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Thalassemia Treatment in India – CMCS Health.

Thalassemia Treatment in India - CMCS Health.

Thalassemia is a genetic disorder which affects the hemoglobin in a patient. The conservative treatment consists of recurrent blood transfusions.These recurrent blood transfusion may cause iron overload in the patient and subsequently bone deformity,liver damage and other health complications follow. Bone marrow transplant is considered a viable treatment option for pediatrics thalassemic patients.At CMCS Health, we offer Child Thalassemia treatment in India at Best BMT Hospitals in Delhi.,with the best specialist indian medical doctors at well equipped and well managed treatment centers and hospitals at an affordable and reasonable cost with very good success rates.

What is Thalassemia?

Thalassemia is a medical condition in which the affected person's body produces abnormal hemoglobin. This abnormal hemoglobin gets the excessive and premature destruction of RBCs subsequently causing anemia in the affected person. A person with thalassemia may require frequent blood transfusions depending upon type and severity.

What are the causes of Thalassemia?

Thalassemia is a mutation in genes responsible for hemoglobin production. It is a genetic or hereditary disorder, which means the disease is passed on to the patient by the parents who are the carrier of the disorder.

What are the Types of Thalassemia?

Thalassemia can be broadly classified as Alpha and Beta Thalassemia. There are many subtypes of Thalassemia.

Understanding Thalassemia:

Hemoglobin molecules are made up of Alpha and Beta parts. Both Alpha and Beta parts are prone to genetic mutations.

Alpha Thalassemia :

Alpha Thalassemia is more common among the south east Asians , south china,India, Africa and middle eastern countries. Four Genes are involved in formation of Alpha Hemoglobin chain. A child will acquire two each from both father and mother. One mutated gene either from father or mother out of the four genes,causes either no symptoms or mild symptoms in child,the child will grow as healthy human being but will be called a silent carrier of Alpha Thalassemia.

Thalassemia Treatment in India

Two mutated genes either from father or mother,the symptoms will be mild in child, such a thalassemia is called Alpha thalassemia minor. Three mutated genes will cause moderate to severe anemia in child. The child will have chronic anemia and will require regular blood transfusions throughout his/her life.This medical condition is also referred as Hemoglobin H disease. Mutation in all four genes is called Alpha Thalassemia major or Bart hydrops fetalis.Fetuses with mutations in all four genes do not survive or die shortly after birth. Blood transfusion given to fetus with four gene mutations rarely works and have very low success rates.

Beta Thalassemia:

Beta Thalassemia is more common among the people of mediterranean region. The prevalence is high in North Africa and west asia. Substantial population in Maldives and certain islands in Indian ocean are the careers. Two genes one each from the father and mother constitutes Beta hemoglobin chain. One gene mutation causes mild symptoms and are referred as Beta Thalassemia minor. If both the genes have mutation, the signs and symptoms may vary from moderate to severe.The affected condition is called Cooley's Anemia or Beta Thalassemia Major. Babies born with mutations in both genes are usually born as healthy child but develops complications of thalassemia within two years of birth.Another form of Beta Thalassemia with both genes mutation but with milder symptoms is called Beta Thalassemia Intermedia.

What are signs and symptoms of Thalassemia?

The signs and symptoms of thalassemia depends on it's type.

Signs and Symptoms of Alpha-Thalassemia:

Majority of children with Alpha-Thalassemia or Hemoglobin-H disease are healthy in general.Symptoms may vary from mild to moderate anemia,Fatigue,drowsiness,pale skin or jaundice,abnormally cold hand and feet ,chest pain,frequent headaches,shortness of breath, dizziness and feeling of impending being faint.enlarged spleen and possibly soft to touch and enlarged liver,they may also have deformity of bones,forehead,cheeks ans jaw may overgrow.

Signs and Symptoms of Beta Thalassemia:

Signs and symptoms of Beta Thalassemia ( thalassemia major or Cooley's anemia ) is generally severe and patient may require regular blood transfusions, the symptoms may include jaundice, frequent infections,cold hand and feet,shortness of breath,a general feeling of malice and being tired,poor appetite,skeletal deformity,delayed growth and delayed puberty,iron overload in body that can harm spleen,heart and liver.

How Thalassemia is diagnosed|

Different diagnostics tests are recommended by treating doctor,if he/she suspects the patient to have Thalassemia.
  • Complete Blood Count ( CBC) is recommended for hemoglobin levels,as thalassemia patients usually have lower hemoglobin.
  • Microscopic examination: is conducted to ascertain any abnormality in RBCs,Thalassemia patients RBCs are smaller in size as compared to an unaffected person.RBCs with uneven hemoglobin distribution,that gives Bull's eye appearance under the microscope.
  • A reticulocyte Count is done to ascertain how fast RBCs are formed by the bone marrow and released in blood.
  • Hemoglobin electrophoresis separates different molecules in RBCs,allowing identification of abnormal RBCs.
  • DNA Analysis  is done to diagnose thalassemia or to ascertain if the person is carrier of mutated hemoglobin gene cells.
  • Iron tests in blood  are done to ascertain if the patient's anemia is because of thalassemia or iron deficiency,as thalassemic patient's do not have Iron deficiency.
  • Physical examination is conducted to ascertain enlarged spleen.

    Thalassemia Treatment in India | CMCS Health.

Treatment for moderate to severe thalassemia may involve frequent blood transfusions.Frequent blood transfusions may cause iron overload in patient's body which in longer run may damage spleen,heart and liver. Iron Chelation is removal of excess iron from the blood. Patients may be prescribed subcutaneous injections of deferoxamine or oral deferasirox. Bone Marrow or Stem Cell transplant is a better treatment option for Thalassemia. Chemotherapy cycles given to the patient prior to BMT for destroying abnormal cells and once the patient is in remission phase,bone marrow from a compatible donor preferably a sibling is transplanted in thalassemia patients. Surgery is also done for some patient with bone deformity and sometimes surgery  removal of spleen and gall bladder is also done.

Thalassemia Treatment in India

Dr Vikas Dua is consultant Pediatrics bone marrow transplant specialist at Fortis Memorial Research Institute Gurgaon,India.

Dr Vikas Dua did his advanced Fellowship in Pediatrics Bone Marrow Transplant from National University Hospital Singapore and also did his training in child BMT from world's No.1 institute in pead.BMT ,St. Jude's Children research Hospital Memphis,USA.

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Robotic assisted Pyeloplasty | dr.anant-kumar

Why a kidney transplant is needed?

Kidney transplant is needed when both the kidneys stop working in a person,the medical condition is also called end stage renal disease.

Hemodialysis is an option but not a permanent solution.

What are functions of healthy Kidney?

The two kidneys in humans are responsible for filtering and excretion of toxins, for maturation of RBCs, regulation of arterial blood,production of erythropoietin,regulation of Vit-D production, glucogenesis , regulation of Acid-Base balance,regulation of arterial blood pressure.

What Causes Kidney Failure?

Prolonged uncontrolled diabetes, Prolonged uncontrolled blood pressure , severe dehydration , trauma to kidney , misuse and overuse of over the counter pain drugs , lupus ( An auto immune disorder) , glomerulonephritis , polycystic Kidney disease.

How Kidney failure is diagnosed?

Usually no eminent symptoms are present in early stages but following symptoms indicate a kidney failure:

  • Decreased urine output
  • Swelling on legs, ankles and feet
  • Shortness of breath
  • Chronic fatigue
  • Nausea ,confusion ,pressure in chest, seizures or even patient going in coma.

How Kidney Failure is diagnosed?

  • Blood tests (BUN   & creatinine)
  • Urine analysis and urine volume
  • MRIs , CT scans
  • Kidney biopsy

Who Could be a Kidney Donor ?

In India a live donor need to be a blood relative Mother,father,son,daughter,brothers and sisters and a husband/wife. After much deliberations grandparents and grandchildren are also included in list of blood relatives.

Donor should be a healthy person between the age group 18- 55 years.

How a kidney transplant is done ?

After initial screening about feasibility for recipient and fitness of donor , approval of government of India appointed organ transplant committee clearance ,surgery date is given and patient and donor are admitted in hospital for the surgery . Donor is discharged usually in 4 to 5 days and patient remains in isolation ICU from 7 to 9 days before discharge.

Transplants can be done either by laparoscopic or Robotic way.

Precautions post Kidney transplant:

Patient need to be taking his medications at prescribed time ( Immunosuppressant) to avoid risk of graft rejection.Regular kidney function tests and tacrolimus level test initially to tailor the dose.Good personal and oral hygiene to ward off any infections due to immunocompromised state.Avoiding any strenuous exercise or physical activity for 6 to 8 weeks.Consuming only properly cooked food and carefully washed fruits.Creating healthy eating habits to help control your weight, blood sugar levels, blood pressure, and body fluid retention.

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Hepatitis-C – Symptoms ,Diagnosis and Treatments.

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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Spine Surgery in India- CMCS Health

Spine Surgery in India- CMCS Health

Spine Surgery in India-Many of the patients of lower back pain can be helped with proper investigation and subsequent diagnosis.

Decompression is done to relieve the pressure over nerves by removing,the diseased discs, ligament flavum and bone which is pressing over the nerves.

Spine Surgery in India

Lumbar fusion surgery is designed to create solid bone between the adjoining vertebras, eliminating any movement between the involved bones.

The goal of the surgery is to reduce pain and nerve irritation.We at CMCS Health are associated with Best Neuro.

Surgeons of India and well equipped and well manged treatment centers to offer Best Spine surgery in India for our Global guests.

Decompression and Spinal Fusion Surgery:

In this surgery, diseased discs would be excised and  replaced with spacer device, Pedicle screws and rods are attached to the back of the vertebra and an interbody fusion spacer is inserted into the disc space from one side of the spine. The surgery is known as spinal fusion surgery.

Spine Surgery in India

Dr. Hitesh Garg is senior consultant in Neuro-Surgery Department at Artemis Hospital ,Gurgaon,India.

Dr Hitesh has extensive experience in spine surgery having trained from the best spine centers of the world and India.

Spine Surgery in India

Dr. Garg specializes in the comprehensive treatment of numerous conditions affecting the cervical, thoracic, and lumbosacral spine including degenerative disc disease, scoliosis, trauma, infections, and tumors.

Spine Surgery in India

He has performed more than 2000 spine surgeries including more than 1500 spinal fusions, 250 deformity correction procedures (Scoliosis and kyphosis), 150 lumbar and cervical artificial disc replacements.

if you want to visit india for the treatment of spine surgery you can contact to the best spine surgery in india dr hitesh garg For The treatment OF india .he has the leading india best soine surgery in india for the treatment,

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Dr ( Col.) Manjinder Sandhu

Pacemaker implant surgery in India

Pacemaker implant surgery in India

There are many reasons why some Bradycardia or low heartbeat patients requires a pacemaker implant.Bradycardia or slow heart beat occurs because of  sinus node’s inability to set the correct pace for your heartbeat.We are associated with best Indian Cardiologist at most well equipped cardiology centers for affordable and durable pacemaker implant surgery in India.

Reasons for slow heart beat or Bradycardia?

The reasons for bradycardia or slow heart beats may be :

  • Heart tissue wearing out due to ageing
  • Damage to heart tissue due to a long standing heart disease or heart attack
  • A congenital heart defect ( A defective heart condition since birth)
  • A complication as a result of any prior heart surgery
  • Inflammation in heart tissues due to some infection ( Myocarditis)
  • Under active thyroid function ( Hypothyroidism)
  • Disruption in breathing during sleep ( Obstructive sleep apnoea )
  • Certain autoimmune disorders like Lupus or rheumatic fever may also cause bradycardia or low heart beat.
  • Serum electrolyte imbalance ( Calcium or potassium ) may be a reason for bradycardia.
  • Certain medications prescribed for treating heart rhythm disorder, high Blood pressure or psychosis may also be responsible for low heart beat and bradycardia.

What are symptoms for bradycardia?

When a person is suffering from slow heart beat , his heart is unable to pump sufficient blood to be organs and tissues of body.

When sufficient blood is not pumped to certain organs and tissues they are deprived of oxygen, and low levels of oxygen in the affected organs and tissues may cause them to function erratically.

Symptoms observed by a person of low oxygen to certain organs and tissues may be:

Fainting ( Syncope)

Unexplained fatigue

Shortness of breath

Feeling dizzy or light hearted

confusions

Chest pain

easily tired after small exertion

Complications of bradycardia:

Sudden heart failure is a serious complication

frequent bouts of fainting

Chest pain

Low or high Blood pressure

Diagnosis of bradycardia or slow heart beat:

ECG or EKG

Holter monitor and event recorder

Tilt table test

Stress test

Blood and other pathology tests

Treatment for Bradycardia or slow heart beat:

Treating underline causes like hyperthyroidism or sleep apnea may correct slow heart beat or bardycardia problems.

Change of certain medications or tapering their dose may correct slow heart beat problems.

When other treatment options fails or not possible, a patient may be advised a pace maker implant for a slow heart beat or bradycardia.

Depending on a patient's heart condition , your doctor will decide to choose one among these two types of pacemaker.

  1. Single chamber pacemaker
  2. Duel chamber pacemaker

Dr Manjider Sandhu is Director Cardiology and Artemis cardiac care center at Artemis hospital ,Gurgaon, India.

Click on Link to know more about Pacemaker implant surgery in India

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Medical Oncologist

Colon or colo rectal cancer

What is colon or colo rectal cancer ?

Colon or large intestine is the last part of the digestive tract. Colon cancer is a cancer that usually occurs in elderly people but it can occur at any age.

Colon cancer usually start as non cancerous (Benign) growth in the inner lining of intestinal lumen called polyps. Over time some of these polyps can become colon cancers.

Colon cancer is sometimes also called as Colo rectal cancers.

The Risk factors associated with colon cancer are:

1.Colon cancer usually is diagnosed in people above 50 years of age , but there are increasing incidences of younger people getting colon cancer.

2.People of African-American are at a higher risk.

3.Ulcerative colitis and crohn’s disease.

4.Diets high in red meat and processed meat.

5.Low-fiber, high-fat diet

6.A sedentary lifestyle and obesity

7.Diabetes

8.Smoking and heavy alcohol consumption

9. Only a small percentage of colon cancers are linked to inherited genes. The most common inherited syndromes that increase colon cancer risk are familial adenomatous polyposis (FAP) and Lynch syndrome, which is also known as hereditary nonpolyposis colorectal cancer (HNPCC).

Signs and symptoms of Colon cancer:

1.A persistent change in your bowel habits, including diarrhea or constipation or a change in the consistency of your stool.

2. Rectal bleeding or blood in your stool

3.Persistent abdominal discomfort, such as cramps, gas or pain.

4.Weakness or fatigue,

5.Unexplained weight loss

Dr. Priya Tiwari is a renowned Medical Oncologist from country premier Institute, All India Institute of Medical Sciences. She is trained in dealing with all aspects of Medical Oncology and Internal Medicine and believes in providing holistic care to the patient. A MBBS gold medalist, she has numerous papers in many reputed journals. Her goal is to develop an oncology care model addressing all important issues concerning cancer patients.

Click on Link below to know more about Colon or colo-rectal cancer in India.

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

Neuro-monitoring in spine surgery.

Bringing in the cutting edge technology for better clinical outcome in spine surgery in India.

Advantages of neuro monitoring in spine surgery:

Intraoperative neuro monitoring is a newer approach for spine surgery. Intra operative neuro monitoring is helpful for neuro surgeons performing complex spine surgery in preventing any possible damage to spinal chord during the spine surgery.

Intra operative neuro monitoring has improved the safety profile for spine surgery in India.

It has been used frequently in all advanced spine surgery centers all across the globe and it has been brought in India for better clinical outcome in complex spine surgeries.

The benefits clearly outweigh the slight increase in cost of surgery.We are committed to provide the best experience for our spine surgery patients in India by adopting the latest techniques prevalent internationally.

To know more about safest spine surgery in India with the cutting edge technology Neuro-montoring click om link below

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dr.yugal-mishra

Endoscopic vein harvesting for a CABG.

Endoscopic vein harvesting or Endovein is a new less invasive way of removing saphenous vein from a CABG ( Bypass heart surgery) requiring patient's leg for doing the bypass graft.

Traditional vessel harvesting procedures require a long incision or a series of incisions down the length of the patient's leg, from the groin to the ankle. The greater saphenous vein is harvested intact through this large incision.

Recent technological advances have made it possible to perform this procedure in a new, less invasive way, called Endoscopic Vessel Harvesting, or EVH.

Endo vein harvesting causes less muscle and tissue damage when harvesting the vein graft. This procedure has eliminated many of the complications associated with the former technique. This may offer significant benefits to you.

How we do Endo Vein harvesting ?

An endoscope is a special instrument, used to view the inside of a hollow area, is connected to a video camera and inserted through a small incision in the leg. The endoscope is used to view the saphenous vein inside the leg and allows us to remove the vein with minimal stress to the leg.

What benefit a CABG requiring patient gets from Endoscopic vein harvesting?

Endoscopic vein harvesting generally results in less muscle and tissue damage and therefore, may reduce the surgical trauma to the patient , quicker wound healing and less chances of infection , due to smaller incision.

In other words:

  • you should experience less tissue scarring
  • your leg wounds should be less painful
  • you should avoid an unsightly scar
  • you will be able to concentrate on your cardiac rehabilitation!

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CA Cervix- CA Ovary - CA Uterus Surgeon

Uterus or Endometrium cancer.

Uterus or endometrium cancer is one of the common cancers in women.Early diagnosis of uterine cancer is possible, if the initial symptoms are noticed by a woman and immediately approaches a clinician with her complaints.We are well equipped to offer the best uterus or endometrium cancer treatment in India.

What are the types of Uterus cancer ?

Uterus cancer usually occurs in the lining of uterus called endometrium but other less common cancers can also occur in women like uterine sarcoma.

Signs and symptoms of uterine cancer

The initial and most important symptom is abnormal bleeding in a woman,like bleeding in between the periods or a vaginal bleed post menopause.

  • Unusual Vaginal discharge which can be foul smelling, pus like or may be blood tinged.
  • Painful coitus
  • Constant and persisting pain in pelvic region, feeling of pressure or mass in pelvic region.
  • Sudden and unexplained weight loss.
  • Loss of appetite.
  • Unusual pain during urination or bowel movement.

Who are at risk of developing uterine cancer

  • Women in whom periods have started at an early age
  • Women who have delayed menopause
  • women who has never delivered a child
  • Being Overweight or obese
  • Post menopausal women who are taking estrogen only HRT
  • Estrogen producing ovarian tumors
  • PCOs
  • Women who have been treated with Tamoxifen for more than two years for breast cancer treatment
  • Woman who had a previous radiation therapy of lower abdomen
  • Less common Lynch or cowden syndrome

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Hematologist

Sickle cell disease treatment in India.

What is Sickle cell disease?

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.

What are complications of Sickle cell disease?

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 can be broadly classified as Acute and chronic.

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.

Stem Cell or BMT for Sickle cell disease

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.

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Medical Oncology

Prostate Cancer – Treatment in India.

Prostate is a walnut size gland in human males located between the penile gland and the urinary bladder and in front of rectum.
Prostate is an important male sex organ. The basic function of prostate is to produce liquid part of semen.Prostate fluid nourishes and protects sperms during coitus and forms the bulk of volume of ejaculation.Prostate gland produces a protein called as prostate specific antigen (PSA). The functioning of prostate is dependent on male sex hormone testosterone.

Prostate Cancer is a one of the serious and life threatening medical condition affecting prostate. Prostate cancer usually affect elderly and above 65 year old men but it may affect younger men too.

Prostate cancer is the second largest cancer in men.Prostate cancer generally metastasizes to bones. Since the growth of prostate cancer is slow it may not affect or diagnosed in early stages but there are instances where the cancerous prostate cells have grown rapidly.

Who are at risk for prostate Cancer?

Prostate cancer affects men above 50 years of age.Over a period of time the survival rate in prostate cancer have improved dramatically from 30% in 1970's to 80% presently.
Prostate cancer may affect any men above the age of 50 years,but the African or African carribbean are at a three fold higher risk than white people.The man whose father or brother have been diagnosed with prostate cancer stand two and a half time higher chances than the men who never had a prostate cancer family history.
Black men are at three times higher risk of being diagnosed with prostate cancer as compared to white men.
Some studies suggest that men among the populations where consumption of "red meat" is more common are at a higher risk of developing prostate cancer.

Prevention of Prostate Cancer

Certain life style changes may reduce risk of prostate cancer. Quitting smoking and regular physical exercises at least for 30 minutes a day and five days a week can cut down risk of prostate cancer. Reduction in consumption of animal fat or red meat also cut down the risk for prostate cancer. A study although not confirmed that a diet high in tomatoes may also be helpful in reducing the risk of prostate cancer.
How Prostate Cancer is diagnosed?
Prostate cancer is usually diagnosed through screening as symptoms appear quite late in patients.The usual diagnostic procedures are a blood test called PSA or prostate specific antigen test. A higher PSA test result indicated possibility of prostate cancer. Although it may be non confirmatory too as Prostatitis may also cause elevated PSA levels.
DRE (Digital Rectal examination) may also suggest presence of prostate cancer, where a qualified and experienced doctor puts a gloved lubricated finger inside the rectum of the patient to feel any bump or hard surface on prostate suggesting a cancerous growth.
Transrectal ultrasound (TRUS) or Transrectal ultrasound guided biopsy are more confirmatory and reliable tests for diagnosing the presence of prostate cancer in a patient.

Treatments for Prostate Cancer

The treatment options for prostate cancer depend on stage and overall general health of patient.
It may involve watchful waiting or active surveillance.
Prostatectomy the surgical removal of part or whole of prostate.
Laparoscopic or robot assisted surgeries are the latest surgical techniques for smaller incision,quicker healing and precise results. Doctors do consider nerve sparing surgical removal of part or whole prostate that does not affect the normal sexual capacity and active sexual life of patient.
 We at Complete Medicare Solutions. are associated with the most experienced cancer surgeons and well equipped hospitals for prostate cancer treatment of our global guests.Expertise of a urological cancer surgeon is very crucial for treatment outcome of prostatectomy.
Other treatment options are Radiation Therapy, it could be external beam radiation therapy. With a 3D conformal radiotherapy assisted with CT scans and MRI for precise results with optimum dose to cancerous cell within the prostate gland.
IMRT or Intensity modulated radiation therapy give more flexibility of dose modulation to Radiation doctors thereby more precise results and avoiding side effect of radiation on bowel and bladder overtime.
Proton therapy is considered superior to external beam radiation therapy for more precise and less side effect associated radiation therapy for prostate cancer treatment.
Brachytherapy can be used for patients who want to avoid daily visit to radiation therapy center or do not want to stay in India for long.
The expertise of Radiation Oncology doctor is again vital for treatment outcome. CMCS Health is associated with the most experienced Radiation oncology doctors and hospitals with latest diagnostics and radiation therapy machines for better treatment outcome of prostate cancer for our global guests.
Hormonal therapies are also used along with surgical and radiation therapies for better treatment options and results for prostate cancer treatments.
Chemotherapy is used for hormone resistant and metastatic or advanced prostate cancer. A combination of chemotherapeutic drugs or single agent therapy are used for better results and lower side effects.
Targeted chemotherapy for prostate cancer holds big promise for recurrent and advanced or prolapsed prostate cancer treatment.
Dr. Deepak Singla - Medical Oncologistis Unit Chief and consultant Medical Oncologist at Dept. of Medical Oncology at Paras Hospitals,Gurgaon,Haryana,India.
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Spine Treatment In India

Spine Treatment In India

Spinal stenosis is a narrowing of the spaces within your spine, which can put pressure on the nerves that travel through the spine. Spinal stenosis occurs most often in the lower back and the neck.

Some people with spinal stenosis may not have symptoms. Others may experience pain, tingling, numbness and muscle weakness. Symptoms can worsen over time.

Spinal stenosis is most commonly caused by wear-and-tear changes in the spine related to osteoarthritis. In severe cases of spinal stenosis, doctors may recommend surgery to create additional space for the spinal cord or nerves.

Types of spinal stenosis

The types of spinal stenosis are classified according to where on the spine the condition occurs. It's possible to have more than one type. The two main types of spinal stenosis are:

  • Cervical stenosis. In this condition, the narrowing occurs in the part of the spine in your neck.
  • Lumbar stenosis. In this condition, the narrowing occurs in the part of the spine in your lower back. It's the most common form of spinal stenosis.

Spinal stenosis care at CMCS Health care

Symptoms

Many people have evidence of spinal stenosis on an MRI or CT scan but may not have symptoms. When they do occur, they often start gradually and worsen over time. Symptoms vary depending on the location of the stenosis and which nerves are affected.

In the neck (cervical spine)

  • Numbness or tingling in a hand, arm, foot or leg
  • Weakness in a hand, arm, foot or leg
  • Problems with walking and balance
  • Neck pain
  • In severe cases, bowel or bladder dysfunction (urinary urgency and incontinence)

In the lower back (lumbar spine)

  • Numbness or tingling in a foot or leg
  • Weakness in a foot or leg
  • Pain or cramping in one or both legs when you stand for long periods of time or when you walk, which usually eases when you bend forward or sit
  • Back pain

When to see a doctor

See your doctor if you have any of the symptoms listed.

Causes

The backbone (spine) runs from your neck to your lower back. The bones of your spine form a spinal canal, which protects your spinal cord (nerves).

Some people are born with a small spinal canal. But most spinal stenosis occurs when something happens to narrow the open space within the spine. Causes of spinal stenosis may include:

  • Overgrowth of bone. Wear and tear damage from osteoarthritis on your spinal bones can prompt the formation of bone spurs, which can grow into the spinal canal. Paget's disease, a bone disease that usually affects adults, also can cause bone overgrowth in the spine.
  • Herniated disks. The soft cushions that act as shock absorbers between your vertebrae tend to dry out with age. Cracks in a disk's exterior may allow some of the soft inner material to escape and press on the spinal cord or nerves.
  • Thickened ligaments. The tough cords that help hold the bones of your spine together can become stiff and thickened over time. These thickened ligaments can bulge into the spinal canal.
  • Tumors. Abnormal growths can form inside the spinal cord, within the membranes that cover the spinal cord or in the space between the spinal cord and vertebrae. These are uncommon and identifiable on spine imaging with an MRI or CT.
  • Spinal injuries. Car accidents and other trauma can cause dislocations or fractures of one or more vertebrae. Displaced bone from a spinal fracture may damage the contents of the spinal canal. Swelling of nearby tissue immediately after back surgery also can put pressure on the spinal cord or nerves.

Risk factors

Most people with spinal stenosis are over the age of 50. Though degenerative changes can cause spinal stenosis in younger people, other causes need to be considered. These include trauma, congenital spinal deformity such as scoliosis, and a genetic disease affecting bone and muscle development throughout the body. Spinal imaging can differentiate these causes.

Complications

Rarely, untreated severe spinal stenosis may progress and cause permanent:

  • Numbness
  • Weakness
  • Balance problems
  • Incontinence
  • Paralysis
Treatment From Mayo Clinics
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