Dr Aravindhan

Welcome to the September 2015 Newsletter.

August was yet another eventful month for Kauvery as we launched our Stroke services, including a dedicated Stroke Care Unit and also conducted a medical education program on management of acute stroke. Dr Hannes Nordmeyer from Germany spoke about how important the golden hour is in prevention of disability after stroke, the brain attack. Dr Prahalad, Senior Consultant Paediatrician and Paediatric Nephrologist, joined the Kauvery family as full time doctor strengthening our paediatric and nephrology services. Many difficult surgeries were successfully performed, including a complex multi level spine surgery done by our new spine surgeon, Dr Balamurali.

We celebrated Independence Day with solemn remembrance of leaders and freedom fighters who lost their lives in the struggle to achieve independence for our great nation. We had our Annual Kauvery Doctors' Meet and this year it was a family meet. More than 150 family members got together for a full day of activities and the bonhomie further strengthening the bonding amongst doctors. We participated in the annual Terry Fox Run, the flagship event of Rotary Club of Madras East and played our part in raising money to fund for cancer research.

We have planned to strengthen our emergency services and are in the process of expanding our emergency room. I request you to bear with us during the renovation work. We hope to continue with the same enthusiastic effort through our existing facilities and new ones in the offing, in the coming months. I wish you all cheer and good health.

Dr. Aravindan Selvaraj, MBBS, MS Ortho, D Ortho (London), FRCS (Ireland), FRCS Ortho (UK/Ireland)
Executive Director & Chief Orthopaedic Surgeon

AGE AND FERTILITY

More and more women today are postponing childbirth due to other priorities, like settling down in a good job, buying a house, being stable financially before starting a family. Unfortunately, fertility in a man or a woman has a time stamp on it. As we grow older, the reproductive organs in the human body, begins to age and the ovaries and sperm lose their vitality.

Fertility in either gender is unpredictable and especially with the lifestyles in vogue, today, the probability of becoming pregnant is becoming a big question. Therefore, postponing childbirth (having the first child) to an age where the biological clock has started clanging the alarm bells, is opening up a range of risks such as miscarriage and other medical complications. The consequences of a late first pregnancy creates a stressful situation for the patient, obstetricians and gynaecologists, and for the families of the pregnant mother.

Older first time mothers:

Research and statistics show that more women are choosing to become pregnant, for the first time, at 35 and beyond. The thought process in the population has had a significant shift in the past 30 years, with women becoming pregnant after 35 years of age and rearing smaller families.

Deciding to conceive later in life leaves many women in the high probability bracket of not being able to get pregnant. Even though the medicine of Assisted Conception Techniques is quite advanced, the same cannot be inferred with reference to Fertility in a person whose biological clock is striking its knell.

Past and present:

Changing trends in the past 3 decades have raised the age bar for first pregnancies:

Year - Mean Age to have First Baby
1968 <18 years
1978 <21 years
2008 25 -29 years

Statistical data shows that women in the age group of 30 – 34, are attempting their first pregnancy and the number of women in this age bracket is twice that of women in the age group of 25-29, which is the ideal time to have the first baby.

The Physiology of Declining Fertility:

Reproductive aging is an ongoing development, which begins even before the birth of a child and carries through the years to menopause. Within a few weeks, after conception of the female foetus, the number of eggs is determined. Depletion in the ovarian pool of growing follicles is the first phase. In comparison to the rest of the organs in the body, the female reproductive system ages rapidly reaching the point of failure at a relatively young age (average age 51 years). Menopause is an easily recognizable end-point in the lifespan of the reproductive system, wherein it becomes dysfunctional, as a result of aging, which begins several years before the final stages.

Men are not spared either

Similar to menopause, men experience a stage called Andropause or decreasing levels of androgens, as age sets in. This decrease causes dwindling sexual activity, alterations in testicular morphology coupled with deterioration of quality of semen in terms of volume, motility and morphology.

Is Assisted Reproductive Techniques the solution?

ART or Assisted Reproductive Techniques, may seem like the miraculous answer to incapability to conceive and perhaps help a postmenopausal woman to achieve pregnancy but this technique has been observed to be, inversely proportional to an increase in infertility.

Logically speaking:

Opting for childbirth at the optimal ages and preventing infertility treatment, considering its efficacy, is the best solution. It cannot be emphasized enough that age is the key factor to amenable action. The ideal age for first time pregnancies are between the ages of 20-30, for a woman to conceive naturally or above 30 years of age to conceive through ART and 40 and above, the chances are very slim.

IVF cannot make up for the delay and physiological decline in the quality of gametes.

Beware of Media

Mixed media messages about fecundity or IVF may also be partially responsible for exacerbating the delay in starting a family, ‘ sensationalizing ’breakthroughs and giving women a false sense of security or, alternatively, a false sense of alarm and anxiety. Discount what the media has to say, instead remember, regardless of quantum leaps in medical technology, there is no solution to defeat the aging process of your reproductive system. Don’t leave it, till it is too late.

Finally, low fertility does not, mean no fertility!

Article By Dr. Karpagambal Sairam, DGO, DNB, MRCOG(London)
Consultant - Obstetrician, Gynaecologist, Fertility specialist

Be ‘FAST’ On Managing Stroke

In order to recognize stroke early and seek early medical help, a quick and simple assessing tool is useful. It is “FAST

FAST is a widely used mnemonics for easy and early recognition of stroke.

  • F - Facial asymmetry or weakness
  • A - Weakness of arm ( /or leg)
  • S - Speech disturbance
  • T - Time. Early recognition and hospital care is so important to prevent long term disability.

Dr Bhuvaneshwari Rajendran, Consultant, Clinical Neurophysiology and Neurosciences of Kauvery Hospital, talks about Stroke Awareness.

Watch her video talk on YouTube.

Ask The Doctor

Doctor I am not feeling too good. I have been having a terrible pain on the right side of my temple and between my eyes. The pain continues across my right cheek down to the back of the right side of my neck. I also have been feverish for the past two days. What is causing me to feel so sick?

Located around your nose, on the frontal lobe of your forehead, between your eyes, on the cheekbones and towards the back of your head are four pairs of sinuses. These are hollow cavities and are lined with soft tissue called mucosa. Usually, the sinus contains a thin layer of mucus. The basic function of the sinus is to humidify the air we breathe.

Sinuses are normally air-filled sacs or cavities. Germs, viruses, bacteria, however can infect the sinuses causing the thin layer of tissue to inflame, which then fills with fluids and blocks the cavities. The pain you are feeling is from this discomfort and blockage.

Conditions that can cause your sinuses to inflame are:

  • The Common Cold
  • Allergic Rhinitis or swelling of the lining in your nose
  • Nasal Polyps (small growth structures on the lining of your nose)
  • A shift in the Nasal Cavity or otherwise known as Deviated Septum

The symptoms you have described are all part of a sinus infection as the primary symptoms of a sinus infection are:

  • Facial pain
  • Stuffiness in the nose
  • Discharge from your nose
  • Cough and congestion

Secondary symptoms include:

  • Dental Pain
  • Fever
  • Fatigue
  • Bad breath

The treatment options are over the counter pain killers, decongestants such as prescribed medications and liquid nasal sprays. You will need to visit the doctor for a complete examination. If the problem is recurrent, you might require investigations like a CT scan of the sinuses which will help in treatment planning. For chronic sinusitis, minimally invasive surgical options are available which will be done with the help of an endoscope.

Doctor I have been having a splitting headache for several days now and I feel very nauseated whenever I sit up. I also am unable to open my eyes as any type of bright light hurts my eyes, sounds make me wince as this causes my head to throb more. Can you help me?

To all appearances you have a migraine. A migraine syndrome or headache is concentrated on one side or your head but most commonly it does affect both sides of your head. Migraine attacks can last for several hours / days. A migraine syndrome can occur from a collection of symptoms or from a specific group of symptoms.

Triggers that set off a migraine headache include:

  • Foods and drinks (alcohol, caffeine, artificial sweeteners, chocolate)
  • Activities and exercises (excessive)
  • Stress
  • Medications
  • Sleeping too little or too much
  • Bright lights
  • Loud sounds
  • Hunger
  • Smells
  • Hormones
  • Fatigue
  • Weather
  • Skipped meals
  • Menstrual periods

Before ruling out the possibility that the pain in your head is not due to any other condition, you might have to undergo some tests like CT or MRI Scan, based on the evaluation by your doctor. After completing the tests and once it is confirmed that your debilitating pain is a migraine syndrome, the doctor will choose the best treatment option for you.

There is no cure for migraine but it can be managed.

  • By lying down in a quiet, dark room helps diminish the pain
  • With pain relieving medications
  • With preventive medications, which need to be taken daily to prevent the severity of a recurring migraine

CHRONIC FATIGUE SYNDROME

Are you or anyone you know, experiencing any or some, of the following signs and symptoms?

  • Extreme exhaustion particularly 24 hours after you have exercised, either physically or mentally
  • You are unable to concentrate or experience memory loss
  • Extreme fatigue
  • Muscle pain for no reason at all
  • Sore throat
  • Enlarged lymph nodes either in the armpits or the neck region
  • A different type of headache not in keeping with the headaches you usually experience
  • Restless sleep
  • Pain in several joints

These are all symptoms and signs of Chronic Fatigue Syndrome. This is an unexplained, complicated condition, which is characterized by extreme fatigue. It could become worse with physical or mental activity and contrary to expectations does not ease up with rest either.

Causes

The exact cause of Chronic Fatigue Syndrome is unknown but there are several theories in existence that presume the cause could be due to some type of viral infection or it could be due to psychological stress. Some of the suspected causes include:

• Hormonal Imbalances – When there is a significant rise in the production of hormones in the following glands – Pituitary Glands, Hypothalamus or Adrenal Glands with a hormone spike in blood levels, people have exhibited conditions of Chronic Fatigue Syndrome

• Viral Infection – some viral infections leave a patient feeling very exhausted after a bout of influenza and hence it is thought that some viruses maybe triggering off Chronic Fatigue Syndrome. Viruses that are suspected to cause Chronic Fatigue Syndrome are – Mouse Leukemia, Epstein-Barr virus, Virus 6 and human herpes

• Problems with the Immune System – Many people suffering from immune system deficiency also exhibit symptoms of Chronic Fatigue Syndrome, but it is not confirmed whether this actually causes the disorder

Risk Factors

The factors that have been found to affect people with Chronic Fatigue Syndrome are:

• Age – it may affect anybody but most commonly it has been found that the age group that suffers from this syndrome lie in the 40s to 50s

• Gender – Women have been found to be affected by Chronic Fatigue Syndrome, in comparison to the men who have reported the disorder

• Stress – when there is difficulty in managing stress, it has been found that this is a major contributory factor leading to Chronic Fatigue Syndrome

Complications

Complications that can arise from Chronic Fatigue Syndrome include – Depression, Lifestyle restrictions, social isolation and frequent absences from workplace.

Treatment

Treatment focuses on reliving the symptoms, through medication and therapy. Depending on your symptoms, medications such as anti-depressants or sleeping pills may be prescribed. The treatment is tailored to each individual’s symptoms and needs.

However, the most effective treatment for Chronic Fatigue Syndrome has been found to be, gentle exercise coupled with psychological counseling.

When should you see a doctor? When you have persistent and excessive fatigue, it is time to make an appointment, consult with your doctor and get treated.

EVENTS OF THE PAST MONTH

Cardiac Screening Camp at Biotech Labs, Arakkonam.

Kauvery Hospital conducted a Cardiac Screening Camp at Biotech Labs, Masudi Street, Arakkonam. The camp was held on 23rd August, 2015 between 9 am to 2 pm. Dr. K. Dhamodharan and his team presided over the camp and 34 people attended it. Mr. Prathap, Proprietor of Biotech Labs, appreciated the staff and their services.


Great Goals Football Tournament

Kauvery Hospital conducted an event "Great Goals Football Tournament" at the YMCA Ground, Nandanam. The event was held on 22nd August, 2015 between 8 am to 6 pm. The Organizing Committee appreciated the staff for their services. More than 200 children participated in the football match.


HDFC ATM services now available inside Kauvery Hospital!

The Inauguration of a HDFC ATM machine was done by Dr. K. Suresh Kumar, Chief Cardiologist, along with Dr. Aravindan Selvaraj, Chief Orthopaedic Surgeon and Director, on the 1st of August 2015. The ATM machine is located at basement, near the Emergency Department of Kauvery Hospital.


Health Talk on "Beauty of Human Creation and Emotions"

A Sathsangam event was held on 2nd of August, 2015 on the 7th Floor of Kauvery Hospital. The event was combined with the Rotary Club members and doctors as well. The talk was attended by 35 people. “Beauty of Human Creation and Emotions” was the main topic of the talk; it was given by Dr. Kailash and Dr. Nandini.


Paediatrics and Cardiology Camp

A Paediatrics and Cardiology camp was held on August 2, 2015 by Kauvery Hospital and Sindhi Medical Centre & Association at New Avadi Road. 65 people attended the camp. Dr. Prashanth Shah, Chief Consultant Paediatric Cardiac Surgeon, Dr. Avijit Basu, Cardiothoracic Surgeon, Dr. Karthik Surya, Paediatric Cardiologist, and Dr. Naveen, Medical Officer, presided over the camp. The Cardiology camp was deemed free for Children and Adults alike.


I Support O

"I Support O" campaign to promote organ donation was launched on July 24, 2015. The campaign consisted of a week long signature drive at Pheonix Market City along with interactive sessions to counter myths associated with Organ Donation.

On August 2, 2015, the entire healthcare fraternity joined hands to support the campaign cause by participating in a car rally. The rally was followed by lunch and prize distribution ceremony. Dr. Iyappan of Kauvery Hospital, Chennai won the first prize and Dr. Sushila. K, also of Kauvery Hospital who participated in the Women's team received a prize.


Cardiac Screening Camp

Kauvery Hospital conducted a Cardiac Screening Camp at KVT Clinical Lab, Tondiarpet. Dr. K.G. Sundar Kumar, Chief Cardiologist of Kauvery Hospital was the presiding doctor. 27 people participated in the camp. Dr. Pugalendhi appreciated the services done by Kauvery.

UPCOMING EVENTS

Cardiology Camp at Manapakkam
Prolife Scans & Kauvery Hospital will conduct a Cardiology camp at River View Road, Manapakkam on 05/09/2015.
Time: 10.00 am – 1.00 pm
Doctor: Dr.K.G.Sundrakumar | Executive: Nagabushanam

Cardiology Camp at Arakkonam
Biotech Labs & Kauvery Hospital will conduct a Cardiology camp (Out Reach Clinic) at Biotech Labs, Masudi Street, Arakkonam on 12/09/2015.
Time: 09.00 am – 1.00 pm
Doctor: Dr.K.Dhamodharan | Executive: Sivakumar

Satsangam - Health Talk
A health talk about “BP Variability & CV risk and Who am I?" will be conducted on 13/09/2015 at 7th Floor, Kauvery Hospital, Chennai.
Time: 02.00 pm – 4.00 pm
Doctor: Dr.Sharma, Tiruvallur | Organizer: Dr.Kathiresan

Cardiology Camp at Perambur
Shafia Begum Trust Hospital & Kauvery Hospital will conduct a Cardiology camp at Shafia Begum Trust Hospital Campus, Jamalia, Perambur on 20/09/2015.
Time: 09.00 am – 1.00 pm
Doctor: Dr.Kathiresan

Cardiology & Paediatric Cardiology Camp at Mannarkudi
Grama Vidiyal Micro Finance Private Limited & Kauvery Hospital will conduct Cardiology & Paediatric Cardiology camp is to be held at Mannarkudi on 26/09/2015*.
Doctors: Dr.K.Dhamodharan & Dr. Karthick Surya
Time: 09.00 am – 1.00 pm
*Date subject to change.

Patient Experience

"In the year 2012 admitted my mother for cancer treatment, 2013 admitted my daughter for typhoid treatment, 2014 I got admitted for Laparotomy surgery .July 2015 admitted my wife for gastroenteritis treatment. August 2015 I got admitted for the same problem. Do I have to prove anything more than that we are loyal to your hospital? Reasons for coming to Kauvery Hospital main is Dr.Ashwin, Dr.K.P.S and services of the nurses particularly in 4th and 5th floor."
- B.V

"D.Shanthi and Dhanalakshmi ward girls did excellent service. Soundarya also did an excellent job like other sisters."
- J.M

"Overall services had been good without hurdles and timely action by insurance team for getting clearance has been very helpful (Mr.Krishna Kumar & Mr.Sridhar)."
- R.B

"Very courteous and efficient hospital."
- M.S

"Well maintained, well disciplined. Hospital is recommendable."
- V.N

"Keep it up. Staff approach is good (PALS)"
- R.K

"A Hospital with good hospitality."
- V.K

"3rd floor sisters are doing an excellent job."
- C.S

"Everything was great. A special mention to the PT team in 2nd floor for support and help in making me walk and mobile again. Thanks a lot."
- B.S

"Kauvery Hospital is like home away from home, please keep the good work. Special mention ward boy Prajith is the most sincere and dedicated God bless him."
- P.R

"The Prayer room in the fourth floor needs some ventilation. Prayer room provision is a good gesture. Thanks."
- S.A

"Very efficient and friendly Doctor. Thank you so much."
- I.K

"Dr.Sivarama Kannan is very good and treating patient kindly."
- T.G

"Excellent Service Keep up the good work."
- S.B

"Staff and services are very good. Nurses attention and services are very good. My wife and me will again visit your hospital only for further treatment."
- R.J

"Thank you so much to the Kauvery team in making this experience as comfortable and homely as possible. Everyone from the nurses, to the ward girls, to the Doctors were excellent! We would definitely recommend Kauvery to others! Thank you all!!"
- R.R

"The hospital staff are very nice and friendly to the patients. Keep it up."
- R.M

"Excellent service. Felt like home, great service."
- C.K

"Dieting Sarah sister was good. Counselling given by Ellen sister was helpful. Housekeeping, security, nurses provided timely and helpful service. Doctors were kind and friendly for me to share my health condition and they listened and counseled me accordingly which was very helpful."
- S.S

"All the services provided by the hospital were very good .Housekeeping staff Geetha, Santha, Dhanalakshmi services was good. Nurses were very friendly and services was very good. Overall I am very much satisfied."
- D.G

"Hospital with international standards in nursing care, hygiene, cleanliness, friendliness. It was a excellent experience. Thanks to each and every staff member. "
- N.R

"5th Floor nurses are very helpful and caring. ICU sisters, 4th floor sisters are also very good. I specially thank below sisters for their caring and good nursing: Sylvia & Bama 5th floor, Fathima and Christina (ICU)."
- S.D

"Good Hospital and treatment is also very good."
- V.K

"Good work and compassionate by the Doctors made feel comfortable as at home away from home. Best wishes to one and all for the invaluable services. God bless all. "
- K.A

"Very hygienic and in good atmosphere. Easy to locate and the team are very good in attending patients. Really boon to middle class people like me."
- D.R

"Kind Doctors and supporting staff. We felt homely. We would like to make a special mention of Dr.Aravindan Selvaraj who with his inviting smile and kind approach dispelled the fear of surgery."
- S.W

"Excellent, remarkable service rendered by the Kauvery Hospital with thanks."
- K.K

Recipe Corner

Paneer Cabbage Wrap - A Low calorie, High Fiber Snack

Serves 6: Serving Size 1 wrap with filling
Calories: 20; total fat 2g, Carbohydrates 11 g, Fiber 3g, Proteins 7g, Sugar 1g

For Non-Vegetarians:
You may swap the paneer for either minced mutton or small bite size chicken pieces and use only carrots and green beans to replace the other vegetables mentioned in the recipe.

Ingredients:
To prepare the filling:

  • 2 tablespoons honey (optional, if you want a spicy filling)
  • Onion – 1 Large (finely diced)
  • Paneer – 1 packet comprising of 2 slabs of paneer, chopped into tiny bite size pieces
  • Potatoes – 1 chopped into tiny bite size pieces
  • Peas – ½ cup (chick peas can also be used instead of fresh peas. Use boiled chick peas)
  • Carrots – 1 large grated
  • Button Mushrooms – ½ cup chopped into tiny bite size pieces (optional)
  • Turmeric Powder – a pinch
  • Chili powder – ¼ tsp (can be increased depending on spice level required)
  • Coriander Powder – ¼ tsp
  • Garam Masala Powder – ¼ tsp
  • Garlic cloves – 2 finely minced
  • 1 tablespoon Refined Oil
  • 1 tablespoon Sesame Oil
  • 6 large Cabbage leaves (either green leaf cabbage or Savoy Cabbage)
  • Salt to taste
  • Water – to cook the vegetables

Method:

  • Place a large Karai or Wok on the stove, over low heat.
  • Add the refined oil and sesame oil.
  • Stir in the onions and sauté until onions are translucent.
  • Next add the turmeric, chili, coriander and garam masala powder and stir for a few minutes.
  • Then add the garlic paste and stir until the oil emerges and the mix is thoroughly mashed up.
  • Add the potatoes, stir, and add just about enough water to cook the potatoes and peas.
  • Once the potatoes and peas are three quarters cooked, add the grated carrots and stir for about 5-8 minutes, until the carrots are half cooked.
  • Next stir in the paneer to the dry mixture and fold it in the masala, until the paneer is well coated. Make sure the filling is dry.
  • Stir in the honey (optional).

To prepare the Cabbage Leaves:

1. Remove about 8-10 leaves of large cabbage leaves. Wash and pat dry with a paper towel. Place the cabbage leaves on a large plate.

2. Place a tablespoon or two of the prepared filling in each cabbage leaf, fold into a wrap and serve with Tomato Ketchup.

This is an easy and quick dish to prepare; it is low in calories, provides good dietary fiber and can be used either as a snack or be served for a light supper.

Kauvery Hospital

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No.199, Luz Church Road, Mylapore,

Chennai 600 004

Phone: 044 - 4000 6000

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Email: info@kauveryhospital.com