Dengue and Chikungunya Awareness- A Must Know In Rainy Season

      Dengue and Chikungunya Awareness- A Must Know In Rainy Season

Precautions and preventions at early step can help us keep our and our near dear’s health intact but it involves not only role of government or health authorities but we also should be aware of the various measures which can be taken .As we are daily seeing in news that there is a drastic global rise in incidence of dengue along with chikungunya  . According to the World Health Organization (WHO), there are about 390 million cases of dengue fever worldwide, and of the total number of cases, 96 million require medical treatment. India also saw a doubling up of cases of dengue from 2014 to 2015 and the worst hit city was Delhi with over 1800 cases of the fever. 2016 isn't expected to be any better and this has become a cause of concern for the country.

We will brief the various signs symptoms and preventive measures needed for our readers.Hope it will be beneficial to cope up the prevalent situation.

DENGUE-

Dengue  is a mosquito-borne viral disease caused by one of the many closely related dengue viruses. It is an acute illness caused by one of the many types of mosquitoes in the genus Aedes Aegypti. Typically people infected with dengue virus are asymptomatic (80 per cent) and only only 5 per cent have severe illness.

Signs and Symptoms-

·         High fever

·         Joint pains

·         Headache

·         Nausea

·         Appetite loss

·         Vomiting

·         Dip in blood pressure

·         Characteristic skin rash- rashes rarely occur on the face. The palms of the hands and soles of the feet may be swollen and bright red.

·         Drop in platelet counts

Diagnosis- Diagnosis of this disease isn't difficult. A blood test for the disease against the virus can tell whether the person is affected or not. . An early detection and a proper medication are considered positive factors and help in lowering fatality rate of the disease. See a doctor, take the prescribed medication which are mostly pain relievers, rest and drink maximum fluids. If the situation worsens in the first 24 hours, do not delay going to a hospital for checking against criticalities.

Dengue prevention plan -

-          Dengue virus is mostly active in the early morning and later afternoon.

-          Tropical and sub-tropical areas are more prone to dengue outbreaks. Travellers from and across such regions can also carry the disease.

-          Reduction of number of mosquitoes by improved water storage, proper waste disposal, and checking water stagnancy.

-          Mosquito repellents are also quite effective but they should be used with the following points of caution: Avoid them for infants below 2 months of age; For infants older than 2 months, apply repellents containing 10 per cent DEET; Avoid applying them on palms, near eyes or mouth; Always read the instruction on the label, particularly for babies, pregnant and breastfeeding women.

-          Avoid wearing dark and tight clothing because mosquitoes are attracted to dark colours. Wear loose, white and long clothes, which cover the whole body. Mosquitoes find it difficult to bite through loose clothes than tight fitting clothes

What is chikungunya? What are the differences between chikungunya, dengue and other mosquito-borne virus?

Like Dengue, chikungunya is a mosquito-borne viral disease transmitted through the bite of infected Aedes mosquitoes. The most common symptoms of chikungunya are fever and joint pain. Other symptoms may include headache, muscle pain, joint swelling, or rash. Symptoms of chikungunya usually resolve within 7-10 days. Chikungunya is very rarely fatal.

Mosquitoes feeding on infected individuals can become infected and then spread the disease toothers. It can be difficult to tell the difference between chikungunya and dengue as they both sharesome clinical signs. Dengue causes more severe disease than chikungunya and hospitalizations and fatalities are much less common with chikungunya.

There is no vaccine or specific treatment for either dengue or chikungunya. Supportive care includes rest, staying hydrated, and taking paracetamol (or acetaminophen) to reduce pain and fever.

Prevention involves protecting yourself from mosquito bites.

High Risk groups-

The specific groups at increased risk include:

• new-borns

• pregnant women

• adults more than 65 years old

• travellers with pre-existing medical conditions (eg. high blood pressure, heart disease,

chronic pulmonary or other serious disease and alcohol abuse) 

What should be the role of Local health authority done to prevent and control chikungunya outbreak?

• focal residual spraying around homes of chikungunya cases,  airport, hospitals,

• surveillance of mosquito populations and breeding sites at  prone sites, major hotels, to

identify risk levels for these sites, and to subsequently control any breeding sites;

• a national mass clean-up campaign   to reduce mosquito breeding sites  

• treatment guidelines  should be developed and distributed to all health professionals;

• community awareness via multi-media campaign  is a must

• community mobilization on source reduction  should be in place 

**Need of hour is -surveillance, clinical management, risk communications, prevention and control.

Foods To Improve Fertility Chances of a couple

                               Foods To Improve Fertility Chances of a couple

Fertility is also a matter of sensitivity, especially in our country. Though, with medical science evolving daily, there are many solutions to treat infertility, yet, there are scientific reasons to believe that an effective solution may lie in the food that you eat. To a large extent, the functioning of our body is governed by our diet.Lifestyle plays a vital role. An unhealthy lifestyle can inhibit the secretion of hormones that promote sperm production.

As such there is no specific food item which can bring miraculous change in fertility and even medicines but there are multiple ways which can add on to improve chances.Basic is definitely healthy habits one should follow.Here we are sharing with readers some of the benefits of specific food items while planning a baby-

1.Eggs – Eggs have a high concentration of vitamin D. It has been widely suggested that this vitamin has a key role to play in pregnancy.

2.Almonds – Almonds are carriers of vitamin E. They promote a harmonic ovarian cycle and thereby lead to better chances of pregnancy.

3.Banana – Fruits, in general can be a great boost to improve your chances of conceiving. Among these, bananas are known because of their high concentration of vitamin B6. The vitamin is a crucial component in the production of sex specific hormones that regulate the normal sexual cycle.

4.Sunflower seeds –     These are concentrated with amino acids and proteins. They can help your body develop a harmonic cycle and optimize the secretion of hormones in the body.

5.Seafood – Sea food that is rich in fatty acids and omega 3 also aids fertility. They help regulate the secretion of essential hormones related to fertility such as the estrogen. These can be consumed for the general well being too.

6.Pomegranate – Pomegranates are fortified with folic acids and vitamin B.   Pomegranate can contribute to an overall well being of the body through the production of red blood cells and improving the circulation. This fruit can be an elixir for enhanced fertility in men.

7.Broccoli – Green vegetables should invariably constitute a chunk of your intake. This is more so if you are trying to conceive. Vegetables such as broccoli contain a high amount of phytosterols. These promote enhanced secretion of hormones in men.

8.Fish – Sea water fishes with a high concentration of fatty acids can be of great help in your quest of becoming a parent. An added constituent in omega 3

The above list includes some of the most common dietary solutions to infertility in men. However, merely intake of these items may not produce the desired or instant results. Often, there is a parallel list of food items you need to avoid. This would invariably include red meat and alcohol.

*Note of caution-

 Some sort of balanced lifestyle need to be maintained as well. However, these food are not substitutes for professional medical help for conditions that are more acute

Healthy Habits Pre Pregnancy

                                                Healthy Habits Pre Pregnancy

When you think of becoming a mother it becomes your responsibility to provide the best in terms of baby’s growth. For that to maintain and follow a healthy lifestyle is a pre requisite.

1.Take balanced diet rich in seasonal fruits and vegetables

2. No smoking: Smoking is absolutely very dangerous for the baby as carbon monoxide, nicotine adversely affect the growth of baby’s organs. Smoking is also considered to cause premature delivery

3.Stay away from alcohol- Say no to alcohol,If you are taking it under peer pressure then you are not doing anything good for your baby. Doctors always advise expecting mothers to stay away from wine, beer or any other kind of alcohol

4.Take adequate sleep- Lack of sleep will make you feel tired and may increase the chances of developing high blood pressure in you, during pregnancy. Minimum 7-8 hours sleep should be there.Proper sleep also helps to get rid of stress

5.Avoid Junk foods like  burgers, pizzas, cold drinks, cake must go out of your life. A successful pregnancy demands lots of necessary nutrients and vitamins which you cannot get from the junk food. For better health of baby in future, get ready to switch to green leafy vegetables, fruits, dry fruits etc.

6. Use of mobile and laptops: Excess use can give you neck and back pain, unseen rays from these gadgets may not be good for your baby. Limit yourself with the use of mobile and computers and focus on book reading or walking or yoga

7.Stay away from negative things

8. Avoid Stress: If you take too much of stress, it can affect your chances of conceiving easily. A stressful mother will not be able to offer good, health to her baby. Stay away from all negative feelings and think positive if you want a healthy and happy baby

9. Avoid taking too much of coffee, soft drinks and other beverages containing caffeine. Excess of caffeine intake can give rise to infertility

10.Don’t take any medicines without consulting your doctor

Stress In working Women and Pregnancy

                               Stress In working Women and Pregnancy

Pregnancy comes with a good news in family but definitely it brings new challenges to the couple.

Especially for a working women, stress may add on in managing work so its better to try to keep a balance. No job is ever stress free  but you need to demarcate that clear line between how much you can take now that you are pregnant. When pregnant, even normal routine tasks go for a toss, and if we talk about work stress, it can sky-rocket. Jobs these days are already stressful and demanding when you are not pregnant, and the stress levels multiply owing to so many changes happening inside when you are pregnant.

A stressed mind tires the body and mind both and can have various impacts like-

We become aggressive, frustrated and depressed emotionally due to over stress.

One may have headaches

Elevated blood pressure

Sleeping Disorders  

Hormonal and physical changes happening to your body add to it

Stress causes the body to produce hormones that can cause miscarriages and other complications like preterm baby and low birth weight.

How to manage stress of work with pregnancy-

Take only that much work what you thing you can manage efficiently

Take your meals on time and regularly and maintain proper hydration

Avoid missing your regular check ups with your doctor

Communicate prior at your work place to avoid add on stress later

Always seek fron any emergency number to contact to help you in need

Resort to deep breathing and relaxation exercises in between

Each pregnancy may take different course so as note of caution whatever new you plan better take opinion of your family members and the treating doctor

Test Tube Baby With Fluid In Body-OHSS

                                               Test Tube Baby With Fluid In Body-OHSS

IVF/Test tube baby is definitely a gift of science to many childless couples but it has certain limitations and side effects which we should know as patients so that we are mentally prepared at our back of mind and not in a situation of surprises.

Ovarian hyperstimulation is one such condition which can happen in some prone patients what we call as OHSS

What Is OHSS-

OHSS is a condition which mostly develops in patients of IVF but can rarely be seen in IUI/Ovulation induction cases also.In this there is fluid collection in tummy and at other areas of body adding distress

Cause and Sequence of presentation-

Causative factor is fertility drugs which are used to grow the eggs.

Generally fertility drugs are used to produce egg sac but sometimes they can cause hyper stimulation of ovaries. This happens when presence of the drugs is more than what your body can handle. As a result, the level of hormones responsible for producing eggs in the ovary increases and too much hormones cause the ovaries to get swollen or enlarged. These enlarged ovaries then start releasing chemicals into the blood stream which ultimately start leaking fluid into the body.

Sometimes that leaked fluid reaches heart, lungs and various other organs and become a serious health problem resulting in grave consequences.

T he Risk of OHSS is mainly to the women who-

At very young age

Have polycystic ovarian condition

Take higher dose of gonadotropins

Have previous history of OHSS

Low weight

Have multiple pregnancy(twins-triplets)

A history of migraines or a previous episode of OHSS

Mild OHSS – women usually experience

Mild abdominal swelling, pain or discomfort

Mild nausea

Diarrhea

Vomiting

Moderate OHSS – Most of the symptoms are same as mild OHSS but with greater intensity

Increased abdominal pain

Increased abdominal girth

Nausea

Urine is dark and very less

Vomiting & diarrhea

And sudden increase in weight

Severe OHSS –  

Intense abdominal pain

Rapid weight gain

Marked abdominal distension

Severe nausea and vomiting

Urine has stopped or very less and much darker

Respiratory difficulties

Extreme thirst

Prevention – Consult your doctor at earliest and clear all doubts esp if you have a strong history of same

How baby Grows- Happiness with concerns !!

                           How baby Grows- Happiness with concerns !!

 

Pregnancy is greatest feeling but definitely till we have a live healthy smiling baby we as parents are always worried every second.What can ease it out is if we are aware about the expected growth changes in this journey of pregnancy.

Pregnancy might leave you feeling delighted, anxious, exhilarated and exhausted — sometimes all at once. Even if you're thrilled about being pregnant, a new baby adds emotional stress to your life.

It's natural to worry about your baby's health, your adjustment to motherhood and the financial demands of raising a child. You might wonder how the baby will affect your relationship with your partner or what type of parent you'll be. If you're working, you might worry about your productivity on the job and how to balance the competing demands of family and career.You might also experience misgivings and bouts of weepiness or mood swings. Remind yourself that what you're feeling is normal.  .

How pregnancy happens-

It all starts with the fertilization of egg with the sperm in the fallopian tube so the resulting healthy embryo migrates and gets fixed in the womb of the mother to form the baby

Stages of pregnancy- There are three stages of pregnancy what we call as Trimesters.Each lasting for three months

Ist,Second and Third

Each triemester has its own significance and implications so needs to have a guided and monitored pregnancy for safe and healthy outcome

How a small uterus will accommodate a growing baby?

Nature at its perfection and nothing can beat/replace it.Pregnancy is a live example.Its one life giving another life with perfection at its peak.

As the days and weeks of pregnancy pass on, your womb will grow and the blood supply also will flourish so making ample room for the new life.Isn’t this the reason Why Mother is Equivalent to GOD

Growth chart of baby for your reference-

Gestational Age	Length (inches)	Weight (oz/lb)	Length (cm)	Mass (g)
8 weeks	0.63	0.04 oz	1.6	1
9 weeks	.9	0.07 oz	2.3	2
10 weeks	1.22	0.14 oz	3.1	4
11 weeks	1.61	0.25 oz	4.1	7
12 weeks	2.13	0.49 oz	5.4	14
13 weeks	2.19	0.81 oz	7.4	23
14 weeks	3.42	1.52 oz	8.7	43
15 weeks	3.98	2.47 oz	10.1	70
16 weeks	4.57	3.53 oz	11.6	100
17 weeks	5.12	4.94 oz	13	140
18 weeks	5.59	6.70 oz	14.2	190
19 weeks	6.02	8.47 oz	15.3	240
20 weeks	6.46	10.58 oz	16.4	300
21 weeks	10.51	12.70 oz	26.7	360
22 weeks	10.94	15.17 oz	27.8	430
23 weeks	11.38	1.10 lb	28.9	501
24 weeks	11.81	1.32 lb	30	600
25 weeks	13.62	1.46 lb	34.6	660
26 weeks	14.02	1.68 lb	35.6	760
27 weeks	14.41	1.93 lb	36.6	875
28 weeks	14.80	2.22 lb	37.6	1005
29 weeks	15.2	2.54 lb	38.6	1153
30 weeks	15.71	2.91 lb	39.9	1319
31 weeks	16.18	3.31 lb	41.1	1502
32 weeks	16.19	3.75 lb	42.4	1702
33 weeks	17.20	4.23 lb	43.7	1918
34 weeks	17.72	4.73 lb	45	2146
35 weeks	18.19	5.25 lb	46.2	2383
36 weeks	18.66	5.78 lb	47.4	2622
37 weeks	19.13	6.30 lb	48.6	2859
38 weeks	19.61	6.80 lb	49.8	3083
39 weeks	19.96	7.25 lb	50.7	3288
40 weeks	20.16	7.63 lb	51.2	3462
41 weeks	20.35	7.93 lb	51.7	3597
42 weeks	20.28	8.12 lb	51.5	3685
43 weeks	20.20	8.19 lb	51.3	3717

Contamination Transmission and IVF-Risks and Safety Issues !!

 Contamination Transmission and IVF-Risks and Safety Issues !!

IVF is showing a rising trend but with limitations of science in place.All done and said in good faith of already stressed childless couples but definitely to bestow them with a good health and a healthy baby .Definitely not at cost of acquiring any infection during this process.Besides safeguarding the health of treating team also-That’s the occupational health what we call.

Since the inception of in-vitro fertilization (IVF), questions about contamination and the transmission of infection have been raised

IVF is not contraindicated in case of HBV or HCV infection, but the decision is far more delicate 

Purpose is to highlight various infections especially grevious ones which can get acquired in process.

This will somehow effect the success rate also besides increasing transmission risk to the prospective child.

Various infectious agents can be-

Sexually transmiited diseases like Chlamydia

HIV

Hepatitis B, C,D

To add to it airborne spread also feared now of Hepatitis B

Genital Tuberculosis

Syphilis

Gonorrohea

Preventions-

Patient should give clear history

Thorough screening should be done

Universal precautions

Rule out and treat any infections before starting treatment

Full antibiotic course should be followed to avoid resistant organisms

Give detailed verbal and written instructions for semen collection

Maintain sterile zone

Chest Pain and Pregnancy- Alarming Symptoms and Prevention !!

Chest Pain and Pregnancy- Alarming Symptoms and Prevention !!

Author- Dr Richa Sharma

Pregnancy is the best feeling in the world but sometimes it may get complicated by certain alarming signs and symptoms which definitely should not be taken casually.

Here's a rundown of symptoms with underlying possible causes which can mimic pain in the chest that should set off your warning bells. But even if you don't see the source of your concern on this list, it's better to err on the side of caution and make that call than to agonize for hours.

Your body is changing so rapidly that it's hard to know whether what you're experiencing is "normal." If you're not sure whether a symptom is serious, you don't feel like yourself, or you're uneasy, trust your instincts and make the call. Your caregiver expects such calls. If there's a problem, you'll get help right away. If nothing's wrong, you'll be reassured.

And if you can't reach a caregiver on the phone, you can always go to the hospital (to labor and delivery) or the emergency room.

Chest pain causes-

Some of the reasons why you may experience chest pain are just routine parts of a normal pregnancy. Some of the most common causes of chest pain are:

·        Stress

·        Pressure of baby

·        Gastritis

·        Inflammation in lungs(Pleuritic pain)

·        Injury locally

·        Inflammation at costochondral junction

·        Engorged Breasts

·        Acute asthmatic attack

·        Myocardial Infarction(Heart Attack)

·        Clotting of blood locally

Treating Chest Pain-

You should contact your doctor on urgent basis so that proper evaluation is done to reduce pain and pin pointing the exact cause for effective management.Avoid self medication and procrastination as treatment that time may be the Golden hours of your life.Here safety comes first so appropriate interventions may be required.

Skin Disorders And Pregnancy

                                         Skin Disorders And Pregnancy

                                                               Author- Dr Richa Sharma

Skin disorders and pregnancy can go hand in hand. Many women with skin problems worry about becoming pregnant and how their health might affect them and their baby. By working with your dermatologist and your ob-gyn, you can create a treatment plan that will keep  problems under control and your baby healthy.If its minor issue then manageable but if its massive then definitely it’s a cause of concern.

Various factors which can decide its affect of pregnancy-

·        Single or both parents affected

·        Any strong family history

·        Role of genetics

·        Previous history of recurrent pregnancy losses

·        Any other associated medical problems like thyroid ,adrenals,diabetes,liver disorders

·        Any gender specific early child demise

·        Duration of illness

·        Treatment taken so far and response to it

Psoriasis and Its impact-

The biggest question that women with psoriasis have when they’re considering pregnancy is: “Should I stop my psoriasis medications?” The answer is typically yes

Its better to be careful  and avoid all those medicines which are considered as harmful to the baby and are prone to birth defects in the prospective child

These medications should be used during pregnancy only if the potential benefit outweighs the potential risk to the fetus.

Psoriasis Can Improve With Pregnancy-

The good news is that a little more than half of women with psoriasis report their psoriasis improves, without treatment, while they are pregnant.It may be due to the immunosuppressive and anti inflammatory affects on the progression of the disease.

Pregnant patients with psoriasis are at increased risks of complications

They are more prone to be overweight or obese and vice versa- reason unexplained

Indirect etiology may be because-women with psoriasis are more likely to smoke, be diagnosed as depressed, and are less likely to have taken prenatal vitamins. Obesity, smoking, and lack of prenatal vitamin intake in pregnancy are all linked to increased risk of adverse pregnancy complications.

Stress also can flare up the acute attack

Planning a pregnancy- As such psoriasis is not a contraindication for pregnancy.But Definitely it adds to stress and various biochemical and physiological changes in the body.

Role Of Genetics-

There is a genetic component to psoriasis, but it does not follow a dominant or recessive pattern of inheritance.

A third of the people with psoriasis have a family history of the disease. But that doesn’t mean a child born to someone with psoriasis will get it.

A child with one parent who has psoriasis has about a 10 percent chance of having psoriasis.

When both parents have psoriasis, chances of the child having psoriasis increase to 50 percent.

Many Thanks and Kind Regards

Dr Richa Sharma

Senior IVF consultant DELHI NCR

Post Doctoral Fellow National Board(FNBE)

Reproductive Medicine(New Delhi), Bangalore

Fellow Reproductive Medicine, Madras Medical Mission (Chennai)

MRCOG(London)

Air Travel and Safety In Pregnancy

                                               Air Travel and Safety In Pregnancy

                            

                                   Author- Dr Richa Sharma

This is a common query, pregnant ladies have in mind as whether they can travel by air.Especially when it is IVF pregnancy, one tends to take extra precautions to be on safer side.Right person to guide you is your health care provider .To add to it many factors actually decide like-

·        Duration of pregnancy

·        Previous obstetric history

·        Any high risk factors -that might be worsened by air travel or require emergency care.

·        Any history of pregnancy complications

·        Duration of travel

·        And the airlines policy

Generally, commercial air travel before week 36 of pregnancy is considered safe for women who have healthy pregnancies.  

Your health care provider might caution against air travel if you're experiencing pregnancy complications The duration of the flight also should be considered. Similarly, your health care provider and many airlines might restrict travel after 36 weeks of pregnancy.

 Precautions to be taken-

• Check the airline's policy about air travel during pregnancy. Guidelines for pregnant women might vary by carrier and destination.
•  Fasten seat belt at proper place- During the trip, fasten the lap belt under your abdomen.
•  Take occasional walks up and down the aisle. If you must remain seated, flex and extend your ankles often.
• Take aisle seat
• Avoid excessive eating and inform crew in case you have any difficulties
• Avoid wearing restrictive clothing. Use of compression stockings might help prevent blood clots.a
• Drink plenty of  clear fluids. Low humidity in the cabin can lead to dehydration.But avoid carbonated drinks
• Avoid gassy foods and drinks pre-flight .

Many Thanks and Kind Regards

Dr Richa Sharma

Senior IVF consultant DELHI NCR

Post Doctoral Fellow National Board(FNBE)

Reproductive Medicine(New Delhi), Bangalore

Fellow Reproductive Medicine, Madras Medical Mission (Chennai)

MRCOG(London)