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- Denis Giles
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Armed with a hot cup of coffee and inherent curiosity I love spending time, looking out of my bedroom window in Manhattan.
It’s going to be an early winter, I reckon, as the cool air rushes in, and I see the temperature is 9 degrees C but this doesn’t stop the joggers from running, keeping fit despite the cold, and then I look with even more amazement as a mother runs pushing her stroller ahead of her. No cold or baby can stop these determined, keep fit folk, and I marvel at their determination! I watch New Yorks slim waist lines and realize to conquer this city, you need to conquer yourselves first!
I peer out a little more, and see the familiar dog walkers.
New York, despite small apartments seems to be a city of pet lovers, and I see dogs of all shapes and sizes being taken for their constitutional walks. The dog walkers are a patient lot, and allow their dogs to sniff each pole and fire hydrant, till they settle on what suits them best.
But something I seequite often is that it’s the small dogs who turn aggressive when they see a bigger fellow in their path. They bristle, and growl, and let out shrill, shrieks of anger, whereas the bigger fellow hardly turns to look at them.
But every now and then the small dog looks at his master or mistress for support and approval and I am certain that without those same walkers by their side, the little fellow would have been a quiet fellow. Reminds me a lot of same situation in my country, where small splinter groups are causing a lot of problems, and would have been quiet and silent if not for the assuring figures of their two big brothers who give them confidence they can get away with murder and get off scot free!
Yes, there’s a lot of pretty women down there, and thank god for them, but often when they walk with their children, and sometimes, its even on weekends, I wonder where dad is? It’s a rare sight to see a family going out together, and knowing how high the divorce rate is here I whisper, “Dad, maybe, a walk with your wife and kids will help you enjoy their growing up years!”
My daughter calls out to me and asks if I’d like to go down to the river, and as I stroll and look at the boats and feel a happiness inside, I look up suddenly conscious of windows on the street opposite looking down on me, and wonder what those people think, looking at a carefree me..!
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- Denis Giles
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Dr. Aditya Gupta
WHAT IS ACOUSTIC NEUROMA
Acoustic Neuroma which is also known as vestibular schwannoma, is a benign tumour which is non cancerous and usually grows slow. It develops on the main nerve that leads from inner ear to brain. The branches of this nerve influence the balance ,hearing and the pressure from an acoustic neuroma that can cause hearing loss, ringing in your ear and unsteadiness.
SYMPTOMS
The symptom starts with the gradual loss of hearing in one ear and the problem is accompanied by the ringing in the ear also with the feeling of fullness in the ear. The acoustic neuromas can cause the sudden hearing loss.
The symptoms that occur over time include :
1. Vertigo. 2. Facial numbness and tingling. 3. Problem with balance. 4. Facial weakness. 5. Change in taste. 6. Difficulty in swallowing. 7. Headaches. 8. Clumsiness. 9. Mental confusion
Cyberknife radiosurgery has revolutionized the treatment of acoustic neuroma
CAUSES OF ACOUSTIC NEUROMA
The cause of the development of acoustic neuroma is unknown. A rare hereditary disease “Neurofibromatosis" is associated with acoustic neuroma.
Acoustic Neuroma can also be caused by:
• Continuous exposure to loud noise
• Radiation on face and neck can lead to acoustic neuroma many years later.
In 1 out of 10 people, an acoustic neuroma is caused by neurofibromatosis type 2 (NF2). NF2 can run in further generations also. Person suffering from NF2 can develop benign tumours on the spinal cord and the coverings of the brain.
Acoustic neuromas is formed through type of cells called a Schwann cell. These cells cover the nerve cells of the body. That's why this tumour is also called vestibular schwannoma.
Acoustic tumour grows with the nerve in the brain. This nerve is called cranial nerves or the acoustic or vestibulocochlear nerve. This nerve is responsible to control the sense of hearing and also the balance of the body.
Acoustic tumour is rare and in between 1 and 20 people in every million worldwide are diagnosed each year with an acoustic neuroma. And its more common in women than men.
ACOUSTIC NEUROMA TREATED WITH CYBERKNIFE
The survey says that two out of 100,000 people aged 30 to 60 develop acoustic neuroma, which makes this condition incredibly rare.
The Acoustic Neuroma treatment depends on the size of the tumour. If the tumour is large, there will be more medical problems. The small size of the tumour is less than 1.5 cm, medium is between 1.5 cm and 2.5 cm and large is 2.5 cm or larger. Small tumours require cyberknife due to their size while the larger tumours typically require surgery.
The newest radiation therapy option for acoustic neuroma is a form of radio surgery that requires absolutely no incisions using new technology called CyberKnife. Patients treated with this new non-invasive experience minimal to no side effects.
Radio surgery techniques can stop tumours from growing by using high-dose exact precision radiation treatment. Patients treated by CyberKnife® technology experience minimal to no side effects, and receive treatment on an out-patient basis. After patients undergo radio surgery, the acoustic neuroma is closely monitored to confirm the growth has stopped or that the tumour has begun to shrink.
The surgery includes advanced robotics, tumour tracking and imaging capabilities.
The patients with particular symptoms like pressure symptoms, tinnitus, or imbalance may be best treated with this surgery because surgery will relieve the symptoms more rapidly. Also the large tumours means the size greater than 3.0 cm are best treated with surgery because these tumours can sometimes swell and cause obstruction in the flow of cerebrospinal fluid.
Treatment starts with the CT scan. The CT scan image is then imported to the CyberKnife Treatment Planning System. The oncologist team make a plan to treat the tumour while avoiding surrounding important sensitive structures.
The process involves several sittings and per sitting lasts for maximum 1 hour per sitting . The treatment does not require any sedation and is painless.
The chances of side effect is next to negligible. Hearing is preserved and achieved in 50-75% of the time. Temporary numbness of one side of face is 2-3%. After the CyberKnife surgery tumours stabilise in size then shrink with time.
Dr. Aditya Gupta is the Director, Neurosurgery, Agrim Institute for Neuro sciences, Artemis Hospital.
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- Denis Giles
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1. Students of Speech Therapy are Given Tuition Fee Waiver by TATA Trusts
The scholarship offering is for students who are looking forward to pursue their post-graduation in programs related to Speech Therapy, i.e., Speech and Hearing, Audiology and Speech-Language Pathology, Audio Speech Therapy, Speech Language Pathology and Audiology, from any institute in India.
Last date to submit the application form is November 05, 2018. In order to be eligible for this scholarship, candidates need to fulfil the mandated requirements:
Eligibility
The applicant must have secured 60% in the graduation degree and is interested to take admission in the post-graduation program related to speech therapy. Candidates who are already enrolled in the first or second year are also welcome to apply.
Scholarship Reward
The eligible candidate will receive waiver in tuition fee and related expenditure.
How to Apply
Interested candidate can make an online application.
Other Important Details
Applying candidates need to submit the below mentioned documents:
• Attested mark sheet(s)
• Research document(s)
• Fee receipt
• Letter from college as per specimen
• Bank details (cancelled cheque/passbook)
Click Here to Know More
http://www.b4s.in/AC/TTS5
https://www.buddy4study.com/scholarship/tata-trusts-scholarship-for-speech-therapy-2018-19
Courtesy: www.buddy4study.com / Call: 08448709545, 08527484563
2. College Board Launches its Scholar Program in India with Free SAT and Full Scholarship. Know More Here…
Students who take the SAT for university admission in India, post class 12, are given an opportunity to avail the benefits under this invite. The call offers a free SAT test in December 2018 and full tuition scholarship at leading Indian universities.
Following are the universities offering tuition free waiver: Ahmedabad University, Ashoka University, Azim Premji University, Bennett University, BML Munjal University, FLAME University, ManavRachna University, Manipal University, SRM Institute of Science and Technology, SVKM's NMIMS
Last date to submit the application form is November 02, 2018. In order to be eligible for this program, candidates need to fulfil the mandated requirements:
Eligibility
1) For free SAT Test:
• Applicant must be an Indian resident
•Must be in class 12 in the current academic session
• Annual family income must not be more than INR 6,00,000
2) For full college tuition scholarship, the applicant must:
• Be an Indian resident and studying in class 12 in 2018-19 session
• Be having annual family income less than INR 4,00,000
• Score minimum 1350 out of 1600 in SAT exam
• Be enrolled in any of the participating Indian universities
Scholarship Reward
Selected scholars will appear for SAT examination worth INR 7000 for freeand full tuition scholarship will be given in any of the listed partnered Indian universities.
How to Apply
Online applications are invited from interested candidates.
Other Important Details
Following documents need to be submitted by the applying candidate:
• Passport-sized Photograph
• Family Income Proof
• Address Proof
• Identity Proof
• 11th Marksheet
Click Here to Know More
http://www.b4s.in/AC/CBI1
https://www.buddy4study.com/scholarship/college-board-india-scholars-program-2019
Courtesy: www.buddy4study.com / Call: 08448709545, 08527484563
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- Denis Giles
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Have been watching the tremors, then rumblings and quakes that the Me Too movement is causing in India, and then find reactions, not just coming from men’s locker rooms, but also from some women who seem quite critical of the outbursts and revelations!
“Why did they take so long?” is the popular criticism levelled against these brave women.
You just have to hear the laughter, the snides and ridicule, that Me Tooers face to know why anybody either takes too long or never reveals anything that happens at all. And if they had revealed what they’d gone through at that particular time that these critics so glibly talk about, then the ridicule, the sniggers and the disbelief would have been a hundred, nay a thousand fold louder.
So why now?
Because, today, they have formed a brigade. Today, compared to yesterday they individually have the power to withstand, and today, they don’t want others to go through what they went through before!
If you are still not convinced, let me give you an example:
Many years ago, a sixteen- year old boy, having just finished high school, and seeing his father’s business in the doldrums decided to use his holidays, to work as a salesman for his father’s nearly bankrupt company. He went on his sales rounds, walked into a major corporate house, and a gentleman by the name of Khoshy, told him, he could get him a big order, if he came over for a meeting at a posh restaurant. He went. He had never been inside the restaurant, though it was right opposite his old school. There he was introduced to another gentleman and the first gentleman disappeared saying that this gentleman was the one who needed the services of my dad’s company.
The new gentleman then said the deal could be discussed in a better environment and suggested the beach. The innocent sixteen- year old went and on the beach found the man was a homosexual, and had other intentions, which he was intent on getting away with. The boy ran for his life before things got too hot, returned home, and never spoke about it to his father, even when the gentleman gave his dad the order.
There were two other incidents of the same nature during his sales, one a doctor who again promised him business and the other another corporate fellow.
The boy was scared. He was just sixteen. He waited, another six years and then with other friends thrashed these three men. You don’t have to guess who the boy was. You don’t need to guess why he waited. He waited till he had the strength and was not vulnerable anymore!
But, it sure helps me understand, why these ladies waited years, before they today have the fists and friends to thrash these men through exposure, men who thought they could get away, when their victims were weak and vulnerable..!
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Dr Pradeep Moonot, Orthopaedic Surgeon & Podiatrist, Nanavati Hospital, Mumbai.
If the joint that connects your big toe to your foot has a sore bump, then chances are you may have a bunion, a common deformity. Largely, Bunions develop when the pressures of bearing and shifting your weight fall unevenly on the joints and tendons in your feet. This imbalance in pressure makes your big toe joint unstable, eventually molding the parts of the joint into a hard knob that juts out beyond the normal shape of your foot.
While tight, high-heeled or too-narrow shoes could be one of the cause for bunions, inherited foot type, foot injuries or any deformity present during the birth are also accountable for the foot deformity. Surprisingly, bunions may also be associated with certain types of arthritis, particularly inflammatory types, such as rheumatoid arthritis.
How Bunion Affects
With a bunion, the base of your big toe (metatarsophalangeal joint) gets larger and sticks out and results in the skin over it may become red and tender. Wearing any type of shoe may be painful and this joint flexes with every step you take. The bigger your bunion gets, the more it hurts to walk. Normally, your big toe may angle toward your second toe, or even move all the way under it to an extent that the skin on the bottom of your foot may become thicker and painful. Sometimes an advanced bunion may make your foot look grotesque. And if it gets too severe, it may be difficult to walk. Therefore, your pain may become chronic and you may develop arthritis.
Prevention and Cure
Though bunions are curable, at times they tend to become permanent unless surgically treated. Your podiatrist or a Foot and Ankle Specialist can identify a bunion by examining your foot. Watching your big toe as you move it up and down will help your doctor determine if your range of motion is limited. Your doctor will also look for redness or swelling. In case conservative treatments like padding your shoe, medication, changing your shoe type, etc, doesn't provide relief, you may need surgery. The goal of bunion surgery is to relieve discomfort by returning your toe to the correct position. There are a number of surgical procedures for bunions, and no one technique is best for every situation. Surgery may involve removal of the swollen tissue from around your big toe joint, straightening your big toe by removing part of the bone, realigning the long bone between the back part of your foot and your big toe, to straighten out the abnormal angle in your big toe joint, etc.
In case of bunion deformity, the surgery helps to produce a narrow foot and the straighter big toe. The toe area needs little extra care much like in any other surgery. "The capsule repair must be protected with the specialised dressing for 2 weeks. The surgery allows to give a 3D cut for precision.
It's possible you may be able to walk on your foot immediately after a bunion procedure. However, full recovery can take weeks to months. After the surgery, usually doctors advise post-operative shoes for almost 6 weeks until the foot is completely healed. The post-operative shoe allows for heel weight bearing (walking) immediately, though this is often too uncomfortable for the first week. Otherwise too, the foot must be elevated (above the level of the pelvis) for 90% of the time for the first 10 days. This helps to reduce swelling and the risk of infection, and helps in healing of the wound. And to prevent a recurrence, you'll need to wear proper shoes after recovery.
Surgery isn't recommended unless a bunion causes you frequent pain or interferes with your daily activities. But in any case, if you suspect a bunion on your feet, don't delay and see a Foot and Ankle Specialist or a Podiatrist.
Tips to help prevent bunions:
Be sure your shoes don't cramp or irritate your toes.
Choose shoes with a wide toe box — there should be space between the tip of your longest toe and the end of the shoe.
Your shoes should conform to the shape of your feet without squeezing or pressing any part of your foot.
Avoid pointy-toed shoes.
Dr Pradeep Moonot is an Orthopaedic Surgeon & Podiatrist, Nanavati Hospital, Mumbai.