Dr. Varini Satish Kumar

Leucorrhea or excessive discharge per vagina can be a troublesome problem for many women. At certain times in the menstrual cycle the vaginal discharge is normally increased as in mid-cycle and just before the periods. This is normal . However if the discharge is smelly or excessive warranting use of sanitary towels or panty liners or associated with vulval/ vaginal itching it needs to be investigated.

Abnormal vaginal discharge associated with the above symptoms may be due to local infection. It may also be related to poor health, mal-nutrition, constipation, worm infestation , anaemia, local trauma and allergy to local soaps and deodrants.

If the discharge is persistent it is very important to consult a Gynaecologist who may prescribe antibiotics, creams, pessaries and sometimes get swabs done.

It is important to keep the area clean using plain water and dry One should avoid any form of soap/ dettol/ detergent and powders and perfumes in that area as it is very sensitive. Also general health should be improved and anaemia and mal-nutrion should be corrected. Deworming may be required. A local wash like V-wash can be applied once in a while locally that helps maintaining local pH. Drinking adequate water daily is also very important.

With an upsurge in the number of women suffering from dysfunctional reproductive systems and a myriad of gynecological problems, resulting in irregular periods, infertility and several other complications, it is of paramount importance to keep a record of the dates and duration of your monthly cycles. This is not only useful for future reference when you visit a gynecologist, but it also helps you to understand if there are delays in period or excess of bleeding in any particular month. 

Why is tracking your menstrual cycles important?

Keeping a track of the menstrual cycles is a mandatory exercise for women who are thinking about pregnancy or those trying to avoid it. It is advisable to abstain from intercourse for a few days before and after the period, which is the prime time for ovulation. Keeping track of your periods gives you a clear indicator of whether you have become pregnant because delay in the menstrual onset implies pregnancy. The reverse is also true; if you are trying to get pregnant, conception is usually fruitful on these days of maximum ovulation, which you can easily calculate based on your well maintained menstrual record.

How should you go about keeping track of your menstruation?

While it not possible to note down every possible aspect of the menstruation in a notebook, the easiest way of maintaining a planner is to mark the first day of each period on the calendar. The difference between two consecutive periods will give you your cycle lengths.

In addition you can choose to make a note of how heavy the bleeding is, or if there are changes in mood and appetite on those days. You will then be well prepared for your next visit to the gynecologist.

Adverse respiratory events (AREs) are leading causes of post-operative morbidity and mortality. Anesthesia is the use of medicine to prevent or reduce the feeling of pain or sensation during surgery or other painful procedures (such as getting stitches). Giving as an injection or through inhaled gases or vapours, different types of anesthesia affect the nervous system in various ways by blocking nerve impulses and, therefore, pain.

Anesthesia can help control your breathing, blood pressure, blood flow, and heart rate. It may be used to:

1. Relax you,
2. Block pain,
3. Make you sleepy or forgetful,
4. Make you unconscious for your surgery.

Adverse Respiratory Events (ARE)
Adverse outcomes of such events are fatal and lead to Death & Brain Damage. Three mechanisms of injury are reported to account for highest adverse respiratory events:
Inadequate Ventilation: Insufficient Gas Exchange can produce the adverse outcome. Esophageal Intubation: Incubation between the two sides of the esophagus inadvertently.
Difficult tracheal intubation: Tracheal Intubation is the placement of a flexible plastic tube into the trachea (windpipe) to maintain an open airway. It is performed facilitate ventilation of lungs in severely ill, anesthetized patients.

Other’s are as listed below:

• Airway Obstruction
• Inadequate inspired oxygen delivery
• Aspiration
• Endobronchial Intubation
• Premature Extubation

Residual neuromuscular blockade is an important postoperative complication associated to the use of neuromuscular blocking drugs and is commonly observed in the post-anesthesia care unit (PACU) after non-depolarizing neuromuscular blocking agents (NMBAs) are administered intra-operatively. Incomplete neuromuscular recovery can be minimized with acceleromyography monitoring. The risk of adverse respiratory events during early recovery from anesthesia can be reduced by intra-operative acceleromyography use.

Reintubation is a serious adverse respiratory event and the consequences include increased cardiac and respiratory complications, prolonged length of stay at the PACU, intensive care unit (ICU) and hospital, prolonged mechanical ventilator support, higher costs, and increased mortality. Overweight and obesity have also been identified as risk factors for postoperative respiratory complications. Most adverse respiratory events are considered preventable with improved monitoring such as:

• Pulse Oximetry
• Capnometry
• Combination of Both

Closed observation of the clinical factors and appropriate monitoring by well trained people are factors necessary to prevent adverse outcome. If you wish to discuss about any specific problem, you can consult a general surgeon.

Liposuction is a process of fat removal from the body through means of suction. This process involves insertion of thin, small and blunt tubes through cuts and incisions on the skin. These tubes are then used to suck out the fats from your body.

There are multiple liposuction techniques such as:

1. Laser assisted liposuction: In this technique, low energy waves are used to melt the fat which is then removed via the tubes inserted in the body.
2. Tumescent liposuction: This procedure initially involves administration of local anesthesia to the part of the body where the tube will be inserted. A large amount of anesthetic solution is then injected into the fat tissues in the body before embarking on the traditional liposuction procedure. General anesthesia is not required for this procedure.
3. Ultrasound assisted liposuction: In this technique, the fat is liquefied by using ultrasound waves. Using this technique, it is easier to remove fat from the sides of the body, upper abdomen and the back.

General info: The procedure is an outpatient procedure and generally does not require an overnight stay at the hospital. Usually local anesthesia is used in this procedure unless it is large amounts of fat that need to be worked on.

What is the objective?: The main purpose of the procedure is not to reduce weight, but to reshape certain parts of your body by getting rid of the fat. It is generally preferred for areas in your body which do not respond to either exercises or diet, such as the buttocks, upper arms and the legs. In some cases, it is combined with other procedures such as face lift, breast reduction and abdominoplasty.

What does it take care of?: Certain medical conditions such as fatty tumors, complications in fat metabolism and enlargement of the male breasts are treated by liposuction. You may notice an improvement in your body shape immediately after the procedure. The skin around the area where the procedure has been performed may turn loose and it may take a few months for the area to be normal again. After the procedure, a course of antibiotics may be prescribed to treat any infection that may occur. The recovery period is around a few days to one week. If you wish to discuss about any specific problem, you can consult a doctor.