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Explaining time-sensitiveness of assisted reproduction

These negative feelings may lead to varying degrees of depression, anxiety, distress, and a poor quality of life,” reiterates Chirumamilla.

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New Delhi, Aug 9 : According to WHO, every 1 in 8 couples (or 12 per cent of married women) has gone through complexities getting pregnant or sustaining a pregnancy. This calls for a timely intervention and awareness amongst the patients to when to consider medical intrusion and opt for an IVF procedure.

Recent statistics show that an on-time IVF has higher success rates than a delayed initiation. This revolutionary procedure is an effective treatment to treat infertility and helps in the conception of a child. Depending on the criticality, patients might opt for less invasive treatment options before going ahead with IVF, which includes reproductive medications, increased production of eggs, or intrauterine insemination. However, if a couple has repeatedly failed to conceive after all other treatments and desires to attempt for IVF, then they should be aware of the procedure and importance of time for opting the same, she says.

IANSlife spoke to Dr. Lakshmi Chirumamilla, Fertility Consultant, Nova IVF Fertility Hyderabad who explains in detail:

Patients, planning to undergo assisted reproductive treatment (ART) like IVF, should first understand that the procedure is usually done using their own eggs and their partners’ sperm. It may also involve eggs, sperm or embryos from an anonymous donor in some cases considering other complexities. Therefore, when a couple undergoes the first sign of infertility, they should consult a fertility expert to understand their biological risk stage, as the process and success rate will depend on their ability to produce eggs or sperms. Patients experience a series of tests like an evaluation of ovarian reserve, semen analysis, uterine cavity exam etc., and post that only in-vitro fertilization is initiated.

In some cases, women with growing age deplete their ovarian reserve and men tend to have lesser sperm count. This often can lead to diminished ovarian reserve (DOR), which happens when women ovaries lose their reproductive potential, causing permanent infertility. Here, the most vulnerable age is after 37 years. In a situation like this, fertility treatment becomes complicated with intricate procedures like embryo transfer as a next step.

“This whole procedure strictly includes a time-sensitive diagnosis and here, a delayed decision of IVF and other ART treatments can often lead to complicacies on the treatment outcome and that can lead to feelings of depression, anxiety, isolation, and loss of control. As per WHO, depression levels in patients with infertility have been compared with patients who have been diagnosed with cancer. These negative feelings may lead to varying degrees of depression, anxiety, distress, and a poor quality of life,” reiterates Chirumamilla.

Adding, “We have witnessed varied cases, where time played a crucial role in the IVF process. We had a couple who came to Nova IVF seeking fertility treatment, where the 28 year old woman had been trying to conceive with her husband for the past 3 years. Up on a detailed further examination, we figures out that the husband’s semen analysis was normal, while woman had a low ovarian reserve. Here, the woman was advised to opt for IVF over a year ago, but had refrained from going ahead with it. Therefore, when a year later they finally decided to go for an assisted reproduction, the chances of the couple conceiving got decreased drastically due to her prolonged low ovarian reserve. Nevertheless, we opted for the procedure and post the first cycle of IVF, we ended up retrieving only two eggs and performed a single embryo transfer, which unfortunately came out negative. In the second cycle, we somehow managed to retrieve three eggs from the woman that then resulted in 2 embryos. Basis that, after performing a single embryo transfer in the second cycle, the woman was finally able to conceive.”

Considering all the odds and still being optimistic at a chance of parenthood, the couple did go ahead with the treatment keeping in mind the age and time-sensitive nature of any IVF-related treatment. It is always important to remember that age is not an indicator to undergo IVF treatment, when IVF is needed it is better to do it sooner than later. Treatment will always be advised according to the cause. Currently, the couple is happily pregnant awaiting the arrival of their little one.

Similar to this, assisted reproductive technology has aided many couples around the world to conceive and given meaning to their lives. There are countless success stories to inspire couples looking to undertake the procedure and fulfil their long-time desire to have a child.

There is no wrong time to have a baby, but it is wiser to not delay the process just because of the stereotyping of the society or present pandemic scenario. It is advisable not to neglect the early signs of infertility and consult a specialist at the initial stage to evaluate criticality and ensure a successful conception. Considering the present scenario, patients should always be cautious about the safety measures taken at the IVF centre and how stringently they are adhering to the govt. directives. Whenever visiting the clinic it is imperative to maintain at least one-meter distance from other people. Just make sure you avoid unnecessary contact with other people over there. Carrying hand sanitizer and mask is compulsory with frequent hand washes whenever required.

(Puja Gupta can be contacted at [email protected])

Health

Eyesight problems rising among kids

Besides, cases of reflective errors in terms of myopia and hypermetropia have also surfaced among children.

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Lucknow, Sep 26 : With children spending more time on computers and mobile phones for online classes and gaming, cases of eye sight problems are on the rise.

Children and teens between the ages of 6 and 18 years have been found to be suffering from convergence efficiency, computer vision syndrome, reflective errors and other eye sight problems.

According to rough estimates, nearly 40 per cent children have complained of various eye and vision related problems in recent weeks.

Majority of the children are being diagnosed with convergence insufficiency — a condition in which the eyes are unable to work together when looking at nearby objects. This condition causes one eye to turn outward instead of inward with the other eye, creating double or blurred vision, said Anil Rastogi, a well-known ophthalmologist.

Children working long hours on computers and smart phones usually complain of itching or burning in eyes, watering, loss of retention power, besides headache and eye pain, Rastogi added.

Shikha Kumar, another ophthalmologist, said that since the national lockdown, most children have been found to be spending eight to 10 hours on electronic devices.

“They are either attending online classes, or watching cartoons or television and playing video games. Parents feel that this is the best way to keep them occupied but this prolonged exposure to electronic devices is playing havoc with their eyesight,” she pointed out.

Doctors say that children are being diagnosed with computer vision syndrome where they complain of pain, redness, dryness, blurring of vision, double vision and other head and neck sprains.

Besides, cases of reflective errors in terms of myopia and hypermetropia have also surfaced among children.

Doctors suggest eye exercises, frequent breaks from TV/computer/ mobile phone screens to prevent permanent damage to the eyes.

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Health

People aged between 30-40 coming with new-found cardio issues

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New Delhi, Sep 26 : Respiratory disorders caused by Covid-19 have taken a centre-stage during the pandemic, overshadowing other burgeoning health issues, particularly cardiovascular disorders (CVDs). With the recent uptick in heart diseases over the last few months, people are facing the likelihood of cardiovascular concerns at a large scale.

The incidences of new-onset and worsening heart problems are being highlighted by medical experts. However, a worrying trend is being noticed by them where patients, coming with new-found CVD aged between 30 and 40 while the majority hails from metro cities.

“We are observing a notable shift in the trend of CVDs where people in their 30-40s are getting heart attacks and other cardiac problems, from metros like Delhi and Mumbai,” observed Dr Partap Chauhan, Director at Jiva Ayurveda, a leading Ayurvedic telemedicine organization in India.

“We had the maximum number of cases from the Maharashtra region (150+ cases), followed by Delhi (200+ cases), Uttar Pradesh (300+ cases) and Haryana (110+ cases), of which around 1,000 were males and 480 were females,” he informed.

Notably, most of these cases also had an observable trend in co-morbidity. “Our doctors consulted 670 cases for hypertension, followed by 216 cases of Hypercholesterolemia and 174 cases of Hridroga (other heart diseases),” Chauhan shared.

Besides, he also estimated that more than cases related to cardiovascular problems have increased by 50 per cent.

“Before lockdown, our doctors consulted 748 cases for cardiovascular diseases, during the complete lockdown, we got 322 cases of CVDs and post-lockdown, our doctors have consulted around 776 cases through our telemedicine centre and clinics,” Chauhan added.

Weighing on the sudden spurt in cardiovascular issues, Chauhan listed certain aggregators that contributed to the rise. “The unavailability of quality medical care and the fear of contagion is one of the few common causes for the worsening condition of patients with pre-existing heart problems. In addition to that, the sudden and disproportionate increase in causative factors such as stress, anxiety, obesity, and physical inactivity is pushing the pre-CVD segment of people in their late 40s and with existing comorbidities into becoming new patients of CVD,” he explained.

He also said that emotional factors such as Isolation, loss of employment, financial dilemmas, and the emotional burden of being away from family members or bereavement have made matters worse. “The psychological effects (loneliness, stress, anxiety, isolation, unemployment fear and economic burden) of the pandemic combined with other lifestyle factors like smoking and drinking, irregular eating habits, unhealthy diet and physical inactivity may increase CVD cases during the pandemic,” Chauhan added.

Meanwhile, stress, bad diet, and emotional turmoil is taking a toll on the heart. Chauhan said that adopting a healthy lifestyle, and adding yoga and herbs in your daily routine can help.

“Over a period, it becomes weak and coupled with incorrect lifestyle choices such as smoking, drinking alcohol or eating junk food, the already high risk of developing heart diseases goes up. Practising yoga and pranayama could reduce stress levels. A gentle head massage or full body massage with oil relieves tension and reduces the load on your heart. Switch off highly charged TV broadcasts if it is causing you stress. Spend time cultivating what makes you happy, healthy and gives you peace,” he advised.

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Health

NPPA steps in to cap price of Liquid Medical Oxygen and Medical Oxygen cylinders

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New delhi: The National Pharmaceutical Pricing Authority of India is now capping price of Liquid Medical Oxygen and Medical Oxygen cylinders.

  1. The present situation of COVID-19 has resulted in increased demand of Medical Oxygen (MO) in the country and hence its availability is of utmost importance. Many of the States/UTs are dependent on the medical oxygen supply from other States/UTs.
  2. The demand of Medical Oxygen has gone up almost four times, from 750MT/day to 2800 MT/day. This has caused strain at all levels in the value chain of production and supply. The manufacturers of Medical Oxygen and Fillers have given representation to the Government for up to three fold price increase in the Ceiling Price of gaseous Medical Oxygen.
  3. The government is committed to uninterrupted supply of Medical Oxygen especially in the times of pandemic. Oxygen Inhalation (Medicinal Gas) is a scheduled formulation, covered under the National List of Essential Medicines (NLEM). Its existing Ceiling Price fixed by NPPA is Rs. 17.49/CUM. However, due to absence of price cap on liquid medical oxygen, manufacturers have hiked prices to fillers. During COVID, supply of medical oxygen through cylinders has increased from 10% to around 50% of total consumption. Price regulation at this end is imperative for continued availability of medical oxygen across the country.
  4. The issue related to availability, including pricing of oxygen has been under the continued consideration of Empowered Group 2, GOI. The Empowered Group 2 has recommended NPPA to consider capping the ex-factory price of liquid oxygen in order to ensure its supply to fillers at reasonable prices. It has also requested NPPA to consider a cap for ex-factory price of oxygen in cylinders in order to ensure supply of oxygen cylinders from filler at reasonable prices.
  5. To deal effectively with the situation, Ministry of Health & Family Welfare (MOH&FW), GOI has vide its letter dated 23.09.2020 conferred the delegation of powers under Section 10(2) (l) of Disaster Management Act, 2005 to NPPA to take all necessary steps to immediately regulate the availability and pricing of LMO and Medical Oxygen in cylinder.
  6. The Authority deliberated upon the matter in its extra ordinary meeting held on 25.09.2020. It has been decided to invoke extra-ordinary powers in public interest, under Para 19 of DPCO, 13 and under Section 10(20) (l) of Disaster Management Act, 2005 to deal with the emergent situation arising due to the pandemic. Accordingly it has been decided:

To cap the ex- factory price of Liquid Medical Oxygen (LMO) at manufacturers end at Rs. 15.22/CUM exclusive of GST; and

To further cap the ex-factory cost of Medical Oxygen Cylinder at filler end at Rs. 25.71/CUM exclusive of GST in suppression of the existing Ceiling Price of Rs. 17.49/CUM, subject to transportation cost fixation at state level, for six months.

  1. The existing rate contracts of state governments for oxygen purchase, as applicable, shall continue, in consumer interest.

The ex-factory price cap of LMO and oxygen gas cylinders will be applicable to domestic production.

The above measures will ensure availability of medical oxygen at consumer end at reasonable price both at hospital level and through oxygen cylinders, especially to distant and interior districts.

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