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Acid reflux

Acidity or acid reflux is the back flow of stomach acid to the chest cavity. It is a very common medical condition among people. It is often caused by one or multiple factors. The gastric acid which aids digestion in stomach rises up to the chest cavity or food pipe. This happens when  the lower oesophageal spincher (LES) that regulates the flow of food from oesophagus to stomach doesn’t close or opens too long.



  • Hiatal hernia: This is a stomach abnormality that occurs when gastric acid builds up or fills the oesophagus as the lower part of the stomach and lower oesophagus moves above the diaphragm.
  • Excess production of acid in the stomach.
  • Excess consumption of spicy and oily foods.
  • Irregular eating patterns and habits.
  • Side effects of medices.
  • Consumption of alcohol.
  • Being pregnant.
  • Snacking just before bed time.
  • Lying on the back or bending over at waist just after a heavy meal.


Acid reflux is generally characterised by a  burning sensation in the stomach throat and heart. The person with acidity may face difficulty in swallowing, indigestion, constipation, restlessness and prolonged sour taste in mouth. Nausea and bad breath are other common symptoms of acidity.


Acidity is usually self diagnosable with its symptoms. If it doesn’t help, a doctor may ask you to undergo,

a) an X-ray of stomach and oesophagus.

b)an endoscopy of gastrointestinal tract


  • Antacids: It helps neutralise the stomach acidity
  • H2  receptor blockers/ histamine blocking agents like nizatidine, famotidine, cimetidine.
  • Home remedies include consuming mint leaves, ginger, clove cardomom, banana , cucumber etc.
  • Drinking a glass of milk every day helps reduce acidity.
  • Follow regular eating patterns.


Choking is a medical emergency where in a foreign body obstructs the air passage to lungs. It is often life threatening caused due to inhalation or ingestion of food or another object .This obstruction can be partial or complete.Partial obstruction allows some air passage to lungs and compete obstruction prevents air passage to lung. It prevents normal breathing and thus body is deprived of oxygen delivery leading to asphyxia. It can be fatal.



  • Difficulty in breathing ,gasping and wheezing
  • Difficulty to speak.
  • Clutching, and grabbing of throat or mouth.
  • Person’s face turns blue and may become unconscious.


It occurs when a foreign body blocks the air passage to lungs. The object may block either the upper or lower air passages. The most common causes of choking are food and toys. Nuts, seeds, peanut butter are the causes of choking in children.Toy and toy parts also have high potential to completely block the airway in children.


  • Alternate back blows and abdominal trust.

a)Five back blows: Stand behind the person choking /kneel down behind a hoking child.Bend the person so that his upper body is parallel to the ground and blow between the shoulder blades using the heel of your hand. Repeat it five times.

b)Wrap the person in your arms at his waist. Position one fist above the person’s navel and hold the fist in the other hand and deliver a hard and quick upward thrust to the abdomen.continue doing this five times.

In case of infants less than one year.

  1. Hold the infant face down in a seated position.
  2. Support his head and neck with your hand so that the head is lower than the trunk.
  3. Blow the infant gently between the shoulder bones using the heels of your arm five times.
  4. If the infant is still not breathing,turn him face up n your fore arm resting on your thigh with the head lower than the trunk.
  5. Give five chest compressions at the center of breast bone using two fingers.Press down to a depth of 1.5 inches and let the chest rise again between each compressions.


Alopecia Areata




Alopecia areata is a medical condition in which hair falls out in round patches..It is an autoimmune disease which is affected by one’s genetic makeup along with factors such as stress and extremes of dieting. The fall out of hair can be from the scalp or elsewhere on the body. Though the hair re grows, it may fall out again and often the hair loss lasts for years. It can occur in all age groups and otherwise healthy people.


  • Hair fall out in patches: Patches of hair are usually noticed on one’s pillow or in shower. Hair fall out may occur on scalp, eyebrows, eyelashes and beards.
  • In severe cases some patients go bald
  • Nail problems: Nails show pinpoint pitting, white spots and loss their shine often splits.
  • Exclamation mark hair: Hair may grow narrow at the end and as round patch at the bald end.


It is an autoimmune disease where the body attacks its own hair follicles. It is not contagious. Alopecia areata patients may have a family history of this disease and are at a higher risk for thyroid disease, vitiligo, asthma , eczema and hay fever.


  • Skin biopsy: A small piece of skin is removed and studied under a microscope by a dermatologist.
  • Blood tests: To look for any chances of other autoimmune diseases.


Currently there is no approved treatment and complete cure so far. Some immunosuppressants and hair regrow medicines are often prescribed by dermatologists to help hair regrow.

Immunosuppressants like corticosteroids and hair regrow medicines such as minoxidil, anthralin and diphencyprone are some other medicines that triggers allergic reactions that help hair regrowth.

Light therapy or photo chemotherapy is a radiation treatment which uses both oral medication called psoralens and UV light.Essential oils like tea rose, rosemary ,lavender, peppermint and oils like coconut, olive,castor and jojoba help reduce symptoms.

The effectiveness of treatment may vary among patients. However hair regrowth may only be temporary. Hair may regrow and fallout again.


Constipation refers to less than three bowel movements in a week. It is the inability to completely empty your bowel or pass stool regularly. A person affected by constipation has a delayed or infrequent emptying of dry hardened feces. Though it affects people of all ages, it affects twice as many women as men and is more common in older adults and during pregnancy. IMG-20190318-WA0019Constipation occurs as a result of too much absorption of water from the food by the body before the waste is stored in the rectum. However, constipation can also occur due to many other reasons.


a. Reduced fiber in diet which includes fruits, vegetables and cereals.
b. Change in eating habits or lifestyle or routine.
c. Ignoring the urge to pass stool.
d. Side effects of certain medicine.
e. Reduced or lack of fluid intake.
f. Depression and anxiety.
g. Physical inactiveness or lack of exercise.
h. In many people milk and dairy products can cause constipation.


Constipation can cause complications like rectal bleeding after continually trying to pass stool, anal fissures around the anus due to straining to open the bowel, swollen inflamed blood vessels of veins in the rectum and fecal impactions in which dried stools collect in rectum and anus leading to an obstruction in the path.


Constipation is generally diagnosed based on one’s symptoms and medical history. General physicians throws up a questionnaire based on which a diagnosis is made, like

a. Do your bowels open less than three times a week?
b. Do you need to strain to open your bowel on more than a quarter of occasion?
c. Do you pass a hard or pellet like stool on more than a quarter of occasion?
The physician may then suggest for some tests for diagnosis like,
a. Physical examination: It includes internal rectal examination to feel for any stool that may have collected. This test is rarely carried out in a child.
b. Blood tests to rule out other conditions.
c. X-rays to produce images of the inside of your abdomen.


The often recommended and first treatment includes changes in diet and lifestyle. Increasing the intake of dietary fiber, drinking plenty of fluids regular and more exercise helps to prevent constipation. Oral laxatives medications are recommended by doctors to empty bowels .Also try resting your feet on a height so that your knees are above your hips .This helps passing stool easier.

Gestational Diabetes

Gestational Diabetes Mellitus (GDM) is the diabetes that occurs during pregnancy and usually disappears after delivery.As gestational diabetes can harm mother and unborn baby,it is important to manage it. GDM appears in the second half of pregnancy ,in 24 -28 weeks.So it is necessary to conduct a screening for blood glucose around this period.31.GDM


In pregnancy, the placenta produces hormones that help the baby grow and develop. These hormones also block the action of the woman’s insulin. This is called insulin resistance. Because of this insulin resistance, the need for insulin in pregnancy is 2 to 3 times higher than normal. If you already have insulin resistance, body may not be able to cope with the extra demand for insulin production and the blood glucose levels will be higher resulting in gestational diabetes being diagnosed.
When the pregnancy is over and blood glucose levels usually return to normal and the gestational diabetes disappears, however this insulin resistance increases the risk of developing type 2 diabetes in later life.


Blood sugar that is not well controlled in a woman with gestational diabetes can lead to problems for the pregnant woman and the baby:

Extra Large Baby
GDM causes the baby’s blood sugar to be high. The baby is “overfed” and grows extra large.The baby can be born with nerve damage due to pressure on the shoulder during delivery.

Cesarean Section
Besides causing discomfort to the woman during the last few months of pregnancy, an extra large baby can lead to problems during delivery for both the mother and the baby. The mother might need a C-Section to deliver the baby.

Preeclampsia is when woman has high blood pressure, protein in her urine and swelling in fingers and toes.Women with diabetes have high blood pressure more often than women without diabetes. High blood pressure might lead to the baby being born early and also could cause seizures or a stroke in the woman during labor and delivery

If a woman’s diabetes was not well controlled during pregnancy, her baby can very quickly develop low blood sugar after birth. The baby’s blood sugar must be watched for several hours after delivery.

Testing for GDM

All women are screened for gestational diabetes at their 24 to 28 week routine check up. Women who are at higher risk may be tested more often. You are at higher risk of developing gestational diabetes if you:

  • are overweight
  • over the age of 25 years
  • a family history of type 2 diabetes
  • come from some Asian backgrounds
  • have had gestational diabetes before
  • have previously had polycystic ovary syndrome
  • have had a large baby before

Glucose tolerance test
Tests include the glucose challenge test and the oral glucose tolerance test (OGTT).‘Glucose tolerance test’ is the diagnostic test used to find out if you have gestational diabetes. It requires fasting for 10 hours (generally overnight). A blood test is taken, followed by a 75g glucose drink and further blood tests at one and two hours later. You will be required to remain at the laboratory for the two-hour duration of the test. If the results of the glucose challenge test show high blood glucose, you will return for an OGTT test to confirm the diagnosis of gestational diabetes.
diagnosis of gestational diabetes doesn’t mean that you had diabetes before you conceived, or that you will have diabetes after giving birth.
If you are diagnosed with GDM,you will need to consult diabetologist also in addition to your gynaecologist.

Mangement,Treatment and Prevention

Managing gestational diabetes includes following a healthy eating plan and being physically active. If your eating plan and physical activity aren’t enough to keep your blood glucose in your target range, you may need insulin.
You can lower your chance of getting gestational diabetes by losing extra weight before you get pregnant if you are overweight. Being physically active before and during pregnancy also may help prevent gestational diabetes.
If you had gestational diabetes, you are more likely to develop type 2 diabetes. Your child is more likely to become obese or develop type 2 diabetes. You may be able to lower your and your child’s chances of developing these problems by reaching a healthy weight, making healthy food choices, and being physically active.

For any queries regarding the procedure and treatment facilities,email us at .

Read about:Organ transplantation


Organ transplantation

Organ transplantation may be considered as one of  the miracles of twentieth century medicine.Transplant can save lives .Organ transplantation is the best therapy for terminal and irreversible organ failure. In some cases ,transplant  can also restore function to improve quality of life like transplanting the cornea is not necessary for life, but can restore sight.A transplant is an organ, tissue or a group of cells removed from the donor and transplanted into the recipient or moved from one site to another in the same person.To reduce the risk of rejection of the donated organ, the recipient will probably need to take immunosuppressive medication for the rest of their life.


 Types of Transplant

It is the transplantation of tissues in the same person.A transplant from one part of body to another part is called an autograft.

Below are a few examples of autografts

  • skin graft – uses healthy skin to help heal a wound or burn on another part of the body
  • blood vessel graft – provides an alternative route for blood flow to bypass a blocked artery, for example, in heart bypass surgery
  • bone graft – reconstructs a damaged area of the body, for example, in spinal fusion
  • bone marrow graft – for example, in a person with cancer, bone marrow collected before chemotherapy can replace their blood stem cells after high-dose chemotherapy.

The main advantage of autograft is that there is least probability of rejection, so long-term medication,immunosuppressants is not needed. However, the retrieval of the tissue results in a new wound in addition to the transplant site, from which the person will need to recover.

It is the transplantion from other people.A transplant between two people who are not genetically identical is called an allotransplant .Donor organs and tissues can be from people who are living, or people who have died because of a significant brain injury or lack of circulation.
Allotransplantation can create a rejection process where the immune system of the recipient attacks the foreign donor organ or tissue and destroys it. The recipient may need to take immunosuppressive medication for the rest of their life to reduce the risk of rejection of the donated organ.
For some transplants like bone marrow, there is also the possibility that immune cells in the donated bone marrow will recognise the host’s body as foreign and attack the cells of the host. This is known as graft-versus-host disease (GvHD).A transplant between identical twins is called an isograft. The recipient will almost never reject an isograft and so immunosuppressants are not needed.

It is the transplantation from other species.A transplant across species is called a xenotransplant.Heart valves from cows and pigs have been used for many years to replace faulty heart valves in people. The animal valves are treated before use to reduce the risk of the immune system rejecting the valve. Heart valves may also be replaced with human valves (allotransplant) or mechanical heart valves.

Transplantable organs and tissues

According to WHO,Kidney transplantation is by far the most frequently carried out transplantation globally.Although end stage renal disease patients can be treated through other renal replacement therapies, kidney transplantation is generally accepted as the best treatment both for quality of life and cost effectiveness.
Transplants can be for:

  • organs – heart, kidney, liver, lung, pancreas, stomach and intestine
  • tissue – cornea, bone, tendon, skin, pancreas islets, heart valves, nerves and veins
  • cells – bone marrow and stem cells
  • limbs – hands, arms and feet.

Although less in number,multi-organ transplants also occur each year. Common multi-organ transplants include heart and lungs or pancreas and kidney.
Medical advances and research  have opened new opportunities for innovation in transplant and are expanding to include face transplants!

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Read about:Varicose vein


Varicose vein

Varicose veins are swollen, twisted veins that can be visible just under the surface of the skin. Although it usually occurs in the legs, they also can form in other parts of the body also.Varicose vein is quite a common condition.29.varicosevein

Veins have one-way valves that help keep blood flowing toward your heart. If the valves are weak or damaged, blood can back up and pool in your veins. This causes the veins to swell, which can lead to varicose veins.
Many factors can raise your risk for varicose veins. Examples of these factors include family history, older age, gender, pregnancy, overweight or obesity, lack of movement, and leg trauma.Varicose veins are treated with lifestyle changes and medical procedures. The goals of treatment are to relieve symptoms, prevent complications, and improve appearance.


Weak or damaged valves in the veins can cause varicose veins. After your arteries and capillaries deliver oxygen-rich blood to your body, your veins return the blood to your heart. The veins in your legs must work against gravity to do this.One-way valves inside the veins open to let blood flow through, and then they shut to keep blood from flowing backward. If the valves are weak or damaged, blood can back up and pool in your veins. This causes the veins to swell.
Weak vein walls may cause weak valves.If these walls become weak, they lose their normal elasticity. They become like an overstretched rubber band. This makes the walls of the veins longer and wider, and it causes the flaps of the valves to separate.When the valve flaps separate, blood can flow backward through the valves. The backflow of blood fills the veins and stretches the walls even more. As a result, the veins get bigger, swell, and often twist as they try to squeeze into their normal space. These are varicose veins.
Many factors can raise your risk for varicose veins. Examples of these factors include family history, older age, gender, pregnancy, overweight or obesity, lack of movement, and leg trauma.

Associated vein problems

Telangiectasias are small clusters of blood vessels usually found on the upper body, including the face.These blood vessels appear red. They may form during pregnancy, and often they develop in people who have certain genetic disorders, viral infections, or other conditions, such as liver disease.Telangiectasias can be a sign of a more serious condition.

Spider Veins
Spider veins are a smaller version of varicose veins and a less serious type of telangiectasias. Spider veins involve the capillaries, the smallest blood vessels in the body.Spider veins often appear on the legs and face. They’re red or blue and usually look like a spider web or tree branch. These veins usually aren’t a medical concern.

Varicoceles are varicose veins in the scrotum and may be linked to male infertility.

Other types of varicose veins include venous lakes, reticular veins, and hemorrhoids. Venous lakes are varicose veins that appear on the face and neck. Reticular veins are flat blue veins often seen behind the knees. Hemorrhoids are varicose veins in and around the anus.


Duplex Ultrasound
Duplex ultrasound combines traditional with Doppler ultrasound. Traditional ultrasound uses sound waves to create a picture of the structures in your body, in this case the blood vessels and anything that may be blocking the flow of blood. Doppler ultrasound uses sound waves to create pictures of the flow or movement of the blood through the veins. Duplex ultrasound combined with traditional together gives a picture of the blood flow in your arteries and veins.

Although it is not very common, an angiogram givest a more detailed look at the blood flow through your veins.An angiogram helps to confirm whether you have varicose veins or another condition.


Varicose veins are treated with lifestyle changes and medical procedures. The goals of treatment are to relieve symptoms, prevent complications, and improve appearance.For more severe symptoms like pain, blood clots, or skin disorders ,one or more medical procedures may be needed.

Medical procedures

Sclerotherapy uses a liquid chemical which is injected into the vein to cause irritation and scarring inside the vein. It causes the vein to close off, and it fades away.This procedure often is used to treat smaller varicose veins and spider veins.

Microsclerotherapy  is used to treat spider veins and other very small varicose veins.A small amount of liquid chemical is injected into a vein which scars the inner lining of the vein, causing it to close off.

Laser Surgery
The laser light makes the vein fade away.Laser surgery mostly is used to treat smaller varicose veins. The main advantage is that no cutting or injection of chemicals is involved.

Endovenous Ablation Therapy
Endovenous ablation therapy uses lasers or radiowaves to create heat to close off a varicose vein.A device at the tip of the catheter inserted to the vein heats up the inside of the vein and closes it off.

Endoscopic Vein Surgery
For endoscopic vein surgery, a small cut is made in your skin near a varicose vein. A tiny camera is used at the end of a thin tube to move through the vein and a surgical device at the end of the camera is used to close the vein.Endoscopic vein surgery usually is used only in severe cases when varicose veins are causing skin ulcers.

Ambulatory Phlebectomy

For ambulatory phlebectomy,  doctor will make small cuts in your skin to remove small varicose veins. This procedure usually is done to remove the varicose veins closest to the surface of your skin.

Vein Stripping and Ligation
Vein stripping and ligation typically is done only for severe cases of varicose veins. The procedure involves tying shut and removing the veins through small cuts in your skin.


Plastic and cosmetic surgery

We often use plastic and cosmetic surgery interchangeably. But this is technically wrong although both specialities are closely related.Cosmetic surgery is focussed on enhancing appearance whereas plastic surgery is reconstructive in nature.Plastic surgery involves procedures for repairing defects to reconstruct normal functioning an d appearance.28.plasticsurgery

Plastic surgery is defined as a surgical specialty dedicated to reconstruction of facial and body defects due to birth disorders, trauma, burns, and disease. Plastic surgery is intended to correct dysfunctional areas of the body and is reconstructive in nature. Improving aesthetic appeal, symmetry, and proportion are the key goals of cosmetic surgery. Cosmetic surgery can be performed on all areas of the head, neck, and body. Because the treated areas function properly, cosmetic surgery is purely optional.

Types of plastic an cosmetic surgery

 For Head, face, and eyes

  • Facelift
  • Brow/forehead lift
  • Eyelid lift
  • Ear pinning
  • Ear reshaping
  • Hair replacement surgery
  • Nasal surgery
  • Nose reshaping
  • Chin, cheek, or jaw reshaping / facial implants
  • Lip augmentation
  • Cleft lip and cleft palate
  • Craniosynostosis (craniofacial anomaly)
  • Oral and maxillofacial surgery


  • Breast augmentation
  • Breast reconstruction
  • Breast reduction in men with gynecomastia
  • Breast lift


  • Tummy tuck (abdominoplasty)
  • Liposuction

Hand and upper limb

  • Chase Hand & Upper Limb Center


  • Chemical peel
  • Dermabrasion / dermaplaning
  • Collagen/fat injectable fillers
  • Botox/filler injections (restylane, radiesse)
  • Glycolic peels
  • Laser peels
  • Vein removal
  • Scar revision
  • Tattoo removal

Surgical Techniques Used in Plastic Surgery

Foetal medicine

Maternal-fetal medicine (MFM) is a specilaity of Gynecology and Obstetrics which specializes in health of pregnant women foetus.The department provides specialized care of the mother and fetus in complicated, high-risk pregnancies.The speciality is also called

Reasons to visit MFM

Sometimes it is the pregnant women who needs care for unexpected problems that develop during pregnancy such as early labor, bleeding, or high blood pressure.  In other cases, it is the baby who faces the non-routine. If birth defects or growth problems are found in the foetus, treatment can be started  before birth by providing monitoring, blood transfusions, or surgery to support babies with the best possible care until they are ready for delivery.

Reasons why you may see an MFM physician:

  • Pregnant women of advanced maternal age (35 years or older) at the expected time of delivery.
  • Pregnant women who have had an abnormal first trimester screening result (for down syndrome and/or Trisomy 18) or an abnormal second trimester quad screen result (for Down Syndrome, Trisomy 18 and/or spina bifida)
  • Pregnant women who have had a positive carrier test results for genetic conditions such as cystic fibrosis and sickle cell disease
  • Pregnant women experiencing complications such as bleeding, preterm labor, hypertension, diabetes and others
  • Pregnant women with a multifetal gestation (twins, triplets, quadruplets)
  • Pregnant women using medications, alcohol or other drugs which could be harmful to the unborn baby
  • Pregnant women who have an abnormality discovered by ultrasound
  • Couples who are pregnant or considering pregnancy who have a family history of birth defects, mental retardation or genetic conditions
  • Couples with unexplained infertility, recurrent miscarriages or fetal loss.
  • Problems with a previous pregnancy, such as multiple previous miscarriages, premature birth, low birth weight baby, Rh sensitization, prior cesarean delivery or a desire for Trial of Labor after cesarean (TOLAC), prior stillbirth or early neonatal demise
  • Cervical insufficiency, also known as incompetent cervix
  • Intrauterine growth restriction (IUGR)
  • Pre-pregnancy diabetes and gestational diabetes
  • Chronic high blood pressure in addition to gestational hypertension, preeclampsia or eclampsia
  • Maternal heart disease such as repaired congenital heart malformation or coronary artery disease
  • Kidney disease such as chronic renal failure, nephropathy, kidney stones or lupus nephritis
  • Placenta abnormalities such as placenta previa (covering the cervix) or placental abruption (premature separation of the placenta)
  • Premature labor threatening to result in early delivery
  • Hyperemesis gravidarum (excessive nausea and vomiting during pregnancy)
  • Infections that could threaten a pregnancy, such as HIV/AIDS, STDs (sexually transmitted diseases), bacterial vaginosis (BV), cytomegalovirus (CMV), hepatitis B virus (HBV), hepatitis A virus (HAV), listerisosis, parvovirus BI9 infection (also know as Fifth’s disease), toxoplasmosis and urinary tract infections
  • Complication from thyroid diseases (Graves disease, Hashimoto’s disease, hypothyroid)
  • Complication from liver diseases (intrahepatic cholestasis of pregnancy, hepatitis, acute fatty liver of pregnancy
  • Thrombophilias or clotting disorders, such as Factor V Leiden mutation, prothrombin gene mutation, antithrombin III deficiency, protein S and protein C deficiencies
  • Autoimmune diseases, such as systemic lupus erythematosus
  • Reproductive abnormalities, such as double uterus
  • Umbilical cord abnormalities, such as vasa previa, nuchal cord, umbilical cord cysts or knots
  • Rh disease and other cases of alloimmunization
  • Managing pre-existing conditions that require medications, such as seizure disorders, cancer, interstitial cystitis, Crohn’s disease or ulcerative colitis,
  • Management of wide range of obstetrical emergencies, such as maternal hemorrhage

Prenatal Diagnostics

Some fetal problems may be identified during pregnancy through tests.Prenatal diagnosis assists couples in making informed decisions regarding the management of their pregnancy.Genetic counseling assesses the risk of passing an inheritable disease or birth defect to your baby.

Screening tests such as 1st Trimester Screening and Multiple Marker Screening (or Quad Test) provide information regarding the relative risk of having a baby with either a genetic (chromosomal) abnormality such as Down syndrome or a structural anomaly such as spina bifida.

  • 1st trimester screening for fetal chromosomal abnormalities is done between about 11 weeks and 13 weeks 6 days of pregnancy. It combines two modalities, ultrasound and a maternal blood specimen. It provides information about a woman’s risk for having a child with Down syndrome  and Edwards or Patau’s syndrome
  • Multiple Marker Screening or Quad Test assesses the child’s risk for having a chromosomal abnormality or neural tube defect (spina bifida or anencephaly).  It is a screening test, not diagnostic. Performed between the 16th and 20th weeks of pregnancy, a sample of the mother’s blood is drawn to help adjust a pregnant woman’s age-related risk.
  • Diagnostic tests used to identify conditions are amniocentesis, chorionic villus sampling (CVS), targeted sonogram examination and percutaneous umbilical blood sampling (PUBS).
    • Amniocentesis is a technique to obtain amniotic fluid containing fetal cells from the “bag of waters” to analyze the cells for the number of chromosomes. It does require inserting a needle into the “bag of waters” to obtain the fluid containing the cells. It is usually done between 15 and 20 weeks of pregnancy for this purpose.
    • CVS is a procedure to obtain a sample of the placenta to detect fetal chromosomal abnormalities. The test is used when information about the chromosomes of the fetus is desired earlier in pregnancy, since it is done between 10 and 13 weeks of pregnancy. This test involves inserting a needle into the developing placenta to obtain the sample.
    • High resolution ultrasonography, including 3-D ultrasonography when indicated, helps identify fetal abnormalities.
    • Percutaneous umbilical blood sampling (PUBS) detects chromosomal abnormalities and blood abnormalities (fetal hemolytic disease) and may be used to diagnose fetal infection (toxoplasmosis or rubella), abnormal fetal platelet count and Rh incompatibility (alloimmunization). It is rarely needed now but when necessary it typically is done later in pregnancy, at 20 weeks of pregnancy and beyond.
  • Maternal blood tests can determine a woman’s status regarding the Rh factor, immunity to rubella (German measles), Parvo virus, toxoplasmosis and chickenpox.


Cervical cerclage is a surgical procedure performed when the cervix cannot hold a pregnancy inside the womb against the forces of gravity.  A stitch is placed to help the developing baby remain inside the uterus as long as possible or until 37-38 weeks of pregnancy. The procedure is often used if the mother has a history of second-trimester miscarriages without labor, a damaged cervix, a previous cone biopsy or LEEP procedure, or an inherited uterine anomaly.There are currently no treatments for fetal chromosomal abnormalities. When the condition is known before birth, full preparations can be made for the arrival of a child who will have special needs.Alloimmunized pregnancy, either from the Rh factor or other red blood cell factors, may require intrauterine transfusion of blood to the fetus to treat or prevent serious fetal low blood count.


First aid

A sudden health illness or injury can occur anytime or anywhere.In these critical situations,it is important to exercise immediate care procedures before emergency services arrive or can be reached.First aid consists of simple life saving techniques.26.Firstaid

Firstly,let us understand some first aid facts.

  • Aims of first aid are 3 P s .It stands for preserve life,prevent harm and promote recovery
  • ABC is how it is performed.It stands for airway,breathing and circulation.
  • CPR is the most important first aid procedure.It stands for cardiopulmonary resuscitation which helps maintain the flow of oxygenated blood.


  • Airway: Making sure the airway is clear. Choking, which results from the obstruction of airways, can be fatal.
  • Breathing: Once the airways are confirmed to be clear, determine whether the person can breathe, and, if necessary, provide rescue breathing.
  • Circulation: If the person involved in the emergency situation is not breathing, the first aider should go straight for chest compressions and rescue breathing. The chest compressions will promote circulation. This saves valuable time. In emergencies that are not life-threatening, the first aider needs to check the pulse.

Recovery position

Even if the individual is breathing,it needs to be made sure that theere is no risk of airway obstruction. The recover position is critical in keeping the patient alive for longer in emergency situtations. Following are how the recover position should be cleared.

  1. Remove glasses if the individual is wearing them.
  2. Kneel next to the person, and place the arm nearest to you at a right angle to the body.
  3. Bring the other arm across the chest. Hold the back of your hand against their nearest cheek.
  4. With your other hand, hold the thigh furthest from you and pull up the knee. Make sure the foot is flat on the ground.
  5. Slowly pull down on the raised knee, and roll the body over towards you.
  6. Move the upper leg slightly, so that the hip and knee are bent at right angles. This makes sure that they do not roll onto their face.
  7. Gently tilt the head back so that the airway is kept open.


If a person is not breathing, CPR needs to be done. These chest compressions and rescue breaths can triple the chances of saving the life of the person.If you are not alone, send someone to call for help. While help is on the way, follow these CPR steps:

  1. Position your hand
    Make sure the patient is lying on his back on a firm surface. Kneel beside him and place the heel of your hand on the center of the chest.
  2. Interlock fingers
    Keeping your arms straight, cover the first hand with the heel of your other hand and interlock the fingers of both hands together. Keep your fingers raised so they do not touch the patient’s chest or rib cage.
  3. Give chest compressions
    Lean forward so that your shoulders are directly over the patient’s chest and press down on the chest about two inches. Release the pressure, but not your hands, and let the chest come back up.Repeat to give 30 compressions at a rate of 100 compressions per minute.
  4. Open the airway
    Move to the patient’s head. Tilt his head and lift his chin to open the airway again. Let his mouth fall open slightly.
  5. Give rescue breaths
    Pinch the nostrils closed with the hand that was on the forehead and support the patient’s chin with your other hand. Take a normal breath, put your mouth over the patient’s, and blow until you can see his chest rise.
  6. Watch chest fall
    Remove your mouth from the patient’s and look along the chest, watching the chest fall. Repeat steps five and six once.
  7. Repeat chest compressions and rescue breaths
    Place your hands on the chest again and repeat the cycle of 30 chest compressions, followed by two rescue breaths. Continue the cycle.

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