Wockhardt Hospitals Blog

The Mitral Valve is located between the left Atrium and the left ventricle of the heart. It acts as a one way door that allows blood flow from the left Atrium to the left ventricle and prevents it from flowing back into the chamber as the heart pumps blood through the Aorta to the rest of the body.

Damage to the Mitral valve affects the normal flow of blood from the lungs to the left Atrium and to the left ventricle. The blood may flow in a reverse direction back into the lungs which could lead to various respiratory problems and several other complications or there could be obstruction to the flow of blood from Left Atrium to Left Ventricle.

The causes for Mitral Valve Prolapse are classified into congenital and acquired. The acquired causes are categorized as: 1) rheumatic heart disease and 2) degenerative heart disease.

Rheumatic heart disease is a condition in which permanent damage to heart valves is caused by rheumatic fever. The heart valve is damaged by a disease process that generally begins with a strep throat caused by streptococcus a bacteria that may eventually cause rheumatic fever. Symptoms of rheumatic fever are fever, swollen, tender, red and extremely painful joints - particularly the knees, ankles, elbows, or wrists, nodules over swollen joints, red, raised, lattice-like rash, usually on the chest, back, and abdomen, uncontrolled movements of arms, legs, or facial muscles weakness and shortness of breath. The symptoms of rheumatic fever may resemble other bone disorders or medical problems. You need to consult your physician for a diagnosis.

The symptoms related to mitral valve failure progresses slowly, however in certain cases the patients don’t experience most symptoms until the disease is in an advanced stage, and there are also cases where the patient does not experience any symptoms at all.

The general symptoms include chest pains, shortness of breadth, difficulty in breathing, unusual heart heartbeat and fatigue.

Diagnosis is often based firstly on the symptoms of the patient. A skilled doctor may detect a murmur in the heart beat during a regular health checkup. There are a number of tests that can help diagnose the disease.

Electrocardiograms (ECG) – gives a complete record of the electrical activities of the heart, any abnormalities of the electrical impulses of the heart shows up in this test
Echocardiograms – gives the doctor graphic representation of sound waves that are bounced of the heart to detect any abnormalities in the valves of he muscles of the heart.

Cardiac Catheterization – where a dye is injected into the blood stream and an x ray is taken that shows the direction of blood flow.

Surgery to replace or repair the mitral valve is often the best option. However if the damage is beyond repair the total replacement is the only other option. Mitral valve replacement surgery is performed to replace the damaged or diseased valve with an artificial one. The artificial valve may be made of metal and pyrolytic carbon (Synthetic) or it may be derived form biological tissue (Biological).

A recent report published by World Health Organization: "World Health Statistics, 2009" shows the life expectancy statics for various countries.

Japan tops the country where people lives the longest,while Sierra Leone occupies the last rank, which is half of what people live in japan. While an average japanese lives for 82 years,citizens of Sierra Lone lives up to an average age of 41 years.

The report shows that children younger than 5 account for nearly 20% of the world's deaths, and that child mortality is a major reason for the wide range in life expectancy among countries.

The World Health Organization's new report is based on data from 2007, the most recent year for which global life expectancy statistics are available.

The report shows that 14 countries had life expectancies of at least 81 years. Here are those countries, along with their life expectancy for babies born in 2007:

At the other end of the life expectancy spectrum, 15 countries had life expectancy below age 50. Here are those countries and their life expectancy for babies born in 2007:

Rhematologist Dr Ramesh Jois, Wockhardt Hospitals,Bangalore explains Ankylosing Spondylitis:

Ankylosing Spondylitis is an inflammatory diseases predominantly affecting the spine and causing severe stiffness ,pain and loss of movement.this chronic diseases at a later stage can lead to fusion of the vetebral column resulting in virtual imobilty. Ankylosing Spondylitis can also affect your joints including hips and knees which can cause pain and swelling of the joints leading to permanent damage if treatement is not done at the right time.

Causes : Its believed that Ankylosing Spondylitis is genetically inherited .Those individuals with the gene HLA-B27 are at a higher risk group.However not everyone having the particular strain of gene will develop Ankylosing Spondylitis.

Severely affected patients can develop complete fusion of the spine and the pain almost disappears ,but the spinal mobilty could be lost .This disease could affect the hips and knees resulting in permanent damage.Some patients develop problems other than spine,including eye inflammation ,skin rashes and diarrhoea.

Physical examination,XRay,MRI findings and blood tests.More recently over the last few years,newer drugs including biological therapy/anti TNF therapy are available.

Ankylosing Spondylitis is approximately three times more common in men than in women.It is generally prevalent in the age group of 20-40 .In very rare cases children are also affected.

Dr Surya Prakash Rao Voleti is one of the few amongst the orthopedic fraternity in the state of Andhra Pradesh doing dedicated work in the field of spine, particularly in the management of spinal deformity & he has been doing this for over a decade now for wockhardt hospitals

He is also trained in minimally invasive techniques in the management of the degenerative and traumatic affections of spine. He is Equally competent in the management of all Orthopedic conditions, both in children and adults. His work on posterior Hemivertebrectomy in management of neglected congenital scoliosis is well appreciated at the National and International orthopaedic forums.

His areas of expertise are Management of complex trauma, neglected limb deformities using Ilizarov system are the other areas of his expertise. He was a faculty at prestigious Nizam’s Institute of medical sciences for which he has served for a decade.

• AO Fellowship at the Department of Orthopaedics and Truamatolgy University of Freiburg, Germany with Prof. N.Sudkamp.

• Recipient of ASSI-Depuy Spine Travelling fellowship for the year 2004 and visited various centers in Delhi and Mumbai in Jan –Feb 2005

• Recipient of GICD – Spine fellowship and visited four centers in France in June –July 2005

• Was awarded ‘ VYAGRESHWARUDU GOLD MEDAL’ for the best paper in the State chapter of IOACON in Guntur in October 2005

• Was awarded Gold Medal For the best paper in the Surgical treatment of Spinal aliments as ISSICON at Delhi in March 2006

• Recipient of Global outreach educational scholarship for the year 2006 and attended the Scoliosis research society (SRS) 41st annual conference at Monterey, California.U.S.

• First orthopaedic surgeon in the state and amongst handful of few spinal surgeons in the country who are awarded the international fellowship of the Scoliosis research society (SRS).

Dr Surya Prakash can be reached for appointments and second opinions via email at enquiries@wockhardthospitals.net

You can also visit Our Center at Hyderabad at the following address for Consultation

Kamineni Wockhardt Hospitals

Gallup found that 29 percent of respondents would consider traveling to non-U.S. destinations for a major problem or procedure, 24 percent would seek cancer diagnosis and treatment overseas, 15 percent would travel for orthopedic procedures, 14 percent would go abroad for heart treatment and 10 percent would travel to get plastic surgery.

The poll concludes that the uninsured are the most interested in medical tourism options, with 37 percent of uninsured respondents saying that they would consider cancer care overseas. Only 22 percent of those with health insurance shared this sentiment.

Gallup says the survey results indicate that the increasing cost of medical care in the United States and large numbers of uninsured is making medical tourism a viable option.

"If strides in insurance reimbursements, overseas hospital quality, and affordability continue, it will be an increasingly attractive option for Americans," Gallup says. "The data suggest the estimated population of 48 million Americans without health insurance are motivated by costs and would be more likely than those with health insurance coverage to consider seeking medical care from alternative sources."

Americans from Mid Western region are the least willing to consider medical treatment abroad. Westerners are the most open to Medical Tourism,while Southerners are also below average in their enthusiasm for medical tourism, with the exception of hip or knee replacement.

Dr. Apul Parikh

Today in Doctor Spotlight we feature Doctor Apul Parikh, who has recently joined us at Wockhardt Hospitals,Bannerghata Road as a Cosmetic Surgeon

Dr. Apul Parikh is amongst the leading plastic and cosmetic surgeons in India. Dr. Parikh has recently moved back to India from the United Kingdom. Dr. Apul initially graduated from the University Of Leeds School Of Medicine. After completing his basic surgical training he specialised in Plastic Surgery in which he has published a number of papers. He has worked in several prestigious London teaching hospitals, including the Royal Free Hospital, St. Bartholomew’s Hospital, the Royal London Hospital and Wexham Park Hospital. He also completed a fellowship at the Memorial Sloane-Kettering Cancer Hospital in New York. Dr Apul Parikh has recently passed the European Board of Plastic surgery (EBOPRAS).


Dr. Apul Parikh has also received further super-specialised training in Cosmetic Surgery. He has successfully completed the UK’s maiden Diploma in Cosmetic Surgery and is now one of the lecturers to the students. He has been privileged to have been trained by Dr. Dai Davies, Dr. Nick Percival, Dr. Jan Stanek, and Dr. Simon Myers who are all regarded as the leading UK surgeons in the field of cosmetic surgery. Dr. Parikh is also one of the privileged few surgeons to have been trained in Cosmetic Vaginal Surgery.

More recently Dr. Parikh underwent specific training in Rhinoplasty (Nose jobs) in Dallas (USA) under the supervision of Dr. Rod Rohrich and Professor Jack Gunther. Dr. Apul Parikh is one of the few Cosmetic Surgeons to offer computer assisted consultations.


Cosmetic Surgery Procedures Offered by Dr Apul Parikh at Wockhardt Hospitals,Bangalore

Face:

▪ Hair transplantation, Brow lifts

▪ Facelift and Neck lift procedures

▪ Blepharoplasty (Upper and Lower Eyelid Surgery)

▪ Rhinoplasty (Nose Jobs)

▪ Otoplasty (Prominent ear correction)

▪ Lip Augmentation

▪ Injectible Fillers/Botox Injections


Breast Procedures


▪ Breast Augmentation

▪ Breast Reduction/Mastopexy (Uplift)

▪ Inverted Nipples Correction

▪ Gynaecomastia (Male Breast Reduction Surgery)


Body


▪ Abdominoplasty (Tummy Tucks), Thigh/Body Lift (Post Massive weight loss/Bariatric Surgery)

▪ Arm Reduction Surgery

▪ Liposuction

▪ Cosmetic Vaginal Surgery (Labia Reduction, Vaginal Tightening, G-Spot Augmentation)



Skin:


▪ Laser Surgery (Tattoo removal, Rejuvenation)

▪ Chemical Peels

▪ Spider Veins removal

▪ Scar Revision Surgery



For appointments with Dr Apul Parikh, please write to enquiries@wockhardthospitals.net

The retina is a thin, transparent tissue of light-sensitive nerve fibers & cells. It covers the interior wall of the eye like wallpaper covers the walls of a room. It functions like the film in a camera- light passes through the lens of the eye & is focused onto the retina. The retina “takes the picture” & transmits the image via the optic nerve to the brain.

It is a condition in which the light sensitive layer of the eye(retina) separates from the underlying eye wall & hence loses its function. It is a serious problem that may occur in any age although it usually occurs in middle-aged or older individuals. It is more likely to develop in people who are nearsighted (myopes) or in those whose relatives have had retinal detachments. A hard, solid blow to the eye may also cause this. If not treated early it may lead to impairment or loss of vision.

Shrinkage & detachment of the vitreous body is a common event with the age but does not cause any problem in most people. In few eyes that have abnormal strong attachments of the vitreous to the retina, a tear can result. Abnormal growth of the eye, which occurs in myopia or injury to the eye, may also cause the vitreous to shrink. Once a tear is present, watery fluid from the vitreous space may pass through the hole & flow between the retina & the outer wall of the eye. This seperates the retina & causes it to “detach” . The part of the retina that is detached does not function properly & there is a blur or a blind spot in vision.

There are other rare conditions such as tumor, which cause retinal detachment without formation of a hole/tear.

One may see floating black spots called floaters, & flashes of light in the vision. In most cases, these do not indicate serious problems. But, in some cases, they may be associated with the retinal tears. A comprehensive eye examination by a retinal specialist to check the retina is necessary to determine if retinal tears are present. Such an examination is desirable as soon as symptoms develop because fresh retinal tears may be treatable without surgery, before they lead to a more severe retinal detachment.

Some retinal detachments may begin without noticeable floaters or flashes of light. In these cases, one may notice a wavy or watery quality in the overall vision or the appearance of a dark shadow in some part of the side vision. Further development of the retinal detachment will blur the central vision & create significant sight loss unless the detachment is repaired.

A few detachments may occur suddenly & one may experience a total loss of vision. Similar rapid loss of vision may also develop by bleeding in the vitreous, which happens when the retina is torn.

A detachment retina cannot be viewed from the outside of the eye. Hence, if symptoms are noticed, a retinal surgeon should be visited as soon as possible. The specialist throughly examines the retina with an instrument called Indirect Opthalmoscope. The instruments bright light & magnification allows the specialist to locate areas of retinal tearing or weakness, which need to be corrected by treatment. Other special diagnostic instruments including special contact lenses, slit lamp etc & Ultrasound may also be used.

There is no medical treatment for retinal detachment. If the retina is torn & retinal detachment has not yet occurred, the same may be prevented by prompt prophylactic treatment. Once the retina becomes detached, it must be repaired surgically by a retinal surgeon. Successful re-attachment of the retina consists of sealing the retinal tear & preventing the retina from pulling away from the back of the wall of the eye again. There are several surgical procedures that may be used. The choice depends on the severity of the retinal detachment & the judgment of the surgeon.

In very select group of patients, one may inject a gas bubble in the eye, treat the retinal hole with cryotherapy (freezing) or laser, & then position the eye to enable successful closer of the hole. This is the simplest of the treatment approaches with least intervention. The success of this procedure is about 70% & in case of failure, scleral buckling procedure can be done.

2.Scleral buckling: most other simple retinal detachments are handled by applying a silicone buckle on surface of the eye, thus indenting the walls inside. The retinal hole is treated with cryotherapy(freezing) & nthe fluid that has collected between the retina & the underlying layers is usually removed. The success rate of this surgery is usually 80-90%.

3.Vitreorentinal procedures: For more complex retinal detachments, complicated surgery called vitreoretinal surgery is needed. In this, the diseased vitreous is removed along with abnormal scar tissue. The retina is attached by use of air, gas or silicon oil. The success of these surgeries varies with type of case. Sometimes, multiple surgeries may be indicated in case of recurrence. Where silicone oil is used, it is usually removed after a variable period of time, once the retina is successfully reattached. The final success can be declared only if the retina remains attached after removal of silicone oil.

Obviously, the more complex the retinal detachment, the more complex will be the surgical procedure needed & less will be the cure rate.

Recovery and Post Operative Care:It is important to understand that surgical success & visual recovery need not go hand in hand. The visual recovery depends upon the basic strength in the retina, the duration of retinal detachment & most importantly, the health of the central, most sensitive part of the retina(mascula). Reading fine print needs excellent vision, hence only a percentage of the eyes with complex retinal detachment can regain reading capabilities. More often, mobile vision is retrieved. Failed surgery usually leads to non-recovery of vision & on occasions these eyes may shrink.

The surgery may be done under local or general anesthesia. With gas in the eye, air travel is restricted. Eye drops or ointment may have to be instilled for 6-8 weeks & glasses are prescribed at final examination.

With simple buckling surgery, vision may start recovering in a few days , but final vision is known after 6 weeks. With more complex vitreorentinal surgeries, it takes longer time for vision to improve & stabilize.

Patients with symptoms of retinal detachment require prompt attention by a retinal surgeon, who will throughly examine & advice about the need for treatment. It is important for persons with significant myopia or with family history of retinal detachment to have periodic eye examination. Early detection of changes in the vitreous or retina can be diagnosed & potential retinal detachment prevented.

To schedule an appointment with our eye care consultants at Wockhardt Hospitals please email us at enquiries@wockhardthospitals.net

A cataract is clouding of the normally clear lens of the eye. It can be compared to a glass window that is frosted or yellowed.

The amount and pattern of cloudiness within the lens can vary. If the cloudiness is not near the center of the lens, you may not be aware that a cataract is present.

The most common type of cataract is age related to aging of the eye. Some other causes of cataract include:

It is not possible to predict exactly how fast cataracts will develop in any given person. The development of cataract varies among individuals and may even be different between the two eyes.Most age-related cataracts progress gradually over a period of years.

Other cataracts, especially in younger people and people with diabetes, may progress rapidly over a short time.

Surgery is the only way a cataract can be removed. However, if symptoms of cataract are not bothering you very much, surgery may not be needed. Sometimes a simple change in your eyeglass prescription may be helpful.

No medications, dietary supplements or exercises have been shown to prevent or cure cataracts. Protection from excessive sunlight may help slow the progression of cataracts. Sunglasses that screen out ultraviolet (UV) light rays or regular eyeglasses with a clear, anti-UV coating offer this protection.

A careful evaluation will also rule out any other conditions that may be causing blurred vision. Problems with other parts of the eye can be responsible for vision loss and may prevent you from having much or any improvement in vision after cataract surgery. If improvement in your vision is unlikely, cataract removal may not be recommended. Your eye doctor can tell you how much visual improvement is likely.

Surgery should be considered when cataracts cause enough loss of vision to interfere with your daily activities.

It is not true that cataracts need to ripe before they can be removed or that they need to be removed just because they are present.

Cataract surgery can be performed when your visual needs require it. You must decide if you can see well enough to do your job, drive safely and read and watch TV in comfort. Does your vision allow you to perform daily tasks, such as cooking, shopping, doing regular work or taking medications without difficulty?

During cataract surgery, which is usually performed under local or topical anesthesia as a daycare procedure, the cloudy lens is removed from the eye. In the most cases a permanent intra ocular lens implant(IOL) is placed in the eye.

Cataract surgery is a highly successful procedure. Improved vision is the result in over 98% of cases, unless there is a problem in other structures of the eye, It is important to understand that complications although rare can occur during or after the surgery.Cataracts are a common cause of decreased vision, particularly for the elderly, but they are treatable. Your ophthalmologist can tell you whether cataract or some other problem is the cause of your vision loss and can help you decide if cataract surgery is appropriate for you.

To schedule an online appointment with our Opthalmologist at Mumbai,please see below or and write to us at enquiries@wockhardthospitals.net

Name of the Doctor	Outpatients Consultation Days	Timings
Dr.Ananad Subramanyam	Tue, Sat	9 am to 12 pm
Dr.Hrihikesh Tadwalkar	Thur	1pm to 2 pm
Dr.Nishikant Borse	Tue, Thu	2 pm to 5 pm
Dr.C.M. Mavikar	Mon, Wed, Sat	3 pm to 5 pm
Dr.Girija Suresh	Mon & Fri	9 am to 1 pm
	Tue, Thu, & Sat	9 am to 5 pm
	Wed	1 pm to 5 pm
Dr.Jaganath Boramani	Tue	3 pm to 5 pm
Dr.Nayan Thakkar	Thur	5 pm to 7 pm
Dr.P.S.Suresh	Mon	9 am to 7 pm
	Tue Thur	1 pm to 5 pm
	Wed	9 am to 1 pm
	Fri	1 pm to 7 pm
	Sat	9 am to 5 pm
Dr.Shivram Nadkarni	Tue & Sat	10 am to 12 pm
Dr.Shashi Kapoor	Fri	9 am to 1 pm
	Wed	7 pm to 9 pm
Dr.Seeta Raman	Fri	5 pm to 7 pm
Dr.Nitha Shanbag	Tue	5 pm to 7 pm
	Fri	7 pm to 9 pm
Dr.Swaranjit Singh Bhatti	Wed	7 pm to 9 pm
	Sat	5 pm to 7 pm
Dr.Manjiri Oak	Mon, Wed	5 pm to 7 pm
Dr.Sumita Phatak	Mon, Wed, Fri	9 am to 5 pm