adminMorning Health Talk ;
New Delhi,June 09,2018 :
Clinical
- Can ageing be reversed: Ageing process will be ‘reversible’, according to two genetic engineers in just published book The Death of Death. Nanotechnology, turning ‘bad’ genes into healthy ones, eliminating dead cells from the body, repairing damaged cells, treatments with stem cells and ‘printing’ vital organs in 3D can work by lengthening the ‘telomeres’. Telomeres become damaged and shortened with the passage of time, a process that speeds up in the event of toxins entering the body – smoking, alcohol and air pollution are among elements that reduce the length of telomeres, thus accelerating ageing.
https://www.thinkspain.com/news-spain/30425/death-will- be-optional-and-ageing- curable-by-2045-say-genetic- engineers
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IMANDB Seminar: Dr OP Yadava, Dr KK Aggarwal, Dr Vikas Ahlawat, Dr Anand Prakash, Dr Maj Prachi Garg
Minimal Invasive Bypass Surgery: Alternative approaches to the performance of standard CABG (“still heart” surgery), in which both cardiopulmonary bypass and cardioplegia are used, include: elimination of both CPB and cardioplegia; or elimination of cardioplegia only (“beating heart” surgery). In addition, sternotomy may also be avoided, replacing it with smaller incisions. Techniques 1 or 2 are often, but, not always combined with the use of smaller incisions. These varied approaches are collectively referred to as “minimally invasive” techniques.
Surgery through smaller incisions (minimal access) and totally endoscopic “robotic” surgery requires utilization of specialized instruments or computer-enhanced tele-manipulation system.
Saphenous vein and radial artery harvest can also be accomplished through small incisions using video-based surgical techniques, decreasing the morbidity associated with leg and forearm incision (pain, infection) and permitting more rapid recovery.
Three alternative techniques have emerged for MID CABG, which differ in the use of CPB.
With MID CABG through a limited anterior thoracotomy with CPB, antegrade and retrograde cardioplegia are delivered to produce optimal myocardial protection. The surgeons can work on an empty, decompressed heart in a still and bloodless field, leading to enhanced myocardial protection and better access and freedom to manipulate and expose the entire heart, which is necessary for multi-vessel CABG. This technique is now very rarely used.
MID CAB without CPB is performed through a limited anterior thoracotomy and is best suited to approach anterior coronary vessels, most commonly the left anterior descending artery as well as lateral (obtuse marginal) coronary targets. In this procedure, the left internal mammary artery is anastomosed to the LAD and lateral grafts are typically fashioned as Y or T grafts off the LIMA with either saphenous vein or additional arterial grafts. These procedures may be performed through direct access, endoscopically, or robotic-assisted.
Multi-vessel minimally invasive CABG can be performed either through a small thoracotomy or totally endoscopic either on the beating or arrested heart with comparable outcomes to conventional CABG and advantages of minimally invasive access.
Hybrid MID CABG (no CPB) with LIMA to LAD and percutaneous coronary intervention with drug-eluting stents to treat residual significant CAD. This emerging therapy is particularly attractive in patients with significant co-morbidities.
NIH:
Women in early pregnancy who have high levels of a certain thyroid hormone may be at greater risk for gestational diabetes, compared to women who have normal levels of the hormone, according to researchers at the National Institutes of Health. Their study appears in the Journal of Clinical Endocrinology and Metabolism.
The researchers found that pregnant women with the highest levels of the thyroid hormone triiodothyronine (T3), were more than four times more likely to develop gestational diabetes, compared to women with lower levels of the hormone. T3 is produced from the related hormone thyroxine (T4). The researchers also found that a high T3/T4 ratio — which indicates a high conversion rate from T4 to T3 — was strongly associated with a higher risk for gestational diabetes. Their findings suggest that screening pregnant women for thyroid disease early in pregnancy could help identify women at high risk for
Dr KK Aggarwal
Padma Shri Awardee
Vice President CMAAO
President HCFI
