Fibroadenomas are benign non carcinogenic tumors that occur in the breasts of women. Although the condition may affect females of any age; spanning from pubescent girls to middle aged ladies, yet it is most commonly diagnosed in young women below 30 years of age. Fibroadenomas can be described as a stiff, smooth, supple marble under the skin of your breasts, which move when touched. These tumors which occur in varied sizes, may shrink or expand with time. Diagnosing through biopsies and treatment by surgeries are commonly employed for such a condition.

Types of fibroadenomas
Fibroadenomas are of two types: simple fibroadenomas and complex fibroadenomas. The simple tumors are usually harmless and almost look the same under the lens of a microscope. On the other hand, the complex tumors are comprised of macro cysts (large fluid-filled sacs) and calcifications (deposits of calcium) which can slightly increase the chance of breast cancer.

What is the primary cause of fibroadenomas?
Doctors aren't able to pinpoint the chief cause of fibroadenomas, but they have reasons to believe that the condition may pertain to the reproductive hormones. The condition may occur during pregnancy or during the use of hormone therapy, owing to which, the tumors may increase in size. The tumors are usually seen to shrink postmenopause, when the hormone levels start to dwindle.

Fibroadenomas are apparent and you may be able to detect them even without a doctor. The marble like tumor within your breasts are usually:
1) painless
2) firm
3) rubbery and elastic
4) easily movable

These tumors can range from being too small to as big as 3 inches or more in diameter. These lumps, which are usually harmless may be a cause of concern if they start to grow or change. Consulting a doctor is duly advised in such cases.

Risks
Fibroadenomas, only in the rarest cases, increase the likelihood of breast cancer. A complex fibroadenoma comprising of cysts or thick tissues called calcifications may aggravate your condition. Causes of concern could be if the tumor pains, a family history of cancer or an event of a questionable biopsy report.

Causes and Symptoms of Fibroadenomas

Formation of blood clots in the arteries of the lungs, heart or legs can actually kill a person. In such a case, the immediate medical action is necessary and the only way to deal with blood clots is thrombolysis.
Thrombolysis or thrombolytic therapy is a medical process that dissolves blood clots and facilitates blood flow to all parts of the body. Thus, it protects tissues and muscles from damage.

What are the causes of blood clots in the body?

  Poor blood circulation
  Conditions such as Deep Venous Thrombosis and atrial fibrillation
  Blood clots can also be formed because of dialysis catheters and by-pass grafts

How can you tell if you have blood clots?

  Swelling in one or more legs
  Cramp and tenderness in the legs
  Breathing trouble might indicate that blood clots have travelled to the lungs
  Sweating and frequent chest pain may suggest that blood clots have travelled to the heart

How is Thrombolysis performed?

Thrombolytic drugs are injected into the body intravenously. They make their way to where the blood clots exist and dissolve them. If there is a medical emergency, the drugs are delivered to the exact location of the blood clots and immediately start dissolving them. Another method is inserting a device into the blood clot infested region to break the clots up. The drugs which on entering the body dissolve blood clots are called thrombolytics. There are many varieties of thrombolytics such as the following-

  Streptokinase - It is a kind of enzyme. It is used when a person has just suffered a heart attack or pulmonary embolism. Doctors do not usually prescribe the second usage of this drug. It is injected into a vein and can be administered to pregnant women.

  Tenecteplase - Also an enzyme, it is a plasminogen activator. When it binds to the surface of the blood clot, it makes the clot degenerate.

  Reteplase - It is actually extracted from E-Coli. It is a sterile intravenous bolus injection

The leading cause of heart attacks and ischemic heart disorder is the formation of blood clots in the arteries that connect the heart and the brain. Thrombolysis is often employed as an emergency treatment for this purpose. Thrombolysis is also effective against blood clots formed in the lungs (which lead to acute pulmonary embolism). Sometimes blood clots are formed in the legs, upper extremities of the body, the pelvic region (deep vein thrombosis). These clots may travel to the lungs and heart.

Consult your doctor before undergoing the treatment.

Thrombolysis - Causes, Symptoms & Treatment Of It!

The  Roux en Y Gastric Bypass  surgery was first performed by Professor Mason in 1966. Being done in the conventional way (i.e by open surgery) earlier and later laparoscopically, the Gastric Bypass has stood the test of time over the last 52 years.

Over 50 years the Gastric bypass surgery is being performed across the globe. It has given excellent results in terms of significant and long-standing weight loss in the morbidly obese, as well as remission of Type 2 diabetes in properly selected patients. Selection of the patient to undergo this procedure is paramount. 50 years of successful results are enough to term this procedure as the GOLD Standard.

Obesity and Diabetes have been a menace over the last 2 decades world over. In India obesity is growing in such a rampant way that we can equate it to an epidemic.

As we all know, India is considered to be the Diabetic Capital of the world. Type 2 diabetes contributes to the major chunk of diabetes affected population. We Indians get affected by diabetes at very early ages and hence complications are seen at very early ages among us. Strikingly important to notice is that Diabetes is seen not only in the obese category of people but also in the normal weight people.

Diabetes is feared of only because of the complications it is capable of causing affecting the vital organs like the brain, heart, eyes, kidneys.

Intermittent or elevated surges in the blood sugars levels during the course of the day are responsible for causing microangiopathies ( damage to the small vessels supplying blood to the vital organs).

We have seen that diabetes is accompanied by high blood pressure and dyslipidemia in most of the cases. So, when a person has diabetes, high blood pressure and dyslipidemia, we label them as having the metabolic syndrome.

Oral hypoglycemic agents (OHA) and insulin form the mainstay of treatment in getting sugars under control. But these are not able to avoid these surges in high sugar levels. This does not mean that OHA s and Insulin are not the right way to treat diabetes- they indeed are.

We are going a step higher, in an attempt to get control of diabetes without OHA and insulin. Not only this, we are trying to tackle not just diabetes, but the metabolic syndrome on the whole i.e one procedure that will take care of diabetes, dyslipidemia and hypertension. This procedure is popularly known and referred to as the  Gastric Bypass  or the  Roux en Y Gastric Bypass . Thus, In short, the gastric bypass surgery offers ICE BURG treatment.

Now, the first question is that  Is this possible . The answer is YES. The second question is that is this procedure applicable for all diabetics. The answer is NO. Only Type 2 diabetics are the beneficiaries of this procedure where insulin resistance has a major role to play. (This procedure does not benefit Type 1 diabetics) Reasons for this will be explained later. The third and important question is that,  Is the Gastric bypass going to give remission of diabetes in all type 2 diabetics?  The answer is NO.

There is strict selection criterion or eligibility criteria to select a patient for The Roux en Y Gastric Bypass surgery. Best results of the Gastric Bypass surgery are seen when it is confirmed that the person is suffering from Type 2 diabetes, duration of diabetes is less than 5 years, the pancreatic reserve is good and showing good levels of C -peptide in the blood, the person has a family history of diabetes, Insulin was not required to control sugar levels within the first 5 years of onset of diabetes and person should not be underweight( BMI > 27.5 preferred).

Losing weight is not easy and even if we lose weight, weight regain is very common. Most of us would have already experienced it. When we are tackling just the weight issue, we are talking into consideration only the morbidly obese people who have a BMI > 37.5. In the morbidly obese, at first, it is very difficult to lose significant weight by the normal method of diet and exercise. Even if weight loss does occur, weight regains or bouncing back is sure.

Here we bring in the trump card   The  Roux en Y Gastric Bypass  that helps the :

 Morbidly Obese  (BMI >37.5) to lose significant weight and reach their ideal weight.
 Obese  (BMI >32.5) who also have comorbidities (like diabetes, hypertension, dyslipidemia, sleep apnea, obesity-induced infertility) not only to lose significant weight and reach their ideal weight but also to get control of the associated comorbidities.
 Type 2 Diabetics  (BMI > 27.5) to get Remission from type 2 Diabetes.
 Metabolic Syndrome  (BMI > 27.5) to get remission from type 2 diabetes, dyslipidemia and Most cases hypertension.
Type 2 diabetics can be offered this procedure even if they are not morbidly obese, is what I would like to bring it to notice.

Exposure to Type 2 diabetes for long years can lead to potential complications like coronary heart disease, chronic kidney failure, brain stroke, gangrene of the lower limbs.

In some, in spite of talking OHA s, Insulin, sugars are not under control. In these cases, the gastric bypass can be offered to those who fulfil the eligibility criteria.

Remission of diabetes after the gastric bypass procedure is very quick, ranging from a week to a month in most of the cases. However, in some, The sugar levels come to normal the very next day after the surgery in some without the OHA and /or insulin.

Gastric bypass is done through laparoscopy i.e through tiny holes over the tummy, requiring 3 days hospital stay. Supplements need to be taken following the procedure on a daily basis. Following the procedure, intake is reduced to a great extent which increases over few months as the gastric pouch stretches.

Gastric Bypass - Be It Bariatric Or Metabolic Surgery, Get Amazing Results!

The kidneys are responsible for the elimination of waste from the body. The blood is filtered in the kidneys and all toxic wastes are filtered out and excreted through urine. When this filtration does not happen effectively, a lot of waste can be found in the blood, which affects normal body function.

Kidneys may lose their functioning either due to age, injury, or disease conditions. Whatever the reason, when kidney function is hampered, the body suffers. If there was an injury or congenital problem, it could be unilateral and the non-affected kidney could still do the function. However, if it is infection or old age, normally both kidneys are affected and then replacement should be looked for externally. This is where a kidney transplant comes into the picture.

What is it?

It is a surgery where a healthy, functioning kidney is placed into the body. The donor could be

Living: These donors have to be related or unrelated. Related is often termed someone, who is a family member and is willing to donate one kidney (one kidney is sufficient for normal, healthy individuals) to the diseased person.
Cadaver: If a person is willing to donate kidneys post death, these are used for transplant, within a specified time.
Identifying the right donor and recipient:

Blood type and tissue type should be matched; a good tissue type match improves the chances of success
Overall health of the donor to ensure there is no heart disease, lung disease, or diabetes
The recipient also should be healthy
What to expect during surgery?

Once a donor is identified, in living donors, the surgery to remove the kidney and to transplant it are done simultaneously
The surgery usually takes about 3 to 4 hours
Antibiotics are given prior to the surgery to prevent infection
The blood vessels and ureter are connected back to the kidney after the transplant
Hospital stay can range from 5 days to 2 weeks, depending on the overall health of the patient and the anticipated risk of rejection.
Most transplanted kidneys work effectively almost immediately. A kidney stored from a cadaver may take a little longer compared to a fresh kidney from a living donor
People who have had transplants are put on immunosuppressants on a chronic basis to reduce chances of rejection. The new kidney will always be recognised by the body as a foreign body, and so this is essential.
Kidney transplant success rates are quite high, and more and more people are opting for transplants as opposed to dialysis.

Kidney Transplant - What To Expect From It?

Losing weight is a daunting task. This becomes all the more difficult for obese people. In many cases, the patient may be advised to undergo bariatric surgery. There are many types of bariatric surgery. Some surgeries address both the stomach and the small intestines while others address only the stomach. A gastric band surgery is one such procedure.

For this procedure, an adjustable band is placed around the upper half of the stomach. This creates a small pouch that can hold a limited amount of food. The band is connected through a plastic tube to a small device placed under the abdominal skin. Sterile fluid may be injected or removed from the band through this device. By injecting saline, the band is made tighter and by removing the liquid the band is loosened. This allows the band to be customized to improve weight loss.

The result of a gastric band surgery may vary from person to person. Band adjustment starts after the third week of surgery. Because the size of the stomach is reduced, the person will feel full faster and hence eat less. In most cases, a person can expect to lose 60 to 75 % of their excess body weight. This should not be confused with a person s total weight. The procedure can be reversed at a later date if need be.



Some people may develop side effects like nausea and vomiting after the procedure. But why this procedure has not gained acceptance compared to other bariatric procedures like gastric bypass and sleeve gastrectomy is because, the compliance with the band is not very good and complications like band erosion, band slippage, band migration are very high. Another dreaded complication following the band surgery in non-compliant patients who eat large quantities and overstretch the small gastric pouch above the band is severe GERD.

In severe cases, rarely, grains of undigested food is seen in the mouth on waking up in the morning. This could be life-threatening. Vitamin deficiencies are rare provided supplements are taken regularly during the weight loss period.  

Gradual band adjustment is required and regular follow up with the bariatric surgeon will yield good results. Over adjustment is not good at all and could lead to higher chances of complications like band erosion. However, proper dietary compliance can make the results of a band better. Ideally, a patient should get follow up checks every month after such a surgery.

All said and done, the percentage of excess weight loss in the gastric bypass and sleeve gastrectomy are far superior to the adjustable gastric banding. Even the compliance, and maintenance of weight loss over years is better in the other bariatric procedures compared to the band.

Gastric Band Surgery - Know How Competent Is It?

If your doctor ever diagnoses you with chronic kidney disease, he/she will give you two options to choose from. The first option is to undergo dialysis for the rest of your life, while the other option is to undergo a kidney transplant. While you may prefer avoiding a major surgery, such as a transplant, dialysis is not the best solution for your condition.

Here are some reasons why you should consider kidney transplant surgery over dialysis if you are looking for better health for the long-term:

1. Increases your life expectancy: What you may not know is that people on dialysis treatment have a severely reduced life expectancy. For instance, if you are 30 years old when dialysis starts, the treatment will keep you alive at most for 15 more years. Therefore, you may not even survive until your fifties with dialysis treatment for your damaged kidneys.

However, if you transplant a healthy kidney your life expectancy increases by 30 to 40 years. Keep in mind that kidneys from living donors are better and will help you live longer.

2. Eliminates the need for undergoing dialysis: If you choose dialysis over transplant surgery, you will need to undergo the treatment on a daily basis. This is not only costly but also affects your quality of life. For instance, a patient on dialysis will need to make special arrangements if he/she wants to go on a vacation with family so that his treatment continues even during the trip.

With a kidney transplant surgery, once you recover from the operation, you can live a normal life, without the need for daily treatment.

3. Lower cost of treatment: While you may think kidney transplant surgery is the costlier option between it and dialysis, you would be wrong to assume so. In kidney transplantation surgery, you pay a hefty amount at the time of the operation. However, in the case of dialysis, you pay smaller sums over very long periods. When you add up these small sums over 10-15 years of dialysis, you will find that transplantation is the cheaper option.

If you are young and have a long life ahead of you, kidney transplantation should be the first and foremost choice of treatment for chronic kidney disease. You can undergo dialysis while you wait for a donor and then receive a healthy organ.

Why Kidney Transplant Should Be Preferred Over Dialysis?

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