Doctors in Aster CMI Hospital
Cardiothoracic Vascular Surgery
Liver Transplant Surgery
Nuclear Medicine Physician
Patient Review Highlights
Naveen Kumar G
very very good and caring, friendly doctor, may god bless him
Very nice and she explained the problem indetail
I am 35 years old and still no baby. Got married before 1 year. TTC from last 5 months but suddenly I came to know I had an endometriosis and I had a surgery on 1st June. At the time of surgery Dr. Checked my tubes and all. Everything was ok. On 2nd of June Dr. Gave me an injection LUPRODEX 3.75 only one shot and added no need for more shots. 15th June I got my periods but dat was the day when I got my periods last time and no periods yet today is 20th August. Dr. Asked me to TTC. I have gone through a test beta HCG and there is no pregnancy. When I will get my periods. Dr. Asked me to wait. How long will it take? It has already been more than 2 months. I want to conceive. It's already too late.
Hi, My wife is 24 years old and her ultrasound result shows that RT Ovary: measures 3.91x1.57x1. 55 cms. Vol.=4.98 cc. Small in size with normal in echotexture, LT Ovary: Not Visualized. CUL-DE-SAC: Free fluid - not present. Impression: Features suggestive of RIGHT OVARIAN ATROPHY. Please answer me what is this result meaning, I will be very thankful to you.
Dear madam, I need a verification for PCOD Problem I am pcod patient .what is the normal range (volume) of right and left ovary. I am taking a medicine for past one year but I didn't cure my problem what is the solution for this?
A cochlear implant is a small electronic device that can help improve the hearing of people with severe, irreversible hearing loss. Although a cochlear implant does not restore normal hearing, it can allow a person to hear and understand more speech than was possible with a hearing aid. For a child, this could mean an opportunity to develop listening and speech skills and the potential to attend school with hearing peers. For adults, a cochlear implant could reduce social isolation and improve communication.
The cochlear implant is a device that is placed in the inner ear. The implant system has three primary parts:
- Microphone and Transmitter —The headpiece and transmitter is worn above the ear to pick up sounds. These sounds are sent to a speech processor.
- Speech Processor — A speech processor is worn externally, behind the ear like a hearing aid, to convert sound into a digital code that is transmitted to an implanted stimulator.
- Implanted Stimulator — The implanted stimulator is a small component placed under the skin behind the ear. It receives a digital code from the speech processor and sends it to the auditory or hearing nerve.
The brain interprets this signal and it is recognized as sound. The small headpiece and transmitter is held in place by a magnet coupled the implanted stimulator, under the skin.
Tests are done to determine if a child is a candidate for a cochlear implantation. Patients are selected based on medical and hearing histories and test results as well as findings. The evaluation, which differs slightly for children and adults, includes the following: *
- Medical Evaluation — Conducted by the cochlear implant surgeon who will take the medical history, examine your ears and explain the surgical process.
- CT Scan of the Temporal bone and MRI Brain and Cochlear imaging - This computerized tomography (CT) scan allows the surgeon to evaluate the ear's internal structure, recommend which ear to implant and may provide information as to the cause of deafness.
- Audiological Evaluation — This evaluation involves a hearing test to confirm the type and degree of hearing loss, hearing aid evaluation to assess the benefit provided by a hearing aid and aided speech recognition testing to determine if a hearing aid might provide greater benefit than an implant.
- Psychological Screening — This screening is conducted by psychologist to assess the feelings about hearing loss and the cochlear implant, such as the reasons for seeking the implant and the expectations.
- Cochlear Implant Counseling — At this time, if one is a candidate for cochlear implant, possible benefits and limitations will be explained and one will be provided with information to select the device.
Before the surgery, one will meet with an anesthesiologist and and complete any necessary tests. Patients generally remain in the hospital overnight and return home the day after surgery.
Implant surgery is performed under general anesthesia and takes about three hours. During the operation, a surgeon will anchor a receiver-stimulator device in the temporal bone in the skull and insert what is called an "electrode array" into the cochlea, the small snail-shaped structure in the inner ear that contains the hearing organ. First, an incision is made behind the ear to expose the temporal bone. The surgeon then positions the implant component against the bone. A hole is made in the temporal bone with a microscopic drill, allowing the surgeon access to the cochlea. A small hole is made in the wall of the cochlea and the electrode array is gently guided into the cochlea. The internal receiver is secured in place on the skull bone with sutures and the incision is closed. A sterile dressing is placed on the incision.
To qualify for a cochlear implant, patients must meet the following criteria:
Adults age 18 and older have:
- Overall good health
- Severe hearing loss in both ears
- Limited benefit from conventional hearing aids determined by a trial period, when appropriate, of about three months
- Psychological and emotional stability
- Realistic expectations of the implant
- No ear conditions or other medical conditions that would interfere with surgery
- Ability to participate fully in a follow-up
Children age 1 to 17 must have:
- Overall good health
- Severe hearing loss in both ears
- Limited benefit from conventional hearing aids
- Realistic expectations of the cochlear implant
- No ear conditions or other medical conditions that would interfere with surgery
- Family commitment to comply with all evaluations before and after surgery
- Enrollment in a post-operative rehabilitative and educational program that supports the use of cochlear implants and the development of hearing skills
Following surgery, patient will return home for four weeks to allow time for swelling to subside and the incision to heal. After several days, the incision may be wet during bathing or showering.
The externally worn speech processor is activated about four weeks after surgery. The processor converts speech into a special code for each user. The activation and programming is performed at the Hospital. Programming for each implant is customized for the patient and takes about six hours over a two-day period.
Visit at regular intervals for device checks and re-evaluation. During these visits, the implant and equipment are checked and performance is measured. Re-testing generally occurs at one, three and six months and one year following the initial device fitting. Then, semi-annual or annual evaluations are performed. Each session for adults involves about three hours.
Benefit from a cochlear implant usually improves with time but can't be guaranteed. Rehabilitation after surgery is key to maximizing the benefits of the cochlear implant. Most people with these implants are able to engage in hearing activities, such as listening to a Walkman, enjoying a movie, using a phone and participating in social activities. The motivation is critical to the success of the implant. Use the device during all waking hours, Listen, speak and interact with others as much as possible, Utilize visual cues when adjusting to the implant, but gradually decrease the use of visual cues when ready, Ask others to identify unfamiliar sounds so they become familiar.
Many people have questions about cochlear implants, how they work and what to expect from the surgery. Here are some common questions and answers-
Will a cochlear implant restore normal hearing for people who are deaf?
No, a cochlear implant does not restore normal hearing. It is a communication tool but not a "cure" for deafness. When hearing functions normally, parts of the inner ear convert sound waves into electrical impulses. These impulses are sent to the brain, where they are recognized as sound. A cochlear implant simulates that process. An implant, supplemented with listening therapy, can help people recognize sound, including speech.
Are there risks in cochlear implant surgery?
Risk is inherent in any surgery requiring general anesthesia. However, the surgical risks for cochlear implantation are minimal and most patients require only a one-day hospital stay and have no surgical complications.
Will I need more surgery as new technology becomes available?
The implanted unit is designed to last a lifetime. The externally worn speech processor, which is responsible for converting sound into code and sending the information to an internal unit, is dependent on software that can be upgraded as technology improves.
Will my child outgrow the internal device and require a new one?
No, the cochlea is fully formed at birth and the skull structures achieve almost full growth by age 2. The electrode array is designed to accommodate skull growth in children. Should I wait for new cochlear implant technology? No, the design of the surgically implanted receiver and electrode array has changed relatively little during the history of cochlear implants. However, speech-coding strategies, which are responsible for delivering the signal to the internal unit and are stored in the externally worn speech processor, have improved significantly over the years. The speech processor can incorporate new technology when available.
Can people with cochlear implants identify environmental noises as well as speech?
Cochlear implants provide a wide range of sound information. Performance in speech perception testing varies among individuals. With time and training, most patients understand more speech than with hearing aids and many communicate by telephone or enjoy music.
Can people with cochlear implants swim, shower and participate in sports?
Yes, people with implants can swim, shower and participate in virtually all types of sport activities when they are not wearing the external equipment. The only restriction relates to skydiving and scuba diving because significant changes in air pressure are not advised. Participation in all other athletic activities is unrestricted, although protective headgear is always recommended. In case you have a concern or query you can always consult an expert & get answers to your questions!
Pregnancy is a really beautiful as well as a very sensitive phase in a woman’s life. Craving for your favourite food in the middle of the night, or even throughout the day, is a perfectly normal phenomenon. Although you deserve to be pampered with your favourite food, however, there are certain foods which irrespective of cravings you really need to avoid for the well being of that tiny little life inside you.
Sesame seeds also tend to excite uterine muscles thereby causing contractions which may lead to abortion. So it would be an intelligent step to avoid intake of these. Other dry fruits like raisins, dates, almonds, walnuts, pistachios are safe to consume in a moderate amount.
Although fish is rich in omega 3 and is an important food to include in the pregnancy diet, intake of some sorts of fish might not be a good idea. Here is a list of the kinds of fishes that should be avoided.
Any form of undercooked or treated meat or poultry. This is because a parasite named toxoplasma may be present that might cause excessive food poisoning which in turn could cause foetal damage or miscarriage.
Sprouts and raw vegetables should be avoided. However, these can be eaten if shallow fried.
Canned food as well as street food.
There are many more little details that should be taken care of but this list would be handy for newly pregnant women.
PCOD or polycystic Ovary Disorder is one of the most common disorders of hormones among women in the age of reproduction. It is yet not discovered why some women become susceptible to this disease and it is believed to be a genetic disorder. The word “polycystic” refers to multiple cysts and a woman suffering from PCOD has multiple cysts in her ovary. This is due to the imbalance of hormones, which don’t allow the ovary to release eggs every month and these numerous unreleased eggs present in the ovary cause it to become polycystic.
What are the symptoms of PCOD?
The regular release of eggs from the ovaries directs a woman’s fertility and allows her to have a normal menstrual cycle. Therefore, women with PCOD face difficulty in conceiving along with irregular, low and absent periods. Some of the most common symptoms of PCOD include infertility and even miscarriage, elevated insulin levels, high blood pressure, diabetes, acne, unhealthy weight gain and obesity. It also leads to loss of hair from the scalp and excessive growth of hair on the body. This is due to over production of male hormones that lead to male pattern of growth of hair, such as on chest, cheek, chin and inner thighs. The hormonal imbalance leads to weight gain and obesity makes the hormonal imbalance even worse, turning it into a vicious cycle.
How is PCOD diagnosed and treated?
Your gynaecologist would be able to determine whether you have PCOD by checking your symptoms. Then she would recommend you to do a few blood tests along with a pelvic ultrasound scan to confirm whether you have PCOD. Though this disease is not reversible, its symptoms may be reduced or minimised. Most women can lead a trouble-free and healthy life if they take proper precautions at the right time.
It has been pointed in several studies that reduction in weight can help in the improvement of most PCOD symptoms because fat contributes to the production of certain hormones. Your doctor will prepare a treatment plan depending on the aspect from which you are suffering. For instance, if you are suffering from irregular periods, your doctor may prescribe you some contraceptives which can help in restoring normal menstrual cycle. But this treatment is definitely unsuitable for those who are trying to conceive. The infrequent and irregular ovulation can make it difficult to conceive and it can be artificially induced with the aid of medications. So, you must consult a gynaecologist to help your situation. In case you have a concern or query you can always consult an expert & get answers to your questions!
The liver has a significant role to play in metabolism and digestion. The failure of a liver can lead to significant health issues. There are some causes for liver failure, which cannot be treated with medications. In these people, a transplant, which is replacing the diseased or injured liver with another liver, is the only definitive treatment option.
Some conditions which can require a liver transplant are:
- Severe cirrhosis with a life expectancy of less than a year
- Severe liver failure
- Non-alcoholic steatohepatitis (NASH)
- Liver cancer
- Chronic hepatitis C
- Biliary atresia in children
Types of transplant:
- Living donor transplant: In some patients, partial liver can be removed from a close family member and transplanted into the affected individual. The liver is known for its regeneration ability, and over time, will grow in the recipient.
- Cadaveric transplant: Immediately after death, a liver can be removed and transplanted.
While the concept of a transplant sounds quite convincing and appealing for those with a severe liver disease, it is also important to note that not all would qualify for a liver transplant. The conditions which would disqualify a recipient are discussed below:
- Significant heart disease: Those with severe coronary artery disease, valvular disease, cardiomyopathy, aortic stenosis, and cardiomyopathy are not candidates for a liver transplant.
- Severe lung disease: Those with poor lung perfusion do not qualify for a liver transplant.
- Advanced age: Greater the age, lesser the survival rates. So, people aged more than 70 are usually not considered for a transplant.
- Obesity: A person with a BMI of more than 35 is often not a good candidate for a transplant. The overall health should be managed in these people.
- Malnutrition: On the other extreme, severely malnourished individuals are also not considered for a transplant.
- HIV infection: A person who is HIV-infected does not qualify for a liver transplant.
- Substance abuse: Anyone who is actively abusing alcohol and/or substances is definitely removed from the list for a transplant.
- Metastasis: If a patient is looking for a liver transplant due to hepatic cancer, it is essential that the cancer is contained. If it has spread to various parts, then containing it would be difficult, and a transplant may not succeed.
- Multisystem organ failure: Other than heart and lungs, even people with poor renal function are not ideal candidates for a liver transplant.
A detailed liver recipient evaluation assessing the severity of liver disease, chances of survival, and overall health are done before a person is listed for liver transplant. This evaluation ensures a better success rate with the transplant.
Post-Transplant Lymphoprolipherative Disorder (PTLD) is a condition or a reaction that happens post your liver transplantation or any kind of organ transplantation. There is a rapid increase in the immune cells or more precisely, the lymphoid cells in the body. These cells start increasing without any control. The seriousness of this growth can be harmless but sometimes, it can develop into lymph node cancer as well.
The major reason behind PTLD is the anti-rejection medicines that are taken by the patient to avoid rejection and attack by the immune system.
Types of Post-Transplant Lymphoprolipherative Disorder (PTLD)
- Early lesions: This will go away by itself, if the dose of anti-rejection medicine is reduced.
- Polymorphic PTLD: This is a mixture of different kinds of lymphoid cells.
- Monomorphic PTLD: This is the most common type of PTLD found in many people who have undergone a liver transplantation. This has just one type of lymphoid cell.
- Hodgkin Lymphoma: This is a very rare kind of PTLD.
Diagnosis of Post-Transplant Lymphoprolipherative Disorder (PTLD)
- Small and painless lump under the armpit, groin, or neck area
- Night sweats
- High fever
- Excessive weight loss
- Low appetite
- Unwell feeling
Usually, it is not at all easy to diagnose PTLD. The lump may grow so deep inside the body that it can be hard to see or feel it from outside. Apart from the lump, others are general symptoms and they can be a reason for any kind of infection in the body post transplantation. It can be a reaction to any new medicine taken by you or a reaction to rejection. Early diagnosis can help you in increasing the chances of a successful treatment. A biopsy is also a good way to detect PTLD, where a small piece of the liver is taken and tested under a microscope to detect PTLD.
Management of Post-Transplant Lymphoprolipherative Disorder (PTLD)
Your liver transplant surgeon is going to work closely with the lymphoma doctor in order to provide the best treatment for you. For early lesions or Polymorphic PTLD, reduction of the anti-rejection dose can give you better results. Your immune system will restore back and will destroy all the abnormal cells in the body. But it has to be done slowly so that it does not cause organ rejection again. If reduction of anti-rejection medicine is not possible or if reduction causes any kind of harm, then other treatment methods like antibody medicine such as Rituximab, or chemotherapy regimen or radiotherapy may be used.
In case you have a concern or query you can always consult an expert & get answers to your questions!