November, 2014 - Best Private Hospital in Dubai Al Mankhool | IMH Dubai

What constitutes the term recurrent pregnancy loss?

When a woman loses 3 or more pregnancies  and none of these pregnancies go beyond 5 months ( 20 weeks ).

Pregnancy loss  can be either in the first 3 months  (12 weeks), with incidence of around 80% , in the second 3 months ( 12 – 28 weeks )  commonly because of  anatomical defects of the uterus and in a condition called antiphospholipid syndrome , and in the last 3 months ( 28 weeks to term ) can be because of premature membrane rupture or  malformations of the fetus .

In todays world with the onset of late marriages and fewer children are we justified in telling the couple to review back after she had 3 miscarriages or with the various investigative modalities available should we start investigating as soon as the lady has one miscarriage is debatable .But with the available data it was suggested that investigation need to be performed when the patient gives a history of 2 pregnancy losses.

Recurrent pregnancy loss complicates 0.5 – 3% of all pregnancies. Large proportion of these cases are unknown  with no proper modalities of treatment  .understanding  of the causes of pregnancy losses will form the basis for investigation and treatment of the condition .

  1. Chromosomal abnormalities : normally occur in 4% of patients commonly being balanced translocation
  2. Anatomical defects : defects of the uterus and cervix like presence of fibroids ( tumor muscle mass in the uterus ) in a submucous location , presence of adhesions inside the cavity ,uterine anomalies like septate uterus  and lastly incompetence of the cervix
  3. Conditions like antiphospholipid antibody syndromes and inherent thrombophilias
  4. Endocrinological disorders like PCOS ( hypersecretion of the hormone called LH ),thyroid dysfunction , diabetes
  5. Immunological factors like presence of antithyroid antibodies
  6. Infections – correction of a condition called bacterial vaginosis has been said to reduce the incidence of pregnancy loss
  7. Lifestyle factors like – smoking , excess alcohol intake and , consumption of high quantities of caffine ( > 300 mg/ day )

 

All these conditions need to be investigated and treatment regimens designed accordingly .

Most importantly  counseling  and proper explanation of the condition is of utmost importance as even with correction of all the abnormalities does not guarantee a good pregnancy outcome .

 

Treatment in a nutshell  will be – supplementation of folic acid and vitamin b12, supplementing with metformin in case of PCOS , asprin  and low molecular weight heparin  in conditions like APLA and thrombophilias , correction of diabetes , treatment of thyroid disorders and treatment of other specific causes

Dr.Raghavendra Prasad
MBBS, DGO, DNB
Specialist Obstetrics / Gynecology

MENTAL HEALTH WELLNESS WEEK

Strategies for Good Mental Health WellnessMHM2013_Pathways_to_Wellness_Logo_web

Strategies for Good Mental Health Wellness

Meditation and Relaxation Techniques: Practicing deep breathing techniques, the relaxation response, or progressive muscle relaxation are ways to help reduce stress and induce relaxation.

Time to Yourself: It is important to set aside time everyday to allow yourself to relax and escape the stress of life. Give yourself a private, mini vacation from everything going on around you.

Physical Activity: Moving around and getting the heart rate up causes the body to release endorphins (the body’s feel good hormones). Exercising provides some stress relief.

Reading: Escape from reality completely by reading. Reading can help you to de-stress by taking your mind off everyday life.

Friendship: Having friends who are willing to listen and support one through good and bad times is essential.

Humor: adding humor to a stressful situation can help to lighten the mood.

Hobbies: Having creative outlets such as listening to music, drawing or gardening are great ways to relax and relieve everyday stress.

Spirituality: Actively believing in a higher power or divine being can have many health benefits. In recent studies, it has been found that people who pray have better mental health than those who do not.

Pets: Taking care of a pet helps distract the mind from stressful thoughts. Studies Show that pets are a calming influence in people’s lives.

Sleeping: The human body needs a chance to rest and repair itself after a long and stressful day. Sleeping gives the body this chance so that it is ready to perform another day.

Nutrition: Eating foods that are good for you not only improve your physical health, but they play a major role in your mental health. When your body gets the proper nutrients, it is better able to function in every capacity.

There are also negative coping skills which can hinder progress in dealing more positively with stress. Actions that are harmful to both mental and physical health include:
Drugs
Excessive alcohol use
Self-mutilation
Ignoring or storing hurt feelings
Sedatives
Stimulants
Excessive working
Avoiding problems
Denial
These actions offer only temporary relief, if any, from stress. Ignoring or covering up how you feel does not solve the problem and the next time the situation arises, you will still have no way of dealing with it.

The next time you find yourself faced with a difficult or stressful circumstance, remember to practice your new coping skills. These skills lead to good mental health and happier you.

Ten Tips for Better Mental Health

Build Confidence – identify your abilities and weaknesses together, accept them, build on them and do the best you can with what you have.

Accept Compliments – many of us have difficulty accepting kindness from others but we all need to remember the positive in our lives when times get tough.

Make Time for Family and Friends – these relationships need to be nurtured; if taken for granted they will dwindle and not be there to share life’s joys and sorrows.

Give and Accept Support – friends and family relationships thrive when they are “put to the test.” Just as you seek help when you are having a tough time, a friend or family member might come to you in their time of need.

Create a Meaningful Budget – financial problems are big causes of stress, especially in today’s economy. Over-spending on our “wants” instead of our “needs” can compound money worries. Writing down where you money is going helps you keep a closer eye on your finances.

Volunteer – being involved in community gives a sense of purpose and satisfaction that paid work cannot. Find a local organization where you life skills can be put to good use.

Manage Stress – we all have stressors in our lives but learning how to deal with them when they threaten to overwhelm us will help to maintain our mental health.

Find Strength in Numbers – sharing a problem with others who have had similar experiences may help you find a solution and will make you feel less isolated. Even talking about situation with people who have not experienced what you are going through is a good way to gain outside perspective.

Identify and Deal with Moods – we all need to find safe and constructive ways to express our feelings of anger, sadness, joy and fear. Channeling your emotions creatively is a wonderful way to work off excess feelings. Writing (keeping a journal), painting, dancing, making crafts, etc. are all good ways to help deal with emotions.

Learn to Be at Peace with Yourself – get to know who you are, what makes you really happy and learn to balance what you can and cannot change about yourself.

Adapted from the Canadian Mental Health Association of Richmond, BC

Dr.Shaju George
Specialist psychiatrist
International modern hospital
Mind Wellness Department
Burdubai,Dubai
Appointments : 971 4 406 3000

WORLD DIABETES DAY 14th NOV 2014

The World Diabetes Day 2014 campaign marks the first of a three-year (2014-16) focus on healthy living and diabetes. This year’s activities and materials will specifically address the topic of healthy eating and its importance both in the prevention of type 2 diabetes and the effective management of diabetes to avoid complications.

The latest estimates from the International Diabetes Federation indicate that there are 382 million people living with diabetes worldwide. By 2035, 592 million people or one person in ten will have the disease. A further 316 million people are currently at high risk of developing type 2 diabetes, with the number expected to increase to almost 500 million within a generation. What makes the pandemic particularly menacing is that throughout much of the world, it remains hidden. Up to half of all people with diabetes globally remain undiagnosed.

These facts and figures reiterate the importance of urgent action. Most cases of type 2 diabetes can be prevented and the serious complications of diabetes can be avoided through healthy lifestyles and living environments that encourage and facilitate healthy behaviour.

The key messages of the campaign aim to raise awareness of how the healthy choice can be the easy choice and the various steps that individuals can take to make informed decisions about what they eat. Special focus on the importance of starting the day with a healthy breakfast.

All campaign activities with the slogan “Diabetes: protect our future.”

The campaign will continue to promote the importance of immediate action to protect the health and well-being of future generations and achieve meaningful outcomes for people with diabetes and those at risk.

The key messages of the campaign include:

  • Make healthy food the easy choice
  • Healthy eating: make the right choice
  • Healthy eating begins with breakfast

Dr  Sushum Sharma
MD(Med),MNAMS,FICP,FISE,FIACM,FIMSA
Specialist Internal Medicine

 
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