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.
Wednesday, December 4, 2013
Tuesday, December 3, 2013
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:
Mumbai
Hyderabad
Kerala
Delhi
Pune
Goa
Bangalore
Nagpur
Jaipur
Chennai
Gurgaon
Chandigarh
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
India
Hysterectomy
42,000
3,300
Myomectomy
42,000
3,600
Uterine Artery Embolization
48,000
3,300
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.
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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:
Mumbai
Hyderabad
Kerala
Delhi
Pune
Goa
Bangalore
Nagpur
Jaipur
Chennai
Gurgaon
Chandigarh
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
India
Hysterectomy
42,000
3,300
Myomectomy
42,000
3,600
Uterine Artery Embolization
48,000
3,300
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
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.
Prevention
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.
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
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.
Prevention
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.
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.
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.
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