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Mar25
Amavata (Rheumatoid Arthritis): An Ayurvedic Approach & cure.
Published in THE HINDU News Paper on Thursday 15th March, 2007 Written by Dr. R. KRANTHI VARDHAN, Chief Physician & Managing Director, Dr Kranthi’s Institute of Ayurvedic Sciences & Research, THE KERALA AYURVEDIC CARE, Speciality Panchakarma Centre, Basheerbagh, Hyd-29. Andhra Pradesh. India. Ph:92461 66636 098666 66055.

Rheumatoid Arthritis is a Joint Disorder, which affects Multiple Joints at various sites. It is described as “Amavata” in Ayurveda. The word ‘Ama’ means Toxic material generated as a un wholesome product in the body due to weakening of digestive fire. This ‘Ama’ is then carried by ‘Vayu’ and travels throughout the body and accumulates in the joints, which is the seat of ‘Kapha’. As this process continuous, all the Joints are gradually affected, which results in Severe Pain and Swelling in the Joints. When ‘Pitta’ also gets aggravated, it causes Burning Sensation around the Joints.

General Clinical Features:

“Angamardaaruchistrushna alasyam gouravam jwara!
Apaka sunyatanganam amavathasya lakshnam!!”

• Body Pains
• Lack of Taste
• Thirst
• General Weakness
• Feeling of Heaviness
• Fever
• Morning stiffness of the Joints
• Pain and swelling in the affected parts
• Shifting of pain in Joints
• Constipation
• Indigestion.

Ayurvedic Management of Amavata:

a. Ahara Chikitsa or Dietary regimen:

One should take Old Rice, Butter Milk, Wet Ginger, Garlic, Wheat, Bitter gourd and Horse Gram in his diet. Avoid consumption of Dairy products, Sweets, Oily foods, Chinese Food, Junk and Fast Foods, Salty and Sour Foods, Jaggery, Black Gram, Fish, Cold Drinks and Ice Creams.

b. Vihara Chikitsa or Life Style Modifications:

One should avoid Cold Breeze and Excessive Wind. Bathing with cold water should be strictly avoided. Warm water bath is recommended. It is also advisable to take a gentle walk after consumption of food. Also it is good to avoid water intake immediately after consuming food.

c. Aushadha Chikitsa or Drug Therapy:

‘Guggulu’ is the most effective drug in treating ‘Amavata’. Also herbal preparations of Ashwagandha, Haritaki, Rasna, Sunthi, Pippai and Trivrut are helpful in ‘Amavata’. Administration of caster oil is also very effective in this disease. The mentioned drugs should be taken only after consulting a Qualified Ayurvedic Physician.

d. Panchakarma Chikitsa or Detoxification Procedures:

This is a purification procedure. By taking this Therapy Toxins are eliminated from the body. The course is as follows:

1. Snehana:
Internal and external oleation to the body / affected parts is given as a preliminary process.

2. Swedana:
This is done by application of steam on the affected parts. It helps in reducing inflammatory conditions in the body. Especially in ‘Amavata’ fomentation with sand bag is recommended. Sankara Sweda is also very helpful. In chronic cases Shali shasthika pinda sweda is recommended.

3. Virechana Karma:
It is a type of Purgation which is induced by oral intake or herbal compound preparations. By the process of Virechana, the ‘Ama’ is eliminated from the body. Also the bowel is cleansed, which results in proper absorption and assimilation of the medicinal preparations properly.

4. Vasthi karma:
This is done by administration of herbal enema. It is helpful in chronic cases. Kashaya Vasthi, Anuvasana Vasthi and Matra Vasthi etc are planned according to the Patient’s requirement and necessity.

Ayurvedic Treatment for Amavata lasts for 14 to 28 days depending upon the severity of the disease, patient’s Constitution (Prakruthi). We at THE KERALA AYURVEDIC CARE, Speciality Panchakarma Centre, 3-6-101/1, St no: 19, Basheerbagh, Hyderabad-29 have Treated Thousands of Patients with 99% results. Speciality Treatments are being done from 1999. For the Services in the field of Ayurveda, Dr. Kranthi Vardhan, the Chief Physician & the Managing Director, has been awarded “KKRUSHI RATNA AWARD”, “AYURVEDA TAPASWI AWARD”, and “VAIDYA RATNA AWARD”.

Care of Joints in ‘Amavata’:

1. Physical activities causing pain in the joints should be avoided.
2. Staying in one position for too long should be avoided.
3. Good posture of the Joints should be maintained.
4. One should sleep on a firm mattress or bed.
5. Weight should be controlled as excess of weight adds stress to the joints.
6. Exercise is very important to keep the joints in working condition.

Preventive aspects:

It is always better to take Preventive Measures before a disease affects us. In order to prevent ‘Amavata’ care should be taken to avoid Sedentary Habits. Also one should perform Daily Exercises or Yoga. One should also avoid Heavy, Viscous and Incompatible foods. Instead one should take High-fibre and Low Fat Diet. Care should also be taken to keep our Digestive Fire intact, as the case of all diseases is the weakening of digestive fire.
The aim of our life is attainment of Dharma, Artha, Kama and Moksha. But it is possible only if we stay Healthy. So let us make a promise, to stay Healthy by following a Healthy Diet and Life Style as described in ‘Ayurveda’ - The Science & Art of Life.


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Mar25
SLIPPED DISC??? COME TO ‘AYURVEDA’ FOR BETTER RELIEF!!!
Published in THE HINDU News Paper on 17th March, 2005. Written by Dr. R. KRANTHI VARDHAN, Chief Physician & Managing Director, Dr. Kranthi’s Institute of Ayurvedic Sciences & Research, THE KERALA AYURVEDIC CARE, Speciality Panchakarma Centre, Basheerbagh, Hyd-29. AP. India.Ph: 092461 66636, 098666 66055.

What is a disc?

The spine is made up of the vertebrae (the bones making up the spine), which have cartilage discs between them. The discs consist of a circle of connective tissue with a central gel-like core. This makes the spine flexible and at the same time acts as a protective buffer. In the centre of this column of vertebrae and discs is the spinal canal, which contains the spinal cord and it continues as a bundle of nerve fibres called the cauda equina stretching down towards the sacrum. Between each vertebra, the spinal cord has nerve root connections to other parts of the body. The spine is divided into three parts:

Neck (cervical vertebrae)
chest (thoracic vertebrae)
the lower back (lumbar vertebrae).
The spine is connected to the ribs at the chest.

What is a slipped disc?

A slipped disc is when the soft part of the disc bulges through the circle of connective tissue. This prolapse may push on the spinal cord or on the nerve roots. However, it is worth noting that 20 per cent of the population have slipped discs without experiencing any noticeable symptoms.The term 'slipped disc' does not really describe the process properly - the disc does not actually slip out of place, but bulges out towards the spinal cord.

What is the cause of a slipped disc?

Many factors increase the risk for slipped disc:
(1) lifestyle choices such as tobacco use, lack of regular exercise, and inadequate nutrition substantially contribute to poor disc health.
(2) As the body ages, natural biochemical changes cause discs to gradually dry out affecting disc strength and resiliency.
(3) Poor posture combined with the habitual use of incorrect body mechanics, hard physical labour (delivery) can place additional stress on the spine.

Combine these factors with the effects from daily wear and tear, injury, incorrect lifting, or twisting and it is easy to understand why a disc may herniate. A herniation may develop suddenly or gradually over weeks or months.

At what age can a slipped disc occur?

A slipped disc in the lower back is most often seen between the ages of 30 and 50. In the cervical vertebrae around the neck, slipped discs are most often seen between the ages of 40 and 60.

A slipped disc occurs most often in the lumbar region of the spine especially at the L4-L5 and L5-S1 levels (L = Lumbar, S = Sacral). This is because the lumbar spine carries most of the body's weight. People between the ages of 30 and 50 appear to be vulnerable because the elasticity and water content of the nucleus decreases with age.


What are the symptoms of a slipped disc?

A slipped disc can be symptom free. If it causes pain, it is primarily due to the pressure on the nerve roots, the spinal cord or the cauda equina.

Symptoms of nerve root pressure:
Paralysis of single muscles, possibly with pain radiating to the arms or legs. There may also be a disturbance of feeling in the limbs.

Symptoms of pressure on the spinal cord:

Disturbance of feeling, muscle spasms or paralysis in the part of the body below the spinal cord pressure. For example, pressure on the spinal cord in the chest area will cause spasms in the legs but not in the arms. Pressure on the spinal cord may cause problems with control of the bladder.



Symptoms of pressure on the cauda equina:
The symptoms can include loss of control of the bladder function, disturbance of feeling in the rectum and the inside of the thighs and paralysis of both legs. These are serious symptoms and anyone developing them should contact a doctor immediately.

What happens in an Ayurvedic session?

The initial consultation involves taking the total health history of the patient. A visual analyze is carried out by examining the eyes, color of the tongue, nails, skin, etc. Once the verbal and visual analyze are completed, further investigation involves examining the tender points (marma points). Focusing on these marma points the ayurvedic physician discovers the malfunctioning of the organs.

Based on these investigations, a final picture is drawn about the patient's condition in relation to the three biochemical forces; vata pitta kapha. The dis-alignment of spinal vertebrae and musculo skeletal system is mainly concentrated and special attention is paid to the patient's food habits and life style. With full history and investigation the ayurvedic physician determines the amount of treatment required. Usually the treatment period is 7/14/21/28 days according to the severity of the disease.

The Treatment usually involves a series of ABHYANGAM, SWEDAM, NASYAM, ELA KIZHI, NAVARAKIZHI, KATI VASTHI, KASHAYA VASTHI & ANUVASANA VASTHI etc. Marma chikitsa, Meru Chikitsa (Ayurvedic Neuro-Therapy) along with Vatahara chikitsa and Brumhana chikitsa are given utmost importance.

In four to six weeks, the majority of patients find their symptoms are relieved without surgery! Be optimistic about your treatment plan and remember that less than 5% of back problems require surgery!

Prevention

Aging is inevitable, but lifestyle changes can help prevent the disc disease. Risk factors include poor posture and body mechanics, weak Spinal muscles, smoking and obesity. Start now to adopt habits that will help preserve your spine for the future.

If you have slipped Disc and are suffering, donot get worried. HELP IS HERE…


We at THE KERALA AYURVEDIC CARE (Dr. Kranthi’s Institute of Ayurvedic Sciences & Research), Skyline theatre lane, Basheerbagh, Hyderabad-29 are aimed at Redefining Ayurveda by propagating the ancient traditions of Ayurveda to the modern world. We are practicing the Genuine, Shastroktha & Purest form of AYURVEDA from the past 5 years with tremendous patient support.

For further details contact Dr. KRANTHI VARDHAN, on 98666 66055, 92461 66636 & 66101140 on all days from 8am to 8pm strictly with a prior appointment.


Come to AYURVEDA for better relief.


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Mar25
“MERU CHIKITSA” – ANCIENT AYURVEDIC SPINAL CARE .
Published in THE HINDU News Paper on 10th Feb, 2005. Written by Dr. R. KRANTHI VARDHAN, Chief Physician & Managing Director, Dr Kranthi’s Institute of Ayurvedic Sciences & Research, THE KERALA AYURVEDIC CARE, Speciality Panchakarma Centre, Basheerbagh, Hyderabad-500029. Andhra Pradesh. India. Ph: 092461 66636, 098666 66055.

What is Meru Dandam? What is its Significance?

The Spine, Meru Dandam, in Ayurveda is a remarkable combination of strong bones, flexible ligaments and tendons, large muscles and highly sensitive nerves. It is designed to be incredibly strong, protecting the highly sensitive nerve roots, yet highly flexible, providing for mobility on many different planes. Most of us take this juxtaposition of strength, structure and flexibility for granted in our everyday lives—until something goes wrong. Once we're in pain, we're driven to know what's wrong and what it will take to relieve the pain and prevent a recurrence.

Why are we usually subjected to Neck & Back Pains?

This spine has a natural S shaped curvature and has two weak portions one at the cervical and the other at the lumbar regions. Any excess pressure in these areas increases the incidence of severe spinal damage. The first symptom to be observed usually is the neck and the back pain followed by the weakness, numbness, radiating pain, discomfort and finally disability.

What are the structures of the spine that produce Neck & Back Pain?

Many different structures in the spine are capable of producing back pain or neck pain, including:
The large nerve roots that go to the legs and arms may be irritated
The smaller nerves that innervate the spine may be irritated
The large paired back muscles may be strained
The bones, ligaments or joints themselves may be injured
The disc space itself can be a source of pain.

What are the Causes of Spinal Damage?

Irregular spinal postures, lifting heavy weights, increased car and motor driving, using dangerously uncomfortable chairs, stress, age, obesity etc. increases the pressure in these sensitive structures of the spine which ultimately leads to Cervical Spondilitis, Slip Disc- in the cervical region & Lumbar Spondilitis, Sciatica, Disc Prolapse, Degenerative Disc- in the lumbar regions and Osteoporosis in general.

Where can you get the solution for your Spinal Problem?

Whether your back is tender, or you have a 'slipped' disc, or you wake up with a stiff neck, or any damage on to the spine; Ayurveda has answers for you!

What is Ayurveda?

Ayurveda, The Science and Art of Life, is the oldest system of Indian medicine. It is not only the ancient science of preventative health & healing but also a philosophy of living. Ayurveda mainly cures by removing the root cause of the disease.

What is Meru Chikitsa?

Ayurveda deals almost in all branches of medical science. ‘meru chikitsa’ is one of them, that has been developed thousands of years ago. The term “meru chikitsa” (meru means ‘Spine’, therapy is ‘application’) places chief emphasis upon the Spine and its associated structures thus maintaining proper health of an individual.

Meru chikitsa-The Spinal Care is an ancient ayurvedic therapy based on the vedic principles & philosophy. This natural healing therapy deals with spine proper and its nerves, muscles, joints and blood & lymphatic channels. Authorities in the field believe that the body is co-ordinated by three different humors or energy forces i.e.; Vata, pitta and kapha. This therapy helps in restoring and balancing the energy forces of the body that regulates the physiological equilibrium to perform better function of the body mind soul & the senses.

How does Meru Chikitsa work?

Meru chikitsa is a complete system of healing, incorporating mechanical, psychological, bio-force, and biochemical aspects of the spine along with the nerves. It discovers the root cause of the disease and treats the same in an integrated manner. The disorder of the bodily organs causes an imbalance in the biochemical forces leading to the development of diseases. These therapies activates or deactivates the organs, through pressure or massage on the nerve channels to stimulate or depress the blood, & other body fluids and the nerve currents so as to restoring the balance and harmony of the body thus helping the body regain its equilibrium.

What happens in the session?

The initial consultation involves taking the total health history of the patient. A visual analyze is carried out by examining the eyes, color of the tongue, nails, skin, etc. Once the verbal and visual analyze are completed, further investigation involves examining the tender points (marma points). Focusing on these marma points the ayurvedic physician discovers the malfunctioning of the organs. Based on these investigations, a final picture is drawn about the patient's condition in relation to the three biochemical forces; vata pitta kapha. The dis-alignment of spinal vertebrae and musculo skeletal system is mainly concentrated and special attention is paid to the patient's food habits and life style. With full history and investigation the ayurvedic physician determines the amount of treatment required. Usually the treatment period is 7/14/21/28 days according to the severity of the disease.

What Therapeutic Methods are applied?

The Treatment usually involves a series of ABHYANGAM, SWEDAM, NASYAM, ELAKIZHI, NAVARAKIZHI, KATI VASTHI, KASHAYA VASTHI & ANUVASANA VASTHI etc. Marma chikitsa along with Vatahara chikitsa and Brumhana chikitsa are given utmost importance.

What are the Applications?

It is used as a therapy for chronic as well as acute diseases of the spine. It does not merely concentrate on particular malfunctioning of a system or disease, but deals broadly with the whole body especially the spine.

What Ayurveda / Meru Chikitsa does is...

Apply scientific and holistic approaches to Treatment.
Assist the body in restoring its natural equilibrium, thus enabling self healing
Treat the whole human system and not only the apparent illness.
Treat with no side effects.
Provides immediate healing of some ailments,others may need relatively longer duration.
Advocates a Natural way of living as the preferred way of living.


About The Kerala Ayurvedic Care:

Dr. Kranthi’s Institute of Ayurvedic Sciences & Research… The Kerala Ayurvedic Care, basheerbagh, hyderabad, Aim at medical evaluation, treatment of all the chronic ailments including the Spinal Disorders. We, from the past 9 years are providing the Care, Comfort, Cure and Hope to all the suffering patients.

Our Mission Statement :

To Improve the Quality of Life for those with Spine Disorders; To advance the understanding and Treatment of those conditions through Research, Prevention and Education; and To deliver the finest quality Spine Care in a Friendly and Compassionate Environment, Treating every patient with the same Care and Respect we would demand for ourselves.

For Appointments, Please Contact:

Dr. Kranthi Vardhan at The Kerala Ayurvedic Care, Skyline Theatre lane, Basheerbagh, Hyderabad. Ph: 98666 66055 / 92461 66636 / 66101140 on all days from 8am –8pm strictly with a prior appointment.

Take Great Care and Avoid Straining that Delicate Structure called the ‘Spine’.


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Mar25
SCIATICA- A NAGGING PAIN DOWN THE LOWER LIMBS-
Published in THE DECCAN CHRONICLE News Paper on 24th May, 2005. Written by Dr. R. KRANTHI VARDHAN, Chief Physician & Managing Director, Dr Kranthi’s Institute of Ayurvedic Sciences & Research, THE KERALA AYURVEDIC CARE, Speciality Panchakarma Centre, Basheerbagh, Hyd-29. Andhra Pradesh. INDIA. Ph: 092461 66636, 98666 66055.

Sciatica, Gridhrasi in Ayurveda, is a Vata roga, charecterised by Sharp Shocking pain radiating from the Hip upto Thigh, Calf or the Toes in one or both the Legs. Numbness, Weakness, Tingling sensation & Discomfort along the path of the Sciatic Nerve are the results of Compression, Irritation & Inflammation of the Sciatic Nerve.

The most common causes are Lumbar herniated disc, Lumbar Spinal stenosis, Degenerative disc disease, Aging, Osteoporosis, Spondilitis, Pelvic Infections, Tumours, Diabetic neuropathies etc.

In the Later & Complicated stages of Sciatica, the gait of the affected person resembles that of an Eagle’s walk & the inflamed nerve appears like Eagle’s beak, hence the term GRIDHRASI.

Majority of these patients give a history of lifting heavy weights on their head or back, adopting improper spinal postures while sitting or bending forward, riding two wheelers on bumpy roads, female patients standing for a longer time in kitchens –these all contribute to the unbearable & excruciating pain called Sciatica.

Ayurveda believes that sciatica/Gridhrasi is caused by the aggravation of Vayu (the one which is responsible for the movement of the muscles & the sensation of the nerves) Sometimes the vitiation of Kapha (phlegm and the body fluids) along with Vata brings on the attack. At times constipation precipitates or aggravates an attack of sciatica.

AYURVEDA prescribes the perfect prescription for Gridhrasi. It includes:

1) Dietary Regimen

2) Life Style Regimen

3) Internal Therapy or the Medications &

4) External therapies or the Panchakarma / Rejuvenation Therapies.


Dietary Regimen: Pulses, beans, and fried foods should be prohibited. Curds and other sour substances should be avoided. Saffron, in small quantities, should be mixed with milk and given to the patient to drink.


Life Style Regimen: Gentle exercise of the leg is advised. Exposure to damp and cold should be avoided. Swimming in warm water is a good exercise for legs. The patient should use a hard bed and wear a lumbo-sacral belt.

Yogic exercises: like Halasana (Plow Pose -improves circulation of blood and lymph, stimulates the immune system and releases stress and tension in the lower back including the spine), Shalabhasana (Locust Pose -strongly strengthens the core body and the low back muscles. It also stimulates the endocrine, nervous and reproductive systems) and Bhujangasana (Cobra Pose- This posture develops the strength & flexibility in the spine and rejuvenates spinal nerves) may be undertaken after pain has subsided to prevent recurrence of sciatica.

Internal Medications: include many types of Ayurvedic preparations like Thailams, Grithams, Gutika, Pills, Lehyams, Churnams, Asavaaristams & Kashayas prepared from the herbs like Raasna, Aswagandha, Dasamoola, Satavari etc. are prescribed by a qualified Doctor after a thorough examination of the patient.

External Therapies: includes the famous Panchakarma & Rejuvenation therapies.

Abhyangam( A whole body massage with specific herbal oils, achieves deepest healing effects by naturally harmonizing Body, Mind, Soul and the Senses), Nadi Swedam(medicated steam bath), Elakizhi (herbal leaf bundle massage), Pizhichil (medicated oil bath), Kati vasthi(a treatment done on to the back to decrease spinal compression), Vasthi( medicated enema) Virechanam( purgation) and other Ayurvedic procedures are performed accordingly for a period of 7/14/21/28 days, thus treating the underlying cause of the disease without any side effects.


If you have SCIATICA and are suffering, donot get worried. HELP IS HERE…

We at THE KERALA AYURVEDIC CARE (Dr. Kranthi’s Institute of Ayurvedic Sciences & Research), Skyline Theatre Lane, Basheerbagh, Hyderabad-29 are aimed at Redefining Ayurveda by propagating the Ancient Traditions of Ayurveda to the Modern World. We are practicing the Genuine, Shastroktha & Purest form of AYURVEDA since 1999 with tremendous patient support.

For further details contact Dr. KRANTHI VARDHAN, on 92461 66636, 98666 66055 & 66101140 on all days from 8am to 8pm strictly with a prior appointment.

Come to AYURVEDA for better relief.


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Mar25
FIRST EVER SCIATICA & SPINAL RESEARCH INSTITUTE IN INDIA
Published in THE DECCAN CHRONICLE News Paper on Thursday 15th Nov,2007 Written by Dr. R. KRANTHI VARDHAN, Chief Physician & Managing Director, Dr Kranthi’s Institute of Ayurvedic Sciences & Research, THE KERALA AYURVEDIC CARE, Speciality Panchakarma Centre, Basheerbagh, Hyd-29. Andhra Pradesh. India. Ph:092461 66636 098666 66055.

In the past, a patient suffering from Disc problems may have been prescribed Pain killers / Medications, Instructed to refrain from physical activities, referred for Physiotherapy, received Steroidal Shots or Injections, and when they weren’t progressing, they were sent for Spinal Surgery. Frankly speaking only 5% of Back pains require Surgeries, the other 95% can be dealt with Conservative & Curative Ayurveda Panchakarma Chikitsa.

Today, you may not have to live with that pain anymore. We at THE KERALA AYURVEDIC CARE, SCIATICA & SPINAL RESEARCH INSTITUTE, Basheerbagh, Hyderabad have successfully Treated Lower Back Pain resulting from herniated, bulging, or degenerative discs. Our Meru Chikitsa (Ayurveda Neuro Therapy) enables patients to return to more active lifestyles.

We are dedicated to improving the health and function of our patients by combining Traditional Ayurveda Panchakarma Chikitsa with modern technology to deliver an unprecedented level of service. Till to date we have treated more than 33000 patients with Spinal conditions like:

• Herniated Discs
• Bulging Discs
• Degenerative Disc Disease
• Sciatica Syndrome
• Spondylosis (Cervical /Lumbar/ Ankylosing).

Our commitment is To Improve the Quality of Life for those with Spine Disorders; To advance the understanding and Treatment of those conditions through Research, Prevention and Education; and To deliver the finest quality Spine Care in a Friendly and Compassionate Environment, Treating every patient with the same Care and Respect we would demand for ourselves.

For Appointments, Please Contact Dr. Kranthi R Vardhan, Chief Physician & Managing Director, The Kerala Ayurvedic Care, Sciatica & Spinal Research Institute, Basheerbagh, Hyderabad-29. Ph: 92461 66636 / 98666 66055 / 66101140 on all days from 8am – 8pm strictly with a prior appointment.

Take great care and avoid straining that delicate structure called the ‘Spine’.


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Mar23
Crystal Pyramids (Relationship pyramids)
Crystal Pyramids (Relationship pyramids)

Crystal Pyramids or as we often call them relationship pyramids are highly useful to mentain healthy relationship among two or more people. It simply generates a positive energy sphere around the person wearing it and prevents his/her mind from getting stressed or receiving negative thoughts as these are the two reasons which first effect the thought process of an individual and then his/her behaviour in a relationship. They are available in couplets, triplets, quadraplets and pentaplets for relationship or family purpose and co- relates each of the individuals dependency and tuning with each other. They can also be programmed in bulk for the use of an office or organisation to reduce individual disputes. Hence, it is an efficient tool to keep the human social network healthy.


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Mar23
Sensational news in medical tourism: Big fibroid operation refused in U.K. & successfully done in India
On 15th December they have operated on patient Mrs. Rashmikaben, U.K.based NRI patient for Big Fibroid laparoscopically was widely covered in many news Medias for their achievement & many compliments for their success. BIG FIBROID (20 cms Intramural Fibroid) REMOVAL REFUSED IN U.K. AND SUCCESFULLY DONE IN INDIA Fibroid is the one of the common problems in female. Previously it was removed by a "Laparotomy" operation (cutting open the stomach). Now, fibroids can be removed very easily and safely by Endoscopic operation. Day care surgery and resuming to her routine activities in two days and all the benefits attached to Endoscopic surgery better visualization and accessibility makes it safer and better to remove a fibroid through Endoscopy.

Dr.Pragnesh Shah, Dr.Himanshu Bavishi & Dr.Parulben Shah are experienced Laparoscopic Surgeons & they have experience of most of the advanced Gynecological Surgeries with world class infra structure in Ahmedabad for any difficult & complicated laparoscopic surgeries.

On 15th December they have operated on patient Mrs. Rashmikaben, U.K.based NRI patient for Big Fibroid laparoscopically was widely covered in many news Medias (on 20th December, 07, India) for their achievement & many compliments for their success.

Patient had searched on internet & communicated with many Laparoscopic surgeons in the world and also visited http://www.laparoscopyexpert.com & http://www.ivfclinic.com and found that Dr.Pragnesh Shah Indian Laparoscopic Surgeon had answered the most satisfactory answers for her quarries for Big Fibroid. This was a unique case where a fibroid was 20cms big. Usually fibroids are detected 5-8 cms in size and easily removed. When it is 20 cms big & intramural there is hardly any space in abdomen to operate the same through Endoscopy. It requires unique skill, lot of experience and expertise, instruments and equipments, setup and team.

He believes that patient does not come to India just to save money but they trust skill, expertise and experience of the doctors. Offering video of patient’s Laparoscopic surgery i.e. live operative files is the best example of transparency in medical practice for complicated case to all his patients. Human approach, personalized care and homely environment are free added benefits to them. Last but not least, at a very low cost compare to other countries.

Internet can be ultimate source for selecting right surgeon & right place for complicated case in the world. Patient gets very fast & reliable information. Doctors are invited to see her video to learn unique surgical technique, photos and all reports of this interesting case & contact on 9824050916

Patient Mrs. Rashmikaben had willingly agreed to communicate with any one on Mobile No.:9727425378 for any quarry for the benefit of anyone who had big fibroid and worried about operation.
Hospital is India based Advanced Gynecological Laparoscopic Training & center for Excellence for most of the Gynecological Endoscopic Surgeries. Dr.Pragnesh Shah & Dr.Parulben Shah are experienced laparoscopic Surgeons & they have experience of most of the advanced Gynecological Surgeries with world class infra structure in Ahmedabad for any difficult & complicated laparoscopic surgeries


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Mar23
Recent advances in Total Knee replacement
Consultant orthopaedic surgeon, Chennai

Osteoarthritis of knees affects predominantly the senior citizen age group. Increasingly large numbers of these elderly people in our towns and cities are electing to have a total knee replacement to end their agony and lead a better quality of life. They survey the market and hope to get the best deals in terms of functional outcome, surgical and post surgical care and costs. Many a time they are dissuaded by skeptical relatives or friends to have the surgery. Since cultural, social and religious requirements of Indians are different from the West, the operation has to be tailored to the specific needs of our countrymen. In this article I shall discuss some recent advances and the implications of these on the outcome of the surgery.
The main factors that deter people from having any major operation for a non life threatening condition are fear and perceived high cost. Fear may stem from the thought of postoperative pain the risks of anesthesia, surgery itself. Specifically the fear of infection is a big bugbear. Ideally a major replacement should be done by well trained and qualified surgeons. Experience of joint replacement is gained by overseas or Indian fellowship training. Infrastructure of the hospital is vitally important. The operating theatres should provide “Ultra clean air” with ideal parameters. Exponential Laminar airflow is ideal where air is changed 25 times per hour. The delivered air is treated by special HEPA (High efficiency particulate air filters) with 99.99 % efficiency so that the chance of infection is reduced to the level of < 1 %. No colony forming units of bacteria should be present. It would be correct to say that facilities are limited for these standards.
Costs are not exorbitant when compared to the west and only amount to one tenth of the cost in the West. A price range of 1.75 lakhs to 2.5 lakhs rupees is quoted by surgeons and hospitals for standard prosthesis designed and manufactured in the west. Increasingly large numbers of UK and USA citizens are coming to undergo this surgery because of these low costs. The quality of care in selected hospitals matches that in the west.
Let us look at some of the recent advances in a total knee replacement.
1) Minimally invasive surgery- If you ask your friend who has undergone a knee replacement, about the worst thing about the surgery, he or she is likely to blame the amount of post operative pain. Some amount of Post op pain is inevitable from any operation. The amount of tissue dissection in normal knee replacements causes iatrogenic damage to the lining of the joint and results in pain postoperatively. A minimally invasive knee replacement is carried out through a smaller incision and produces less amount of pain. In this procedure the same prosthesis is implanted using smaller incisions and specially designed instrumentation. Duration of hospitalization will be lesser, there is no need of transfusions, pain is lesser and the cosmetic effect is better. Rehabilitation will also occur faster, a return to normal activity may be possible in 6 weeks. Fig.1.Knee replacement scar measures 5 inches only



Chronological Bilateral knee replacements done spinal anesthesia

2. Alternative modes of anesthesia- Many anesthetists and surgeons prefer regional and local modes of abolishing operative pain. Spinal, Epidural and local nerve blocks may be administered by skilled anesthetists. The benefits are increased safety as there is less stress upon the body. Diabetics, Hypertensives, and people with ischemic heart disease can undergo safe surgery. As the patient is not unconscious and is only sedated, he is unlikely to feel postoperative nausea and vomiting. A drink or light meal can be given soon after surgery as tolerated and this comes as a big boon to many elderly who are unable to tolerate overnight starvation and thirst.
3. Multi modal pain relief- Instead of relying on opioids, multimodal analgesia employs a battery of pain relief methods and drugs. Pain relief is near total and the patient will not regret that he experience at all. Ice packs, oral drugs, pain pumps, epidural anesthesia are all used to make your experience as pleasant as possible.
4. High flexion knee prosthesis-Special knee implants are available which provide more flexion or bending at the knee to suit Indian, and South Asian habits of kneeling for prayer, or sitting cross legged on the ground for meals or social purposes. Muslims in particular need this to offer prayers. Even westerners have begun to appreciate the benefits of high flexion knee prosthesis as they can pursue hobbies like gardening and are also gratified for the ability to do recreational acts. The design features of such knees incorporate cut outs at the front, rotating platform or mobile bearings, increased bony


resection at the back amongst others. Fig 4.Patient squatting after knee replacement with high flexion prosthesis.

5. Navigational surgery- In this age of computers, navigational surgery has some benefits to offer. Not only can the trained surgeon perform the operation through smaller incisions, the seating of the implants could be more accurate. Perfectly positioned implants are less likely to loosen over time. Only selected prosthesis and not all types of knee prosthesis can be implanted through less sophisticated systems and this could be a disadvantage. Costs could be slightly higher in such centres.

A knee replacement offers permanent pain relief from osteoarthritis and could be made more attractive by doctors who have embraced the latest techniques and advances.
The author is a Knee specialist in Chennai and can be contacted by mobile 9282165002. More information on knee and shoulder problems is available on websites www.kneeindia.com, www.shoulderindia.com


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Mar23
Stress and Meditation
* Stress and Meditation



When our bodies are exposed to a sudden stress or threat, we respond with a characteristic "fight or flight" response. This is sometimes called an "adrenaline rush" Because the hormones epinephrine (adrenaline) and norepinephrine are released from the adrenal glands, resulting in an increase in blood pressure and pulse rate, faster breathing, and increased blood flow to the muscles. deep relaxation in which our breathing, pulse rate, blood pressure, and metabolism are decreased.

All we need to do is to sit in a comfortable position and relax. We sould not fight with the thoughts striking our mind. If they are coming, Let them come. Try to feel as if you have no body and soon you will recognise that your breath is getting shorter and shorter. When the breath will become limited to our nostrils only, our body will start receiving Cosmic Energy from the universe and all our diseased and stressed veins will fill with energy. We will start feeling stonger and healthier.

A daily practice will boost your immune system and you will notice an improvement in your physical and mental efficiency.


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Mar22
No good deed goes unpunished
We have all been approached by our colleagues, friends, relatives and acquaintances for medical problems formally and sometimes embarrassingly informally at social gatherings and even at road side berms or in the corridors. We usually hesitatingly oblige them although we know that we are not practicing good medicine. These encounters frequently lead to inappropriate treatment. In the socially related patients, very often an inadequate history or l examination is performed. Many acquaintances just barge in to the consultation clinic embarrassing the treating doctor who is midway of his consultation with another patient. The situation gets further compounded, when the treating physician has previously been in a subordinate position, such as a medical student, or a junior attending physician. This can often adversely influence the treatment plan of the younger physician. In such situations if the treating physician is not able to maintain the control of the medical management of the patient, the medical literature recommends to terminate the doctor-patient relationship. It is also important to keep in mind that the visits with the acquaintance patient may, paradoxically, take longer than the typical office consultation. The social, hospital, and practice issues will often insinuate themselves into the conversation. Thus it is a good practice to schedule them at times when they will not interfere with other appointments. The anxiety of treating such patients and our effort to be extra vigilant makes us begin to doubt our usual protocols. There is a tendency to want to change our routine. It is important that the treating physician continue to practice what he or she would do for any patient with a similar problem without beginning to doubt what has worked well for all previous patients.
Finally, there may be a strong temptation to discuss the patient’s ailment with colleagues or other acquaintances resulting in the risk of rising of the ethical issues of a doctor – patient relationship. There are some proposed guidelines for the treating physician which should make him ask the following questions before treating an acquaintance patient:

1. Can I remain objective in maintaining the doctor-patient relationship or is an inappropriate collegial rapport likely to ensue?
2. Do I have an excessive amount of anxiety that may jeopardize my ability to care for a colleague or friend?
3. Am I treating this patient in the same manner that I treat all of my other patients (e.g., with regard to history and physical examination, diagnostic testing, and treatment considerations)?
4. Have I carefully explained to this patient about the illness and the prognosis in the same detail that I would for a ordinary patient?
5. Have I clarified the boundaries of the prior existing relationship and made it comfortable for the patient to discuss freely, and to continue or terminate the relationship without sentiments of guilt or anxiety?
6. Can I maintain this patient’s confidentiality?
7. Can I always act for the good of this patient even if it means making decisions that may jeopardize the friendship?

Thus we should always try to ask these questions before continuing any doctor patient relationship otherwise there is a definite risk of causing avoidable medical errors and blunders, and our initial acts of pleasing our acquaintances will ultimately lead us to discover the truth in Clare Boothe Luce’s observation that ‘‘no good deed goes unpunished.’’


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