Wockhardt Hospitals Blog

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.