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Nuclear medicine

Feb 21, 2019 Posted by admin General, Speciality 0 comments

Did not expect word ‘nuclear’ in the field of medicine?Well,’Nuclear Medicine’ exists and let us understand it here.
Nuclear medicine is a subspeciality of medical imaging/radiology.But unlike radiology where radiation enter the body from outside,radioactive materials are introduced to the body in Nuclear medicine.These radioactive tracers in combination with imaging instrumentation is used to assess bodily functions and to diagnose , determine the severity of or treat a variety of diseases, including many types of cancers, heart disease, gastrointestinal, endocrine, neurological disorders and other abnormalities within the body.

Technique explained

Small amounts of radioactive materials are attached to special compounds to form radiopharmaceuticals. The radioactive part is referred to as a radioactive label or a radioactive tracer.The pharmaceutical part,complex molecules, helps to carry the radioactive part to the area of the body being studied. It is mostly the pharmaceutical part that determines where the radiopharmaceutical will go inside the body.
Radiopharmaceutical is injected,inhaled or swallowed depending on the type of medical examination.This makes the body slightly radioactive for a short time. A special nuclear medicine camera detects the radiation, which is emitted from the body and produces an image of the tracer’s distribution in the body.Because the tracers follow physiological pathways, the result is a functional image.It can show disease processes based on increased or decreased uptake of the tracer compared to normal in various organs. As nuclear medicine procedures are able to pinpoint molecular activity within the body, they offer the potential to identify disease in its earliest stages as well as a patient’s immediate response to therapeutic interventions.

Nuclear medicine Vs Other imaging techniques

Nuclear medicine scans detect the radiation coming from a radiopharmaceutical that is inside a patient’s body. In contrast, other imaging procedures (for example, X-ray and CT scan) obtain images by using machines that send radiation through the body.
Nuclear medicine is also different from other imaging procedures in that it determines the presence of disease based on biological changes in tissue rather than changes in anatomy.
Nuclear medicine procedures are among the safest diagnostic imaging exams available; the amount of radiation received from a nuclear medicine scan is comparable to that of many diagnostic X-ray and CT procedures.

Types of Scans

Single Photon Emission Computed Tomography or SPECT and Positron Emission Tomography or PET scans are the two most common imaging modalities in nuclear medicine.

SPECT imaging instruments provide three-dimensional (tomographic) images of the distribution of radioactive tracer molecules that have been introduced into the patient’s body. The 3D images are computer generated from a large number of projection images of the body recorded at different angles. SPECT imagers have gamma camera detectors that can detect the gamma ray emissions from the tracers that have been injected into the patient. Gamma rays are a form of light that moves at a different wavelength than visible light. The cameras are mounted on a rotating gantry that allows the detectors to be moved in a tight circle around a patient who is lying motionless on a pallet.
SPECT scans are primarily used to diagnose and track the progression of heart disease, such as blocked coronary arteries. There are also radiotracers to detect disorders in bone, gall bladder disease and intestinal bleeding. SPECT agents have recently become available for aiding in the diagnosis of Parkinson’s disease in the brain, and distinguishing this malady from other anatomically-related movement disorders and dementias.

PET scans also use radiopharmaceuticals to create three-dimensional images. The main difference between SPECT and PET scans is the type of radiotracers used. While SPECT scans measure gamma rays, the decay of the radiotracers used with PET scans produce small particles called positrons. A positron is a particle with roughly the same mass as an electron but oppositely charged. These react with electrons in the body and when these two particles combine they annihilate each other. This annihilation produces a small amount of energy in the form of two photons that shoot off in opposite directions. The detectors in the PET scanner measure these photons and use this information to create images of internal organs.
The major purpose of PET scans is to detect cancer and monitor its progression, response to treatment, and to detect metastases. Glucose utilization depends on the intensity of cellular and tissue activity so it is greatly increased in rapidly dividing cancer cells. In fact, the degree of aggressiveness for most cancers is roughly paralleled by their rate of glucose utilization. In the last 15 years, slightly modified radiolabeled glucose molecules (F-18 labeled deoxyglucose or FDG) have been shown to be the best available tracer for detecting cancer and its metastatic spread in the body.A combination instrument that produces both PET and CT scans of the same body regions in one examination (PET/CT scanner) has become the primary imaging tool for the staging of most cancers worldwide.

Other types

Bone or Joint Scan: The scan is done to identify abnormal areas within the bones or joints. A small amount of radioactive material is injected into the vein and then images are taken 2 to 3 hours after the injection.
Gallium Scan: This is done to detect infection or tumor. A special camera is used to capture images. After the injection of a radioactive material, the images are taken after 24, 48 or 96 hours, depending on the medical history of the patient.
Gastric Emptying: This is done to evaluate the function of the stomach.
Hepatobiliary Scan: This test is done to evaluate the function of gall bladder and to assess the bile ducts. After the injection of the radioactive material, images are taken immediately with a special camera for a minimum of one hour that can extend up to three hours.
Liver or Spleen Scan: This is a type of scan done to find out the size and function of the liver and spleen.

Thyroid Scan, Kidney Scan, MUGA Scan and White Blood Cell Scan are the other types of nuclear medicine scans.

Diagnosis

Nuclear medicine imaging procedures are noninvasive and, with the exception of intravenous injections, are usually painless medical tests that help physicians diagnose and evaluate medical conditions.The most commonly used radiotracer is F-18 fluorodeoxyglucose, or FDG, a molecule similar to glucose. Cancer cells may absorb glucose at a higher rate, being more metabolically active. This higher rate can be seen on PET scans, and that allows your doctor to identify disease before it may be seen on other imaging tests. FDG is just one of many radiotracers in use or in development for a variety of conditions throughout the body.
In many centers, nuclear medicine images can be superimposed with computed tomography (CT) or magnetic resonance imaging(MRI) to produce special views, a practice known as image fusion or co-registration. These views allow the information from two different exams to be correlated and interpreted on one image, leading to more precise information and accurate diagnoses. In addition, manufacturers are now making single photon emission computed tomography/computed tomography (SPECT/CT) and positron emission tomography/computed tomography (PET/CT) units that are able to perform both imaging exams at the same time. An emerging imaging technology, but not readily available at this time is PET/MRI.

Therapy

Nuclear medicine also offers therapeutic procedures, such as radioactive iodine (I-131) therapy that use small amounts of radioactive material to treat cancer and other medical conditions affecting the thyroid gland, as well as treatments for other cancers and medical conditions.

Non-Hodgkin’s lymphoma patients who do not respond to chemotherapy may undergo radioimmunotherapy (RIT).Radioimmunotherapy (RIT) is a personalized cancer treatment that combines radiation therapy with the targeting ability of immunotherapy, a treatment that mimics cellular activity in the body’s immune system

Any risks ?

The total radiation dose conferred to patients by the majority of radiopharmaceuticals used in diagnostic nuclear medicinestudies is no more than what is conferred during routine chest x-rays or CT exams. There are legitimate concerns about possible cancer induction even by low levels of radiation exposure from cumulative medical imaging examinations, but this risk is accepted to be quite small in contrast to the expected benefit derived from a medically needed diagnostic imaging study.
Like radiologists, nuclear medicine physicians are strongly committed to keeping radiation exposure to patients as low as possible, giving the least amount of radiotracer needed to provide a diagnostically useful examination.

Nuclear medicine examinations provide unique information—including details on both function and anatomic structure of the body that is often unattainable using other imaging procedures.For many diseases, nuclear medicine scans yield the most useful information needed to make a diagnosis or to determine appropriate treatment, if any.A nuclear medicine scan is less expensive and may yield more precise information than exploratory surgery.Nuclear medicine offers the potential to identify disease in its earliest stage, often before symptoms occur or abnormalities can be detected with other diagnostic tests.By detecting whether lesions are likely benign or malignant, PET scans may eliminate the need for surgical biopsy or identify the best biopsy location.PET scans may provide additional information that is used for radiation therapy planning.

For any queries regarding treatment facilities,email us at query@gtsmeditour.com .

Read about:India’s growth as a medical tourism hub

India’s growth as a medical tourism hub

Feb 18, 2019 Posted by admin General 0 comments

India has several feathers to her hat.And is in the process of adding another golden one,namely ‘the medical tourism hub’.The country is already ranking among the top 5 wellness destinations in the world.According to Federation of Indian Chambers of Commerce and Industry (FICCI),half a million foreign patients avail treatment facilities in India annually.The latest data by the Indian government shows a whopping 45% increase in the medical visas issued in the year 2016 alone.It is estimated that India’s current share of 18 % in the global medical tourism market will increase to 20 % by 2020 valued at 9 billion USD.

Several factors contribute to making India a favourite medical destination.

Affordability
Medical Tourism Market Report 2015 establishes India as ‘one of the lowest cost and highest quality of all medical tourism destinations’. As an instance,an open-heart surgery would cost around USD 150,000 in the US, but it would cost only somewhere between USD 3000-10,000 in the best hospitals of the country.So it can be observed that procedures are offered at one-tenth of the cost compared to the cost of similar procedures in US.
Quality professionals
India is the largest creator of doctors in the world.Having said that,the Indian Medical Association (IMA) regulates the quality of medical schools and guarantees the excellence of medical professionals being produced each year. Each medical college undergoes a fierce yearly inspection by IMA. IMA also maintains Indian Medical Register, a database of licensed medical practitioners in the country.Stringent guidelines are also in place to ensure the quality of medical practitioner.As a result,India boasts of well-certified and highly skilled medical professionals
Also a significant portion of medical fraternity in USA and UK consists of specialists hailing from India implying that you would receive doctoring at par with these countries but at considerably lower rates.
High end infrastructure
India has innumerable multi specialty hospitals with world class infrastructure also equipped with experienced medical professionals.Currently, India has over 38 JCI-accredited (Joint Commission International) and 563 NABH-accredited (National Accreditation Board for Hospitals and Healthcare) hospitals across the country.
These hospitals can offer top notch treatments in every medical specialization like cardiology,neurology,cosmetic surgery,organ transplant ,to name a few.Hospitals are also incorporated with full phase technological implementation, latest medical devices and equipment.The complete treatment cycle from the clinical outcome to post treatment therapies are usually assisted by high end programs by the implementation of advanced information systems.
Personalized and immediate care
Several countries like in UK and Russia have long waiting period.But in India,any medical service can be accessed immediately.Also, the care comes customized for each person for complete phases of treatment.
Alternate treatment options
India is home to alternate treatment options like Ayurveda,Yoga, Sidha, Unani, Acupuncture and Homeopathy .Ayurveda is recognized as an alternative treatment option by WHO. Natural therapies provides holistic wellness and are popular in India as post treatment therapies.Ayurveda is one of the most sought after treatment approach by foreign nationals.
E visa
E-visas to India makes travelling to the country much easier.Also getting visas for medical purposes has become simpler.
Language advantage
Another important factor is that the medical team including the doctors,nurses and guides is well versed with English.The general populace in India is also English familiar making it uncomplicated for foreigners.

Growing insurance market, strong pharmaceutical industry, cheap international travel are also making India a preferred medical destination. India hosts medical tourists from the US, Canada, Australia and UK, as well as from African countries and Asian neighbours, like Bangladesh, Sri Lanka and China yearly.Russia has joined the list recently.There is a huge influx of patients from Middle -East.India has cost advantage over other medical destinations like Taiwan,Singapore and Malaysia.Top Medical destinations in India are Mumbai,Chennai,Bangalore,Ahmedabad,Delhi,Goa etc.

With rich culture,heritage and already flourished tourism industry,medical value travel industry is going to shape future of India’s economy and health care.Indeed, Incredible India!

For any queries regarding treatment facilities,email us at query@gtsmeditour.com .

Read about:Vitiligo

Vitiligo

Feb 15, 2019 Posted by admin Dermatology 0 comments

Vitiligo is a dermatological condition which causes the skin to lose its natural colour and as a result, uneven white patches appear on the body. It is not medically dangerous or life threatening.Also it is not contagious and affects about 1% of people in the world.Apart from skin,vitiligo may cause depigmentation in the hair on the scalp, mouth,eyelashes or eyebrows.It is not a form of skin cancer and in fact, most of the people with vitiligo are every bit as healthy as a normal person.

Vitiligo is due to the melanocytes of skin being destroyed. Melanocytes are the cells within skin that produce melanin,which gives the pigment to the skin.Melanin also protect the skin from sun’s UV rays.The destruction of melanocytes is thought to due to an autoimmune problem where the immune system attacks healthy tissues.
People with an autoimmune disease, such as Hashimoto’s disease,Addison disease,pernicious anemia,diabetes or alopecia areata, are at an increased risk of developing vitiligo. Vitiligo is also seen to run in families.
Although vilitigo affects any race equally,but it tends to be more more noticeable in darker skinned people due to the contrast.

Types of Vitiligo

There are three types of vitiligo, depending on the extent and location on the body:

Focal vitiligo: A person has a few vitiligo spots in a single area.
Generalized vitiligo: This is the most common type.In this type,the person affected has patches all over the body in a symmetrical pattern on right and left sides
Segmental vitiligo: This type of vitiligo causes patches only one part/side of the body.This is the least common among the three.It usually starts at a younger age,progresses for about 2 years and then stop.

Vitiligo can happen anywhere on the body, but it’s more likely to develop in some areas:

skin that’s exposed to the sun, such as the face or hands
skin that has folds, such as the elbows, knees, or groin
skin around the eyes, nostrils, belly button, and genital areas

Signs and Symptoms

Symptoms usually appear as depigmented areas where lot of sun exposure is received such as face ,arms and hands but may also appear in the groin area, in the armpits, and around the belly button.

Some signs of vitiligo include

Premature graying of hair
Eyelashes or eyebrows losing color and turning white
Change of color in the retina of the eye
Color loss in the nose and mouth
Photo sensitiveness on the affected parts.

Vitiligo may also lead to inflammation in the iris or hearing loss.

Diagnosis and Treatment

Mostly,dermatologists identify the condition visually.Some dermatologists request for further testing like a skin biopsy,which will show whether melanocytes are present in the skin. He may also test for a blood test to see if you have another autoimmune disease.

Topical medicine applied to the skin:Corticosteroid creams, when applied to white patches very early in the disease may help to bring some color back to the skin by decreasing the inflammation that leads the skin to have fewer pigment cells
Light treatment:Uses light to restore lost color to the skin
Photochemotherapy also known as PUVA light therapy:Uses a medicine called psoralen and UVA light to restore skin color.
Narrow-band ultraviolet B (UVB) therapy. This treatment is more widely used than PUVA. It’s similar, except that the ultraviolet light used is UVB instead of UVA. UVB treatment doesn’t require psoralen.
Surgery:Different surgical procedures are available. Most involve removing skin with your natural color or skin cells and placing these where you need color.
Unconventional treatment:Some vitamins, minerals, amino acids, and enzymes have been reported to restore skin color in people who have vitiligo.
Depigmentation:This treatment removes the remaining pigment from the skin.Very few patients opt for this treatment.Removing the rest of the pigment leaves a person with completely white skin.

Vitiligo is more than a cosmetic condition and needs attention. Vitiligo can greatly impact the self esteem of affected person.Combined medical and mental health treatment can elevate the quality of affected individual.

For any queries regarding the procedure and treatment facilities,email us at query@gtsmeditour.com .

Read about:Tennis elbow

Tennis elbow

Feb 14, 2019 Posted by admin Orthopaedic 0 comments

Tennis elbow or ‘Lateral epicondylitis’ is a condition of persistent pain on the outer side of the elbow.It is caused by an overuse of forearm muscles resulting in repetitive injury to the tendons attached to the elbow.It can become responsible for substantial pain and loss of function of the affected limb.As the name may confuse,it is not only associated with the sport ‘Tennis’.It can be due to any other sport or work related activities.

Condition explained

The extensor muscle called the extensor carpi radialis brevis, helps to straighten and stabilize the wrist.This muscle attaches to a part of the elbow bone called the lateral epicondyle (thus the medical name ‘lateral epicondylitis’). It is the tendons that connect and transmit a muscle’s force to the bone. In lateral epicondylitis, tendon’s attachment to the bone is degenerated due to repetitive use, weakening and placing greater stress on the forearm muscles. This can lead to pain associated with activities in which this muscle is active.

Causes

Here are some potential causes of this condition:

Overuse: This can be both non-work and work-related. Overuse can happen from “repetitive” gripping and grasping activities such as cutting, plumbing,gardening,carpentry, painting, etc.
Trauma: Although less common, a direct blow to the elbow may result in swelling of the tendon that can lead to degeneration. This can make the elbow more susceptible to an overuse injury.

Who is affected?

Tennis elbow is most commonly seen in following groups of people:

Manual Laborers
People who work with their hands like plumbers or bricklayers are at greater risk of developing tennis elbow.
Sports Participants
Sports participants, especially racquet sport players and throwing sports persons(discus and javelin),are prone to developing tennis elbow.
People doing activities that involve fine, repetitive hand and wrist movements – such as using scissors or typing

It is present in 40% of all racquet sport players and 15% of people working in repetitive manual trades like . It can occur at any age, however, sufferers are generally between the ages of 35 and 50.Predictably, the side affected is usually associated with handedness, but it can occur in the non-dominant arm. Males and Females are affected equally.

Symptoms

The typical symptom is pain in outer side of elbow,the area also becomes tender.But the pain can radiate into forearm and wrist also.

Pain when performing gripping tasks or resisted wrist/finger extension
Pain when the muscles are stretched.
Tenderness directly over the bony epicondyle

There may be rigger points in the wrist muscles.In severe cases, there may be local swelling .Also some activities, such as making a fist, shaking hands, carrying bags like a briefcase, turning on taps may be painful.Some sufferers will also have neck stiffness and tenderness, as well as signs of nerve irritation.

Diagnosis and treatment

Usually, doctors are able to make the diagnosis based on the history and a physical examination.Additional tests such as X-rays or ultrasound may be needed to exclude other causes and/or assess the severity of tendon damage.
Initial treatment involves relative rest and avoiding activities that aggravate the pain.If you are diagnosed with tennis elbow, activities that strain affected muscles and tendons should be immediately stopped.Taking analgesics may help ease mild pain and inflammation caused by tennis elbow.. Wearing a tennis elbow brace can help to protect the tendon.
Physiotherapy has been shown to be effective in the short and long-term management of tennis elbow.Physiotherapy treatment can include gentle mobilisation of your neck and elbow joints, electrotherapy, elbow kinesio taping, muscle stretches, neural mobilisations, massage and strengthening.
A small percentage of patients diagnosed with tennis elbow may finally require surgical treatment. Patients may consider surgery if conservative treatments are not effective after a period of 6 – 12 months.

Untreated Tennis Elbows can last anywhere from 6 months to 2 years. You are also prone to recurrence.Aside from pain, the major complication of tennis elbow is that it impedes your ability to perform physical activities, such as certain sports or types of work.

For any queries regarding the procedure and treatment facilities,email us at query@gtsmeditour.com .

Read about:Endometriosis

Endometriosis

Feb 13, 2019 Posted by admin Gynaecology 0 comments

Endometriosis a painful condition caused when tissues that line the uterus grow outside of uterus.The tissues that make up the lining of the uterus is called endometrium.Women with endometriosis have tissues similar to endometrium on other organs of the body. Endometriosis usually occurs usually on other reproductive organs inside the pelvis or in the abdominal cavity and affects women of childbearing age.

Understanding the condition

In a regular menstrual cycle,if fertilization has not happened , hormonal changes signal the uterus to prepare to shed its lining.The endometrial tissues build up and egg along with the uterine lining is shed in form menstrual bleeding.Whereas in patients with endometriosis,the misplaced endometrial tissues also respond to the hormonal signals and by building up and breaking down just like the endometrium does, resulting in small bleeding inside of the pelvis.Unlike the cells in the uterus that leave the body , this blood has no way to escape.This leads to inflammation, swelling and scarring of the normal tissue surrounding the endometriosis implants.
Mostly,the endometrial tissues grow on ovaries, Fallopian tubes, bowel and outer walls of the uterus.But it can appear anywhere in the body.Though very rarely,it is found to develop on kidney, bladder and lungs. Endometriosis can be located on and even within an ovary, causing fibrous cysts called endometriomas. Blood become embedded in the normal ovarian tissue surrounded by endometrioma.

Causes

Several ideas have been proposed to explain what causes the tissues on uterine lining to grow on other parts of the body.One idea explains endometriosis by retrograde menstruation.It is a sort of reverse menstruation in which the period blood and tissues travel out of the uterus through Fallopian tubes to the abdominal cavity where it attaches and grows.But this idea fail to explain the occurrence of endometriosis at strange locations like thumb and knee.It is better explained by another theory that suggests that some cells outside uterus can transform into endometrial cells. Another possible explanation is that the cells from the lining of the uterus travel and implant via blood vessels or lymphatic system to reach other organs similar to how cancer cells spread. Also, endometriosis can spread as a result of direct transplantation during a cesarean section where in endometriosis cells attach to the abdominal incision and endometriosis is formed in the scar.

Symptoms

Symptoms of endometriosis vary in different women. Some women experience mild symptoms, but others can have moderate to severe symptoms. The severity of your pain is not the indicator of stage of the condition. Mild form of the disease may cause agonizing pain. It’s also possible to have a severe form but very little discomfort.For some,it is asymptomatic.

Pelvic pain is the most common symptom of endometriosis. You may also have the following symptoms:

painful periods especially excessive menstrual cramps or irregular periods
pelvic pain before and during menstruation
infertility
heavy menstrual bleeding or spotting between periods
Painful urination or blood in the pee during menstrual period
uncomfortable bowel movements
pain after sexual intercourse
lower back pain that may occur at any time during your menstrual cycle
feeling sick, constipation, diarrhoea
Nausea and fatigue

Endometriosis and Pain,infertility

Due to the misplaced cells,the woman with endometriosis have bleeding from tissues outside the uterus as well during menstrual period.When blood comes into contact with other organs especially in the abdomen, it causes inflammation and irritation, creating pain. Also,the scar tissue developed from the endometriosis contribute to the pain.
Endometriosis seems to impair fertility by causing distortion of the fallopian tubes making it incapable of picking up the egg after ovulation and by creating inflammation that can adversely affect the function of the ovary, egg, fallopian tubes or uterus.
Statistics show that 20 – 40% of women with infertility have endometriosis and this points to how much of a factor endometriosis is in infertility!

Diagnosis

Since endometriosis manifests itself in many ways and shares symptoms with other conditions, diagnosis can be difficult and often delayed. The condition is in most case diagnosed ,when the patient tries to evaluate infertility and pelvic pain in one another reason.The only definitive way to diagnose endometriosis is by laparoscopy.Laparoscopy is a minor surgical procedure in which a laparoscope, a thin tube with a camera at the end, is inserted into the abdomen through a small incision. Laparoscopy helps to determine the location, extent and size of the endometrial growths.

Treatment

Treatment options available to women with endometriosis are:

Surgery
As a treatment for endometriosis, surgery can be used to alleviate pain by removing the endometriosis, dividing adhesions or removing cysts.
Conservative surgery: This aims to remove or destroy the deposits of endometriosis and is usually done via a laparoscopy (keyhole surgery). This is also used to diagnose the disease and can be used to improve fertility. Although surgery can provide relief from symptoms, they can recur in time.
Radical surgery: This refers to a hysterectomy or oophorectomy: Hysterectomy is the removal of the womb, with or without removing the ovaries. If the ovaries are left in place then the chance of endometriosis returning is increased. Oopherectomy is the removal of the ovaries, either one or both.When both ovaries are removed, a woman will experience an instant and irreversible menopause.
These procedures may be decided after taking many factors into consideration.
Hormone treatment
These are treatments that are used to act on the endometriosis and stop its growth. They either put the woman into a pseudo-pregnancy or pseudo-menopause because during pregnancy the endometrium is thin and also inactive. Both states are reversed when the patient stops taking the hormones. In addition, testosterone derivatives are occasionally used to mimic the male hormonal state.All of these have a contraceptive effect, so are not used if the patient is trying to become pregnant.
Pain relief
Pain medication avoids the use of hormones so it does not prevent the growth of endometriosis.When taken appropriately, pain medication can be extremely effective. Either painkillers, or drugs that modify the way the body handles pain, can be used.

Some complementary therapies may be beneficial in controlling the symptoms of endometriosis.These include acupuncture,homeopathy,yoga etc.

The course of treatment depends on several factors.The approach will depend on how severe the disease is and when you expect to become pregnant.Endometriosis is a debilitating and challenging condition. Fortunately, there are treatments available which can alleviate the symptoms and condition.

For any queries regarding the procedure and treatment facilities,email us at query@gtsmeditour.com .

Read about:Crohn’s disease

Crohn’s disease

Feb 12, 2019 Posted by admin Gastroenterology 0 comments

Crohn’s disease is a chronic inflammatory condition of the gastrointestinal tract and belongs to the group of Inflammatory Bowel Diseases (IBD). It is named after Dr. Burrill B. Crohn, who first described the disease in 1932.While it primarily causes ulcerations in the small and large intestines, it can affect any part of the digestive system, from the mouth to the anus.What differentiate it from ulcerative colitis is that Crohn’s disease can affect any part of the digestive tract.Ulcerative colitis is limited to the colon, also called the large intestine.

When the immune system activates its immune cells and proteins to do battle, it causes inflammation at the site. In Crohn’s disease there is a loss of regulation of the immune system within the intestinal tract and it cycles between periods of great activity, ulceration, and periods of relative calm or remission.About 20% of people with Crohn’s have a blood relative who has IBD.It affects men and women equally.It can occur any time but mostly start in the ages 15-35.

Types and Symptoms

There are five types of Crohn’s disease based on which part of the gastrointestinal tract it affects.The associated sypmtoms and complication differ for each types. It is important to analyse the type and symptoms together to get an understanding of the type of Crohn’s disease.

Ileocolitis
This is the most common form of Crohn’s. ileocolitis affects the ileum(the end of the small intestine) and the colon (large intestine). Symptoms: Diarrhea , cramping in the right lower part or middle of the abdomen, weight loss.

Ileitis
This type affects only the ileum. Symptoms :same as ileocolitis. but in severe cases, complications may also include fistulas in right lower quadrant of abdomen.

Gastroduodenal Crohn’s disease
This type affects the stomach and the duodenum(the beginning of the small intestine). Symptoms: loss of appetite, weight loss, nausea and vomiting.

Jejunoileitis
This type is characterized by patchy areas of inflammation in the jejunum(the upper half of the small intestine ). Symptoms: mild to intense abdominal pain and cramps following meals, diarrhea. In severe cases, fistulas may be formed.

Crohn’s (granulomatous) colitis
This type affects the colon only. Symptoms: diarrhea, rectal bleeding, and disease around the anus like abscess, fistulas and ulcers, skin lesions and joint pains.

Also Crohn’s disease can be classified on the basis of the nature of disease as follows.

Inflammatory in nature, it results in small erosions and breakdown of the lining of the bowel wall.
Fibrostenotic, scar tissue forming. The inflammation is healed by the body but the resulting scar tissue can cause obstructive types of symptoms where the bowel is not moving properly.
Penetrating type, the inflammation goes through the wall of the bowel and has a tendency to form connections between loops of bowel or connections between the bowel and other organs or the skin.

Diagnosis

It’s important to diagnose Crohn’s disease early because Crohn’s disease is a progressive disease. And in some people the Crohn’s disease can progress very rapidly to complications such as narrowing of the small intestine leading to blockages, or perforation of the small intestine requiring surgery.

In general, there are two reasons to undergo Crohn’s tests and procedures:

To determine whether you have Crohn’s (to obtain or disprove a Crohn’s disease diagnosis)
To re-evaluate your Crohn’s disease — something your gastroenterologist will probably want to do on an ongoing, regular basis

Common tests for Crohn’s disease are
Blood Tests.Although blood tests alone cannot diagnose Crohn’s disease, they’re an important tool in diagnosis and monitoring of this disease. Several different kinds of blood tests are used.

Routine blood testsThese are used to detect infection, anemia, indicators of inflammation, and to identify deficiencies of vitamins or minerals.
Fecal blood test
Antibody blood tests

Imaging Tests
These are tests that take pictures of different parts of your body to provide a clearer picture of your condition. They show your doctor areas of disease activity and identify possible complications. These are only some of the imaging tests used for Crohn’s—there are others your doctor may recommend.

Conventional X-rays
A standard X-ray of your abdominal area can show narrowing of the intestines or an intestinal blockage, possibly from inflammation or scarring. It may also be done to rule out certain Crohn’s complications.
Contrast X-rays
Computerized tomography (CT scan)
Leukocyte scintigraphy (white blood cell scan)
Endoscopy (includes colonoscopy)
Endoscopic ultrasound
Magnetic resonance imaging (MRI)

Treatment

Crohn’s is a chronic, life-long disease that requires constant treatment. Even though there is no cure for Crohn’s, there are many different medications available to treat it.The following are the categories of drugs prescribed to treat Crohn’s:

Antibiotics :Antibiotics may be used when infections occur, or to treat complications of Crohn’s disease.
Aminosalicylates (5-ASAs):To decrease inflammation in the lining of the intestines and are usually used to treat mild to moderate Crohn’s symptoms.
Corticosteroids (Steroids):To reduce inflammation by suppressing the immune system and are usually given to help with moderate to severe Crohn’s symptoms.
Immune modifiers (Immunomodulators):To suppress the body’s immune response so that it cannot cause ongoing inflammation.
Biologic therapies (Biologics):To uppress the immune system to reduce inflammation by targeting a specific pathway, and is usually given to people who have not responded to conventional therapy.

Regarding pregnancy,most women who have Crohn’s disease can have a normal pregnancy and healthy baby.However, some Crohn’s disease medicines can harm an unborn baby, so you should speak to your doctor if you are planning pregnancy.Women may also find it harder to get pregnant during a flare-up.Possible complications of the disease are

damage to your bowel that may require surgery
difficulty absorbing nutrients from food leading to problems like osteoporosis or anaemia.
bowel cancer :regular cancer screening is needed to check this.

So adequate screening and diagnosis is required for handling the disease and to prevent severe complications.

For any queries regarding the procedure and treatment facilities,email us at query@gtsmeditour.com .

Read about:Robotic or minimally invasive cardiac surgery

Robotic or minimally invasive cardiac surgery

Feb 11, 2019 Posted by admin Cardiology 0 comments

Ever imagined what goes through the mind of a patient when he or she is told that they need to undergo a surgery?And then,after the patient has gathered enough courage and has submitted to it,the trauma it leaves behind is severe. Robotic cardiac surgery is a breakthrough development which provides greater advantages for heart patients for and post surgery.The use of minimally invasive procedures has not only changed the performance but also the strategic approaches to surgeries in general.Also,surgical robots have enhanced the ability and precision of the surgeon.
Robotic cardiac surgery ,also called closed chest heart surgery, is done through very small cuts in the chest rather than a median sternotomy (cutting through the breastbone).An incision in the right side of the chest between the ribs offers quicker recovery and better outcomes for many patients.
The surgeon uses a specially-designed computer console to control surgical instruments on thin robotic arms. This technology allows surgeons to perform certain types of complex heart surgeries with smaller incisions and precise motion control, offering patients improved outcomes. With the use of tiny instruments and robot-controlled tools, surgeons are able to do heart surgery in a way that is very much less invasive than open-heart surgery. The procedure is sometimes called da Vinci surgery after the manufacturer of the robot often used for this procedure.

Candidates for Robot Surgery

The treatment type recommended for your condition will depend on several factors like the type and severity of heart disease, age, medical history and lifestyle etc.Several diagnostic tests are carried out to determine if you are appropriate for robotic cardiac surgery.This include a cardiac catheterization and chest x-ray. An echocardiogram and/or a computed tomography scan also may be required to provide more details about the medical condition.After reviewing the results of all these tests,doctors conclude whether to take robotic cardiac surgery or not.

Types of robotic cardiac surgery

Mitral valve repair and replacement
Tricuspid valve repair and replacement
Aortic valve replacement
Ablation of atrial fibrillation or Maze procedure for atrial fibrillation
Coronary artery bypass surgery
Saphenous vein harvest for coronary artery bypass surgery
Atrial septal defect (ASD) repair
Patent foramen ovale (PFO) repair
Removal of cardiac tumors (Myxoma, Fibroelastoma)
Combined coronary artery bypass and angioplasty

Advantages

With open heart surgery ,splitting the sternum and spreading the rib cage to gain access to the heart contribute to significant morbidity. Also,cardiac surgery is different than other surgical procedures because the heart-lung machine adds further morbidity which is avoided in closed chest heart surgery.In addition,other advantages are

Less blood loss
Lower risk of infection
Reduced trauma and pain
Shorter time in the hospital, faster recovery and quicker return to normal activities
Smaller, less noticeable scars.Traditional surgery would leave a 20 cm scar for rest of the life.

Risks

As with any surgery,robotic assisted surgeries also pose some risks.Although the minimally invasive procedure removes many complications,some possible risks are

Heart attack
Stroke
Infection

In some cases, doctor may not be able to complete the surgery with the robot. In that case, open-heart surgery may be needed.

Technological advances have facilitated totally endoscopic/key hole robotic cardiac surgery.In India several hospitals provide minimally invasive endoscopic surgeries.The success rate is very high ,more than 92%.The potential in this technology is enormous and the path is minimal.
For any queries regarding the procedure and treatment facilities,email us at query@gtsmeditour.com.

Read about: Meningitis,the deadly disease

Meningitis

Feb 8, 2019 Posted by admin Neuropathy, Paediatrics 0 comments

Meningitis is deadly that it can kill in a matter of hours.Though some cases of meningitis improve without treatment,others can be life-threatening and require emergency treatment.
Meningitis occur when the fluid surrounding the meningis become infected causing inflamamtion of meningis. Meningis are three delicate protective membranes of brain and spinal cord.

Causes

Meningitis is caused by bacterial,viral or fungal infection,viral infected ideas being the most common.It can also be caused by other factors such as cancer,drug irritations.Like any other infection,meningitis can be contagious too which can be transmitted through touch,sneezing etc.

Bacterial meningitis
Though it is rare,it can be fatal if not treated right away.Bacterial meningitis can cause stroke, hearing loss, and permanent brain damage.The disease can occur when certain bacteria invade the meninges directly or when the bacteria spread to the meninges from a severe head trauma or a severe local infection, such as a serious ear infectionor nasal sinus infection (sinusitis).Several bacteria can first cause an upper respiratory tract infection and then travel to brain via bloodstream.

Pneumococcal meningitis is the most serious form of bacterial meningitis,caused by the bacterium Streptococcus pneumoniae.It also causes pneumonia, blood poisoning (septicemia), and ear and sinus infections.
Meningococcal meningitis is caused by the bacterium Neisseria meningitides. If diagnosed, people in close contact should be given preventative antibiotics.
Haemophilus influenzae meningitis.

Viral meningitis
Also called aseptic meningitis ,it is usually caused by common viruses that enter the body through the mouth and travel to the brain and surrounding tissues.Many of the enteroviruses viruses that cause meningitis are common, such as those that cause colds, diarrhea and the flu.Other viruses that cause meningitis include varicella zoster (chicken pox virus),, mumps, HIV, and herpes simplex type 2 (genital herpes).

Fungal meningitis
The most common of this is caused by the fungus cryptococcus neoformans(found mainly in dirt and bird droppings). Fungal infectionns can affect brain.Although treatable, fungal meningitis often recurs in 50 % of the affected persons.
Meningitis can affect anyone .Children,people with weakened immune systems( including persons with HIV or taking immunosuppressant drugs) are at increased risk.

Symptoms

Significant signs of meningitis are

sudden fever
severe headache
nausea or vomiting
double vision, drowsiness
sensitivity to bright light
stiff neck.

In infants ,fever, lethargy, not waking for feedings, vomiting, body stiffness, unexplained irritability, and bulging fontanel (the soft spot on the top of the head) are important signs of meningitis and should be watched for.
Distinctive rashes called meningitis rash are seen in some forms of the disease.This is one late sign of bacterial meningitis.These are faint rashes and may not be easily visible in dark skinned people.Rash will become more obvious as infection worsen and spots grow darker. Meningococcal meningitis damages capillary cells leading to capillary damage and mild blood leaks.
Meningitis can also cause septicaemia.It is the blood poisoning caused by the same germs that cause meningitis.It is the more life threatening form of the disease. Septicaemia can occur with or without meningitis.

Diagnosis

Early diagnosis is vital, as symptoms can appear suddenly and escalate to brain damage, hearing and/or speech loss, blindness, or even death.
Diagnostic tests include:

series of physical examination tests designed to assess motor and sensory function, nerve function, hearing and speech, vision, coordination and balance, mental status, and changes in mood or behavior.
screening of blood, urine, and body secretions can help detect and identify brain and/or spinal cord infection.
Cerebrospinal fluid is tapped to detect the presence of bacteria, blood, and viruses. Analysis of the fluid can also reveal infections in the brain and/or spinal cord, acute and chronic inflammation, and other diseases.

Brain imaging is used to detect signs of brain inflammation, internal bleeding or hemorrhage.Following are noninvasive painless imaging procedures routinely used

Computed tomography, also known as a CT scan to produce rapid, clear, two-dimensional images of organs, bones, and tissues.
Magnetic resonance imaging (MRI) can help identify brain and spinal cord inflammation, infection, tumors, and other conditions.

Furthermore, electroencephalography(EEG) can identify abnormal brain and diagnose patterns that may suggest specific viral infections such as herpes virus and to detect seizures.

Treatment

Early treatment of bacterial meningitis involves antibiotics that can cross the blood-brain barrier . Appropriate and immediate antibiotic treatment for most types of meningitis can greatly reduce the risk casualties. Anticonvulsants to prevent seizures and corticosteroids to reduce brain inflammation may be prescribed.Infected sinuses may need to be drained. Corticosteroids such as prednisone are usually prescribed to relieve brain pressure, swelling and to prevent hearing loss that is common in Haemophilus influenza meningitis.Viral meningitis can ease without treatment over a few weeks.Fungal meningitis is treated with intravenous antifungal medications.

Vaccination

Vaccinations offer protection against certain causes of meningitis.These include the:

meningitis B vaccine – offered to babies aged 8 weeks, followed by a second dose at 16 weeks, and a booster at 1 year
6-in-1 vaccine – offered to babies at 8, 12 and 16 weeks of age
pneumococcal vaccine – offered to babies at 8 weeks, 16 weeks and 1 year old
Hib/MenC vaccine – offered to babies at 1 year of age
MMR vaccine – offered to babies at 1 year and a second dose at 3 years and 4 months
meningitis ACWY vaccine – offered to teenagers, sixth formers and “fresher” students

Outcome generally depends on the the severity of the illness and how quickly treatment is given. In most cases, meningitis can make a full recovery although the process may be slow. Individuals may need long-term therapy, medication, and supportive care in more serious cases where disease has caused permanent damages like brain and nerve damage,blindness,memory loss,seizures,lack of muscle control etc

Bronchiectasis

Feb 7, 2019 Posted by admin Uncategorized 0 comments

Bronchiectasis is serious!Bronchiectasis is a form of chronic obstructive pulmonary disease (COPD) .It is a lung condition in which the airways to the lungs are damaged making it abnormally wide,scarred and thickened.This extra space allows bacteria and mucus to build up causing recurrent infections and leading to the blockages of airways.Bronchiectasis in Detail

When we breathe, air is carried into lungs through our airways, also called bronchi. The bronchi divide into thousands of smaller airways called bronchioles which contain tiny glands that produce mucus.Mucus is a slimy substance that helps to keep airways moist and traps the dust and germs that are inhaled.The mucus is moved away by tiny hairs, called cilia, which line the airways.
In bronchiectasis, airways are scarred and inflamed with thick mucus, also called phlegm or sputum,airways slowly lose their ability to clear out mucus. When mucus can’t be cleared, it builds up and creates an environment in which more bacteria are breathed in.Bacteria grows in the excess mucus, leading to repeated, serious lung infections.Each infection causes more damage to your airways ,the breathing tubes become baggy and holes form in the lungs.. Over time, the airways lose their ability to move air in and out preventing enough oxygen from reaching your vital organs.This can ultimately lead to the loss of lung function over time, as well as serious health problems such as respiratory failure,heart failure and atelectasis.

Causes

Bronchiectasis can be congenital resulting from an abnormal lung development before birth. Bronchiectasis usually begins with some type of lung damage which might have been caused by a common childhood infection such as whooping cough or measles, or from a lung-related medical condition such as cystic fibrosis or primary ciliary dyskinesia.There are two main categories of this condition. One is related to having cystic fibrosis and is known as CF bronchiectasis. CF is a hereditary condition that causes an abnormal production of mucus.The other category is non-CF bronchiectasis, which isn’t related to CF.

Bronchiectasis can develop in the following conditions:

Humoral immunodeficiency (low levels of infection-fighting proteins in the blood)
Inflammatory bowel disease (Crohn’s disease and ulcerative colitis)
Rheumatologic diseases (rheumatoid arthritis and Sjögren’s disease)
Alpha1-antitrypsin deficiency (genetic cause of COPD in some people)
Chronic obstructive pulmonary disease or COPD
HIV infection
Allergic bronchopulmonary aspergillosis (a type of allergic lung inflammation)
pneumonia
Whooping cough or measles
Tuberculosis
Fungal infection

Symptoms

The most common signs and symptoms of bronchiectasis are:

A daily cough that occurs over months or years
Daily production of large amounts of sputum (spit). Sputum, which you cough up and spit out, may contain mucus (a slimy substance), trapped particles, and pus.
Shortness of breath and wheezing (a whistling sound when you breathe)
Chest pain
Clubbing (the tissue beneath the nail thickens and the fingertips become rounded and bulbous)
Fatigue which is profound

Diagnosis

If your doctor listens to your lungs with a stethoscope, he or she may hear abnormal lung sounds.

Some tests that aid in the diagnosis include:

Chest x-ray: A chest x-ray may show some signs of the disease, but other tests (such as a CT) are usually needed to confirm or refute the diagnosis.
Chest CT scan: The diagnosis is usually made based on the appearance of a CT scan.
Pulmonary function tests can help with the diagnosis as well as the severity.
A bronchoscopy may be done to rule out a foreign body or lung cancer.

Treatment

The goals of treatment are to:

Treat any underlying conditions and lung infections.
Remove mucus (a slimy substance) from your lungs. Maintaining good hydration helps with mucus removal.
Prevent complications.

Early diagnosis and treatment of the underlying cause of bronchiectasis may help prevent further lung damage. In addition, any disease associated with the bronchiectasis, such as cystic fibrosis or immunodeficiency, also should be treated.
Medicines
Your doctor may prescribe antibiotics, bronchodilators, expectorants, or mucus-thinning medicines to treat bronchiectasis.
Antibiotics
Antibiotics are the main treatment for the repeated lung infections that bronchiectasis causes. Oral antibiotics often are used to treat these infections.For hard-to-treat infections, your doctor may prescribe intravenous (IV) antibiotics. These medicines are given through an IV line inserted into your arm. Your doctor may help you arrange for a home care provider to give you IV antibiotics at home.Expectorants and Mucus-Thinning MedicinesYour doctor may prescribe expectorants and mucus thinners to help you cough up mucus.
Expectorants help loosen the mucus in your lungs. They often are combined with decongestants, which may provide extra relief. Mucus thinners, such as acetylcysteine, loosen the mucus to make it easier to cough up.
Hydration
Drinking plenty of fluid, especially water, helps prevent airway mucus from becoming thick and sticky. Good hydration helps keep airway mucus moist and slippery, which makes it easier to cough up.
Chest Physical Therapy
CPT also is called physiotherapy (FIZ-e-o-THER-ah-pe) or chest clapping or percussion. This technique is generally performed by a respiratory therapist but can be done by a trained member of the family. It involves the therapist pounding your chest and back over and over with his or her hands or a device. Doing this helps loosen the mucus from your lungs so you can cough it up.You can sit with your head tilted down or lie on your stomach with your head down while you do CPT. Gravity and force help drain the mucus from your lungs.
Some people find CPT hard or uncomfortable to do. Several devices can help with CPT, such as:

An electric chest clapper, known as a mechanical percussor.
An inflatable therapy vest that uses high-frequency air waves to force mucus toward your upper airways so you can cough it up.
A small handheld device that you breathe out through. It causes vibrations that dislodge the mucus.
A mask that creates vibrations to help break loose mucus from your airway walls.

Some of these methods and devices are popular with patients and doctors, but little information is available on how well they actually work. Choice usually is based on convenience and cost.
Several breathing techniques also are used to help move mucus to the upper airway so it can be coughed up. These techniques include forced expiration technique (FET) and active cycle breathing (ACB).FET involves forcing out a couple of breaths and then doing relaxed breathing. ACB is FET that involves deep breathing exercises.
Other Treatments
Depending on your condition, your doctor also may recommend bronchodilators, inhaled corticosteroids, oxygen therapy, or surgery.
Bronchodilators
Bronchodilators relax the muscles around your airways. This helps open your airways and makes breathing easier. Most bronchodilators are inhaled medicines. You will use an inhaler or a nebulizer to breathe in a fine mist of medicine.Inhaled bronchodilators work quickly because the medicine goes straight to your lungs. Your doctor may recommend that you use a bronchodilator right before you do CPT.
Inhaled Corticosteroids
If you also have wheezing or asthma with your bronchiectasis, your doctor may prescribe inhaled corticosteroids (used to treat inflammation in the airways).
Oxygen Therapy
Oxygen therapy can help raise low blood oxygen levels. For this treatment, you’ll receive oxygen through nasal prongs or a mask. Oxygen therapy can be done at home, in a hospital, or in another health facility.
Surgery
Your doctor may recommend surgery if no other treatments have helped and only one part of your airway is affected. If you have major bleeding in your airway, your doctor may recommend surgery to remove part of your airway or a procedure to control the bleeding.In very rare instances of severe bronchiectasis, your doctor may recommend that you receive a lung transplant replacing your diseased lungs with a healthy set of lungs.

To prevent bronchiectasis, it’s important to prevent the lung infections and lung damage that can cause it.Childhood vaccines for measles and whooping cough prevent infections related to these illnesses. These vaccines also reduce complications from these infections, such as bronchiectasis.Avoiding toxic fumes, gases, smoke, and other harmful substances also can help protect your lungs.Proper treatment of lung infections in children also may help preserve lung function and prevent lung damage that can lead to bronchiectasis.Stay alert to keep children (and adults) from inhaling small objects (such as pieces of toys and food that might stick in a small airway). If you think you, your child, or someone else has inhaled a small object, seek prompt medical care.In some cases, treating the underlying cause of bronchiectasis can slow or prevent its progression.

Uterine didelphys

Feb 6, 2019 Posted by admin Uncategorized 0 comments

We have two kidneys,one brain,one heart. Aren’t the numbers right?Now,can you guess how many uterus a woman can have?Most of you would say ‘one’.But there can be ‘two’ too!In this post,we are discussing one of the congenital uterus anomaly-uterine didelphys. There are two uterus ,two cervices involved and in many cases two vaginas too.

Formation and malformation

As aforementioned,uterine didelphys is an anomaly and so a result of malformation.

Now let’s look at the formation of uterus,females fetus ofcourse. The development of the normal female reproductive tract is a complex process. It starts in the womb.The mesonephros , principal excretory organ during early embryonic life (4—8 weeks), appears in humans during the 4th week of gestation and degenerates after 8th week. Draining function of this transient kidney is handled by mesonephric ducts(Wolffian ducts).The ‘indifferent’ or ‘bipotential’ gonad (meaning it appears same for both sexes at this stage) differentiates to the ovary.Two paramesonephric ducts called Müllerian ducts form from coelomic epithelium extending from the vaginal plate to lie beside the developing ovary. The wall between these paired tubes breaks down in its lower aspect (fuse from the vaginal plate end), forming the primordial body of the uterus .And the unfused lateral portion of the paramesonephric ducts form the uterine tubes.
Thus,the mesonephros, Wolffian and Müllerian ducts differentiate in an orchestrated manner to form the uterus, vagina and lower urinary tract. Any disordered differentiation can result in congenital abnormalities affecting the female reproductive tracts, renal tract and lower intestines.When the Müllerian ducts do not fuse completely resulting in complete duplication of uterine horns as well as duplication of the cervix, with no communication between them,it is called uterine didelphys or double uterus.

Other anomalies due to the incomplete fusion are

Uterus bicornis
Uterus bicornis unicollis rudimentary horn
Uterus Arcuatus
Atresia of cervix
Atresia of vagina

Symptoms and complications

In most women,the condition is asymptomatic.In others,it remains undetected untill menarche,the time when menstrual cycles start in a girl.They can discover this condition as putting a tampon into one of the vaginas does not cause bleeding to stop completely.Since women with uterine didelphys also has vaginal septum or partition in varying degrees,some may present with following symptoms.
Dyspareunia or painful intercourse
Dysmenorrhea or painful periods.This is accompanied by heavy monthly menstrual periods .
In extremely rare cases, genital neoplasms(tumor of the genital system) and renal anomalies are reported.

The condition is in most cases diagnosed when women undergo frequent miscarriages.It usually do not hinder woman becoming pregnant.One of the uteri is usually bigger and better than the other, which is also composed of stronger tissues and muscles, which can support implantation which occurs once she conceives. That is why, women with double uterus can carry their babies only in the stronger one.
The pregnancy in these women is classified as high risk .The pregnancy complications associated are reccurent miscarriages,late miscarriage,pre term delivery and still births.Term deliveries of untreated didelphys uterus is approximately 45%.
Despite these complications, there are many women that did not exhibit any gestational challenges.Some percentage of women can go on to have full term and healthy babies.The delivery would normally require a C section.Also a very few cases are known where these women delivered vaginally.
For those of women who do not face pregnancy problems,contraception may pose an issue.Often the two uteri are of unequal size, so fitting an intrauterine device to each may not be possible.They will need to use contraceptive pills which can work like for any other normal woman.

Diagnosis

Hysterosalpingography for Double Uterus Diagnosis: This method of examination make use of a dark colored dye which is filled into the uterus which is followed by taking X rays of the reproductive organs. As the uterus is filled with colored dye, a clear image of the shape of uterus can be observed in the images taken by the X-rays.However, these methods rely on the clinician’s subjective interpretation rather than strict diagnostic criteria
Ultrasound Test is Conducted to Diagnose Double Uterus: The use of 3D ultrasound is becoming more commonly used for diagnosis as it is not only noninvasive, but it also overcomes the limitation of 2D ultrasound by providing a coronal view that enables examination of both the endometrial cavity and uterine fundus, thus giving all the information needed for morphological classification.Modern ultrasounds make use of advanced transducers that are capable of producing a 3-D image of the tissue. It is more effective than traditional ultrasound.
Sonohysterogram: This is a special type of ultrasound for diagnosing double uterus in which the uterus is filled with a fluid before carrying out ultrasound scan. Usually a tube is first inserted into the uterus through which the fluid is filled into the uterus. It gives a better view of the vagina to the doctor and helps him in proper diagnoses of condition.
Magnetic Resonance Imaging (MRI): It is an advanced method of imaging which is more effective than ultrasound for double uterus. It consists of tunnel shaped MRI machine that is open at both the ends. The person to be examined is made to lie on a table that is moved into this tunnel. This tunnel shaped machine produces a combination of radio waves and magnetic waves to produce a 3 dimensional image of the complete body.

Treatment

It is the degree of the müllerian malformation that bears the most important consequences on reproductive outcome rather than the type of malformation encountered.Generally, women with this condition should make sure to work closely with a doctor during pregnancy to watch for signs of pre term or other risks to the baby. These women will likely need an obstetrician who specializes in high-risk pregnancies.
Before conceiving, a woman with a double uterus should discuss her plans to become pregnant with her physician. Doctors may perform surgery to unify the uterus or to remove an underdeveloped uterus if a woman is having health problems.
Surgery is rarely performed for the condition, though. It’s usually reserved for women who’ve had repeated pregnancy problems. A physician may also help such women take additional steps to lower their risk of complications during pregnancy, labor, and delivery.

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