13 October, 2012 Clippings

‘65% patients of knee replacement are women’

Women in the state, particularly in the city, seem to be going weak in the knees, literally. No, it is not the sight of drop-dead handsome men, but lack of calcium and adequate exercise coupled with general disregard for their health that is playing havoc with their knees.

Knee replacement surgeons in the city say that 60-70% of such operations are carried out on women. And an equal number of them are also their patients, most complaining of bone problems.

Speaking at a function held to talk about the new advancements in knee replacement surgeries and how more people were undergoing the procedure, Dr HP Bhalodiya said that 60-65% of his patients are women. He said many undergo the procedure to get relief from pain owing to arthritis.

“In women, menopause, sedentary lifestyle and general callousness towards health are some of the factors leading to poor bone health. When compared to men, women lead a more sedentary lifestyle that does not involve much of physical work. This is another reason,” said Bhalodiya.He said that new implants even allowed patients to sit cross-legged. At the meet, several patients who had their knees replaced performed garba to show their relief from pain. Echoing similar sentiments, Dr Dimple Parekh, another joint replacement surgeon, said that 70% of his patients who undergo knee replacement are women.

“A part of the problem is genetic, but other factors include obesity, improper calcium intake and hormonal changes following menopause,” said Parekh.

He added that in India the problem was more severe. In the western countries the women to men ratio for knee replacement is 50:50. But here it is in the ratio of 70: 30, he pointed out.

“Osteoporosis is another common ailment affecting our women which again is a result of lack of exercise and unhealthy living habits among others,” said Parekh.

Source: www.dnaindia.com

13.10.2012

Low cholesterol does not mean healthy heart

Got your cholesterol levels checked? Relieved because you are still on the borderline of prescribed limit? However, before you rejoice, here’s a grim fact: If doctors are to be believed, you may have already overshot the limit. How? Well, it’s because while checking cholesterol levels at present, most laboratories use standards set for western people, which may not be ideal in case of Indians. City cardiologists say that as per research Indians are genetically predisposed to have high levels of lipoprotein(a) or LP(a), which increases the risk to Coronary Artery Disease.

“Elevated LP(a) found in about 40% of Indians magnifies adverse consequences of other factors like use of tobacco, consumption of unhealthy foods and poor physical activity,” said Dr Hitesh Shah, interventional cardiologist. Shah was speaking at a press conference held as part of World Heart Day on September 29.

Thus, a smoker or junk food addict also genetically predisposed to have high LP(a) levels as well, will be at a greater risk of suffering heart disease.

Emphasising on the need to have different threshold level for Indians when measuring parameters like BP, waist size, cholesterol levels etc, Shah said, “Even the Indo-US Health Summit too had recommended stricter levels for the same,” adding that most laboratories, however, continue to measure these parameters as per western standards.

The summit had recommended 30mg lower levels for Low-density Lipoprotien cholesterol (LDL-C) and non-high density lipoprotein cholesterol (HDL-C) than what was in use.
Shah recently carried out an angioplasty on a 22-year-old engineering student. Talking on the reasons why more young were falling prey to heart disease, he said: “Chirag was genetically predisposed to have high LP(a) levels. This, combined with his unhealthy eating habits, is the reason why he had to undergo an angioplasty at such a young age.”

Source: www.dnaindia.com

13.10.2012

Correction does much,

but encouragement does more

Johann Wolfgang

Mnemonics

MNEMONICS TO REMEMBER YOUR SUBJECT

824. Cirrhosis: causes of hepatic cirrhosis  HEPATIC Hemochromatosis Enzyme deficiency Post hepatic Alcoholic Tyrosinosis Indian childhood Cardiac/ Cholestatic	828. JVP: raised JVP: extra-cardiac causes  FAT PEA Fever Anaemia Thyrotoxicosis Pregnancy Exercise A-V fistula
825. Whipple's disease: clinical manifestations SHELDA Serositis Hyperpigmentation of skin Eating less Lymphadenopathy Diarrhea Arthritis	829. Myocardial infarction: some emergency treatment drugs ABCD Aspirin Beta blockers Clot busters Dynamite
826. Splenomegaly: causes CHIMP Cysts Haematological Infective Metabolic Portal hypertension	830. Constipation: causes DOPED Drugs Obstruction (eg IBD, cancer) Pain Endocrine (eg hypothyroid) Depression
827. MI: immediate treatment DOGASH Diamorphine Oxygen GTN spray Asprin 300mg Streptokinase Heparin	831. Pancreatitis: Ranson criteria for pancreatitis at admission LEGAL Leukocytes > 16.000 Enzyme AST > 250 Glucose > 200 Age > 55 LDH > 350

12 October, 2012 Clippings

Patients shouldn't drink coffee post colon surgery

Coffee speeds up bowel function return after colon surgery (Thinkstock photos/Getty Images)

Patients who drink coffee rather than water after bowel surgery to remove a part of their colon experience a quicker return to bowel movements and tolerance of solid food, researchers say.

These are two of the key findings of a comparative study of 80 patients, carried out at University Hospital Heidelberg, Germany.

"Post-operative bowel obstruction is a common problem after abdominal surgery and the aim of this study was to test our theory that coffee would help to alleviate this," lead author Dr Sascha Muller said.  The 80 patients were randomised into coffee and water groups before their operation, with one patient in the water arm subsequently excluded due to a change in their surgical procedure.  Patient characteristics were similar in both groups. Their average age was 61 years and 56 per cent were male.

Just over half (56 per cent) had colonic cancer, 28 per cent had diverticular disease (a structural problem with the wall of their colon), 13 per cent had inflammatory bowel disease and four per cent had other conditions. The majority had open surgery (61 percent) and the remainder had laparoscopic surgery. The patients were given 100mls of coffee or water three times a day.

Key findings of the study were - time to first bowel movement after surgery was just over 60 hours in the coffee group and 74 hours in the water group, the coffee group were able to tolerate solid food in just over 49 hours, compared to just under 56 hours in the water group, the coffee drinkers were also able to pass wind just under 41 hours after surgery, compared with over 46 hours for the water group and length of hospital stay and ill health were similar in both groups.

"This randomised trial showed that the time to first bowel movement after surgery was much shorter in the coffee drinkers than the water drinkers," Dr Muller said.

"Although 10 per cent of the patients did not want to drink strong coffee at this time, it was well accepted by the group and no coffee-related complications were noted.

"It is not clear how coffee stimulates the intestine and caffeine appears to have been ruled out by previous studies, which found that decaffeinated coffee, which was not used in this study, also has beneficial effects.

"Whatever the mechanism, it is clear that postoperative coffee consumption is a cheap and safe way to activate bowel motility after elective colonic surgery," Mueller added.

The study has been published in the journal BJS.

Source: www.timesofindia.com                                             12.10.2012

Polio back in the country?

After a polio-free run for 21 months, there’s a chance that the virus is back in the country. A case was reported in Darbhanga on Thursday though UNICEF, India denied it was a polio case. State chief of UNICEF, Yameen Mazumder said, ‘Although, a case of wild poliovirus type 3 (WPV3) was reported at Darbhanga, the test was negative.’

The 18-month old child was suspected of carrying the P3 polio virus though he was vaccinated against polio. Apparently, the child is also under-nutritioned. The stool test conducted at ERC Mumbai laboratory was found negative, Mazumder said.

Meanwhile, the union health ministry, in a statement issued on Thursday, said immunization drive would be launched in 28 districts of Bihar from next week as a precautionary measure. Notably, Bihar has not reported a single wild poliovirus type 3 case since January 2010. As per WHO norms, if there is no polio case for three consecutive years then only India would be declared polio-free. Right now, India’s been taken of the polio-endemic list – a notable achievement.

Source: http://health.india.com

12.10.2012

Dreams and dedication are

a powerful combination

William Longgood

11 October, 2012 Clippings

77% people who suffer from mental health issues never get treated: Experts

According to psychiatrists in the capital, depression coupled with alcohol consumption and suicidal tendency is the biggest mental health challenge right now. A staggering 77 % people who suffer from mental health issues never reach a mental health institute.

“There is a two-way relationship between depression, alcohol consumption and suicide. A depressed person takes to alcohol and feels suicidal. An alcoholic is more prone to getting depressed,” said Dr Nimesh G Desai, director of Institute of Human Behaviour and Allied Sciences (IHBAS).

“Also, people with suicidal tendency get depressed and start taking alcohol more easily. Thus, the three have to be seen together,” said Dr Desai. “A study by the Indian Council of Medical Research from 2004 to 2009 in Delhi, Lucknow and Chennai showed a huge treatment gap, especially among the poor and lower middle class,” said Dr Desai.

“People who could reach a facility but did not were 77 per cent of 10,800 respondents. They understood there was a problem, but either did not know that it was a health problem or were unaware that treatment was available. Stigma was not given as the main reason.” Delhi has nearly 250 psychiatrists practicing in public and private institutions.

“We need at least 20,000 for the population here. We understand this cannot be done overnight. A general practitioner can be trained in four weeks to treat basic depression and prescribe medicines,” said Dr Desai. Global data shows that incidence of depression among women is higher than men. “Biologically, women have to go through more hormonal changes, starting from puberty till post-menopause, which spans from 12 to 60 years. This leads to possibility of depression among them,” said Dr Desai.

Source: http://health.india.com

11.10.2012

Eating lunch at desk ups blood clot risk

Eating lunch at desk ups blood clot risk (Thinkstock photos/Getty Images)

Ten people a day are dying of blood clots as more and more workers eat at their desk, researchers say.

Nearly 75 per cent of office staff between the ages of 21-30 and working 10-hours a day do not get up to take a break, thereby doubling their chances of getting deep vein thrombosis (DVT).

"We all do it, work long hours and grab a sandwich at our desk," the Mirror quoted DVT charity Lifeblood's Annya Stephens-Boal as saying.

Recent figures have shown that the number of DVT victims under 40 is rising rapidly, with 94 dying in 2010 up 40 per cent from 67 in 2007.

It kills when blood clots in veins move to the lungs.

Ms Stephens-Boal fears many cases are never detected.

According to experts, the best way to avoid DVT is to keep mobile, lose excess weight, give up smoking and eat a low salt and low fat diet.

Source: www.timesofindia.com

11.10.2012

It takes less time to do things right than to explain why you did it wrong

Henry Wadsworth Longfellow

10 October, 2012 Clippings

Last stage of liver cancer? There’s hope

Even stage IV liver cancer patients have chances of survival— this is the message that doctors in the city tried to convey through Liver Update 2012, a conference on liver surgery held in the city on Sunday.

The event aims to spread awareness about the various treatments available for liver metastases from colorectal cancer. Liver metastases refers to the cancer that is first detected in the colon and then spreads to the liver.

Dr Hitesh Chavda, organising secretary, Liver Update 2012, said that at least 20% of the patients suffering from metastatic colorectal cancer —stage IV liver cancer—can be cured completely.

He asserted that co-ordinated effort on part of doctors is required to help such patients. “It is not the work of surgeon alone. You need oncologists, radiologists and others. They need to work together to explore a range of treatments and develop the one that is of optimal use in a particular situation,” he explained.

Chavda added that not many medical practitioners are aware of the curability of this type of cancer. “This conference is an attempt to discuss the various modalities available and how they can be used best,” he said.

However, he cautioned that the curability was dependent on several factors including the size of the tumour, its aggressiveness etc. “Nowadays, molecular markers can tell a doctor how a patient will react to a certain therapy of cancer treatment,” he said.

He added that the exact cause of colon cancer is not known. “However, the instances of colon cancer are 10 times less than what we see in western countries,” he said. Chavda said that in 50% of the cases, colon cancer may spread to the liver as well. “In 30% of the cases, cancer would have spread from the colon to the liver by the time it is detected,” he added.

Source: www.dnaindia.com

10.10.2012

Psychiatry must be included in MBBS syllabus: Experts

On the eve of World Mental Health Day at a discussion on ‘Depression: A Global Crisis’, experts said that psychiatry must be included in the MBBS syllabus. The event was organized at the Bangalore Medical College and Research Institute by the Karnataka State Mental Health Association.

‘We need at least 1 lakh psychiatrists in India. The government must take steps to include psychiatry as a subject in the MBBS syllabus; at least one semester would be enough. If depression is treated with professional care, patients will not hesitate to come forward to seek treatment,’ Justice N Kumar of the Karnataka High Court said.

‘We require trained professionals to help cure mental illness. For this, we need to integrate mental healthcare into public healthcare. We need to create trained professionals, who can handle mental healthcare at Primary Health Centers as depression is highly prevalent in rural areas. MBBS doctors, counsellors, nurses, etc can be trained. Medical colleges must design special courses for mental health treatment,’ said Madam Goal, principal secretary, department of health and family welfare and chairman, Karnataka State Mental Health Authority. Karnataka has just two government institutes – Nimhans and Dharwad Mental Institute — to treat mental illness. The government must set up more institutes to treat mental illness, pointed Dr BN Magadha, professor, department of psychiatry.

Source: http://health.india.com

10.10.2012

There is only one thing that makes a dream impossible to achieve: the fear of failure

          Paulo Coelho

9 October, 2012 Clippings

Your palm an indicator of illness

Your health is in your hands, and quite literally so. Our hands are the barometers of our well-being and the littlest changes on them may convey a serious medical problem elsewhere in the body.

Discoloured nails

Your nails should be a healthy, pinkish colour. If they have a greenish-yellow tinge then you probably have a fungal infection and should ask your doctor for an anti-fungal treatment. Besides, yellow nails can be a sign of a lung disease.

Spoon-shaped nails

A healthy nail should be slightly raised in the middle and slightly curved down at the tip. If you nail looks the opposite of this, like a spoon, it's a symptom of iron deficiency and anemia. You can correct this by taking iron supplements and including more dark green veggies and some red meat in your diet. Nail clubbing, where the nail takes on a ball-like shape, is even more worrisome as it can mean an internal disease such as lung cancer or heart problems.

Finger lumps

Small lumps close to the nail beds are the first signs of osteoarthritis. These lumps come up as the disease causes a loss of joint space, leading to broadening of joints while new bones begin to form. Osteoarthritis, which is general wear and tear of the joints, is common among women and is painful.

Trembling hands

Everyone's hands shake to some degree but if yours tremble noticeably, it may be an early warning sign that you are developing Parkinson's disease, which affects the nervous system.

Dry skin

Very dry skin can be a sign of an under-active thyroid as it causes the skin to lose moisture.

Red palms

For centuries doctors have associated a reddening of the palm with liver disorders, in particular cirrhosis.. Red palms can also be a symptom of rheumatoid arthritis, thyroid disorders and, sometimes, pregnancy.

Sweaty palms

Our palms often heat up when we are nervous or anxious, but if this is happening to you on a regular basis, your thyroid could be to blame. An over-active thyroid causes an increase in your metabolic rate. This means you burn more calories and sweat more as your body temperature increases. You may also experience unexplained weight loss, a constant feeling of nervous energy and a swelling of the thyroid gland in the throat.

Source: www.timesofindia.com

09.10.2012

Nobel Prize in physiology, medicine is shared by Briton, Japanese

British scientist John Gurdon and Shinya Yamanaka of Japan shared the 2012 Nobel Prize in physiology or medicine Monday for experiments separated by almost 50 years. Their work provides deep insight into how animals develop and offers hope for a new era of personalized medicine.

"Their findings have revolutionized our understanding of how cells and organisms develop," the Nobel committee said in the prize announcement.

Gurdon, 79, is an emeritus professor at Cambridge University who still conducts research at an institute there bearing his name and was knighted in 1995 for his work in developmental biology. His frog experiments a half-century ago showed that scientists 'should be able to derive any one kind of cell from another, because they've all got the same genes," Gurdon said Monday at a news conference in London.

In 2006 and 2007, Yamanaka extended this insight by turning back time on individual cells from both mice and humans. By sprinkling four genes on ordinary skin cells, Yamanaka discovered a virtual fountain of youth: Any cell, he found, could be reverted to an early embryonic state.

These "induced" embryonic cells behave much like the ethically contentious stem cells gleaned from human embryos. Like embyronic cells, they can be grown into many other types of tissues — but without having to destroy any embryos.

The breakthrough offered hope that someday skin cells could be harvested from a patient, sent back to an embryonic state, and then grown into replacement tissues such as heart muscle or nerve cells.

A huge global research effort is now under way to develop pluripotent stem cells, as they're called, into treatments for heart disease, some forms of blindness, Parkinson's disease and many other disorders.

Because the cells made by the technique are genetically identical to the patient, the advance "may one day allow us to transplant rejection-proof tissues," said a leading U.S. stem cell researcher, George Daley, director of the Harvard Stem Cell Institute.

Yamanaka's work "has now expanded to hundreds of labs around the world that are exploiting the techniques to study virtually every kind of disease. The impact cannot be overstated," Daley continued.

09.10.2012

There's only one way to succeed in anything, and that is to give it everything

Vincent "Vince" Lombardi

8 October, 2012 Clippings

Patient gets Hepatitis C virus during dialysis

The Columbia Asia Referral Hospital in Yeshwanthpur, Bangalore, is facing a probe by the department of health and family welfare over alleged negligence towards a patient undergoing dialysis.

The patient, Beerappa Methre, a 28-year-old mechanical engineer based in Pune, has alleged in his complaint that he got infected with Hepatitis C virus during treatment.

The assistant director of health and family welfare has sent a letter directing the district health officer, Bangalore Urban, to conduct an inquiry and submit a report. Confirming the inquiry, BK Eshwarappa, assistant director, health and family welfare department, said that health minister Aravind Limbavali had directed the department to look into Methre’s complaint.

Methre had come to the hospital in February for dialysis, as he was suffering from a renal problem. Before admitting him, the hospital had referred his blood samples to Reliance Life Sciences, Mumbai for testing. In the results HCV RNA PCR were not detected.

The hospital conducted dialysis for a few months. When he again got his blood tested on August 8 at Ananya Hospital, he was shocked to know that he had tested positive for Hepatitis C virus. “Later I got tested at Religare SRL Diagnostics and Anand Diagnostic Laboratory. Both the tests confirmed presence of Hepatitis C virus. The HCV Viral load was 5,43,000. After coming to know about my health condition, my mother died. I have lost my health and mother. I spent a few lakhs of rupees for the treatment and dialysis. Now I have no money even to pay for dialysis,” Methre told DNA.

Source: www.dnaindia.com

08.10.2012

Ailment more deadly than AIDS, cancer: Doctors

Thirty-six people die every hour in India of sepsis, a disease that kills more people than cancer and AIDS put together. Yet it is one of least known diseases not just among the general public but medical professionals as well.

Sepsis is a serious medical condition caused by the body’s response to a bacterial infection and in this state the body is fighting a severe infection that has spread via the bloodstream. It can lead to complications affecting multiple organs and even cause death.

“Sepsis is a serious infection usually caused by bacteria, which can originate in many body parts, such as the lungs, intestines, urinary tract, or skin that make toxins that cause the immune system to attack the body’s own organs and tissues. If not recognised early, body’s response to infection can damage its own tissues. It is sad that though it is one of the leading killers, especially of people with compromised immunity, it is one of the least understood diseases,” said Dr PK Joshi, director of Niramaya Hospital and president of Pune chapter of Indian Society of Critical Care Medicine (ISCCM). One of the most common reasons to develop sepsis is hospital-based infections.

“People admitted to healthcare set-ups are already suffering from some infection and hence immuno-compromised. Also we see that antibiotics are rampantly used by doctors and combinations of antibiotics are used even in simple infections. There should hence be a hospital policy on use of antibiotics,” said Dr Ramesh Ranka, owner and chief orthopaedic surgeon at Ranka Hospital.

A common misconception is that sepsis is blood poisoning and usually happens due to open wounds etc. “A patient suffering from a viral infection can develop sepsis and even a cancer patient suffer from secondary infection and develop sepsis,” said Prayag Hospital director Dr Shirish Prayag.

Source: www.dnaindia.com

08.10.2012

If you have knowledge, let others light their candles in it

Margaret Fuller