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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

Neurosciences

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Neurosciences

Is your diet cola making you dumb

July 15, 2019 0 2 minutes, 24 seconds read

The artificial sweeteners used in diet sodas—and thousands of other processed foods—are anything but sweet. In fact, they can be toxic to the brain. Consuming these sugar substitutes on a regular basis is not a recipe for a healthy memory.

We see a lot of patients who believe artificial sugar drinks are good and would help them lose weight. On the other hand these drinks tend to cause digestive issues, arthritis, forgetfulness, and confusion. In fact, these chemical laden drinks can hurt your brain and cause memory loss.

Research has linked drinking diet colas to stroke and Alzheimer’s disease.

4 Ways Artificial Sweeteners Steal Your Mind

1. Forgetful.

One of the most commonly used artificial sweeteners, aspartame, is extremely harmful to the brain. In simple words aspartame works by stimulating brain cells, but in excessive amounts and over long term it can overstimulate the brain cells and works like a potent neurotoxin. It can damage brain cells and cause cell death which leads to forgetfulness and ultimately dementia.

2. CHRONICALLY HIGH INSULIN.

Elevated insulin levels increase your risk for Alzheimer’s disease and also raises the risk of heart disease, diabetes, metabolic syndrome, and other health problems. High Insulin  is associated with weight gain and obesity.

3. SLOW  METABOLISM.

Contrary to the belief that artificial sweeteners can cause weight loss, they actually make you gain weight. Many animal studies have shown that artificial sugars slow down the metabolism  and cuase weight gain. In one such study,  rats which were fed artificially sweetened foods were found to  have slower metabolisms and greater weight gain than those given sugar-sweetened foods—despite the fact that the rats that ate sugary foods consumed more calories than those that ate artificially sweetened foods.  Both diabetes and obesity are considered independent risk factors for memory problems and several forms of dementia. 

4. IMPAIRED GUT HEALTH.

Artificial sweeteners (aspartame, sucralose, saccharine, and acesulfame potassium) have toxic effects on gut bacteria. Compromised gut bacteria can lead to issues such as indigestion,  acidity, impaired absorption of nutrients like leaky gut, a condition in which the lining of the gut becomes excessively permeable. Leaky gut has been linked to the development of Alzheimer’s disease and other dementias.

Sweeter Alternatives

If you want to avoid sugar and don’t want the damage that comes from artificial sweeteners, here are two options.

Erythritol, a sugar alcohol that comes in crystals or powder form, is calorie-free and doesn’t cause blood sugar or insulin levels to spike. (Note: Be aware that sugar alcohols, such as Xylitol and Maltitol, may cause GI distress.)

Stevia, a natural plant extract, is 200-300 times sweeter than sugar, but it does not impact blood sugar levels the way sugar does. Some evidence suggests stevia may stabilize blood sugar, but more research is needed.  (Note: If you take medication for blood pressure or diabetes, talk to a healthcare provider before using stevia.)

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All that Shakes is NOT Parkinson’s

April 23, 2019 0 1 minute, 6 seconds read

Parkinsonism constitutes a number of conditions which have the following similar features:

  • Slowing of activities
  • Tremors
  • Stiffness/Rigidity of body
  • Postural instability (Tendency to fall)

If 2 out of the above 4 symptoms are present then the condition is Termed Parkinsonism.

Parkinsonism is a syndrome which has several similar but distinct conditions within it such as Parkinson’s disease, Vascular Parkinson’s, Parkinson’s plus syndromes (Multiple System Atrophy, Progressive Supranuclear Palsy, Normal Pressure Hydrocephalus. This can be compared to the example of Motor vehicles given below:

MOTOR VEHICLES (PARKINSONISM)

  • BUSES (PARKINSON’S PLUS)
  • TRUCKS (DRUG INDUCED PARKINSON’S)
  • SCOOTERS (VASCULAR PARKINSON’S)
  • VANS (NPH)
  • CARS (PARKINSON’S DISEASE)

The common early symptoms of Parkinson’s include:

  • Excessive salivation
  • Shoulder pain – often misdiagnosed as frozen shoulder
  • Vivid dreams and dream-enacting behavior called REM sleep behavior disorder (RBD)
  • Slurred indistinct, low volume speech
  • Handwriting becoming smaller
  • Stooping of posture when walking, sitting
  • Expressionless face - often confused with depression.

It is important to recognize the symptoms of Parkinsonism early make the correct diagnosis and start treatment early. It is even more important to diagnose Mimic condition such as essential tremors which are often mistaken as Parkinson’s disease.

Treatment results in relief and resolution of symptoms to a great extent.

For advanced cases new therapeutic modalities such as Deep Brain can be considered.

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Back Pain & Sciatica - Does Cold Weather Make Spine Problems Worse?

February 1, 2019 0 2 minutes, 50 seconds read

As the Season Changes and the temperature drops chances of developing acute back pain may go up most people with back pain and sciatica say firmly that winter makes it worse.  Do cold temperatures really make spine Problems worse? As winter sets in, muscles stiffen up in the cold. Added tension can make the pain worse with the risk of a muscles sprain that in turn can cause plenty of back pain.

Dark and gloomy days with colder temperature and fewer hours of sunlight in winter may contribute to depression which in turn can cause or aggravate chronic back pain. Shorter, colder days discourage from exercising which can be a recipe for back pain. Avoiding exercise is one of the worst things you can do for your aching back in winter. Below are some common reason people experience acute low back pain in winter reason along with tips you can try to avoid unnecessary pain.

BENDING AND TWISTING ACTIVITIES

  • Some helpful tips to avoid low back pain during these activities include :
  • Be sure and warm up your muscles.
  • Pace yourself: Exhausting and difficult physical activities are prone to worsen back pain, and should be done with frequent breaks as necessary.
  • Proper form : Always lift with your legs and not your back. Bend at your Knees when lifting, and avoid bending and twisting as much as possible.

Cold temperatures and snow on the ground can lead to slick sidewalks and ice covered surfaces. 

Tips to avoid slips and falls:

  • Wear proper Footwear and gloves .Treads on Winter foot wear help to prevent slips and falls.
  • Watch were you are going .it sound simple But with everyone’s eyes glued to their smart phone, it’s no wonder people fall from not looking where they are going.

REGULAR EXERCISE REGIMEN

Tips for avoiding lack of exercise:

  • Maintain a healthy home exercise program to strengthen your back
  • Spend less time on the couch watching TV and cricket. Take commercial breaks to stand up and stretch or do some home exercises.
  • Avoid overeating during winters to avoid excessive weight gain which can certainly lead to episodes of acute back pain.

KEEP WARM

Many patients complain of joint pain as the temperature drops, but there are simple ways to try and avoid this.

  • Dress warm .when it’s cold outside dress warm and wear layers you can always remove some articles of clothing if you get too warm. Many people under dress and leave themselves vulnerable avoid this common mistake by wearing layers of clothing that will Keep you warm in these cold conditions 
  • Try a heating pad on sensitive areas. The local heat can be therapeutic to the area
  • Stretch and warm up muscles before any outdoor and strenuous activity.

If you do have pain this winter, there are things you can do:

  • Mild Pain: employ rest, analgesics and continue your home exercise program as tolerated.
  • Moderate to severe pain: This is the time to see a healthcare provider to help you give a diagnosis and setup an appropriate patient specific treatment plan.

TAKE CARE THIS WINTER SEASON

  • Maintain a healthy home exercise program to strengthen your back.
  • While watching TV, take commercial breaks to stretch or do some home exercises.
  • Avoid overeating during winters to avoid excessive weight gain that can lead to backache.
  • When it’s cold outside, dress warm and wear layers of clothes that’s easy to remove.

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Can You Have A Healthy Pregnancy If You Are Suffering From MS?

November 1, 2018 0 2 minutes, 41 seconds read

Also known as MS, Multiple Sclerosis is an autoimmune disorder that affects the brain and spinal cord. Unfortunately, in cases of many women, the diagnosis comes at a stage when they are about to plan a pregnancy. Several studies have shown that pregnancy, delivery, and rate of congenital disabilities are no different in women with MS when equated to those without MS. The good part is that there are no substantial evidence of MS causing infertility.

In the past, women with MS were advised not to start a family as the condition may keep them away from giving proper care to their newborn baby. In addition, it was also presumed that pregnancy might worsen the symptoms. 

So, if someone is fighting hard with MS and wishes to plan a pregnancy, the advice is to seek consultation from the best neurologist in Gurgaon to better understand the chances of having a healthy pregnancy. 

Living with MS While Pregnant

Luckily, the picture today is somewhat different. Multiple studies have shown that pregnancy reduces the chances of relapse and this mainly happens in the third trimester. However, if someone has unrecognized MS, they are more likely to start having symptoms during pregnancy. The incapacitating effects of MS may make it substantially hard to carry a pregnancy without any complications. Coordination problems and muscle weakness may surge the likelihood for falls. Furthermore, fatigue may worsen. With fatigue, wheelchair dependence may increase and so the risk of encountering UTIs. 

Keeping the above things in mind, during pregnancy, women need regular and close monitoring to keep track of the condition and overall health of the baby. They may also require recurrent prenatal visits. Though, no standard treatment modifies the course of MS; there are medicines such as steroids and anti-inflammatory drugs that may help. 

During pregnancy, rehabilitation and supportive treatment become especially important. Rehabilitation differs depending on the symptoms, but may help in: 

  • Performing everyday activities
  • Getting the family involved
  • Being independent
  • Using canes, walkers and other assistive devices
  • Enhancing motor skills
  • Refining communication skills in those having trouble speaking caused by weakness or lack of coordination between face and tongue muscles
  • Dealing with bowel or bladder incontinence

Will There Be Any Complications in Breastfeeding?

Multiple Sclerosis does not carry any obstacle in breastfeeding. However, because it is still not clear whether disease-modifying drugs are passed in breast milk, most neurologists advise not to resume therapy until the time someone is breastfeeding. However, there is always an option to resume therapy and formula-feed the baby. Neither of them is right or wrong, as in the end only the mother can decide what is best for them and the baby.

The Role of Neurologist While Pregnant

The neurologist plays a significant role when someone is trying to conceive and that during pregnancy. They also have an opinion about therapy options that will work well in having a smooth pregnancy and prevent relapse after the delivery. Thus, the need of seeking consultation from the best neurologist in Gurgaon. Furthermore, some neurologists also prescribe intravenous immunoglobulin (IVIG) immediately after childbirth to significantly reduce the risk of postpartum relapse. On the other hand, some neurologists may recommend one or several doses of intravenous corticosteroids for the same purpose. 

 

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Dr. Himanshu Agarwal

Dr. Himanshu Agarwal
Consultant – Interventional Neurology
Dr. Himanshu Agarwal - Max Hospital
Memberships: 
  • Society of Therapeutic Neurointervention (STNI)
  • Indian Society of Neuroradiology (ISNR)
  • Indian Radiological and Imaging Association (IRIA)
     
Share This: 

PROFESSIONAL JOURNEY

Work Experience: 
  • Consultant, Interventional Neurology, Max Saket
  • Ex. Associate Consultant, INR, Max Saket
  • Ex. Assistant Professor, INR, AIIMS, New Delhi
  • Ex. Senior Resident, INR, AIIMS, New Delhi
     
Education & Training: 
  • DM, AIIMS, New Delhi
  • MD, GSVM Medical College
  • MBBS, SN Medical College
     
Awards Information: 
  • Gold Medal from President of India for best student in post graduation
  • PGME topper in entire state
  • First prize in health awareness video competition
  • Honors in various subjects in MBBS
  • Published multiple papers in International and National journals, including largest series of Vein of Galen Aneurysmal Malformation from India
     
Speciality Interest: 
  • Diagnostic cerebral and spinal angiography
  • Acute stroke  Mechanical Thrombectomy
  • Intracranial Aneurysms
  • Cranial and Spinal AVM;s
  • Cranial and Spinal DAVF
  • Carotico-cavernous fistulas
  • Parent vessel occlusion
  • Carotid Stenting
  • Head and Neck Tumor embolisation
  • Balloon test occlusion
  • Petrosal sinus sampling
  • Venous sinus thrombectomy
  • Intra-arterial chemotherapy for Retinoblastomas
  • Brain and Spine Imaging 
  • CT guided Spinal Interventions
     
Duration Of OPD: 

   Max Super Speciality Hospital, Saket

  • Mon to Fri : 11 am – 4 pm

TAME THE HEAT: DANGERS OF HEAT STROKE IN CHILDREN

June 13, 2018 0 83 3 minutes, 55 seconds read

Summer is here, and Delhi will get hot and dusty.  Alongside mangoes, this season brings with it the risk of heat-related illness. Sweating heavily without replacing enough fluids can lead to dehydration or heat cramps. If the body cannot shed enough heat for any reason, there is a risk of heat exhaustion and, in extreme cases, heat stroke - a medical emergency.

WHY ARE CHILDREN MORE VULNERABLE TO HEAT STROKE?

Children are particularly vulnerable to heat-related illnesses, because their bodies have a greater surface area-to-body mass (which causes a greater heat gain). They tend to produce more metabolic heat per mass and their sweating capacity is considerably lower in children than in adults.

ARE THERE OTHER KINDS OF HEAT RELATED INJURIES OTHER THAN HEAT STROKE?

Heat injuries can be viewed as a continuum of illnesses relating to the body's inability to cope with an increase in heat load. They can be heat cramps, heat exhaustion and the feared heat stroke.

WHAT ARE THE MILDER VERSIONS OF HEAT RELATED ILLNESSES?

  1. Heat Cramps are acute, painful and involuntary muscle contractions that occur during or after intense exercise sessions in the heat. Heat cramps are associated with fluid deficiencies (that can lead to dehydration), electrolyte imbalances and neuromuscular fatigue. They can be earliest indications of heat injuries and may occur independently or with other symptoms of heat exhaustion.
  2. Heat exhaustion: Heat exhaustion is caused by loss of water and salt, often as a result of exercise in hot weather. If it is not treated, it may progress to heat stroke. Symptoms of heat exhaustion include (but are not limited to)   normal or elevated body temperature, although not as high as 40°C (104°F),   profuse sweating, pale skin, fast, shallow breathing, fast, weak pulse, headache, nausea, vomiting, dizziness, weakness, or fainting, heat cramps and   exhaustion .If his symptoms are severe, or if your child seems confused or disoriented or is behaving oddly, it is imperative to take him to a doctor right away.

WHAT IS HEAT STROKE?

It is an acute, life-threatening emergency, which results from an overload or impairment of heat-dissipating mechanisms. It is defined as a core temperature ≥40 to 41°C (104 to 105.8°F) accompanied by central nervous system dysfunction in patients with environmental heat exposure.

WHO IS AT RISK?

At risk are the elderly, infants, the obese, people with hyperthyroidism, and those taking certain drugs.

WHAT ARE THE MAIN SIGNS OF HEAT STROKE?

The main signs that indicate heat stroke are increase in core body temperature, usually above 40° C (104° F) ,  central nervous system dysfunction, which may take the form of altered consciousness, seizures, confusion, emotional instability( including irritability, aggressiveness, apathy) or irrational behaviour .It can progress to  seizures and even coma.

Other possible signs of heat stroke include(but are not limited to)   nausea, vomiting,  diarrhoea ,headache,  dizziness or weakness ,  hot and wet or dry skin ,  increased heart rate alongside  fast breathing .

WHY ARE WE AFRAID OF HEAT STROKE?

If child is not treated promptly, it can result in multi-organ failure. This process may include muscle breakdown, renal impairment, difficulty in breathing and requirement of ventilation (ARDS). It can also cause impairment in clotting (DIC), injury to organs as heart, intestines, liver, pancreas among others. In such a case, your child will need admission to PICU, and will need rapid cooling, dialysis among other treatments.

 

SO, WHAT CAN WE DO?

  • Children should wear clothing that is light-coloured and lightweight to facilitate body cooling.
  • Plan their physical activities and rest breaks in accordance with the intensity of activity and environmental conditions, if possible limit outdoor activities.
  • Try activities such that they stay out of direct sunlight and crowded areas.
  • Make sure they drink non-alcoholic, non-diuretic fluids. Water is a good option, but children may drink more of a flavoured beverage such as juice .
  • Cool the body with water.
  • NEVER leave children or pets alone in a car, even for a few minutes. Cars can heat up to dangerous temperatures very quickly. Children who are left unattended in parked cars are at very high risk for heat stroke, and possibly death.

 

ANY SPECIAL PRECAUTIONS FOR CHILDREN PLAYING SPORTS?

Children who exercise in the heat are at higher risk than adults, because they produce more heat, sweat less, and may forget to drink enough.

  • Make sure the coach or supervisor is knowledgeable about exercising in the heat and that there is a plan for dealing with heat-related illnesses if they arise.
  • Reduce the intensity of exercise when it is very hot, humid, or sunny.
  • Make sure children take frequent breaks.
  • They should preferably wear lightweight, light-coloured clothing.
  • Make sure children are well hydrated before exercising, and regularly when exercising. 
  • IMPORTANTLY, seek medical care immediately if your child has symptoms of heat related illness.

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What Do You Need to Know About Locked-In Syndrome?

June 1, 2018 0 125 2 minutes, 56 seconds read

There are over 600 neurological disorders. Each one has its own shocking complications and symptoms that prove the fact that human mind is way more complex than what we conceive. Even a simple defect in the smallest of the nerves can result in challenging complications.

While you may have heard of common neurological conditions like brain tumor disease or may even know about brain stroke symptoms or brain tumor treatment, there are various other neurological conditions you might have never heard. One such rare neurological disorder is “Locked-In Syndrome”.

Also known as pseudocoma, Locked-In Syndrome (LIS) is a condition in which the patient loses the ability to move all voluntary muscles except for some like blinking of the eyes. To put it in simple words, the patients suffer from a complete paralysis where though they are aware of their surroundings, it is impossible for them to make any movement or use verbal communication. Another condition known as total locked-in syndrome causes paralyses even to the eyes; thus, barring communication.

Here is what you need to know about locked-in syndrome:

Signs and Symptoms

The syndrome is mainly characterized by the complete loss of movement in the voluntary muscles. However, there are some other signs and symptoms as well which may vary from one patient to another.

Patients suffering from locked-in syndrome are not able to speak or make any facial movement. The only way they can communicate is through blinking or eye movements. They can understand everything that happens around them and recognize people as their cognitive function remains unaffected during locked-in syndrome.

Causes

Locked-in syndrome is often caused by damage to a specific part of the brain known as pons which contains the important neuronal pathways between the cerebellum, spinal cord and cerebrum. A damage to this part interrupts the movement of motor fibers running from grey matter in the brain causing paralysis. Here are some of the causes and conditions that may lead to locked-in syndrome:

  • Amyotrophic Lateral Sclerosis (ALS)
  • Brainstem stroke
  • Traumatic brain injury
  • A stroke or brain hemorrhage
  • Lesion of the brain stem
  • Infection in the certain part of the brain
  • Poisoning from krait bite or other neurotoxic venoms

Diagnosis

There are various other disorders like Akinetic mutism and a Guillain–Barré syndrome that exhibit symptoms similar to that of locked-in syndrome. This makes it difficult to recognize the occurrence of locked-in syndrome and hence the delay in treatment. Therefore, it is vital that one should seek medical consultation from hospitals that have an excellent neurological department.

We at Max Healthcare have highly experienced neurologists who have specializations in all type of neurological disorders and neurosurgery like brain tumor surgery. Some of the diagnostic tests that are performed for locked-in syndrome include Magnetic Resonance Imaging, Magnetic Resonance Angiography and Electromyography.

Treatment

Though there is no specific treatment for locked-in syndrome, there are some therapies and supportive care methods that can increase the chances of recovery. In most of the cases, the doctors try to treat the underlying cause of the syndrome. They may also recommend tracheotomy to aid the patient in breathing.

Furthermore, to ensure that the patient gets enough nutrition, gastrostomy (where a feeding tube is inserted in the stomach) is performed as feeding and drinking via mouth is not possible. A special therapy called functional neuromuscular stimulation can also be used to stimulate muscle reflexes which can activate paralyzed muscles.

Another essential and effective treatment option is care, support and hope of the family members who can help the patient fight this unfortunate condition.

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