Dr. Chetana

After marriage usually sexually active couple do get good news of pregnancy usually within the first year unless they are intentionally delaying or postponing it. But if they not getting pregnancy it is common to face embarrassing questions when they attend a social gathering which s bombarded by family and friends. 
So the couple get stressed out and sometimes go into depression and start thinking about not getting pregnant all the time leading to loss of interest in usual work and life and get disturbed even at work place.
Soon follows the advice of friends n family to visit some age old so called baba or to visit some particular place of worship to get pooja s done to become pregnant instead of asking them to visit a gynaecologist or infertility specialist to find out the cause of not conceiving and getting help by getting treated.

We doctors keep saying that at the present era of digitisation couple should start visiting gynaecologist or infertility specialist soon after one year of infertility to get themselves counselled, diagnosed the problem and to get treated. So that patients get help from trained professionals and get pregnant sooner than they think by using various treatment modalities. The latest modalities available include IUI, IVF, ICSI, laser hatching, blastocyst culture, ovum or sperm donor programme, etc.

So I request all the infertile couple to please do visit nearest infertility specialist to get diagnosed your problem and get treated for the specific problem and lead a happy family life.

The word weight loss brings an image of starving, eating just enough to survive, and reduce weight. However, that is not the case always. There are some foods that can actually help burn fat, the more you eat of these on a regular basis, the lesser the chances of you growing fat. The good old coconut, which has formed a regular part of our diet for ages is one such wonderful item. Listed below are some benefits that show how coconut helps in weight loss.

1. Good Fiber: Foods usually contain two types of fibers soluble and insoluble. The soluble usually contains sugar and starch. These are digested to provide calories. The non-soluble on the other hand is not digested and only provides roughage. Coconut contains an astounding 61% of non-soluble fiber, which is completely devoid of calories and therefore, no contribution whatsoever to weight loss.
2. Instant Energy Source: For athletes and sports people, coconut provides an instant source of energy with lesser number of calories. This energy can help them curb hunger for prolonged period of time. People who eat coconut regularly can go without food for longer hours without experiencing symptoms of low blood sugar.
3. Lowered Glycemic Index: The glycemic index is an indication of how fast sugar is released into the bloodstream, leading to higher sugar level. Sugar has a glycemic index of about 80 and coconut is about 35. Therefore, it reduces the pace at which sugar is released into the body and does not promote formation of fat. Coconut is also easy on the pancreas, not pushing it to pump insulin into the system.
4. Reduced appetite: By improving insulin secretion and promoting blood glucose usage, the cravings to have something sweet to boost energy is reduced. The super nutritious coconut is digested to right away produce energy and consume it, thereby improving endurance.
5. Good fat source: The coconut is a rich source of medium chain fatty acids which are good for health. Unlike the long chain fatty acids, which contribute to weight gain, the medium ones are good for heart and do not add to weight in a big way.
6. Easy on the stomach: Coconut also improves digestion in general and improves absorption of nutrients (vitamins, minerals, and amino acids) from other food substances, thereby improving overall nutrition. The good fiber, good fat and good sugar all add to the immense benefits of coconut. Not just whole coconut, even coconut oil and coconut milk are being used more now. 

Not just weight loss, coconut is also very healthy for the heart, skin, and hair. It has no trans-fat, no gluten, is nontoxic and hypoallergenic and boosts immunity. Eat coconut in any form and enjoy the various benefits.

Knee pain is one of the most common and painful ailments that can limit mobility. Injuries can result in cartilage or meniscal tears or sprains too. Obesity is another reason because of which knee pain is on the rise. Also, regular wear and tear of ligaments and tendons around the knees due to old age is another cause. These days, with reduced physical activities and sedentary lifestyles, the rate at which knees are wearing out has also become accelerated. Whatever the reason, a correct diagnosis followed by prompt treatment can help. Over the years, physiotherapy has been playing an important role in treating knee injuries. Whether to supplement the various drugs to reduce pain and inflammation or to avoid surgery, physiotherapy has helped many and its popularity is growing every day. Here are some ways that physiotherapy can help reduce pain.

• Improve flexibility of tendons: The knee cap is an area where there are lot of tendons and ligaments, coordinating to enable movement. Careful exercising can ensure that the flexibility of tendons and ligaments is improved, thereby making your knee movement easier and less painful.
• Improves blood supply: As we all know, proper movement requires good blood supply. Exercising with special focus on the knee ensures that blood supply is improved, and thereby the supporting ligaments and tendons function optimally.
• Enhances the knee cap function: The knee cap is that portion which joins your thigh bone to your calf bones. This is prone to slip out of place, especially with arthritis and injuries. This can be painful and limit movement to a great degree. Focused exercises aimed at improving knee cap function will ensure that the knee cap has a wider range of function, and does not slip out of its socket easily.
• Reduce rigidity: Once you start physiotherapy, you will feel your knees getting more flexible. The rigidity that had set in as a result of injuries and/or old age will also reduce over a period of time.
• Slow down the wear and tear: When you start physiotherapy after knee damage, continuing the exercise routine, of course with expert guidance, can reduce the pace at which further damage might happen. A word of caution though. Be sure to consult an experienced physiotherapist before you begin. Exercising in a bad manner can do equal or more harm than the original injury or old age itself.

Undigested food that lurks around in the digestive tract produces a host of disorders due to intestinal distress. These disorders range from acidity to gastro-oesophageal reflux and even colon diseases like cancer, irritable bowel syndrome, constipation, gallstones, ulcers and Crohn's disease. Cramps, nausea, vomiting, loose motions, gas, and acidity are some of the most common symptoms that visit the patient as a result of such ailments. There are many ways of dealing with such intestinal distress, as follows :-

1. Diet: Introduce plenty of fibre into your diet to aid the digestion process. This can cut the risk of many such ailments and also aid in the treatment of the same. Intestinal distress is largely caused by food that is still lurking around in the digestive tract, so it is important to clean out the digestive system with plenty of fibre and water.
2. Nutrition for better Digestive System Health: Food that is rich in minerals, vitamins, antioxidants and iron will help in creating a stronger system that cleanses the digestive tract and helps in reducing the production of excess acid in the stomach. A balanced diet with plenty of nutrition aids digestion and makes the immunity stronger.
3. Study your Triggers: Watch out for foods that can trigger reflux action and other acidity related issues on the intake. These can include fatty food, fried and oily food as well as extremely spicy food. Stress is also a major trigger of intestinal distress, so it would be a good idea to avoid stressful situations or take medical help to deal with them in a better manner.
4. Medication: Antacids and other medication to prevent the onset and growth of such distress can be sought out after due consultation with a medical practitioner. Medication will help in dealing with and altering the acid level production in the stomach.
5. Surgery: In very extreme cases like ulcers and large size gallstones, surgery may be helpful so that you avoid rupturing the stomach's lining which can lead to a serious infection or even internal bleeding.

Knowing your triggers and getting into a better routine as far as your diet goes is as important as seeing a doctor about the severity of your case when it comes to intestinal distress.

To know more, take a private consultation today!

High blood pressure, or hypertension, is defined as blood pressure higher than 140/90 mm hg. Hypertensive disorders in pregnancy are a major cause of maternal, fetal and neonatal morbidity and mortality, both in developing and developed countries. Hypertension is the most common medical problem in pregnancy.
If high blood pressure continues after 20 weeks of pregnancy, preeclampsia and other complications can develop.

What causes high blood pressure during pregnancy?
According to the national heart, lung, and blood institute (nhlbi), there are several possible causes of high blood pressure during pregnancy.
These include:
- being overweight or obese
- failing to stay active
- smoking
- drinking alcohol
- first-time pregnancy
- a family history of pregnancy-related hypertension
- carrying more than one child
- assistive technology (such as ivf)
- maternal age is also a factor, with pregnant women over the age of 40 being more at risk.

BP measurement:
# use a sitting or semi-reclining position so that the arm to be used is at the level of the heart.
# do not take the bp in the upper arm with the woman on her side, as this will give falsely lower readings.

What are the complications of high blood pressure during pregnancy?
- if high blood pressure continues after 20 weeks of pregnancy, there can be complications. Preeclampsia can develop.

What is preeclampsia?

This condition can cause serious damage to your organs, including your brain and kidneys. Preeclampsia is also known as toxemia or pregnancy-induced hypertension. Preeclampsia with seizures becomes eclampsia. This can be fatal.

Thorough prenatal care, including regular doctor’s visits, should be able to address preeclampsia symptoms. Symptoms include:

@protein in a urine sample
Abnormal swelling in hands and feet
@persistent headaches

Preventing high blood pressure during pregnancy:
Common risk factors for high blood pressure, such as obesity and a history of high blood pressure, can be minimized through diet and exercise. Of course, during pregnancy, it is inevitable that you will gain some weight. It’s recommended that pregnant women consult with their doctor to identify a weight gain target that is healthy for them.

Dietary guidelines for pregnant women vary from person to person. Speak with a nutritionist who will keep your specific height and weight in mind when creating a nutrition plan for you.

The nhlbi emphasizes that it’s important to take steps to lessen your risk of high blood pressure. You should steer clear of smoking and drinking alcohol, both of which have been known to raise blood pressure.

Pregnancy causes hormone shifts, as well as psychological and physical changes. This can bring on stress, which can make high blood pressure harder to manage. Try stress reduction techniques such as yoga and meditation.

Management:
Management depends on the woman's bp, gestational age and blood flow in the placenta. Non-pharmacological management is recommended for many women but is not recommended when there is the presence of associated maternal and fetal risk factors. Non-pharmacological management includes close supervision, limitation of activities, and some bed rest in the left lateral position.

All pregnant women should receive antenatal education so that they are aware of the symptoms associated with pre-eclampsia, its importance, and the need to obtain medical advice.

Such symptoms include:
Severe headache.
Visual problems: blurred vision or flashing before the eyes.
Severe epigastric pain.
Vomiting.
Sudden swelling of the face, hands or feet.
 

Women who are at high risk of pre-eclampsia are recommended to take 75 mg aspirin daily from 12 weeks of gestation to delivery. Such women are those with:

- hypertension or pre-eclampsia/eclampsia in a past pregnancy.
- chronic kidney disease.
- autoimmune disease (eg, systemic lupus erythematosus (sle) or antiphospholipid syndrome).
- diabetes mellitus (both type 1 or 2).
- chronic hypertension.

Women should also take 75 mg aspirin daily from the 12th week if they have any two of the following features:- in their first pregnancy.
- aged ≥40 years.
- previous pregnancy >10 years ago.
- body mass index (bmi) of ≥35 kg/m2 at booking.
- family history of pre-eclampsia.
- multiple pregnancy.

Medication for high blood pressure during pregnancy:
Some traditional blood pressure medications can cause problems in pregnant women should be avoided when you are pregnant:

-ace inhibitors
-renin inhibitors
-angiotensin receptor blockers
These drugs in particular will be passed through the bloodstream to the developing baby. They can negatively impact the baby’s health. These medications may also cause blood to thin, which can compromise the mother’s ability to carry the baby to term.

Methyldopa and labetalol are both drugs that have been deemed safe for use to manage blood pressure during pregnancy.

Talk to your doctor about how to control your blood pressure if you develop hypertension during pregnancy.

Summary:
High blood pressure during pregnancy doesn’t usually lead to serious problems. However, if it goes untreated, hypertension can become life-threatening for both mother and baby.