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Hip Replacement Surgery: Procedure

Hip Replacement Surgery

Hip replacement, or arthroplasty, is a surgical procedure in which the diseased parts of the hip joint are removed and replaced with new, artificial parts. These artificial parts are called the prosthesis. The goals of hip replacement surgery include increasing mobility, improving the function of the hip joint, and relieving pain.

Who should undergo hip replacement?

People with hip joint damage that causes pain and interferes with daily activities despite treatment may be candidates for hip replacement surgery. Osteoarthritis, rheumatoid arthritis, osteonecrosis (or avascular necrosis, which is the death of bone caused by insufficient blood supply), injury, fracture, and bone tumors also may lead to breakdown of the hip joint and the need for hip replacement surgery.

Why Do People Have Hip Replacement Surgery?

For the majority of people who have hip replacement surgery, the procedure results in:

A decrease in pain
Increased mobility
Improvements in activities of daily living
Improved quality of life.


X-ray, MRI, CT and Ultrasound
Procedure/ Treatment plan

The hip joint is located where the upper end of the femur, or thigh bone, meets the pelvis, or hip bone. A ball at the end of the femur, called the femoral head, fits in a socket (the acetabulum) in the pelvis to allow a wide range of motion.
Process of hip replacement

During a traditional hip replacement, which lasts from 1 to 2 hours, the surgeon at Manipal makes a 6- to 8-inch incision over the side of the hip through the muscles and removes the diseased bone tissue and cartilage from the hip joint, while leaving the healthy parts of the joint intact. Then the surgeon replaces the head of the femur and acetabulum with new, artificial parts. The new hip is made of materials that allow a natural gliding motion of the joint.

In recent years, smaller incisions and a shorter recovery time than traditional hip replacement is being followed. Candidates for this type of surgery are usually age 50 or younger, of normal weight based on body mass index and healthier than candidates for traditional surgery. Joint resurfacing is also being used.

There are two types of hip replacement:

Unilateral Hip replacement- procedure where only one of the hip joints are replaced
Bilateral hip replacement- procedure where both the hip joints are replaced

Preparing for Surgery
Medical Evaluation

If you decide to have hip replacement surgery, your orthopaedic surgeon may ask you to have a complete physical examination by your primary care doctor before your surgical procedure

Several tests, such as blood and urine samples, an electrocardiogram (EKG), and chest x-rays, may be needed to help plan your surgery.
Preparing Your Skin

Your skin should not have any infections or irritations before surgery.
Blood Donations

You may be advised to donate your own blood prior to surgery. It will be stored in the event you need blood after surgery.

Tell your orthopaedic surgeon about the medications you are taking.
Weight Loss

If you are overweight, your doctor may ask you to lose some weight before surgery to minimize the stress on your new hip and possibly decrease the risks of surgery.
Dental Evaluation

Although infections after hip replacement are not common, an infection can occur if bacteria enter your bloodstream. Because bacteria can enter the bloodstream during dental procedures, major dental procedures (such as tooth extractions and periodontal work) should be completed before your hip replacement surgery.
Urinary Evaluation

Individuals with a history of recent or frequent urinary infections should have a urological evaluation before surgery.
Social Planning

Although you will be able to walk with crutches or a walker soon after surgery, you will need some help for several weeks with such tasks as cooking, shopping, bathing, and laundry.
Home Planning

Several modifications can make your home easier to navigate during your recovery. The following items may help with daily activities:

A raised toilet seat
A stable shower bench or chair for bathing
A long-handled sponge and shower hose
Securely fastened safety bars or handrails in your shower or bath
Secure handrails along all stairways
A stable chair for your early recovery with a firm seat cushion (that allows your knees to remain lower than your hips), a firm back, and two arms
A dressing stick, a sock aid, and a long-handled shoe horn for putting on and taking off shoes and socks without excessively bending your new hip
A reacher that will allow you to grab objects without excessive bending of your hips
Firm pillows for your chairs, sofas, and car that enable you to sit with your knees lower than your hips
Removal of all loose carpets and electrical cords from the areas where you walk in your home.

Post-operative care

Patients are closely monitored by the staff.
Looking after your new hip

With care, your new hip should last well. The following tips will help you care for your new hip:

avoid bending your hip more than 90° (a right angle) during any activity
avoid twisting your hip
do not swivel on the ball of your foot
when you turn around, take small steps
do not apply pressure to the wound in the early stages (so try to avoid lying on your side)
do not cross your legs over each other
do not force the hip or do anything that makes your hip feel uncomfortable
avoid low chairs and toilet seats (raised toilet seats are available)

Possible Complications of Surgery

The complication rate following hip replacement surgery is low.

The most common complication of hip replacement is that something goes wrong with the joint, which occurs in around 1 in 10 cases. Serious complications, such as joint infection, occur in less than 2% of patients. Major medical complications, such as heart attack or stroke, occur even less frequently. However, chronic illnesses may increase the potential for complications. Although uncommon, when these complications occur they can prolong or limit full recovery.

Infection may occur superficially in the wound or deep around the prosthesis. It may happen while in the hospital or after you go home. It may even occur years later.
Blood Clots

Blood clots may form in the leg veins or pelvis.
Leg-length Inequality

Sometimes after a hip replacement, one leg may feel longer or shorter than the other.
Loosening and Implant Wear

Over years, the hip prosthesis may wear out or loosen. Loosening of the joint can occur at any time, but it normally occurs 10-15 years after the original surgery was performed.
Other Complications

Nerve and blood vessel injury, bleeding, fracture, and stiffness can occur. In a small number of patients, some pain can continue or new pain can occur after surgery.

This occurs when the ball comes out of the socket.
Wear and tear

Another common complication of hip replacement surgery is wear and tear of the artificial sockets.
Joint stiffening

The soft tissues can harden around the implant, causing reduced mobility.

Knee Joint Replacement Surgery: Images, Procedure

The knee joint can be thought of as a hinge joint with the primary motion of straightening and bending. In reality, it is more complex than a simple hinge, as the surfaces actually glide and roll upon one another. It is composed of the end of the thigh bone (femur), the top of the leg bone (tibia), and the kneecap (patella). The ends of the bone are covered with a smooth, glistening layer called articular cartilage. The articular cartilage is what allows the bones to glide smoothly with less resistance than ice sliding on ice. The articular cartilage can be seen on x-ray as the space in between the bones. Knee replacement, or knee arthroplasty, is a surgical procedure to replace the weight-bearing surfaces of the knee joint to relieve pain and disability. Knee replacement surgery can be performed as a partial or a total knee replacement.[2] In general, the surgery consists of replacing the diseased or damaged joint surfaces of the knee with metal and plastic components shaped to allow continued motion of the knee.
Who should undergo knee replacement?
Today, a knee replacement surgery is considered a routine operation. Below are the three most common reasons for the procedure:

Osteoarthritis : This type of arthritis is age related – caused by the normal long wear and tear of the knee joint. The majority of patients are over 50; however, younger people may be affected.
Rheumatoid Arthritis : also called inflammatory arthritis, occurs when the membrane surrounding the knee joint is inflamated and thick. This inflammation becomes chronic and will damage the cartilage causing soreness and stiffness.
Post-traumatic Arthritis : This type of arthritis is due to a severe knee injury. When the bones around the knee break or the ligaments tear, this will affect the knee cartilage. Sometimes, surgery is the best option.

When is knee replacement surgery recommended?
When considering the option of knee replacement surgery, doctors take into account a number of symptoms:

Severe knee pain or stiffness : Do symptoms seriously undermine the patient’s ability to carry out everyday tasks and activities, such as walking, going upstairs, getting in and out of cars, getting up from a chair, etc?
Moderate but continuous knee pain : Is pain present while sleeping or resting?
Chronic knee inflammation and swelling : Does the swelling not improve after taking medications or resting? Do drugs cause unpleasant side effects?
Knee deformity : Is there is a noticeable arch in the inside or outside of the knee?
Nothing else worked : The doctor has prescribed medications and physical therapy without any substantial improvement.
Depression : Depression can be a serious, debilitating and devastating illness. Chronic pain and problems with mobility can eventually lead to depression, especially if the patient cannot do normal daily or social activities properly. Replacement knee surgery may prevent depression from occurring, or help get rid of it.

Polycystic Kidney Disease: Procedure

Polycystic Kidney Disease Treatment

The kidney in the human body is too vital an organ to be ignored. Their principal role is to cleanse the blood off the impurities that accumulate as a result of other organ activities. When kidneys fail to carry out their role as was intended by nature, the first casualty is the quality of blood circulating through the body. This will cause other body organs to malfunction as well and generally bring down the quality of life. What causes kidney cysts is not clear. Kidney cysts usually show as an individual grows older, but they are known to occur in young people also.

The kidneys in your body are susceptible to infections and abnormalities like any other body organs and kidney cysts are one of it. Kidney cysts are globular pouches that contain fluid and grow inside the kidneys. There are 2 common varieties of cysts – polycystic and simple cysts. Simple cysts are non-cancerous and rarely cause complications, and generally don’t require treatment. Polycystic kidney disease symptoms seriously affect the normal functioning of kidneys and therefore require to be treated at the earliest.

Symptoms pointing to need for Polycystic Kidney Disease Treatment
Simple kidney cysts generally don’t show any signs or symptoms. However when they grow larger you will know about it from the following symptoms.

Mild pain in the back and on the sides
Fever and abdominal pain

Here are some complications that occur as a result of having polycystic kidney disease symptoms.

Cysts can contract an infection resulting in the kidneys malfunctioning
Cysts can burst and cause severe pain on the back and sides
Cysts can block the normal flow of urine and result in the kidney swelling

The 2 tests that doctors order to establish polycystic kidney disease symptoms are:

Imaging tests – Imaging tests include the use of ultrasound, CT scan (computerized tomography) and MRI (magnetic resonance imaging). These tests will establish whether the growth is a cyst or a tumor.
Kidney function tests – Kidney function tests are done by drawing a sample of blood and checking whether it is due to a cyst.

Overview – Polycystic Kidney Disease Treatment
If your kidney condition is polycystic, you will be treated for:

High Blood Pressure – Controlling high blood pressure can help to slow down cyst growth. You will be also advised to go on a diet consisting of low sodium salt, low fat, low protein and low calorie. You will also have to quit smoking, do exercise regularly and keep stress under control.
Pain – If you have pain on your back and sides you will be required to take medication. In rare cases where polycystic growth is the cause for extreme pain, you will have to undergo surgery for removing it.
Cysts complication – Though rare, if the cysts affect other body organs and blood vessels from functioning normally you will have to undergo surgery for draining off the fluids that have accumulated in the cysts.
Bladder infection – If diagnosis reveals bladder infection due to cysts you will be treated with antibiotics. Likewise signs of blood in the urine will also be treated. You will be required to drink large quantities of water to prevent clotting in the urinary tract.
Other treatments include – non-surgical management of liver cysts, intracranial aneurysms and control of cholesterol.

Facilities for Treating Polycystic Kidney Disease
The Manipal Group of Hospitals has extensive facilities for treating polycystic kidney disease symptoms. Manipal Hospitals is a multi-specialty group of hospitals and uniquely every hospital in the group is self contained. The benefits that accrue to the patient are that they don’t have to hop between different healthcare facilities to get tests done and diagnosed. With more than 1,000 kidney transplants to its credit, patients are assured of utmost safety and first-class care. There is a separate department with expert doctors and paramedics for taking care of patients with kidney conditions. Another advantage of seeking treatment at Manipal Hospitals is the highly developed clinical laboratory attached to each of its hospitals.

Some facilities that make it unique are:

GE Signa 1.5 Telsa super conductive MRI unit
Advanced CT Scan
Color Doppler
Digital Subtraction Angiography
Mammography, X Rays and many other advanced equipment

Kidney Transplantation: Procedure, Images

About Kidney Transplantation

Renal transplant or Kidney transplant, as it is commonly known, refers to the transfer of kidney from a healthy person to a patient whose kidneys have lost the capability of performing the essential process of filtration. There are two types of kidney transplantation: deceased-donor and living-donor. Among these, living-donor transplantation can be further sub categorized as related and non-related kidney transplants.
Who is eligible for Kidney Transplant?

At multispeciality hospital anyone who is identified with kidney or renal failure is eligible for kidney transplant. Stage 4 is the highest level (the near end-stage) of a kidney patient. Diabetic people whose average insulin requirement per day is more than 1 unit/kg of their body weight and obese people with a BMI of greater than 30 with renal complications are also eligible to undergo kidney transplantation.
What are the benefits?

A successful kidney or renal transplant gives the patient a greater stamina, strength and energy and helps restores his or her life back to normal. People who were on dialysis prior to kidney transplantation will be able to enjoy a greater level of freedom and comfort post kidney transplant. Moreover renal transplantation helps stabilize anemia and blood pressure to a great extent.

The kidney transplant procedure entails replacing a patient’s damaged kidney by a donor’s healthy kidney. The healthy kidney in placed on either the left or right side of the patient’s abdomen depending on the requirements. Our doctors then connect the kidneys to the neighboring blood vessels by means of surgical procedures. The right placement of kidney ensures smooth functioning of the urinary bladder and the nearby blood vessels. Also the veins and arteries are connected appropriately via surgical procedures. The old kidney is removed only when it’s overly damaged. If it’s able to perform atleast 20% of its functions, it will be retained.

Here we take the patient through a detailed medical evaluation which involves a thorough physical examination, EKG, and an X-ray of the chest. Blood tests are to be done for Anemia and to determine if there is any existence of viral diseases like AIDS or hepatitis. In addition to these, the patient will also be tested for cardiac problems and cancer diseases.
Pre surgery requirements

Our doctors evaluate the test reports of all the aforementioned tests and assess the patient’s body conditions. Not only that the donor (the person who donates his or her kidney) will be also be required to take up most of the aforementioned tests. We match the test results and see if the donor’s kidney will suit the recipient or not. Other requirements that will be looked into involve the age and blood group of the donor and the recipient.
Post operations

Once the kidney transplant is accomplished, the patient will be shifted to the ICU where he or she will be under intense care for about 1-2 weeks. Upon recovery, the patient will be discharged from the hospital. We will prescribe drugs and natural diet for the next few weeks or months to ensure that patient’s immunity strengthens post surgery. Also follow-ups visits to our kidney transplant department will be required.

There are various packages to choose from. To get the exact details of the kidney transplant charges or packages we suggest you schedule an appointment with our expert kidney transplant doctors.
Local legal requirements

It’s important that the donor and recipient understand the risks and benefits involved in kidney transplant. Our doctors advice them on the right procedures that are to be followed during the entire kidney transplant process. The donor and recipients are required to sign an agreement an ‘Organ transplant agreement’ which is formulated by the Government of India. All the rules and regulations will be given in detail on the agreement. And our doctors are available to clear all your queries regarding the same.

Physiatry & Rehabilitation (PMR) : Treatment, description

About Physical Medicine and Rehabilitation (PMR)

Physical Medicine and Rehabilitation is also known as Physiatry or Rehabilitation Medicine. This branch of medicine aims to restore and enhance functional abilities and Quality of life of those with physical impairments or disabilities.The specialty emphasizes on prevention,diagnosis and treatment of clinical conditions that lead to limitations in function. The conventional medical approach aims “adding years to life” and this specialty with its functional model accomplishes “adding life to years”.

Department of Physical Medicine and Rehabilitation(PMR) provides comprehensive multi-disciplinary rehabilitation program for all age groups . Our unique and customized programs are designed to promote or enhance recovery,health and wellness that fit each patient’s needs.It helps them to reach their fullest potential while enhancing their overall quality of life upon return to community. Emphasis is on minimizing pain and suffering, maximizing functional outcome in areas of mobility, self care, communication, cognition and psychosocial adjustment for patients.

Our Sevices

Inpatient Care
Outpatient Care
Neurological Rehabilitation Unit
Pain and MusculoskeletalRehabilitation Unit
Pediatric Rehabilitation Unit
Cardio-Pulmonary Rehabilitation
Dedicated Rehabilitation Ward
Home Care-Physiotherapy Services

Our programmes are patient centric,affordable and designed with focus on patient comfort and convenience in the most patient-friendly atmosphere.

Who We can Help?

We work with individuals who are struggling to deal with specific functional problems enumerated below,incorporating their families and caretakers for the same.

Limitation faced due to pain may include:

Difficult in walking,climbing stairs,getting out of bed
Difficult in Swallowing
Loss of coordination and balance
Problems with speech or language
Memory deficits or judgment difficulties
Loss of bowel or bladder control
Problems returning to work or everyday routine in the community

The PMR Team

Our team comprises of dynamic multi-disciplinary professionals committed to helping each patient achieve maximum living potential.The team,lead by a physiatrist includes Physical therapists,occupational therapists,speech & language pathologists,rehabilitation nurses,dieticians,medical social workers and clinical psychologists.

Physical Medicine and Rehabilitation(PMR) Physicians or Physiatrists provide comprehensive and individualized rehabilitation program to patients after detailed clinical assessment keeping in consideration of pre-morbid functional status as well as existing co-morbidities
Physical Therapy to help restore maximum physical function enabling the individual to return to an active life as quickly as possible
Speech Therapy to improve swallowing,communication and cognitive abilities to build a patient’s confidence and independent behavior.


Physical therapists manage movement dysfunction and enhance physical and functional abilities .They help in restoring function,improve mobility,relieve pain and prevent or limit permanent physical disabilities of patients suffering from injuries or diseases.A physiotherapist examines the patient to establish his/her sensed needs focusing on strength,flexibility,sitting and standing balance,coordination and build a treatment plan using exercise regime,techniques and modalities.

Services Available

Electrotherapy modalities like Electrical Stimulation,Short waveDiathermy(SWD),ultrasound Therapy(UST),Infra Red Therapy,Laser Therapy,Lympha press,pain relief modalities like Interferential therapy(IFT),Transcutaneous Electrical Nerve Stimulator(TENS),Inter X,Cervical and Lumbar Traction
Joint and Soft-tissue Mobilization
Balance and Coordination Training
Core Body Strength Training
Body Weight Support Treadmill Training for Functional Mobility and Gait Training
Ergonomics,Body Mechanics and Energy Conservation Training
Neuromuscular Re-education
Pulmonary and Cardiac Therapy
Sports specific therapy
Therapeutic Exercises
Lymphedema Management
Myofascial Release

Occupational Therapy

Occupational therapists specialize in restoring independence in patients of all ages who exhibit impairments in physical,psychological or cognitive function.A comprehensive assessment helps our therapists to develop individualized plans of care that enable a patient to systematically overcome barriers in social and functional participation.We provide a thorough analysis of daily living activities and share recommendations to assist patients in resuming life roles.

Occupational Therapy focuses on the performance of functional activities such as self-care,functional mobility,home management,perception,cognition and psychosocial functioning.The occupational therapist specializes in managing splinting and other adaptive equipments for upper extremity function,hand injuries and pediatric rehabilitation.Occupational therapist may employ motor retraining,fine motor coordination and dexterity activates,skill-building,activates of daily living training,Splinting,assertive communication techniques,wheelchair assessments and modifications,goal-setting & problem solving strategies,home management tasks,prevocational skills,self-care and transfer training,sensory-integration techniques, Stress-management and coping strategies,time-management methods,etc.

They assist in environment modifications such as adapted commode,tub seats,grab bars,shower chairs,non-skid flooring,ramps and handrails,wheelchair seating and positioning aids.

Speech and Language Pathology

Speech and Language Pathology focuses on evaluation and treatment of a variety of communication,cognitive and swallowing disorders in acute Inpatient and Outpatient setting for all ages.These are related to neurological or organic conditions an injuries as well as development delays.Programmes include Neurological Rehabilitation for Dysarthria,Aphasia,Cognition,Dysphagia,Voice Disorders,Fluency disorders,Memory etc.

A speech therapist provides specialized Oral Myofunctional Therapy to correct an imbalance between the tongue and facial muscles used at rest and for swallowing.

Speech language pathologists are trained to treat disorders of speech,language,cognition,or motor,voice,swallowing and hearing.They help to restore cognitive,memory,speech,language and swallowing skills.

Who can visit?

Individuals Suffering from any medical condition that is limiting their physical function and impairing their quality of life can visit our department,Our areas of clinical expertise include:

Neurological Rehabilitation: Stroke,Head Injury,Spinal Cord Injury,Guillain Barre Syndrome,Myelopathy,Myopathies,Parkinson’s Disease,Motor Neuron Disease,Movement Disorders,Balance & Coordination Disorders,Cognitive Disorders,etc.
Musculoskeletal Rehabilitation: Neck & Back pain spondylosis,disc prolapse,etc.Frozen Shoulder ,knee pain Osteoarthritis,Bursitis,ligament injuries.Sports injuries like AnkleSprain,Rotator cuff tears,Impingement syndrome,Rehabilitation following AGL repair,hip/knee replacement, Osteoporosis,Deconditioning due to chronic Illness,Rheumatological disorders,Mobilization following surgery,fractures,polytrauma.
Pediatric Rehabilitation: This inter-disciplinary programme is for infants and childern.Services are provided in the treatment of physical disabilities,developmental delay,congenital deformities,n euro-sensory impairments,orthopedic injuries and communication disorders.Our pediatric therapists have special training in the areas of development hand function,Neuro-Development Treatment (NDT),handwriting,proprioceptive neuromuscular facilitation,sensory integration .Services are available for conditions like:Cerebral Palsy,Development Disorders,Autism,pre-maturity,Attention Deficit Disorder, Brain Injury,Specific Learning Disorders,Visual Perceptual Difficulties,Down’s syndrome,Feeding Problems,Hearing Impairments,Speech Delay,Multiple Disabilities,etc.
Geriatic Rehabilitation: A Balance and coordination issues,Fall risk assessment,Fall Prevention Programme .This programme will help improve balance,endurance,muscle strength and coordination so that they can perform day-to-day tasks comfortably thereby improving quality of life.
Cardio Pulmonary Rehabilitation: This aims to prevent and minimize impairments secondary to cardiac or pulmonary illnesses and improve fitness & the quality of life of patient.Individualized rehab programme which cover exercise schedule,education and lifestyle modification are designed based on the needs and abilities of patients.Services are available for condition like:Post Myocardial infarction,Post CABG,Stable angina,Valvular heart diseases,At risk cardiac patients,Obstructive/restrictive airway disease,etc.
Chronic Pain Management: Our holistic rehab approach including counseling,interventional pain procedures and therapeutic modalities helps the patients to overcome chronic pain syndromes like Fibromyalgia,Myofascial pain syndrome,Repetitive strain injuries,Failed Back syndrome,plantar fasciitis,Tendo-Achillits,Retrocalcaneal bursitis(Heel pain),etc.
Cancer Rehabilitation: Lymphedema management,Endurance training,Pain management etc.
Women’s Health Issues: Ante natal and post natal exercise programmes,Pelvic Pain Management,Urinary Incontinence,Pre or Post natal Postural/Musculoskeletal pain.
Vestibular/Balance Disorders Evaluation and Treatment: Vestibular Rehabilitation serves patients with dizziness and other related balance problems.It consists of a comprehensive evaluation and a stage by stage progressive treatment plan to alleviate the symptoms,identity possible triggers and minimize recurrence.
Amptuee Rehabilitation: Pre amputation assessment and counselling,prescription and checkout of prosthesis and prosthesis related musculoskeletal problems.
Fitness Programme Prescription: For those planning to join Gym.
Ergonomics /Onsite Workstations Evaluations: Ergonomics Awareness and Training to prevent Repetitive Strain Injury(RSI) and other Work Related Musculoskeletal Disorders(WRMSDs).

Total Anomalous Pulmonary Venous Connection(TAPVC): Images, Procedure

Single ventricle defects :

Shortly after birth, the baby will be given an injection of medication called prostaglandin. This will encourage the mixing of oxygen-rich blood with oxygen-poor blood. The condition will then need to be treated using a three-stage surgical procedure.

Tetralogy of Fallot :

Tetralogy of Fallot is treated using surgery. If the baby is born with severe symptoms, surgery may be recommended soon after birth.
If the symptoms are less severe, surgery will usually be carried out when the child is three to six months old.

During the operation, the surgeon will close the hole in the heart and open up the narrowing in the pulmonary valve.

Total anomalous pulmonary venous connection :

Total anomalous pulmonary venous connection (TAPVC) is treated with surgery. During the procedure, the surgeon will reconnect the abnormally positioned veins into the right position in the left atrium.

Once the baby’s health has stabilised, it is likely surgery will be recommended. This should ideally be carried out during the first month of the baby’s life. A surgical technique called arterial switch is used. This involves detaching the arteries and reattaching them in the correct position.

Truncus arteriosus :

Surgery is used to treat truncus arteriosus. This is usually carried out within a few weeks after birth.
The abnormal blood vessel will be split in two to create two new blood vessels, and each one will be reconnected in the correct position..

Surface Brain Tumor Surgery: Images, Procedure

Meningiomas or surface brain tumors are the second most common primary tumors affecting the central nervous system. Meningiomas grow from cells of the middle layer of the meninges (the three membranes enveloping and protecting the brain and spinal cord). They often are found at the surface of the brain near the top of the head, at the base of the skull, and along the spinal cord.


Meningiomas grow very slowly and conform to the space around them, often going undetected for years. However, this also means they may grow to be very large before causing any noticeable symptoms. Symptoms eventually occur when a tumor puts pressure on brain tissue or other structures like the optic nerve (which controls sight) or important veins that allow blood to flow within the brain.

Common symptoms include:

Nausea and/or vomiting
Muscle weakness
Loss of movement or sensation in a specific area
Changes in mood and sleep
Vision problems like blurriness or double-vision
Hearing loss
Slurred speech


Imaging Studies
MRI (Magnetic Resonance Imaging)
Neurovascular Angiography

Ventricular Septal Defects: Images, Procedures

Septal defects

The treatment of ventricular and atrial septal defects depends very much on the size of the hole. No treatment will be required if your child has a small septal defect that does not cause any symptoms or stretch on the heart

For larger ventricular septal defect, surgery is usually recommended to close the hole.

If there is a large atrial septal defect, this can be closed with an umbrella device inserted with a catheter. If the defect is too big or not suitable for the umbrella, surgery may be needed to close the hole.

Single ventricle defects

Shortly after birth, the baby will be given an injection of medication called prostaglandin. This will encourage the mixing of oxygen-rich blood with oxygen-poor blood. The condition will then need to be treated using a three-stage surgical procedure.

Tetralogy of Fallot

Tetralogy of Fallot is treated using surgery. If the baby is born with severe symptoms, surgery may be recommended soon after birth.
If the symptoms are less severe, surgery will usually be carried out when the child is three to six months old.

During the operation, the surgeon will close the hole in the heart and open up the narrowing in the pulmonary valve.
Total anomalous pulmonary venous connection

Total anomalous pulmonary venous connection (TAPVC) is treated with surgery. During the procedure, the surgeon will reconnect the abnormally positioned veins into the right position in the left atrium.

Once the baby’s health has stabilised, it is likely surgery will be recommended. This should ideally be carried out during the first month of the baby’s life. A surgical technique called arterial switch is used. This involves detaching the arteries and reattaching them in the correct position.

Truncus arteriosus

Surgery is used to treat truncus arteriosus. This is usually carried out within a few weeks after birth.
The abnormal blood vessel will be split in two to create two new blood vessels, and each one will be reconnected in the correct position..

Congenital Heart Diseases: Images, Procedures

Congenital heart disease is a general term for a range of birth defects that affect the normal workings of the heart. The term congenital means the condition is present at birth.

Why it happens?

In most cases, no obvious cause of congenital heart disease is identified. However, there are some things known to increase the risk of the condition, including:

Down’s syndrome – a genetic disorder that affects a baby’s normal physical development and causes learning difficulties
He mother having certain infections, such as rubella, during pregnancy
The mother having poorly controlled type 1 diabetes or type 2 diabetes

Types of congenital heart disease

There are many types of congenital heart disease. Some of the more common defects include:

Septal defects
Coarctation of the aorta
Pulmonary valve stenosis
Transposition of the great arteries

Treating congenital heart disease

The treatment for congenital heart disease usually depends on the defect you or your child has.
Modern surgical techniques can often restore most or all of the heart’s normal function, and nowadays about 80% of children with congenital heart disease will survive into adulthood.
Symptoms of congenital heart disease

Congenital heart disease can have a range of symptoms, as the condition refers to several different types of heart defect.

General symptoms of congenital heart disease can include:

excessive sweating
extreme tiredness and fatigue
poor feeding
rapid heartbeat
rapid breathing
shortness of breath
Chest pain
Ablue tinge to the skin (cyanosis)

In more severe cases, these problems may develop shortly after birth. However, symptoms sometimes don’t develop until the teenage or early adulthood.


Children and adults with congenital heart disease can also develop a range of further problems, such as:

problems with growth and development
repeated respiratory tract infections (RTIs)
heart infection (endocarditis)
pulmonary hypertension
heart failure

Aortic valve stenosis

If treatment is required, a procedure called a balloon valvuloplasty is often the recommended treatment option.

During this procedure a small tube (catheter) is passed through the blood vessels to the site of the narrowed valve. A balloon attached to the catheter is inflated, which helps widen the valve and relieve any blockage in blood flow.

If balloon valvuloplasty is ineffective or unsuitable, it is usually necessary to remove and replace the valve using open heart surgery.

Coarctation of the aorta

In less serious form of coarctation of the aorta in later life, the main goal of treatment will be to control their high blood pressure. This will usually involve using a combination of diet, exercise and, in some cases, medication.

In more serious form of coarctation of the aorta that develops shortly after birth, surgery to restore the flow of blood through the aorta is usually recommended.

Ebstein’s anomaly

If Ebstein’s anomaly is mild, it does not require treatment. If the valve is very leaky, surgery to repair the abnormal tricuspid valve is usually recommended.

Patent ductus arteriosus

Many cases of patent ductus arteriosus (PDA) can be treated with medication shortly after birth.If PDA does not close with medication, the duct may be sealed with a coil or plug, which is implanted using a catheter.

Pulmonary valve stenosis

Mild pulmonary valve stenosis does not require treatment as it does not cause any symptoms or problems.More severe cases of pulmonary valve stenosis usually require treatment

As with aortic valve stenosis, the main treatment for pulmonary valve stenosis is a balloon pulmonary valvuloplasty. However, if this is ineffective or the valve is not suitable for this treatment, surgery may be needed to open the valve (valvotomy).