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Any kind of bleeding from the uterus, which is not normal, can be termed as abnormal uterine bleeding. This refers to bleeding between periods or before periods, bleeding after having sex, spotting, abnormally heavy bleeding or bleeding after attaining menopause. If you are suffering from any of these issues, you need to consult with the doctor.
It is very important to diagnose abnormal uterine bleeding. There are several examinations and tests that have to be carried out, depending on age. For irregular spotting, a pregnancy test can be undertaken in case you think you could be pregnant. If your uterine bleeding is very heavy, a test has to be performed to check blood count. This is done to observe whether you have anemia. An ultrasound test of the pelvic region will also be advised by your doctor to know the cause of the bleeding. Several hormonal tests and thyroid function tests are required as well.
Other diagnostic tests include:
- Sonohysterography: When fluid is placed within the uterus and ultrasound images of the uterus are taken. An image of the pelvic organs is obtained.
- Hysteroscopy: It can be carried out when a device is inserted via the vagina and enables the doctor to examine the uterus internally.
- Magnetic resonance imaging: This is also used to get images of the organs.
- Endometrial biopsy: It involves insertion of a catheter to take out a tissue which is microscopically observed.
There are different types of treatment for abnormal uterine bleeding depending upon factors such as the cause of bleeding and the age of the patient.
- Medications: Several medicines are used to treat abnormal uterine bleeding. Sometimes hormonal medicines are used. Birth control pills are also used to improve the regularity of periods. Hormonal infections, vaginal creams and an IUD device releasing hormone can be used. Non steroidal anti-inflammatory drugs are also used to control bleeding. Several antibiotics may also be prescribed.
- Surgery: In some cases of abnormal uterine bleeding, a woman has to undergo a surgery for the removal of growth such as polyps and fibroids, which results in bleeding. While some fibroids can be removed via hysteroscopy, others require different techniques for treatment.
- Endometrial ablation: It can be undertaken to control bleeding. This mode of treatment aims at reducing the bleeding permanently. In case all treatment methods fail, hysterectomy has to be carried out. This is a serious surgery and after it is performed, a woman does not have periods anymore and will not be able to conceive a child.
Abnormal uterine bleeding is a serious health condition, which may lead to severe complications. Immediate diagnosis and appropriate treatment methods should be undertaken in case of any abnormal uterine bleeding.
Uterine prolapse is a condition which occurs due to a weakness in the muscles and ligaments of the pelvic floor which are responsible for supporting the uterus. This condition results in the bulging out of the uterus from the vagina. The continuous stretching in the muscles of the pelvic floor due to the lifting of heavy things might initiate uterine prolapse. If you suffer from severe uterine prolapse, the doctors might suggest laparoscopic surgery to get rid of the pain. Lack of diagnosis might form infected ulcers in the pelvic regions.
The risk factors that can trigger a uterine prolapse are as follows:
- You are more prone to suffering from uterine prolapse as you age because aging causes a significant reduction in the estrogen (the hormone responsible for the overall development of the pelvic muscles) levels of the body.
- If your pelvic muscles and the adjoined tissues have suffered sustained damage during pregnancy or childbirth, you have a higher risk of suffering from uterine prolapse.
- Obesity, sustained episodes of constipation or coughing make you more vulnerable to uterine prolapse.
- In women, estrogen levels reduce significantly after menopause.
- A woman who has undergone vaginal childbirth multiple times can suffer from uterine prolapse.
- Having undergone surgery in the pelvic region and experiencing severe pain during excretion raises the risk levels even more.
The symptoms of uterine prolapse vary with the severity of the condition. If the prolapse is a minor one, there will be no symptoms. But severe uterine prolapse might bring with it the following symptoms:
- Severe pain in the lower back region along with significant problems during urination such as leakage of urine.
- Bulging out of tissues from the vagina.
- Recurrent instances of constipation and abnormal discharges from the vagina.
- Infection in the bladder and experiencing severe problems during sex intercourse.
In case you have a concern or query you can always consult an expert & get answers to your questions!
1. What are the symptoms of liver disease? When to see a doctor?
Most of the liver diseases present with similar symptoms with some variations. Some of the common symptoms can be loss of appetite, nausea and vomiting, vomiting of blood, jaundice(yellowish discoloration of the eye), abdominal pain, itching, distension of abdomen( accumulation of fluid- ascites), swelling of lower limbs, weight loss, altered sensorium, confusion, and in a late stage- coma.
2. Can liver disease be prevented?
Liver is a crucial body organ which is responsible for processing essential nutrients from the food you eat, synthesizing bile and most importantly removing harmful toxins from the system. To ensure that your liver keeps performing its functions, you need to follow a healthy lifestyle.
Some of the liver diseases are metabolic and hence inherent at the time of birth and manifest later. However, some of the more common liver diseases are preventable like alcohol induced liver disease, fatty liver induced liver disease (NAFLD), Hepatitis A, B and C.
3. What is liver transplantation? What is the average cost of liver transplantation?
Liver transplantation is the treatment for end stage liver disease in both adults and children. In this operation, the diseased liver is removed and replaced by a healthy one. The success rate for the operation is high and terminally ill patient can return to normal lives.
The average cost of liver transplantation is Rs 18 to 20 Lakhs at Sahyadri specialty hospital, Pune Maharashtra. The cost of investigations of the donor and recipient is Rs 90,000. When patients are too sick and require prolonged stay following liver transplantation, the cost of treatment can escalate; hence it is advisable to patients to have the liver transplantation before they develop complications secondary to the liver disease (Cirrhosis).
Most of the patients seek help at a very late stage or referred late to a Surgeon. It is advisable for patients to seek the opinion of a Surgeon at a very early stage of the disease. The patient needs to take medicines for the rest of his life to prevent rejection of the new liver. The cost of medicines and the investigations in the first year is approximately Rs 10-15000/-. The number of medicines and the frequency of blood investigations are much less after the first year of liver transplantation.
The cost of liver transplantation in India is one-twentieth when compared to USA, UK and other European Countries.
4. When should a liver transplant be performed?
When a person’s liver is severely damaged and cannot function properly or complications may develop and liver transplantation should be considered. Conditions like hepatic coma, massive upper gastrointestinal bleeding, and liver cancer is the best treated by complete removal of the liver (cirrhotic liver).
In general, when a patient needs a new liver, the earlier the operation, the higher the success rate is.
Urgent liver transplantation is recommended in patients who have acute liver failure and this could be due to many reasons. The common conditions are Hepatitis B, Hepatitis A, Hepatitis E and drug induced. In such patients, liver transplantation is urgently needed in order to save the life of the individual.
5. What are the advantages/benefits to the recipient of getting a living donation vs cadaver?
A new liver can come from either of the two sources: A living donor or a brain-dead deceased donor.
Living donor transplantation:
It is technically feasible to remove part of the liver from a living person and transplant it to a patient who needs a new liver. The operation has now been done since 1989. Depending on the size matching of the donor and recipient, either the left side (about 35-40%) or the right side (60-65%) of the liver will have to be removed. The liver remnant in the donor will grow to its original size in 6-8 weeks time.
This process helps in an earlier transplantation before the recipients’ conditions deteriorates. It is a planned procedure whilst cadaver liver transplantation is an emergency procedure. It avoids the risk of death while waiting for a deceased donor liver graft(40% overall and 75% for patients in Intensive care units). The survival rate of a living donor transplant is over 90%.
There are risks like complications of the investigations and surgical procedures but the possibility of donor death rate is of 0.2-0.5%. Seventeen donor deaths have been reported in Brazil, France, Germany, Egypt, Hong Kong, Japan, USA and India.
This is well established in the Europe and USA. Unfortunately, the availability of deceased donor liver is not very often in India. Depending on your blood group, you may have to wait for 0 to 6 months before you get a new liver.
During this waiting period, you may develop complications like spontaneous bacterial peritonitis (infection of the fluid in the abdomen) which, if repetitive may produce severe adhesions in your abdomen rendering liver transplantation difficult if not impossible.
It is important for everyone to register for organ donation, so that when we die, this noble act will help many people to lead normal lives. In the Western world the organ donation rate is between 15-18/million population where as in Indi it is less than 1/million.
6. Who can be a suitable living donor?
The most important criteria is that the donation of portion of the liver is done voluntarily. The donor has to be less than 50 years of age, body mass index of less than 25 and is a near relative of the recipient. Both the donor and the patient should have the same Blood group or O Blood group.
Besides, the potential donor should understand clearly that
- The donor operation carries complication rate of 10-15%.
- The recipient is successful in 90-95%, which means that there is 5-10% chance of dying.
- The donation is done out of his/her own wish and without any coercion.
- There is no financial gain related to the act of donation.
- The donor has the right to withdraw at any time without the need of giving any reasons to do so.
7. Which patients are excluded from liver transplantation procedure?
Patients who have cancer in another part of the body, active alcohol or illegal drug abuse, active or severe infection in any part of the body, serious heart, lung or neurological conditions or those who are unable to follow doctors’ instructions are excluded generally.
8. What are the risks to the recipient from the surgery?
The overall success rate of liver transplant is over 94% and the majority of recipients can return to normal activities and achieve 95% of their quality of life which they had prior to liver disease. Since the recipients’ body may reject the new liver, it is essential for them to take immunosuppressive medications and continue follow up at the liver transplant clinic. They will need to continue these medications for life, at a reducing dosage.
The risk for the recipient is the return of the original problem that necessitated the liver transplant in the first place, e.g. hepatitis C, recidivism (return to alcoholism), noncompliance of medications. The other complications that can arise are thrombosis of blood vessels going into or out of the liver, primary or delayed graft non-function, bile duct complications, renal failure and other infections.
9. What are the side effects of having a liver transplant?
After a successful liver transplantation (95% of patients) – the patient is advised to take care of infections and to take anti-rejection medicines for life. The patient can return to normal quality of life and can return back to work in three months time. The patient has to regularly follow up with the surgeon in the first year and later at regular intervals as advised by his doctor. He will require blood tests to determine that his liver functions and to adjust his medications in the beginning and later the tests are infrequent. The patient is advised not to take any herbal or alternative drug treatment.
The transplant patient is assessed regularly for various complications like rejection, infection, narrowing of blood vessels etc., and appropriate treatment is initiated. Post transplantation, he is under the guidance of his doctor throughout his life. Any health problems that do come up have to be investigated and treated, though they are infrequent.
In case you have a concern or query you can always consult an expert & get answers to your questions!
Due to night fall my nerve system is very week and now I am suffering from disk in my back please suggest me some medicine fr improvement of nerves.
I got spine l4 l5 disc herniation surgery in which my QI nerve was compressed on 13 Feb 2016 .I'm all fit now but I want to know that can I continue gym in future. Along with precautions.
Patra panda sweda(ela kizhi) is a specialized therapy which is performed for the diseases related to Bones, muscles and nerves. Patra means leaves of medicinal plants. Pinda means a bolus. Sweda means Fomentation or sudation. The swedana karma or sudation therapy which is given by using a bolus which is prepared by the different combination of medicinal leaves which is processed with medicinal oil along with the medicinal herbs is called as patra panda sweda or ela kizhi. This procedure is unique, which comprises both snehana (oleation) and swedana (sudation) (snehayukta swedana)
Benefits of Patra Pinda Sweda:
It strengthens and rejuvenates the bones, muscles and nerves
Strengthens the tissues
Increases the circulation
Provides color and complexion of the skin
Helps to Reduce pain, inflammation and stiffness of the muscles
Induces good sleep and reduces the stress.
Breasts are a part of female identity- which is why for most women, breast cancer still continues to be a big fear. Many feel that having cancerous cells in these parts rob them of their identity and puts a question on everything they stand for. More than a disease, many women treat it as an emotional trauma that one has to go through, rather than something that has to be dealt at a physical level. But breast cancer is not a taboo subject anymore and with the huge awareness created, women are now more knowledgeable in identifying their risk levels. What’s more, breast cancer can be prevented to the maximum by making minor changes to our daily chores and life style.
Let us have a look at ways to keep breast cancer in check.
- Have regular checkups: Move over traditional mammography methods; new digital checks that are more accurate in identifying the symptoms have come into the picture. Make these checks mandatory as a part of the yearly check-ups and never postpone them.
- Exercises: Regular exercises can be very helpful in keeping the body fit. Estrogen is the biggest factor that can stimulate breast cancer. Having regular activities alters the estrogen metabolism thus minimizing the cancer levels. Even a relaxed exercise of 15 - 20 minutes can do a world of good, both for the body and mind in keeping the condition under check.
- Family history: About 5% to 10% of the breast cancers are hereditary. Hence always ensure that you know your family history and their tryst with cancer.
- Minimize screening tests that use radiation: Go for X-ray screening and chest x-rays only when absolutely necessary. Always consult with the physician about the precautions to be taken when going for a screening test.
- Reduce hormone intake: Hormone therapy is most commonly used to manage menopausal symptoms. However, there is a chance that they can indirectly aid in producing estrogen that can cause breast cancer. Always have a proper consultation with the gynecologist and as far as possible avoid hormone intake. Try to treat the symptoms through natural ways.
- Breast Feeding: This is one of nature's ways of preventing the contagion that causes breast cancer. Breast feeding naturally reduces the estrogen levels thus drastically reducing the chances.
- Diet and the right food: Tons of articles have been written about the good food to have and the proper diet to maintain. When it comes to breast cancer, increasing the carotenoid levels in the body can decrease the chances of breast cancer. Foods that are rich in carotenoid include fresh vegetables and fruits and greens. Also, increase the intake of fibers to have a natural defense mechanism against cancer.
- Early detection: There is no better treatment plan for breast cancer than detecting it early. The symptoms do not appear initially and they appear only in the advanced stages. Hence make sure that regular checkups are done to diagnose it.
- Alcohol abuse: Alcohol can be had in minimal quantities but do not abuse them. Excessive drinking can increase the chances of breast cancer.
- Smoking: Researchers have found a direct link between smoking and breast cancer. This increases phenomenally during menopause stages. Quit smoking altogether for a better life and in preventing many other ailments.
Breast cancer can be an emotional phase for women and following the above methods can keep breast cancer in check and prevent them in the long run.
In case you have a concern or query you can always consult an expert & get answers to your questions!
What is ECMO?
Like dialysis for unfunctional kidney, Ecmo for unfunctional lung.
Ecmo stands for extracorporeal membrane oxygenation. It is a method of giving oxygen for the body when icu pateint lungs and/or heart are not able to supply oxygen on their own.
Why ICU pateint put on ECMO?
Doctors place ICU patients on ECMO when patients are not able to supply oxygen to the body.
When a patient’s lungs fail, he/she first is intubated (breathing tube) and hooked up to a ventilator (breathing machine).
However, sometimes lungs are so damaged that providing oxygen through intubation is not enough.
This is when doctors turn to v-v ecmo.
A heart can fail for many reasons including heart attack, pulmonary embolism, bad valve disease, or worsening heart failure. When a heart fails, doctors try to fix the underlying problem. They may also start medications (called ionotropes) to help improve the pump function of the heart. If medications are not enough, doctors will turn to v-a ecmo.
How long can someone stay on ecmo?
That is a complicated question. Due to the risks of ecmo discussed above, doctors try to keep patients on ecmo for as short a time as possible. Often patient will be on ecmo for several days up to 1-2 weeks. Every day, several blood and imaging tests are done to determine if a patient is ready to come off ecmo. As the technology of ecmo improves, hopefully side effects will decrease and patients can remain on ecmo for longer periods of time.
What is the difference between ecmo and a ventilator (breathing machine)?
Both ecmo and a ventilator aim to provide oxygen to the body when the patient’s own lungs and breathing are failing. The ventilator assists the patient’s own lungs by pushing oxygen with pressure into the lungs. Ecmo instead provides oxygen directly via a catheter placed in a patient’s vein or artery. We almost always try oxygenating a patient with a ventilator first. However, when a patient’s lungs are too sick for this, we turn to ecmo to assist in providing oxygen to the body. V-v ecmo provides oxygen through a vein. This blood then has to travel to the heart and be pumped around the rest of the body through arteries. Therefore, with v-v ecmo or with a ventilator, a patient must have a well-functioning heart to get the oxygen pumped throughout the body. V-a ecmo has the additional advantage of pumping blood directly to arteries. This “by-passes” the heart and is therefore the method of ecmo we use when a patient’s heart is failing.