Surgery: Archives

Aortic Stenosis/TAVR/TAVI August 21, 2023

Aortic Stenosis: Understanding a Major Heart Condition

Aortic stenosis (AS) is a severe and potentially life-threatening condition affecting millions worldwide. While the condition can develop slowly over time, it can quickly become a major health concern, if left untreated or caught late, AS can progress rapidly and cause massive organ damage, leading to congestive heart failure and death within weeks or even days.

That is why knowing the causes and symptoms of AS is crucial to understand the severity of the condition and catching it early before it gets out of hand. So read on to learn more about this condition and how to protect yourself from its potentially life-ending consequences.

What is Aortic Stenosis?
Aortic stenosis (AS) is a medical condition affecting the aortic valve, which regulates blood flow from the heart to the body. It is caused when the aortic valve narrows, leading to restricted blood flow and increased pressure on the heart. This can cause your heart to work harder and strain against the walls of the blood vessels, resulting in fatigue and pain. When this happens, it can interfere with the normal blood flow out of the heart, cause heart damage, and result in a sudden catastrophic event known as a dissection. Dissection can prove to be fatal, leading to death.

Causes of Aortic Stenosis
There are a few causes of Aortic Stenosis. It can be hereditary and may run in families, increasing the risk of the condition. It is also more likely to occur in people aged 40-70 and above due to calcium buildup on the valve over time. Other causes include congenital heart defects, rheumatic fever and radiation therapy. Furthermore, medical conditions such as hypertension, Paget’s disease of the bone, heart failure, kidney disease, and autoimmune diseases can also increase the risk. Last but not least, smoking and untreated infections can also damage the heart valves and increase the risk of aortic stenosis.

Diagnosing Aortic Stenosis
Aortic stenosis is typically detected during a cardiovascular examination, including an EKG and listening for heart murmurs with a stethoscope. Other detection methods include chest X-ray, angiography, cardiac CT scan, cardiac catheterization, and heart MRI.

How Severe is Aortic Stenosis?
Aortic stenosis progresses slowly over several years and can worsen with age and secondary health conditions, such as heart failure, high blood pressure, and diabetes. While aortic stenosis can be a severe condition, its severity depends on various factors, including the extent of valve narrowing and the patient’s age and overall health. The degree of severity can vary from mild to severe. However, as mentioned above, any level of aortic stenosis can lead to significant complications if left untreated.

Heart Failure: One of the most serious complications of aortic stenosis is heart failure. It happens when the heart is unable to circulate an adequate amount of blood. The heart has to work harder to push blood through the narrow opening as the aortic valve becomes more obstructed. Over time, this can lead to a weakened heart muscle and an inability to pump blood to the rest of the body effectively. Symptoms of heart failure include swelling in the legs and feet, fatigue, shortness of breath, and an irregular heartbeat. Heart failure can sometimes be fatal, particularly if not diagnosed and treated promptly.
Arrhythmia:Another potential complication of aortic stenosis is arrhythmia or an irregular heartbeat. This can occur because the heart exerts more effort than necessary to circulate blood through the obstructed valve. As a result, it can disrupt the heart’s normal electrical activity. Arrhythmia can lead to symptoms such as palpitations, dizziness, and fainting. While it can often be managed with medication or other treatments, it can also be a serious condition that requires close monitoring and intervention.
Cardiac Arrest: Cardiac arrest is probably one of the most severe complications of aortic stenosis. Cardiac arrest occurs when the heart stops beating suddenly. In some cases, people with aortic stenosis may experience sudden cardiac arrest without warning signs or symptoms. However, in many cases, cardiac arrest can be preceded by symptoms such as chest pain, shortness of breath, dizziness, or fainting. Cardiac arrest is life-threatening if not treated immediately.

Prevention of Aortic Stenosis
AS caused by natural aging is not usually preventable. But one should continue to lead a healthy lifestyle which includes managing diet, exercise, sleep, weight, and being alert to limit the interference of any cardiovascular disease. In addition, there are a few ways you can protect yourself against the development of aortic stenosis. These include:

Maintain a healthy weight throughout your life by eating a balanced diet and exercising regularly. This helps to keep your blood pressure under control and lowers your risk of cardiovascular disease.
Maintain healthy heart health by not smoking and following a healthy lifestyle, including getting enough sleep, avoiding alcohol.
Maintain and protect your blood vessels from damage by staying hydrated, avoiding excessive salt and sugar intake, getting enough exercise, and staying away from excessive sun exposure.
Aortic stenosis caused by bacterial infection is preventable if infections are treated on time with antibiotics and other medications.
Aortic stenosis caused by chronic or inherited conditions is not always preventable.
Periodic monitoring of routine ECG and regular medical checkups.

Summary
AS is most commonly seen in older people, especially after age 65. In some rare instances, children can be born with a defect in the aortic valve that can cause stenosis. Unfortunately, many do not realize they have AS until the condition triggers symptoms such as Pain or tightness in the chest with activity (angina), feeling of dizziness or fainting during activity, tiredness (fatigue), shortness of breath (dyspnoea), irregular heartbeats (arrhythmia) or Heart palpitations, swelling in your legs or they detect it during a medical diagnosis. AS is a complicated problem hence speaking with your doctor at the earliest about AS risks, especially when you have symptoms, can bring in timely intervention. There are advances in surgical and catheter-based techniques that can help treat the cases of older people with multiple conditions that complicate care in their recovery process. Timely or early treatment will ensure a good prognosis. Of course, that needs to be backed by lifelong follow-up and care to lead an everyday life. If left untreated, it can cause severe repercussions. Most do not make it more than a few years without treatment. If treatment is delayed, the extent of Heart damage decides if a full/partial recovery is possible.

FAQs

What is the leading cause of aortic stenosis?
Calcium buildup on the aortic valve that comes with aging and over time is the most common cause of Aortic stenosis, which makes the valve tissue stiff, narrow, and less flexible & hence restricts the blood flow from the Heart to the rest of the body.

How severe is aortic stenosis?
Those with severe Aortic stenosis develop symptoms with a survival rate as low as 50% at two years and 20% at five years without aortic valve replacement.

What are the signs and symptoms of aortic stenosis?
Symptoms of aortic stenosis can include chest pain, troubled breathing, dizziness, heart murmur, rapid or irregular heartbeat, difficulty walking short distances, swelling of ankles and feet, and difficulty sleeping.

What is the life expectancy with severe aortic stenosis?
Aortic stenosis can be dangerous, costly, and debilitating. Chances of survival without treatment for severe symptomatic aortic stenosis are as low as 50% at two years after symptom onset and 20% at five years.

References :
https://my.clevelandclinic.org/health/diseases/23046-aortic-valve-stenosis
https://bestpractice.bmj.com/topics/en-us/325
https://www.pennmedicine.org/for-patients-and-visitors/patient-information/conditions-treated-a-to-z/aortic-valve-stenosis
https://www.ncbi.nlm.nih.gov/books/NBK557628/
https://emedicine.medscape.com/article/150638-overview
https://www.webmd.com/heart-disease/aortic-valve-stenosis
https://medlineplus.gov/ency/article/000178.htm
https://www.heart.org/en/health-topics/heart-valve-problems-and-disease/heart-valve-problems-and-causes/problem-aortic-valve-stenosis

Hip Replacement August 12, 2023

Diet and Hip Osteoarthritis: How Nutrition Can Impact Hip Osteoarthritis

Nutrients for Joint Health

When it comes to managing hip osteoarthritis, certain nutrients have been identified to be particularly beneficial in promoting joint health and reducing inflammation.

Omega-3 Fatty Acids: These anti-inflammatory properties might help alleviate hip joint pain and stiffness. One commonly recognized benefit of consuming these healthy fats is their ability to decrease the generation of inflammatory compounds within the body, thereby relieving individuals with hip osteoarthritis.
Vitamin D: This is essential for maintaining bone health. Research suggests vitamin D deficiency may be linked to an increased risk of hip osteoarthritis. Sunlight is one of the best sources of vitamin D, and its role in managing bone health cannot be ignored. Vitamin D can be obtained through foods like fortified dairy products, egg yolks, and fatty fish.
Antioxidants: Antioxidants are crucial in reducing oxidative stress and inflammation in the body. Antioxidant-rich food help protect the joints from damage caused by free radicals. Including many fruits and vegetables in your diet will provide a wide range of antioxidants beneficial for joint health.

Foods to Eat and Avoid for Hip Osteoarthritis

While certain foods can promote joint health, others can worsen hip osteoarthritis symptoms. Here are some dietary recommendations for individuals with hip osteoarthritis:

Fatty Fish: Add fatty fish like salmon, mackerel, and tuna to your diet for omega-3 fatty acids. They can help reduce inflammation and relieve hip joint pain.
Leafy Greens and Berries: Include a variety of leafy greens, such as kale, spinach, and collard greens, as well as berries and cherries in your meals. These are antioxidant-rich vegetables and fruits. They provide essential vitamins and minerals that support joint health.
Turmeric: This golden spice contains curcumin, known for its anti-inflammatory properties. Adding turmeric to your dishes or consuming it as a supplement may help reduce hip joint pain and stiffness.
Whole Grains: Always go for grains like quinoa, brown rice, and whole wheat bread over refined grains. Whole grains contain fibre, which has been known to affect reducing the levels of inflammation in the body positively.

Foods to Avoid

Limiting or avoiding certain foods that can exacerbate hip osteoarthritis symptoms is important. For example, processed snacks, sugary drinks, and foods high in saturated fats should be minimised as they can contribute to inflammation and worsen hip joint pain and discomfort.

Conclusion

While diet cannot cure hip osteoarthritis, conscious choices about our foods can significantly impact symptom management and overall joint health. By incorporating nutrient-rich foods like fatty fish, leafy greens, and turmeric, individuals with hip osteoarthritis can provide their bodies with the necessary building blocks for joint repair and reduce inflammation.

FAQs

Q: Can diet make a difference in managing hip osteoarthritis?
A: Absolutely! While diet alone cannot cure hip osteoarthritis, it is recognised to play a vital role in managing the symptoms and potentially slowing down the progression of the disease. In addition, certain nutrients and foods have been found to have anti-inflammatory properties and promote joint health, which can alleviate pain and stiffness associated with hip osteoarthritis.

Q: Which nutrients are beneficial for individuals with hip osteoarthritis?
A: Several nutrients have been identified as beneficial for individuals with hip osteoarthritis. Omega-3 fatty acids in chia seeds, fatty fish, and walnuts have anti-inflammatory properties. Vitamin D, obtained through sunlight or foods like fortified dairy products and fatty fish, is crucial for maintaining bone health. Antioxidants in berries, spinach, kale, and broccoli help protect the joints from oxidative stress and inflammation.

Q: Are there any foods I should avoid if I have hip osteoarthritis?
A: Certain foods should be limited or avoided if you have hip osteoarthritis. Processed snacks, sugary drinks, and food rich in saturated fats may cause inflammation and worsen hip joint pain and discomfort. Additionally, some individuals may find that nightshade vegetables like tomatoes, peppers, and eggplants trigger inflammation, so observing any personal sensitivities to these foods may be worth observing.

Contraception July 28, 2023

Evolution of Pregnancy Testing: From Traditional Methods to Testing Kits

The Early Days of Pregnancy Testing

The earliest methods of detecting pregnancy were crude and unreliable. For instance, in ancient Egypt, women would urinate on barley and wheat seeds to determine whether they were pregnant. If the seeds sprouted, it was believed that the woman was pregnant. Similarly, in ancient Greece, women would observe changes in the colour and appearance of their urine to determine if they were pregnant.

It was in the early 20th century that the first recorded pregnancy test was developed. In 1928, two German physicians named Selmar Aschheim and Bernhard Zondek discovered that injecting the urine of a pregnant woman into a female mouse would cause the mouse’s ovaries to enlarge.

In 1931, the first commercial urine-based pregnancy test was introduced, called the “Rabbit Test.” This test involved injecting a woman’s urine into a female rabbit and observing changes in the rabbit’s ovaries.

However, the rabbit test had many limitations, including being time-consuming and requiring skilled technicians. It also had a relatively high rate of false positives and false negatives. As a result, it wasn’t until the 1960s that a more reliable and practical urine-based pregnancy test was developed.

The Modern Pregnancy Testing Kit

In the 1970s, the modern home pregnancy testing kit was introduced. These kits are based on the same principle as the urine-based pregnancy test but are much easier to use and more reliable. Home pregnancy tests are designed to detect the presence of hCG in a woman’s urine. They use antibodies that bind to the hCG hormone, causing a reaction that produces a colour change or a line on the test strip.

Home pregnancy test kits are very easy to use. A woman must urinate on the test stick or the strip and then wait for the results. Most home pregnancy tests can provide accurate results within a few minutes. These tests are relatively inexpensive and widely available in pharmacies and online stores.

The reliability of home pregnancy tests has improved significantly since their introduction. Most tests can detect hCG levels as low as 20-25 mIU/mL, about the level at which a woman would miss her period. However, false negatives can occur if a woman tests too early or has low levels of hCG. False positives can occur if a woman has recently had a miscarriage, is taking fertility drugs, or has certain medical conditions.

Advancements in Pregnancy Testing

Pregnancy testing technology has witnessed significant development recently. The introduction of early pregnancy testing is one. Early pregnancy tests can detect hCG levels as low as 6-10 mIU/mL, which is about a week before a woman’s missed period. These tests are especially useful for women who are trying to conceive.

Advancement in pregnancy testing has been the use of digital tests. Digital tests use the same technology as traditional home pregnancy tests, but the result is displayed on a digital screen instead of a line or colour change.

Despite the availability of home pregnancy testing kits, it is essential to note that healthcare professionals still play a crucial role in pregnancy testing. Doctors can perform more accurate and reliable tests, such as blood tests. Healthcare professionals can also support and advise women who may be uncertain or anxious about the home pregnancy test results.

Conclusion
The evolution of pregnancy testing has come a long way, from crude and unreliable methods to modern home testing kits. The introduction of the urine-based pregnancy test and, later, the home testing kit has made it easier and more convenient for women to detect pregnancy.

References
https://history.nih.gov/display/history/Pregnancy+Test+Timeline#:~:text=1976,the%201976%20Medical%20Devices%20Act.
https://sitn.hms.harvard.edu/flash/2018/pee-pregnant-history-science-urine-based-pregnancy-tests/
https://en.wikipedia.org/wiki/Rabbit_test
https://www.ancient-origins.net/history-ancient-traditions/bizarre-methods-baby-detection-short-history-pregnancy-test-009764

Cancer July 24, 2023

Understanding Endometriosis Surgery: Different Types And Benefits

Laparoscopy

Laparoscopy is a minimally invasive surgery in which an incision is made near the belly button. A thin tube with a fitted camera, also known as a laparoscope, is inserted. The camera allows the surgeon to see the organs in the pelvic area and locate the endometriosis. The surgeon can then remove the endometriosis tissue using a small surgical instrument.

Laparoscopy is usually recommended for mild to moderate endometriosis. It is a safe and effective procedure with a faster recovery time than open surgery. Patients can get back to their routine within a week.

The benefits of laparoscopy for endometriosis surgery are:

Minimally invasive: Laparoscopy requires only tiny incisions, resulting in less scarring and a faster recovery time.
Accurate: The camera allows the surgeon to see the endometriosis tissue and remove it precisely.
Cost-effective: Laparoscopy is less expensive than open surgery.
Shorter hospital stay: Laparoscopy usually is an outpatient procedure; the patient can go home very next day of the procedure.

Hysterectomy

A hysterectomy is a surgical intervention that involves the removal of the uterus. In certain instances, the procedure may also include the removal of the fallopian tubes and ovaries. Hysterectomy is usually recommended for severe endometriosis that does not respond to other treatments.

Hysterectomy can be done differently; vaginal, abdominal, and laparoscopic. The type of surgery depends on the patient’s condition and the surgeon’s preference.

The benefits of hysterectomy for endometriosis surgery are:

Permanent solution: Hysterectomy removes the uterus, which means the patient will no longer have periods and endometriosis-related pain.
Effective: Hysterectomy is a highly effective treatment for severe endometriosis.
Reduced risk of ovarian cancer: Removing the ovaries reduces the risk of ovarian cancer in women with a high risk of developing it.
Improved quality of life: Hysterectomy can improve the patient’s quality of life by relieving pain and other symptoms.

Excision Surgery

In excision surgery, the endometriosis tissue is removed from the affected organs. This surgery is usually recommended for women with severe endometriosis.

Excision surgery can be laparoscopic or an open surgery, depending on the extent of the endometriosis. The surgeon removes the tissue using a surgical instrument and then repairs any organ damage.

The benefits of excision surgery for endometriosis surgery are:

Precise removal of endometriosis tissue: Excision surgery removes the endometriosis tissue completely, reducing the recurrence risk.
Preserves fertility: Excision surgery can preserve the ovaries and fallopian tubes, improving the patient’s chances of conceiving.
Improved quality of life: Excision surgery can relieve pain and other symptoms, improving the patient’s quality of life.

Radical Hysterectomy

Radical excision surgery is recommended for women with severe endometriosis that has spread to other organs in the pelvic area. It involves removing the affected organs, such as the uterus, ovaries, fallopian tubes, and sometimes even the bladder or rectum.

Radical excision surgery can be done as an open surgery or laparoscopically, depending on the extent of the endometriosis. The surgeon removes the affected organs and then repairs any damage to surrounding tissues.

The benefits of radical excision surgery for endometriosis surgery are:

Permanent solution: Radical excision surgery removes the affected organs, which means the patient will no longer have periods and endometriosis-related pain.
High success rate: Radical excision surgery has a high success rate in treating severe endometriosis.
Reduced risk of recurrence: Removing the affected organs reduces the risk of recurrence.
Improved quality of life: The patient’s quality of life may be improved by undergoing radical excision surgery, which can alleviate their pain.

Conclusion

In conclusion, endometriosis surgery can help manage the symptoms of endometriosis and improve the patient’s quality of life. However, the recommended type of surgery depends on the endometriosis’s severity and extent. Each type of surgery has its benefits. Patients must consult their doctor to discuss the various options and determine the best treatment plan for their individual needs.

References

https://www.healthline.com/health/endometriosis/laparoscopy-for-endometriosis
https://my.clevelandclinic.org/health/treatments/4620-endometriosis-surgery
https://www.brighamandwomens.org/obgyn/infertility-reproductive-surgery/endometriosis/surgical-treatment-of-endometriosis-excision-and-destruction#:~:text=Excision%20of%20endometriotic%20lesions%20or,different%20kinds%20of%20energy%20sources.
https://www.circlehealthgroup.co.uk/health-matters/womens-health/radical-endometriosis-surgery#:~:text=What%20is%20radical%20surgery%20for,other%20treatments%20did%20not%20help.

Contraception July 22, 2023

Optimising Fertility: Tracking with Ovulation Test Kits

Understanding Ovulation and Fertility

The term ovulation pertains to the discharge of a mature egg from the ovary, which occurs approximately once a month. The egg travels through the fallopian tube, waiting for sperm to fertilise it. The fertile window is when a woman is most likely to conceive. This window lasts about six days, including five days preceding the ovulation and the day of ovulation.

Hormones play a vital role in fertility. The follicle-stimulating hormone helps to stimulate the growth of follicles in the ovary, which contains the eggs. Luteinising hormone (LH) surges just before ovulation, triggering the discharge of the egg from the follicle.

The Role of Data in Fertility Tracking

Accurate Timeline : Fertility tracking involves recording information about menstrual cycles, basal body temperature, and cervical mucus changes. Ovulation test kits can provide additional information about the surge in LH that occurs just before ovulation. Tracking this information can help determine the fertile window more accurately. For example, if a woman’s cycle length is typically 28 days, she can predict that ovulation will occur on day 14. However, if she tracks LH surges, she can pinpoint ovulation more accurately and optimise her chances of conceiving.
Better Reproductive Health : Interpreting and using the data effectively is also crucial in optimising reproductive health. For example, couples can use the recorded data to make lifestyle changes, such as improving diet and exercise, to increase their chances of conception. The data can also help identify potential fertility issues, prompting couples to seek medical advice when necessary.
Identify Irregularities : Furthermore, fertility tracking can help identify irregularities in menstrual cycles and ovulation, which could indicate underlying health issues. For example, a consistently short luteal phase (the duration between ovulation and the start of menstruation) could indicate a hormonal imbalance or other health issues that could impact fertility.

Other Factors That Can Impact Fertility

Lifestyle factors like excessive alcohol consumption, smoking, and poor diet can impact fertility. Maintaining a healthy lifestyle can improve fertility and increase the chances of conception. Certain medical conditions, such as PCOS or polycystic ovary syndrome, can impact fertility. It is recommended to seek medical advice if you are unsuccessful in conceiving after a year of trying.

Several treatment options are available for infertility, including fertility drugs, intrauterine insemination (IUI), and in vitro fertilisation (IVF). These treatments can help women who are struggling to conceive.

Conclusion

In conclusion, ovulation test kits are a valuable tool in fertility tracking. By tracking data, women can optimise their chances of conceiving and improve their reproductive health. However, it is essential to note that several lifestyle factors and medical conditions can impact fertility. Therefore, maintaining a healthy lifestyle and seeking medical advice when necessary can also increase the chances of conception.

FAQs

Q: What are ovulation test kits, and how do they work?
A: Ovulation test kits are tools that measure the level of luteinising hormone (LH) in a woman’s urine. LH surges right before ovulation, so by measuring the level of LH in the urine, the kits can predict when ovulation is likely to occur. This information can help pinpoint the most fertile days in a woman’s menstrual cycle and increase the chances of getting pregnant.

Q: Which lifestyle factors can affect fertility?
A: Several lifestyle factors can impact fertility, such as smoking, alcohol consumption, obesity, and stress. Maintaining a healthy diet, exercising regularly, reducing stress, and avoiding harmful substances such as alcohol and tobacco can help optimise reproductive health and improve fertility.

Q: I have irregular periods. What’s the best time to test?
A: This makes it harder to predict when to start testing ovulation kits. If your cycle is irregular and varies by a few days every month, take the average of the last 3 months. Count 12 days from the first day of your period and then take the test.

Q: When should I seek medical advice for fertility issues?
A: If you have been trying to conceive for over a year and have not succeeded, seeking medical advice is essential. Additionally, suppose you have irregular menstrual cycles, a history of sexually transmitted infections, or other health issues that could impact fertility. In that case, it is crucial to talk to a doctor.

Q: How can interpreting data effectively improve reproductive health?
A: Effectively interpreting the data can help couples make informed decisions about lifestyle changes that can optimise reproductive health, such as improving diet and exercise. Additionally, interpreting data can help identify potential fertility issues, prompting couples to seek medical advice when necessary. Using data to form decisions, women can increase their chances of conception and improve overall reproductive health.