Kidney cancer can be a surprise

  • By Pace Hospitals
  • 25 Jul, 2017

Kidney Cancer refers to the Cancer that can originate in the kidneys. Kidney cancer ranks among the top 10 most cancers in both men and women. 

The incidence of Kidney Cancer has been increasing in recent times as it is being now more frequently detected with improved diagnostic techniques, imaging technologies and general health awareness among general population. According to The American Cancer Society statistics around 65,000 new cases of kidney cancer will occur in 2017 and about 14,400 people will die from the disease. The average age to develop kidney cancer is 64 years. Life time risk of developing a kidney cancer is 1 in 63 (1.6%). Unlike other cancers, as prostate, cervix or breast, there is no recommended screening test for kidney cancer. Since kidney cancers do not usually produce any signs or symptoms, it is easy to go unnoticed until the disease has progressed.

Hence it becomes important for those at a higher risk of developing the disease to know to the symptoms that can occur and consult their urologist.

SYMPTOMS

The common symptoms of Kidney Cancer are:-

·        Blood in urine

·        Pain in back

·        Weight loss , decreased appetite

·        Excessive fatigue

·        Lump in abdomen

CAUSES & RISK FACTORS

Kidney Cancer is caused by the genetic mutation of cells turning them from normal to abnormal cells in the kidney. The exact cause of the mutation is yet unascertained. Some of the factors that increase the risk of kidney cancer are:

·        Obesity & excess body weight

·        Type-2 diabetes

·        Family history of kidney cancer

·        Excessive smoking

Other kidney disorders

A variety of genetic and lifestyle choices can increase one’s risk of developing kidney cancer, including family history, obesity, smoking and some inherited conditions.

DIAGNOSTIC TESTS

Includes blood tests, urinalysis, a CT scan/MRI scan and in rare cases a biopsy. A CT scan helps us identify a growth in the kidney, its spread and usually determine if it is malignant. 


TREATMENT  

The treatment approach depends on the patient’s condition as well as the stage and size of the tumor. If treatment is recommended, tumor removal with minimally invasive techniques using laparoscopy are preferred over larger-open incision approaches, which scores by reducing pain, hospitalization and recovery time. Treatment for a patient whose cancer has metastasized (spread beyond kidney) typically involves removal of the affected kidney followed by chemotherapy. If you have concerns or questions about kidney cancer, talk with your urologist.

By Pace Hospitals 15 Nov, 2017
If you have blood in urine, vomiting, or painful when urinate, you may have kidney stone. Technically, kidney stone is a solid piece of material that occurs in the urinary tract. It is normal if there is a small stone in your kidney. A small stone may pass and leave the body in the urine stream without causing symptoms. But if the stone grows to more than 5 millimeters, it definitely can cause blockage of the ureter.

Here are 5 best steps in preventing kidney stone you should follow.

  1. Drink Extra Water:  This first step is not a secret anymore. The fact, water can dilute the substances in urine that lead to stone. So, make sure that you drink enough fluids to pass 2 liters of urine a day. Another fact said that citrus beverages such as lemonade and orange juice are also beneficial to help kidney stone.

  2. Don’t Do Some Heavy Exercises:  Exercise seems as a healing of every disease, but the heavy one may worsen your condition. Some other activities such as sauna, hot yoga are not good either. Those activities can make you loss of water through sweating and it will leads to less urine production.

  3. Get the Calcium:  Having enough calcium is good as a prevention of kidney stone. Getting too little calcium can cause oxalate levels to rise and cause kidney stone. So, make sure that you take enough calcium appropriate to your age. Men 50 and older should get 1000 mg of calcium per day.

  4. Avoid the Trigger Foods:  A number of foods such as beets, chocolate, spinach, tea and most nuts are rich in oxalate. Those can lead you to kidney stone. Avoiding these foods are vital.

  5. Reduce Sodium:  High-sodium diet may increase the amount of calcium in your urine so it can trigger kidney stone. You are highly recommended to do a low-sodium diet. This diet is also good for your blood pressure and heart.

If you have kidney stone, book an appointment with:

Dr Shyam Varma
Advanced Laser & Laparoscopic Urologist,
Andrologist and Renal Transplant Surgeon
By Pace Hospitals 13 Nov, 2017
The University of Southampton has revealed their findings after a 15 year study of liver cirrhosis in more than 4,00,000 patients, and coffee has come out as the top antidote to heavy drinking. It took multiple scientists and doctors to come up with their best solution to reduce liver damage, and all were shocked that a few simple cups of coffee had the most significant healing power.

“Cirrhosis is potentially fatal and there is no cure as such. Therefore, it is significant that the risk of developing cirrhosis may be reduced by the consumption of coffee: a cheap, ubiquitous and well-tolerated beverage.”  

There are slightly more fatal cases of liver cirrhosis in males than females, and most prominent in individuals aged between 25-34, according to the National Institute of Alcohol and Alcohol Abuse. In the United States approximately 24% of the population engages in binge drinking, which causes 88000 deaths per year. Of that, almost half are liver-damage related.

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Does More Coffee Make Your Liver Merrier?
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One cup of coffee per day reduces the risk by 22%, two cups by 44%, 3 cups by 56% and 4 cups by 65%, showing that the compound effect declines slightly, but that the percentage is still remarkable per extra cup.

It was thereafter suggested that 2-4 cups of pure, filtered coffee per day would produce the maximum results, and that any additional cups would have a negative effect on the rest of the body due to the caffeine and acidity load.

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How Do I Know if I am Drinking Too Much?
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While there is no global consensus of how much alcohol exceeds the health limit, an average of governmental recommendations show that the benchmark sits at 14 units per week, which equates to about two glasses of wine taken daily or 8-10 grams of pure alcohol. Binge drinking has proven to have detrimental and compound damaging effects on your body, with your liver taking the biggest knock.

The major symptoms of liver cirrhosis include:

  • Fatigue
  • Weight Loss
  • Loss of Appetite
  • Frequent Nose Bleeds
  • Visible Spider-shaped Arteries Under the Skin
  • Swollen legs
  • Severe Itching
  • Abdominal Swelling
  • Jaundice/Yellowing of the Skin
The Good News is that your liver is an organ which regenerates cells annually, and can recover from the effects of heavy drinking, which cause liver cirrhosis.

The scar tissue caused by alcohol damage can be reduced and healed back into health, and coffee is the perfect beverage to support its path to a healthy condition. Up to 69% of Americans are undiagnosed with this condition, and up to one million people die per year from it.

Diagnosis involves observing symptoms, and completing a liver scan at your local medical centre. By cutting down the consumption of alcoholic beverages and adding a few cups of coffee to your day, you reduce the risk of fatality dramatically.

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Why Coffee?
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Studies are still ongoing, but the previous nine extensive studies have revealed that the powerful antioxidants, the caffeine and the excellent anti-inflammatory properties contained in coffee, such as chlorogenic acid, kahweol and cafestol are the reason behind its remarkable effect on damaged livers. By reducing inflammation, healing oxidative and corrosive stress and giving your body a healthy dose of circulation-inducing caffeine, your liver has the chance to recover from poor lifestyle choices made over a number of years.


References:  http://www.getholistichealth.com
By Pace Hospitals 26 Oct, 2017
Kidney stones have many causes and can affect any part of your urinary tract — from your kidneys to your bladder. Often, stones form when the urine becomes concentrated, allowing minerals to crystallize and stick together.

Passing kidney stones can be quite painful, but the stones usually cause no permanent damage if they're recognized in a timely fashion. Depending on your situation, you may need nothing more than to take pain medication and drink lots of water to pass a kidney stone. In other instances — for example, if stones become lodged in the urinary tract, are associated with a urinary infection or cause complications — surgery may be needed.

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Symptoms
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A kidney stone may not cause symptoms until it moves around within your kidney or passes into your ureter — the tube connecting the kidney and bladder. At that point, you may experience these signs and symptoms:

  • Severe pain in the side and back, below the ribs
  • Pain that radiates to the lower abdomen and groin
  • Pain that comes in waves and fluctuates in intensity
  • Pain on urination
  • Pink, red or brown urine
  • Cloudy or foul-smelling urine
  • Nausea and vomiting
  • Persistent need to urinate
  • Urinating more often than usual
  • Fever and chills if an infection is present
  • Urinating small amounts

Pain caused by a kidney stone may change — for instance, shifting to a different location or increasing in intensity — as the stone moves through your urinary tract.

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Causes
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Kidney stones often have no definite, single cause, although several factors may increase your risk.

Kidney stones form when your urine contains more crystal-forming substances — such as calcium, oxalate and uric acid than the fluid in your urine can dilute. At the same time, your urine may lack substances that prevent crystals from sticking together, creating an ideal environment for kidney stones to form.

Types of kidney stones include:

  • Calcium stones. Most kidney stones are calcium stones, usually in the form of calcium oxalate. Oxalate is a naturally occurring substance found in food and is also made daily by your liver. Some fruits and vegetables, as well as nuts and chocolate, have high oxalate content.

    Dietary factors, high doses of vitamin D, intestinal bypass surgery and several metabolic disorders can increase the concentration of calcium or oxalate in urine.

    Calcium stones may also occur in the form of calcium phosphate. This type of stone is more common in metabolic conditions, such as renal tubular acidosis. It may also be associated with certain migraine headaches or with taking certain seizure medications, such as topiramate (Topamax).
  • Struvite stones. Struvite stones form in response to an infection, such as a urinary tract infection. These stones can grow quickly and become quite large, sometimes with few symptoms or little warning.

  • Uric acid stones. Uric acid stones can form in people who don't drink enough fluids or who lose too much fluid, those who eat a high-protein diet, and those who have gout. Certain genetic factors also may increase your risk of uric acid stones.

  • Cystine stones. These stones form in people with a hereditary disorder that causes the kidneys to excrete too much of certain amino acids (cystinuria).
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Risk factors
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Factors that increase your risk of developing kidney stones include:

  • Family or personal history . If someone in your family has kidney stones, you're more likely to develop stones, too. And if you've already had one or more kidney stones, you're at increased risk of developing another.

  • Dehydration. Not drinking enough water each day can increase your risk of kidney stones. People who live in warm climates and those who sweat a lot may be at higher risk than others.

  • Certain diets. Eating a diet that's high in protein, sodium (salt) and sugar may increase your risk of some types of kidney stones. This is especially true with a high-sodium diet. Too much salt in your diet increases the amount of calcium your kidneys must filter and significantly increases your risk of kidney stones.

  • Being obese. High body mass index (BMI), large waist size and weight gain have been linked to an increased risk of kidney stones.

  • Digestive diseases and surgery. Gastric bypass surgery, inflammatory bowel disease or chronic diarrhea can cause changes in the digestive process that affect your absorption of calcium and water, increasing the levels of stone-forming substances in your urine.

  • Other medical conditions. Diseases and conditions that may increase your risk of kidney stones include renal tubular acidosis, cystinuria, hyperparathyroidism, certain medications and some urinary tract infections.

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Diagnosis

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If urologist suspects you have a kidney stone, you may have diagnostic tests and procedures, such as:

  • Blood testing. Blood tests may reveal too much calcium or uric acid in your blood. Blood test results help monitor the health of your kidneys and may lead your doctor to check for other medical conditions.
  • Urine testing. The 24-hour urine collection test may show that you're excreting too many stone-forming minerals or too few stone-preventing substances. For this test, your doctor may request that you perform two urine collections over two consecutive days.
  • Imaging. Imaging tests may show kidney stones in your urinary tract. Options range from simple abdominal X-rays, which can miss small kidney stones, to high-speed or dual energy computerized tomography (CT) that may reveal even tiny stones.
  • Other imaging options include an ultrasound, a noninvasive test, and intravenous urography, which involves injecting dye into an arm vein and taking X-rays (intravenous pyelogram) or obtaining CT images (CT urogram) as the dye travels through your kidneys and bladder.
  • Analysis of passed stones. You may be asked to urinate through a strainer to catch stones that you pass. Lab analysis will reveal the makeup of your kidney stones. Your doctor uses this information to determine what's causing your kidney stones and to form a plan to prevent more kidney stones.
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Treatment
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Certain medications have been shown to improve the chance that a stone will pass. The most common medication prescribed for this reason is tamsulosin. Tamsulosin (Flomax) relaxes the ureter, making it easier for the stone to pass. You may also need pain and anti-nausea medicine as you wait to pass the stone.

Kidney stones that can't be treated with conservative measures — either because they're too large to pass on their own or because they cause bleeding, kidney damage or ongoing urinary tract infections — may require more-extensive treatment. 

Surgery may be needed to remove a stone from the ureter or kidney if:

  • The stone fails to pass.
  • The pain is too great to wait for the stone to pass.
  • The stone is affecting kidney function. Small stones in the kidney may be left alone if they are not causing pain or infection. Some people choose to have their small stones removed. They do this because they are afraid the stone will unexpectedly start to pass and cause pain.
Kidney stones should be removed by surgery if they cause repeated infections in the urine or because they are blocking the flow of urine from the kidney. Today, surgery usually involves small or no incisions (cuts), minor pain and minimal time off work. Surgeries to remove stones in the kidneys or ureters are:

  • Shock wave lithotripsy (SWL):  Shock Wave Lithotripsy (SWL) is used to treat stones in the kidney and ureter. Shock waves are focused on the stone using X-rays or ultrasound to pinpoint the stone. Repeated firing of shock waves on the stone usually causes the stone to break into small pieces. These smaller pieces of stones pass out in the urine over a few weeks.
  • Ureteroscopy (URS):  Ureteroscopy (URS) is used to treat stones in the kidney and ureter. URS involves passing a very small telescope, called an ureteroscope, into the bladder, up the ureter and into the kidney. Rigid telescopes are used for stones in the lower part of the ureter near the bladder. Flexible telescopes are used to treat stones in the upper ureter and kidney.
  • Percutaneous nephrolithotomy (PCNL):  Percutaneous Lithotripsy (PCNL) is the best treatment for large stones in the kidney. General anesthesia is needed to do a PCNL. PCNL involves making a half-inch incision (cut) in the back or side, just large enough to allow a rigid telescope (nephroscope) to be passed into the hollow center part of the kidney where the stone is located.
  • Other surgery:  Other kidney surgery is rarely used to remove stones. 

Open, Laser, Laparoscopic or robotic surgery may be used only if all other less invasive procedures fail.  If you have Kidney stone better to consult with Urologist before going for surgery or medication.


Book an appointment :

Dr Shyam Varma
Consultant Laser, Laparoscopic Urologist, Andrologist and Kidney Transplant Surgeon

By Pace Hospitals 20 Oct, 2017

Osteoporosis is a occurs due to decrease in the density of bone, decreasing its strength and resulting in fragile bones. Osteoporosis leads to abnormally porous bone that is compressible, like a sponge. This weakens the bone and results in frequent fractures (breaks) in the bones.

Normal bone is composed of protein, collagen, and calcium, all of which give bone its strength. Bones that are affected by osteoporosis can break (fracture) with relatively minor injury that normally would not cause a bone to fracture. The fracture can be either in the form of cracking (as in a hip fracture) or collapsing (as in a compression fracture of the vertebrae of the spine). The spine, hips, ribs, and wrists are common areas of bone fractures from osteoporosis although osteoporosis-related fractures can occur in almost any skeletal bone.

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Factors that will help developing osteoporosis: 
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  • Family history of osteoporosis
  • Thin and small body frame
  • Caucasian or Asian race
  • Thin and small body frame
  • Personal history of fracture as an adult
  • Smoking Cigarette
  • Alcohol consumption
  • Lack of exercise
  • Diet low in calcium
  • Poor nutrition and poor general health, especially associated with chronic inflammation or bowel disease
  • Gastrointestinal disorder
  • Early menopause or with early surgical removal of both ovaries
  • Low testosterone levels in men
  • Chemotherapy that can cause early menopause due to its toxic effects on the ovaries
  • Chronic inflammation, due to chronic inflammatory arthritis or diseases, such as rheumatoid arthritis or liver diseases
  • Immobility, such as after a stroke, or from any condition that interferes with walking
  • Hyperthyroidism, a condition wherein too much thyroid hormone is produced by the thyroid gland
  • When vitamin D is lacking, the body cannot absorb adequate amounts of calcium from the diet to prevent osteoporosis.
  • Certain medications can cause osteoporosis.

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Symptoms and signs
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Osteoporosis can be present without any symptoms for decades because osteoporosis doesn't cause symptoms until bone breaks (fractures). Moreover, some osteoporotic fractures may escape detection for years when they do not cause symptoms. Therefore, patients may not be aware of their osteoporosis until they suffer a painful fracture. The symptom associated with osteoporotic fractures usually is pain; the location of the pain depends on the location of the fracture. The symptoms of osteoporosis in men are similar to the symptoms of osteoporosis in women.

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Osteoporosis consequences
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  • Osteoporotic bone fractures are responsible for considerable pain, decreased quality of life, lost workdays, and disability.
  • Up to 30% of patients suffering a hip fracture will require long-term nursing-home care. Elderly patients can develop pneumonia and blood clots in the leg veins that can travel to the lungs (pulmonary embolism) due to prolonged bed rest after the hip fracture.
  • Osteoporosis has even been linked with an increased risk of death. Some 20% of women with a hip fracture will die in the subsequent year as an indirect result of the fracture.
  • In addition, once a person has experienced a spine fracture due to osteoporosis, he or she is at very high risk of suffering another such fracture in the near future (next few years).
  • About 20% of postmenopausal women who experience a vertebral fracture will suffer a new vertebral fracture of bone in the following year.

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How to determine bone strength
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Bone mass (bone density) is determined by the amount of bone present in the skeletal structure. Generally, the higher the bone density, the stronger the bones. Bone density is greatly influenced by genetic factors, which in turn are sometimes modified by environmental factors and medications.

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Person should go for bone density testing
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  • All postmenopausal women below age 65 who have risk factors for osteoporosis
  • All women aged 65 and older
  • Postmenopausal women with fractures, although this is not mandatory because treatment may well be started regardless of bone density
  • Women with any of more than 50 medical conditions associated with osteoporosis; a primary care physician can scan a patient's list of medical illnesses to determine if one of these conditions is present (see causes above)
  • Women whose decision to begin treatment for osteoporosis might be aided by bone density testing to determine the presence or absence of osteoporosis or osteopenia

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Treatment for osteoporosis
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Although early detection and timely treatment of osteoporosis can substantially decrease the risk of future fractures, none of the available treatments for osteoporosis are complete cures. Therefore, prevention of osteoporosis is as important as treatment.

  • Quitting cigarette smoking
  • Curtailing excessive alcohol intake
  • Exercising regularly
  • Consuming a balanced diet with adequate calcium and vitamin D
  • Medications that stop bone loss and increase bone strength

The outlook for patients with osteoporosis depends greatly on where fractures occur. Additionally, if treatment is begun when the bone disease is detected early, the outcome is better. Get the expert consultation before going for treatment.


Book an appointment:

Dr Jayini P Rammohen
Consultant Orthopedics, Sports Medicine Specialist and Joint Replacement Surgeon

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Dr Anand V Agroya
Consultant Orthopedics & Trauma Surgeon, Specialist in Joint Replacement

 

By Pace Hospitals 18 Oct, 2017

Quitting smoking may be one of the best things you can do for your health and for your fertility.

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Smoking can cause infertility.
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Smokers are more likely to have fertility problems . If you smoke for many years, or smoke many cigarettes per day, your risk for fertility is increased.

When you smoke, more than 7000 chemicals spread throughout your entire body simultaneously all of your organs. This can lead to fertility problems, including the following:

  • Genetic issues
  • Ovulation problems
  • Damage to your reproductive organs
  • Damage to your eggs or premature menopause.
  • Increased risk of cancer and increased risk of miscarriage

In addition, smokers that try fertility treatments tend to take longer to get pregnant. Smokers are also more likely to give birth to babies with health problems.

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Passive smoking can also affect your fertility.
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  • If you live with a smoker or surrounded by smoker, Passive smoking exposes you to poisonous chemicals, affecting your fertility. In fact, experts say that passive smoking is almost as damaging to your fertility as if you were smoking yourself! Exposure to cigarette smoke for even just a few days can affect your health and your fertility.
  • Passive smoking is also a known cause of Sudden Infant Death Syndrome (SIDS). If you do become pregnant, you and your partner must stop smoking to protect the health of your baby.

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Smoking increases the chance of miscarriage
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  • The pain of miscarriage can be devastating. Due to the toxins from smoking, smokers are more likely to suffer from miscarriage. In addition, smoking increases several health risks during pregnancy, such as preterm labor and ectopic pregnancy.
  • Despite these warnings, millions of women of childbearing age still continue to smoke. By doing so, they risk their own health and the health of their babies.

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Smoking causes fertility problems for men.
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Men that smoke cigarettes are at an increased risk for the following male fertility problems:

  • Hormonal issues
  • Erectile dysfunction - trouble getting or maintaining an erection
  • Lower sperm count and sperm motility problems (motility is the ability of sperm to swim towards and penetrate the egg)

If you are trying to get pregnant without success and your partner smokes, encourage him to quit. The sooner he quits, the sooner you may be able to conceive.

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Stop smoking to increase your chances of getting pregnant.
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Fertility often improves for women after they stop smoking. Studies show that female smokers can increase their chances of conceiving by quitting at least two months before trying to get pregnant. Quit smoking and you may just find it easier to get pregnant.

Make an appointment with your doctor today and find out how to kick the habit for good.

Book an appointment with:

Dr. Shyam Varma
Laser, Laparoscopic Urologist and
Kidney Transplant Surgeon


By Pace Hospitals 14 Oct, 2017
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What is swine flu?
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Influenza, commonly known as the “flu”, is an acute infection of the respiratory tract caused by influenza viruses. There are three types of seasonal influenza viruses – A, B and C. Influenza A viruses are further categorized into subtypes. Seasonal influenza epidemics can be caused by new virus strains that are antigenically distinct from previously circulating virus strains to which a population has immunity; this is known as antigenic drift.

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How it transmit?
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Influenza viruses are spread from person-to-person. They can be transmitted by exposure to infectious droplets expelled by coughing or sneezing that are then inhaled, or can contaminate hands or other surfaces. Most persons ill with influenza shed virus (i.e. may be infectious) from a few days before symptoms begin through 5-7 days after illness onset.

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Clinical features
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Infection with influenza viruses can give rise to a wide range of clinical presentations, ranging from asymptomatic infection to severe illness and death depending on the characteristics of both the virus and the infected person. In the majority of people, influenza is an uncomplicated illness which is characterised by sudden onset of constitutional and respiratory symptoms such as fever, myalgia, cough, sore throat, rhinitis and headache. Uncomplicated influenza illness resolves after 3-7 days although cough and malaise can persist for >2 weeks.
  • Uncomplicated influenza: ILI (Influenza-like illness) may present with fever, cough, sore throat, coryza, headache, malaise, myalgia, arthralgia and sometimes gastrointestinal symptoms, but without any features of complicated influenza.
  • Complicated/severe influenza: Influenza requiring hospital admission and/or with symptoms and signs of lower respiratory tract infection (hypoxaemia, dyspnoea, tacchypnoea, lower chest wall indrawing and inability to feed), central nervous system involvement and/or a significant exacerbation of an underlying medical condition. 
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Risk factors for complicated/severe influenza:
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  • Pregnant women (including the post-partum period)
  • HIV–infected individuals
  • Individuals with tuberculosis
  • Persons of any age with chronic disease, including:
  • Pulmonary diseases (e.g. asthma, COPD)
  • Immunosuppression (e.g. persons on immunosuppressive medication, malignancy)
  • Cardiac diseases (e.g. congestive cardiac failure)
  • Metabolic disorders (e.g. diabetes)
  • Renal disease
  • Hepatic disease
  • Certain neurologic and neurodevelopmental conditions, including: disorders of the brain, spinal cord, peripheral nerve, and muscle such as cerebral palsy; epilepsy (seizure disorders); stroke; mental retardation; moderate to severe developmental delay; muscular dystrophy; or spinal cord injury.
  • Haemoglobinopathies (e.g. sickle cell disease)
  • Persons aged ≥65 years
  • Persons ≤18 years receiving chronic aspirin therapy
  • Persons who are morbidly obese (i.e. BMI ≥40)[23]
  • Young children (particularly <2 years of age)
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Prevention of influenza 
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Influenza vaccination is the most effective method for prevention and control of influenza infection available currently. In general, influenza vaccines are most effective among children ≥ 2 years and healthy adults.

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Influenza vaccination 
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Because of the changing nature of influenza viruses, WHO monitors the epidemiology of influenza viruses throughout the world. Each year recommendations about strains to be included in the vaccine for the following influenza season are made. Separate recommendations are made for the Southern and Northern Hemisphere vaccines each year.


Consult for medical advise. Book an appointment with 

Dr Sudhaker Barla
Consultant Physician, Diabetologist and Intensivist

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