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    Month: March 2020

    16March 2020

    FROZEN SHOULDER: WHAT IT IS?

    Have you ever experienced shoulder pain just after waking up in the morning? Or your shoulder gets stiff after 2-3 hours of mobilization. A condition of shoulder joint accompanied by stiffness, tenderness, and pain in your shoulder joint. This condition is also known as ‘adhesive capsulitis‘. Generally, it occurs due to inflammation of the synovial capsule. Most of the time the symptoms occur and get worsen. It takes about two to three years to get normal if left untreated.

     

    How did it feel to have a frozen shoulder?

    Frozen shoulders develop gradually. It has 3 stages each stretches to 3-4 months.

    • Freezing stage – The range of motion from the shoulder gets limited. Shoulder movements are painful.
    • Frozen stage – Pain may get reduce but, your shoulder gets more stuff and movement gets more difficult from the shoulder joint.
    • Thawing stage – Reliving stage pain reduced and range of motion improves.

    Pain may get worsen during night and interrupt sleep.

    Are you at risk of developing a frozen shoulder?

    The joint at the shoulder is encased in a capsule; this capsule gets inflamed and tightens restricting the movement.

    Causes aren’t sure that why it happens, however, some people are at risk:

    1. Age and sex – Age more than 40 years, mostly women are at risk of getting frozen shoulder.
    2. Compromised mobility – People who’ve had compromised mobility of the shoulder. The following are the conditions: Rotator cuff injury, broken arm, Stroke, Recovery from surgery, Systemic diseases.
    3. Some disease conditions likely to aid in frozen shoulder.
    • Diabetes.
    • Hyperthyroidism
    • hypothyroidism
    • Tuberculosis
    • Parkinson’s disease

    How you can prevent it?

    Regular exercise – If you have any risky condition. Then talk to your doctor for a minimum range of motion you can practice preventing it.

     

    How you will get it diagnosed?

    1. Physical examination — during this doctor ask you to do a range of motion by own then he will move your hand checking range of motion. Active and passive range motion both are affected in this condition.
    2. Usually, signs and symptoms are enough to diagnose. But a doctor can advise radiological tests — X-rays or an MRI — to rule out problems.

    What are the treatments for frozen shoulder?

    • The first aim of treatment is to control pain and preserving the range of motion of the shoulder.
    • Medications- anti analgesic and anti-inflammatory drugs given to relieve pain.
    • Therapy- Physiotherapist teach you a range of motion to restore movement.
    • Surgical and other procedures

    Most of the time frozen shoulder gets better on its own. For frequent and persistent condition your doctor may suggest

    • Steroid injections – in the shoulder joint.
    • Joint distension – by injecting sterile water in a joint to stretch the tissue for good movement.
    • Shoulder manipulation – The doctor moves the shoulder in a different direction to relieve tightness of joint
    • Shoulder Arthroscopy Surgery – If the above methods are not helping you, your doctor may recommend surgery to take out scar tissue and adhesion of joint.

     

    A surgeon performs this surgery with the tubular camera having attached light to examine or repair the tissues inside or around your shoulder joint and with minimally invasive procedure scar and adhesion is removed with the help of arthroscopy. The camera displays pictures on a video monitor and the surgeon uses these images to guide miniature surgical instruments. Along with the endoscopic camera system, an endoscope trolley is also needed to place instruments and monitor. Endoscope trolley helps in minimizing the extra burden to arrange the endoscopy devices like LED cold light, CO2, Suction irrigation, Monitor with MIS instruments.

    After surgery, after two weeks you can resume a normal routine life. The procedure is easy and heals fast.

    16March 2020

    BAD OBSTETRICAL HISTORY: NEED TO CONSULT

     

    Conceiving or getting news of carrying a life inside you is news of immense pleasure. But if it is holding for long and your body expels it out? You may question yourself!  Why you are not conceiving? Why is your womb not holding your baby? Your uterus may be diseased and not helping your pregnancy. The reason for this can be Endometriosis.

    What is Endometriosis?

    A disease condition in which the inner lining of the uterus called endometrium gets hypertrophied and come outside the uterus.

    Symptoms of Endometriosis?

    • Painful periods (dysmenorrhea) Cramping of lower abdomen and pelvis you may experience lower back pain during menstruation.
    • Painful intercourse. Pain during or after you become intimate happens in Endometriosis.
    • Pain with motion or urination.
    • More bleeding. Bleeding during menstruation or in-between two cycles of menstruation.
    • Not conceiving or abortion.

    How it get diagnosed?

    Your doctor will ask for symptoms you are facing.

    1. Pelvic exam. Manually examining pelvis with finger to check pelvis abnormalities.
    2. Ultrasound. This test checks the inside of the organ for any abnormal growth.
    3. Magnetic resonance imaging (MRI) – helps to find images of an organ
    4. Laparoscopy. Your doctor may advise you to a surgeon to perform a procedure that provides the surgeon to visualize your abdomen (laparoscopy).

    How laparoscopy is performed for Endometriosis?

    • A laparoscope is an endoscope that is a tubular, slender metallic, lighted telescope. These laparoscopes are sometimes highly equipped with hot and cold light, laparoscopy suction and irrigation pump. It allows your doctor to view inside your body cavity or organ. Diagnostic laparoscopy can diagnose if you are having condition or fibroids.
    • Laparoscopy can be for treatment also. With miniature instruments. Your doctor may do many surgeries.
    • Let’s have a look to the laparoscopic procedure,
    • Laparoscopy is an indoor basis procedure. You have to get admitted for laparoscopy.
    • Anaesthesia- is performed under general anaesthesia. So patients get back to their senses in 4-5 hours.
      You have to be nill by mouth for at least 12 hours.
    • After all procedure work. The surgeon makes tiny incisions and inflate the abdomen then insert laparoscope with the camera to visualize cavity. Many times these laparoscopes are equipped with laparoscopic suction irrigation pump to wash and clean areas to visualize. Normal saline is put inside with the help of irrigation pump and then with laparoscopic suction pump, it is taken out.
    • During laparoscopic surgery, a mini instrument is inserted in another incision. To wash the bleeding during surgery laparoscopic suction irrigation pump is very useful to have a clear image on the monitor. Your surgeon, may cut, remove tissue (excision) or burn it with a laser beam or electrocautery.

     

    When you are facing tremendous pain (unexplained) in lower abdomen and back. Consult you, a gynaecologist. It’s a matter of concern. Add wings to your womb and make it healthy. The laparoscopic test provides direct visualization of organs.

    11March 2020

    ASHERMAN SYNDROME: ALL YOU NEED TO KNOW.

    Are you having absent periods? Getting cramps but not menstruating? And you have a history of frequent abortion, injury or any scaring. Then you may need to see a gynecologist. You may be suffering from ASHERMAN syndrome.

    What is known as asherman syndrome?

    Asherman syndrome is an uncommon uterine condition. In which scaring of the inner wall of uterus causing adhesion of anterior and posterior wall of the uterus. It may vary from mild to severe. Depending on areas of adhesion and type of adhesion (thick or thin). This condition leaves very little space in the uterus.

    Presented with what kind of symptoms?

    • absent periods or very light periods (amenorrhea or hypo menorrhea)
    • severe cramps during the period date but menstruating sparsely
    • unable to get pregnant

    What is the cause or risk factor of asherman syndrome?

    Near about 90 percent of Asherman syndrome cases occur due to dilation and curettage (D and C) procedures. D &C is usually done for missed abortion, elective abortion, retained placenta after delivery or incomplete abortion.

    If a woman undergone D&C many times then it’s a high risk that a woman may develop asherma syndrome.

    Sometimes adhesions can happen following pelvic surgeries, like a caesarean section or surgeries of uterine or ovarian cyst, fibroid or polyp.

     

    How do I get diagnosed with asherman syndrome?

    • Assessing the symptom you have
    • A blood test to evaluate other illnesses.
    • Ultrasonography.

    Hysteroscopy is the final diagnostic procedure for asherman syndrome. The procedure involves dilatation of the cervix and inserting a hysteroscope. A small slender telescope. It can help to view inside of the womb for any scaring.

    Hysterosalpingogram, inject dye and imaging it’s a pathway in uterine cavity on x-ray.

     

    How to get it treated?

    Operative Hysteroscopy (minimally invasive surgery):

    Asherman syndrome can be treated by using minimally invasive surgery known as an operative hysteroscopy. Minimal invasive surgical instruments are attached to the Hysteroscope (endoscopic surgery instrument) used to separate adhesions. This minimally invasive surgery is performed under general anesthesia.

    Antibiotics and estrogen tablets after surgery. A repeat hysteroscopy (endoscopic procedure) may be done after a few days to check the uterus condition.

    Why Operative Hysteroscopy to be performed for asherman syndrome?

    Operative Hysteroscopy (minimally invasive surgery) is the only technique to remove scaring and improve uterine quality. If you want to conceive and you have to scare of uterus you have to undergo the procedure.

    Usually done on an outpatient basis.

    It’s a minimally invasive surgery, making it tolerable and acceptable to the patient.

    Getting a life inside you is a matter of immense pleasurable feeling. Consult you, gynecologist, if you are having a recurrent abortion. This minimally invasive surgery can do wonder in your life. Visit our site for more information http://diasurge.com

    2March 2020

    EMBEDDED IUDS: DIAGNOSIS AND REMOVAL OF IUDS

    Contraception is the requirement of today’s world. Your gynecologist may help you in choosing methods of contraception best suited for you. These methods are different for different people. Efficiency is also different for every method. Its failure is an emergency as it may result in conceiving. One of the contraception failures is embedded IUDs (intrauterine devices) or missing thread. The original position of a copper T or hormone-releasing IUD is in the fundal wall of the uterine spaces. Its malpositioning is a failure and needs to be checked.

    What are IUDs?

    These are intrauterine devices placed in the uterine cavity by experts to prevent pregnancy. These are usually “T” shaped loaded with copper and hormones. Placement is generally at the fundus of the uterus.

    What is the malpositioning of IUDs?

    The IUD should be placed at the fundus of the uterus, with the arms of IUD fully separated and stretched toward the uterine cornua. The vertical portion of the “T” should extend straight in the uterine cavity. Malpositioned IUDs may be described as follows:

    Located in the lower uterine segment or cervix.

    Rotated. See the below figure

     

    Embedded in the myometrium (inner wall of the uterus) one or both arm of IUDs. See the figure below.

     

    Partially expelled, if the lower part of IUD is out of cervical external os.

    Protruding outside the uterine serosa or wall and entering the abdominal cavity (perforation of the uterus).

    What are the Symptoms of embedded IUD?

    An IUD displacement, expulsion or embedded may cause physical symptoms in some cases, these are the following:

    • Heavy bleeding.
    • Severe cramping.
    • Abnormal vaginal discharge.
    • Sudden lower abdomen pain.

    How IUDs can be removed?

    IUD removal is a very easy procedure done by experts on an indoor basis. To remove the IUD, the gynecologist holds the thread by forceps and pulls it out. If it doesn’t come out by this method then it may require hysteroscopy to visualize and to take it out.

    How hysteroscopy is performed?

    You may require a hysteroscopy to remove the IUD when it gets hooked in your uterine wall. It’s a non – invasive procedure. During this method, your doctor will apply speculum to make space in your genital cervix to insert a Hysteroscope. The Hysteroscope allows tiny tools to enter your uterus to pick up IUD and take it out. You may need anesthesia for this method.

    A missing thread can be managed calmly. Don’t panic and consult your doctor for its removal. Hysteroscopy is available at many gynecological clinics. For further information regarding endoscopes please visit:- http://diasurge.com/