The Curious Case of Refractory Persistent Pulmonary Hypertension of the Newborn: A Tale of Rescue by Vasopressin

Introduction:

An inborn term neonate weighing 2600 g developed meconium aspiration syndrome (MAS) at birth. The baby experienced respiratory failure requiring high-frequency oscillatory ventilation support. Pulmonary hypertension, along with hypotension and left ventricular dysfunction noted on point-of-care echocardiography (POCE), necessitated a trial of epinephrine and inhaled nitric oxide (iNO). The case was further complicated by bilateral pneumothorax. Despite an extremely complex presentation with severe hypoxemic failure refractory to iNO, a novel treatment plan led to intact survival.

Case Presentation:

A 37-week, 2600-gram male neonate was delivered by emergency lower segment cesarean section for fetal distress and meconium-stained liquor. The antenatal period was uneventful. The baby developed worsening respiratory distress at 15 hours of life, requiring high-frequency oscillatory (HFO) ventilation with a mean airway pressure as high as 20 cm and an oxygenation index (OI) of 22. Point-of-care functional echocardiography revealed severe PPHN (pulmonary artery pressure 70 mmHg) with left ventricular (LV) dysfunction (LV fractional shortening 18%). Epinephrine was initiated to augment LV contractility, followed by iNO therapy for hypoxemic respiratory failure (HRF) secondary to severe PPHN. However, the baby turned out to be an iNO non-responder.

The Crucial Salvage:

This complex scenario of HRF with hypotension and iNO-refractory PPHN was managed by adding vasopressin infusion, which has a unique combination of vasopressor activity on systemic circulation and vasodilatory action on pulmonary circulation. The addition of vasopressin to iNO therapy helped improve hypotension and reduce pulmonary pressures. The baby also developed bilateral pneumothorax, which was managed with bilateral intercostal drainage. As blood pressure improved with epinephrine, milrinone was added to further improve PPHN due to its ino-dilatory properties.

Outcome:

Following an intricate protocol of epinephrine, iNO, vasopressin, and milrinone in a novel and crucial sequence, along with continuous bedside point-of-care functional echocardiography for monitoring LV function and PPHN, the baby was successfully salvaged and discharged on day 30 of life.

Follow-up:

At 3 months of age, the baby had appropriate weight gain and a completely normal neurological examination without any respiratory issues.

Severe PPHN: Management Strategies in iNO Non-Responders

Inhaled NO is the treatment of choice for pulmonary artery hypertension (PAH) in neonates. However, poor lung development secondary to extraneous contents in the thorax or prolonged suppression of endogenous NO synthase have been postulated as reasons for poor response to iNO. Sildenafil (a phosphodiesterase V inhibitor) and milrinone (a phosphodiesterase III inhibitor) have been used to treat PPHN non-responsive to iNO with variable success rates.

Vasopressin acts on systemic arterial V1 receptors and causes vasoconstriction. By activating pulmonary vascular endothelial nitric oxide synthase through the oxytocin endothelial receptor, it has also been reported to have pulmonary vasodilatory effects. This action helps create a high systemic and low pulmonary vascular resistance (PVR) state, thereby tipping the balance towards a higher systemic vascular resistance (SVR)ratio.

Conclusion:

This case highlights the importance of combining clinical and physiological principles of drug actions and synergisms to treat complicated cases of refractory PPHN with systemic hypotension and hypoxemic respiratory failure. Point-of-care neonatologist-performed echocardiography-based management is crucial for monitoring dynamic changes in neonatal pulmonary and cardiac functions, facilitating physiology-based, timely treatment in critically ill neonates.

Learning Points:

  • This case demonstrates the potential of vasopressin in the treatment of severe pulmonary artery hypertension (PAH) that is refractory to inhaled nitric oxide.
  • Vasopressin has a favorable effect on both systemic and pulmonary vasculature, unlike other non-selective pulmonary vasodilators (e.g., sildenafil) currently in use.
  • Point-of-care neonatologist-performed echocardiography-based management aids in timely and physiology-based management of fragile, sick newborns.

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Transform Your Breastfeeding Journey: Essential Tips for Success

Breastfeeding is a beautiful journey, but it comes with its own set of challenges. Dr. Eman Samir, a Specialist in Obstetrics & Gynecology at Medeor Hospital, shares essential tips to support you through this journey. From ensuring a proper latch to taking care of your own health, these insights can make breastfeeding a smoother experience for both you and your baby.

Benefits for Baby

Breastfeeding provides the ideal nutrition for infants. It contains the perfect mix of vitamins, protein, and fat that your baby needs to grow. Breast milk is easier to digest than formula, and the antibodies in breast milk help your baby fight off viruses and bacteria, reducing the risk of infections and diseases.

Ensure a Good Latch

A proper latch is essential for comfortable breastfeeding and efficient milk transfer. Make sure your baby’s mouth covers most of the areola, not just the nipple. This helps prevent nipple soreness and ensures that your baby gets enough milk. If you’re having trouble with latching, don’t hesitate to seek help from a lactation consultant.

Breastfeeding Positions

Finding a comfortable breastfeeding position is important for both you and your baby. Experiment with different positions such as cradle hold, football hold, or lying on your side until you find what works best. Comfort can help make breastfeeding more enjoyable and reduce the risk of issues like blocked ducts or mastitis.

Feed on Demand

Newborns typically need to breastfeed 8-12 times a day. Feeding on demand means responding to your baby’s hunger cues, which can include rooting, sucking on fingers, or making sucking noises. Frequent feeding helps establish and maintain your milk supply and ensures that your baby gets the nutrition they need.

Eat Nutritious Foods

A balanced diet is vital for nursing mothers. Eating a variety of nutritious foods, including fruits, vegetables, whole grains, and lean proteins, supports your health and milk production. Pay attention to your body’s signals and eat when you’re hungry to keep your energy levels up.

Benefits for Mom

Breastfeeding is not only beneficial for babies but also for mothers. It helps in burning extra calories, aiding postpartum weight loss. Breastfeeding releases oxytocin, which helps your uterus return to its pre-pregnancy size and may reduce uterine bleeding after birth. It also lowers the risk of breast and ovarian cancer and may help prevent osteoporosis.

Burping Your Baby

Gently burping your baby after feeding helps release any air they might have swallowed during breastfeeding. This can reduce fussiness and discomfort. Hold your baby upright with their head on your shoulder and gently pat or rub their back to help them burp.

Breastfeeding can be a rewarding experience when equipped with the right knowledge and support. Follow these tips from Dr. Eman Samir to help ensure a healthy and comfortable breastfeeding journey for you and your baby.

For more personalized advice and support, schedule a consultation with Dr. Eman Samir at Medeor Hospital. Our team is here to assist you every step of the way.

Contact us today to book your appointment and take the next step towards a successful breastfeeding journey!

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Briji Sobhana Panicker
Mona Amin Mohamed Elmelega
Pooja More
Mukundan Gangadharan
Richa Saini

Why Lung Cancer Screening Matters: A Closer Look on Lung Cancer Awareness Day 

As we mark Lung Cancer Awareness Day, it’s crucial to shine a light on a silent killer that claims more lives annually than breast, prostate, and colorectal cancers combined. Lung cancer often sneaks up on us, remaining undetected until it’s advanced. That’s why early detection through screening is so vital.

Let’s discuss why lung cancer screening is a game-changer, especially here in the UAE.

The Lung Cancer Challenge

Lung cancer is a formidable foe, responsible for about a quarter of all cancer deaths worldwide. In 2020, it claimed nearly 1.8 million lives globally. The scary part? By the time symptoms appear, the cancer is often already in its later stages.

But here’s the good news: catch it early, and your chances of beating it skyrocket. We’re talking about a five-year survival rate of almost 60% for early-stage lung cancer, compared to a grim less than 10% for advanced cases.

Who’s at Risk?

In the UAE, several factors increase the risk:

  • Smoking: It remains the leading risk factor for lung cancer, especially among men in the UAE.
  • Work Hazards: Rapid industrialization has increased exposure to harmful substances like asbestos and radon.
  • Air Quality: Our desert climate, dust storms, and urban growth don’t do our lungs any favors.
  • Genetics: Sometimes, it’s in the DNA. Some people are naturally more susceptible to lung cancer.

Why Screening is a Smart Move ?

  • Early Detection: Low-dose CT scans can detect lung cancer when it’s still small and more treatable.
  • More Treatment Options: Early detection provides more treatment choices. Surgery or radiation might be sufficient, avoiding more aggressive therapies.
  • Lives Saved: Studies show that proper screening can reduce lung cancer deaths by up to 20%.
  • Cost-Efficiency: Although screening might seem costly initially, it’s cheaper than treating advanced cancer in the long run.

Who Should Get Screened?

Not everyone needs screening. Consider it if:

  • You’re between 55 and 80 years old.
  • You’re a current smoker or have quit within the last 15 years.
  • You have a significant smoking history (e.g., a pack a day for 30 years).
  • Lung cancer runs in your family.

Spread the Word

Awareness days like this are all about spreading the message. The more people know about lung cancer screening, the more lives we can save. It’s that simple.

Wrapping Up

Lung cancer screening is a powerful tool in our fight against this deadly disease. For those at high risk, it could be a lifesaver. This Lung Cancer Awareness Day, let’s make some noise about screening. Talk to your doctor, spread the word, and let’s catch this sneaky killer before it catches us.

Remember, knowledge is power. And in this case, it could be the power to save a life—maybe even your own.

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Mitali Dhawal Modi
Saheer Sainalabdeen

Dry Eye 

Symptoms, Causes, and Long-Lasting Relief

Dry eyes are a common condition in which the eyes do not produce enough tears to keep them adequately lubricated and moist. This can result in red, irritated eyes and, if left untreated, may even lead to vision loss. Understanding the symptoms, causes, and treatment options for dry eyes is crucial for maintaining eye health.

What Are Dry Eyes?

Dry eyes occur when the eyes fail to produce enough tears or when the tears evaporate too quickly. Tears are essential for eye lubrication and comfort. Without adequate tears, the eyes can become red, irritated, and, in severe cases, vision can be compromised.

What Causes Dry Eyes?

Several underlying causes can lead to dry eyes. The most common cause is decreased tear production, often due to a deficiency in one or more tear components: mucus, water, and oil. A frequent cause of decreased tear production is Meibomian Gland Dysfunction (MGD), where the glands do not produce enough oil to keep the eyes moist.

Environmental Conditions

Environmental factors such as wind and cold weather can exacerbate dry eyes. Prolonged use of digital devices like mobile phones, tablets, and computers also contributes to this condition, causing significant discomfort. Exposure to air conditioning or heating systems can also dry out the eyes by reducing humidity levels in the environment.

Health Conditions

Certain health conditions, such as diabetes and autoimmune disorders like Sjogren’s syndrome, can reduce tear production. Sjogren’s syndrome involves the immune system attacking the tear glands, leading to chronic dryness. Other autoimmune conditions, such as rheumatoid arthritis and lupus, can also impact tear production and cause dry eyes.

Additional Factors

  • Age: Tear production slows down with age, making dry eyes more common in older adults. The aging process can affect the glands that produce tears, leading to decreased tear production.
  • Contact Lenses: Wearing contact lenses can irritate and damage the eye’s surface, leading to dryness. Long-term use of contact lenses can reduce the amount of oxygen that reaches the cornea, exacerbating dryness.
  • Medications: Some medications, including antihistamines, decongestants, blood pressure medications, and antidepressants, can cause dry eyes as a side effect. Allergy eye drops and steroid ointments can also contribute to dryness.

Symptoms, Causes, and Long-Lasting Relief

Dry eyes are a common condition in which the eyes do not produce enough tears to keep them adequately lubricated and moist. This can result in red, irritated eyes and, if left untreated, may even lead to vision loss. Understanding the symptoms, causes, and treatment options for dry eyes is crucial for maintaining eye health.

What Are Dry Eyes?

Dry eyes occur when the eyes fail to produce enough tears or when the tears evaporate too quickly. Tears are essential for eye lubrication and comfort. Without adequate tears, the eyes can become red, irritated, and, in severe cases, vision can be compromised.

What Causes Dry Eyes?

Several underlying causes can lead to dry eyes. The most common cause is decreased tear production, often due to a deficiency in one or more tear components: mucus, water, and oil. A frequent cause of decreased tear production is Meibomian Gland Dysfunction (MGD), where the glands do not produce enough oil to keep the eyes moist.

Environmental Conditions

Environmental factors such as wind and cold weather can exacerbate dry eyes. Prolonged use of digital devices like mobile phones, tablets, and computers also contributes to this condition, causing significant discomfort. Exposure to air conditioning or heating systems can also dry out the eyes by reducing humidity levels in the environment.

Health Conditions

Certain health conditions, such as diabetes and autoimmune disorders like Sjogren’s syndrome, can reduce tear production. Sjogren’s syndrome involves the immune system attacking the tear glands, leading to chronic dryness. Other autoimmune conditions, such as rheumatoid arthritis and lupus, can also impact tear production and cause dry eyes.

Additional Factors

  • Age: Tear production slows down with age, making dry eyes more common in older adults. The aging process can affect the glands that produce tears, leading to decreased tear production.
  • Contact Lenses: Wearing contact lenses can irritate and damage the eye’s surface, leading to dryness. Long-term use of contact lenses can reduce the amount of oxygen that reaches the cornea, exacerbating dryness.
  • Medications: Some medications, including antihistamines, decongestants, blood pressure medications, and antidepressants, can cause dry eyes as a side effect. Allergy eye drops and steroid ointments can also contribute to dryness.

What Are the Symptoms?

The symptoms of dry eyes can vary but typically include:

  • Eye discomfort
  • Eye irritation or pain
  • A gritty feeling in the eyes
  • Difficulty focusing on near objects
  • Burning sensation in the eyes
  • An itchy or scratchy feeling
  • A foreign body sensation (feeling like something is in the eye)
  • Sensitivity to light
  • Blurred vision or eye fatigue
  • Excessive tearing (as a response to irritation)

How Is It Diagnosed?

Dry eye is diagnosed through a comprehensive eye exam. The ophthalmologist will review your medical history and perform a thorough eye examination. Common diagnostic tests include:

  • Visual Acuity Test: Measures how well you can see at different distances.
  • Punctate Corneal Staining: Uses special dyes to highlight damage to the surface of the eye, indicating dryness or infection.
  • Schirmer Test: Measures tear production by assessing how much liquid is produced when you blink. Small strips of filter paper are placed under the lower eyelids to measure tear output.
  • Tear Film Break-Up Time (TBUT): Measures how long it takes for the tear film to break up, indicating tear film stability. A dye is applied to the tears, and the time it takes for dry spots to appear on the cornea is measured.

What Is the Treatment for Dry Eyes?

Treating dry eyes involves addressing all potential causes. Start by ensuring your eyelids are clean, avoiding allergens, and limiting screen time. If symptoms persist, consider using artificial tears or prescription eye drops that contain lubricating agents. Other treatment options include:

  • Warm Compresses: Applying a warm compress to the eyes can help unclog the meibomian glands and improve oil production.
  • Lid Hygiene: Cleaning the eyelids with a gentle cleanser can help reduce inflammation and bacterial buildup that can contribute to dry eyes.
  • Omega-3 Supplements: Consuming omega-3 fatty acids, found in fish oil and flaxseed oil, can improve the quality of tears and reduce inflammation.
  • Punctal Plugs: These small devices are inserted into the tear ducts to prevent tears from draining away too quickly, keeping the eyes moist for a longer period.
  • Prescription Medications: Anti-inflammatory medications, such as cyclosporine or lifitegrast, can be prescribed to reduce inflammation and increase tear production.

For persistent dry eyes, consult with a specialist ophthalmologist like Dr. Anjana Karunakaran or Dr. Ayesha Farheen Shaikh at Medeor Hospital Dubai, who can provide advanced treatments tailored to your needs.

How to Prevent Dry Eyes

Preventing dry eyes involves maintaining a clean and healthy eye area. Regularly wash your face with gentle, non-irritating soap and rinse with water. To keep your eyes hydrated:

  • Drink plenty of water throughout the day to stay hydrated.
  • Avoid smoking and limit alcohol consumption, as both can contribute to dehydration and dry eyes.
  • Limit the duration of contact lens wear and ensure proper cleaning and handling of lenses.
  • Use a humidifier in your home or office to maintain adequate humidity levels.
  • Take frequent breaks from screen time to reduce eye strain and dryness. Follow the 20-20-20 rule: every 20 minutes, look at something 20 feet away for at least 20 seconds.
  • Wear sunglasses to protect your eyes from wind and UV rays, which can exacerbate dryness.

If you experience dry eye symptoms, such as burning, itching, or redness, consult with an eye doctor promptly. Regular check-ups with an experienced ophthalmologist can help manage and treat dry eyes effectively.

Understanding the Risks and Managing Dry Eyes

Dry eyes can be temporary or chronic, and untreated chronic dry eye can lead to complications like double vision or infections. Relief is available through home remedies, over-the-counter (OTC), or prescription eye drops. It is also essential to understand the underlying causes to prevent or manage them effectively.

Common Causes of Chronic Dry Eye

  • Aging: Tear production declines with age, especially after 50.
  • Medications: Certain medications reduce mucus production, contributing to dry eyes.
  • Computer Use: Staring at a computer screen can reduce blinking, leading to quicker tear evaporation.
  • Laser Surgery: Temporary dry eye can occur after laser vision correction surgery.
  • Menopause: Hormonal changes can reduce tear production.
  • Vitamin A Deficiency: A lack of vitamin A in the diet can lead to dry eyes.
  • Wind Exposure: High winds can cause tears to evaporate too quickly.
  • Sjögren’s Syndrome: An autoimmune disorder affecting tear production.
  • Other Autoimmune Conditions: Conditions like arthritis, lupus, and diabetes can affect tear production.
  • Blepharitis: Inflammation of oil glands on the eyelid.
  • Allergies: Allergies can cause eye dryness and irritation.
  • Mild Dehydration: Not drinking enough fluids can lead to dry eyes.
  • Low Humidity: Dry air can cause tears to evaporate quickly.
  • Smoke: Smoking or exposure to smoke can dry out the eyes.
  • Contact Lenses: Long-term use can obstruct oxygen to the cornea.

Tips for Relief

Avoid smoking, dry environments, and direct air exposure. Use eye drops, humidifiers, and take breaks from screens. If certain medications cause dryness, consult your doctor about alternatives. In some cases, doctors may suggest temporary or permanent procedures like placing plugs in tear ducts to help retain moisture.

When to See a Doctor

If you experience persistent dryness, redness, or pain, consult with an eye doctor. Specialists like Dr. Anjana Karunakaran and Dr. Ayesha Farheen Shaikh at Medeor Hospital Dubai can help diagnose and treat chronic dry eye, preventing complications such as infections or inflammation.

Takeaway

Understanding the causes of dry eye is the first step toward effective treatment. With the right care, lifestyle adjustments, and medical support, you can manage dry eye symptoms and reduce the risk of complications.

By consulting with experienced ophthalmologists, you can ensure that your eyes stay healthy and comfortable.

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Anjana Karunakaran
Ayesha Farheen Shaikh

Illuminating Squint: Navigating Treatment and Beyond at Medeor Dubai 

In the kaleidoscope of life, where every moment is painted with hues of experience, the journey of visual health becomes a vivid narrative. Squint, often perceived as a mere optical quirk, reveals a deeper tale of discord between the eyes, where the convergence of gazes is disrupted, leading to dissonance in both perception and appearance.

Understanding the Roots of Squint

Delving into the intricacies of squint unveils a complex interplay of factors. At its core lies an imbalance in the delicate orchestra of eye muscles, orchestrated by various triggers such as nerve trauma, refractive anomalies, or underlying systemic conditions. Contrary to popular belief, squint isn’t confined to adulthood’s realm; its shadows extend even to childhood, where vigilant eyes may detect the subtle signs of ocular misalignment. Here, the guidance of skilled orthoptists becomes pivotal, illuminating the path toward early intervention and effective management.

Charting the Course of Squint Treatment

Step into the realm of Medeor Dubai’s esteemed Department of Ophthalmology, where the journey toward visual clarity begins. Here, each patient is embraced with a tailored approach to treatment, blending expertise with empathy.

From the subtle adjustments afforded by corrective lenses to the precise maneuvers of surgical interventions, every avenue is explored to sculpt a path toward ocular harmony.

Surgical and Non-Surgical Avenues for Squint Correction

For those embarking on the surgical voyage, it’s a symphony of skill and precision, orchestrating the realignment of ocular trajectories to restore symmetry and function. Yet, the odyssey of squint correction isn’t limited to the operating theater alone. Non-surgical alternatives, including prism glasses or vision therapy, offer alternative routes toward visual equilibrium, ensuring a spectrum of choices tailored to individual needs and preferences.

Navigating Treatment Costs

Within the halls of Medeor Dubai, accessibility intertwines seamlessly with affordability, ensuring that the beacon of hope remains within reach for all. Here, financial constraints need not dim the prospects of optimal eye care, as dedicated specialists stand ready to extend their expertise without the burden of undue strain.

Post-Surgical Care and Ongoing Management

But the journey transcends the confines of treatment, extending into the realm of holistic healing and enduring support. Beyond the surgical suite, post-operative care emerges as a cornerstone of recovery, guided by regular check-ups and tailored therapy sessions aimed at nurturing ocular health and well-being.

Meet Our Expert: Dr. Ayesha Farheen Shaikh

In the intricate tapestry of Medeor Dubai’s Ophthalmology Department, Dr. Ayesha Farheen Shaikh shines as a beacon of expertise and compassion.

With a wealth of knowledge in Ophthalmology and Pediatric Ophthalmology, Dr. Shaikh embodies the commitment to guiding patients toward visual clarity and holistic ocular health.

Embracing Prevention and the Path Forward

Yet, the saga of squint transcends mere treatment, encompassing a journey of prevention and empowerment. Through our blog, we invite you to embark on this voyage with us, as we delve into the realms of eye health, sharing insights, tips, and anecdotes that inspire proactive care and brighter horizons for your eyes.

Medeor Dubai—Your Beacon of Hope in the Journey to Clearer Sight

Amidst the bustling landscape of Dubai’s urban sprawl, the Department of Ophthalmology at Medeor Dubai stands as a sanctuary of hope—a haven where squint finds solace, and vision finds clarity.

Whether you’re navigating the labyrinth of ocular misalignment or seeking to enhance your visual acuity, rest assured that you’re not alone. Our doors are always open, and our hearts are forever dedicated to ensuring that your eyes behold the world with crystalline clarity and unwavering confidence.

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Anjana Karunakaran
Ayesha Farheen Shaikh

Case of huge Fibroid Uterus

Case of huge Fibroid Uterus

Today, we present the case of a 38-year-old female patient who visited Gynae Clinic on 11 April 24 with complaints of pain during periods and pre-pregnancy check up.

History of Presenting Illness:

She was Para 1 Live 1 with history of previous caesarean in Sept 2015. She was diagnosed to have fibroid uterus at that time. Unfortunately the patient did not have any further follow up check-ups for the same.  

Initial Assessment:

On examination uterus was found to be enlarged to 32 weeks size with multiple large fibroids.  The patient was presuming it to be abdominal fat as her BMI was 37.13 kg/m2 (90.35kg, Height 156cm). The patient was shocked to learn about the diagnosis and size of the mass.  

Investigations and Final Diagnosis:

Transabdominal ultrasound revealed significantly enlarged uterus reaching till supraumbilical level with multiple fibroids partially obscuring the details. Further evaluation with MRI pelvis with contrast was done for mapping.  

MRI pelvis with contrast revealed multiple large fibroids of size 12.8 x 11.3 x 16.1 cm, 9.8 x 8.4 x 10 cm, and 10.8 x 6.4 x 7 cm. Multiple small fibroids were also noted. There were dilated lymphatic channels as well due to the pressure effect. 

LDH level was 258 – borderline high, pre-op hemoglobin was 13.9 g/dl.  

Surgical Management:

In view of the massively enlarged uterus, patient was counselled to undergo laparotomy and myomectomy. Patient underwent surgery on 06/05/2024 under general anesthesia. A vertical midline infra-umbilical incision was made.  

Intra operative findings  

Uterus enlarged with multiple large fibroids up to 32 weeks size total 7 fibroids removed, largest fundal intramural of size 16 x 10 cm, other subserosal fibroid of size 10 x 6 cm & 6x 5 cm arising from the anterior wall, band of adhesions between bladder & the uterus, 4 small fibroids removed, bilateral tubes & ovaries normal. 

Loculated fluid collection noted in the broad ligament left side ? pressure effect – same drained. 

Specimen weight was 2.242kg. Post operative hemoglobin was 12.4 g/dl. Surgery and recovery was uneventful. Patient did not require any blood transfusion, blood loss was only 800ml.  

Histopathology – Fibroid uterus without any atypia  

Conclusion

This case highlights the importance of regular gynecological check ups especially if diagnosed to have fibroids. If patient had presented earlier, the fibroids could have been tackled laparoscopically. Intra operative use of diluted vasopressin helped significantly to reduce the blood loss. 

MRI showing multiple large fibroids and loculated fluid collection on the left side.  

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Hema Diwakar
Sagimole Tojichen
Anu Bansal
Elizabeth Mathew
Nagendra Sardeshpande

Understanding Asthma: Types, Causes, Symptoms, Diagnosis & Treatment | Medeor Hospital Abu Dhabi

Asthma is a prevalent chronic respiratory condition in the UAE, affecting millions of individuals across different age groups. This blog aims to provide insights into asthma, covering its definition, types, triggers, symptoms, diagnosis, and management strategies, tailored for the UAE population.

What is Asthma?

Asthma, also known as bronchial asthma, is a chronic respiratory disease characterized by inflammation and narrowing of the airways, leading to symptoms such as wheezing, coughing, chest tightness, and shortness of breath. Unlike temporary respiratory conditions, asthma requires ongoing medical management and can be life-threatening if left untreated.

Understanding Asthma Attacks

During an asthma attack, several factors contribute to the characteristic symptoms:

  • Bronchospasm: Constriction of the muscles around the airways, leading to airflow restriction.
  • Inflammation: Swelling of the airway lining, further obstructing airflow.
  • Increased Mucus Production: Excessive mucus production, further clogging the airways.

These mechanisms collectively lead to symptoms such as wheezing, coughing, and shortness of breath, often referred to as exacerbations or flare-ups.

Types of Asthma

Asthma is categorized into various types based on its severity and triggers:

  • Intermittent Asthma: Symptoms occur intermittently, with periods of normalcy in between.
  • Persistent Asthma: Symptoms are present most of the time, with varying degrees of severity.
  • Allergic Asthma: Triggered by allergens such as pollen, dust mites, or pet dander.
  • Non-Allergic Asthma: Triggered by factors like exercise, stress, or respiratory infections.
  • Exercise-Induced Asthma: Triggered by physical activity.
  • Occupational Asthma: Triggered by workplace irritants.
  • Adult-Onset Asthma: Onset occurs after the age of 18.
  • Asthma with obesity : associated with obesity 
  • Asthma with persistent airflow limitation 
  • Asthma-COPD Overlap  (ACO): Coexistence of features of  asthma and chronic obstructive pulmonary disease (COPD).

Asthma Triggers

Asthma attacks can be precipitated by various triggers, including:

  • Allergens: Pollen, dust mites, pet dander.
  • Environmental Factors: Air pollution, tobacco smoke, dust.
  • Respiratory Infections: Viruses such as respiratory syncytial virus (RSV).
  • Exercise: Vigorous physical activity.
  • Occupational Exposures: Workplace irritants like chemicals or dust.

Symptoms and Diagnosis

Common symptoms of asthma include chest tightness, coughing (especially at night), wheezing, and shortness of breath. Diagnosis typically involves a thorough medical history, physical examination, lung function tests (spirometry), and sometimes imaging studies.

Management and Treatment

Management of asthma focuses on controlling symptoms and preventing exacerbations. Treatment options may include:

  • Bronchodilators: Relax the muscles around the airways, relieving symptoms.
  • Anti-Inflammatory Medications: Reduce airway inflammation and mucus production.
  • Biologic Therapies: Used for severe asthma unresponsive to standard treatments.
  • Lifestyle Modifications: Avoiding triggers, maintaining a healthy weight, and quitting smoking.

Prevention and Outlook

While asthma cannot be cured, effective management strategies can significantly improve quality of life and reduce the risk of complications. Preventive measures include identifying and avoiding triggers, adhering to prescribed medications, and developing an asthma action plan in collaboration with healthcare providers.

Living with Asthma

Living with asthma involves understanding one’s triggers, adhering to treatment plans, and being proactive in managing symptoms. Regular follow-up appointments with healthcare providers are essential for monitoring asthma control and adjusting treatment as needed.

COVID-19 and Asthma

Individuals with asthma, particularly those with poorly controlled symptoms, may be at greater risk of severe illness from COVID-19. It’s crucial to follow recommended precautions, including vaccination, mask-wearing, and avoiding exposure to the virus.

In conclusion, asthma is a chronic respiratory condition that requires ongoing management and care. By understanding its causes, triggers, symptoms, and management strategies, individuals with asthma can take proactive steps to maintain optimal respiratory health and overall well-being. For personalized asthma care and expert guidance, consult with Dr. Remya Rajan, Specialist in Pulmonary Disease, at Medeor Hospital Abu Dhabi.

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Remya Rajan

Preparing for Bariatric Surgery: A Comprehensive Guide by Medeor Hospital Dubai

Obesity is a rising global health concern, with increasing rates and associated health risks. Bariatric surgery has emerged as an effective intervention, and Medeor Hospital Dubai stands at the forefront of providing these life-changing procedures. This comprehensive guide explores the various aspects of bariatric surgery, including benefits, dietary modifications, and how to prepare for surgery.

What is Bariatric Surgery?

Bariatric surgery includes surgical procedures designed for weight loss by making alterations to the digestive system, typically the stomach and sometimes the small intestines. Notable procedures such as Gastric Sleeve, Gastric Bypass, Gastric Band, and Duodenal Switch are mainly aimed at reducing food intake and absorption, which aids in significant weight loss.

Types of Bariatric Surgery: Understanding Gastric Sleeve and Gastric Bypass

Gastric Sleeve Surgery

This procedure involves removing about 80% of the stomach, drastically reducing its size and the amount of food it can hold, which diminishes hunger and leads to weight loss.

Gastric Bypass Surgery

A small upper pouch is created in the stomach and connected directly to the small intestine, bypassing a large part of the stomach. This helps in reducing calorie absorption and inducing weight loss.

Obesity can lead to numerous health issues like hypertension, diabetes, heart disease, and more. Maintaining a healthy weight is crucial for overall health and wellbeing.

Dietary and Lifestyle Changes for Managing Obesity

A balanced diet, healthy eating habits, and regular physical activity are key components in managing obesity. Post-surgery, it’s important to follow specific dietary guidelines to ensure successful weight loss.

Medical and Psychological Evaluations for Bariatric Surgery

Comprehensive assessments are necessary to determine if a patient is a suitable candidate for surgery. These evaluations ensure that the individual is physically and psychologically prepared for the surgery and the post-operative lifestyle changes.

Frequently Asked Questions (FAQs)

Am I a Candidate for Weight-Loss Surgery?

Candidates typically have a Body Mass Index (BMI) of 40 or higher, or a BMI of 35 with obesity-related health issues. Consultation with a specialist is crucial to evaluate suitability

How to Schedule an Appointment?

Appointments with Medeor Hospital Dubai’s experts, including Dr. Dildar Hussain, can be scheduled by calling or WhatsApp at 800 55.

Benefits and Risks of Bariatric Surgery

The surgery offers significant benefits like resolving or improving obesity-related conditions and boosting quality of life. However, potential risks like nutritional deficiencies and surgical complications must be thoroughly discussed with healthcare providers.

Preparing for Bariatric Surgery

Preparation involves consultations, dietary and lifestyle adjustments, and undergoing necessary pre-operative tests. Following your healthcare team’s guidance is crucial for a successful surgery outcome.

Making Changes Before Surgery

Lifestyle modifications, including a proper diet, regular exercise, quitting smoking, and limiting alcohol intake, are essential steps to effectively prepare for the surgery.

For more information or to consult with our highly experienced bariatric surgery team, visit Medeor Hospital Dubai’s profile.

Dr. Dildar Hussain and the team at Medeor Hospital Dubai are committed to providing personalized care to help patients navigate their weight loss journey safely and effectively. Remember, choosing bariatric surgery is a significant step towards a healthier life, but it requires a commitment to lifelong changes in diet and lifestyle.

Gastric Sleeve Surgery: 10 Burning Questions Answered & Your Path to a Healthier You

Embarking on the quest for a healthier, more confident you can be daunting. For many grappling with significant weight issues and associated health concerns, Gastric Sleeve surgery shines as a beacon of hope. However, such a major decision naturally brings up numerous questions. This blog aims to answer 10 commonly asked questions about Gastric Sleeve surgery, empowering you with the knowledge to make an inform

1. Why is the Gastric Sleeve Soaring in Popularity?

Gastric Sleeve surgery stands out for several compelling reasons:

  • Minimally Invasive: It involves smaller incisions, leading to quicker recovery and reduced complications compared to traditional weight-loss surgeries.
  • Effective Weight Loss: Patients often lose 60-70% of excess weight, resulting in improved health outcomes.
  • Durable Results: The surgery’s restrictive nature helps with long-term weight management, assuming lifestyle changes are adopted.

2. Journey Duration: From Consultation to Recovery

The entire process begins with a 30–60-minute consultation. The surgery itself typically lasts 1 to 2 hours. Patients are then hospitalized for 1 to 2 days for initial healing. Most can return to work within 1 to 2 weeks, depending on their recovery and job type. Remember, the true journey entails a lifelong commitment to a healthy lifestyle.

3. Managing Pain: Myth vs. Reality

Pain management is a top priority in modern medicine. While post-surgical pain and tightness are expected, they can be effectively managed with the right medication and plan, making recovery as comfortable as possible.

4. Motherhood After Surgery: A Dream Possible

Post-surgery, achieving motherhood remains possible. Consultation with your doctor is crucial to time pregnancy safely, typically recommended 18 months post-surgery for optimal weight stabilization and nutrient absorption.

5. Post-Surgery Nutrition: Fueling Your Body

Post-surgery nutrition is vital and includes:

  • Eating small, frequent meals
  • Prioritizing protein
  • Limiting sugar and fat
  • Maintaining consistency A tailored plan from a doctor or nutritionist will guide you.

6. Success Stories: Distinguishing Reality from Expectation

Research paints a promising picture. Studies reveal significant success rates, with an average excess weight loss of 60-70%. Improved health outcomes in conditions like diabetes and sleep apnea are also documented. However, the crucial caveat lies in long-term lifestyle changes. Remember, surgery is a tool, not a magic bullet.

7. Addressing Saggy Skin Concerns

Skin laxity varies by individual and may be influenced by factors like age and initial weight. Regular exercise and a nutritious diet can significantly improve skin tone and reduce concerns.

8. Am I a Candidate for the Sleeve?

Eligibility criteria include:

  • BMI of 35+
  • Weight-related health issues
  • Age 18-65
  • Willingness for lifestyle changes
  • Understanding the risks and benefits Consult a bariatric surgeon to determine your suitability.

9. The Consultation: Unraveling the Mystery

The initial consultation is your chance to discuss goals, medical history, and concerns. It’s crucial to understand the procedure and ask questions.

10. Beyond the Blog: Taking the First Step

While this blog serves as a primer, consulting with a bariatric surgeon is essential to making an informed decision on Gastric Sleeve surgery.

Your Partner in Health: Dr. Dildar Hussain

Seeking a skilled General Surgeon for your journey? Medeor Hospital in Dubai boasts a team of experienced surgeons, including Dr. Dildar Hussain, ready to guide you through your weight loss journey. Contact us for a personalized consultation.

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Understanding Thyroidectomy Surgery: Types, Procedure, and Aftercare

Thyroidectomy surgery is a medical procedure designed to remove all or part of the thyroid gland, a butterfly-shaped organ located in the neck below the Adam’s apple. This gland plays a crucial role in producing the hormone thyroxine, which controls vital functions such as heart rate, temperature, and growth. In this comprehensive guide, we’ll delve into the types of thyroidectomy, the surgical process, and crucial aftercare measures.

Types of Thyroidectomy

One might undergo thyroidectomy for various reasons, including an enlarged thyroid (goitre) causing difficulty in swallowing or breathing, hyperthyroidism or thyrotoxicosis (an overactive thyroid), or the presence of a lump that could be thyroid cancer. The range of thyroid operations includes a partial thyroidectomy (hemithyroidectomy), or the complete removal of the thyroid gland, known as a total thyroidectomy.

The Surgical Procedure

Thyroidectomies are typically performed under general anesthesia. During the surgery, a skilled general surgeon makes an incision in the front of the neck, approximately 2cm to 3cm above the collarbone. Precision is crucial to avoid damage to the nerves connected to the voice box and the parathyroid glands, located behind the thyroid, which regulate calcium levels in the body. Once the thyroid gland is removed, the incision is carefully stitched to facilitate healing.

After Thyroidectomy

After undergoing a thyroidectomy, it’s essential to be vigilant about potential postoperative symptoms. Any swelling, bleeding, redness, or warmth at the incision site should be monitored closely. Additionally, a fever of 101 degrees or higher, along with numbness or tingling in the face, hands, or lips, warrants immediate attention. If you experience any of these symptoms or have concerns about your thyroidectomy, don’t hesitate to reach out to your healthcare provider.

When to Call Your Healthcare Provider

 Knowing when to contact your healthcare provider after a thyroidectomy is crucial. Reach out if you notice swelling, bleeding, redness, or warmth at the incision site. A fever of 101 degrees or higher, as well as numbness or tingling in your face, hands, or lips, are also warning signs that should prompt a call to your healthcare provider. Open communication with your surgeon is encouraged to address any questions or concerns you may have about your thyroidectomy and its aftermath.

Understanding the nuances of thyroidectomy surgery, from the types and procedures to postoperative care, is vital for individuals facing this medical intervention. By staying informed about potential symptoms and maintaining a proactive line of communication with healthcare providers, individuals can navigate the thyroidectomy process with confidence and ensure a smoother recovery.

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Hadil Farouk Al Ahmed
Kerim Erdem Ulucay
Ali Sulieman Hassan Sulieman
Sasikumar Vallachira Pisharom