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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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Gave birth to 4 through caesarean section. 29 years old. I am diagnosed with hydronephrosis. But under control. Have cramps on my leg. I feel dizzy at times and sometimes vomit. Have severe headache. I always feel drowsy. Weight 37 kgs. Please help. Bp around 100/70 - 80/60.
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Hello doctor, please help me. I had protected sex till now but I'm still scared about being pregnant. I had 2 days period and few hormonal changes during that like breast soreness and I even got a pus discharge from one of my nipple but after putting band aid it is all fine now. I had my period 7 days back and my tummy came out it isn't going inside. I'm so scared he never ejaculated inside my vagina even though he wore a condom. But still I'm worried. Please help me I'm so scared.
How to ensure a normal period when you're suffering from PCOS?
Polycystic ovary syndrome (PCOS) is a hormonal disorder affecting 12-18% of women of reproductive age. PCOS is a condition where at least two of the following conditions occur:
1. Appearance of acne, excessive hair on your body
2. Irregular delayed periods
3. The presence of 10 to 12 small cysts in the ovaries.
You do not ovulate each month, and some women do not ovulate at all if they are suffering from PCOS. This is because although the ovaries of women, suffering from PCOS, usually have many follicles, they do not develop fully and so ovulation often does not occur. If you do not ovulate, you may not have periods.
So what can you do to have normal periods?
Although some women with PCOS have regular periods, high levels of androgen and also the hormone insulin, can disrupt the monthly cycle of ovulation and menstruation. If you have PCOS, your periods may be irregular or may stop altogether. The average menstrual cycle is 28 days with one ovulation, but anywhere between 21 and 35 days is considered normal, and for a woman suffering from PCOS, this cycle can take as much as 3 months to complete.
To ensure a normal period during PCOS, your doctor can prescribe hormonal contraception. The medication can also reduce menstrual cramps, acne, and excess hair growth. The estrogen and progesterone in hormonal contraception act to override the body's normal hormonal control of menstrual cycle and ovulation. Production of hormones such as testosterone is greatly reduced by the oral contraceptive pill. Some oral contraceptive pills not only aim to block the effects of testosterone but also increase insulin resistance.
By allowing the regular shedding of the uterus lining during menstruation, the pill can reduce the risk of developing endometrial cancer while ensuring you get normal periods.
Note: it is important that you closely watch your weight. Lifestyle changes and weight reduction help a lot when you are suffering from PCOS.
Related Tip: How Not to Miss Your Workout During Your PERIOD
Here are some tips on pregnancy after recurrent abortions
Most women follow some kind of routine to keep their private parts healthy. Often, some habits have a bearing on sex life and possible future risk of diseases like cancer - Avoid Douching the vagina - Douching and deep cleaning the vagina by pushing in cleansing liquids or using tissues to wipe the vagina from deep within is no longer considered healthy. It may be harmful and cause internal injuries and burns. Many decades back women used to douche using natural ingredients like yogurt for yeast infection but better treatment is now available and one should seek proper medical advice in case of any trouble
I am 19 years old female. I am very slim and periods are lighter? What should I do? In the beginning having heavy period but now I am getting slim also due to tb.
Maine 3 march ko dimpa enjection liya tha uske baad mujhe 3 month menses m bhut km bleeding hui. Then 15 june ko maibe i-pills li uske baad mujhe 23 june ko heavy periods hua pure 5 days then uske baad fr 1july ko thodi bleeding hui then 10 july se fr period s start ho gye .aisa q ho rha h .ya fr pills ki wajh se .
Hi doctor I am a 47 year old healthy female . And while I enjoy sex totally I have never been able to orgasm .
I am 58 years old but I am energetic as 40 yrs. My girlfriend is 28 yrs. Old and I have sex with him. Have any chance of pregnancy?
My wife is pregnant in 6 to 7 week about but ultrasound report is not show heart beat in baby now so doctor given some medicine so I want know what any chance then some day after so this is normal and show heart beat please help.
Mujhe kaise pata chalega ke meri wife pregnant ho rahe hai. Uski date is mahine 4 din aage ja chuke hai.
I am 34 years female trying to conceive. Last month I had symptoms during ovulation but after 3days bleeding near my menstrual cycles no symptoms. Could I be pregnant because bleeding was little lighter than my regular 28days cycles?
On the other hand, you can have a kidney infection when the bladder infection has not been treated and has spread to the kidneys. Symptoms of a kidney infection include acute pain in the lower back, fever and vomiting.
It is best not to delay treatment if you suspect you have a UTI. Those with a weak immune system, diabetes or bad kidneys should immediately see a doctor. Pregnant women are also susceptible to UTIs. There are times when a UTI can give no symptom or warning. It is only a urine test that can disclose if a person has a UTI.
Once the infection spreads to the kidneys, treatment should be undertaken on an urgent basis because the damage to the kidneys can be permanent. When bacteria enters the urinary system, UTIs occur. The bacteria travels to the urethra and the bladder, where it causes an infection. This ailment is more common among women who are sexually active. Other things which can increase your risk of getting a UTI are dehydration, not peeing when you want to and having kidney stones
A urine test will determine if you have a UTI. Once confirmed, your doctor will put you on medication, which is excellent at treating UTIs. One has to drink copious amounts of water and make frequent trips to the loo, which helps flush out the bacteria.
Effective ways to prevent UTIs include drinking a lot of water, going to the bathroom before as well as after sex and wiping the genital area properly — from front to back.
If a woman is two months pregnant, then what should she not eat and how can she take care of her pregnancy and what should she do for her health?
Pregnancy test machine me kya indicate hone k baad pata chal jata hai lady pregnent hai. Please advise.
Both my daughter in laws didn't conceive so far. First married 7 years back and second three years back. First is in oversaes and the second is with us in chennai. Her tsh level is 0.08 and she had been put on eltroxin 125 mg. Tabs. By her gynaec. Chances of our getting a grand child!
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)
Mirena is a contraception that can be inserted into the uterus for long term use. This insertion is done with a proper clinical procedure. The Mirena is a device that may be classified as a hormonal Intrauterine device (IUD). This device releases a kind of progestin, which prevents the sperm from travelling to the egg to fertilise it. This hormone basically makes the cervical mucus thick and makes the uterine lining thin, so that ovulation gets suppressed.
Let us get to know more about the procedure and the results of Mirena Insertion.
Reasons: There are a variety of reasons why women use this kind of long term contraception. After insertion, one does not need to have any interruptions in the act of sex in order to look for and use contraception. It also reduces the risk of developing pelvic inflammatory disease. This kind of disease is usually caused by STDs or sexually transmitted diseases. This kind of device can also help in bringing down the pain experienced during menstrual cycles. It also reduces the risk of falling prey to endometrial cancer as well as cervical cancer.
Eligibility: You are not an eligible candidate for this kind of procedure if you have suffered from breast cancer, cervical cancer or liver disease. Also, if you suffer from diabetes or other cardiovascular diseases, then it is not safe to go through this procedure.
Procedure: The procedure will be carried out at the doctor’s clinic. The gynaecologist will insert a speculum into your vagina. Then, the doctor will continue to clean the area including the cervix with the help of an antiseptic solution. Thereafter, a special instrument will be used in order to align the uterine cavity with the cervical canal. During this process, the doctor will also measure the depth of the patient’s uterine cavity. The device will then be folded and placed within an applicator tube, which will be inserted into the cervical canal. Then, the applicator tube will be removed. After this, the device will remain in place.
Result: Once the device has been inserted, it will be effective for a period of at least five years. Every month, you will need to get the strings of the device checked so that they are not protruding from the cervix. You may experience side effects like pain during sex as well as others like headaches and persistent migraines. These must be reported to the doctor so that the doctor may deal with any complications.
Removal: If there are any kinds of complications and risks that may develop after the procedure, the doctor can remove this device. This can be done with the help of forceps. The device can also be removed and replaced after five years.