Kauvery bids September adieu with the warm satisfaction of more momentous events that keep us at the forefront.
Since its inception, Kauvery has established itself as the only hospital in Chennai offering complete care to the elderly citizens through its comprehensive geriatric care services. Located as it is, in the midst of a densely populated residential neighbourhood, we realise the need for a state-of-the-art paediatric facility and have taken steps to establish a world-class Paediatric Department under the leadership of Dr N Prahalad, who has joined Kauvery as a full-time paediatrician. The Paediatric ward was inaugurated by Dr Sarala Rajajee, Senior Consultant in Paediatric Immunology and Haematology. In short, Kauvery lives up to its name of a multispecialty hospital offering services from paediatrics to geriatrics.
Cataract is a common occurrence amongst the seniors. To optimise the geriatric services under one roof, the Ophthalmology Department was inaugurated by Dr Prithikachary (Senior Neurologist and Neurosurgeon) and will be headed by Dr Anil Chandra, Senior Consultant Ophthalmologist.
Kauvery has also opened a new Operation Theatre for emergency surgeries for needy patients.
Pharmacist day was celebrated on 25th Sep 2015 with a cake distributed to patients and staff. This day holds the beacon to pharmacies and the positive benefits they offer in the health industry.
The 3rd health camp was conducted successfully at Nellore, attended by hundreds of patients who benefited from the succour and attention provided by our team of doctors.
Another looming issue in the city is Dengue. I request you to take preventive measures and in case of fever, to consult your physician without delay.
Kauvery steps into October with renewed zeal in its mission to go beyond curing, into healing – beyond the treatment of physical symptoms to an integrative restoration that includes mental and emotional well being. I thank you all for your continued support to our efforts to make a healthy change in our lives.
Dr. Aravindan Selvaraj, MBBS, MS Ortho, D Ortho (London), FRCS (Ireland), FRCS Ortho (UK/Ireland)
Executive Director & Chief Orthopaedic Surgeon
Article By Dr. N. Anandan, MS., FRCS., DIP UROL (London)
Senior Urologist & Andrologist
Generally, Benign Prostatic Hyperplasia (BPH) or prostate gland enlargement can develop in one out of every three men, who are 60 years and beyond. The enlargement is also a consequence of hormonal imbalances that take place as the aging process progresses. The expansion of the prostrate extrapolates into the urethra and obstructs the flow of urine, which in turn causes irritation and interruption in the functioning of the urinary bladder.
What are the symptoms of Enlarged prostate?
- Frequent urination especially at night
- Urgency to urinate with a weak and interrupted stream
- Incomplete emptying of the bladder
- Difficulty to begin the process of urinating
- Sudden stoppage of urination (acute urinary retention)
- Continued dribbling of urine
What are the complications?
When left untreated BPH can become complicated and these complications include:
- Acute urinary retention
- Passing blood in the urine
- Urinary tract infection
- Bladder damage
- Kidney damage
- Overflow incontinence and Kidney failure
There is no permanent cure for BPH. However, there are two types of medications that are usually prescribed which focus on relieving the symptoms. It works in about 70% of the patients treated. Regular follow up is essential to ensure control of symptoms and checking for development of complications. Some groups of patients may not respond completely, to medical treatment.
When medical treatment does not work, the alternative treatment available is minimally invasive surgery. There are several types of minimally invasive procedures available. The various types of minimally invasive procedures used are “heat energy” processes that shrink a portion of the prostrate and these procedures have been effective.
Types of Minimally Invasive Procedures
- Transurethral microwave thermotherapy or TUMT – this is a procedure for mild to moderate blockage in the urinary tract. The result of this procedure is that it reduces the frequency, straining, and urgent need to urinate and improves the flow from an intermittent flow. During this procedure, computer controlled microwave heat energy is used to destroy a select portion of the tissue in the prostrate. A cooling system protects the walls of the urethra from getting damaged.
- Transurethral radio frequency needle ablation or TUNA – involves the heating up of the tissue in the prostrate with high frequency radio-waves that destroy the selected tissue. This procedure helps improve urination and symptoms.
- Prostatic Stents – A tiny metal coil or stent is inserted into the urethra to widen the passage and to keep it open. This is an outpatient procedure and requires local anesthesia.
Who needs surgical treatment?
Patients who are unresponsive to medications and patients who develop complications are prime candidates for surgical treatment.
Before the advent of modern day techniques and technology, the Monopolar procedure, a type of resection of the prostrate, was used to surgically correct the disorder. This is an endoscopic procedure, which does not leave a scar. The monopolar instrument is specially designed to pass through the urethral passage, prostrate and bladder. In this endoscope procedure, electrocautery energy is used to remove the obstructive tissue. In some cases troublesome bleeding may occur, besides reducing sodium levels in the blood causing confusion and hypertension in the patient.
At Kauvery Hospital, prostrate surgery is done using the most modern technique, called BIPOLAR RESECTION. This instrument is a specially designed generator that provides energy to cut the prostrate and seal the bleeding (if any) at the same time. Consequently, there is virtually no bleeding during the procedure and with its specially designed enucleating loop, even very large sized prostrates can be downsized easily. The risks associated with the Monopolar type of instrument do not exist in the Bipolar Resection Instrument.
DIABETES & BPH
In a Diabetic patient the bladder muscle contraction as well as bladder sensation is poor, compared to normal individuals. They can have difficulty in emptying urine and this goes unrecognized. They are prone to ‘overflow incontinence’. Both medical and surgery cannot provide any relief at this stage. Diabetic patients are advised to have prostate surgery early if medications are not effective, to avoid serious complication like overflow incontinence.
The incidents of heart disease are increasing in epidemic proportions. Why? The single most important factor is lack of physical exercise. Lack of physical exercise is glaringly present in majority of the people coming with coronary heart disease. Obesity is increasing, again in epidemic proportions in India.
As we are aware, life style modification is very important to control risk factors. If you modify your lifestyle by, maintaining an optimum body weight, regular physical exercise and stop smoking and do yoga/meditation or any of these things you can reduce heart disease by 40%.
Dr.K.P.Suresh Kumar, Chief Cardiologist of Kauvery Hospital, talks about Coronary Heart Disease.
- Doctor could you please help me understand the significance of my HbA1c test?
The HB in HbA1c refers to glycosylated haemoglobin or glycated haemoglobin. This condition develops when glucose present in the blood attaches itself to the protein in the blood that carries oxygen throughout the body. The combining of each glucose molecule with the protein, is directly proportional to the total amount of glucose present, in the patient’s system, at the time of drawing, of the blood.
Measuring the HbA1c levels in your blood, helps you / your treating doctor to understand what the average glucose levels in your blood, for the past few weeks / over a period of 3 months, generally are.
This test provides an accurate, long term average measurement of blood sugar control. Since blood cells survive about 10 weeks before they are regenerated, this test is performed once in 3 months.
When the HbA1c levels are high, this gives off warning signals, as the higher the HbA1c, the higher the risk of the patient developing complications that normally arise because of constant high sugar levels.
When the HbA1c results fall in any one of the following indicators, it signifies:
- 4-5.9% - means good control, for people without diabetes.
- 6.5% - means good control for people with diabetes.
- 7.5% - is again considered to be alright, especially if the diabetic person is prone to hypoglycemia (low blood sugar levels).
- Anything beyond 7.5% means the diabetic person is open to risks of complications and this is a forewarning.
The possible complications that can rise out of constant high blood glucose levels are:
- Nephropathy (diabetic kidney disease)
- Retinopathy (damage to the retina)
- Neuropathy (damage to the nervous system)
Checking your blood sugar levels on a daily basis is important, for some it is necessary to do so before every meal, so as to understand which foods help you control your sugar levels and which don’t.
- I am 60 years old female, post menopausal and I have mild back pain. I am worried about weakening of bones and fracture. Is there any simple test which can detect this?
Weakening of bones is commonly due to osteoporosis. Osteoporosis involves a gradual loss of calcium, as well as structural changes, causing the bones to become thinner, more fragile and more likely to break. DEXA is today's established gold standard test for measuring bone mineral density (BMD).
DEXA test can also assess an individual's risk for developing fractures. The risk of fracture is affected by age, body weight, history of prior fracture, family history of osteoporotic fractures and life style issues such as cigarette smoking and excessive alcohol consumption. These factors are taken into consideration when deciding if a patient needs therapy.
DEXA Scan is recommended in:
- Post-menopausal women not taking estrogen.
- Personal or maternal history of hip fracture or smoking.
- Post-menopausal women who are tall (over 5 feet 7 inches) or thin (less than 125 pounds).
- Men with clinical conditions associated with bone loss.
- Use of medications that are known to cause bone loss, including corticosteroids such as Prednisone, various anti-seizure medications such as Dilantin and certain barbiturates, or high-dose thyroid replacement drugs.
- Those suffering from type 1 diabetes, liver disease, kidney disease or a family history of osteoporosis.
- Patients with high bone turnover, hyperthyroidism or hyperparathyroidism.
- History of fracture after only mild trauma.
- Patients with x-ray evidence of vertebral fracture or other signs of osteoporosis.
The scan takes around 20 minutes of time and no special preparation is necessary for the scan. In addition to the bone mineral density report, a fracture risk assessment is also done using FRAX tool. The radiation associated with a DEXA scan is very minimal at around 0.0002 mSv which is well below the background radiation (2 mSv).
Article by Dr. Iyappan Ponnuswamy MD, FRCR
Consultant Radiologist, Kauvery Hospital
Leiomyomas or Myomas are non-cancerous growths occurring in the Uterus. They are also known as Uterine Fibroids and normally occur during the childbearing years. For those women, who plan on having children (in the future), Uterine Fibroid Embolization (UFE) is the best alternative to hysterectomy or myomectomy.
UFE is a minimally invasive procedure performed by a Radiologist, to treat symptomatic uterine fibroids.
Symptoms of Fibroids
Despite, the very high incidence of uterine fibroids, many patients are asymptomatic. The most common symptom associated with fibroids is heavy menstrual bleeding. Other symptoms include dysmenorrhea, pelvic pain and pressure, urinary frequency, and hydronephrosis. Fibroids have also been implicated in reduced fertility, infertility, and complicated pregnancies.
How are fibroids diagnosed?
Large fibroids may be palpable on physical examination. For an internal examination of the uterus, the ultrasound is usually the first modality used, to diagnose uterine fibroids. This procedure is easily available, it does not cause radiation and is relatively inexpensive. For an accurate diagnosis, MRI scans are used. MRI also does not cause radiation, but is rather more expensive than an ultrasound.
Uterine fibroids: Should I have UFE?
Most patients with symptomatic fibroids are candidates for UFE, and it is indicated for those who wish to avoid major surgery or definite loss of reproductive capacity.
How is UFE performed?
This procedure is performed in a cathlab (the same place where angiograms of the heart are done). A doctor specialised in this procedure, known as an interventional radiologist inserts a thin flexible tube called a catheter into the femoral artery, in the upper thigh and with real time x-ray guidance, passes this tube into the arteries which supply blood to the fibroid. The blood supply to the fibroid is then cut off by blocking it with a particle solution. This technique is known as embolization. Usually, this procedure takes about 1 to 2 hours and after the procedure, the catheter is removed and pressure is applied to the puncture site to stop the bleeding. A bandage is then applied and post procedure, a minimum of 6 hours of bed rest is mandatory.
What happens after UFE?
Blocking the blood supply to the fibroid results in generating pain, which is consequently treated with pain suppressants.
Although, UFE is performed as an outpatient procedure, it is recommended that the patient spends a night at the hospital to help manage the pain and for observation purposes. Nausea and vomiting may occur, which is again controlled with oral medications. Generally, the patient may return to her normal activities, within a week.
What are the advantages of UFE compared to other treatment methods?
The advantages of having an UFE procedure, in comparison to hysterectomy, myomectomy or through medical (GnRH) treatment, are:
- No incision in the belly or abdomen region and no general anaesthesia, is required.
- Blood transfusions are not required as there is no heavy loss of blood.
- All the fibroid growths in the uterus can be treated simultaneously.
- UFE does not cause osteopenia or thinning of the bone, nor does it cause any of the other serious side effects that are associated with GnRH-a therapy.
World Heart Day 2015 - "Save the Heart" initiative by Kauvery Hospital
World Heart Day 2015 was celebrated by Kauvery Hospital on 29/09/2015. As part of the celebration "Save the Heart" initiative was conducted by displaying placards with Heart Day slogans at Luz Church Road junction. A free camp (BP and Sugar Tests) was conducted at Besant Nagar beach early in the morning as well. Free apples were distributed and more than 150 people participated in this free camp.
Inauguration of Kauvery Eye Centre
Kauvery Eye Centre, a centre for excellence in cataract surgery was inaugurated at the 2nd Floor of Kauvery Hospital on 23/09/2015 by Dr.Prithikachary, Senior Neurologist & NeuroSurgeon, Kauvery Hospital. Other services provided by the centre include refractive surgery, anterior segment surgery, pediatric ophthalmology, treatment of glaucoma and retinal diseases. The centre is headed by Dr Anil Chandra, Senior Consultant Ophtholmologist.
Inauguration of Paediatric Ward
Paediatric Ward was was inaugurated at the 2nd Floor of Kauvery Hospital on 23/09/2015 by Dr.Sarala Rajajee, Senior Paediatric Haemologist & Immunologist, Kauvery Hospital. The paediatric department is headed by Dr N Prahalad, Senior consultant paediatrician and nephrologist.
General Health Check-up Camps
Dignity Foundation and Kauvery Hospital conducted general health check-up camps at Kanaki Nagar on 05/09/2015 and at Saidapet on 06/09/2015. Hundreds of people attended the camp and got benefitted.
Cardiology Camp at Arakkonam
Kauvery Hospital will conduct a Cardiology camp at Arakkonam on 03/10/2015.
Time: 10.00 am – 1.00 pm
CME at Villupuram
Kauvery Hospital will be conducting a Continuing Medical Education Meeting (CME) at Villupuram on 04/10/2015.
Dr. Karthick Surya will participate in the meeting.
Cardiology Camp at Thiruvallur
Kauvery Hospital will conduct a Cardiology camp at Thiruvallur on 11/10/2015.
Time: 10.00 am – 1.00 pm
Elder's Day Celebration
Kauvery Hospital will be celebrating Elder's Day at P.S Higher Sec. School, Mylapore on 11/10/2015.
Time: 10.00 am – 1.00 pm
Cardiology Camp at West Mambalam
J.P Clinic & Kauvery Hospital will conduct a Cardiology camp at J.P Clinic, T.Nagar on 18/10/2015.
Time: 10.00 am – 1.00 pm
Ortho and Spine Camp at Nellore
Out Reach Clinic & Kauvery Hospital will conduct a Ortho and Spine camp at at Nellore on 18/10/2015.
Medical Camp at Perambur
Kauvery Hospital will conduct a paid Medical camp at Jupiter Hospital, Perambur on 25/10/2015.
Health Talk @ Raadhus Academy
A health talk will be conducted on 26/10/2015 at Raadhus Academy.
"I'm fully satisfied for the treatment taken and the stay in the hospital and also recommend the hospital to others. May god bless the medical team and hospital staff."
"Good service. Doctors are very polite."
"We had a comfortable stay here as a patient. The patient was very well attended and taken care. We thank the entire Doctor team."
"Excellent care by all nurses semi-private and all staffs, PALS Team, Housekeeping, Doctors."
"An excellent team work of entire 3rd floor, especially the housekeeping lady Mrs.Shanthi, Personal care exemplary. Dr. Sabeeha’s special care was very crucial in the recovery. Divinity should bless her and guide her to continue her good work."
"Nurses services is excellent. Especially Priyanka has taken more care while doing the service. Thank you so much for her. I appreciate her efforts."
"Excellent services rendered by the nursing staff and PALS Team. Thanks to Mr.Sridhar and Mrs.Rajalakshmi for speedy cashless procedure."
"The complete service provided by the hospital, Doctors, Nurses all are excellent."
"Special thanks to Dr Sabeeha was very helpful and made us feel comfortable at all times."
"Overall good experience with the Doctor’s and staffs. Happy with the procedures. Like to appreciate the work of CT ICU staff Nandhini, Soundriya and Manju."
"I am impressed by the promptness and the required assistance arranged by Ellen (PALS Team)."
Vegetable Pepper Bowls
Capsicum or Peppers are one of the most versatile vegetables. You can use them in curries, in fried rice, pulaos, in salads and as stuffed bowls. The stuffing could be cooked or used as a salad. Whichever way you use it, it is delicious and colorful. Capsicums come in four different colors – Green, Red, Yellow and Orange and each color gives off a different flavor.
Capsicum contains small levels of capsaicin, an alkaloid compound, which has anti-bacterial , anti-carcinogenic analgesic and anti-diabetic properties. They are also a rich source of Vitamin C, A, Vitamin B complex and minerals such as manganese, potassium, selenium, magnesium, zinc, copper and iron.
Nutritional Value in this Recipe: Per serving – 342 calories; Carbohydrate – 8g, fat – 11g, sodium 46g, fiber 17g, cholesterol – 550mg.
- Green, Red, Orange, Yellow Capsicum or Peppers – 6 medium size
- Potatoes – 4 medium size
- Onion – 1 small finely diced or ¾ cup of finely diced onions
- Green Peas – ½ cup fresh (can substitute with black cow peas / karamani)
- Carrots – 1 finely chopped
- Green beans – 10 finely chopped
- Jeera – ½ tsp
- Turmeric powder – ¼ tsp
- Red chili powder – ¼ tsp
- Garam Masala – ¼ tsp
- Ginger / Garlic paste – 1 tsp
- Salt to taste
- Corn Flour – 1 cup
- Oil (Refined) – 1 cup
1. Wash the capsicum and cut open at the top. Remove all the seeds and white soft layers from within the capsicum and discard. Arrange the capsicum shells on a plate and set aside.
2. In a pot, boil potatoes with water. Once cooked, peel and mash. Set aside.
3. Place a Karai on the stove (low heat). Add 2 tablespoons of Oil.
4. Once the oil is a bit hot, add the diced onions and sauté, until the onions turn pink or translucent.
5. Add the carrots, peas, and beans.
6. Add the Jeera, Turmeric, Chilie and Garam masala powders. Add in the salt.
7. Stir in the Ginger / Garlic paste and sauté for 5 minutes.
8. Once the vegetables are half done, stir in the mashed potatoes, mix and remove from the stove.
9. Next in a small bowl, mix just enough water to make a thick paste of the corn flour.
10. Using a teaspoon or tablespoon, ladle the vegetable mix into the capsicum bowls.
11. Once the vegetables are filled to the brim, cover each capsicum with the corn flour paste to seal in the vegetables.
12. In a Karai, pour in oil for shallow frying. Take each capsicum bowl filled with vegetables and gently fry it in the shallow oil, until the capsicum is cooked.
Serve as a side dish with dal and rice or any other curry / curd and rice. Non-vegetarians can substitute the beans with minced meat (beef, lamb or mutton) of their choice.