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Case Study | Sameena: A Tongue Cancer Survivor
Sep 2, 2019|Dr Harsimran Singh

Case Study | Sameena: A Tongue Cancer Survivor

Background & Early Signs

Sameena is a 32-year-old, mother of 5 children. She has fought a successful battle against advanced oral(mouth) cancer, enduring complex treatment consisting of Radical Surgery followed by Chemo radiotherapy. She is now free of cancer and back to her normal life.

Sameena had been a tobacco user (she consumed ‘Gutka’) for close to 15 years, consuming it intermittently without her family’s knowledge. In November 2018 she developed a blister in her mouth. It was irritating her, but she thought it would go away. A week passed. Then two. And it didn’t. She saw some Doctors locally who gave her symptomatic medicines, but the blister didn’t heal.

So, she took matters into her own hands and massaged it vigorously causing it to burst. It broke up into a thousand of fragments inside her mouth and spread in her mouth and throat and she started experiencing pain.

Till that time, she had not spoken about it to her husband. But when the problem spread and she was in pain and discomfort, she told her husband. They visited a government hospital in Delhi who took a skin swab from the affected area and did a biopsy. The results of the tests were not good. Sameena was told that she had oral cancer. Life stopped that day for Sameena and her family.

Oral Cancer

India has the largest number of Oral (Mouth) Cancer patients, due to the rampant habit of tobacco chewing. Oral Cancer is described as cancer occurring in Buccal (cheek), tongue, floor of the mouth, jawbone and palate. Rampant smoking and alcohol abuse also contribute to the occurrence of oral cancer. Majority of times the formation of oral cancer is preceded by certain changes like difficulty in mouth opening, white or red coloured patches and/or presence of ulcers that do not respond to conventional treatment. There is a myth hat if we touch the cancerous area by way of any surgical methods including even a biopsy, it will spread, “Ched diya to badh Jayega.” These leads to the patient seeking alternative or conservative treatment methodology leading to a delay in diagnosis and treatment and at times loss of life as well.

The cure in oral cancer is hardly possible without surgery. Oral cancer surgery has two components, first part is to remove the cancer along with its nodal basin which is the territory of its spread followed by reconstruction or putting back the removed part so that the patient can eat, speak and have a near normal appearance. Early stage oral cancer involves less extensive resection (removal) of the affected area with simple reconstruction measures. But as the stage advances the resection becomes more extensive and reconstruction becomes more complex. Also, at an early stage we can achieve cure with single modality whereas in advance stages, surgery has to be followed by radiation or chemoradiation to achieve cure or prevent recurrence, i.e. multimodality.

When she came to us

Sameena came to us when the ulcer had involved half of her tongue and spread to her neck in form of nodal metastases. Had it spread, beyond the neck, her chances of getting cured from the cancer would have been minimal.  To save her life, surgical intervention was the only way forward. On hearing this, the world crashed down around her and she lost consciousness. The family toiled hard to mobilise resources for her treatment. The disease played havoc with the family’s finances and the children’s education was also interrupted. We subsidised the expenses of the treatment at the CK Birla Hospital as far as possible to support the patient.

Watch the video below as Sameena talks about her journey to recovery.

Surgery

Sameena underwent radical resection of the left half of tongue including the posterior most limit alongwith removal of lymph nodes from both sides of the neck. We used the tissue from the left cheek to reconstruct the tongue. The tongue is a complex and sensitive organ of the body – contributing or directly providing various functions such as tasting, swallowing, breathing, and speaking. Therefore, a tongue surgery for cancer is a complex procedure. The task before the surgeons was not just to get rid of cancer with adequate margins not leaving anything behind but also to replace the lost tongue so that patient can speak and swallow food and get back a life as normal as possible.

The surgery lasted for more than six hours followed by two days in the ICU.  The surgeons did a tracheostomy, (an artificial opening was created in the windpipe) to secure the patient’s breathing during the recovery period. Also, a feeding tube was put through the nose to feed the patient.  The surgery was successfully performed by Surgical Oncologist leading Head & Neck and Breast Oncologist at CK Birla hospital and a Consultant, Surgical Oncology. Sameena was discharged six days after hospitalization. So, within a week, she was able to walk out of the hospital without any assistance and speak as well. For six weeks post-surgery Sameena was on a liquid diet administered through the nasal feeding tube.

Post-Surgery

It is now three months since Sameena has completed her radiation. She is cancer free, eating soft food with decent speech and back to regular daily routine and involved in raising her kids. She has now taken a strong vow to never touch Gutka again.

IUI Treatment
Aug 30, 2019|Dr Tripti Raheja

IUI Treatment

Intrauterine insemination (IUI) is a relatively simple fertility process of inserting the male ready semen through the neck of the female internal reproductive organ (cervix) and into the uterus, close to the process of ovulation.

During IUI, a woman’s eggs are surgically retrieved from her ovaries; inseminated and developed into embryos inside a lab; then transferred into her womb. During IUI, the sperm (whether from your partner or a donor) when it is ready, is inserted into the womb through a soft tube.

IUI treatment

A typical IUI treatment cycle begins at the beginning of your menses and ends after you take a blood pregnancy test, concerning the period after your IUI.

First, you’ll get a blood test on the second or third day of your menses to confirm that you aren’t already pregnant. Your doctors can typically perform a transvaginal ultrasound to look at your uterine lining and your ovarian follicles.

During the weeks before ovulation, your doctor can perform further ultrasounds to make positive that your uterine lining is thickening, and your follicles are growing.

When a minimum of one mature egg (oocyte) on the ultrasound measures over twenty millimetres, ovulation is probably going to happen soon. At now, your doctor may instruct you to require a gonadotrophin trigger shot (which induces ovulation about 36 hours after the injection) and will schedule your IUI.

Or, your doctor may tell you to continue measuring the level of gonadotropin (which peaks 24 to 48 hours before ovulation) in your urine with a nurse at-home test. Once the test indicates that your LH levels have peaked, the IUI is usually performed the following day.

If you’re using sperm from a male partner, he can come to the clinic on the day of your IUI to deposit a sample, and therefore the fertility clinic can prepare it for insemination. This method involves washing it to get rid of unwanted substances like non-motile sperm, white blood cells and prostaglandins (hormone-like chemicals which will cause painful cramping once deposited into the uterus).

If you’re using frozen donor sperms, your clinic will thaw it on the morning of your IUI.

During the IUI, your doctor will insert a speculum into your vagina and thread a thin, versatile tube through your cervix to deposit sperms into your womb.

The entire method sometimes takes about 5 minutes. Your doctor can doubtless advise you to lie down for about ten minutes after the procedure to prevent you from feeling lightheaded or dizzy.

About a week later, several fertility clinics can check your progestogen levels with a blood test to see whether you ovulated around the time of the procedure.

About two weeks after your IUI, you’ll take a blood test to check if you’re pregnant. For most women, this “two-week wait” is the hardest a part of the IUI cycle. It is tempting to read into each symptom you experience. Do your sore breasts mean you’re about to get your period? Or does it mean that you’re pregnant? Solely the blood test can offer official confirmation.

Success rates of IUI

IUI is less invasive and less expensive than I.V.F., it tends to be less effective. Research suggests that women with unexplained infertility have about a 20-to-25-percent probability of getting pregnant over a few cycles. women under 35 years of age who choose to do IUI as a result of they aren’t getting periods often will see success rates as high as 50 % across 3 to 6 cycles.

Desirable Candidate

  • If you or your partner has been diagnosed with infertility, hostile cervical mucus secretion, minor sperm abnormalities or other male disorders, IUI is sometimes a winning option.
  • It also can be used when semen has been frozen due to a husband’s absence or before therapy or radiation therapy.
  • It is more useful in women who are not of advanced maternal age.

Rate of success for women in their 40s

Yes, however, the probabilities of becoming and staying pregnant are lower than they are for women in their 20s or 30s.

Risks

The IUI procedure carries few risks. While there’s a “theoretical” risk of infection with any procedure that involves “introducing something through the vagina and therefore the cervix and into the uterus,” infections are rare.

There is, however, the chance of becoming discouraged given the comparatively low success rates,

the main risk to IUI is that the couple might lose stamina and drop off having not even begun effective medical treatment for infertility “You’ve ought to be prepared for a negative pregnancy test 9 out of 10 times. If you’re ready for that, then IUI is unquestionably the first thanks to going for many of our patients.

The Essence

  • Intrauterine insemination, or IUI, is a non-surgical fertility procedure in which sperm is injected into a woman’s uterus through a thin, flexible catheter.
  • It is timed to occur just before ovulation and takes a few minutes to perform.
  • Women often try IUI before progressing to more expensive and invasive fertility treatments, like in-vitro fertilization, or I.V.F.
  • IUI is a modest intervention with similarly modest results. In the best-case scenarios, success rates can range from a 20 to 50 percent chance of pregnancy throughout a few IUI cycles. So, if it doesn’t work, don’t blame yourself.
  • Your success rate is typically dependent on your age and the reason you’re getting an IUI in the first place.
  • IUI is not supposed to hurt, though you may feel some cramping afterward.
    • After IUI, it’s O.K. to resume normal day to day activities.

Learn more about the IUI process best explained in the video here by Dr. Pankaj Talwar, the best fertility specialist at the CK Birla Hospital in Gurgaon. Book your appointment today!

 

Egg Freezing
Aug 30, 2019|Dr. Akta Bajaj

Egg Freezing

If you want to have a child in the future but are not mentally prepared to conceive right now, then egg freezing may help you keep the options open and become pregnant in the future – once you are ready to start a family.

A woman is most fertile in her 20s and early 30s because this is the time when her ovaries contain many healthy eggs. As the female ages, the quality and quantity of her eggs deteriorate. For the 10 to 15 years before menopause, despite having a regular menstrual cycle, an ovarian function might drop. This is especially so for women in their 40s who are unlikely to produce a healthy pregnancy.

What is Egg Freezing?

Egg freezing (oocyte cryopreservation) is a technique whereby eggs are frozen soon after being collected. To collect and freeze eggs, a woman will go through ovarian stimulation.  The process of Ovarian stimulation involves hormone medications that are undertaken for approximately 10-12 days which assist to stimulate your ovaries. The fertility specialist will explain the best treatment and medication plan for your case.

Commonly, hormone medication involves giving yourself an injection with a small needle under the skin. Do not be afraid, this is nothing to worry about, and your fertility nurse is available to help throughout your treatment. Whilst you are undertaking ovarian stimulation, you will be monitored with blood tests and ultrasounds.

During a normal cycle in a woman’s body, only 1 egg will mature and be released per cycle (ovulation). Ovarian stimulation helps several of the eggs to mature and once matured, they can be collected.

Egg Collection

When your eggs are ready to be collected, you will be asked to go to the hospital for the day procedure where the eggs will be collected from your ovaries. You will have sedation administered by an Anaesthetist. The egg collection (or ‘egg pick up’) procedure takes about 20-30 minutes and you will be asleep during that time. You can opt for your egg to pick up under local anaesthetic upon request.

By the means of advanced ultrasound technology, a Fertility specialist guides a needle into each ovary (eggs are contained in the fluid within the follicles in your ovaries and invisible to the naked eye). The specialist will extract the fluid from the sacs that look like they have grown enough to have an egg inside. Before retrieval, your ultrasound gives a good indication of the number of eggs available for collection, the average number of eggs collected is 8-15.

Your collected eggs will be passed straight on to scientists, scientists will distinguish which eggs are mature enough to be kept, immature eggs do not generate successful pregnancies. Those mature eggs are then frozen via vitrification.

Recovery takes about 30 minutes and you will be able to walk out on your own. However, as with all sedation, you will not be able to drive after the procedure for 24 hours thus bringing a support person with you is recommended.

Using Your Eggs

Frozen eggs can be kept for as long as you wish. When you are ready to use your frozen eggs, contact your fertility specialist to discuss the best plan for you.

When your eggs are ready to be used, they will be thawed by warming quickly to 37 degrees Celsius. Once at 37 degrees, the eggs are ready for insemination by ICSI (Intra Cytoplasmic Sperm Injection) a process whereby a single sperm is injected into the egg. Once the sperm has fertilised the egg, the egg develops into an embryo, and a transfer may occur. Unfortunately, not all eggs will fertilise and reach the embryo stage.

Egg Freezing Success Rates

Specialists explained, as 100% success is not assured, you would want to know your chances of success. Before you go ahead and decide to freeze your eggs, you should know the general success rate and that of the specific IVF centre you are visiting.

Some aspects come into play here. Primarily, egg freezing is a relatively new technology. This means there isn’t a large amount of data available on babies born after egg thawing. Also, the available data does not necessarily connect to your own country. Actually, as this technology is new so there isn’t enough data about any birth defects among babies born after freezing of eggs. The unavailability of long-term statistics makes it difficult to calculate the egg freezing success rates for the procedure.

From the women ‘respective, the most crucial information is regarding the efficacious pregnancy and live birth achieved after thawing of eggs. All-female are concerned about knowing the potential of the frozen eggs to produce a new-born. It means how an egg recovers after thawing and produces an embryo. The miscarriage rates also need to be considered as it is a common occurrence among older women.

In a nutshell, freezing of eggs is an excellent option of fertility preservation in women. There are factors to consider and you should do the necessary research on your behalf as well. You need to know whether it is right for you to use the option or not. You should weigh in the pros and cons of the procedure, before taking any decision.

Consult fertility expert, Dr. (Col.) Pankaj Talwar at the Fertility Department, CK Birla Hospital in Gurgaon to discuss more the egg freezing success rate and the pros and cons of the procedure. Book your appointment today!

 

Exercise Tips During Pregnancy
Aug 30, 2019|Dr. Astha Dayal

Exercise Tips During Pregnancy

Aching back, swollen ankles and insomnia-sounds familiar? In other words, you’re likely to be pregnant!  Is there anything you can do to minimise these uncomfortable symptoms of pregnancy? Turns out, there is exercise. Maintaining a regular exercise routine during the course of your pregnancy can help you stay hale and hearty.

Working out while you’re pregnant provides a lot of health benefits — a mood booster, a diminution in many pregnancies-related uncomfortable symptoms and a speedier postpartum recovery. Some studies have presented that exercise may even cut down a woman’s risk of complications, like preeclampsia and gestational diabetes, significantly

It doesn’t matter if you were an ironwoman or lazybones until now. You can still benefit from getting some exercise during pregnancy. It’s safe, as long as you get the go-ahead from your doctor before hitting any new or familiar workout routine and abide by a few pregnancy-specific revisions.

Is exercise safe during pregnancy?

Overall and in the majority of the cases, exercise is safe during the duration of pregnancy. You should check with your doctor before starting any exercise routine.

Usually, as a rule, if you were physically active before your pregnancy, it can be said that it is safe to remain active during pregnancy. Chances are that your doctor will tell you to continue being active, as long as you are comfortable and there are no former or new health conditions signifying otherwise.

What Are the Benefits of Exercising During Pregnancy?

Undoubtedly, exercise is beneficial for both you and your baby, barring any complications

It can help you:

  • Feel better: Exercise releases endorphins which make you feel better, boost your energy levels and improve your sense of control. Exercising in the right manner can:
    • relieve backaches and improve your posture by toning muscles in your back, butt, and thighs and providing increased strength and balance
    • ease constipation by accelerating bowel movement
    • prevent wear and tear of your joints by stimulating the lubricating fluid in your joints
    • releasing the stress and anxiety, which in turn regulates your sleeping patterns
  • Look better: Exercise increases the blood circulation to your skin, giving you a healthy pregnancy glow.
  • Prepare you and your body for birth: Strong muscles and a fit heart can aid labor and delivery.
  • Regain your pre-pregnancy body more quickly: Maintaining the fitness level is beneficial for your body during and after pregnancy. It helps you shed the additional weight gained during pregnancy easily.

What Are the Best Strength and Flexibility Exercises You Can Do While Pregnant?

Strength workouts help build and tone your muscles. Stronger muscles, in turn, help you to endure the weight you gain throughout your pregnancy and keep your joints from injuries as your ligaments relax. Here are the top strengthening exercises for pregnant women:

  • Weightlifting

A good way to increase your muscle tone when you’re expecting is weightlifting — just go for more reps using a lower weight than usual. You may also want to shift to machines, which bound your range of motion to reduce any chances of injury.

  • Pilates

Pilates routine centres mainly on strengthening your core and lengthening your muscles with low- to no-impact, which will help reduce backaches and develop your posture as well as your flexibility, as long as it is a pregnancy-appropriate routine.

  • Barre

Barre classes — a combination of Pilates, yoga and ballet-inspired moves — are superb for expecting women because they encompass strengthening your lower body and core without much jumping. They also include balance exercises, which help keep you stable as your baby bump throws off your balance. Be sure to inform your instructor that you’re pregnant before you start so he or she can give you modifications for the few exercises that can put extra strain on your abdominal muscles.

  • Yoga

Prenatal yoga is another ideal workout for moms-to-be: It boosts relaxation, flexibility, focus and deep breathing — an all – in – one preparation for the beautiful journey of birth.

Tips for Cardiovascular exercises while you are pregnant

All of these cardiovascular exercises increase blood circulation, tone your muscles and improves your endurance level:

  • Swimming

Swimming and water aerobics are just the ideal pregnancy workout. A dip in the pool aids in relieving nausea, sciatic pain, and swollen ankles. It’s gentle on your loosening joints and ligaments as the baby’s floating along with you.

It is advisable to step or slide into the water compared to diving or jumping in. Your growing baby isn’t prepared to handle the bubbles that form inside the body when you swiftly change altitudes under the pressure of the water. Hence, scuba diving is strictly a no-no.

  • Walking

The simplest exercise to fit into your hectic schedule is walking… and it’s a workout you can carry on right up until your delivery date. You don’t need any special equipment or a gym membership to join in — just a pair of good sneakers.

  • Running

Want to go to a higher level? Trained runners can stay on track for the duration of their pregnancy. Choose to work out on a treadmill or a level terrain and never overdo it as it makes you highly susceptible to injuries.

  • Ellipticals and stair climbers

Both ellipticals and stair climbers are good bets during pregnancy. Adjust speed, incline, and tension according to your comfort levels. Remember that as your pregnancy progresses, you may have a tougher time with resistance and you will need to watch your step to avoid stumbles.

  • Group dance or aerobics classes

Low-impact aerobics and dance workout classes like Zumba are a good way to get your heart rate up and get those endorphins flowing if you’re a rookie exerciser. As your pregnancy progresses, refrain from any activities that require watchful balance.

  • Indoor cycling

If at least six months before pregnancy, you have been spinning, then you should be able to carry on as long as you reduce the intensity of the workout. Indoor cycling can be great exercise, as it allows you to pedal at your own speed without the risk of falling or putting pressure on your ankle and knee joints.

  • Kickboxing

Many expecting kickboxers find they aren’t relatively as lithe or swift as pre-pregnancy, but if you still feel at ease getting your kicks in the ring and you have adequate experience, it’s okay to continue now.

  • High-intensity interval training workouts (HIIT)

High-intensity interval training certainly isn’t for every expecting woman. The workouts, which comprise of more hard-core moves to get your heart rate up followed by periods of rest, are simply too extreme to begin for the first time when you’re expecting.

However, if you’ve been at HIIT for some time and get the go-ahead from your practitioner, classes can be safe with adjustments to your routine, from your instructor.

Keep in mind that there are a multitude of ways to fit in fitness during pregnancy — as well as a few more exercises you shouldn’t do, too. If you’re at all uncertain about what’s safe, connect with our expert gynaecologists about what’s okay and what’s not for you. Whatever you do, try not to be too hard on yourself when it comes to exercising, and don’t forget to relax and enjoy!

Things to know about ACL injury

Things to know about ACL injury

Sports participation results in 70 percent of Anterior Cruciate Ligament (ACL) tears and the majority of these occur in the 15-45-year-old population, but these injuries are also seen commonly in non-sports cases. Majority of ACL injuries are non-contact injuries that occur at the time of sudden change in direction with a planted foot (i.e. cutting) or stopping suddenly.

The ACL is an important stabilising ligament of the knee that provides the hinge to keep the knee stable while moving. When a tear occurs the patient often reports hearing a pop and they usually cannot walk on the injured limb. During the injury it is common for the knee to partially dislocate, resulting in bruising and sometimes a small fracture at the back of the tibia and on the femur.

Females, particularly female athletes are two to eight times more prone to ACL injuries. This is primarily due to mechanical reasons. Another factor that increases the risk of ligament rupture is the interface between the player’s shoes and the ground that results in higher friction. High risk sports include football, basketball, volleyball & hockey.

Preventive programmes are based on analysing the mechanism of injury of ACL ruptures as well as the kinematics of the body position during landing and cutting. The goal is to train the athlete/patient to keep their centre of gravity forward and to encourage better leg rotation and control. These programmes aim reduce the incidence of ACL injuries by up to half.

Athletes and patients with ACL reconstruction often feel that continuing with a knee brace can prevent further such injuries. There is however no evidence to support use of braces in prevention of ACL injuries.

Speak with our orthopaedic expert, Dr. Reetadyuti Mukhopadhyay, Shoulder and Anthroscopy Surgeon, Department of Orthopaedics at the CK Birla Hospital about exercises and programmes to help prevent ACL tears and injuries.

Is pain in the breasts or breast soreness an alarming sign?

Is pain in the breasts or breast soreness an alarming sign?

Breast soreness occurs due to stimulation of breast tissue by elevated estrogen levels which can occur during puberty. Also, during menses, various hormones cause variations in the breast tissue that usually leads to pain (called mastalgia) or uneasiness in some women.

Types of breast pain

Cyclical breast pain is often felt around the time of a woman’s menstrual period. It goes away after her period ends. This type of pain usually occurs in both breasts. It is more common in younger women and often stops after menopause.

Non-cyclical breast pain is not connected to the menstrual cycle. This type of breast pain is more prevalent in women between the age group of 30 and 50 years. It may arise in just one breast.

Pain may be felt in a part of the breast or the full breast. It may also be felt in the upper arm or armpit.

Breast pain may be described as:

  • sharp, stabbing or shooting pain
  • aching or burning
  • heaviness or swelling of the breast

Breast Soreness: can it be a sign of cancer?

Breast pain is usually not associated with breast cancer. It is majorly a sign of a non-cancerous (benign) breast conditions such as:

  • breast cysts
  • fibrocystic breasts
  • fat necrosis
  • mammary duct ectasia
  • breast infection (called mastitis)
  • abscess(puss)s in the breast

Breast pain is only usually linked to breast cancer in advanced stages when skin is involved, or the disease has spread to axilla. Cancer is majorly painless to begin with. Having breast pain or fibrocystic breasts does not mean you are at a higher risk of developing cancer.

What to do when you have breast pain?

  • Use less salt
  • Wear a supportive bra
  • Apply local heat to the painful area
  • Take over-the-counter pain relievers sparingly, as advised by your Doctor
  • Avoid caffeine – Though well-designed studies have not shown any link between avoiding caffeine and incidence of breast pain. However, many women report significant improvement in their symptoms when they reduce their intake of tea, coffee, chocolate, and energy drinks
  • Vitamin E – Studies have do not consistently show benefits of vitamin E for treating breast pain, though some women find it helpful. Using vitamin E for a few weeks to see if it will help is unlikely to cause any harm. However, long-term use of vitamin E supplements is not recommended for breast pain, as there are some studies suggesting this may not be safe
  • Evening primrose oil – Similar to Vitamin E, studies have not consistently shown evening primrose oil to be helpful in treating breast pain, though it does help some women. Evening primrose oil can be procured over the counter. Side effects might include nausea, diarrhoea, and headaches. In the past, there was a concern that certain patients might be at increased risk of seizures when taking this supplement, though this is now disputed.
  • Omega 3 fatty acid – Though not proved conclusively, some women find increased intake of fish oils/omega-3 supplements to be helpful. Natural dietary sources include dark green leafy vegetables, ocean-raised (“wild”) cold-water fish, flax, walnuts, and sesame. Omega-3 supplements are also available by prescription and over the counter.

In most cases, breast pain goes away on its own after a few months, without any treatment.

If in any case the pain persists, then connect with the expert breast surgeon, Dr. Rohan Khandelwal at the Breast Centre, CK Birla Hospital in Gurgaon.

Breast Enlargement

Breast Enlargement

The female breast has been synonymous with femininity and hence a lot of focus has been given to the aesthetics of the organ. The ideal size and shape vary, depending upon the build of the individual and the cultural characteristics. Many a time, breast development does not take place adequately. Therefore, females with smaller than regular breasts feel that they have an uneven figure and they seek a modification through surgery. Breast enlargement is a procedure to make the breasts larger and rectify their shape. This procedure can also be named as breast augmentation or augmentation mammoplasty.  It is, therefore, important that the surgeon also takes into consideration the patient’s desires, when planning an augmentation surgery. Breast augmentation can have a significant positive influence on body image.

Common reasons for breast augmentation: –

  • Restoring breast plumpness lost after pregnancy & breastfeeding
  • Feeling more confident in a swimsuit
  • Enhancing self-image
  • Increase the size of small breasts.
  • Restore fullness and shape that may have been lost due to age.
  • Reconstruct breasts that have been damaged or removed due to injury or illness, such as breast cancer.
  • Create a proportionate balance between the breasts and the rest of the body.

Indications

Many females opt for breast enlargement to rectify hypoplastic breasts. Those who have undergone significant postpartum involution also opt for augmentation, for further improvement. These women have experienced the fullness and want the volume back.

Since the introduction of silicone gel prosthesis in 1962, breast augmentation must turn out to be the most frequently performed procedure in cosmetic surgery.

History

Czerny attempted the first augmentation mammoplasty, in which he transferred a lipoma to the breast, in 1895. Longacre performed autogenous flap augmentation in 1950. Many injectable materials were being tried, since the 1950s. Uchida reported the use of injectable silicone in 1961. The introduction of the silicone gel breast implant in 1962 by Cronin and Gerow initiated the modern era of breast augmentation.

Mammoplasty procedures (also known as breast augmentation procedures) involves the use of saline or silicone implants to create larger and/or fuller breasts. Breast augmentation is among the most sought-after cosmetic procedure available, and the demand continues to rise.

Why seek out a Breast Enlargement Procedure

Some of the most common reasons are: –

While breast enlargement procedure can yield remarkable results, one area that breast augmentation does not address is severely sagging breasts. If a patient has severely low hanging breasts, then a breast lift procedure may be the best option. Breast lift surgery can be performed with breast implants to achieve the desired effect.

There are many options in mammoplasty procedures, and each should be considered carefully before deciding to move forward with the procedure. Options for implants vary by the type of implant (silicone, saline, or cohesive gel), the shape of the implant (round or teardrop-shaped), and the size of the breast implant.

Being informed and having clear expectations during the consultation process is the best way to ensure that a patient will be satisfied with her breast augmentation procedure results.

Technique

Breast augmentation can be performed with saline or silicone gel-filled implants. The implants can be placed through several different incisions. Many factors should be discussed with your physician, such as the size and shape of implants, the location of surgical incisions, and whether the implants should be positioned on the upper part of the breast or beneath the chest muscle.

Recovery

  • You will be sore and will need to rest for the first few days
  • Most women can resume normal activity after a few days
  • You will need to wear a surgical bra or another non-underwire bra for several weeks, till the time the swelling subsides
  • Fertility and pregnancy are unaffected
  • Breastfeeding is usually possible afterwards
  • Sensation to the nipple and areola may be rarely affected

Life After Breast Enlargement

Breast enlargement is an outpatient procedure, typically performed using general anaesthesia. You can walk around on your own within a few hours after the operation, and most patients are comfortable enough in leaving their house within the next day or two.

You may feel sore the first week or so, and you will need to limit strenuous exercise for about 2-4 weeks. Your Doctor may also ask you to opt for a surgical bra or sports bra for a while after breast enlargement surgery—it is important to follow your surgeon’s advice to ensure your recovery optimally.

Once you are done with your breast implants, you’ll have to keep the following points in mind: It’s safe to have mammograms with breast implants, so be sure to maintain regular screening as prescribed by your doctor.

Upcoming pregnancies or weight variations may mark your results, and a second surgery may be needed to correct any changes you are unhappy with over time.

Conclusion

Nobody can break the normal ageing course; over time, breast tissue does change. You can aid in avoiding unnecessary sagging by opting for a bra with suitable support for your activity level.

Breast augmentation is an extremely gratifying aesthetic procedure. When done by a qualified cosmetic surgeon, breast enlargement is a safe procedure with long-lasting results, and most patients are very glad they chose to have the procedure.

Connect with Dr. Rohan Khandelwal, expert in breast surgery at the CK Birla Hospital in Gurgaon to know more about this procedure. He holds one of the largest experiences in oncoplastic breast conservation surgery, autologous primary breast reconstruction with mastectomy. Book your appointment today!

Tubal Ectopic Pregnancy
Aug 30, 2019|Dr. Anjali Kumar

Tubal Ectopic Pregnancy

Normally, after fertilisation, the egg becomes a zygote and develops in the ovary for a certain period before migrating from the ovaries to the uterus through the fallopian tube. In the uterus, the zygote gets implanted in the uterine walls and develops into a full-grown baby gradually.

An ectopic pregnancy is one that grows outside the uterus. An ectopic pregnancy can be life threatening because as the pregnancy gets bigger inside the tube, it can burst (rupture) causing severe pain and internal bleeding.

Incidence

Approximately 2 out of 100 pregnancies turn out to be ectopic.

Causes

The following conditions might increase the chances:

  • History of ectopic pregnancy
  • History of pelvic surgery
  • History of pelvic inflammatory disease
  • Failed tubal ligation
  • Reversal of tubal ligation
  • IVF pregnancy
  • Sexually transmitted disease

Symptoms

In most cases, ectopic pregnancy develops in the initial few weeks of pregnancy only. At times the women may not even know that she is pregnant by the time she is diagnosed with an ectopic pregnancy. The Symptoms of ectopic pregnancy may include:

  • Pain in your lower abdomen. This may develop suddenly or may come gradually. It may be on one side only
  • Vaginal bleeding. You may have some spotting or bleeding
  • Pain in the tip of your shoulder. This pain is experienced if the tube starts to burst and is a suggestion that condition is getting worst. You should seek urgent medical advice if you experience this
  • Severe abdominal pain /collapse- if the tube ruptures suddenly

Diagnosis

The diagnosis can be made based on clinical examination. Pelvic examination, ultrasound findings and blood tests confirming levels of pregnancy hormone HCG.

It can sometime take few days to reach to the diagnosis as presentation can be varied. You may need to attend hospital for serial HCG (pregnancy hormone) levels and ultrasound scan to make a diagnosis.

Treatment

The pregnancy cannot be continued, and all options will be discussed with you to end the pregnancy. Depending at the point of time when the pregnancy is diagnosed, treatment can consist of medication or surgery. In the initial stages of implantation prior to the stage of tubal rupture, medications can be given to inhibit the growth of the zygote which then gets absorbed gradually. In cases which have progressed further, a laparoscopic procedure (keyhole surgery) may be required to remove the ectopic mass. If the fallopian tube is damaged, then the doctor might have to remove the fallopian tubes.

Future after an ectopic pregnancy

There are fair chances that the affected female will have normal subsequent pregnancies. However, it is advisable to consult a doctor before planning for next pregnancy.

Preventive steps

There’s no definite preventive step for ectopic pregnancy. Practicing safe sex, avoiding smoking and alcohol, leading a healthy lifestyle and undergoing regular gynaecological checkup can help in reducing the risk.

Ectopic Pregnancy Doctors at the CK Birla Hospital in Gurgaon to learn more about the condition and treatment options. Book your appointment today!

Ways to Get Rid of Period Cramps
Aug 26, 2019|Dr. Astha Dayal

Ways to Get Rid of Period Cramps

What causes period cramps?

During the menstrual cycle, when the flow is not being expelled in the right manner the female might have abdominal cramps. There are some common reasons why an individual has menstrual cramps.

Pelvic inflammatory diseases

It is an infection of the female reproductive system which is usually caused by sexually transmitted bacteria that spreads from the vagina to the womb (uterus).

Endometriosis 

This is a condition in which the tissues that line the uterus start to grow outside the uterus, mostly on the fallopian tubes or ovaries.

Uterine fibroids

Uterine fibroids are noncancerous growths of the uterus that appear during women’s childbearing years.

Why Are Period Cramps Painful?

Period cramps could be uncomfortable for a variety of reasons. Menstruation is the process in which your uterus sheds its lining every month. While some discomfort is normal during your period, there can be times when the pain can be severe or devastating.

Dysmenorrhea is a condition that causes unpleasant periods. It’s the most prevalent type of menstrual irregularity: Every month, more than half of menstrual women experience pain for at least the first two days. There are two types of menstrual pains

  • Primary dysmenorrhea: Occurs shortly after the first period.
  • Secondary dysmenorrhea: Occurs more common later in life and is generally caused by a reproductive problem.

No matter the level of pain you’re experiencing, there are several ways to reduce the pain.

What food helps period cramps?

Foods Rich in omega 3

Foods rich in omega 3 fatty acids can help reduce inflammation in the body and may help relieve period pain.

Foods rich in omega 3 fatty acids are:-

  • Flaxseeds
  • Walnuts
  • Soybean oil
  • Chia seeds
  • Yogurts
  • Juices
  • Algal Oil

Dark chocolate

Dark chocolate has been considered as one of the snacks that can help relieve the period’s cramps immediately. Dark chocolate gives you that sugar rush needed to relieve the pain. It is both tasty as well as a good source of magnesium and iron.

Beans & legumes

Beans and legumes are high in iron and protein and consuming legumes and beans can help in the menstruation cycle. It is one of those healthy proteins which will keep your stomach full for long hours.

Home Remedies to get relief from menstrual pains

Water

Being hydrated may not restrain your cramps directly but can help with reducing bloating. When you are nearing to your period, it is suggested that you should drink plenty of water. Avoiding alcohol and lowering down the consumption of salt are recommended as these two can pull out water from your system.

Food

Avoiding fried foods (potato chips, doughnuts etc.) can help a lot. It is recommended to go for a diet which is rich is fiber and low fat.

Caffeine

Caffeine can make your cramps worse; you should avoid intake of coffee in any form instead switch to a smoothie packed with veggies.

Painkiller

You can take a painkiller to get relief from the pain, but make sure that these medicines that you might want to take are discussed with your gynecologist before you use them.

Heat as a cure

Usage of heat pads, heat wraps (rechargeable or disposable) can really help to deal with these cramps.

Exercise

Exercise release brain chemicals that can make you feel good. Taking a walk, jumping, yoga, etc. can make you feel good.

Massage

Belly massage can help you feel better It is recommended to use essential oils as they have pain killing compounds.

Acupressure

Touching key parts on your belly, feet, back, fleshy parts between thumb and index finger that can help relive aches and pains, seek help of expert to help you find those points.

Proper sleep

Sleep may be a problem during period because of cramps, you can try different positions to sleep, avoid usage of smartphones during bedtime and focus on following proper bedtime routine.

Bathing

Warm water bath can really help you calm your muscles and mind.