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 something which has become so common over the past few decades and this is said to be a cause of worry as most people don't understand how to prevent and manage it. This has led to some myths, gaining more than their fair share of popularity. So, wouldn t it be a good idea to get to know a little more so as to separate the myths from the facts?

Weight & watch: One of the most common myths when it comes to diabetes is the belief that a person is going to have his or her life adversely affected if he or she is overweight. While it is true that being overweight happens to be one of the risk factors related to diabetes, it is important to keep in mind the fact that there are other risk factors which are responsible, as well. Some of these factors are age and family history, as well as the ethnicity of the person. Taking this into account, it should not come as too much of a surprise to know that there are quite a few people who are not overweight, but are still fighting diabetes.
Packaged tricks: Considering the rise in the number of people who are suffering from diabetes, this has led to food being marketed specifically for their consumption. However, in reality, whatever represents a healthy diet is sufficient for a person who is diabetic. So a diet which does not have a high amount of saturated fats and trans fats and does not go overboard with starch and sugar, but features a fair amount of lean protein works well too. All the fancy diabetic food, which a person buys, is only likely to drive a great hole in the wallet and not have any additional health benefits. Therefore, the extra spending is nowhere close to being worthwhile and should be avoided.
Fruits punch: Many people are of the opinion that it is the processed and sugary food items, which cause diabetes and this is true to a significant extent. However, some people are of the view that since fruit is natural, diabetics can eat as much of it as they like. This is where the thinking gets dangerous. Some fruits are rich in carbohydrates and so it should be consumed in a reasonable quantity, as part of the daily meal plan. After all, too much of any good thing is bad!

Diabetes - 3 Myths Decoded!

Top 5 things all diabetics must do

As you are aware, diabetes is an increasingly common problem not only in adults but with children and young people too. Preventing or delaying diabetes is possible with a few lifestyle changes. And for those who have been diagnosed with type-2 diabetes, changes in lifestyle can prove beneficial to keep it under control. This is important and should not be taken lightly as diabetes can lead to other serious health complications. There are few simple things which if done regularly can keep you safe and absolutely fine.

5 ways to combat diabetes.

1) exercise - do minimum 45 to 30 minutes of exercise like brisk walking (for people with heart ailments make sure that you have done stress test/tmt). Keep yourself physically active all the time this will help you in losing weight, controlling blood sugar, blood pressure, cholesterol. It will also improve insulin sensitivity in your body. 
2) high fiber diet - include high fiber foods like fruits, vegetables, leafy vegetables, beans, nuts, seeds, and whole grains, cinnamon, green tea in your diet. This will improve your blood sugar level and also reduce your risk of developing diabetes and helps you to lose weight. Do not get into fad diets and tv commercials as they are often misleading.
3) reduce stress - tension and worry releases certain chemicals (stress hormones) which can increase your blood sugar level. Try relaxation therapy like meditation, yoga, music and soundful sleep.
4) restrict intake of alcohol - alcohol increases body weight, triglyceride (cholesterol) level and blood pressure. They may make you unaware of symptoms of hypoglycemia (low blood sugar which may be dangerous). They are empty calorie with no nutritional value. Permissible limit is 2 drinks (60ml) a day for men and 1 drink (60ml) for women, it is also not advisable to smoke.
5) regular check-ups - make sure that you regularly check your blood sugar levels and modify treatment from your diabetologist doctor (if required.) your body and your friend/ relative / colleague's body are different, so is your need of medicine for diabetes as well. What works best for them may not be right for you. So it is my sincere request is to avoid any self medication as it can be dangerous. Regularly undergo screening for early detection of diabetes complications like eye, nerve, heart, foot, kidney.

From lybrate: if you found this tip useful, please thank the doctor by clicking on the heart icon below. Also, spread good health by sharing this tip with your loved ones over whatsapp, facebook and other media.


Top 5 Things All Diabetics Must Do

Many people know that smoking causes several problems including cancer, heart disease, and respiratory disease. However, there are other diseases occur because of smoking and chewing tobacco. Buerger's Disease is one such disease in which the blood vessels in legs and arms get blocked. This blockage will interfere in blood flow and results in forming blood clots. These clots will affect both legs and
hands.
Buerger's Disease is also known as Thromboangitis Obliterans. It is a type of vasculitis which causes inflammation in the blood vessels including thickening, narrowing, weakening, or scarring.
Buerger's Disease cannot be cured easily. However, by quitting the use of tobacco and smoking, one can limit the symptoms from getting worse. If a person is not able to quit smoking, he/she might end up
suffering from severe tissue damage. One can also even lose toes, fingers, or other parts of the limbs. This is why quitting all type of tobacco or smoking is the only way to treat Buerger's Disease.

What Causes Buerger's Disease?
As discussed earlier, smoking cigarettes or cigars and chewing any form of tobacco is one of the main causes of Buerger's Disease. Still, the exact cause of this disease is unknown, but in most cases of Buerger's Disease, the sufferer has consumed tobacco products. It is an assumption that chemicals present in tobacco, cigarettes, and cigars may affect the lining of blood vessels, causing them to swell. According to experts, the genes in the body may also cause this disease. It is suspected that this disease is caused by an autoimmune response in which the immune system of the body attacks healthy tissues mistakenly. According to this theory, some people are prone to this disease.

Symptoms of Buerger's Disease-
Some of the most common symptoms of Buerger's Disease are:
  Pain in the hands and feet while exercising
  Stiffness due to reduced blood flow
  Pain at Rest
  Skin ulcerations
  Gangrene of the fingers and toes in severe cases
  Numbness, coldness, or tingling of the feet and hand
  Pale, reddish, or blue-tinted hands or feet.

Diagnosis of Buerger s Disease-
There is a set of tests that can diagnose Buerger s disease. Doctors first ask a person about his/her lifestyle, use of tobacco, and symptoms. After seeing a few symptoms, doctors may perform a test to check the blood flow. He may also look for other diseases that cause similar symptoms. Some of the common test to diagnose Buerger s Disease are:


  Allen Test: The Allen test is a blood flow test. In this type of test, patients squeeze their hand into a firm fist, which pushes out blood from hand. The doctor presses the arteries to slow down the
blood flow of the hand. At this stage, the normal color of the skin gets pale. After that, patients open his/her hand and doctors release the pressure from both sides of the wrist one by one. If it takes a longer time to go back to the normal skin color, it may be an indication of Buerger s disease

  Angiogram: It is a type of X-ray that will help to check the blockage of the blood vessels in the legs and arms. In this test, doctor place catheter (thin tube) into an artery to pump the dye. After
that, he takes X-ray images. Doctors may also perform tomography (CT) or MRI scan for clear results.

  Blood Tests: The blood tests will help the doctor to check if there is any other disease that causes the same symptoms as most of the vascular diseases mimics the symptoms of Buerger s
Disease. The doctor may also perform tests to check for diseases like lupus, diabetes, and those that cause blood clots.

Treatment of Buerger' Disease-
Quitting smoking and use of tobacco will help a person to lower the symptoms of this disease. Doctors may also prescribe for pain killers or antibiotics to get rid of the pain in affected areas. If a person finds it difficult to quit smoking, doctors help him/her with the right program and rehabilitation techniques.

Take Away-
Buerger's Disease is one of the rare illness caused by intake of tobacco products, this is why quitting smoking is most important to treat this disease. It is also advisable to consult a doctor as soon as a person identify any of the above symptoms.

All You Need To Know About Peripheral Vascular Injuries!

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?

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