Gynecological Urology

Urethral Reimplantation Surgery in India Available at Appealing Cheap Cost

Urethral reimplantation surgery in India at Chennai, Mumbai and Hyderabad is done at very cheap cost with the high quality medical healthcare facilities. Developmental abnormalities of the ureter encompass a wide range of disorders. Ureteral anomalies are a common cause of morbidity in children and frequently require surgical intervention. Hospitals of Urethral reimplantation surgery in India approach to correct the vesico urethral reflux are the least invasive surgical procedure to be proven effective over 95% of the time. This approach corrects the reflux condition without having to open the bladder and does not require the use of postoperative stents or drains. India has some of the best world renowned surgeons for Urethral reimplantation surgery at some of the best hospitals in India which will completely take care of your health and make you feel at home

Urethral reimplantation is a procedure commonly performed by both urologists and pediatric surgeons. Although the vast majority is successful, there are patients in whom technical considerations and/or bladder or urethra abnormalities might mitigate against success. Reimplantation of the Urethral into a groove of the bladder mucosa has been used to simplify the procedure of reimplantation and to over­ come problems of trabeculated bladder by obviating the creation of sub-mucosal tunnel. Anti-reflux urethral reimplantation may be performed by a variety of techniques with consistently satisfactory results. Complications such as persistent reflux post-surgery and urethra vesical obstruction may be encount­ered. The Politano and Leadbutter anti-reflux uretero-neocystostomy is the most accepted method for urethral reimplantation. The evaluation of the complications of uretero­ neocystostomy is varied based on the etiological factors such as malformations, gynecologic Urethral and stenos of the lower urethra and reflux and the technique used. The Cohen technique has yielded the best success rate. Most of the failures are due to stenosis of the reimplanted urethra. Other methods for reimplantation were evaluated like psoas-bladder hitch confirming that this is a versatile procedure that suits a number of indications. The modified Lich Gregoire technique of extra vesical urethral reimplantation is successful, simple to be performed and reproducible and associated with low morbidity requiring minimal hospital stay. The use of laparoscopy in reimplantation was reviewed.Two common techniques of urethra reimplantation for kidney transplant­ations, the Politano-Leadbutter and the extra­vesical uretero-neostostomy with judicious use of double J stent are also emphasized to reduced urological complications which occur in about 7-15% in most series.The incidence of urological complications after renal transplantation, although are still a source of morbidity and mortality, are not very common. Uretero-neocystostomy with Lich Gregoire and Politano-Leadbutter techniques were evaluated with the frequent complications being early urethral obstruction (3.6%), obstru­ction (1.8%), lithiasis (1.8%) and urinary extravasation. The use of laparoscopy in reimplantation was reviewed. Two common techniques of Urethral reimplantation for kidney transplant­ations, the Politano-Leadbutter and the extra ­vesical uretero-neostostomy with judicious use of double Urethral lesions due to endometriosis and gynecological surgery are common findings in urology.

Medical Tourism is now a major world business, with millions of people traveling away to avail of better facilities, better price and better waiting times. Many countries, style themselves as “Medical Tourist Centers” but India has been a center for far longer than most. From humble beginnings of tourists visiting the local private hospital for a medical check-up, India has grown a huge infrastructure of medical facilities, cutting edge technology and world class expertise in the field of medical services to international patients To be successful a health tourism center should provide tourists with ultra modern facilities, up to date medical technology, great service, very competitive pricing, no waiting and be a great “all year round” holiday destination as well. Modern India meets and surpasses all these requirements India is one of the world’s premier health tourist destinations because the growth of the industry here was organic, in response to tourist needs.Medical Tourism in India works because of : Many and varied medical facilities, Western trained, English speaking medical staff, medical accreditation, Cheap cost surgeries in comparison to europe and USA, Level of medical service, Medical procedures available, good tourist location. For more details about Urethral reimplantation surgery in India visit http://www.forerunnershealthcare.com and enquiry@forerunnershealthcare.com

Clinical Negligence Claims in the UK

Medical negligence is where doctors or any other professional in the medical profession have been found in breach of a duty of care. For example if a doctor failed to diagnose a medical condition or diagnosed the wrong condition this would be classed as medical negligence.

Doctors, dentists, midwives, nurses, physiotherapists, psychologists and psychiatrists all have “duty of car” to ensure their patients receive the correct treatment in a proper ethical manner. If you or someone feels that they incurred an injury or suffered emotionally because one of these medical professionals not doing their job probably then you maybe able to make a medical negligence claim against them or the organization they work for. Maybe the treatment you received went wrong in which case the treating doctor is required by his governing body the “General medical Council” to inform the patient that the treatment went wrong. At the very least you are entitled to an explanation.

Injuries such as these can arise out of for example, cancer treatment, accident and emergency treatments, anesthetics, cardiothoracic surgery, cardiology, gastroenterology, oncology, keyhole surgery, mental health, neurosurgery, obstetrics and gynecology, oncology, ophthalmology, orthopedics, pediatrics, plastic surgery, psychiatry, sterilization, urology, dentistry, vascular surgery and the list goes on. Also if you or a family member suffered brain damage or psychological injuries like nervous shock or the worst scenario death these are fine examples of medical/clinical negligence.

It is not just patients of the NHS, those who were treated in private hospitals as private patients will also be able to claim for breach of contract if your medical treatment was substandard.

Claiming financial compensation for clinical or medical negligence can be quite a lengthy and complex matter. Because of which it is paramount that you enlist the help of a professional personal injury specialist. If this puts you claiming it shouldn’t. When someone claims for personal injuries (compensation) for a road traffic accident it is generally easy for your personal in jury lawyer to establish who was at fault and whether the injuries were due to that accident. If the accident wasn’t your fault, and your injuries were obviously related to the accident (like whiplash), you will have a strong case. With claims against the medical profession the claimant will need to obtain medical records and get statements to prove that:

• That there were serious errors in your medical treatment which no competent doctor would have made
• The doctor or other healthcare professional owed a duty to take care of the claimant and not cause injury
• There was a breach of that duty to take care
• That breach of duty has caused harm to the claimant
• Damage or other losses have resulted from that harm

Claiming compensation for clinical/medical negligence is your civil and legal right. Without claiming you could be putting someone else at risk. Sadly it take unfortunate situations like a medical error of judgment to occur for people in the medical profession to wake up and make changes to their practice to ensure this type of malpractice doesn’t happen again.

How to Become a Certified Medical Transcriptionist

A Certified Medical Transcriptionist is required to take and pass examinations that are offered by the American Association for Healthcare Documentation Integrity (AHDI) and accumulate at least 2 years of acute medical experience.

With this qualification you will be a true professional and will have a clear advantage over most of your competition who do not train to this level.

While a Medical Transcriptionist school program will lead eventually to receiving a certificate by successfully completing the training program, it will not entitle you to use the title Certified Medical Transcriptionist and you will have to challenge the AHDI examination.

Most school programs take about a full academic year and prepare you position of Certified Medical Transcriptionist.

A training program will typically study the basics of medical transcription such as medical fundamentals and definitions, practicing dictation skills by writing reports, improving listening skills, proof reading and becoming familiar with the various tools needed such as computers, dictation machines and foot pedal controls

You will then move on to in depth understanding of the following medical practices:-

Dermatology
Otorhinolaryngology
Ophthalmology
Pulmonary Medicine
Cardiology/Hematology
Gastroenterology
Endocrinology
Urology/Nephrology
Obstetrics & Gynecology
Orthopedics
Neurology
Psychiatry

A practicum is sometimes offered with a medical transcription program. A practicum is work experience in an actual job setting as part of a learning program. This is an excellent approach in preparing you for full time work as a transcriptionist and can often lead to an employment offer.

As a graduate of a medical transcription educational program and with fewer than 2 years experience in acute care, you can apply to become a Registered Medical Transcriptionist with AHDI. This credential is awarded upon successfully passing the AHDI level 1 registered medical transcription exam.

Medical Transciption school provides you with the training as a medical transcriptionist. To call yourself a Registered Medical Transcriptionist you have to pass an examination set by the AHDI and to become a Certified Medical Transcriptionist, you will need to successfully pass a Level 2 examination set by the AHDI and have at least 2 years of on the job training.

Retirement in Puerto Vallarta–afraid of Medical Care South of the Border?

Ten years ago, the fear of needing emergency medical or dental care while south of the border ranked close to the fear of running out of gas while crossing the railroad tracks; both had you calling for spiritual guidance!

In 1997, shortly after we moved to Puerto Vallarta, Mexico, referred to as PV or Vallarta by the locals, a friend of ours elected to have a substantial amount of cosmetic surgery done here in PV. At that time, there were a number of small hospitals and clinics in town, however only two that she considered. One was of the 50´s vintage and the other more like the 60´s because it had window air-conditioners in the three patient rooms. My son, a surgical veterinarian in California, would have been reluctant to practice his specialty in the other hospitals and clinics!

The surgical procedure on our friend was satisfactory and although none of the nurses spoke English, the attention and care she received during recuperation were excellent. At that time, good medical care was difficult to find in Vallarta and if anyone needed major medical care, they would need to go to Guadalajara or fly to the States. In 1997 there were a number of dentists in PV, but they were pretty scary looking places, resembling those you saw in the 60´s, although a couple of them did have window air-conditioners. Ten years ago, if you had a broken arm, toothache, etc., you were best off flying back to the good old USA for care.

Now, ten years later, we have two huge, ultra modern, fully equipped hospitals and one smaller, yet still modern hospital in Vallarta. Of course, many of the small dilapidated hospitals still exist, but would not be considered by North Americans. The small AmeriMed Hospital is fully capable of handling most emergencies, conducting most testing, and is adequate for all but the most serious problems. Across the street from AmeriMed is the new San Javier Hospital which was built about five years ago. This ultra modern hospital is capable of handling just about every medical problem imaginable. They recently performed emergency open heart surgery on a cruise boat passenger. San Javier has an MRI machine, cardiac catheterization, angioresonance, neuroradiologic, mammographic, ecosonographic, etc. equipment. Of course the patient recovery rooms meet the highest standards, equipped with everything you would expect in a fine US hospital. The newest hospital is the Cornerstone Hospital which was built two years ago and meets the same standards as the new Cornerstone Hospitals in Texas. Cornerstone has the only Radiology Clinic in Western Mexico with state-of-the-art CAT scan and MRI equipment. It is the center for dialysis and lithotripsy as well as having emergency pediatric care, full cardiac services, an ophthalmology department, a 24 hour emergency room, an intensive care unit, an on-site pharmacy, recovery room, and beautiful, almost plush, patient rooms.

Between San Javier and Cornerstone, we are fully covered for any matter pertaining to orthopedics, trauma, nephrology, urology, anesthesiology, internal medicine, gastroenterology, obstetrics and gynecology, endocrinology, rheumatology, neurology, cardiology, general surgery, plastic and reconstructive surgery, hematology, dermatology, and just about anything that ails you.

These hospitals accept most all international insurance and the majority of the US veteran benefits. In fact, the veterans here indicate that they are receiving better care in PV than the overcrowded VA facilities in the US.

Virtually all the doctors and nurses in these hospitals speak English. Furthermore, the majority of the doctors have received part of their education in the States or Europe. There are two main differences between these hospitals and those in the States. They are price and service! Surgical procedures and hospital services are a third to a half of what they are in the States. The attention, care, and follow-up far exceed that in the US. The doctors and nurses really care and treat each patient as a friend. They seem to be more interested in treating and curing the patient than they are in collecting the money. Most doctors carry cell-phones and are available for consultation 24 hours a day.

Cosmetic and reconstructive surgery has become so popular in PV that many Americans and Canadians come here specifically for a nip and tuck. So many, that a major spa specializing in postoperative care is currently in the planning stage, allowing those in the market to come to Paradise for a week or two and return home looking ten years younger!

Today, there are a few exceptional dentists in Vallarta, each with state-of-the-art offices meeting US standards. Root canals, caps, crowns, and implants are done on a daily basis in beautiful, high-tech, and sterile offices. Again, they are all fluent in English and their prices are a third to a half of what they are in the States. For that reason, many North Americans are also coming here for new caps, crowns, and implants- maybe the same people that come for the cosmetic surgery!

We don’t look forward to needing any of the new medical clinics, state-of-the-art hospitals, or modern dental offices, however if and when the time comes, we’ll certainly not be afraid of medical care south of the border!

Surgery for Urinary Stress Incontinence May Make Incontinence Worse

Women who submit to surgery for urinary stress incontinence should be aware that they may be taking part in what may be nothing more than a large scale clinical trial. Countless women’s lives have been devastated by needless and ineffective surgery for urinary stress incontinence.

During both a TVT surgery (tension-free vaginal tape), and the newer TOT (transobturator tape), a tape is drawn under the urethra. The theory is that the tape will support the urethra so that under the ’stress’ of sneezing, coughing, etc., it will eliminate the leaking of urine that women who suffer from stress incontinence are familiar with. These procedures are most definitely not risk-free and leave some women suffering more after the surgery than before.

“In most continence surgery the benefit of restoring continence is often at the expense of developing new symptoms, or exacerbating existing lower urinary tract symptoms”. This is from a study undertaken by the Department of Urology, Mid-Western Regional Hospital, Limerick, Ireland, and the Department of Obstetrics and Gynaecology in the Regional Maternity Hospital, Limerick, Ireland, and documented in the National Institute of Health Sciences Bulletin, June 2004.

The first TVT was performed in Sweden in 1995. The TOT was introduced from France in 2001. The long term results of these surgeries may be catastrophic for women. Follow up studies are generally carried out within three years of the operation. Three years is not long enough to qualify as a long term study considering the life-span of women today.

Health services around the world are investing billions in solutions for urinary stress incontinence that may make the problem worse or create new problems. One recent hospital report states that 57% of women presenting for urodynamic evaluation over the course of the year had already had some form of pelvic surgery.

Urinary stress incontinence occurs due to a weakness in the pelvic floor muscles. “There is a better way than surgery to correct most cases of pubococcygeal weakness” Dr Arnold Kegel, TIME magazine, 3 Dec 1956.

The better way Dr Kegel, an American gynaecologist, and Associate Professor of gynaecology at the University of Southern California was referring to over 50 years ago is that of properly exercising the pelvic floor muscle against resistance. He was alarmed at the amount of pelvic surgery being carried out back in the 1940’s. Resistance exercise was a method he developed which reduced the amount of unnecessary pelvic surgery, and often greatly improved the sex lives of the women who practised it a welcome side-effect for once! Resistance exercise was found to be so much more effective than surgery in eliminating urinary stress incontinence in women that by 1950, routine surgery for urinary stress incontinence was no longer carried out in Dr Kegel’s hospital. The success rate of 93% that Dr Kegel achieved with resistance exercise in alleviating urinary stress incontinence far surpasses the success rate acheived with today’s ‘minimally invasive’ surgeries.

“On the strength of these favorable results urinary stress incontinence in women is no longer routinely treated by surgical intervention at…LA County General Hospital.” Dr Kegel (A progress in Gynecology 1950, p768).

Resistance exercise must not be confused with the nonsensical instruction to squeeze your pelvic floor muscles against nothing. This cannot prevent or alleviate urinary stress incontinence in the same way that working the pelvic floor muscles against resistance can. Just look at any fitness gym any muscle toning is ALWAYS done against some form of resistance. Pelvic floor exercises were never meant to be done the way they are taught today. They were ALWAYS meant to be performed against resistance. It could be argued that anyone who instructs women to squeeze against nothing may contribute to the problem, as women conclude that pelvic floor exercises don’t work for them and opt for surgery as a result.

A repair job’ can never be better than a woman strengthening her body to the degree that a repair’ is unnecessary. A repair job’ to alleviate urinary stress incontinence may cause more problems in the long term than it resolves. Both the TVT and TOT involve the formation of scar tissue to fix the mesh in place. It is often only a matter of time before the repair becomes ineffective as the weakness in the pelvic structure increases, and then the incontinence will eventually reappear. There may come a point after successive surgeries where no further surgery may be carried out. The woman may then be left permanently incontinent. Dr Kegel observed that scar tissue from previous surgery contributed to the failure rate of the few women who did not succeed with resistance exercise.

More doctors today are becoming aware that resistance exercise, not surgery, is the answer to the problem of urinary stress incontinence. As resistance exercise becomes more widely practised we can expect to see a significant reduction in the numbers of women suffering from urinary stress incontinence and from the after-effects of a surgery they may have been easily able to avoid.

A basic understanding of the value of resistance exercise would allow a woman to make a more informed choice about consenting to a surgery that may not be in her best long term interest.

© Abigail O’Donovan 2007

Medical Device Manufacturer Fights FDA Over Defective Product Recall

A New Jersey-based company that makes tissue-based products used in open-heart surgeries is embroiled in a heated court battle and war of words with the Food and Drug Administration (FDA). This tension between Shelhigh and the FDA began April 17 when the federal regulatory agency pulled about 1 million parts at the company’s plant in New Jersey after a 10-week inspection of the facility in the fall of 2006.

According to the civil complaint that the FDA filed in the U.S. District Court in Newark, the company violated several federal safety manufacturing standards. FDA officials say that the manufactured products were placed in a poorly constructed and maintained clean room, that Shelhigh did not properly inspect the products for possible microbial contamination, that they did not follow procedures to test products for sterility and that the company was not able to scientifically support their product expiration dates.

These products include pediatric heart valves, conduits for blood flow, surgical patches, arterial grafts and annuloplasty rings for repairing heart valves. FDA officials said that since these devices were placed in seriously ill patients their sterility is absolutely vital to prevent infection in those patients. An FDA press release states that Shelhigh’s own records indicate that a number of sterility test failures occurred and that its testing and retesting procedures were not properly carried out, but Shelhigh officials are saying that is not true.

In fact, Shelhigh managers are taking an aggressive stance against the FDA allegations and have indicated that they aren’t giving in any time soon. They vehemently deny that there is anything wrong with their products, a majority of which is exported to European countries such as Italy and Spain. Company officials say the FDA lacks evidence to prove that the products have malfunctioned or caused any injuries or fatalities in patients. Shelhigh valves are reportedly used in heart patients of all age groups – infants, older children, adults and seniors.

Shelhigh defied a formal FDA request earlier this month to recall these products. Shlomo Gabbay, the company’s CEO and chief science officer, says his company “has no intention to initiate the recall,” according to an article published in the New Jersey Star-Ledger, which has been following the latest developments in this saga very closely. The newspaper quotes Gabbay, who maintains that the FDA has no facts to support its claims against his company.

“The FDA should understand that it must prove its allegations before it can make a request and their newest statements do not provide any further factual support for their claims,” he told the Star-Ledger.

Apparently, this defiance on the part of Shelhigh is reflective of a trend. While drug makers are quick to recall a defective drug, device manufacturers are more contentious. Drug companies usually want to avoid lengthy court battles and the negative publicity associated with such episodes. But not these device makers, recent news reports say. In 2005, the FDA demanded a recall from Utah Medical Products, Inc., a Salt Lake City manufacturer of a variety of medical devices used in obstetrics, gynecology, neonatal intensive care, urology, electro-surgery and blood pressure monitoring.

As with Shelhigh, FDA inspectors said the Utah company was not complying with federal quality control standards and demanded a recall. But Utah Medical fought the recall and won what was considered an improbable victory against the federal agency. The FDA did not appeal that court decision.

In the case of Shelhigh, however, there are some other facts that have come to light. According to a May 16 article in the Star-Ledger, court papers show Spanish regulators last month recommended that surgeons in that country consider not using Shelhigh products because of problems in 1997 with seven pericardial patches and three incidents involving the company’s heart valves, two of them fatal.

Last week, Shelhigh suffered a setback when a federal judge declined to release the products in FDA’s possession. The judge said in a five-page opinion that he could not determine whether the devices met those standards without first holding a hearing. The judge assured Shelhigh’s attorneys that he would set the date for such a hearing soon and also encourage the opposing sides to engage in mediation and arrive at a settlement. Shelhigh attorneys are pushing for a quick decision because the company gets 70 percent of its sales from exports. They say the company could go belly up and lay off its 50 employees if it cannot satisfy the demands of its overseas distributors. Attorneys for the company also say that Shelhigh is “clinging to its life” and bankruptcy is looming large.

Experts who have watched FDA actions in the past, say Shelhigh’s fighting stance is extremely risky. The FDA, they say, has the power to put a company out of business and that the regulatory agencies in Europe and the United States are more in tune with each other now than they were ever before.

Among the products that the FDA asked that Shelhigh recall, include the following:

Medical devices manufactured by Shelhigh include: Pericardial Patch, No-React Pericardial Patch, No-React PneumoPledgets, No-React VascuPatch, No-React Tissue Repair Patch/UroPatch, Pulmonic Valve Conduit No-React Treated, No-React Dura Shield, BioRing (annuloplasty ring), No-React EnCuff Patch, No-React Stentless Valve Conduit, Internal Mammary Artery, Gold perforated patches, Pre Curved Aortic Patch (Open), NR2000 SemiStented aortic tricuspid valve, BioConduit stentless valve, NR900A tricuspid valve, MitroFast Mitral Valve Repair System, BioMitral tricuspid valve and Injectable Pulmonic Valve System.

The FDA is asking that consumers report adverse reactions or quality problems experienced with the use of these products to their MedWatch Adverse Event Reporting program either online, fax (800-332-0178), or regular mail (use postage-paid FDA form 3500 available on the FDA website, and mail to MedWatch, FDA, 5600 Fishers Lane, Rockville, MD 20852-9787.

Keyhole Surgery in India at Affordable Cost- Keyhole Surgery India

Keyhole Surgery in India 

Minimally Invasive / Keyhole Surgery

We Care India partner hospitals have one of the largest and most experienced Keyhole surgery practices in the India, performing thousands of procedures each year. Keyhole surgery is performed both on an inpatient (stay in the hospital) and outpatient (go home the same day) basis….

Overview

Keyhole or laparoscopic surgery uses high–tech surgical instruments and cameras linked to high definition televisions that allow surgeons to perform major operations through small incisions. This compares favorably to traditional techniques, which require large incisions through muscles and other tissue to approach surgical sites. It also allows the adult or child to recuperate faster and with less pain….

“Benefits of Keyhole surgery include smaller incisions, faster recovery times, and less pain.”

Keyhole surgery is any technique involved in surgery that does not require a large incision. This relatively new approach allows the patient to recuperate faster with less pain. Not all conditions are suitable for Keyhole surgery…..

Many surgery techniques now fall under Keyhole surgery, including : -

A  ]   Laparoscopy : -

A test that uses a tube with a light and a camera lens at the end (laparoscope) to examine organs and check for abnormalities. Laparoscopy is often used during surgery to look inside the body and avoid making large incisions. Tissue samples may also be taken for examination and testing….

B  ]   Endoscopy : -

a test that uses a small, flexible tube with a light and a camera lens at the end (endoscope) to examine the inside of part of the digestive tract. Tissue samples from inside the digestive tract may also be taken for examination and testing….

C  ]   Arthroscopy : -

with the use of an endoscope, surgeons can look at the interior of a joint. This technique is most often used to inspect the inside of the knee joint…

D  ]   Bronchoscopy : -

the examination of the bronchi (the main airways of the lungs) using a flexible tube (bronchoscope). Bronchoscopy helps to evaluate and diagnose lung problems, assess blockages, obtain samples of tissue and/or fluid, and/or to help remove a foreign body…

E  ]   Cystoscopy : -

inserting a viewing tube up the urethra to examine the urethra and bladder cavity…

F  ]   Gastroscopy : -

examining the lining of the esophagus, stomach, and the first part of the small intestine with a long viewing tube…

G  ]   Hysteroscopy : -

a visual inspection of the cervical canal and uterine cavity with an endoscope…

H  ]   Laryngoscopy : -

inspecting the larynx (voice box) with a mirror or viewing tube….

I  ]   Sigmoidoscopy : -

examination of the rectum and sigmoid colon with a viewing tube…

J  ]   Robotic Surgery : -

through the use of two daVinci robotic surgical systems, is offered as a treatment option for several surgical procedures….

Keyhole Surgical Procedures

Heart Surgery Colon and Rectal Surgery Gastroenterologic and General Surgery Gynecologic Surgery Neurosurgery Orthopedic Surgery Otorhinolaryngology (Ear, Nose and Throat) Thoracic Surgery Urology Vascular Surgery…..

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