HEADACHE

Pregnancy Induced Hypertension

What Is High Blood Pressure?

Blood pressure is the amount of force exerted by the blood against the walls of the arteries. A person's blood pressure is considered high when the readings are greater than 140 mm Hg systolic (the top number in the blood pressure reading) or 90 mm Hg diastolic (the bottom number). In general, high blood pressure, or hypertension, contributes to the development of coronary heart disease, stroke, heart failure and kidney disease.

What Are the Effects of High Blood Pressure in Pregnancy?

Although many pregnant women with high blood pressure have healthy babies without serious problems, high blood pressure can be dangerous for both the mother and the fetus. Women with pre-existing, or chronic, high blood pressure are more likely to have certain complications during pregnancy than those with normal blood pressure. However, some women develop high blood pressure while they are pregnant (often called gestational hypertension).

The effects of high blood pressure range from mild to severe. High blood pressure can harm the mother's kidneys and other organs, and it can cause low birth weight and early delivery. In the most serious cases, the mother develops preeclampsia - or "toxemia of pregnancy"--which can threaten the lives of both the mother and the fetus.

What Is Preeclampsia?

Preeclampsia is a condition that typically starts after the 20th week of pregnancy and is related to increased blood pressure and protein in the mother's urine (as a result of kidney problems). Preeclampsia affects the placenta, and it can affect the mother's kidney, liver, and brain. When preeclampsia causes seizures, the condition is known as eclampsia--the second leading cause of maternal death in the U.S. Preeclampsia is also a leading cause of fetal complications, which include low birth weight, premature birth, and stillbirth.

There is no proven way to prevent preeclampsia. Most women who develop signs of preeclampsia, however, are closely monitored to lessen or avoid related problems. The only way to "cure" preeclampsia is to deliver the baby.

How Common Are High Blood Pressure and Preeclampsia in Pregnancy?

High blood pressure problems occur in 6 percent to 8 percent of all pregnancies in the U.S., about 70 percent of which are first-time pregnancies. In 1998, more than 146,320 cases of preeclampsia alone were diagnosed.

Although the proportion of pregnancies with gestational hypertension and eclampsia has remained about the same in the U.S. over the past decade, the rate of preeclampsia has increased by nearly one-third. This increase is due in part to a rise in the numbers of older mothers and of multiple births, where preeclampsia occurs more frequently. For example, in 1998 birth rates among women ages 30 to 44 and the number of births to women ages 45 and older were at the highest levels in 3 decades, according to the National Center for Health Statistics. Furthermore, between 1980 and 1998, rates of twin births increased about 50 percent overall and 1,000 percent among women ages 45 to 49; rates of triplet and other higher-order multiple births jumped more than 400 percent overall, and 1,000 percent among women in their 40s.

Who Is More Likely to Develop Preeclampsia?

·         Women with chronic hypertension (high blood pressure before becoming pregnant).

·         Women who developed high blood pressure or preeclampsia during a previous pregnancy, especially if these conditions occurred early in the pregnancy.

·         Women who are obese prior to pregnancy.

·         Pregnant women under the age of 20 or over the age of 40.

·         Women who are pregnant with more than one baby.

·         Women with diabetes, kidney disease, rheumatoid arthritis, lupus, orscleroderma.

What Are the Symptoms of Preeclampsia and How Is It Detected?

Unfortunately, there is no single test to predict or diagnose preeclampsia. Key signs are increased blood pressure and protein in the urine (proteinuria). Other symptoms that seem to occur with preeclampsia includepersistent headaches, blurred vision or sensitivity to light, and abdominal pain.

All of these sensations can be caused by other disorders; they can also occur in healthy pregnancies. Regular visits with your doctor help him or her to track your blood pressure and level of protein in your urine, to order and analyze blood tests that detect signs of preeclampsia, and to monitor fetal development more closely.

How Can Women with High Blood Pressure Prevent Problems During Pregnancy?

If you are thinking about having a baby and you have high blood pressure, talk first to your doctor or nurse. Taking steps to control your blood pressure before and during pregnancy-and getting regular prenatal care-go a long way toward ensuring your well-being and your baby's health.

Before becoming pregnant:

·         Be sure your blood pressure is under control. Lifestyle changes such as limiting your salt intake, participating in regular physical activity, and losing weight if you are overweight can be helpful.

·         Discuss with your doctor how hypertension might affect you and your baby during pregnancy, and what you can do to prevent or lessen problems.

·         If you take medicines for your blood pressure, ask your doctor whether you should change the amount you take or stop taking them during pregnancy. Experts currently recommend avoiding angiotensin-converting enzyme (ACE) inhibitors and Angiotensin II (AII) receptor antagonists during pregnancy; other blood pressure medications may be OK for you to use. Do not, however, stop or change your medicines unless your doctor tells you to do so.

While you are pregnant:

·         Obtain regular prenatal medical care.

·         Avoid alcohol and tobacco.

·         Talk to your doctor about any over-the-counter medications you are taking or are thinking about taking.

Does Hypertension or Preeclampsia During Pregnancy Cause Long-Term Heart and Blood Vessel Problems?

The effects of high blood pressure during pregnancy vary depending on the disorder and other factors. According to the National High Blood Pressure Education Program (NHBPEP), preeclampsia does not in general increase a woman's risk for developing chronic hypertension or other heart-related problems. The NHBPEP also reports that in women with normal blood pressure who develop preeclampsia after the 20th week of their first pregnancy, short-term complications-including increased blood pressure-usually go away within about 6 weeks after delivery.

Some women, however, may be more likely to develop high blood pressure or otherheart disease later in life. More research is needed to determine the long-term health effects of hypertensive disorders in pregnancy and to develop better methods for identifying, diagnosing, and treating women at risk for these conditions.

Even though high blood pressure and related disorders during pregnancy can be serious, most women with high blood pressure and those who develop preeclampsia have successful pregnancies. Obtaining early and regular prenatal care is the most important thing you can do for you and your baby.

 Dr. Sarita Kapoor, MS (Ob & Gyn), Getwell Medical Center, Dubai

Hair Transplant at Getwell Medical Center

Infertility by Dr. Sarita Kapoor, Getwell Medical Center

Infertility

What is infertility?

Infertility means not being able to get pregnant after one year of trying. Or, six months, if a woman is 35 or older. Women who can get pregnant but are unable to stay pregnant may also be infertile.

Is infertility a common problem?

Yes. About 10 percent of women (6.1 million) in the United States ages 15-44 have difficulty getting pregnant or staying pregnant, according to the Centers for Disease Control and Prevention (CDC).

Is infertility just a woman's problem?

No, infertility is not always a woman's problem. Both women and men can have problems that cause infertility. About one-third of infertility cases are caused by women's problems. Another one third of fertility problems are due to the man. The other cases are caused by a mixture of male and female problems or by unknown problems.

What causes infertility in men?

Infertility in men is most often caused by:

·      A problem called varicocele (VAIR-ih-koh-seel). This happens when the veins on a man's testicle(s) are too large. This heats the testicles. The heat can affect the number or shape of the sperm.

·         Movement of the sperm. This may be caused by the shape of the sperm. Sometimes injuries or other damage to the reproductive system block the sperm.

Sometimes a man is born with the problems that affect his sperm. Other times problems start later in life due to illness or injury. For example, cystic fibrosis often causes infertility in men.

What increases a man's risk of infertility?

A man's sperm can be changed by his overall health and lifestyle. Some things that may reduce the health or number of sperm include:

·         heavy alcohol use

·         drugs

·         environmental toxins, including pesticides and lead

·         smoking cigarettes

·         health problems such as mumps, serious conditions like kidney disease, or hormone problems

·         medicines

·         radiation treatment and chemotherapyfor cancer

·         age

What causes infertility in women?

Most cases of female infertility are caused by problems with ovulation. Without ovulation, there are no eggs to be fertilized. Some signs that a woman is not ovulating normally include irregular or absent menstrual periods.

Ovulation problems are often caused bypolycystic ovarian syndrome (PCOS). PCOS is a hormone imbalance problem which can interfere with normal ovulation. PCOS is the most common cause of female infertility. Primary ovarian insufficiency (POI) is another cause of ovulation problems. POI occurs when a woman's ovaries stop working normally before she is 40. POI is not the same as early menopause.

Less common causes of fertility problems in women include:

·      blocked Fallopian tubes due to pelvic inflammatory disease,endometriosis, or surgery for an ectopic pregnancy

·         physical problems with the uterus

·         uterine fibroids, which are non-cancerous clumps of tissue and muscle on the walls of the uterus.

How does age affect a woman's ability to have children?

Many women are waiting until their 30s and 40s to have children. In fact, about 20 percent of women in the United States now have their first child after age 35. So age is a growing cause of fertility problems. About one-third of couples in which the woman is over 35 have fertility problems.

Aging decreases a woman's chances of having a baby in the following ways:

·         Her ovaries become less able to release eggs.

·         She has a smaller number of eggs left.

·         Her eggs are not as healthy.

·         She is more likely to have health conditions that can cause fertility problems.

·         She is more likely to have a miscarriage.

How long should women try to get pregnant before calling their doctors?

Most experts suggest at least one year. Women 35 or older should see their doctors after six months of trying. A woman's chances of having a baby decrease rapidly every year after the age of 30.

Some health problems also increase the risk of infertility. So, women should talk to their doctors if they have:

·         Irregular periods or no menstrual periods

·         Very painful periods

·         Endometriosis

·         Pelvic inflammatory disease

·         More than one miscarriage

It is a good idea for any woman to talk to a doctor before trying to get pregnant. Doctors can help you get your body ready for a healthy baby. They can also answer questions on fertility and give tips on conceiving.

Getwell Medical Center - Dr. Sarita Kapoor, MS (Ob & Gyn)

Dental Care & Your Health

Liposuction

Liposuction, also called lipoplasty, liposculpture suction lipectomy, or lipo, is a type of cosmetic surgery which breaks up and "sucks" fat from various possible parts of the body, most commonly the abdomen, thighs, buttocks, neck, chin, upper and backs of the arms, calves, and back. The fat is removed through a hollow instrument - a cannula - which is inserted under the skin. A powerful, high-pressure vacuum is applied to the cannula.

Liposuction is the most common cosmetic operation in America and the United Kingdom. Over 400,000 procedures are carried out in the USA each year.

Patients who undergo liposuction generally have a stable body weight, but would like to remove undesirable deposits of body fat in specific parts of the body. It is not an overall weight-loss method - it is not a treatment for obesity. Liposuction does not remove cellulite, dimples or stretch marks. The aim is esthetic - the patient wishes to change and enhance the contour of his/her body.

Liposuction permanently removes fat cells from the body. It can alter the shape of a body. However, if the patient does not lead a healthy lifestyle after the operation there is a risk that the remaining fat cells grow bigger.

The amount of fat than can be safely removed is limited. Liposuction has a number of possible risks, including infection, numbness and/or scarring. If too much fat is removed there may be lumpiness or dents in the skin. Experts say that the surgical risks are linked to the amount of fat removed.

Some medical conditions may benefit from liposuction, including:

• Lipomas - benign fatty tumors.
• Gynecomastia - where fatty breast tissue has developed in men.
• Lipodystrophy syndrome - a lipid (fat) metabolism disturbance in which there is too much fat in some parts of the body and partial or total absence of fat in other parts. Sometimes a side effect of some HIV medications.

What are the uses of liposuction?

Liposuction is mainly used to improve how a person looks, rather than providing any physical health benefits. In many cases, the patient would probably achieve the same results, and sometimes better ones if they adopted a healthy lifestyle - good diet, regular exercise and a good night's sleep every night.

Experts say that liposuction should ideally only be used if the individual did not achieve the desired results with a lifestyle change. For example, if some obstinate areas of fat that are resistant to exercise and diet.

When you gain weight each fat cell increases in size and volume. Liposuction reduces the number of fat cells in isolated areas. How much is removed from a specific area depends on its appearance and the volume of fat. Contour changes resulting from liposuction can be long-lasting, as long as the patient's weight does not increase.

Liposuction is only done in relatively small areas of the human body, and is in no way a treatment for obesity or long-term weight loss. It should not be used if the person wants to get rid of stretch marks, cellulite, dimpling, or other skin surface irregularities.

Patients should discuss the pros and cons of liposuction with their GP (general practitioner, primary care physician) before deciding on whether to proceed. If the individual still wants to go ahead, they should talk to their surgeon sincerely about why they want to do it, what they hope to gain out of it personally, and what their expectations are.

Liposuction should only be carried out after a lot of thought. Results are never dramatic; they are subtle.

The following body areas are commonly targeted for liposuction treatment:

• Abdomen
• Back
• Buttocks
• Chest
• Inner knees
• Hips
• Flanks (love-handles)
• Neckline and the area under the chin (submental)
• Thighs - saddlebags (outer thighs), and inner thighs
• Upper arms

According to the American Society of Aesthetic Plastic Surgery, liposuction is performed more commonly on the thighs and abdomen of women, and the abdomen and flanks (sides, love-handles) of men.

Experts say that the best liposuction candidates are those who have good skin tone and elasticity, where the skin molds itself into new contours. People whose skin lacks elasticity may end up with loose-looking skin in areas where the procedure was done. The patient needs to be in good health - people with circulation (blood flow) problems, such as coronary artery disease, diabetes, as well as those with weakened immune systems should not undergo liposuction. Candidates should be over the age of 18 years. Liposuction is sometimes used to treat certain conditions, including:
Lymphedema - a chronic (long-term) condition in which excess lymph (fluid) collects in tissues, causing edema (swelling). The edema commonly occurs in the arms or legs. The fluid accumulation occurs faster than it can be drained away. Liposuction is sometimes used to reduce swelling, discomfort and pain.

However, doctors tend only to use liposuction with patients who have severe symptoms. After the operation patients have to wear a compression bandage for several months, sometimes up to a year after the operation.
Gynecomastia - sometimes fat accumulates under a man's nipples. Liposuction can remove some of the fat, reducing the swelling.
Lipodystrophy syndrome - fat accumulates in one part of the body and is lost in another. Liposuction can improve the patient's appearance by providing a more natural looking body fat distribution.
Extreme weight loss after obesity - if a morbidly obese person has lost at least 40% of his/her BMI (body mass index) after perhaps a gastric band or bypass procedure, excess skin and other abnormalities may need treatment. Sometimes liposuction is used to correct abnormalities.

What happens before and during the liposuction operation?

Before the operation - patients will need to undergo some health tests to ensure that they are fit for surgery. The medical team will ask the patient to:
Stop taking aspirin and anti-inflammatory drugs for at least two weeks before the surgery.
Women - if undergoing an extensive operation, they may be asked to stop taking the contraceptive pill for a specific period before the operation.
Patients with anemia - they will be asked to take iron supplements for a specific period before the operation.
Consent form - the patient will be asked to sign a consent form, which confirms that they are fully aware of the risks, benefits and possible alternatives to the procedure.
During the operation

The surgeon will mark out lines on the patient's body, indicating where treatment will take place. Photos of the target area, and sometimes the patient's whole body may be taken; they will be compared to pictures of the same areas taken afterwards.

Anesthesia - the patient will most likely be under a general anesthetic; they are put to sleep before the procedure and remain so during it. A liposuction operation may last from 1 to 4 hours. The doctor may use an epidural for treatments on the lower body - the anesthetic is injected the epidural space surrounding the dura (fluid-filled sac) around the spine, partially numbing the abdomen and legs. A local anesthetic may be used when liposuction is done on very small areas.

Patients may feel a dull rasping during the procedure as the cannula moves under the skin. This is normal. If any acute or different pain is felt the doctor needs to be told, as the medication or movements may need modification.

If the patient requires only local anesthesia, he/she may be asked to stand up during the procedure to ensure proper fat removal.

One of the following liposuction techniques may be used:
Tumescent liposuction - several liters of a saline solution with a local anesthetic lidocaine and vessel-constrictor epinephrine (adrenaline) is pumped subcutaneously (below the skin) in the area that is to be suctioned. Epinephrine helps minimize bleeding, bruising and post-operative swelling. The fat is suctioned (sucked out) through small suction tubes (microcannulas). This is the most popular form of liposuction.

The amount of liquid pumped into the area may be up to three times the amount of fat to be removed. This volume of fluids creates a space between the muscle and the fatty tissue, allowing more maneuverability for the cannula.
Wet liposuction - a small amount of fluid with less volume than the amount of fat to be removed is injected into the target area. The fluid is similar to the one used in tumescent liposuction and minimizes bleeding and bruising. The fluid helps loosen the fat cells. The fat cells are suctioned out.
Super-wet liposuction - this technique uses less liquid that tumescent liposuction; about the same amount of liquid as fat to be removed. Otherwise, the technique is very similar to tumescent liposuction. The patient may need a separate anesthetic.
Dry liposuction - no fluid is injected before fat is removed. This method is seldom used today. There is a higher risk of bruising and bleeding.
Ultrasound-assisted liposuction (UAL) , also known as ultrasonic liposuction - the cannula is energized with ultrasound. This makes the fat melt away on contact - the ultrasound vibrations burst the walls of the fat cells, emulsifying the fat (liquefying it) and making it easier to suction out. This method is a good choice for working on more fibrous areas, such as the male breast, back, and in areas where liposuction had been done before.

UAL is especially useful for stubborn fat accumulations. However, longer incisions in the skin are needed for this procedure, and there is a risk of skin or internal burns. This procedure takes longer than the others, because it is often done alongside tumescent liposuction. It is also more expensive. After ultrasonic liposuction, it is necessary to perform suction-assisted liposuction to remove the liquefied fat.

UAL techniques were initially linked with cases of tissue damage, generally because of over-exposure to ultrasound energy. A third-generation UAL device - the Vaser Lipo system - prevents this problem by using pulsed energy delivery and a specialized probe that allows surgeons to safely remove excess fat.
Power-assisted liposuction (PAS) , also known as Powered liposuction - uses a specialized cannula with a mechanized system that rapidly moves back-and-forth, allowing the surgeon to pull out fat more easily. It is similar to traditional UAL, but the surgeon does not need to make so many manual movements, as in other methods.

This method may sometimes cause less swelling and pain, and may allow the surgeon to remove fat with more precision, especially in smaller areas.
Laser Assisted Lipolysis (LAL) , or laser-guided lipo - requires the use of tumescent fluid. It is a far less invasive and bloody procedure than the traditional liposuction method for removing fat. A microcannula is inserted through a small incision to deliver laser energy and heat into subcutaneous fat (fat under the skin).
The liposuction cannula - this is a stainless steel tube, which is inserted through an incision in the skin and is used to suction the fat (suck the fat out).

The liposuction microcannula - is a very small cannula with an inside diameter of less than 3 mm (some experts define them with less than 2.2mm diameter).

Liposuction surgery tools

The size of the cannula can influence how smooth the skin is after liposuction. Large cannulae tend to create irregularities more commonly than microcannulas. Large cannulae are more frequently used for total-body liposuction.

After an area has been prepared for treatment, a small cut is made (sometimes several, depending on the size of the area), and a microcannula is inserted into the cut. The microcannula is attached to a special vacuum machine. The microcannula first loosens and then sucks the fat out of the area.

Draining out excess fluid and blood - after the operation the surgeon may leave the incisions open so that fluid can drain from the body.
After the liposuction operation

Anesthetic - patients who underwent a general anesthetic usually spend the night in hospital. Those who had a local anesthetic may be able to leave hospital on the same day. Patients should not drive for at least 24 hours after receiving an anesthetic.
Support bandages - the patient will be fitted with either an elasticated support corset or bandages for the targeted area after the operation. They help reduce inflammation and bruising. They should be worn for several weeks. It is important to follow the doctor's advice on keeping the area clean and how to do this.
Antibiotics - patients may be given antibiotics immediately after the operation.
Painkillers - the doctor will most likely prescribe or recommend analgesics (painkillers) to relieve pain and inflammation.
Stitches - the patient will be given a follow-up appointment to have the stitches removed.
Bruising - there will be significant bruising in the targeted area. The amount of bruising is usually linked to how big the targeted area was. The bruising may go on for several weeks; in some cases for as long as six months.
Numbness - patients may experience numbness in the area where fat was removed. This should improve within six to eight weeks.
Results - patients and their doctors will not be able to fully appreciate the results of liposuction until the inflammation has gone down, which in some cases may take several months. Typically, most of the swelling will have settled after about four weeks and the area where fat was removed should appear less bulky.

Patients who maintain their weight can usually expect permanent results. Those who gain weight after the procedure may find that their fat distribution alters. Those who previously had fat accumulating in their hips might find that their buttocks become the new problem area.

If a patient has thought everything through carefully beforehand, talked to their GP and surgeon about their aims, motives and expectation, the surgeon is skilled and well qualified, and there are no complications, most patients are pleased with their results.
What are the risks of liposuction?

Any type of major surgery carries a risk of bleeding, infection and an adverse reaction to anesthesia. Risk of complications is usually associated with how large the procedure is, as well as the surgeons skills and specific training. The following risks, unpleasant side effects, or complications are possible:
Bad bruising - this is especially the case if patients have been taking anti-inflammatory medications or aspirin. Patients with a tendency to bleed are also at higher risk of bad bruising.
Inflammation - the swelling in some cases may take up to six months to settle. Sometimes fluid may continue to ooze from the incisions.
Thrombophlebitis - a blood clot forms in a vein, causing inflammation of that vein. This may affect liposuction patients, especially inside the knee and on the inside of the upper thigh (when these areas have been treated).
Contour irregularities - if the patient has poor skin elasticity, has healed in an unusual way, or fat removal has been uneven, the skin may appear withered, wavy or bumpy. This undesirable result may be permanent. The cannula may cause damage that makes the skin appear spotted. Seromas may form under the skin (temporary pockets of fluid), which may need to be drained.
Numbness - the area that was worked on may feel numb for a while; this is usually only temporary. There may also be temporary nerve irritation.
Infections - although rare, skin infections may occur after liposuction surgery. Sometimes this needs to be treated surgically, with the risk of scarring.
Internal organ punctures - this is very rare. If the cannula goes in too deeply one of the internal organs may be punctured. Further surgery may be required. Internal organ punctures can be life-threatening.
Death - anesthesia carries with it a small risk of death.
Kidney or heart problems - as fluids are being injected and or suctioned, the change in the body's fluid levels may cause kidney or heart problems.
Pulmonary embolism - fat gets into the blood vessels and travels to the lungs, blocking the lungs. This can be life-threatening.
Pulmonary edema - this may be a result of fluid being injected into the body. Fluid accumulates in the lungs.
Allergic reaction - there may be an allergic reaction to medications or material used during surgery.
Skin burns - the cannula movement may cause friction burns to the skin or nerves.
Lidocaine toxicity - in the super-wet or tumescent methods, too much saline fluid may be pumped into the body, or the fluid may have excessively high concentrations of lidocaine. If lidocaine levels are too high for the patient's system he/she may experience lidocaine poisoning (toxicity) - initially they will experience tingling and numbness, then seizures, followed by unconsciousness, and possibly respiratory or cardiac arrest.

Heart Healthy Eating

HEART HEALTHY EATING

CHANGING THE DIET THAT U HAVE BEEN EATING FOR YEARS IN NOT EASY. PLEASE STILL TRY TO BE ATTENTIVE TO YOUR DIET AND MAKE IT HEALTH POSITIVE.

 

• FATTY ACIDS IN THE DIET.
• SATURATED FATS AVOID-BUTTER, GHEE, COCONUT OIL, PALM OIL.
• POLYUNSATURATED FATS ARE GOOD . INCREASE HDL AND LOWER LDL-SUNFLOWER OIL, CORN OIL.
• OLIVE OIL PEANUT OIL GINGERLY OIL ARE GOOD.
• LIMIT EGG YOLK TO A MAXIMUM OF 2 PER WEEK
• CAKES, PASTRIES, BISCUITS =AVOID. CAN EAT RARELY.
• LIMIT FRIED FOODS AND SNACKS.