Dialysis is a very important and life-saving procedure. It is performed to replace kidney function in case of renal failure. Wastes and extra fluids in the blood are filtered out during this process. To be able to perform Dialysis, the connection between the patient s bloodstream and the equipment for performing Dialysis (dialyzer) outside the body is established. This connection is created through Dialysis Access Surgery. It is a type of Vascular Surgery which forms the vascular opening for access during Dialysis. Thus, Dialysis Access Surgery is the lifeline for the survival of the patient.

Types of Vascular Access for Dialysis- 
There are three types of Vascular Access for Dialysis: Arteriovenous (AV) Fistula, Arteriovenous (AV) Graft, and Venous Catheter.

  Arteriovenous (AV) fistula is a surgical connection of an artery to a vein. An AV fistula is usually placed in the upper arm or in the forearm. It causes extra blood to flow into vein making it grow large. A larger vein hence provides easy access to blood vessels. An AV fistula is preferred over other methods as it lasts longer than other methods of access and provides a good flow of blood. Moreover, it is less prone to infection and blood clots than other methods. Before an AV Surgery, a Vessel Mapping Test is sometimes performed for assessing the blood vessels most suitable for Dialysis. An AV fistula is performed under local anaesthesia and requires two to three months for maturation before hemodialysis. If it fails to mature, the procedure is repeated.

  Arteriovenous (AV) graft is performed when AV fistula fails to mature. It is hence the second most preferred choice for long-lasting access to vascular tissues for Dialysis. An AV graft is a looped plastic tube which establishes a connection between an artery and a vein. Like AV fistula, AV graft is also performed under local anaesthesia. It is slightly more difficult to maintain than an AV fistula.

  A venous catheter is used for short- term hemodialysis. It is a tube which is inserted into chest, neck, leg, or near groin for vascular access. After exiting the body, the tube splits into two halves. In the case where a renal disease has made quick progression leaving little or no time for the AV fistula or AV graft to mature, a venous catheter is used to establish the required vascular connection. This procedure is also performed under local anaesthesia. It is a tool for emergencies but is not suited for long- term use. It can cause narrow vein due to an infection,
scarring, or blood clot. If long- term venous catheter is used, it is tunnelled under the skin which has fewer problems associated with it and is more comfortable. 

How to Care for a Vascular Access?
  Get checked for infections and other problems before each hemodialysis session;
  Use the operated site for access only for the intended use;
  Always keep the access clean;
  Prevent cutting or bumping the access;
  Check for thrill/ vibration in the access and inform the doctor if any;
  Do not put pressure on the access site;
  Do not put blood pressure cuff around the access arm;
  Do not wear jewellery or tight-fitting garments over the site;
  Do not lift a weight.

Take Away-
Vascular Surgery for Dialysis is performed to provide vascular access for the procedure. AV fistula is the most preferred type followed by an AV graft. A venous catheter is recommended to be used only in case of an emergency when there is not much time left for the other two options to mature.

Vascular Surgery - Can It Help For Dialysis?

Are you suffering from diabetes? If yes, then it s time for you to be extra careful about your health. Diabetes may cause several other diseases as well. You must check your lifestyle and take medical efforts to get rid of diabetes as soon as possible. 


You are at risk of developing nerve damages (neuropathy), vascular injuries and other heart diseases, regardless of your age, sex or other external or internal factors. Diabetes patients must strive to maintain fasting blood glucose levels less than 110 mg/dL and hemoglobin HbA1C level less than 7%.  Also, diabetes patients should keep a check on blood pressure and cholesterol levels. 


Here s how diabetes can affect your overall health:
1. Check your heart: There is a correlation between blood pressure, cholesterol levels and diabetes. Researchers have found that high bad cholesterol levels act as a hindrance to insulin regulation. People with diabetes are more likely to develop heart-related diseases. About 60% diabetes patients die due to heart attacks. Diabetes is responsible for hardening of arteries or atherosclerosis. This situation is dangerous and can cause heart attacks, strokes or other chronic diseases.


2. Neuropathy: Diabetes leads to impaired nerve function. This is called neuropathy. This condition is of two types: Peripheral (which affects toes, feet, legs, hand and arms) and Autonomic (which affects digestion, bowel, bladder, heart and sexual activity). Symptoms of neuropathy include tingling, weakness, burning sensation, numbness in the limbs, digestive disorders, infection of the bladder and erectile dysfunction.


3. Nephropathy: Diabetes is responsible for causing damage to the kidneys as well. This is called nephropathy. In this condition, the filters in the kidney or glomeruli get damaged. As a result, there is a leakage of protein in the urine. Consequently, kidneys get damaged. Urine showing small amounts of protein is an indication of kidney damage. About 20-40% patients suffering from diabetes die due to renal failure. The symptoms of renal disorder due to diabetes include itching, fatigue, urine with protein, swelling of feet and ankles and pale skin colour.


4. Foot ulcers and amputations: Diabetes causes non-injury amputations as it affects the nerve in the limbs, especially foot. Usually, minor infections in the foot may lead to ulcers and later require amputation. In rare cases, Charcot joint or Charcot foot may also occur. This is called neuropathic arthropathy. The symptoms include swelling and reddening of the foot. The bones of the affected foot have a tendency to develop cracks, deforming the entire region.


5. Retinopathy: Diabetes leads to blindness in adults. The eye disorder caused due to diabetes is called retinopathy. Patients with diabetes develop cataract easily. The capillaries and blood vessels in the retina get damaged or obstructed, resulting in damage to the entire retina.

Diabetes: It Can be the Reason Behind Other Disorders

In our bodies, the vascular system is composed of vessels. This system is comprised of a complex network of veins and arteries. The arteries transport oxygenated blood away from the heart and spread it throughout our bodies and veins brings the deoxygenated blood (oxygen-poor) back to the heart for purification. Whenever this complicated process gets disturbed, pain, dysfunction of the system, and other complications may occur.

Most common complications among all are:
1. Abdominal Aortic Aneurysm: This condition is when there is a  bulge  formed in the weak area of the largest artery in the abdomen and keeps on increasing with each pressure flow of blood from that artery. This condition weakens the artery further and massive internal bleeding may occur.

2. Carotid Artery Disease - Stroke: This condition arises when the main blood vessels flowing blood to the brain develops a plague caused due to hardening of the arteries (atherosclerosis). The continuous increase of plague can cause a stroke.

3. Peripheral Arterial Disease: This condition occurs when the flow of oxygen-rich blood is insufficient to the lower limbs of the body due to hardening of the arteries in that area. This can cause difficulty in walking, foot ulcers, infections and can even lead to amputation.

The complication of these types are corrected by the vascular surgeon with the process is commonly known as vascular surgery. However, this condition is sometimes medically managed by an innovative, less invasive procedure called Endovascular surgery. 

Vascular Surgery-
Vascular surgery is generally the traditional surgery that corrects the diseases outside of the heart and the brain. This procedure is more invasive as it involves incisions that are surgical in nature. Vascular surgery comprises of the surgery of the aorta, carotid arteries, and other small diametric arteries. This surgery also involves surgery of veins for treating various conditions such as varicose veins and May-Thurner syndrome.

Endovascular Surgery:
However, this type of surgery is an innovative way to treat medical conditions related to the vascular system. For instance, during the procedure of treating the Abdominal Aortic Aneurysm, it involves making a small cut near the hip area and inserting the endovascular graft through the arteries and is positioned inside the aorta, in a catheter, which is a flexible, long, and narrow tube. The endovascular graft is a tube device made up of special fiber and is framed within stainless steel self-expanding stents. The grafts expand and seal off the aneurysm. This stops the internal bleeding the system and the graft remain in the aorta permanently.

This method has a short recovery time, smaller incisions, less discomfort, less stress on the heart and has fewer risks. This surgery is appropriate for the patient who is at high
risk of complications. 

Take Away-
Diseases related to artery and veins are now being treated with various methods such as angiography, stenting, sclerotherapy in various countries. These days vascular surgeons have become proficient with the endovascular surgical methods. Endovascular surgery is durable and less painful and stressful when viewed with the context of vascular surgery. However, the cost of staying longer at the hospitals is somewhat got balanced by the high cost of imaging equipment and other high financial expenses in the endovascular surgery.

Endovascular VS Vascular Surgery - Know The Difference!

Diabetes is a condition where the blood sugar level rises in your body either due to less insulin level in the body or reduced sensitivity of the body to insulin. The foods you eat have a major role in controlling your blood sugar levels. You need to pick your foods wisely to prevent your blood sugar levels from spiking.


The various foods that you should be eating if you have diabetes are:

1. Dark chocolate: chocolate contains good amounts of flavonoids that help in improving insulin sensitivity and limits food cravings. It also reduces your chances of heart attack.

2. Blueberries: blueberries are rich in fiber that helps you in managing your blood sugar levels. They also contain anthocyanins that assist in regulating your blood sugar levels.

3. Fish: fish is rich in omega 3 fatty acids that reduce inflammation in the body, thus reducing your chances of heart problems. Fish is also a good source of protein that helps you in feeling fuller.

4. Olive oil: olive oil is rich in antioxidants that help in reducing your chances of heart diseases and diabetes.

5. Oranges: make sure you eat plenty of oranges as they are rich in vitamin c and they reduce the risk of diabetes. You may also opt for broccoli or strawberries.

The various foods you should avoid are:

1. White rice: white rice is a refined grain which, when consumed, tends to spike your blood sugar levels. You can instead opt for brown rice.

2. Bananas: banana may contain vitamins and minerals, but are also rich in carbohydrates. Instead, opt for fruits like berries that are not only rich in fiber and antioxidants, but also have a low glycemic index.

3. Sugary foods: the term sugary foods is used to describe foods such as pastries, cakes, and cookies. These foods are carbohydrate rich and do not contribute much in making the body healthy. Instead, replace them with natural foods such as chickpeas and peanuts.

4. Dried fruit: various dried fruits contain a high concentration of sugar, which happens due to the dehydration process by which they are formed. So replace them with fresh fruits such as guava and peaches to control your blood sugar levels.

Amongst all other dry fruits, almonds and walnuts can be had in moderation as they contain essential fatty acids and do not affect blood sugars.

Foods to Eat and Avoid When You Have Diabetes

Diabetes is a lifestyle disease that can easily be managed by controlling our diet. Along with being aware of your sugar intake, your diet should help you lower blood pressure and cholesterol levels. However, this does not mean you have to resign yourself to a lifetime of tasteless food.

Here are a few diet tips that can help manage diabetes: 

Choose high fiber carbohydrates: Carbohydrates are an essential element of the daily diet but have a huge impact on blood sugar levels. Hence, it is important to pick the right carbohydrates. Your diet should have a limited amount of refined carbohydrates such as white bread, pasta, soda etc. and should be focused more on high fiber carbohydrates such as brown rice, sweet potatoes, rolled oats and bran flakes that are digested slowly. This prevents your body from producing excessive insulin.
Be sweet smart: The key to indulge your sweet tooth and controlling diabetes is moderation. Abruptly, removing sugar from your diet can make you crave for it. Instead, gradually lower your sugar intake. If you can't miss out on the dessert at the end of a meal, reduce the amount of carbohydrates in your meal. Adding healthy fats like peanut butter, yogurt or nuts to your dessert can also slow down the digestive process and thus control blood sugar level.
Keep a food diary: When you are diabetic, it is very important to eat at regular intervals. Eating frequent, small meals are often better than fewer large meals. Try and maintain a food diary to keep track of your calorie intake. This helps identify problem areas of where your body is getting excessive calories from. When you are aware of the calories associated with things you eat, it is easier to cut down on snacks and replace unhealthy snacks with healthier options.
Choose fats wisely: It is impossible to completely cut out fats from your diet. While some fats such as liquid vegetable oils and commercial baked goods are unhealthy, others have important health benefits. Unsaturated fats are the healthiest and safest. Replacing your vegetable cooking oil for olive oil and biscuits with nuts are easy ways to make smart choices with your fat intake.
Go green: Green leafy vegetables are low on carbohydrates and high on nutrients. Thus, make them an integral part of your meal. Vegetables like kale, spinach, lettuce, etc. can be eaten raw or cooked. Along with being nutritious, they also add texture and color to your meals, thus making them more visually appealing.
If you wish to discuss about any specific problem, you can consult a doctor and ask a free question.

5 Tips To Control Diabetes Through A Diet!

Whether it's a child or a grown-up, difficulty in concentrating is often experienced by many people. While, people tend to brush off this particular problem to be nothing worth being concerned about, but sometimes, there may be a more serious underlying issue for which concentration problem is only a mere symptom. Yes, difficulty in concentrating can be a sign of a neurological disorder. Keep on reading to know more about neurological disorder, its symptoms, and treatment.

Reasons behind difficulty in concentrating
Inability to focus properly is a periodic and normal occurrence for many. While sometimes it is the emotional stress or physical tiredness that is responsible for it, at times it is the outcome of hormonal changes in the body, such as during pregnancy or menopause that causes it. However, when experienced in severe degrees, it may be a characteristic of a serious psychological condition called neurological disorder. Affecting both adults and the children, the neurological disorder can be a serious threat if not treated at the right time.

Neurological disorder
Neurological disorder refers to any condition that happens due to the dysfunction of the nervous system or the parts of the brain. Depending on the location of the damage to the nerve or in the spinal column or the brain, different areas controlling the vision, movement, thinking or hearing can be severely affected. The decreased ability to focus on something or loss of concentration power being one of the many symptoms of neurological disorders among the various complications it causes.

Causes behind neurological disorder
Many reasons lead to neurological disorder or its associated symptoms like difficulty in focusing. From lifestyle-related issues to nutrition related causes, physical injuries to some infections, complications during childbirth, and genetics to environmental influences, numerous factors can be responsible for such disorder. Depending on the type of neurological disorder, the symptoms can vary from to another, while for some difficulty concentrating can be a symptom, for some, the symptoms can be more of physical difficulties such as problems in walking or difficulty speaking or seeing, etc.

Dealing with difficulty concentrating
Once the cause of the neurological disorder is determined, there are various treatment options, offered by the doctors. To deal with the neurological disorder as the cause of difficulty concentrating one may need medications and treatment provided by the medical professionals. However, there are a few tips that one can keep in mind, such as minimizing multitasking and focusing on one single thing or thought at one time or dividing tasks into small steps, etc.

Difficulty in concentrating means the ability to focus on thoughts or action decreasing. In case one experience this issue on a long term basis or excessively, visiting the neurologist as soon as possible should be the best thing to do.

Problem In Concentrating Could Be A Sign Of Neurological Disorder!

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