Tuberculosis during pregnancy is the third leading cause of maternal mortality. In fact, it is one of the most feared diseases during pregnancy for mothers as well as children. The problem with Tuberculosis during pregnancy is that it is most often not diagnosed until very late in pregnancy or until child birth. This acts as a double-edged sword since it leads to progression of the disease in the mother and transmission of the disease to the child concurrently.

The best way to prevent Tuberculosis during pregnancy is to stay away from causative factors for tuberculosis.

Effects on Pregnancy

Tuberculosis during pregnancy can harm both the mother and the child. It can be grouped in two ways: effect on mother and effect on fetus.

Effect on Mother

Diagnosing Tuberculosis during pregnancy becomes difficult due to various changes in the body, including the immune system. Diagnosis is further vitiated due to no apparent weight loss. In fact, weight loss due to Tuberculosis is disguised by weight gain during pregnancy. However, pregnant women with Tuberculosis may experience less than normal weight gain.

There is an increased risk of miscarriage and abortion and premature labor.

Effect on Fetus

Tuberculosis during pregnancy affects the baby in different ways:

The fetus may contract the disease from the mother through the umbilical cord. This is referred to as congenital tuberculosis. The baby can contract the disease during its passage through the birth canal too.  However, the symptoms of congenital Tuberculosis are often non-specific in nature. Since the mother also does not show any specific symptoms, it becomes difficult to diagnose the disease right after birth.

The child may suffer from swelling in the liver or spleen.

It may also suffer from respiratory problems, fever, etc.

How to Stay Away from Contracting Tuberculosis

The danger of contracting Tuberculosis bacteria during pregnancy is multiplied if the pregnant mother has a weak immune system. If a pregnant woman is exposed to bacteria during pregnancy, she may contract the disease. This is why pregnant women need to stay away from the disease by doing the following:

Staying away from TB infected persons around you

Stopping smoking since it enhances the risk of contracting the disease

Avoiding poor living conditions

Fighting Tuberculosis During Pregnancy

Management of Tuberculosis during pregnancy is extremely important since that can help you avoid any harm either to the mother or to the child. Though doctors would in all probability prescribe antibiotics, there are certain medicines that you need to avoid during pregnancy. Gynecologists are well aware of these drugs. Along with taking antibiotics, you also need to make sure that you:

Eat a balanced and healthy diet.

Breathe plenty of fresh air.

Talk to doctors about side effects like headaches, nausea, vision changes, etc.

Conclusion

People might think that taking medicine for Tuberculosis can harm their unborn child. However, the untreated Tuberculosis is even more harmful for the fetus. This is why doctors may recommend some TB drugs that help prevent the child from Tuberculosis. There are many medicines available that won t affect the child.

Eating healthy food, following proper treatment and medication, and some preventing measures will surely help the women to save the child from these conditions.

Tuberculosis - All About The Disease!

What is Palpitation?
Palpitation is a feeling of awareness of your own heart beat. It is usually described as heart rate being either too fast (racing), too slow or a sensation of missing a beat.

Types of palpitations?
Normal (Benign)
- These palpitations occur as a response to physical or mental stress like exercise, fever, pain, fear, anxiety etc. 
- They are harmless and settle on their own once the precipitating factors disappear. They do not require any medical treatment.

Abnormal
- These palpitations occur due to some underlying abnormality in either the structure of heart or the beating of heart. 
- These can be dangerous and at times life threatening. They may or may not settle on their own and require some medical treatment.

Warning signs that suggest palpitations are abnormal?
Palpitations are abnormal, if they are associated with chest heaviness, chest pain, uneasiness, sweating, weakness, giddiness, feeling of black out, fainting, nausea, vomiting, seizures. Palpitations are more likely to be abnormal in people who have some existing heart disease and these patients should report to their doctor at the earliest.

What to do during palpitations?
1. Stay calm. 
2. Call for help. If u are alone avoid driving, use a taxi or auto, go to your nearest hospital/doctor and try to get an ECG during the palpitations. If you are helping someone having palpitations, if they faint, call for help, start CPR if they remain unresponsive and take them to the nearest hospital. 

Which doctor can treat palpitations?
Doctors who specialise in the treatment of palpitations are called Electrophysiologists. They specialise in heart rhythm and are capable of performing a variety of complex tests to identify and treat different types of palpitations.

Which investigations are used to diagnose palpitations?
ECG: Taken during palpitations and when the patient is normal is a very helpful tool. 
Holter: Externally applied recorder, which continuously records heart rhythm for 24 hrs. 
ELR: Extended loop recorder, is like holter, but it records rhythm for longer durations. 
ILR:  Internal loop recorder is attached within the body for recording rhythm for long duration. 
EPS: Electrophysiology study, is the most sure shot test to diagnose, identify and treat 
Palpitations.

What is EPS?
EPS stands for Electrophysiology study. By this test a trained Electrophysiologist studies the conduction and formation system of heart beat, to understand the source, cause and type of palpitation. It is a simple and safe procedure of 2 to 3 hours and can be done as a day care procedure (by admitting the patient for a few hours in hospital, with discharge on same day).

It requires fasting for 4 hrs, some standard blood investigations and is done with local anaesthesia and if required it can be combined with treatment like ablation in the same sitting.In the procedure Electrophysiologist take catheters into your heart to study and stimulate the palpitations and understand them. Once found they can use various techniques to stop the palpitations, the techniques are called Ablation.

What are the treatment options available for palpitations?
There are many options depending upon the nature of palpitations and condition of the patient: 
- Drug therapy 
- Cardioversion where either a drug or electric shock is given to stop palpitations immediately. 

Ablations using many sophisticated computer softwares 
Device Therapy like ICD (Internal cardiac defibrillator) 
Combination of all the above therapies.

Your Electrophysiologist and you as a team can make a choice about the options that will be best for you.

Palpitations - Everything You Need to Know

Copd, which is short for chronic obstructive pulmonary disease, is a severe form of lung disease that is characterized by increased breathlessness and obstruction of airflow from the lungs. People who are suffering from copd are at an increased risk of developing lung cancer, heart diseases and many other conditions. It includes progressive lung diseases such as chronic bronchitis, emphysema, few forms of bronchiectasis and refractory (non-reversible) asthma. The former two are the most common conditions contributing to copd. 

Chronic bronchitis induces inflammation in the airway that carries air to the lungs and fills it with mucus. This either completely blocks the airway or narrows it, causing difficulty in breathing. However in emphysema, the air sacs inside the lungs which inflate and deflate as you breathe in and out, lose their elasticity due to which less air comes in and goes out leaving you breathless.

The best way to treat copd is to quit smoking. Your doctor may also prescribe you medications or ask you to enroll in a lung rehab program. 
Causes:
1. Smoking
Smoking is one of the most common causes of copd. This is because smoking is known to destroy the stretchy fibers in people's lungs and irritate the airways. Even passive smoking is unhealthy. About 90% of the people having copd are current or former smokers. 
2. Genetics
Some individuals suffer from copd even after refraining from smoking. Genes might be at the helm of copd in such a case. Aatd i. E. Alpha -1 antitrypsin deficiency, is a protein in the lungs, the lack of which is one of the most common genetic factor causing emphysema. 
3. Environmental factors
Breathing in harmful pollutants present in your environment is also one of the causes of copd. Fumes, dust or certain chemicals are a few examples of harmful lung irritants. Organic cooking fuel may also cause copd. Exposing yourself to the aforementioned environmental factors for a prolonged period of time increases your risk of developing copd substantially. 

Symptoms:
1. Shortness of breath especially after exercising
2. Wheezing
3. Tightness in your chest
4. Unintended weight loss
5. Lack of energy
6. Frequent respiratory infections
7. Wheezing
8. Cough accompanied by mucus

Diagnosis:
1. Physical exam where your doctor monitors the functioning of your lungs. 
2. Questioning about your past health (smoking or other harmful lung irritants).
3. Spirometry and other breathing tests.
4. Chest x-rays and other tests to eliminate other problems which could be causing your symptoms.

All About COPD!

Many children are affected by constipation; for them, it usually implies pain while passing stool as the stools tend to be hard. In some cases, parents often tend to confuse soiling as diarrhea when it may actually indicate symptoms of impacted constipation (obstruction of faeces). In order to prevent constipation from turning into a chronic problem, make sure your child receives proper treatment at the earliest.

Symptoms of constipation
Constipation in children can be characterized by its symptoms which are:
1. Your child will experience difficulty in passing stools
2. He/she may also experience pain during the process; trace amounts of blood may be present on the nappy.
3. The stool tends to be large in size and hard by nature
4. The child may not have normal bowel habits; he may pass stools less than the normal number of times.
5. Loss of appetite
6. He/she may experience intense pain in the stomach
7. This condition may cause sudden changes in behavior; your child may become irritated or unhappy very easily.
8. He/ she may experience nausea
9. The child may also often soil his/her clothes by passing feces at irregular intervals

Causes of constipation in children
Constipation in children may be caused due to a number of factors, which are:
1. Withholding of stool: In some cases, your child may try to forcefully hold back bowels every time he/she may want to go to the toilet. This may happen due to reasons such as lack of toilet training or not wanting to use toilets at certain places.

2. Diet: A diet devoid of fiber may be the cause behind your child's constipation. Also, not drinking enough water throughout the day may cause the stools to harden, thus causing difficulty while passing them. The fiber content in food adds roughage to the diet and thus, helps in facilitating smooth bowel movements.

3. Psychological problems: Constipation may also be caused due to certain emotional problems and drawbacks, such as certain fears or phobias. An example would be when the child feels the need to go to the toilet at night, but withholds it if he/she has a fear of ghosts. A change in the surroundings such as moving to a new place may also cause bowel problems in your child.

Causes of Constipation in Children

Spirometry is a common medical test that is conducted in order to detect whether your lungs are working properly. This is done by detecting the amount of air you can inhale and exhale along with the time taken to complete both of these procedures. Spirometry is useful to diagnose any underlying medical condition like asthma, Chronic Obtrusive Pulmonary Disease, persistent coughing or problem during breathing. If you are receiving treatment for chronic lung disorder, spirometry is also useful to check whether or not your lungs are responding to the specific kind of treatment.

Procedure: The process of spirometry involves the use a mouthpiece and a tube adjoined with a machine which displays the recorded results. Before the onset of the procedure, which generally takes place in a hospital, you will be prescribed by the doctor to wear comfortable clothing which will not restrict your normal breathing process and will be asked to have a light meal before the procedure. The procedure will be conducted while you are sitting. 

Spirometry takes an estimated amount of 15 minutes to get over with. The nurse will put a clip on your nose in order to close your nostrils. After that, you have to take a deep breath and then breathe out as hard as possible on the tube for a few seconds. You have to make sure that there's no air leakage during this procedure by putting your lips tightly over the tube. In order to arrive at a stable result, you have to conduct the test three times at least. If the results are hugely diverse, then you have to take the test again. The highest result among the three tests is usually denoted as the ultimate test result.

Risks: Spirometry is generally a low-risk inducing procedure. But in some cases, it might cause loss of breath, moments after the procedure. Also, spirometry should not be conducted if the patient has recently had a heart attack or surgery of the eye, abdomen or chest. If you are suffering from vomiting tendencies and you have regular instances of blood in your cough, you should also avoid spirometry.

The Procedure and Risks of Spirometry

Carotid artery disease occurs when an oily, waxy substance called plaque builds up inside the carotid arteries. These are arteries that supply oxygenated blood to your brain, face, scalp, and neck.
Carotid artery disease is very serious as it can cause a brain stroke. It, in fact, starts with damage to the inner layer of the carotid artery. To stem this damage your body starts a healing process and this leads to a build up of plaque at the point where the artery is damaged.

When this plaque ruptures, platelets are rushed in and these create an obstruction to the flow of blood to the brain. When the blood supply to the brain is cut off, which happens in carotid disease, the brain cells begin to die causing a stroke. This neural death impairs the parts of the body that these brain cells control. So, you can get paralyzed, become speech or vision impaired, have long  term effects like paralysis or even die due to a stroke.

Causes of carotid disease

Smoking
High cholesterol levels
High blood pressure
High levels of sugar in the blood due to diabetes
What s even more worrisome is that carotid artery disease may not cause any signs or symptoms until the carotid arteries are severely narrowed or blocked. And what usually happens is that a stroke becomes the first sign of the disease.

How scary is that?
So, the next question that comes to the mind is - Can this condition be cured? Let s learn more about management and prevention of the same-

Prevention
Lifestyle changes are key. Since hypertension, uncontrolled diabetes, sedentary lifestyles and imbibing too much fat are all risk factors, taking care of them minimizes the risk of carotid disease and strokes. Heart healthy lifestyle changes that include moderate exercise are a great way to prevent carotid disease.

Treatments
Treatments for carotid artery disease include:

Medicines: Sometimes lifestyle changes do not stem the rot. You need medicinal help. Doctors usually prescribe statin medications to control your cholesterol levels. These lower the bad cholesterol that can narrow your carotid arteries and cause brain strokes and damage. Statins are usually prescribed for people who have:

Heart disease
Those who ve had a stroke
Diabetes
High LDL or bad cholesterol levels
Medicines like Aspirin and Clopidogrel to prevent blood clots are the mainstay treatment if you suffer from carotid disease. They prevent platelets from clumping together inside your carotid arteries and forming blood clots. Apart from these, your doctor may also medicate you for conditions that can damage your carotid arteries and cause strokes. These medicines are for lowering your BP, blood sugar levels, preventing the formation of blood clots anywhere in your body including inside your heart, and preventing and reducing inflammation.

Medical Procedures
These are used to open narrowed or blocked carotid arteries.
The two common procedures are:
Carotid endarterectomy: It s mainly for people whose carotid arteries are blocked 50 percent or more. In this, the inner lining of the carotid artery that is blocking blood flow is removed.
Carotid artery angioplasty and stenting: Here, doctors use a procedure called angioplasty to widen the blocked carotid arteries and restore blood flow to the brain. A stent is inserted into your carotid artery to broaden the lumen. 

High Cholesterol Level - Can It Cause Carotid Disease?

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