What is Deep Vein Thrombosis?

Blood clots can arise anywhere in your body. They develop when blood thickens and clumps together. When a clot forms in a vein deep in the body, it's called Deep Vein Thrombosis (DVT). Deep vein blood clots typically occur in the lower leg or thigh. But if your symptoms stem from a blood clot deep in your leg, it can be dangerous. Blood clots can happen to anyone, anytime. But some people are at increased risk. Therefore, they should immediately consult with vein specialist to avoid blood clot forming in the veins which can help avoid potentially serious problems.

DVT Symptoms:

"Deep vein thrombosis has classic symptoms - for example, swelling, pain, warmth, and redness on the leg," says Dr. Rajendra Bansal, a DVT treatment expert in Jaipur.  But about 30 40% of cases go unnoticed since they don't have typical symptoms.  In fact, some people don't realize they have a deep vein clot until it causes a more serious condition.

Deep Vein Clots:

DVT symptoms include deep vein clots - especially those in the thigh - can break off and travel through the bloodstream. If a clot lodges in an artery in the lungs, it can block blood flow and lead to a sometimes-deadly condition called pulmonary embolism. This disorder can damage the lungs and reduce blood oxygen levels, which can harm other organs as well.

Some people are more at risk for deep vein thrombosis than others. "Usually people who develop deep vein thrombosis have some level of thrombophilia, which means their blood clots more rapidly or easily," Dr. Bansal says, a DVT specialist in Jaipur. Getting a blood clot is usually the first sign of this condition because it s hard to notice otherwise. In these cases, lifestyle can contribute to a blood clot forming if you don t move enough, for example. Your risk is higher if you ve recently had surgery or broken a bone if you re ill and in bed for a long time, or if you're traveling for a long time (such as during long car or airplane rides).

Other Symptoms:

Having other diseases or conditions can also raise your chances of a blood clot. These include a stroke, paralysis (an inability to move), chronic heart disease, high blood pressure, surgical procedure, or having been recently treated for cancer. Women who take hormone therapy pills or birth control pills are pregnant, or within the first 6 weeks after giving birth are also at higher risk. So are those who smoke or who are older than 60. But deep vein thrombosis can happen at any age.

Chronic vs Acute DVT:

Chronic DVT refers to long-standing venous thrombosis present for more than 28 days.  It can either permanently block the vein or it can adhere to the wall of the vein.  Chronic DVT that doesn t block the vein can still cause long-term problems known as Post Thrombotic syndrome which occurs due to pooling of blood in legs by gravity as the protective valves are damaged or destroyed. Patient symptoms are:

Leg swelling after standing for long periods
Aching pain
Varicose veins
Skin ulcers in severe cases.
Acute DVT refers to venous thrombosis for which symptoms have been present for 14 days or less. The symptoms of acute DVT are sudden limb swelling and pain. During this period the clot is soft and easily treated with clot-dissolving drugs. The period between 14-28 days is called Sub-acute DVT.

Clues of a Clot:

Seek DVT treatment if you have these symptoms. They may signal a deep vein clot or pulmonary embolism:

Swelling of the leg or along a vein in the leg
Pain or tenderness in the leg, which you may feel only when standing or walking
Increase in warmth in the area of the leg that s swollen or painful
Red or discolored skin on the leg
Unexplained shortness of breath
Pain with deep breathing
Coughing up blood
A prompt diagnosis and a proper DVT treatment can help prevent the complications of blood clots. See your doctor immediately if you have any signs or symptoms of deep vein thrombosis or pulmonary embolism. A physical exam and other tests can help doctors determine whether you ve got a blood clot.

Your doctor will diagnose deep vein thrombosis (DVT) based on your medical history, a physical exam, and the color Doppler ultrasound or sometime may require CT or MRI. He or she will identify your risk factors and rule out other causes of your symptoms. After analyzing the risk factors, the doctor will tell you whether you need an immediate DVT treatment or not.

DVT Treatment

There are many ways in Deep Vein Thrombosis treatment. DVT treatment process includes medicines, certain devices, and therapies. The main goals of DVT treatment include:

Stopping the blood clot from getting bigger
To dissolve the already formed clot
Preventing the blood clot from breaking off and moving to your lungs
Reducing your chance of having another blood clot
To prevent long-term complication known as Post Thrombotic Syndrome.
Anticoagulants (Blood Thinners):

These are the most common medicines in DVT treatment. These medicines decrease your blood s ability to clot. They also stop existing blood clots from getting bigger. However, blood thinners can t break up blood clots that have already formed. (The body dissolves most blood clots with time.)

Blood thinners are taken either as a pill, an injection under the skin, or through a needle or tube inserts into a vein (called intravenous or IV injection). There are different types of  Blood thinner. The choice of anticoagulant depends upon multiple factors, including the preference of the patient and the healthcare provider, the patient s medical history and other conditions, and cost considerations.

Initial anticoagulation is continued for 5 to 10 days. After that, long-term anticoagulation is continued for 3 to 12 months depending upon the patient profile, length of vessel involvement and risk of recurrence. In some patient where permanent risk factor like a congenital cause or cancer lifelong anticoagulation may require.

Other available treatments, which are for specific situations, include thrombolytic therapy or placing a filter in a major blood vessel (the inferior vena cava).

Thrombolysis (Clot-Busting DVT Treatment):

Minimally invasive procedures in DVT treatment are performed by an interventional radiologist under X-ray Guidance, if a patient has severe pain, difficulty in walking, significant swelling while on blood thinners, or if there is clot blocking the pelvic veins (iliac veins).  When performed early, thrombolysis is highly effective at dissolving a clot and preserving the valves in the veins.

It is designed to rapidly break up the clot, restore blood flow within the vein, and potentially preserve valve function to minimize the risk of post-thrombotic syndrome. The interventional radiologist inserts a tiny tube called catheter into the vein behind the knee or other leg vein and threads it into the vein containing the clot using x-ray guidance. The catheter tip is placed into the clot and a  clot-busting  drug is infused directly to the thrombus (clot) followed by clot removal by special devices. The fresher the clot, the faster it dissolves   one to two days. Clinical resolution of pain and swelling and restoration of blood flow in the vein is greater than 85 percent with these invasive techniques.  In patients in whom thrombolysis or blood thinners are not medically appropriate, an interventional radiologist can insert a vena cava filter, a small device that functions as an umbrella to capture blood clots that would float to the lung, but allows normal liquid blood to pass.

DEEP VEIN THROMBOSIS PREVENTION:

You can take simple steps to lower your chances for a blood clot:

Exercise your lower leg muscles if you re sitting for a long time while traveling.
Get out of bed and move around as soon as you re able after having surgery or being ill.
The more active you are, the better your chance of avoiding a blood clot.
Take any medicines your doctor prescribes to prevent clots after some types of surgery.
Wear compression stocking to prevent complication or recurrence as per instruction.
Keep regular follow-up with your doctor to avoid or prevent post DVT complication.
SPECIAL PRECAUTIONS FOR PEOPLE WITH DEEP VEIN THROMBOSIS:

Patients being treated for venous thrombosis are at an increased risk for developing another blood clot. The patient should watch for new onset leg pain or swelling. If these symptoms occur, the patient should speak to his/her health care provider or seek medical attention as soon as possible.
Risk of bleeding is high with anticoagulant so dose should not change unless the provider or clinic directs the patient to do so.
Patients may bleed easily from anywhere while taking anticoagulants. In some cases, bleeding can develop inside the body and can t notice immediately. Bleeding inside the body can cause a person to feel faint, or have pain in the back or abdomen. A healthcare provider should be notified immediately if there is any sign of this problem.

What is Deep Vein Thrombosis (DVT) - Symptoms,Treatment & Prevention

5 Ways to protect your skin this summer

Staying out in the sun too long can cause you to suffer from a host of skin problems such as age spots, wrinkles and even increase your risk of developing skin cancer. During the summer months, you need to take extra care of yourself as the sun is at its peak at that time. Here's what you can do in this summer to ensure that your skin remains protected:

1. Avoid the rays of the sun between 10 am and 2 pm

The strength of the UV rays depends on a number of factors such as reflective surfaces, height, and time of day. The sun's UV rays are at their strongest between 10 am and 2 pm. If you're outdoors, seek a cool area to protect yourself from the damaging rays of the sun. You could stand under a tree or use an umbrella to shield yourself from its ultraviolet rays.

2. Don't use tanning beds

Several studies reveal that tanning beds can cause skin cancer. According to these studies, individuals under 30 who use tanning beds increase their risk of melanoma (the most deadly of all skin cancers) by about 75%.

3. Increase your fluid intake

One of the ways in which you can beat the sun and protect your skin is by increasing your fluid intake during this time. On an average, one should have about 3 liters of fluids every day, which is about 1.5-2 liters of water and 1 liter of fluid from solid foods. From summer foods like watermelon and berries to beverages like fruit juice, milk, etc and liquid-based meals - all these avenues should be considered.

4. Have a proper cleansing regimen

To help your skin look fresh even during the summer months, you should exfoliate regularly. When you do this, all the dead skin cells are removed, giving your face a youthful and fresh appeal.

5. Use a sunscreen all the time

To protect yourself from the damaging ultraviolet rays of the sun, you should never forget to apply sunscreen when going out. Ideally, a sunscreen that has an SPF of 30 should be applied thoroughly to your skin 30 minutes before leaving your house. More importantly, it should be applied again every 2 hours.



5 Ways to protect your skin this summer

Rectal problems in women are quite common. It is experienced by many women in some form or the other such as rectal itching, pain or bleeding. Rectal problems are more common in women than in men. These conditions need to be attended to immediately as severe rectal problems may cause several health problems. There are many ways to deal with rectal problems in women.

Treating rectal itching: Rectal itching is a common rectal problem. These can be treated by

    Improve hygiene: You should clean the rectum area gently using cotton balls moistened with water. You should apply mild ointments to prevent irritation and soothe the skin.
    Unscented toilet paper or unscented lotions and creams: You should use white toilet paper that does not have any scent. Scented soaps, creams or lotions should be avoided as it may cause further irritation. You can also apply ointments containing 1% hydrocortisone.
    Control excessive sweating: Rectal problems may occur due to excess sweating. You should avoid sweating too much by wearing light clothes and using talcum powder for the absorption of moisture.

In case of excessive itching, you should follow the following tips:

    Do not scratch the area as scratching may lead to further itching. You can take an oral antihistamine during the night to get better sleep.
    You can take a warm sitz bath after every bowel movement, for at least three days, every day. The anus should be dried properly after the bath.
    Abstain from foods that stimulate rectal itching like tea, coffee, aerated drinks, alcohol, chocolate, spicy food, tomatoes and excess vitamin C, for a period of two weeks.
    You must maintain short fingernails to avoid injuries during scratching. To prevent unconscious scratching during sleep, wear cotton gloves.
    Stress should be managed as increased stress may lead to enhanced rectal itching. When you are anxious, do not scratch the rectal area.

Treating rectal bleeding: Rectal bleeding is another problem, which may be accompanied by other rectal problems. In case of rectal bleeding, avoid taking aspirin or any other non-steroidal, anti-inflammatory drug. These drugs may cause bleeding in the digestive tract. This will increase the blood amount in your stool. Bleeding hemorrhoids can worsen by the intake of these medicines. For soothing pain, opt for an acetaminophen. Constipation and diarrhoea may also lead to rectal bleeding. However, it is advised to consult a doctor before consuming any medicine.

Prevention
For prevention of rectal problems, you must have a good sense of hygiene. Keep the rectum region clean and avoid sitting in the toilet for a long time. You should have a fiber-rich diet including fresh fruits and vegetables. Avoid food items, which may cause rectal problems. General rectal problems are not very serious and can be treated using simple measures. Maintaining proper rectal hygiene is very important to avoid rectal problems. It is highly recommended to visit a doctor if the problem persists.

Rectal Problems in Women - Doctor Recommended Tips

Formation of blood clots in the arteries of the lungs, heart or legs can actually kill a person. In such a case, the immediate medical action is necessary and the only way to deal with blood clots is thrombolysis.
Thrombolysis or thrombolytic therapy is a medical process that dissolves blood clots and facilitates blood flow to all parts of the body. Thus, it protects tissues and muscles from damage.

What are the causes of blood clots in the body?

  Poor blood circulation
  Conditions such as Deep Venous Thrombosis and atrial fibrillation
  Blood clots can also be formed because of dialysis catheters and by-pass grafts

How can you tell if you have blood clots?

  Swelling in one or more legs
  Cramp and tenderness in the legs
  Breathing trouble might indicate that blood clots have travelled to the lungs
  Sweating and frequent chest pain may suggest that blood clots have travelled to the heart

How is Thrombolysis performed?

Thrombolytic drugs are injected into the body intravenously. They make their way to where the blood clots exist and dissolve them. If there is a medical emergency, the drugs are delivered to the exact location of the blood clots and immediately start dissolving them. Another method is inserting a device into the blood clot infested region to break the clots up. The drugs which on entering the body dissolve blood clots are called thrombolytics. There are many varieties of thrombolytics such as the following-

  Streptokinase - It is a kind of enzyme. It is used when a person has just suffered a heart attack or pulmonary embolism. Doctors do not usually prescribe the second usage of this drug. It is injected into a vein and can be administered to pregnant women.

  Tenecteplase - Also an enzyme, it is a plasminogen activator. When it binds to the surface of the blood clot, it makes the clot degenerate.

  Reteplase - It is actually extracted from E-Coli. It is a sterile intravenous bolus injection

The leading cause of heart attacks and ischemic heart disorder is the formation of blood clots in the arteries that connect the heart and the brain. Thrombolysis is often employed as an emergency treatment for this purpose. Thrombolysis is also effective against blood clots formed in the lungs (which lead to acute pulmonary embolism). Sometimes blood clots are formed in the legs, upper extremities of the body, the pelvic region (deep vein thrombosis). These clots may travel to the lungs and heart.

Consult your doctor before undergoing the treatment.

Thrombolysis - Causes, Symptoms & Treatment Of It!

Hectic lifestyle, unhealthy food habits, poor bowel movements, and stress can all add up to one condition called the GERD. Gastroesophageal reflux disease or GERD refers to a particular type of digestive disease, and mainly affects the LES or lower esophageal sphincter, which is a muscle ring between the stomach and the esophagus resulting in the symptoms such as burning sensation in the chest or difficulty in swallowing.

Treatment options
While the moderate or mild GERD can usually be treated with healthy lifestyle changes, diet, and medications, when the condition gets severe, surgery becomes the only option to prevent the issue from deteriorating further. Here are some of the common surgical options available for treating GERD:

Fundoplication: This surgical procedure is the most common and standard surgical option for treating GERD. It focuses on tightening and reinforcing the LES by wrapping the upper portion of the stomach around the outer side of the lower esophagus which strengthens the sphincter.
Transoral Incisionless Fundoplication: Transoral incisionless fundoplication or TIF is another surgical procedure available for treating GERD and can be performed when an open fundoplication cannot be performed. It is performed by creating a barrier between the esophagus and the stomach which prevents the stomach acid from reflux or going backwards.
Stretta: This surgical procedure is performed as an outpatient option using an endoscope. Here, a flexible tube is passed into the esophagus where the electrode present at the tip of the tube creates tiny cuts on the esophagus by heating the esophageal tissues. As a result, the scar tissues formed, block the nerves that are responsible for acid reflux.
Bard EndoCinch System: This surgical procedure also uses an endoscope to create stitches to make pleats in the lower esophageal sphincter, which strengthens the LES. However, this surgical treatment option is not as common as other GERD treating procedures.
Linx Surgery: In Linx surgery, a special device called Linx, a ring containing microbeads of magnetic titanium, is wrapped around the sphincter to make it strong. As the beads are magnetized, they help in keeping the opening between the esophagus and stomach closed, while letting the food pass normally.
Recovery
As long as the surgical option is laparoscopy, they are the least time-consuming as well as less painful with lesser downtime, but may not be ideal for everyone. When it comes to traditional surgical treatment options like fundoplication, it takes around minimum six weeks to resume the daily activities. However, for laparoscopic fundoplication, the downtime is one or two weeks. Linx surgery is a minimally invasive surgical option and therefore, the recovery time is shorter than other traditional surgeries for treating GERD. Depending on the patient's health conditions and response to surgery, the recovery time may vary for each surgical treatment options for GERD.

So, seek the advice of your gastroenterologist for the best possible treatment option to get completely cured of the condition.

Treating GERD: 5 Surgery Options That Can Help!

Bariatric surgery is a surgery performed on the stomach and is usually recommended for people who are obese. If you have a BMI value more than 40, then this surgery is a very good option. Along with those having an obesity problem, this surgery is also said to be ideal for those people who are suffering from type 2 diabetes and having a BMI value between 35 to 40.

There are many studies which show that there is a great improvement in people with type 2 diabetes after bariatric surgery. Even the cholesterol and blood pressure levels can also be controlled with the help of this surgery. Post-surgery, you will have to take fewer medicines or in some cases, you need not have to take medicine at all.

How does the doctor decide if you need bariatric surgery?
Basically, there are two things that will be considered by the doctor. The first one is the BMI value, which should be above 35. And the second parameter to consider is if you have tried any other methods to lose weight but did not succeed. Based on these and if you are ready to face the mental and physical challenges after the surgery, you will be advised to go through this surgery. You should make sure that you are doing regular exercise and also eat less.

Types of bariatric surgeries for type 2 diabetes

Gastric bypass: In this kind of surgery, the stomach is divided into two parts. One small part at the top is separated from the lower part of the stomach. Whatever you eat, will go into this small part of the stomach and that makes you feel full faster. Also, fewer nutrients and calories are absorbed into the body. After this kind of surgery, more than 80 percent of diabetes patients showed no signs of diabetes at all.
Gastric sleeve: In this surgery, a large portion of the stomach is removed and hence you will be able to eat less. This also reduces the amount of ghrelin, the hormone responsible for making you feel hungry, produced. This is successful in 60 percent of people with type 2 diabetes.
Adjustable gastric band: A small inflatable band is placed around the stomach. This will look like a small pouch at the place where the food goes in. This pouch will get full a lot quicker and hence you will not be able to eat too much.
Does it help?
Some surgeries show 80 percent success rate and some show 60 percent success rate, but that is in terms of diabetes levels. Due to less food, the body will not get the required minerals and vitamins, which will result in other health complications. Some surgeries are also irreversible. So, it is your doctor who understands the surgery and your health better and they will always suggest the best option for you.

Bariatric Surgery For Type 2 Diabetes - Does It Help?

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