Monthly Archives: May 2020

Diabetic Kidney Disease

Diabetic Kidney Disease

Diabetes is the leading cause of kidney failure in the developed world, says the best nephrologist in Delhi.

The diabetes, characterized disease excess blood glucose can affect various organs of the body including the kidneys (diabetic nephropathy) or eyes (diabetic retinopathy). Good diabetes control is able to prevent, delay or decrease the appearance of these and other complications of the disease.

The constant maintenance of high levels of glucose (sugar) in the blood causes a disturbance in the wall of the arteries. As a consequence, the blood does not correctly reach the tissues and this leads to a disorder in the structure and function of different organs in the body, explains the nephrologist in Delhi.

The mechanism by which excess glucose affects the arteries is very complex. On the one hand, the wall of the arteries is made up of proteins. Glucose tends to bind to these proteins, and this phenomenon can ultimately deconstruct the arterial wall. On the other hand, the insulin deficiency characteristic of diabetes means that the transformation of glucose for energy is carried out through a specific type of metabolic pathway. As a consequence, the body accumulates a series of substances that can also cause alterations in the walls of the arteries, says the nephrologist in Noida.

The appearance of complications in a diabetic person also depends on their personal susceptibility to changes caused by high glucose levels.

Diabetes is the leading cause of kidney failure in the developed world, accounting for approximately 35-40% of new cases of kidney failure each year, says the nephrologist in Gurgaon. It should be known that:

The development of early stages of diabetic nephropathy is frequent

Throughout life, around 50% of people with type 1 diabetes develop microalbuminuria – presence of the albumin protein in the urine, which is an indicator of impaired kidney function.

Approximately 20% of people with type 1 diabetes develop kidney failure.

In Caucasian people with type 2 diabetes, between 5 and 10% go on to develop end-stage chronic kidney failure (CRFD), while among non-Caucasians the proportion is even higher.

Diabetic kidney failure is the most common cause of admission to kidney replacement programs, dialysis or transplantation, in most countries of the world, says the kidney transplant doctor in Delhi.

In India, around a third of people with end-stage chronic kidney disease have diabetes. This population is estimated to grow at an annual rate of 8%.

Up to 40% of new cases of IRCT can be attributed to diabetes.

The risk of CKD is 12 times higher in people with type 1 diabetes compared to those with type 2 diabetes, says the kidney specialist in Delhi.

There are two treatment options when the kidneys fail.

Dialysis – peritoneal dialysis or hemodialysis – and kidney transplant. The costs of both treatments are high. Diabetes is estimated to represent between 5 and 10% of the national health budget in western developed countries.

Diabetic kidney failure develops so slowly that it may not give symptoms for many years.

The best way to detect the problem is to test your urine for proteins, which should not normally be present, such as albumin. The Kidney Specialist in Noida recommends that every person with diabetes undergo a urine test for albuminuria each year.

Close control of the blood glucose level reduces the risk of microalbuminuria, and therefore of future chronic terminal renal failure, by up to 35%.

There is conclusive evidence that good blood glucose levels can significantly reduce the risk of developing complications and slowing their progression in all types of diabetes.

Control of high blood pressure and high levels of fats in the blood (hyperlipidemia) is also very important, says the nephrologist in Delhi.

Knee Arthroscopy For Better Mobility of Your Knee

Knee Arthroscopy For Better Mobility of Your Knee

Arthroscopy in Delhi is a surgical intervention allowing the exploration of the joint using a tube a few millimeters in diameter, introduced into the knee through several tiny holes (2 to 4) (about 1 cm). This tube, fitted with optics coupled to a miniaturized video camera, is connected to a color television screen on which the main elements of the knee will be viewed:

  • the cartilages of the femur, tibia and patella
  • the cruciate ligaments (anterior and posterior),
  • menisci (internal and external),
  • synovial membranes

ARTHROSCOPY THEREFORE ALLOWS:

  • to specify the possible causes of a knee dysfunction: pain, blockage, swelling, instability, in addition to the clinical and radiological examination, then guiding at best the choice of the subsequent treatment which will be proposed.
  • to perform a certain number of surgical procedures using fine instruments, “without opening the knee” under the control of the television screen.

THESE INTERVENTIONS CAN BE:

  • meniscal lesion removal
  • ligament plasty (cruciate ligament operations)
  • regularization of cartilage when it is irregular or worn,
  • removal of free bone or cartilage fragments in the joint,
  • synovial biopsy
  • release of adhesions,
  • fold section (plica)

IN PRACTICE

Arthroscopy in West Delhi is performed in the operating room, under anesthesia. The terms of this will be decided between you and the anesthesiologist. You will be admitted to the hospital the same morning; you must bring the x-rays as well as the biological examinations in your possession and report the usual treatments in progress.

On the day of the arthroscopic surgery in Delhi you must be on an empty stomach and respect the  instructions of orthopaedic surgeon in Delhi.

As soon as you get back to your room, you can start to gently mobilize your knee, walking being allowed with the help of the nurse or physiotherapist a few hours later.

The exit from the hospital will generally be rapid. During this, you will be given:

  • a first consultation appointment,
  • a rehabilitation order intended to improve functional recovery,
  • a work stoppage suited to the nature of your knee injuries and the type of professional activity you exercise.

During the first week, you will be advised:

  • not to bend the knee more than 90 °,
  • to walk or climb the stairs moderately,
  • avoid prolonged immobile standing, – apply an ice pack (4 times – 10 minutes a day),
  • to contract the extended quadriceps leg muscle many times,
  • not to resume sport before medical authorization

Arthroscopy is a surgical procedure.

If the hazards inherent in this technique are rare, do not hesitate to report any local incident to orthopaedic in Delhi that would worry you: persistent fever, increasing pain, hematoma or significant swelling of the knee (moderate, painless swelling is however usual with possible sensation of ” splashing “due to temporary persistence of fluid in the knee).

HIP ENDOPROSTHETICS

HIP ENDOPROSTHETICS

Pain in the hip joint is most often the result of osteoarthritis and can seriously affect your ability to lead a full and active lifestyle. Hip osteoarthritis is called coxarthrosis in medicine.

Endoprosthesis of the hip joint can help relieve pain and return to normal life. Over the past 20 years, thanks to the introduction of new materials and techniques into practice, the results of endoprosthetics operations have significantly improved.

Endoprosthesis of the hip joint is becoming more and more prevalent as the world’s population is aging. At the moment, hip replacement surgery in Delhi is the most commonly performed in the world.

HIP ANATOMYHip Anatomy

The hip joint is spherical in structure, so movements in it are possible in many planes. The joint is formed by the acetabulum, forming, as it were, a deep bowl and the head of the femur, which has the shape of a ball, explains the orthopaedic in Delhi.

The femoral head is connected to its main part (diaphysis) using a short portion of the bone called the femoral neck. Strong and thick muscles and tendons surround the joint. The surfaces of the acetabulum and femoral head are covered with articular cartilage. The thickness of the articular cartilage is about half a centimeter in large joints. The articular cartilage is a hard and smooth material covering the bones in the joint area. The articular cartilage allows the bones coated with it to glide smoothly relative to each other without being damaged. The color of the articular cartilage is white and shiny.

The joint is surrounded by a dense waterproof capsule, inside which a special fluid is produced that lubricates the mating surfaces. The bones in the joint hold tight ligaments and muscles together. The design of the hip joint provides extremely high mobility while maintaining satisfactory stability. The powerful muscles around the joint allow us to move for a long time in an upright position, and also, if necessary, accelerate when running and jumping. Important nerves and blood vessels also pass around the joint.

WHEN CAN ENDOPROSTHETICS REQUIRED?

The main indications for hip replacement in Delhi are arthrosis of the hip joint (coxarthrosis), fracture of the femoral neck, aseptic necrosis of the femoral head.

With arthrosis, degenerative changes in the articular cartilage occur, which ultimately leads to cartilage wear. Bone growths (osteophytes) form around the joint.

Due to the deterioration of the cartilage, a decrease in its thickness, a significant decrease in smoothness, as well as a change in the shape of the articular surfaces, the friction in the joint increases, which leads to pain and a progressive violation of the movements in the joint.

Aseptic necrosis of the femoral head is another cause of destruction of the hip joint. With this disease, the femoral head loses blood supply and actually collapses. The shape of the femoral head changes, the bone tissue making up the head is resorbed.

The articular surfaces of the acetabulum and the femoral head cease to correspond in shape, pain and impaired movement in the joint appear. The causes of the disease can be previous hip dislocations, birth injuries, prolonged treatment with corticosteroids, as well as some infections.

The main goal of replacing the joint in any of the degenerative diseases with an artificial one is to reduce pain and return movements. To do this, damaged surfaces are replaced with artificial ones, as a result of which the smoothness and painlessness of movements in the joint returns.

Fracture of the femoral neck is also an indication for joint replacement surgery in Delhi.

In case of fractures of the femoral neck, the blood supply to the head is disturbed, in connection with which its gradual destruction occurs.

Fracture fusion in these conditions is impossible, hip replacement surgery in Delhi is the only way to activate the patient and return him to everyday activity.

PREPARATION FOR HIP JOINT REPLACEMENT

The decision about the operation is made by the orthopaedic doctor in Delhi together with the patient. After clarifying the medical history, the doctor performs a thorough clinical examination to measure the current range of motion, the level of pain, the patient’s functionality. During the examination of the patient, the orthopaedic surgeon in Delhi examines the radiographs, as well as the data of CT and MRI studies.

A thorough and complete medical examination before surgery is also required. This is done in order to minimize the risk of complications during hip replacement surgery in Delhi. If a long-term operation or hemoglobin level of the patient is expected to be below normal values, a blood transfusion may be required after or during the operation. Mandatory prophylaxis of thromboembolic complications.

TYPES OF ENDOPROSTHESES

There are several main types of endoprostheses – cementless and cement.

Cemented endoprostheses are held in the bone using a special cement that fixes the metal to the bone. The surface of cementless prostheses is made in such a way that the bone tissue grows into it over time, due to which the prosthesis is held in the bone. In order for the endoprosthesis to grow, the bone is treated with special tools.

Both types of fixation of endoprostheses are widely used in medical practice. Also, in some cases, a combination may be used where, for example, the acetabular component (cup) is fixed with cement, and the femoral component (leg) is cementless. The decision about whether to use a cement or cementless endoprosthesis is made by the orthopaedic surgeon in Delhi based on the age, lifestyle of the patient and the quality of his bones.

The endoprosthesis consists of two main parts.

The acetabular component (cup) replaces the articular surface of the acetabulum. The shell of the acetabular component is made of metal, inside of which is placed a plastic or ceramic insert that is directly in contact with the femoral component.

The femoral component replaces the head and neck of the femur, usually made entirely of metal. In some designs of the endoprosthesis, the head may be made of ceramic.

Endoprosthetics can be total when both components are replaced, and unipolar. With unipolar endoprosthetics (hemiarthroplasty), only the femoral component changes. Hemiarthroplasty is usually performed for fractures of the femoral neck in elderly and debilitated patients.

With this type of endoprosthetics, the earliest verticalization of the patient is allowed, the very next day. This significantly reduces the risk of thromboembolic and hypostatic complications in elderly debilitated patients with femoral neck fractures. Equally important is the shorter operation time for hemiarthroplasty compared with total arthroplasty, which also reduces the risks during anesthesia and blood loss during surgery. Currently, our clinic uses modern cemented bipolar hip arthroplasty. A bipolar endoprosthesis is a modern type of unipolar prosthesis in which the head is double.

A similar design of the endoprosthesis increases the life of the prosthesis, increases its stability and range of motion.

MORE ABOUT HIP JOINT OPERATION

The orthopaedic surgeon in Delhi performs access to the hip joint, a skin incision is performed in the upper third of the thigh. After the hip joint is exposed, surgeons dislocate the worn femoral head from the acetabulum.

Then, a resection of the damaged head and neck of the femur is performed with a special electric saw.

Then, using special mills, the acetabulum is processed. During the treatment, the worn cartilage is completely removed and a hemisphere is formed into which the acetabular component will be implanted.

After the formation of the acetabulum, the surgeon fills the cavity with bone cement and establishes a suitable acetabular component. At this stage, the correct spatial orientation of the acetabular component at the right angle is important. This affects the life of the endoprosthesis and the likelihood of complications in the postoperative period.

After cement hardens and fixation of the acetabular component, the surgeon proceeds to the femur. At this stage, the bone canal of the femoral canal is developed with special rasps to the required size.

Next, cement is placed in the prepared canal in the femur and the femoral component is installed.

A head of the required size is selected and the femoral component is set into the acetabular.

After the orthopaedic surgeon in West Delhi checks the stability of the thigh and range of motion.

As soon as the surgeon is convinced that everything is set properly, the wound is sutured in layers. Drainages are established for a day. The patient is sent to a special ward in the postoperative ward, explains the orthopaedic in Delhi.

From the first day, rehabilitation of the patient begins.

The Secrets To Having A Good Erection

The Secrets To Having A Good Erection

A delicate subject to tackle, erection is a sensitive subject for men. Dr. P K Gupta, sexologist in Delhi, answers all our questions on the subject and takes the opportunity to deliver his advice in order to be able to better master the subject.

THERE ARE INVOLUNTARY ERECTIONS

True: the only erection that does not need to be stimulated is the one that occurs in the morning. It actually occurs during REM sleep phases. During these periods, the “sympathetic” system which most of the time keeps the penis at rest by small muscles no longer controls the situation. The muscles relax. “The nocturnal erection, involuntary movements and gestures have nothing to do with an erotic dream “, explains the best sexologist in Delhi.

In adolescence, the mere sight of an attractive girl can cause an erection, but this reactivity loses its splendour over time and emotional control.

ALCOHOL AFFECTS ERECTION

True and false. It depends on the amount of alcohol absorbed. The consumption of alcohol in small doses promotes letting go and can help some individuals to liberate themselves sexually. But beware, too much alcohol really harms erection. Longer to come, more complicated to hold, the erection does not like alcohol abuse, and neither does ejaculation.

The alcohol problem? Manage the right amount. Because too much alcohol prevents a hard and long erection. In fact, under its influence, the blood circulation is modified, like the secretion of testosterone”, explains sexologist doctor in Delhi.

FREQUENCY OF INTERCOURSE PROMOTES ERECTION

True: the more a man makes love, the more interest he has in the sexual act, the better he is armed to control his erections.

A MAN WHO HAS NO ERECTION HAS NO PLEASURE

False: an erection is a very sensitive mechanism. Generally speaking, a stressed or anxious man can have erection problems. “When your partner does not have an erection, it is often because he is afraid of disappointing or that he is stressed, ” explains top sexologist in Delhi. Erectile dysfunction is a beautiful metaphor. Men are often in the performance and they are afraid of not being up to par. To avoid showing their weakness, some of them, stressed, take shelter from sexual intercourse and undergo erectile dysfunction. Even when desire is present, erection can be lacking.

TO MAKE YOUR ERECTION LAST, EXPRESS YOUR DESIRE

True: to limit the tension related to the erection, it is important for the partner to show that he/she likes his sex in erection or by caresses, kisses, looks or why not even words! It is important to show that your pleasure is not necessarily linked to penetration or orgasm, but also to the simple physical sensual proximity of your body against hers. Learn to massage, cuddle without systematically seeking to have sex. And, remember, a simple kiss can trigger an erection.

TO MAINTAIN AN ERECTION, PLAY WITH WHAT EXCITES YOUR PARTNER

True: Your partner has a slight weakness for cotton underwear? Food sex games? He is extremely sensitive to the caresses of the shoulders? To stimulate your partner, use your strengths and “small weaknesses”. “Without becoming a sexual object, it is good to know how to develop your sexual and sensual sensitivity. Men are mainly stimulated by sight, learn to know the codes of sexual attraction of your partner and to play with it,” recalls sex specialist in Delhi.

IT SHOULD BE POINTED OUT TO HIM IF HIS ERECTION IS WORSE

False: it is essential never to make reflections that are neither murderous nor compassionate (do not become your mother). We must remain in the register of tenderness. “Above all, do not interpret the erectile dysfunction at all. Do not take offense at a reduction in stiffness. It can come back, if you continue your caresses, if not, just understand that your partner is not a machine, move on to other things, more tender caresses, cuddles in love so as not to overhang it and let the erection come back later ”explains sexologist in Delhi. One should not attach importance to a temporary erectile dysfunction, and especially not to associate “Not to bandage is equivalent to not being a man and not having desire”.

THERE IS A PERIOD DURING WHICH A MAN CANNOT HAVE AN ERECTION

True: this time is called the refractory period. This period after ejaculation is the time during which a new orgasm is impossible. It is a natural phenomenon against which we cannot fight. This period evolves with age. Extremely short at 17 or 18, it can reach a day or two at 80. It lasts on average 2 to 3 hours.

However, you can note that the higher your excitement, the shorter the refractory period,” explains sexologist in Delhi. Over the ages, Viagra can be prescribed, because one of the beneficial effects of this drug is to shorten this refractory period from 1 hour to 10 minutes,” concluded sexologist in Delhi.

Sexual Disorders: When To Consult?

Sexual Disorders: When To Consult?

Taboo, sexual difficulties are more frequent than one might imagine. According to sexologist in Delhi, one in two people would suffer from sexual difficulties, one in three from a real sexual disorder. They affect men as well as women, the young, and the elderly.

When encountering sexual difficulties, when should you consult?

When sexual difficulties cause significant distress, either individually or as a couple, it is best to consult a sex specialist in Delhi. These problems should not be underestimated because they can be accompanied by great personal or marital suffering and seriously affect the quality of life. Also, if the disorder recurs, if it is persistent and lasting, the help of a specialist will improve well-being.

Who to contact in case of sexual difficulty?

When suffering from sexual difficulties, you must contact the primary care physicians, either your family doctor, your urologist or your gynecologist. But, as much to specify, not all the doctors, nor the psychologists are trained in the field or are comfortable to speak about it. If you do not find the result expected, do not give up, but consult a recognized sexologist doctor in Delhi. Your attending physician can give you the address of a specialist.

However, it is important to first contact a sex doctor in Delhi. Because sexual disorder can, in certain cases, be the symptom of an organic disease. It is therefore essential to rule out any somatic health problem before treating the sexual disorder itself, to avoid any health risk and to be able to cure the patient.

What is a “sexual disorder”?

There are three main categories of sexual disorders, which can be at the origin of a sexological consultation:

Sexual dysfunctions

Sexual dysfunctions are the most common causes of consultation with the best sexologist in Delhi. Among them, we must mention: the drop in desire in men or women, the absence of orgasm, premature ejaculation, vaginismus, and pain during intercourse called “dyspareunia”, etc.

Gender identity disorders

Gender identity disorders relate to issues related to trans-sexuality or the difficulty of experiencing one’s sexual orientation, whatever it may be.

Paraphilia

The term “paraphilia” refers to all atypical sexual behavior (prohibited or not by law). Among the two hundred paraphiliae (approximately) described to date, we can cite voyeurism, exhibitionism, sadomasochism, pedophilia, fetishism, sexual addictions, etc.

More generally, one can also turn to a top sexologist in Delhi in the event of discomfort on one of the aspects of his sexual life or general questions on sexuality, which represents a reason for consultation quite frequently. On the fringes of sexual disorders, strictly speaking, it must be emphasized that false beliefs themselves can have a heavy impact on sexuality. Information sessions of the “counseling” or “coaching” type are an opportunity to undermine misconceptions that are fatal to sexuality and to regain personal fulfillment. 

Should you go alone or as a couple?

There are no rules on this, everyone does as they can and as they wish. However, if it is a question of marital sexual difficulties, the sexologist in Delhi may ask to see the couple at least once during the therapy. 

Why consult a specialist in sexology?

Sexual health is a right recognized by the World Health Organization (WHO), which defines it in these terms: “Sexual health is a state of physical, emotional, mental and social well-being in relation to sexuality, and not just the absence of disease, dysfunction or infirmity. It is an integral part of overall health, well-being and quality of life. ”

Also, sexual difficulties can generate great suffering, the consequences of which should not be underestimated. They can lead to a loss of quality of life, and even a feeling of deep distress within the couple or the family.

In addition, certain sexual problems can be the expression of a somatic disease that should be diagnosed and treated by sexologist in Delhi.

Take care of your sexuality on a daily basis

Sexual well-being depends in part on good physical and mental health. A healthy diet and a healthy lifestyle, the practice of regular physical activity contribute to feeling good in your body, in your emotions, and in the relationship with the other.

Respectfully, respecting your partner, listening, and spending time together can contribute to a better sexual understanding. According to sexologist in Delhi, couples who share intense and stimulating activities strengthen their sexual harmony.

Many myths and received ideas circulate on sexuality and can compromise sexual fulfillment, as well as a lack of knowledge on the issue. Getting information can be useful as long as you turn to reliable sources.

Bladder Cancer: Causes, Diagnosis and Treatment

In the last decades there has been an increase in the incidence of bladder tumors. However, there have been significant advances in bladder cancer treatment in Delhi, leading to increased survival.

The bladder is an organ whose function is to store the urine produced by the kidneys, until it is eliminated by contraction of its muscles.

Internally, the bladder resembles the interior of the oral cavity, being covered by a thin film, or mucosa, called urothelium. This same urothelium also lines the inside of the ureters, the pelves and the renal chalices, which transport the urine produced in the kidneys to the bladder. Under the bladder mucosa is an even thinner layer, called the lamina propria, and below this, the bladder musculature. Externally, the bladder musculature is surrounded by fatty tissue.

Causes

Not yet known are all the changes that lead to the development of bladder cancer. However, a number of substances have already been identified that are associated with a higher incidence of this type of tumor, especially those related to cigarettes and some chemical substances, such as hair dyes. Smoking is associated with 50% of all bladder tumors diagnosed in India as an isolated factor. Prolonged exposure to paints and dyes appears to be the cause of these tumors in 20% to 25% of patients, says urologist in Noida.

More than 90% of malignant bladder tumors originate in the urothelium, most of which are confined to the mucosa and submucosa (superficial tumors), with no muscle involvement (infiltrative tumors).

Symptoms

According to the best urologist in Noida, the most frequent symptom is the presence of visible bleeding in the urine (hematuria), usually bright red and accompanied by coagulated blood. More rarely, this bleeding can only be seen through a urine test.

The exclusive presence of hematuria, microscopic or not, is insufficient for the diagnosis of bladder cancer, as it can be a symptom of other diseases, or even be considered “normal” for some individuals. Therefore, further tests are needed to diagnose bladder tumors.

Other symptoms associated with bladder cancer are very frequent urination and painful urination (dysuria). Again, these symptoms are also nonspecific and only suggest the possibility of a bladder tumor.

Diagnosis

Through clinical history and physical examination, the urologist in Ghaziabad may suspect this disease. As the presence of bleeding in the urine can result from other diseases in the kidneys, in the collecting systems (goblets and renal pelves), in the excretory pathways (ureters) and in the bladder, the best urologist in Ghaziabad may order some imaging tests (computed tomography, ultrasound, resonance) magnetic, excretory urography) to assess these structures.

The analysis of urine may also include the analysis of urothelial cells that are released and carried by the passage of urine (urinary cytology), as well as some substances dissolved in it and that may be related to urothelial tumors.

The most important diagnostic test for bladder tumors is endoscopy (cystoscopy), which allows the urologist in Delhi to view the inside of the bladder. This examination can usually be performed without the need for hospitalization and under mild sedation, or even under local anesthesia through the introduction of an anesthetic jelly in the urine channel (urethra).

If the urologist in Greater Noida diagnoses the presence of a tumor, or if they have already been diagnosed through imaging tests, there will be a need for hospitalization to perform an endoscopic surgery. This surgery takes place under general or epidural anesthesia / spinal anesthesia, in which we will try to “scrape” (transurethral resection – TURP) the entire visible tumor, which will allow the study of its microscopic characteristics (anatomopathological study), fundamental data for defining the prognosis and bladder cancer treatment in Noida.

The anatomopathological study will allow the pathologist to examine tumor cells and compare them with normal cells in the same tissue. With this, the best urologist in Greater Noida will be able to conclude how much the tumor cells differ from the normal ones and classify the tumor in “low grade” and “high grade”. The tumor grade reflects the aggressiveness of the tumor, that is, the probability of becoming infiltrative, if it is a superficial tumor, or of spreading through the body (developing metastases).

The pathologist will also define how deep the tumor has invaded the bladder, whether it has compromised only the mucosa and submucosa (superficial tumors), or whether there has already been involvement of the bladder muscles (infiltrative tumors).

Through radiological exams, the urologist in Vaishali will check for possible involvement of other structures in the body, especially the lungs, liver and lymph nodes (lymph nodes) located inside the belly (abdominal cavity). All of this information constitutes tumor staging and it is this that will define the most appropriate form of treatment, as well as the prognosis.

Staged tumors such as Ta, Tis and T1 are considered superficial tumors. Most Ta tumors are low grade tumors and rarely progress to infiltrative tumors. However, they are often recurrent. T1 stage tumors, on the other hand, often evolve with involvement of the bladder muscles.

The Tis stage features a type of high-grade tumor called “in situ” carcinoma (CIS). These tumors are difficult to remove and are treated by bladder instillation of substances, such as BCG. When left untreated, they end up evolving to infiltrative tumors.

Treatment

Removal of stage Ta and T1 tumors – Performed through endoscopic scraping (resection) by transurethral approach (RTU), which allows material to be obtained for anatomopathological study.

Chemotherapy and intravesical immunotherapy – After removal of the tumor by endoscopic route, depending on the case, and particularly in the CIS, the best urologist in Delhi may opt for intravesical instillation of immuno or chemotherapy in order to reduce the incidence of recurrences. Intravesical instillation is performed through a catheter (probe) inserted into the bladder through the urethra. The procedure is done on an outpatient basis, requiring only local anesthesia obtained with the introduction of an anesthetic jelly in the urethra.

The instilled substance is retained in the bladder for approximately 1 hour, and then eliminated through urination. After instillation, the patient is expected to experience a little burning sensation when urinating, which may persist for 24 to 48 hours. The most frequently used immunotherapeutic drug is BCG. Among chemotherapeutic agents, thiotepa, doxorubicin, and mitomycin-C may be used.

Cystectomy – Partial or complete removal of the bladder may be necessary in patients with CIS or high-grade T1 stage, who do not respond to intravesical chemotherapy and immunotherapy. In these situations, the risk of developing infiltrative disease is greater, which requires more aggressive treatments in order to reduce the possibility of metastasis.

Cystectomy is also the most appropriate way to treat infiltrative tumors (which affect the bladder muscles). It may be preceded by systemic chemotherapy (intravenous injection of chemotherapeutic drugs) in special situations. Exceptionally, infiltrative tumors can be treated only with endoscopic resection associated with chemotherapy and radiotherapy.

With the complete removal of the bladder, it becomes necessary to create an alternative for the elimination of urine produced by the kidneys (urinary diversion).

The preferred way, whenever it is possible to use it, is to make a “new” bladder with a segment of the intestine. This surgery allows the urine produced to be stored in this intestinal reservoir (neo-bladder ileal) to be eliminated by the urethra, allowing the patient to live with a very good quality of life. However, some tumors may make this form of urinary diversion impossible, requiring the use of urinary collection bags attached to the skin, or that a drainage of the urine into the intestine be created.

Knee Arthroscopy: General Information

What is knee arthroscopy?

Knee arthroscopy in Delhi is a minimally invasive procedure that allows access and treatment of injuries that affect the various structures of the joint. For this, 2 or 3 small incisions of less than one centimeter are made that allow access to the joint.

Most knee surgeries that do not involve the knee replacement in Delhi are performed with a complete or partial approach with knee arthroscopy. It is the technique of choice to deal with many injuries because it allows a better and greater visualization of the joint. In a non-aggressive way, all the points of the knee can be accessed to make a cartilaginous cleaning, small perforations of the bone that has lack of cartilage (microfractures), stabilize the cartilage and apply substances or elements that regenerate cartilage (plasma rich in platelets or stem cells).

Likewise, knee arthroscopy in Delhi is also used to support other open techniques, since it improves the diagnosis and prognosis of the patient’s injury, as it is less aggressive.

Surgery can be performed under local, regional or general anesthesia, depending on the injury and the patient himself. The anesthesiologist will decide the best method for the patient, provided he suffers as little as possible, explains the best knee surgeon in Delhi.

Why is it done?

Knee arthroscopy in Delhi is used to resolve knee injuries. Thus, meniscus injuries are one of the most common pathologies and, thanks to arthroscopy, it is possible to preserve most of the menisci, since the resection is not complete but partial. Meniscal sutures and the possibility of transplanting the meniscus with knee arthroscopy are common techniques that allow better protection of the cartilage of the joint.

Another of the most dangerous injuries related to sports is the rupture of the anterior cruciate ligament. If this is injured, it causes instability in the knee that makes it impossible for the patient to practice practically any sport. Continued instability can injure surrounding structures, such as menisci and cartilage. Hence, it is necessary to reconstruct the anterior cruciate ligament with grafts, accessing the joint by arthroscopy, explains the sports injury specialist in west Delhi.

On the other hand, cartilage injuries (chondropathies, arthrosis or osteochondritis) are also very frequent. Preserving cartilage will also preserve the joint, avoiding wear and tear on the knee.

What does it consist of?

The orthopaedic surgeon in Delhi will make the small incisions in the knee to be able to access it. Firstly, you will fill the knee joint with a sterile solution and remove any cloudy fluid. This way you can see the joint clearly and in detail.

The specialist will then insert the arthroscope (a very thin device with a camera at its end) into the knee. This device sends the images to the television monitor, so that the surgeon can see all the structures in detail. Through the other holes the orthopaedic surgeon in Delhi will introduce the surgical material that will allow him to tackle the injury and repair the damaged structures.

It is a procedure that usually does not last more than an hour. After that, the patient will be transferred to a rehabilitation room and will be able to leave the hospital after two hours, more or less.

Preparation for knee arthroscopy

Before surgery, the patient must undergo a complete physical examination so that the orthopaedic in Delhi can assess his health and any abnormality that may interfere with the arthroscopy. Likewise, the patient must inform the surgeon of the medication they are taking, so that they can tell them which ones they should stop taking before the intervention. Some additional preoperative tests will also be performed, such as MRI, EKG, or blood tests.

Care after the intervention

Recovery after arthroscopy in Dwarka is faster than conventional open surgery. However, the advice of the orthopaedic doctor in Delhi must be followed so that the knee recovers correctly.

It is normal for the patient to suffer inflammation in the days after the intervention, so it is recommended that the leg be elevated during those first days after surgery. Also, applying ice will relieve pain and reduce inflammation.

Incisions should also be healed, keeping them clean and dry. The orthopaedic in Delhi will indicate to the patient when they can shower or change the bandage.

On the other hand, shortly after the intervention, the patient should begin rehabilitation exercises with a Physiotherapy specialist, who will establish a program appropriate to the patient and the injury. This will help you restore movement and strengthen your knee muscles.

Alternatives to this treatment

The alternative to knee arthroscopy in West Delhi will be conventional open surgery, which is currently only used in more severe cases, in which a prosthesis must be placed. Any other technique will suppose a greater invasion in the knee and worse postoperative, explains the orthopaedic in Delhi.

Prostate Cancer: Symptoms, Diagnosis and Treatment Options

Understanding the prostate

The prostate is a gland and is part of the human reproductive system. It is below the bladder and above the rectum, encompassing the entire back of the first portion of the urethra. The prostate contributes to the production of seminal fluid that helps to load sperm during ejaculation. One of the most common prostate problems is its benign growth, which, over time, can compress the urethra and cause difficulty urinating, explains the best urologist in Noida.

Prostate cancer

No one knows exactly what causes prostate cancer. However, it is known that it is not a contagious disease and that some risk factors make certain men more likely than others to develop it.

Prostate cancer is the most common malignant tumor in men and it is estimated that on average one in six men will develop the disease, says the urologist in Noida.

Age – Age is the most important factor, being uncommon before age 45 and most common after age 60.

Family history – If a first-degree relative (father or brother) has already developed the disease, the risk is greater.

Race – It is believed that the racial issue may be important in the development of prostate cancer. In the United States, the disease is more common among blacks. But this is not necessarily repeated in other countries, in which there are groups descended from African tribes of different ethnicities. In the East, in general, it is less frequent. However, this low incidence may not have exclusively the racial factor as a justification, since Orientals who migrate to the West and acquire local habits, present a progressively higher risk of prostate cancer in subsequent generations.

Diet – Some studies suggest that prostate cancer is related to a diet rich in meat and animal fat, while a diet rich in fruits and vegetables could be a protective factor. Conditions such as benign prostate growth, obesity, smoking, having undergone a vasectomy, a viral infection of the prostate and a lack of physical exercise are not considered risk factors, explains the urologist in Greater Noida.

Early detection– Since localized or early stage prostate cancer usually does not cause symptoms, you should try to discover the disease before the symptoms appear. For that, it is recommended to perform the examination of the prostate by digital rectal examination. The collection of a blood test, PSA (acronym in English for prostate specific antigen) is a controversial topic in the medical field, although the dosage of this substance is an important marker for prostate cancer. On the one hand, the risk of false positives may be associated with invasive and unnecessary interventions. But, on the other hand, early detection is linked to a better prospect of total tumor elimination. American guidelines suggest that men as young as 50 years of age go to the urologist in Ghaziabad to investigate the health of the gland.

  • Touch examination – Also known as digital examination of the prostate by the rectum, it is performed by the doctor to identify hardened areas in the prostate and other changes that may lead you to suspect cancer. It lasts a few seconds and is painless.
  • PSA – It is measured in the blood and used as a marker of prostate cancer, suggesting the presence of the disease mainly when the total value is greater than 2.5 ng/ml. However, it can increase in other prostate diseases, such as benign growth and prostatitis (infection and inflammation of the prostate). There are other fractions of the PSA (free and linked to other molecules) and other parameters that can help the doctor to suspect an eventual prostate cancer, such as the speed of growth of the PSA (how much it increases from year to year), the density of the PSA (ratio of the test result to the size of the prostate) and the expected PSA for age.

Symptoms – Mostly prostate cancer have no symptoms. The discomfort to urinate or the presence of blood in the urine or sperm are more related to the benign growth of the prostate or prostatitis. A urological evaluation is often necessary to clarify the real source of these symptoms, says the best urologist in Ghaziabad.

Diagnosis – Localized prostate cancer does not appear in most imaging tests such as ultrasound, tomography, MRI and PET-SCAN. Therefore, the diagnosis is made through biopsy (removal of small fragments by a fine needle inserted through the rectum) guided by ultrasound and made with sedation. The removed fragments are analyzed by a pathologist who evidences the existence or not of the problem.

This exam has become standardized and routinely performed in the best institutions, with a low risk of serious complications and with a quick return of the individual to his normal activities. A biopsy exam performed does not completely exclude the presence of the disease and other biopsies may be necessary depending on the analysis of several risk factors.

Disease stages – When the diagnosis is confirmed by biopsy, it is necessary to perform a series of tests that will determine whether the disease is located in the prostate, whether it is just beyond the limits of the prostate, or whether malignant cells have already spread to other organs. .

Treatment Options

  • Localized disease – It is the stage that can offer the greatest chances of cure. There are some options for Prostate Cancer Treatment in Delhi for managing the disease to be discussed:
  • Surgery – It is called radical prostatectomy. It consists of the complete removal of the prostate, seminal vesicles and eventually lymph nodes that may be compromised. After removal of the gland, the bladder is connected to the urethra using stitches and a probe is left that goes out through the hole in the penis. This probe drains the urine, protects the stitches and remains after surgery for a time ranging from five to 14 days. In surgery, it is possible or not to preserve the nerves responsible for the erection that pass very close to the prostate and this depends mainly on the local conditions, mainly on the suspicion of invasion of the nerves by the tumor. Surgery can be done through three different routes: the conventional open route, the laparoscopic route or the perineal route.
    • The open route consists of an abdominal incision made below the umbilical scar until close to the bone above the base of the penis.
    • The laparoscopic approach consists of an abdominal access through four or five incisions from 5 mm to 10 mm, with gas insufflation and a view of the surgical field through a monitor connected to a microcamera inserted in the abdomen through one of these holes. This technique can also be performed with the aid of a robot (called Da Vinci).
    • The perineal route consists of an incision between the scrotum and anus with direct access to the prostate. This way, there is a limitation on the possibility of removing the nodes. There is no consensus on the best access route to perform radical prostatectomy and some surgeons have more experience and / or preference for one technique or another. The advantages and disadvantages of each should be discussed with the urologist in Delhi.
  • Radiotherapy – It consists of the application of radiation directed to the prostate. It can be done by external radiation (3-D conformational and with modulated intensity – IMRT Intensity Modulated Radiation Therapy) or by implanting radioactive seeds (brachytherapy) in the prostate, which is done under anesthesia.
  • Locally advanced disease – When the tumor exceeds the limits of the gland, there are some possibilities for prostate cancer treatment in Noida to be considered and discussed, such as blocking the male hormone for a period prior to, concomitant with or after surgery or radiotherapy.
  • Metastatic disease – When identifying sites for the spread of the tumor to other organs, such as bones, for example, the prostate cancer treatment in Ghaziabad may be blocking the male hormone (testosterone). Malignant cells in the prostate grow stimulated by testosterone and blocking this hormone can cause the tumor anywhere in the body to regress and become latent. There are several ways to block the hormone and the procedure to be adopted, as well as its possible side effects, should be discussed with the urologist in Delhi. When the disease no longer responds to hormone therapy, current chemotherapy is effective in treating symptoms and increasing the life expectancy of patients with prostate cancer.

Neurological Disorders Five Times More Likely to Cause Suicide

The danger of self destruction is especially high among those with ALS and is additionally high in those with Huntington’s illness, MS, and epilepsy.

Individuals with neurological conditions like Parkinson’s sickness, different sclerosis (MS), amyotrophic sidelong sclerosis (ALS, otherwise called Lou Gehrig’s illness), Huntington’s malady, and dementia are at a higher risk for self-destruction, an examination conducted in February 2020 in the Journal of the American Medical Association has found.

As indicated by a report released in US for this present month by the Centers for Disease Control and Prevention (CDC), self destruction rates rose in almost every US state somewhere in the range of 1999 and 2019. Half of all states saw suicides increment by in excess of 30 percent since 1999.

Stress, Hopelessness, and Low Quality of Life

As indicated by the creators, from the Danish Research Institute for Suicide Prevention (DRISP) in Copenhagen, the higher paces of self destruction among those with these mind issue are likely the after-effect of stress and sentiments of misery when they become familiar with their analysis and anticipation. In spite of the fact that the indications of a large portion of these conditions can be dealt by medicating and different approaches, none can be restored — in any event, not yet.

Likewise, a considerable lot of these leads to noteworthy incapacity, which may affect the personal satisfaction of the individuals who are analyzed just as their families and companions.

Inherent & Related Causes:

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    • Genetic Factors, truth be told, organic elements are likewise capable.
    • Chromosome variations from the norm
    • Metabolic issues
    • Congenital contortion
    • Infections
    • Environmental factors
    • Asphyxia/Hypoxia
    • Improper nourishment
    • Complication while conceiving an offspring
    • Interaction impacts

A portion of these causes are connected with mind issues like despondency and uneasiness, which may prompt self-destruction.

People With Neurological Disorders Almost Twice as Likely to Take Their Own Lives

While the vast majority comprehend the term self destruction to mean deliberately or purposefully ending one’s life, it’s essential to comprehend the curve of self-destructive conduct and the related actions.

With an end goal to build mindfulness and comprehension of this developing medical issue we utilizes the accompanying suggested phrasing:

Self-coordinated brutality:

Behaviour that is self-coordinated and purposely brings about injury, or potential injury, to oneself.

Non-self-destructive self-coordinated viciousness:

This incorporates conduct that is self-coordinated and planned to cause injury or can possibly cause injury, however for which there is no proof, verifiable or unequivocal, of self-destructive purpose.

Suicidal self-coordinated savagery:

This incorporates conduct that is self-coordinated and expected to cause injury or can possibly cause injury, with proof, certain or unequivocal, of self-destructive expectation.

Undetermined self-coordinated brutality:

Behaviour that is self-coordinated and planned to make injure oneself. However the self-destructive aim is hazy based on the proof.

Suicide endeavour:

A nonfatal self-guided damaging conduct with endeavour to kick the bucket. A self destruction endeavour isn’t constantly effective.

Interrupted self-guided brutality:

An individual finds a way to harm themselves however stops oneself or is halted by someone else.

Eventually, more than 35,000 of those remembered for the examination died by self-destruction, and about 15 percent of the individuals who passed on by self destruction had been determined to have a neurological issue. Generally speaking, we found that those with neurological scatters are twice as liable to end their own lives as the individuals who hadn’t been determined to have these conditions.

Danger of self destruction among those with ALS was very nearly multiple times higher than that of everyone, while the self destruction chance for those with Huntington’s, MS, and epilepsy was generally twice as high.

Be on the Lookout for Depression, Anxiety, and Suicidal Thoughts

In view of their discoveries, the Premium Surgeon recommends that parental figures — companions and friends and family just as social insurance experts — intently screen those with these conditions for gloom and tension, passionate misery, and self-destructive contemplations.

“Emphasize that self destruction is an uncommon occasion — by and large and furthermore among individuals with neurological scatters. It’s doubtlessly essential to know about one’s psychological prosperity — particularly when determined to have an interminable issue. Fortunately, it’s rare sorts of people who create burdensome manifestations, however in the event that one does, at that point it is critical to address a medicinal services proficient and survey whether further activities are required

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Fertility Test In Men And Women

Whether it is to know when you are most fertile or to prepare for having a child, fertility tests for women allow you to know the period of the reproductive cycle in which you are. In men, they are used to measure the level of sperm. How to properly use male and female fertility tests?

What is a fertility test?

A fertility test makes it possible to know the fertility rate of a person, that is to say, his capacity or not to be able to procreate naturally. Male and female fertility tests are different. They can be done in the hospital, by taking a blood test, after consulting a sexologist in Delhi. But there are also self-tests, sold in pharmacies, to be carried out directly at home. In men, they measure the level of sperm in the sperm, while in women, they provide information on the period of ovulation.

Fertilization, ovulation, menstrual cycle: some reminders of biology

In order to understand the functioning of a woman’s menstrual cycle, that is to say, her menstrual cycle, it is first necessary to define the phenomenon of ovulation and that of fertilization. As best sexologist in Delhi explains each month, during a period of about a day, the ovulation phase takes place. During this, the ovum (or oocyte) is expelled by the ovary. The latter lives approximately 24 hours in the body. In order to maximize the chances of getting pregnant, you must have sex on this day, so that sperm comes to fertilize the woman’s egg (note that the sperm expelled during ejaculation survive between 3 and 5 days in the cervix).

Fertilization of the ovum by the sperm, which corresponds to the fusion of the male and female gametes, if it takes place, is then done in stride, within the uterus. If it does not happen, the rules will reappear the following month to start a new cycle, suggests top sexologist in Delhi.

Why and when to take a fertility test?

Fertility tests can be done for several reasons. For example, if you want to have a child but are having difficulties, a test can tell you about your situation regarding procreation, and whether these difficulties have a cause. If you are looking to have a baby, the test can also tell you which is the best time to have a sex to maximize the chances, that is, if the period is right for fertilization.

In this case, your sexologist doctor in Delhi may order a daily test, which will allow you to have sex on specific dates, which correspond to female ovulation. Finally, a test can, conversely, allow you to know the period when you are least fertile, and when intercourse is less conducive to fertilization (but also does not guarantee 100% not to fall pregnant).

How to do a fertility test in the hospital?

When a couple is having difficulty having a child, it is possible to be prescribed fertility tests, female and male, to check whether one of the two partners is not infertile, or has a low rate of fertility. If you want to obtain reliable results, it is advisable to turn to fertility tests by a blood test, prescribed by a sex specialist in Delhi, which will be carried out in the hospital.

In certain cases, in the event of an anomaly detected, additional analyzes may be prescribed. In men, this test, called a spermogram, is used to assess the quality and quantity of sperm in the semen, and to check for infection. It is carried out with a sperm sample taken after masturbation, in a specialized laboratory, says sexologist in Delhi.

The male and female self-test, to know your fertility rate at home

For women, fertility self-tests are actually ovulation tests. They are used in the same way as pregnancy tests, on the toilet. Thanks to a hormone detected in the urine, which is present in greater quantity during the ovulation phases, the test indicates or not if one is in a period of high fertility. In this case, this is the best time to get pregnant. For men, the self-test makes it possible, as in laboratories, to calculate the quantity of mobile sperm present in the sperm. Be careful though, this system, although quite reliable, provides information only on the quantity and therefore does not allow other important elements to be taken into account, such as the shape of the sperm. The result of the self-test must, therefore, be put into perspective, suggests sexologist in Delhi.

What to do in case of infertility?

The first step is to target the cause of infertility: does it come from a man, a woman, or both? Be aware that below 15 million sperm per milliliter, a man is considered infertile. Then, medical follow-up must be done with a sexologist in Delhi. Indeed, these days, it is quite possible to get pregnant despite an infertility problem: it is possible to consider solutions to help procreation, either by helping natural fertilization or in vitro.