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Cardiology - Heart, Vascular and Thoracic Care
MYTHS About Heart Disease
Myth 1: A normal heart rate is 60-100 beats per minute
That’s the old standard. As per latest research on subject about 50-70 beats per minute is ideal.
Recent studies suggest a heart rate higher than 80 beats per minute when you’re resting may be linked to a higher risk of heart attack.
Myth 2: An erratic heart rate means I’m having a heart attack.
When your heart beats in an irregular pattern, you’re having what’s called palpitations. You may feel as if it skipped a beat or speeds up. Or it may seem like a brief flutter or a pounding in your chest.
Having an irregular heartbeat doesn’t mean you’re having a heart attack
Myth 3: If my pulse is fast, it always means I’m stressed out.
Stress is just one thing that can raise your pulse. Your heart rate may also speed up when you exercise, get excited, or feel anxious or sad.
When you stand up, your pulse may go up for 15 to 20 seconds before it goes back to normal. Even the weather, like high temperatures or humidity, can raise it.
Myth 4: If you have heart disease, you need to take it easy.
“For the vast majority of people with heart disease, avoiding physical activity is a bad idea. It can lead to blood clots in the legs and a decline in overall physical condition. Physical activity helps strengthen the heart muscle, improves blood flow to the brain and internal organs, and improves overall health and well-being.
What you can do: Ask doctor what kind of exercise would be right for you, and how much you should do. Most people can walk, and any amount of walking is good for your heart.
Myth 5: If you take a cholesterol-lowering drug, you can eat anything.
Cholesterol in the bloodstream comes from two sources—your liver makes some, and you get some from certain foods. CLD’s can reduce the amount of cholesterol made by the liver. This causes blood levels of cholesterol to drop, which, in turn, reduces the amount of cholesterol deposited in your arteries. If you take a CLD’s and continue to eat foods that are high in cholesterol plus saturated fat, the drug will not be as effective, and your cholesterol level will not fall, and may even rise.
What you can do: Limit your cholesterol and saturated fat intake, so your CLD’scan do their job.
Myth 6: It’s okay to have higher blood pressure when you’re older.
Blood pressure tends to rise with age, but the fact that this trend is “normal” doesn’t mean that it is good for you. It happens because artery walls become stiff with age. Stiff arteries force the heart to pump harder. This sets up a vicious cycle. Blood pounding against the artery walls damages them over time. The overworked heart muscle becomes less effective and pumps harder to meet the body’s demands for blood. This further damages the arteries and invites fat into the artery walls. This is how high blood pressure increases the risk of heart attack and stroke.
What you can do: Have your blood pressure checked. If it’s above 140/90 millimeters of mercury, ask your doctor what you can do to bring it down.
Myth 7: Diabetes won’t cause heart disease if you take diabetes medication.
Diabetes medication helps lower blood sugar levels. Maintaining normal blood sugar levels is important for preventing complications that affect the smaller blood vessels (micro vascular complications), such as kidney disease, loss of vision, erectile dysfunction, and nerve damage.
But blood sugar Medication has less effect on the large blood vessels that become inflamed and diseased, increasing the risk of heart attack and stroke.
What you can do: Take your diabetes medication to prevent micro vascular complications. Also do everything you can to lower high cholesterol and high blood pressure, stop smoking and drop extra weight. These measures will reduce your risk of heart disease and stroke.
Myth 8: You can lower your risk of heart disease with vitamins and supplements.
The antioxidant vitamins E, C, and beta carotene factor into lowering heart disease risk. However, clinical trials of supplementation with these vitamins have either failed to confirm benefit or were conducted in such a way that no conclusion could be drawn. The American Heart Association has stated that there is no scientific evidence to justify using these vitamins to prevent or treat cardiovascular disease.
What you can do: For reasons not yet understood, the body absorbs and utilizes vitamins and minerals best when they are acquired through foods. To ensure you get the vitamins and minerals you need, skip store-bought supplements and eat a wide variety of nutritious foods of every colour of the rainbow.
Myth 9: If you have smoked for years, you can’t reduce your risk of heart disease by quitting.
The benefits of quitting smoking start the minute you quit, no matter your age, how long you have smoked, or how many cigarettes a day you have smoked. Only one year after quitting, your heart attack risk will have dropped by 50%; in 10 years, it will be the same as if you never smoked.
What you can do: Seek help to quit smoking. Many people require stop-smoking aids, such as nicotine patches, nicotine gum, or a stop-smoking medication, to be successful.
Myth 10: Heart disease is really a man’s problem.
Since 1984, more women than men have died each year from heart disease. Heart disease is the leading cause of death in women over age 65, just as it’s the leading killer of men.
What you can do: Whether you are a man or a woman, ask your doctor to conduct a baseline heart examination that includes checking your cholesterol and blood pressure. Then follow your doctor’s recommendations.
Heart disease: Men vs. women
By retirement age, 70% of men and women have cardiovascular disease, which includes coronary artery disease, heart failure, stroke, and hypertension. Risk continues to rise, and by age 80, 83% of men and an even higher percentage of women—87%—are affected.
Myth 11: If you have heart disease, you should eat as little fats as possible.
It’s true you should eat a diet low in saturated fat, partially hydrogenated fat, and trans fat. But other fats, notably the unsaturated fats in vegetable oils and other foods, are beneficial. In fact, eating fish high in omega-3 fatty acids, such as salmon, twice a week can lower the risk of heart disease.
What you can do: Include low-fat dairy products, fatty fishes, nuts, and olive oil in your diet. If you eat meat, make sure the cuts are lean, and remove the skin from your poultry.
Myth 12: A small heart attack is no big deal.
“A small heart attack isn’t a big deal in terms of how well your heart can function. It may even pass unnoticed. But it’s a huge warning sign that you have serious heart disease, and your next heart attack may kill you
What you can do: Minimize your risk of heart attack by keeping your weight, cholesterol, and blood pressure in a normal range, not smoking, and seeing your doctor regularly to make sure no risk factors are elevated.
Myth 13: Angioplasty and stenting can “fix” your heart.
Angioplasty and stenting can do wonders for relieving chest pain (angina) and improving quality of life. But they don’t stop the underlying disease—atherosclerosis. Without correcting the problems that contribute to atherosclerosis, arteries will continue to become clogged with fatty plaque, which may mean the return of angina or worse—a heart attack or stroke.
What you can do: After undergoing angioplasty or bypass surgery, it’s important to correct the problems that led to the need for the procedure, such as high cholesterol or blood pressure, a poor diet, smoking, or lack of exercise.
MYTH 14: Bypass surgery is very painful and takes long to recover
With the present day medications, technology and anesthesia, bypass surgery has really become almost painless. In few selected patients, a special pain catheter is inserted in their back which makes the surgery totally painless. Most of the patients are on their foot on day 1 after surgery and are out of hospital in 7 days time. Most of the patients can go back and join work within a month’s time. If bypass is done through a small key-hole cut, patient can even join back work in 2 weeks time.
MYTH 15: Bypass surgery is very risky in Diabetic patients
Patients with blocked arteries also have diabetes. You will be surprised to know that bypass surgery is the most preferred therapy for diabetic patients. In all the scientific data, its very well established that bypass surgery gives a very long lasting result up to 25 years in diabetes patients. Bypass surgery is also much more superior over stenting or angioplasty.
MYTH 16: Bypass surgery operation fails after some time
With good lifestyle control, regular medications, a present day bypass operation usually lasts for at least 15 to 20 years. Some of the patients even celebrated their golden jubilee following bypass operation. In diabetic patients, however the disease process may progress faster and for this reason a very good diabetic control is mandatory.
MYTH 17: Exercise is restricted after bypass operation
Usual patients can perform all types of passive limb exercises after a month’s time. Passive yoga is very helpful for all types of bypass surgery patients. However, active treadmill should be avoided for at least 3 months after a bypass operation and to consult the surgeon or the cardiologist before starting treadmill exercise.
The tests you'll need to diagnose your heart disease depend on what condition your doctor thinks you might have. No matter what type of heart disease you have, your doctor will likely perform a physical exam and ask about your personal and family medical history before doing any tests. Besides blood tests and a chest X-ray, tests to diagnose heart disease can include:
· Electrocardiogram (ECG). An ECG records these electrical signals and can help your doctor detect irregularities in your heart's rhythm and structure. You may have an ECG while you're at rest or while exercising (stress electrocardiogram).
· Holter monitoring. A Holter monitor is a portable device you wear to record a continuous ECG, usually for 24 to 72 hours. Holter monitoring is used to detect heart rhythm irregularities that aren't found during a regular ECG exam.
· Echocardiogram. This noninvasive exam, which includes an ultrasound of your chest, shows detailed images of your heart's structure and function.
· Stress test. This type of test involves raising your heart rate with exercise or medicine while performing heart tests and imaging to check how your heart responds.
· Cardiac catheterization. In this test, a short tube (sheath) is inserted into a vein or artery in your leg (groin) or arm. A hollow, flexible and longer tube (guide catheter) is then inserted into the sheath. Aided by X-ray images on a monitor, your doctor threads the guide catheter through that artery until it reaches your heart.
The pressures in your heart chambers can be measured, and dye can be injected. The dye can be seen on an X-ray, which helps your doctor see the blood flow through your heart, blood vessels and valves to check for abnormalities.
· Cardiac computerized tomography (CT) scan. This test is often used to check for heart problems. In a cardiac CT scan, you lie on a table inside a doughnut-shaped machine. An X-ray tube inside the machine rotates around your body and collects images of your heart and chest.
· Cardiac magnetic resonance imaging (MRI). For this test, you lie on a table inside a long tube-like machine that produces a magnetic field. The magnetic field produces pictures to help your doctor evaluate your heart.
Heart disease treatments vary by condition. For instance, if you have a heart infection, you'll likely be given antibiotics. In general, treatment for heart disease usually includes:
· Lifestyle changes. These include eating a low-fat and low-sodium diet, getting at least 30 minutes of moderate exercise on most days of the week, quitting smoking, and limiting alcohol intake.
· Medications. If lifestyle changes alone aren't enough, your doctor may prescribe medications to control your heart disease. The type of medication will depend on the type of heart disease.
· Medical procedures or surgery. If medications aren't enough, it's possible your doctor will recommend specific procedures or surgery. The type of procedure will depend on the type of heart disease and the extent of the damage to your heart.
Orthopedics & Joint Replacement
“The prospect of walking around with finely-honed metal, plastic and ceramic in your knee or hip raises anxiety in some prospective joint replacement patients. Sometimes the anxiety felt by these patients can be due to myths that they have heard regarding joint replacement,” says McLeod Orthopedic Specialist Rodney Alan, MD. “Here’s the truth behind some myths that should help patients decide whether or not joint replacement is a good choice.”
During the physical exam, your doctor is likely to:
· Inspect your knee for swelling, pain, tenderness, warmth and visible bruising
· Check to see how far you can move your lower leg in different directions
· Push on or pull the joint to evaluate the integrity of the structures in your knee
In some cases, your doctor might suggest tests such as:
· X-ray. Your doctor may first recommend having an X-ray, which can help detect bone fractures and degenerative joint disease.
· Computerized tomography (CT) scan. CT scanners combine X-rays taken from many different angles, to create cross-sectional images of the inside of your body. CT scans can help diagnose bone problems and subtle fractures. A special kind of CT scan can accurately identify gout even when the joint is not inflamed.
· Ultrasound. This technology uses sound waves to produce real-time images of the soft tissue structures within and around your knee. Your doctor may want to move your knee into different positions during the ultrasound to check for specific problems.
· Magnetic resonance imaging (MRI). An MRI uses radio waves and a powerful magnet to create 3D images of the inside of your knee. This test is particularly useful in revealing injuries to soft tissues such as ligaments, tendons, cartilage and muscles.
If your doctor suspects an infection or inflammation, you're likely to have blood tests and sometimes a procedure called arthrocentesis, in which a small amount of fluid is removed from within your knee joint with a needle and sent to a laboratory for analysis.
Treatments will vary, depending upon what exactly is causing your knee pain.
Your doctor may prescribe medications to help relieve pain and to treat underlying conditions, such as rheumatoid arthritis or gout.
Strengthening the muscles around your knee will make it more stable. Your doctor may recommend physical therapy or different types of strengthening exercises based on the specific condition that is causing your pain.
If you are physically active or practice a sport, you may need exercises to correct movement patterns that may be affecting your knees and to establish good technique during your sport or activity. Exercises to improve your flexibility and balance also are important.
Arch supports, sometimes with wedges on one side of the heel, can help to shift pressure away from the side of the knee most affected by osteoarthritis. In certain conditions, different types of braces may be used to help protect and support the knee joint.
In some cases, your doctor may suggest injecting medications or other substances directly into your joint. Examples include:
· Corticosteroids. Injections of a corticosteroid drug into your knee joint may help reduce the symptoms of an arthritis flare and provide pain relief that may last a few months. These injections aren't effective in all cases.
· Hyaluronic acid. A thick fluid, similar to the fluid that naturally lubricates joints, hyaluronic acid can be injected into your knee to improve mobility and ease pain. Although study results have been mixed about the effectiveness of this treatment, relief from one or a series of shots may last as long as six months.
· Platelet-rich plasma (PRP). PRP contains a concentration of many different growth factors that appear to reduce inflammation and promote healing. These types of injections tend to work better in people whose knee pain is caused by tendon tears, sprains or injury.
If you have an injury that may require surgery, it's usually not necessary to have the operation immediately. Before making any decision, consider the pros and cons of both nonsurgical rehabilitation and surgical reconstruction in relation to what's most important to you. If you choose to have surgery, your options may include:
· Arthroscopic surgery. Depending on your injury, your doctor may be able to examine and repair your joint damage using a fiber-optic camera and long, narrow tools inserted through just a few small incisions around your knee. Arthroscopy may be used to remove loose bodies from your knee joint, remove or repair damaged cartilage (especially if it is causing your knee to lock), and reconstruct torn ligaments.
· Partial knee replacement surgery. In this procedure, your surgeon replaces only the most damaged portion of your knee with parts made of metal and plastic. The surgery can usually be performed through small incisions, so you're likely to heal more quickly than you are with surgery to replace your entire knee.
· Total knee replacement. In this procedure, your surgeon cuts away damaged bone and cartilage from your thighbone, shinbone and kneecap, and replaces it with an artificial joint made of metal alloys, high-grade plastics and polymers.
Neurology & Neurosurgery
Neurosurgery is surgery of the nervous system.
Most people think of neurosurgery as brain surgery — but it is much more!
It is the medical specialty concerned with the diagnosis and treatment of of patients with injury to, or diseases/disorders of the brain, spinal cord and spinal column, and peripheral nerves within all parts of the body. The specialty of neurosurgical care includes both adult and pediatric patients. Dependent upon the nature of the injury or disease a neurological surgeon may provide surgical and/or non-surgical care.
Neurology (from Greek: νεῦρον (neûron), "string, nerve" and the suffix -logia, "study of") is a branch of medicine dealing with disorders of the nervous system. Neurology deals with the diagnosis and treatment of all categories of conditions and disease involving the central and peripheral nervous systems (and their subdivisions, the autonomic and somatic nervous systems), including their coverings, blood vessels, and all effector tissue, such as muscle. Neurological practice relies heavily on the field of neuroscience, the scientific study of the nervous system.
A neurologist is a physician specializing in neurology and trained to investigate, or diagnose and treat neurological disorders. Neurologists may also be involved in clinical research, clinical trials, and basic or translational research. While neurology is a nonsurgical specialty, its corresponding surgical specialty is neurosurgery.
Significant overlap occurs between the fields of neurology and psychiatry, with the boundary between the two disciplines and the conditions they treat being somewhat nebulous.
IVF - In Viftro Fertilization
a medical procedure whereby an egg is fertilized by sperm in a test tube or elsewhere outside the body.
Fast facts about in-vitro fertilization (IVF)
In-vitro fertilization (IVF) can help achieve pregnancy when other treatments have not worked.
The process involves fertilizing an egg outside the body, and implanting it to continue the pregnancy.
One percent of babies born in the United States are conceived through IVF.
There is a higher chance of a multiple birth with IVF.
ENT - Ear Nose and Throat
Symptoms of Heart Problems in Babies
Babies are used to receiving lower amounts of oxygen when they are in the womb. After birth, however, their oxygen levels should be the same as a healthy adult. When a baby is receiving less oxygen than normal, their skin may appear bluish. This is called cyanosis. Many hospitals and states are routinely checking the oxygen level of newborn babies using a simple, painless test called pulse oximetry.
The main job of a baby is to feed well and grow. When this is not happening, it could be due to the effects of congestive heart failure, or an inability of the body to keep up with the demands of an inefficient circulation.
Babies can breathe faster than normal and appear as if they are panting. This fast breathing is called tachypnea. Since heart problems can cause the baby to use more energy, poor feeding and inadequate weight gain can occur.
Excessive sweating with feeding (diaphoresis), can also occur, but is less common.
Symptoms of Heart Problems in Toddlers
Toddlers seem to be built to wear out parents. A toddler who seems to be shortness of breath too often, fatigued and unable to keep up with other children, it can sometimes signal a heart problem. Because toddlers do not have well-developed vocabulary, they often cannot accurately describe what they are feeling. For example, a toddler may describe an abnormal heart rhythm (arrhythmia) as “heart beeping,” “heart owie,” or “heart squeeze.” Or they may simply point to the chest.
Passing out (syncope) is less common in toddlers, but it can occur in rare situations.
Also, some young children are diagnosed as having “seizures” that are actually cardiac events.
Symptoms of Heart Problems in Older Children and Teenagers
Some older children and teenagers are very aware of what is going on in their bodies. Others are not. Some can feel every abnormal heartbeat, while others have no sensation of arrhythmia. Anytime a child passes out (syncope) with exercise, he or she should be carefully evaluated.
Excessive shortness of breath with activity can be difficult to distinguish from asthma, which is very common.
Unlike in adults, chest pain rarely indicates a cardiac condition in children, but a doctor should be notified if chest pain occurs with exercise.
When evaluating for heart problems in children, it is important to have a good understanding of the family history on both the mother’s and the father’s side. The child's care team should be aware of any sudden, unexplained death in the family as well as any seizure disorders, drownings, arrhythmias, other children born with heart problems and abnormal heart function (cardiomyopathies).
Oncology & Bone Marrow Transplant
HepatoBilliary & Liver Transplant
Endocrinology - Diabetes
Endocrinology is the study of medicine that relates to the endocrine system, which is the system that controls hormones. Endocrinologists are specially trained physicians who diagnose diseases related to the glands. Because these doctors specialize in these conditions, which can be complex and have hard-to-spot symptoms, an endocrinologist is your best advocate when dealing with hormonal issues.
Most patients begin their journey to the endocrinologist with a trip to their primary care provider or family doctor. This doctor will run a series of tests to see what could be the potential problem the patient is facing. If a problem with the hormones is suspected, the primary care doctor will provide a referral. The endocrinologist's goal is to restore hormonal balance in the body.
What Do Endocrinologists Do?
They cover a lot of ground, diagnosing and treating conditions that affect your:
Adrenals, glands that sit on top of your kidneys and help to control things like your blood pressure, metabolism, stress response, and sex hormones
Bone metabolism, like osteoporosis
Hypothalamus, the part of your brain that controls body temperature, hunger, and thirst
Pancreas, which makes insulin and other substances for digestion
Parathyroids, small glands in your neck that control the calcium in your blood
Pituitary, a pea-sized gland at the base of your brain that keeps your hormones balanced
Reproductive glands (gonads): ovaries in women, testes in men
Thyroid, a butterfly-shaped gland in your neck that controls your metabolism, energy, and brain growth and development
Nephrology & Kidney(Renal) Transplant
Opthalmology - Eyecare
Urology & Urosurgery
Gastroenterology & GI Surgery
Dental and Maxillofacial Surgery
Oral and Maxillofacial Surgeons are specialists in the diagnosis and treatment of a broad range of disorders affecting the facial complex and skeleton, including the jaws and oral cavity.
Contemporary training in both medicine and dentistry enables oral & maxillofacial surgeons to treat conditions requiring expertise in both fields. These include a range of common oral surgical problems (eg. impacted teeth, dental implants), jaw and congenital facial disproportion, facial trauma, oral cancer, salivary gland disease, temporomandibular joint disorders, and various benign pathologies (eg. cysts and tumours of the jaws).
Following the acquisition of dental and medical degrees, prospective trainees must complete basic general surgical training as residents and then apply to be selected into one one of the six Oral and Maxillofacial Surgery training Centres. Specialty training involves four years with an examination in the first year and the final examination in the fourth year. Oral and Maxillofacial Surgery training, together with a compulsory research component and the final Fellowship qualification, are recognized by both the Australian Medical Council and the Australian Dental Council. The training, accreditation and examination requirements are administered by the Board of Studies in Oral and Maxillofacial Surgery within the Royal Australasian College of Dental Surgeons.
Patients are referred to an Oral and Maxillofacial Surgeon by both general and specialist dental and medical practitioners. In many instances, Oral and Maxillofacial Surgeons work in collaboration with other specialists such as orthodontists, ear nose and throat surgeons, plastic and reconstructive surgeons and oncologists as part of multidisciplinary teams to optimise the treatment of major conditions and diseases of the mouth, faces and jaws.
Cosmetic / Plastic Surgery
Cosmetic surgery is a type of plastic surgery that aims to improve a person's appearance, but it should be approached with caution.
Procedures are available for almost any part of the body, but the choice to undergo cosmetic surgery should not be taken lightly. The results are often permanent, so it is important to be sure about the decision, to use an appropriate practitioner, and to have the right motivation.
A surgeon may refer a patient for counseling before surgery if they believe there is an underlying problem that cannot be solved by the surgery, or if the patient shows signs of Body Dysmorphic Disorder (BDD).
BDD can cause a person to perceive that there is something seriously wrong with their appearance, when objective evidence suggests otherwise.
Reconstructive surgery is another type of plastic surgery. It aims to improve function and to give a normal appearance to a part of the person's body that has been damaged, for example, after a mastectomy.
Gynecology & Obstetrics
mother & child
minimally invasive surgery