Tuesday, 26 July 2016

Diabetes - A Major Risk Factor for Kidney Disease

Diabetes is the commonest reason for chronic kidney failure. Longstanding uncontrolled diabetes harms blood vessels within the kidney. Microalbuminuria (leakage of small quantities in urine) is the earliest sign of kidney damage. Protein leakage increases gradually following which hypertension and renal failure may develop. Dialysis and kidney transplantation can be safely performed in diabetics with kidney failure. 

Dr. R Balasubramaniyam MBBS, DNB (Gen.Med), DNB (Neph)
Chief Nephrologist, Kauvery Hospital

Watch his video interview on diabetes & the kidney.

Sunday, 24 July 2016

What is food intolerance?

Image Courtesy - www.lifehacker.com

When a person has difficulty in digesting certain foods it is termed as Food Intolerance. The symptoms are Nausea, Stomach Bloating, Diarrhea, Vomiting, Cough and in some cases Heart Burn, Headaches, Irritability and Nervousness.

Most common foods which people might be intolerant to are Dairy Products, Wheat, certain vegetables like Capsicum, Cucumber, Peanuts, undercooked beans, caffeine, tea, chocolates, some kinds of fish, Mint, Tomato sauce, Citrus fruits and foods with added preservatives. 

The best current treatment for food intolerance is to either avoid the suspected foods or eat them less often and in smaller amounts, as well as taking some supplements that may help digestion.

Food Allergy is different from Food Intolerance. Food Allergies cause an immune system reaction which can become serious or life threatening. Food intolerance symptoms are less serious and mostly limited to digestive problems. 

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What is Asthma?

Asthma is technically defined as a daytime variation in breathing symptoms. Asthma is grossly under reported and the current incidence of Asthma is estimated to be about 2.5% of the population in India. Asthma can present at any age and tolerance of symptoms often leads to a delayed diagnosis.

Asthma can be caused by many factors. In some cases it is hereditary, while at other times it is an allergy or climate induced. It can also be hormonal in women. Assessing the root cause helps to target the treatment. Upper respiratory symptoms are often associated in patients and needs to be addressed independently.

Investigating Asthma is simple. Blood tests often indicate an Eosinophilia (blood cell important in allergy response). Skin and blood tests for specific allergens can help find the cause. Breathing tests indicate the state of the Lungs and help assess progress. Home monitoring with a simple device helps the patient predict deterioration.

Timely and clear diagnosis allows optimal management will prevent permanent breathing disability.

Dr Supriya Sundaram, FRCP(London), FRCP(Edin), Consultant Respiratory Physician

Thursday, 21 July 2016

Be ‘FAST’ On Managing Stroke

In order to recognize stroke early and seek early medical help, a quick and simple assessing tool is useful. It is “FAST”

FAST is a widely used mnemonics for easy and early recognition of stroke.

F - Facial asymmetry or weakness
A - Weakness of arm ( /or leg)
S - Speech disturbance
T - Time. Early recognition and hospital care is so important to prevent long term disability.

Dr Bhuvaneshwari Rajendran, Consultant, Clinical Neurophysiology and Neurosciences of Kauvery Hospital, talks about Stroke Awareness.

Non-Invasive imaging methods to treat Heart Blockages

An angiogram has been the gold standard for testing any blockages for 40 years. Recent data suggests angiogram is not always foolproof. In other words, what you actually see on an angiogram is not what actually it is.

Intravascular Ultrasound (IVUS) and Optical Coherence Angiography (OCT) study the characteristic of the blockage in much more detail. It helps Interventional Cardiologists to choose the right method of removing the blockages. Not many are aware of these newer treatments. These imaging treatments can also prevent a bypass surgery.

Intravascular Ultrasound (IVUS)
Image Courtesy - 

Optical Coherence Angiography (OCT)
Image Courtesy - www.

By using IVUS and OCT one can optimize the Stenting procedure. Patients who are planning a bypass surgery can avoid the surgery and can actually be treated by Angioplasty by the help of these imaging technologies. 

Abdominal Pain - Symptoms, Causes and Treatments

Abdomen is called the "Temple of Surprises". Abdomen has got 9 compartments. The upper abdomen, the middle abdomen and lower abdomen are divided into 3 compartments each. The major organs in upper right quadrant are the liver and gall bladder, in the middle upper portion we have the stomach, in the upper left quadrant is the spleen, in the middle abdomen on both sides we have the kidneys, in the middle portion we have pancreas, transverse colon and small intestine. In the lower abdomen, on the right lower quadrant we have the appendix, in left lower quadrant we have the large intestine's terminal portion and in the middle lower portion we have rectum as well as the urinary bladder. The abdominal pain can be related to the organs underlying the particular area. Sometimes we call this as the radiating pain. For example a person with heart attack can have severe pain in the upper part of the abdomen.

Prof. D. Kannan, Senior Consultant Surgical Gastroenterologist at Kauvery Hospital, talks about abdominal pain symptoms, its causes and treatment.

Monday, 18 July 2016

Know About Cardiac Arrhythmia - Irregular Heartbeat

Have you ever wondered what initiates a heartbeat?
The heart beats due to electrical impulses generated from two nodes present in it. These impulses are produced at regular intervals and as a result, the heart beats in a rhythmic pattern. Any change in our body that causes these impulses to become irregular affects the heart and as a result, the heart may beat faster /slower or beat irregularly. This irregularity is called Cardiac Arrhythmia. There are many causes for  Arrhythmia.
Image Courtesy - www.ghmsl.com
The Heart’s Pacemaker
The heart has two nodes the sinoatrial (SA) node and the atrioventricular (AV) node. The SA node generates impulses and hence it is rightly termed as the heart’s natural pacemaker because the rest of the cardiac rhythm depends on the initial impulse.

The impulse from the SA node goes to the AV node and one heartbeat is produced and the cardiac cycle continues. If the electrical signals are not generated or sent rhythmically, a Cardiac Arrhythmia may occur.

Causes of Arrhythmia

Here are some key causes.

  • Blocked Arteries.
  • Hyperthyroidism and hypothyroidism
  • Smoking
  • A heart attack
  • Excess caffeine or alcohol or drug abuse.
Once you know the cause for Arrhythmia, you need to identify the type of Arrhythmia. Before we get to that remember that the rate at which the heart beats is around 72 bpm (beats per minute)

For a person who has Bradycardia, his/her heart beats very slowly lesser than 60 beats per minute. This could indicate that the heart’s natural pacemaker is defective and the signals produced are disrupted. The heart’s ability to pump sufficient blood is impaired.  On the contrary very fit individuals like athletes have a lower heart rate. This is because the body gets sufficient blood supply at a lower heart rate thus avoiding the need for the heart to work harder.


If a person has tachycardia his/her heart beats very fast. The heart rate exceeds 100 bpm. In this case the heart’s natural pacemaker sends signals very quickly thus making the heart work more. In contrast to bradycardia a person who has tachycardia is always at risk of a disorder of any kind. As the heart beats very fast, the heart chambers are not filled with sufficient blood before they send It out to the body and this could cause fibrillation (cardiac arrest).

Atrial or ventricular fibrillation could be caused due to tachycardia and the person should be given treatment immediately. The heart could collapse and go into cardiac arrest. The patient should be given external defibrillation to stabilize the heart. So as you can see tachycardia is very dangerous and could be life threatening.

Once diagnosed with arrhythmia, it is advisable to get treated at the earliest. Keeping fit and leading a healthy lifestyle will ensure a happy heart and years of good health.

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Thursday, 14 July 2016

Coronary Heart Disease Awareness

The incidents of heart disease are increasing in epidemic proportions. Why? The single most important factor is lack of physical exercise. Lack of physical exercise is glaringly present in majority of the people coming with coronary heart disease. Obesity is increasing, again in epidemic proportions in India.

As we are aware, life style modification is very important to control risk factors. If you modify your lifestyle by, maintaining an optimum body weight, regular physical exercise and stop smoking and do yoga/meditation or any of these things you can reduce heart disease by 40%.

Dr.K.P.Suresh Kumar, Chief Cardiologist of Kauvery Hospital, talks about Coronary Heart Disease.

Wednesday, 13 July 2016

HDL and LDL. Do you know the difference?

HDL stands for High-Density Lipoproteins and LDL stands for Low-Density Lipoproteins. These proteins are carriers of cholesterol. Cholesterol does not dissolve in the blood, they get transported to the bloodstream by these lipoproteins, more specifically HDL.
Image Courtesy - www.developinghealthyhabits.com

Is Cholesterol totally bad for the body?

The answer is NO! Cholesterol, in fact, is quite useful for the body when it is maintained within the limits. People often get tensed when they hear the word cholesterol. Not many people actually know the uses of cholesterol.

• Cholesterol can be used to synthesize certain important steroid hormones in the human body, like androgen and estrogen in the reproductive parts.
• They are also a precursor to Vitamin D. The term precursor is used because Cholesterol forms one of the bases for the production of Vitamin D.

• It is required to maintain the membrane fluidity of various organelles which is one of its important functions. 

These are just a few of the many functions of cholesterol. Now that you know the good effects of cholesterol, let’s talk more about their carriers.   

What is the major difference between LDL and HDL?

• LDL cholesterol is considered as a bad cholesterol as it contributes to plaque. Plaque is a thick dense substance that blocks the arteries and leads to various heart issues like atherosclerosis or can cause a heart attack or may cause a stroke.

• HDL cholesterol, on the other hand, is considered to be a good cholesterol. HDL plays a vital role in the transportation of LDL back to the liver where it is broken down into smaller components. These smaller components are relatively harmless.

• The level of HDL should be higher than LDL for a healthy life.

The main structural difference between HDL and LDL is the amount of cholesterol and protein composition. 25% of LDL is protein but 50% of HDL is protein. Since proteins have a greater density than fat the name “High Density” arises.

What are the appropriate levels of HDL?

HDL cholesterol levels greater than 60mg/dl (milligram per deciliter) is quite good and can carry out its functions effectively. If its level falls below 40mg/dl the functioning gets impaired and may lead to various heart diseases as discussed above.

What can you do to improve your HDL levels?

• Doing Aerobic Exercises can greatly help in increasing the levels of HDL. Exercise for 40-60 minutes regularly to keep your heart pumping.

• Stop Smoking. The tobacco present in cigarettes is a major cause for the reduction of     HDL.

• Maintain good Food habits like taking olive oil, peanuts and canola oils. These oils have monounsaturated and polyunsaturated fatty acids that improve the HDL’s abilities.

• Nuts and Fish like salmon have Omega-3-fatty acids in them that have the ability to convert LDL into HDL. Make sure you have good quantities of this food to maintain your body in good shape.

Now that you know what cholesterol really is and what good and bad it does to you maintain a correct approach to the cholesterol intake to keep your heart smiling.

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Tuesday, 12 July 2016

Management of Diabetic Foot

This video is about diabetic foot disease and why people with diabetes are losing their legs. There are blood vessels which carry good blood and ones which carry bad blood. The vessel which carries good blood is called artery. People with diabetes may develop blocks in the arteries of their legs resulting in gangrene which is death of the tissue. This is more common in people with diabetes, blood pressure, high cholesterol and in people who smoke or use tobacco in any form.

Talk by Prof N Sekar, MS, MNAMS, MCh (vascular), FICS, DSc (Hon.Causa), FRCS (Glasgow), Senior consultant vascular surgeon, Kauvery Hospital, Chennai.

Monday, 11 July 2016

Importance of Medicines, Diet and Physical Activity to control Coronary Heart Disease

Lot of patients come to our OPD and ask us as to why they developed Coronary Artery Disease. Once I say that this is because of long standing diabetes and blood pressure, their immediate reply would be why they developed heart disease even though their sugar and pressure has been well under control for the past 10 years. So, that obviously means that taking medicines alone for the adequate control of sugar and pressure is not enough and you have to go beyond. This is called "Lifestyle Modification".

Dr. K.P.Suresh Kumar, Chief Cardiologist at Kauvery Hospital, talks about the importance of medicines, diet and physical activity to control Coronary Heart Disease.

Thursday, 7 July 2016

Myths of Spinal Surgery

Most people think that spine surgery is very complicated and one will get bed ridden and one cannot get back to normal activties. This is a myth. Spine surgery is safe. Complications occur only in about 1 or 2% of patients. Many of the spinal surgeries can now be done through minimally invasive methods. A patient who has undergone a spine surgery gets back to normal life. Failure to get back to normal is extremely rare. Get help before problem advances. Never keep spine surgery as last resort.

Dr. G. Balamurali, Spine and Neuro Surgeon at Kauvery Hospital, talks about the myths of spinal surgery.

Coronary Artery Bypass Grafting [CABG]

Coronary Artery Bypass Grafting [CABG] is usually performed on patients with coronary artery disease when they have one or more critically blocked vessels that supply blood to the heart. Coronary artery patients usually present to the cardiologist with critical occlusions caused by cholesterol or calcium deposits in the coronary arteries. This disease is a lifestyle disease and has many risk factors including uncontrolled diabetes, uncontrolled high blood pressure and or smoking along with family history of coronary artery disease and lack of exercise. 

Dr. J. Saravana Ganesh, Consultant Cardiothoracic Surgeon at Kauvery Hospital talks about Coronary Artery Bypass Grafting.

Wednesday, 6 July 2016

What Triggers Palpitations

Palpitations are a rapid, strong and irregular heartbeat due to some kind of illness or excess agitation or overexertion of the muscles. Palpitation is associated with anxiety and does not necessarily indicate any abnormality of the heart, but it can be a symptom arising from an irregular heartbeat. The anxiety might be caused due to excess consumption of caffeine or nicotine or alcohol. Sometimes palpitations could occur during pregnancy. Palpitation can be intermittent and of different intensity and duration, or continuous. Generally, palpitations are not serious or harmful and usually go away on their own.

What causes palpitations?
Palpitations are mainly associated with the following

• Coronary heart diseases, congestive heart failure, heart valve problems.
• Thyroid problems such as hyperthyroidism.
• Low blood pressure, fever.
• During pregnancy if the mother has anemia or hormonal changes.

Some people experience palpitations after eating heavy meals composed of a lot of carbohydrates, sugar, or fat. Monosodium Glutamate (MSG) present in certain foods can also trigger palpitations.

Wonder what happens to the heart during palpitations?

During palpitation the upper chamber of the heart, the arteries contract prematurely. In order to compensate this, the arteries rest for a fraction of a second longer than usual and this is followed by the forceful contraction of the lower chambers of the heart (the ventricles).

Sometimes the lower chambers of the heart contract prematurely and if this keeps continuing for every beat then it leads to a condition called ventricular fibrillation. Ventricular fibrillation requires immediate medical attention because it is the most frequent cause of cardiac arrest.

Here are the symptoms associated with palpitations.

• The person might begin to feel slightly dizzy or light headed.
• The person could experience difficulty in breathing properly.
• Sometimes the person might faint and lose consciousness.
• Excessive sweating accompanied by pain and pressure in the chest can also be felt.

Medical treatment is required as soon as possible if the condition becomes serious.

How do you control palpitations?

In many cases, palpitations are harmless and go away on their own. Generally, if there are no underlying conditions like a heart disease then  the following might prove very effective:

• Keep your alcohol, nicotine and caffeine levels under control.

• Stress and anxiety are a major cause so focus on doing more yoga and relaxing exercises. Take a peaceful walk on the beach and focus on keeping serene.

• If you have allergies that make you cough, avoid those substances at all cost.

These are very general methods to avoid palpitations, but for more specific conditions like anemia or heart disease, more focus should be given to eliminate the underlying disease.

So, once you’ve found the problem and treated it, make sure you follow the correct lifestyle to keep palpitations at bay and safeguard your ever pumping heart from danger.

Monday, 4 July 2016

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