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Category: blog

09 Jan 2020

DRA (Distal Radial Access)

Distal radial access for angiography and angioplasty is now the buzz. It is done by very few cardiologists in India.
Interest in distal radial artery access (DRA) is growing rapidly. Among the benefits of DRA are the low risk of entry site bleeding complications and the low rate of radial artery occlusion
At Apex hospital Mulund now Dr Mayur Jain does many of the diagnostic procedures from distal radial artery.
The advantages of this technique include:
1. Minimal Risk of Hand Ischemia Due to Preservation of Blood Flow in the Forearm
2. Advantages for Hemostasis
3. Reduction in Nursing Staff Time
4. Greater Comfort for the Patient and the Operator
5. The Sheath is Secured with Less Movement in the Distal Segment
6. DRA Leaves Additional Arterial Access Options Open for Crossover
Dr Mayur Jain a gold medalist in DM cardiology is well known for his innovative work and complex angioplasty. He is now available daily for procedures at Apex hospital, Mulund.
We promise better patient care, patient safety and patient comfort by using new technology at our hospital.

09 Jan 2020

OCT (Optical Coherence Tomography)

OCT is an imaging technique that uses low-coherence light to capture micrometer-resolution, two- and three-dimensional images from within optical scattering media (e.g., biological tissue)
It is an imaging tool used in angioplasty to give precise results and to prevent complications.
This imaging method helps the cardiologist to use proper size of stent and to see the details of the stent to the level of 200 microns so that all the complications related to stent opposition can be avoided.
It is a very small catheter which is negotiated in the coronary arteries to get these images from within the coronary artery.
This technology is now available at Apex hospital during angioplasty.
Dr Mayur Jain, DM cardiology, Gold medalist has learnt this technique at Cleveland clinic USA, and in multiple OCT workshops to make his angioplasty results even better. He is available daily at Apex hospital Mulund for the procedures.
All Multi specialty & Super specialty hospitals of Apex Group is delivering total patient care in an ethical and open environment with state-of-the-art equipment.
It is a chain of Hospitals managed and run by expert Medical Professionals with experience of 25 years. Currently we are managing more than 350+ beds and providing qualitative healthcare services to the people of Mumbai and surrounding areas.

27 Dec 2019

Ectopic pregnancy – A Life Threatening Event

A pregnancy which grows in any other place outside the uterus is called an Ectopic pregnancy. The commonest site for an ectopic pregnancy is in the tube. The pregnancy continues to grow there but as the tube can’t expand beyond a certain limit, it ruptures. This leads to torrential internal bleeding, which may not be visible externally at all. At times when the pregnancy test is positive, most women safely take it for granted that all must be well. However, a few women who actually experience an ectopic pregnancy in their lifetime will vouch that it is not safe to assume so.

When a woman misses her monthly period, and the pregnancy test is positive, the site of the pregnancy must be confirmed by an examination or an ultrasound.

We present a patient who was pregnant and who has bleeding after 6 weeks and assumed that she had a miscarriage. However, this mild bleeding is also seen in an ectopic pregnancy. The pregnancy continued at the junction of the uterus and her tube and one fine day, 7 weeks later, burst!!

She reached the hospital in pain and in a breathless condition. The symptoms were only for a few hours but she looked very pale. Ultrasound was not Confirmatory. Dr. Siddesh Iyer, the consultant Gynaecologist immediately diagnosed the case as ectopic pregnancy on history and clinical examination. When urine pregnancy test was done, it still was positive (which should have been negative assuming she had a miscarriage 3 weeks ago) , and the diagnosis was confirmed.

  • She was immediately taken for emergency surgery. She had 3 and half liters of blood in her abdomen. Including 100 grams of blood clots. The tube had burst at the cornual region (junction of the tube and the uterus) and was still bleeding profusely.
  • The bleeding was controlled and the condition started to improve.
  • She needed 3 bottles of blood and 4 fresh frozen plasma. She stayed in the ICU for 2 days..
  • She was kept in wards for another 2 days and was discharged on day 4.
  • Stitch removal was done on day 9 and the stitches were healthy.
25 Nov 2019

Simple Steps to Keep Your Heart Healthy

Heat diseases are not something to be taken lightly. It is always better to keep your heart healthy and prevent heart diseases instead of treating them. Here are some steps you can take to achieve this:
Have a yearly checkup of your cholesterol, blood pressure and glucose level. Take recommendations from a professional regarding keeping your heart healthy.

  • Exercise at least 15 minutes a day.
  • Drink lots of water to stay hydrated.
  • Have more fruits and vegetables instead of junk, processed food.
  • You need to keep a check on your cholesterol level. Eat food that is low in trans and saturated fat.
  • Lower your salt intake to regulate your high blood pressure.
  • Quit Smoking
  • Maintaining a healthy weight is important as excessive weight puts your heart at risk.
  • If you get off track, don’t lose hope and stay positive.
  • Give yourself some credit when you can successfully maintain your momentum

Keeping your heart healthy is simple when you look at the big picture: Get exercise. Eat right. Stress less. Watch your weight. Don’t smoke.

Follow these tips and you’ll be doing your heart a favor. You’ll feel better and be able to stay active with a heart-healthy lifestyle.

21 Jun 2019

Yoga — A Panacea For Mental Health Problems

Dr Pratik Surandashe, MD Psychiatry, Consultant Psychiatrist, Apex Group Of Hospitals, Borivali, talks about the relevance of yoga in holistic management of mental disorders and promote emotional well-being
Yoga means ‘union’. It implies the union of mind and the body. It has been part of the ancient Indian wisdom and has been practised since many millennia. It’s a way of life that transcends religions, socio-economic strata, creed or gender. There are four paths of yoga, namely, karma yoga (active path), Jnana Yoga (philosophical path), Bhakti Yoga(devotional path) and Raja Yoga (scientific path). From the above, Raja Yoga is the most popular path taken by many to achieve mental well-being. Raja Yoga employs eight steps:

  1. Yama- Right moral conduct
  2. Niyama- Self Discipline, contentment
  3. Asana- Postural exercises
  4. Pranayama- Control of breathing
  5. Pratyahara-Control of senses
  6. Dharana- Concentration
  7. Dhyana-Meditation
  8. Samadhi- the super-conscious state

The Indian sage Patanjali mentioned in his first yoga sutra (or aphorism) that “yoga is the restraint of mental modification”. It is no surprise that many mental health professionals are advising their patients to practice yoga. In India, path-breaking studies are being done to know the effects of yoga on various psychiatric illnesses. Sudarshan Kriya Yoga, Pranayama, Sahajyoga and Asanas are being used effectively either as the primary treatment modality or as an adjunct to pharmacological treatments in various mental health disorders.

Follow these tips and you’ll be doing your heart a favor. You’ll feel better and be able to stay active with a heart-healthy lifestyle.

Yoga is culturally acceptable, needs minimal supervision, is largely free of side effects when practised properly and last but not the least, it gives the patient a sense of control over their illness. These distinctive qualities of yoga contribute to its universal appeal.

Looking at the case of Mrs A, a 35-year-old housewife who had come to our hospital complaining of sad mood, loss of pleasure in life, easy fatigability, poor appetite and poor sleep quality from months. After the results of her thorough physical and laboratory examination came out to be normal, she was finally advised to seek psychiatric help. Mrs A was diagnosed with major depressive disorder. She complained that she couldn’t carry out her day to day responsibilities. She also reported that she has stopped meeting her friends and felt guilty for no apparent reason. Mrs A consented to treatment and was treated with antidepressant medication.

Within a period of two weeks, she reported an improvement in her mood and appetite. She also underwent counselling and regular follow-ups showed significant improvement in most of her symptoms which was further endorsed by objective measurements. However, intermittently, Mrs A would still complain about feeling low and having poor sleep. She especially complained of not feeling fresh upon waking up in the morning. So as a part of lifestyle modification, she was advised yoga practice.

She consulted a yoga practitioner and started practising pranayama, meditation and asanas. Gradually her sleep improved and Mrs A experienced a near-complete improvement in her symptoms. This shows that yoga can be used as a treatment modality in conjunction with medications and counselling, especially for residual symptoms persisting despite adequate treatment.

Today there is ample evidence to suggest that yoga improves the levels of Serotonin and Brain Derived Neurotrophic Factor (BDNF) which are low in patients suffering from depression. It also attenuates the over-active hypothalamo-pituitary-adrenal axis in patients of depression and provides relief from fatigue and being chronically stressed out.

In another case, Mr B, a 29-year-old male working as a finance executive in a multinational company, suffered from repeated episodes of feeling nervous and “being on the edge”. He would get palpitations, breathlessness, sweaty palms and dry mouth before making presentations to seniors or when facing difficult work projects. He came to our hospital seeking help to manage his anxiety. Mr B reported a very stressful work environment and was interested in trying out yoga to mitigate his problems. We trained him in relaxation and breathing exercises. He was advised to keep practising the breathing exercises even at work. After some time, he reported that he was able to handle the stressful situations at work more successfully with the combination of yoga and medications.

Yoga reduces stress by releasing GABA, a chemical which produces a relaxed state of mind. It influences the autonomic nervous system to reduce the sympathetic arousal that produced anxiety symptoms. Ashtanga Yoga also employs mindfulness in its practice of asanas and pranayamas. Mindfulness means ‘staying in the present’. A person who worries about the future is anxious and thus, yoga keeps the person focussed on the ‘now’.

Along with depression and anxiety, yoga is proven to improve cognition in patients with schizophrenia. It improves negative symptoms like avolition, anhedonia, asociality. It helps by releasing oxytocin, a hormone which improves bonding with others. Apart from the patients, yoga also helps their caregivers by reducing their stress levels.

Sudarshan Kriya Yoga also helps people with alcohol addiction. It reduces symptoms of depression occurring during alcohol withdrawal and also in the long-term treatment. Depression is a common comorbidity in alcohol addiction and is a risk factor for relapse after treatment. Fortunately, the practice of yoga reduces the chances of relapse.

Children with Attention Deficit Hyperactivity Disorder (ADHD) also benefit from yoga. Practising yoga in addition to pharmacological treatment has been known to improve inattention in many children with ADHD. It can be effectively done in the evening after school hours as a fun activity along with other family members.

Yoga is helpful to all age groups. When practised by senior citizens it improves sleeping disorders like insomnia. It promotes a sense of well-being and enhances the quality of life in the geriatric population.
The ancient wisdom of yoga is now being recognized as a relevant tool even in the practice of modern medicine. It is slowly becoming a mainstream modality for holistic care of patients and will soon be indispensable.