Using artificial "Cervical Disc" for degenerative disc diseases
Tuesday, October 13, 2009
Degenerative disc diseases can now be replaced with an artificial cervical disc. The biggest advantage of cervical artificial disc is the preservation of movement operated segment. The simple surgical intervention helps quicker healing and faster recovery time because of minimum hospital stay and faster return to work.
Till now, the most common treatment for patients with degenerative discs in the cervical spine was spinal fusion. In this procedure a surgeon removes the damaged disc then implants a bone graft and metal plate to fuse the vertebrae together. During artificial disc replacement surgery, the damaged disc is removed and replaced with an artificial disc, a stainless-steel device with a ball-in-trough design intended to allow for replication of normal motion.
The artificial cervical disc mimics the normal functions of healthy spinal disc for patients suffering from chronic and persistent neck pain which triggers and radiates right through the shoulders, arms and fingers can be relived with this safe and simple surgical treatment option, according to Dr Deshpande V Rajakumar, consultant, neurosurgeon, Wockhardt Hospital, Bangalore.
This is one of the biggest medical studies of its kind. Surgeons incorporating artificial cervical discs in their treatment regime recommend this procedure for young and active patients who suffer from chronic cervical discopathy symptoms and are uncomfortable to opt for surgical fusion of inter-vertebral discs. Experts are of the opinion that the advanced cervical artificial disc technology could well benefit surgery of the degenerative discs at any level of the neck - from C2/C3 to C7/T1, he added.
Operation of the cervical spine with the Artificial Disc Replacement procedure is performed with the patient lying on the back. A small incision is made on one side of the front of the neck to expose the disc between the vertebrae after pulling aside the surrounding fat and muscle tissues. The intervertebral disc and, in some cases, a portion of the bone around the nerve roots and/or spinal cord is removed to relieve the compressed neural structures to create additional space.
The cervical disc is then implanted in the space with the help of an appropriate surgical instrument.. The incision is closed and dressed. According to Dr Rajakumar, if a person is anticipating a cervical surgery, it is important to find out on being a potential candidate for a cervical artificial disc implant. Patients should also discuss the risks and limitations post surgery.
Patients with conditions like local infection, inflammation, pregnancy, morbid obesity, fever, mental illness, osteoporosis, and paediatrics are not advised for this procedure.
source:Pharmabiz.com
Medical Tourism in India: The Road Ahead
According to the Deloitte study, the number of Americans going abroad for treatment was set to double from 75,000 last year to 150,000 this year, before zooming to 600,000 next year. With a heart bypass costing up to US$80,000 (Dh293,840) in the US and as little as $10,000 in India, according to McKinsey, the economics are obvious.
Indian Corporate Hospitals has seen an significant increase of overseas patients in the last 3 to 4 years . Dr Ramakanta Panda, India’s most famous heart surgeon, who has operated on Indian Prime Minister , "Dr Manmohan Singh" operates on more than 400 International patients.
According to Dr Panda Of late there has been a surge in government ministers and senior businessmen, from Africa and the Middle East , out of four or five consultations about one is operated.
We probably do not do more than two or three American or European inpatients in a month,” Dr Panda estimates. “Health is something people are very scared to outsource. It’s very easy to outsource IT Services, but outsourcing life seems very dangerous.”
Sudarshan Mazumdar, the marketing director at Fortis Healthcare, India’s second-largest hospital chain, is similarly circumspect about the long anticipated surge in American and European patients.
“A lot of African countries or Middle East countries who used to look at London and the US are now looking more and more towards India. That’s going to keep on happening. What isn’t happening is Canada, Australia, US and Europe – that belt hasn’t happened at all.”
Estimates of the scale of medical outsourcing vary wildly. Within months of last year’s Deloitte study, a study by McKinsey, using a tighter definition, put the number of medical tourists worldwide at just 60,000 to 80,000 a year, a tenth of Deloitte’s estimate for the US alone. McKinsey estimated the US provided just 10 per cent of medical tourists.
The number of medical tourists coming to India is similarly uncertain. At the Association of Indian Chambers of Commerce’s medical tourism conference in January, a presentation from India’s Institute for Clinical Research said India had treated 300,000 medical tourists back in 2006.
Another study, citing McKinsey, said it had only received 150,000 as of last year. But seeing as Wockhardt Hospitals, the Indian hospital group that has most enthusiastically targeted medical tourism, only treated 3,500 foreign patients last year – of which about half came from the US and Europe – the McKinsey figure seems more likely.
Wockhardt expects the number of foreign patients to rise by 38 per cent this year. But that will still leave it a fraction of the company’s 55,000 to 60,000 domestic patients.
Vishal Bali, the chief executive of Wockhardt Hospitals, one of the few Indian hospital groups to push hard for international business, believes that the long awaited takeoff is finally here. “A lot of work had happened from 2004 to 2007, and that is beginning to show very positive results.”
What could make this happen is if large US companies and insurance companies incorporated a medical tourism option.
Wellness Tip to keep your "Heart Working at " Workplace"
- Take the Stairs : Sure this is slower,but it gives your heart a great workout.
- Take a break:Find an excuse every hour to get up from your cubicle to stretch or walk around.
- Kick the Butt !! Completely : Use your time to take up a hobby or an interest. Find a friend who wishes to quit smoking too.
- Homemade Food : Pack Your Food from home and avoid eating out
- Sleep Well : About 6-7 hours sleep should be enough for you.
- Smile:Your physical health depends a lot on your emotional health. A smile is the biggest cardio workout.
World Arthritis Day: Symptoms and Treatments
Monday, October 12, 2009
Today is World Arthritis Day . Arthris Day is celebrated every year on 12th october.Arthritis can have significant physical and psychological repercussions that impact quality of life. Arthritis affects more women than men worldwide.
This year’s World Arthritis Day theme is ‘Let’s Work Together’ which considers the challenges of work, be it paid employment, voluntary work or work at home supporting a family, and embraces people with rheumatic diseases, healthcare professionals and employers.World Arthritis Day was first celebrated in 1996 by ARI (Arthritis Rheumatism International)
Approximately 30% of diseases of the joints have the potential of becoming serious life threatening systemic problems. This is especially so if the patient is a young or middle-aged woman.
Women of all ages bear a disproportionate burden of arthritis and its impacts compared to men and it is the most common and disabling chronic condition in Indian women. Women tend to have a lower age at onset than men. They also have greater levels of pain and disease-associated depression. Differences such as pain levels and functional status may stem from the inherent differences between the male and female musculoskeletal system. Given that woman is the "weaker vessel" concerning musculoskeletal size and strength and her baseline values are lower than men's, the same burden of a musculoskeletal disease may appear to be more harmful to a woman than to a man.
Other things which may increase the risk of getting arthritis or of worsening your existing arthritis include being overweight, chronic stress across joints, multiple microfractures in the related bone, major joint trauma, or other metabolic or inflammatory injuries. Because of the gender differences in arthritis incidence, hormones have long been suspected to have a role in disease origin and progression.
- Arthritis affects approx 37 million Americans (NIAMS)
- Prevalance Rate: approx 1 in 7 or 13.60% or 37 million people in USA
- Prevalance of Arthritis: An estimated 40 million people in the United States have arthritis or other rheumatic conditions. By the year 2020, this number is expected to reach 59 million.
- Rheumatic diseases are the leading cause of disability among adults age 65 and older ( data source )
Despite its cyclical nature, arthritis is a progressive condition. If the symptoms are not stopped or slowed down with early treatment, it can cause extensive joint damage and long term disability. Many women with arthritis have difficulty carrying out normal activities associated with daily living, including simple things like standing, dressing themselves, going to the bathroom and carrying out household chores, climbing stairs, sitting on floor.
Arthritis self-management programs also play an important role in helping women learn how to cope with the pain, as well as the other effects of the disease.
Arthritis is a group of conditions involving damage to the joints of the body. There are different forms of arthritis and each has a different cause.
The most common and primary form of arthritis is OSTEOARTHRITIS, also referred to as degenerative joint disease. Some of the other primary forms of arthritis are:
• Rheumatoid arthritis
• Gout and pseudogout
• Ankylosing spondylitis
• Psoriatic Arthritic
1.) Osteoarthritis
Osteoarthritis is a chronic condition characterized by the breakdown of the joint’s cartilage. Cartilage is the part of the joint that cushions the ends of the bones and allows easy movement of joints. The breakdown of cartilage causes the bones to rub against each other, causing stiffness, pain and loss of movement in the joint.
2.) Rheumatoid arthritis
Rheumatoid arthritis is, mainly characterized by inflammation of the lining, or synovium, of the joints. It can lead to long-term joint damage, resulting in chronic pain, loss of function and disability.
3.) Gout and pseudogout
Gout and pseudogout are the 2 most common crystal-induced arthropathies. They are debilitating illnesses in which pain and joint inflammation are caused by the formation of crystals within the joint space.
4.) Ankylosing spondylitis
Ankylosing spondylitis is a form of chronic inflammation of the spine and other joints. Chronic inflammation in these areas causes pain and stiffness in and around the spine & joints.
Rheumatoid arthritis and psoriatic arthritis are autoimmune diseases in which the body attacks itself. Gouty arthritis is caused by deposition of uric acid crystals in the joint, causing inflammation.
Symptoms
The primary and main symptom of arthritis is joint pain, which is associated with muscle spasms around the joint. The pain in the joint may be due to two reasons:
• Age-related degeneration of the joints, as seen in osteoarthritis
• Systemic inflammation of the joints, as seen in rheumatoid arthritis
Excessive movement of the joints causes aggravation of the pain. Patients experience severe pain classically in the early hours of the day, when they wake up and get out of bed, though it is not uncommon for patients to experience severe pain at night. Patients also feel pain when they get up after sitting at one place for a while.
Other symptoms of arthritis include restriction of movement, crepitus in the affected joint, deformities and also possible instability at the joint.
Patients with arthritis of the lower limb joints experience difficulty in walking, climbing stairs, sitting on Indian toilets, sitting cross-legged on floor, or getting up after sitting down for some time or swatting down to perform household activties. Patients with arthritis of the upper limb joints experience difficulty in using the affected hand for basic tasks like eating, combing their hair, and wearing/changing clothes.
For normal and routine activities, it is critical that our joints are mobile, stable, and pain-free. Arthritis is characterized by at least one of the three conditions not being met, making it difficult for the patient to perform their daily activities. The patient’s activities get even more limited if the arthritis is at one of the major joints of the lower limb – the hip or the knee. Patients suffering from advanced stages of arthritis experience stiff and extremely painful joints. An option advised for such patients today is joint replacement surgery, which can provide patients with absolutely PAINLESS, STABLE, and MOBILE joints.
Treatment for Arthritis
Arthritis treatment primarily is of two types:
• Non-surgical treatment
• Surgical treatment or joint replacement surgery
Non-surgical Treatment for Arthritis
The non-surgical treatment option for arthritis can be explored depending on the condition of the patient. There are a number of non-surgical options available for treating arthritis. These include:
• Exercise & Weight Reduction
• Physiotherapy
• Use of support devices
• Medication
The physician may decide on which of these treatment options to use depending on the type of arthritis, and after discussions with the patient.
Lifestyle change
This includes weight reduction and moving away from activities that increase the knee pain like climbing stairs. The objective is to switch to a lifestyle that involves lesser stress to the knee and, therefore, lesser pain in that region.
Exercise
Patients can engage in exercising to treat their arthritis non-surgically. The exercises depend on the kind of arthritis the patient is suffering from, with the emphasis being on providing pain relief to the affected region.
Consulting a physiotherapist for using exercises to treat arthritis is important as he is qualified and best suited to prescribe exercises that increase the patient’s mobility and muscle strength.
Physical therapy is a non-surgical option that is used a lot these days, and is a combination of therapeutic exercising and passive treatment. A common form used is providing passive treatment like ice packs or heat packs in combination with exercises to increase the mobility and flexibility of the affected body part and also strengthen the muscle.
Surgical Treatment of Arthritis
If the arthritis is severe and if the patient is experiencing extreme pain and discomfort, then physicians explore surgery as the next treatment option. Surgery is also suggested in cases where the non-surgical treatment is not having any positive impact or where its effect is gradually waning. Surgical treatment of arthritis involves primarily the replacement of the affected joint. Joint replacement surgery is effective in restoring mobility and taking out completely the pain factor, thereby enabling patients to live a normal and pain-free life. Today joint replacement surgery is absolutely safe in well equipped hospitals with experienced surgeons.
Wockhardt Hospitals Medical Breakthroughs :The 900 Miracle
Thursday, October 8, 2009
For more medical Breakthroughs click here
Most hospitals wouldn’t operate on an infant who was only four months old and weighed 900grams. He was almost the size of a palm. His heart was just one-inch–long and had a one –centimetre fungal mass in the right chamber, which had infected his blood.
An open heart surgery was his only chance of survival, but was risky, considering his loss of weight. A risk that most hospitals were not willing to take. They wanted to wait till Jonathan gained more weight, which meant they needed more time. Time is what he did not have.
But the team at Wockhardt had belief. Belief in their skills and belief that they would save Jonathan's life. The six hour surgery was a success. Jonathan was reborn.
Two Day Old Girl Gets Second Lease Of Life
Tuesday, October 6, 2009
As the mother of a baby girl, born just six days ago, Airoli homemaker Sujata Rane (name changed on request) is expected to have many a query about how to breastfeed her and how make her burp. Instead, the 31-year-old asked a doctor, "Can we use cellphone near her?"
It has become foremost for Rane to learn how not to let any appliance, at home or outside, having a electro-magnetic field around it, interfere with the pacemaker fitted to the the baby's abdominal wall, and the batteries attached to it. The yet-to-be-named infant was born with a complete congenital heart block on September 25. The very next day, she had a pacemaker implant, which the attending doctors say, will help her lead a normal life.
A routine sonography in the seventh month of Rane's pregnancy showed an anomaly in the foetal heartbeat. "The baby's heartbeat was just 40," she said. She was told by the attending doctor that the baby might need a paceaker immediately after its birth.
"Ideally, a newborn baby's pulse rate should be 110. A low heart rate means less blood is going to the body. Over a period of time, the baby could develop congestive heart failure," said Dr Suresh Joshi, chief paediatric cardiac surgeon, Wockhardt Hospital, Mulund, who performed the two-hour surgery on the baby that cost the family about Rs2 lakh. Complete congenital heart block is a rare condition, affecting one in over one lakh newborns, he added.
"I was aware of the baby's heart condition. So, I chose to undergo an elective Caesarean at MGM Hospital, Vashi, in order to get the baby's heart attended to at the earliest," said Rane.
Dr Joshi said, "Unfortunately, very few seem to know that a simple sonography in the second trimester of pregnancy is the tool that can easily detect any such problem and enable parents to ensure that the baby gets timely help as soon as it is delivered."
Every month, Dr Joshi sees 30-odd children with heart problems -- 70% of them neonates. "About three years ago, I used to get about seven cases a month. Thankfully, the awareness is increasing," he said.
Courtesy: DNA
World Heart Day: A Guide to Working Out With Your Heart
Thursday, September 24, 2009
World Heart Day was created to inform and educate people around the world about the increasing risk of heart disease . Heart Related Ailments and stroke are the world’s leading cause of death, claiming 17.2 million lives each year.According to the "The World Heart Federation " at least 80% of premature deaths from heart disease and stroke could be avoided if the main risk factors, tobacco, unhealthy diet and physical inactivity, are controlled.
World Heart Day will be observed on Sunday, 27 September 2009 to inspire you to “Work with Heart”. World Heart Federation members, comprising 196 cardiology societies and heart foundations in more than 100 countries, organize activities for World Heart Day. A large number of non-members, whether hospitals, cardiac clinics, universities, schools, individuals and a number of other organizations, also join in by organizing event.This Years World Heart Day Theme is " Work With Your Heart"
Almost half of those who die from chronic diseases are in their productive years . The economic consequences - driven by productivity reduction and increase in costs caused by these diseases among workforces are dramatic. The WHO estimates that between 2005-2015 income loss (in international dollars) could rise to as much as $558 billion in China, $237 billion in India, $303 billion in Russia and $33 billion in the UK.
Wockhardt Hospitals urges you to work hard and most importantly work with your Heart too !! You can download the " Working out with your Heart" Booklet below.
World Heart Day : Wockhardt Hospitals Guide to Working with Your Heart
Rare Spinal Cord Tumor Removed from a 21 Year Old Girl
Monday, September 21, 2009
In a rare incidence of spinal cord tumour, Doctors at Wockhardt Hospitals,Bannerghata Road,Bangalore, removed a giant shaped tumour from a 21 year old girl’s neck. The team led by Dr. K N Krishna, Senior Consultant, Brain & Spine, Wockhardt Hospitals,Bangalore successfully removed the tumour which is medically known as Crippling Giant Dumbell Nerve Sheath Tumour or Spinal Dumbbell Schwannoma from the girl who was paralysed for more than a year. Spinal Dumbell Schwannoma is a rare disease which afflicts around 3.75 per 10 million people.
Meenakshi, a married lady from Tumkur was complaining of progressive weakness in her limbs which compromised her mobility and was unable to perform simple day to day activities independently. Her tightness in both her legs made her unable to walk without support. She also noticed a gradually increasing swelling on the left side of neck just above the collar bone (clavicle) restricting her neck movement. Weakness in her four limbs crippled her life and she was bedridden for almost a year. Both her legs and one of her hands were totally paralysed,We consultated around 9 hospitals and all of them turned us back saying that there was not much they could do . Finally we landed up at Wockhardt Hospitals,Bangalore ,said Mahesh Krishnamurthy,Meenakshi's brother.
Finally her family brought her to Wockhardt Hospitals. An initial clinical evaluation showed a severe cervical compressive myelopathy and also a large 5cm diameter mass on the left side of neck. MRI of Cervical Spine and Neck showed an Intraspinal / Extradural Tumour on the left side of the neck pushing the spinal cord to the right side. The tumour also extended outwards through the Intervertebral Foramen reaching in front of the neck over like an hourglass shaped Tumour. The Tumor on the left side of her neck was pushing the spinal cord on the right.
According to Dr. K N Krishna, Senior Consultant, Brain & Spine, Wockhardt Hospitals “Dumbbell shaped tumours have been managed as extraordinary tumours in the spinal cord, because of their varied locations, features, clinical symptoms, different from other spinal cord tumours and therefore, their surgical treatment is also different.
In Meenakshi’s case since the tumour was complicatedly placed involving her neck muscles and blood vessels doctors had to decide on the nature of surgery and approach to the tumour. Ideally anterolateral approach that is, from the front of neck on left side would give sufficient access to remove the tumour completely including the intraspinal part but this would also require a fusion by using plate / screws at that level, which would restrict her neck movements and also add significantly to the cost.”
Finally the doctors decided to perform the surgery in two stages. First step involved removal of the intraspinal by approaching from the back of neck, removing the tumour through a minimal access technique which entails about a 3cm incision, removal of bone on only one side to maintain the stability of spine and avoid fusion.
“After few days we planned the anterior approach from the left side of neck after a thorough planning as it had engulfed the vertebral artery within it. First part of this surgery involved identifying and isolating the vertebral artery at its origin under the collar bone, so as to clip it if the engulfed part tears off while removing the tumour. Next the tumour was debunked and separated from the vertebral artery and brachial plexus (plexus of nerves which control the upper limb movements) and removed completely” Dr. Krishna added.
About Spinal Schwanoma Tumor:Spinal Schwannoma is a rare tumour with occurrence of just 2.5 in a million and Spinal Dumbbell Schwannoma is even rarer with 3.75 per 10 million people. Schwannoma originates from the sheath encasing the roots arising from the spinal cord and the cranial nerves leaving the base of skull through various foramina. About 25% of Schwannoma’s are found in the head and neck and also about one third of primary spinal cord tumors are schwannomas.
About 70 to 80% of spinal schwannomas are reported to be intradural in location, and those extending through the dural aperture as a dumbbell mass with both intradural and extradural components account for another 15%. The spinal cord tumors appear more commonly in the thoracic and lumbar spine than the cervical spine. In contrast, the dumbbell tumors are seen most commonly in the cervical spine (44%), followed by the thoracic spine (27%) and the lumbar spine (21%).
Two major unsolved problems with Spinal Schwannomas are high recurrence rate and postoperative cervical deformity especially in teenage patients. An ideal surgical strategy for cervical dumbbell tumor should be able to reduce the recurrence rate and avoid cervical deformity at the same time.
Meenakshi’s recovery was very fast after the surgery.Within a week’s time she was able to walk independently and eat with a spoon and started performing fine motor functions later.
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