Difference between Acute leukemia and Chronic Leukemia
Acute leukemia: Develops and progresses rapidly. Patient may feel tired,is vulnerable to development of bruises and is also susceptible to infections. Acute leukemia is characterized by the production of Leukemia cells that are immature blood cells, normally referred to as blasts. Immature blood cells or blasts have the tendency to divide rapidly, which is out of control and that is how the Acute leukemia also progressively grows. However, unlike normal blasts cells, they do not stop dividing. The difference between Acute and Chronic leukemia lies in the pace of the onset of the disease and level of maturity of the Leukemic cells. Acute leukemia progresses and manifests itself in weeks whereas Chronic Leukemia may take even years to show up.
Secondly, although in both the cases the leukemic cells are immature blast cells. However, in Acute leukemia, the affected cells are completely immature and in their first stage of development from hematopoietic stem cells to mature specialized blood cells whereas in Chronic Leukemia, the affected leukemic cells are further down their path to maturation and development. i.e., they are more like mature specialized blood cells in appearance and function, though not normal. They not only divide rapidly but also live longer than normal cells would do.
Leukemia Treatment in India
Chronic Leukemia: Develops and progresses slowly, over years. Unlike Acute Leukemia, patient may not feel sick initially and most of the times Leukemia is accidentally discovered in a routine blood test. The leukemia cells are more mature as compared to that in Acute Leukemia, however, they are not fully normal and work well in this type either. They are not capable of fighting infection as normal White blood cells would. As compared to Acute leukemia, they are hard to cure.
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Gamma Knife is an advanced radiation treatment used for treating brain tumors and other disorders of brain such as arteriovenous malformation,trigeminal neuralgia.The radiosurgery system irradiates the tumor or the affected area with extreme precision while sparing the surrounding healthy tissue.It is a viable non invasive alternative to conventional brain surgery without the side effects that are normally associated with traditional brain surgery.
Benefits of Gamma Knife Radiosurgery treatment
Gamma knife is referred to as bloodless surgery for brain disorders.
The treatment is carried out in a single session.
Generally Outpatient procedure or sometimes overnight hospital stay may be required.
Quick recovery and early resumption of normal activities.
No need to cut open the skull to carry out the treatment.
Prevents complications such as hemorrhage or infection, that may be associated with traditional neurosurgery, since there is no incision.
Ideal for treating very small targets present deep in the brain and in sensitive areas.
Spares surrounding healthy tissue.
Treatment with extreme precision.
The cost of treatment with Gamma Knife is 25% to 30% cheaper than that of the conventional Neurosurgery.
Works best for inoperable or complex tumors.
FDA approved radiation therapy for Brain Metastasis.
Gamma Radiosurgery is being effectively and safely used in treating the following medical conditions:
Very small to moderate size brain tumors even deep seated ones or at sensitive position such as
Vascular malformations in the brain such as AVM(Arteriovenous malformation)
Post surgery remaining tumor cells.
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Total Hip Arthroplasty or Total hip replacement surgery, one of the most common hip surgery, involves the removal of damaged cartilage and bone of the hip joint and replacing it with artificial implants or prosthesis.
Why do I need Hip replacement surgery in the first place?
Hip replacement surgery is considered a viable treatment option for a painful and disabled hip joint which fails to show any improvement after trying all non surgical measures such as
Anti Inflammatory medicines
Restricting painful activities
Use of Glucosamine and Chondroitin Sulfate
Devices used for walking assistance
The most common condition that necessitates hip replacement surgery is Osteoarthritis. Osteoarthritis is a degenerative joint disease characterized by the loss of cartilage in the hip joint. It leads to pain and restriction of movement severe enough to compromise on the quality of life. Patient is unable to carry out even the daily activities such as sitting and walking that needs bending of the hip joint.
Rheumatoid arthritis or arthritis due to hip injury are other causes besides above.
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Could you have ever imagined the possibility of Brain tumor surgery on an outpatient basis?
Yes, you heard it right! There does exist an entity called Brain tumor surgery on an outpatient basis.
Why is everyone seeking out for less invasive brain tumor surgery or any other surgery for that matter. It is for obvious reasons such as
Offers convenience to patients
Most favorable utilization of resources
Reduced duration of hospital stay
Saves substantial amount of money
Simple, fast and brings out better outcomes.
Increased level of patient satisfaction
Economically beneficial not only for the patient but also for the surgeon and the healthcare provider.
This has been made possible by technological advancements in the field of neurosurgery supported by enhancements in anesthesia. Patient comes at the hospital in the morning for the surgery or procedure and leaves by the evening thus avoiding overnight stay at the hospital.
However, despite its range of benefits, it has not yet garnered much deserved popularity especially in developing nations due to medico legal and ethical aspects associated with it.
It is believed that prolonged stay in the hospital makes the patient vulnerable to hospital acquired infections, thromboembolic complications and besides that, it is strongly suggested that patients who stay with their family respond well in their post surgery period.
Having said that, Brain tumor surgery in an ambulatory setting has its own share of disadvantages. Primary concern is of course of its safety as it is understandable that Neurological complications can be dealt well within controlled hospital environment.
It is still debatable amongst surgeons whether brain tumor surgery on an outpatient basis is a viable option. Selection of the right candidate for such procedure is significant. Not every patient is a suitable patient for such procedure. Many surgeons believe that close observation is required for such patients who have undergone neurosurgery especially since such procedures have high possibility of delayed neurological complications. Moreover, some healthcare providers insist to have an MRI done within 24 to 48 hrs post surgery.
In nutshell, the specialist will determine the feasibility of Brain tumor surgery on an outpatient basis after thoroughly evaluating each patient and after mutual discussion with the patient and thoroughly educating the patient.
It is a revolutionary approach to minimally invasive brain tumor surgery, but is still under scrutiny and until it gets over all the associated hurdles and a standard protocol is established, the surgeon will use his clinical judgement to find the best treatment protocol for the patient.
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Benefits of Fertility treatment in India from HealthcaretripIndia affiliated hospitals/IVF centers
State of the art infrastructure
Well equipped with the most advanced technology to deal with gamut of fertility issues and offer their respective infertility treatments like IVF, ICSI, IUI, laser assisted Hatching, IMSI, Egg and embryo donation, Embryo freezing Blastocyst culture and so on.
Accredited with International organizations such as JCI for quality standards.
USA, UK trained IVF specialists who are the pioneers in their field, have decades of experience and keep consistently evolving their knowledge and skill base with the rapidly evolving technology.
Most affordable treatment cost without compromising on the quality.
High success rate comparable to that in USA, UK
Highly professional, English speaking and compassionate staff to complement. translators are also available, if need be.
No waiting period
Infertility is defined as the inability to conceive even after one year of regular(once in every 2 to 3 days) unprotected sex i.e., without utilizing any method of contraception. According to statistics, generally around 85% of the couples conceive within an year of regular unprotected sex, however, in United Kingdom, infertility is only diagnosed if there is an inability to conceive even after 2 years or 24 months of regular unprotected sex, without contraception. According to the data provided by National Health Service, UK, 95% of the couples will conceive by 2 years. Infertility may be due to innate inability of one of the partner to contribute his/her bit in conception or even when the female is not able to carry the pregnancy to the full term.
Pregnancy happens when:
Egg or ovum (female reproductive cell) is released by one of woman’s ovaries.(Ovulation)
Sperm or male reproductive cell unites with ovum.(Fertilization)
Fertilized egg travels through the fallopian tube until it reaches the uterus(womb).
Fertilized egg adheres to the uterine wall.(Implantation)
Problem with one or more of the above milestones in the pregnancy process, may result in infertility.
There are mainly two types of infertility.
Primary Infertility: Primary Infertility term is used for the couples who have not been able to conceive at least once, even after an year of regular unprotected sex, without contraception.
Secondary Infertility: Secondary infertility term is used for the couples who were previously able to have their own, one or more biological child/children naturally but are inable to conceive now or carry the pregnancy to the full term.
CAUSES OF MALE INFERTILITY
A6 There are several causes responsible for male infertility. Semen analysis is carried out initially to determine whether male factor is responsible for infertility and if yes, then how and accordingly further course of action is planned by the specialist. Semen analysis looks into the appropriate concentration of sperms(number), their functional capacity(motility) and their structure(shape). The responsible causes of male infertility work by affecting sperm production, their quality (structure,motility,viability) and delivery. They can be summarized as follows:
Impaired testicular function or ejaculation
Varicocele(abnormal enlargement of veins in the scrotum, the loose bag of skin in which the testes are present). It causes the testes to overheat which not only leads to low sperm production but also adversely affects their quality.
Injury to the testes
History of Undescended testicles or cryptorchidism
Indiscriminate use of alcohol,excessive smoking, use of anabolic steroids or use of illicit drugs are some of the detrimental habits.
Certain medications or summplements also adversely affects the male fertility.
May be a result of cancer treatment such as chemotherapy, radiation therapy or surgical treatment that involves removal of one or both the testicles.
Certain medical conditions may adversely affect testes such as Diabetes, Cyctic Fibrosis, some autoimmune disorders and infections such as Gonorrhoea, Chlamydia.
Sperm delivery is compromised due to
Blockage or damage resulting from injury or diseased condition of the reproductive organs in males.
Genetic defects such as Cystic Fibrosis that results in abnormal development or absence of vas deferens, epididymidis(the muscular tubes that stores and transports sperm from the testes to the ejaculatory ducts).
Disorders of hypothalamus and pituitary gland leading to impaired testicular function. Prolactin secreting Pituitary tumor leads to increased production of hormone Prolactin, a condition referred to as Hyperprolactinemia which causes loss of libido, impaired sperm production, impotence. Hypothalamus and Pituitary gland in the brain produce hormones that are responsible for the normal function of the testes.
Congenital adrenal hyperplasia
Klinefelter’s syndrome, Y chromosome microdeletion are some of the genetic disorders that result in low or no sperm production.
CAUSES OF FEMALE INFERTILITY
Female infertility can be attributed to the disorders of one or more of the following:the ovaries, Fallopian tubes and uterus.
They need to be healthy and fully functional. The causes can be summarized as below:
Impaired ovarian function wherein release of the egg from the ovaries(ovulation) is affected. It may be due to
Polycystic Ovary Syndrome(PCOS): A medical condition characterized by development of several fluid filled sacs(cysts) in the ovaries. It is one of the most common reason for female infertility and is treatable. It is associated with hormonal imbalances leading to anovulation or irregular ovulation (release of eggs from the ovaries) indicated by irregular or no periods, weight gain, fertility issues and depression. It is also associated with increased level of male hormone (testosterone) responsible for acne, excess hair growth(hirsuitism) and hair thinning on the scalp.
Diminished ovarian reserve (DOR): Every women is born with all the eggs she will ever have in her lifetime. As she ages, the number of eggs decrease naturally. However, there are various other congenital, medical, surgical or unknown causes responsible for abnormally low number of remaining eggs in the ovaries. As the condition’s name implies, diminished ovarian reserve means that there are less number of eggs left in the ovaries. Women with DOR may conceive naturally, however, their response to the fertility treatment may result in production of less number of eggs.
Functional Hypothalamic Amenorrhoea (FHA), a condition resulting from a lot of exercise, stress or extremely low body weight. It sometimes accompany eating disorders such as anorexia (loss of appetite).
Inefficient functioning of hypothalamus and pituitary gland in the brain- Hormones released by hypothalamus and pituitary gland are responsible for the normal function of ovaries and release of eggs from them. However, in a medical condition Hyperprolactinemia, which is characterized by high production of hormone prolactin from the pituitary gland, woman may not ovulate.
Premature Ovarian Insufficiency (POI), also referred to as Premature menopause, wherein ovaries stop functioning even before 40 yrs of woman’s age i.e., far earlier than the age when normal menopause sets in. Although there are certain conditions that makes a woman susceptible to POI, such as chemotherapy or pelvic irradiation exposure or certain medical conditions. Usually the cause is unknown.
Menopause, a normal phase of woman’s life that sets in around 50 yrs of her age and is characterized by normal decline of ovarian function, hormones estrogen and progesterone are no longer produced by the ovaries and cessation of menstruation or periods. Once menopause begins, she is no longer able to conceive naturally. Menopause is considered to have set in if periods have not occurred for one whole year.
Fallopian tube obstruction: A pair of thin and long muscular tubes in the abdominal cavity of the woman that extends from the ovaries to the uterus. Fully functional,normal, open and unobstructed fallopian or uterine tubes are paramount in successful spontaneous reproduction. They play a significant role in transport of reproductive cells(ovum and sperm), provide favorable environment for fertilization of egg and early embryo development. There are various tubal elements that come into play to make the tube work efficiently. They are rhythmic muscular contraction of the tube, ciliary function(thin hair like projections on the inside of the walls of the fallopian tube) and tubal secretions. History of pelvic infection, abdominal surgery, ruptured appendicitis, Chlamydia or Gonorrhea infection or endometriosis may point towards tubal blockage or occlusion.
Uterus disorders such as uterine fibroid that distort the uterine cavity and make it difficult for implantation to take place. However, they are treatable. Scarring or adhesion within the uterus or malformation of the uterus are some other causes for female infertility.
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Brain suite is the latest and most advanced technology being employed for carrying out brain tumor surgery. Its an MRI guided brain tumor surgery, also referred to as Intra Operative MRI Neurosurgery suite. Brain Suite plays a crucial role in making the surgery as perfect as possible by amalgamating image guided surgery,high field MRI within the operation theatre, data management and visualization at the same time. This specialized set up in the operation theatre leverages all the required surgical and diagnostic tools, well integrated to treat even the most complicated brain tumors and other neurosurgical disorders.
The navigation system simulates the GPS (Global Positioning System) for the brain giving immediate updates on the location of the instruments with respect to the tumor. This advantage comes handy especially when the surgery is being done near the critical structures inside the brain.
Brain Suite may be used for several conditions that call for brain surgery. They can be summarized as below:
Glioma and for other primary brain tumors
Surgery for vascular malformations in the brain
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Minimally invasive surgery for Gall bladder removal is referred to as Laparoscopic Cholecystectomy surgery in medical parlance. It is considered as the treatment of choice for patients with symptomatic gall bladder stones. Gall bladder is a pear shaped organ that lies beneath the liver on the upper right side of the abdomen. It collects and store the digestive fluid(Bile) secreted by the liver and releases it into the small intestine in order to facilitate the fat digestion.
Cholecystectomy is commonly carried out due to the symptoms or the complications produced as the result of blockage caused by the gall stones. Under such circumstances, the patient usually presents with excruciating pain in the right upper part of the abdomen. Patient is discharged from the hospital the very same day of the surgery. It is a very common surgical procedure with very few complications, if at all.
There are different ways of carrying out the surgery. One with the use of video camera and specialized surgical tools inserted through four small key hole incisions in the abdomen, is referred to as Laparoscopic Cholecystectomy and the other that is carried out with one large incision in the abdomen, is referred to as Open Cholecystectomy.
Laparoscopic Cholecystectomy surgery offers several advantages over conventional cholecystectomy surgery as mentioned below:
Shorter hospital stay
Minimal blood loss
Early resumption of activities
Aesthetically sound, minimal scarring
You may require Cholecystectomy surgery if you have evidence of
Gall stones causing symptoms or complications-Most common indication.
Gall stones in the gall bladder(Cholelithiasis)
Gall stones in the bile duct(Choledocholithiasis)
Gall bladder inflammation (Cholecystitis)
Pancreas inflammation due to gall stones(Pancreatitis)
Biliary dyskinesia, a medical condition in which gall bladder fails to function properly.
Brachytherapy for Breast Cancer treatment is an advanced radiation treatment for breast cancer, wherein the radiation source is placed inside the breast. It is of three types. Out of three types, only two types are currently in use and third one is still experimental.
Interstitial Needle-Catheter Brachytherapy, also referred to as Multi catheter Internal Radiation
It involves the use of Radioactive seeds to deliver radiation directly to the cancer affected area of the breast. The seeds are placed in tiny tubes known as catheters. The catheters are then put into place and stitched under the skin for the duration of the treatment in the hospital, which may last for few hours or few days. Once the treatment is over, the seeds, catheters and the stitches are taken out and the patient is discharged.
Balloon Internal Radiation
This type involves the placement of the special tube with a balloon at one end, in the cancer affected area of the breast. The other end comes out of the skin through a hole. This tube is placed during the Lumpectomy surgery or afterwards at the specialist’s office. Each treatment session involves placing a radioactive seed in the centre of the balloon through a machine, for 5 to 10 minutes, or long enough to deliver requisite radiation to the cancer affected area of concern. Patient is discharged from the hospital after the seed is removed. 10 treatment sessions are usually carried out over a span of 5 days. That makes 2 treatment sessions per day, generally 6 hrs apart. Once the final treatment is over, the tube and the balloon are taken out through the small hole in the skin.
3-D conformal External Beam Radiation (3-D CRT)
This experimental method involves planning session wherein a special MRI/CAT scan of the breast is carried out in order to elicit those small treatment areas of the breast that are at risk. The goal of the therapy is to maximize the delivery dosage of the radiation to the target area while protecting the surrounding healthy tissue at the same time from harmful effects of the radiation. The type and distribution of the radiation is taken into account while planning the therapy to meet the above goal. Linear accelerator machine, the machine that is used for external beam radiation therapy, is utilized to deliver radiation twice a day for around 1 week.
Ilizarov method is generally used to correct limb deformities. The Ilizarov technique is based on the principle of Distraction Osteogenesis. According to this principle, the concerned bone, is strategically cut (osteotomy) into two, pulled apart in a controlled manner(distraction) with the help of an external device commonly referred to as Ilizarov apparatus named after the doctor who used it for the first time.
This device consists of metal rings, rods and wires that encircles the limb in such a way so as to pull apart the broken ends of the bone in a controlled manner usually at the rate of 1mm/day and this stimulates the formation of new bone naturally over a period of time and so its nerve and blood supply. The best part of this technique is that it permits a person to lead a normal life despite a fracture.
Ilizarov surgery is indicated for the following:
Birth defects of the lower limbs that need both lengthening and correction of angular deformities.
Reconstruction surgery to fill the large bone gaps created as a result of trauma, tumor or infection
Contraction of the joints
Non-Union of fracture
Mal-Union of fracture
Dwarfism, for lengthening
Few acute fractures
Distraction of joints
Limb lengthening has four stages:
1.Distraction– This stage commences 5 to 7 days after surgery. Most favourable distraction(controlled pulling apart of bone’s cut ends) is done at a rate of 1mm/day, 0.25 mm every 6 hrs, until the required length is procured. For eg. for lengthening of 5 cm, time would be 50 days for distraction.
2.Consolidation (Hardening)– This phase involves the hardening of the newly formed soft bone. This time is twice the amount of time taken for distraction. Time is nearly 1 month for each 1 cm of lengthening. Therefore for 5 cm, time would be approximately 5 months. During this time external fixator remains at its place and only removed once the newly formed bone is strong enough to permit its removal.
3. Removal of the external fixator or frame Xrays and clinical examination are the usual methods carried out to evaluate the strength of the new bone in order to decide the best time to remove the frame. The best time for removal of the frame is when the xray shows that the newly formed bone has bridged the gap completely and cortex has been formed at the lengthened region. Then connecting rods of the external fixator are removed under General anesthesia and the strength of the bone is clinically examined. The external frame is completely removed only when the bone is considered solid enough to do so. Eventually, cast or brace is applied on the surgical site for another 4 to 6 weeks.
4. Rehabilitation Limb rehabilitation is initiated after the cast or brace is taken off. range of motion and strengthening exercises are advised as part of physiotherapy. This stage last for couple of months.
Bone marrow transplant is the only promising procedure with a potential for curing sickle cell disease in young symptomatic patients. Sickle cell disease is the most common inherited blood disorder which is characterized by sickle shaped red blood cells due to the presence of abnormal hemoglobin(Hb-S) subsequently resulting in rigid,fragile RBCs, frequent hemolysis and microvascular occlusion(clog small blood vessels).
Sickle cell Anemia
Bone marrow transplant weakens and destroys cells or tissues that are responsible for causing blood disorders and replace them with healthy blood cells derived from the stem cells of the donor. This restores the normal healthy blood. BMT is, however, recommended for patients with severe SCD accompanied with symptoms such as frequent pain episodes, acute chest syndrome and stroke.
There are mainly three kinds of Bone marrow transplant depending upon who is the donor, such as:
Also reffered to as rescue transplant. “Auto” means self. In this type of transplant the stem cells from the patient’s bone marrow are extracted prior to chemotherapy or radiation therapy and then replaced back.
“Allo” means other. Here, the immature bone marrow cells or stem cells are extracted from the donor. Allogeneic means from a genetically different individual from the same species and hence immunologically incompatible.