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Management of Surrogacy
Caesarean Section Procedure
Treatment of Gynae Problems
Gynecology Laparoscopy Procedures
Treatment Of Female Sexual Problems
Treatment Of Menopause Related Issues
Treatment Of Menstrual Problems
Treatment of Mirena (Hormonal Iud)
Pap Smear Procedure
Polycystic Ovary Syndrome Treatment
Treatment of Uterine Bleeding
Antenatal And Postnatal Exercise
Management of Postnatal Care
Adiana System Treatment
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I enjoyed my sex life with my boyfriend without precaution and I got period date after a day. Am worrying that i'll get pregnant? Please help me to avoid pregnant.
Hi doctor it's for my sister. She is pregnant since last two months and now she gets too much of vomit. How to. Control it.
I had posted a question two days back and this is in continuation History is LMP 9th April, usual cycle 26 days, last and only sex this moth 22 April with condom but as I felt condom leaked took I pill ECP on 23 (in 26 or 27 hrs after the episode), HPT negative and I got Beta HCG yesterday and the level is less than one But I have not started my menses even today, please guide can I be pregnant.
I ws pregnant but in 12 th week ie 1april ultrasound got to knw baby had no heartbeat n growth so I had my d&c on 2 april 2016. I want to what all precautions I need to take nw nd fr how long. Nd aftr d&c how many days bed rest is required?
Dengue fever is a painful mosquito-borne disease. It is caused by any one of four types of dengue virus, which is transmitted by the bite of an infected female Aedes aegypti mosquito.
Previous dengue infection with similar serotype provides immunity but different serotype causes more severe infection.
Common symptoms of dengue include high fever, runny nose, a mild skin rash, cough, and pain behind the eyes and in the joints. However, some people may develop a red and white patchy skin rash followed by loss of appetite, nausea, vomiting, etc.
Patients suffering from dengue should seek medical advice, rest and drink plenty of fluids. Paracetamol can be taken to bring down fever and reduce joint pains. However, aspirin or ibuprofen should not be taken since they can increase the risk of bleeding.
The risk of complications is in less than 1% of dengue cases and, if warning signals are known to the public, all deaths from dengue can be avoided.
Best test is NS1, specific
Cannot be false +ve
Is + from day 1 to 7 ideally.
If on day 1 is -ve, repeat it next day.
Always ask for ELISA based NS1 tests as card tests are misleading.
IgG & IgM dengue
In a pt with reduced platelets and looking "sick" on day 3 or 4 of illness, a very high titre of IgG with borderline rise in IgM signifies secondary dengue. These pts are more prone to complications.
In primary dengue IgG becomes + at end of 7 days, while IgM is + after day 4.
Immature Platelet fraction (IPF)
A very useful test in Dengue for patients with thrombocytopenia.
If IPF in such a pt is > 10%, despite a platelet count of 20, 000, he is out of danger & platelets will rise in 24 hrs.
If its 6%, repeat the same next day. Now if IPF has increased to 8% his platelets will certainly increase within 48 hrs.
If its less then 5%, then his bone marrow will not respond for 3-4 days & may be a likely candidate for platelet transfusion.
Better to do an IPF even with borderline low platelet count.
A low Mean Platelet volume or MPV means platelets are functionally inefficient and such patients need more attention.
The primary cause of death in patients suffering from dengue is capillary leakage, which causes fluid deficiency in the intravascular compartment, leading to multi-organ failure. Platelet deficiency is not the cause of death in most of the patient suffering from Dengue .
According to International guidelines, unless a patient’s platelet count is below 10,000 or there is spontaneous, active bleeding, no platelet transfusion is required. The outbreak of dengue in the City and Hospital beds are full and families are seen running around in search of platelets for transfusion. However what most people do not realize is that the first line of treatment for dengue is not platelet transfusion. In fact, it does more harm than good if used in a patient whose counts are over 10,000.
At the first instance of plasma leakage from the intravascular compartment to the extravascular compartment, fluid replacement amounting to 20 ml per kg body weight per hour must be administered. This must be continued till the difference between the upper and lower blood pressure is over 40 mmHg, or the patient passes adequate urine. This is all that is required to treat the patient. Giving unnecessary platelet transfusion can make the patient more sick.
“While treating dengue patients, physicians should remember the ‘Formula of 20' i.e. rise in pulse by more than 20; fall of BP by more than 20; difference between lower and upper BP of less than 20 and presence of more than 20 hemorrhagic spots on the arm after a tourniquet test suggest a high-risk situation and the person needs immediate medical attention.”
Read WHO guidelines for further fluid management strategies & Hematocrit monitoring.
Losing weight is very difficult and for that you don't have to eat less or exercise more as it will not work. The quantity of calories is not taken into account, but it is only the quality of the calories that make a huge difference without the need of you going hungry. It is very necessary that your body is able to burn the calories you eat and in this way, you can lose weight. Eating few calories on a regular basis can result in malnutrition, nutrient deficiencies and in unhealthy weight loss.
Conditions That Occur due to under eating: By intake of few calories on day to day basis, our body system learns to live with smaller amount, and it slows down the metabolism of your body. The worst thing is that you even stop losing weight and feel irritated as well as sluggish on the diet you intake. The practice can be reversed, and it will not take much time for your body to recover and its metabolism to become better.
Long term intake of low diet can also put you at a higher risk of nutritional deficiency. As by eating less, the body does not get the necessary vitamins and minerals required for daily functioning.
To keep alive it is very important that a minimum blood-glucose level is maintained. If the blood glucose is less than required, a lot of stress can be created on your organs, and it would damage vital organs of your body.
It is very important that we develop positive food thoughts, and constant restriction can result in eating disorders like orthorexia and anorexia.
Opt For Healthy Eating:
- The simple and healthy way which you can start with to lose weight would be at first to make small changes like eliminating beverages that are sugary as well as replacing your diet with healthier choices.
- It is best to avoid unhealthier choices like eating muffins and donuts for breakfast. Instead, you should eat whole foods, oatmeal, eggs and fruit for breakfast.
- The basic rules that should be followed are that men should not eat above 1500 calories in a day, and women should not eat above 1200 calories in a day.
- It is best to focus on eating healthy food instead of calorie counting. The weight loss may be slow, but it would be stable and long-lasting.
The most important step that needs to be followed to lose weight effectively is to have a proper mindset and follow a healthy diet to achieve your goal.
She has bad stomach pain and back pain just before 5 to 10 days of periods. Its very bad pain . After periods she is normal. What is the issue ? Can any one help.
Hi doctor I have married 5 days ago. When I had sex with my wife, she had very severe pain in her abdomen and she is crying. Now 5 days has over and still have pain. What happened to her.
After using unwanted 72 I am suffering from bleeding like one drop or half drop of blood inside my vagina is these are periods.
Hello Doc, Mai last 3 times se hcg treatment le rahi hu but mai conceive hi nahi ho rahi hu asa kiyo?
Hi doctor my gynecology gave me for metformin 500 mg twice a day and normal tablets 15 days twice a day So how many months after I will get pregnant? Doctor told to took for yamini 21 tablets for 2 months for hormones balance Please tell me.
My 28 days missed period. And 58 days from first day of my last period yet negative home pregnancy test? am I not pregnant?? please suggest.. Totally confused.
my wife didn't come in periods for last 2 months. last to last month we consult the dr and he gave us medicines and dimpal comes in periods. but now once again it happens. so whats the problem for that.?
Bariatric surgery is a procedure that involves modifications to the digestive system so that the food intake can be restricted or the nutrients absorbed by the body is reduced. This surgery is recommended when exercise and diet may not cause the desired results with weight loss. Bariatric surgery is a group of surgeries that are procedure to reduce weight in the body.
The various types of surgeries that come under this category are:
- Gastric bypass: The most common bariatric surgery, gastric bypass is a procedure used to reduce the size of the stomach pouch in the body. Once the size is reduced, it leads to reduced consumption of calories. This procedure also causes alterations in the behavior of the gut hormones resulting in appetite reduction.
- Adjustable gastric band: This procedure involves placing an inflatable band around the upper stomach to make a small stomach area above the band. This causes one to feel full just after eating a small amount of food.
- Sleeve gastrectomy: In this procedure, almost 80% of the stomach area is removed surgically, resulting in a small stomach pouch being left. It reduces the stomach size, which cause an overall reduction in the amount of calories. Modifications also occur in the behavior of the gut bacteria linked with reduced appetite.
- Biliopancreatic diversion with duodenal switch: This procedure involves surgical removal of a large area of the stomach along with bypassing a major portion of the smaller intestine. This procedure may reduce fat absorption of up to 70%. The behavior of the gut hormones change resulting in a decrease in appetite and improved satiety.
Various complications may result from this surgery such as -
- May cause infections in the body
- Clots may form in the blood
- It can result in bowel problems
- Ulcers can form in the stomach
What is recurrent miscarriage?
If you have three or more miscarriages in a row, doctors call it recurrent miscarriage. If you have experienced recurrent miscarriage, your GP or midwife will refer you to a gynaecologist. Your gynaecologist will try to identify the reason for your losses.
Having miscarriage after miscarriage may leave you feeling utterly drained of hope. At times, it may be hard to keep trusting in the future. This experience affects every aspect of a woman’s life from her mental and emotional health to her physical health and social well-being.
If you can, try to draw comfort from the fact that most women who experience recurrent losses do go on to have a baby. This is especially the case if tests can find no reason for the losses. Six out of 10 women who have had three miscarriages will go on to have a baby in their next pregnancy.
Treatment of Recurrent Pregnancy Loss
Treatment for anatomic abnormalities of the uterus involves surgical restoration through removal of local lesions such as fibroids, scar tissue and endometrial polyps or timely insertion of a cervical cerclage (a stitch placed around the neck of the weakened cervix) or the excision of a uterine septum when indicated.
A thin endometrial lining has been shown to correlate with compromised pregnancy outcome. Often times this will be associated with reduced resistance to blood flow to the endometrium. Such decreased blood flow to the uterus can be improved through treatment with sildenafil (Viagra), Terbutaline and possibly aspirin.
Sildenafil (Viagra) Therapy Viagra has been used successfully to increase uterine blood flow. However, to be effective it must be administered starting as soon as the period stops up until the day of ovulation and it must be administered vaginally (not orally). Viagra in the form of vaginal suppositories given in the dosage of 25 mg four times a day has been shown to increase uterine blood flow as well as thickness of the uterine lining. To date, we have seen significant improvement of the thickness of the uterine lining in about 70% of women treated. Successful pregnancy resulted in 42% of women who responded to the Viagra. It should be remembered that most of these women had previously experienced repeated IVF failures.
Terbutaline this is a medication that relaxes the muscle in the uterine wall and so permits improved hormone delivery to the endometrium. The use of Terbutaline will often cause an increase in heart rate. It should not be prescribed to women who have irregular heart beats (arrhythmias), and women who have decreased cardiac reserve.
Aspirin this is an antiprostaglandin that improves blood flow to the endometrium. It is administered at a dosage of 81mg orally, daily from the beginning of the cycle until ovulation.
Selective Immunotherapy Using Intralipid, heparin, aspirin and corticosteroid
Many causes of pregnancy loss or failure can be treated with immunotherapy comprising combinations of aspirin and heparin and corticosteroids (dexamethasone or prednisone) and Intralipid (IL) to regulate increased level of Natural Killer Cell Activation (NKa). Achievement of optimal success with Intralipid/corticosteroid therapy requires that the treatment be initiated well before ovulation takes place (about 7-14 days prior to anticipated implantation). Given the fact that only 10-15% of natural cycles (with or without the use of insemination and/or fertility drugs) will result in a pregnancy, it follows that repeated administration of Intralipid will be required in most cases before a pregnancy will occur. IVF achieves pregnancy rates that are often 2-3 times higher. This often makes IVF a treatment of choice in cases of immunologic recurrent pregnancy loss.
Role of IVF
Preimplantation genetic diagnosis (PGD) a procedure whereby the embryo can be tested for genetic or structural chromosomal abnormalities requires the use of IVF to select the best embryo(s) for transfer to the uterus. In cases of structural chromosomal (translocations) egg or sperm donation is often another option worth considering.
In those cases where due to intractable anatomical or alloimmune dysfunction IVF repeatedly is unsuccessful or is not an option, Gestational Surrogacy might represent the only recourse other than adoption.
If a couple with Recurrent Pregnancy Loss is open to all of the diagnostic and treatment options referred to above, a live birth rate of 70% – 80% is ultimately achievable.
Hi doctor. I have one doubt. HSG is rare cause for Endometriosis? Is any relationship between HSG and Endometriosis. Can you explain me about Endometriosis.
Nipple discharge is a common part of breast functioning, which normally occurs during breast-feeding or pregnancy. It is often associated with the changes of menstrual hormone. The milky discharge post breast-feeding usually continues for up to two years after stopping nursing. The condition normally gets resolved on its own but if the situation persists for a long time resort to medical assistance.
The following are some of the causes of normal nipple discharge:
- Stimulation: Normal nipple discharge can arise due to stimulation; chafing of your breast skin due to tight bras or vigorous exercises.
- Pregnancy: Most women tend to witness clear nipple discharge in the early stages of their pregnancy. Towards the later stages, this discharge usually turns watery and becomes milky in color
- Stopped Breast-feeding: In some cases, nipple discharge continues for some time after the mother has stopped breast-feeding her newborn
- Hormonal Imbalance: Some women notice tenderness in breasts and nipple discharge during their menstrual cycle
What is an abnormal nipple discharge: An abnormal nipple discharge is usually bloody in color and is accompanied with tenderness of the breast. Papilloma is a non-cancerous tumor that is often responsible for bloody nipple discharge. Continuous nipple discharge from one of the breasts or nipple discharge that arises without any stimulation or external irritation is abnormal in nature.
The possible causes of abnormal nipple discharge include:
- Abscess: It is an assortment of pus that get accumulated within the tissues of your body. It is usually accompanied by redness, pain and swelling. Boils and carbuncles are types of abscess. Formation of abscess in breasts may result in nipple discharge.
- Breast cancer: Breast cancer often results in bloody nipple discharge and is often found with a presence of lump in one of the breasts.
- Mastitis: It is a breast infection that affects the tissues of the breast and is usually prominent during breastfeeding. Fatigue, fever and body aches are common in this situation.
- Ductal carcinoma in situ (DCIS): Normally characterized by the growth of cancerous cells in the milk ducts of your breasts, it is generally identified through mammography screening.
- Fibroadenoma: In this situation most young women witness an appearance of solid, tumor like structure
- Galactorrhea: Galactorrhea is nipple discharge of milk when not pregnant or breastfeeding. The discharge can vary in color and can be expressed from either or both breasts.
What Causes Galactorrhea: Galactorrhea is commonly caused by hyperprolactinemia, especially when it is associated with amenorrhea. Hyperprolactinemia is most often induced by medication or associated with pituitary adenomas or other sellar or suprasellar lesions.
The release of prolactin from the pituitary is held in check by dopamine from the hypothalamus. Prolactin release is encouraged by serotonin and thyrotropin-releasing hormone. This balance can be disrupted by medication (ie. antipsychotics), underactive thyroid function, pituitary tumors, hypothalamic tumors, damage to the pituitary stalk, nipple stimulation, chest trauma, herpes zoster, and emotional stress as well as a variety of other factors.