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Treatment of Pregnancy and related Disorder
Treatment of Irregular Periods
Treatment of No Periods
Management of Pregnancy
Treatment of Ovarian Cysts
Management of Pregnancy Query
Management of Abortion
Treatment of Painful Periods
Avoiding Pregnancy Procedures
Birth Control Treatment
Treatment of Painful Sexual Intercourse
Treatment of Pregnancy Symptoms
Treatment of Heavy Periods
Treatment of Polycystic Ovary Syndrome
Treatment of Breast Pain
Treatment of Vaginal Discharge
Treatment of Miscarriage
Treatment of Vaginal Itching
Treatment of Cervicitis
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My case was a very complicated one as I was suffering from the disease (Endometriosis) since many years. Over the years I had consulted many doctors but the problem persisted. Under the guidance of Dr Amit Kyal, finally I was cured of the disease and am able to live a healthy life. Thanks Dr Amit Kyal..
Dr. Amit Kyal provides answers that are caring, well-reasoned, very helpful and nurturing. Tq sir i was really very tensed first but now am relaxed tq....sooomuch sir
Very professional and competent doctor who is well updated and explains properly about the condition of the patient and the treatment required. Very satisfied.
Dr. Amit Kyal provides answers that are very helpful, knowledgeable, well-reasoned, caring and sensible. Thank you doctor for your reply!!
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Dr. Amit Kyal provides answers that are knowledgeable, very helpful and professional. Thanks for your valuable reply..
Very very satisfied with doctor Amit Kyal... He is genuinely a good doctor as well as a good human being..
Extremely knowledgeable doctor, takes good care of his patients. Must follow his consultancy.
I found the answers provided by the Dr. Amit Kyal to be very helpful. Thank u soo much sir
Dr. Amit Kyal provides answers that are very helpful. Thank u doctor
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Honest and efficient
Taken preganot kit and still has no bleeding. I took the first mifepristone two days ago and first 2 tablets of misoprostol today 19 hours have gone and still no bleeding took place. What should I do?
I had unprotected sexual activity without insertion on 1st jan. I took ecp after 27 hours. I had bleeding after 17 days. I missed my periods for next two months. I took meprate tablet and got normal flow periods within a week. Mean while I did several home pregnancy test but all were negative. Now after 2 and half months of sexual activity I observe stretch marks. Is there any chance of getting pregnant?
I'm 18 year old. I had sex with my boyfriend without any safety a week ago and I had my last period on 7 th april, 19. So, to avoid pregnancy I used norlut n tablet. Now, i'm bleeding and I thought it's my period but im not discharging any period blood but i'm discharging allot of flesh. Should I consult a doctor now?
Meri pregnancy lagbhag 66 days ka hai ish se jyada ka nahi hoga kya ish time me zydus mifegest ka prayog kar abortion ho sakta hai bahot jaruri hai kripa kar uchit paramarsh de.
Hi my wife is 5 weeks pregnant and she had zempred 8 mg tablet 10 tablets for 5 weeks in his 2nd week of pregnancy. We were not aware of his pregnancy and was suggested this medicine by dermatologist can we continue pregnancy? Or will der by any impact on child during birth.
I am pregnant. Lmp is 16/03/2019. I did home pregnancy test and the results is positive. When should meet doctor? Last time I got ectopic pregnancy. Now I need to know my pregnancy is normal or ectopic? Please suggest me.
I am 11 weeks pregnant and I have a student cough, possible pharyngitis and I was given cefpodoxime proxetil 200 mg for 5days is it safe to have during pregnancy?
I have pcod and Dr. suggest krimson 35 which I have used now they suggest diane 35 m worry about these tablets bcoz it's getting side effects. Me and my hubby are taking precautions to not conceive baby, m want to heal from pcod how I can it? Pls tell me.
A) Hypothyroidism In Pregnancy-
1) primary maternal hypothyroidism is defined as the presence of an elevated TSH concentration during Gestation
2) elevation in serum TSH should be defined using pregnancy specific ranges
3) if the laboratory does not provide population and trimester-specific reference ranges for TSH, an upper reference limit of approximately 4.0 mu/l is used
4) overt hypothyroidism (oh) is defined as an elevated TSH in conjunction with a decreased Free t4
Women with TSH of 10miu/l or above irrespective of their ft4 levels are considered to have oh
5) subclinical hypothyroidism (SCH) is defined as an elevated serum TSH and a normal free t4
6) isolated hypothyroxinemia in pregnancy: Normal maternal TSH conc. In conjunction with ft4 conc. In the lower 5th or 10th percentile of the reference range
B) Causes of hypothyroidism:
1) Hashimoto's thyroiditis (most Common) Thyroid autoantibodies are detected in -
- 50% of pregnant women with SCH
- 80% of pregnant women with oh
2) iodine deficiency
3) cruciferous vegetables (cauliflower, Cabbage, broccoli)
4) deficiency in selenium, iron, Vitamin a
5) prior to radioactive iodine treatment
6) surgical ablation
7) pituitary or hypothalamic disease
C) Complications of hypothyroidism in pregnancy:
1) preeclampsia and gestational hypertension
2) placental abruption
3) nonreassuring fetal heart rate tracing
4) preterm delivery, including very preterm delivery (before 32 weeks)
5) low birth weight
6) increased rate of cesarean section
7) postpartum hemorrhage
8) perinatal morbidity and mortality
9) neuropsychological and cognitive impairment in the child
The risk of complications during pregnancy is lower in women with subclinical rather than overt hypothyroidism
According to American thyroid association (ata, 2017) the risk of pregnancy-specific complications was apparent in TPO positive women with TSH >2.5 mu/l but was not consistently apparent in TPO negative women until TSH values exceeded 4mu/l.
Recommendation ata (2017):
Pregnant women with Tsh > 2.5mu/l should be evaluated for TPOab status
D) treatment considerations:
1) OH should be treated in pregnancy with full dose Replacement of lt4 (ata guidelines)
2) SCH in pregnancy should be Approached as follows:
Lt4 therapy is recommended for:
A) TPOAB positive women with a TSH > Than pregnancy-specific reference range
B) TPOAB negative women with a TSH greater than 10 mu/l
Lt4 therapy may be considered for:
A) TPOAB positive women with TSH > 2.5mu/l and below the upper limit of the pregnancy-specific reference range
B) TPOAB negative women with TSH > Pregnancy-specific reference range and below 10mu/l
E) general dosing consideration
1) TSH >4 mu/l (or above trimester specific upper limit) with low free t4: Full replacement dose is given (approximately 1.6 mcg/kg body weight per day)
2) TSH >4 mu/l, with normal free t4: intermediate dose (approximately 1 mcg/kg per day)
3) TSH 2.6 to 4 mu/l: if a decision has been made to treat, low dose (typically 50 mcg daily)
F) Aim of therapy:
The goal is to maintain TSH in the lower half of the trimester-specific reference range. If not available a goal TSH of <2.5 mu/l is reasonable.