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?

What do we mean by the term Anemia?

It is described as a decrease in the total number of red blood cells, or hemoglobin in the blood, or a decreased oxygen-carrying capacity of blood.

How to know if an individual has Anemia?

An individual with anemia may show one or more of the following signs or symptoms:
Shortness of breath, chest pain, and headache are especially seen with exercise as the oxygen supply decreases
Difficulty in concentration which is mostly seen in children
Easy tiredness, fatigue, and loss of energy
Dizziness because of low blood volume leading to hypotension
Hair loss especially while combing, washing hair. Also, hair becomes brittle and dry due to anemiaInsomnia (lack of sleep)
Cramps in legs especially calf muscle 
Rapid heartbeat with exercise as the demand for oxygen increases during exercise, so your heart beats faster than usual
Craving for indigestible substances, such as pica, paper, mud, ice, dirt, etc.
Koilonychia (spoon-shaped nails or upward curvature of the nails)
Soreness and cracks at the corners of the mouth
Very heavy menstrual periods or irregular bleeding because of low hemoglobin count
Pale skin is especially seen over the palms of your hands and under your nail beds. Also, the conjunctiva looks pale
Anemia due to Deficiency of Vitamin B12 Dementia (loss of memory)
Tingling sensation in the hands or feet
Loss of the sense of touch
Difficulty in walking
Stiffness in the arms and legs
Delayed growth and development in children
Swelling of the hands and feet
Episodes of severe pain in the joints, abdomen, and limbs as the red blood cells obstruct capillaries
Anemia by Chronic Red Blood Cell Destruction/Hemolytic anemia

Jaundice (yellowish or greenish pigmentation of skin and sclera of the eyes)
Brown or red colored urine due to the destruction of red blood cells
Fever due to the destruction of red blood cells
Small bruises under the skin
Abdominal pain because of enlargement of the spleen and liver
Black stools due to the destruction of the red blood cells
Anemia Caused by Chronic Lead Poisoning
Level of lead in blood is higher than 50  g/dLA blue-black line is seen on the gums. It is also known as a lead line
Abdominal pain
Constipation
Vomiting
Investigations 

Complete blood count: This test will help an individual know the percentage of hemoglobin in blood as well as red blood cell count. Also, mean cell volume (MCV) is used to categorize anemia.
Serum Ferritin Test: Ferritin levels below 15 20 micrograms/L in a person confirms iron-deficiency anemia.
Total Iron-Binding Capacity: It measures the blood's capacity to bind iron with transferrin.

How Can Anaemia Be Diagnosed?

The skin is the largest external organ as well as the largest organ in general in the human body. There are many types of skin diseases that can afflict your body and they may appear anywhere. Ayurveda is a potent weapon which can be used to treat many skin diseases effectively. The natural remedies of Ayurveda are being increasingly adopted throughout the world. Let's take a look at a few of the skin diseases that can be easily cured by Ayurveda.

Eczema - one of the most common types of skin diseases, eczema is characterized by the reactions that the skin has. These reactions can manifest themselves in many forms. The most common reaction is swelling of the skin with redness. Other forms may also develop blisters, cracking of the skin, scaling or papules.

Scaly rashes - scientifically known as papulosquamous eruptions, scaly rashes are usually the result of itching which in itself is a reaction to some internal or external factors. These rashes can be mild to severely painful depending on what had caused them. Some factors behind these may be eczema, reaction to drugs, psoriasis and others.

Urticaria - these rashes differ from other ones as they persist for a short period of time and usually result in swellings on the skin. These swellings may be very sensitive and itchy. Some common examples of urticaria are nettle rashes and hives that may develop due to an external factor such as bug bites.

Psoriasis - Ayurveda has great treatments for this disease as its incidence within the population is quite high. This is a non-infectious skin condition where inflammation occurs in the affected parts of the skin and reddish scales form on the body. This problem is usually attributed to excessive cells within the body.

Pruritus or itching - another very common skin affliction which can be caused by a variety of factors, it can be a reaction to something external or be caused by internal issues that may be developing. Mostly caused by the reaction of external nerve endings they may become very painful if over stimulated.

Ayurveda has many remedies for all of the ailments mentioned above along with many other skin disorders and has gained popularity as it completely natural and devoid of side effects encountered with conventional medicine.

Common Skin Diseases That Ayurveda Can Easily Cure

For many people, their morning is incomplete without a cup of hot beverage. A hot cup of tea (black, white or green) or coffee can lift your mood and spirits in no time. After a long and tiring day, most people crave for hot beverages. It helps them feel relaxed and rejuvenated.

But now comes a big jolt for the ardent fans of hot beverages. As per the findings by the International Agency for Research on Cancer (IARC) (an agency that deals with the evaluation of the cariogenic factors and agents for the World Health Organization), drinking very hot beverages may trigger cancer (especially of the mouth and esophagus) in some people. While alcohol, tobacco, red meat, to name a few, have already found their way into the list of carcinogenic agents, the hot beverages had been the latest addition that has left many people shocked and baffled.

The same agency, IARC had in the 1990's (1991 to be precise) classified yerba mat  tea (a famous and traditional South American tea usually served very hot) as a potential carcinogenic agent. The study suggested that using yerba mat  for long (often in large quantities) can trigger cancer (mouth, lungs, and esophagus) in some people. Some research stressed that the main cause of concern was the presence of the carcinogenic agent, Polycyclic Aromatic Hydrocarbons (PAHs) in yerba mat .

However, the latest study has included all hot beverages, heated over 65C or 149F as potential carcinogens. The study stressed on the fact that when you drink a very hot beverage, more than often, it goes on to injure the esophageal cells and tissues. In some cases, this can trigger cell multiplication. If unfortunately, some of these cells undergo mutations in the process, then it can, in turn, result in abnormal cell growth. This deviation, in turn can eventually give rise to tumors, which are often found to be malignant and carcinoid in nature. In other words, the thermal injury caused to the esophageal lining due to hot beverages can cause cancer.

In many places (restaurants and cafes), the hot beverages are typically served at a temperature, ranging from 71 - 85 degree Celsius, thus making the situation even worse.

However, there is a lot to rejoice for the coffee lovers. The WHO and IARC have surprising dropped coffee from its list of potentially carcinogenic agents. What was believed to be a carcinogenic agent (especially bladder cancer) for long has suddenly been rendered harmless. Some researchers and scientists believe that the antioxidants present in the coffee beans can go a long way to prevent and reduce the instances of cancer. Thus, having coffee in moderation may prove to be helpful. However, the credibility of these findings is yet to be accepted by one and all.

The hot tea lovers will surely wait for similar path-breaking research and miracles. If you wish to discuss any specific problem, you can consult a General Physician.

Hot Beverages - Did You Know They Can Cause Cancer?

Sugar is present in all your beverages, smoothies, cookies, desserts, food items and more. But the not so sweet truth is that too much sugar in your diet can turn your life topsy-turvy. It increases your risk of obesity, diabetes, heart diseases, deters the immune system and even harms the brain function. So, in order to break the addictiveness of sugar that can rob you of your health, all you need is a clear path to detox from sugar.

Here are some pointers on how to detox your body off excess sugar:

Turn away from sugar: Sugar is more addictive than cocaine. So you need to develop a strong will power to eliminate sugar completely, as you would do if you are trying to come out of alcoholism or other intoxications. You should not just avoid table sugar, but also keep away from all the sneaky sugars available in processed food and beverages. Ideally, a time period of 10 days is suggested to give up on any kind of sugar.
Stack up on proteins: Eat meals that contain lots of good protein and fat. Since they are difficult to digest and take more time to absorb, it will make you feel full for a long time and sustain your energy levels. The key to balancing blood sugar and insulin levels, without much cravings can be achieved through a high protein diet.
Eat the right carbs: Avoid refined carbs and starchy foods like potatoes, white bread, pasta and baked goods. Instead opt for natural carbohydrates present in vegetables like broccoli, cauliflower, leafy greens, eggplant, and artichokes. It is also good to avoid grains and beans during your detox period.
No artificial sweeteners: You might be tempted to replace sugar with artificial sweeteners, but this is not really beneficial. Artificial sweeteners are just temporary solutions when weaning from sugar and we do not know about its long term benefits. In the long run, it might be just as addictive as sugar. If at all you crave for something sweet, go for natural fruits.
Consume whole foods: Foods that don t come in boxes, cans or bottles. Whole foods like vegetables, fruits, lean meat, nuts, fish, seeds and healthy fats will help a great deal to curb cravings and also keep you satiated.
Sleep well: Last but not the least, get quality sleep time to beat cravings for sugar and suppress hunger hormones. Sleep your way to fight against the desire to overeat and improve your energy levels. A good night s sleep will do wonders for your overall well-being.

Excess Sugar In Body - Know How You Can Cleanse It!

The primary aim of the treatment in patients suffering from seizure is leasing a seizure-free life without giving way to any adverse effects. This goal can be accomplished in over 60 percent people with the help of anticonvulsants. Some patients also experience adverse effects since they suffer from a seizure which is refractory to medical therapy. Here are some of the common treatment options for seizures:

Monotherapy: Sometimes, monotherapy is given as it reduces the chance of all sorts of adverse effects and even avoids drug interactions. Moreover, this type of treatment approach is much less expensive than polytherapy since many older generation of the anticonvulsant agent comprises of hepatic enzyme which is responsible for reducing the serum level of the concomitant drug which leads to an increase in the dosage level of such medicines.
Social And vocational rehabilitation: People suffering from problems in psychosocial adjustments after the diagnosis may also need social and vocational rehabilitation. Many physicians do not pay enough attention to the consequences that an epilepsy diagnosis may leave on the patient. For instance, people with epilepsy may have a fear of experiencing next attack of seizure and they may be unable to work at heights or drive.
Consulting an expert: It is important to refer patients with intractable spells to epileptologist or neurologist for subsequent workup. A neurosurgical consultation may also be needed when the patient has to be treated surgically.
Importance Of anticonvulsant therapy
Patients who have had already suffered from recurrent attacks of unprovoked seizure may need treatment with an anticonvulsant. This treatment is not recommended until the person has risk factors for suffering from the problem yet again. The primary means of treating seizure is anticonvulsant therapy where the most suitable drug is chosen based on accurate diagnosis of the syndrome as a response to specific anticonvulsants may vary from one patient to another. The difference in response may reflect the various pathophysiologic mechanisms in different types of seizures.

Types of anticonvulsant therapy
Some of the anticonvulsant therapy medication may have multiple action mechanism while some have an only single mechanism of action. Some of the most common variants of the therapy include:

Neuronal potassium channel referred to as KCNQ opener
Blockers of unique binding sites such as perampanel, gabapentin, and levetiracetam
H-current modulators such as lamotrigine and gabapentin
Carbonic anhydrase inhibitors such as zonisamide and topiramate
Alpha-amino 3-hydroxy 5-methyl 4-isoxazole propionic acid receptor blockers like topiramate and perampanel.
N and L-calcium channel blockers like zonisamide, valproate, topiramate, and lamotrigine
Even though there are so many types of drugs available, all of them cannot be used for the treatment of seizures. Doctors would evaluate the condition thoroughly before prescribing a medication that can be helpful in reducing the severity of the condition.

Seizures - 3 Ways It Can Be Treated!

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