Foot Care For Diabetic Patients

Thursday, June 25, 2009


Proper foot care for diabetic patients is very important. Poor foot care with diabetes can lead to serious health problems, including Foot ulceration, sepsis, and amputation are known and feared by almost every person who has diabetes diagnosed. Yet these are potentially the most preventable of all diabetic complications by the simplest techniques of education and care.

A person with diabetes, is more vulnerable to foot problems Every 30 seconds a leg is lost to diabetes somewhere in the worldbecause diabetes can damage your nerves and reduce blood flow to your feet. The American Diabetes Association estimates that one in five people with diabetes who seek hospital care do so for foot problems. By taking proper care of your feet, most serious health problems associated with diabetes can be prevented.

However some people have very low risk while some have very high risk. Grading the risk helps the individuals and the health professionals to take appropriate measures without being too relaxed or too strict. This is not only good for the individuals, it also helps to direct valuable health care resources to people who need it. Patients at low risk only need general advice. Patients at high risk need detailed, specific and practical footcare instruction.

The overall risk of an individual developing a diabetic foot ulcer is determined by a combination of factors. In general, the risk is higher if:
  • Neuropathy is more severe (because more sensation is lost)
  • Peripheral vascular disease is more severe (because there is less circulation to bring enough oxygen to repair tissue damage)
  • There are coexisting abnormalities of the shape of the foot which make the local effects of neuropathy or vascular disease more severe (because it increases local pressure and callus)
  • The person is unable to practise reasonable self care to maintain general condition of the feet and to prevent trauma (because there are more chances of damaging the feet)
  • The diabetic control is very poor (because of susceptibility to infection and poor wound healing)
  • There is a past history of foot ulceration due to diabetes (because the above factors often persist)
Here are some diabetes foot care tips to follow.
  • Wash and Dry Your Feet Daily
  • Use mild soaps.
  • Use warm water
  • Pat your skin dry; do not rub. Thoroughly dry your feet.
  • After washing, use lotion on your feet to prevent cracking. Do not put lotion between your toes.
Examine Your Feet Each Day
  • Check the tops and bottoms of your feet. Have someone else look at your feet if you cannot see them.
  • Check for dry, cracked skin.
  • Look for blisters, cuts, scratches, or other sores.
  • Check for redness, increased warmth, or tenderness when touching any area of your feet.
  • Check for ingrown toenails, corns, and calluses.
  • If you get a blister or sore from your shoes, do not "pop" it. Apply a bandage and wear a different pair of shoes.
Take Care of Your Toenails
  • Cut toenails after bathing, when they are soft.
  • Cut toenails straight across and smooth with a nail file.
  • Avoid cutting into the corners of toes.
  • You may want a podiatrist (foot doctor) to cut your toenails.

Be Careful When Exercising

  • Walk and exercise in comfortable shoes.
  • Do not exercise when you have open sores on your feet.
  • Protect Your Feet With Shoes and Socks
  • Never go barefoot. Always protect your feet by wearing shoes or hard-soled slippers or footwear.
  • Avoid shoes with high heels and pointed toes.
  • Avoid shoes that expose your toes or heels (such as open-toed shoes or sandals). These types of shoes increase your risk for injury and potential infections.
  • Try on new footwear with the type of socks you usually wear.
  • Do not wear new shoes for more than an hour at a time.
  • Look and feel inside your shoes before putting them on to make sure there are no foreign objects or rough areas.
  • Avoid tight socks.
  • Wear natural-fiber socks (cotton, wool, or a cotton-wool blend).
  • Wear special shoes if your health care provider recommends them.
  • Wear shoes/boots that will protect your feet from various weather conditions (cold, moisture, etc.).
  • Make sure your shoes fit properly. If you have neuropathy (nerve damage), you may not notice that your shoes are too tight. Perform the "footwear test" described below.
To schedule an health check or a diabetic check ,please email to enquiries@wockhardthospitals.net

courtesy:
Diabetic Foot Diseases
Webmd.com

Wockhardt Hospitals Telemedecine Initiatives

Patients in rural India are finally being able to get expert advice from a specialist in a metro or even from a doctor from India's top corporate Hospitals like Wockhardt Hospitals without having to move out of their environs which was unthinkable in the past,but is a growing reality today.

The healthcare industry seems to be venturing into telemedicine in a big way with hospital groups trying to `virtually' expand their reach.

Telemedecine has provided Healthcare Companies the opportunity to have the tie-ups by creating linkages among smaller hospitals and larger super-speciality healthcare centers within the group, connecting with hospitals overseas as well as educational institutions.

Telemedicine may be as simple as two health professionals discussing a case over the telephone, or as complex as using satellite technology and video-conferencing equipment to conduct a real-time consultation between medical specialists in two different countries.

Wockhardt Hospitals have already put in place 2 tele-medicine centres - one in Chitradurga in Karnataka and the second one at Erode in Tamil Nadu. Both these centres are catering to rural / semi urban patients and are linked to the state of the art tertiary care hospital at our Hospital at Bannerghatta Road in Bangalore. Through this network, patients are in a position to utilize the services of specialist doctors at the Wockhardt Hospitals which in the normal course would not have been accessible to them on account of both affordability and distance. Tele consultations are provided free of cost to all patients.

A third centre is expected to be commissioned by July 2009 in the Coorg district of Karnataka - which again is an area that is severely under served in terms of healthcare facilities. Over the next one year, the Company expects to put in place tele medicine centres in the Konkan areas of Maharashtra as well as in some North Eastern States.

The Nest Birthing Services at Bangerghatta Road,Bangalore

Wednesday, June 24, 2009



The NEST birthing suites at Bannerghata Road Center at Wockhardt Hospitals,fulfills two big concerns during pregnancy and delivery,safety and comfort. Today's women juggles between her career demands and family’s needs. With more and more nuclear families on the rise, the support system that a woman earlier was used to is no longer there.

With increasing responsibilities at work besides managing home, she has barely has time to look after herself. A lot of questions that a pregnant woman looks forward remains unanswered. and is left to the hands of the caregiver . The Nest Birthing Services is an one stop destination for Women for the next nine months.

The Nest is a part of Wockhardt Hospitals Woman Care that derives its safety standards from Harvard Medical International ( HMI)

The” Nest Birthing center is backed by Wockhardt clinical specialties. with a wide choice of eminent obstetricians and gynecologists and specialties from other disciplines. Along with a team of highly trained nurses and paramedics our excellence in clinical care is complemented by the latest technology in terms of investigations, diagnosis and treatments. Our state of the art Neonatal Intensive Clinic Unit (NICU), blood bank and emergency service stand by as a guard against surprises in the last moment.

For nine months the Nest offers you superlative care in a homely and caring environment. Our ante –natal program prepares you and your spouse both physically and emotionally for the birth of your baby. Our (Labor Delivery Postpartum) LDRP and elegant birthing suites are designed to make your stay during your delivery memorable and pleasant. We emphasis on natural birthing and provide you support services like Lamaze and ante natal classes. We give you the option of comfortable natural birthing with painless delivery techniques. Pregnancy is something to look forward to at the “ Nest Birthing Center.


Wockhardt Hospitals “Nest TLC Package” (Tender Loving Care)For Pregnant Women


The baby in the womb goes through the same emotions as you do. The Nest TLC privilege package monitors your health and after your delivery, your babies health. This special TLC package performs all ante-natal tests, routine investigations and support services like Lamaze and yoga and of course plenty of Tender Loving and Care.

Details of the TLC Package for Pregnant Women

  • Gynecologists consultations from second trisemester onwards till delivery(12-14 consultations)
  • Pediatrician consultation for post delivery -3 visits ( 1 month to 3 months)
  • All standard lab tests from second trisemester (13th week ) upto delivery 92-4 times as per doctors recommendation.
  • Tetanus Injections (2-3 times ) s per doctors recommendation
  • The Lamaze classes ( on registration )
  • nte-Natal education
  • Physiotherapists counseling ( for C –Section)
  • Newborn screening tests
  • All requirements for the baby (diaper clothes, tie cloths etc are taken care by the hospital during the stay (3 days for normal and 5 days for C section )
  • Operation Theatre Charges
  • Consumables, disposables and medicines used during delivery
  • Antibiotics used for C Section
  • Diet/Dietician counseling
  • NST Charges
  • 24 hours nursing care

Extra Value Added Services Provided in the TLC Package

  • Welcome Kit
  • Wockhardt pregnancy Guide Book
  • Gift hamper at the time of discharge
  • Baby Album
  • Baby Name Book
  • Wockhardt Birth Certificate
  • Photo Frame with Photo
Lab tests included along with the TLC Package are
  • *CBC
  • VDRL
  • HBSAG
  • Urine Routine
  • Blood Sugar
  • HB
  • TSH
  • Blood Grouping
  • Platelet Count
  • HIV 1& 2
  • RBS
  • Post Prandial blood Sugar
  • OGCT ( if history of diabetes
  • TSH
  • New Born Screening Tests

Ultrasound Included are
  • NT Scan
  • Anomalies Scan
  • BPS Scan for bio- physical profile(3rd trisemester)
  • This Package does not Include
  • Any stay in the hospital beyond the delivery period package ( 3 days in case of normal delivery and 5 days in case of C-Section )
  • NICU or ICU stay
The Following are not a part of standard charges

Consumables over the limit
Cost of certain drugs and medicines used under special circumstances
Visit of consultants of other specialties like a urologist
Vaccine cost for the baby
Any additional physiotherapy sessions
Investigations, medication and treatments for any pre-existing diseases
Additional investigation lab tests in addition to the regular pregnancy tests in case of any complications
3D/4D Scan
Cost for epidural Analgesia
Triple Market tests

For consulatations and enquiries email us at enquiries@wockhardthospitas.net

Interventional Cardiologist at Mumbai: Dr Manjeet Juneja

Tuesday, June 23, 2009


Dr. Manjeet S. Juneja
Interventional Cardiologist
M.D. (General Medicine), D.M. (Cardiology), M.N.A.M.S
Fellow in Interventional Cardiology, Australia


Dr.Manjeet .S.Juneja has joined Wockhardt Hospitals, Mumbai after an extensive stint at the Prince Charles Hospital, Brisbane, Australia and various hospitals of Cardiac Care in India.

In Australia, Dr.Juneja was extensively trained in complex interventions including the use of rotablators and intra vascular ultrasound. Whilst in India and in Australia, he aggressively pursued the Primary Angioplasty program and had standardized a regimen for the use of intravenous Nicorandil in these patients to prevent no flow, slow reflow phenomenon.

He has vast experience in cardiac care and his area of interest is Adult Interventional Cardiology including primary angioplasties, complex interventions and balloon valvuloplasties.He has more than 25 publications in peer reviewed National and International journals and had served on the editorial board of Medicine Update 2002. He has participated in various stent trials including the RESOLUTE &ZOMAXX II and was involved in the early research on the use of Bivalirudin during percutaneous interventions in acute coronary syndrome.


Professional Qualifications and Fellowships:

(1990-1995) M.B.B.S - Seth G.S.Medical College and K.E.M. Hospital, Mumbai
(1995-1999) M.D. - Topiwala National Medical College and B.Y.L.Nair Hospital, Mumbai
(1999-2002) D.M. - Grant Medical College and Sir J.J.Group of Hospitals, Mumbai


Earlier Work of Dr Manjeet Juneja

  • Lecturer-Grant Medical College and K.E.M Hospital ,Mumbai(1990-1995)
  • Staff Cardiologist-Madras Medical Mission & Institute of Cardiovascular Diseases, Chennai(2004-2005)
  • Associate Consultant Cardiologist- Madras Medical Mission & Institute of Cardiovascular Diseases, Chennai(2005-2006)
  • Fellow in Interventional Cardiology-The Prince Charles Hospital,Brisbane,Australia(2006-2008)
  • Consultant Interventional Cardiologist-Bombay Hospital &Medical Research Centre, Mumbai(2008)

Papers, Publications and Awards:

  • Faculty and Chairperson. Euro PCR 08. “Call For Clinical Cases’, Barcelona, Spain, May 2008.
  • Award winner. Euro PCR 07. “Percutaneous Closure of an Ascending Aorta Pseudo-Aneurysm by an AmplatzerTM Septal Occluder’. Third prize. Barcelona, Spain, May 2007.
  • Best Speaker. Mumbai Medical Congress, April 1997.
  • National Talent Search Scholar. June 1987.

For Consultation please email to enquiries@wockhardthospitals.net
To Fix an Appointment call : 022-67994121 and 022-67994123

14 year Old Teenager from Uganda Gets a New Life at Wockhardt Hospitals

Thursday, June 18, 2009



A 14 year old girl from Uganda who came to India with a dilating heart showing signs of heart failure has undergone a complicated open heart surgery at Wockhardt Hospitals. The cardiac team at Wockhardt Hospitals led by Dr. Vivek Jawali, Chief Cardio Thoracic Surgeon performed risky and complicated open heart procedure to replace the mitral valve, repair a leaking tricuspid valve and maze procedure to correct her abnormal heart rhythm.

Abigail Kanyonyozi was brought to Wockhardt Hospitals when she was on the brink of heart failure. Abigail was diagnosed to have a blood cancer called acute myeloid leukaemia in 2000 and Lynda’s saga of her fight for her daughter began. Abigail had undergone a prolonged and expensive treatment in South Africa for her blood cancer. This led Lynda (her mother) exhaust her all finances to bring Abigail back to normal life. After few years of fully recovering from her blood cancer Abigail was diagnosed with heart disease called dolurebecin cardio myopathy which dilates the heart resulting in cardiac failure.

Dr. Vivek Jawali, Chief Cardio Thoracic Surgeon, Wockhardt Hospitals said, “On further examination it was found that the child had a heavy heart and was suffering from rheumatic heart disease (a condition in which permanent damage to heart valves is caused by rheumatic fever), with severe leakage of her heart valves – mitral and tricuspid valve (a valve located between the right atrium and the right ventricle). The leakage had caused stretching of the heart and irregular heart rhythm called Atrial Fibrillation (AFib) which was primarily contributing to her heart failure. Her condition was very critical and immediate surgery was the only option to save the child.” Abigail had to undergo a complex and prolonged surgery which involved replacement of her mitral valve, repairing of tricuspid valves and a complicated maze operation to correct her heart rhythm.

The surgery was successfully performed and the heart was contracted to a great extent. Abigail was no longer suffering from breathlessness and body swelling and her heart was strongly beating. “The child can now live a robust life adds DR. Jawali”. Abigail was discharged from the hospital within a week’s time post her surgery.

Atrial fibrillation is a condition where the speed or rhythm of the heart beat is affected due to a disorder in the hearts electrical impulses. The heart may beat too fast or too slow or it may vary in pace as the hearts upper and lower chambers beat out of sequence.

About Doctor Vivek Jawali:Dr.Vivek Jawali is the pioneer of minimally invasive cardiac surgery in India. Dr Jawali performed India's first minimally invasive bypass surgery and also performed India's first awake bypass surgery on a fully conscious patient without general anesthesia or ventilator, using the technique of continuous high thoracic epidural analgesia.

Dr Jawali performed the world's first awake open heart surgery, which involved an aortic valve replacement with a triple bypass on a 74-year-old patient. He has many indexed publications and the world's highest experience on this procedure. Click here To know more about Dr Vivel Jawali and to schedule and appointment with him,or email us at enquiries@wockhardthospitals.net to schedule and appointment with Dr Jawali

5 Kinds of Pains You Should Never Ignore


While covering the Iraq War as an embedded journalist ,NBC reporter David Bloom who was with the US Marines, began to feel a sudden pain behind his knee. He reportedly sought out medical advice by satellite phone, However he decided not to follow the advice which were on the lines of "Go to a doctor". However he popped a few aspirin, and kept right on going. Three days later, Bloom died of a pulmonary embolism caused by DVT( deep-vein thrombosis). He was only 39.

Most of us tend to take a pain very lightly unless it keeps on re-appearing and affects our life style or work. However according the Mens Health Magazine,their are a few kinds of pain which should never be taken lightly, and medical intervention should be sought immediately
Severe Back Pain

The condition: "If it's not related to exercise, sudden severe back pain can be the sign of an aneurysm," says Sigfried Kra, M.D., an associate professor at the Yale school of medicine. Particularly troubling is the abdominal aneurysm, a dangerous weakening of the aorta just above the kidneys.A less threatening possibility can be also of a kidney stone.

A CT scan using intravenous radiopaque dye does the best job of revealing the size and shape of an aneurysm. Once its dimensions are determined, it'll be treated with blood-pressure medication or surgery to implant a synthetic graft.

A pain in The Foot or Shine

A nagging pain in the top of your foot or the front of your shin that's worse when you exercise, but present even at rest and even ibuprofen and acetaminophen does not seem to be having a difference

These kinds of pain are probably a stress fracture. Bones, like all the other tissues in your body, are continually regenerating themselves. "But if you're training so hard that the bone doesn't get a chance to heal itself, a stress fracture can develop," explains Andrew Feldman, M.D., the team physician for the New York Rangers. Eventually, the bone can be permanently weakened.

Sharp Pain in the Abdomen:Since the area between your ribs and your hips is jam-packed with organs, the pain can be a symptom of either appendicitis, pancreatitis, or an inflamed gallbladder. In all three cases, the cause is the same: Something has blocked up the organ in question, resulting in a potentially fatal infection. Exploding organs can kill a guy. See a doctor before this happens.

Transient Chest Pain

The condition could be indigestion. Or it could be a heart attack. "Even if it's very short in duration, it can be a sign of something serious,

A blood clot may have lodged in a narrowed section of a coronary artery, completely cutting off the flow of blood to one section of your heart.

How much wait-and-see time do you have? Really, none. Fifty percent of deaths from heart attacks occur within 3 to 4 hours of the first symptoms. You're literally living on borrowed tim

Leg Pain with Swelling

Specifically, one of your calves is killing you. It's swollen and tender to the touch, and may even feel warm, as if it's being slow-roasted from the inside out.

Leg Pain with Swelling :if you sit in one place for 6 or more hours straight without taking a talk with taking time out,then you wait for the blood that pools in your lower legs to form a clot ( deep-vein thrombosis, or DVT). This would be big enough to block a vein in your calf, producing pain and swelling.

Unfortunately, the first thing you'll probably want to do—rub your leg—is also the worst thing. "It can send a big clot running up to your lung, where it can kill you," warns Doctors

Painful Urination :A painful Urination can be in the worst cases a sign of bladder cancer. specially for Men .According to Joseph A. Smith, M.D., chairman of the department of urologic surgery at Vanderbilt University, "The pain and the blood in your urine are symptoms of this, the fourth most common cancer in men."

Smoking is the biggest risk factor. Catch the disease early, and there's a 90 percent chance of fixing it. Bladder infections share the same symptoms.


disclaimer: This is a part of patient education series and may not represent Wockhardt Hospitals or their Doctors Views. These views are taken from MensHealth Magazine

Doctor Spotlight : Dr Latha Venkatraman

Wednesday, June 17, 2009


Dr. (Padma) Latha Venkataram
FRCOG (UK), MRCPI (Dublin)
Consultant Obstetrician and Gynaecologist

Dr. Latha Venkataram specially qualified and trained in OBG and Medicine, has an extensive experience in Medical disorders in Pregnancy (high risk) both in United Kingdom and Bangalore, India. She is currently the senior OBGYN specialist and Chief Co-coordinator, Department of OBGYN, Wockhardt Hospital, Bangalore.

Dr. Latha Venkataram got MRCOG (United Kingdom, 1992) and MRCPI (Dublin, 1994) and was awarded the fellowship of RCOG, FRCOG. She has been academically very sound and was a meritorious student throughout her education, obtained highest marks in medicine for the university and was awarded the best outgoing student award from Bangalore Medical College.

Dr. Latha is one of the first to have combined clinics for medical disorders in pregnancy like Diabetes & Pregnancy clinic, Recurrent pregnancy loss clinic, etc in Bangalore. She has initiated skill training in emergency Obstetric care, which is a very successful ongoing program for doctors through Bangalore RCOG Trust and Bangalore Society of Obstetricians & Gynecologists.

She has held many executive posts including President, Bangalore Society of OBGyn and she is presently the secretary for Bangalore RCOG trust.

She is associated with several organizations both rural and urban projects promoting quality care, targeting Maternal Mortality. She is actively involved in establishing the efficacy of Yoga and other Alternate systems of medicine in the treatment of OBGyn related problems. She has to her credit papers published in International indexed journals. Currently she is guiding Doctoral candidates in the field of Yoga and pregnancy.

She has special interest in Obstetric intensive care and emergency Obstetric care and has treated many patients who are critically ill. Her main interest in the field of Gynaecology is vaginal surgeries and has skill and experience in removing large Uteri vaginally.

To set up an appointment with Dr Latha. Kindly email us at enquiries@wockhardthospitals.net

Minimal Access Spine Surgery Perfomed by Doctors at Wockhardt Hospitals,Kalyan

Tuesday, June 16, 2009

Wockhardt Hospitals, Kalyan successfully performed a revolutionary minimally invasive spine surgery - Percutaneous Endoscopic Lumbar Discectomy (PELD) on a 49-year-old man suffering from severe backache.

Truly a minimally invasive spinal surgery, the procedure known as PELD was performed with a single 0.6 cm incision using a technically evolved Yeung endoscopic spine system (YESS) method under local anaesthesia. The PELD Technique is known to be an innovative spine procedure that can help appropriately screened patients recover faster without scars or stitches and more importantly, helps patients walk immediately after the procedure without any pain.

The patient, Sunil Ghag, was suffering from acute back pain as a result of prolapsed inter-vertebral disc, more commonly known as slipped disc. With the severity of the pain only increasing with time, conservative treatment with non-steroidal anti-inflammatory drugs (NSAID) and intermittent pelvic tractions was of little help, forcing him to seek surgical intervention.

An MRI confirmed the prolapsed disc, revealing disc degeneration. "The patient had two options," recalls Dr Vikas Gupte, consultant spine surgeon, Wockhardt Hospitals. "He could either opt for the conventional open discectomy, or the minimally invasive PELD under local anaesthesia." The patient was convinced about going for it as the chances of root injuries were minimal with PELD, promising immediate normalcy and discharge from the hospital.

As Dr Gupte explains, "In the PELD procedure, the patient is made to lie prone on a special operation table and the exact entry point is mapped on the patient's body using image intensifier x-ray system. A long spinal needle is then passed from the side of the back which goes into the disc directly by-passing other bone and ligaments. Through this needle, a guide wire is passed and after making a 6mm incision under local anaesthesia, a dilator and working cannula are passed through the incision. The camera and the monitor are attached to an endoscope that is passed through the incision and the prolapsed part of disc is removed under vision. Advanced instruments like radio-frequency and laser machine are used for such surgery. The surgery lasted for 40 minutes and the wound was closed with a single stitch."

Dr Deepu Banerjee, Neurosurgeon, Wockhardt Hospitals points out that the instrumentation using YESS technique consists of a 6 mm scope that facilitates direct view of the disc fragments in the spine thus minimizing muscle, ligament and tissue damage, while alleviating chances of nerve root injury. "Even the nerve roots are clearly visible through the powerful camera of the Yeung endoscope," he added.

Post-op, the patient was able to walk without any pain and was discharged after 24 hours. According to experts, PELD with YESS technique is the ultimate form of minimal invasive spine surgery in appropriately screened patients.Justify Full

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