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Let Prevent Cervical cancer

Posted on by Kajal mangukiya

Cervical cancer is a type of cancer that occurs in the cells of the cervix — the lower part of the uterus that connects to the vagina.
Various strains of the human papillomavirus (HPV), a sexually transmitted infection, play a role in causing most cervical cancer.

When exposed to HPV, the body’s immune system typically prevents the virus from doing harm. In a small percentage of people, however, the virus survives for years, contributing to the process that causes some cervical cells to become cancer cells.
You can reduce your risk of developing cervical cancer by having screening tests and receiving a vaccine that protects against HPV infection.

Symptoms

Early-stage cervical cancer generally produces no signs or symptoms.
Signs and symptoms of more-advanced cervical cancer include:
    •    Vaginal bleeding after intercourse, between periods or after menopause
    •    Watery, bloody vaginal discharge that may be heavy and have a foul odor
    •    Pelvic pain or pain during intercourse
 

Causes

Cervical cancer begins when healthy cells in the cervix develop changes (mutations) in their DNA. A cell’s DNA contains the instructions that tell a cell what to do.

Healthy cells grow and multiply at a set rate, eventually dying at a set time. The mutations tell the cells to grow and multiply out of control, and they don’t die. The accumulating abnormal cells form a mass (tumor). Cancer cells invade nearby tissues and can break off from a tumor to spread (metastasize) elsewhere in the body.
It isn’t clear what causes cervical cancer, but it’s certain that HPV plays a role. HPV is very common, and most people with the virus never develop cancer. This means other factors — such as your environment or your lifestyle choices — also determine whether you’ll develop cervical cancer.

Types of cervical cancer
The type of cervical cancer that you have helps determine your prognosis and treatment. The main types of cervical cancer are:
    •    Squamous cell carcinoma. This type of cervical cancer begins in the thin, flat cells (squamous cells) lining the outer part of the cervix, which projects into the vagina. Most cervical cancers are squamous cell carcinomas.
    •    Adenocarcinoma. This type of cervical cancer begins in the column-shaped glandular cells that line the cervical canal.
Sometimes, both types of cells are involved in cervical cancer. Very rarely, cancer occurs in other cells in the cervix.
 

Risk factors:
Risk factors for cervical cancer include:
    •    Many sexual partners. The greater your number of sexual partners — and the greater your partner’s number of sexual partners — the greater your chance of acquiring HPV.
    •    Early sexual activity. Having sex at an early age increases your risk of HPV.
    •    Other sexually transmitted infections (STIs). Having other STIs — such as chlamydia, gonorrhea, syphilis and HIV/AIDS — increases your risk of HPV.
    •    A weakened immune system. You may be more likely to develop cervical cancer if your immune system is weakened by another health condition and you have HPV.
    •    Smoking. Smoking is associated with squamous cell cervical cancer.
    •    Exposure to miscarriage prevention drug. If your mother took a drug called diethylstilbestrol (DES) while pregnant in the 1950s, you may have an increased risk of a certain type of cervical cancer called clear cell adenocarcinoma.
 

Prevention:
To reduce your risk of cervical cancer:
    •    Ask your doctor about the HPV vaccine. Receiving a vaccination to prevent HPV infection may reduce your risk of cervical cancer and other HPV-related cancers. Ask your doctor whether an HPV vaccine is appropriate for you.
    •    Have routine Pap tests. Pap tests can detect precancerous conditions of the cervix, so they can be monitored or treated in order to prevent cervical cancer. Most medical organizations suggest beginning routine Pap tests at age 21 and repeating them every few years.
    •    Practice safe sex. Reduce your risk of cervical cancer by taking measures to prevent sexually transmitted infections, such as using a condom every time you have sex and limiting the number of sexual partners you have.
    •    Don’t smoke. If you don’t smoke, don’t start. If you do smoke, talk to your doctor about strategies to help you quit.

Challenge and problems are a part of life. It gives me Satisfaction to provide the best solutions to everyone and happiness to the patients

Posted on by Kajal mangukiya

One year ago, a 32 years old female, married since 10years came to orkid hospital and IVF center with 5th pregnancy and complaint of missed abortion including past history of recurrent spontaneous miscarriage. Dr. Kajal Mangukiya advised the patient to go for D&E procedure to clear the retained products of conception.
Moreover, the distressed couple also wanted to know the reason behind this problem and desperately needed a way out. Our expert consultant obstetrician Dr. Kajal Mangukiya advised the patient to go for particular tests done for her recurrent pregnancy losses to rule out the exact cause of such mishappenings. It was a shocking news that the reports indicated HbA1C of 13.9 and RBS was 450mg/dl. Thus with the years experience and knowledge of our consultant obstetrician and gynaecologist ruled out that she was a chronic type 2 diabetes mellitus which could be the reason behind previous recurrent abortion. She was then referred to specialist consultant of endocrinology, Dr. Pradeep Dalwadi and started appropriate treatment to control her chronic diabetes. After bringing the HbA1C value to less than 7, our senior consultant Dr. Kajal Mangukiya did the routine sonography and found second part of hurdle that her antral follicle count was very low which suggested poor ovarian reserve. Hence, with the knowledge and experience of 16years our infertility specialist  Dr. Kajal Mangukiya advised the patient that her best possible treatment option is to go for IVF and without any hesitations, the couple agreed as they had full faith on our consultant Dr. Kajal Mangukiya. The patient conceived in the first cycle itself at orkid hospital and IVF center. However, this wasn’t all. As she came positive in her pregnancy test, this case was categorised as high risk pregnancy with advanced age and bad obstetric history. Additionally, with constant monitoring and regular check ups, the pregnancy went by uneventful. However, she developed preterm rupture of membranes. Hence, she was taken for emergency cessarian section and delivered healthy baby girl weighing 2kgs. Even with preterm delivery, the baby showed no signs of distress and mother is also stable with controlled glucose levels.

“Once you choose hope, anything’s possible”

Male Infertility – Everything You Should Be Aware Of!

Posted on by Kajal mangukiya

Infertility is defined as a condition where a woman is unable to conceive a child despite having 1-2 years of unprotected sexual intercourse with a male partner but help for conception can be sought after 6 months of trying pregnancy. In over half the cases, infertility is usually with the male partner which is characterised by a low sperm count.

Infertility causes social anxiety as well as relationship problems among couples and can severely affect the self-esteem of the person.

Symptoms

Male infertility tends to have certain tell tale signs some cases or no apparent reasons in other cases. In some cases, male infertility occurs due to underlying medical conditions like genetic problems, widened veins around the testicle or hormonal imbalances and some of the symptoms could be like:

  • Recurrent problems during sexual intercourse due to severe pain in the testicular zone.
  • You might lose your ability to smell due multiple instances of infections of the respiratory system.
  • There might be a reduction in the body hair.
  • Abnormal sperm count.
  • Lack of sexual desire.

Causes

Some of the common causes of male infertility could be:

  • Past injury or surgery of the testicles
  • Erectile dysfunction
  • Premature ejaculation
  • Sexually transmitted infections
  • Testicular deformation along with low sperm count
  • Blockage of the ejaculatory

In other cases, the reasons could be:

  • Obesity
  • Old age
  • Mental anxiety
  • Excessive alcohol consumption
  • Diabetes or as a
  • Side effect of radiation therapy
  • Prescribed medications to treat other existing ailments within the body

Diagnosis and Treatment

The infertility of the male partner is usually diagnosed by your specialist by evaluating the medical condition and past histories of surgical procedures, sexual practices etc. Infertility can also be diagnosed by analysing the semen.
The treatments for male infertility are varied and depend on the severity and the exact cause of the condition. Male infertility can be treated by hormonal replacement therapies and procedures, counselling or medication (for erectile dysfunction and premature ejaculation) and procedures to retrieve sperm which is then used for artificial insemination.

TORCH TEST

Posted on by Kajal mangukiya

The TORCH test in gynecology refers to a group of tests used to screen for certain infectious diseases that can be harmful to a developing fetus. The acronym TORCH stands for:

T – Toxoplasmosis
O – Other (syphilis, varicella-zoster, parvovirus B19)
R – Rubella (German Measles)
C – Cytomegalovirus (CMV)
H – Herpes simplex virus (HSV)

These tests are typically performed on pregnant women to determine if they have been infected with any of these viruses, as some of these infections can cause serious harm to the developing fetus. The screening typically involves a blood test to detect the presence of antibodies to these viruses, and in some cases, additional tests may be performed to confirm the results. If a woman tests positive for any of these viruses, her healthcare provider will discuss the options available to minimize the risk of harm to the fetus.

The TORCH test is a screening test performed on pregnant women to check for exposure to certain infectious diseases that can harm the developing fetus. Here’s a more in-depth look at each of the infections included in the TORCH test:

Toxoplasmosis:

This is a parasitic infection that can be contracted by eating undercooked meat, exposure to infected cat feces, or through contaminated soil or water. If a woman contracts this infection during pregnancy, it can lead to serious birth defects, including brain damage, hearing and vision loss, and more.

Other:

This category includes infections such as syphilis, varicella-zoster (chickenpox), and parvovirus B19. Syphilis can cause serious harm to the developing fetus, including birth defects and stillbirth. Varicella-zoster can lead to birth defects such as skin scarring, limb abnormalities, and more. Parvovirus B19 can cause a condition called fetal anemia, which can lead to serious health problems for the fetus.

Rubella (German Measles):

This is a highly contagious viral infection that can cause birth defects if a woman contracts it during pregnancy, including deafness, heart defects, and intellectual disability.

Cytomegalovirus (CMV):

This is a common viral infection that is usually harmless in healthy individuals but can cause serious health problems in a developing fetus, including birth defects and intellectual disability.

Herpes simplex virus (HSV):

This virus can be transmitted to the fetus during delivery and can lead to serious health problems, including brain damage and death.

PRIMARY AMENORRHEA DUE TO A RARE CONDITION CALLED MRKH SYNDROME

Posted on by Kajal mangukiya

Girls with MRKH have normal external female genitalia with a markedly shortened vagina. In some cases, uterine remnants are present with or without endometrium. All patients with MRKH have normally functioning ovaries, although they are sometimes found in atypical locations. MRKH is not uncommon & has an incidence of approximately one in 4000-5000 female births. It is typically diagnosed during adolescence, during workup and evaluation for primary amenorrhea which is defined as absence of menses at the age of 15 regardless of secondary sexual characteristics.

There are two types of MRKH,

Type1 MRKH – Isolated Mullerian agenesis
Type2 MRKH – Mullerian agenesis with another associated congenital anomaly

Evaluation of primary amenorrhea
When menstruation has not occurred by:
• By age 15
• 3 years after thelarche
• By age 13 & lack of breast development
• By age 14 with signs of hirsutism
• By age 14 with h/o painful intercourse or examination suggesting short vagina.

History:
⁃ CNS symptoms
⁃ Pubertal development
⁃ Obstructive symptoms
⁃ Symptoms of Hyperandrogenism
⁃ Stress, diet or exercise changed
⁃ Medication

Physical examination:
⁃ Growth curves
⁃ Tanner stages
⁃ External genital exam
⁃ Skin for hirsutism, acne or/& striae
⁃ Turner stigmata

Pelvic ultrasound
Laboratory investigations:
⁃ UPT (urine pregnancy test)
⁃ FSH, E2, TSH
⁃ Serum Testosterone
⁃ Karyotyping

Genital Examination
• External inspection
• Labial traction
• Lubricated Q-tip to evaluate depth (if tolerated by the patient)
• No speculum (with suspected vaginal agenesis)

Differential Diagnosis for a patient with primary amenorrhea & a shortened vagina
1. Obstructing vaginal or uterine anomalies
2. Imperforated hymen
3. Transverse vaginal septum
4. Distal vaginal agenesis
5. Complete androgen insensitivity syndrome (i.e difference of sex development)

MRKH Evaluation:
1. Examination, Imagining, Labs
2. Renal ultrasound
3. Spinal x-ray

Q. When to refer to a pediatrician & Adolescent Gynaecologist?
• Psychosocial support and counseling
• Management of uterine remnants
• Vaginal creation
• Fertility counseling