The Weird thing about emergence!!

As an Anaesthesiologist, we need to give sedation and anaesthesia to patients for short or long surgeries and procedures. The Anaesthetic drugs have varied effect on patient's brains, and makes them have some weird dreams, hallucinations to almost nothing. During my practice, i ve come across some really funny statements by patients when coming out of anaesthesia.
Here are a few

"Am I Alive" 

"Dude, this stuff was great, never felt so high"

"Where is my bartender, i need more"

"You are great, you are like god to me"

"Am I home"

"Get me out of this Airplane"

"So how long the surgery is gonna take"

"Is it over already"

"You come to my home tonight, lets have some scotch"

"U din't give me enough drugs, i'l settle things when u come outside the hospital"

"Gosh , that was so long"  

        

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Have a Hearty Life !!

There has been a growing incidence of heart diseases in India in the last decade. The levels have almost increased exponentially.

Today i had a patient for Coronary artery bypass surgery. He looked like a routine case for surgery. I took a look at his file. It said " 27 yrs / M " . I was really shocked to see his age. He has had an episode of Myocardial Infarction some 6 months back and now had come for a bypass surgery. Above all he was diagnosed of having Diabetes too. A guy with such young age has come with symptoms and problems, which a person used to have only after some 45-50 yrs a decade ago. Everyone had this mindset that heart diseases occur only in elderly. But nowadays, lot of  young population in india are having stress related cardiac problems. The incidence of heart diseases and similar problems, have been alarmingly high these days, with so much stress involved in day to day life. In this over competitive world, its tough to stay ahead of the rest, without taking a toll on ur health and mind.

Its better to take precaution from early age, rather than suffering later. Ive just put some points to take care of your beloved Heart -

Exercise regularly 

If you have a family history of heart disease, you really need to exercise regularly and maintain healthy lifestyle  

Meditation helps a lot , de-stresses you

Avoid eating oily fried food daily

Use refined safflower or sunflower oil for cooking, avoid coconut oil - lot of heart diseases seen in malayali population 

Avoid any addictions like alcohol or smoking, occassional drinking or smoking should'nt hurt :P

Eat more nutritious foods like green leafy vegetables, eggs, avoid more of meat.

Use less salt and sugar in your food

Be happy, don't worry much

Take 1-2 trips in a year. Its really important to get out of you routine schedule and visit some places of solaces and calm. 

Take less stress in life, you got just one life, so live it easy.

More Importantly be positive in life and be cheerful and smiling everyday.

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Anesthetist who??

These days, when i meet new people. I kinda don't want to say what im doing. because they don't understand wht do i do. Thers very little information about anesthesia or anesthetists among common people.
Few people have asked me, 'such a branch exists?' , 'sumtin related to asthma ?' , 'whts there in anesthesia - just make the patient sleep'. While in some the knowledge of anesthesia is limited to chloroform, an agent leisurely abused in bollywood. Well such weird and discouraging questions are just a small example of the amount of ignorance among common people.
I just want to put up a broader perspective of this reality. Anesthesiologists just don't make the people sleep, they also take care of the intensive care unit, trauma centres etc. They are usually the first person to be called in an ER, in case of emergency, usually life threatening circumstances. They handle specialized ventilators, and are often the last mode of help, when there is a difficulty in intravenous line. They are usually the part of all emergency teams in hospitals. Even in lot of surveys done across the world, even in the most educated of all countries, the info regarding anesthesia is very less.
Basically its a thankless job. because the patient usually comes to anesthetist either for a surgery or a dire emergency, there is not too much interaction with the patient. Like In a big budget movie, everyone sings the praises of the Actors or directors, the cameramen, choreographers, or editors, dont get so much credit like the others. Similarly in any successful surgeries, the limelight is on someone else. One senior doctor had rightly commented, Anesthesiologists are ' backbench doctors'. still no qualms about it , coz thts how its gonna be in the future too. I chose this field not for popularity but out of interest.
Adios

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HIV/AIDS in India!!

Today i got a SMS from N.A.C.O. It stated 'free, Confidential & Reliable HIV at the Integrated Counseling & Testing centre at your Nearest Government Hospital'.
Many of use might not know what N.A.C.O is .
N.A.C.O stands for National Aids Control Organization.
It is a semi-autonomous body, was established under the Ministry of Health and Family Welfare to implement the National AIDS Control program.
Its a very good move by the government to create more awareness of the disease. Currently India is among the highest HIV affected countries.
Problem is even in this era, there are so many people in our country who don't know much about HIV/ AIDS. Our great Ministers in the parliament think it spreads by Mosquito bite.
Many illiterate people in rural areas lack awareness of the disease, and many literate people in urban areas are ignorant about the disease.
Although you can get, tons of information in the net, ive compiled some important facts about the disease here.
Please check it out. If you have any queries, you can email me at shashdude@gmail.com
and don't worry your identity will be confidential.

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New Hope for Diabetics !!

Gastric Bypass Surgery which has been a boon for all the severely Obese people, has found to have long term benefits in Type 2 Diabetes Patients too.
Gastric bypass surgery, a type of bariatric surgery (weight loss surgery), is a surgical procedure that alters the process of digestion. Bariatric surgery is the only option today that effectively treats morbid obesity in people for whom more conservative measures such as diet, exercise, and medication have failed. Usually done is a procedure called Roux-en-Y Gastric bypass.
Though it is a major surgery and one has to weigh the risks of surgery and post-operative care before going for such a major surgery, it has good long term benefits in:

• persons with a Body Mass Index (BMI) greater than 40
  
• men who are 100 pounds over their ideal body weight or women who are 80 pounds over their ideal body weight
  
• persons with a BMI between 35 and 40 who have another condition such as obesity-related type 2 diabetes, sleep apnoea, or heart diseaseP

Procedure:
In this surgery, the size of stomach and small intestine are reduced, which leads to decreased demand for food leading to loss of weight. In the metabolic surgery for Type 2 Diabetes mellitus, technique is same but difference is alteration of length of small intestine without any alteration in stomach.
Mechanism of Action:
When the Small intestine's length is reduced, A portion of small intestine which has never been exposed to raw food, comes in contact with it. This leads to certain beneficial hormonal changes, which stimulates pancreas to secrete Insulin ( hormone implicated in causation of diabetes). This holds good for diabetes type 2 where there is atleast some insulin producing cells in pancreas. Whereas in type 1 , there is complete absence of insulin producing cells, so only treatment in that case is externally given insulin.
Many Experts say this surgery not only reduces the problem of Obesity, but also gives a better control of Blood Sugar, Cholesterol, Triglycerides etc. indicating having a role in arresting or delaying the progression of Chronic Diseases like Diabetes, Hypertension, Heart Disease.
According to some researchers, this surgery has found to be useful not only in Obese diabetics, but also in moderate to normal weight patients. For some patients it has been completely curative, and for many there has been drastic improvement in survival and quality of Life.
Well on the Other hand, Risks of a major surgery always prevail.

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Basics of CPR (Cardiopulmonary Resuscitation)

In our day to day life, We may face with emergency situations when a person near might collapse or stop breathing and you don't know what to do. So I am jotting down some basics of Resuscitation, which everyone must know.

Cardiopulmonary resuscitation, commonly called CPR, combines rescue breathing (one person breathing into another person) and chest compression in a lifesaving procedure performed when a person has stopped breathing or a person's heart has stopped beating. When performed quickly enough, CPR can save lives in such emergencies as loss of consciousness, heart attacks or heart attacks, electric shock, drowning, excessive bleeding, drug overdose, and other conditions in which there is no breathing or no pulse. The purpose of CPR is to bring oxygen to the victim's lungs and to keep blood circulating so oxygen gets to every part of the body. When a person is deprived of oxygen, permanent brain damage can begin in as little as four minutes and death can follow only minutes later.

In our Medical practice, We have been thought to always remember the " ABCs of Resuscitation". It means first you look for the A- Airway, then B- Breathing and finally C- Circulation. Airway Implies to check whether any object, foreign body or food material is blocking the Oral cavity, Air passage or the structures nearby. Breathing is checked by putting your ears or hand in front of the patient's nose, if present u will feel the warm gush of air. And Finally Circulation implies whether the patient's heart is pumping blood to other parts of the body which is felt by checking the pulse, preferably the 'Carotid Pulse' in the Neck. Every time the Resuscitation done should be in this order, which is vital for survival.

CPR in basic life support
Always First step if you see any victim who has collapsed, immediately call for Medical Help.
In the meanwhile, you can resuscitate the victim as shown in the adjoining picture.

Figure A: The victim should be flat on his back and his mouth should be checked for debris, foreign body etc.
Figure B: If the victim is unconscious, open airway, lift neck, and tilt head back.
Figure C: If victim is not breathing, begin artificial breathing. It is done by closing the victim's nose with one hand, with the other hand open the victim's mouth, take a deep breath and blow into the victim's mouth directly as shown in the figure. Give four quick full breaths.
Figure D: Check for carotid pulse.
Figure E: If pulse is absent, begin artificial circulation by depressing the central bone of chest called Sternum. Remember while giving the thrust on Sternum you should use your heel of the hand and keep your elbows straight. The thrust should be directly from the shoulders. Take precaution that you don't press too forcibly or else you will break the rib of the patient. The sternum should be pumped at a rate about 100/min with sternum sufficiently depressed up to 4-5 cm
Figure F: Mouth-to-mouth resuscitation of an infant.
The Resuscitation is conventionally given in the form of 2 successive breaths for every 15 chest compressions

I hope this might have given you some idea of resuscitation, If you have further doubts, I will be grateful to help.

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Hope for new Parkinsons' Therapy

Scientists have discovered a protein which may help to slow, or even reverse symptoms of Parkinson's disease.
Parkinson's destroys nerve cells that produce the brain chemical dopamine, causing movement and balance problems.
Finnish researchers found the new molecule can prevent degeneration of these cells - and help damaged cells start to recover.
Their paper, featured in Nature, showed symptoms eased in rats given injections of the protein.
Our new protein has great potential to be developed as drug for Parkinson's disease Dr Mart Saarma University of Helsinki
Current anti-Parkinson's drugs do not stop nerve cells from degenerating and dying, and their effects can be patchy and short-lived.
The researchers, from the University of Helsinki, believe the new molecule - dubbed conserved dopamine neurotrophic factor (CDNF) - has great potential as a treatment.
Previous research has centred on another protein - GDNF - which some research had suggested could improve symptoms in Parkinson's patients.
However, other studies have thrown doubt over the effect of the protein - and raised serious safety issues.
The Helsinki team decided to search for related proteins - known as growth factors - which worked in a similar way, but were likely to be better tolerated.
They found that CDNF, unlike other similar growth factors, was specific to brain nerve cells.
Experiments were carried out on rats bred to show symptoms similar to Parkinson's.
In tests, CDNF protected 96% of nerve cells in the brains of the animals from degeneration.
Delay in treatment
To test whether the protein could also help repair damage in nerve cells the researchers also waited a month before treating some of the animals to allow Parkinson's symptoms to really take hold.
This was designed to mimic the situation in human patients, who may already have lost 70% of their dopamine-producing nerve cells by the time they seek treatment.
Following treatment 58% of the dopamine-producing nerve cells were left alive, compared with just 26% in animals who did not receive the protein.
Lead researcher Dr Mart Saarma said: "Our new protein has great potential to be developed as drug for Parkinson's disease, but we need to do more animal experiments and also toxicology studies before we can start clinical trials."
Dr Kieran Breen, of the Parkinson's Disease Society, said the research was still at a very early stage.
"What is interesting is that the protein shows similar neuro-protective actions to GDNF which indicates that this general type of drug may be useful in the future for developing new therapies for treating Parkinson's.
"However, while GDNF showed some benefits in early clinical trials, larger trials showed side effects, which led to it being withdrawn. It is therefore too early to predict the therapeutic potential of CDNF."

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New Adult Stem Cell Treatment A Possible Antidote For Dilated Cardiomyopathy

Cardiomyopathy is a term that means "heart muscle disease." It is also a term describing a series of disorders causing primary heart muscle dysfunction in both men and women, often leading to heart failure or sudden death. It is estimated that dilated cardiomyopathy, the most common form of cardiomyopathy is responsible for 10,000 deaths each year in the United States. There is no known cure.

Now, Theravitae, an international biotechnology company based in Thailand, claim they have a new possible panacea for dilated cardiomyopathy -- Theravitae's adult stem cell therapy. Theravitae's patented adult stem cell therapy, VesCell, is proving a lifeline to all those heart patients who do not wish their lives to be characterized by restricted activity, low energy, pain, cost and brevity. One of their biggest success stories is Michigan native, Jason Ludwick.

Jason Ludwick aged 34 from West Bloomfield, Michigan, counts himself a lucky man. Born with an atrial septal defect, by the time he was 15 he had a pacemaker; by 21 he was diagnosed as having cardiomyopathy and by 25 he had a defibrillator in place and an ejection fraction of just 8-10 percent. Heart failure dominated and restricted his life until he received adult stem cell therapy. Now he says that with training he could do a triathlon.

His mother searched for help after he was removed from a heart transplant list. He was then left only with medications, some of which had unpleasant side-effects and he felt constantly tired and depressed as he went back and forth to specialists having his medications reviewed. And then his mother found Theravitae, the Israeli-Thai researcher and developer of adult stem cell therapy, and Dr. Patel from the University of Pittsburgh. After being examined by Dr. Patel, Jason's life was about to change.

Dr. Patel felt that adult stem cells could help Jason, so he flew to Bangkok where a small amount of his blood was withdrawn and the stem cells that could help his heart were harvested in a laboratory then injected directly into his heart muscle at Bangkok Heart Hospital. Just one month later, Jason knew his life was going to change, "My heart was beating better, more rhythmically, and I had more energy," he said. "After six months I was up and flying, feeling 100 percent different. I could mow the lawns, take walks, ride a bike with my kids, lift weights -- do whatever I liked," he said. "I'm always on the go with our fifth child on the way and always busy as a full-time parent."

Jason has always enjoyed a huge level of support from his family and friends, but is very happy to spend time advising other cardiomyopathy sufferers of the power of positive thinking. "Always try to be positive," he counsels. "There is hope. Take care of your diet and help get the word out that adult stem cell therapy is worth getting done. It's nothing like what you would have thought." He loves helping Theravitae as a patient volunteer, talking to patients contemplating flying to Thailand for the help that is currently unavailable in the U.S.

The trend will continue to grow as more and more people become aware that they cannot be harmed by a therapy that uses their own adult stem cells and that the procedures are straightforward, effective and performed in world-class hospitals by skilled, often eminent, heart specialists. Most encouraging clinical outcomes are being supported by research findings as well as by patient report.

About TheraVitae

TheraVitae is a private, multinational company focused on using stem cells from the patient's own blood in order to treat a variety of disorders, especially cardiovascular diseases. The company has developed a proprietary stem cell technology, 'VesCell', that is currently being used by hospitals in Thailand and Singapore to treat patients with heart disease and peripheral artery disease.

VesCell -- A Natural Treatment for Heart Disease and Peripheral Arterial Disease (PAD)

The body has natural ways of healing itself and the cardiovascular system is no exception. Angiogenic Cell Precursors (ACPs) originate in bone marrow and then circulate in the blood vessels. To manufacture VesCell, TheraVitae expands a small number of ACPs harvested from about 250cc of blood into a therapeutic quantity. VesCell is injected either through a coronary artery via catheter, or during surgery, directly into the heart muscle.

A key aspect of VesCell therapy is the advanced cell isolation and expansion technique that allows for the ACPs to be harvested from blood collected in a procedure similar to a common blood donation. VesCell uses a patient's own adult stem cells to treat Heart Disease and PAD and is a viable therapeutic possibility for heart or PAD patients without any other treatment option.

http://www.theravitae.com
http://www.vescell.com

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