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Robotic prostatectomy for prostate cancer treatment- Dr. Prof. Anant Kumar.

Pyeloplasty – UPJ obstruction treatment.

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Dr ( Prof.) Anant Kumar - Urologist | Kidney Transplant Surgeon is regarded as the best and most experienced Kidney Transplant Surgeon of India and Director-Urology,Kidney Transplantation and Robotics at Max Hospital,Saket,New Delhi,India.

What is Uretero-pelvic junction Obstruction?

Uretero-pelvic junction obstruction occurs when the flow of urine from the renal pelvis to proximal ureter have an obstruction. The condition may lead to Hydronephrosis. Hydronephrosis is a medical condition ,where the kidneys are swollen with urine because of narrowing or blocking of ureters. Ureters empty the urine from kidneys into urinary bladder. The resultant back pressure within the renal pelvis may cause progressive kidney damage or deterioration of kidney function. Uretero-pelvic junction obstruction may appear in children due to a congenital abnormality or even in adults following any previous surgery or any other medical condition that causes inflammation of upper urinary tract.

What causes pediatrics UPJ Obstruction ?

The exact cause of pediatrics uretro pelvic junction obstruction is still not known. Many times the defect is present in an unborn baby and is termed as congenital defect. It is diagnosed during routine prenatal ultrasound. There may be many reasons for UPJ obstruction during the gestation period. some of them are:
  • During the developing phase the child's ureter is not fully formed resulting in a narrowed section of ureter which may be blocked later on.
  • A faulty muscle in ureter wall which may not squeeze normally.
  • Formation of a "Crossing Vessel" ,i.e., an additional artery feeding the kidney of developing fetus. This may result in kinking or blocking of the ureter.
It can have a genetic component,i.e., it runs in families .Although the responsible gene is not identified yet.

What are symptoms for pediatrics UPJ Obstruction?

Sometimes a UPJ Obstruction in a child does not have any symptoms. A UPJ Obstruction in a developing fetus is usually observed during a routine prenatal ultrasound. It is detected because of hydronephrosis. In majority of cases it is corrected on its own after the child birth. But in moderate to severe condition the following symptoms may occur and they do need a medical attention as if left untreated,it may cause a permanent damage to kidney or urinary system of child.
  • The renal pelvis or kidneys or both are dilated (hydronephrosis).
  • Abdominal,back or flank ( sides) pain.
  • Frequent UTIs ( Urinary tract infections).
  • Edema
  • Swelling around eyes.
  • Lump in abdomen ( Abdominal mass).
  • Poor or retarded growth in infants.
  • Fever.
  • Rashes.
  • vomitting.
  • Bloody urine or diarrhea.
  • Abnormal urine output.

How UPJ Obstruction is diagnosed?

If Hydronephrosis is observed in a developing fetus during a routine prenatal ultrasound , doctor in charge for delivery of child will do more periodic ultrasound to keep a close vigil on any complications arising of the present medical condition. Many times this medical condition is resolved on it's own ,once the child is born. But the doctor may do following tests after a few week of birth of child.
  • Creatinine clearance.
  • BUN ( Blood urea Nitrogen).
  • CT Scan.
  • Electrolytes.
  • CT- Urogram.
  • Nuclear scan of Kidneys.
  • Voiding cystourethrogram.
  • Ultrasound.

What causes UPJ Obstruction in adults?

The reasons for UPJ obstruction in adults may be due to scar tissues,infection,any previous surgery or renal calculi (Kidney Stones). The other reasons may be:
  • A previous renal pelvic trauma.
  • Obstructing calculus immediately distal to PUJ.
  • Previous pyelitis with scarring.
  • Intrinsic malignancy,e.g. upper tract urothelial carcinoma.
  • Extrinsic ureter compression due to
  1. Fibrosis. 2. Crossing vessel at PUJ. 3.An underlying malignancy.

Symptoms of UPJ Obstruction in adults:

Adults may experience following symptoms because of UPJ Obstruction:
  • Renal colic.
  • Chronic back pain.
  • Other non specific signs may be hematuria,Urinary tract infections and pyelonephritis.

Treatment Options:

Treatment line depends on presence of underlying cause.In Majority of congenital cases,no intervention is required and the condition subsides after some time however in case of a definite structural obstruction ,surgical intervention in the form of pyeloplasty or stenting may be needed. Surgery is also inevitable in case of deterioration of renal function or when associated symptoms are severe and progressive.Aim of treatment is to normalize renal drainage and if possible,improve if  reversing the damage to kidneys is not possible.    

         
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Uterine Fibroids – Cause of female Infertility | Infertility treatments in India.

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Uterine Fibroids - Cause of Female Infertility | Infertility Treatments in India.

We offer cost-effective Uterine Fibroids - Infertility Treatments in India. Uterine Fibroid is one of the factors associated with female factor infertility. Uterine fibroids are benign (non-cancerous growth) in the muscular walls of the uterus. They are common in women of childbearing age. Fibroids can be very small or big, sometimes they are huge too. There may be multiple fibroids in the uterus. Generally,  fibroids do not cause any problem or symptoms but in some women, because of the location and size, they may cause pain and heavy bleeding during menses. Fibroids are also associated with infertility in women of childbearing age. The formation and growth of uterine fibroids are estrogen and progesterone-dependent. Women in the age group of 25 years onwards and up to pre-menopause are more susceptible to fibroids, which may cause infertility. As more and more women are delaying pregnancy because of career goals, the chances of uterine fibroid being the cause of Infertility are increasing.

What are the factors responsible for Uterine fibroids:

The factors responsible for Uterine fibroids cannot be pinpointed. But the factors commonly associated with Uterine fibroids are the non-malignant mutation in a single cell, causing it to produce the abnormally larger amount of collagen and other proteins. Female hormones estrogen and progesterone play a role in the growth of uterine fibroids. Proteins common in bloodstream known as growth factors are also associated with formation of uterine fibroids.

Who are at risk of developing Uterine Fibroids:

postpubertal women are at risk of developing uterine fibroids, the risk is higher in the age group of 25 to 35 years.
  • A hereditary medical condition, if someone's mother or sisters have developed uterine fibroids, they are at increased risk of developing them too.
  • Women of African-American origin are at 2 to 5 times higher risk of developing uterine fibroids.
  • Obesity is associated with the formation of uterine fibroids.
  • deficiency in Vitamin-D may be one of the associated factors for uterine fibroids.

Diagnosis of Uterine Fibroid:

The treating Doctor may diagnose the uterine fibroid by taking the detailed history of the patient and by physical examination called bimanual physical examination. The treating doctor evaluates the shape and size of the uterus by inserting two fingers properly sterilized and gloved, into the cervix and surrounding pelvic regions while palpating the patient's abdomen above the pelvic bone with the other hand. Ultrasounds, hysteroscopy, hysterosalpingogram, CT Scans and MRI are confirmatory tests for Uterine fibroids and polyps.

Not all Uterine Fibroids or Polyps cause Female Infertility:

Not all uterine fibroids cause infertility. It is the location and size of uterine fibroid that makes the Infertility specialist suggest medical treatment for infertility. A uterine fibroid that may be blocking the passage of sperm to the fallopian tube to fertilize the ova needs to be treated. Uterine fibroids may also obstruct implantation of fertilized ova in the uterus to grow as an embryo. Large Uterine fibroids may cause miscarriage or natural termination of pregnancy and need to be treated. Uterine fibroids can affect fertility in many ways. They may change the shape of the cervix and obstruct the flow of sperms in the uterus. Change in the shape and structure of the uterus hampers the movement of sperms and embryo. Even fallopian tubes may be blocked by the fibroids. They may have an impact on the size of the lining of the uterine cavity and reduced blood flow, thereby reducing the chances of a fertilized embryo to be implanted in the uterus. The uterine fibroids which are supposed to have a big impact on fertility ( unless they are large and many in numbers) are the submucous type. Because submucous fibroids infiltrate the uterine cavity, they may cause an abnormality in the uterine cavity and cause infertility and miscarriage. Submucous fibroids are surgically removed to increase the chances of conception.

How Uterine Fibroids are treated:

The treatment of uterine fibroids depends on their location and symptoms. The treatment of uterine fibroid can be broadly classified into three categories.

Medical Intervention:

The medical management of Uterine fibroid involves using GnRH Analogue (Leuprolide acetate) and levonorgestrel-containing intrauterine device( Mirena). But they are not advised for a woman trying to conceive. Leuprolide and Mirena delay the ability to pursue attempts at conception.

Alternative treatments for fibroid:

Uterine artery embolization is a radiological alternative to surgery that involves placing a catheter into an artery in the leg and guiding the catheter via x-ray pictures to the arteries of the uterus. Once there, the catheter is used to deliver agents that block off these major blood vessels. The safety of this procedure in women desiring pregnancy has not been demonstrated yet and is discouraged by treating infertility specialists.

Surgical Interventions:

Surgical interventions are most advocated by infertility specialists for treatment of Uterine fibroid as they increase the chances of conception. Surgical removal of uterine fibroids are the most appropriate treatment for fibroids if the infertility specialists feel that they are the cause of infertility and recurring miscarriages, Hysteroscopic myomectomy is most appropriate for infertility causing submucous fibroids of size as large as 4 to 5 centimeters. Laparotomy, minimally invasive laparoscopy, and latest robot-assisted laparoscopy are also used as a minimally invasive surgical procedure for fibroid removal.

When should a woman start trying for conceiving after Fibroid treatment:

Different infertility specialist suggests a different time frame after myomectomy, most of the doctors suggest a time gap of six months for recovery of the uterus before woman start trying for conceiving. However, it is safe to start trying after three months.

     
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Best Indian bone marrow transplant specialist | CMCS health.

Sickle Cell Anemia – BMT in India.

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Sickle Cell Anemia - An overview.

Sickle cell anemia is a common blood related disease in Africa and part of India. Sickle cell anemia is a severe form of anemia caused by genetic mutation in the Red blood cells. It is a genetic disorder which is inherited by the patient from the two faulty hemoglobin genes from both the parents. Because of the genetic mutation,the shape of RBC ,which is flexible circular disc shaped changes to rigid sickle or crescent shaped rods. Hemoglobin a protein in RBCs,works as a transporter of nutrients and oxygen to cells all across the body.Normal RBCs are disc shaped,with the centers partially scooped out. They are flexible and soft and therefore have the capacity to squeeze through even the tiniest of blood vessels to reach every cell in the body.Due to genetic mutation the RBCs acquire the shape of a crescent moon or Sickle and become rigid and brittle.These Abnormal shaped RBCs which are not flexible get struck in small blood vessels causing slow or blockage of blood flow to other tissues of body and disrupt supply of Oxygen to those parts. Moreover the lifespan of abnormal sickle shaped RBCs is only 10-20 days as compared to 120 days of normal RBCs.Human body keeps on forming new RBCs to replace the old ones,but in a person with sickle cell disease the balance in formation of new RBCs and Destruction of existing RBCs is disturbed. This results in lower RBC count or anemia  in a person suffering with Sickle cell disease.

Complications Of Sickle cell anemia:

Sickle cell anemia may have different complications in different people at different stages of disease,but the major and severe complications for a person suffering from sickle cell anemia are:

Acute Complication:

Sickle cell crisis:
Sickle cell crisis or VAS ( Vaso occlusive crisis ) manifests as acute severe pain.Sickle cells disrupts blood supply through smaller capillaries resulting in ischemia. Sudden pain across body that may persist from a few hours to a few days.The pain usually occurs in limbs,chest and back.
Fever and infections:
Patients with sickle cell disease are prone to severe bacterial infections because of reduction or absence of splenic function. This may expose the patient to extremely high risk of septicemia and meningitis.Pneumonia is the most common infection ,meningitis,influenza and hepatitis are other infections occurring in sickle cell disease patients.
A Stroke:
Sickle cell disease may cause a a stroke in an affected person because of oxygen deprivation due to blockage in supply of blood to tissue of brain. Some of the sickle cell anemia patients may experience a Transient ischemic attack.
Acute Chest Syndrome:
Pneumonia like complications in a child or adult suffering from sickle cell disease. The reason could be an infection or sickle cells trapped in micro capillaries of lungs.
Hepatobiliary complications:
Hepatobiliary tract abnormalities are common in sickle cell disease patients.They may include cholelithiasis, acute cholecystitis, biliary sludge, and acute choledocholithiasis,acute Hepatic Sequestration and acute intrahepatic cholestasis.
Acute renal failure:
A decrease in kidney functions due to dehydration or obstruction or even because of intrinsic renal disease.
Acute Anemia:
May be because of Splenic sequestration.
Multisystem Organ failure:
A systemic failure of lungs,liver and kidney is a life threatening medical condition for sickle cell anemia patients.

Chronic Complications:

Vision Problems:
A sickle cell disease patient may develop vision problems over a period of time.It may include proliferative sickle retinopathy and vitreous hemorrhage. Complete vision loss is also possible.
Avascular Necrosis:
Avascular or aseptic necrosis can occur when capillaries are occluded by sickled erythrocytes at distal portions of a bone, near a joint, where hypoxia is maximal and collateral circulation is inadequate .The most common site for sickle cell anemia induced avascular necrosis is femoral neck.
Leg Ulcers:
Leg ulcers appear in patients of sickle cell anemia.
Pulmonary Hypertension:
Pulmonary hypertension occur in sickle cell disease patients.

Sickle cell anemia-Treatments:

Sickle cell anemia patients are  usually referred to a Hematologist ( A doctor who has specialized in blood disease management). Treatment of sickle cell anemia may involve determining many factors by the treating hematologist.Treatment of sickle cell anemia includes regular monitoring and follow up with a hematologist,Medications for management of symptoms and complications,pain management,blood transfusions, oxygen supplementation and allogeneic Bone Marrow transplant.

Allogeneic Bone marrow Transplant for treating Sickle cell Anemia:

Stem cell or Bone marrow transplant is a viable treatment option for those young sickle cell anemia patients where the diseases condition is severe and can not be managed with conventional methods. A sickle cell anemia child who is having a matching sibling donor is referred for a bone marrow transplant by the hematologist considering all the pros and cons. Risk involved is big but a stem cell or bone marrow transplant is the only cure for sickle cell anemia child or young adult.

Before the transplant, bone marrow cells are taken from a close matching healthy brother or sister. The patient with  sickle cell disease is then treated with chemotherapy and radiation that destroy his or her bone marrow cells. After that, the donated bone marrow stem cells are transplanted in the patient.

Dr Rahul Bhargava is Head of Department-Bone Marrow Transplant and Blood Cancer Treatment at Forts memorial Research Institute,Gurgaon,India.

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Hepatitis-C – Symptoms ,Diagnosis and Treatments.

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Hepatitis-C - Treatment -Symptoms -Diagnosis.

Dr Pawan Rawal- Liver Disease Specialist | Gastroenterologist is one of the leading and most experienced Gastro. Physician of North India and is HOD - Hepatobiliary sciences and Gastroenterology at Artemis Hospital ,Gurgaon,India. A New generation Hospital with best Medical equipment and Best Liver transplant ICUs and Paramedical ICU staff in the country.

What is Hepatitis-C ?

Hepatitis C is a viral infection that infects liver and causes inflammation and scarring of normal liver tissues. If left untreated it may cause serious, life threatening damage to liver over a period of time. The prolonged and persisting inflammation in liver tissues may cause scarring of healthy liver tissues. An extensive scarring of Liver tissues leads to cirrhosis. It is this stage of chronic liver disease that starts affecting the life of the Infected. Chronic cirrhosis may also cause Cancer of Liver. Hepatitis-C can be cured in many cases with combination of drugs.Sometimes the treatment for cirrhotic liver is Liver transplant.

How one acquires Hepatitis-C Infection?

Hepatitis-C spreads through mingling of blood from a infected person to a healthy person.Usually it is percutaneous transmission of HCV from an infected person to a healthy person.Hepatitis-C is seven times more infectious than HIV. The most common cause of Hepatitis-C infection is Intravenous drug usage and infected needles (Injections). Unhygienic tattooing and body piercing centers which may use unsterile needles for the purpose,It may be transmitted from an infected mother to an unborn child,Very few and rare chances of transmitting through sexual intercourse,Using common household items like a shaving razor,Scissors,Manicuring equipments,tooth brushes etc., People who may have taken a blood transfusion before 1990,Hemodialysis,a medical procedure , an accidental injection needle prick from an infected person in a healthcare worker etc.

Who are at Risk of Hepatitis-C infection?

Healthcare workers,people who uses common shaving and hair cutting saloons,may be because of an infected razor or scissor,People who had a blood transfusion before 1992,people who had received hemodialysis on a machine which has dialysed an HCV infected person,elderly people who may have had a surgery before 1990. An unborn child whose mother may be HCV positive.

Symptoms Of Hepatitis-C:

Majority of people in early stages of Hepatitis-C Infection does not have noticeable symptoms.But once the disease progress the symptoms start appearing, are: The early symptoms appear in a very small infected population and may be because of other medical conditions too. Yellowing of Skin (jaundice) and whites of eye,Uncommon fatigue or general malice, Dark coloured urine,loss of appetite,fever,muscles and joint pains, Stomach ache etc. But in an advanced stage of disease the symptoms may include Itching and rashes on skin,Weight loss,Enlargement of breast in men(Gynecomastia),Easy bleeding and bruising of skin,Prolonged blood coagulation time ( time taken in stopping of bleeding from a wound is prolonged),swelling of feet,rashes on palms,fluid accumulation in stomach (ascites),appearance of spider web like blood vessels ( Spider angiomas),Kidney functions being derailed ( Cryoglobulinemia),persistent yellowing of skin and eye whites. More severe symptoms of chronic hepatitis-C include portal hypertension ,esophageal varices ( engorged veins in the swallowing tube) that may bleed suddenly,enlarged spleen that may result in anemia,fall in platelets count (thrombocytopenia) that makes the infected person prone to bleeding easily and prolonged time of stopping of bleeding and confusion,disorientation and even coma because of hepatic encephalopathy.

How Hepatitis-C is diagnosed?

HCV Antibody testing ,HCV viral load testing, HCV genotype testing for determining the treatment course and duration,and the possibility of curing the disease.Other tests may be done for a Hepatitis-C patient like LFT (liver function test) to determine the damage to liver,a liver biopsy to determine cirrhosis,imaging tests like ultrasound,CT scan and MRI to determine fatty liver and liver cancer.

Treatment of Hepatitis-C :

Treatment,duration and medication for Hepatitis-C depends on several factors. A gastro. Physician will consider all the aspects in every individual patient before prescribing a medicine or combinations of medicines. Some of the factors determining the course of treatment and management of Hepatitis-C are listed below:
  • Genotype of HCV.
  • Viral load ( The quantity of virus present in blood stream)
  • treatment history ( Previously treated or untreated patient)
  • degree of damage to liver (Cirrhosis).
  • status of patient,i.e., if patient is a liver transplanted patient or a candidate for a planned liver transplant in future.
  • Patient's general health and tolerability of treatment.
The invention and approval of sofosbuvir a new drug for treating Hepatitis-C infection have brought in a dramatic change in the outcome of treatment of HCV. Sofosbuvir can be used in combination with ribavirin or as a three drug combination of Sofosbuvir,pegylated Interferon Alfa and ribavirin. There are contraindications for Sofosbuvir and it should not be used as an empirical therapy for every Hepatitis-C patient.

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Medical Treatment of Afghans in India

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Medical Treatment of Afghans in India

CMCS Health an NCR-India based registered medical and healthcare consultancy firm has signed an agreement with Ghazali Memorial Hospital, Kabul, Afghanistan for Specialized Medical Treatment of Afghans in India. A very high number of Afghan people come to India for various medical treatments. As there is no governing or regulating body, many of these guests fall in hands of touts, who do not have a medical background and these guests lands up at wrong hospitals and wrong specialist doctors and spend a big amount of money on their medical treatments.

Medical Treatment of Afghans in India

Many times the guest are not even aware of the medical treatment required before starting from their country, the course of treatment and approx. cost of medical treatment and India and hospital stay required.

CMCS health and Ghazali Memorial Hospital in Kabul Have decided to bring in more transparency and organize the medical treatment of Afghans in India in a patient benefiting manner.

According to Dr. Walidullah Adil Sahibzada from Ghazali Memorial Hospital, Charleston Qalai, Ghaibi, Kabul, Afghanistan many provinces in Afghanistan does not have proper diagnostic facilities and medical treatment facilities for complicated medical procedures. Awareness among the population is also low. These people are targets for the touts who are eyeing these people for making some fast money. Ghazali Memorial hospital has entered an agreement with CMCS Health to provide video conferencing facility for these guests with treating Indian doctors. An initial screening and basic investigations will be performed at Ghazali Memorial Hospital, the reports will be sent to CMCS Health, who on their part, discuss the case with concerned leading specialist doctors from India and enquire about treatment course, cost and outcome of the treatment. Ghazali Memorial Hospital with CMCS Health's collaborations, help the patient in choosing to treat hospitals and doctors as per their needs and budget. A treatment offer letter is given to the patient with all relevant details in Kabul, Afghanistan, empowering them with all the information about treating doctor, treating hospital, the course of treatment, cost of treatment and logistics even before they start from their country.

Medical Treatment of Afghans in India

On the patient's coming to India, their medical treatment, stay arrangement is well coordinated by CMCS Health, to ensure the patient's best interest and benefits. As per MOU between CMCS Health and Ghazali Memorial Hospital, campaigns for awareness and screening of cancer, kidney and liver diseases, blood cancer and thalassemia will be conducted in all the provinces and then consultation and possible medical treatment will be given to Afghan patients by expert Indian specialist doctors, who will keep on visiting Ghazali Memorial Hospital. These visiting Indian specialist will also train Afghan doctors and paramedical staff for effective management of these life-threatening conditions.

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Scoliosis,Spinal fusion and decompression surgery | Best Spine surgeon in India

Idiopathic-degenerative Scoliosis | Treatment in India|Spine Surgery in India.

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Idiopathic-degenerative Scoliosis|Treatment in India|Spine Surgery in India.

Scoliosis is an abnormal sideways (Lateral) Curvature in spine.At CMCS Health,we are associated with best Spine Surgeons of india for cost effective treatment of Idiopathic-degenerative scoliosis| treatment in India|Spine Surgery in India for our Global Guests. Scoliosis treatment depends on age,Abnormal curvature in spine and how this curvature is affecting the quality of life of the person.

Idiopathic scoliosis treatment in India:

When the abnormal curvature in spine is unexplained ,it is called idiopathic scoliosis. Young adults and children are more affected with idiopathic scoliosis. Idiopathic scoliosis treatment in children involves Periodic Observation with Imaging diagnostics to monitor the increase in abnormal curvature of spine,Casting,bracing and spinal fusion surgery as the final step if the condition is severe and affecting quality of life. The surgery may require repetition to keep the pace with child's growth.Young Girls are more prone to idiopathic scoliosis as compared to boys.

Degenerative Scoliosis treatment in India:

Degenerative scoliosis affects the elderly adults. The possible factors responsible for Degenerative scoliosis are arthritis,osteoporosis,a trauma to spine may be because of some injury or illness.usual wear and tear to spine due to ageing, osteoporosis,muscular dystrophy,Vertebral compression fracture and degeneration of disc.Another scoliosis cause may be a benign ,non cancerous tumor in spine,which puts undue pressure on nerves and spinal cord and patient may start bending in the opposite direction to avoid putting pressure on tumor ,which causes a postural bending. Degenerative scoliosis causes pain in mid to lower back,a pain that shoots from lower back and radiates to legs,numbness and weakness in legs and feet.

Signs and Symptoms of Scoliosis:

The signs of idiopathic scoliosis are very sublime and are felt only when the curvature of spine is big and it start affecting the normal functioning.The most common symptoms of scoliosis is a change in posture,a sideways or lateral bending on one side,The affected person may feel that there clothes do not fit them as they used to previously or the pant legs are longer on one side.Scoliosis may cause head to appear off center and one shoulder or hip appear to be higher than the other side.The severe cases may cause difficulty for lungs or heart to function properly.,culminating in shortness of breath or chest pain.

Who are at risk of developing Scoliosis?

Age is one of the risk factors,as symptoms for idiopathic or child scoliosis start appearing between the age of 9 to 15 years.Girls are more prone to be affected than the boys. A genetic history is also considered to be one of the causes.
Earlier it was thought that scoliosis was only a childhood condition but now there are increasing evidences of elderly people getting affected. Arthritis and osteoporosis also increases the risk of Scoliosis in elderly patients.

How Scoliosis is diagnosed?

Scoliosis is diagnosed with physical examination by the treating doctor and is confirmed with diagnostic imaging techniques like,X-ray,CT-Scan and MRI.

Idiopathic-degenerative Scoliosis |Treatment in India|Spine Surgery in India.

Treatment for Idiopathic Scoliosis:

The treatment for idiopathic scoliosis which is common in children involves periodic Observation with diagnostic imaging techniques to keep on monitoring the increase in abnormal curvature of spine,casting,bracing and Spinal fusion surgery as a last resort if the curvature is more than 40%. The child may need subsequent surgeries to keep up pace with growth of child.

Treatment of Degenerative Scoliosis:

Treatment of degenerative scoliosis may involve either one or two procedures. Namely Spinal Fusion surgery or spinal decompression surgery.The aim is to reduces the pressure on spinal chord and give room to nerves.

Post Spine surgery care and Management:

Surgeon advises physiotherapy post the spine surgery for gaining strength in muscles.Antibiotics are prescribed to reduce chances of infection and pain relieving medicines are given to reduce any pain or discomfort. Patient is advised to avoid forward or backward bending as it carries the risk of dislocation of the implants till bone fusion takes place.

Dr Hitesh Garg is Consultant spine and scoliosis surgeon at Artemis Hospital Gurgaon,India.

 
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Liver Transplant in India

Liver Transplant in India | Best liver Transplant In India

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Liver Transplant in India

Liver Transplant in India-At CMCS Health we are associated with best Indian Liver transplant Hospitals and best indian Liver transplant surgeons for Best and Cost Effective Liver Transplant in New Delhi-NCR,for our Global Guests. Dr. Anupam Saha did his Post Graduation in General Surgery from Armed Forces Medical College Pune and 2 yr Fellowship in Castro Intestinal Surgery from AIIMS New Delhi. He completed 1 yr Fellowship in Liver Transplantation from Kings College Hospital London.

Best and Cost-effective Liver Transplant in New Delhi-NCR, India.

Liver Transplant in India-He was entrusted to establish the only Liver Transplant Centre of the Indian Armed Forces at the premier Army Hospital Research & Referral, New Delhi in 2007. He was the lead Liver Transplant surgeon of the Indian Armed Forces and has the experience of more than 250 Liver Transplantations involving adult as well as paediatric patients. Performed India's First In Situ Split Liver Transplant in 2008 Performed Liver Transplant in the youngest recipient in India in 2010. Liver Transplant in India-Liver is necessary for survival of a human because of its complex functions in human body. Although liver dialysis techniques can be used for a short term survival but CURE definitely is a liver or hepatic transplant. Liver is the only human organ capable of regeneration. Even 25% of healthy and disease free liver can regenerate in to a full liver.

Best Liver transplant Surgeon In India

Orthotopic transplantation is the most common and widely used liver transplant procedure. in which the diseased liver in a patient is removed and replaced by a portion of liver donated by a healthy Live relative donor. The transplanted liver grows into the recipient to full functionality, and donor’s liver also regenerate to a full liver within few weeks. With the advent of newer class of immunosuppressant medicines, like tacrolimus ,the successs rates have increased many folds.

Best and Cost effective Liver Transplant in New Delhi - NCR,India.

What Liver Patients, require a liver transplant?

Anyone with an irreversible liver damage.Most transplants are done for chronic liver diseases leading to cirrhosis, such as chronic hepatitis C, alcoholism, autoimmune hepatitis, and many others.

Who is a Suitable Liver donor ?

Any member of the family, parent, sibling, child, spouse can donate their liver. The criteria for a liver donation include:
  • Being in good health and preferably of the same or bigger physical size as recipient.
  •  Having a blood type that matches or is compatible with the recipient's.
  • Being between 18 and 60 years old.
  • With the recent advances of noninvasive imaging, living liver donors usually have to undergo imaging examinations for liver anatomy to decide if the anatomy is feasible for donation. The evaluation is usually performed by doing current MDCT and MRI. This will allow to rule out un suitable donor and unnecessary surgery for donor.
Dr Anupam Saha is one of the most experienced liver transplant surgeons of India and director of Liver transplant surgery at Fortis Memorial Research Institute,Gurgaon,India.

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Infertility Treatment in India

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Infertility Treatment in India |IUI |IVF| ICSI | IMSI specialists.

Increasing Infertility is one of the major causes of stress in married couples. Infertility can be both primary and secondary.With the advancement in diagnostic procedures and surrogacy,more and more infertile couple are realizing the dream of holding the own bundle of joy in their hands. We offer cost effective Infertility treatment in India| IUI | IVF | ICSI | IMSI | specialist, with globally at par success rates. Dr Nalini Gupta,Founder Director of “Harmony” the super specialty assisted conception program center at Park Hospital,Gurgaon has done her MBBS,MD and M Sc. in clinical Embroyology from Leeds.(United Kingdom).

Infertility Treatment in India

Dr Nalini Gupta is pioneer in field of reproductive medicines and assisted conception programs for infertile couples. Her vast experience and qualification combined with empathetic attitude and religious zeal in the field of managing the infertility among the couples have paved way for A center for reproductive medicine and fertility as a center par excellence with success rates at par with the leading Assisted reproductive treatment centers in the world.

Infertility Treatment in India

The biggest dilemma faced by the married couple these days is to not be able to produce their own bundle of joy.It is still a big social stigma in a conservative society like ours. The Sedentary and ever demanding life styles and environment is creating a big havoc even among the otherwise healthy couples in realizing the biggest joy of their life.

Infertility Treatment in India

Many of these infertile couple can be helped by counseling and recent advent of newer technologies. An Initiative to overcome this ever growing menace has been taken by Dr Nalini Gupta Fertility specialist At Park Hospital,Q-Block,South city-II,Sohna road,Sector 47 ,Gurgaon Haryana. The Biggest joy for a married couple is to have an offspring of their own. The little bundle of joy completes the cycle of life.

Infertility Treatment in India

The biggest dilemma faced by the married couple these days is to not be able to produce their own bundle of joy It is still a big social stigma in a conservative society like ours. The Sedentary and ever demanding life styles and environment is creating a big havoc even among the otherwise healthy couples in realizing the biggest joy of their life. Many of these infertile couple can be helped by counseling and recent advent of newer technologies.

Who require Medical Treatment ?

A healthy couple living together for more than one year and having frequent copulation without any contraceptives and still not conceiving,may be require assisted conception techniques. The chance of getting pregnant in each menstrual cycle (each month) is calculated to be one in four for an average fertile couple. However, it may take a long time to conceive, even if everything is normal. Eight out of every ten women trying for a baby will fall pregnant within the first year. Women who do become pregnant without any medical assistance generally do so within two years of trying. It is common for couples to seek help and advice if there is difficulty conceiving. Overall, around 15 per cent (one in six) of all couples will seek help. The point at which they may want to seek help will depend on various factors. For example, if they are over 35 years of age or if they have any worrying symptoms, such as infrequent periods, the couple should seek help after about six months of trying.

Which partner need Treatment ?

Both the male and female partner may require a thorough evaluation for knowing the exact cause. After knowing the cause a suitable treatment option is chosen.

Management of infertility may be both medical and surgical:

Medical Management:

For correction of hormonal imbalance, Ovulation induction using gonadotrophins in female partner and increasing sperm count and sperm mortality in male partner.

Surgical Management:

Surgeries may be required for uterine fibroid, or blocked fallopian tube in female partner, and for Varicoceles etc. in male partner.

Infertility Treatment in India | IUI |IVF | ICSI | IMSI Specialist.

The Common Treatment course for management of Infertility are :

In vitro fertilization (IVF) Intra-cytoplasmic sperm injection (ICSI) Donor insemination for male factor infertility. • Egg donation for female factor infertility.

Dr Nalini Gupta is an Experienced infertility specialist in India with many successful infertility treatments in her patients. The patient benefiting and ethical approach has made Dr Nalini Gupta a well known name among infertility specialist doctors.

Dr Nalini Gupta is Senior visiting consultant at Miracle IVF center,Director at Harmony, a center for reproductive medicine and fertility and Owner of Dyanamic Fertility and IVF Center in South-Ex New Delhi.

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Thalassemia treatment | BMT

Bone Marrow Transplant for AML in India

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Bone Marrow Transplant for AML in India

Bone Marrow Transplant for AML in India-BMT (Bone Marrow Transplant) or Hematopoietic stem cell  transplant is newer medical Intervention for treating hematological malignancies (Blood Cancers) and non malignant medical conditions in children.In this blog,we are discussing the the disease AML,how AML is diagnosed,what are the classific ation method for AML, treatment choices for AML and Bone Marrow Transplant for AML in India.

What are Indications for BMT in Children?

Bone Marrow or Hematopoietic Stem cell transplant is indicated in certain hematological malignancies as well as non malignant medical conditions in Children. The major indications for BMT in children because of blood cancers are: Acute Myeloid Leukemia (AML) Acute Lymphoblastic Leukemia (ALL) The non malignant medical conditions requiring BMT are: Sickle cell disease and Thalassemia. Aplastic Anemia or other Bone marrow Failure Syndrome. Immune deficiency diseases,inherited metabolic disorder and others.

Bone Marrow Transplant for AML in India

  In this Blog we will highlight the need of Bone Marrow Transplant for AML ( Acute Myeloid Leukemias) Acute Myeloid Leukemia (AML) is a kind of blood cancer.It may consists of multiple disorders involving replacement of healthy bone marrow with abnormal primitive hematopoietic cells. It may affect both adults and children.AML can affect children of any age and sex. A subdivision of AML helps the treating doctor chose the best treatment option and ensure better treatment outcome. AML can be subdivided in a cluster of diseased medical conditions.The most common and widely used classification for sub division of AML is French-American-British system also known as FAB. Another newer subdivision recommended by World Health Organization known as WHO system is also prevalent.

As per FAB ,AML subdivision is as follows:

M0 - AML with minimal evidence of myeloid differentiation. M1 - AML without maturation. M2 - AML with maturation. M3 - Acute promyelocytic leukaemia (APL) M4 - Acute myelomonocytic leukaemia M5 - Acute monocytic/monoblastic leukaemia M6 - Acute erythroleukemia M7 - Acute megakaryoblastic leukaemia

Subdivisions of AML as per WHO System:

(Rarely used in pediatrics patients) AML with characteristic cytogenetic translocations. AML with multilineage dysplasia. AML and myelodysplasia syndromes secondary to therapy. AML not otherwise categorized.

Signs and Symptoms of AML in children: Bone Marrow Transplant for AML in India

As we have discussed in earlier slides that AML is not one disease but a cluster of associated medical conditions. The signs and symptoms can also be classified according to diseased medical condition. Symptoms due to deficiency of normal functioning cells: Cytopenia,Anemia.Hemorrhage and fever. Symptoms due to infiltration of abnormal leukemic cell: Extramedullary infiltration,Mediastinal mass which may cause superior Vena Cava Syndrome or respiratory insufficiency. Abdominal masses causing pain or obstruction in GI or urogenital tracts. Gingival hyperplasia. CNS infiltration.

Causes and factors responsible for pediatric AML:

Causes and factors for AML in children are still being studied.Nothing concrete can be said but the things which may be linked to AML in children are: Children with genetic disorders such as downs syndrome or Li Fraumeni Syndrome are considered to be at a higher risk of developing Pediatric Leukemia. Although very small,but children with siblings having AML stand a risk of having AML. Children suffering from Non malignant medical conditions like Aplastic anemia and MDS (myelodysplastic syndrome) also stand the danger of getting AML. Link between exposure to radiation,living nearby high voltage power lines and certain chemicals and pesticides are being studied.

Treatments for AML| Bone Marrow Transplant for AML in India

The treatment for AML is guided with intention of destructio  of the leukemic cells and enabling the bone marrow to produce normal cells and function in a normal way. Chemotherapy is the back bone of AML treatment. A combination of chemotherapeutic or Anti cancer medicines are used for the optimum results and lower side effects.

The treatment of AML is multiphasic.

The first phase is usually called as induction phase. The aim of induction phase is to destroy abnormal leukemic cells. Induction phase involves chemotherapy with combination chemotherapeutic agents for at least for two chemotherapy cycles. A bone marrow test is conducted at the end of this phase to ensure that the child is free of leukemia.If there is no evidence of leukemia ,the child's condition is referred as being in remission. Two more cycles of chemotherapy are given to child post the induction phase,to ensure destruction of any left over leukemic cell in blood or bone marrow and prevent any relapse.

Bone Marrow Transplant For AML in India:

Bone Marrow Transplant or BMT is recommended for treatment of AML when the disease has relapsed or the treating doctor feels that the child is at a higher risk for relapse. Sometimes AML may develop in CNS ,that is spinal chord and brain and in such cases intrathecal chemotherapy is administered to child directly in spinal fluid.Sometimes radiotherapy to brain is also used in conjunction.  

Dr Vikas Dua is Senior Consultant at DEPT. of Hematology and BMT at FMRI,Gurgaon,India.Artemis Hospital is well equipped and well manged for a complicated medical procedure like BMT.

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Bone Marrow Transplant In India | Best medical tourism Company In India

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Bone Marrow Transplant in India -Blood cancer Treatment in India

Bone Marrow Transplant In India-or Hematopoietic stem cell transplant for Blood cancers is a viable option for treating certain Hematological Malignancies. We at CMCS Health are associated with best Bone Marrow Transplant Specialist Doctors in India  and well equipped medical centers for conducting successful Bone Marrow Transplant- Blood cancer treatments in India.

Bone Marrow Transplant In India | Best Bone Marrow Transplant Surgeon In India

Dr. Vikas Dua  is widely regarded as one of the best bone marrow transplantation specialists and clinical hematologists of his generation by virtue of his excellent patient outcomes that have consistently been among the very best in his field in India and abroad. Dr vikas Dua  CV lists his impressive training credentials. After an initial 2-year stint at the Christian Medical College, Vellore, a center widely regarded as the cradle of hematology and bone marrow transplantation in India under the famed Prof. Mammon Chandy, he moved to the All India Institute of Medical Sciences,

Bone Marrow Transplant In India |Best Blood cancer Treatment In India

New Delhi, India for a formal 3-year superspecialist degree of DM in Clinical Hematology. At AIIMS he trained under renowned names like Professors Rajat Kumar, VP Chaudhry and Renu Saxena. Subsequently, Dr. Vikas dua  was selected for a fellowship in Vancouver, Canada and underwent specific training in voluntary stem cell and umbilical cord transplantation. Upon his return to India, he joined the Medanta Medicity, Gurgaon, India . He developed its bone marrow transplantation and hematology services from the ground-up,

Bone Marrow Transplant In India

achieving a remarkable 100 transplants in a period of  36 months in the then new hospital that soon became one of the largest medical centres in the country. Dr. Bhargava currently heads the Hematology and Bone Marrow Transplantation department at the Artemis Hospital in Gurgaon, India. The department has its own transplantation unit and extensive laboratory facilities,

Blood cancer Treatment In India

providing cutting-edge clinical skills and the latest in technology at affordable costs for transplantation and other hematological services. His fame attracts patients not only from all parts of India but also from Pakistan, Bangladesh, Nepal, Bhutan, Africa, Iraq and Russia among others. Till date, Dr. Rahul Bhargava has performed close to 200 adult bone marrow transplants which is record-breaking in whole of North India.

Bone Marrow Transplant IN India - Best BMT Surgeon In India

BMT is replacement of abnormal or damaged bone marrow in a person by healthy bone marrow. Bone marrow transplant is also known as stem cell transplant. Stem cells are undifferentiated biological cell that has ability to develop in differentiated biological cells. Bone marrow transplant are life saving medical intervention for saving lives of people suffering from abnormal and damaged bone marrow stem cell ,giving rise to diseased medical conditions which can be both malignant or cancerous and non malignant or non cancerous.

Blood Cancer Treatments in India-Bone marrow transplant In India

Blood cancers or Hematological malignancies requiring Bone Marrow transplants are:- Leukemia, Multiple Myeloma and myelodysplasia. Non Cancerous medical conditions requiring bone marrow transplants are : Aplastic anemia and Hemoglobinopathies. Bone marrow transplants can be classified as: Autologuos bone marrow transplant where patients own bone marrow cells are infused back and Allogenic bone marrow transplant where the bone marrow stem cells are procured from a donor. At Complete Medicare Solutions, We are associated with Best Indian Hematologist and Bone Marrow Transplant Specialists. A bone marrow transplant requires a highly upgraded and well equipped medical center as the risk of life-threatening infections are high with BMT procedures. At Complete Medicare Solutions we have selected best Indian hospitals which are well equipped and well managed for risk-free BMT procedures for our Global guests.

What patients and Attendants Need to know before BMT:

Like any other organ transplant, bone marrow transplants may be associated with serious risks; the treating doctors will help the patient and attendant in considering pros and cons of going for a bone marrow transplant. BMT is definitely a life-saving condition for many patients. Selection of a suitable donor is very important for the success of BMT.HLA tests determine how the antigens of recipient’s stem cells matches to antigens of donor’s stem cell. The higher the number of  matching HLA antigens ,the greater are chances of recipient’s body accepting the donor stem cells. Close relatives like brothers and sisters of recipient have better chances of matching HLA antigens and thereby successful BMT procedures as compared to a non related donor.

What is ideal time to do BMT for patients with Blood cancer :

The ideal time to do BMT with good success rate is when the disease is in remission ( The signs and symptoms are not present usually after completion of chemotherapy cycles) and in early stage of disease, children and generally good health of patient.

Bone Marrow Transplant IN India

Chemotherapy induced hepatotoxicity .Conditioning induced neutropenia and thrombocytopenia resulting in infections, bleeding and mucositis. Approximately within 4 weeks of BMT ,signs of engraftment start appearing. When the patient is found fit to be discharged post successful BMT,patient is discharged from hospital but proper follow up medical care is advised by the doctors post discharge.  

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