Monday, December 30, 2013

Super-speciality block nearing completion - The Hindu

Super-speciality block nearing completion - The Hindu
Parasitic twin operated on in Trichy hospital
Dec 31, 2013, 01.18AM IST TNN?
TRICHY: The doctors at Mahatma Gandhi Memorial Government Hospital (MGMGH) here performed a complicated surgery on a parasitic twin for the first time in the history of the hospital. The male baby, which was born with extra organs, has now been put on ventilator as its condition was unstable.
"A team of five doctors including paediatric surgeons and anaesthetists performed the surgery on the five-day-old male parasitic twin born with parasitic phagus from 10am to 1.30pm on Monday. We successfully removed the additional legs, arms, penis and urinal bladder conjoined with the normal baby. The anaesthetists also played a major role in the operation," said paediatric surgeon Dr Baskaran, head of paediatric surgery department at the MGMGH, on Monday.
The case is considered to be rarest of the rare because the baby's intestines and spleen are still outside the body. The doctors have left the two organs outside after surgery because they cannot be pushed into the abdominal cavity. "The intestines and spleen cannot be inserted into the abdominal cavity as it will lead to major complications. So, we have adopted SILO technique by which the two organs will be covered by a bag to nudge the intestine into the abdominal cavity. As it will take three to four days, the baby is put on ventilator," said Dr Baskaran who had already said that the success rate is very low.
The baby is the fifth one born to Vijaya and Mamundy, both labourers, from Poigaipatti near Manapparai. The baby, which was born in a private hospital at Manapparai, was referred to the MGMGH on December 25. Since then the MGMGH doctors conducted numerous tests before deciding on operating the baby.
The MGMGH doctors have not estimated the surgery cost. "Normally, private hospitals don't take up this task. But it will cost about Rs 5 lakh for this operation," said Dr Baskaran.
Neurologist Dr MA Aleem, vice-principal of KAPV Government Medical College, said Vijaya did not take abdominal ultrasound test while carrying the baby. "It is a must for all pregnant women to undergo this test. The congenital deficiency could have been diagnosed and the fetus aborted to avoid such complicated births," said Dr Aleem.

Friday, December 27, 2013

Anxiety Increases Stroke Risk

High anxiety levels were associated with an increased risk for incident stroke independent of other risk factors, including depression.

"Anxiety is a modifiable experience that is highly prevalent among the general population. Its assessment and treatment may contribute to developing more effective preventive and intervention strategies for improving overall cardiovascular health.

"Everyone has some anxiety now and then. But when it's elevated and/or chronic, it may have an effect on your vasculature years down the road.

More anxiety symptoms at baseline was associated with an increased risk for incident stroke after adjustment for standard biological and behavioral cardiovascular risk factors.


Chronic anxiety could lead to excess activation of the hypothalamic-pituitary-adrenal axis and sympathetic nervous system that may increase the risk for stroke.

Anxiety could also contribute to stroke or other cardiovascular disease by lowering the threshold for arrhythmia or by reducing heart rate variability

Wednesday, December 25, 2013

8 Limbed baby to be operated in Trichy

8 Limbed Baby to be Operated in Tiruchy

By Express News Service - TIRUCHY

Published: 26th December 2013 08:00 AM

Last Updated: 26th December 2013 08:02 AM

Dr M A Aleem and Dr D Baskaran checking the baby at MGMGH in Tiruchy on Wednesday | M K ASHOK KUMAR

In what is being seen as a major medical challenge, a baby who was born with eight limbs at a Manapparai private hospital two days ago has been admitted to Mahatma Gandhi Memorial Government Hospital (MGMGH) for treatment.

The medical officials were quick to form a team to perform a surgery next Monday. The medicos say that the case is rarest of rare and they are proceeding medical investigation to remove the extra limbs of the baby, who is sick to some extent.

According to officials, the woman, wife of Mamundi of Manapparai had developed labour pain on December 23 and was admitted in a private hospital in Manapparai. During the delivery, she gave birth to a baby boy with octo-limbs and the medical officials referred the case to the Tiruchy MGMGH.

D Baskaran, Pediatrician, MGMGH, said when a diagnosis was done, they found that the baby was affected by ‘Parasitic Pagus’, in which the baby has asymmetric legs and hands, but looked like one limb. “We will perform the surgery to remove the limbs,” he said, adding that the baby should be fine post operation.

Hospital officials said that this is the first case the MGMGH has received in its history. Tiruchy KAPV government medical college, vice-principal, Dr M A Aleem told Express, “One in a million would get this kind of case and it is also new to the MGMGH. A team has been formed to perform the surgery”.

The surgery would be performed under the Chief Minister’s Comprehensive Health Insurance Scheme (CCHIS), he added.

Conjoined twins to undergo surgery - The Hindu

Conjoined twins to undergo surgery - The Hindu

Parasitic twins

Trichy doctors to operate on parasitic twins

Dec 26, 2013, 01.40AM IST TNN[ R Gokul ]

TRICHY: Two-day old parasitic twins have been admitted to the Mahatma Gandhi Memorial Government Hospital (MGMGH) here on Wednesday. The doctors will conduct a risky surgery on them to remove their extra limbs on December 30. A surgery of this type will be the first in the history of MGMGH.

"It will be one of the rarest of rare surgeries. Their extra two legs and two arms are conjoined with chest. So, it will be a complicated surgery," said Dr D Baskaran, head of paediatric surgery department at the MGMGH.

The conjoined twins, which have the medical condition called 'parasitic pagus', were born to a poor couple Mamundy and Vijaya who are residents on the outskirts of Manapparai. This is their fifth baby.

Vijaya gave birth to the twins at a private hospital in Manapparai on Tuesday. Considering the complication, the babies were referred to the MGMGH on Wednesday. The two arms and two legs of the infants are conjoined with the chest. "We have decided to take up the rarest of the rare surgery on Monday. Such cases will happen in one in one-million babies," said Dr MA Aleem, vice-principal of KAP Viswanatham Government Medical College which is part of the MGMGH.

Dr Aleem also said that MGMGH doctors have never performed such a surgery. "We are proud to take up the challenge and our team of doctors will succeed in the task," said Dr Aleem.

The doctors said the MGMGH has all the facilities to conduct the planned surgery which will commence at 8am on Monday. "Many tests have to be conducted before the surgery. The costs cannot be calculated because we will be doing it for the first time. The doctors from our hospitals will only be part of the task because we have all the specialists as far as this surgery is concerned," said Dr Baskaran.

On the success rate of the surgery, Dr Baskaran said "The success rate is very low. Nevertheless, we will try our best to make our attempt successful."

"Medical conditions like 'parasitic pagus' is very uncommon anywhere in the world," said Dr Baskaran.

Saturday, December 21, 2013

Fast food and Kids

Children find themselves amidst a complex society that is undergoing breathtaking changes. Concepts, relationships, lifestyles are metamorphisised to accommodate the new jet-setting age. Food is no exception. Healthy nutritious foods have been replaced by the new food mantra - JUNK FOOD! Junk food comprises of anything that is quick, tasty, convenient and fashionable. It seems to have engulfed every age; every race and the newest entrants are children. Wafers, colas, pizzas and burgers are suddenly the most important thing. The commonest scenario is a child who returns from school and plonks himself in front of the television, faithfully accompanied by a bowl of wafers and a can of cola. Children suddenly seem to have stepped into a world of fast foods and vending machines, totally unaware of the havoc they are creating for themselves. 
The years between 6-12 are a time of steady growth; good nutrition is a high priority. Children must know that what they eat affects how they grow, feel and behave. Changes in our society have intensified the need for food skills, to the extent that they need to become a part of the child's basic education for good health and survival. The vast majority of working mothers with school age children are laboured with exhausting commutes, upswings in the households, and stress, leading to a situation where parents get to spend limited time with their children. Traditional food skills are not passed on automatically from parent to child. Most people have forgotten that the primary reason for eating is nourishment. In the not so distant past, food was treated with reverence because of its life sustaining quality. Enjoying a meal was sharing experience with the others. Today family dinners are rare. In many ways, our culture is structured to foster poor eating habits. Television commercials and supermarkets are propagating a wide variety of enticing junk foods, attractively packaged and often tagged with a tempting sop. We should be constructing an environment that protects our children. Instead we have a highly seductive environment that undermines eating habits. 
For children who have less vision of the heart disease, cancer, high blood pressure or diabetes that might befall them decades later, the tentacles of a junk food environment are virtually inescapable.  Studies reveal that as early as the age of 30, arteries could beginning clogging and lay the groundwork for future heart attacks. What children eat from puberty affects their risks of prostate and breast cancer.  Osteoporosis and hypertension are other diseases that appear to have their earliest roots in childhood when lifelong eating habits are being formed. Children are especially vulnerable. Poor diets can slow growth, decay new teeth, promote obesity and sow the seeds of infirmity and debilitating disease that ultimately lead to incurable disease and death or worse make life insufferable. 
Most of the times these junk foods contain colors that are laced with colors, those are often inedible, carcinogenic and harmful to the body. These foods and their colors can affect digestive systems, the effects of it emerging after many years. Studies have found that food coloring can cause hyperactivity and lapses of concentration in children. Children suffering from Learning Disabilities are often advised against eating food with artificial coloring. Chocolates, colas, flavored drinks and snack tit bits are full of artificial coloring. 
Not surprisingly, junk food not only has physiological repercussions, but also psychological ones - far reaching ones that affect the child's intellect and personalities. Coping intelligently with their dietary needs increases their self-esteem, and encourages further discovery. School days are full of educational challenges that require long attention spans and stamina. Poor nutritional habits can undermine these pre-requisites of learning, as well as sap the strength that children need for making friends, interacting with family, participating in sports and games or simply feeling god about themselves. 
Junk foods are often eaten in instead of regular food, an essential Indian diet that consists of wholesome chapatis and vegetables or snacks like upmas and idlis. Not surprisingly eating junk food leads to a sense of starvation both physically and mentally, as the feeling of satiation and contentment that comes after a wholesome meal is absent. There is simply no substitute for the feeling that descends, when you wake up and find that you are ready to take on the world and this primarily stems from GOOD HEALTH! There is no better time than now to build a supportive environment for nurturing our children and endowing them with a legacy of good health.

Health effect of Fast Food in Indian children

Forty per cent of Indian parents admitted that they often give into their children's demands for junk food, according to a recent survey .But the next time you're thinking about buying dinner on the go, bear in mind the impact it will have on your kids before the day is over.

Fast food will encourage your child to eat more

The fats, sugar and salt in fast food draw kids like a magnet, largely because they appeal to a child's "primordial tastes". "From an evolutionary point of view, humans are hard-wired to crave high-calorie food as a survival mechanism, so each time we see, smell or eat junk food, many chemicals and neurotransmitters are released in our body$

"When your child bites into a burger, his brain reward system gets activated since dopamine, which is the main neurotransmitter responsible for pleasure and excitement, gets secreted. And then he will feel a complete lack of control and an intense demand from his brain for more.

If that isn't enough to convince you to ditch the takeaway, a study published in the Archives of Pediatrics & Adolescent Medicine (a medical journal published by the American Medical Association) found that once children have eaten fast food, they consume more calories and fewer nutrients for the rest of the day. On days when kids ate fast food, compared with days when they ate at home, adolescents and young children consumed an additional 309 and 126 calories, respectively.

Fast food will damage arteries immediately

Experts have known for years that long-term consumption of junk food clogs arteries, but recently they've recognised that this damage begins the same day. A study published in the Canadian Journal of Cardiology indicates that damage to the arteries occurs almost immediately after just one - that's right, one - junk food meal.

Fast food will cause school work to suffer

Diet has a significant effect on children's study habits. Junk food and foods with high-sugar content deplete energy levels and the ability to concentrate for extended periods of time. "If a kid is having sweets, chocolate croissants or sweetened beverages during the first break time at school instead of his fruit portion or his sandwich, he would definitely feel hungry within an hour and that would disrupt his concentration in class, and could affect his overall performance in school.

children who ate fast food four to six times within a given week tested significantly lower in maths and reading compared with children who did not.

Fast food will make your kid depressed

Eating foods rich in antioxidants, such as fruits and vegetables, and healthy fats, such as cold-water fish and nuts, leads to positive energy and moods - both of which derive from positive brain function. A diet high in fast food lacks these nutritional benefits, increasing the risk of depression.

Fast food will put your child off healthy food

The artificial taste of junk food is thought to be addictive and children used to spicy junk food may have trouble adjusting their palates to relatively blander healthy foods.

"Another problem is that junk food tends to replace other, more nutritious, foods. "When children are snacking on chips and cookies, they're usually not having enough fruits and vegetables, which will decrease their vitamin C and fibre intakes."

Fast food will cause constipation

Fast food typically lacks fibre. The less fibre children consume, the more likely they are to develop constipation, which can cause abdominal pain and discomfort. Will they know about it by the end of the day? Probably.

Fast food will make them irritable

"The high content of sugar in junk food causes fluctuations in children's blood glucose levels. "This makes them edgy, sleepy and irritable throughout the day and leaves them with no motivation to be active."

Fast food will ruin bedtime

Having sugary drinks or fruit juice with dinner even twice a week can affect children's sleep and wake-up cycle. The caffeine from sodas acts as a stimulant, keeping them awake longer and negatively affects their metabolism. "Studies have shown that moderate to high caffeine consumers [100 to 300mg of caffeine] have more disturbed and more interrupted sleep than low- or no-caffeine consumers.

Monday, December 16, 2013

Achievers Award 2013 to Dr.M.A.Aleem

Achievers award 2013 was given by st. Joseph college alumni Trichy to Dr.M.A.Aleem vice principal HOD and professor of neurology kapv Govt medical college. and MGM Govt hospital Trichy for his dedicated recognised service in the field of medicine-neurology by hon 'ble justice S. Rajaswaran judge Madras High Court on 14.12.2013 in the presence of st Joseph college Rector Rev Dr.S. John Britto SJ.

Friday, December 6, 2013

stem cell therapy under CM health insurence scheme

Though the state government has taken an initiative to promote cord blood banks to cell therapy affordable to the poor, awareness on the promising treatment method is low in tier-2 cities like Trichy, as was revealed during a seminar held here on Friday. Moreover, crucial facilities required to encourage the treatment is lacking.

Stem cell therapy is used in the treatment of several genetic diseases, cancers, and blood disorders. Blood harvested from umbilical cord is stored for retrieval for future use. Stem cells (undifferentiated biological cells) taken from the blood are injected into damaged tissue to treat disease or injury.

"Knowledge about the advantages of stem cell therapy is low in our city. At the same time, we have treated many patients, including six-year-old to 94-year-old, through stem cell therapy in a span of eight years," said Dr P Ramachandran, plastic surgeon at Maruthi Hospital in the city, while addressing the students of KAP Viswanatham Government Medical College.

As storing cord blood in private hospitals is not financially feasible to many, Mahatma Gandhi Memorial Government Hospital (MGMGH) has plans to set up a facility. Already, some private hospitals in the city are trying to persuade parents of new-born babies to store umbilical cord blood, though no such facility exists in Trichy unlike Chennai and Bangalore. In May 2013, the state government had announced Rs 9 crore grant to the cord bank of a private company in Chennai. As per the initiative the poor can store cord blood free of cost under the chief minister's comprehensive health insurance scheme. Unfortunately, many are not aware of the facility

However, oncologist Dr Arun Seshachalam, a member of the Indian Medical Association (IMA), is of the view that it will take a while before stem cell therapy picks up in the state. "A lot of research is on to make it useful for treating many complicated disease. Currently, stem cell therapy has proved to be a definite treatment for blood cancer and thalassemia. At the same time, the cost of treatment is very high," said Dr Seshachalam.

Interestingly, several doctors and medicine students are yet to regard the emerging field seriously and start learning about the therapy. "We organise workshops to make our students keep abreast of latest developments in stem cell therapy. If the facility is available in government hospital, many poor will be benefited," said Dr D Saminathan, head of department of paediatrics, MGMGH.

Commenting on the necessity of providing stem cell therapy at MGMGH, Dr MA Aleem, vice-principal of KAP Viswanatham government medical college, said a facility for it could be set up at the super-speciality block which is under construction on the MGMGH campus.

Thursday, December 5, 2013

Mission with Vision for a Healthy Tamilnadu

Mission to with vision to Create a Healthy Tamil Nadu

“When it comes to providing healthcare services to the citizens, Tamil Nadu is the first best performing state among the larger states in India says our chief minister J. Jayalalitha.
The aim of various health scheme in Tamil Nadu is to provide universal access to equitable, affordable and quality healthcare services. We seek to promote policies that strengthen public health management and service delivery effectively and handle the increased allocations as prescribed under the NRHM Guidelines. Efforts are being made to further strengthen the entire healthcare sector in the state by adding and operationalising new urban and rural PHCs (Primary Healthcare Centres) as per the needs. With NRHM providing support for strengthening secondary and tertiary care centres under certain categories, we expect to have a robust healthcare system with strong HR, infrastructure and equipments to meet any exigencies at all levels. In order to improve the quality of rural healthcare and in accordance with the standards of IPHS, all the PHCs are manned by two Medical Officers so that the quality of care is not different for the vast majority of rural population. New PHCs are established every year and we are also in the process of upgrading one PHC in each block into an Upgraded PHC with 30 beds and better infrastructure. One upgraded PHC in each Health Unit District is being developed into a comprehensive MCH Centre which can handle obstetric emergencies including caesarean section. These centres are adequately provided with manpower and equipments. In the entire country, only in Tamil Nadu almost 90 percent of deliveries take place in government institutions. NRHM has strengthened the infrastructure and provided high-end equipments in the Secondary Healthcare Sector, supplementing the inputs by the World Bank funded Tamil Nadu Health System Project. In the Tertiary Healthcare Sector, focus is provided more on very high quality MCH care and every year Two Medical Colleges are strengthened into RCH – Centre of Excellence with additional buildings, equipments and manpower.

Many young MBBS doctors do not like to work in rural places. What steps have you taken to encourage doctors to work in rural areas?
Tamil Nadu is one of the few states in the country where there is minimum vacancy in the healthcare sector even in rural areas. For this achievement, I would like to give credit to our recruitment system through which we have successfully encouraged doctors to work in rural places. We have set up the Medical Recruitment Board first of this kind in india by our CM which is an organisation entitled to recruit doctors by conducting examinations. Recently we have recruited more than 1,500 doctors. We have 19 medical colleges in the state and around 50 percent of post graduate seats are reserved for our government doctors. Any doctor who serves in rural area is entitled for two marks for every year of service in rural areas in his PG entrance exam. Moreover, the facilities and infrastructure available in rural PHCs are such that the doctors are able to provide quality medical care to the public. This gives them the satisfaction of putting to effective use what they have learnt through their five years of medical education. This encourages the doctors to opt for rural services.

The rising cost of medicine is an area of great concern. What steps are being taken by our CM Jayalalithaa to regulate prices of essential medicines
Tami Nadu is one of the few states in India where medicines have always been provided free of cost at all levels of government healthcare facilities. We have been providing generic medicines to the patients in Tamil Nadu for the past fifteen years. We have also set up Tamil Nadu Medical Services Corporation Ltd (TNMSC) with the primary objective of ensuring easy availability of all essential drugs and medicines in the government medical institutions throughout the state. The TNMSC follows a very transparent and efficient procedure for the procurement, storage and distribution of medicines. The corporation is engaged in the procurement, storage and supply of 268 drugs and medicines, 84 suture items and 63 surgical items to the various Government Hospitals, Primary Health Centres and through them to the health sub-centres throughout Tamil Nadu. TNMSC is also engaged in procurement, storage and distribution of 114 veterinary drugs to the various veterinary dispensaries under the control of the Directorate of Animal Husbandry. Our Government of Tamil Nadu has taken a conscientious decision to provide quality medicines to the stake holder irrespective of the cost. The bulk purchase of medicines and other items through TNMSC brings down the prices considerably. At the same time the suppliers are aware that there should be no compromise in the quality of drugs and other supplies least they would be black listed from all supplies in future. We have ensured that there is no shortage of medicine in any government hospital throughout the state of Tamil Nadu. You will find a single medical store near any government hospital as we provide free generic medicines to patients in the hospital itself.

Our vision is to provide universal access to equitable, affordable and quality healthcare services

How would you rate the performance of NRHM in Tamil Nadu? What has been the organisation’s most significant achievement in past ten years?
Tamil Nadu is ranked among the high-performing states in India, in the area of human development. The state is noted for its low mortality rates and effective healthcare services for which NRHM has been catalytic in the last decade. The state has a long track record of innovations in the health care sector and has pioneered in making new approaches to enhance effective access to quality healthcare at low financial costs. NRHM have been instrumental in delivering the Health Care nearer to the community. The three staff nurse model in the primary health centre has changed the service availability of the PHCs. This has ensured that there is one skilled birth attendant at any point of time to provide quality service or appropriate referral to higher centres without delay. This along with the improved facilities and infrastructure has increased the number of deliveries in the PHCs from few thousands to three lakhs at present. This has also enabled us to make all 1614 PHCs as 24 x 7 centres for maternity care. This model is being emulated by other states also. NRHM has significantly contributed to the fall in IMR in the State. 47 NICUs (Neonatal Intensive Care Units) and 42 NBSUs (New Born Stabilisation Units) have been established and 17 NICUs and 114 NBSUs have been strengthened under NRHM. With support from NRHM the State has added 211 New PHCs and in the current year 118 New PHCs are in the pipeline. It is noteworthy to say 209 PHCs have been upgraded with 30 bedded facilities and we have planned to upgrade 60 more in the current year. 385 Mobile Medical Units are functioning as Hospital on Wheels at one per block. This caters to the people in the remote and hard to reach areas by providing health care at their door steps. Tailor made health care plans are being executed for the tribal population. Birth waiting rooms are provided in tribal areas where the pregnant mother along with one relative can stay well before her expected date of confinement. Their food and other expenses during the stay are being met from NRHM allocation. Other than the Maternal and Child Health care services the remarkable fields into which scrupulous actionable points has been taken till now are Provision of Emergency management services through “108” ambulances with the ‘response Time’ of less than 15 minutes in Urban and 20 minutes in Rural population ; making Inter-sectoral Coordination with the Departments of School Education, Sarva Shiksha Abhyan and SCERT; mainstreaming of AYUSH (Ayurvedha, Yoga & Naturopathy, Unani, Siddha and Homeopathy) services , Palliative Care services (next to the state of Kerala); hierarchal steps to reduce the prevalence of preventable blindness from 1.4-0.3 percent through involvement of Non Governmental Organisations ; entrusting the public with the increased awareness about Health related issues both Communicable and Non-communicable and many others.

Tell us about the Dr Muthulakshmi Reddy Maternity Benefit Scheme that you have implemented.
Dr Muthulakshmi Reddy Maternity Benefit Scheme is implemented by the Government of Tamil Nadu under which a financial assistance of `12,000 is given in three instalments to women from BPL families in order to compensate the wage loss during pregnancy and to get nutritious food so as to avoid low birth weight babies. A mother is eligible for receiving the first instalment of `4,000 after a minimum of three Ante-natal check-ups at the end of seven months; the second instalment of `4,000 after the baby is delivered in a government institution and `4,000 when the baby completes immunisation up to the third dose of DPT. The pregnant mother should be of age 19 years and above, and she should be in the BPL category for availing the benefit. The entire process is being done online and currently we are successfully transferring funds of about `600 Crores to more than three lakh beneficiaries every year. For this purpose we have linked all the primary health centres in the state with broadband connectivity We have trained all our doctors with private agencies and all our PSEs are connected through broadband.

Tell us about the key challenges that you face in managing the healthcare sector in the state of Tamil Nadu.
A huge infrastructure is required to provide efficient and effective healthcare to the people. At present we are having the capacity to admit about 70,000 inpatients in all the Government Facilities in the State. Every year we are constructing new buildings and also increasing the man power available in the Government Health Institutions to cater to the increasing needs of the General Public. Today the State has 19 Government Medical Colleges and every year we are improving our Medical Education by increasing the number of Medical seats in the colleges and also by opening New Medical Colleges. But our main challenge lies in addressing the gaps in effective coordination among all the health directorates. We are trying to provide comprehensive healthcare services to all the people of the State. There are certain areas of Health Provision which need to be strengthened and we also need to involve the private sector for better outcome in those areas. In fact, we are already partnering with many private organisations for implementing the Chief Minister’s Comprehensive Health Insurance Scheme for the people. Also we are involving the Private Sector, wherever necessary, in all high end requirements. We have made a detailed plan and hope to address the health needs of large number of poor people who live in urban areas and in urban slums through the forthcoming Urban Health Mission.

Tuesday, December 3, 2013

12 kg tumour removed from woman’s uterus - The Hindu

12 kg tumour removed from woman’s uterus - The Hindu

Fibroid tumor of uterus

Fibroids affect at least 20% of all women at sometime during their life. Women aged between 30 and 50 are the most likely to develop fibroids. Overweight and obese women are at significantly higher risk of developing fibroids, compared to women of normal weight. Malignant (cancerous) growths on the smooth muscles inside the womb can develop, called leiomyosarcoma of the womb. However, this is extremely rare.
What is a Fibroid?
Fibroid is a non-cancerous (benign) tumors that grow from the muscle layers of the uterus (womb). They are also known as uterine fibroids, myomas, or fibromyomas. The singular of uterine fibroids is Uterine Fibroma. Fibroids are growths of smooth muscle and fibrous tissue. Fibroids can vary in size, from that of a bean to as large as a melon.
Types of Fibroid
There are four types of Fibroid:
Intramural: These are located in the wall of the uterus. These are the most common types of fibroids.
Subserosal fibroids: These are located outside the wall of the uterus. They can develop into pedunculated fibroids (stalks). Subserosal fibroids can become quite large.
Submucosal fibroids: These are located in the muscle beneath the lining of the uterus wall.
Cervical fibroids: These are located in the neck of the womb (the cervix).
Causes of Fibroid
A fibroid starts as a single muscle cell in the uterus. For reasons that are not known, this cell changes into a fibroid tumor cell and starts to grow and multiply. Heredity may be a factor. It is thought that a muscle cell in the uterus may be "programmed" from birth to develop into a fibroid sometime perhaps many years after puberty (the start of menstrual periods). After puberty, the ovaries produce more hormones, especially estrogen. Higher levels of these hormones may help fibroids to grow, although exactly how this might happen is not understood.
Symptoms of Fibroid
The symptoms of fibroids may include:
Heavy Vaginal Bleeding: Excessively heavy or prolonged menstrual bleeding is a common symptom. Women describe soaking through sanitary protection in less than an hour, passing blood clots and being unable to leave the house during the heaviest day of flow.
Pelvic Discomfort:  Women with large fibroids may feel heaviness or pressure in their lower abdomen or pelvis. Often this is described as a vague discomfort rather than a sharp pain. Sometimes, the enlarged uterus makes it difficult to lie face down, bend over or exercise without discomfort.
Pelvic Pain: A less common symptom is acute, severe pain. This occurs when a fibroid goes through a process called degeneration. Usually, the pain is localized to a specific spot and improves on its own within two to four weeks. Using a pain reliever, such as ibuprofen, can decrease the pain significantly.
Bladder Problems: The most common bladder symptom needs to urinate frequently. A woman may wake up several times during the night to empty her bladder. Occasionally, women are unable to urinate despite a full bladder.
Low Back Pain: Rarely, fibroids press against the muscles and nerves of the lower back and cause back pain. A large fibroid on the back surface of the uterus is more likely to cause back pain than a small fibroid within the uterine wall. Because back pain is so common, it is important to look for other causes of the pain before attributing it to fibroids.
Rectal Pressure: Fibroids also can press against the rectum and cause a sensation of rectal fullness, difficulty having a bowel movement or pain with bowel movements. Sometimes, fibroids can lead to the development of a hemorrhoid.
Discomfort or Pain with Sexual Intercourse: Fibroids can make sexual intercourse painful or uncomfortable. The pain may occur only in specific positions or during certain times of the menstrual cycle. Discomfort during intercourse is a significant issue. If your doctor doesn't ask you about this symptom, make sure you mention it.
Diagnosis for Fibroid
In most cases, the symptoms of fibroids are rarely felt and the patient does not know she has them. They are usually discovered during a vaginal examination. The following are the tests conducted for the diagnosis of fibroids.
Ultrasound: The doctor thinks fibroids may be present; he/she may use an ultrasound scan to find out. Ultrasound can also eliminate other possible conditions which may have similar symptoms. Ultrasound scans are often used when the patient has heavy periods and blood tests have revealed nothing conclusive.
Trans-vaginal scan: A small scanner is inserted into the patient's vagina so that the uterus can be viewed close up.
Hysteroscopy: This is a small telescope that examines the inside of the uterus. During this procedure, if necessary, a biopsy can be taken of the lining of the uterus (womb).
Laparoscopy: A laparoscope is a small device that looks at the outside of the uterus - where the doctor examines its size and shape. A laparoscope is a small flexible tube. During this procedure, if necessary, a biopsy can be taken of the outer layer of the uterus.
Biopsy: A small sample of the lining of the uterus is taken and then examined under a microscope.
Preparing for Fibroid Surgery
Your doctor/health practitioner should check whether you are pregnant, before he/she gives any treatment for fibroids. The fact that you have fibroids does not mean you are infertile; many women have had successful pregnancies with fibroids in their womb. Sometimes they are only diagnosed on for the first time during an ultrasound during pregnancy.  Surgery, of any kind, can cause a disruption of the normal functioning of the body's systems. The following measures should promote general good health, thereby helping the body to be in the best shape possible for surgery.  When planning for surgery, whether or not it requires a stay in the hospital, several steps can be taken to prepare both you and those around you for what is to come. Preparation can summed up in the following ways:
Doing things to promote health and eliminate unhealthy habits, such as cigarette smoking, recreational use of drugs, or excessive drinking of alcoholic beverages.
Providing your doctor with a full personal and family health history,
Deciding whether or not to donate some of your own blood for use during surgery,
Preparing your home to be as convenient as possible for your recovery,
Having some laboratory tests done, and
Doing some immediate preparation before surgery
Eat a well balanced diet, which includes plenty of fresh foods and vitamins and minerals. Vitamin C, in particular, is thought to play an important role in healing.
Provide the Doctor with information about all prescription and over-the-counter medications you have recently taken or are currently taking.
Ask friends or family to help out when you get home from the hospital. Check with your doctor about what you should or shouldn't eat before surgery
Some people choose to donate some of their own blood before surgery, which can be used to replace any blood lost during the procedure
Fibroid Surgery Procedures
When medications have not worked, the patient may have to undergo surgery. The following surgical procedures may be considered:
Hysterectomy: Hysterectomy is the surgical removal of the uterus (and usually of the cervix as well). It is the most common treatment for fibroids. Three out of every 10 hysterectomies in the United States are performed because of fibroids. Currently, hysterectomy is the only permanent cure for fibroids. However, a woman cannot become pregnant or carry a baby after having a hysterectomy. Hysterectomy is often considered when the uterus reaches the size it would be at 12 weeks of pregnancy. In the past, many doctors recommended a hysterectomy because they feared that such large fibroids could hide the presence of cancer of the uterus. A hysterectomy is usually performed through an incision in the abdomen. Sometimes the ovaries are removed in addition to the uterus and cervix. The decision to remove the ovaries depends on the woman's age and on whether the ovaries are diseased. Sometimes, for smaller fibroids, the uterus can be removed through the vagina. This is known as a vaginal hysterectomy. After a vaginal hysterectomy, the only stitches are inside the vagina. The body absorbs the stitches in four to six weeks.
Myomectomy: Myomectomy is the removal of fibroids without removing the uterus. This operation preserves a woman's ability to bear children. However, a successful pregnancy is not guaranteed. Only 4 or 5 out of 10 women become pregnant and give birth after a myomectomy. Heavy bleeding can occur when the fibroids are removed. A woman is more likely to need a blood transfusion after a myomectomy than after a hysterectomy. She is also at higher risk for problems such as infection and blood clots in the legs. Fibroids may grow back after a myomectomy, and another operation may be needed later to remove them. The risk of re-growth is related to the number, not the size, of fibroids removed. If more than three fibroids are removed, the risk of re-growth is about 50-50. Like a hysterectomy, a myomectomy is usually performed through an incision in the abdomen. The risks and recovery time are about the same as for a hysterectomy. Sometimes a myomectomy can be performed with the assistance of a laparoscope or hysteroscope.
UFE (Uterine Fibroid Embolization): Uterine fibroid embolization (UFE) is a minimally invasive treatment for fibroid tumors of the uterus. The procedure is also sometimes referred to as Uterine Artery Embolization (UAE), but this term is less specific and, as will be discussed below; UAE is used for conditions other than fibroids. Fibroid tumors, also known as myomas, are benign tumors that arise from the muscular wall of the uterus.  It is extremely rare for them to turn cancerous. More commonly, they cause heavy menstrual bleeding, pain in the pelvic region, and pressure on the bladder or bowel. In a UFE procedure, physicians use an x-ray camera called a fluoroscope to guide the delivery of small particles to the uterus and fibroids. The small particles are injected through a thin, flexible tube called a catheter. These block the arteries that provide blood flow, causing the fibroids to shrink. Nearly 90 percent of women with fibroids experience relief of their symptoms. Because the effect of uterine fibroid embolization on fertility is not fully understood, UFE is typically offered to women who no longer wish to become pregnant or who want or need to avoid having a hysterectomy, which is the operation to remove the uterus.
Endometrial Ablation: This involves removing the lining of the uterus. This procedure may be used if the patient's fibroids are near the inner surface of the uterus. This procedure is considered as an effective alternative to a hysterectomy. The entire lining of the uterus (the endometrium) is removed or destroyed. The standard endometrial ablation and resection techniques are equally effective in reducing bleeding. In general, either one reduces bleeding by about half. At least 90% of women find either procedure acceptable and about three-quarters are totally or generally satisfied with the treatment. Only about 15% of women require a hysterectomy later on. Since no procedure has any particular advantage, a woman's best option may be to select the procedure based on their surgeon's skill and experience with it.
Magnetic Resonance Guided Percutaneous Laser Ablation - An MRI (magnetic resonance imaging) scan is used to locate the fibroids. Then very fine needles are inserted through the patient's skin and pushed until they reach the targeted fibroids. A fiber-optic cable is inserted through the needles. A laser light goes through the fiber-optic cable, hits the fibroids and shrinks them.
Magnetic Resonance Guided Focused Ultrasound Surgery:  Is an MRI (magnetic resonance imaging) scan locates the fibroids, and then sound waves are aimed at them. This procedure also shrinks the fibroids. Most experts say Magnetic-resonance-guided percutaneous laser ablation and Magnetic-resonance-guided focused ultrasound surgery are both effective - however, there is some uncertainty regarding their benefits vs. risks.
Post Operative Care after Fibroid Surgery
Full recover will take about 2-4 weeks. When you return home, do the following to help ensure a smooth recovery:
Be sure to follow your doctor's instructions.
Wear sanitary pads or napkins to absorb blood. The first menstruation after the procedure may be heavier than normal.
Try to walk often. This will decrease the risk of blood clots.
Take medicines as prescribed by your doctor. If you had to stop medicines before the procedure, ask your doctor when you can start again.
Bathe or shower as normal. Gently wash the incision area with mild soap.
Ask your doctor when you will be able to:
Return to work and drive
Resume sexual activity
Resume strenuous activity (You may need to wait 2-6 weeks.)
Recovering after Fibroid Surgery
The recovery from fibroid removal may require a hospital inpatient stay of a few days and recovery can take several weeks. The following are the recovery for Hysterectomy and Myomectomy  
Recovery from Hysterectomy: An abdominal hysterectomy involves a large incision and has a recovery time of 4 to 6 weeks. Laparoscopic and vaginal hysterectomies utilize small incisions reducing recovery time to 3 to 4 weeks. All hysterectomies require 2 to 3 day hospital stays, painkillers, potentially a catheter to assist with the passage for urine, and moving around to prevent blood clots.
Recovery from Myomectomy: Recovery time after a single, large incision myomectomy lasts about 4 to 6 weeks. Laparoscopic and vaginal myomectomies have shorter recovery times of 1 to 3 weeks. All mymectomies require 2 to 3 day hospital stays, painkillers, and moving around as quickly as possible to prevent blood clots.
Advance Treatment Options for Fibroid Surgery
The following are newer treatment options for Fibroid Surgery:
Embolization: This procedure shrinks fibroids by cutting off their blood supply. Guided by an X-ray image, the doctor threads a small catheter (a thin flexible tube) through a tiny incision in the groin into the main arteries that supply blood to the uterus. He or she then injects particles of inert plastic through the catheter to block these blood vessels. The uterus itself is not damaged because smaller arteries continue to supply the nutrients and oxygen it needs. The procedure takes about an hour. It may be performed with local or general anesthesia. The woman must lie flat on her back for six hours afterward to stop bleeding from the incision in the groin. Cramps in the pelvis are common, and the doctor usually prescribes a pain medication for them.
Laparoscopic Surgery: Some procedures can be performed using a laparoscope, a pencil-thin surgical telescope similar to a hysteroscope. The surgeon inserts the laparoscope and tiny surgical instruments through one or more small incision in the abdomen. If the fibroids are small and easy to reach, the surgeon makes an incision in the uterus and removes them. This is called a laparoscopic myomectomy. It may require an overnight hospital stay. When the fibroids are larger or harder to reach, the surgeon may use a laser or an electric needle to destroy or shrink them. This procedure is known as laparoscopic myolysis. Women who have this procedure done can often go home the same day.
Hysteroscopic Resection: This procedure uses a hysteroscope, a thin telescope that is inserted through the cervix. It enables the surgeon to see inside the uterus. The surgeon may then remove the fibroids with a laser or an electrical knife, wire, or probe. No incision is made. The procedure may be done with local or general anesthesia. The woman may stay overnight in the hospital or be treated as an outpatient. Full recovery takes a week or two.
Fibroid Surgery in India
India has emerged as an option abroad for Fibroid Surgery and other medical treatments for the international patients looking for low cost solutions with high quality service. Surgeons performing Fibroid Surgery in India treat with best medical facilities and provide highest successful results to these patients.
India finds the infrastructure and technology at par with that in USA, UK and Europe. Fibroid Surgery is one the common treatments for global patients coming to India. The good facilities provided in India are certainly beneficial but also the skyrocketing medical costs and long waiting lists to get treated by the specialists in the western countries are helping Indian medical tourism industry.
India has highly trained doctors to appeal to the medical tourists with a large pool of professionally qualified doctors, nurses and paramedics. The world-class facilities and infrastructure is further supported by low cost airfare and other facilities related to their stay in India in the following cities:
Cost of Fibroid surgery in India
The cost of surgery less when it is compared with the other western countries, it is relatively cheap because that is the way the international economy runs. A cost comparison of various medical treatments can give you the exact idea about the difference:
Medical   Treatment
Procedure Cost (US$)
United States
Uterine Artery Embolization

International day for people with disabilities 3.12.2013

Patients with disability due to Spinal cord injury

Every year, around the world, between 250 000 and 500 000 people suffer a spinal cord injury (SCI).

The majority of spinal cord injuries are due to preventable causes such as road traffic crashes, falls or violence.

People with a spinal cord injury are two to five times more likely to die prematurely than people without a spinal cord injury, with worse survival rates in low- and middle-income countries.

Spinal cord injury is associated with lower rates of school enrollment and economic participation, and it carries substantial individual and societal costs.

Understanding spinal cord injury

The term ‘spinal cord injury’ refers to damage to the spinal cord resulting from trauma (e.g. a car crash) or from disease or degeneration (e.g. cancer). There is no reliable estimate of global prevalence, but estimated annual global incidence is 40 to 80 cases per million population. Up to 90% of these cases are due to traumatic causes, though the proportion of non-traumatic spinal cord injury appears to be growing.

Symptoms of spinal cord injury depend on the severity of injury and its location on the spinal cord. Symptoms may include partial or complete loss of sensory function or motor control of arms, legs and/or body. The most severe spinal cord injury affects the systems that regulate bowel or bladder control, breathing, heart rate and blood pressure. Most people with spinal cord injury experience chronic pain.

Demographic trends

Males are most at risk in young adulthood (20-29 years) and older age (70+). Females are most at risk in adolescence (15-19) and older age (60+). Studies report male-to-female ratios of at least 2:1 among adults, sometimes much higher.


Mortality risk is highest in the first year after injury and remains high compared to the general population. People with spinal cord injury are 2 to 5 times more likely to die prematurely than people without SCI.

Mortality risk increases with injury level and severity and is strongly influenced by availability of timely, quality medical care. Transfer method to hospital after injury and time to hospital admission are important factors.

Preventable secondary conditions (e.g. infections from untreated pressure ulcers) are no longer among the leading causes of death of people with spinal cord injury in high-income countries, but these conditions remain the main causes of death of people with spinal cord injury in low-income countries.

Health, economic and social consequences

Spinal cord injury is associated with a risk of developing secondary conditions that can be debilitating and even life-threatening—e.g. deep vein thrombosis, urinary tract infections, muscle spasms, osteoporosis, pressure ulcers, chronic pain, and respiratory complications. Acute care, rehabilitation services and ongoing health maintenance are essential for prevention and management of these conditions.

Spinal cord injury may render a person dependent on caregivers. Assistive technology is often required to facilitate mobility, communication, self-care or domestic activities. An estimated 20-30% of people with spinal cord injury show clinically significant signs of depression, which in turn has a negative impact on improvements in functioning and overall health.

Misconceptions, negative attitudes and physical barriers to basic mobility result in the exclusion of many people from full participation in society. Children with spinal cord injury are less likely than their peers to start school, and once enrolled, less likely to advance. Adults with spinal cord injury face similar barriers to economic participation, with a global unemployment rate of more than 60%.

Existing data do not allow for global cost estimates of spinal cord injury, but they do offer a general picture.

The level and severity of the injury have an important influence on costs--injuries higher up on the spinal cord (e.g. tetraplegia vs. paraplegia) incur higher costs.

Direct costs are highest in the first year after spinal cord injury onset and then decrease significantly over time.

Indirect costs, in particular lost earnings, often exceed direct costs.

Much of the cost is borne by people with spinal cord injury.

Costs of spinal cord injury are higher than those of comparable conditions such as dementia, multiple sclerosis and cerebral palsy.


The leading causes of spinal cord injury are road traffic crashes, falls and violence (including attempted suicide). A significant proportion of traumatic spinal cord injury is due to work or sports-related injuries. Effective interventions are available to prevent several of the main causes of spinal cord injury, including improvements in roads, vehicles and people’s behaviour on the roads to avoid road traffic crashes, window guards to prevent falls, and policies to thwart the harmful use of alcohol and access to firearms to reduce violence.

Improving care and overcoming barriers

Many of the consequences associated with spinal cord injury do not result from the condition itself, but from inadequate medical care and rehabilitation services, and from barriers in the physical, social and policy environments.

Implementation of the UN Convention on the Rights of Persons with Disabilities (CRPD) requires action to address these gaps and barriers.

Essential measures for improving the survival, health and participation of people with spinal cord injury include the following.

Timely, appropriate pre-hospital management: quick recognition of suspected spinal cord injury, rapid evaluation and initiation of injury management, including immobilization of the spine.

Acute care (including surgical intervention) appropriate to the type and severity of injury, degree of instability, presence of neural compression, and in accordance with the wishes of the patient and their family.

Access to ongoing health care, health education and products (e.g. catheters) to reduce risk of secondary conditions and improve quality of life.

Access to skilled rehabilitation and mental health services to maximize functioning, independence, overall wellbeing and community integration. Management of bladder and bowel function is of primary importance.

Access to appropriate assistive devices that can enable people to perform everyday activities they would not otherwise be able to undertake, reducing functional limitations and dependency. Only 5-15% of people in low- and middle-income countries have access to the assistive devices they need.

Specialized knowledge and skills among providers of medical care and rehabilitation services.

Essential measures to secure the right to education and economic participation include legislation, policy and programmes that promote the following:

physically accessible homes, schools, workplaces, hospitals and transportation;

inclusive education;

elimination of discrimination in employment and educational settings;

Vocational rehabilitation to optimize the chance of employment;

micro-finance and other forms of self-employment benefits to support alternative forms of economic self-sufficiency;

access to social support payments that do not act as disincentive to return to work; and

correct understanding of spinal cord injury and positive attitudes towards people living with it.

Monday, December 2, 2013

Risk of hearing loss in teens

Less than 5% of parents think their child is at risk for high-frequency hearing loss despite the silent epidemic affecting almost 20% of adolescents.

Few parents believe that their teenager is at risk of hearing loss and most parents have a poor understanding of hazardous noise exposures for adolescents. However, the 19.5% prevalence of hearing loss among 12- to 19-year-olds is comparable to the 18.4% obesity rate, which gets much more attention.

When presented with a list of activities, most only recognized headphone use with an iPod as being high-risk factor. Many other common sources of hearing loss were overlooked, such as talking on a loud cell phone, band practice, shop work, summertime lawnmower operation, and motorcycle riding.

"Certainly, many of the hearing-hazardous activities in which adolescents partake are also important components of their education, growth, and development. The goal is not to eliminate these activities but to approach them with some knowledge of the potential hearing risks and take the appropriate steps for hearing conservation.

Risk of hearing loss in teens

Less than 5% of parents think their child is at risk for high-frequency hearing loss despite the silent epidemic affecting almost 20% of adolescents.

Few parents believe that their teenager is at risk of hearing loss and most parents have a poor understanding of hazardous noise exposures for adolescents. However, the 19.5% prevalence of hearing loss among 12- to 19-year-olds is comparable to the 18.4% obesity rate, which gets much more attention.

When presented with a list of activities, most only recognized headphone use with an iPod as being high-risk factor. Many other common sources of hearing loss were overlooked, such as talking on a loud cell phone, band practice, shop work, summertime lawnmower operation, and motorcycle riding.

"Certainly, many of the hearing-hazardous activities in which adolescents partake are also important components of their education, growth, and development. The goal is not to eliminate these activities but to approach them with some knowledge of the potential hearing risks and take the appropriate steps for hearing conservation.