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The first & only center
45-A, Pankaja Mill Road GEM HOSPITAL
in South India to be certified as
Ramanathapuram, Coimbatore - 641 045 International Center of Excellence
in Obesity and Diabetes Surgery
Tel: 0422 - 2325100, Fax: 0422 - 2320879 Obesity is a medical condition in which excess Unlike most disease, Obesity doesn't have a single cause; there Obesity is rarely just a physiological problem. This disorder has far body fat has accumulated to the extent that it are several. Recent research suggests that the rise in obesity is reaching effects; physiological, psychological and social. On the may have an adverse affect on health. It is a life- primarily due to altered, sedentary lifestyles, high calorie diets physical front, obesity can lead to several complications that could long progressive, life threatening disease and reduced physical activity secondary to globalisation, be fatal or incapacitating if left untreated.
which can significantly reduce life expectancy. Some of the most common causes of obesity are as follows: Some of the most common diseases that are directly and When weight reaches extreme levels, it is indirectly linked to obesity are: called MORBID OBESITY which is prone to It has been scientifically shown that heredity influences the You are here, only because you are develop numerous medical, psychological and distribution of fat tissue. Moreover, weight regulation in the not happy with the way you are, be social consequences. human body depends upon various genetically determined factors such as hormones. Any abnormality in these factors could it the way you look or the way you It can be defined based on the Body Mass result in substantial weight gain. Almost 60% of obese people Index into various categories as shown below.
live. Isn't it? And you definitely are said to have inherited this condition. There are several BMI Classification: genetic conditions that also contribute or lead to weight gain. know the solution for this is not BMI = w + (kg) / [ht (m)] But this more often blamed as the cause, and these are definitely simple too. It requires a multi BMI is a useful general guideline and is a good modality care. For this we need estimator of body fat for most adults between 19 and 70 years of age In rare cases, some may develop obesity secondary to certain therapists from different aspects like hormonal disorders. This includes diseases like Cushing However, it may not be an accurate the nutritionist, lifestyle therapist syndrome, hypothyroidism, hypogonadism in men and measurement of body fat for body builders, polycystic ovarian syndrome in women and hypothalamic and a medical professional certain athletes, and pregnant women lesions like tumours.
dedicated to treat Obesity and Healthy weight is defined as BMI equal to or greater than 19 and less than 25 Diabetes and related diseases. What Certain drugs like steroids, sulfonylureas for diabetes, steroidal BMI greater than or equal to 25 is overweight contraceptives and antiepileptics such as valproate may cause if all these people are within one weight gain. Antipsychotics, antidepressants, mood stabilizers BMI greater than or equal to 30 is obesity roof. And the result - GEM like lithium are also known to possess the same properties. Even BMI ≥ 35 or 40 is severe obesity certain unapproved medications for weight loss may cause Obesity Diabetes Surgery Centre.
increase in weight and hence not recommended.
BMI of ≥ 35 or 40 - 44.9 or 49.9 is morbid Psychological Causes This is a speciality at GEM since Depression is most often associated with binge eating and may 2003 with more than 1000 A BMI of ≥ 45 or 50 is super obesity lead on accumulation of weight. The relationship between Obesity is also defined by waist size - over 90 obesity and one's emotional set-up is now widely recognized. Obesity surgeries being done so far, cm in males and over 80 cm in females.
Over time this becomes a repetitive process and eventually leads and now we have made this With every single increase in BMI, the chances speciality an exclusively dedicated of developing diseases like Diabetes, The food inflation may be high but still the world today is more department to handle these diseases.
affluent than it ever was, and people have access to a multitude of dietary options. People nowadays are also less active than their predecessors, however the calorific content of their diet hasn't decreased; instead it has increased. Diets around the world have drastically changed; we have transitioned from a high-protein, high-fat diet to a high-carbohydrate, high-fat diet.
Moreover, the consumption of empty-calorie foods like alcohol, aerated drinks, candies, cookies, chocolates etc. has also risen sharply. All of this, coupled with a sedentary lifestyle, makes the ideal combination for susceptibility to obesity and diabetes Type 2 diabetes also called non-insulin-dependent diabetes mellitus (NIDDM) has the strongest association with obesity. In type II diabetes, the body does not respond correctly to available insulin. In other words, a person becomes insulin resistant. The basic principles in treating Obesity Insulin resistance means that fat, liver, and muscle cells do not respond normally to insulin. As a result, blood sugar does not get Degenerative diseases of weight-bearing joints such as the into cells to be stored for energy and the blood sugar levels knee are common complications of obesity. The cause of this is Ÿ Diet and healthy Eating: Healthy eating and inevitably increase. People who are overweight are more likely to mechanical damage to joints due to the excess weight. Lower eating low calories with increased physical activity have insulin resistance, because fat interferes with the body's back pain is also more common in obese people and may be and life style habits is the easy way to reduce weight. A ability to use insulin. Family history and genetics play a major one of the major contributors to obesity-related absenteeism registered dietitian will help to design a diet suitable for the role in type II diabetes. Low activity level, poor diet, and excess individual needs along with physical activity plan. body weight (especially around the waist) significantly increase Psychological Aspects Ÿ Medications: Weight-loss medicines of various kinds are your risk for type 2 diabetes.
available in the market, but at Obese people are stigmatized world over. It is perceived as an Cardiovascular Disease and Hypertension undesirable physical appearance, and supposedly embodies Cardiovascular disease (CVD) includes coronary heart disease several character defects. Even children often perceive obese (CHD), stroke and peripheral vascular disease. These diseases children in a negative manner. It is not uncommon to see patients have patients as our priority. And recommend them as most of these preparations have more account for up to 33% of deaths in most industrialized countries - breakdown even during a consultation.
especially with regard to obesity we understand that it is a adverse side effects compared to their benefits.
a figure that's increasing rapidly in developing countries as well.
debilitating disease of the mind, body and the Quality of life(QoL) Obese people face discrimination everywhere. A study of Ÿ Bariatric Surgery or Weight Loss Surgery: Bariatric surgery is the Obese individuals are more likely to have higher blood and MUST BE ADDRESSED HOLISTICALLY to achieve long-term overweight young women in the USA showed that they earn next step for people who remain severely obese after trying triglycerides (blood fats) and low-density lipoprotein (LDL) (bad significantly less than healthy women who are not overweight or approaches other than surgery, especially if they have a disease cholesterol) and lower high-density lipoprotein (HDL) (good than women with other chronic health problems.
It has to start from you and your family UNDERSTANDING & linked to obesity. Bariatric surgery restricts food intake, which cholesterol). This is most often seen in obese people with high MOTIVATION and accepting that Obesity is not just a cosmetic leads to weight loss. Patients who have bariatric surgery must levels of abdominal fat, and has been consistently linked to a issue, but, its a disease that must be handled at it's roots.
Sleep apnea is a chronic condition that disrupts sleep. In this commit to a lifetime of healthy eating and regular exercise. These higher risk of CHD. A 10 kg weight loss can produce a 15% condition there are one or more pauses in breathing or shallow healthy habits may help patients maintain weight loss after Obesity is often a misunderstood word. If one has to be cured of decrease in LDL cholesterol levels and an 8% increase in HDL breaths while sleeping. These breathing pauses can last from obesity one must begin with classifying him/herself. People a few seconds to minutes. They often occur 5 to 30 times or whose BMI is between 23.5 - 27.5 are classified as overweight, if more per hour. Typically, normal breathing then starts again, not tackled in time, overweight people can easily become obese. sometimes with a loud snore or a choking sound. Even Snoring For these patients, we recommend our personalised Gem Weight is a sign of Sleep apnea at it early stages.
Loss Program.
This results in poor sleep quality that makes one feel tired during If your BMI is between 27.5 - 32.5 you fit into Grade I Obesity the day. Sleep apnea is one of the leading causes of excessive category. It is important to be very careful with your weight; at this daytime sleepiness. stage there is tremendous scope to get back to your ideal weight yet there are equal chances to slip into Grade II Obesity. About 3065% of hypertension (high blood pressure) sufferers in Obesity is a leading cause of sleep apnea. It is more prevalent in the West develop hypertension as a result of obesity. Blood older people and is more commonly seen in males.
Grade II Obesity is often symptomatic; most patients would have pressure increases with BMI; for every 10 kg increase in weight, had developed co-morbidities at this stage. Type 2 Diabetes, Diagnosis is based on history and sleep study. Weight loss leads blood pressure rises by 2-3mm Hg. Conversely, for each 1% hypertension, sleep apnoea, cardiac problems, joint pains are to marked improvement in sleep apnea. Breathing devices such reduction in body weight, blood pressure falls by 1-2mm Hg.
some of the most common co-morbidities for these individuals. It is as CPAP are useful and smokers need to quit smoking at the very important that one immediately takes reversal action at this The risk of hypertension in overweight adults is nearly three times earliest. It has been scientifically shown that Obesity Surgery stage as this condition could lead to morbid obesity or any other higher than in non-overweight adults. This risk is nearly six times induced weight loss controls sleep apnea in more than 90% of fatal illness. If one doesn't show any symptoms of co-morbidities higher for overweight people aged between 20 and 44.
the patients.
one can certainly reduce their weight with diets and exercise and a great amount of will power. Several studies have found an association between obesity and People with BMI beyond 37.5, fall in the last and the most the incidence of certain cancers, particularly of hormone- dangerous category called Grade III or Morbid obesity. At this dependent and gastrointestinal cancers. Obese women have stage diets and exercise deliver negligible results. Most patients been proved to be at greater risk of breast, endometrial, ovarian would have had developed more than one co-morbidity at this and cervical cancers. There is also evidence for higher risk of stage, many are even rendered immobile. Corrective action at this prostate and rectal cancer in men. Obesity also increases the risk stage is imperative, the only clinically proven way for morbidly of colon cancer by nearly 3 times in both men and women.
obese people to lose and maintain weight is bariatric surgery.
Ÿ What is the first step in obesity management? 50 percent or more of his or her excess weight. Most patients Ÿ Will I be able to eat all lose all of their excess weight and gain numerous health Dietary modification (not dietary restriction) and adequate benefits, while some may require exercising to accelerate the physical activity is the initial step in the management. Yes. One can eat all kinds weight loss rate.
of food, however it is Ÿ Are there any medicines for weight loss? important to make a Ÿ Are there activity restrictions following a bariatric surgery There are a few in the market and most of these are not healthy choice as portion we believe in making you understand approved and better not recommended sizes will be smaller.
the importance behind a healthy Like in any other surgery a few hours or days of rest is Ÿ Who should consider bariatric surgery? recommended. One can resume everyday activities almost Ÿ Can I consume alcohol? balanced diet regimen and life style Patients unsuccessful with conservative line of management immediately after the surgery. We recommend a week's rest management including adequate Yes, alcohol is permitted 12 months after and those who cannot try these for practical reasons, may before resuming work. We also mention that one should avoid surgery; however a responsible diet will not include alcohol, as physical activity which are the corner stones of consider this option.
strenuous activities like weight lifting etc until a month. it has empty calories that do not deliver any nutritional value.
enduring weight loss and holistic health. Walking is strongly recommended, to hasten the healing Ÿ What is bariatric surgery? Each diet is tailored keeping your lifestyle in mind, and process and accelerate the weight loss.
Ÿ Will I have loose skin after losing my excess body weight? Bariatric surgery is a simple surgical procedure targeted at a Patients losing large amounts of weight may have excess skin. is customized according to your weight/height, co- change in physiology helping you to lose weight.
Ÿ Do insurance companies cover bariatric surgery This depends on an individual basis, age and elasticity of one's morbidities, metabolism and body composition. Ÿ What are the benefits of surgery? skin plays an integral role in determining excess skin. This to We understand that each individual is unique and has Unfortunately insurance companies in India do not cover Bariatric surgery leads to drastic weight loss, in a significantly some extent can be handled my means of toning exercises, their own set of lifestyle constraints, nutritional needs bariatric surgery, however efforts are being made to amend smaller time frame; it also requires less effort to lose weight. which we will be recommending books after surgery. If the this, as bariatric surgery is now proving to be a lifesaver for and activity levels. Our qualified nutritionists More importantly bariatric surgery significantly increases the excess skin causes skin infections or affects your appearance, most patients.
collaborate with you to get you in touch with your life span of an obese individual simultaneously ridding of co- you may consider undergoing body lifts or abdominoplasty.
body and customize a basic, easy to follow and holistic Ÿ Are there any dietary restrictions following bariatric surgery? Ÿ Is there any problems with relation to future sexual activity or diet and exercise plan to help you get safely and Since bariatric surgery deals with the metabolism of the body it Ÿ What are the various bariatric surgery procedures? effectively to your target weight. Doing so will allow is important to alter ones diet before and after surgery. All the Ÿ Bioenteric Intragastric Balloon (BIB) Definitely not. As the surgery has nothing to do with the sexual your body to adjust slowly, making for lasting changes dietary requirements will be taken care of by our bariatric organs or the hormones there is no interrelationship to this Ÿ Laparascopic Adjustable Gastric Banding (LAGB) that will endure! Altering your diet will also help nutritionist. A detailed pre and post operation diet plan will be surgery and future pregnancy. In fact its one of the treatment Ÿ Laparascopic Sleeve Gastrectomy (LSG) reduce/eliminate acne and promote healthy, glowing provided once planned for surgery.
options for infertility when its because of obesity.
Ÿ Laparoscopic Roux en Y Gastric Bypass (LGB) Ÿ How long will it take to lose excess weight after bariatric Ÿ Can I become pregnant immediately after surgery? Ÿ What is the recovery time following bariatric surgery? Our experienced nutritional counselors and life No. You may have to wait for atleast a year before you can All of our patients have recovered from a bariatric surgery style therapists will work with you to: Excess weight loss begins right after surgery and continues for become pregnant for nutritional factors.
procedure without any complications. We encourage our 12-18 months after surgery.
Ÿ Identify your struggles with weight loss/weight gain patients to get out of bed and start walking by the next day. The Ÿ Will the scars be very obvious? Ÿ Is it possible to gain the weight back after a bariatric surgery Ÿ Understand and address emotional touch points hospital stay varies from 3 to 4 days depending on each case Not very much, The surgeries are done with 5-6 holes usually that trigger binge eating and the procedure opted for.
ranging from 5mm-12mm and are within the skin creases and Bariatric surgery is the only clinically proven way to lose and not very much obvious. But for those who are concerned of Ÿ Formulate wholesome and satisfying meal plans Ÿ When is bariatric surgery considered successful? maintain weight. However there are marginal chances of this, there's a newer modality called SINGLE INCISION that balance caloric requirements with taste Success in weight loss is inevitable with bariatric surgery. weight gain, only if one opts for an irresponsible and unhealthy LAPAROSCOPIC SURGERY, where the entire surgery is done However we consider it successful only when our patient loses through one hole within the umbilicus which is hidden.
We are here to lost world !!!


Pii: s0925-2312(01)00540-9

Neurocomputing 38}40 (2001) 93}98 A bursting mechanism of chattering neurons based on Ca>-dependent cationic currents Toshio Aoyagi  *, Nobuhiko Terada , Youngnam Kang , Takeshi Kaneko , Tomoki Fukai  Department of Applied Analysis and Complex Dynamical Systems,Graduate School of Informatics, Kyoto University, Kyoto 606-8501 Japan


International Journal of Systematic and Evolutionary Microbiology (2013), 63, 893–899 Pseudonocardia antitumoralis sp. nov., adeoxynyboquinone-producing actinomyceteisolated from a deep-sea sediment Xin-Peng Tian,1 Li-Juan Long,1 Su-Mei Li,1 Jing Zhang,1 Ying Xu,2Jie He,2 Jie Li,1 Fa-Zuo Wang,1 Wen-Jun Li,2 Chang-Sheng Zhang1and Si Zhang1 1Key Laboratory of Marine Bio-resources Sustainable Utilization, CAS; RNAM Center for Marine