Author Archives: Manbir & Gurpreet

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About Manbir & Gurpreet

Gurpreet Kaur’s journey in this world .... Gurpreet Kaur was a Musician. She was a singer and a composer of music. Her interest was composing and singing Gurbani Shabads in Indian Classical style. She sang Shabads in All the Raags mentioned in Sri Guru Granth Sahib Ji. She also taught Gurmat Sangeet at Gurmat Gian Missionary College, Jawadi, Ludhiana. Elder child to Pushpinder Kaur and Dr. Brig. Harminder Singh, was born in Amritsar on 13th Jan 1962. She attended various convent schools as a child because her father would get frequent Army postings as a dental surgeon. She graduated with Music Honors from Govt. College for Women, Chandigarh. Music was her hobby and she composed and sang Raag based Gurbani Shabads. Doing Kirtan was part of growing up nurtured by her parents. She learned music from her father Dr. Brigadier Harminder Singh who was a dental surgeon in Indian Army and a very good singer himself. Gurpreet’s Bhua (father’s sister), Ajit Kaur retied as a Head of Department of Music from Govt. College for Women Ludhiana, and was a renounced Punjabi singer of her time. Gurpreet Kaur also learned nuances of Indian Classical Music from Pandita Sharma. She was a mother of three children, and a grandmother. Her daughter Keerat Kaur is a Computer Engineer. Her two sons Gurkeerat Singh and Jaskeerat Singh are doctors in USA. Her daughter Keerat Kaur too was part of her group ~ Gurmat Gian Group. Gurpreet Kaur left this world at the age of 54yrs on 12th Sept 2016 in Baltimore USA. She had recorded around 25 cds of Gurbani Keertan. 'Raag Ratan' Album (6 CDs) is a Compilation of Shabads in All the 31 Sudh Raags of Sri Guru Granth Sahib Ji. 'Gauri Sagar' Album (3 CDs) is a Compilation of All forms of Raag Gauri in Sri Guru Granth Sahib Ji. 'Nanak Ki Malhaar' ~ ((3 CDs) is an album of Raag Malhar Shabads in various forms of Malhar. 'Gur Parsaad Basant Bana' ~ (3 CDs) is an album of Shabads in Raag Basant sung in various forms of Raag Basant. Har Ki Vadeyai Sarni Aayea Sewa Priya Kee Preet Piyaree Mohan Ghar Aavho Karo Jodariya Mo Kao Taar Le Raama Taar Le Tere Kavan Kavan Gun Keh Keh Gawan Mera Baid Guru Govinda Saajanrraa Mera Saajanrraa

Ultrasonic liposuction

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Ultrasonic liposuction
Ultrasonic liposuction is a very new technique. There are now two main types of ultrasonic liposuction:INTERNAL (with the vibrating cannula) and

EXTERNAL (done by a vibrating machine just prior to the liposuction procedure).

It can be performed with either the traditional, wet or tumescent methods.
Ultrasonic means high-pitched sound. This property has many uses outside of the operating room in “shaking things loose” as in the new ultrasonic toothbrushes. The ultrasonic principle is to loosen the fat, so that fat or oil can be vacuumed out of the body faster than it might with other methods.

Unfortunately, the ultrasonic equipment used (referred to as cannulae, or tubes) may overheat and has caused burns to patients. At times, Ultrasonic cannulae have perforated patients kidneys and gallbladders. Additionally, Ultrasonic Liposuction may cause “end hits”, a burning through of the surface skin. “End hits” occur when the ultrasonic cannula pushes on the skin from the inside out, resulting in blister formation and sometimes scarring. Ultrasonic Liposuction results in more seroma formation than other methods. Seromas are collections of fluid. These fluid balls are made in the tissue as a response to injury. Seromas may be long-lasting and unsightly. Moreover, Ultrasonic instrumentation is very expensive.
  
Obesity

Liposuction

Tumescent Liposuction 


Tumescent Liposuction

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Tumescent Liposuction
The Tumescent Technique, which permits the local anesthesia of large areas of subcutaneous fat, was developed by a California dermatologic surgeon Jeffrey Klein, M.D., in 1985. Klein first presented his findings in 1986 at the Second World Congress of Liposuction Surgery in Philadelphia.
The Tumescent Technique utilizes large volumes of saline solution, containing dilute local anesthetic and adrenaline, which is injected into the fatty tissue. The injected area then becomes locally anesthetized – “numbed”. There may be some discomfort during the initial process of injection. With the tumescent technique, liposuction patients usually need no general anesthesia, as compared with the traditional standard liposuction methods. However, patient may require intravenous sedation or narcotics. In fact, many receive only minor sedation to help them relax, and are completely conscious and comfortable during suctioning portion of tumescent liposuction surgery. After surgery, most patients may get up and walk out of the office without assistance. Patients are usually back to their regular routine in a couple of days. With the Tumescent Technique, postoperative discomfort is significantly reduced, since the local anesthesia remains in the treated tissue for 16 hours after surgery.The Klein formula tumescent solution is injected into the fatty tissue through small, “numbed” slit incisions in the skin. These slit incisions are made, when possible, in inconspicuous places. The tumescent fluid is injected under pressure which causes the target fatty tissue to become firm and inflated. This allows the surgeon to later extract the fat in a more accurate and uniform fashion, thereby producing smoother results. The anesthetic and other agents in the tumescent solution should be allowed sufficient time to diffuse (percolate) and take full effect throughout the fatty tissue. The solution will numb the areas as well as reduce bleeding by temporarily closing down capillaries. Constricting the capillaries is important to reduce bleeding during and after surgery. Less bleeding means less bruising. Not only does this make the surgery safer, it also speeds up postoperative recovery. As a result, most patients can return to work or their regular routines in a couple of days.
Advantages of Tumescent Liposuction

  1. Tumescent liposuction is a dermatologic surgical procedure that can be done safely and less expensively in the office surgical suite.
  2. Relatively large liposuction cases can be done safely in an office surgical setting, affordably, using the tumescent method.
  3. The risks of general anesthesia are eliminated with tumescent liposuction (e.g.: risks of endotracheal intubation, risks of significant blood loss, risks of hypoxemia (low blood oxygen), and risks of side effects from general anesthesia).
  4. The desired fat compartments can be anesthetized (numbed) individually with tumescent liposuction.
  5. Intraoperative blood loss has been greatly reduced with tumescent liposuction. Usually, only 12cc of blood is lost for each liter of fat that is removed with tumescent liposuction. More blood than this (about 24cc) is required for a routine preoperative blood test!
  6. Blood transfusions and intraoperative intravenous fluid replacement are rarely necessary with tumescent liposuction.
  7. Sensations felt during the suctioning portion of tumescent liposuction are usually minimal. Patients rarely have intraoperative discomfort. However, some patients with a history of pain sensitivity may benefit from having an anesthesiologist “stand-by” or administer some “light sedation”. Patients who have never had surgery may wish this option as well if large or many areas are planned for liposuction.
  8. Post-operative recovery is faster following tumescent liposuction as, opposed to traditional/standard liposuction.
  9. The post-operative recovery period at home is usually 1-2 days. Many patients desire to have their liposuction performed on Thursday or Friday to take advantage of weekend (non-work) days.
  10. Post-operative discomfort is typically minimal. Significant numbing usually lasts for 18 hours in the suctioned areas. This is yet another major advantage that tumescent liposuction has over the other methods.
  11. Patients usually dress without assistance following tumescent liposuction and may walk out without assistance. In comparison, patients are customarily very bruised, very sore, and may be incapacitated for weeks following standard liposuction under general anesthesia.
  12. Post-operative pain medicines are rarely needed with tumescent liposuction.
  13. There is usually much less bruising and swelling with tumescent liposuction compared with standard liposuction under general anesthesia.
  14. Medical journal studies confirm that the aesthetic results of tumescent liposuction are superior.
 
Obesity 
Liposuction

Liposuction

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 Liposuction

History of Liposuction

Though liposuction is a relatively new form of cosmetic surgery, it has, nevertheless, become the most commonly performed cosmetic procedure in the United States. Since it was first introduced in the US in the early 1980’s, many refinements have been made. The most significant improvement was the use of dilute local aesthetic instead of general anaesthesia: this is the Klein Tumescent Technique. Again, the Klein technique is the most revolutionary technique in liposuction to date. Dr. Klein is a California Dermatologist.

SUCTION ASSISTED LIPECTOMY OR FAT SUCTIONING

Lipectomy means removal of fat by surgery. In lipolysis the surgeon loosens and removes the fat from an area by using long or short metal tubular instruments connected to a Suction machine. The suction tubes are usually made of stainless steel. The tips are blunt. The tubes have 1 to 5 holes near the tip on one side or on different sides. The suction machines used for this purpose create very powerful negative pressures (1 ton to 35 ton at sea level). Lipolysis was started in France in late 70’s and since 1981 is in practice in the United States and other parts of the world.

Fat collections at the Hips, Thighs, Buttocks, Abdomen, Arms, Under the Chin, Upper Torso, etc., can be reduced by this procedure.

Can one’s weight be reduced by this operation? 
Who is a good candidate for Lipolysis ?

Lipolysis is neither a substitute for dieting nor a cure for obesity

Persons with reasonably normal weight and healthy elastic skin with extra localized fat in certain areas, get the best results from this procedure. (Healthy elastic skin has the capacity to shrink after the surgery). Lipolysis can be done on patients up to 45 or 50 years of age, but it is not normally done if the skin is loose in the particular area. One could have loose skin after losing lot of weight or after pregnancy,or one could lose the elasticity of skin due to old age or other reasons. In these patients in addition to lipolysis, some of the skin should also be removed, i.e. Dermolipectomy to get a satisfactory contour for which hospitalisation is required.

The fat cells that are removed for ever do not come back again. Most of fat cells are situated under the skin. The total number of fat cells present in a person’s body does not increase as one grows older or when one gains weight. When a person gains weight, the size of the fat cells increases as more fat is being deposited in it. When one loses weight, the fat is mobilised out of the fat cells and so these cells become smaller in size. Only liver and skin have the capacity to regenerate in the human body. Fat cells cannot regenerate or multiply. And so, the fat cells that are removed are removed for ever.

SURGICAL PROCEDURE:

A small cut about 4 mm to 10 mm is made a few inches away from the area to be suctioned & the suction cannulae are inserted. The cuts are usually made in the skin folds and so, the scars are not much noticeable. Depending upon the areas to be suctioned and recontoured or reduced, anywhere from 600 gms to 3000 gms of the material is removed in one sitting. If more material is removed that would require blood transfusions. The removed material usually consists of 65% to 85% fat & the remainder would be blood, plasma and serum.

AFTER THE SURGERY snug or light dressings is applied for 5 to 8 days to promote the shrinkage of the skin and to minimise the swelling. In most instances, one is required to wear a support or a girdle for several weeks or months during the healing time. One could feel localised areas of hardness or firmness in the suctioned areas for 1 to 4 months after the surgery.

One may require pain medication by mouth for one to two days after the surgery. During the healing period, numbness or discomfort could be present for varied periods of time. After the surgery, there will be swelling in the areas of the surgery. Even through most of the swelling is gone in the first 2-3 weeks. It takes 2-4 months for all the swelling to be gone. Discolouration could last up to several weeks after the surgery. Even after muitiple area lipolysis one should be able to be up and around in 1 to 2 days and back to most of the normal activities in 10 to 14 days

Results

Results depend upon the expectations of the patients and the amount of fat that is suctioned from the given area. Usually patients with good elastic skin and who come for contouring a particular area are very happy. Older patients and patients who are overweight could be unhappy. Perfection and symmetry are not possible in every patient. Also in some patients, all unwanted fat cannot be removed in certain areas in the first sitting. On these patients, the lipolysis may have to be repeated. But a second lipolysis cannot be done until all the swelling is gone from that particular area (i e. about 4 months).

On rare occasions rippled or uneven skin or areas of loose skin could result from this surgery which might require further surgeries to correct them.

Dr. Wahiguru Pal Singh Sidhu
M.B.B.S,M.S.[SURG.]M.Ch.[PLASTIC SURG.]

NOTEWORTHY HISTORICAL HIGHLIGHTS ABOUT LIPOSUCTION
1974 Liposuction Invented in Rome, Italy by Dr. Giorgio Fischer, a GYNECOLOGIST.
1978 Taken to Paris, France and popularized by Dr. Illouz, a Plastic Surgeon.
1980’s Liposuction reaches the US. Initial enthusiasm peaks and falls as news spreads of increased complications and several deaths. Many of the deaths related to Board Certified Plastic Surgeons combining liposuction with abdominoplasty “tummy tucks.”
1985 Dr. Jeffrey Klein, a California Dermatologist, and Dr. Patrick Lillis, another Dermatologist, invent and pioneer the Tumescent Technique, the safest method known.
1993 Dr. Klein publishes his technique in the prestigious journal PLASTIC AND RECONSTRUCTIVE SURGERY, November issue.
1995 20/20 and Dateline interview and broadcast Dr. Klein and his methods.

Obesity & its associated Risks

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Obesity & its associated Risks
Being overweight is the second leading cause of preventable death in the United States.
It was always known to us that obesity has associated health related risks. The risks result primarily from increased risks for cardiovascular disease, high blood pressure, diabetes mellitus, and, possibly, some types of cancer.

Cardiovascular system

Increased risk of sudden death, Cardiac Arrhythmias, increased risk of atherosclerosis, abnormal lipid profile with decreased levels of HDL, and increased levels of low density lipoproteins. Prevalence of hypertension is also increased.
A waist circumference above 100 cm in men and above 90 cm in women is associated with increased levels of triglyceride and reduced levels of HDL cholesterol.

Diabetes Mellitus

Type 2 diabetes mellitus [non-insulin- dependent diabetes mellitus] has direct relation with abnormal weight of an individual. Diabetes is almost nonexistent in individuals with a BMI below 22.

Cancer

Obese men – higher incidence of cancer of prostate, colon and rectum.
Obese women – higher incidence of Uterus, Overies and Gal Bladder cancers.

24% of all cancers are linked to obesity

Gall Bladder Disease

Gall Bladder disease with formation of cholesterol stones also increases with obesity.

Respiratory system

Sleep apnoea occurs with excessive obesity.

Joints

Ostheoarthritis and gout is associated with obesity.

Skin Problems

Acanthosis nigricans, manifested by darkening of the skinfolds on the neck, elbows, and dorsal interphalangeal spaces. Fungal and other skin infections in the skin folds.

Endocrine system

Insulin resistance leading to hyperinsulinemia is a uniform feature and is directly related to the degree of obesity. Testosterone levels may be reduced in extreme obesity in men. Obesity leads to an earlier onset of menarche, and greater frequency of irregular and anovulatory cycles, and to earlier menopause.

Obesity

Hope for a new Fat Control Drug

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Hope for a new Fat Control Drug
The scientists, from Johns Hopkins University in Baltimore, US, found  a chemical, called C75 that stops the production of a hormone that makes the mice hungry. This compound that appears to switch off appetite in mice may hold clues to a similar drug for humans. It rapidly turns off appetite in mice and causing weight loss similar in many ways to that achieved by fasting.

Scientists have long known that a hormone called Neuropeptide Y is a major appetite regulator – if animals fast, the amount of NPY increases and stimulates appetite.

The C75 chemical was given to the mice by injection, and the scientists found that their interest in food ceased suddenly within 20 minutes. The chemical is not thought to be toxic in any other way to mice, although far more rigorous scientific testing would be needed before any similar compound could be used on humans.

Obesity