Dr. Suhasini

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Following are the most common foot conditions which require surgery:

1. Plantar fasciitis: It is one of the most common causes of heel pain which is aggravated in the morning with initial few steps. Too much pressure on feet can damage or tear the ligaments because of which the plantar fascia becomes inflamed, and the inflammation causes heel pain and stiffness.
2. Rheumatoid arthritis: It is an autoimmune condition that affects the joints and causes swelling of the joint lining (synovium). It commonly affects the small joints of the hands and feet. Surgery is required when the condition leads to deformity or cartilage loss.
3. Sesamoiditis: It is a condition where there is a pain on the bottom of the foot at the base of the great toe. Excision of the chronically inflamed sesamoid is required.Ankle arthritis: It is usually caused by osteoarthritis where the cartilage covering the ends of bones gradually roughens and becomes thin and the bone underneath thickens. This leads to pain, swelling, and occasional deformity of the joint. 
4. Fracture: Healing fractures require immobilizing the foot with a boot and sometimes even surgery.
5. Bone spurs: An excessive growth of bone is causing pain or limitation of movement. These spurs develop at the edge of the joint causing pain, tenderness, and difficulty in walking. Surgery is required to remove these excessive growths.
6. Gangrene: It is one of the most common conditions requiring amputation where the death of the tissue occurs.
7. Clubfoot/Talipes Equinovarus: It is a foot deformity in newborns where the foot is rotated inwards (varus) and downwards (equinus).
8. Claw Toes/Hammer Toes: It is a condition affecting the toes in people as they age causing difficulty and pain while walking. The affected joints require replacement with artificial joint or fusion (surgical stiffening). 
9. Morton's Neuroma: The patient presents with pain in the forefoot, in the “ball” of the foot causing irritation of one or more of the small nerves, just before they travel into the toes.
10. Hallux Valgus/Bunion: It is one of the most common conditions, especially seen among women, where bony lumps develop on the side of the foot and at the base of the big toe causing malpositioning of the foot. For some people, it is only a cosmetic problem. Bunionectomy is a surgery performed to remove the bony prominence.
11. Hallux Limitus/Rigidus: It is an arthritic condition of the big toe joint leading to pain and loss of motion.
12. Diabetes mellitus: It affects circulation and blood supply causing delayed healing. Ulcerations, infections, and sometimes severe infections require amputations.
13. Cysts and ganglions: These are painful lumps that cause pressure and rub on the shoe while walking. If a change in the footwear doesn’t solve the problem, surgical removal of the cyst or ganglion is done.

The tendency for the development of Attention Deficit Hyperactivity Disorder, which is more popularly known as ADHD, during the months of pregnancy is growing with each passing day. The main reason behind this is the increased exposure to the digital devices. This disorder is characterized by some specific characteristics, the most common ones being the inability to concentrate on anything and being hyperactive at all times of the day. People tend to show impulsive actions in all cases.

But the good news is that the researchers have come up with some possible solutions to ADHD during pregnancy with the help of which it can be prevented-

1. Curb the intake of sugars: One of the main steps that you can take towards preventing the development of ADHD during your pregnancy is going on a low sugar diet. Several types of research have proved that when the mother has a high sugar diet, it directly correlates to the development of ADHD. The reason behind this is quite simple. It is because there is a particular gene in the human body called the IGF2 and this gene is responsible for the development of the brain. But when there is a high amount of sugar in the diet, the IGF2 levels are compromised which ultimately leads to the development of ADHD. So, don’t take too much of processed proteins and stick to a healthy diet. If necessary, approach a dietician who can give you a proper diet chart to follow.
2. Get the proper probiotics for yourself: Probiotics have a major role in many of the health conditions and one of them is the development of ADHD in pregnancy. Adding the necessary probiotics to a pregnant woman is not only good for her overall health but also enhances the growth and development of the fetus. Not only does the application of the right probiotics prevents the chances of development of ADHD in newborns, but it also reduces the risk of development of conditions like autism, bipolar disorder, mood disorders, and even schizophrenia.
3. Keep your cell phones away from you: All forms of digital devices create a heavy impact on the fetus leading to ADHD in many cases. Mobile phones are no doubt an important part of your lifestyle but you can keep them away from yourself when they are not needed, especially, keep them away from your pockets.
4. Drink filtered water: Unfiltered water contains many chemicals and other unhygienic substances. You should refrain from consuming unfiltered water especially in your months of pregnancy.

In the months of pregnancy, when your body is vulnerable to the outside factors that are harmful, you must stay extra vigilant and take all the precautions necessary to ensure that your child does not develop ADHD. Maintain your diet and don’t skip your checkups. In case you have a concern or query you can always consult an expert & get answers to your questions!

The ovarian reserves in any women mean the quality of reproduction of the eggs in the women. However, low ovarian reserves indicate that there are factors due to which the quality of ovaries to reproduce is diminishing and causing infertility in women. Many factors are contributing to this condition, but aging is the prime cause of low ovarian reserve. Studies have shown that low ovarian reserves can be treated with new age medical science and reproduction technology.

Leading Causes of Low Ovarian Reserves-

As mentioned above, generally menopause and aging are the causes of the diminished quality of eggs in women. However, with the change in time, doctors have noticed below mentioned causes too for this condition:

● Genetic problems like tender chromosome X or distressed chromosome present in women.
● History of ovarian surgery: If the patient has undergone any ovarian surgery in the past, it may result in low ovarian reserves.
● Smoking cigarettes: Smoking actively and passively hinders the ovaries of women. It results in inhalation of harmful gas and can cause low ovarian reserves.
● Any other environmental factors like exposure to radiation, exposure to chemicals or radioactive waves, etc.

Symptoms of Low Ovarian Reserves-
There are no such symptoms noted by patients in low ovarian reserves. The problems faced by patient are trouble in conceiving and not being able to have a baby. Some women may also observe delay in their period cycles, depletion of bleeding or spotting before period cycles.

Diagnosis of Low Ovarian Reserves-
There is a debate regarding the diagnosis method of this condition. However, doctors use the combination of ultrasound of vaginal area and testing of hormones. The combination of both helps the endocrinologists to determine the quality and number of eggs in the women to reproduce successfully. The hormone evaluations include the level checking of FSH, estrogen, and the AMH. The evaluation takes by testing the level of FSH and AMH in women in her early days of menstrual cycle. These are good indicators of fertility in women. FSH helps to determine the stimulation of fertility and ability to conceive, and AMH indicates the number of quality eggs women carry.

Treatment-
There are several treatments available for low ovarian reserves condition. But, IVF method along with donors’ eggs fertilization is considered the best. The aging of the ovaries cannot be stopped. But, when a woman notices the symptoms and causes as mentioned earlier, she can freeze her ovaries which can be used later. However, this method entails risks and gets affected by other factors. In the donor eggs method, fertilization takes place with the partner's sperm and pregnancy can be achieved by implanting the embryo in recipient womb. However, the characteristics of the baby will not match as the birth mother but will match the egg donor. The recipient mother will only get to carry the baby till the time of delivery. An early course of IVF is the only option left with the women facing problems of low ovarian reserves. Other methods are time taking and involve high cost. They do not guarantee safe and successful pregnancy and childbirth. Consulting a doctor is always recommended before going for any method.