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Management of Abortion
Caesarean Section Procedure
Treatment Of Female Sexual Problems
Termination Of Pregnancy Procedure
Treatment Of Pregnancy Problems
Well Woman Healthcheck
Treatment Of Female Sexual Problems
Treatment Of Medical Diseases In Pregnancy
Treatment Of Menstrual Problems
Intra-Uterine Insemination (IUI) Treatment
Medical Termination Of Pregnancy (Mtp) Procedure
Gynecology Laparoscopy Procedures
Pap Smear Procedure
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Medico legal aspects of sex therapy
Sex and human sexuality are sensitive subject. To deal effectively with any problem of human sexuality, one has to constantly evaluate its merits and demerits from social, scientific, moral, ethical and most importantly from the legal angle. Following are some of the guidelines for therapist to keep in mind while dealing with clients with sexual problems.
Taking informed and expressed consent is of utmost importance while managing any patient. Examining and / or treating a patient without consent would amount to assault and battery which is punishable under criminal law irrespective of absence of negligence or successful outcome of treatment. The consent should be free willed, informed, intelligent, specific and express. Person giving consent should be competent to do so, failing which, consent should be obtained from the lawful guardian of the patient (in cases of minor and/or mentally retarded).
Examinition of a female client
Besides obtaining a valid consent, in case of female patient, the therapist should always have a female assistant present when examining a female patient this is important for the therapist in order to protect himself from a possible charge of indecent behaviour molestation or even sexual offence like rape ect. Being llevelled against him. Mere presence of husband or any male companion of the female patient is not enough. A sex therapist, in particular, is most vulnerable and therefore should be most careful.
Use of surrogate partners
Use of surrogate partners for sex therapy is questionable both ethically as well as legally. Sexual involvement of the therapist is universally accepted as unethical. There have been a number of cases where the therapists themselves, having acted as surrogates, have been punished for sexual molestion of their patients. It may also invite a criminal charge of adultery in some countries, including india. There are cases on record where the therapists have been charged with and convicted of rape.
Unlike some other countries, the socio cultural set up in india is different. The laws governing sexual behaviour are neither liberal nor evolved as much as in some of the western countries. Besides, surrogacy is likened to prostitution by many. Even if one were to consider surrogate partner as a therapist, then the ethical code prevents a sexual relationship with a client. Moreover, there is every possibility of a disease being transmitted. Particularly the hiv infection, in view of sex with multiple partners by a surrogate person.
Therapist should have uppermost in mind the special values of intimacy and love that our culture teaches us to nurture.
It is the ethical responsibility of every sex therapist to maintain high standards of professional competence and integrity. Competence without integrity or integrity without competence is an unsatisfactory compromise of professionalism. It is most important to protect the public and the other professionals from persons who represent themselves as sex therapists who are in fact lacking in competence and intergrity.
Competence in another primary discipline such as psychology, psychiatry or counselling is not equivalent to competence in sex therapy.
A sex therapist should possess adequate knowledge of the following:
1. Sexual and reproductive anatomy and physiology.
2. Developmental sexuality from a psychobiological point of view.
3. Marital, family and interpersonal relationship and socio-cultural factors in sexual values
4. Physiological and medical factors that may influence sexual functions such as pregnancy, contraception and fertility, illness, disability, medications.
5. Multimodel techniques and theory of sex therapy and psychotherapy.
6. Pharmacology of the medications used to treat sexual dysfunctions particularly with respect to their adverse effects and interactions with the drugs being consumed for other ailments.
7. Ethical issues in sex therapy and principles of evaluation and referral.
8. Laws related to sexual behaviour.
Points to bear in mind
all forms of sex therapy which violate the local laws should be handled with care recommending oral sex as a part of therapy is violative of section 377 of the indian penal code which deal with unnatural sexual offences.
the hippocratic oath forbids the physician to take advantage of the therapeutic context in order to engage in either homosexual or heterosexual relationship.
it is a universal rule that whenever dealing with reproductive functions is involved, express consent of both the spouses should be obtained.
proof of competence is the ability to provide objective and responsible services to the clients.
there does exist a potential liability under the laws of the land prohibiting consensual conduct such as prostitution, fornication, lewd and lascivious behaviour and adultery which might arise from therapeutic or non- therapeutic sex research activities.
sex between therapist and client is always unethical. No matter how therapeutic the rationale might appear, there is no justification for a therapist having sex with a client. The purpose of sex therapy is to improve function, not to change values or beliefs of the client.
Hi, I have almost regular periods with cycle length between 28 and 33. Last month I had periods on March 8th. This month I had it on April 6th. So my cycle was 29 days long. We are trying for a baby. This month I started looking into the cervical mucus to identify the fertile period. Even today (20th April), 15th day from periods, I am getting light creamy mucus. We contacted on 17th, 19th and 20th. Is it possible that your cervical mucus is creamy but still you can get pregnant? Can you let me know more about the cervical mucus and its relation with ovulation? Also could you let me know which is the best days to contact if we are trying to get pregnant?
Hello Doctor, I am 17 years old. I have problem with irregular periods from past three years. I was menstruated at age 12. The problem is very bothering me a lot. First I have used English medicine but it had some effect when I stopped using the problem again effected me a lot. After I went to homeopathy in homeopathy the reaction will be slower. I am using the medication from 1 year there was no use. My sister has also the same problem. My mom told that she had the same problem before marriage after marriage it was sorted out. Doctor, please tell me or suggest me what should I do now because I was not menstruated for past 8-9 months. I am using medicines it was of no use. In my scanning report there was no problem. Please help me. I am eating fruits, healthy food. When I do some work I strain a lot. Please suggest me some medicines or advise. Tell me which doctor should I consult.
Slow metabolism leads to deposits of calories and increase in weight. One needs to get active to boost metabolism but when your metabolism goes slow; you face lot of health-related problems such as weight gain and resultant side-effects, stomach related problems or simply lethargy, or you may feel low on energy.
Let’s see what morning mistakes you must be making which have resulted in slow metabolism: -
1. Absence of Workout: Working is the easiest and best way of boosting your metabolism be it walking, running or cycling. All these activities result in sweating which helps in giving you desired results. Not doing any of these activities in the morning will ultimately slow down your metabolism.
2. Not eating fresh fruits and salads: Sometimes out of carelessness or lack of knowledge people do not take fresh fruits and salads which are very essential for boosting metabolism. Infact, you should make it a habit of taking fruits in the morning instead of taking parathas or heavy carb stuff.
3. Not drinking water: If your metabolism is running slow, one reason could be less intake of of water. Infact, you should start your day with at least 2-4 glasses of water. It’s the best way to start your day as it helps in keeping your body hydrated.
4. Skipping breakfast and starting your day late: If your metabolism is slow, it could also be because you are skipping breakfast or eating too less. Getting up late in the morning also slows down metabolism.
You need to concentrate on right habits to boost your metabolism, look fit and stay healthy.
If you would like to consult with me privately, please click on 'Consult'.
I am 24 years old and my girlfriend is 23 and we had unprotected sex few weeks back but I ejaculated outside her. She was expecting her monthly periods on 25th april but now its 10 days delayed. Is there anything serious to worry?
Is it safe to take juice of pomegranate and beetroot during first trimester. If it is safe, how much it should be taken.
Non Hodgkin Lymphoma is when the cells in your lymphatic system become cancerous. The lymphatic system is responsible for fighting off diseases, which may attack your body. Initially, tumors develop from the lymphocytes in your body. Non-Hodgkin lymphoma is much more common than the other type of lymphoma which is Hodgkin lymphoma. There are various types of Non-Hodgkin lymphoma; the most common of which are diffuse large B-cell lymphoma and follicular lymphoma. Here is everything you need to know about Non-Hodgkin lymphoma.
1. Swollen lymph nodes: A swollen lymph node in the neck, underarm and armpit which comes about without any pain is a very common symptom of Non-Hodgkin lymphoma.
2. Fever: When you have a sudden unexplained fever, it may be due to Non-Hodgkin lymphoma.
3. Night sweats: Night sweats are simply when you sweat excessively in the night.
4. Fatigue: Feeling extremely tired can be due to Non-Hodgkin lymphoma.
5. Weight loss: A sudden unexplained loss of weight is a very common symptom of Non-Hodgkin lymphoma.
6. Itchiness: An itchy skin is a rather serious indicator of Non-Hodgkin lymphoma.
Just like other forms of cancer, it is not known what causes Non-Hodgkin lymphoma, but there are factors, which put you more at risk compared to others.
1. Immunosuppressive drugs: You are most likely to develop Non-Hodgkin lymphoma, especially after taking immunosuppressive drugs after a major organ transplant.
2. Bacteria and viruses: Certain bacterial and viral infections cause Non-Hodgkin lymphoma including the HIV and Epstein-Barr virus as well as the Helicobacter pylori bacteria.
3. Pesticides: Research suggests that overexposure to the pesticides which kill weeds increases your likelihood of developing Non-Hodgkin lymphoma.
4. Age: Elder people are also more likely to suffer from Non-Hodgkin lymphoma.
1. Chemotherapy: Chemotherapy comprises of administering drugs to kill the cancerous cells, either through injection or orally which kill cancer.
2. Radiation therapy: Radiation therapy deals with radiation which is directed at the parts of your body affected by cancer.
3. Medications to enhance the immune system: There are many medications which fight off cancer by boosting the immune system. If you wish to discuss about any specific problem, you can consult an Oncologist.
What is Obesity and how to confirm that?
The most often asked questions in this context are- what is a normal acceptable weight, when does one get labelled as overweight and what is the definition of obesity? Another important question we often get asked is- what’s the difference between being overweight and obese?
In very simple terms, what a physician evaluates to check for obesity in a person is a simple index known as “body mass Index” or BMI. BMI can be calculated by simply dividing the person’s body weight in Kg by the square of person’s height measured in meters. BMI is measured as Kg/m2. Following are broad guidelines for detection of obesity-
1. BMI of < 18.5 indicates that the person is underweight
2. BMI between 18.5 and 24.9 indicates that the person has got normal weight
3. BMI between 25 and 29.9 indicates that the person is overweight
4. BMI of > 30 indicates obesity
How does Obesity affect fertility?
Excessive body weight in women causes multiple hormonal imbalances, which can result in irregular menstruation and reduced frequency of ovulation, thus leading to infertility. Also, the outcome of Infertility treatment in obese women is poorer than in their normal weight counterparts. Obesity also increases the chances of pregnancy related complications such as miscarriage, pregnancy induced hypertension and gestational diabetes and hence increases the requirement offers cesarean delivery. And not to forget that the labor is that much harder and prolonged for obese women.
Obese males also suffer from reduced fertility as they tend to have lower level of testosterone, which suppresses sperm production. Obesity can also case erectile dysfunction in men, which can result in reduced fertility.
What can you do?
Here are five easy weight management tips to help you realize your dream of having a child-
1. Watch your meals- take a healthy diet and avoid excess carbohydrates and fat
2. Watch your beverages- drink adequate quantity of water, avoid soft drinks as they contain empty calories and refrain from alcohol
3. Stop smoking and keep in mind that there is nothing like occasional/ moderate smoking
4. Exercise regularly and maintain a healthy, active lifestyle- short sessions of brisk walking, swimming, jogging or skipping are good means to keep one active and healthy
5. Avoid stress and practice Yoga/ meditation or other stress buster techniques that suit you
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