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Epilepsy and Pregnancy: What You Need To Know

Epilepsy is also known as a seizure disorder. A seizure is a brief temporary disturbance in the electrical activity of the brain. It is a neurological disorder in which brain activity becomes abnormal. In 40% of cases, it occurs due to brain trauma, infection in the brain, injury, or tumour, and in the case of the other 60% of patients, no identifiable cause is seen.

Epilepsy causes seizures or periods of unusual behaviour, unusual sensations, and sometimes loss of awareness. It affects both males and females irrespective of age, race, or ethnic background. It may occur as a result of a genetic disorder or an acquired brain injury, such as trauma or stroke. Even today 4 out of 10 people in the industrialized world do not receive appropriate treatment. This ratio is high in the case of developing nations, where 8 out of 10 people do not get adequate treatment for this medical condition.

In India, 0.5-1.0% of its population is affected by epilepsy.

Symptoms of epilepsy vary depending on the type of seizure. Some Conditions Mimic Like Seizures For Example Syncope, Hypoglycaemic attacks, Transient ischemic attacks, Panic attacks, Physiological jerks during sleep, breath-holding spells in children, and Psychogenic episodes.

There are two types of epilepsy -- partial and generalized. These are based on how and where the abnormal brain activity begins. Seizures that appear to involve all areas of the brain fall in the generalized category. Within generalized seizures there are 6 types:

• Absence Seizures (Staring and blinking)

• Myoclonis Seizures (Brief jerking movements, usually of upper body)

• Tonic-Clonic (Going stiff and falling – followed by convulsions (jerking movements)

• Tonic (Going stiff and falling but without convulsions)

• Atonic (Falling limply to the ground)

Diagnosis & Treatment

EEG is the most common test to diagnose epilepsy. The electrodes record the electrical activity of the brain and diagnose it. Patients with epilepsy may still get seizures due to failure to take medication at the right time. Sleep deprivation, Stress, Dehydration, Alcohol or drug use or withdrawal, Hormonal Fluctuations, Flashing lights, are common triggers for seizures reoccurrence. Accurate diagnosis of patient’s seizure type and where seizures begin to provide the best chance for finding an effective treatment. Epilepsy patients have to maintain a seizure diary, do regular follow-ups with the doctor, and AED compliance.

The average risk of secondary seizure following a single unprovoked seizure is 35-40%. Generally, the first seizure cannot be treated. Prolonged focal seizure, first seizure as status epilepticus, presence of focal deficit, family history of seizures, EEG abnormality, and abnormal neuroimaging in these circumstances a single seizure may be treated. In India, two types of treatment options are available, primary treatment and secondary treatment. In primary treatment, the doctor uses anti-epileptic drug therapy or surgery to treat epilepsy. In case of secondary options, doctors apply Vagal Nerve Stimulator, Ketogenic diet, Psychological or complementary therapy to help the patient recover from epilepsy.

For epilepsy treatment in Vijayawada, book an appointment with the best neurology hospital now.

Epilepsy and Pregnancy

90% of women with epilepsy syndrome have normal pregnancy and delivery. All patients should be taking folic acid 5mg/day. During pregnancy in 25%, seizures may remain unchanged. In 50% of women, it could improve and in around 25% of women, it can get worse. All patients should be given two doses of VIT-K 10mg IM at 34-36 weeks of pregnancy and also fetal malformations screening (16 weeks - 18 weeks) is a must. All infants born to mothers taking AEDs should be given Vitamin K 1-mg IM at birth. The overall incidence of fetal abnormalities in children born to mothers with epilepsy is 5–6%, compared to 2–3% in healthy women. The patient has to take the anti-seizure medication exactly as prescribed by the doctor during pregnancy. Uncontrolled seizures could pose a greater risk to your baby than any medication. It is also important to make healthy lifestyle choices like taking prenatal vitamins, getting enough sleep, avoid smoking, alcohol, illegal drugs, and caffeine.

Manipal Hospital is one of the best neurology hospital in Vijayawada equipped with the latest techniques and equipment and has experienced neurologist in Vijayawada with vast experience in the field of neurology.

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Renal Replacement Therapy

Why do we need dialysis?

Our kidneys play an important role in filtering out waste and excess fluid from the body, which is then excreted through urine. When the kidneys fail to function properly toxins and excess fluids and electrolytes build up in the body leading to several complications such as high blood pressure, swelling in the extremities, nausea, vomiting, heart disease, weak bones, decreased immunity, etc. Without treatment, the worsening can progress leading to death. In such cases, the person needs medical support in the form of renal replacement therapy (RRT) or dialysis, which mimics the functioning of the kidneys. RRT is generally recommended when the kidney functions fall by 80-90% and the glomerular filtration rate (GFR is a test used to measure kidney function) is <15 ml/ms/1.7ml BSA.

If you are looking for a hospital for renal replacement therapy in Salem then book an appointment with Manipal Hospital now.

Can dialysis reverse kidney disease?

No, dialysis cannot reverse kidney disease. It only helps to carry out the functions of the kidneys, such as removing toxins and excess fluid from the body, maintaining electrolyte balance essential for normal body functioning and helping regulate blood pressure.

Who requires dialysis?

Several conditions may require RRT, including:

Acute kidney Injury: when the kidney stops working suddenly due to snakebite/toxics or other health condition such as septic shock, dehydration, heart complications, enlarged prostate, high blood pressure in pregnancy, etc it is known as acute kidney injury. Acute kidney injury is reversible and the kidneys start functioning once the primary condition causing it is taken care of.

Chronic kidney disease: This condition is characterised by progressive worsening of kidney functions due to diabetes, hypertension etc leading to end-stage kidney disease, where the kidneys stop functioning completely. This condition is irreversible and the person is dependent on lifelong dialysis or renal transplant for survival.

Are dialysis and RRT the same?

Technically speaking, dialysis is a type of RRT.

RRT is carried out in patients with kidney failure to replace the filtration functions of the kidneys. RRT techniques include hemodialysis, peritoneal dialysis and continuous hemofiltration and hemodialysis.

RRT is usually done periodically or continuously depending upon the patient condition. Continuous therapy is usually reserved for acute kidney injury patients.

What is Haemodialysis?

This is the most common type of dialysis.

During the procedure, a tube is attached to the needle in your arm, through which blood is made to pass into an external machine (dialyser), which filters it just like your kidneys. Post filtration, the purified blood is pumped back into the body through another tube in the arm.

This can be done at home or at a dialysis centre, around 2-3 sessions a week each session lasting for about 2-6 hours depending upon patient conditions and severity.

Complications of haemodialysis may include low blood pressure, skin itching, muscle cramps, dry mouth, and rarely blood-borne infections like hepatitis b &hepatitis C. Hence our centre does dialysis at segregated for HBV and HCV infected patients.

What is Peritoneal dialysis?

This process makes use of the internal lining of your abdomen also known as the peritoneum to filter out toxins and fluids instead of the machine.

In this procedure, a tiny incision is made near your belly button and a catheter (thin tube) is inserted through it to reach the inside of the peritoneal cavity (protective sac around the abdomen). During every session, the dialysis fluid from a bag flows into the cavity through the catheter. When the bag is emptied, you need to remove it from the catheter opening and place a cap at the catheter tip so that you can move around with it. As blood passes through the tiny blood vessels lining the peritoneal cavity, the toxins and excess fluid is drawn out into the dialysis fluid from the blood. After a few hours, the dialysis solution with toxins is drained out from the body into an empty bag, which is discarded.

The process needs to be repeated about 3-5 times a day or while you sleep at night.

Peritoneal dialysis can be done manually or with a help of a machine, which automatically fills and discards fluids from the belly.

Unlike haemodialysis, peritoneal dialysis needs to be done every day. The patient can set it done at home and need not visit the hospital for dialysis. However, it allows you a less restricted diet, better kidney function retainment and more flexibility to travel as compared to hemodialysis.

Complications of peritoneal dialysis may include infection of the abdominal cavity, weight gain as the dialysis fluid contains a high amount of sugar, hernia and inadequate filtration after a few years requiring haemodialysis.

What are Continuous hemofiltration and haemodialysis?

The third type of dialysis is known as continuous hemofiltration and the hemodiafiltration procedure is generally used to remove toxins and excess fluids continuously throughout the day in patients with acute kidney injury in ICU settings, such as those with multiorgan failure or shock. This method of dialysis is far gentler than the other forms of dialysis and requires medical expertise for optimal outcomes.

Manipal is one of the best hospital for renal replacement in Salem having a top nephrologist in Salem who is highly experienced in treating any type of kidney-related conditions.

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Alzheimer's Disease & Dementia: What is the Difference?

Dementia is characterized by a progressive, global deterioration in intellect including memory, learning, orientation, language, comprehension, and judgment due to disease of the brain. There is no cure for dementia. Treatment is only to delay or slow the progress of deterioration. AD was named after a scientist Dr. Alois Alzheimer. He reported a case of a woman with memory loss, language problems, and unpredictable behaviour and had changes in her brain tissue.

Every year on 21st September we celebrate World Alzheimer’s day to create awareness among the public, decreasing stigma, and urging policymakers to invest in providing care. AD is usually the disease of the elderly population and accounts for around 50-60% of all dementias. Prevalence increases with progressive age if it’s around 0.6% in people aged above 65years and increases to 20% in >85 years. Among 138 crores Indian population, 14 crore population are senior citizens and among them, around 50Lakh (5%) people are suffering from dementia. Among all dementia, Alzheimer’s dementia is the commonest type.

Dementia not only affects senior citizens but also their family members. There is a huge burden on the family and the community. As the disease progress dementia cases need assistance in their daily activities and will need a person dedicated 24/7 in providing care.

Signs and symptoms of dementia include- progressive declining memory loss, mood changes, including irritability and anxiety, difficulty processing new information and learning new things, loss of spontaneity and initiative, difficulty in identifying family members & friends, confusion about time and place, forgetting the way back home or difficulty finding the right path even at home, communication difficulties, decline inability to perform routine tasks, shorter attention span, difficulty with reading and writing and numbers, poor personal hygiene. Personality changes (e.g., aggression, significant mood swings), requires increasing assistance with daily tasks, psychotic symptoms, and are completely dependent on another person.

The exact cause of AD is not known. However, research and studies say neurons (brain cells) start to degenerate, lose connections with each other and eventually die. There is a build-up of abnormal proteins that form “amyloid plaques” and “tangles” around the brain cells. The e4 version of the APOE gene- provides instructions for making a protein called apolipoprotein E. This gene might be responsible for causing amyloid plaques and tangles.

Increasing age, family history, hypertension, diabetes, obesity, history of head injury, substance use and smoking, sedentary lifestyle, poor sleep habits, less formal education are the various risk factors for dementia.

It’s a diagnosis of exclusion- substances induced, nutritional, vascular, NPH/SOL/Tumours, subdural hematoma, infections, epilepsy, Cushing’s/Addison’s/hypothyroidism, chronic renal failure/ liver failure, and Wilsons’s disease needs to be excluded. Diagnosis is done by complete medical and psychiatric history and complete physical and neurological examination followed by routine blood and urine tests, CT scan &/or MRI scan, mental status examination to determine the level of mental deterioration, caregiver interview to determine the level of dependency.

There is no cure, treatment is only to slow the disease process (slowing the degeneration in brain cells) decreasing the caregiver’s burden, by giving care in the community and sharing them. Disease slowing agents available are cholinesterase inhibitors- galantamine, rivastigmine, donepezil, and memantine. Aducanumab is a recently FDA-approved drug that is a human antibody or immunotherapy, that targets the protein beta-amyloid and helps to reduce amyloid plaques, which are brain lesions associated with Alzheimer’s. Any medical or psychiatric comorbidities need to be treated.

There is various non-medical treatment available for dementia. These interventions can be learned by family members with few training sessions and can be administered at home.

1. Reminiscence therapy: Elicits recall past events, activities, and memories using tangible aids such as photographs, familiar items from the past, music, and movies

2. Validation therapy: Focused on validating the feelings of the person with dementia rather than focus on the confusion and loss. It is found to decrease stress, promote contentment and suppress behavioral disturbances.

3. Reality orientation: Aims to decrease confusion and behavioral symptoms in people with dementia by orienting the individual to time, place, and person.

4. Cognitive stimulation therapy: Typically delivered in a social setting in small groups involving cognitive-based tasks and activities, including word games and puzzles.

5. To care in the community: Nursing care by hiring nurses, long-term care homes, dementia homes, telemedicine for professional help, home visits by health care workers, and daycare centres.

Caregiver stress is inevitable, it can be dealt with by giving proper training and psychoeducation, stress management, decreasing the expectations and sharing the responsibilities, and by institutional care. Family members should be encouraged to socialize, forming self-help groups in the community, improving the treatment and care accessibility from the government side, providing economical support to caregivers and time outs and breaks as stress don’t burn them out. Caregiver’s guilt also needs to be addressed and providing professional help to them when needed by periodic assessment of the caregivers for depression and anxiety.

If you are looking for Neurology Hospital in Mangalore for Alzheimer’s Disease treatment then contact Manipal Hospital. They have the best Neurologist in Mangalore who are trained in Alzheimer’s Disease Treatment in Mangalore.

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Detecting the early symptoms is the key to control Asthma

Asthma is a respiratory disorder that occurs due to the narrowing of the airways. The airways in the lungs of asthmatic patients become inflamed and may get filled with mucus, limiting the airflow. It occurs due to the allergies or irritants such as smoke and is more likely during winters. Few people have asthma attacks during physical activities or while exercising.

Asthma can be chronic (long-lasting) and can range from mild to severe based on the extent to which your breathing is affected. You will have episodes of coughing, wheezing, chest tightness, and controlling your breath can be really difficult. For effective control, you need to be aware of the early symptoms and signs of asthma which can occur suddenly. People with a family history of asthma are more prone to develop the condition, so it is better to seek suggestions from the top pulmonologist in Jaipur in advance. Asthma is more common in women than in men while the reverse is true among children.

Asthma is not a serious condition if recognized early and treated properly. We are lucky enough to have medicines to control asthma. A person with severe asthma can have an improved quality of life with proper medication.

“Childhood-asthma” occurs before the age of five in a majority of the children. If your question is “Can my child diagnosed with asthma cannot do activities or play sports like the other children?” The answer is an emphatic “NO” as there are controller medications. In fact, some Olympic athletes also have asthma.

Inhaler corticosteroids which reduce inflammation and bronchodilators which relax the muscles of the airways keeping them open are the commonly used medications to reduce the frequency of asthma attacks. Bronchodilators can also reverse most of the asthma cases, which are not severe. Nearly 90-95% of asthma cases can be controlled with medications. The remaining 5-10% of people are those with severe asthma who do not respond well to the treatment. If you have allergic asthma, the first thing you should do is to avoid the allergens such as pollen, dust, mites, air pollution, extreme weather conditions, etc. that trigger asthma. The attacks can be fatal in severe asthma cases, and when you stop taking medications or do not take them in the right way. So, you need to be serious about the condition before it gets serious! It is also recommended to regularly monitor your asthma using a peak flow meter.

Symptoms of asthma can temporarily appear and go away, so it is not definitive that you have asthma. Only a doctor can diagnose and say if you have asthma. Firstly, a correct diagnosis is essential for proper treatment and helps to dispel the fear of the patient.

Extreme asthma attacks can be life-threatening, but the key is to control it. Although a complete cure of asthma has remained elusive, the symptoms are controllable, and you or your loved ones can lead a normal life. If you notice the symptoms of asthma, you should consult a doctor for proper treatment. In a nutshell, it is not very serious. Visit Manipal for Respiratory allergy treatment in Jaipur today.

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Lung Scarring Secondary to COVID-19: A Call to Arms?

COVID 19 infection may advance to pneumonia and ARDS, which may require assistive breathing support.ARDS is a severe respiratory failure characterized by inflammation in the lungs. A subset of patients who survive COVID-19 infection and recover from ARDS may develop lung fibrosis.ILD is a group of disorders associated with fibrosis (scarring) of the lungs.

ILD includes IPF  and other lung diseases. The fibrosis that develops after surviving ARDS is severe but is usually not progressive. Because fibrosis in ARDS and chronic ILD may share underlying commonalities, however, there is a possibility that treatment for fibrosis may be beneficial for those associated with COVID 19

The main problem of COVID is post-recovery repercussions you may get all sorts of conditions and problems like fibrosis its’ even more problematic if you are suffering from other chronic lung diseases like asthma. On the occasion of world lung day, I warn that COVID 19 is undisputedly the most serious disease.

We in the Outpatient pulmonary clinic are seeing many patients with significant lung fibrosis, months after their acute illness from COVID was declared “cured”, the damage is apparently permanent. We have treated dozens of coronavirus sufferers in the past few weeks, from symptom-free spreaders to intensive care patients on HFNO machines. They have suffered very painful lung damage.

Recovered patients are also at particular risk in swimming. The severe changes in the lungs can significantly increase the risk of accidents.

In the check-up after several weeks, many patients showed a significant oxygen deficiency during exercise as a typical sign of persistent lung damage. Many asthmatics with COVID showed more suffering or breathing difficulty than usual “you have to have regular checks with lung damage like this”.The extent to which long-term effects remain on the lungs is unclear and currently speculative, according to many observations across the world.

We don’t think anybody has the data now, only predictions based on small series from SARS and MERS, it may be similar or different and potentially not limited to the lung parenchyma.

Recently in Chennai and Hyderabad post-COVID patients with pulmonary fibrosis are listed for lung transplantation.

I am sure that pulmonary fibrosis will be a diagnosis spoken a lot in the post COVID world. Chronic lung disease and the costs to our healthcare system and economy go far and beyond the immediate mortality rate.

There is been extensive debate on the persistence of fibrosis after COVID 19 and also the effective medications to manage it, but most of them seem to be experimental therapies. Consult with the pulmonologist in Goa to know more about the therapies.

A small study presented at the virtual European respiratory society international congress shows the importance of pulmonary rehabilitation in patients recovering from COVID 19.

The specialized pulmonary rehabilitation hospital in Goa demonstrates recovery and had normal lung volume and

The researchers observed that the longer a patient waited to begin pulmonary rehabilitation, the less and the slower the patient would recover from COVID 19 infection. These researches tell us the importance of pulmonary rehabilitation post-COVID 19.

Dr. Prabhu Prasad N.C Heads the department of pulmonology at Manipal Hospitals Goa is responsible for clinical management of post-COVID lung crisis and also heads the Pulmonary Rehabilitation unit.

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Robotic GI Cancer surgery: Da-Vinci Robotic System for Precision Cancer Surgery

The world has witnessed a sea of change in the surgical world in the last decade. Cancer care has improved dramatically. We are now moving from a radical approach towards precision surgery, accurate surgery and Robotic cancer Surgery is a part of it.

Surgery is an important aspect of the treatment of solid cancers including Gastrointestinal cancers. Minimal access to cancer surgery has redefined the outcome of surgical procedures including major GI cancer surgery of the colon and rectum. Minimal access cancer surgery can be performed by a Robotic DaVinci system. Combining surgical skills with technology has wonderful results.

If we talk about Robotic Surgery and Gastrointestinal cancer, it is done only at a few limited centres. Robotic GI cancer surgery is safe. The combination of magnified stereoscopic 3 D vision and versatile Robotic endo wrist helps in minimal tissue handling, better control and tissue dissection with patient safety. Surgery is difficult and inaccessible areas happen with ease with the DaVinci robotic system especially in pelvic surgery, rectal cancer surgery.

No large incision, faster recovery, minimal postoperative pain, the reduced hospital stay is true for Robotic cancer surgery.

Robotic surgery also results in improved functions, both urinary and sexual functions. It offers better function preservation and nerve preservation, nerves supplying the vital pelvic organs, normally difficult to identify with naked eyes. Sexual function is important in young individuals, unfortunately, a less discussed and addressed issue, especially in females.

When a patient who has undergone a complex surgery like Robotic rectal cancer surgery, tells you that he/she has intact urinary bladder and sexual function in particular, as a Robotic surgeon you feels satisfied & happy. It makes your day.

Manipal Hospital is one of the best hospital for robotic GI surgery in Delhi having renowned onco-surgeon in Delhi who are experts in treating all types of cancer and have hands-on experience in using the latest equipment and technologies. So if you are looking for a good surgeon or good hospital for Robotic GI Surgery in Delhi then book an appointment with Manipal Hospital.

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Kidney Transplant after a COVID-19

Kidneys are crucial for filtering out harmful waste material and excess fluids from the body. Many conditions including diabetes, hypertension, and obesity can impair the filtering capacity of kidneys. Chronic kidney disease (CKD) also called renal failure or kidney failure is a slowly progressive loss in kidney functions resulting in the building-up of harmful fluids and waste products in the body. It affects multiple organs and can eventually death if left untreated.

Life-long dialysis and kidney transplantation are two treatment options for kidney failure. Comparatively, a kidney transplant is a better choice of treatment and involves surgically replacing a diseased kidney with a healthy kidney that is received from a living person (living donor) or someone who has recently died (deceased or cadaver donor).

Benefits of Kidney Transplantation

Kidney transplantation is the best therapeutic option for patients with end-stage kidney disease and has numerous benefits such as:

Does not require lifelong dialysis treatment.

Compared to patients who are on life-long dialysis treatment, kidney transplantation patients live longer with an average life expectancy of 10 to 15 years.

Higher energy levels and enthusiasm to do regular day-to-day activities.

Fewer dietary restrictions

Sometimes the end-stage kidney disease can also cause end-stage liver disease. For treating such patients with multiple organ dysfunction, simultaneous replacement of more than one organ (e.g., combined kidney and liver transplantation) gives them multiple benefits including single surgery and usage of lower immunosuppression dose.

Risks of Delaying Kidney Transplantation

In chronic kidney disease, the kidneys have lost around 90% of their filtering functions. Delay in treatment can cause a build-up of the high content of calcium, sodium, potassium, and fluid in the body which is life-threatening. It can also result in heart problems, bone diseases, anaemia, etc. It is, therefore, imperative for patients suffering from chronic kidney diseases not to avoid or postpone kidney transplantation.

Impact of COVID-19 Pandemic on Kidney Transplantation

Organ donation and transplantation programs have suffered a major setback owing to the coronavirus disease 2019 (COVID-19) pandemic. Global data suggests a drop of about 51-91% in various countries during the first peek of the pandemic. Another report suggests a 2.2 times higher risk of death among patients awaiting kidney transplants during the pandemic.

Most of the hospitals in India and around the world temporarily suspended kidney transplantation related activities as the intensive care units and hospital wards were dedicated exclusively to the care of COVID-19 patients. In addition, the fear of contracting COVID-19 infection kept people suffering from kidney diseases from visiting hospitals for treatments.

Is it safe to undergo a kidney transplant during the COVID-19 pandemic?

There are many causes of a successful kidney as well as combined kidney and liver transplants during the pandemic. Even after recovering from COVID - 19 infection, many patients with stage 5 chronic kidney failure have undergone successful transplantation without requiring additional dialysis treatment, post-operatively.

Safety Protocols for Safe Kidney Transplantation During the COVID-19 Pandemic

Hospitals are following exceptional and aggressive safety protocols to protect their patients during the COVID-19 pandemic.

Both the donor and the recipient are aggressively screened for COVID-19 symptoms and exposure history, such as travel history.

Before kidney transplant, in the donor and the recipient, active COVID-19 infection is ruled out with a negative RT-PCR test and absence of symptoms for at least 3 days or 72 hours.

If the kidney patient or the donor is COVID-19 positive, the transplant will not be performed until a complete cure occurs. After at least 14 days of the onset of symptoms, and a negative RT-PCR report (which is repeated 2 - 3 times consecutively to conform results), the transplantation is performed.

Due to virtual evaluations of both the potential kidney donors and recipients, via video or phone, the hospital visits are less frequent and shorter which prevents chances of infection.

Because kidney transplant patients take immunosuppressive drugs, they may be at a higher risk for infection. To prevent this, the patient is educated on the importance of wearing a face mask, hand hygiene, coughing and sneezing etiquette.

The dialysis centre, ICU, and the hospital premises are aggressively disinfected regularly, beds are arranged at a good distance with no attendant policy to prevent the spread of infection.

A separate ICU is maintained for kidney transplant patients.

Conclusion

Transplantation is a life-saving procedure and its benefits outweigh the risk of contracting the COVID-19 infection in the current scenario. The ongoing vaccination drive and the standard safety protocols being followed have reduced the chances of contracting severe COVID-19 largely. Most International guidelines recommend not to postpone transplantation procedures in high-risk patients to delay complications. Overall, it is safe for both the donors and the recipient to come forward for kidney transplantation or combined kidney and liver transplantation at present. Visit the Best Kidney Transplant Hospital in Bangalore if you have any queries.

If you are looking for a Kidney Transplant in Brookefield, Bangalore then consult Manipal Hospital where they have the Best Doctor for Kidney Transplants in Bangalore who have years of experience in kidney transplants.

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Kidney Transplant after a COVID-19

Kidneys are crucial for filtering out harmful waste material and excess fluids from the body. Many conditions including diabetes, hypertension, and obesity can impair the filtering capacity of kidneys. Chronic kidney disease (CKD) also called renal failure or kidney failure is a slowly progressive loss in kidney functions resulting in the building-up of harmful fluids and waste products in the body. It affects multiple organs and can eventually death if left untreated.

Life-long dialysis and kidney transplantation are two treatment options for kidney failure. Comparatively, a kidney transplant is a better choice of treatment and involves surgically replacing a diseased kidney with a healthy kidney that is received from a living person (living donor) or someone who has recently died (deceased or cadaver donor).

Benefits of Kidney Transplantation

Kidney transplantation is the best therapeutic option for patients with end-stage kidney disease and has numerous benefits such as:

Does not require lifelong dialysis treatment.

Compared to patients who are on life-long dialysis treatment, kidney transplantation patients live longer with an average life expectancy of 10 to 15 years.

Higher energy levels and enthusiasm to do regular day-to-day activities.

Fewer dietary restrictions

Sometimes the end-stage kidney disease can also cause end-stage liver disease. For treating such patients with multiple organ dysfunction, simultaneous replacement of more than one organ (e.g., combined kidney and liver transplantation) gives them multiple benefits including single surgery and usage of lower immunosuppression dose.

Risks of Delaying Kidney Transplantation

In chronic kidney disease, the kidneys have lost around 90% of their filtering functions. Delay in treatment can cause a build-up of the high content of calcium, sodium, potassium, and fluid in the body which is life-threatening. It can also result in heart problems, bone diseases, anaemia, etc. It is, therefore, imperative for patients suffering from chronic kidney diseases not to avoid or postpone kidney transplantation.

Impact of COVID-19 Pandemic on Kidney Transplantation

Organ donation and transplantation programs have suffered a major setback owing to the coronavirus disease 2019 (COVID-19) pandemic. Global data suggests a drop of about 51-91% in various countries during the first peek of the pandemic. Another report suggests a 2.2 times higher risk of death among patients awaiting kidney transplants during the pandemic.

Most of the hospitals in India and around the world temporarily suspended kidney transplantation related activities as the intensive care units and hospital wards were dedicated exclusively to the care of COVID-19 patients. In addition, the fear of contracting COVID-19 infection kept people suffering from kidney diseases from visiting hospitals for treatments.

Is it safe to undergo a kidney transplant during the COVID-19 pandemic?

There are many causes of a successful kidney as well as combined kidney and liver transplants during the pandemic. Even after recovering from COVID - 19 infection, many patients with stage 5 chronic kidney failure have undergone successful transplantation without requiring additional dialysis treatment, post-operatively.

Safety Protocols for Safe Kidney Transplantation During the COVID-19 Pandemic

Hospitals are following exceptional and aggressive safety protocols to protect their patients during the COVID-19 pandemic.

Both the donor and the recipient are aggressively screened for COVID-19 symptoms and exposure history, such as travel history.

Before kidney transplant, in the donor and the recipient, active COVID-19 infection is ruled out with a negative RT-PCR test and absence of symptoms for at least 3 days or 72 hours.

If the kidney patient or the donor is COVID-19 positive, the transplant will not be performed until a complete cure occurs. After at least 14 days of the onset of symptoms, and a negative RT-PCR report (which is repeated 2 - 3 times consecutively to conform results), the transplantation is performed.  

Due to virtual evaluations of both the potential kidney donors and recipients, via video or phone, the hospital visits are less frequent and shorter which prevents chances of infection.

Because kidney transplant patients take immunosuppressive drugs, they may be at a higher risk for infection. To prevent this, the patient is educated on the importance of wearing a face mask, hand hygiene, coughing and sneezing etiquette.

The dialysis centre, ICU, and the hospital premises are aggressively disinfected regularly, beds are arranged at a good distance with no attendant policy to prevent the spread of infection.

A separate ICU is maintained for kidney transplant patients.

Conclusion

Transplantation is a life-saving procedure and its benefits outweigh the risk of contracting the COVID-19 infection in the current scenario. The ongoing vaccination drive and the standard safety protocols being followed have reduced the chances of contracting severe COVID-19 largely. Most International guidelines recommend not to postpone transplantation procedures in high-risk patients to delay complications. Overall, it is safe for both the donors and the recipient to come forward for kidney transplantation or combined kidney and liver transplantation at present. Visit the Best Kidney Transplant Hospital in Bangalore if you have any queries.

If you are looking for a Kidney Transplant in Jayanagar, Bangalore then consult Manipal Hospital where they have the Best Doctor for Kidney Transplants in Bangalore who have years of experience in kidney transplants.

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Diet Plan For Mothers After a C-Section

Our mothers are superheroes and they take care of us with their whole heart and soul but they themselves don’t take the time to take care of themselves properly. When a woman gives birth to a baby, either vaginally or via a C-section, she goes through a lot of pain and they are at their weakest. This is why every new mom deserves special care and attention. When it comes to Cesarean delivery, the care of a mother is a little different than that of a normal delivery. Post-pregnancy care begins with a healthy diet. Here is a healthy diet plan for mothers after a C-section. Lactation is the process for the production and secretion of milk by the mammary glands.

Energy

The lactating mother needs more calories during breastfeeding. For this purpose, energy-dense food needs to be replaced by nutrient-dense food like nut, milk, pulse, egg, and fish.

Proteins

Proteins are essential for proper healing and growth of new bodily tissues as well as to provide strength to muscles which in turn helps in aiding regular bodily processes. Foods such as eggs, chicken, fish, and meats (for non-vegetarians) and milk, cheese, dried beans, peas, and nuts (for vegetarians) are rich in protein. Consult with the best gynecologist in Jayanagar regarding your diet during pregnancy time.

Calcium

Calcium is one of the important mineral required during pregnancy and lactation. During lactation, calcium is essential for milk production and it also helps in promoting bone and teeth health and relaxes the muscles as well. Calcium also helps in the coagulation of blood and preventing harmful diseases like osteoporosis. Milk and milk products like yoghurt are great sources of calcium. Foodstuff like ragi, Bengal gram, soybean, amaranth radish leaves etc is prescribed as food items in a daily meal of lactating mother.

Vitamins

Just as calories, proteins and calcium requirements are increased during lactation, vitamin requirements are also increased. Vit A, B1, B2, B3, C, folic acid and Vit B12 are the major vitamins needed at this time. Vitamin C is a special vitamin required due to its immense ability to fight against bacterial infections and its ability to speed up the process of recovery. Food items such as papayas, oranges, grapes, tomatoes, broccoli, melons and strawberries are rich sources of vitamins.

Iron

There is no additional requirement of iron during lactation. This is due to lactation-induced amenorrhea and thus mothers will not have any losses of iron through menstruation. The baby is born with enough reserves since milk is not a good source of iron. But iron-rich foods are important for the mother’s health.

Essential fatty acid

An intake of additional fat is recommended to meet essential fatty acid needs particularly DHA and long-chain fatty acids in the maternal diet is crucial for brain development.

Fiber

Constipation is a common problem after delivery for many women. It can put a lot of pressure on the wounds which can be dangerous as it may lead to breaking up of stitches. Eating fibrous foods such as raw vegetables, fruits in the form of salads can help ease the symptoms of constipation.

Fluids

Fluids help in dealing with dehydration, constipation as well as smoothening bowel movements. The requirement for fluids increases especially during breastfeeding as there is the loss of water is involved. Some of the best sources of fluids are soups, coconut water, non-citrus fruit juices, and water, of course, as well as other non-caffeinated drinks.

Foods To Eat After A C-Section

Galactagogues are substances used to induce, maintain, and increase milk production.  Foods Considered to be Galactagogues are –

Whole grains, especially oatmeal

Dark, leafy greens (alfalfa, kale, spinach, broccoli)

Fennel

Garlic

Chickpeas

Nuts and seeds, especially almonds

Ginger

Papaya

Foods To Avoid:

Avoid consumption of acidic food

Avoid caffeinated drinks like tea/coffee  very frequently

Avoid alcohol consumption

Avoid smoking

Avoid junk food and fried food as they may cause a gastric problem

Visit Manipal, the obstetrics and gynecology clinic Jayanagar to know more about the diet plans.

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Holmium Laser Enucleation of the Prostate (HoLEP)

Manipal Hospital is the best hospital in Malleshwaram located towards the north of Bengaluru, it is an 81 bedded secondary care hospital renowned for its medical expertise in the areas of Urology, Cancer Care, Neurosurgery, General Medicine, Nephrology, Orthopedics & Gynecological services.

The hospital has in a very short time introduced new services that were unheard of in the region, including General Surgery, Renal Sciences, Medical Gastroenterology, Surgical Gastroenterology, Pediatric Surgery, Plastic surgery, Spine surgery & Hand & Reconstructive Surgery.

The hospital is a medical center in the Northern region with a gamut of facilities. With the excellent success rate of the hospital, more & more people are beginning to avail the multiple benefits of facilities & amenities, close geographical proximity & an economical pattern of charges.

Our core values are built around the thought of patient-first and that each doctor at Manipal Hospitals is a human care expert, going above and beyond the call of duty as they live by the belief that every single life is priceless. When they embark on these journeys, stories emerge - stories of grit, determination and never giving up. Join us on a journey to discover stories that reinforce your belief in 'Life's On.

Urology Dept.

The Urology Department at Manipal Hospitals Malleshwaram is centered on the well-being of our patients who are recovering from prostate surgery. That is probably one of the main reasons why we are known to be the leading name in the field of urology-related treatments and prostate surgery recovery. Our hospitals have the best urology doctor in Bangalore who is globally acclaimed for all their treatment techniques and diagnostics excellence for prostate surgery laser.

Even the most challenging urological diseases seem to have their end right here with our urologists’ specialists in Bangalore and their treatments of prostate surgery by laser. We are amongst the list of the best-ranked departments all across India for our prostate surgery options. Being specialized in this treatment for prostate surgery with a laser has made our doctors recognized and renowned.

Not to mention that here we have a wide spectrum of treatment options available for most of the urological diseases of all time. After getting treated, patients can also opt for prostate surgery recovery time at home. We offer diagnosis and treatment options for kidney stones, incontinence, prostate surgery side effects, cancer and much more. Apart from that, our hospitals have a well-functioning fertility restoration spot as well for those who are in the need for some respite from prostate surgery complications. People who are looking forward to having sound treatment options need to contact us to know the affordable prostate surgery cost.

The doctors and specialists at Manipal Hospitals Malleshwaram are extremely diverse and have a wide range of expertise when it comes to conducting prostate surgery for BPH or Benign Prostatic Hyperplasia. This expertise allows our patients to be an integral part of technologically advanced and innovative treatment surgeries. We also have some great options for Prostate surgery recovery exercises that are recommended by our urologists in Indiranagar. Our methods and equipment used in the prostate surgery procedure are unparalleled and not available in any part of the country.

The team consisting of experts will mitigate all of the prostate surgery risks and ensure the physical as well as mental well-being of the patients. Consisting of board-certified and fellowship-trained urologists in Malleshwaram, our hospitals are definitely the safe haven for providing quality treatment at affordable rates. Patients will not only get state-of-the-art treatment but will also be able to relish on the care and attention provided individually. We have a wide range of prostate surgery types for the people who need it.

Prostate Surgery & available procedure

Prostate surgery can be a very complicated and time-taking process. So, any respite from that agony is most welcome in several hospitals and urology departments in India. Amongst some cutting-edge technology and globally renowned equipment used in Manipal hospital Malleshwaram, there is currently one more name added to that list. The Auriga 50W XL Helium Laser (HoLEP) is a newly acquired and functional machine currently in use for the process of prostate surgery.

Some of the main benefits of the HoLEP procedure are complications after the surgery, pain and longer periods of healing. This revolutionary invention can also be used in order to detect stones and smaller tumors in the body of a patient. The HoLEP prostate surgery is also an optimal solution for men suffering from Benign Prostatic Hyperplasia. With its advanced features, HoLEP surgery is definitely revolutionizing the entire treatment process related to prostate surgery in the best way. The comparison between HoLEP vs. TURP clearly has one winner and that is HoLEP because of its cost-effective properties and functional treatment process.

Laser prostatectomy can be considered as an otherwise safe and sound procedure used by urologists for a very long period of time. This is where the HoLEP urology machine can help people suffering from an enlarged prostate. Also, patients with cardiac problems and pulmonary compromise can rely on the HoLEP operation for sure.

HoLEP or more commonly referred to as the Gold Standard treatment machine is definitely one of the best solutions that transpired. The widely accepted HoLEP incontinence solution has led to the belief that this machine is truly helpful when it comes to treating all prostate-related problems. One might have a few questions that are HoLEP better than TURP but when it comes to the benefits provided by this widely-acclaimed treatment machine, there is no doubt that it can be a boon for people dealing with problems such as bleeding, and few other complications. TURP while effective might have some side effects such as excessive bleeding and TUR syndrome that are otherwise mitigated thanks to HoLEP.

For those who need to know what is HoLEP surgery, there are a few things that they need to know about. One of the main aspects of the HoLEP procedure steps includes the laser removal of the entire enlarged section of the male prostate. Then the enucleated part is disintegrated into smaller pieces so that they can be further removed from the body of the patient without any difficulty.

Some Of The Advantages Of Using HoLEP

There could be many different benefits of using HoLEP surgery options for people. We are mentioning a few of these for better understanding purposes.

This revolutionary procedure offers the prostate tissue for several testing procedures one of which is the postoperative histopathological examination or more commonly known as Biopsy which further provides the means for diagnosis and treatment of unsuspected cancerous elements.

When compared to TURP, most people might think about how much does HoLEP surgery cost. Well, to put it in simpler words, the surgery is definitely affordable and uses much more side-effects-free methods to treat the ailments of people.

Outcomes from HoLEP are extremely durable with the rates of re-operation just 4% at a follow-up of about 8 years in total.

HoLEP surgery is not limited by the size of the prostate.

A single laser of Holmium can be used for about 20-50 different patients, thus reducing the HoLEP cost and making it one of the most cost-effective measures for the treatment of prostate-related ailments.

Treatment using HoLEP will not lead to incontinence and impotence in people as is seen in most of the conventional forms of surgery.

Find out the HoLEP surgery cost in Bangalore and opt for the options right now to have quality treatment and recovery options right now.  Visit Manipal, the best urology hospital in Malleshwaram today.

[manipalhospital]

Unexplained Infertility and Chances of Pregnancy

Having a diagnosis of unexplained infertility is not only frustrating but also frightening. The term “unexplained infertility” sounds as if the diagnosis is grave and no other options remain for the treatment. However, this is far from reality. “Unexplained infertility” just means “unexplored infertility” i.e., the cause of infertility has not been found yet.

If you are looking for an infertility clinic in Whitefield, Bangalore then consult Manipal Hospital Bangalore, they have the best infertility specialist working 24/7 to take care of your needs.

How do we define unexplained infertility?

A diagnosis of unexplained infertility is given when you have tried naturally for a period of 1 year and have not conceived with the following normal results on evaluation:

1. Normal ovarian reserve with ovulation happening in each cycle

2. At least one fallopian tube is open on hysterosalpingography

3. Semen parameters are normal

4. No obvious uterine abnormality on ultrasound or hysteroscopy

What is the incidence of unexplained infertility?

The incidence of unexplained infertility is approximately 5% to 10%.

What are the most common causes of Unexplained infertility?

1. Hostile cervical mucus

2. Minimal to mild endometriosis

3. Poor egg quality

4. Poor sperm quality

5. Abnormal endometrial receptivity

6. Idiopathic i.e., everything may be normal

What can you do to improve your fertility?

1. Exercise daily for 45 minutes

2. Include yoga and meditation in your routine to reduce stress

3. Eat wholesome homemade healthy food. Do not undergo any form of a strict diet.

4. Sleep early and wake up early.

What are the treatment options available for Unexplained Infertility?

1. Expectant management: Couples who are young with no obvious cause of infertility and the period of infertility is short may just be asked to wait for around 6 months to 1 year to try naturally. During this kind of treatment, you can undergo folliculometry i.e., regular ultrasonography to determine the exact days for timed intercourse.

2. Superovulation and Intrauterine insemination (IUI): Superovulation is the process of developing up to 2 to 3 follicles instead of just one. In those couples for whom expectant management has failed, or the duration of infertility is more or the average age of the couple is more, it's better to go ahead with superovulation and IUI. The aim here is to increase the gamete density by processing and concentrating the sperms and getting them closer to more than one egg, such that the chances of conception increase. In doing this,  we also overcome any hostile cervical mucus which may be encountered by the sperms while trying naturally.

3. In Vitro Fertilization: In those who have tried 3 to 4 cycles of IUI and have not conceived, IVF is the next viable option. In most laboratories nowadays, IVF is accompanied by ICSI i.e., Intracytoplasmic Sperm Injection. During this treatment, as many eggs as possible are developed, they are retrieved under ultrasonographic guidance, the eggs are microinjected with individual sperms and embryos are thus formed. These embryos can then be transferred into the uterus of the woman. IVF usually increases the success rate of clinical pregnancy to 55 to 60% in one cycle.

4. Role of laparoscopy: If the duration of infertility is more than 3 years, it may be useful to go ahead with a Diagnostic Hysterolaparoscopy to rule out any abnormalities which have been missed on ultrasound and simpler tubal tests.

5. Role of Genetic analysis of the embryo: In a situation where even IVFs have failed without any known cause, or the mothers age is approaching 40 years or there is a suspicion of genetic abnormality, Preimplantation Genetic Testing or PGT may be advised to screen for any genetic abnormality in the embryo before transferring it into the uterus.

The Infertility and Reproductive Medicine consultant in Bangalore are highly experienced in providing solutions for male and female infertility.

[manipalhospital]

Covid Appropriate Behaviour And Its Importance Today

With the imminent danger of the third wave in India due to the Omicron variant, there is an increased importance of practising the COVID-19 appropriate behavior. Implementation of steps related to COVID-19 protocol, along with contact tracing and increased testing, are found to be effective in managing the pandemic.

Covid-19 Appropriate Protocol

People at all times should follow the COVID-19 appropriate protocols. Some of them are:

Maintain Social Distancing: People should take all safety measures to minimize physical contact and maintain a distance of at least 6 feet to prevent the spread. Avoid physical greetings, such as shaking hands, and instead, greet from a distance. People should lower the number of visitors to their homes and avoid social gatherings. Stay in the house for most of the time and step out only when necessary.

Wear a mask even in the house: The symptoms of COVID-19 take some time to appear. During this period, the infected person unknowingly becomes a carrier. Wear a mask while going out and even at home. People must wear masks when they are with other people in the room. Wearing the mask is essential if the person has signs of cold, cough, or flu. It will help in reducing the transmission of infection. It is necessary to practice the COVID-19 appropriate behavior even at home to prevent disease transmission to family members, especially to the children and elderly.

Frequently wash your hands: Wash your hands frequently with soap and water or an alcohol-based hand sanitiser, especially before wearing and after removing the mask. Washing hands will remove or kill the germs present in your hands.

Avoid touching the eye or nose: Avoid touching your nose and eyes frequently. The person may have touched several surfaces that might have germs. Touching the nose or eyes with contaminated hands may allow the germs to enter the respiratory system and make people sick.

Maintain respiratory hygiene: People must always maintain respiratory hygiene. While coughing, they must use a handkerchief or tissue paper. If these are not available, they should cough or sneeze into the bent elbow. It is necessary to wash hands after coughing or sneezing.

Avoid spitting in public: Spitting in public increases the risk of spreading the COVID-19 pandemic. It increases the risk of life to others. Spitting in public is also a punishable offence under the law.

Get Vaccinated: Currently, vaccination is the only way to prevent transmission and reduce the severity of the disease in case of infection. It also helps in limiting the spreading of the virus. Eligible people should get vaccinated.

Cleaning the frequently touched surfaces: Frequently touched surfaces may have viruses that increase the risk of transmission. It is necessary to clean the frequently touched surfaces at hospitals, public places, and even at home.

Other steps: Other steps are to be followed for effective management of the pandemic. Avoid forwarding any COVID-19 –related unverified information that may create a sense of anxiety and stress in public. Seek help during poor psychological health and call national helpline numbers for any COVID-19-related queries.

Importance Of Covid-19 Appropriate Protocol

Some of the advantages of following the COVID-19 appropriate protocol are:

Prevents transmission: The most critical step to managing any pandemic is to slow down its spread. The Omicron variant is believed to be highly contagious and fast-spreading. People must follow the COVID-19 protocol stricter than before.

Early containment of the disease: The severity of the pandemic is generally evaluated through reproductive numbers and positivity rate. The reproductive number is the number of people infected from each patient. Positivity rate is the number of people tested positive from every 100 people getting tested. Following COVID-19 protocol decrease these numbers indicating better management of pandemic.

Safeguard the children and adults: Children and the elderly are at high risk for contracting COVID-19 with increased severity. Children are not vaccinated. Adults have compromised immune systems, along with other underlying diseases. It is necessary to maintain a COVID-19 behavior at home.

Reduced social stress: Social isolation affects physical and psychological health,  as seen in earlier COVID-19 waves. Controlling the new wave at an early stage, through appropriate COVID-19 behavior, will reduce social stress.

Decreased financial stress: The severity of the COVID-19 wave is directly proportional to widespread financial stress. The number of days of lockdown varies with the transmission of infection, positivity rate, and the number of people infected at a given point. Lockdown may result in shutting businesses and job losses.

If you are looking for a Covid treatment Hospital in Old Airport Road, Bangalore then book an appointment with Manipal Hospital, they have a world-renowned Interventional Cardiologist in Bangalore working 24/7 to take care of your health.