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All About Kidney Stone
By Admin / 30/11/2017

Normally, urine contains many dissolved substances. At times, some materials may become concentrated in the urine and form solid crystals. These crystals can lead to the development of stones when materials continue to build up around them, much as a pearl is formed in an oyster.

Stones formed in the kidney are called kidney stones. Ureteral stone is a kidney stone that has left the kidney and moved down into the ureter. Urinary bladder stones are either migratory stone from kidney or formed inside the bladder due to stagnation of urine.

The majority of stones contain calcium, with most of it being comprised of a material called calcium oxalate. Other types of stones include substances such as calcium phosphate, uric acid, cystine and struvite.

Although stones occur more frequently in men but the number of women who get them has been increasing over the past 10 years, causing the ratio to change. If a person forms a stone, there is a 50 percent chance that he/she will develop another stone.

Causes of stone formation:

Scientists do not always know what makes stones form. While certain foods may promote stones in susceptible people, researchers do not believe that eating specific items will cause stones in people who are not vulnerable. Yet common risk factors are:

  • Less intake of liquids.

  • Hot climate.

  • Family history of stones, especially in a first-degree relative.

  • Diet with high salt content, high animal protein content or oxalate-rich diet such as leafy green vegetables, potato chips, nuts, nut butters or chocolate.

  • Medications- Certain diuretics, calcium pills, calcium based antacids

Certain medical conditions – Hyperparathyroidism, chronic diarrhoea, crohn’s disease, post gastric bypass surgery, obesity, Obstruction to urinary passage like in prostate enlargement or stricture disease, Hypercalciuria, Hyperuricosuria, rare hereditary disorders such as cystinuria, primary hyperoxaluria etc.

What Are The Symptoms Of A Kidney Stone?

The following may be symptoms of kidney stones that need a doctor’s help:

  1. Extreme pain in your back or side.

  2. Blood in your urine.

  3. Fever and chills.

  4. Vomiting

  5. Urine that smells bad or looks cloudy

  6. A burning while passing urine.

How Are Kidney Stones Diagnosed?

The following mentioned imaging modalities give your doctor information about the size, location and number of stones to determine appropriate treatments.

Ultrasound, X-ray KUB and CT scan

How Can Kidney Stones Be Prevented?

Unfortunately, kidney stones are a recurrent disease, meaning that if you have one stone you are at risk for another stone event. In general, the lifetime recurrence risk for a stone former is thought to be around 50%. Stone prevention, therefore, is essential.

A good first step for prevention is to drink more liquids and water so as to produce at least two litres of urine in every 24-hour period.

People who form calcium stones used to be told to avoid dairy products and other foods with high calcium content. However, recent studies have shown that restricting calcium may increase stone risk. So, calcium intake should be reduced but not to stop.

High doses of calcium, Vitamin D, or Vitamin C may increase the risk of developing stones, especially in people with a family history of stones. These people need to be careful and should calcium supplementation be needed; calcium citrate is best.

Other general recommendations for stone formers is that they should consume a low sodium and low animal protein diet.

How Are Kidney Stones Treated?

Stone size, the number of stones and their location are perhaps the most important factors in deciding the appropriate treatment for a patient with kidney stones. Treatment options are:

Nonsurgical:

  • Medical Expulsive Therapy (MET)

  • Shock Wave Lithotripsy (ESWL)

Surgical:

  • Ureteroscopic stone removal (URS)

  • Retrograde Intrarenal Surgery (RIRS)

  • Percutaneous Nephrolithotomy (PCNL)

  • Laparoscopic Pyelolithotomy/ Nephrolithotomy

  • Open Conventional Surgery



WHAT ARE THE DOS AND DON’TS AFTER HIP REPLACEMENT?
By Admin / 18/11/2017

The patient who has undergone hip replacement surgery needs a decent time to recover completely and to be able to carry on day-to-day simple physical activities properly. The duration of the recovery can vary from person to person and the damage he/she had on the hip bone. It also varies from the care that a person has taken after the hip replacement process.

There are certain activities that patient will be restricted to do. It goes step by step. In the initial weeks the patient will be allowed to do simple activities like going for a walk and performing simple exercises. As the body healing progresses, he/she can take the physical activities a notch higher. He can start going for long travelling and other different exercises, as suggested by the doctor and the physiotherapist.

The orthopedic surgeon will advise the patient to follow certain dos and don’ts after hip replacement. It will put a patient on the road to fast recovery and allow the replacement to last for longer time.

What are the dos?

  •   1. Do low stress activities: The patient can engage in low stress physical activities like going for a walk in morning and evening, climbing small stairs and go for shopping.
  •  2. Take regular physical therapies: The patient needs to take the physical therapy treatment regularly as prescribed by the surgeon. It will help in rehabilitating the joint and will reduce the pain and discomfort.
  •  3. Do regular exercises: The patient will be advised to perform certain exercises for the hip joint that he/she should do regularly. If there is pain, then he/she should stop doing more exhaustive exercise and consult the surgeon.
  •  4. Use stool or high platform: Patient should use an elevated structure (stool) under their feet while sitting, so that the knee comes below the level of hip joint. While working in kitchen, they should stand on high platform.
  •  5. Use ice packs to reduce pain: If you feel pain that is causing discomfort, then you can use ice packs and apply on the area to reduce it.

What are the don’ts?

  •   1. Avoid Driving: Patient should avoid driving till the surgeon gives a green signal. It can be distressing if you start driving in the initial week as it can lead to joint stiffness for sitting in one position.
  •  2. Don’t bend legs inward: Make sure you don’t sit or stand with pigeon toes or bend legs inward.
  •  3. Don’t twist legs: Patient should not twist legs or bend hips more than 90 degree, at least for the initial 7-8 weeks.
  •  4. Don’t jump or lift heavy objects: Don’t jump or make any reflexive move that gives pressure on the hip joint.
  •  5. Don’t lean forward while sitting: Patient should not lean forward while sitting.
  •  6. Don’t kneel down on the non-affected leg: You should not kneel down on your non-affected leg as it is the good side and you should not let it get affected.

Apart from these dos and don’ts, your physician will suggest you certain other things. It is suggested that you note down those points and prepare a proper chart to follow.



KNOW WHAT YOU DON’T KNOW ABOUT CARDIAC SURGERY
By Admin / 18/11/2017

Introduction: –

A cardiac issue in India is a growing concern. As statistics, India is home to more than 30 million patients with cardiac problems. And by 2020, the burden of cardiovascular diseases in India is estimated to go beyond that of any other country globally. Factors like aging, unhealthy lifestyles, wrong eating habits and the ever – changing socio-economic determinants like accessibility to healthcare are fuelling the rising number of cardiac patients across the country.

Cardiothoracic Surgery:

Involves surgical procedures performed for healing & treating problems related to heart, lungs, Oesophagus & other organs of chest. A cardiac operation involves procedure to rectify acquired or congenital issues of heart’s anatomy and or its functionality. Surgeons, who operate on heart, also operate on blood vessels for repairing the damage or blockage caused in them by ailment or disorders of the cardiovascular system.

What Determines When Someone Need Cardiac Surgery? Several symptoms & signs may be present like:

  •  Chest pain / discomfort, uneasiness
  •  Troubled breathing or rapid breathing or shortness in breathing
  •  Excessive sweating/ vomiting accompanying heart or chest pain
  •  Sudden fainting / wooziness/ frequent loss of consciousness
  •  Excessive weakness

These symptoms / signs determine further investigations such as echocardiogram, stress tests& coronary angiography.

Indications of Cardiac Surgery: Based on these investigative test& their / results, cardiac surgery is indicated if

  •  There is severe triple coronary Artery Disease
  •  Severe calcified coronary A’s which are choked/ blocked
  •  Severe left main coronary Artery Disease
  •  If heart inner valves like Mitral &/ or Aortic are stenosed or leaking (Regurgitation)
  •  Severe left ventricular dysfunction requiring ventricular Assist devices
  •  Cardiac transplant, if heart has failed

Types Of Cardiac Surgery – Two Main Types:

(A)Open Heart Surgery (B) Beating Heart Surgery

In open Heart surgery, Heart – lung machine is used and surgery is performed on hole in heart, heart valves, muscles and or arteries, installing VAD & TAHs/ Cardiac transplant 
In Beating Heart Surgery, clogged arteries of heart are bypassed while heart is beating there by restoring blood flow to the heart. This is also known as coronary Artery Bypass Grafting or CABG.

Minimal Invasive Surgery:

Involves cardiac or lung surgery where whole chest is not opened instead through small cuts/ holes & with help of endoscope & long instruments surgery is performed. Itinvolves minimal body trauma, blood loss and faster/ early recovery.

What are Benefits / Risks of Cardiac Surgery ?

Alongside advantages in relief of signs of cardiac disease, prolonging life of patient, it also reduces further incidence of heart attack & danger of death.

Some of complications & risks of heart surgery are –

  •  Mild fever
  •  Infection of chest wound
  •  Post operative bleeding
  •  Weakness for few days
  •  Failure of lungs or kidneys
  •  Neurocognitive symptoms like loss of consciousness or vagueness

How Long Does A Cardiac Surgery Take?

  •  Depending on type of operation, you are undergoing, the average time of cardiac surgery is 3-4 hours. Patient usually is awake after 6-8 hrs of successful heart surgery and is removed from the ventilator.
  •  He or she recovers within 5 days to one week and discharged home at end of 5-7 days. It takes 5-6 weeks to completely recover.
  •  At time of discharge from hospital, all necessary precautions regarding precautions, type of lifestyle & food habits to be followed are told to the patient
  •  Physiotherapy plays useful &very advantageous role in early recovery of the patient.

If you are in search of multi-specialist Heart Hospital in India, which can provide both medical & surgical treatment for heart, then SPES HOSPITAL is worth considering.