Wednesday, May 29, 2013

Benefits of Red Wine ~ a surgeon’s viewpoint

As a surgeon, lot of people keep asking me whether wine is good or bad for the heart. Well, my instant reply is – Depends on how much of it you are consuming J
Research shows that Moderate Consumption of wine (i.e. 5-US-fluid-ounce (150 ml) glass of wine per day for women and two glasses per day for men) is beneficial to health in terms of longevity and heart health. But by that, as a surgeon, I am not advocating wine consumption, rather, I’m advising ‘moderate consumption’ of wine.
Personally, I prefer to have red wine as it is known to have resveratrol, a substance known to be good for heart health. Also, I prefer to have Indian wines. Four Seasons Merlot is one of the good options in red wine that I have consumed in recent times.
So, to sum up a surgeon’s viewpoint – Have red wine and if you are from India, stick to Indian brands.

Sunday, May 26, 2013

Medical Certificates

Issuing medical certificates is the one job which I hate the most and being in the government hospital,   I encounter these every week
Government offices , school, college have an unwritten rule of  accepting only government hospital issued medical certificates, even though the person has received treatment at private hospitals.  
There many types of people requesting medical certificates. First  are the people requesting for fake medical certificates. Government of India allows 7 fullpaid and 7 half paid medical leaves which when not utilized are carried forward. They will  shamelessly  ask for medical certificates stating that they are not ill but have some work. When denied their facial expression suggest that you are high headed  and have  no business  to deny them medical leave which is their right.
Second are students who have missed their school or college and to make up their attendance they need medical certificates. Some of them have been treated by others and some candidly admit that they were on vacation or were attending marriage.
Then there are ones who are medically fit to join their duties after their illness but they think otherwise and want to extend the medical rest period.
Most dangerous one are those who want to skip a court date and most of the time they will use other pretext for this.
Then there are ones who who want a medical fitness certificate for joining job, school, or even going for amaranth yatraa and most of them want in absentia without getting examined.
How to refuse?  Simple keep saying no and eventually you will develop a reputation of a non cooperating doctor and people will stop coming to you and you have to refuse less number.
Have I given a medical certificate when it is not required? Yes I have, sometimes it is difficult to refuse.

Sunday, September 16, 2012

Quit Smoking

Today I was  talking to a patient who was operated for carcinoma(or Cancer) of urinary bladder about a year back but required to be operated again for a complication (strangulated parasternal hernia). He had a bad chest infection which was contributed by smoking. Smoking is one of the cause of bladder cancer and I clearly remember telling him to stop. I was upset and asked him the reason for continuing to smoke. To this he replied that as the cancer is removed by operation so he thought he can smoke again. I was amused by his answer. 
One is so addicted to nicotine that one is ready to suffer the consequences rather than leave smoking.

As a Doctor and surgeon I come across  many patients whom I advice to stop smoking. Only few really do. Smokers are in a denial mode. Quite a few of them will say that they have quit smoking. When one ask them for how long, then for many the answer will be for only a few days. Smoking increases the risk during operation and we advice them to avoid smoking atleast a week before surgery. I have cancelled surgery for quite a number of patients on finding them smoking in corridors of the hospital.
One of my Professors used to get very upset about tobacco. Significant disfigurement is caused in operation for oral cancer. When patient raise their concerns regarding that he used to put the blame in straight words on them for consuming tobacoo.
Smokers should pray that if they are to have problem then it's better be a heart attack. Atleast they would not suffer. Cancers, ischemia of limb are far worse. These cause prolonged sufferings.

Better quit tobacco!!

Friday, June 22, 2012

Plight of paitents with chronic renal failure

Chronic Renal Failure is the condition where kidneys stop functioning because of a variety of conditions. At some stage these patients require to undergo dialysis which is a procedure where the blood is purified of the wastes products. Simply put, the job of the kidney is to be done by some artificial means, which is known as dialysis. Haemodialysis is a form  of dialysis where blood is purified by machines. In order to do this, one requires to take the blood out of the arteries, which goes to the dialysis machine, purified and sent back to the body via veins. With the repeated puncture of veins for dialysis, blood clot forms in the vein (thrombosis) and vein becomes unsuitable for further procedures. Due to this, before commencing on dialysis, one makes an arterio venous (AV) fistule(connecting the artery with the vein), which increases the flow in the vein and makes it amenable  to be repeatedly used for dialysis without formation of clots.

                         photograph - AV fistula performed by me

Very few government hospitals in Delhi provide this facility for making AV fistule.  Many of the lower socio economic strata patients cannot afford to get the same procedure done at private hospitals, costing around  Rs. 15, 000 to 20,000.  Around 2 years ago, I started providing this facility at my hospital for such patients. In the last one year, I have made AV fistule for 70 odd patients and it has been a successful endeavor. My idea behind this attempt is to provide some kind of relief to the patients and their families undergoing dialysis. 
For the patients with chronic renal failure, dialysis has to be done at given intervals which can range from one to three times in a week. Patient has to be accompanied by atleast one relative to the hospital for such sessions. So, both the patient and his/her relative lose valuable time in each visit. Government hospitals in Delhi cannot accommodate all the patients for routine dialysis as the patient load is enormous. Hence after the stabilization of the condition of the patient, they are asked to get it done at private hospitals where each session costs 2000- 5000 Rs. Its results in financial strain to the entire family of the patient, with some patients telling me that they have sold their property, land and even sometimes cattle (for rural patients) for getting dialysis at private hospitals.
The only other solution for renal failure is transplant, which requires a donor (hard to find a match and costly). Plus there is also recurring cost of Rs. 10,000 per month for medicines post transplant.
On my part, I do this with the thought that I may be alleviating some of these patients’ agony and contribute to lowering their financial strain, since this procedure is free of cost my hospital.

Friday, March 18, 2011

Anyone for.....

Baked Beans on Toast???
wife loves this, I don't!!!...

Saturday, November 13, 2010

Weekend Breakfasts: time to chill!!

Like any other working couple, only on weekends, do I and my wife have the time to enjoy proper & elaborate breakfasts...and she tries to innovate a lot during these two days and cook something different each weekend..and it is our time to chill and take it easy!!!
Today it was half english breakfast..consisting of double egg fry, sauteed mushrooms, capsicums , tomato and toasted brown bread...
I loved it, so here's to a great weekend guys!!!

Sunday, September 12, 2010

Amritsar : a Foodie Trip

Last fortnight, we went to Amritsar...great time spent having some delicious food and visiting olden Temple, Jalianwala Bagh & Wagah Border