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Category : All ; Cycle : April 2010
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Apr27
Understand Your Fibromyalgia (By Mehraj sheikh)
Understand Your Fibromyalgia (By Mehraj sheikh)

Fibromyalgia syndrome affects the muscles and soft tissue. Fibromyalgia symptoms include chronic pain in the muscles, fatigue, sleep problems and painful tender points or trigger points at certain parts of the body. Fibromyalgia pain and other symptoms can be relieved through medications, lifestyle changes, stress management, and other fibromyalgia treatment.



Symptoms of Fibromyalgia
Symptoms of fibromyalgia include:
• Chronic muscle pain, muscle spasms or tightness, weakness in the limbs, and leg cramps
• Moderate or severe fatigue and decreased energy
• Insomnia or waking up feeling just as tired as when you went to sleep
• Stiffness upon waking or after staying in one position for too long
• Difficulty remembering, concentrating, and performing simple mental tasks
• Abdominal pain, bloating, nausea, and constipation alternating with diarrhea (irritable bowel syndrome)
• Tension or migraine headaches
• Jaw and facial tenderness
• Sensitivity to one or more of the following: odors, noise, bright lights, medications, certain foods, and cold
• Feeling anxious or depressed
• Numbness or tingling in the face, arms, hands, legs, or feet
• Increase in urinary urgency or frequency (irritable bladder)
• Reduced tolerance for exercise and muscle pain after exercise
• A feeling of swelling (without actual swelling) in the hands and feet
• Painful menstrual periods
• Dizziness
Diagnosis & Tests
Because there is no lab test or X-ray to diagnose fibromyalgia, oftentimes patients are misdiagnosed, which can delay good treatment. Find out how doctors make a fibromyalgia diagnosis and which doctors are experts in treating this common pain syndrome.
Diagnosis
Diagnosis and Misdiagnosis
Diagnosing fibromyalgia is oftentimes difficult -- and can be misdiagnosed. Learn the important steps you should go through to make sure you get an accurate diagnosis.
Finding the Right Doctor
Learn what to look for and steps to take to help you find the best fibromyalgia doctor for you.
Treatment & Care
Learn which fibromyalgia treatments work best, including treatments that target muscle pain and trigger points, treatments that help with sleep problems and depression, and treatments that help manage stress and anxiety.
Treatment
Fibromyalgia Treatments
Get up-to-date information on the latest fibromyalgia treatments -- from medications to ease pain, fatigue, and sleep problems to physical therapy, relaxation modalities, and regular exercises.
Medications
Fibromyalgia medications treat symptoms, such as the deep muscle pain, sleep problems, anxiety, and depression. Learn more to find out which medication might be right for you.
Cymbalta
Cymbalta helps people manage the unique symptoms of fibromyalgia. Is this medicine right for you?
Lyrica
Doctors think Lyrica may help fibromyalgia by calming overly excited nerves that cause pain. Learn more to see if this treatment may help you.
Savella
Doctors aren't exactly sure how Savella helps fibromyalgia but it's been shown to relieve pain and improve physical function. Learn more.
Physical Therapy
Physical therapy is often recommended to help ease fibromyalgia pain and teach self-management skills. Learn more about the different types of physical therapy for fibromyalgia.
Home Remedies
Many people turn to home remedies, including herbs, supplements, and alternative treatments, for relief of fibromyalgia symptoms. Discover which home remedies may help and which may not work at all.
Complementary Treatment
Herbs and Supplements
Can natural herbs and supplements help fibromyalgia symptoms? Review the different fibromyalgia herbs and supplements and learn how they might help manage symptoms.
Complementary Treatments
Complementary treatments for fibromyalgia include massage, acupuncture, meditation, and more. But are they safe and effective in ending fibromyalgia pain and fatigue? Discover the latest findings.
Diet
The Diet Connection
Can certain foods or nutrients ease symptoms of pain, stiffness, and fatigue? Can other foods actually trigger fibromyalgia symptoms? Learn more about the diet connection to fibromyalgia.



Exercise
Fibromyalgia & Exercise
Discover the importance of exercise for fibromyalgia. Find out which exercises are best for easing muscle pain and stiffness.
Coping
Tips for Coping
There's no doubt that fibromyalgia can be exhausting -- both physically and emotionally. Discover strategies to manage your symptoms so you can do the things you enjoy in life.
Fibromyalgia and Sex
Have problems with fibromyalgia and sex? Discover some practical tips to help reignite your libido and sex life without fear of added pain and stiffness with fibromyalgia.
Fibromyalgia and Pregnancy
Learn all about the effects of fibromyalgia on your pregnancy. Discover ways to manage fibromyalgia symptoms so you and baby stay healthy.
Work and Disability
Does fibromyalgia affect your ability to work? Find out how to cope with work-related obstacles and fibromyalgia symptoms at work.
Finding Help
Shoot an email through my IHB message box.
Thank you,


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Apr27
HEALTHY MARRIAGE KUNDLI 'MEDICAL HOROSCOPE'
Dear Doctor

PHOENIX HOSPITAL & DIAGNOSTIC CENTRE, SCO 8, SECTOR 16, PANCHKULA HARYANA 134109 INDIA is launching a new concept and we are pretty sure you would agree, appreciate & participate that no doubt the marriage is settled in heaven & celebrated on earth, nevertheless, the health of would be couple is most important than comparing the horoscope of girl & boy. The horoscope is not going to give the details of health part of each person.

In present time & changing scenario knowing actual health details would be most satisfying & tension free at the time of wedding both for the girl’s as well as boy’s family.

Won’t you agree that just by comparing the compatibility of horoscope of both the boy and girl & thereby knowing their Gunas / Doshas does not in anyway solve the purpose except finding little solace and leaving rest in the hands of God? Such kind of compatibility does not give any kind of details of the diseases like HIV, VDRL, TB and Cardiac Problems etc. etc.

It is in the mutual interest of boy or girl and their families to know prior to nuptial knot the health picture which sometime later leads to unsavory situation and many a times divorce. By this even if need be congenital abnormality / chromosomal defects type diseases could also be known.

Therefore, PHOENIX HOSPITAL is launching

*HEALTHY
MARRIAGE KUNDLI
(MEDICAL HOROSCOPE)
OF WOULD BE COUPLE


‘Please visit for free consultation & counseling’
*Conditions apply
*Charges as applicable

Regards

Dr T M Aggrwal
Ph: 0172-5054321, 5011333


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Apr25
Micro Acupuncture Point System - MAPS
MicroAcupunktSysteme or Micro Acupuncture Point System - MAPS is organized by Dr. J. Gleditsch of Ludwig Maximilian University, Munich Germany. He taught this wonderful system to me at Harvard.

Microsystem Acupuncture is based on the Somatotopic fields comprising of specific points of correspondence in the Auricle (Ear), Scalp, Oral Cavity etc. A micro system is like a Map of the body - somatotope or a cartography of the whole organism similar to the homunculus discovered in the sensory motor cortex of the brain.

Each of the Micro system points have a clearly defined correlation to and interrelation with a particular organ or function. Thus MAPS is a very effective and efficient treatment as well as a diagnostic tool for physicians. In Europe - especially in France & Germany - micro-system acupuncture is adopted in the allopathic treatments.

For Example EAR Acupuncture is one such Micro-system. It was discovered by the french doctor Nogier who decoded the functional correspondences of the respective ear points. The punctual cartography of the Ear resembles an upside down embryo.

In India especially in the South Indian traditions - Ear piercing is an important event for Children. The ear point so chosen is in the auricular lobule - corresponding to the brain and more closely the Eye. So piercing both ears is a way of re-booting the brain and opening the third eye.

For laypeople - some very useful treatments can be attempted as remedy for minor ailments:

You need to consult Ear Anatomy book first to understand the location ( sorry I can not upload a picture here!)

Hiccups - Just press the middle of the Inferior antihelical crus with your finger for 3-5 min. Hiccup will stop!

Stress Buster - If you are taking your Maths exam or IIT/IIM entrance exam - use this. 2 CMs from the Antitragus is the Jerome Point - press for 3 min! It will relax your brain quite fast. It is also the point for increasing performance & virility.

Eye trouble - If your eyes are tired after browsing the Internet & you see stars - use this. Press the center of the Ear lobule for 2/3 min - your eyes will clear and vision will be sharp.

Depression - If you are depressed by an oppressing Boss in the office or a nagging partner - use this. 3 CMs from the lower part of the Tragus - press this point for 3 min ( intersection of the vegetative groove)- your depressive feelings will change.

Sneezing - If you have uncontrollable sneezing - us this. Just 2/3 CMs below the eye point. Press this point for 3 /4 min - you will be OK.

I know it is a tough call to locate the points without a ear map. Use Google to get a map of the ear and enjoy good health.

I feel preventive medicine approach sound for many ailments - by teaching simple Acupressure points to patients - we can focus on more serious cases.

Micro system can be a wonderful modality that a qualified Doctor can learn and add to his practice. It is very easy for ENT, Dentists and General Medicine practitioners to learn and use in their practice. That way an ENT Doctor can treat not only ENT issues but can also help in solving an additional ailment - say - Migraine Headache. Little touch-ups using MAPS can be a great relief to your patients.

If you are interested in learning MAPS write to me. Pl do not call - as it will disturb my practice.

Only board certified Doctors/ PT/Acupuncturists can take the course - CMAPS - Certified in Micro Acupuncture Point System course offered by Medaku Research. Bright Science/ Engineering Graduates with some experience can take a Junior Certificate - JC - MAPS. We need more barefoot doctors in India to offer first-aid and first level medicare to the poor in rural areas. This is a Distance program with one week of practical workshops at Chennai. Limited Seats only.


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Apr25
“What is inguinal hernia & its new operation technique-Desarda Repair?”
Hernia disease is now generally known to common people just as appendicitis is known. When a bulge or swelling appears in the groin, every body knows that it is hernia. So bulge or swelling due to any other disease might be mistaken as hernia bulge. Like wise, hernia occurs only in the groin is also a misconception. It can occur any where inside the body as well as visibly out side the body. The hernias which are visible on the surface of the body mainly occur on the abdomen.
When any organ of our body or part of it leaves its original place and enters into other cavity through a defect or hole, it forms a hernia sac. This sac becomes visible on the abdomen when intestines enter in to it on coughing. This bulge seen on the abdomen is called as hernia. It is seen in nearly 1-1.5% of our people but this incidence is higher (2-3%) in the western countries and Africa. Abdominal wall hernias are given different names depending on the area where they arise. Inguinal hernia, umbilical hernia, epigastric hernia, lumbar hernia, spigelion hernia etc. are some of such hernias that are seen on the abdominal wall. Hernias can occur inside the body also that are not visible outside. Diaphragmatic hernia is an example of this.
Why hernia forms? Every body naturally wants to know as to why at all hernia forms in their body or on abdomen. What are the reasons? Weakness of the abdominal wall muscle cover at some place or spot is the main reason. Then if by any reason say like coughing or straining while passing stools or urine, intra-abdominal pressure rises and the result is the hernia formation through the weak spot. Chronic cough as seen in asthmatic patients, job of lifting heavy weights, constipation, obstruction in passing urine due to enlarged prostate are some of the important reasons that precipitates the hernia formation in the groin or at some other place on abdomen. Stretching of muscles as seen in pregnancy or ascitis can also result in hernia formation. These reasons are not seen in children; still they are affected with hernia due to pre formed hernia sac.
What are the symptoms: A soft swelling appearing in the groin that increases in size after coughing and disappears after lying down or during sleep then you can think that it is groin hernia. This groin swelling is small betel nut size in the beginning but later if kept untreated goes on increasing and enters in the scrotum also. Initially, this bulge can be pushed inside the abdomen but later it becomes impossible to push them back because intestines get adherent to the hernia sac. There is no pain in this hernia swelling. That is the main reason why people are not serious about its early treatment. In general, pain in hernia is to be understood as an alarming symptom. It occurs whenever this hernia gets obstructed and you can not push intestines back or when hernia gets strangulated, a serious condition. Blood supply to the intestines gets cut off and they start dying inside the hernia sac during the process of strangulation. Patient does not allow touching the hernia swelling because it becomes painful and tender. Some times, intestines get perforated inside the sac and peritonitis takes place. Patient starts vomiting, there is abdominal distension and general condition of the patient deteriorates fast. This is a life threatening emergency and needs to be operated immediately to save the life of the patient. Therefore, it is advised that hernia should be treated as early as possible and not to wait till it starts paining.
Examination & treatment: Examination of hernia gives an idea about the type of hernia and whether there are any complications developed in it. What type of organ e.g. intestines or omentum has entered the hernia sac is also judged. Then general examination is done to find out whether patient is having any systemic disease like bronchitis, hypertension, heart disease, enlarged prostate etc. Some blood tests, x-ray chest or ECG. is done to find out whether patient is fit to undergo surgery. If there are some serious complications developed in hernia and patient needs urgent surgery to save his life then patient can be taken for surgery without doing these tests also. Just as a torn shirt needs stitching to repair it, similarly this torn shirt of abdominal muscles also need proper stitching to repair the hernia. First of all the hernia sac is separated from other tissues and it is excised. Second part of the operation is to stitch the hernia hole to prevent hernia formation again. This is called as herniorrhaphy or hernioplasty. Therefore, do not believe if some body assures you that hernia can be cured without surgery and with medicines or some other means. Many times patients are advised to do exercises so as to strengthen the muscles and cure the hernia. It is absolutely wrong to do exercises when there is hernia because every exercise increases the intra-abdominal pressure and that tends to increase the size of hernia. Some times advice of using a hernia truss is given to avoid the surgery. This hernia truss or hernia belt is fitted on the hernia hole in an attempt to prevent it from coming outside. This is not cure to the hernia. At the most you can postpone surgery for some time by using it. But now surgeons clearly advise not to use truss in any situation because of its complications. Hernia belt slips from the hernia hole due to movements and the intestines can get obstructed easily giving rise to a dangerous situation of obstruction or strangulation.
Hernia operation is done by stitching a piece of synthetic cloth called as mesh on the hernia hole. Polypropylene, polyethylene, prolene, Dacron, Teflon is such synthetic chemical thread from which mesh is prepared. This mesh is imported and costly also. Therefore, at many places a low quality mesh is used to save on the cost. This increases the chances of hernia reappearing or getting infected. Recurrence, infection, pain, mesh migration are some of the well documented complications associated with this mesh repair because mesh is a synthetic cloth and a foreign body. Re-operation is the only remedy to treat those complications and this re-surgery is very difficult, complicated and commanding even in the hands of expert surgeons because mesh causes extensive damage to the nearby tissues and fibrosis. Techniques older than this are now discarded because they all had unacceptable rate of surgery failures.
A new technique- “Dr. Desarda repair”: A search to find out some operation technique that
does not use mesh and gives excellent results was going on through out the world. Desarda repair introduced in the market in year 2001 became immediately popular because it gives what you want and that too without use of any foreign body like mesh. This operation is done by taking a cut on the skin. It is simple and does not require any foreign body like mesh or any complicated instruments like endoscopes. A strip of a nearby muscle is separated and stitched on the weak spot to cover the hernia hole. There is no foreign body like mesh or no endoscopes are required therefore, this operation is free from all complications and risks that are associated with the mesh or laparoscopic repair. There is no tension on the stitches or muscles as seen in Bassini-Shouldice operation. Therefore, there are no complications and risks that are associated with the Bassini- Shouldice operation. Hernia hole is covered by a strong muscle. Therefore, protection starts on the operation table itself. Patient is admitted in the morning and immediately taken for surgery after preparation. Operation is done under local or spinal anaesthesia. No general anaesthesia is required. Operation is completed in 30 minutes and patient is back on his feet as soon as anaesthesia effect is gone. Patient goes to bathroom on his own within couple of hours and moves freely in the wards afterwards and goes home same day night or next day morning. Patients are allowed to drive car and go to office, bend, squat, climb up the staircase or carry luggage and travel. All foreign patients coming to Indian Hernia Institute go back to their country on third day carrying their luggage and a journey of 20-22 hours without any difficulty. The most important quality of this operation is that there is virtually no recurrence or pain. This operation is spreading rapidly around the globe and today it is being followed in many countries.

Interested patients and doctors can contact Dr. Desarda on his mobile no. 0091 (0)9373322178 or log on to his website http://desarda.webs.com or http://herniasurgery.tripod.com


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Apr25
“Different types of groin hernia operations”
Hernia is a common disease that can affect any body from his childhood to old age. Operation is the only remedy to get relief from this disease. Patient will not mind to get operated if he is sure that he is going to be hernia free after surgery. But this does not happen in many patients because rate of relapse or reappearance of hernia at the same place is also quite high and unacceptable. Different surgeons recommend different operations to repair the hernia. Therefore, there is confusion in the mind of patients as to which operation they should prefer for their hernia surgery. This article gives details of different types of groin hernia operations done worldwide for knowledge of those patients.

Groin anatomy in hernia patients: All the vessels, lymphatics, vas, nerves along with their covers, together called as spermatic cord pass from abdomen to scrotum through inguinal canal. A protrusion of peritoneum called as hernia sac appears in this canal along with the cord and goes on increasing in size if this hernia sac is kept untreated. This canal and cord is normally protected by cover of two muscles behind and one muscle in front. The reason why hernia sac formation takes place is the weakness in those two muscles behind. This weakened spot in the posterior wall is called as weak spot or hernia hole. All traditionally done operations are designed to repair this hernia hole so that there is no recurrence of hernia after surgery.
There are two parts of hernia operations. First part is to separate the hernia sac and excise it. Second part is to repair this weak spot or hernia hole so as to prevent any recurrence in future.

Bassini Shouldice operation: In this operation patient is kept in the hospital for 2-4 days.
General or spinal anaesthesia is given. Hernia sac is excised. Then for repair of hernia hole, back two muscles are pulled down and sutured to the groin ligament. Surgeon takes several stitches so as to keep these pulled down muscles in place. There is tension on those stitches so patient has to take care for life time to avoid disruption of sutures. Unfortunately, this tension on muscles cause pain in groin area and prolonged rest needs to be taken to get relief and then only he can go to his routine work. There is more than 10% recurrence rate in this operation and increases with time because of contraction of the scar tissue adding more tension on the sutures. This results in more incidences of recurrences and groin pain. Repeat operation for recurrence or pain is difficult and bigger and the results are also far from satisfaction.
Some surgeons use another modification of this technique to reduce tension on the stitches. They suture back muscles and fascia in 4 layers. This reduces the tension on the muscles and sutures but for that many more complicated sutures are needed to be taken. Therefore, this operation can be done only by expert and specially trained hernia surgeons. This has brought down the recurrence rate but it has not totally disappeared. This operation is grouped under ‘tension repairs’ because there is tension on the stitches and muscles.

Mesh repair: In this operation no muscles are pulled down to cover the hernia hole. Instead, mesh is sutured on the weak spot to cover the hernia hole. This mesh is a piece of synthetic cloth just like a mosquito net and it is in no way some thing special. There is no tension on the stitches so this operation grouped under ‘tension free repair’. This has reduced the recurrence rate to a great extent (7-8% in USA) but it did not disappear completely. Reduced recurrences and simplicity of operation made it popular immediately all over the world. The mesh per se does not give any protection because it is delicate. But because it is a foreign body stitched inside, foreign body reaction starts and a tissue curtain is formed just like a corn following the thorn prick. This takes 4-6 months to form the curtain. It takes another 2-3 years to gain strength in this curtain. So, practically patient remains without protection for 2-3 years after surgery and if patient gets an attack of cough or sneezing during this period then there are increased chances of recurrence.
Contraction of this scar tissue adds more to the chances of recurrence. Involvement of nerves, vas or other structures in this scar formation results in to groin pain in 28 to 42% of operated patients. Tearing of sutures, disintegration of mesh, infection, migration are all noted complications. The mesh used by many surgeons is of low quality to save on the cost. Such meshes contract more than 50-60% naturally causing more recurrences. All above complications following mesh repair requires repeat surgery and this surgery is quite difficult and commanding even in the hands of hernia expert surgeons and the results are also poor.

Laparoscopic repair: This operation is done by inserting endoscopes inside by making 4 holes on the abdomen. General anaesthesia is given. Co2 gas is pumped in side the abdomen to inflate it. A much larger size of mesh is required to be stitched to cover the hernia hole from inside the abdomen. It is claimed that there is less pain following this surgery and patient can go to his work earlier. This operation can be done by inserting endoscopes to hernia site through abdominal wall instead of entering the abdominal cavity. This operation can be done only by experts in doing such surgery. More recurrences are seen if done by a novice surgeon. There are more risks involved in this surgery like general anaesthesia, pumping Co2, or trauma to intestines etc. Costly equipments, bigger mesh and expertise required to do this risky operation increase the cost of surgery.

Dr. Desarda repair: This operation is done by taking a cut on the skin. It is simple and does not
require any foreign body like mesh or any complicated instruments like endoscopes. A strip of a nearby muscle is separated and stitched on the weak spot to cover the hernia hole. There is no foreign body like mesh or no endoscopes are required therefore, this operation is free from all complications and risks that are associated with the mesh or laparoscopic repair. There is no tension on the stitches or muscles as seen in Bassini-Shouldice operation. Therefore, there are no complications and risks that are associated with the Bassini- Shouldice operation. Hernia hole is covered by a strong muscle. Therefore, protection starts on the operation table itself. Patient is admitted in the morning and immediately taken for surgery after preparation. Operation is done under local or spinal anaesthesia. No general anaesthesia is required. Operation is completed in 30 minutes and patient is back on his feet as soon as anaesthesia effect is gone. Patient goes to bathroom on his own within couple of hours and moves freely in the wards afterwards and is ready to get discharged same day night or next day morning. Patients are allowed to drive car and go to office, bend, squat, climb up the staircase or carry luggage and travel. All foreign patients coming to Indian Hernia Institute go back to their country on third day carrying their luggage and a journey of 20-22 hours without any difficulty. The most important quality of this operation is that there is virtually no recurrence or pain. This operation is spreading quite rapidly all around the globe and today it is being followed in many countries.

Interested patients and doctors can contact Dr. Desarda on his mobile no. 0091 (0)9373322178 or log on to his website http://desarda.webs.com or http://herniasurgery.tripod.com


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Apr25
“Why hernia re-occurs again and again”
When some part of our body leaves its original place and enters in to other cavity or comes out on the body surface then we call it as a hernia formation. Operation is the only remedy to get relief from this disease. Patient will not mind to get operated if he is sure that he is going to be hernia free after surgery. But this does not happen in many patients because rate of relapse or reappearance of hernia at the same place is also quite high and unacceptable. Mesh, which is a piece of synthetic cloth, was introduced in the market in 1990 for use in hernia repairs. We stitch a small piece of cloth to repair our torn shirt. Same principle is used in mesh repairs where in this mesh is stitched on the weak spot or hernia hole to give protection and prevent recurrence. Relapse rate or failure rate after groin hernia surgery has come down to 7-8% in USA after every body started doing hernia surgery by using a mesh, but it failed to give complete cure.
Majority of the hernias, almost 99%, are external and seen on the body surface and majority of them are seen on the abdominal wall. Amongst them, the groin hernias are seen in almost 75% of patients. But in India, proportion of other abdominal wall hernias like umbilical, epigastric, ventral or incisional hernia is also quite high. Our intestines are kept in a delicate balloon like bag in side the abdomen and protection is given by 3 layers of muscles all around them. When these muscles get damaged at some spot then that becomes a weak spot or hernia hole from where hernia formation takes place. This damage can happen due to surgery or stretching due to pregnancy or ascitis or they get weakened due to aging or some other disease.

In all traditionally done hernia surgeries, hernia sac is excised and a mesh is stitched on this weak spot or this hernia hole in an attempt to give protection to the weak spot and prevent relapse or recurrence. But this does not happen immediately after surgery because this mesh is delicate like a mosquito net. Then why it is stitched if it does not give protection? A foreign body reaction sets in and around the mesh and tissue penetrates in it to form a delicate curtain on the weak spot. This takes couple of months and then it takes another 2-3 years to get sufficient strength in it to give protection. It means the patient is not fully protected for 2-3 years in spite of mesh surgery. If patient gets an attack of cough or sneezing or some such other instance during this period then this mesh gets torn or stitches get torn or mesh moves away from the stitched place and relapse of hernia takes place. Another important reason for more relapses or recurrences seen in India is the low quality mesh used to save on the cost. This low quality mesh shrinks by 50-60% in side the body. Naturally there is increased tension on the sutures due to this shrinkage that tend to break beyond certain limits inviting hernia recurrence. Mesh shrinkage or mesh migrations are well documented complications inviting failures after the mesh surgeries. All hernia surgeries are done by hernia experts or consultants in USA, but, paradoxically in India, hernia surgeries are dedicated to the resident doctors who are not expert in hernia surgeries. This is also one of the important reasons for high rate of hernia recurrences in India.
A story of 38 year old Mr. David from USA is worth listening. He had left groin hernia since 2 years. He consulted with 2-3 consultants and hernia experts in Los Angeles, All of them had said that they will repair his hernia with a mesh. As is done by every American, David also did his own thorough search on the internet to get more knowledge about groin hernias. He found that almost 30 out 100 patients operated with mesh had suffered either from recurrence or chronic groin pain or infection or mesh migration in to the abdomen. These patients had undergone either open surgeries or endoscopic surgeries. So he started search to find out whether there is any centre which does hernia surgeries without using mesh. To his amazement, he found only two such centre all over the world. One was Shouldice centre in Canada and another was “Desarda Centre” in Pune from India. During his further search, he found that Shouldice centre use stainless steel wires to sutures and there is 1-2% of recurrence. So he chose Desarda Centre and came here to our Indian Hernia Institute to get his hernia set right. This story did not end with David, but many more patients from USA, France, and Australia etc have visited our centre for their hernia repairs. The main reason why every body now prefers to come to our centre for his hernia repair is that we do not use any foreign body like mesh. Therefore, no complications are seen in our repairs that are associated with mesh. We use a strip of near by strong muscle to cover the weak spot or hernia hole. Therefore, protection starts on the operation table itself. And patient gets almost complete cure without any fear of relapse or recurrence in future.

Dr. Desarda has operated on more than 1500 patients till today by this new technique and all of them are well and without any recurrence till today. This operation does not require general anesthesia, it is done under local or spinal anesthesia. Patient is admitted in the morning and taken for surgery immediately after preparation. Time required for surgery is average 30 minutes and patient can be on his foot as soon as anesthesia effect is gone. Normally patient goes to pass urine on his own within 4-5 hours and he is freely mobile in the wards same day night or next day morning ready to get discharged and go home. There are no restrictions on his movements or food intake. He can drive car and go to office, can climb a staircase, can carry luggage and travel, squat and sit down without much pain within 2-3 days. He is asked to carry his normal routine work as soon as possible and as per his tolerance. So, patient gets high level of satisfaction after this new operation technique. All foreign patients coming to Indian Hernia Institute go back to their country on third day carrying their luggage and a journey of 20-22 hours without any difficulty. The most important quality of this operation is that there is virtually no recurrence or pain. This operation is spreading quite rapidly all around the globe and today it is being followed in many countries.

Interested patients and doctors can contact Dr. Desarda on his mobile no. 0091 (0)9373322178 or log on to his website http://herniasurgery.tripod.com or http://desarda.webs.com


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Apr25
“What is mesh used in hernia surgery?”
Hernia is a common disease that can affect any body from his childhood to old age. We need to stitch the shirt if it is torn, like wise we have to do surgery to get relief from this disease. Many times a small piece of cloth is used to repair the torn shirt, like wise this mesh is used to cover the weak spot of hernia or the hernia hole to repair it.
If your surgeon tells you that he will use a piece of your shirt or any other synthetic cloth after getting it sterilized for stitching on the hernia hole then you will never agree to his proposal. No body can think of this idea because you are sure and afraid that a piece of cloth can not be stitched inside your body and to do so is inviting lots of problems and trouble for your life time. You are aware that even if you take out the thorn, a small particle of it remaining inside the body forms a big corn, it pains for years and gets infected any time even after years.
Then what is mesh that is used routinely by almost all the surgeons during hernia operation? Every body imagines that mesh must be some special material prepared by the companies for hernia surgery and it must be safe in all respects for our body. In reality, it is not so. It is a simple cloth prepared from synthetic threads of polypropylene, polyethylene or prolene or some other such synthetic material. If companies had made it known to all that this is a piece of synthetic cloth then no body would have accepted it for use in hernia surgery. Therefore, it was named with a special name like “Mesh” and sold in the market. A big cloth is prepared from those synthetic threads. Then it is cut into pieces of various sizes and shapes and then it is nicely packed, sterilized and then sold in the market at exorbitant price. It is estimated that companies are selling those meshes worth Rs. 1000 crores every year in India alone.

The mesh which is used today was brought in the market somewhere during 1990. But such meshes prepared from Dacron or Teflon were already used in many patients all over the world much before that. A famous surgeon from Pune, late Dr. Sulakhe and the author himself did use such pieces of cloth like Terene, Terylene etc available at that time around 1970-75 after due sterilization in many patients. But such operations were already rejected by the surgical community because of unacceptable rate of infection following its use in hernia surgery. In reality, those old meshes and today’s mesh both are prepared from synthetic threads and technically there is no difference between them. But because of improved sterilization techniques and availability of better and higher antibiotics after 1990 reduced this infection rate to a great extent and therefore its use in hernia surgery became rapidly popular. Another reason for this was the high rate of recurrence following hernia surgeries done with old techniques. But this does not mean that now there is no recurrence of hernia after it is repaired by using this mesh. Recurrence is still there following mesh repair and it is 7-8% in USA as per their studies. Though recurrence rate and infection rate is substantially brought down, another major problem following mesh repair of chronic groin pain still remains and it is 28-42% as per many studies.

Your shirt becomes alright as soon as it is stitched but this does not happen when this mesh is stitched on the weak spot or hernia hole. The mesh is a delicate cloth just like a mosquito net and therefore fails to give immediate protection following the surgery. A foreign body reaction starts in and around the mesh and a curtain of tissues is formed within couple of months just like a corn following thorn prick. Then it takes another 2-3 years for developing sufficient strength in this curtain so as to give real protection against reappearance of hernia. It means the patient is not protected for 2-3 years in spite of hernia surgery with mesh. And if he gets an attack of cough or sneezing etc. during this period then the mesh gets torn or displaced or stitches get avulsed resulting in reappearance of hernia. This mesh can also get crimpled or retract to a size that is 20-50% less increasing chances of recurrences. This is seen in many more cases in India because the mesh routinely used in hernia is of low quality to save on the cost. Therefore, the rate of recurrence seen in India is much more than what is seen in USA.
These mosquito net like meshes when used for hernia repairs have made lives of many patients miserable. Many patients from USA and other countries have posted on the internet hernia forums their story of miserable life after mesh repairs. Specialists and specialty clinics are established in USA who does the only job of removing the mesh or treating the chronic groin pain syndrome. Recurrence, infection or pain following mesh surgery requires much larger, difficult and commanding operation to take out the mesh again for getting relief.
“Dr. Desarda Repair” is a new invention by Dr Desarda from Pune, which is a groin hernia operation without mesh. A strip of a strong near by muscles is stitched on the weak spot or the hernia hole instead of mesh. Therefore, protection starts on the operation table itself. This operation does not require general anesthesia, it is done under local or spinal anesthesia. Patient is admitted in the morning and taken for surgery immediately after preparation. Time required for surgery is average 30 minutes and patient can be on his foot as soon as anesthesia effect is gone. Normally patient goes to pass urine on his own within 4-5 hours and he is freely mobile in the wards same day night or next day morning ready to get discharged and go home. There are no restrictions on his movements or food intake. He can drive car and go to office, can climb a staircase, can carry luggage and travel, squat and sit down without much pain within 2-3 days. He is asked to carry his normal routine work as soon as possible and as per his tolerance. So, patient gets high level of satisfaction after this new operation technique. Dr. Desarda has operated on more than 1500 patients till today by this new technique and all of them are well and without any recurrence till today. All foreign patients coming to Indian Hernia Institute go back to their country on third day carrying their luggage and a journey of 20-22 hours without any difficulty. The most important quality of this operation is that there is virtually no recurrence or pain. This operation is spreading quite rapidly all around the globe and today it is being followed in many countries.
Interested patients and doctors can contact Dr. Desarda on his mobile no. 0091 (0)9373322178 or log on to his website http://herniasurgery.tripod.com or http://desarda.webs.com


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Apr25
“NEW THEORIES OF GROIN HERNIA FORMATION”
As far as groin hernias are concerned, Prof. Dr. Desarda has raised questions about the theories mentioned in the text books that prevent herniation. Obliquity of inguinal canal or shutter mechanism or high muscle arch or patent processus vaginalis, etc., are not the real factors that prevent hernia formation in the normal individuals. Real factor that prevents hernia formation in the normal individual is presence of aponeurotic extensions from the transversus abdominis aponurotic arch in first place and strong musculo-aponeurotic structures around the inguinal canal in the second place. REF: Desarda MP. Surgical physiology of inguinal hernia repair. BMC Surgery 2003, 3:2 or visit website http://herniasurgery.tripod.com or http://desarda.webs.com


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Apr25
Anger Management
Anger Management
People get angry for many reasons. Feeling hurt, guilty, insecure, powerless or betrayed are just few of the underlying causes of anger. While anger may be a natural and healthy response to a given situation, holding on to it is not. It can lead to host of psychological and physical ailments, not the least of which is depression.

Anger is a powerful emotion and serves as a mask of other feelings, feelings that you would rather not examine and acknowledge. Thoughts such as inferiority or depression are less likely to surface when you are angry.

Anger may offer you a sense of identity. You need to have something to believe in, something to stand up for. Anger gives you something to feel and generates a passion for something. acy, guilt

You may believe that you need anger and a feeling of being fed up to give you impetus to take action and make changes in your life. You want to generate enough pain in order to motivate to make a change in your life.
It is the only way you believe people will listen to you or respect you. If you do not get angry, others may think that you don’t really care enough or not really serious. Examine whether your anger masks other feelings.

Anger finds it root in fear. It is impossible to be angry without first being afraid. Investigate the source of your fear. Look at it and examine it objectively. Awareness is a powerful weapon.

Once you understand the reason for anger, it loosens its grip on you.

Passion, strength and conviction are admirable qualities indeed. Channel the fire and intensity of your anger intelligently so that people respect you don’t fear you. Harsh, blustery words are not the only way to get people listen – infact every one knows bullies are coward at heart.

Show that you are in control of your actions, and cognizant of their effects. Identify with strength, passion, and courage not with anger. Learn the difference between aggressiveness and assertiveness. Learn what has made the world leaders so great and study the qualities of the people around you whom you admire most

Relaxation
Breathe deeply, from your diaphragm; breathing from your chest will not relax you. Picture your breath coming up from your "gut."

Slowly repeat a calm word or phrase such as "relax," "take it easy." Repeat it to yourself while breathing deeply.

Use imagery; visualize a relaxing experience, from either your memory or your imagination. Learn to use them automatically when you are in a tense situation.


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Apr21
Acupressure and Acupuncture
I received a comment - Quote from

"Mr. Vinod Kumar Singhal
on Wednesday, 21st-April-2010 at 6:03 PM

Basically I am Metallurgist/Scientist but for last 16 years I am associated with Acupressure Therapy and following Foot Reflexology and getting very good results in all types of diseases including psycho cases.Some of the Dr's and hospitals rfering the hopeless cases to us. Mr.Sunil Dutt, Actor and MP had been our One of successful and satisfied patient.
In our opinion Acupressure is much better than Acupuncture and have no side effects.
vinod singhal,Mumbai"

Acupressure is one of the several modalities of Acupuncture such as Moxibustion, Press Tags, Hot Needle, LASER and Electro Acupuncture. Acupressure is absolutely safe and follows the TCM paradigm of 5 Elements & 10 stems with palpation as a main diagnostic modality. It uses the meridian channels and points to tonify or disperse Qi and Blood. The basic pattern recognition and balancing Yin and Yang applies to acupressure. The beauty of Acupressure is that a TCM Acupuncturist Doctor can teach a few pressure points to the patient for home treatment especially in cases with Carpal Tunnel Syndrome, Tourettes and certain chronic pain cases.

The ancient Indian custom of Ear Piercing is an example of Auricular Acupressure on the Ear. It boosts the brain power and re-balances the Yin & Yang in a child. The idea stems from the discovery of Homunculus structure of the body in the Ear by Dr. Nogier of France considered to be the father of modern auricular acupuncture.

Interestingly there are points in the Ear that can be used to Jump Start the brain such as Jerome Point is for relaxation that boosts performance. This can be suitably used by students before taking a competitive exam without taking any designer drug. Even race horses respond well to Jerome Point and win races! Certain addictions can be treated with Ear acupressure to stop the craving. In many states in the US people convicted for Addiction are given two options - Option 1 - Acupuncture or Option 2 - Jail.

My congratulations to Mr. Singhal and his team for the good work and humane services that they extend to patients. My suggestion will be to include all modalities of Acupuncture to be a full service TCM clinic.

MedAku Contacts - You can reach me in my cell +91 81220 62636.


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