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Treatment of Child and Adolescent Problems
Thyroid Problems Treatment
Thyroid Disorder Treatment
Paediatric Critical Care
Treatment of Childhood Infections
Child Nutrition Management
Growth And Development Including General Paediatri
Management of New Born Care
Preimplantation Genetic Diagnosis (Pgd)
Congenital Ear Problem Treatment
Treatment of Polycystic Ovary Syndrome In Adolesce
Treatment of Thyroid Disease in Children
Cleft Lip Treatment
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Hello everybody. I'm Dr Pulkit Nandwani. I'm a consultant gynaecologist and laparoscopic surgeon here at Saroj Medical Institute Rohini. Today, I would like to share some information with you about fibroids.
Fibroids are becoming increasingly common these days. They usually occur in the age group of 30 to 40 years of women but can occur at any age group usually at the age group of 30 to 40years.
Now what are fibroids?
Fibroids are usually noncancerous just an overgrowth of the muscle tissue of the uterus. Fibroids are also called myomas or leiomyomas. Now these fibroids can be located anywhere in the uterus. They can be either in the muscle tissue of the uterus or even in the ovaries or from a stem hanging inside the uterus or out of the wall of the uterus by hanging by a stem. The size and location number of fibroids vary a lot and according to them the symptoms depend.
Now what are the symptoms of fibroids?
The symptoms of fibroids depend on where the situation where the fibroid is located, how big it is and how many numbers of fibroids are located. The symptoms can be they usually cause the change in menstruation. The patient usually experiences heavy bleeding with painful cramping and now instead of monthly bleeds. The bleed may come at irregular intervals and at least twice or thrice in a month. There can be pain during bleeding. Other than the painful bleeding, the fibroid can also result in various symptoms. Because of the size and the weight of the fibroid, it might press on the urinary bladder and the patient might experience frequency of urination even pain during urination. Same if it's at the back of the uterus, it might press on the anus and cause painful deification obtained while passing motions. Because of the heavy bleeding patient might land up with low hemoglobin and having anemia and generalized symptoms of anemia like the fatigue, the weakness, loss of strength, loss of stamina, all these are the symptoms of fibroids. Just a pain in the lower abdomen can also be the manifestation of fibroid.
Fibroid can also cause infertility. Patient might find difficulty in conceiving or there are chances if the patient conceives if the fibroid is located inside the lining of the uterus it might cause increased chances of miscarriages. There might be abortions then but the good thing is that fibroids rarely cause cancer. It might twist on itself, cause severe pain and but it rarely causes cancer and grows over a period of time. It slowly grows over a period of time, sudden growth is a matter of danger sign.
Now, what are the treatments available for fibroid?
Fibroid if it is asymptomatic the patient is comfortable it was just the routine diagnosis, need not require any treatment at all but usually fibroids cause bleeding problems. So the most common treatment that we employ is starting the patient on medical treatment, a number of hormonal pills come which regulate the hormones inside the body of the uterus and limits the blood flow of the patient and the patient remains comfortable. If medical treatment is either not successful or by the location of the fibroid we already know that medical treatment will not work as in case if the fibroid is coming inside the lining of the uterus. In those cases the fibroid has to be removed surgically for the fibroid is usually done. If it is coming inside the lining of the uterus even if it is very small or a big fibroid is obstructing, the uterus lining causing pressure symptoms. In that case surgery has to be done. Now for surgery also there are two to three types of surgery which can be done.
- If so patient is young, she has to conceive again and family is not completed, we try to remove only the fibroid. It is known as myomectomy.
- If the patient is elderly age family is completed, it caues a lot of problproblemshere are multiple fibroids, in that case, the modality of treatment is a one-stop treatment in which we prefer to remove the whole uterus in which case it is known as hysterectomy.
- Regularly total laparoscopic hysterectomy fully by laparoscopy is done routinely at the hospital at Saroj Medical Institute for fibroids.
So this is much for fibroid for today. If you have any query you can contact me at lybrate. I am Dr. Pulkit Nandwani or you can even take a consultation appointment at Saroj Medical Institute Rohini, Delhi.
Since last 15 days my 9 month old daughter was not able to digest anything. Whatever she is eating that is coming with mucus. Doctor told it is stomach infection. But now mucus is not coming but for the last 2 days one drop of blood is coming with stool. Kindly advice.
My son is 1.5 year old, sometime he is suffering from tight potty even though we give him lots of water of to drink. But still sometime he faced the problem and had problem while doing potty. Can you please suggest me some medicine to cure from root.
My 3 years old child is sick with a temperature of 100 degrees she can not keep anything down including liquids. What should I do?
Symptoms and Treatment for Attention Deficit Hyperactivity Disorder (ADHD)
I’m Dr. Prashant Shah, a psychiatrist from Ghatkopar, Mumbai. Today I am going to speak about Attention Deficit Hyperactivity Disorder also known as ADHD. ADHD as the name suggests the full form is Attention Deficit Hyperactivity Disorder. This is a common disorder seen in children and adolescence and at times may extend also into adult life. The common features of this problem are diminished attention, hyperactivity, and impulsivity. As I said earlier, it is most commonly seen in children and adolescents, the usual complaints will be from the parents and teachers. The parents and teachers will complain that these children have difficulty sustaining attention, they are hyperactive and they are impulsive in their day to day activities.
Sustaining attention means that these children cannot sustain or carry out any particular task to the end. They get bored very easily, they will lose interest, they may want to start many activities; they will say that they want to join this activity, they want to do this thing but then halfway down the line they will get bored, and they will stop doing that activity. They would have difficulty in focusing which will result in making careless mistakes in their works, in their calculations, in their day to day works, in their homework. They will be making careless mistakes because they cannot just focus on what they are doing. They get distracted very easily. The teachers will complain that in the school when the teacher is teaching they are looking out of the window or they are speaking with other children. They will drop down their pencil, eraser, and maybe make mischief with other children. Many times there are younger children; they are always on the go. They cannot sit in one place. They are not in their seat; they are roaming around in the class; they talk excessively; they will blurt out answers; they are forgetful; they will not mention about homework or assignment which has been given to them or the project work which has been given. They will inform their parents just at the last minute and then everything will have to be rushed. They will forget or they will misplace their books. Their clothes will be in disarray at home if you visit their room. Everything will be like it is not in its place. They cannot wait for their turn. Now all these are problems which the children-parents pick up.
What is the effect of this on the children? Because of this kind of behavior they are labeled as mischievous. They are the ones who get pointed out whenever something goes wrong in the class. They will be the first ones to be signaled out and given punishment. And at times maybe it is not their fault also but because they show this kind of behavior they are labeled as mischievous and it is they who get the punishment. Everyone ridicules them for this kind of behavior. Even the parents punish them. This will lead to many times frustration, decreased confidence which in turn affects their school performance. Many times this results in deviantju8 behavior. In adolescence if we go on to see this may result in risk-taking behavior, seeking novelties and at times in drug-addiction also.
Now, what can be done about this?
As I said earlier it is a neuro-developmental disorder, we do not know as psychiatry illnesses, we don’t know what the causes are of this illness or why does this illness occur. It may range from genetic to neurological to psychopharmic or neuro-developmental problems in the brain. But what is good is that treatment options are available. So what treatment options are there for ADHD? They are both pharmacological and non-pharmacological treatments available. Usually for children less than five years initially we advise non-pharmacological treatment. This non-pharmacological treatment is occupation therapy and sensory integration where depending upon the severity of the problem, children are called for occupation therapy sessions, parents maybe also given some home programme which they can carry out at home and this results in improvement. The improvement is slow but carried out religiously, diligently by the parents for a period of 1 year to two years this definitely is going to show improvement.
In other children or if the problems are severe enough, we do start medicines. In children parents are hesitant to start medicines and that too from a psychiatrist. But believe me there are good medicines available for ADHD, they do show response, there are no major side effects. The groups of medicines that are available are stimulants or non-stimulants. Stimulants are the first choice of drugs, usually we start with a low dose, so that the child can tolerate the dose, there is no side effect and then we gradually build up the dose so that the improvement is seen. Even if there is some side effect there is minor side effect which can be always taken care of. It is not that there is only one drug available, the child is not responding, we can definitely shift to some other. But the thing to understand is that treatment is required. This ADHD can be controlled and if the signs and symptoms of ADHD are controlled then the child’s performance is definitely going to improve. It will not only reflect in the child’s studies but also overall development of the child. So it is for the parents and teachers working in this field to find out these kinds of children who maybe having this problem and refer them for treatment.
Thank you. For any further enquiries you can always get me to me through Lybrate