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Endometrial Ablation Procedure
Treatment of Treatment of Breast Cancer
Management of Abortion
Hormonal Replacement Therapy Treatment
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
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Hello Doctor we are planning for our second child but my wife is getting periods in 20 days. Kindly suggest what should we do? My wife is 32 years of age and we do not have any medical history.
I was born a baby in Feb 2015 and my period is starting from this month but not regularly why is it a problem?
Actually sir, my girlfriend monthly periods are not be continues, I means periods are comes irregular intervals in every month some time 35 day / 45 day n some time 25 day. What I do ?
Here are some simple changes that can improve your diet and help relieve constipation:
Add veggies. You don't have to count grams of fiber to get the recommended amount. Instead, aim to eat 2 cups of fruit and 2 ½ cups of vegetables every day. Make sandwiches with roasted veggies, add a salad instead of fries to your meal, buy pre-cut vegetables to snack on with low-fat dip, keep the fruit bowl full for a handy and healthy snack, and add chopped, dried fruit to oatmeal and cereal.
Go for grains. Replace white bread, white rice, and regular pasta with whole-grain bread and whole-wheat pasta and brown rice. Eat more whole oats, multi-grain cereals, and whole-wheat crackers -- just be sure to choose low-fat and low-sugar options. Snack on air-popped popcorn instead of chips. When buying cereal, choose brands that have at least 5 grams of fiber per serving.
Bulk up on beans. Replace meat with a bean or legume dish at least once or twice a week. Add cooked beans to salads, and try bean soups and stews as main course meals.Add fiber gradually. Make changes slowly over the course of a week or so -- increasing fiber too quickly can cause bloating and gas. Be patient -- it may take time for your body to adjust.
Consider a fiber supplement. If you have trouble getting enough fiber in your diet, consider a fiber supplement such as Citrucel, FiberCon, and Metamucil. Also called bulk-forming laxatives, fiber supplements are generally safe and non-habit forming. Just be sure to talk with your doctor before using them as they can interfere with some medications.
Stay hydrated. If you add more fiber to your diet either with food or supplements, be sure to drink more fluids to aid digestion. Aim for about 8 glasses a day. Choose low or no-calorie beverages -- drinking sugary soda and fruit drinks will add extra calories you don't need.
In vitro fertilisation, commonly known as IVF, is the process of fertilising single or multiple eggs outside the body. This treatment can be performed by either using your own egg and sperm or using donated egg or sperm or sometimes both. The resulting sperms and eggs are evaluated for quality and then one or more of them are positioned properly in the uterus through the cervix. IVF is regarded as one of the most commonly opted treatment plans, and it accounts for more than 99% of assisted reproductive technology processes.
Who are suitable for IVF?
IVF can be helpful for you in case you have some issues with the egg quality or ovulation, fallopian tubes that are blocked in some way or endometriosis. It can also help you get pregnant if your partner has problems with mortality and reduced sperm count and when you have opted for donor eggs. About 1.5% of babies in the United States are conceived through the IVF process.
How does IVF work?
There are several steps through which IVF process works and the timeline follows the following steps:
- Stimulation for ovary: You will have to take a special kind of fertility drug for 8 to 14 days near the start of your menstruation cycle. This drug aids in the stimulation of your ovaries for developing multiple mature eggs to fertilise instead of a single one. You may also need to take an artificial hormone-like cetrofelix and leuprolide for keeping your body from releasing eggs very early.
- Development of follicle: When you are under all these medications, you will have to visit your doctor’s office often for checking the hormone levels as well as ultrasound measurements for the ovaries.
- Getting the trigger shot: Once the follicles are ready, you are likely to receive a trigger shot, which is an injection causing the eggs for maturing fully and becoming capable of being fertilised. Your eggs are ready for being retrieved after about 36 hours of receiving this shot.
- Gathering the eggs: At this stage, you are likely to receive an aesthetic or ultrasound probe that is inserted through the vagina for checking the ovaries and identifying the follicles. Normally, about 8 to 15 eggs are retrieved through the insertion of a thin needle.
- Fertlisation: This is the most vital step, where an embryologist is going to examine the eggs before they are combined with the sperm and incubated overnight. Fertilisation happens at this particular time, but abnormal eggs are not fertilised.
Then the embryos slowly develop and are planted on the basis of your age and clinical condition. When the treatment is working, an embryo is implanted in the uterine walls and starts developing.
I had a anal sex with someone it results in little bleeding but that person is healthy .i was asking that is there any matter to worry .it happened 6 month earlier.
Hi, My fuency & I tried having sex many a times but I never able to penetrate. She is a virgin, whenever I try to my penis in her vagina she suffer a lot of pain & she start moving her legs & hands in pain here & there & I never able to penetrate. I even placed two of fingers in in but she suffers lot of pain & I have to take them out. She cant handle pain in that area. So everytime I only do orgasm to satisy her. I feel she is really phobic about penetration, she fear that pain. I tried Lox 2 % , lubic but that also not helped, she had pain which she cant resist. Then we even tried while we are drunk but then also she had pain. I am really depressed as I tried everything & nothing is working out. Please guide us so that we can have normal sex life like others.
I want to reduce my weight. I have taken treatment for pcod and taking tablet for thyriod. Also I have irregular period.
Female partner ko excited kaise kiya jaye. Body, boobs, lip kissing and vagina ko touch krne se bhi jayda excited ni ho pata. Aur excited krne ke liye kya kiya ja sake pls kuch idea dijiye eske bare me.
I had a sex with a prostitute in 01st june 2015 without condom after that I feared that she might have hiv then I got tested on june then july then in september and again in february 2016 all tests results were non reactive do I have to retest again to get it confirmed? Please help me.
I had sex with my wife and she is conceived now. But I do not want her to carry the baby so is it possible to place the baby in another womens womb. (she has conceived for 12 - 14 days)Please tell.
Doctor I just came to know that I am pregnant and today completed 5th weeks as my last period date was 18 aug, I was suffering from mid cycle spotting since 1 year continuously and even this month also so doctor gave me progesterone sustained release 200 mg to take after dinner and since 3 days I am feeling period like cramping in my lower abdominal region and lower back also, special when I am standing and walking, I am worried, please tell if it is ok to have these cramps, apart from this I don't have any other problem.
In 5 Years, Threat Of Drug-Resistant Superbugs Doubles
A 72-year-old woman in Bengaluru consulted a hospital physician about a severe skin infection and fever. She had previously consulted a couple of general practitioners, who prescribed a course of penicillin for three days and fluoroquinolones—both antibiotics—for two days.
There was no relief.
So, the consultant ordered a culture sensitivity test of pus from the skin lesions to identify what was causing her ailment and figure out what antibiotics it would respond to.
Here’s what the report said:
Pathogen: Klebsiella pneumoniae
Susceptible to: No antibiotic
Resistant to: All antibiotics, including advanced drugs like fluoroquinolones, carbapenems and even the last resort combination usually reserved for severe cases of ICU infection, colistin-tigecycline.
With nothing to offer the patient, save a prescription for paracetamol to keep her fever in check, the doctor sent the patient home, and asked her to return after a week.
In such cases, sometimes, the body’s immunity kicks in and throws off the infection, the physician, Sheela Chakravarthy, consultant (internal medicine) at Fortis Hospital, Bengaluru, told IndiaSpend.
Sometimes, resistance to one or more drugs abates, allowing treatment to be resumed. Chances of that happening are greater at home, not in the hospital, which is a more infectious space where sepsis—a disproportionate and potentially life-threatening immune response by your body to an infection—could set in, she explained.
Most patients, however, succumb to the infection.
Chakravarthy faces situations where she has nothing to offer patients, not because they are suffering from terminal illnesses, such as some forms of cancer, but even when they present with what should be curable infections, “almost every day”, she said.
What Chakravarthy described is the consequence of rampant, inappropriate consumption of antibiotics, spurring the development of superbugs, as the recently released State of the World’s Antibiotics Report 2015 affirms.
India is fast becoming home to superbugs
Escherichia coli, Klebsiella pneumoniae and Staphylococcus aureus are three of the deadliest pathogens facing humanity, according to the World Health Organisation (WHO). And India is gradually but increasingly becoming home to multi-drug resistant strains of these pathogens, according to the State of the World’s Antibiotics Report 2015.
Escherichia coli is notorious for causing food poisoning and urinary tract infections.
In 2010, 5% of Escherichia coli samples in India were resistant to carbapenems, last-resort antibiotics for bacteria that are resistant to first-, second- and third-line drugs. By 2014, 12% of E. coli samples were similarly resistant.
Klebsiella pneumoniae causes pneumonia, septicaemia and infections in the urinary tract, lower biliary tract and at surgical wound sites, to name a few.
While 29% of Klebsiella pneumonia isolates were resistant to carbapenems in 2008, this increased to 57% in 2014.
For comparison, fewer than 10% of Klebsiella pneumoniae infections in Europe are carbapenem-resistant.
Staphylococcus aureus can cause skin and soft tissue infections, bloodstream infections, pneumonia and surgical site infections. A particularly nasty strain of, methicillin-resistant Staphylococcus aureus (MRSA), is common in India and increasingly hard to treat.
MRSA was responsible for 40% of post-surgical site infections, according to a 2013 study by the Jawaharlal Nehru Medical College and Hospital, Aligarh.
Between 2009 and 2014, the incidence of MRSA in India has risen from 29% to 47%.
People with MRSA are 64% more likely to die than people with a non-resistant form of the infection, according to the WHO.
How ignorance is spurring the development of superbugs
“My understanding of antibiotic is that it stops bacteria growing in body…I think amoxicillin is for throat infection.”
–An urban participant of a study of perceptions about antibiotic use and resistance among urban and rural doctors, pharmacists and public in Vellore.
Mox, short for amoxicillin, has become a household word across India.
A little knowledge, however, is a dangerous thing. It encourages self-medication, even when medicine is unnecessary, such as when people suffer viral infections—against which drugs are ineffective. Most viral fevers dissipate on their own after a few days with rest, hot fluids and a check on the fever.
Consuming too many antibiotics contributes to pathogen drug resistance.
“Resistance is an outcome of accumulated use,” said Ramanan Laxminarayan, vice president, Research and Policy, Public Health Foundation of India, and director and senior fellow, Centre for Disease Dynamics, Economics & Policy, US, and co-author of the State of the World’s Antibiotic Report 2015.
Indians often rely on corner pharmacists, whose knowledge of dosages may be limited.
Here’s what a rural pharmacist participant of the aforementioned Vellore study said: “Amoxicillin, 6 tablets is to be taken [for full course].”
Amoxicillin’s full course depends on the kind and severity of bacterial infection.
When an antibiotic of lower strength or fewer pills than needed is prescribed, the body cannot fully eradicate the pathogen. Sensing it has come under attack, the bacterium responds by evolving into more resilient, antibiotic-resistant strains.
But with a course of antibiotics, say generic Amoxicillin, costing about Rs 160, close to a day’s wage in many states, and a doctor’s consultation costing anywhere between Rs 100 and Rs 1,000, more than a day’s wage in most places, patients are bound to cut corners.
Another Vellore study participant summed up the situation thus: “If I have money I go to hospital. If not, I get medicine from pharmacy shop. If I get better, I stop and keep for future use.”
Stopping a course of drugs mid-way also contributes to antibiotic microbial resistance.
In a 2015 study in Chennai, 70% respondents confessed to stopping the medication when they felt better. Only 57% completed the antibiotic course.
“Less is more”: the key to preserving antibiotic efficiency
Educate health professionals, policy makers and the public on sustainable antibiotic use, says the State of the World’s Antibiotics Report 2015.
That is sensible advice.
Denmark and Sweden boast of low rates of antibiotic use and near-zero rates of antibiotic resistance because the risks of antibiotic overuse are widely known.
Instituting regulations on antibiotic use has reduced the proportion of MRSA in Europe and the US by about a fifth over the last eight years.
India requires more stringent regulations for antibiotic use.
It isn’t enough to tell physicians that they should prescribe antibiotics only when essential to cure bacterial infections. The right way is to order a culture sensitivity test, which costs money, and the patience to wait for the result.
“Patients want instant and cheap relief, and are willing to shop around for a doctor who obliges,” said Dr Himanshu Shekhar, medical director, SCI International Hospital, New Delhi.
“Some judge doctors on how fast the prescribed medicine cures. Practice pressures lead many doctors to prescribe advanced drugs, without getting a culture-sensitivity test done.”
So, it’s also not enough to have 24 advanced antibiotics, including third- and fourth-generation cephalosporins, carbapenems, and newer fluoroquinolones, under the ambit of Schedule H1 of the Drugs & Cosmetic Rules, 1945, with effect from March 1, 2014.
That means these drugs cannot be sold over-the-counter, but they are still freely prescribed.
Chakravarthy’s suggestion: “Make Schedule H antibiotics available only through hospitals and health centres.”
“Changing antibiotic usage behaviours is critical to preserve the efficacy of existing and new drugs,” proposed Laxminarayan.
India also sorely needs regulations to check antibiotic use in animals raised for human consumption, to meet the State of the World’s Antibiotic Report 2015 recommendation to reduce and eventually phase out sub-therapeutic antibiotic use in agriculture.
Sub-therapeutic use implies mixing antibiotics in animal feed to make them grow faster and to prevent infections from devastating the herd or flock.
India is among the world’s five biggest consumers of antibiotics for livestock. IndiaSpend has earlier reported increasing evidence of antibiotic-resistant bacteria in animals in India, and how this impacts humans.
“Using antibiotics to make animals fatter faster is a waste of a precious resource,” said Laxminarayan.
How surgeons contribute to antibiotic resistance
Surgical antibiotic prophylaxis refers to the prescribing of antibiotics before, during and after operations to prevent infection.
Between 19% and 86% of patients in hospitals in India receive “inappropriate antibiotic prophylaxis”, according to the State of the World’s Antibiotics Report 2015. A prophylactic is preventive treatment for a disease.
Ideally, antibiotic prophylaxis should be administered as a single dose within 60 minutes of the skin incision. However, a 2013 Mangalore-based study found timing adhered to in 22% of cases in a government hospital, 64.9% cases in a medical-college teaching hospital and 80.7% of patients in a tertiary care corporate hospital.
“Smart antibiotic prophylaxis also includes choosing narrow-spectrum antibiotics to target the organism most likely to present concerns based on the kind of surgery being performed, this avoids needless exposure to antibiotics for the other microbes and helps prevent resistance,” said Vimesh Mistry, assistant professor, Pharmacology, Baroda Medical College.
Staphylococcus aureus, which lives on the skin, is most likely to cause infection during surgery. But surgeons frequently make poor antibiotic choices.
“We found appropriateness of choice of antibiotic in 68% cases and 52% compliance with the in-house prophylaxis guidelines,” said Tanu Singhal, infectious diseases specialist, Mumbai, and co-author of another study on antibiotic prophylaxis conducted in PD Hinduja Hospital, Mumbai.
Other prophylaxis inaccuracies include the unnecessary prescribing of antibiotics, inaccurate dose and inaccurate duration of prescription.
“We logged 63% accuracy in prescription duration. Surgeons tend to prescribe antibiotics for too long fearing post-surgery infection,” said Singhal.
In the trade off between protecting the patient better and increasing the risk to society of a pathogen developing resistance, surgeons are choosing the former.
Needed: A back-to-the-basics approach to health
Reducing the need for antibiotics through improved water, sanitation and immunisation is another strategy recommended in the State of the World’s Antibiotics Report 2015.
“Vaccination against pathogens such as the diarrhoea-causing rotavirus and pneumonia-causing Klebsiella pneumoniae helps curtail antibiotic demand, thereby reducing the chances of resistant strains developing,” said Laxminarayan.
In Canada, the widespread use of pneumococcal conjugate vaccines for pneumonia in children has reduced the incidence of pneumonia caused by strains the vaccine covers.
However, just as antibiotic usage spurs the development of superbugs, vaccination is a double-edged sword.
Canada is seeing a rapid increase in the incidence of other strains of pneumonia not protected against by the vaccine.
So, it is better to focus on the basic constituents of health.
Making available clean drinking water and improving sanitation would prevent people from getting sick in the first place. India still has a lot to do on both these fronts.
Improving individual immunity is the best bet to ward off infections, and that is also achievable by healthier eating, exercising, healthier living and the better management of chronic conditions like diabetes and asthma that increase vulnerability to infections when they are not kept in check.
Dr Himanshu Shekhar
( Above Article , with My Inputs was published in a leading Health Magazine)
I am six months pregnant my scan is good not having low lying placenta can I continue to my office and I have to climb steps for my office.
What is erythroblastosis fetalis?
Erythroblastosis fetalis is also known as haemolytic anaemia in the newborn. This occurs due to blood incompatibility in the mother and foetus. Due to this incompatibility, the antibodies present in the mother’s blood, will pass through the placental barrier and attack the blood cells of the foetus. This will lead to the destruction of the red blood cells of the foetus and it is likely to cause anaemia in the foetus. This condition varies from mild to very serious. In its moderate or severe stage, the erythroblasts or immature red blood cells are formed in the blood of the foetus and this disease is called erythroblastosis fetalis.
Why does it happen?
The two main causes of erythroblastosis fetalis are Rh incompatibility and ABO incompatibility.
- Rh Incompatibility: When the mother is Rh –ve and the father is Rh +ve, there is a good chance for the baby to be Rh +ve. The antigens present in the blood of the Rh +ve baby will behave like a foreign agent and the mother will produce antibodies against it. If it is the first pregnancy, then the child may not be at risk, however, if the second child ends up being of +ve blood group again, then the antibodies present in the mother’s blood will attack the baby and may result in a spontaneous abortion.
- ABO Incompatibility: This usually occurs when the mother’s blood group A, B, O does not match the baby’s. This causes fewer complications in comparison to Rh incompatibility, but it may be severe if the child has a very rare blood group.
How to avoid it?
It is a highly preventive condition. Firstly, you have not tested your blood group; it is advised to get it tested along with the blood group of the father. If you already know your blood group, then you must mention it to your doctor. If the father has negative blood group, then there will be no problem. However if the father is Rh positive, then it is advised to get routine tests done by the doctor.
The other preventive measure to take is a treatment called RhoGAM or the Rh immunoglobulin. It reduces the reaction of the mother to the baby’s blood cells. This shot is administered around the 28th week of the pregnancy. It is also administered 72 hours after the birth of the baby with the positive blood group. If you wish to discuss about any specific problem, you can consult a pediatrician.