Gynecologic laparoscopy is an alternative to open surgery where a slender, lighted telescope called laparoscope is used to look inside the body.


Laparoscopy can be used for diagnosis, treatment, or both. Some reasons for diagnostic laparoscopy are:
• unexplained pelvic pain
• unexplained infertility
• a history of pelvic infection
Laparoscopy generally has a shorter healing time than open surgery. It also leaves smaller scars.


Hysteroscopy is a minor surgery that provides a way for your physician to look inside your uterus. A hysteroscope is a thin, telescope-like instrument that is inserted into the uterus through the vagina and cervix. This tool often helps a physician diagnose or treat a uterine problem.


It is done to visualize the inside of the uterus to make sure that there are no pathologies, which could cause infertility. And is such a problem exists, it can be corrected by operative hysteroscopy to improve fertility. Hysteroscopy may be either diagnostic or operative.


The best time for hysteroscopy is during the first week or so after your period. During this time your physician is best able to view the inside of the uterus.


The different types of laparoscopic treatment may include:
• Hysterectomy, or removal of the uterus
• removal of the ovaries
• removal of ovarian cysts
• removal of fibroids
• blocking blood flow to fibroids
• endometrial tissue ablation, which is a treatment for endometriosis
• adhesion removal
• reversal of a contraceptive surgery called tubal ligation
• Burch procedure for incontinence
• vault suspension to treat a prolapsed uterus


Depending upon the nature of surgery time taken is somewhere between 30 minutes to 1 hour.


Unless otherwise advised by consultants beforehand; patients can get up from bed and start moving around as early as 2 hours after surgery. Climbing stairs etc. can be resumed after 4-6 hours of surgery. However, you should avoid performing certain activities during recovery. These include:
• pushing and pulling objects, such as a vacuum cleaner • lifting heavy items • bending • sexual intercourse


Approximately 3 hours after surgery. Initially soft diet is advised but normal diet can be allowed from next day onwards.


Patients can bathe the day after the surgery.


There may be some bleeding after hysteroscopy, which subsides on its own.


Skin irritation and bladder infection are common side effects of this procedure


Slight pain and distension in abdomen may be there. Shoulder pain is also quite common. This pain usually settles after 24 hours.


It is a surgical procedure to remove a woman’s uterus. This type of surgery is done to treat a number of chronic pain conditions as well as certain types of cancer and infections. After hysterectomy, you’ll stop having menstrual periods. You’ll also be unable to get pregnant.

When you start thinking about trying to conceive, you should:
• See your doctor for a pre-pregnancy checkup. Ask about things like family medical history, risk of birth defects, genetic conditions, and chronic illnesses. Discuss all medications you take.
• In addition to eating a healthy diet (lots of leafy greens, lean proteins, and fiber), boost your nutrients with a multivitamin specially formulated for pregnancy -- usually called a prenatal vitamin. It's particularly important to get sufficient folic acid before getting pregnant. Take prescribed multivitamin from your gynecologist.
• If you smoke, quit. Smoking poses a host of risks to a developing baby, including birth defects and low birth weight. It also doubles your risk of having an ectopic pregnancy.
• Get checked for hepatitis B and C, sexually transmitted infections, and HIV.
• Get any health problems -- like diabetes and high blood pressure -- under control.


Get all essential vitamins and minerals daily including the prenatal vitamins you started prior to becoming pregnant, as well as eating a healthy diet.
Lots of leafy greens, fruits, veggies, and whole grains. Get plenty of calcium-rich foods like broccoli and low-fat milk and yogurt, to help build your baby's bones and teeth. Stick to lean meats like chicken and turkey.

Foods to avoid during pregnancy include:


• Fish with lots of mercury. High levels of mercury can damage a baby's developing brain. But don't cut out fish completely -- they give you important omega-3 fatty acids. Avoid fishes like swordfish, tilefish, and shark. You can still eat tuna and snapper, -- just cut back to no more than one serving a week. You can eat up to two servings of fish like salmon, catfish, mahi and cod, along with shellfish like shrimp, crab, and scallops.
• Unpasteurized soft cheeses like brie, Camembert, feta, gorgonzola, and Roquefort.
• Unpasteurized milk, which can also contain listeria.
• Cold ready-to-eat meats, like hot dogs and luncheon meats; these can also contain listeria. Reheat these foods until they are steaming.
• Uncooked or cured eggs and meats, like prosciutto, runny eggs, and sauces made with raw eggs (like some hollandaise).
• Alcohol. There is no known safe level of exposure to alcohol for a fetus. Prenatal exposure to alcohol can interfere with healthy development and lead to fetal alcohol syndrome.
• Caffeine. While some studies show that moderate caffeine intake during pregnancy is OK, others have found a link to miscarriage, so it's particularly important to steer clear of caffeine during the first trimester.


DO:

• Exercise. Light to moderate exercise during pregnancy is good for you, strengthening your back and abdominal muscles, improving your balance and helping to speed your recovery after delivery.
• Have sex. Unless you have a high-risk pregnancy and your doctor has advised you against it, sex during pregnancy is safe.
• Wash your hands before preparing food, before meals, after handling raw meats, and after using the bathroom.
• Clean house. Most household cleaning products, including bleach, are safe for use during pregnancy. Just be sure the room is well ventilated, read warning labels, and avoid mixing chemicals (like ammonia and bleach).
• Travel by airplane -- sometimes. Be sure to stay hydrated during the flight by drinking plenty of fluids, and keep your seat belt on!
• See your dentist. Preventive cleanings and annual exams are a very good idea during pregnancy, as your rising hormone levels can cause bleeding gums and irritation.

DON'T:

• Change the cat's litter box. Cat feces can transmit an infection called toxoplasmosis, which can lead to severe problems in newborns.
• Use saunas, hot tubs, and tanning booths. Excessive heat can be harmful to the baby.
• Don’t expose yourself to toxic substances and chemicals, which include paint and cleaning solvents.
• Unless you absolutely have to, avoid tests like X-rays and mammograms while pregnant, because they can be dangerous to your growing baby. If you absolutely must have an X-ray, make sure that your doctor or dentist knows you are pregnant so they can take extra precautions.
• Avoid using rides that are bumpy or scary.


• Nausea and vomiting: Get up slowly in the morning; movement can make nausea worse. Don't let your stomach completely empty: eat five or six small meals throughout the day. Drink plenty of fluids, get lots of fresh air, and avoid fatty foods that are hard to digest.
• Leg cramps: Exercise regularly, get plenty of fluids, and avoid sitting in the same position for a prolonged period of time.
• Heartburn: Avoid greasy or fatty foods, garlic, spicy foods, and drinks containing caffeine. Eat smaller meals, and avoid bending or lying down right after a meal.
• Hemorrhoids: Drink plenty of liquids, eat a high-fiber diet, exercise regularly, and avoid long periods of standing or sitting. To relieve hemorrhoid pain, take periodic sitz baths, apply cold compresses, and ask your doctor which OTC creams are safe to use.
• Backache: Wear low-heeled shoes with good arch support to avoid straining your lower back muscles. Avoid lifting heavy objects or standing for long periods of time. Make sure your mattress is firm, and that chairs you sit in have good back support Don't take medications for back pain unless advised by your doctor. Try a heating pad, warm water bottle, or cold pack instead.


If you're pregnant and experience any of the following symptoms, call your health care provider immediately:
• Unusual or severe cramping or abdominal pain
• Significant reduction in the baby's movements after 28 weeks (less than 10 movements in a 2-hour period)
• Shortness of breath or difficulty breathing
• Any bleeding in the second or third trimester
• Signs of premature labor, such as regular pains or tightening in the lower back or abdomen or significant fluid discharge
• Fever over 100 Fahrenheit (37.5 Centigrade)
• Severe or persistent diarrhea or vomiting
• Fainting spells or dizziness
• Blurred vision or spots in front of your eyes
• Swelling in your hands, fingers, or face


Depression during or after pregnancy is perfectly normal. In fact, researchers believe it's one of the most common complications associated with pregnancy. Symptoms can include feeling sad and hopeless; crying often; withdrawing from friends and family; eating or sleeping too little or too much; feeling worthless or guilty; and even being afraid of hurting yourself or the baby. Many new mothers -- as many as 80%, according to the National Mental Health Association -- experience the "baby blues" right after delivery, and these relatively mild symptoms (mood swings, crying spells, irritability) can go away within a few days to a few weeks. Treatment isn't necessarily needed, but support can be invaluable. Try seeking out new-mom support groups through the hospital or birthing center where you delivered. If the feelings linger, become severe, or if you have a family history of depression, it's important to get treatment for postpartum depression.

Osteoporosis is a disease in which bone density and quality are reduced. As bones become more porous and fragile, the risk of fractures greatly increases. Bone loss occurs "silently" and progressively – often there are no symptoms until the first fracture occurs. For these reasons, osteoporosis is often referred to as the "silent epidemic".


Though women are at a greater risk of osteoporosis than men because of hormonal changes; there are other risk factors associated with osteoporosis for both men and women.
• A close family member diagnosed with osteoporosis
• A family history of fractures resulting from minor bumps and falls
• Frequent falls
• A previous fracture
• Long-term enforced bed rest
• Little physical activity
• Low body weight
• Loss in height
• Periods stop for more than 12 months
• A diet low in calcium and vitamin D
• High alcohol intake
• Smoking
• Certain medications in long-term use such as corticosteroids
• Age 60+
• Chronic disorders such as anorexia nervosa, malabsorption syndromes including coeliac disease and Crohn's disease, chronic liver disease, primary hyperparathyroidism, post-transplantation, chronic renal failure, hyperthyroidism, Cushing's syndrome, arthritis


As osteoporosis has no obvious symptoms other than a fracture when the bone is already significantly weakened, it is important to go to the doctor if any of the above mentioned risk factors apply to you. The doctor will take a thorough medical history that includes information on any recent fractures and may determine that the next step is to have a bone mineral density (BMD) test. A number of different types of BMD tests are available, but the most accurate is DXA (dual energy X-ray absorptiometry). DXA is a low radiation X-ray capable of detecting quite low percentages of bone loss.


Lifestyle changes and medical treatment are part of a total program to prevent future fractures. A diet rich in calcium, daily exercise, and drug therapy are treatment options. Good posture and prevention of falls can lower your chances of being injured. Further, these drugs are approved for the treatment or prevention of osteoporosis: Alendronate (Fosamax®), Risedronate (Actonel®), Calcitonin (Miacalcin®), Raloxifene (Evista®), Estrogen therapy (ET), or Hormone Therapy (HT), Parathyroid Hormone or Teriparatide (Fortéo®)


Although heredity plays a large part in determining whether you will be at heightened risk of osteoporosis, certain lifestyle factors play a key role in helping to build and maintain strong bones. These include a good exercise regime and healthy eating habits from childhood and maintaining these good habits as an adult. Ensure that you get enough calcium and vitamin D each day, eat a healthy diet, do regular weight-bearing exercises, don't smoke, and only drink alcohol in moderation.


While jogging is a high-impact weight-bearing exercise that can help build strong bones, it may also increase the risk of breaking a bone for people with osteoporosis. Therefore it is considered unsafe for such patients. Power walking and walking briskly are safer options and almost as effective for achieving the many health benefits of exercise.


Like many vitamins and minerals, vitamin K appears to play a role in bone health. The recommended daily intake is 90 -120 micrograms (μg).There are two types of vitamin K. They are vitamin K1 and vitamin K2. Vitamin K1 sources include kale, brussels sprouts, spinach, mustard greens, turnip greens and vegetable oils. Vitamin K2 sources include egg yolks, organ meats and natto (a type of fermented soybean). At this time, research does not support the practice of taking vitamin K supplements to prevent osteoporosis and broken bones.

Joint Replacement Surgery is an operation in which the damaged or worn parts of the joint are replaced with new artificial joints.


Knee replacement surgery is essentially a ‘resurfacing’ surgery of the knee, in which only the damaged joint surfaces are removed and new material is placed in its place. The lower thigh bone (femur) is replaced with ‘metal’ and the upper part of the leg bone (tibia) is replaced by ‘polyethylene’ (plastic), which rests on metal. These ‘metal on polyethylene’ surfaces are very smooth.


In hip replacement surgery various combinations can be used. We decide the combination based on the age of the patient and underlying disease of the hip.


With the latest implants, most joint replacements done with a good surgical technique lasts for an average period of 15 to 20 years. This also varies according to the usage of the joint. In people who are less active, these artificial joints will last for a longer period.


You will feel a dramatic relief of pain after the operation, though you may have some pain in the first few days wherein you’ll be prescribed pain killers. You will be made to stand and walk on the 2nd postoperative day. Initially you will be made to walk with the help of a walker. You will need to undergo Physiotherapy in the form of knee bending exercises, knee muscle strengthening exercises and for some patients we give continuous passive motion (CPM). This CPM machine will help you bend your knees. Your stitches will be removed by the 12th postoperative day.


More than 95% of knee and hip replacement surgeries have successful outcomes. A possible complication is infection, which can occur during your hospital stay or after you have left the hospital. Other complications that can occur years after the replacement include wearing out of the plastic and loosening of the artificial joint. Dislocation is a specific complication of total hip replacement.


Hip joint is a ball and socket joint. In total hip replacement the entire ball and socket are replaced by artificial joint. In hip resurfacing, only the surface of the ball is replaced leaving most of the ball intact. The replacement of the socket is the same in both procedures.


A total knee replacement is really a cartilage replacement with an artificial surface. The knee itself is not replaced, as is commonly thought, but rather an artificial substitute for the cartilage is inserted on the end of the bones. This is typically done with a metal alloy on the femur and plastic spacer on the tibia and kneecap (patella). This creates a new, smooth cushion and a functioning joint that does not hurt.


Knee-replacement surgery has a high rate of success in eliminating pain and restoring range of motion; 90-95 percent of patients achieve good to excellent results.


We expect most knees to last more than 10–15 years. However, there is no guarantee, and 5–10 percent may not last that long. A second replacement may be necessary.


Yes. You should discuss preoperative physical therapy and exercise options with your surgeon. Exercises should begin as soon as possible.


We reserve approximately two to two-and- a-half hours for surgery. Some of this time is taken by the operating room staff to prepare for the surgery. The surgery itself may take as little as 30 minutes.


Yes. High-impact activities such as contact sports, running, singles tennis and basketball are not recommended. Injury-prone sports such as downhill skiing are also dangerous for the new joint. You are encouraged to participate in low-impact activities such as walking, dancing, golfing, hiking, swimming, bowling and gardening.