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Category : All ; Cycle : October 2016
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Chikungunya is a mosquito-borne viral disease first described during an outbreak in southern Tanzania in 1952. It is an RNA virus that belongs to the alphavirus genus of the family Togaviridae. In 2006, total 13,90,322 clinically suspected cases of Chikungunya were reported from 16 States/UTs in India.This Chikungunya fever guideline is published by the Directorate of National Vector Borne Disease Control, Govt of India in the year 2016. This guideline synopsis is dedicated to the Clinical management of Chikungunya. The information also covers the origin of the disorder, its epidemiology, diagnostic evaluations of the tests and management of the disease. Clinical Management of Chikungunya guidelines are summarized as follows: Since 1960, the outbreaks of the Chikungunya disease in South Eastern Asia were reported from India, Sri Lanka, Myanmar, Thailand, Indonesia, Philippines and Malaysia. Chikungunya outbreaks typically result in large number of cases but deaths are rarely encountered. Transmission and Trends: Chikungunya fever epidemics display cyclical and seasonal trends. There is an inter-epidemic period of 4-8 years (sometimes as long as 20 years). Outbreaks are most likely to occur in post-monsoon period when the vector density is very high and accentuates the transmission. Human beings serve as the Chikungunya virus reservoir during epidemic period. Types of Laboratory Tests available For Detection of Chikungunya Virus: Virus Isolation (Exposing cell lines samples from blood). Serological Diagnosis (ELISA IgM Specific). RT-PCR. Differential Diagnosis: Dengue Fever Malaria Leptospirosis Enteric Fever Rheumatic Fever Reactive arthritis Serum sickness illness Rickettsial disease Clinical Features: Acute phase: Less than 3 weeks Sub-acute phase: > 3 weeks to 3 months Chronic phase: > 3 months Symptoms: Fever Arthralgia/Arthritis Backache Headache Skin rash/Itching Symptoms which are seen in Children (Rarely in Adults) Photophobia Retro-orbital pain Vomiting Diarrhea Meningeal syndrome Acute encephalopathy Long course symptoms: Arthralgia Myalgia Arthritis Persistent Joint stiffness Restricted joint movement Painful joint movement Enthesopathy Tendinnitis Skin pigmentation Skin rash Impact of chikungunya on Pregnancy: A pregnant woman can get affected with the chikungunya virus at any stage of pregnancy. The time of huge risk of Chikungunya virus transmission from a mother to a fetus appears to be during birth. Chikungunya is more deadly in children as compared to adults because children cannot express exact symptoms and it may take time to diagnose the disease. Chikungunya in Elderly: The elderly are affected in more serious manner than the younger population. The body resistance is low in case of elderly and this causes the debilitating effects on their bodies. Chikungunya in elderly people could cause cerebral problems like dementia and paralysis and kidney disorders. Chikungunya Co-infection with Dengue: This is not very unusual as both Dengue and Chikungunya are arboviral diseases, transmitted by the same Aedes mosquitoes. The other observed symptoms in the patients who are suffering from infections of chikungunya and dengue are other non-specific constitutional symptoms such as anorexia, vomiting, headache, and muscle or joint pains and subjected the samples to Chikungunya serology as well. Guidelines for Management of the Chikungunya Disease: Management during Acute and sub-acute phase of the illness Management during Chronic phase or Sequelae. There is no antiviral drugs against Chikungunya Most of the signs and symptoms are self-limiting. Treatment for Chikungunya is purely symptomatic-supportive care and rest and nutrition Analgesics, antipyretics and fluid supplementation are important aspects in managing this infection. Supportive or Palliative Medical Care With Anti-inflammatories Supportive care with rest is indicated during the acute joint symptoms. Movement and mild exercise tend to improve stiffness and morning arthralgia, but heavy exercise may exacerbate rheumatic symptoms. There Is No Vaccine Currently Available. Disabling peripheral Arthritis/ Artropathy refractory to NSAID: Short term corticosteroid may be used. Long term anti-inflammatory therapy Physiotherapy Chloroquine phosphate Management of Chikungunya with High risk group: Proper management of Co-morbid condition and co-infection. Through the recent epidemics, Chikungunya has demonstrated its ability to spread and infect large proportions of the population. There is a very good chance that Chikungunya will continue to spread unless measures are taken to improve the recognition of the disease, to control the vectors responsible for the transmission Show Less

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When to See a Fertility Specialist, Fertility Doctor for Infertility?
Infertility or reproductive problems are often treatable with infertility drugs and high-tech procedures. Assisted reproductive technology (ART) is a group of different methods used to help infertile couples. With the help of Assisted Reproductive Technology the chances of becoming pregnant for infertile couples has increased significantly. In Vitro Fertilization (IVF) is one such ART technique. IVF works by removing eggs from a womanís body. The eggs are then mixed with sperm in petri dish in ivf laboratory to make embryos. The embryos are then transferred in the womanís body. For nearly 40 years, in vitro fertilization (IVF) treatment has helped millions of couples worldwide to overcome a wide variety of infertility problems and has enabled them to realize their dreams of becoming parents. IVF helps infertile couples become pregnant by joining the egg and sperm together in an embryology laboratory where embryos are created that can later be transferred back into the woman's uterus.

In vitro fertilization (IVF) can be used to treat infertility with the following patients: blocked or damaged fallopian tubes; male factor infertility including decreased sperm count or sperm motility; women with ovulation disorders, premature ovarian failure, uterine fibroids; women who have had their fallopian tubes removed; individuals with a genetic disorder and unexplained infertility.

In Vitro Fertilization is assisted reproductive technology (ART) commonly referred to as IVF. IVF is the process of fertilization by manually combining an egg from ovaries and sperm in a laboratory dish, and then transferring the embryo to the uterus. Other forms of ART include gamete intrafallopian transfer (GIFT) and zygote intrafallopian transfer (ZIFT).

The treatment of IVF is helpful for couples diagnoised with problems including

Fallopian tube damage or blockage.
Ovulation disorders.
Premature ovarian failure.
Uterine fibroids.
Previous tubal sterilization or removal.
Impaired sperm production or function.
Unexplained infertility.
A genetic disorder.
Fertility preservation for cancer or other health conditions.

Learn in detail about ivf treatment, fertility and infertility in women and men at

Advantages of IVF Treatments

The most obvious advantage of IVF treatment is the ability for the couple to have a biological child of their own. The IVF process uses only the best eggs and sperm from the couple, meaning the fertilization is more likely to be successful on the first try. A baby born through the IVF treatment will be no different from a baby conceived through natural means. IVF treatments are a great way to get around any infertility issues a couple might be having, without the need for major surgery or extensive infertility treatments. IVF can also be a great solution for patients who are unable to get pregnant through normal means, such as single mothers or same sex couples. Using donated eggs or sperm, they can use the IVF process to realize their dream of having a child. Even the infertile couple with male infertility or female infertility can opt for ivf with donor egg or donor sperm.

Side effects and Risks associated with IVF Treatment include multiple births, premature delivery and low birth weight, ovarian hyperstimulation syndrome, miscarriage, egg-retrieval procedure complications, ectopic pregnancy, birth defects, ovarian cancer and stress due to heavy ivf cost.

What To Expect After IVF Treatment

In vitro fertilization (IVF) related injections, monitoring, and procedures are emotionally and physically demanding on the female partner. Superovulation with hormones requires regular blood tests, daily injections, frequent monitoring by doctor and harvesting of eggs. These procedures are done on an outpatient basis and require only a short recovery time. Cramping during the procedure is common. According to the need and condition, patient may be advised to avoid strenuous activities for the remainder of the day or to be on bed rest for a few days after doctors advise.

Few considerations before opting for the IVF treatmentat at infertility clinic.

1. Itís not 100 percent successful. The most important fact to know about IVF is that itís not 100 percent successful. The process can take time, money, and even an emotional toll on your life, and in the end, it might not work. Thats where choosing the correct IVF clinic will help you a lot in evry single step of the fertility treatment process.

2. The number of IVF cycles needed will vary from patient to patient. Several factors play a role in the success of IVF treatment including age of the patient, degree of infertility among couple and the quality of the embryo and semen. Some women will only require one treatment before successfully conceiving, while other women may need to undergo as many as six IVF cycles. Unfortunately, some women are unable to conceive even after undergoing multiple IVF cycles.

3. If your fertility issues are less severe, you may opt for mini-IVF, which costs less because it involves lower doses of fertility drugs and less comprehensive oversight for your cycle. If your fertility issues do not result from ovulation issues, you may be eligible for natural cycle IVF, which involves no fertility medications.

4. The important point to be considered is the cost of money involved. It is good to have a clear idea of the costs involved before starting treatment, and to have finances in order before beginning. There is significant emotional drain on the couple and their relationship.

5. Be patient during IVF Treatment. One of the biggest misconceptions about IVF is that it works right away. Itís very common youíll need to do it more than once. In younger patients it may be a little less (if youíre not pregnant in the first cycle, youíll likely get pregnant in the next), but if youíre in your forties the average is like three cycles. This is only an indicative figure and will vary from person to person and case to case basis.

6. Have a detailed discussion with your partner. Both should stand on the same page. Decide the time frame for how long you would like to continue with the treatment. Till how long you will continue or when would you stop infertility treatment?

You should discuss your chances for success with IVF with your fertility specialist to determine which type of treatment may be right for your health and budget. Be sure to inquire about any additional costs that may arise during treatment, such as extra testing or psychological counseling, so that you can be prepared. Some fertility clinics offer financial planning assistance to help patients afford treatment.

Know about IVF treatment process, treatment options available, ivf cost and anything and anything about ivf at

How to Choose an IVF Specialist

The in vitro fertilization process is complicated and very personal, so finding a good doctor is important. Most likely, you will begin your journey toward IVF at your gynecologist's office. He or she will run basic fertility tests and conduct exams to diagnose your condition before making a recommendation. Your gynecologist may suggest your partner see an urologist. Once you and your partner have decided that IVF is the right treatment option, you'll need to choose a specialist. Finding a Clinic and narrowing down your choices is an important, potentially difficult process. Since IVF is such an involved procedure, you'll need to find a clinic where you feel comfortable with the staff and confident in your chances of conception. Finding a clinic and specialist who make you feel secure is an important step in your IVF process.

Located in south Gujarat in Surat Me and Mummy hospital & IVF Centre has handled hundreds of infertility cases and has achieved remarkable success in them, a rare feat which few hospitals claim. With todayís advanced reproductive technology, you can always find a solution to all the fertility problems. You must meet an expert in the infertility field. Quality patient care and world class services are always the prime issues for Me and Mummy Clinic in Surat. Clinic gives meticulous attention to all the issues related to treatments, infrastructure, team composition and other related factors.

Dr.Praful Doshi a consultant Gynaecologist and IVF Specialist has over 20 years of experience in fertility and assisted reproduction techniques and specialises in infertility, IVF and in Assisted Reproductive Techniques. Dr.Praful Doshi performs in vitro fertilization (IVF), Donor Egg IVF, ovulation induction, artificial insemination, intrauterine insemination (IUI) and intracytoplasmic sperm injection (ICSI). Dr.Praful doshi has been playing major role in providing specialised treatments to overcome infertility problems and making your dream of family complete. We provide affordable & high quality male & female infertility treatment with advanced reproductive technologies and world class IVF lab infrastructure. The whole IVF section is provided with HEPA filtered, sterile, pressurised air for bacteria free and particle free atmosphere to improve the success of the treatment.

Contact us today for consultation with highly-skilled fertility specialist for the assisted reproductive technology treatments available and know more about ivf treatment, procedure, causes and ivf cost at
Book an appointment with a fertility expert Dr Mitsu B Doshi & Dr Praful B Doshi today on 91-261-2471111 or email at

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