Urodynamic Testing

What is urodynamic testing?

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Urodynamic testing is any procedure that looks at how well parts of the lower urinary tract—the bladder, sphincters, and urethra—work to store and release urine. Most urodynamic tests focus on how well your bladder can hold and empty urine. Urodynamic tests can also show whether your bladder is contracting when it’s not supposed to, causing urine to leak.

• leak urine
• go to the bathroom frequently
• feel pain while urinating
• feel a sudden, strong urge to use the bathroom
• have trouble starting to urinate
• have problems emptying your bladder completely
• have repeated urinary tract infections

What urodynamic tests do health care professionals use?

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• uroflowmetry
• postvoid residual urine measurement
• cystometric test
• leak point pressure measurement
• pressure flow study
• electromyography
• video urodynamic tests

Uroflowmetry

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Uroflowmetry measures how much urine is in your bladder and how fast the urine comes out, also known as flow rate. The results of this test can show if your bladder muscles are weak or if urine flow is blocked.

During a uroflowmetry test, you urinate into a special toilet or funnel that has two parts: a container for collecting the urine and a scale. The uroflowmetry equipment creates a graph that shows changes in the flow rate while you urinate. Your health care professional uses the graph to see when the flow rate is the highest and how many seconds it takes to get there.

Your flow rate can also be measured by recording how long it takes to urinate into a special container that accurately measures how much urine you release.

Postvoid residual measurement

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This urodynamic test measures how much urine is left in your bladder after you urinate. If you have 100–150 milliliters of urine or more left in your bladder, your bladder is not emptying completely. This test can be conducted with an ultrasound or by feeding a catheter into your bladder to drain and measure remaining urine.

Bladder ultrasounds are performed by a specially trained technician in a health care professional’s office, radiology center, or hospital.

Hernia Surgery

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A hernia is usually treated with surgery. The three main types of hernia surgery are open repair, laparoscopic (minimally invasive) repair, and robotic repair. This article provides details of each procedure.

What is a hernia?

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A hernia is the protrusion of an organ through the structure or muscle that usually contains it. The condition occurs most often in the abdominal wall, when the intestine pushes through a weak spot in the wall. The most common abdominal wall hernia is an inguinal hernia.

What is open hernia repair surgery?

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Open hernia repair is where an incision, or cut, is made in the groin. The hernia containing the bulging intestine is identified. The surgeon then pushes the hernia back into the abdomen and strengthens the abdominal wall with stitches or synthetic mesh. Most patients will be able to go home a few hours after surgery, and feel fine within a few days. Strenuous activity and exercise are restricted for four to six weeks after the surgery.

What is laparoscopic (minimally invasive) hernia repair surgery?

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Laparoscopic (minimally invasive) hernia repair uses a laparoscope, a thin, telescope-like instrument that is inserted through a small incision at the umbilicus (belly button). This procedure is usually performed under general anaesthesia, so before the surgery, you will have an evaluation of your general state of health, including a history, physical exam (and possibly lab work) and an electrocardiogram (EKG).

You will not feel pain during this surgery. The laparoscope is connected to a tiny video camera, smaller than a dime, that projects an “inside view” of your body onto television screens in the operating room.

The abdomen is inflated with a harmless gas (carbon dioxide), which creates space to allow your doctor to view your internal structures. The peritoneum (the inner lining of the abdomen) is cut to expose the weakness in the abdominal wall. Mesh is placed on the inside to cover the defects in the abdominal wall and strengthen the tissue.

After the procedure is completed, the small abdominal incisions are closed with a stitch or two or with surgical tape. Within a few months, the incisions are barely visible.

Benefits of laparoscopic hernia surgery include three tiny scars rather than one larger incision, less pain after surgery, a quicker return to work and a shorter recovery time (days instead of weeks).

How can I reduce and manage pain after hernia surgery?

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surgeon will provide you with a specific plan but may not be able to give you an exact time frame in advance. Doctors usually cannot fully diagnose the severity of a hernia until they perform the surgery.

Hernia procedures are usually outpatient surgeries. In general, the sooner you can start moving afterward, the better. This movement helps prevent constipation and blood clots. Be sure to adhere to the doctor’s instructions about what you can lift, how to lift, and how long to remain on any restrictions; some may be permanent.

Advin Hernia Surgery Instrument Set

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• Multi-Function Trocar
• Port Closer
• Suction irrigation Set
• Grasper
• Bipolar Forceps
• Vessel Sealer with Cutter
• Monopolar Electrodes
• Hernia Mesh
• Needle Holder
• Knot Pusher
• Veress Needle
• Laparoscope
• Advin Electro+
• HD Camera System
• Vessel Sealer Cautery machine
• LED Light Source

Hospitals are also an essential part of health system development. Currently, external pressures, health systems shortcomings and hospital sector deficiencies are driving a new vision for hospitals in many parts of the world. In this vision, they have a key role to play to support other healthcare providers and for community outreach and home-based services and are essential in a well-functioning referral network.

Hospitals matter to people and often mark central points in their lives. They also matter to health systems by being instrumental for care coordination and integration. They often provide a setting for education of doctors, nurses and other health-care professionals and are a critical base for clinical research.

Health care is the basic need and right of every citizen of our country. Hospitals, nursing homes, clinics, medical camps etc form the platform for this healthcare delivery, assisted by doctors, nurses and other medical staff. This is far below the world average of 30 hospitals per 10,000 population.

Setting up a hospital requires skills that are not taught in medical schools – devising a sustainable business plan, obtaining necessary finances, being more visible to potential patient, and the sorts. The Process is undoubtedly long-drawn and, without prior know-how, can be a series of trials and errors before bearing fruit. Following are the pointers one needs to keep in mind and set in place for setting up a private hospital:

Location of the hospital

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This has to be chosen well, because if there are already some hospitals in the locality, then it will be difficult to pool in patients. Also, the hospital needs to be set up in an area which has good transportation facility or is close to a railway station. Considering the cost of real estate, a huge financial investment is required.

Facilities your hospital offers

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One has to be sure what set-up is planned and what infrastructure is required. A paediatric, orthopaedic, gynaecologic, oncology, pathology, imaging, etc facility in the hospital all require different facilities.

Permits for your hospital

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1. Land and construction

Land allotted for agriculture cannot be used. To start building the hospital wing, several permissions from local authorities need to be taken. Numerous documents need to be approved, like land deed, architect’s plan, etc.

An occupation certificate is obtained after clearing all formalities.

2. Electricity and water

As per the requirements of the hospital, permission has to be taken from the local governing body to obtain electric meters and water supply. Water requirement has to be calculated, which for any setup is approx. 100 litres per day.

3. Sewage

Proper disposal of waste requires a well-planned sewage and drainage system, which is done after permission is sought from the local board.

4. Biomedical waste

This is very vital aspect and permission of Municipal Corporation/ Government is required for installing incinerators required to dispose of medical waste and body parts.

5. Fire and Health Licence

A Fire licence is necessary to prove that the hospital will not cause any damage or loss of life and needs to be procured from the local municipal council.  Procuring a health licence is vital to provide health care to the patients.

Planning your hospital infrastructure

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Take care of all these:

• Doctors, their qualifications and registration numbers recorded
• Nurses and working shifts discussed and set
• Medical equipment and instruments purchased
• Computers and other hardware devices set up

Engineers and staff required for maintenance, plumbing, medical gas pipelines, air conditioning, etc. set

Multiple medical laws and ethics must be followed at every step. A set of guide lines and eligibility criteria have been put forth by government for hospitals, which provide services to central government health scheme beneficiaries.

A tremendous amount of planning, large finances, approvals, certifications, licences and guide lines need to be followed while setting up a hospital as per country. It might be well worth it at the end, but needs ample time and mammoth effort to pool together the resources in place.

Medical devices play an important role in helping patients manage their medical conditions. They also provide doctors and health practitioners with the information they need to follow their patient’s progress long after the office visit is over. Technology is ever-evolving to bring new, advanced developments in how patients and physicians can track medical conditions.

Medical devices do more than help a doctor or facility diagnose what is happening — they add a level of convenience for the patient that they never experienced before. A modern medical device could reduce the amount of time a person needs to spend at a doctor’s office, medical clinic, or hospital undergoing tests. Many diagnostics that used to be only performed in a clinic can now be measured remotely while the individual goes about their daily life. Let’s take a closer look at some current medical device trends and how they are impacting the healthcare sector.

Mobile Health Apps and Privacy

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Regardless of the condition and device, going digital is an important aspect of the latest medical devices. Wearable tech or medical devices can monitor a patient’s health and track symptoms, but the information the device is recording is best managed by a medical professional. Apps can keep medical practitioners connected so they can keep abreast of how their patients are doing, without as many follow-up visits needed.

Patient confidentiality and privacy is critical. The Health Insurance Portability and Accountability Act (HIPAA) mandates that medical facilities and practitioners must safeguard the privacy of their patients’ confidential information. Do patients expose themselves to privacy violations if they’re using mobile phone apps to monitor, track, and share their medical data? It’s unlikely.

Long gone are the days when mobile phone apps were primarily for smashing cartoon pigs, much less simply making phone calls. Helpful apps are now central to many people’s daily lives.

According to Statista data, Apple App Store carries 2.2 million apps for iPhone users, and Google’s GooglePlay store offers 3.48 million apps for users of phones with the company’s Android operating system.

Among these are an estimated 99,366 medical, health, and fitness apps. Collectively, they are referred to as mHealth apps.

The connectedness and convenience that mHealth — and most other facets of eHealth — provides have the potential to greatly improve quality of life and ease of care when used appropriately.

From improved medication adherence to aggregated patient data, the benefits are plenty.

As people become more mobile and travel becomes more accessible, patients will increasingly expect the healthcare record system to provide essential health information via mobile devices, which will give their treating physician basic information such as medical condition and drug/allergy information. Demographics, insurance data, medications, allergies, alerts in respect of new symptoms, and vital signs are some of the records recommended to be provided in at least read-only format and to the extent relevant for emergency care and quick reference. It is also possible that the patient will be able to provide certain clinical readings (BP, temperature, glucose count) and lifestyle data (steps walked, distance run, sleep duration and quality), which will serve as key clues and information on her/his overall health status. Notwithstanding a shadow of uncertainty in respect of the applicable rules and regulations of such mobile applications, the guidelines for their governance are clear.

New Tech Advancements for Diabetes

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Diabetes is at the forefront of medical devices that track and monitor illnesses. For many diabetics, the disease interferes with their quality of life because of the demanding daily requirements to keep the condition under control. Many diabetes sufferers must take daily blood sugar readings, sometimes many times each day, to monitor blood sugar levels. More severe cases may need to perform the blood sugar readings as often as 10 times per day. The testing can be taxing, especially because of the pinpricks required to draw blood.

Then there’s the medication. Many patients take diabetes medication such as Toujeo, a form of insulin that must be injected, at least daily. In the case of testing and taking insulin shots, it’s all too easy to forget and accidentally skip a dose or reading. That’s where new technology comes in.

A new device is under development that could regulate Type 1 diabetes more effectively by delivering insulin automatically as needed. Known as a closed-loop delivery system, this technology is not a new concept. The FDA approved the first hybrid artificial pancreas version in 2016. The latest device under testing is known as Control-IQ system. It will use algorithms to adjust a patient’s insulin doses automatically so they no longer have to repeatedly test their blood sugar levels and remember to take their insulin injections.

Diabetes smartphone apps Yes, there’s an app for that — many of them, in fact. Nowadays, diabetes apps can track your blood sugar levels and show trends; monitor your diet and suggest recipes; log your exercise; and provide support from other people with diabetes. “Coaching apps can also give you access to highly trained diabetes educators and fitness coaches,” Porter says.

Continuous glucose monitoring (CGM)

CGM, commonly known as blood sugar monitoring, automatically tracks blood glucose levels throughout the day and night through a button-like device that is fixed to a person’s arms.

You may view your glucose level at a glance at any moment.

You may look at how your glucose levels fluctuate over a few hours or days to determine if there are any diet or activity changes.

Seeing your glucose levels in real-time can help you make more educated decisions about how to balance your meals, physical activity, and medications throughout the day.

CGM works by inserting a small sensor (almost painless cannula) beneath your skin, commonly on your abdomen or arm. The sensor detects interstitial glucose, which is glucose contained in the fluid between cells. Every few minutes, the sensor checks the glucose level. Data are wirelessly sent to a monitor by a transmitter.

CGM devices have evolved throughout time, with significant advancements in accuracy, dependability, and simplicity of use. However, there are several key distinctions between the two primary types of CGM—real-time and intermittently scanned—that you should consider when selecting the proper system for you.

Heart Failure Detectors

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Patients who are at high risk for heart failure are often implanted with a small device known as an ICD (Implantable cardioverter-defibrillator) or CRT-D (Cardiac Resynchronization Therapy Device). Boston Scientific’s Heart Logic device can be included in either ICD or CRT-D to predict heart failure weeks in advance. The Heart Logic device’s sensors monitor for the warning signs leading to heart failure. The tiny device is fitted with sensors that can track a patient’s vitals and heart rate, listen for changes in heart sounds, monitor respiration, and watch for shortness of breath.

Besides the Heart Logic device, there are other options using wearable tech that could track heart activity. For patients with less severe heart conditions, wearable tech, such as the Fitbit and Apple Watch, can track vital signs like heart rate. The tech may detect irregular heart rhythms which can lead to stroke or heart failure.

Another interesting medical device innovation: There is now a lung fluid vest available that measures the level of fluids inside a person’s lungs and monitors lung congestion levels to reduce the risk of heart failure. The alternative would be regular (and more invasive) chest X-rays. The wearable vest is more effective at identifying the condition before it’s too late without causing the patient too much inconvenience.

3D print technology helping save lives

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Another emerging technology that is expected to gain a lot of traction in the medical device industry is 3D print technology. 3D printing is the process of making 3-dimensional solid objects from a digital file. When used in the medical device industry, 3D rendering technology has remarkable capacity to create a positive impact and save lives. With 3D print technology, it is possible to generate prosthetics that are customized to patients, produce custom-made organs and tools used for surgical procedures. In addition to this, these printed objects can also be used for the development of prototypes and for purposes of research. Moreover, 3D print technology is also used for the enhancement of design in dentistry and orthodontics.

Medical wearable technology is becoming popular

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One of the most significant advancements in the healthcare industry is the advancement of wearable technologies. Smart wearable medical technology has made it possible to monitor the status of a patient or monitor their own status, which is incredibly valuable. The trend for consumer smartwatches is set to become more widely adopted and their potential to be used in healthcare applications must be noted. In addition to this, smartwatches are also improving in their ability to provide more precise blood vitals in their users.

Smart watches are not the only technology that will see a growing curve in the coming years. Bio patches and small hearing aids have similar levels of impact when it comes to promoting overall health and wellness and optimize healthcare given to patients.

The Indian healthcare system continues to be impacted by aspects of availability, affordability and quality of health services. Given these, India lags behind averages of BRIC Countries. A key area of concern for India is the proportion of non-communicable diseases which is expected to rise in the next decade. The total healthcare expenditure in India was only 3.9% of GDP, compared to 8.9% for Brazil, 6.2% for Russia and 5.2% for China. Out-of-pocket expenditure is as high as 61%, with only 25% of the population being covered by health insurance.

While the government and value chain participants have undertaken several steps to address the issues of healthcare access, quality and affordability, these have been executed in silos. Specifically, while medical device companies have focused largely on extending life expectancy and improving quality of care, there is a need to increase affordability for a widespread impact. The challenge therefore for companies in India is to produce medical devices that are both cost competitive and effective to increase penetration and use. It is in this context that the Make in India initiative becomes significant for the medical devices industry.

Medical devices play a role not only in screening, diagnosing and treating patients but also in restoring patients to normal lives and in regularly monitoring health indicators to prevent diseases. With technological advancements, the role of medical devices is now expanding to improve quality of care across each stage of the healthcare continuum:

Screening and diagnosis:

Both accuracy and complexity of screening and diagnosis are increasing. Point-of-care / portable diagnostic devices provide care at home resulting in improved outcomes, patient satisfaction and, increased access to care in under-penetrated and remote regions, while facilitating treatment outside health facilities.

Treatment/Care:

Advanced surgical equipment is not only enabling doctors treat highly critical and complex cases but also reducing length of hospital stays. It is increasingly allowing elective but complex surgeries like knee replacement, bariatric, pain management, etc. to be shifted to outpatient / short stay surgery centre.

Restoration:

Hospitals and physiotherapy-rehabilitative centres are now enabling patients to restore their health faster and return to normal productive lives through the use of advanced assistive and rehabilitative device.

Monitoring:

Health screening devices are enabling patients to take charge of their health at home and regularly monitor health indicators. Further, devices are being used to monitor patients remotely for early diagnosis thus minimizing hospital visits and reducing pressure on the country’s over-burdened medical resources.

Overall growth in healthcare infrastructure

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There is a significant increase in the number of hospitals and hospital beds in India. Bed strength had increased from 0.8 million in 2002 to 1.6 million in 2012, and is further expected to increase to around 2.9 million by 202513. This increase has been driven primarily by growing presence of corporate hospital chains, international companies and service providers entering tier 2 and tier 3 cities.

• There is an increasing presence of diagnostics laboratory chains focusing on imaging and pathology. It is estimated that there are more than 100,000 diagnostic laboratories across the country, with the number expected to grow at a rate of 15% – 20%.
• The healthcare industry is also witnessing the emergence of new formats like chains of multispecialty outpatient clinics, mother-and-child hospitals, short stay surgery centres, IVF centres, etc; which are driving demand for medical devices.

Increasing focus of healthcare providers on quality and accreditation

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There has been a strong focus on upgrading medical technology by hospitals and laboratories to comply with accreditation requirements. Around 285 hospitals in India are NABH accredited with 472 additional proposals submitted for accreditation. Similarly, 347 laboratories in India are NABL accredited with 150 additional proposals submitted.

While the potential of the medical devices sector is acknowledged with its inclusion in the ‘Make in India’ initiative, it is essential to leverage the initiative to kickstart indigenous manufacturing and realize the twin objectives of accessibility and affordability.

Advin Health care is aimed at understanding the context, Constraints and opportunities for medical device Players, healthcare provides and key policy makers; Exploring the significance of India and other global manufacturing destinations; and aligning ‘Make in India’ fo medical devices with other key government supports.

Current landscape and key considerations for growth

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The medical devices market grew at a 10% CAGR in the past five years, reaching a value of USD 3.7 billion16 in 2014. From 2014 levels, if the industry continues on its organic growth trajectory, it is expected to reach USD 8.6 billion in size by 2020, growing at a CAGR of around 15% against the expected global industry growth of 4-6%.

In this scenario, the focus on augmenting healthcare infrastructure due to increased demand and improved access is expected to provide the requisite industry growth. Currently, the Indian medical devices industry represents just over 1.3% of the global medical devices market of USD 335 billion, which is dominated by USA (USD 134 billion in 2014). With an enabling policy framework and ecosystem support, industry estimates indicate a potential to grow at ~28% to USD 50 billion by 202519. This growth is expected to be driven by indigenous manufacturing and exports and, sales from local innovation.

Export Scenario

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India has a 75-80% import dependency on medical devices. Export of medical devices from India stood at US$ 2.53 billion in FY21, and are expected to rise to US$ 10 billion by 2025.

To increase export of medical devices in the country, the Ministry of Health and Family Welfare (MOHFW) and Central Drugs Standard Control Organisation (CDSCO) implemented the following initiatives:

Re-examination and implementation of Schedule MIII (a draft guidance on good manufacturing practices and facility requirements) System for export labelling Clinical evaluation and adverse reporting clarification State licencing authority to extend free sales certificate validity from 2 years to 5 years to allow exports Create a list of manufacturers with export licencing for easy access to regulatory authorities worldwide.

The Medical Devices Virtual Expo 2021 showcased Indian products and enabled direct interaction between Indian suppliers and buyers/importers from participating countries; 300 foreign buyers from the healthcare sector participated in this event.

Overview

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Dilation and curettage (D&C) is a procedure to remove tissue from inside uterus. Health care providers perform dilation and curettage to diagnose and treat certain uterine conditions — such as heavy bleeding — or to clear the uterine lining after a miscarriage or abortion.

In a dilation and curettage, your provider uses small instruments or a medication to open (dilate) the lower, narrow part of uterus (cervix). Your provider then uses a surgical instrument called a curette, which can be a sharp instrument or suction device, to remove uterine tissue.

Who needs a dilation and curettage (D&C?)

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You may need a D&C if you have or had:

• A miscarriage.
• Leftover tissue in your uterus after an abortion.
• Unexplained bleeding between menstrual periods.

Sometimes, you have a D&C and hysteroscopy. During this procedure, your provider inserts a device into your cervix to see the inside of your uterus. You may have a hysteroscopy with a D&C if your provider is trying to diagnose a problem.

To diagnose a condition

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Before doing a D&C, your provider might recommend a procedure called endometrial biopsy or endometrial sampling to diagnose a condition. Endometrial sampling might be done if:

• You have unusual uterine bleeding
• You have bleeding after menopause
• You have unusual endometrial cells, which are discovered during a routine test for cervical cancer

To perform the test, your provider collects a tissue sample from the lining of your uterus (endometrium) and sends the sample to a lab for testing. The test can check for:

• Endometrial intraepithelial hyperplasia — a precancerous condition in which the uterine lining becomes too thick
• Uterine polyps
• Uterine cancer

If more information is needed, your provider then might recommend a D&C, which is usually done in an operating room.

To treat a condition

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When performing a D&C to treat a condition, your provider removes the contents from inside your uterus, not just a small tissue sample. This might be done to:

• Prevent infection or heavy bleeding by clearing tissues that remain in the uterus after a miscarriage or abortion
• Remove a tumor that forms instead of a typical pregnancy (molar pregnancy)
• Treat excessive bleeding after delivery by clearing out any placenta that remains in the uterus
• Remove cervical or uterine polyps, which are usually noncancerous (benign)

A D&C might be combined with another procedure called hysteroscopy. During hysteroscopy, your provider inserts a slim instrument with a light and camera on the end into your vagina, through your cervix and into your uterus.

Your provider then views the lining of your uterus on a screen, checking for areas that look unusual. Your provider also checks for polyps and takes tissue samples as needed. During a hysteroscopy, uterine polyps and fibroid tumors can be removed.

At times, a hysteroscopy might be done combined with an endometrial biopsy before a full D&C procedure.

What are the advantages of a dilation and curettage (D&C)?

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A D&C can help your provider figure out why you have abnormal bleeding. It can also help detect abnormal endometrial cells, which may be a sign of uterine cancer. After a D&C, your provider sends the sample of cells to a laboratory where pathologists can identify if you have normal or abnormal tissue, polyps or cancer.

A D&C may also be important for your health after a miscarriage or abortion. It removes any leftover tissue to prevent heavy bleeding and infection.

ADVIN D & C Instrument SET

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• Sponge Holding Forceps
• Vulsellum Forceps
• Ovum Forceps
• Uterine Sound
• Curette
• Sims Speculum Med
• Dilator Set 8

Chronic Kidney Disease

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Chronic kidney disease (CKD) means your kidneys are damaged and can’t filter blood the way they should. The disease is called “chronic” because the damage to your kidneys happens slowly over a long period of time. This damage can cause wastes to build up in your body. CKD can also cause other health problems.

The kidneys’ main job is to filter extra water and wastes out of your blood to make urine. To keep your body working properly, the kidneys balance the salts and minerals—such as calcium, phosphorus, sodium, and potassium—that circulate in the blood. Your kidneys also make hormones that help control blood pressure, make red blood cells, and keep your bones strong.

Kidney disease often can get worse over time and may lead to kidney failure. If your kidneys fail, you will need dialysis or a kidney transplant to maintain your health.

The sooner you know you have kidney disease, the sooner you can make changes to protect your kidneys.

What are the symptoms of CKD?

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Early CKD may not have any symptoms

You may wonder how you can have CKD and feel fine. Our kidneys have a greater capacity to do their job than is needed to keep us healthy. For example, you can donate one kidney and remain healthy. You can also have kidney damage without any symptoms because, despite the damage, your kidneys are still doing enough work to keep you feeling well. For many people, the only way to know if you have kidney disease is to get your kidneys checked with blood and urine tests.

As kidney disease gets worse, a person may have swelling, called edema. Edema happens when the kidneys can’t get rid of extra fluid and salt. Edema can occur in the legs, feet, or ankles, and less often in the hands or face.

Symptoms of advanced CKD

• chest pain
• dry skin
• itching or numbness
• feeling tired
• headaches
• increased or decreased urination
• loss of appetite
• muscle cramps
• nausea
• shortness of breath
• sleep problems
• trouble concentrating
• vomiting
• weight loss

What is Haemodialysis?

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With haemodialysis, a machine removes blood from your body, filters it through a dialyzer (artificial kidney) and returns the cleaned blood to your body. This 3- to 5-hour process may take place in a hospital or a dialysis centre three times a week.

You can also do haemodialysis at home. You may need at-home treatments four to seven times per week for fewer hours each session. You may choose to do home haemodialysis at night while you sleep.

What happens before hemodialysis?

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Before you start haemodialysis, you’ll undergo a minor surgical procedure to make it easier to access the bloodstream. You may have:

• Arteriovenous fistula (AV fistula): A surgeon connects an artery and vein in your arm.
• Arteriovenous graft (AV graft): If the artery and vein are too short to connect, your surgeon will use a graft (soft, hollow tube) to connect the artery and vein.

AV fistulas and grafts enlarge the connected artery and vein, which makes dialysis access easier. They also help blood flow in and out of your body faster.

If dialysis needs to happen quickly, your provider may place a catheter (thin tube) into a vein in your neck, chest or leg for temporary access.

Your provider will teach you how to prevent infections in your fistula or graft. This provider will also show you how to do haemodialysis at home if you choose to do so.

What happens during haemodialysis?

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During haemodialysis, the dialysis machine:

• Removes blood from a needle in your arm.
• Circulates the blood through the dialyzer filter, which moves waste into a dialysis solution. This cleansing liquid contains water, salt and other additives.
• Returns filtered blood to your body through a different needle in your arm.
• Monitors your blood pressure to adjust how fast blood flows in and out of your body.

What is peritoneal dialysis?

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With peritoneal dialysis, tiny blood vessels inside the abdominal lining (peritoneum) filter blood through the aid of a dialysis solution. This solution is a type of cleansing liquid that contains water, salt and other additives.

Peritoneal dialysis takes place at home. There are two ways to do this treatment:

• Automated peritoneal dialysis uses a machine called a cycler.
• Continuous ambulatory peritoneal dialysis (CAPD) takes place manually.

What happens before peritoneal dialysis?

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About three weeks before you start peritoneal dialysis, you’ll have a minor surgical procedure. A surgeon inserts a soft, thin tube (catheter) through your belly and into the peritoneum. This catheter stays in place permanently.

A healthcare provider will teach you how to perform peritoneal dialysis at home and prevent infections at the catheter site.

What happens during peritoneal dialysis?

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During peritoneal dialysis, you:

• Connect the catheter to one branch of a Y-shaped tube. This tube connects to a bag that has dialysis solution. The solution flows through the tube and catheter into the peritoneal cavity.
• Disconnect the tube and catheter after about 10 minutes, when the bag is empty.
• Cap off the catheter.
• Go about your usual activities while the dialysis solution inside the peritoneal cavity absorbs waste and extra fluids from the body. This process can take 60 to 90 minutes.
• Remove the cap from the catheter and use the other branch of the Y-shaped tube to drain the fluid into a clean, empty bag.
• Repeat these steps up to four times a day. You sleep with the solution in your stomach all night.
• Some people prefer to do peritoneal dialysis at night. With automated peritoneal dialysis, a machine called a cycler pumps the fluid in and out of the body while you sleep.

ADVIN NEPHROLOGY / Haemodialysis SETUP

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We, Advin Provides international Quality Standards Products for Haemodialysis Product

• Haemodialysis Machine
• Dialysis Chair
• RO Plant
• Bicarbonate Mixture
• Dialyzer
• Blood Line set
• AVF Needle
• Haemodialysis Double / Triple lumen Catheter Kit
• Acid Concentrate Part A Liquid / Solid
• Bicarbonate Part B Liquid / solid
• Bicarbonate Bi-Bag
• Bicarbonate Bi-Cart
• Hot Disaffection
• Cold Sterilant
• Peritoneal Dialysis Kit
• Heparin
• EPO Injection

Kidney Transplant – a successful answer for patients experiencing end stage renal sickness. The rates of Kidney failure are expanding alarmingly with factors like hypertension and diabetes adding to it. When the kidney begins disintegrating, it becomes Chronic Kidney Disease.

With time, working of kidney progressively deteriorates till it can’t support body works; this is End Stage Renal Disease. At this stage, dialysis becomes compulsory for proper working of the body. What are the choices accessible for a patient with End Stage Renal Disease? Haemodialysis: As a part of Haemodialysis, a patient goes through least of 2-3 dialysis each week in the medical clinic.

To keep up with such a patient on dialysis, a vascular access is expected through which arterial blood is pumped into the dialysis machine. After the cleaning procedure, blood is returned back into the body.

Continuous Ambulatory Peritoneal Dialysis: This is a type of peritoneal dialysis which can be done by the patient himself at home. A tube is inserted into the abdomen precisely, through which dialysing liquid is filled. The patient needs to make 2-3 such exchanges day to day for typical working of the body. This is relatively expensive and may introduce infection if not done carefully.

Kidney Transplantation: This is the best technique that is also cost effective, where the patient can return to an ordinary life. A healthy kidney from donor is transplanted into patient to support ordinary renal function. Patient is kept up on dialysis till Kidney transplantation is finished. Legally, family members who can give the kidney are the patient’s father, mother, brother, sister, grandparents and spouse. Unrelated transplantation is possible only in some cases where there is no suitable family donor.

What are the base necessities for a Kidney Donor? Donor should be from matching blood group or O+ve (universal donor) as in blood transfusion. Such transplantation is called ABO compatible transplantation. Presently ABO inconsistent renal transfer is likewise conceivable with good results. Donor’s kidneys should be working well so his/her renal function can be supported regularly with a single kidney after donation. Donor likewise goes through HLA typing which decides the number of antigens that are matching. Minimum mismatch means good and long-term implant survival. What is the interaction for Kidney Transplant? After all conventions are finished, the donor and patient are presented to an independent authorisation committee that has been approved by the govt. for an approval.

The donor kidney is first recovered through an open a medical procedure or laparoscopic medical procedure. In the recipient his/her native kidneys are left accordingly and the new kidney is transplanted in the lower abdomen. During the surgery, the artery and vein of the giver kidney (renal corridor) are joined to the artery and vein of the patient, respectively. This re-establishes blood circulation in the transplanted kidney, thus restoring functioning of the kidney. The Ureter of the donor kidney is joined to the urinary bladder, thus finishing a medical procedure.

Post- surgery, what should the patient watch out for? In spite of being a relative’s kidney, the body’s immune system doesn’t accept any foreign organ and tries to reject it, making the kidney non- functional. To keep away from this, the immune system is suppressed by immuno-suppressive drugs, which should be taken forever. Post-surgery, patients can continue ordinary life after kidney transplantation. Assuming antigen match is good, the kidney can work for over 30 years.

Nephrology Products

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We, Advin Health Care, provide international quality standard products for Nephrology Products.

• Dialysis Machine
• Dialysis Patient Chair
• Dialyser Reprocessing Machine
• Nephrology Products

advin is a leading supplier to Australasian healthcare facilities for all their hospital furniture needs. Our extensive sourcing capability provides our clients with a broad choice of options to meet their budget, clinical performance, safety and patient comfort needs.

With strong international alliances, advin is able to provide our clients with the latest products, trends, and innovations from Europe, the USA and other developed healthcare markets.The brands and suppliers we represent are proven performers on an international stage with a reputation for quality, cost effectiveness, and durability.

Regardless of the size of the order or your equipment specification – advin has the capability to understand your requirements, and customise a solution tailored to your needs – that’s why we are the Safe Choice in Furniture and Medical Equipment Fitout and Replacement.

We provide the biggest range of quality hospital grade furniture, equipment and storage solutions. This includes patient transport, examination tables, treatment chairs, pediatric and bariatric equipment, patient seating options, bedding, medical trolleys, showering, lighting, and hospital grade refrigeration. Other specialised clinical furniture we source includes – racking and storage, mortuary equipment, disposable curtains and custom curtains, which are proven to create a more positive clinic atmosphere and improve patient experience.