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Saleem pasha 2021-04-15

Endoscopic skull base surgery Endoscopic skull base surgery is a minimally invasive technique of brain surgery,that enables surgeon access to inaccessible areas of the brain where certain types of tumors and abnormalities may develop.

The skull is made of many bones and cartilages, the base of skull is formed by bones of the eye socket, roof of the nasal cavity, some sinuses and the bones that surround the inner ear.

It allows for the removal of cancerous and non cancerous tumors and abnormalities underside the brain, and the top of the spinal column as these areas are difficult to see and reach, without the need for a large incision in the skull; instead, tumors are removed through the mouth, nose, or a small opening above the eyebrow.Traditionally the tumors in the base of the skull were removed through the bony skull, which required large skull and facial incisions, bone flaps, and brain retraction to reach these tumors and remove them through a network of blood vessels and nerves.

An endoscope is like a small camera that looks at the pathology or problem.

The surgery is performed while watching the screen and the actual target size is magnified over 100 times.The aim is to get to the target pathology or problem while minimizing the trauma to the surrounding tissues.

The endoscopic skull base surgery is performed using an endoscope, which is a small, rigid tube with a camera and a small set of surgical instruments attached.

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Saleem pasha 2021-04-12

Brain Tumor Brain Tumor is one of the most serious forms of a tumor, it is a condition where the brain cells multiply abnormally .Brain is enclosed by the skull which is very rigid .The brain fits exactly into the skull, any growth in the brain can cause an increased pressure inside the skull and the surrounding tissues.

Causes for Brain tumors There is no specific cause for brain tumors, brain tumor is so variant that we cannot pin- point one cause — It can run in families or it can occur spontaneously where no one in the family had, there are varieties of brain tumors.

-There are many syndromes (that is a group of diseases ) which manifest as tumors in the brain and nerves.

-Tumors show up in different age groups from children to adults.

Symptoms of Brain tumor The signs and symptoms of a brain tumor usually vary based on the size of the tumor, its location and the rate of growth.• Headache is a common symptom of brain tumor, not all headaches are due to brain tumor , below are some of the types of headaches which may differ from the normal headaches which may be of concern and need an evaluation from a neurosurgery..-Headaches which are worse in the morning -Hedache while you are sleeping-Increased headaches on coughing, sneezing or during exercise — Infrequent, persistent headaches, alongside the feeling of increased pressure inside the head.

-There could also be a new onset or change in the pattern of headaches Some of the other symptoms are• vomiting• Abrupt vision problems, blurring ,double vision and abnormal eye movement • Seizure even without any history of it and more in those who have a history of seizures• Loss of appetite• Difficulty in balance, swaying while walking• The weakness of limbs, lethargy or loss of sensation• Memory problem, confusion in routine things, behavioral changes• Rapidly enlarging head, in babies or toddlers• Changes in the ability to hear, taste or smell• Dizziness or vertigo• Difficulty in writing and reading• Numbness or tingling on one side of the body• Decreased alertness, Change in mental functioning Types of brain tumors Depending on the origin of the tumor they can be primary or secondary Brain tumors.

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Saleem pasha 2021-04-08

Are you doubtful about the IVF success and worried about the financial burden caused by the treatment?Many couples undergo repeated IVF cycles.

However, the outcome is not always successful.

The cause of the failure may be due to multiple reasons.

Diagnosing the root cause is what makes all the difference.

At the IVF centers, the treatment is started only after a thorough checkup and then given a customized treatment plan to each couple, thus increasing the chances of success of the fertility treatment. 

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Saleem pasha 2021-04-06

Endoscopic skull base surgery Endoscopic skull base surgery is a minimally invasive technique of brain surgery,that enables surgeon access to inaccessible areas of the brain where certain types of tumors and abnormalities may develop.

The skull is made of many bones and cartilages, the base of skull is formed by bones of the eye socket, roof of the nasal cavity, some sinuses and the bones that surround the inner ear.

It allows for the removal of cancerous and non cancerous tumors and abnormalities underside the brain, and the top of the spinal column as these areas are difficult to see and reach, without the need for a large incision in the skull; instead, tumors are removed through the mouth, nose, or a small opening above the eyebrow.Traditionally the tumors in the base of the skull were removed through the bony skull, which required large skull and facial incisions, bone flaps, and brain retraction to reach these tumors and remove them through a network of blood vessels and nerves.

An endoscope is like a small camera that looks at the pathology or problem.

The surgery is performed while watching the screen and the actual target size is magnified over 100 times.The aim is to get to the target pathology or problem while minimizing the trauma to the surrounding tissues.

The endoscopic skull base surgery is performed using an endoscope, which is a small, rigid tube with a camera and a small set of surgical instruments attached.

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Saleem pasha 2021-04-15

Since we know that ovulation is the key to conception, many couples are keen to know when is the best time to have intercourse to get pregnant.

If we really look at it, there is a window of 12 to 24 hour period, where a woman can conceive.

This is because the egg is available in the woman’s fallopian tubes in this time window for the sperm to reach it and fertilize it.So how do you know the best time for conception?

The answer is – time of ovulation.

By understanding your ovulation cycle, you can target the optimal time frame to get pregnant.What is ovulation?Ovulation is the time when an egg is released from the ovary so that it may travel down the fallopian tube and become fertilized by a sperm.

During ovulation, the lining wall of the uterus thickens so that a fertilized egg can get implanted and the pregnancy can continue.Facts about ovulation:• An egg is available for fertilization only for 12 to 24 hours.• Usually, only one egg is released during each cycle.• Ovulation often rotates between ovaries.• Light bleeding may occur during ovulation.• It is possible to ovulate even if the menstrual cycle has not occurred.

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Saleem pasha 2021-04-12

Endoscopic skull base surgery Endoscopic skull base surgery is a minimally invasive technique of brain surgery,that enables surgeon access to inaccessible areas of the brain where certain types of tumors and abnormalities may develop.

The skull is made of many bones and cartilages, the base of skull is formed by bones of the eye socket, roof of the nasal cavity, some sinuses and the bones that surround the inner ear.

It allows for the removal of cancerous and non cancerous tumors and abnormalities underside the brain, and the top of the spinal column as these areas are difficult to see and reach, without the need for a large incision in the skull; instead, tumors are removed through the mouth, nose, or a small opening above the eyebrow.Traditionally the tumors in the base of the skull were removed through the bony skull, which required large skull and facial incisions, bone flaps, and brain retraction to reach these tumors and remove them through a network of blood vessels and nerves.

An endoscope is like a small camera that looks at the pathology or problem.

The surgery is performed while watching the screen and the actual target size is magnified over 100 times.The aim is to get to the target pathology or problem while minimizing the trauma to the surrounding tissues.

The endoscopic skull base surgery is performed using an endoscope, which is a small, rigid tube with a camera and a small set of surgical instruments attached.

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0
Saleem pasha 2021-04-08

Pregnancy may be getting delayed in the woman due to issues in either of the partners or a combination of factors.

Every step related to ovulation, fertilization and the embryo development until delivery has to go on correctly to get pregnant.

Sometimes the issues that cause infertility incouplesare hereditary or they may develop sometime later in life.Causes for male infertility: • Abnormal sperm production or sperm function because of genetic defects, undescended testicles, health problems like diabetes, or infections like chlamydia, gonorrhea, mumps, or HIV.

These include hormonal disorders like polycystic ovarian syndrome.

Hyperprolactinemia, (hyperthyroidism) or (hypothyroidism) can affect the cycle or cause infertility.

Other underlying causes may include an excessive amount of exercise, eating disorders, or tumors.

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Saleem pasha 2021-04-06

Pregnancy requires not just a healthy embryo, but also a healthy and mature endometrium, which ensures the implantation of the embryo and the onset of your long-awaited pregnancy.

Endometrial Rejuvenation is the process to enhance quality of Endometrium for successful implantation of embryo by improving the endometrial thickness & blood supply which helps embryos for implantation giving them proper nutrition & hormones.

The membrane lining the uterus is called the endometrium, the endometrium thickens during the menstrual cycle in preparation for the implantation of an embryo.

However, if any of those factors are perturbed, the result will be endometrial disorders with intrauterine scar formation, dysregulated proliferation and heavy menstrual bleeding.

• Low levels of Estrogen hormone •Trauma to the uterus (cesarean sections, repetitive curettage), •Previous anti- tumoral treatments (radiotherapy, chemotherapy, surgery) ∙ Asherman’s syndrome,( formation of adhesions (scar tissues) inside the endometrial cavity either post D or because of pelvic infections.

)  • Chronic infections (Endometritis, Pelvic Inflammatory Disease) • Conditions which cause inadequate blood flow (stress, malposition of uterus, fibrosis),• Clomiphene citrate -(a drug used for ovarian stimulation) if used excessively• Patients with low estradiol values • Post hysteroscopic surgeries done for removal of polyps, fibroids & adhesions - mainly because of excessive use of electric cautery.

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Saleem pasha 2021-04-15

  Obesity and Infertility Obesity or overweight is the body mass index (BMI) of 30 or above.

It is a condition where excess fat accumulates to such an extent that affects the health of an individual.

The link between obesity and infertility is more significant when excess fats get accumulated in the abdominal region.

Obesity causes changes in the secretion of sex hormones and thereby increases infertility.

The hormonal imbalance leads to an increased production of androgens called hyperandrogenism.Insulin is significant for the production of sex hormones.

Increased insulin production due to obesity leads to hyperandrogenism and abnormal follicles in the ovary.

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Saleem pasha 2021-04-12

In couples where there is severe male infertilityand is unable to conceive even after repeated fertilization attempts by conventional IVF treatment or after egg freezing (oocyte preservation), is the next step in fertility treatment.

If a man does not have any sperm in his ejaculate, but he is producing sperm in his testis, these produced sperms are retrieved through a surgical step called as testicular sperm extraction (TESE).

ICSIis also the method of choice in cases of retrograde ejaculation, where the sperm retrieval is from the urine.

In such cases during the next IVF cycle, ICSI is tried.• Frozen sperm is being used: If the thawed sperm appear to be inactive, ICSI-IVF is on a recommendation.• Frozen oocytes are being used: Verification of eggs can cause hardening of eggshell, which causes complication in fertilization.

IVF with ICSI can help in overcoming this hurdle.• PGD is being done: PGD (Preimplantation Genetic Diagnosis) is an IVF technique which allows genetic screening of embryos.

Who can opt for ICSI?• Couples who want to include PGT in their cycles to ensure fertilization is better.• Couples who are facing severe male infertility• When the only course of action is by sperm retrieval through TESE/MESA• Poor oocyte quality/ low oocyte yield• Suitable for women aged over 40 years of age ( to overcome sperm-Oocyte Penetration Issues)• Couples who are facing repeated fertilization failure• Ejaculatory Dysfunction The procedure involved in IVF-ICSI: As with regular IVF procedure, ovarian stimulation drugs are given.

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Saleem pasha 2021-04-06

Spinal tuberculosis or Pott’s diseaseTuberculosis is a highly communicable disease caused by the bacterium, Mycobacterium tuberculosis.

Tuberculosis (TB) is most common in developing countries and death because of TB is one among the top-10 causes of death worldwide.

The infections spread from one vertebra into the intervertebral disc space of other vertibrae the severity increases.

This results in three phenomena-• Narrowing of the vertebral space• Vertebral collapse• Spinal damageTB of the spine can cause the destruction of the bone tissue that finally ends up in the development of kyphotic or kyphoscoliotic disfigurement and possible compression of nerve roots with the collapse of the vertebrae.Spinal canal can narrow due to the protrusion of granulation tissue, lesions like cold abscesses developed in the course of the TB infection, or because of direct infiltration.Spinal tuberculosis affects the vertebrae and spreads to adjacent spinal structures, resulting in osteomyelitis, and arthritis in several vertebraeWhat causes spinal tuberculosis?Spinal TB occurs once you contract tuberculosis and it spreads outside of the lungs.

After one contracts tuberculosis the bacterium can travel through the blood from the lungs or lymph nodes into the bones, spine, or joints.

When bone TB is diagnosed, signs and symptoms are very advanced.Symptoms of patients with spinal TB may or may not experience normal symptoms of tuberculosis, which include:Chronic illness, malaise, night sweats, fever, fatigue, weight loss, back pain.Sometimes the disease could be dormant within the lungs and spread without the patient knowing that they had tuberculosis, there are some symptoms to look out for once a patient has contracted bone TB:• Severe back pain• Swelling• Stiffness• AbscessesWhen tuberculosis in the bone is more advanced, some dangerous symptoms include:• Neurological complications• Paraplegia/paralysis• Limb-shortening in children• Bone deformitiesLate symptoms that occur after significant bony destruction and deformity which can be made out by physical examination are• Kyphotic deformity (angular deformity due to the destruction of vertebral bodies),• Neurological deficits seen in patients with Pott’s disease,• Mechanical pressure on the cord due to granulation tissue, by an abscess, tubercular debris or caseous tissue,• Mechanical instability like subluxation or dislocation,• Paraplegia with severe deformity from healed disease,• Stenosis from ossification adjacent to severe kyphosis.How is Pott’s disease diagnosed and treated?For the right detection of Pott’s disease, a detailed diagnosis of both the respiratory manifestations and also the joint ailments is extremely necessary.

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Saleem pasha 2021-04-06

At times, when they are not able to conceive naturally, science and technology can come to their rescue.In-vitro Fertilization is a process of conception, in which eggs are collected from the woman and combined with the male partner’s sperm, outside the woman’s body - in the laboratory.

This fertilized egg is then put back into the woman’s womb for the embryo to grow there, until the delivery.There are, however, some myths around IVF, that we need to put at rest.MYTH 1.

One needs to take complete bed rest during IVF: It is one of the most prevalent myth that plagues every IVF patient.

Patients need to know that nature designed the body with enough ‘ability’ that walking, running, coughing, and sneezing does not cause an embryo to fall out.

The fetus remains safe in the womb, and just because they have been in an incubator in the IVF does not make any difference.

The needed injections are given with the help of a specialized pen, which is a painless process.

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Saleem pasha 2021-04-12

Spinal tuberculosis or Pott’s diseaseTuberculosis is a highly communicable disease caused by the bacterium, Mycobacterium tuberculosis.

Tuberculosis (TB) is most common in developing countries and death because of TB is one among the top-10 causes of death worldwide.

The infections spread from one vertebra into the intervertebral disc space of other vertibrae the severity increases.

This results in three phenomena-• Narrowing of the vertebral space• Vertebral collapse• Spinal damageTB of the spine can cause the destruction of the bone tissue that finally ends up in the development of kyphotic or kyphoscoliotic disfigurement and possible compression of nerve roots with the collapse of the vertebrae.Spinal canal can narrow due to the protrusion of granulation tissue, lesions like cold abscesses developed in the course of the TB infection, or because of direct infiltration.Spinal tuberculosis affects the vertebrae and spreads to adjacent spinal structures, resulting in osteomyelitis, and arthritis in several vertebraeWhat causes spinal tuberculosis?Spinal TB occurs once you contract tuberculosis and it spreads outside of the lungs.

After one contracts tuberculosis the bacterium can travel through the blood from the lungs or lymph nodes into the bones, spine, or joints.

When bone TB is diagnosed, signs and symptoms are very advanced.Symptoms of patients with spinal TB may or may not experience normal symptoms of tuberculosis, which include:Chronic illness, malaise, night sweats, fever, fatigue, weight loss, back pain.Sometimes the disease could be dormant within the lungs and spread without the patient knowing that they had tuberculosis, there are some symptoms to look out for once a patient has contracted bone TB:• Severe back pain• Swelling• Stiffness• AbscessesWhen tuberculosis in the bone is more advanced, some dangerous symptoms include:• Neurological complications• Paraplegia/paralysis• Limb-shortening in children• Bone deformitiesLate symptoms that occur after significant bony destruction and deformity which can be made out by physical examination are• Kyphotic deformity (angular deformity due to the destruction of vertebral bodies),• Neurological deficits seen in patients with Pott’s disease,• Mechanical pressure on the cord due to granulation tissue, by an abscess, tubercular debris or caseous tissue,• Mechanical instability like subluxation or dislocation,• Paraplegia with severe deformity from healed disease,• Stenosis from ossification adjacent to severe kyphosis.How is Pott’s disease diagnosed and treated?For the right detection of Pott’s disease, a detailed diagnosis of both the respiratory manifestations and also the joint ailments is extremely necessary.

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Saleem pasha 2021-04-12

 Test Tube baby is a non-medical term for babies that are conceived using the artificial reproductive technique of in-vitro fertilization (IVF).

Here the eggs are fertilized outside the human body and implanted in the uterus A pregnancy starts with fertilization when a woman’s egg joins with a man’s sperm.

If the fertilized egg successfully travels down the fallopian tube and implants in the uterus, an embryo starts growing.

When this normal process of fertilization does not take place in couples who plan to have baby advanced techniques of Assisted Reproductive Techniques (ART) are done to increase the chances of conceiving a healthy baby.

It is advised usually to• Women who are unable to conceive even after one year of trying or six months if a woman is 35 or older• Women who can get pregnant but are unable to stay pregnant• If there are difficulties in conceiving a child because of issues in you or your partner then, These are some of the Indications for Test tube baby (IVF):Blocked or defects in fallopian tubes  Premature ovarian failure  Stage 3 or 4 endometriosis, Uterine fibroids Poor ovarian reserve Women with ovulation troubles due to advanced age Individuals with a genetic disorder Women with removed fallopian tubes Unexplained infertility Repeated IUI failures Male factor infertility with diminished counts, motility or morphology A problem called varicocele-This happens when the veins on a man’s testicle(s) are too large.

The heat can affect the number or shape of the sperm.

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Saleem pasha 2021-04-06

Brain Tumor Brain Tumor is one of the most serious forms of a tumor, it is a condition where the brain cells multiply abnormally .Brain is enclosed by the skull which is very rigid .The brain fits exactly into the skull, any growth in the brain can cause an increased pressure inside the skull and the surrounding tissues.

Causes for Brain tumors There is no specific cause for brain tumors, brain tumor is so variant that we cannot pin- point one cause — It can run in families or it can occur spontaneously where no one in the family had, there are varieties of brain tumors.

-There are many syndromes (that is a group of diseases ) which manifest as tumors in the brain and nerves.

-Tumors show up in different age groups from children to adults.

Symptoms of Brain tumor The signs and symptoms of a brain tumor usually vary based on the size of the tumor, its location and the rate of growth.• Headache is a common symptom of brain tumor, not all headaches are due to brain tumor , below are some of the types of headaches which may differ from the normal headaches which may be of concern and need an evaluation from a neurosurgery..-Headaches which are worse in the morning -Hedache while you are sleeping-Increased headaches on coughing, sneezing or during exercise — Infrequent, persistent headaches, alongside the feeling of increased pressure inside the head.

-There could also be a new onset or change in the pattern of headaches Some of the other symptoms are• vomiting• Abrupt vision problems, blurring ,double vision and abnormal eye movement • Seizure even without any history of it and more in those who have a history of seizures• Loss of appetite• Difficulty in balance, swaying while walking• The weakness of limbs, lethargy or loss of sensation• Memory problem, confusion in routine things, behavioral changes• Rapidly enlarging head, in babies or toddlers• Changes in the ability to hear, taste or smell• Dizziness or vertigo• Difficulty in writing and reading• Numbness or tingling on one side of the body• Decreased alertness, Change in mental functioning Types of brain tumors Depending on the origin of the tumor they can be primary or secondary Brain tumors.

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Saleem pasha 2021-04-05

Lumbar surgery refers to any type of surgery in the lumbar spine, or lower back, between one and more of the L1-S1 levels.

There are two general types of lumbar spine surgery that comprise the most common surgical procedures for the lower back: Lumbar Decompression The goal of decompression surgery is usually to relieve pain caused by nerve root pinching.

There are two common causes of lumbar nerve root pressure: from a lumbar disc which is herniated or stenosis of the lumbar spine.

Decompression surgery involves removing a small a portion of the bone over the nerve root and/or disc material from under the nerve root to relieve pinching of the nerve and provide more room for the nerve to heal.

The most common types of decompression surgery are microdiscectomy and laminectomy which was explained earlier There are also a few alternatives available to the above two standard procedures, such as an X-STOP which is a possible option instead of a laminectomy for lumbar spinal stenosis.Lumbar Fusion The goal of a lumbar fusion is to stop the pain at a painful motion segment in the lower back.

Most commonly, this type of surgery is performed for pain and disability caused by lumbar degenerative disc disease or spondylolisthesis.

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Saleem pasha 2021-04-15

Endoscopic skull base surgery Endoscopic skull base surgery is a minimally invasive technique of brain surgery,that enables surgeon access to inaccessible areas of the brain where certain types of tumors and abnormalities may develop.

The skull is made of many bones and cartilages, the base of skull is formed by bones of the eye socket, roof of the nasal cavity, some sinuses and the bones that surround the inner ear.

It allows for the removal of cancerous and non cancerous tumors and abnormalities underside the brain, and the top of the spinal column as these areas are difficult to see and reach, without the need for a large incision in the skull; instead, tumors are removed through the mouth, nose, or a small opening above the eyebrow.Traditionally the tumors in the base of the skull were removed through the bony skull, which required large skull and facial incisions, bone flaps, and brain retraction to reach these tumors and remove them through a network of blood vessels and nerves.

An endoscope is like a small camera that looks at the pathology or problem.

The surgery is performed while watching the screen and the actual target size is magnified over 100 times.The aim is to get to the target pathology or problem while minimizing the trauma to the surrounding tissues.

The endoscopic skull base surgery is performed using an endoscope, which is a small, rigid tube with a camera and a small set of surgical instruments attached.

Saleem pasha 2021-04-15

  Obesity and Infertility Obesity or overweight is the body mass index (BMI) of 30 or above.

It is a condition where excess fat accumulates to such an extent that affects the health of an individual.

The link between obesity and infertility is more significant when excess fats get accumulated in the abdominal region.

Obesity causes changes in the secretion of sex hormones and thereby increases infertility.

The hormonal imbalance leads to an increased production of androgens called hyperandrogenism.Insulin is significant for the production of sex hormones.

Increased insulin production due to obesity leads to hyperandrogenism and abnormal follicles in the ovary.

Saleem pasha 2021-04-12

Brain Tumor Brain Tumor is one of the most serious forms of a tumor, it is a condition where the brain cells multiply abnormally .Brain is enclosed by the skull which is very rigid .The brain fits exactly into the skull, any growth in the brain can cause an increased pressure inside the skull and the surrounding tissues.

Causes for Brain tumors There is no specific cause for brain tumors, brain tumor is so variant that we cannot pin- point one cause — It can run in families or it can occur spontaneously where no one in the family had, there are varieties of brain tumors.

-There are many syndromes (that is a group of diseases ) which manifest as tumors in the brain and nerves.

-Tumors show up in different age groups from children to adults.

Symptoms of Brain tumor The signs and symptoms of a brain tumor usually vary based on the size of the tumor, its location and the rate of growth.• Headache is a common symptom of brain tumor, not all headaches are due to brain tumor , below are some of the types of headaches which may differ from the normal headaches which may be of concern and need an evaluation from a neurosurgery..-Headaches which are worse in the morning -Hedache while you are sleeping-Increased headaches on coughing, sneezing or during exercise — Infrequent, persistent headaches, alongside the feeling of increased pressure inside the head.

-There could also be a new onset or change in the pattern of headaches Some of the other symptoms are• vomiting• Abrupt vision problems, blurring ,double vision and abnormal eye movement • Seizure even without any history of it and more in those who have a history of seizures• Loss of appetite• Difficulty in balance, swaying while walking• The weakness of limbs, lethargy or loss of sensation• Memory problem, confusion in routine things, behavioral changes• Rapidly enlarging head, in babies or toddlers• Changes in the ability to hear, taste or smell• Dizziness or vertigo• Difficulty in writing and reading• Numbness or tingling on one side of the body• Decreased alertness, Change in mental functioning Types of brain tumors Depending on the origin of the tumor they can be primary or secondary Brain tumors.

Saleem pasha 2021-04-12

In couples where there is severe male infertilityand is unable to conceive even after repeated fertilization attempts by conventional IVF treatment or after egg freezing (oocyte preservation), is the next step in fertility treatment.

If a man does not have any sperm in his ejaculate, but he is producing sperm in his testis, these produced sperms are retrieved through a surgical step called as testicular sperm extraction (TESE).

ICSIis also the method of choice in cases of retrograde ejaculation, where the sperm retrieval is from the urine.

In such cases during the next IVF cycle, ICSI is tried.• Frozen sperm is being used: If the thawed sperm appear to be inactive, ICSI-IVF is on a recommendation.• Frozen oocytes are being used: Verification of eggs can cause hardening of eggshell, which causes complication in fertilization.

IVF with ICSI can help in overcoming this hurdle.• PGD is being done: PGD (Preimplantation Genetic Diagnosis) is an IVF technique which allows genetic screening of embryos.

Who can opt for ICSI?• Couples who want to include PGT in their cycles to ensure fertilization is better.• Couples who are facing severe male infertility• When the only course of action is by sperm retrieval through TESE/MESA• Poor oocyte quality/ low oocyte yield• Suitable for women aged over 40 years of age ( to overcome sperm-Oocyte Penetration Issues)• Couples who are facing repeated fertilization failure• Ejaculatory Dysfunction The procedure involved in IVF-ICSI: As with regular IVF procedure, ovarian stimulation drugs are given.

Saleem pasha 2021-04-08

Are you doubtful about the IVF success and worried about the financial burden caused by the treatment?Many couples undergo repeated IVF cycles.

However, the outcome is not always successful.

The cause of the failure may be due to multiple reasons.

Diagnosing the root cause is what makes all the difference.

At the IVF centers, the treatment is started only after a thorough checkup and then given a customized treatment plan to each couple, thus increasing the chances of success of the fertility treatment. 

Saleem pasha 2021-04-06

Spinal tuberculosis or Pott’s diseaseTuberculosis is a highly communicable disease caused by the bacterium, Mycobacterium tuberculosis.

Tuberculosis (TB) is most common in developing countries and death because of TB is one among the top-10 causes of death worldwide.

The infections spread from one vertebra into the intervertebral disc space of other vertibrae the severity increases.

This results in three phenomena-• Narrowing of the vertebral space• Vertebral collapse• Spinal damageTB of the spine can cause the destruction of the bone tissue that finally ends up in the development of kyphotic or kyphoscoliotic disfigurement and possible compression of nerve roots with the collapse of the vertebrae.Spinal canal can narrow due to the protrusion of granulation tissue, lesions like cold abscesses developed in the course of the TB infection, or because of direct infiltration.Spinal tuberculosis affects the vertebrae and spreads to adjacent spinal structures, resulting in osteomyelitis, and arthritis in several vertebraeWhat causes spinal tuberculosis?Spinal TB occurs once you contract tuberculosis and it spreads outside of the lungs.

After one contracts tuberculosis the bacterium can travel through the blood from the lungs or lymph nodes into the bones, spine, or joints.

When bone TB is diagnosed, signs and symptoms are very advanced.Symptoms of patients with spinal TB may or may not experience normal symptoms of tuberculosis, which include:Chronic illness, malaise, night sweats, fever, fatigue, weight loss, back pain.Sometimes the disease could be dormant within the lungs and spread without the patient knowing that they had tuberculosis, there are some symptoms to look out for once a patient has contracted bone TB:• Severe back pain• Swelling• Stiffness• AbscessesWhen tuberculosis in the bone is more advanced, some dangerous symptoms include:• Neurological complications• Paraplegia/paralysis• Limb-shortening in children• Bone deformitiesLate symptoms that occur after significant bony destruction and deformity which can be made out by physical examination are• Kyphotic deformity (angular deformity due to the destruction of vertebral bodies),• Neurological deficits seen in patients with Pott’s disease,• Mechanical pressure on the cord due to granulation tissue, by an abscess, tubercular debris or caseous tissue,• Mechanical instability like subluxation or dislocation,• Paraplegia with severe deformity from healed disease,• Stenosis from ossification adjacent to severe kyphosis.How is Pott’s disease diagnosed and treated?For the right detection of Pott’s disease, a detailed diagnosis of both the respiratory manifestations and also the joint ailments is extremely necessary.

Saleem pasha 2021-04-06

Endoscopic skull base surgery Endoscopic skull base surgery is a minimally invasive technique of brain surgery,that enables surgeon access to inaccessible areas of the brain where certain types of tumors and abnormalities may develop.

The skull is made of many bones and cartilages, the base of skull is formed by bones of the eye socket, roof of the nasal cavity, some sinuses and the bones that surround the inner ear.

It allows for the removal of cancerous and non cancerous tumors and abnormalities underside the brain, and the top of the spinal column as these areas are difficult to see and reach, without the need for a large incision in the skull; instead, tumors are removed through the mouth, nose, or a small opening above the eyebrow.Traditionally the tumors in the base of the skull were removed through the bony skull, which required large skull and facial incisions, bone flaps, and brain retraction to reach these tumors and remove them through a network of blood vessels and nerves.

An endoscope is like a small camera that looks at the pathology or problem.

The surgery is performed while watching the screen and the actual target size is magnified over 100 times.The aim is to get to the target pathology or problem while minimizing the trauma to the surrounding tissues.

The endoscopic skull base surgery is performed using an endoscope, which is a small, rigid tube with a camera and a small set of surgical instruments attached.

Saleem pasha 2021-04-06

At times, when they are not able to conceive naturally, science and technology can come to their rescue.In-vitro Fertilization is a process of conception, in which eggs are collected from the woman and combined with the male partner’s sperm, outside the woman’s body - in the laboratory.

This fertilized egg is then put back into the woman’s womb for the embryo to grow there, until the delivery.There are, however, some myths around IVF, that we need to put at rest.MYTH 1.

One needs to take complete bed rest during IVF: It is one of the most prevalent myth that plagues every IVF patient.

Patients need to know that nature designed the body with enough ‘ability’ that walking, running, coughing, and sneezing does not cause an embryo to fall out.

The fetus remains safe in the womb, and just because they have been in an incubator in the IVF does not make any difference.

The needed injections are given with the help of a specialized pen, which is a painless process.

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Since we know that ovulation is the key to conception, many couples are keen to know when is the best time to have intercourse to get pregnant.

If we really look at it, there is a window of 12 to 24 hour period, where a woman can conceive.

This is because the egg is available in the woman’s fallopian tubes in this time window for the sperm to reach it and fertilize it.So how do you know the best time for conception?

The answer is – time of ovulation.

By understanding your ovulation cycle, you can target the optimal time frame to get pregnant.What is ovulation?Ovulation is the time when an egg is released from the ovary so that it may travel down the fallopian tube and become fertilized by a sperm.

During ovulation, the lining wall of the uterus thickens so that a fertilized egg can get implanted and the pregnancy can continue.Facts about ovulation:• An egg is available for fertilization only for 12 to 24 hours.• Usually, only one egg is released during each cycle.• Ovulation often rotates between ovaries.• Light bleeding may occur during ovulation.• It is possible to ovulate even if the menstrual cycle has not occurred.

Saleem pasha 2021-04-12

Spinal tuberculosis or Pott’s diseaseTuberculosis is a highly communicable disease caused by the bacterium, Mycobacterium tuberculosis.

Tuberculosis (TB) is most common in developing countries and death because of TB is one among the top-10 causes of death worldwide.

The infections spread from one vertebra into the intervertebral disc space of other vertibrae the severity increases.

This results in three phenomena-• Narrowing of the vertebral space• Vertebral collapse• Spinal damageTB of the spine can cause the destruction of the bone tissue that finally ends up in the development of kyphotic or kyphoscoliotic disfigurement and possible compression of nerve roots with the collapse of the vertebrae.Spinal canal can narrow due to the protrusion of granulation tissue, lesions like cold abscesses developed in the course of the TB infection, or because of direct infiltration.Spinal tuberculosis affects the vertebrae and spreads to adjacent spinal structures, resulting in osteomyelitis, and arthritis in several vertebraeWhat causes spinal tuberculosis?Spinal TB occurs once you contract tuberculosis and it spreads outside of the lungs.

After one contracts tuberculosis the bacterium can travel through the blood from the lungs or lymph nodes into the bones, spine, or joints.

When bone TB is diagnosed, signs and symptoms are very advanced.Symptoms of patients with spinal TB may or may not experience normal symptoms of tuberculosis, which include:Chronic illness, malaise, night sweats, fever, fatigue, weight loss, back pain.Sometimes the disease could be dormant within the lungs and spread without the patient knowing that they had tuberculosis, there are some symptoms to look out for once a patient has contracted bone TB:• Severe back pain• Swelling• Stiffness• AbscessesWhen tuberculosis in the bone is more advanced, some dangerous symptoms include:• Neurological complications• Paraplegia/paralysis• Limb-shortening in children• Bone deformitiesLate symptoms that occur after significant bony destruction and deformity which can be made out by physical examination are• Kyphotic deformity (angular deformity due to the destruction of vertebral bodies),• Neurological deficits seen in patients with Pott’s disease,• Mechanical pressure on the cord due to granulation tissue, by an abscess, tubercular debris or caseous tissue,• Mechanical instability like subluxation or dislocation,• Paraplegia with severe deformity from healed disease,• Stenosis from ossification adjacent to severe kyphosis.How is Pott’s disease diagnosed and treated?For the right detection of Pott’s disease, a detailed diagnosis of both the respiratory manifestations and also the joint ailments is extremely necessary.

Saleem pasha 2021-04-12

Endoscopic skull base surgery Endoscopic skull base surgery is a minimally invasive technique of brain surgery,that enables surgeon access to inaccessible areas of the brain where certain types of tumors and abnormalities may develop.

The skull is made of many bones and cartilages, the base of skull is formed by bones of the eye socket, roof of the nasal cavity, some sinuses and the bones that surround the inner ear.

It allows for the removal of cancerous and non cancerous tumors and abnormalities underside the brain, and the top of the spinal column as these areas are difficult to see and reach, without the need for a large incision in the skull; instead, tumors are removed through the mouth, nose, or a small opening above the eyebrow.Traditionally the tumors in the base of the skull were removed through the bony skull, which required large skull and facial incisions, bone flaps, and brain retraction to reach these tumors and remove them through a network of blood vessels and nerves.

An endoscope is like a small camera that looks at the pathology or problem.

The surgery is performed while watching the screen and the actual target size is magnified over 100 times.The aim is to get to the target pathology or problem while minimizing the trauma to the surrounding tissues.

The endoscopic skull base surgery is performed using an endoscope, which is a small, rigid tube with a camera and a small set of surgical instruments attached.

Saleem pasha 2021-04-12

 Test Tube baby is a non-medical term for babies that are conceived using the artificial reproductive technique of in-vitro fertilization (IVF).

Here the eggs are fertilized outside the human body and implanted in the uterus A pregnancy starts with fertilization when a woman’s egg joins with a man’s sperm.

If the fertilized egg successfully travels down the fallopian tube and implants in the uterus, an embryo starts growing.

When this normal process of fertilization does not take place in couples who plan to have baby advanced techniques of Assisted Reproductive Techniques (ART) are done to increase the chances of conceiving a healthy baby.

It is advised usually to• Women who are unable to conceive even after one year of trying or six months if a woman is 35 or older• Women who can get pregnant but are unable to stay pregnant• If there are difficulties in conceiving a child because of issues in you or your partner then, These are some of the Indications for Test tube baby (IVF):Blocked or defects in fallopian tubes  Premature ovarian failure  Stage 3 or 4 endometriosis, Uterine fibroids Poor ovarian reserve Women with ovulation troubles due to advanced age Individuals with a genetic disorder Women with removed fallopian tubes Unexplained infertility Repeated IUI failures Male factor infertility with diminished counts, motility or morphology A problem called varicocele-This happens when the veins on a man’s testicle(s) are too large.

The heat can affect the number or shape of the sperm.

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Pregnancy may be getting delayed in the woman due to issues in either of the partners or a combination of factors.

Every step related to ovulation, fertilization and the embryo development until delivery has to go on correctly to get pregnant.

Sometimes the issues that cause infertility incouplesare hereditary or they may develop sometime later in life.Causes for male infertility: • Abnormal sperm production or sperm function because of genetic defects, undescended testicles, health problems like diabetes, or infections like chlamydia, gonorrhea, mumps, or HIV.

These include hormonal disorders like polycystic ovarian syndrome.

Hyperprolactinemia, (hyperthyroidism) or (hypothyroidism) can affect the cycle or cause infertility.

Other underlying causes may include an excessive amount of exercise, eating disorders, or tumors.

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Brain Tumor Brain Tumor is one of the most serious forms of a tumor, it is a condition where the brain cells multiply abnormally .Brain is enclosed by the skull which is very rigid .The brain fits exactly into the skull, any growth in the brain can cause an increased pressure inside the skull and the surrounding tissues.

Causes for Brain tumors There is no specific cause for brain tumors, brain tumor is so variant that we cannot pin- point one cause — It can run in families or it can occur spontaneously where no one in the family had, there are varieties of brain tumors.

-There are many syndromes (that is a group of diseases ) which manifest as tumors in the brain and nerves.

-Tumors show up in different age groups from children to adults.

Symptoms of Brain tumor The signs and symptoms of a brain tumor usually vary based on the size of the tumor, its location and the rate of growth.• Headache is a common symptom of brain tumor, not all headaches are due to brain tumor , below are some of the types of headaches which may differ from the normal headaches which may be of concern and need an evaluation from a neurosurgery..-Headaches which are worse in the morning -Hedache while you are sleeping-Increased headaches on coughing, sneezing or during exercise — Infrequent, persistent headaches, alongside the feeling of increased pressure inside the head.

-There could also be a new onset or change in the pattern of headaches Some of the other symptoms are• vomiting• Abrupt vision problems, blurring ,double vision and abnormal eye movement • Seizure even without any history of it and more in those who have a history of seizures• Loss of appetite• Difficulty in balance, swaying while walking• The weakness of limbs, lethargy or loss of sensation• Memory problem, confusion in routine things, behavioral changes• Rapidly enlarging head, in babies or toddlers• Changes in the ability to hear, taste or smell• Dizziness or vertigo• Difficulty in writing and reading• Numbness or tingling on one side of the body• Decreased alertness, Change in mental functioning Types of brain tumors Depending on the origin of the tumor they can be primary or secondary Brain tumors.

Saleem pasha 2021-04-06

Pregnancy requires not just a healthy embryo, but also a healthy and mature endometrium, which ensures the implantation of the embryo and the onset of your long-awaited pregnancy.

Endometrial Rejuvenation is the process to enhance quality of Endometrium for successful implantation of embryo by improving the endometrial thickness & blood supply which helps embryos for implantation giving them proper nutrition & hormones.

The membrane lining the uterus is called the endometrium, the endometrium thickens during the menstrual cycle in preparation for the implantation of an embryo.

However, if any of those factors are perturbed, the result will be endometrial disorders with intrauterine scar formation, dysregulated proliferation and heavy menstrual bleeding.

• Low levels of Estrogen hormone •Trauma to the uterus (cesarean sections, repetitive curettage), •Previous anti- tumoral treatments (radiotherapy, chemotherapy, surgery) ∙ Asherman’s syndrome,( formation of adhesions (scar tissues) inside the endometrial cavity either post D or because of pelvic infections.

)  • Chronic infections (Endometritis, Pelvic Inflammatory Disease) • Conditions which cause inadequate blood flow (stress, malposition of uterus, fibrosis),• Clomiphene citrate -(a drug used for ovarian stimulation) if used excessively• Patients with low estradiol values • Post hysteroscopic surgeries done for removal of polyps, fibroids & adhesions - mainly because of excessive use of electric cautery.

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Lumbar surgery refers to any type of surgery in the lumbar spine, or lower back, between one and more of the L1-S1 levels.

There are two general types of lumbar spine surgery that comprise the most common surgical procedures for the lower back: Lumbar Decompression The goal of decompression surgery is usually to relieve pain caused by nerve root pinching.

There are two common causes of lumbar nerve root pressure: from a lumbar disc which is herniated or stenosis of the lumbar spine.

Decompression surgery involves removing a small a portion of the bone over the nerve root and/or disc material from under the nerve root to relieve pinching of the nerve and provide more room for the nerve to heal.

The most common types of decompression surgery are microdiscectomy and laminectomy which was explained earlier There are also a few alternatives available to the above two standard procedures, such as an X-STOP which is a possible option instead of a laminectomy for lumbar spinal stenosis.Lumbar Fusion The goal of a lumbar fusion is to stop the pain at a painful motion segment in the lower back.

Most commonly, this type of surgery is performed for pain and disability caused by lumbar degenerative disc disease or spondylolisthesis.