CORRECT PUBLIC AWARENESS IS MUST TO FIGHT THIS PANDEMIC. HENCE ENLISTED SOME DO'S & DON'TS FOR AWARENESS IN PUBLIC. IT WILL ELIMINATE THE FEAR& ANXIETY
Don Not Be Panic!! Stay Informed!! Stay Healthy!!
Emerging Pandemic-Novel Coronavirus-"2019 nCoV"
When the World is encountered with a novel public health challenge, it is the utmost essential tool is "Effective public awareness" to containment and control strategy.
Requesting everyone to share this book with your family and friends. This is really having a solution for all corona related queries. Please share it as much as possible, it can really help someone. For any corona related queries, Call on +917290047401.
Don Not Be Panic!! Stay Informed!! Stay Healthy!!
Emerging Pandemic-Novel Coronavirus-"2019 nCoV"
When the World is encountered with a novel public health challenge, it is the utmost essential tool is "Effective public awareness" to containment and control strategy.
Requesting everyone to share this book with your family and friends. This is really having a solution for all corona related queries. Please share it as much as possible, it can really help someone. For any corona related queries, Call on +917290047401.
वर्तमान परिस्थित में समूचा विश्व करोना वायरस से पीड़ित है एवं निरंतर संक्रमित व्यक्तियों की संख्या में वृद्धि हो रही है. जिसके कारण कई देशों में नागरिक आसामयिक ही काल के ग्रास बन रहे हैं . सारी गतिविधियाँ रुकी हुई हैं जिसके कारण आर्थिक हानि हो रही है. लोगों के रोज़गार छिन रहे हैं. जीवन यापन हेतु आवश्यक मूलभूत सुविधाओं का भी उपलब्ध नहीं हो पा रही है. लोग घबराये हुये है. लाखों की संख्या में लोग बड़े शहरों से अपने गाँव लौट रहे हैं जिसका प्रभाव ग्रामीण अर्थव्यवस्था में भी पड़ सकता है.
जैसा की हम सब जानते हैं की पूरी दुनिया इस समय कोरोनावायरस की चपेट में हैं । हर देश अपने-अपने तरीके से लगा हुआ है कोरोनावायरस से बचने के लिए । भारत के प्रधानमंत्री श्री नरेंद्र मोदी जी भारतीय जनता को इस दुःख की स्थिति से बाहर निकालने की कोशिश कर रहे हैं और लगातार हमे प्रोत्साहित कर रहे हैं । ऐसे में हम सब की यह ज़िम्मेदारी है की हम भी इसमें उनका साथ दे और कोरोनावायरस से बचने के सारे उपाए माने । आइये कुछ ऐसे उपाए जाने और उन्हें अपने रोज़मर्रा के जीवन का हिस्सा बनाये जिससे हम खुद को और अपने परिवार को कोरोनावायरस से बचा सके ।
अभी तो दुनिया से कोरोना वायरस का खतरा पूरी तरह ख़त्म भी नही हुआ और फिर से एक नये वायरस ने हमला बोल दिया है। पुरे विश्व के कई देशों में इस वायरस के मामले पाए गये है, जिसे लोग "मंकी वायरस या मंकीपॉक्स" के नाम से जानते है। यह बीमारी पहली बार 1958 में ब्रिटेन से शुरू हुई थी और अब यह कनाडा, स्पेन, बेल्जियम, जर्मनी, फ्रांस और ऑस्ट्रेलिया जैसे देशों में तेजी से बढ़ रहे है, लेकिन भारत में अभी भी इसका असर नही है। इस बीमारी के वायरस मुख्य रूप से मंकी यानि बंदरो में और इसके जैसे बहुत से जंगली जानवरों में भी पाया जाता है।
इस बीमारी के मरीज को शुरुआत में ठंढ लगना, पुरे शरीर के मांशपेशियो में दर्द, थकान, तेज सरदर्द और बुखार जैसे मुख्य लक्षण दिखते है। जब यह बीमारी अपने गंभीर रूप में आने लगता है तो हाथ, पैर, चेहरे एवं शरीर के अन्य हिस्सों में दाने और चकते भी हो जाते है। विश्व स्वास्थ्य संगठन WHO ने ये सन्देश जारी किया है कि इसे महामारी घोषित कर देना चाहिए। चूकि यह बीमारी पहली बार बंदरो से इंसानों में पहुँची है और इसके चकते भी दिखने में वैसे ही लगते है, इसीलिए इसे मंकीपॉक्स नाम दिया गया है। ये बीमारी किसी भी संक्रमित इंसान के संपर्क में आने वाले व्यक्ति को भी हो सकती है क्योंकि यह एक-दूसरे के संपर्क में आने से भी फैलती है।
मंकीपॉक्स वायरस का संचरण तब होता है जब कोई व्यक्ति किसी जानवर, मानव या वायरस से दूषित सामग्री के, वायरस के संपर्क में आता है। मंकीपॉक्स वायरस त्वचा, आंख, नाक या मुंह के माध्यम से शरीर में प्रवेश करता है। यह संक्रमित जानवर के काटने से, या उसके खून, शरीर के तरल पदार्थ, या फर को छूने से हो सकता है। संक्रमित जानवर का मांस खाने, असुरक्षित यौन सम्बन्धों से भी मंकीपॉक्स हो सकता है।
कैसे करे मंकी पॉक्स का इलाज
मंकीपॉक्स वाले अधिकांश लोग आमतौर पर विशिष्ट उपचार के बिना दो से चार सप्ताह के भीतर ठीक हो जाते हैं। मंकीपॉक्स का कोई विशेष और निश्चित इलाज अभी उपलब्ध नही है, क्योंकि ये वायरस उतना अधिक भयावह नही है। फिर भी जिन लोगों में इस वायरस का संदेह हो या जो लोग इससे प्रभावित हो उन्हें चेचक के इलाज के अनुसार ही इलाज किया जाना चाहिए। जैसे: अलग–अलग कमरों में रखना, वैसे जानवरों के संपर्क में आने से बचना जिनसे वायरस के फैलने का खतरा अधिक हो। किसी कारण से आप संपर्क में आ भी जाए तो हाथों को साबुन, पानी, हैण्ड सेनेटाईजर जैसे चीजो का प्रयोग करके आप इसके असर से बच सकते है। इन सबके साथ ही असुरक्षित यौनसंबंधो से भी बचे, क्योंकि एक बिस्तर का उपयोग भी इसे फैलाने में बहुत सहायक साबित हो सकता है। आमतौर पर चेचक के लिए उपयोग किए जाने वाले एंटीवायरस को प्रयोगशाला अध्ययनों और पशु परीक्षणों में प्रभावी दिखाया गया है।
Management of anaemia in pregnancy BY DR ALKA MUKHERJEE DR APURVA MUKHERJEE N...alka mukherjee
Prenatal vitamins typically contain iron. Taking a prenatal vitamin that contains iron can help prevent and treat iron deficiency anemia during pregnancy. In some cases, your health care provider might recommend a separate iron supplement. During pregnancy, you need 27 milligrams of iron a day.
Good nutrition also can prevent iron deficiency anemia during pregnancy. Dietary sources of iron include lean red meat, poultry and fish. Other options include iron-fortified breakfast cereals, prune juice, dried beans and peas.
The iron from animal products, such as meat, is most easily absorbed. To enhance the absorption of iron from plant sources and supplements, pair them with a food or drink high in vitamin C — such as orange juice, tomato juice or strawberries. If you take iron supplements with orange juice, avoid the calcium-fortified variety. Although calcium is an essential nutrient during pregnancy, calcium can decrease iron absorption.
How is iron deficiency anemia during pregnancy treated?
If you are taking a prenatal vitamin that contains iron and you are anemic, your health care provider might recommend testing to determine other possible causes. In some cases, you might need to see a doctor who specializes in treating blood disorders (hematologist). If the cause is iron deficiency, additional supplemental iron might be suggested. If you have a history of gastric bypass or small bowel surgery or are unable to tolerate oral iron, you might need intravenous iron administration. Oral iron is recommended as the first line treatment, with repeated checking of Hb at 2 to 3 weeks after starting treatment to assess compliance, correct administration and response to treatmentOnce Hb reaches the normal range, it is recommended that iron replacement should continue for three months and until at least six weeks postpartumIntravenous (IV) iron is recommended for women who could not tolerate or respond to oral iron, and for those with moderately severe to severe anemia (Hb ≤ 90 g/LHb be measured within 24 to 48 hours after delivery in women with blood loss more than 500 mL, those with uncorrected anemia detected during pregnancy or those with symptoms suggestive of anemia postnatallyOral iron is recommended for women with Hb <100 g/L postpartum, who are hemodynamically stable, asymptomatic or mild symptomatic
Anemia signs and symptoms include:
• Fatigue
• Weakness
• Pale or yellowish skin
• Irregular heartbeats
• Shortness of breath
• Dizziness or lightheadedness
• Chest pain
• Cold hands and feet
• Headache
Keep in mind, however, that symptoms of anemia are often similar to general pregnancy symptoms. Regardless of whether or not you have symptoms, you'll have blood tests to screen for anemia during pregnancy. If you're concerned about your level of fatigue or any other symptoms, talk to your health care provider.
Secondary amenorrhoea by dr alka mukherjee dr apurva mukherjeealka mukherjee
The first step in the evaluation of any patient with secondary amenorrhea is a urine pregnancy test. Every contraceptive method has a failure rate, and anyone who is menstruating is potentially fertile, regardless of age. [5][6]
If the pregnancy test is negative, consider the clinical picture: hirsutism, acne, and a long history of infrequent and irregular menses suggest polycystic ovarian syndrome. By the Rotterdam criteria, a patient may be diagnosed with PCOS if she has two of the following: clinical or chemical hyperandrogenism, oligo- or amenorrhea, or polycystic ovaries on ultrasound. So if a patient has evidence of hirsutism and oligo- or amenorrhea, she can be diagnosed with PCOS without further laboratory testing or imaging.
If history and physical exam are not consistent with PCOS, a TSH should be ordered. Both hyper- and hypothyroidism can lead to menstrual dysfunction.
If TSH is normal, check a serum prolactin. Elevated serum prolactin suggests prolactinoma.
Early pregnancy loss by dr alka mukherjee dr apurva mukherjee nagpur ms indiaalka mukherjee
Early pregnancy loss, or loss of an intrauterine pregnancy within the first trimester, is encountered commonly in clinical practice. Obstetricians and gynecologists should understand the use of various diagnostic tools to differentiate between viable and nonviable pregnancies and offer the full range of therapeutic options to patients, including expectant, medical, and surgical management.
Early pregnancy loss is defined as a nonviable, intrauterine pregnancy with either an empty gestational sac or a gestational sac containing an embryo or fetus without fetal heart activity within the first 12 6/7 weeks of gestation 1. In the first trimester, the terms miscarriage, spontaneous abortion, and early pregnancy loss are used interchangeably, and there is no consensus on terminology in the literature.
Pprom by dr alka mukherjee dr apurva mukherjee nagpur indiaalka mukherjee
Preterm premature rupture of the membranes (PPROM) is a pregnancy complication. In this condition, the sac (amniotic membrane) surrounding your baby breaks (ruptures) before week 37 of pregnancy. Once the sac breaks, you have an increased risk for infection. You also have a higher chance of having your baby born early.
In most cases of PPROM, the cause is not known.
These things may increase risk:
• Having a preterm birth in a previous pregnancy
• Having an infection in your reproductive system
• Vaginal bleeding during pregnancy
• Smoking during pregnancy
Symptoms can occur a bit differently in each pregnancy. They can include:
• A sudden gush of fluid from your vagina
• Leaking of fluid from your vagina
• A feeling of wetness in your vagina or underwear
Call your healthcare provider right away if you have these symptoms.
The symptoms of this health problem may be similar to symptoms of other conditions. See your healthcare provider for a diagnosis.
Diagnosis
• pH (acid-base) balance testing. The pH balance of amniotic fluid is different from vaginal fluid and urine. Your healthcare provider will put the fluid on a test strip to check the balance.
• Looking at a sample under a microscope. When amniotic fluid is dry, it has a fern-like pattern.
• ultrasound exam. This is done to check the amount of amniotic fluid around baby.
Public education on breast cancer hindi by dr alka mukherjee nagpur ms i...alka mukherjee
Abnormal lump — Breast cancer can be discovered when a lump or other change in the breast or armpit is found by a woman herself or by her healthcare provider. In addition to a lump, other abnormal changes may include dimpling of the skin, a change in the size or shape of one breast, retraction (pulling in) of the nipple when it previously pointed outward, or a discoloration of the skin of the breast not related to infection or skin conditions such as psoriasis or eczema.Mammogram — A mammogram is a very low-dose X-ray of the breast. The breast tissue is compressed for the X-ray, which decreases the thickness of the tissue and holds the breast in position, so the radiologist can find abnormalities more accurately. Each breast is compressed between two panels and X-rayed from two directions (top-down and side-to-side) to make sure all the tissue is examined. Mammograms are currently the best screening modality to detect breast cancer. Some mammograms capture images digitally, offering better clarity, the ability to adjust the image, and a decreased likelihood that the woman will need to return on a different day for repeat pictures.
Cancer cervix awareness in hindi by dr alka mukherjee nagpur ms indiaalka mukherjee
Cervical cancer occurs when the cells in the cervix grow abnormally or out of control. The cervix is part of the female reproductive system. The exact cause of cervical cancer is unknown. Certain strains of the human papillomavirus (HPV), a sexually transmitted disease, cause the majority of cervical cancer.
A new vaccine is available to prevent infection against the two types of HPV that are responsible for the majority of cervical cancer cases and the two types of HPV that are responsible for the majority of genital wart cases. A pap smear test is a preventive measure that can detect precancerous or cancerous cells. Precancerous cells are 100% curable.
Telehealth medico legal aspects by dr alka mukherjee nagpur ms indiaalka mukherjee
The term telehealth includes a broad range of technologies and services to provide patient care and improve the healthcare delivery system as a whole. Telehealth is different from telemedicine because it refers to a broader scope of remote healthcare services than telemedicine. While telemedicine refers specifically to remote clinical services, telehealth can refer to remote non-clinical services, such as provider training, administrative meetings, and continuing medical education, in addition to clinical services. According to the World Health Organization, telehealth includes, “Surveillance, health promotion and public health functions.”
Telemedicine involves the use of electronic communications and software to provide clinical services to patients without an in-person visit. Telemedicine technology is frequently used for follow-up visits, management of chronic conditions, medication management, specialist consultation and a host of other clinical services that can be provided remotely via secure video and audio connections.
Evolution and current practices in emergency contraceptives BY DR ALKA MUKHER...alka mukherjee
ey facts
Emergency contraception (EC) can prevent up to over 95% of pregnancies when taken within 5 days after intercourse.
EC can be used in the following situations: unprotected intercourse, concerns about possible contraceptive failure, incorrect use of contraceptives, and sexual assault if without contraception coverage.
Methods of emergency contraception are the copper-bearing intrauterine devices (IUDs) and the emergency contraceptive pills (ECPs).
A copper-bearing IUD is the most effective form of emergency contraception available.
The emergency contraceptive pill regimens recommended by WHO are ulipristal acetate, levonorgestrel, or combined oral contraceptives (COCs) consisting of ethinyl estradiol plus levonorgestrel.
Screening for gestational diabetes an update by dr alka mukherjee nagpur ms i...alka mukherjee
Gestational Diabetes Mellitus (GDM) is defined as any glucose intolerance with the onset or first recognition during pregnancy. This definition helps for diagnosis of unrecognized pre-existing Diabetes also. Hyperglycemia in pregnancy is associated with adverse maternal and prenatal outcome. It is important to screen, diagnose and treat Hyperglycemia in pregnancy to prevent an adverse outcome. There is no international consensus regarding timing of screening method and the optimal cut-off points for diagnosis and intervention of GDM. DIPSI recommends non-fasting Oral Glucose Tolerance Test (OGTT) with 75g of glucose with a cut-off of ≥ 140 mg/dl after 2-hours, whereas WHO (1999) recommends a fasting OGTT after 75g glucose with a cut-off plasma glucose of ≥ 140 mg/dl after 2-hour. The recommendations by ADA/IADPSG for screening women at risk of diabetes is as follows, for first and subsequent trimester at 24-28 weeks a criteria of diagnosis of GDM is made by 75 g OGTT and fasting 5.1mmol/l, 1 hour 10.0mmol/l, 2 hour 8.5mmol/l by universal glucose tolerance testing. Critics of these criteria state that it causes over diagnosis of GDM and unnecessary interventions, the controversy however continues. The ACOG still prefer a 2 step procedure, GCT with 50g glucose non-fasting if value > 7.8mmol/l followed by 3-hour OGTT for confirmation of diagnosis. In conclusion based on Hyperglycemia and Adverse Pregnancy Outcome (HAPO) study as mild degree of dysglycemia are associated with adverse outcome and high prevalence of Type II DM to have international consensus It recommends IADPSG criteria, though controversy exists. The IADPSG criteria is the only outcome based criteria, it has the ability to diagnose and treat GDM earlier, thereby reducing the fetal and maternal complications associated with GDM. This one step method has an advantage of simplicity in execution, more patient friendly, accurate in diagnosis and close to international consensus. Keeping in the mind the diversity and variability of Indian population, judging international criteria may not be conclusive, thus further comparative studies are required on different diagnostic criteria in relation to adverse pregnancy outcomes
Hague convention for inter country adoption by dr alka mukherjee nagpur ms indiaalka mukherjee
The Hague Convention on the Protection of Children and Co-operation in Respect of Intercountry Adoption (Convention) is an international agreement to safeguard intercountry adoptions. Concluded on May 29, 1993 in The Hague, the Netherlands, the Convention establishes international standards of practices for intercountry adoptions. The United States signed the Convention in 1994, and the Convention entered into force for the United States on April 1, 2008The Convention applies to all adoptions by U.S. citizens habitually resident in the United States of children habitually resident in any country outside of the United States that is a party to the Convention (Convention countries). Adopting a child from a Convention country is similar in many ways to adopting a child from a country not party to the Convention. However, there are some key differences. In particular, those seeking to adopt may receive greater protections if they adopt from a Convention country.
The Convention requires that countries who are party to it establish a Central Authority to be the authoritative source of information and point of contact in that country. The Department of State is the U.S. Central Authorityfor the Convention.
The Convention aims to prevent the abduction, sale of, or trafficking in children, and it works to ensure that intercountry adoptions are in the best interests of children.
The Convention recognizes intercountry adoption as a means of offering the advantage of a permanent home to a child when a suitable family has not been found in the child's country of origin. It enables intercountry adoption to take place when, among other steps:
1. The child has been deemed eligible for adoption by the child's country of origin; and
2. Due consideration has been given to finding an adoption placement for the child in its country of origin.
The role of judiciary & the legal procedure in an adoption case by dr alka mu...alka mukherjee
Central Adoption Resource Authority (CARA) is the nodal agency to monitor and regulate in-country and intra-country adoption and is a part of Ministry of Women and child care.
Following are the certain essential conditions in order to be eligible to adopt a child:
• The procedure for adoption is different in case of Indian citizen, NRI or a foreign citizen and a child can be adopted by any of the three.
• Irrespective of their gender or marital status, any person is eligible to adopt.
• Provided that a couple is adopting a child, they should have completed two years of stable marriage and both should agree for the adoption.
• 25 years should be the minimum age difference between the child and the adoptive parents.
WHEN CAN A CHILD BE ELIGIBLE TO BE ADOPTED?
• Any orphan, surrendered or abandoned child is legally declared free for adoption by the child welfare committee as per the guidelines of the Central Government of India.
• A child without a legal parent or a guardian or the parents are not capable of taking care of the child anymore is said to be an orphan.
• When a child is deserted or unaccompanied by parents or a guardian and the child welfare committee has declared the child to be abandoned, a child is considered to be abandoned.
• Renounce on account of physical, social and emotional factors that are beyond the control of parents or the guardian is called a surrendered child as declared by the child welfare committee.
• In case of adoption, a child requires to be “legally free”. A child is considered to be legally free if even after trying their level best the police fails to find the true parent or guardian of the child.
WHAT ARE THE NORMAL CONDITIONS TO BE FULFILLED BY PARENTS?
• The adoptive parents need to be mentally, physically and emotionally stable.
• The adoptive parents should be financially stable.
• The adoptive parents should not be suffering from any life- threatening diseases.
• Apart from cases of special needs children, couples with three or more kids are not allowed for adoption.
• A single female is allowed to adopt a child of any gender but a single male is not allowed to adopt a girl child.
• The maximum age limit of a single parents should be 55 years.
Laws , rules & regulations governing adoptions in india by dr alka mukherjee ...alka mukherjee
ADOPTION IN INDIA
The custom and practice of adoption in India dates back to the ancient times. Although the act of adoption remains the same, the objective with which this act is carried out has differed. It usually ranged from the humanitarian motive of caring and bringing up a neglected or destitute child, to a natural desire for a kid as an object of affection, a caretaker in old age, and an heir after death.[iii]
But since adoption comes under the ambit of personal laws, there has not been a scope in the Indian scenario to incorporate a uniform law among the different communities which consist of this melting pot. Hence, this law is governed by various personal laws of different religions.
Adoption is not permitted in the personal laws of Muslims, Christians, Parsis and Jews in India. Hence they usually opt for guardianship of a child through the Guardians and Wards Act, 1890.
Indian citizens who are Hindus, Jains, Sikhs, or Buddhists are allowed to formally adopt a child. The adoption is under the Hindu Adoption and Maintenance Act of 1956 that was enacted in India as a part of the Hindu Code Bills. It brought about a few reforms that liberalized the institution of adoption.
Tuberculosis in prenancy by dr alka mukherjee dr apurva mukherjee nagpur ms i...alka mukherjee
Prevention of Tuberculosis
The BCG vaccine has been incorporated into the National immunization policy of many countries, especially the high burden countries, thereby conferring active immunity from childhood. Nonimmune women travelling to tuberculosis endemic countries should also be vaccinated. It must, however, be noted that the vaccine is contraindicated in pregnancy [72].
The prevention, however, goes beyond this as it is essentially a disease of poverty. Improved living condition is, therefore, encouraged with good ventilation, while overcrowding should be avoided. Improvement in nutritional status is another important aspect of the prevention.
Pregnant women living with HIV are at higher risk for TB, which can adversely influence maternal and perinatal outcomes [73]. As much as 1.1 million people were diagnosed with the co-infection in 2009 alone [2]. Primary prevention of HIV/AIDS is, therefore, another major step in the prevention of tuberculosis in pregnancy. Screening of all pregnant women living with HIV for active tuberculosis is recommended even in the absence of overt clinical signs of the disease.
Isoniazid preventive therapy (IPT) is another innovation of the World Health Organisation that is aimed at reducing the infection in HIV positive pregnant women based on evidence and experience and it has been concluded that pregnancy should not be a contraindication to receiving IPT. However, patient's individualisation and rational clinical judgement is required for decisions such as the best time to provide IPT to pregnant women
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Similar to Corona preventive measures for public awareness IN Hindi by dr alka mukherjee nagpur m.s. india
वर्तमान परिस्थित में समूचा विश्व करोना वायरस से पीड़ित है एवं निरंतर संक्रमित व्यक्तियों की संख्या में वृद्धि हो रही है. जिसके कारण कई देशों में नागरिक आसामयिक ही काल के ग्रास बन रहे हैं . सारी गतिविधियाँ रुकी हुई हैं जिसके कारण आर्थिक हानि हो रही है. लोगों के रोज़गार छिन रहे हैं. जीवन यापन हेतु आवश्यक मूलभूत सुविधाओं का भी उपलब्ध नहीं हो पा रही है. लोग घबराये हुये है. लाखों की संख्या में लोग बड़े शहरों से अपने गाँव लौट रहे हैं जिसका प्रभाव ग्रामीण अर्थव्यवस्था में भी पड़ सकता है.
जैसा की हम सब जानते हैं की पूरी दुनिया इस समय कोरोनावायरस की चपेट में हैं । हर देश अपने-अपने तरीके से लगा हुआ है कोरोनावायरस से बचने के लिए । भारत के प्रधानमंत्री श्री नरेंद्र मोदी जी भारतीय जनता को इस दुःख की स्थिति से बाहर निकालने की कोशिश कर रहे हैं और लगातार हमे प्रोत्साहित कर रहे हैं । ऐसे में हम सब की यह ज़िम्मेदारी है की हम भी इसमें उनका साथ दे और कोरोनावायरस से बचने के सारे उपाए माने । आइये कुछ ऐसे उपाए जाने और उन्हें अपने रोज़मर्रा के जीवन का हिस्सा बनाये जिससे हम खुद को और अपने परिवार को कोरोनावायरस से बचा सके ।
अभी तो दुनिया से कोरोना वायरस का खतरा पूरी तरह ख़त्म भी नही हुआ और फिर से एक नये वायरस ने हमला बोल दिया है। पुरे विश्व के कई देशों में इस वायरस के मामले पाए गये है, जिसे लोग "मंकी वायरस या मंकीपॉक्स" के नाम से जानते है। यह बीमारी पहली बार 1958 में ब्रिटेन से शुरू हुई थी और अब यह कनाडा, स्पेन, बेल्जियम, जर्मनी, फ्रांस और ऑस्ट्रेलिया जैसे देशों में तेजी से बढ़ रहे है, लेकिन भारत में अभी भी इसका असर नही है। इस बीमारी के वायरस मुख्य रूप से मंकी यानि बंदरो में और इसके जैसे बहुत से जंगली जानवरों में भी पाया जाता है।
इस बीमारी के मरीज को शुरुआत में ठंढ लगना, पुरे शरीर के मांशपेशियो में दर्द, थकान, तेज सरदर्द और बुखार जैसे मुख्य लक्षण दिखते है। जब यह बीमारी अपने गंभीर रूप में आने लगता है तो हाथ, पैर, चेहरे एवं शरीर के अन्य हिस्सों में दाने और चकते भी हो जाते है। विश्व स्वास्थ्य संगठन WHO ने ये सन्देश जारी किया है कि इसे महामारी घोषित कर देना चाहिए। चूकि यह बीमारी पहली बार बंदरो से इंसानों में पहुँची है और इसके चकते भी दिखने में वैसे ही लगते है, इसीलिए इसे मंकीपॉक्स नाम दिया गया है। ये बीमारी किसी भी संक्रमित इंसान के संपर्क में आने वाले व्यक्ति को भी हो सकती है क्योंकि यह एक-दूसरे के संपर्क में आने से भी फैलती है।
मंकीपॉक्स वायरस का संचरण तब होता है जब कोई व्यक्ति किसी जानवर, मानव या वायरस से दूषित सामग्री के, वायरस के संपर्क में आता है। मंकीपॉक्स वायरस त्वचा, आंख, नाक या मुंह के माध्यम से शरीर में प्रवेश करता है। यह संक्रमित जानवर के काटने से, या उसके खून, शरीर के तरल पदार्थ, या फर को छूने से हो सकता है। संक्रमित जानवर का मांस खाने, असुरक्षित यौन सम्बन्धों से भी मंकीपॉक्स हो सकता है।
कैसे करे मंकी पॉक्स का इलाज
मंकीपॉक्स वाले अधिकांश लोग आमतौर पर विशिष्ट उपचार के बिना दो से चार सप्ताह के भीतर ठीक हो जाते हैं। मंकीपॉक्स का कोई विशेष और निश्चित इलाज अभी उपलब्ध नही है, क्योंकि ये वायरस उतना अधिक भयावह नही है। फिर भी जिन लोगों में इस वायरस का संदेह हो या जो लोग इससे प्रभावित हो उन्हें चेचक के इलाज के अनुसार ही इलाज किया जाना चाहिए। जैसे: अलग–अलग कमरों में रखना, वैसे जानवरों के संपर्क में आने से बचना जिनसे वायरस के फैलने का खतरा अधिक हो। किसी कारण से आप संपर्क में आ भी जाए तो हाथों को साबुन, पानी, हैण्ड सेनेटाईजर जैसे चीजो का प्रयोग करके आप इसके असर से बच सकते है। इन सबके साथ ही असुरक्षित यौनसंबंधो से भी बचे, क्योंकि एक बिस्तर का उपयोग भी इसे फैलाने में बहुत सहायक साबित हो सकता है। आमतौर पर चेचक के लिए उपयोग किए जाने वाले एंटीवायरस को प्रयोगशाला अध्ययनों और पशु परीक्षणों में प्रभावी दिखाया गया है।
Management of anaemia in pregnancy BY DR ALKA MUKHERJEE DR APURVA MUKHERJEE N...alka mukherjee
Prenatal vitamins typically contain iron. Taking a prenatal vitamin that contains iron can help prevent and treat iron deficiency anemia during pregnancy. In some cases, your health care provider might recommend a separate iron supplement. During pregnancy, you need 27 milligrams of iron a day.
Good nutrition also can prevent iron deficiency anemia during pregnancy. Dietary sources of iron include lean red meat, poultry and fish. Other options include iron-fortified breakfast cereals, prune juice, dried beans and peas.
The iron from animal products, such as meat, is most easily absorbed. To enhance the absorption of iron from plant sources and supplements, pair them with a food or drink high in vitamin C — such as orange juice, tomato juice or strawberries. If you take iron supplements with orange juice, avoid the calcium-fortified variety. Although calcium is an essential nutrient during pregnancy, calcium can decrease iron absorption.
How is iron deficiency anemia during pregnancy treated?
If you are taking a prenatal vitamin that contains iron and you are anemic, your health care provider might recommend testing to determine other possible causes. In some cases, you might need to see a doctor who specializes in treating blood disorders (hematologist). If the cause is iron deficiency, additional supplemental iron might be suggested. If you have a history of gastric bypass or small bowel surgery or are unable to tolerate oral iron, you might need intravenous iron administration. Oral iron is recommended as the first line treatment, with repeated checking of Hb at 2 to 3 weeks after starting treatment to assess compliance, correct administration and response to treatmentOnce Hb reaches the normal range, it is recommended that iron replacement should continue for three months and until at least six weeks postpartumIntravenous (IV) iron is recommended for women who could not tolerate or respond to oral iron, and for those with moderately severe to severe anemia (Hb ≤ 90 g/LHb be measured within 24 to 48 hours after delivery in women with blood loss more than 500 mL, those with uncorrected anemia detected during pregnancy or those with symptoms suggestive of anemia postnatallyOral iron is recommended for women with Hb <100 g/L postpartum, who are hemodynamically stable, asymptomatic or mild symptomatic
Anemia signs and symptoms include:
• Fatigue
• Weakness
• Pale or yellowish skin
• Irregular heartbeats
• Shortness of breath
• Dizziness or lightheadedness
• Chest pain
• Cold hands and feet
• Headache
Keep in mind, however, that symptoms of anemia are often similar to general pregnancy symptoms. Regardless of whether or not you have symptoms, you'll have blood tests to screen for anemia during pregnancy. If you're concerned about your level of fatigue or any other symptoms, talk to your health care provider.
Secondary amenorrhoea by dr alka mukherjee dr apurva mukherjeealka mukherjee
The first step in the evaluation of any patient with secondary amenorrhea is a urine pregnancy test. Every contraceptive method has a failure rate, and anyone who is menstruating is potentially fertile, regardless of age. [5][6]
If the pregnancy test is negative, consider the clinical picture: hirsutism, acne, and a long history of infrequent and irregular menses suggest polycystic ovarian syndrome. By the Rotterdam criteria, a patient may be diagnosed with PCOS if she has two of the following: clinical or chemical hyperandrogenism, oligo- or amenorrhea, or polycystic ovaries on ultrasound. So if a patient has evidence of hirsutism and oligo- or amenorrhea, she can be diagnosed with PCOS without further laboratory testing or imaging.
If history and physical exam are not consistent with PCOS, a TSH should be ordered. Both hyper- and hypothyroidism can lead to menstrual dysfunction.
If TSH is normal, check a serum prolactin. Elevated serum prolactin suggests prolactinoma.
Early pregnancy loss by dr alka mukherjee dr apurva mukherjee nagpur ms indiaalka mukherjee
Early pregnancy loss, or loss of an intrauterine pregnancy within the first trimester, is encountered commonly in clinical practice. Obstetricians and gynecologists should understand the use of various diagnostic tools to differentiate between viable and nonviable pregnancies and offer the full range of therapeutic options to patients, including expectant, medical, and surgical management.
Early pregnancy loss is defined as a nonviable, intrauterine pregnancy with either an empty gestational sac or a gestational sac containing an embryo or fetus without fetal heart activity within the first 12 6/7 weeks of gestation 1. In the first trimester, the terms miscarriage, spontaneous abortion, and early pregnancy loss are used interchangeably, and there is no consensus on terminology in the literature.
Pprom by dr alka mukherjee dr apurva mukherjee nagpur indiaalka mukherjee
Preterm premature rupture of the membranes (PPROM) is a pregnancy complication. In this condition, the sac (amniotic membrane) surrounding your baby breaks (ruptures) before week 37 of pregnancy. Once the sac breaks, you have an increased risk for infection. You also have a higher chance of having your baby born early.
In most cases of PPROM, the cause is not known.
These things may increase risk:
• Having a preterm birth in a previous pregnancy
• Having an infection in your reproductive system
• Vaginal bleeding during pregnancy
• Smoking during pregnancy
Symptoms can occur a bit differently in each pregnancy. They can include:
• A sudden gush of fluid from your vagina
• Leaking of fluid from your vagina
• A feeling of wetness in your vagina or underwear
Call your healthcare provider right away if you have these symptoms.
The symptoms of this health problem may be similar to symptoms of other conditions. See your healthcare provider for a diagnosis.
Diagnosis
• pH (acid-base) balance testing. The pH balance of amniotic fluid is different from vaginal fluid and urine. Your healthcare provider will put the fluid on a test strip to check the balance.
• Looking at a sample under a microscope. When amniotic fluid is dry, it has a fern-like pattern.
• ultrasound exam. This is done to check the amount of amniotic fluid around baby.
Public education on breast cancer hindi by dr alka mukherjee nagpur ms i...alka mukherjee
Abnormal lump — Breast cancer can be discovered when a lump or other change in the breast or armpit is found by a woman herself or by her healthcare provider. In addition to a lump, other abnormal changes may include dimpling of the skin, a change in the size or shape of one breast, retraction (pulling in) of the nipple when it previously pointed outward, or a discoloration of the skin of the breast not related to infection or skin conditions such as psoriasis or eczema.Mammogram — A mammogram is a very low-dose X-ray of the breast. The breast tissue is compressed for the X-ray, which decreases the thickness of the tissue and holds the breast in position, so the radiologist can find abnormalities more accurately. Each breast is compressed between two panels and X-rayed from two directions (top-down and side-to-side) to make sure all the tissue is examined. Mammograms are currently the best screening modality to detect breast cancer. Some mammograms capture images digitally, offering better clarity, the ability to adjust the image, and a decreased likelihood that the woman will need to return on a different day for repeat pictures.
Cancer cervix awareness in hindi by dr alka mukherjee nagpur ms indiaalka mukherjee
Cervical cancer occurs when the cells in the cervix grow abnormally or out of control. The cervix is part of the female reproductive system. The exact cause of cervical cancer is unknown. Certain strains of the human papillomavirus (HPV), a sexually transmitted disease, cause the majority of cervical cancer.
A new vaccine is available to prevent infection against the two types of HPV that are responsible for the majority of cervical cancer cases and the two types of HPV that are responsible for the majority of genital wart cases. A pap smear test is a preventive measure that can detect precancerous or cancerous cells. Precancerous cells are 100% curable.
Telehealth medico legal aspects by dr alka mukherjee nagpur ms indiaalka mukherjee
The term telehealth includes a broad range of technologies and services to provide patient care and improve the healthcare delivery system as a whole. Telehealth is different from telemedicine because it refers to a broader scope of remote healthcare services than telemedicine. While telemedicine refers specifically to remote clinical services, telehealth can refer to remote non-clinical services, such as provider training, administrative meetings, and continuing medical education, in addition to clinical services. According to the World Health Organization, telehealth includes, “Surveillance, health promotion and public health functions.”
Telemedicine involves the use of electronic communications and software to provide clinical services to patients without an in-person visit. Telemedicine technology is frequently used for follow-up visits, management of chronic conditions, medication management, specialist consultation and a host of other clinical services that can be provided remotely via secure video and audio connections.
Evolution and current practices in emergency contraceptives BY DR ALKA MUKHER...alka mukherjee
ey facts
Emergency contraception (EC) can prevent up to over 95% of pregnancies when taken within 5 days after intercourse.
EC can be used in the following situations: unprotected intercourse, concerns about possible contraceptive failure, incorrect use of contraceptives, and sexual assault if without contraception coverage.
Methods of emergency contraception are the copper-bearing intrauterine devices (IUDs) and the emergency contraceptive pills (ECPs).
A copper-bearing IUD is the most effective form of emergency contraception available.
The emergency contraceptive pill regimens recommended by WHO are ulipristal acetate, levonorgestrel, or combined oral contraceptives (COCs) consisting of ethinyl estradiol plus levonorgestrel.
Screening for gestational diabetes an update by dr alka mukherjee nagpur ms i...alka mukherjee
Gestational Diabetes Mellitus (GDM) is defined as any glucose intolerance with the onset or first recognition during pregnancy. This definition helps for diagnosis of unrecognized pre-existing Diabetes also. Hyperglycemia in pregnancy is associated with adverse maternal and prenatal outcome. It is important to screen, diagnose and treat Hyperglycemia in pregnancy to prevent an adverse outcome. There is no international consensus regarding timing of screening method and the optimal cut-off points for diagnosis and intervention of GDM. DIPSI recommends non-fasting Oral Glucose Tolerance Test (OGTT) with 75g of glucose with a cut-off of ≥ 140 mg/dl after 2-hours, whereas WHO (1999) recommends a fasting OGTT after 75g glucose with a cut-off plasma glucose of ≥ 140 mg/dl after 2-hour. The recommendations by ADA/IADPSG for screening women at risk of diabetes is as follows, for first and subsequent trimester at 24-28 weeks a criteria of diagnosis of GDM is made by 75 g OGTT and fasting 5.1mmol/l, 1 hour 10.0mmol/l, 2 hour 8.5mmol/l by universal glucose tolerance testing. Critics of these criteria state that it causes over diagnosis of GDM and unnecessary interventions, the controversy however continues. The ACOG still prefer a 2 step procedure, GCT with 50g glucose non-fasting if value > 7.8mmol/l followed by 3-hour OGTT for confirmation of diagnosis. In conclusion based on Hyperglycemia and Adverse Pregnancy Outcome (HAPO) study as mild degree of dysglycemia are associated with adverse outcome and high prevalence of Type II DM to have international consensus It recommends IADPSG criteria, though controversy exists. The IADPSG criteria is the only outcome based criteria, it has the ability to diagnose and treat GDM earlier, thereby reducing the fetal and maternal complications associated with GDM. This one step method has an advantage of simplicity in execution, more patient friendly, accurate in diagnosis and close to international consensus. Keeping in the mind the diversity and variability of Indian population, judging international criteria may not be conclusive, thus further comparative studies are required on different diagnostic criteria in relation to adverse pregnancy outcomes
Hague convention for inter country adoption by dr alka mukherjee nagpur ms indiaalka mukherjee
The Hague Convention on the Protection of Children and Co-operation in Respect of Intercountry Adoption (Convention) is an international agreement to safeguard intercountry adoptions. Concluded on May 29, 1993 in The Hague, the Netherlands, the Convention establishes international standards of practices for intercountry adoptions. The United States signed the Convention in 1994, and the Convention entered into force for the United States on April 1, 2008The Convention applies to all adoptions by U.S. citizens habitually resident in the United States of children habitually resident in any country outside of the United States that is a party to the Convention (Convention countries). Adopting a child from a Convention country is similar in many ways to adopting a child from a country not party to the Convention. However, there are some key differences. In particular, those seeking to adopt may receive greater protections if they adopt from a Convention country.
The Convention requires that countries who are party to it establish a Central Authority to be the authoritative source of information and point of contact in that country. The Department of State is the U.S. Central Authorityfor the Convention.
The Convention aims to prevent the abduction, sale of, or trafficking in children, and it works to ensure that intercountry adoptions are in the best interests of children.
The Convention recognizes intercountry adoption as a means of offering the advantage of a permanent home to a child when a suitable family has not been found in the child's country of origin. It enables intercountry adoption to take place when, among other steps:
1. The child has been deemed eligible for adoption by the child's country of origin; and
2. Due consideration has been given to finding an adoption placement for the child in its country of origin.
The role of judiciary & the legal procedure in an adoption case by dr alka mu...alka mukherjee
Central Adoption Resource Authority (CARA) is the nodal agency to monitor and regulate in-country and intra-country adoption and is a part of Ministry of Women and child care.
Following are the certain essential conditions in order to be eligible to adopt a child:
• The procedure for adoption is different in case of Indian citizen, NRI or a foreign citizen and a child can be adopted by any of the three.
• Irrespective of their gender or marital status, any person is eligible to adopt.
• Provided that a couple is adopting a child, they should have completed two years of stable marriage and both should agree for the adoption.
• 25 years should be the minimum age difference between the child and the adoptive parents.
WHEN CAN A CHILD BE ELIGIBLE TO BE ADOPTED?
• Any orphan, surrendered or abandoned child is legally declared free for adoption by the child welfare committee as per the guidelines of the Central Government of India.
• A child without a legal parent or a guardian or the parents are not capable of taking care of the child anymore is said to be an orphan.
• When a child is deserted or unaccompanied by parents or a guardian and the child welfare committee has declared the child to be abandoned, a child is considered to be abandoned.
• Renounce on account of physical, social and emotional factors that are beyond the control of parents or the guardian is called a surrendered child as declared by the child welfare committee.
• In case of adoption, a child requires to be “legally free”. A child is considered to be legally free if even after trying their level best the police fails to find the true parent or guardian of the child.
WHAT ARE THE NORMAL CONDITIONS TO BE FULFILLED BY PARENTS?
• The adoptive parents need to be mentally, physically and emotionally stable.
• The adoptive parents should be financially stable.
• The adoptive parents should not be suffering from any life- threatening diseases.
• Apart from cases of special needs children, couples with three or more kids are not allowed for adoption.
• A single female is allowed to adopt a child of any gender but a single male is not allowed to adopt a girl child.
• The maximum age limit of a single parents should be 55 years.
Laws , rules & regulations governing adoptions in india by dr alka mukherjee ...alka mukherjee
ADOPTION IN INDIA
The custom and practice of adoption in India dates back to the ancient times. Although the act of adoption remains the same, the objective with which this act is carried out has differed. It usually ranged from the humanitarian motive of caring and bringing up a neglected or destitute child, to a natural desire for a kid as an object of affection, a caretaker in old age, and an heir after death.[iii]
But since adoption comes under the ambit of personal laws, there has not been a scope in the Indian scenario to incorporate a uniform law among the different communities which consist of this melting pot. Hence, this law is governed by various personal laws of different religions.
Adoption is not permitted in the personal laws of Muslims, Christians, Parsis and Jews in India. Hence they usually opt for guardianship of a child through the Guardians and Wards Act, 1890.
Indian citizens who are Hindus, Jains, Sikhs, or Buddhists are allowed to formally adopt a child. The adoption is under the Hindu Adoption and Maintenance Act of 1956 that was enacted in India as a part of the Hindu Code Bills. It brought about a few reforms that liberalized the institution of adoption.
Tuberculosis in prenancy by dr alka mukherjee dr apurva mukherjee nagpur ms i...alka mukherjee
Prevention of Tuberculosis
The BCG vaccine has been incorporated into the National immunization policy of many countries, especially the high burden countries, thereby conferring active immunity from childhood. Nonimmune women travelling to tuberculosis endemic countries should also be vaccinated. It must, however, be noted that the vaccine is contraindicated in pregnancy [72].
The prevention, however, goes beyond this as it is essentially a disease of poverty. Improved living condition is, therefore, encouraged with good ventilation, while overcrowding should be avoided. Improvement in nutritional status is another important aspect of the prevention.
Pregnant women living with HIV are at higher risk for TB, which can adversely influence maternal and perinatal outcomes [73]. As much as 1.1 million people were diagnosed with the co-infection in 2009 alone [2]. Primary prevention of HIV/AIDS is, therefore, another major step in the prevention of tuberculosis in pregnancy. Screening of all pregnant women living with HIV for active tuberculosis is recommended even in the absence of overt clinical signs of the disease.
Isoniazid preventive therapy (IPT) is another innovation of the World Health Organisation that is aimed at reducing the infection in HIV positive pregnant women based on evidence and experience and it has been concluded that pregnancy should not be a contraindication to receiving IPT. However, patient's individualisation and rational clinical judgement is required for decisions such as the best time to provide IPT to pregnant women
Torch infections during pregnancy by dr alka mukherjee nagpur ms indiaalka mukherjee
TORCH Syndrome refers to infection of a developing fetus or newborn by any of a group of infectious agents. "TORCH" is an acronym meaning (T)oxoplasmosis, (O)ther Agents, (R)ubella (also known as German Measles), (C)ytomegalovirus, and (H)erpes Simplex. Infection with any of these agents (i.e., Toxoplasma gondii, rubella virus, cytomegalovirus, herpes simplex viruses) may cause a constellation of similar symptoms in affected newborns. These may include fever; difficulties feeding; small areas of bleeding under the skin, causing the appearance of small reddish or purplish spots; enlargement of the liver and spleen (hepatosplenomegaly); yellowish discoloration of the skin, whites of the eyes, and mucous membranes (jaundice); hearing impairment; abnormalities of the eyes; and/or other symptoms and findings. Each infectious agent may also result in additional abnormalities that may be variable, depending upon a number of factors (e.g., stage of fetal development
How to develope your personality by dr alka mukherjee nagpur ms indiaalka mukherjee
Personality is what makes a person a unique person, and it is recognizable soon after birth. A child's personality has several components: temperament, environment, and character. Temperament is the set of genetically determined traits that determine the child's approach to the world and how the child learns about the world. There are no genes that specify personality traits, but some genes do control the development of the nervous system, which in turn controls behavior.
A second component of personality comes from adaptive patterns related to a child's specific environment. Most psychologists agree that these two factors—temperament and environment—influence the development of a person's personality the most. Temperament, with its dependence on genetic factors, is sometimes referred to as "nature," while the environmental factors are called "nurture."
While there is still controversy as to which factor ranks higher in affecting personality development, all experts agree that high-quality parenting plays a critical role in the development of a child's personality. When parents understand how their child responds to certain situations, they can anticipate issues that might be problematic for their child. They can prepare the child for the situation or in some cases they may avoid a potentially difficult situation altogether. Parents who know how to adapt their parenting approach to the particular temperament of their child can best provide guidance and ensure the successful development of their child's personality.
Finally, the third component of personality is character—the set of emotional, cognitive, and behavioral patterns learned from experience that determines how a person thinks, feels, and behaves. A person's character continues to evolve throughout life, although much depends on inborn traits and early experiences. Character is also dependent on a person's moral development .
Personality by dr alka mukherjee nagpur ms indiaalka mukherjee
The word personality itself stems from the Latin word persona, which refers to a theatrical mask worn by performers in order to either project different roles or disguise their identities.
At its most basic, personality is the characteristic patterns of thoughts, feelings, and behaviors that make a person unique. It is believed that personality arises from within the individual and remains fairly consistent throughout life.
While there are many different definitions of personality, most focus on the pattern of behaviors and characteristics that can help predict and explain a person's behavior.
Explanations for personality can focus on a variety of influences, ranging from genetic explanations for personality traits to the role of the environment and experience in shaping an individual's personality.
Qualitative blood loss in obstetric hemorrhage by dr alka mukherjee indiaalka mukherjee
• Quantitative methods of measuring obstetric blood loss have been shown to be more accurate than visual estimation in determining obstetric blood loss.
• Studies that have compared visual estimation to quantitative measurement have found that visual estimation is more likely to underestimate the actual blood loss when volumes are high and overestimate when volumes are low.
• Although quantitative measurement is more accurate than visual estimation for identifying obstetric blood loss, the effectiveness of quantitative blood loss measurement on clinical outcomes has not been demonstrated.
• Implementation of quantitative assessment of blood loss includes the following two items: 1) use of direct measurement of obstetric blood loss (quantitative blood loss) and 2) protocols for collecting and reporting a cumulative record of blood loss postdelivery.
Dysmenorrhea and related disorders by dr alka mukherjee dr apurva mukherjee n...alka mukherjee
Dysmenorrhea is a common symptom secondary to various gynecological disorders, but it is also represented in most women as a primary form of disease. Pain associated with dysmenorrhea is caused by hypersecretion of prostaglandins and an increased uterine contractility. The primary dysmenorrhea is quite frequent in young women and remains with a good prognosis, even though it is associated with low quality of life. The secondary forms of dysmenorrhea are associated with endometriosis and adenomyosis and may represent the key symptom. The diagnosis is suspected on the basis of the clinical history and the physical examination and can be confirmed by ultrasound, which is very useful to exclude some secondary causes of dysmenorrhea, such as endometriosis and adenomyosis. The treatment options include non-steroidal anti-inflammatory drugs alone or combined with oral contraceptives or progestins.
Dyspareunia & vulvodynia by dr alka mukherjee dr apurva mukherjee nagpur m.s....alka mukherjee
Pain during or after sexual intercourse is known as dyspareunia. Although this problem can affect men, it is more common in women. Women with dyspareunia may have pain in the vagina, clitoris or labia. There are numerous causes of dyspareunia, many of which are treatable. Common causes include the following:
• Vaginal dryness
• Atrophic vaginitis, a common condition causing thinning of the vaginal lining in postmenopausal women
• Side effects of drugs such as antihistamines and tamoxifen (Nolvadex and other brands)
• An allergic reaction to clothing, spermicides or douches
• Endometriosis, an often painful condition in which tissue from the uterine lining migrates and grows abnormally inside the pelvis
• Inflammation of the area surrounding the vaginal opening, called vulvar vestibulitis
• Skin diseases, such as lichen planus and lichen sclerosus, affecting the vaginal area
• Urinary tract infections, vaginal yeast infections, or sexually transmitted diseases
• Psychological trauma, often stemming from a past history of sexual abuse or trauma
Symptoms
Women with dyspareunia may feel superficial pain at the entrance of the vagina, or deeper pain during penetration or thrusting of the penis. Some women also may experience severe tightening of the vaginal muscles during penetration, a condition called vaginismus.
Chronic pelvic pain by dr alka mukherjee dr apurva mukherjee nagpur m.s. indiaalka mukherjee
Chronic pelvic pain in women is defined as persistent, noncyclic pain perceived to be in structures related to the pelvis and lasting more than six months. Often no specific etiology can be identified, and it can be conceptualized as a chronic regional pain syndrome or functional somatic pain syndrome. It is typically associated with other functional somatic pain syndromes (e.g., irritable bowel syndrome, nonspecific chronic fatigue syndrome) and mental health disorders (e.g., posttraumatic stress disorder, depression). Diagnosis is based on findings from the history and physical examination. Pelvic ultrasonography is indicated to rule out anatomic abnormalities. Referral for diagnostic evaluation of endometriosis by laparoscopy is usually indicated in severe cases. Curative treatment is elusive, and evidence-based therapies are limited. Patient engagement in a biopsychosocial approach is recommended, with treatment of any identifiable disease process such as endometriosis, interstitial cystitis/painful bladder syndrome, and comorbid depression. Potentially beneficial medications include depot medroxyprogesterone, gabapentin, nonsteroidal anti-inflammatory drugs, and gonadotropin-releasing hormone agonists with add-back hormone therapy. Pelvic floor physical therapy may be helpful. Behavioral therapy is an integral part of treatment. In select cases, neuromodulation of sacral nerves may be appropriate. Hysterectomy may be considered as a last resort if pain seems to be of uterine origin, although significant improvement occurs in only about one-half of cases. Chronic pelvic pain should be managed with a collaborative, patient-centered approach.
Chronic pelvic pain by dr alka mukherjee dr apurva mukherjee nagpur m.s. india
Corona preventive measures for public awareness IN Hindi by dr alka mukherjee nagpur m.s. india
1. PUBLIC AWARENESS – COVID 19
PREVENTIVE MEASURES
DR ALKA MUKHERJEE
NAGPUR M.S. INDIA
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कोरोना वायरस को फै लने से कै से रोकें ?
इस जानलेवा कोरोना वायरस को फै लने से रोकने के ललए जरूरी कदम उठाने की जरूरत है।
WHO ने कु छ गाइडलाइंस भी ददए हैं ताकक इस जानलेवा बीमारी को फै लने से रोका जा सके
- बीमार मरीजों की सही तरीके से मॉननटररंग की जाए
- रेस्पिरेटरी यानी सांस से जुडी बीमारी के लक्षण ककसी में ददखें तो उससे दूर ही रहें
- स्जन देशों या जगहों िर इस बीमारी का प्रकोि फै ला है वहां यात्रा करने से बचें
- हाथों को अच्छी तरह से धोएं और हाथों की सफाई का िूरा ध्यान रखें
- खांसी या छींकते वक्त अिने मुंह और नाक को अच्छी तरह से ढंककर रखें
- अिने हाथ और उंगललयों से आंख, नाक और मुंह को बार-बार न छू एं
- िस्ललक प्लेस, िस्ललक ट्ांसिोटट में कु छ भी छू ने या ककसी से हाथ लमलाने से बचें
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10. • इन बातों का रखें ध्यान -
• बार-बार आंख, नाक मुंह छू ने से बचें।
• सावटजननक पथानों िर जाने से िहले एन-95 मापक िहनें।
• संक्रलमत लोगों से दूरी बनाकर रखें।
• सदी, जुकाम, बुखार और कफ होने िर अपिताल जरूर जाएं।
• 20 सेकं ड तक साबुन से हाथ धुलें।
• साफ-सफाई का ववशेष ध्यान रखें।
• एक इंसान से दूसरे में फै लता है।
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13. • इन सावधाननयों के अलावा ध्यान रखना चादहए कक कोरोनावायरस
का कोई भी लक्षण ददखे तो लोग गंभीरता बरतें।
• बुखार, खांसी या सांस लेने में ददक्कत हो तो डॉक्टर को एक बार जरूर
ददखाएं।
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16. • इस बीमारी से बचने के ललए बेलसक अवेयरनेस जरूरी है।
• अगर कोई आिका फै लमली मेंबर इन संक्रलमत देशों की यात्रा से
लौटकर आया है खास सावधानी की जरूरत है।
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21. • आि इसे कै से रोक सकते हैं
कोरोना वायरस से बचने के ललए कम से कम अभी तक कोई टीका
नहीं है। MERS वैक्सीन के ललए िरीक्षण चल रहे हैं।
• आि बीमार लोगों से दूरी रह कर संक्रमण के अिने जोखखम को कम
कर सकते हैं।
• अिनी आंखों, नाक और मुंह को छू ने से बचने की कोलशश करें। अिने
हाथों को अक्सर साबुन और िानी से अच्छी तरह कम से कम 20
सेकं ड तक धोएं।
• यदद आि बीमार हैं, तो घर िर रहें और भीड से बचें व दूसरों से संिकट
न करें।
• जब आि खांसते या छींकते हैं, तो अिने मुंह और नाक को ढक लें और
आिके द्वारा पिशट की जाने वाली वपतुओं और सतहों को
कीटाणुरदहत कर दें।
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23. • छींक में बरतें सावधानी
•
छींकते समय सावधानी बरतना स्जतना जरूरी है, उतना ही जरूरी है
दूसरों की छींक से खुद को बचाना।
• ववश्व पवाप्य संगठन ने भी अिने ददशाननदेश में इस बात िर जोर
ददया है। कोरोनावायरस के लक्षणों में सदी-जुकाम भी शालमल है।
• ऐसे में यह जरूरी है कक जब कोई व्यस्क्त छींक रहा हो तो उससे दूरी
बना लें और अिना मुंह जरूर ढक लें।
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25. • लक्षणों को समय रहते िहचानें –
• अचानक बुखार और सांस लेने में तकलीफ। बहुत अधधक खांसी और
जुकाम होना।
• शरीर में तेज ददट के साथ कमजोरी। ककडनी और ललवर में
तकलीफ। ननमोननया के लक्षण सामने आना।
• िाचन कक्रया में तकलीफ शुरू होना।
26. • इन बातों का रखें ध्यान
• बार-बार आंख, नाक मुंह छू ने से बचें। सावटजननक पथानों िर जाने से िहले एन-95
मापक िहनें।
• संक्रलमत लोगों से दूरी बनाकर रखें। सदी, जुकाम, बुखार और कफ होने िर
अपिताल जरूर जाएं।
• 20 सेकं ड तक साबुन से हाथ धुलें। साफ-सफाई का ववशेष ध्यान रखें।
• 3 से 6 फु ट की दूरी बना भीडभाड में चलें। बार-बार हाथ धोते रहें ताकक कीटाणु न
फै लें।
• सावटजननक वाहन से यात्रा के दौरान दपताने िहनें। मुंह िर मापक िहनकर रखें,
ननयलमत बदलते रहें।
• भीडभाड या अपिताल वाले क्षेत्रों में जाने से बचें। सान से दूसरे में फै लता है।
•
ददन भर में बीमारी फै लाने वाले जर्मसट जर्मसट आिके हाथों में लगें हैं उनसे बचने के
ललए बार-बार हाथ धोएं।
अगर साबुन ना हो तो आर अल्कोहल वाले सैननटाइजर का इपतेमाल कर
सकते हैं।