Dr. Shamkant Chaudhari's Clinic

Mechanical ventilation is the artificial method of assisting a person to breathe with the help of a device called ventilator. It is employed when a person’s spontaneous breathing who has been affected and cannot breathe on his/her own.

When is Mechanical Ventilation indicated?

Several injuries or other medical conditions could call for assisted breathing-

• Apnea (inhalation muscles become non-functional) that leads to intoxication and respiratory arrest
• Lung injury or trauma that leads to an inadequate exchange of gases between the lungs
• Acute asthma that requires intubation
• Chronic obstructive pulmonary disease
• Obesity hypoventilation syndrome
• Respiratory acidosis (excessive carbon dioxide in the blood)
• Respiratory distress like tachypnea that leads to rapid breathing
• Hypoxemia (too little oxygen in the blood)
• Muscular dystrophy (weakening of skeletal muscles)
• Amyotrophic lateral sclerosis (neurons controlling the voluntary muscles die)

Duration of artificial respiration

1. It is used for the entire duration of a surgery.
2. Long-term ventilation is necessary for people suffering from chronic illnesses who have been hospitalized. In such cases, special measures are taken to stabilize the trachea.
3. It can be used by ailing persons at home as well.

How is mechanical ventilation performed?

1. A tube is inserted into the trachea. This process is called intubation. The tube goes in through the mouth or nose (endotracheal tube). The tube is kept in place with a metal strap that goes around the head. The other end of the tube is attached to the ventilator. The ventilator pumps oxygen and other gases into the lungs. It can be a painful process, and before surgeries, it is performed under anaesthesia.

2. The tube can be inserted through a surgical hole in the throat. This process is called tracheotomy.

When the ventilator applies pressure to blow air into the lungs, it is called positive pressure. the exhalation can be done by the person himself/herself or if spontaneous respiration is compromised, the ventilator will help pump out the carbon dioxide.

Both types of tubes affect a person’s ability to speak because they pass through the vocal chords. Tracheotomy is performed on people who will require ventilation for long stretches of time because endotracheal tubes are uncomfortable and sometimes painful.

Risks associated with artificial ventilation:

1. The gravest risk is that of pneumonia. A person who is undergoing ventilation is already physically weak. And that makes the person susceptible to a wide range of diseases. The tube that is inserted into the trachea allows the entry of different types of bacteria. The result is Ventilation Associated Pneumonia (VAP). Because the tube is always present in the trachea, a person cannot cough. Coughing flushes out many bacteria. VAP is curable with antibiotics.

2. Endotracheal tubes may also lead to a sinus infection

3. Pneumothorax is yet another risk linked with artificial ventilation. Air leaks from the lungs and this causes pain and in extreme cases may even lead to the collapse of the lungs.

4. Because air is pushed into the lungs with pressure, it might cause lung damage.

5. Too much oxygen is also harmful to the lungs.

Taking a person off ventilation

This process is called weaning. The ventilator is turned off but still attached to the person. The person is allowed to breathe on his/her own. If there are difficulties, the ventilator is turned back on. It is like a trial run. Gradually the individual develops the ability to breathe on his/her own.

Mechanical ventilation is a painful and often risky method. But when a person is unable to breathe, it is the only way to save his/her life.

Carpal tunnel syndrome is a condition that affects around 3%-5% of the population and generally affects women more than men. This syndrome affects the fingers therefore drastically impairing your ability to perform routine tasks.

Causes of Carpal Tunnel Syndrome
Anything that bothers or stresses the median nerve in the carpal tunnel area can lead to carpal tunnel. However, there are lot of other reasons which may contribute towards causing a condition like carpal tunnel syndrome. They are:

1. Obesity- Being overweight is considered to be one of the major causes of carpal tunnel since all that extra fat puts a lot of pressure on your bones, which puts pressure on the nerve.
2. Gender- Carpal tunnel is generally more common in women because the size of women’s carpal tunnels are smaller than men. 
3. Anatomical reasons- Arthritis or bone dislocation and fracture can lead to modification of the space in the carpal tunnel area. This puts intense pressure on the median nerve and also leads to deformation of the wrist bone.
4. Nerve conditions- Conditions such as multiple sclerosis and diabetes can lead to carpal tunnel syndrome because they mainly affect and damage the nerves, which means it also affects the median nerve where the carpal tunnel is located.
5. Medical conditions- Several medical conditions such as kidney damage or kidney failure, hypothyroid or hyperthyroid and menopause can also cause carpal tunnel syndrome.
6. Inflammation- Inflammation is one of the biggest reasons of carpal tunnel. Rheumatoid arthritis, which is directly caused by inflammation can damage the tendons in your wrist and put a lot of pressure on your median nerve leading to carpal tunnel
7. Body fluids imbalance- As it is commonly known, menopause and pregnancy can cause a lot of fluid retention in the body which tends to aggravate the median nerve in which the carpal tunnel is located.

Symptoms of Carpal Tunnel
Carpal tunnel syndrome doesn’t happen overnight, it is more of a gradual condition. The common symptoms of carpal tunnel are:

1. Loss of strength in arm- This condition can cause a lot of weakness in your arms which may lead to you dropping things. The median nerve in which the carpal tunnel is located regulates and controls the thumbs pinching muscles and when these muscles become weak, it causes you to momentarily lose your motor skills.
2. Numbness and prickling sensation- In carpal tunnel syndrome, except for the little finger all the other fingers are affected i.e. ring finger, middle finger, index finger and the thumb. Carpal tunnel patients generally experience an electric shock-like sensation in their fingers while holding things and this pain travels from the wrist to the hand. This sensation can even cause you to come awake at night.
3. Pain and burning that travels up your arm
4. Wrist pain at night that interferes with sleep

How can physiotherapy help with carpal tunnel syndrome?
Physiotherapy is a very good idea for dealing with a condition like carpal tunnel syndrome because it takes into account the whole problem and tries to solve it without involving getting into medications.
Once your physiotherapist has understood where the pain is and from where it is originating, he will treat you and guide you in such a way that will work towards lessening the strain on your median nerve. Some of the most useful ways of fighting carpal tunnel are:

1. Splints and braces- The use of splints and braces because it keeps your hands in a stable and straight position and prevents too much pressure on them. In case your physiotherapist feels that your work is aggravating your condition, he will ask you to stop putting excessive pressure on your body especially your hands.
2. TENS- TENS is a type of a machine which stands for Transcutaneous Electrical Muscle Stimulation. This machine helps in reducing the pain of carpal tunnel syndrome.
3. Ultrasound- Ultrasound therapy helps in countering the pain of carpal tunnel by applying an instrument on the affected area and releasing sound waves which are then absorbed by the tissues. This helps in the reduction of disability and pain.
4. Laser- Cold laser also known as low level laser therapy is a highly effective and painless form of treatment which helps in decreasing pain and inflammation and also helps in reinstituting healthy tissue. The laser treatment also rehabilitates the body’s normal functioning by repairing the affected tissues and cells and also increases blood circulation and all this in combination helps in getting rid of the pain.

Physiotherapy is a universally acknowledged and safe form of treatment when it comes to bone-related ailments. This type of treatment doesn’t just help you with your condition, but it also saves a lot of your money and time when compared to other modes of treatments. 

A small piece of bone is known as a fragment and it is very common that an avulsion fracture also tends to damage the protrusions of bone to which the tendons attach. This basically means that the tendon or ligament will come away from the bone and it will take a small piece of bone with it. It is sometimes very hard to find out what type of injury you have and this is why knowing the causes and symptoms of an avulsion fracture are very helpful in determining exactly how severe the injury is.

Here are the causes of an avulsion fracture.

Causes:

1. Explosive Landing: Athletes who tend to jump or land with great impact tend to get these most commonly. Therefore, it is crucial for your health that if you participate in such sports, you do follow the correct method of jumping.

2. Explosive Extension: Similar to how an athlete landing ferociously can get an avulsion fracture, someone who is extending the legs very violently and explosively during an exercise can also get an avulsion fracture. This is because the bone getting extended could very well damage the protrusions to which the tendons are attached.

Symptoms:

These are the two main causes of an avulsion fracture. There are not many symptoms of an avulsion fracture. This is because an avulsion fracture can only be determined by an MRI or by an X-ray scan. Therefore it is nearly impossible to diagnose that you have an avulsion fracture without looking at the results of the tests performed on the part of your body. However, the way you got the fracture and especially the details of it are very good indications of whether you have an avulsion fracture or not.

Growth hormone or somatropin is responsible for cell growth as well as reproduction. But insufficient somatropin production by the pituitary gland may result in lack in height. It is mostly caused by a serious brain injury, any prevalent medical condition or might occur as a birth defect.

Types:

1. Congenital GHD - This form of GHD appears from at the time of birth itself.
2. Acquired GHD- GHD can be acquired during later life as a result of trauma, infection, tumor growth within the brain or radiation therapy.
3. Idiopathic GHD- Idiopathic GHD is the third, and comparatively worst kind of GHD since it has no treatment.

GHD is mostly permanent, but can also be transient. Read on to know how to detect whether you or your child is suffering from growth hormone deficiency(GHD).

Symptoms:
Childhood onset

1. Restricted height- Compared to other children of your child's age, he/she may be of shorter height, which is a rather conclusive sign to detect somatropin deficiency.
2. Chubby and comparatively younger appearance- Your child may have a proportionate body, but if he/she is unnaturally chubby and has a baby-face compared to other children, he/she may be suffering from GHD.
3. Late puberty- Your child's puberty maybe later than usual or even not appear at all, depending upon the gravity of the GHD.
4. Hypoglycemia and exaggerated jaundice- Low blood sugar is amongst the most primary manifestations of GHD, along with extended duration of jaundice.
5. Micro-penis- Micro penis condition is one of the incident signs of GHD, which later escalates to growth deficit as the infant gets older.

Adult onset:

1. Fatigue- Adults with GHD may experience extreme tiredness throughout the day, with reduced muscle strength.
2. Osteoporosis- Osteoporosis, along with bodily deformities, is a common sign in adults with GHD.
3. Lipid abnormalities- A test of your lipid profile may reveal abnormalities in LDL cholesterol, insulin resistance, and impaired cardiac functions.

Tests to determine GHD:

1. Physical test- A chart is drawn to determine the proportion of height and weight with respect to your age to detect anomalies.
2. Hand X-ray- A hand X-ray can determine whether the age of bones are at par with your age.
3. MRI-MRI scan can determine the health of your brain and pituitary gland.
4. Test for other hormones- Growth Hormone may not be solely responsible for your health condition, so it is important to determine if other hormone levels are all normal.

Treatment:

1. Hormone supplements- Hormone supplements like corticosteroids (hydrocortisone or prednisone), Levothyroxine (levoxyl, synthroid, etc), and others work to replenish the deficiency of pituitary hormones.
2. Growth hormone injection- GH is injected beneath your skin, to cure GDH. This is a long-term treatment and requires constant monitoring.

"You are what you eat". Consuming a well-balanced diet is key to a healthy life, but at times we simply ignore it. Keeping our kidneys healthy is vital for our overall health. Fortunately, a healthy diet can help keep the kidneys in good shape. Here’s how:

1. Choose or prepare food with less salt or sodium: Avoid overly processed foods and stick with natural foods. Don’t consume an excessive amount of salty foods. Keeping a check on the sodium intake will keep your blood pressure levels safe and not lead to any complications with the kidney
2. Eat the right amount of proteins: Consuming high amount of proteins can stress the kidneys. However, if you don’t get enough you can become weak. So, it is essential to calculate how much protein your body needs and limit your protein intake accordingly. Be aware of which foods contain high protein including meat, poultry, and seafood and incorporate them into your diet wisely.
3. Fluids: Drinking more water is not always good. The National Kidney Foundation (NKF) recommends drinking just enough fluids to keep your urine either light yellow or colorless. A standard recommendation is 13 cups daily for men and 9 for women. Also, cranberry juice has a positive association with kidney health for a long time, especially urinary tract infections and can be consumed.
4. Watch your Potassium and Phosphorous: A diet high in potassium and phosphorous can thwart the kidney function. A diet with the right amount of Potassium will help your nerves and muscles work the right way. Also, the right phosphorous levels will help protect your bones and blood vessels. It is better to stay away from packaged foods, junk foods and colas that contain high phosphorous and potassium.
5. Restrict the Fructose: As with sodium, your sugar levels are also to be watched. Since a high sugar diet can lead to diabetes and increase your risk for kidney disease, avoid high sugar foods. Sweetened beverages like sodas, fruit juices and energy drinks are not recommended.
6. Kidney-friendly Superfoods: Adding the following foods to your diet can help promote optimal kidney function:
   • Red bell peppers – Low potassium and rich in vitamins, folic acid and fiber
   • Cabbage – Rich in phytochemicals that protect against toxins and low in potassium
   • Ginger, Garlic and Onion – Anti-oxidants and anti-inflammatory agents
   • Kale – Rich in iron which is important for kidney health
   • Fruits – Apples, berries, cherries and red grapes are good to maintain kidney health
   • Watermelon – Has diuretic properties that help to flush out toxins

Keeping your kidney in good health is essential to lead a happy and disease-free life. So, start out by making small changes to your diet by following the above tips.

What you eat has a direct effect on your skin; eat healthy and your skin looks healthy, eat unhealthy food and your skin looks dull. Eating right can even fight signs of aging thus, negating the need for procedures like Botox. Not only does it cost less, but healthy food boosts your overall health as well.

Here are 6 such foods that can help you fight signs of aging and give you a flawless complexion.

1. Turmeric: Turmeric is well known for its yellow colour and anti-inflammatory properties. Many home remedies suggest the use of turmeric for a number of health ailments including skin conditions. Turmeric can fight signs of aging by reducing inflammation and oxidation. This, in turn, helps the skin heal faster. This spice can be added to your food or mixed with warm milk to benefit from it.

2. Tomatoes: Tomatoes are rich sources of vitamin C and lycopene. Vitamin C helps stimulate the production of collagen and hence keeps the skin firm while lycopene protects the skin against harmful UV radiation. As a general rule of thumb, the deeper red the tomato is, the better it is.

3. Berries: Berries such as blueberries and raspberries are excellent sources of Vitamin E and antioxidants that fight against the effects of pollution and rids the body of free radicals and other toxins that cause premature aging. These berries also have anthocyanins that boost the effects of vitamin C

4. Honey: Honey can be eaten or applied topically on the skin to benefit from it. Honey helps keep the body hydrated by absorbing moisture and preventing the skin from drying out. It also has antibacterial properties that prevent acne and other breakouts. Ideally, honey should be used and consumed in its raw, unprocessed form.

5. Nuts: Nuts are a great snack that keeps your skin looking young and fresh. Almonds are excellent sources of vitamin E that help fight acne, psoriasis and eczema among other skin ailments. Walnuts are rich in Omega-3 fatty acids that keep the skin soft and supple. Brazil nuts are also rich sources of vitamin E. However, keep in mind the high calorific value of these nuts and do not overindulge in them.

Avocados: Avocados are filled with essential fatty acids that moisturize and nourish skin. They are also rich in Vitamin B, C and E. While vitamin C boosts collagen production, vitamin E maintains the elasticity of skin and prevents sagging.

When blood clot blocks one or more arteries in your lungs the condition is known as pulmonary embolism. It can cause a decrease in the oxygen levels in your blood, damage to your lungs due to sudden restrictions in the flow of blood along with adverse effects on other parts of your body. Life threatening blockage can cause death if left untreated and you should immediately contact your health care provider to get proper diagnosis. Pulmonary embolism requires various lab tests and generally requires short time to resolve.

Symptoms: The symptoms of pulmonary embolism mainly depend upon many factors pertaining to your previous medical history. Pulmonary embolism varies with the size of your lungs, the size of the clots formed in your blood, and any other underlying history of the heart or lungs. That said, pulmonary embolism has symptoms which are not similar to any two persons and will vary accordingly.

The common symptoms however may include the following and you are advised to opt for a health checkup if these are persistent in your body:

1. Cough along with bloody sputum is a common symptom.
2. Shortness of breath, which will become worse as the days passes by. They will appear suddenly and cause huge discomfort in breathing.
3. Chest pain which may give you the feeling of a heart attack. The pain will intensify when you sit to eat or cough. Deep breath will cause problems too and will not go away easily with exertion.
4. Some other symptoms include fever, excess sweat, irregular heartbeat and dizziness.

Pulmonary embolism can be diagnosed by the following methods:

1. Electrocardiography (also known popularly as ECG) to measure your heart's electrical activity and functioning.
2. CT plumonary angiography is gold standard for diagnosing pulmonary embolism.
3. Chest x ray, which is a common and non invasive test to check your heart and lungs as well as the problems with any bones surrounding them.
4. ECHO can detect secondary changes in heart due to pulmonary embolism.

Treatment of pulmonary embolism can be done with medicines if it is detected at an early stage or also if the clot is small. However, if the size of your clot is problematic and blocks the blood flow to your lungs or heart then surgery may be necessary. Open surgery and clot removal surgery are common in the treatment of pulmonary embolism and will require good regular follow up check ups. Regular leg exercises will also reduce the chances of any underlying disease and you should hence consult your doctor.

Ascites is a disease that is characterized by the buildup of protein-containing fluid in the abdominal cavity. It is a dangerous condition for the body and can cause kidney failure. At times, it is also a sign of life-threatening disease like cancer. So, it is important to start the treatment of the disease at the earliest. Symptoms such as bloating, abdominal stiffness, weight loss, weakness, and dilated veins should not be ignored and must be brought to the notice of a doctor immediately. If the examination confirms ascites, treatment should begin at the earliest. Ayurveda offers a complete treatment for this condition and it is long-lasting and not harsh on the body. Additionally, it does not cause any side effects.

Ayurveda medicines act as a diuretic
In ascites, the abdominal cavity experiences abnormal retention of protein-containing fluid, which is dangerous for the system and needs to be removed. Therefore, Ayurveda prescribes medicines that possess strong diuretic and cleansing properties. These medicines increase the secretion of urine from the body, which helps flush out the ascetic fluid retained in the abdominal cavity.

Ayurveda cleanses toxins
Since Ascites affects the functions of the liver, the body cannot remove toxins from the system. It starts building up gradually and adds to the ascetic fluid retained in the abdominal cavity. Therefore, herbs possessing detoxification action are given to the patient.

Ayurveda soothes inflammation
In ascites, the abdominal cavity and liver get scarred and this leads to swelling and pain. So, Ayurveda also prescribes medicines with anti-inflammatory properties as it soothes the inflammation in the liver and the abdominal cavity. A light, fat-free, and non-spicy diet is also anti-inflammatory in nature and soothes the gastrointestinal tract. It also takes away the load from the digestive system as such food gets digested easily.

Ayurveda increases immunity
In ascites, the immunity of the patient is severely affected. The patient becomes weak and also loses appetite. To make the patient recover from the illness, it is necessary to get their immunity back to its earlier state and Ayurveda does so with the help of diet, medicines, and external therapies. Medicines help boost immunity, while the easy-to-digest diet provides sufficient nutrition to the body and also gets absorbed easily.

The restrictions on alcohol, smoking, and the instruction to take enough sleep are also meant to act as immunity-enhancing remedies.

Ayurveda works in a holistic manner to provide relief from the painful symptoms and also soothe the gastrointestinal tract and liver in case of ascites. It increases the stamina of the patient as well so that the recovery is quicker and smoother. The whole treatment procedure is focused on curing the disease from the roots while making sure that the patient does not experience any side effect.

Ascites is severe and complicated situation patient must need proper consultation of an expert Ayurvedic doctor.

Complications in the heart valve occur when the functioning of the heart valve is impaired. Valves of the heart allow the blood to flow in one direction and prevent the blood from flowing back into the ventricles of the heart.

Heart valve diseases can be classified as follows:

1. Valvular stenosis: This condition occurs when the valves of the heart does not open completely due to stiffness. As the opening is narrow, the heart has to work hard to pump blood. This condition may lead to heart failure.
2. Valvular insufficiency: This is a condition where the valve does not close tightly. This causes some of the blood to flow back to the valve. As this condition deteriorates, the heart has to work harder to pump blood. 

Types and Causes of valve diseases:

1. Acquired valve disease: The structure of the valve changes due to various infections or rheumatic fever. Rheumatic fever is caused by bacterial infectionthat had not been treated. It tends to occur in children and cause inflammation of the valve.
2. Congenital valve disease: This condition usually affects the pulmonary valve where the size of the valve is abnormal.
3. Bicuspid aortic valve disease: It is a type of valve disease that impairs the aortic valve. Instead of the regular three cusps, the bicuspid valve only has two. This may cause the valve to be stiff or cause it to leak.
4. Mitral valve prolapse: This condition causes the valve to flop back when the heart contracts. This condition also causes the leaflets of the valve to turn irregularly and cause it to stretch. This condition causes the valve to leak.

Symptoms: The symptoms of valve diseases are as follows:

1. Weakness: This condition may cause weakness and cause severe discomfort while performing daily activities.
2. Palpitations: Symptoms such as irregular heartbeats, skipped beats and rapid heart rhythm occurs in this condition.
3. Rapid weight gain: This condition can cause you to gain weight very rapidly.
4. It may cause swelling in your ankles, abdomen and feet.
5. This condition causes shortness of breath.