Rheumatic heart disease (RHD) is a condition in which the heart valves are permanently damaged by rheumatic fever. The heart valve damage may start shortly after an untreated or undertreated streptococcal infection, such as strep throat or scarlet fever. While this condition has become rare in wealthy nations, it remains a major health challenge in South Asia and other developing regions.

At Sterling Hospitals, we believe that understanding the connection between a simple sore throat and serious heart damage is the first step toward prevention. RHD affects between 40 and 55 million people globally and claims hundreds of thousands of lives every year. The tragedy of this disease is that it is preventable.

Understanding the Cause

The path to rheumatic heart disease begins with a common bacterial infection known as group A streptococcal pharyngitis, or strep throat. If this infection is not treated properly with antibiotics, it can trigger an autoimmune reaction in the body about two to four weeks later. This reaction is called acute rheumatic fever.

During rheumatic fever, the body’s immune system tries to fight the bacteria. However, the tissues of the heart valves share a similar molecular structure to the bacteria. This case of mistaken identity causes the immune system to attack the heart’s own tissues. This inflammation can cause scarring and stiffness in the valve flaps.

Over time, this damage disrupts the normal flow of blood through the heart. It usually affects the left side of the heart, specifically the mitral valve and the aortic valve.

Who is at Risk?

Rheumatic fever mostly affects children and adolescents between the ages of 5 and 15. However, the permanent heart damage may not show symptoms until a person is a young adult.

Living conditions play a large role in the spread of the bacteria. Overcrowding and limited access to medical care increase the risk of repeated strep infections. In India and other parts of South Asia, the burden of this disease remains high. Repeated episodes of rheumatic fever cause cumulative damage to the heart valves. This is why preventing the recurrence of infection is a primary goal.

How RHD Affects the Heart Valves

The inflammation from rheumatic fever changes the shape and flexibility of the heart valves. This can lead to two main problems:

• Valve Stenosis: The valve opening becomes narrowed. The valve flaps may fuse together or become stiff and thickened. This prevents the valve from opening fully and reduces blood flow. The heart has to work harder to pump blood through the narrow opening.
• Valve Regurgitation: The valve does not close tightly. This allows blood to leak backward in the wrong direction. The heart must pump more blood to make up for the leak

The mitral valve is affected in a large majority of cases. Damage to the aortic valve is also common, while the tricuspid valve is affected less often.

Recognising the Symptoms

Symptoms of rheumatic heart disease often depend on how much damage the valves have sustained. Some people may not notice issues for years after the initial fever. When symptoms do appear, they often include:

• Shortness of breath, especially during physical activity or when lying flat
• Chest pain or discomfort
• Fatigue and weakness
• Swelling in the stomach, hands, or feet
• A sensation of a rapid or irregular heartbeat (palpitations)

If you experience these symptoms and have a history of rheumatic fever, it is vital to consult a doctor. We have the best cardiologist in Ahmedabad available to evaluate your history and current condition.

Diagnosis

Diagnosing RHD involves a review of your medical history and a physical exam. A doctor will listen to your heart for a specific sound called a murmur. This sound is caused by blood flowing through a damaged valve.

To confirm the diagnosis, we use several tests:

• Echocardiogram: This ultrasound of the heart is the most useful test. It allows doctors to see the moving pictures of the heart valves and assess the severity of the damage.
• Electrocardiogram (ECG): This records the electrical activity of the heart and detects irregular rhythms.
• Chest X-ray: This can show if the heart is enlarged or if there is fluid in the lungs.

Treatment Options

There is no cure for rheumatic heart disease, but the condition can be managed effectively. The goal of treatment is to prevent further damage and manage symptoms.

Medications

• Antibiotics: This is the cornerstone of treatment. Patients often require long-term antibiotics every three to four weeks, to prevent the return of strep infections. This can continue for 10 years or until age 40, depending on the severity.
• Blood Thinners: These reduce the risk of stroke or blood clots, especially if the patient has a heart rhythm disorder like atrial fibrillation.
• Heart Failure Medications: These help the heart pump more effectively and remove excess fluid from the body.

Procedures and Surgery

If the heart valves are severely damaged, intervention may be necessary.

• Balloon Valvuloplasty: For some cases of valve narrowing, a doctor can insert a balloon through a blood vessel to widen the valve opening. This is a procedure done without open-heart surgery.
• Valve Repair: Surgeons can sometimes repair the damaged valve to help it function better. This preserves the natural heart tissue.
• Valve Replacement: If the valve is too damaged to repair, it may need to be replaced with a mechanical or biological valve.

We are proud to be a heart specialist hospital in ahmedabad equipped with advanced cath labs and surgical suites to perform these complex procedures safely.

Pregnancy and Rheumatic Heart Disease

Pregnancy puts extra strain on the heart because the volume of blood in the body increases. For women with RHD, this can be dangerous. It is a leading cause of heart-related complications during pregnancy in our region.

Women with RHD who plan to become pregnant should discuss their condition with a healthcare provider beforehand. Close monitoring throughout the pregnancy is essential to ensure the safety of both the mother and the baby.

Prevention Strategies

The most effective way to prevent rheumatic heart disease is to treat strep throat infections promptly. If you or your child has a sore throat with a fever, swollen lymph nodes, or pain when swallowing, seek medical attention. A simple course of antibiotics can stop the immune reaction that leads to heart damage.

For those who have already had rheumatic fever, sticking to the schedule of preventative antibiotics is crucial. Missing doses can leave the body vulnerable to another attack, which causes further damage to the heart valves.

Living with RHD

Living with this condition requires regular medical checkups. You may need to limit certain physical activities depending on the severity of your valve disease. Dental hygiene is also important, as bacteria from the mouth can enter the bloodstream and cause infections in damaged heart valves.

At Sterling Hospitals, we provide you with the utmost care and comfort throughout your journey to a healthier heart. If you are looking for the best  cardiovascular surgeons in Ahmedabad, Vadodara, Rajkot, or Gandhidham, we've got you.

With considerable years of experience, we have built a team of thebest cardiologists in these regions to provide you with premium treatment and the best results.Contact Sterling Hospitals to schedule a consultation and embark on a journey towards a healthier heart.

Your heart is a complex pump responsible for moving blood throughout your body. When a baby is born with a problem in the structure of the heart, doctors call this congenital heart disease (CHD). This term covers a wide range of issues that affect how blood flows through the heart. Some defects are simple and might not need treatment, while others are more complex and require surgery soon after birth.

Congenital heart disease is the most common type of birth defect. In India alone, about 200,000 to 300,000 babies are born with a heart defect each year. This affects nearly 1% of all births. The good news is that medical care has improved greatly over the last few decades. Today, more than 94% of Indian children born with a heart defect who had surgical intervention survive into adulthood.

At Sterling Hospitals, we understand that a diagnosis of a heart defect can feel overwhelming for parents and patients. We are here to help you understand what this condition means, how it is diagnosed, and what treatment paths are available.

What Goes Wrong in the Heart?

During the first six weeks of pregnancy, a baby’s heart begins to take shape and starts beating. This is when congenital heart defects usually develop. The problems can affect different parts of the heart:

• Walls: The heart has walls that separate the left side from the right side. If a hole forms in these walls, blood can mix incorrectly.
• Valves: These are like doors that open and close to control blood flow. A valve might be too narrow or completely closed, forcing the heart to work harder.
• Blood Vessels: The arteries and veins that carry blood to and from the heart might not form correctly.

These structural issues change the normal flow of blood. This can lead to blood moving too slowly, going in the wrong direction, or failing to reach the lungs or body efficiently.

Types of Heart Defects

Doctors generally group these defects into two main categories based on how they affect oxygen levels in the body.

Cyanotic Heart Defects

These defects lower the amount of oxygen delivered to the body. Babies with this type often have a blue tint to their skin because their blood does not carry enough oxygen.

Acyanotic Heart Defects

These defects do not usually cause low oxygen levels. However, they can still cause abnormal blood flow that puts stress on the heart and lungs.

Symptoms to Watch For

Signs of a heart defect can appear at birth, during infancy, or much later in childhood. Some people do not show symptoms until they are adults.

In Infants and Babies:

• Pale gray or blue skin color (cyanosis), especially on the lips or fingernails.
• Rapid breathing or shortness of breath.
• Swelling in the legs, belly, or around the eyes.
• Shortness of breath during feedings, leading to poor weight gain.

In Older Children and Adults:

• Getting out of breath easily during exercise or activity.
• Fainting during exercise.
• Swelling in the hands, ankles, or feet.
• Extreme tiredness (fatigue).

If you notice these signs, it is important to consult a doctor. Finding the right heart hospital in Ahmedabad is the first step toward getting an accurate diagnosis.

Causes and Risk Factors

In most cases, doctors do not know exactly why a baby’s heart fails to develop correctly. It is often a mix of genetics and environmental factors.

• Genetics: Heart defects can run in families. Certain genetic conditions, such as Down syndrome, increase the risk.
• Infections: Having German measles (rubella) during pregnancy can affect heart development.
• Medical Conditions: If a mother has diabetes, keeping blood sugar controlled before and during pregnancy helps lower the risk.
• Substances: Smoking, drinking alcohol, or taking certain medications during pregnancy can increase the likelihood of heart defects.

How We Diagnose Heart Defects

Thanks to modern technology, many heart defects are found before a baby is born.

Prenatal Diagnosis

Doctors use a test called a fetal echocardiogram to create pictures of the baby’s heart while still in the womb. This allows the medical team to plan for care immediately after birth.

Postnatal Diagnosis

After birth, doctors use several tests to check heart function:

• Pulse Oximetry: A painless sensor on the finger or toe checks oxygen levels.
• Echocardiogram: Ultrasound waves create images of the heart structure.
• Electrocardiogram (ECG): This records the electrical activity of the heart.
• Chest X-ray: This shows the size of the heart and the condition of the lungs.

For adults or complex cases, we might use cardiac MRI or cardiac catheterization to get a detailed view. If you are looking for a heart specialist hospital in Ahmedabad with advanced diagnostic tools, these technologies are essential for accurate assessment.

Treatment Options

Treatment depends entirely on the type of defect and how severe it is. Some mild defects, like small holes, may close on their own as a child grows. Others require medical intervention.

Procedures and Surgery

Many defects can now be fixed without open-heart surgery. Doctors use a procedure called cardiac catheterization. They thread a thin tube through a blood vessel to the heart to repair holes or open narrow valves.

For more complex problems, surgery is necessary. Surgeons may patch holes, repair valves, or widen blood vessels. In severe cases, a series of surgeries over several years might be needed. As a leading best cardiology hospital in Ahmedabad, Sterling Hospitals is equipped to handle these complex interventions.

Medications

Sometimes, surgery isn’t needed right away, or at all. Medications can help the heart work more efficiently. These might include drugs to lower blood pressure, remove excess fluid from the body, or keep the heartbeat regular.

Living with Congenital Heart Disease

Decades ago, congenital heart disease was considered a condition only of childhood. Today, there are more adults living with CHD than children. This shift means that care does not stop at age 18.

Adults who had heart surgery as children need regular checkups. Issues like irregular heartbeats or valve problems can develop years later. We recommend that adults with a history of heart defects see a cardiologist who understands congenital conditions.

Quality of Life

Most people with CHD live active, full lives.

• Exercise: Physical activity is good for the heart. Most patients can exercise safely, though some may need to avoid intense competitive sports.
• Pregnancy: Women with CHD can have successful pregnancies, but it requires careful planning with a doctor to manage risks.

When to Seek Care

You should see a doctor if you or your child experience symptoms like chest pain, severe shortness of breath, or fainting. Regular follow-up appointments are vital for anyone with a known heart defect, even if you feel fine.

At Sterling Hospitals, we provide you with the utmost care and comfort throughout your journey to a healthier heart. If you are looking for the best  cardiovascular surgeons in Ahmedabad, Vadodara, Rajkot, or Gandhidham, we've got you.

With considerable years of experience, we have built a team of the best cardiologists in these regions to provide you with premium treatment and the best results. Contact Sterling Hospitals to schedule a consultation and embark on a journey towards a healthier heart.

By understanding the condition and staying proactive with medical appointments, you can manage congenital heart disease effectively and lead a healthy life.

What Is the Thyroid Gland and What Does It Do?

The thyroid is a gland that sits low on the front of the neck, below the larynx (voice box). Its primary job is to produce and release thyroid hormones, mainly thyroxine (T4) & triiodothyronine (T3).

These hormones are essential for controlling your metabolism. Metabolism is the process by which the human body converts the nutrients from food into usable energy. The rate at which your body uses energy, even at rest, is known as the basal metabolic rate (BMR).

Thyroid hormones set this rate. They determine the speed at which your body will burn calories, how fast your heart beats, and how your body regulates its temperature.

Hypothyroidism vs. Hyperthyroidism

A thyroid imbalance occurs when the gland produces either too much or too little hormone.

• Hypothyroidism (Underactive Thyroid): A condition that arises when the thyroid gland does not generate or release an adequate amount of thyroid hormones. When hormone levels are low, the body's functions slow down.
• Hyperthyroidism (Overactive Thyroid): The opposite condition, in which the thyroid produces excess hormones. This imbalance speeds up the body's metabolism and functions.

While both conditions are serious, the specific issues of weight gain and persistent fatigue are primarily associated with hypothyroidism.

How Hypothyroidism Affects Energy and Weight

Because thyroid hormones regulate metabolism, a shortage of these hormones has a direct, twofold effect on the body.

The Energy Connection

When the thyroid is underactive, the body's metabolic rate slows. This "slowing down" of your internal engine means cells are not functioning at their normal pace. For the individual, this is directly experienced as persistent fatigue, sluggishness, & a general lack of energy that is not relieved by rest.

The Weight Connection

The link between hypothyroidism and weight is complex but clear. A slower basal metabolic rate (BMR) means your body burns fewer calories at rest than it normally would. This can contribute to a calorie surplus, in which unused energy is stored, leading to weight gain.

However, the nature of this weight gain is specific. Hypothyroidism is rarely the sole cause of significant or excessive weight gain. The weight gain directly attributable to an underactive thyroid is typically modest, often 5 to 10 pounds. A large portion of this increase is not due to fat accumulation but to excess accumulation of salt and water in the body, a condition known as myxedema.

Common Symptoms of an Underactive Thyroid

• Persistent fatigue, sluggishness, or feeling "run down"
• Modest weight gain
• Difficulty losing weight
• Increased sensitivity to cold (cold intolerance)
• Dry skin
• Thinning hair or hair loss
• Constipation
• Muscle aches, weakness, or stiffness
• Puffy face
• Slowed heart rate (bradycardia)
• Depression or slowed mental processes

What Causes Thyroid Function to Slow Down?

• Hashimoto’s Disease: This condition is an autoimmune disorder in which the immune system mistakenly targets and harms the thyroid gland. This assault compromises the gland's function and reduces its capacity to manufacture hormones.
• Treatment for Hyperthyroidism: Previous treatments for an overactive thyroid, such as radioactive iodine therapy or anti-thyroid medications, can sometimes result in permanent hypothyroidism
• Thyroid Surgery: The partial or complete removal of the thyroid gland (thyroidectomy), often done to treat thyroid nodules, cancer, or hyperthyroidism, will reduce or stop hormone production
• Radiation Therapy: Exposure to therapeutic radiation for head and neck malignancies can impair the thyroid gland, leading to the development of hypothyroidism
• Thyroiditis: Inflammation of the thyroid gland. It can cause the gland to release all its stored hormones at once (leading to brief hyperthyroidism), followed by a period of hypothyroidism that may or may not become permanent.
• Certain Medications: Some drugs can interfere with thyroid hormone production

How a Doctor Confirms a Thyroid Problem

• Medical and Family History: A doctor will discuss your symptoms, personal medical history, and whether any family members have had thyroid disease.
• Physical Exam: First, a physical exam will be conducted, including palpation of the neck to assess for thyroid gland enlargement (goiter), lumps, or nodules.
• Blood Tests: This is the most definitive way to diagnose a thyroid condition.
• TSH (Thyroid-Stimulating Hormone): This is the most important and sensitive test. TSH is produced by the pituitary gland and signals the thyroid to produce hormones. A high TSH level indicates the pituitary is trying to "shout" at an underactive thyroid to work harder.
• T4 (Thyroxine): This test measures the level of the primary hormone produced by the thyroid. A low T4 level combined with a high TSH level confirms the diagnosis of hypothyroidism.

Restoring Balance and Managing Symptoms

• Thyroid Hormone Replacement Therapy: The condition is managed by taking a daily oral medication.
• How It Works: This medication is a synthetic (man-made) version of the T4 hormone that the thyroid gland is failing to produce. It replaces this missing hormone, allowing the body's metabolism and functions to return to normal.
• Lifelong Monitoring: Treatment for hypothyroidism is typically lifelong. A healthcare provider will use regular TSH blood tests to monitor hormone levels and ensure the medication dosage is correct, adjusting it as needed over time.
• Symptom Resolution: Once the correct dosage is established, the medication typically resolves symptoms like fatigue and cold intolerance and helps stabilize the body's metabolic rate.

Sterling Hospital is Your Partner in Better Health Across Gujarat

At Sterling Hospital, we provide the utmost care and comfort throughout your journey to a healthier life. If you are looking for the best endocrinologist in ahmedabad-gurukul or Rajkot, we've got you covered. 

Our endocrine department is built with a team of the best endocrinologists in these regions to provide premium treatment and the best results.Contact Sterling Hospital to schedule a consultation and embark on a journey towards a healthier future.

Your spine is a sophisticated structure of bones, joints, discs, and nerves. It serves two primary functions: providing the structural support that allows you to stand upright and move, and encasing the delicate spinal cord that transmits messages between your brain and body.

In modern life, activities like prolonged sitting, repetitive movements, or poor posture place sustained stress on the spine's components. With time, this can lead to discomfort, stiffness, and vulnerability to injury.

The key to long-term spinal health is not avoidance of movement, but rather the cultivation of a strong, adaptive, and well-aligned support system. A spine is protected by the muscles that surround it. This article outlines a targeted exercise approach focused on three pillars, stability, mobility, and posture, to build this natural defense and maintain a resilient, pain-free back.

The Three Pillars of Spinal Resilience

A healthy spine requires a balance of strength and flexibility. We can break this down into three essential attributes:

• Core Stability: This refers to more than just the abdominal "six-pack" muscles. The core is a 360-degree network of muscles in your abdomen, lower back, and glutes. When strong and engaged, these muscles form a natural "corset" that braces the spine, distributing loads evenly and protecting the vertebrae and discs from excessive strain.
• Spinal Mobility and Flexibility: Your spine is designed to move—bending forward (flexion), arching back (extension), and twisting (rotation). At the same time, the muscles and joints that connect to the spine, particularly the hips and hamstrings, must be flexible. Stiff hips or tight hamstrings often force the lower back to compensate by moving excessively, which is a common source of strain.
• Postural Awareness: Posture is the foundational alignment of your body. This includes "static" posture (how you hold yourself when sitting or standing) and "dynamic" posture (how you maintain alignment while moving, bending, or lifting). Correct posture minimizes stress by keeping the spine in a neutral, efficient position.

Foundational Exercises for a Healthy Back

The following exercises are low-impact and designed to build the three pillars of spinal health. Focus on slow, controlled movements.

Movements for Core Stability

• Bridge: This exercise strengthens the glutes and back muscles, which support the lower spine.
• How to: Lie on your back with your knees bent, feet flat on the floor hip-width apart, and arms by your sides. Squeeze your glutes and lift your hips off the floor until your body forms a straight line from your shoulders to your knees. Hold for a few seconds, then slowly lower your hips back down.
• Bird-Dog: This movement teaches the core to remain stable and the spine to stay neutral while your limbs are in motion.
• How to: Start on your hands & knees, with your hands directly under your shoulders & knees under your hips. Engage your abdominal muscles to keep your back flat. Slowly extend your right arm straight forward & your left leg straight back, keeping your hips level. Hold for 5-10 seconds, then slowly return to the start. Repeat with the opposite arm and leg.
• Partial Crunch: A full sit-up can pull on the neck and round the back excessively. The partial crunch strengthens the abdominal muscles with less spinal stress.
• How to: Begin by lying supine (face-up) with your feet grounded and your knees angled upward. For stability, you can interlace your fingers behind your head or cross your arms over your sternum. Initiate the movement by contracting your abdominal muscles. Keeping your lumbar spine anchored to the floor, lift your upper body—head and shoulders included —just until your shoulder blades clear the mat. Hold the peak contraction briefly before returning to the floor with a controlled motion.

Movements for Mobility and Flexibility

• Cat-Cow: This dynamic stretch gently moves the spine through flexion and extension, improving mobility and releasing tension.
• How to: Adopt a tabletop position, aligning your shoulders directly over your wrists and your hips over your knees. Begin by taking a deep breath in. As you inhale, allow your abdomen to sink toward the ground, simultaneously lifting your tailbone and gazing upward to create a gentle arch in your back (cow pose). Next, expel the air completely. While exhaling, draw your navel firmly toward your spine, rounding your back toward the ceiling like a stretching cat. Tuck your chin down toward your chest (cat pose). Continue to flow smoothly and mindfully between these two postures, coordinating each movement with the rhythm of your breath.
• Knee-to-Chest Stretch: This action releases tension in the lower back and glutes, which can become tight from sitting.
• How to: Lie on your back with your knees bent. Gently bring one knee up and pull it toward your chest with your hands, holding for 20-30 seconds. Feel the gentle stretch in your lower back and hip. Lower the leg, then repeat on the other side.
• Child's Pose: This is a resting pose that actively elongates, decompresses, and relieves tension along the entire length of the spine.
• How to: Start on your hands and knees. Sit back so your glutes rest on your heels. Fold forward, resting your torso on your thighs and your forehead on the floor. Reach your arms out long in front of you. Breathe deeply, feeling the stretch in your back.

Movements for Posture and Alignment

• Hamstring Stretch: Tight hamstrings (the muscles on the back of your thighs) pull on the pelvis, which can flatten the natural curve of your lower back and cause strain.
• How to: Lie on your back with both knees bent. Lift one leg and loop a towel around your foot (or hold the back of your thigh). Slowly straighten this leg toward the ceiling until you feel a gentle stretch. Keep your back flat on the floor. Hold for 20-30 seconds and switch legs.
• Press-up Back Extension: This movement counters the forward-flexed posture of sitting and helps restore the natural extension curve in your lower back.
• How to: Lie on your stomach with your hands under your shoulders, palms flat. Keeping your hips on the floor, use your back muscles (and assist with your arms) to press your upper body—head, chest, and shoulders—off the floor. Hold for 5-10 seconds, then slowly lower. Only go as high as is comfortable.

Beyond the Mat: Integrating Spine Health into Daily Life

Exercises are only part of the solution. How you move all day matters.

• Conscious Posture: When sitting, ensure your feet are flat on the floor, keep your shoulders back and relaxed, and avoid slouching. Your hips should be level with or slightly higher than your knees. When standing, distribute your weight evenly on both feet and stand tall, with your head balanced over your spine.
• Safe Lifting Mechanics: To protect your back, master the "hip hinge." When lifting an object, bend at your hips and knees, not your waist. Keep your back straight, engage your core, and drive up with your legs and glutes, keeping the object close to your body.
• Low-Impact Aerobic Activity: Activities like walking and swimming increase blood flow throughout the body. This enhanced circulation delivers oxygen & vital nutrients to the tissues and discs in your spine, keeping them nourished and healthy.

Sterling Hospital is Your Partner in Better Health Across Gujarat

Sterling Hospital has proven itself to provide the best orthopedic hospital in Ahmedabad, Vadodara, and Rajkot. We provide you with the utmost care and comfort throughout your journey to healthy bones and joints. If you are looking for the best orthopedic doctor in Ahmedabad, Vadodara, Rajkot and Gandhidham,  we've got you. Safeguard your bone health and contact Sterling Hospital to schedule a consultation and embark on a journey towards a healthier life.

A stroke occurs when the blood supply to the brain is  reduced or interrupted. This deprives brain tissue of essential oxygen and nutrients, causing brain cells to begin to die within minutes.

Immediate treatment is critical. Early action can reduce brain damage and prevent potential long-term disability or death.

The Main Types of Stroke

• Ischemic Stroke: It happens when a blood vessel supplying the brain becomes blocked or plugged, often by a blood clot. These clots can form in arteries damaged by fatty deposits (atherosclerosis) or travel from other parts of the body, such as the heart.
• Hemorrhagic Stroke: This type occurs when a blood vessel within or on the surface of the brain leaks or ruptures (bursts). This causes bleeding into the brain tissue or the surrounding spaces, which puts excessive pressure on brain cells and damages them. Causes include uncontrolled high blood pressure, aneurysms (bulges in a vessel wall), or arteriovenous malformations (AVMs), which are irregular tangles of blood vessels.

A Transient Ischemic Attack (TIA), or "mini-stroke," is a related condition. It involves a temporary period of stroke-like symptoms caused by a brief decrease in blood supply to the brain. While a TIA doesn't typically cause permanent damage, it serves as a serious warning sign that a major stroke may be imminent.

Recognizing the Symptoms: Act F.A.S.T.

Stroke symptoms appear suddenly. Recognizing them is the first step to getting life-saving help. The F.A.S.T. acronym is a simple way to remember the key signs:

• F - Face: Ask the individual to smile. Check if one side of their mouth or face sags or appears uneven.
• A - Arms: Instruct the person to lift both arms in front of them. Observe if one arm lowers involuntarily or is incapable of being raised fully.
• S - Speech: Ask them to repeat a very basic sentence. Listen for speech that sounds thick, slurred, or odd. Also, note if they have trouble comprehending instructions.
• T - Time:  If you observe any single one of these warning signs, treat it as a medical emergency.

Other sudden symptoms to watch for include:

• Unexplained weakness or numbness in the limbs or face, particularly when these symptoms manifest only on one half of the body.
• Confusion.
• Trouble seeing in one or both eyes, such as sudden blurred or blackened vision.
• Dizziness, or a loss of balance & coordination.
• A severe headache with no known cause, which may be accompanied by vomiting or dizziness.

Understanding the Causes and Risk Factors

While the direct causes are a clot (ischemic) or bleeding (hemorrhagic), numerous risk factors increase the likelihood of a stroke. These factors are categorized as controllable or uncontrollable.

Controllable (Modifiable) Risk Factors: These are factors you can manage with lifestyle changes or medical treatment.

• Medical Conditions:
• High Blood Pressure (Hypertension): This is the single most significant risk factor for stroke.
• High Cholesterol: Can lead to the buildup of plaque in arteries.
• Diabetes: Poorly controlled diabetes damages blood vessels over time.
• Heart Conditions: Atrial fibrillation (an irregular heartbeat), heart defects, and other heart diseases can create clots.
• Obstructive Sleep Apnea: A sleep disorder that can raise blood pressure.
• Lifestyle Factors:
• Tobacco Use: Smoking or chewing tobacco damages blood vessels and raises blood pressure.
• Physical Inactivity: Lack of exercise contributes to obesity, high blood pressure, and high cholesterol.
• Unhealthy Diet: Diets high in saturated fats, trans fats, and sodium can raise cholesterol and blood pressure.
• Heavy Alcohol Use: Can increase blood pressure.
• Use of Illegal Drugs: Drugs like cocaine can narrow arteries.

Uncontrollable Risk Factors:

• Age: The risk of stroke increases as you get older.
• Family History: A personal or family history of stroke, heart attack, or TIA increases your risk.
• Race and Ethnicity: Some groups, such as African Americans, have a higher risk of stroke.
• Sex: Men have a slightly higher risk of stroke than women, though women are often older when they have strokes and are more likely to die from them.
• Hormones: The use of estrogen-containing birth control pills or hormone therapies can increase risk.

How a Stroke is Diagnosed

In an emergency setting, a medical team will work quickly to determine the type of stroke. This involves:

• Physical and Neurological Exam: Checking mental alertness, coordination, balance, vision, speech, and for weakness or numbness.
• Brain Imaging: A Computerized Tomography (CT) scan is often done first. It can quickly show bleeding in the brain (hemorrhagic stroke) or damage from an ischemic stroke. A Magnetic Resonance Imaging (MRI) scan provides a more detailed image of brain tissue and can detect damage earlier than a CT.
• Other Tests: A carotid ultrasound uses sound waves to check for plaque buildup in the neck arteries. An echocardiogram can create images of the heart to find a source of clots. Blood tests are also performed.

Treatment

The treatment for a stroke depends entirely on its type.

For an Ischemic Stroke: The goal is to restore blood flow to the brain as quickly as possible.

• IV Medicines: An injection of recombinant tissue plasminogen activator (tPA) is the gold standard. This clot-busting drug must be given within 3 to 4.5 hours of when symptoms started.
• Endovascular Procedures: These are performed directly inside the blocked vessel. A mechanical thrombectomy involves a surgeon threading a catheter to the clot and using a device (a stent retriever) to pull it out. This can be effective up to 24 hours after symptom onset in certain cases.

For a Hemorrhagic Stroke: The goal is to control the bleeding and reduce pressure on the brain.

• Medication: Drugs are given to lower blood pressure, counteract blood thinners, and prevent seizures or blood vessel spasms.
• Surgery: If the bleeding is severe, surgery may be needed to remove the blood and relieve pressure. If the stroke was caused by a ruptured aneurysm, a surgeon may perform:
• Surgical Clipping: A tiny clamp is placed at the base of the aneurysm.
• Coiling (Endovascular Embolization): Tiny coils are placed inside the aneurysm via a catheter to block blood flow and cause clotting.

Recovery and Prevention

Recovery from a stroke, known as rehabilitation, is a critical part of the process and often begins in the hospital. The goal is to regain skills and independence. This may involve:

• Physical Therapy to regain strength, balance, and movement.
• Occupational Therapy to relearn daily activities like eating, dressing, and writing.
• Speech Therapy to help with language, speaking, and swallowing.

The best way to manage stroke is to prevent one. Controlling your modifiable risk factors is the most effective strategy. This includes managing high blood pressure, quitting smoking, eating a healthy diet, exercising regularly, & managing conditions like diabetes and atrial fibrillation.

​A Complete Spectrum of Emergency Medical Services

Sterling Hospital delivers rapid, specialized emergency care through a well-structured response system designed to meet critical medical needs. The emergency department is equipped to manage severe trauma from accidents and injuries, deploying experienced medical teams for immediate intervention in complex cases.

The hospital excels in treating acute cardiovascular events such as myocardial infarctions and cardiac rhythm disturbances, using advanced diagnostic tools and evidence-based treatment protocols to ensure timely care.

Neurological emergencies are addressed with prompt evaluation and targeted treatment strategies aimed at minimizing long-term damage. The emergency team is also trained to manage a wide range of urgent medical conditions with swift stabilization and appropriate clinical management.

Enhancing this care pathway are Sterling’s specialized critical care units, which are staffed around the clock by intensivists and physicians certified in critical care medicine. These units combine expert supervision with state-of-the-art life support systems and continuous monitoring to create the best possible outcomes for patients in life-threatening conditions.

A hernia occurs when an organ, intestine, or fatty tissue pushes through a weak spot or opening in the surrounding muscle or connective tissue, known as fascia. While many hernias happen within the abdominal wall, the area between the chest and hips, they can also commonly appear in the upper thigh and groin areas.

Common Types of Hernias

A hernia’s type is determined by its location and cause. The most frequent types include:

• Inguinal Hernia: This is the most common type of hernia. It occurs when tissue, such as part of the intestine, protrudes through a weak spot in the lower abdominal wall. This location, the inguinal canal, is in the groin.
• Hiatal Hernia: This internal hernia occurs when a portion of the upper stomach pushes up through the diaphragm—the large muscle separating the chest and abdomen—and into the chest cavity.
• Umbilical Hernia: This appears as a bulge near the belly button (navel). It happens when fat or part of the intestine pushes through the abdominal muscle near this area. It is common in infants but can also affect adults.
• Incisional Hernia: This type occurs when tissue pushes through a weakened area caused by a scar from a previous abdominal surgery.
• Femoral Hernia: A less common type of groin hernia, this involves a bulge of fatty tissue or part of the bowel into the upper thigh, just below the groin. Femoral hernias are more common in women.
• Ventral Hernia: This is a general term for any hernia that occurs along the front (ventral) wall of the abdomen. Incisional and umbilical hernias are two types of ventral hernias.

Key Causes and Risk Factors

A hernia is caused by a combination of two factors: muscle weakness and physical strain (pressure). An organ or tissue can push through an opening or weak spot only when that spot is subjected to pressure.

This weakness in the muscle or tissue wall can be present at birth (a congenital condition) or it can develop over time. Factors that contribute to muscle weakness or increased abdominal pressure include:

• Aging
• Damage from a previous injury or surgery
• Strenuous exercise or lifting heavy objects
• Pregnancy, especially multiple pregnancies
• Chronic, persistent coughing (such as from smoking)
• Straining during bowel movements (due to chronic constipation)
• Straining to urinate
• Obesity, which adds continuous pressure to the abdominal wall

Signs and Symptoms

The most common sign of a hernia is a visible lump or bulge in the affected area, such as the groin or near the belly button. This bulge may become more obvious when you are standing, coughing, or straining, and it might retract or "disappear" when you lie down.

While some hernias cause no symptoms, others may present with:

• A feeling of pressure, weakness, or a dull ache in the area.
• Discomfort or sharp pain, especially when bending over, coughing, or lifting.

Note: Some types of hernias, like a hiatal hernia, are internal and do not produce a visible bulge. Instead, they may cause symptoms such as heartburn, chest pain, or difficulty swallowing.

When to Seek Medical Help

You should consult a healthcare professional if you suspect you have a hernia. While many hernias are not immediately dangerous, they do not go away on their own and can lead to serious complications.

A hernia becomes dangerous when the protruding tissue gets trapped (known as incarceration) and cannot be pushed back into place. This can lead to strangulation, a life-threatening emergency where the blood supply is cut off to the trapped tissue, causing it to die.

Seek immediate medical care if you have a hernia and experience any of the following symptoms:

• Sudden, severe, or worsening pain
• Nausea and vomiting
• Fever
• A hernia bulge that becomes firm, tender, or changes color (such as turning red, purple, or dark)
• An inability to pass gas or have a bowel movement

How Hernias Are Diagnosed

A diagnosis for most hernias begins with a physical examination. A healthcare provider can often see or feel the bulge in the abdomen or groin. As part of the exam, you may be asked to stand, bend, or cough, as these actions can make the hernia more prominent.

If the diagnosis is not obvious from a physical exam, or if an internal hernia is suspected, imaging tests may be ordered to view the tissue:

• Abdominal Ultrasound: This uses sound waves to create images of the inside of the body and is commonly used for groin hernias.
• CT (Computed Tomography) Scan: This scan combines X-rays to create detailed images and can clearly show the hernia and any trapped tissue.
• Barium X-ray or Endoscopy: For a suspected hiatal hernia, you may drink a liquid barium solution that highlights your digestive tract on an X-ray. An endoscopy, which uses a small camera on a flexible tube, may also be used to look directly at the stomach and esophagus.

Treatment Options for Hernias

Treatment depends on the type, size, and location of the hernia, as well as the severity of your symptoms.

• Watchful Waiting: For a small hernia that is not causing any pain or problems, a doctor may recommend monitoring it. This approach involves regular check-ups to ensure the hernia is not growing or causing complications.
• Nonsurgical Support: For some hernias, such as an inguinal hernia, wearing a supportive garment like a hernia truss may help hold the hernia in place and relieve discomfort. This does not repair the hernia and should only be used after consulting a healthcare provider.
• Lifestyle and Medication: For hiatal hernias, treatment often focuses on managing symptoms of acid reflux. This may include dietary changes, such as avoiding large meals, or using medications that reduce stomach acid.
• Surgical Repair: Surgery is the only treatment that can permanently repair a hernia. It is typically recommended if the hernia is painful, growing larger, or causing complications. The two main types of hernia repair are:
• Open Surgery: The surgeon makes an incision near the hernia, pushes the protruding tissue back into its proper place, and then repairs the weakened muscle wall. The repair often involves reinforcing the area with stitches or a piece of synthetic surgical mesh.
• Minimally Invasive (Laparoscopic) Surgery: This procedure requires several small incisions. The surgeon uses a thin, lighted tube with a camera (laparoscope) and tiny surgical instruments to repair the hernia, usually reinforcing the area with mesh. This approach generally results in less discomfort and a faster recovery.

Hernia Prevention Strategies

While it is not possible to prevent all hernias, especially those that are congenital, you can reduce your risk of developing a hernia by minimizing strain on your abdominal muscles and tissues.

• Maintain a healthy weight. Excess weight increases the pressure on the abdominal wall.
• Emphasize high-fiber foods. Eating fruits, vegetables, and whole grains helps prevent constipation, which causes you to strain during bowel movements.
• Use proper lifting techniques. If you must lift something heavy, bend from your knees, not your waist. Keep your back straight and use your legs to do the work. Avoid lifting objects that are too heavy for you.
• Stop smoking. Smoking can lead to a persistent, heavy cough that puts repeated pressure on the abdomen.
• See a doctor for chronic coughs or urination issues. Do not ignore a chronic cough or straining to urinate, as these conditions create ongoing pressure that can lead to a hernia.

Sterling Hospital is Your Partner in Better Health Across Gujarat

At Sterling Hospital, we provide you with the utmost care and comfort throughout your journey to a healthier life. If you are looking for the best gastro surgeon in Ahmedabad, Vadodara, or Rajkot, we've got you. 

With considerable years of experience, we have built a team of the best gastro surgeons in these regions to provide you with premium treatment and the best results. Contact Sterling Hospital to schedule a consultation and embark on a journey towards a healthier future.

Liposarcoma is a rare type of cancer that originates in your fat cells. As a form of soft tissue sarcoma, it develops from connective tissues, which include fat, muscles, nerves, and blood vessels. 

The cancerous tumors in liposarcoma are made of fat cells (lipocytes) and can grow almost anywhere in the body. Still, they most commonly occur in the muscles of the limbs, particularly the thigh, or in the abdomen.

Symptoms of Liposarcoma

• A growing lump of tissue under the skin
• Swelling or numbness in the affected area
• Pain
• Weakness of the limb
• Abdominal pain or cramping
• Swelling or an increase in belly size
• Feeling full quickly when eating
• Constipation
• Blood in the stool
• Nausea and vomiting
• Fatigue
• Fever
• Unintentional weight loss

Classification of Liposarcoma

Liposarcoma is classified into several subtypes based on the microscopic appearance of the cancer cells. This classification helps doctors determine the tumor's likely behavior and the most effective course of treatment. The types are:

• Well-differentiated Liposarcoma. This is the most common subtype. It is a low-grade cancer, meaning its cells resemble normal fat cells & tend to grow slowly. These tumors are least likely to spread to other parts of the body. When this type develops in the abdomen, it's called an atypical lipomatous tumor.
• Myxoid Liposarcoma. This is the second most common subtype. It is considered an intermediate-grade cancer. These tumors often develop in the thigh muscles and contain a network of blood vessels.
• Pleomorphic Liposarcoma. This is the rarest and most aggressive subtype. It is a high-grade cancer, meaning the cells look very abnormal and multiply rapidly. It has a high risk of spreading to other parts of the body (metastasizing).
• Dedifferentiated Liposarcoma. This type is a combination of a low-grade (well-differentiated) tumor and a high-grade tumor. It begins as a well-differentiated liposarcoma but then has areas that transform into a more aggressive, faster-growing cancer.

What Causes Liposarcoma?

The cancer develops when fat cells undergo changes, or mutations, in their DNA. These mutations disrupt the normal instructions that control cell growth and death, leading to an uncontrolled multiplication of abnormal cells that accumulate to form a tumor. 

While the specific trigger for these genetic changes is unknown, some factors can escalate the risk of developing soft tissue sarcomas like liposarcoma. These risk factors include having certain inherited genetic syndromes, such as Li-Fraumeni syndrome and neurofibromatosis, a history of receiving radiation therapy for a previous cancer, or long-term exposure to specific industrial chemicals.

Diagnosis of Liposarcoma

Initial Examination

A doctor will perform a physical check to assess the lump or area of swelling and discuss your personal and family medical history.

Imaging Tests

To get a detailed look at the tumor's size, location, and relationship to surrounding tissues, one or more of the following imaging tests may be used:

• X-rays provide a basic image of the affected area.
• Computed Tomography (CT) scans create detailed, cross-sectional images of the body.
• Magnetic Resonance Imaging (MRI) uses magnets and radio waves to produce a detailed image of soft tissues, making it particularly useful for viewing tumors in the arms and legs.
• Positron Emission Tomography (PET) scans can help determine if the cancer has metastasize to other parts of the body.

Biopsy

This procedure involves taking a small sample of the tumor tissue for examination in a laboratory. There are two main methods:

• Core needle biopsy: A doctor inserts a long, thin needle past the skin to extract a small core of tissue from the tumor.
• Surgical biopsy: A surgeon makes an opening to remove either a piece of the tumor (incisional biopsy) or the entire tumor (excisional biopsy).

Laboratory Analysis

The tissue sample from the biopsy is sent to a pathologist. They examine the cells under a microscope to confirm that it is liposarcoma and identify its specific subtype. Advanced lab tests may also be performed on the tumor cells to look for specific genetic mutations, which can help guide treatment decisions.

Treatment for Liposarcoma

The treatment for liposarcoma is tailored to the individual and depends on factors like the tumor's subtype, size, location, and whether it has spread. The primary goal is to eleminate the cancer completely while also preserving as much function as possible.

Surgery

• This is the most common and primary treatment for liposarcoma. The goal is to remove the whole tumor along with some margin of healthy tissue that surround it to ensure no cancer cells are left behind.
• For tumors in the arms or legs, surgeons perform limb-sparing surgery whenever possible to avoid amputation.
• If a tumor is large or located near critical organs, other treatments may be used first to shrink it and make the surgery safer and more effective.

Radiation Therapy

• This treatment uses high-energy beams, such as X-rays or protons, to kill cancer cells.
• It may be administered before surgery (neoadjuvant) to shrink the size of the tumor, making it efficient to remove completely.
• It can also be used during surgery (intraoperative) to deliver a direct dose of radiation to the area after the tumor is removed.
• It is often used after surgery (adjuvant) to destroy any remaining cancer cells & reduce the risk of the cancer returning.

Systemic Therapies

These treatments use medications to destroy cancer cells throughout the body and are typically used for liposarcoma that has spread or cannot be removed surgically.

• Chemotherapy: This involves using powerful medications that are effective at killing rapidly dividing cells, including cancer cells. It can be administered through a vein (intravenously) or as a pill.
• Targeted Therapy: These are newer drugs that target specific weaknesses or abnormalities present within cancer cells. By blocking these targets, the medications can cause the cancer cells to die.
• Immunotherapy: This type of treatment saves the body's own immune system to find & fight cancer cells more effectively.

Living with Liposarcoma 

Consistent Follow-Up Care

• Regular Appointments: You will need to attend follow-up appointments with your oncology team. The frequency of these visits will be highest in the first few years after treatment and will gradually decrease over time.
• Imaging Scans: Expect to undergo periodic imaging tests, such as MRI or CT scans, of the original tumor site and your chest. These scans are crucial for monitoring for any signs of the cancer returning (recurrence) or spreading.

Rehabilitation and Physical Health

• Physical Therapy: If surgery affected a limb, physical therapy is essential to help you regain strength, flexibility, and a full range of motion.
• Occupational Therapy: An occupational therapist can help you find new ways to perform daily activities, such as dressing, bathing, and working, especially if you have long-term physical limitations.
• Managing Lymphedema: If lymph nodes were removed or affected by treatment, you may be at risk for lymphedema (swelling). Your care team can provide strategies to manage or reduce this risk, such as specialized exercises or compression garments.

Emotional and Mental Well-being

• Seek Support: Connecting with support groups, either in person or online, can be incredibly helpful. Sharing your experience with others who have undergone a similar diagnosis can help reduce feelings of isolation.
• Professional Counseling: A cancer diagnosis and its treatment can be emotionally challenging. Speaking with a therapist or counselor can provide you with coping strategies for anxiety, fear, and stress.
• Communicate Openly: Maintain an open dialogue with your doctors, nurses, and family about any physical or emotional challenges you are facing.

Outlook and Prognosis

The long-term outlook for someone with liposarcoma varies significantly and depends on several factors, including the tumor's specific subtype, its grade (how aggressive the cells are), its size and location, and whether it was removed entirely with surgery. 

Low-grade tumors that are fully removed have a very good prognosis, while high-grade or advanced cancers present more challenges. Your doctor is the best resource for information about your specific situation.

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At Sterling Hospital, we provide you with the utmost care and comfort throughout your journey to a healthier and brighter life. We've got you if you are looking for the best oncologist in ​​Ahmedabad (Gurukul) & (Sindhu Bhavan), cancer hospital in Vadodara (Bhayli & Race Course Road), or Rajkot. 

With considerable years of experience, we have built a team of the best oncologists in these regions to provide you with premium treatment and the best results. Contact Sterling Hospital to schedule a consultation and embark on a journey towards a healthier future.

The gallbladder is a small organ located in the upper right side of your abdomen, just beneath the liver. Its primary job is to act as a storage pouch for bile, a greenish-brown digestive fluid produced by your liver. The gallbladder concentrates this bile, which is then released into the small intestine after a meal to help break down fats.

Gallstones are deposits that form inside the gallbladder. These deposits are made of substances found in the bile, such as cholesterol or bilirubin. Gallstones can vary greatly in size. It can be as tiny as a grain of sand to as large as a golf ball. A person may have a single gallstone or many at once.

There are two types of gallstones:

• Cholesterol Stones: The most common type. They are typically yellow-green and composed primarily of undissolved cholesterol.
• Pigment Stones: These are smaller, darker stones made from bilirubin. Bilirubin is a substance produced when your body breaks down red blood cells. These stones are more common in individuals with specific medical conditions, such as liver cirrhosis or certain blood disorders.

Key Causes and Risk Factors for Gallstones

Gallstones form when the chemical balance of your bile is disrupted. Over the years, specilists have identified three main mechanisms:

• Your bile contains too much cholesterol: Bile naturally holds a sufficient concentration of compounds to keep the cholesterol released by your liver in a dissolved state. However, if your liver produces more cholesterol than your bile can dissolve, the excess may form hard crystals that eventually become stones.
• Your bile contains too much bilirubin: Certain medical conditions, like liver damage (cirrhosis) and some blood disorders, can cause your liver to produce too much bilirubin. This excess bilirubin can contribute to the formation of pigment gallstones.
• Your gallbladder does not empty properly: If your gallbladder fails to empty completely or frequently enough, the bile inside can become highly concentrated. This concentration increases the likelihood of gallstone formation.

Several factors can increase your risk of developing gallstones. These include:

• Being female
• Being age 40 or older
• Being overweight or obese
• Having a family history of gallstones
• Losing a large amount of weight very quickly
• Being pregnant
• Eating a high-fat or high-cholesterol diet that is low in fiber
• Having diabetes
• Having liver disease
• Taking certain medications that contain estrogen, such as oral contraceptives or hormone replacement therapy

Symptoms of Gallstones

Most people with gallstones experience no symptoms. These are known as "silent stones" and typically do not require treatment. Symptoms usually occur when a gallstone blocks one of the bile ducts, triggering gallbladder spasm. This is often called a gallbladder attack or biliary colic.

Key symptoms are:

• Sudden intensifying pain in the upper right part of your abdomen.
• Pain that may also be felt in the center of your abdomen (just below the breastbone), in your back between the shoulder blades, or in your right shoulder.
• The pain is severe and can last from 30 minutes to several hours.
• It may occur after eating a heavy or high-fat meal, often during the evening or at night.
• Other symptoms include nausea or vomiting.

How Gallstones Are Accurately Diagnosed

A doctor will use your symptoms and medical history, along with specific tests, to confirm a diagnosis of gallstones.

• Abdominal Ultrasound: This is the most common and effective test for detecting gallstones. It uses sound waves to produce clear images of your gallbladder and bile ducts, enabling a doctor to visualize the stones.
• Blood Tests: These tests can identify signs of infection, inflammation, jaundice, or pancreatitis, which can be caused by gallstones blocking a duct.
• Hepatobiliary Iminodiacetic Acid (HIDA) Scan: This test, also called a gallbladder scan, checks how well your gallbladder is working. A safe radioactive substance is injected and tracked as it moves through your bile ducts, revealing any blockages or problems with the gallbladder itself.
• Computerized Tomography (CT) Scan: An abdominal computed tomography (CT) scan utilizes X-rays to generate detailed, cross-sectional views of the internal structures of your abdomen. This imaging tool is highly effective for detecting gallstones and identifying associated issues, such as infection or a rupture.
• Magnetic Resonance Cholangiopancreatography (MRCP): Specialized MRI technology is utilized to create comprehensive, non-surgical views of key organs, including the bile ducts, gallbladder, liver, and pancreas
• Endoscopic Retrograde Cholangiopancreatography (ERCP): This procedure is less common for diagnosis alone, but is used when a stone is suspected to be lodged in the bile duct. A thin, flexible tube (an endoscope) with a camera is inserted into the throat and into the small intestine. Dye is injected into the ducts, & X-rays are taken. This procedure can also be used to remove a stone from the bile duct at the same time.

Gallstone Treatment Options

The treatment for gallstones depends entirely on whether they are causing symptoms.

• For Asymptomatic (Silent) Stones: If you have gallstones but do not have any symptoms, you typically do not need treatment. Your doctor will recommend "watchful waiting," which means monitoring your condition and seeking help only if symptoms develop.
• For Symptomatic Stones: If you experience gallbladder attacks, the most common and definitive treatment is surgery to remove the gallbladder. This procedure is called a cholecystectomy.

Surgical Options (Cholecystectomy)

• Laparoscopic Cholecystectomy: This is the most common type of gallbladder surgery.
• The surgeon makes a few small incisions in the abdomen.
• A tiny video camera & special surgical tools are inserted through the incisions.
• The surgeon watches a video monitor to remove the gallbladder.
• This method is less painful and has a faster recovery. Most patients can go home the same day or the next.
• Open Cholecystectomy:
• This traditional method involves one larger incision in the abdomen to remove the gallbladder.
• It is typically reserved for cases where the gallbladder is severely inflamed, infected, or scarred from previous operations, or if complications arise during a laparoscopic procedure.
• Recovery from open surgery takes longer, usually requiring a hospital stay of several days.

Non-Surgical Options

These methods are used less often and are typically reserved for people who cannot undergo surgery.

• Medications to Dissolve Gallstones: For cholesterol stones, doctors may prescribe oral medications to dissolve them. However, this is not a common solution as it can take many months or even years to work, and the gallstones frequently return once the medication is stopped.
• ERCP (Endoscopic Removal): If a gallstone has moved out of the gallbladder and is blocking a bile duct, a procedure called an ERCP (Endoscopic Retrograde Cholangiopancreatography) may be used. A flexible tube is pushed down the throat to find and remove the stone from the duct, but this procedure does not remove the gallbladder itself.

Life After Gallbladder Removal

• You can live a healthy life without your gallbladder
• The liver's bile production remains constant. However, since it is no longer stored in the gallbladder, the bile now flows directly into the small intestine in a steady drip.
• For most individuals, the digestive process remains unaffected. However, some may temporarily notice a change in how often they move their bowels, such as having softer stool, an issue that typically improves with time.

Gallstone Prevention Strategies

While some risk factors like age and genetics cannot be changed, you can take steps to reduce your risk of developing gallstones:

• Do not skip meals: Try to stick to consistent meal times each day. Irregular eating patterns, particularly skipping meals or prolonged fasting, can increase the chances of developing gallstones.
• Lose weight slowly: Aim for a gradual pace of about one to two pounds (0.5 to 1 kilogram) per week. Rapid weight loss can trigger gallstone formation.
• Maintain a healthy weight: Excess body weight, or being obese, increases your overall health risk. To reach and sustain a healthy weight, concentrate on consuming fewer calories and boosting your level of physical exercise
• Eat a high-fiber, balanced diet: Include plenty of fiber-rich foods, such as fruits, vegetables, and whole grains. Reduce your intake of high-fat and high-cholesterol foods.

Sterling Hospital is Your Partner in Better Health Across Gujarat

At Sterling Hospital, we provide you with the utmost care and comfort throughout your journey to healthy kidneys. If you are looking for the best kidney specialist in Ahmedabad - Gurukul, Vadodara - Race Course Road, Vadodara - Bhayli, and Gandhidham we've got you. 

With considerable years of experience, we have built a team of the best nephrologists in these regions to provide you with premium treatment and the best results. Safeguard your kidney health and contact Sterling Hospital to schedule a consultation and embark on a journey towards a healthier life.

Knee replacement surgery, or knee arthroplasty, is a procedure to resurface a knee joint that has been damaged by injury or arthritis. The goal is to relieve pain & restore function to the joint.

Your decision to have this surgery is a major step. A successful outcome depends on both your surgeon's skill and your own preparation. Understanding what to expect & how to prepare can help you move toward a smoother, faster recovery.

When Is Knee Replacement Surgery Considered?

This surgery is a solution for severe joint damage. It is typically recommended only after all other non-surgical treatments have failed to provide adequate relief.

The most common conditions that lead to knee joint damage include:

• Osteoarthritis: This is the most common "wear-and-tear" form of arthritis, where the protective cartilage on the ends of your bones wears down over time.
• Rheumatoid Arthritis: This is an autoimmune disease in which the body's immune system attacks the lining of the joint, causing chronic inflammation and joint damage.
• Post-Traumatic Arthritis: This can develop years after a serious knee injury, such as a bone fracture or a major ligament tear, which damaged the joint surface.

Your orthopaedic surgeon will use a combination of physical exams, X-rays, and your personal medical history to assess your joint. Surgery is generally recommended when you experience:

• Severe, persistent pain that limits or prevents you from doing everyday activities, such as walking, climbing stairs, or getting in and out of chairs.
• Moderate or severe pain even while at rest, either during the day or at night (pain that disrupts your sleep is a key indicator).
• Chronic knee inflammation and swelling that does not improve with rest or medications.
• A visible knee deformity, such as your knee bowing inward (knock-kneed) or outward (bow-legged).
• Failure of non-surgical treatments, including anti-inflammatory medications, physical therapy, assistive devices (like a cane), or joint injections.

Understanding the Potential Risks and Complications

Knee replacement is a very common and successful procedure. However, like any major surgery, it carries risks. Your surgical team will take extensive measures to prevent them, but it is important that you are aware of them.

Immediate Post-Surgical Risks:

• Blood Clots: This is one of the most common complications. Clots can form in your leg veins (Deep Vein Thrombosis or DVT), which can be life-threatening if they break free & travel to your lungs (Pulmonary Embolism or PE). Your doctor will have a prevention plan that includes blood-thinning medication, compression stockings, and early movement.
• Infection: You can develop an infection at the incision site or deep within the new joint. While deep infections are rare (occurring in fewer than 2% of patients), they are serious and may require additional surgery and implant removal.
• Nerve or Blood Vessel Damage: Nerves or some blood vessels in the surgical area may be injured in some rare cases, leading to weakness, numbness, or pain.

Long-Term Risks:

• Implant Loosening or Wear: Over many years, the plastic spacer in the artificial joint can wear down, or the metal components can loosen from the bone. This may require a "revision" surgery to replace the worn parts.
• Stiffness: Scar tissue can sometimes form around the joint, limiting your knee's range of motion. Following your physical therapy plan is critical to prevent this.
• Persistent Pain: While the goal is to eliminate pain, a small number of patients may still experience some pain after the surgery.

Medical Preparations

Once you decide on surgery, you will begin a series of pre-operative evaluations to ensure you are healthy enough for the procedure and to minimize risks.

• Orthopaedic Evaluation: Your surgeon will review your final X-rays, confirm the extent of the damage, and discuss the specifics of the procedure and the type of implant that will be used.
• General Health Clearance: You will need a complete physical examination from your primary care physician. This is to confirm that any chronic conditions (like diabetes or high blood pressure) are well-managed. This check-up typically includes:
• Blood tests
• A urine test
• An electrocardiogram (ECG)
• The Dental Evaluation: This is a critical safety step. Any active infections in your body, such as from gum disease or an abscessed tooth, must be treated before your surgery. Bacteria from a dental infection can enter your bloodstream and travel to your new knee joint, causing a severe infection. Complete all necessary dental work (including extractions or deep cleanings) well in advance of your surgery.
• Medication Review: You must review your entire medication and supplement list with your doctor. You will be instructed to stop taking certain medications 7 to 14 days before surgery. These often include:
• Blood thinners
• Nonsteroidal anti-inflammatory drugs (NSAIDs)
• Certain supplements known to increase bleeding

Preparing Your Body

You can play an active role in your own success by preparing your body for the stress of surgery and the work of recovery.

• Pre-Operative Exercises: Your doctor or a physical therapist may give you simple exercises to do in the weeks before your surgery. The goal is to strengthen the muscles that support your knee (quadriceps and hamstrings). A stronger leg going into surgery often leads to a faster, easier recovery.
• Nutrition: Focus on a balanced diet rich in protein, vitamins, and minerals. Good nutrition helps your body's tissues heal.
• Smoking Cessation: You must stop smoking. Nicotine slows the healing process, reduces blood flow to the skin, and significantly increases your risk of post-operative infection, blood clots, and complications with anesthesia. Your surgeon may require you to stop smoking for a set period before they will perform the surgery.

Preparing Your Home for a Safe Recovery

Your mobility will be limited when you first return home. You will be using a walker or crutches, and bending your knee will be difficult. Preparing your home in advance is essential for your safety.

• Eliminate Tripping Hazards: This is your first priority.
• Remove all loose throw rugs.
• Secure or tape down all electrical cords and cables.
• Ensure all pathways are wide enough for a walker.
• Set Up a Recovery Station: If your bedroom is on another floor, set up a temporary living space on the main floor for the first week or two. Place a firm chair with armrests or a bed here. Keep everything you need within arm's reach:
• Phone and charger
• Television remote
• Medications
• Tissues, water bottle, and snacks
• Modify Your Bathroom: The bathroom is a high-risk area for falls.
• Raised Toilet Seat: Install one with support arms to make sitting and standing much easier.
• Shower Chair or Bench: Get a stable bench or chair for use in the shower or tub.
• Secure Grab Bars: If possible, install secure (not suction-cup) grab bars.
• Gather Helpful Tools: These items will reduce your need to bend or reach, which will be painful or impossible at first:
• A "reacher" or "grabber" tool
• A sock aid
• A long-handled shoehorn
• A long-handled bath sponge

Arranging Your Personal Support System

You will need significant help for the first several days, and potentially for several weeks, after you return home.

• Assign a "Recovery Coach": Arrange for a family member or friend to stay with you 24 hours a day for at least the first week. This person will help you with meals, medications, changing dressings, and getting up to move.
• Organize Transportation: You will not be able to drive for 4 to 6 weeks. Arrange your ride home from the hospital and for someone to take you to your follow-up appointments and physical therapy.
• Plan for Daily Chores: You will need help with cooking, shopping, cleaning, and laundry.
• Prepare Meals in Advance: Cooking will be difficult. Consider preparing and freezing meals before your surgery so they are easy to reheat.

What to Do Before Surgery

Pre-Surgical Washing: Your surgeon will provide a special antibacterial soap for you to use. You will be instructed to shower with this soap the night before and the morning of your surgery. This is a crucial step to reduce the amount of bacteria on your skin and lower the risk of infection.

Fasting: You will be given strict instructions about when to stop eating and drinking. The most common rule is no food or drink after midnight the night before your surgery.

The Hospital Call: A hospital staff member will typically call you the afternoon before your surgery to confirm your final instructions and tell you exactly what time to arrive.

Packing Your Hospital Bag: You will only be in the hospital for 1-2 days, so pack light.

What to Bring:

• Your ID, insurance card, and any required hospital paperwork.
• A complete list of your medications, dosages, and allergies.
• Loose-fitting, comfortable clothing for physical therapy and your trip home (shorts or loose pants are ideal).
• Slip-on shoes with a closed back and non-skid soles.
• Your labeled walker or crutches, if you already have them.
• Basic toiletries (toothbrush, toothpaste, deodorant, etc.).

What to Leave at Home:

• All valuables (jewelry, wedding rings, watches).
• Large amounts of cash.
• Your actual medication bottles (the hospital will provide all medications you need during your stay).

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The term "heart blockage" most often refers to coronary artery disease (CAD). This is a common heart condition that develops when the coronary arteries (blood vessels that supply oxygen-rich blood directly to the heart muscle) become damaged or diseased.

This damage is caused by a buildup of cholesterol-containing deposits, known as plaque, on the artery walls. This process is called atherosclerosis. As plaque accumulates, it causes the arteries to narrow, which decreases the amount of oxygen-rich blood that can reach your heart.

This condition often develops over decades. A reduced blood flow can cause symptoms, and a complete blockage can result in a heart attack.

Key Warning Signs of Coronary Artery Disease

As the arteries narrow, the heart cannot get enough oxygen-rich blood, especially during times of exertion. This can produce several warning signs. Symptoms may be mild or unnoticeable at first, only appearing when the heart is working hard.

• Chest Pain (Angina): It is often described as a feeling of pressure, tightness, squeezing, heaviness, or aching. It typically occurs in the middle or left side of the chest and is often triggered by physical activity or emotional stress.
• Shortness of Breath: When heart cannot pump enough blood to meet your body's demands, you may feel winded or unable to catch your breath, particularly after exertion.
• Fatigue: You may feel unusually or extremely tired, especially with activity, as the heart struggles to supply the body with oxygenated blood.
• Pain in Other Areas: Discomfort from angina is not always isolated to the chest. It can be felt in other areas as the pain radiates, including the shoulders, arms (especially the left arm), back, neck, jaw, or even the teeth and upper abdomen.
• Other Serious Symptoms: While less common as early signs, symptoms like dizziness, lightheadedness, fainting (syncope), or heart palpitations (a feeling of skipped or irregular beats) should be taken very seriously. These can indicate a severe blockage or a related complication.

"Silent" CAD and Atypical Symptoms

It is possible to have coronary artery disease and not know it. Some people, particularly women, older adults, and individuals with diabetes, may experience atypical symptoms that are not the classic crushing chest pain. These symptoms can include:

• Nausea or heartburn-like feelings
• Sharp pain or a sting felt in the neck, arm, or back
• Cold sweats
• Sudden dizziness
• Heart attack (only in some cases)

Tests and Diagnosis

Initial and Non-Invasive Tests

• Blood Tests: These tests measure levels of substances in your blood that indicate heart health. This includes checking cholesterol (total, LDL, and HDL), triglycerides, and blood sugar. A test for high-sensitivity C-reactive protein (hs-CRP) may also be used to detect arterial inflammation.
• Electrocardiogram (ECG or EKG): This test is used to record the electrical activity of your heart. An ECG can show if you are having, or have had, a heart attack. It can also reveal irregular heart rhythms (arrhythmias) or strain on the heart muscle that may be caused by coronary artery disease.
• Echocardiogram: An echocardiogram uses ultrasound (sound waves) to produce moving images of your heart. This test allows a doctor to see the size and shape of your heart, how well its chambers and valves are working, and identify areas of the heart muscle that are not contracting properly, which can be a sign of poor blood flow or previous heart muscle damage.

Stress Testing

Because symptoms of CAD often appear during exertion, a stress test is used to monitor your heart while it works hard.

• Exercise Stress Test: During this test, you will walk on a treadmill or ride a stationary bike while your heart rhythm, blood pressure, & breathing are monitored. This helps show if your heart is receiving adequate blood flow during activity.
• Pharmacologic Stress Test: If you are unable to exercise, you will be given a medication intravenously that stimulates the heart, mimicking the effects of exercise.
• Nuclear Stress Test: This advanced stress test involves injecting a small, safe amount of radioactive tracer into your bloodstream. A special camera captures images of how the tracer moves through your heart, both at rest and after exertion (or medication). This allows doctors to clearly identify areas of the heart muscle with poor blood flow.

Advanced Imaging and Definitive Diagnosis

• CT Coronary Angiogram (CCTA): This is a non-invasive imaging test that uses a powerful CT scanner and an injection of contrast dye to create highly detailed, 3D images of your coronary arteries. This test can precisely show if there is plaque buildup or narrowing in the arteries. A related test, the coronary calcium scan, is a simple heart CT that measures the amount of calcified plaque in your arteries, which indicates the presence of CAD.
• Cardiac Catheterization and Coronary Angiogram: This is the most definitive test for diagnosing and evaluating coronary artery disease. It is an invasive procedure performed in a hospital.
• A thin, flexible tube (a catheter) is inserted into a blood vessel, typically in your wrist or groin
• The catheter is carefully guided through your blood vessels to your coronary arteries
• A dye is injected through the catheter
• X-ray images (angiograms) are taken as the dye fills the arteries, providing a clear, detailed map of any blockages, their location, and their severity

Treatment for Coronary Artery Disease

1. Foundational Lifestyle Changes

• Quit Tobacco Use: If you smoke, quitting is the single most effective action you can take. Smoking damages blood vessels, raises blood pressure, and reduces the amount of oxygen in your blood.
• Adopt a Heart-Healthy Diet: This involves eating foods that are low in salt, added sugars, and saturated and trans fats. Focus on a diet rich in fruits, vegetables, whole grains, and lean proteins. Incorporating sources of unsaturated fats (like those found in oily fish, avocados, nuts, and seeds) can help improve cholesterol levels.
• Engage in Regular Physical Activity: Exercise strengthens your heart muscle and improves blood flow. Aim for regular aerobic activity, such as brisk walking, swimming, or cycling, as recommended by your doctor.
• Maintain a Healthy Weight: Losing excess weight, even a small amount, can significantly lower risk factors by helping to reduce high blood pressure, high cholesterol, and high blood sugar.
• Manage Stress: Chronic emotional stress can contribute to artery damage. Finding healthy ways to manage stress, such as through physical activity, mindfulness, or hobbies, is beneficial for heart health.

2. Medications

• Cholesterol-Lowering Medicines: These medications help reduce the amount of "bad" (LDL) cholesterol in your blood, which is the primary component of plaque. This slows down, stops, or may even reverse the buildup of deposits in your arteries.
• Blood-Thinning Medications: These medicines help prevent blood clots from forming by making platelets in your blood less "sticky." This is crucial for reducing the risk of a heart attack, which is often caused by a clot blocking an already-narrowed artery.
• Blood Pressure-Lowering Medicines: Several classes of medication are used to manage high blood pressure. Some work by relaxing and widening your blood vessels, while others work by slowing your heartbeat. Both actions reduce the workload on your heart.
• Medications for Chest Pain: If you experience angina (chest pain), your doctor may prescribe medicines that widen your coronary arteries, allowing more blood to reach the heart muscle and relieving the discomfort.

3. Procedures to Restore Blood Flow

• Coronary Angioplasty & Stent Placement: This is a minimally invasive, non-surgical treatment. The procedure begins with the insertion of a thin, flexible tube, called a catheter, usually into a blood vessel in the wrist or groin. A tiny balloon at the catheter's tip is guided to the heart's narrowed artery. When the balloon is inflated, it pushes the accumulated plaque against the wall, effectively widening the vessel. Typically, a small, mesh tube known as a stent is then deployed. This stent remains permanently, serving as a support structure to keep the artery open and ensure uninterrupted blood flow.
• Coronary Artery Bypass Graft Surgery (CABG): CABG is a major surgical procedure, commonly known as "open-heart surgery." The surgeon procures a healthy blood vessel, a graft, from another site on the body (like the leg, chest, or arm). This graft is then attached to create a new route that bypasses the blocked section of the coronary artery. By creating this alternate path, the surgery restores critical blood flow to the heart muscle. Doctors often recommend CABG for patients with extensive, multiple blockages or when angioplasty is medically unsuitable.

Complications of Coronary Artery Disease

If coronary artery disease progresses, the reduced blood flow and damage to the heart muscle can lead to serious and potentially life-threatening complications.

• Heart Attack (Myocardial Infarction): This is the most acute and dangerous complication. A heart attack occurs when a coronary artery becomes completely blocked, usually when a plaque deposit ruptures and a blood clot forms. This cuts off all blood flow to a portion of the heart muscle, leading to the death of heart tissue. A heart attack is a medical emergency.
• Heart Failure: Over time, CAD can chronically weaken the heart muscle or make it stiff. Because the heart is consistently deprived of the oxygen it needs to work efficiently, it may become too weak to pump enough blood to meet the body's demands. This condition is known as heart failure, which causes symptoms like persistent shortness of breath, severe fatigue, and fluid retention (swelling) in the legs and abdomen.
• Arrhythmia (Irregular Heartbeat): Inadequate blood flow or scarring from a previous heart attack can damage the heart's electrical system. This interference can disrupt the normal timing of the heartbeat, causing it to beat too quickly, too slowly, or in an erratic, irregular pattern. Some arrhythmias can be life-threatening.
• Worsening Angina: While angina (chest pain) is a primary symptom, a change in its pattern is a serious complication. Unstable angina is chest pain that becomes more frequent, occurs with less physical effort, lasts longer, or happens even at rest. This indicates that a blockage has become more severe and the risk of a heart attack is extremely high.

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