Wockhardt Hospitals Blog

The transition of Wockhardt Hospitals in Mumbai, Bangalore and Kolkata to Fortis Healthcare network is the largest merger in the Indian healthcare delivery sector. With this transition the new entity named as Fortis Hospitals headed by Mr. Vishal Bali is all set to add significant scale and look at consolidation in the Indian healthcare space.

Addressing a press conference today Mr. Vishal Bali, Chief Executive Officer, Fortis Hospitals Group said “The transaction of the 10 Wockhardt Hospitals into the Fortis Healthcare network has been completed and these hospitals will now be rechristened as Fortis Hospitals. This deal is a landmark in the Indian Healthcare sector and the transition has been accomplished seamlessly”

With the addition of 10 hospitals of Wockhardt, Fortis Healthcare scales up its presence to a network of 39 hospitals and bed capacity from 3278 to 5180. It now extends its reach to 12 cities across the country and adds to its kitty 2 internationally accredited hospitals (Joint Commission International – JCI accreditation) located in Bangalore and Mumbai besides its own one in Mohali. The Fortis network has been strengthened by 3000 people including a team of accomplished clinicians and 15 member senior management team.

With this merger the Fortis Healthcare Network gets further strengthened to provide patient care in super specialty areas of Cardiac care, Neuro Sciences, Orthopedics, Minimal Access Surgery, Renal Sciences and Liver Transplants.

Fortis Hospitals will scale up its presence in Bangalore with the upcoming 120 bedded tertiary facility in Peenya which is likely to be commissioned by July 2010. The group has also opened a super specialty out-patient medical centre in Marathalli giving it a much needed foothold in East Bangalore. A hospital in East Bangalore is also being planned.

Mr. Bali also spoke about the significant growth in the Mumbai market with an addition of 300 beds which will happen in two phases. The first phase will see a capacity addition of 150 beds by December 2010. A full-fledged Oncology centre would be part of the phase 1 of the expansion. Apart from this, 2 super specialty out-patient clinics in Mumbai are also on the anvil.

Mr. Bali also spoke about consolidating the Eastern market with the launch of a 414 bedded Super specialty Hospital in Kolkata which will be commissioned in June 2010. With a network of 2 hospitals and 1 day care surgery centre Fortis Hospitals will become a major healthcare provider in Eastern India.

Strengthening India as a Healthcare Hub Fortis Hospitals will front end Tertiary Hospitals across key cities to the Medical value traveler from across the globe. The combined might of the new entity would enable Fortis to consolidate its position in the Medical value travel space. With Delhi, Bangalore, and the Mumbai facilities being front ended a wider choice would be offered to overseas patients across geographies.

“We have made significant progress in our International patient volumes particularly from the developed world. Our current international patient volume is growing by 35% and a major component of this growth is from the US. We have clearly established India as a key destination for the global medical value traveler” said Mr. Vishal Bali.

Fortis Healthcare Limited was incorporated in the year 1996 with its first hospital commencing in 2001 at Mohali. It was founded on the vision of creating an integrated healthcare delivery system. Headquartered in New Delhi, Fortis which acquired Escorts Heart Institute and Research Centre Limited in September 2005, has operations in Amritsar, Bangalore, Chennai, Faridabad, Jaipur, Kolkatta. Kota, Mauritius, Mohali, Noida,New Delhi, Raipur and Mumbai. With the recent additions of four hospitals in Mauritius, Bangalore, Kota and S.L. Raheja in Mumbai and ten Wockhardt hospitals Fortis is now a network of 39 hospitals with the capacity to increase inpatient beds to 5180 beds. These hospitals include multi specialty hospitals, as well as super-specialty centres providing tertiary and quaternary healthcare to patients in areas such as cardiac care, orthopedics, neurosciences, oncology, renal care, gastroenterology and mother and child care. The hospitals that Fortis operates include a “boutique” hospital for women - Fortis La Femme, its first foray into women’s health and maternity care.

Fortis Hospitals consists of 10 hospitals located in Bangalore, Mumbai and Kolkata out of which 8 are fully functional and 2 are upcoming projects. The hospital focuses on high end tertiary care around the specialties of cardiac care – adult and pediatric cardiology and cardiac surgery, neuro sciences, minimal access surgery and woman care. The entity consists of 2 JCI accredited hospitals located in Bangalore and Mumbai.

In an extra ordinary medical feat Wockhardt Hospitals,Bangalore – "A Network Hospital of Fortis, has set yet another benchmark in the history of medical science by performing a very complicated cardiac surgery on a 27 year old who suffered a massive heart attack.

“An angiogram showed severe blockage in 3 arteries. His heart was severely damaged and weakened. His life was in danger. We had to put him on an Intra-Aortic- Balloon-Pump (IABP), but he still had breathing difficulty. So he was put on a ventilator and special medication to stop clots from forming again. Surgery was the only option to save his life as his chances for survival was minimal even after surgery”, said Dr. N S Devananda, Cardiac Surgeon, Wockhardt Hospitals,Bangalore – A Network of Fortis.

“It was a big decision for his family to make him undergo surgery with less than 5% chance of survival. But his parents decided to go ahead” he added.

Rupesh underwent bypass surgery with the assistance of heart and lung machine to maintain blood circulation. Post the surgery his heart was extremely weak (Pulmonary Adema) and was not coping and he was on the verge of death, hence the doctors could not take him off the heart and lung machine.

Later the doctors decided to place him on an extra carboniam membrane operation (ECMO) and he was shifted to the ICU for 24 hours. ECMO treatment provides oxygenation until the patients lung function has sufficiently recovered to maintain appropriate O2 saturation.

On 22nd of November 2009 Rupesh was taken off circulatory system for 4 hours with his chest still open, but his heart was still too weak. Doctors put him back on circulatory support for another 12 hours after which his heart started strengthening and he was removed from the machine. 4 days later he was removed from the IABB and 9 days later he was taken off the ventilator. His heart recovered well and was discharged after 2 weeks.

Dr. Devananda said “I have never come across such a difficult case in my entire career. This is miracle, where a patient who was on mechanical life support for survival for so long recovering to live a normal life. This is truly a victory for modern technology and the never say die attitude of this 27 year old”.

These days’ young people are not immune to heart diseases and when it happens in younger people it is sudden, severe and caused more damage to the heart. Of late there is an alarming increase in the number of youngsters with heart diseases.

Orthopedic team led by Dr. Kaushal Malhan, Consultant Orthopedic Surgeon, Wockhardt Hospitals,Mulund,Mumbai performed a revision hip replacement surgery on a 29 year old girl from Philippines.

29 year old Elvira was suffering from a congenital birth defect wherein her hip bone had not developed and her hip had no cup since birth. At the age of 21 she had her first hip replacement surgery in Philippines. However the surgery was not a successful one and after a month of her operation she had to undergo a second surgery on the same hip. The second surgery was also not a success and Alvira’s left leg was shortened nearly by 6 cms due to dislocation of her hip joint. Since then she continued to be in pain and had difficulty in walking and performing all the simple day to day chores. Her physical condition restricted her life to a great extent and she lived a compromised life without being able to enjoy the pleasures that one enjoyed at her age. This left Elvira in pain, frustrated, mentally depressed and she decided to sit back home and not interact with any one, for over 3 yrs.

To distract herself and get out of her agony Elvira decided to go for her graduation in 2005 and completed Pharmacy graduation in 2009. Meanwhile destiny gave her a second chance, having suffered for so long Elvira mustered the courage to rectify her problem and decided to come down to India and get operated upon her hip once again.

“Elvira’s problem was a complicated one as she had already undergone hip replacement before and both those operations were failures. The surgeries had damaged Elvira’s bone and now we had to be very careful while performing the revision replacement surgery so as to not damage her bones any further”, said Dr. Kaushal Malhan.

The length of her shortened leg was also corrected and made equal. The implants used have been put in a manner that allows her to sit on the floor without the risk of dislocation, as is seen in conventional Total Hip Replacement (THR) surgery. Elvira is very comfortable post surgery and has already started sitting properly in a manner which she has not been able to do for years. Her pain is completely reduced and now she is hoping to study further to become a doctor.

“My parents consulted a Pediatric doctor at Philippines to sort my problem but we could never get the right direction and the Doctors were not able to offer any solution as mine was a birth defect. Since then I had a compromised gait and could not do all those regular activities which a child of my age used to. When both my surgeries failed I almost lost all hopes and the thought of living a challenged life devastated by morale. But like the saying goes every cloud has a silver lining! I too saw some hope after 8 years. My fiancé read about total hip replacement surgery in a magazine and we got curious and searched on the internet to know more about it. That’s when we read about the credentials of joint replacement surgeries at Wockhardt Hospitals and expertise of various joint replacement surgeons including Dr. Kaushal Malhan who has done some interesting and compelling replacement surgeries. Hence we contacted Wockhardt Hospitals and once everything was finalized we decided to fly down to India for my surgery” said Elvira.

“I no longer have to limp, I am no more in pain and most importantly I can now do everything I had dreamt of doing all these years. This has given a new meaning to my life and I would like to make the most of it now without losing a single opportunity!! All I want to say is there is a solution to every problem, only thing is we need to hunt out for the opportunity and everything else falls in place”, says Elvira with a comforting smile on her face.

Doctors at Wockhardt Hospitals led by Dr. K N Krishna, Senior Consultant in the Brain and Spine service successfully performed a rare and complicated spinal deformity correction surgery to save a 14 year old from leading a complete disabled life. Shah Rukh Khan a 9th standard student was suffering from Neurofibromatosis (an autosomal dominant disorder that affects the bone, the nervous system, soft tissue, and the skin) with a severe spinal deformity. There have been only a few cases reported the world over on surgical treatment for a rotational dislocation of the spine in neurofibromatosis.

About Neurofibromatosis:

While the cost of the surgery amounts to Rs 2.5 lakh, the hospital did not charge them much, except for consumable medicines. Shahrukh's family managed to borrow Rs 70,000 for his surgery and further treatment.

Doctors at Wockhardt Hospitals,Bangalore led by Dr. Ganeshakrishnan Iyer, Consultant Cardiovascular Surgeon, gave a news lease of life to 68 year old man who was suffering from Chronic Type B Dissection of the Aorta with rupture in the Plura (space around the lung) a condition with high fatality rate. He was returned to normal life after a marathon ten hour surgery to repair the breached aorta.

Sampangi, a retired employee of BHEL, first complained of pain in the chest, back and knee as early as 2003. After, initial treatment at a hospital in the city, he was sent home as the doctors felt that his condition was too risky for surgery. He was normal for a while and then the symptoms resurfaced within a couple of years. Once again he started complaining of pain in the knee, back and chest which his family ignored it initially. As time went by the pain became unbearable and he found it difficult to walk a few steps. He was confined to bed for more than 3 months. Later, he stopped taking solid food because of pain while swallowing.

At this stage he was brought to Wockhardt Hospitals to consult Dr. Ranganath Nayak, Consultant Cardiologist, who diagnosed him with Chronic Type B Dissection of the Aorta with rupture in the Plura. He was loosing blood in the chest (plural cavity) and his lung was compressed necessitating surgery. He was then referred to Dr. Ganeshakrishnan Iyer, Consultant, Cardiovascular Surgeon, Wockhardt Hospitals who performed the surgery.On 7th November 2009 Sampangi underwent the surgery which surgery lasted for more than 10 hours.

Post surgery, Sampangi was kept under observation for 3 days and later shifted to the room. He started having solid food the next day and started walking for 5 minutes with minimal help.

Treatment

Mr Madhukar seen above with Dr Kaushal Malhan

For three years, a host of doctors were unable to diagnose Manju Talwar’s medical problem. The 24 year old school teacher complained of abnormal lactation, irregular menstrual cycles and was unable to conceive.

All symptoms suggested a possible gynaecological problem but despite heavy medication, Talwar’s condition did not improve. However, early this year, a MRI scan revealed a tumour in her pituitary gland.

The pea-sized gland situated at the base of the brain controls growth, metabolism and reproductive functions among others. In Talwar’s case, the tumour was pressing her optic nerve, which could lead to blindness. She was advised immediate surgery.

Talwar’s was not an easy surgery as while removing the tumour we had to ensure that the gland is preserved as she is in the child bearing age,” said Dr. Deepu Banerji, a neurosurgeon at Wockhardt Hospital,Mulund,Mumbai.

The Pituitary gland which is located at the center of the brain manufactures and secretes hormone that regulate growth ,sexual development and fluid balance in the body.

Pituitary adenomas(tumors) are abnormal growth on the pituitary glands which account for about 10% of intracranial neoplasms. They often remain undiagnosed, and small pituitary tumors have an estimated prevalence of 16.7% (14.4% in autopsy studies and 22.5% in radiologic studies). Tumor removal is usually done through transspheoidal approach. Endoscopic surgery is the new approach allowing a surgeon to gain maximum access within the narrow confines of the region avoiding extensive dissection.

Surgery is a common treatment for pituitary tumors. Trans-sphenoidal adenectomy surgery can often remove the tumor without affecting other parts of the brain. Endoscopic surgery has become common recently.

Dr Deepu Banerji, who operated on Talwar over three months, opted for a relatively new endoscopic trans-nasal technique for the delicate operation. This involved insertion of an endoscope through nasal cavity.

Banerji claimed that so far in Mumbai most doctors have been using microscopic transeptal technique, which involves a microscope inserted through the nasal cavity. This, he claimed has led to post-operative complications like numbness around nose and lips, nasal deformity or pain and incomplete removal of tumor.

In the new technique, an endoscope provides good view of the tumor to the doctor. Also, it makes it easier to differentiate between the tumor and the gland – leading to greater chances of complete tumour removal and preserving hormonal functions.

Talwar said she has so far not complained of any post-operative complications.For inquiries please contact us at enquiries@wockhardthospitals.net

14th November,2009 was a special day for Wockhardt Hospitals,Bangalore.Apart from being Children s Day .. the day also celebrated as the day when Children from all over the city assembled at the hospital to say a big Cheers to Life. These Children were all at some point of their lives threatened by life threating congenital disorders,who managed to overcome their medical problems with a little help from the Hospital.

More than 50 children aged between 3 and 13 who had undergone cardiac surgery at Wockhardt Hospitals were treated to a variety of fun filled activities on the occasion of Children’s Day. Dr Devananda, Pediatric, Cardiac Surgeon Wockhardt Hospitals, who took part in the celebrations spoke on the prevalence of Congenital Heart Disease in India vis-à-vis the developed countries and stressed the need to create awareness among people that the Congenital Heart Disease is curable.

“Congenital Heart disease in a child is not the end of the world. This is a treatable condition with excellent success rate, the children present here today of all ages are a testament to this fact.” Dr Devananda, Pediatric, Cardiac Surgeon Wockhardt Hospitals

“Today, India has the expertise and the knowledge to treat this condition, however there are two major obstacles we need to overcome that is that lack of awareness of the disease and the non availability of finance as insurance companies in India do not cover pre-existing diseases” he added.

Magic shows, caricature, face-painting, interactive games and competitions enthralled the children who were eager to participate, adding to the happiness and joy of this special occasion.

But these were not your regular kids. All of them had suffered from life-threatening heart problems , at some point or the other and had gone through complicated surgeries at the Bannerghata Road,hospital at Bangalore.

"It was great to see these children doing so well and enjoying themselves at Children's Day. Seeing them so happy, no one would have guessed that they were suffering from fatal heart problem at one time," said Dr Devananda, pediatric cardiac surgeon.

The "reunion" party was as emotional for the families as it was for the doctors. And in between the celebrations, the parents recalled those difficult times when they were scared about their children safety.

Deepak Singh, father of Vikram Singh, who had a serious heart disease, said, "We had to take him to the hospital daily for checkups and after a lots of tests, we got to know that he had a hole in his heart. Those were the most difficult times of our life. But now that he is healthy, I have no words to explain how happy we feel."

A magic show, dance programmes and many other interactive sessions made the day special for the children. The enthusiasm of the kids soon inspired the adults too as many of them joined the little ones in the buoyant celebrations and some even shook a leg.

"Apart from the fun that we had, this event was a great platform to spread awareness about heart ailments. Also, families, which had gone through similar trauma, were brought together and the sharing of their knowledge and experiences, made the event a memorable one," said Dr Devananda.

He went on to add, "India, today, has the expertise and the knowledge to treat heart ailments, but we face two major obstacles. One is the lack of awareness and second is the non-availability of finance as insurance companies in India do not cover pre-existing diseases. We need to look into these issues now."

Prof. Dr. C.V Harinarayan, Chief Consultant Endocrinologist, Specialist in Metabolic Bone Disease and Osteoporosis, Wockhardt Hospitals,Bangalore has been conferred the prestigious Fellow of Academy of Medical Sciences (FAMS) degree for his outstanding contribution in the field of metabolic bone diseases.

Prof. Dr. C.V Harinarayan through his work on metabolic bone disease has documented through extensive population surveys, the high prevalence of low dietary calcium intake and varying degrees of Vitamin D deficiency in South India. His groundbreaking work could potentially contribute to revision of national guidelines of dietary allowances for calcium and Vitamin D.

The FAMS degree is one of the highest and most coveted hallmarks of distinction in the medical profession given for original academic work in India.

Prof. Dr. Harinarayan M.D. (Int. Med.), D.M. (Endocrinology)has completed his DM in Endocrinology from AIIMS, New Delhi. He has many National and International awards to his credit. Prof. Harinarayan is an excellent clinician, accomplished researcher and scientist, with over two decades of experience. He is specialized in Endocrinology, Diabetes, Thyroid and Metabolic Bone Diseases. He has won several laurels for demonstrating wide prevalence of Vitamin D deficiency, as the predominant cause for radiological bone changes in Primary Hyperparathyroidism in India.

November 17th is observed as World Epilepsy Day .Eplilepsy is the commonest serious neurological disorder; prevalence figures ranging from 2 to 5 per thousand people.The World Health Organisation (WHO) estimates that 10% of people have a seizure at some point in their lifetime, with 50 million suffering from active epilepsy. A study conducted by the Christian Medical College in Vellore in 2006 estimated that neurocysticercosis is the cause of nearly one-third of all the cases of active epilepsy in both urban and rural regions of Vellore. The study estimated that "about 1 million patients in India with active epilepsy attributable to neurocysticercosis''.

Neurocysticercosis is a condition in which parasitic tapeworms, from contaminated water and food, find their into the brain of an unsuspecting individual. The colony of tapeworms, which are breed in the brain, can trigger headaches, epilepsy, imbalance and even sudden death. On National Epilepsy Day on Tuesday, most doctors feel the battle against epilepsy can be won to a great extent if two of the preventable causes, namely birth injuries and neurocysticercosis, are dealt with firmly and effectively.

About 50 million people worldwide have epilepsy, with almost 90% of these people being in developing countries. Epilepsy is more likely to occur in young children, or people over the age of 65 years, however it can occur at any time. Epilepsy is usually controlled, but not cured, with medication, although surgery may be considered in difficult cases. However, over 30% of people with epilepsy do not have seizure control even with the best available medications. Not all epilepsy syndromes are lifelong – some forms are confined to particular stages of childhood. Epilepsy should not be understood as a single disorder, but rather as syndromic with vastly divergent symptoms but all involving episodic abnormal electrical activity in the brain.

India accounts for the largest number of diabetic patients in the world with approximately 56 million people affected and the number is set to grow to 900 million over the next 20 years i.e. 9% of the countries population. This disturbing trend has set alarm bells ringing as a large population of India still does not have access to basic health care needs. Unlike other diseases diabetics lasts for a lifetime leading to many other complications such as heart disease, stroke, blindness, kidney failure, damaged arteries to name a few. Studies have estimated that two out of three diabetic patients are likely to die of heart disease or stroke.

Diabetes is a chronic disease that occurs when the human body fails to produce enough insulin or when there is disruption in the process of insulin circulation. Insulin is a hormone secreted by the pancreas that enables cells to utilize glucose and convert it into energy. Most of the food we eat is converted into glucose (a from of sugar) and dispersed in the blood stream to be used as energy. In the absence of insulin the cells in the body are deprived of energy and begin to starve. Consequently glucose levels rise in the blood stream leading to several other disabilities.

High blood sugar over a period of time leads to damaged nerves and blood vessels. There is hardening of the blood vessels and increased deposit of cholesterol on their walls – a process termed as atherosclerosis. Atherosclerosis can lead to narrowing of blood vessels with increased tendency of blood clot formation. The narrowing of blood vessels and the formation of blood clots are the leading causes of heart disease and stroke.

• Since diabetes is a chronic disease that can only be controlled, it is very important to stick to the advice given by the doctor and to take your daily dose of medication at the right times. Go for regular check ups and monitor your blood pressure and blood sugar regularly.

• Quit smoking: it could be the worst thing for you

Normally a very active home-maker Mrs. Rina Gupta for whom multitasking at her household management was a vital and enjoyable job, had to gradually restrict her activities due to continuous shoulder & arm pain, stiffness and weakness of her shoulder muscle. Struggling to get the basic household work done, Mrs. Gupta restored to various medications and regular physiotherapy for pain relief but saw no signs of improvement. When the pain refused to go and her dependency on her family increased, Mrs. Gupta decided to visit Wockhardt Hospitals for a final opinion for her shoulder pain. At Wockhardt Hospitals she was diagnosed with subacromial impingement with bursitis and acromio-clavicular joint osteoarthritis – inflammation and pinching of the tendon of the rotator cuff and was advised to undergo arthroscopic surgery of her shoulder.

“Failing to bear the excruciating pain and being in a condition where I was dependant on my family members to perform basic household activity, I became frustrated and depressed not knowing how to get rid of this pain. During our routine visit to Wockhardt Hospitals, I decided to go for a final round of check up and that’s when we consulted Dr. Keyur Buch who explained accurately what problem I was suffering from and offered the option of key-hole, minimally invasive surgery” said Mrs. Rina Gupta.

“Subacromial impingement with bursitis and frozen shoulder are very common problems amongst the Indian population of 35 to 65 years; women more than men. Currently, most patients have no choice but to go for the medicinal therapies only, which don’t help a considerable number of patients. These patients end up either suffering long term, or visiting several doctors, specialists and alternative therapists, causing them much suffering, confusion, waste of time and also unrewarding expense” said Dr. Keyur A. Buch, Consultant Upper Limb & Arthroscopic Surgeon, Wockhardt Hospitals.

The four muscles that raise and lower the arm (and their respective tendons) are collectively known as the rotator cuff. The function of the rotator cuff is to push the main part of the shoulder down and away from the acromion when the arm is elevated. The space between the acromion and the rotator cuff tendons is filled by the subacromial bursa. This bursa is a fluid filled sac that allows for smooth gliding of the rotator cuff under the acromion with overhead movements of the shoulder.

Subacromial impingement develops if either the rotator cuff is injured (strained) or some bone deformity (usually a bone spur) is present under the acromion. The rotator cuff and acromion will then rub against one another, causing a painful condition known as impingement. Each time the arm is raised there is a bit of rubbing on the tendons and the bursa between the tendons and the acromion, which may cause pain and inflammation.

“Mrs. Gupta’s problem wasn’t an uncommon one, however usage of medicinal therapy over a period of time had masked her real problem and worsened her condition and she came to us with sever shoulder pain and complete stiffness of her right arm and we decided to perform arthroscopic surgery with coblation technique to correct her condition” added Dr. Keyur Buch.

Arthroscopy (also called arthroscopic surgery) is a minimally invasive surgical procedure in which an examination and treatment of damage of the interior of a joint is performed using an arthroscope, a tiny camera inserted into the joint through a key hole incision. Arthroscopic procedures can be performed either to evaluate or to treat many orthopedic conditions including torn floating cartilage, muscle or tendon repair, ligament reconstruction, and treatment of shoulder dislocation, healing damaged cartilage etc.

The advantage of arthroscopy over traditional open surgery is that the joint does not have to be opened up fully. Instead a number of small incisions are made - one for the arthroscope and one or two for the surgical instruments. This reduces recovery time and may increase the rate of surgical success due to fewer traumas to the soft tissues. It is especially useful for athletes and also for the common populations, who frequently injure their shoulder & knee joints and require through diagnosis & proper treatment. There is also less scarring, because of the smaller incisions.

While arthroscopic surgeries are not new to India, Dr Keyur Buch is an orthoapedic surgeon with significant experience of using the most patient friendly new technology called Coblation technique at Wockhardt Hospitals. With the Coblation technique, Wockhardt Hospitals is able to offer treatment for various kinds of shoulder pains, frozen shoulder, torn muscles, tennis elbow, jumper’s knee, heel pains to name but a few conditions. The unique advantage of coblation technique is that the diseased tissues of various joints can be treated for the first time in India without any damage to the surroundings healthy tissues. It is definitely more tissue-friendly than laser or conventional radiofrequency or mechanical instruments.

“Today after the surgery my hand movement has improved to a great extent and I am able get my confidence and independence once again. With an extensive physiotherapy regime post surgery recovery has also been very speedy” said Mrs. Gupta.

The advantages of arthroscopic surgery of the joint with coblation technique are phenomenal – surgical pain is exceptionally reduced, post surgery recovery is very fast as compared to the traditional method, the hospital stay is reduced to a great extent, movement of the joint post surgery is almost back to normal and the patient can get back to his / her routine work within a very short span of time.

Chandrakanth Kothere with Dr Sachin Bhonsle

Mrs Shobha Kothere and Chandrakanth Kothere

Portal hypertension is an increase in the blood pressure within a system of veins called the portal venous system. Normally, the veins come from the stomach, intestine, spleen and pancreas, merge into the portal vein, which then branches into smaller vessels and travels through the liver. If the vessels in the liver are blocked, it is hard for the blood to flow causing high pressure in the portal system.

Patients with portal hypertenson may undergo EGD to rule out esophageal varices, and perhaps correct them at the same time with banding or sclerotherapy. Acute or severe complications may be treated with intravenous octreotide or terlipressin (an antidiuretic hormone analogue) to decrease the portal pressure. Octreotide inhibits the release of vasodilator hormones such as glucagon, indirectly causing splanchnic vasoconstriction and decreased flow into the portal system.

For those of us who spends a large time at our workplace sitting on a chair and working on the computer tend to forget about our sitting position.How you sit on your desk affects the spine. A posture that keeps your spine in its position can prevent you from backaches and other spinal problems.

Adjust your chair at the proper height : Tall people tend to slump towards the desk and short people tend to slump forwards.. Keep your feet flat on the floor and keep your knee at a 90 degree angle.

Take frequent breaks and stretch yourself .Do not work more than 2 hours on your desk without taking a break.

Avoid leaning too much towards your desk. Keep your computer at the right angle so as to avoid straining forward or backward.

Good Posture:Sit with your back firmly supported on the back of the chair.The basis for good posture is maintaining a "neutral spine."

Having good posture eases a lot of stress on the spine and promotes a healthy spine. There are several ways to change your posture. One is by standing up straight and the other is by sitting up straight.

If you are a young urban professional spending more than 10 hours of your working away at climbing up the corporate ladder and also fighting to keep your job, you should know that all time which you think you are spending to make your life more meaningful might have different repercussion to your health.

Today various Work-related upper limb pain is becoming more and more common in Indian cities,specially the metros and among IT professionals.

The problem may be ascribed to a number of reasons such as bad sitting posture and the viewing of the computer screen from various awkward angles, not taking enough breaks from work,sedentary lifestyles, not paying attention to view the computer at the right anglesf and incorrect head and neck posture leads to upper limb pain frequently.

"Arthritis has long been ignored, as people do not think it is life threatening," says rheumatologist Ramesh Jois from Wockhardt Hospitals,Bangalore

"It is very important for the doctor to be able to diagnose the disease firstly and, secondly, get it treated immediately," says Jois.

"There is great chance of getting the disease within control if early intervention is sought . This can prevent permanent disabilities," says Jois.

However what is increasingly becoming more and more apparent that the younger people too are slowly falling prey to Arthritis.There is a myth that only old people suffer from the disease.

"Anybody can suffer from Arthtritis, from the middle-aged to the very young," says Jois. "Westernised lifestyle, obesity, change in lifestyle, not leading a physically active life, using the computer for most of the time , without using the correct posture all lead to different types of this disease including Arthritis.

Patient interest groups are being formed that will be endorsed by the medical fraternity. "Arthritis is a chronic disease and people are in this for the long term," he says. "It is more important to know what people think."

An easy way to prevent infection :Hand washing is a simple habit that can help keep you healthy. Learn the benefits of good hand hygiene, when to wash your hands and how to clean them properly.

Hand washing is a simple habit, something most people do without thinking. Yet hand washing, when done properly, is one of the best ways to avoid getting sick. This simple habit requires only soap and warm water or an alcohol-based hand sanitizer — a cleanser that doesn't require water. Do you know the benefits of good hand hygiene and when and how to wash your hands properly?

The annual observance was launched in 2008 as an initiative of the Global Public-Private Partnership for Handwashing with Soap. It is endorsed by a wide array of governments, international institutions, civil society organizations, non-governmental organizations, private companies and individuals.

Change in handwashing behavior is critical to meeting the Millennium Development Goal of reducing deaths among children under the age of five by two-thirds by 2015 worldwide.

Despite the proven health benefits of hand washing, many people don't practice this habit as often as they should.Throughout the day you accumulate germs on your hands from a variety of

sources, such as direct contact with people, contaminated surfaces, foods, even animals and animal waste. If you don't wash your hands frequently enough, you can infect yourself with these germs by touching your eyes, nose or mouth. And you can spread these germs to others by touching them orby touching surfaces that they also touch, such as doorknobs.

Infectious diseases that are commonly spread through hand-to-hand contact include the common cold, flu and several gastrointestinal disorders, such as infectious diarrhea. While most people will get over a cold, the flu can be much more serious. Some people with the flu, particularly older adults and people with chronic medical problems, can develop pneumonia. The

combination of the flu and pneumonia, in fact, is the eighth-leading cause of death among Americans.

Inadequate hand hygiene also contributes to food-related illnesses, such as salmonella and E. coli infection. According to the Centers for Disease Control and Prevention (CDC), as many as 76 million Americans get a food-borne illness each year. Of these, about 5,000 die as a result of

their illness. Others experience the annoying signs and symptoms of nausea, vomiting and diarrhea.

Good hand-washing techniques include washing your hands with soap and water or using an alcohol-based hand sanitizer. Antimicrobial wipes or towelettes are just as effective as soap and water in cleaning your hands but aren't as good as alcohol-based sanitizers.

Antibacterial soaps have become increasingly popular in recent years. However, these soaps are no more effective at killing germs than is regular soap. Using antibacterial soaps may lead to the development of bacteria that are resistant to the products' antimicrobial agents — making it even harder to kill these germs in the future. In general, regular soap is fine. The combination of scrubbing your hands with soap — antibacterial or not — and rinsing them with water loosens and removes bacteria from your hands.