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?

Diabetes is often called the silent killer. This is because you would not even know when it sneaks up on you. It may not have any symptoms initially but once you have it, you would need lifelong administration of drugs. Diabetes or diabetes mellitus, is a metabolic disease in which sugar does not get metabolized properly in the body. This means that the blood sugar levels continue to be high, threatening the normal functioning of the body.

Types of Diabetes

There are three types of diabetes. These are:

Type 1 Diabetes: this is a condition in which in which the body does not produce insulin at all. Patients suffering from this condition may need to take insulin supplements for the rest of their life, in order to properly metabolize sugar in the body. This is a very rare, genetic condition.

Type 2 Diabetes: this is a condition in which the insulin product is impaired and there is not enough insulin in the body for metabolizing sugars properly. This leads to high blood sugar and eventually, the symptoms of diabetes.

Gestational Diabetes: This is an affliction of pregnant women. Some women s bodies may not be able to produce enough insulin at the time of pregnancy and therefore they have excess sugar in their blood stream. Gestational diabetes may be harmful for both the mother and the baby.

Diabetes Treatment in Ayurveda

For Ayurvedic treatment of diabetes, the first step is usually dietary planning and lifestyle change. Adopting a more active lifestyle, and a healthy, balanced diet low on sugars and starches, is a must. You must begin by avoiding sugars in all forms. This means you will have to get rid of rice, potatoes, white bread, sugar coated cereals, bananas, colocasia and much more. Add a lot of green leafy vegetables to your diet to improve your nutritional status and metabolism. In addition to these, also add some herbs to your diet. Ayurvedic herbs that act as natural medicine for diabetes include turmeric, bitter gourd, gurmar leaves, bael, fenugreek and many more.

Apart from diabetes Ayurvedic treatment, you could also practice yoga, which can help you improve your health. Several yogic asanas help massage your internal organs so that they are healthier and can function much better. Some of the asanas are especially beneficial for the pancreas, which produce insulin. You may have to make some changes to your lifestyle as well. For starters, you will have to maintain a more active lifestyle. You will also have to avoid sleeping in the daytime. Avoid smoking and consuming alcohol and take extra care of your feet.

Here are a few home remedies that may help cure diabetes naturally:

Juice of Bitter Gourd:

You may consume 30ml of fresh juice of Karela/ bitter melon every day early in the morning. You can also mix it with other things to make simple recipes and consume it.

How to prepare:

Separate the seeds and mix the fruit in the mixer. Add a little bit of water and mix it in the blender. Use a sieve to obtain the juice.

Small and thin pieces of the bitter gourd are cut. Fry them with some mustard oil and the required quantity of salt. Add green chillies and onions to the pan and heat the mixture for 10-15 minutes.

Aloe Vera and Ground bay leaf:

The mixture of aloe vera gel (1 tbsp), ground bay leaf (1/2 tsp), and turmeric (1/2 tsp) is recommended to be taken twice a day before lunch and dinner for effective hyperglycaemic control.

Methi Seeds:

Methi seeds, also known as Fenugreek seeds, when taken by itself or in combination with other Ayurvedic herbs, can act as an effective remedy to lower the symptoms of diabetes.

How to prepare:

Grind a few Methi seeds and turmeric together and take it with a glass of milk at least twice a day.

Soak fenugreek seeds in warm water overnight followed by chewing it in the morning.

Soak 4tbsp of fenugreek seeds in about 300ml of water overnight and chew it the following morning.

Prepare chapattis with fenugreek seed powder

Jamun Seeds:

The powdered seeds of Eugenia jambolana (about 1 tsp) should be taken twice a day with lukewarm water. Jamun has the beneficial property of not allowing the starch in food to get converted into sugar.

Amla:

Amla juice (Embelica officinalis) (20 ml) two times a day is beneficial for a diabetic patient. You may also use powdered  Amla  powder and consume it twice a day.

Banyan Tree Bark:

A decoction of the bark of banyan tree is taken (50 ml) twice a day.

Preparation method: 20 gm of the banyan tree bark is boiled in 4 glasses of water. Evaporate the water until only about one glass of the decoction is remaining and drink it when it is warm.

Cinnamon Powder:

Cinnamon powder is probably considered as one of the most important home remedies.

How to prepare: Add 3-4 Tbsp of cinnamon powder and add to one litre of water and boil the same for about 20 minutes. Strain this mixture and cool the same. It is recommended to consume it every day.

Diabetes Cure In Ayurveda 

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

There was an era where we had deadly infections like plague and polio causing death of thousands of people. We still have occasional outbreak of swine flu, but by and large, infections are quite controlled. The new killer diseases are caused because of the lifestyle we have adapted and the damage we have done to the environment. High intake of processed foods, artificial chemicals in our foods, sedentary lifestyle with very minimal to no physical activity, couching over the computers; the list is quite long. All these have led to diseases like diabetes and cancer that were not so common about say few decades ago.

Detailed observation has revealed that both these new epidemiologic diseases have a close correlation. There are factors, which induce diabetes and diabetes in turn and in some cases, diabetes inducing agents, can cause cancer also. It has also been observed that mortality is severely increased if diabetic patients are diagnosed with cancer. There are two types of diabetes. While type 1 is mostly hereditary, type 2 is lifestyle induced and the age at which this is being diagnosed is taking a severe plunge. Adolescents and teenagers are being diagnosed for diabetes. Cancer, on the other hand, is of various types (leukaemia, melanoma, etc.) and can affect various organs (lung, breast, prostate, stomach, liver, etc.).

The medical community is yet to decipher the disease pattern of both these conditions. While there is no definite correlation between diabetes and all types of cancer, some types of cancer are definitely correlated with a definite reason identified, pancreatic and liver cancer for instance. The high amounts of insulin that diabetic patients are exposed to causes changes in liver and pancreas including fatty liver and cirrhosis, here the incidence of cancer is higher. The linkage is not very clear in lung and intestinal cancers and also there is no link between prostate cancer and diabetes.

Diabetes is considered as a state of chronic inflammation and leads to conditions like hyperinsulinemia (higher levels of insulin in the blood) hyperglycemia (higher levels of sugar in the blood). These are believed to aggravate the neoplastic process of cancer formation, thereby inducing cancer at a greater pace and also increasing the mortality rates.

The following are risk factors that are applicable to both age, physical activity, diet, obesity, drinking and smoking. It is also possible that onset of one can be followed by the other. As noted earlier, more detailed research is awaited to establish a definite linkage, but the correlation cannot be ignored at all.

Both these new epidemics are here to stay and since they have a common set of factors, we need to work on ways to contain them.

Diabetes and Cancer: The New Epidemic?

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 probably one of the worst enemies of human health. Why? That is because unlike many other diseases which make you aware of their presence in your body instantly, diabetes is a silent attacker. So, you may continue to be unaware of the disease for a very long time, before you suddenly realize that something is wrong with your body one day. And then tests reveal that you are afflicted with diabetes.

In order to make sure that this doesn't happen to you, you have to keep an eye on the symptoms of diabetes because prevention, no matter how tedious it is, is always better than the cure. Here is a look at the usual but often ignored signs which indicate that you might be suffering from diabetes.

If you are taking more bathroom breaks than usual, and if the rate of going to the loo is increasing gradually with time, it can well be a sign of diabetes. When you are suffering from diabetes, your body becomes less efficient in breaking down the consumed food into sugars and utilising it. Therefore, a lot of sugar gets saturated in your bloodstream and your body gets rid of it by flushing it out through urination.
If you urinate a lot, it is self-evident that you would also feel very thirsty all the time. In some cases, the patients don't realize their problem and drink chocolate milk or aerated drinks which have sweet flavours. This leads to excess sugar in your body again, and the problem continues. So all in all, if you feel very thirsty all the time, get yourself checked.
You might lose weight, and it may really seem like a great thing in the beginning but it is not. When a person has diabetes, he is likely to lose his weight because of the decreasing water level in his body as well as the inability of the body to break down food into more suitable forms.
If you are tired all the time, and by all the time we mean even after getting up from a long and good night's sleep, you may have diabetes. The reason for this is that fatigue comes to you when your body cannot produce enough energy from the food you consume, and this happens only when you have diabetes.
If your cuts and bruises heal slower than ever, you definitely are a victim of diabetes. This is because the immunity and clotting system of your body don't work well when there is a saturation of sugars in your body.

5 Signs That You're Suffering from Diabetes

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