Friday, 18 August 2017

Article on PCOS - causes, symptoms and treatment


You will be shocked to know that at any given time, 20- 40% of teenage girls are plagued by a condition that many have never even heard of- Polycystic Ovarian Syndrome (PCOS). This disease usually leads to irregular periods, acne, excessive hair growth and sufferers are also likely to be overweight. PCOS is nothing but altered state of psychology and abnormal hormone levels. The three main complications in PCOS are Insulin Resistance, Anovulation (absence of ovulation) and Hyperandrogenia (high levels of testosterone).

The high intake of sugar in the form of carbohydrate, sweets, carbonated drinks etc leads to high level of Insulin in blood, which in turn causes an increase in resistance towards insulin. Thus diet becomes an important catalyst in contributing to this disease. High-fat intake also causes and aggravates insulin resistance, so a calorific western style diet (like unhealthy fast foods) is a typical example of the kind of diet that should be avoided in children to prevent PCOS. Insulin resistance typically causes symptoms like tiredness, lethargy, darkening of skin flexures (behind the neck) and increased the occurrence of diabetes even in young adults.

Another symptom in PCOS is the presence of high levels of androgen (male hormone) compared to the normal girls. This can lead to a myriad of psychological symptoms like irritability, aggressiveness, mood variations, anxiety, depression, social isolation, and poor body image. Physical symptoms may include acne and excessive hair growth, but these symptoms may be absent in some girls. These indications can be controlled by routine exercise and a low-calorie diet in most of the cases.

Unfortunately, these girls are repeatedly condemned to silently suffer from these symptoms, as the teachers and parents quite often misinterpret their behavior without attributing the cause to PCOS. As the girls have the tendency to put on weight and are likely to have extra facial hair, they are further ridiculed by peers and this adds to their predicament of loneliness and social isolation. It is common to find suicide notes by teenagers on the sites of counselors requesting for help, as they find no solace from friends/parents. Counseling of parents and girls greatly helps in the recognition and management of what is essentially a treatable problem, so that they grow up to become confident and healthy individuals.

Furthermore, studies show that in India many of the women who have PCOS fall under the lean PCOS group meaning that they have PCOS even if they are normal or even underweight. As doctors and paramedics traditionally associate PCOS with obesity, women falling under this category are many times under diagnosed.

In addition to the problems discussed earlier, PCOS also leads to long term complications such as sub fertility and pregnancy related problems. They are also at a high risk of developing diabetes, high blood pressure, cardiovascular problems, inflammatory diseases, autoimmune diseases and allergic disorders as the body produces inflammatory markers.

In my long career as an infertility specialist, I have seen that one of the main causes of female sub fertility is PCOS. Many of my patients who had previously undergone unsuccessful multiple IVF treatments at other infertility centres have conceived naturally under my treatment just by controlling PCOS. This prompted me to explore this subject deeply by comprehensive reading and understanding the problem by attending numerous international conferences and lectures on PCOS. I have been lucky to meet and gather medical information from prominent doctors and researchers on PCOS. Infertility treatment is quite expensive, making it beyond the reach of many couples and the medicines have side effects if used repeatedly. The long term implications of PCOS are frightful and the sheer volume of girls affected with PCOS is appalling. Hence, I have opened a specialized PCOS wing at GIFT IVF Centre, Kochi for controlling and prevention of this disease, so that many of the affected women can achieve their dream of having a baby and for building a generation of women who are equipped to deal with this menace.

It is the need of the hour that all members of society are aware of this condition that greatly affects the life of not just the woman suffering from PCOS but has a wider impact on her family and society. We need to give priority to introducing fitness programs in school and provide healthy home cooked food to growing children. It is high time to make our young girls healthy and save them from the huge catastrophe related to the pandemic disorder of PCOS.

As a major step towards addressing this concern and for the benefit of our doctors and patients, we are conducting an International Medical Conference on PCOS at Gift IVF centre, Athani( Kochi) on 18/02/18 in collaboration with PCOS Challenge Group USA, where distinguished and prominent International experts on the topic of PCOS will partake and share their invaluable knowledge . This symposium is going to be first of its kind in that PCOS patients and their parents are going to be a part of the conference wherein they can directly interact and clear the doubts with the eminent doctors and related medical faculty learning about the latest methods of treatment.

Dr. Anita Mani
Infertility& Surrogacy Specialist at Gift IVF Centre
anitadane@gmail.com
www.giftivf.com 
+91 484 2475031,  +91 484 2475034, 

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Dr. Anita Mani is a renowned infertility specialist in south India with 18 years experience in ART (Assisted Reproductive Technology). Dr. Anita has successfully set up ART hospitals in Cochin and Bangalore,  along with her spouse  Dr. S Mani, who specialises in surrogacy. She completed MRCOG, from Royal College of Obstetrician and Gynaecologist  London, DFFP from  ART Warwick university and  worked in UK for 5 years. Dr. Anitha believes in scientific and ethical practice and is currently the director of Gift Gyno IVF centre Cochin and  Bangalore.  Apart from advanced laparoscopic surgeries, she is also an expert in various ART techniques including IVF, IUI, ICSI , donor egg / sperm  and surrogacy. Her proficiency is in genetic abnormalities and high risk pregnancies.

Monday, 1 May 2017

An unforgettable experience




During the long course of my career as an infertility specialist, I have met thousands of patients yearning for their own kids and by God’s grace,  I could be instrumental in bringing happiness to quite a few of them. I treasure each of those memories, but some of the cases are very special and unforgettable. I would like to share the story of an amazing couple which is very close to my heart.

After several failed attempts of infertility treatment in another hospital, the couple came to me with the hope of conceiving. They were overjoyed when she conceived in the very first attempt of IVF  cycle. Although we never advise patients to get admitted or take complete rest after IVF, they insisted that they want to stay at the hospital for the full term. This is a stark contrast from most of the other patients, who are reluctant to get admitted even if there is medical intervention. I had advised them to go home, but this couple was so eager and concerned about their babies that they wanted to stay around and make sure that they get expert help. They felt more safe  & secure with us than in their own house. When twin pregnancy was confirmed, we were all overjoyed.

Staying at the hospital for so long, they became so close to us and the hospital staff that they were like part of our family. It was like a second home for them, the lady made lots of paintings in her spare time and the couple would walk around the organic farm around the hospital.  After eagerly waiting for nine months, the twin babies were delivered via caesarean as there was some obstetric indication.

The excitement turned into shock for us, when the second twin appeared to be suffering from down syndrome. Although we were not sure, prima facie it seemed like that. One of the most difficult experiences in a gynecologist’s life is when we have to disclose the possibility of down syndrome to the parents. With exacerbating pain, expecting an outburst I reluctantly gave them the news. But to my utmost surprise, they took the news very well, both the father and mother smiled at me and said that they would love and take care of the child, just like the other twin.

There were tears in my eyes when I came back from my rounds and joy filled my heart at the thought of the unconditional love and selfless commitment of the parents. It was not just a momentous decision on their part to make a baby, they were committed from the deep abyss of their heart to give pure and continuous love to their kids despite any adversities.
Even though they were discharged after a week, they requested to stay back for ten more days, which again proved the trust factor. I made an exception to my policy of not taking gifts from my patients and cherish the handmade ornaments, dress, and painting, which she gifted me before they left for the long journey back home.

Dr. Anita Mani
Infertility& Surrogacy Specialist at Gift IVF Centre
anitadane@gmail.com
www.giftivf.com 
+91 484 2475031,  +91 484 2475034, 


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Dr. Anita Mani is a renowned infertility specialist in south India with 18 years experience in ART (Assisted Reproductive Technology). Dr. Anita has successfully set up ART hospitals in Cochin and Bangalore,  along with her spouse  Dr. S Mani, who specialises in surrogacy. She completed MRCOG, from Royal College of Obstetrician and Gynaecologist  London, DFFP from  ART Warwick university and  worked in UK for 5 years. Dr. Anitha believes in scientific and ethical practice and is currently the director of Gift Gyno IVF centre Cochin and  Bangalore.  Apart from advanced laparoscopic surgeries, she is also an expert in various ART techniques including IVF, IUI, ICSI , donor egg / sperm  and surrogacy. Her proficiency is in genetic abnormalities and high risk pregnancies.



Friday, 27 January 2017

PERILS OF SLEEP DEPRIVATION




What our forefathers believed centuries back makes sense today- “ Early to bed and early to rise makes a man- healthy, wealthy and wise." In today’s hustling and bustling calendar, it is almost unworkable to follow this wise thinking, but if you want to have a physically and emotionally stable life and want to be in the pink of health when you reach old age, unquestionably you need at least seven to eight hours of uninterrupted quality sleep in a day. It’s interesting to learn that the sleep needs of respective individuals are dissimilar, so if one person’s sleep quota is completed in 6 hours, another individual may require ten hours, yes, you read it correctly ten hours. Some theories even suggest that women require more sleep than men.

WHAT IS KEEPING YOU AWAKE

Have you ever been puzzled why the new generation is tormented by so many chronic illnesses compared to our grandfather's and great grandfather’s generation? The answer may be traced to the deprivation of sleep, combined with increased stress along with other environmental factors. The main cause of sleeplessness can be attributed to smartphones and other modern gadgets. Before popping sleeping pills, try to find out the cause for your misery through self-evaluation and find solutions like yoga, meditation or other forms of relaxation like music or dance. Some people have medical conditions of insomnia and depression which needs to be treated with medicines.

WHY SLEEPING WELL IS IMPORTANT FOR KIDS

I have heard several parents complaining that their kids are not concentrating on their studies, they cannot remember anything even after hours of toil, they always appear tired and exhausted. I always advise these parents to see that the kids are getting proper sleep. It’s not only video games or smart phones which are stripping the valuable hours of sleep, often long hours of tuitions and training are the culprits of burdening the budding minds. If you do not want them to grow up into emotionally and physically drained individuals, please see that they get appropriate sleep.

WHAT HAPPENS WHEN YOU ARE SLEEP DEPRIVED

You will be shocked to know that apart from depression, tiredness, mood swings and lack of concentration, sleep deprivation also leads to diabetes, heart and kidney problems, hair loss, early aging etc. There is a general perception that over- sleeping will lead to weight gain, but did you know that inadequacy of sleep can also lead to obesity. Hormone levels in the body are upset by sleep deficiency, which leads the mind to think that you are hungry, even when you are not and you keep eating and the result is obvious. Sleep deprivation can bring diabetes closer to you and it also shoots up the level of blood sugar in the diabetic patients. Sleeplessness can also indirectly cause sub fertility due to stress and depression.

SLEEP PATTERNS

Do not consider sleep as just a waste of time, your body is repairing and rejuvenating itself when you are under a deep slumber. The brain is not switched off during sleep, intriguingly brain activity is often accelerated in sleep. Sleep patterns can be broadly classified into two – REM (rapid eye movement) and NREM (non rapid eye movement)  and in the span of a night’s sleep, the body keeps changing between these stages in a cyclical pattern. There are stages of light sleep and deep sleep. In REM sleep, you might be dreaming and the eyeballs will be moving, but the body will be motionless and muscles are relaxed. This may be a body mechanism to avoid you acting out in the dream. This is the stage when a person is most difficult to be awakened.

After a good night’s sleep, you wake up feeling refreshed and full of energy, on the contrary, if you miss couple of hours sleep you wake up like a zombie, drained and tired.

"Sleep that knits up the ravelled sleave of care
The death of each day's life, sore labour's bath
Balm of hurt minds, great nature's second course,
Chief nourisher in life's feast."
-William Shakespeare, Macbeth


Dr. Anita Mani
Infertility& Surrogacy Specialist at Gift IVF Centre
anitadane@gmail.com

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Dr. Anita Mani is a renowned infertility specialist in south India with 15 years experience in ART (Assisted Reproductive Technology). Dr. Anita has successfully set up ART hospitals in Cochin and Bangalore,  along with her spouse  Dr. S Mani, who specialises in surrogacy. She completed MRCOG, from Royal College of Obstetrician and Gynaecologist  London, DFFP from  ART Warwick university and  worked in the UK for 5 years. Dr. Anitha believes in scientific and ethical practice and is currently the director of Gift Gyno IVF centre Cochin and  Bangalore.  Apart from advanced laparoscopic surgeries, she is also an expert in various ART techniques including IVF, IUI, ICSI, donor egg/sperm  and surrogacy. Her proficiency is in genetic abnormalities and high-risk pregnancies.



Wednesday, 18 January 2017

Steps to be followed if you cannot conceive after trying for a year





The first and foremost thing to remember is ‘NOT TO PANIC’, keep in mind that anxiety and tension will stand in the way of your pregnancy. So relax and calm down, in many cases pregnancy is achieved over a period of time without any treatment.  Medical science has advanced so much that there is a solution for most of the problems. One small word to the friends and relatives as well, “please don’t taunt the couples with questions of the impending pregnancy. Do not trouble the already distraught souls”. Stress causes sub fertility, so try to reduce stress and spend quality time with your partner. http://bangaloreivf.blogspot.ae/2014/09/reduce-stress-to-improve-fertility.html


There are some simple tests and procedures which can detect the cause of infertility and more often than not, some simple procedures or medication can give you the result.  I frequently get patients who have undergone multifarious expensive tests and treatment in infertility centers, but some basic inexpensive tests which would have given the definite reason of the complication were omitted. Sadly as the years pass by, the chance for a successful pregnancy starts dwindling and the desperation and dismay along with the financial drain leads to depression and isolation.


The tests which are to be undergone varies from person to person,  I would like to suggest some basic tests which might reveal where the problems lie. In many cases, a simple laparoscopic drilling can give instant results. Detecting the problem at an early stage and following up with prompt and appropriate treatment will increase the chance of pregnancy.

Tests for Men
Basic test is Semen Analysis
Tests for Women
AMH, On Day2 - LH, FSH, prolactin
Baseline Scan to check reproductive organs
Follicular monitoring for ovulation
Tubal patency tests

Lab Tests required For  Husband  & wife
General tests
C B C
R B S
Group+Rh
Urine R/E
For Infection screening
H I V 1 + 11
H B S Ag
H C V
VDRL

For Systemic Disorder
T S H
L F T
R F T

Genetic screening - Karyotyping might be required in later stages if multiple miscarriages or unexplained infertility

Dr. Anita Mani
Infertility& Surrogacy Specialist at Gift IVF Centre
anitadane@gmail.com

-----------------------------------------------------------------------------------------------------------------------

Dr. Anita Mani is a renowned infertility specialist in south India with 15 years experience in ART (Assisted Reproductive Technology). Dr. Anita has successfully set up ART hospitals in Cochin and Bangalore,  along with her spouse  Dr. S Mani, who specialises in surrogacy. She completed MRCOG, from Royal College of Obstetrician and Gynaecologist  London, DFFP from  ART Warwick university and  worked in the UK for 5 years. Dr. Anitha believes in scientific and ethical practice and is currently the director of Gift Gyno IVF centre Cochin and  Bangalore.  Apart from advanced laparoscopic surgeries, she is also an expert in various ART techniques including IVF, IUI, ICSI, donor egg/sperm  and surrogacy. Her proficiency is in genetic abnormalities and high-risk pregnancies.