Glaucoma

Glaucoma – The Silent Thief of Sight

Glaucoma is an ailment that affects the eyes. It is one of the leading cause of blindness in the world with 65 million people suffering from this condition. It is also the second major cause of blindness, first one being cataract. The prevalence of Glaucoma is highest in African nations followed by Asia. It is a matter of grave concern that of all the people suffering from Glaucoma, 5% eventually lose their sight. Even with appropriate treatment 10% people still experience significant loss in sight.

What is Glaucoma ?
Glaucoma is a condition of optic nerve damage. Optic nerve is the channel through which the images captured through our eyes are transmitted to the vision centre of our brain. When this nerve deteriorates slowly over a period of time, we gradually lose our sense of sight.

Our eye contains a clear fluid, called aqueous humour, that keeps the eye healthy by nourishing various internal parts like cornea and the lens. This fluid periodically get drained through the drainage system of the eye to maintain the pressure inside the eye cavity. In Glaucoma, pressure inside the eye cavity increases due to fluid build up, usually in the front part. This progressively strains the optic nerve and causes irreversible damage to it. Surprisingly a person loses as much as 40% of vision without even realizing it.

What are the types of Glaucoma ?
There are two major types of Glaucoma, as described below.

  • Primary Open-angle Glaucoma: It is most the common type that is caused due to inadequate drainage of the fluid inside the eye. It is usually painless and detected quite late. So early examination can help detect early signs of optic nerve damage.
  • Primary angle-closure Glaucoma: When the drainage angle is narrow or blocked in eye pressure builds up. This type of Glaucoma may present with an “acute attack”, which is a medical emergency. Many people with angle closure develop slowly. So, if not detected and treated early, can lead to blindness.

What are the risk factor for development of Glaucoma ?
Though Glaucoma can develop in any person, there are certain risk factors associated with this condition.

  • Family history of Glaucoma
  • Age more than 40 years
  • Medical conditions that builds high eye pressure
  • Diabetes, Hypertension
  • Chronic steroid use

What are the symptoms of Glaucoma ?
Most people do not realize any issue in vision until the damage is quite severe. The process of optic nerve damage is irreversible and that’s why Glaucoma is called the “Silent Thief of Sight”.
Only regular eye examination can detect the condition. Sometimes acute angle closure Glaucoma can present with severe headache, blurring of vision, severe pain and redness of eyes.

How can Glaucoma be prevented?
As stated earlier, it is not a preventable condition; buyt, it can be controlled. Regular eye check-up is the best course of action to control Glaucoma. The diagnosis tests generally include:

  • Eye pressure check
  • Visualization of drainage angle
  • Examination of optic nerve
  • Visual field evaluation
  • Photograph of optic nerve
  • Measurement of thickness of Cornea

How is Glaucoma treated / controlled ?

  • Medical treatment like eye drop
  • Surgical treatment if not controlled with drops
  • Laser treatment
Paleo-Diet

PALEO DIET – Should I go for it?

Being a Nutritionist, I am frequently asked by various health-watchers about FAD diets, crash diets and whether to opt for a change over to an entirely different diet plan. And one frequently asked the question is about the Paleo diet.

Hence, today we would explore the do’s and don’ts and the Pros and Cons of this diet so as to throw light on better understanding for the practical implementation of the Paleo diet in the Indian scenario.

You are what you eat – and perhaps surprisingly, you also are what your ancestors ate – Jack Challem

Developed by Loren Cordain, Ph.D., a researcher from Colorado State University in the 1970’s, the Paleo diet is often embraced by few and heavily debated by many. Also called as the stone-age or Caveman’s diet, the concept behind this diet is simple: “If you want to shed your pounds, eat like a caveman!”

The Paleo diet is rich in protein, fibre and the so-called healthy fats, due to which it results in losing weight without losing calories, and with no physical exercises. This diet also claims to safeguard us from diabetes, heart disease, hypertension, cancer and other health problems.

Carefully read through the table below to see the freely permitted foods and those that need to be avoided on a Paleo diet.

The two different food pyramids, one for a balanced diet and the other for the Paleo diet explore the foods allowed under each.

Pyramid

Sunscreens

Summer in Chennai is a time when our shadows are brightly lit by sun rays. The human skin undergoes a vast spectrum of changes when exposed to the sun’s rays. The chronic damage it causes to the skin, manifest on the skin as photo ageing. A classic example being the difference between an individual’s skin on a sun exposed area (hands) and the skin on the covered area (abdomen).

The acute damage that the sun causes on the skin is the infamous “sunburn” or the “suntan”. We all know how it manifests on our skin. It’s time to know the importance of sunscreen and the ways to choose a sunscreen that is the best for your skin.

  • Choose a sunscreen lotion even if you don’t have direct sun exposure.
  • For those who are out in the sun and sweat under it, a sunscreen gel or sunscreen serum is the best.
  • We understand that you feel dull and greasy after applying your sunscreen. Combat it by applying a “finger tip unit” for the entire face and avoid outdoors for 15 minutes after application. It blends well into the skin and neutralises the grease during that period.
  • If you’re blessed with dark skin, you are safer from the sun damage and have the options of using “tinted sunscreens”.
  • Use a sunscreen even if you stay indoors, the ultraviolet radiation from gadget screens and LED lights can damage the skin.
  • Reapply your sunscreen in the afternoon.
  • Please check if your sunscreen has a good SPF factor (Ranging from 25-40) for Indian skin. Higher numbers don’t mean increased efficacy.
  • Verify the booster rating on the package as this denotes the efficacy of the sunscreen for our climatic conditions.
  • Makeup may be applied over the sunscreen after a 15 minute period. Hydrating foundations and powders with SPF factors are preferred. Avoid mousse and creams as make up foundations.

AHPI Nursing Excellence Award

We are extremely proud to announce that SIMS Hospital has been facilitated with a prestigious award for Nursing Excellence at the AHPI’s Global Conclave at ITC Chola, Chennai, on 10 February 2017. Association of Healthcare Providers of India (AHPI) is a representative body of Healthcare Organizations in India, which recognizes and celebrates the excellence achieved in various fields of the healthcare industry.

Two senior assessors, Dr. Thuppil Venkatesh and
Dr. Annabel D’Souza Sekar inspected our hospital for 25 objective elements in nursing care on 12 January 2017. Prof. Dr. Sundari Edwin, Nursing Director of SIMS, spearheaded the presentation, which showcased among others our automated staffing model (Nurse’s duty dashboard) that helps Nursing Managers to plan allocation as required by the INC and NABH with ease.

The assessors seemed to be equally impressed with other features such as the use of mobile apps for competency based training and assessment, and the Employee Self Service(ESS) module that provides access to policies and procedures, and training materials.

The Principal Assessor Dr. Thuppil Venkatesh, who has assessed more than a thousand hospitals globally, was excited and applauded a few innovations in our hospital, and has recommended patency.

The endorsement from a patient’s attender, who happened to be the Quality Advisor – Healthcare for Ministry of Bangladesh, was a feather in the cap. In all, the assessors were extremely happy with the service, quality, system, nursing workshops, conferences attended, patients’ feedback, and most importantly the teamwork.

At this juncture, we profoundly thank all the departments of SIMS and PERS, including Medical Services, HR, IT, Housekeeping, Security, F&B, Infection Control, Purchase and stores, Hospitality, Operations, and the like, who put in their best efforts and extended huge support for the Nursing Department to achieve excellence.

The Nursing team were elated by this recognition – a tribute to their unity and strength – and motivated to move forward taking nursing care to its pinnacle of success at SIMS. They were grateful to the management for taking the initiative towards this recognition and their constant support, and each and every department such as Human Resources, Quality and IT for their immense help.

“Excellence is doing ordinary things extraordinarily well”
— John W. Gardner

 

Partial Knee Replacement

A young 52-year-old mother who had treatment for breast cancer earlier presented with severe right knee pain limiting her daily activities. The pain was confined to the inner aspect of her knee joint. The x-ray examination showed severely damaged cartilage on the medial (inner) compartment alone. The knee has 3 compartments and the other two compartments were pristine. She was treated with conservative methods and intraarticular injections, but this did not work as there was no cartilage remaining in the inner compartment. Once full thickness cartilage loss occurs the only solution is surgical. The routinely done Total Knee Replacement would be an over kill for such a young lady with limited arthritis and hence we performed Partial Knee Replacement (Unicompartmental knee Replacement) which is relatively new in India.

A mini skin incision was used. The eroded bone on the medial (inner) side of the knee is freshened and resurfaced with suitable sized implants recreating the normal anatomy and biomechanics allowing full range of motion without the arthritic pain. The rest of the bones and more importantly the ligaments of the knee were left untouched. (In the total knee replacement surgery the ligaments are removed) The preservation of ligaments gives the partial knee replacement a natural feel (proprioception) that precisely mirrors the other non-operated knee. With mini skin incision the post-operative pain is much less and the post operative rehabilitation recovery was much faster when compared to the routinely done Total Knee Replacement.

Partial Knee Replacement
Partial Knee Replacement

 

Partial Knee Replacement

The incidence of knee arthritis in younger patients is dramatically increasing in India possibly due to the modern lifestyle changes. The non-operative management of such patients is crucial which consists of weight loss, lifestyle modifications, physiotherapy and joint injections. However, for some patients the progressive loss of joint cartilage is relentless resulting in bone on bone situation at which point the only option is surgery. The routinely done Total Knee Replacement can be considered to be too severe an intervention for patients with changes limited to one side of the joint. It goes without saying that bone conservation becomes more critical with decreasing age of the patient. One of the significant features of the partial knee replacement is that a total knee replacement can be done later if required though current studies indicate that revision surgery is unlikely. The only issue with a partial knee replacement is that it is a very technique sensitive and the bearing can dislocate unlike a TKR.

The surgeon experience with this procedure is an important determinant of final outcome.

The patient had complete relief of pain within 3 weeks and was able to do all her household chores and cope with the demands of her job in an insurance company. She does yoga regularly and feels that this surgery has changed her whole personality in a positive way by getting rid of the chronic pain and at the same time preserving the full, normal function of her knee.

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