Apollo Health Blog
Theme – Brain Health and the Ageing Population
In the present life style noise plays a vital role in effecting brain, it leads many health problems.
Effects Of Noise On Brain -
- Memory Loss :
Noise has an adverse effect on important functions of the brain
such as memory, speech processing and concentration.
- Migraine and Headache :
Noise increases the frequency and severity of headaches in a
patient with migraine. It also leads to headache in a normal person.
- Seizures in Epileptics :
Sudden noise can be cause for increased risk of seizures in some
- BP and Hypertension :
Hypertension arising from prolonged exposure to noise puts a
person at increased risk of brain stroke.
- Effect on Children :
Children exposed to prolonged background noise at school or
home may suffer from learning difficulties in relation to
concentration and memory. Repeated exposure to noise during
early childhood can also affect a child’s acquisition of speech,
language and language-related skills such as listening and
The recent news(June, 2016) of isolation of VDPV (vaccine derived polio virus) from a sewer near Amber pet indeed has raised a lot of concern among parents largely because of inadequacy of the information related to it.
Salient features that parents need to know:
India has been declared polio free in 2014 and it still remains the same. As a part of surveillance routine random checking revealed a wild polio virus strain (similar to P2 strain in the old oval polio vaccine).
To prevent it from infecting children who are less immune, government is on a drive to raise the immunity of all at risk (susceptible) children at once by mass immunization through inject able polio vaccine which induces immunity against this virus. So it is mandatory for all children between 6 weeks to 3 years age group to take this vaccine at government identified canters only. Privately it is not available and people are not authorized to give this during this period (June 20th – June 26th).
Why inject able polio and not oral polio mass immunization? – It is because the now available oral polio vaccine no longer contains polio virus type2, unlike the older oral vaccine which had all three (1, 2, 3) strains. On the other hand IPV immunizes them against type 2 also.
Even if you have received inject able polio in your routine schedule you still need to immunize your child in the mass immunization to help drive the wild virus away.
The world blood donor day is celebrated on 14th June every year. This event was first started in the year 2004, to increase public awareness about the need for safe blood donation. Blood donors are the key role players as they donate life-saving gift of blood to a needy patient .At the present time, there is no substitute for blood. This year the theme of world blood donor day is “Blood connects us all”.
Which patients require blood?
According to the World Health organization ,the world over about 234 million major surgical procedures are performed every year, with 63 million people undergoing surgery for traumatic injuries, 31 million people as a part of cancer therapy and another 10 million for pregnancy-related complications. Modern medicine has conquered various diseases like cancer and complex surgical procedures such as liver, pancreatic and heart transplantation are performed with blood transfusions playing a key role to support such programs. Thalassemia children depend on blood for their very survival.
Where does the blood come from?
Blood transfusion is a core service within health care systems and individuals who donate their blood provide a unique contribution to the health and survival of others. Every country faces an ongoing challenge to collect sufficient blood from safe donors to meet national requirements. Blood donation by voluntary non-remunerated blood donors is recognized as being crucial for the safety and sustainability of national blood supplies. In India states like West Bengal and Maharashtra have a good voluntary donor system while other states strive to achieve 100% voluntary blood donations and are still dependant on the replacement donation by the family and friends of patients .Building a sustainable base of safe blood donors requires a long-term approach that requires the establishment of an effective voluntary blood donor program as well as improved public awareness and acceptance of the importance of blood donation
Why should one donate blood?
According to a 2012 World Health Organisation (WHO) report, In India nine million units are collected annually, while the need is for 12 million units having a deficit of 3 million units. In order to make up this deficit there must be a good voluntary donor movement and every healthy individual must take it upon himself/herself to donate blood, in fact with a population touching one billion in our country, there should never be a dirth of blood donors
Basic facts on blood donation
A healthy person between the age of 18-65 can donate blood. The individual fills up a health questionnaire, undergoes a basic medical examination and if found fit, is allowed to donate blood either 350ml or 450 ml of blood. The blood thus donated is screened for blood borne infectious agents such as HIV, HBV, HCV, syphilis and malaria and if found to be free of these pathogens, the unit can be transfused to a patient. Blood is separated into blood components like packed cells, fresh frozen plasma, platelets etc.
Essentially from one single donation three components are prepared and thus it is said one blood donor saves three precious lives!
Dr Sudha Ranganathan, MBBS, DIM,
Consultant Transfusion Medicine,
Apollo Health City, Hyderabad
Brain Tumor is sighted in the brain, it can be any part of the brain. It can attack at any age group both in male & female. Tumors can be benign or malignant and can occur in different parts of the brain. It is of two types- primary and metastatic. A primary tumor starts in the brain, whereas a metastatic tumor spreads to the brain from another part of the body.
Risk Factors – Brain Tumor
Aside from exposure to vinyl chloride or ionizing Radiation, there are no known environmental factors associated with brain tumors.
Mutations and deletions of tumor suppressor can lead to some forms of brain tumors. People with inherited diseases like von Hippel-Lindau syndrome and neurofibromatosis type 2 are at high risk of developing brain tumors.
Screening - Brain Tumor
It Includes Magnetic Resonance Imaging (MRI) And Computed Tomography (CT)-Scans.
Signs And Symptoms:-
- 1. First headache complaint from a person over 50 years old
- 2. First migraine attack in person over 40 years old
- 3. Headache in person under 6 years old
- 4. Severe headaches and very high blood pressure
- 5. Headache and fever (with reduced consciousness)
- 6. Stiffness of the neck/neurological dysfunction
- 7. Headache with signs of elevated intracranial pressure
- 8. Focal neurological dysfunction, fits
- 9. Loss of consciousness
- 10. Early morning vomiting or vomiting unrelated to headache or other illness
- 11. Behavioral changes or rapid decline in school results
Brain Tumor Treatment:-
When a brain tumor is diagnosed, a specialized team of doctors try to evaluate the treatment options. The treatment options are based on neoplasm type and location.
The key intention of surgery is to remove maximum tumor cells possible. However, sometimes the access to the tumor is unfeasible due to which surgery is not allowed.
The objective of radiation therapy is to kill tumor cells and leave normal brain tissue undamaged. In external beam radiation therapy, several treatments of standard-dose radiation are applied to the brain.
Stereotactic Radiosurgery uses computerized calculations to give radiation at the tumor location while reducing the radiation dose to the nearby brain. Types of radiotherapy for brain cancer are external beam radiation therapy, brachytherapy, and sometimes stereotactic radiosurgery, such as Gamma knife, Cyberknife or Novalis Tx Radiosurgery in more complex cases.
Chemotherapy uses drugs that prevent the growth or division of cancer cells in the body. Patients undergoing chemotherapy are more likely to experience improved survival rates. The decision to undergo chemo is based on the type of tumor, extent of cancer and the health of the patient.
DR. VIJAY ANAND REDDY PALKONDA
M.D (R.T)., Radiation Oncology, Medical Oncology (ESMO)
FUICC (UK), FNDM (USA), FUICC (AUS)
Director & Senior Consultant,
Apollo Cancer Hospital, Hyd
Breastfeeding – Never deprive your child of this miracle food
Breastfeeding is the natural way of providing nutrients and vitamins for the baby for their normal growth and development. All mothers can breastfeed if they are educated, supported and taught few basics of breastfeeding and get proper support from society as well.
Who and UNICEF recommend:
- Early initiation of breast feeding. As early as possible in normal delivery and within one hour after cesarean delivery
- Exclusive breast feeding till 6 months and continuation of breastfeeding till two years along with supplements after six months.
- Colostrums, the yellowish sticky secretion from breast in first few days is the perfect food for baby and must be given.
Optimal breastfeeding is so critical that it could save about 800 000 under 5 child lives every year. Breast milk is an optimal source of energy, minerals and vitamins. It can provide half or more of a child’s energy needs between the ages of 6 and 12 months, and one third of energy needs between 12 and 24 months. Breast milk is also a critical source of energy and nutrients during illness, and reduces mortality among children who are malnourished.
Breast milk is a complete food. It has more than 400 nutrients and also several antibodies which give strength to baby to fight infections. Formula milk can never beat breast milk in its composition.
There are several short-term and long-term advantages of breast feeding for the baby. Breastfeeding can increase childhood IQ, it has protective role for Type 2 diabetes and Obesity..Human milk feeding decreases the incidence of multiple infectious diseases in infancy, including bacterial meningitis, bacteremia, diarrhea, respiratory tract infections, otitis media and urinary tract infections.
Not only the child but it also benefits mother, as it is associated with a decrease in the incidence of both breast and ovarian cancers, and a delay in the return of ovulation and greater postpartum weight loss. Breastfeeding is economical for families, with no need to purchase bottles and formula.
“Breastfeeding does benefit the nation by reducing morbidity and mortality and also by reducing healthcare costs”.
There are few situations where breastfeeding may be better avoided such as HIV, galactocemia, mother on some drugs which may harm the baby, active tuberculosis when mother is not on treatment, mother abusing drugs.
For a successful breastfeeding one has to be Aware (A), Be Patient (C) and Comfortable (C). Awareness about its benefits, demand feeding, positions. You should be patient to feed your baby exclusively for 6 months and till the age of 2 years and also be comfortable and stress free for proper milk formation and let down.
Above all breastfeeding helps create a strong emotional bonding between mother and baby…
Dr.Vimee Bindra, MBBS, MS, MHA
Consultant Gynaecologist and Obstetrician,
Apollo Health City, Jubilee hills, Hyderabad.
Thalassemia is an inherited Genetic condition of Haemoglobin abnormality.
Haemoglobin carrys oxygen to different parts of body. It is made of Alfa and Beta chains. There are various types of thalassemia depending on the site of genetic abnormality.The most common types being Alfa Thalassemia and Beta Thalassemia. severity can vary from no symptoms other than mild Anaemia to severe anaemia that requires regular blood transfusions.
These abnormal Haemoglobin cells are more fragile and break down easily. The Body produces more red cells in order to do the function but they are defective.
In India there are estimated 10,000 -12,000 new Thalassemia cases diagnosed every year. The higher incidence is due to high consanguineous marriages in India.
Thalassemia Trait or Thalassemia Minor means you carry the defective gene but can still make enough red blood cells. So you do not have any symptoms and will only know after doing some blood tests( CBC) which show slight reduction in Haemoglobin level and small red cell size reflected by reduced MCV on CBC report. Many times these patients are wrongly treated as Iron deficiency with Iron suppliments . If we know the diagnosis we can assess the possibility of their children having Thalassemia major by receiving double dose faulty genes if her partner or husband also has Thalassemia minor.
Symptomatic Thalassemia: Thalassemia Major
There is more than one gene abnormality and most of the Haemoglobin produced is faulty and they become severely anemic by 6 months of age and will need frequent blood transfusions.
These children need blood transfusions every few weeks or monthly for their life. This causes excess iron accumulation in liver and heart and damage of organs leads to reduced life span. Repeated blood transfusions also pose risk for transfusion-transmitted infections like Hepatitis B and Hepatitis C.Their growth and development is also affected by this.
These patients need treatment for reducing iron overload called iron chelation, which is an expensive treatment and is not easily available for most of our patients.
Bone Marrow Transplantation is the cure for these patients. The earlier the transplant is done the better the outcome. But unfortunately very few patients avail this treatment due to lack of awareness and the cost.
If we calculate the cost of life long transfusions, Iron chelation, patient and family time spent in hospitals for transfusions and risk of viral infections we still believe Bone marrow Transplant is cost effective on long run. We are offering the services at Apollo Hyderabad and few other hospitals in Hyderabad and all our patients do not need to travel all the way to Vellore.
Many advanced countries like England offer antenatal thalassemia screening blood test for all pregnant ladies.
We need to adopt universal thalassemia screening in all pregnant ladies to predict risk in newborn and adopt antenatal diagnosis if required. Early referral for Bone Marrow Transplant, which is the only option to cure this. Safe blood transfusions and early initiation of Iron chelation is the key for success.
MD, MRCP, FRCPath(Haematology)
Apollo Hospitals, Jubilee Hills,Hyderabad,India
Heat is increasing slowly and dehydrating you too slowly. Our bodies require more liquids than our regular intake. Liquids help in cooling body and help in maintaining our hydration levels. In summer our body tends to sweat alot through which we lose our appetite and our mineral levels come down. Diet plays a major role to keep our body hydrated.
Few Tips To Stay Cool This Summer:
1. Daily minimum intake of 8 glasses of water
2. Try and consume regularly Coconut Water / Butter Milk / Fresh Friut Jiuces on a daily basis
3. Fruits like Water Melon, Musk Melon, Kiwi, Oranges, Grapes, Etc help cool body instantly
4. Avoid eating Chicken, Mutton & Beaf as they tend to over heat body easily
5. Sea Food like Fish, Shrimp, Prawns, Crabs have high water contents tend to supply required minerals & vitamins to our body
6. Fresh Green Leafy or Green color vegetables tend to protect our body from sun strokes.
7. Always carry a water bottle with you while travelling
8. Light colored cotton clothes are good to wear in summer
9. Apply Sun Screen Lotion before stepping out, it helps our skin from tanning.
Jubilee Hills, Hyd
There are two age old routes of child delivery which everyone is aware of that is either vaginally or abdominally by cesarean section. If you ask me what are the latest child delivery methods? I would say we cant change the routes of delivery but yes there are latest trends in which we can modify the existing delivery patterns to make it more comfortable for the mother as well baby or we can better call it assisted delivery.
What are the different ways of Child Delivery?
- Vaginal Delivery is the most common route of delivery and should be the preferred route of delivery until unless there is an indication for cesarean section.
Benefits of vaginal delivery: Shorter hospital stay, Short recovery time, Less chances of respiratory problems in the newborn
- Forceps delivery is a kind of assisted vaginal delivery in which a spoon shaped instrument is used to deliver the baby head in certain circumstances such as baby is under distress or to cut short the second stage of labour. It’s a kind of operative vaginal delivery. Sometimes in cesarean section also forceps can be used when baby’s head is floating.
- Vacuum Delivery is also a type of instrumental delivery in which a cup (rigid or soft cup) attached to the vacuum is used to apply on baby’s head to guide its delivery through the birth canal. Use of vacuum is almost same as forceps except in cases of preterm babies.
- Cesarean Section is a way of delivering baby abdominally. In this procedure an incision is given on abdomen usually on the lower abdomen and uterus is cut in the lower segment to deliver the baby. After delivery of baby uterus and abdomen is closed in layers. This method of delivery is used for some special conditions where vaginal birth cannot be used as the primary method of delivery such as placenta previa, cephalo-pelvic disproportion or in some cases where vaginal birth is being tried but not possible because of mother or baby’s condition, it can be done as an emergency procedure.
- Vaginal Birth After Cesarean also popularly known as VBAC. This is not a universal method that can be used for all women who had cesarean section rather individualization of cases is needed and whoever fits the criteria for VBAC is allowed vaginal birth after cesarean.
- Painless Labour or epidural analgesia is a way of providing pain relief during labour. An injection is given in epidural space in the back that delivers continuous pain relief to the lower part of the body while you remain fully conscious. It decrease sensation but doesn’t result in total lack of feeling.
Advantages of Epidural Analgesia
- Provides effective pain relief
- Dose, amount and strength of analgesia can be controlled
- Medication does not reach the baby as it has local effect
- You remain awake which helps in pushing in second stage of labour
- In case of emergency, analgesia can be converted to anesthesia for cesarean delivery anytime
- Water Birth in which you experience a part of labor or delivery in warm water. Giving birth under water may be interesting to you as it is less stressful for the mother as well as the baby. It’s easier to move inside water as compared to movements on bed so it may make the labour little less painful as compared to normal labour without water.
Precautions to be taken for water birth
- You should have an experienced health care professional to help you throughout the labour and delivery
- High standards to be maintained to prevent infection
- Make sure the tub is cleaned and well maintained
- You and your baby being monitored properly while in tub
- Water temperature should be well regulated
- Keep drinking water during water birth to prevent dehydration
You should not try water birth if
- You are less than 18 or more than 35 years of age
- You have medical problems such as diabetes, pre-eclampsia
- Baby in breech position
- You need constant monitoring which is not possible in water
- You are having twins or multiple pregnancy
- You have an infection
Whatever methods of assisted deliveries are available, they are to help the mother deliver successfully a healthy baby.
Dr Vimee Bindra,
Apollo Health City, Hyderabad
Glucose monitors, usually called Glucometers are readily available in the market and are useful devices to monitor one’s blood glucose levels, in order to understand where one stands in terms of his or her glucose control. They facilitate achieving optimal glucose control, are user friendly and cost-effective.
They are invaluable tools for Type 1 Diabetics who are on Insulin treatment. Glucometers are also helpful in Type 2 Diabetics who are using Insulin and also are recommended sometimes in some Diabetics on Oral Diabetes medications.
Glucometers help readily recognize if a Diabetic is having low blood Glucose, fluctuations in blood glucose, very high blood glucose. They are not usually recommended for diagnosing Diabetes newly. Glucometers are reasonably accurate and check capillary blood glucose.
Whether one should buy a Glucometer and check at home depends on the type and severity of Diabetes, the stage of Diabetes, their clinical needs, risk of low glucose, whether on oral medications or Insulin, the type of oral medications used by the person and also affordability to a certain extent especially in the Indian context. The frequency of checking would also depend on these parameters and is advocated to take the advice of one’s doctor, so that one does not under use or over use Glucometer.
Haemophilia Patients can have near normal life!
Prevention is always a best approach
Normally, when you cut yourself, substances in the blood known as clotting factors combine with blood cells called platelets to make the blood sticky and stop bleeding.
However, in haemophilia, there is reduction in one of the clotting factors making person susceptible for prolonged bleeding or taking longer time to stop bleeding. The symptoms of hemophilia can be mild to severe, depending on the level of clotting factors you have. Most cases are mild who would need treatment only during operations or following trauma. But people with severe haemophilia experience bleeding symptoms either spontaneously or with minimal trauma which requires ongoing care. This usually occurs around the joints and muscles, causing pain and stiffness. It can also lead to joint damage over time.
Haemophilia is an inherited genetic condition meaning the condition is passed to a child by one or both of their parents that affects the blood’s ability to clot. Boys tend to be the sufferer and girls tend to be the carriers given the X linked genetic basis. Carrier means they carry the defective gene but are not affected with bleeding problems but have tendency to pass the abnormal gene to half of their children. Carrier mother could still have unaffected boy with help of prenatal diagnosis.
Haemophilia affects 1 in 10,000 births, current estimated 3380 cases in Andhra Pradesh and 50,000 cases in India as per ICMR statistics in 2014.
Although there’s no cure for haemophilia, treatment usually allows a person with the condition to enjoy a good quality of life. Treatment of haemophilia is by replacement of the missing clotting factors, which is done by injection into a vein.
Historically, treatment was only given once a bleed had occurred or prior to surgery. Modern treatment involves giving regular or prophylactic factor replacement therapy twice a week to prevent any damage to joints or muscles and improve good quality of life.
Haemophilia treatment is expensive when it is to be given as prevention, there is need for development of national programs focusing on comprehensive individual care, family support, genetic counseling and prevention.
Haemophilia although is not curable, patients could have near normal life with preventative regular factor replacement therapy and good medical care. Further transmission could be prevented by prenatal diagnosis from 9 weeks of pregnancy onwards.
MD, MRCP, FRCPath(Haematology)
Consultant Haemato oncology and Stem cell Transplant
Apollo Hospitals, Hyderabad