Gestational diabetes is also known as gestational mellitus diabetes (gdm). It is a prevalent disorder which affects pregnant women and the main cause of this condition is the imbalance in the functioning of the insulin, which mainly happens due to the presence of human placental lactogen. Expecting mothers show a raise in their blood sugar level, especially during the last trimester of their pregnancy. Women who do not have a medical history of diabetes can also be affected with this condition.

Prominent symptoms of gestational pregnancy include:
Gestational diabetes does not have any prominent symptoms; it can only be diagnosed through proper and professional screening of blood sugar level. You should immediately consult a doctor if you have any of the following symptoms:
1. Increased level of blood sugar
2. Trouble to concentrate
3. Recurrent headaches
4. Increased thirst
5. Blurry vision
6. Sudden weight loss
7. Decrease in low blood sugar level
8. Anxiety
9. Dizziness
10. Pangs of hunger
11. Pale skin and dry skin
12. Excessive sweating
13. Persistent weakness

How can you manage gestational diabetes?
Modification of lifestyle pattern, healthy food habits and moderate physical exercise can help minimize the risk of gestational diabetes in expecting mothers.
In order to manage gestational diabetes, the following things should be followed:
1. The treatment when accompanied with balanced diet and routine exercises, reduces the occurrence of health problems in both mother and child.
2. A routine screening for type ii diabetes should be conducted throughout the pregnancy, to ensure early detection and treatment of the same.
3. A diet rich in fiber and whole grains minimizes the risk of diabetes in pregnancy, fresh fruits and vegetables are also known to check the blood sugar level in expecting mother, minimizing the occurrence of health problem in both mother and child.
4. Giving up the use of cigarettes and other forms of tobacco may reduce the chances of gestational diabetes in female smokers.

How does gestational diabetes affect pregnancy?
Gestational diabetes is harmful for both the expecting mother and the child. It increases the risk of complications in pregnancy that can prove to be fatal.
Potential risks of gestational pregnancy include:
1. Increased risk of needing a c-section
2. Miscarriage
3. Preeclampsia and high blood pressure
4. Preterm chance of birth.

Gestational Diabetes

Handling an Auto Immune Disease

What are Autoimmune Disorders?
It is a disorder of the immune system where the immune system can get ‘hyperactive’ or on the other end of the spectrum can become exceptional slow in its response to germs and bacterium, leaving the individual vulnerable to a host of infections and diseases.
When in ‘Hyper mode’ the body’s immune system starts producing antibodies (White Blood Cells) attacking and damaging the body’s own tissues (Red Blood Cells) beyond repair. Treatment of the Auto-Immune diseases generally focuses on reducing the activity levels of the immune system so as to let the Red Blood Cells multiply and heal the body to an extent.
Not all Auto Immune diseases are life threatening or terminal in nature. Some are even classified as “commonly occurring” disorders in the larger population. Examples of these would be –
1) Psoriasis – A Skin disorder where overactive immune system blood cells called T-cells collect in the skin. The immune system activity stimulates skin cells to replicate rapidly, producing layers of silvery scaly plaques on the skin. These often look like ‘Dandruff’ and can be seen all over the individual’s body, accompanied by severe itching and skin irritability. Psoriasis is often triggered due to stress and hormonal imbalances along with other environmental factors such as poor hygiene, inadequate diet, lack of sleep etc. Along with oral medication, lifestyle changes such as reducing stress at work or home, making sure one gets at least 8 hours of restful sleep per night and regular head and body massages are known to help reduce the severity of the problem to a great extent.

2) Rheumatoid Arthritis – The hyper immune system produces antibodies that attach themselves to the joint linings and then start to eat away at the cartilage and tissues causing swelling or inflammation and a sharp stabbing continuous pain. Oral medication along with gentle cardio (slow walking) and stretching exercise routines such as Yoga, Tai Chi and Pilates are known to have countered the ill-effects of this movement restricting disorder, to a large extent.


3) Aggravated Thyroid – An aggravated thyroid is a result of the excessive antibodies produced by an overactive immune system which attack the thyroid gland and slowly destroy the cells that produce the all-important thyroid hormone. Prolonged negligence or when left undetected for long, it often leads to Grave’s Disease (linked to hyperthyroidism) or Hashimoto’s Thyroiditis (linked to hypothyroidism.) The former can lead to weight-loss, bulging eyes, rapid heart-rate, and chronic fatigue while the later often causes sudden weight gain, depressed state of mind, dry skin and severe constipation.  A good way to avoid diseases of the thyroid would be to maintain a healthy active lifestyle and a stable healthy body weight. It is also recommended that one goes in for regular preventive health check-ups for early detection of any thyroid related disorders.

A little can go a long way in limiting ill effects of autoimmune disorders.


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How To Live With or Handle Auto Immune Disease

Urinary incontinence is the unintentional passing of urine. It's a common problem thought to affect millions of people. There are several types of urinary incontinence, including:

Stress Incontinence  when urine leaks out at times when your bladder is under pressure; for example, when you cough or laugh.
Urge Incontinence  when urine leaks as you feel a sudden, intense urge to pass urine, or soon afterwards.
Overflow Incontinence (chronic urinary retention)  when you're unable to fully empty your bladder, which causes frequent leaking.
Total Incontinence  when your bladder can't store any urine at all, which causes you to pass urine constantly or have frequent leaking.
It's also possible to have a mixture of both stress and urge urinary incontinence.

What causes urinary incontinence in men?

Urinary incontinence in men results when the brain does not properly signal the bladder, the sphincters do not squeeze strongly enough, or both. The bladder muscle may contract too much or not enough because of a problem with the muscle itself or the nerves controlling the bladder muscle. Damage to the sphincter muscles themselves or the nerves controlling these muscles can result in poor sphincter function. These problems can range from simple to complex.

A man may have factors that increase his chances of developing UI, including

birth defects problems with development of the urinary tract
a history of prostate cancer surgery or radiation treatment for prostate cancer can lead to temporary or permanent UI in men
UI is not a disease. Instead, it can be a symptom of certain conditions or the result of particular events during a man s life. Conditions or events that may increase a man s chance of developing UI include

benign prostatic hyperplasia (BPH) a condition in which the prostate is enlarged yet not cancerous. In men with BPH, the enlarged prostate presses against and pinches the urethra. The bladder wall becomes thicker. Eventually, the bladder may weaken and lose the ability to empty, leaving some urine in the bladder. The narrowing of the urethra and incomplete emptying of the bladder can lead to UI.
chronic coughing long-lasting coughing increases pressure on the bladder and pelvic floor muscles.
neurological problems men with diseases or conditions that affect the brain and spine may have trouble controlling urination.
physical inactivity decreased activity can increase a man s weight and contribute to muscle weakness.
obesity extra weight can put pressure on the bladder, causing a need to urinate before the bladder is full.
older age bladder muscles can weaken over time, leading to a decrease in the bladder s capacity to store urine.
Treating Urinary Incontinence

Initially, your GP may suggest some simple measures to see if they help improve your symptoms. These may include:

lifestyle changes   such as losing weight and cutting down on caffeine and alcohol
pelvic floor exercises   exercising your pelvic floor muscles by squeezing them, taught by a specialist 
bladder training   where you learn ways to wait longer between needing to urinate and passing urine, guided by a specialist
You may also benefit from the use of incontinence products, such as absorbent pads and handheld urinals.
Medication may be recommended if you're still unable to manage your symptoms.
Surgery may also be considered. The specific procedures suitable for you will depend on the type of incontinence you have.
Surgical treatments for stress incontinence, such as tape or sling procedures, are used to reduce pressure on the bladder or strengthen the muscles that control urination.
Operations to treat urge incontinence include enlarging the bladder or implanting a device that stimulates the nerve that controls the detrusor muscles.

Men Urinary Incontinence Treatment

Insomnia is the condition of acute sleeplessness, and it takes a heavy toll on your mood, your energy levels, and your ability to concentrate and work during the day. Some of the most common symptoms of the condition are:

You find it difficult to fall asleep even if you are tired
Once you wake up in the middle of the night, you cannot get back to sleep
You cannot work or concentrate on anything during the day
You stay mostly fatigued, or irritated throughout the day
You have to depend on pills or alcohol to fall asleep.
You wake up very early in the morning, no matter how late you sleep

What could be the causes for insomnia?

Insomnia might last just a few days if it is induced by some temporary cause, like stress at your workplace, or any other personal issue you can be facing. However, when the cause is a long rooted one, insomnia might persist for a long time. There can be a mix of many causes for that to happen:

Psychological stress or other emotional discomforts

Common psychological problems like anxiety, depression, chronic work stress, grief, and also bipolar disorder can be the causes for insomnia.

Illness or other medical problems

There can be many medical causes or other illnesses at the root of insomnia like allergies, acute asthma, hyperthyroidism, Parkinson's disease, kidney related diseases and cancer as well.

Medications

There can be many drugs, which might be prescribed by your doctor, but still be responsible for insomnia. These include antidepressants, corticosteroids like thyroid hormone medicines, few blood pressure medications, certain contraceptives and stimulants for ADHD (Attention Deficit Hyperactivity Disorder).

Sleep Disorders

Insomnia, though in itself is a sleep disorder, can also be the symptoms for other sleep disorders like sleep apnea, restless leg syndrome, and other disorders related to jet lag or if you are working on a late night shift.

In addition to these causes, some daily lifestyle habits might act as triggers to insomnia, which include:

Consumption of large amounts of caffeine on a regular basis
Developing irregular sleep schedules
Taking your smartphone to bed and ending up spending a lot of time with it in the night
Eating late in the evening

Causative Factors Behind Insomnia

Liver transplant in the only curative option available for patient who develop cirrhosis of liver due to any cause ( Chronic Hepatitis B , Chronic Hepatitis C, Alcoholic Cirrhosis, NASH etc). Once patient has been diagnosed with cirrhosis it can not be reversed with any non-surgical treatment . Over a period of time patient may develop worsening in liver function resulting in complications of cirrhosis (bloody vomitus, black stools, jaundice , altered sensorium, renal dysfunction, abdominal swelling etc) labeled as  decompensated cirrhosis . These patients require Liver transplant at the earliest and should be reffered to a liver transplant centre immediately. Ideally all patient diagnosed with cirrhosis should be under the follow-up of a gastroenterologist/Hepatologist. The source of graft liver can be from two sources namely from a deceased brain-dead donor or a Living-related donor and termed respectively as DDLT ( Deceased donor liver transplant) and LDLT ( Living Donor Liver Transplant) . However both DDLT and LDLT have nearly 90% success rate and both the procedures have their own benefits and lacunaes. Also the decision to go for DDLT and LDLT may vary for any particular patient. 

Before the Liver transplant 

All recipient and Living donor go thorough evaluation before the transplant process that includes blood investigations, Imaging studies, Cardiac and pulmonary fitness tests, multidisciplinary consultation before the clearance for liver transplant is achieved. The healthcare provider will explain the entire procedure. The healthcare provider is also supposed to answer all your questions. You would be needed to sign a consent form that allows the doctor to do the surgery. Eating food is not allowed at least 8 hours before the surgery. If you cannot stay relaxed before the surgery, a sedative will be given. 

After the Liver Tranplsant 
The recipient surgery lasts for anywhere between 12-16 hrs and donor surgery for 8-12 hrs. After the surgical procedure is complete, you will be taken to the intensive care unit (ICU)and will be closely watched for several days. 

Immediately After the Surgery 
You will most likely have a tube in your throat. This is so that you can breathe with the help of a machine (a ventilator) until you can breathe on your own. The ventilator tube will be removed on next morning when all parameters are found to be satisfactory. All parameters are monitored by round the clock critical care doctors and staff for a few days. The recipient has to stay in the hospital for three weeks and the donor is discharged in one week. 

Blood samples will be collected on a regular basis to check the functioning of the new liver. Antibiotics will be infused via IV channels to prevent you from infections. The area where the operation was done should always be kept clean after you have reached home. Any stitches or surgical sutures will be removed at a follow-up visit.

Complications that may arise 
Blocked blood vessels to the new liver, bleeding, an infection, leakage of bile or blocked bile ducts, or the new liver not working for a short time right after surgery are a few complications that may arise. Not to aggravate the condition, in the case of a complication, it is imperative to visit your doctor.

Liver Transplant - What To Expect Before & After The Procedure?

Syphilis is a STD caused by the bacterium Treponema pallidum. It has several stages, like primary, secondary, latent and tertiary and is common in homosexual men. It should be remembered that Syphilis is curable. It can be treated, if diagnosed in early stage. It can be cured, if medical help is sought for. Sharing toilets, clothes, or utensils doesn t cause this disease. It will vanish forever, if treated at once. However, it can be reinfected if exposed to the bacteria through new syphilis sore. It can also spread, if transmitted by direct touch or contact with Syphilitic sore via anus, skin surface, vagina, mouth and lips. It is very rare though that syphilis can be spread during a kiss.

Syphilis can live within the body for months, even years or decades. Initially, it remains as a painless sore on the genitals like anus, vagina, mouth or skin surface. If present for many years, there is an increased risk of contracting HIV.

Causes
The major causes of syphilis are unsafe sex with homosexual partners and the practice of having unprotected sex like anal, vaginal and oral sex. Individuals who have multiple sexual partners and are specially sexually linked to HIV-infected persons have the highest risk of contracting Syphillis.

It can not only be spread through multiple sexual unsafe intercourses, but also has its high risk in spreading from mother to baby during pregnancy; commonly unknown as congenital syphilis. In such cases, the baby has low birth weight and can develop cataract, deafness or seizures. In some cases, even new born babies die from the disease.

Diagnosis
The doctor will first conduct a physical examination of the patient. Thereafter, blood and urine are collected for bacterial test. If a sore is found on the body, the doctor may collect a sample from the sore to examine the presence of syphilis bacteria. If there are nervous system disorders in the patient, a spinal tap or lumbar puncture is done to collect the spinal fluid. The fluid is then tested for syphilis bacteria.

Treatments for syphilis
Initially, syphilis is treated with penicillin. It has to be kept in mind that long-term exposure to the disease can have life-threatening consequences. Patients suffering from syphilis are either given a single dose or multiple doses of penicillin. The quantum of the dose depends on the nature of symptoms and the infection. Individuals must use condoms to reduce the risk of transmitting the disease while having sexual intercourse. In the case of penicillin allergy, the patient is recommended to have alternative medicines. Infants and newborns born with syphilis undergo antibiotic treatment.

Syphilis - How to Diagnose And Treat It?

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