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Bio Medical Waste Report For Shalimar Bagh

Month Red Autoclave(Infected Plastic Waste) Yellow- Incineration(AnatomicalWaste & Soiled Waste) Blue Autoclave (Glass- Bottles) Black Cytotoxic- Incineration( Cytotoxic Contaminated Items) White- Sharp Total Bags Total Weight(In KG's)
  No. of Bags Weight (in KG's) No. of Bags Weight (in KG's) No. of Bags Weight (in KG's) No. of Bags Weight (in KG's) No. of Bags Weight (in KG's)    
Apr-17 924 2963.50 954 2994.10 239 1017.30 103 279.20 1645 606.40 3865 7861.00
May-17 1175 4624.12 1028 3498.40 276 1524.34 87 195.01 1803 823.85 4369 10665.71
Jun-17 1060 4511.45 902 2886.66 293 1324.05 76 194.00 2057 1100.69 4388 10016.85
Jul-17                     0 0.00
Aug-17                     0 0.00
Sep-17                     0 0.00
Oct-17                     0 0.00
Nov-17                     0 0.00
Dec-17                     0 0.00
Jan-18                     0 0.00
Feb-18                     0 0.00
Mar-18                     0 0.00
YTD 3159 12099.065 2884 9379.155 808 3865.69 266 668.705 5505 2530.94 12622 28543.555

Cardiac Sciences

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Clinical Directorate

For more info please call 8744 888 888 (Delhi – NCR) & 9988 422 333 (Chandigarh Tri-city), or mail at

Max Institute of Cardiac Sciences strives to provide patients with expert treatment and care. We believe in offering the patients with an ethical and open environment to recover. Our team of expert cardiologists and cardiac surgeons believes in carrying out an in-depth investigation of patient condition taking into account patient’s complete medical history, therefore strategizing a tailored treatment and recovery plan for each.

Our expertise in cardiac care helps us in caring for patients with heart disease by providing complete all-round care. From diagnosis, prevention, treatment, surgical care to cardiac rehabilitation and wellness services, we look after your heart A to Z.

Why Women are Different from Men at Heart-Even Electrically

June 10, 2015 0 45 3 minutes, 0 seconds read

Electrical Explanation for Gender Differences

The fact that heart of a woman is electrically wired differently from men should come as no surprise. The development of every part of the body is determined genetically, and modified by the sex hormones. The heart works through an electrical system that we can measure on the surface with the ECG.

Women Have a Faster Baseline Heart Rate than Men

On an average, women tend to have a faster baseline heart rate than men. This difference is seen in girls, as young as five years old.

Women’s ECG Readings may be Different

Women are more likely than men to be seriously affected by either congenital or acquired QT (a segment in ECG) prolongation which puts them at an increased risk for drug-induced torsades de pointes (a life threatening arrhythmia). The hormone (androgen and estrogen) levels may explain the gender differences in QT interval. Caution to be used in women when prescribing drugs like antibiotics, antifungals, antidepressants, anticonvulsants and antiarrhythmics that can precipitate QT prolongation as a side effect. It is not unusual to find congenital long QT syndrome as a cause of syncope and sudden death in young women.

Differences in abnormal heart rhythms in men and women

Delayed or missed diagnosis of an arrhythmia is a significant problem for women. Often, symptoms can be mistaken for other conditions including panic, stress, and anxiety and are usually not evaluated as cardiac problems.

  • PSVT – a rapid heart rate that originates from upper chamber of heart is more commonly seen in women, completely curable but commonly “missed” diagnosis.
  • Sinus Node Dysfunction – a slow heart rhythm that originates once the main pacemaker of heart becomes diseased, more commonly seen in women but often diagnosed late.
  • Atrial fibrillation - One of the most common irregular heart rhythms in women associated with valvular heart disease and an increased risk for stroke and cardiovascular death as compared to men older than age 75. However, women are less likely to receive anticoagulation and ablation procedures compared to men.
  • Sudden cardiac death (SCD) - It is a sudden, unexpected death caused by loss of heart function. SCD occurs almost as frequently in women as men and is related to about 400,000 deaths per year in women worldwide. It has been seen that while the majority of women who had SCD had no prior history of cardiac disease before death, they had at least one cardiac risk factor (smoking, hypertension or diabetes). Family history also played a role in increased risk if one parent died of heart disease before age 60. The majority of SCD in women was related to an abnormality of the heart rhythm (88%). This reinforces the need for careful screening of heart disease risk factors in women and managing these concerns even without symptoms being present.
  • Paradoxical Scenario-Both men and women have been shown to derive an equal survival benefit from implantable cardioverter defibrillators (ICD) and cardiac resynchronization therapy (CRT) (both devices used in heart failure scenario), although these devices are significantly underutilized in women. Women also appear to have a better response to cardiac resynchronization therapy in terms of reduced numbers of hospitalizations and more robust reverse ventricular remodeling. Electrophysiologists are cardiologists with extensive specialized training in the diagnosis and treatment of heart rhythm problems. Electrophysiology department at Max Healthcare Superspeciality Hospitalthe best heart hospital in Delhi headed by a Women Cardiac Electrophysiologist, Dr Vanita Arora performs over 1000 procedures every year and the program has grown into one of the most experienced lab in the country. We have become the "go to" resource within the field of arrhythmia management and care.

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Be Heart Healthy

April 9, 2014 0 51 1 minute, 36 seconds read

Every 36 seconds, one person dies from heart disease. Therefore, it's imperative to learn all you can about heart health. What causes a heart attack? It occurs when the blood flow to a part of the heart is blocked, often by a blood clot.

This happens because coronary arteries that supply the heart with blood slowly become thicker and harder from a build-up of fat, cholesterol and other substances called plaque.

If the plaque breaks open and a blood clot is formed that blocks the blood flow, a heart attack occurs. Here are some of the symptoms of a heart attack: Uncomfortable pressure, squeezing, or pain in the centre of your chest. It lasts more than a few minutes, or goes away and comes back.Pain or discomfort in one or both arms, your back, neck, jaw or stomach Shortness of breath with or without chest discomfort You or someone you know has chest discomfort, especially with one or more of the above signs, don't wait more than five minutes before calling for help. Call the emergency medical services (EMS) in your area or get to a hospital immediately. Check out the best heart hospital in Delhi.

How can I recover from it? You may only be in the hospital for a few days but your recovery involves making changes in your daily life. Start by modifying your lifestyle to reduce your risk of having another heart attack.

Don't smoke, and avoid inhaling second hand smoke as well Maintain a healthy diet that's low in saturated fat, trans fat, cholesterol and salt Exercise at least 30 minutes on most or all days of the week. Aim to keep your weight in the normal range Take your medicines as prescribed and control your blood sugar if you have diabetes Talk with your doctor about what physical activity you should be indulging in and avoiding altogether Joining a cardiac rehabilitation programme can help too.

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September 3, 2020 0 1 minute, 59 seconds read

Heart is an organ of the body which keeps on working nonstop throughout our lifetime . The heart beats about 2.5 billion times over the average lifetime, pushing millions of gallons of blood to every part of the body. This steady flow carries with it oxygen, nutrients , hormones, other compounds, and a host of essential cells. It also whisks away the waste products of metabolism.

Given the heart's never-ending workload, it's a wonder that it performs so well, for so long. But it can also fail, brought down by a a number of health conditions and other factors.

In 2016, the estimated number of people having heart disease  in India was estimated to be 54.5 million. One in 4 deaths in India are now because of heart related diseases  with ischemic heart disease (coronary artery blockage )and stroke responsible for >80% of this burden.

The important factors responsible for heart disease are Diabetes, hypertension (high blood pressure), tobacco use( including smoking ), dyslipidaemia ( bad cholesterol in blood) , obesity, unhealthy diet,  physical inactivity and aging population.

Now question arises “ how to prevent the development of heart disease?” 

Most of these factors are modifiable. It means we can effectively control or stop these conditions before they cause heart problems, like good control of blood pressure and diabetes, treatment of bad cholesterol, avoiding tobacco & smoking , regular physical exercise and avoiding / controlling mental stress.  

For a normal healthy individual any form of aerobic exercise like brisk walking, cycling , jogging, or swimming for at least 45 minutes a day is heart healthy exercise. 

A balanced diet with limited use of fats/oil, carbohydrate  and sugar, and having high amount of fibres ,green vegetables & fruits is good for heart.

People with conditions like high blood pressure and diabetes , those with family history of heart disease and individual above age of 40 years should undergo periodic ( at least once in a year ) evaluation of their heart health. 

Another important step is community education about heart diseases and symptoms of heart attack , so that a person having heart attack can be identified early and can be shifted to a hospital capable of dealing with heart attack. After heart attack every minute wasted before treatment decreases chances of survival and reduces heart’s pumping capacity permanently.

With a healthy life style, preventive measures and early detection and treatment of heart disease we can save people and our community from heart related deaths and disabilities.

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July 9, 2020 0 3 minutes, 33 seconds read

“Awareness” is crucial in connection with stroke. Studies show a direct correlation of improved results with speedy onset-to-treatment time (OTT). And that’s why, in treating stroke, the memorable phrase is “time equals brain.” The quicker the treatment, the less the damage and the better the outcome.

Stroke is the fourth leading cause of death in the India. On average, one stroke-related death occurs every four minutes, or nearly 130,000 deaths each year. Approximately 800,000 persons a year will experience a stroke. It is the leading cause of long-term disability and the number two cause of death worldwide.

A stroke occurs if the flow of oxygen-rich blood to a portion of the brain is blocked. Without oxygen, brain cells begin to die after a few minutes. Sudden bleeding in the brain also can cause a stroke if it damages brain cells. If brain cells die or are damaged because of a stroke, symptoms occur in the parts of the body that these brain cells control. A stroke is a serious medical condition that requires emergency care. A stroke can cause lasting brain damage, long-term disability or even death.

Eighty seven percent of all strokes are ischemic strokes, which are caused by a blood clot blocking an artery in the brain. The other type is a hemorrhagic stroke, which is caused by a bleeding blood vessel in the brain.

A transient ischemic attack (TIA) is a “mini-stroke,” or “warning stroke,” that produces temporary stroke-like symptoms with no lasting damage. Recognizing and treating TIAs can reduce a person’s risk of a major stroke, as TIAs can be the precursor of a full stroke.

Many patients ignore a TIA. But being attentive is vital, as the risk of major stroke following a TIA is particularly increased in the subsequent first few weeks. Depending on the TIA cause, a doctor can help reduce the risk of stroke with medications and/or lifestyle changes.”

The acronym F.A.S.T. is an easy way to remember the sudden signs of stroke.

  • Face drooping,
  • Arm weakness,
  • Speech difficulty,
  • Time to call emergency helpline number

Signs of stroke include sudden numbness or weakness in the face, arm, or leg, especially on one side of the body, sudden confusion, trouble speaking or difficulty understanding speech, sudden trouble seeing in one or both eyes, sudden trouble walking, dizziness, loss of balance, or lack of coordination and sudden severe headache with no known cause.

The major risk factors for stroke include high blood pressure, smoking, diabetes, coronary heart disease, brain aneurysms or arteriovenous malformations (AVMs), age and gender. Stroke risk increases as one gets older and at younger ages, men are more likely than women to have strokes. However, women are more likely to die from strokes. Women who take birth control pills also are at a slightly higher risk of stroke. Personal or family history of stroke or TIA also plays a role. In addition to those who benefit from medications to help prevent stroke, following a healthy lifestyle can lower the risk of stroke.

Stroke treatment has vastly improved.

Historically stroke was a disease we didn’t do a lot for in the past. There was nothing done in terms of acute care. Times have changed a lot. Today, it’s a disease for which treatment has changed significantly. In addition to improved medications and surgical procedures, one of the most important aspects to stress is how time-sensitive stroke is in terms of when a person has a symptom. A lot of people still tend to sweep aside the symptoms. It is really important for patients and families to learn these symptoms cannot be ignored.

“From a patient perspective, what is crucial is to call the emergency helpline number and to make sure to pick a good hospital. Even if patients arrive at one not specializing, after being stabilized in a primary care stroke center, they can ask if that hospital is willing to transfer them to a comprehensive stroke center.

It is also important to know that anyone can have a stroke at any age.

In addition to diligence due to significant family history of heart disease or stroke, routine or early follow-up screening with a primary care physician can help to make sure people are controlling any other risk factors.

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How to take care of your heart in COVID-19 pandemic?

July 6, 2020 0 2 minutes, 12 seconds read

COVID-19 infection is caused by a novel corona virus which was discovered in 2019. The first case was reported in China, but now it has spread all over the world with  around half million cases reported in India. Interestingly it belongs to the same family of viruses which causes benign diseases like ‘common cold’. The most common manifestations are fever, cough, breathlessness, headache and loss of taste. In majority of patients it presents with mild fever and lasts a few days. However, in a few patients it can lead to complications and even death. As of now there are no vaccinations to prevent this infection, trials are underway and maybe we will have a vaccine by the year end. Once a person is infected, there are medications which aid in recovery but we do not have a cure. Therefore, it becomes very important to prevent from acquiring the infection by taking adequate precautions and also to identify patients who are at high risk for developing complications from COVID -19.

Patients who are older, smokers, obese, diabetic or already have heart, lung or kidney problems are at a higher risk.  Heart patients are especially at a higher risk as most of them are elderly and have other co-morbid conditions. In addition, COVID-19 infection itself can also lead to heart attacks, heart failure and cardiac arrhythmias. In fact some of the medications given to treat COVID-19 infection can also precipitate fatal cardiac arrhythmias.

Steps to be taken by heart patients in COVID-19 pandemic.

  1. Maintaining social distancing, regularly washing hands and wearing a mask whenever going out of your house.
  2. Do not stop your heart, blood pressure and diabetes medications. In fact if you keep your blood pressure and diabetes in check, complications from COVID-19 infection can be minimized.
  3. Do not stop your regular exercise regimes, as it is good for your heart but maintain social distancing while you exercise.
  4. Keep a positive attitude; avoid negative messages on social media and news channels.
  5. Keep yourself busy; cultivate a hobby in your leisure time.
  6. Socialize with friends/ relatives over phone, whatsapp and Skype.
  7. Avoid unnecessary travel and avoid crowded places.
  8. Eat lots of fruits, vegetables to build your immunity, taking multi- vitamin tablets is not that helpful .
  9. Work from home is advised to reduce risk of exposure.
  10. Be vigilant and if you develop symptoms suggestive of COVID-19 infection, consult your doctor.

In nutshell, prevention is better than cure and this is all the more important for heart patients as they are at a higher risk of complications. Even if a heart patient develops COVID-19 infection, he should not be disheartened as most will recover without any complications.


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May 15, 2020 0 4 minutes, 6 seconds read

World over ,  fewer patients with heart attack are being seen in the emergency . Decrease in disease due to reduction of pollution , reduced stress by staying at home  ,  decrease in eating out  etc is wishful thinking . There may be some reduction but more likely patients are not reporting to  hospitals for treatment and the number of sudden deaths is increasing . 

 Heart Attack occurs when the blood flow to the heart muscle is cut off by the formation of a clot , usually on an underlying cholesterol deposit (plaque ) . With every passing minute , the heart muscle gets progressively injured , and may get permanently damaged if the flow is not restored . 

Symptoms are usually pain  is in the center of the chest , more like pressure , radiates to arms , jaw , neck , back , may be associated with profuse sweating and a sense of doom . It may be milder , feeling like gas, or a cervical pain , may come and go and then become constant , progressively increasing , at times becoming unbearable . The patient just knows that there is something really wrong .

In the presence of chest discomfort , ECG is the first test done , there are changes called ST Elevation – that are diagnostic of blockage of a heart artery. These changes in a clinical context are adequate to diagnose a heart attack 

Chest discomfort that comes and goes , with ECG changes suggestive of heart attack , usually is investigated further  with 2 tests : troponin I and ECHO .

Troponin I is a blood test that indicates injury to heart muscle – it is a very sensitive test – is abnormal 4 – 6 hours after the onset of discomfort . 

ECHO is a ultrasound of the heart – if a part of the heart is not contracting strong enough or the heart is weak – it is visible . These defects develop after injury to the heart . The presence of a normal ECHO does not rule out underlying heart problem.

If a patient has STEMI or acute heart attack – the standard of care is to shift the patient to the cath lab as fast as possible , the  Cardiologist does a procedure to open the artery , usually by placing a stent , after giving blood thinner. Restoration of blood flow  stops the heart attack and the heart starts healing . Recovery of the heart is slow if there have been delays in reaching hospital  and delivery of care . Care is a team or Institution based process – where the emergency , Cardiologist , Post procedure  CCU care are all done in an integrated seamless manner . Coordination between all team members is essential for each patient to get the best care . With optimal process of care the mortality after suffering heart attack has reduced from 20% in the 1980’s to 4-5% these days .

In the COVID -19 pandemic , fear has overtaken all – patients and healthcare workers . This fear is more from lack of understanding . As we care for patients with COVID infection , and we learn from others doing the same world over , we realize that this epidemic will take its time to settle . We all have to learn to take precautions : they are universal .

These precautions work if done together – Hand Hygiene , Screening , Distancing and use of Masks . Each sounds small but put together , by each one of us , the effect is huge  : A chain is as strong as its weakest link ! 

At Max , if a patient comes in with Chest pain suggestive of a heart attack , and the ECG shows changes that require an immediate procedure , CODE STEMI is activated – the cath lab is prepared , the Interventional Cardiologist , technical staff and nurses are ready – while the emergency team prepares the patient and shifts to the Cath lab – usually within 15 minutes and the procedure is performed . In the COVID Times – universal precautions are taken , so you will find all of us working with PPE kits . After the procedure , the patient will be shifted to the CCU and observed for 48 – 72 hours till recovery and mobilization before discharge. If there is any index of suspicion , COVID testing will be done . To prevent spread of infection in the hospital , knowing that some patients are asymptomatic carriers , we are inclined to  COVID testing   more liberally although ICMR does not mandate the test . 

In the last month , we have seen 40% decrease in number of patients with acute heart attack as compared to April last year . A majority of patients , particularly elderly women , have come in 24 – 48 hours after onset of heart attack – they fear putting their loved ones to risk of acquiring infection and suffer till it is unbearable . Unfortunately these delays translate to poor outcomes. 

It is my humble request , if you are not well and need hospital care – please do not delay – it is painful to see patients with treatable disease die from delays in care . Please do not fear the emergency or worry about un necessary isolation – we will take precautions to keep healthcare workers and patients safe as we continue to do what we can –  serve and take care of patients 

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Are Heart Patients at higher risk of COVID 19?

May 15, 2020 0 1 minute, 52 seconds read

Coronavirus has everyone's attention. Everyone is being cautious and people with heart diseases have reasons to be morecautious.Individuals who are above 65 with hypertension, diabetes or are suffering from any heart related illnesses, the concern is serious as they may develop more severe and rapid symptoms.
The virus could affect heart disease patients in several ways like causing ischaemia, myocarditis, arrhythmias and sudden cardiac arrest.

Any individual can contact the virus in the same manner, i.e., via droplets in the air from an infected person coughing, sneezing, talkingor via touching contaminated surfaces.
It directly infects the lungs, as a result of which there occurs a fall in the blood oxygen level. The inflammatory effect of the virus can cause the blood pressure to drop. In such cases, the heart must beat faster and harder, to supply oxygen to major organs.
During this scenario, people with existing heart problems where pumping of the heart is inefficient, this virus can cause a severeand rapid deterioration.  

People with chronic medical conditions and existing heart issues may also have a less robust immune system and their body’s immune response may not be as strong when exposed to coronavirus.
The people who have fat/cholesterolbuildup in their arteries, also known as plaques, may also be at risk from this virus. Research indicates that viral illnesses may destabilize these plaques, possibly contributing to blockage of artery supplying blood into the heart, thus putting patients at risk of heart attack. 

One challenge that heart specialists may face is that previous viruses that affected the society at large, such as SARS, MERS offered more insights as compared to Coronavirus, for which information is changing almost every hour.These earlier viruses were also linked to problems such as inflammation of the heart muscle, heart attack and rapid-onset heart failure. 

There are no special protocols for higher-risk cardiac patients, except for being more careful in protecting themselves by staying at home, maintaining social distance,washing hands regularly, keeping surfaces clean.
In addition to these recommendations, it is extremely important to do exercise (can practice breathing exercise at home), yoga, meditation, get enough sleep, manage stress, and eat a balanced diet. These healthy habits will help to bolster the immune system in the longer term.

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My heart tests are normal- Am I immune from heart attack?

March 2, 2020 0 2 minutes, 14 seconds read

A forty-five year old CEO of a start-up came to emergency room with sudden chest pain. He was having a heart attack.

When this was revealed to his wife, she was exasperated “How can this happen? Only ten days back he had complete heart check-up at another hospital and he was told everything was fine!”, you can see all these reports in my mobile.”

She was right, his basic check-up including a cardiac stress test were normal then. However, now his angiography showed 100% blockage in one of the main arteries of his heart, which required placing a stent to save heart and life.

The question arises: Does normal stress test for heart (TMT/Stress echo/ Stress Thallium) gives you immunity from heart attack?

The answer is NO!

So what is the utility of these tests?

The vessels which supply blood to the heart may have cholesterol deposits within their walls. This process is called atherosclerosis, and leads to narrowing of the vessels. Unless the vessel is narrowed more than 70%, it does not severely affect the functioning of heart. A regular heart check-up including a stress test would not pick up heart vessel narrowing if it is not severe enough to limit the blood supply to heart muscles. Even a stress test may remain normal. A heart attack, as opposed to angina, is due to a sudden, complete blockage of a blood vessel of the heart. This catastrophic phenomenon, unfortunately, can happen with any degree of narrowing over a period of few hours to result in heart attack. This is due to the fat deposits in the vessel wall rupturing inside the vessel, suddenly clogging it up. While various tests may help us in stratifying the risk of heart disease, there is no way to accurately predict when these fat deposits may destabilize and rupture. Therefore, adequate lifestyle modification and adherence to advised medications is of utmost importance.

  • Diet – Should have more vegetables, fruits & avoid trans fat
  • Proper control of blood pressure & diabetes
  • No to tobacco (any form)
  • Regular physical exercise
  • Control over Cholesterol
  • Reduce stress

It is also of equally essential to identify the symptoms of heart attack at the earliest and seek timely medical assistance. The damage to the heart muscles increases drastically as time passes, and can soon become irreversible. Unfortunately, the symptoms can often be subtle or confusing, leading to a delay in seeking medical assistance.

With the near-ubiquitous penetration of smart phones in the general population, a mobile app can help disseminate information as well as preliminary assessment of suspicious symptoms.

While these can in no way replace a doctor’s assessment, they definitely can facilitate patients to seek early medical attention.

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