Dr. T Gowri Devi

Indications:

1. Primary Infertility
2. Secondary Infertility
3. Investigating & treating a case of B.O.H.
4. Investigating & treating Abnormal bleeding P/V
5. Investigating & treating case of mass inside the uterine cavity

Objective:

Hysteroscopy is the commonest type of work up in the entire Infertility patient along with Diagnostic Laparoscopy. Only diagnostic hysteroscopy is the commonest work up recommended before IVF. We record Hysteroscopy diagnostic & operative procedure for future important record in Infertility patient, for second opinion & for deciding future treatment protocol. 

Benefits of Hysteroscopy Surgery:

1. Shorter Hospital stay.
2. Earlier return to your routine work.
3. Cosmetically no scar on abdomen.
4. Less pain after operation.
5. Best fertility enhancement & Fertility results following hysteroscopy
6. Video-live operative file available in CD/DVD for future reference (Transparency about surgical procedure).
7. Patient discharged within 2-4 hours after procedure.
8. Patient can resume to her normal routine work within 12-24 hours after the procedure.

Pre-operative Check Lists:

1. Lab. Investigation for Surgery (Urine complete & Blood complete, HbsAg, HIV, R.B.S.Etc.); Pelvic Trance vaginal USG report.
2. Specific Investigations for Infertility (Endocrine, Blood, Genetic, Husband’s Semen report etc. If The couple is infertile)
3. Operation planned from 4th to 10th day of Menstrual Cycle.
4. Preparation of local parts.
5. No. Of Cuts on Abdomen: Nil 

Average Stay in Hospital:
2 to 4 hours. (DAY CARE SURGERY)

Average Duration of Surgery:
2 to 10 minutes

Average Blood loss during Surgery:
Negligible

Average time after operation to resume normal activities/work:
Within 12-24 hours.

Anesthesia:

General Anesthesia (Patient will not feel any pain in Operation Theatre during surgery)Procedure:Patient is given general anesthesia. Patient is put on lithotomy position. Local parts cleaning & paintings with antiseptic solution & draping are done. After P/V examination cervix is checked with uterine sound. For Diagnostic hysteroscopy after removing the air, hysteroscopy (varsascope/1.9 mm/ 2.9 mm Hysteroscopy along with irrigation of Normal saline is introduced inside the cavity. Systemically both corneal openings, cavity, both lateral walls and anterior & posterior wall of the uterine wall is noticed for any lesions or normalcy. For operative/therapeutic hysteroscopy cervix is dilated up to 7mm / 10 mm for introduction of Operating hysteroscopic sheath or resectoscope for operative hysteroscopy. Hysteroscopy requires dilatation of the uterine cavity to create working space inside the uterine cavity and flushes both fallopian tubes with high pressure fluid helps in achieving very good fertility enhancing results following Hysteroscopy in infertility patients. Addressing all the infertility related lesions like broad septum from the fundus, intra-uterine adhesions, polyps or tubal cannulation helps us in treating infertility patients in the same sitting
                        
Post-operative Course:

Patient remains drowsy/sedated for 1-2 hours after hysteroscopy but conscious & pain free. Patient can take fluids 1-2 hours after hysteroscopy & light food after 2-4 hours. She may feel little discomfort after hysteroscopy for 6-8 hours but it can be relieved with pain killer tabs. Most of the patients can walk normally without support and can take normal diet 6-8 hours after the hysteroscopy. She can be discharged on the same day of the operation. Few patients may feel nausea & vomiting after hysteroscopy, which can be very well controlled with injection in post-operative room. Patient can do her normal activity within 12-24 hours after hysteroscopy. Patient is advised to take antibiotics & analgesic tabs for 5 days following hysteroscopy. Patient is advised to report to doctor for severe pain or bleeding or fever in postoperative period (Day-1 to Day-5) immediately. Patient is advised to come for follow up 7 days after the next period or on the day for IVF protocol & preparation for IVF. In case you have a concern or query you can always consult an expert & get answers to your questions!

When it comes to bananas, most of us just grab them on the go; after all, as they are everyone's favorite fruit and the perfect 100-calorie goody. So, how do you pick your banana fruit? Because, when you look at this fruit, you either think that, 'oh, it’s too ripe' or 'too green'. A banana has two major stages, ripe and unripe. The nutritional value of a banana actually changes as it ripens? Different maturity stages of bananas give different health benefits to your body. 

Also, a banana gradually ripens, they become sweeter in taste.  But, why does this change happen? It happens because there are enzymes in the banana that breakdown into starch, which isn't sweet in nature, into a new substance called sugar. These changes makes the banana easily digestible. 

Let's determine the right stage at which the bananas should be consumed:

Features of ripe banana

Ripe bananas are yellow in color and often feature brown or black spots on their surface.

Pros of consuming ripe bananas

• As compared to unripe bananas, ripe bananas are sweeter and better in taste.
• They contain around 8 percent starch and about 91 percent sugar
• The resistant starch present in unripe bananas changes into simple sugar form as the bananas ripen.
• Yellow bananas are easy to digest since they have a higher glycemic index as compared to unripe bananas
• When the bananas ripen fully, they produce a substance called Tumor Necrosis Factor or TNF and this compound is known for its anti-cancer qualities
• Ripe bananas also have a high level of antioxidants which offer a host of benefits right from boosting your gut health to improved skin

Cons of consuming ripe bananas

• According to some studies, bananas tend to lose some of their micronutrients as they ripen.
• Since ripe bananas are sweeter than unripe ones, they are unsuitable for people affected with Type 2 diabetes.

Unripe bananas

Features of bananas 

Unripe bananas are waxy and green

Pros of consuming unripe bananas

• One of the most excellent benefits of unripe bananas is that they are rich in resistant starch content.
• Unripe bananas are ideal for people suffering from high blood sugar levels. Therefore, if you have diabetes but like bananas, then you should stick to unripe bananas.
• They are incredibly rich in probiotic bacteria, which is necessary for maintaining gut and colon health.
• Moreover, green bananas can absorb nutrients like calcium much better, and therefore they are always a good option for health-conscious people.

Cons of consuming unripe bananas

• They contain around 40 percent starch.
• They are bitter and due to their low glycemic index makes them difficult to digest
• The level of antioxidants increases as the fruit ages and therefore, unripe bananas are low in terms of their antioxidant content as compared to the ripe variety.
• Green bananas are also known to cause bloating and gas formation owing to higher resistant starch content.

All in all, both types of bananas come with a set of benefits. If you don’t have any existing medical condition, you should alternate between both variants to enjoy their respective health benefits. But in case you have diabetes, it is best to avoid ripe bananas. In case you have a concern or query you can always consult an expert & get answers to your questions!

So you have just found out that you are pregnant and you and your partner are over the moon about it! While congratulations are in order, so are a host of tips, which will help you settle into the pregnancy. It is important to remember that the first trimester of your pregnancy is a crucial phase where you may not change that much physically, but will be prone to many emotional changes. It is also a phase where you will make way for the changes that will inevitably come in the next two trimesters and for a long time after delivery of the baby too. Read on to unravel our first trimester guide.

1. Pregnancy Test: You must ensure that you know you are pregnant by monitoring your menstrual cycles closely so that even one missed period points at the possibility of pregnancy. This test can be a home based kit available at the chemists' or can even be conducted with a lab test based on a urine sample. Despite the results that you may get on a home pregnancy test, it is best to get a professional opinion as well.
2. Finding the Right Doctor: In this phase of your pregnancy itself, it is imperative to home in on a gynaecologist who will put you ease. Take care to pick someone who may be recommended by family and friends. Have a talk with the doctor a few times to see how well he or she engages you as a patient and if you are suitably convinced with the sessions and appointments.
3. Activity: While heavy activities may not be recommended by all doctors as the foetus needs to latch on, one can indulge in plenty of walks and a normal routine as well. Ensure that your pregnancy is a normal one and ask your doctor about any precautions that you may need to take with the progressing trimesters. Also, find ways to deal with any morning sickness with the help of the doctor. 
4. Supplements: In this crucial phase, ensure that your doctor gives you plenty of folic acid supplements that you must ingest on a regular basis. This will keep any risk of neural tube birth defects at bay. 
5. Other Medications: Find out more about over the counter drugs or any medication that you may have been taking as this may have to be stopped or adjusted for the pregnancy. The doctor should be able to guide you on this aspect too.

The other activities during the first trimester include taking pre natal appointments and choosing and interacting with your caregiver who will also be a support after you have had the baby.

Related Tip: "First Trimester Pregnancy - What to Expect"