They may also check for neurological damage or abnormal sensation in the fingers. In some cases, an MRI scan might be needed to determine the extent of the damage.

How is a Hand Fracture Treated?

A hand fracture is treated differently depending on the type of fracture.

A simple fracture, which involves only one bone, is treated by placing a splint on the hand and wrist. The splint keeps the bones in place while they heal.

Complex fractures are more severe and involve multiple bones or joints. They may require surgery to place pins and screws to hold the bones in place while they heal.

In some cases, fractures can be treated with surgery alone. In these cases, it is essential to consult an expert hand surgeon about whether surgery is recommended for your specific condition.

Hand fractures are common injuries for athletes and active people. They can be caused by a fall, an impact from a hard object or another person, or an accident that involves sudden braking. If you suspect you have a hand fracture and cannot move the injured finger or knuckle, or if your finger or knuckle is deformed, swollen, or discolored, you should seek medical attention immediately.

Expert Hand Surgeons at Burjeel Hospital Dubai provide the best treatment for hand fractures. We will work with you to determine the best way to treat your fracture, whether that means surgical intervention or non-surgical treatment.

Our Expert Hand Surgeons in Dubai

Dr. Marouane Bouloudhnine

Consultant Orthopedics Surgeon

Years of Experience: 22

Nationality: France

Languages Known: Arabic, English, French, Italian

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Dr. Khalid Alawadi

Consultant Hand & Plastic Surgeon (Specialized in Plastic, Reconstructive & Hand Surgery) (Visiting Doctor)

Years of Experience: 21

Nationality: UAE

Languages Known: Arabic, English, German

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Dr. Jamil Al Jamali

Consultant Hand Surgeon (Specialized in Plastic & Reconstructive Microsurgery) (Visiting Doctor)

Years of Experience: 22

Nationality: Germany

Languages Known: Arabic ,English, German

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Have you looked in the mirror while getting ready for a big day and noticed that your teeth are not as white as you would like them to be? While you might know how to “fix” it, let’s talk about what causes your teeth to be stained and how to prevent it.

What Causes Tooth Discoloration?

Aging. As you age, the transparent enamel surface of your teeth may wear down, disclosing the yellowish color of the underlying dentin. 

Poor Oral Hygiene. This causes the accumulation of food debris and plaque formation, a thick layer rich in bacteria. These factors can cause the teeth to look stained and yellow.

Tooth Decay. Poor oral hygiene can lead to decay of teeth which starts as white patches and then turns brown or black. 

Habits. Excessive intake of tea or coffee and smoking can cause brown staining of the teeth.

Stress. Stress affects most body functions, and among that, it affects the normal flora of your mouth, which results in the activation of some kinds of bacteria, which will result in dotted black stains on the teeth at the gum line.

Fluoride. Too much fluoride can cause white spots. This is called fluorosis, and it happens when teeth are exposed to much fluoride from drinking water or excess use of fluoridated mouthwashes or toothpaste.

Improper Dental Treatments. Amalgam filling (silver fillings) can cause the tooth to look black. When root canal treatment is done, tooth color changes to yellow, brown, or even black in some cases.

Antibiotics. Exposure to some antibiotics during tooth formation, like in the mother’s womb or at an early age, can cause yellow to green lines on the teeth. This kind of stain is internal and needs more invasive treatment to be covered.

How to Prevent Teeth Staining?

Prevention is key to healthy teeth. For that, try to minimize the intake of colored beverages, avoid smoking, reduce stress, maintain a good oral hygiene routine, and visit the dentist regularly.

How is Tooth Discoloration Treated?

There are multiple options to have a brighter smile and whiter teeth.

Brushing your Teeth. when you miss brushing for a few days, your teeth will have a yellow plaque layer. Once you brush, you will see the difference.

Scaling and Polishing in the clinic will remove all the calculus, plaque, and black stains, leaving your teeth looking whiter and brighter.

In-Office Teeth Whitening. It’s a professional way of removing the stains absorbed by your teeth over the years, disclosing the white and bright teeth you have,

Proper Dental Treatment. We might need to replace fillings, do internal bleaching or do root canal treatment again to remove the discolored improperly done root canal filling materials

Crowns and Veneers are used in case of internal staining caused by the use of antibiotics and for the aged teeth to replace the lost tooth structure and get the white smile you deserve.

Having a bright smile is a matter of having a good oral hygiene routine, and tooth discoloration can affect how you feel about your smile and oral health. Treatments and prevention methods exist to help you feel more confident. Our Expert Dentists at Burjeel MHPC provide various services to help you maintain the health of your teeth and gums.

Our expert Dentists will work with you to determine the best approach for restoring your tooth’s natural color and shape and preventing future discoloration. From dental crowns to veneers, we have the skills necessary to provide quality treatment that is both safe and effective.

What is Cardiac Rehabilitation? 

Cardiac rehabilitation is a program to help patients with heart disease or surgery recover their strength and fitness. It can also help people with other heart conditions, such as diabetes, high blood pressure, or sleep apnea. Cardiac rehabilitation programs usually involve 

• exercise training, 
• education about healthy nutrition and behavior change, 
• support from other patients in the program, and 
• sometimes psychological counseling. 

A cardiac rehabilitation program can be tailored to meet your needs and meet at times that are convenient for you. The most important part of cardiac rehab is exercise training. This helps your body get stronger and more efficient at managing its health. 

Who Needs Cardiac Rehabilitation? 

Cardiac rehabilitation program is not only for people who have had heart surgery but also for those who have had a heart attack or other conditions that affect their hearts. These include: 

• Aneurysm (a bulge in the wall of an artery) 

• Arrhythmia (irregular heartbeat) 
• Heart attack 
• Heart failure 
• High blood pressure 

What does Cardiac Rehab Involve? 

Cardiac rehab starts with an initial evaluation by a doctor. The goal of cardiac rehabilitation is to help patients learn how to manage their heart disease and prevent future complications. Cardiac rehabilitation includes several different types of interventions, including: 

Behavioral interventions focus on changing the patient’s behaviors to reduce their risk for future complications. Behavioral interventions include smoking cessation programs and weight loss programs. 

Dietary interventions teach patients healthy eating habits to help them manage their heart disease symptoms and prevent future complications. 

Exercise training focuses on helping patients learn how to exercise safely to improve their cardiovascular fitness levels and reduce the risk for future complications. 

After the initial evaluation, you will meet with your cardiologist. They will discuss your medications, how much activity you should be doing, and how often to exercise. 

You will also meet with an exercise physiologist who will design an exercise program that meets your needs and goals. The goal is to gradually increase the intensity of your physical activity over time while staying within safe limits based on your current health status. 

Cardiac rehab sessions typically last six weeks but can vary depending on your condition and needs. Cardiac rehab usually involves two types of exercise: aerobic and resistance training.  

Aerobic exercise includes walking on a treadmill, using an elliptical machine, or running on a track.  

Resistance training involves lifting weights to build muscle mass. Cardiac rehab also includes education on healthy diet and lifestyle choices, such as quitting smoking and managing stress levels. 

What are the Advantages of Cardiac Rehabilitation? 

Some of the advantages of cardiac rehab include: 

• Stress management: Cardiac rehab teaches you how to manage stress through exercises, which can help reduce your blood pressure and keep your heart healthy by reducing the amount of cortisol in your body. 
• Improved fitness: Cardiac rehab improves your fitness level by getting you moving again and engaging in activities that increase endurance, strength, flexibility, and balance. This is especially important if you’ve recently had an illness or surgery because it’s crucial to stay active when recovering from these procedures so that you don’t lose too much muscle mass or become too weak. 
• Improved diet: Cardiac rehab helps you develop healthy eating habits so that you’re not just eating whatever foods are convenient for when you’re hungry or tired—you’re ingesting nutrients from foods that will benefit your body long-term. 

What Happens After Cardiac Rehab? 

After cardiac rehab, you will continue to practice your new healthy habits. You will be advised to continue with your prescribed exercise program and any medication.  

Your cardiologist and physiotherapist will continue to monitor your health and may recommend further treatment if necessary. 

How to Stay Fit After a Heart Attack? 

After a heart attack, staying fit is essential to improve your health and reduce the risk of a second heart attack. Getting back into your routine as soon as possible is crucial, including exercise. 

Here are some tips for staying fit after a heart attack: 

• Start with walking. Walking is the easiest way to move again, primarily if you’re not used to exercising regularly. It can also help you lose weight and lower blood pressure. Walking 30 minutes daily will help you regain shape faster than other exercises. 
• Increase your activity gradually until you do 30 minutes of moderate exercise five times per week (for example) or 20 minutes of vigorous activity three times per week (like running). You may need to take it slow at first—even just getting out of bed in the morning and walking around may be enough for now! You should be able to add more time as long as it doesn’t cause pain or fatigue. 
• Don’t forget about strength training! After a heart attack, your body will be weaker than before because it needs more oxygen due to damaged muscle tissue that needs repair; therefore, strength training is essential. 

Cardiac rehabilitation can save your life after a heart event like a heart attack. It helps reduce the risk of dying from heart disease and the risk of having another heart event. It enables you to get back to being an active community member. 

Researchers at Harvard Medical School reported that cardiac rehab reduces heart-related mortality by 20%, hospital readmissions by 28%, and increases the patient’s quality of life, ability to carry out daily activities, and overall mental well-being. 

Our experienced physiotherapists are dedicated to helping you recover from a heart attack or surgery. They will guide you through a comprehensive program of exercises, which have been tailored specifically for your needs to help you achieve your goals—whether that’s walking again or simply feeling better. 

We believe in empowering our patients and helping them regain control over their health. If you’re looking for an expert team of physiotherapists who can help support you on your journey back to wellness, look no further than Burjeel Hospital, Abu Dhabi. 

What is Anal Fistula?

Anal Fistula is a condition where the skin around the anus becomes inflamed and develops a tunnel-like opening. This tunnel can lead to a chronic infection that may require surgery to repair. This tunnel allows bacteria to enter the body and can cause severe pain. Anal fistulas are most common in people who have Crohn’s disease. Still, they can also occur in people with other conditions such as ulcerative colitis or diverticulitis.

What Causes of Anal Fistula?

Anal fistulas are usually caused by chronic inflammation and infection in the lining around the anus and rectum, which can result from various factors, including:

• Constipation
• Diarrhea
• Infection of the lining around the anus (anal fissure)
• Inflammation of the tissue inside the rectum (internal hemorrhoids)

What are the Symptoms of an Anal Fistula?

Symptoms of an anal fistula include:

• Painless discharge from the anus that may be clear, cloudy, or bloody
• Pain in the lower abdomen, bottom, or perineum
• Swelling in the area around the anus
• Persistent itching or burning sensation around the anus
• Painful bowel movements

How is Anal Fistula Diagnosed?

Anal fistulas are usually diagnosed by a doctor and then confirmed with tests. The following tests may be used:

Physical examination: Thedoctor will examine the anus and rectum to check for abnormalities. They may also ask about the symptoms and do a rectal examination to find out more about the exact location of the fistula.

Rectal exam: A proctoscopy is where a special telescope with a light on the end is used to look inside the anus and rectum. It helps detect an anal fistula so treatment can start as soon as possible. Sometimes, the doctor may recommend additional tests as part of the evaluation. These tests include an ultrasound scan, MRI scan, or CT scan.

Ultrasound scan: This test uses sound waves to create an image of internal structures within the body, such as organs or blood vessels. It may be used during surgery if there is no other way to determine if there’s an anal fistula present and may help guide doctors when trying to repair one surgically by showing them where it is located in relation to nearby organs such as nerves or blood vessels that could otherwise be damaged during surgery.

What are the Risk Factors for Anal Fistula?

The risk factors for anal fistulas include:

• Age: The older an individual is, the higher their risk for developing new anal fistulas.
• Gender: Women are more likely to develop anal fistulas than men.
• Diabetes: This condition increases the risk of developing an anal fistula and other complications related to Crohn’s disease or ulcerative colitis.
• Anal Fissure is a tear in the lining of the anus.
• Anal Abscess is an infection in the area between the anus and the rectum.
• Crohn’s Disease or Ulcerative Colitis, diseases that cause inflammation of the digestive tract.
• Diarrhea can cause chronic constipation or hard stool that sticks and causes pain when it passes through the anus.
• Hemorrhoids are swollen blood vessels around the anus that cause pain and bleeding.

What are the Types of Anal Fistula?

There are four main types of anal fistulas.

• Intersphincteric Fistulas occur at the level of the internal sphincter, which is located between the internal and external sphincters.
• Transphincteric Fistulas occur at the level of the external sphincter, which is located between the internal and external sphincters.
• Suprasphincteric Fistulas occur above both internal and external sphincters, usually as a result of trauma to the anus or rectum.
• Extrasphincteric Fistulas occur outside both internal and external sphincters, usually as a result of trauma to the anus or rectum.

What are the Treatments Available for Anal Fistula?

Anal fistulas are usually treated by a general surgeon, a colorectal surgeon, or a proctologist (an expert in diseases of the anus and rectum). Treatment for anal fistulas may include the following:

Fistulotomy involves cutting out the internal portion of the fistula with a surgical knife or laser beam, allowing normal tissue to grow in its place. It’s usually performed under general anesthesia and requires an overnight stay in the hospital.

Seton Techniques are used to treat anal fistulas. Setons are fine wires placed in the fistula tract to drain pus and fluids from the anal canal. The seton is removed after several months when healing has occurred.

The Advancement Flap Procedure involves creating a new passage for fecal matter to exit the body by moving tissue from one area to another. The advancement flap procedure is typically performed in conjunction with other procedures, such as a posterior sphincterotomy or surgical removal of affected tissues. The advancement flap procedure may also be referred to as a mucosal advancement flap procedure.

The Ligation of Intersphincteric Fistula Tract (LIFT) procedure is a minimally-invasive surgery that involves removing a portion of the intersphincteric fistula tract and then closing it with absorbable suture closure.

Endoscopic Ablation is a minimally-invasive procedure that uses lasers to remove the damaged tissue from around the anus and close off the tunnel. This allows the area to heal and prevents further infection from occurring.

Laser Surgery for anal fistula is a minimally invasive procedure that can be used to treat the condition. It can be performed under local or general anesthesia and often involves only one or two small incisions in the affected area. A laser beam is then used to seal off the openings of the fistula, which helps prevent infection from spreading and relieving symptoms.

Fibrin Glue is a medical adhesive used to treat anal fistulas. Fibrin glue is made from a clotting protein called fibrinogen, extracted from human blood. Fibrin glue can be injected into the anal canal to seal off the fistula and stop the leaking of fecal matter, which causes the symptoms of this condition.

FAQ’s

How serious is a fistula?

A fistula is a serious medical condition that can lead to surgery and other complications.

How serious is a fistula?

A fistula is a serious condition that can cause many problems for an individual’s health, both short-term and long-term. It’s important to understand what causes fistulas, how they’re treated and managed, and the potential complications.

Can a fistula heal on its own?

Fistulas can heal on their own, but the rate of healing varies depending on the severity of the condition. Fistulas are not always life-threatening but can be incredibly uncomfortable and require treatment. If an individual has a fistula, they should see their doctor find out how to treat it.

Is fistula a major surgery?

Fistula is not major surgery. The procedure is often performed under local anesthesia; most patients can go home the same day. However, some patients may need to stay in the hospital overnight.

How long does fistula surgery last?

Fistula surgery lasts anywhere from 30 minutes to 2 hours. The length of the procedure depends on how many surgeries an individual has, what type of fistula a persona has, and how complicated the case is.

How painful is fistula surgery?

Fistula surgery is a minimally invasive procedure. It is typically done under general anesthesia, and the patient will spend one to two hours in the recovery room after the surgery is complete.

What food should be avoided in fistula?

One way to avoid worsening a fistula is to avoid foods containing indigestible carbohydrates like roughage or fiber. These include wheat bran, whole wheat bread, cereals, beans and lentils, nuts, and seeds. The problem with these foods is that they can be difficult to digest, which can contribute to bacterial overgrowth in the small intestine, leading to inflammation in the area around the fistula or diverticular abscesses. Fistula pain is a burning sensation that can be felt in the lower abdomen, groin, or rectum. It may be experienced as a constant dull ache or as sharp pains that come and go.

What does fistula pain feel like?

Fistula pain can vary from person to person. Some patients may feel a burning sensation, while others may feel more of an ache or aching sensation. The pain can differ depending on where the fistula is located and how long it has been there.

How do you heal a fistula?

Fistulas can be very painful, but there are several ways to heal them. If there is an open wound, it’s essential to keep it clean and covered with a bandage. One should also avoid walking around in public, as this could expose it to bacteria that can worsen the fistula. If one has an internal fistula, their doctor may prescribe antibiotics or other medications to help treat the infection. One should also consider undergoing surgery if symptoms don’t improve after using antibiotics for several weeks or months. The type of surgery performed will depend on what type of fistula an individual has.

Our expert Proctologists can help manage anal fistula with a combination of medications, procedures, and lifestyle changes. We’ll work with you to identify the best treatment for your needs.

Our Expert Proctologist

Dr. Ibrahim Gamal

Specialist General Surgeon

Years of Experience : 10

Nationality : Eygpt

Languages Known : Arabic , English

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Vaginal Discharge  

Vaginal discharge is a fluid produced by glands within the vagina and cervix. It keeps the vagina clean and helps prevent infections. It is normal the majority of the time. Natural variations in estrogen levels during ovulation, sexual stimulation, the use of birth control tablets, and pregnancy might cause an increase in the amount of discharge.

Type of Vaginal Discharge  

The amount and type of vaginal discharge can indicate the health of the reproductive system. Here are some of the most common types, 

• White milky or colorless discharge without odor is typically normal  
• Yellowish discharge. This is also normal and usually caused by cervical mucus
• Whitish, like cottage cheese, can be a signal of fungal infection
• Light brown or pinkish discharge indicates inflammation or infection, which may be due to an STI bacterial vaginosis, trichinosis, or yeast infection
• Grayish discharge shows an STI, such as chlamydia or gonorrhea. It has a foul smell and can cause itching around your vaginal area.  

Causes

There are many reasons a woman may have vaginal discharge, the most common cause is bacterial vaginosis (BV), which is caused by an imbalance in the normal bacteria in the vagina.

Other causes include sexually transmitted infections (STIs), yeast infections, and other infections.  

Diagnosis

If you are experiencing vaginal discharge, you must see a gynecologist who will do a physical exam and ask questions about your medical history and symptoms. They may also perform some tests, such as pelvic exams and vaginal swabs.  

Treatment for Vaginal Discharge  

The treatment for vaginitis depends on what is causing the discharge. If the cause is BV, then the doctor will prescribe antibiotics. If it is a yeast infection, the doctor will prescribe medication to treat the disease and prevent further spread if possible. If you notice any abnormal changes in your discharge, experience any other symptoms that may indicate an infection, or want to know more about what might be causing it, schedule an appointment with our expert gynecologist at Burjeel Medical Center, Marina Mall, Abu Dhabi. 

What are Pelvic Floor Exercises?

Pelvic floor exercises are physical exercises that can help you have better control over your pelvic muscles. When you exercise these muscles, they become stronger. Pelvic floor exercises can help prevent or treat urinary incontinence, pelvic organ prolapse, and other conditions.

Why is it Important to Perform Pelvic Floor Exercises During Pregnancy?

During pregnancy, your body undergoes many changes to prepare for childbirth. The pelvic floor muscles are no exception. During this time, they relax and stretch to accommodate the growing fetus and allow for vaginal delivery. Because these muscles stretch beyond their normal range of motion during the last trimester, it is essential to do pelvic floor exercises during pregnancy to keep them strong and healthy.

Should I Continue to do Pelvic Floor Exercises After Giving Birth?

After delivery, women often experience a loss of bladder control and pelvic prolapse, which can lead to incontinence and other issues related to poor pelvic muscle tone. Pelvic floor exercises can help minimize these risks by strengthening your pelvic muscles to support your organs more efficiently.

It has been proved postpartum (exercise after delivery) can improve mood, maintain cardiorespiratory fitness (aerobic capacity), improve weight control, promote weight loss, and reduces depression and anxiety.

Despite all these known benefits of exercise after having a baby, most of the time, most women do not resume their pre-pregnancy activity after the baby’s birth.

The primary reason for the lack of physical activity after delivery is a lack of awareness and guidance on when to start the exercises and what kind of exercises are safe.

When to Start the Exercises After Pregnancy?

After delivery period can be divided into 2 phases:

1. Immediate Postpartum – Hospital discharge to six weeks of postpartum

2. Later postpartum – Six weeks to one year

Most of the international guidelines suggest that after six weeks, physical activities can be started (later postpartum). But, it depends upon various factors like a vaginal delivery, C section, associated comorbidity, and activity level of the person before delivery.

However, in case vaginal delivery exercises can be started after six weeks, in C section after eight weeks, provided no associated risks are involved.

What Should I do Before Starting Exercises?

Meet with your gynecologist six weeks after delivery to receive clearance to begin exercising. Most of the time, gynecologists will refer you to a physiotherapist for a thorough evaluation before beginning physical activity.

What is the Role of a Physiotherapist in Postpartum Recovery?

Before beginning your routine exercises, the physiotherapist will thoroughly examine your pelvic floor muscles and prescribe a specific type of exercise if they find any abnormalities.

What are the Common Musculoskeletal Problems Post Pregnancy?

Nearly all pregnant women are estimated to experience musculoskeletal discomfort, with 25% experiencing at least temporarily incapacitating symptoms including,

• Low back and pelvic griddle pain
• Diastasis recti – abdominal separation
• Sacrococcygeal dislocation and coccygodynia – tail bone pain while sitting

What is the Importance of Physiotherapy After Birth?

Pelvic floor muscles are getting stressed/loaded at the time of pregnancy (beginning of 3rd trimester) to support the baby’s growth. These muscles get strained when delivered, which leads to weakness. If it’s not identified earlier, it will lead to bowel and bladder incontinence (accidental bowel and bladder leakage); therefore, it becomes essential to identify the strain/weakness of the pelvic floor muscles and to treat it to avoid postpartum complications.

What is Pelvic Floor Rehabilitation?

After a detailed assessment of the pelvic floor and abdominal muscles, our women’s health specialists will tailor your exercise program to rehabilitate the involved pelvic floor and abdominal muscles. This program may include specific exercises (Kegels exercises) and ultrasound-guided – (bio-feedback) pelvic floor muscles rehabilitation, education on posture, etc.

What are Kegel Exercises?

Kegel exercises are a type of physical therapy that can help strengthen the pelvic floor. Dr. Arnold Kegel developed them to help women who had given birth strengthen their pelvic floor muscles, which would help prevent them from leaking urine or experiencing constipation.

Kegel exercises work by contracting and relaxing your pelvic floor muscles, which are the group of muscles that surround your urethra, vagina, and rectum. You will be lifting your pelvic area by contracting these muscles.

Strong pelvic muscles can help you have an easier birth and recover more comfortably. Performing pelvic floor exercises regularly throughout and after your pregnancy improves the strength and endurance of your pelvic floor muscles. Our physiotherapists at Burjeel Hospital, Abu Dhabi, are extensively trained to assess your muscle strength and endurance and tailor a program that’s right for you to improve your pelvic muscle strength, flexibility, and endurance.

What is Morton’s Neuroma?

Morton’s Neuroma is a painful swelling of the nerve running either between the second and third toes or the third and fourth toes. It is often part of a bursa (a soft tissue swelling, often found asymptomatically in feet) and some swelling around the nerve. It is called Morton’s Neuroma because it was first written up in the medical literature by Thomas Morton in 1867. The word neuroma is the medical term used for swelling on a nerve. It is not sinister but can often cause disproportionate pain in the forefoot.

What are the Symptoms of Morton’s Neuroma?

• Pain in the forefoot
• Numbness or tingling in the toes
• Feeling as if you are walking on a pebble
• Feeling if there is something inside your shoe

What are the Causes of Morton’s Neuroma?

No one knows!

There are theories about tight-fitting shoes, particularly ladies’ footwear, repetitive low-grade trauma, such as the frequent wearing of high-heeled shoes, and rarely, injury. However, if this was the case, many more sportsmen would have a neuroma. Most cases are idiopathic.

What are the Risk Factors of Morton’s Neuroma?

Not really!

We know it occurs more frequently in women, probably because of footwear. Still, lots of ladies wear fashionable shoes and never have any problems! The shape of the feet does not increase the likelihood of developing a neuroma. There are no genetic factors.

Can I Prevent It From Occurring?

As we do not know the cause, we can do little to prevent it from occurring. Of course, if you feel pain in certain (tight fitting) shoes, it would be a good idea to try another pair of shoes!

How is Morton’s Neuroma Diagnosed?

It is largely a clinical diagnosis and is best assessed by a foot and ankle surgeon familiar with diagnosing and treating these.

X-rays are important to exclude a bony cause for the forefoot pain.

Scanning with the ultrasound machine or the MRI scanner does not always confirm the presence, nor can it confidently exclude a neuroma.

Does Morton’s Neuroma Cause Any Lasting Harm?

Not at all, but usually, it becomes enough of a problem that people seek help for the pain. 

What is the Treatment for Morton’s Neuroma?

First, seek advice from a foot and ankle surgeon to confirm the correct diagnosis. Once the diagnosis is established, the treatment options are: 

• Simple painkillers, such as anti-inflammatories
• Insoles
• Injection of Cortisone
• Surgery to remove the painful nerve

Although a neuroma is painful, there is no need to rush into surgery, and simple measures should always be tried first. Your surgeon will discuss this with you.

What are the Surgical Options for Morton’s Neuroma?

Several options are suggested in the literature. Again, your foot and ankle surgeon will discuss this with you. The most predictable procedure is a short, day-case operation to excise the Neuroma. This will often leave some numbness along the side of the two toes, but to most patients, this is an acceptable compromise to be free of the restrictive pain.

The Foot and Ankle Clinic at the Dubai Burjeel Hospital for Advanced Surgery would be delighted to see and help with your foot pain and discuss available treatments. The first step is to get the correct diagnosis and formulate a treatment plan that you are comfortable with.

Our Orthopedic Foot & Ankle Expert

_{Dr. Andrew Foggitt}

Consultant Orthopedic Foot & Ankle Surgeon

Burjeel Hospital for Advanced Surgery, Dubai

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What are Dry Eyes?

Dry eyes are a condition in which the eye does not produce enough tears. Tears are essential because they keep the eye lubricated and moist. The result is that it becomes red and irritated and can even lead to a loss of vision if left untreated.

What Causes of Dry Eyes?

Dry eyes are a common complaint among many people, but several underlying causes exist. The most common cause is the result of decreased tear production. This is often due to a deficiency in one or more components that make up tears: mucus, water, and oil. The most common cause of decreased tear production is meibomian gland dysfunction (MGD), which occurs when the meibomian glands do not produce enough oil to keep your eyes moist.

Environmental Conditions: Wind and cold weather can make your eyes dry, and prolonged usage of mobile phones, tablets, and computers can also cause this condition and make you uncomfortable.

A decrease in tear production can also be caused by health conditions like diabetes or autoimmune disorders such as Sjogren’s syndrome, in which the immune system attacks the tear glands and reduces tear production.

Tear production can be affected by several other factors, including:

Age: As we age, our tear glands begin to slow down. This is often why most people experience dry eyes as they age.

Contact Lens: Contact lenses can irritate and damage your eye’s surface, leading to dryness.

Medications: Some medications, like allergy eye drops or steroid ointments, may cause your eyes to feel dry and irritated.

What are the Symptoms?

The symptoms can vary from person to person, but they typically include:

• Eye discomfort
• Eye irritation or pain
• A gritty feeling in your eyes
• Difficulty focusing on near objects
• Burning sensation in the eye
• An itchy or scratchy feeling in the eyes
• A foreign body sensation (feeling like something is in your eye)

How is it Diagnosed?

Dry eye is diagnosed using a comprehensive eye exam. The Ophthalmologist will take a thorough medical history and perform an eye examination. The eye doctor may use any of these tests to diagnose the condition:

Visual Acuity Test – This test measures how well you can see at a distance and near.

Punctate Corneal Staining – This test looks for white spots on the surface of your cornea, which can indicate dryness or infection.

Schirmer Test – This test measures how much liquid you produce when you blink. It’s used to help diagnose dry eyes caused by insufficient tear production.

Tear Film Break-Up Time (TBUT) – To measure TBUT, fluorescein strips are instilled into the patient’s tear film. The patient is asked not to blink while the tear film is observed under a broad beam of blue illumination. A short tear break-up time is a sign of a poor tear film; the longer it takes, the more stable the tear film.

What is the Treatment for Dry Eyes?

The first step in treating the condition is to ensure that you address all the possible causes of your symptoms. This means ensuring that your eyelids are clean and free of debris, that you don’t have any allergies or irritants in your environment, and that you aren’t spending too much time staring at a computer screen or other devices.

Suppose these steps do not help to alleviate your symptoms. In that case, you may want to consider using artificial tears or other prescription eye drops. These drops contain lubricating agents that help keep the eyes moist and comfortable.

If the problem persists, it’s likely time for further evaluation by an ophthalmologist specializing in treating dry eyes.

How to Prevent Dry Eyes?

The best way to prevent it is by keeping your eye area clean and healthy. This can be done by regularly washing the area with gentle, non-irritating soap and then rinsing it with water.

To keep your eyes hydrated, drink plenty of water throughout the day. You should also avoid smoking and drinking alcohol, as these can dry your eyes. You should also avoid wearing contact lenses for long periods as this can cause your eyes to become dry.

If you are experiencing dry eye symptoms such as burning, itching, or redness in both eyes at any time during the day, it is recommended to consult an eye doctor

Dry eyes are a common problem that can be treated. If you are experiencing any of the symptoms of dry eye, consult with our experienced Ophthalmologist, who provides treatment for dry eyes and any other ocular diseases.

Our Expert Ophthalmologist

_{Dr. Shobhana Pariyani Krishna}

Specialist Ophthalmology

Burjeel MHPC Health Center, Abu Dhabi

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What is Idiopathic Intracranial Hypertension? 

Idiopathic intracranial hypertension, or IIH, is a condition that causes increased pressure inside the skull. This pressure can cause severe headaches and vision problems. It is also known as pseudotumor cerebri and benign intracranial hypertension. IIH is a rare but essential disease associated with significant morbidity.  

The condition was first described in 1897, though its cause remains unknown. About 2 per 100,000 people have newly affected annually, most commonly affecting women aged 20–50. Females are affected about 20 times more often than males. 

The pathophysiology of IIH involves dysregulation of CSF dynamics and venous sinus pressure. After circulating through the body, CSF usually is reabsorbed into the body through blood vessels; however, if too much fluid is produced or not enough is reabsorbed, the CSF can build up and cause pressure within the skull, which is an enclosed space. 

What Causes Idiopathic Intracranial Hypertension? 

The exact cause of idiopathic intracranial hypertension is unknown. Still, it’s thought that several factors can cause the increased pressure 

• Obesity 
• Head trauma or injury 
• Birth control pills and certain medicines

Who is at Risk for Idiopathic Intracranial Hypertension? 

In most cases, it affects people between 20 and 40 years old who are female. However, it also affects some children and men. It is unclear why this condition occurs or how to prevent it from happening again. People at risk for idiopathic intracranial hypertension include

• People who are overweight 
• Have a history of head trauma 
• Have a genetic predisposition to the condition

What are the Symptoms of Idiopathic Intracranial Hypertension? 

The symptoms of idiopathic intracranial hypertension (IIH) can vary from person to person. In addition to headaches, the most common symptoms include: 

• Pain in the back of the head or neck 
• Blurred vision or loss of vision
• Dizziness or vertigo 
• Double vision 
• Trouble focusing on the eyes
• Nausea or vomiting 
• A stiff neck 

How is IIH Diagnosed? 

TTo diagnose IIH, a Neurologist will perform a physical examination after taking the patient’s medical history.

Comprehensive Eye Exam. The doctor may order a comprehensive eye exam, including checking for papilledema ((swelling of the part of the optic nerve (optic discs)). Suppose there’s a strong suspicion of IIH based on symptoms and the exam results. MRI of the brain as well as MRA of the head and/or CT cerebral venography should be requested as part of the required investigations.

A Lumbar Puncture (Spinal Tap). During this procedure, the doctors insert a needle into the lower back , in the lumbar region. During a lumbar puncture, a needle is inserted into the space between two lumbar bones (vertebrae) to remove a sample of cerebrospinal fluid. The amount of fluid removed will be measured (measurement of CSF pressure.), which allows doctors to determine whether the patient has excess cerebrospinal fluid in the head or not. The test is diagnostic and therapeutic as well. 

What are the Complications of IIH? 

The complications of idiopathic intracranial hypertension are numerous and can be dangerous. The most common complication of IIH is papilledema—swelling of the optic disk caused by increased pressure inside the skull. Papilledema can cause vision loss if left untreated, but it usually resolves once IIH is treated.

How is Idiopathic Intracranial Hypertension Treated? 

IIH is treated with medications and lifestyle changes. 

First, the doctor will prescribe medications to help relieve the pressure around the brain and on the optic nerve. 

Sometimes, an individual may need surgery to treat idiopathic intracranial hypertension. Surgery is done to remove excess cerebrospinal fluid from around the brain and spinal cord. 

Individuals who have signs of IIH must see a doctor immediately. Untreated IIH can cause permanent vision damage, so it’s essential to find out what’s causing the symptoms and get treatment as soon as possible. Our expert Neurologists at Burjeel Hospital, Abu Dhabi, provide comprehensive care for patients with IIH and offer specialized treatments including medications and surgery to help manage this condition. 

Our Expert Neurologist

_{Dr. Atta Ghassan Al Khaznaji}

Head of Neurology Department | Specialist Neurology

Burjeel Hospital, Abu Dhabi

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