Burn Management in Children

Sri Sai Hospital is organizing  Weight loss and Bariatric Surgery Clinic for obese people on Every Tuesday. People who were obese and facing health problems due to obesity came to the Clinic for their medical check-up, which includes BMI, body fat analysis, blood sugar. Also free nutrition and diet advice was given by experts.

Dr. Zuhaib Naseem, Consultant Minimal Access and Bariatric Surgeon at Sri Sai Hospital said, "Today among all other diseases, obesity has emerged as one of the growing health problem among people especially those living in urban areas.  Sedentary life style and lack of physical exercise is one of the major cause of  obesity.  Also, an obese person can have other health complications like high blood pressure, heart disease, diabetes mellitus, sleep apnea etc. Hence it is essential for people with obesity to get the right medical treatment at the right time and protect themselves from further health hazards".

The camp was organized with the sole purpose of helping people to know their obesity level and opt for the right treatment. A person with a BMI (Body Mass Index) of 25 to 30 is said to be overweight and if it is greater than 30 it is generally considered obese. Overweight conditions can be easily managed with proper diet control, exercise and physical activities. In severe cases where BMI is greater than 30, it is often difficult to maintain and reduce weight. According to Dr Zuhaib Naseem of Sri Sai Hospital, bariatric surgery is an ideal option in such situations. Surgery reduces the size of the stomach and sometimes bypasses a part of the small intestine. Bariatric Surgery improves health problems related to obesity and also improves physical function, mood, and improved quality of life.

 Dr. Zuhaib Naseem said, "We will regularly conduct weight loss and bariatric surgery clinics every Tuesday at Sri Sai Hospital and it will be our pleasure to do more and more free camps in the near future".

अनियमित जीवनशैली, अनुचित खान पान व उम्र बढ़ने के कारण घुटनो की समस्या बढ़ जाती है। जैसे-जैसे घुटने जवाब देने लगते है, चलना-फिरना, उठना-बैठना, यहाँ तक कि बिस्तर से उठ पाना भी मुष्किल हो जाता है ऐसी स्थिति में भी रिप्लेसमेंट यानी घुटनो का प्रप्यारोपण पीड़ित व्यक्ति को राहत देने के लिये प्रभावी विकल्प है। नी रिप्लेसमेंट के लिए कम्प्यूटर नेविगेषन तकनीक के आ जाने के बाद यह बेहद प्रभावी और आसान हो गया है।

श्री साई सुपर स्पेशीऐलिटी हाॅस्पिटल में डाॅ0 अकुर गोयल के सक्षम नेतृत्व में कंप्यूटर नैविगेशन तकनीक से घुटनोे का सफलतापूर्वक प्रप्यारोपण किया जा रहा है। यह संस्थान उत्तर प्रदेश में कंप्यूटर नैविगेशन तकनीक से सफल घुटना प्रत्यारोपण करने के लिये बेहद प्रसिद्ध है। इस तकनीक से नी-रिप्लेमेंट सर्जरी में काफी बेहतरी आई है, इसमें जख्म जल्द भरता है और ट्रांसप्लान्ट का फायदा लोगो को लंबे समय तक मिलता है। इसके अलावा यह तकनीक किसी भी संभावित गलती को कम करके मरीज की परेशानी के अनुसार इलाज करती है।

घुटना प्रप्यारोपण की सटीक तकनीक है कंप्यूटर नेविगेशन

पिछलें 10 सालो की तुलना में जोड़ प्रप्यारोपण की संख्या में कई गुना वृद्धि हुई है उसके साथ-साथ नई तकनीको का भी इस्तेमाल बढ़ा है कंप्यूटर नेविगेशन भी एक सटीक तकनीक है कंप्यूटर नेविगेशन द्वारा प्रप्यारोपित जोड़ को सटीक अलाइनमेंट एवं पूरी तरह से बैलेस करके लगाया जा सकता है। कंप्यूटर नेविगेषन के द्वारा लगाया गया कृत्रिम जोड़ सटीक अलाइनमेंट एवं सही बैलेंस होने के कारण मैनुवल तकनीक से किए गये घुटना प्रप्यारोपण की तुलना में कई वर्ष अधिक चलता है। इस तकनीक के और भी कई फायदे है। श्री साई हाॅस्पिटल में इस तकनीक का उपयोग कर प्रप्यारोपण करने के लिए अनुभवी व विषेशज्ञ चिकित्सकों की टीम है। अभी तक कंप्यूटर नेविगेशन के द्वारा जोड़ प्रप्यारोपण करवाने के लिये रोगी को दिल्ली,मुबंई, अहमदाबाद एवं जयपुर जैसी जगह पर जाना पड़ता था आज इस संस्थान के माध्यम से मुरादाबाद में भी इस तकनीक द्वारा सफल घुटना प्रप्यारोपण किया जा रहा है। सटीक प्रप्यारोपण के लिये कंप्यूटर नेविगेटेड सिस्टम से एक विषेश जाँच की जाती है। यह मषीन घुटनों के सटीक अलाईनमेंट के लिए बहुत उपयोगी है। कंप्यूटर नेविगेटेड सर्जरी एक अत्याधुनिक शल्य चिकित्सक तकनीक है। कंप्यूटर असिस्टेड सर्जरी द्वारा प्रप्यारोपण कराने के दौरान रोगी की हड्डीयों और जोड़ों के सूक्ष्म बिंदू तक नजर आते  जिन्हें नंगी आँखो द्वारा देख पाना सम्भव नही है।

अत्याधुनिक कंप्यूटर नेविगेशन माॅडल के उपयोग से इंप्लाट फिटिगं परफेक्ट होती है इसमें गलती की आषंका बिल्कुल कम हो जाती है। इस तकनीक में छोटे से चीरे के साथ ऑपरेशन करके घुटने का जोड़ बदला जाने लगा है। मरीज के घुटने  का सीटी स्कैन करके उसकी सही फिटिगं वाला जोड़ नही लगा पाने से जो घुटना प्रप्यारोपण 15-20 साल तक ही चल पाता था अत्याधुनिक कंप्यूटर नेविगेशन माॅडल के उपयोग से अब इसकी लाईफ दोगुनी हो गयी है हाल ही में घुटना प्रप्यारोपण की दरो में आई कमी के बाद आज कल यह बहुत कब दरों में संभव है।

डाॅ0 अंकुर गोयल

वरिश्ठ ज्वाइंट रिप्लेसमेंट सर्जन

यू.के. एवं जर्मनी से प्रशिक्षित  

श्री साई सुपर स्पेशीऐलिटी हाॅस्पिटल, दिल्ली रोड, मुरादाबाद।

विषेशता:-

• प्रिसिज़न नी नेविगेशन सिस्टम का इस्तेमाल करने वाला पष्चिमी यू0पी0 का प्रमुख संस्थान 
• तेजी से रिकवरी
• प्राकृतिक घुटनो का एहसास
• स्थिरता मिलती है
• प्रप्यारोपण लंबे समय तक चलता है
• सुरक्षित व कारगर तकनीक है।

Read in English

Lumbar disc prolapse (sciatica) is very common problem in today's life. It can lead to  severe pain in back and in both legs.. In severe cases it can cause even weakness in legs, difficulty in urination and passing stool. Gud weight control, proper posturing and maintaining healthy life style are some of the easy ways to keep yourself away from problem of siatica. Surgery is required only very severe cases. Although with advancement in neurosciences safer and minimally invasive surgical procedures are now available. So consult the doctor timely regarding any backache and lower limb pain..

Urinary problems are commonly encountered in children of all age groups. It may vary from burning Micturating, pain during passage of urine, dribbling of urine, not passing urine in stream, recurrent urinary tract infection, bedwetting in older children, frequent passage of urine unknowingly in clothes. It is troublesome for the child most of the time. Sometimes it may become a social stigma, as no one likes to play with a child having wet and smelly clothes. It becomes difficult for the child to attend school, as frequent complaints from teachers and fellow classmates reduce the self-esteem of the child. These problems could be an indication of various Paediatric Urology diseases that may cause kidney damage if not detected and treated on time. Nowadays antenatal ultrasound done during pregnancy detect several common Pediatric Urology problems which can be treated after birth and hence kidney damage and an array of urinary problems can be avoided. Broadly there are four kinds of paediatric urology diseases encountered in day to day practice. Posterior urethra valve is a disease which can be detected during pregnancy before the birth of the child. There is partial obstruction in the urethra (part through which urine passes to come out of the body). If undetected for a long period of time and finally if the diagnosis is delayed, the child may have permanent kidney damage. Ultrasound, Micturating cystourethrogram are two investigations that can confirm the diagnosis. Treatment is done by Pediatric Cystoscopy in which no cut is made over body and obstruction is removed and the child leads a happy life thereafter. child may suffer from recurrent urinary infection, dribbling of urine Hydronephrosis is swelling up of the kidney because of obstruction in outflow of urine from kidney. It is usually diagnosed during pregnancy and Paediatric Surgeons operate and cure the disease by creating a pathway for drainage of urine as early as 4 to 6 weeks of age and hence kidney is protected from getting damaged. Vesicoureteric reflux (VUR) is a disease where the urine keeps circulating in the system. Urine is waste product of the body meant to be thrown out. There is unidirectional flow of urine from kidney to outside. Here, when we urge to urinate, bladder compresses and urine is sent back to kidneys, hence it keeps infecting and damaging the kidney. The child presents with recurrent urinary infections. The diagnosis is made by Micturating Cystourethrogram. Treatment is by creating a valve mechanism to prevent reflux and hence the cure. Neurogenic bladder is a complex entity due to neural dysfunction. So, the crux is don't ignore urinary problems in children. Meet your nearest Pediatric Surgeon whenever there is a problem so that the kidneys of your child can be saved in time before they get damaged.

What is Prematurity

• Every year, an estimated 15 million babies are born preterm (before 37 completed weeks of gestation), and this number is rising.
• Preterm birth complications are the leading cause of death among children under 5 years of age, responsible for approximately 1 million deaths in 2015 (1).
• Three-quarters of these deaths could be prevented with current, cost-effective interventions.
• Across 184 countries, the rate of preterm birth ranges from 5% to 18% of babies born.

Preterm is defined as babies born alive before 37 weeks of pregnancy are completed. There are sub-categories of preterm birth, based on gestational age:

• extremely preterm (less than 28 weeks)
• very preterm (28 to 32 weeks)
• moderate to late preterm (32 to 37 weeks).

Induction or cesarean birth should not be planned before 39 completed weeks unless medically indicated.

Who is at risk for prematurity?

Many women have no known risk factors for premature birth. But several things can make premature birth more likely.

Women with these risk factors are more likely to deliver early:

• Having had a past preterm labor or birth.
• Getting pregnant within a short time (less than a year) after having had a baby.
• Being pregnant with more than one baby.
•  Having an abnormal cervix or uterus " Being younger than 16 or older than 35
• Having health problems such as high blood pressure, diabetes, heart disease, or kidney disease or high levels of social and psychological stress.
•  Smoking

 In addition, women who develop any of the following problems during pregnancy are more likely to deliver early-

• Infections
• High blood pressure
• Diabetes
• Blood-clotting problems
• Problems with the placenta
• Vaginal bleeding

How is prematurity treated?

Treatment will depend on your child's symptoms, age, and general health. It will also depend on how severe the condition is.

Treatment may include:

• Corticosteroid medicine is given to the mother before a premature birth to help the baby's lungs and other organs grow and mature.
• Watching the baby's temperature, blood pressure, heart and breathing rates, and oxygen levels.
• Temperature-controlled bed or incubator.
• Oxygen is given by mask or with a breathing machine called a ventilator.
• IV (intravenous) fluids, feedings, or medicines.
• Special feedings with a tube in the stomach if a baby can't suck.
• X-rays or other imaging tests.
• Skin-to-skin contact with the parents (kangaroo care).

What are the possible complications of prematurity?

Premature babies are cared for by a Neonatologist. This is a doctor with special training to care for newborns. Other specialists may also care for babies, depending on their health problems.

Premature babies are born before their bodies and organ systems have fully matured. These babies are smaller than they would have been if they were born at full term. They may need help breathing, eating, fighting infection, and staying warm. Extremely premature babies, those born before 28 weeks, are at the greatest risk for problems. Their organs and body systems are not ready for life on their own outside the mother's uterus. And they may be too immature to function well even with intensive care support.

Some of the problems premature babies may have include:

• Keeping their body temperature steady or staying warm.
• Breathing problems, including serious short- and long-term problems.
• Blood pressure problems due to immaturity of various organ systems (especially low blood pressure in early hours and days).
• Blood problems These include Jow red blood.
• Blood problems. These include low red blood cell counts (anemia), yellow color to the skin from breaking down red blood cells (jaundice).
• Kidney problems due to immaturity.
• Digestive problems, including immature absorption and digestion. Most premature babies need intravenous IV nutrition for some time at birth. In some cases, there may be inflammation and death of parts of the intestine (necrotizing enterocolitis). Babies are often not able to feed by mouth until closer to their due date and will need tube feedings. The best feeding is mom's own milk. If this isn't possible, donor human milk from a milk bank is the safest alternative.
•  Nervous system problems, including bleeding in the brain or seizures.
• Infections.

Premature babies can have long-term health problems as well. Generally, the more premature the baby, the more serious and long-lasting the health problems may be.

Can prematurity be prevented?

More babies are surviving even though they are born early and are very small. But it is best to prevent preterm labor if possible.

It's important to get good prenatal care while you are pregnant. Your healthcare provider can help find problems and suggest lifestyle changes to lower the risk for preterm labor and birth. Some ways to help prevent prematurity include:

• Stop smoking if you smoke. You should stop smoking before you are pregnant.
• Finding out if you are at risk for preterm labor.
• Learning the symptoms of preterm labor.
• Getting treated for preterm labor

Your healthcare provider may give you the hormone progesterone if you are at high risk for preterm birth. Progesterone can help if you have had a past preterm birth.

Computerized Navigation System in Joint Replacement has revolutionized Joint Replacement Surgery. Poor alignment is the most common cause of premature failure of the implant in manual Joint Replacement. New technology of computer based navigation system has completely eliminated poor alignment and made Joint Replacement surgery 100% accurate. The Computerized Navigation System (Nav-3) enables surgeons to consistently obtain results that are far more accurate than conventional methods. Dr. Ankur Goel is working on the most Advanced Navigation System for Joint Replacement by Computerized Navigation System (Nav-3) at Sri Sai Hospital Moradabad.

Since the level of accuracy is very high, it also helps in increasing the life of the implant by 20-25 years, and also reduces the blood loss to the patient. Patients who undergo this type of Surgery in our hospital are able to walk and climb stairs without assistance within a few days after surgery. The Computerized Navigation System helps the surgeon to make precise cuts and correct deformities in the knee. It also removes human errors in surgery.

Sri Sai Hospital, Moradabad uses Computerized Navigation System (Nav-3) to provide real-time, patient-specific information about patients during surgery, including infrared cameras, state-of-the-art software, due to while costly Investigations like Intensive CT and MRI Scans prior to surgery etc. does not need to be done. At the beginning of the operation, the surgeon strategically places small transmitters on the patient's leg. The surgeon then guides the foot through a series of prescribed movements, which, in turn, are recorded by the navigation's infrared camera and transmitted to a computer. The computer analyzes those positions to create an anatomical 'model' of the knee and updates this information throughout the procedure, displaying all relevant axes, angles and distances for the surgeon. Analyzing and providing this continuous data, navigation helps guide the surgeon through the bone cut, implant positioning.

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