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Sep04
Medical Social Work at Nadiad Kidney Hospital
MULJIBHAI PATEL UROLOGICAL HOSPITAL, NADIAD (MPUH)

MEDICAL SOCIAL WORK DEPARTMENT / MAKE-A-WISH FOUNDATION

Master Raghuvendra’s Dream Comes True

Master Raghuvendra Pandya, a 15-year old, end stage renal disease patient (from Ratlam, M.P.) is scheduled to undergo kidney transplantation on 7th September 2009 at MPUH, Nadiad. His mother will be the kidney donor.

Like his father, Raghuvendra also aspires to become a painter. Not surprisingly, when asked for a wish, he desired to meet a renowned painter before his kidney transplant surgery.

MPUH and the Make-a-Wish Foundation have jointly been facilitating fulfillment of wishes of children before they undergo major surgeries in Nadiad Kidney Hospital.

At the request of the Make-a-wish Foundation, Shri Amit Ambalal, the renowned painter from Ahmedabad visited MPUH Nadiad and met the young Raghuvendra today. He also sketched two paintings on the spot, autographed it, and presented them to Raghuvendra. It was indeed a dream come true for the young Raghuvendra. His parents were also so happy to see their son elated.

Shri Amit Ambalal was a businessman until the age of 37 when he took up his passion for painting as a full time vocation. He has a contemporary approach to tradition via the popular religious traditions, and the historical Rajasthani Nathdwara devotional paintings. He greatly appreciated the efforts of the MSW department of MPUH and the ‘Make a Wish Foundation’ in trying to bring some happiness to the children during their otherwise stressful time while in the hospital.

Other than Dr. Sujata Rajapurkar, Medical Social Worker and transplant coordinator at MPUH, Ms. Niketa Ghiya who is a volunteer with the Make A Wish Foundation, was also present at the function, besides Dr. Umapati Hegde and other Doctors and staff. Ms. Niketa Ghiya, who is on maintenance dialysis herself, has been performing Bharat Natyam for the last several years to raise funds to help needy dialysis patients at MPUH.

P A Joseph
Officer on Special Duty
MPUH (Nadiad Kidney Hospital)


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Aug25
PCNL
MULJIBHAI PATEL UROLOGICAL HOSPITAL, NADIAD
JAYARAMDAS PATEL ACADEMIC CENTRE


NO STONE LEFT UNTURNED – INSTRUCTION COURSE ON PCNL

'German Doctor praises Nadiad Kidney Hospital for pioneering work'

Jayaramdas Patel Academic Centre (JPAC) at the Muljibhai Patel Urological Hospital (MPUH), Nadiad organised yet another Instruction Course on PCNL (Percutaneous nephrolithotripsy) during 2 -4 July, 2009.

Stone management occupies a major portion of our clinical practice. Basically most of the stone cases are either neglected or diagnosed late. Very often they complicate other health problems like diabetes, hypertension, obesity, pregnancy, neurological diseases, CRF, Bleeding Diathesis, etc. This increases complication or failure to clear all stones. Though PCNL (Percutaneous nephrolithotripsy), URS (Ureteroscopic lithotripsy) and ESWL (Extracorporeal shock wave lithotripsy) are still indicated, their applications have been modified. It requires special attention.

International faculty who participated in the Course included Peter Alken from Germany and Adrian Joyce from UK, while Samir Rai and Anil Bradoo will be among the National faculty members. Mahesh Desai, Director, JPAC and Chairman, Dept. of Urology; and R.B. Sabnis, Vice Chairman, Dept. of Urology will also be present, among others, from MPUH.

Dr. Peter Alken told DNA "I invented the PCNL technique in 1980s, but the doctors here (in MPUH Nadiad) perfected it. I am really very glad to see good use of the technique here. I admire the hospital and its doctors for making a great success of the technique".

The main aim of the Course was to focus on complicated situations. There will be ‘hands on’ facilities to increase the skill. Around 50 Urologists participated in the programme.

Muljibhai Patel Urological Hospital, who are the pioneers in the field of nephro-urology in India, has handled more than 16000 stone cases so far.

Kidney Stones Overview
The kidney acts as a filter for blood, removing waste products from the body and helping regulate the levels of chemicals important for body function. The urine drains from the kidney into the bladder through a narrow tube called the ureter. When the bladder fills and there is an urge to urinate, the bladder empties through the urethra, a much wider tube than the ureter.
In some people, the urine chemicals crystallize and form the beginning, or a nidus, of a kidney stone. These stones are very tiny when they form, smaller than a grain of sand, but gradually they can grow to a quarter inch or larger. The size of the stone doesn't matter as much as where it is located.
When the stone sits in the kidney, it rarely causes problems, but should it fall into the ureter, it acts like a dam. The kidney continues to function and make urine, which backs up behind the stone, stretching the kidney. This pressure build up causes the pain of a kidney stone, but it also helps push the stone along the course of the ureter. When the stone enters the bladder, the obstruction in the ureter is relieved and the symptoms of a kidney stone are resolved.

Kidney Stones Causes
There is no consensus as to why kidney stones form.
Heredity: Some people are more susceptible to forming kidney stones, and heredity certainly plays a role. The majority of kidney stones are made of calcium, and hypercalciuria (high levels of calcium in the urine), is a risk factor. The predisposition to high levels of calcium in the urine may be passed on from generation to generation. Some rare hereditary diseases also predispose some people to form kidney stones. Examples include people with renal tubular acidosis and people with problems metabolizing a variety of chemicals including cystine (an amino acid), oxalate, (a type of salt), and uric acid (as in gout).
Geographical location: There is also a geographic predisposition in some people who form kidney stones. There are regional "stone belts," with people living in the stone belts having an increased risk. This is likely because of the hot climate, since these people can get dehydrated, and their urine becomes more concentrated, allowing chemicals to come in closer contact and begin forming the nidus of a stone.
Diet: Diet may or may not be an issue. If a person is susceptible to forming stones, then foods high in calcium may increase the risk, however if a person isn't susceptible to forming stones, nothing in the diet will change that risk.
OTC products: People taking diuretics (or "water pills") and those who consume excess calcium-containing antacids can increase the amount of calcium in their urine and increase their risk of forming stones. Patients with HIV who take the medication indinavir (Crixivan) can form indinavir stones.
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Aug25
Flexible URS (Ureteroscopy)
MULJIBHAI PATEL UROLOGICAL HOSPITAL, NADIAD
Jayaramdas Patel Academic Centre

www.mpuh.org

Flexible Ureteroscopy

Muljibhai Patel Urological Hospital (MPUH), Nadiad organised a 3-day Instruction Course on Flexible URS (ureteroscopy), during 20th to 22nd August 2009. Flexible Ureteroscopy has become increasingly popular in the management of stone disease. It is more nephron saving than PCNL and ESWL.

During the past two decades, URS has dramatically changed the management of ureteral calculi and is extensively used in many urological centres all over the world, including the Nadiad Kidney Hospital (MPUH). Major improvements have taken place especially in the area of flexible URS that offers minimally-invasive removal of stones from the proximal ureter and the kidney. Flexible URS has demonstrated its efficacy for small or mid-sized stones. Further technical advancements, more experience and better skills of the urologists will expand its indications, making flexible URS a preferred treatment option for renal calculi. The three-day Instruction Course at MPUH was attended by more than 100 urologists from all over India and abroad.

The star faculty included Drs. Michael Grasso, S V Kandasami and Pradeep P Rao. From MPUH, Dr. Mahesh Desai, Director, JPAC and Chairman, Department of Urology; and Dr. R B Sabnis, Vice-Chairman, Department of Urology will also be participating in the Programme and sharing their experience. There were ‘hands-on’ training on simulators and a model.

*****


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Aug22
Homeopathy and Chronic renal failure
A Case Of Chronic Renal Failure:

It was a precious opportunity for me to treat few cases of chronic renal failure.
I am discussing here one such case of interest.

On the 12 th June 2003 a gentleman aged 73 years came to my office with his wife and daughter.
He was a man of short thin built, with a yellowish complexion and looking pale and withered. He had a calm and composed expression. It was characteristically fearless, showing no anxiety or concern of any kind.

He had been a professor of language for 17 years and had composed many poems. He had taught literary criticism to students of Masters in Arts.

His wife and daughter were doing all the talking. He reprimanded them right at the beginning of the interview and asked them whether they were going to let him talk.

He started as, ‘I have absolutely no complaints. I am a diabetic since 20 years. That was detected in a routine blood examination before my operation for cataract. I am a hypertensive since 15 years. That was detected in a routine medical check up.
Since a few weeks I had slight nausea and aversion for food. So I had a check up done when high urea and creatinine was found in my blood.’

He has been on anti-hypertensive allopathic drugs and Insulin injections for about 15 years.

The levels were Blood Urea level 220 mg/dl (normal range being 15-40 mg/dl)
and Serum creatinine at 3.9 u/dl (Normal range being 0.5-1.5)

His Renal Doppler suggested diffuse renal parenchymal disease. An atrio-ventricular fistula had been made in his right arm, and he was to go for a dialysis the following week.

2 years back he had a toe amputation for an intractable infection.
So it is quite evident that he is suffering from complications of diabetes.

Let us take note here that there is a major problem in his body, but the only symptoms the vital force has expressed is slight nausea and aversion for food.

The relative lack of subjective symptoms was striking.
This brought to mind the syphilitic miasm so definitely.

The syphilitic miasm is of a deep destructive nature, which hardly shows up in the form of subjective symptoms. Its very nature is like the silent killer.

The relative lack of subjective symptoms gives us the clue that psora is more or less latent at this point of time.
Psora in its very essence means expression; psora needs to express as it needs to communicate its primary anxiety of separation. Psora expresses to connect with others so that they may feel less separated; less lonely. The mental ‘itch’ may thus somewhat be relieved.

So we find that his economy only communicates minimally, in the form of two symptoms, nausea and an aversion for food. That is quite unlike an active psora.

He has a low appetite, and nausea. Empty retching.
He likes spicy pickles and sweet meats when well. Let us note here that it is not a craving, a mere preference. So we cannot really put it high up in the hierarchy.
He drinks less water as his chest seems to fill up with it. His stools are sometimes dry and hard.
He passes about 1 litre of urine per day.

He is a man of few words. And they are precious ones.
Quite unlike an active psora!

He has a small friends’ circle of renowned writers and poets. He used to read a lot, but is not happy with the present shallow writing, and thinking. So now, he generally does not read much, nor does he write anymore.
He had a huge collection of books all of which he donated to a library.
We understand this as a need to collect and retain followed by a total discharge, probably out of a growing indifference.
It means he is tuning away from the things he ardently loved before.

He has stopped his expression- his writing and teaching, and become indifferent now. He has a feeling that it is not worth it anymore.

The symptoms I could gather were-

Absence of symptoms where expected
Reserved
Philosophical
Indifferent
Irritated on being disturbed
Renal failure

But to summarize the observations made before,
He was in psora and tubercular miasm initially.
Psora because it being a basic ‘ mother miasm’, is always present, though varying in its active influence or activity during the lifetime of a person.
And psora, also because he was very expressive, teaching, writing.
The tubercular miasm shows itself by his creativity and innovative ideas;

Only creative persons can write poems. And those who think and feel deeply and can express it in verse.
The Syphilitic miasm seems to have been present in the past, but had been latent in his constitution. This conclusion is on the basis of his mentioning that he did not have any ‘subjective symptoms’ of diabetes or of hypertension. These had been detected during routine blood tests.

That means there was hardly any expression of the inner disturbance; which means not much activity of psora although psora is always there.

Now at this point of time, when the patient is in chronic renal failure, the syphilitic miasm seems more dominant as it has brought about a silent irreversible organ damage and the little activity of a largely latent psora seems to have brought up the nausea and aversion for food, which are the only subjective symptoms, or expressions in his case.

If psora had remained almost completely latent, he would have had no symptoms, no nausea or food aversion. He would probably have straight away gone into uraemic coma.

Besides this miasmatic analysis we see a prominent theme in the case.
‘Retention.
He used to collect- ‘retain’ a large number of books, which he has now given away- discharged. We see a polarity of need and aversion here.
He is reserved- ‘retains’ emotions. Initially he expressed them in verse, now he does not. He ‘retains’.
He is a deep, sensitive thinker.


The theme of retention, his depth of thinking and his past tryst with verse, brought to mind Natrum and the radical chloride.
So one dose consisting of 2 pellets of Natrum mur 6X were given to him. The rest was plain Sac lac.

In organ damage, I have observed great benefit with the low potencies. Here I have often used the X potencies instead of the C. The C correspond more to the higher frequencies of disturbance as they are more potent than the X potencies.

The frequency of energy of a disturbance is a relative term, by which I mean that—the higher the frequency, the more is the ‘energy’ of expression of the symptoms.
The symptoms will be sharp, strong, marked, and violent.
The ‘higher’ potencies correspond to these sublimated forms of expression.

The lower the frequency of energy of a disease, the lower is the intensity of expression of symptoms.
Like it is in our patient. So the lower potencies are more similar here. Though certainly not a material dose!

The low potencies correspond to the more physical aspects of disease; to the disturbances of a lower frequency so to say.

The problem with him right now, is- his failing kidneys.
I could not have given him a higher potency as his constitution would have been overwhelmed by it. They would just not correspond to him! It would bring about aggravation.
So he had one dose of Natrum Mur 6X.

He reported back about a month later on 17th July 2003, with his BUL and S. Cr. Levels.

BUL was 136 mg/dl……which had been 220 mg/dl before.
S .cr was 3.15 ug/dl……which was 3.9 ug/dl before.


He said ‘I feel more energetic’ and he looked less yellow for sure. He looked more interested than before. This means the syphilitic miasm has reduced in its activity a little.

Placebo was continued up to 29/09/03. His allopathic medications continued as before.

Now his BUL was 166 mg/dl
S.cr 3.9 ug/dl

During this period, he had an episode of vertigo.
He also had fluctuations in Blood sugar levels in the last one week.
He seemed to be more irritated this time. His wife said he seemed to want to cast off all the restrictions put upon him by doctors.
He decided that he wanted to travel to Canada, to his daughter. ‘I need to travel. It is a tonic for me. I always wanted to travel. But my wife’s osteoarthritis never let us go anywhere. My kidneys feel better now. Please give me something that I can travel without a problem with them’.

Do we see here the rebellious Tubercular miasm coming up! Let us recall that he was a thinker, poet and teacher, the creative Tubercular.

These statements were quite startling as compared to his first visit. He seemed to have come out of the Natrum Mur phase. He wanted to go out, travel, connect back with his distant relatives, and even risk his health for that.

This brought to mind another member of the Natrums, Natrum Phos.

The outgoing, communicating effervescent Phosphate radical, who can burn himself by his own warmth if he is not able to give it out.

Now Natrum Phos 12X was given.

I chose the 12X now, as we see that the ‘energy’ of his symptoms have increased to a higher level. The frequency is higher than a 6X.

Nat phos has known to have an affinity for the pancreas and hence diabetes; says the Biochemistry man Schussler.
Nat phos is irritated. And incidentally our patient had a deep yellow coated tongue which confirmed my choice of Natrum Phos!

2 months later, his BUL was 97 mg/dl….(previous reading – 166mg/dl)
S.cr 2.2 ug/dl ……….(previous reading- 3.9 ug/dl )

His allopathic anti-hypertensive and insulin shots continued, but he needed only half the initial dose now!

This was encouraging.

He went on well for about 3 years. He did travel abroad to Canada to visit his daughter, and enjoyed his stay there for a period of six months. After Natrum phos, he did not rebel against medical advice regarding diet and regimen, and so did not ‘burn’ himself, or I mean land himself into trouble, like he would have without our Natrum Phos 12 X.
He was independently going about his routine activities and even went out alone for a short walk.
He visited every month and was quite stable. As symptoms came up he got a single dose of the indicated remedy. Natrm sulph 30 X one dose on one occasion and Nux vomica 30 one dose on another.

3 years later he started deteriorating. He complained of breathlessness, and disorientation.
He died of cardiac arrest peacefully at the ripe age of 76 years.

We do understand here that it was a case with irreversible renal damage. But the medicine seemed to have accentuated the functioning of the remaining healthy renal cortical tissue for a fairly good period of time. He did not require dialysis except on the last day of his life, as his condition had been stable, and his blood biochemistry was fairly good.

Homeopathy could give him a better quality of life. I can say that it was probably even considerably prolonged with Homeopathy.


Dr. Swapna Potdar
BHMS (Pune, INDIA)
D. (Hom)Devon, (UK)


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May20
Painkillers
Zingeber Officinale
Nux Vomica
Lycopodium
Apis
Withania Somnifera


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May10
LAPAROSCOPIC ADRENALECTOMY
1. What is an adrenal gland?
The adrenal glands are paired endocrine glands that produce hormones involve in regulating blood pressure, blood electrolytes and body metabolism. There is one adrenal gland located at the upper pole of each kidney.
2. What are the symptoms of adrenal gland tumor?
Adrenal gland tumors commonly overproduce one hormone. This can result in high blood pressure that is difficult to control, muscle weakness due to low blood potassium or excessive weight gain, skin striae, moon face etc consistent with Cushing's syndrome. Alternatively, they can present with symptoms related to the mass effect of the tumor or pain when the size is large and invades surrounding tissues. Occasionally, the adrenal tumor maybe detected incidentally during investigation for unrelated reason.
3. How can adrenal tumor be detected?
Detecting an adrenal tumor requires combination of biochemistry tests for hormones in the blood and radiologic imaging of the adrenal glands, usually computerized tomography (CT scan) or magnetic resonance imaging (MRI scan). Angiography (radiography with the use of contrast in the blood vessel) maybe indicated in selected cases. Majority of the adrenal tumor are benign.
In the rare incidence of adrenal gland hyperplasia due to excessive external stimulating factors from the pituitary, CT scan or MRI of the brain may be needed.
4. What are the indications for laparoscopic adrenalectomy?

• Benign functioning adrenal tumors, such as pheochromocytoma, Conn's syndrome.
• Adrenal hyperplasia with excess hormone production resulting in disturbance of body metabolism eg Cushing Syndrome.
• Non-functioning or incidental adrenal mass without malignant feature
• As part of adjuvant hormonal ablation for hormone sensitive tumor eg breast cancer.

*Laparoscopic adrenalectomy is generally not recommended for malignant adrenal tumor, large adrenal masses (>10 cm) and in patients with bleeding tendency.
5. How do I prepare for the operation?
Your endocrinologist will check and ensure that your hormonal balance, blood pressure and electrolytes are optimally controlled prior to the operation. These may take several days to few weeks.
Arrangement will be made for an anesthesiologist to assess your general fitness for general anesthesia and the operation. Some baseline blood tests, chest X-ray and ECG will be done.
You will be admitted to the hospital one day before the scheduled operation. Blood tests may need to be checked one more time, and blood and blood product standby for the operation. You may be given laxative to clear your bowel in preparation for the operation.
6. How is the operation conducted?
Laparoscopic adrenalectomy is performed under general anesthesia and with the patient in the semi-lateral position. We prefer the trans-abdominal approach. The abdominal cavity is distended by insufflation with carbon dioxide to create space for the operation. Visualization is achieved with a 10mm diameter rigid telescope and the operation carried out using two to three 5mm-diameter instruments. Majority of the adrenal tumor secrete active hormones, the approach is to detach the adrenal gland from its surrounding tissue, ligating its connecting blood vessels and minimal handling of the gland; to minimize sudden release of active hormones to the blood circulation causing fluctuation in blood pressure. The completely detached adrenal gland is then retrieved using a plastic pouch.
7. Are there dangers associated with the operation?
Complications following laparoscopic adrenalectomy are few. Symptoms related to anesthesia such as nausea, headache and sore throat are quite common. Collapse of lungs bases, leg vein thrombosis and embolism of clots to the lung, and wound infection may affect small number of patients. These complications are more common among patients with Cushing disease.
More specific surgical complications such as bleeding, damage to adjacent organs occurs rarely but may necessitate conversion to conventional operation via open wound.
Fluctuation of blood pressure may occur during operation especially in patients with pheochromocytoma. The anesthesiologist in attendance will be prepared to counter these with intravenous drugs.
8. What can I expect after the operation?
Post anesthetic nausea, headache and sore throat are common; you will be prescribed medications to relieve these symptoms and they usually resolve after 1-2 days.
Majority of patients have good pain relief with oral analgesics only. If needed, patient control analgesia can be added and is very effective in relieving surgical wound pain.
Most patients recover without complications and are well enough to go home on 2nd or 3rd post-operative day. The surgical stitches can be removed after one week.
The opposite normal adrenal gland may be suppressed by the abnormally high hormones level from the tumor and may take a while to regain normal function. During this period, you may need replacement hormone therapy. Your endocrinologist will be attending to you and these medications will be weaned off in the next few weeks.
9. When can I return to work and resume normal activities?
This varies from patient to patient. One of the advantages of laparoscopic adrenalectomy is the smaller wounds, therefore faster recovery and lesser wound pain. Most patients recover very quickly after laparoscopic adrenalectomy and are comfortable returning to normal daily activities such as driving, walking, climbing stairs and deskwork within the one week. However, strenuous physical exercises are usually not recommended until at least 4-6 weeks after the operation.
10. Are there long-term problems after the operation?
There is no significant long-term side effect following removal of one adrenal gland. In fact, excessive hormones production from adrenal gland tumor is one of the causes of the rare form of secondary hypertension; this can be cured after excision of the adrenal tumor. The remaining adrenal gland can normally compensate adequately for the absent counterpart although it may take a while (up to a few weeks) to regain normal function after being suppressed by the abnormally high hormonal level from the tumor. Patients who have had bilateral adrenalectomy need long-term hormonal replacement therapy.


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Apr12
Diabetes impacts Kidneys:
The most common prescription for diabetes is Insulin and Insulin often causes damage to the small blood vessels of the body. This damage also impact the retina of the eye and result in loss of vision and slowing this damage is extended to the delicate blood vessels in the filters of the kidneys. Diabetes may also damage the nerves in the body including the bladder; it may be difficult to pass urine with infected bladder. The pressure from urine building up in the bladder can cause kidney damage.

Chances of a diabetic person developing a kidney disease are very high (more than 60%). If left untreated, this could lead to more kidney damage or kidney failure.

One can have serious kidney damage without being aware of it. There are usually no specific symptoms of kidney disease until the damage is severe. However, if you have diabetes, you should be tested once a year to see if diabetes has affected your kidneys. Your doctor can arrange a urine test for protein (a random urine test for “albumin to creatinine ratio”), and a blood test to check how well your kidneys are functioning (the “serum creatinine”).

Symptoms:

Early symptoms of kidney disease show high level of protein in the urine. Eventually excess loss of protein from the blood causes the water from the blood to move into the body tissues causing swelling (edema). Itchiness, breathlessness and tiredness may also occur before the kidney failure occurs.

Cause of kidney disease:

Kidney infection is another major cause of kidney failure. Diabetic patients show high level of sugar in their urine causing the growth of bacteria. People with diabetes must take special care to avoid infections and have them treated immediately.

Kidney failure:

When the kidneys are about to fail you might experience tiredness, nausea and vomiting. You could also retain salt and water, which could cause swelling of your feet and hands, and shortness of breath. You may also find that you need less insulin than usual. When the kidneys fail, wastes and fluids will accumulate in your body and you will need dialysis treatments or a kidney transplant. You may be referred to a nephrologist (a kidney specialist) if your doctor thinks the damage to your kidneys is severe.

What can you do to prevent kidney damage?

There are special treatments (including proper food choices and medications) which may help to delay kidney failure. It is necessary to start these treatments as soon as your doctor notices any of the early signs or risk factors.

There are many things you can do to help prevent kidney damage:

* Have your urine, blood and blood pressure checked regularly by your doctor
* Maintain good control of your blood sugar
* Control high blood pressure (less than 130/80* on most readings)
* Stop smoking
* Exercise regularly
* Make the proper food choices
* Avoid excess alcohol
* See your doctor if you think you have a bladder infection
* Get enough sleep

If you are suffering from kidney failure and would like more information on alternative medicine, please visit www.kundankidneycare.com


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Apr12
Hypertension (blood pressure) and Kidney Disease
High blood pressure is the second most leading cause of kidney failure, and end-stage renal disease (ESRD). Blood pressure measures the force of blood against the walls of the blood vessels. Extra fluid in the body increases the amount of fluid in blood vessels and makes blood pressure higher. Narrow, stiff, or clogged blood vessels also raise blood pressure.

High blood pressure makes the heart work harder and, over time, can damage blood vessels throughout the body. If the blood vessels in the kidneys are damaged, they may stop removing wastes and extra fluid from the body. The extra fluid in the blood vessels may then raise blood pressure even more. It’s a dangerous cycle.

People with kidney failure opt to one of the two choices, either receive a kidney transplant or have regular blood-cleansing treatments called dialysis. Both options do not offer any assurance that the person will live a normal life. Dialysis is not a cure but a temporary solution to blood-cleansing and with transplant a regular medication is required and there are too many other complications. One of the things that may help avoid kidney failure is to keep the blood pressure under control.

Like high blood pressure early kidney disease is a silent problem and does not have any symptoms. People may have CKD but not know it because they do not feel sick. A person’s glomerular filtration rate (GFR) is a measure of how well the kidneys are filtering wastes from the blood. GFR is estimated from a routine measurement of creatinine in the blood. The result is called the estimated GFR (eGFR).

Creatinine is a waste product formed by the normal breakdown of muscle cells. Healthy kidneys take creatinine out of the blood and put it into the urine to leave the body. When the kidneys are not working well, creatinine builds up in the blood. This reading alone can give a good indication if there is any abnormality about kidneys.

Another sign of CKD is proteinuria, or protein in the urine. Healthy kidneys take wastes out of the blood but leave protein. Impaired kidneys may fail to separate a blood protein called albumin from the wastes. At first, only small amounts of albumin may leak into the urine, a condition known as microalbuminuria, a sign of failing kidney function. As kidney function worsens, the amount of albumin and other proteins in the urine increases, and the condition is called proteinuria.

Many people need medicine to control high blood pressure. Several effective blood pressure medicines are available in modern and Alternate medicine. The most common types of blood pressure medicines doctors prescribe are diuretics, angiotensin-converting enzyme (ACE) inhibitors, angiotensin receptor blockers (ARBs), beta blockers, and calcium channel blockers. Diuretics, also known as “water pills,” help a person urinate and get rid of excess fluid in the body. A combination of two or more blood pressure medicines may be needed to keep blood pressure below 130/80. In Ayurveda Sarpgandha, Vacha, Brahmi, Punarnava, are the herbs which can control mild to moderate blood pressure.

All these medicines may be required to keep the blood pressure low however, the bigger question is how to cure the disease? Transplant or Dialysis is not a cure but a temporary solution to the situation.

To find out more about the alternative herbal cure for kidney disease, please visit http://www.kundankidneycare.com


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Apr06
KIDNEY OR RENAL FAILURE CAUSE AND SYSMTOMS
Heavy Metal Toxicity and Kidney Disease

Heavy metals are metals that are at least five times denser than water. They cannot be metabolized by the body and include mercury, nickel, lead, arsenic, cadmium, and aluminum. Our Kidney Helper product is recommended for helping to balance the body allowing it to purge heavy metals from the kidneys. Heavy metals have no function or nutritive value in the body and are toxic. In modern society, toxicity from heavy metals is a growing problem throughout the world.

Heavy metals can be taken into the body in several ways. Inhalation, absorption through the skin, and ingestion are three examples. If you take them into your body and they are allowed to accumulate faster than the body can detoxify them, heavy metal poisoning will occur.

You do not need heavy exposure at once to become poisoned by heavy metals. Light exposure repeated over time will do the same amount of damage. Metals can accumulate in your fat cells, in your liver and kidneys, and in other organs. Heavy metal toxicity can impair many different systems in the body, including kidney, liver, and colon--and can cause skin damage, cardiovascular illness, and endocrine, gastrointestinal, immune, and nervous system damage.

If you suspect you have heavy metals in your system, there are several ways you can be tested. One is through a kidney biopsy or a bone biopsy. Blood and urine can also be examined. A less invasive method is to have your hair tested. Because your body tries to rid itself of heavy metals, they often show up in your hair. Many times, however, doctors overlook the possibility that people are poisoned this way, and the problem goes undiagnosedKidney Damage

The location of the kidneys protects them from many external forces. They are located deep within the abdomen. Protected by the spine, lower rib cage and back muscles, this location keeps their large blood supply intact. Still, kidneys can be injured if there is damage to the blood vessels that supply or drain them. If you were to injure your kidneys, you could bleed severely. People with undiagnosed kidney conditions are more susceptible to injuries to the kidneys.

Each kidney filters about 1,700-2,000 liters of blood per day, outputting waste into about one liter of urine per day. This exposure to toxins each day makes them highly susceptible to injury from toxic substances. When waste products are allowed to build up within the kidneys, toxic kidney damage can occur. Medical procedures such as surgeries and certain medications can also do damage.

Symptoms of acute kidney damage should be treated as an emergency. They may include severe pain in the flanks, back pain, fever, abdominal swelling, blood in the urine, drowsiness, coma, increased heart rate, pale skin and sweating. A decreased output of urine or inability to urinate is also a symptom. Symptoms of chronic kidney damage include irritability and weight loss, and constipation occurs with toxic injury such as lead poisoning.

To prevent kidney damage, it is necessary that you stay on top of your health. Drink plenty of flKidney Disease And High Blood Pressure

High blood pressure is one of the most common causes of kidney disease. It's also a common cause of kidney failure (end-stage renal disease). When we get older, we experience a higher risk of serious health problems, such as cancer, heart disease, and kidney disease. Those of us with hypertension or diabetes have an even higher risk of developing kidney disease. Fortunately, often, it can be prevented.

The reason high blood pressure increases risk of kidney disease is because it can damage blood vessels and filters in the kidney. The kidneys' main function is to filter waste and clean the blood. The damage caused by hypertension makes it difficult for the kidneys to remove waste from the body.

High blood pressure can sometimes be a symptom of kidney disease. Other symptoms include difficulty urinating, a decrease in the amount of urine, and edema, especially in the lower legs. The need to urinate more often is another symptom. Lab tests such as testing the blood for serum Creatinine and blood urea nitrogen can help diagnose kidney disease. Too much of either substance in the blood can mean there is damage to the kidneys.
If you have high blood pressure, there are certain things you can do that will help in preventing kidney disease. First, try to keep your blood pressure below 130/80, and take your medicine properly. Check your blood pressure on a regular basis, and eat right. As with any disorder, see your doctor for proper diagnosis.uids and avoid becoming dehydrated. Keep your blood pressure at an acceptable level and if you have diabetes, manage it well. Finally, see your health care practitioner if you have any of the above symptoms in order to get a proper diagnosis.


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Mar09
Robotic HIFU for prostate cancer treatment
Our website : www.mpuh.org


MULJIBHAI PATEL UROLOGICAL HOSPITAL (MPUH)
A ‘NOT-FOR-PROFIT’ TRUST HOSPITAL

SUPER SPECIALTY NEPHRO-UROLOGY HOSPITAL
ISO 9001:2000, CRISIL RATING ‘A’

‘Every life deserves world class care’

PRESS RELEASE – 18th JANUARY, 2009

ROBOTIC HIFU Ablatherm – FIRST TIME IN INDIA


Muljibhai Patel Urological Hospital (MPUH), popularly known as Nadiad Kidney Hospital, has procured and commissioned the state-of-the-art Robotic HIFU Ablatherm – High Intensity Focused Ultrasound - for treatment of Prostate Cancer. MPUH has become the first hospital in the country to have this state-of-the-art Robotic equipment.

During the Press Conference, well known Urologist and an expert on Robotic HIFU, Dr. Stefan Thuroff from Munich, Germany, explained the stages of prostate cancer; the reasons why prostate cancer is not generally detected early enough to treat it more efficaciously and cost-effectively; the need to build awareness leading to timely preventive check-ups, etc. He emphasized the fact that the earlier the cancer is detected, faster it becomes to cure prostate cancer. He also explained the advantages of using Robotic HIFU for the treatment of prostate cancer. Others present at the press conference included Dr. Mahesh R. Desai, Managing Trustee and Head of Urology, and Dr. M M Rajapurkar, Medical Director and Head of Nephrology.

Early prostate cancer can be cured by surgery or HIFU, but the reality in India is that by the time patient becomes symptomatic, prostate cancer is advanced where nothing much can be done by way of treatment. We have taken the lead to acquire this new technology for the first time in India which will give more options to treat various stages of prostate cancer from ‘early’ to ‘advanced’. The beauty of this technology is that it is non-invasive, state-of-the-art technology which is truly robotic. Robotic means, it designs, acts and re-acts; it has the highest degree of safety and efficacy.

What is HIFU?

HIFU, which is short for High Intensity Focused Ultrasound, is a state-of-the-art technology acoustic ablation technique that utilizes the power of ultrasound to destroy deep-seated tissue with pinpoint accuracy for treatment of prostate cancer. HIFU focuses sound waves in a targeted area which rapidly increases the temperature in the focal zone causing tissue destruction.

In most cases, HIFU is a 1 – 2.5 hour, one-time procedure performed under spinal anesthesia. Unlike radiation, HIFU is non-ionizing; this means that HIFU may also be used as a salvage technique if other prostate cancer treatments fail, like Radiation or Surgery, both of which are painful and requires hospitalization for 4-5 days.

How Does HIFU Work Against Prostate Cancer?

In order to understand the basic concept of how HIFU works, an analogy can be drawn between HIFU ablating the prostate and sunrays entering a magnifying glass to burn a leaf. When a magnifying glass is held above a leaf in the correct position on a sunny day the sunrays intersect below the lens and cause the leaf to burn at the point of intersection. If you insert your hand into the path of either one of the sun rays individually, away from the point of intersection, there is no significant heat felt or harm caused. Alternatively, if you place your hand at the point of intersection you will be burned.

The scientific principles at work in this example are the same as those with HIFU. Instead of light as the energy source, HIFU utilizes sound. Instead of a magnifying glass HIFU uses a transducer. Just as the individual sunray is harmless to the hand, and individual sound wave is harmless to the healthy tissue it travels through.

During HIFU, the physician uses continuously updated real-time images of the prostate to map out and execute the entire treatment plan. These images show treatment progression and permit the physician to customize treatment for maximum safety and effectiveness.

The Benefits

• Non-invasive treatment
• Destruction of the cancerous tissue with minimal effect to the surrounding organs
• Treatment does not use radiation
• Treatment can be performed under spinal anesthesia
• Treatment can be repeated
• Other therapeutic alternatives can be considered if results are unsatisfactory.
• Ablatherm HIFU can be used for all tumor stages as for the treatment of local recurrences (i.e. after external beam radiotherapy).


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