FAQ's

CARDIOLOGY 

What cardiology services does Rhythm heart institute (RHI) provide?

RHI provides emergency,    elective & preventive services for heart diseases like heart attack, angina (ischemic heart diseases), valvular heart disease, congenital  heart disease (heart disease present from birth) Arrhythmia (irregular heart beats), Cardiomyopathy (disease of heart muscles) pericardial diseases etc.

What cardiac procedures & surgeries are done at RHI ?

Diagnostic & treatment procedures like Electrocardiogram, 2d, 4d Echocardiography, TEE, Holter monitoring, TMT,  Ambulatory BP monitoring. Coronary angiography, EP study, cardiac catheterization as diagnostic procedures.
Coronary angioplasty including complex  intervention like Left main stenting, bifurcation lesions, CTO,  Ballon mitral valvotomy, Transcatheter Aortic  Valve replacement (TAVR), intra aortic balloon pump support, Radio frequency ablation, IVUS, Rota ablation, pericardial tapping, Atrial septal defect device closures,  as Cardiac interventions.
Cardiac surgeries like Coronary Artery bypass grafting (CABG), Valve replacement & repair, pericardiacectomy, ASD, VSD, PDA surgical closures etc..

How can heart disease be prevented ?

Proper healthy  diet, regular physical exercises, good mental health, regular cardiac check ups and advice by cardiologist can help to prevent heart disease.

What are major risk factors leading to heart disease  ?

Diabetes, Smoking, tobacco consumption, high blood pressure, unhealthy diet, sedentary life style, high levels  cholesterol in blood, anxiety ect.

What are common symptoms which helps to identify heart disease ? 

Chest pain, breathlessness, palpitations, fatigue, swelling in feet, sudden loss of consciousness, if you notice any of above mentioned symptoms contact cardiologist immediately

Nephrology

 

What is Dialysis?

 

Dialysis is a medical process through which a person’s blood is cleansed of the toxins or wastes that kidneys normally remove. It is used when a person’s kidneys no longer function optimally. The purpose is to keep the right levels of chemicals, fluids and salts in the body so that body functions normally.

 

  How Many types of dialysis are there ?

• Renal dialysis falls into two main divisions: haemodialysis and peritoneal dialysis.
• Hemodialysis cleans and filters your blood using a machine to temporarily remove harmful wastes, extra salt, and extra water from your body. Hemodialysis is most often performed in a dialysis centre but home treatment options are also available.
• Peritoneal dialysis uses the lining of your abdomen and dialysis solution (a mixture of minerals and sugar dissolved in water) to filter your blood removing wastes, chemicals and extra water from your body. After several hours, the used solution is drained from your abdomen through a tube and the cycle is repeated with fresh solution

Is it dangerous to skip dialysis ?

 

Yes, this can lead to fluid overload and breathing problem. It can also increase your serum potassium level which can lead to serious cardiac complications. Therefore skipping dialysis can be life threatening.

 

Can dialysis patient travel ?

 

Yes, they can travel and whenever they need to travel they should make prior arrangements for dialysis to wherever they are travelling.

 

What basic precautions should a patient of dialysis take?

 

While on dialysis you should watch your diet. In case of any breathing trouble you should contact your doctor as you may require urgent dialysis. Care of the vascular access should be ensured as advised by your physician.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Gastroenterology

 

 

What is GI Endoscopy ?

Gastrointestinal endoscopy is done when to see the inside of the stomach or intestines. Gastrointestinal endoscopy involves placing a thin tube-like instrument through the mouth or the back passage, the rectum, and down into the gullet, or oesophagus, stomach or intestines. The tube is able to carry pictures back to a video screen or camera. When endoscopy is done through the mouth, it is called upper endoscopy or esophagogastroduodenoscopy (EGD for short). When endoscopy is done through the rectum, it is called lower endoscopy or colonoscopy.

Common Reasons For Its Use And Benefits:

• BLEEDING – The most common reason for gastrointestinal endoscopy is to find the source of bleeding from the oesophagus, stomach or intestines. Sometimes, if the source is found, doctors can use the endoscope to stop the bleeding. ?TUMOURS – Sometimes tumours can cause discomfort or even clog the oesophagus, stomach or intestines. The endoscope can be used to find tumours and take a small sample for analysis in the lab, called a biopsy.
• DIARRHEA – Sometimes severe diarrhea can be caused by inflammation or infections of the colon and endoscopy can be used to help find the cause. ?BELLY PAINS – Sometimes severe stomach pain can be a sign of ulcer, a clog in the gastrointestinal track, inflammation or infection. Endoscopy can help find the reasons for some belly pains.

What is Banding Therapy?

Banding is used to treat oesophageal varices which result from a condition called portal hypertension.

 

What Is Portal Hypertension ?

 

Sometimes with liver disease, blood flow through the liver is restricted causing an increase in the blood pressure in and around the liver. This is called portal hypertension. This back pressure of blood can cause a network of enlarged, weak varicose veins to develop in the oesophagus or stomach. These are called varices. If one of these veins ruptures severe bleeding can occur resulting in vomiting of blood or passing blood in the form of black stools. In patients who have fluid retention due to their liver disease, portal hypertension can result in a build up of fluid in the abdomen. This is called ascites.

How Does Banding Work?

 

Banding is just one way to treat oesophageal varices. It involves a long, flexible tube with a light on the end (an endoscope) which is passed through your mouth into the stomach. The doctor can view the varices in the oesophagus and inserts a rubber band round each of these varices. This stops the blood supply in these veins and they eventually disappear. This will not affect the normal blood supply to the oesophagus. The varices are extra veins that have developed and we need to try to eradicate them, otherwise they may rupture and bleed.

 

Prior To The Procedure

 

Banding is sometimes carried out as an ’emergency’ to stop severe bleeding of varices .However sometimes the procedure can be planned ahead of time to prevent the varices from bleeding. In this case, you will be admitted to a ward where blood samples will be taken. The procedure will be explained to you along with the potential risks and you will be asked to sign a consent form. To allow a clear view, the stomach must be empty. You will therefore be asked not to have anything to eat or drink for at least 6 hours before the test. On the day of the banding you will be asked to change into a hospital gown. You will also have to remove any false teeth. A needle will be inserted into a vein in your arm. This is used for giving you sedation during the procedure.

During The Test

• Banding is usually carried out in the endoscopy unit and can take between 15-30 minutes. You will be asked to lie on your left side and will be attached to monitors to measure your heart rate and blood pressure.
• You may be given sedation through the needle in your arm which will make you drowsy and relaxed. The back of your throat will be sprayed to numb the area. To keep your mouth slightly open, a plastic mouthpiece will be gently placed between your teeth.
• The endoscope is then passed into the stomach. This can be a little uncomfortable but is not painful and does not interfere with your breathing. Air is passed down the tube which distends the stomach to allow the doctor to have a better view of the gullet. If you get a lot of saliva in your mouth, this will be cleared using special suction equipment. The bands are then placed around the varices. The air is then sucked out of the stomach and the tube removed quickly and easily.
• Once the procedure is complete, the monitors are removed and you will be transferred back to the ward.

What is Colonoscopy ?

Colonoscopy

 

Colonoscopy is a procedure that enables your doctor to examine the lining of the colon (large bowel) by inserting a flexible tube that is about the thickness of your finger into the anus and advancing it slowly into the rectum and colon.Colonoscopy is a procedure that enables your doctor to examine the lining of the colon (large bowel) by inserting a flexible tube that is about the thickness of your finger into the anus and advancing it slowly into the rectum and colon.

What Preparation Is Required?

 

The colon must be completely clean for the procedure to be accurate and complete. The hospital will give you detailed instructions regarding the dietary restrictions to be followed and the cleansing routine to be used. Preparation consists of either drinking a large volume of a special cleansing solution or several days of clear liquids, laxatives, and enemas prior to the examination. Follow your doctor’s instructions carefully. If you do not, the procedure may have to be cancelled and repeated later.

What About My Current Medications?

 

Most medications may be continued as usual, but some can interfere with the preparation or the examination. Please inform your doctor of your current medications as well as any allergies to medications several days prior to the examination. Aspirin products, anticoagulants (blood thinners), insulin, and iron products are examples whose use should be discussed with your doctor prior to the examination. You should alert your doctor if you require antibiotics prior to undergoing dental procedures, since you may need antibiotics prior to colonoscopy as well.

What Can Be Expected During Colonoscopy?

 

Colonoscopy is usually well tolerated and rarely causes much pain. There is often a feeling of pressure, bloating, or cramping at times during the procedure. Your doctor will give you medication through a vein to help you relax and better tolerate any discomfort. The colonoscope is advanced slowly through the large intestine and the lining is carefully examined. The procedure usually takes 15 to 60 minutes. In some cases, passage of the colonoscope through the entire colon cannot be achieved. The doctor will decide if the limited examination is sufficient or if other examinations are necessary.

What If The Colonoscopy Shows Something Abnormal?

 

If your doctor thinks an area of the bowel needs to be evaluated in greater detail, a forceps instrument is passed through the colonoscope to obtain a biopsy (a sample of the colon lining). If colonoscopy is being performed to identify sites of bleeding, the areas of bleeding may be controlled through the colonoscope by injecting certain medications or by coagulation (sealing off bleeding vessels with heat treatment). If polyps are found, they are generally removed. None of these additional procedures typically produce pain. Remember, the biopsies are taken for many reasons and do not necessarily mean that cancer is suspected.

What Are Polyps And Why Are They Removed?

 

Polyps are abnormal growths from the lining of the colon which vary in size from a tiny dot to several inches. The majority of polyps are benign (noncancerous) but the doctor cannot always tell a benign from a malignant (cancerous) polyp by its outer appearance alone. For this reason, removed polyps are sent for tissue analysis. Removal of colon polyps is an important means of preventing colorectal cancer.

How Are Polyps Removed?

 

Tiny polyps may be totally destroyed by fulguration (burning), but larger polyps are removed by a technique called snare polypectomy. The doctor passes a wire loop (snare) through the colonoscope and severs the attachment of the polyp from the intestinal wall by means of an electrical current. You should feel no pain during the polypectomy. There is a small risk that removing a polyp will cause bleeding or result in a burn to the wall of the colon, which could require emergency surgery.

What Happens After A Colonoscopy?

 

After colonoscopy, your doctor will explain the results to you. If you have been given medications during the procedure, someone must accompany you home from the procedure because of the sedation used during the examination. Even if you feel alert after the procedure, your judgment and reflexes may be impaired by the sedation for the rest of the day, making it unsafe for you to drive or operate any machinery.

What Are The Possible Complications Of Colonoscopy?

• Colonoscopy and polypectomy are generally safe. One possible complication is a perforation or tear through the bowel wall that could require surgery, although this is very uncommon.
• Bleeding may occur from the site of biopsy or polypectomy. It is usually minor and stops on its own orcan be controlled through the colonoscope. Rarely, blood transfusions or surgery may be required.
• Other potential risks include a reaction to the sedatives used and complications from heart or lung disease.
• Localised irritation of the vein where medications were injected may rarely cause a tender lump lasting for several weeks, but this will go away eventually. Applying hot packs or hot moist towels may help relieve discomfort.

Spine Surgery

 

What You Need To Know About The “Slipped Disc”?

Understanding the spineThe spine is made up of many bones called vertebrae. These are roughly circular and between each vertebra is a disc. The discs are made of strong rubber-like tissue, which allows the spine to be fairly flexible. A disc has a stronger fibrous outer part, and a softer jelly-like middle part called the nucleus pulposus.

The spine protects the spinal cord, which contains the nerves that come from the brain. Nerves from the spinal cord come out from between the vertebrae to take and receive messages to various parts of the body. Strong ligaments attach to the vertebrae. These give extra support and strength to the spine. Various muscles also surround, and are attached to various parts of the spine.

What Is A Prolapsed Disc ?

When you have a prolapsed disc (commonly called a slipped disc). A disc does not actually slip. What happens is that part of the inner softer part of the disc (the nucleus pulposes) bulges out through a weakness in the outer part of the disc. A prolapsed disc is sometimes called herniated disc. The bulging disc may press on nearby structures such as a nerve coming from the spinal cord. Some inflammation also develops around the prolapsed part of the disc.

Any disc in the spine can prolapse. However, most prolapsed discs occur in the lumbar part of the spine (lower back). The size of the prolapse can vary. As a rule, the larger the prolapse, the more severe the symptoms are likely to be.

How Does A Prolapsed Disc Progress?

In most cases, the symptoms tend to improve over a few weeks. Research studies of repeated MRI scans have shown that the bulging prolapsed portion of the disc tends to get smaller (regress) over time in most cases. In only about 1 in 10 cases is the pain still bad enough after six weeks to consider surgery.

Are Any Tests Needed?

Your doctor will normally be able to diagnose a prolapsed disc from the symptoms and by examining you. (It is the common cause of sudden back pain with nerve root symptoms). In most cases, no tests are needed as the symptoms often settle within a few weeks. Tests such as X-rays or scans may be advised if symptoms persist. In particular, an MRI scan can show the site and size of a prolapsed disc. This information is need if treatment with surgery is being considered.

Which Is Most Common?

Idiopathic scoliosis is the most common form of spinal deformity seen. By definition, it is lateral curvature of the spine occurring in an otherwise healthy child, for which no recognizable cause exists. It is divided into three categories depending on the age at which the curve is first detected:

• Infantile idiopathic scoliosis – when the cure occurs before the age of 3 years.
• Juvenile idiopathic scoliosis – first appears between the age 3 and 10 years.
• Adolescent idiopathic scoliosis – the most common type and is first detected after puberty i.e. after 11 years.

Adolescent idiopathic scoliosis is the most common type of spinal curvature. It occurs around the onset of puberty in otherwise healthy boys and girls. It is more common in girls.

What Are The Surgical Options Available?

Surgical treatment of scoliosis is employed if the cure at detection is of greater magnitude (> 40). The aim of surgical correction is to achieve a well-balanced spine in which the patient’s head, shoulders and trunk are centered over the pelvis. This is done by using instrumentation to reduce the magnitude of the deformity and obtaining fusion in order to prevent future curve progression. When fusion is done in skeletally immature patients, Crank shafting and flat back syndromes occur producing more severe deformity and these also severely retard growth. A more recent development in the treatment of such patients is the use of staples on the convex side of the curve, which correct and maintain the curve till the patient is skeletally mature. These staples allow differential growth to take place i.e. less growing speed on the stapled side than the conclave side thereby correcting the curve as the child grows. This principle has long been used in the correction of long bone deformity in the skeletally immature.