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KIDNEY STONES– facts to consider

Author: Dr Kabilan Saminathan – MS,
Dr. Mehta’s Hospitals
Kidney stones are the most common problem we come across in the Urology clinic. Kidney stones are also a serious problem. They can cause a lot trouble by blocking the urine tube (ureter)causing very severe pain or they remain silent in the kidney getting bigger in size over a period of time. If not treated properly they can damage the kidneys gradually ending in renal failure.Kidney stones are aggregation of salts that are excreted in the urine. Most common kidney stones are aggregation of calcium oxalate salt crystals. Stones are formed by simple theory of crystallisation. When the salt e.g. Calcium oxalate concentration in the urine exceeds the solubility capacity of urine – crystals are formed. The crystals aggregate to form a stone. Also, there are promoters and inhibitors of stone which are produced by the body and in the diet, we take. The balance between these influence stone formations.

Stones are formed in the kidneys but they can get stuck anywhere in the urinary tract from the renal papilla to the urethral meatus. Medical management of stones is feasible for small stones. Surgical treatment of renal stones is needed for bigger and complicated stones. Surgical treatment is very much advanced. Latest techniques are RIRS (retrograde intrarenal surgery) and PCNL (Per-Cutaneous Nephro Lithotomy). In RIRS a flexible scope and LASER probe is used to break the stone. In PCNL a one-inch hole is made overlying the kidney region and stone inside the kidney accessed and removed. Also, the best way to prevent stone recurrence is complete clearance of stones in the kidney.
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An insight to congestive heart failure: Symptoms and tests you can take up

CHF or congestive heart failures are chronic and progressive conditions that affect the pumping of heart muscles. When this happens, blood does not flow efficiently through the circulatory system and the ventricles do not pump sufficient amount of blood to the body. As a result, blood and other fluids begin to accumulate in the lungs, liver, abdomen etc. Any delay in congestive heart failure treatments can be quite life-threatening and we at Mehta’s advise that you seek immediate medical attention if someone is suspected of having CHF.

What causes CHF?

It can be a result of a combination of health conditions that can directly affect the cardiovascular system. Some of the most common causes of congestive heart failure include the following factors

  • Hypertension
  • Blocked coronary arteries
  • Damaged heart valves
  • Congenital heart diseases
  • Prolonged and serious rhythm problems
  • Weakened heart muscle or cardiomyopathy

There are many lifestyle habits that can aggravate congestive heart failures which include alcohol or cocaine abuse, smoking, lack of physical activity and high intake of salt which lead to fluid retention in the body.

Symptoms and signs that the patient will notice initially

  • Increased weight
  • Fatigue and tiredness
  • Urge to urinate often especially at night
  • Swelling of the legs, ankle, and feet

When the condition worsens, he/she will start noticing these

  • Rapid breathing
  • Congested lungs followed by a cough
  • Chest pain
  • Fainting
  • Wheezing and shortness of breath
  • Irregular heartbeat
  • Bluish skin due to lack of oxygen in lungs

If the patient experiences any of the symptoms that are pointed above, he must seek medical attention immediately from best cardiologists in Chennai for timely treatment of the condition.

What the tests that can be performed to diagnose congestive heart failure

Here are the common tests that can be done to diagnose heart failure

1.Electrocardiogram-It can efficiently record the heart rhythm and brings to notice any abnormality.

2.Echocardiogram-This test uses sound waves to check the proper functioning of the heart. An echo can help to determine if the patient has any muscle damage, poor blood flow and abnormal contractions of the heart. It gives information about EF (ejection fraction) which is an indication of heart function with the normal EF being 50 to 70%.

3.MRI or Magnetic Resonance Imaging: This test takes still as well as moving pictures of the heart helping the doctors to diagnose and lookout for structural abnormalities or damages to the heart.

4.Stress Test: is taken to access how the heart performs under stress. When the heart works harder, it gets easier for the doctor to diagnose the conditions with restricted blood flow that is coronary changed as the ECG changer or Echo changes would appear or worsen.

5. Coronary angiogram: This can be done to rule out blocked arteries and to treat blocks just in case they exist helping it to improve heart function.

It is therefore important to be aware of symptoms and what tests need to be taken up in case of a heart failure as early diagnosis and treatment can help to prevent the progression of heart failure and save a life.

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Monsoon Tips: Dengue symptoms and Treatments

Author: Dr. Haripriya – Head of Pediatrics , Dr. Mehta’s Hospitals

Dengue(DENG – gey) fever is a mosquito borne disease that occurs in tropical and subtropical areas of the world. Mild dengue causes a high fever, rash and muscle & joint pain. A severe form of dengue fever also called as dengue hemorrhagic fever, can cause severe bleeding, a sudden drop in blood pressure and even death.

Researchers are working on dengue fever vaccines.  For now the best prevention is to reduce mosquito habitat in areas where dengue fever is common.

Symptoms of Dengue Fever:

Many people, especially children and teens, may experience no signs or symptoms during mild case of dengue fever. When symptoms do occur, they usually begin four to seven days after you are bitten by an infected mosquito.

Dengue Virus causes a high fever – 104F degrees – and atleast two of the following symptoms

– Headache

– Muscle, bone and join pain

– Nausea

– Vomiting

– Pain behind the eyes

– Swollen glands

– Rash

Most people recover within a week or so. In some cases, symptoms worsen and can become life threatening. Blood vessels often become damaged and leaky. And the number of platelets in the blood stream may drop. This can cause a severe form of dengue fever, called dengue hemorrhagic fever, severe dengue or dengue shock syndrome.

Risk Factors:

Factors that put you at a greater risk of developing dengue fever or a more severe form of the disease include

Living or travelling in tropical areas. Being in tropical and sub-tropical areas increase your risk of exposure to the virus that cause dengue fever.

Prior Infection with a dengue fever virus. Previous infection with a dengue fever virus increase your risk of having severe symptoms if you are infected again

Controlling the mosquito population and human exposure is still the most critical part of prevention efforts

So for now, if you are living or travelling in an area where dengue fever is known to be, the best way to avoid being bitten by mosquitoes that carry disease.

Tips to Avoid Dengue Fever

If you are living or travelling in tropical areas where dengue fever is common, please follow these tips, it may help your risk of mosquito bites

Stay in air conditioned or well screened housing. The mosquitoes that carry the dengue viruses are most active from dawn to dusk, so they can also bite at night.

Wear Protective Clothing. When you go into mosquito infected areas , wear a long-sleeved shirt, long pant, shoes and socks.

Use Mosquito Repellent. Permethrin can be applied to your clothing, shoes, camping gear and bed netting. You can also buy clothing made with permethrin already. For your skin use a repellent containing atleast 10% concentration of DEET

Reduce Mosquito Habitat. The mosquitoes that carry dengue virus typically live in and around houses, breeding in stagnated water in automobile tyres, air-coolers, air conditioners and many more. You can lower mosquito population by eliminating the habitats where they lay their eggs. At least once a week, empty and clean containers that hold standing water such as planting containers, animal plates and flower vases. Keep standing water containers covered between cleanings.

Treatment for Dengue Fever

No specific treatment for dengue fever exists. Your doctor may recommend that you drink plenty of fluids to avoid dehydration from vomiting and a high fever.

While recovering from dengue fever, watch  for signs and symptoms of dehydration. Call your doctor right away if you develop any of the following

Decreased urination

– Few or no tears

– Dry mouths or lips

– Lethargy or confusion

– Cold or clammy extremities

Acetaminophen ( tylenol, others) can alleviate pain and reduce fever. Avoid pain relievers that can increase bleeding complications – such as aspirin, ibuprofen (Advil, Motrin IB, others) and naproxen sodium ( Aleve, others)

If you have dengue fever, you may also need:

Supportive care in the hospital

– Intravenous (IV) Fluid and electrolyte replacement

– Blood Pressure Monitoring

– Transfusion to replace blood loss

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What is Dyslexia?

Dyslexia is a condition that makes it hard to learn and read. It happens when there is a problem with the way the brain processes graphic symbols

The problem in dyslexia is a linguistic tone, not a visual one. Dyslexia in no way stems from any lack of intelligence. People with severe dyslexia can be brilliant also. Although it is neurological condition, dyslexia is not linked to intelligence. The effects of dyslexia vary from person to person. The only shared trait among people with dyslexia is that they read at level lower than typical for people of their age.

Quick facts about Dyslexia symptoms

  • Classic symptoms include: slow reading, very poor spelling and weak phonemic awareness resulting in great difficulty in sounding out words, especially unfamiliar ones
  • Pre-school warning signs include: Delayed Speech, difficulty in learning the alphabet, inability to rhyme words, confusion of left & right, before and after, other directional or relational words, poor pencil grip and messy writing
  • Symptoms can be seen as early as the first six months of age
  • Difficulty in tying shoe laces and reading a clock with hands are reliable indicators of dyslexia
  • Reading problems are often unexpected relative to other cognitive abilities or skills
  • Dyslexia varies from mild to severe, with symptoms varying in degree and number accordingly
  • Often co-exist with ADHD, dysgraphia, dyscalculia and dyspraxia

How to cure Dyslexia?

There is no known way to correct the underlying brain abnormality that causes dyslexia – dyslexia is lifelong problem. However early detection and evaluation to determine specific needs and appropriate treatment can improve success

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Fast facts on Heart Disease

Author: Dr. Kasinthan – Cardiothoracic Surgeon

Heart disease, such as coronary heart disease, heart attack, congestive heart failure, and congenital heart disease, is the leading cause of death for men and women in the India. Prevention includes quitting smoking, lowering cholesterol, controlling high blood pressure, maintaining a healthy weight, and exercising.

Heart Disease:

Heart diseases broadly classified as

1) By birth
2) Earned due to unwanted habits like smoking / consumption of alcohol/junk foods
3) Lack of immunity, infection by germs and due to pollution – lung diseases
4) Stress – Coronary Artery Disease (CAD)
5) Due to Ageing

Heart diseases from birth is due to marriage among the close relatives, ailments and stress during pregnancy

Acquired or earned heart diseases like rheumatic or chronic heart diseases are due to lack of awareness of bad habits like smoking, consumption of alchol & junk foods

Any heart disease, PREVENTION IS ALWAYS BETTER.  Early consultation with family physician/ Pediatrician/ pulmonologist/ cardiologist/ cardiothoracic Surgeon is mandatory to avoid life threatening complication like heart failure and heart attack


Regular physical and breathing exercise
Diet Control (mainly on salt, sugar & fat)


Quit smoking
Quit Alchol
Quit Junk Food


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OSCE Mock Question & Answer

Dear Students!

                        Greetings! Thank you for your sincere and enthusiastic participation in OSCE 2018! Please find questions and answer keys for mock OSCE 1 & 2 in the attachments. All the best for your exams and future!

Best wishes,









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