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20 Feb 2023

Doctors At Apex Group Of Hospitals Successfully Complete First Ever Shockwave-Assisted Angioplasty

The first Shockwave Intravascular Lithotripsy (IVL) assisted complex angioplasty done by Dr Hemant Khemani and Dr Sagar Yesale in the ASH cath lab was successful.

Firstly let’s go through the process one by one to know what is this technique:

The Shockwave Intravascular Lithotripsy (IVL) System with the Shockwave C2 Coronary Intravascular Lithotripsy (IVL) Catheter includes the Shockwave C2 Coronary IVL Catheter, IVL Connector Cable, and IVL Generator. A tube-like device referred to as a balloon catheter contains integrated lithotripsy emitters, which can break down hard materials (calcification) that restrict blood flow to the heart.

What Happens during this process?

The doctor makes a small incision (incision) into the patient’s arm or leg in order to deliver the catheter into the cardiovascular system. 

The lithotripsy emitters at the end of the catheter apply pressure waves intended to break up the clots obstructing the heart’s blood vessels. This assists to open the blood vessels when a balloon is inflated (angioplasty). After using the Shockwave system, the physician will implant another device called an angioplasty balloon, which is a metal tube that helps keep the vessel open

When is this technique used and what are its possible outcomes?

The real question in your mind would be when is this technique used. Well! The Shockwave C2 Coronary IVL Catheter is used before implanting a stent, to open the arteries that supply blood to the heart (coronary arteries) that are narrowed or blocked due to calcification. The device allows for the opening of calcified arteries to allow stent implantation. In the clinical trial of 384 patients, 92% of them were able to receive the stent and survived without a heart attack or another procedure for 30 days. After one year, approximately 75% of patients survived without a heart attack or additional practice.

30 Jan 2023
Shortness of breath

Is Shortness of Breath Hinting a Bigger Issue?

One who typically feels short of breath may have found an early symptom of an underlying condition. Shortness of breath is a normal reaction to weaker heart performance.

If you’re doing something you usually do while experiencing shortness of breath, or there’s shortness of breath when you’re not exerting yourself, that could be a sign that a heart condition which is causing the symptoms. In most cases, asymptomatic instances of hypertension are numerous. This is due to the fact that many people don’t experience any physical symptoms, unfortunately.

Keeping in mind the fact that a number of these symptoms are known to be part of serious underlying issues, idioms like “The chest pain or discomfort up to dizziness or fainting with activity, worsening, fluid retention (oedema), and coughing blood signify that you must see the doctor” can relate to the case at hand. You require immediate medical action if you discover that these symptoms have appeared suddenly. If you do not catch the issue quickly enough, your symptoms may worsen or possibly be permanent.

A couple of symptoms similar to moderate or serious headaches, nervousness, shortness of breath, nosebleeds, palpitations, or tingling sensations in the throat might be the outcome of high blood pressure. For this reason, contact your physician as soon as possible to schedule a check so you can monitor your health on an ongoing basis.

As the age-old saying goes….

“PREVENTION IS BETTER THAN CURE” so visit your nearest doctor and get evaluated as soon as possible.

– Article by 

Dr Sagar Patil

27 Jan 2023

Have you ever thought that diabetes can be reversed?

Diabetes is a serious condition that affects millions of people worldwide. For many years, it was believed to be an incurable disease with no treatment options available. However, recent studies have shown that it is possible to reverse diabetes naturally and effectively. Diabetes is said to be reversed when your HbA1c is less than 6.5% and stays in this range for at least 6 months WITHOUT medications. The next obvious question in everyone’s mind is – How to reverse diabetes, go off of medications and live a worry-free life?

Reversing diabetes can be achieved through a combination of medications and other solutions. Many medications are now available to help people with diabetes control their blood sugar levels, and they should be taken as prescribed by a doctor. Other solutions may include lifestyle changes such as dietary modifications, regular physical activity, and weight management. In order to reverse diabetes, reducing the amount of fat in the diet is essential. This leads to a decrease in the fat stored inside muscle cells, which increases their sensitivity to insulin. As a result, the body is better able to control blood sugar levels and manage diabetes more effectively. By focusing on reducing fat intake and maintaining muscle mass, it is possible to effectively reverse diabetes without losing muscle mass. Making positive lifestyle changes is also essential to managing or reversing type 2 diabetes. Eating a well-balanced diet and exercising regularly are the two most important components of these changes. It has many benefits such as increasing insulin sensitivity, improving blood sugar control and reducing cardiovascular risk. Exercise helps to lower the risk of developing diabetes complications by helping to strengthen the heart and reduce inflammation. Regular exercise also reduces stress levels, boosts mood and energy, and helps people maintain a healthy weight.

Bottom line:

Diabetes (Type II) can be reversed with the right approach, time and effort. Diabetics should focus on nutrition, exercise and lifestyle changes to improve their overall health. The key is to find a combination of treatments that works for them. It’s important to remember that reversing diabetes takes time and dedication, but the result can be well worth it. A visit to your doctor is the best first step in creating an effective plan for reversing diabetes.

– Article by 

 Dr Balbir Singh

17 Jan 2023
Arthroscopic Surgery in Mulund

As winter chill plays havoc on joints, here’s how to keep them healthy

The problem in joints and bones does not just restrict your movement but can also cause a lot of discomfort and pain. If you do not take care of them properly, with the onset of winter, problem in bones and joints is inevitable.

What causes joint pains in winter?

Due to the cold temperature, the pain threshold of the body decreases as the nerve endings become sensitive, exceeding the pain tremendously. Another reason for joint pains is that the blood doesn’t circulate properly in the body parts causing pain and stiffness in the joints.

In winter, the physical activity of the body also decreases and hence, the joints start paining. Another reason behind this can be the restricted absorption of Vitamin D (sunlight) in your body during winter.

What to do?

Healthy Lifestyle: Balanced Diet and Exercise

A balanced diet is key to overall healthy living. Eat a diet which comprises fruits, vegetables, cereals, dairy products and pulses. Along with diet, physical activity is also important. Your physical activity may not necessarily be an hour in the gym but can also be a 30-minute brisk walk. To maintain a healthy life, one needs to eat calories and then burn them, so keep moving. Exercising also strengthens the muscles and maintains your weight and thus supports your knees to balance your weight

Warm-up before exercise is important:

Exercise is important but makes sure that you warm up before starting any rigorous exercise. This will avoid injury and make your body more flexible. The warm-up also increases your blood circulation which increases the effect of exercise. 

Stay Hydrated:

Many associates it with combating dehydration but water is essential for joint pain relief as well. In winter, we tend to reduce our water consumption but it is necessary because the cartilage between the joints has to be smooth and in order to maintain the right amount of friction, the body needs to be hydrated

Stay Active, Maintain Weight:

Changes in dietary habits and reduced physical activity during winter can result in weight gain. This increases the load on major joints like the knees which can cause or worsen joint pain. Reducing body weight can help prevent pain

Say No To Carbonated Drinks:

Caffeinated drinks like cola and other fizzy ones minimise the absorption of calcium. And calcium deficiency can lead to problems in bones. So, apart from having calcium-rich food, one should avoid having fizzy drinks so that the calcium that you are having is absorbed by your body

Avoid Smoking:

It is a lesser-known fact that people who smoke tend to have lower bone density and hence, are at higher risk of issues related to bones and joints. Quit smoking for a healthier lifestyle and robust bones!

Maintain Right Posture:

Standing and sitting in the right posture prevents problems in joints and bones. Slouching can affect your bones and create a problem for you. Posture is important even when you are carrying something. If you pick up something heavy, then don’t bend your back rather bend your knee

Comfort Aching Joints:

Application of heat in the form of a hot water bag or electric heating pad can provide comfort to aching joints. Warm baths can also help relax muscles and relieve joint pain

Calcium-rich Diet:

Your body needs calcium to maintain stronger bones. Some calcium-rich foods are milk, yoghurt, broccoli, cheese, legumes, dry fruits, seafood and green leafy vegetables. And your body needs Vitamin D to absorb calcium. Both calcium and Vitamin D are essential in maintaining healthy bones and joints.

Watch Out For CKD ( VITAMIN C, K AND D)

People who have a problem with their joints and muscles are prescribed to have foods rich in vitamins D, K and C.

During winters we don’t get sufficient sunlight which is a vital source of Vitamin D. Apart from having a diet rich in Vitamin D you can also have a Vitamin D supplement once a week. A deficiency of Vitamin D can lead to osteoporosis if it persists for a longer time. These three Vitamins help in the absorption of calcium in the bones and also help in the production of cartilage. Examples of some foods rich in Vitamin D are fatty fish, egg yolks, milk and cheese. Some foods rich in Vitamin K are green leafy vegetables like broccoli, spinach, cabbage and kale. Some foods rich in Vitamin C are oranges, lemons, strawberries and kiwi.

Positive Mindset and Good Company:

From Our Ancient Texts:

नित्यं हिताहारविहारसेवी समीक्ष्यकारी विषयेष्वसक्त: ।

दाता सम: सत्यपर: क्षमावानाप्तोपसेवी च भवत्यरोग: ॥

One who indulges daily in healthy foods and activities, who discriminates the good and bad of everything and then acts wisely, who is not attached too much to the objects of the senses, who develops the habit of charity, of considering all as equal, of truthfulness, of pardoning and keeping the company of good persons only, becomes free from all diseases.

– Article by 

 Dr Tanay Nahatkar

MS Orthopedics

24 Nov 2022

Young Boy’s life saved by a Balloon

This is an interesting and motivating story of a young 21year old boy, who came from a remote village in Uttar Pradesh for his treatment in Mumbai. He had been suffering from fever, cold, cough and voice change for two months from July 2021. He kept visiting nearby physicians and surgeons but had no relief. His condition worsened and he could no longer eat or drink.

He came to consult Dr Binhi H. Desai, a practising ENT and Voice surgeon (Laryngologist) at Desai Orthopedics and ENT clinic and Apex Superspeciality Hospital, Borivali west, Mumbai. The patient had a nasogastric feeding tube and was coughing incessantly. He had lost weight and had become weak. Stroboscopic evaluation with Olympus Flexible system (World’s best technology) was performed at Apex Superspeciality Hospital, Borivali west. This facility (Olympus) is available only at this hospital in the western suburb. The larynx (voice box) was severely inflamed (refer to image 1). Sputum was sent for microbiological evaluation. It came as a bacterial infection for which he received the appropriate treatment. The patient showed improvement and the feeding tube was also removed. Gradually over two months, he started developing breathlessness which became so severe that he could not even tie his shirt. He developed a fear of dying due to breathlessness. He was afraid, he would not survive if he had an attack and hence, he started staying in a hospital. He again visited Dr Binhi H. Desai. At that time, he was in severe respiratory distress. Saturation on the oxygen cylinder was 88 per cent. He was immediately admitted for a detailed evaluation and to know the exact cause of his breathlessness, Dr Binhi H. Desai did an Endoscopic evaluation of airways with Laryngol-Bronchoscope (Flexible and Rigid) under general anaesthesia.  He had developed severe narrowing of the windpipe(trachea) measuring 8 cm in length. It was starting at the level of vocal folds (voice box) going below into the windpipe (total length of the windpipe is 10-12cm). The narrowing was the widest above and it tapered down to pinpoint with a diameter of just 3mm (The normal diameter of the windpipe is 20-25mm). His previously inflamed vocal folds had healed with scar formation. Multiple tissue specimens were taken for microbiological and pathological evaluation (refer to images 2, 3 and 4).

This required urgent surgery otherwise it could be fatal. 

Dr Binhi H. Desai performed a highly challenging procedure of Tracheal Balloon dilatation (images 5,6) under Thrive anaesthesia. The anaesthesia technique was also very challenging. In this, narrowed trachea with opened endoscopically with a balloon three times in the same setting. The surgery is very challenging as it is associated with complications and can also cause death on the table. The surgery was successful (refer to image 7 showing the completely opened windpipe). Immediately after the procedure, the patient further showed complete relief in his symptoms of breathlessness.  

His tissue report came as tuberculosis. Thus, he had a very rare presentation of primary tuberculosis of the trachea(windpipe). He was immediately started on anti-tubercular treatment.

Gradually he resumed his routine activities.

After the intensive phase (two months) and completion of anti-tubercular treatment. check Laryngol-Bronchoscopy of airways under short anaesthesia was done to access the previous site of surgery. He showed excellent healing. 

Presently, the patient is under regular follow-up. He has returned to his home town and is doing all his regular activities without any fear.

This is an inspiring and motivating story of a young boy who would not have survived had he not come at the right time to the right doctor. This also is a story of deep faith and trust instilled by the patient in his treating doctor. 

In the end, we want to conclude by saying that any symptoms such as voice change, breathing difficulty or swallowing difficulty requires a detailed assessment by a Laryngologist (ENT surgeon specializing in voice, swallowing and airways). These difficulties can severely affect your quality of life and can occasionally become fatal. Hence, timely help from a trained professional can go a long way in improving your health and life.


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