Tuesday, April 26, 2011

Neurons – Mysteries of the Mind!


Brain cells of a human body, or Neurons, are extremely complex cells that send and receive electro-chemical signals in the body. Managing diseases in these cells have been and is still a very challenging task. Neurological diseases are a multifaceted problem, hence requires a multifocal approach to deal with them.  

The most common form of disorder to brain cells is when a bunch of abnormal brain cells sparkles to produce Epilepsy, which is also known as fits. In spite of advanced CT, MRI and PET scans, it is difficult to locate the abnormal areas that are responsible for fits. This limitation is now eliminated with the use of Continuous VIDEO ASSISTED EEG MONITORING- a technique in which a patient is continuously studied in a dedicated laboratory for two to three days. The abnormal electrical brain waves that are recorded in this way helps in locating the diseased area of the brain.

Another form of disorder to the neurons is Brain stroke or Brain attack, which causes paralysis of limbs and is equivalent to Heart attacks in the aspect of fatality and extent of damage to the body.

Aneurysms or abnormal dilatation of brain vessels is another fatal condition, which can be treated with coils and balloons using the same interventional techniques.

Global Hospitals & Healthcity, Chennai, has such a multifocal state of the art, comprehensive neuro care center – The Institute of Neurosciences and Spinal disorders. The center comprises of 3 highly qualified and experienced doctors – Dr. J. K. B. C. Parthiban (HOD – Neuro Surgery & Spine unit), Dr. S. Dinesh Nayak(Senior consultant – Neurologist & Epileptologist) and Dr.  Selvapandian (Senior Consultant – Neuro Surgery & Interventional Neuro Radiology). These three specialists work as a team to give a new lease of life to the patients in need, suffering from illnesses that range from Severe Brain Injury to Acute Stroke, Epilepsy and Brain cancers.

Global Hospital & Health city is the only centre in south India to have the facility of Video Assisted EEG Monitoring available continuously for 72 hrs. In case of epilepsy, this form of monitoring can detect the abnormality in the brain easily and at an early stage.  “Since 95% of fits can be effectively managed by medications, the remaining 5% (Refractable Epilepsy) of patients can be benefited by excising those abnormal areas using high profile delicate micro surgeries i.e., Epilepsy Surgery”, says Dr. Dinesh Nayak. At Global Hospitals, a team of Neurophyscians and Neurosurgeons execute the treatment process for epilepsy with great competency and high success rates.

In case of paralysis of the brain, Global Neurosciences centre is the only centre of its kind to have a team of Interventional Neurosurgeons and Neuroradilogists working together in the same CATH LAB.  “If treated during the golden hours i.e., – within one hour after the attack, brain paralysis can be reversible. Blood Clots that obstruct the vessels can be dissolved by using Pin Hole Techniques i.e., Interventional Neurovascular procedures”, says Dr. Selvapandian.

In the recent times, a Nigerian girl’s broken neck bones were surgically removed and the crushed spinal cord was decompressed (freed), which facilitated recovery of limb functions and reduction in the stiffness. This paved way for the overall improvement in her mobility. Dr. J. K. B. C. Parthiban, the HOD of the department highlights the value of delayed decompression of the crushed spinal cord and claims that this was the most challenging spinal surgery of all. Ever since the successful spine surgery of the Nigerian girl, Global Hsopital’s Spinal Department has attracted the attention of many people from different parts of the globe suffering from Spine illness.

The Institute of Neurosciences and Spinal disorders of Global Hospitals & Healthcity provides complete and comprehensive neuro-care under one roof and is managed by very efficient doctors who are specialists in each subdivision. A one-of-its-kind Acute Stroke, Head and Spine Injury Care Unit has also been established to cater to all Neuro emergencies round the clock.

In a critical scenario, where neurological disorders invade the human body at a lightning pace, there is a need for centres of excellence to challenge its fatality and Global Hospitals & Healthcity presents just the right mix of technology and expertise to handle these cases.

Monday, April 18, 2011

All About Osteoporosis

Osteoporosis                   
Osteoporosis or “porous bone” - a common metabolic bone disorder affecting 200 million people worldwide –is a slow progressing and silent disease that becomes symptomatic with a fracture.  Osteoporosis affects both men and women, usually as they grow older. Adequate steps taken can reduce the risk of developing osteoporosis and avoid the debilitating bone fracture, which occurs because of the disease.
About Osteoporosis             
Osteoporosis is a metabolic bone disorder characterised by low bone density and deterioration of bone micro architecture that reduces bone strength and increases the risk of fracture especially of the hip, spine and wrist.
Human bone is involved in the process of continuous remodelling, comprising of bone resorption and new bone formation. Osteoporosis is the result of imbalance in bone remodelling. In osteoporosis, there is too much bone loss and too little repair or vice-a-versa, resulting in low bone mass. This causes the bones to become thinner and structurally weaker. This imbalance gets more pronounced with advancing age and hence elderly people are more susceptible to osteoporosis.
Causes/Risk Factors for Osteoporosis
The causes and risk factors for osteoporosis are many. A few of them are listed below:
  • Previous fracture at <50 yrs
  • Parent or sibling with previous fractures
  • Cigarette smoking
  • Senility
  • Malnutrition
  • Low calcium intake
  • Hormonal disturbance
  • Excessive alcohol intake
  • Physical inactivity
  • Excessive intake of certain medications like steroids
Symptoms
Osteoporosis is a disorder with many obvious symptoms. Some of these symptoms are:
  • Pain in the bones
  • Fractures with little or no trauma
  • Loss of height (as much as 6 inches over time)
  • Low back pain due to fracture of bones of the spine (lower)
  • Neck pain (fracture of bones of spine in the neck)
  • Stooped posture
Diagnosis of Osteoporosis
Diagnosis of osteoporosis is basically done with DEXA (Dual energy X-ray (absorptiometry), which is a simple test that measures the bone mineral density (BMD) in different parts of the body such as spine and hips. It is a quick and painless test similar to having an X-ray taken bit uses much less radiation. The results of the DEXA test are scored in comparison to the BMD of young healthy individuals resulting in a measurement called T score. Bone density is considered normal if the T score is between 1.0 and -1.0
 The World Health Organisation (WHO) has defined bone disease based on BMD T scores:
  • Osteopenia (low bone mass): Tscore between -1 and -2.5
  • Osteoporosis: T score greater than or equal to -2.5
  • Established osteoporosis: T score less than -2.5 and the presence of fracture
Treatment for Osteoporosis
Treatment of osteoporosis is a two-step process, which are:
 Goals of Treatment:
A part of the treatment includes setting up the goals, which include:
  • Maintain bone mass and integrity
  • Slow down the bone loss
  • Treat the symptomatic problems and its sequel
Maintain Bone Health:
The next part is to maintain the deteriorating bone density:
  • Life style adjustments
  • Minimise use of alcohol
  • Stop smoking
  • Reduce the intake of coffee
  • Avoid carbonated beverages
  • Supplemental calcium and vitamin D
  • Enough calcium in the diet (1000mg per day of calcium for adults under the age of 50 and 1200mg  per day of calcium for those 50 and older)
  • Taking adequate vitamin D, which is important for calcium absorption and for maintaining muscle strength. The recommended dosage is 400-800IU per day for adults lesser than 50 and 800- 1000IU for those age 50 and older)
  • Physical exercise programmes tailored to the needs of the individual patient. This includes balance training, postural training, resistance training, stretching and weight bearing aerobic exercise. In patients with severe osteoporosis, activities that require vigorous flexing or rotation of the spine should be avoided.
Medications
Medications used in the prevention and treatment of osteoporosis are those which either reduce the bone loss (antiresorptive) or increase the bone growth (anabolic). These include:
  • Bisphosphonates (alendronate, risedronate, ibandronate and zolendronic acid): These have been approved for the prevention and treatment of postmenopausal osteoporosis in women and osteoporosis in men.
  • Calcitonin: This medication is given usually as a nasal spray or as an injection under the skin. This is helpful in controlling the pain after an osteoporotic vertebral fracture.
  • Estrogen or Hormone Replacement Therapy: This medication reduces the risk of osteoporosis and osteoporotic fracture. This increases the risk for breast cancer, stroke, and heart attack.
  • Selective Oestrogen Receptor Modulators (SERMs): This medication mimics the good effects of oestrogen in bone without the serious side effects (breast cancer).
  • Teripartide (forteo): This medication is a form of parathyroid hormone that helps to stimulate the bone formation.
Few Points to Remember…
  • In Osteoporosis, the bones are weak and break easily, resulting in severe limitation of activities and bring down the quality of life as well increase the risk of death, especially after 65 years.
  • Osteoporosis occurs in both sexes but is more common in women.
  • Osteoporosis may not be outwardly apparent until a fracture occurs. It can be detected before the first fracture, if the risk factors are identified and BMD test are done in time.
  • It is never too early to adopt preventive measures or too late to begin treatment to prevent further fracture.
  • Leading a healthy lifestyle, having a balanced & regular check up with your Physician or Rheumatologist are the key points to prevent Osteoporosis
  • The more you know about the prevention and treatment of osteoporosis the better are your chances of staying active and independent. 

Dr. R. Kirthi
MD DM (Rheumatology)
Consultant Rheumatologist
Global Hospitals & Health City

Thursday, April 14, 2011

OBESITY – AN EPIDEMIC



In the fast-growing consumer society today, things are getting easier for even school kids to obtain. A fast-food store like McDonald’s is right next to schools advertising a “Happy Meal.” Soda vending machines are available in schools. Fast foods and sodas is neither restricted nor banned products and increasing number of parents buy these foods to appease their children and save time without imagining the harmful effects of these foods. The result is that 30.5 percent of adults are considered obese and obesity is killing more people than smoking. These shocking statements are not imaginary but these are facts of the world, in which we live.
The Obesity has reached epidemic proportions globally, with more than 1 billion adults overweight - at least 300 million of them clinically obese - and is a major contributor to the global burden of chronic disease and disability. Often coexisting in developing countries with under-nutrition, obesity is a complex condition, with serious social and psychological dimensions, affecting virtually all ages and socioeconomic groups.

Obesity has become an epidemic across the world and if steps are not taken immediately – both at individual levels as well as at national levels – obesity can become a calamity.

HOW DOES OBESITY SET IN
To understand obesity, it is essential to understand how it all beings. It begins with the wrong TAP – Type of food, Amount of food & Pattern of food consumed. The result is that the amount of calories consumed is not expended. An average adult requires about 2000 calories per day, approximately. If the amount of intake exceeds 2,000 calories for a long time without exercise and proper workouts, the person tends to become obese. In most cases, people do not realize they are obese. They just tend to think they have put on extra weight. People do not need to go to a doctor to find if they are obese, they just have to follow a simple calculation to detect obesity:
BMI = Weight (kg) / Height x Height (m2)                
                                                            
Normal = BMI < 23
Over weight = BMI 23 – 25
ObeseBMI > 25

Calculate your BMI on a regular basis to check if you are getting obese. Also, keep a note of your calorie intake. So, next time you pick up a pack of chips or aerated drink or chocolate, glance through the nutritional facts and calories!

TREATMENT


                                          
OBESITY TREATMENT PYRAMID
Obesity is an irreversible disease. Proper diet and physical activities are any day preferred to any other forms of treatment. Medicines are of limited value in the treatment of Obesity. Only, Morbid Obesity (BMI > 40) usually requires surgery as other forms of weight management fail to provide satisfactory and sustained weight loss. Morbid obesity affects the normal mechanical, metabolic, and physiological bodily function. These "co-morbidities" affect nearly every organ in the body in some way, and produce serious secondary illnesses, which may also be life threatening. The cumulative effect of these co-morbidities can interfere with a normal and productive life and can seriously shorten life, as well. For morbid obesity, as mentioned above, there is remedy – Bariatric Surgery.


Bariatric surgery, or weight loss surgery, is a type of procedure performed on people who are morbidly obese so that they can lose weight. The surgical procedure is of three types:
·         Reducing the size of the stomach that stores ingested food with an implanted device (gastric banding) or
·         Removing of a portion of the stomach (sleeve gastrectomy)
·         Re-routing the small intestines to a small stomach pouch (gastric bypass surgery)

OBESITY IN INDIA
Obesity has reached epidemic proportions even in India in the 21st century, with morbid obesity affecting 5% of the country's population. India is following a trend of other developing countries that are steadily becoming more obese. Processed food has become much more accessible following India's continued integration in global food markets. Indians are genetically susceptible to weight accumulation especially around the waist. A shocking study presents the following ratings of obese Indians:

States
Males (%)
Males rank
Females (%)
Females rank
30.3
1
37.5
1
24.3
2
34
2
20.8
3
27
3
19.8
4
24.4
4
17.6
5
22.7
10
17.6
5
22.7
10
17.3
6
21
8
16.9
7
20.3
17
16
8
19.5
12
15.9
9
18.1
13
15.4
10
17.7
7

India being the DIABETES CAPITAL with about 50 million estimated diabetics, obesity only worsens the situation, as it is a major contributor to diabetes.

In such a situation, where can you seek help for this epidemic? Some say the government should take charge of the situation like in the cases of seatbelt and smoking laws. Others say that it is the responsibility of the private sector. Actually, it has to be a joint effort. The government should have some control over what people are consuming and should regulate fast food. Fast food joints and soda makers should be more socially conscious than just a moneymaking body. People should also be more aware, keep control of their diet, and get proper exercise.

Freedom is a birth right….so is health! Why not claim it!


Presented by Global Hospitals & Healthcity
Dr. NS. Balaji
Sr. Consultant – Minimal Access & Bariatric Surgery
Global Hospitals & Health City





Monday, April 11, 2011

Cosmetic Surgery at Global Hospitals India


Flaws in appearances are common and no body is perfect, but if imperfections in appearance is making you unhappy and destroying your self-esteem, then its time you consider cosmetic surgery.

Cosmetic Surgery or Aesthetic Plastic Surgery - a branch of Plastic Surgery - deals with correcting minor as well as major flaws in appearances. Plastic surgeons work towards brining about aesthetic and acceptable changes in body shapes with the help of a wide range of surgical techniques and procedures that have developed over the years. The idea is to bring about a change that makes the patient feel confident about their body. Plastic surgeons also ensure that these surgical changes will not cause any major side effects for the patients. It is the perfect way to remove low self-esteem creating flaws.

Cosmetic surgery and procedures are techniques that change, restore, or enhance your appearance. They range from reconstruction after surgery or injuries, to enhancements to features: for e.g., face-lifts, breast augmentation or reduction, and certain skin treatments. In this issue we would discuss two particular procedure ie. Face rejuvenation, rhinoplasty and breast augmentation.

Facial Rejuvenation Surgery
Ageing process is inevitable. Skin, eventually, loses its elasticity and muscles tend to slacken, leading to wrinkling of the face, drooping of eyebrows and lips, sagging of eyelids, jaw line and neck skin. Virtually all aspects of the human face can be enhanced with various cosmetic procedures. Facial rejuvenation surgery can remove wrinkles, refine features, tone sagging skin, and even change the contour of the face. The most commonly performed operations of facial rejuvenation are face lifting, skin peeling, dermabrasion, injections of botox or fillers, blepharoplasty (eyelid surgery), and eyebrow lifting. One or more of these operations can be combined as per each individual’s problem to achieve the best results.

Rhinoplasty
It is the most common form of cosmetic surgery because people feel most self-conscious about the structure of their nose. Rhinoplasty or Nose Reshaping is a common cosmetic surgery procedure to reshape the nose to improve the facial appearance. A broad nose, nose with hump, depressed nose, deformed nose etc can be corrected to suit the facial profile. The scars in these operations are not visible. If you have some difficulty in breathing through your nose, it may be possible to improve this at the same time.

Breast Augmentation
Genetic inheritance pre-determines breast growth, which is also influenced by hormones released by the body. Breast size, shape, and proportion greatly influence the confidence levels in a woman. A well-proportioned body helps women to move confidence. However, small breast size can greatly affect a girl’s confidence and self esteem levels.
There are innumerable ways prescribed in various sources to increase breast size, but these are practically useless. Exercise merely causes the pectoral muscles to grow. It has no influence on the size of breasts, nor does massaging the breasts with various creams etc. The only way to create a permanent increase in the size of the breasts safely is by an operation called Augmentation mammaplasty.
Breast augmentation is done using silicon or saline breast implants for patients with small breasts. Implants are available in a wide range of sizes and a variety of shapes so that the appropriate implant for the individual patient can be obtained. The scars are hidden in the armpit, fold of the breast or edge of the nipple, where they remain covered under a brassiere. There is no harm done if you want to have a pregnancy afterward and you would be able to breast-feed your baby if you wished. 
Droopiness or sagging breasts are a common legacy of motherhood. It is possible to reshape the breast to look more youthful and feel more firm by an operation called Mastopexy. This can be combined with either increase or decrease of the size of the breasts as per the individual’s expectations.
Having large breast is a boon for women, but if large breast occur in men, then it becomes an issue. Cosmetic surgery also helps these men reduce their breast size. Prominent breast in males is called gynecomastia. Cosmetic surgery goes a big way in restoring confidence in them. The treatment is tailored to the patients with the problem. Removal of breast tissue and contouring with liposuction gives excellent results.

A perfect body is a great confidence booster and with the gen-next, clamoring to be the best at all times a little medical help can do wonders. Plastic surgery has become a part of our society and it does not look like it is going anywhere. In previous generations, plastic surgery was considered the domain of the rich and famous. Today, it is available for everybody who considers improving their appearance, including those who need it to change any deformity or surgical scars. At Global Healthcity, options are available for everybody and strives to bring joy and happiness to others’ lives through high quality, safe and affordable cosmetic procedures.

Dr.V B Narayanamoorthy
Sr. Consultant
Dept of Reconstructive & Cosmetic Surgery
Global Hospitals & Health City

DIABETES MELLITUS - FOOT CARE – You can take care.

Foot problems and the dangerous consequences of it in diabetic subjects:

In diabetic subjects, loss of the foot and sometimes the loss of life are very well known. However what is not known is that, foot is the only organ in diabetes where effective prevention can be undertaken. Prevention of the complications of the foot can be done using simple techniques which will be detailed here. Unlike the brain, the heart, the kidney and the inside of the eye, feet is visible to us and so the status of the foot can be seen at least on a daily basis. What is also not known is the fact that once the complications of the foot set in, one ends up being admitted to the hospital more often than the complications of the other organs. Infections of the foot occur frequently requiring frequent hospitalization and the use of expensive drugs to control the infection. Thus neglected feet prove to be most expensive. The reality that one cannot walk and therefore become dependent on others for even for the simple basic things in life is the worst scenario an unfortunate person wakes up to suddenly.

The brightest side of things is that all this can be prevented by following some simple rules.

It's all about taking good care of your feet. Theses are some of the steps we can adopt.


1.      Take care of your Diabetes

Work with your doctor to make a diabetes plan that fits you.  This will help you to:

Know how and when to test your blood sugar.
Take prescribed medicines.
Eat regular meals that contain a variety of healthy, low-fat, high-fibre foods including fruits and vegetables each day.
Increase your physical activity each day.


2.      Check your feet everyday
You may have serious foot problems, but feel no pain. Check your feet for cuts, sores, red spots, swelling, and infected toenails. Find a time (evening is best) to check your feet each day. Make checking your feet part of your every day routine.
If you have trouble bending over to see your feet, use a plastic mirror to help. You also can ask a family member to help you.

Make sure to call your doctor right away if a cut, sore, blister, or bruise on your foot does not begin to heal after one day


3.      Wash your feet every day

Wash your feet in warm, not hot, water. Do not soak your feet, because your skin will get dry.
           
Dry your feet well. Be sure to dry between your toes. Use talcum powder to keep the skin between your toes dry.


4.      Keep the skin soft and smooth

Rub a thin coat of skin lotion, cream, or petroleum jelly on the tops and bottoms of your feet. Do not put lotion or cream between your toes, because this might cause an infection.


5.      Smooth corns and calluses gently   

After bathing or showering, use a pumice stone to smooth corns and calluses. A pumice stone is a type of rock used to smooth the skin. Rub gently, only in one direction, to avoid tearing the skin.
           
Do not cut corns and calluses. Don't use razor blades, corn plasters, or liquid corn and callus removers -- they can damage your skin.
     
If you have corns and calluses, check with your doctor.


6.      Trim your toenails each week or when needed

Trim your toenails with clippers after you wash and dry your feet.
Trim toenails straight across and smooth them with an emery board or nail file.
Don't cut into the corners of the toenail.
If you can't see well, or if your toenails are thick, have a doctor trim them.

7.      Protect your foot at all times

Do not walk barefoot -- not even indoors -- because it is easy to step on something and hurt your feet.

Always wear footwear with soft insoles and firm outer soles to help avoid blisters and sores.

Choose socks made of cotton. They help keep your feet dry.

Check the insides of your footwear before you put them on to be sure the lining is smooth and that there are no objects in them.

Wear footwear that fit well and protect your feet.


8.      Protect your feet from hot and cold
     
Wear your footwear at the beach or on hot pavement.

Put sun screen on the top of your feet to prevent sunburn.

Keep your feet away from radiators and open fires.

Do not put hot water bottles or heating pads on your feet.

Wear socks at night if your feet get cold.

Check your feet often in cold weather to avoid frostbite.


9.      Keep the blood flowing to your feet

Put your feet up when you are sitting.

Wiggle your toes for 5 minutes, 2 or 3 times a day. Move your ankles up and down and in and out to improve blood flow in your feet and legs.

Don't cross your legs for long periods of time.

Don't wear tight socks, elastic or rubber bands, or garters around your legs.

Don't smoke. Smoking reduces blood flow to your feet. Ask your doctor or nurse to help you stop smoking.


10.  Be more active
     
Walking, swimming, and bicycling are good forms of exercise that are easy on the feet.
     
Avoid activities that are hard on the feet, such as running and jumping.
     
Always include a short warm-up and cool-down period.
     
Wear athletic shoes that fit well and that provide good support.


Apart from the above 10 important steps: Always ask your doctor to do the following:

·         Check the sense of feeling and pulses in your feet, ask him how often should it be checked

·         Tell you if you are likely to have serious foot problems. If you have serious foot problems, your feet should be checked at every visit to your doctor.

·         Show you how to care for your feet.

·         Refer you to a specialist, if needed.



MOST IMPORTANT ASK YOUR DOCTOR WHEN YOU SHOULD NOT WALK, WHEN SHOULD WEAR SPECIAL FOOTWEAR. WHEN SHOULD YOU STOP WALKING AS AN EXERCISE AND USE NON WALKING EXCERSISES? YOU MAY HAVE TO AVOID WALKING IF YOU HAVE A CONDITION CALLED CHARCOTS FOOT.

Remember an unprotected, ignorant or neglected foot walks to its grave.