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Beating heart surgery: There’s hope for octogenarians EYESIGHT
Asians, Africans left out of stem cell research: study Health Notes
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Beating heart surgery: There’s hope for octogenarians Bypass surgery used to be a remote possibility in the Indian scenario on octogenarians a couple of years back. But thanks to technological breakthroughs in the medical field and the new techniques developed, now bypass surgery can be offered to this age group with equal success rates. The technique heart surgery has helped achieve this even in situation like poor heart functioning or after a recent heart attack. In beating-heart surgery, the procedure is performed without stopping the heart, using a special device that renders the part of the heart motionless where surgery is to be done. The heart continues to perform its normal function of circulating blood to the heart muscles during the surgery.
The advantages
Beating-heart surgery has a better success rate and better survival rate, especially among high-risk patients. There is less of post-surgery trauma as the patient recovers very fast and gets discharges from the hospital in a short
time. There are reduced risks of any post-surgery complications. Age is definitely one of the risk factors for bypass surgery as per Euro Score, which is an international criterion to the judge the risks factor involved in particular case pre-operatively. Such patients have already wear and tear effect on all of their body organs and they have generally multiple problems like diabetes, hypertension or renal dysfunction. So, one needs to investigate these patients in great detail, to see whether they will be able to withstand such a major surgery. They need to be prepared properly before surgery. Physically, they need to be active and mentally motivated to undergo bypass surgery. With increasing awareness about the benefits of bypass surgery, they acceptability about this beating-heart procedure is constantly increasing and with this new technique of beating heart surgery, the recovery in such patients is very fast. Basically, the side-effects of the earlier technique, in which we used the heart-lung machine to support the body for the period the heart was arrested, have been eliminated with beating heart surgery. They do require an extra effort during and after surgery as the body tissues have aged and are fragile.
Is beating-heart a common procedure?
It is technically-demanding and requires specialised skills and training and, therefore, not many surgeons prefer it, though it is now becoming a common procedure for coronary bypass. The writer is Head, Department of Cardiac Surgery, Alchemist Hospital,
Panchkula.
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EYESIGHT Common eye problems
Eye infections in newborns are not uncommon. Between the period from birth and up to three weeks, a baby can suffer from neonatal conjunctivitis, which shows up as redness and discharge. This infection needs to be controlled by appropriate antibiotics as prescribed by the eye specialist. Continuous watering from one or both eyes accompanied by a copious discharge is a frequent problem encountered in babies. During the first four weeks of a baby’s life, the tear secretions are less than normal, so any watering from the eye is abnormal. Discharge and watering from the eyes at birth suggests infection; while the appearance of the same symptoms when the baby is three weeks old or more suggests failure of tear ducts to open. Tear ducts are tiny tubes connecting the inner ends of the eye to the nose and help drain tears. They usually develop after three to four weeks. Massaging at the bridge of the nose alongwith antibiotic drops may help in this situation. If watering does not stop by three or four months, a probing procedure is recommended in which a blunt probe is passed through the tear ducts thereby opening them. Any delay in seeking this simple treatment may result in major surgery later on in life. Believe it or not, Kala Motia, too, may be present at birth. Buphthalmos or infantile glaucoma is a condition in which watering may be accompanied by severe photophobia (sensitivity to light). It needs treatment with “pressure lowering” eye drops followed by surgery. If untreated, it may result in complete blindness as the optic nerve gets damaged by the increased eye pressure. If the central black part of the eye (cornea) is hazy or has white areas, it needs immediate consultation. Infections inside the eye of the baby may have been transmitted from the mother during pregnancy. It can be confirmed by performing the TORCH test on both mother and child. Any abnormality of the eyelid should also be taken seriously. A child may have a congenital eyelid coloboma in which a part of the eyelid may be missing. Normally, the eyelid covers 1-2 mm of the cornea. In case it covers more than that, it’s a condition called “drooping of the eyelid”. The baby’s eye movements must be observed carefully. Any restriction in the eye movement may be a sign of nerve palsy. Pre-term infants are at a high risk for developing ROP or Retinopathy of Prematurity. This disorder which is potentially blinding and affects both eyes occurs more commonly in children who have low birth-weight and are born prematurely. Normally, the eye grows rapidly during the last 12 weeks of pregnancy but if the baby is born pre-term before normal eye growth is complete, abnormal vessels beg in to grow. These fragile vessels bleed, leading to scarring and retinal detachment and in severe cases may also lead to a permanent loss of vision. Screening by an expert ophthalmologist is necessary for such babies to prevent further complications and save vision. Ocular alignment should also be checked. Mal-aligned eyes suggest a squint. An expert eye specialist, specialising in paediatric ophthalmology should be consulted immediately in such babies. However, some variations in alignment are acceptable up to the age of six months. The writer is Chairman and Medical Director, Centre for Sight, New Delhi. Email: drmahipal@ gmail.com
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Asians, Africans left out of stem cell research: study Asians and Africans may be less likely to benefit from pioneering stem cell research than people of European origin, thanks to a lack of racial diversity in cell stocks, a US study said Wednesday. A University of Michigan research team found that stem cell lines came overwhelmingly from individuals of European descent, which could leave the impact of diseases on other races understudied, the team said. "It is crucial that diverse lines are available for this research to ensure that all patients benefit from the results," said Sean Morrison, director of the university's Center of Stem Cell Technology. The study, published on Wednesday in the New England Journal of Medicine, examined 47 commonly used embryonic stem cell lines, of an estimated 700 currently being used in research. Of the 47 lines, just two were of East Asian origin, none were of African or Pacific Island descent, nor from groups indigenous to the Americas. Stem cells, which are capable of developing into almost every tissue in the body, are seen as the greatest hope in curing a range of diseases from cancer to Alzheimer's, and of growing transplantable organs and tissues. "We expected Europeans to be overrepresented, but we were surprised by how little diversity there is," said Morrison. "Embryonic stem cell research has the potential to change the future of medicine," said Morrison. "But there is a lack of diversity among today's most commonly used human embryonic stem cell lines, which highlights an important social justice issue." In a statement researchers said wider diversity was needed "because certain groups may respond to medications and treatments differently." Embryonic stem cell research has grown apace in recent times, thanks in part to a US government's decision lifting a ban on developing new lines. But as new research has developed, so too has the number of bioethical questions surrounding the new technology. The research has long been controversial because human embryos are destroyed in order to obtain the primitive cells. — The Independent
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Health Notes Melbourne: A black market in breast milk is booming as parents Down Under are desperate to feed their babies the natural elixir. They are being charged up to $ 1000 a litre on the Internet. Breast milk provides antibodies that protect babies against diseases and is especially important for premature babies. One of the mothers contacted the Gold Coast based Mother’s Milk Bank to ask what the real “going rate” was for breast milk after online sellers sought an exorbitant amount when she placed a web advertisment seeking human milk. Mother’s Milk Bank director Marea Ryan told her that the not-for-profit bank sold milk for $ 50 for 1.2 litres. –
ANI
Students witnessing bullying
more vulnerable to stress
Washington: A new study suggests that students who witness their peers being abused verbally or physically are likely to suffer from metal stress themselves. The study, covering nearly 2,000 students in the ages of 12 to 16 from 14 British public schools, also found that bullies and bystanders are also more susceptible to take drugs and alcohol. Lead author Ian Rivers said: “It’s well documented that children and adolescents who are exposed to violence within their families or outside of school are at a greater risk for mental health problems than those children who are not exposed to any violence.” – ANI
Doctors overprescribe antibiotics
in fear of lawsuits
Washington: Doctors are overprescribing antibiotics in fear of lawsuits, a new study claims. Researchers at New York Medical College believe that medical liability concerns may be triggering the increase of MRSA in healthcare settings by encouraging clinicians to prescribe antibiotics more often and more broadly than clinical circumstances and evidence-based guidelines warrant. Census figures, statistics on population density of attorneys and physicians and data on antibiotic utilisation for the United States, Canada, and 15 European countries, were analyzed as part of the study.
– ANI
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In many cases even today, the heart-lung bypass machine is used during heart bypass surgery at some centers in which the heart stopped by the surgeon to perform the necessary procedure on a motionless heart. After the surgery blood has to be introduced again into the heart, called reperfusion, which may, at time, cause impairment due to reperfusion injury, especially in high-risk patients such as elderly ones who have undergone heart surgery earlier or have other health complications.
The arrival of a newborn is a joyous occasion for the entire family. The baby becomes the cynosure of all eyes, and all eyes are on the baby’s eyes. For the proud parents, it is important to look beyond the colour of their baby’s eyes. They should closely examine the baby’s eyes to detect any abnormality. Any eye abnormality detected at birth should be immediately brought to the notice of an eye specialist. An infant’s eyes are slightly smaller than that of an adult. It takes around two years for a baby’s eyes to develop to a size similar to that of an adult. Let’s see what all can be detected at home.