The decision of when you will receive your epidural will be a joint decision between you, your anesthesiologist and obstetrician. Such factors may depend on your pain level, the level of dilation, position of the baby, and whether this is your first baby. Women do not have to wait until they are dilated to a certain level before they can ask for, or receive, an epidural. If a woman is in active, established labour, and is uncomfortable, epidural analgesia is the most effective method of pain relief
When can we get an Epidural during labour?
What is Anaesthesia? What is the significance of this procedure?
Anaesthesia is a state without sensation. Such a state can be obtained from a single drug which alone provides the correct combination of effects, or occasionally a combination of drugs (such as hypnotics, sedatives, paralytics and analgesics) to achieve very specific combinations of results. A patient who is undergoing an operative procedure commonly known as surgery is taken into such a reversible state where he or she does not experience the pain of the procedure he or she is undergoing.
What are the different types of Anaesthesia?
There are three main types of anaesthesia: local, regional and general.
The anaesthetic drug is usually injected into the tissue to numb just the specific location of your body requiring minor surgery, for example, on the hand or foot.
Your anesthesiologist makes an injection near a cluster of nerves to numb the area of your body that requires surgery. You might be awake, or you may be given something to help you relax, sometimes called a sedative. There are several kinds of regional anaesthesia. Two of the most frequently used are spinal and epidural anaesthesia, which is produced by injections made with a high exactness in the appropriate areas of the back. They are often preferred for childbirth and prostate surgery.
You are unconscious and have no awareness or other sensations. There are some general anaesthetic drugs. Some are gases or vapours inhaled through a breathing mask or tube, and others are medications introduced through a vein. During anaesthesia, you are carefully monitored, controlled and treated by your anesthesiologist. A breathing tube may be inserted through your mouth and frequently into the windpipe to maintain proper breathing during this period. The length and level of anaesthesia are calculated and continually adjusted with high precision. At the conclusion of surgery, your anesthesiologist will reverse the process, and you will regain awareness in the recovery room.
How safe is Anaesthesia?
Due to advances in patient safety, the risks of anaesthesia are very meagre. Over the past 25 years, anaesthesia-related deaths have decreased from two deaths per 10,000 anaesthetics administered to one death per 200,000 to 300,000 anaesthetics administered. Certain types of illnesses, such as heart disease, high blood pressure and obesity, can increase your anaesthesia risks. Even so, anesthesiologists routinely bring even very sick patients through major operations safely.
What are the risks of Anaesthesia?
All operations and all anaesthesia have some risks, and they are dependent upon many factors including the type of surgery and the medical condition of the patient. Fortunately, adverse events are very rare. Your anesthesiologist takes precautions to prevent an accident from occurring.
The specific risks of anaesthesia vary with the particular procedure and the condition of the patient. You should ask your anesthesiologist about any risks that may be associated with your anaesthesia.
Should I continue taking medications before the surgery?
It is important to tell your doctors what medications you are taking before the surgery, so that they can make correct decisions about stopping or continuing these medications.
What happens during a pre-anaesthesia visit with the anesthesiologist?
1. The pre-anaesthesia visit is an essential visit when you will have a chance to learn about your options for anaesthesia and to ask questions. It is also a time when the anaesthesia care team can review your medical records, do a focused physical exam and make decisions about ordering additional tests and consultations.
2. The interview with the anesthesiologist is an essential part of this review. During this interview, the anesthesiologist may ask questions that cover the following:
- Your general health, including any recent changes
- Allergies to medications or other items.
- Chronic (long-term) medical problems, such as high blood pressure, heart disease, diabetes, asthma, acid reflux and sleep apnea.
- Recent hospital admissions, including surgery or procedures.
- Previous experiences with anaesthesia, especially any problems.
- When there are different anaesthesia alternatives, such as general or regional (nerve block) anaesthesia, your anesthesiologist may give you information about these options.
How will my anesthesiologist know how many doses of anaesthesia should be given to me?
There is no single or right amount of anaesthesia for all patients. Every anaesthetic must be tailored to the individual, and to the operation or procedure that the person is having. Individuals have different responses to anaesthesia. Some of these differences are genetic, or inborn, and some differences are due to changes in health or illness. The amount of anaesthesia needed can differ according to such things as age, weight, gender, medications being taken or specific diseases (such as heart or brain conditions). Among the things, the anesthesiologist measures or observes, and uses to guide the type and amount of anaesthetic given are: heart rate and rhythm, blood pressure, breathing rate or pattern, oxygen and carbon dioxide levels and exhaled anaesthetic concentration. Because every patient is unique, the anesthesiologist must carefully adjust anaesthetic levels for each patient.
Why do I need to have an empty stomach before the surgery?
Patients must have an empty stomach before any surgery or procedure that needs anaesthesia. When anaesthesia is given, it is common for all the normal reflexes to relax. This condition makes it easy for stomach contents to go back into the oesophagus (food tube) and mouth or even the windpipe and lungs. Because the stomach contains acid, if any stomach contents do get into the lungs, they can cause acute pneumonia, called aspiration pneumonitis.
Can I smoke cigarettes before the surgery?
You should stop smoking cigarettes for as long as you can before and after the surgery. This will help you have best results from your surgery. Quitting cigarette smoking will reduce the chances of problems like a wound infection after the operation. It is especially important not to smoke on the morning of the surgery – just like you don’t consume food few hours before your surgery.
Many people find that surgery is also an excellent opportunity to quit smoking for good, because most people do not have cravings for cigarettes while in the hospital. Your chances of successfully quitting are almost doubled if you try it around the time of surgery.
What are the different types of sedations?
Sedation allows patients to be comfortable during certain surgical or medical procedures. Sedation can provide pain relief as well as relief of anxiety that may accompany some treatments or diagnostic tests.
During light or moderate sedation, patients are awake and able to respond appropriately to instructions. However, during deep sedation, patients are likely to sleep throughout the procedure with little or no memory. Breathing might slow down during the surgery, and supplemental oxygen is given during deep sedation.
What is a Blood Transfusion?
Blood transfusion is an important medical treatment that can save lives. When blood is lost during the surgery, or due to trauma, fluids are given to replace the blood. These fluids are essential for the heart and circulation.However, they do not contain necessary platelets and proteins that are needed to carry oxygen to the tissues which clot when they are injured and fight infection. Only a blood transfusion provides these things.
Do anesthesiologists administer Blood Transfusions?
Anesthesiologists administer approximately half the blood transfusions in the United States and are experts in making the risk and benefit assessments needed during a transfusion. Anesthesiologists are committed to the responsible use of the blood supply and to make the best decisions for patients.
Am I fat?
Fat is often referred as obese in medical terminology. To determine whether you are fat, doctors calculate your BMI (Body Mass Index) to know how much excess weight a person has in relation to their height. BMI of a person with normal weight ranges from 18 to 24.9kg/m2.
What is bariatric surgery?
Bariatric surgery is a type of surgery which is performed to include long term excess weight loss along with curing or improving most of the medical problems like diabetes, blood pressure, arthritis, etc.
How does weight loss surgery help to reduce excess weight?
It will restrict or reduce the amount you can eat or can avoid absorbing all food you have eaten. Also, there can be a combination of both.
How effective is weight loss surgery?
Depending on the type of surgery (patients complications & lifestyle) anywhere from 90% of your Excess Body Weight (EBW) will be lost over a period of 6 months to two years. Clinical studies have shown that post surgery, most patients lose weight rapidly and continue to do so up until 18 to 24 months after the procedure.
What is the expected hospital stay for the surgery?
Most of the patients stay in the hospital for 48hrs – 72hrs, if no complications occur, but may require longer observation for 4 to 6 days in some patients.
What type of diet will be recommended after surgery?
You will be on liquid diet for almost three weeks. Dieticians will advise you about an appropriate diet.
What is life like, after surgery?
Life transforming effect, in-fact the whole lifestyle changes. It enhances your health & makes you more active and energetic in your daily routine.
When can I have children after the surgery?
The female patients are advised to wait at least two years after surgery to avoid the stress of pregnancy during the period of rapid weight loss and allow her weight to stabilise. You are strictly advised to use contraceptive methods for first 14 months.
Will the obesity related complications get resolved after surgery?
Yes, some of the complications will resolve, and some will improve gradually, like sleep apnea, asthma, hypertension and high cholesterol. In fact, obesity surgery is now considered the best treatment for Type II diabetes.
What is your role in making the surgery a success?
Surgery can help you lose weight and also keep it off. But surgery alone won’t work. You need to change your diet and lifestyle in such way that you eat healthily and have an active life. You will need to:
- Commit to improving your health
- Discuss your health history with the surgeon
- Get all answers and have all information on the procedure
- Follow all the instructions given before the surgery
- Follow all the instructions regarding nutrition, activity and exercise after the surgery
What is the surgeon’s role in making the surgery a success?
Your doctor will help you protect your health before; during and after surgery.
- Evaluate you as a possible surgery patient
- Describe the surgical options: risks and benefits
- Perform the best procedure for you
- Prescribe regular follow up
- A registered dietician will provide you with a diet chart and plan your meals according to your needs
Do cardiac tests hurt?
You may already know that imaging techniques such as a sonogram, MRI, X-ray, CT scan etc do not hurt and a blood test only requires a prick. Some heart tests will have you wear a device on your chest for a day or two. Needless to say, that too does not hurt.
People generally worry about the stress test and catheterization. During a catheterization, you will be given medication to ease your discomfort. But a stress test can be a little stressful. But that is an essential diagnostic test. But rest assured that you will be monitored all along and no harm to your health will occur.
I have high blood pressure. Will it affect my heart functioning?
High blood pressure is directly related to heart diseases. While one episode of high BP might not kill you but you suffer from high BP in general, it is advisable that you seek medical help that will help you manage your heart health.
How long do cardiac rehab programs last?
A cardiac rehab program can be as short as a few weeks or as long as more than 3 months. It depends on what kind of disease you have and what kind of lifestyle you lead. If you have a healthy lifestyle, free of any kind of addiction, a 3 month rehab program is more than enough. But if you have a serious heart condition and you are addicted to drugs, tobacco and alcohol, you will need a longer rehab program.
For managing less serious conditions like a little raise in blood pressure levels, you can wind up your rehab session in a few hours by visiting a cardiologist followed by a counseling from a nutritionist.
I have a heart condition. Will it affect my pregnancy?
In most cases, a heart condition will not affect your pregnancy when the entire period is monitored by a medical expert. In any case, your heart condition will not affect the health of the child. As for the mother, medicines, exercises and dietary control can ease her way during pregnancy, childbirth and recovery.
But if you have a very serious heart condition, your doctor will let you know about the risks and how you can mitigate them.
Does stress affect heart health?
Stress has an impact on your bp level. A high bp increases the risk of a heart attack. But there are other factors which you should consider. Like, how do you cope with your stress? Do you find comfort in fast food binge? Do you drink alcohol and smoke? Do you alienate yourself to a corner? Such practices can lead to rise in cholesterol levels, leading to heart diseases.
How long should patients with a cleft lip be under the supervision of a maxillofacial surgeon?
In spite of stage wise surgeries, a child with clefts can show differential growth of maxilla and mandible (jaws) and also several missing or unerupted teeth. So a cleft patient should be under a maxillofacial surgeon’s follow up till the growth period is complete. for timely interventions which will promote proper growth. Sometimes cosmetic surgery may be required to enhance facial profile after growth is completed.
Can cleft lips and cleft palates be repaired?
Yes. Surgery provides excellent results. A Maxillofacial surgeon work with a child’s parents and paediatrician to choose the best timing for surgery. Most surgeons agree that a cleft lip should be repaired by the time a baby is three months old. To restore the partition of mouth and nose as early as possible, a cleft palate is repaired between the ages of 12 and 18 months. Any surgical procedure is dependent upon a child’s general health and the nature of the cleft lip or cleft palate.
What is Snoring & OSA?
Loud snoring is not only a social problem but can also be a symptom of an underlying disease called Obstructive Sleep Apnea. In adults, OSA can cause excessive daytime sleepiness, morning headaches, and hypertension and if left untreated can lead to serious consequences like Heart failure.
Patients suffering from these conditions are advised to reduce weight, and in selected cases, the airway is improved.
What is Cochlear Implant Program?
Cochlear implantations are for patients with hearing losses, and who are unable to efficiently manage other hearing aids. Implants do not restore normal hearing, and the patients feel that the sound is mechanical. It is only through time and trial that the brain becomes familiar with new sound and speech signals and environmental sounds. Cochlear implants help in:
- Lip reading
- Improved perception of environment sounds
- Monitoring the volume of one’s voice
ENT Specialists at Sunshine’s ENT outpatient clinic understand and treat a broad range of hearing, balance and communication disorders. The Cochlear Implant program is a significant initiative towards Sunshine’s commitment to helping restore hearing to deaf children and adults. A multi-disciplinary team comprising of consultants belonging to various clinical areas like otology, audiology, speech pathology and psychology work in unison to make the program a tremendous success.
What is Audiology?
Sunshine Hospitals offer a broad range of diagnostic evaluations for hearing and balance, along with restorative technology and services. The team has the experience of working with the newborns, children, adults and the older adults, and customises services according to the need. Services include:
- Hearing tests
- Newborn infant hearing screening
- Hearing aid fitting
- Assistive listening devices
- Cochlear implant services
What is Chronic Nasal and Sinus Disorders?
The key to effective treatment of chronic nasal and sinus disorders is a precise diagnosis. ENT specialists at Sunshine Hospitals deliver exceptional care to patients suffering from complex sinonasal disorders. Depending on the condition of the patient, a combination of medical treatments or sinus and nasal surgery, if required, is employed. The multidisciplinary team includes experts in allergy, radiology, neurology and pulmonology.
Some of the conditions treated at Sunshine Hospitals are:
- Nasal stuffiness
- Recurrent infection
- Loss of smell
- Chronic sinusitis
- Nasal polyps
What is Paediatric Otolaryngology?
A multi-disciplinary approach is embraced to treat children with ear, nose and throat problems. Paediatric ENT specialists work in sync with nurses, audiologists and speech professionals to address simple disorders like ear, tonsil and sinus infections, snoring and obstructive sleep apnea to the most complex ones like congenital hearing loss and severe airway problems.
What is Vocal Cord Disorders?
Located in the larynx (voice box) in the neck area are two bands of smooth muscle tissue that produces the sound of an individual’s voice called as vocal cords. Some of the common reasons that cause vocal cord disorders are vocal abuse such as overuse of the voice to sing, talk, smoke, cough, scream, etc. If symptoms like change in voice persist longer than two weeks, then you should immediately consult a doctor. In some cases, hoarseness in voice has indicated laryngeal cancer.
ENT surgeons diagnose and treat a broad range of vocal cord disorders that include:
- Vocal nodules
- Vocal polyps
- Vocal cord paralysis
- Contact ulcers
- Laryngeal papillomatosis
Depending on the condition of a patient and the extent and type of disorder, a specific treatment plan is prepared and implemented by the ENT team at Sunshine. Treatment may include avoiding activities that triggered the vocal cord disorder, medication or surgery.
Who is an oral Maxillofacial Surgeon?
An oral and maxillofacial surgeon is a specialist who focuses on the diagnosis, surgical and treatment of diseases, abnormalities and injuries in the Face Mouth and jaws. They are also called as Facial Surgeons or Facio-Maxillary Surgeons. After graduating from dental school, they have an additional four to seven years of hospital-based surgical and medical training, which enables them to perform a broad range of procedures including all types of surgery of both the bones and soft tissues of the face, mouth and jaws.
Who needs a Maxillofacial Surgeon?
Oral and Maxillofacial surgery encompasses the diagnosis, surgical and related treatment of the head and neck area. An Oral and Maxillofacial surgeon cares for patients with facial fractures and lacerations, is trained in the facial reconstruction of malformed jaw structures, manages patients with lesions of an Oral and Maxillofacial area, treats jaw dysfunction, reconstructs areas of missing teeth with dental implants and performs surgical removal of teeth.
What is an Orthognathic Surgery?
Orthognathic Surgery is also known as Cosmetic Facial Surgery (Corrective Jaw Surgery) involves moving the bones of the upper or lower jaw or both. The jaws are lengthened or shortened, moved up or down, in or out, resulting in a more harmonious bite and facial appearance.
Who needs an orthognathic surgery?
People who can benefit from orthognathic surgery include those with an unpleasing improper bite or jaws that are positioned incorrectly. Jaw growth is a gradual process, and in some instances, the upper and lower jaws may not match at the end of growth. Injury to the jaw during growth may be a cause for the incongruent growth of the jaws. The result can cause a host of problems that can affect chewing function, speech, long-term oral health and appearance. Some bite problems can be corrected by orthodontics alone.
Is orthodontic treatment necessary before or after orthognathic surgery? If yes, then how long does this treatment last?
At times presurgical orthodontic treatment can be avoided, but post-surgical orthodontics is a must as the dental occlusion which is disturbed due to jaw movements during surgery need to properly aligned. The treatment would take a minimum of six months to a maximum of one year.
What can I expect during the first few weeks after the surgery?
Initially, there would be facial swelling and difficulty in chewing. It would take around 7 to 14 days for these symptoms to settle down. During this period suggested exercises should be done.
How long is the hospital stay?
2 to 3 days.
What is a Temporomandibular Joint? How is it different from other joints?
TMJ stands for temporomandibular joint. The TMJ is the jaw joint. The TMJ is a unique joint in many respects. It is the only joint that both rotates and slides and is connected to the joint on the other side of the body [right and left] via the chin. It has a disc that is made of fibrocartilage, and its embryonic origins are unique. Chemically biologically and physically it is different from all other joints. Most importantly it has a special relationship to the teeth, such that the joint will adjust its position to satisfy occlusion (the way the teeth bite together). If someone has a bad bite (occlusion), then that can lead to TMJ problems.
Who treats Temporomandibular Disorders?
Many think like all other joints of our body an orthopaedic surgeon treats this joint too. But due to its unique anatomy and function, it is exclusively dealt by a Maxillofacial surgeon.
What is TMJ Pain?
TMJ pain is classified under the broader category of TMD (temporomandibular disorders). Temporomandibular disorders encompass TMJ (joint) problems along with musculoskeletal disorders like facial pain dysfunction syndrome (MFPDS), migraines, sinus disease, temporal arteritis and anything else that could cause pain in the area of the temples, ear and jaw joint.
A thorough exam including special x-rays and sometimes CT or MRI of the joint is necessary to distinguish the cause of TMD pain. Patients are often seen by more than one specialist, and visits to the Maxillofacial surgeon can only “rule out” joint problems.
Is surgery the only solution for TMJ Disorders?
There are several treatment options available for TMJ problems ranging from medical to less invasive to surgery. The choice of therapy depends on the severity of the complaint and condition of the joint.
What are TMJ devices of Splints?
Splint – A splint is a special type of mouthguard that helps with TMJ problems. Don’t buy a commercial over the counter TMJ device. They almost always make things worse. A TMJ mouth guard or occlusal splint can only be properly made by someone who understands the TMJ and occlusion. The splint is a device worn on the upper or lower jaw, covering all of the teeth. It causes changes in the way you bite to relieve TMJ pain. It is made of hard acrylic, not soft rubbery material. Splints are sometimes worn all day long but often just at night.
- Night Guard – A night guard helps you stop clenching or grinding your teeth and reduces muscle tension at night and contributes to protecting the cartilage and joint surfaces.
- Anterior Positioning Appliance – An anterior positioning appliance moves your jaw forward, relieves pressure on parts of your jaw and aids in disk repositioning. It may be worn 24 hours/day to help your jaw heal. An orthotic stabilisation appliance is worn 24 hours/day or just at night to move your jaw into proper position. Appliances also help to protect from tooth wear.
My jaw and bite have never felt the same after my facial injury. Is there anything I can do?
Yes. We often treat patients who are suffering from chronic issues stemming from old accidents and injuries. Perhaps your jaw is not correctly aligned because of trauma, or perhaps a past broken nose has significantly hindered your ability to breathe. There is no reason to continue wondering if you can ever feel healthy again, without ever taking action – come in for a consultation and find out if we can help.
I suffered facial injury years ago. Is it too late to do anything for my scar?
Many types of severe facial injuries can result in scars – and facial scars are often on display for everyone to see, reminding you of the trauma you went through. If you wonder if your scar could be minimised, there are some different treatment methods and strategies for making scars less apparent, from laser skin treatments to facial surgery.
Whom should I consult for a facial bone and soft tissue injury?
Undoubtedly a maxillofacial surgeon.
What kind of injuries does the Maxillofacial Department of Sunshine Hospital treat?
Facial and oral injuries have a variety of causes including accidents, sporting injuries, assault or self-harm. Injuries can be medical or surgical emergencies or requests to treat old injuries that could have improved cosmetic or functional features.
In the Maxillofacial Surgery Department, we are used to treating people who have had accidents, assaults or who have self-harmed, and won’t judge you on the causes of the injury just help you get the best functional and aesthetic result.
Will I need the stitches in my mouth to be taken out?
Usually, Maxillofacial surgeons use dissolving sutures (stitches) inside the mouth, which won’t need to be removed.
What should I do If I have had stitches in my mouth recently?
If you have had any recent procedure in your mouth, particularly after an injury or trauma, it is important to keep your mouth clean. Keeping the mouth clean prevents infection and is also for your benefit in the long run. We recommend warm salty or antiseptic mouthwashes 3-4 times a day, as well as gentle brushing of the teeth and gums.
I have a facial fracture. How long will it take to heal?
Recovery of a facial fracture will depend on the type and extent of the fracture and what other problems and treatment you had. Usually bruising and swelling takes 2 to 3 weeks to settle down. At this point, you will begin to look more normal. After this time the body will continue to heal itself inside.
I experience numbness after I had a facial injury. How long will I take to recover and get back to being normal?
The facial bones have many channels in them in which small nerves run. These nerves are sensory nerves (sensing hot, cold, touch, pain, etc.) When the nerves emerge from the bones, they distribute themselves through the soft tissues and skin of the face. A facial injury (including a fracture), damages the soft tissues, skin and the bones. This can not only lead to short-term pain but also numbness or altered sensation to the face. Depending on the position and extent of the injury, this change in sensation often takes many weeks or maybe even months to disappear completely.
What plates are used to treat facial fractures?
The plates used to repair facial fractures are made of titanium. They hold together and strengthen the bones of your face and jaws.
Will I have to have the plates removed?
The plates used to repair facial fractures are designed to be left in place and stay with your bone permanently. Very occasionally, they might need to be removed later for example if they cause an infection or discomfort.
Will the plates set off metal detectors at airports?
Because the plates are made of titanium, they do not set off the metal detectors used at airports.
Do I need to tell anyone that I have a metal plate in my face/jaws?
It is wise to mention your metal plate if you need to have scans such as computerised tomography (CT) or magnetic resonance imaging (MRI).
Why have I been told that I should not blow my nose for the next few days?
If you have a fracture of the cheekbone, you should not blow your nose for about ten days following the injury. This is because you might force air from your sinuses into the skin, which can result in facial swelling around the eyes. This swelling is temporary and will disappear with time. If you have any questions, you should seek advice from your oral and maxillofacial surgeon.
If I have had a facial fracture, what other things should I avoid for the next few weeks?
If you have had a facial fracture, you will be advised by your Maxillofacial team to avoid knocks or bumps to the area for at least 6-8 weeks until the fracture has healed. This is because ‘impacts’ on fractured areas might move the affected bones.
For how long should I take antibiotics?
Often we will prescribe a course of antibiotics for people who have had a facial fracture or other procedure to the mouth or face. This is to prevent an infection. Whenever you are prescribed antibiotics, it is important to finish the course as instructed. This is for your health and also to prevent the emergence of antibiotic resistance in the general population. If you have any problems taking the antibiotics (e.g., side effects), do contact your general practitioner (GP) or the Maxillofacial team that treated your injury or performed the procedure.
Why do cysts form in the jaws?
Cysts in jaw bones can form at the tip of the roots of dead teeth. They can also form around the crowns (and roots) of buried teeth. Most cysts form because the teeth they are associated with have died (infection or trauma). Others form because of a mistake in the way the teeth have developed (including being unable to grow into the mouth properly). Rarely, dental cysts are part of a genetic syndrome that has other symptoms (e.g., Gorlin’s syndrome). A Maxillofacial surgeon will explain to you more about the cause of your cyst.
Can I develop more than one cysts in my jaws?
Any teeth can develop dental cysts. Most people will only have one at a time, but some people are more susceptible to developing them either because of the condition of their teeth or because they have an inherited genetic problems or endocrine disorders that have cysts as part of its features.
What are the problems associated with Jaw Cysts?
Jaw cysts can cause several problems, but some remain undetected for months or even years. Many cause problems when:
- They become infected (causing pain and swelling)
- They slowly resorb some bony tissue (they can weaken the jaws)
- They press against other teeth and structures
- They prevent the proper function of the teeth and oral tissues
How are jaw cysts treated?
The treatment depends on the location, type and size of the cyst. Ideally, cysts should be removed.
How do you know if you have Sleep Apnoea?
Sleep Apnoea can be identified by irregular, loud and interrupted snoring, accompanied by one as while asleep and if you feel tired during the day or have chronic fatigue.
What can a maxillofacial surgeon do to treat Sleep Apnoea?
Most commonly a backwardly positioned mandible can be a reason for sleep apnoea. In such cases, a mandibular advancement (orthognathic surgery) is performed by a maxillofacial surgeon, which will give relief to the patient.
Where does Oral Cancer occur?
About two-thirds of cancer of the mouth or oral cavity occurs in the floor of mouth and tongue but can take place in the upper or lower jaw, lips, gums, and cheek lining. Just behind the mouth is an area known as the oropharynx. Oropharyngeal cancer (one-third of cases) occurs in the back of the tongue, tonsils and throat tissue.
Who are at risk of having Oral Cancers?
People who use tobacco are six times more likely to develop oral cancer. Eight of 10 oral cancer patients are smokers. Heavy alcohol drinkers are also more at risk. 80% of people diagnosed with oral cancer consume more than 21 drinks weekly. Finally, individuals with a history of oral human papillomavirus infections are at greater risk to develop oral cancer even if they don’t smoke or drink.
What are the symptoms of having Oral Cancer?
- Red or white patches in or behind the mouth
- Mouth sores or ulcers that bleed easily and do not heal
- Unexplained lump in the neck throat or floor of the mouth
- Difficulty or discomfort swallowing
- Pain and tenderness in teeth or gums
- Change in the fit of dentures or partial dentures
- Visible change in mouth tissue
- Unpleasant sensations (pain, discomfort, numbness)
- Diminished ability to perform routine functions such as opening jaw, chewing or swallowing
- Unexplained swelling or fullness in the neck
How can you prevent Oral Cancer?
It is recommended to have a comprehensive oral evaluation and soft tissue exam annually. Your Maxillofacial surgeon must perform a thorough evaluation of your mouth including the associated structures in the head and neck area.
An oral cancer screening is painless; treatment for advanced oral cancer is not.
How is Oral Cancer treated?
Most cases of oral cancer are curable. Many cases of oral cancer are treated with surgery. There are several types of surgery used. If major surgery is done, the surgeon may also rebuild parts of the oral cavity to preserve the appearance and function of the mouth. Radiation therapy is also used to treat and cure oral cancer. It may be used with surgery. Chemotherapy may be utilised before or after surgery or used alone when the cancer is diagnosed at a later stage. Effective chemotherapy can control further spread of cancer.
What is Hypertension?
The heart pumps blood into the arteries (blood vessels), which carry the blood throughout the body. While moving through the arteries, blood exerts some degree of pressure or force exerted against the walls of the blood vessel. This is blood pressure, which can be high or low. High blood pressure is also called hypertension.
High blood pressure, also called hypertension, means the pressure in your arteries is above the normal range. In a majority of the cases, the apparent cause of high blood pressure is unknown.
With continuous access to the most advanced treatment options and specialist expertise from fields like nephrology, endocrinology, pharmacology and others, Sunshine Hospitals follows a multidisciplinary approach. Also, post-treatment results are studied so that the patients achieve best blood pressure control rates.
- Our team of doctors holds vast experience in working in
- Identifying abnormal causes of hypertension
- Measuring and monitoring blood pressure
What is Kidney Transplantation?
Kidney Transplantation is considered when an individual experiences permanent kidney failure. Kidney Transplantation will help you enjoy life as that of people with healthy kidneys. With time, latest advancements have made kidney transplants safer by minimising the side effects of medicines.
It is to be understood that kidney transplantation is not a cure. Rather, it is an ongoing treatment that will require the individual to be on medication as well. Along with that, the wait time to find the right donor can run into years.
At Sunshine Hospitals, we ensure a successful transplant with a well-coordinated effort from a healthcare team that is all inclusive – comprising nephrologists, transplant surgeons, transplant coordinator, pharmacist, and dietitian. Most importantly, we include you and your family as part of the treatment.
With continuous access to the most advanced treatment options and specialist expertise – from fields like nephrology, endocrinology, pharmacology and others – Sunshine Hospitals follows a multidisciplinary approach. Also, post-treatment results are studied so that the patients achieve best blood pressure control rates.
Our team of doctors holds vast experience in working in:
- Identifying abnormal causes of hypertension
- Measuring and monitoring blood pressure
- Chronic Kidney Disease
- Identify the causes
- Lessen the worsening of the disease
- Attend complications
- Restore the lost kidney function
Based on the extent of non-functioning of the kidney, a suitable type of dialysis treatment is recommended. With state-of-the-art facilities and expert nephrologists, Sunshine Hospitals offers the following services:
- Comprehensive evaluation of the kidney functioning
- Planning and guidance for peritoneal dialysis
- Reverse Osmosis water treatment system
- Renal Transplantation
- Careful medical evaluation for deciding on transplant
- Assistance in finding the right donor
- Performing the actual transplant operation
- Post-surgery care
What is Chronic Kidney Diseases?
Chronic Kidney Disease (also known as a chronic renal disease) is a progressive loss of renal function over a period of months or years. The deteriorating state of kidneys can be recognised by identifying symptoms that include general feeling unwell and experiencing a reduced appetite.
Chronic kidney disease is not a direct result of the specific diagnosis. It is known as a result of screening of people known to be at risk of kidney problems such as high blood pressure or diabetes. Also, complications such as cardiovascular disease, anaemia or pericarditis may point to CKD.
How is kidney failure treated?
- Peritoneal dialysis
- Kidney transplantation
What Is a Stroke?
A stroke is a condition where a blood clot or ruptured artery or blood vessel interrupts blood flow to an area of the brain. Lack of oxygen and glucose (sugar) flowing to the brain leads to the death of brain cells and brain damage, often resulting in an impairment of speech, movement, and memory. The two main types of stroke include ischemic stroke and hemorrhagic stroke. Ischemic stroke accounts for about 75% of all strokes and occurs when a blood clot, or thrombus, forms that block the blood flow to part of the brain. If a blood clot forms somewhere in the body and breaks off to become free-floating, it is called an embolus. This wandering clot may be carried through the bloodstream to the brain where it can cause ischemic stroke. A hemorrhagic stroke occurs when a blood vessel on the brain’s surface ruptures and fills the space between the brain and skull with blood (subarachnoid haemorrhage) or when a defective artery in the brain bursts and fills the surrounding tissue with blood (cerebral haemorrhage). Both result in a lack of blood flow to the brain and a buildup of blood that puts too much pressure on the brain. The outcome after a stroke depends on where the stroke occurs and how much of the brain is affected. Smaller strokes may result in minor problems, such as weakness in an arm or leg. Larger strokes may lead to paralysis or death. Many stroke patients are left with weakness on one side of the body, difficulty speaking, incontinence, and bladder problems.
Who gets a Stroke?
Anyone can suffer from a stroke. Although many risk factors for stroke are out of our control, several can be kept in line through proper nutrition and medical care.
Risk factors for stroke include the following:
- People above the age of 55
- African American, Hispanic or Asian/Pacific Islander
- A family history of stroke
- High blood pressure
- High cholesterol
- Smoking cigarettes
- Obesity and overweight
- Cardiovascular disease
- A previous stroke or transient ischemic attack (TIA)
- High levels of homocysteine (an amino acid in blood)
- Birth control use or other hormone therapy
- Cocaine use
- Heavy use of alcohol
What causes Stroke?
Ischemic strokes are ultimately caused by a thrombus or embolus that blocks blood flow to the brain. Blood clots (thrombus clots) usually occur in areas of the arteries that have been damaged by atherosclerosis from a buildup of plaques. Embolus type blood clots are often caused by atrial fibrillation – an irregular pattern of the heart beat that leads to blood clot formation and poor blood flow.
Haemorrhage strokes can be caused by uncontrolled high blood pressure, a head injury, or aneurysms. High blood pressure is the most common cause of cerebral haemorrhage, as it causes small arteries inside the brain to burst. This deprives brain cells of the blood and dangerously increases pressure on the brain.
Aneurysms – Abnormal blood-filled pouches that balloon out from weak spots in the wall of an artery – are the most common cause of subarachnoid haemorrhage. In an aneurysm rupture, blood spills into the space between the surfaces of the brain and skull, and blood vessels in the brain may spasm. Aneurysms are often caused or made worse by high blood pressure.
A study found that a single gene defect can lead to stroke and deadly diseases of the aorta and coronary arteries.
A less common form of haemorrhage stroke is when an arteriovenous malformation (AVM) ruptures. AVM is an abnormal tangle of thin-walled blood vessels that is present at birth.
A study found that migraines increase stroke risk during pregnancy.
What are the symptoms of Stroke?
Within a few minutes of having a stroke, brain cells begin to die, and symptoms can become present. It is important to recognise symptoms, as prompt treatment is crucial to recovery.
Common symptoms include:
- Dizziness, trouble walking, loss of balance and coordination
- Speech problems.
- Numbness, weakness, or paralysis on one side of the body.
- Blurred, blackened, or double vision.
- Sudden severe headache.
- Smaller strokes (or silent strokes), however, may not cause any symptoms, but can still damage brain tissue.
A possible sign that a stroke is about to occur is called a transient ischemic attack (TIA). It is a temporary interruption of blood flow to part of the brain. Symptoms of TIA are similar to a stroke, but last for a shorter period and do not leave noticeable permanent damage.
A study found that women are more likely to experience non-traditional stroke symptoms.
How is stroke diagnosed?
Stroke is a medical emergency. Anyone suspected of having a stroke should be taken to a hospital immediately so that necessary tests are performed, and the correct treatment is provided as quickly as possible.
Physicians have several tools available to screen for stroke risk and diagnose an active stroke.
- Physical Assessment – Blood pressure tests and blood tests to see cholesterol levels, blood sugar levels, and amino acid levels
- Ultrasound – A wand waved over the carotid arteries in the neck can provide a picture that indicates any narrowing or clotting
- Arteriography – A catheter is inserted into the arteries to inject a dye that can be picked up by X-rays
- Computerised Tomography (CT) scan – A scanning device that creates a 3D image that can show aneurysms, bleeding, or abnormal vessels within the brain
- Magnetic Resonance Imaging (MRI) – A magnetic field generates a 3D view of the brain to see tissue damaged by stroke
- CT and MRI with Angiography – Scans that are aided by a dye that is injected into the blood vessels to provide clearer and more detailed images
- Echocardiography – An ultrasound that makes images of the heart to check for embolus
How is stroke treated?
The primary goal in treating ischemic stroke is to restore blood flow to the brain. This will be attempted using blood clot-busting drugs such as aspirin, heparin, or tissue plasminogen activators that must be administered within three hours of the stroke. Also, surgical procedures may be performed that can open up or widen arteries. These include carotid endarterectomy (removal of plaque and widening of the carotid artery) and angioplasty (a balloon that widens the carotid artery and is held open with a metallic mesh tube called a stent).
A study found that cholesterol-lowering drugs can prevent stroke recurrence.
Hemorrhagic stroke is treated differently than ischemic stroke. Surgical methods used to treat this stroke variant include aneurysm clipping, aneurysm embolisation, and arteriovenous malformation (AVM) removal. Aneurysm clipping consists of a small clamp placed at the base of an aneurysm that isolates it from the circulation of its attached artery and keeps an aneurysm from bursting or re-bleeding. Aneurysm embolisation (coiling) uses a catheter inserted into an aneurysm to deposit a small coil that coil fills an aneurysm, causing clotting and sealing off an aneurysm off from arteries. AVM removal is a surgical procedure to remove usually smaller AVMs or AMVs that are in a more accessible portion of the brain to eliminate the risk of rupture.
Most stroke victims will require rehabilitation after the event. A person’s condition depends on the area of the brain and the damaged amount of tissue. It is common for the rehabilitation process to include speech therapy, occupational therapy, physical therapy, and family education.
How can stroke be prevented?
One way to prevent a stroke is to notice a transient ischemic attack (TIA) – or mini-stroke – that produces symptoms similar to a stroke. Knowing the symptoms of stroke can lead to earlier treatment and better recovery.
Much of stroke prevention is based on living a healthy lifestyle.
What is Parkinson’s Disease?
Parkinson’s Disease (PD), paralysis agitans, and shaking palsy is a gradually progressive, degenerative neurological disorder which impairs the patient’s motor skills, speech, writing, as well as some other functions. Sufferers often have a fixed, inexpressive face, tremor at rest, slowing of voluntary movements (bradykinesia), an unusual posture, and muscle weakness. In extreme cases, there is a loss of physical movement (akinesia). Parkinson’s Disease is both chronic and progressive. Chronic means long-term, while progressive means it gradually gets worse. Parkinsonism is a neurological syndrome characterised by tremor, rigidity, postural instability, and hypokinesia (decreased bodily movement).
While about 5% of individuals with Parkinson’s disease are under the age of 40 years, the majority are over 50. When signs and symptoms develop in a person aged between 21 and 40 years, it is known as Young-onset Parkinson’s disease. Approximately 1 in every 20 patients diagnosed with PD is under 40 years of age. When signs and symptoms appear in people under 18 years old, it is known as Juvenile Parkinson’s disease. It affects both sexes; males more than females.
As a significant number of elderly patient with early Parkinson’s disease symptoms assume that their symptoms may form part of healthy ageing and do not seek medical help, obtaining accurate statistics is probably impossible. There are also several different conditions which sometimes have equal signs and symptoms to PD.
PD is named after James Parkinson (1755-1824), an English apothecary surgeon, palaeontologist, geologist and political activist. In his most famous work “An Essay on the Shaking Palsy” (1817), he was the first person to describe paralysis agitans, which eventually was named after him.
Parkinson’s disease belongs to a group of conditions called movement disorders. Movement disorders describe a variety of abnormal body movements that have a neurological basis and include such conditions as cerebral palsy, ataxia, and Tourette syndrome. Parkinson’s disease results from decreased stimulation of the motor cortex by the basal ganglia, typically caused by insufficient formation and action of dopamine.
As on April 2010, there is no current cure for Parkinson’s disease. Treatment focuses on alleviating symptoms. Sometimes treatment may include surgery, like deep brain stimulation. Stem cell therapy is a new modality of treatment.
What is Dementia and what causes it?
Symptoms of Dementia: The word dementia comes from the Latin demeaning “apart” and means from the genitive mental meaning “mind”. Dementia is the progressive deterioration in cognitive function – the ability to process thought (intelligence). Progressive means the symptoms will gradually get worse. The deterioration is more than might be expected from normal ageing and is due to damage or disease. Damage could be caused by a stroke, while an example of a condition might be Alzheimer’s. Dementia is a non-specific syndrome in which affected areas of brain function may be affected, such as memory, language, problem solving and attention. Dementia, unlike Alzheimer’s, is not a disease in itself. When dementia appears, the higher mental functions of the patient are involved initially. Eventually, in the later stages, the person may not know what day of the week, month or year it is, he may not know where he is, and might not be able to identify the people around him.
Dementia is significantly more common among seniors. However, it can affect adults of any age.
What are the symptoms of Dementia?
Memory Loss – The patient may forget his way back home from the shops. He may remember names and places. He may find it hard to remember what happened earlier on during the day.
Moodiness – The patient may become more and moodier as parts of the brain that control emotion becomes damaged. Moods may also be affected by fear and anxiety – the patient is frightened about what is happening to him.
Communicative Difficulties – The affected person finds it harder to talk read and write. As dementia progresses, the patient’s ability to carry out everyday tasks diminishes and he may not be able to look after himself.
Diseases that cause dementia
Alzheimer’s Disease – This is by far the most common cause of dementia. The chemistry and structure of the brain of a person with Alzheimer’s disease changes and his brain cells die prematurely.
Stroke (Vascular problems) – This means problems with blood vessels (veins and arteries). Our brain needs a good supply of oxygen-rich blood. If this supply is undermined in any way, our brain cells could die – causing symptoms of vascular dementia. Symptoms may appear suddenly, or gradually. A major stroke will cause symptoms to appear suddenly while a series of mini strokes will not.
Dementia with Lewy Bodies – Spherical structures develop inside nerve cells. Brain cells are nerve cells; they form part of our nervous system. These spherical structures in the brain can damage the brain tissue. The patient’s memory, concentration and ability to speak are affected. Dementia with Lewy bodies is sometimes mistaken for Parkinson’s Disease because the symptoms are somewhat similar.
Frontotemporal Dementia – This includes Pick’s disease. The front part of the brain is damaged. The patient’s behaviour and personality are affected first, later his memory changes.
Other Diseases – Progressive supranuclear palsy, Korsakoff’s syndrome, Binswanger’s disease, HIV and AIDS, and Creutzfeldt-Jakob disease (CJD). Dementia is also common among patients who have Parkinson’s disease, Huntington’s disease, Motor Neurone disease and Multiple Sclerosis. People who have AIDS sometimes go on to develop cognitive impairment.
There are two main categories of dementia. These are Cortical and Subcortical dementias.
Cortical Dementia – The cerebral cortex is affected. This is the outer layer of the brain. The cerebral cortex is vital for cognitive processes, such as language and memory. Alzheimer’s disease is a form of cortical dementia, as is CJD (Creutzfeldt-Jakob disease).
Subcortical Dementia – A part of the brain beneath the cortex (deeper inside) becomes affected or damaged. Language and memory are not usually affected. A patient with subcortical dementia will often experience changes in his personality, his thinking may slow down, and his attention span may be shortened. Dementias which sometimes result from Parkinson’s disease are subcortical dementias, as are those caused by AIDS and Huntington’s disease.
A patient with multi-infarct dementia will have both the cortical and subcortical parts of the brain affected or damaged.
Diagnosis of dementia
Although there are some brief tests, a more reliable diagnosis needs to be carried out by a specialist. The following tests are commonly used:
It is important that the patient’s score is interpreted in context with his socio-economic, educational and cultural background. The tester must also factor in the patient’s present physical and mental state – does the patient suffer from depression, is he in great pain?
What is the treatment for Dementia?
In the majority of cases, dementia is incurable. Researchers are making inroads into treatments that may slow down the progress of Dementia. Cholinesterase inhibitors are frequently administered during the early stages. Cognitive and behavioural therapies may also be useful. Several studies have found that music therapy helps patients with dementia. It is important to remember that the patient’s caregiver also needs training and emotional support.
Tacrine (Cognex), donepezil (Aricept), galantamine (Razadyne), and rivastigmine (Exelon) have been approved for the treatment of Dementia caused by Alzheimer’s Disease – some physicians prescribe these drugs for vascular dementia as well. Selegiline, which is used for treating Parkinson’s Disease, has been found to slow down the progress of Dementia.
What is Urinary Incontinence?
Millions of women experience involuntary loss of urine called urinary incontinence (UI). UI can be slightly bothersome or debilitating. Some women suffering from this condition become cautious of the public embarrassment and thereby avoid enjoying activities with their family and friends. UI is a medical problem that is more common in older women than in the younger. Urine incontinence occurs when there is a problem with the muscles and nerves holding or releasing urine. It is observed that a majority of women suffering from UI can witness improvement without surgery.
At Sunshine Hospitals, our team will begin with diagnosing the type of UI. Our comprehensive diagnosis helps us define the problem such as straining and discomfort, fluid intake, use of drugs, recent surgery, illness and others.
Types of sprains:
- Behavioural remedies
- Injections for stress incontinence
- Medication for Overactive Bladder
- Vaginal devices for stress incontinence
- Surgery for stress incontinence
What is Amenorrhoea?
The absence of the menstrual period in a woman of reproductive age is called amenorrhoea. Physiological states of amenorrhoea are witnessed during pregnancy and lactation (breastfeeding).
Women undergoing significant weight loss, dieting, or performing considerable amounts of exercise on a regular basis are at risk of developing hypothalamic (or ‘athletic’) amenorrhoea. Another serious risk is the severe bone loss sometimes resulting in osteoporosis and osteopenia. Also, certain medications, particularly contraceptive medications, can induce amenorrhoea in a healthy woman.
Sunshine’s treatment varies based on the underlying condition. Key issues are problems of surgical correction, if appropriate, and oestrogen therapy if oestrogen levels are low.
What is Dysmenorrhea?
A gynaecological medical condition of pain during menstruation that disturbs everyday activities is Dysmenorrhea (or dysmenorrhoea). More commonly, it is described as menstrual pain or excessive menstrual pain.
Common symptoms appear alongside dysmenorrhea condition include nausea and vomiting, dizziness, headache, constipation, hypersensitivity to sound, light, smell and fatigue.
Before commencing any treatment, Sunshine’s team of gynaecologists considers two key factors – woman’s age and interest in conceiving.
- The treatment varies based on the cause and can include any of the following
- Medication (anti-prostaglandin drugs / NSAIDs)
- Hysterectomy (If necessary)
- Self-management plan
What is Infertility?
Persistent inability to contribute to conception is infertility. It can happen with both women and men. Age, poor diet, stress, alcohol overuse, smoking, sexually transmitted infections (STIs) are some of the factors that increase the risk of infertility.
At Sunshine Hospitals, our team will first spend time in understanding medical history. Later, few basic tests may be conducted to identify the reason for not being able to conceive. Depending on the results of the tests, right treatment will commence.
The treatment varies based on the cause and can include any of the following:
- At-home conception
- At-home assessment
- Intrauterine insemination
- Assisted reproductive technology
- Gestational carrier
What is Menorrhagia?
Heavy and prolonged menstrual periods occurring at regular intervals is menorrhagia. Some of the reasons that cause menorrhagia are blood clotting, disruption of normal hormonal regulation of periods or disorders of the endometrial lining of the uterus.
At Sunshine Hospitals, we make an effort to identify the underlying cause and base treatment on it.
The treatment varies based on the cause and can include any of the following:
- First line
- Second Line
- Third line
- Dilation and curettage (D&C)
- Endometrial ablation
- Uterine artery embolisation (UAE)
- Hysteroscopic myomectomy
What is Pelvic Organ Prolapse?
Medically speaking, prolapse refers to a condition where the muscles and ligaments supporting a woman’s pelvic organs weaken and the pelvic organs tend to slip out of place.
Protruding organs or a spinal disc herniation is also categorised as “disc prolapse”.
Pelvic organ prolapse worsens with time and surgery may be required to fix it.
Women over 55 years, who have undergone hysterectomy, or have delivered more than one natural birth are prone to pelvic organ prolapse. Other risk factors include obesity, persistent cough and constipation.
At Sunshine Hospitals, our team of gynaecologists works in coordination with urologists and other specialist surgeons to assess and treat the different types of pelvic organ prolapse.
Cases of pelvic organ prolapse typically require surgery. Sunshine team holds required experience in surgical procedures, including minimally invasive techniques. Our treatment procedures ensure a quicker recovery.
- Kegel exercises
- Recommending lifestyle changes
- Hormone therapy
What is Shoulder Arthroscopy and Sports Injury?
- A SLAP (Superior Labrum Anterior to Posterior) tear occurs when a special type of tissue called labral tissue of the shoulder gets torn from the glenoid (socket) bone. This causes pain in the shoulder, typically in overhead movements
- It can occur due to falling on an outstretched hand or as an overuse injury in overhead throwing sports like cricket and volleyball.
- When physiotherapy fails to improve the condition, an arthroscopic surgery can be performed to reattach the torn labrum
- Treatment also comprises of specific exercises
What are Rotator Cuff Tears?
- The term “rotator cuff” refers to a group of four tendons that blend as they attach to the upper end of the arm bone (humerus). Usually, these tendons transmit the force of muscles originating on the shoulder blade (scapula) to the arm providing motion and stability.
- Defects in the rotator cuff can come from a sudden injury (cuff tear) or degeneration (wear and tear in older people). However in sports, the rotator cuff may get damaged due to overuse of the shoulder.
- The symptoms of rotator cuff disease include difficulty lifting the arm and pain while lifting the arm.
- Smaller tears can be improved with physiotherapy, but more significant tears require surgery to repair the torn tissue, usually arthroscopic surgery in this case.
What is a Shoulder Dislocation?
- The shoulder joint is the most frequently dislocated major joint of the body. In a typical case of a dislocated shoulder, a strong force that pulls the shoulder outward or extreme rotation of the joint pops the ball of the shoulder out of the shoulder socket.
- The shoulder can dislocate either forward, backwards, or downward but most frequently in a forward direction. Not only the arm appears out of position when the shoulder dislocates, but the dislocation also produces severe pain. Muscle spasms may increase the intensity of pain.
- Dislocation is treated by putting the head of the humerus (ball) back into the joint socket — a procedure called Manipulation & Reduction (M&R). The arm is then immobilised in a sling, or a device called a shoulder immobiliser for several days.
- In some patients, the shoulder keeps dislocating repeatedly. This condition is called recurrent dislocation. Treatment of this troublesome problem requires surgery to prevent the displacement from happening again and again. Majority of these patients can be cured by an arthroscopic type (Key-hole / Endoscopic) of surgery.
What is Impingement Syndrome?
- Shoulder impingement syndrome, also called painful arc syndrome, supraspinatus syndrome, swimmer’s shoulder, and thrower’s shoulder is a clinical syndrome which occurs when the tendons of the rotator cuff muscles became irritated and inflamed as they pass through the subacromial space, the passage beneath the acromion.
- The most common symptoms of impingement syndrome are; pain, weakness and a loss of movement at the affected shoulder. The pain is often worsened by shoulder overhead movement and may occur at night, especially if the patient is lying on the affected shoulder.
- Impingement syndrome is usually treated conservatively which may include rest, cessation of painful activity, and physiotherapy focused on maintaining a range of movement and avoids shoulder stiffness.
- A local steroid injection may be helpful.
- Rarely an arthroscopic surgery may be necessary.
What is a Tennis Elbow?
- Lateral epicondylitis or lateral epicondylalgia, also known as tennis elbow, shooter’s elbow and archer’s elbow, is a condition where the outer part of the elbow becomes sore and tender. Even though it is common in tennis players, it may occur to athletes playing any sport. Tennis elbow is an overuse injury occurring in the lateral side of the elbow region, but more specifically, occurs at common extensor tendon that originates from the lateral epicondyle.
- The symptoms may include pain on the outer part of the elbow, point tenderness over the lateral epicondyle – a prominent part of the bone on the outside of the elbow, gripping and movements of the wrist hurt, especially wrist extension and lifting movements.
- Conservative treatment includes Non-steroidal Anti-inflammatory Drugs (NSAIDs) to relieve lateral elbow pain in the short term and physiotherapy including stretches and progressive strengthening exercises to prevent re-irritation of the tendon and other exercise measures. A counter-force brace or “elbow strap” is used to reduce strain at the elbow epicondyle, and to limit pain provocation and offer protection against further damage.
- In recalcitrant cases, surgery may be an option. Either arthroscopic surgery or an open surgery can be done.
- Return to sport requires corrections in the technique of the game and adjustment of the racquet/bat etc. which might have predisposed for the condition.
What is a Golfer’s Elbow?
- Golfer’s elbow or medial epicondylitis is an inflammatory condition of the medial epicondyle of the elbow. It is in some ways similar to tennis elbow. The tendons of anterior forearm muscles come together in a common tendinous sheath, which is inserted into the medial epicondyle of the humerus at the elbow joint. In response to minor injury, or sometimes for no apparent reason at all, this point of insertion becomes inflamed.
- Non-specific palliative treatments include Non-steroidal Anti-inflammatory Drugs (NSAIDs). A counter-force brace or “elbow strap” is used to reduce strain at the elbow epicondyle, and to limit pain provocation offer protection against further damage. Physiotherapy will include a variety of exercises for muscle/tendon reconditioning, starting with stretching and gradual strengthening of the flexor-pronator muscles.
- If all else fails, debridement of the damaged muscle (surgery) may be useful.
What is a Little League Elbow?
Wrist & hand
- There are many bones in the wrist joint which can sustain fractures or the ligaments connecting various bones can be injured.
- Little League Elbow (LLE) syndrome is a valgus overload or overstressed injury to the medial elbow that occurs as a result of repetitive throwing motions. It is most commonly seen in children and adolescents playing sports like tennis, javelin throw, baseball, etc.
- Signs and Symptoms include pain on the inner side of the elbow, decreased throwing speed or distance, point tenderness, swelling, deformity (flexion contracture).
- Conservative treatment commonly consists of complete rest from throwing activities for a minimum of 4-6 wks, ice, Non-steroidal Anti-inflammatory Medication (NSAIDs), elbow extension brace if a flexion contracture is present, immobilisation if symptoms are severe and physiotherapy to correct abnormal biomechanics.
- Arthroscopic surgery may be necessary to treat loose bodies in the joint and cartilage injuries etc.
What is a Scapholunate Ligament Injury?
- Can happen due to falling on the palm with dorsiflexed wrist
- When arthroscopy is indicated, simple cleaning of the ligament is sufficient in case of minor injuries, and ligament repair is advised in case of severe injuries
What is a Lunotriquetral Ligament Injury?
- Pain on the inner side of wrist
- Happens due to fall on the palm thus affecting the radiotriquetral attachments
- Conservative management with wrist immobilization is advised
- Arthroscopic surgery or sometimes open surgery may be required
What is a Mallet Finger?
- It is an injury of the extensor digitorum tendon of the fingers at the last joint of the finger
- It usually occurs when a ball (such as a softball, basketball, or volleyball), while being caught, hits and suddenly bends a finger
- Symptoms include pain and a bent finger with an inability to straighten the finger
- Treatment options include putting the finger in a Mallet splint. The splint allows the tendon to return to normal length. If the finger is bent during these weeks the healing process must begin all over again. Occasionally surgery is used to reattach the tendon
What is Snapping Hip Syndrome?
- Snapping Hip Syndrome (also referred to as coxa saltans, iliopsoas tendinitis, or dancer’s hip) is a medical condition characterised by a snapping sensation felt when the hip is flexed and extended
- Symptoms include an audible snapping or popping noise and pain or discomfort. Pain often decreases with rest and diminished activity. Without proper treatment symptoms usually, last months or years, and can be very painful
- If it is painless, there is little cause for concern. This condition is usually curable with appropriate treatment, or sometimes it heals spontaneously. Correcting any contributing biomechanical abnormalities and stretching tightened muscles, such as the iliopsoas muscle or iliotibial band is the goal of treatment to prevent recurrence
- Corticosteroid injections may be used for pain relief. Surgery may be recommended if the patient does not respond well to medicine or physical therapy, or if abnormal structures are found
What is Greater Trochanteric Pain Syndrome?
- Greater Trochanteric Pain Syndrome (GTPS), also known as trochanteric bursitis, is inflammation of the trochanteric bursa, a part of the hip
- The symptoms are pain in the hip region upon walking, and tenderness over the upper part of the femur, which may result in the inability to lie in comfort on the affected side
- The primary treatment advised is rest and avoiding actions which result in aggravation of the pain. Icing the joint may help. Non-steroidal Anti-inflammatory drugs may relieve pain and reduce the inflammation
- Physical therapy to strengthen the hip muscles and stretch the iliotibial band can relieve tension in the hip and reduce friction. The use of ultrasound may also be helpful
- The inflamed bursa can be removed surgically through a procedure known as Bursectomy
What is Muscle Strain?
- A strain is an injury to a muscle or tendon in which the muscle fibres tear as a result of overstretching. A strain is also colloquially known as a pulled muscle. The similar injury to a ligament is a sprain. Strains are commonly seen in hamstrings, quadriceps and adductors (groin pull).
- Typical symptoms of a strain include localised pain, stiffness, discoloration and bruising around the strained muscle.
- Commonest strains are adductor strain in which the player complains of pain on the inner side of the thigh which is commonly seen in athletes who play sports like hockey, football, etc. In hamstring strain, the player complains of sudden onset of pain in the back of the thigh, commonly seen in sprint events and water skiing. In Quadriceps strain, the player complains of pain in the front of the thigh, common in sports involving kicking movements like soccer.
- The first-line treatment for a muscular strain in the acute phase includes four steps commonly known as R.I.C.E [Rest, Ice, Compression and Elevation].
- This immediate treatment is usually accompanied by the use of Nonsteroidal Anti-inflammatory Drugs. Therapeutic ultrasound can be used to break down poorly healed muscle strains and permit them to heal properly.
What is Fmoroacetabular Impingement?
- Femoroacetabular Impingement (FAI) or hip impingement syndrome is a condition affecting the hip joint in young and middle-aged adults. Impingement occurs when the ball-shaped femoral head rubs abnormally or doesn’t have a full range of motion in the acetabular socket. Damage in the hip joint can occur to the articular cartilage or the labral cartilage.
- FAI-related pain may be felt in the groin, lower back and generally around the hip.
- Conservative/nonsurgical treatments include reducing levels of physical activity and taking pain medication and physiotherapy sessions. Surgical intervention may include an arthroscopic or open surgery
What happens in an Anterior Cruciate Ligament Injury?
- An injury to the anterior cruciate ligament can be a debilitating musculoskeletal injury to the knee, seen most often in athletes.
- Symptoms of an ACL injury include hearing a sudden popping sound, swelling, and instability of the knee. Pain is also a major symptom of an ACL injury and can range from moderate to severe. In a chronic ACL injury, the commonest complaint is one of an unstable knee with a feeling of constant slipping of the knee especially with sporting activities, running and jumping, etc. Continued athletic activity on a knee with an ACL injury can have devastating consequences, resulting in massive cartilage damage, leading to an increased risk of developing osteoarthritis later in life.
- A partial tear can be conservatively managed with physiotherapy and use of a knee brace.
- Surgery involves an arthroscopic surgery to reconstruct the torn ACL ligament. ACL surgery is one of the commonest sports operations carried out these days. It commonly includes reconstruction with a hamstring muscle graft. ACL surgery over the decades has evolved, and recent advances in the anatomic ACL reconstruction and double bundle ACL reconstruction are increasingly used.
How does a Stress Fracture happen?
- A Stress Fracture is a type of incomplete fracture in bones. It is caused by “unusual or repeated stress” and impact of heavyweights on the ankle or leg.
- It typically occurs in weight-bearing bones, such as the tibia (bone of the lower leg) and metatarsals (bones of the foot). It is a common sports injury, and most cases are associated with athletics.
- Stress fractures very few symptoms. A stress fracture could be present as a generalised area of pain and tenderness associated with weight bearing.
- If a stress fracture occurs in a weight-bearing bone, healing will be delayed or prevented by continuing to put weight on that limb. Rest is the decent option for complete healing of a stress fracture.
- With severe stress fractures, surgery may be needed for proper healing.
What is a Posterolateral Corner Injury?
- The Posterolateral Corner (PLC) of the knee is a complex area of the knee on the outer side formed by the interaction of multiple structures. Injuries to the Posterolateral Corner can be debilitating to patients and require prompt recognition and treatment to avoid long-term consequences
- Injuries to the PLC often occur in combination with other ligamentous injuries to the knee; most commonly the Anterior Cruciate Ligament (ACL) and Posterior Cruciate Ligament (PCL)
- Patients often complain of pain and instability at the joint. With concurrent nerve injuries, patients may experience numbness, tingling and weakness of the ankle dorsiflexor and great toe extensors
- Conservative treatment relies on immobilising the knee to allow the stretched or torn ligaments to heal. Surgical treatment involves reconstruction of PLC with a muscle graft
What happens in a Posterior Cruciate Ligament Injury?
- The incidence of injuries of the PCL is less than that of the ACL. This might be due to the greater thickness of the PCL.
- Symptoms of a PCL tear can vary; the most prominent include pain, swelling and a feeling of unsteadiness in the knee.
- A partial tear can be conservatively managed with physiotherapy and use of a knee brace.
- Whereas in a complete tear, a procedure called PCL reconstruction can be done by an arthroscopic surgery with a hamstring muscle graft.
What is a Meniscal Tear?
- A tear of a meniscus is a rupturing of one or more of the fibrocartilage strips in the knee called menisci
- They can be torn by traumatic force encountered in sports or other forms of physical exertion. The traumatic action is most often a twisting movement at the knee while the leg is bent. In older adults, the meniscus can be damaged following prolonged ‘wear and tear’ called a degenerative tear
- The patient’s primary complaints are usually knee pain and swelling. These worsen when the knee bears more weight (for example, while running). Another typical complaint is joint locking
- Conservative management involves physical therapy which involves exercise to strengthen the muscles around the knee. The patient will probably have to take a small break from his or her normal activities, allowing the knee to heal
- The surgical procedure involves arthroscopic surgery of the knee depending on the type of the tear. The torn portion can be excised (partial meniscectomy) or the tear can be repaired (meniscal repair)
What is Patellar Tendinitis?
- Patellar Tendinitis (Patellar Tendinopathy, also known as jumper’s knee and Sinding-Larsen-Johansson disease), is a relatively common cause of pain in the inferior patellar region in athletes. It is common with frequent jumping.
- Patients report anterior knee pain, often with an aching quality. The symptom onset is insidious. It begins as inflammation in the patellar tendon where it attaches to the patella and may progress by tearing or degenerating the tendon.
- Early stages may be treated conservatively using the R.I.C.E (Rest, Ice, Compression and Elevation) methods. A physical therapist may also recommend specific exercises and stretches to strengthen the muscles and tendons.
- Uncommonly it may require surgery to remove myxoid degeneration in the tendon.
What is Patellofemoral Pain Syndrome?
- Patellofemoral Pain Syndrome (PFPS) is a syndrome characterised by pain or discomfort seemingly originating from the contact of the posterior surface of the patella (back of the kneecap) with the femur (thigh bone). It is the most frequently encountered diagnosis in sports medicine clinics.
- Typically patients will complain of pain in the front of the knee which is exacerbated by sports, walking, sitting for a long time, or stair climbing. Descending stairs may be worse than ascending.
- VMO strengthening is commonly suggested because it helps to stabilise the patella. Inflexibility has often been cited as a source of patellofemoral pain syndrome. Stretching of the hip, hamstring, calf and iliotibial band may help restore proper biomechanics.
- In addition to physical therapy, external devices such as braces and tape could be used to stabilize the knee. Arch supports and custom orthotics may also help to improve lower extremity biomechanics.
- Patellar Tendon Rupture is a rupture of the tendon that connects the patella to the tibia. When rupture occurs, the patella loses support from the tibia and moves toward the hip where the quadriceps muscle contract, hindering the leg’s ability to extend. This means that those affected cannot stand, as their knee buckles and gives way when they attempt to.
- If the tendon rupture is partial, then non-surgical methods of treatment may suffice. Complete rupture requires surgical procedure where the tendon is repaired onto the patella. In some cases, muscle graft may be necessary.
What is a Flat Foot?
- Flat Feet (also called pes planus or fallen arches) is a formal reference to a medical condition in which the arch of the foot collapses, with the entire sole coming into complete or near-complete contact with the ground.
- Although many people have no signs or symptoms associated with flat feet, some people experience foot pain, particularly in the heel or arch area, difficulty standing on tiptoe, swelling along the inside of the ankle. These patients are more prone for repeated ankle sprains with sports
- Shoe inserts (orthotic devices) may help relieve the pain caused by flat feet. Shoe inserts won’t cure flat feet, but they often reduce the symptoms associated with the disorder. Some people with flat feet also have a shortened Achilles tendon. Exercises to stretch this tendon may help.
- In some cases, surgery can provide lasting relief, and even create an arch where none existed before. However, it should be considered as a last resort.
What is an Ankle Sprain? How many types of sprains are there?
Ankle Sprain also knew as a sprained ankle, twisted ankle, rolled ankle, ankle injury or ankle ligament injury, is a common medical condition where one or more of the ligaments of the ankle is torn or partially torn.
Types of sprains:
- Inversion (lateral) Ankle Sprain: The most common type of ankle sprain occurs when the foot is inverted too much, affecting the lateral side of the foot. When this type of ankle sprain happens, the ligament on the outer side of the ankle is either stretched or torn. Approximately 90% of ankle sprains belong to this category
- Eversion (medial) Ankle Sprain: A less common type of ankle sprain is called an eversion injury, affecting the medial side of the foot. When this occurs, the ligament on the inner side of the ankle (deltoid ligament) is injured
- Pain, swelling, warmth and redness are the common symptoms
- Use of a proper compression wrap is the most important first step. Use of Rest, Ice, Compression and Elevation method of conservative management is to be followed
- When the problem persists for a prolonged time arthroscopic or open surgery can be carried out to repair the ligaments
- Achilles tendon is the prominent tendon on the back of the calf going to the back of the heel
- Achilles Tendonitis (also Achilles tendinopathy) is tendonitis of the Achilles tendon, generally caused by overuse and is more common among athletes training in under less than ideal conditions
- Pain, tenderness, swelling, warmth are the common symptoms found
- Treatment is possible with ice, cold compression therapy, wearing heel pads to reduce the strain on the tendon, and an exercise routine designed to strengthen the tendon
- Conservative management may also include Non-steroidal Anti-inflammatory drugs, ultrasound therapy and physical therapy techniques
What is a Respiratory Failure?
Insufficient gaseous exchange by the respiratory system is respiratory failure. This situation typically results in the inability to maintain arterial oxygen and carbon dioxide levels within the normal ranges. There may be a drop in blood oxygenation (hypoxemia) or a rise in arterial carbon dioxide levels (hypercapnia).
At Sunshine Hospitals, the team begins by establishing exact reason for respiratory failure and later draws up the treatment plan based on the disease or condition. Treatment includes medicines, procedures and other therapies as listed below:
- Pharmacologic Therapy
- Intravenous Nutritional Support
- X-ray Monitoring
- Weaning the Patients from Ventilators (Weaning is the process of returning the patient to unassisted and spontaneous breathing)
- Discontinuation of Ventilatory Support
Snoring is the vibration of respiratory structures during sleep that results in a sound. It is caused by obstructed air movement during breathing. The sound can be soft or loud and unpleasant.
Sleep Apnoeais a sleep disorder characterised by abnormal pauses in breathing or instances of abnormally low breathing during sleep. Each pause in breathing is called an apnoea, and can last from a few seconds to minutes.
Snoring is no laughing matter! It is an indication of problems with night-time breathing that may harm the snorer. Snoring can be reduced.
At Sunshine Hospitals, you can avail expert help to put an end to all your snoring and sleep apnoea worries. Before proceeding with any treatment, the impact of snoring and sleep apnoeas on the quality of life of the patient and partner needs are evaluated, and the immediate and long-term benefits of surgical and non-surgical treatments are compared. We also adopt contemporary psychometric techniques to offer a multidisciplinary approach to the management of snoring and sleep apnoeas.
- ENT PROCEDURES
- Non-surgical Treatments
What is Allergy?
Allergy is a hypersensitivity disorder of the immune system. Allergic reactions occur when exposed to normally harmless substances known as allergens. The individual is said to be allergic to that particular substance. You can experience an allergic reaction if you breathe in, eat or have physical contact with the substance you are allergic to.
About 20 to 30 percent of us have a tendency to develop allergies. Moreover, allergies may be hereditary. However, not all people inherit allergies. Common allergic reactions include eczema, hives, hay fever, asthma attacks, food allergies, and reactions to the venom of stinging insects such as wasps and bees.
At Sunshine Hospitals, Our team focuses on your treatment and actions you must follow to avoid allergies.
The treatment includes:
- Nasal sprays
- Asthma medications
What is Asthma?
Asthma is a common disease, and it affects close to 70 million in India. It occurs during childhood but can occur for the first time even in the old age. So what happens in Asthma? Asthma affects airways, the tubes carrying air in and out of the lungs. People who have asthma have sensitive airways which become irritated in some situations. The airways become narrow and sometimes produce more mucus than usual. This creates difficulty in breathing.
Asthma can run in families, but many people with asthma do not have relatives with the condition. Asthma cannot be cured! It can be controlled so that recurring attacks can be prevented. Most people with asthma who receive proper treatment (and follow medication promptly) can lead healthy lives.
At Sunshine Hospitals, the core objective of our team is to get your asthma under control and keep it that way. Our team discusses treatment options with you and ensures you understand the procedure/approach. Great care is extended by a team of pulmonologists and nurses trained in asthma management. You are provided complete information on your condition and control measures. Regular checks are mandated to keep the condition under check.
Asthma Treatment at Sunshine includes:
- Developing self-management plans
- Recommending right medication
- Suggesting the use of reliever inhalers
- Suggesting the use of preventer inhalers
- Suggesting long acting reliever inhaler
What is Chronic Cough?
Experiencing cough that refuses to go away? Most likely, it is a chronic cough. A chronic cough is not a disease. In fact, it is a symptom resulting from other health disorders and is a common complaint amongst most individuals.
Common causes of a chronic cough include asthma, allergic rhinitis, sinus, and oesophagal reflux of stomach contents. In some rare occasions, chronic cough may also occur due to inhaling of foreign objects into the lungs and is observed in children.
At Sunshine, after a comprehensive review of your medical history and physical examination after that, our team will decide on the tests to undergo. These tests are aimed at diagnosing the core cause of your chronic cough.
What is COPD?
The occurrence of a pair of diseases of the lungs, chronic bronchitis and emphysema, is called chronic obstructive pulmonary disease (COPD). In COPD, the airways of the lungs become narrowed leading to a restricted flow of air to and from the lungs, thereby causing shortness of breath. As compared to asthma, this airflow obstruction is poorly reversible and worsens with time.
COPD ranks among leading causes of death worldwide. Common causes of COPD include tobacco smoking that causes an abnormal inflammatory response in the lung. Also, acute exacerbations (occasional sudden worsening of symptoms), mostly caused by infections or air pollution are typical to COPD.
At Sunshine Hospitals, the team of pulmonologists considers a host of options before designing treatment for individual patients. Upon diagnosing a person with COPD, our team works with the individual to manage the symptoms and ensure a better quality of life.
- Alpha – 1 Antitrypsin Deficiency
- Chronic Bronchitis
Medications (such as bronchodilators and inhaled steroids)
- Pulmonary Rehabilitation
- Physical Activity Training
- Lifestyle Changes
- Oxygen Treatment
- Sudden Lung Complications
- Know when to seek emergency assistance
A few situations requiring you to act fast and get emergency assistance are listed below:
- Unusual difficulty in walking or talking
- Rapid or irregular heartbeat
- Lips or fingernails turning grey or blue
- Tough and rapid breathing even while on medication
- ●Also, it would be hugely helpful if you maintain vital information – prescription details, hospital, doctor’s name and contact information – within reach for immediate access during an emergency.
Interstitial Lung Disease?
A group of lung diseases (over 180 lung disorders) affecting the interstitium (the tissue and space around the air sacs of the lungs) is called interstitial lung disease (ILD). ILD is a term used to distinguish these conditions from obstructive airways diseases.
Common symptoms include shortness of breath, fatigue and weakness, loss of appetite, loss of weight, dry cough without phlegm, discomfort in the chest, laboured breathing, etc.
Consult your physician for a diagnosis.
At Sunshine Hospitals, after a comprehensive review of your medical history and physical examination after that, our team will decide on the tests to undergo.
- Pulmonary function tests
- Spirometry +Transfer factor
- Peak flow monitoring (PFM)
- Blood tests
- Bronchoalveolar lavage
- CT or CAT scan
- Chest x-rays
- Lung biopsy in patients who required
Treatments may include:
- Influenza vaccine
- Pneumococcal pneumonia vaccine
- Oral medications
- Physical Lung Exercises
- Oxygen Supplementation if necessary
What is Lung Cancer?
Lung cancer is a result of uncontrolled cell growth in tissues of the lung. This kind of growth may eventually lead to metastasis, a condition where other tissues are invaded, and infiltration spreads beyond lungs.
Lung cancer is found to be the commonest reason behind cancer-related deaths in men and women. Shortness of breath, cough (including coughing up blood), and weight loss are some of the most common symptoms of lung cancer. Common causes include smoking, asbestos, radon gas, viruses and particulate matter.
At Sunshine Hospitals, you can avail expert care to address lung cancer.
Services for lung cancer treatment include:
- CT scan
- Positron Emission Tomography (PET)
- Blood tests and spirometry (lung function testing)
- Surgery for lung cancer
- Wedge resection (removal of part of a lobe)
- Segmentectomy (removal of an anatomic division of a particular lobe of the lung)
- Lobectomy (one lobe)
- Bilobectomy (two lobes)
- Pneumonectomy (whole lung)
- Palliative care
What is Pneumonia, and how to treat it?
Pneumonia is an infection causing inflammation and excess fluid deposition in air sacs and the smaller airways of the lungs. Specialised white blood cells then travel to the lungs to fight off the infection. This makes it difficult for the lungs to receive oxygen from the air and pump into the bloodstream and then throughout the whole body.
Anyone can contract pneumonia. Even the young and fit! However, it is more common and usually more severe in the very young, the very old, smokers and anyone weakened by long term illness – especially if the illness interferes with the body’s normal defences against infection.
At Sunshine Hospitals, treatment for pneumonia varies depending on the cause and severity. For instance, while antibiotics are suggested for bacterial pneumonia, the same are ineffective against viral pneumonia.
Treating Infective Pneumonia
Although the treatment for infective pneumonia depends on the cause of the condition, some simple steps can help speed recovery from pneumonia:
- Medications – Usually antibiotics
- Bed rest (until body core temperature returns to normal)
Recovery: The extent of recovery from pneumonia depends on the type of pneumonia and the person’s general health. Most people with pneumonia recover completely.