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Management of Abortion
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Treatment Of Female Sexual Problems
Termination Of Pregnancy Procedure
Treatment Of Pregnancy Problems
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Treatment Of Female Sexual Problems
Treatment Of Medical Diseases In Pregnancy
Treatment Of Menstrual Problems
Intra-Uterine Insemination (IUI) Treatment
Medical Termination Of Pregnancy (Mtp) Procedure
Gynecology Laparoscopy Procedures
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Hello, I have an ovarian cyst, I am under treatment. Doctor said, it will dissolve in 3 months. Once ny cyst is dissolved, is there any possibility to get it in near future? If yes, what should be done to not get the cyst again?
My mother has undergone removal of ovaries due to fibroids formation recently a year ago. And she's having severe chronic pain in the lower back bone. She couldn't sit straight. Please help doctor.
Hi, I'm trying to conceive for 7 months, every month my period cycle in between 26-29, today 32 day to me, discharge was started with some itching and stomach pain, and this time journey was good for me or bad, and am I pregnant or hormonal imbalance please suggest me.
My wife is 7 weeks pregnant. We have done all blood test. TSH value is :- 3.5.Dr. Has told that it is slightly high. It should be below 2.5.But in thyroid report it shows normal range is around 4.5 - 5. Another Dr. Whom we prescribed this blood reports did not prescribed" thyroxine". But the Dr. Whom we are consulted for pregnancy has prescribed" thyroxine"daily in morning empty stomach. Kindly tell me what would be normal range for TSH for my wife who is pregnant? My wife do not have any thyroid issue before pregnancy. Her value before pregnancy was TSH :- 1. 7.Is this medicine normal for our baby? Thanks in advance for answer. Please guide properly. Why every Dr. Have different point of view?
I am joita, 22 years old. Unmarried. Few days back After my period stopped we had intercourse (unprotected) within 3 days of period stopped. And then that night I took ipill as the sex was not planned. And after 4 days again my period happened (gap between periods are maximum of 7 days). And yesterday it stopped. But today I found brownish blood traces. Is everything alright? Please help as soon as possible.
HI I am 25 yrs, old, I got married and I had 3 children, I got operation with vasectomy (not to have children) in the month june last year, after that operation there was a problem started, for me there is a lot of white discharge from that time after I got operation there was a white discharge, and in the menses time the discharge is more and when compared to other than menses, if I take long gap for having urine the clothes are getting wet. And the severity of this problem is more from last 2 months please suggest.
She has ovarian cyst of 5 mm. Is there a problem in conceiving as she has no baby yet. Any cure? Side effect of surgery.
I am 24 year old women I got pregnant can I calculate my intercourse date please tell me the procedure.
I have got small rashes in and outside of my vagina. It burns while urinating and on touching please help me sir and suggest me some good ointment or medicine. Thank you.
What are the best possible things which can be done to have normal delivery instead of cesarean.(i mean to say any exercises, food to have and avoid etc)
I missed my periods I have a 6 months old baby I have done home test for pregnancy It was negative Still not getting my periods Why.?
My periods delayed for a month & now it cmg drop by drop from 2 days? Like today a drop & tomo again a drop?
Dear sir ,me and my girl met physically on 2nd of this month, her period time is 15th of this month, but till today period not came, so yesterday and today morning 2 times she checked pregnancy with home test kit, it showed negative 2 times, no early symptoms are appearing, and 1st time in her life 8 days delayed period, so please suggest us sir, and is there any chances for pregnancy.
Impact of sexually transmitted infections on women health:
Stis are sexually transmitted infections that are globally becoming more common. Every year millions of stis are passed from person to person primarily through sexual contact. This is undoubtedly because more and more people are having sex, often with different partners, and aren't taking the necessary precautions to prevent the spread of sexually transmitted infections.
There are so many different types of diseases that can be spread by touching, oral sex, penetrative sex, sharing needles or even through child birth, so you need to be so careful when having sex that you avoid ever contracting this type of disease. Most stis are curable with medication; however some, like hiv, can never be cured. Additionally, not all stis carry noticeable symptoms so you could have a sexually transmitted infection and not even know you've got it. This is why it's so crucial to get yourself checked out at a sexual health clinic if you are sexually active, to make sure that you don't have any nasty infections.
The organisms that cause the diseases usually enter the body through open membranes, such as the vagina, anus or mouth. Stis can be caught through intimate contact with someone, especially through anal, vaginal or oral sex, however some are also transmitted without sexual activity.
Chlamydia: an extremely common and fast spreading sexually transmitted infection. Unfortunately, many people (especially females) have no symptoms at all, so it's often difficult to detect. Men often experience more symptoms than women, however this is not always the case. Chlamydia is particularly dangerous if left untreated as it can cause infertility in women, so it's so important to get yourself checked even if you haven't experience any symptoms.
Gonorrhoea: gonorrhoea is caused by a bacterium that grows and multiplies very quickly in moist areas of the body such as the cervix, urethra, mouth or rectum. For women, the cervix is the most common site of infection. The disease can also spread to the fallopian tubes in a woman and other genital organs, which can cause conditions such as pelvic inflammatory disease that may also lead to infertility. It is most commonly spread through genital contact, however it can also be passed through oral sex and if a mother is infected she can easily pass it to her new-born infant during delivery.
Genital herpes: genital herpes is a highly contagious condition caused by the herpes virus. It infects the skin and membranes around the genitals, but it can also appear around the mouth, especially on the lips. It is transmitted generally through physical or sexual contact. Often you can have the virus, but not show symptoms. Symptoms usually include spots around your genitals or mouth.
Hiv and aids: aids is a potentially lethal disease that is caused by the hiv virus. Hiv invades and destroys the immune system, which protects the body from infection. This means that a person who carries the hiv virus is easily prone to catch many different illnesses, and may die from diseases that are harmless to healthy people, such as a cold or a cough. Hiv can be transmitted not only through sexual activity, but also by sharing needles or having blood contact with someone who has the disease.
Genital warts- warts are caused by the hpv virus, and are often not detected straight after you have transmitted the disease. Many months can pass from the time of infection to the actual development of warts, so it may be very difficult to determine whom you got them from. They can easily be treated by cream from the doctor.
Syphilis: if left untreated, syphilis is a dangerous and life-threatening disease. It is passed on through intercourse and almost all other forms of sexual interaction, including anal sex. The first symptom often appears between 9-90 days after exposure to the germ that causes it, and a small lump develops at the site of infection that soon breaks down to form an ulcer; usually painless. There is a secondary stage (characterised by fever, rashes and throat ulcers) and a tertiary stage, in which the germ may attack the brain and other organs and may cause death.
In order to avoid catching a sexually transmitted disease, there are a few things to bear in mind:
The fewer sexual partners you have, the lower your risk of infection;
Most sexually transmitted diseases can be avoided by practicing safe sex (using condoms);
You should avoid from having casual sex, as this increases your risk of coming into contact with an sti;
Both you and your partner should always get tested at a sexual health clinic before engaging in condom-free sex (using the pill is only a preventative against pregnancies); there is nothing wrong with getting tested at a sexual health clinic, as it's always better to be safe than sorry.
- There are two level of your mind: conscious or subconscious.
- You think with your conscious mind & whatever you habitually think sinks down into your subconscious mind, which create according to the nature of your thoughts.
- Subsconscious mind is the seat of your emotions & is the creative mind. If you think good, good will follow; if you think evil, evil will follow. This is the way your mind works.
- Your subconscious mind accepts what is impressed upon it or what you consciously believe. It does not reason things out like your conscious mind,& it does not argue with you controversially.
- Your subconscious mind is like a soil, which accepts any kind of seed, good or bad.
Your thoughts are active and might be likened unto seeds. Negative, destructive
thoughts continue to work negatively in your subconscious mind, and in due time will come forth into outer experience which corresponds with them.
- Subsconsious mind does not engage in proving whether your thoughts are good or bad, true or false, but it responds according to the nature of your thoughts or suggestions. Example if you consciously assume something as true, even though it may be false, your subsconscious mind will accepts it as true and proceed to bring about results, which must necessarily follow, because you consciously assumed it to be true.
- The law of your mind is this: you will get a reaction or response from your subsconscious mind according to the nature of the thought you hold your conscious mind.
My cycle due is 28 days very regular last month this is late by 5 days i. E. My date is 25.4. 2015 but period came by 1.5. 2015 this month my period came 25.5. 2015 why it is changed like this and tell me best days to participate sex for conceive.
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)