Surgery to remove abnormal growths of the brain, peripheral nervous system or the spine or any disorder can be tricky because the brain and the skull that shields it are complex areas. In the old days, open surgery was the only way to access the brain or spinal cord. But, with the invention of laparoscopy, keyhole surgery to treat neurological issues is gaining ground.

What is Neuroendoscopy? 
Neuroendoscopy is a surgical procedure that is favoured by doctors and patients alike because it is minimally invasive.
Before the surgery, you will be administered general anaesthesia so that you will be unconscious during the entire duration. During the surgery, the surgeon will drill a minute hole into your skull just above the eyebrows. You skull also has two natural openings. That is why the surgeon may make use of the nose or the mouth to access the region that needs to be operated upon.

Neuroendoscopy is useful because -

  It lets the surgeon reach regions that are not accessible with open surgery
  The tumour can be removed without any damage being done to surrounding tissues

An endoscope is a delicate device with a high-resolution camera mounted on it. There is an eyepiece on the other end. The device is also fitted with a light. When it is inserted into the brain, it lights up the passage and the eyepiece allows the surgeon to take a look inside. The camera sends a live feed of the path it is traversing and this guides the surgeon. When the tumour is reached, it is gently removed with other surgical instruments that too were inserted through the cavities or the drilled hole.

Benefits of Neuroscopy -
There are several advantages of relying on laparoscopy -

  The patient endures less pain
  Fewer chances of infection
  Faster recovery
  Very little scarring of tissues

Which Disorders call for Neuroendoscopy?
Any of the following disorders can be put to rights with a neuroendoscopic surgery -

  Pituitary tumours
  Rathke s cleft cysts
  Pineal area tumours
  Ventricular tumours
  Skull base tumours
  Brain inflammation triggered by an infection
  Chordomas
  Cerebrospinal fluid fistulas
  Trigeminal neuralgia
  Cerebral aneurysm

After Surgery-
Once you undergo the neuroendoscopic surgery, you will have to be rehabilitated so that your condition can be monitored round the clock. Neuroendoscopy is a state of the art clean and efficient surgery that is beneficial to both surgeons as well as the patients.

Know More About Neuroendoscopy And Its Uses!

At this point of time, diabetes is one of the most chronic, fastest growing lifestyle disease in the world. Also known as diabetes mellitus, the condition is basically a metabolic disorder, wherein the human body cannot store and use fuel for the energy. This fuel or glucose is the one that powers all our bodily organs and ensures that we have the energy to carry out activities throughout the day.

And while diabetes is a popular medical condition, a lot of people don't have much information about it. Although, they know the major types of diabetes, they have no clue about the difference between them. Here we outline type I vs type ii diabetes-

***Type I diabetes- Formerly known as juvenile onset or insulin dependent diabetes, type I diabetes is the one in which your body's immune system destroys all kinds of cells that release insulin. Over a period of time, this results in elimination of insulin production from the body, because of which the cells cannot absorb glucose or sugar and produce energy. Type I diabetes have episodes of low blood sugar level and it cannot be problem. Symptoms usually start from childhood or young adulthood.

***Type ii diabetes- The adult onset or non-insulin dependent diabetes can develop at any age, particularly after the 30s, although the cases of same are rising rapidly among children. This type of diabetes involves production of insulin, but not in a right way, a condition known as insulin resistance. For this kind of diabetes, the person usually might not have symptoms before the diagnoses and there are rarely any episodes of low sugar level. It can be easily prevented or delayed by following a healthy lifestyle and indulging in regular exercising.

If you have any of the above symptoms or have more questions related to diabetes, click on consult privately to ask me.

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You Surely Know About Diabetes. But Do You Know Its Various Types?

Vascular disorders are disorders of the vessels in your body that carry either blood or waste products. The vascular system consists of the arteries (that carry blood away from the heart), veins (that carry blood to the heart) and lymph vessels (that carry waste products to be excreted from the body). The various diseases of the vascular or circulatory system are:

Peripheral Artery Disease: Peripheral arteries carry blood to the various organs and tissues in the body. Accumulation of cholesterol and fat in the vessels narrow the pathway for the blood to flow. This can impair blood flow to the tissues in the body and cause complications. Various medications used to lower cholesterol and blood pressure can also be used for peripheral artery disease.
Buerger's Disease: This disease causes obstructions in the veins and arteries in the legs. This can hamper blood supply in the toes and the feet. It causes pain and may require amputation in severe cases. Treatments for this disease include smoking cessation and medications to dilute blood vessels.
Aneurysm: An aneurysm is swelling in the blood vessel walls; it usually occurs in the aorta. The artery walls become fragile and are placed under a lot of stress; this may lead to a sudden rupture of the aortic vessels. This disorder is usually treated by surgical procedures.
Peripheral Venous Disease: Peripheral venous disease is characterized by damage to the valves that allows blood to flow in a single direction. Damaged valves can cause blood to flow backwards and therefore, accumulate. Treatments for this disorder are incorporating certain lifestyle habits such as quitting smoking and alcohol.
Blood clots in the veins: Blood clots may occur in the veins present inside the muscles of the thighs and lower legs which lead to deep vein thrombosis. You may be prescribed anti-coagulants, also known as blood thinners, to treat this disorder.
Causes
People with diseases such diabetes, high blood pressure, or kidney failure can be more likely to have vessel problems. Working with vibrating tools, being in cold temperatures, and smoking can worsen vascular problems. Causes of vascular disorders usually fit into one of 5 groups:

Traumatic, which occur after injury
Compressive, which occur when the pipes flatten
Occlusive, which occur when pipes are blocked
Tumors (growths) or malformations (deformed, tangled pipes), which may or may not be present at birth
Vessel spasms, which occur when abnormal control of vessels causes them to narrow
Symptoms
Symptoms of vascular disorders can include:

Pain
Abnormal color changes in the fingertips
Ulcers or wounds that do not heal
Hand problems when in cold temperatures or locations
Numbness or tingling of the fingertips
Swelling
Cool or cold fingers and/or hands

5 Common Vascular Disorders

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?

Peripheral Artery Disease (PAD) is caused by atherosclerosis or plaque build-up in the leg arteries. Mostly, individuals with PAD have mild or no symptoms. But with the extension of the blockages, individuals may experience disability and pain that restricts free walking. In more severe cases, individuals may develop a risk of losing their limb if the circulation is not improved. 

There are various ways to improve the flow of blood in the leg, especially for individuals with severe PAD. The objectives of improving the blood flow in the limb include improving functional ability, reducing pain, preventing amputation, and providing a better quality of life. 

Symptoms 

Symptoms of Peripheral Artery Disease may include gangrene, claudication or pain in leg muscle while walking, pain at night mainly in the feet and leg, and feet sores.

Bypass Surgery

There are a number of treating methods for PAD. Both invasive and traditional methods are used to treat Peripheral Artery Disease. 

Stenting and Angioplasty are invasive treatment methods. The traditional method includes bypass surgery. The best available treatment method for an individual depends upon various factors such as severity, location of the artery blockage in the leg, general health of the patient, history of any vascular problems, and previous treatments.

Surgical bypass in the leg or Lower Extremity Bypass Surgery is usually the last option for the patients with PAD. This method is used when all the other alternative treatment methods fail or are not suitable for the individual. During the Leg Bypass Surgery, the surgeon forms an alternative channel for blood flow to bypass or avoid the blocked area and restore the direct flow of blood to the lower leg and foot. 

The risks and benefits of the surgery are calculated prior to the surgery. For the best result of the surgery, surgeons try to use the patient s own saphenous vein, from inside the leg, to execute these grafts. Surgeons may also use veins from other leg or arms or use prosthetic or artificial graft, in case the required length of the saphenous vein cannot be achieved. 

The results of artificial and saphenous vein from other limbs are not as effective as the saphenous vein from the same leg. Thus, the availability of an appropriate vein to execute this method is an important consideration that is taken into account before the surgery. 

Takeaway

Leg Bypass Surgery is one of the medical procedures for the treatment of Peripheral Artery Disease. In PAD, the artery of the leg is blocked which can hinder the daily life of the individual. 

The symptoms can be mild or absent but, in the case, where symptoms are severe, and affecting the quality of life of the patient, treatment becomes a necessity. Bypass surgery is the last option used when other alternative methods fail to help the patient. 

Leg Bypass - Know More About It!

Diabetes is growing to be the epidemic of modern days. The challenge here is it is not just about managing your sugar levels, but the whole lot of symptoms that diabetes brings with it. From bones to teeth to kidneys to wounds, diabetes affects all body systems. It is therefore very essential to watch out for symptoms of diabetes and curb it in its early stages. This will help control diabetes significantly along with its effects on the whole body.

Diabetes Complications-

Long-term complications of diabetes develop gradually. The longer you have diabetes   and the less controlled your blood sugar   the higher the risk of complications. Eventually, diabetes complications may be disabling or even life-threatening. Possible complications include:

Cardiovascular disease. Diabetes dramatically increases the risk of various cardiovascular problems, including coronary artery disease with chest pain (angina), heart attack, stroke and narrowing of arteries (atherosclerosis). If you have diabetes, you are more likely to have heart disease or stroke.
Nerve damage. Excess sugar can injure the walls of the tiny blood vessels (capillaries) that nourish your nerves, especially in your legs. This can cause tingling, numbness, burning or pain. Left untreated, you could lose all sense of feeling in the affected limbs. 
Kidney damage. The kidneys contain millions of tiny blood vessel clusters (glomeruli) that filter waste from your blood. Diabetes can damage this delicate filtering system. Severe damage can lead to kidney failure or irreversible end-stage kidney disease, which may require dialysis or a kidney transplant.
Eye damage. Diabetes can damage the blood vessels of the retina (diabetic retinopathy), potentially leading to blindness. 
Foot damage. Nerve damage in the feet or poor blood flow to the feet increases the risk of various foot complications. These infections may ultimately require toe, foot or leg amputation.
Skin conditions. Diabetes may leave you more susceptible to skin problems, including bacterial and fungal infections.
Hearing impairment. Hearing problems are more common in people with diabetes.
Alzheimer's disease. Type 2 diabetes may increase the risk of Alzheimer's disease. 
The following are some of the basic must do's if you have diabetes. These can go a long way in preventing adverse diabetic side effects.

Diet: Whether diabetic or not, it is always important to watch your diet. You are what you eat. Eat what your body needs, reduce refined foods, processed foods and increase the amount of whole grains and fruits and vegetables. Eating small frequent meals goes a long way in managing sugar levels than binging at one meal and starving the rest of the day. Reduce intake of saturated fats; include more lean meats. Choose grilling and steaming over frying and roasting. Diet is very important in diabetes. Recommended foods - Healthy carbohydrates, Fiber-rich foods, Heart-healthy fish and Good fats. Foods to avoid - Saturated fats, Trans fats, Cholesterol and Sodium
Exercise: Every week, make sure about 2 hours is dedicated to physical activity. This could include any exercise of your choice, brisk walking, swimming, cycling, aerobics, hiking, jogging, skipping, gymnastics, or playing games like football or basketball. While in most cases, the person can do these on their own, in some people, supervision may be required.
Watch your weight: For a diabetic person, controlling weight to a desirable level of BMI of 18 and 23 is very important. Obesity is one of the predisposing factors for diabetes, and reducing weight controls the onset of diabetes and helps the progression of symptoms in diabetics.
Smoking: Another risk factor for diabetes onset, quitting is the best option. If not feasible, reducing smoking and gradually quitting should be aimed at. Not just diabetes, the effects on overall health will be evident almost immediately after quitting.
Stress management: One of the main risk factors for diabetes, there is no getting away from stress. Everybody has their stresses but the trick is to manage it well. Whether it is music or meditation or medication or counselling, make sure stress levels are managed. This also helps prevent diabetic complications like heart disease and stroke and promotes well-being.
Constant Checkups: Periodic check-up of blood sugar levels, cholesterol levels, eye exam, dental checkup, foot checkup to test for nerve damage are all extremely important. Take your medications regularly without fail.
Diabetes requires a change in lifestyle, which may seem tedious initially. But after a while, it will become the norm and then diabetic control does not feel like something additional that is to be done.

Diabetes - 6 Ways You Can Prevent it

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