Cosmesis refers to the preservation, restoration of a body part in it’s original form. Breast cosmesis is an important aspect and an endpoint of breast conserving therapy. The surgeons who carry out surgeries related to breast removal or upliftment, need to be precise in getting the other breast in exact shape to maintain symmetry. Their next priority is to make everything look good in the process.
Cosmesis plays a critical role in a woman’s physical and emotional recovery. Being fully treated and getting themselves out of danger is always the first priority but once women are out of danger, they would obviously be concerned about their looks, hence good cosmesis is a necessity.
Factors Affecting Good Cosmetic Outcome
Cosmetic outcome which follows the breast-conserving surgery is dependent on various factors like:
Though the best method to assess good cosmesis in breast cancer surgery is still not clear but there are certain objective and subjective methods in combination, known to give a fairly good assessment of cosmesis.
Methods and materials involved to determine good cosmetic outcome
The general methods followed to ensure good cosmesis are Breast Retraction Assessment (BRA) and percentage Breast Retraction Assessment (pBRA). These are the objective measurements of the amount of breast retraction, determined primarily by comparing positions of nipple in relation to the sterna notch between the treated breast and contralateral breast.
The pBRA technique has been proved to have low intra and interobserver variability. Lower values of percentage Breast Retraction Assessment have been shown to correlate with improved cosmetic outcomes, hence making percentage Breast Retraction Assessment a reliable and an objective measure of cosmesis.
How is cosmetic assessment generally done?
In a particular case, evaluation of cosmesis was done before treatment, around 6-8 weeks post-treatment, 3-4 months post treatment, 6-8 months post-treatment, then every 6 months period for next 4-5 years and finally the assessment was down to yearly basis. The qualitative evaluation of cosmesis involved comparing treated breast with the untreated breast using the rating system.
The global cosmetic result, appearance of the scar made due to surgery, breast size, breast shape, colour of the skin, location of the areola and nipple and shape of the nipple and areola. All these were scored on a 4-point scale,
Physical measurements to calculate Breast Retraction Assessment and percentage
Breast Retraction Assessment were taken in a live example, while patients were in a seated position with both arms at the side of the body. Both the assessments were determined prior to the treatment as well as at the follow-up. As Percentage Breast Retraction reports retraction in terms of percentage, so it was used for analysis. On each occasion both the patients and physician reported the perceived cause of cosmesis as mainly because of radiation, surgery, unknown or no significant change.
The National Doctors’ Day in India is celebrated on the 1st of July every year. It is a campaign attempting to increase awareness about the roles, responsibilities, and the importance of doctors in society. It also promotes and encourages medical professionals and doctors for following their responsibilities with dedication and efficiency. It is also a way to express gratitude and appreciation towards medical professionals and acknowledge their commitments towards society.
All doctors after graduation take oath for the selfless service to humanity. Over the years, doctors have been providing the same without any prejudice to the profession. Of late a society outlook has changed towards doctors resulting in attacks on doctors. This doctor day, by means of this article, we would make an attempt to change society outlook towards doctors. Health is defined by WHO, as a state of complete social psychological and physical wellbeing and not merely an absence of infirmity. Being healthy is the responsibility of every individual. Doctor steps in, once an individual feels unhealthy.
In India, the National Doctors’ Day is celebrated to honour legendary doctor and 2nd chief minister of West Bengal, “Dr. Bidhan Chandra Roy”. This day is celebrated as a tribute to him and to acknowledge his work towards society during his entire medical profession. Dr. Bidhan Chandra Roy was born on 1st July 1882 in Bihar and passed away on 1st July 1962 in West Bengal. He was one of the famous freedom fighters and physicians. He was a highly respected West Bengal’s chief minister for 14 years. He was also a great architect and founded five cities of West Bengal, which include Habra, Bidhannagar, Durgapur, Kalyani, and Ashoknagar. He was honoured with India’s highest civilian award, Bharat Ratna.
Why National Doctors’ Day is Celebrated in India?
In India, the National Doctors’ Day was first celebrated in 1991 and since then it is celebrated every year on the 1st of July.
National Doctors’ Day is a great opportunity in India to acknowledge the actual need of physicians and doctors in today’s society. This is an annual celebration as well as an awareness program that helps people to understand the roles, responsibilities, and importance of medical professionals. It is a well-known fact that people are dependent on doctors and their quality treatments in many ways. This shows the value and importance of the medical profession. National Doctors’ Day gives people an opportunity to show encouragement and support towards doctors and medical professionals.
This annual celebration campaign is a great opportunity for all doctors to reflect on their roles and responsibilities to save the life of the people.
General Camps Organized on National Doctors’ Day
There are several camps organized on this day to make people aware of different issues related to health. Some of the common health camps organized on this day are:
● Health Counseling
● Health Nutrition Talk
● Chronic Diseases Awareness
● Free Blood Test
● Free Blood Sugar Test
● ECG and EEG
● Blood Pressure Checkup
Takeaway
National Doctors’ Day is celebrated every year to show respect towards medical professionals who dedicatedly work to save the lives of patients. This day gives us an opportunity to come together as a society and honour the practitioners of this noble profession.
Prevention is better than cure. But individuals tend to ignore or willfully become ignorant of their illness. They remain in denial mode. But if anything goes wrong with them, then the doctor is blamed for not treating them well. We need to take healthcare in a holistic approach. Society needs to understand that. Today on doctors day, we would like to create awareness about society's role in health care and its responsibilities towards health care. Support the doctors and make health care effective qualitatively and quantitatively. Society needs to take a pledge to support health care in their surroundings and support doctors to prevent various diseases.
Infertility is a global health issue in current world health dynamics, that has far-reaching and serious socioeconomic consequences. A declining trend in male fertility indicates an acute need of accessible as well as economical diagnosis and treatment. Conventional Assisted Reproductive Technologies are useful but the success rate has become constant over time.
There have been various experiments performed for demonstrating the capabilities of Microfluidics systems in a number of Assisted Reproductive Technologies like oocyte manipulation, sperm sorting, embryo culturing, insemination, assessment of quality of sperm and embryo, etc. However, most of the clinical applications have been in sperm sorting or purification. Many opportunities have emerged for microfluidics to address male infertility. Microfluidics is a multidisciplinary field with a number of potential applications involving behavior, manipulation, and precise control of fluids.
They are constrained geometrically to a small scale on microfluidic chip, containing a pattern of engraved or molded microchannels. Sperms traverse their way towards the ovum in tiny mucosa microchannels, between the cervix and uterus, in a unidirectional. The flagellar movement in a naturally filtered environment that selects functional sperm. Microfluidics technology mimics the microenvironment of the female reproductive tract, to help in selection of superior, significantly more motile sperm for Intracytoplasmic sperm injection (ICSI).
Current Sperm Selection Techniques:
Conventional clinical sperm selection techniques, like density gradient isolation methods, physiological intracytoplasmic sperm injection (PICSI) method, and morphology-based selection methods, provides reliable solutions for isolating normal sperm from semen samples. Sperm morphology is an important predictor of fertilization. Morphology-based selection is generally employed. Unlike morphology-based selection, PICSI is a biologically inspired technique that mimics the natural attraction between mature sperm and ovum, depending mainly on sperm motility for selective fertilization.
In recent times, paper-based microfluidics have emerged as a low cost, simple, faster, and effective alternative to conventional techniques of sperm analysis, much similar to pregnancy testing kits at home for semen analysis. It is a major breakthrough and is expected to reach a wider population as it is easily accessible to all.
Advantages:
Here are some of the advantages of microfluidics for sperm selection method:
Selection of quantitatively sufficient and qualitatively healthy sperm is an extremely important sample preparation process in the treatment of male infertility. Microfluidics help in recovery of motile sperm from semen, from highly heterogeneous mixtures, and reduce skill required for purification of sperm.
Microfluidic technologies are emerging as low-cost and rapid diagnostic alternatives for male fertility testing.
Microfluidics mimic in-vivo process and enable a selection of high-quality sperm, promising near-term advances in understanding male infertility and clinical execution.
Paper-based microfluidics is also possible at home and are easily accessible to many users.
Microfluidics can work with small volume samples leading to reduced costs, by minimizing the volume of expensive reagents. Thus, it is a cost- effective solution.
Microfluidics can help improve the efficiency of sample preparation, enable consistent cells and embryo culturing, and reduce human error.
Take Away:
Microfluidics is an emerging scientific field for sperm selection for Assisted Reproduction Technology and is expected to revolutionize the face of male fertility all over the world by being accessible to a wider population. Ongoing research suggests that it is expected to be very cost-effective, efficient, and precise in the near future.
Myth : Homeopathy establishes “Magic Cure” – it is just an unproven method of treatment.
Fact : Homeopathy is a method of treatment based on laws and principles drawn from sound logic and experimental data. Its exact scientific basis still remains unproven but the clinical and experimental data prove its efficacy.
Myth : Homeopathic medicines are placebo and have no medicinal action.
Fact : This issue is the most popular myth regarding homeopathy. An occasional burp of it has become a routine affair. It is true that the sugar pills given are inert and do not have medicinal power but they are just vehicles or carrier of homeopathic medicines. Homeopathic medicines can be given dissolved in water or in sugar pills but still they establish cure. It is the resultant cure which shows the medicine has acted and was not just a placebo. The scientific study of efficacy of homeopathic cures throughout the world cannot be merely from placebo effect.
Myth : Homeopathy is only suited to chronic cases or terminal cases.
Fact : It is a common notion that homeopathy is the choice for treating chronic cases or those patients who are not relieved or do not go well along with allopathic drugs. Most of the patients have attained this knowledge through their contacts or maybe some unlucky ordeal. It may be true in some cases but not always. The rightful act for attaining complete relief is to approach homeopathy before it is too late. If you are delaying a visit to doctor or health professional then it is another story but if you are delaying because you have to visit a homeopath then it is health negligence on your part. Most commonly the time of visit depends on your complaint; it can be summed up as:
In Acute cases: Acute diseases are those diseases which have sudden origin and the intensity of discomfort is high. In such cases people generally take conventional medicine thinking, Homeopathy is slow acting and is not worth trying in acute cases. But the truth is that, homeopathy is also effective in acute cases if the choice of similimum is proper. In Surgical cases: The scope of homeopathy is limited in surgical cases; in some cases homeopathic medicines prevent surgeries while in some the patient needs to be referred to surgical OPDS (Out Patients Department) for the needful. It all depends on your health state and the disease condition when you consult the homeopathic physician.
In Chronic cases: Chronic diseases are those cases which have insidious origin, long duration with less to moderate discomfort. Homeopathy has now and again proved its efficacy in these cases.
In Terminal cases: These cases include those cases which have been diagnosed as beyond the range of complete cure. In such cases homeopathy can help to reduce the suffering and also improve the quality of life.
If you are not sure of your disease better visit the physician and let him decide for you. Better safe than sorry.
Thus we see that the common myth that homeopathy is limited to some diseases is not true. Every science has limitations; no science is complete in itself, so why blame homeopathy alone? The best way to get maximum results is to approach homeopathy when you are still within the curable zone.
Myth : Homeopathy works slow.
Fact : This is the most popular myth about homeopathy but it is not true in all the cases. In fact, if the choice of similimum is proper the patient would show immediate signs of improvement. In acute diseases the response time is within minutes while in chronic diseases it can extend to days; it all depends on your disease state and the duration of action of the remedy. Your homeopathic physician would inform you about the signs of improvement that you can notice for yourselves. So you can find it for yourself that in most cases homeopathy can work faster, providing quicker relief than the other systems of medicine.
Myth : Excessive medicine effects fast.
Fact : Sometimes people summarize this rule owing to their experiences with conventional medicine; but this does not hold true in the case of Homeopathy. Law of Minimum Doses is one of the cardinal principles of Homeopathy – homeopathic medicines are given in qualitative doses i.e. in potencies and not quantitatively. A single dose of the similimum be it of poppy sized globule can work wonders for you. If you are taking more than you are prescribed, you are hindering your cure.
Myth : Homeopathic medicines do not have side effects.
Fact : It’s a well known fact that anything taken in excess is bound to be harmful. So why won’t homeopathic medicines cause harmful effects if you take them in excess due to negligence or thinking them to be placebo. (For the latter you can consult homeopathic physician to give you an insight into which medicine would show immediate response to enlighten you.) Moreover, homeopathic medicines act on the dynamic plane. So you may not be able to see the immediate after effects but it will become evident sooner or later. So it is best not to take the medicine unless needed or prescribed.
Myth : A good medicine must have expiry date on it.
Fact : Homeopathic medicines do have an expiry date; it would not be fruitful if you intend to pass the medicine phials through generations. Homeopathic medicines have a certain amount of alcohol mixed in them to preserve them; once it evaporates your medicines are of no use. For better results it is advised to store your medicines in dark colored bottles away from sunlight – it just helps them to last longer (read not forever).
Myth : People taking homeopathic medicines should not take onions, garlic, tobacco, etc.
Fact : As we have found now and then that most things we use in our food have power to affect our health, it all depends on how we utilize them. Since Homeopathic medicines act on the dynamic plane and affect us even through minimum doses, it becomes very essential not to interfere with the medicinal action. Taking food stuffs like onions, garlic, camphor, herbs in our diet only adds extra medicines to the prescribed ones preventing its proper action and thus affecting cure. But the modern culinary trend involves the use of spices to such an extent that it is difficult to completely avoid it. So one can go for using them in moderate amount and with brief interlude. As for spirituous liquors and tobacco, avoiding them is always good.
Myth : Bitter medicines effect faster and more.
Fact : There is no scientific fact to this – a medicine has its power in its constituent and not its taste. And if you believe it then sure you must know that most homeopathic remedies are bitter so they are given in medium of sugar globules to soothe your tongue; for Homeopathy acts gently.
Myth : Every symptom or complaint has different medicine.
Fact : It is not always true, for homeopathy treats the patient as a whole and not his individual sicknesses or complaints. So the choice of medicine is always one which belongs to patient as a whole. It may be possible that a new symptom may be so important that it changes the choice of medicine but it may not happen always. You may go by what your physician advises for he knows better when to change the prescription and when not to. On your part you can only tell him as much as you know about your disease.
Myth : Homeopathy acts by “aggravating” the complaints.
Fact : Homeopathic medicines are always prescribed such that the power or potency of drug should be just higher than the power of disease. Then only the medicine establishes cure. The medicine is perfect for your case only if it produces a slight aggravation of your present symptoms i.e. slight intensification of your complaints. But it is slight enough to provide minimum discomfort. That is, homeopathic medicines do produce a slight aggravation but it is for your own benefit as this slight aggravation is a sure sign that your medicine is perfectly chosen and will cure you. But do care to inform your physician about this aggravation if you find it discomforting. DO NOT TAKE ANY MEDICINE BY YOUR FREE WILL in such cases as you will again hamper the curative action of similimum.
Myth : Homeopathy is about psychological healing.
Fact : People sometimes feel that homeopathy is about psychological healing. We don’t deny it altogether, as what cure you can do if you let the patient bottle up his grievances and sorrows. We do admit that sometimes when the patient is suffering from suppressed emotions and only talking-it-out can do him some good that is the only way out (even the psychiatrics would approve it). In such cases homeopathic case-taking and counseling acts as “catharsis” and relieves the patient, but it is not always. The thorough case taking is for choosing the right medicine to cure the patient. It may be that talking-out provides momentary relief but it is only the medicine which establishes cure and not the case taking.
Myth : Homeopath asks many personal questions without any relevancy with the disease, only to confuse the patient.
Fact : Homeopath cures the patient as a whole and not just his complaints. To understand a patient as a whole requires knowing him as a person that includes apart from his complaints his likes, dislikes, his habits, his behavior, his response to certain situations etc. To know him better sometimes the physician can ask some personal questions – it can be about his bowel habits, his sexual life, sleeping pattern, his dreams, his past and present emotional setbacks etc. these are not to confuse or irritate the patient; they are just to know him better. This knowledge would help the physician in the choice of right medicine which would provide speedy recovery to the patient. So you can just relax and answer truthfully what your physician asks – it is only for your own benefit (off course you can excuse yourself if it becomes overbearing).
Myth : If my spouse/friend/relative suffers from the same complaint as I have- the same medicine will benefit all of us. That is I can give them the same medicine.
Fact : This is one of the most common myths in homeopathy. Homeopathic medicines are prescribed on the basis of Individualisation which tailoring the remedy according to individuals need. It means every individual is different from others in some way; be it his stature, talking, choices, behavior, or his susceptibility to diseases. Even the fraternal twins are different from each other in one way or the other; so how can same medicine be given to two different people even if they have the same complaint. Homeopathic medicines are always prescribed for the complete package that is the individual so naturally the medicine will change for different persons.
Myth : If I am going to a homeopath for some complaint, it is not necessary to tell him about the other medicines I am taking from other doctors.
Fact : This is not true; in any pathy i.e medicine (allopathy, Ayurveda, siddha, homeopathy etc.) you have to inform the physician what other complaints you have and what medications you are on. Especially in homeopathy where the choice of medicine would change with your case; let’s understand it like if the individual data changes the resultant choice changes. So be open with him about your complaints and choice of treatment. It may even be possible that you can have medicine for all your complaints from the homeopath himself and you won’t have to go to other doctors.
Myth : If I want to take homeopathic medicines for some chronic complaint I can not take any other medications especially allopathic medicines alongwith.
Fact : Ideally it should not be taken; but most of the chronic cases coming for homeopathic treatment are already taking allopathic medicines. If they resort to homeopathy it is better to wait for betterment to start from homeopathic medicines then gradually taper the allopathic medication. It causes some discomfort as your body takes time to adjust once you switch medicines, so it is better to remain in close contact with your homeopathic physician.
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