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My Health n Wellness [ MyHnW ]
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We are happy to announce the addition of Online Medial Writing Crash Course Program based on your request and demand.

The learning modules of training program remain as it is in Comprehensive Medical Writing Program. Refer: Click Here
The difference is with number of assignments/ projects you undertake in Crash Course. There are 7 sets of assignments/ projects in Crash course whereas Comprehensive Medical Writing Program has 14 sets of assignments/ projects to practise.
The fee is Rs 7000 + ST.
Duration is 15 weeks extendable up to 6 months

Foundation Course in Medical Writing
Foundation Course in medical writing is a tailor-made program to enhance participant's medical writing skill. Medical writing is all about communicating the medical/scientific knowledge/information customized as per specific needs of the target audience. (Scientific, Consumer, Corporate/business community, Students, Professionals)

The participants will comprehensively learn and practice following: 
Scientific/ publication writing
Consumer health writing
Medico marketing writing
Regulatory /Clinical Research Writing

For more detail visit us
Foundation Course in Medical Writing
Tue, July 17, 2012, 2:30 PM
InfocusRx Marketing and Communication Pvt. Ltd., Hyderabad 504, Saptagiri Towers, Begumpet Hyderabad, AP - 500 016, India

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Epilepsy and Pregnancy

There is a complex interaction between epilepsy, antiepileptic medicines, and pregnancy. Epilepsy and antiepileptics can affect pregnancy and vice versa. Anybody who has seizures will be afraid how pregnancy is going to be, and above all how the disease and its treatment will affect the baby.

Conceiving may have been a dream come true for you. Women with epilepsy have several reasons to have a lower fertility. Epilepsy is associated with menstrual irregularities and several disorders that disrupt the hormonal balance of the reproductive phase. Alternatively, you may have conceived accidentally. You were on oral birth control pills and your epilepsy was well under control with medicines. You do not remember missing your pill and you have religiously been taking all your medicines. You are confused how you could have gotten pregnant and are now worried about the effects of your antiepileptics on your baby. This is no paradox! Antiepileptics interact with and reduce the effectiveness of birth control pills.

Pregnant and epileptic
It is a risk to get pregnant if you have epilepsy. You should go in for preconception counseling with your gynecologist, neurologist, and midwife. Discuss your epilepsy, its control, prevention, possible complications, and risks to the baby. If you have been planning to have a baby and have not had any episode of epilepsy for many years, your health professional can gradually take you off your antiepileptics before you conceive. Never try to stop or reduce your dosing by yourself

If you are already pregnant, you should keep taking your seizure medicines as usual, start taking folic acid, and see your health professional as soon as possible.

Pregnancy affects seizures. Hormonal and other body changes in pregnancy can change the concentrations of the antiepileptics in blood, and hence pose a greater likelihood of seizures. Up to 1/3rd women with epilepsy have increased frequency of seizures when pregnant.

Pregnancy can be more troublesome in women with epilepsy. These include excessive vomiting, vaginal bleeding, anemia, premature labor, non-progressing labor, and increased tendency to surgical deliveries. There is a greater risk of falls and injuries, abortions, increased blood pressure, and detachment of the placenta, an organ that connects the baby to the womb.

Most women with epilepsy will deliver healthy babies through a natural process of labor and may be given pain control during labor like in any usual pregnancy. A hospital delivery is better. If you develop an episode of seizures during labor, you will need antiepileptic medicines to be infused into blood. Otherwise, you should continue your regular medicines during labor.

Risk to the baby
Epilepsy in pregnancy poses risks for the growing baby. There is a risk of miscarriage and retarded growth of the baby in the womb. If you suffer from an episode of seizures when in labor, your baby may have a low supply of oxygen and go into distress. The heart rate of the baby may start falling. Epilepsy per se does not increase the risk of birth defects in the baby. Your baby may be born before term of pregnancy is completed, may be low in birth weight and have a higher risk of bleeding and jaundice in the first few days of life. Worst of all, the baby may die in the womb.

Antiepileptic medicines pose a risk of malformations to your baby. These include birth defects in the organs like spine, brain, heart, limbs, facial features, or other organs. Some medicines are more notorious than others to cause these defects. Some can cause fetal anticonvulsant syndrome (FACS) that comprises developmental or learning difficulties and behavior problems as the child grows.

Protect yourself and the baby
You should protect yourself from epilepsy and its adversities. The best approach is to keep your seizures under control. Take medicines as advised by your health professional. You may need to switch to other drugs or adjust amount and timings of doses. It is best to use a single drug, in the lowest possible dose, and adopt multiple dosing regimen. There is no best drug. Your doctor will select the safest one for you. As pregnancy advances, the changes in your body will necessitate frequent dose adjustments. Remember! Uncontrolled epilepsy can do more harm than any antiepileptic drug.

You will need to protect your baby. While you are planning to get pregnant, start taking folic acid, i.e. vitamin B9. A dose of 0.4 mg per day is advised for women before conception and at least up to 12 weeks of pregnancy. In epileptics, this dose may be increased to 5 mg per day. This helps to prevent malformations of the nervous system, brain, spine, and others.

You will need to take vitamin K, 10 mg daily, in the last month of pregnancy. If not the oral form, you may need two injections of 10 mg of vitamin K in the 34 and 36 weeks. Antiepileptics can reduce the total vitamin K which control bleeding mechanisms. As a result the baby may develop bleeding problems called ‘hemorrhagic disease of newborn’. Vitamin K prevents bleeding. The baby should be given 1 mg of vitamin K after birth.

You should take proper rest and moderate exercise, avoid triggers of epilepsy, eat a healthy diet, and take vitamins and medicines regularly.

During Pregnancy
Managing epilepsy and pregnancy can be challenging. You will need frequent consultations with your doctor to adjust the drug dosages and monitor the growth of the baby. You may have to undergo some additional tests. These include alpha fetoprotein (AFP) measurement in blood and ultrasound examinations. AFP is a protein produced in excess if there is an anomaly in the developing baby. It may also be measured in the amniotic fluid, the waters that bathe the baby in the womb. A sample of the amniotic fluid may be obtained with a syringe through your belly, a process called amniocentesis. Ultrasound shows any major malformations of the baby. An echo of the heart of the baby may be done.

You may breast feed your baby though antiepileptic medicines are secreted in breast milk. Watch your baby consistently. If the baby gets drowsy, hyperexcitable, or irritable, contact your health professional.

Your child may inherit epilepsy from you, if the underlying cause is a genetic disorder. Some reports of higher risk of epilepsy in children born to epileptic mothers do exist. Relax! Chances are high that you have a normal baby. Care and caution when pregnant can help you to mitigate the risks and have a healthy baby.
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A guide to gestational diabetes

Pregnancy is the time when a woman has to take extra care about herself to avoid any harm to the growing fetus and herself too. Among the many conditions to keep a watch on, diabetes during pregnancy is the most important. A high blood sugar is harmful to the pregnant woman and the growing baby, and may complicate the pregnancy and the birth process.

Understanding gestational diabetes
During pregnancy, the fetus gets all the nourishment from the mother through placenta, a structure which connects the baby with the uterus of the mother. Placenta also secretes various hormones, which may interfere with the normal functions of other hormones in the mother. Usually, pancreas secretes hormone insulin that helps the body use sugar for production of energy. In pregnant women, the hormones from placenta may interfere with function of insulin, thereby elevating the levels of blood sugar. As a result, a woman who was non-diabetic before pregnancy, may develop high blood sugar when pregnant. This condition is called gestational diabetes. Gestational diabetes, if untreated is harmful to the mother as well as the fetus. The sooner the treatment starts the better it is for the health of the mother and child. In most of the cases, the gestational diabetes disappears once the child is born.

The chances of getting gestational diabetes is more in people who are overweight, who are above 25 years of age, who have a family history of diabetes, who are Asian American, Hispanic/Latino, African American, American Indian or Pacific islander because of genes susceptible to gestational diabetes in these ethnic races, who have given birth to a baby before that was weighing more than nine pounds and who have a previous history of gestational diabetes, miscarriage and repeated infections.

There are different tests that are done to diagnose gestational diabetes. The fasting blood sugar test is done when the patient is fasting, drinking only water for 8 hours. The random blood sugar test is done anytime of the day. In the screening glucose tolerance challenge test, the patient is given a sugary drink and then the blood glucose level is checked after an hour. This test can be done anytime of the day.

Another test for diagnosing gestational diabetes is the Oral glucose tolerance test. You are asked to fast for 8 hours before the testing. The blood is taken for the test during fasting. Thereafter, you would be asked to drink sugar water, and then blood sugar is tested every hour for 3 hours. A fasting blood sugar above 95mg/dl, at 1 hour above 180mg/dl, at 2 hours above 155mg/dl and at 3 hours above 140mg/dl, indicates gestational diabetes. All diagnostic tests are done generally between 24 to 28 weeks of pregnancy which is the time when gestational diabetes can occur in pregnancy.

Managing gestational diabetes
To manage gestational diabetes, firstly modifications in diet are essential. With the help of a dietician, a well balanced diet plan to lower the blood sugar has to be made. Foods rich in sugars like cookies, desserts, sweets, candies and sweet juices have to be avoided. Carbohydrates foods like pasta, bread, potatoes, cereal, and rice are good for the mother and the baby. They should however be taken in limited quantities. Eating many small meals at regular intervals are recommended to avoid rise in blood sugar level. Apart from diet planning, careful monitoring of sugar level is essential. You can use a home blood sugar monitoring device to check your blood sugar at least four times daily or as advised by your physician.

In addition, physical activity is important to maintain normal blood glucose levels. Swimming and walking are good exercises and you can do them after the approval of your doctor. If the mother has any complications, then only upper body exercises are advised by the doctor that can be performed sitting on the chair. Aerobics in water is also a good exercise that is relaxing and fun.

Apart from diet planning and physical exercise some women with gestational diabetes will need to take insulin shots or oral medications depending on the test results. Insulin is not harmful to the baby and is given under doctor’s supervision.

Complications of untreated gestational diabetes
Untreated gestational diabetes leads to complications in the mother as well as the baby. In mothers it may lead to a condition called preeclampsia, where there is excess protein lost in the urine, and high blood pressure that occurs in the 20th week of pregnancy. Due to excess sugar in urine, mothers with gestational diabetes have more chances of getting urinary tract infections than mothers in normal pregnancies. Mothers with history of gestational diabetes may develop it again during second pregnancy or may get diabetes in later years.

During pregnancy, the mother having gestational diabetes has more sugar in the blood which crosses the placenta and reaches the baby. The pancreas of the baby then starts producing more insulin to counter the glucose resulting in overgrowth of the baby. This condition is called macrosomia. Delivery of such large babies may need a caesarean section.

The babies after birth may develop low blood sugar which may result in seizures of the baby. Careful monitoring and intravenous glucose are administered by the doctor under such circumstances. The infant’s blood sugar levels are carefully monitored by conducting blood sugar tests. If the infant is diagnosed with low blood sugar, then sugar water or glucose is administered to the baby intravenously or through a tube into the vein of the infant. Untreated gestational diabetes may result in birth of a baby with breathing problem which continues till the lungs become stronger. The baby in later life has a high risk of developing diabetes and obesity. The baby may also develop problems in walking and balancing. There can be disorders like hyperactivity or inattentiveness. If bilirubin (the yellowish pigment found in bile produced by liver) level is found to be high, then it is treated with light therapy. In this treatment the baby is placed under blue green spectrum of light that changes the structure of bilirubin molecules which are then easily excreted out in urine and stool of the baby. Plastic shield filters are used to protect the baby against any harmful rays. The baby is also given eye patches for eye protection during the therapy. The baby wears a diaper only during the treatment.

Your bundle of joy
By following the doctor’s advice and taking all the necessary precautions you can get over gestational diabetes. Awareness regarding gestational diabetes removes all fears and apprehensions regarding the safety of your baby. The health and safety of your ‘bundle of joy’ is in your hands!
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Triple Screening in Pregnancy

Every pregnancy is precious. As they are many complications during pregnancy that results in various abnormality in the baby, it is important that women with pregnancy-related complications get medical attention as early as possible. It is estimated that about 2 – 3% of babies are born with some type of birth abnormalities. These problems may be due to abnormal chromosome, increased mother’s age, maternal diabetes, high blood pressure and many other maternal complications. Earlier, it was difficult to detect complications in an unborn fetus, but now with so many advanced techniques it is possible to detect abnormality in fetus before delivery. Tests that are done in a pregnant women who do not show any obvious symptoms of disease, but is at high risk of developing complications during pregnancy is called as screening tests. This helps to prevent or treat any suspected abnormality in the fetus. One screening test is the triple screening test during pregnancy.

About Triple Screening
As it is very clear from the name, triple screening is done using mother’s blood sample that measures the level of three factors – alpha-fetoprotein, human chorionic gonodotropin, and unconjugated estriol. It is also called as multiple marker screening.

Triple screening is called a screening test as it helps only to suspect that there might be some kind of abnormality in the fetus. Remember it is not a diagnostic test. This test only points that the mother is at possible risk of delivering a baby with genetic abnormality.

Triple screening performed during the 15th to 29th week of pregnancy but test performed during 16th to 18th week of pregnancy is said to give more accurate results. Triple screening test is recommended for women who

Are above 35 years of age
Have a previous history birth defect in family
Suffer from diabetes and have or still using insulin
Had any viral infection during pregnancy
Have used harmful drugs or medications during pregnancy
Exposed to radiations of any type
Alpha-fetoprotein (AFP) is a protein that is produced in the liver and in the yolk-sac of the fetus. The level of AFP decreases soon after birth. This test is done to screen birth defect, detect liver disorder, and look for cancerous tumor in the fetus. A high level of AFP suggests neural tube defect such as Spina bifida or anencephaly. Mostly, the high level of AFP is because of inaccurate dating of pregnancy.

Human chorionic gonodotropin (hCG) is a pregnancy hormone that is produced by the placental cells. In non-pregnant women, the level of hCG is undetectable, but during pregnancy the level of hCG doubles every 2 or 3 days. This test is done during pregnancy to monitor trophoblastic disease (disease in the blastocyst stage) or germ cell tumors. This test is performed as early as 10 days after missed periods, if doctor suspects ectopic pregnancy, trophoblastic disease or germ cell disease.

Unconjugated estriol is produced by the placenta using the precursor cells from fetal adrenal gland and liver. This test in association with AFP and hCG helps to detect the presence of Down syndrome (trisomy 21) and trisomy 18.

Abnormal test results
As triple screening test is just a screening and not a diagnostic test, it only tells us the possibility of any birth abnormalities. Abnormal result of triple screening does not mean that the baby has some birth defect, it only says there may be or may not be any complications. The test results are sometime abnormal as the doctor mis-predicts the age of the fetus; the fetus may be too young or too old than the doctor thought. Triple screening does not screen all the birth defects. Abnormal triple screening results means that further diagnostic tests are needed. In some cases, doctors prefer to perform a second triple screening test, which is followed by high definition ultrasound. Ultrasound scanning helps to find out the exact age of the baby, look at the structure of brain, kidney, heart, and spinal cord for any abnormalities. If the second triple screening test still shows abnormal result, then advanced invasive procedures like amniocentesis may be performed. Amniocentesis may help to diagnose any birth defect in the baby. Before invasive procedure discussing the pros and cons of the procedures with the healthcare provider is very important.

The advanced screening test is actually a great step forward that helps to have a healthy future generation. Some screening tests during pregnancy are recommended to all pregnant women and some are recommended only to women who are at high risk of complications either to mother or to the baby. Risk factors include family history, any medical complications, and ethnic background or based on the result of previous tests. Identifying the complications at an early stage helps the doctor to find a way to treat or plan for nay special care that is required for the mother and the baby.
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A sad and depressing story of how a girl's life was greatly influenced by a drunk driver.
I hope this convinces you not to drink and drive.
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A complete guide on Health and Wellness care
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91- 40- 655 55860 , , 91- 40- 655 55870
504, Saptagiri Towers, Begumpet Hyderabad, AP - 500 016