Tuesday, May 18, 2010

On leave

Dear Friends,

I am unable to take your calls.As I don't have email ids of all my patients can't inform all of you separately.
I am away from India from 16th to 23rd may 2010 and won't be able to take your calls.If you leave me a mail on my email id which you all know if you have been my patients,I would surely respond back.
See you all on 24th may.Till then if you have any queries please contact my team mate Dr Deepa Maheshwari (+919871199511)

Tuesday, May 11, 2010

Pudendal neuralgia

Its a not so common but easily overlooked condition where females as well as males can have pelvic and genital pain , hyper arousal particularly after sitting for prolonged period.Mainly it is pain in the organs innervated by pudendal nerve.
Later this month I shall be leaving for France to learn the nuances of its surgical and medical management from expert Dr Eric Boutrant.
Once I am back and more enlightened about the condition will share the same with you.With the help of Dr Boutrant we might be able to start the Indian society of pudendal info.

Monday, May 10, 2010

"I'll Never Let You Go" by The Jammies - Congenital Diaphragmatic Hernia...

Diaphragmatic hernia

This blog is for women health and I am talking about a congenital condition found in children.Well a women health blog is incomplete if we don't talk about those 1% of pregnancies where babies have congenital ( since birth) structural defect.
Today I got a frantic call from a very anxious father to be refered to me by a patient of mine.His wife has been diagnosed in advanced stage of pregnancy with Diaphragmatic hernia.
What is diaphragmatic hernia?

 A diaphragmatic hernia is a birth defect in which there is an abnormal opening in the diaphragm, the muscle that helps you breathe. The opening allows part of the organs from the belly (stomach, spleen, liver, and intestines) to go up into the chest cavity near the lungs.

Symptoms

Severe breathing difficulty usually develops shortly after the baby is born, because of ineffective movement of the diaphragm and crowding of the lung tissue, which causes collapse. The reason why this occurs is not known.

Treatment

A diaphragmatic hernia is an emergency that requires surgery. Surgery is done to place the abdominal organs into the proper position and repair the opening in the diaphragm.Baby needs ventilator soon after birth and thus good Obstetrician,Neonatology department and Paeds surgeon.



http://www.nlm.nih.gov/medlineplus/ency/article/002936.htm

Prognosis

With advances in neonatal and surgical care, survival is now greater than 80%.

I was happy that though I can't guaranty a full recovery for this unborn child but with a good team of doctors and a good nursery at our Hospital I could give some hope to a distraught father.

Saturday, May 8, 2010

My teachers

One keeps on learning throughout one's life
One comes across teachers who have a large contribution to what you are today.In my life I can think of many such names. I wish to dedicate few posts of my blog to some of these great teachers.To begin with the two names which come to my mind are Mr Philip Banfield and Mr Aled Plemming.One a great academician and obstetrician another an all in one package.we used to joke that if Mr Plemming could have his way he would even deliver the babies using laparoscope.He is that good.Both of them instilled so much confidence in me by teaching and appreciating my work and by also standing behind me at difficult times that now all my Juniors in India know their name without even ever meeting them.

I admit I miss them.I miss teachers like them in this cut throat world of corporate practice.

Twin Pregnancy

Sorry folks it took me a while to keep my promise to write the differences between multiple and Singleton pregnancy.BTW I have created a website cum blog http://www.gurgaongynaecology.wordpress.com/ and was quite impressed by my tech savviness :)))
There are a numbers of differences but to name a few important ones
  • The morning sickness in twin pregnancy is much more than Singleton pregnancy.
  • The risk is more if both the twins are sharing the same 'kitchen '(Placenta) and same' living room'(sac) in comparison to when they have separate placenta and sac.
  • One twin can outgrow the other and can even become a parasite on another twin,so more frequent Ultrasounds(called serial ultrasound scans) are required in comparison to uncomplicated Singleton pregnancy
  • Weight which one is carrying during pregnancy is also of two baby's rather than one.
  • There is increased risk of Diabetes of Pregnancy as well as hypertension of pregnancy
  • There is a possibility of preterm labour pains
  • The rate of Cesarean section is more in twin pregnancy than Singleton pregnancy

Sunday, May 2, 2010

Multiple Births (Pregnancy Considerations #4)

Twin Pregnancy

Last saturday a young couple walked in to my chamber at Max Hospital.They looked visibly excited and happy.And I think they had all the reasons to be so.After an IVF treatment they had been blessed with twin pregnancy.They had come to me on recommendation of a fellow doctor(I am happy now after almost 3 years of practice in India my fellow collegues have started showing their confidence in me).The lady asked me a question which brought a smile to my face.Similar question 10 years back by a senior consultant at Lady hardinge medical college,where I worked as a senior resident for 15 days made me leave the institution.The question was doctor 'Do you have enough experience to handle twin Pregnancy?'This time I could understand the apprehensions of a would be mom but 10 years back just out of my college after postgraduation,I was offended.My answer was:It's a simple case,I have even performed difficult caseareans of twins  since I was second year PG student'.And I made a quick decision ,not necessarily right to leave the institution where a senior resident is thought incapable of handling something so very basic.It was my Good fortune to be trained in Gujarat where I have to accept that training is very good and systematic.
I promised this new patient of mine to write my next blog on twin pregnancy.This is just a prelude to my actual blog on multiple pregnancy which would be dealing with 'How is it different from a singelton Pregnancy'?It is surely high risk Pregnancy but not something over which one should loose one's sleep.So wait for my next post........Goodnight and take care.

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