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Max Super Speciality Hospital, Saket
Description: 
  • Robotic Urological Surgery: 15 years journey 
    Dr. Rahul Yadav, Dr. Anant Kumar
  • Robotic surgery is the latest in advanced onco surgical procedures 
    Dr. Harit Chaturvedi
  • Percutaneous balloon aortic valvuloplasty & balloon dilatation of aortic coarctation in a 10 year old child 
    Dr. Neeraj Awasthy, Dr. Sushil Shukla
  • Role of CT/MR imaging and echocardiography in evaluation of valsalva sinus aneurysm 
    Dr. Reena Anand, Dr. Raj Kumar, Dr. Divya Malhotra, Dr. Bharat Aggarwal
  • Risk factors for patients undergoing treatment for Breast Cancer
    Ms. Kanika Arora, Ms. Ritika Samaddar
  • Radiology Case of The Month 
    Dr. Nafisa Shakir Batta, Dr. Dhruv Jain
Date: 
October, 2015 :15
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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

What do you need to know about Osteoporosis and Spinal Fractures?

September 7, 2017 0 41 3 minutes, 11 seconds read

One in four patients dies within one year due to an Osteoporotic Hip Fracture. The disease is characterized by low bone mass and structural deterioration of bone tissue, leading to bone fragility and increased susceptibility to hip, knee and spine fractures.

Dr. Bipin Walia says that 50% women and 25% men (above 50+) are prone to Osteoporosis-related fracture once in their lifetime. This disease is responsible for causing more than 1.5 million fractures annually in the U.S., including 7, 00,000 spinal fractures, 2,50,000 hip fracture, and 3,00, 000 hip fractures. Having one spinal fracture can increase the chance of having a second fracture. Moreover, two or more vertebral fractures can increase the chance of having an additional fracture by 12 times.

Do you know that a hip fracture in an older person can increase the risk of death by 6 times?

Consequences of Suffering from Osteoporosis

It is called as the “Silent Disease” as a bone loss can occur without symptoms. It may so happen that you will not even get to know that you are suffering from Osteoporosis until your bones become so weak that a sudden strain, bump or fall causes a fracture.

Fractured vertebrae can cause:

  • Severe back pain
  • Loss of height
  • Spinal deformities such as kyphosis (stopped posture)

You need to get a bone density done as it can predict the risk of Osteoporosis and hip fracture as well as determine the rate of bone loss and monitor the effect of treatment.

How can you Prevent Osteoporosis?

A step alone towards preventing the disease is not the right solution rather a combination of the following is recommended:

  • A balanced diet rich in Calcium (1200mg daily for men and women over 50) and Vitamin D (between 400 and 600 IU daily)
  • Weight bearing exercises (any exercise in which your bones and muscles work against gravity)
  • Quitting smoking, and reducing alcohol intake
  • Getting bone density tests at regular intervals and taking timely medications as advised to you by the physician depending upon the severity of Osteoporosis.

What is a Vertebral Compression Fracture (VCFs)/Spinal Fractures?

It occurs when a vertebral bone in the spine collapses, causing the spine to shorten and often bend forward. This leads to thoracic and lumbar spinal deformity. The thoracic spinal deformity is referred to as kyphosis.

Our clinicians' advice that patients with a painful spinal fracture have received palliative care, including bed rest (can extend upto 6 months), external bracing and narcotic analgesics.   

Are long term consequences of VCFs painful?

The long term consequences can be devastating and may cause:

  • Acute and Chronic debilitating pain
  • Change in spinal alignment after spinal fracture is healed
  • Significant Impairment in physical, functional and psychological domains in older women
  • Decreased pulmonary function and increased lung disorders
  • Decreased appetite and malnutrition due to stomach compression
  • Clinical anxiety and depression

Treatment option for VCFs:

One of the treatment options is Balloon Kyphoplasty. It is a minimally invasive treatment that stabilizes the fracture and corrects the deformity. The patient experiences improvement in mobility like performing daily activities like walking, and pursuing the hobbies. 90% of the patients report a total pain relief within 24 hours of the procedure.

How is Kyphoplasty done?

The spine specialist creates a small pathway into the fractured bone. A small balloon is guided through the instrument into the vertebra to make an incision of size approximately 1 cm in length. The balloon is carefully inflated in an attempt to raise the collapsed vertebra to its normal position. Once the vertebra is in the correct position the balloon is deflated and removed. The cavity is filled with bone cement forming an internal cast to support the surrounding bone to prevent further collapse. Generally, the procedure is done on both sides of the vertebral body.

The procedure typically takes about one hour and may require an overnight stay. The surgeon will determine the most appropriate method depending upon the condition of the patient.

 

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Are you Stroke Smart? Calculate your Stroke Smart Score

August 31, 2017 0 23 3 minutes, 36 seconds read

Let’s see if you are stroke smart. Below are eleven questions based on general knowledge about stroke. Try and answer them and then score yourself to see if you are a Stroke Novice or a Stroke GOD.  Every question is one point.

1. What is Stroke?

  • Is it how you swim?
  • Related to cricket?
  • A brain emergency
  • A heart disease.
  • Its bad, but I don’t know what it is exactly

Answer: Stroke is rapid and sudden damage to the brain. Also known as brain attack or paralytic attack.

2. How common is a stroke?

  • Very rare, haven’t heard anything about it.
  • It's common but I will never see it in my life.
  • Who cares!!!
  • It’s so common that someone close to me might be having one right now.

Answer D: Stroke is the third leading cause of death, after coronary heart disease and cancer. On average, someone in the United States has a stroke every 40 seconds. More women die of stroke than of breast cancer.

3. Which organ does stroke affect?

  • Brain
  • Heart
  • Lungs
  • Muscles
  • Cricket bat

Answer A: Brain, Brain, Brain.

4. How do you diagnose Stroke?

  • Stroke is painful, chest pain may occur.
  • Stroke can cause a lot of symptoms like weakness, numbness, slurred speech etc.
  • Stroke can’t be diagnosed it is happening quietly inside the body.
  • Only doctors can diagnose it.

Answer B: Stroke can cause a lot of symptoms like weakness, numbness, slurred speech etc.  Most of the strokes are painless. Stroke can be diagnosed reliably by patients and their relatives. In fact, its easy to diagnose stroke, keep reading....

STROKE: REMEMBER THE 7 S METHOD TO DIAGNOSE STROKE

SUDDEN (symptoms usually start suddenly)
SLURRED SPEECH ( speech is not 
clear, as if drunk)
SIDE WEAK ( face, arm or leg or all three can get weak)
SPINNING (VERTIGO) and disbalance.
SEVERE HEADACHE
Sight ( sudden loss of vision)
SECONDS (note the time when the symptoms start and rush to the hospital).

5. Who is at risk of having Stroke?

  • Stroke affects old people only.
  • Stroke affects unhealthy old people.
  • Stroke can affect young and the old generation.
  • Babies don’t have a stroke.

Answer C: Up to one-third of stroke patients belong to the age group of 20 to 60. Even babies can have a stroke.

6. Is paralysis/ stroke treatable?

  • No way. It’s permanent.
  • May be, Ayurveda or homeopathy may help.
  • Yes,  Yes, Yes

Answer C: Yes. Newer treatment modalities have changed the paradigm of stroke treatment. Stroke is very much treatable and the patients do extremely well.

7. What should you do if someone close to you has a stroke?

  • Lay them on the floor and get them some water.
  • Wait for the symptoms to get better.
  • Ask them to sleep, may be they are tired.
  • Rush to the hospital.

Answer D: Rush to the hospital immediately. Don’t waste time. The longer you wait the more brain injury happens. Brain loses 1900000 brain cells every minute.

8. How bad is stroke?

  • Not really, no one dies of a stroke.
  • Stroke can kill you!
  • The stroke will get better, just stay calm.
  • Stroke is like flu. It will pass over.

Answer B: Over 15% of people who have had a stroke die within 30 days, and 15-30% of people who survive a stroke are permanently disabled.

9. Is it worse in women or men?

  • Doesn’t matter.
  • Men
  • Women
  • Men have more strokes but, women die more often.

Answer D: Women have a higher stroke mortality rate than men. Six in ten stroke deaths occur in women, largely due to strokes occurring later in life in women, when strokes are more dangerous.

10. Is it preventable?

  • No, it’s your karma
  • Yes, of course, you don’t need a doctor.
  • I am not sure
  • It all in the genes.

Answer B: Yes, it is. Control BP, sugar and cholesterol. Stop smoking. Active life style and daily exercise prevent stroke. Some stroke may be genetic though.

11. Until how long is the recovery possible?

  • 1 week and then no recovery is seen.
  • 1 month
  • 1 year
  • 2 years.

Answer D: People seem to think that recovery is only possible for the first few days after stroke, however, patients can continue to recover with physical therapy for up to a year in most cases and sometimes recovery is seen even at 2 years.

Stroke SMART score:

0-4: Stroke Novice
5-7: Stroke Player
8-10: Stroke Pro
11: Stroke GOD

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Looking for a Neurologist? Here are 5 Tips to Choose One

August 25, 2017 0 229 3 minutes, 17 seconds read

To receive the best medical care, you should always first consult your primary care doctor. Your primary care doctor will be able to recommend you a neurologist basis your condition. However, in cases of emergencies, it makes sense to consult a specialist.

Neurology is a broad and complex field of medicine that deals with the disorders of the nervous system. It specifically deals with the diagnosis and treatment of all diseases involving the central, peripheral and autonomic nervous systems. A neurologist is an expert who treats diseases in the brain and spinal cord, peripheral nerves, and muscles. Neurological diseases can include epilepsy, headaches, stroke, and movement disorders like a tremor or Parkinson’s disease.

If you or a family member have been diagnosed with any of these diseases, then consulting a neurologist should be the first thing must do. Remember, it is a personal decision, albeit an important one.

If you are looking for a neurologist, here are five tips to choose one –

Get Referrals

Start by reviewing the references provided by your primary care doctor. If you don’t have a family doctor, ask friends, family and other healthcare providers for recommendations. Take time and research the credentials and experience of every doctor in the list. As you are narrowing down the list, ask for a consult appointment with the neurologist and see if you want to continue with them.

Consider the Neurologist’s Experience

The experience of the doctor matters when you or a family member is facing a severe neurological illness. The more experience a neurologist has with treating a particular condition, the better your chances of getting better. Ask the consulting neurologist about their experience, and how many patients they have successfully treated. For instance, if you are a patient of multiple sclerosis, then ask the neurologist about their experience in treating this condition.

Hospital Quality

Remember, your doctor’s hospital is your hospital. Consider the quality of care given by the hospital and what are the facilities available for patients. Hospital quality is a highly critical factor because the patients at top-rated hospitals suffer from fewer complications and have better survival rates. You can also bring the location of the hospital in the account and see if the proximity of location is a necessity for you. Closer the hospital, the better are your chances of reaching there in a case of a mishap. For instance, if you are based out in Delhi or the NCR region, Max Healthcare has the best neurologist in Delhi.

Communication Style and Approachability

A doctor must be easily approachable, one with whom you feel comfortable talking and who shows absolute transparency in your treatment. Since neurological diseases are complex and require an extensive study of patient’s history, you must be able to communicate freely with the neurologist. Treating neurological diseases hinge more on discussions than sophisticated scans. Look how welcoming the neurologist is, and if they answer all your questions. Ensure that there is a suitable amount of two-way communication.

Neurologist’s Credentials

Accreditation is one of the key factors to consider when choosing a neurologist. Credentials, education, and training will tell you about the qualification of your neurologist. It will showcase doctor’s training, experience, and skills.

The points mentioned above are crucial when choosing a neurologist. It is imperative to visit the neurologist in person and put together every piece of information for a successful diagnosis and treatment. The final choice of choosing the neurologist is yours. However, it’s for the neurologist to explain how best they can help you.

*There is a difference between a neurologist and a neurosurgeon. The training is totally different. Common people do not know the difference and land up with a neurosurgeon for neurological problems. If there is any neurological problem first consult a neurologist (DM neurologist in particular trained from good and reputed institute) and then let him decide whether the patient requires neuro surgeon opinion or not.

 

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When Should You See a Doctor for Neck Pain?

August 23, 2017 0 46 2 minutes, 56 seconds read

In many cases, faulty ergonomics at workplace, poor posture are causes of neck pain and causing our muscles to get overworked while we are working in these positions, as a result causing fatigue. It may also be true that a neck pain may be due to an injury, so it is important to rule out if there is any fracture of bones or neck or disruption of soft tissues that hold the bone in normal alignment.

Dr. Ashish C Gupta says that underlying changes in the discs or small joints of the neck can cause muscles to ache. And as our age increases the degenerative or spondylotic changes begin to happen in our spine, thereby causing severe neck pain.

Conditions such as rheumatoid arthritis are particularly known to affect the neck.

What can you do?

  • Spend less time in front of the computer or change the height of the monitor
  • Avoid hunching, stand tall with chest sticking out
  • Refrain from using phone for hours on one side of the neck
  • Take warm showers, apply local ointments

When should you see the doctor?

See a doctor if neck pain develops following an injury. Moreover, it is recommended to contact a physician in these situations.

  • The pain is severe or lasts for more than a few days
  • Neck pain travels into the arms
  • Neck pain is usually accompanied by weakness, numbness in the arms or legs or sometimes a severe headache

What is Cervical Disc Herniation?

Cervical disc herniations (ruptures) are a common problem that can lead to neck pain and symptoms that radiate down the arms to the fingers. These discs are the soft material that are located between the bones of the neck. This material acts as a cushion or shock absorber that decreases the stress between the bones and allows free neck movement. When they become weak, they can tear or rupture, causing the disc material to herniate or bulge outward. This can bulge to the point where they push on the nerves and the spinal cord, which can lead to nerve problems.

Is surgery always required for cervical disc herniation?

The surgeon will perform an extensive neurological examination to detect any neurological signs and symptoms of nerve damage. In severe cases, the disc not only pinches the nerves which exit the spine, but also the spinal cord which is a serious and potentially catastrophic situation. However, most patients do not need an immediate surgery and can try numerous non-operative treatments to attempt to resolve the pain. The conservative therapies like rest, anti-inflammatory medications, cervical collar, pain medications, muscle relaxants, and physiotherapy can provide you some relief.

If all the conservative options fail, then the clinician might suggest you with the surgical options as the latter have a higher success rate. The urgency of the surgery is not the same for all patients and the timing has to be individualized based on the patient’s condition.

Is spine surgery safe?

The risks of spine surgery are like any other general surgical procedure. The selection of patients is the key concept in the successful outcome of spine surgery. Modern cervical spine surgery is completely safe provided it is performed at a center equipped with latest equipment like operating microscope, image intensifiers, endoscopes, and navigation equipment. 

Most patients suffering from a cervical disc disease improve with a carefully implemented treatment program without the need for surgery. The important points are to make sure that you see your doctor in time so that the condition is amenable to conservative treatment.

 

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What to Do When You Get Epilepsy Attack!

August 21, 2017 0 44 4 minutes, 26 seconds read

Epilepsy is a chronic neurological disorder that causes unprovoked and recurrent seizures. A seizure is a sudden rush of electrical activity to the brain which causes an episode of vigorous shaking from brief to an extended period. The recurrent and unprovoked seizures happen due to the alterations in structure or brain functions.

The overload of electrical activity in the brain causes a temporary disturbance in the messaging systems between the brain cells. There are diverse types of seizures, and every patient will have epilepsy in their own way. Since the nervous system triggers every function in our bodies, when a patient experiences a seizure it depends on which part of their brain is activated by epileptic activity, and how it proceeds from that area. It is important to control occurrences of seizures to minimize chances of any grave injury.

Epilepsy treatment is possible and is classified under the neurosciences branch. Max Institute of Neurosciences provides comprehensive and compassionate care to people suffering from seizures. With our neurologist in Delhi, you will get the best epilepsy treatment which will ease your daily life by miles. Let’s take a closer look at epilepsy; its symptoms and what to do if there is an instance of a seizure –

The primary symptoms of epilepsy are repeated seizures, however, if they are accompanied the following symptoms, a patient should see a doctor –

  • Short spells of blackout or confused memory
  • The person is unable to respond to instructions or questions for a brief period
  • The person suddenly falls for no apparent reason
  • A convulsion with no rise in temperature
  • Sudden instances of chewing, without any apparent reason
  • Repetitive movements that are inappropriate
  • Panic for no reason
  • Peculiar changes in senses

Types of Epileptic Seizures

Idiopathic Without any apparent cause
Cryptogenic Where a doctor thinks there is probable cause, but cannot pinpoint it
Symptomatic

When the doctor knows the cause

Based on the diagnosis the seizures are further classified into two types –

Focal or Partial Seizure

In the case of a focal seizure, the epileptic activity took place in just one part of the patient’s brain. The partial seizure is further classified into two types –

Simple Partial Seizure – In this case, the patient is aware of their surroundings and is conscious during the seizure.
Complex Partial Seizure – The patient’s consciousness is impaired, and they will not remember the seizure. They also have a vague memory of the episode.

Generalized Seizure

A generalized seizure is characterized when the epileptic activity occurs in both halves of the brain. A patient will lose consciousness when the seizure is in progress.

Tonic-clonic Seizures – Loss of consciousness accompanied by body stiffness and shaking.
Absence Seizures – Short lapses in consciousness where the patient appears to be staring into space.
Tonic Seizures – Muscles will become stiff, and the patient may experience a fall.
Atonic Seizures – Loss of muscle control which leads to a fall.
Clonic Seizures – Where a patient experiences rhythmic and jerky movement.

What to do in case of an Epilepsy Attack?

With effective epilepsy treatment, one can minimize the instances of seizures and epilepsy attacks. Consult a neurologist and let the expert diagnose you effectively. However, in the case of an emergency here’s what you need to do if someone around you is experiencing seizures.

This first aid is for all seizure types –

Always Stay with the patient until the seizure is subsided

Seizures are unpredictable, and it can be difficult to tell how long they will last or what will occur during an episode. There could be an injury during a seizure, so, it is imperative to stay near the patient.

Note the length of the seizure

Record the duration of the seizure, and how long it took the patient to recover from the same. This record will help the medical practitioner in determining a more effective treatment.

Stay Calm

Keep calm and assure the patient is suffering from a seizure that they will recover from the same. Staying calm will also determine how the next person will react to the situation.

Clean the space around the patient

Removing sharp objects, especially ones that could hurt the patient. Since seizures are sudden and most patients do not remember the instances, it is necessary to minimize dangerous situations around the patient.

Make the patient comfortable

Help them sit down in a safe and secure place. Support the person’s head to prevent it from hitting the floor.

Do not Give Water, Pills, or Food by Mouth

An individual who has epilepsy might not be fully conscious during a seizure. They might not swallow correctly, and it can go into their lungs instead of the stomach.

Call for Medical Help If

  • A seizure which lasts up to 5 minutes or longer
  • There are cases of consecutive seizures where a person does not gain consciousness between seizures.
  • Seizures occurring in water
  • Injury
  • The person asks for medical help

Remember, be supportive and stay calm. Seizures can be treated effectively with medications and following practices that are advised by the doctor. In the case of situations where a person does not regain consciousness, make sure you call for medical help immediately. With an effective epilepsy treatment, a person can live a healthy and managed life. With your neurologist’s advice and medications, there are steps to control the symptoms of epilepsy. 

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Brain Tumor: Symptoms & Causes

August 16, 2017 0 82 3 minutes, 47 seconds read

A brain tumour, like any an other tumour in the body, occurs when at an abnormal rate to form a mass of abnormal cells. These tumours may be benign or malignant (cancerous).These tumours grow over a varying period of depending upon whether they are benign or malignant in nature. These tumours affect the function of normal brain cells by invading them or causing pressure on normal surrounding brain tissue. The brain is enclosed in a skull, so when excess tumour cells start growing in the brain, pressure within the closed space i.e skull increases which would give rise to symptoms.

This abnormal growth of tumours is classified into various types depending on their nature-Benign or Malignant, location i.e depending upon the part of the brain involved, and whether a tumour is primarily from the brain tissue or secondary spread from cancer else where in the body.

A brain tumour is a life-threating disease if not diagnosed in time. Focused on spreading such awareness, we have researched the useful knowledge about the symptoms and causes of a brain tumour that can help you in identifying the problem at an early stage and getting the brain tumour treatment in time.

SYMPTOMS

Let us begin with the general signs and symptoms of a brain tumour. There are different symptoms that depend on the type of a tumour and its location. Some of the tumours do not show any symptoms until they reach a dangerous level where they progress at a rapid pace leading to serious health issues in the patient.

The most common signs and symptoms are as follows:

  • Recurrent Headaches, often associated vomitings at a later stage of the disease
  • Seizures(Fits)
  • Problem in Vision
  • Hearing loss with or without recurrent Giddiness
  • Weakness in Specific Body Parts(paralysis )
  • Memory loss or recent behavioural changes
  • Numbness in Legs and Arms
  • Changes in the Personality
  • Imbalance while walking
  • Intractable facial pain or facial abnormal movements(Spasms)

If you are suffering from any of the listed symptoms, then immediately visit the best neuro hospital in Delhi and get your checkup done from a skilled doctor. There are chances that these symptoms may not be related to a brain tumour. However, if you are diagnosed with a brain tumour do not panic. Rather start focusing on the ways you can get the brain tumour treatment to be healthy again.

CAUSES

After knowing the symptoms of a brain tumour, the next question that may be bothering you will certainly be: What causes it?While the doctors are still unable to find the cause of the primary brain tumours, they have identified several risk factors that make you vulnerable to brain tumours. 

Radiation: Exposure to radiation is one of the most known risks of a brain tumour. People who had a cancer history and have undergone radiotherapy, Repeated CT scans or x-rays to the head are more prone to developing brain tumours. 

Genetic Diseases: There are some genetic diseases that can put you at risk of brain tumours. Some of them are Neurofibromatosis which is a tumor-causing genetic disorder, Turcot syndrome that is characterized by abnormal cells, Von Hippel-Lindau syndrome, and Li-Fraumeni syndrome. 

HIV or AIDS: Those who are suffering from HIV or AIDS are more vulnerable to a brain tumour as compared to other people as they have low immunity.

Today, brain tumours have affected lives of millions of people through their agonizing and distressing condition. If one can diagnose them on early stage and begin with the treatment, then there are chances to fight brain tumors with success.

Benign Tumors can most often be removed completely. In certain circumstances, if some part of a benign tumour is left behind to preserve important nerves, second stage therapy in the form of Gamma knife or Cyber knife for the residual tumor will certainly cure the disease.

In malignant tumours, complete approach to the tumor is three fold –Surgery, Radiotherapy with or without Chemotherapy depending upon the stage of cancer. With advanced radiotherapy machines, as in Max Healthcare, this modality is very well tolerated and has very fewer side effects.

With such an endeavour to eradicate the health issues of people through specialized care and treatment, we, at Max Healthcare offer world-class health facilities and dedicated team of doctors who decide which treatment will be the best for patient’s condition. To focus on the brain tumor and other neurological disorders, our Institute of Neurosciences offers a broad spectrum of services to ensure accurate treatments leading to the high success rates among patients.

 

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Early Signs of Stroke You Should Know!

August 11, 2017 0 40 4 minutes, 18 seconds read

Stroke remains one of the leading causes of death and disability across the world. A stroke is a sudden stop of blood supply to the brain due to a blocked blood vessel or either the blood vessel ruptures. Some people have strokes without ever knowing it, and they are called silent strokes that can cause permanent damage to the brain. These silent strokes have symptoms that are difficult to recognize, and most people often forget them in a whim.

It is highly recommended to get a stroke treatment if you feel any of its symptoms. It is called the 3-hour period i.e. golden window after this period stroke is crucial, however, the treatment benefit can be extended up to 6 hours after onset of symptoms of stroke. In this period, a stroke treatment can save the patient from permanent damage to the brain. With our best neurologist in Delhi and dedicated team, Max Institute of Neurosciences offer Community Stroke Program with Risk Assessment and Counselling.

Here are early signs of stroke that you should never ignore, as it can leave to disability and even death –

  • Severe Headaches without any reason.
  • Numbness or Weakness in your arms, face, or leg, generally on one side
  • Trouble seeing with one or both eyes
  • Trouble staying or walking coordinated or balanced (Gait Disturbances)
  • Dizziness for no reason
  • Difficulty swallowing
  • Confusion or loss of memory
  • Loss of sensation in any part of the body
  • Muscle stiffness
  • Behavioral changes

Remember the “BE FAST” Approach

To successfully undergo stroke treatment, it is imperative to act fast without any delay. Immediate treatment can make a change, and minimize long-term effects relating to brain damage and can reduce the risk of death.

BE FAST is also an acronym which is used to recognize the early warning signs and symptoms of stroke.

B - Balance

If you are walking or standing and feel a sudden loss of balance or coordination, it might be a sign of stroke. Try and walk in a straight line or touch your nose to confirm.

E - Eyes

A sudden change in vision, double vision or blindness in one eye

F - Face

Try to smile and see if one side of the face droops.

A - Arms

Raise both arms and see if one arm drops down.

S - Speech

Say a few words or a short phrase and check for strange or slurred speech.

T - Time

If you notice any of these symptoms, call an ambulance immediately. It is imperative to act well within time to minimize damage. Get immediate medical assistance for stroke treatment.

Transient Ischemic Attacks

TIAs or Transient Ischemic Attacks are mini-strokes that occur right before a major stroke and are often concluded as ‘warning strokes.'They might be ‘mini,' but they carry a major risk. The symptoms occurring in the case of TIAs are like that of a stroke, but, they subside on their own. However, they are not to be ignored and must be dealt with immediately. Getting a stroke treatment is essential even in the case of Transient Ischemic Attacks where an artery is temporarily blocked, and blood supply to the brain is affected. TIAs typically occur because of the following reasons –

  • Low blood flow to the narrow part of a major artery carrying blood to the brain.
  • A blood clot somewhere in the body breaks off, travels to the brain and blocks a blood vessel in the brain.
  • Plaque build-up which decreases the blood flow through an artery or leads to the development of a clot.

Here’s how you can cut down the risk of a stroke

  • Lose Weight – Maintain a healthy BMI and keep your weight under check. It is advisable to get down to the weight what your doctor considers healthy.
  • Eat a Healthy Diet – It is imperative to cut back on saturated fat, cholesterol, sugar, salt and red meat. Include green leafy vegetables, whole grains, poultry, fish and nuts in your everyday meal.
  • Avoiding drinking Alcohol – Heavy drinkers are at a higher risk of developing a stroke and liver cirrhosis. It is imperative to be modest at best when you are drinking, and remember to never binge a drink, even if you are a social drinker.
  • Exercise – Exercise helps in eliminating many risks associated with our health, including the risk of stroke. Make sure you are walking enough and are avoiding sitting all day long. Take adequate breaks and keep your body in motion. Alternatively, work out and exercise to maintain a healthy mind and body.
  • Stop Smoking – Smoking does more harm than most people anticipate. It increases the risk of blood clots and contributes to the development of cholesterol containing fatty deposits in the arteries.

Worldwide, stroke is one of the primary reasons for disability and deaths. It is often termed as a ‘silent killer,' because most people tend to avoid the initial symptoms. However, it can be damaging and life-threating in the long run. Getting a stroke treatment is essential if you have felt any of the symptoms mentioned above. With the best neurologist in Delhi, Max Healthcare is dedicated and equipped in providing the necessary stroke treatment.

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Dr. Vinod Puri

Dr. Vinod Puri
Senior Director - Neurology and Head of Unit, Saket
Dr. Vinod Puri
Memberships: 
  • Treasurer Delhi Neurological Association w.e.f. 1998 to 2002
  • Secretary, Delhi Neurological Association w.e.f. 2002 to 2006 
  • Member National Executive body, Neurological society of India w.e.f. 2003-2006
  • Member  executive committee of Indian Academy of Neurology  2011-2014
  • Currently President elect -Delhi Neurological Association  -2017
     
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PROFESSIONAL JOURNEY

Work Experience: 
  • Director Professor,  Neurology, G.B. Pant Hospital (GIPMER), New Delhi w.e.f. October 29, 2008 – April 30, 2017
  • Professor , Neurology, G.B. Pant Hospital, (GIPMER),  New Delhi w.e.f. July 27,1994 to October 28,2008
  • Associate Professor , Neurology, G.B. Pant Hospital. GIPMER, New Delhi w.e.f. February 6, 1990 to July 26, 1994
  • Assistant Professor , Neurology, G.B. Pant Hospital. GIPMER, New Delhi w.e.f. January 25, 1985 to Feb 5, 1990.
  • Director- Professor and Head - Neurology, G.B. Pant Hospital, GIPMER, New Delhi,  2002  to 2007 and 2012 to 2014
  • Head of Comprehensive Epilepsy Care, GB Pant Hospital, GIPMER, New Delhi, 2007 to April 30, 2017
     
Education & Training: 
  • MBBS (1974) Kashmir University, Kashmir
  • MD (1978) Punjabi University, Patiala
  • DM, Neurology (1984) University of Delhi, Delhi
     
Awards Information: 
  • WHO fellowship for clinical Neuroelectrophysiology at USA,1993
  • Visiting Professor of Neurology, Indiana University Medical School Indiana, USA
  • Visiting Professor of Neurology ,University of Illinois at Chicago, USA
  • State award for the year 2010-2011 for meritorious services  in healthcare in Delhi
Speciality Interest: 
  • Clinical Neuroelectrophysiology
  • Nerve & Muscle disorders.
  • Epilepsy
  • Stroke
     
Duration Of OPD: 

   Max Super Speciality Hospital, Saket

  • Monday - Saturday : 10 a.m. to 5 p.m

Treatment Dilemmas in Women With Epilepsy

July 26, 2017 0 20 2 minutes, 12 seconds read

There are about 50 million people with epilepsy worldwide and half of them are women. About a sixth of women with epilepsy in the world are in India. In India, there are about 2.73 million WWE (Women with Epilepsy) and 52% of them are in reproductive (15- 49) age group. It has also been estimated that three to five births per thousand will be to WWE. Social stigma, marriage and child-rearing were seen as inappropriate for women with epilepsy. These unfortunate and misguided attitudes were often based on the following mistaken ideas:

  • Epilepsy is always inherited
  • The treatment of women with epilepsy has a negative impact on child-rearing. This is untrue. More than 90% of women with epilepsy have healthy babies without seizure disorders and they lead healthy and active lives.

What is Reproductive Counselling?

  • Counselling should be sought either before marriage or planning pregnancy.
  • Every WWE is reassessed for confirming the diagnosis of epilepsy.
  • Those who are in remission (seizure free for 2-3 years) are considered for antiepileptic drug withdrawal. The risk of recurrence on suddenly stopping the treatment should be explained.
  • The risk of major congenital malformations is 6-8%, more common in women on high doses of antiepileptic drugs (AEDs) or multiple AEDs.
  • Risk can be reduced by using most appropriate drug in smallest effective dose and avoiding polytherapy unless absolutely required.
  • It is not safe to abruptly discontinue medicine during pregnancy.
  • Low serum or red cell folate levels are associated with spontaneous abortion and neural tube defects.
  • Hence it is recommended to give 5 mg of folic acid to all WWE on AED and planning for pregnancy and should continue throughout the pregnancy.
  • WWE who smoke has higher risk of premature labour and delivery.

Breast Feeding

In a recent prospective study showed that there was no difference between infants who are exposed to AEDs through breast milk and those who were not exposed, with regards to the IQ at 3 yrs of age.

It is recommended that mothers first nurse the babies and then consume the AEDs so that blood levels will not be very high during breast feeding.

It is advised to nurse the baby in such a way that in the event of a seizure, they would not drop the baby or suffocate her.

Dr Vivek Kumar says Epilepsy Management options should be discussed with a neurologist before planning a pregnancy. Its treatment should not be stopped suddenly. Moreover, more than 90% of infants born to mothers on AEDs remain healthy. The risk of major malformations is 6-8%, mostly in those who are on higher doses or polytherapy. So it is better to rationalise the AED therapy with the neurologist before planning your pregnancy.

 

 

 

 

 

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Who Are the Right Candidates for Cervical Disc Replacement Surgery?

July 17, 2017 0 26 2 minutes, 39 seconds read

Physical Therapy, Medications, and Spinal injection procedures are initial treatments for symptomatic cervical disc disease. If the symptoms like pain, numbness, or weakness (that radiates from the neck to one or both arms) continues and are bothersome for more than 6-12 weeks, surgical treatment is considered.

Disc disruption and degeneration can be a source of neck pain as well as a cause of neurologic symptoms.

Who are the right candidates for surgery?

Cervical disc replacement is indicated in patients with pain (radiculopathie and myelopathie) or neurological symptoms related to disc degeneration on one level between C3 and C7 after unsuccessful neurological symptoms conservative treatment for at least 6 weeks unless in cases of severe or progressing neurological deficits. Contra-indications are advanced spondylosis, active infection, material allergies, cervical instability, multi-level disease, severe facet joint pathology, and osteopenia.

How is Cervical Disc Replacement different than the conventional technique?

The conventional method of cervical disc replacement involved an anterior cervical discectomy and fusion surgery.

Dr. Ashish C Gupta says, in a Cervical disc replacement the damaged or degenerated cervical disc is removed and replaced with an artificial disc device.

With this new technique, an incision is made in the front of the neck which allows the surgeon to remove the damaged and protruding disc. After the disc is removed, the gap that has been created between the two bones is then filled with a piece of the bone graft. A plate having screws is put in the front of the spine to provide the initial stability that assists in achieving a solid fusion. Following the fusion, patients are often immobilised for up to six weeks in a cervical collar.

Total disc arthroplasty is now an FDA approved an option for treating symptomatic cervical disc disease surgically.  This procedure is similar to the anterior cervical discectomy and fusion except that the defect that is created by removing the disc from between the two vertebrae is filled with a disc replacement device

Composed of two metallic surfaces- one of which is attached to the upper and the other to the lower vertebra at the affected disc level, the disc replacement devices allow for movement between the two vertebrae to be maintained and avoids the need for a fusion. These metal implants can then slide on each other directly or can be separated by a piece of medical grade plastic. The device

What are the Advantages of the Procedure?

  • A disc replacement device preserves motion at the affected level which protects against accelerated degeneration of the discs above and below the disc replacement.
  • NO bone grafting is required
  • The bones are not fused together so the possibility of a non-healed spinal fusion (called a non-union or pseudarthosis) is eliminated. 
  • With disc arthroplasty, the surgeons avoid putting the plate in front of the spine. Avoiding the need for a plate may potentially lessen the irritation of the oesophagus and reduce swallowing difficulty that sometimes occurs following anterior cervical surgery. 
  • This surgery reduces the cervical collar immobilisation to a week or less, compared to the standard 4 to 6 weeks of immobilisation usually prescribed after fusion surgery.
  • Patients are typically discharged home the same day or the next morning following surgery. 

 

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