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Jun14
GLOBAL GURU KRUPA: DR. SHRINIWAS KASHALIKAR
GLOBAL GURU KRUPA: DR. SHRINIWAS KASHALIKAR

My guru Shri Gondavalekar Maharaj taught throughout his life; that NAMASMARAN is the way of individual and universal emancipation.

But we don't see expected results in our personal life and global life as an effect of NAMASMARAN. This creates doubt!

Gradually we learn to appreciate that our comprehension is limited and fallible whereas the GRUKRUPA; in personal as well as global terms is accurate and beyond our imagination and often different from our predictions! We realize that it is our inevitable privilege to be immersed in NAMASMARAN and NAMASMARAN is an incoming and blissfully unstoppable global spring!

Blessed and privileged are those of us, who realize this; and rejoice in welcoming this spring, by practicing NAMASMARAN and globalizing it; by sharing its grandeur with others in one way or another!


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Jun12
BENEVOLENT GLOBAL SPRING: DR. SHRINIWAS KASHALIKAR
BENEVOLENT GLOBAL SPRING: DR. SHRINIWAS KASHALIKAR

NAMASMARAN is an act of connecting with or uniting with one's true self (which is the same as the SELF of universe). It is practiced in different ways in different traditions and is the fountainhead of universally benevolent perspectives, thoughts, policies, plans, motivations, urge and actions!

Indeed it is an incoming benevolent global spring; as predicted by Sadguru Brahmachaitanya Shri Gondavalekar Maharaj over hundred years ago and keeps inspiring billions for last one and half century!

Blessed, are those of us, who are enabled to recognize and rejoice this and devote their lives in and for NAMASMARAN!

SHRIRAM SAMARTH!


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Jun11
Artificial Insemination Benefits, Risks and Side Effects
Artificial insemination is a form of assisted reproductive technology technique. Artificial insemination is a technique that can help treat certain kinds of infertility in both men and women. In this procedure, sperm are inserted directly into a woman's cervix, fallopian tubes, or uterus. This makes the trip shorter for the sperm and bypasses any possible obstructions. Ideally, it makes pregnancy possible where it wasn't before. Intrauterine insemination (IUI), in which the sperm is placed in the uterus, is the most common form of artificial insemination.

Artificial insemination techniques available include intra cervical insemination and intrauterine insemination. Artificial insemination is a fertilization procedure in which sperm is artificially placed into a woman’s cervix (intra cervical insemination) or uterus (intrauterine insemination). During the treatment, the woman’s menstrual cycle is closely monitored using ovarian kits, ultrasounds, and blood tests. The semen to be implanted is “washed” in a laboratory, which increases the chances of fertilization while removing unnecessary, potentially harmful chemicals. The semen is inserted into the woman, and if the procedure is successful, she conceives. The chances of becoming pregnant using artificial insemination depends a lot on what type of fertility issue is preventing a natural conception. Generally there is a 5-25% rate of success per treatment for women who use AI to get pregnant, and these chances increase if the woman uses fertility drugs before the treatment.
Artificial insemination has been a popular form of fertility treatment for couples trying to conceive. The original technique used for artificial insemination was referred to as Intra cervical insemination or ICI. Today’s most common technique is called intrauterine insemination or IUI and is more effective procedure than the original. This process turns the dreams of having a child into a reality for many couples facing infertility issues and single women.

Though the pregnancy rates for women undergoing artificial insemination may not be as high as they are for some more advanced techniques, this technique has some key advantages: It's a simple procedure with few side effects and it is not expensive.
For these reasons, doctor may recommend it as an initial form of treatment for infertility.

Why is Artificial Insemination used?

Artificial insemination can be used for many kinds of fertility problems. Artificial insemination is beneficial to couples or individuals in many circumstances. For example a couple may be producing healthy sperm and eggs but not necessarily be able to have a child due to a medical condition. Some other scenarios where artificial insemination could be beneficial are listed below.

1. IUI is often performed as a first treatment for unexplained infertility along with ovulation-inducing medications.

2. It is often used to impregnate women whose partners have very low sperm counts or sperm that aren't strong enough to swim through the cervix and up into the fallopian tubes.

3. IA is used for infertility issues dues to cervical factor infertility. It means that cervix is unable to produce enough mucus and allows the sperm to travel to the womb. The mucus surrounding the cervix is hostile to sperm and prevents sperm from getting into the uterus and fallopian tubes. Artificial insemination allows the sperm to bypass the cervical mucus entirely.

4. Fertility issues caused by endometriosis.

5. When the male partner is impotent or suffers from infertility those results from medical issues.

6. In rare cases, some women suffer from a semen allergy that prohibits having direct contact with the sperm.

7. Women that want a child without a partner may consider artificial insemination.

8. Couple that is in a same-sex relationship may use artificial insemination to have a child.

Donor Sperm and Artificial Insemination

Women can use their husband’s sperm for insemination if it is viable, or they can choose to use donor sperm. In this case they will be using Artificial Insemination by Donor (AID) to get pregnant. This process may be needed if the husband’s sperm is not viable or if the female is single and wishes to have a baby on her own. This type of fertility treatment can also be utilized by couples where the male partner has a genetic disorder, or when more advanced treatments like intracytoplasmic sperm injection (ICSI) is too expensive.

The process of Artificial Insemination

An insemination procedure uses a thin, flexible tube (catheter) to put sperm into the woman's reproductive tract. For some couples with infertility problems, insemination can improve the chances of pregnancy. Donor sperm are used if the male partner is sterile, has an extremely low sperm count, or carries a risk of genetic disease. A woman planning to conceive without a male partner can also use donor sperm. Prior to insemination, the sperm usually are washed and concentrated (placing unwashed sperm directly into the uterus can cause severe cramps). Concentration is accomplished by selectively choosing highly active, healthy sperm that are more capable of fertilizing an egg.
Intrauterine insemination (IUI): Intrauterine insemination (IUI) is the placing of sperm into a woman's uterus when she is ovulating. This is achieved with a thin flexible tube (catheter) that is passed into the vagina, through the cervix, and into the uterus. IUI can use sperm from the male partner or a donor. It is often combined with super ovulation medicine to increase the number of available eggs.

Artificial insemination (AI): Artificial insemination (AI) is another name for intrauterine insemination but can also refer to placing sperm in a woman's vagina or cervix when she is ovulating. The sperm then travel into the fallopian tubes, where they can fertilize the woman's egg or eggs. AI can be done with sperm from the male partner or a donor, and can be combined with super ovulation.

Intrauterine insemination is a relatively simple and safe procedure, and the risk of serious complications is low. Risks include:

Infection: Studies indicate that less than 1 percent of women experience infection as a result of the procedure.

Spotting: Sometimes the process of placing the catheter in the uterus can cause a small amount of internal bleeding. This does not usually have an effect on the chance of pregnancy.

Multiple pregnancy: IUI itself is not associated with an increased risk of a multiple pregnancy — twins, triplets or more.
However, when coordinated with ovulation-inducing medications, the risk of multiple pregnancy increases significantly. A multiple pregnancy has higher risks than a single pregnancy does, including early labour and low birth weight.

What to Expect After Treatment?

These techniques are done on an outpatient basis and require only a short recovery time. You may experience cramping during the procedure, especially if sperm are inserted into your uterus. You may be advised to avoid strenuous activities for the remainder of the day. The treatment is pretty simple and painless with maybe a little cramping. It is performed in the fertility specialist clinic and the procedure can be done by a qualified nurse or a doctor.

IUI may also be used if a couple would like to avoid the higher cost of IVF treatment. Even though IUI is less effective per cycle than IVF, a couple may be able to afford more attempts with IUI. Artificial insemination should not be used in women with blocked fallopian tubes. The tubes are often checked out with an x-ray test called a hysterosalpingogram. Female age is a significant factor with IUI. Intrauterine insemination has very little chance of working in women over 40 years old. IUI has also been shown to have a reduced success rate in younger women with a significantly elevated day 3 FSH level, or other indications of significantly reduced ovarian reserve. If the sperm count, motility and morphology scores are quite low, intrauterine insemination is unlikely to work. Insemination is a reasonable initial treatment that should be utilized for a maximum of about 3 months in women who are ovulating (releasing eggs) on their own. It is reasonable to try IUI for longer in women with polycystic ovaries (PCOS) and lack of ovulation that have been given drugs to ovulate.

While artificial insemination does not guarantee pregnancy, it does have success rates of around 30 percent. The success rates do depend on a variety of factors that include the insemination method used, the age of the female, egg and sperm quality, male factor infertility and the endometriosis factor. Anyone interested in artificial insemination should seek a consultation with the fertility specialist.

With today's 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. We pride in our state of the art modern equipments for women's care, all under one roof. Our sophisticated infrastructure well aided by qualified staff has given us extra edge in gynaecological and infertility services. We are progressing rapidly with a vision of delivering finest care and service.

Dr.Praful Doshi a consultant Gynaecologist and IVF Specialist has over 15 years of experience in fertility and assisted reproduction techniques and specialises 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.

Common causes of infertility problems in women - Ovulation problems - Endometriosis - Poor egg quality - Polycystic ovarian syndrome - Tubal factors - Unexplained fertility problems - Get expert guidance from the IVFspecialist - pregnancy and parenting experts today.

Know all about artificial insemination and IVF treatment, intrauterine insemination, donor sperm intrauterine insemination, in vitro fertilization (IVF), intracytoplasmic sperm injection (ICSI), Donor Egg IVF, ovulation induction, surrogacy, Reproductive Endocrinology and Gynecology including advanced Laparoscopic Surgery, Tubal reconstruction, and Minimally Invasive USG-guided therapeutic procedures at http://www.meandmummyindia.com and contact the top fertility expert in Surat to get satrted by calling at 91-261-2471111 or 2472222


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Jun07
सहिष्णुता: डॉ. श्रीनिवास कशाळीकर
सहिष्णुता: डॉ. श्रीनिवास कशाळीकर

१. अंतर्बाह्य ईश्वर असताना त्याचा जणू पूर्ण विसर पडणे व त्याविषयी टिंगल टवाळीची भावना असणे आणि वासनाविवशतेचे अर्थात हीन स्वार्थाचे उद्दंड आणि बेभान समर्थन करणे (सहिष्णुता?)
२. वासना आणि ध्येय यांच्यात संघर्ष होऊन सारखी ओढाताण होणे अन वासनेमध्ये पुन्हा पुन्हा नाईलाजाने ओढले जाणे व वाहात जाणे व आपल्या आतल्या आणि बाह्य जगातील वासनेविषयी चीड येणे (असहिष्णुता) आणि कधी ह्या संघर्षामध्ये तीव्र खिन्नता येणे
३. ध्येयावरची पकड भक्कम होता होता वासनेची पकड ढिली होत जाणे आणि स्वत: आणि इतरांच्या वासनेविषयी असलेली चीड हळु हळु कमी होत जाणे व त्याचबरोबर ध्येयाविषयी अस्वस्थता,आतुरता व तळमळ निर्माण होणे
४. कालांतराने; ध्येयसिद्धीची खात्री झाली की अंतर्बाह्य वासनांचा भपका, बडेजाव, प्रभाव, बाऊ वा दबाव वाटेनासा होणे
५. अंतर्बाह्य पसरलेल्या वासनेचे पर्यवसान अखेर; त्याच एकमेव ध्येयात वेगळ्या वेगळ्या प्रकारांनी आणि वेगवेगळ्या काळानुसार पण निश्चीतपणे होते याची जाणीव ठळक होऊन; ध्येयाचा आग्रह/हेका/हट्ट आणि वासनेचा तिरस्कार व तिटकारा (ताप उतरल्यावर घाम निघून जावा तसे) हळु हळु निघून जाणे (सहिष्णुता!)
६. आतील आणि बाहेरील वासनांचा प्रभाव कमी झाल्यामुळे एकाच वेळी अंतर्बाह्य परिवर्तनाची विजयी अनुभूती येऊ लागणे आणि अंतर्बाह्य आघात विफल होऊ लागल्यामुळे शाश्वत समाधान आणि सार्थकता आवाक्यात येऊ लागणे
नामधारकाच्या आयुष्यातील अनुभवांचा हा सर्वसाधारण व ढोबळ मानाने आलेख आहे.
श्रीराम समर्थ!


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Jun06
कर्तव्य: डॉ. श्रीनिवास कशाळीकर
कर्तव्य: डॉ. श्रीनिवास कशाळीकर

प्रत्येकाला पूर्णत्वाची आंस असते.

पण ती ओळखता येतेच असे नाही. तसेच शब्दात सांगता बोलता येतेच असे नाही. त्याचप्रमाणे ती आंस तृप्त करण्याचे साधन माहीत असतेच असे नाही. एवढेच नव्हे तर ते साधन कळले तरी त्या साधन मार्गावर चालता येतेच असेही नाही. आणि अखेर साधन मार्गावर चालू लागला तरी अखेरपर्यंत चिकाटीने चालत राहणे जमतेच असे नाही!

आपलेही तसेच असते!

म्हणून कधीही कुणाहीबद्दल असहिष्णू असणे योग्य नाही.

पण आपण सहिष्णू व्हायचा उपाय कोणता?

आपली पूर्णत्वाची वाटचाल चालू ठेवणे म्हणजेच नामस्मरण चालू ठेवणे आणि जमेल तसे ते वाढवीत राहणे हाच सहिष्णू होण्याचा; म्हणजेच स्वत:च्या आणि इतरांच्या प्रती आपले सर्वाधिक महत्वाचे कर्तव्य चोखपणे पार पाडण्याचा रामबाण उपाय आहे.

तसे करता करता आपली इतरही कर्तव्ये आपोआपच आणि पूर्वीपेक्षा अधिक प्रेमाने पार पाडली जातात!

श्रीराम समर्थ!


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Jun03
Repeated Miscarriage- A Painful experience for the couples
Pregnancy gives a woman completeness by turning her into mother from a simple woman. It is the thing which makes the couple parents, the dream which they nurture right time from their marriage. Of course there are many couple s who are not fortunate enough to achieve pregnancy and they are usually termed infertile and we have discussed it in separate post. But there are other couple s who may or may not (as this is the usual case) find difficult to conceive but the pregnancy does not continue to the age of viability. Age of viability means the age, when a baby born can survive. Thanks to the improvement in neonatal care by leaps and bounds and availability of NICU which made it possible to survive even a baby born at 22 weeks. For example last month we delivered a baby at 28 weeks of pregnancy, who is fine now. But if the baby is 'born' before 20 weeks, it is called MISCARRIAGE. This is because these babies who weigh less than 500 gram cannot survive outside the uterus. It is seen that 10-15% couples who conceive successfully may not be able to carry pregnancy beyond 20 weeks. Thus the miscarriage rate for a single pregnancy is 10-15%. But in most of the time this mishap does not recur in future. We call it 'sporadic miscarriage' and often the cause is not known. But almost 1% of the couples who wamt to get pregnant may suffer from repeated miscarriage. That means the unfortunate events can repeat. These are called 'RECURRENT MISCARRIAGE' or 'REPEATED PREGNANCY LOSS *RPL).

CAUSES

So, what's the reason for RPL which is equally frustrating for the patients as well as the doctors? First of all let me honestly confess that in most of the cases the cause is not known (50-60%) and this is called 'UNEXPLAINED RPL'. Again we have to admit that despite tremendous advancement in science, the knowledge behind RPL is limited. Many theories and causes have ben proposed but most of them could not withstand the taste of time. That means if a problem is found in husband or wife, we are not certain whether the treatment of that problem will prevent future miscarriage. This should be explained properly to the couples to have realistic expectations and avoid unnecessary frustration s in future. Only factors which are definitely associated with RPL are only two- anti-phospholipid antibody syndrome (APS) and chromosomal problem of either of the couples. Detection and treatment of these problems are often rewarding as after treatment pregnancy continuation rate us very high. The other causes have been proposed but as mentioned above the link between RPL and these causes are not yet very clear and need further scientific research. Please remember according to the timing, RPL may be divided into two categories- the 1st trimester RPL (occurring before 12 weeks in each pregnancy) or second trimester RPL (12-20 weeks in each pregnancy).

4-5% cases may be due to genetic or chromosomal problem of the couples. These problems can affect the egg (ovum) and/or the sperms. Even if the couples are normal, the baby may have abnormal chromosome.It is blessing that a genetically abnormal baby is miscarried by the nature, otherwise if it survives there is high chance that it may be mentally or physically handicapped. The reason may be increased age of the mother (above 35 years especially), exposure of mother to some environmental pollutants or sometimes increased age of the father (the latter is controversial). The diagnosis is done by chromosomal analysis of the couple by Karyotyping or FISH from blood samples. If the baby has been miscarried, it may be rational to send the tissue of the baby for chromosomal analysis to find iut the cause. The treatment option in next pregnancy in such cases is genetic counseling by an expert and in most cases unfortunately ine option remains- that us IVF and PGD (pre implantation genetic diagnosis) where only genetically tested normal embryos are transferred by IVF ('test tube baby').

Anatomical factors are responsible for 12-15% if RPL, in most cases the second trimester RPL. The most common cause is 'CERVICAL INCOMPETENCE'. The cervix is the mouth of the uterus which should remain closed in pregnancy to support pregnancy and should only open during delivery. But in some cases it xan open prematurely leading to miscarriage. Usually this causes apparently painless miscarriage. In many women fibroid is found as a tumour of uterus. Whether fibroids cause RPL is again very controversial among the scientists and doctors. In some women who had repeated abortion or surgery to uterus and even tuberculosis (TB) there may be adhesion (binding together) between the walks of uterus. This is called Asherman Syndrome which causes scanty or absent periods and RPL. In few women there may be Congenital Anomaly of the uterus- that is yhere is some abnormalities inside uterus from birth. Thesr xan sometimes caus RPL, although controversial. These anatomical problems are diagnosed by proper examination, some tests like HSG (hystero salpingogram), SSG (sono salpingogram), 3D ultrasonography (USG), MRI, hysteroscopy and/or laparoscopy, depending on the women and test results. The treatment should be dobe cautiously as treatment may not always prevent RPL. For cervical incompetence usually we put stitch in the cervix in pregnancy or sometimes before pregnancy. Operation xan be done, before pregnancy for fibroids, Asherman and congenital anomalies.

In many cases (more than 70%) cases hormonal problems may be there and these may cause both 1st and 2nd trimester RPL. However whether treatment us beneficial or not, is again controversial. The commonest pattern is Luteal Phase Deficiency (LPD) due to deficiency of hormone progesterone. PCOS (Polycystic Ovaries) is also asdociated with RPL. The other causes are uncontrolled diabetes, thyroid problems, high prolactin and high testosterone, high insulin and low ovarian reserve. As mentioned earlier, it is not clear whether they all need testing and treatment but usually tests advised for these are blood for progesterone, TSH, Prolactin, FSH, LH, AMH, Insulin, Testosterone, sugar, HbA1C etc. Treatment is usually progesterone supplement along with correction of hormonal imbalance. It is to be mentioned that these patients need high dose of thyroid drugs (TSH normal for other people may be considered abnormal for RPL) and more tight control of blood sugar in diabetes.

In 60-70% cases the cause is Thrombolphilia, that is tendency to thrombosis or blood clotting. The most common is anti phospholipid antibofy syndrome (APS) which nay or may not be associated with thrombosis in other sites but can cause thrombosis if blood supply to the baby and thus causes stopage of its heart and miscarriage. Although more common in the Western World, some Hereditary Thrombolphilia may be found in other family members and commonly cause miscarriage and thrombosis. Deficiency of folic acid and vitamin B12 rarely xan cause thrombosis and RPL. The APS testing is often successful, so as the treatment with aspirin and heparin injection throughout pregnancy. With this 80% women can expect full term pregnancy. Folic acid and B12 vitamin supplement is commonly given to RPL patients. Whether testing for hereditary thrombophilia is needed in our country ir not is controversial. But treatment is like APS- that is aspirin and heparin injection.

Diseases of mother like diabetes, epilepsy, liver or kidney diseases, SLE etc can cause miscarriage. Exposure of mother to harmful substances like environmental pollution, radiation, chemotherapy and some toxic drugs, smoking, alcohol, cocaine, cannabis etc are alse responsible but the latter usually cause sporadic miscarriage rather than RPL. So these drugs should be stopped and replaced by safer drugs anf the diseases mudt be treated properly. Even exposure of father to some drugs can cause RPL. Again some abnormalities of sperms may cause RPL. So, semen analysis of the husband is usually done as a test for RPL.

The most controversial topic for RPL is the infections. But itbis the fact proved by scientific studies that only infection in current pregnancy causes miscarriage. So infection is a cause of sporadic miscarriage, not RPL. In the past TORCH testing was very much popular but nowadays it is obsolete test and there is no scientific ground for tests or treatment of TORCH. Only test we recommend is rubella testing. If rubella IgG is negative that means you may get infection in pregnancy so we advice to take rubella vaccine and avoid pregnancy for one month. On the other hand, rubella IgG positive neans you are already imune and thus you can never get rubella. So vaccine is not useful in those cases. If any genital infection is found in husband or wife, both if them should be tested and treated aggressively.

TESTS REQUIRED

First of all we ned to know when we should advise tests. Assuming that most cases of miscarriages are SPORADIC, we usually di not advise investigation after single miscarriage unless the couple insists or there is some reason by the doctor to suspect some abnormalities that might cause future miscarriage. In the past testing was started after 3 miscarriages. But nowadays we do not want to give the couple, especially the woman a third trauma. So we usually advise tests after 2nd miscarriage. The tests usually start with checking for chromosome of the baby. It is followed by chromosome analysis of both the partners along with proper history taking and physical examination. Semen analysis us fone for the husband. The wife is advised ultrasonography, routine blood, thyroid testing, testing for APS and blood group. These are tests usually dine everywhere. Further tests are done depending on the results if initial tests ans0d especially if no cause us found after initial tests. It should be mentioned to the couples that the 2nd group if tests often do not have scientific grounds and are done only on benefit of doubt. They may not change the management plan. TORCH test is not done in modern era.

TREATMENT

The basic treatment is support if the couples, reducing stress as stress can be responsible for RPL. When a cause is found this should be treated. While an optimistic approach should be taken with expectations for normal pregnancy in future but this should be based on scientific and realistic approach to avoid future frustration. The treatment may not be 100% effective and most treatment may not have scientific base but are usually not harmful. Treatment may not guarantee a successful future pregnancy but a positive attitude is necessary. This is called TENDER LOVING CARE (TLC) where proper support and discussion can help more than explanation if mere statistics. Treatment should be continued both before and after pregnancy confirmation, as mentioned above. This isbto be mentioned thst even after 6th miscarriage, the chance that future pregnancy will be normal is more than 50%. So, the message should be not to give up hope.


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