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Management of Abortion
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Treatment Of Female Sexual Problems
Termination Of Pregnancy Procedure
Treatment Of Pregnancy Problems
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Treatment Of Female Sexual Problems
Treatment Of Medical Diseases In Pregnancy
Treatment Of Menstrual Problems
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Medical Termination Of Pregnancy (Mtp) Procedure
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Cerebral Palsy: What You Need to Know
Injuries to the brain before, during or after birth can cause cerebral palsy.
- Symptoms of cerebral palsy are usually noticed in infants and toddlers.
- There is currently no cure for cerebral palsy, but treatment options are available to treat associated orthopaedic conditions.
- The functional abilities and intellect of a person with cerebral palsy can vary greatly.
What is cerebral palsy?
Cerebral palsy (CP) is a condition that is a result of a brain injury. This injury can occur before, during or shortly after birth. Cerebral palsy affects movement and muscle tone.
What are the symptoms of cerebral palsy?
Signs of CP are usually noticed during infancy or in toddlers. It can be associated with exaggerated reflexes, floppiness in the trunk or limbs, or stiffness in the trunk and limbs. It can present with involuntary movements and abnormal gait.
There is no cure for CP, but there are many treatment options to help with the orthopaedic problems associated with CP.
Common Orthopaedic Conditions Seen in Children with Cerebral Palsy
This is a deformity of the hip that can be found on one or both hips in children with an underlying neuromuscular condition, such as CP. Increased or decreased tone in the muscles can lead to migration of the femoral head out of the hip socket, requiring additional treatment.
- Proximal Femoral osteotomy:This surgical procedure can be used to correct hip subluxation or dislocation in children who have an underlying neuromuscular disorder. It is used to correct the position of the proximal femur for better coverage by the acetabulum, leading to better distribution of weight on the femur. A wedge of bone is typically removed to place the proximal femur into the hip joint. A plate and screws are used to secure the femur bone properly in place.
- Acetabular osteotomy: This surgical procedure can be used to provide better coverage of the femoral head by the acetabulum. A wedge of bone is cut and placed in a position to add coverage. Hardware is used to secure the bone in place.
Neuromuscular scoliosis is a condition of the spine associated with an underlying neuromuscular condition, such as cerebral palsy, muscular dystrophy or spinal cord injury. The underlying condition typically causes changes in the muscles, leaving them unable to support the spine adequately. This leads to a curvature of the spine. The typical presentation is an abnormal S- or C-shaped curvature. The spine can also have rotation creating a multidimensional curve. The curvature can be progressive, especially with growth spurts.
- Bracing: A back brace may assist in better positioning and supply better support, but it usually does not stop the progression of the curve. In children who are nonambulatory, modifications to the wheelchair can also assist in better spine support and sitting position.
- Spinal usion surgery: This is a common treatment option for neuromuscular scoliosis when the curvature of the spine interferes with function or becomes a high degree of curvature. The spinal fusion surgery fuses the spine with metal hardware to stabilize the curve and secure the spine.
This is a foot deformity commonly seen in children with CP. Due to muscle imbalance, the deformity can make weight-bearing activities challenging.
- Split anterior tibial tendon transfer: This surgical intervention releases and transfers tendons in the foot to correct the deformity.
- Calcaneal Osteotomy: This bony surgical procedure is used in patients who have more rigidity of the deformity in the hind foot.
This is a deformity of the foot due to an underlying neuromuscular condition. The abnormality of the muscles in the feet leads to a flat foot with minimal or no arch. This condition is commonly seen in children with hypotonia or low tone.
Orthotics: In children with flexible flatfoot, a brace or orthotic may be helpful to provide better arch support and decrease pain. In children with rigid or painful flatfoot, a surgery may be recommended to correct this deformity and improve the alignment of the foot.
This is a condition in children with an underlying neuromuscular disorder that leads to high tone or muscle tightness in a child’s ankles, and can cause them to walk on the toes or balls of the feet.
- Physical therapy: Several sessions to work on stretching the tight muscles may be beneficial to decrease the amount of toe walking.
- Serial casting: Short leg casts can be applied for two-week intervals to progressively work on stretching the tight muscles to improve the position of the foot and ankle. The addition of Botox injections to help stretch the tight muscles in casts may be more effective in some children.
- Achilles tendon or gastrocnemius lengthening: When physical therapy and serial casting are ineffective in correcting the tight ankle, a surgery may be necessary to achieve a flat foot position with walking. A lengthening is a surgical procedure in which the tight Achilles tendon or gastrocnemius muscle is lengthened to allow greater range of motion and function of the foot and ankle. The lengthening also allows children to better tolerate ankle-foot orthosis and achieve a flat foot position with walking.
Limb Length Inequality
Limb length inequality is a difference in the lengths of a child’s lower extremities (legs). The difference in length can be found in children with hemiplegic CP.
The application of a shoe lift inside a child’s shoe on the shorter side assists in lessening the discrepancy. Surgical treatment to shorten the longer leg is also a way to decrease the discrepancy in children with a greater than 2-centimeter discrepancy. The procedure is called epiphysiodesis, and it is a carefully calculated surgery to close the growth plate in the longer leg and allow the shorter leg to continue to grow and balance out the discrepancy.
Some children with CP develop an inward or outward twist in their lower extremities. When this is excessive, it can interfere with their gait pattern.
Tibial or femoral rotational osteotomy: This surgical procedure is used to correct deformity of the tibia or femur bone. The bone is cut, placed in a corrected position and secured with hardware. The deformities can be surgically corrected with different techniques to provide improved function, especially with gait.
In a child with an underlying neuromuscular disorder, muscle tone can be increased, which can lead to a contracture of the muscle. This means the muscle does not stretch well. Common muscles involved are the hamstrings, adductors, hip flexors and gastrocnemii.
- Physical therapy and bracing: Physical therapy and bracing techniques can help keep muscles stretched to improve range of motion and assist in preventing a muscle contracture.
- Botox: An injection of this is used to temporarily weaken the muscle to allow for stretching of the muscle. The effects of Botox typically last about three months and then wear off. During this time, it is important to aggressively stretch the affected muscle to optimize the medication. Physical therapy and serial casting are commonly used in conjunction with Botox treatment.
- Tendon lengthening surgery: When stretching and bracing are not effective in improving range of motion, tendon lengthening surgery can be used to provide additional stretch and function at various muscle sites. Common muscles lengthened include hamstrings, gastrocnemii and adductors.
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I like sugarcane juice very much. When I return from my job around 1.00 pm I feel the urge to drink sugarcane juice. Is it safe to drink sugarcane juice daily. Does it has an adverse effect on our body by daily intake?
I am getting married soon. But my fiancée had already declared that he had few boy friends. How would I understand that whether she had sex or not earlier with anyone? What are the symptoms whether she is virgin or not?
Sleep disorders are problems in the pattern of sleep of an individual, often leading to a serious mental, physical and psychological strain. The most common types of sleep disorders are:
- Insomnia: People suffering from insomnia usually display symptoms like difficulty in falling asleep, waking up in the middle of the night and being unable to get back to sleep or waking up feeling tired.
- Sleepwalking: People suffering from this disorder get up and walk around, being asleep all this time.
- Narcolepsy: People suffering from narcolepsy usually complain of overwhelming drowsiness after waking up and the drowsiness persists throughout the day.
- Obstructive sleep apnea: Patients suffering from this, generally experience a state where their breathing pauses for a while and resumes after few seconds. This usually happens when throat muscles block the airway and create problems.
Homeopathy offers several treatments for these disorders and they are:
- Using Nux Vomica: This is especially helpful in case of insomnia; it can help in recovering from a general state of sleeplessness.
- Using Coffea cruda: Sleep disturbance and waking up in the middle of the night are symptoms for which this medicine proves to be beneficial.
- Belladonna: Bad dreams of deep-lying insecurities that don't let the patient sleep are most common symptoms that can be treated by this. Belladonna helps in case of problems of consistent sleep.
- Stramomium: It is beneficial for sleepwalking and also proves to be helpful to an extent in case of sleep apnea.
- Aconite: Especially, helpful for patients suffering from narcolepsy as it reduces the onset of tiredness brought about by lack of sleep and thus, helps in recovering from the drowsiness and lack of activity that narcolepsy brings.
- Phosphorus: Helps in case of sleepwalking and is often beneficial in cases of insomnia too.
- Pulsatilla: Beneficial for obstructive sleep apnea by reducing the muscle constriction and for people suffering from acute cases of narcolepsy.
- Arsenicum: It helps with better sleep for people suffering from sleeplessness due to anxiety, fear or worry. Acute thirst of water coupled with lack of sleep past midnight and general drowsiness are the symptoms that you need Arsenicum. This works well for sleepwalking patients too.
- Valerianna: Especially, beneficial for sleepwalking patients. Patients who are only able to sleep towards the morning are the ones on whom this works well and this can be taken in herbal capsule form as well.
Dear Doctor, my mother aged 72 years has a problem in her chest. Lab report says " Echogenic breast tissue and small cyst with internal echoes in nipple region "what is this? Please explain me in simple term & what is the ideal treatment for this?
Ankles, feet and fingers often swell a little in pregnancy as your body is holding more water than usual.
Towards the end of the day, the extra water tends to gather in the lowest parts of the body, especially if the weather is hot or if you have been standing a lot. The gradual swelling isn't harmful to you or your baby, but it can be uncomfortable.
Avoiding and Easing Swollen ankles:
- Avoid standing for long periods
- Wear comfortable shoes
- Do the foot exercises
Foot Exercises During Pregnancy:
You can do foot exercises sitting or standing. They improve blood circulation, reduce swelling in the ankles, and prevent cramp in the calf muscles:
Bend and stretch your foot up and down 30 times
Rotate your foot in a circle eight times one way and eight times the other way
Repeat with the other foot
When swelling can be serious:
You should seek medical attention immediately if your face, feet or hands swell up suddenly. A pregnancy condition called pre-eclampsia can cause sudden swelling, although most women with swelling don't have pre-ecplampsia.
If it happens to you, consult a gynaecologist, or hospital immediately. If you do have pre-eclampsia, you'll need to be monitored carefully, as the condition can be serious for both you and your baby.
You should get vaginal examination at least once a year. This is important for general health assessment and the prevention of sexually transmitted diseases. If you are using birth control medication, there might be irregularity in the hormonal cycles and this can lead to a number of conditions, another reason to get an annual vaginal examination.
6 ways in which changing weather affects health
The impact of weather and the natural world on human health is multifarious. The science that pertains to atmospheric effects on the body is known as biometeorology and experts in this field have conducted various tests and studies to determine the nature of the relationship between changes in weather patterns and the health of human beings.
Some of the ways in which seasonal and atmospheric changes in weather affect human health are as follows:
- Migraines and Headaches
People who are susceptible to frequent attacks of headaches and migraines are easily affected by changes in weather. Falling atmospheric pressure, spikes in temperature and increase in humidity can lead to these conditions.
- Asthma attacks
Fluctuations in weather patterns are known to cause asthma attacks in those who suffer from respiratory conditions. This happens especially in the case of thunderstorms or sudden temperature drops.
- Stiffening of joints
The onset of cold and damp weather conditions are known to cause joint stiffness. Those who suffer from chronic joint pain and arthritis suffer the most when the weather turns for the worse.
Many people blame the occurrence of allergy related symptoms to the presence of pollen in the air during spring. But in certain cases, anomalies in atmospheric pressure, temperature and humidity can lead to the onset of allergies and related symptoms such as incessant coughing, sneezing and nasal congestion.
- Cardiovascular disorders
Low temperatures create a lot of risks for those who suffer from heart conditions and other cardiovascular disorders. Cold weather impairs functioning of the arteries by constricting them and can lead to heart attacks and strokes. Harsh winters and cold waves are problematic for heart patients as their thermoregulatory systems are poorly equipped to deal with the drop in mercury levels.
- Skin diseases
The skin is the first line of defense against external factors like changes in the temperature. Hot and humid weather can cause skin rashes and eczema, leading to itchiness and irritation. On the other hand, cold and windy climes are known to make the skin rough and dehydrated. Hence, temperature fluctuations adversely affect skin health.
Related Tip: 4 Ways to Never Fall Sick at Season Change
I am suffering from loose motions during my 7th month of pregnancy. Is this a serious problem or else is it common in pregnancy? Please suggest me some home remedies.
I am 8 month pregnant and my 9 month is going to start. Please suggest should I have little bit desi ghee daily in my diet. Does by having desi ghee it cause Bp problem and breathing issue. Moreover can I have dry fruits in my diet now. Pls suggest what should we eat to have normal delivery?
Hello, I want to ask that I do sex with my girlfriend without condom but I didn't inject sperm in her vagina. After 48 hours of sex I gave her unwanted 72. Is there anything to worry like pregnancy type please clear my doubt. I am in stress with this.
Endometriosis is an often painful disorder in which tissue that normally lines the inside of your uterus — the endometrium — grows outside your uterus. Endometriosis most commonly involves your ovaries, fallopian tubes and the tissue lining your pelvis. Rarely, endometrial tissue may spread beyond pelvic organs.
With endometriosis, displaced endometrial tissue continues to act as it normally would — it thickens, breaks down and bleeds with each menstrual cycle. Because this displaced tissue has no way to exit your body, it becomes trapped. When endometriosis involves the ovaries, cysts called endometriomas may form. Surrounding tissue can become irritated, eventually developing scar tissue and adhesions — abnormal bands of fibrous tissue that can cause pelvic tissues and organs to stick to each other.
The primary symptom of endometriosis is pelvic pain, often associated with your menstrual period. Although many women experience cramping during their menstrual period, women with endometriosis typically describe menstrual cramp that's far worse than usual. They also tend to report that the pain increases over time.
Common Signs and Symptoms of Endometriosis may include:
Pain with intercourse. Pain during or after sex is common with endometriosis.
Pain with bowel movements or urination. You're most likely to experience these symptoms during your period.
Excessive bleeding. You may experience occasional heavy periods (menorrhagia) or bleeding between periods (menometrorrhagia).
Infertility. Endometriosis is first diagnosed in some women who are seeking treatment for infertility.
The severity of your pain isn't necessarily a reliable indicator of the extent of the condition. Some women with mild endometriosis have intense pain, while others with advanced endometriosis may have little pain or even no pain at all.
Endometriosis is sometimes mistaken for other conditions that can cause pelvic pain, such as pelvic inflammatory disease (PID) or ovarian cysts. It may be confused with irritable bowel syndrome (IBS), a condition that causes bouts of diarrhea, constipation and abdominal cramping. IBS can accompany endometriosis, which can complicate the diagnosis.
When to see a doctor
See the doctor if you have signs and symptoms that may indicate endometriosis.
Endometriosis can be a challenging condition to manage. An early diagnosis, a multidisciplinary medical team and an understanding of your diagnosis may result in better management of your symptoms.
Although the exact cause of endometriosis is not certain, possible explanations include:
Retrograde menstruation. In retrograde menstruation, menstrual blood containing endometrial cells flows back through the fallopian tubes and into the pelvic cavity instead of out of the body. These displaced endometrial cells stick to the pelvic walls and surfaces of pelvic organs, where they grow and continue to thicken and bleed over the course of each menstrual cycle.
Transformation of peritoneal cells. In what's known as the "induction theory," experts propose that hormones or immune factors promote transformation of peritoneal cells — cells that line the inner side of your abdomen — into endometrial cells.
Embryonic cell transformation. Hormones such as estrogen may transform embryonic cells — cells in the earliest stages of development — into endometrial cell implants during puberty.
Endometrial cells transport. The blood vessels or tissue fluid (lymphatic) system may transport endometrial cells to other parts of the body.
Immune system disorder. It's possible that a problem with the immune system may make the body unable to recognize and destroy endometrial tissue that's growing outside the uterus.
Several factors place you at greater risk of developing endometriosis, such as:
Never giving birth
Starting your period at an early age
Going through menopause at an older age
Short menstrual cycles — for instance, less than 27 days
Having higher levels of estrogen in your body or a greater lifetime exposure to estrogen your body produces
Low body mass index
One or more relatives (mother, aunt or sister) with endometriosis
Any medical condition that prevents the normal passage of menstrual flow out of the body
Endometriosis usually develops several years after the onset of menstruation (menarche). Signs and symptoms of endometriosis end temporarily with pregnancy and end permanently with menopause, unless you're taking estrogen.
The main complication of endometriosis is impaired fertility. Approximately one-third to one-half of women with endometriosis have difficulty getting pregnant. Endometriosis may obstruct the tube and keep the egg and sperm from uniting. But the condition also seems to affect fertility in less-direct ways, such as damage to the sperm or egg. Inspite of this, many women with mild to moderate endometriosis can still conceive and carry a pregnancy to term. Doctors sometimes advise women with endometriosis not to delay having children because the condition may worsen with time.
Ovarian cancer does occur at higher than expected rates in women with endometriosis. Although rare, another type of cancer — endometriosis-associated adenocarcinoma — can develop later in life in women who have had endometriosis.
Diagnosis: To diagnose endometriosis and other conditions that can cause pelvic pain, the doctor will ask you to describe your symptoms, including the location of your pain and when it occurs.
Tests to check for physical clues of endometriosis include:
Pelvic exam. During a pelvic exam, the doctor manually feels (palpates) areas in your pelvis for abnormalities, such as cysts on your reproductive organs or scars behind your uterus. Often it's not possible to feel small areas of endometriosis, unless they've caused a cyst to form.
Ultrasound. A transducer, a device that uses high-frequency sound waves to create images of the inside of your body, is either pressed against your abdomen or inserted into your vagina (transvaginal ultrasound). Both types of ultrasound may be done to get the best view of your reproductive organs. Ultrasound imaging won't definitively tell the doctor whether you have endometriosis, but it can identify cysts associated with endometriosis (endometriomas).
Laparoscopy. Medical management is usually tried first. But to be certain you have endometriosis, the doctor may advise a surgical procedure called laparoscopy to look inside your abdomen for signs of endometriosis.
While you're under general anesthesia, the doctor makes a tiny incision near your navel and inserts a slender viewing instrument (laparoscope), looking for endometrial tissue outside the uterus. He or she may take samples of tissue (biopsy). Laparoscopy can provide information about the location, extent and size of the endometrial implants to help determine the best treatment options.
Treatment for endometriosis is usually with medications or surgery. The approach you and the doctor choose will depend on the severity of your signs and symptoms and whether you hope to become pregnant.
Generally, doctors recommend trying conservative treatment approaches first, opting for surgery as a last resort.
The doctor may recommend that you take an over-the-counter pain reliever, such as the nonsteroidal anti-inflammatory drugs (NSAIDs) ibuprofen (Advil, Motrin IB, others) or naproxen (Aleve, others), to help ease painful menstrual cramps.
If you find that taking the maximum dose of these medications doesn't provide full relief, you may need to try another approach to manage your signs and symptoms.
Supplemental hormones are sometimes effective in reducing or eliminating the pain of endometriosis. The rise and fall of hormones during the menstrual cycle causes endometrial implants to thicken, break down and bleed. Hormone medication may slow endometrial tissue growth and prevent new implants of endometrial tissue.
Hormone therapy isn't a permanent fix for endometriosis. You could experience a return of your symptoms after stopping treatment.
Therapies used to treat endometriosis include:
Hormonal contraceptives. Birth control pills, patches and vaginal rings help control the hormones responsible for the buildup of endometrial tissue each month. Most women have lighter and shorter menstrual flow when they're using a hormonal contraceptive. Using hormonal contraceptives — especially continuous cycle regimens — may reduce or eliminate the pain of mild to moderate endometriosis.
Gonadotropin-releasing hormone (Gn-RH) agonists and antagonists. These drugs block the production of ovarian-stimulating hormones, lowering estrogen levels and preventing menstruation. This causes endometrial tissue to shrink. Because these drugs create an artificial menopause, taking a low dose of estrogen or progestin along with Gn-RH agonists and antagonists may decrease menopausal side effects, such as hot flashes, vaginal dryness and bone loss. Your periods and the ability to get pregnant return when you stop taking the medication.
Progestin therapy. A progestin-only contraceptive, such as an intrauterine device (Mirena), contraceptive implant or contraceptive injection (Depo-Provera), can halt menstrual periods and the growth of endometrial implants, which may relieve endometriosis signs and symptoms.
Danazol. This drug suppresses the growth of the endometrium by blocking the production of ovarian-stimulating hormones, preventing menstruation and the symptoms of endometriosis. However, danazol may not be the first choice because it can cause serious side effects and can be harmful to the baby if you become pregnant while taking this medication.
If you have endometriosis and are trying to become pregnant, surgery to remove as much endometriosis as possible while preserving your uterus and ovaries (conservative surgery) may increase your chances of success. If you have severe pain from endometriosis, you may also benefit from surgery — however, endometriosis and pain may return.
The doctor may do this procedure laparoscopically or through traditional abdominal surgery in more extensive cases.
Assisted reproductive technologies
Assisted reproductive technologies, such as in vitro fertilization (IVF) to help you become pregnant are sometimes preferable to conservative surgery. Doctors often suggest one of these approaches if conservative surgery doesn't work. If you wish to discuss about any specific problem, you can consult a Gynaecologist.