PTOSIS
What is ptosis?
Ptosis is drooping of the eyelid. The eye appears smaller, there is difficulty opening th e eye. Ptosis may occur in one eye or both eye. There is obstruction of vision and a sleepy and tired appearance.

Why does ptosis occur?
There is a muscle in the upper lid, called the levator- the function the levator is the lift the eyelid open. If the levator is not working well, the eyelid droops.
In many patients who have ptosis since birth, the levator muscle is weak since birth.
In patients where ptosis starts later in life, there may be multiple causes : injury, age, use of contact lens for many years, some neurological diseases.

Do we need to consult a neurologist?
A small proportion of ptosis stems from neurologic diseases. Usually the oculoplasty surgeon is able to differentiate these on examination. They will then refer you to a neurologist.

How important is it to correct ptosis?
For an adult, a ptosis can block part of the visual field, obstructing the vision. There can be strain by lifting the brow muscles to compensate. More and more people opt for ptosis correction to avoid looking tired, sleepy and unhappy.

In a child, the ptosis may cause delay in the development of vision, and a lazy eye (amblyopia). This has to be corrected at a young age, and appropriate glasses and exercise started. Once the patient is older, vision correction cannot be achieved. It is extremely important to have an accurate assessment of vision in a child with ptosis.

What are the methods of correction of ptosis?
The oculoplasty surgeon assesses the measurements of the eye. If the natural muscle can be strengthened with stitches, that is the method of choice. If the natural muscle levator is too weak for correction, an implant (most commonly silicone) is places to connect the forehead muscles and the eyelids. The patient can then effectively use the forehead muscle to lift the eyelid.
Some neurologic diseases such as myasthenia can be treated by oral medicines.
Rarely, there are some ptosis patients where it is not safe to do surgery. These patients are recommended crutch glasses, spectacles which prop the eye open.

What are the outcomes with ptosis surgery?
After ptosis surgery, the final outcome is known at 6 weeks .This is because each person’s body heals in a slightly different way, and a small percentage of uncertainty remains. Eight of ten patients have the eyelid set exactly at the correct height, two may be little higher or lower.

Usually the eyelid height is equal when the patient looks forward, but some difference is seen when the patient looks upward or downward. In a few patients, when the patient sleeps after surgery, a small gap may remain open in the eyelids. A silicone sling when used, has greater flexibility, allows natural blinking, and can be re-adjusted if required.

Article by
Narayana nethralaya

WHAT IS GLAUCOMA?

Glaucoma is a disease of the nerve for vision (optic nerve) caused by increased pressure in the eye.

HOW DOES GLAUCOMA OCCUR?
Glaucoma : The inside of the eye contains a fluid, which is being produced and drained out of the eye constantly. It is drained through a sieve like structure situated at the angle between the transparent cornea and the brown coloured iris. When the drainage mechanism becomes ineffective, the pressure in the eye (intra-ocular pressure) increases leading to optic nerve damage.

WHAT ARE THE EFFECTS OF GLAUCOMA?
Glaucoma can lead to permanent loss of vision. Initially, the loss of vision starts from periphery and progressively affects the central vision. The central visual acuity is affected only in the advanced stage.

Progressive loss of visual field with corresponding loss optic nerve damage
Progressive loss of visual field with corresponding loss optic nerve damage

ARE ALL THE GLAUCOMAS SAME?
No, there are many types of glaucoma. Some of these are:

Open angle glaucoma, in which, despite of open drainage angle, the drainage does not occur
Angle closure (closed angle) glaucoma, in which, the angle itself is closed preventing fluid drainage
Secondary glaucoma, which occurs due to other eye disease or treatment
Glaucoma3

HOW DO I KNOW WHETHER I HAVE GLAUCOMA?
95% patients with glaucoma do not have any sypmtoms. Glaucoma is a silent disease that cannot be detected or felt by the patient since central vision remains unaffected till the late stages of the disease. Hence it is rightly called as the ‘sneak thief of sight’. It is usually detected during a routine eye checkup.

WHEN SHOULD I GO FOR EYE CHECKUP?
Everyone over the age of 40 years should have a detailed eye check up, at least when one needs reading glasses. Hence it is advisable to not stop with visiting an optician alone.
Those who have additional risk factors should undergo an early evaluation.

WHAT ARE THE RISK FACTORS ASSOCIATED WITH GLAUCOMA?
If you

have blood relatives with glaucoma
have diabetes mellitus, hypertension, or thyroid disease
are near sighted
are on treatment with steroids (in the form of tablets, skin ointments, inhalers, eye drops)
have a history of trauma
You will need an early check up if you have any of the above symptoms.

WHAT ARE THE TESTS I NEED TO UNDERGO?
Tests help in finding out the presence of glaucoma and also its progression in the subsequent follow ups.
These tests include;

Tonometry: To measure the pressure in the eye
Gonioscopy: To assess the drainage angle
Ophthalmoscopy: To view the optic nerve
Pachymetry: To check the thickness of cornea
Perimetry: To assess the field of vision
All these tests are painless.

WHAT IS THE TREATMENT?
Glaucoma is a treatable disease that needs early detection as the damage is not reversible. The treatment can include medicines, laser or surgery.
The medicines either decrease the production of the fluid or increase the drainage of the fluid so as to keep the eye pressure under control as determined by your doctor. You may need lifelong treatment as per the instructions given by doctor.
Lasers are used in the treatment of glaucoma to increase the flow of fluid.
When medical or laser treatment fails, you may need surgery.

DOES TREATMENT RESTORE THE LOST VISION?
Treatment of glaucoma aims at preserving the existing vision; it does not restore the vision that is already lost. Therefore, early detection and treatment are very important.

SPECIALIZED TESTS FOR GLAUCOMA
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INSTRUMENTS USED FOR DIAGNOSIS OF GLAUCOMA
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FLOWCHART FOR INITIAL EVALUATION OF A GLAUCOMA PATIENT
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Department of Glaucoma at Narayana Nethralaya is equipped with the latest diagnostic facilities including,

Perimeters – Humphrey Visual Field Analyser, VFA Octopus and Humphrey Matrix.
Retinal Nerve Fiber Layer Analysers
– Optical Coherence Tomography (OCT)
– GDX
– Heidelberg Retinal Tomogram (HRT-3)
Ultrasound Pachymetry.
Ultrasound Biomicroscopy.
Anterior Segment OCT (AS-OCT).
Newer Tonometers – Tonopen, I-Care, Dynamic Contour Tonometer, ORA.

Article by

Narayana Hospitals
Bangalore

Bilio-pancreatic Diversion:

The DS is more effective in achieving excellent weight loss in the extremely obese. In the DS, a sleeve resection of the stomach is performed by removing about 2/3 of the stomach, maintaining continuity of the gastric lesser curve. The stomach remains attached the first segment of the small intestine, the duodenum, which allows pylorus, the valve that controls food drainage from the stomach, to be left intact. The 2nd part of duodenum is then separated from the rest of the small intestine. The duodenum is then attached to the lowest part of the small intestine, bypassing the majority of the second and third segments of the small intestine. The small intestines are arranged so that the section where the food mixes with the digestive juices is fairly short. No small intestine is defunctionalized.

Bilio Pancreatic
Who needs BPD-DS?

Same as Gastric bypassPeople who want to eat normally
Advantages

The primary advantage of duodenal switch (DS) surgery is that it results in a very high percentage of excess weight loss for obese individuals, with a very low risk of significant weight regain.Various clinical studies showed resolution of type 2 diabetes [90%], hyperlipidemia [95%], sleep apnea [90%], and hypertension [80%]. The results are so favorable that some surgeons are performing the “switch” or intestinal surgery on non-obese patients for the benefits of curing the diabetes.Because the pyloric valve between the stomach and small intestine is preserved, people who have undergone the DS do not experience the dumping syndrome common with people who’ve undergone the Roux-en-Y gastric bypass surgery.Diet following the DS is more normal and better tolerated than with other surgeries. The malabsorptive component is fully reversible.Liver problems are much less frequent and the procedure essentially eliminates stomal ulcer.
Risks and Complications:

The malabsorptive element of the DS requires that those who undergo the procedure take vitamin and mineral supplements above and beyond that of patients having the gastric bypass surgery.Like Gastric bypass patients, DS patients require lifelong and extensive blood tests to check for deficiencies in vitamins and minerals. Follow-up care is non-optional and must continue for as long as the patient lives.DS patients also have a higher occurrence of smelly flatus and diarrhea, although both can usually be mitigated through diet, including avoiding simple carbohydrates and fatty foods

Article by
Columbiaasia Hospitals
Bangalore

Gastro Esophageal Reflux Disease (GERD) is a condition in which the contents of the stomach are regurgitated into the esophagus (the tube that carries food from your mouth to your stomach). This is also called “Acid Reflux.” Gastroesophageal refers to the stomach and esophagus and Reflux refers to regurgitation or return of the contents. Therefore, gastroesophageal reflux is the regurgitaion of the stomach’s contents back up into the esophagus.

Many people, including pregnant women, suffer from various symptoms and indications of GERD such as heartburn or acid indigestion. Mostly, heartburn can be relieved through dietary and lifestyle changes. At times, heartburn is also believed to be caused by hiatal hernia. However, in many cases, it may require medication or surgery.

In the process of normal digestion, the Lower Esophageal Sphincter (LES) opens up and allows food to pass through to the stomach thus preventing food, acid and other juices to flow back into the esophagus.

A weak or inappropriately relaxed LES allows the stomach’s contents to flow up into the esophagus, thus causing gastroesophageal reflux.

The severity of GERD depends on level of LES dysfunction and on the type and amount of fluid brought up from the stomach and on the neutralizing effect of saliva.
Some factors that may cause GERD:

Dietary Factors
Shorter dinner to bed time
High fat diet
Obesity
Smoking
Lifestyle associated factors
Stress
Major life events and alcoholic events
Family history

Symptoms

Following are the most common symptoms for people with GERD:

Heartburn: Commonly after a meal.
Regurgitation: Regurgitation can produce a sour or bitter taste, and you may experience a “wet burp” or even vomit some contents of your stomach.
Stomach Pain
Abdominal bloating/Gas
Acidity
Excessive Burping
Nausea
Trouble Swallowing
Asthma: Refluxed acid can worsen asthma by irritating the airways and the medications used to treat it can make GERD worse.
Sore Throat: If acid reflux gets past the upper esophageal sphincter, it can enter the throat (pharynx) and even the voice box (larynx), causing sore throat.
Excessive Night Cough/Excessive Dry Cough: Chronic dry cough, especially at night. GERD is a common cause of unexplained coughing. It is not clear how cough is caused or aggravated by GERD.
Sudden increase of saliva
Bad breath
Ear aches

Article By
Fortis Healthcare
Bangalore

Growth failure (eg. Short stature, Growth hormone deficiency, Turner syndrome etc):

Children go through an amazing process called ‘growth’. Growth includes not just increase in height and weight, but also various developmental and physical milestones which a child is expected to achieve during childhood and adolescence. Growth depends on various factors such as hormones, nutrition, genetic make up of the child and underlying disease. Growth is monitored using serial height and weight measurements and plotting them on a growth chart. It is good to maintain growth record for children from birth. You should be concerned and seek medical opinion if your child is

1. shortest in the class.
2. not outgrowing his/her dresses.
3. very short when compared to siblings/ parents.
4. falling off the centile on growth chart.
Some of the conditions which cause short stature (lack of growth hormone, Turner syndrome etc) can be treated with growth hormone therapy.

Article by
Apollo Hospitals

Respiratory Care

Our Pulmonary services cover the entire spectrum of Respiratory Care and Chest Medicine, ranging from lung disease prevention and detection to pharmacologic and interventional treatment. We have specialized Pulmonary medicine expertise with the most sophisticated techniques and technologies available to diagnose and treat many patients with chest and respiratory problems The disease spectrum includes the following:

1.Airway Disorders such as Asthma, bronchitis, COPD, and Bronchiectesis The incidence of asthma, bronchitis, chronic cough, and recurrent respiratory infections and other airway disorders is on the rise in India in general, and urban cities in particular. We are a specialized center for preventive, educational and treatment aspects of asthma, COPD and other airway disorders and provide comprehensive services to take care of these patients.

2.Pleural diseases such as pleural effusion and pneumothorax

3.Interstitial lung Disease (ILD), including Sarcoidosis and IPF

4.Pulmonary Vascular disease, including Pulmonary Hypertension, Pulmonary embolism and others

5.Lung Cancer, and other forms of cancer which affects the lungs 6.Shortness of breath due to any cause

7.Peri-operative care of patients with lung disease

8.Respiratory care of Neuromuscular disease such as motor neuron disease, kyphoscoliosis and so on

9.Smoking related lung disorders and smoking prevention.

10.Interventional Pulmonology: A unique specialty by itself

11.Sleep Disorders including Obstructive Sleep Apnea

We provide expertise in diagnosis and management of diseases such as obstructive sleep apnea, and other sleep disorders such as narcolepsy, restless leg syndrome, and insomnia. Our credentials include American Board Certification in Sleep Disorders medicine, and considerable experience with dealing with these disorders in India. These disorders play a major role to hypertension, cardiovascular disease, congestive heart failure, diabetes and stroke, and are strongly under diagnosed and untreated due to lack of knowledge and expertise.

Article by
Apollo Hospitals

Hand Microsurgery:
Surgery of the hand is a new speciality in our country. For the first time in the private sector, The Apollo Hospitals Group has developed a 24 hour state-of-the-art facility for comprehensive care of hand injuries at The National Institute in Hand Surgery, Microsurgery and Plastic Surgery. Apollo Hospitals, is one of the very few dedicated centers for treating hand injuries in the country.

Micro surgery is a sub-speciality performed with the aid of a microscope on structures that are barely visible to the naked eye. This sub-speciality mainly deals with ‘Replantations’ (reattaching severed parts of the limb). The department consists of senior consultants who have trained and worked at leading medical institutions in India and abroad.

Notable features of this department include:

A dedicated operating theatre, exclusively for hand and general trauma.Fully trained staff round the clockSenior consultants available on callLatest series of equipmentContinuity in management on individual basis
Apollo Hospitals offers surgical treatment for hand injuries and problems such as:

Congenital Abnormalities

The most common hand problems in infants are syndactyly (webbed fingers) and polydactyly (extra fingers). In all hand surgeries and especially pediatric hand surgeries at Apollo Hospitals, India atraumatic techniques (causing no tissue damage) are used.

Carpal Tunnel Syndrome

Carpal Tunnel Syndrome occurs most commonly due to the compression of the median nerve at the wrist where it passes through a narrow area called the carpal tunnel. The symptoms include numbness in the thumb, index, and middle fingers especially at night or upon waking up in the morning.

Carpal Tunnel Syndrome can be treated by releasing the constriction through endoscopic or minimal access surgery.

Arthritis

Reconstruction of painful arthritic deformities is performed routinely and includes tendon transfers, muscle release and joint displacement fusion.

Reconstructive Surgery (for tumors, nerve compression and arthritis)

Reconstructive hand surgery alleviates pain and helps correct deformities caused by tumors, nerve compression and arthritis. Many benign tumors of the hand and wrist don’t always cause pain and subside soon. However, when pain persists or limits necessary function, removal is recommended and is almost universally curative.

Microsurgery (for finger deformities)

Replantation of a single finger or multiple fingers can be done through microsurgery. Even if multiple finger amputation has been done, one or more fingers can be replanted in a position that will allow functioning of the hand. Replantation surgery will be followed by rehabilitative therapy for the hand.

Article by

Apollo hospitals

Cardiac emergencies are life threatening. They can arise due to various causes. Whatever may be the cause, the resulting damage is devastating. So the eponym “When the bolt strikes…” is indeed very appropriate to describe cardiac emergencies.

What is a Heart Attack?
“Heart Attack”, technically termed Myocardial Infarction, is a result of total blockage of the blood vessel (coronary artery) which supplies blood to the heart. The blockage is due to the formation of plug composed of cholesterol, blood cells, fibrin and calcium. The heart attack may manifest with a sudden onset of severe central chest pain described as heavy, compressing pain, which can radiate to the left hand, jaw or to the back. It is often associated with profuse sweating and weakness. The presentation can be so sudden that the patient suddenly collapses and becomes unresponsive with profuse sweating and cold peripheries.

A patient with the above mentioned symptoms has to be rushed to the nearest hospital equipped with ECG facilities and a physician / cardiologists on call. Emergency measures include supplemental oxygen through a face mask, pain relief with strong analgesics, intravenous access and initial dose of aspirin and statins (lipid lowering drug). Once the diagnosis of heart attack is confirmed, the treatment is initiated. The important aim of early institution of treatment is to save the heart muscle from damage following lack of blood supply. Blood thinning medications, drugs that improve demand-supply imbalance (beta blockers), drugs that reduce blood cholesterol (statins) and drugs that improve the remodeling of the heart after the attack (ACE inhibitors) form the mainstay of management of heart attacks.

However, the most important component of the treatment consists of Conventional Thrombolytic Therapy -Using clot dissolving medications like Streptokinase, Urokinase or Recombinant TPA to improve blood flow.

Primary Percutaneous Coronary Intervention or Primary Angioplasty (PCI)-An emergency coronary angiogram (to visualize the blockade) followed by balloon Angioplasty with stenting thereby improving the blood flow.

Both methods have got their own merits and demerits. Advantages of primary PCI are that the blockage is visualized, opened and stented, ensuring normal blood flow. The chances of recurrent heart attack, recurrent block and death are less when compared to the clot dissolving medications. Disadvantages include inadequate availability of cathlabs with trained professionals who could perform PCI, and the high cost of the procedure.

Thrombolysis with clot dissolving medications is a time-tested method of treatment. The chief advantage is its universal availability at affordable cost. The disadvantages are the lesser degree of blood flow improvement (54% success rate when compared to 93-98% success with primary PCI), bleeding complications and allergic reactions.

Whatever may be the modality of treatment, the earlier it is instituted the better will be the outcome for the patient. The first one hour is called “The Golden hour” and if treatment as described above is given, the complications and mortality are significantly reduced.

Complications of heart attack:
Cardiogenic shock

If even after thrombolysis the patient continues to have chest pain and develops low blood pressure he is said to be in “cardiogenic shock”. “Rescue PCI” is done for such patients to delineate the blood supply to the heart and open the occluded blood vessel. Such patients in cardiogenic shock will benefit from mechanical support to augment the blood pressure to ensure adequate blood supply to the heart and brain. This is done by inserting an intra aortic balloon pump (IABP) through an artery in the leg. IABP is a mechanical device in which a balloon is intermittently inflated by Helium from an external control, which will augment the patient’s blood pressure and improve the pumping of the heart. This offers temporary support and gives time for the heart to heal.

Rhythm Disturbances

At times a patient presenting with a heart attack can present with heart rhythm disturbances. The heart rate can be fast or slow. If the heart rate is slow it is temporarily increased by implanting a temporary pacemaker within the heart. If the heart rate is very fast it is controlled either by medications or DC electric shock, which is given externally over the chest.

Heart Failure

The heart can fail to pump resulting in low oxygen levels in blood and fluid accumulation in lungs, which sometimes may require ventilatory assistance.

Septal Rupture

Occasionally the heart muscle gives way at the partition between two ventricles (septum) resulting in a communication between left and right ventricles. This is termed ventricular septal rupture and this affects the overall pumping function of the heart. The valve of the left side of heart can start leaking secondary to the attack and this can worsen the pump failure. Such patients require early intervention followed by emergency surgical correction of the problem. TA patient who is being taken up for an emergency angiogram with the aim to do PCI may even end up undergoing emergency bypass surgery if the blocks are multiple and present in all blood vessels.

In an occasional patient, the heart can rupture at its weakest point and blood collects within the pericardium (layer surrounding the heart). Such a complication almost always results in catastrophe.

How is a heart attack treated?
The routine management of a case of heart attack (with no complications) will require 5-7 days of hospitalization with initial CCU care for stabilization in the initial 48-72 hours. The patient is then subjected to further investigation by way of coronary angiogram, based on which the post heart attack treatment is decided. The treatment could be either medical, PTCA (Angioplasty) or CABG surgery (Bypass surgery).

Prior to discharge, counseling for the patient is mandatory regarding regular follow up (6 months to one year), continuation of medications, life style modification, smoking cessation, physical exercise, tight control of sugar and blood pressure levels and strict diet control.

Efficacy in timely management of a case of heart attack and its complication depends on a good Critical Care Unit and is a combined effort of the Cardiologist and Intensivist along with efficient nursing care. Good surgical back up with a competent cardiothoracic surgical team also contribute immensely to successful management of heart attack.

It is here that a centre like Apollo Hospitals has the edge over other facilities as it possesses every advantage for the successful management of a patient with heart attack, including world class cardiologist and cardiothoracic surgeons, state of the art Cath Labs and Operating Rooms, a highly efficient Critical Care Unit and a renowned Emergency care facility including timely and effective ambulance services, thus making it a one stop facility for successful outcomes after a heart attack

Why do some people get Heart Attacks? Can one prevent it?
When many lakhs of cars are moving on the roads only a few cars meet with accidents. Cars with defective brakes, gears or non-aligned tyres have increased chances of accidents. Likewise, extensive clinical and statistical studies have identified several factors that increase the risk of coronary heart disease and heart attack.

Major risk factors are those that research has shown significantly increase the risk of heart and blood vessel (cardiovascular) disease. Other factors are associated with increased risk of cardiovascular disease, but their significance and prevalence haven’t yet been precisely determined. They are called contributing risk factors.

The American Heart Association has identified several risk factors. Some of them can be modified, treated or controlled, and some can’t. The more risk factors you have, the greater your chance of developing coronary heart disease. Also, the greater the lever of each risk factor, the greater the risk. For example, a person with a total cholesterol of 300 mg/dL has a greater risk than someone with a total cholesterol of 245 mg/dL, even though everyone with a total cholesterol greater than 240 mg/dL is considered high-risk.

Non-modifiable Risk Factors:

Increasing age:

Over 83 percent of people who die of coronary heart disease are 65 or older. At older ages, women who have heart attacks are more likely than men are, to die from them within a few weeks.

Gender:

Men have a greater risk of heart attack than women do, and they have attacks earlier in life. Heredity (including Race): Children of parents with heart disease are more likely to develop it themselves. Just as you can’t control your age, sex and race, you can’t control your family history. Therefore, it’s even more important to treat and control any other risk factors you have.

Modifiable Risk Factors:

Smoking:

Smokers’ risk of developing coronary heart disease is 24 times that of nonsmokers. Cigarette smoking is a powerful independent risk factor for sudden cardiac death in patients with coronary heart disease. Exposure to other people’s smoke increases the risk of heart disease ever for nonsmokers.

People who stop smoking at 60 years gain 3 years extra life, at 50 years-6 years, at 40 years – 9 years and at 30 years – 10 years. Smoking also totally cancels the actions of Aspirin, a cardiovascular protecting drug and cancels 75% of the actions of Statins.

High blood cholesterol:

As blood cholesterol rises, so does risk of coronary heart disease. When other risk factors such as high blood pressure and tobacco smoke are present, this risk increases even more. A person’s cholesterol level is also affected by age, sex, heredity and diet.

High blood pressure:

High blood pressure increases the heart’s workload, causing the heart to thicken and become stiffer. It also increases your risk of stroke, heart attack, kidney failure and congestive heart failure. When high blood pressure exists with obesity, smoking, high blood cholesterol levels or diabetes, the risk of heart attack or stroke increases several times.

Physical inactivity:

An inactive lifestyle is a risk factor for coronary heart disease. The more vigorous your activity, the greater are your benefits. However, even moderate-intensity activities help if done regularly. Exercise can help control blood cholesterol, diabetes and obesity, as well as help lower blood pressure in some people. Doctors have liberalized the physical activity programmes as anywhere and at any time.

Obesity:

People who have excess body fat especially if a lot of it is at the waist are more likely to develop heart disease and stroke even if they have no other risk factors. Excess weight increases the heart’s work. It also raises blood pressure and blood cholesterol and triglyceride levels, and lowers HDL (“good”) cholesterol levels. It can also make Diabetes more likely to develop. Many obese and overweight people may have difficulty losing weight. But by losing even as few as 10 pounds, you can lower your heart disease risk.

Diabetes mellitus:

Diabetes seriously increases your risk of developing cardiovascular disease. Even when glucose (blood sugar) levels are under control, Diabetes increases the risk of heart disease and stroke, but the risks are even greater if blood sugar is not well controlled. About three-quarters of people with Diabetes die of some form of heart or blood vessel disease. If you have Diabetes, it’s extremely important to work with your healthcare provider to manage it and control any other risk factors you can.

Stress:

Individual response to stress may be a contributing factor. Some scientists have noted a relationship between coronary heart disease risk and stress in a person’s life, their health behaviors and socioeconomic status. These factors may also affect established risk factors. For example, people under stress may overeat, start smoking or smoke more than they otherwise would. Alcohol: Drinking too much alcohol can raise blood pressure, cause heart failure and lead to stroke. It can contribute to high triglycerides, cancer and other diseases, and produce irregular heartbeats. It also contributes to obesity, alcoholism, suicide and accidents.

Article by
Apollo Hospitals

COMPREHENSIVE HEALTH CHECK FOR FEMALE

Women should get regular health checkup every year or as per recommended by the doctor. Regular checkups can help pick up early signs of any health disorder. With increasing prevalence of cardiac diseases, diabetes and cancer in women, it is very important to keep an update of the health to discover the disease earlier when the treatment is often effective.

Benefits of the Package:

• Designed to suit basic needs of a woman for a health checkup

• Consultations with our medical experts

• Early disease detection for complete protection

• Use of latest technology for perfect assessment of the health

INVESTIGATIONS

• CBC

• ESR

• Blood grouping & RH typing

• Urine routine & microscopy

• Stool routine

• Peripheral Smear

• Audiometry

• Pap Smear

• Chest X ray

• Ultrasound abdomen & pelvis

• Sonomammogram(Less than 40 yrs)/Mammogram (Above 40yrs)

DIABETES EVALUATION

• Fasting Blood Sugar

• Post Prandial Blood Sugar

Lipid Profile

• Total Cholesterol

• HDL

• LDL

• VLDL

• Triglycerides

Liver Function Test

• Alkaline Phosphatase

• SGOT

• SGPT

• GGPT

• Albumin

• Globulin

• Total Protein

• Total & Direct Bilirubin

KIDNEY PROFILE

• SR CREATININE

• SR Uric Acid

• Calcium

• Phosphorus

• BUN

Thyroid Profile

• T3

• T4

• TSH

CARDIAC RISK EVALUATION

• ECG

• ECHO Screening/Tread Mill Test

CONSULTATIONS

• Physical examination

• Opthalmology Consultation

• Dental

• Diet Consultation

• Physician Consultation

• Gynecology Consultation

Medical Reports

Instructions

• Please be fasting from 10:00 p.m. the previous night and report to Manipal Hospitals at 08:00 a.m. on the day of the Health Check.

Article by
Manipal Hospitals

The implants themselves are tiny titanium posts, which are inserted into the jawbone where teeth are missing. These metal anchors act as tooth root substitutes. They are surgically placed into the jawbone. The bone bonds with the titanium, creating a strong foundation for artificial teeth. Small posts are then attached to the implant, which protrude through the gums. These posts provide stable anchors for artificial replacement teeth.

Implants also help preserve facial structure, preventing the bone deterioration that occurs when teeth are missing.

The Surgical Procedure

For most patients, the placement of dental implants involves two surgical procedures. First, implants are placed within your jawbone. For the first three to six months following surgery, the implants are beneath the surface of the gums gradually bonding with the jawbone. You should be able to wear temporary dentures and eat a soft diet during this time. At the same time, your dentist is forming new replacement teeth.

After the implant has bonded to the jawbone, the second phase begins. Our doctors will uncover the implants and attach small posts, which will act as anchors for the artificial teeth. These posts protrude through the gums. When the artificial teeth are placed these posts will not be seen. The entire procedure usually takes six to eight months. Most patients experience minimal disruption in their daily life.

Surgical Advances

Using the most recent advances in dental implant technology, our doctors are able to place single stage implants. These implants do not require a second procedure to uncover them but do require a minimum of six weeks of healing time before placing artificial teeth on them. There are even situations where the implants can be placed at the same time as a tooth extraction further minimizing the number of surgical procedures. Advances in dental implant technology have made it possible in select cases, to extract teeth, and place implants with crowns at one visit. This process, called “immediate loading” greatly simplifies the surgical process.

Who actually performs the implant placement?

Implants are a team effort between an Oral and Maxillofacial Surgeon and a prosthodontist. While our doctor performs the actual implant surgery, and initial tooth extractions and bone grafting if necessary, the prosthodontist fits and makes the permanent prosthesis.

What types of prostheses are available?

A single prosthesis (crown) is used to replace one missing tooth – each prosthetic tooth attaches to its own implant. A partial prosthesis (fixed bridge) can replace two or more teeth and may require only two or three implants. A complete dental prosthesis (fixed bridge) replaces all the teeth in your upper or lower jaw. The number of implants varies depending upon which type of complete prosthesis (removable or fixed) is recommended. A removable prosthesis (over denture) attaches to a bar or ball in socket attachments, whereas a fixed one is permanent and removable only by the dentist.

Our doctors perform in-office implant surgery in a hospital-style operating suite, thus optimizing the level of sterility. Inpatient hospital implant surgery is for patients who have special medical or anesthetic needs or for those who need extensive bone grafting from the jaw, hip or tibia.

Why dental implants?

Once you learn about dental implants, you finally realize there is a way to improve your life. When you lose several teeth – whether it’s a new situation or something you have lived with for years – chances are you have never become fully accustomed to losing such a vital part of yourself.
Dental implants can be your doorway to renewed self-confidence and peace of mind.

Why would you select dental implants over more traditional types of restorations?

There are several reasons: Why sacrifice the structure of surrounding good teeth to bridge a space? In addition, removing a denture or a “partial” at night may be inconvenient, not to mention that dentures that slip can be uncomfortable and rather embarrassing.

Are you a candidate for implants?

If you are considering implants, your mouth must be examined thoroughly and your medical and dental history reviewed. If your mouth is not ideal for implants, ways of improving outcome, such as bone grafting, may be recommended.

What type of anaesthesia is used?

The majority of dental implants and one graft can be performed in the office under local anaesthesia, with or without general anesthesia.

Do Implants need special care?

Once the implants are in place, they will serve you well for many years if you take care of them and keep your mouth healthy. This means taking the time for good oral hygiene (brushing and flossing) and keeping regular appointments with your dental specialists.

Article by
sparsh hospitals