How To Shed The Extra Fat!

In a recent article by Dr. Zaqui Ladha (soon to join Royal Bahrain Hospital as a Visiting Consultant General & Laparoscopic Surgeon), Dr. Zaqui has made it clear that the rise of obesity in Bahrain is becoming a health problem for many, and an option is obesity surgery.

However, despite the fact that obesity surgery is something everyone is familiar with, many do not know that obesity surgery comes in different types. There are two main types of obesity surgery: restrictive and combined restrictive and malabsorptive.

Restrictive surgery uses bands to create food intake restriction. The bands or staples are surgically placed near the top of the stomach to section off a small portion that is often called a stomach pouch. A small outlet is left at the bottom of the stomach pouch. 

Patients who have gone through restrictive surgery must learn to eat smaller amounts of food at one time, to chew their food well and to eat slowly. Failure to adjust eating habits may inhibit weight loss.

One more restrictive procedure which is getting very popular is the sleeve gastrectomy, where the stomach is reduced to a small tube, which could be a step procedure to a bypass, or a procedure by itself.

The combined restrictive and malabsorptive surgery is a combination of restrictive surgery (stomach pouch) with bypass (malabsorptive surgery), in which the stomach is connected to the small intestine, bypassing the duodenum and part of the jejunum.

The results have been very encouraging, especially with the by-pass procedures. Many of the patients who have undergone a gastric banding have lost around 30 kg, have changed their waist size from a 22 to a 14, some of them have shaped their body by plastic surgery, and look really good. The patients who have done a gastric by-pass or a sleeve gastrectomy have lost much more weight, and still continue losing it. The weight loss is above 40 kg in most cases, and still going down. One of the patient said that if she had known this result, she would have done her by-pass years ago, and so would be healthy earlier!

Dr. Zaqui Ladha will be joining Royal Bahrain Hospital soon as a Visiting Consultant General & Laparoscopic Surgeon. To book your appointment in advance, call 17246800 or visit www.royalbahrainhospital.com for more information..

Shed the Extra Fat!

The numbers of obesity cases in Bahrain are alarmingly bulging: 20-25 % of the people in Bahrain, particularly women, are considered obese defined as having a body mass index (BMI) of 30 or more. The rising obesity problem stems largely from poor eating habits, lack of exercise, and sedentary lifestyles.

Although obesity has genetic determinants, the increasing prevalence of obesity in Bahrain suggests a significant relationship between obesity and physical inactivity, according to studies on the prevalence of obesity in the Middle East.

People need to be aware about the many serious medical complications in being obese. Obesity often leads to a host of diseases, diabetes, high blood pressure, heart attacks, respiratory diseases, arthritis, even infertility. Diabetes is killing patients, yet people seem to care less. We need to go back to the basics of eating the right kind of food and exercise. Current diets consist a lot of rice and fast food, but very few contain the required amount of vegetables every day.

Obesity is commonly measured by using the BMI calculator, which gauges body fat taking into account a person’s height and weight. 

A person with a BMI of 30 or more is considered obese. Severe obesity is defined as having a BMI of 40 or more for which surgery is recommended.

Obesity Surgery

Surgery is a treatment option as a method of losing the extra fat. Surgery is a well-established method of long-term weight control for persons with severe obesity.

Obesity surgery helps in losing weight by changing the way the body digests and absorbs food. Digestion and absorption begin in the stomach, continue through the small intestine and end in the large intestine, which digests and absorbs what it can and eliminates the rest as waste. Obesity surgery involves making changes to the stomach or the small intestine.

The stomach is made smaller in size with surgery. A section of the stomach is closed to limit the amount of food it can hold and causes the person to feel full.

Through food intake restriction, malabsorption or both, a person can lose weight since less food either goes into the stomach or stays in the small intestine long enough to be digested and absorbed. Currently, obesity surgeries are available at Royal Bahrain Hospital.

Dr. Zaqui Ladha will be joining Royal Bahrain Hospital soon as a Visiting Consultant General & Laparoscopic Surgeon. To book your appointment in advance, call 17246800 or visit www.royalbahrainhospital.com for more information. Please look forward to the second part of this article, out Thursday June 7^th.

Weight Loss Solution!

A chronic health problem on the rise is obesity, which is a result from an excess of fat exceeding the body’s physical needs. According to Dr. Stephen Angamuthu, Consultant General Surgeon at Royal Bahrain Hospital, explains the problems of obesity. “Obesity almost always leads to a number of other chronic health conditions, which we call co-morbidities. Some examples are cardiovascular disease, hypertension, type II diabetes, Pulmonary dysfunction, Osteoarthritis, Gallbladder disease, Cancer (breast and colon), and many others.”

However, it is difficult to shed all of the excess fat through just diet and exercise. With proper commitment this can be achieved, but nonetheless many find the most rigorous of diets and exercise routines difficult to follow or not success. “Bariatric surgery is the perfect option for those who want the full and permanent solution if a conservative line fails. Millions of people worldwide have undergone bariatric surgery successfully. As a matter of fact, in most cases, the risks that arise from remaining obese are greater than that of undergoing surgery.”

Dr. Stephen goes on to explain about the surgery itself and how it is done at Royal Bahrain Hospital. “We have adopted the modern, minimally-invasive techniques to be used whenever the case allows it. These techniques have made bariatric surgery even safer, and include less bleeding and shorter post-operation recovery times.”

In order to combat the rising rate of obesity in Bahrain, Dr. Stephen recommends all people to assess their weight and choose their options. “If you choose bariatric surgery, you will finally see all the beneficial effects it will have on your health, which have been confirmed by numerous studies. For example, you will prevent obesity-related diseases, have an extended life span, increased energy and self-esteem, and of course weight loss. The average weight loss expected over three years is 62% of the excess weight.

“If you want to know if you’re a good candidate for bariatric surgery, schedule an appointment with a trusted surgeon who has performed this operation. He or she will be able to assess your case fully and work with you to begin your journey to becoming healthier.” Says Dr. Stephen.

Dr. Stephen Angamuthu is a Consultant General Surgeon at Royal Bahrain Hospital. To book your appointment, call 17246800 or visit www.royalbahrainhospital.com for more information.

Blood Donation Campaign

On April 24th, 2012, from 9am to 1pm, Royal Bahrain Hospital will open its doors for blood donors to come and give blood.


Here are 25 facts about blood donation:

1. Someone needs blood every two seconds.
2. One pint of blood can save up to three lives.
3. Healthy adults who are at least 17 years old, and at least 110 pounds may donate about a pint of blood – the most common form of donation – every 56 days, or every two months.
4. Four main red blood cell types: A, B, AB and O. Each can be positive or negative for the Rh factor. AB is the universal recipient; O negative is the universal donor of red blood cells.
5. Forty-two days: how long most donated red blood cells can be stored.
6. Five days: how long most donated platelets can be stored.
7. One year: how long frozen plasma can be stored.
8. Much of today's medical care depends on a steady supply of blood from healthy donors.
9. 26.3 pints: the average whole blood and red blood cell transfusion.
10. Children being treated for cancer, premature infants and children having heart surgery need blood and platelets from donors of all types, especially type O.
11. Anemic patients need blood transfusions to increase their red blood cell levels.
12. Cancer, transplant and trauma patients, and patients undergoing open-heart surgery may require platelet transfusions to survive.
13. Many patients with severe sickle cell disease receive blood transfusions every month.
14. A patient could be forced to pass up a lifesaving organ, if compatible blood is not available to support the transplant.
15. Thirteen tests (11 for infectious diseases) are performed on each unit of donated blood.
16. 17 percent of non-donors cite "never thought about it" as the main reason for not giving, while 15 percent say they're too busy.
17. Shortages of all blood types happen during the summer and winter holidays.
18. Blood centers often run short of types O and B red blood cells.
19. If all blood donors gave three times a year, blood shortages would be a rare event (The current average is about two.).
20. 46.5 gallons: amount of blood you could donate if you begin at age 17 and donate every 56 days until you reach 79 years old.
21. Four easy steps to donate blood: medical history, quick physical, donation and snacks.
22. The actual blood donation usually takes about 10 minutes. The entire process – from the time you sign in to the time you leave – takes about an hour.
23. After donating blood, you replace the fluid in hours and the red blood cells within four weeks. It takes eight weeks to restore the iron lost after donating.
24. You cannot get AIDS or any other infectious disease by donating blood.
25. Giving blood will not decrease your strength.

Breast Cancer Detection

Breast cancer is the leading cause of death in middle aged women. As there is lot of attention focused on breast cancer worldwide, there is a fear developing in women when they notice a lump or any change in the breast. Could it be a cancer? But 80-85% of all breast lumps/swelling are benign. Again it is better a surgeon concludes the nature of the lump by clinical examination and tests instead of assuming or neglecting it as benign. The present day diagnostic tools offer a high degree of accuracy in excluding cancer.

Female breast is a dynamic structure with monthly cyclical changes along with changes of development and involution throughout the women’s reproductive life brought about by various hormones. These changes and influences make the breast prone for many disorders including cancer.

There are certain risk factors identified as cause of breast cancer, they are - older age, first child at late age, absence of breast feeding, family history of breast or ovarian cancer, obesity, high alcohol consumption and exposure to radiation.

Women with breast disorder present with 3 main symptoms, breast lump, breast pain and nipple discharge.

When screening for breast disorders it is very important to go through 3 evaluating tools which will enhance the diagnostic accuracy. First a detailed history of the problem and a thorough examination by the clinician. Second is imaging (Mammogram, Ultrasound and MRI). Third is biopsy of the problem area.

It is also important that a woman examines her breast frequently to note any changes and report to the doctor for further evaluation.

Common benign breast conditions which frequently seen are Fibroadenoma, Fibrocystic disease, Mastalgia, Breast cysts, Cyclical nodularity, Galactocele, Sclerosing adenosis, Fat necrosis, Duct ectasis, Duct papillomas and Mastitis.

It is found that hesitation to consult a doctor and ending up in late diagnosis of a cancer has led to high mortality. Breast cancers can be diagnosed very early and early treatment gives high cure rates.

Dr. Narendra Kumar M [MBBS, MS, FMAS] is a General Surgery Specialist at Royal Bahrain Hospital. For more information or to book your appointments call 17246800 or plan your visit at www.royalbahrainhospital.com.

Treatment for Piles

“Piles” is a common problem suffered by millions of people worldwide. Haemorrhoids commonly known by the name “Piles” are swollen veins in the anus and rectum. Haemorrhoids may be located inside the rectum (internal haemorrhoids), or they may develop under the skin around the anus (external haemorrhoids).

Haemorrhoids develop from an increase in pressure in the lower rectum. Factors that might cause increased pressure are straining during bowel movements, sitting for long periods of time on the toilet, chronic diarrhea or constipation, obesity, pregnancy. Symptoms of hemorrhoid are bleeding while passing stools, itching in the anal region, pain or discomfort, swelling around the anus.

Procedures to diagnose internal hemorrhoids are, Digital Rectal Examination (DRE) and Visual inspection of anal canal and rectum with a proctoscope. If haemorrhoids produce only mild discomfort, over-the-counter creams, ointments and suppositories are sufficient.

For persistent bleeding or painful hemorrhoids, Rubber band ligation, Injection (sclerotherapy), Coagulation (infrared, laser or bipolar) and Haemorrhoidal Artery Ligation (HAL) are the minimally invasive procedures available.

If minimally invasive procedures haven't been successful or the hemorrhoids are large, surgical procedures are recommended. Haemorrhoidectomy is the most effective and complete way to remove hemorrhoids. Another procedure, called stapled Haemorrhoidectomy, generally involves less pain than Haemorrhoidectomy and allows an earlier return to work. Talk to your surgeon about what might be the best option for you.

The best way to prevent haemorrhoids is to keep your stools soft, so they pass easily. Follow these tips to prevent haemorrhoids: Eat high-fiber foods, drink plenty of fluids, consider fiber supplements, don't strain while passing stools, pass stools as soon as you feel the urge, exercise, avoid long periods of standing or sitting.

(Note: Rectal bleeding is seen in various conditions, including colorectal cancer and anal cancer. Don't assume that bleeding is coming from haemorrhoids without consulting a doctor).

Dr. Narendra Kumar [MBBS, MS, FMAS] is a General Surgery Specialist at Royal Bahrain Hospital. For more information or to book your appointments call 17246800 or plan your visit at www.royalbahrainhospital.com.

Googling Illness

Increasing numbers of people using the internet to diagnose themselves poses serious health risks. Websites such as WebMD receive around 30 million users a month. According to the Bupa Health Pulse survey, about 58% of people self-diagnose using online information.

However, only 25% of these people checked to see if the information they were reading was correct. Detrimental effects may occur when taking treatment advice from a non-certified online source, possibly leading to either of two scenarios. The first is following an incorrect treatment, such as applying random ‘remedies’ on infections, which may aggravate the medical condition further. The second is that the treatment followed is for one illness when you could be undergoing another, which unwillingly delays the time to get treatment, or may arbitrarily worsen the undiagnosed medical condition.

Additionally, many tend to believe they have the worst condition. Usually many common complaints show a myriad of illnesses, and some people may unjustifiably jump to the worst conclusion. This causes people to suffer anxiety and waste time and money on unnecessary tests or treatments, says the British Medical Association. On the reverse side, a person may mistake a serious illness for a mild one, like kidney stones as mere indigestion, and may continue to ignore it until it starts to affect their daily lives.

Dr. Ravisankar Pillai, Specialist Urologist, states that although many understand the information, many don’t know how to analyze it. He likens that situation to a story by Ernest Hemmingway, where a boy believes he will die from a fever of 102 degrees since doesn’t realize is that it’s in Fahrenheit.  Having medical knowledge and knowing how to apply are what differentiate a doctor from a regular person.

If it helps, you may even bring the information read online to the consultation, where the doctor will help clarify which parts may have been non-factual. Dr. Amr Rashad, Specialist Radiologist says that showing a doctor what you fear is your condition can help them select the right tests to clear away your fears or to detect a problem early in the process.

To schedule an appointment at Royal Bahrain Hospital, call 1724 6800.

Breast Cancer: What Do You Actually Know?

According to the World Health Organization, breast cancer is the top cancer to affect women in both the developed and developing world. Considering that October is Breast Cancer Awareness months, it is important to be aware of the risk factors, prevention and treatments for this devastating disease.

There are many risk factors, some of which we can control and some that we cannot. Of course, being a woman greatly increases your chances. The American Cancer Society estimates that 5%-10% of breast cancer cases are hereditary. Your risk of breast cancer doubles if a first degree relative (i.e. mother, sister, or daughter) has had cancer.

Factors that can be controlled would include our diet and exercise habits, as obesity increases the risk of cancer, while indulging in physical activity for 1.25 to 2.5 hours per week can reduce the risk by 18%.

Although many believe that it starts with a lump, that is not the only sign. Pain, irritation, redness, dimpling, scaliness or swelling or any other unusual changes are possible symptoms, and are not diagnosable unless reviewed by a doctor.

In fact, not all breast lumps are cancerous. Some lumps are benign, such as cysts, which are sacs of fluid that build up in the breast tissue. According to the Macmillan Cancer Support, a top cancer support charity in the United Kingdom, nearly 1 in 10 women will have cysts at some time during her life. Another type of lump is a fibroadenoma, a solid tumor that is made of glandular and fibrous tissue and most commonly found in women in their 20s and 30s. Cysts and fibroadenomas are easily treated, and therefore you should visit a doctor regardless of your fear of finding out if it may be cancer.

If it has unfortunately been found to be cancer, many women should still hold hope. Getting screened as earliest as possible is a must, as the National Cancer Data Base shows a survival rate of women treated whilst in the earliest stages between 81% to 93%, while being treated at much later stage shows a survival rate from 67% to as low as 15%.

Schedule a normal check-up or a mammogram with your doctor if you feel you’re at risk or if you’ve noticed any unusual changes.

To schedule a women’s health check-up, call Royal Bahrain Hospital on 1724 6800 or 8000 1090 and schedule your appointment.

What Are Those? Varicose!

We all know that veins conduct blood from different parts of our body to the heart. What we don’t know is that varicose veins are swollen, twisted, and sometimes painful veins that have filled with an abnormal collection of blood. This results in unsightly appearance of the skin. In normal veins, valves in the vein keep blood moving forward toward the heart. In varicose veins, the valves do not function properly, allowing blood to remain in the vein. Pooling of blood in a vein causes it to enlarge.

Symptoms include heaviness, aching pain of legs, swelling or brown discoloration or ulcers of the skin at the ankles.

Points to note are:

1. Maintain your ideal body weight to reduce excess pressure on your legs, have healthy diet high in fiber and low in fat and salt.
2. Avoid alcohol, which can cause the veins in your legs to dilate.
3. Avoid wearing tight clothing and excessive heat on your legs. Wear support compression leg stockings.
4. Do not cross your legs when sitting.
5. If you are working at a desk all day, try to get up and walk around every hour or so to allow the muscles to pump the blood out of the veins, avoiding sitting for extended periods of time. Flexing your ankles periodically will pump the blood out of your legs (simulating walking), so flex them 10 times and repeat every 10 minutes.
6. Elevate your legs when possible, keeping your feet positioned higher than heart level.
7. Exercise daily. Walking, climbing stairs, cycling and swimming

Treating early symptoms results in an excellent outcome, as untreated Varicose veins usually enlarge and worsen over time leading to  severe health problems like blood clots, sores or skin ulcers, spontaneous bleeding, ongoing irritation, swelling and painful rashes of the legs.  Your doctor will require a Duplex scan, and treatment options include surgery or Sclerotherapy or Laser ablation or Radiofrequency ablation.

In case a vein ruptures and starts to bleed, immediately elevate your leg and compress the area. Contact your doctor or seek emergency medical care immediately.

Dr.Renny Napoleon, [MBBS, MS, FRCS] is a General Surgery Consultant at Royal Bahrain Hospital. For more information or to book your appointment, call 1724 6800 or plan your visit at www.royalbahrainhospital.com.

Thyroid VS You

Heard of by many but understood by few, there are many myths and stories revolving around this tiny gland. The thyroid gland is located on the front part of the neck below the thyroid cartilage (Adam's apple), normally weighing less than 20gms. The gland produces thyroid hormones, which regulate body metabolism. This means that that the thyroid gland determines everything from body weight to shape, and from feeding habits to your fertility (ability to conceive).

The thyroid gland functions by taking iodine, found in many foods, and converting it into thyroid hormones namely thyroxine (T4) and triiodothyronine (T3).

Thyroid cells are the only cells in the body which can absorb iodine; therefore every cell in the body depends upon thyroid hormones for regulation of their metabolism. The normal thyroid gland produces about 80% T4 and about 20% T3.

As the thyroid gland is under the control of the pituitary gland, when the level of thyroid hormones (T3 & T4) drops too low, the pituitary gland produces Thyroid Stimulating Hormones (TSH) which stimulate the thyroid gland to produce more hormones.

Clinical studies show that soybean-related foods, peaches, strawberries, millet and cruciferous vegetables like cabbages and broccoli can potentially cause thyroid gland goiters. Defects in these delicate regulatory pathways may result in hypothyroidism (underactive thyroid problem) or hyperthyroidism (overactive thyroid problem). Symptoms include excessive fatigue, poor growth in children, poor school performance, constipation, and pain in the wrists accompanied by numbness of the hands. Further symptoms may extend to lack of sleep, hand tremors, nervousness and a fast heart beat rate.

The main risk hypothyroidism poses is during pregnancy, where it increases the chance of stillbirth or growth retardation of the fetus, or pregnancy complications. Whereas hyperthyroidism in pregnancy is known to cause fetal and maternal complications including poor weight gain and fast heart rate.

Seek immediate attention if you have these signs and symptoms:

·         Shortness of breath

·         Abdominal pain

·         Tremors

·         Confusion

·         Unexplained weight gain or loss

·         Unexplained fatigue

Early Diagnosis and treatment of thyroid diseases is necessary to prevent long term complications.

Dr.Renny Napoleon, [MBBS, MS, FRCS] is a General Surgery Consultant at Royal Bahrain Hospital. For more information or to book your appointment, call 1724 6800 or plan your visit at www.royalbahrainhospital.com.