For WE
Kind attn: Mr Divesh Nath
Name: Sudha Hariharan
A/c No 424
Date: March 17,2010
Nursing: Gaining popularity as a profession of choice
With the growth of the health industry, the demand for nurses is also increasing making a career in nursing very attractive. Nursing includes a wide range of responsibilities and functions. At the initial levels, the nurses take general care of patients, are engaged in dispensing medication, setting up and operating medical equipment, keeping records of patient's progress and administration.
Nurses and nursing assistants form the largest group of workers in health sector. They are required in the hospitals and health centers right from general ward to operation theatre.
With increasing health consciousness in India, the quality of health services has improved. Skilled and specialized nurses are in high demand by the health organizations
and nurses can get excellent employment opportunities in government or private hospitals, clinics, nursing homes, orphanages, old age homes, military services, industries and schools.
Majority of the nurses in India go abroad. Most of the nurses working throughout the world are from the Indian state of Kerala. Skilled nurses can also get the employment in specialized fields like Surgical, Medical, ICU, Telemetry and ER. Nursing today is not been given the importance in healthcare as it was three decades ago. The backbone of quality healthcare is still nursing. While a surgeon may perform a good operation if this is not backed up by excellent nursing then the ultimate result is mediocre. Nursing, in our country as well as in other countries, is undergoing a transition and is being looked upon increasingly as a profession of choice.
Ms Sheeja Kanade, recently appointed as principal of HiCON (Hiranandani College of Nursing) is an eminent personality in Nursing Education since the last 7 years. Previously associated with Terna Nursing College, MG M College of Nursing, Bombay Hospital College of Nursing, Mumbai, Leelabai Thackersey College of Nursing, Mumbai, her mission is to foster health and well -being through excellence in nursing education, practice and service. Armed with MSc Nursing degree, she has had a fulfilling and successful career spanning different areas of business and involving numerous skills
Here she answers a few pertinent and frequently asked questions:
What are the basic education qualifications necessary to join nursing course?
An individual should be HSC passed with Science stream, should have scored 45per cent and above in Physics, Chemistry, Biology and English. Qualifying a CET or Associate CET exams in Maharashtra is preferred .
What qualities are essential for someone who wants to take up nursing?
“ I believe that nursing is a diverse and rewarding practice a discipline that combines compassion with sophisticated health technology. Nurses design, manage, and coordinate care for individuals, families, groups, communities, and larger populations. They help people meet basic health needs, adapt to physical changes, recover from illness, and die with dignity.”
“Compassion, empathy, emotional stability, good communication skills, confidence, honesty, dedication, a cheerful, alert and pleasant demeanour are some of the basic qualities a person aspiring to be a nurse should have.”
“Nursing field is physically and mentally demanding and involves some risk factors such as exposure to infectious diseases. This profession requires long hours of work. The nurses should be courageous enough to handle all kinds of patients. They should be ready for night shifts and to extend their duties in emergency cases”, she adds.
Why are Indian nurses so much in demand and why are most of them from Kerala?
Indian nurses are in demand the world over because they are educated, professional well- trained, emotionally stable and dedicated. Most of them are from Kerala because of the high rate of literacy among women there, their dedication and caring attitude.
Are they well paid in India and abroad?
They are definitely better paid overseas.
What are the major advantages of opting for nursing?
The main advantage is that they can be recruited immediately after completion of studies. A graduate in nursing has immense overseas opportunities in western countries and the Gulf. There is also scope for higher and specialized education and training.
What health risks do they commonly face?
The most common risk they face is infection . This also depends on the area of function.
Do hospitals here provide for health check-ups for nurses in their employ?
hospitals do, others do not. The policy regarding regular check-ups varies from hospital to hospital
Tell us about HICON and its vision…..
I am really delighted to highlight Hiranandani college of Nursing (HiCON) as a unique College of Nursing established in the year 2009 affiliated to Maharashtra University of Health Sciences and recognized by Indian Nursing Council and State Nursing Council. Our focus is on overall development of an individual geared towards addressing not only the ongoing health challenges but also emerging health issues of the 21st century.HiCON will strive to be positioned in the top five nursing colleges in India by 2014 and to be the best in professional training.
The infrastructure is matchless, the training aids are frontline and have been procured from the very best vendors and there is; also a college hostel provided.The course curriculum at HiCON is in line with the Indian Nursing Council. Additionally they propose to introduce a Diploma Course in Health Management to arm students with a management degree. This it will give them an option to pursue a career in health management, if at some time they would like to give up nursing. The college will train students in B.Sc (Nursing) with further scope for M.Sc (Nursing) or Ph.D, if they so desire.
For WE
Kind attn: Mr Divesh Nath
Name: Sudha Hariharan
A/c No 424
Date: March 17,2010
Nursing: Gaining popularity as a profession of choice
With the growth of the health industry, the demand for nurses is also increasing making a career in nursing very attractive. Nursing includes a wide range of responsibilities and functions. At the initial levels, the nurses take general care of patients, are engaged in dispensing medication, setting up and operating medical equipment, keeping records of patient's progress and administration.
Nurses and nursing assistants form the largest group of workers in health sector. They are required in the hospitals and health centers right from general ward to operation theatre.
With increasing health consciousness in India, the quality of health services has improved. Skilled and specialized nurses are in high demand by the health organizations
and nurses can get excellent employment opportunities in government or private hospitals, clinics, nursing homes, orphanages, old age homes, military services, industries and schools.
Majority of the nurses in India go abroad. Most of the nurses working throughout the world are from the Indian state of Kerala. Skilled nurses can also get the employment in specialized fields like Surgical, Medical, ICU, Telemetry and ER. Nursing today is not been given the importance in healthcare as it was three decades ago. The backbone of quality healthcare is still nursing. While a surgeon may perform a good operation if this is not backed up by excellent nursing then the ultimate result is mediocre. Nursing, in our country as well as in other countries, is undergoing a transition and is being looked upon increasingly as a profession of choice.
Ms Sheeja Kanade, recently appointed as principal of HiCON (Hiranandani College of Nursing) is an eminent personality in Nursing Education since the last 7 years. Previously associated with Terna Nursing College, MG M College of Nursing, Bombay Hospital College of Nursing, Mumbai, Leelabai Thackersey College of Nursing, Mumbai, her mission is to foster health and well -being through excellence in nursing education, practice and service. Armed with MSc Nursing degree, she has had a fulfilling and successful career spanning different areas of business and involving numerous skills
Here she answers a few pertinent and frequently asked questions:
What are the basic education qualifications necessary to join nursing course?
An individual should be HSC passed with Science stream, should have scored 45per cent and above in Physics, Chemistry, Biology and English. Qualifying a CET or Associate CET exams in Maharashtra is preferred .
What qualities are essential for someone who wants to take up nursing?
“ I believe that nursing is a diverse and rewarding practice a discipline that combines compassion with sophisticated health technology. Nurses design, manage, and coordinate care for individuals, families, groups, communities, and larger populations. They help people meet basic health needs, adapt to physical changes, recover from illness, and die with dignity.”
“Compassion, empathy, emotional stability, good communication skills, confidence, honesty, dedication, a cheerful, alert and pleasant demeanour are some of the basic qualities a person aspiring to be a nurse should have.”
“Nursing field is physically and mentally demanding and involves some risk factors such as exposure to infectious diseases. This profession requires long hours of work. The nurses should be courageous enough to handle all kinds of patients. They should be ready for night shifts and to extend their duties in emergency cases”, she adds.
Why are Indian nurses so much in demand and why are most of them from Kerala?
Indian nurses are in demand the world over because they are educated, professional well- trained, emotionally stable and dedicated. Most of them are from Kerala because of the high rate of literacy among women there, their dedication and caring attitude.
Are they well paid in India and abroad?
They are definitely better paid overseas.
What are the major advantages of opting for nursing?
The main advantage is that they can be recruited immediately after completion of studies. A graduate in nursing has immense overseas opportunities in western countries and the Gulf. There is also scope for higher and specialized education and training.
What health risks do they commonly face?
The most common risk they face is infection . This also depends on the area of function.
Do hospitals here provide for health check-ups for nurses in their employ?
hospitals do, others do not. The policy regarding regular check-ups varies from hospital to hospital
Tell us about HICON and its vision…..
I am really delighted to highlight Hiranandani college of Nursing (HiCON) as a unique College of Nursing established in the year 2009 affiliated to Maharashtra University of Health Sciences and recognized by Indian Nursing Council and State Nursing Council. Our focus is on overall development of an individual geared towards addressing not only the ongoing health challenges but also emerging health issues of the 21st century.HiCON will strive to be positioned in the top five nursing colleges in India by 2014 and to be the best in professional training.
The infrastructure is matchless, the training aids are frontline and have been procured from the very best vendors and there is; also a college hostel provided.The course curriculum at HiCON is in line with the Indian Nursing Council. Additionally they propose to introduce a Diploma Course in Health Management to arm students with a management degree. This it will give them an option to pursue a career in health management, if at some time they would like to give up nursing. The college will train students in B.Sc (Nursing) with further scope for M.Sc (Nursing) or Ph.D, if they so desire.
For WE
Kind attn: Mr Divesh Nath
Name: Sudha Hariharan
A/c No 424
Date: March 17,2010
Nursing: Gaining popularity as a profession of choice
With the growth of the health industry, the demand for nurses is also increasing making a career in nursing very attractive. Nursing includes a wide range of responsibilities and functions. At the initial levels, the nurses take general care of patients, are engaged in dispensing medication, setting up and operating medical equipment, keeping records of patient's progress and administration.
Nurses and nursing assistants form the largest group of workers in health sector. They are required in the hospitals and health centers right from general ward to operation theatre.
With increasing health consciousness in India, the quality of health services has improved. Skilled and specialized nurses are in high demand by the health organizations
and nurses can get excellent employment opportunities in government or private hospitals, clinics, nursing homes, orphanages, old age homes, military services, industries and schools.
Majority of the nurses in India go abroad. Most of the nurses working throughout the world are from the Indian state of Kerala. Skilled nurses can also get the employment in specialized fields like Surgical, Medical, ICU, Telemetry and ER. Nursing today is not been given the importance in healthcare as it was three decades ago. The backbone of quality healthcare is still nursing. While a surgeon may perform a good operation if this is not backed up by excellent nursing then the ultimate result is mediocre. Nursing, in our country as well as in other countries, is undergoing a transition and is being looked upon increasingly as a profession of choice.
Ms Sheeja Kanade, recently appointed as principal of HiCON (Hiranandani College of Nursing) is an eminent personality in Nursing Education since the last 7 years. Previously associated with Terna Nursing College, MG M College of Nursing, Bombay Hospital College of Nursing, Mumbai, Leelabai Thackersey College of Nursing, Mumbai, her mission is to foster health and well -being through excellence in nursing education, practice and service. Armed with MSc Nursing degree, she has had a fulfilling and successful career spanning different areas of business and involving numerous skills
Here she answers a few pertinent and frequently asked questions:
What are the basic education qualifications necessary to join nursing course?
An individual should be HSC passed with Science stream, should have scored 45per cent and above in Physics, Chemistry, Biology and English. Qualifying a CET or Associate CET exams in Maharashtra is preferred .
What qualities are essential for someone who wants to take up nursing?
“ I believe that nursing is a diverse and rewarding practice a discipline that combines compassion with sophisticated health technology. Nurses design, manage, and coordinate care for individuals, families, groups, communities, and larger populations. They help people meet basic health needs, adapt to physical changes, recover from illness, and die with dignity.”
“Compassion, empathy, emotional stability, good communication skills, confidence, honesty, dedication, a cheerful, alert and pleasant demeanour are some of the basic qualities a person aspiring to be a nurse should have.”
“Nursing field is physically and mentally demanding and involves some risk factors such as exposure to infectious diseases. This profession requires long hours of work. The nurses should be courageous enough to handle all kinds of patients. They should be ready for night shifts and to extend their duties in emergency cases”, she adds.
Why are Indian nurses so much in demand and why are most of them from Kerala?
Indian nurses are in demand the world over because they are educated, professional well- trained, emotionally stable and dedicated. Most of them are from Kerala because of the high rate of literacy among women there, their dedication and caring attitude.
Are they well paid in India and abroad?
They are definitely better paid overseas.
What are the major advantages of opting for nursing?
The main advantage is that they can be recruited immediately after completion of studies. A graduate in nursing has immense overseas opportunities in western countries and the Gulf. There is also scope for higher and specialized education and training.
What health risks do they commonly face?
The most common risk they face is infection . This also depends on the area of function.
Do hospitals here provide for health check-ups for nurses in their employ?
hospitals do, others do not. The policy regarding regular check-ups varies from hospital to hospital
Tell us about HICON and its vision…..
I am really delighted to highlight Hiranandani college of Nursing (HiCON) as a unique College of Nursing established in the year 2009 affiliated to Maharashtra University of Health Sciences and recognized by Indian Nursing Council and State Nursing Council. Our focus is on overall development of an individual geared towards addressing not only the ongoing health challenges but also emerging health issues of the 21st century.HiCON will strive to be positioned in the top five nursing colleges in India by 2014 and to be the best in professional training.
The infrastructure is matchless, the training aids are frontline and have been procured from the very best vendors and there is; also a college hostel provided.The course curriculum at HiCON is in line with the Indian Nursing Council. Additionally they propose to introduce a Diploma Course in Health Management to arm students with a management degree. This it will give them an option to pursue a career in health management, if at some time they would like to give up nursing. The college will train students in B.Sc (Nursing) with further scope for M.Sc (Nursing) or Ph.D, if they so desire.
Kind attn: Divesh Nath
Name: Sudha Hariharan
A/c No: 424
Date: May10,2010
Need to encourage more Swap Kidney Transplant operations ( Box Item)
There is a major need to encourage more Swap kidney transplant operations in the country, which is vital for needy patients who have lined up for transplant operations. This was the message sent out by nephrologists assembled at a kidney transplant awareness programme on the occasion of World Kidney Day.
In a swap kidney transplant, a mutual understanding is reached between two families, where the healthy member donates one of his kidney’s to the needy member of the other family and vice versa. Even in western countries, more number of people opt for swap transplants due to more relaxed regulations.
“Today strict regulations from the government are not allowing more swap transplants. Consequently many patients have to wait for a long time, as they are dependent only on cadaver transplants (transplant from a brain dead person). I am sure if the rules are simplified, we will have more number of families opting for swap transplants,” said Dr Haresh Dodeja, Nephrologist & Transplant physician at Fortis Hospital.
“In the last 2 years Fortis has taken a lead in harvesting large number of cadaver kidney donations and we are proud of our contribution to the city. We would like to continue to do good work and the next step would be to initiate swap transplant to tide over
shortage of donors in the current scenario of nuclear families with limited numbers of donors in the family,” said Dr. Dodeja.
We have come a long way from the days of cadaver transplant, where the immediate recovery of kidney function was delayed, and the patient required 4-6 weeks to normalize and get discharged, adding to the costs of the transplant. Today we have managed to successively do cadaver transplants simulating live donor conditions, and achieving immediate graft function, and quick recovery without dialysis, and a fast discharge, saving on the costs considerably.”
Dr Dodeja who is the clinical coordinator for the dialysis and transplant services believes that a good integrated system of involving the ICU team, social workers and regular awareness programs by nephrologists will go a long way in the success of a cadaver transplant program.”
The Mumbai Nephrology Group has also decided to recognise ‘World Kidney Day’ on March 11, under the theme ‘Protect your Kidneys – Control Diabetes’. The aim of this program is to create awareness among patients, doctors and people at large about Diabetes and Kidney diseases.
In India, more than 2,000,000 patients are affected with renal failure and every year around 1, 00, 000 new patients are affected with end-stage renal failure (ESRD) that requires treatment, dialysis or transplant. Only 2 per cent of these patients can avail of dialysis treatment, 5 per cent get transplants and less than 0.5 per cent of these patients undergo peritoneal dialysis.
Maharashtra alone requires 10,000 kidney transplants per year, but only 2.5 per cent of these patients receive it.” The prevalence of chronic kidney disease (CKD) continues to increase worldwide, as does end - stage renal diseases. The most common cause of CKD is diabetes. Diabetic nephropathy affects a third of people suffering from diabetes,” said Dr. Hemant Mehta, of Mumbai Nephrology Group.
Diabetes is the most common cause of kidney failure. When people suffer from diabetes the excess glucose in the blood reacts with proteins to form compound which makes the nephron filters too porous or leaky. As a result, protein molecules begin to slip through the kidneys’ filters and into the urine leading to CKD.
Dialysis is an expensive treatment, and there is severe shortage of donated kidneys available for transplantation. Many patients therefore cannot afford end -stage renal failure treatment and hence the focus is on prevention. Simple, routine tests of urine and blood can show early signs of kidney problems. Once the problems are identified, patients can slow down and even stop chronic kidney disease, with medication and change in lifestyle habits.
Kind attn: Mr. Divesh Nath
For Woman’s Era
Name: Sudha Hariharan
A/c No: 424
Date: May 10,2010
Teenagers too can be plagued by chronic kidney disease
Its not a disease that afflicts only adults. Chronic Kidney Disease (CKD) can plague teenagers too. Dr. Rajan Ravichandran ( Director-Nephrology ,MIOT Hospital Chennai)speaks at length on how CKD affects women and the youth and how the disease can be treated
The kidneys make urine from the waste products of the body. Most kidney infections start when bacteria get into the urethra, the tube used to urinate. The bacteria may spread to infect the kidneys.
For women, risk factors for kidney infections are the same as for bladder infections (cystitis). They include:
Having sex often
Using a spermicide for contraception
Having had cystitis in the last year
Having diabetes
Having blood pressure
Sometimes the symptoms do not occur at all initially but otherwise the symptoms of having kidney infections are:
high temperature with shivering
pain in the side
back ache
nausea, vomiting or diarrhea
the need to pass urine very often
urine may look cloudy or be a different color
loss of appetite
To measure kidney function, primary care doctors typically order a blood test called creatinine. The serum creatinine should also be plugged into a formula that gives an estimated kidney filtration rate (called glomerular filtration rate, or eGFR) which is a much more accurate estimate of kidney function. Women have a lower eGFR than men for the same level of serum creatinine. Thus, the same serum creatinine level that initially appears normal for both a man and a woman can translate into depressed kidney function for the woman, making her at higher risk for undetected kidney disease.
Young girls are particularly vulnerable and can experience impaired growth and abnormal menstrual cycles due to altered metabolism and hormone deficits.
can contribute to ovarian failure and premature menopause
decreased fertility and unsuccessful child births
pregnant women with CKD are also risk developing hypertension and kidney function loss
Kidney problems in Teenagers
Kidneys are responsible for removing waste and extra fluid from what you eat and drink from in the body. The nutrients you need remain in your body while the extra waste is filtered by the kidneys. Kidneys are made up of millions of tiny filters called nephrons which remove the unwanted fluids from the blood by creating urine. The urine travels down the ureters into the bladder and is stored until it is released through the urethra.The two most frequent causes for adults to develop chronic kidney disease are high blood pressure and diabetes. In teens these causes are uncommon. However, due to unhealthy eating habits leading to excessive weight gain, more young people are prone to diseases such as diabetes and high blood pressure, which can cause kidney disease later in life.
For most teens, CKD is caused by congenital disorders or diseases that develop such as:
Urinary problems, such as UTIs (urinary tract infection)
Reflux nephropathy
Nephrotic syndrome
Nephritis
The Urinary tract infection (UTI)
urinary tract consists of the urethra, the bladder, the ureters and the kidneys. Urinary tract infection (UTI) is caused when bacteria moves up into the bladder and multiplies. A bladder infection, or cystitis, is the most common UTI. Urinary tract infections are usually easy to diagnose in teens and adults.
Symptoms Symptoms include:
frequent, painful urination
inability to urinate despite the urge
urine that appears cloudy or has an unusual smell
blood in the urine
fever and flank or lower back pain if the kidneys are infected
To diagnose a UTI, a urine sample is taken to check for the growth of bacteria. If the teenager is given antibiotics, relief usually begins within 12 to 24 hours of treatment. If the UTI affects the kidneys, intravenous medications may be necessary, requiring teens to be hospitalized.
After treatment, the doctor will collect another urine sample to determine if the medicine has gotten rid of the infection. Since UTIs tend to come back again, the doctor may want your teen to be tested on a regular basis.
Advice to prevent the recurrence of UTIs include:
After voiding, girls and women should wipe from front to back to prevent contaminating the urethra with bacteria from the anal area.
Drinking plenty of water to flush the urinary tract
Not resisting the urge to urinate
Taking a shower instead of a bath
Reflux nephropathy
Reflux disorder is often diagnosed after a teenager has a UTI. It occurs when urine goes back up from the bladder to the kidney. This is due to a defect of the “valves” between the ureters and the bladder. Reflux can cause an infection to spread to the kidneys. This can be serious and may lead to kidney damage. About 30% of older children with UTIs will suffer from reflux disorder.
Sometimes surgery is done to correct reflux disorder, but most teens are treated with antibiotics. Teens diagnosed with reflux disorder usually recover after treatment. Typically, they do not have relapses. If kidney damage occurs, however, teens may get high blood pressure later in life. If one kidney is damaged, the risk of getting high blood pressure is 10%. If both kidneys have been injured, the risk rises to 20%. Most teenagers who experience reflux disorders do well and do not experience kidney damage.
Nephrotic syndrome
Nephrotic syndrome usually occurs in children aged 6 months to 5 years old, although it can happen at any age. Boys are two times more likely to suffer from nephrotic syndrome than girls. This occurs when the kidneys are diseased and unable to keep protein from leaking into the urine. It often appears for the first time after a child has had a cold or infection
.
The cause of nephrotic syndrome is unknown. Many researchers are working to determine its cause and develop treatments. Today, nephrotic syndrome is typically treated with the medicine prednisone, and most young people improve with its use. Sometimes doctors prescribe immunosuppressive medicines. Whichever medicine your doctor chooses, your child will be monitored closely and get periodic blood tests.
Although there is no cure for nephrotic syndrome, most young children do well with treatment, and many “outgrow” the disease by the time they reach their teens. Even when a child has frequent episodes, if he responds well to treatment then permanent kidney damage is not likely.
Nephritis
Nephritis is when the kidney becomes inflamed, sometimes due to infection or a disease in the immune system called systemic lupus erythematosus (SLE). When the kidneys become irritated, they pass protein and red blood cells into the urine, causing it to have a color which resembles cola.
Teenagers who get nephritis are treated and most get better over time. Medical treatment depends on the symptoms, and includes reducing the swelling, inflammation and lowering blood pressure.
Basic symptoms for CKD in teenagers
Consult your doctor if your teenager exhibits any of the following:
Unexplained low-grade fever
Swelling around the eyes, feet, and ankles
Lower back pain
High blood pressure
Persistent abdominal pain
Frequent severe headaches
Unpleasant-smelling urine
Urine that is cloudy, bloody or dark brown
Burning sensation when urinating
Poor appetite
Slow growth or weight gain
Weak urinary stream, dribbling or fanning of urine stream
Painful urination
Weakness, excessive tiredness or loss of energy
Pale skin or “washed out” appearance
Kind Attn:
Mr. Divesh Nath
For WE
Name : Sudha Hariharan
A/c No: 424
Date: May 10,2010
Tackling kidney stones during pregnancy
A family physician who started his practice in 1958 from the heart of Delhi’s Chandni Chowk,Dr. B.S. Bansal was a man with vision. He wanted to do away with unnecessary surgery and long hospital stays and thus introduced the concept of Lithotripsy in India in 1987. Once again he introduced the concept of Holmium Laser for the treatment of enlarged prostate in 1999. He is a mentor for all Urologists across the world. He is popularly known as “Father of Lithotripsy”. Under the commendable guidance and leadership of Dr. Bansal, R G Stone has treated more than 1,00,000 patients.
DR. B.S. BANSAL,(CMD), RG Stones Urology and Laproscopy Hospital, talks about the unique, efficient and non-invasive treatment.
What would you do if you develop kidney stones during pregnancy?
Studies reveal that, “getting kidney stones during pregnancy is more likely for woman. A woman’s body goes through a number of hormonal and other changes during pregnancy. 1 of every 1500 pregnant women face kidney stones problem during their pregnancy. 80-90% are diagnosed in the first trimester.”
The changes that a woman’s body goes through during pregnancy create an environment for stone formation in urine. There is hypercalciuria during pregnancy which is extensive amount of calcium in the urine which leads to stone formation. 66-85% pregnant woman pass ureteric stone spontaneously with medical treatment.
Since X-Ray cannot be used, Ultrasound is first line of imaging study during pregnancy. Though kidney stone does not have a direct risk to foetus, but can pose problems for the mother and child such as:
* Pyonephrosis
* Infection causing growth retardation
* Abortion
* Premature labour during pregnancy
The aim is to remove the stone without harming the fetus- the risk to the fetus being through anesthesia and surgery. In such circumstances it becomes difficult to remove stones efficiently without harming the fetus.Utheroscopy with Holmium laser lithotripsy is a safe and efficient treatment in such situations. If URS is not possible then stenting can be done where the stent need to be changed every 4-6 weeks
What exactly is Pyronephrosis?
A. Pyonephrosis is a collection of pus in the kidney.
2. Are there any precautionary measures women can take to avoid this condition?
1) Drinking lots of water is of primary importance
2) If the patient is diabetic, control on sugar level needs to maintain.
3) If any kidney blockage or stone is there, take a expert doctors opinion.
3. What are the lines of treatment- ---how are they done?
. The treatment is through Uteruscopy and use of stents
1) Stenting is a procedure where a DJ stent is inserted through
natural passage which is fixed or interlock at a junction where the ureter
end to avoid infection to have a proper passage of urine and to dilate the
ureter.
2) In nephrostomy, you make a puncture and enter to kidney on your
flankside through a nephrostomy tube.
4. Is the treatment affordable?
Yes, the treatment costs 5-10 thousand only
5. Are women aware of this? Do gynecologists caution them of this? If this is such a common problem (pyonephrosis) for pregnant women, why are they not advised by their gynaecs? What can be done to create awareness?
Pyonephrosis is not very common for pregnant women, actually urinary tract infection is more common during pregnancy which can be dealt with by a gynaecologist .
6. Are there any simple home remedies to control the ailment?
No.
R G Stone has 17 branches across India and is Asia’s largest urology chain. R G employs the largest pool of super specialists under one roof and features in the Guinness Book of Records for removing the largest stone without surgery.
.
Tuesday, August 3, 2010
Every Km matters!
Kind Attn: Divesh Nath
Name: Sudha Hariharan
A/c No: 424
Date: April 2, 2010
Cancer Awareness…Every kilometer in the journey counts
Dr. [Captain] Ritu Biyani is a multi-faceted and courageous woman—a dental surgeon, mountaineer, first lady Paratrooper from the Army Dental Corps, skydiver, avid photographer, and most importantly a breast cancer survivor. She has served in the Indian Army Dental Corps for 10 years and has traveled extensively across India.
Highways Infinite is the registered public trust founded in March 2008 by Dr. .[Capt] Ritu Biyani.
The genesis of Highways Infinite was based on her experiences and response generated after her first pilot project, Project High>>>Ways, which she conceptualized in 2005, launched and spearheaded in 2006. This also became the platform for her subsequent projects Highways Beyond Cancer 2007,2008, 2009----a unique initiative to link adventure sports with cancer awareness across the country. Assisted by her daughter Tista Joseph---the duo was awarded Manthan Awards South -Asia 2008 for pioneering on cancer education at the grassroots level.
Project Highways - 2006 was a very first of its kind endeavor undertaken in India and earned the mother-daughter team recognition in the Limca book of Records- India 2007 and 2008 .
Her innovative efforts on her High>>>ways Beyond Cancer, has taken her to various forums where she has presented papers, at many national and international conferences, to name some, Tata Memorial Hospital Mumbai, Mohandai Oswal Cancer Research Hospital, Ludhiana, 5th World Breast Cancer Conference, Canada, Reach to Recovery International Breast Cancer Support Conference Australia, UICC World Cancer Congress - Geneva, Premier Lance Armstrong Global Cancer Summit Ireland and Global Leadership Cancer Forum Canada, etc.
India has one of the largest road networks of 3.32 million kilometers including expressways, national and state highways, major and minor district roads and village roads and of course another 1000s of kms of trekking routes. Dr Ritu has so far covered 66,000 plus km since 2006 .
She feels she has miles to go as the journey has just begun. Dr. ( Capt) Biyani wants people to connect with Highways to encourage, support, contribute, and to participate in more such journeys to create awareness, motivate and bring a smile to many faces.
Dr Ritu Biyani-Joseph is currently scheduling her next expedition on cancer in May 2010, “ Every kilometer in the journey counts…similarly every contribution big or small counts”, she says.
For further information contact Dr. Ritu Biyani-Joseph at +91 9881232744 or email at missionhighways@gmail.com or visit www.highwaysbeyondcancer.org [ presently under [ HIGH>>>WAYS…INFINITE : Public Trust registered in Pune Division ( State: Maharashtra, India) on 18/March/2008, under Bombay Public Trust Act 1860.) Reg. No E-5111. Donations exempted under 80G [5] of the income tax Act, 1961]
Name: Sudha Hariharan
A/c No: 424
Date: April 2, 2010
Cancer Awareness…Every kilometer in the journey counts
Dr. [Captain] Ritu Biyani is a multi-faceted and courageous woman—a dental surgeon, mountaineer, first lady Paratrooper from the Army Dental Corps, skydiver, avid photographer, and most importantly a breast cancer survivor. She has served in the Indian Army Dental Corps for 10 years and has traveled extensively across India.
Highways Infinite is the registered public trust founded in March 2008 by Dr. .[Capt] Ritu Biyani.
The genesis of Highways Infinite was based on her experiences and response generated after her first pilot project, Project High>>>Ways, which she conceptualized in 2005, launched and spearheaded in 2006. This also became the platform for her subsequent projects Highways Beyond Cancer 2007,2008, 2009----a unique initiative to link adventure sports with cancer awareness across the country. Assisted by her daughter Tista Joseph---the duo was awarded Manthan Awards South -Asia 2008 for pioneering on cancer education at the grassroots level.
Project Highways - 2006 was a very first of its kind endeavor undertaken in India and earned the mother-daughter team recognition in the Limca book of Records- India 2007 and 2008 .
Her innovative efforts on her High>>>ways Beyond Cancer, has taken her to various forums where she has presented papers, at many national and international conferences, to name some, Tata Memorial Hospital Mumbai, Mohandai Oswal Cancer Research Hospital, Ludhiana, 5th World Breast Cancer Conference, Canada, Reach to Recovery International Breast Cancer Support Conference Australia, UICC World Cancer Congress - Geneva, Premier Lance Armstrong Global Cancer Summit Ireland and Global Leadership Cancer Forum Canada, etc.
India has one of the largest road networks of 3.32 million kilometers including expressways, national and state highways, major and minor district roads and village roads and of course another 1000s of kms of trekking routes. Dr Ritu has so far covered 66,000 plus km since 2006 .
She feels she has miles to go as the journey has just begun. Dr. ( Capt) Biyani wants people to connect with Highways to encourage, support, contribute, and to participate in more such journeys to create awareness, motivate and bring a smile to many faces.
Dr Ritu Biyani-Joseph is currently scheduling her next expedition on cancer in May 2010, “ Every kilometer in the journey counts…similarly every contribution big or small counts”, she says.
For further information contact Dr. Ritu Biyani-Joseph at +91 9881232744 or email at missionhighways@gmail.com or visit www.highwaysbeyondcancer.org [ presently under [ HIGH>>>WAYS…INFINITE : Public Trust registered in Pune Division ( State: Maharashtra, India) on 18/March/2008, under Bombay Public Trust Act 1860.) Reg. No E-5111. Donations exempted under 80G [5] of the income tax Act, 1961]
Pregnant women, teenagers prone to varicose veins
KA: Divesh Nath
For WE Health,Beauty & Sex special
Name:Sudha Hariharan
A/cNo: 424
Date: February 21,2010
Pregnant women, teenagers prone to Varicose Veins
Nature has provided for the need to push used blood back to the heart by 2 unique devices---the location of the veins and a system of valves. The veins in the legs are woven among the muscles so that when each muscle contracts, it squeezes a vein. Squeezing the vein pushes the blood closer to the heart. The valves in the vein prevent the blood from flowing backwards when the muscle relaxes
If we spend too much time sitting or standing, the used blood from the lower part of the body does not get the push it needs to return to the heart. This causes fatigue and sluggishness.
Varicose veins result from a failure of the used blood in the legs to return to the heart at the proper rate. The veins may lose some of their elasticity or the valves may fail to close properly. The used blood then accumulates and causes veins to swell. Varicose veins occur often in the legs of people whose jobs require that they stand a great deal.
Dr. Shoaib Padaria pioneered ELVES (Endovenous Laser Treatment of Varicose Veins) in India in January’ 2003. Since then, he has successfully performed over 2,500 procedures. He is a Consultant Interventional Cardiologist associated with Jaslok Hospital and other leading hospitals in Mumbai.
“Varicose Veins are enlarged, tortuous, knotty and bulging veins seen in the legs. Some of these veins may be very tiny (reticular or spider veins), while others are typically larger, increasing in size when you stand for a long period of time. In fact, this condition is known to be hereditary, and in such cases symptomatic patients could even be teenager’s “, says Dr. Shoaib. Padaria. There are two types of veins that carry blood in the body---deep veins and superficial veins. The blood flows from the superficial veins to the deep veins. These veins have valves which control the blood flow and keep the blood flowing towards the heart. However, when these valves do not function properly, the blood flows in the wrong way, leading to varicose veins.
“Varicose veins are prominent during pregnancy. During pregnancy, the growing uterus puts added pressure on the veins. As a result, the valves are also squeezed and the blood flow to our heart is disrupted. This condition is very common during the third trimester because this is when the uterus will be at its heaviest.”
“ If you are having a twin pregnancy, there are greater chances of being affected by varicose veins. During the last trimester of pregnancy, the veins on your legs may become prominent and get a dark purple or blue colouration. Apart from that, you will also experience pain in your limbs. These are symptoms of varicose veins. Usually, the symptoms disappear after delivery, but in serious cases, the bluish colouration of the veins can stay for life”, adds Dr. Shoaib.
While it usually causes problems in people over the age of 50, quite a few patients are also younger. In fact, varicose veins are known to be hereditary, and in such cases symptomatic patients could even be teenagers. It is important to diagnose varicose veins early. “In the past,” says Dr. Shoaib,” the only option was surgery – legations and stripping were used to remove a damaged vein and prevent further complications of vein damage. Today, there’s a permanent treatment for varicose veins: the laser technique.”
Endovenous Laser Treatment of Varicose Veins (ELVES) in an outpatient procedure usually completed within an hour in a clinical setting. It utilizes a diode laser, which deliver’s laser energy at a wavelength of 980 nanomicrons. This wavelength is optimally suited for absorption by haemoglobin in the blood, and does not cause any thermal injury to structures around the veins. ELVES is a safe and quick procedure that offers successful results without the complications of surgery.
Meenakshi Desai in her ninth month of pregnancy felt a sudden pain in her thigh. A bulge appeared where the pain was. Over the next seven years, it became a painful varicose vein. Eventually, the vein ran from her groin to her ankle and inhibited her in everything, from walking to caring for her children.
Mr. Sarang, a 50- year- old builder from Pune, loved walking and going for hikes in the Sahyadri Hills. A regular at the Mumbai Marathon, last year he found that he could not complete the run owing to severe pain in his legs, because of varicose veins that he had developed many years ago.
Mr. Dedhia, owner of a grocery shop, had to stand in his small shop for up to 14 hours every day. Over the years, he developed swelling in both his feet, and finally painful ulcers near his ankles that refused to heal. He was diagnosed with varicose veins.
All the above were advised regular surgery but were scared to undergo the procedure as it would hamper their lifestyle and leave scars. However, all of them finally benefited from Endovenous Laser Treatment by Dr. Padaria.
ELVES have many advantages over surgery. The treatment is performed under local anesthesia and with ultrasound guidance. A small needle is inserted into the dilated varicose veins, and a thin laser wire is passed through the needle into the vein. Laser energy delivered into the vein seals and closes the vein painlessly. The main varicose vein and its branches are closed in a similar manner, and the entire procedure takes about 30 minutes. A compression bandage is applied over the treated leg, and the patient can walk home soon after, resuming normal work the next day. The patient is required to wear special full-length stockings (socks) during waking hours for about two months after the treatment.
Many people with varicose veins live without any symptoms. However, in others, it can limit their lifestyle. Aches and pains in the legs, cramps in the calves, heaviness in the legs and swelling around the ankles while standing are common symptoms. Sometimes enlarged veins can rupture, causing sudden bleeding. A clot may form within the dilated vein and can travel to the heart. It is quite easy to diagnose varicose veins. A simple ultrasound called the Venous Doppler can show the leaking valves and swollen veins.
Meenakshi Desai, who was treated by Dr. Shoaib Padaria, says, ‘I instantly felt better.” She now feels no discomfort while walking or playing with her children.
“Everyone is at risk when it comes to developing varicose veins,” says Dr. Padaria. “But the main cause is genetic, with women nearly twice as likely to suffer as men. People with past venous diseases, new mothers, overweight individuals and people with jobs or hobbies requiring extended standing are at increased risk.”
“Meenakshi Desai’s experience shows that varicose veins can have a dramatic effect on lifestyle,” Dr. Padaria says. “They can progress from being a cosmetic nuisance to a serious medical problem causing swelling and pain in the legs. But thanks to laser treatment, these veins now can be removed simply, without surgery.”
Dr. Shoaib Padaria pioneered this treatment in India in January’ 2003. Since then, he has successfully performed over 2,500 procedures. He is a Consultant Interventional Cardiologist associated with Jaslok Hospital and other leading hospitals in Mumbai.
For WE Health,Beauty & Sex special
Name:Sudha Hariharan
A/cNo: 424
Date: February 21,2010
Pregnant women, teenagers prone to Varicose Veins
Nature has provided for the need to push used blood back to the heart by 2 unique devices---the location of the veins and a system of valves. The veins in the legs are woven among the muscles so that when each muscle contracts, it squeezes a vein. Squeezing the vein pushes the blood closer to the heart. The valves in the vein prevent the blood from flowing backwards when the muscle relaxes
If we spend too much time sitting or standing, the used blood from the lower part of the body does not get the push it needs to return to the heart. This causes fatigue and sluggishness.
Varicose veins result from a failure of the used blood in the legs to return to the heart at the proper rate. The veins may lose some of their elasticity or the valves may fail to close properly. The used blood then accumulates and causes veins to swell. Varicose veins occur often in the legs of people whose jobs require that they stand a great deal.
Dr. Shoaib Padaria pioneered ELVES (Endovenous Laser Treatment of Varicose Veins) in India in January’ 2003. Since then, he has successfully performed over 2,500 procedures. He is a Consultant Interventional Cardiologist associated with Jaslok Hospital and other leading hospitals in Mumbai.
“Varicose Veins are enlarged, tortuous, knotty and bulging veins seen in the legs. Some of these veins may be very tiny (reticular or spider veins), while others are typically larger, increasing in size when you stand for a long period of time. In fact, this condition is known to be hereditary, and in such cases symptomatic patients could even be teenager’s “, says Dr. Shoaib. Padaria. There are two types of veins that carry blood in the body---deep veins and superficial veins. The blood flows from the superficial veins to the deep veins. These veins have valves which control the blood flow and keep the blood flowing towards the heart. However, when these valves do not function properly, the blood flows in the wrong way, leading to varicose veins.
“Varicose veins are prominent during pregnancy. During pregnancy, the growing uterus puts added pressure on the veins. As a result, the valves are also squeezed and the blood flow to our heart is disrupted. This condition is very common during the third trimester because this is when the uterus will be at its heaviest.”
“ If you are having a twin pregnancy, there are greater chances of being affected by varicose veins. During the last trimester of pregnancy, the veins on your legs may become prominent and get a dark purple or blue colouration. Apart from that, you will also experience pain in your limbs. These are symptoms of varicose veins. Usually, the symptoms disappear after delivery, but in serious cases, the bluish colouration of the veins can stay for life”, adds Dr. Shoaib.
While it usually causes problems in people over the age of 50, quite a few patients are also younger. In fact, varicose veins are known to be hereditary, and in such cases symptomatic patients could even be teenagers. It is important to diagnose varicose veins early. “In the past,” says Dr. Shoaib,” the only option was surgery – legations and stripping were used to remove a damaged vein and prevent further complications of vein damage. Today, there’s a permanent treatment for varicose veins: the laser technique.”
Endovenous Laser Treatment of Varicose Veins (ELVES) in an outpatient procedure usually completed within an hour in a clinical setting. It utilizes a diode laser, which deliver’s laser energy at a wavelength of 980 nanomicrons. This wavelength is optimally suited for absorption by haemoglobin in the blood, and does not cause any thermal injury to structures around the veins. ELVES is a safe and quick procedure that offers successful results without the complications of surgery.
Meenakshi Desai in her ninth month of pregnancy felt a sudden pain in her thigh. A bulge appeared where the pain was. Over the next seven years, it became a painful varicose vein. Eventually, the vein ran from her groin to her ankle and inhibited her in everything, from walking to caring for her children.
Mr. Sarang, a 50- year- old builder from Pune, loved walking and going for hikes in the Sahyadri Hills. A regular at the Mumbai Marathon, last year he found that he could not complete the run owing to severe pain in his legs, because of varicose veins that he had developed many years ago.
Mr. Dedhia, owner of a grocery shop, had to stand in his small shop for up to 14 hours every day. Over the years, he developed swelling in both his feet, and finally painful ulcers near his ankles that refused to heal. He was diagnosed with varicose veins.
All the above were advised regular surgery but were scared to undergo the procedure as it would hamper their lifestyle and leave scars. However, all of them finally benefited from Endovenous Laser Treatment by Dr. Padaria.
ELVES have many advantages over surgery. The treatment is performed under local anesthesia and with ultrasound guidance. A small needle is inserted into the dilated varicose veins, and a thin laser wire is passed through the needle into the vein. Laser energy delivered into the vein seals and closes the vein painlessly. The main varicose vein and its branches are closed in a similar manner, and the entire procedure takes about 30 minutes. A compression bandage is applied over the treated leg, and the patient can walk home soon after, resuming normal work the next day. The patient is required to wear special full-length stockings (socks) during waking hours for about two months after the treatment.
Many people with varicose veins live without any symptoms. However, in others, it can limit their lifestyle. Aches and pains in the legs, cramps in the calves, heaviness in the legs and swelling around the ankles while standing are common symptoms. Sometimes enlarged veins can rupture, causing sudden bleeding. A clot may form within the dilated vein and can travel to the heart. It is quite easy to diagnose varicose veins. A simple ultrasound called the Venous Doppler can show the leaking valves and swollen veins.
Meenakshi Desai, who was treated by Dr. Shoaib Padaria, says, ‘I instantly felt better.” She now feels no discomfort while walking or playing with her children.
“Everyone is at risk when it comes to developing varicose veins,” says Dr. Padaria. “But the main cause is genetic, with women nearly twice as likely to suffer as men. People with past venous diseases, new mothers, overweight individuals and people with jobs or hobbies requiring extended standing are at increased risk.”
“Meenakshi Desai’s experience shows that varicose veins can have a dramatic effect on lifestyle,” Dr. Padaria says. “They can progress from being a cosmetic nuisance to a serious medical problem causing swelling and pain in the legs. But thanks to laser treatment, these veins now can be removed simply, without surgery.”
Dr. Shoaib Padaria pioneered this treatment in India in January’ 2003. Since then, he has successfully performed over 2,500 procedures. He is a Consultant Interventional Cardiologist associated with Jaslok Hospital and other leading hospitals in Mumbai.
The Power of Epidurals
Kind attn : Mr. Divesh Nath
For WE Health, Beauty & Sex Special
Name: Sudha Hariharan
A/c No : 424
Date: Feb 18, 2010
GAIN WITHOUT PAIN : The Power of Epidurals
The term epidural is often short for epidural anesthesia, a form of regional anesthesia involving injection of drugs through a catheter placed into the epidural space. The injection can cause both a loss of sensation (anaesthesia) and a loss of pain (analgesia), by blocking the transmission of signals through nerves in or near the spinal cord. An epidural can be done for regular labor and childbirth, induced labors (induction), a forceps or vacuum delivery or even a Cesaerean section.
With over 15 years of rich and successful experience in the areas of sales, training, strategic marketing, business management and people management in healthcare industry, Dr. Prabhu Vinayagam ,urrently Director, Clinical Services- Asia Pacific, BD India (Becton Dickonson India),shares a wealth of information on the subject.
“Motherhood is undoubtedly one of the most wonderful experiences in any woman’s life” says Dr. Vinayagam.” During pregnancy, a woman goes through various emotions ranging from joy to anxiety. She is not only anxious to know whether she will be blessed with a son or a daughter, but her anxiety also lies in the fact that would presumably need to go a through a painful delivery. In addition, couples today live in a nuclear set up and do not have elders living with them during this period who could provide emotional support. This loneliness also adds to their anxiety levels “.
Ironically, advancements in science and technology and increasing education levels have not done much to alleviate the fallacies and myths surrounding childbirth. A woman is usually bounded by old wives’myths and tales which hinder her from the right of having a painless delivery. First time mothers are filled with apprehension, anxiety and fear about labor pains - as one says, there’s no gain without pain.
However, today this statement can surely be amended to ‘All gain no pain’. Yes, painless delivery is possible. “Avoiding pain” during delivery is gaining acceptance – given the increasing acceptance of pre-planned Cesarean deliveries by women, who plan to have only one or two children.
Most Cesarean deliveries are done under general anesthesia, which has its own risks like the anesthetic medicine may reach the blood stream of the baby, and also subjects the body to significant surgical trauma. Epidural anesthesia offers an alternative to Cesarean (when the only reason for Cesarean was to avoid the pain of normal delivery and where there is no other medical need for the procedure) .What needs to be understood by expectant mothers is that child birth by this method is an absolutely normal delivery; and the pain is much less.
“Epidural anaesthesia is advancement in pain management during labor, which ensures that the expecting mother has a smooth and comfortable journey through labor and delivery. As labor progresses and the fetus advances through the birth passage, certain impulses occur and aggravate pain. Epidural process is used to obstruct the pain by inserting a catheter into the vertebral column for the duration of the delivery, and pain relieving drug is injected through it. This drug numbs the body below the waist and keeps the sensations and muscle functions active. This facilitates easy delivery of the baby” says Dr. Vinayagam. The mother is now advised to push at the time of the contractions. The effect of the anesthesia gradually wears off within an hour or two. Epidural anesthesia is unlikely to affect the central nervous system, thus it does not reach the child. For this reason, the mother and the child are alert after the delivery. Some women feel the contractions but do not experience the pain at all.
“Epidural procedure is suitable for patients who find it hard to get through labor pains. Since epidurals are completely safe for the mother as well as the baby, more and more patients are opting for it. Until last decade, epidurals were unheard of in India whereas today, many hospitals offer these facilities for its patients. Certain hospitals have set up individual departments for epidural anaesthesia”, adds Dr. Vinayagam.
“Epidural Anesthesia is more commonly used for C- section as well as a mean of post operative pain management. However, epidural anesthesia when used during normal delivery is also known as Painless Labor Delivery. Labor pains often last for as long as 12 hours and epidural is an efficient mean to control such pain.”
When asked about after effects,Dr. Vinayagam said, “ similar to any other surgery, complications like epidural hematoma may occur. However, there are no direct serious harmful consequences of Epidural Anesthesia. “
In India while about 10-15% of urban population is aware of the epidural procedure, only the high society opts for it whereas in developed countries like US, epidural deliveries are a widespread procedure. It is advised that one should go for epidural deliveries after obtaining knowledge about the process. It is imperative for the doctors to observe and examine the patients carefully before advising the dosage on epidurals during labor.
“ An obstetrician’s role”, says Dr. Vinayagam.” is critical where she herself has to be absolutely willing and confident while handling the patient opting for epidural analgesia”.
Rising above the myths of risks of incidence of Cesarean, more backaches and an injurious affect on baby or mother, most women today choose to use an epidural for pain relief at some point during labor.
“Contrary to common belief, says Dr. Vinayagam,” This is not true though most people tend to avoid the procedure fearing the extra cost, but it is a known fact that epidural anesthesia is a cheaper procedure than general anesthesia”.
Women, who go for an epidural delivery, state high levels of satisfaction with this form of pain management. Through this painless delivery procedure, the woman tends to concentrate more on the procedure of pushing the baby and can psychologically enjoy the happiest moment of her life. The overall objective is to achieve a good mental state and to have a wonderful birthing experience.
( Companies, such as, Becton Dickinson (BD), one of the world leaders in the field of medical device technology, has been a pioneer in introducing products for providing regional anesthesia. One of its specialised products includes BD Perisafe™ catheter kit which is a complete epidural anaesthesia solution kit. The kit contains accurately designed Epidural needle, catheter, syringe, catheter connector and filler for the administration of epidurals.)
For WE Health, Beauty & Sex Special
Name: Sudha Hariharan
A/c No : 424
Date: Feb 18, 2010
GAIN WITHOUT PAIN : The Power of Epidurals
The term epidural is often short for epidural anesthesia, a form of regional anesthesia involving injection of drugs through a catheter placed into the epidural space. The injection can cause both a loss of sensation (anaesthesia) and a loss of pain (analgesia), by blocking the transmission of signals through nerves in or near the spinal cord. An epidural can be done for regular labor and childbirth, induced labors (induction), a forceps or vacuum delivery or even a Cesaerean section.
With over 15 years of rich and successful experience in the areas of sales, training, strategic marketing, business management and people management in healthcare industry, Dr. Prabhu Vinayagam ,urrently Director, Clinical Services- Asia Pacific, BD India (Becton Dickonson India),shares a wealth of information on the subject.
“Motherhood is undoubtedly one of the most wonderful experiences in any woman’s life” says Dr. Vinayagam.” During pregnancy, a woman goes through various emotions ranging from joy to anxiety. She is not only anxious to know whether she will be blessed with a son or a daughter, but her anxiety also lies in the fact that would presumably need to go a through a painful delivery. In addition, couples today live in a nuclear set up and do not have elders living with them during this period who could provide emotional support. This loneliness also adds to their anxiety levels “.
Ironically, advancements in science and technology and increasing education levels have not done much to alleviate the fallacies and myths surrounding childbirth. A woman is usually bounded by old wives’myths and tales which hinder her from the right of having a painless delivery. First time mothers are filled with apprehension, anxiety and fear about labor pains - as one says, there’s no gain without pain.
However, today this statement can surely be amended to ‘All gain no pain’. Yes, painless delivery is possible. “Avoiding pain” during delivery is gaining acceptance – given the increasing acceptance of pre-planned Cesarean deliveries by women, who plan to have only one or two children.
Most Cesarean deliveries are done under general anesthesia, which has its own risks like the anesthetic medicine may reach the blood stream of the baby, and also subjects the body to significant surgical trauma. Epidural anesthesia offers an alternative to Cesarean (when the only reason for Cesarean was to avoid the pain of normal delivery and where there is no other medical need for the procedure) .What needs to be understood by expectant mothers is that child birth by this method is an absolutely normal delivery; and the pain is much less.
“Epidural anaesthesia is advancement in pain management during labor, which ensures that the expecting mother has a smooth and comfortable journey through labor and delivery. As labor progresses and the fetus advances through the birth passage, certain impulses occur and aggravate pain. Epidural process is used to obstruct the pain by inserting a catheter into the vertebral column for the duration of the delivery, and pain relieving drug is injected through it. This drug numbs the body below the waist and keeps the sensations and muscle functions active. This facilitates easy delivery of the baby” says Dr. Vinayagam. The mother is now advised to push at the time of the contractions. The effect of the anesthesia gradually wears off within an hour or two. Epidural anesthesia is unlikely to affect the central nervous system, thus it does not reach the child. For this reason, the mother and the child are alert after the delivery. Some women feel the contractions but do not experience the pain at all.
“Epidural procedure is suitable for patients who find it hard to get through labor pains. Since epidurals are completely safe for the mother as well as the baby, more and more patients are opting for it. Until last decade, epidurals were unheard of in India whereas today, many hospitals offer these facilities for its patients. Certain hospitals have set up individual departments for epidural anaesthesia”, adds Dr. Vinayagam.
“Epidural Anesthesia is more commonly used for C- section as well as a mean of post operative pain management. However, epidural anesthesia when used during normal delivery is also known as Painless Labor Delivery. Labor pains often last for as long as 12 hours and epidural is an efficient mean to control such pain.”
When asked about after effects,Dr. Vinayagam said, “ similar to any other surgery, complications like epidural hematoma may occur. However, there are no direct serious harmful consequences of Epidural Anesthesia. “
In India while about 10-15% of urban population is aware of the epidural procedure, only the high society opts for it whereas in developed countries like US, epidural deliveries are a widespread procedure. It is advised that one should go for epidural deliveries after obtaining knowledge about the process. It is imperative for the doctors to observe and examine the patients carefully before advising the dosage on epidurals during labor.
“ An obstetrician’s role”, says Dr. Vinayagam.” is critical where she herself has to be absolutely willing and confident while handling the patient opting for epidural analgesia”.
Rising above the myths of risks of incidence of Cesarean, more backaches and an injurious affect on baby or mother, most women today choose to use an epidural for pain relief at some point during labor.
“Contrary to common belief, says Dr. Vinayagam,” This is not true though most people tend to avoid the procedure fearing the extra cost, but it is a known fact that epidural anesthesia is a cheaper procedure than general anesthesia”.
Women, who go for an epidural delivery, state high levels of satisfaction with this form of pain management. Through this painless delivery procedure, the woman tends to concentrate more on the procedure of pushing the baby and can psychologically enjoy the happiest moment of her life. The overall objective is to achieve a good mental state and to have a wonderful birthing experience.
( Companies, such as, Becton Dickinson (BD), one of the world leaders in the field of medical device technology, has been a pioneer in introducing products for providing regional anesthesia. One of its specialised products includes BD Perisafe™ catheter kit which is a complete epidural anaesthesia solution kit. The kit contains accurately designed Epidural needle, catheter, syringe, catheter connector and filler for the administration of epidurals.)
The Power of Epidurals
Kind attn : Mr. Divesh Nath
For WE Health, Beauty & Sex Special
Name: Sudha Hariharan
A/c No : 424
Date: Feb 18, 2010
GAIN WITHOUT PAIN : The Power of Epidurals
The term epidural is often short for epidural anesthesia, a form of regional anesthesia involving injection of drugs through a catheter placed into the epidural space. The injection can cause both a loss of sensation (anaesthesia) and a loss of pain (analgesia), by blocking the transmission of signals through nerves in or near the spinal cord. An epidural can be done for regular labor and childbirth, induced labors (induction), a forceps or vacuum delivery or even a Cesaerean section.
With over 15 years of rich and successful experience in the areas of sales, training, strategic marketing, business management and people management in healthcare industry, Dr. Prabhu Vinayagam ,urrently Director, Clinical Services- Asia Pacific, BD India (Becton Dickonson India),shares a wealth of information on the subject.
“Motherhood is undoubtedly one of the most wonderful experiences in any woman’s life” says Dr. Vinayagam.” During pregnancy, a woman goes through various emotions ranging from joy to anxiety. She is not only anxious to know whether she will be blessed with a son or a daughter, but her anxiety also lies in the fact that would presumably need to go a through a painful delivery. In addition, couples today live in a nuclear set up and do not have elders living with them during this period who could provide emotional support. This loneliness also adds to their anxiety levels “.
Ironically, advancements in science and technology and increasing education levels have not done much to alleviate the fallacies and myths surrounding childbirth. A woman is usually bounded by old wives’myths and tales which hinder her from the right of having a painless delivery. First time mothers are filled with apprehension, anxiety and fear about labor pains - as one says, there’s no gain without pain.
However, today this statement can surely be amended to ‘All gain no pain’. Yes, painless delivery is possible. “Avoiding pain” during delivery is gaining acceptance – given the increasing acceptance of pre-planned Cesarean deliveries by women, who plan to have only one or two children.
Most Cesarean deliveries are done under general anesthesia, which has its own risks like the anesthetic medicine may reach the blood stream of the baby, and also subjects the body to significant surgical trauma. Epidural anesthesia offers an alternative to Cesarean (when the only reason for Cesarean was to avoid the pain of normal delivery and where there is no other medical need for the procedure) .What needs to be understood by expectant mothers is that child birth by this method is an absolutely normal delivery; and the pain is much less.
“Epidural anaesthesia is advancement in pain management during labor, which ensures that the expecting mother has a smooth and comfortable journey through labor and delivery. As labor progresses and the fetus advances through the birth passage, certain impulses occur and aggravate pain. Epidural process is used to obstruct the pain by inserting a catheter into the vertebral column for the duration of the delivery, and pain relieving drug is injected through it. This drug numbs the body below the waist and keeps the sensations and muscle functions active. This facilitates easy delivery of the baby” says Dr. Vinayagam. The mother is now advised to push at the time of the contractions. The effect of the anesthesia gradually wears off within an hour or two. Epidural anesthesia is unlikely to affect the central nervous system, thus it does not reach the child. For this reason, the mother and the child are alert after the delivery. Some women feel the contractions but do not experience the pain at all.
“Epidural procedure is suitable for patients who find it hard to get through labor pains. Since epidurals are completely safe for the mother as well as the baby, more and more patients are opting for it. Until last decade, epidurals were unheard of in India whereas today, many hospitals offer these facilities for its patients. Certain hospitals have set up individual departments for epidural anaesthesia”, adds Dr. Vinayagam.
“Epidural Anesthesia is more commonly used for C- section as well as a mean of post operative pain management. However, epidural anesthesia when used during normal delivery is also known as Painless Labor Delivery. Labor pains often last for as long as 12 hours and epidural is an efficient mean to control such pain.”
When asked about after effects,Dr. Vinayagam said, “ similar to any other surgery, complications like epidural hematoma may occur. However, there are no direct serious harmful consequences of Epidural Anesthesia. “
In India while about 10-15% of urban population is aware of the epidural procedure, only the high society opts for it whereas in developed countries like US, epidural deliveries are a widespread procedure. It is advised that one should go for epidural deliveries after obtaining knowledge about the process. It is imperative for the doctors to observe and examine the patients carefully before advising the dosage on epidurals during labor.
“ An obstetrician’s role”, says Dr. Vinayagam.” is critical where she herself has to be absolutely willing and confident while handling the patient opting for epidural analgesia”.
Rising above the myths of risks of incidence of Cesarean, more backaches and an injurious affect on baby or mother, most women today choose to use an epidural for pain relief at some point during labor.
“Contrary to common belief, says Dr. Vinayagam,” This is not true though most people tend to avoid the procedure fearing the extra cost, but it is a known fact that epidural anesthesia is a cheaper procedure than general anesthesia”.
Women, who go for an epidural delivery, state high levels of satisfaction with this form of pain management. Through this painless delivery procedure, the woman tends to concentrate more on the procedure of pushing the baby and can psychologically enjoy the happiest moment of her life. The overall objective is to achieve a good mental state and to have a wonderful birthing experience.
( Companies, such as, Becton Dickinson (BD), one of the world leaders in the field of medical device technology, has been a pioneer in introducing products for providing regional anesthesia. One of its specialised products includes BD Perisafe™ catheter kit which is a complete epidural anaesthesia solution kit. The kit contains accurately designed Epidural needle, catheter, syringe, catheter connector and filler for the administration of epidurals.)
For WE Health, Beauty & Sex Special
Name: Sudha Hariharan
A/c No : 424
Date: Feb 18, 2010
GAIN WITHOUT PAIN : The Power of Epidurals
The term epidural is often short for epidural anesthesia, a form of regional anesthesia involving injection of drugs through a catheter placed into the epidural space. The injection can cause both a loss of sensation (anaesthesia) and a loss of pain (analgesia), by blocking the transmission of signals through nerves in or near the spinal cord. An epidural can be done for regular labor and childbirth, induced labors (induction), a forceps or vacuum delivery or even a Cesaerean section.
With over 15 years of rich and successful experience in the areas of sales, training, strategic marketing, business management and people management in healthcare industry, Dr. Prabhu Vinayagam ,urrently Director, Clinical Services- Asia Pacific, BD India (Becton Dickonson India),shares a wealth of information on the subject.
“Motherhood is undoubtedly one of the most wonderful experiences in any woman’s life” says Dr. Vinayagam.” During pregnancy, a woman goes through various emotions ranging from joy to anxiety. She is not only anxious to know whether she will be blessed with a son or a daughter, but her anxiety also lies in the fact that would presumably need to go a through a painful delivery. In addition, couples today live in a nuclear set up and do not have elders living with them during this period who could provide emotional support. This loneliness also adds to their anxiety levels “.
Ironically, advancements in science and technology and increasing education levels have not done much to alleviate the fallacies and myths surrounding childbirth. A woman is usually bounded by old wives’myths and tales which hinder her from the right of having a painless delivery. First time mothers are filled with apprehension, anxiety and fear about labor pains - as one says, there’s no gain without pain.
However, today this statement can surely be amended to ‘All gain no pain’. Yes, painless delivery is possible. “Avoiding pain” during delivery is gaining acceptance – given the increasing acceptance of pre-planned Cesarean deliveries by women, who plan to have only one or two children.
Most Cesarean deliveries are done under general anesthesia, which has its own risks like the anesthetic medicine may reach the blood stream of the baby, and also subjects the body to significant surgical trauma. Epidural anesthesia offers an alternative to Cesarean (when the only reason for Cesarean was to avoid the pain of normal delivery and where there is no other medical need for the procedure) .What needs to be understood by expectant mothers is that child birth by this method is an absolutely normal delivery; and the pain is much less.
“Epidural anaesthesia is advancement in pain management during labor, which ensures that the expecting mother has a smooth and comfortable journey through labor and delivery. As labor progresses and the fetus advances through the birth passage, certain impulses occur and aggravate pain. Epidural process is used to obstruct the pain by inserting a catheter into the vertebral column for the duration of the delivery, and pain relieving drug is injected through it. This drug numbs the body below the waist and keeps the sensations and muscle functions active. This facilitates easy delivery of the baby” says Dr. Vinayagam. The mother is now advised to push at the time of the contractions. The effect of the anesthesia gradually wears off within an hour or two. Epidural anesthesia is unlikely to affect the central nervous system, thus it does not reach the child. For this reason, the mother and the child are alert after the delivery. Some women feel the contractions but do not experience the pain at all.
“Epidural procedure is suitable for patients who find it hard to get through labor pains. Since epidurals are completely safe for the mother as well as the baby, more and more patients are opting for it. Until last decade, epidurals were unheard of in India whereas today, many hospitals offer these facilities for its patients. Certain hospitals have set up individual departments for epidural anaesthesia”, adds Dr. Vinayagam.
“Epidural Anesthesia is more commonly used for C- section as well as a mean of post operative pain management. However, epidural anesthesia when used during normal delivery is also known as Painless Labor Delivery. Labor pains often last for as long as 12 hours and epidural is an efficient mean to control such pain.”
When asked about after effects,Dr. Vinayagam said, “ similar to any other surgery, complications like epidural hematoma may occur. However, there are no direct serious harmful consequences of Epidural Anesthesia. “
In India while about 10-15% of urban population is aware of the epidural procedure, only the high society opts for it whereas in developed countries like US, epidural deliveries are a widespread procedure. It is advised that one should go for epidural deliveries after obtaining knowledge about the process. It is imperative for the doctors to observe and examine the patients carefully before advising the dosage on epidurals during labor.
“ An obstetrician’s role”, says Dr. Vinayagam.” is critical where she herself has to be absolutely willing and confident while handling the patient opting for epidural analgesia”.
Rising above the myths of risks of incidence of Cesarean, more backaches and an injurious affect on baby or mother, most women today choose to use an epidural for pain relief at some point during labor.
“Contrary to common belief, says Dr. Vinayagam,” This is not true though most people tend to avoid the procedure fearing the extra cost, but it is a known fact that epidural anesthesia is a cheaper procedure than general anesthesia”.
Women, who go for an epidural delivery, state high levels of satisfaction with this form of pain management. Through this painless delivery procedure, the woman tends to concentrate more on the procedure of pushing the baby and can psychologically enjoy the happiest moment of her life. The overall objective is to achieve a good mental state and to have a wonderful birthing experience.
( Companies, such as, Becton Dickinson (BD), one of the world leaders in the field of medical device technology, has been a pioneer in introducing products for providing regional anesthesia. One of its specialised products includes BD Perisafe™ catheter kit which is a complete epidural anaesthesia solution kit. The kit contains accurately designed Epidural needle, catheter, syringe, catheter connector and filler for the administration of epidurals.)
The Silent Killers
Kind attn: Mr. Divesh Nath
For Woman’s Era
Name: Sudha Hariharan
A/c No: 424
Date: April 26, 2010
Arthritis in Youngsters, Osteoporosis in Women …The Silent Killers
Osteoporosis is a condition characterized by a decrease in the density of bone, decreasing its strength and resulting in fragile bones. Osteoporosis literally leads to abnormally porous bone that is compressible, like a sponge. This disorder of the skeleton weakens the bone and results in frequent fractures (breaks) in the bones.
In the U.S., 44 million people have low bone density (10 million have osteoporosis and 34 million have osteopenia. The situation is even worse in Asian patients. One in two Caucasian women will experience a bone fracture due to osteoporosis in her lifetime. Approximately 20 per cent of those who experience a hip fracture will die in the year following the fracture. Only one-third of hip-fracture patients regain their pre-fracture level of function.
It is a rare adult who has never experienced some form of arthritis or rheumatism. These diseases are very common and among the oldest known to man. It is only of late that the magnitude of the problem been appreciated. Consequently a great deal of new knowledge, understanding and treatment is now available. Though a complete cure is not available, treatment is helpful specially if started within the first 6 months of onset. Arthritis need not be crippling.
A recent pan-India health survey reveals that osteoarthritis has emerged as the numero uno ailment in India, even trouncing traditional heavyweights like AIDS, diabetes, cancer and hypertension. The survey conducted by TNS, an ISO-accredited market research agency in Delhi, was carried out across a swathe of 15 cities - Delhi, Lucknow, Ludhiana, Jaipur, Varanasi, Chennai, Bangalore, Hyderabad, Cochin, Kolkata, Patna, Mumbai, Ahmedabad, Nagpur and Indore.
According to the study, in the age band of 25 to 35 years, osteoarthritis is the second most prevalent disease in India after diabetes. The study showed that despite this, awareness amongst Indians about the bone ailment is almost nil as compared to high profile diseases like cancer, AIDS and diabetes. The prevalence of doctor-diagnosed arthritis is projected to increase to nearly 25 percent of the adult population by the year 2030.
Almost one-third of all cases will be in working-age adults, those 45 to 64 years old. This large increase poses a major challenge to the health care and public health systems. The World Health Organization (WHO) estimates that 70 million Indians are victims of arthritis. According to the US-based Arthritis Foundation, 80 per cent of the 50-plus people in the world will experience arthritis in one of its many hundred forms.
A study published (in the Journal of Community Medicine Vol. 1, No.1, January 2007) showed significant difference in the prevalence of osteoarthritis in elderly of rural and urban areas. The low prevalence of osteoarthritis in rural elderly could be due to differences in their life style. Rheumatoid Arthritis has a prevalence of 0.75 per cent; projected to the whole population, this would give a total of about 7 million patients in India.
Dr. Kaushal Malhan, Hip and Knee Surgeon, Fortis Hospital sheds light on the causes, symptoms and the most hi-tech and effective lines of treatment .
“Statistics have shown that over the past several years, the age of onset of osteoarthritis has been steadily decreasing. Also secondary arthritis is being commonly seen in younger people. The number of young patients with endstage joint disease seeking a satisfactory remedy is going up day by day. These patients are beyond the scope of medicines and need surgical treatment. These are high- demand patients who need high -performance surgery. Conventional joint replacement surgery is therefore less appropriate. The innovative tissue and bone sparing techniques we have been doing at our centre are very appropriate for this group of patients” says Dr. Kaushal Malhan.
Ketan Mhatre (33) a young IT professional says “Since the age of 24, when I was first diagnosed with rheumatoid arthritis, I thought I had no hopes but to live with the pain and compromised gait, till I consulted Dr. Malhan who gave me hope of a new beginning with specialized tissue preserving knee and hip surgery. He understood the needs of a young person like me and with advanced surgery truly gave a new meaning to my life” Ketan has undergone a hip resurfacing and bilateral knee replacement with tissue preserving technique.
Dr. Malhan, along with his team performed the hip resurfacing and knee replacement surgery on Ketan with specialised tissue- preserving methods to treat his worn out joints. Ketan Mhatre who lives with his wife and parents in Thane was suffering from severe pain in his joints. His hip and knee joints were damaged to the extent that they made a cracking sound while walking. He was unable to stand and walk due to excruciating pain. Medicines of all sorts were not helping him as his joints were totally damaged by arthritis. With endstage secondary arthritis in almost all his weight- bearing joints, Ketan’s life and career was crippled. This disease had completely compromised his physical and social life and posed a threat to his career.
“Ketan’s problems began with the onset of inflammatory type of joint arthritis which started to damage a number of joints in his body especially those of the lower limbs. In spite of good medical treatment , the disease progressed unabatedly and caused severe damage to the right hip and both knees. He was unable to stand straight and walk. Since the joints were completely destroyed there was no option but to consider replacement surgery. In view of his young age I decided to replace his joints with techniques that would preserve as much as possible. I did a bone conserving hip resurfacing surgery and bilateral tissue preserving total knee replacement. Both knees had to be done in one sitting because of the extreme deformity. Doing one at a time would not allow proper rehabilitation and Ketan was in no condition to allow a long drawn wait and rehabilitation,” explains Dr. Malhan.
What exactly is osteoporosis?
Normal bone is composed of protein, collagen, and calcium all of which give bone its strength. Collagen is the term applied to the supporting connective tissues of the body. It would be correct to think of bone structure as being similar to a column made of metal girders (protein chains) and concrete (calcium or hydroxyapatite). Osteoporosis represents a reduction in both of these and therefore damage to the microstructure of bone and not simply deficiency of calcium as is commonly believed. Deficiency of calcium and vitamin D can aggravate osteoporosis but is not the main and only cause. Naturally, just taking calcium and vitamin D to treat osteoporosis is not enough.
Are there any obvious symptoms that manifest with the onset of the disease?
Osteoporosis can be present without any symptoms for decades because it does not cause symptoms until bone fractures. Moreover, some osteoporotic fractures may escape detection for years when they do not cause symptoms. Therefore, patients may not be aware of their osteoporosis until they suffer a painful fracture. The symptom associated with osteoporotic fractures usually is pain and disability depending on the location of the fracture. Osteoporosis is therefore often called the “the silent killer”.
Do women have lower bone density?
Bone mass (bone density) is determined by the amount of bone present in the skeletal structure. Generally, higher the bone density, stronger the bones. Estrogen, a hormone in women is important in maintaining bone density. When estrogen levels drop after menopause, loss of bone density accelerates. During the first five to 10 years after menopause, women can suffer up to 2-4 per cent loss of bone density per year! This can result in the loss of up to 25-30 per cent of their bone density during that time period. Accelerated bone loss after menopause is a major cause of osteoporosis in women. Hormone replacement therapy post menopause prevents this loss but is of no major help once the window period of 6 yrs post menopause is over. The male hormone testosterone also maintains bone density in men and senile osteoporosis i.e. due to ageing may be seen in men after 70 yrs age due to reduction in the hormone levels. Also steroids and some medicines may predispose to osteoporosis.
What are the common risk factors women face?
Female gender, caucasian or Asian race, thin and small body frame, family history of osteoporosis, cigarette smoking, excessive alcohol consumption, lack of exercise, diet low in calcium and poor nutrition, malabsorption. Low estrogen levels in women (such as occur in menopause or with early surgical removal of both ovaries), low testosterone levels (hypogonadism), chemotherapy that can cause early menopause due to its toxic effects on the ovaries, amenorrhea (loss of the menstrual period) in young women associated with low estrogen and osteoporosis.
Amenorrhea can occur in women who undergo extremely vigorous exercise training and in women with very low body fat, for example, women with anorexia nervosa, chronic inflammation, due to chronic diseases such as rheumatoid arthritis or liver diseases, immobility, such as after a stroke, or from any condition that interferes with walking, hyperthyroidism, a condition wherein too much thyroid hormone is produced by the thyroid gland or is ingested as thyroid hormone medication. Certain medications can cause osteoporosis. These include long-term use of anti-seizure medications such as phenytoin and phenobarbital, and long-term use of oral steroids.
How can one detect the onset of osteoporosis?
A routine X-ray can reveal osteoporosis of the bone because the bones appear much thinner and lighter than normal bones. Unfortunately, by the time X-rays can detect osteoporosis, at least 30 per cent of the bone has already been lost. In addition, X-rays are not accurate indicators of bone density.
What are the treatment options available?
The best treatment for osteoporosis is prevention. Increase the bone mass as much as possible in the formative years. Impact loading exercise like brisk walking and adequate calcium, vitamin D and proteins in a healthy well balanced diet helps. Reduce risk factors as mentioned above. At risk people should get themselves screened.
In patients for established disease, treatment with calcium and vitamin D alone is not enough. One has to supplement with special osteoporosis medicines like antiresorptives e.g. bisphosphonate or bone forming drugs like teriparatides depending on which is suitable. Patients with low hormone levels will benefit from hormone replacement therapy taken after consultation the doctor.
Can you tell us a little more about preventive measures and treatments available?
Treatment of osteoporosis consists of treatment of the condition itself which is medical and its complications, which is a combination of medical and surgical treatment The best treatment is to prevent the disease. This can be done by increasing the bone mass during the first three decades of life with a good healthy diet containing adequate protein, calcium and vitamin D. Milk, eggs, nuts, cheese, curds and lots of sunshine are good sources of these. Calcium and vitamin D tablets can be taken to supplement the diet. High impact loading exercise will increase the skeletal bone mass and a daily brisk walk is useful.
The same steps are useful for patients of established osteoporosis but in addition they need anti -osteoporosis medication. This can be in the form of antiresorptives which prevent further bone mass deterioration and hence indirectly increase the overall bone stock, and anabolic drugs like teriparatides that cause production of more bone and increase the strength of the skeleton.
Are there any measures for perimenopausal and early menopausal women?
Perimenopausal and early menopausal women may consider the option of hormone replacement after discussing with their doctor. Such therapy is however useful in only the first 6-7 yrs after menopause and needs to be continued lifelong to maintain the bone mass. If started after 6-7 yrs post menopause then it of little benefit. Women who have lost their normal hormonal support due to removal of ovaries or other problems early in life can consider artificial hormone replacement therapy. Surgery is needed to mend complications like fractures due to weak bones. Common fractures are those of the hip, wrist and spine. Treatment options may range from simple plaster treatment to fixation of fractures with metal implants or joint replacement options. Non- healing painful spinal fractures may be tackled with minimally invasive techniques like vertebroplasty.
For Woman’s Era
Name: Sudha Hariharan
A/c No: 424
Date: April 26, 2010
Arthritis in Youngsters, Osteoporosis in Women …The Silent Killers
Osteoporosis is a condition characterized by a decrease in the density of bone, decreasing its strength and resulting in fragile bones. Osteoporosis literally leads to abnormally porous bone that is compressible, like a sponge. This disorder of the skeleton weakens the bone and results in frequent fractures (breaks) in the bones.
In the U.S., 44 million people have low bone density (10 million have osteoporosis and 34 million have osteopenia. The situation is even worse in Asian patients. One in two Caucasian women will experience a bone fracture due to osteoporosis in her lifetime. Approximately 20 per cent of those who experience a hip fracture will die in the year following the fracture. Only one-third of hip-fracture patients regain their pre-fracture level of function.
It is a rare adult who has never experienced some form of arthritis or rheumatism. These diseases are very common and among the oldest known to man. It is only of late that the magnitude of the problem been appreciated. Consequently a great deal of new knowledge, understanding and treatment is now available. Though a complete cure is not available, treatment is helpful specially if started within the first 6 months of onset. Arthritis need not be crippling.
A recent pan-India health survey reveals that osteoarthritis has emerged as the numero uno ailment in India, even trouncing traditional heavyweights like AIDS, diabetes, cancer and hypertension. The survey conducted by TNS, an ISO-accredited market research agency in Delhi, was carried out across a swathe of 15 cities - Delhi, Lucknow, Ludhiana, Jaipur, Varanasi, Chennai, Bangalore, Hyderabad, Cochin, Kolkata, Patna, Mumbai, Ahmedabad, Nagpur and Indore.
According to the study, in the age band of 25 to 35 years, osteoarthritis is the second most prevalent disease in India after diabetes. The study showed that despite this, awareness amongst Indians about the bone ailment is almost nil as compared to high profile diseases like cancer, AIDS and diabetes. The prevalence of doctor-diagnosed arthritis is projected to increase to nearly 25 percent of the adult population by the year 2030.
Almost one-third of all cases will be in working-age adults, those 45 to 64 years old. This large increase poses a major challenge to the health care and public health systems. The World Health Organization (WHO) estimates that 70 million Indians are victims of arthritis. According to the US-based Arthritis Foundation, 80 per cent of the 50-plus people in the world will experience arthritis in one of its many hundred forms.
A study published (in the Journal of Community Medicine Vol. 1, No.1, January 2007) showed significant difference in the prevalence of osteoarthritis in elderly of rural and urban areas. The low prevalence of osteoarthritis in rural elderly could be due to differences in their life style. Rheumatoid Arthritis has a prevalence of 0.75 per cent; projected to the whole population, this would give a total of about 7 million patients in India.
Dr. Kaushal Malhan, Hip and Knee Surgeon, Fortis Hospital sheds light on the causes, symptoms and the most hi-tech and effective lines of treatment .
“Statistics have shown that over the past several years, the age of onset of osteoarthritis has been steadily decreasing. Also secondary arthritis is being commonly seen in younger people. The number of young patients with endstage joint disease seeking a satisfactory remedy is going up day by day. These patients are beyond the scope of medicines and need surgical treatment. These are high- demand patients who need high -performance surgery. Conventional joint replacement surgery is therefore less appropriate. The innovative tissue and bone sparing techniques we have been doing at our centre are very appropriate for this group of patients” says Dr. Kaushal Malhan.
Ketan Mhatre (33) a young IT professional says “Since the age of 24, when I was first diagnosed with rheumatoid arthritis, I thought I had no hopes but to live with the pain and compromised gait, till I consulted Dr. Malhan who gave me hope of a new beginning with specialized tissue preserving knee and hip surgery. He understood the needs of a young person like me and with advanced surgery truly gave a new meaning to my life” Ketan has undergone a hip resurfacing and bilateral knee replacement with tissue preserving technique.
Dr. Malhan, along with his team performed the hip resurfacing and knee replacement surgery on Ketan with specialised tissue- preserving methods to treat his worn out joints. Ketan Mhatre who lives with his wife and parents in Thane was suffering from severe pain in his joints. His hip and knee joints were damaged to the extent that they made a cracking sound while walking. He was unable to stand and walk due to excruciating pain. Medicines of all sorts were not helping him as his joints were totally damaged by arthritis. With endstage secondary arthritis in almost all his weight- bearing joints, Ketan’s life and career was crippled. This disease had completely compromised his physical and social life and posed a threat to his career.
“Ketan’s problems began with the onset of inflammatory type of joint arthritis which started to damage a number of joints in his body especially those of the lower limbs. In spite of good medical treatment , the disease progressed unabatedly and caused severe damage to the right hip and both knees. He was unable to stand straight and walk. Since the joints were completely destroyed there was no option but to consider replacement surgery. In view of his young age I decided to replace his joints with techniques that would preserve as much as possible. I did a bone conserving hip resurfacing surgery and bilateral tissue preserving total knee replacement. Both knees had to be done in one sitting because of the extreme deformity. Doing one at a time would not allow proper rehabilitation and Ketan was in no condition to allow a long drawn wait and rehabilitation,” explains Dr. Malhan.
What exactly is osteoporosis?
Normal bone is composed of protein, collagen, and calcium all of which give bone its strength. Collagen is the term applied to the supporting connective tissues of the body. It would be correct to think of bone structure as being similar to a column made of metal girders (protein chains) and concrete (calcium or hydroxyapatite). Osteoporosis represents a reduction in both of these and therefore damage to the microstructure of bone and not simply deficiency of calcium as is commonly believed. Deficiency of calcium and vitamin D can aggravate osteoporosis but is not the main and only cause. Naturally, just taking calcium and vitamin D to treat osteoporosis is not enough.
Are there any obvious symptoms that manifest with the onset of the disease?
Osteoporosis can be present without any symptoms for decades because it does not cause symptoms until bone fractures. Moreover, some osteoporotic fractures may escape detection for years when they do not cause symptoms. Therefore, patients may not be aware of their osteoporosis until they suffer a painful fracture. The symptom associated with osteoporotic fractures usually is pain and disability depending on the location of the fracture. Osteoporosis is therefore often called the “the silent killer”.
Do women have lower bone density?
Bone mass (bone density) is determined by the amount of bone present in the skeletal structure. Generally, higher the bone density, stronger the bones. Estrogen, a hormone in women is important in maintaining bone density. When estrogen levels drop after menopause, loss of bone density accelerates. During the first five to 10 years after menopause, women can suffer up to 2-4 per cent loss of bone density per year! This can result in the loss of up to 25-30 per cent of their bone density during that time period. Accelerated bone loss after menopause is a major cause of osteoporosis in women. Hormone replacement therapy post menopause prevents this loss but is of no major help once the window period of 6 yrs post menopause is over. The male hormone testosterone also maintains bone density in men and senile osteoporosis i.e. due to ageing may be seen in men after 70 yrs age due to reduction in the hormone levels. Also steroids and some medicines may predispose to osteoporosis.
What are the common risk factors women face?
Female gender, caucasian or Asian race, thin and small body frame, family history of osteoporosis, cigarette smoking, excessive alcohol consumption, lack of exercise, diet low in calcium and poor nutrition, malabsorption. Low estrogen levels in women (such as occur in menopause or with early surgical removal of both ovaries), low testosterone levels (hypogonadism), chemotherapy that can cause early menopause due to its toxic effects on the ovaries, amenorrhea (loss of the menstrual period) in young women associated with low estrogen and osteoporosis.
Amenorrhea can occur in women who undergo extremely vigorous exercise training and in women with very low body fat, for example, women with anorexia nervosa, chronic inflammation, due to chronic diseases such as rheumatoid arthritis or liver diseases, immobility, such as after a stroke, or from any condition that interferes with walking, hyperthyroidism, a condition wherein too much thyroid hormone is produced by the thyroid gland or is ingested as thyroid hormone medication. Certain medications can cause osteoporosis. These include long-term use of anti-seizure medications such as phenytoin and phenobarbital, and long-term use of oral steroids.
How can one detect the onset of osteoporosis?
A routine X-ray can reveal osteoporosis of the bone because the bones appear much thinner and lighter than normal bones. Unfortunately, by the time X-rays can detect osteoporosis, at least 30 per cent of the bone has already been lost. In addition, X-rays are not accurate indicators of bone density.
What are the treatment options available?
The best treatment for osteoporosis is prevention. Increase the bone mass as much as possible in the formative years. Impact loading exercise like brisk walking and adequate calcium, vitamin D and proteins in a healthy well balanced diet helps. Reduce risk factors as mentioned above. At risk people should get themselves screened.
In patients for established disease, treatment with calcium and vitamin D alone is not enough. One has to supplement with special osteoporosis medicines like antiresorptives e.g. bisphosphonate or bone forming drugs like teriparatides depending on which is suitable. Patients with low hormone levels will benefit from hormone replacement therapy taken after consultation the doctor.
Can you tell us a little more about preventive measures and treatments available?
Treatment of osteoporosis consists of treatment of the condition itself which is medical and its complications, which is a combination of medical and surgical treatment The best treatment is to prevent the disease. This can be done by increasing the bone mass during the first three decades of life with a good healthy diet containing adequate protein, calcium and vitamin D. Milk, eggs, nuts, cheese, curds and lots of sunshine are good sources of these. Calcium and vitamin D tablets can be taken to supplement the diet. High impact loading exercise will increase the skeletal bone mass and a daily brisk walk is useful.
The same steps are useful for patients of established osteoporosis but in addition they need anti -osteoporosis medication. This can be in the form of antiresorptives which prevent further bone mass deterioration and hence indirectly increase the overall bone stock, and anabolic drugs like teriparatides that cause production of more bone and increase the strength of the skeleton.
Are there any measures for perimenopausal and early menopausal women?
Perimenopausal and early menopausal women may consider the option of hormone replacement after discussing with their doctor. Such therapy is however useful in only the first 6-7 yrs after menopause and needs to be continued lifelong to maintain the bone mass. If started after 6-7 yrs post menopause then it of little benefit. Women who have lost their normal hormonal support due to removal of ovaries or other problems early in life can consider artificial hormone replacement therapy. Surgery is needed to mend complications like fractures due to weak bones. Common fractures are those of the hip, wrist and spine. Treatment options may range from simple plaster treatment to fixation of fractures with metal implants or joint replacement options. Non- healing painful spinal fractures may be tackled with minimally invasive techniques like vertebroplasty.
Monday, September 7, 2009
PATHBREAKING MEDICAL TECHNOLOGY
World’s First Robotic Arm for Angioplasty Arrives in India at Dr L H Hiranandani Hospital
By Sudha Hariharan
The world’s first robotic arm for angioplasty arrived in India at the renowned Dr LH Hiranandani Hospital, Powai, Mumbai. With this Dr LH Hiranandani Hospital has become the country’s first and one of the world’s few centres of excellence to carry on research on this exciting international breakthrough. The robotic arm allows remote manipulation of Percutaneous Coronary Interventions (PCI).
For the first time in India, Dr L H Hiranandani Hospital conducted a live demonstration of angioplasty using this robotic arm.
As part of the multicentric clinical evaluation for US FDA approval Interventional Cardiologists Dr.Ganesh Kumar of Dr LH Hiranandani Hospital has been chosen as principal investigator and Dr. Ajay Chaurasia of Dr LH Hiranandani Hospital as co-investigator to conduct this study in India.
Earlier in December 2005, Dr. Ganesh Kumar teamed up with Rafael Beyar (considered the father of stents) and other eminent members including Tal Wenderow, Doron Lindner, and Rona Shofti, in Israel, to develop and test this equipment. The result of this path-breaking study was published in Europe’s EuroIntervention journal in November 2005. The study concluded that remote navigation system for coronary interventions including balloon angioplasty and stenting is feasible. The system was tested initially in a glass coronary model with visual feedback of the device movements through the transparent glass.
Later a normal coronary sheep model (animal model experiments) was employed to test the safety of the system. The third step was a pilot FIM (First in Man) clinical study, conducted on 15 patients with single coronary artery narrowing.
Dr. Ganesh Kumar was part of the first in man pilot study in Romania through which this system was evaluated on fifteen patients with stable angina pectoris and a typical risk of coronary heart disease with 100 percent clinical success and technical results in over 92 percent of cases. This study was a turning point in establishing the potential of such a system and was published in 2006 January in the Journal of American College of Cardiology.
Many advantages over traditional system
Percutaneous coronary intervention (PCI) is a major method of revascularization for coronary artery disease, with over 2 million coronary interventions performed annually. The majority of interventions (70-80%) are coronary dilatations using stents. Recently, drug-eluting stents (DES) have shown sustained advantage compared to bare metal stents, with a marked reduction of restenosis rates.
The catheterization laboratory personnel so far have been operating in an unfriendly environment subject to a continuous X-ray radiation throughout life. This has been unchanged since the beginning of the field of interventional cardiology more than 25 years ago. “Interventionalists’ disc disease” is a well confirmed entity with cardiologists reporting more neck and back pain, more subsequent time lost from work, and a higher incidence of cervical disc herniations, as well as multiple level disc disease owing to the tiresome standing procedure of angioplasty and the heavy weight of the anti -radiation gear that takes a toll on the operator.
This robotic remote control PCI system not only helps patients avail services of their preferred doctors over large distances, but also helps physicians operate in an X-ray free and relaxed environment with lesser chances of spinal risk thereby increasing the ability of the operator to deal with long procedural hours.
In contrast to the present angioplasty process that requires two cardiologists, the robotic remote control procedure can be conducted without need of assistants making the process more efficient and reproducible and reducing chances of operator-based error.
In this system motors and motion sensors are used to manipulate angioplasty wires, stents and balloons via a joystick and a computer touch screen, leading to enhanced precision of balloon and stent-positioning (which may be an extremely important feature in DES therapy). Semi-automatic procedures can also be robotically controlled by the system by obtaining continuous image base feedback data. On-line communication with the patient is obviously of value in generating trust and confidence of the lightly sedated patient and the medical team. The robotic remote-control system allows for doctor-patient interactions with voice and image technology. If for any reason the system malfunctions it can be switched to manual mode in a few seconds.
The current RNS (Remote Navigation System) is the first clinically oriented system for remote manipulation of PCI and allows full navigation of coronary wires and devices in parallel allowing operation in a standardized catheterization laboratory using standard wires and devices that are robotically manipulated and allow for transatlantic communication. This RNS is composed of a bedside unit and a remote manipulation unit. The bedside unit has individual wire and device manipulators capable of precise maneuvering and positioning of the wires and devices.
Hiranandani Hospital, Mumbai is considered as a centre for excellence in international quality healthcare and is well known for Primary Angioplasty in Myocardial Infarction (PAMI). Says Dr. Sujit Chatterjee, CEO of Dr LH Hiranandani Multispeciality Hospital, “We are proud that our hospital waschosen to conduct this pioneering study for the first time in India, and Dr Ganesh Kumar as the principal investigator of the world’s first team to have worked on creating such a system. We are very excited about a future possibility wherein our doctors can conduct angioplasties from our hospital when the patient is in another remote location and cannot be transported in time to our hospital due to any reason, through the help of precision controlled robots….such a process will indeed bring about a revolutionary era in cardiac interventions.”
Says Dr. Ganesh Kumar, “What was science fiction yesterday is fast becoming reality. With the positive results of the revolutionary studies, I am hopeful that the day is not far away when robotic remote control angioplasty will be the preferred procedure in coronary care bringing many far reaching advantages to the public.”
World’s First Robotic Arm for Angioplasty Arrives in India at Dr L H Hiranandani Hospital
By Sudha Hariharan
The world’s first robotic arm for angioplasty arrived in India at the renowned Dr LH Hiranandani Hospital, Powai, Mumbai. With this Dr LH Hiranandani Hospital has become the country’s first and one of the world’s few centres of excellence to carry on research on this exciting international breakthrough. The robotic arm allows remote manipulation of Percutaneous Coronary Interventions (PCI).
For the first time in India, Dr L H Hiranandani Hospital conducted a live demonstration of angioplasty using this robotic arm.
As part of the multicentric clinical evaluation for US FDA approval Interventional Cardiologists Dr.Ganesh Kumar of Dr LH Hiranandani Hospital has been chosen as principal investigator and Dr. Ajay Chaurasia of Dr LH Hiranandani Hospital as co-investigator to conduct this study in India.
Earlier in December 2005, Dr. Ganesh Kumar teamed up with Rafael Beyar (considered the father of stents) and other eminent members including Tal Wenderow, Doron Lindner, and Rona Shofti, in Israel, to develop and test this equipment. The result of this path-breaking study was published in Europe’s EuroIntervention journal in November 2005. The study concluded that remote navigation system for coronary interventions including balloon angioplasty and stenting is feasible. The system was tested initially in a glass coronary model with visual feedback of the device movements through the transparent glass.
Later a normal coronary sheep model (animal model experiments) was employed to test the safety of the system. The third step was a pilot FIM (First in Man) clinical study, conducted on 15 patients with single coronary artery narrowing.
Dr. Ganesh Kumar was part of the first in man pilot study in Romania through which this system was evaluated on fifteen patients with stable angina pectoris and a typical risk of coronary heart disease with 100 percent clinical success and technical results in over 92 percent of cases. This study was a turning point in establishing the potential of such a system and was published in 2006 January in the Journal of American College of Cardiology.
Many advantages over traditional system
Percutaneous coronary intervention (PCI) is a major method of revascularization for coronary artery disease, with over 2 million coronary interventions performed annually. The majority of interventions (70-80%) are coronary dilatations using stents. Recently, drug-eluting stents (DES) have shown sustained advantage compared to bare metal stents, with a marked reduction of restenosis rates.
The catheterization laboratory personnel so far have been operating in an unfriendly environment subject to a continuous X-ray radiation throughout life. This has been unchanged since the beginning of the field of interventional cardiology more than 25 years ago. “Interventionalists’ disc disease” is a well confirmed entity with cardiologists reporting more neck and back pain, more subsequent time lost from work, and a higher incidence of cervical disc herniations, as well as multiple level disc disease owing to the tiresome standing procedure of angioplasty and the heavy weight of the anti -radiation gear that takes a toll on the operator.
This robotic remote control PCI system not only helps patients avail services of their preferred doctors over large distances, but also helps physicians operate in an X-ray free and relaxed environment with lesser chances of spinal risk thereby increasing the ability of the operator to deal with long procedural hours.
In contrast to the present angioplasty process that requires two cardiologists, the robotic remote control procedure can be conducted without need of assistants making the process more efficient and reproducible and reducing chances of operator-based error.
In this system motors and motion sensors are used to manipulate angioplasty wires, stents and balloons via a joystick and a computer touch screen, leading to enhanced precision of balloon and stent-positioning (which may be an extremely important feature in DES therapy). Semi-automatic procedures can also be robotically controlled by the system by obtaining continuous image base feedback data. On-line communication with the patient is obviously of value in generating trust and confidence of the lightly sedated patient and the medical team. The robotic remote-control system allows for doctor-patient interactions with voice and image technology. If for any reason the system malfunctions it can be switched to manual mode in a few seconds.
The current RNS (Remote Navigation System) is the first clinically oriented system for remote manipulation of PCI and allows full navigation of coronary wires and devices in parallel allowing operation in a standardized catheterization laboratory using standard wires and devices that are robotically manipulated and allow for transatlantic communication. This RNS is composed of a bedside unit and a remote manipulation unit. The bedside unit has individual wire and device manipulators capable of precise maneuvering and positioning of the wires and devices.
Hiranandani Hospital, Mumbai is considered as a centre for excellence in international quality healthcare and is well known for Primary Angioplasty in Myocardial Infarction (PAMI). Says Dr. Sujit Chatterjee, CEO of Dr LH Hiranandani Multispeciality Hospital, “We are proud that our hospital waschosen to conduct this pioneering study for the first time in India, and Dr Ganesh Kumar as the principal investigator of the world’s first team to have worked on creating such a system. We are very excited about a future possibility wherein our doctors can conduct angioplasties from our hospital when the patient is in another remote location and cannot be transported in time to our hospital due to any reason, through the help of precision controlled robots….such a process will indeed bring about a revolutionary era in cardiac interventions.”
Says Dr. Ganesh Kumar, “What was science fiction yesterday is fast becoming reality. With the positive results of the revolutionary studies, I am hopeful that the day is not far away when robotic remote control angioplasty will be the preferred procedure in coronary care bringing many far reaching advantages to the public.”
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