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Vol.2 | Issue No.2 | Jul - Sep 2017

Bladder Control Problems in men The power of

Pancreas Zika:

The virus that causes birth defects

Even distorted facial assets can be corrected to retain appealing visage

AIMS’ Robotic Surgery expert cures cancers in women

Cover Story:

Dental Tourism India, The Crown Jewel

A Complete Magazine on Healthcare in Asia



Medical Tourism Jul. - Sep. 2017

A Complete Magazine on Healthcare in Asia


Vol.2 | Issue No.2 | Jul. - Sep. 2017


tourism RNI No. KERBIL/2016/68979

Editor & Publisher Benny Thomas

Executive Editor TKV.Mani Editorial Co-ordinator Ninu Susan Abraham

Layout & Design Lal Joseph Legal Advisor Adv. Biju Hariharan BUSINESS ASSOCIATES Overseas USA : CHICAGO: Vincent Joseph Mob: 847 299 9954 USA : Houston: Shaju Joseph Mob: 847 899 2232 USA : NEW YORK Vincent Sebastian Mob: 917 992 9629 USA : CALIFORNIA: Wilson Nechikat, Ph: 408 903 8997 Canada : Jose Sebastian, Ph: 416 - 509 – 6265 UK : Dileep Mathew, Ph: 044 787 743 2378 Switzerland : Dr. George Sebastian, Ph: 527204780 Ireland : Thomas Mathew Mob: 00353 87 123 6584 Middle East : Anil Nath, Ph: 506854500 Singapore : Mahesh A, Ph: +65 906 22828 Germany : Thomas Vallomtharayil Ph: 02305 4455 100 Austria : Monichan Kalapurackal Ph: 0043 6991 9249829 Korea : Dr. A. Thomas, Ph: 0082 10 5822 5820 Australia : S. Mathew, Ph: 61247026086 BUSINESS ASSOCIATES India New delhi : V Murugan, Mob: +91 989 9931 879 Mumbai : Mohan Iyer, Mob: +91 22 6450 5111 Chennai : C. Shankar, Mob: +91 984 097 8060 Eastern India : Sanjay D. Narwani Mob: +91 983 120 7202 Ahmedabad : Madanan MA, Mob: +91 989 800 2522 Hyderabad : Vinod Menon, Mob: +91 081 436 17672 Puducherry : K. Ramasubramanian, +91 989 497 7161 Goa : Olavo Edviges Lobo - +91 982 258 9237 Trivandrum : Kuriyan K Raju, Mob: +91 944 610 6644 Kozhikode : T. Rajendran Nair, Mob:+91 953 900 9305

Medical Tourism Jul. - Sep. 2017

Mind you, statistics show that up to 150 million Americans live without dental insurance. Ruing want of sufficient funds, they don’t have to suffer excruciating pain of the teeth and gums any more, for there are any number of purse -savvy smart facilities available in the host countries to take care of their woes.

What is the first thing you notice when you look in the mirror? Obviously, the smile and perfect teeth. This shows how concerned we are about our self-image and self-esteem and the role of smile in enhancing them. It is said that the power of a beautiful smile is the key to a successful life. A smile radiates energy and creates a positive atmosphere that erases out any rough situation. It is scientifically proved that smiling increases the production of endorphins, which are a bunch of hormones within the brain and nervous system. These hormones increase the confidence and positivity of a person.

Vice President-Marketing Sunil Nair


Get past all the teething troubles, just hop on a plane, visit a specialist dentist in the country of your choice like India and save up substantial amount of money for even routine procedures like crowns and root canals.

Not just alleviating biting, chewing and masticating problems, there are facilities for lifting up the looks and image of individuals. Irregularity in the mouth, teeth, gums, jaws, lips that browbeats anyone with a festering awkward look can be set right, imparting attractive appearance. Who would not enjoy a bit of Narcissism on seeing manifestation of enhanced image?

Consulting Editor O.J. George

CORPORATE OFFICE FM Media Technologies PVT Ltd, Penta Square, Opp.Kavitha, MG Road, Cochin -682016, Kerala, India. Tel/Fax: +91 484 403 4055 Email: www.

Buzz of the beeline for Dental Tourism

However, it is indispensable to have a healthy mouth and teeth for a bright and sparkling smile. A healthy mouth is a sign of a healthy body, but all mouth problems are not always dental. They can show up the symptoms of many diseases like diabetes, heart disease, HIV and cancer. Some mouth-related problems may also indicate different eating disorders. If we don't take care of our teeth, we could ultimately end up losing them. Nine out of 10 people are said to visit a dentist at least once in their lifetime as nobody can claim to have a set of perfect teeth. Today, there are specialist departments in hospitals for dental issues. People travel overseas seeking cost- effective treatments. India is one of the most preferred destinations for dental tourism. Here, the patients are assured of very good services at reasonable cost compared to other developed and developing countries. Indian hospitals have highly- qualified and experienced specialists with facilities that are at par with international standards. Now-a-days people go to the dentist not just for treating a toothache. Currently, we live in an age of cosmetic dental treatment that involves porcelain veneers, teeth whitening, orthodontics (without braces treatments), dental bonding and reshaping and refining smile. The American Academy of Cosmetic Dentistry states: "A skilled, experienced cosmetic dentist can help to improve your appearance, your smile, even your selfesteem, and confidence. Today, cosmetic dentistry has continued to evolve to where cosmetic dentists can address functional and aesthetic patient concerns." Our cover story is on dental health and it covers everything from daily dental hygiene to cosmetic treatment. Our other stories include details on urinary incontinence, Bladder control problems in men, Power of Pancreas, Keep the Beat in tact, a story on keeping healthy blood pressure, a report on relationships – Do Social Ties Affect Our Health, Need of health insurance and Dental Tourism in India. We also have provided a list of some of the leading hospitals that provide specialist dental services for patients. We assure you that this issue is worth keeping and it offers value for money. Keep



Printed, published and owned by Benny Thomas FM Media Technologies Pvt. Ltd, Penta Square, Opp.Kavitha, MG Road, Cochin -682016, Kerala, India. Editor: Benny Thomas

Printed at Sterling Print House Pvt Ltd, Door No. 49/1849, PonekkaraCheranellur Road,Aims, Ponekkara P.O, Cochin-682041, Ph: 0484 2800406.

Disclaimer: The statements in this magazine have not been evaluated by the Food and Drug Administratin of USA or any other country. Information provided in this magazine are not intended to diagnose, treat, cure or prevent any disease. If you have a medical condition, consult your physician. All information is provided for research and education purpose only.

A Complete Magazine on Healthcare in Asia




Medical events


New dental equipment




Doctor speaks


Health news


Cover story- Dental tourism: India, the crown jewel


Cover story/Dental health: Take care of your mouth to be in good health


Interview: Rajagiri Hospital


Bladder control problems in men


How anxiety affects your daily life


Eating disorders: What to watch for


Soothing a sore throat


The power of pancreas


AIMS’ Robotic Surgery expert cures cancers in women


Spotlight: Padmashri Prof. Dr. A. Marthanda Pillai


Do social ties affect our health?


Your eyes are precious


Tai Chi and your health


Zika: The virus that causes birth defects


Think before you ink: Are Tattoos safe?


Counting sheep to go to sleep?


Even distorted facial assets can be corrected to retain appealing visage


Dazzling Delhi for medicare and sightseeing


Medical Tourism Jul. - Sep. 2017


Cover Story: DENTAL TOURISM:INDIA, The Crown Jewel


Bladder Control Problems in Men

38 How anxiety affects your daily life

60 Zika: The virus that causes birth defects


Soothing a sore throat

64 Think before you Ink: Are Tattoos safe?

46 The power of pancreas


Counting sheep to go to sleep? 68

48 AIMS’ robotic surgery expert cures cancers in women


Even distorted facial assets can be corrected to retain appealing visage

A Complete Magazine on Healthcare in Asia


Medical Tourism Medical events

HMC 2017 July 22-23, 2017 Mumbai, India The 7th edition of Hospital Management Conference and CIMS Healthcare Excellence Awards is scheduled to be held in Mumbai, India. For details contact: CIMS, Boomerang, B-Wing 403, Chandivali, Mumbai-400072, India.

Tel.: +91-993 093 7020 E-mail:, Website:

MEDICALL 2017 July 28-30, 2017, Chennai, India The 17th edition of India's largest B2B Medical Equipment and Hospital Needs exhibition is scheduled to be held at Chennai Trade Centre in Chennai, India. For details contact: Medexpert Business Consultants Pvt Ltd, 199, 7th Floor, Luz Church Road, Mylapore, Chennai, 600-004, Tamil Nadu, India. Mobile: +91-93607-07044, E-mail:,

MediPharm Expo 2017 August 17-19, 2017,

Ho Chi Minh City, Vietnam

The 17th edition of Vietnam International Hospital, Medical and Pharmaceutical Exhibition is scheduled to take place at Saigon Exhibition and Conference Centre in Hochiminh City, Vietnam. For details contact: National Trade Fair & Advertising JSC (VINEXAD), 9 Dinh Le St., Hanoi, Vietnam.

Tel.: +84-4-3825-5546, Fax: +84-4-3936-3085 E-mail: ; Website:

Wellness India Expo 2017

Aug. 29-31, 2017, New Delhi, India

A health expo on lifestyle and environmental pressures which are giving rise to a host of ailments ranging from high cholesterol, heart and liver related, as well as non-communicable diseases such as cancer, diabetes, and chronic respiratory diseases etc. is scheduled to be held at Pragati Maidan in New Delhi, India. For details contact: Exhibitions India Group, 217-B, Okhla Industrial Estate, Phase III, New Delhi 110020, India.

Tel.: +91-11-4279 5158, Fax: +91-11-4279 5098. E-mail:, Website:

Medical Fair

Sept. 6-8, 2017, Bangkok, Thailand

The 8th International Exhibition on Hospital, Diagnostic, Pharmaceutical, Medical and Rehabilitation Equipment and Supplies will be held in Bangkok, Thailand. For details contact: Messe DĂźsseldorf Asia Pte Ltd, 3 HarbourFront Place #09-02 Harbour, Front Tower Two, Singapore 099254.

Tel.: +65-6332-9620, Fax: +65-6332-9655. E-mail: ; Website:

HIMSS AsiaPac 2017

Sept. 11-15, 2017, Marina Bay Sands, Singapore

A Conference dedicated to learn, share and discuss on insights, team based care that benefit the patients both clinically and operationally is scheduled to be held in Marina Bay Sands, Singapore. For details contact: HIMSS Asia Pacific, 3 Killiney Road, #04-04 Winsland House 1, Singapore 239519.

Tel.: +65-666-411-84. E-mail: ; Website: http:// www.himssasiapacconference.orgSept. 15-17, 2017

Indonesia Dental Exhibition 2017 Sept. 15-17, 2017, Jakarta, Indonesia Indonesia Dental Exhibition & Conference being organized by Koelnmesse, the Indonesian Dental Association and PT Traya Eksibisi International, will take place in Jakarta Convention Center, Jakarta, Indonesia. For details contact: Koelnmesse Pte Ltd, 152, Beach Road, #25-05 Gateway East, Singapore-189721.

Tel.: +65-65006700, Fax: +65-62948403. E-mail: ; Website:

SINMAC 2017 Sept. 28-30, 2017, Abu Dhabi, UAE SINMAC - SENA International Nursing, Midwifery & Allied Health Conference will be held in Abu Dhabi, UAE. For details contact: Medetarian Conferences Organizing, 1st Floor, Office Tower, BHS Building, Hamdan Street, Abu Dhabi, UAE.

Tel.: +971-2658-8717, +971-2627-5509, +971-55-5860152. E-Mail: ; Website:


Medical Tourism Jul. - Sep. 2017

Medical Tourism new dental Equipment

Assistina 301


Prestige Medical Classic

Plus Dental Sterilizer - W&H

Master Cordless Gutta Percha Obturator Meta BioMed

Portable Dental Autoclave - Aseptico

The maintenance process of Assistina 301 Plus starts automatically at the touch of a button. After only 35 seconds, the instrument is perfectly maintained. The automatic rotational lubrication ensures optimum distribution of the oil and that an even film of lubricant is created. Dirt particles are loosened and removed. The lifespan of the instruments is increased significantly whilst service costs are reduced.

The E&Q Master cordless gutta percha obturator has the battery charging system as the mobile phone. It operates at low voltage for users safety. If the battery is discharged during use, it can be replaced with an extra battery on standby for continuous use. The slim design and simple operation of the E&Q Master will maximize effectiveness and convenience.

The prestige medical classic portable dental autoclave is a compact and portable sterilizer. It is easy to operate and takes 18 min for a sterilization cycle (23 min total cycle time). Only 6 minutes is taken to reach the sterilization temperature. The sterilization temperature is 121°C (250°F).






Permanent Power Dental Compressor

Pre-Vacuum Sterilizer - Tuttnauer


The BeeFill 2in1 is a 3-dimensional, dense and durable obturation of root canals. It gives a reliable obturation of the entire root canal system: oval canals, isthmi, ramifications, lateral canals. Homogenous and dense filling is possible with this system.

The EHS is our fastest tabletop autoclave. This is achieved with a jacketed double walled chamber, which acts as an instant supply of steam and keeps the autoclave warm and ready for use. The powerful water-ring vacuum-pump provides for fast pre and post vacuum air removal.



Providing unrivalled performance, KAESER’s "Permanent Power System" (PPS) enables up to 90 percent compressed air availability. To regenerate the desiccant in the SECCOMAT dryer, the PPS uses a highly efficient process whereby fresh ambient air is drawn in and warmed via the compressor and then passed through the dryer.

CS 1500

M9 UltraClave

Root ZX

Intraoral Camera-CareStream

Automatic Sterilizer - Midmark

Mini Dental Apex Locator - Morita

The CS 1500 Intraoral Camera is the ideal communication tool for any dental professional. Delivering precise, true-to-life images with each shot, the CS 1500 Camera provides the visual evidence needed to educate patients and make more accurate diagnoses.

The Midmark M9 ultraclave has intuitive display and simple prompts helps to easily select the cycle needed, whether it is for unwrapped items, pouches, packs or handpieces. Once the sterilization process is complete, the automatic-opening door quietly opens to dissipate steam, providing fast and efficient instrument drying. Simply load it, set it and forget it.

The Root ZX mini is compact and light-weight design. It is Built on the industry standard Root ZX technology. The Root ZX mini measures in both wet or dry canal conditions with class-leading accuracy.

Gutta Percha Obturator - VDW




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Medical Tourism hospitals

Ananthapuri Hospitals & Research Institute

Apollo Hospitals Chennai Ph: +91-44-2829 6569/2829 3333

Trivandrum Ph: +91-471-2579900/2506565 Email :

Email :

Apollo Gleneagles Hospitals

Aster Medcity Kochi 0811 199 8115

Kolkata Ph: +91-33-23203040/23202122 Email :

Email :

Artemis Health Institute

Baby Memorial Hospital

Gurgaon Ph: +91-9711379010

Kozhikode Ph: +91-952 605 5566

Email :

Email :

Aware Global Hospitals

Bangalore Baptist Hospital Hyderabad Ph: +91-8885511072

Email :

Bangalore Ph: +91-80-22024700

Email :

BLK Super Speciality Hospital

Believers Church Medical College Hospital

Delhi Ph: +91-11-30653122

Email :

Thiruvalla, Kerala Ph: 0469 302 3100 E-mail:

Continental Hospitals Ltd.

Christian Medical College Hyderabad Tel: +91 40 67000000.

Vellore +91-41-62288000 / 41-62282004

Email :

Dr. Kamakshi Memorial Hospital

FLT. LT. Rajan Dhall Fortis Hospital Delhi Sector B, Pocket 1, Aruna Asaf Ali Marg,Vasant Kunj

Chennai Ph:+91-44-663 00300 805 630 0300 Email :

Email :

Frontier Lifeline Hospital

Felix Hospital Chennai Ph: +91-44-42017575

Email :

10 Medical Tourism Jul. - Sep. 2017

Noida +91-783 599 9777

Email :

Medical Tourism hospitals

Jaslok Hospital & Research Centre

Indian Spinal Injuries Centre

Mumbai Ph:+91-22-66573333/66573067

Delhi Ph: +91-8527221115

Email :

Email :

Jupiter Hospital

K.G. Hospital & Post Graduate Medical Institute

Coimbatore Ph: +91-422-2212121/9843131217

Mumbai Ph:+91-22-21725583 Email :

Email : /

Kovai Medical Center & Hospital

KIMS Hospital

Coimbatore Ph: +91-422-4323800/4323944

Trivandrum +91-471-3041385/9995268011

Email :

Email :

Lourdes Hospital

Lakeshore Hospital & Research Centre

Cochin Ph: 04844121101/ +919496002266/9496002100

Email :

Manipal Hospital

Bangalore Ph:+91 9900027157/88-49360449

Cochin Ph:+91-484-2701032

Email :

M. S. Ramaiah Memorial Hospital Bangalore Ph: 9008364411/9900054804

Email :

Email :

Rajagiri Hospital

Max Super Speciality Hospitals

Aluva, Kerala Ph: 0484 665 5000

Delhi Ph:+91-11-26515050

Email :

Email :

P.D. Hinduja Hospital & Medical Research Center

Narayana Multi Speciality Hospital Bengaluru Ph: + 1860 208 0208

Mumbai Ph: 022-24451515/2444919

Email :

Email :

Star Hospitals

SevenHills Hospital

Email :

Hyderabad Ph: 040-44777777

Mumbai Ph: 022 6767 6767

Email :

A Complete Magazine on Healthcare in Asia


Medical Tourism Doctor speaks

Deformity correction & spinal fusion surgery

Renowned Spine Surgeon Dr. Arvind G Kulkarni of Bombay Hospital, Mumbai writes about how he successfully treated a patient suffering from Scoliosis The 14-year-old girl who was brought to our clinic was born with a congenital spinal defect known as Scoliosis. Even though she was born with it , there were no noticeable symptoms until she turned 10. Her condition started worsening in terms of appearance when her parents noticed her prominent ribs, disproportionate shoulder level and an uneven hump on the left side of the hip when she bent. This also created discrepancy in the length of her legs. She started having problems in breathing as the area in the rib cage region was confined drastically. Her parents decided to consult doctors. When she arrived at our clinic, her long erect xrays revealed significant scoliosis as result of D12 hemivertebra. This basically means that her 12th thoracic vertebra was half in size. Only the right triangular half of D12 was formed and the left half was missing. This led to bending of the spine on the missing side, leading to scoliosis. The right shoulder blade was more prominently protruding along with one hip higher than the other. This caused significant cosmetic deformity leading to loss of confidence and social stigma to the patient. Progressively the curve got worse in severity and the patient developed weakness in the legs and loss of balance on walking. This was a result of spinal cord compression at the sharp convexity (apex of the bend). As the condition was progressing with time, deformity correction and spinal fusion surgery was performed immediately to reduce the

12 Medical Tourism Jul. - Sep. 2017

severity and prevent it from worsening. Deformity correction is a highly challenging surgery in view of abnormal angulation and tilting of the spinal column. However, the use of 3D C-arm and Spinal Navigation creates a virtual image of the curved spine on the screen and this optimises the placement of the pedicle screws and rods with close to 100 per cent accuracy. Spinal cord injury is one of the most fearsome complication of scoliosis corrective surgery. The use of neuromonitoring as well as spinal navigation increases the safety of deformity surgery thus minimising the risk of spinal cord damage. We routinely utilise the services of spinal navigation and neuromonitoring to make deformity correction surgery extremely safe.. She has recovered well and is now confident about her appearance.

Dr. Arvind G Kulkarni Consultant Spine Surgeon Mumbai Spine Scoliosis & Disc Replacement Centre Bombay Hospital, Mumbai +91-9892875490

Official Magazine

A Complete Magazine on Healthcare in Asia


Medical Tourism health news

Everyday ideas to move more

Help your family move more each day and have fun with it. Think about what your family can do to be active together. Here are some ideas.

• Exercise with friends.

Make time

Develop new friendships with physically active people. Join a group, such as the YMCA or a hiking club.

• Identify free times. Keep track of your daily activities for one week. Pick two 30-minute time slots you could use for family activity time. • Add physical activity to your daily routine. For example, walk or ride your bike to work or a friend's house, walk the dog with your children, exercise while you watch TV, or park farther away from your destination. • Try doing something active after dinner with your family, or on weekends. • Check out activities requiring little time. Try walking, jogging, or stair climbing. Bring others into it • Ask friends and family to support your efforts.

• Play with your kids or ask them to join you for an exercise video or fitness game.

Energise yourself • Plan to be active at times in the day or week when you feel you have a lot of energy. • Convince yourself that if you give it a chance, physical activity will increase your energy level; then try it. Stay motivated • Plan ahead. Make physical activity a regular part of your family's schedule. Write it on a family activity calendar. • Join an exercise group or class. Sign your children up for community sports teams or lessons.

• Invite them to be active with you.

• Pick activities requiring walking or climbing stairs.

• Set up a party or other social event with activities that get people moving, like dancing or having a jump rope contest.

• Exercise with friends who are at the same skill level as you are. Create opportunities for your children to be active with friends.

14 Medical Tourism Jul. - Sep. 2017






Medical Tourism health news • Select activities that don't need costly sports gear, such as walking, jogging, jumping rope, or doing push-ups. • Identify cheap, local resources in your area, such as programs through your community center, park or recreation group, or worksite. Make the most of all conditions • Develop a set of activities for you and your family that are always available regardless of weather, such as indoor cycling, indoor swimming, stair climbing, rope skipping, mall walking, dancing, and active games that you can play indoors. • When the weather is nice, try outdoor swimming, jogging, walking, or tennis. Build new skills • Find a friend who can teach you new skills. • Take a class to develop new skills and enroll your children in classes too, such as swimming, dancing, or tennis.

Children should get at least 60 minutes of physical activity each day. NIH. Adapted from: "Overcoming Barriers to Physical Activity? " Centers for Disease Control and Prevention's Division of Nutrition and Physical Activity.

The unpleasant smell lic, can also cause your breath to smell, as can smoking and drinking alcohol . Occasionally, bad breath can occur after an infection or illness, or as a result of taking certain types of medication.. Treatment and prevention Improving your oral hygiene is usually enough to cure bad breath and stop it happening again. To improve your oral health, make sure you: • floss between your teeth daily • brush your teeth and gums regularly • clean your tongue regularly When to seek medical advice See your dentist, dental hygienist or dental therapist first if you still have bad breath after making changes to improve your dental hygiene.


ad breath is a common problem that can affect anyone at any age. About one in four people are thought to have bad breath (halitosis) on a regular basis.

There are a number of things that can cause bad breath. It's usually the result of poor oral hygiene. If bacteria build up in your mouth, the toxins produced can cause your breath to smell. Bacteria break down pieces of food in the mouth, and may release an unpleasant-smelling gas. Any food trapped on your teeth – particularly between them – is broken down by bacteria, which may cause bad breath. Persistent bad breath can sometimes be a sign of gum disease. Eating strongly flavoured foods, such as onions and gar-

You may also need to visit your GP as there may be a medical cause that needs to be investigated. Don't try to hide the smell of your breath when seeking medical advice as it may make it more difficult to find out what's causing the problem. Do I have bad breath? It's not always easy to tell if you have bad breath. Other people may notice it first, but they could feel uncomfortable telling you. A simple test to find out whether you have bad breath is to lick the inside of your wrist with the back of your tongue and wait a few seconds until the saliva dries. If your wrist smells unpleasant, it's likely your breath does, too. A Complete Magazine on Healthcare in Asia


Medical Tourism health news

Keep your voice sound of your voice. That’s why each person’s voice sounds so different. People who depend on their voices for work—like teachers, lawyers, singers, and politicians—are at risk of overusing their voice. Overuse and misuse of your voice such as screaming, cheering, or talking above loud background noises can strain your vocal folds. It’s best to avoid such activities. Perhaps you’ve woken up with a hoarse voice after attending a concert or a sporting event. Repeatedly clearing your throat; a raw, achy throat; a deeper voice; or a sudden inability to hit high notes when singing are also signs of an unhealthy voice.

Whether answering the phone, chatting with coworkers, or even letting loose on karaoke nights, your voice helps you connect with others. It acts as a reflection of your personality, mood, and health.. You can take steps to keep your voice healthy and avoid problems. In many ways, your voice is as unique as your fingerprint. It’s produced in your throat by 2 bands of muscle tissue called vocal folds, which sit at the top of your windpipe. The larynx, commonly called the voice box, houses the vocal folds. When you speak, the folds come together as air from your lungs rushes through them. The air blowing through the folds makes them vibrate. The vibrations make sound waves that travel through your throat, nose, and mouth. The size and shape of these structures create the pitch, loudness, and tone

It’s important to identify and avoid behaviours that might harm your voice. For example, instead of speaking loudly when talking to a large group, consider arranging for a microphone. On days that your voice sounds raspy or hoarse, protect it by not straining or overusing it. Choose a quiet restaurant when meeting friends for a meal. Although many voice conditions result from misuse or overuse, other voice disorders may be related to disease. Voice disorders may result from growths on the vocal folds, gastric reflux, head or neck cancer, neurological problems, or other causes. If you think you have a voice problem, talk with your health care provider. They may recommend that you see a specialist—such as an ear, nose, and throat doctor (otolaryngologist) or a speech-language pathologist—to help diagnose and treat voice issues.

Yoga to reduce side effects of prostate cancer treatment Men who attended a structured yoga class twice a week during prostate cancer radiation treatment reported less fatigue and better sexual and urinary function than those who didn't, according to a clinical trial led by the Perelman School of Medicine at the University of Pennsylvania. It is the first randomised trial to look at the effect of twice-weekly yoga on the side-effects and quality of life issues caused by prostate cancer treatment. The results published recently in the International Journal of Radiation Oncology, Biology, and Physics. All of the patients in the trial underwent between six and nine weeks of external beam radiation therapy for prostate cancer. The patients were randomized into two groups: one arm participated in a yoga class that met twice a week and the other arm served as a control group. Patients who already practiced yoga on their own were not eligible for the study, nor were patients with a history of prior radiation therapy or those with metastatic disease. "Yoga is known to strengthen pelvic floor muscles, which is one of several postulated theories that may explain why this group did not demonstrate declining scores, as seen in the control group," said the trial's principal investigator Neha Vapi16 Medical Tourism Jul. - Sep. 2017

wala, MD, an associate professor of Radiation Oncology ."That may also explain the yoga patients' improved urinary function scores, another finding of this trial." Vapiwala pointed out that the findings on improved or stable urinary function are consistent with other research on the effects of physical therapy on pelvic floor muscles. The trial also found that while the emotional well-being of both groups increased as patients progressed through treatment, the evaluation scores in the yoga group rose more rapidly than in the control group. An evaluation of physical well-being showed a similar pattern.

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Medical Tourism Cover story

India is fast emerging as one of the most sought after destination for healthcare tourism. One of the factors driving this surge in interest is cost-effective world-class dental services.

18 Medical Tourism Jul. - Sep. 2017



The Crown Jewel By T. K. V. Mani


tudies have shown that in recent years, the number of overseas tourists seeking dental treatment in India has increased. After the treatment or before, they visit the country’s incredible tourist destinations.

The volume of foreign patients travelling to India has increased multi-fold over the years compared to other countries in the Asian region. They come from the United States, Europe, Middle East, Africa and India’s neighbouring countries. Most overseas and even domestic tourists look to tie up their trips to meet their healthcare requirements tempted by the quality of medical services and

infrastructure available across the country. Besides lower expenses, the visitors are also attracted by competent and professional services offered by Indian dentists. Studies have shown that India is becoming the favoured destination for dental tourism. Its medical technologies are on a par with the developed countries like the US. India has some of the best oral healthcare centres in the world with universally acclaimed facilities. Market research shows that even with airfare, the cost of dental treatment can be economical. The quality of services is often better than in the Western world.

Experts say that the most important hubs for dental tourism include cities such as Mumbai, Delhi, Chennai, Jaipur, Chandigarh, and states like Kerala and Goa. The clinics there offer trained dental experts, latest dental technology and world-class facilities. India is considered a superb destination for dental tourism as it has a huge reservoir of highly-trained world class dental care professionals and very good dental clinics. It is well connected by international flights and the domestic connectivity is also good. The government has also eased visa rules to help people from more countries to come to India for medical treatment.

A Complete Magazine on Healthcare in Asia


India advantage • Holistic oral health care in India is now well accepted globally because of the availability of highly qualified dental care providers in most of the major cities. • There are several state-of-the-art dental clinics that offer highly competent dental services that patients require. • Dental care in India offers significant cost savings for overseas patients compared to treatment back home. The cost in India is approximately 70 per cent lower than what is available elsewhere in the world. • Indian speciality hospitals are well equipped with most modern technologies for all kinds of dental care.

Cost competitive Research has shown that world class dental services are available in India at 1/10th of the cost in the Western world. India offers affordable dental care such as root canals, veneers, fillings, crowns, dental bridges, dental implants, orthodontic care etc. For example, cost of root canal treatment in India will range anywhere between $100 and $200 whereas in the US it is as high as $3000. A dental filling costs between $20 and $40 in India whereas in the US it is between $300 and $400. A dental implant in the US costs around $4,000 and in the UK $3,500. Prices can go as low as $750 in India and the patient can also expect better services. For Western tourists in particular, the comfort level they get is quite high because of reasons such as the availability of English speaking doctors and paramedics, shorter waiting time at dental clinics which also follow international standard in sterilization protocols. It is an undisputed fact that tourists flock to India pulled in by its incredible sights and 5000 years of civilisation. Rising business opportunities, improving road and aviation infrastructure and a wide range of hotel facilities, are encouraging overseas visitors to seek specialised quality and cost-effective dental treatment in India. It is noted that most foreign patients combine their dental treatment along with a family vacation. Some estimates say that dental tourism is set to grow beyond 30% of the total Indian medical tourism segment, thanks to affordable oral health services that are available from highly qualified and experienced professionals.

Dental tourism is the crown jewel. 20 Medical Tourism Jul. - Sep. 2017

Destination choices Major places where quality dental health facilities are located: Mumbai, Hyderabad, Kerala, Delhi, Pune, Goa, Bangalore, Nagpur, Jaipur, Chennai, Gurgaon and Chandigarh

Available services Intra-mouth dental scanning Extraction of normal/fractured teeth under local anaesthesia Extraction of impacted wisdom teeth Ceramic caps without gold under microscopic control Maxillary Surgery Dental Bridges, Porcelain/Ceramic crowns Bleaching Prosthesis on the implant/ Dental Implants Vertical and horizontal bone grafting Gum Grafting/ Gums treatment Palatal orthodontics Fluoride treatments for children Cosmetic dentistry Smile designing Root Canal Teeth whitening Tooth contouring and reshaping Dental Fillings

Dental tourism benefits Why dental tourism is attractive? • Access to state of the art medical facilities • English speaking medical staff • Significant savings on healthcare • No waiting time to get treatment • High quality service that follows world class protocols

Treatment for dental problems in Western countries is very costly. Hence it is a great money saver. The packages offered include boarding, lodging and travelling. High quality services are cheap, but it does not mean the services are any inferior. The doctors are well qualified and trained. The infrastructure, equipment and facilities are on a par with international standards. Above all, services of English speaking paramedical staff are always available.

Advantage quotients No waiting or delay in getting the required treatment. Patient can hope to get immediate service. Better convenience Comprehensive price packages for the treatment and holidays. Travel opportunities There are also great travel opportunities for those who love going to places to explore the beauty and culture of India. There are many exciting locations: the sunny beaches of Goa, beautiful palaces of Rajasthan, enchanting backwaters of Kerala and the iconic Taj Mahal, to mention some. Travel within India is cheap. Domestic airfares are surprisingly low cost making a holiday extension is very attractive and affordable. A Complete Magazine on Healthcare in Asia


5 easy steps to have a healthy teeth and gums

• Ask your dentist or dental hygienist to show you the best way to floss your teeth.

1. Brush your teeth at least twice each day with fluoride toothpaste.

• Change your toothbrush every three months, or earlier if the toothbrush looks worn or the bristles spread out. A new toothbrush removes more plaque.

Aim for first thing in the morning and before going to bed. Once a day, use floss or an interdental cleaner to remove food your toothbrush missed.

• If you wear dentures, be sure to remove them at night and clean them before putting them back in the next morning.

Make sure you:

2. Have a healthy lifestyle.

• Drink water that contains added fluoride if you can. Fluoride protects against dental decay.

• Eat healthy meals. Cut down on tooth decay by brushing after meals. Avoid snacking on sugary or starchy foods between meals.

• Gently brush all sides of your teeth with a soft-bristled brush. Round and short back-and-forth strokes work best. • Take time to brush along the gum line, and lightly brush your tongue to help remove plaque and food. 22 Medical Tourism Jul. - Sep. 2017

• Don't smoke. It raises your risk of gum disease, oral and throat cancers, and oral fungal infections. It also affects the color of your teeth and the smell of your breath.

• See your dentist right away if:

Your gums bleed often You see any red or white patches on the gums, tongue, or floor of the mouth You have mouth or jaw pain that won't go away You have sores that do not heal within two weeks You have problems swallowing or chewing

• Besides your dentist, there are other types of dental providers. Your dentist may send you to a specialist if you need extra care. Other providers include: Dental hygienists: Members of the dental staff who clean gums and teeth and teach patients how to maintain good oral health. Periodontists: Dentists who treat gum disease and place dental implants. Oral surgeons: Dentists who operate on your mouth and supporting tissues. Orthodontists: Dentists who straighten teeth and align jaws. Endodontists: Dentists who perform root canals. Prosthodontists: Dentists trained in restoring and replacing teeth. 4. Follow your dentist's advice. Your dentist may suggest ways to keep your mouth healthy. He or she can teach you how to properly floss or brush. Follow any recommended steps or treatments to keep your mouth healthy. 5. If you have another health problem, think about how it may affect your oral health. For instance, if you take medicines that give you a dry mouth, ask your doctor or nurse if there are other drugs you can use. Have an oral exam before starting cancer treatment. And if you have diabetes, practice good oral hygiene to prevent gum disease.

• Limit alcohol use. Heavy alcohol use raises your risk of oral and throat cancers. Using alcohol and tobacco together raises your risk of oral cancers more than using one alone. • Limit how much soda you drink. Even diet soda contains acids that can erode tooth enamel. 3. Get regular checkups. • Have an oral exam once or twice a year. Your dentist may recommend more or fewer visits depending on your oral health. At most routine visits, the dentist and a dental hygienist will treat you. During regular checkups, dentists look for signs of diseases, infections, problems, injuries, and oral cancer.

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Medical Tourism cover story/Dental health

Take care of your mouth to be in good health 24 Medical Tourism Jul. - Sep. 2017

The health of your mouth can be a sign of your body's health. Mouth problems are not just cavities, toothaches, and crooked or stained teeth. Many diseases, such as diabetes, heart disease, HIV, cancer, and some eating disorders are linked with oral health problems. Regular dental exams help you maintain good oral health and avoid related health problems Common oral health problems? The most common oral health problems are cavities and gum disease. Cavities We are all at risk of tooth decay, or cavities. (Cavities look like chalky white and/or brown holes on your teeth). Bacteria (germs) that naturally live in our mouths use sugar in food to make acids. Over time, the acids destroy the outside layer of your teeth. Then cavities and other tooth harm occur. Gum diseases Gum diseases are infections caused by bacteria, along with mucus and other particles that form a sticky plaque on your teeth. Plaque that is left on teeth hardens and forms tartar. Gingivitis is a mild form of gum disease. It causes red, swollen gums. It can also make the gums bleed easily. Gingivitis can be caused by plaque buildup. And the longer plaque and tartar stay on teeth, the more harm they do. Most gingivitis can be treated with daily brushing and flossing and regular cleanings at the dentist's office. This form of gum disease does not lead to loss of bone or tissue around the teeth. But if it is not treated, it can advance to periodontitis. Then the gums pull away from the teeth and form infected "pockets." You may also lose supporting bone.

• Respiratory, digestive, or other health problems • Some medicines Burning mouth: People with this condition describe a burning feeling in the mouth or tongue. It is most common in postmenopausal women. The cause is unknown, but might be linked to: • Hormones

• Smoke

• Dry mouth (which can be caused by many medicines and disorders such as Sjögren's syndrome or diabetes)

• Have a disease such as diabetes or HIV/AIDS

• Taste problems

• Use methamphetamine

• Nutritional deficiencies

Other problems

• Use of ACE inhibitors (blood pressure medicines)

Bad breath: Bad breath is also called halitosis (hal-lih-TOHsuhss). Bad-smelling breath can be caused by several things, including:

• Anxiety and depression

Your risk of gum disease is higher if you:

• Poor oral hygiene • Some foods • Dentures • Gum disease • Dry mouth • Tobacco use

• Dentures that do not fit • Infections (especially fungal infections) Cold sores: These small, painful sores are caused by herpes simplex virus type 1. Once you are exposed to the virus, it can hide in your body for years. Things that trigger the virus and lead to cold sores include: • Getting too much sun • Having a cold or infection A Complete Magazine on Healthcare in Asia


• Having your period

• You have a weak immune system

• Feeling stressed

• You don't make enough saliva

Cold sores can spread from person to person. They most often form on the lips and sometimes under the nose or chin. The sores heal in about 7 to 10 days without scarring.

• You take antibiotics

Dry mouth. Dry mouth is also called xerostomia (ZEER-ohSTOM-mee-uh). This problem happens when you don't have enough saliva, or spit, in your mouth. Some reasons why people get dry mouth include:

Oral health can affect the health of your entire body. Good oral health does not just mean you have pretty teeth. Your whole mouth needs care to be in good health.

• Side effect of medicines or medical treatment, such as cancer treatments • Health problems, such as diabetes, Parkinson's disease, and Sjogren's syndrome • A blocked salivary gland Dry mouth may make it hard to eat, swallow, taste, and speak. If left untreated, it can lead to cavities. This is because saliva helps break down bits of food and helps stop acid from forming plaque on your teeth. Oral cancer. This cancer can affect any part of the mouth and part of the throat. If you smoke or chew tobacco, you are at higher risk. Excessive alcohol use along with smoking raises your risk even more. However, nonsmokers can also develop oral cancer. It often starts as a tiny white or red spot or sore anywhere in the mouth. Other signs include: • A sore that bleeds easily or does not heal • A color change in the tissues of the mouth • A lump, rough spot, or other change • Pain, tenderness, or numbness anywhere in the mouth or on the lips • Problems chewing, swallowing, speaking, or moving the jaw or tongue • A change in the way the teeth fit together Thrush. Thrush is also called oral candidiasi.s These fungal infections appear as red, yellow, or white lesions, flat or slightly raised, in the mouth or throat. It can look like cottage cheese. This fungus lives naturally in your mouth. Your risk of getting thrush increases if: 26 Medical Tourism Jul. - Sep. 2017

Problems in mouth and other parts of the body

Cancer. If you are being treated for cancer, you may develop sores or other problems with your mouth. Pay attention to your mouth each day, and remember to brush and floss gently. Diabetes. People with diabetes are at special risk for gum disease. Gum disease can lead to painful chewing and even tooth loss. Dry mouth, often a symptom of undetected diabetes, can cause soreness, ulcers, infections, and tooth decay. People with diabetes can also get thrush. Smoking makes these problems worse. Heart disease. Before some dental treatments, patients who have certain heart conditions or joint replacements may take antibiotics. These people may be at risk of getting an infection when bacteria that lives in the mouth goes into the bloodstream during treatment. Antibiotics lower this risk. HIV. Oral problems are common in people with HIV because of a weak immune system. These problems can make it hard to eat. If mouth pain or tenderness makes it hard to chew and swallow, or if you can't taste food like you used to, you may not eat enough. Nutrition problems. Sometimes people who are missing teeth have to limit their food choices because of chewing problems. This can lead to a lack of vitamins in the body. If you are missing teeth and have trouble chewing, check with your doctor to make sure you are eating the right foods MT Desk

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Medical Tourism Hospital

Rajagiri Hospital:

Providing the most advanced Healthcare that leads to 'Abundance of Life'


rom the time of securing land to setting up the hospital in 40 acres of land,Rajagiri hospital has set high standards for themselves even for their testing lab and their kitchen.

These practises of high standard, dedication and perseverance of Rajagiri Hospital didn’t go unnoticed by reputed Organisations like Consortium of Accredited Healthcare Organisations (CAHO) who have declared RajagiriHospital ,Chunangamvely, Aluva as a Centre for Quality Promotion (CQP). The hospital has joined hands with CAHO in training and helping other hospitals and healthcare organisations to get accredited. Rajagiri Hospital is an NABH and JCI accredited hospital and today even provides support to other hospitals to get NABH Accreditation. The hospital has a multitude of departments comprising of the most highly qualified doctors. The Hospital kitchen also received the ISO 22000; 2005 certification in Food & Beverages services. In an exclusive interview with Medical Tourism, the Executive Director of Rajagiri, Fr. Johnson Vazhappilly CMI, explains how this was made possible and also the Hospital’s prospects and initiatives in the Medical Tourism Sector. 28 Medical Tourism Jul. - Sep. 2017

The CMI Congregation needs no introduction in India. However, Rajagiri Hospital would be the first major step in the Healthcare sector by CMI, as a high-end Super – specialty hospital with an investment of over 300 Crores. What promoted CMI to do this? Carmelites of Mary Immaculate (CMI) has been active in healthcare through other major initiatives like Amala Medical College, Thrissur. In Gospel, Jesus’ ministry has two major parts: teaching ministry and healing ministry. Rajagiri is into both the ministries. Through Rajagiri Hospital we try to reach out to the sick. Rajagiri gives utmost importance to education, hence Rajagiri Hospital will eventually also extend to the field of Medical education and research. What would be the mission of Rajagiri Hospital and which activities do you specialize in? Rajagiri Hospital’s Mission is 1. To provide the most advanced and scientific, curative, preventive and promotive healthcare that leads to an ‘abundance of life’

• Affordability is higher in Cochin compared to other Metropolitan cities like New Delhi, Bangalore, Mumbai, etc. You have been accredited by JCI and NABH. Has this made a difference in how the International market sees you? Primarily, all accreditations are meant to ensure patient safety. As a result, it may lead to more foreign patient flow to Rajagiri Hospital. What are your views on the health Insurance facilities available here?

Fr. Johnson VazhapPilly CMI Executive Director & CEO 2. To undertake specialized and holistic healthcare services of world standard and to provide them to all sections of the society, with special concern for the marginalized 3. To grow into a model and global leader in healthcare, innovative teacher in medical sciences and a pioneer research Centre in healthcare. We being a tertiary care hospital, specialize in all areas of our services. It is extremely difficult for the common man to afford advanced medical facilities in our country. As a large organization with Charitable activities, how have you tried to reach out to this segment? We try to combine Affordability and Quality. Rajagiri Hospital is not a profit oriented hospital but we have to grow on our own and be self-sufficient. Sustainability is the norm for our rates here and not profit. In addition to the PG Diploma programs, we understand that you plan to start a Medical College and Retirement Home soon. Where would these institutions be and what would be their objectives? We are in the process of obtaining necessary statutory permissions to start our Medical College. We expect to realize it in next five years. On our retirement home project, the plans are ready. Financial viability and market study is going on. Rajagiri Hospital, Our Medical College and Retirement home will be in the same 40 acre campus in Aluva, Cochin. You have the advantage of being located very close to Cochin International Airport. What steps are you currently taking to promote Medical Tourism and attract International patients to your Hospital? • Aiming at international standards for quality and patient care

Presently only close to 20 percent of the patients in our hospital fall under the insurance bracket. With the escalating cost of healthcare, it is imperative that health insurance schemes will dominate in the coming years. Furthermore government is also offering health insurance schemes to address healthcare needs of the community at large. Still our country has to move a long way to increase the gamut of health insurance coverage. As a Charitable Organization, what would be the steps taken to reach out to the marginalized in the Healthcare Sector? We make sure that our patients are not denied treatment even if they don’t have necessary money. We facilitate this internally and externally with people who have goodwill to help the needy. You have also started to reach out to other hospitals in the country by way of tie-ups, like Victor Hospital in Goa. What is the strategy behind this? Do you plan to have a chain of hospitals all over the country? Rajagiri Institutions whether in healthcare or education have always tried to have tie ups with other institutions. Right now our educational institutions have academic tie ups with more 20 institutes nationally and internationally. Rajagiri Hospital also follows the same line of action. It’s a process of sharing between the engaged parties, can be knowledge or resources. With Rajagiri Victor hospital in Goa, we have started in this direction and yes we would like to move forward. International patients would be happy to note that being a CMI Organization, Rajagiri Hospital is cost effective since no unrequired Scans or tests are suggested by the Doctors. How do you manage this with such a large Infrastructure such as yours? We believe in numbers and the secret of numbers is in the trust you establish among the public. So the main shortcut to reach out to public and generate confidence in the public is to be genuine in your approach and process. Any untruthful shortcut, I believe, is self-defeating. What would be your message to both Indian and International Medical Tourists planning to visit Rajagiri Hospital? It’s a safe place where you can get quality and affordable treatment.

• Having the latest technical know-how and human talent required for healthcare delivery A Complete Magazine on Healthcare in Asia


A Global Destination for Tertiary HealthcareMany Nations, One Destination The Management Team


ajagiri Hospital which is centrally located in the state of Kerala offers world class care in over 40 medical specialties to Medical Tourists from across the globe. Some of them are

Cardiac Sciences, General Surgery & Trauma Care, General Medicine, Bariatric Surgery, Clinical Haematology & Hemato Oncology, Oncology, Pulmonology , Neurosciences, Urology & Nephrology, Orthopaedics, Ophthalmology, Paediatric, Medical & Surgical Gastroenterology, Neonatology, Endocrinology, Dermatology, Plastic Surgery, Radiology, Anaesthesiology, Pathology, ENT, Critical care, Preventive Health Check up, Emergency, Obstetrics & Gynaecology, Support Medical Specialities, Cranio Maxillofacial Surgery- Implantology & Dental Science , Forensic Medicine & Toxicology and Physical Medicine & Rehabilitation. International Patient Care at Rajagiri Hospital The International Patient Care Helpdesk at Rajagiri Hospital functions as a single-window to the all the services offered at Rajagiri Hospital. From registration to discharge, our team will help you move seamlessly between the clinical departments to offer you the best of medical care within strict infection control practices. We can also help you plan your itinerary better by providing a tentative treatment plan on the basis of emailed medical reports.

30 Medical Tourism Jul. - Sep. 2017

may contact the Rajagiri International Patient Care helpline at international@ for visa invite letters • Your health /medical history report(s) or any statements relating to the past or ongoing medical treatment

Dr. Vijay Agarwal, President CAHO presented the CQP certificate plaque to Fr. Johnson Vazhappilly CMI, Executive Director & CEO, Rajagiri Hospital.

Luxurious In-patient Accommodation Facilities

 Assistance during inpatient stay and after discharge

Rajagiri Hospital provides single and deluxe category of in-patient rooms to offer you a comfortable stay with amenities including satellite TV, WiFi, multi-cuisine menu, room service, laundry service, etc. We also provide hotel / guest house accommodation in close proximity of the hospital, for both pre-admission as well as post discharge days. During hospital admission, one attendant is permitted to stay along with the patient in the room. We can also facilitate hotel / guest house accommodation in close proximity of the hospital for larger families.

 Assistance with medical records and prescriptions  Airport Pickup / Drop  Assistance with MEDIF/MEDA (Medical Form issued by the Air lines) for return travel  Certificate from the Foreigner Re gional Registration Office  Nursing escort in case of air transfer of sick patients  Liaising with Insurance and TPAs

 Handling of medical enquiries through telephone, email, etc  Scheduling of Appointments and fol low-up care  Cost estimation of proposed medical treatment  Personal escort for medical appoint ments  Language interpretation  We accept payment in foreign currency / international credit & debit cards

• Carry sufficient currency, traveler’s cheques or credit/debit cards

 Assistance with hospital admission and discharge process

 Assistance with visa application and extension

Services offered by the Rajagiri International Patient Care Helpdesk

• Copies of Vaccination Certificates (Yellow Fever, Polio, etc.), X-Rays, MRI reports, immunization records, prescriptions, and relevant medical documents including records of previous surgeries. Make sure you have these medical reports and associated medication with you at all times in your bag or carry-on luggage.

 Issuing necessary documents like treatment summary, leave letters etc.  Out-patient accommodation arran gements at Rajagiri Guest house or patient’s preference  Travel arrangements for sightseeing  Assistance with flight bookings and rescheduling for return travel

Place of Worship Rajagiri hospital receives patients with varied religious beliefs and practices from across the world. Our team understands your need for religious freedom even when you are away from home. Our team will facilitate a contact in the local community for information on prayers / service timings. We also offer dedicated prayer areas within Rajagiri Hospital to meet your needs.

When planning to travel to Kerala for medical treatment, it is imperative to prepare and carry the necessary documents required to ensure a smooth and hassle-free experience:

For any specific query or further assistance in organizing documents / travel plans, please contact us:

• Passport and visa, wherein the patient must be on a medical visa. You

24 hr helpline: +91 7356600866.

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Medical Tourism Special feature

Bladder Control Problems in Men 32 Medical Tourism Jul. - Sep. 2017

Urinary incontinence (Bladder Control problems) is the loss of bladder control, resulting in the accidental leakage of urine from the body. For example, a man may feel a strong, sudden need, or urgency, to urinate just before losing a large amount of urine, called urgency incontinence.


can be slightly bothersome or totally debilitating. For some men, the chance of embarrassment keeps them from enjoying many activities, including exercising, and causes emotional distress. When people are inactive, they increase their chances of developing other health problems, such as obesity and diabetes. What is the urinary tract and how does it work? The urinary tract is the body’s drainage system for removing urine, which is composed of wastes and extra fluid. In order for normal urination to occur, all parts in the urinary tract need to work together in the correct order. Kidneys. The kidneys are two beanshaped organs, each about the size of a fist. They are located just below the rib cage, one on each side of the spine. Every day, the kidneys filter about 120 to 150 quarts of blood to produce about 1 to 2 quarts of urine. The kidneys work around the clock; a person does not control what they do. Ureters. Ureters are the thin tubes of muscle—one on each side of the bladder—that carry urine from each of the kidneys to the bladder. Bladder. The bladder, located in the pelvis between the pelvic bones, is a hollow, muscular, balloon-shaped organ that expands as it fills with urine. Although a person does not control kidney function, a person does control when

the bladder empties. Bladder emptying is known as urination. The bladder stores urine until the person finds an appropriate time and place to urinate. A normal bladder acts like a reservoir and can hold 1.5 to 2 cups of urine. How often a person needs to urinate depends on how quickly the kidneys produce the urine that fills the bladder. The muscles of the bladder wall remain relaxed while the bladder fills with urine. As the bladder fills to capacity, signals sent to the brain tell a person to find a toilet soon. During urination, the bladder empties through the urethra, located at the bottom of the bladder. Three sets of muscles work together like a dam, keeping urine in the bladder between trips to the bathroom. The first set is the muscles of the urethra itself. The area where the urethra joins the bladder is the bladder neck. The bladder neck, composed of the second set of muscles known as the internal sphincter, helps urine stay in the bladder. The third set of muscles is the pelvic floor muscles, also referred to as the external sphincter, which surround and support the urethra. To urinate, the brain signals the muscular bladder wall to tighten, squeezing urine out of the bladder. At the same time, the brain signals the sphincters to relax. As the sphincters relax, urine exits the bladder through the urethra. What is the prostate? The prostate is a walnut-shaped gland that is part of the male reproductive

system. The prostate has two or more lobes, or sections, enclosed by an outer layer of tissue. Located in front of the rectum and just below the bladder, the prostate surrounds the urethra at the neck of the bladder and supplies fluid that goes into semen. The male urinary tract What causes urinary incontinence in men? Urinary incontinence in men results when the brain does not properly signal the bladder, the sphincters do not squeeze strongly enough, or both. The bladder muscle may contract too much or not enough because of a problem with the muscle itself or the nerves controlling the bladder muscle. Damage to the sphincter muscles themselves or the nerves controlling these muscles can result in poor sphincter function. These problems can range from simple to complex. A man may have factors that increase his chances of developing UI, including • birth defects—problems with development of the urinary tract • a history of prostate cancer—surgery or radiation treatment for prostate cancer can lead to temporary or permanent UI in men UI is not a disease. Instead, it can be a symptom of certain conditions or the result of particular events during a man’s life. Conditions or events that may increase a man’s chance of developing UI include A Complete Magazine on Healthcare in Asia


• benign prostatic hyperplasia (BPH)—a condition in which the prostate is enlarged yet not cancerous. In men with BPH, the enlarged prostate presses against and pinches the urethra. The bladder wall becomes thicker. Eventually, the bladder may weaken and lose the ability to empty, leaving some urine in the bladder. The narrowing of the urethra and incomplete emptying of the bladder can lead to UI. • chronic coughing—long-lasting coughing increases pressure on the bladder and pelvic floor muscles. • neurological problems—men with diseases or conditions that affect the brain and spine may have trouble controlling urination. • physical inactivity—decreased activity can increase a man’s weight and contribute to muscle weakness. • obesity—extra weight can put pressure on the bladder, causing a need to urinate before the bladder is full. • older age—bladder muscles can weaken over time, leading to a decrease in the bladder’s capacity to store urine. What are the types of urinary incontinence in men? The types of UI in men include • urgency incontinence • stress incontinence • functional incontinence • overflow incontinence • transient incontinence Urgency Incontinence Urgency incontinence happens when a man urinates involuntarily after he has a strong desire, or urgency, to urinate. Involuntary bladder contractions are a common cause of urgency incontinence. Abnormal nerve signals might cause these bladder contractions. Triggers for men with urgency incontinence include drinking a small amount of water, touching water, hearing running water, or being in a cold environment—even if for just a short while— such as reaching into the freezer at the grocery store. Anxiety or certain liquids, medications, or medical conditions can make urgency incontinence worse. The following conditions can damage the spinal cord, brain, bladder nerves, 34 Medical Tourism Jul. - Sep. 2017

or sphincter nerves, or can cause involuntary bladder contractions leading to urgency incontinence:

• After prostate surgery

• Alzheimer’s - a disorder that affects the parts of the brain that control thought, memory, and language

• After trauma, such as injury to the urinary tract

• Injury to the brain or spinal cord that interrupts nerve signals to and from the bladder

Functional Incontinence

• Multiple Sclerosis - a disease that damages the material that surrounds and protects nerve cells, which slows down or blocks messages between the brain and the body • Parkinson’s - a disease in which the cells that make a chemical that controls muscle movement are damaged or destroyed • stroke—a condition in which a blocked or ruptured artery in the brain or neck cuts off blood flow to part of the brain and leads to weakness, paralysis, or problems with speech, vision, or brain function

• After neurologic injury to the brain or spinal cord • During older age Functional incontinence occurs when physical disability, external obstacles, or problems in thinking or communicating keep a person from reaching a place to urinate in time. For example, a man with Alzheimer’s disease may not plan ahead for a timely trip to a toilet. A man in a wheelchair may have difficulty getting to a toilet in time. Arthritis—pain and swelling of the joints—can make it hard for a man to walk to the restroom quickly or open his pants in time. Functional incontinence occurs when physical disability, external obstacles, or problems in thinking or communicating keep a person from reaching a place to urinate in time. Overflow Incontinence When the bladder doesn’t empty properly, urine spills over, causing overflow incontinence. Weak bladder muscles or a blocked urethra can cause this type of incontinence. Nerve damage from diabetes or other diseases can lead to weak bladder muscles; tumors and urinary stones can block the urethra. Men with overflow incontinence may have to urinate often, yet they release only small amounts of urine or constantly dribble urine. Transient Incontinence Transient incontinence is UI that lasts a short time. Transient incontinence is usually a side effect of certain medications, drugs, or temporary conditions, such as • A urinary tract infection (UTI), which can irritate the bladder and cause strong urges to urinate • Caffeine or alcohol consumption, which can cause rapid filling of the bladder • Chronic coughing, which can put pressure on the bladder • Constipation—hard stool in the rectum can put pressure on the bladder • Blood pressure medications that can cause increased urine production • Short-term mental impairment that reduces a man’s ability to care for himself • Short-term restricted mobility How common is urinary incontinence in men?

Urgency incontinence is a key sign of overactive bladder. Overactive bladder occurs when abnormal nerves send signals to the bladder at the wrong time, causing its muscles to squeeze without enough warning time to get to the toilet. Stress Incontinence Stress incontinence results from movements that put pressure on the bladder and cause urine leakage, such as coughing, sneezing, laughing, or physical activity. In men, stress incontinence may also occur

Urinary incontinence occurs in 11 to 34 per cent of older men. Two to 11 per cent of older men report daily UI.1 Although more women than men develop UI, the chances of a man developing UI increase with age because he is more likely to develop prostate problems as he ages. Men are also less likely to speak with a health care professional about UI, so UI in men is probably far more common than statistics show. Having a discussion with a health care professional about UI is the first step to fixing this treatable problem. MTDesk/Women’

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36 Medical Tourism Jul. - Sep. 2017

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Medical Tourism Women’s health

How anxiety affects your daily life

Anxiety is a normal response to stress. But when it becomes hard to control and affects your day-to-day life, it can be disabling. Women are more than twice as likely as men to get an anxiety disorder in their lifetime.Anxiety disorders are often treated with counseling, medicine, or a combination of both. Some women also find that yoga or meditation helps with anxiety disorders. 38 Medical Tourism Jul. - Sep. 2017


nxiety is a feeling of worry, nervousness, or fear about an event or situation. It is a normal reaction to stress. It helps you stay alert for a challenging situation at work, study harder for an exam, or remain focused on an important speech. In general, it helps you cope. But it can be disabling if it interferes with daily life, such as making you dread nonthreatening day-to-day activities like riding the bus or talking to a coworker. Anxiety can also be a sudden attack of terror when there is no threat. What are anxiety disorders? Anxiety disorders happen when excessive anxiety interferes with your everyday activities such as going to work or school or spending time with friends or family. Anxiety disorders are serious mental illnesses. They are the most common mental disorders in the United States. Anxiety disorders are more than twice as common in women as in men.

What are the major types of anxiety disorder? The major types of anxiety disorder are: • Generalized anxiety disorder (GAD). People with GAD worry excessively about ordinary, day-to-day issues, such as health, money, work, and family. With GAD, the mind often jumps to the worst-case scenario, even when there is little or no reason to worry. Women with GAD may be anxious about just getting through the day. They may have muscle tension and other stress-related physical symptoms, such as trouble sleeping or upset stomach. At times, worrying keeps people with GAD from doing everyday tasks. Women with GAD have a higher risk of depression and other anxiety disorders than men with GAD. They also are more likely to have a family history of depression.3 • Panic disorder. Panic disorders are twice as common in women as in men.4 People with panic disorder have sudden attacks of terror when there is no actual danger. Panic attacks

may cause a sense of unreality, a fear of impending doom, or a fear of losing control. A fear of one’s own unexplained physical symptoms is also a sign of panic disorder. People having panic attacks sometimes believe they are having heart attacks, losing their minds, or dying. • Social phobia. Social phobia, also called social anxiety disorder, is diagnosed when people become very anxious and self-conscious in everyday social situations. People with social phobia have a strong fear of being watched and judged by others. They may get embarrassed easily and often have panic attack symptoms. • Specific phobia. A specific phobia is an intense fear of something that poses little or no actual danger. Specific phobias could be fears of closed-in spaces, heights, water, objects, animals, or specific situations. People with specific phobias often find that facing, or even thinking about facing, the feared object or situation brings on a panic attack or severe anxiety. What causes anxiety disorders? Researchers think anxiety disorders are caused by a combination of factors, which may include: • Hormonal changes during the menstrual cycle • Genetics. Anxiety disorders may run in families. • Traumatic events. Experiencing abuse, an attack, or sexual assault can lead to serious health problems, including anxiety, post-traumatic stress disorder, and depression. What are the signs and symptoms of an anxiety disorder? Women with anxiety disorders experience a combination of anxious thoughts or beliefs, physical symptoms, and changes in behavior, including avoiding everyday activities they used to do. Each anxiety disorder has different symptoms. They all involve a fear and dread about things that may happen now or in the future. Physical symptoms may include: • Weakness • Shortness of breath • Rapid heart rate • Nausea • Upset stomach • Hot flashes • Dizziness Physical symptoms of anxiety disorders often happen along with other mental or physical illnesses. This can cover up your anxiety symptoms or make them worse.2 How are anxiety disorders treated? Treatment for anxiety disorders depends on the type of anxiety disorder you have and your personal history of health problems, violence, or abuse. Often, treatment may include: • Counseling (called psychotherapy) • Medicine • A combination of counseling and medicine A Complete Magazine on Healthcare in Asia


How does counseling help treat anxiety disorders?

What is the latest research on anxiety disorders and women?

Your doctor may refer you for a type of counseling for anxiety disorders called cognitive behavioral therapy (CBT). You can talk to a trained mental health professional about what caused your anxiety disorder and how to deal with the symptoms.2

Researchers are studying why women are more than twice as likely as men to develop anxiety disorders and depression. Changes in levels of the hormone estrogen throughout a woman’s menstrual cycle and reproductive life (during the years a woman can have a baby) probably play a role.

For example, you can talk to a psychiatrist, psychologist, social worker, or counselor. CBT can help you change the thinking patterns around your fears. It may help you change the way you react to situations that may create anxiety. You may also learn ways to reduce feelings of anxiety and improve specific behaviors caused by chronic anxiety. These strategies may include relaxation therapy and problem solving. Can complementary or alternative medicine help manage anxiety disorders? Maybe. Some women say that complementary or alternative medicine (CAM) therapies helped lower their anxiety. CAM therapies that may help anxiety include: • Physical activity. Regular physical activity raises the level of brain chemicals that control mood and affect anxiety and depression.9 Many studies show that all types of physical activity, including yoga and Tai Chi, help reduce anxiety.10 • Meditation. Studies show meditation may improve anxiety.11 Regular meditation may help by boosting activity in the area of your brain responsible for feelings of serenity and joy. How do anxiety disorders affect other health conditions? Anxiety disorders may affect other health problems that are common in women. These include: • Depression. Anxiety disorders can happen at the same time as depression. When this happens, treatment for both anxiety and depression may not be as effective. You may need a combination of treatments, such as counseling and medicine. • Irritable bowel syndrome (IBS). IBS symptoms are common in people with anxiety disorders. Generalized anxiety disorder is also common among people with IBS.12 Worry can make IBS symptoms worse, especially gastrointestinal (GI) symptoms such as upset stomach or gas. GI symptoms can also be stressful and lead to more anxiety. Although treatments for IBS can help treat anxiety, it’s important that you treat both conditions.13 • Chronic pain. Anxiety disorders are common in women with certain diseases that cause chronic pain, including rheumatoid arthritis, fibromyalgia, and migraine. • Cardiovascular disease. Anxiety and depression increase the risk for heart disease, the leading cause of death for American women. Anxiety can also make recovery harder after a heart attack or stroke. • Asthma. Studies link asthma to anxiety disorders. Stress and anxiety can trigger asthma attacks while the shortness of breath and wheezing during asthma attacks can cause anxiety. Studies show that breathing retraining may help asthma control and ease anxiety.14

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Researchers also recently studied the male hormone testosterone, which is found in women and men but typically in higher levels in men. They found that treatment with testosterone had similar effects as antianxiety and antidepressant medicine for the women in the study. MT Desk Women’s health

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Medical Tourism

Eating Disorders: Eating disorders

What to Watch For By Dr. Alan E. Simon, M.D. Medical Officer, Office on Women’s Health

Eating disorders or disordered eating includes Anorexia Nervosa, Bulimia Nervosa, and other disorders. While most people struggling with an eating disorder show behaviours that don’t fit cleanly into any one disease definition, here are the basic definitions: Anorexia nervosa is when a person restricts how much they eat, leading to low body weight as well as a fear of gaining weight or becoming fat. People with anorexia also judge themselves largely on their weight or body shape and don’t recognize the seriousness of their own low body weight. Bulimia nervosa, in general, is defined as recurrent episodes of binge eating followed by some inappropriate behavior to compensate for these episodes, such as vomiting or taking laxatives. People with bulimia also judge themselves largely on their weight or body shape. Binge eating is eating more food at one time than most people would, because a person feels a loss of control of his or her ability to stop eating. Eating disorders are common. While estimates vary widely, one study suggested that approximately 1 in every 4 high school girls has symptoms of an eating disorder. The same study suggested that about 1 in 10 boys has symptoms, too. Genetics play a role, and there are other factors that put girls at risk for eating disorders. Participation in activities where being thin is considered helpful, such as dansing, gymnastics, modeling, and running, puts people at higher risk for developing eating disorders. People who diet are also at higher risk. 42 Medical Tourism Jul. - Sep. 2017

What can you do to help identify an eating disorder in yourself or others? First, look out for these signs: • Having a lot of concern or an obsession about weight and food. • Being very defensive about eating or weight loss habits. • Having a fear of food, or changing plans to avoid eating. • Exercising excessively. • Losing weight or not gaining weight when still growing taller (ask your doctor about how your weight should be changing, if at all). • Going on extremely restrictive diets. • Eating large amounts of food at once (binge eating) • Vomiting or using diuretics, laxatives, diet pills, stimulants, steroids, or ipecac. • Involvement or interest with pro-anorexia or pro-bulimia websites (yes, they exist). • Not having regular periods. • Feeling weak, faint, or dizzy, bruising easily, looking pale, complaining of being cold a lot, losing your hair, or having abdominal pain.

• Not hanging out with friends during mealtimes. • Experiencing mood changes or depression. • Growing thin, soft hair on your body’s midsection and extremities. • Having cavities or erosion of the enamel on your teeth. If you notice any of these symptoms in yourself, make sure that you tell an adult you trust (if you are a teen) and see a doctor or nurse as soon as possible. Make sure that the doctor screens you for eating disorders by telling them that you are concerned about an eating disorder. If you see these symptoms in a friend or family member, please talk to them(link is external) privately and express concern for them. Offer your support and offer to go to a doctor with them. Don’t blame them for their behavior. If you are still concerned after speaking with them, speak to a trusted medical professional, adult, school counselor, or parent for help. You won’t be able to fix this problem by yourself. Your friend will need to get the help of a doctor or counselor. Also, follow up with your friend or family member and make sure they are getting help. One in 20 people with anorexia nervosa and about 1 in 25 people with bulimia nervosa die in the US from the disease. As a pediatrician, I have seen teenagers who are dangerously sick from their eating disorders. Eating disorders can cause problems with any body system, including heart problems and kidney problems.

Dr. Alan E. Simon, M.D.

Source:--Office on Women’s Health/qomen’

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Medical Tourism HEALTH

Soothing a We’ve all had sore throats around this time of year. Your throat feels scratchy and may hurt when you swallow. A look at what can you do to soothe a sore throat and when is it a sign of a more serious infection.


ost sore throats are caused by viral infections such as the common cold or the flu. These throat problems are generally minor and go away on their own.

To soothe your irritated throat, keep it moist. “Ever notice that a sore throat seems worse in the morning? It’s because your throat gets so dry overnight,” says Dr. Valerie Riddle, an infectious disease expert at National Institutes of Health,US. “Having lozenges or hard candies— or anything that stimulates saliva production—will keep your throat moist. It’s also important to drink plenty of fluids.” For young children who might choke on hard candies or lozenges, try cold liquids and popsicles. Throat pain might also be soothed by throat sprays and over-the-counter pain relievers such as acetaminophen, ibuprofen or aspirin, but don’t give aspirin to young children. Contact a doctor if your sore throat is severe, doesn’t feel better after a few days, or is accompanied by a high fever or swollen glands. These symptoms could be signs of a bacterial infection, such as strep throat. Taking antibiotics won’t help at all if your sore throat is caused by viruses, but they’re essential for fighting bacterial infections like strep. Strep is the most common bacterial throat infection. Although it can occur in adults, strep throat is more common in children between ages 5 and 15. Riddle says strep can be harder to detect in younger children, because it can cause a runny nose and other symptoms that make it seem like a cold. “If your child has severe throat pain, a fever above 100.4 degrees, or swollen glands, you should get medical attention right away,” advises Riddle. Children with strep also may experience nausea, vomiting and stomach pain.

44 Medical Tourism Jul. - Sep. 2017

To see whether you have strep throat, the doctor will take a throat swab. If test results confirm strep, your doctor will prescribe antibiotics. After 24 hours of taking them, you should no longer be contagious. You’ll likely begin feeling better within a couple of days, but to fully recover it’s important to finish all of the medicine. Strep is highly contagious. Treat it quickly to prevent it from spreading to others. Riddle says, “Not only can the infection be transmitted, but there are potential complications from untreated strep throat.” These include ear infections, rheumatic fever and kidney problems. Another fairly common throat infection is tonsillitis, which occurs when you have sore, swollen tonsils. It’s caused by many of the same viruses and bacteria that cause sore throats. If you have frequent bouts of tonsillitis or strep throat, you may need surgery (called a tonsillectomy) to have your tonsils removed. The best way to protect yourself from the germs that cause these infections is to wash your hands often. Try to steer clear of people who have colds or other contagious infections. And avoid smoking and inhaling second-hand smoke, which can irritate your throat. Source:NIH News in Health

sore throat

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Medical Tourism HEALTH

The power of pancreas How much you eat alters more than your waistline. It also affects your body’s organs, starting with your pancreas. With each bite, your pancreas must release enough digestive juices and hormones for you to benefit from the food you eat. Putting too much stress on your pancreas—by too much eating, drinking, or smoking—can cause serious health issues.


he pancreas lies behind your stomach. It’s surrounded by the intestines, liver, and gallbladder. These neighbouring organs work together to help you digest your food.

“The pancreas produces a variety of enzymes to help break down the carbohydrates, proteins, and fats in your diet into smaller elements that are more easily used for energy,” says Dr. Dana Andersen, a pancreatic specialist at National Institutes of Health (NIH). “It also produces specialised hormones that travel through the blood and help regulate a variety of body functions.” The best known hormone produced by the pancreas is insulin. Insulin controls how much sugar, or glucose, is taken up by your body’s cells. If the insulin-producing cells in the pancreas are damaged, diabetes may arise. Type 2 diabetes occurs when the pancreas can’t produce enough insulin to handle the sugar in your blood. Obesity worsens type 2 diabetes. “Obesity can make your body less sensitive to insulin, so it takes more insulin to achieve the same metabolic work. That puts more stress on the pancreas,” Andersen says. “Just losing

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5 or 10 pounds can help the pancreas to work more efficiently.” High levels of fat in the blood can also lead to inflammation of the pancreas, or pancreatitis, which can be chronic or acute. With chronic pancreatitis, the inflammation doesn’t heal and gets worse over time. Eventually, it can lead to permanent damage. Acute pancreatitis occurs suddenly and is very painful. It usually resolves in a few days with treatment. In severe cases, bleeding and permanent tissue damage may occur. The most common causes of acute pancreatitis are gallstones and heavy alcohol use. Gallstones are small, pebble-like substances made of hardened bile (a liquid produced by the liver to digest fat). Other causes of acute pancreatitis include abdominal trauma, medications, and infections. Genetic disorders of the pancreas and certain autoimmune disorders can also lead to pancreatitis. But in nearly half of cases, the cause is unknown—a condition known as idiopathic pancreatitis.

Tracking your family’s medical history can help you learn if you’re at risk for pancreatic problems. “It’s always a good idea to tell your doctor if there’s been a family history of pancreatic disease,” Andersen says. “That may not sound like much, but to a doctor it’s very important information.” Knowledge of family health history is especially important for possible early detection of pancreatic cancer, which usually has no symptoms in its early stages. When caught early, pancreatic cancer may be curable with surgery. But most patients with pancreatic cancer aren’t diagnosed until more advanced stages, when the chances for survival are low. NIH researchers are looking for new ways to detect pancreatic diseases early and predict who’s most at risk. Eating a healthy diet and limiting your exposure to harmful substances, like tobacco and alcohol, can help keep your pancreas and your entire digestive system working properly. MT Desk

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Medical Tourism SPECIAL REPORT

AIMS’ robotic surgery expert cures cancers in women Dr. Anupama Rajanbabu, a specialist in Gynaecologic Oncology at Kochi’s Amrita Institute of Medical Sciences (AIMS), has been using cutting-edge robotic equipment to treat patients successfully. She has performed over 240 robotic procedures since 2015 using the minimally invasive da Vinci Surgery manufactured by the American company Intuitive Surgical. 48 Medical Tourism Jul. - Sep. 2017


Anupama, who is involved with the prevention and management of cancer in women, says AIMS has this efficacious and cost-effective procedures that offer succour to the patient in the most cost-effective way. AIMS receives nearly 500 new gynaecological cancer cases each year. Its Advanced Centre for Robotic Surgery equipped with da Vinci Surgery has brought hope to the patients. Cancer surgeons have a big battle on their hands. According to figures put out by the premier medical body, Indian Council of Medical Research (ICMR), the country is likely to have over 1.73 million new cases of cancer

In this context it is important to promote robotic surgeries as they offer solution to complex cases giving a new lease of life to patients.

In another case, an 84-year old patient who opted for robotic surgery for endometrial cancer just 10 days before her granddaughter was to get married in the US, could travel long distance. Soon after being discharged, the patient undertook the long travel and attended all ceremonies at her granddaughter’s wedding.

For instance, one of Dr Anupama's recent patients was a woman with a recurrence of ovarian cancer and a growth adjacent to the urinary bladder. Being too frail and weak to withstand open surgery or chemotherapy, robotic surgery was suggested. The operation was successful and the patient experienced no discomfort.

Amrita Hospital’s Advanced Centre for Robotic Surgery equipped with a da Vinci Surgical Robot has emerged as a major medical institution. Dr Anupama says robotic surgery is far more superior to laparoscopic procedures as it allows 3D visualisation and precise control, especially in critical to complex surgeries.

by 2020 . It is mostly cancers of breast, lung and cervix. ICMR’s gloomy assessment is that nearly 800,000 patients could succumb to cancer by 2020.

Many cases that Dr Anupama has taken up for robotic surgery have been of endometrial cancer. But there have also been cases of cervical cancer, early ovarian cancer, and also breast cancer patients undergoing risk reduction hysterectomy. Of the first 200 cases she took up, 171 had cancerous or pre-cancerous changes. Even as cancer’s spread has been virulent, doctors have been adopting new procedures to tackle this malignant disease. After joining Amrita in 2009, Dr Anupama began a specialisation in the different aspects that cause cancer among women and their management. Soon thereafter, she began to closely track developments in robotic surgery, including observing live master classes in robotic surgery at various hospitals in India. Impressed with the sheer precision with which robotic arms could access the body and repair, Dr.. Anupama decided to pursue this form of surgery in 2011. Inspired after seeing a live demonstration of robotic surgery, she went to Montreal (Canada) in 2012 to receive training from Dr Walter Henri Gotlieb, Professor of Oncology, Obstetrics & Gynaecology at McGill University. In 2014, Amrita Hospital chose her to train in robotic surgery and set up Advanced Centre for Robotic Surgery with a da Vinci Surgical Robot. Dr Walter H Golieb came down from Canada to mentor her during her first few cases in 2015. A Complete Magazine on Healthcare in Asia


The relief that patients felt clearly showed that they can avoid the trauma of traditional surgery with accompanying pain, and long hospital stays. Dr Anupama was able to reduce a typical six-day hospital stay to a single day in most cases of endometrial cancer, thanks to da Vinci Surgical System. A family passion Coming from a family of doctors, Dr Anupama was always attracted to the field of medicine. After completing her MBBS in 2000 from Mahatma Gandhi University, Kottayam, as a university rank holder, she specialised in Obstetrics and Gynaecology at Government-run Stanley Medical College, Chennai, from 2001-2004. In 2006, she was trained in laparoscopic and hysteroscopic procedures under Dr Paul P.G., one of the leading gynaecological endoscopic surgeons in the country. Dr. Anupama is driven by a deep commitment to help women conquer an increasing range of gynaecological maladies ranging from rising incidence of fibroids, endometriosis, hysterectomies and cancer. She is equally passionate about sharing her knowledge and experience with other gynae surgeons keen to adopt robotic surgery as it provides an easy and safer option. Peer recognition Dr. Anupama has been awarded several times for her clinical and research work in gynaecological cancers. She spearheaded the Master Class in Gynaecologic Oncology and also the Robotic Surgeons Council of India at the Amrita Hospital in Kochi in September 2015, where she worked with Dr Mario Leitao Jr., Director, Minimal Access and Robotic Surgery Program at New York’s Memorial Sloan Kettering Hospital. She has contributed two chapters for a book on robotic surgery edited by eminent Robotic Urology Surgeon Dr Ajit Saxena. Robotics at Amrita Dr. Anupama is proud to be a part of the robotic surgery team at Amrita where urology surgeons are doing a wide spectrum of cases robotically and have been doing robotic renal transplant too. The gastro intestinal surgery team has done colorectal surgeries, pancreatic cancer removal surgery and also robotic liver resections. Head and neck oncology and thoracic surgeries are also being done on a regular basis. Amrita Hospital has been operating training centres of Intuitive Surgical Inc, the maker of the da Vinci Surgical system. The idea is to train super specialist surgeons to become Robotic Surgeons since 2016.

50 Medical Tourism Jul. - Sep. 2017

Medical Tourism spotlight

Padma Shri Prof. Dr. A. Marthanda Pillai Dr. A. Marthanda Pillai- MS (Neuro), MNAMS (Neuro), FRCS, is a renowned Indian neurosurgeon based in Thiruvananthapuran. In 2011 he was awarded the prestigious Padma Shri Award by Government of India for recognizing his contributions to the medical sector. Dr. A. Marthanda Pillai joined the Kerala Medical Education Service as a tutor in Neurosurgery in 1973 and later became professor and Head of the Department of Neurosurgery in the Medical College Hospital, Trivandrum and worked there from 1996 to 2002. He is the first former National President and former Vice-President of the Indian Medical Association in Kerala State. When Dr. Pillai served in the government Health Service he oversaw the improvement of the neurosurgical services to one of the best at the national level. He performed thousands of brain and spinal operations at no fee to the poorest patients, saving thousands of lives. He is currently the managing director of Ananthapuri Hospitals & Research Institute in Trivandrum. He accepts only nominal fees for consultation, to remain accessible to poor patients.] He is a visiting surgeon to several leading hospitals in India and abroad. Presently he is Senior Consultant Neurosurgeon in Ananthapuri Hospitals and Research Institute, Thiruvananthapuram. He was the State Secretary of Indian Medical Association for 1986 – 1988 and President of Indian Medical Association, Kerala State in 1990. He has been winner of various other awards including; • Dr. A.L.Sahney award for Scientific Contribution in 1993, • Dr. P.A. Alexander Oration Award for original contribution in Medicine in 1995 and • Kerala State Government Best Doctor Award 1998 • IMA Presidents Award. IMA Kerala State – 1993 • Certificate of Appreciation for Polio plus mobilization from Rotary International. He has been presenting Health Awareness Programme in Kairali TV under Kunkumam Programme. In spite of being a very active neuro Surgeon and administrator he continues to have deep involvement in Public health issues. He has drafted a Health Policy document for Kerala and a Drug Policy document at the National level for Indian Medical Association.

PHILANTHROPIC WORK 1. Free treatment to deserving patients to the tune of 2.5 crores through Ananthapuri Hospitals and Research Institute. 2. Free Neurosurgical operations to needy patients through the Rotary International. 3. Regularly conducting Medical Camps and Disease detection camps over the years. 4. Giving Leadership to Smile Train Project ( a free operation for cleft lip) AHRI Sureksha ( A health insurance programme for accident victims) Eco Friendly Practices (Planting and maintaining trees by the side of National Highway by pass road and at Trivandrum International Airport).

Prof. Dr. A. Marthanda Pillai MS(Neuro) MNAMS (Neuro) FRCS Former Professor & Head of the Department of Neurosurgery, Medical College Hospital, Thiruvananthapuram. Chairman & Managing Director and Senior Consultant Neurosurgeon Ananthapuri Hospitals & Research Institute Thiruvananthapuram. Padma Shri Awardee 2011 National President, Indian Medical Association 2014 – 2015 Dr. B.C. Roy National Awardee for the year 2015 in the category of ‘To recognize outstanding service in the field of Socio Medical Relief.

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Medical Tourism Relationships

Do social ties affect our health? Cuddles, kisses, and caring conversations. These are key ingredients of our close relationships. Scientists are finding that our links to others can have powerful effects on our health. Whether with romantic partners, family, friends, neighbours, or others, social connections can influence our biology and well-being. A look at the biology of relationships


ide-ranging research suggests that strong social ties are linked to a longer life. In contrast, loneliness and social isolation are linked to poorer health, depression, and increased risk of early death. Studies have found that having a variety of social relationships may help reduce stress and heart-related risks. Such connections might improve your ability to fight off germs or give you a more positive outlook on life. Physical contact— from hand-holding to sex—can trigger 52 Medical Tourism Jul. - Sep. 2017

release of hormones and brain chemicals that not only make us feel great but also have other biological benefits. Marriage is one of the most-studied social bonds. “For many people, marriage is their most important relationship. And the evidence is very strong that marriage is generally good for health,” says Dr. Janice Kiecolt-Glaser, an expert on health and relationships at Ohio State University. “But if a relationship isn’t going well, it could have significant health-related consequences.” Married couples tend to live longer and have better heart health than unmar-

ried couples. Studies have found that when one spouse improves his or her health behaviors—such as by exercising, drinking or smoking less, or getting a flu shot—the other spouse is likely to do so, too. When marriages are full of conflict, though, such health benefits may shrink. In NIH-funded studies, Kiecolt-Glaser and her colleagues found that how couples behave during conflict can affect wound healing and blood levels of stress hormones. In a study of more than 40 married couples, the researchers measured changes to body

chemistry over a 24-hour period both before and after spouses discussed a conflict. The troublesome topics included money, in-laws, and communication. “We found that the quality of the discussion really mattered,” Kiecolt-Glaser says. Couples who were more hostile to each other showed much larger negative changes, including big spikes in stress hormones and inflammation-related molecules. “In the more well-functioning marriages, couples might acknowledge that they disagree, or find humor in the situation, but they don’t get sarcastic or roll their eyes when the

other is talking,” Kiecolt-Glaser says. In a related study, blister wounds healed substantially more slowly in couples who were nastier to each other than in those who were kinder and gentler during difficult discussions. Couples with the “double-whammy” of hostile marriages and depression may also be at risk for weight problems. After eating a high-fat meal and discussing a difficult topic, these troubled couples tended to burn fewer calories than less hostile counterparts. “The metabolism in these couples was slower in ways that could account for weight

gain across time,” Kiecolt-Glaser says. Compared to the kinder couples, the distressed spouses had signs of more fat storage and other risks for heart disease. The quality of a marriage—whether supportive or hostile—may be especially important to the health of older couples. Dr. Hui Liu at Michigan State University studied data on the health and sexuality of more than 2,200 older people, ages 57 to 85. Good marriage quality, she found, is linked to reduced risk of developing cardiovascular disease, while bad marriage quality is tied to increased A Complete Magazine on Healthcare in Asia


risk, particularly in women. “The association between marriage quality and heart health becomes increasingly strong at older ages,” Liu says. Liu and colleagues are also looking at the links between late-life sexuality and health, including whether sex among the very old is beneficial or risky to heart health. “Some people assume that sex isn’t important in older ages, so those ages are often overlooked in research studies related to sex,” Liu says. “But our studies suggest that for many older people, sex quality and sex life are important to overall quality of life.” In one recent analysis, Liu and co-workers found that older women who reported having a satisfying sex life were at reduced risk for high blood pressure 5 years later. But the researchers also found that some older men, ages 57 to 85, were at increased risk for certain heart-related problems after 5 years if they reported having frequent (at least once a week) or extremely enjoyable sex. The reasons for these increased risks aren’t clear and are still under study. Experts suggest that older men and women talk with their doctors about concerns related to sexual issues or potential health risks. Other types of relationships are important, too. These can include friends, family, neighbors, co-workers, clubs, and religious groups. Studies have found that people who have larger and more diverse types of social ties tend to live longer. They also tend to have better physical and mental health than people with fewer such relationships. Social support may be especially protective during difficult times. Dr. Sheldon Cohen, a psychologist at Carnegie Mellon University in Pittsburgh, has been exploring the links between relationships and health for more than 3 decades. In one study, his team exposed more than 200 healthy volunteers to the common cold virus and observed them for a week in a controlled setting. “We found that the more diverse people’s social networks—the more types of connections they had— the less likely they were to develop a cold after exposure to the virus,” Cohen says. He and his team have since found

54 Medical Tourism Jul. - Sep. 2017

evidence that people with more types of connections also tend to have better health behaviors (such as not smoking or drinking) and more positive emotions. The scientists have also been exploring whether simply believing you have strong social support may help protect against the harms of stress. “Long-term conflicts with others are a potent stressor that can affect health. But we’ve found that its effects are buffered by perceived social support,” Cohen says. “People who have high levels of conflict and low levels of social support are much more likely to get sick when exposed to a virus. But those with high conflict and high levels of social support seem protected.” In addition, hugging seemed to shield against stress. People who reported having more frequent hugs were less likely to develop an infection after viral exposure. Social ties can have mixed effects on our health. But overall, research suggests that the benefits of interactions with others can outweigh any risks. “It’s generally healthy for people to try to belong to different groups, to volunteer in different ways, and be involved with a church or involved in their neighborhood,” Cohen says. “Involvement with other people across diverse situations clearly can have a very potent, very positive effect on health.” MT Desk/ NIH news in health

Advancing frontiers of Liver Care: Using technology to enhance recovery, fostering trust! Liver diseases are showing an increasing trend, resulting from increasing affluence and changes in lifestyle. Easier access to testing means more liver function abnormalities are being picked up, often when there are no symptoms. Often, the problems can be treated by medicines, surgery or by radiologists, each with its advantages and disadvantages. At PSRI a multidisciplinary team of liver specialists, surgeons and interventional radiologists reviews your records, debates and gives you a combined opinion after considering all options (personalised care). We make sure you get an opinion from a team after considering all options, one that is the best one for you. When surgery is the best treatment option, you will meet a capable, compassionate and experienced team. You will find the team very responsive, accessible to address every concern of yours in hospital, and equally accessible after discharge when many queries arise. Patients from outside of India, who come for the operation, often joke that it is easier to reach the team here in PSRI than their local doctors.

Dr. Vasudevan K.R.

Head, Liver Transplant (PSRI Hospital)

The surgery team has done pioneering work to reduce the stress of surgery by incorporating laparoscopy to liver resections. This technique is the latest and the best available to make recovery from surgery faster and less painful for your near and dear ones. PSRI hospital is one of the first centres to make this available in India. The liver transplantation service: The team with an experience of over 1500 transplants has standardised the care before, during and after the operation. This reduces the risk of complications, making the procedure safer for the patient. All this is provided in a pleasing ambience of a new building, with state of the art equipment. At PSRI, we respect the trust placed in the hospital for liver ailments. With This new team offering pioneering surgical service, hopes to further and nurture this relationship!

Medical Tourism Industry News

Medical Equipment– the future of medical industry

Medical Fair Thailand

The medical industry is one that is fast progressing and keeping pace with it is the medical equipment industry. Manual diagnosis of diseases or symptoms are a thing of the past. Today, these activities are replaced by state-of-the art equipment\ that are precise and perfect. Keeping in tune with these developments the 17th edition of India’s largest B2B exhibition on Medical Equipments and Hospital Needs is scheduled to be held at the Chennai Trade Center in Mylapore. The exhibition titled ‘Medicall 2017’ will take place from July 28-30, 2017.

Medical Fairs are not new to people associated with the medical industry. It brings together experts in this field under a single umbrella to discuss, update and network about the happenings in this industry. Thailand will host one such event that will exhibit the various developments in hospital, diagnostics, pharmaceuticals, medical & rehabilitation equipment & supplies. This fare will witness experts from all around the globe who will talk about their careers in the light of their experiences. This 8th International Medical Fair will happen from September 6 to 8 2017 in Thailand.

E-mail: Website:

Email: Website: www.medicalfair-thailand A Complete Magazine on Healthcare in Asia


Medical Tourism Eyes

don't ignore eye troubles

Your eyes are an important part of your health. Most people rely on their eyes to see and make sense of the world around them. But some eye diseases can lead to vision loss, so it is important to identify and treat eye diseases as early as possible. You should get your eyes checked as often as your health care provider recommends it, or if you have any new vision problems. And just as it is important to keep your body healthy, you also need to keep your eyes healthy. 56 Medical Tourism Jul. - Sep. 2017

Eye care tips There are things you can do to help keep your eyes healthy and make sure you are seeing your best: Eat a healthy, balanced diet Your diet should include plenty of fruits and vegetables, especially deep yellow and green leafy vegetables. Eating fish high in omega-3 fatty acids, such as salmon, tuna, and halibut can also help your eyes. Maintain a healthy weight Being overweight or obese increases your risk of developing diabetes. Having diabetes puts you at higher risk of getting diabetic retinopathy or glaucoma. Get regular exercise Exercise may help to prevent or control diabetes, high blood pressure, and high cholesterol. These diseases can lead to some eye or vision problems. So if you exercise regularly, you can lower your risk of getting these eye and vision problems. Wear sunglasses Sun exposure can damage your eyes and raise your risk of cataracts and are-related macular degeneration. Protect your eyes by using sunglasses that block out 99 to 100 per cent of both UV-A and UV-B radiation. Wear protective eye wear To prevent eye injuries, you need eye protection when playing certain sports, working in jobs such as factory work and construction, and doing repairs or projects in your home. Avoid smoking Smoking increases the risk of developing age-related eye diseases such as macular degeneration and cataracts and can damage the optic nerve. Know your family health history Some eye diseases are inherited, so it is important to find out whether anyone in your family has had them. This can help you determine if you are at higher risk of developing an eye disease. Know your other risk factors. As you get older, you are at higher risk of developing age-related eye diseases and conditions. It is important to know you risk factors because you may be able to lower your risk by changing some behaviors. If you wear contacts, take steps to prevent eye infections. Wash your hands well before you put in or take out your contact lenses. Also follow the instructions on how to properly clean them, and replace them when needed.

Eye tests and exams Everyone needs to have their eyesight tested to check for vision and eye problems. Children usually have vision screening in school or at their health care provider's office during a checkup. Adults may also get vision screenings during their checkups. But many adults need more than a vision screening. They need a comprehensive dilated eye exam. Getting comprehensive dilated eye exams is especially important because some eye diseases may not have warning signs. The exams are the only way to detect these diseases in their early stages, when they are easier to treat. The exam includes several tests: A visual field test to measure your side (peripheral) vision. A loss of peripheral vision may be a sign of glaucoma. A visual acuity test, where you read an eye chart about 20 feet away, to check on how well you see at various distances Tonometry, which measures your eye's interior pressure. It helps to detect glaucoma. Dilation, which involves getting eye drops that dilate (widen) your pupils. This allows more light to enter the eye. Your eye care provider examines your eyes using a special magnifying lens. This provides a clear view of important tissues at the back of your eye, including the retina, macula, and optic nerve. If you have a refractive error and are going to need glasses or contacts , then you will also have a refraction test. When you have this test, you look through a device that has lenses of different strengths to help your eye care professional figure out which lenses will give you the clearest vision. At what age you should start getting these exams and how often you need them depends on many factors. They include your age, race, and overall health. For example, if you are African American, you are at higher risk of glaucoma and you need to start getting the exams earlier. If you have diabetes, you should get an exam every year. Check with your health care provider about if and when you need these exams. Source: Medlineplus

Give your eyes a rest. If you spend a lot of time using a computer, you can forget to blink your eyes and your eyes can get tired. To reduce eyestrain, try the 20-20-20 rule: Every 20 minutes, look away about 20 feet in front of you for 20 seconds.

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Tai chi and your health

Medical Tourism Lifestyle

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eferred to as “moving meditation,” Tai Chi is an ancient mind and body practice. Studies suggest that the flowing postures and gentle movements of Tai Chi have many amazing health benefits. A look at what it’s all about

There are many types of Tai Chi. They typically combine slow movements with breathing patterns and mental focus and relaxation. Movements may be done while walking, standing, or sitting. “At its root, Tai Chi is about treating the whole person and enhancing the balance and crosstalk between the body’s systems,” says Dr. Peter Wayne, a longtime Tai Chi researcher at Harvard Medical School. “It’s a promising intervention for preserving and improving many areas of health, especially in older adults.” Several studies have found evidence that Tai Chi can increase balance and stability in older people and reduce the risk and fear of falls. Each year, more than 1 in 4 older adults falls, and 1 out of 5 of these falls causes a serious injury such as broken bones or a head injury. “Trying to be careful can make you more prone to falls,” Wayne says. “Tai Chi may help you move more confidently and safely again.” The US-based NIH-funded research suggests that tai chi may also improve balance and prevent falls in people with mild-to-moderate Parkinson’s disease.

Research suggests that practising Tai Chi might help improve posture and confidence, how you think and manage emotions, and your quality of life. Studies have found that it may help people with fibromyalgia sleep better and cope with pain, fatigue, and depression. Regular practice may also improve quality of life and mood in people with chronic heart failure or cancer. Older adults may find that tai chi can help improve sleep quality and protect learning, memory, and other mental functions. Further study will be needed to fully evaluate and confirm the potential benefits of Tai Chi. But since the practice involves moving slowly and mindfully, there’s little chance of harm when done correctly. “Whether you’re interested in trying Tai Chi to help with a chronic health issue or the stresses of everyday life, tai chi—if taught properly—can be a great complement to other ways of healthy living and rehabilitation,” Wayne says. “I think we’re all looking for tools to help us live productive, long lives with a little more grace and ease.” There are different styles and ways to practice tai chi, Wayne says. If you’re interested in trying it, you can start simply. For instance, try standing behind and holding onto a sturdy chair for support, then mindfully rock back and forth to build awareness of all the parts of your body and their connections. Eventually, you might move on to practice more complex movements or sequences. MT Desk/NIH News in Health

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Medical Tourism World Health


The virus that causes birth defects 60 Medical Tourism Jul. - Sep. 2017

You’ve probably heard about Zika virus on the news. Zika is a mosquito-borne virus that causes birth defects. In its recent outbreak, it has infected more than 1 million people in the Americas and Caribbean. Lieutenant Commander (LCDR) Sue Partridge from the Centers for Disease Control and Prevention (CDC) US explains here about the virus, how it impacts people and gives tips for preventing infection and what to do if you’re travelling to an area with Zika, and more.

Why is Zika virus a concern for women? Zika was a relatively unheard of virus until May 2015, when the Pan American Health Organization issued an alert to report the first confirmed Zika virus infections in Brazil. Since then, Zika has become a concern for anyone who lives in or travels to an area with Zika. Infection during pregnancy may result in the fetus being infected with Zika and developingmicrocephaly, a condition where a baby’s head is much smaller than expected, or other severe brain defects. Are there women who should be more aware of Zika than others? A pregnant woman and her fetus are at most risk for complications of infection with Zika virus. Infection during pregnancy may result in the fetus being infected with Zika and developing serious birth defects such as microcephaly. A Complete Magazine on Healthcare in Asia


Here’s what we know: • Pregnant women can be infected with Zika virus. The primary way that pregnant women get Zika virus is through the bite of an infected mosquito. Zika virus can and oral sex.






• A pregnant woman can pass Zika virus to her fetus. Zika virus can be passed from a pregnant woman to her fetus during pregnancy or at delivery. Here’s what we do not know: • If a pregnant woman is exposed, we don’t know how likely she is to become infected with Zika. If a pregnant woman is infected, we don’t know: How the virus will affect her or her pregnancy. How likely it is that Zika will pass to her fetus. If the fetus is infected, whether it will develop birth defects. When in pregnancy infection might cause harm to the fetus. If sexual transmission of Zika virus poses a different risk of birth defects than mosquito-borne transmission. How do women get Zika? People get infected with Zika: Primarily from mosquito bites. Through sex. There is a strong possibility that be spread through blood transfusions.




What should women do if they are planning to travel to an area with Zika? If you are pregnant: DO NOT travel to an area with Zika. If you must travel to an area with Zika, talk to your doctor or other health care provider. What are the most common symptoms of a Zika virus infection, and what should women do if they think they might have Zika? Many people infected with Zika virus won’t even know they have the disease because they won’t have symptoms. That’s why it’s important to prevent mosquito bites. If you are pregnant or are trying to become pregnant, you should seek medical advice if you’ve been to an area with Zika, even if you don’t have symptoms. Symptoms

viruses. Treatment There is no vaccine to prevent or medicine to treat Zika virus, but you can treat the symptoms. • Get plenty of rest. • Drink fluids to prevent dehydration. • Take medicine, such as acetaminophen (Tylenol®) or paracetamol, to reduce fever and pain. • Do not take aspirin and other non-steroidal anti-inflammatory drugs (NSAIDs) until dengue can be ruled out to reduce the risk of bleeding. • If you are taking medicine for another medical condition, talk to your doctor or other health care provider before taking additional medication.

When people do have symptoms, the most common ones are fever, rash, joint pain, or conjunctivitis (red eyes). Other common symptoms include muscle pain and headache. The illness is usually mild with symptoms lasting for several days to a week. See your doctor or health care provider

If you have Zika, prevent mosquito bites for the first week of your illness.

If you have lived in or traveled to an area with Zika and get sick, see your doctor or health care provider. Make sure you tell your doctor or health care provider where you traveled. He or she may order blood tests to look for Zika or other similar

• An infected mosquito can then spread the virus to other people.

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• During the first week of infection, Zika virus can be found in the blood and passed from an infected person to a mosquito through mosquito bites.

Will there be Zika outbreaks in the United States?

What should people in sexual relationships know about Zika?

A: CDC is not able to predict how much Zika virus will spread in the continental United States. Many areas in the United States have the type of mosquitoes that can become infected with and spread Zika virus. Recent outbreaks in the continental United States of similar viruses spread by the same type of mosquito have been relatively small and limited to a small area.

Men and women can take important steps to protect their partners and families from Zika.

What can women do to prevent mosquito bites? Cover up. When possible, wear long-sleeved shirts and long pants. For extra protection, treat clothing with permethrin(link is external). Do NOT use permethrin products directly on skin. They are intended to treat clothing. Use insect repellent. Use an Environmental Protection Agency (EPA)–registered insect repellent with one of the following active ingredients: DEET, picaridin, IR3535, oil of lemon eucalyptus, or para-menthane-diol. Mosquito-proof your home. Use screens on windows and doors. Use air conditioning when available. Keep mosquitoes from laying eggs in and near standing water.

• If you are travelling to an area with Zika, protect yourself from mosquito bites. • If you have a pregnant partner and have lived in or travelled to an area with Zika, use a condom correctly every time you have vaginal, anal, and oral sex or do not have sex during the pregnancy. If you have lived in or travelled to an area with Zika but do not have a pregnant partner and have been diagnosed with Zika or have (or had) symptoms, consider using condoms or another barrier method, or not having sex for at least 6 months after symptoms begin. Source: Women” Author: LCDR Sue Partridge is the Associate Director for Policy and Communication in CDC’s Division of Vector-Borne Diseases. Sue works with CDC to both respond to epidemics and develop better tools to predict, prevent, and control risk, especially at a time when vector-borne diseases are emerging and spreading.

Source: Women”

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Medical Tourism Special report

Think before you

64 Medical Tourism Jul. - Sep. 2017

Are Tattoos safe? Tattoos are designs on the skin made with needles and coloured ink. This ancient body art is becoming increasingly popular among the youth across the world. In the West, it is reported that, approximately 3 per cent to 5 per cent of the population has at least one decorative tattoo. Though it is generally safe when performed in a professional setting, it can also be associated with umpteen risks. Modern tattoo inks are found containing ingredients causing allergic reactions. However, before you get a tattoo, consider these key questions, answered by Dr. Linda Katz, M.D., M.P.H., director of the US Food and Drug Administration (FDA)’s Office of Cosmetics and Colors.

Should I be concerned about unsafe practices, or the tattoo ink itself? Both. While you can get serious infections from unhygienic practices and equipment that isn’t sterile, infections can also result from ink that was contaminated with bacteria or mold. Using non-sterile water to dilute the pigments (ingredients that add color) is a common culprit, although not the only one. There’s no sure-fire way to tell if the ink is safe. An ink can be contaminated even if the container is sealed or the label says the product is sterile. What is in tattoo ink? Published research has reported that some inks contain pigments used in printer toner or in car paint. FDA has not approved any pigments for injection into the skin for cosmetic purposes. FDA reviews reports of adverse reactions or infections from consumers and healthcare providers. We may learn about outbreaks from the state authorities who oversee tattoo parlors. What kinds of reactions may happen after getting a tattoo? You might notice a rash—redness or bumps—in the area of your tattoo, and you could develop a fever. More aggressive infections may cause high fever, shaking, chills, and sweats. Treating such infections might require a variety of antibiotics—possibly for months—or even hospitalisation and/or surgery. A rash may also mean you’re having an allergic reaction. And because the inks are permanent, the reaction may persist. Can scar tissue build up after getting a tattoo? Scar tissue may form when you get a tattoo, or you could develop “granulomas,” small knots or bumps that may form around material that the body perceives as foreign. If you tend to get keloids—scars that grow beyond normal boundaries—you may develop the same kind of reaction to the tattoo.

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What do I need to know about MRIs if I get a tattoo? Some people may have swelling or burning in the tattoo when they have magnetic resonance imaging (MRI), although this happens rarely and does not last long. Let your health care professional know that you have a tattoo before an MRI is ordered. What about do-it-yourself tattoo inks and kits? Inks and kits sold as “do-it-yourself” to consumers have been associated with infections and allergic reactions. FDA is also concerned that consumers may not know how to control and avoid all sources of contamination. Could other problems occur later on? Although research is ongoing at FDA and elsewhere, there are still a lot of questions about the long-term effects of the pigments, other ingredients, and possible contaminants in tattoo inks. FDA has received reports of bad reactions to tattoo inks right after tattooing and even years later. You also might become allergic to other products, such as hair dyes, if your tattoo contains p-phenylenediamene (PPD). Then there’s tattoo removal. We don’t know the short- or long-term consequences of how pigments break down after laser treatment. However, we do know some tattoo removal procedures may leave permanent scarring. If I get a tattoo and develop an infection or other reaction, what should I do? First, contact your health care professional. Second, notify the tattoo artist so he or she can identify the ink and avoid using it again. Ask for the brand, colour, and any lot or batch number of the ink or dilutent to help determine the source of the problem and how to treat it. Removing tattoos may be harder than you think So think before you ink. Consider the risks. Remember, too, that removing a tattoo is a painstaking process, and complete removal without scarring may be impossible. Source:FDA US Food and drug administration

What kinds of reactions have been seen with tattoos? You might notice a rash—redness or bumps—in the area of your tattoo, and you could develop a fever. Serious infections can require months of treatment with a variety of antibiotics. More virulent or aggressive infections may be associated with high fever, shaking, chills, and sweats. If these symptoms arise, you may need antibiotics, hospitalization and/or surgery. Your physician or other health care professional will make that determination. If you have an allergic reaction, the exact cause may be hard to pinpoint. You could have an allergic reaction to a pigment (one of the ingredients that add color to the ink) or to a diluent (the liquid used to dilute the pigments). Or you could have a reaction to a contaminant that got into the ink during manufacturing. And because the inks are permanent, the reaction may persist.

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HELP LINE NO.: 011-30051818, Mob: 9582211755

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Medical Tourism sleep

Counting sheep to go to sleep? Some people think that adults need less sleep as they age. But there is no evidence to show that seniors can get by with less sleep than people who are younger. As people age, however, they often get less sleep or they tend to spend less time in the deep, restful stage of sleep. Older people are also more easily awakened. 68 Medical Tourism Jul. - Sep. 2017


nd it’s not just the number of hours of sleep you get that matters. The quality of the sleep you get is also important. People whose sleep is frequently interrupted or cut short might not get enough of certain stages of sleep. If you are wondering whether you are getting enough sleep, including quality sleep, ask yourself • Do you have trouble getting up in the morning? • Do you have trouble focusing during the day? • Do you doze off during the day? If you answered yes to these three questions, you should work on improving your sleep. What are the health effects of not getting enough sleep? Sleep is important for overall health. When you don’t get enough sleep (sleep deprivation), it does more than just make you feel tired. It can affect your performance, including your

ability to think clearly, react quickly, and form memories. This may cause you to make bad decisions and take more risks. People with sleep deprivation are more likely to get into accidents. Sleep deprivation can also affect your mood, leading to • Irritability • Problems with relationships, especially for children and teenagers • Depression • Anxiety It can also affect your physical health. Research shows that not getting enough sleep, or getting poor-quality sleep, increases your risk of • High blood pressure • Heart disease • Stroke • Kidney disease • Obesity • Type 2 diabetes Not getting enough sleep can also mean that you don’t get enough of the hormones that help children grow and help adults and children build muscle mass, fight infections, and repair cells. Sleep deprivation magnifies the effect of alcohol. A tired person who drinks too much alcohol will be more impaired than a well-rested person. How can I get better sleep? You can take steps to improve your sleep habits. First, make sure that you allow yourself enough time to sleep. With enough sleep each night, you may find that you’re happier and more productive during the day. To improve your sleep habits, it also may help to • Go to bed and wake up at the same time every day • Avoid caffeine, especially in the afternoon and evening • Avoid nicotine • Exercise regularly, but don’t exercise too late in the day • Avoid alcoholic drinks before bed • Avoid large meals and beverages late at night • Don’t take a nap after 3 p.m. • Relax before bed, for example by taking a bath, reading or listening to relaxing music • Keep the temperature in your bedroom cool

want you to do a sleep study, to help diagnose the problem. If you are a shift worker, it can be even harder to get a good sleep. You may also want to

• Get rid of distractions such as noises, bright lights, and a TV or computer in the bedroom. Also, don’t be tempted to go on your phone or tablet just before bed.

• Take naps and increase the amount of time available for sleep

• Get enough sunlight exposure during the day

• Limit shift changes so your body clock can adjust

• Don’t lie in bed awake; if you can’t sleep for 20 minutes, get up and do something relaxing

• Limit caffeine use to the first part of your shift

• See a doctor if you have continued trouble sleeping. You may have a sleep disorder, such as insomnia or sleep apnea. In some cases, your doctor may suggest trying over-the-counter or prescription sleep aid. In other cases, your doctor may

• Keep the lights bright at work

Remove sound and light distractions in your bedroom during daytime sleep (for example, use light-blocking curtains) MT Desk.Source: Medlineplus

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Medical Tourism reflections

Even distorted facial assets can be corrected to retain appealing visage By O.J.George (Consulting Editor)


eauty is in the eye of the beholder, so goes the adage. But then there should be substantive elements in the appearance and facial attractiveness, symmetry and the flawless features, even though appearances are deceptive. They also say cloths make man, but we know our drawbacks should also be rectified so that appearances could be original. The visage, supported by bold bones, should stand out sending shivers down the spine of the beholder of the beauty. The compositeness of the significant landmarks on the face and femininity of females send feelings of ripples to even the most morose man. Machismo males also have handsomeness affecting the vibes of the fair sex. In this case, it may not be just about having a good- looking face, rather a

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man needs to be complete in body, looks and appeal, all the same the visage speaks for itself. Speaking about facial beauty, upon seeing Helen of Troy. Faustus utters the ever quoted lines: “Was this the face that launched a thousand ships, and burnt the topless towers of Ilium”. The Trojan war was all about recovering the beauty queen, Helen. In Greek mythology, she was the daughter of Zeus and Leda, and was sister of Clytemnestra, Castor and Pollux, and she was considered the most beautiful woman in the world. By marriage she was the Queen of Laconia, a province in Greece, and was the wife of King Menelaus. Her elopement with Prince of Paris of Troy brought about the Trojan war. According to one description, “she was beautiful, ingenuous and charming. Her legs were

the best, her mouth the cutest. There was a beauty mark between her eyebrows”. Which means the composite visage explains everything. Da Vinci’s Mona Lisa has been a subject of research for deciphering the secret behind her suppressed smile. A beaming smile should electrify the feelings and carnal emotions. Any man would fall for a fellow who has supple mouth, sparkling milk white teeth and kind words. A foul mouth can mar the mien of any man and, for that matter, any woman, arousing feelings of distraction. In sum, what I wanted to drive home was the point that happy visage and salubrious verbal outpouring of sweet nothingness would be magnetic, attracting the opposite sex.

Coming to the mouth and its internal assets that support a sturdy face, the role of dental experts is significant, for they can make or mar the impression. First impression is the best impression, they say, but the oral and maxillo-facial experts can bring about a sea change in one’s manifestation and image, torpedoing the worst of first impression. Consider for example, the cleft lip, which definitely looks irregular and awkward. But the deformity can be corrected in toto, instilling confidence in the suffering patient. In case of accidents, head and facial injuries, fractures of jaws and the like are very common. These problems are usually set right by the specialists concerned. These days irregular teeth, injured teeth and foul smelling conditions can

be corrected to the utmost satisfaction of the patient.

excruciating conditions that sometimes defy calm and composed conduct.

There Is no point in feeling dejected and depressed on having congenital or accidental deformities, particularly of the face.

Bu then there is solution to each and every problem, and one should attempt all medical procedures to get past the insurmountable woes.

Cheer up, these and even worse conditions have correction when skillful, deft hands of the specialist surgeons get to work.

For the Westerners, Europeans and the like, if hefty fee is a deterrent, don’t hesitate to travel to India and other regions to get suitable treatment at substantially cost- effective and affordable rates.

Even total replacement of the face could be thought of in the present day scientific and medical achievements. I am not scaring you, but there can be any number of problems within and surrounding the oral cavity.


Dental cavities, gum diseases, infectious diseases, trauma injuries, oral cancers and the like may be causing

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Medical Tourism

Dazzling Delhi

for medicare and sightseeing By Ninu Susan Abraham


re you living in Europe or America where dental treatments are frighteningly expensive? Are you in search of places in Asia where dental treatments are less expensive? Then, worry not. India is a place you should anchor for cost effective quality medical treatments. Here, the treatments are not just world-class but the doctors are also highly qualified. But considering the vast geographical area of India, it is difficult to make a choice in which place to do the treatment. Here we shall discuss on how Delhi can be the apt place for treatment for any medical condition. Considering that New Delhi is the capital of India it is easily accessible by air, road and rail from the major countries in the world. Many hospitals here focus on foreign

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nationals or Indians settled abroad. These hospitals are located on sprawling campuses very much similar to the facilities provided by five-star hotels. Here, you get to experience both – a comfortable stay as well as quality treatment for your illness. All this at a cost that might be mind bogglingly small for a foreign pocket. Also, staying and undergoing treatment at one of these five star facilities is very much like staying in a luxury resort rather than a hospital. After your treatment here, you can enjoy a tour around Delhi thus making full use of your money spent on travel for treatment. Being the capital of the second largest democracy in the world, there ae so many places that attract a visitor. A tour of Delhi can be a rich and fruitful experience. The city

• Jama Masjid • Jantar mantar • Lodi Tomb • Parliament House • Qutab Minar • Rashtrapathi Bhavan • Red Fort • Safdarjung Tomb • Rajghat

is known for its Mughal heritage and British empire buildings. In mythology, it was Indraprastha,the palace state of Pandavas from the Mahabharatha. The remains said to be of that are still there.

The variety of foods available here deserve exploration. The cuisine here is elaborate and meets the need of every race and geographical location.

Touring around Delhi is never tiring . The metro rail here makes travelling around the city very easy. It also contributes to the low level of pollution of this place now, which was once known as the most polluted place. This makes the climate and the land very condusive to any tourist who longs to visit this place. In case you are alone you could utilise the help from the friendly Medical tour operators who are helpful and will take you around the city. They are sure to explain to you the significance and the story behind the different monuments and archieology.

• Akshardham Temple

Some of the places in Delhi that you should not miss visiting are:• Azad Hind Gram • Lotus Temple • Birla Mandir • Dilli Haat INA • Dilli Haat Pitampura • Dilli Haat Janakpuri • Garden of Five Senses • Humayun’s Tomb • India Gate • Iskon Temple

Apart from places of political and historical importance are the different parks, museums and zoos that will be a banquet to your eyes and your intellect. Since the majority of Delhi has an English speaking population it would be rare that you lose yourself in this wonderful city. Communication, therefore is hardly an issue . Finally, foreigners get to experience the flavour and culture of India by just visiting this city. Along, with their treatment they can also get a wonderful Tourism Package at a very cost effective rate. So, if ever you are thinking of a medical treatment in Delhi, club it up with a tour and thus make your visit special and pleasurable and finally worth every penny you spend on your tour. The proximity to Agra which hosts the formidable Taj Mahal and other places like Rishikesh (Capital of Yoga), Jaipur and other locations in the Himalayas makes Delhi all the more worth visiting.

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‫انتشار فيروس زيكا في الواليات المتحدة القارية‪ .‬العديد من‬ ‫المناطق في الواليات المتحدة لديها نوع من البعوض التي يمكن‬ ‫أن تصبح مصابة ومنتشرة لفيروس زيكا‪ .‬وكانت الفاشيات األخيرة‬ ‫في الواليات المتحدة القارية من الفيروسات المماثلة التي تنتشر‬ ‫عن طريق نفس النوع من البعوض صغيرة نسبيا وتقتصر على‬ ‫منطقة صغيرة‪.‬‬ ‫ما الذي يمكن أن تفعله النساء لمنع لدغات‬ ‫البعوض؟‬ ‫التستر‪ .‬عندما يكون ذلك ممكنا يرجى ارتداء قمصان طويلة‬ ‫األكمام والسراويل الطويلة‪ .‬ولمزيد من الحماية تعالج المالبس مع‬ ‫بيرميثرين (الربط خارجي)‪ .‬ال تستخدم منتجات البرميثرين مباشرة‬ ‫على الجلد‪ .‬وتهدف إلى لمعالجة المالبس‪.‬‬ ‫استخدمي طارد الحشرات‪ .‬استخدمي وكالة حماية البيئة‬ ‫(‪ -)EPA‬طارد الحشرات المسجلة مع واحدة من المكونات‬ ‫النشطة التالية‪ :‬ديت‪ ،‬بيكاريدين‪ ،IR3535 ،‬زيت األوكالبتوس‬ ‫الليمون‪ ،‬أو با ار منثان ديول‪.‬‬ ‫اجعلي منزلك واقيا من البعوض‪ .‬استخدمي شاشات على النوافذ‬ ‫واألبواب‪ .‬استخدمي تكييف الهواء عند توفره‪ .‬قزمي بالحفاظ على‬ ‫البعوض من وضع البيض في وقرب المياه الراكدة‪.‬‬ ‫بطلب فحوص الدم للبحث عن زيكا أو فيروسات أخرى مماثلة‪.‬‬ ‫العالج‬ ‫ال يوجد لقاح لمنع أو دواء لعالج فيروس زيكا‪ ،‬ولكن يمكنك‬ ‫عالج األعراض‪.‬‬ ‫• الحصول على الكثير من الراحة‪.‬‬ ‫• اشرب السوائل لمنع الجفاف‪.‬‬ ‫• تناول الدواء‪ ،‬مثل أسيتامينوفين (‪ )®Tylenol‬أو‬ ‫الباراسيتامول‪ ،‬للحد من الحمى واأللم‪.‬‬ ‫• ال تأخذ األسبرين وغيرها من العقاقير المضادة لاللتهابات‬ ‫غير الستيرويدية حتى يمكن استبعاد حمى الضنك للحد من‬ ‫خطر النزيف‪.‬‬ ‫• إذا كنت تتناول الدواء لحالة طبية أخرى‪ ،‬تحدث مع طبيبك أو‬ ‫مقدم الرعاية الصحية قبل تناول أدوية إضافية‪.‬‬ ‫إذا كان لديك زيكا يرجى منع لدغات البعوض لألسبوع األول من‬ ‫مرضك‪.‬‬ ‫• خالل األسبوع األول من العدوى يمكن العثور على فيروس‬ ‫زيكا في الدم ونقله من شخص مصاب إلى بعوض من خالل‬ ‫لدغات البعوض‪.‬‬ ‫• البعوض المصاب يمكن بعد ذلك نشر الفيروس إلى أشخاص‬ ‫آخرين‪.‬‬ ‫هل سيكون هناك تفشي زيكا في الواليات‬ ‫المتحدة؟‬ ‫أ‪ :‬ال يستطيع مركز السيطرة على األمراض القيام بالتنبؤ بكمية‬

‫ماذا يجب أن يعرفه الناس في العالقات‬ ‫الجنسية عن زيكا؟‬ ‫يمكن للرجال والنساء اتخاذ خطوات هامة لحماية شركائهم وأسرهم‬ ‫من زيكا‪.‬‬ ‫إذا كنت مساف ار إلى منطقة وفيها زيكا يرجى حماية‬ ‫• ‬ ‫نفسك من لدغات البعوض‪.‬‬ ‫إذا كان لديك شريك حامل وعاشت أو سافرت إلى‬ ‫• ‬ ‫منطقة وفيها زيكا استخدم الواقي الذكري بشكل صحيح في كل‬ ‫مرة تقوم بالجنس المهبلي أو الشرجي أو الفموي أو ال تمارس‬ ‫الجنس أثناء الحمل‪.‬‬ ‫إذا كنت قد عشت أو سافرت إلى منطقة وفيها زيكا ولكن لم يكن‬ ‫لديك شريك حامل وتم تشخيصها مع زيكا أو يكون (أو كان)‬ ‫لديها األعراض فانظر في استخدام الواقي الذكري أو طريقة‬ ‫حاجز آخر‪ ،‬أو عدم ممارسة الجنس لمدة ‪ 6‬أشهر على األقل‬ ‫بعد بدء األعراض‪.‬‬ ‫المصدر‪Women” :‬‬ ‫المؤلف‪:‬‬ ‫‪ LCDR‬سو بارتريج هو المدير المساعد للسياسة واالتصاالت‬ ‫في شعبة األمراض المنقولة جنسيا لدى األمراض المنقولة‪ .‬يعمل‬ ‫سو لدى مركز السيطرة على األمراض للرد على األوبئة وتطوير‬ ‫أدوات أفضل للتنبؤ والوقاية من المخاطر والسيطرة عليها‪ ،‬خاصة‬ ‫في الوقت الذي تظهر فيه األمراض المنقولة جنسيا وتنتشر‪.‬‬ ‫المصدر ‪ :‬‬

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‫• الطريقة الرئيسية التي تحصل بها النساء الحوامل على فيروس‬ ‫زيكا هو عن طريق لدغة البعوض المصاب‪.‬‬ ‫• يمكن أن ينتشر فيروس زيكا عن طريق الجنس المهبلي‬ ‫والشرجي والشفوي‪.‬‬ ‫• يمكن للمرأة الحامل أن تنقل فيروس زيكا لجنينها‪.‬‬ ‫• يمكن نقل فيروس زيكا من امرأة حامل إلى جنينها أثناء الحمل‬ ‫أو عند الوالدة‪.‬‬ ‫وإليكم ما ال نعرفه‪:‬‬ ‫• إذا تعرضت المرأة الحامل فإننا ال نعرف مدى احتمال‬ ‫إصابتها بزيكا‪ .‬إذا أصيبت امرأة حامل فإننا ال نعرف‪:‬‬ ‫• كيف سيؤثر الفيروس على حملها‪.‬‬ ‫• ما مدى احتمال تنقل زيكا لجنينها‪.‬‬ ‫• إذا أصيب الجنين ما إذا كان سيؤدي إلى تشوهات خلقية‪.‬‬

‫إذا كنت حامال‪:‬‬ ‫• ال تسافري إلى منطقة وفيها زيكا‪.‬‬ ‫• إذا كان عليك أن تسافري إلى منطقة زيكا‪ ،‬تحدثي إلى طبيبك‬ ‫أو موفر الرعاية الصحية‬ ‫ما هي األعراض األكثر شيوعا لعدوى فيروس‬ ‫زيكا‪ ،‬وماذا ينبغي للمرأة أن تفعل إذا تعتقد‬ ‫أنها قد تكون مصابة بزيكا؟‬ ‫العديد من المصابين بفيروس زيكا لن يعرفوا حتى أنهم مصابون‬ ‫بالمرض ألنه لن يكون لديهم أعراض‪ .‬وهذا هو السبب في أنه‬ ‫من المهم منع لدغات البعوض‪ .‬إذا كنت حامال أو تحاول أن‬ ‫تصبح حامال‪ ،‬يجب عليك طلب المشورة الطبية إذا كنت قد‬ ‫انتقلت إلى منطقة وفيها زيكا ولو لم يكن لديك أعراض‪.‬‬

‫• عندما تكون في حالة الحمل قد تسبب العدوى ضر ار للجنين‪.‬‬

‫األعراض‬ ‫عندما يكون لدى الناس أعراض‪ ،‬وأكثرها شيوعا هي الحمى‬ ‫والطفح الجلدي وآالم المفاصل أو التهاب الملتحمة (العيون‬ ‫الحمراء)‪ .‬وتشمل األعراض الشائعة األخرى آالم العضالت‬ ‫والصداع‪ .‬يكون المرض عادة معتدال مع أعراض تستمر لعدة‬ ‫أيام إلى أسبوع‪.‬‬

‫• في المقام األول من لدغات البعوض‪.‬‬

‫راجع طبيبك أو مقدم الرعاية الصحية‬

‫• ما إذا كان انتقال فيروس زيكا الجنسي يشكل خط ار مختلفا‬ ‫للعيوب الخلقية عن انتقال العدوى بالبعوض‪.‬‬ ‫كيف تحصل النساء على زيكا؟‬ ‫الناس يصابون بزيكا‪:‬‬ ‫• عن طريق الجنس‪.‬‬ ‫• هناك احتمال قوي بأن ينتشر فيروس زيكا عن طريق نقل الدم‪.‬‬ ‫‪75‬‬ ‫‪26‬‬

‫ما الذي ينبغي أن تفعله المرأة إذا كانت تخطط‬ ‫للسفر إلى منطقة وفيها زيكا؟‬

‫‪A Complete Magazine on Healthcare in Asia‬‬

‫إذا كنت قد عشت أو سافرت إلى منطقة وفيها زيكا وتتعرض‬ ‫للمرض‪ ،‬فراجع طبيبك أو مقدم الرعاية الصحية‪ .‬وتأكد من إخبار‬ ‫طبيبك أو مقدم الرعاية الصحية حيث سافرت‪ .‬ويقوم هو أو هي‬

‫ربما كنتم قد سمعتم عن فيروس زيكا في‬ ‫األخبار‪ .‬زيكا هو الفيروس المنقول بالبعوض‬ ‫الذي يسبب العيوب الخلقية‪ .‬وفي تفشيهه‬ ‫مؤخرا قد أصاب أكثر من مليون شخصا‬ ‫في األمريكتين ومنطقة البحر الكاريبي‪.‬‬ ‫سو بارتريدج )‪ (LCDR‬ويوضح الرائد البحري‬ ‫من مراكز المراقبة على األمراض والوقاية‬ ‫الواليات المتحدة هنا عن )‪ (CDC‬منها‬ ‫الفيروس‪ ،‬وكيف يؤثر على الناس‪ ،‬ويقدم‬ ‫نصائح لمنع العدوى وماذا تفعلون إذا كنتم‬ ‫‪.‬مسافرين إلى منطقة وفيها زيكا‪ ،‬و اكثر‬

‫لماذا يعتبر فيروس زيكا مصدر قلق للمرأة؟‬ ‫كان زيكا من الفيروسات غير المسبوقة نسبيا حتى مايو ‪ /‬أيار ‪ ،2015‬عندما أصدرت منظمة الصحة للبلدان األمريكية إنذا ار لإلبالغ‬ ‫عن أول إصابات فيروس زيكا المؤكدة في الب ارزيل‪ .‬ومنذ ذلك الحين أصبح زيكا مصدر قلق لكل من يعيش أو يسافر إلى منطقة وفيها‬ ‫زيكا‪ .‬قد تؤدي العدوى أثناء الحمل إلى إصابة الجنين بزيكا ونمو قاع الرأس‪ ،‬وهو حالة يكون فيها رأس الطفل أصغر بكثير مما كان‬ ‫متوقعا‪ ،‬أو غيرها من عيوب الدماغ الشديدة‪.‬‬ ‫هل هناك نساء يجب أن يكن أكثر واعية من زيكا من اآلخرين؟‬ ‫المرأة الحامل وجنينها أكثر عرضة لمضاعفات العدوى بفيروس زيكا‪ .‬قد تؤدي العدوى أثناء الحمل إلى إصابة الجنين بالزيكا وتطور‬ ‫عيوب خلقية خطيرة مثل صغر الرأس‪.‬‬ ‫وإليكم ما نعرفه‪:‬‬ ‫• يمكن أن تصاب النساء الحوامل بفيروس زيكا‪.‬‬ ‫‪76 Medical Tourism Jul. - Sep. 2017‬‬ ‫‪25‬‬

‫السياحة الطبية‬ ‫الصحة العالمية‬

‫زيكا‪:‬‬ ‫الفيروس الذي يسبب‬ ‫العيوب الخلقية‬

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‫‪A Complete Magazine on Healthcare in Asia‬‬

‫وسوف تكون هناك حاجة إلى مزيد من الدراسة للتقييم الكامل وتثبيت الفوائد المحتملة من تاي تشي‪ .‬ولكن بما أن‬ ‫الممارسة تنطوي على التحرك ببطء وبصراحة‪ ،‬هناك فرصة ضئيلة للضرر عندما يقام به بشكل صحيح‪.‬‬ ‫يقول واين‪" :‬إذا كنت مهتما بمحاولة تاي تشي للمساعدة في معالجة مشكلة صحية مزمنة أو ضغوط الحياة اليومية‬ ‫فإن تاي تشي ‪ -‬إذا تم تدريسه بشكل صحيح ‪ -‬يمكن أن يكون مكمال كبي ار لطرق أخرى للحياة الصحية إو�عادة‬ ‫التأهيل‪ ،‬وأعتقد أننا جميعا نبحث عن أدوات لمساعدتنا على أن نعيش حياة منتجة ومثمرة مع أكثر نعمة وسهولة"‪.‬‬ ‫هناك أنماط وطرق مختلفة لممارسة تاي تشي‪ ،‬ويقول واين‪ .‬إذا كنت مهتما في محاولة ذلك يمكنك البدء ببساطة‪.‬‬ ‫على سبيل المثال حاول الوقوف خلفا واإلستناد على كرسي قوي للحصول على الدعم‪ ،‬ثم يهزز إلى الوراء واألمام‬ ‫لبناء الوعي من جميع أجزاء الجسم وروابطها‪ .‬وفي النهاية قد تنتقل إلى ممارسة الحركات األكثر تعقيدا أو متواليا ‪.‬‬ ‫‪MT Desk/ NIH --.‬‬

‫‪78 Medical Tourism Jul. - Sep. 2017‬‬ ‫‪23‬‬

‫السياحة الطبية‬ ‫نمط الحياة‬

‫تاي تشي‬ ‫وصحتكم‬ ‫يشار إليه "التأمل المتحرك"‪ ،‬تاي تشي هو ممارسة العقل والجسم القديم‪ .‬وتشير الدراسات إلى أن المواقف المتدفقة‬ ‫والحركات اللطيفة في تاي تشي لها العديد من الفوائد الصحية المدهشة‪ .‬نظرة على كل شيء ما هو‬ ‫هناك أنواع كثيرة من تاي تشي‪ .‬وعادة ما تجمع بين التحركات البطيئة مع أنماط التنفس والتركيز العقلي‬ ‫واالسترخاء‪ .‬وتتم الحركات أثناء المشي أو الوقوف أو الجلوس‪.‬‬ ‫يقول الدكتور بيتر واين‪ ،‬الباحث في تاي تشي منذ فترة طويلة في كلية الطب بجامعة هارفارد‪ " :‬فإن تاي تشي في‬ ‫جذوره يتعلق بمعالجة الشخص كامال وتعزيز التوازن والتداخل المتبادل بين أنظمة الجسم‪ .‬وانه تدخل واعد للحفاظ‬ ‫على العديد من مجاالت الصحة وتحسينها وخاصة في كبار السن"‪.‬‬ ‫وقد وجدت العديد من الدراسات أدلة على أن تاي تشي يمكن أن يزيد التوازن واالستقرار في كبار السن والحد من‬ ‫المخاطر والخوف من السقوط‪ .‬يسقط أكثر من ‪ 1‬في ‪ 4‬من كبار السن في كل عام وواحد من أصل ‪ 5‬من هذه‬ ‫السقوط تسبب إصابة خطيرة مثل كسر العظام أو إصابة في الرأس‪.‬‬ ‫يقول واين‪" :‬إن المحاولة ألن تكون حذ ار يمكن أن تجعلكم أكثر عرضة للسقوط‪ ،‬إو�ن تاي تشي قد يساعدكم على‬ ‫التحرك بمزيد من الثقة واألمان مرة أخرى"‪ .‬وتشير البحوث التي تمولها المعهد الوطني للصحة ومقره الواليات‬ ‫المتحدة إلى أن تاي تشي قد يحسن التوازن ويجنب السقوط لدى األشخاص الذين يعانون من مرض باركنسون‬ ‫الطفيف إلى المعتدل‪.‬‬ ‫وتشير البحوث إلى أن ممارسة تاي تشي قد تساعد على تحسين الموقف والثقة وكيف كنت تعتقد وتعامل مع‬ ‫العواطف ونوعية حياتك‪ .‬وقد وجدت الدراسات أنه قد يساعد الناس بفيبروميالغيا النوم بشكل أفضل والتعامل مع‬ ‫األلم والتعب واالكتئاب‪ .‬وقد تؤدي الممارسة المنتظمة أيضا إلى تحسين نوعية الحياة والمزاج لدى المصابين بفشل‬ ‫القلب المزمن أو السرطان‪ .‬وسيجد كبار السن أن تاي تشي يمكن أن يساعد على تحسين نوعية النوم وحماية التعلم‬ ‫والذاكرة والوظائف العقلية األخرى‪.‬‬

‫‪79‬‬ ‫‪22‬‬

‫‪A Complete Magazine on Healthcare in Asia‬‬

‫الملتهب‬ ‫لقد كان لدينا جميعا الحلق الملتهب حول هذا الوقت‬ ‫من السنة‪ .‬تشعر حلقكم شائكة ويمكن أن يضر عند‬ ‫االبتالع‪ .‬نظرة على ما يمكنككم القيام به لتهدئة التهاب‬ ‫الحلق ومتى يكون هو عالمة على عدوى أكثر خطورة‬ ‫تحدث معظم التهابات الحلق عن طريق العدوى الفيروسية مثل‬ ‫الزكام أو االنفلونزا‪ .‬هذه المشاكل في الحلق هي طفيفة عموما‬ ‫وتبعد من تلقاء نفسها‪.‬‬

‫طفلك يعاني من ألم حاد في الحلق والحمى فوق ‪ 100.4‬درجة‬ ‫أو تورم الغدد يجب أن تحصل على الرعاية الطبية على الفور"‪،‬‬ ‫ينصح ريدل‪ .‬األطفال الذين يعانون من المكوري العقدي أيضا قد‬ ‫يواجهون الغثيان والقيء وآالم في المعدة‪.‬‬

‫ولتهدئة الحلق المهيج يرجى إبقاؤه رطبا‪" .‬هل الحظتم في أي‬ ‫وقت أن التهاب الحلق يبدو أسوأ في الصباح؟ "ألن حلقكم يكون‬ ‫جافا جدا خالل الليل"‪ .‬يقول الدكتور فاليري ريدل‪ ،‬وهو خبير‬ ‫في األمراض المعدية لدى المعهد الوطني للصحة (‪ ,)NIH‬في‬ ‫الواليات المتحدة‪" :‬وجود المعينات أو الحلوى الصلبة ‪ -‬أو أي‬ ‫شيء يحفز إنتاج اللعاب ‪ -‬سوف تبقي حلقكم رطبا‪ .‬ومن المهم‬ ‫أيضا شرب الكثير من السوائل‪" .‬‬

‫لمعرفة ما إذا كان لديك المكوري العقدي فإن الطبيب سوف يأخذ‬ ‫مسحة الحلق‪ .‬إذا أثبتت نتائج االختبار بكتيريا المكوري العقدي‬ ‫سوف يصف الطبيب المضادات الحيوية‪ .‬وبعد ‪ 24‬ساعة من‬ ‫تناولها ال تكون معدية‪ .‬ومن المرجح أن تبدأ أن تشعر على نحو‬ ‫أفضل في غضون بضعة أيام‪ ،‬ولكن من المهم إنهاء كل من‬ ‫الدواء لالستعادة تماما‬

‫لألطفال الصغار الذين قد يخنقون على الحلوى الصلبة أو‬ ‫المعينات حاولوا السوائل الباردة والمصاصات‪ .‬ويمكن أيضا‬ ‫تهدئة ألم الحلق عن طريق بخاخات الحلق ومسكنات األلم دون‬ ‫وصفة طبية مثل األسيتامينوفين أو اإليبوبروفين أو األسبرين‪،‬‬ ‫ولكن ال تعطي األسبرين لألطفال الصغار‪.‬‬

‫بكتيريا المكوري العقدي شديد العدوى‪ .‬يرجى عالجه بسرعة‬ ‫لمنعها من االنتشار إلى اآلخرين‪ .‬يقول ريدل‪" :‬ليس فقط يمكن‬ ‫أن تنتقل العدوى‪ ،‬ولكن هناك مضاعفات محتملة من دون عالج‬ ‫المكوري العقدي بالحلق‪ ".‬وتشمل هذه التهابات األذن والحمى‬ ‫الروماتيزمية ومشاكل في الكلى‪.‬‬

‫اتصل بطبيب إذا كان التهاب الحلق شديدا وال تشعر أفضل‬ ‫بعد بضعة أيام أو يرافقه ارتفاع في درجة الح اررة أو تورم الغدد‪.‬‬ ‫يمكن أن تكون هذه األعراض عالمات على عدوى بكتيرية مثل‬ ‫المكوري العقدي بالحلق‪ .‬إن تناول المضادات الحيوية لن يساعد‬ ‫على اإلطالق إذا كان التهاب الحلق بسبب الفيروسات‪ ،‬ولكنها‬ ‫ضرورية لمكافحة االلتهابات البكتيرية مثل المكوري العقدي‬

‫وهناك التهاب الحلق اآلخر الشائع إلى حد ما هو التهاب‬ ‫اللوزتين والذي يحدث عندما يكون لديك التهاب وتورم اللوزتين‪.‬‬ ‫وانه يسبب من العديد من نفس الفيروسات والبكتيريا التي تسبب‬ ‫التهاب الحلق‪ .‬إذا كان لديك نوبات متكررة من التهاب اللوزتين‬ ‫أو بكتيريا الحلق‪ ،‬قد تحتاج لعملية جراحية (تسمى استئصال‬ ‫اللوزتين) إلزالة اللوزتين‬

‫المكوري العقدي هو العدوى البكتيرية األكثر شيوعا بالحلق‪ .‬على‬ ‫الرغم من أنه يمكن أن يحدث في البالغين‪ ،‬يكون المكوري العقدي‬ ‫بالحلق هو أكثر شيوعا في األطفال الذين تتراوح أعمارهم بين‬ ‫‪ 5‬و ‪ .15‬يقول ريدل يمكن أن يكون من الصعب الكشف عن‬ ‫المكوري العقدي في األطفال األصغر سنا ألنه يمكن أن يسبب‬ ‫سيالن األنف وأعراض أخرى تجعله يبدو وكأنه الزكام‪" .‬إذا كان‬

‫أفضل طريقة لحماية نفسكم من الجراثيم التي تسبب هذه‬ ‫االلتهابات هي غسل يديكم في كثير من األحيان‪ .‬حاولوا‬ ‫التخلص من الناس الذين يعانون من نزالت الزكام أو العدوى‬ ‫المعدية األخرى‪ .‬وتجنبوا التدخين واستنشاق الدخان غير المباشر‬ ‫والتي يمكن أن تهيج الحلق‪.‬‬ ‫المصدر ‪ NIH :‬أخبار في الصحة‬

‫‪80 Medical Tourism Jul. - Sep. 2017‬‬ ‫‪21‬‬

‫السياحة الطبية‬ ‫الصحة‬

‫تهدئة الحلق‬

A Complete Magazine on Healthcare in Asia

81 20

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82 Medical Tourism Jul. - Sep. 2017

‫• مرض باركنسون ‪ -‬وهو مرض تتلف‬ ‫فيه الخاليا التي تصنع مادة كيميائية‬ ‫تتحكم في حركة العضالت أو تدمرها‬

‫يحدث سلس البول الوظيفي عندما تبقي‬ ‫اإلعاقة الجسدية أو العقبات الخارجية أو‬ ‫مشاكل في التفكير أو‬

‫• السكتة الدماغية ‪ -‬وهي حالة يؤدي‬ ‫فيها انسداد أو تمزق الشريان في الدماغ‬ ‫أو الرقبة إلى قطع تدفق الدم إلى جزء‬ ‫من الدماغ وتؤدي إلى ضعف أو شلل‬ ‫أو مشاكل في الكالم أو الرؤية أو وظيفة‬ ‫المخ‬

‫التواصل شخصا من الوصول إلى مكان‬ ‫للتبول في الوقت المناسب‪.‬‬

‫سلس البول المستعجل إشارة رئيسية إلى‬ ‫المثانة المفرطة‪ .‬تحدث المثانة المفرطة‬ ‫عندما ترسل األعصاب غير الطبيعية‬ ‫إشارات إلى المثانة في وقت خاطئ مما‬ ‫يسبب عضالتها أن تضغط دون وقت‬ ‫إنذار كاف للوصول إلى المرحاض‪.‬‬

‫سلس البول الفائض‬ ‫عندما ال تفرغ المثانة بشكل صحيح‬ ‫يتسرب البول مما يسبب في سلس البول‪.‬‬ ‫يمكن أن يسبب ضعف عضالت المثانة‬

‫• بعد الصدمة مثل إصابة الجهاز البولي‬ ‫• في سن الشيخوخة‬ ‫سلس البول الوظيفي‬

‫‪83‬‬ ‫‪18‬‬

‫• اإلمساك ‪ -‬يمكن البراز الصلب في‬ ‫المستقيم أن يضغط على المثانة‬

‫ما مدى انتشار سلس البول‬ ‫لدى الرجال؟‬

‫• بعد اإلصابة العصبية في الدماغ أو‬ ‫الحبل الشوكي‬

‫‪A Complete Magazine on Healthcare in Asia‬‬

‫• السعال المزمن والذي يمكن أن يضغط‬ ‫على المثانة‬

‫• تحديد التنقل على المدى القصير‬

‫• بعد جراحة البروستاتا‬

‫الزهايمر ال يخطط للمستقبل لرحلة في‬ ‫الوقت المناسب إلى المرحاض‪ .‬قد‬ ‫يواجه رجل في كرسي متحرك صعوبة‬ ‫في الحصول على مرحاض في الوقت‬ ‫المناسب‪ .‬التهاب المفاصل ‪ -‬واأللم‬ ‫وتورم المفاصل ‪ -‬يمكن أن تجعل من‬ ‫الصعب على الرجل على المشي إلى‬ ‫الحمام بسرعة أو فتح سرواله في الوقت‬ ‫المناسب‪.‬‬

‫• استهالك الكافيين أو الكحول والذي‬ ‫يمكن أن يسبب الملء السريع للمثانة‬

‫• القصور العقلي قصير األمد الذي يقلل‬ ‫من قدرة الرجل على العناية بنفسه‬

‫سلس البول لإلجهاد ينتج عن الحركات‬ ‫التي تضغط على المثانة ويسبب في‬ ‫تسرب البول‪ ،‬مثل السعال أو العطس أو‬ ‫الضحك أو النشاط البدني‪ .‬وفي الرجال قد‬ ‫يحدث سلس البول اإلجهادي أيضا ‪:‬‬

‫التواصل شخصا من الوصول إلى مكان‬ ‫للتبول في الوقت المناسب‪ .‬على سبيل‬ ‫المثال رجل يشكو من مرض‬

‫• عدوى المسالك البولية (‪ )UTI‬والتي‬ ‫يمكن أن تهيج المثانة وتسبب في الحث‬ ‫القوي على التبول‬

‫• أدوية ضغط الدم التي يمكن أن تسبب‬ ‫زيادة إنتاج البول‬

‫سلس البول لإلجهاد‬

‫يحدث سلس البول الوظيفي عندما تبقي‬ ‫اإلعاقة الجسدية أو العقبات الخارجية أو‬ ‫مشاكل في التفكير أو‬

‫المخدرات أو الظروف المؤقتة مثل‬

‫أو مجرى البول المسدود هذا النوع من‬ ‫سلس البول‪ .‬تلف األعصاب من مرض‬ ‫السكري أو غيرها من األمراض يمكن‬ ‫أن يؤدي إلى ضعف عضالت المثانة‪.‬‬ ‫األورام والحصى البولية يمكن أن تمنع‬ ‫مجرى البول‪ .‬يضطر الرجال الذين يعانون‬ ‫من سلس البول الفائض إلى التبول في‬ ‫كثير من األحيان‪ ،‬ولكنهم يفرغون كميات‬ ‫صغيرة فقط من البول أو يقطر البول‬ ‫باستمرار‬ ‫سلس البول العابر‬ ‫سلس البول العابر هو سلس البول الذي‬ ‫يستمر لفترة قصيرة‪ .‬ويكون السلس العابر‬ ‫عادة تأثي ار جانبيا لبعض األدوية أو‬

‫يحدث سلس البول في ‪ 11‬إلى ‪ 34‬في‬ ‫المائة من كبار السن من الرجال‪ .‬ويذكر‬ ‫أن ‪ 2‬إلى ‪ 11‬في المائة من الرجال‬ ‫األكبر سنا يعانون من سلس البول اليومي‬ ‫(‪ .)1‬وعلى الرغم من أن عدد النساء‬ ‫اللواتي يصبن من سلس البول يزيد عن‬ ‫عدد الرجال إال أن فرص اإلصابة بسلس‬ ‫البول من الرجال تزيد مع تقدم العمر ألن‬ ‫احتمال إصابته بمشاكل البروستاتا أكثر‬ ‫عندما يتقدم عمرا‪ .‬ويكون الرجال أيضا‬ ‫أقل عرضة للتحدث مع أخصائي الرعاية‬ ‫الصحية حول سلس البول‪ ،‬ولذلك ربما‬ ‫يكون سلس البول في الرجال أكثر شيوعا‬ ‫بكثير مما تظهر اإلحصاءات‪ .‬القيام‬ ‫بمناقشة مع أخصائي الرعاية الصحية‬ ‫حول سلس البول هو الخطوة األولى‬ ‫إلصالح هذه المشكلة القابلة للعالج‬ ‫‪MTDesk / Women'‬‬

‫ما الذي يسبب سلس البول في الرجال؟‬ ‫يحدث سلس البول في الرجال عندما ال يشير الدماغ المثانة‬ ‫بشكل صحيح والعضلة العاصرة ال تضغط بقوة بما فيه الكفاية أو‬ ‫كليهما‪ .‬تتقلص عضالت المثانة كثي ار أو ال تكفي بسبب المشكلة‬ ‫في العضالت نفسها أو األعصاب التي تتحكم على عضالت‬ ‫المثانة‪ .‬األضرار التي لحقت بها العضلة العاصرة نفسها أو‬ ‫األعصاب المتحكمة على هذه العضالت يمكن أن يؤدي إلى‬ ‫ضعف وظيفة العضلة العاصرة‪ .‬هذه المشاكل يمكن أن تتراوح‬ ‫من البسيطة إلى المعقدة‬ ‫قد يكون للرجل العوامل التي تزيد فرص اإلصابة بسلس البول‬ ‫بما في ذلك‬ ‫• العيوب الخلقية ‪ -‬المشاكل بتطور المسالك البولية‬

‫• السعال المزمن – يزيد السعال طويل األمد من الضغط على‬ ‫عضالت المثانة وقاع الحوض‪.‬‬ ‫• المشاكل العصبية ‪ -‬الرجال الذين يعانون من األمراض أو‬ ‫الظروف التي تؤثر على الدماغ والعمود الفقري قد يكون لديهم‬ ‫صعوبة في التحكم على التبول‪.‬‬ ‫• الخمول البدني ‪ -‬انخفاض النشاط يمكن أن يزيد من وزن‬ ‫الرجل ويساهم في ضعف العضالت‬ ‫• السمنة ‪ -‬الوزن الزائد يمكن أن يضع الضغط على المثانة‬ ‫مما يسبب في الحاجة إلى التبول قبل أن تكون المثانة ممتلئة‪.‬‬ ‫• كبر السن ‪ -‬يمكن أن تضعف عضالت المثانة بمرور الزمن‬ ‫مما يؤدي إلى انخفاض في قدرة المثانة على تخزين البول‪.‬‬ ‫ما هي أنواع سلس البول في الرجال؟‬ ‫تشمل أنواع سلس البول في الرجال‪:‬‬ ‫• سلس البول المستعجل‬ ‫• سلس البول لسبب اإلجهاد‬ ‫• سلس البول الوظيفي‬ ‫• سلس البول الفائض‬ ‫• سلس البول العابر‬ ‫سلس البول المستعجل‬ ‫يحدث سلس البول المستعجل عندما يتبول رجل ال إراديا بعد‬ ‫أن كانت لديه رغبة قوية أو المستعجلة للتبول‪ .‬تقلصات المثانة‬ ‫غير الطوعية هي سبب شائع لسلس البول المستعجل‪ .‬قد تسبب‬ ‫إشارات األعصاب غير الطبيعية هذه التقلصات للمثانة‪.‬‬

‫• يمكن أن يؤدي تاريخ اإلصابة بسرطان البروستاتا ‪ -‬الجراحة‬ ‫أو العالج اإلشعاعي لسرطان البروستاتا إلى سلس البول المؤقت‬ ‫أو الدائم لدى الرجال‬ ‫ال يكون سلس البول مرضا‪ .‬بدال من ذلك يمكن أن يكون أحد‬ ‫أعراض بعض الظروف أو نتيجة أحداث معينة خالل حياة‬ ‫الرجل‪ .‬والظروف أو األحداث التي قد تزيد من فرصة رجل‬ ‫لإلصابة بسلس البول تشمل‪:‬‬ ‫• تضخم البروستاتا الحميد (‪ -)BPH‬وهي الحالة التي يتم فيها‬ ‫تكبير البروستاتا ولكن ليست سرطانا‪ .‬في الرجال الذين يعانون‬ ‫من تضخم البروستاتا تضغط البروستاتا وتضيق مجرى البول‪.‬‬ ‫ويصبح جدار المثانة أكثر سميكا‪ .‬وأخي ار قد تضعف المثانة وتفقد‬ ‫القدرة على اإلفراغ ويترك بعض البول في المثانة‪ .‬يمكن أن‬ ‫يؤدي تضييق مجرى البول والتفريغ غير الكامل للمثانة إلى سلس‬ ‫البول‪.‬‬

‫وتشمل المشغالت للرجال المصابين بسلس البول المستعجل‬ ‫شرب كمية صغيرة من الماء أو لمس المياه أو سماع المياه‬ ‫الجارية أو البقاء في بيئة باردة ‪ -‬ولو لفترة قصيرة فقط ‪ -‬مثل‬ ‫الوصول إلى الثالجة في محل البقالة‪ .‬يمكن أن يجعل القلق‬ ‫أو بعض السوائل أو األدوية أو الظروف الطبية سلس البول‬ ‫المستعجل أسوأ‪.‬‬ ‫يمكن أن تضر الظروف التالية الحبل الشوكي والدماغ وأعصاب‬ ‫المثانة أو العضلة العاصرة العصبية أو يمكن أن تسبب تقلصات‬ ‫المثانة غير الطوعية مما يؤدي إلى سلس البول المستعجل‪:‬‬ ‫• مرض الزهايمر ‪ -‬وهو اضطراب يؤثر على أجزاء الدماغ‬ ‫التي تتحكم في الفكرة والذاكرة واللغة‬ ‫• إصابة الدماغ أو الحبل الشوكي الذي يقاطع إشارات‬ ‫األعصاب من إو�لى المثانة‬

‫• التصلب المتعدد ‪ -‬وهو مرض يدمر المواد التي تحيط وتحمي‬ ‫الخاليا العصبية مما يبطئ أو يحد من الرسائل بين الدماغ‬ ‫والجسم‬ ‫‪84 Medical Tourism Jul. - Sep. 2017‬‬ ‫‪17‬‬

‫يمكن أن يكون سلس البول المستعجل‬ ‫مزعجا قليال أو منهكا تماما‪ .‬وبالنسبة‬ ‫لبعض الرجال فإن فرصة اإلحراج‬ ‫تحرمهم من التمتع بالعديد من األنشطة‪،‬‬ ‫بما في ذلك ممارسة الرياضة وتسبب‬ ‫الضائقة العاطفية‪ .‬وعندما يكون الناس‬ ‫غير نشطين يزيد من فرصهم في إصابة‬ ‫مشاكل صحية أخرى‪ ،‬مثل السمنة‬ ‫والسكري‪.‬‬ ‫ما هو المسالك البولية وكيف‬ ‫تعمل؟‬ ‫المسالك البولية هي نظام الصرف في‬ ‫الجسم إلزالة البول والذي يتكون من‬ ‫النفايات والسائل اإلضافي‪ .‬ومن أجل‬ ‫حدوث التبول الطبيعي ال بد أن تعمل‬ ‫جميع األجزاء في المسالك البولية معا في‬ ‫الترتيب الصحيح‪.‬‬ ‫الكلى‪ .‬الكلى هما الجهازان على شكل‬ ‫الفول كل عن حجم قبضة تقريبا‪ .‬وهي‬ ‫تقع مباشرة تحت القفص الصدري واحد‬ ‫على كل جانب من العمود الفقري‪ .‬وتقوم‬ ‫الكلى بتصفية حوالي ‪ 120‬إلى ‪150‬‬ ‫كوارت من الدم كل يوم إلنتاج حوالي‬ ‫‪ 1-2‬كوارت من البول‪ .‬تعمل الكلى على‬ ‫مدار الساعة والشخص ال يسيطر على‬ ‫ما تفعله‪.‬‬ ‫الحالب‪ .‬الحالب هي أنابيب رقيقة من‬ ‫العضالت واحد على كل جانب من‬ ‫المثانة التي تحمل البول من كلتي الكلى‬ ‫إلى المثانة‬ ‫المثانة‪ .‬المثانة التي تقع في الحوض‬ ‫بين عظام الحوض هي الجهاز الجوفاء‬ ‫العضلية على شكل بالون والتي تتوسع‬ ‫كما تمأل بالبول‪ .‬وعلى الرغم من أن‬ ‫الشخص ال يتحكم على وظائف الكلى‬ ‫فإن شخصا ال يتحكم عندما يفرغ المثانة‪.‬‬ ‫ويعرف إفراغ المثانة بالتبول‪ .‬وتخزن‬ ‫المثانة البول حتى يجد الشخص الوقت‬ ‫والمكان المناسبين للتبول‪ .‬وتتصرف‬ ‫المثانة العادية مثل خزان ويمكن أن‬ ‫تحتوي على ‪ 1.5-2‬كوبا من البول‪ .‬كم‬ ‫مرة يحتاج الشخص إلى التبول يعتمد‬ ‫على مدى سرعة الكلى في إنتاج البول‬ ‫الذي يمأل المثانة‪ .‬تبقى عضالت جدار‬ ‫المثانة مريحة بينما تمأل المثانة بالبول‪.‬‬ ‫عندما تمأل المثانة إلى السعة تخبر‬ ‫‪85‬‬ ‫‪16‬‬

‫‪A Complete Magazine on Healthcare in Asia‬‬

‫اإلشارات التي ترسل إلى الدماغ للشخص‬ ‫أن يجد مرحاضا قريبا‪ .‬أثناء التبول تفرغ‬ ‫المثانة من خالل مجرى البول التي تقع‬ ‫في الجزء السفلي من المثانة‪.‬‬ ‫تعمل ثالث مجموعات من العضالت معا‬ ‫مثل السد تحافظ على البول في المثانة‬ ‫بين الخطى إلى الحمام‪.‬‬ ‫المجموعة األولى هي عضالت مجرى‬ ‫البول نفسها‪ .‬المنطقة التي ينضم فيها‬ ‫مجرى البول المثانة هي رقبة المثانة‪.‬‬ ‫ورقبة المثانة التي تتألف من المجموعة‬ ‫الثانية من العضالت المعروفة باسم‬ ‫العضلة العاصرة الداخلية تساعد البول‬ ‫على البقاء في المثانة‪ .‬المجموعة الثالثة‬ ‫من العضالت هي عضالت قاع الحوض‬ ‫ويشار إليها أيضا باسم العضلة العاصرة‬ ‫الخارجية والتي تحيط وتدعم مجرى البول‪.‬‬

‫وللتبول يشير الدماغ إلى عضالت‬ ‫جدار المثانة للتشديد تضغط البول من‬ ‫المثانة‪ .‬وفي الوقت نفسه يشير الدماغ‬ ‫إلى العضلة العاصرة لالسترخاء‪ .‬وعند‬ ‫استرخاء ا العضلة العاصرة يخرج البول‬ ‫من المثانة عن طريق مجرى البول‪.‬‬ ‫ما هي البروستاتا؟‬ ‫البروستاتا هي الغدة على شكل الجوز‬ ‫التي هي جزء من الجهاز التناسلي‬ ‫للذكور‪ .‬البروستاتا لديه اثنان أو أكثر من‬ ‫فصوص أو أقسام محاطة بطبقة خارجية‬ ‫من األنسجة‪ .‬تقع أمام المستقيم وتحت‬ ‫المثانة مباشرة‪ ،‬وتحيط البروستاتا مجرى‬ ‫البول في عنق المثانة وتزود السوائل التي‬ ‫تذهب إلى السائل المنوي‬

86 Medical Tourism Jul. - Sep. 2017 15

‫السياحة الطبية‬ ‫صحة المرأة‬

‫مشاكل‬ ‫التحكم على‬ ‫المثانة في‬ ‫الرجال‬ ‫سلس البول (مشاكل التحكم على المثانة)‬ ‫هو فقدان التحكم على المثانة مما يؤدى إلى‬ ‫تسرب عرضي للبول من الجسم‪ .‬على سبيل‬ ‫المثال قد يشعر رجل حاجة قوية ومفاجئة أو‬ ‫مستعجلة للتبول قبل فقدان كمية كبيرة من‬ ‫‪.‬البول ويسمى هذا سلس البول المستعجل‬

‫‪87‬‬ ‫‪14‬‬

‫‪A Complete Magazine on Healthcare in Asia‬‬

‫فيوتشر إنسايت‬

‫شارب سايت‬ ‫)مجموعة مستشفيات العيون(‬

‫تقوم بتوفير خدمات العناية بالعيون‬ ‫مستوى عالمي‬ ‫•‬ ‫•‬ ‫•‬ ‫•‬






‫أكثر من ‪ 1‬مليون مريض سعيد‬ ‫مزودة بأحدث لتكنولوجيا‬ ‫العناية بالعيون الشاملة بتكلفة معقولة تحت سقف واحد‬ ‫أطباء العيون ذوي المهارات العالية المدربون‬ ‫من المؤسسات العريقة‬

‫نحن نقدم‬ ‫• جراحة الساد الروبوتية فيمتو • السيك فيمتو خالية من الشفرة‬ ‫و الجسم الزجاجي الشبكية • القرنية • الزرق • الحول وطب عيون األطفال‬ ‫ت• الجراحة التعويضية للعيون • العين االصطناعية • معينات البصر المنخفضة • البصرية والصيدلة‬ ‫شارب سايت‪ :‬أ – ‪ ،15‬سواستيا فيهار‪ ،‬مقابل عمود ميترو رقم ‪ ٫82‬فيكاس مارغ‪ ،‬بريت فيهار‪ ،‬دلهي‬ ‫خط المساعدة ‪ ،011 – 30051818 :‬الجوال‪9582211755 :‬‬ ‫المراكز لدينا ‪ -‬دلهي الشرقية ‪ :‬سواستيا فيهار | شهدا ار | غمري وسط دلهي‪ :‬طريق بو از | جنوب دلهي‪ :‬يستيند (شانتي نيكيتان)‬ ‫الوالية الشمالية‪ :‬خوج ار | إيندرابورم | لوني | جمو كشمير‪ :‬سريناغار | نيجيريا‪ :‬بنين | تجكستان‪ :‬دوشانديه‬ ‫‪ |‬‬ ‫‪24 Medical Tourism Jan - Mar 2017‬‬ ‫‪88 Medical Tourism Jul. - Sep. 2017‬‬

‫كيف يساعد االستشارة في عالج اضطرابات القلق؟‬ ‫يقوم طبيبكم بإحالتكم للحصول على نوع من المشورة الضطرابات‬ ‫القلق يسمى العالج السلوكي المعرفي (‪ .)CBT‬يمكنكم التحدث‬ ‫إلى أخصائي الصحة النفسية المدرب حول ما تسبب اضطراب‬ ‫القلق وكيفية التعامل مع األعراض‬ ‫على سبيل المثال‪ ،‬يمكنكم التحدث إلى طبيب نفسي أو إخصائي‬ ‫نفسي أو أخصائي اجتماعي أو مستشار‪ .‬يمكن أن تساعدكم‬ ‫(‪ )CBT‬على تغيير أنماط التفكير حول المخاوف الخاصة بكم‪.‬‬ ‫وتساعدكم على تغيير الطريقة التي تتفاعل مع الحاالت التي قد‬ ‫تثير القلق‪ .‬وأنتم تتعلمون أيضا الطرق للحد من مشاعر القلق‬ ‫وتحسين السلوكيات المحددة الناجمة عن القلق المزمن‪ .‬قد تشمل‬ ‫هذه االستراتيجيات العالج االسترخاء وحل المشاكل‪.‬‬ ‫هل يمكن أن يساعد الطب التكميلي أو البديل‬ ‫في عالج اضطرابات القلق؟‬ ‫ممكن‪ .‬تقول بعض النساء إن عالجات الطب التكميلي أو البديل‬ ‫(‪ )CAM‬ساعدت على تقليل قلقهن‪.‬‬ ‫عالجات (‪ )CAM‬التي قد تساعد القلق ما يلي‪:‬‬ ‫• النشاط البدني‪ .‬النشاط البدني المنتظم يرفع مستوى المواد‬ ‫الكيميائية في الدماغ التي تتحكم في المزاج وتؤثر على القلق‬ ‫واالكتئاب (‪ .)9‬وتظهر العديد من الدراسات أن جميع أنواع‬ ‫النشاطات البدنية بما في ذلك اليوغا وتاي تشي‪ ،‬تساعد على‬ ‫الحد من القلق (‪)10‬‬ ‫• التأمل‪ .‬تظهر الدراسات أن التأمل قد يحسن القلق (‪.)11‬‬ ‫ويساعد التأمل المنتظم عن طريق تعزيز النشاط في منطقة‬ ‫دماغكم المسؤولة عن مشاعر الصفاء والفرح‬ ‫كيف تؤثر اضطرابات القلق على ظروف صحية‬ ‫أخرى؟‬ ‫قد تؤثر اضطرابات القلق على المشاكل الصحية األخرى الشائعة‬ ‫في النساء‪ .‬وتشمل هذه‪:‬‬ ‫• اإلكتئاب‪ .‬يمكن أن تحدث اضطرابات القلق في نفس وقت‬ ‫االكتئاب‪ .‬وعندما يحدث ذلك ال يكون العالج لكل من القلق‬ ‫واالكتئاب فعاال‪ .‬فقد تحتاج إلى مجموعة من العالجات مثل‬ ‫المشورة والطب‪.‬‬ ‫• متالزمة القولون العصبي (‪ .)IBS‬أعراض القولون العصبي‬ ‫شائعة في األشخاص الذين يعانون من اضطرابات القلق‪.‬‬ ‫واضطراب القلق العام هو أيضا شائع بين الناس الذين يعانون‬ ‫من ‪ )IBS (12‬يمكن أن يجعل القلق أعراض القولون العصبي‬ ‫أسوأ‪ ،‬وخاصة أعراض الجهاز الهضمي (‪ )GI‬مثل ضيق المعدة‬ ‫أو الغاز‪ .‬يمكن أيضا أن تكون أعراض ‪ GI‬مرهقة وتؤدي إلى‬ ‫مزيد من القلق‪ .‬على الرغم من أن عالجات القولون العصبي‬ ‫يمكن أن تساعد في عالج القلق‪ ،‬فمن المهم أن تعالج كلتا‬ ‫الحالتين ‪13‬‬ ‫• األلم المزمن‪ .‬اضطرابات القلق شائعة في النساء مع بعض‬ ‫‪89‬‬ ‫‪12‬‬

‫‪A Complete Magazine on Healthcare in Asia‬‬

‫األمراض التي تسبب األلم المزمن بما في ذلك التهاب المفاصل‬ ‫الروماتويدي وفيبروميالغيا والصداع النصفي‪.‬‬ ‫• أمراض القلب واألوعية الدموية‪ .‬القلق واالكتئاب يزيد من‬ ‫خطر اإلصابة بأمراض القلب‪ ،‬وهو السبب الرئيسي للوفاة بين‬ ‫المرأة األمريكية‪ .‬يمكن أيضا أن يجعل القلق االنتعاش أصعب‬ ‫بعد نوبة قلبية أو سكتة دماغية‪.‬‬ ‫داء الربو‪ .‬تربط الدراسات داء الربو مع اضطرابات‬ ‫• ‬ ‫القلق‪ .‬يمكن أن يؤدي التوتر والقلق إلى نوبات الربو في حين أن‬ ‫الضيق في التنفس والصفير أثناء نوبات الربو يمكن أن يسبب‬ ‫القلق‪ .‬وتظهر الدراسات أن إعادة تدريب التنفس قد تساعد على‬ ‫التحكم بالربو وتخفف من القلق (‪)14‬‬ ‫ما هي أحدث البحوث عن اضطرابات القلق‬ ‫والنساء؟‬ ‫الباحثون يدرسون لماذا تكون النساء أكثر من ضعف احتمال‬ ‫الرجال لإلصابة باضطرابات القلق واالكتئاب‪ .‬التغيرات في‬ ‫مستويات هرمون االستروجين طوال الدورة الشهرية للمرأة والحياة‬ ‫اإلنجابية (خالل السنوات التي يمكن للمرأة أن يكون لها طفل)‬ ‫ربما تلعب دورا‪.‬‬ ‫كما درس الباحثون مؤخ ار عن الهرمون الذكري تستوستيرون الذي‬ ‫يوجد في النساء والرجال ولكن عادة في مستويات أعلى لدى‬ ‫الرجال‪ .‬ووجد الباحثون أنه كان للعالج بالهرمون تستوستيرون‬ ‫آثار مماثلة مثل مضادات القلق ومضادات االكتئاب للنساء في‬ ‫الدراسة‪.‬‬

‫ما هي األنواع الرئيسية من اضطراب القلق؟‬ ‫األنواع الرئيسية من اضطراب القلق هي‪:‬‬ ‫• اضطراب القلق العام (‪ . )GAD‬الناس المصابون بـ ‪GAD‬‬ ‫يقلقون بشكل مفرط حول القضايا العادية في الحياة اليومية مثل‬ ‫الصحة والمال والعمل واألسرة‪ .‬وفي حالة ‪ GAD‬يقفز العقل‬ ‫غالبا ما إلى أسوأ السيناريوهات حتى عندما يكون هناك القليل‬ ‫أو ال يوجد سبب للقلق‪ .‬النساء بـ ‪ GAD‬قد تكون قلقة حول‬ ‫مجرد قضاء اليوم‪ .‬قد يكون لديهن توتر العضالت وغيرها من‬ ‫األعراض الجسدية المرتبطة باإلجهاد مثل اضطرابات النوم‬ ‫أو اضطراب في المعدة‪ .‬وفي بعض األحيان إن القلق لدى‬ ‫األشخاص الذين يعانون من ‪ GAD‬يشغلهم عن القيام بالمهام‬ ‫اليومية‪ .‬النساء بـ ‪ GAD‬لديهن خطر أعلى من االكتئاب‬ ‫واضطرابات القلق األخرى من الرجال بـ ‪ .GAD‬كما تكون أكثر‬ ‫عرضة لتاريخ عائلي من االكتئاب‬ ‫• اضطراب الذعر‪ .‬اضطرابات الذعر شائعة مرتين في النساء‬ ‫كما هو الحال لدى الرجال (‪ .)4‬ويواجه األشخاص الذين‬ ‫يعانون من اضطرابات الذعر هجمات الرعب المفاجئة عندما‬ ‫ال يكون هناك خطر فعلي‪ .‬فهجمات الذعر قد تسبب الشعور‬ ‫بعدم الواقعية والخوف من الوفاة الوشیکة أو الخوف من فقدان‬ ‫السیطرة‪ .‬والخوف من األعراض الجسدية غير المبررة للشخص‬ ‫نفسه هو أيضا عالمة الضطراب الذعر‪ .‬والناس الذين يعانون‬ ‫من نوبات الذعر يعتقدون في بعض األحيان أنهم يعانون من‬ ‫نوبات قلبية وفقدان عقولهم أو الموت‪.‬‬ ‫• الرهاب االجتماعي‪ .‬الرهاب االجتماعي ويسمى أيضا اضطراب‬ ‫القلق االجتماعي يتم تشخيصه عندما يصبح الناس قلقين جدا‬ ‫وواعيين بالنفس في المواقف االجتماعية اليومية‪ .‬والناس الذين‬ ‫يعانون من الرهاب االجتماعي لديهم خوف قوي من أن اآلخرين‬ ‫يشاهدونهم ويحكمون عليهم‪ .‬وهم يشعرون بالحرج بسهولة وغالبا‬ ‫ما يكون لديهم أعراض هجوم الذعر‬

‫ما هي عالمات وأعراض اضطراب القلق؟‬ ‫تعاني النساء المصابات باضطرابات القلق من مزيج من األفكار‬ ‫أو المعتقدات القلقة واألعراض الجسدية والتغيرات في السلوك‬ ‫بما في ذلك تجنب األنشطة اليومية التي اعتادوا القيام بها‪ .‬ولكل‬ ‫اضطراب القلق أعراض مختلفة‪ .‬وكلها تنطوي على الخوف‬ ‫والفزع من األشياء التي قد تحدث اآلن أو في المستقبل‪.‬‬ ‫قد تشمل األعراض الجسدية ما يلي‪:‬‬ ‫• الضعف‬ ‫• الضيق في التنفس‬ ‫• معدل ضربات القلب السريع‬ ‫• الغثيان‬ ‫• معده مضطربه‬ ‫• الهبات الساخنة‬ ‫• دوخة‬ ‫األعراض الجسدية لالضطرابات القلق غالبا ما يحدث جنبا إلى‬ ‫جنب مع غيرها من األمراض النفسية أو الجسدية‪ .‬هذا يمكن أن‬ ‫تغطي أعراض القلق الخاصة بكم أو تجعلها أسوأ‬ ‫كيف يتم عالج اضطرابات القلق؟‬ ‫عالج اضطرابات القلق يعتمد على نوع من اضطراب القلق‬ ‫لديكم وتاريخكم الشخصي من المشاكل الصحية والعنف أو سوء‬ ‫المعاملة‪.‬‬ ‫في كثير من األحيان قد تشمل العالج‪:‬‬ ‫• االستشارة (تسمى العالج النفسي)‬ ‫• الدواء‬ ‫• مزيج من المشورة والدواء‬

‫• الرهاب المحدد‪ .‬الرهاب المحدد هو خوف شديد من شيء‬ ‫يطرح القليل أو ال يوجد خطر حقيقي‪ .‬ويكون الرهاب المحدد‬ ‫المخاوف من األماكن المغلقة أو المرتفعات أو المياه أو األشياء‬ ‫أو الحيوانات أو الحاالت المحددة‪ .‬الناس الذين يعانون من‬ ‫الرهاب المحدد غالبا ما يجدون أن المواجهة أو حتى التفكير في‬ ‫المواجهة لألشياء أو المواقف المخوفة يجلب على هجوم الذعر‬ ‫أو القلق الشديد‪.‬‬ ‫ما الذي يسبب اضطرابات القلق؟‬ ‫يعتقد الباحثون أن اضطرابات القلق هي ناجمة عن مجموعة من‬ ‫العوامل‪ ،‬والتي قد تشمل‪:‬‬ ‫• التغيرات الهرمونية خالل الدورة الشهرية‬ ‫• الوراثة‪ .‬اضطرابات القلق قد تعمل في األسر‪.‬‬ ‫• األحداث الصادمة‪ .‬إن التعرض لإلساءة أو االعتداء أو‬ ‫االعتداء الجنسي يمكن أن يؤدي إلى مشاكل صحية خطيرة‪ ،‬بما‬ ‫في ذلك القلق واضطراب ما بعد الصدمة واالكتئاب‪.‬‬ ‫‪90 Medical Tourism Jul. - Sep. 2017‬‬

‫السياحة الطبية‬ ‫صحة المرأة‬

‫كيف يؤثر‬ ‫القلق على‬ ‫حياتكم اليومية‬ ‫القلق هو استجابة طبيعية لإلجهاد‪.‬‬ ‫ولكن عندما يصبح السيطرة عليه‬ ‫من الصعب ويؤثر على حياتكم‬ ‫اليومية يمكن أن يكون تعطيال‪.‬‬ ‫تكون النساء أكثر من ضعف احتمال‬ ‫الحصول مثل الرجال على اضطراب‬ ‫القلق في حياتهم‪ ]2[ .‬غالبا ما يعالج‬ ‫اضطرابات القلق باإلرشاد أو الطب‬ ‫أو مزيج من االثنين معا‪ .‬كما توجد‬ ‫في شأن بعض النساء أن اليوغا أو‬ ‫التأمل يساعد في حالة اضطرابات‬ ‫‪.‬القلق‬ ‫‪91‬‬ ‫‪10‬‬

‫‪A Complete Magazine on Healthcare in Asia‬‬

‫القلق هو الشعور بالهم والعصبية أو الخوف حول الحدث أو‬ ‫الوضع‪ .‬بل هو رد فعل طبيعي لإلجهاد‪ .‬وانه يساعدكم على‬ ‫البقاء في حالة تأهب لحالة صعبة في العمل‪ ،‬ودراسة أكثر شاقة‬ ‫لالمتحان‪ ،‬أو ال تزال تركز على خطاب هام‪ .‬وبشكل عام فإنه‬ ‫يساعدكم على التعامل‬ ‫ولكن يمكن أن يكون تعطيال إذا كان يتداخل مع الحياة اليومية‪،‬‬ ‫مثل الفزع من األنشطة اليومية مثل ركوب الحافلة أو التحدث‬ ‫مع زميل في العمل‪ .‬ويمكن أن يكون القلق أيضا هجوما مفاجئا‬ ‫من الرعب عندما ال يكون هناك تهديد‬ ‫ما هي اضطرابات القلق؟‬ ‫تحدث اضطرابات القلق عندما يتداخل القلق المفرط مع األنشطة‬ ‫اليومية مثل الذهاب إلى العمل أو المدرسة أو قضاء بعض‬ ‫الوقت مع األصدقاء أو العائلة‪ .‬إن اضطرابات القلق أمراض‬ ‫نفسية خطيرة‪ .‬وهي االضطرابات النفسية األكثر شيوعا في‬ ‫الواليات المتحدة‪ .‬وتوجد اضطرابات القلق شائعة أكثر من مرتين‬ ‫في النساء مما هو الحال في الرجال‬

‫فوائد سياحة طب األسنان‬ ‫إن العالج لمشاكل األسنان في البلدان الغربية مكلف جدا‪ .‬ومن ثم‬ ‫هو موفر عظيم للمال‪ .‬وتشمل الصفقات المقدمة األطعمة والسكن‬ ‫والسفر‪.‬‬ ‫تكون الخدمات عالية الجودة رخيصة ولكن هذا ال يعني أن‬ ‫الخدمات هي أدنى‪ .‬واألطباء مؤهلون تأهيال عاليا ومدربون‪ .‬إن‬ ‫البنية التحتية والمعدات والمرافق على قدم المساواة مع المعايير‬ ‫الدولية‪ .‬وفوق كل شيء تتوفر خدمات الموظفين الطبيين الناطقين‬ ‫باللغة اإلنجليزية دائما‬

‫حاصالت الميزة‬ ‫بدون انتظار أو تأخير في الحصول على العالج المطلوب‪ .‬يمكن‬ ‫للمريض أن يأمل في الحصول على خدمة فورية‪.‬‬ ‫الوسائل الراحة الممتازة‬ ‫عروض األسعار الشاملة للعالج والعطالت‬ ‫فرص السفر‬ ‫وهناك أيضا فرص كبيرة للسفر ألولئك الذين يحبون الذهاب إلى‬ ‫أماكن الستكشاف جمال الهند وثقافتها‪ .‬هناك العديد من المواقع‬ ‫المثيرة‪ :‬شواطئ غوا المشمسة ‪ ،‬القصور الجميلة من راجاستان‪،‬‬ ‫المياه الخلفية الساحرة من والية كيراال ‪ ،‬تاج محل المبدع‪ ،‬بعضها‬ ‫على سبيل المثال‪ .‬السفر داخل الهند رخيص‪ .‬تذاكر الطيران‬ ‫المحلية منخفضة التكلفة بشكل مدهش مما يجعل تمديد العطلة‬ ‫جذابا جدا وبأسعار معقولة‪.‬‬ ‫‪92 Medical Tourism Jul. - Sep. 2017‬‬ ‫‪9‬‬

‫ميزة الهند‬ ‫• أصبحت الرعاية الصحية الفموية الشاملة في الهند مقبولة‬ ‫اآلن على الصعيد العالمي بسبب توافر مقدمي رعاية طب‬ ‫األسنان المؤهلين تأهيال عاليا في معظم المدن الكبرى‪.‬‬ ‫• ويوجد هنا العديد من عيادات طب األسنان الحديثة التي تقدم‬ ‫خدمات طب األسنان عالية الكفاءة التي يحتاج إليها المرضى‪.‬‬ ‫• تقدم رعاية طب األسنان في الهند وفورات كبيرة في التكاليف‬ ‫للمرضى من الخارج مقارنة مع العالج في الوطن‪ .‬وتقل التكلفة‬ ‫في الهند بنسبة ‪ 70‬في المائة عما هو متاح في أماكن أخرى من‬ ‫العالم‪.‬‬ ‫• المستشفيات المتخصصة الهندية مجهزة تجهي از جيدا بأحدث‬ ‫التقنيات لجميع أنواع الرعاية الطبية لألسنان‪.‬‬ ‫لماذا تكون سياحة طب األسنان جذابة؟‬ ‫•‬ ‫•‬ ‫•‬ ‫•‬ ‫•‬

‫الوصول إلى أحدث المرافق الطبية‬ ‫الطاقم الطبي يتحدث االنجليزية‬ ‫وفورات كبيرة على الرعاية الصحية‬ ‫بدون وقت االنتظار للحصول على العالج‬ ‫خدمة عالية الجودة التي تتبع بروتوكوالت من الطراز العالمي‬

‫لماذا تكون سياحة طب األسنان جذابة؟‬ ‫•‬ ‫•‬ ‫•‬ ‫•‬ ‫•‬

‫الوصول إلى أحدث المرافق الطبية‬ ‫الطاقم الطبي يتحدث االنجليزية‬ ‫وفورات كبيرة على الرعاية الصحية‬ ‫بدون وقت االنتظار للحصول على العالج‬ ‫خدمة عالية الجودة التي تتبع بروتوكوالت من الطراز العالمي‬

‫الخدمات المتاحة‬ ‫مسح األسنان داخل الفم‬ ‫استخراج األسنان العادية ‪ /‬المكسورة تحت التخدير الموضعي‬ ‫استخراج أسنان الحكمة المتضررة‬ ‫قبعات السيراميك دون الذهب تحت التحكم المجهري‬ ‫جراحة الفك العلوي‬ ‫جسور األسنان‪ ،‬تيجان الخزف ‪ /‬السيراميك‬ ‫تبيض‬ ‫الجراحة الترقيعية على الزرع ‪ /‬زراعة األسنان‬ ‫تطعيم العظام العمودي واألفقي‬ ‫تطعيم اللثة ‪ /‬عالج اللثة‬ ‫تقويم األسنان الحنكي‬ ‫عالجات الفلورايد لألطفال‬ ‫طب األسنان التجميلي‬ ‫تصميم االبتسامة‬ ‫قناة الجذر‬ ‫تبييض األسنان‬ ‫تكفيف األسنان إو�عادة التشكيل‬ ‫حشوات األسنان‬

‫خيارات الوجهة‬ ‫األماكن الرئيسية حيث تقع مرافق الجودة لصحة األسنان‪ :‬مومباي وحيدرأباد وكيراال ودلهي وبونيه وغوا وبنغلور وناغبور وجايبور‬ ‫وتشناي وغورغاون وشانديغار‬

‫‪93‬‬ ‫‪8‬‬

‫‪A Complete Magazine on Healthcare in Asia‬‬

‫والقشرة والحشوات والتيجان وجسور األسنان وزراعة األسنان‬ ‫ورعاية تقويم األسنان الخ‪.‬‬ ‫على سبيل المثال فإن تكلفة عالج قناة الجذر في الهند تتراوح‬ ‫بين ‪ 100‬و ‪ 200‬دوالر‪ ،‬بينما تصل في الواليات المتحدة إلى‬ ‫‪ 3000‬دوالر‪ .‬تكاليف حشو األسنان تكون بين ‪ 20‬و ‪ 40‬دوال ار‬ ‫في الهند بينما تكون في الواليات المتحدة ما بين ‪ 300‬و ‪400‬‬ ‫دوالر‪ .‬إو�ن زراعة األسنان في الواليات المتحدة تكلف حوالي‬ ‫‪ 4000‬دوالر وفي المملكة المتحدة ‪ 3,500‬دوالر واألسعار‬ ‫يمكن أن تكون منخفضة تصل إلى ‪ 750‬دوالر في الهند ويمكن‬ ‫للمريض أن يتوقع أيضا خدمات أفضل‪.‬‬ ‫وبالنسبة للسائحين الغربيين على وجه الخصوص فإن مستوى‬ ‫الراحة الذي يحصلون عليه مرتفع جدا ألسباب مثل توافر األطباء‬ ‫الناطقين باللغة اإلنجليزية والمسعفين الطبيين ووقت االنتظار‬ ‫القصير في عيادات األسنان التي تتبع أيضا المعايير الدولية في‬ ‫بروتوكوالت التطهير‬

‫الحضارة‪ .‬إو�ن زيادة الفرص التجارية وتحسين البنية التحتية‬ ‫للطرق والطيران ومجموعة واسعة من مرافق الفنادق تشجع الزوار‬ ‫األجانب على السعي للحصول على جودة متخصصة وعالج‬ ‫فعال من حيث التكلفة لعالج األسنان في الهند‪ .‬وتجدر اإلشارة‬ ‫إلى أن معظم المرضى األجانب يجمعون عالج األسنان مع‬ ‫عطلة عائلية‬ ‫وتذكر بعض التقديرات أن سياحة طب األسنان من المتوقع أن‬ ‫تنمو إلى ما فوق ‪ 30٪‬من إجمالي السياحة الطبية الهندية‪،‬‬ ‫وذلك بفضل الخدمات الصحية الفموية بأسعار معقولة متوفرة من‬ ‫المهنيين المؤهلين تأهيال عاليا وذوي الخبرة‪.‬‬

‫سياحة طب األسنان هي جوهرة التاج‪.‬‬

‫ومن الحقائق التي ال جدال فيها أن السياح يتدفقون إلى الهند‬ ‫مسحوبين إلى مشاهدها التي ال تصدق و ‪ 5000‬سنة من‬ ‫‪94 Medical Tourism Jul. - Sep. 2017‬‬ ‫‪7‬‬

‫سياحة طب‬


‫الهند "‪ :‬جوهرة التاج‬ ‫بقلم‪ :‬تي كيه في ماني‬

‫الهند هي ناشئة بسرعة باعتبارها واحدة من أكثر المناطق المرغوبة كالوجهة‬ ‫للسياحة في الرعاية الصحية‪ .‬ومن العوامل التي تدفع هذه الزيادة في االهتمام هي‬ ‫‪.‬خدمات طب األسنان ذات المستوى العالمي الفعالة من حيث التكلفة‬ ‫وقد أظهرت الدراسات أنه في السنوات األخيرة قد زاد عدد السياح‬ ‫في الخارج الذين يسعون لعالج األسنان في الهند‪ .‬وهم يزورون‬ ‫الوجهات السياحية التي ال تصدق في البالد بعد العالج أو قبله‪.‬‬ ‫وقد ازداد عدد المرضى األجانب الذين يسافرون إلى الهند‬ ‫عدة مرات على مر السنين مقارنة بالبلدان األخرى في المنطقة‬ ‫اآلسيوية‪ .‬وهم يأتون من الواليات المتحدة وأوروبا والشرق األوسط‬ ‫وأفريقيا والبلدان المجاورة للهند‪.‬‬ ‫يبحث معظم السياح من الخارج وحتى السياح المحليين عن ربط‬ ‫رحالتهم لتلبية متطلبات الرعاية الصحية مغرين بنوعية الخدمات‬ ‫الطبية والبنية التحتية المتاحة في جميع أنحاء البالد‪ ، .‬يكون‬ ‫الزوار مجتذبين أيضا من الخدمات المختصة والمهنية التي‬ ‫يقدمها أطباء األسنان الهنديين إلى جانب انخفاض النفقات‬ ‫وقد أظهرت الدراسات أن الهند أصبحت الوجهة المفضلة لسياحة‬ ‫طب األسنان‪ .‬تكون تقنياتها الطبية على قدم المساواة مع الدول‬ ‫المتقدمة مثل الواليات المتحدة‪ .‬وفي الهند هناك بعض من أفضل‬ ‫مراكز الرعاية الصحية الفموية في العالم مع المرافق المعتمدة‬ ‫عالميا‪ .‬وتبين أبحاث السوق أنه باإلضافة إلى رسوم التذاكر‬ ‫‪95‬‬ ‫‪6‬‬

‫‪A Complete Magazine on Healthcare in Asia‬‬

‫تكون تكلفة عالج األسنان اقتصادية‪ .‬إو�ن جودة الخدمات غالبا‬ ‫ما تكون أفضل مما هي في العالم الغربي‪.‬‬ ‫ويقول الخبراء ان اهم محاور سياحة طب االسنان تشمل المدن‬ ‫مثل مومباي ودلهى وتشيناي وجايبور وشانديغار والواليات مثل‬ ‫كيراال وغوا‪ .‬تقدم العيادات هناك خبراء األسنان المدربين وأحدث‬ ‫تقنيات طب األسنان والمرافق ذات المستوى العالمي‪.‬‬ ‫تعتبر الهند وجهة رائعة لسياحة طب األسنان كما أن لديها خزان‬ ‫ضخم من المهنيين ذوي الخبرة في مجال طب األسنان ذوي‬ ‫الخبرة العالية وعيادات األسنان الجيدة جدا‪ .‬وهي متصلة بشكل‬ ‫جيد من قبل الرحالت الدولية وتكون االتصاالت المحلية أيضا‬ ‫جيدة‪ .‬كما قامت الحكومة بتسهيل قواعد التأشيرات لمساعدة‬ ‫الناس من المزيد من الدول للقدوم الى الهند للعالج الطبى‬ ‫تكلفة تنافسية‬ ‫وقد أظهرت األبحاث أن خدمات طب األسنان من الدرجة‬ ‫العالمية متوفرة في الهند بـ ‪ 1/10‬من التكلفة في العالم الغربي‪.‬‬ ‫تقدم الهند رعاية طب األسنان بأسعار معقولة مثل قنوات الجذر‬



‫سياحة طب األسنان‬ ‫الهند "‪ :‬جوهرة التاج‬

‫تهدئة الحلق‬ ‫الملتهب‬

‫‪22‬‬ ‫تاي تشي‬ ‫وصحتكم‬

‫‪10‬‬ ‫كيف يؤثر القلق‬ ‫على حياتكم اليومية‬

‫‪14‬‬ ‫مشاكل التحكم على‬ ‫المثانة في الرجال‬

‫‪23‬‬ ‫زيكا‪ :‬الفيروس الذي‬ ‫يسبب العيوب الخلقية‬ ‫‪96 Medical Tourism Jul. - Sep. 2017‬‬ ‫‪5‬‬

‫في لداخل‬

‫‪97‬‬ ‫‪4‬‬

‫‪A Complete Magazine on Healthcare in Asia‬‬

‫سياحة طب األسنان الهند "‪ :‬جوهرة التاج‬


‫كيف يؤثر القلق على حياتكم اليومية‬


‫مشاكل التحكم على المثانة في الرجال‬


‫تهدئة الحلق الملتهب‬


‫تاي تشي وصحتكم‬


‫زيكا‪ :‬الفيروس الذي يسبب العيوب الخلقية‬


‫الطنانة من الخط المباشر لسياحة طب األسنان‬

‫‪Vol.2 | Issue No.2 | Jul. - Sep. 2017‬‬

‫تجاوزوا عن جميع مشاكل األسنان‪ ،‬واركبوا فقط على متن الطائرة‪ ،‬وقوموا بزيارة‬ ‫طبيب أسنان متخصص في البلد الذي تختارونه مثل الهند وتتوفروا ما يصل إلى‬ ‫مبلغ كبير من المال حتى باإلجراءات الروتينية مثل التيجان والقنوات الجذرية‪.‬‬ ‫نفيدكم علما بأنه تظهر االحصاءات ان ما يصل الى ‪ 150‬مليونا من األميركيين‬ ‫يعيشون بدون تأمين األسنان‪ .‬ولعدم وجود األموال الكافية فإنهم ال يضطرون إلى‬ ‫معاناة األلم الشديد من األسنان واللثة أكثر من ذلك‪ ،‬ألن هناك أي عدد من المرافق‬ ‫الذكية المالئمة للمحفظة المتاحة في البلدان المضيفة لرعاية مشاكلهم‪.‬‬ ‫ليس فقط التخفيف من مشاكل العض والمضغ والعلك وهناك مرافق لرفع الجمال‬ ‫وصورة األفراد‪ .‬عدم انتظام في الفم واألسنان واللثة والفكين والشفاه الذي يرهب أي‬ ‫شخص مع مظهر محرج خبيث يمكن إصالحه بإتاحة مظهر جذاب‪ .‬ومن الذي ال يتمتع‬ ‫قليال من النرجسية على رؤية مظهر من الصورة المحسنة؟‬ ‫ما هو أول شيء تالحظه عندما تنظر في المرآة؟ من الواضح أنه هو االبتسامة واألسنان‬ ‫المثالية‪ .‬وهذا يدل على مدى اهتمامنا بشأن صورتنا الذاتية واالحترام الذاتي ودور‬ ‫االبتسامة في تعزيزها‪ .‬ويقال أن قوة ابتسامة جميلة هي المفتاح لحياة ناجحة‪ .‬وإن‬ ‫االبتسامة تشع الطاقة وتخلق جوا إيجابيا يمحو أي حالة غليظة‪ .‬وقد ثبت علميا أن‬ ‫اإلبتسامة تزيد من إنتاج االندورفين والتي هي مجموعة من الهرمونات داخل الدماغ‬ ‫والجهاز العصبي‪ .‬هذه الهرمونات تزيد من ثقة وإيجابية الشخص‪.‬‬ ‫ومع ذلك فإنه ال بد من وجود الفم واألسنان الصحيحة البتسامة مشرقة ومتألقة‪ .‬يكون‬ ‫الفم الصحي هو عالمة على صحة الجسم‪ ،‬ولكن جميع مشاكل الفم ليست دائما من‬ ‫األسنان‪ .‬ويمكن أن تظهر أعراض العديد من األمراض مثل السكري وأمراض القلب‬ ‫وفيروس نقص المناعة البشرية ‪ HIV‬والسرطان‪ .‬وبعض المشاكل المتعلقة بالفم قد‬ ‫تشير أيضا إلى اضطرابات األكل المختلفة‪ .‬وإذا كنا ال نهتم بأسناننا يمكن أن نصل‬ ‫في النهاية إلى فقدانها‪ .‬ويقال إن تسعة من كل ‪ 10‬أشخاص يزورون طبيب األسنان‬ ‫مرة واحدة على األقل في حياتهم حيث ال يمكن ألحد أن يدعي أن لديه مجموعة من‬ ‫األسنان المثالية‪.‬‬ ‫اليوم هناك أقسام متخصصة في المستشفيات لمشاكل طب األسنان‪ .‬ويسافر‬ ‫الناس إلى الخارج بحثا عن عالجات فعالة من حيث التكلفة‪ .‬وتكون الهند هي واحدة‬ ‫من الوجهات األكثر مفضلة لسياحة طب األسنان‪ .‬هنا يتم ضمان المرضى من خدمات‬ ‫جيدة جدا بتكلفة معقولة مقارنة مع غيرها من البلدان المتقدمة والنامية‪ .‬وفي‬ ‫المستشفيات الهندية اخصائيون ذوي مؤهالت وخبرة عالية وبمرافق تتساوى مع‬ ‫المعايير الدولية‪.‬‬ ‫وفي هذه األيام ال يذهب الناس إلى طبيب األسنان لعالج وجع االسنان فقط‪ .‬ونحن‬ ‫نعيش حاليا في عصر من عالج األسنان التجميلي والذي ينطوي على القشرة الخزفية‬ ‫وتبييض األسنان وتقويم األسنان (بدون عالجات األقواس) وترابط األسنان وإعادة‬ ‫تشكيل وتكرير االبتسامة‪ .‬تقول األكاديمية األمريكية لطب األسنان التجميلي‪" :‬يمكن‬ ‫لطبيب األسنان المهرة وذوي الخبرة أن يساعد على تحسين مظهركم وابتسامتكم‬ ‫وحتى احترامكم الذاتي والثقة‪ ،‬واليوم قد واصل طب األسنان التجميلي يتطور إلى‬ ‫حيث يمكن ألطباء األسنان التجميلي معالجة وظيفية ومخاوف المرضى الجمالية "‪.‬‬ ‫المقالة الرئيسية عندنا هي على صحة األسنان ويغطي كل شيء من النظافة اليومية‬ ‫لألسنان إلى العالج التجميلي‪ .‬وتشمل مقاالتنا األخرى التفاصيل عن سلس البول‬ ‫ومشاكل السيطرة على المثانة في الرجال وقوة البنكرياس والحفاظ على الفوز في‬ ‫اللباقة ومقالة في الحفاظ على ضغط الدم الصحي وتقرير عن العالقات ‪ -‬هل العالقات‬ ‫االجتماعية تؤثر على صحتنا وحاجة التأمين الصحي و سياحة طب األسنان في الهند‪.‬‬ ‫كما قدمنا قائمة ببعض المستشفيات الرائدة التي تقدم خدمات طب األسنان‬ ‫المتخصصة للمرضى‪.‬‬ ‫ونحن نؤكد لكم أن هذا العدد يستحق حفظه وأنه يوفر قيمة مقابل المال‪ .‬استمروا‬ ‫باالبتسامة!!‬


‫‪Disclaimer: The statements in this magazine have not been‬‬ ‫‪evaluated by the Food and Drug Administratin of USA or‬‬ ‫‪any other country. Information provided in this magazine‬‬ ‫‪are not intended to diagnose, treat, cure or prevent any‬‬ ‫‪disease. If you have a medical condition, consult your‬‬ ‫‪physician. All information is provided for research and‬‬ ‫‪education purpose only.‬‬

‫‪Printed at Sterling Print‬‬ ‫‪House Pvt Ltd, Door No.‬‬ ‫‪49/1849, Ponekkara‬‬‫‪Cheranellur Road,Aims,‬‬ ‫‪Ponekkara P.O,‬‬ ‫‪Cochin-682041,‬‬ ‫‪Ph: 0484 2800406.‬‬


‫‪tourism‬‬ ‫‪RNI No. KERBIL/2016/68979‬‬

‫‪Editor & Publisher‬‬ ‫‪Benny Thomas‬‬ ‫‪Consulting Editor‬‬ ‫‪O.J. George‬‬ ‫‪Executive Editor‬‬ ‫‪TKV.Mani‬‬ ‫‪Editorial Co-ordinator‬‬ ‫‪Ninu Susan Abraham‬‬ ‫‪Vice President-Marketing‬‬ ‫‪Sunil Nair‬‬ ‫‪Layout & Design‬‬ ‫‪Lal Joseph‬‬ ‫‪Legal Advisor‬‬ ‫‪Adv. Biju Hariharan‬‬ ‫‪BUSINESS ASSOCIATES Overseas‬‬ ‫ ‪USA‬‬ ‫‪: CHICAGO: Vincent Joseph‬‬ ‫‪ Mob: 847 299 9954‬‬ ‫ ‪USA‬‬ ‫‪: Houston: Shaju Joseph‬‬ ‫‪ Mob: 847 899 2232‬‬ ‫ ‪USA‬‬ ‫‪: NEW YORK Vincent Sebastian‬‬ ‫‪ Mob: 917 992 9629‬‬ ‫ ‪USA‬‬ ‫‪: CALIFORNIA: Wilson Nechikat,‬‬ ‫‪ Ph: 408 903 8997‬‬ ‫ ‪Canada‬‬ ‫‪: Jose Sebastian, Ph: 416 - 509 – 6265‬‬ ‫ ‪UK‬‬ ‫‪: Dileep Mathew, Ph: 044 787 743 2378‬‬ ‫ ‪Switzerland‬‬ ‫‪: Dr. George Sebastian, Ph: 527204780‬‬ ‫ ‪Ireland‬‬ ‫‪: Thomas Mathew‬‬ ‫‪ Mob: 00353 87 123 6584‬‬ ‫ ‪Middle East‬‬ ‫‪: Anil Nath,‬‬ ‫‪ Ph: 506854500‬‬ ‫ ‪Singapore‬‬ ‫‪: Mahesh A, Ph: +65 906 22828‬‬ ‫ ‪Germany‬‬ ‫‪: Thomas Vallomtharayil‬‬ ‫‪ Ph: 02305 4455 100‬‬ ‫ ‪Austria‬‬ ‫‪: Monichan Kalapurackal‬‬ ‫‪ Ph: 0043 6991 9249829‬‬ ‫ ‪Korea‬‬ ‫‪: Dr. A. Thomas, Ph: 0082 10 5822 5820‬‬ ‫ ‪Australia‬‬ ‫‪: S. Mathew, Ph: 61247026086‬‬ ‫‪BUSINESS ASSOCIATES India‬‬ ‫ ‪New delhi‬‬ ‫‪: V Murugan, Mob: +91 989 9931 879‬‬ ‫ ‪Mumbai‬‬ ‫‪: Mohan Iyer, Mob: +91 22 6450 5111‬‬ ‫ ‪Chennai :‬‬ ‫‪C. Shankar, Mob: +91 984 097 8060‬‬ ‫‪Eastern India : Sanjay D. Narwani Mob: +91 983 120 7202‬‬ ‫‪Ahmedabad : Madanan MA, Mob: +91 989 800 2522‬‬ ‫ ‪Hyderabad‬‬ ‫‪: Vinod Menon, Mob: +91 081 436 17672‬‬ ‫ ‪Puducherry‬‬ ‫‪: K. Ramasubramanian, +91 989 497 7161‬‬ ‫ ‪Goa‬‬ ‫‪: Olavo Edviges Lobo - +91 982 258 9237‬‬ ‫ ‪Trivandrum‬‬ ‫‪: Kuriyan K Raju, Mob: +91 944 610 6644‬‬ ‫ ‪Kozhikode‬‬ ‫‪: T. Rajendran Nair, Mob:+91 953 900 9305‬‬

‫‪Printed, published and owned by‬‬ ‫‪Benny Thomas‬‬ ‫‪FM Media Technologies Pvt. Ltd,‬‬ ‫‪Penta Square, Opp.Kavitha,‬‬ ‫‪MG Road, Cochin -682016,‬‬ ‫‪Kerala, India.‬‬ ‫‪Editor: Benny Thomas‬‬

‫‪CORPORATE OFFICE‬‬ ‫‪FM Media Technologies PVT Ltd,‬‬ ‫‪Penta Square, Opp.Kavitha, MG‬‬ ‫‪Road, Cochin -682016, Kerala, India.‬‬ ‫‪Tel/Fax: +91 484 403 4055‬‬ ‫‪Email:‬‬ ‫‪www.‬‬

‫‪98 Medical Tourism Jul. - Sep. 2017‬‬ ‫‪3‬‬

A Complete Magazine on Healthcare in Asia


‫‪Vol.2 | Issue No.2 | Jul - Sep 2017‬‬

‫سياحة طب األسنان‬ ‫الهند "‪:‬‬ ‫جوهرة التاج‬ ‫كيف يؤثر القلق على‬ ‫حياتكم اليومية‬ ‫مشاكل التحكم على‬ ‫المثانة في الرجال‬ ‫تهدئة الحلق الملتهب‬ ‫تاي تشي وصحتكم‬ ‫زيكا‪ :‬الفيروس الذي يسبب‬ ‫العيوب الخلقية‬ ‫‪100 Medical Tourism Jul. - Sep. 2017‬‬

Medical Tourism Vol2 Issue2  
Medical Tourism Vol2 Issue2