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Preventive Health Check-A Boon To Society

Author: Dr.M. ROSE RAICHEL ,M.B.B.S,DNB(INT.MEDICINE), F.DIAB, CCGDM,
Consultant Physician and Diabetologist, Department of Internal Medicine
Dr. Mehta’s Hospitals
Good health begins with prevention and that all starts with the individual. Establishing good health habits means people may enjoy longer ,healthier,happier lives. Modern lifestyle doesn’t leave much time for exercise or having a healthy diet, leading to an increase in non communicable diseases like diabetes,hypertension, heart disease, strokes, dyslipidemia and cancers

Regular health check ups are an important part of prevention routine and help people on track with their health goals

The aim of health check is to help find, prevent or lessen the effect of a disease. Getting the right checks at the right time throughout the life may help people to detect potential health problems at the earliest. Health checks provide an insight of patients lifestyle,medical history and family history to identify preventable health conditions, which inturn allows early treatment and better outcomes

Health check ups help a person to understand their health needs,values and concerns, identify risk factors where they can make healthy lifestyle changes and enjoy better quality of life. Health checks are more cost effective rather than unexpected medical emergencies/ complications diagnosed later which are more expensive

Health  check up aims at early detection of cancers(cervical,breast, prostate, lung and bowel), diabetes, cardiac diseases ,hypertension,high cholesterol levels, metabolic and endocrine diseases, osteoporosis and early treatment and prevent the complications of the disease.All men above 35 yrs of age and women above 40 yrs of age should have an annual health check up.

General preventive measures include availability of fresh air, clean potable water, regular physical exercise, adequate rest, balanced and nutritious diet, avoidance of smoking and tobacco use, immunisation against certain diseases and of course regular medical checkup.

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Cervical cancer

Author: Dr. Lakshmi MBBS., MS (OBGY) Dip NB (OBGY) MRCOG ( London),
Department of Obstetrics & Gynecology,
Dr. Mehta’s Hospitals

What is cervical cancer?

Cervical cancer is the second most common cancer among Indian women (As per Globocan 2018). Cervical cancer develops in a woman’s cervix (the entrance to the womb from the vagina). It mainly affects sexually active women aged between 30 and 45.
The best way to protect yourself from cervical cancer is by attending regular cervical screening (previously known as a “smear test”) and follow up. Unfortunately, most women in India are not aware about the screening.

Burden of the disease

More women in India die from cervical cancer than in any other country.

  • New cases of cervical cancer detected in India: 96,322 every year
  • Deaths due to cervical cancer in India: 60,078/year

Risk factors?

Persistent infection of cervix with a virus called Human Papillomavirus (HPV)

  • Having many sexual partners
  • Husband having multiple sexual partners
  • Having first sexual intercourse at a younger age
  • Giving birth to many children
  • Smoking

Other diseases such as HIV/AIDS, immunosuppressive drugs, renal transplant etc.
These risk factors does not imply that you will definitely acquire cancer. However, if you have one or more of these risk factors, it is advisable to consult the doctor.

Can it be prevented​?

Cervical screening tests

Screening tests are performed  in apparently healthy women to detect abnormal changes in the cells of the cervix which are pre-cancerous and could possibly develop into cervical cancer in the future.  Available screening tests for cervical cancer include Pap smear test, VIA (visual inspection with acetic acid), VILI (visual inspection with Lugol’s iodine) and HPV DNA test.

Women aged 25 to 49 are invited for screening every 3 years. Women aged 50 to 64 are invited every 5 years. For women who are 65 or over, only those who have not been screened since they were 50, have had recent abnormal tests or have never been screened before are still eligible for screening.

It’s important to attend your cervical screening tests, even if you’ve been vaccinated for HPV, because the vaccine does not guarantee protection against cervical cancer.

If you’ve been treated for abnormal cervical cell changes, you may be invited for screening more frequently for several years after treatment. How regularly you need to go will depend on how severe the cell changes are.

Although it can identify most abnormal cell changes in the cervix, cervical screening is not 100% accurate. This means you should report any symptoms, such as unusual vaginal bleeding, to your GP, even if you’ve recently had screening.

HPV vaccination:  vaccines for cervical cancer target HPV 16 and 18, the most common oncogenic types of HPV responsible for cervical cancer. HPV vaccination is not effective against all oncogenic HPV types. Currently two vaccines, licensed globally are available in India; a quadrivalent vaccine (against HPV genotypes 6, 11, 16, 18) and a bivalent vaccine (against HPV genotypes 16, 18). . The recommended age for initiation of vaccination is 9–14 years. Catch-up vaccination is permitted up to the age of 26 years.
Females who have not been exposed to the HPV infection are likely to benefit more from the vaccine.

Indian Academy of Pediatrics (IAP) recommendations on HPV vaccination[4]:

Only 2 doses of either of the two HPV vaccines for girls aged 9-14 years: doses at interval of 6 months

For girls 15 years and older, and those with HIV/AIDS on chemotherapy or after organ transplant: dose at 0, 1-2 and 6 months.

Please Note:

Although the HPV vaccine can significantly reduce the risk of cervical cancer, it does not guarantee complete protection against cervical cancer. You should still attend cervical screening tests, even if you’ve had the vaccine.

VACCINATION IS NOT A REPLACEMENT FOR CERVICAL CANCER SCREENING

SAFER SEX

Most cases of cervical cancer are linked to an infection with certain types of human papilloma virus (HPV). HPV can be spread through unprotected sex, so using a condom can reduce your risk of developing the infection. Following safe sex practices (avoid multiple sexual partners) and timely treatment of reproductive tract infections can protect from cervical cancer

Avoid smoking

You can reduce your chances of getting cervical cancer by not smoking. People who smoke are less able to get rid of the HPV infection from the body, which can develop into cancer.

When to consult a doctor?

  • Abnormal vaginal bleeding: Bleeding and spotting between periods, unusually longer or heavier periods,
  • Bleeding aftermenopause
  • Unusual or excessive vaginal discharge with foul smell
  • Vaginal bleeding after having sexual intercourse
  • Pain in the lower abdomen or pelvic pain
  • Pain during sexual intercourse

If you have one or more of these, it is advisable to consult the doctor.

Cervical Cancer Screening Test

The Pap smear is a simple test that is done to collect a few cells from the cervix and and checked under a microscope for abnormalities. It also aids in diagnosing infections of the lower reproductive tract.

Who should get the Pap test done?

As per the International recommendations, women above the age of 21 years can get the pap test.

If you are 30 years and above Pap test should be done once in every 3 years till you turn 65 years of age. If this test is combined with HPV test, then the test may be repeated every 5 years.

Women who do not routinely require Pap test

Women aged less than 21 years and above 65 years

Women who had their womb removed for non-cancerous conditions

What is the right time for a Pap test?

The Pap test yields optimum results if scheduled between 10 to 20 days from the first day of menstrual period. The woman should not be menstruating at the time of test.

Preparation for Pap smear

You should avoid the following for 48 hours before the Pap test:

  • Intercourse
  • Douching of vagina
  • Vaginal medications
  • Vaginal contraceptives like creams/ jellies

Procedure

An instrument called a speculum is gently introduced into the vagina . This holds the walls of the vagina open so the cervix can be seen.There may be some discomfort or cramping during the procedure, but it is usually not painful.

A small soft brush will be used to gently collect some cells from the surface of your cervix. and then sent off to a laboratory for analysis and you should receive the result within 2 days.

Results of Pap test

A Pap test result may be reported as normal or abnormal.

Normal Pap test

If the test report is normal, this means  no abnormal cell changes have been found in the smear taken. A normal test result means  No action is needed and you don’t need another cervical screening test until it’s routinely due.

Inadequate

If the test report is inadequate , then you need to have a repeat test because the first one couldn’t be read properly.

This may be because:

  • not enough cells were collected
  • the cellscouldn’t be seen clearly enough
  • an infection was present

another sample of cells should be  taken, usually after about 3 months.

Abnormal Pap tests

If the report is abnormal , it can be either of the two:

  • borderline or low-grade changes (dyskaryosis)
  • moderate or severe (high-grade) dyskaryosis

If the result is low-grade, it means that although there are some abnormal cell changes, they’re very close to being normal and may disappear without treatment.

In this case, the  sample will be tested for HPV DNA. If HPV isn’t found , the risk of  developing cervical cancer before the  next screening test is very low.

Depending on the woman’s age ,  routine screening is done in  3 to 5 years

If HPV is found, then  examination called colposcopy, which looks at the cervix more closely is done

Abnormal Pap test results do not mean that the woman has cancer.It just means that some of the cells are abnormal, and if they’re not treated they may develop into cervical cancer.

If the test findings suggest more severe abnormality like  high-grade dyskaryosis, your sample won’t be tested for HPV, but you’ll be offered colposcopy to check the changes in the cervical cells, it is then confirmed by further diagnostic procedures:

Colposcopy: A procedure in which a colposcope (a lighted, magnifying instrument) is used to check the vagina and cervix for abnormal areas.

Biopsy: A sample of tissue is cut from the cervix and viewed under a microscope by a pathologist to check for signs of cancer. A biopsy that removes only a small amount of tissue (punch biopsy) is usually done in the OPD.

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Stricture Urethra

A urethral stricture is scarring in or around the urethra that narrows or blocks the passageway through which urine flows from the bladder. The scarring can occur anywhere between the bladder and the tip of the penis

Causes

Symptoms

It is much more common in men than women. Common in young . In addition to uncomfortable urinary symptoms such as reduced flow rate and more frequent urination, a urethral stricture can lead to complications that include urinary tract infections, prostatitis, urinary retention and kidney damage.

Diagnosis

The retrograde urethrogram and antegrade urethrogram are imaging techniques that can help to pinpoint the length, position, and severity of the stricture. This also helps to guide the treatment course.

Treatment

1. Gradually stretching the narrowed area with Teflon tubes is called dilation

2. Cutting the stricture with a laser or knife using a specially designed cystoscope (urethrotomy)

3. Surgically removing the stricture and then re-joining the ends with stiches (anastomotic urethroplasty)

4a. Graft of inner cheek mucosa taken

4b. The taken graft is used to reline the strictured part

Among the many approaches to treating strictures are gradually stretching them, a process called dilation; cutting the stricture with a laser or knife using a specially designed cystoscope (urethrotomy); and surgically removing the stricture and then reconstructing the area with grafts (anastomotic urethroplasty). The choice of treatment depends largely on the severity of the stricture. In minor cases in which the complication risk is low, doing nothing may be the best option; more moderate or severe cases are best addressed using either a minimally invasive or open surgical approach.

Contact

Dr.Kabilan Saminathan.MS.MCh

Department of Urology

Cell: 9600076566

urology@mehtahospital.com

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Importance of Regular Heart Health check-ups

“Read on to learn why seeing a doctor for regular health check-up is a must”


Let’s face it. We give a number of excuses that we may use to avoid seeing a doctor on a regular basis. That too when we are too young and healthy or too scared that something might really be wrong with us or just we are too busy. Whatever be the excuse, research shows that seeing your doctor for check-ups can actually save lives. both young or the old.

With heart disease being the number one killer of men and women worldwide, you must always remain in the accurate picture of perfect health. And to learn more about cardiovascular health, you must know the risk factors that you might have such as high cholesterol, hypertension or diabetes, being overweight or obese. The problem, however, is that not all of these risk factors are plain to see.

In fact, blood pressure and high cholesterol have virtually no symptoms, yet can cause virtually no symptoms but can cause permanent damage to the arteries. They can also lead to stroke or heart attacks and all that without you ever knowing the risk factors. This the main reason why nearly half of the individuals who are dying from a heart attack in 2018 had absolutely no symptoms of heart disease.

While it may be a scary thought, the good news is that we can take control of our heart health in a number of ways. First, by having regular check-ups, primary care doctors at Dr Mehta’s Hospitals can capture a picture of our health over time, helping them to notice any changes that may require further attention. They may also check for traditional cardiovascular risk factors such as high blood pressure and can treat or refer to a cardiologist if necessary. For all those who already know that there are a number of risk factors such as family history, high cholesterol can go ahead and make an appointment with our cardiologist at Dr Mehta’s Hospitals. By addressing the risk factors that you have, you can work with your doctor to lower the risk of heart attack or a stroke by up to 30 per cent. This is the advantage that something you could not pull off earlier.

What happens at a heart health check-up

A heart health check is done as part of a normal check-up with the doctor or the health practitioner. Your doctor will be taking blood tests, check your blood pressure and ask you about your lifestyle and your family. Give the doctor as much information as you can about your lifestyle and family. Once the doctor has your blood tests on hand, you can ask them for your report which will state if you have high(>15%), moderate(10-15%) or low risk(<10%) of a heart attack or stroke. Most guidelines suggest that individuals of all ages should see their primary care provider once each year, at a minimum.

Taking care of your heart should be a priority and getting regular checkups is the best way to ensure you’re keeping your heart healthy. To learn more about keeping your heart healthy, visit https://mehtahospital.com/index.php/master-health-checkup/ or e-mail at appointments@mehtahospital.com to schedule an appointment.

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Healthy Thyroid Gland Function means Healthy Pregnancy

Author:Dr. Swetha Rajan. MBBS., MS.,
Dr. Mehta’s Hospitals
Thyroid gland is Butterfly shaped gland that is located in the neck, which produces hormone called ‘Thyroxine’ that plays pivotal role in maintaining various bodily functions. Thomas Wharton in 1656 gave the Thyroid gland its modern name. Abnormal function of thyroid gland is more common in Adults, more common in Females than in Males, and frequently has undesirable consequences.
Hypothyroidism is a condition where in thyroid gland fails to produce enough of hormone known as ‘Thyroxine’. Women with Hypothyroidism may experience poor ability to tolerate cold, feeling of tiredness, constipation, depression, weight gain, swelling in the front of neck, menstrual abnormalities, infertility and decreased IQ.Thyroxine produced by the pregnant woman is important for normal brain development of the unborn offspring. Hence it is essential to identify and treat any abnormal thyroid function during pregnancy. The pregnant woman is required to make 50% more of thyroid hormone during pregnancy to meet the demands rendered by her Fetus. Some Women are known to be unable to meet this increased demand in pregnancy, resulting in an overall reduction in thyroid hormone production and progression towards Hypothyroidism.As per the National data, it’s noted that 4.8 – 12% pregnant women in India suffer from Hypothyroidism.

As per the national guidelines, Screening for hypothyroidism with blood tests measuring TSH (Thyroid stimulating hormone) and Thyroxine levels are recommended in ‘all the at risk’ pregnant women. It’s worth a note that Women who are diagnosed to be Hypothyroid are advised to take thyroxine medications regularly on advice of the care taker.
Early diagnosis and treatment of hypothyroidism in pregnancy are potentially known to reduce the adverse effects of hypothyroidism on the pregnant Women and their Offspring.

Fact Box:
4.8 – 12% pregnant women in India suffer from Hypothyroidism.
Deficiency of thyroid hormone in pregnancy can lead to:

  • Miscarriage
  • Hypertension or fits during pregnancy
  • Diabetes
  • Intra uterine growth restriction
  • Excessive bleeding during delivery
  • Preterm birth
  • Low birth weight baby
  • Respiratory distress and consequent hospitalization of newborn
  • Possibility of a birth defect in offspring or low IQ baby-Cretinism
  • Rarely Heart failure.

Notable risk factors for Hypothyroidism:

  • The Prevalent Iodine deficiency in people residing in hilly areas and foothills
  • Iron deficiency anemia
  • Obesity
  • prior thyroid dysfunction or prior thyroid surgery
  • History of thyroid dysfunction in parents/siblings/Children
  • History of diagnosed mental retardation in family/previous births
  • History of infertility
  • Known autoimmune diseases.
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