Health – Page 2 – Fernandez Hospital

Intake of Ghee during pregnancy – good or bad?

April 29, 2016February 6, 2018 Fernandez Hospital Leave a comment

Introduction

Maintaining a healthy diet is one of the key factors for a healthy pregnancy as the baby receives its nutrition from the food that the pregnant woman eats. During the nine months of pregnancy, you have to follow a strict diet and may have a variety of problems like uneasiness, nausea, mood swings etc. But all these seem nothing in comparison to the little bundle of joy that will arrive at the end of the third trimester. So, make the best of your pregnancy by having nutritious food that will help your baby develop in a healthy manner.

All through your pregnancy, you will get an array of advice regarding what food you must eat and what you should avoid. Ghee is one such item in the food list suggested by your relatives and other concerned people.

Importance of ghee

An integral part of Indian cuisine, ghee is nothing but clarified butter. It has lots of nutritional benefits and contains Omega 9 fatty acids, Omega 3 fatty acids, vitamins, minerals, antioxidants etc. Though there are many health benefits of ghee for a normal person but whether the consumption of ghee during pregnancy is beneficial is not properly known.

Some of the health benefits of ghee are:

Maintains the cholesterol level of blood
Stimulates the digestive fibre of the body
Enhances metabolism
Boosts the immune system
Moisturises and nourishes skin
Nourishes scalp hair
Maintains healthy growth of brain and bones of the baby

Consumption of ghee during pregnancy

According to nutritionists, the consumption of ghee is not a good idea during pregnancy as ghee is said to be a saturated fat. Though the benefits of ghee for pregnant women is not proven, but in Indian culture it is believed that consuming ghee during this period has the following effects.

Helps in the development of the baby’s brain
Nourishes the baby
Helps in relieving constipation
Improves digestive function
Helps to induce labour by acting as a laxative
Helps in stimulating contractions naturally for smooth delivery

Conclusion

If you follow a diet that consists of fresh fruits and vegetables and other healthy options, adding ghee in a small proportion to your diet does not cause any harm. Homemade ghee is often supposed to be a healthy option and is considered stable for cooking in comparison to butter or oil. And if your weight gain is quite normal, it is safe to have ghee during this period. But if you have gained excess weight, it is advisable not to take ghee. No matter what, it is always good to consult your doctor regarding the inclusion of ghee in your diet and in what amount.

Images Courtesy:

www.momjunction.com

http://pregnant.sg/articles/pregnancy-myth-eat-ghee-for-easy-delivery/

https://www.youtube.com/watch?v=SD1qrbaTUYM

Common Problems in Babies

April 21, 2016February 6, 2018 Fernandez Hospital Leave a comment

Problem1

Why do babies cry?

Most parents nowadays expect babies to behave like adults from the time they are born! They think every cry has a medical reason, and most of them want a medicine to help the baby to stop crying!

Babies require timely attention and constant contact with their mothers. They try to convey their feelings through the only language they know. Crying is not always a call for food.

What can make a baby cry?

When it is hungry
If it is uncomfortable
If it is feeling hot or cold
If it is ill
The baby may just want to go out, as it is bored with the same environment
If the baby has colic – this problem is so exaggerated that most babies are on anti-colic medications nowadays
Evening colic is very common between 6 pm and 11 pm

Your exclusively breastfed baby will not require medicine for the following during the neonatal period (first 6 months)

Breast engorgement in newborns – Don’t squeeze it
Bleeding per vagina – It will stop in 4 days
Constipation – Common to pass stool even once in 3-5 days
Frequent passage of stools – Stool of babies who are breastfed are sticky golden yellow
Indigestion and vomiting – Requires only proper positioning and burping
Crying before and after passing urine and stool

Jaundice in Newborns

Jaundice in newborn babies is normal and often not very serious. Majority of babies can have Jaundice at birth. When your baby’s skin turns yellow it’s called Jaundice. The whites of your baby’s eyes may also turn yellow. This is due to excess amount of a pigment called bilirubin. The bilirubin comes from the breakdown of old red blood cells.

This type of Jaundice starts when the baby is 2 to 3 days old. It goes away by the time your baby is 2 to 3 weeks old. Jaundice progresses from head to toes; and it regresses from below upwards. White part of eyes may remain yellow for a longer period of up to 2 to 3 weeks.

Rh or ABO problems

Jaundice can happen if the mother and baby have different blood group types. There are two different types of blood group incompatibility that can cause Jaundice. When the mother’s blood group is O positive and the baby’s group is A, B or AB positive; or when the mother’s blood type is negative and the baby’s blood type is positive. This type of Jaundice more often starts from the first day of the baby’s life. Please ask your Pediatrician for further information. Your baby can also get Jaundice by being born too early, or from infection and diseases like neonatal hepatitis syndrome.

Breast Milk Jaundice (BMJ)

It is normal for breastfeeding babies to have Jaundice. It usually occurs at 10 to 21 days of age, and can last for 2 to 3 months. As long as the baby is gaining weight, passing lots of clear yellow urine and yellow or green stools, and having bowel movements, there is no need to be worried. It is not harmful, therefore do not stop breastfeeding.

Diarrhoea

Thirst is the earliest indicator of dehydration. Look for it.
Sunken eyeballs and fontanelle indicate dehydration.
Replace the amount of water lost in diarrhoea.
Like flowers, children also droop without water.
A child suffering from diarrhoea loses lot of fluid from the body. Hence, it is important for the child to be hydrated enough at regular intervals to compensate the loss of fluid.
A child who dies from diarrhea, dies from dehydration.
Use salt sugar solution (SSS) to prevent dehydration. A glass of water mixed with a pinch of salt and a spoon of sugar in small quantity should be given to the baby suffering from diarrhoea.
A right way of administering salt, sugar solution is 5 teaspoon every 10 minutes.
Too much salt and sugar in the rehydration fluid is dangerous.
Let the parents make oral rehydration solution (ORS) and feed the baby before they leave from home – 50 to 100cc/kg every 4 hours.
Use medicines for diarrhoea only on doctor’s advice (Zinc is needed).
Other drugs for diarrhea may do more harm than good.
Continue breastfeeding during diarrhoea.
Diarrhoea is not worsened by giving food.
The worst treatment for diarrhoea is to stop food and fluids.
Give one extra feed for one week after diarrhoea.
Wet mopping of floor twice a day prevents diarrhoea.
Everything that goes in his mouth, must be clean.
Malnutrition can also be a cause for diarrhoea, so avoid malnutrition. Diarrhoea, in turn, leads to malnutrition.
To prevent diarrhoea: continue breastfeeds, give measles vaccine, use proper sanitation, keep food and water clean, wash hands before touching food, control houseflies, give vitamin A.

Common respiratory infections and wheezing

There are different reasons why your child may cough or wheeze. Possible causes include:

Colds or other viruses – this is a very common cause of coughing.
Choking – the coughing is sudden and the child has not been unwell.
Croup – this tends to cause a barking, hoarse cough.
Bronchiolitis – this is a chest infection, which can cause coughing and wheezing.
Smoke – smoking around babies can cause them to cough and should be avoided.
Allergy – this can cause coughing after exposure to specific substances.
Asthma – coughing tends to be worse at night or after exercise. The child may also wheeze.
Whooping cough – a contagious infection, which can be prevented by immunization.
Pneumonia – this causes a sudden onset of cough, high fever and fast breathing; it can be prevented by immunization.

When to seek immediate medical help

Children can stop breathing during a severe respiratory attack. If the coughing and wheezing don’t settle, or if your baby becomes more distressed or unwell, take the baby to your doctor or children’s hospital straight away.

Seek immediate medical help in these situations

Breathing problems – if your child is having difficulty breathing or its breathing becomes rapid or irregular.
Breathing is noisy – if your baby’s breathing is noisy when they are not crying.
Skin colour changes – if the skin turns blue or the baby becomes very pale.
Tired – if baby seem unusually tired.
Choking – if your baby suddenly starts to cough and has not been unwell, they may be choking. They may have breathed something into their airways. Choking requires immediate emergency treatment.
Something stuck in the nose – a child with a one sided runny or blocked nose may have something stuck in their nose and should be seen by a doctor.
Refuses food or drink — this should always be a cause for concern.
Fever – if baby has a temperature over 37°C

Proper Exercises During Pregnancy

April 7, 2016February 6, 2018 Fernandez Hospital Leave a comment

Being pregnant does not mean that it is time for you to rest and relax throughout this period. While you do need rest and relaxation, you have to keep yourself active during pregnancy. Exercising is one of the best ways to keep healthy and fit.

Exercising not only helps in improving your strength and muscle tone but also to adapt to the changes that occur due to pregnancy. You can join classes or consult your doctor regarding the same. In case of any pregnancy related complications, it is better not to do exercises.

Benefits of exercising:

It will provide you strength and energy to keep yourself active
As it is normal to gain weight in pregnancy, exercising will help you carry this weight
It will help you during labour and childbirth, as it prepares you for the physical challenges associated with them
It will allow you to have proper sleep
It will help to deal with mood swings which is very common in pregnant women
It will help you to get back in shape after childbirth

Some exercises you can do during pregnancy:

Walking: Brisk walking is one of the best ways to remain fit and healthy during pregnancy. This is one of the safe cardio-vascular workouts possible without putting stress on your ankles and knees. If you can walk 30 minutes daily, five times a week, it is perfectly good for your health.
Swimming: One of the best exercises with little risk of injury, swimming is safe during pregnancy. Swimming lets your legs, arms, heart and lungs to work out. Moreover, it helps reduce swollen feet and backaches. But if you don’t know swimming, it is not the best time to start this exercise.
Yoga: Yoga during pregnancy helps you improve your posture, flexibility, muscle tone, blood circulation and to relax. It may help you in maintaining blood pressure, as well. You can even learn methods to stay calm and relaxed during labour.

Aerobics: Low impact aerobics can be done by pregnant women. It is better to join classes if you are planning to do aerobics during pregnancy. It will help you to strengthen your muscle tone as well as your heart and lungs.
Cycling: Cycling on stationary cycle is absolutely safe during pregnancy. This is the best way to strengthen your heart without putting much strain on your knees. Stationary cycles also reduce the risk of falling down.

Tips to follow while exercising:

Drink plenty of fluids and remain hydrated while exercising
Don’ t indulge in exercises that involve lying flat on the back or on the stomach
Avoid exercises that include heavy weights and straining
Don’t exercise to the point of exhaustion
Have healthy meals

Images Courtesy:

http://kidshealth.org/en/parents/exercising-pregnancy.html

http://www.wikihow.com/Get-Better-Sleep-During-Pregnancy

http://www.momjunction.com/articles/steps-to-do-butterfly-exercise-during-pregnancy_00123123/

https://www.youtube.com/watch?v=2LTj7FZ520k

Infant Skin Care

March 9, 2016February 6, 2018 Fernandez Hospital Leave a comment

The skin is the largest organ in the human body. Besides serving as a protective barrier, it has the function of thermoregulation, UV protection, protection from invasion of microbes and external antigens, repair and regeneration of wounds and synthesis of nutrients. It also has immunological and sensory autonomic functions. We must remember that the skin of the neonate is not the miniature of the adult skin.

Differences between adult and term or preterm neonate skin

The skin of the newborn is 20 to 30% thinner than the adult skin.
Newborn skin is less hydrated and has reduced natural moisturization factor compared to adult.
Ratio of body surface area to weight of a term neonate is up to 5 times that of an adult and that of preterm is 7 times than of an adult.
Stratum corneum or the outermost layer of skin of a preterm baby is thinner than that of a term baby.
At birth, the pH of newborn skin is slightly acidic whereas the adult skin has acidic pH from 5 to 5.5. Alkaline pH predisposes to diaper dermatitis and favours colonisation of Staphylococcus aureus and Candida albicans.

The skin of the newborn undergoes structural and functional modifications from the first few days of life up to almost the first year to adapt to the transition from the utero wet world to the extrauterine environment. The structural and functional immaturity of the skin of a preterm baby results in increased transepidermal water loss, susceptibility to mechanical trauma, microbial invasion and percutaneous absorption of toxins. In order to reduce the morbidity associated with immature skin barrier, optimum care for the skin of a newborn is essential.

Cleansing and cleansers

Cleansing is a process of removing dirt, sebum, micro-organisms, exfoliated corneum cells from the skin surface by a complex interaction between the skin barrier, dirt, body secretions and a surfactant. Water is a good cleanser which removes the water soluble dirt but not the fat soluble particles.

Cleansers are surface active substances that emulsify the fat soluble particles and convert them into water soluble matter which can be washed off with water. Today a wide variety of soaps, special soaps and liquid cleansers are available in the market.

Cleansers are classified into three categories, namely true soaps, syndet bars and combars. Soaps are fatty acids derived from animal fat or vegetable fat processed with sodium or potassium hydroxide by saponification.

True soaps are composed of long chain fatty acid-alkali salts with a pH between 9 and 10. The high alkaline nature causes dissolution of lipids from the skin surface, disruption of acid mantle and stratum corneum barrier and raises the pH of the skin, Soap precipitates in hard water producing insoluble calcium or magnesium salts that prevent foam formation. Use of soap particularly in diseases of the skin may cause dryness and irritation of the skin resulting in redness and itching.

Special additives added to the soaps have resulted in the various subsets of soaps such as superfatted soaps, transparent soaps, medicated antibacterial soaps. Superfatted soaps contain increased oil and fat which help in minimizing the dryness of skin. Transparent soaps contain glycerine and sucrose. Antibacterial soaps contain antibacterial agents such as triclosan, triclocarban. These soaps reduce the skin biofilm bacterial count by blocking the lipid synthesis in the bacterial cell wall.

Syndets or synthetic detergents are synthetically derived organic quarternary ammonium compounds or polymerized or sulfonated fatty acids. They have a pH of 5.5 to 7. They are less likely to produce dryness and irritation of the skin.

Combars are composed of alkaline soaps to which surface active agents with a pH of 9 and 10 are added. They are milder cleansers than true soaps.

Other variants of cleansers

Soapless cleansers are lotions that are primarily composed of either glycerine or propylene glycol and cetyl/steryl alcohols and they can be wiped off without using water.

Liquid cleansers with appropriate blend of anionic, non-ionic and amphoteric surfactants are available. They are milder in nature and do not disrupt the skin barrier or acid mantle.

An ideal skin cleanser is one that is mild and has minimal interaction with skin and removes all unwanted materials from the skin. It should not affect the acid mantle of skin surface. It should be colourless and fragrance free and should not irritate the skin or eyes.

Shampoos

Shampoos that are available in the market are soapless and consists of a principal surfactant for detergent and foaming power, secondary surfactants to improve and condition the hair and additives to complete the formulation and special effects. Formaldehyde is the most common preservative used in shampoos and does not cause any side effects due to the short contact.

Baby shampoos should be ideally fragrance free and should not cause eye irritation. Medicated shampoos with ketoconazole, tar, zinc pyrithione, salicyclic acid are available for special hair conditions.

Vernix Caseosa

It is a naturally occurring complex, lipid rich substance coating the skin surface of the fetus. It is a chalky white material with shed epithelial cells, sebum and sometimes lanugo hair.

Preterm babies have very little vernix compared to the term babies and post term babies may not have vernix.

Vernix is highly beneficial. It is a natural cleanser and moisturizer with anti-infective, antioxidant and wound healing properties. It helps in the development of acid mantle and supports the normal bacterial colonization. WHO guidelines mention that vernix should not be removed at the time of birth.

Bathing the newborn

WHO guidelines mention that the initial bath for term newborn should be given 6 hours after birth. Any baby who is term and weighs more than 2.5 kgs could be given bath 6 hours after birth. In term IUGR babies only sponge bath is to be given until the baby’s weight crosses 2.5 kgs. There are some studies which have advocated bath after fall of the umbilical cord. Bathing makes the baby calmer and quieter than washing with cloth or sponge. The tactile stimulation that occurs during bathing provides a pleasurable experience for the baby and promotes the bonding between the baby and the parent or the caregiver.

How to give a bath:

Should be given in a warm room
Temperature of the bathwater should not exceed 37°C
Check the temperature of the water before placing the baby in the bath
If tub bath is given, the depth of the water should be 5cm up to the hip of the baby
Bathtubs may be a potential source of infection hence they must always be disinfected
Bath duration should not exceed 5 minutes in order to prevent overhydration of the skin which may lead to easy fragility of the skin and decrease threshold for injury

Routine bathing

Routine bathing of newborns and infants does not cause any harm. Daily baths are more preferable but during winter and in the hilly regions babies may be given bath twice or thrice in a week.

Cleansers

Use of alkaline soaps during the neonatal period is to be avoided. If possible, liquid cleansers with acidic or neutral pH may be used which will not affect the skin barrier function or acid mantle. Syndets and mild soaps may be used in infants.

Care of the diaper area

Diaper area is exposed to excessive hydration, occlusion, friction and maceration. Faecal ureases catalyze the breakdown of urea to ammonia, which increases the pH of the skin surface. The pH increase will contribute to the activity of faecal enzymes, proteases, ureases and lipases which are highly irritant to the skin. Water and wet cloth are the gold standards for cleansing the nappy area. Mother should be advised to use only cloth napkins which should be changed frequently. It is important to keep the area dry. After defecation, moistened cloths or cotton balls soaked in lukewarm water can be used for cleaning the area. In case diapers are used, barrier creams containing zinc oxide and petrolatum based preparation could be used. Cloth napkins are to be washed with a mild detergent in warm water and dried in sunlight. Use of antiseptics to be avoided as a routine.

Care of the umbilical cord

Umbilicus should be kept dry and clean. Lukewarm water should be used for cleaning and cord should be kept exposed to air.

Care of the scalp

Cradle cap of the scalp is common in newborns. Mineral oil can be applied to the crusts and removed after two to three hours. Baby shampoos which are free from fragrance could be useful in removal of crusts and scales. The pH of the shampoos should be close to that of tears and should not cause irritation to the eyes.

Baby’s hair wash is to be given after the cord falls with a frequency of twice a week after that.

Use of baby powders

Mothers should be advised to smear the powder on the hands and then gently apply on the baby’s skin. Accidental inhalation of powders could happen if applied with puffs.

Care of the skin of preterm baby

Preterm babies have immature barrier function which results in increased transepidermal water loss, increased skin permeability, impaired thermoregulation, increased percutaneous absorption and susceptibility to trauma.

There is acceleration of permeability barrier maturation following birth hence within 2 to 3 weeks post-natally, babies develop competent barriers. But in preterm born at 22 to 25 weeks it takes 8 weeks to mature. In these preterm babies acid mantle develops over 2 to 8 weeks after birth. Gentle and minimal handling of the preterm babies is to be practiced. Hand hygiene measures are to be strictly followed by the mother or health care workers.

Sponge bath with water is to be given until the baby weighs 2.5 kgs after which regular bath is advised with mild cleanser. Micropore adhesives may be used to secure IV cannulas and while removing the adhesives use guaze piece soaked with warm water. Gentle application of emollients will help reduce the dryness and maintain the barrier function. Emollients also decrease the risk for invasive infections in preterms by preventing access to deeper tissues and the bloodstream through skin portals of entry.

Emollients

Emollients are lipid containing substances that soften the skin and prevent transepidermal water loss. They help in restoration of skin barrier and thus retard further damage. Emollients contain hydrocarbon oils like petrolatum, mineral oils, paraffin and squalene. Fatty acids like lanolin acid, stearic acid and fatty alcohol like lanolin alcohol and cetyl alcohol are also used as emollients. Regular use of emollients is indicated in preterm babies. Emollients could be used in term babies with cleansers induced dryness.

Massage – Touch therapy

Touch is considered absolutely essential for growth and development of a neonate.

Lack of appropriate touch results in poor growth of the infant, delayed attachment to parent and psychological disturbances. Systematic application of touch is termed as massage. Massage promotes circulation, suppleness and relaxation of the different areas of the body and tones up the muscles. Massage results in promotion of mother-infant bonding.

Benefits of massage

Increases food absorption hormones such as insulin
Increased weight gain by increasing insulin and insulin like growth factor
Greater bone mineralisation and more optimal behavioural and motor responses
Babies become more active and alert

Oil massage

Oil massage is traditionally practiced in India. Oil enhances skin barrier function, acts as a source of warmth and nutrition and increases weight gain. Infants also showed less stress behaviour and lower cortisol levels following massage. Very low birth weight preterm neonates given oil massage showed better weight gain. Coconut oil, sunflower oil, mineral oil and synthetic oil are being used for massage. Mustard oil is recently been discouraged due to irritant and allergic contact dermatitis potential. Sunflower oil enhances the skin barrier function. Some studies have shown that olive oil can cause erythema and disruption of skin barrier function. During summer one has to avoid oil massage when baby has miliaria rubra. Oil massage should be given before bath during summer and after bath during winter.

Massage is ideally given by mother, father, grandparents or caregivers. It could be started after the 10^th day of life in a well baby. Massage is to be given to babies when they are alert and active, preferably 1 to 2 hours after feed. Massage is to be done in a warm room. Mother or the caregiver has to cut their nails, and remove rings and watch. Strokes should be gentle and firm and not jerky. These gentle strokes should be given from head to foot. As the baby may not lie still, one should work with and not against the movements. Full body massage will take 15 minutes.

Comfortable signs of baby enjoying massage are happy vocal sounds like cooing, easy breathing pattern, bright-eyed look, ability to focus and take in surroundings comfortably and enjoying stretching, sucking, clasping own hands or feet.

Fatigue Problems During Pregnancy

January 28, 2016February 6, 2018 Fernandez Hospital Leave a comment

During pregnancy, most women experience extreme tiredness and fatigue. It is quite normal to feel tired during pregnancy as your body undergoes different types of changes, and pains, aches, tender nipples etc occur. During the early and later stages of pregnancy, fatigue becomes very common. Some pregnant women experience fatigue throughout the whole pregnancy yet some don’t feel tired at all.

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Reasons for fatigue

Though the actual reasons for fatigue during early pregnancy are not known, it is assumed that hormonal changes are the main reason. As progesterone is known to make one tired and sluggish, rapid rise of this hormone in pregnant women make them feel more tired. The hormonal changes results in a mess of stress level with the mental state taking a toll on the rest of the body making you feel tired. At the end of the first trimester, all these symptoms reduce to a great extent. If they still continue in the second trimester, it is advisable to consult your doctor.

Moreover, most pregnant women get affected with anaemic problems. The symptom of anaemia during pregnancy is fatigue. An expectant woman needs greater amount of iron for the baby and for the blood loss during the delivery.

Some other causes of fatigue may include the stress of becoming a mother, carrying twins, vitamin D deficiency etc.

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How long does fatigue last?

Fatigue is common in the first and third trimester, but in some cases it may occur in the second trimester, as well. You will gain more weight during the last months of pregnancy resulting in trouble while sleeping, backache, leg cramps, heartburn etc. So, it is very natural to get tired and restless during the first three months and the last months of pregnancy.

How to reduce fatigue during pregnancy?

Though there is no prescription to reduce fatigue, doctors advise pregnant women to rest and relax. The following tips may help you to prevent and manage fatigue during pregnancy.

Take rest as much as possible
Drink lots of fluids in order to keep hydrated
Take power naps in the afternoon to compensate loss of sleep at night
Eat small but healthy meals throughout the day which will help you gain energy
Do some deep-breathing exercises, some stretches or take a short walk every day
Include protein and iron rich food like whole grain bread, red meat, sea food, leafy vegetables
Go to bed early and try to get a good night’s sleep
Adjust your work schedule and be less busy during your pregnancy. You can ask your family to help you in household activities.

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Consult your doctor if the following occur:

Fatigue due to extreme thirst and hunger
Fatigue due to sore throat, swollen glands or fever
Excessive fatigue along with vomiting, nausea, increased urination etc
Fatigue due to depression or stress
Fatigue even after proper rest

Though it is pretty normal to be tired during the first and last trimester of pregnancy, at times it is advisable to consult your doctor. Taking proper rest is one of the best ways to get relief from stress and tiredness during pregnancy.

All You Wanted to Know About Pelvic Exercises During Pregnancy

November 24, 2015February 6, 2018 Fernandez Hospital Leave a comment

Pic courtesy – http://www.bepilates.org/

While pregnancy is physically demanding, exercise becomes necessary to cope with the physical as well as biological changes that affect specific areas such as muscles, joints, backbone and especially the pelvic floor. In this post, we are going to share how pelvic floor exercises during pregnancy are important since they not only help reduce pelvic pain but also ease the childbirth procedure.

Your takeaway from this blog post on pelvic floor exercises during pregnancy –

Where are pelvic floor muscles located
How to locate pelvic floor muscles
Why is pelvic floor exercise so important
How does pregnancy affect pelvic floor
Benefits of pelvic floor exercises
Types of pelvic floor muscle exercises
What else you should know about pelvic floor exercises

Before we jump into the workout section, let’s have a quick intro on pelvic floor –

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Pic courtesy- http://pelvicguru.com/2013/06/22/dear-crossfit-and-crossfit-gynecologist-im-appalled-theres-help-for-peeing-during-workouts/

Where are pelvic floor muscles located?

As the name suggests, the pelvic floor muscles form the base of the pelvis.

Pelvic floor is a group of muscles, ligaments and sheet-like tissues that stretch from the front side to the back side i.e. base of your spine. These muscles are attached to the pelvis sides (the bones that we sit upon). They are also attached to the pubic bone and the coccyx i.e. tailbone. These muscles pass through the vagina, anus and urethra, as shown in the image.

What do pelvic floor muscles do?

They help in supporting the bladder, uterus and intestines.
They help in controlling bowel and bladder movement.
They help in sneezing, coughing and lifting heavy objects.
They support the spine and help during sex.

How to locate pelvic floor muscles?

Try to control your flow while urinating, and you can soon identify the muscles which help you stop the flow in the middle of urinating. However, it is not ideal to do this as an exercise as stopping the flow can affect your bladder.

Another way of identifying these muscles is by inserting two fingers into your vagina and try squeezing them. You will soon understand the mechanism.

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Pic courtesy – http://www.xft-china.com/support/detail_17_85.html

Why is pelvic floor exercise so important?

As already discussed above, the pelvic floor muscles support the uterus and help in bowel as well as bladder movement, so if the pelvic floor is weakened then the muscles become harder to be squeezed which affects urinating and bowel movement.
Weak pelvic muscles may also put you in an embarrassing situation as you may pee a little while coughing or sneezing. This further leads to a heavy dragging-like feeling because of improper bladder and womb movement.
Weak pelvic muscles also affect vaginal muscles.
Not only during pregnancy but pelvic muscles should be well maintained as post menopause hormonal changes worsen the abovementioned problems, thereby causing sagging of the uterus and bladder towards the walls of the vagina.

By regularly doing a few pelvic floor exercises, bladder weakness or prolapse symptoms are kept at bay, while reducing the pelvic pain during pregnancy and labour pain as well.

How does pregnancy affect the pelvic floor?

The extra pounds that you put on following pregnancy exert pressure on your pelvic floor muscles, thereby leading to weakness that persists even after the childbirth. The pelvic floor tends to become weak as early as 12 weeks into your pregnancy.

As constipation is one of the common health problems for expecting moms, it can put more strain on your pelvic floor thus increasing the pelvic pain.

Benefits of doing pelvic floor exercises

They help in toning up the pelvic floor.
They help in reducing the risk of uterine/bladder prolapse.
They help during labour, while improving the recovery time.
They help in reducing post-partum discomforts such as perineal swelling and hemorrhoids.
They help in healing the area between anus and vagina i.e. perineum post-partum, by improving the blood circulation.
They help in reducing perineal tearing and the likelihood of episiotomy.
They help in the complete emptying of the bladder and bowel.
They help in maintaining the muscle tone of the vagina thereby easing the delivery process.
They help in preventing urinary leakage during pregnancy.

Types of pelvic floor exercises

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Pic courtesy – http://v-tightgelreviews.net/ultimate-guide-kegel-exercises/

Since your pelvic floor muscles comprise two types of fibres — fast fibres that render strength and slow fibres that render stamina; we offer you two types of pelvic exercises during pregnancy for best results.

Short squeezes in pelvic floor exercise –

Sit down comfortably by slightly stretching your knees. Stretch the muscles around the back passage just as you would do to stop your bowel movement.
Now do the same thing at the front, as if you are squeezing your vagina to stop urinating.
Make sure the squeezes are strongly executed in as much that you feel a definite ‘let go’.
These types of short squeezes should not last for more than a few seconds.
Try to do three sets per day in different positions.

Long squeezes in pelvic exercises during pregnancy

Sit down in the same position as you had done for short squeezes and repeat the above step. The only difference is you need to hold it for a longer time i.e. a few extra seconds. But always remember to breathe normally.
Make sure in the process you’re not constricting your buttock muscles. You can stress your lower abdominal muscles a bit but don’t squeeze out your anus.
Take a break of few seconds before repeating the above step. However, you should stop immediately if you feel your muscles are tired.
Try to find out how long you can hold on to the squeezing, say 4 seconds. This will help you do the long squeezes better.
Now when you become comfortable with the 4-second long squeeze, try to increase it to say 10 seconds. You can gradually increase the counts with each workout.

Bonus points — What else you should know about pelvic floor exercises?

It is equally important to relax pelvic floor muscles as it is to tighten and squeeze them. It is especially important when the baby starts crowning its head during second stage of labour. The pelvic muscles need to be relaxed during this stage, so as to avoid episiotomy.

Make sure you drink a lot of fluid and that you urinate only when you feel your bladder is completely full. Since the frequency of urinating increases during pregnancy, do not try to hold on for too long as it affects the bladder.

Cervical Cancer

September 4, 2015February 6, 2018 Fernandez Hospital Leave a comment

Cervical Cancer CAN be avoided

The thought of cervical cancer is a particularly alarming one for all women, since no one knows exactly how it is caused. Many factors appear to be involved and not all of these will be present for every woman.

Pic courtesy: http://www.healthcare-online.org/Cervical-Cancer-Symptoms.html

Why have a Cervical Smear Test?

Cervix is the lowermost part of the uterus. If detected early, the majority of cervical cancer cases can be avoided and the disease can be halted. Unfortunately, during the early stages there are no signs to tell a woman that she may be at risk. One of the simple ways to detect it, is by having a cervical smear test (also called a PAP SMEAR). Once it is discovered, treatment to counteract can be initiated. The early warning signals can be detected, which if left untreated could lead to cancer.

What is a Cervical Smear Test?

A smear test is a very simple way of checking the health of the cervix. By looking at the smear, experts can confirm if the cervix is normal and healthy, or abnormal. Presence of abnormal cells suggests cancer may develop in the future.

When to have the Smear Test?

Women between the ages of 20 – 60 years should do the test every 3 years.
Women who have excess / recurrent attacks of vaginal discharge or bleeding after sexual intercourse should do the test, regardless of their age.
It should be done within 10 days of the onset of periods.
There should be no bleeding at the time of the test.

How is a Smear Test done?

The smear test is a simple out patient procedure where the gynaecologist scrapes some of the cells from the cervix (the neck of the uterus), and smears it on a glass slide and sends it to the lab for examination.

What happens after the Test?

It takes 3-4 days to get the results from the lab. If the smear test is normal, (as it is in a majority of cases), then it should be repeated after 3 years.

If the test discloses some “abnormalities”, this usually means that some changes have occurred in the cells, which, if left untreated, could develop into cancer after many years. Remember, most women who have had an abnormal smear test are successfully treated.

Once treatment is started, it will be necessary to repeat the test after some months. If the subsequent smear tests are normal, then the tests should be done every 3 years.

If, however, the subsequent smear tests are not normal and continue to show some abnormalities, then it will be necessary to investigate further.

One of the easiest and most accurate ways of studying the cervix and confirming the disease is by undergoing a Colposcopy.

Colposcopy?

Colposcopy is an in-depth examination of the cervix, through a special microscope called a colposcope. A colposcope acts like a magnifying glass with a light and allows the doctor to have a closer look at the cervix.

What happens during Colposcopy?

A Colposcopy examination is an out patient procedure, just like the smear test. A solution is applied to the cervix, which will cause any problem areas to turn white. The cervix is then viewed through the colposcope, which is placed just outside the vagina. If there are any abnormal areas on the cervix, a tiny sample of tissue is taken (biopsy) and sent to the lab for further testing.

After Colposcopy

There is no need for an overnight stay in the hospital after a Colposcopy. As mentioned earlier, it is an out patient procedure. If some tissue is taken from your cervix, you may experience some mild cramping or light bleeding for a few days, which can be relieved by any anti-inflammatory medication. It is advisable to abstain from sexual intercourse for a few days after a biopsy.

he results of the biopsy will determine the course of action to be taken. Feel free to talk to your gynaecologist about the type of treatment, the duration, and the options available.

Prevention of Cervical Cancer (HPV Vaccine)

August 28, 2015February 6, 2018 Fernandez Hospital Leave a comment

What is HPV ?

HPV (Human Papilloma Virus) is a common virus that is passed from one person to another through direct skin-to-skin contact during sexual activity. Most sexually active people will get HPV at some time in their lives, though most will never even know it. HPV infection is most common in late teens and early 20s.

There are many strains (types) of HPV that can infect the genital areas of men and women. Most HPV types cause no symptoms and go away on their own. But some types can cause cervical cancer in women and other less common cancers – like cancers of the anus, penis, vagina, and vulva (area around the opening of the vagina) and oropharynx (back of throat including base of tongue and tonsils). Other types of HPV can cause warts in the genital areas of men and women. These genital warts are not life-threatening. However, they can cause emotional stress and the treatment can be very uncomfortable.

Pic courtesy: http://www.virology.wisc.edu/virusworld/viruslist.php?virus=hpv

Why are HPV vaccines important ?

The vaccines target the HPV types that most commonly cause cervical cancer. One of the two currently available vaccines also protects against genital warts caused by HPV. Both vaccines are highly effective in preventing specific HPV types.

What is the vaccination schedule ?

The schedule is three doses of intramuscular injections, administered over a period of six months.

Who needs to get vaccinated ?

HPV vaccination is recommended for girls and women (9 to 45 years of age).

Can pregnant women take the vaccine ?

The vaccines are not recommended for pregnant women. Although studies show that HPV vaccines do not cause problems for babies born to women who received HPV vaccination when pregnant, more research is still needed. If the patient becomes pregnant in the middle of the vaccine series, then the doses should be completed after delivery. Vaccination can be given during breastfeeding.

Should girls and women be screened for cervical cancer before getting vaccinated?

Girls and women do not need to get an HPV test or Pap test to find out if they should get the vaccine. However it is important that women continue to be screened for cervical cancer, even after getting all three shots of the HPV vaccine.

How effective is the vaccination ?

It is a prophylactic vaccine. As with any vaccine, a protective immune response may not be elicited in all cases. The vaccines are less effective in preventing HPV-related disease in young women who have already been exposed to one or more HPV types. That is because the vaccines can prevent HPV only before a person is exposed to it. HPV vaccines do not treat existing HPV infections or HPV-associated diseases.

How long does the vaccine protection last ?

Research suggests that the vaccine protection is long-lasting. Current studies (with up to about seven years of follow-up data) indicate that the vaccines are effective long term, with no evidence of decreasing immunity.

Do the vaccines protect against all HPV types ?

The vaccines do not protect against all HPV types. They are ineffective in about 30% of cervical cancers. It is important, therefore, for women to continue regular screening (Pap tests) for cervical cancer.

How safe is the vaccine ?

Both vaccines have been licensed by the Food and Drug Administration (FDA) and approved by Centre for Disease Control (CDC) as safe and effective. Common mild adverse events reported during these studies include pain at the injection site, fever, dizziness and nausea.

In what other ways can women prevent cervical cancer ?

Regular cervical cancer screening and follow-up can prevent most cases of cervical cancer. The Pap test can detect cell changes in the cervix before they turn into cancer. Pap tests can also detect most, but not all, cervical cancers at an early treatable stage. There are HPV tests, which may be used with the Pap test in certain cases, to help determine the next step in cervical cancer screening. Use of condoms and limiting the number of sexual partners may lower the chances of getting HPV.

STEM CELLS – Frequently Asked Questions

July 24, 2015February 6, 2018 Fernandez Hospital Leave a comment

Q. What are stem cells?
A. Stem cells are the master cells of our body from which all the other 250 types of cells are formed. The umbilical cord blood mainly contains hematopoietic or blood cell forming stem cells i.e., stem cells that form Red Blood Cells, White Blood Cells and platelets.

Pic courtesy: http://nas-sites.org/stemcells/stem-cell-basics/download-stem-cell-figures/

Q. In what conditions can stem cells be used?
A. As of now, stem cells have been used to treat almost 70 blood related diseases. Some of them are blood cancers like Leukemia and Myelo-proliferative disorders, Inherited Red Cell abnormality like Thalassemia, Immune-deficiency disorders and inherited metabolic disorders.

Q. What is the difference between Public Cord Blood Banking and Private Cord Blood Banking?
A. In public cord blood banking, there is no cost to the family concerned. The family donates their baby’s cord blood to the bank for future use by any Indian, subject to HLA compatibility or for research purposes. The cells belong to the bank and the family has no claims on the cells.

In private cord blood banking, the family pays a fee for storing their baby’s cord blood ONLY for their future use. The cells belong to the family.

Q. What is the rationale for public banking?
A. When the stem cells are donated, these cells can be made available to anyone across the world who is a perfect HLA match. Hence the likelihood of usage is much more, especially for Indians in any part of the globe as these HLA proteins are similar in people of the same ethnic origins.

Q. Does collecting cord blood affect the baby?
A. No. Cord blood is collected only after the birth of the baby and after clamping of the umbilical cord. The baby is in no way deprived of blood as the routine process of delivery is not interfered with in any way.

Q. Does the cord blood collection harm the mother?
A. No, it does not harm the mother in any way. It is a completely safe, harmless and painless procedure.

Q. Can all pregnant women donate cord blood?
A. Every healthy pregnant woman who has a normal pregnancy and a healthy foetus can opt to donate the cord blood of her baby.

Q. Will a blood sample be collected from the mother?
A. Yes, a sample from the mother will be collected at the time of onset of labour.

Q. What is HLA testing?
A. HLA or Human Leukocyte Antigen testing is the test for specific proteins that are present on the surface of the leukocyte (white blood cell). If stem cells from one individual have to be used for another person, the HLA types of the donor and recipient need to match.

Pic courtesy: http://www.stemcellclinic.com/scientists-learned-how-to-expand-successfully-cord-blood-stem-cells/?lang=en

Q. How do I benefit from donating my baby’s cord blood?
A. Your cord blood donation will help the public cord blood bank to create a large inventory of tested stem cell units ready for transplant and thus increase the chances of finding a match. In the unforeseen event of any of your children needing a unit of stem cells for treatment of any haematological diseases, the public cord blood bank will make all efforts to find a best match available. In such an instance, you will only have to pay any additional testing charges and cost of transportation of the unit to the place of treatment.

Q. What are the chances that any one of us may need stem cells?
A. For a family to make use of the cells banked for itself, the likelihood varies from 1 in 400 to 1 in 200,000, as the usefulness is limited to the close family alone. Most of the childhood illnesses and cancers have a genetic basis and as the stem cells will carry signs of any genetic illness, the likelihood of the child using its own stored cells is also very remote.

Q. What happens if I donate to the public bank and then I need the stem cells myself?
A. If the cells you have donated are required for anyone else, the public bank shall issue these cells and keep you informed. If the cells are still with the bank, they will make them available to you at a concessional cost. This cost is for any additional testing and transport of the cells to the transplant site.

Q. What if there are twins?
A. Ideally, 70 ml or more cord blood is required to get adequate numbers of stem cells for transplant. In twin pregnancies, the volume of cord blood collected from each twin is appreciably less, as the weight of each twin is also less than an average weight of a newborn. Hence only in rare instances is cord blood collection in twin pregnancies encouraged.

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