PAP Smear

Pap Smear also known as Papanicolaou smear is a screening test for cervical cancer. It is a microscopic examination of cells scraped from the cervix and is used to detect abnormal cervical cells (precancerous cells) which helps to treat cancer in early stage.

WHO SHOULD UNDERGO PAP SMEAR AND HOW FREQUENT

-All women aged more than 20 years and below 65 years

-Pap Smear done once in 3 years

-HPV Liquid based cytology is done once in 5 years

However in some conditions, if recommended once a year in following people

On abnormal Pap Smear

  1. HIV Patients
  2. Weak immune system due to organ transplant, chemotherapy,

Chronic corticosteroid use

  1. Smoking women

Pap Smear not to be done in following

After total hysterectomy, where uterus with cervix fully removed for non-cancerous indication. If hysterectomy done for precancerous and cancer indication, then routine PAP Smear has to be done.

-Age 65yrs and above

Draw back of PAP smear test are

The false negative results, because of the following reasons

-Inadequate collection of cells

-Blood or inflammatory cells obscuring the abnormal cells.

Although it’s possible for abnormal cells to go undetected, time is on your side as cervical cancer takes several years to develop and if one test doesnŸ??t detect the abnormal cells, the next test most likely will detect.

How to prepare

To ensure that your PAP smear is most effective, follow these tips prior to your test.

Avoid intercourse or any vaginal douching or medicine for 2 days before having a PAP smear, as these may wash away or obscure abnormal cells.

-Not to do during menstrual periods.

If abnormal cells were seen in PAP smear

A colposcopy examination done for cervical tissue biopsy to diagnose cancer.

ORAL CARE AND PREGNANCY- Blog by Dr. Omar Farookh

Pregnancy oral care tips by Dr. Omar - Motherhood Hospital India.

Pregnancy can lead to dental problems including gum disease and an increased risk of tooth decay.
During pregnancy increased hormonal changes can affect the body’s response to the plaque on your
Teeth. However, the demands of pregnancy can lead to particular dental problems in some women,
With proper hygiene at home and professional help from your dentist, your teeth should remain
healthy throughout pregnancy.
Dental disease can affect a developing baby
Research has found a link between gum disease in pregnant women and premature birth with low
Birth weight. Babies who are born prematurely may be at risk of a range of health conditions including
Cerebral palsy and problems with eyesight and hearing.
Estimates suggest that up to 18 out of every 100 premature births may be triggered by periodontal
disease, which is a chronic infection of the gums. Appropriate dental treatment for the expectant
mother may reduce the risk of premature birth.
Causes of dental health problems:
Gum problems The hormones associated with pregnancy can make women susceptible to gum
problems like gingivitis (gum inflammation), more likely to occur from the first trimester with
symptoms including swelling of the gums and bleeding particularly during brushing and when
flossing between teeth.
Undiagnosed or untreated periodontal disease, pregnancy may worsen this infection and can
lead to tooth loss.
Pregnancy epulis, a localized enlargement of the gum, which can bleed easily.
During pregnancy, the gum problems that occur are not due to increased plaque, but a worse
response to plaque as a result of increased hormone levels.
Tooth Decay- Some women experience unusual food cravings while they are pregnant and a
regular desire for sugary snacks may increase the risk of tooth decay.
Morning sickness- Pregnancy hormones can cause gastric reflux (regurgitating food or drink) or
the vomiting associated with morning sickness that can coat the teeth with strong stomach
acids. Repeated reflux and vomiting can damage tooth enamel and increase the risk of decay.
Dental treatment and Pregnancy: Safety Factor
The safest time to undergo dental treatment is the 2 and trimester of pregnancy. Preventive
scaling or professional cleaning of the gums and teeth, cavity fillings and annual dental check-
ups during pregnancy are not only safe but are recommended. Elective treatments such as teeth
whitening and other cosmetic procedures should be postponed until after birth. However,
sometimes emergency dental procedures like tooth extraction or a root canal treatment can be
performed under precaution and following strict protocols.
Medications: Anesthesia is an integral part of dental procedures if needed the amount of
anesthesia to be administered should be as little as possible, but enough to make the patient
comfortable, at times additional anesthesia may be required. According American Dental
Association controlled administration of local anesthesia does not cause any significant harm to

the developing baby or the mother. Certain group of antibiotics and analgesics can safely be
prescribed throughout the 9 month pregnancy period.
X-rays: Routine x-rays typically taken during annual check-ups can usually be postponed until
birth. X-rays are necessary to perform many dental procedures especially emergencies. According
to American College of Radiology, no single x-ray has a radiation dose significant enough to cause
adverse effects in a developing embryo or fetus with appropriate shielding.
Treatment Planning during Pregnancy:
1. All pre-existing dental issues need to be sorted out before planning for a child, it is
recommended.
2. If already pregnant with pre-existing dental issues, it is advised to inform the dentist about
the pregnancy, the stage of pregnancy and the due date for the delivery. This information is
very important for the dentist to plan and execute the best possible oral care.
Home oral Care:
1. Brush your teeth with fluoridated toothpaste twice daily.
2. Floss your teeth regularly and rinse your mouth with an alcohol-free mouthwash.
3. Replace the toothbrush every month and use a soft bristle toothbrush.

Breast Cancer: What Every Women Should Know About It

Lumps in the breast are common problems in females. Only 20% of these breast lumps are cancerous. Breast cancer has replaced cervical cancer and now ranks first in cancers seen among females. The incidence of breast cancer is on the rise among Indian females, especially among younger generations. In spite of various treatment options available for treating breast cancer, the survival rates are less among Indian population compared to western population due to the presentation in advanced stages, lack of awareness about presenting symptoms and social stigma among village population.

Breast Cancer Screening
Screening is a method to diagnose an illness in its early stages with the goal to prevent death and suffering with timely medical interventions. Detection of breast cancer in the early stage has survival rates of above 95% which drops to 50% in stage III. So Screening for Breast cancer plays a major role in early detection and better treatment outcomes. Mammography, self-breast examination and examination of Breast by a trained medical professional are various screening options available.

American cancer society recommends clinical Breast Examination as the best screening modality for early detection. In India, mammography and clinical breast examination are most commonly followed modalities. Mammography is an imaging technique which helps to detect lesions in early stages which could not be appreciated by clinical palpating. Every female above 40 years of age is recommended to undergo annual screening in the form of mammography and clinical breast examination. Females with other risk factors like family history of breast and ovarian cancer, previous breast lesions are advised to undergo screening from an early age than the regular population.

Am I at Risk of Developing Breast Cancer?
In India, nearly 40 out of 1 lakh females develop breast cancer. There is a significant increase among younger females in the past few years. Risk factors for developing breast cancer can be broadly divided into modifiable and non-modifiable risk factors. Hormone replacement therapy, family history of breast, ovarian or male breast cancer, previous breast biopsy, exposure to ionizing radiation, not bearing children are all non-modifiable risk factors. Smoking, obesity, alcoholism are modifiable risk factors.

We advise to lead a healthy active life style and avoiding Smoking and alcoholism. People with non-modifiable risk factors are advised to get counselled by a doctor regarding the precautions and should understand the presenting symptoms. People with a strong family history should undergo frequent screening than people with normal risk. Strong family history can be due to an inherited genetic mutation, such individuals can undergo genetic testing only after a proper counselling with a geneticist. Genetic testing without people counselling is not advisable.

Self-Breast Examination
A self-breast examination is one of the options for females to keep themselves on a regular check. Every female should be aware of the presenting symptoms of breast cancer like a lump in the breast, bleeding from the nipple, Ulcer (wound) over the breast skin or nipple area, dimpling of the skin over the breast etc.

Self Breast Examination Includes 2 Steps :-
1) Looking at the breast in a mirror for any skin or nipple changes, any visible swellings in the breast and axillary.
2) Feeling both the breasts in lying down position on a flat surface. Feeling the breast should follow a regular pattern not to miss any part of the breast.

A self-breast examination should be done after 3-5 days of the beginning of your monthly menstrual bleeding. Females who have attained menopause can examine the same any particular day of a month.

Types of Hysterectomy Procedure by Dr. Suhasini Inamdar

Hysterectomy is the removal of the uterus (baby bag) surgically. There are various methods and approaches:

1)Laparoscopic hysterectomy:

This is minimally invasive surgery, it is done through keyhole openings, approximately 4-5 in number, on the skin surface of the abdomen. These are 2-3 cms in size. The uterus is detached of all the attachments and it is delivered out through the vaginal route.

2)Abdominal hysterectomy:

Here a bikini cut is given on the abdomen and the uterus is detached of attachments and removed through the abdomen.

3)Vaginal hysterectomy:

This is a common approach when the uterus is descending and coming down in or out of the vagina, which is called prolapse of the uterus. This approach is also used for some cases of non-descend, where the uterus is not very big, and no other abdominopelvic pathology is detected.

The laparoscopic family planning procedure

Family planning is a method which helps the couple plan the number of children in the family. This can be temporary like ORAK CONTRACEPTIVE PILLS, CUT, CONDOMS, VAGINAL CONTRACEPTIVE SPONGES. The permanent method is tying of the Fallopian tubes in ladies and of VAS DEFERENCE in men.

The best and minimally traumatic method of tying of fallopian is LAPAROSCOPIC TUBECTOMY

It is a day-care procedure, the patient gets admitted on fasting stomach. It is done under general anesthesia. The patient is started on liquids by mouth and made to walk and use the washroom 6 hours after the procedure. The patient walks home same evening and comes for review after a week

By Dr.Suhasini Inamdar

High-Risk Pregnancy

Motherhood can be considered to be one of the most beautiful experiences in a woman’s life. It is important to ensure motherŸ??s health is taken care of that will eventually result in growth and development of the fetus. Regular antenatal care will assure a healthy and safe delivery for the mother. If adequate steps are not taken in ensuring the health of the mother and the fetus high risk concerns may set in.

What is considered a High-Risk Pregnancy?

Pregnancy can be considered as high risk if there are potential complications that could affect either you, your baby, or both. These cases require special intervention by experts and specialists to ensure that the best possible outcome occurs for both the mother and the baby. Unforeseen illnesses or preexisting diseases can complicate the pregnancy, which, in turn, puts you and your baby at risk.

High-Risk Pregnancy Factors

These are some of the factors that can classify a pregnancy as a high-risk pregnancy-
  • Teenage pregnancy and Pregnancy above the age of 35.
  • Women with previous history of repeated pregnancy losses, previous preterm delivery, previous history of preeclampsia (increase blood pressure with edema). History of gestational diabetes in the previous pregnancy or any other medical disorder including psychiatry illness.
  • History of placenta praevia, antepartum bleeding, preterm premature rupture of membranes also come under high risk category.
  • Women with preexisting conditions like Hypertension, Diabetes mellitus, Cardiac disease, Anemia, Blood Dyscrasia, Haemoglobinopathy, Platelet disorders and Liver problems.
  • Women with a history of thromboembolism (obstruction of a blood vessel by a blood clot that has become dislodged from another site in the circulation), strokes, myocardial infarction.
  • Some women who have autoimmune diseases, thyroid, other endocrine disorders, renal disorders
  • Lifestyle choices like smoking cigarettes, drinking alcohol, substance abuse and obesity.
  • Women with neurological problems like epilepsy, brain tumours, multiple sclerosis, cerebral venous thrombosis and psychiatric illness.

What You Can Do to Ensure a Safe Delivery

If you are expecting a baby or want to have one in the future, there are some guidelines to be followed for a safe, healthy pregnancy and delivery-
  • Schedule a preconception appointment Ÿ?? if you are trying to conceive, make sure that you consult your healthcare provider. If you have a medical condition or have recently been diagnosed with one, your treatment might need to be adjusted to prepare for the pregnancy.
  • Seek prenatal care regularly Ÿ?? prenatal visits can help your healthcare provider in monitoring your health and your baby’s health.
  • Have a healthy diet – youŸ??ll need more folic acid, calcium, iron and other essential nutrients during pregnancy. A daily dosage of prenatal vitamins can help as well.
  • Gaining the right amount of weight can support the health of your baby and make it easier to shed the extra pounds after your delivery.
  • Opt for a tertiary centre as all the specialty doctors at that centre will be available and that will be beneficial to both the mother and the baby.
  • Avoid risky substances such as cigarettes and drugs. Make sure that you consult your healthcare provider before you start or stop taking any medications or supplements.

Specific Symptoms to Look Out For

If you have the following signs or symptoms during your pregnancy period, be sure to consult your doctor-
  • Vaginal bleeding
  • Decreased fetal activity
  • Pain or cramps in the lower abdomen
  • Watery vaginal discharge in a gush or a trickle
  • Regular or frequent contractions Ÿ?? a tightening sensation in the abdomen area
  • Pain or burning during urination
  • Changes in vision, including blurred vision
  • Persistent headaches
To conclude high risk pregnancy should be monitored and managed in a center with facilities available for adequate maternal and fetal care. Consultant liaison with Physicians, Neonatologists, Anesthesiologist and senior Obstetricians, optimum care can be provided for the better outcome.

Menstruation Matters

Menstruation is a unique phenomenon in a woman’s life. It is the mark where a girl enters the womanhood and is blessed with the gift of giving life. However, this gift is always encircled by taboos that isolate women from the social and cultural life.

Till date, menstruation is described with code words such as red alert, shark week, on the rag, and so on which proves that talking about it is a taboo in the society. Therefore, such taboos make the period cycle a topic of stigma and shame to be discussed out in the open which leads to a ton of misinformation related to it. To cater to the needs of this series of misinformation, given below are answers to a few unanswered questions related to menstruation, give it a read.

Can the change of diet ease my period pain?

Well, yes. Your diet can be your friend or foe when you’re on your period. Consumption of certain foods during your periods can worsen the symptoms than usual. Try to avoid salty and spicy food or any food that can cause bloating, pain and discomfort. Hence, stick to clean and healthy food for a happy period.

Is there a way to tackle irregular periods?

A typical cycle length is of 28 days, and any changes in it mean that your cycle is unpredictable or irregular. There are many reasons for it. To have a more unobstructed view of this, we suggest you consult with your healthcare specialist.

Other than that you can maintain healthy body weight, exercise regularly, eat a balanced diet and regulate your thyroid levels to avoid such instances.

How often should I change my pad?

Be it your heavier days or lighter flow days you should change your pad every 3 or 4 hours. It is to avoid any odor from the bacteria growing in the blood.

What is the idea behind using a menstruation cup?

A menstruation cup is a flexible cup made of silicone or rubber (used inside the vagina) used to collect menstrual blood. It collects the menstrual flow rather than just absorbing it as tampons or pads do. It is gaining popularity because it is easy to use, reduces the foul odor and maintains the vaginal pH.

How do I deal with my first period?

Menarche or your very first period may not be the happiest time of your life cause of the cramps and bloating, but don’t forget that it is a stepping stone to your fertility which officially makes you a woman!

Here are a few things that you can do to make yourself more comfortable:

1. Cut back on coffee
2. Cut down on deep-fried foods
3. Consume more antioxidant-rich foods
4. Consume food rich in Iron

Even though we have come so far in the today, few things still need progress and advancement. That is why menstruation needs attention and an open conversation in the society.

ANAEMIA & CERVICAL CANCER – THE UNNOTICED KILLERS AFFECTING INDIAN WOMEN

India has been making great headway in the eradication of diseases like Polio & Small Pox but this is just the tip of the iceberg. Certain conditions like Anaemia do not get the attention they deserve. Characterized by subtle symptoms, diseases of this nature can go untreated for a long period leading to serious complications or occasionally even death. Women may be totally unaware that they are suffering from such conditions.

Anaemia in varying degrees is widely prevalent amongst Indian women. Global Nutrition Report 2017 states that about 51% of women of reproductive age in India suffer from anaemia. It is predominantly due to nutritional deficiency. Women also have to cope with blood loss during their monthly periods which can further reduce their haemoglobin levels. It is prevalent across all socioeconomic strata and is a condition that can be easily diagnosed and treated.

Anaemia characterized by low blood hemoglobin levels increases the risk of infection, preterm delivery, and suboptimal fetal growth. In infancy and early childhood, Anaemia can cause recurrent illness, failure to thrive, poor performance at school and failure to participate in physical training and games at school. Analysis by a think tank, IndiaSpend, states that anaemia has remained the leading cause of disability across the ages in India for the past 10 years. Anaemia can be easily diagnosed by a simple blood test called Complete Blood Count.

Cervical cancer is a leading cause of death from cancer amongst Indian women. It runs parallel to breast cancer in incidence. A study on cervical cancer by ASSOCHAM-National Institute of Cancer Prevention and Research (NICPR) reveals India alone accounts for one-fourth of the total cervical cancer burden globally. Almost 17% of cancer-related fatalities in women between the age of 30-69 can be attributed to cervical cancer. Majority of cervical cancers in India even today are diagnosed at a late stage. There is, however, an opportunity to detect precancerous changes of the cervix at least 15 to 20 years ahead by a simple test known as the Pap Smear. This test, although widely available to the affluent classes, is not easily accessible to the lower social strata. Cervical Cancer, however, unfortunately, is more prevalent in this lesser privileged section of our society.

Simple tests such as Pap Smears & Complete Blood Count (CBC) can go a long way in not only saving the lives of many Indian women but also improving their quality of life. Due to the rapid changes in lifestyles as well as lack of awareness of such diseases, our mothers, sisters and daughters fall victim to these ‘unnoticed killers’. What is even more alarming is that due to the high cost associated with such tests many women from the underprivileged sections of our society may not have access to such lifesaving screening tests.

In an effort to create awareness amongst our women and in order to provide women from the underprivileged section of our society an opportunity to avail these tests Motherhood Women and Children hospital conducted a free medical camp for women in partnership with the Thuluva Vellala Association. Basic history, examination, blood counts, blood sugars, ECG and BP and Pap-smears test were performed and referrals to specialists were made if required. The camp was attended by more than 150 men and women. A significant number of women were benefited by the special services offered at this camp.

Hypothyroidism Treatment By Dr. Archana Pathak

Hypothyroidism is a condition in which the thyroid gland produces an abnormally low amount of thyroid hormone. Hypothyroidism symptoms usually develop incredibly slowly; it can take years for them to show up. Also, some symptoms mimic symptoms of other diseases, such as fibromyalgia and rheumatoid arthritis. Hypothyroidism symptoms include constipation, depression, and fatigue. Pale, dry skin; sensitivity to cold; joint pain; elevated cholesterol levels, irregular periods; brittle fingernails and hair; and unexplained weight gain are other common symptoms. Thyroid can be detected by thyroid test. If these tests show an elevated thyroid-stimulating hormone (TSH) and low levels of thyroid hormones, like free T4, total T3, or free T3, it may be an indication that you have hypothyroidism. Typically, if you have a low level of T4 along with a high level of TSH, you have hypothyroidism. Hypothyroidism can be easily treated with thyroid hormone replacement. At Motherhood Bangalore and Chennai, with a team of thyroid experts and specialists, we provide the best endocrinology treatment with world class state of the art facilities. With the best Hypothyroidism treatment at Motherhood at the right time, you can lead a healthy and happy life. Consult our experts today for the Hypothyroidism treatment. ByDr. Archana Pathak

Uterine Fibroid Treatment Types & Symptoms

Uterine Fibroid Treatment in Bangalore & Chennai

Uterine fibroids are a type of tumor. However, they are composed of smooth muscle fiber like the uterine wall. They are much denser than the normal uterine wall muscle fiber. In a normal situation, these fibroids do not cause any pain unless they are exceptionally large to create pressure in the bladder or any other organs. Types of uterine fibroids:
  • Subserosal Fibroid
  • Submucosal Fibroid
  • Intramural Fibroid
  • Pedunculated Fibroid
Symptoms:
  • Heavy menstrual bleeding.
  • Menstrual periods lasting more than a week.
  • Pelvic pressure or pain.
  • Frequent urination.
  • Difficulty emptying the bladder.
  • Constipation.
  • A backache or a leg pain.
Surgical Options :
  • Myomectomy (Removal of fibroid)
  • Hysterectomy (Removal of Uterus and fibroid)
  • Salpingo-oophorectomy (Hysterectomy with removal of Fallopian tubes and ovaries)

Motherhood Hospital is a designated Center of Excellence in Minimally Invasive Gynecological surgery. WeŸ??re led by the highly accomplished clinicians, supportive nursing care ably supported by the latest technologies and treatment protocols.With state-of-the-art NICUŸ??s, Labor Suites, Adult ICUŸ??s, Operative Rooms, Laboratory Services and 24/7 pharmacy, Motherhood delivers the best in women, new born and childrenŸ??s healthcare. Book your appointment today with our experts or send us an enquiry.

By Dr. Sireesha Reddy from Hebbal

Changes in human body during pregnancy

Human body undergoes enormous changes during pregnancy. It affects the body from head to toes. It is amazing how the body accommodates the baby so smoothly.

1) There is a new growth spurt in hair, glow on the face and bleeding gums because of increased estrogen in the blood.

2) Increased pigmentation on face ,neck , nipples and abdomen due to increase in melanin . This pigmentation is also known as melasma or chloasma or PREGNANCY MASK.

3) Water retention leading to puffiness of face , swelling of fingers and toes . Swelling around sciatic nerve causes pain in lower back and thigh . Contact lens users feel difficulty in their usage.

4) There is marked increase in the size of breasts as they need to get ready for nursing the baby.

5) Dryness of skin and breakage of collagen leading to stretch marks.

6) Constipation because of progesterone ,the hormone of pregnancy ,it is known to make the bowel sluggish.

7) Joints and ligaments loosen around pelvis and other places because of pregnancy hormones specially RELAXIN, this helps for accommodating baby and delivery. Loosening also results in back pain, change in gait WADDLING.

8) Increase in body temperature, heart rate and breathlessness due to increase in metabolic rate and increased cardiac output.

9) Increase in stagnation of venous blood flow leads to hemorrhoids or piles, varicose veins.

10) Acne worsens as the hormonal shift makes skin very oily.

By,

Dr. Suhasini Inamdar