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CORONA VIRUS AND PREGNANCY

Pregnancy is an exciting and stressful time. Your mind races with a number of questions and concerns ranging from mild to very serious when you are ill. A common question is how illness affects the baby while you’re pregnant.

In 2019, a new virus hit the world scene and is spreading rapidly, a novel Corona virus responsible for the respiratory
disease  COVID-19 .
And in 2020, the  World Health Organization (WHO) trusted Source  declared the global outbreak of  COVID-19 a “public health emergency of international concern’’

COVID-19 is still a new disease that hasn’t been well studied.
How it affects pregnant women and their developing babies isn’t fully known

WHAT IS CORONA VIRUS ?
Corona virus disease 2019 (COVID-19) is defined as illness caused by a novel corona virus now called SEVERE ACUTE RESPIRATORY SYNDROME Corona virus 2 (SARS-CoV-2; formerly called 2019-nCoV), which was first identified amid an outbreak of respiratory illness cases in Wuhan City, Hubei Province, China. They are a family of viruses that circulate in both humans and animals and can cause everything from the common cold to more serious respiratory illnesses.

EFFECTS OF CORONA VIRUS IN PREGNANCY
1. What are the symptoms in a pregnant woman infected with corona virus?

  • Mostly mild flu like symptoms-Dry cough, Fever, Sore throat, runny nose, fatigue, Headache, nausea, diarrhoea
  • Moderate to severe symptoms-Shortness of breath,Pneumonia, Severe Acute Respiratory Distress syndrome

Symptoms  typically appear between 2 and 14 days after exposure to the new coronavirus.

2. What are the modes of spread of Corona Virus infection?
The COVID-19 virus spreads primarily through droplets of saliva or discharge from the nose when an infected person coughs or sneezes

3. Are pregnant women at high risk of corona virus infection?
Large majority of pregnant women experience only mild to moderate flu like symptoms. More severe symptoms like Pneumonia are common only in older people and immunodeficient individuals.As yet there is no evidence to prove that pregnant women who get this infection are at risk of severe complications

4. Will it affect the baby when a pregnant mother gets corona virus infection ?
As it is a new infection, there is as such no evidence that the virus can pass to your baby while you are pregnant or during birth (this is called vertical transmission) or retardation of baby’s growth and development or miscarriage or premature delivery

5. Can the virus be transmitted to the baby during child birth?
As this infection can be transmitted only by droplet infection or nasal discharge or aerosol it is very much unlikely that the virus can be transmitted during childbirth

6. Will only C section be needed for a pregnant lady with covid 19 during the time of labour?
vaginal delivery is favorable to a cesarean delivery, provided you’re eligible for a vaginal delivery and aren’t recommended for a c-section due to other factors

7. Can an infected mother breast feed her baby?
In a few studies done on breast feeding mothers with corona virus there is no evidence of virus transmission through breast milk

However to limit the exposure of baby to virus,during breast feeding these precautions are recommended

  • Wash your hands before touching your baby, breast pump or bottles
  • Try to avoid coughing or sneezing on your baby while feeding at the breast
  • Consider wearing a face mask while breastfeeding, if available

8.Will the baby be tested for Corona virus?
Yes, if mother has suspected or confirmed Corona virus at the time of delivery, baby will be tested for Corona virus.

9.What can be done to reduce the risk of catching Corona virus during pregnancy?

  • Wash your hands regularly with soap and water for 20 seconds, or clean them with alcohol-based hand rub.
  • Maintain at least 1 metre distance between you and people coughing or sneezing.
  • Avoid touching your face mainly mouth, nose and eyes.
  • Cover your mouth and nose with tissue or face mask when coughing or sneezing. Discard it immediately after use
  • Practice cough etiquette by coughing into a flexed elbow
  • Stay home if you feel unwell.
  • Practice physical distancing by avoiding unnecessary travel and staying away from large groups of people.
  • Eat well. Get enough rest.Minimal exercise

10. Do all pregnant women need to be tested for Corona virus and what is the test recommended?
Pregnant mothers with mild mild symptoms need not be tested and need only home isolation, paracetamol for fever and symptomatic treatment , adequate rest and hydration Recommended tests include RT PCR analysis of Naso pharyngeal or throat swabs

11. Is there any medicine/vaccine or antibiotic available?
No vaccine or medicine available.Antibiotics are not effective. Only symptomatic treatment advised

TAKE HOME MESSAGE TO ALL PREGNANT MOTHERS

  • Be prepared but not scared about the virus.
  • Practise regular hand washing, social distancing, avoidance of crowds and proper cough etiquette to protect you and your baby

Dr.M.Rose Raichel, MBBS, DNB(INT.MED),F.Diab
Consultant Physician and Diabetologist
Mehta Hospital Global campus, Velappanchavadi

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Covid – 19: Pregnant Women need to know

Coronavirus or COVID-19 is an infectious respiratory disease that has turned into a global pandemic and has been spreading from people-to-people through respiratory droplets when an infected person coughs or sneezes. As the virus has a slow rate of decay people who touch surfaces or objects with viruses on them are at risk of being infected when they touch their mouth, nose, and eyes later. Sometimes infected people may not show immediate symptoms of illness; however, they are able to spread the virus to other people, through direct or indirect contact. Thus, it becomes necessary to take preventive measures such as maintaining social distance and regularly washing or
sanitizing the hands with soap or hand sanitizer.

Coronavirus like all virus of similar type such as SARS, MERS, etc. poses a high risk to people with weaker immune system or distracted immune system such as those with older age, severe medical condition and pregnant women. Thus, it is very essential for people coming under this group to be very cautious and take necessary preventive steps to avoid getting infected.

As COVID-19 is a new virus, there isn’t much data available on its behavior and effect on pregnant women and babies, however researchers have been able to find and predict a few of the patterns through past data collected from viruses of a similar type such as SARS and MERS. The following is a list of information that pregnant women should know:

Are women with pregnancy at high risk of getting infected?
Present data is not enough to determine the level of risk COVID-19 poses to pregnant women and has been said to be the same level as any average healthy adult; but based on past data collected from a virus of a similar type, pregnant women are at a high risk of getting infected since the immune system is less quick in responding to infection during this period.

While the disease may show symptoms in the form of mild or moderate flu, they are at risk of developing severe symptoms such as pneumonia and high fevers which can lead to devastating results such as birth defects, miscarriage, and stillbirth. Thus, it is necessary to be in constant touch with the healthcare provider when showing the slightest sign of infection.

Will the infection be transmitted to the baby?
The good news is that there has been no virus detected in amniotic fluid, cord blood, placenta tissue or breast milk and currently it is assumed that there is no vertical transmission of the virus from mother to fetus.  Although, at least two cases of possible vertical transmission have been reported, it remains unclear if the newborns with COVID-19 were infected after birth or were born with the infection.

Will the infection affect pregnancy?
In some cases mothers with COVID-19 infection have given birth prematurely, but the total number of such cases is very low to determine if the infection has caused early labor or if it was recommended to carry delivery sooner to preserve the mother’s health.

How to prevent or reduce of getting in infected?
As there is no vaccine or treatment available to cure people infected with COVID-19 in the present time taking preventive measures is the only way to ensure safety from this pandemic. The following is a list of methods to prevent getting infected from COVID-19:

  • Practise social distancing both at home and outside. It is even better to avoid going outside if possible.
  • Wash hands frequently.
  •  Use a tissue when coughing or sneezing and safely discard them in the trash can, also remember to disinfect hands later.
  • Avoid contact with people showing symptoms of the infection.
  • Avoid places with large and small gatherings such as markets, malls, restaurants or other enclosed spaces since infection can spread easily in these places.
  •  Avoid using public transport unless necessary.
  • Use telephone or online services to order essential services.
  • Don’t attend gatherings of friends or family and recommend them not to in this period.
  • Work from home if possible.
  • Use a face mask both at home and outside.
  • Be in touch with your healthcare provider and not hesitate to inform them if there is the slightest sign of infection.
  • Try not to touch your face, eyes, nose, and mouth as much as possible.
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COVID-19 Uncovered

Since December of 2019, the world is experiencing one of the worst pandemics of 21st century after 2009’s H1N1 influenza, COVID-19 or the Coronavirus disease 2019 is a new strain of the virus which was previously undiscovered and belongs to the large family of Coronaviruses ; a group of viruses that usually infect and cause disease in mammals and birds.
In humans, this group of viruses appears in the form of respiratory tract infection that can range from mild levels of cold or fever to fatal levels of pneumonia and multi-organ failure. Interestingly, it shares the same origin with other epidemics which have affected the 21 st  century on a global scale SARS and MERS, although on a greater scale. The rate of infection and spread of COVID-19 is far greater than the SARS and MERS epidemic, with 14, 171 + deaths and 339,645+ confirmed infected cases globally, this pandemic has forced countries to halt production and enforce a curfew for preventing further spread of infection.
Here is little information about COVID-19 that can help you become aware and take preventive actions against this global pandemic:

Signs & Symptoms
Generally, those infected with COVID-19 show mild flu-like symptoms such as cold, fever, sore throat and shortness of breath in the initial stages. These symptoms appear within 2-14 days from the date of infection.
As the disease further progresses it can cause difficulty in breathing, frequent chest pains, dizziness, difficulty in walking, abnormal heartbeat, etc. In severe cases COVID-19 causes pneumonia, severe acute respiratory syndrome and multi-organ failure eventually leading to death.

Causes
The COVID-19 primarily spreads between people via respiratory droplets such as cough and sneezes. Thus, one is at high risk of infection by having close contact with people infected with COVID-19 or by touching surfaces that may have come in contact with droplets such as hands, elevator switch, office tools, etc. The rate of decay of the virus on different material surfaces such as copper, cardboard, plastic, etc. can range from 4 hours to 72 hours.

High Risk Group
COVID-19 has a high chance of infecting people with weak immune system, older age and serious underlying medical condition such as those suffering from heart disease, lung disease and diabetes. Pregnant mothers are also very susceptible to be infected by COVID-19.

Prevention
As the virus is spread via close contact taking a few preventive steps can help avoid exposure to infection. The following is a list of preventive measures:

  • Wash hands regularly with soap and use hand sanitizer after having touched a contact surface such as hands, table, files, computer, handrails, etc.
  • Avoid touching face with unwashed hand.
  • Maintain suitable distance or currently trending term ‘social distance’ from others.
  • Avoid densely populated places such malls, markets, public transportation etc.
  • Avoid contact with pets and other animals.
  • Wear a face mask within and outside home.
  • Cough and sneeze into tissues and securely dispose them in trash bin and wash hands promptly afterwards.
  • Avoid sharing personal items and disinfect rooms and equipments routinely.
  • Constantly monitor symptoms and contact doctors immediately in case of abnormality.

Home isolation is currently the best solution to tackle this pandemic as there are no treatments or vaccine available to cure COVID-19. As with any disease prevention is always better than cure.

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utreus removal surgery

Uterus Removal Surgery

The Uterus removal surgery or Hysterectomy is a surgical procedure used for removal of the uterus (womb, the organ in which the baby grows during a women’s pregnancy) in women either partially or completely. At present, there many types of uterus removal surgery performed by surgeons; the type of surgery a patient needs is decided based on their medical history and the underlying cause for surgery. The uterus removal surgery is carried out to remedy certain conditions that affect the women’s reproductive system. These could include:

  • Chronic or long term pain caused in the pelvic region.
  • Development of Non-cancerous tumors or fibroids.
  • Menorrhagia or menstrual periods with abnormally heavy or protracted bleeding.
  • Development of Cancer in any portion of the patient’s reproductive system.
  • Endometriosis or abnormal tissue growth outside the uterine lining.
  • Uterine prolapse or sliding of the uterus from its standard position into the vaginal canal.
  • Thickening of the uterus.

The uterus removal surgery is typically divided into three categories:

Partial or Supracervical Hysterectomy – The upper fraction of the uterus is surgically removed, without affecting the cervix portion.

Total Hysterectomy – The complete uterus including the cervix is surgically removed.

Radical Hysterectomy – The surgery involves the removal of the uterus, upper cervix portion of the vagina and the tissue lining on either side of the cervix. This method is mostly used only for the treatment of cancer patients.

There are different techniques used for Uterus removal surgery but generally, it depends on the surgeon’s experience, the patient’s overall health condition, and the underlying condition. The type of surgery used will determine the size and form of the post-surgical scar if any and the duration of healing and recuperation required by the patient.

There are two types of approaches used for Uterus Removal Surgery:

Traditional or Open Surgery

Abdominal Hysterectomy is a type of open surgery and one of the most commonly used procedure for 54% of all conditions that require removal of the uterus. In this procedure the uterus is removed through a cut in the lower abdomen. The surgeon performs a 6-12 inch incision either horizontally or vertically across the stomach and removes the uterus through this incision. The patient usually spends 2-3 days in the hospital post-surgery and this technique also leaves behind a visible scar in the place of surgery.

Minimally Invasive Procedure

Minimally invasive the procedure is more popular among patients due to shorter duration of healing and lesser to no visible scars post-surgery. There are several types of minimally invasive procedures available for removal of the uterus, few of which include:

Vaginal Hysterectomy – A minor incision is made in the vagina through which the uterus is removed. This procedure leaves no visible scars post-surgery.

Laparoscopic Hysterectomy – This procedure uses a laparoscope, a tube with a lighted camera. Surgical tools are inserted through several minor cuts or one small cut in the belly button. The surgeon performs the operation from outside using a video screen to view the area of surgery. The size of the incision is very small and the healing period shorter compared to open surgery. The duration necessary to stay in hospital after surgery may just be a single night and there are no visible scars post-surgery.

Robot-assisted Laparoscopic Hysterectomy – This a version of laparoscopic hysterectomy in which the surgeon uses a state-of-art robotic system to perform the operation. This procedure provides better visualization in comparison to general laparoscopic hysterectomy and offers a distinct advantage when performing complicated surgery such as radical hysterectomy for patients with cancer in their reproductive system.

After, undergoing the uterus removal surgery, a woman will enter menopause immediately if the ovaries have been removed too. In case, the ovaries haven’t been removed during the operation they may enter menopause at an earlier age. It is also essential to understand that after having a hysterectomy the patient will no longer have periods, which signals the end of fertility or inability to bear a child. Thus, many women wait for completing their family before opting for the surgery.

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knee replacement surgery

Knee Replacement Surgery

Knee replacement surgery or Knee arthroplasty is used to alleviate pain and restore function to severely diseased knee joints.  The procedure involves removing damaged bone and cartilage segments from the thighbone, shinbone & kneecap and then replacing them with an artificial joint made of metal alloy, high-grade plastics and polymer. Knee replacement surgery in Chennai is primarily recommended for patients suffering from severe pain caused due to osteoarthritis. People with osteoarthritis find it painful to sit or stand for any duration; walk or climb a staircase and few even suffer pain even when resting.

A knee replacement surgery can help the patient lead a better life and avoid experiencing the constant pain they had prior to the surgery; they would gradually recuperate and resume physical activity like any other person. Although, they cannot engage in any intense physical activity they could still enjoy a brisk walk, light jog and sit or stand for any duration without a problem.

However, there are many stories circulating around Chennai which make a patient in need reluctant to perform a Knee replacement surgery. Friends and relatives talk about the surgery without much knowledge and loose information spreads inducing more fear.

Here is a list of 5 stories about Knee replacement surgery in Chennai that are simply not true:

Story 1: ‘A knee replacement surgery will put you in bed for a very long time’

Fact: Advancement in the field of surgery has made it possible for patients to be able to walk and use toilet independently within 1 or 2 days after surgery. Patients can begin walking outside within 3 weeks and resume working within 6 weeks.

Story 2: ‘I would need constant physiotherapy throughout the long recovery period’

Fact: About 99% of the people who underwent knee replacement surgery don’t require any physiotherapy. It is rare for physicians to recommend physiotherapy after the surgery as most people are able to recuperate on their own by practicing exercise instruction given before discharge. Also, the recovery period is very short and patients can walk without aid after 4 weeks.

Story 3: ‘People suffering from Diabetes or Hypertension or Heart disease are not able to undergo knee replacement surgery’

Fact: There is no restriction to undergo knee replacement surgery. The surgery takes place after a thorough assessment of the patient’s health condition. Although these diseases do not affect the result of surgery minimum caution is always necessary. In a certain sense, having a knee replacement surgery is better for patients suffering from these health conditions as after having undergone this treatment they would gradually be able to take long walks and maintain their health better.

Story 4: ‘Knee replacement would completely substitute the knee joints with artificial implants. A foreign object would definitely be rejected by the body’

Fact: Knee replacement is only used to restore or repair the knee joint rather than completely replacing it like a kidney. The operation is used to remove worn-out or damaged sections of the knee and replace them with artificial parts rather than implanting a complete artificial knee. Also, these implants are made with special alloys that are compatible with the human body and can stay in the system for a long time without any side effects.

Story 5: ‘Knee replacement surgery can be avoided by undergoing alternative treatment procedures such as massage with herbal oils, laser therapy, and Magnetic therapy etc.’

Fact: There is no clinically approved non-surgical cure for people suffering from conditions such as advanced arthritis or osteoarthritis. Alternative treatments such as these may be able to delay the condition and provide temporary relief; however, there is no avoiding the inevitable. Delaying the surgical procedure would only induce more panic and fear towards undergoing the procedure and worsen the condition of the knee.

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pregnancy

High-Risk Pregnancy Care

High-risk pregnancy is a term used to define scenarios when an expecting mother, her unborn child or both have high chances of experiencing critical health problems or even facing a life-threatening situation before, during or after childbirth.

Present-day technologies enable specialists to predict women who have greater chances of experiencing high-risk pregnancy even before they conceive and though there are cases where a pregnancy gradually develops into becoming high-risk one with time, with early prenatal care and constant check-ups such risks can be mitigated.

Factors What Can Cause High-Risk Pregnancy

There are many factors that can cause a pregnancy to enter the high-risk category; it may due to physical health, age, medical condition or even lifestyle. Here is a list of a few of the factors:

Advanced Age: Expecting mothers with an age, greater than 35 have a more chance of having a high-risk pregnancy.

Lifestyle Decisions: Women with habits of regular smoking, alcohol consumption and illegal drug abuse have higher chance of being affected.

Medical Condition/ History: Pregnant mothers having certain medical conditions such as diabetes, heart disease, chronic hypertension, deep vein thrombosis, pregnancy loss, etc or with surgical history of undergoing multiple abdominal and uterus surgeries such as c-section, uterine tumors, colorectal resection etc have a need for high-risk pregnancy care.

Pregnancy Complications: In certain cases complications might occur as the pregnancy progresses, such as fetal growth restriction, abnormal placenta position, Rh sensitization.

Multiple Pregnancy: High-risk pregnancy care is necessary in cases of expecting mothers carrying twins or more fetuses.

Living in Harsh Environment: Expecting mothers living in a harsh environment such as with extreme temperatures, radiation exposure, chemical exposure, or highly unhygienic and polluted environment may need high-risk pregnancy care.

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