RNI No. DELENG/2010/33833
www.medgatetoday.com
Volume I Issue IV
Nov. - Dec. 2010
Gateway to Health & Medical World
MEDGATE TODAY ` 75
News update | Doctor Speak | Eye Care | Dental Hygiene | Health & Fitness | Expert Views
300 + Customer Base in India in Just 6 years Driven by Customer Insights, Satisfaction & Expectations Fuelled By NNOVAT ON PRODUCT PORTFOLIO • Patient Privacy Screens with Strongest Tracks & Runners “Soflex” • Unique IV Hangers “Double Telescopic” with provision for infusion pump holders “JH DMF” • IV Hanger Non-Telescopic “OHMH” • All S.S. Pedestal IV Stand “Classique” • Bed mount IV Stand “Companion” CORE COMPETENCIES & BUSINESS ETHICS • Transparent Approach to the Business 90% of our Sales is reference driven • Need Based Selling If there is no need we do not sell • Layout Specialization Our forte, Best, Spacious Practical, Economical Layout • Reasonable & Competitive Price Our Prices are affordable • High Quality “Customer is our Quality Guru” • High Deliverability Project Deadlines are also Efficiency Guidelines • High Commitment Levels We make customer for Lifetime
An A & R (ACCESSIBLE & RESPONSIBLE) Company
Lets Make it Simple Through Commonsensology… Bangalore | Bhubeneshware | Bhopal | Bilaspur | Chennai | Calicut | Lucknow | Indore | Mumbai | Delhi
E D ITO R S P E A K
Diabetes Has an Impact on Sex Life Middle aged and older adults are interested in sexual activity, but diabetes impairs libido and can result in erectile dysfunction. Many researchers say men diagnosed with diabetes are more likely to express a lack of interest in sex, but also to experience erectile dysfunction. The study found that about 70% of men and 62% of women with diabetes and sexual partners were found to engage in sexual activity two or three times a month - comparable to people without diabetes. t .FO XFSF NPSF MJLFMZ UP FYQSFTT B MBDL PG JOUFSFTU JO TFY JG UIFZ IBE EJBCFUFT t .FO BMTP XFSF NPSF MJLFMZ UP TVÄŒFS FSFDUJMF EZTGVODUJPO JG UIFZ IBE EJBCFUFT t 8PNFO BT XFMM BT NFO XJUI EJBCFUFT SFQPSUFE B IJHIFS SBUF PG PSHBTN difficulty, including climaxing too quickly for men, or not at all, which was reported by both men and women. t 0OMZ PG XPNFO DPNQBSFE UP PG NFO BMM XJUI EJBCFUFT IBE discussed sexual problems with a doctor, and men were more likely to talk about it than women. t .FO JO UIF TUVEZ SFHBSEMFTT PG BHF PS EJBCFUFT TUBUVT XFSF NPSF MJLFMZ UIBO women to be married or living with a partner, and more men than women said they were sexually active.
Patients and Doctors Should Discuss Sexual Activity "Patients and doctors need to know that most middle age and older adults with partners are still sexually active despite their diabetes. "However, many people with diabetes have sexual problems that are not being addressed." The study found, based on blood tests, that: t PG NFO IBE EJBCFUFT t IBE UIF EJTFBTF CVU IBEOhU CFFO QSFWJPVTMZ EJBHOPTFE t "MNPTU PG UIF XPNFO IBE EJBCFUFT JODMVEJOH XIP IBE CFFO EJBHOPTFE BOE OPU QSFWJPVTMZ EJBHOPTFE "OZ UIPVHIUT PS RVFTUJPO ZPV NBZ IBWF NBJM VT info@medgatetoday.com
%S . " ,"."Editor-in-chief
13th-15th December, 2010 NASC Complex, PUSA, New Delhi, India
2
For Participation Please Contact Vantage Trde Fairs 38/16, 3rd Floor, East Patel Nagar, New Delhi - 110 008 India Call us at: +91-11-252757181, 25757182 Fax us at: +91-11-25757180 Mail us at: contact@vantagetradefairs.com
Opportunity to have a solid footing in an expanding & demanding market Nov – Dec 2010
'SRXIRXW N EWS
U P D AT E A Unique European healthcare innovation bringing smiles to ENT doctors & patients
6
Fortis Hospitals performs GMX]¸W ÁVWX 16- 'SQTEXMFPI Pacemaker
6
*(% %TTVSZIW ']QFEPXE JSV 'LVSRMG 1YWGYPSWOIPIXEP 4EMR
10
/VSRSW 7MKRMÁGERXP] )\TERHW Presence in India
13
H E A LT H &
FITNESS
51
An orange a day may keep stroke awayy
DOCTO R
SPEAK
52
32 Green Vegetables
E X P E RT
VIEWS
1SXLIV¸W 1MPO is complete Food for baby
EYE
I NTE RVI EW
24 Knee 6ITPEGIQIRX
CARE
38
48
Dr. Devi Shetty most renowned Heart Surgeons
Accommodating IOL’S
sŽůƾžĞ /ŕ´Ş/Ć?Ć?ƾĞ /s
EDITOR Dr. M A Kamal EDITORIAL ADVISOR Dr. Ajay Kumar Dr. Shakilur Rahman Dr. Sharad Lakhotia Dr. Piyush Pankaj NATIONAL HEAD Afzal Kamal SR. MANAGER I. A. Khurshid CHIEF CORRESPONDENT S A Rizvi Dr. H N Sharma INDEX TO ADVERTISER "DVSPO .................................... "TJUFDI ...............................cover Dibya Industries..................... Edrees Medical ....................... Garware Bestretch..................27 )** ................................. Hospaccx India...... Inside cover Human Diagnostic ................. Infi............................................. - % 5FDIOPMPHZ ........Back cover -JGF 1MVT .................................. -JGFDBSF ................................... Medaccx.................................. Medicall .................................. Medication groups .................
HYG I E N E
All rights reserved by all everts are made to ensure that the information published is correct, MEDGATE TODAY holds no responsibility any unlikely errors that might occur.
PUBLISHED BY ADVANCE MEDIA GROUP Circulation Office 92/17, Zakir Nagar, Opp. New Friends Colony Okhla, New Delhi - 110025 Tel.: +91 11 26989438 Fax: +91 11 26982464 Mob: +91 9289336800, 9212366351 E-mail: info@medgatetoday.com medgatetoday@gmail.com Visit us: www.medgatetoday.com
Meditek...................................
74, 2nd Floor. Bentinck Street, Kolkata 700001 Mobile: +91 9088848636
Sharma Diagnostic...................
42
SUBSCRIPTION & CIRCULATION Pallavi Gupta
Kolkata Office
Millennium ............................
What is a Dental Abscess? What causes au auses uses Dental Abscesses??
SALES & MARKETING Amjad Kamal Rahul Ranjan Kashif Saigal S Firoz Nitu Sinha S.Y. Ahamed Khan
Medifest ....... Inside Back Cover
Meelan ....................................
D E N TA L
DESIGN & LAYOUT SPRING Design
Mumbai Office 7, Ground Floor, Aradhana CHS Ltd, Bal Samant Marg, Bandra (W), Mumbai 400050 Tel: +91 22 26452920
Chennai Office
5FDIOPDBSF .............................
11, Krishnan Koil Street, 3rd Floor, Rotary Lane Chennai - 600 001, India Tel: +91 44 25214568 Mob: +91 9840054355
8FCDPO .................................
Printed by
South Medilab ........................
B.B.Graphic Printer, E-49/8 (2nd. Floor), Okhla Industrial Area Phase-II, New Delhi-110020
N EWS
U P D AT E
Now in India: A Unique European healthcare innovation bringing smiles worldwide to ENT doctors & patients Nasal packing is the post-surgery application of gauze or cotton packs to the nasal chambers to control bleeding. This application follows surgery of septum or sinuses, to prevent synechiae or adhesions and to treat epistaxis. The existing nasal dressings present in the Indian market need to be removed post surgery or after healing period, thereby causing pain and discomfort for the patients Research has shown that the removal of conventional nasal dressings is related to re-bleeding
and thereby mucosal tissue damage. NexusNovus TCS P Ltd is introducing a solution to these problems; NASOPORE ®. NASOPORE ® is a revolutionary European nasal dressing, with the unique feature of being the first biodegradable wound dressing product in India! Treatment with NASOPORE ® will easily reduce the incidence of complications induced
by removal of nasal packing and thereby significantly increase the patient’s convenience and comfort.
Fortis Hospitals performs city's first MRI Compatible pacemaker on an 80 year old gentleman Heart patients with rhythm disturbance or commonly called as Arrhythmia who needs to undergo a pacemaker implant can now opt for an MRI Compatible Pacemaker. Dr. Venketesh, Interventional Cardiologist from Fortis Hospitals Bannerghatta Road has successfully implanted the latest MR compatible pacemaker procedure on an 80 year old gentleman. efore this procedure, cardiac patients with pacemaker was barred from undergoing any MR scanning as exposure to magnetic radiation can lead to serious complications 6
in the patients. However with this newly introduced technological advanced implant patients can easily undergo MRI at any given point in time. Mr. Rangan, an 80 year old gentleman, hypertensive for almost a decade was suffering from frequent episodes of giddiness and fainting. Upon diagnosis it was revealed that he had a complete heart block – a condition where the heart rhythms / beats are irregular and upper and lower chambers of the heart beat independent to each other. This disassociation of the
heart beats led Mr. Rangan’s pulse rate go down to 28-30bpm which proved to be life threatening for him. Mr. Rangan was advised to undergo a pacemaker implantation to correct the rhythm disturbances in his heart. Considering the old age and the probability of the need to undergo an MRI in the future doctors gave Mr. Rangan the option of MRI compatible pacemaker. Eventually Mr. Rangan successfully underwent the procedure and was discharged from the hospital within three days and now is leading a complete normal life. Nov – Dec 2010
O.T CLEAN ROOMS & O.T EQUIPMENTS
OT Auto Doors
OT Air Curtains
OT S.Steel Panelling
OT Scrub Stations
O.T. Pendent
O.T Clean Rooms
AUTOCLAVES , STERILIZERS, ETO’S & SHREDDERS
O.T Clean Rooms O.T Pendents O.T HEPA Filters O.T Scrub Stations O.T Air Curtains O.T Auto Doors O.T Pass Boxes O.T Positive Pressure Module O.T Laminar Flows Biological Bio-Safety Cabinets
ETO Shredders Automatic Autoclaves Flash Autoclaves g Autoclaves Front Loading H.P.Vertical Autoclaves Horizontal Autoclaves Dental Autoclaves
OPERATION ATION T A TABLES A & ICU BEDS
Surgical Operating Tables Electric Operating Tables H Hydraulic Operation Tables ( C-Arm Compatible))
H Hi - Low Operating Tables p Orthopedic Tables ICCU Beds Motorized Beds E M Electromatic C-ARM Compatable O.T. Tables Fowlers & Semi Fowler Beds
Fowler Beds Hydraulic O.T.Table ICCU Beds
O.T LIGHTS ( Mobile & Ceiling )
O.T Ceiling light Double Dome (7R+4R) D Double Dome (7R) Double Dome (4R) O.T Wall Mounted Light O.
L GHT T FLOOR FL LO OOR O MODEL. M MO O.T LI LIGHT
O.T LIGHT (4R)
OT LIGHT ( 7+4R)
O.T.LIGHT (7R)
CRASH CARTS TS , TROLLE TROLLEYS & FURNITURE (S.S)
Mayo Trolley
Instrument Trolley I t e tT olle
Dressing Trolley
Crash Cart
Monitor Trolley M itt T ll
S.STEEL SUCTION PUMP , DRESSING DRUMS ,TRAYS etc
Formalin Chambers
Catheter Trays ( S.S)
Kidney Trays ( S.S)
Instruments Trays ( S.S)
Dressing Drums Seamless( S.S)
INSTRUMENTS STERILIZER & HOLLOWWARE
Urinal- (S.S) Male /Female
Bed Pan - (S.S) ( Female/Male)
Wash ( S.S) Basin
Dustbins ( S.S ) (Push / Pedstal )
Fumigator ( S.S)
OT Free Standing lights Crash Carts (S.S) Ultraviolet Inst. Sterilizer g y Trolley y (( Emergency ((S.S)) Monitor Trolleys (S.S)) y ((S.S)) Medicine Trolleys ethesia Trolley ( S.S) Anaethesia Dressing Trolleys (S.S)) ments Trolleys (S.S)) Instruments Mayo’s Instru.Trolleys (S.S)
Suction Apparatus (S.S)) Instruments Sterilizers (S.S)) Swab Rack ((S.S)) Dressing Drums (S.S)) Instruments Trays (S.S)) Catheter Trays (S.S) Kidney Trays (S.S)) Cidex Tray (S.S)) Suction Apparatus ratus s Formalin Chamber ( S.S) Instrument Sterilzers ((S.S)) Fumigator (S.S) Dustbins (S.S) Wash as Basins as s (S (S.S) S) d Pan - Female (S.S) Bed Bed Pan - Male (S.S) Urinal - Female ((S.S)) Instruments Steriliser t ili Urinal - Male (S.S) ( S.S)
Manufactured & Exported by
WEBCON INSTRUMENTS & EQUIPMENTS 894 , Ganeshpuri , Suswahi , Behind Hydrabad Gate , BHU , Varanasi-221005 ( INDIA ) Ph : 0091-542-2575984 , 2575985 Fax : 0091-542-2575027 Email : info@wbcon.org , webconjoshi@yahoo.co.in & webcon@rediffmail.com
N EWS
U P D AT E
Unpasteurized Baugher's Apple Cider Linked To 7 E. Coli Infections, Three Hospitalized The Maryland Department of Health and Mental Hygiene (DHMH) informs that three infected people have been admitted to hospital, but there have been no deaths. Baugher's Orchard & Farm of Westminster has issued a voluntary recall of all its apple cider produce, due to possible E. coli contamination. The company stresses that none of its other products are included in this recall. According to the DHMH, between 20 and 40 cases of E. coli 0157:H7 infections are reported in Maryland annually. Last year there were 24 reported cases.
About E. coli E. coli, also known as Escherichia coli, are types of bacteria that line the human intestine. E. coli typically exists in the human colon. The bacterium can be present in uncooked beef, contaminated water and untreated milk and dairy products. Most E. coli strains are not hazardous to human health, except for 0157:H7, which can cause serious infection, also known as food poisoning.
An accurate diagnosis of E. coli poisoning is only possible by taking and testing a sample of the patient's stool (feces). Infection can spread by eating tainted foods, particularly undercooked ground beef (typically used for making beef burgers), or raw vegetables that have been soaked or washed in infected water. Individuals who are in close contact with infected animals may also become ill. Less commonly, humans can transmit E. coli infection to other humans. E. coli signs and symptoms may include: 'LDUUKHD 7KLV PD\ GHYHORS into hemorrhagic diarrhea (with blood), in which case abdominal cramps are severe. $EGRPLQDO SDLQV 6RPH SDWLHQWV PD\ GHYHORS D fever, but not always Most infected patients will be better within a few days. E. coli 0157:H7 produces a toxin which damages the lining of the intestine. Children with E. coli poisoning can develop anemia and kidney failure (hemolytic-uremic syndrome). Some may have seizures, and even go into coma. Adults with weakened immune systems, such as the very elderly can also develop anemia.
HPV Vaccine: Cost-effective Way to Prevent Anal Cancer
Study Shows Benefits of HPV Vaccine in Men Who Have Sex With Men The human papillomarvirus (HPV) shot is a cost-effective way to prevent genital warts and anal cancer in men who have sex with men. This is the finding of a new study that appears in The Lancet. In 2010, there will be about 5,260 new cases of anal cancer diagnosed in the U.S, and about 720 people will die from this disease, according to the American Cancer Society. There are no routine prevention programs or screening tests for anal cancer. HPV vaccines protect against certain types of HPV that are linked to cervical cancer and anal cancer. A sexually transmitted disease, HPV or genital warts can be transmitted through vaginal, anal, and oral sex. Nearly 80% of cases of anal cancer are linked to two of the types of HPV that the vaccine targets.
The DHMH says that anybody with similar symptoms to those described above should see a health care professional as soon as possible. People who have purchased the cider should discard it. 8
Nov – Dec 2010
All Kind of Laboratory · · · · · · · · · · · · · ·
Haematology Biochemistry Liver Function Test Kidney Function Test Elisa Tests Hiv (Aids) 1&2 Tumour Markers Hepatitis Profile Hormone Assay Bacteriology Cytology & Histopathology Urine Examination Stool Examination For Sputum
SHARMA DIAGNOSTICS Dr. Jagdeo Sharma
Dr. B K Sharma
Dr. Rajiv R Sharma
MD (Path), DCP, FIAMS
MD (Path), DCP, FAMS
MD (Biochemistry), FAMS
Address VIP Road, Bengalitola Chowk Laheriasarai – 846001 Darbhanga (Bihar) Phones 06272-244667, 244608 Mobile 09334921864 E-mail shdiagno@hotmail.com
N EWS
U P D AT E
FDA Approves Cymbalta for Chronic Musculoskeletal Pain
Cymbalta Effectively Treats Osteoarthritis and Chronic Low Back Pain A drug used to treat depression, anxiety, fibromyalgia, and diabetic neuropathy has been approved by the FDA for a new use -- to treat chronic musculoskeletal pain, including pain caused by osteoarthritis and chronic low back pain.
Vitamin D deficiency common in advanced cancer Many patients with advanced cancer are vitamin D deficient and this may be contributing to their pain symptoms and cognitive decline, a palliative care physician says. In a letter to the Journal of Pain and Symptom Management Dr Timothy To from Flinders University Adelaide detailed a study of vitamin-D deficiency in a consecutive cohort of hospice inpatients. “Patients with advanced cancer are frequently troubled by chronic pain, cognitive changes, and declining function and mobility‌ many have multiple risk factors for vitamin D deficiency including malnutrition, chronic renal and liver disease and are using medications that affect vitamin D levels, including anticonvulsants and corticosteroids.
Chronic low back pain is one of the most common forms of musculoskeletal pain, and finding an effective treatment can sometimes be challenging. The approved dose for chronic musculoskeletal pain is a 60-milligram capsule taken once a day, swallowed whole; it does not have to be timed with meals.
Chocolate leads to a healthier althier heart Chocolate leads to a healthier heart: study Older women who eat chocolate regularly are less likely to develop cardiovascular disease, an Australian study shows. Researchers in Perth found that women who ate chocolate were less likely to be hospitalised or die of atherosclerotic vascular disease than those who steered clear of it. And they did not even need to overindulge to obtain the cardiovascular benefit, with similar benefits applying to those who ate chocolate only once a week and those who ate it daily, according to the study published in Archives of Internal Medicine. 10
More than 1,200 women over 70 took part in the study and were tracked for a decade. Nearly half had less than one serving of chocolate a week, which was the equivalent amount of cocoa in one cup of hot chocolate.
Nov – Dec 2010
N EWS
U P D AT E
KronosË Significantly Expands Presence in India
Mr. James Thomas, Country Manager, India Operations, Kronos; Mr. Arun Datta, Vice President, Human Resources, Medanta; Mr. Aron Ain, Chief Executive Officer, Kronos; Mr. Peter George, Chief Technology Officer, Kronos and Mr. Birendra Prasad, General Manager, Human Resources, Delhi International Airport Limited. Opens New Corporate Facility in Noida as Workforce Management Software Grows in Relevance in India
Kronos customer base is strong and growing Kronos revenue in India increased 300 percent in the past 12 months. Kronos’ growing customer base in India includes leading multi-nationals and local organizations such as: Bombardier Transportation, a global leader in the rail sector; Eaton, a leading global diversified industrial manufacturer; GENPACT, a global leader in managing business processes; Hindustan Zinc Ltd., the largest integrated Indian producer of zinc and lead; Medanta – The Medicity, one of India's largest multi-super specialty institutes; and Viraj Profiles Limited, one of the world’s largest producers of stainless steel products.
Dr. Naresh Trehan, chairman and managing director, Medanta, one of India’s largest and most respected healthcare facilities “We have built an institution which matches the highest standards of healthcare delivery across the world and we realize that quality of patient care and the reputation of the organization are heavily dependent on the frontline workforce. In addition to solutions like ERP and HIS, we also wanted to deploy a best-of-breed workforce management solution to plan and manage our workforce in real-time. We chose Kronos not only for its ability to meet our requirements but also, as a global leader in healthcare, to bring in the best healthcare practices used by healthcare organizations worldwide.
To Advertise in this Magazine Call +91 9212366351, +91 9289336800 12
Nov – Dec 2010
Manufactured By: AcuronTM Products E-23-B, Nandadeep Everest, C.H.S.L, Shell Colony, Chembur (W) Mumbai - 400 071 URL: www.acuron.co.in, Email: sales@acuron.co.in Contact Nos.: +91 9930999336 / 9323460807 / 9892210967
N EWS
U P D AT E
Spectacular World Dental Show Signal India’s Growing Dental Sector
The three day event demonstrated to the world that the future of dentistry lies in India IDA-ADITI hosted World Dental Show, the flagship event beyond compare, got off to a splendid start at the specially erected podium at the Bandra Kurla Complex here on 29 October 2010. Dr Roberto Vianna, the President of the FDI World Dental Federation, who was the Chief Guest at the glittering ceremony, inaugurated the World Dental Show in the company of a galaxy of dental luminaries. The inaugural ceremony became truly global with the august presence of the President of the Federation of Dentaire International (FDI) and the faculty members from the University of California, San Francisco. The World Dental Show, the leading dental trade exhibition and a key platform for expanding the Indian dental market was held from October 29-31, 2010 at the Bandra Kurla Complex, the emerging locale for trade exhibitions. Occupying over 20,000 14
sq. m. area of exhibition space, it was the biggest dental show ever held in India. Considerable participative interest in the World Dental Show was evinced by countries across all the continents except Africa. The ambience at the event left a truly international mark in the minds of the people. The event provided an opportunity to the participants to assimilate modern technologies and secure a chance to witness the state of the art dental equipment and products displayed. As many as 32 companies from14 countries (China, Czech Republic, Brazil, Germany, Hong Kong, Israel, Italy, Japan, Korea, Russia, Taiwan, UK, USA and UAE) other than the 123 companies from India had occupied 384 Trade Fair Stalls that displayed several innovative devices that made the event truly global. Over 1500 delegates had registered for participation at the Scientific Conference over the three days of the event. The international exhibitors were amazed at the potential that existed in the dental market in India. The exhibitors did a lot of business and they met the entire dental fraternity of India at one place. The exhibitors were really happy to see the
large number of visitors numbering over 16,000 to the Show. The fact that the event was a sequel to what transpired at the inaugural event in 2009 goes to prove the concept and success of WDS as a global event and the desire of the exhibitors to participate in the development of dentistry in India. WDS 2010 brought together exhibitors from all over the world together with the doyens of Indian dental industry. In Mumbai, India's most dynamic industial and commercial city, WDS 2010 combined exhibition, scientific
Nov – Dec 2010
N EWS
U P D AT E range of products, technologies and innovations that were on display. WDS 2010 has successfully brought about a fusion of the latest innovations and emerging technologies from around the globe to India’s dental community. WDS 2010 provided visitors with a truly global glimpse of the trends shaping the world of dentistry and the diverse range of dental professionals that the conference was able to attract. Visitors to WDS 2010 also benefited from the wide-range of products, technologies and innovations on display.
programme and the user-oriented workshops to create a platform which was unique in itself. All segments of the dental sector like dental professionals, trade and industry, laboratory technicians were well represented, besides the large number of dentally discerned who visited the three day fair. Events like this are expected to improve the oral healthcare sector in India
Nov – Dec 2010
and consequently oral health of the people which is the mission of IDA. Cementing its position as the premier dental showcase in the region, WDS 2010 brought together participants from several countries in a three day event that delivered the cutting edge in dental technology, techniques and patient treatment. Visitors to WDS 2010 immensely benefited from the wide
Encouraged by the success, preparations for the event to be held in September 2011 have already begun and booking of booths for WDS 2011 has started in right earnest in this event itself. For More detail Contact: .T 5FKBM ,IBOOB Manager (Events & Communication) .PC
8PSME %FOUBM 4IPX UFKBM!JEB PSH JO
XXX XET PSH JO
15
C-278/3, A.A.F. F. Enclave Part IEnclave I , Delhi New -Delhi -rIrI110025, +91-11-64562268 C-278/3, Ab AAbul bul Part Fazal Fazal Enclave Part Part ttII,II, New NewTel: Delhi-110025 Delhi-110025 25 25 Ph: Ph:Mob: 011011-+91-9717085785 64562268 64562268 C-278/3, Enclave II, New 110 025 Mobile +91-9717085785 E-mail humandiagno@gmail.com
MEDICATION INDIA PVT. LTD. 215/23, DLF Colony, Rohtak - 124 001 (HARYANA) Customer Care No. 01262 - 230619 Contact No. +91 - 9416053531, +91-9416053532 E-mail: medicationindia@gmail.com
COVE R
STORY
World Diabetes Day November 14, was initiated by the International Diabetes Federation (IDF) in 1991. It has been celebrated ever since and is a truly global event. In December 2006, the United 2EXMSRW VIGSKRMWIH ;SVPH (MEFIXIW (E] EW ER SJÁGMEP 92 (E]
D
iabetes is a chronic disease that arises when the pancreas does not produce enough insulin, or when the body cannot effectively use the insulin it produces. Insulin is a hormone made by the pancreas that enables cells to take in glucose from the blood and use it for energy. Failure of insulin production, insulin action or both leads to raised glucose levels in the blood (hyperglycaemia). This is associated with long-term damage to the body and the failure of various organs and tissues. Understand diabetes: Know the warning signs*
18
Frequent urination Excessive thirst Increased hunger Weight loss Tiredness
Lack of interest and concentration Vomiting and stomach pain (often mistaken as the flu) A tingling sensation or numbness in the hands or feet Other signs include blurred vision, frequent infections and slow-healing wounds
Understand diabetes and take control The 2009–2013 campaign calls on all those responsible for diabetes care to understand diabetes and take control. For people with diabetes, this is a message about empowerment through education. For governments, it is a call to implement effective strategies and policies for the prevention and management of diabetes to make sure that their citizens with and at risk
of diabetes receive the best possible care. For healthcare professionals, it is a call to improve knowledge so that evidence-based recommendations are put into practice. For the general public it is a call to understand the serious impact of diabetes, to know how to identify the condition and, where possible, know how to avoid or delay diabetes and its complications.
k'LDEHWHV SRVHV severe risks for families, countries DQG WKH HQWLUH ZRUOG y The United Nations has shown its commitment to the fight against diabetes by throwing its support behind World Diabetes Day and by highlighting the global impact of the Nov – Dec 2010
COVE R
STORY
disease. The resolution marked the first time that a noncommunicable disease was recognized as posing as serious a global health threat as infectious epidemics like malaria, tuberculosis and HIV/AIDS. The world is experiencing an epidemic of noncommunicable diseases that threatens to overwhelm healthcare systems worldwide. Diabetes, cardiovascular disease, cancer and chronic respiratory diseases cause 35 million deaths a year, with four in every five of these deaths occurring in low- and middle-income countries.
This represents a public health emergency in slow motion.” Type 1 diabetes Type 1 diabetes is an autoimmune disease characterized by the destruction of the insulin-producing cells in the pancreas. Consequently, people with type 1 diabetes produce very little or no insulin and must take insulin to survive. Type 1 diabetes, which used to be called juvenileonset diabetes, is most commonly diagnosed in children and young adults.
Type 2 diabetes The development of type 2 diabetes is marked by insulin resistance. People with type 2 diabetes cannot use the insulin that they produce effectively. They can often manage their condition through exercise and diet. However, in many cases oral drugs are needed and often insulin is required. Type 2 diabetes accounts for over 90% of the more than 250 million people living with diabetes worldwide.
Non-communicable diseases are estimated to reduce GDP by up to 5% in many low- and middle-income countries. They are an underappreciated cause of poverty and now present a serious barrier to economic development. UN Secretary-General Ban Ki-moon recently described the epidemic of non-communicable diseases as posing a greater threat than infectious diseases: “Cancer, diabetes, heart diseases are no longer the diseases of the wealthy. Today, they hamper the people and the economies of the poorest populations even more than infectious diseases. Nov – Dec 2010
19
COVE R
STORY
Both type 1 and type 2 diabetes are serious and both can affect children. It is important to know the warning signs of diabetes.
Gestational diabetes Gestational diabetes (GDM) is a condition in which women without
previously diagnosed diabetes have high blood glucose levels during their pregnancy. GDM affects about 4% of all pregnant women. It has few symptoms and usually disappears when the pregnancy ends. However, GDM poses a risk to both child and mother. Babies of mothers with GDM are at increased risk of being large
for gestational age (which can lead to delivery complications), are at higher risk for some other medical complications after delivery and often have an increased life-long risk of glucose intolerance and obesity. Women who have had GDM have a significantly increased risk of developing type 2 diabetes.
Other rarer types of diabetes also exist. The complications of diabetes Diabetes is a chronic, life-long condition that requires careful monitoring and control. Without proper management it can lead to very high blood sugar levels. These are associated with long-term damage to the body and the failure of various organs and tissues.
Complications include: t Cardiovascular disease, which affects the heart and blood vessels, 20
Nov – Dec 2010
COVE R
STORY
and may cause fatal complications such as coronary heart disease (leading to a heart attack) and stroke. t ,JEOFZ EJTFBTF (diabetic nephropathy), which may result in total kidney failure and the need for dialysis or kidney transplant. t Nerve disease (diabetic neuropathy), which can ultimately lead to ulceration and amputation of the toes, feet and lower limbs. t Eye disease (diabetic retinopathy), characterized by damage to the retina of the eye which can lead to vision loss.
13th-15th December, 2010 NASC Complex, PUSA, New Delhi, India Nov – Dec 2010
Call us +91 -11-25757181 +91 -11-25757182 21
COVE R
STORY
Diet Plan for
(-%&)8-' Person Avoid these FOODS Generally Type 2 diabetic patients need 1500-1800 calorie diet per day to promote weight loss, however calories requirement may vary depending upon patients age, sex, activity level and body weight. 50% of total daily required calories should come from carbohydrates. One gram of carbohydrate is about 4 calories. A diabetic patient on a 1600 calorie diet should get 50% of these calories from carbohydrate. In other words it will be equal to 800 Calories from Carbohydrates; it means you have to take 200gms of carbohydrates every day. It is better that you buy food tables with calories measurements to know more about your daily required food.
t
t
t
t
t If you are a diabetic patient try to avoid following list of foods. t 4VHBS BSUJÄ•DJBM TXFFUFOFST BOE honey. However you may take sweetener like stevia. It is difficult to omit sugar from your diet at-once, I will recommend you to decrease sugar in your diet gradually. t :PV TIPVME TUPQ UBLJOH TXFFUT BOE chocolates. If you are in a party and want to take chocolate, then preferably try to take Continental dark chocolate with at-least 70% or more cocoa solids, and try to avoid chocolates where sugar is the first named ingredient t 5SZ UP BWPJE GPPET DPOUBJOJOH ingredients end in (ol) or (ose) as these are mainly different forms of carbohydrates like fructose, glucose, dextrose. t "WPJE HSBJOT MJLF DBLFT CJTDVJUT 22
t
pies, tarts, breakfast cereals, wheat, rye, barley, corn, rice, bread, pasta, pastry, "WPJE WFHFUBCMFT XIJDI DPOUBJO larger amount of starch and carbohydrates like potatoes, carrots, peas, beans, parsnips, beet. "MTP BWPJE GSVJUT MJLF XBUFS NBMMPO mangoes, banana, Chikoos (Pakistani), jackfruit, grapes, Strawberry, Sugarcane. :PV NBZ UBLF NJML CVU JO TNBMM quantity. Avoid fat yogurts and cheeze. Also be careful not to drink too much coffee or tea and add only as much sugar as in needed for taste. "WPJE DPNNFSDJBMMZ QBDLBHFE foods like TV dinners, "lean" or "light" in p particular, and snack foods, fast st foods. "WPJE GSFTI FTI GSVJU KVJDFT BT UIFTF BSF highly concentrated oncentrated carbohydrates. If you like ke fruit juices you may dilute one part of juice uice with 3 or 4 parts rts of water. "MXBZT BWPJE saturated d fats like fatty meat, full ll fat dairy s, products, butter, lard. Try to prefer
it has a high carbohydrate content and very little fat
Advisable FOODS These are foods you can eat t :PV NBZ UBLF GSVJUT MJLF BQQMF Grapefruit, Lime, Peaches. You must divide your fruit and vegetable diet in five portions through all the day, by Spreading the fruit you eat through the day helps to avoid a sudden rise in blood sugar levels. t :PV NVTU UBLF IJHI Ä•CSF EJFU Fibrous diet is Cereals, Fruits, Nuts, Pulses, Seeds, and Vegetables. Fibrous diet not only lowers your glucose level but also decreases blood cholesterol.
ated unsaturated fats like olive oil, corn la oil, oil, canula er oil, sunflower soya oil. Avoid cottage cheese as Nov – Dec 2010
COVE R
STORY t "MXBZT USZ UP UBLF XIPMF HSBJO rather than processed food and take things like whole-wheat spaghetti and brown rather than white rice(Indian Pakistani). Pakistani and Indian people do like white rice very much, but if you are diabetic, please avoid these. t :PV NBZ UBLF NFBU PG MBNC CFFG once or twice a week. Organ meats can also be taken like liver kidneys and heart to meat your vitamin needs. t 5SZ UP UBLF XIJUF NFBU MJLF QPVMUSZ chicken fish meat duck etc. t :PV NBZ UBLF 'JTI BOE TFBGPPE of all types. It is recommended to boil, steam, bake or grill fish rather than frying it. t "MXBZT QSFGFS OPO GBUUZ EBJSZ products such as "skimmed milk", non-fat cheese and yoghurt. t :PV NBZ UBLF FHHT BT XFMM CVU USZ to take whitish part not the yellow
one as it may increase your cholesterol level. t "MM DIFFTFT DBO CF UBLFO FYDFQU cottage cheese. t :PV NBZ UBLF BMM vegetables; onion and garlic are known for decreasing blood glucose level.
Manufacturer and supplier of cubicle curtains, cubicle track, vertical blinds, shower curtains, and decorative products for the Healthcare industry.
PRODUCT PORTFOLIO Softlex Partion (High performance Hospital cubicle Systems) (Aluminium Track with netted 100% polyester curtains) Window curtains for hospitals Mobile I.V.Hanger Monitor Stand Medical Stretchers Foot Stoll Vertical/Horizontal blinds Hosp.bed sheet with pillow cover
We are proud to supply the following medical institutions: * Apollo Hospitals Enterprises Limited, Chennai * SRI RAMACHANDRA HOSPITAL, Porur, Chennai
* Apollo Speciality Hospital, Chennai & Madurai * Chettinad Hospital & Research Institute (Chettinad Academy of research & education), Kelambakkam
* SRM Institute of science & Technology, Kattangulathur * Manipal Hospital, Salem * Lifeline Group of Hospitals, Perungudi & Madipakkam
* Malar Hospitals Limited, Adyar, Chennai * Sri Narayani Hospitals & Research Centre,Vellore
Contact Person Address Phone Telefax Mobile Email Website
Nov – Dec 2010
: Mr.S.Prabakaran : No. 40, Marrison Street, Alandur, Chennai – 600 016, : 044-22313967 : 044-22313967 : +91 94441 03 093 : sp_karan2002@yahoo.com, spkaraan@rediffmail.com : www.medaccx.com
23
E X P E RT
VIEWS
/RII 6ITPEGIQIRX
W
ith more and more accessibility to good medical care and ever increasing awareness about health and well being, the life expectancy is on the rise all over the world. This is a good sign and a tribute to the dedication of our medical fraternity. People are now able to work actively in their sixties and seventies and many of these elderly members of society are participating in sports and leisure activities like golf, tennis, trekking, swimming etc. From a clinician’s point of view this has lead to a huge and rising volume of active and health conscious elderly population. More and more of these people are now visiting our OPD’s with geriatric conditions like cardiac problems, hypertension, diabetes, osteoarthritis etc. Out of all these, osteoarthritis is one disease for which there is a single step solution i.e. joint replacement. Once done the patient is free from all pain killers and visits to the orthopaedic surgeon. Knee replacement surgery has been a taboo amongst our patient, people are ‘scared’ when the doctor mentions surgery. The reasons for the repulsion are various : financial, some bad experience, lack of family support, additional medical problems etc.
24
Dr. Ashwani Maichand
Let's take these one by one.
M. S. (Ortho) M.Ch (Ortho) Fellowship Joint Replacement Senior consultant Orthopedic Surgeon Dr. B L Kapur Memorial Hospital Sri Balaji Action Medical Institute
Financial: In spite of India’s phenomenal rise as an economy many people don’t have reach to basic health care facilities so knee replacement is just like a dream. Another reason is that our elderly are most of the times dependent on their next generation Nov – Dec 2010
E X P E RT
VIEWS
replacement is a once in lifetime surgery, it should not be taken casually. Choose your hospital and surgeon carefully. The centre should be fully equipped for all sorts of emergencies, should have good ICU and cardiac back up as we are dealing with elderly patients. One thing that is difficult to judge for a patient is : efficient and disciplined technical manpower. This comes automatically to a place where attention is given to every detail, it’s a culture which has to be ingrained by the institution in its every employee. The surgeon should be trained for joint replacement surgery which means he must have worked at some good centre at least for few years. It’s an entirely different discipline from general orthopaedics which the surgeon subconsciously imbibes during his training. The initial training makes him aware of ‘something wrong somewhere’ but with time he raises the bar and starts looking for excellence. This doesn’t happen in weeks and months.
How I help my patients
for finances leading to so many ‘ifs’ and ‘buts’ that the dream becomes impossibility. Bad Experience: Knee replacement is a dream for many surgeons also because every young surgeon wants to be a knee replacement surgeon. This has given some of the worst results and a bad name to the surgery. Lack of Family support: Apart from finances these patients need some sort of physical assistance in their post operative period from the family members. In this age of nuclear families it may be difficult many a times for any of the younger members to devote that much time. Nov – Dec 2010
Medical Problems: Most of these patients do have some medical ailments like cardiac, renal, respiratory insufficiency, diabetes etc. Such patients presume that such a major surgery (which is not a life saving surgery) is not worth taking the risk.
God helps those who help themselves Many a times we meet patients who are not doing well after knee replacement. The reason why they chose a particular hospital for their surgery ; commonest answer is :’it’s close to our house.’ This is something that surprises us as surgeons. Knee
Over the years as a joint replacement surgeon I have realized that my forty minutes with the patient in the operation theatre are going to decide his/her fate for the rest of their lives. But… more important than that is how much time I spend with my patient before and after the surgery. I have seen patients getting operated but they are still unable to walk, reason: surgeon was too busy to do a detailed examination, patient was actually having a spine disorder ! Looks unbelievable… it happens when we as surgeons stop looking beyond knee joint . We as a team make sure that the patient is examined at least three times before surgery i.e. in OPD, after admission and on table just 25
E X P E RT
VIEWS
and support staff for achieving the same. We are doing our knee replacements by MIS technique. This means smaller scar, minimal tissue injury, less post operative discomfort and early mobilisation. This translates into benefit to the family i.e. shorter hospital stay reduces cost of treatment, less tissue trauma means no blood transfusion again reducing cost and complications . Early mobility means easier nursing care for the attendants and most importantly for this age group the overall physical and psychological well being dramatically improves once they become self dependent for their daily activities. After the surgery we as a team of surgeons follow every little development the patient makes. These patients are not allowed many visitors for first five days to avoid any cross infection. Our persistent presence sort of fills that void also. We try to create the sense of belongingness with these patients by spending time with them and encouraging them to do better. Even after the discharge our team visits the patient frequently for physiotherapy, feedback and to look for any problem the patient or the family is facing.
Conclusion Knee replacement is an excellent surgery which has given a new life to so many arthritic patients all over the world. The family and the surgical team (the family at hospital) need to put in extra efforts, need to be more vigilant to give the best results to these senior members of our family because they deserve it. before surgery. Detailed history is taken, every time by a different surgeon. Once the patient consents for surgery, the limb to be operated is marked, which is again checked by surgeon and confirmed by the scrub nurse and patient in the operation theatre. 26
The limb to be operated is cleaned & painted with antiseptic solution and wrapped in a sterile linen . It starts 24 hrs before surgery and is done twice a day. We have only one chance to give the patient a painfree and infectionfree knee and the credit goes to my junior colleagues
Min O Max 7A/75, W.e.A, Pusa Road, Karol Bagh, New delhi-5 Mob: + 91 9811129607 Website: www.minomaxortho.com Nov – Dec 2010
PRODUCT
LINE
% 6IZSPYXMSREV] Nasal Dressing in the world of ENT
NEXUSNOVUS Introduces:
absorbent capacity (up to 25 times its weight).
1$62325(Ë kNext generation packingy A unique bioresorbable synthetic foam for the nasal cavity
28
Prevents formation of postsurgical adhesions
Nasopore® being the latest innovation in nasal dressings, not only avoids the drawbacks associated with conventional packs but also offers additional benefits:
Nasopore® separates mucosal surfaces during the critical, early days of post sinus surgery when mucosal swelling is heightened. By keeping mucosal tissue separated, NASOPORE® prevents formation of post-surgical adhesions in the nasal cavity.
Biodegradable
Natural drainage
Nasopore® is biodegradable synthetic polyurethane foam. It is available in different lengths and can be easily cut to the appropriate size depending on the application. This biologically inert foam is a highly interconnected porous structure with a rapid and high
Nasopore® slowly starts to fragment whilst still offering sufficient wound support during the critical healing period. During this period it does not swell and so will not hinder natural drainage. After fragmentation Nasopore® will be drained from the Nov – Dec 2010
PRODUCT
LINE
nasal cavity via natural pathways without any pain. Daily spraying with saline solution is recommended in the first week after surgery to fasten the fragmentation and to reduce the risk of infection.
Key Benefits t 'VMMZ TZOUIFUJD GPBN DMJOJDBMMZ proven to be biologically inert. t (FOUMF DPNQSFTTJPO EVSJOH B period of 36 - 48 hours after insertion. t #JPEFHSBEBCMF QSPQFSUZ SFTVMUT JO rapid and uniform fragmentation. t &BTJMZ NBOJQVMBUFE UP BMMPX optimum placement within the nasal cavity. t 3FUBJOT JUT QPTJUJPO BęFS JOTFSUJPO and does not swell. t 7BMVBCMF XPVOE TVQQPSU EVSJOH UIF critical healing period. t ćF VOJRVF TUSVDUVSF IBT B QSPWFO high absorption capacity, being able to absorb up to 25 times its original weight. t 1SFWFOUJPO PG BEIFTJPOT BęFS OBTBM and sinus surgery - can be used to medialize the middle turbinate and septum – and prevent lateralization. t /P OFFE GPS QPTU PQFSBUJWF removal. t "USBVNBUJD BOE DPNGPSUBCMF GPS patients.
Nov – Dec 2010
Various study results indicate that the use of the new fragmentable nasal dressing is efficient, increases comfort for the patient and lowers the risk of epistaxis, thereby avoiding new wounds in the nasal cavity as associated with the removal of non-fragmentable nasal dressings.
About NexusNovus NexusNovus Tech Consultancy Services Pvt. Ltd. is an IndoDutch company that offers quality Import – Distribution Solutions and Consultancy Services for firms with the ambition to tap into the rapidly growing Indian market through unparalleled services ranging from exploration to implementation. It has a strong focus on bringing high quality, innovative healthcare products from Europe to India. They are now proud to introduce NasoporeŽ into the Indian market and are the exclusive importers for the same. You can visit www.polyganics.com for more information on Nasopore and www.nexusnovus.com for more information about the activities and products of NexusNovus TCS Pvt Ltd.
For further information, contact: Mr. Tanmai Saxena NexusNovus Tech Consultancy Services Pvt. Ltd. 7/1, 5th ‘C’ Cross, Hutchins Road, Cooke Town, Bangalore – 560084. (T): +91 80 65464803 (M): +91 09916805539 (E): hc@nexusnovus.com
29
PRODUCT
LINE
A new way to investingate the
body signals
T
oday medicin provides to doctors a variety of supplementary examinations. These test (Lab test, Imagery) help to understand the patient conditions and help in the decision of therapeutic plan. ESTECK Complex could increase these possibilities by adding a new kind of supplementary examinations and therefore increase the chances of
Cost Effective clinical assessment NonInvasive bio-electrical Impedance body measurement Assessment 30
success of Doctors by providing new tool to estimate the homeostasis in health screening. The goal of the combination of devices is to estimate the homeostasis in health screening (internal medium and the mains regulatory mechanisms of the human body). The American physiologist Walter Cannon introduced the concept of homeostasis and the existence of steady conditions of regulatory mechanisms. Changes in cell function always occur in the context of a whole organism, and different tissues and organs affect one another. The estimation of the homeostasis is necessary: t 5P TDSFFO UIF QBUIPMPHJFT PS dysfunctions with another way, in
adjunct with the signs, symptoms, labs tests and imagery and to have data of the diseases not from a classification, but from the body responses. t 5P TDSFFO UIF FČFDUJWFOFTT BOE PS the side effects in case of treatment in adjunct of signs, symptoms, labs tests and imagery with the body responses data. Therefore, the use of the ESTeck complex results need to be taken as specific supplementary examinations and combined with others test like lab test and imagery, rather then be compared. ESTeck results are specific to the understanding of the body responses and the patient homeostasis potential. This is a very important adjunct in the therapeutic plan management and follows up. Nov – Dec 2010
PRODUCT
LINE
Features of ESTECK complex: Esteck complex is a medical device comprising 5 features in 1 system. t ćJT OPO JOWBTJWF UFTU t 8JUI SFTVMUT JNNFEJBUFMZ available, t 0OMZ NJOVUFT UFTU BU MPX DPTU t (JWF B VOJRVF DIBODF UP EPDUPS to understand the pathologies, treatments, or life style of their patients.
The benefits of the ESTECK complex are simple: 1. Adjunct supplementary examination to the existing ones 2. Understanding of the Homeostasis: Understanding of the capacity of the body to answer & manage the aggressions, and therefore, the capacity of the body to react to pathologies, Stress, Life style changes AND treatment effectiveness or side effects. 3. Treatment follow up and regular monitoring 4. Quick understanding of patient emergency conditions and therefore better management of patient's hospitalization volume 5. Reduction of treatment cost 6. Telemedicine opportunities by providing patients with the technology and operate remote consultation, support, or by proving alternative to remote areas where population need to be tested.
With the help of esteck complex we can investigate 69 physiological parameter, with 94% accuracy.
These are some main parameters: 1. Digestive system results integration and modeling: Stomach and colon tissue indicators, Liver gallbladder and pancreas's function indicators
2. Cardiovascular system results integation and modelling: HRV (Heart rate variability), Blood pressure indicators Ischemic risk and heart failure indicators Left ventricle function
3. Brain system results integration and modeling: Brain tissue state indicators Neural excitability indicators Neurotransmitter indicators
Concept of ES TECK Complex Device is Invented by Dr Albert Maarek, and Manufactured by LD Technology Miami, USA with Certification of FDA, KEMA, EURO CAT, and HEALTH CANADA. The ES Teck Complex Systems is a combination of 2 biosensor technologies with 5 features and signal processing analysis managed by software. Here with the help of 6 tactile electrodes and biosensor plate for hands and feet’s we are sending 1.28 dc volt through the interstitial fluid which shows 69 physiological parameter, within 4 min. with 94% of accuracy. Nov – Dec 2010
4. ANS system results integration and modeling: Sympathetic and parasympathetic system activity indicators
5. Harmonal system results integration and modeling: Indicators of Thyroid & Parathyroid Adrenaline nor adrenaline, Hypothalamus and pituitary activity indicators
6. Respiratiory system results integration and modeling: Gasses balances Respiratory rate
7. Metabolic general function from results: Electrolytes Acid base balance Lipid profile (cholesterol and triglyceride) Glucose secretion Water balance Metabolic syndrome indicators
8. Ginitourinary system results integration: Genitourinary tissue indicators Kidney function indicators
9. Cross analysis summary: 10. Follow up to visit: 11. BIA (Body index analysis): Estimation of body composition Body msaa index Fat mass Fat free mass Total body energy expenditure Water balance Basal metabolic rate 31
DOCTO R
SPEAK
1SXLIV¸W 1MPO is complete Food for baby
B
reastfeeding is the best gift a mother can give her baby. As the milk flows, so does her love. A serene mother fondly cradling her baby is one of the most beautiful sights to behold. Breastfeeding is one of the most natural acts. And the way to go. Scientifically proven, breast milk is the ideal nourishment for your little one. Manufactured and packaged by Mother Nature itself.
Dr Suman Bijlani MD, DGO, FCPS Gynaecologist & Obstetrician Director, GyneGuide Clinic
32
Breastfeeding has a range of benefits for you as well as your little one. 1. It is the simplest and most economical way to feed your baby. 2. It contains the right mix of proteins (the perfect balance of amino acids), fats, sugars, water, minerals, vitamins, enzymes and antibodies for your baby. 3. It boosts your baby’s immunity and protects him/her from infections, such as diarrhoea, respiratory and ear infections. 4. Breastfed babies show a lower incidence of diabetes, obesity and allergic conditions. 5. Breastfed babies show better cognitive development (learning skills and information processing). 6. It provides an effective birth control technique. If you are less than 6 months post delivery, are Nov – Dec 2010
DOCTO R
SPEAK
hormone prolactin, which produces milk, and the hormone oxytocin, which promotes milk ‘let down’ or ejection. Thus, suckling is essential to milk production and release. More frequently the mother suckles, better is her milk output. Milk output is a matter of demand and supply. The more the needs of the baby, and more frequently that the baby feeds, more the milk production. The hormone oxytocin, also known as the love hormone, produced during breast feeding, is responsible for the bonding and the maternal instinct to a large extent. It also helps the uterus to contract and come back to its original pre pregnancy size and reduces bleeding. These hormones have a soothing effect on the mother and baby, which relaxes the twosome too.
Root reflex and suck reflex Babies have primitive reflexes to help them survive. When the mother gently touches the baby’s cheek or lips with her nipple, the baby instinctively turns to the nipple with mouth open. That is known as the ‘rooting reflex’. The baby is now ready to suck.
Positioning and Latching on
exclusively breastfeeding your baby (no top feeds including water) and haven’t yet got your period, you are 98% protected from pregnancy. 7. Breastfeeding promotes emotional bonding between you and your little one. It creates an environment closest to the womb, which comforts the baby and makes him/ her feel secure. 8. Breastfeeding decreases the amount of blood loss after delivery. 9. Breastfeeding mothers find it easier to lose weight after delivery. 10.Women who have breastfed their babies have a lower risk of breast cancer than those who did not. Nov – Dec 2010
The hormonal basis of breastfeeding The breasts prepare themselves for lactation during the nine months of pregnancy under the influence of hormones like oestrogen (stimulation development of milk ducts), progesterone (stimulates development of milk glands) and prolactin (triggers milk production).
The position of the mother and baby vis-a-vis each other is very important. It is important to get the perfect latch. The mother should give her whole breast in the baby’s mouth (which should be wide open), rather than just her nipple. A good latch on is very important to prevent nipple soreness and cracks. Patience and persistence are the key to a successful ‘tuning’ between mother and baby. If the baby is sick or premature, he/she may not be able to suckle well and may need expressed feeds.
Foremilk and hindmilk After delivery, the oestrogen and progesterone levels decrease. When the baby suckles, in response to nipple stimulation, the pituitary gland in the brain releases the
The milk which is first drawn during feeding is known as the foremilk. It is more watery and contains less fat and satisfies the baby’s thirst. 33
DOCTO R
SPEAK
Hindmilk is the milk which follows during feeding. It is higher in fat and calories. It is important to satisfy the baby’s hunger, and for his health and growth. If you feed only for a short time at one breast, the baby only gets the foremilk and gets hungry soon, demanding frequent feeds and cries often. Hence, feed the baby adequately at one breast before switching to the other one or unlatching your baby.
Recommendations for breastfeeding Exclusive breastfeeding until 6 months of age, and as much breastfeeding as possible, till one year of age, along with supplementary feeds. Breast feeding should be continued upto the age of two years and beyond, if desired.
WHO recommendation “The vast majority of mothers can
34
and should breastfeed, just as the vast majority of infants can and should be breastfed. Only under exceptional circumstances can a mother’s milk be considered unsuitable for her infant. For those few health situations where infants cannot, or should not, be breastfed, the choice of the best alternative – expressed breast milk from an infant’s own mother, breast milk from a healthy wet-nurse or a humanmilk bank, or a breast milk substitute fed with a cup, which is a safer method than a feeding bottle and teat – depends on individual circumstances.” The WHO recommends exclusive breastfeeding for the first six months of life, after which "infants should receive nutritionally adequate and safe complementary foods while breastfeeding continues for up to two years of age or beyond. UNICEF, WHO and WABA along with the scientific community strongly recommend initiating breastfeeding
within half an hour of birth. Evidence shows that early initiation can prevent 22% of all deaths among babies below one month in developing countries. Every newborn, when placed on the mother’s abdomen, has ability to find its mother’s breast all on its own and to decide when to take the first breastfeed. This is known as the ‘Breast Crawl’.
Mother's nutrition while she is breastfeeding A nursing mother produces 750 ml of milk per day, containing 300 milligrams of calcium. About 500 calories per day are lost in breast milk and the mother needs to add that to her daily intake. The mother produces milk from the nutrients in her blood and hence, she needs a wholesome balanced diet. Plenty of fruits and vegetables with whole grain breads and cereals,
Nov – Dec 2010
South MediLab Expo Get the technology edge
Organised by Online Media Partners
Cell:09789986422 / 044-22264687 chennaitradeevents@gmail.com
Magazines:
DOCTO R
SPEAK
along with dairy products are recommended. Water intake should be high as a lot of water goes into milk production. Protein requirement increases greatly as milk contains high amount of protein. Iron is important as the new mother has been through pregnancy and delivery, both of which drain her iron stores. Eating smaller portions more frequently is important to prevent decrease in sugar levels.
Top feeds vs breastfeeding Infant formulae can never be the same as breast milk as the composition of breast milk is not completely known and it changes as per the baby’s needs. Cow's milk Infants fed whole cow's milk don't get enough vitamin E, iron, lactose and essential fatty acids. They also get too much protein, sodium, and potassium. These levels may be too high for the infant's system to handle. Also, whole cow's milk protein and fat are more difficult for an infant to digest and absorb. And your baby may develop allergy to cow milk protein.
Buffalo's milk The fat and solute content is higher and can overload his delicate digestive tract. Constipation is more common in bottle fed babies (Any kind of milk substitute) Should there be a law about breastfeeding? Every mother has a natural instinct to breastfeed. It is her right, as well as duty. However, it is a personal choice. Nature has designed breastfeeding in such a way that only a loving and committed mother would be able to successfully breastfeed her baby. It is obvious then that law cannot force an unwilling woman to feed her own baby. It would be rather unfortunate though, for the mother and the baby to lose out on such a beautiful experience of a lifetime. There are certain conditions wherein a mother cannot or should not breastfeed for various reasons. Conditions when breastfeeding is not recommended t $FSUBJO JOGFDUJPOT JO UIF NPUIFS such as active tuberculosis, HIV infection, HTLV -1 infection (which causes some types of cancer)
t 8IFO UIF CBCZ JT TVČFSJOH GSPN a condition called galactosemia (a rare genetic disorder in which the infant cannot digest lactose and galactose) t 8IFO UIF NPUIFS JT PO DFSUBJO medications such as anticancer chemotherapy, radioactive iodine treatment, lithium, etc. t 4VCTUBODF BCVTF CZ UIF NPUIFS (cocaine, heroin, LSD) Tips for the breastfeeding mother t (FU FEVDBUFE BCPVU CSFBTUGFFEJOH in your pregnancy itself to save yourself trouble after delivery. t *OJUJBUF OVSTJOH BT TPPO BT QPTTJCMF within half an hour of delivery if possible. t ,FFQ B ĘFYJCMF APO EFNBOE schedule. t .BLF ZPVSTFMG DPNGPSUBCMF whatever position you choose. t 4MFFQ XIFO ZPVS CBCZ TMFFQT t (FU FOPVHI SFTU BOE BTL GPS IFMQ with chores. t %P OPU SFTUSJDU UIF EVSBUJPO PS frequency of feeds. t -FBSO UP QJDL VQ GFFEJOH ADVFT GSPN your baby. t 'FFE POF CSFBTU BU B UJNF HJWJOH adequate time. Give the other breast when he unlatches himself. t #VSQ ZPVS CBCZ BęFS FWFSZ GFFE t 4FFL IFMQ GSPN B MBDUBUJPO DPOTVMUBOU if faced with any difficulty. Difficulty in lactation which may lead to failure to feed t /JQQMF DPOGVTJPO GFFEJOH VTJOH bottle... baby may get used to the bottle and turn down the breast) t 4USFTTPST o NFOUBM BT XFMM BT physical, which can suppress pituitary hormones t "UUJUVEF PG UIF NPUIFS MBDL PG confidence and negative thoughts due to myths and improper education t *OWFSUFE OJQQMFT TPSF OJQQMFT t &OHPSHFE CSFBTUT t 8FBL PS QSFNBUVSF CBCZ XIP JT unable to suck effectively) t "EEJOH UPQ GFFET XIJDI EFDSFBTFT demand and consequently supply) t 4JDL NPUIFS OPU FOPVHI NJML
36
Nov – Dec 2010
DOCTO R
SPEAK
Support from the spouse and family are very important to boost her confidence and help her physically cope up with the challenges of motherhood in a positive manner. How to know milk supply is adequate t :PVS CBCZ TFFNT SFMBYFE BOE satisfied and your breast feels soft and supple after feeding t :PVS CBCZ JT HBJOJOH XFJHIU BOE JT adequately hydrated t )F TIF JT XFUUJOH IFS EJBQFST BCPVU 6 to 8 times a day (varies widely), after the first few days Some common myths related to breast feeding 1. Smaller breasts won’t get enough milk. 5SVUI Size has nothing to do with it. 2. If I squeeze to check, and there are only a few drops of milk coming out, it means I am not producing enough milk.
Nov – Dec 2010
5SVUI Milk pours well after a while of suckling. Hence, this is a wrong way to check if you are producing enough milk. 3. You should not feed your baby if your nipples are bleeding. 5SVUI Swallowed blood does not harm your baby. He/she may pass it as stools or vomit it out. 4. Colostrum is harmful to my baby. On the contrary, it has protective antibodies for your little one and is high in proteins. 5. Milk output is not enough in the first few days. 5SVUI Baby’s stomach capacity is small and thus his needs are low in the first few days. 6. The mother should wash her breasts each time she breastfeeds. 5SVUI Repeated washing removes protective oils over the nipples, leading to dryness and soreness.
7. My baby should have a fixed feeding schedule, otherwise he/she will not gain weight. 5SVUI Feeding schedules vary greatly and a healthy baby will demand feeds as per his/her needs. Be flexible and relaxed, unless there are warning signs.
37
I NTE RVI EW
spoke to Dr. Devi Shetty
One of the best & most renowned
Heart Surgeons we have in India What are the thumb rules for a layman to take care of his heart? 1. Diet - Less of carbohydrate, more of protein, less oil 2. Exercise - Half an hour's walk, at least five days a week; avoid lifts and avoid sitting for a longtime 3. Quit smoking 4. Control weight 5. Control blood pressure and sugar
Is eating non-veg food (fish) good for the heart? No
It's still a grave shock to hear that some apparently healthy person gets a cardiac arrest. How do we understand it in perspective? This is called silent attack; that is why we recommend everyone past the age of 30 to undergo routine health checkups.
38
Nov – Dec 2010
I NTE RVI EW Are heart diseases hereditary? Yes
What are the ways in which the heart is stressed? What practices do you suggest to de-stress? Change your attitude towards life. Do not look for perfection in everything in life.
Is walking better than jogging or is more intensive exercise required to keep a healthy heart? Walking is better than jogging since jogging leads to early fatigue and injury to joints
How can I control cholesterol content nt without using medicines? Control diet, walk and eat walnut.
Can yoga prevent heart ailments? Yoga helps.
Which is the best and worst food for the heart? Fruits and vegetables are the best and the worst is oil.
Which oil is better groundnut, sunflower, olive?
care care unit un nit i since the maximum maaximu mum m casualty ty takes tak akes es place plaace within ithin n the first firs fi rsst hour. hour ho ur..
How w do you differentiate different between ween pain caused ca by a heart attack attac and that caused due to gastric trouble?
All oils are bad .
You have done so much for the poor and needy. What has inspired you to do so?
Extremely difficult without ECG.
What is the routine checkup one should go through? Is there any specific test?
Mother Theresa, who was my patient
Can people with low blood pressure suffer heart diseases? Extremely rare
Does cholesterol accumulates right from an early age or do you have to worry about it only after you are above 30 years of age? Cholesterol accumulates from childhood.
How do irregular eating habits affect the heart ?
Routine blood test to ensure sugar, cholesterol is ok. Check BP, Treadmill test after an echo.
What are the first aid steps to be taken on a heart attack? Help the person into a sleeping position , place an aspirin tablet under the tongue with a sorbitrate tablet if available, and rush him to a coronary
What is the main cause of a steep increase in heart problems amongst youngsters? I see people of about 30-40 yrs of age having heart attacks and serious heart problems. Increased awareness has increased incidents.. Also, sedentary lifestyles, smoking, junk food, lack of exercise in a country where people are genetically three times more vulnerable for heart attacks than Europeans and Americans.
Is it possible for a person to have BP outside the normal range of 120/80 and yet be perfectly healthy? Yes.
You tend to eat junk food when the habits are irregular and your body's enzyme release for digestion gets confused. Nov – Dec 2010
Marriages within close relatives can lead to heart problems for the child. Is it true? Yes, co-sanguinity leads to congenital abnormalities and you may not have a software engineer as a child 39
I NTE RVI EW
Many of us have an irregular daily routine and many a times we have to stay late nights in office. Does this affect our heart ? What precautions would you recommend? When you are young, nature protects you against all these irregularities. However, as you grow older, respect the biological clock.
Will taking anti-hypertensive drugs cause some other complications (short / long term)? Yes, most drugs have some side effects. However, modern anti- hypertensive drugs are extremely safe.
Will consuming more coffee/ tea lead to heart attacks? No.
Are asthma patients more prone to heart disease?
How would you define junk food?
going to another chair and sitting helps a lot.
Fried food like Kentucky, McDonalds, samosas, and even masala dosas..
Is there a relation between heart problems and blood sugar?
You mentioned that Indians are three times more vulnerable. What is the reason for this, as Europeans and Americans also eat a lot of junk food? Every race is vulnerable to some disease and unfortunately, Indians are vulnerable for the most expensive disease.
Does consuming bananas help reduce hypertension? No.
Yes. A strong relationship since diabetics are more vulnerable to heart attacks than non-diabetics.
What are the things one needs to take care of after a heart operation? Diet, exercise, drugs on time , Control cholesterol, BP, weight.
Are people working on night shifts more vulnerable to heart disease when compared to day shift workers?
Can a person help himself during a heart attack (Because we see a lot of forwarded emails on this)?
No.
Yes. Lie down comfortably and put an aspirin tablet of any description under the tongue and ask someone to take you to the nearest coronary care unit without any delay and do not wait for the ambulance since most of the time, the ambulance does not turn up.
There are hundreds of drugs and your doctor will chose the right combination for your problem, but my suggestion is to avoid the drugs and go for natural ways of controlling blood pressure by walk, diet to reduce weight and changing attitudes towards lifestyles.
Do, in any way, low white blood cells and low hemoglobin count lead to heart problems?
Does dispirin or similar headache pills increase the risk of heart attacks?
What are the modern antihypertensive drugs?
No. No.
No. But it is ideal to have normal hemoglobin level to increase your exercise capacity.
Sometimes, due to the hectic schedule we are not able to exercise. So, does walking while doing daily chores at home or climbing the stairs in the house, work as a substitute for exercise? Certainly. Avoid sitting continuously for more than half an hour and even the act of getting out of the chair and 40
Why is the rate of heart attacks more in men than in women? Nature protects women till the age of 45.
How can one keep the heart in a good condition? Eat a healthy diet, avoid junk food, exercise everyday, do not smoke and, go for health checkup s if you are past the age of 30 (once in six months recommended)‌ Nov – Dec 2010
D E N TA L
HYG I E N E
What is a
Dental Abscess? What causes
Dental Abscesses?
42
Nov – Dec 2010
D E N TA L
HYG I E N E
A
dental abscess, or tooth abscess, is an accumulation of pus that forms inside the teeth or gums. The abscess typically originates from a bacterial infection, often one that has accumulated in the soft pulp of the tooth. Bacteria exist in plaque, a byproduct of food, saliva and bacteria in the mouth which sticks to the teeth and damages them, as well as the gums. If the plaque is not removed by regular and proper tooth brushing and flossing the bacteria may spread within the soft tissue inside the tooth or gums, eventually resulting in an abscess.
There are 3 types of dental abscess Gingival abscess - the abscess is only in the gum tissue and does not affect the tooth or the periodontal ligament. Periodontal abscess - this abscess starts in the supporting bone tissue structures of the teeth. Periapical abscess - this abscess commences in the soft pulp of the tooth.
According to Medilexicon's medical dictionary t " HJOHJWBM BCTDFTT JT BO BCTDFTT confined to the gingival soft tissue." t " QFSJPEPOUBM BCTDFTT JT BO alveolar abscess or a lateral periodontal abscess." t " QFSJBQJDBM BCTDFTT JT BO BMWFPMBS abscess localized around the apex of a tooth root." A dental abscess usually requires treatment; otherwise it can worsen and result in the destruction of bone tissue.
What are the signs and symptoms of a dental abscess? A symptom is something the patient feels and reports, while a sign is something other people, including a doctor or nurse may detect. For example, pain may be a symptom while a rash may be a sign. Signs and symptoms of a dental abscess may include Pain - the main symptom. This may be a throbbing pain, and is often intense. The pain usually starts suddenly, and becomes more intense over the subsequent hours or days. In some cases the pain may radiate to the ear, jawbone and neck. t 1BJO JO UIF BČFDUFE BSFB XIFO CJUJOH t 5PVDIJOH UIF BČFDUFE BSFB NBZ CF painful t 4FOTJUJWJUZ UP DPME PS IPU GPPE BOE liquids Nov – Dec 2010
t " GPVM UBTUF JO UIF QBUJFOUhT NPVUI t 'FWFS t (FOFSBM NBMBJTF UIF QBUJFOU GFFMT generally unwell) t 5SJTNVT UIF QBUJFOU Ä•OET JU IBSEFS to open his/her mouth t %ZTQIBHJB TXBMMPXJOH EJÄ?DVMUJFT t *OTPNOJB
What causes a dental abscess? A dental abscess in most cases is a complication of a dental infection. Bacteria, often bacteria present in plaque, infect and make their way into a tooth. Periapical abscess Bacteria enter the tooth through tiny holes caused by tooth decay (caries) that form in the tooth enamel (hard outer layer of the tooth). The caries eventually break down the softer layer of tissue under the enamel, called dentine. If the decay continues, the hole will eventually penetrate the soft inner pulp of the tooth - infection of the pulp is called pulpitis. As the pulpitis progresses the bacteria make their way to the bone that surrounds and supports the tooth, called the alveolar bone, and a periapical abscess is formed. Periodontal abscess When bacteria which are present in plaque infect the gums the patient has periodontitis. The gums become inflamed, which can make the periodontal ligament (tissue surrounding the root of the tooth) separate from the base of the tooth. A periodontal pocket, a tiny gap, is formed when the periodontal ligament separates from the root. The pocket gets dirty easily and is very hard to keep clean. As bacteria build up in the periodontal pocket, periodontal abscess is formed. Patients can develop periodontal abscesses as a result of a dental 43
D E N TA L
HYG I E N E Surgery for dental abscesses Patients with a periapical abscess and a recurring infection may need to have diseased tissue surgically removed. This will be done by an oral surgeon. Patients with a periodontal abscess and a recurring infection may have to have their gum tissue reshaped and the periodontal pocket removed. This procedure will be performed by an oral surgeon. If the dental abscess recurs, even after surgery, the tooth may be extracted (taken out).
Treatment for pain procedure which accidentally resulted in periodontal pockets. Also, the use of antibiotics in untreated periodontitis, which can mask the symptoms of an abscess, can result in a periodontal abscess. Sometimes gum damage can lead to periodontal abscesses, even if no periodontitis is present.
What should I do if I have dental abscess symptoms? Any person with symptoms linked to a dental abscess should see a dentist immediately. Dental abscesses are easily diagnosed by a qualified dentist. In the UK the National Health Service (NHS) advises people to visit either their usual registered dentist, a local Dental Access Centre, or the emergency department of their local general hospital. People who have swallowing and/or breathing problems should go straight to the emergency department of their local hospital. If for some reason you cannot get to a dentist immediately you could visit your GP (general practitioner, primary care physician). A GP cannot treat an abscess, but he/she may prescribe medication and advise on self-care and pain management, and 44
is also likely to know the fastest way of getting emergency treatment, if required.
What is the treatment for a dental abscess? The only person who can effectively treat a dental abscess is a dentist. Treatment may involve typical dental procedures, and in some occasional surgery.
OTC (over-the-counter, no prescription required) painkillers (analgesics) may help reduce the pain while the patient is waiting for treatment. It is important to follow the information on the packet carefully. Painkillers are only there for pain reduction, they cannot replace the visit to a dentist.
Treating a periapical abscess - root canal treatment will be used to remove the abscess. A drill is used to bore a hole into the dead tooth so that the pus can come out. Any damaged tissue will be removed from the pulp. A root filling is then inserted into the space to prevent subsequent infections.
Aspirin, ibuprofen or Tylenol (parecetamol) are effective painkillers. However, some are unsuitable for certain types of patients (read below): t *CVQSPGFO BOE BTUINB JG ZPV BSF asthmatic do not take ibuprofen. t *CVQSPGFO BOE TUPNBDI VMDFST EP not take ibuprofen if you have, or ever had stomach ulcers. t "TQJSJO BOE DIJMESFO EP OPU HJWF aspirin to children under 16 years of age. t "TQJSJO BOE QSFHOBODZ BOE breastfeeding - do not take aspirin if you are pregnant or breastfeeding.
Treating a periodontal abscess - the abscess will be drained and the periodontal pocket cleaned. The surfaces of the root of the tooth will then be smoothed out by scaling and smoothing (planing) below the gum line. This helps the tooth heal and prevents further infections from occurring.
Things you can do yourself t "WPJE DPME GPPET BOE ESJOLT t "WPJE IPU GPPET BOE ESJOLT t .PEFSBUFMZ DPPM GPPET DIFXFE PO the "good" side of your mouth will probably be less painful t %P OPU ĘPTT BSPVOE UIF BČFDUFE area t 6TF B WFSZ TPę UPPUICSVTI
Incision - the abscess needs to be cut out (incised) and the pus, which contains bacteria, drained away. The patient will be given a local anesthetic.
Nov – Dec 2010
D E N TA L
HYG I E N E Antibiotics - these may be prescribed to prevent the infection from spreading, and may be taken together with painkillers. Examples of antibiotics include amoxicillin or metronidazole. In no way should antibiotics be seen as a way of substituting treatment with a dentist, or postponing treatment.
What are the complications of a dental abscess? In the vast majority of cases, complications only occur if the abscess is left untreated. However, complications can occur, even after seemingly effective treatment, but this is very rare. Possible complications include: Dental cysts - a fluid-filled cavity may develop at the bottom of the root of the tooth if the abscess is not treated. This is called a dental cyst. There is a significant risk that the cyst
Nov – Dec 2010
will become infected. If this happens the patient will need antibiotics, and possibly surgery. Osteomyelitis - the bacteria in the abscess gets into the bloodstream and infects the bone. The patient will experience an elevated body temperature, severe pain in the affected bone, and possibly nausea. Typically, the affected bone will be near the site of the abscess; however, as it may have spread into the bloodstream any bone in the body may be affected. Treatment involves either oral or intravenous antibiotics. Cavernous sinus thrombosis - the spread of bacteria causes a blood clot to form at the cavernous sinus - a large vein at the base of the brain. Cavernous sinus thrombosis is treated with antibiotics, and sometimes surgery to drain the sinus. In some cases the condition
can be fatal. This is a very rare complication. Ludwig's angina - this is an infection of the floor of the mouth when the dental abscess bacteria spread. There is swelling and intense pain under the tongue and in the neck. In severe cases the patient may find it hard to breathe. Ludwig's angina is a potentially fatal condition. Patients are treated with antibiotics. In severe cases a tracheostomy (procedure to open the airway) is performed if there are breathing problems. Maxillary sinusitis - the bacteria spread into small spaces behind the cheeckbones, called the maxillary sinuses. This is not a serious condition, but can be painful, and the patient may develop a fever and have tender cheeks. Sometimes the conditions resolves on its own. Depending on the severity, the doctor may prescribe antibiotics.
45
PRE
S H OW
Start to end solutions for building or upgrading hospitals of the future all under one roof at Hospital Infrastructure India 2010 he first of its kind exhibition and conference on hospital infrastructure in India, will feature the latest technology and solutions in hospital infrastructure, medical equipments, healthcare architecture, hospital planning and supplies from India and abroad from 7 – 9 December 2010 at Bombay Exhibition Centre, Mumbai.
T
technology, HII will be an ideal exhibition to deliver these concepts.”
Some of the world’s biggest suppliers will be on hand to demonstrate their newest products and services at Hospital Infrastructure India (HII) 2010. Exhibitors include names like Larsen and Toubro (L&T), Sony, Armstrong, Draeger, Forbo Flooring, HKS, Everest Industries, GMP Technical, Promark Associates, HLL Lifecare amongst others.
Private hospital professionals, hospital entrepreneurs, government hospitals, healthcare planners, engineers, architects, project management consultants and senior officials from state and central health departments amongst others will assemble to network and make valuable new business contacts…make sure you’re part of it.
“We are delighted that so many big companies with varied mix of products and services are participating at the event,” said Guru Prasath of IIR Exhibitions India, organisers of the event. “There are a number of hospital expansion plans announced by the Government of India, Indian private players and international consortiums. HII is well placed to be a crucial platform for the healthcare professionals and entrepreneurs to come together to witness the future of hospital technology on display.” “HII 2010 offers us a great opportunity to see a range of latest technologies and innovation in terms of infrastructure, equipments under one roof,” commented Mr. Peter Dsouza, Chief Engineer, Lilavati Hospital and Research Centre.
There will be special features like product demonstrations, workshops, conferences and seminar forums for the visitors at HII 2010. There are health missions organised by United Kingdom Trade & Investment (UKTI) and Australian Trade Promotion (Austrade) to coincide with the show.
Hospital Infrastructure India Conference A world class technical conference is being organised in association with HOSMAC, India’s leading healthcare consultancy firm, for industry professionals to benefit from the experience of the renowned industry leaders from across the world. There would be modular sessions and the major topics would include healthcare design/build, healthcare infrastructure, planning, Public Private Partnerships (PPP) and interactive panel discussions. Some of the eminent industry experts have been invited to speak at the conference. The HII conference would be an ideal platform for sharing knowledge, exchanging ideas and building profitable networks.
firm, will showcase their solutions for the Indian market at HII 2010. They provide the full spectrum of services from health service planning to briefing, architectural and interior design, equipment and commissioning. TAHPI offers the popular web-based toolkit known as the Health Facility Briefing System (HFBS) and training. Global leader in healthcare design HKS from US to showcase their solutions in the Indian context HKS will take the opportunity of participating at HII to showcase their achievements in successfully integrating the internationally adopted best practices in healthcare design in the regional context of India. They see this opportunity as a great platform to share their extensive experience in designing world class healthcare facilities. :RUOG V kJUHHQHVWy ZDOO SURWHFWLRQ material from US manufacturer InPro Corporation InPro Corporation is a premier manufacturer of architectural products in the United States. Their product range includes door and wall protection, expansion joint systems, privacy curtain tracks and wayfinding signage. Among InPro’s top products are hand rails, wall guards, corner guards and anti-bacterial fabrics. They will be introducing G2, the world’s “greenest” wall protection material. For more information please contact: Mehul Thakkar
Technology Preview at HII 2010 Marketing Manager “This show will facilitate the modernisation of the healthcare industry. With the ever increasing demand for originality, uniqueness, innovation and 46
Healthcare planning and design experts from Australia - TAHPI TAHPI, an Australia based specialist healthcare planning and design
5FM +91 22 4020 3304 Email mehul.thakkar@informa.in IIR Exhibitions India is a part of Informa Group – www.informa.com Nov – Dec 2010
EYE
CARE
Accommodating IOL’S
W
hen Cataract develops obscuring good vision, it has to be replaced by an artificial lens called intraocular lens. Traditionally monofocal lenses have been used which have fixed focus. Usually the focus is for distance but it may be for intermediate or reading distance. There came era of multifocal lenses which have either refractive & detractive configurations. They provide focus for distance, intermediate & near vision. Halos & glare remains a major problem and also adaptability to these lenses remains a big problem. Moreover a major portion of ray entering the eyes is used for distance and a minor portion for reading. When we operate upon Cataract, it looses its ability to accommodate. Ideally we should replace such Cataract with an artificial clear lens with ability to accommodate thus restoring both distance & near vision. Accommodating IOL’S interact with Ciliary muscles & Zonules. They use hinges at both end to Latch on and move forward & backward inside the capsular bag as in natural accommodation. Hales & glare are reduced to a great extend. They provide excellent vision for all distance ie, far, intermediate & near. They project no unwanted retinal images & no loss of contrast sensitivity or adaptation.
48
FDA approved Eyeonice’s Ines’ Crystalens AT-45, in Nov 2003 as accommodating IOL’ Bausch & Lomb acquired crystalens in 2008 & introduced a new model crystalens’ HD in 2008 which is the only FDA approved accommodating IOL in the market. The long term refractive ability with these lenses remains uncertain. The initial results seem promising at 6months. However the accommodator amplitude may fades over time. John A. Vukich is of the opinion that crystalens gives good distance vision but may not provide very fine near vision capabilities. Dr. Chang says crystalens HD has approximate +ID spherical add in the centre of the lens. He assumes if it coincides with visual axis, it will improve near vision with a little compromise in optical quality. William B. Trattler suggests that spherical aberration contribute to near correction in crystalens. If spherical aberration is reduced with AO optic, there is some improvement in contrast sensitivity at the expense of depths of field.
Synchrony IOL Synchrony from AMO is another accommodating IOL which is under review by FDA. It has been demonstrated
to actually move as designed by accommodation. It is a dual optic accommodating IOL. The front optic is high powered at +32D in every person. The rear optics is minus powered depending upon the target. The net power between distance & near optic is individualized. Ultrasound bimicroscopy has demonstration that front optic moves with accommodation. A greater degree of accommodation is achieved with high powered front lens. It is about 3.3D with 1.5 mm movement of front optic. The dual optic design keeps the anterior & posterior capsule apart thus epithelial lens do not undergo fibroblastic proliferation and capsular opacification. Thus posterior capsule remains flexible.
Tetraflex IOL The Tetra flex IOL (Lenstec, Inc) is another accommodating IOL. It is an anterior vaulted patented 5 contoured haptic design, ingle piece foldable IOL implanted through injector system with a 3mm incision. The lens optic is 5.75mm and made of hydrophilic acrylic material. The IOL’ S two haptics, each with two footplates, sit posteriorly in the periphery of capsular bag. Nov – Dec 2010
EYE
CARE
Dr. Sharad Lakhotia President of Delhi Ophthalmological Society Lakhotia Eye Centre & laser Institute, New Delhi
On ultrasound bimicrosepy (UBM), the lens moves fooward during accommodation. This is because when ciliary muscle contracts, Zonules are loosened & vitreous pressure is increased. The higher radius of curvature of lens anteriorly increases the net refractive power of the lens. It also induces coma which is a very important part of normal accommodation process in prepresbyopic phakic eyes.Yag-laser capsulotomy has not negatively affected accommodation in such patients. Tetrafix IOL centre very well & can be easily loaded in injector system. Nov – Dec 2010
There other accommodating lenses which hold future are:
Nulens IOL Nulens accommodating lens (Nulens ltd.Herzliya, Israel) is unique in structure, concept of operation & performance. It is designed to change its true power during accommodation through alteration of lens curvature, unlike axial movement of fixed power optical surfaces.
It uses capsular bag as a component of moving diaphragm consisting of collapsed capsular bag, zonules and the ciliary processes. The contracting ciliary muscle through dynamic diaphragm transforms force to the device attached. A piston pressurizes a small rigid chamber containing silicon gel. The silicon gel is pressure by forward movement and depressurized by backward movement of capsular diaphragm. The pressurized gel displaced through a round hole changing its curvature in relation to ciliary muscle movement. Such IOL proto types in primate eye 49
EYE
CARE have shown to deliver more than 40. D accommodation using only 500 microns of vertical diaphragm displacement. Similar mechanism has been demonstrated in normal lenses of waterfowl. Nulens is developing silicons of higher refractive index & improved elasticity for further generation IOL. Another feature is construction of a dynamic component that will be implanted in psuedophakic eyes to restore accommodation for long years.
Fluid Vision IOL Fluid Vision IOL (Power Vision): It is a one piece lens with ‘applied microfluidic’ technology. The fluid reservoir, at the haptic tips is connected to dynamic optic. It relies on hydraulic
50
induced shape change. The radius of curvature is altered reversibly by microfluidic pumps by redistributing peripheral fluid centrally, producing up to 10D power change.
Liqui Lens IOL Liqui Lens (vision solution): It is a dual liquid gravity dependent lens. It consists of single optic with 2 immiscible fluids of different refractive index. With downward gaze power up to +30 D is produced by changes in liquid position.
Smart IOL (Medennium): It is a thermo plastic flexible acrylic gel polymer that can be made to specifical optical precision & customized into any size, shape& power. It is converted to a thin rod at room temperature and implanted through a micro incision. At body temperature, it assumes original shape of 9.5 mm width & 3.5mm thickness. Wave front, toric & multifocal technology can be imprinted on its surface. Thus we can see that, with current research & modalities in accommodating IOL available, a complete freedom from glasses can be expected after cataract surgery with minimal problems & complications. Thus cataract surgery is moving towards a total refractive solution in times to come.
Nov – Dec 2010
H E A LT H &
FITNESS
An 36%2+) a day may keep stroke away
N
utrition may have a role to play in the pathogenesis of stroke, according to neurologists from the Prince of Wales Hospital in Sydney. The doctors reported a case of ischaemic stroke in a 34year old man with severe vitamin C deficiency caused by poor nutrition. The patient, who had recently been diagnosed with type 2 diabetes, had no history of hypertension or hypercholesterolaemia and no family history of stroke. Coagulation and lipid profiles were normal and the patient tested negative for underlying thrombophilia, vasculitides and Fabry disease. Tests showed the patient had normal carotid and vertebral arteries and a structurally normal heart without a source of embolus.
deposition, scorbutic gums and gingival inflammation, and reported easy bruising in recent months. Suspecting a diagnosis of scurvy, the doctors discovered that his diet consisted mainly of fast food, with negligible vegetable and fruit intake. Laboratory testing confirmed the presence of severe vitamin C deficiency (< 5 μmol/L; reference range, 40–100 μmol/L). “We hypothesise that an unhealthy diet resulted in deficiencies in antioxidants and this contributed to stroke pathogenesis, the authors wrote in a letter to the MJA.
resulted from effect modification of antioxidant deficiency on conventional atherosclerotic risk factors such as diabetes, they added. It is unlikely that a direct causal link will ever be established but since malnutrition and unhealthy eating practices continue to be a serious public health problem, the doctors suggest attention to nutritional status should be incorporated into the new standard of stroke care.
The marked prematurity of disease onset may have
However the patient had poor dentition, with calculus
Nov – Dec 2010
51
H E A LT H &
FITNESS
Green Vegetables A major source of Iron & Calcium Green vegetables are also a major source of iron and calcium for any diet. Swiss chard and spinach are not considered good sources of calcium, due to their high content of oxalic acid. Green leafy vegetables are rich in beta-carotene, which can also be converted into vitamin A, and also improve immune function. Millions of children around the world have he w orld h ave aan n increased blindness, d rrisk isk ooff b lindness, and otherr iillnesses because llnesses b ecause of inadequate dietary quate d ietary vitamin A ffrom rom ggreen reen leafy vegetables. etables.
antioxidants that have cancer-protective properties. In a Swedish study, it was reported that eating 3 or more servings a week of green leafy vegetables significantly reduced the risk of stomach cancer, the fourth most frequent cancer in the world. Cabbage, cauliflower, brussels sprouts, and broccoli are rich in indoles and which iisothiocyanates, sothiocyanates, w hich
protect us against colon and other cancers. Broccoli sprouts have been reported to contain 10 or more times as much sulforaphane, a cancerprotective substance, than does mature broccoli. A higher consumption of green leafy vegetables has been shown to significantly decrease the risk of breast cancer and skin cancer.
Green veggies eggies contain a variety off carotenoids, ids, flavonoids ds and otherr powerfull
52
Nov – Dec 2010
Nomination Form #FTU %PDUPS "XBSE GPS his services & excellence.
'JSTU /BNF ............................... -BTU /BNF ............................................................... 2VBMJÃ&#x2122;DBUJPOT............................................................................................................... 4QFDJBMJ[BUJPO .............................................................................................................. &YQFSJFODF /P 0G :FBS ............................................................................................. /BNF PG )PTQJUBM PS $MJOJD .......................................................................................... %FTJHOBUJPO ................................................................................................................. "WFSBHF /P PG 1BUJFOU %BZ ......................................................................................... "EESFTT ...................................................................................................................... $JUZ .......................................... State ........................................................................ 1PTUBM DPEF ............................. $PVOUSZ .................................................................... Phone ...................................... .PCJMF ..................................................................... & NBJM ......................................................................................................................... 8FCTJUF........................................................................................................................ Success Story ............................................................................................................. ..................................................................................................................................... ..................................................................................................................................... .....................................................................................................................................
4JHOBUVSF Note: Please make photo copy for more than one use. 1MFBTF Ã&#x2122;MM UIF BQQMJDBUJPO GPSN BOE TFOE VT CZ DPVSJFS QPTU PO CFMPX BEESFTT
Medgate Today ;BLJS /BHBS 0QQ /FX 'SJFOET $PMPOZ 0LIMB /FX %FMIJ .PCJMF & NBJM JOGP!NFEHBUFUPEBZ DPN NFEHBUFUPEBZ!HNBJM DPN 8FCTJUF XXX NFEHBUFUPEBZ DPN
* XPVME MJLF UP TVCTDSJCF GPS UJDL BT BQQMJDBCMF
1 year #J NPOUIMZ JTTVFT GPS ` 64 2 years #J NPOUIMZ JTTVFT GPS ` 64 'JSTU /BNF ......................................... -BTU /BNF .................................... %FTJHOBUJPO ....................................... 0SHBOJ[BUJPO ................................. "EESFTT ..................................................................................................... $JUZ .................................................... State ............................................. 1PTUBM DPEF ....................................... $PVOUSZ ......................................... Phone ................................................ 'BY ............................................... &NBJM ..........................................................................................................
I enclose cheque no ........................... ESBXO PO ....................................... EBUFE ......................... UPXBSET TVCTDSJQUJPO GPS .FEHBUF 5PEBZ NBHB[JOF JO GBWPVS PG Medgate Today.
4JHO ......................................................%BUF ............................
Donâ&#x20AC;&#x2122;t Miss Out on the Medgate Action!!! â&#x20AC;&#x153;Subscribe Nowâ&#x20AC;?
.BJM UIJT GPSN XJUI QBZNFOU UP Medgate Today ;BLJS /BHBS 0QQ /FX 'SJFOET $PMPOZ 0LIMB /FX %FMIJ .PCJMF & NBJM JOGP!NFEHBUFUPEBZ DPN NFEHBUFUPEBZ!HNBJM DPN 8FCTJUF XXX NFEHBUFUPEBZ DPN
Indiaâ&#x20AC;&#x2122;s Top Health & Medical Magazine
Orthopaedic Solutions Medical Shoes Custom made insole Diabetics Shoes Artificial Limbs Spinal Support Rehabilitation Aids
Edrees Medical Equipment P.O Box 123876, Dubai, U.A.E, Behind Day to day, Karama Tel. +971 43979594 Fax: +971 43979584 Mobile. +971 502108378 Email: info@edreesmedical.com Website: www.edreesmedical.com
HO: Jeddah, Kingdom of Saudi Arbia
Features of PLEX ESTEC K COM
PLEX is a ESTEC K COM ng 5 ice comprisi medical dev system. features in 1 nvasive test t This non-i tely lts immedia t With resu available at inutes test, t Only 5 m low cost to ique chance t Give a un derstand the doctor to un treatments, pathologies, of their or life style patients
e h t e t a g i t s e v n i o t y a
A new w
s l a n g i body s
LD TECHNOLOGY INDIA PVT. LTD. A/803, 8th Floor, BSEL Tech Park, Opp. Vashi Railway Station, Vashi, Navi Mumbai - 400705, Maharashtra, INDIA Phone: Fax:
+91 022 6516 1971 / 72 022 27811438
Mobile: +91 9323582268
Email: ldindia.ss@gmail.com / ldindia.mb@gmail.com