Gurgaon, Haryana — (SBWIRE) — 11/16/2011 — The liver is the largest organ in the human body. it is also one of the most important ones. Liver Biliary Pancreas Surgery practice offers a multidisciplinary approach to surgical and non-surgical treatment strategies for patients with complex liver, biliary and pancreatic disease. Liver Biliary Pancreas Surgery compiled from a variety of sources including the online resources, but is not intended to substitute or replace the professional medical advice you receive from your physician. At Liver Biliary Pancreas Surgery in order to reach a diagnosis for liver, biliary, or pancreatic disorders, a thorough and accurate medical history will be taken by your physician, noting the symptoms you have experienced and any other pertinent information. a physical examination and a series of blood tests also are done to help assess the problem more completely.Liver Biliary Pancreatic Surgery India, Program at Medanta Institute of Liver Transplantation and Regenerative Medicine is one of the most experienced and innovative hospital. many peoples are comes from throughout the world to Medanta Institute for this complex procedure and for comprehensive care before, during and after transplantation. this center provide a central point for patients and families and referring physicians to aid in the evaluation and management of patients with disorders of the liver, gall bladder, bile ducts, pancreas, and the gastrointestinal tract. some liver, biliary, and pancreatic diseases are present at birth. In any case, whether these diseases are congenital, injury-related, viral-induced, or alcohol-induced, they can be devastating to a person’s health and require medical care.The overall mission of the Medanta Institute of Liver Transplantation and Regenerative Medicine is to provide the highest possible level of patient care. At Liver Biliary Pancreas Surgery, We are a group of dedicated and highly trained liver surgeons specializing in the area of Hepato Pancreato Biliary Surgery. this includes surgery of the Liver, Pancreas, Biliary system and Gall bladder. The biliary system consists of the bile ducts, gallbladder, and pancreas – all closely associated with the functioning of the liver. Liver Biliary Pancreas Surgery depends on the location of the tumor in the pancreas. For more details please visit liverbiliarypancreassurgery.com/ or mail us at or call us at +91- 8800267222. this service is run at the Medanta Institute of Liver Transplantation and Regenerative Medicine at Gurgaon, Delhi (NCR).

As was discussed within the 1st write-up of this three-part series, neurologists who face a patient with feasible Parkinson’s have no definitive test: no scans, no blood tests or spinal taps with which to base their diagnosis. Parkinson’s Disease is what’s referred to as a “clinical diagnosis.” this indicates that the choice as to whether or not or not a patient really has Parkinson’s demands an extensive face to face interaction having a neurologist. that meeting generally entails a thorough history-taking or interview, along with a comprehensive physical examination. Even though extremely frequently videotaping or other aids are utilized, the diagnosis completely depends on the clinical acumen of the neurologist as he/she investigates what the patient presents in word and on exam.

To sum up the approach extremely briefly, whilst interviewing and examining the patient, the neurologist creates a running list of possibilities in his/her head. this list is known as the “differential diagnosis,” frequently referred to a just the “differential.” a great neurologist a lot like a great detective, keeps adjusting, refining the differential as if it had been a list of suspects. He/she redirects the line of questioning and also the focus of the physical exam based on ruling in and ruling out suspects.

Every of the findings assists the neurologist to continuously reshuffle and re-prioritize the differential. As the list narrows to just a couple of possibilities, he/she will ask further questions and refine the examination. Then the patient is sent for tests that may rule out other possibilities. for example, patients get a brain CT or MRI not to diagnose Parkinson’s but to rule out bigger structural causes that may mimic Parkinson’s symptoms like a brain tumor or even several sclerosis. Frequently an electrical stimulation and measurement of nerve response in an affected limb known as an EMG (electromyogram) is carried out to rule out nearby nerve injury as an additional trigger.

If every thing points to Parkinson’s the patient is given a trial of a drug that either replaces or mimics dopamine. if the patient shows improvement then everybody could be fairly particular it is Parkinson’s

The point is that there’s no single protocol or textbook pathway to generating the diagnosis. although the neurologist follows a formal structure to cover all of the so-called bases, the specifics of that path extremely depend upon the findings along the way, which guide every next step inside that structure.

Early Parkinson’s could be tough to diagnose simply because it presents differently in each and every patient, and frequently with symptoms that will effortlessly be dismissed as minor like a little persistent twitching, sleepiness, a minor tremor, as well as depression or anxiety attacks.

A typical story everybody has either experienced or heard of is that 1 or two of the ten typical early warning symptoms (Component 1) show up and on that initial go to to a neurologist the twitching pinky finger (in Michael J. Fox’s case) or in my own, new-onset depression, either get dismissed or symptomatically treated. I was given an antidepressant and when a tremor developed it was dismissed as a side impact of the antidepressant. It was not until I was totally unable to play piano and had inordinate difficulty writing, both from severe slowing in my correct hand, that I was then totally worked up.

In either case, mine or mr. Fox’s, nobody created a mistake or missed anything essential. It is just that for example any 1 or two of the ten warning signs could be interpreted as because of other causes, and generally is.

Review of early symptoms:

Tremor or shaking higher on 1 side

Trouble/stiffness in moving or walking

Soft or Low Voice

Loss of facial expression, “masked facies”

Dizziness and fainting

Stooping or hunching over

I’ve added two much more to this list:

EDS (excessive daytime sleepiness) or fatigue

New-onset psychiatric disorder (generally depression or anxiety attacks)

As soon as PD is suspected, a host of other illnesses and conditions have to be regarded as and ruled out. that is where the so known as “differential diagnosis” list comes in. Every differential list is slightly various depending on what the patient presents to the neurologist and in admiration to neurology as a specialty, these lists can initially be very big. Ruling out all of the other causes on the list prior to PD reaches the top demands a solid working information of every list item and how it’s diagnosed.

Other lab tests and scans are utilized to rule out other causes but ultimately, Parkinson’s Disease is really a clinical diagnosis with probably the most important “test” becoming that initial old-fashioned face to face discussion with, and physical exam by a seasoned neurologist.

A 42 year old woman, a cello player within the nearby symphony, presents to the neurologist complaining of tremor in her correct hand and difficulty manipulating the bow whilst playing. Sadly she has been politely asked to “take a break” from her job with the symphony until she gets adequately evaluated. She has also turn out to be very depressed over the incident. She says the tremor really goes away when she’s playing however it feels like the bow is “caught on something” and so she can’t sweep it across the strings as swiftly.

Here’s a sample beginning differential diagnosis for somebody presenting having a persistent tremor of the proper hand. Even though the reality that the tremor occurs at rest and goes away with movement, and particularly combined with the reality that it occurs only on the proper side elevates PD to #1 on the list.

Sample differential diagnosis list for Parkinson’s (keep in mind that the neurologist should have extensive working information of how every of these presents):

Parkinson’s Disease

Important tremor (a nonspecific tremor of unknown trigger and which doesn’t get worse)

Brain Tumor: she will need to have a CT scan or MRI scan of the brain

Harm to the nerves within the arm within the affected side by trauma or several sclerosis(MS). She will likely undergo EMG nerve evaluation of the proper arm.

Other degenerative neurologic illnesses, a lengthy sub-list, details of which I shall skip:

Benign familial tremor

Dominant SCA (Spinal Cerebellar ataxia)

Olivopontocerebellar degeneration

Familial Basal ganglion calcification (Fahr’s syndrome)

Alzheimer’s syndrome

Amyotrophic lateral sclerosis

Dementia, Lewy-body kind

Parkinsonism-dementia complicated

Progressive supranuclear palsy

Cerebellar degeneration, subacute

Striatonigral degeneration

Corticobasal Degeneration syndromes

Frontotemporal dementia

Lesions of the basal ganglia where the brain controls movement by stroke/hemorrhage

Drugs (her main physician put her on nortriptyline for depression)

Antipsychotic medications

MPTP (a byproduct of poor practices in generating Ecstasy that will induce a parkinson’s like syndrome following a single dose)

Alcohol or narcotic withdrawal

Alcoholic brain degeneration

Following performing a directed interview and examination, her neurologist utilized his own fund of information and expertise, and did not believe she showed functions of any of the other degenerative illnesses listed.

On physical exam and observation he noticed that she would swing her correct arm much less when walking down the hallway. She even slightly dragged her correct foot.

He had her copy some sentences out of a medical text. It took her a lengthy time and also the writing was extremely little.

When he held her arm and moved it at the wrist and elbow he could really feel a ratcheting instead of smooth passive movement (recognized as “cogwheeling”, a classic PD sign).

She denied any drug history and rarely consumes alcohol.

She’s from San Diego where Lyme-carrying deer ticks do not flourish.

An MRI scan of her brain was regular so there is no brain tumor or evidence or stroke/hemorrhage, and no defects suggestive of MS. Parkinson’s usually yields a extremely regular brain scan. Some study methods that use radioactive dopamine-like compounds can reveal a defect nevertheless they’re not usually obtainable, and unnecessary as we see here that the diagnosis could be adequately created with out it.

Her EMG nerve exam showed regular nerve function within the affected arm.

Lastly, and very essential in establishing Parkinson’s as her diagnosis, he placed her on a drug that mimics dopamine and examined her a week later. She showed nearly none of the previous findings on that second go to following a week on the drug.

At that point the neurologist was particular it was PD and gently broke the news to her.

Jan 14, 2011

Bladder Cancer Treatment

Bladder Cancer Risk factors

Smoking : – Smoking appears to be the single greatest risk factor for bladder cancer.

Industrial chemicals : – Repeated exposure to chemicals.

Age : – the chance of getting bladder cancer increases as you grow older.

Race : – Whites are twice as likely to develop bladder cancer as blacks and Hispanics / Asians.

Sex : – Men are about four times as likely to get bladder cancer as women are…

Symptoms Of Bladder Cancer

• Blood in the urine (urine looks bright red or rusty).
• Pain or burning when urinating.
• Passing urine often.
• Feeling the need to urinate but no urine comes out.
• Difficulty in passing urine.

Diagnosis of Bladder Cancer

To diagnose bladder cancer, the doctor will take a medical history, do a physical examination and request a urine test. He or she may order an x-ray test and perform a cystoscopy (described below) and if needed, a biopsy for bladder cancer. A urine sample is taken and then examined under a microscope for cancerous cells (for bladder cancer).

An x-ray procedure, called an Intravenous pyelogram (IVP), is used to detect any abnormalities or growths in the bladder. for the IVP x-ray, a special dye containing iodine is given to the patient through a needle inserted in the vein. the dye goes in the bladder, making the bladder easier to see on the x-rays.

A Cystoscopy is a procedure using a thin, lighted tube called a cystoscope that is inserted into the bladder through the urethra. if the doctor sees any abnormal areas or growths, he or she will remove some of that tissue (biopsy) for further examination under a microscope.

Treatment of Bladder Cancer in India

There are four main types of treatment for bladder cancer: surgery, radiation therapy, chemotherapy and biological therapy. the type and staging of the cancer, age, and overall health, determine which treatment method(s) will be used.

Surgery

There are three (3) main types of surgeries for bladder cancer :-

Transurethral resection (TUR) is an operation that uses a cystoscope inserted into the bladder through the urethra. the doctor then uses a tool with a small wire loop on the end to remove the cancer or to burn the tumor away with high-energy electricity.

Cystectomy is an operation to remove the bladder. There are two types of cystectomy – segmental (partial), and radical (complete). Segmental cystectomy is an operation to take out part of the bladder where the cancer is located…

Urinary diversion is an operation to make way for urine to pass out of the body so that it does not go through the bladder.

Radiation therapy in India

Radiation therapy (also called radiotherapy) may be needed when the cancer cannot be removed with TUR because it involves a larger area of the bladder. X-rays destroy the ability of cancer cells to grow and multiply. Internal radiation therapy, with radioactive material placed in the bladder, may be combined with external radiation, which comes from a machine located outside the body…

Biological therapy in India

Often a form of intravesical chemotherapy, biological therapy uses materials made by the body or made in a laboratory to boost, direct or restore the body’s natural defenses against the cancer.

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Recognizing the early warning signs of bladder cancer

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Prostate Problems: a men’s health problem many men are reluctant to confront

Prostate Problems: a men’s health problem many men are reluctant to confront

For most men an enlarged prostate means years of annoying and some times embarrassing symptoms, often not bad enough to treat with surgery but bad enough to mean a lifetime of swallowing pills.

Hopefully most men get a blood test and/or a physical examination for prostate cancer some time in early middle age.  by the time men reach 50 – or earlier if they are experiencing a reduced flow of urine or there is a history of prostate problems in the family – they should be on their way to the Doc for a digital examination.   And no, a digital examination does not mean the Doctor uses some sort of electronic gadget.

A prostate examination should be a priority for middle aged men even if no symptoms are present.

If the typical symptoms of an enlarged prostate are not present it does not necessarily mean there is no cancer.  This is why it is important for men to have a prostate check even if they think they do not have a prostate problem.

A digital examination will very quickly determine if the prostate gland is enlarged but even if the prostate is enlarged it is not necessarily cancerous as most enlarged prostates are due to a non cancerous enlargement.  if a mans prostate is found to enlarged then it is likely the Doctor will arrange for a blood sample to be tested for Prostate Specific Antigens –  the PSA test. unfortunately the tests for prostate cancer are well known to be unreliable with both false positives and false negatives common and a blood test that gives a high ‘PSA” score (Prostate Specific Antigens) does not necessarily mean that cancer is present as a high PSA count can be temporarily caused by:

1: recent sexual activity2: Some physical activities may also cause a temporary blip in the PSA score3: Aging  (PSA levels increase as men age)4: Inflammation or infection of the prostate or urinary tract5: Benign or non cancerous enlargement of the prostate6: Obesity

There is a normal and natural level of Prostate Specific Antigens so men always have some showing in the test.  Your Doctor will discuss the test result with you but if the test scores over about 5 there may be some cause for a follow up. unfortunately PSA test results are not 100% reliable in indicating the presence of cancer and can vary due to age and other factors so do not panic if  the test result is a little high. I know one man who had an alarmingly high PSA result and was later found not to have prostate cancer.  it is therefore possible to have a blood test that indicates a possibility of prostate cancer and yet have no symptoms and no cancer.

A High PSA Score indicates Further Testing is Needed

If your blood test indicates a high PSA score then the Doctor will most likely arrange for a biopsy where a small sample of the prostate gland is taken via the anus for further analysis.  This involves a small tool being inserted in the anus which makes a serious of small punctures through the bowel and into the prostate gland to take tissue samples of the prostate.  This sounds painful but men who have experienced the procedure report it is pretty much a non event with just a sharp minor sting that doesn’t cause any significant pain or discomfort.  the anticipation is reported to be worse than the reality. the results of this test is likely to show there is no cancer as most men do not have or do not develop prostate cancer even if the prostate is enlarged.

Enlarged Prostate Symptoms

The symptoms of an enlarged prostate are usually incredibly annoying and can cause a sudden urge to urinate frequently. the swollen gland does not allow the bladder to completely empty as it squeezes the urethra and restricts the flow of urine just like squeezing a garden hose can restrict or stop water flowing through it.   an enlarged prostate is usually the problem of middle-aged men and the swelling of the prostate makes passing urine difficult and in the very worse cases, impossible.  If a complete blockage occurs urgent medical treatment is necessary.

Symptoms of Enlarged Prostate

Usually the symptoms become so annoying before a total blockage is experienced that treatment is sought long before it gets to this stage.  an enlarged prostate usually means the bladder is never emptied completely resulting in the frequent sudden urge to urinate and annoyingly, this often happens not long after previously urinating.  Usually the flow of urine is reduced to a very weak stream and there may be difficulty in getting started.  when the symptoms get bad the urine flow may be not much more than a dribble.  the urge to urinate can be so sudden and strong at times it can cause involuntary small discharges of urine and frequent waking in the night.  Sleep patterns are interrupted and fatigue result which result in some pretty unhappy men who are not only tired but have to try and manage their frequent need to urinate.

Left untreated, any difficulty in passing urine can lead to bladder and other problems so it is important to seek medical advice even when the symptoms are moderate.  about 45% of men can expect to start developing benign prostatic hyperplasia by their late forties with symptoms increasing in severity as they age.  Treatment with a drug is usually satisfactory for most men with mild symptoms although it does not entirely deal with the problem.  if the problems passing urine becomes unmanageable then surgery is often necessary and there are a several surgical techniques available now to improve the flow of urine.

I have more information about prostate issue and also about a diet for better prostate health on my health blog.

Ian MillerHealth Writer

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The Importance of Annual Prostate Cancer Screenings

When September rolls around, people often think about the beginning of school and fall, but a select few may remember that September is Prostate Cancer Awareness Month. According to the American Cancer Society, prostate cancer affects one in six men, with skin cancer being the leading cause of cancer-related death. As a preventative measure, men should get checked annually for prostate cancer. Fortunately, prostate cancer treatment is available and the cancer is curable if detected early.

When should I get Checked for Prostate Cancer?

An annual physical examination can help detect the symptoms of prostate cancer in men. It is suggested that all men age 50 and above have an annual prostate-specific antigen (PSA) blood test and a digital rectal exam (DRE). If your father or brother has prostate cancer, you may want to consider getting tested before the age of 50.

Listed below are the most common symptoms of prostate cancer. There are no specific warning signs or symptoms of early prostate cancer, which is why annual prostate screening is so important.

Symptoms of Prostate Cancer:

- Weak or interrupted flow or urine- Urinating often (especially at night)- Difficulty urinating or holding back urine- Pain or burning when urinating

Other Symptoms of Prostate Cancer:

- Blood in the urine or semen- Pain in the back, hips or pelvis- Difficulty having an erection

Remember, the symptoms of prostate cancer may resemble other conditions or medical problems, so consult your physician for a diagnosis. your physician will also be able to answer any questions about prostate cancer and discuss prostate cancer treatment options.

Why you should get Tested for Prostate Cancer Annually:

The majority of men diagnosed with prostate cancer had no symptoms when prostate cancer was first detected. an annual PSA blood test can detect prostate cancer quickly. Even if your PSA levels are normal (e.g., below 4) an increase in your PSA levels can help detect prostate cancer in its early stages.

What is a PSA Test?

A PSA test is a blood test that detects the amount of prostate-specific antigens (a protein) in the blood. As the prostate enlarges, more of this protein is produced and the increase is detected by the test. During a PSA test, a nurse or doctor takes a sample of blood from your arm and sends it to a lab for analysis. After the test, you will receive a copy of the results with your PSA levels.

A high PSA level may indicate prostate cancer. however, any activity that irritates the prostate may also cause PSA levels to rise.

Causes of an Elevated PSA:

- Benign Prostatic Hyperplasia (BPH), an enlarged prostate- Prostatis, a condition where the prostate becomes inflamed due to an infection- a Prostate Biopsy- recent Ejaculation- Bicycle Riding

Information about PSA:

- According to the American Cancer Society, a PSA level between 4 and 10 may indicate prostate cancer. If this is the case, prostate cancer surgery and radiation are treatment options.- PSA is measured by nanograms per millimeter of blood.- PSA is released into the blood by the prostate gland.- PSA is common in semen.

The most common symptoms of prostate cancer are urinary problems, which include the need to urinate often, trouble urinating and the decreased force in the stream of urine. Other indicators include blood in the urine or in semen as well as frequent pain in the lower back and hips. however, the best way to detect prostate cancer early is by getting an annual PSA test.

Prostate cancer affects more than 186,000 American men each year. Remember the importance of having your doctor check for prostate cancer before you develop any symptoms. If you have any concerns or questions, talk to your doctor. Men diagnosed with prostate cancer have many treatment options, and the sooner you get treated, the sooner you can recover.