All posts by Paras Bliss

I am a 28 yrs old and have just delivered a baby boy. I feel depressed and worthless. What should I do?

Studies suggest that 70% of the women post delivery might suffer from some form of mental illness such as depression. The feeling of being burdened with a child, loss of freedom and change in bodyappearance may affect women. these can be overcome by speaking with your partner, engaging in useful activities, reading or spending more time doing constructive activities. If you feel tired and fatigued all the time and also feel disinterested in activities, it is best that you push yourself to
engagement and formulate an active social circle. If the symptoms and the illness persists, consult a psychologist at the earliest.

I am pregnant and exercise severe skin stretch and back pain. How can physiotherapy help?

Pregnancy leads to weight gain, muscle stretch and back pain complains are common. Pregnant women also tend to spend time on the bed and refrain from any physical activity. It is best that you enrol yourself in a pre natal physiotherapy session or ante natal class that teaches you the breathing exercises, stretching regimes and the couple sessions. Talk to a physio expert to get guidance on the same.

I am a 45 yr old woman. Post pregnancy, I start to experience urine leaks. Is there is a treatment other than surgery?

Kegel exercises and pelvic floor exercises are the best recommendations for you. They are a bunch of exercises that can help strengthen the pelvic muscles and help you control your urine. This issue is called urinary incontinence. By simply getting a session of training you will be able to strengthen your bladder muscles. You can perform the simple exercises at home or even while working. The most important aspect is the right guidance.

I am a 55 yrs old woman, is it too late to opt for physiotherapy classes for muscle toning and fitness?

There is no age restriction for fitness. You can start at any age and it is never too late. Issues caused by one or more pregnancies, childbirth, chronically poor ways of moving or menopause often don't get better on their own.   They typically get worse or can manifest later in life.  It's never too late to get checked and we urge you to do so.  If you have never actually gone through childbirth yet you find yourself facing various health issues related to pelvic health, such as diastasis recti, incontinence, prolapse,  vaginismus or other types of pelvic pain, please do not hesitate to contact us.  We work with women in all stages of life and are here to serve you.

Why Fetal Medicine?

One may argue that birthing is since ages of Adam and Eve, then why do we need a special branch now? The specialised medical discipline- Fetal Medicine is an endeavour to bring a healthy baby to you, diagnosing the abnormalities-structural, chromosomal or growth, before it is born and perhaps treating the fetus in the womb through different medical techniques. The idea behind this is to have a paradigm shift to the management BEFORE the baby is born rather after.

What should I do in a Lamaze Class?

You should be open about your fears and apprehensions. You can share the same with the instructor or the experts in private or on a group. You should also shut out negative thoughts and relax. Explore your medical intervention options for delivery – C Section, Normal or Painless. Also track the trigger and the cause of your worries and share it. Ask for advice and guidance without any apprehensions.

What is the basic information that is provided in a Lamaze Class?

Lamaze classes are sessions recommended for expecting mothers and their outcome is best whenboth the partners attend the same. Information and training is provided regarding the pregnancy health, health outcomes – pre and post delivery, labour pain management, pain relief, epidural choices, relaxation methods- breathing and massage, birthing positioning techniques, communication skills and medical procedures.

What is Pap Smear test?

Pap Smear can be defined as the most inexpensive and recommended way to check cervical cancer – the second most prevalent cancer amongst women. Cervical Cancer can be defined as the cancer of the cervix. In a Pap Smear Test a small sample of the cells from the cervix – the lower narrow end of the uterus – is taken and is examined microscopically to detect the growth of cancer cells, especially Cervical Cancer Cells.

pap smear test

How is it done?

This is a simple OPD procedure that takes only 10 minutes to perform. No hospitalization is required for the same. Also the procedure should be performed by a specialized gynecologist only.

When you enter the cabin of the doctor, they would request you to dress down completely or from the waist down. You will be told to lay down on the examination bed with your knees bent. The doctor will gentle insert a speculum (a small instrument) in your vagina. This instrument would hold the walls of the vagina apart so that the doctor can see the cervix easily. During this procedure you might feel some pressure in your pelvic area. Then with the help of a spatula or a small brush the doctor collects the samples of the cervix. This process 98% of the times doesn’t hurt. The doctor transfers the cells on a glass slide or in some liquid for examination.

When should you get a Pap Smear Test?

A Pap Smear test is best to detect the presence of Human Pappilloma Virus (HPV) responsible for causing Cervical Cancer. HPV infection can be from men and women. Every woman should go for an annual Pap Smear Test after commencing their sexual life. Many a times an HPV infection is asymptomatic and can stay undetected for a number of years. Also women post the age of 35 yrs should have a annual Pap Smear test for sure. It is to be noted that with the increase in the number of sexual partners the probability of contracting HPV infection increases, and so does the risk of developing Cervical Cancer.

Post three normal Pap Smear Tests, you can discuss with your doctor if you can opt for Pap Smear tests after an interval of 5 yrs.

How to prepare for a Pap Smear Test?

For your gynecological exam, make sure of the following:

  • You should not be menstruating at the time of the examination. If you are reschedule your appointment.
  • You should refrain from sexual activity for at least 48 hrs before the test.
  • You stay calm and relaxed during the test.

Post a Pap Smear test you are free to walk and do any kind of physical activity. In some select cases spotting has been observed, however the same is minor and doesn’t include any complications.

Paras Bliss Hospital organizes in-house gynae camp to educate women on gynae and obstetrics problems

While women do not pay attention to their health and regular screenings, many are unaware about the gynae and obstetrics issues that they might suffer from

Women often ignore their own health concerns as they devote their lives to caring for their children and family

Women undergo several changes in their body mechanisms throughout their lives. The hormonal changes, menstrual cycles, greater propensity to suffer early bone loss and arthritis are factors exclusive to women. However, often they ignore their own health issues, do not pay attention to indicators or warning symptoms as they are too busy looking after their families.

To draw the attention of mothers and women to their own health issues and the need to stay alert, doctors at Paras Bliss Hospital for Mother & Child conducted an in-house gyaencology and obstetrics camp to educate the women regarding health procedures and gynaecologic concerns with expert and compassionate care.

From urinary tract infections, to pelvic function disorders to such serious concerns as cervical cancer — women face multiple health worries during and beyond their reproductive periods. While it is important for women to immediately react to the noticeable symptoms, a regular health checkup is highly recommendable, especially post menopause.

At multiple points in their lives, women face different kinds of health issues ranging from hormonal imbalance, disturbed menstrual cycles, polycystic ovary syndrome or other reproductive health issues to more serious health woes such as cervical or ovarian cancer. The key to warding off dangers and threats is to stay alert and keep up the defences.

“Cervical cancer and breast cancer are the top two diseases that cause maximum cancer deaths for women worldwide. A little amount of alertness and awareness about these issues can save a number of lives by detecting the developments on time. This is particularly relevant in the case of cervical cancer, which is the only form of cancer that can be prevented with vaccination. However, we find that awareness is very abysmal among Indian women about health issues that are so crucial to them. Hence through this camp we aimed at educating the women regarding gynaecological diseases and health problems concerning them,” said Dr Shilva, Consultant –Obstetrics and Gynaecology, Paras Bliss Hospital for Mother & Child.

Women body undergoes different stages throughout her life, and accordingly takes place the hormonal changes. In the period after pregnancy, women experience several characteristic health issues such as urinary incontinence, issues with the bowel movement and painful sex. Sometimes there can emerge serious disorders such as pelvic function disorders or pelvic organ prolapse. These issues should never be taken lightly and should be immediately reported to the doctor.

“India suffers from lack of culture of regular checkups. The ignorance increases when it comes to women. However, regular visits to doctor for a routine checkups and preventive screening is one of the important aspects of maintaining health. In India, this concept is considered to be waste of money, especially in case of women. Breast cancer and cervical cancers can be detected through simple and cost effective tests like an ultrasound/mammography and a PAP Smear. However, most women don’t even know the importance of the same. Also many a times, gynaecological symptoms tend to resemble other medical conditions or urological problems. Therefore, it further necessitates the need to consult a physician for diagnosis. Women face menstrual (bleeding) problems at some point or the other in life. It is mandatory to get the right opinion so that the appropriate treatment is done and unnecessary operative interventions are avoided.” Dr. Harpreet Kaur Isher – Consultant –Obstetrics and Gynecology, Paras Bliss Hospital for Mother & Child

The camp  attracted a lot of women participants who eagerly gained knowledge from the experts on gynecological diseases such as irregular menses, increased decreased bleeding during menses, leucorrhoea, persistent leucorrhoea not responding to the treatment,  lower abdominal pain, backache, bleeding after menopause, primary infertility, Polycystic Ovary Syndrome (PCOS), which occurs when hormones are out of balance and causes issues during menstruation and difficulty in getting pregnant.

Are babies sensitive to light? Should exposure be controlled?

Your baby’s eyes are not very sensitive to light in the first month of life. In fact, the amount of light required for a 1-month-old infant to be aware that light is present (called the light detection threshold) is 50 times higher than that of an adult. So, normal lights can be kept on during the day, but lights should be switched off at night to facilitate biological/circadian rhythm, which promote baby’s growth.

Can babies be given over the counter drugs for cough and cold?

It is advised to consult the baby’s doctor/paediatrician before giving over the counter drugs to the baby as the doses of these drugs depend on the body weight, and hence cannot be generalized to all babies. Too small doses will be ineffective, and higher doses can cause harmful side effects, and possibility of drug toxicity. Most governing bodies in Paediatrics including American Academy of Paediatrics (AAP) advises against giving OTC cough and cold medicines which includes decongestants and cough suppressants to children younger than 6 years old.

How to prevent my new born from pneumonia?

Pneumonia is one of the leading causes of morbidity in both western world and developing countries including India. It kills one child every 15 seconds. Despite these sobering statistics, there is good news: solutions exist to prevent and treat pneumonia, and ultimately save young lives and significantly reduce the burden of families and society

Preventive strategies for pneumonia in children include:

Immunization:

  •  It’s the most effective way to prevent pneumonia
  • Vaccinate your baby against Hemophilus influenza(Hib)
  • Pneumococcus, Measles and Whooping cough (pertussis)

Adequate nutrition: It’s a key to improve baby’s natural defences, Research studies suggest exclusive breastfeeding for the first 6 months of life is effective in preventing pneumonia and also reduces the duration of illness and hospital stay.

Healthy environment:  Addressing indoor and outdoor air pollution and encouraging good hygiene in crowded places goes a long way in promoting health in general and pneumonia in particular.

What is SIDS? How can the same be prevented?

Sudden infant death syndrome (SIDS), also known as cot death or crib death, is defined as the sudden death of an infant younger than 1 year of age that remains unexplained after a thorough case investigation, including performance of a complete autopsy, thorough examination of the death scene, and review of the infant’s and family’s clinical histories

Prevention: –

  • Baby to sleep on his back; on a firm mattress
  • Room-sharing without bed-sharing is recommended
  • Keep soft objects and loose bedding out of the crib
  • Pregnant women should receive regular prenatal care
  • Avoid smoke exposure during pregnancy and after birth
  • Avoid alcohol and illicit drug use during pregnancy and after birth
  • Breastfeeding is recommended
  • Consider offering a pacifier at nap time and bedtime
  • Avoid overheating
  • Infants should be immunized as per schedule.
  • Avoid commercial devices marketed to reduce the risk of SIDS

Should we avoid travel with new born babies?

Your baby can travel soon after birth. Most airlines prefer babies to be at least two days old, but after that, it’s up to you. Young babies generally make good travellers if they feel cuddled and secure and are fed regularly. The movement and activity often helps them sleep, too! By three months, the baby is more likely to be ready to travel. If you are flying, a front carrier or baby sling is an ideal way to transport your baby. Being carried close to the mother or father will make baby feel safe.

Baby carriers also make travelling much easier on trains and buses. If your baby is very young, a travel system with a car seat that fits on to the push chair chassis may be the best option. In this situation, a lightweight, umbrella-folding pushchair is a useful alternative.

What should be the sound level around new born infants?

Infants especially newborns are susceptible to hearing damage from loud noises because their skulls are thinner. Exposure to excessive noise during pregnancy may result in high-frequency hearing loss in newborns, and may be associated with prematurity and intrauterine growth retardation. Loud noises can cause hearing loss by damaging parts of the inner ear; the area responsible for hearing.

Safe Levels: Safe levels can vary according to the duration of the exposure and the loudness level. Noises less than 80 decibels should not cause hearing damage. This is the equivalent to noise in a restaurant or in city street traffic. A normal conversation is about 60 decibels.

Is follow up care required for new born babies?

Follow-up is needed for most babies, with varied aims. Babies with an uneventful hospital stay have to be watched for jaundice 24-48 hours after discharge, if discharged within first 3 days of delivery.

Babies who have been sick due to any reason, will be followed up for assessment of their brain functions, hearing and visual assessment. Biggest risk factors among them are probably gestational age and birth weight. Such conditions include, but are not limited to prematurity, low birth weight, Asphyxia, shock, need for ventilation, infections, jaundice, heart diseases and congenital malformations.

How to take care of babies at home?

Care of a normal baby at home is of utmost importance especially during first few weeks and includes:

  • Exclusive breastfeedingfor the first 6 months of life.
  • Keep umblical cord open and dry.
  • Eyes of the baby must be cleaned with a sterile swab soaked in sterile water.
  • Baby to be bathed once in 3-4 days with lukewarm water during early weeks of life.
  • Watch for jaundice for first few days of life.
  • Vaccinations advised by paediatrician should be followed.
  • Babies should preferably be placed down for sleep on their back.
  • Oil massage with coconut oil/olive oil can be a daily routine.
  • DO NOT apply kajal/surma in eyes or put oil in ear or boric acid in nostrils.

Can relatives spend time with the new born baby?

Welcoming a newly born baby is so exciting! But there are some newborn etiquette which have to be ensured.

  • Avoid too many guests. This allows mother- baby dyad to bond and learn breastfeeding techniques.
  • Guests with flu like symptoms should avoid visiting the newly born till they are symptom free.
  • Handling of the baby by the guests should be reduced to minimum.
  • Proper hand washing/disinfectants to be used before touching the baby and his/her surroundings.
  • Hands of the care giver should be warm and the baby should be well-clothed and covered.
  • Firm and steady grip should be maintained over the baby’s trunk.
  • Avoid kissing the baby to prevent droplet infection.
  • Stay of the guests should not be more than 30 minutes to 1 hour.
  • Use soft, gentle voices and try to be as calm as possible.
  • Don’t wear perfume.
  • Put your cell on silent.

What is Kangaroo Mother Care?

Kangaroo mother care (KMC) is a simple and safe method of caring for low birth weight babies. It includes early, prolonged and continuous skin- to -skin contact with the mother/father or any care giver and exclusive breast feeding. KMC is initiated in the hospital and continued at home as long as the baby needs and likes it. During KMC babies are held naked between the breasts of the mother (mimicking a kangaroo’s pouch) and should be covered with a blanket to avoid heat loss. KMC should be given for atleast 6-8 hours a day; gradually increased upto 24 hours a day. KMC benefits the baby with more stable sleep patterns, temperature stability, better weight gain, better maternal-baby bonding, along with reduction in early mortality and morbidity. Kangaroo care integrates the family into the neonatal intensive care team.

Is there is any kind of specific medicine and treatment for infertility?

There are few medicines that are recommended for the treatment of infertility. Clomiphene is given as it stimulates your ovaries to release eggs. Metformin is used to treat polycystic ovary syndrome. New drugs containing myo-Inositol and acetyl cysteine have been found beneficial in correcting the underlying physiology of PCOD. However self medication is a not recommended. It is best to consult a specialist and discuss your situation.

Can my gynae doctor treat me for infertility?

Many OB/GYNs received just a few weeks of infertility training during residency. Unless their medical practice is fully focused on fertility issues, a fertility specialist may be the most qualified doctor to help you overcome infertility and finally get pregnant. It is better to go for treatment with fertility expert. A fertility specialist diagnoses and treats problems better related to infertility. A fertility specialist can guide you in selecting the fertility treatment procedure that may help you carry the baby to term.

Does infertility treatment include injections and surgery?

Yes infertility treatment includes injections and surgery. Injections are required for COH in ART(IUI and IVF). Gonadotrophins are most commonly used injections. Diagnostic laparoscopy is required in woman with unexplained infertility to identify any finding of endometriosis.  It is best to consult a fertility expert who shall advice you your treatment plan. Apprehensions and fears may be associated with infertility treatment, however it is important to have the support of your family in your road ahead to motherhood.

What is IVF and what is its treatment?

IVF is performed when there is problem with female reproductive system to conceive. The procedure involves collection of good sperm and ova from men and women, combining the ova and sperm outside and finally inserting into other female. The basic elements of the procedure involves ovaries stimulation to release several eggs, removal of eggs from ovary, in-vitro fertilization of egg and sperm, and then placement of 2days old embryo into the uterus.

Treatment of IVF includes down regulation using:

  • GNRH agonist
  • COH using gonadotropins with follicular monitoring using TVS and assessment of serum estradiol levels.
  • Oocyte maturation using HCG
  • Oocyte retrieval
  • Fertilization
  • In vitro embryo culture
  • Luteal support using progesterone
  • Embryo transfer
  • First trimester pregnancy monitoring

What is artificial insemination?

Artificial Insemination is a procedure used to treat infertility that involves direct insertion of semen into a woman’s womb. Commonly used method of artificial insemination includes IUI (Intrauterine Insemination) and it has the best success rate. Other types of artificial insemination include:

  • IUTPI (Intrauterine tuboperitoneal insemination)
  • ICI (Intracervical insemination)
  • ITI (Intratubal insemination)

What is the difference between IVF and IUI?

IUI is referred as Intrauterine Insemination. It is usually performed when there is problem with men who have weaker sperm or woman is suffering from unexplained infertility.  The procedure involves insertion of motile sperm into the woman’s uterus. Basic elements of IUI include collection of male sperm, cleaning for good sperm and directly inserting into the women’s cervix. IUI concerned women must consider intrauterine insemination to conceive. It has been recommended that patients with unexplained infertility should undergo 3 to 6 cycles of IUI before therapy is changed or discontinued.

IVF is performed when there is problem with female reproductive system to conceive. The procedure involves collection of good sperm and ova from men and women, combining the ova and sperm outside and finally inserting into other female. The basic elements of the procedure involves ovaries stimulation to release several eggs, removal of eggs from ovary, in-vitro fertilization of egg and sperm, and then placement of 2days old embryo into the uterus.

Can infertility be treated?

Some fertility problems can be more easily treated than others. It’s important to understand that even if you are able to get pregnant, no treatment can guarantee a healthy baby. On the other hand, scientists in this field have made many advances that have helped millions of couples have babies. The success of treatment of infertility depends on the underlying cause of the problem, woman’s age, history of previous pregnancies and how long she has had infertility issues.

What are the reasons and causes for infertility?

Both women and men can have problems that cause infertility. About 30% of infertility cases are caused by women’s problems. Another 30% of infertility problems are due to problem in male partner. The other cases are caused by a mixture of male and female problems or by unknown problems.

Causes of infertility in female:

  • Ovulatory Dysfunction: It caused by PCOD, decreased ovarian reserve, premature ovarian failure. Ovulatory dysfunction contributes to 30 to 40 % of female infertility.
  • Tubal Factor: Tubal factors accounts for 30 to 40% of infertility. Tubal factors include damage of fallopian tubes because of previous PID, previous pelvic or tubal surgery or endometriosis. Other causes of tubal damage include isthmica nodosa or benign polyps within tubal lumen.
  • Unexplained Infertility: Accounts for10 to 15% cases. In this psychological and gynecological support is to be provided.

What is infertility?

Infertility refers to an inability to conceive after having regular unprotected sex for a period of one year. Approximately 85 to 90 % of young and healthy couples conceive with in 1 year. Infertility therefore affects 10 to 15 % of couples. This is a reason for concern for women who have being to conceive. The issues for infertility may be hormonal and can be associated with the man or the woman. It is important that couples opting to plan families refer to fertility consultants to discuss their issues.

Is there any way to prevent stretch marks?

There are certain creams which are prescribed by the dermatologists to prevent stretch marks. Antenatal exercises are the best treatment to prevent stretch marks from occurring. If your changing body exercises and goes through the recommended stretch exercises, the marks can be managed. Please consult specialists for the ante natal physiotherapy and yoga sessions. Post delivery stretch marks treatment can be done through various ways. The suitability is as per patient condition & requirement.

What sorts of skin care routine do you recommend for pregnant women?

Taking care of our skin during pregnancy is very important task one must do. Maintaining a proper hygiene by cleaning skin on regular intervals and moisturizing it to prevent it from getting dried is also recommended. Proper intake of fluids and doing antenatal exercises also help to maintain a healthy skin. If you are experiencing pigmentation on your body, face or your abdomen area, you should consult a specialist. You should also consult a nutritionist to suggest you the right diet that can complement your skin care.

Is it true that women glow in pregnancy? Is yes, why?

Yes it is true that skin glows in pregnancy because of certain hormonal changes taking place inside the body. Releases of certain hormones like estrogen or progesterone are responsible for the changes happening. The increase in blood flow is also an important factor. During pregnancy production of blood increases by 50%. You can slow the mask of pregnancy and use an oil free cleanser. Consult a Dermatologist to retain your skin glow.

Can laser hair removal be done during pregnancy?

No, laser hair removal is not recommended during pregnancy, especially in the first trimester when organogenesis takes place. But it is recommended not to undergo any type of hair removal treatment for at least 6 months post delivery. This is because new mothers are recommended exclusive breast feeding and its better not to expose yourself to any foreign high radiations or lazers. There is also no conclusive research that shows the affect of the lazers on the feotus, referring to the same consultants don’t recommend any lazer treatment pre and immediately post pregnancy.

Post my pregnancy I am experiencing acne. What should I do?

Increase in sebum secretion happens due to hyper activation of all the glands in the body which leads to formation of acne. If the problem persists for long, one should consult a dermatologist. It usually takes a year for a body to settle the hormonal imbalances and rush. In the meantime consulting a dermatologist shall help you chose the right skin care regime and diet routine to reduce and manage the acne outgrowth.

What are the common skin conditions during pregnancy?

The common skin conditions during pregnancy are pigmentation of the face known as chloasma, the change in the color of the abdomen skin known as linea nigra. Women also start developing stretch marks. There are certain changes in the nails of hands and feet, as they start getting brittle. Sometimes, women face excessive hair growth known as Hirsutism. This is due to the hormonal changes that are happening in the body. Varicose veins are one of the common issues faced by women during pregnancy. You might feel the veins in your feet are buldging and becoming more prominent. Consult a Dermatologist or a General Physician. Miliaria or prickly heat, a condition in which one has excessive itching on certain body parts, is also one of the common issues during pregnancy.

Will my skin complexion get affected during pregnancy?

Yes, the skin complexion will get affected during pregnancy. Certain pigmentation changes happen due to hormonal changes in the body. The pigmentary changes in the face are called chloasma which also means darkening or discoloration in the area of the cheeks, forehead and nose. It is also known as the mask of pregnancy. You might feel that your skin has tanned. This discoloration can disappear after few months post delivery. If you are concerned you can consult a Dermatologist for the same. The changes in the skin of abdomen are called Linea Nigra. It is a dark vertical line that appears on the abdomen during about three quarters of all pregnancies. This is natural pigmentation and is not a reaction to any chemical or physical factor. It fades away after a few months post delivery.