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eva hospital ludhiana

Infertility: Diagnosis, Prevention and Treatment

March 28, 2022November 16, 2023
by Eva Hospital

Introduction: An Infertility

If one is under 35 years of age and unable to get pregnant after having unprotected, regular sex for six months to one year, it can be a sign of infertility.

There are no definite symptoms of infertility. However, Women with infertility may sometimes have irregular or absent menstrual periods and some men with infertility may show signs of hormonal problems, such as changes in hair growth or sexual function.

The good news is that many safe and effective treatments are available nowadays and they can considerably improve the chances of pregnancy in couples who have been trying for a long time without success and a couple should immediately seek the consultation of a competent fertility specialist if they are facing issues in getting pregnant. The correct diagnosis and timely treatment can help couples in successfully achieving pregnancy.

When to See An Infertility Doctor?

Women Should Consult An Infertility Specialist if:

They are 35 years or older of age and have been trying to get pregnant for six months or longer
They have irregular or no periods
Their periods are painful
Have fertility problems they are aware of
They have been diagnosed with endometriosis or a pelvic inflammatory disease
They have a history of multiple miscarriages
They have at some point in life undergone the treatment for cancer

Men Should Talk to An Infertility Doctor if:

They have a low sperm count or other sperm-related issues.
They have a history of testicular, prostate, or sexual issues, they are aware of or suspect
Have at some point undergone treatment for cancer
They have small testicles
There has been a history of infertility problems in the family

How is Female Infertility Diagnosed?

The doctor may initially ask the couple to record the signs of ovulation. These signs include basal body temperature and cervical mucus.

There are a few tests that can also help diagnose infertility issues in females:

Pelvic examination: A pelvic examination, including a Pap smear, is performed to check for any structural issues or signs of disease.
Blood test: Blood tests can help to check hormone levels, including thyroid function tests.
Transvaginal ultrasound: An ultrasound wand is inserted into the vagina to establish problems with the reproductive system if any.
Hysteroscopy: A thin, lighted tube (hysteroscope) is inserted into the vagina by the doctor, to examine the uterus.
Saline sonohysterogram (SIS): The uterus is filled with saline and transvaginal ultrasound is conducted.
Hysterosalpingogram (HSG): An injectable dye performs an x-ray as it travels through the fallopian tubes, looking for blockages if any
Laparoscopy: A laparoscope i.e. a thin tube with a camera is inserted into a small abdominal incision. The pelvic laparoscopy in females helps to identify issues like endometriosis, fibroids, and scar tissue.

How is Male Infertility Diagnosed?

The following tests can help diagnose infertility issues in males:

Semen analysis: It helps to establish semen-related issues in men, such as low sperm count, poor morphology, and poor mobility. Needle biopsy is sometimes needed in some men to collect the sperm for testing from the testicles and this is the only test needed in the workup of infertility for most men.
Blood test: Testosterone, thyroid, and other hormone levels are checked through a blood test. Genetic blood tests help find out chromosomal abnormalities.
Scrotal ultrasound: Varicoceles or other testicular problems, if any can be identified with the help of the ultrasound of the scrotum.

Besides all these tests, the patient should listen to their body and inform the doctor if at any time they notice a sign or a symptom. The earlier an infertility problem is diagnosed, the more are the chances of getting pregnant.

How Can Infertility Be Prevented?

Some types of infertility are not preventable. However, many techniques may increase one’s chance of getting pregnant.

Following steps can be taken by both men and women to protect their fertility, particularly while trying to conceive:

They must eat a well-balanced diet and maintain a healthy weight.
They must avoid smoke, drugs, or excessive alcohol consumption.
They must take treatment for STDs.
The exposure to toxins must be limited.
Physical activity is important but overdoing exercise must be avoided.

Additionally, the men must:

Avoid high temperatures found in hot tubs and hot baths as they can have a temporary effect on sperm production and motility.
Avoid exposure to industrial or environmental toxins as they can sometimes affect sperm production.
Try to maintain a healthy weight as being both overweight and underweight can affect hormone production and cause infertility.

What Is The Treatment For Female Infertility?

The usual treatment for infertility in women include:

Medications: Fertility drugs are prescribed to alter hormone levels to stimulate ovulation.
Surgery: Blocked fallopian tubes can be opened and uterine fibroids and polyps can be removed through surgery. Surgical treatment of endometriosis can increase a woman’s chances of pregnancy by almost two times.

What Is The Treatment For Male-Related Infertility?

The recommended treatments for male infertility include:

Medications: Testosterone or other hormone levels can be raised with the help.of medications. There are a few drugs that can help with erectile dysfunction.
Surgery: Blockages in the tubes that store and carry sperm can be opened surgically.

What Are The Fertility Treatment Options For All Genders?

Although the above prevention and treatments can help some couples to conceive successfully, others might need more treatment options to increase their odds of pregnancy. Some medications may be prescribed to women to stimulate ovulation, before trying one of the following options:

Intrauterine insemination (IUI): A long, thin tube is used to place sperm directly into the uterus.
In vitro fertilization (IVF): A kind of assisted reproductive technology, it implicates harvesting the eggs at the end of the stimulation and placing sperm and eggs together in a lab dish. These eggs are then fertilized by the sperm and one of the fertilized eggs (embryo) is placed into the uterus.
Intracytoplasmic sperm injection (ICSI): In a procedure similar to IVF, a single sperm is directly injected into each of the harvested eggs by an embryologist and then an embryo is transferred into the uterus.
Third-party ART: Donor eggs, donor sperm, or donor embryos are recommended to be used by Some couples may also need a gestational carrier or surrogate, who agrees to carry and deliver their baby.

Outlook For Couples With Infertility

Dr. Shivani Bhutani at Eva Hospital has been dealing with patients of both genders with infertility. She explains that almost 90% of couples succeed in getting pregnant after undergoing fertility treatments. However, the success rates of these treatments depend on the cause of infertility, the couple’s ages, and other aspects.

Although Infertility can pose many challenges and can sometimes affect relationships as well as emotional health, infertility treatments these days are proving highly successful in helping couples to eventually

start a family. An accurate diagnosis and appropriate treatment is the right step in this direction.

If you and your partner have been facing problems in conceiving despite trying for more than 6 months to a year, you may book an appointment here with Dr. Shivani Bhutani.

Eva Hospital

Polycystic Ovary Syndrome (PCOS): Symptoms, Causes, and Treatment

January 18, 2022March 29, 2024
by Eva Hospital

Overview

Polycystic Ovary Syndrome and Pregnancy is a condition that affects a woman’s hormone levels during their childbearing years. Women’s ovaries, the reproductive organs that produce the menstrual cycle regulating oestrogen and progesterone are affected in PCOS.

A small amount of male hormones called androgens is also produced by ovaries. An egg is released by the ovaries every month to be fertilised by a man’s sperm. This process is called ovulation.

PCOS affects the ovaries and ovulation. Its three main features are:

Cysts in the ovaries
Higher levels of male hormones
Erratic or skipped periods

Many small, fluid-filled sacs or cysts grow inside the ovaries in PCOS. The word “polycystic” infers “many cysts.” The cysts though not harmful otherwise, can lead to an imbalance in hormone levels.

These sacs are actually follicles, each one containing an immature egg. The eggs never mature enough to trigger ovulation.

The levels of oestrogen, progesterone, FSH, and LH are altered, making Progesterone levels lower than usual and androgen levels higher than usual. A disruption in the menstrual cycle is caused by higher male hormones, thus women with PCOS get lesser periods than usual.

Higher than normal amounts of male hormones in women cause them to skip menstrual periods and this imbalance makes it harder for them to get pregnant.

Hair growth on the face and body, baldness and long-term health problems like diabetes and heart disease are also caused by PCOS.

Women with PCOS have a higher incidence of miscarriage, gestational diabetes, pregnancy-induced high blood pressure and premature delivery if they conceive.

Causes

The exact cause of PCOS is not known by doctors. It is believed that elevated levels of male hormones prevent ovaries from a normal production of hormones and eggs.

Though the exact cause of PCOS is unknown, there is an indication that genetics play a major role.

Many other factors play a role in causing PCOS:

Higher levels of male hormones (androgens): Ovaries are prevented from releasing eggs (ovulation) due to higher levels of androgen, causing erratic menstrual cycles. High androgen might also cause acne and excess hair growth in women.

Insulin resistance: The hormone produced by the pancreas to help the body use sugar from energy foods is called insulin. Elevated insulin levels trigger the ovaries to make and release male hormones, which in turn, suppress ovulation and add to other symptoms of PCOS. Obesity can also cause insulin resistance and both are contributing factors to an increase in the risk for type 2 diabetes

Low-grade inflammation: A tendency of chronic low-grade inflammation has been noticed in women with PCOS. Blood tests that measure levels of C-reactive protein (CRP) and white blood cells, can reveal the level of inflammation in the body. Inflammation can also be caused because of being overweight. Excess inflammation is linked to higher androgen levels.

Common Symptoms of PCOS

Symptoms are noticed by some women around the time of their first period, whereas others discover they have PCOS after they have gained a lot of weight or there is trouble getting pregnant.

The most common PCOS symptoms are:

Irregular periods: Lack of ovulation inhibits the shedding of uterine lining every month, causing missed periods or lack of periods.
Heavy bleeding: The uterine lining builds up for a longer period of time, causing the periods (when they happen) to be heavier than normal.
Hair growth: Excessive hair growth on, the face, body, back, belly, and the chest is experienced by many women who suffer from PCOS.
Acne: The skin is oilier than usual due to male hormones, causing breakouts on areas like the face, chest, and upper back, which is usually difficult to treat.
Weight gain: Difficult to lose weight gain and obesity is experienced by 80% per cent of women with PCOS.
Male pattern baldness: Thinning of hair or falling out of the hair on the scalp
Darkening of the skin: Dark patches of skin especially in body creases like the neck, armpits in the groyne, and under the breasts is noticed in women with PCOS.
Headaches: Hormone changes cause triggering of excruciating headaches in some women
Skin tags: Little flaps of extra skin are often found in the armpits or on the neck in women with PCOS.
Infertility: PCOS is one of the major causes of female infertility. Decreased ovulation or lack of it can result in not being able to conceive as the woman is not able to produce enough eggs to be fertilised. PCOS is one of the leading causes of infertility in women.

Metabolic Syndrome

Most of the women with PCOS are overweight or obese. Both of these can increase the risk for:

Elevated blood sugar
Raised blood pressure
Low level of HDL “good” cholesterol
High level of LDL “bad” cholesterol

All these factors together are called metabolic syndrome, and can pose to be a high-risk factor for:

Heart disease
Diabetes
Stroke

Endometrial Cancer

The uterine lining sheds during ovulation. However, if the woman is not ovulating every month, it can cause the lining to build up.

This thickened uterine lining can cause an increase in the risk for endometrial cancer.

Depression

Hormonal changes and symptoms like unwanted hair growth negatively affect emotions, eventually causing depression and anxiety in many patients with PCOS

Pregnancy and PCOS

As the normal menstrual cycle is interrupted by PCOS, getting pregnant gets harder. Fertility problem is experienced by almost 70 and 80 per cent of women with PCOS.

The risk for pregnancy complications, premature delivery, miscarriage, gestational diabetes, high blood pressure also increases with PCOS.

Management and Treatment

The treatment is based on the symptoms of the patient, medical history and other health conditions, and if the patient wishes to get pregnant.

Dr Shivani Bhutani at Eva Hospital says that the Management of PCOS includes medications, lifestyle changes or a combination of both.

Weight loss

Lifestyle changes like weight loss, diet, and exercise are the first step to treating PCOS

Losing bodyweight can help regulate the menstrual cycle and improve PCOS symptoms besides improving cholesterol levels, lowering insulin and reducing the risk of heart disease and diabetes.

Cosmetic Treatments

Excessive hair growth or acne can sometimes lower confidence and self-esteem. Cosmetic treatments or consultations with a dermatologist might prove helpful in this respect.

For ones trying to get pregnant

Dr Shivani further adds that for the ones trying to conceive after having been diagnosed with PCOS, the first thing to keep in mind is to Eat healthily and lower the stress levels. These can go a long way in helping one manage PCOS.

The treatment options for patients wanting to conceive are-

Patches, shots, a vaginal ring or an intrauterine device (IUD) can help regulate the menstrual cycle, improve acne help with excess hair growth and protect against endometrial cancer

Surgery

As an option to improve fertility, surgery is usually recommended when other treatments don’t work.

Surgical options include:

Ovarian drilling: A procedure in which tiny holes are made in the ovaries to reduce the levels of androgens being produced.
Oophorectomy: Surgery for removal of one or both ovaries.
Hysterectomy: Removal of whole or part of the uterus.
Cyst aspiration: A procedure to remove fluid from the cyst.

Drugs to induce ovulation

Ovulation is a prerequisite for a successful pregnancy. Certain drugs can help to induce ovulation in women with PCOS. Clomiphene (Clomid), a combination of clomiphene and metformin, or injectable gonadotropins, such as follicle-stimulating hormone (FSH) and luteinizing hormone (LH) medications are generally recommended by Gynaecologist in Ludhiana In some cases, letrozole (Femara) may also be recommended.

In vitro fertilisation (IVF)

The woman’s egg is fertilised with the partner’s sperm in a lab and then transferred to the uterus. IVF is a highly recommended and viable option with a substantial success rate for women with PCOS who wish to get pregnant and medication doesn’t help with ovulation.

Conclusion

PCOS can play havoc with a woman’s menstrual cycles making it harder to get pregnant. Elevated levels of male hormones cause unwanted symptoms like hair growth on the face and body.

Lifestyle modifications are the first steps recommended to manage PCOS by the doctors, and they are highly effective too.

Weight loss helps to treat PCOS symptoms, improving the odds of getting pregnant.

However, if lifestyle changes do not work, medications are a viable option. Pills and metformin restore normal menstrual cycles to help relieve PCOS symptoms.

Early diagnosis can help alleviate symptoms, reducing the risk of complications. A timely consultation with a doctor helps to manage the symptoms of PCOS and treatments like Ovulation medicines and IVF Process Start to Finish can help the patients with PCOS to get pregnant and start a family.

Eva Hospital

Is Outpatient Surgery a Safe Option?

January 13, 2022March 29, 2024
by Eva Hospital

Joint Replacement Surgery- An Introduction

Arthritis and routine wear and tear can cause hip, knee, and other joint pains. However when these pains and stiffness begin to impede the quality of life and the patient is not responding to other more conservative treatment methods, it may be time to consider a joint replacement surgery.

Newer surgical developments and minimally invasive techniques have made total joint replacement a great treatment option that can help restore quality of life & allow people to return to a normal and active lifestyle.

Outpatient Joint Replacement Surgery

Lately, for some patients who meet the specific requirements, the procedure can be done on an outpatient basis for example younger patients in their 40s, 50s, and 60s whose work, activity level, and lifestyle do not allow them to slow down.

Outpatient surgery or same-day surgery implies a surgery that does not require hospitalization. The patient is most likely discharged on the same day or in some instances, one may spend an overnight in the hospital, without being officially admitted to a hospital.

Opting for an outpatient joint replacement is an ortho doctor near me and the patient make together after considering the pros and cons to decide if it is a safe and preferable choice for the particular patient.

However, even if one chooses same-day surgery, the doctor may decide that one needs extra time at the hospital, after reviewing the condition of the patient post the surgical procedure.

The surgical procedure is the same for both conventional & outpatient joint replacements.

Benefits of Outpatient Surgery

Outpatient joint replacement is usually done if the doctor believes the patient will have the same or better outcome as with inpatient admission to a hospital.

Recovering in the comfort of a patient’s own home is one of the greatest advantages of outpatient surgery.

The recovery of patients in Outpatient joint replacement recovery is usually healthier, quicker, and much more effective than after inpatient surgery.

It has several other benefits for patients like:

Quick return to regular activities
Lower risk of hospital-acquired infections
Cost-saving when compared to an inpatient procedure/recovery
Cleaner, better-controlled environment
Lesser chances of post-surgery falls

Disadvantages of Outpatient Hip Replacement

One of the biggest disadvantages of outpatient surgery is lesser direct medical supervision in the first day or two after surgery.

There are some general issues faced by the patients after joint replacement surgery, which are common for both inpatient and outpatient surgeries.

These issues can be:

Pain and Nausea: Though improved anesthesia methods have cut down severe pain and nausea issues to a great measure, still there is a certain amount of post-surgery pain involved in all kinds of surgeries. The patient and the caregiver should learn about post-surgical medications, including how and when to take them.

Help is required: After the patient returns home from joint replacement surgery, assistance from a family member, friend, or hired helper is needed. However, this becomes especially important if one has had an outpatient joint replacement.

Limited Movement: The patients usually have restricted movement during the first few days of the surgery. Activities like going to the bathroom and moving about the house may pose a challenge.

Post-Surgical complications: A proper examination is done by Surgeons, nurses, and anesthesiologists before discharge to make sure that it is safe to send the patient home.

However despite all precautions complications can arise, which are rare but can be serious. It is advisable to be fully aware of what is to be done in case of any emergency.

Outpatient Joint Replacement & Safety

The safety of joint replacement surgery depends on the health of the patient. Everyone cannot be a candidate for outpatient joint replacement surgery. Besides considering the patient’s personal choice & comfort level, many other criteria need to be fulfilled before a patient can be approved for an outpatient joint replacement procedure.

Dr. Tanveer Bhutani at Eva Hospital says he recommends outpatient joint replacement surgery if the patient wants to have same-day surgery

Enjoys good health without serious medical issues that may require monitoring in a hospital setting.
Wants a simple and traditional total joint replacement that involves no special surgical circumstances
Has sufficient in-home help and a home layout that is conducive for an early discharge
Has the potential to be actively involved in his or her own care plan and is motivated to contribute to a rapid recovery protocol at home and diligent post-surgical physical therapy.
The Patient and the caretakers are adept enough to be able to satisfactorily manage the pain at home.
The patient is a non-smoker
Have an optimal body mass index (BMI)

One needs to keep in mind that only those patients for whom the use of minimally invasive surgical techniques is possible can be eligible to recover at home post joint replacement surgery.

Bottomline

If you are suffering from any kind of joint pain that is hindering your normal routine but you cannot afford to spend a long time in hospital due to personal or professional reasons, outpatient joint replacement surgery might be an option for you.

But before you decide to go in for this option, there are a few factors that might need to be considered after a careful assessment by a competent surgeon.

You can book an appointment and consult Dr. Tanvir Bhutani about making a decision about this option of Outpatient Joint Replacement Surgery.

Eva Hospital

Pregnancy after 40. Benefits and Risks

November 5, 2021March 29, 2024
by Eva Hospital

Pregnancy & childbirth after the age of 40 has become an increasingly common affair. The number of first-time births among women ages 40 to 44 has increased substantially.

But many questions come to mind when couples decide to have a baby at a later age.

What are the Benefits?

Having a baby later in life can have more advantages than having children early, sometimes.

Already having established a career, you may be able to dedicate more time to raising children or the financial situation can be more favorable.

Steady relationship status may make you want to have a baby at this age.

These are some more possible benefits, of having babies after 40 including:

Reduced mental decline
extended life span
better academic outcomes in children, such as higher test scores and graduation rates

What Will the Pregnancy Be Like?

The advances in technology concerning fertility, pregnancy, and delivery, have made it possible to safely have a baby at the age of 40.

Nonetheless, Conception and Pregnancy can be more challenging as you age this pregnancy after age 40 is deemed as high risk.

It’s important to talk to your gynecologist in Ludhiana about what you can expect during your pregnancy based on your age and overall health.

How Does Age Affect Fertility?

Women’s fertility rate drops considerably after a certain age and they experience fertility issues due to the following risk factors that increase with age:

More chances of health conditions that can inhibit fertility
Significant decrease in Ovarian Reserve or egg cells.
Improper release of eggs by the ovaries
An age-based decline in egg quality lessens the viability of fertilization for the eggs released by the ovaries as women age.
Chromosomal abnormalities due to the age of the egg may result in incorrect implantation of the embryo in the uterus causing miscarriage or Down syndrome in pregnancy.

Conception can take some time, regardless of age. But most women after 40 can’t get pregnant naturally and for those who have been trying unsuccessfully to have a baby naturally for more than six months, it may be time to see a fertility specialist.

An experienced fertility specialist like Dr. Shivani Bhutani at Eva Hospital can run tests to discern whether there are factors that are affecting one’s ability to get pregnant, and can suggest treatments to increase the chances of getting pregnant.

Genetic conditions

There are more chances of older women to give birth to a child with a genetic condition such as Down syndrome.

Talking to the doctor about the possibilities of these problems will help you ascertain what can be done about it.

Some tests can be recommended by the doctor but they’re a personal choice. These tests include screening like an early ultrasound and a blood test.

In case of heightened likelihood of the problem, one can have a diagnostic test such as chorionic villus sampling and amniocentesis.

Genetic counseling can also be arranged, where a specialist counselor talks about family and about what might happen with your baby, and about how the situation can be handled.

Treatment

An urgent and individualized treatment approach is important for women who are trying to conceive and are over 40 years of age. The sooner treatment is started, the higher are a woman’s chances of pregnancy are.

Among the several types of infertility treatment available to women over 40, it is important to remember that some of the treatments offered by fertility centers may not be the best option for women over 40 due to.

IVF and donor eggs are far more effective treatments for women over 40 than “mini IVF” and IUI that give vastly poorer pregnancy likelihood for older women.

IVF is a proactive and contentious treatment philosophy to maximize each woman’s chance of pregnancy.

For women looking to conceive with their own eggs after age 40, IVF with ovarian preparation stimulation is the fastest and most credible treatment option.

The women older in age opting for IVF need a different treatment than the younger women. Eva Hospital has had very impressive pregnancy rates even at very advanced maternal ages, as well as for those with largely diminished ovarian reserve

Other Risk Factors

Also chances of Vaginal delivery decrease after the age of 40, primarily due to the fertility treatments that can enhance the risk of premature birth.

There may also be an increased risk of preeclampsia, which may make cesarean delivery imperative to save both mother and baby.

The process of vaginal delivery can also be more challenging after 40 and there is an increased risk of stillbirth.

However many women deliver healthy babies at or over the age of 40 successfully. A doctor can guide you about what to expect, and come up with a backup plan.

Like, in case you’re planning a vaginal delivery, discuss it with your doctor.

Takeaway

Giving birth to a baby at 40 is very common these days, so if you’ve postponed having children until now, you can plan one.

Despite the challenges it may take to conceive, having healthy children in their 40s is certainly a possibility with a well-formulated IVF plan by a competent doctor.

Talk to your doctor about all your risk factors before starting a family at this stage in your life.

Dr. Shivani Bhutani at Eva Hospital has been assisting many couples over the age of 40 to have healthy children and she can guide you about the pregnancy at the age of 40.

Eva Hospital

The Young Adult Knee and Early Arthritis – what…

April 12, 2021March 30, 2024
by Eva Hospital

Although arthritis is a condition mostly attributed to the senior population, athletes and young adults are also susceptible.

Knee arthritis is defined as a group of conditions caused by defective articular cartilage and alterations in bone morphology.

It is considered the most prevalent type of arthritis, and the most notable health issue that permeates modern society.

Juvenile joint problems are found to be the result of injuries, occupational activities, sports, obesity or genetic factors.

Diagnosis of Young Adult’s Knee Arthritis

Diagnosing arthritis in young people is pretty challenging because they have a higher threshold of pain.

Before treating the condition, orthopedic surgeons make a definite diagnosis with the help of clinical examination, tests, X-rays, radiographs, and study of history. Thereafter a line of treatment is suggested.

Know about Risk factors

Sporting Activity

Ironically, the major risk factor for early knee arthritis is surplus activity and playing sports.

Studies have found that sportspersons are more susceptible to joint injuries than normal people.

They simply use their joints more, causing faster wear and tear of cartilage, thereby increasing the risk. It does not mean that they should stop being active or playing sports, but they must be aware of the risks involved.

Obesity

Being overweight or obese makes the young population invite knee arthritis at an early age. Maintaining a healthy weight is one of the best routes to prevent the condition.

Dr. Tanveer Bhutani says,” Extra kilos put more pressure on the joints as they have to support the body weight.

This wears down the cartilage much sooner than it would have. Adults in their late 20s or early 30s are increasingly experiencing an early onset of joint problems due to being overweight.

Injury

Injuries can damage the cartilage inside the joints and inflict OA in young adults, especially those who indulge in sports.

Athletes are naturally more prone to injury than others. Additionally, they are more predisposed to joint trauma in the lower limbs.

But they must realize that injuries can also lead to arthritis maybe 20 years before then it would have happened otherwise.

Joint injuries can cause joint instability and degeneration of the articular cartilage, even for non-athletes.

Know about treatments

Exercise is the Best Treatment for Youngsters

For young knees, the best treatment for arthritis is exercise. Though it does not cure the disease completely, they are highly effective.

Exercises or physical therapy aimed to increase strength, flexibility, and aerobic capacity work wonders for OA. The specific exercises have to be designed based on individual aspects of the disease process.

Active athletes recover better with muscle-strengthening exercises, and they can resume their sport sooner.

Aerobic workout shows results slowly, so may not be good for athletes but for other less active individuals. It is apparent that each physical program has to be custom-made. Cortisone injections

This is yet another treatment option that is beneficial for athletes who require short-term relief to participate in sports.

Cortisone injections with HA are intra-articular injections for temporary relief from pain and inflammation in the knees. However, they must be taken after consultation with an experienced sports injury specialist.

Surgery

For severe cases, minimally invasive Arthroscopy is the first surgical option considered in OA. Although it has short-term benefits, it may be very important for young adults wanting to delay joint replacement for a good number of years.

The second option is joint replacement surgery.

Know about Prevention

Rectify and transform your exercise routine

Going the extra mile sounds wonderful but you may have to change the way you work out. Always listen to the body and not the mind.

If your knee is already triggered, avoid high-impact training and running. It would inflame your joint and aggravate the symptoms.

Bid adieu to flexion strength exercises such as squats, lunges, and leg presses), says Dr. Bhutani. “They put an excess of pressure on the front of the knee joint.”

However, keep working out. For young persons exercising is vital for protecting joint health. It strengthens the muscles surrounding the knee and improves the range of motion.

Also, it keeps the weight in check. Just do not do high-intensity regimes. Focus more on your heart rate and low-impact activities such as swimming, cycling, & circuit training.

Lastly

Mostly young adults who are athletic, obese, or have a history of trauma or injury are likely to get arthritis at early stages in life. Prevention is better than cure in this case.

Eva Hospital

Office and Work – Understanding Repetitive Stress Injuries (RSIs)

February 25, 2021March 30, 2024
by Eva Hospital

You might think that office work is more of a mental job rather than a physical one. However, desk work strains muscles and joints that keep working in the same fashion throughout the day.

Occupational tasks tend to be monotonous and routine and involve the same set of movements repeatedly. It not only strains the concerned muscles and their related joints but is also capable of causing serious damage over a period of time.

Consequences can be an inability to continue with the same job and developing a serious disability.

What is RSI or Repetitive Stress Injury?

RSI is an injury or damage to muscles, tendons, and nerves resulting from repeated movements. Work-related repetitive stress injuries may be caused by a variety of continuous activities such as:

Operating a computer mouse
Typing on a keyboard or typewriter
Writing
Lifting or gripping items

Occupational muscle stress is also faced by musicians, cleaners, cooks, craftsmen, and drivers, etc

What Causes RSI?

RSI is caused by overuse as the name suggests. It is a by-product of repeating the same movements for hours on end. The overused muscles that face the brunt are those that are not strong enough and the postures are faulty. So what exactly are the risk factors?

Some activities that can increase the potential risk of injury are:

You remain in the same posture for hours
You use the same limb or hand all the time. For example, if your job requires you to make phone calls most of the time, you would be holding a phone constantly in one hand.
Your posture or positioning is wrong. For example, you are keeping the mouse at a higher level than your elbows.

Common Types of RSIs and Their Symptoms

The body parts that are most affected by office-related RSI include wrists, hands, elbows, forearms, shoulders, and neck. This may cause orthopedic conditions such as,

Bursitis

Tennis Elbow

Rotator Cuff Tendonitis

Carpal Tunnel Syndrome

Symptoms develop gradually and become persistent and more intense with time.

It is very important to recognize the symptoms and adopt preventive and primary measures to ensure that the condition does not become chronic and serious.

Here are the common symptoms that you will experience in the muscles that you are using repeatedly:

Pain
Stiffness
Weakness
Throbbing
Tenderness
Tingling or numbness
Throbbing
Heat or cold sensitivity

The pain and weakness become gradually severe, preventing you from performing routine tasks. You may find it difficult to type, handle the computer mouse or even write.

Treatment For RSI

Office-related RSI is fairly mild in the beginning and if addressed early, it can be controlled effectively at the onset.

The treatment is conservative and initially, doctors prescribe conventional medication and physical therapy.

Dr. Tanveer Bhutani, sports injury specialist and orthopedic surgeon at Eva Hospital says,” Maintaining a workout regime is vital. Office goers tend to ignore joint health while pursuing ambitious careers.

As a result, repetitive movements cause overuse injuries and damage all-around health. It is similar to sporting injuries. Relieving pain and strengthening the muscles is

the prime concern in RSI treatment.” Primary care consists of :

RICE treatment- rest, ice, compression, and elevation
Pain-relieving nonsteroidal anti-inflammatory drugs or NSAIDs
Exercise
Use of braces, bandages, or supporting devices to rest the muscles.
Steroid injections in severe cases
Physiotherapy
Workstation adjustments, e.g. your desk, chair, or other equipment.

Serious cases may require surgery to protect the joints from severe damage.

Tips for Preventing RSI

Do these standard adjustments in your way of working to make a world of difference:

Do not slouch. Maintain an erect posture. Back straight, shoulders squared and neck centered. It is the best way to protect your muscles from undue stress.

Adjust your workstation. The level and type of equipment at work should be supportive and comfortable. Align the elbow with the keyboard.

Refrain from sitting continually. Keep taking those breaks from sitting. Stand, walk and move about, at regular intervals.

Keep the monitor at eye level. You should not be looking down or up all the time. Keep the screen at an arm’s length away. If you make calls all the time, wear a headset.

Taking small breaks. Take frequent breaks throughout the day to stretch and flex your fingers and wrists. Take a walk, and do shoulder stretches. It is very important.

Conclusion

Little changes make a large difference in the prevention and recurrence of work-related repetitive stress injuries.

Eva Hospital

The Clicking Shoulder – When to Worry and What…

February 20, 2021March 30, 2024
by Eva Hospital

Is shoulder clicking or popping a serious matter? Well, it can be. Sometimes you hear a sound or have a cracking feeling when you lift or rotate your arms.

It may or may not be accompanied by pain. We tend to ignore it, stretch a little, take painkillers and generally forget about it. However, you must address the issue for all that your health is worth. We don’t want to make it worse, do we?

In medical terms, the clicking that you feel is called Crepitus. You can have crepitus in any joint but when it occurs in the shoulder, it may indicate several problems, mostly benign.

Often it is related to a person’s profession or hobby which inflicts extra burden on a particular muscle and is best tackled by a Dr. Tanveer Singh Bhutani sports injury specialist. However, it may not always be the case. But we surely do not want to delay treatment till it becomes serious.

How is it caused? What do you need to do and which are the symptoms that need immediate care?

For this, you must understand the working of the shoulder joint.

Shoulder Joint Structure

The human shoulder is an impressive and complex structure. It is the most mobile joint in the body that provides a tremendous range of motion.

Classified as a ball and socket joint, it is held together by a sophisticated system of tendons, ligaments, muscles, and cartilage.

It provides mobility, stability, and range of motion to your arms. Nonetheless, it is more prone to injury compared to other joints in the body.

Common causes of Clicking

Shoulder cracking can develop due to any of the following reasons:

Formation of gaseous pockets within the joint from the release of gases from internal fluids.
Inflammation of Bursa – the fluid sacs that cushion the joint. Mostly affects sportspersons.

Cartilage tear owing to trauma, overuse, or old age.
Rotator cuff injury-causing harm to muscles and tendons
Slipping out or dislocation of the ball and socket out of place.
Cartilage overgrown or degeneration

Osteoarthritis causing regression of cartilage
A clicking sound may also indicate a former fracture that hasn’t healed completely and produces a sound of friction

Remember, the above issues may or may not be accompanied by pain. Nonetheless, they do raise an alarm. Do you want to know the risks involved, if you ignore them?

How to Protect Yourself and Prevent Crepitus

Dr. Bhutani, Sports Injury Specialist at Eva Hospital, suggests a few guidelines to protect your shoulder joints that you can easily incorporate into your daily activities.

At Work :

Most people sit in front of a computer screen all the time while they work. So, keep your back absolutely straight and use a chair that keeps your knees evened with the hips.

Do not keep your hands in a position that raises from the elbow up. Keep the wrist at a lower level than the elbows. Take frequent breaks, move about, and stretch.

In the Gym & Swimming Pool:

The thumb rule is not to take your body parts for granted. Warm up the shoulder muscles before starting the activity and stretch them afterward to ease the tension.

Avoid the butterfly stroke. Freestyle is great, however, backstroke is extremely beneficial for this joint.

When doing the bench press in the gym, keep the elbows at an angle of 75 degrees to avoid injuring your shoulders.

While you Sleep:

The seven or eight hours that a person sleeps is a pretty long time to be in a particular posture. Sleeping on the side puts extra strain on shoulders and causes problems in the future. Lie on your back to avoid the extra weight-bearing.

The Risk of Ignoring the Clicking

Frozen shoulder is the major risk you carry by ignoring that clicking. Time can damage the structure further leading to adhesive capsulitis- its medical name. The tissues in the joint get scarred and tight, causing pain, inflammation, and stiffness.

It becomes difficult for the patient to even perform simple tasks such as putting on clothes.

What you should do

Most people worry a lot when they experience something strange like cracking joints. Unfortunately, that’s all they do. Seeking timely medical help for rehabilitation is very important.

If you have a clicking shoulder accompanied by pain, get yourself diagnosed before it becomes serious.

As they say, nip the problem in the bud! Make an appointment with Dr. Tanveer Bhutani for an expert consultation today, by calling our Ludhiana clinic. He has great expertise with joint replacement and sports injuries too.

If you don’t have symptoms of pain or swelling, you may consult a physiotherapist, although no pain doesn’t mean it’s trivial. He can recommend specific exercises that you can perform on your own too.

For persistent pain, clicking, inflammation, and other indications make an appointment at your nearest ortho clinic immediately.

Addressing your condition early and following the doctor’s instructions meticulously brings lasting benefits.

Eva Hospital

How do you decide the time of Knee Replacement…

July 28, 2020March 30, 2024
by Eva Hospital

Has climbing the stairs become a menace? Have you been facing difficulty walking a long-distance? Do you find yourself complaining about your worn-out knees too often? It may be time for knee replacement surgery

You may wonder and panic hearing the word ‘surgery’. However, if your knees are troubling and can’t support the daily motion, you need to step out and consider surgery as your orthopedic recommends.

The process of knee replacement surgery is over two hours, but you need to prepare and make arrangements for recovery when you get back home. Hence to prepare for adequate arrangements and decide when to get the surgery done is important and a few factors must be considered before taking any decision.

“A detailed assessment is crucial before making any decisions for a surgical procedure. You can resume your daily chores and start driving within three months of the surgery,” says Dr. Tanveer Bhutani, the best orthopedic of Punjab at EVA Hospital.

When Can You Avoid Surgery?

Total knee replacement (TKR) surgery has yielded successful results over the past 20 years and more than 90% of patients resume their daily chores within three months. Dr. Bhutani advises his patients regarding the surgery keeping in mind the past history and the present of the patient. He suggests that in the following cases, undergoing knee surgery can be postponed for a while:

Alternate Treatments

If you have bearable pain and you want to try alternative sources of treatment like ice, painkilling medicines, heat, or physiotherapy, you may wait and see if the pain subsides. Regular muscle strengthening exercises can also help you alleviate the pain.

Bearable Pain

The orthopedic usually suggests if the pain is bearable and doesn’t bother you in the routine chores, you may postpone the surgery for a while. The level of pain is what determines the urgency of the surgery.

Overweight

If you have massive weight, the newly replaced knee joint will not be able to survive the weight and may disturb the placement of the knee joints. This may aggravate pain after the surgery. So the orthopedic usually suggests reducing the body weight before undergoing a knee replacement surgery.

Routine Activities Unhampered

Dr. Bhutani says if you are able to carry out daily chores uninterrupted, you may wait for the surgery and get the routine chores going.

Weak Thigh Muscles

Weak thigh muscles will not be able to provide support to new joints. They are also more susceptible to infections and open wounds.

When is it time for Surgery?

Dr. Tanveer Bhutani says Total Knee Replacement (TKR) is the most effective surgery in case the pain in the knee or the condition of the knee is overwhelming. The surgery has minimum risks if done at the hands of an expert orthopedic surgeon. With proper medications and exercises, you can resume your daily activities in a short span of time.

Following are some scenarios that make the knee replacement quintessential:

Medications are Ineffective

Strong pain killers or anti-inflammatory medications are ineffective in helping cure excruciating pain. Such is the case when the orthopedic will recommend getting the knee joint replaced with the help of minimally invasive surgery.

It is an alarming scenario when alternate medication systems like steroids, injections, and physiotherapy are not able to heal the pain. The best knee replacement surgeon of Punjab, Dr. Bhutani says that if the pain in the knee is unbearable, you must consult the orthopedic and book surgery.

Inability to do Routine Chores

When you are unable to do routine chores like climbing out of bed, climbing the stairs, walk for grocery shopping, or even dress up or bathe without wincing in pain, you must seek the suggestion of the orthopedic and consider knee replacement surgery to live a pain-free life.

Dr. Bhutani adds that this is the case when patients are in deep pain and feel their normal life is also messed up.

Evident Deformity in the Knee

Injury or arthritis may sometimes cause a deformity in the knee and make your knee bowed in or bowed in. The orthopedic consider this knee deformed from the body midline with acute pain as the time for surgery. You must make arrangements for the surgery sooner than later to avoid further deformity or pain.

Age and severity of the Pain

Dr. Bhutani says age isn’t the foremost criterion for considering knee replacement surgery. TKR can be performed for patients of all age groups. However, if you are 50 years and above and facing debilitating knee pain, you must understand it is time for replacing the knee.

The severity of the pain is a key indicator for the time to undergo the surgery. If the pain is beyond the control of medicines, and if you experience pain day in and out, and are compelled to walk with a walker or crane, Dr. Bhutani suggests there is no reason to wait or postpone the surgery.

Final Words

Why live with pain when modern-day surgery is the quick fix for a healthy life full of joy! With a small minimally invasive incision, you will add years to your life and lead a pain-free life. Seek help from the orthopedic regarding the right time of the surgery.

Delayed action can worsen the condition of the knee. Do not let the suffering or pain overpower your happiness and seek the opinion of the best orthopedic in Ludhiana, Dr. Tanveer Bhutani, EVA Hospital, and live a pain-free life.

Eva Hospital

How many times is IVF Possible

July 20, 2020March 30, 2024
by Eva Hospital

Pregnancy and parenting a baby are a dream for many. It becomes a fond dream when you are unable to conceive and get pregnant.

Thanks to modern science and technology, there are many new ways in which you can target to get pregnant and raise a baby.

The infertility drugs and various procedures of ART- Assisted Reproductive Techniques are a scientific blessing to achieve the state of pregnancy.

The most common ART procedures are intrauterine insemination (IUI), In-vitro fertilization (IVF), sperm or egg donation, and Intra-cytoplasmic

Sperm Injection (ICSI). However, the most commonly used procedure with a high success rate is In-vitro fertilization (IVF). Over 200000 babies were conceived with IVF successfully in the US alone in a year and you are no exception.

“Don’t give up!” advocates Dr. Shivani Bhutani, the best gynecologist of Punjab, from EVA Hospital, “With calculated actions and appropriate treatments, pregnancy can be achieved.”

How successful is IVF Treatment?

IVF is the process where the woman’s eggs are extracted and fertilized under controlled laboratory conditions and then the resulting embryo is transferred into the women’s uterus through the cervix.

If you have been trying to get pregnant in natural ways and haven’t been successful, with further investigation, the doctor will examine the causes of infertility. The most likely infertility causes are as follows:

Premature ovarian failure
Ovulation disorders
Hormonal imbalances
Endometriosis
Blocked Fallopian Tube
PCOS
Male infertility (in case of low sperm count, poor motility, and poor quality sperm)
Failed IUI treatment cycle
Unexplained infertility

Patients with any of the above lacunas have known to benefit from the cycles of IVF. Usually, patients around the age of 40 are known to have recommended IVF at the earliest.

IVF has been successful in all countries in the world. The Centre for Disease Control and Prevention (CDC) reports about 4 million births per year in the US. This implies that nearly 1% to 2% of births in the US are IVF babies. This clearly signifies that IVF and other ART techniques are the new buzzwords in combating infertility.

What Are the Factors That Affect the Success of Ivf?

There are a couple of factors affecting the success of IVF. Dr. Shivani Bhutani says, “The age of the woman is a predominant factor in the success of IVF.

Patients between the age brackets of 35-41 are more likely to get a successful IVF. There is a 4% success rate of patients who are over 42 years of age. Chances of success of IVF are higher at a younger age than older women with fewer eggs or poor quality eggs.

The fertility problem or the reason for infertility also determines how quickly the patient can get pregnant. Sometimes a large dosage of ovarian stimulation drugs is needed to be administered to patients with ovarian dysfunction. Male infertility problems and unexplained infertility may, however, take longer than anticipated.

Previous pregnancy, miscarriages, age of the donor in case of donor eggs and the duration of time over which the couple has been infertile have been a few other factors affecting the success of IVF.

Dr. Bhutani strongly says apart from medical abnormalities, the lifestyle of the patient plays an important role in determining the success of IVF.

Overweight or underweight women, women who smoke, women who do not exercise or eat healthy have higher chances of prolonged infertility.

How Many Cycles of Ivf Are Recommended?

Depending on the factors mentioned above and the expertise of the doctor, the numbers of cycles of IVF vary from individual to individual.

The cost of IVF hovers between Rs.90000 to Rs.3,00,000 depending on the city and the facilities at the clinic. Research has shown that about 70% of the patients are usually successful after 6 or more cycles of IVF if the woman is about 40 years in age.

Dr. Bhutani recommends patients stop using their own eggs after 3-4 failed IVF cycles. The woman may not be producing sufficient eggs or eggs of good quality, so the doctor usually advises them to go for the donor eggs.

Dr. Shivani is known among her patients to endorse optimism and positivity and not to lose hope in such despairing times. She understands that the patient spends a fortune in each cycle and also adds to the mental agony with each failed IVF cycle. So she always advises her patients with empathy and positivity.

“There is no guarantee with each cycle and the process and the results vary from person to person,” says the best gynecologist in Punjab, dr. Bhutani.

You may be lucky to get pregnant in the first IVF cycle, but it may not hold true for any other couple. Dr. Bhutani says an average couple may need tentatively six IVF cycles before entering the threshold of parenthood.

Final Words

Pregnancy is a dream for many couples and lets the best team on board turn your dream into reality. Analyze the facilities the clinic provides and study the expertise of the gynecologist you plan to approach.

With finesse in skills and expertise and the best modern facilities at EVA hospital, Dr. Shivani Bhutani is the most trusted name for IVF in Punjab. Seek the help of the best team at EVA and get your queries solved and let the aim of parenthood achieve a real shape.

Eva Hospital

What are the Alternate Treatments to Cure Infertility?

June 24, 2020March 30, 2024
by Eva Hospital

Getting married at the age of 32, Shiva, tried her best to mother a baby. After a few months of unsuccessful attempts, she consulted a gynecologist who recommended In-vitro fertilization (IVF). But Shivia knew she could not afford the cost of IVF at any point in time. Shattered, she was upset for a long time. Little did she know that there are alternate treatment therapies that can help the body gain the vitality to nurture a baby.

Dr. Shivani Bhutani, an expert gynecologist in North India, says that getting pregnant is the process of mating two healthy bodies and two healthy minds.

The onus lies in creating a sound body where the embryo can grow and stay. Dr. Bhutani suggests a few alternative therapies that can aid the body to get its nutrients and gain strength to bear a baby.

What are the Safest Alternative Therapies to Get Pregnant?

Dr. Bhutani says that the following alternate therapies are mechanisms, which along with medical treatment, can ensure a healthy and sound body to get pregnant and fight infertility:

Yoga

Yoga is an age-old therapy from the yore of the yogis of the bygone era. Yoga was the secret of their ageless skin and health. Dr. Bhutani says the specific asanas in yoga can help increase the libido, make your body and mind stress-free, improve the blood circulation and heal the vices (doshas) in the body which prevent you from getting pregnant.

The calming techniques in yoga are good for all age groups for holistic development in the body and definitely make you calm enough to deal with the stress of infertility.

Acupuncture

The age-old Chinese practice of using needles and energy, Acupuncture, has now proved that this can be an effective aid to help avoid miscarriages and enhance the success rate of IVF. The anecdotal success of acupuncture as an alternate source of treatment is commendable. Studies have shown that IVF patients can get huge success with the help of acupuncture treatments done at the hands of specialists.

Dr. Bhutani, an experienced infertility expert, says that cases of unexplained infertility, where the cause of infertility or miscarriages cannot be known, can be dealt with with this alternate therapy.

Diet rich in Nutrients

The old saying –

‘You are what you eat, holds true in magnanimous proportion in pregnancy and fertility.

Also, read- What is the right diet to boost fertility?

IVF alone cannot help you get and stay pregnant if your body has been exposed to too many vices like alcohol and cigarettes. A sound body can be prepared by incorporating healthy nutrients, vitamins, minerals, and herbs that promote fertility.

Healthy oils, Omega-3, flaxseeds, green vegetables, sesame, plant-based proteins, and dairy products help in controlling hormones production, keeping insulin in check, and enhancing regular ovulation.

Dr. Bhutani advocates a healthy diet much before you even plan to get pregnant. She emphasizes a healthy diet for both the man as well as the woman to be able to conceive a baby.

Exercise and Meditation

You need to gain control over your lives before entering parenthood. Exercise stimulates the pregnancy hormones and meditation helps alleviate stress due to infertility and other tensions. You need to be at peace to get pregnant soon. Shiva realized that stress was the most important factor that was curtailing pregnancy. Meditation helped her gain peace of mind to welcome the baby and get pregnant.

Last Words

Pregnancy is a feeling of utmost joy in the world. The thought of parenting the little bundle of joy can be the happiest feeling.

If infertility or miscarriage are the obstructions, get in touch with Punjab’s best and the most reliable gynecologist, Dr. Shivani Bhutani at EVA Hospital, Ludhiana and seek consultation regarding IVF and effective alternate sources of treatment to enter the world of parenthood.