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Rheumatology: Procedures

Rheumatology

Rheumatology in modern terms is called Clinical Immunology. It is now acknowledged that the under lying cause for a disease like rheumatism is a dysregulation of the normal functioning of the immune system. However for the sake of continuity and ease of identification among patients the term rheumatology is still retained and this branch is often referred to as Clinical Immunology and Rheumatology.

Therefore diseases resulting from the dysregulation (meaning altered regulation) of the normal functioning of the immune system, ( which often results in the immune system – which is meant to protect the body – turning on its own body and hence causing disease of the immune system ) can affect virtually any organ of the body, however the systems most commonly involved are
Joints : Disease of joints is called ARTHRITIS (which in turn are of many varieties)
Blood Vessels : Diseases of blood vessels are called VASCULITIS (and since blood vessels are ubiquitous in the body, any organ like the brain, heart, lungs, kidneys, gut, skin joint, muscle, etc can be affected)
Muscles : Disease affecting muscles is called MYOSITIS
Skin : Disease affecting the skin is called Systemic SCLEROSIS
Eyes : Disease affecting part of the eyes is called UVEITIS
Kidney : Disease of the kidney is collectively called NEPHRITIS
Soft Tissue Rheumatism : A group of conditions which are not included in the above but which can cause tremendous pain over the entire body called FIBROMYALGIA which is fairly commonly.
Chronic Fatigue Syndrome : A rarer condition in our country, the disorder causes pain at the insertion of muscles, tendons called ENTHESOPATHY or TENDINITIS respectively
Tenosynovitis : Inflammation around tendons and ligaments called TENOSYNOVITIS which can manifest as CARPAL TUNNEL SYNDROME or TRIGGER FINGERS
SLE (Systemic Lupus Erythematosus) : A chronic generalized inflammatory condition which is characterized by fever and affecting all or any combination of organs mentioned above. This condition is diagnosed by the presence of typical antibodies in the blood called ANA antibodies.

Ophthalmology: Procedure

Ophthalmology

Ophthalmology is the branch of medicine that deals with the anatomy, physiology and diseases of the eye. An ophthalmologist is a specialist in medical and surgical eye problems. Ophthalmology includes sub-specialities which deal either with certain diseases or diseases of certain parts of the eye.

Some of them are:

Anterior Segment Surgery
Retinal Ophthalmology – emphasis on LASER treatment of the retina and actual retinal surgery
Cataracts – not usually considered a subspecialty per se, since most general ophthalmologists perform cataract surgery
Cornea, Ocular Surface and External Disease
Glaucoma
Medical Retina deals with treatment of retinal problems through non-surgical means
Neuro-ophthalmology
Ocular Oncology
Oculoplastics & Orbit Surgery
Ophthalmic Pathology
Pediatric Ophthalmology/Strabismus (mis-alignment of the eyes)
Refractive Surgery
Uveitis
Immunology
Vitreo-retinal Surgery deals with surgical management of retinal and posterior segment diseases and disorders
Medical Retina and Vitreo-retinal Surgery sometimes together called posterior segment subspecialisation.

Dermatology & Cosmetology: Procedure

Dermatology & Cosmetology:

Skin is the largest organ of our body hence care needs to be taken to keep it healthy and glowing. Many factors like good and healthy nutrition, plenty of water and fluids, adequate exercise and sun protection add to the well being of our skin. A good nutrition consisting of green leafy vegetables, proteins, fruits, atleast 6 to 8 glasses of water every day is required to maintain a good skin texture and glow. Half an hour of moderate exercise everyday helps retain a good skin tone and a good sun block cream to protect your skin from the intense ultraviolet radiation reduces the effects of aging and protects your skin from skin cancers.
Dermatologis provide management and care for diseases related to skin, hair, nails, sexually transmitted diseases, cosmetology and dermatosurgical procedures.

Sub-specialities services of dermatology at NH include

Paediatric dermatology
Dermatosurgery
Cosmetology
Allergies All infections related to skin
Venereology

We treat common skin conditions like eczemas, psoriasis, vitiligo, leprosy, fungal, viral and common bacterial conditions. Others include hair disorders like baldness, hair loss, and nail disorders as well. All kinds of allergies along with sexually transmitted diseases and HIV are also treated.

In addition to our daily out-patient services, we carry out diagnostic and cosmetic procedures like skin biopsies, electrocautery for removal of skin tags, warts curettage of molluscum contagiosum, chemical peels for pigmentation and scars, treatment of acne scars, dermaroller for scars, ear piercing, cryotherapy for warts, corns, intralesional injections for keloids, patchy hair loss, patch testing and allergy testing.
We also have in patient services for dermatology. Our daily services also include referrals from other departments every day.

Training programs are offered for Post – Graduates in Dermatology and Venereology.

Derma-Oncology (Skin Cancer)
Skin being the largest organ, is subjected to non-stop exposure of various harmful agents such as intense sunlight, UV rays, chemicals and environmental agents. This constant irritation and exposure make the skin susceptible to cancers. Most common types of skin cancers are
Basal Cell Carcinoma (BCC) Melanoma Squamous Cell Carcinomas Lymphomas

Cosmetology
If genetics didn’t oblige you with striking features, you need not worry. Surgeons at Narayana Health have a solution. With an excellent track record of success in high-end Cosmetic Surgery, thanks to a team of skilled medical professionals, backed by advanced surgical facilities and expert nursing care, we follow the latest and safest techniques, often opting for endoscopic procedures with minimal recovery time and discomfort. The services offered include Facelift, Rhinoplasty, Liposuction, Eyelid surgery, Breast Reduction, Breast Augmentation, Breast Lift, Tummy Tuck and Body Lift.
Surgeons at Mazumdar Shaw Medical Center at NH Health City Bangalore have performed over 1000 cosmetic and reconstructive surgeries in a year.

Article by
Narayana Health city

Thoracic Surgery: Procedures

Thoracic Surgery

All thoracic diseases pertaining to the lungs, esophagus, mediastinum, chest wall and diaphragm.

We are a state-of-the-art tertiary referral centre offering all major thoracic surgical procedures such as complex lung resections including segmental and sleeve resections for lung cancer, tuberculosis and other infective conditions, emphysema and congenital lesions.

Tracheal surgery and reconstructions is our forte and we have the largest series of tracheal reconstructions in Bangalore.

The unit also specializes in Video Assisted Thoracoscopic Surgery and Mediastinoscopy (one of the few in the country) capable of performing major intra-thoracic surgical procedures through “key holes” with the help of a thoracoscope.

We have a considerable expertise in surgery for major mediastinal tumors, chest wall tumors and reconstructions. We are also well versed with esophageal surgery for cancer, strictures, etc. Management of major cardiothoracic trauma due to road traffic accidents, assault and stab injuries, gunshots, etc., are some of the routinely handled procedures and surgeries. Due to our capacities of handling the most intricate cases with immense diligence, we have become a major referral centre for all types of thoracic surgical problems.

Lung volume reduction surgery is performed for emphysematous conditions as well as chronic COPD on a regular basis. Health City, Bangalore has been accredited and ready to embark on a Lung and Heart-Lung transplant programme.

We are ably complemented with well equipped systems of Chest Medicine with very experienced Chest Physicians, Interventional Pulmonologists and respiratory technicians and it makes us a “one stop centre” for all thoracic surgical conditions.

Article By
Narayana Health City

Reproductive Medicine, (IVF): Treatment

Reproductive Medicine

Having a baby is one of the wonders of creation. But some couples have difficulty in fulfilling this dream; this is where the scientific knowledge and application of the medical fraternity brings joy to millions of couples by assisting them to conceive through IVF.

What is IVF?

IVF (In Vitro Fertilization) is the advanced scientific technology for assisted conception for which Prof. Robert G Edwards was aptly conferred the prestigious Noble Prize. With the birth of the first IVF baby Lousie Brown in 1978 and millions born subsequently IVF has established itself as time tested method for achieving pregnancy. Commonly termed as test-tube baby, IVF involves fertilization of the egg and sperm outside the body (in vitro).

IVF comprises of

Stimulation and monitoring of the development of follicles (eggs) in the female
Retrieval of these eggs under ultrasound guidance
Procurement of sperms from the male
Fertilization of the egg with sperm in the lab
Culturing the embryo for a few days
Transfer of the embryo back into the uterus of the female partner
Intra Cytoplasmic Sperm Injection (ICSI) – A variation of the procedure involves injecting the sperm into the egg

Why is the procedure required?

IVF is done to help a woman become pregnant. It is used to treat many causes of infertility, including

Damaged or blocked fallopian tubes (can be caused by pelvic inflammatory disease or prior reproductive surgery)
Endometriosis
Male factor infertility, including decreased sperm count and blockage
Unexplained infertility
Advanced age of the woman

Rheumatology: Procedures

The Department of Rheumatology provides diagnosis, treatment and rehabilitation for adults and children with rheumatic and related disorders. Chronic diseases like rheumatoid arthritis, osteoarthritis, gout, pseudo gout and fibromyalgia are some of the diseases commonly treated. Other diseases managed are collagen vascular diseases like Systemic Lupus Erythematosus (SLE), Poly Arteritis Nodosa (PAN) and Sjögren’s syndrome

Rheumatic diseases affect many parts of the body, hence multi-disciplinary care is required and treatment is customized for each patient. The consultants also use different modes of therapy like pain medications, anti-inflammatory medications, chemotherapeutic agents and intra-articular steroids.

The focus is on alleviating pain, improving quality of life and prolonging the life expectancy of patients with chronic rheumatic diseases. The department is supported by physiotherapists and occupational therapists.
Treatments and Procedures

1. Treatment and management of rheumatoid arthritis, osteoarthritis and spondylo-arthropathies
2. Treatment for psoriatic arthritis, vasculitis, systemic lupus erythematosus and scleroderma
3. Management of gout and pseudogout
4. Treatment of polymyositis and polymyalgia rheumatica
5. Treatment for fibromyalgia

Article By:
Columbiaasia Hospitals.

Deep Brain Stimulation (DBS): Treatments

Deep Brain Stimulation (DBS)

Deep Brain Stimulation (DBS) in India

The Department of Neurosurgery have a team of highly qualified and experienced neurosurgeons and neurologists specializing in all types of neurosurgery for comprehensive management of diseases and disorders of the brain, spinal cord and peripheral nerves. The department aims at excellence in neurosurgical care through the practice of evidence based medicine and treatment according to international protocols.

Columbia Asia Hospital is one among the few centers in India to have DBS expertise in treating neurological diseases like Parkinson’s disease. The hospital has a team of high profile consultants who help patients manage all aspects of the complex condition through an integrated approach including counseling of the patients and their relatives.

Deep brain stimulation is considered to be one of the latest and advanced technologies in the treatment of Parkinson’s diseases. DBS uses high frequency electrical signals to block the abnormal nerve signals that cause the symptoms of Parkinson’s disease (tremor, rigidity, walking problems, stiffness, and others) without harming the brain.
Salient features of DBS In India at Columbia Asia Hospitals

Experienced team of professionals, including a specialist neurologist (movement disorder specialist), specialist neurosurgeon, neuroradiologist, physiotherapist and dietary specialists who provide high-quality care
Over 90% success rate achieved on patients suffering from Parkinson’s diseases
State-of-the-art operation theatre with modern equipment like
Operating microscope- zeiss pentero & opmi vario
Mizuho ot table
Sugita head frame
Midas rex legend drill system
Cusa/ dsac arm
Aesculap & codman micro instruments
Storz spinal endoscope
Leksell steriotaxic apparatus
Minimum blood loss and a short hospital stay of just 3 days
In this surgery the brain is not injured, hence it is relatively risk free.
Surgery is completely reversible and programmable
Parkinson medications are reduced which results in improvement of drug related side effects.
Vast improvement in quality of life

Treatment / Procedures

DBS for Essential Tremours and Dystonia
DBS for management of Parkinsons’s

Psychiatry (Developmental Disorder, Memory and Behavior)

Psychiatry

Mental illness is a sickness just like diabetes or heart problem or any other disease that requires treatment. The department of Psychiatry at BBH consists of well qualified psychiatrists and a clinical psychologist. The psychiatrists are trained to manage all mental health problems occurring in children, adolescents, adults and the elderly. The clinical psychologist has vast experience in counseling and offers various forms of psychotherapies.

The out-patient department functions on all 6 working days of the week including an evening clinic on Wednesdays. The in-patient facility allows admission of patients who are in need of more supervised care.

We abide by the hospital’s motto and strive to provide quality health care to all our patients at a cost affordable to them.

The following facilities are provided by our department:

Assessment and management of:

All mental health issues

Childhood onset problems like developmental delay, autism, attention deficit hyperactive disorder, behavior problems, communication problems & academic difficulties

Alcohol and other substance-related addiction
Mood changes like depression & bipolar disorder
Anxiety disorders including Obsessive Compulsive Disorder
Psychotic disorders like schizophrenia
Sleep, eating and sexual related problems
Suicidal behaviors

Our psychological/ counseling services include:

IQ tests
Specific Learning Disability Tests
Academic or career guidance
Cognitive behavior therapy
Relaxation therapy
Family therapy
Marital or couple therapy
Personality assessment
Supportive psychotherapy
Care giver assessment and education

Specialty Clinics:

Comprehensive memory and behavior assessment clinic every Wednesday
Developmental Disorders clinic every Friday

Bariatric Surgery: Procedures

Bariatric Surgery

Unwanted weight gain has become a life threatening aspect in the recent past. Losing weight and making drastic changes in lifestyle has now become a necessity for those who tend to gain extra kilos by the pass of every day. Bariatric surgery is a common treatment procedure used to solve health related issues that are associated with excessive weight gain. Critical conditions of such disorders are treated by surgical procedures that involve altering the whole digestive system. Our weight loss surgical procedures are tailored to satisfy the requirements of individual patients. A dedicated team of bariatric nutrition specialists, trained physiotherapist, psychologist, anesthetist, bariatric surgeons, cardiologist and physician who offer the best services and comprehensive care right from the evaluation process to the follow up stage. Being highly equipped with the advanced state of art devices for bariatric surgery, it provides prime concern to patient privacy and comfort when undergoing weight loss treatment in the hospital.

How does bariatric surgery become successful for weight loss?

The bariatric bypass techniques enhance the early sensation of fullness thereby reducing excessive food intake
Decreased absorption of food after critical gastric bypass surgeries
Conversion of extra fat to glucose for body requirement enhancing weight loss
Reduction in size of the abdomen by surgery reduces food intake

Bariatric Surgical procedures are:

Gastric Banding
Laparoscopic sleeve gastrectomy
Gastric bypass surgery
Duodenal switch surgery
Biliopancreatic diversions

Apart from the above mentioned surgical procedures, Manipal Hospital provides special medical management techniques and excellent patient support groups to render unconditional support and help to families and relatives of the patient. Type II diabetes, increased cholesterol, stress, hypertension and sleep disorders are caused due to morbid obesity. A combination of the right exercise regime and proper diet after bariatric surgery is what we recommend to achieve the desired level of weight loss.

We not only concentrate on losing weight when treating such patients. Gaining that extra will power and skill to keep away the aspects causing weight gain is an added task that we consider important. With quality treatment by our experienced professionals in the Bariatric space and excellence in patient care, Manipal Hospital is a place where you can approach and gain treatment for weight related issues and diseases. Approach us, get treated and walk home with confidence.

Hysterectomy (Uterus removing Surgery):Procedure

A hysterectomy is a surgical procedure to remove the uterus.

A hysterectomy is an operation for a woman that will only be recommended if other treatment options have been unsuccessful.
Causes for Hysterectomy

The most common reasons for having a hysterectomy include:

Heavy periods (menorrhagia), due to fibroids for example
Pelvic pain, due to endometriosis, unsuccessfully treated pelvic inflammatory disease (PID) or fibroids for example
Prolapse of the uterus
Cancer of the uterus, ovaries or cervix

Procedure

Vaginal hysterectomy illustration key

Removing uterus through vagina
Pelvic bone
Bladder
Fallopian tubes and ovaries

Performing a hysterectomy

The most common reasons for having a hysterectomy include:

There are three ways that a hysterectomy can be performed. They are:

Open Hysterectomy:
vaginal hysterectomy
abdominal hysterectomy
laparascopic hysterectomy

Open hysterectomy

During an open hysterectomy, the uterus and cervix are removed through an incision that is made.After the uterus and cervix have been removed, the incision will be sewn up. The operation usually takes about an hour to complete.After your uterus has been removed, the incision is stitched up.

The operation will take about an hour to perform and a general anaesthetic is used.An abdominal hysterectomy may be recommended if your uterus is enlarged by fibroids or pelvic tumours and it is not possible to remove it through your vagina.

Laparoscopic hysterectomy

Laparoscopic surgery is also known as keyhole surgery. Nowadays, a laparoscopic hysterectomy is the preferred treatment method for removing the organs and surrounding tissues of the reproductive system. A laparoscopic hysterectomy is less invasive than a vaginal or abdominal hysterectomy because the incisions that are made are much smaller. This means that the wounds will be smaller and the recovery time will be quicker.

During the procedure, a small tube containing a telescope (laparoscope) and a tiny video camera will be inserted through a small incision in your abdomen.Laparoscopic hysterectomies are usually carried out under general anaesthetic.
Preoperative care

If you need to have a hysterectomy, it’s important to be as fit and healthy as possible.Good health before your operation will help reduce your risk of developing complications and speed up your recovery.

As soon as you know that you are going to have a hysterectomy, take the following steps:

Stop smoking (if you smoke).
Eat a healthy, balanced diet.
Exercise regularly.
Lose weight (if you are overweight).

Some blood tests and a general health check is done a few days before the operation to ensure that you are fit for surgery
Postoperative care

You will be given painkillers to help reduce any pain and discomfort.

The day after your operation, you will be encouraged to take a short walk. After the catheter has been removed, you should be able to pass urine normally. Any stitches that need to be removed will be taken out five-to-seven days after your operation.As a laparoscopic hysterectomy is a less invasive operation, you will usually be in hospital for a shorter period of time, providing there are no complications.

It takes about six-to-eight weeks to fully recover after having a hysterectomy. During this time, you should rest as much as possible and not lift anything heavy, such as bags of shopping. Your abdominal muscles and the surrounding tissues need time to heal.
Complications of a hysterectomy
General anaesthetic

It is very rare for serious complications to occur after having a general anaesthetic (1 in 10,000 anaesthetics given).

Bleeding
Bladder or bowel damage
Infection
Thrombosis
Vaginal problems
Ovary failure
Early menopause

Side effects

After having a hysterectomy, you may experience some temporary side effects as outlined below.

Bowel and bladder disturbances
Vaginal discharge

Getting back to normal
Returning to work

How long it will take for you to return to work will depend on how you feel and what sort of work you do.
Driving

Don’t drive until you’re comfortable wearing a seatbelt and can safely perform an emergency stop.
Exercise and lifting

After having a hysterectomy, the hospital will give you information and advice about suitable forms of exercise while you recover.Don’t lift any heavy objects during your recovery period. If you have to lift light objects, make sure that your knees are bent and your back is straight.
Sex

After a hysterectomy, it’s generally recommended that you don’t have sex until any vaginal discharge has stopped and you feel comfortable and relaxed, or after a minimum of six weeks.
Contraception

You no longer need to use contraception to prevent pregnancy after having a hysterectomy. However, you will still need to use condoms to protect yourself against sexually transmitted infections (STIs).