Insomnia

Sleep in a physiological activity occurring in the dark at the end of the day. The internal clock of the brain cells circadian rhythm clock sets the sleep wake cycle in conjuction with the night & day. About a third of adults experience some type of sleep disorder during their lifetimes, over half of them do not seek medical advice ay any time. Insomnia is the most common and most widely recognized sleep disorder.

What is Insomnia?

Insomnia is difficulty in initiating or maintaining sleep. It may be transient or persistent. It is the deviation from the normal sleep duration for the particular individual resulting in disturbances in ones life style. The quality of sleep in Insomnia in non-restorative in nature. The more the individual tries to sleep the greater the sense of frustration and distress and the more elusive sleep becomes.

Transient Insomnia is most often associated with anxiety, either as a sequelae to an anxious experience or in anticipation of an anxiety provoking experience, i.e., an examination or an impending job interview. Some others may have transient Insomnia because of grief, change in life style or stress.

Persistent Insomnia in which the individual experience difficulty falling asleep. The difficulty in fairly long in duration before any one realizes that it could be due changes in the sleep patterns rather than occurring due to anxiety and stress.

Due to consumption stimulants like caffeine or caffeine containing beverages like coffee, soft drinks or drugs one may develop persistent Insomnia.

During alcohol oropioid abstience the drug addicts may experience Insomnia. On several other occasions like painful disorders like post surgical state, injuries & arthritis one can develop Insomnia.
Some psychological disorders like depression, psychology anxiety disorders are associated with Insomnia.

Symptoms :

The individual with Insomnia is mostly pre-occupied with the difficulty falling asleep. High levels of arousal during the night time and anxiety with distress further results in delay in onset of sleep.
They may feel sleepy during the day time or may virtually experience sleep attacks. Difficulty in concentrating on tasks during day time, irritation and restlessness at workplace may also be noticed frequently. The lack of feeling of freshness when they get up in the morning is also occasionally described by the individuals suffering from Insomnia.

Total duration of sleep time at night would be reduced significantly and may be associate / at time with multiple awakenings in between.

Feeling of tiresomeness, lack of interest in work, forgetfulness are some other problems faced by individuals with Insomnia.

Dur to psycho physiological disturbances in the life style arising out Insomnia. One may have reduced work efficiency, accidents while driving, injuries at work place while handling machinery may also occur due to Insomnia.

How to treat :

Transient Insomnia can be treated by managing the stress or by getting over the immediate cause of the problem.

Persistent Insomnia requires medication.

The principles of beating Insomnia are :

•	medication shall be prescribed for another period i.e., 2 weeks.
•	Specific medication with proper precaution to the usage of medication like timing, dosage and length of duration of treatment shall be explained to the patients.
•	Awareness about the long term usage of hypnotics to the patient is essential, commonly used drugs for Insomnia are benzodiazepines like alprazolam, lorazepam and chlordiazepoxide. The problem with these drugs are if they are not properly prescribed or explained to the patients they have high addict potential.

New hypnotics drugs like zolpidem and zoleplon are useful and have less addiction potential, it used under supervision

Medication for Insomnia shall be used only after detailed check up by the doctor and under his case find supervision only.

Ones should never attempt to borrow others prescription or buy drugs out the counter at the medical outlets.

Some tips for good night sleep

•	The bedroom should be generally be dark and quiet, no television, sterio or other noise generating sources be allowed in the bed room.
•	Never attempt to read or simply stay in bed without sleeping.
•	If you are not able to fall asleep within 10 minutes get up and do something else until you feel sleepy again.
•	Wake up times should be strictly adhered to relaxation, meditation practices are occasionally helpful to get into sleep.
•	Avoid hot, cafeiene containing beverages and smoking before going to bed.
•	Remember alcohol results in disturbed sleep.

Dr. Tejam,
Consultant Psychiatrist.

source : teluguone

Robotic Heart Surgery

Robotically-assisted heart surgery is a major headway in medical community’s endeavour to minimize the extent and the trauma of cardiac surgery. With this technology, the surgeon manipulates the surgical instruments with the help of a computer.

Robotically-assisted heart surgery technology involves insertion of surgical instruments through pencil sized holes, instead of the conventional way of making a 12 to 15 inch long incision required to split a patient's breast bone. An endoscope and two surgical instruments are passed through tiny incisions in the chest wall. The surgeon views the image provided by the endoscope on a computer screen. Instead of manipulating the surgical instruments directly, the surgeon manipulates them via a computer console - similar to manipulating a computer games console. The computer interprets the surgeon's hand movements and causes the surgical instruments to respond accordingly. This system addresses the major disadvantages of moving the long surgical instruments manually - computer control of the surgical instruments essentially eliminates the tremor effect, and also the non-intuitive feel of maneuvering such instruments.

The Robotic Surgical System enhances a surgeon's hands much like a microscope enhances a surgeon's eyes. This 'enhancement' gives the surgeon the extra precision and dexterity necessary to perform these very delicate procedures without having to crack the patient's chest, wide open.

While it takes special training to become adept at using robotically-assisted instruments, most surgeons who have had such training report that they feel quite comfortable maneuvering surgical instruments via a console instead of directly.

Much of the early work with robotically-assisted heart surgery has been with bypass surgery, limited to single bypass grafts. However, it is predicted that with advances in technology, multiple grafts with robotic assistance will be possible, at virtually any location on the heart.

The chief advantage of such surgery is incisions that are made are tiny, eliminating the large incision and provide the benefits of significantly reduced patient pain and trauma, shorter recovery times and convalescent periods. Rapid recovery from cardiac surgery is not only better for the patient, but it is also less expensive.

The chief disadvantage at this point is that the technology is new, and (despite early encouraging reports) is still evolving. Its efficacy and safety have not yet been proven sufficiently.
Another disadvantage is the cost of the robotic systems. The bottom line: it is likely to be several years before robotic heart surgery is widely available.

However this technology throws open new possibilities, for instance, a surgeon performing a heart operation while sitting at a console 15 feet away from the patient, can also perform with equal efficiency the same operation while sitting 1500 miles away from the patient. In other words patients could be operated upon by only the very best surgeons.
Dr. Vijay Dikshit, MS, MCh
Chief Cardiothoracic Surgeon.

source : teluguone

HOW DOCTORS THINK

HOW DOCTORS THINK: Jerome Groopman; Byword Books Pvt. Ltd., GF-15, Virat Bhavan, Mukherjee Nagar Commercial Complex, Delhi-110009. Rs. 395.

Like most of us, Jerome Groopman believes that practitioners of modern medicine are all too human and so are prone to make errors in judgment. But since the doctor’s errors can be fatal, every effort should be made to minimise them. That requires studying medical errors scientifically. This is precisely what the author does in this splendid volume.

The book, he says, “is about what goes on in a doctor’s mind as he or she treats a patient.” Every physician — even the most brilliant — makes a misdiagnosis or chooses a wrong therapy. Groopman differentiates “medical mistake” from “misdiagnosis.” While the former involves prescribing a wrong dose of drug or looking at an X-ray upside down, the latter is about the way doctors think, analyse a situation, or arrive at a diagnosis taking into consideration all the factors available at that time.

A majority of medical errors, according to him, do not qualify as technical mistakes, but are attributable to flaws in the physician’s thinking. He quotes a study of one hundred cases of incorrect diagnosis where inadequate medical knowledge was identified as the reason in only four cases. The rest are all due to what he calls “cognitive-traps,” which are of three types. First is “availability,” where recent or dramatic cases come to mind and colour judgment about the case in hand. Then comes “anchoring,” or short-cut thinking, where the doctor does not consider multiple possibilities but quickly and firmly latches on to a single one. And the third is “attribution,” where stereotypes can prejudice the doctor’s thinking and lead to conclusions that do not flow from the data on hand.

“Distorted pattern recognition” can be the result of the “ecology” of the patient. (A Navajo woman with breathlessness is diagnosed as a case of pneumonia when she, in fact, was suffering from Aspirin toxicity.) “Confirmation bias” refers to selecting data which suit the already made diagnosis and ignoring the rest. “Affective error” resembles confirmation bias in selectively surveying data.

To avoid falling into these cognitive traps, Groopman has this simple but sound advice: “Even when you think you have an answer, generate a short list of alternatives.” He cites examples from each speciality to explain these cognitive errors and goes on to show that availability of time, unethical promotional activities of the pharmaceutical firms, and patterns of health coverage like insurance can ultimately influence the treatment. “Zebra-retreat” refers to doctors’ shying away from a rare diagnosis and settle for a common one. “Diagnosis momentum” refers to mental fixation of a doctor, despite incomplete evidence. (An unkempt coloured labourer who admits to taking alcohol may be conveniently branded as having alcoholic liver disease when, in fact, he may be suffering from something entirely different, for example Wilson’s disease.)

Uncertainty

And there is a whole chapter on “uncertainty.” Based on previous studies, Groopman describes three types of uncertainty: one that results from incomplete or imperfect mastery of available knowledge; another, from the limitations in current medical knowledge; and the third, from the difficulty in distinguishing between the individual’s ignorance and the limitations of the present state of medical knowledge. The challenge of modern medicine is to make decisions “in the absence of certitude” which, according to him, forms the “core reality of practice of medicine.”

To patients, Groopman offers a very practical advice: expect from your doctors and demand of them, 3-Cs — communication, critical reasoning, and compassion. Note that he does not include academic brilliance! A medical practitioner who is able to deliver on these three counts is unlikely to err in his judgment. This book is a must-read for doctors who would like to re-evaluate their medical decisions, critically and constantly.

source: the hindu

12 Healthy Habit Changes For 2009

Habit 1: Drink more water.
Sure, I know about all the news reports that say it's possible to drink too much water.
Surprisingly, this same story is told just about every 4 years when news stations have no other "news" going on, and it always seems to stir up all sorts of awareness on the topic. The truth is, in all my years of guiding individuals on proper nutrition, I have yet to run into one person who had an H2O disorder.
A well-hydrated body has a much easier time at shedding unwanted body fat and preserving lean muscle mass. A healthy, active individual should be consuming 6to 7 Litres of water per day.

Habit 2: Eat more fiber.
I'll say it again. People do not get nearly enough fiber in their diets. Work on trying to get anywhere from 25 - 30 grams of fiber per day into your eating plan. Fiber provides a plethora of benefits from increasing the thermic effect (calories burned from digestion) of a meal, to trapping and evacuating excess fats.


Habit 3: Eat every 3 hours.
Start splitting your larger meals up into smaller, more frequent bouts of eating. Spreading your calories throughout the day allows for an increase in metabolism and insures that none of the nutrients you are consuming go to waste.
This can be difficult for many people who maintain busy lifestyles, which is why I suggest picking one or two days a week to do all of your cooking. At that point, Tupperware containers become your new best friend.

Habit 4: Eat more fruits and vegetables.

And eat a large variety as well. The more colors you consume the better. They're packed with fat-burning fiber, vitamins, and minerals.
We all know that vegetables are gold, but when it comes to fruit, it sometimes gets a bad rep. I often get the question "but doesn't fruit have a lot of sugar in it?" Again, I have yet to meet the person who has a well-balanced diet who has found that fruit was the main reason they couldn't let go of the extra body fat.
Get over it. If you're obese fruit isn't the culprit. Take a long look at everything else you're eating, and I'm positive you'll find something a little more worthy to drop.

Habit 5: Avoid alcohol.

Alcohol has damaging effect on your lungs, brain, and on your psyche, it makes you unaware and unconscious about life itself. Alcohol, makes you to destroy yourself.

Habit 6: Choose organic and local foods when possible.

There is no doubt in my mind that we will start to see more and more studies come out showing the adverse effects of consuming over-processed food. It's only a matter of time.
Digestion is a delicate process, a process our bodies have spent hundreds of thousands of years perfecting. In just the past few decades we have started introducing extra hormones, antibiotics, and other impurities into our foods. Our bodies have filters that take care of these things, but let's not put them to the test.

Habit 7: Reduce the amount of sugars consumed.
At this point it should be a no-brainer. If anything good has come from the hundreds of diet books written this past decade, it's the awareness that controlling your blood sugar is crucial to achieving optimal health. The sweets do not have to be eliminated from your diet completely, but you should have them well under control.


Habit 8: Stop going to the super market hungry.
Real simple. If you're hungry, you'll buy what you want, not what you need.
Our bodies are still hard-wired for survival. Unfortunately when you stroll down the aisle at your local food supply your brain will target just about anything in your field of vision and deem it an acceptable choice of nourishment, regardless of its nutritional value.

Habit 9: Take regular stand up breaks at work.
Do it for your posture, do it for circulation, and do it for your own sanity. Our bodies were not designed to be in a seated position all day long.
You could prevent much of life's chronic pains if you would just take a moment to stand up and stretch your legs every 30 or 40 minutes. Set a timer on your desktop if you have to; just get it done.

Habit 10: Start using the stairs instead of the elevator.
Even park farther away from your destination so you have to walk a few extra steps in the day. Adding a tiny bit of extra footwork can add up at the end of the year. I know it's not exciting or drastic, but the difference can be a few extra pounds that you don't need hanging around your waist.

Habit 11: Balance your physical and sedentary activities.
I'm talking about what you do with your free time. Have you ever spent a couple of hours on the weekend watching TV, playing video games, or browsing the Internet looking at cat pictures?
Try to create some balance by doing an equal amount of leisure activities on your feet. Take a walk, shoot some hoops, and maybe take up a new physically active hobby. Who knows, you might find something new you really like.

Habit 12: Keep a health journal.
One of the most powerful ways to be successful with your health is to write it all down.
Keep track of your workouts and your nutrition. It can be very hard to figure out where you're going if you don't remember where you've been. You'll be giving yourself a point of reference so you can truly see if any of the changes you make are creating a difference. If they're not, then at least you know that and can change your plan of action and recalibrate.

A lot of times we get a little too ambitious when it comes to our New Year's resolutions and try to take on more than we can handle. This inevitably leads to failure. Start with the small habits and work your way up the fitness ladder for a more subtle and long-term experience.



NADEEMUDDIN
[B.com, PG in P.P.H.C, RIA, PGD in M& A]
CEO, activelifeconsulting
Mail : activelifeconsulting@gmail.com
Call-9849345798

Living Happily with Asthma - a practical situations fact sheet

One third of worlds 115 million Asthma patients are in India. By 2025 there will be an estimated 100 million more asthma patients due to Environmental pollution and Lack of awareness towards the disease and its morbidity. India has second highest mortality rate of asthma in the world. Day by day the pollution levels are increasing everywhere forcing the humanity for suffocation. As with decrease in natural forests and increase in urban concrete forests, the newer spectrum of photochemical pollutants, due to combustion of petrol and diesel are on rise. Today the principal pollutants posing detrimental effects on Human lungs are the oxides of Nitrogen (NO2), Ozone (O3) and particulates.

→ Ozone levels more than 100µg/m3 is hazards to human lungs.
→No2 is emitted from unvented gas appliances and heating appliances, in indoor conditions and vehicular traffic fumes, at outdoors pose great threat to lungs. A level of NO2 more than 28.2microgram/m3 may contribute to Asthma.
→Particulate matter (PM10) consists of a mixture of particulate components including traffic and combustion generated Carbon. Particulate matter can be, Centered ultra fine particles, secondary salt particles (Nitrates & Sulfates), geological and also biological particles (Spores and pollens) of Particle size 2.5µm (PM 2.5 diameter) are capable upon inhalation of reaching, the deepest portions of the lungs and can cause irreparable damage to lungs. All these factors act as potential triggers of Asthma and make worse conditions in an already known asthmatic.

“People with Asthma are often sensitized and exposed to more than one allergen. And there also exists variability between individuals in the magnitude of response to the same levels of allergens.” Says Dr. Vyakarnam Nageshwar, Consultant Pulmonologist , Wockhardt Hospitals. He further adds “A high allergen exposure in sensitized individuals may contribute to poor asthma control. Exposure to dangerous allergens like “alternaria allergen” has been shown to cause sudden respiratory arrest leading to death in Asthmatics.


Indoor Pollutants or Domestic Allergens:-
Practical measures for Avoidance majority of exposure to indoor allergens and mite probably occurs in bed, where we spend on average a third of or lives in close contact with mattresses, Pillows and duvets.

a) Covers: - Covers of pillows, beddings and other furniture are the most common site of allergens. It is very important to cover mattresses pillows and duvet with covers that are impermeable to mite allergens. It is also must to ensure that covers are wiped at each change of bedding.
b) Washing: - All the exposed beddings should be washed at 55*c .as this temperature kills mites in beddings.
c) Feather vs. Synthetic Pillows: - Asthmatics are often wrongly told to avoid using feather pillows. In the last few decades, sales of synthetic pillows have increased enormously based on the misconception that synthetic pillows are non-allergic. But recent studies have confirmed that synthetic pillows being non allergic is just a Myth. A synthetic pillow accumulates the mite allergens more significantly faster than feather filled pillows.


Dr. Vyakarnam stresses on the fact that "People should be more aware of the fact that so called ‘Hypo allergic’ synthetic pillows and quilts are not hypo allergic at all.”

d) Carpets:-

These are important microhabitat for mite colonization and possible source of allergens.
-All fitted carpets should ideally be replaced with polished wood or vinyl flooring.
-Steam cleaning or exposure of carpets to direct sun light for at least 3 hrs will kill mites.
e) Pets at Home: -
The most powerful risk factor for severe asthma in children was pet ownership. Concentration of both cat and dog allergens are high in almost in all homes with pets. It was observed in recent studies that 62% of children are sensitized to dog and cat allergens, who had a poor control over their asthma, inspite of correct medication.
The best way to reduce exposure to cat or dog allergens is remove the animal from bed rooms and living rooms. “One should be alarmed that it takes months before reservoir allergen levels decrease and the symptoms of the patient subside, even after the animal removed from home.” Air borne allergen levels increase by 5 folds when pet is in the room.
It is an unfortunate condition that “Asthma is often severe and difficult to control in pet exposed Asthmatics.”

It is always safe to undertake an investigation of Lung Function Test (Spirometry) at the earliest sign of breathlessness, chest tightness, dry cough, nocturnal wheezing, sleeplessness at nights, which may or may not be associated with cold and sneezes. There exists a scientific way to get treated with inhalation devices to achieve an early and complete control on Asthma.

Dr. Vyakarnam further adds that “In a recent discussion with Yogic Guru Ramdev Baba we have been able to unveil a completely new dimension in the management of Asthma, which is the use of Scientific Yogic Pranayams which will benefit the Asthmatic sufferers . It is after a two hour discussion on Pranayamic postures for Asthmatic patients that we have been able to identify 4 basic Pranayamic Postures , a) Anulom Vilom, b) Kapal Bhati, c) Bhramari and lastly d) Bhastrika, these postures increase the lung capacity of the Asthmatic patient and decreases the symptoms”

How is management of Asthma different at Wockhardt?
At Wockhardt, we use a team approach which consists of a Pulmonologist , Clinical immunologist , Dietician and a physiotherapist for the treatment of our patients, providing our patients with complete comprehensive holistic treatment. We make sure that every patient is aware of his/ her condition, and there is adequate knowledge sharing with even the family members to provide adequate support to the patient. At Wockhardt we believe that we are only the facilitators in your care management and it is our patients who manage their Asthma in their individual ways. In the year 2008 Dr. Vyakarnam Nageshwar Consultant Pulmonologist, had patented a special Allergen Identification Record, which is a completely new approach for the management of Allergy and Asthma this has been recognized and published at the proceedings of the World Congress of Asthma. Talking about this Dr. Vyakarnam added “ The Contribution of Wockhardt Hospitals, Hyderabad towards management of Asthma has come across not because we have done something new its because we have looked at asthma from a different perspective our patients perspective.”

ABOUT DOCTOR





Dr. Vyakarnam Nageshwar is a young, dynamic Pulmonologist, active in clinical practice since half a decade. Over these years he has been involved in performing interventional Pulmonology procedures. To his credit there are over 500 Tube Thorocostomies, 600 Pleural Aspirations, 300 Pleural Biopsies, 200 Fiber Optic Bronchoscopies ,35 FNAC Procedures, 20 Tru Cut Lung Biopsies and 30 Thoracoscopies.
Dr. Vyakarnam Nageshwar, has also been involved in many Health Awareness Campaigns organized at different levels. The District Collector, Khammam, has honoured him as “Best doctor of Khammam District” for his care and compassion towards his patients. Besides many other laurels, he distinctly holds the honour of treating thousands of patients suffering with Chest diseases especially in HIV positive cases. For this work he received appreciation and blessing from The Holy Father Benedict XVL from the Vatican City (The Holy Pope) in recognition of his attitude of sincere commitment and involvement in relief of patient’s suffering. He is known for his Clinical acumen and dedication towards his patients.
His success rate in treatment of Asthma (Acute / Chronic) is noteworthy with very good patient satisfaction.




Expertise

· Fiber Optic Bronchoscopies
· Thoracoscopies
· Asthma Allergy Counselling
· Needle Aspirations
· Transbronchoscopic Lung Biopsies


Papers, Publications & Awards
· Author of the Text “ The Fundamentals of Hospital Practice and Patient care.”
· Co-author of the “Textbook of Community Medicine”
· He has presented many papers at the state and the national level conferences.

DR. VYAKARNAM NAGESHWAR
M.B.B.S., MD, FCTP, ATC (New Delhi)
CONSULTANT INTERVENTIONAL PULMONOLOGIST.
WOCKHARDT HOSPITALS
HYDERABAD. INDIA
PH : +91 99495 29392

Are there medicines to treat swine flu?

Swine flu is a type of virus. It's named for a virus that pigs can get. People do not normally get swine flu, but human infections can and do happen. The virus is contagious and can spread from human to human. Symptoms of swine flu in people are similar to the symptoms of regular human flu and include fever, cough, sore throat, body aches, headache, chills and fatigue.

Q. What is swine flu?
A. Swine influenza, or flu, is a contagious respiratory disease that affects pigs. It is caused by a type-A influenza virus. Outbreaks in pigs occur year-round.
The most common version is H1N1. The current strain is a new variation of an H1N1 virus, which is a mix of human and animal versions.

Q. Does swine flu affect humans?
A. While the virus causes regular outbreaks in pigs, people usually are not struck by swine flu. However, there have been instances of the virus spreading to people -- and then from one person to another. The only difference is, says the CDC, transmission in the past did not spread beyond three people -- as it has done this time.

Q. What is behind the spread of the virus this time?
A. Researchers do not know yet know. People usually get swine flu from infected pigs. For example, farmers handling infected pigs can contract the virus. However, some human cases have occurred without contact with pigs or places they inhabited.

Q. What are the symptoms of swine flu?
A. The symptoms are similar to the common flu. They include fever, lethargy, lack of appetite, coughing, runny nose, sore throat, nausea, vomiting and diarrhea.

Q. How does the virus spread?
A. The virus spreads the same way the seasonal flu does. When an infected person coughs or sneezes around another person, the latter is put at risk. People can become infected by touching something with the flu virus on it and then touching their mouth, nose or eyes. An infected person can pass the virus to another before any symptoms even develop.

Q. Why is this spread troubling?
A. Scientists are concerned whenever a new virus is able to jump from an animal to a person -- and then spread from person to person. When the flu spreads person to person, it can continue to mutate, making it harder to treat or fight off.
The World Health Organization has said the current outbreak has "pandemic potential," and has urged governments to take precautions to prevent its spread. If the virus continues to mutate, drug makers won't be able to come up with vaccines fast enough.

Q. Can swine flu be fatal?
A. Just like the regular flu, swine flu worsens pre-existing medical conditions in people. So people with already compromised immune systems can die after contracting it.

Q. But doesn't the common flu kill more people?
A. Yes, common seasonal flu kills 250,000 to 500,000 people worldwide every year. But what worries officials is that a new strain of the flu virus can spread fast because people do not have natural immunity and vaccines can take months to develop.

Q. Have there been swine flu outbreaks in the past?
A. From 2005 to January 2009, 12 human cases of swine flu were detected in the United States, without deaths occurring, the CDC said. In September 1988, a healthy 32-year-old pregnant woman in Wisconsin was hospitalized for pneumonia after being infected with swine flu and died a week later. And in 1976, a swine flu outbreak in Fort Dix, New Jersey, caused more than 200 illnesses and one death.

Q. What does the World Health Organization mean when it says swine flu has "pandemic potential"?
A. If the virus spreads over a wide geographic area and affects a large segment of the population, it is upgraded from an "epidemic" to a "pandemic."

Q. How deadly have pandemics been in the past?
A. In 1968, a "Hong Kong" flu pandemic killed about 1 million people worldwide. And in 1918, a "Spanish" flu pandemic killed as many as 100 million people.

Q. How can one keep from getting swine flu?
A. There are no vaccines available. But several everyday steps can help prevent the spread of germs: Washing hands frequently; avoiding close contact with people who are sick; and avoiding touching surfaces that might be contaminated.

Q. Are there medicines to treat swine flu?
A. Yes, the CDC recommends using anti-viral drugs. They keep the virus from reproducing inside the body. And in an infected person, the drugs make the illness milder.

Q. Can one contract swine flu from eating or preparing pork?
A. No. Pork and other pig-derived products, if properly handled and cooked, do not transmit swine flu. The flu virus is killed by cooking temperatures of 160°F (70°C).

There are antiviral medicines you can take to prevent or treat swine flu. There is no vaccine available right now to protect against swine flu. You can help prevent the spread of germs that cause respiratory illnesses like influenza by

• Covering your nose and mouth with a tissue when you cough or sneeze. Throw the tissue in the trash after you use it.
• Washing your hands often with soap and water, especially after you cough or sneeze. You can also use alcohol-based hand cleaners.
• Avoiding touching your eyes, nose or mouth. Germs spread this way.
• Trying to avoid close contact with sick people.
• Staying home from work or school if you are sick.

THE FIRST KNEE REPLACEMENT SURGERY USING REVOLUTIONARY MINIMAL INVASIVE SURGERY TECHNIQUE

Technologically advanced Minimal Invasive Surgery not only leads to less muscle cut – but also Makes the rehabilitation of the patient faster



Mrs. Sarojana, 65 yrs old housewife hailing from Hyderabad was suffering from severe knee pain and severe deformity in her knee. She was a very active person but the pain started affecting her daily activities and she was unable to walk. Now after the joint replacement surgery with the help of MIS technique she was able to straighten her leg with a flexibility of 1 - 100°. On the 2nd day of surgery she was able to walk independently without any support. Due to the advanced technique of MIS there was no cut or damage of the muscle which let to her quick recovery.


In the traditional surgery there is extreme loss of blood due to incision made during the surgery which delays the recovery time also. Whereas in the minimal invasive surgery small hole is made for the surgery which leads to very less blood loss thus leading to fast rehabilitation.


The patient was operated by Dr. Sudhir Reddy, Consultant orthopaedic Surgeon, Yashoda Hospital, using the revolutionary Minimal Invasive Surgery technique.


Dr. Reddy was convinced to use this new surgery technique. The surgeon believed that MIS technique has revolutionized knee replacement surgery as well as many fields of medicine.


"I wanted my patients to recover fast that too by not undergoing a painful surgical process which involves more of muscle damaging thus increasing the blood loss and thereby extending the recovery time to more than 6 weeks. So this MIS technique was designed taking into consideration all these and specific features have been incorporated into the technique which addresses these without compromising on other aspects," said. Dr. Sudhir Reddy, Consultant Orthopedic Surgeon, Yashoda Hospital.


"I lost hope of walking & faith of independent living. I was nervous to think about my painful & bedridden future. Dr. Reddy has given me a new lease of life," Mrs. Sarojana.


Minimal Invasive Surgery Technique


Joint Replacement Surgery has evolved tremendously over the last few years. Traditionally it is done through a large incision, muscles are cut, takes a long time to recover and on average patients take about 6 weeks to achieve the primary goals of independent walking and bending the knee up to 90°. With the new technique all these problems have been addressed. As there is very little damage to the tissues, the recovery s extremely quick, pain is much less, muscle strength is much better and bending at the knee is much more as demonstrated in this patient.


Benefits Of Minimal Invasive Surgery :
* Minimally invasive total knee replacement is a technique developed to dramatically improve the successful outcome and reduce the pain & recover time.
* In MIS technique a very small incision of less than 10 cms is made as compared to 25 cms of traditional TKR.
* In MIS technique muscles are not cut/damaged at all whereas in traditional TKR muscle of the leg is divided thereby leading to weakening the knee.
* Minimal Invasive surgery is a very special technique where special instruments are used to perform the surgery.
* Minimally invasive surgery improves the patient's lives after knee replacement. There is very little damage to the tissues, the recovery is extremely quick, pain is much less, muscle strength is much better and bending at the knee is much more.
* In the MIS surgery the operative time is longer, but hospitalization time is shorter.
* This technique causes less pain, less blood loss and thus speedy recovery.
* It drastically reduces the typical time taken to independent walking from 6 weeks to 2-3 days.

Traditional TKR MIS - TKR
Length of incision 25 ms < 10 cms

Time taken to walk with support 2-3 days Few hours

Time taken for Independent walking 4-6 weeks 2 days

Time taken to bend the knee to 90° 7 – 20 days < 1 day

Length of stay in hospital 7 days 2 days

Average flexion achieved 100° 120°

Blood loss 500 – 700 ml Minimal

Dr. Sudhir Reddy,
Consultant orthopaedic Surgeon,
Yashoda Hospital,
Somajiguda, Hyderabad. INDIA.
Cell : 09866939188
ksudhirreddy@gmail.com
ksudhirreddy@hotmail.com