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Revision Gastric Bypass Surgery in India Reduces Your Cost Expenditure

Obesity

Obesity is a major health problem approaching an epidemic proportions. An NIH consensus conference on the surgical treatment of obesity recommended consideration of surgery in patients with a BMI of greater than 40 kg/m2 without medical complications or a BMI of greater than 35 kg/m2 if severe co morbidity were present. Obesity accelerates the progression of coronary arteriosclerosis in young men (age range 15 to 34 yr). Obesity increases the risk of developing:

Hypertension,

Hyperlipidemia,

Type 2 diabetes,

Coronary artery disease,

Cerebrovascular disease,

Osteoarthritis,

Sleep apnea,

Endometrial, breast, Prostate, and colon Cancers.

Severe obesity is a chronic condition that is difficult to treat through diet and exercise alone. Gastrointestinal surgery for obesity, also called Bariatric surgery, is an option for persons who are severely obese and cannot lose weight by traditional means or who suffer from serious obesity-related health problems.

Bariatric surgery

Bariatric is derived from the Greek term bars, meaning weight. Bariatric surgery creates an anatomic barrier preventing over-consumption and accumulation of excess calories either by restricting the gastric reservoir or by inducing malabsorption. Bariatric surgery alters the digestive process and is classified into two categories:
Restrictive

Malabsorptive.

Nearly all morbidly obese patients with satisfactory postoperative weight loss, experience substantial improvement in the quality of their lives. At present, Roux en Y Gastric Bypass (RYGB) may be the only Bariatric operation that has produced durable long-term weight loss at an acceptable level of risk.

Indications:

Body mass index (BMI) above 40
Significant obesity comorbidity (e.g., hypertension, diabetes, sleep apnea, pickwickian syndrome, incapacitating osteoarthritis)
Obesity-related physical problems that interfere with employment, walking, or family function may be a candidate.

Procedure of Bariatric Surgery:

1.Restrictive procedures

Promote weight loss by closing off parts of the stomach to make it smaller, thus restricting the amount of food the stomach can hold. Restrictive procedures do not interfere with the normal digestive process.

As a result of this surgery, most persons lose the ability to eat large amounts of food at one time. After an operation, the person usually can eat only ¾ to 1 cup of food without discomfort or nausea. Also, food has to be well chewed.
Restrictive operations for obesity include the following:

Adjustable gastric banding
Vertical banded gastroplasty

Both the methods are used to create a small stomach pouch.

2. Malabsorptive Procedure

The most common gastrointestinal surgeries for weight loss, combine stomach restriction with a partial bypass of the small intestine. A direct connection from the stomach to the lower segment of the small intestine is created, bypassing portions of the digestive tract that absorb calories and nutrients.

Biliopancreatic diversion (BPD):

In this more complicated malabsorptive operation, portions of the stomach are removed. The small pouch that remains is connected directly to the final segment of the small intestine, completely bypassing the duodenum and the jejunum. Although this procedure successfully promotes weight loss, it is used less frequently than other types of surgery because of the high risk for nutritional deficiencies. A variation of BPD includes a “duodenal switch,” which leaves a larger portion of the stomach intact, including the pyloric valve that regulates the release of stomach contents into the small intestine. It also keeps a small part of the duodenum in the digestive pathway.

Roux-en-Y gastric bypass

Roux-en-Y gastric bypass (RGB) is an accepted operation for the control of body weight in morbidly obese patients. This operation is the most common and successful malabsorptive surgery. First, a small stomach pouch is created to restrict food intake. Next, a Y-shaped section of the small intestine is attached to the pouch to allow food to bypass the lower stomach, the duodenum, and the first portion of the jejunum. This bypass reduces the amount of calories and nutrients the body absorbs

Operative Consideration :

Severely obese patients tolerate general anesthesia remarkably well. However, Endotracheal intubation may be difficult.
Patients may require admission to the intensive care unit postoperatively.
Patients with sleep apnea, congestive heart failure, and severe asthmatic bronchitis should spend one or two nights in the intensive care unit for close monitoring of their cardiopulmonary status

Complications from bariatric surgery:

The risk of formation of gallstones.

Inflammatory hepatitis.

Occult cirrhosis

Dumping Syndrome, (stomach contents move too rapidly through the small intestine includes nausea, weakness, sweating, faintness, and sometimes diarrhea after eating)

Constipation / Diarrhea

Vitamin B12 Deficiency

Nutritional deficiencies

Anemia (due to reduced absorption of Iron in the stomach)

Metabolic bone disease (due to less calcium absorption in the small intestine)

Abdominal Pain

Vomiting

Incisional Hernia / Abdominal Hernia

Bleeding (including splenic injury)

Gastrointestinal leaks(inadvertent injury to the GI tract)

Wearing away of the band and breakdown of the staple line.

In very less cases post operative infection or death from complications may occur.

REVISION OPERATIONS

Early technical complications and inadequate weight loss, well-known sequelae of this procedure, necessitated reoperation . The incidence of major postoperative complications following revisional bariatric procedures is substantially higher compared to primary operations.

Patients who have gastric bypass occasionally require revision, either for inadequate weight loss or for complications. The incidence of major postoperative complications following revision Bariatric procedures is substantially higher compared to primary operations. Early morbidity rates range from 15% to 50%. The mortality rate reported after revision operations ranges as high as 10%, undoing any Bariatric operation without conversion to another weight-reduction procedure is invariably associated with the patient’s promptly regaining the lost weight.

Indications for reoperation includes

Dilated gastrojejunal anastomosis

Inadequate weight loss without demonstrable enlargement of the anastomosis

Staple line breakdown

Anastomotic obstruction

Anastomotic leak

Enlarged proximal gastric pouch .

Reoperation consisted of :

Completely redoing the initial RGB

Redoing the anastomosis alone

Staple line revision

Intraoperative dilatation of the anastomosis
.
Intractable marginal ulcer

Major postoperative complications are:

RGB failure

RGB revision for early technical failure

Inadequate weight loss is associated with a high incidence of major complications

subsequently, negligible weight loss.
Intractable marginal ulcer.

Severe metabolic complications

Therefore repair of RGB for technical failure or complications is not recommended.
Gastric bypass patients with anatomically intact operations and unsatisfactory weight loss have probably “outeaten” the operation.Gastric bypass patients with unsatisfactory weight loss are best converted to a more malabsorptive modification of Roux-en-Y gastric bypass, or in some cases biliopancreatic diversion. Unfortunately, some patients who are converted to a malabsorptive procedure suffer severe metabolic complications.

The more extensive the bypass, the greater the risk for complications and nutritional deficiencies. Persons with extensive bypasses of the normal digestive process require close monitoring and life-long use of special foods, supplements, and medications

Why to undergo gastric bypass surgery in India

Revision Gastric bypass surgery in India has seen a phenomenal growth during recent past. Most patients from countries like USA and UK travel to India for treatment.

Few main reasons:
India offers wide range of cheapest pricing options of treatment.

While planning a treatment in India, one does not require waiting in patient queues or registering for a waiting list.

Moreover the doctors and the medical facilities in India are comparable to the best in the world.

Another main reason for choosing India for revision gastric bypass surgery is comfort of communication; one does not face a problem as most people speak English.

Above all, India always offers a good holiday, which can help in fast health recovery. Another important reason why more and more people from overseas are considering India for health treatments is the advancement and the medical and technical superiority of the medical fraternity in India. Hence India is the most ideal destination for Medical tourism.

About the Author

I am a physiotherapist ,completed my MPT Geriatris from MAHER university Chennai,India.I have 5 years of experience in treating various patients from Vijaya Cardiac foundations and The Best Hospital in India at Chennai.

You can gather more information by visiting http://www.forerunnershealthcare.com

You can also email your query and doubts to: enquiry@forerunnershealthcare.com

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Dyadic Approaches to the Divine: Kierkegaard, Nietzsche, Religion and Gender in a Post-modern World

Dyadic Approaches to the Divine: Kierkegaard, Nietzsche, Religion and Gender in a Post-Modern World

Understanding the role religion could or should play in the modern era is a central topic in the study of religion. Today, in world where God is almost, but not quite dead, how can we translate traditional beliefs into the post-modern world? Furthermore, we must ask ourselves what role gender can then play in this newly born definition of religious experience. To answer these questions we must first, as a matter of logical of necessity, examine the nature of religious experience itself and see if a reasonable case can be put forward that there may be more than one type of approach to the divine, and if this is indeed the case, we must then see if a correlation can be made between religious experience itself and gender.

In modernity three distinct spheres of culture are referred to; respectively these are known as the culture spheres of science, morality, and art – the basis of which is derived from the works of Kant (Critique of Pure Reason, Critique of Pure Practical Reason, and Critic of Judgment). The three existence spheres formulated by Kierkegaard, the aesthetical, the ethical, and the religious seem to have been composed in a similar spirit to the three culture spheres of Kant. What is of great significance in the work of Kierkegaard is that he identified two separate strands of religious thought: Religiousness Type A and Religiousness Type B. These two diametrically opposed forms of religion can be defined in the following way: Religiousness Type A can be understood to embody the fourth culture sphere that has been glossed by the makers of modernity, and Religiousness Type B provides a critical principle and transcending perspective on the culture-spheres as culture-spheres, including religion as a culture-sphere along with those of science, morality and art. To further clarify the distinction between the two types, Religiousness A could be best described as an externalized mode, in which rituals and the regulations of social roles play a part. By contrast, in Religiousness B the stress is not so great on that of the communal role (or principle of communitas as it would be called by Victor Tuner) but is instead more reliant on the role of the individual. What matters in Religiousness Type B is the principle of being religious itself, and not the adherence to doctrines and practices formulated as in Religiousness Type A. What is being expressed by these two polarities, if indeed they are such, is a pattern of religious thinking which is quite similar in its bipolar opposition to the contrasting roles of Apollo and Dionysus, which formed the basis of Nietzsche’s work, The Birth of Tragedy. Not only did this idea have great impact on Nietzsche’s own work, but it has come to be widely regarded in other areas – its impact can still be felt in the art world and the journals of philosophy. Why, though, is this theory of Nietzsche’s connected to Religiousness Type A and B? To answer fully this question one first need to understand the roles of the two gods he used to draw this dichotomy with. Firstly, they both are gods of aesthetics. They occupy similar roles – but one (Apollo) is the god of Sculpture, of art with form. Dionysus, by contrast presides over music – his influence is unseen; it is only heard or felt. What he represents cannot be captured in form, for even in his role as the God of the Theatre, he is always masked. The face of Dionysus is never seen. Usually the two gods are examined in their relation to the art world – but their opposition echoes back to another area; that of religion and the nature of ones relation to the divine. Apollo communicates to his brethren through the sedate art of dream. Dionysus whispers the words of madness to one’s ear – the state of mind though which Dionysus communicates is via intoxication , whether this is in the form of theatre, music, madness or any other form of expression, what lies behind the Dionysian element is the expression of pathos, or emotion. As Nietzsche himself says, “In order to grasp these two tendencies, let us first conceive of them as the separate art-worlds of dreams and drunkenness. These physiological phenomena present a contrast analogous to that existing between the Apollonian and the Dionysian.” The representations of Dionysus appear irrational or subconscious, those of Apollo rational. Furthermore, Apollo is a god of boundary drawing – both ethical and conceptual – he is the god of the principium individuationis. Apollo, therefore represents a sense of unity but also of restriction. Dionysus, by way of contrast, expands his horizons by transcending boundaries – hence for the Dionysian religious type ‘intoxication’ is a transcendence of everyday consciousness in which we overcome individuality. The polarity reflected in these two divinities is here also reminiscent of the opposition seen in modernism where science is viewed as masculine, and religion as feminine. Though Apollo and Dionysus are both male deities, despite an ambiguous iconography which is found in some of the myths and depictions of both gods, in the past there has been a number of attempts to draw parallels between the two deities, depicting Apollo as the masculine force and Dionysus as the feminine force. Notably among the ranks of those scholars who have endeavored to transpose the image of the feminine onto Dionysus, was Bachofen, a contemporary of Nietzsche himself. Bachofen associates Dionysus with potent male sexuality inseparable from the earth, and thus with the first (tellurian) and the second (which he designates matriarchal) stages of existence because written and iconographical evidence links the god to woman: “The phallic god [Dionysus] cannot be thought of separately from feminine materiality.”

Though at first this overlaying of gender onto the two male gods may seem absurd, it is no more so than some of the dualistic notions that have been previously expressed in modern discussions of gender. The word itself, gender, is firstly by way of explanation, an artificial construct. The gender of a body may or may not be an exact match for the sex of a body. Gender can therefore be explained as an expression of sexuality, rather than that of the biological sex. Given the binary nature of the sexes, it is completely erroneous to approach the topic of sex or gender without adopting a dualistic approach to doing so. Such ideas of duality have their ideological roots as far back as 1974 when Ortner wrote “Is female to nature what male is to culture?” The context of this work was based on an assumption that the category female is metaphorically connected to nature while that of male is connected to culture. The logic of this notion rests on the basis that women as reproducers remain bound to nature, while men, who cannot reproduce, produce and are therefore bound to culture. In terms of taking the dualistic approach to finding a resolution via gender, ironically another dichotomy is encountered – the opposition between sex and the new terminology of gender forms yet another dichotomy. For many theorists in this area, sex is seen to be real (nature) and gender is artificial (culture). In terms of relating sex and/or gender back to the original Apollo/Dionysus dichotomy, this duality could also be easily compared. Gender, as an artificial and hence cultural construct, could be linked back to the supra-rational Apollonian sphere. Sex, as the more natural category of definition would lie in the realm of the Dionysian. It is worth noting at this point that Nietzsche himself, at the beginning of the Birth of Tragedy likens the contrast of the Apollonian and the Dionysian elements to that of the sexes: ‘the continuous development of art is bound up with the Apollonian and Dionysian reality: just as procreation depends on the duality of the sexes, involving perpetual strife with only periodically intervening reconciliations.’ The fact that even at the earliest stage of his formation of this core concept in his philosophy, Nietzsche is aware enough of the similarities between the two rival deities and the relationship between the sexes that he chooses to employ this metaphor hints at the possibility of this association being evident to Nietzsche even at the time of its composition. However, this is merely a metaphor, not a tautological statement – for there is in truth no clear boundary between the Apollonian nature and the Dionysian nature; there is always within one an element of the other, for as Nietzsche says “There is no Dionysian appearance [Schein] without an Apollonian reflection [Wierderschein]” . Therefore, if the Apollonian/Dionysian dichotomy were to be rendered applicable to the new ideologies imposed by the modern understanding of gender, we must accept the fact that it is a logical impossibility for one to be purely Apollonian or Dionysian, for one always contains an element of the other. If we were to apply this relation to the concept of gender, we could say that though one is biologically male or female, there will always be some ‘essence’ of the other to their aspect. If the comparison holds true, though one could be purely masculine or feminine in appearance, in terms of gender, the sexuality of the individual (in contrast to the individuals biological sex) would not be purely composed of either the male or the female essence – rather the Apollonian/masculine and Dionysian/feminine elements would coexist as matter of parts or percentages than as a ‘pure’ essence of masculinity or femininity.

Having examined the rudimentary distinctions betwixt Apollo and Dionysus, and their possible relation to gender, how then does this relate to Kierkegaard’s’ Religiousness Type A and Religiousness Type B? To complete the image and the association found here, we need to also examine Nietzsche’s theories on religion. His famous proclamation, “God is Dead” is of course well known; what is lesser known however is the complex chain of references that connect this statement to other key points within his philosophy. One of these is to found within the poem ‘Ariadne’s Lament’ in Zarathustra, in which the poem hints at another concept of Nietzsche’s known as the ‘the ladder of religious cruelty’. The three rungs of the ladder represent three stages in the development of the sacrifice: in times of archaic religion people sacrificed humans to their gods; in times of moral belief people sacrificed their strongest drives and instincts to their gods; in a time yet to come people will sacrifice god himself (representative of any belief in consolation and salvation) as a final act of cruelty against themselves. . This three step model of the evolution of religion is important as it ties in with another key point in Nietzsche’s philosophy – the doctrine of eternal reoccurrence or the eternal return. Both the idea of the eternal return and the ladder of cruelty are derived directly from an earlier intellectual influence on Nietzsche, namely the philosopher Schopenhauer. To Schopenhauer dealing with death is the first, and most essential, function of any authentic religion. It is in this sense, by failing to provide a solution to the problem of death, that Schopenhauer regarded Judaism and Graeco-Roman ‘paganism’ as failed religions since they lack a properly developed doctrine of immortality. To Nietzsche’s mind of course, Graeco-Roman ‘paganism’ did provide such a doctrine, for Dionysus, like Christ, is a ‘dying god’ – he dies to be reborn through sacrifice, and in the Greek myths of Dionysus comparisons are draw between the concepts of earthly life (Bios) and eternal life (Zoë) found in the Dionysian Mystery Traditions of Ancient Greece. The Dionysian aesthetic presented in this work is therefore also to be interoperated as an answer to the problem of redemption ( a response to the Schopenhauerian philosophy of redemption), and to the problem of how man can justify his own individual existence in the face of the ‘terrifying’ and ‘absurd’ abyss of life.

The more one examines not the philosophy of Nietzsche, but his personal beliefs on religion, the more it becomes clear that he favoured not the Apollonian pole, but the Dionysian one. Furthermore, his rejection of Christianity in preference to a highly individualized conception of the Dionysian Mystery Traditions paints a very clear picture of Nietzsche’s own religious essence – in the terminology of Kierkegaard what Nietzsche is expressing is a strong emanation of Religiousness Type B. Moreover, not only can Religiousness Type B be connected with Nietzsche’s own beliefs, they can be directly tied to the relationship between Apollo and Dionysus themselves. The essence that emanates from the Apollonian current is an external mode of worship: his formal rites could be seen and were accessible to all, and as the god of sculpture/form his aesthetics could be experienced by all. Those of the Dionysian current, by contrast, are not seen, they can only be ‘felt’, either through music or via the Dionysian mode of worship, which involved induced states of ecstasy, and as this could only be experienced on an individual basis, it was not accessible to all. Thus it can be seen that the Dionysian invokes an internal form of religion and aesthetics, whilst the Apollonian evokes an external form of religion and aesthetics. In terms of both art and religion this is the primary difference between the two deities. Given the previous definitions for Religiousness Type A and Religiousness Type B, it now becomes very easy to relate the more external and communal Religiousness Type A to the nature of the Apollonian and the highly individual nature of Religiousness Type B to the Dionysian. By employing the comparison between Apollo and the masculine element of gender, and Dionysus as the feminine element of gender, Religiousness Type A then becomes associated with the masculine, and Religiousness Type B with the feminine. It is also here important to remember that Religiousness Type B, in its rejection of need for religious ceremonies in favour of highly personalized worship, is distinctly a feature of post-modernism. Modernism, derived from the Latin root modo, means now or the present age. Post-modernism then, cannot be thought of correctly in a chronological sense, for it is impossible to exist outside of the present moment. Modernism and post-modernism seem to be held as extreme polarities, in which neither pole can ever meet the other – thus essentially providing another seemingly irreconcilable dyad. Modernism is thought of as being representational of secular thought, unity and order. Post-modernism, by contrast is characterized by possessing the features of spirituality and diversity. This then reduces all the dichotomies involved down to the following hypothesis: There are two very similar gods in Greek mythology which embody certain characteristics that relate to religion and art which are diametrically opposed in a dyadic or binary relationship. These two gods are Dionysus and Apollo. In mythology and the classical tradition, one of these gods, though being externally male, has many feminine connections in classical myth, even at times being portrayed as a hermaphrodite. Furthermore the nature of Apollo is more akin the Kierkegaard’s Religiousness Type A and modernism, Dionysus to Religiousness type B and post-modernism.

Before concluding one additional fact also needs to be brought to light – the concept of the Apollonian/Dionysian dichotomy was preexistent to Nietzsche, and interestingly enough remnants of this idea can be found within Hinduism. Though this idea may appear to be original, Nietzsche himself always regarded Dionysus as having emigrated to Greece from ‘Asia’ and was also familiar with many key concepts in the Hindu Tradition. Since Nietzsche’s lifetime, others have also explored this angle, comparing the roles of Dionysus to the god Shiva, notably Alain Daniélou in his work ‘Gods of Love and Ecstasy’. The fact that these two gods share so many features in myth and iconography does lend a great deal of credibility to this theory of them having a conjoint origin. What is more interesting however is that a similar dyad to that of Apollo and Dionysus occurs in Hinduism within the relationships expressed between the gods Shiva and Vishnu. Like Dionysus, Shiva is sometimes depicted as being an hermaphrodite. Can we then conclude, from the works of scholars such as Daniélou and Bachofen, that Dionysus is not a purely masculine emanation, and in fact embodies a disguised representation of feminine consciousness? In terms of sexuality, the answer is no, for both gods depict a certain ambiguity in regards to their sexuality not just Dionysus – Apollo’s iconography also contains an air of sexual ambiguity to it, and out of all the Greek gods, it is Apollo who takes the most male lovers. It can therefore be said that both gods express a bisexual ambiguity in terms of gender, and that it is through this shared set of gender characteristics (as opposed to sexual ones) that the true dichotomy is born, for like all polar opposites, they are in truth not a dyadic opposition, but rather an expression of polar linearity on the same plane; fundamentality they are same thing, but in both cases the essence of the absolute reveals itself through contrasting modes of self expression. If we were to describe them in terms of Religiousness Type A and Religiousness Type B, the polarity would be clear with the Apollonian nature of man at one end, and the Dionysian at the other. To a certain extent they can also be seen to embody the opposition of science and religion, which occurs frequently in modernist/post-modernist thought – Apollo can be seen to portray the scientific, rational mind and Dionysus the raw emotive power that can only be unleashed though belief and emotion alone. For gender however, both gods cannot be said to be either fully masculine or feminine, but rather each signifies a complimentary state of sexual ambiguity – and as the immortal representatives of this state, they perfectly embody the fact that gender does not necessarily correlate to biological sex. Both the Apollonian, with their expression of outer belief as Religious Type A and the Dionysian with their expression of inner belief as Religiousness Type B are the perfect expressions of the fluctuating principle of gender in the post-modern world.

About the Author

Gwendolyn Toynton is a Masters student in Religious Studies. She is also the the publisher and editor of Primordial Traditions a free online magazine, published quarterly. Gwendolyn Toynton is also a published poet and exhibited artist.

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Parabola $30.00 Founded in 1976, Parabola is devoted to the exploration of the myths, symbols, rituals, and art of the world’s religious and cultural traditions. Every issue explores one of the facets of human existence from the point of view of many world religions and spiritual traditions with essays and images….

Anime J-Pop Music?

Does anyone Know of a Site that give Mp3′s of any anime and J-pop Music? Cuz’ i’m looking to find music that are related to these anime:

Bleach
Naruto
DN Angel
Code Geass
Gundam Series
Dragonball Series
D. Gray Man
Death Note
Katekyo Hitman Reborn
Marchen Awakens Romance
Prince of Tennis
Hikaru no Go
One Piece
Shaman King
Afro Samurai
Rurouni Kenshin
Blood +
Bobobo-bo Bo-bobo
Cowboy Bebop
Full Metal Alchemist
Inuyasha
Yu Yu Hakusho
Ghost in the Shell
Trigun
Hellsing
Trinity Blood
.Hack Sign
Initial D
Cased Closed
Rave Master
S-CRY-ED
Samurai Deeper Kyo
Shin Chan
Tenchi Muyo!

http://www.gendou.com
it’s a great site where you can download all the anime music you want. And it’s free and completely legal.

Trance – Angels Crying (Dj Mystik)

Essential Willie Nelson $11.25 CD 11. Night Life 2. Hello Walls 3. Crazy 4. Funny How Time Slips Away 5. I Never Cared For You 6. The Party’s Over 7. Good Times 8. Me And Paul 9. Shotgun Willie 10. Bloody Mary Morning 11. Blue Eyes Crying In The Rain 12. Good Hearted Woman With Waylon And Jennings 13. If You’ve Got The Money I’ve Got The Time 14. Uncloudy Day 15. Mammas Don’t Let Your Babies Grow Up To Be Cowboys With Waylon An…

O, Yeah! Ultimate Aerosmith Hits $14.74 Over a remarkable 30 years, Aerosmith has delivered near-perfect hybrids of rock and balladry, converting generations of listeners into devout fanatics. O, Yeah! Ultimate Aerosmith Hits drives chronologically through 30 of their best songs, providing a tour of the construction process. And what a process! Listen to “Mama Kin” and you might not recognize Aerosmith at all–here is a young Tyler, bef…

Recollection 2 CD Set $10.49 LANG K. D. RECOLLECTION…

WhiteOak Art Designs Angel Prints – Emotions I Wept An Angel Crying – Mouse Pads $11.99 …