Utero Vaginal Prolapse Utero Vaginal Prolapse Home Overview Utero vaginal prolapse is a common age-related condition, wherein the uterus drops down into the vaginal canal due to weakened ligaments and pelvic floor muscles (muscles and tissues in the pelvis that support pelvic organs, such as the uterus, bladder, rectum, and vagina). Generally, it can happen to any woman; however, it commonly occurs in menopausal women and in women who have had more than one vaginal delivery. Generally, utero vaginal prolapse has many stages. In an incomplete uterine prolapse, the uterus may slip partly into the vagina, creating a bulge. In severe cases, i.e., complete prolapse, the uterus may slip so far enough that it comes out of the vagina. Causes The main cause of utero vaginal prolapse is weakened pelvic floor muscles, which can be attributed toChildbirth: Multiple pregnancies and vaginal deliveries can weaken the muscles and tissues of the pelvic floor. Aging: With age, the pelvic muscles may lose strength and elasticity, increasing the risk of prolapse, particularly after menopause.Hormonal changes: A decrease in oestrogen levels during menopause can weaken the pelvic support tissues.Obesity: Excessive weight puts additional pressure on the pelvic floor, thereby contributing to its weakening over time.Chronic coughing or straining: Conditions such as chronic bronchitis or constipation can lead to repeated straining, further weakening the pelvic floor.Genetic predisposition: Some women may be more prone to developing pelvic floor disorders based on their genetic background. Symptoms Mild cases of uterine prolapse may be associated with the absence of any obvious symptoms. However, as the uterus slips farther out, other pelvic organs (bowels or the bladder) might be affected, resulting in one or more of the following symptoms: Feeling of pressure or heaviness: Many women report a sensation of heaviness in the pelvic region, especially towards the end of the day or after prolonged standing.Bulging or protrusion: You may notice or feel a bulge or lump in the vaginal area, which can be more pronounced when straining or during physical activity.Urinary issues: Increased frequency of urination, urgency, or even incontinence can occur as the prolapse affects bladder function.Bowel problems: Difficulty emptying the bowels or a feeling of incomplete bowel evacuation may arise.Discomfort during intercourse: Prolapse can lead to discomfort or pain during sexual activity.Lower back pain: Chronic discomfort or pain in the lower back can sometimes be associated with prolapse. Diagnosis Discussing any symptoms you have been experiencing can help in the detection and subsequent diagnosis of the condition. A few diagnostic strategies include:Pelvic examination: A thorough pelvic exam will help the doctor assess the position of your uterus and other pelvic organs.Imaging tests: Imaging tests such as ultrasound or MRI may be used detect any changes in the position of the uterus.Urodynamic testing: This test assesses how well the bladder and urethra are functioning and may be recommended if urinary symptoms are present. Treatment Lifestyle modifications: Simple changes like weight loss, pelvic floor exercises (e.g., Kegel exercises), and avoiding heavy lifting can help alleviate symptoms.Pessaries: A pessary is a device inserted into the vagina to support the uterus. It is a non-surgical option that many women find helpful.Physical therapy: Pelvic floor physical therapy can strengthen the pelvic muscles and provide relief from symptoms.Medications: If urinary symptoms are present, medications may help manage those symptoms.Surgery: If symptoms are severe or persistent and non-surgical methods are not effective, surgical options may be considered. These can include procedures to support the uterus or remove it altogether (hysterectomy), depending on individual circumstances. When to see a doctor You observe a noticeable bulge or protrusion in the vaginal area.You exhibit symptoms of urinary or bowel dysfunction.You experience discomfort or pain in the pelvic region.You observe any changes in the menstrual pattern or unusual bleeding. Read more about Utero Vaginal Prolapse Filter Alphabet U
Urinary Incontinence Urinary Incontinence Home Overview Urinary incontinence is a commonly encountered condition that refers to loss of bladder control, resulting in the unintentional passing of urine. Incontinence can occur at any age and is more prevalent in women, particularly after childbirth or during menopause. Urinary incontinence can sometimes be linked to other underlying health issues, so understanding its nature is crucial for effective management. Types Urinary incontinence can be of many types; these include:Stress incontinence: This is characterised by occasional urine leakage when bladder is under pressure, e.g., when sneezing, coughing, laughing, exercising, or lifting heavy weights.Urge incontinence: This is characterised by a sudden, strong, uncontrollable urge to urinate.Overflow incontinence: This is characterised by inability to completely empty the bladder, which results in frequent leakage of small amounts of urine over time (instead of one big gush). Overflow incontinence is more common in individuals with chronic conditions like diabetes, stroke, or multiple sclerosis (MS).Neurogenic incontinence: This is characterised by bladder dysfunction or the lack of bladder control due to brain, spinal cord, or nerve problems. Neurogenic incontinence is extremely common in people with spinal cord injuries, cerebral palsy, and stroke; sometimes, it may also be congenital (caused by birth defects).Total incontinence: This is characterised by the inability of the bladder to store urine, which results in frequent urine leakage.Mixed incontinence: A combination of factors is responsible for urine leakage. Causes Several factors can contribute to urinary incontinence, and they often differ between individuals. Some common causative factors are enumerated below:Weak pelvic floor muscles: Childbirth, pregnancy, and menopause can weaken the muscles that support the bladder, leading to stress incontinence.Overactive bladder: This condition is characterised by an urgent need to urinate, often resulting in urge incontinence. It can happen without warning and may lead to frequent trips to the bathroom.Neurological conditions: Multiple sclerosis, Parkinson’s disease, and stroke can affect the nerves that are responsible for normal bladder control and function.Urinary tract infections (UTIs): Infections can irritate the bladder, causing temporary incontinence. Once the infection is treated, incontinence usually resolves.Medications: Some medications, such as diuretics, can increase urine production and lead to incontinence.Obesity: Excess body weight can put pressure on the bladder, contributing to stress incontinence.Chronic coughing: Conditions like chronic bronchitis can weaken pelvic floor muscles, leading to leakage when coughing.Hormonal changes: Fluctuations in hormone levels, particularly during menopause, can impact bladder function and support. Symptoms The symptoms of urinary incontinence can vary based on the type of incontinence experienced. Lower urinary tract symptoms (LUTS) are common features associated with urinary incontinence; these include:Problems with storing urine, e.g., a sudden or frequent urge to pass urine or feeling that you need empty your bladder again just after you have done so.Problems with passing urine, e.g., straining to pass urine, slow stream of urine, or stopping and starting when you pass urine.Problems after passing urine, e.g., feeling of not completely emptying the bladder or leakage of few urine drops after urination. Diagnosis Discussing the patients’ symptoms, medical history, and any medications they are taking can help understand the situation better. Additionally, keeping a bladder diary, i.e., a record of the urination frequency, fluid intake, and leakage episodes (if any) can provide valuable information about your condition. The following tests can be conducted to diagnose urinary incontinence:Physical examination: A physical examination of the pelvis can be conducted to assess the strength of the pelvic floor and check for any abnormalities.Urinalysis: A simple urine test can help detect infections or blood in the urine, and urinary incontinence attributed to infections can be treated following a positive diagnosis.Urodynamic testing: This involves measuring how well your bladder and urethra are storing and releasing urine. It can help determine the cause of incontinence more precisely.Imaging tests: In some cases, an ultrasound or MRI may be necessary to check for anatomical abnormalities responsible of urinary incontinence. Treatment The treatment of urinary incontinence depends on the underlying cause and type of incontinence. Here are some common approaches:Pelvic floor exercises (Kegel exercises): These helps strengthen the pelvic floor muscles, helping the patient control the sphincter muscles better and prevent leakage.Bladder training: This involves scheduling bathroom visits and gradually increasing the time between urinations to help retrain the bladder.Medications: For urge incontinence, medications that relax the bladder may be prescribed. Hormonal therapies can help some women post-menopause.Lifestyle modifications: Simple changes, such as weight loss, reducing caffeine and alcohol intake, and quitting smoking, can significantly correct the symptoms.Absorbent products: If leakage occurs, using absorbent pads or adult diapers can provide a sense of security while managing the condition.Physical therapy: Working with a physical therapist trained in pelvic floor rehabilitation can provide personalised strategies for managing incontinence.Surgical options: In severe cases, surgical procedures may be recommended to support the bladder or to enhance control. Prevention While not all types of urinary incontinence can be prevented, one or more of the following steps can be taken to reduce the risk of developing this condition: Maintain a healthy weight: Obesity management can help decrease pressure on the bladder.Stay active: Regular exercise strengthens pelvic floor muscles and improves bladder function.Pelvic floor exercises: Incorporate Kegel exercises into your routine to keep your pelvic floor strong.Limit irritants: Reducing caffeine, alcohol, and spicy foods can lessen bladder irritation.Stay hydrated: Drinking enough water can help maintain bladder health; however, excessive water intake should be avoided right before activities.Seek help for constipation: Chronic straining can weaken the pelvic muscles, so addressing constipation is crucial. Read more about Urinary Incontinence Filter Alphabet U
Recurrent Miscarriages/Pregnancy Loss Recurrent Miscarriages/Pregnancy Loss Home Overview Recurrent pregnancy loss is defined as the occurrence of two or more consecutive miscarriages. Though pregnancy loss is relatively common (occurring in 10–20% of known pregnancies), recurrent pregnancy loss is less frequent, affecting 1–2% of couples trying to start a family. The probability of failed pregnancy after two pregnancy losses increases with each loss. Importantly, the risk of repeated pregnancy loss increases with age. Older women with previous repeated pregnancy loss are at a much higher risk of subsequent pregnancy loss than younger women. Types Recurrent pregnancy loss is of two types:Primary recurrent pregnancy loss: This occurs in individuals who have never given birth to a live baby.Secondary recurrent pregnancy loss: This occurs in individuals who have given birth to a live baby. Causes Recurrent pregnancy loss can be attributed to many factors; the common causes for this condition include:Chromosomal abnormalities: Genetic issues might make it impossible for the embryo to develop properly. These issues account for more than half of the recurrent pregnancy loss cases.Uterine abnormalities: Structural problems in the uterus, like uterine fibroids, scar tissue, or an abnormally shaped uterus, can prevent the pregnancy from continuing. Approximately, 10‒15% of the women with multiple pregnancy losses have uterine anomalies.Hormonal imbalance: Certain conditions like polycystic ovary syndrome (PCOS), thyroid disorders, and luteal phase defects, cause imbalances in the levels of reproductive hormones, such as luteinising hormone (LH), insulin, thyroid-stimulating hormone (TSH), and progesterone; this, in turn, complicates the maintenance of the pregnancy.Blood clotting disorders (Thrombophilia): Certain conditions cause blood to clot more easily (blood clotting disorders), resulting in interference with the ability of the placenta to nourish the baby. These conditions are therefore a major cause of pregnancy complications, including recurrent pregnancy loss.Immune system disorders: In addition to the maternal molecules, the foetus contains paternal and ‘self’ molecules; some immune system-related disorders, such as lupus, may increase the risk of recurrent pregnancy loss as they cause the mother’s immune system to consider the paternal and ‘self’ molecules as foreign and thus, attack the foetus.Maternal health conditions: Chronic illnesses, such as diabetes or unmanaged hypertension, have been shown to increase the risk of repeated pregnancy loss.In some cases, the cause of recurrent miscarriages may remain unknown (idiopathic) even after thorough testing. Symptoms Recurrent pregnancy loss shares many symptoms with miscarriage; these include:Vaginal bleeding.Cramping or pain.However, in some cases, pregnancy loss occurs silently without any noticeable symptoms. Diagnosis Ultrasound: A pelvic ultrasound can check for uterine abnormalities—such as fibroids, polyps, or septum—that suggest a risk of miscarriage.Hysteroscopy: In this procedure, a small camera is used to visually examine the inside of the uterus for structural issues. It can be used to determine the cause of repeated miscarriages.Hormonal tests: The serum levels of progesterone, thyroid-stimulating hormone (TSH), follicle-stimulating hormone (FSH), prolactin, oestradiol, and anti-Mullerian hormone (AMH) are evaluated to diagnose recurrent pregnancy loss.Blood clotting tests: As clotting disorders are a major cause of recurrent pregnancy loss; blood clotting tests are used to check for clotting disorders. Autoimmune tests: If there is a suspicion of immune system involvement, doctors might perform tests to screen for lupus anticoagulant, anti-beta2 glycoprotein I (IgG and IgM), and anticardiolipin antibodies (IgG and IgM) to check if your body is attacking its own tissues or the pregnancy.Genetic testing: The chromosomes of both parents can be checked (karyotyping) to look for any underlying genetic issues that can result in recurrent pregnancy loss. Treatment The treatment for recurrent pregnancy loss depends on the cause. Generally, one or more of the following treatment options may be considered:Chromosomal issues: If a genetic problem is identified, preimplantation genetic testing (PGT) during IVF may be recommended to ensure only healthy embryos are implanted.Uterine abnormalities: If structural problems—such as fibroids or septa—are found, surgery may be an option to correct the issue.Hormonal imbalance: For conditions like PCOS or thyroid disorders, managing the hormone levels with medications can help regulate the pregnancy cycle and support a healthy pregnancy.Blood clotting disorders: Blood thinners, such as aspirin or heparin, can be prescribed to help improve blood flow to the placenta, thereby reducing the risk of miscarriage.Autoimmune problems: If immune system problems are suspected, treatments that dampen the immune response might be recommended.Sometimes, lifestyle changes that include sustaining a healthy weight, controlling diabetes, and quitting smoking can significantly increase your chances of carrying a pregnancy to full term. When to see a doctor Early intervention, after just two miscarriages, can help you get the support and testing you need sooner. Read more about Recurrent Miscarriages/Pregnancy Loss Filter Alphabet R
HIV-associated Neurocognitive Disorders (HAND) HIV-associated Neurocognitive Disorders (HAND) Home Overview HAND, previously termed HIV-associated neurological disorders, encompasses a range of neurocognitive impairments linked to HIV infection. Symptoms and diagnosis associated with the different types HIV-associated dementia (HAD)Occurs in advanced stages of HIV and is characterized by difficulties in attention, memory loss, and apathy. Early signs include jerky eye movements, hyperreflexia, and cerebellar dysfunction.DiagnosisInvestigations to rule out alternative conditionsMRI shows atrophy and diffuse white matter changesCSF examination to check non-specific cytochemical abnormalitiesNeuropsychological assessment —to investigate abnormal information processing, psychomotor speed, and recall memoryVascular myelopathy (VM)Typically co-occurs with HIV dementia, presenting as spastic paraparesis without a distinct sensory level. Resembles subacute combined degeneration seen in vitamin B12 deficiency.DiagnosisMRI for imaging changesVitamin B12 and homocysteine levels.HTLV-1 serology to detect co-infectionDistal sensory peripheral neuropathy (DSPN)Appears in late-stage AIDS approximately 25% of patients, with paraesthesia, burning pain, and dysesthesia. Weakness is minimal, ankle reflexes are diminished or absent, pain temperature sensations impaired.DiagnosisAssess vitamin B12 and glucose levelsNerve conduction studies may indicate an axonal neuropathy.Nerve biopsy (rarely needed)Other peripheral nerve syndromes includingMononeuritis multiplex: Associated with HIV vasculitis and CMV.Demyelinating polyneuropathyDiffuse inflammatory lymphocytosis syndrome (DILS): mimics Sjögren’s syndrome, occurs during immunocompetent stages, and is linked to elevated CD8+ cell countsPolyradiculopathyMyopathyPolymyositis: Seen in early HIV stages.Zidovudine-Induced Myopathy: Linked to mitochondrial dysfunction.Opportunistic infectionsCauses, symptoms, and diagnosisToxoplasmosis: Results in multiple ring-enhancing brain lesions, leading to increased intracranial pressure and headaches.Cryptococcal meningitis causes headache, altered mental status, and meningism. MRI reveals meningeal enhancement and hydrocephalous. CSF may reveal pleocytosis.Progressive multifocal leukoencephalopathy (PML): caused by JC virus reactivation. Symptoms include headache and focal signs. MRI presents white matter abnormalities, while CSF investigations detect presence of JC virus.CMV infection: causes meningoencephalitis, polyradiculopathy. CSF testing confirms presence of CMV virus. Risk factors Older ageA low count of CD4+ cellsAdvanced stage of HIV infectionSubstance useComorbid conditions such as depression and anxietyLow educational levelOther medical conditions such as hypertension, hyperlipidaemia, diabetes, and CVDTraumatic brain injuryAntiretroviral therapy Specialist to approach Neurologist/ Infectious disease specialist Treatment SymptomaticManagement of underlying infections Read more about HIV-associated Neurocognitive Disorders (HAND) Filter Alphabet H
Pregnancy-induced Hypertension Pregnancy-induced Hypertension Home Overview Approximately 10‒12% women experience increased blood pressure during pregnancy (hypertensive disorders of pregnancy), and of these, ~6% are diagnosed with pregnancy-induced hypertension (PIH), also known as gestational or transient hypertension, a condition characterised by hypertension without proteinuria (protein in urine). According to the guidelines proposed by the American College of Obstetricians and Gynaecologists, PIH is defined as the presence of blood pressure greater than or equal to 140/90 mmHg at two separate instances (measured at an interval of at least 4 hours) after 20 weeks of pregnancy (when the previous blood pressure was normal). Though PIH generally subsides by the 6th week after delivery, it is a concerning condition as it can affect placenta development and function, meaning that the foetus may not get adequate nutrients, and both the mother and child are at high risk of developing complications (before labour, during labour, and after delivery). If left unmanaged, PIH can progress to serious conditions like preeclampsia, which can cause organ damage, seizures, and complications for the baby. Causes Although the exact cause of PIH has not yet been identified, certain risk factors for this condition have been identified:Age: Women over 35 years of age are at moderate risk of developing PIH.First pregnancy: PIH is more common in first-time mothers.Multiple pregnancies: Carrying twins or triplets increases your chances of developing PIH.Pregnancy-related conditions: Having or PIH or preeclampsia during previous pregnancies can increase the risk of developing PIH.Obesity: Being overweight before pregnancy can also contribute to PIH.Pre-existing illness: PIH risk is higher in case of pre-existing illness, such as chronic hypertension, kidney disease, diabetes, or lupus.Family history: A history of PIH or preeclampsia in the family is also a key risk factor. Symptoms High blood pressure (>140/90 mmHg).Severe headaches that do not go away.Blurred vision or seeing spots.Pain under the ribs (upper abdomen).Sudden swelling of limbs (hands/feet) or face.Fluid retention and subsequently, rapid weight gain.Reduced urine output.Thrombocytopenia (low platelet count). Diagnosis Hypertensive disorders of pregnancy are diagnosed based on consistently high blood pressure measurements (above 140/90 mmHg) during blood pressure monitoring. Additionally, as weight gain during pregnancy can increase the risk of these hypertensive disorders, frequent weight measurements are used to monitor them However, the diagnosis of PIH is more of an elimination analysis, i.e., the patient does not develop preeclampsia (no protein in urine) and the blood pressure values return to normal by week 6 after delivery. In other words, a diagnosis of PIH is made after ruling out other more hypertensive disorders of pregnancy, such as preeclampsia, chronic hypertension, and the superimposition of the two. One or more of the following routine diagnostic techniques are used to diagnose PIH:Urine tests: Urine samples are checked for the presence of protein to rule out preeclampsia.Oedema assessment: Swelling in both legs (bilateral leg oedema) is indicative of PID.Liver and kidney function tests: These tests are used to rule out preeclampsia.Blood clotting tests: These tests are used to rule out preeclampsia.If a diagnosis of PID is made, physicians also perform routine tests to monitor foetal health; these include:Ultrasound: This test helps monitor the baby’s development and check for complications.Non-stress test: This test is used to observe the baby’s heart rate and ensure that they are doing well in the womb.Foetal movement counting: This test involves keeping track of the number or frequency of foetal kicks and movements, a change in which indicates foetal stress.Biophysical profile: This test—usually performed after the 28th week of pregnancy—involves combining the nonstress test with ultrasound to observe the foetus.Doppler flow study: This type of ultrasound is used to measure the flow of the baby’s blood through a blood vessel. Treatment PIH treatment is aimed at managing your blood pressure and preventing it from progressing into more dangerous conditions like preeclampsia. Treatment depends on the severity of your condition and how far along you are in your pregnancy.Lifestyle changes: In mild cases, your doctor may recommend more rest, reducing salt intake, and frequent monitoring.Medications: If blood pressure is too high, your doctor may prescribe antihypertensive medications (medications to control the blood pressure). However, if PIH progresses to preeclampsia, magnesium sulphate may be used to prevent seizures.Hospitalisation: In severe cases, your doctor may recommend a hospital stay for close observation and management.Early delivery: If PIH puts you or your baby at risk, early delivery might be the best option, sometimes through labour induction or a caesarean section. Prevention Though PIH cannot be prevented, the below steps help in reducing PIH risk and ensuring a healthier pregnancy:Maintaining a healthy weight: Patients are advised to attain a healthy weight before pregnancy and follow the doctor’s advice for weight gain during pregnancy.Consuming a balanced diet: Diet comprising fruits, vegetables, proteins, grains, and diary with less salt helps to control hypertension.Staying active: Light to moderate exercise can help manage weight and maintain healthy blood pressure levels. Attending prenatal appointments: Regular check-ups are essential for catching PIH early.Monitoring blood pressure at home: If you are at risk, your doctor may advise you to keep an eye on your blood pressure between appointments. Read more about Pregnancy-induced Hypertension Filter Alphabet P
Herpes Simplex Encephalitis Herpes Simplex Encephalitis Home Overview Herpes simplex encephalitis refers to a brain parenchyma infection caused due to herpes simplex viral infection. It leads to inflammation and swelling of brain parenchyma and covering of the brain (meninges). Cause Herpes simplex virus infection Risk factors Genetic defects in the Toll-like receptor (TLR3)-interferon (IFN) and IFN-responsive pathwaysChemotherapy and chronic alcoholismHistory of substance abuseA past medical history of sinusitis or psychotic disorders Symptoms FeverHeadacheAltered sensorium- confusion, disorientation, comaNeck stiffnessSeizuresWeakness, nausea, vomitingIf not treated timely and adequately, may prove to be life threatening Specialist to approach Neurologist Diagnosis CSF examination to determine pleocytosisMRI brain to determine contrast enhancement in temporal areas, or vasculitic infarctsEEG to check periodic lateralized discharges.Blood tests for HIV antibodies Treatment Antiviral therapy (acyclovir)Supportive care- management of seizures, fluid replenishment, hydration and calory supplementationICU care may be required Read more about Herpes Simplex Encephalitis Filter Alphabet H
Ovarian Cysts Ovarian Cysts Home Overview Ovarian cysts are pouch-like structures filled with liquid or semi-solid material that form in your ovaries. They can either form either within the ovary or on the ovarian surface. Rarely, some ovarian cysts become malignant (cancerous) and/or cause serious complications; less than 1% of ovarian cysts are cancerous. Most ovarian cysts are benign (harmless) and are cleared on their own. However, very heavy cysts can cause ovarian torsion, a condition in which the ovary turns over on itself one or more times, leading to reduced or zero blood flow to the ovary, necessitating surgery. Types Based on their development, ovarian cysts can be broadly categorised into two classes:Functional cysts: These cysts develop as a part of the ovulation cycle (the release of an egg from the ovary) and are a sign of properly functioning ovaries; these cysts generally shrink over time.Pathological cysts: These cysts are formed as a result of abnormalities and are much less common than functional cysts. Pathological cysts include:Cystadenomas: Fluid-filled cysts that form on the ovarian surface.Dermoid cysts (teratomas): Cysts containing cells from all types of tissues (hair, teeth, skin, and even brain tissues).Endometriomas: Cysts filled with endometrial tissue, i.e., the same tissue that lines your uterus and bleeds during the menstrual cycle.Ovarian cancer cysts: Ovarian tumours (solid masses of cancer cells). Causes Hormonal changes during ovulation are the main cause of ovarian cysts. Other causative factors include:Endometriosis: Ovarian cysts can form in advanced stages of endometriosis, a condition in which tissue similar to the uterine lining (womb lining) grows in places outside the womb.Pelvic inflammatory disease (PID): Severe PID—an infection of the female reproductive system, usually caused by bacteria from sexually transmitted infections—can cause scarring and cyst formation in the ovaries. Women with PID are more likely to develop ovarian cysts that are infected with bacteria. Rupture of such cysts can lead to sepsis.Genetics: Some women may be at a high risk of developing ovarian cysts owing to their genetic background.Obesity: The underlying hormonal imbalances associated with obesity have been reported to increase the risk of ovarian cyst formation. Symptoms Most women with ovarian cysts may not exhibit any noticeable symptoms, especially if the cysts are small. However, large cysts or cyst rupture can result in various symptoms, including: Pelvic pain: You might experience pain on one side of the pelvis (the region below your bellybutton). The pain levels vary, ranging from a dull, persistent heavy sensation to an unexpected, severe, and sharp pain.Bloating: You may have a feeling of fullness or heaviness in your belly.Changes in the menstrual cycle: You might suffer from irregular periods, abnormal bleeding, or painful periods. Pain during intercourse: You might feel discomfort during sex.Urinary symptoms: You might experience difficulty in emptying the bladder or there might be an increased urgency to urinate.Difficulty in bowel movement: You might face bowel movement problems, such as constipation or pain during bowel movements. Diagnosis Pelvic examination: In this examination, a doctor physically checks for any abnormal masses (lumps) or tenderness in the pelvic region.Ultrasound: This sound wave-based imaging procedure can help determine the size, type (cystic, solid, or both), location, contents, and appearance of the cyst, in addition to providing details regarding the vascular content, i.e., blood vessels penetrating the cyst. Patients undergoing ultrasound for ovarian cysts must drink a lot of water at least one hour before the appointment and avoid emptying their bladder before the procedure.Blood tests: As hormonal imbalance can cause ovarian cysts, the serum levels of reproductive hormones (luteinising hormone (LH), follicle-stimulating hormone (FSH), oestradiol, and testosterone) are measured to determine the cause of ovarian cysts.Cancer antigen 125 (CA 125) test: As CA 125 levels can increase when a person has ovarian cancer, the CA 125 test is suggested for women with ovarian cysts, especially if they are postmenopausal, have a high risk of developing ovarian cancer, or if the cyst is suspected to be cancerous.Magnetic resonance imaging (MRI): In rare cases, more advanced imaging methods are required to diagnose ovarian cysts. MRI can accurately differentiate between harmless and cancerous ovarian masses with 88‒93% accuracy. They can identify different types of material in ovarian cysts, including fat, fluid, solid, and haemorrhage.Computed tomography (CT): Though CT is not typically used to evaluate ovarian cysts, it is the best technique for imaging haemorrhagic ovarian cysts (ovarian cysts filled with blood). Treatment Generally, if the cyst is small and is not causing too much difficulty to the patient, doctors usually recommend monitoring the cyst over a few menstrual cycles as most cysts tend to get cleared on their own. For cysts that persist and are associated with complications, the treatment depends on several factors, including cyst type and size and patient age. Here are some common treatment options:Medications: Hormonal contraceptives or birth control pills—that help regulate the menstrual cycle—can prevent the development of new ovarian cysts, but they cannot resolve the existing ones. Over-the-counter painkillers (e.g., acetaminophen (Tylenol), ibuprofen (Advil), naproxen (Aleve)) and can temporarily relieve ovarian cyst‒related pain. Narcotic medications like oxycodone and morphine sulphate are recommended for moderate to severe pain.Laparoscopic ovarian cystectomy: Laparoscopy may be recommended for noncancerous cysts that are less than 3 inches in size. In this procedure, a camera is inserted through a cut in the abdomen and the pelvis is inflated with gas to create extra space for accessing the ovaries. Then, a few more small cuts are made to insert the surgical tools and remove the cyst. Patients undergoing this surgical procedure can go home the same day.Ovarian cystectomy (Laparotomy): Laparotomy may be recommended for cysts that are particularly large or potentially cancerous. In this surgery, a single, large cut is made in the abdomen to access and remove the cyst. Patients need to stay in the hospital for a few days after surgery and avoid heavy physical work for some days. When to see a doctor You experience severe pelvic pain or abdominal pain.You exhibit symptoms of a ruptured cyst, e.g., sudden, sharp pain, nausea, vomiting, or faintness.You notice changes in your menstrual cycle or unusual bleeding.When your urinary or bowel symptoms persist. Read more about Ovarian Cysts Filter Alphabet O
Hereditary Neuropathy with Pressure Palsies (HNPP) Hereditary Neuropathy with Pressure Palsies (HNPP) Home Overview HNPP is a neurological disorder, which is autosomal dominant inherited, with an increased tendency for nerve compression at common compression sites like elbow and fibular head. Cause Caused due to mutation in PMP22 gene Risk factors Inheriting the mutated PMP22 gene from a parent Symptoms Weakness such as wrist drop/ foot drop/ weakness of small muscles of hand after prolonged posturingTingling/ numbness/ painAtrophy of musclesLoss of sensationThe weakness may persist for a few weeks or may become permanent Diagnosis Nerve conduction studies for site and severity of nerve compressionMR neurographyNerve biopsy (rarely required)Genetic testing Specialist to approach Neurologist Treatment Short course of steroids may be warrantedOrthosis and assistive devicesPhysiotherapyAvoidance of compression at common sites prone for nerve injury Read more about Hereditary Neuropathy with Pressure Palsies (HNPP) Filter Alphabet H
Hemianopia Hemianopia Home Overview Hemianopia means loss of field of vision on one side (right/ left). The patient cannot see the objects on the affected side. Causes Traumatic brain injuriesEpilepsyBrain tumoursLymphomaAlzheimer’s diseaseDementiaHydrocephalusMultiple sclerosisHigh brain pressureCarotid artery aneurysmsShaken baby syndrome Risk factors Brain inflammation or infection (for e.g., neurosyphilis or encephalitis)Brain tumours/lesionsTraumatic brain injuriesConcussionsSeizures and epilepsyDegenerative brain diseases like Alzheimer’s disease or Creutzfeldt-Jakob diseaseMetabolic conditions or effects, like low blood sugarInflammatory and autoimmune conditions (neuromyelitis optica or multiple sclerosis)Migraines (especially with auras) Symptoms Partial loss of vision Diagnosis Clinical examinationPerimetryMRI brain Types Homonymous hemianopia - Caused by stroke, tumourBitemporal hemianopia- In patients with pituitary adenoma and craniopharyngioma patientsInferior quadrantanopia- In stroke and tumour patientsSuperior quadrantanopia- Caused by stroke, tumourBinasal hemianopia - In patients with bilateral internal carotid artery aneurysmsBilateral scotomas- In patients with head injuryJunctional scotoma- In patients harbouring tumours Specialist to approach Neurologist Treatment Treatment of underlying cause.Repetitive visual stimulation for affected side Read more about Hemianopia Filter Alphabet H
Headache Headache Home Overview Headache is a prevalent condition, presented with pain or discomfort in the head and neck region. Most chronic headaches are vascular in nature and typically not life-threatening. Headaches that require immediate medical attention are Acute severe headache which has never happened in past (acute thunderclap headache)Change in character/ severity/ location of headacheHeadache associated with focal neurological signs like weakness/ visual disturbancesHeadache along with loss of consciousness/ seizuresNew onset headache in elderlyHeadache worsening while leaning forward or straining Causes Tension type headacheSinus headacheMigraineRebound headache (due to overuse of pain medication)Cluster headacheIdiopathic intracranial hypertensionMixed headache as in combination of tension type headache and migraine Less common causes are: Mass lesion in brain like tumour or granulomaHead injuryIntracranial or subdural haemorrhageMeningitis/ encephalitis/ other CNS infectionsRaised intracranial pressure due to brain swellingVasculitis/ other inflammatory disorders of CNS Risk factors SexBody mass index (BMI)SmokingFamily historyClimateExcessive caffeine consumptionAgeOveruse of medicationPsychiatric comorbidities (e.g., anxiety, insomnia, and depression)Occipital spurChronic dehydrationTemporomandibular disorders Specialist to approach Neurologist Diagnosis History and clinical examinationFundus examination to check for signs of raised intracranial pressureMRI/ CT head whenever required Treatment Supportive- rest, pain abortive medications like paracetamol, naproxen depending on cause of headacheProphylactic medication- on a regular basisSpecific treatment- CSF drainage/ removal of lesion depending on aetiologyLifestyle changes and avoidance of precipitating factorsBotulinum injection in specific cases Read more about Headache Filter Alphabet H