Treatment Choices

Cardiac surgery is surgery on the heart and/or great vessels performed by a cardiac surgeon. Frequently, it is done to treat complications of ischemic heart disease, for example, coronary artery bypass grafting(CABG), correcting congenital heart disease, or treating valvular heart disease created by various causes. It also includes heart transplantation.

Cardiac surgery techniques have been developing ever since 1950s. The development of cardiac surgery and cardiopulmonary bypass techniques has reduced the mortality rates of these surgeries to relatively low levels.
Open heart surgery:  This is a surgery in which the patient's chest is opened and surgery is performed on the heart. The term "open" refers to the chest, not to the heart itself. The heart may or may not be opened depending on the particular type of surgery.

Modern beating-heart surgery:  Since the 1990s, surgeons have begun to perform “off-pump bypass surgery”, a coronary artery bypass surgery without the cardiopulmonary bypass (a technique that temporarily takes over the function of the heart and lungs during surgery, maintaining the circulation of blood and the oxygen content of the body). In these operations, the heart is beating during surgery, but is stabilized to provide an almost still work area. Some researchers believe this approach results in fewer post-operative complications and better overall results.

Minimally invasive surgery: A new form of heart surgery that has grown in popularity is robot-assisted heart surgery. This is where a machine is used to perform surgery while being controlled by the heart surgeon. The main advantage to this is the size of the incision made in the patient. Instead of an incision being at least big enough for the surgeon to put his hands inside, it does not have to be bigger than 3 small holes for the robot's much smaller hands to get through.

References and More Reading:
www.nlm.nih.gov/medlineplus
www.sts.org
www.cts.usc.edu
www.wikipedia.org
www.kenthospital.com/kenthastanesi/eng/fip/y_coronary_angiogram.asp

Check is the general assessment of the health condition of the healthy individuals and to scan a disease that did not cause any complaints for the time being. Having a check up is to care for yourself and your health. Early diagnosis is extremely critical in some of the diseases and particularly cancer. Therefore, early diagnosis of this type of diseases as a result of check up scans also increases the success of treatment. Early awareness and early treatment in each field and disease of health will increase the life quality as well as life time of the individual.

The tests that must be included in a standard check-up control are as follows; blood count, blood tests that assess organ functions (liver, kidney, etc.), sedimentation, cholesterol and lipid levels, thyroid (goitre), urinalysis, whole abdominal ultrasonography, pulmonary graphy, electrocardiography and scanning of stool for blood.

In addition to the tests which everybody above the age of 40 should have, the following tests are recommended to be performed even if there is inherited risk or not; eye examination, cardiological examinations and additional examinations for cancer scanning. Those who have inherited risks should not wait for the age of 40 in order to have these tests. Those who are included in the risk group must have the additional tests done starting from their 30’s.

Another purpose of having a check up is to determine the possible disease risks that are carried with age, sex, cigarette smoking, and hormonal periods particularly in women (such as fertility-menostasis), to research the diabetes, coronary artery disease, seizure and cancer risks that are sourcing from family history.

Additional check up examinations for those who have a coronary artery disease risk sourcing from family are as follows; HDL cholesterol, LDL cholesterol, effort test and echocardiography.
Women who have cancer history in their families must receive the following procedures once a year; PAP smear test, breast ultrasonography, mammography, respiratory function tests and computer tomography. Men who have a cancer history in their families must have the following procedures once a year; prostate-specific antigen, respiratory function test and computer tomography.
The American Medical Association suggests that people have medical check ups every five years until age 40 and then every one to three years thereafter.

Some people reward themselves by caring about their health. Some reward themselves by joining a nice holiday abroad. The reward may duplicate if people bring their holiday and a check up program together where  these check ups generally take only a couple of hours .

Common Check up Programs

1. Standard check up
2. Male check up below the age of 40
3. Male check up above the age of 40
4. F emale check up below the age of 40
5. Female check up above the age of 40
6. Executive Check up (Male)
7. Executive Check up (Female)
8. Executive Check up (Female – Below the age of 30)
9. Cardiological Check up
10. Infant Check Up

References and More Reading:
www.cdc.gov/family/checkup
www.hri.org/news/balkans/omri/1996/96-11-15.omri.html#05
www.doganhastanesi.com/eng/dept-checkup.asp
www.acibademinternational.com/check_up.asp

Cosmetic surgery is usually performed to correct a physical abnormality or to enhance an otherwise normal physical feature and thus improve appearance. Cosmetic surgery is an extremely broad field that may offer reconstructive surgery for a patient after a damaging burn or other physical trauma, yet can also be used to smooth out wrinkles, enlarge breasts, or reshape a nose. In the not so distant past, Cosmetic surgery was confined only to surgery which was absolutely necessary to the health and well-being of the patient -- for instance, skin-grafting for serious burns, reconstructing a dislodged eye, repairing a broken nose or jaw, or treating an unseemly birthmark across the face. Cosmetic surgery was first used regularly after World War I, when treatment and reconstruction of war injuries gave hope to young soldiers.

As recently as fifty years ago, as the rich and famous began opting for elective cosmetic surgery, the subject was whispered about and considered taboo. Celebrities and others in elite circles would disappear for months and then emerge after secret cosmetic surgery looking younger, prettier, and thinner. Over time, cosmetic surgery has become accepted and even encouraged in some circles. Today there is open acceptance of cosmetic surgery to the point that there are even television reality shows about it. There are a wide range of choices for cosmetic surgery, from tiny tucks and snips to full-blown face-lifts.

Some of the more popular forms of cosmetic surgery are liposuction, in which excessive fat is sucked out of the body with a tube and vacuum device; laser facial resurfacing, which smoothes lines on the face around the eyes and mouth and eliminates facial blemishes;  facelift, which pulls back the skin around the face, jowls and neck; breast enlargement, which enhances the size of the breasts using saline implants; and hair replacement surgery, which fills in balding areas using a patient's own hair. There are many more forms of cosmetic surgery, including variations of these.

Blepharoplasty (Eyelid Surgery)

Blepharoplasty is a procedure in which the physician surgically removes excess skin, bags, pouches, and wrinkles from both the upper or lower eyelids to redefine the shape of the eye. This can be cosmetic or reconstructive in nature.

The procedure can be done with a scalpel or with a CO2 laser (a type of laser used in cosmetic procedures. It vaporizes skin on the surface, effectively removing the top-most layers of the skin).

Botox Injection

Botox cosmetic is an injectable agent used to temporarily diminish or eliminate lines and wrinkles on the face by relaxing underlying facial muscles into which it is injected. It is derived from botulinum toxin type A, a bacterium-produced neuromuscular toxin that can be deadly in a pure state. Botox contains a highly diluted form of the toxin and has been proven safe. For this reason, the U.S. Food and Drug Administration has approved botulinum toxin treatment for alleviating eye-muscle disorders and smoothing frown lines. This treatment is often used in conjunction with facial plastic surgery procedures such as a face lift or eyelid lift to maximize its cosmetic benefit.

Some of the uses for which Botox is currently approved includes treating the following:

1. Horizontal forehead furrows
2. Glabellar Frown Lines
3. Horizontal furrows at the nasal bridge
4. Eyebrow Asymmetry
5. Eyebrow Contour
6. Eyebrow prosis
7. Lateral Canthal Rhytids (crows feet)

Botox has many other uses than wrinkle reduction and some health concerns like cerebral palsy, muscular spasms, urinary incontinence, headaches,  tinnitus, excessive sweating, excessive salivation or post-stroke spasticity may be treated with Botox.

Breast Augmentation

Breast Augmentation is a surgical procedure, often involving the use of a prosthetic implant, to increase the size or alter the shape of the breast.  Implants are breast-shaped  pouches that are saccular in shape, made of a silicone outer shell, and filled with silicone gel or saline (salt water).

Breast implantation is usually performed to make normal breasts larger for cosmetic purposes. Sometimes a woman having a breast reconstruction after a mastectomy will need the opposite breast enlarged to make the breasts more symmetrical. Breasts that are very unequal in size due to trauma or congenital deformity may also be equalized with an enlargement procedure.

Breast Lift

Breast lift, or mastopexy, is a surgical procedure to raise and re-contour sagging breasts. In some cases, it can be performed in conjunction with surgery to enlarge the size of the breasts with breast implants.

Mastopexy typically is performed to lift sagging, loose breasts or breasts that have lost volume and elasticity after childbearing. It also can reduce the size of the areola, the dark pink skin surrounding the nipple. The extent of the procedure depends on what changes are desired and what is deemed appropriate.

Breast Reduction

Breast reduction, or reduction mammaplasty, is a surgical procedure to reduce the size and contour of large breasts. It can allow more comfortable physical activity, relieve weight-bearing pain in the breasts, shoulders, neck and back, and improve an individual's overall appearance.

Reduction mammaplasty typically is performed to reduce disproportionately large, sagging breasts. It also can reduce the size of the areola (the dark pink skin surrounding the nipple) which frequently becomes enlarged as the breast develops. The extent of the procedure depends on what changes are desired and what your surgeon deems appropriate.

Ear Surgery (Otoplasty)

Ear surgery or otoplasty, is usually done to set prominent ears back closer to the head or to reduce the size of large ears.

For the most part, the operation is done on children between the ages of four and 14. Ears are almost fully grown by age four, and the earlier the surgery, the less teasing and ridicule the child will have to endure. Ear surgery on adults is also possible, and there are generally no additional risks associated with ear surgery on an older patient.

Face Lift

Also known as rhytidectomy, a facelift is a surgical procedure to improve visible signs of aging in the face and neck. During the surgery, the facial skin is lifted away allowing the surgeon to tighten the underlying tissues.

The procedure is most often performed under a general anesthetic although in some instances an intravenous sedative (Sedatives administered by injection into a vein to help you relax) and a local anesthetic injection are used. A rhytidectomy requires several hours to complete, so most patients prefer to be asleep. It is not unusual for the surgery to result in a night's stay in a hospital.

As we get older, signs of aging appear initially in the face as wrinkles, looser skin, crow's feet, and a variety of other skin defects. They combine to reduce the vigor of your face, which is the most prominent feature of your persona. Though you may feel youthful and energetic on the inside, people won't see this if you appear to be weathered. A plastic surgery face lift can reverse these obvious signs of aging and give you back decades.

If you want an idea of what a face lift could do for you, look in the mirror and use your hands to pull back the skin on your face. That's what a plastic surgery face lift can do you for you with permanent results.

Face lifts come in a variety of flavors, but all of them seek to pick up the slack in your face's skin and reduce fine lines and wrinkling. There are plastic surgery techniques, non-surgical techniques, and some natural face lift techniques available.

Liposuction

Liposuction (suction-asisted lipectomy) can be defined as an aesthetic procedure that removes subcutaneous fatty tissue from the body in an attempt to bring the body into conformity with current perceptions of attractiveness. The focus of body contour procedures is the body unequal distrubition of fat, its overabundance in some areas and absence in others.

Liposuction (suction-assisted lipoetomy) consist of the removal of body fat using a device called a cannula that aspirates fat cells by suction. This procedure is effective in removing exess fat of the face, chin, arms, axillary breasts, abdomen, hips, trochanteric area (saddle bags), thighs, knees and ankles. There are limits to amount of the fat that can be removed and the degree of body sculpturing that can be accomplished with liposuction. However, in patients with abnormal deposition of fat liposuction is extremely helpfull in enhancing appearance.

Liposuction is effective in most patients who have good skin elasticity because the skin contracts after the fat has been removed. In most areas of the body where abnormal collection of fat have developed, liposuction has been beneficial in recontouring the area. Older patients and others with poor tissue elasticity may benefit from liposuction in conjunction with traditional body contour methods, such as facelift, abdominoplasty and thigh plasty.

Obesity Surgery

Being obese or severely obese puts people at a higher risk for developing or worsening many serious medical conditions.  There are more than 30 obesity-related medical conditions that can damage the quality of life and cause early death.  Some obesity-related medical conditions include arthritis, several cancers, carpal tunnel syndrome, cardiovascular disease, gallbladder disease, gout, hypertension, infertility, liver disease, low back pain, obstetric and gynecologic complications, sleep apnea, stroke, type 2 diabetes, and urinary stress incontinence.

Obesity surgery helps to lose weight by changing the way the body digests and absorbs food.  Our body digests food to break down what we eat into small pieces of nutrients (carbohydrates, proteins, fats, vitamins and minerals).  When the pieces are small enough, the cells of our body absorb the nutrients to give us energy to live.

Digestion and absorption begin in the stomach, continue through the small intestine and end in the large intestine, which digests and absorbs what it can and eliminates the rest as waste.  Obesity surgery involves making changes to the stomach and/or small intestine.

The Stomach - is made smller in size with surgery.  A section of the stomach is removed or closed which limits the amount of food it can hold and causes one to feel full.  This is called food intake restriction.

The Small Intestine - is where most of digestion and absorption take place.  It has three parts: the duodenum (upper part connected to the stomach), the jejunum (middle part) and the ileum (lower part connected to the large intestine).  Surgery shortens the length of the small intestine and/or changes where it connects to the stomach. This limits the amount of food that is completely digested or absorbed and is called malabsorption.

Through food intake restriction, malabsorption or both,  one can lose weight since less food either goes into the stomach or stays in the small intestine long enough to be digested and absorbed.

Rhinoplasty

Rhinoplasty, or nose remodeling, is the most widespread one among all plastic surgery procedures. Rhinoplasty can make the nose bigger or smaller, it can change the shape of the nose tip or the vault of the nose, it can shrink the size of the nostrils or change the angle between the nose and upper lip. It can also correct some birth anomalies and may help to solve some respiratory problems.

References and More Reading:
www.dh.gov.uk/en/Publichealth/CosmeticSurgery/A-Z/DH_A-Z_AZCP
www.plasticsurgery.org/Patients_and_Consumers/Procedures/Cosmetic_Procedures.html
www.anadolumedicalcenter.com/plastic_and_reconstructive_surgery.aspx

All of us have possibly heard about dental treatments such as fillings, bridges, dentures,  root canals, crowns and others.  From general to cosmetic, preventive to restorative dentistry there is a  wide variety of dental treatments which we meet at some stage of our lives.

Either if it is a canal treatment, dental bridges, implants or dentures for  missing teeth or an extraction, we do not like the dentist’s chair. However we are all aware that we have to be careful about our own or  our children’s dental health.

Depending on your dental health needs, you may ask for the below mentioned dental treatments at  technologically advanced dental healthcare structures where  you may avoid long waiting lists or high treatment costs:

1. Bridges
2. Crowns
3. Cleansing and Polishing
4. Dental Implants
5. Extraction 
6. Fillings
7. Restorative Dentistry
8. Root Canal Treatment
9. Tooth Whitening
10. Veneers

References and More Reading:
www.ada.org/public/index.asp
www.bdasmile.org
eng.dentistanbul.com.tr/Default.aspx?pageID=25
www.hisarhospital.com/EN/?Unitelerimiz&p=tedaviunitelerimiz&s=detay&id=133

Dialysis is a treatment to replace the filtering function of the kidneys when they reach end stage renal disease. When kidney function goes below about 15%, kidney dialysis is necessary to clean the blood. There are two main types of dialysis:  Peritoneal dialysis (PD) and hemodialysis.

Peritoneal dialysis (PD) is a treatment for kidney failure patients, which allows dialysis to occur inside the body by infusing fluid into the abdomen. Most patients who choose PD perform their own treatments at home or at their workplace.

Hemodialysis is a treatment for end stage renal disease (ESRD), or kidney failure, in which blood is removed from the body, filtered through an artificial kidney and then the cleaned blood is returned to the body Whichever dialysis modality is chosen, one can enjoy a fun vacation and still get dialysis treatments away from home. With the right planning and close communication with your health care team and a desire to venture out, you can enjoy getting away from it all on vacation.

There are different types of vacations that people on dialysis can enjoy. They can sail on a cruise ship, enjoy a vacation abroad, road trip across the country or visit famous sightseings. Whether you are on hemodialysis or peritoneal dialysis, you can travel and still get dialysis treatments either at a visiting dialysis center or by bringing your dialysis equipment.

Advanced planning for a vacation is necessary when you are on dialysis. It is recommended that dialysis patients talk with their nurse or doctor well in advance before traveling. Once the plans are set, you won’t have to worry about arrangements for dialysis treatments away from home and can enjoy all the benefits of getting away on vacation.

References and More Reading:
www.kidney.org
www.kidneypatientguide.org.uk
www.davita.com
www.eczacibasi-baxter.com.tr/tedavialanlari/bobrek.aspx

Eye surgery, also known as ocular surgery, is the surgery performed on the eye or its adnexa, typically by an ophthalmologist.

Going overseas for eye surgery such as cataract, glaucoma, squint, myopia, hyperopia, astigmatism  or presbyopia correction is becoming a more common practice.

Laser eye correction has become a popular option for restoring vision and  replacing dependence on contact lenses and glasses by correcting wide ranges of vision issues such as farsighted, nearsighted and astigmatism. The procedure uses a laser to reshape the cornea, the clear outer layer of the eye.

Photorefractive Keratectomy (PRK) was the first surgical procedure developed to reshape the cornea using a laser. Since the introduction of LASIK laser surgery in earlier 90s, surgical techniques have continued to develop and improve. Apart from the conventional LASIK, there are different options that improve the results and increase the amount of people that can benefit from laser eye surgery. These options are: IntraLase (Blade-Free LASIK), Wavefront LASIK, Epi-LASIK, LASEK (Laser Epithelial Keratomileusis) and Presby LASIK.

While the older techniques are performed less frequently, they may still be a more viable solution for some patients.

Apart from the laser eye correction techniques, patients may get the following treatments at technologically well advanced  eye clinics and hospitals abroad.

Cataract Surgery
Glaucoma Surgery
Lens Implants
Zoom Progressives.

References and More Reading:
www.aboutlasereyesurgery.com
www.eyesurgeryeducation.com
www.wikipedia.org
www.nlm.nih.gov/medlineplus
www.eyesurgeryinstitute.com
www.eyesurgeryusa.com

Hair loss  is the thinning of hair on the scalp. The medical term for  hair loss is alopecia. Alopecia can be temporary or permanent. The most common form of hair loss occurs gradually and is referred to as "androgenetic alopecia," meaning that a combination of hormones (androgens are male hormones) and heredity (genetics) is needed to develop the condition. Hair loss  normally occurs gradually with age in both men and women, but is typically more pronounced in men.

Most people normally shed 50 to 100 hairs a day. But with about 100,000 hairs in the scalp, this amount of hair loss shouldn't cause noticeable thinning of the scalp hair. Gradual thinning is a normal part of aging. However, hair loss may lead to baldness when the rate of shedding exceeds the rate of re-growth, when new hair is thinner than the hair shed or when hair comes out in patches.
Sudden hair loss can signal an underlying medical condition and may require medical treatment.

The following medical conditions are some of the possible causes of hair loss:

• Baldness (Male - female pattern baldness )
• Hereditary baldness
• Normal aging
• Menopause
• Nervous hair pulling - usually in children
• Excessively tight hair accessories
• Excessive shampoo or hair-drying
• Childbirth - hair gets stronger during pregnancy and falls out after birth.
• Poor diet
• High fever
• Chronic fever (see Fever)
• Excessive dieting
• Alopecia (Alopecia areata , Telogen alopecia , Anogen alopecia )
• Skin conditions
• Skin injury
• Eczema
• Dermatitis
• Burns
• Psoriasis
• Hormonal disorders (Thyroid disorder , Hypothyroidism , Hyperthyroidism , Pituitary disorder, Hypopituitarism)

Following a series of evaluations, male or female type hair loss may be treated either by medical treatment or different hair transplantation techniques.

Most commonly, there are two main surgical methods for hair transplantation: FUE and FUT. At both methods, the important surgical step is placement of hair grafts into the scalp. A graft is the tissue unit of one or more hair follicles that has been removed from a donor site on the scalp, to be inserted into an area of hair loss.

At the first step: hair roots are removed from a donor site (The difference between the two methods is apparent only in this step. For the next steps, both methods are identical ). At the second step the hair roots and the areas to plant are prepared. Third step is the plantation process. Graft placement is a surgical procedure that the patient cannot see while it is in progress. The patient sees the end result after grafts have been placed and bandages removed from the scalp.

References and More Reading:
www.ishrs.org
www.plastikcerrahi.net/tag/plusmed-sac-ekim
www.americanhairloss.org/hair_loss_treatment/
www.iahrs.org

Oncology is the branch of medicine dealing with the physical, chemical, and biologic properties and features of tumors and cancer, including causes and the disease process.

There are more than 200 different types of cancer and there are over 60 different organs in the body where a cancer can develop. Many cancer types can be cured these days.  7 out of 10 children are cured of cancer. Testicular cancer, Hodgkin’s disease, and many cases of leukaemia can all be cured in adults with current treatments.  Most skin cancers are cured with surgery.  Many cases of thyroid cancer and cancer of the larynx (voice box) are cured with radiotherapy.

Many other types of cancer are also cured if they are found early enough – for example, three quarters (75%) of breast cancer found at an early stage.  Of course, there is still a long way to go before men can cure most cancers. The difficulty is that different cancers

• Are caused by different things, so no one strategy can prevent them     
• Respond to different treatments so no one treatment can cure them all

Among the wide variety of treatment of cancers we may mention the chemotherapy, radiation therapy, surgery and other therapies (angiogenesis inhibitors, biological, gene, hyperthermia, lasers, photodynamic therapies, etc). These therapies either cures, controls cancer or ease cancer symptoms.

Among the variety of different treatments, we will be mentioning two radiosurgery treatments used to attack different tumors at the body without damaging healthy surrounding tissues. Given that the following gamma knife and cyber knife techniques may not be available locally or approved  in your local domicile, we may suggest medical travel to Turkey for these treatments.

Gamma Knife therapy is a treatment using gamma rays, a type of high-energy radiation that can be tightly focused on small tumors or other lesions in the head or neck, so very little normal tissue receives radiation. The gamma rays are aimed at the tumor from many different angles at once, and deliver a large dose of radiation exactly to the tumor in one treatment session. This procedure is a type of stereotactic radiosurgery. Gamma Knife therapy is not a knife and is not a classical surgery.

Cyber Knife therapy is a new approach to stereotactic radiosurgery.  This non-invasive, outpatient procedure destroys tumors without the risks and complications of traditional surgery. It can deliver radiation to tumors anywhere in the body (Head, neck, spine, lung, pancreas, liver, kidney,  pelvis, other sites as appropriate) whereas standard radiosurgery techniques only offer treatments to the head and neck area. An x-ray source located on the CyberKnife's robotic arm delivers concentrated beams of radiation to the tumor from multiple positions and angles. Each individual beam is not strong enough to damage healthy surrounding tissue. The beams are targeted to intersect at the tumor, where their combined strength is intense.

References and More Reading:
www.cancerhelp.org.uk
www.cancer.gov
www.anadolumedicalcenter.com/cyberknife.aspx
www.hacettepe.com.tr
www.onkoloji.gov.tr
www.sbkeah.gov.tr
www.iuonkolojienstitusu.org
www.swmedicalcenter.com

Orthopedic surgery is the medical specialty devoted to the diagnosis, treatment, rehabilitation, and prevention of injuries and diseases of the body's musculoskeletal system.

Most patients undergo orthopedic surgery to correct problems with their knees, shoulders and hips or to treat musculoskeletal ailments ranging from arthritis to congenital deformities.
With the improvement at the arthroscopic surgery technologies, recovery times get shorter.

Joint replacements become easier with the use of synthetic components made of metal, plastic or ceramic and these allow patients to get mobile quicker and to suffer less pain.
Common types of orthopedic surgery include:

• Arthroscopy
• Cruciate Ligament Reconstruction
• Discectomy
• Disk Fusion
• Disk Replacement
• Hip Replacement
• Hip Resurfacing
• Rotator Cuff  Repair
• Shoulder Replacement
• Treatment of Osteoarthritis
• Treatment of Cartilage Defects
• Total Knee Replacement

References and More Reading:
www.abos.org
www.orthoinfo.aaos.org
www.anadolumedicalcenter.com/orthopaedics_%20and_traumatology.aspx

Psoriasis is a chronic, non-contagious autoimmune disease which affects the skin and joints. It commonly causes red scaly patches to appear on the skin. The scaly patches caused by psoriasis, called psoriatic plaques, are areas of inflammation and excessive skin production. Skin rapidly accumulates at these sites and takes on a silvery-white appearance. Plaques frequently occur on the skin of the elbows and knees, but can affect any area including the scalp and genitals.

The disorder is a chronic recurring condition which varies in severity from minor localized patches to complete body coverage. Fingernails and toenails are frequently affected (psoriatic nail dystrophy) and can be seen as an isolated finding. Psoriasis can also cause inflammation of the joints, which is known as psoriatic arthritis. Ten to fifteen percent of people with psoriasis have psoriatic arthritis.

There are many treatments available, but because of its chronic recurrent nature psoriasis is a challenge to treat. There can be substantial variation between individuals in the effectiveness of specific psoriasis treatments. Because of this, dermatologist often  use a trial-and-error approach to finding the most appropriate treatment for their patient.

The decision to employ a particular treatment is based on the type of psoriasis, its location, extent and severity. The patient’s age, sex, quality of life, comorbidities, and attitude toward risks associated with the treatment are also taken into consideration. Cognitive behaviour therapy, topical treatment, phototherapy, photochemotherapy, systemic treatment and alternative therapies are used to treat the disease.

Among all, an alternative and spesific treatment that you can find in Turkey is a “Doctor Fish” therapy. The doctor fish which live in the outdoor  pools of Sivas Kangal hot spring, are encouraged to feed on the psoriatic skin of people with psoriasis. The fish only consume the affected areas of the skin gently. The outdoor location of the spa may also have a beneficial effect. This treatment provides temporary relief of symptoms. Treatment in this hot spring has been examined in two small clinical trials, with positive results.

References and More Reading:
www.cumhuriyet.edu.tr/sivas/doctorfish/tez1e.html
www.psoriasisfish.com
www.associatedcontent.com/article/30335/kangal_hot_spring_for_the_treatment.html
www.wikipedia.org

Urology is the medical specialty dedicated to the treatment of disorders and diseases related to the male and female genito-urinary organs including the kidney, ureters, bladder, prostate and genitalia.

Problems in these areas are common and new medical technology continues to offer an expanding array of diagnostics and effective treatments.

Mainly for bladder and prostate, men's reproduction and women's incontinence problems, urologists provide a wide variety of invasive diagnostic and ambulatory treatment procedures including cystoscopy, trans-rectal ultrasound, Doppler ultrasound,  urodynamic assessment of bladder dysfunction, urologic operations (laparoscopic, trans-urethral or open).

The following  surgical interventions are widely performed to treat various urological problems:

• Circumcision
• Correcting congenital defects
• Correcting sexual dysfunction, infertility  and incontinence
• Cryotherapy (a method of freezing) of the prostate or of the kidney tumors
• Hydrocele Operation
• Nephrectomy  (kidney removal)
• Nephrolithotomy  (removal of kidney stones)
•  Prostatectomy for benign enlargement of the prostate
• Prostatectomy for malignant tumors of the prostate
• Ureterolithotomy (removal of ureter stones)
• Vasectomy

References and More Reading:
www.prostatehealthguide.com
www.urologyplace.com
www.continence-foundation.org.uk
www.almanhastanesi.com.tr/makale/uroloji.htm