pReGnAnCy

In a woman’s uterus, the fertilization as well as the development of either one or more off-springs called as embryo or foetus is called pregnancy. Pregnancy may also be defined as the fertilization of an egg in the woman’s Fallopian tube after ovulation (the matured egg released from one of the woman’s ovaries) due to the penetration of a male sperm. A sperm in all has 23 chromosomes that include either xchromosome or ychromosome (X and Y chromosomes are the two types of sex chromosomes). Fertilization of an egg due to a sperm having x – chromosome produces a girl, whereas fertilization of an egg due to a sperm having y-chromosome produces a boy. As a sperm, each egg also consists of 23 chromosomes. To make a human, 46 chromosomes are required. When a sperm and an egg fuse together, each having 23 chromosomes, the chromosome count becomes 46, which is required to make a human being.

After fertilization, the fertilized egg is called a zygote. Soon after fertilization, the zygote starts dividing itself and continues till a cluster of cell is formed. Villi (root like veins) are put out, when the divided cells attach themselves to the uterus wall (womb), after the continuous division of the zygote. The cells are known as an embryo. The villi ensure that the embryo gets attached to the uterus lining. The villi eventually get transformed into the placenta, which protects and provides food for the embryo/foetus.

There may be multiple gestations (carrying of embryo/foetus), in the pregnancy of a woman, as in the case of twins or in the case of triplets. Usually after 38 weeks of conception, childbirth occurs. Conception is achieved through either sexual intercourse or assisted reproductive technology like IVF (in vitro fertilization).

Following the first eight weeks after conception, the developing off-spring is called as embryo whereas subsequently, till childbirth, the term foetus is used. Human pregnancy is divided into three trimester periods in many societies’ legal and medical definition. High risk of miscarriage (natural death of the foetus/embryo) is carried in the first trimester. The development of the foetus can be easily monitored during the second trimester. The ability of the foetus to survive without or with medical aid outside the uterus can be determined at the start of the third trimester. In the United Kingdom and the United States, 40 percent of the pregnancies are unplanned. In the 40 percent of the unplanned pregnancies, quarter and a half are unwanted. 60 percent of the women use birth control to an extent, during the conception month.

SYMPTOMS: Most of the pregnant mothers show the following symptoms:

  • Vomiting.
  • Nausea.
  • Fatigue.
  • Tiredness.
  • Craving for certain special foods that are not often sought for.
  • Frequent urination during night.

Certain medical symptoms may also be shown by the pregnant mothers. They are as follows:

  • Presence of hCG (human chorionic gonadotropin) in the urine and blood.
  • Bleeding due to the embryo implantation, in the third or fourth week after the last menstrual period, in the uterus.
  • Chadwick’s sign (darkening of vagina, vulva and cervix).
  • Goodell’s sign ( vaginal portion of the cervix being soft).
  • Breast tenderness.

COMPLICATIONS: According to W.H.O, more than 20 million women of the entire world, experience ill-health due to pregnancy. Lives of eight million women are threatened and in the year 1995, more than, 500,000 women are estimated to die due to the causes related to childbirth and pregnancy.

Pregnancy causes many levels of health risk for women, as per their medical profile, prior to pregnancy. Few complain, which may occur during or after pregnancy, because of the changes that occur in a woman’s body, due to pregnancy. They are as follows:

  • Hypertension induced due to pregnancy.
  • Pain in back.
  • Anaemia.
  •  Constipation.
  • Oedema.
  • Urinary Tract Infection.
  • Varicose vein.
  • Postpartum depression.
  • Postpartum psychosis.

RECOMMENTAIONS: Drugs that are used at the time or during pregnancy may have permanent or temporary effects on the foetus. Hence, many physicians prefer not to prescribe for pregnant women, due to the concern being over teratogenicity (Abnormality that may cause to the foetus) of the drugs.

The drugs are classified into A, B, C, D and X categories according to the rating system provided by the Food and Drug Administration (FDA), for providing guidance on the foetal risks and potential benefits. Some drugs including some multivitamins having no foetal risks as per the controlled studies in human are put in category A whereas drugs like thalidomide with proven foetal risks are put in category X.

From the above, it is imperative that during pregnancy and after pregnancy, a competent medical advisor should be in regular contact with the pregnant women.

REFERENCE:

 

 

 

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AlCoHoLiSM

Alcoholism is generally meant as compulsive or uncontrolled consumption of alcohol by a person, usually determinant of the person’s personal relationships, health as well as social standings. It is considered an addictive illness or a disease in terms of medicine. It is also called as ‘alcohol dependence syndrome’. Alcohol dependence was known as dipsomania in the 19th and 20th century.  People are called ‘alcoholics’, who are alcohol dependent or suffer from alcoholism. There are 140 million alcohol dependent people worldwide, as estimated by the W.H.O. Some alterations like tolerance and physical dependence occur due to the minimal use of alcohol in a short period of time. This results in alcohol withdrawal syndrome or alcoholism’s compulsive inability to stop drinking. Misuse of alcohol may damage almost every body organ, including the brain, in the body. Chronic alcoholism can cause both psychiatric and medical problems. In general, alcohol is considered as alcoholism, if the person continues drinking even after experiencing health or social problems. Treatment may be done, including several steps. Medicines like diazepam (Valium), form of benzodiazepines may be involved to control alcohol detoxification. People sometimes have the addiction of benzodiazepines in addition to alcohol, it may complicate the steps. Support such as self-help groups or group therapy are given to the person to remain sober after detoxification.

SYMPTOMS: A person who is alcohol dependent may show physical as well as psychiatric symptoms. The symptoms may be as follows:

PHYSICAL SYMPTOMS: Long term misuse of alcohol may show the symptoms like:

  • Cirrhosis of liver.
  • Pancreatitis.
  • Epilepsy.
  • Poly-neuropathy: It is a life threatening neurological disorder, that occurs when nerves throughout the body simultaneously malfunctions.
  • Heart disease.
  • Peptic ulcer.
  • Sexual dysfunction.
  • Nutritional deficiency.

Other physical effects may include an increasing risk of developing,

  • Cardiovascular disease.
  • Cancer
  • Damage to the nervous system and peripheral nervous system.

Development of long term complications due to alcohol dependence in women is more rapid than in men. The mortality rate due to alcoholism is higher in women than in men.

Complications due to long term alcohol dependence may include:

  • Heart, brain and liver damage.
  • Risk of breast cancer.

Alcoholism in women may also result in reproductive dysfunction like:

  • Decrease in ovarian mass.
  • Problems/irregularity of the menstrual cycle.
  • Early menopause.

PSYCHIATRIC SYMPTOMS: 25 percent of the people suffering from alcohol dependence suffer from psychiatric disorders or disturbance. Some common psychiatric symptoms are depression and anxiety. The psychiatric treatment worsens during the withdrawal of alcohol. Psychosis, organic brain syndrome and confusion may be caused due to the misuse of alcohol. Panic disorder syndrome may also worsen in long term misuse of alcohol.

Women with alcohol-use disorders may show anxiety, major depression, borderline personality, post-traumatic stress disorder or bulimia, whereas men with alcohol-use disorders may show antisocial personality disorder, bipolar disorder or hyperactivity disorder.

CONSEQUENCES IF NOT TREATED: Alcohol dependence or alcoholism, if left untreated may cause physical, social or moral harm to the drinkers.

RECOMMENDATION: Recommendations made by the Department of health for men, women and pregnant women are as follows:

  • Men: Men should have at least two days in a week which should be observed as alcohol free days. They should not drink more than 4 units of alcohol in a day or more than 21 units in a week.
  • Women: Women should also observe at least two days as alcohol free days in a week. They should not take more than 14units of alcohol a week.
  • Pregnant women: Women who are trying to conceive or the women who are pregnant should avoid consumption of alcohol. If they at all drink, they should not drink more than 2 units of alcohol in a week to avoid complications to the baby.

Reference- www.en.wikipedia.org/wiki/alcoholism

 

 

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LADAKH

A trip to Ladakh, India’s cold desert is a once-in-a-lifetime experience. With its spectacular natural beauty, the place is a visual treat for both your eyes and your digital cameras. Read on…

Nestled at an altitude of 3,500 meters above the sea level, between the Kunlun Mountain Range in the north and the main Great Himalayas to the south, is a small, yet bustling town of Leh. Being the largest city of Ladakh, Leh enjoys the maximum tourism. It not links one of the sleepy hamlets and valleys of the district, but is also one of the few remaining Buddhist destinations in South Asia.

Being a cold desert, this arid terrain experiences drastic weather changes. The temperatures are so extreme that while one in winters experiences temperatures range between 0 degrees to -28 degrees, in summers one gets to face temperatures like 3 degrees to 30 degrees. Since the temperatures are diverse and the altitude only gets higher, travellers are suggested to have preventive medication for altitude sickness before embarking on their journey.

Must see
The Leh Palace, which is situated behind the main market has eight stories and is similar to the Potala Palace of Lhasa and still belongs to the royal family of Ladakh. Just ahead of the palace is the famous Chamba Temple, which is a oneroomed shrine that has a huge icon of Maitreya, the Buddha to come. Since this temple cannot be found easily, it is essential to enquire about it in the second row of shops.

Also in the bazaar, at the top of the street, one can see the Jama Masjid. This has been painted in green and white colour. Another place that you must visit is the Sankar Gompa, which is situated within the city and is one of the oldest structures here. At one time, this monastery only welcomes maximum twenty monks and is a fairly active one. Also the monks here are extremely hospitable and always offer yak butter tea to those visiting the monastery.

Also a visit to the famous Thikse Monastery is a must. This monastery is the largest such structure in central Ladakh and is primarily known for its magnanimous statue of Maitreya (future Buddha) in its Maitreya Temple. This statue is 15 meters (49 ft) high and the largest such statue in Ladakh. The Buddha here is unusually portrayed as seated in the lotus position rather than his usual representations as standing or in a sitting posture on a high throne.

Must do
On Old Leh Road exists the Tibetan Refugee Market which is an ideal place for shopping in Leh. Tibetan markets are popular for their metal-ware. The visitors here who have an eye for artistic pieces would find sonorous bowls made of nine metals like cymbals, decorative brass and copper trumpets. Besides, cymbals that have religious themes that are used in meditation are also found here.

Also if one is fond of jewellery, it is possible to find relevant items like unpolished silver and turquoise jewellery and chunky shell bangles worn by Ladakhi women. There are also a range of excellent rugs and carpets that have traditional Persian and Kashmiri themes. Some other attractions of these markets are the native Thangka paintings, jewellery made of semi-precious stones, small prayer wheels, shawls, stoles and music bowls. One can also find the lapis lazuli from Afghanistan and the rubies from Burma.

Must know
The cheapest way to travel within the region is by the state buses, which ply on fixed routes according to fixed time schedules. The most comfortable and convenient though expensive mode of travel, however, is taxi, which is available for hire on fixed point-to-point tariff basis.

For visits to the newly opened areas of Nubra, Dah-Hanu, Tsomoriri, Tsokar and Pangong Lake, it is mandatory to engage the services of a registered and recognised travel agency that makes the requisite arrangements including internal transport.

How to reach

By road
The overland approach to Ladakh from Kashmir Valley via Kargil is approximately 434 kms, which remains open for traffic from early June to November. The most dramatic part of this roadjourney is the ascent up the 11,500 feet 3,505 m high Zoji-La, the pass in the Great Himalayan Wall that serves as the gateway to Ladakh.

There is also a motorable route between Manali and Leh which is 473 kms long. Manali-Leh Road has been serving as the second overland approach to Ladakh. Open for traffic from around mid-June to early October, this high road traverses the upland desert plateau of Rupsho, where altitude ranges from 3,660m to 4,570m. A number of high passes fall enroute among which the highest one known as Taklang-La is the world’s second highest motorable pass at an altitude of 17,469 feet/5,235 m. Both the Himachal Pradesh Tourism (HRTC) and J&K State Tourism (SRTC) operate daily deluxe and ordinary bus services between Manali-Leh and Srinagar-Leh. The bus journey between Leh and Manali takes about 19 hours or two days with an overnight halt in camps at Serchu or Pang. And the Srinagar-Leh trip takes 17 hours.

By air
Ladakh is well connected by air with New Delhi, Jammu and Srinagar.

C ourtesy- http://www.timesofindia.indiatimes.com

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URinARy TRaCT InFeCtIoNs

                                                         

When any part of the Urinary system gets infected, it causes Urinary Tract Infections. To understand it better one should know the Urinary System.

Urinary System- In a human body, the Urinary System (also known as the Renal System) comprises of two kidneys, two Ureters, the Bladder and the Urethra. The female Urinary System differs from the main Urinary system only on one aspect and that is the female Urinary system has a shorter Urethra.

a)      Kidneys: The main function of the two Kidneys is to receive and filter the waste products from the blood that are soluble in water. Electrolytes like Calcium, Sodium and Potassium are excreted and reabsorbed by the Kidneys. The kidneys regulate electrolytes and concentrate urine.

b)      Ureters: The urine is transported from the kidney to the Bladder through two tubes. These two tubes are called “Ureters”.

c)       Bladder: The Bladder acts like a storage tank that holds the Urine until it is excreted.

d)      Urethra: It is a tube that carries the excreted Urine from the Bladder outside the body.

If any one of the above four (a, b, c and d) getting infected, it would result in Urinary Tract Infection. Harmful micro-organisms present in the stool and in the large intestine travel up through the Urethra into the Bladder and with time into the Ureters and finally into the two kidneys, causing Urinary Tract Infection. Urinary Tract Infections are more common in females, as they have a shorter Urethra. As the germs have a shorter distance to travel due to a shorter Urethra, the female Urinary Tract is more vulnerable to Urinary Tract Infections. Since the Urethra and the Bladder are nearest to the outside, these two get infected the most. Thus the lower Urinary Tract that comprises of the Urethra and the Bladder, is more vulnerable to infections. The upper Urinary Tract comprises of the two Ureters and the two Kidneys.

Bladder Infections: Women are more prone to Bladder infections. Bladder infection is found to be very rare in men. As women have a shorter Urethra (½ inch long approximately), it is easier for the germs to enter the bladder and infect.  The medical terminology for Bladder infection is” Cystitis”. Bladder infections usually result in the inflammation of the Bladder. If treated early, it is not serious. If neglected and ignored for a long time, it may cause Kidney infections, which may be complex in nature and ultimately may cause death.

SYMPTOMS OF URINARY TRACT INFECTIONS:

1)      Burning sensation inside the genitals while urinating or even after the Urination.

2)      Urge to Urinate often.

3)      Foul smelling Urine.

4)      Pain under ribs on one side of the back (Placement of Kidneys).

5)       Nausea, Vomiting

6)      Chills and fever.

CONSEQUENCES IF NOT TREATED: If not treated and ignored for a long time there may be Complete Renal Failure, Kidney Damage, etc.. When ignored for a long time, the infections spread and reaches the kidney from the Urethra through the Ureters and then through the Bladder and can cause permanent damage to the kidneys resulting in death.

RECOMMENDATIONS: To keep oneself away and safe from Urinary Tract Infection, please follow the following:

1)      Drink 2-3 liters of pure/mineral water daily.

2)      Don’t hold back Urine. Whenever you get the urge to Urinate, pass urine.

3)      Females should urinate after having an intercourse.

4)      If there is any annoyance or feeling of discomfort while urinating, visit a good physician and in the case of females, a competent gynecologist.

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KAAS PATHAR (KAAS PLATEAU)

                                                                                             

Around 24 km from SATARA, 37km from MAHABALESHWAR and 130 km from PUNE lies KAAS plateau, locally known as KAAS PATHAR. Recently (June 2012) declared a bio- diversity site by UNESCO, KAAS PATHAR is really western India’s very own Switzerland. As you get closer to the site, the views get better and better and is incredible as you approach the top. Once there, the all around  scenic beauty leaves its indelible imprint in your mind to last forever.

THE JOURNEY- If you want to visit from MUMBAI, come to Satara by train and then take a private car to Kaas Pathar. The journey is quite comfortable and enjoyable. By car, it takes around half an hour to reach Kaas Pathar from Satara. Plenty of budget hotels are available at Satara to stay overnight and have a day trip to Kaas Pathar. You are advised not to look for staying options at Kaas Pathar. En route you may visit Mahabaleshwar, a famous hill station and quite close to Satara(about one hour by car). You may opt to stay at Mahabaleshwar and in my opinion will be the wisest decision. Plenty of staying options are available at Mahabaleshwar that cater to the need, taste and budget of every individual.  Mahabaleshwar is famous for leather footwear all over the country, trousseau saris, strawberry fields, forest honey, turmeric and last but not the least its all around scenic beauty. If you opt to visit Kaas Pathar from Pune, the approximately three and half hour journey by car is quite enjoyable and comfortable for the well maintained four lane highway.

STAYING OPTIONS- If you want to stay in style and utmost comfort, choose either Mumbai or Pune. If you want to mix styles and comfort with adventure, choose either Mahabaleshwar or Satara.

FOOD OPTIONS- If you are an Indian and travelling by car, you will pass by many famous towns of Maharashtra where you can pick and choose from a wide range of food items that cater to the need, taste and budget of every individual. However, if you are an outsider, pack and take along your lunch box with you from your hotel.

THINGS WORTH DOING AND WATCHING AT KAAS PATHAR

If you visit KAAS PATHAR on a clear day ( the best time is between September and February) you may view the incredible and massive Shivsagar lake and the Sajjangadh fort at a distance. The awesome landscape all around dotted with the rarest of the rare wild flowers of different colors is a sight to behold and lives in the memory forever. Walk around and enjoy the incredible Flora and Fauna, some of which are only found here and are among the most endangered species. Spend some time down-hill on the bank of KaasTalav ( Kaas lake) that will remind you of a sea shore as the bank of the lake is flat and sandy like a seashore. The view of a waterfall falling and flowing into the lake adds to the overall beauty of the place, especially during the monsoon.

One thing is for sure, you will see many different shades of pink and purple here in the flowers that can hardly be seen anywhere else in the world.

 

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VoMiTtInG

Everybody knows and most of the individuals, if not all, have experienced “Vomitting” at some point of time, in their lives. When the content of one’s stomach gets expelled, spontaneously, through one’s mouth and sometimes through the nose, it is called vomitting. Vomitting is known as “Emesis” in medical term. Since “Nausea” is associated with vomiting, people often consider nausea and vomiting to be one and the same. Actually nausea is the feeling (a watery, bitter taste in the mouth and contractions of the stomach muscles) that one gets, just before the expulsion of the contents of one’s stomach, which does not lead to vomitting always. A wide variety of conditions cause vomiting. Sometimes, vomiting is due to some specific reasons, like poisoning or gastritis and sometimes due to some non-specific reasons, like brain tumour or exposure to ionizing radiation.

Some of the causes that lead to vomiting are given below

a)      Overeating

b)      Food allergies

c)       Food poisoning

d)      Milk allergy or lactose intolerance (in case of babies).

e)      Peritonitis

f)       Indigestion

g)      Gastroenteritis

h)      Gastritis

i)        Hepatitis

j)        Pancreatitis

k)      Appendicitis

l)        Bowel  obstruction

m)    Pyloric stenosis

n)      Motion sickness

o)      Concussion

p)      Cerebral  hemorrhage

q)      Migraine

r)       Brain tumour

s)       Hypertension

t)       Anxiety

The vomiting act has two phases. In the first phase, called the retching phase, the diaphragm and the muscles used in the respiratory system together with the abdominal muscles, undergo some rounds of harmonized contractions. Nothing from the stomach is expelled, in this phase. In the second phase, known as the expulsive phase, enormous shifts in the diaphragm and abdominal muscles, creating intense pressure in the stomach, are experienced. The shifts or contractions of the muscles extend to a longer period of time than the normal muscular contraction period. Then, due to the sudden release of pressure, the upper esophageal sphincter relaxes and the gastric contents come out forcefully.

Consequences

While vomiting, if the gastric content enters the respiratory tract, it can be dangerous. Despite recurrent vomiting, if no care is taken, it may lead to dehydration and electrolyte imbalance, Mallory- Weiss tear and Dentistry.

Mallory-Weiss tear- Tear caused in the esophageal mucosa due to repeated vomiting.

Dentistry- Acid present in the vomit causes destruction of the tooth enamel

Symptoms-

a)      Vomit carrying bright red blood is an indication of bleeding in the esophagus

b)      Dark red vomit is indication of profuse bleeding in the stomach.

c)       Coffee ground-like blood indicates less severe bleeding in the stomach.

d)      Yellow vomit indicates flow of bile from the duodenum into the stomach.

Recommendations:

An antiemetic (a drug) can be given to check nausea and vomitting. A competent physician is to be consulted in case of repeated vomiting. Avoid dehydration at any cost. Since antiemetics are not considered safe for the children, oral rehydration therapy (ORT) is recommended for the children and should be take under the supervision of a competent authority. In case vomiting persists for long, children should be hospitalized to return to the body, fluids, by injecting fluids through the veins (IV).     

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STarVAtiON

                                                                       

Acute deficiency in vitamin intake, nutrients and caloric energy causes starvation. Starvation is caused due to extreme malnutrition. Permanent damage of organs and even death may be caused due to prolonged starvation.

Hunger is the one and the most serious threat to the health of people in the world, as per W.H.O. According to WHO, malnutrition contributes to most of the mortality. The death of 2.6 million children every year is caused due to undernutrition. As per the statistics given by the Food and Agricultural Organization, about 14 percent of the world’s total population are under the effect of acute under-nourished. Children are more prone to Kwashiorkor, which include symptoms like loss of weight and wasting of muscle. Kwashiorkor is a form of malnutrition caused due to inadequate consumption of calories combined with a deficiency of protein.

The fundamental cause of starvation is the imbalance between the intake of energy and the expenditure of the energy. In starvation, the expenditure of energy is more than the intake of the energy in the body. This can be caused due to circumstantial conditions or medical conditions which may include:

Medical condition:

  • Anorexia Nervosa: This is an eating disorder, where people restrict the intake of food due to the fear of gaining weight.
  • Bulimia Nervosa: This is an eating disorder, where people take a large amount of food in a very short period of time, which is followed by vomiting, taking laxative or exercise, in an attempt to get rid of the food.
  • Coeliac Disease: It is a disorder of the small intestine, which occurs in the people of all ages. Its symptoms may include fatigue, chronic diarrhoea and sometimes some symptoms may be observed in the organ system.
  • Coma: It is a state in which unconsciousness last for more than six hours.
  •  Major depressive disorder: It is a mental disorder which is accompanied by the loss of pleasure or interest and low self esteem.
  • Diabetes Mellitus.
  • Digestive disorder.
  • Constant vomiting.

Circumstantial causes:

  • Famine: This may be due to any reason like political strife or war.
  • Fasting: If done without proper supervision.
  • Poverty.

SYMPTOMS: Starvation may have some early symptoms like:

  • Hyperactivity.
  • Irritability.
  • Impulsivity.
  • Dehydration.

Prolonged starvation may show the following symptoms:

  • Loss of weight.
  • Deficiency of vitamins, which leads to scurvy, beriberi, anaemia and pellagra.

The above mentioned diseases may cause skin rashes, diarrhoea, oedema and cardiac arrest, collectively.

CONSEQUENCES IF NOT TREATED:

If starvation is not treated with proper medication and care, may lead to the following:

  • Severe weight loss.
  • Dehydration.
  • Hypotension: This is also called as low blood pressure. This may lead to coma or even death, if left untreated.

RECOMMENDATIONS:

Starvation can be prevented, if intake of good amount of food is ensured and the food should provide the body, a complete nutritional diet.

Treatment can be done for starvation, but to avoid refeeding syndrome, it must be done very cautiously (a syndrome in which metabolic disturbance occurs due to re-instituting of nutrients in the starved patients is called re-feeding syndrome).

Maintenance of warmth and rest should be provided. Water mixed with glucose should be given at regular interval of time. Fruit juices may also be given. Gradually small quantities of food may be given. An increase in the quantity of food can be done over time. Administration of protein should be done intravenously, so that serum protein level may be raised.

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