Friday, 27 April 2012

Ultrasound Therapy

Ultrasound therapy is given for soft tissue injury to reduce inflammation, swelling and pain. Used as an adjunct to the primary care in the acute stage. In the chronic state, helps in the elongation and remodeling of the tissues.

Non- thermal effect used during acute stage helps reducing swelling and thus pain. The tissue should kept at rest after the therapy to prevent further damage. Cryotherapy and elevation are the other modalities help reducing the inflammation.

Thermal property of ultrasound is used at the chronic stage to alleviate pain and increases the collagen extensibility. This serves as an adjunct for the further therapies such as stretching and strengthening of the tissues, which brings the normal length and function of that tissue.


For Further Information, Contact:
Ms. P. Pughana Ambhigai B.P.T, M.P.T
Physiotherapist, Kauvery hospital, Chennai.
044 4000 6000

Wednesday, 25 April 2012

Interventional Radiology Management of Hemoptysis (Coughing up blood)

Massive hemoptysis (coughing up blood) is a life threatening condition with a mortality rate of 50 to 85 percent with conservative management. embolization. Asphyxiation and less commonly exsanguination are the usual causes of death. Aggressive management is required to manage these emergencies. 
Surgical resection of the causative lesion is the initial treatment of choice for those patients with isolated abnormalities and adequate pulmonary reserve.

However, patients with chronic lung disease and limited pulmonary reserve are often considered unacceptable surgical risks, and this group may benefit from  bronchial artery embolization.

In addition, there is some evidence that the surgical mortality rate may be lowered by preoperative bronchial artery embolization in those patients who are actively bleeding. It is well established that safe and rapid control of massive hemoptysis can often be obtained by therapeutic transcatheter embolization of the bronchial arteries.

More recently, moderate hemoptysis (greater than or equal to three episodes of 100 ml of blood per day within 1 week) and even mild hemoptysis (chronic or slowly increasing hemoptysis) are considered indications for transcatheter therapy.

Bronchial artery is the main source of bleed in patients with massive hemoptysis.  However, many non bronchial systemic arteries such as the intercostal arteries, internal mammary artery and inferior phrenic artery may also be the cause for bleed and it is essential to identify these vessels and embolise them for proper management.  MDCT with contrast can help in the identification of these vessels and acts as a roadmap for subsequent management.

The embolisation procedure is done by an interventional radiologist and takes approximately one hour time. It is performed in the cathlab under local anaesthesia. The main complication of this procedure is inadvertent embolisation of spinal artery which can result in paraplegia, but this is very unusual.

Hypertrophied Bronchial Artery Before Embolisation

Post Embolisation Image Showing Stasis of Contrast

Dr. Iyappan Ponnuswamy MD, FRCR
Consultant Interventional Radiologist
Kauvery Hospital, Chennai
Ph: 044-30606345
Mob: 09551942599
Email: driyappan@kauveryhospital.com

Tuesday, 24 April 2012

Neurological Physiotherapy

Neurological physiotherapy rehabilitates patients with neurological disorders to improve their functional capabilities and independence thus improves their Quality of life. Neurological conditions which involve brain, spinal cord, peripheral nerves and muscles can be treated with specific treatment strategies and special techniques. Treatment includes both adult and pediatric management. 

The main stay of treatment for Pediatric conditions such as Cerebral palsy and other developmental delay is Neuro developmental therapy which concentrates on movement through sensory input to the children.

Adult disorders involving:

BRAIN: Stroke, traumatic brain injury, Parkinson’s disease, Multiple sclerosis, cerebellar disorders, vestibular disorders and General degenerative conditions etc.,

SPINAL CORD DISORDERS:  Congenital and traumatic spinal cord injuries, transverse myelitis, Gullain barre syndrome and other infectious and hereditary diseases.

PERIPHERAL NERVE INJURIES: Both upper limb and lower limb nerves, Diabetic neuropathy.

MUSCLE PATHOLOGY: Muscular dystrophy, dystonias etc.,

Assessment of the patient focuses on the analysis of the specific movement and pattern of dysfunction. Analysis of dysfunction reveals the skill of the therapist on which the whole treatment strategies is going to build upon. Documentation is made for each and every disorder specifically.

Treatment is based upon the understanding of anatomy and the biomechanics of the neurological systems. Training the Sensory motor system, motor control, and motor learning influences the plasticity of the neurological system thus improves balance, proprioception and other elements. Thus restores the movement patterns and aid in the recovery of the function. Treatment techniques such as – Bobath technique, Task specific training, Motor relearning programme, Mental imagery, Sensory reeducation, muscle stimulation, Treadmill training for spinal cord injured patients, novice mirror neuron therapy and every other technique helps in the recovery and independence of the patient.

Physiotherapy practices for neurological conditions are evidence based and trails have been done for so many years and still going in the newly evolved fields. Rehabilitation of a neurological patient is a comprehensive and a long term process. Therapist has to train the patient at the hospital, home and at the community level also. He has to work on the physical and cognitive aspects of the patient for the betterment and the early recovery.
 
For Further Information, Contact:

Ms. P. Pughana Ambhigai B.P.T, M.P.T in Advanced Neurological Physiotherapy
Physiotherapist, Kauvery hospital, Chennai. 
044 4000 6000

Monday, 23 April 2012

Suicide - Are we listening to our loved ones

Suicide: a word which most of us fears, and wants to avoid-hearing or discuss about!!! Webster dictionary defines Suicide as “the act or an instance of taking one's own life voluntarily and intentionally especially by a person of years of discretion and of sound mind”. In the recent days there has been news bombarded at us in the media highlighting- Suicide among Students in various parts of the Country. As research suggests Suicide in India is a little high compared to other parts of the world. It has gradually increased over the past two decades from 7.9 to 10.65 per 100000, with quite high rates in Southern India.              



As scary as it may sound: Suicides are a reality in our society right now – especially with the Youth. There are innumerable causes for someone to commit suicide. One of the most important reasons a person is pushed to kill himself is “unbearable emotional pain”. Mental Health issues are not discussed or treated due to the enormous stigma. When an individual struggles with an issue that might be difficult and challenging- they feel ashamed to ask for help. If someone goes beyond that and asks for help – it is trivialized or mocked at - in our communities.                



It is time we look at ourselves honestly and ask some questions about our youngsters - to see reason. The pressure our youngsters are put through to achieve something “Great” starts as early as 2 ½ years and nobody knows when that ends??? A 3 ½ year old child is expected to read, write, recite and memorize!!! Children are told what to do, when to do, and how to do –all the time. There is no time or space to think, analyze or explore. Adolescents have no way of expressing themselves, their emotional needs met, awareness or information to ask for help. Most children are able to adapt to conditioned living, where as some children are not. Sometimes these individuals choose “Suicide” as their only way out!!!                



A couple of questions: what does this mean to us? And how do we make sense of this? It just means there is a huge need in our communities to help our children, adolescents and Young adults to feel supported, safe, and motivated.         



Understanding their unique needs, Counseling & Treatment, creating safe support networks, helping them see a healthy option to deal with life’s’ stressors will help alleviate some of this pressure.                



Recognizing that people who try to or commit suicide are not looking for advice or solutions to their problems, but are asking for support and understanding. Once we understand their needs -we are able to support them. And invariably when a person: young or old - finds someone who understands their unique need-they start to believe that they can survive. It is possible for us to be that one person who listens, Are we listening?



Dr. Kamali. R. SampathKumar., M.B.B.S. (KMC, Mangalore), Dip. In AdTP (Canada) is a Consultant in Behavioural Disorders specializing in Concurrent Disorders at Kauvery Hospital Chennai. She can be contacted at 730588705 / 9952001587.
Email: drkamali@kauveryhospital.com

Friday, 20 April 2012

Frozen Shoulder Is A Surgical Disease

Introduction
In 1934, Codman described the frozen shoulder as a condition which is difficult to define, difficult to explain and difficult to treat. Codman’s description remained true until 10 years ago. But, with the advent of shoulder arthroscopy, understanding of this condition and treatment has significantly improved.
Periarthritis Is A Misnomer
We now clearly know that there is no involvement of glenohumeral joint. So, periarthritis is a misnomer. It is the capsule which is diseased. So, pericapsulitis is also a misnomer. The terms which closely describe the condition are adhesive capsulitis and frozen shoulder. There is widespread consensus among the shoulder specialists that “contracted shoulder” is the most appropriate term to describe this condition.
What Is It?
Frozen shoulder is characterized by two principal features’
  • Pain
  • Stiffness
Sudden onset of pain and stiffness in a previously normal shoulder is frozen shoulder until proved otherwise.
Types:
The Frozen Shoulder can be of two types, primary or secondary. Primary is the most common type with no specific etiology. The secondary frozen shoulder can be due to trauma, infection, or surgery. The primary frozen shoulder can be associated with the lot of medical conditions.
Associated Conditions:
Diabetes is a very specific risk factor for developing frozen shoulder. 20% of the diabetics have frozen shoulder at some point of their lifetime. This rises to 36% in insulin-dependent diabetics. In diabetics, it is often bilateral and resistant to treatment. The etiology is probably auto immune in origin. The other associated conditions are thyroid disorders, ischemic heart disease, post-cardiac surgery, hyperlipidemia, and other neurologic conditions.
Differential Diagnosis :
The frozen shoulder should be differentiated from other conditions like biceps tendon pathology, brachial neuritis, cervical disc disease, chronic regional pain syndrome, Pancoast's tumour, hemiplegia, and rotator cuff disease.
Treatment:
The treatment of the frozen shoulder depends on the stage of presentation.
  • Stage 1 (pain) : Treated with intra-articular steroid and medications for the neuropathic pain.
  • Stage 2 (pain + stiffness):Treatment by manipulation under anaesthesia , steroid injection and followed by aggressive physiotherapy.
  • Stage 3 (stiffness):Treatment by arthroscopic surgical release.

Wednesday, 18 April 2012

Nonsurgical Uterine Fibroid Embolization – A Major Advance in Women’s Health

Uterine fibroid embolization (UFE) is a minimally invasive treatment for fibroid tumors of the uterus. The procedure is also sometimes referred to as Uterine Artery Embolization (UAE), but this term is less specific and, as will be discussed below, UAE is used for conditions other than fibroids.

Fibroid tumors, also known as myomas, are benign tumors that arise from the muscular wall of the uterus. It is extremely rare for them to turn cancerous. More commonly, they cause heavy menstrual bleeding, pain in the pelvic region, and pressure on the bladder or bowel.

In a UFE procedure, physicians use an x-ray camera called a fluoroscope to guide the delivery of small particles to the uterus and fibroids. The small particles are injected through a thin, flexible tube called a catheter. These block the arteries that provide blood flow, causing the fibroids to shrink. Nearly 90 percent of women with fibroids experience relief of their symptoms.

Because the effect of uterine fibroid embolization on fertility is not fully understood, UFE is typically offered to women who no longer wish to become pregnant or who want or need to avoid having a hysterectomy, which is the operation to remove the uterus.

UFE Vs Myomectomy

Swine Flu - Frequently Asked Questions

What is swine flu?

Swine flu, also known as 2009 H1N1 type A influenza, is a human disease. People get the disease from other people, not from pigs.

The disease originally was nicknamed swine flu because the virus that causes the disease originally jumped to humans from the live pigs in which it evolved.  Scientists are still arguing about what the virus should be called, but most people know it as the H1N1 swine flu virus.

The swine flu viruses that usually spread among pigs aren't the same as human flu viruses. Swine flu doesn't often infect people, and the rare human cases that have occurred in the past have mainly affected people who had direct contact with pigs. But the current "swine flu" outbreak is different. It's caused by a new swine flu virus that has changed in ways that allow it to spread from person to person --  among people who haven't had any contact with pigs.

That makes it a human flu virus.

Many people have at least partial immunity to seasonal H1N1 viruses because they've been infected with or vaccinated against this flu bug. These viruses "drift" genetically, which is why the flu vaccine has to be tweaked from time to time.

What are swine flu symptoms?

Symptoms of H1N1 swine flu are like regular flu symptoms and include fever, cough, sore throat, runny nose, body aches, headache, chills, and fatigue. Many people with swine flu have had diarrhea and vomiting. But these symptoms can also be caused by many other conditions. That means that you and your doctor can't know, just based on your symptoms, if you've got swine flu.

Only lab tests can definitively show whether you've got swine flu. State health departments can do these tests. During the peak of the pandemic, these tests were reserved for patients with severe flu symptoms.

If I think I have swine flu, what should I do? When should I see my doctor?

If you have flu symptoms, stay home, and when you cough or sneeze, cover your mouth and nose with a tissue. Afterward, throw the tissue in the trash and wash your hands. That will help prevent your flu from spreading. If you can do it comfortably, wear a surgical mask if you must be around others.

If you have only mild flu symptoms, you do not need medical attention unless your illness gets worse. But if you are in one of the groups at high risk of severe disease, contact your doctor at the first sign of flu-like illness. In such cases, the CDC recommends that people call or email their doctor before rushing to an emergency room.

But heed these signs of a medical emergency:

Children should be given urgent medical attention if they:

·Have fast breathing or trouble breathing
·Have bluish or gray skin color
·Are not drinking enough fluid
·Are not waking up or not interacting
·Have severe or persistent vomiting
·Are so irritable that the child does not want to be held
·Have flu-like symptoms that improve but then return with fever and a worse cough
·Have fever with a rash
·Have a fever and then have a seizure or sudden mental or behavioral change.

Adults should seek urgent medical attention if they have:

·Difficulty breathing or shortness of breath
·Pain or pressure in the chest or abdomen
·Sudden dizziness
·Confusion
·Severe or persistent vomiting
·Flu-like symptoms that improve, but then come back with worsening fever or cough

Should I wear a face mask or respirator?

Short answer: Maybe. Face masks and respirators may very well offer extra protection, but should not be your first line of defense against either pandemic or seasonal flu.
Every day, newspapers carry pictures of people wearing face masks to prevent swine flu transmission. But very little is known about whether face masks actually protect against the flu.

If I am infected, how can I stop others from becoming infected?

·Limit your contact with other people
·Do not go to work or school
·When you cough or sneeze cover your mouth with a tissue. If you do not have a tissue, cover your mouth and nose.
·Put your used tissues in a waste basket
·Wash your hands and face regularly
·Keep all surfaces you have touched clean
·Follow your doctor's instructions

Friday, 6 April 2012

Piles Treatment at Kauvery Hospital

Piles is a curable condition if timely treatment is taken. If you have any symptom like pain or itching in the anal region or bloody stools or any other type of discharge, it is possible that you may be suffering from this disease. Kauvery Hospital offers special care and treatment for Piles.

Diabetes Foot Care at Kauvery Hospital

 
If you are a diabetic, you might already know that it is important to take good care of your feet to avoid complications. Diabetologists and Podiatry specialists at Kauvery will guide you in your fight against diabetes. Our foot care program is aimed at offering both preventive and curative care. Walk in to Kauvery and walk out as a confident, new person.

World Health Day 2012

World Health Day:

07 April is World Health Day.  The topic of World Health Day in 2012 is Ageing and health with the theme "Good health adds life to years" The focus is how good health throughout life can help older men and women lead full and productive lives and be a resource for their families and communities. Ageing concerns each and every one of us – whether young or old, male or female, rich or poor – no matter where we live.

Healthy Living as We Age!

Health is defined as "a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity," by the W.H.O. Today- as we celebrate World Health Day – It would be helpful to see how our seniors can stay “Healthy”.

Seniors today have spent their entire lives’ so far caring for their families and extended families. Now – it is time to sit down, relax and chart out a new way of life for them. Caring for self means understanding one’s physical well being as well as mental (emotional) & social well being. It can be done by recognizing ones health needs.

Self-Care for Seniors:
  • Physical: taking care of health conditions such as Blood pressure, Diabetes, Heart, and others conditions, having regular health check up, meet your family physician regularly for follow up. 
  • Emotional & mental well being: Understanding & accepting Aging as a normal process, and continue to have enthusiasm for life. Understanding that being retired or staying home does not have to become “loneliness”. Finding ways to keep one engaged in things you were not able to do when working (being employed) or in ones’ younger days, finding new hobbies other than regular routine. e.g. Painting, Handicrafts, Yoga, Meditation, Visualization, and Relaxation. 
  • Social: creating a supportive social network, having contact with friends and families, volunteering in the community, & being of service.
As our seniors learn new ways to live & enjoy Life as they age - the Golden years - will become Healthy each and every day!

Kauvery Hospital and World Health Day:

At Kauvery hospital, we take special care to look after our ageing seniors everyday.  To mark this special occasion, we are organising  a special celebration at our hospital for Septuagenarians. We encourage them to lead and live the right kind of life and add life to years.

வாழ்க்கை வாழ்வதற்கே!


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