Like every medical procedure, IVF has certain risks and complications, such as multiple pregnancy, ectopic pregnancy and OHSS ( ovarian hyperstimulation). Here’s what you can do to minimise your risks.
Like every medical procedure, IVF has certain risks and complications, such as multiple pregnancy, ectopic pregnancy and OHSS ( ovarian hyperstimulation). Here’s what you can do to minimise your risks.
Why is multiple pregnancy a concern?
Being pregnant with more than one baby is exciting and is often a happy event for many couples. However, multiple pregnancy has increased risks for complications. The most common complications include the following:
preterm labor and birth
About half of twins and nearly all higher-order multiples are premature (born before 37 weeks). The higher the number of fetuses in the pregnancy, the greater the risk for early birth. Premature babies are born before their bodies and organ systems have completely matured. These babies are often small, with low birthweights (less than 2,500 grams or 5.5 pounds), and they may need help breathing, eating, fighting infection, and staying warm. Very premature babies, those born before 28 weeks, are especially vulnerable. Many of their organs may not be ready for life outside the mother’s uterus and may be too immature to function well. Many multiple birth babies will need care in a neonatal intensive care unit (NICU).
pregnancy-induced hypertension
Women with multiple fetuses are more than three times as likely to develop high blood pressure of pregnancy. This condition often develops earlier and is more severe than pregnancy with one baby. It can also increase the chance of placental abruption (early detachment of the placenta).
anemia
Anemia is more than twice as common in multiple pregnancies as in a single birth.
birth defects
Multiple birth babies have about twice the risk of congenital (present at birth) abnormalities including neural tube defects (such as spina bifida), gastrointestinal, and heart abnormalities.
miscarriage
A phenomenon called the vanishing twin syndrome in which more than one fetus is diagnosed, but vanishes (or is miscarried), usually in the first trimester, is more likely in multiple pregnancies. This may or may not be accompanied by bleeding. The risk of pregnancy loss is increased in later trimesters as well.
twin-to-twin transfusion syndrome
Twin-to-twin syndrome is a condition of the placenta that develops only with identical twins that share a placenta. Blood vessels connect within the placenta and divert blood from one fetus to the other. It occurs in about 15 percent of twins with a shared placenta.
In TTTS, blood is shunted from one fetus to the other through blood vessel connections in a shared placenta. Over time, the recipient fetus receives too much blood, which can overload the cardiovascular system and cause too much amniotic fluid to develop. The smaller donor fetus does not get enough blood and has low amounts of amniotic fluid.
abnormal amounts of amniotic fluid
Amniotic fluid abnormalities are more common in multiple pregnancies, especially for twins that share a placenta.
cesarean delivery
Abnormal fetal positions increase the chances of cesarean birth.
postpartum hemorrhage
The large placental area and over-distended uterus place a mother at risk for bleeding after delivery in many multiple pregnancies.
What is multifetal pregnancy reduction?
In recent years, a procedure called multifetal pregnancy reduction has been used for very high numbers of fetuses, especially four or more. This procedure involves injecting one or more fetuses with a lethal medication, causing fetal death. The objective of multifetal reduction is that by reducing the number of fetuses in the pregnancy, the remaining fetuses may have a better chance for health and survival. Consult your physician for additional information.
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Calorie is a measurement of the energy content of food. The body needs calories as “fuel” to perform all of its functions, such as breathing, blood circulation, and physical activity.
1 gm of carbohydrate provides 4 Calories, 1 gm of protein provides 4 Calories and 1 gm of fat provides 9 Calories.
Eating too many calories and not getting enough physical activity to burn those calories results in overweight & obesity.
Adults with a BMI greater than 30 are considered obese and adults with a BMI between 25 and 29.9 are considered overweight.
Obesity increases the risk of developing several health problems like high blood pressure, insulin resistance, type 2 diabetes, coronary artery disease (heart attacks), cerebrovascular disease (stroke), gout, gallstones, colon cancer, sleep apnea and non alcoholic fatty liver disease.
Obesity & High blood pressure:
Multiple factors are responsible for increase in blood pressure in obesity.
– Weight gain is associated with decrease in elasticity of blood vessels & increase heart rate.
– Excess calories are deposited in body as fat in fatty tissue. This fatty tissue increases demand for oxygen & nutrients, which in turn increases amount of blood circulating in the body. More blood traveling through arteries adds pressure on walls of arteries leading to increase in blood pressure.
– Obesity increases level of insulin in body. Insulin causes sodium & water retention in body, which results in increase in blood volume & extra pressure on arteries.
All of these factors can increase blood pressure.
Obesity & Diabetes: – Increased blood sugar level:
Type2 diabetes is a common health problem in diabetes.
– Insulin controls blood sugar.
– Insulin is required for the entry of sugar (glucose) into body cells from blood.
– Excess body fat in obesity makes body resistant to insulin. Because of this insulin resistance, sugar will remain in blood, which will lead to increase in blood sugar or diabetes.
– High amount of sugar in blood leads to complications in kidney, eyes, blood vessel, and heart.
Atherosclerosis or fatty deposits in blood vessels:-
Cholesterol is carried in the blood as two compounds: Low-density lipoproteins (LDL) and High-density lipoproteins (HDL). HDL is also called the ‘good’ cholesterol and LDL is also called the ‘bad’ cholesterol.
– Obesity is associated with low levels of good (high-density lipoprotein) cholesterol and high levels of bad (LDL) cholesterol.
– When cholesterol levels are high, some of the cholesterol is deposited on the walls of the blood vessels. Cholesterol deposits reduces the elasticity of blood vessels, narrows blood vessels & decreases blood flow. All these changes lead to atherosclerosis and an increased risk of heart disease & stroke.
Coronary artery disease – angina & heart attack:
Atherosclerosis (fatty deposits in arteries) in coronary arteries (arteries that supply heart) reduces blood supply to heart. Decreased blood flow to heart can cause angina (chest pain) and complete blockage of blood flow to heart can cause heart attack.
Stroke or paralysis:
Atherosclerosis (fatty deposits in arteries) in arteries of brain can reduce blood supply to that part of brain. This decrease in blood flow can result in stroke or paralysis.
Osteoarthritis:
Obesity & overweight increases the load on the joints such as the knee, hip & lower back. This extra pressure on these joints speeds up the breakdown of cartilage, resulting in joint pain & stiffness.
(Cartilage is a flexible tissue that covers bone ends in a joint to cushion the bone and allow the joint to move easily without pain).
Gout:
Gout is type of arthritis caused by the accumulation of uric acid crystals in joints.
– Obesity is associated with increased production of uric acid, which can form solid crystal-like masses. Uric acid crystals are deposited in the joints & provokes an inflammatory reaction in joints leading to arthritis.
Sleep apnea:
Overweight & excess fat around neck causes narrowing of airways & leads to sleep apnea. Sleep apnea is a condition in which person stop breathing for short periods during sleep & snore heavily. It results in frequent awakening at night and subsequent drowsiness & tiredness during the day.
Fatty liver disease (Non alcoholic fatty liver) :
Obesity increases the risk of developing fatty liver disease due to accumulation of fat in liver. These fatty deposits in liver can lead to inflammation & scarring of the liver called non-alcoholic fatty liver disease. Serious complication of this scarring is cirrhosis of liver.
Gallbladder disease and gallstones:
The gallbladder is a small pear-shaped organ situated beneath the liver on the right side of the abdomen. In obesity, excessive cholesterol gets deposited in gall bladder, which can lead to formation of gallstones. Rapid weight loss or loss of a large amount of weight can also increases the chances of developing gallstones.
So, obesity is not just a cosmetic problem, but lot of health problems & complications are associated with it.
For details on complications of obesity, please click here. You can get some important information on natural supplements for weight loss & books on our nutrition website here.
Diabetes is the most common cause of new blindness. It is one of the major causes of kidney disease. It more than doubles the risk of heart disease and stroke.
Diabetes may lead to male impotence. It causes a person to have many more infections than normal, and it may make foot or leg amputations necessary. All of these are in addition to the usual out of control blood sugar level complications such as hypoglycemia, ketoacidosis, and hyperglycemia.
Not every diabetic will develop such complications, but he must constantly be alert for the warning signs of problems. The diabetic must have medical checkups quite often. Most likely, he will need considerably more medical care than the average person.
Thousands of people have diabetes without even knowing it. Many of them will only discover their diabetes when they go to a doctor for other problems. And they find out that the trouble with their eyes, feet or heart is actually a complication of diabetes.
If you have never been checked for diabetes, but someone in your family has diabetes, if you are overweight and if you are above the age of 35, you may be at risk. Don’t take a chance, go for a diabetes screening test or ask your doctor to check your blood sugar level.
If you know that you have diabetes, the best way to avoid or at least delay complications is to keep your blood glucose as close to non diabetic levels as possible. This requires staying in constant control of diabetes, testing frequently, exercising regularly, and eating wisely.
A diabetic who already has a complication may be able to prevent it from getting worse by staying in good control of his blood sugar level.
No one can accurately predict who will develop any of the complications of diabetes, but whether you are a gambling person or not, one thing is a safe bet, prevention is much better than cure. Living a healthy lifestyle with a good blood glucose control, proper diet, regular exercise, and no smoking will greatly reduce your chances of trouble.
With diabetes, life is even more of a gamble. Every day the diabetic has decisions to make, big decisions, little decisions. But every one of them makes a difference in how well the diabetes is controlled. And every one of them may be making a difference whether or not the diabetic will have any of the serious complications of diabetes later on.
If you look at smoking and lung cancer, a non smoker may still get the disease, while a heavy cigarette smoker may escape without even getting cancer. So it is with diabetic and all his efforts at maintaining good control. Even with the best efforts at regulating his life, he may still have complications. And a person who always seems careless about his diabetes may somehow escape without serious problems. Yet statistically speaking, looking at the law of chances, the person who is careful about his diabetes control has a much better chance of escaping the complications so common to the diabetic.
Samuel Fuentes is a Filipino Registered Nurse from the Philippines. To know more about diabetes you may visit his site on www.diabetic.com.ph/.
In super obese patients, performing surgical treatments like gastric bypass, gastric band operation and duodenal switch procedure carries great risk. In such cases, a surgical procedure called sleeve gastrectomy is done. According to a large number of surgeons, the procedure of sleeve gastrectomy is relatively safe and brings very few negative results. However, it may show some complications in some cases. But before we look at the common sleeve gastrectomy complications, let’s find out some information about the sleeve gastrectomy procedure.
Sleeve Gastrectomy Procedure
Sleeve gastrectomy is also called vertical sleeve gastrectomy or just vertical gastrectomy. It is a kind of bariatric surgery that is performed on obese people having a body mass index of 40 or more. It takes place in two stages. The first stage is called sleeve gastrectomy and the second stage is known as gastric bypass or duodenal switch. After the first stage only, the patient loses a large quantity of their weight and the second stage is not needed. If weight loss is not sufficient enough after the stage first, then gastric bypass or duodenal switch is conducted.
Sleeve gastrectomy is a serious and non-reversible surgery that is done laparoscopically to remove a portion of the stomach. It involves stapling the stomach by using harmonic stapling devices. This surgery is generally conducted on the major curve of the stomach. It reduces the overall size of the stomach by 15-35% and gives it a shape of a tube or sleeve, hence the name sleeve gastrectomy. Another major result of this surgery is weight loss. Since it is done laparoscopically, it brings certain advantages over other bariatric surgeries. These include shorter recovery, less pain, fewer incisions and problems related with it. However, complications associated with sleeve gastrectomy are not unknown. Let’s find out what could be the most probable sleeve gastrectomy complications. Read more on obesity treatment options.
Complications of Sleeve Gastrectomy
The most significant complications associated with this bariatric surgery are leakage, sleeve dilation and a number of other general problems. Let’s take a look at them.
Leakage
In sleeve gastrectomy surgery, a portion of the stomach is removed and the edges of the stomach are stapled or fixed together. Sometimes, due to intra-abdominal pressure, the staple line shows leakages and hemorrhages. However, such sleeve gastrectomy complications can be easily treated, by conducting a second procedure that strengthens the staple line of the sleeve.
Gastroesophageal Reflux
Gastroesophageal reflux is a medical term for stomach content flowing back into the esophagus. The acids present in the stomach content cause irritation of the esophagus. This, in turn, leads to heartburn, which is highly uncomfortable. It is often found to be one of the complications of laparoscopic sleeve gastrectomy, probably because of the change in the shape of the stomach.
Gastric Fistula
The irregular, hollow and tube-like passage connecting the stomach to the wall of the abdomen is called gastric fistula. It is created, either pathologically or by surgery. In some 3-5% of sleeve gastrectomy cases, it comes as a post-operative result. Hence, it is another possible sleeve gastrectomy complcation. A second surgery is required to treat the condition.
Narrowing of Stoma
Sleeve gastrectomy procedure may cause narrowing of stoma or opening between the stomach and intestine. Another surgery may be required to fix this condition. In some cases, it can be corrected with the help of an instrument. A dilating tube is entered from the mouth to pass through the stomach. It expands the stoma.
Hernia
In about 15% cases of sleeve gastrectomy complications, hernia is found to be one of the problems. It is the protrusion of an organ or its muscle through the cavity that contains it. Usually, surgery is required to repair the condition.
Malabsorption of Vitamins and Minerals
One long-term complication of sleeve gastrectomy is difficult or malabsorption of certain vitamins and minerals. This leads to deficiency of those particular vitamins and minerals, which further causes a number of other disorders. Deficiency of iron results in anemia and insufficient vitamin B12 can cause neurologic disorders. Changes in absorption of calcium, phosphates and oxalates can lead to the formation of kidney stones. Similarly, deficiency of calcium, phosphates and vitamin D can give rise to various bone diseases.
Other Possible Complications
Vertical sleeve gastrectomy often shows some common complications associated with bariatric surgery. The most prominent among those is microbial infection at the wound site. Another problem topping the list is deep vein thrombosis (DVT) or formation of blood clot in the leg. The best way to reduce the risk of venous thrombosis in legs is to walk. There is yet another complication that is sometimes seen after sleeve gastrectomy. This is dilation of sleeves that results in increase in the food intake capacity of the patient.
In addition to all the complexities listed above, sleeve gastrectomy complications may include hair loss, hair thinning, mood swings, dry skin and a general feeling of weakness. Any issues with sleeve gastrectomy needs a high level of medical attention and care. It is never advisable to try anything on your own. Also, strictly follow the advice and treatments as directed by your surgeon.
Varicose veins are caused by the failure of valves in the veins which are responsible for ensuring that blood only flows in one direction around the body. They frequently appear close to the surface on the back of the legs, because these veins experience particularly high pressure blood flow as the blood must flow back up to the heart against gravity. Fortunately, varicose veins are rarely a serious medical condition but they are unsightly and they can be painful which mandates treatment to alleviate the condition.
Symptoms of Varicose Veins
Symptoms include aching legs, frequently accompanied by a feeling of heaviness and typically, this is felt most acutely at night or after exercising. There may also be a visual reference in the form of “spider veins” which show through to the surface as the veins become twisted and distorted due to losing structural integrity and becoming weaker.
As the valves weaken, effective circulation becomes problematical and so issues with blood pooling in the lower extremities becomes an issue. This leads to swollen ankles and possibly lower legs which become enlarged due to blood pooling there.
The skin may become discolored and adopt a bruised look with a bluish/brown tinge close to the affected veins. In addition, the area may become itchy and dry, which if may lead to excessive scratching by the patient and in turn lead to ulceration which can be extremely painful. In addition, irritation builds up due to the collection of waste products which would normally be removed by the proper blood circulation.
The patient may also experience cramps after sitting still and making an effort to get up or engaging in sudden movement. In addition, cuts and scrapes to the area may also need a much longer period to heal and they may bleed excessively.
In extreme cases, the fat around the ankle may become hardened and this causes the skin to shrink and shrivel. In addition, white patches may occur around the ankles which resemble scar tissue which is known as atrophie blanche.
Staging Varicose Veins
Varicose veins are “staged”, i.e. the surgeon will assess what stage the condition has reached and use the staging assessment as the basis for delivering medical therapy to the patient.
The stages are:
C0 – no visible signs of the condition;
C1 – appearance of spider veins (reticular or telangectasia);
C2 – varicose veins are evident;
C3 – edema is present;
C4a – skin changes in pigmentation or presence of eczema;
C4b – advanced skin changes – e.g. atrophie blanche;
C5 – the same as C4 but with healed ulcers; and
C6 – presence of active ulcers.
Varicose Vein Complications
Varicose veins are most frequently benign, however there are complications which may arise as a consequence of leaving the condition untreated. The major issue is in connection with the poor circulation of blood through the body, particularly the lower limbs and extremities. This leads directly and indirectly to pain, inability to walk properly, difficulty in standing (and thus an inability to perform work) as well as a host of unpleasant skin conditions including dermatitis and eczema.
Ulcers can be particularly serious, as well as painful, and it is important that these are treated both for their immediate presentation of symptoms as well as the underlying cause to prevent recurrence. There is some evidence that untreated varicose veins may contribute to an increase in malignant growths (cancer) where ulcers are present.
Inability of the skin to heal and stop excessive bleeding is also an issue, particularly amongst elderly patients. Clotting is also an issue for sufferers of all ages, especially if the affected veins are the deep veins, i.e. those situated deep within the legs and not close to the surface (which is what we typically can see). This clotting can lead to cardiac and stroke incidents which may be fatal.
Calorie is a measurement of the energy content of food. The body needs calories as “fuel” to perform all of its functions, such as breathing, blood circulation, and physical activity.
1 gm of carbohydrate provides 4 Calories, 1 gm of protein provides 4 Calories and 1 gm of fat provides 9 Calories.
Eating too many calories and not getting enough physical activity to burn those calories results in overweight & obesity.
Adults with a BMI greater than 30 are considered obese and adults with a BMI between 25 and 29.9 are considered overweight.
Obesity increases the risk of developing several health problems like high blood pressure, insulin resistance, type 2 diabetes, coronary artery disease (heart attacks), cerebrovascular disease (stroke), gout, gallstones, colon cancer, sleep apnea and non alcoholic fatty liver disease.
Obesity & High blood pressure:
Multiple factors are responsible for increase in blood pressure in obesity.
– Weight gain is associated with decrease in elasticity of blood vessels & increase heart rate.
– Excess calories are deposited in body as fat in fatty tissue. This fatty tissue increases demand for oxygen & nutrients, which in turn increases amount of blood circulating in the body. More blood traveling through arteries adds pressure on walls of arteries leading to increase in blood pressure.
– Obesity increases level of insulin in body. Insulin causes sodium & water retention in body, which results in increase in blood volume & extra pressure on arteries.
All of these factors can increase blood pressure.
Obesity & Diabetes: – Increased blood sugar level:
Type2 diabetes is a common health problem in diabetes.
– Insulin controls blood sugar.
– Insulin is required for the entry of sugar (glucose) into body cells from blood.
– Excess body fat in obesity makes body resistant to insulin. Because of this insulin resistance, sugar will remain in blood, which will lead to increase in blood sugar or diabetes.
– High amount of sugar in blood leads to complications in kidney, eyes, blood vessel, and heart.
Atherosclerosis or fatty deposits in blood vessels:-
Cholesterol is carried in the blood as two compounds: Low-density lipoproteins (LDL) and High-density lipoproteins (HDL). HDL is also called the ‘good’ cholesterol and LDL is also called the ‘bad’ cholesterol.
– Obesity is associated with low levels of good (high-density lipoprotein) cholesterol and high levels of bad (LDL) cholesterol.
– When cholesterol levels are high, some of the cholesterol is deposited on the walls of the blood vessels. Cholesterol deposits reduces the elasticity of blood vessels, narrows blood vessels & decreases blood flow. All these changes lead to atherosclerosis and an increased risk of heart disease & stroke.
Coronary artery disease – angina & heart attack:
Atherosclerosis (fatty deposits in arteries) in coronary arteries (arteries that supply heart) reduces blood supply to heart. Decreased blood flow to heart can cause angina (chest pain) and complete blockage of blood flow to heart can cause heart attack.
Stroke or paralysis:
Atherosclerosis (fatty deposits in arteries) in arteries of brain can reduce blood supply to that part of brain. This decrease in blood flow can result in stroke or paralysis.
Osteoarthritis:
Obesity & overweight increases the load on the joints such as the knee, hip & lower back. This extra pressure on these joints speeds up the breakdown of cartilage, resulting in joint pain & stiffness.
(Cartilage is a flexible tissue that covers bone ends in a joint to cushion the bone and allow the joint to move easily without pain).
Gout:
Gout is type of arthritis caused by the accumulation of uric acid crystals in joints.
– Obesity is associated with increased production of uric acid, which can form solid crystal-like masses. Uric acid crystals are deposited in the joints & provokes an inflammatory reaction in joints leading to arthritis.
Sleep apnea:
Overweight & excess fat around neck causes narrowing of airways & leads to sleep apnea. Sleep apnea is a condition in which person stop breathing for short periods during sleep & snore heavily. It results in frequent awakening at night and subsequent drowsiness & tiredness during the day.
Fatty liver disease (Non alcoholic fatty liver) :
Obesity increases the risk of developing fatty liver disease due to accumulation of fat in liver. These fatty deposits in liver can lead to inflammation & scarring of the liver called non-alcoholic fatty liver disease. Serious complication of this scarring is cirrhosis of liver.
Gallbladder disease and gallstones:
The gallbladder is a small pear-shaped organ situated beneath the liver on the right side of the abdomen. In obesity, excessive cholesterol gets deposited in gall bladder, which can lead to formation of gallstones. Rapid weight loss or loss of a large amount of weight can also increases the chances of developing gallstones.
So, obesity is not just a cosmetic problem, but lot of health problems & complications are associated with it.
For details on complications of obesity, please click here. You can get some important information on natural supplements for weight loss & books on our nutrition website here.
Calorie is a measurement of the energy content of food. The body needs calories as “fuel” to perform all of its functions, such as breathing, blood circulation, and physical activity.
1 gm of carbohydrate provides 4 Calories, 1 gm of protein provides 4 Calories and 1 gm of fat provides 9 Calories.
Eating too many calories and not getting enough physical activity to burn those calories results in overweight & obesity.
Adults with a BMI greater than 30 are considered obese and adults with a BMI between 25 and 29.9 are considered overweight.
Obesity increases the risk of developing several health problems like high blood pressure, insulin resistance, type 2 diabetes, coronary artery disease (heart attacks), cerebrovascular disease (stroke), gout, gallstones, colon cancer, sleep apnea and non alcoholic fatty liver disease.
Obesity & High blood pressure:
Multiple factors are responsible for increase in blood pressure in obesity.
– Weight gain is associated with decrease in elasticity of blood vessels & increase heart rate.
– Excess calories are deposited in body as fat in fatty tissue. This fatty tissue increases demand for oxygen & nutrients, which in turn increases amount of blood circulating in the body. More blood traveling through arteries adds pressure on walls of arteries leading to increase in blood pressure.
– Obesity increases level of insulin in body. Insulin causes sodium & water retention in body, which results in increase in blood volume & extra pressure on arteries.
All of these factors can increase blood pressure.
Obesity & Diabetes: – Increased blood sugar level:
Type2 diabetes is a common health problem in diabetes.
– Insulin controls blood sugar.
– Insulin is required for the entry of sugar (glucose) into body cells from blood.
– Excess body fat in obesity makes body resistant to insulin. Because of this insulin resistance, sugar will remain in blood, which will lead to increase in blood sugar or diabetes.
– High amount of sugar in blood leads to complications in kidney, eyes, blood vessel, and heart.
Atherosclerosis or fatty deposits in blood vessels:-
Cholesterol is carried in the blood as two compounds: Low-density lipoproteins (LDL) and High-density lipoproteins (HDL). HDL is also called the ‘good’ cholesterol and LDL is also called the ‘bad’ cholesterol.
– Obesity is associated with low levels of good (high-density lipoprotein) cholesterol and high levels of bad (LDL) cholesterol.
– When cholesterol levels are high, some of the cholesterol is deposited on the walls of the blood vessels. Cholesterol deposits reduces the elasticity of blood vessels, narrows blood vessels & decreases blood flow. All these changes lead to atherosclerosis and an increased risk of heart disease & stroke.
Coronary artery disease – angina & heart attack:
Atherosclerosis (fatty deposits in arteries) in coronary arteries (arteries that supply heart) reduces blood supply to heart. Decreased blood flow to heart can cause angina (chest pain) and complete blockage of blood flow to heart can cause heart attack.
Stroke or paralysis:
Atherosclerosis (fatty deposits in arteries) in arteries of brain can reduce blood supply to that part of brain. This decrease in blood flow can result in stroke or paralysis.
Osteoarthritis:
Obesity & overweight increases the load on the joints such as the knee, hip & lower back. This extra pressure on these joints speeds up the breakdown of cartilage, resulting in joint pain & stiffness.
(Cartilage is a flexible tissue that covers bone ends in a joint to cushion the bone and allow the joint to move easily without pain).
Gout:
Gout is type of arthritis caused by the accumulation of uric acid crystals in joints.
– Obesity is associated with increased production of uric acid, which can form solid crystal-like masses. Uric acid crystals are deposited in the joints & provokes an inflammatory reaction in joints leading to arthritis.
Sleep apnea:
Overweight & excess fat around neck causes narrowing of airways & leads to sleep apnea. Sleep apnea is a condition in which person stop breathing for short periods during sleep & snore heavily. It results in frequent awakening at night and subsequent drowsiness & tiredness during the day.
Fatty liver disease (Non alcoholic fatty liver) :
Obesity increases the risk of developing fatty liver disease due to accumulation of fat in liver. These fatty deposits in liver can lead to inflammation & scarring of the liver called non-alcoholic fatty liver disease. Serious complication of this scarring is cirrhosis of liver.
Gallbladder disease and gallstones:
The gallbladder is a small pear-shaped organ situated beneath the liver on the right side of the abdomen. In obesity, excessive cholesterol gets deposited in gall bladder, which can lead to formation of gallstones. Rapid weight loss or loss of a large amount of weight can also increases the chances of developing gallstones.
So, obesity is not just a cosmetic problem, but lot of health problems & complications are associated with it.
For details on complications of obesity, please click here. You can get some important information on natural supplements for weight loss & books on our nutrition website here.
Root canal treatments, also known as endodontic therapy, may give rise to certain complications in some cases. But with the advent of the latest technology in root canal treatments, like sophisticated instruments, new filling materials, advanced techniques, etc., there are very less chances of root canal complications, as compared to the yesteryears. Even if some problems arise, they can easily be treated and cured and dental health can be restored.
What is Root Canal Treatment?
The center of a tooth houses a hollow portion called the pulp chamber, which is located at the coronal portion and is connected to the roots of the tooth through very narrow channels called root canals. A root canal starts from the central pulp chamber and runs through the entire root of the tooth. These root canals and pulp chambers are filled with blood vessels, nerve tissues and a number of cellular entities. The blood vessels carry nutrition for the pulp, whereas the nerves carry signals to the brain. Normally, each tooth contains one to four root canals, but those towards the back of the mouth may have more.
Root canal treatment or endodontic therapy, is recommended in case of any infection in the root canals and pulp chamber, which affects the blood or nerve supply. In some cases, any injury to the tooth can cause such damage and in turn lead to the death of the teeth, due to tooth decay. If the pulp chamber is infected, it may lead to the formation of an abscess with pus and causes inflammation of the surrounding gums. The person may not feel any pain or inflammation in the initial stages of infection. All these situations necessitate a root canal treatment, which removes the entire structure inside the pulp chamber and root canals. Once emptied, this pulp chamber and root canals are cleaned, decontaminated and filled with some inert filling. If the infection has spread to the crown, then it is also replaced.
Root Canal Complications
A root canal treatment is an expensive and a lengthy procedure, which requires three to four visits to the dentist, in normal cases. In case of root canal complications, you may have to spend more time at the dentist’s clinic for further treatment. The following are some of the circumstances, which can lead to root canal complications.
One of the most common reasons for root canal complications is a missed root canal or canals. Some teeth may have many root canals and the dentist may miss some of these canals while cleaning. In some cases, it is difficult to clean some canals, like curved and horizontal ones. If the dentist fails to measure the full length of the roots, it may lead to insufficient cleaning and filling, which in turn, may cause a spread of infection and tooth abscess.
An infection may lead to a dead tooth and dead teeth are prone to fracture. While filling such teeth, a fracture may occur, which can lead to root canal complications. Such situations demand endodontic surgery to remove the fractured root.
If there are many root canals with curves, the cleaning and filing process becomes difficult. Sometimes, while filing a curve in the root canal, the tool may accidentally penetrate the side of the tooth causing a fresh perforation. This hole has to be filled properly to prevent further infections, through that perforation.
Root canal complications may arise if the doctor fails to detect any cracks in the teeth. Such undetected small cracks may become the gateway for the entry of bacteria and infect the tooth again.
Another common root canal complication is the accidental breakage of the tools inside the tooth. Sometimes, the tools used for cleaning and filing the root canals may break during the process. If the tooth is already cleaned, then the broken part is left inside and the tooth is filled. But if the tool breakage happens while cleaning, the broken piece has to be removed. In some cases, surgery is required to remove the broken part of the tool.
Root canal complications may involve the infection of the tooth after root canal treatment, due to defective dental restoration or any other factor. In some cases, the infection may have caused extensive tooth damage, which forces the dentist to decide if the tooth is not fit for root canal treatment and he may prefer a tooth extraction.
In case of root canal complications, there are many treatment options. Minor complications, like pain and swelling, can be treated with medications. Other procedural defaults are tackled with root canal re-treatment. Some of the root canal complications may require surgery, as in the case of a fracture of the tooth. If the tooth has suffered irreparable damage and cannot be saved, then extraction is suggested. You can replace this lost tooth with dental implants. However, don’t be afraid of this dental procedure, which actually cannot be avoided at such a stage, if you have an infection of the tooth. Remember, dental care is a prominent part of regular health care.
Diabetes mellitus is a disease produced by insufficient insulin or insulin resistance. There are mainly two types of complications of diabetes. Short Term Complications and long term complications. Here we will discuss short term complications of diabetes.
Short Term Complications
Hypoglycaemia
Hyperosmolar NonKetotic Coma
Ketoacidosis
Hypoglycaemia Causes:
Hypoglycaemia is seen when patient’s blood glucose level falls too low. The causes of hypoglycaemia are
1- Insufficient intake of meal, specially after taking glucose lowering drugs or insulin.
2- Excessive dose of Insulin or Sulphonylureas may cause hypoglycaemia as well.
3- Excessive exercise can also lead to hypoglycaemia specially those who are on antidiabetic drugs. By doing exercise glucose goes into cells and glucose level in blood decreases.
Hypoglycaemia Symptoms:
Whenever hypoglycaemia occurs, patient can have symptoms like palpitations, feeling shaky, sweating, tingling in the lips, going pale, heart pounding, rapid pulse rate, anxiety, confusion and irritability. These are just warning signs, however if we will not treat hypoglycaemia then patient can lead to coma and even death can occur.
What to do if Hypoglycaemia occurs:
If you are in a hospital and your nurse or doctor find out that you are in hypoglycaemia, then most probably you will be injected with 25% dextrose water 5 ampules depending upon your blood glucose level. At home, hypoglycaemia can be treated simply by taking some sweet juice like orange juice or glucose containing tablets. If patient goes to coma stage then intramuscular injection of GLUCAGON may help. Glucagon is a hormone that raises blood glucose level. So it is necessary that if you are traveling or going outside, must take your glucagon kit with you. Family and friends should be taught how to inject Glucagon, as patient is already unconscious and can not take it himself. If patient becomes unconscious never try to put food or drink in his mouth as it may lead to choking. If you are on insulin and taking alcohol, there are great chances of going into hypoglycaemia as body will be unable to produce glucose rapidly. It is suggested that man on insulin should take 3 units of alcohol and women should take 2 units. Moreover while drinking, you should always eat something.
What is Ketoacidosis, Definition of ketoacidosis
Ketosis is the accumulation of ketone bodies (produced by breakdown of fat) in the blood and Acidosis is increased acidity of the blood, i.e PH of blood decreases. It is a serious condition that can also lead to coma. Usually seen in type 1 diabetic patients, may also appear in type 2 diabetes specially older patients. Diabetic acidosis is often initiated by an infection like Urinary track infection or chest infection.
Pathophysiology and causes of Diabetic Kitoacidosis:
Usually we see DKA when you miss doses of insulin, as a result blood glucose level will rise, and body cells will start burning fat which leads to production of ketone bodies and acidosis.At the same time, the high secretion of glucose into the urine causes dehydration due to loss of water and salts. Ketoacidosis occurs when cells of body can not fulfilled their metabolic demand in absence of sufficient glucose. Instead, cells start getting energy by breakdown of fatty acids which results in formation of ketone bodies. PH of body will become acidic and body will try to eliminate acids by increasing rate and depth of acids.
Symptoms and signs of ketoacidosis:
Tiredness Fruity smell to breath like nail polish remover Increase thirst Polyuria increase urination. Weight-loss. Oral Thrush muscle wasting. Aggression Confusion Agitation Irritation Emesis (vomiting), Abdominal pain. Loss of appetite. Flu-like symptoms. Lethargy and apathy. Patients breathe more deeply and rapidly. Unconsciousness (diabetic coma) after prolonged DKA.
Prevention of diabetic ketoacidosis
If you are ill and having an infection, always remember your body will need more insulin in such conditions, so try to increase your insulin dose during infectious illness, but before taking insulin should always check your blood glucose level. Keep tight control of your blood sugar level by regularly checking it with glucometer. Whenever you feel unwell, just check your blood glucose level. If you ever find that blood glucose is high, then go for your urine examination for presence of ketone bodies. You should always have ketone measuring urine strips at home.
Diabetic acidosis is often seen in stomach infection Gastritis, as you think that less insulin is needed if you are having symptoms of gastritis like nausea vomiting and reduced eating and this insufficient insulin may lead to acidosis.
How do you know if you have diabetic acidosis?
The diagnosis is made by: Always measure blood glucose – It is always high in diabetic ketoacidosis. Urine examination for ketone bodies a blood sample taken from an artery – it is done in the hospital and measures the PH of the blood. Doctor will also perform tests to rule out any infection.
How to treat diabetic ketoacidosis.
This condition usually requires hospital admission. Treatment consists of: Intravenous salt fluids like NaCl, KCl etc Insulin is given via intravenous drips. potassium supplements added to the infusion If infection is present then antibiotics are also added.
Prognosis is quit good, if diabetic ketoacidosis is diagnosed and treated earlier, patient usually recovers within few days, however if acidosis is not treated earlier, it may become life threatening.
Hyperosmolar nonketotic Coma
Diabetic Coma in Type 2 Diabetes Hyperglycaemic hyperosmolar nonketotic coma is a serious complication seen in type 2 diabetes patients with severe infection or stress. Diabetic coma is seen when blood glucose level becomes too high and there is severe dehydration. Unlike ketoacidosis which is usually seen in type 1 diabetes, in hyperosmolar stage we dont see any ketones in body and urine, and there is no acidosis. Diabetic hyperosmolar coma is usually seen in diabetic patients older than 60 years as they have altered sense of being thirsty and are more likely to become severely dehydrated. If there is severe loss of water from body, it can lead to shock, syncopy, coma and death
What are Causes of Diabetic Coma?
Severe Infection UTI, respiratory tract infection, bacterial meningitis,retropharyngeal abscess, hepatobiliary sepsis. Noncompliance with diet or insulin therapy Heart attack Renal failure Drugs (diuretics, steroids, phenytoin, ß -blockers, calcium channel blockers) Fever Illness Bleeding ulcer Blood clot hyperglycaemia Trauma CVA Pancreatitis
Symptoms of Hyperosmolar Coma:
Symptoms of hyperosmolar coma are produced due to hyperglycaemia and dehydration. Increased urination Increased thirst Severe Weakness Drowsiness Altered mental status Headache Restlessness Inability to speak Paralysis If you have any of these signs and symptoms, check your blood glucose and call your doctor if your blood glucose is high. Diabetic hyperosmolar coma typically seen when blood glucose increases to 600 mg/dL or more.
What are laboratory findings of Diabetic Coma patient.
• Severe hyperglycaemia (> 500mg/dl)
• Plasma hyperosmolality
• urea:creatinine ratio increased
• Secondary glycosuria
• Absence of significant ketoacidosis o Metabolic acidosis absent or mild
How Is Diabetic Coma Treated? It is an emergency situation, and should be treated immediately. Patient should be hospitalised. Treatment goals are to treat hyperglycaemia with insulin and treat dehydration with intravenous fluids. Infection can be treated with antibiotics.
How to prevent diabetic coma? Monitor and Check your blood glucose regularly, as recommended by your doctor Check your blood glucose every four hours when you are suffering from any infection. Take special care of yourself when you are having severe illness.
Learn more about Diabetes Complications at our website www.diabetessymptomscure.com
Dr.Armughan Riaz M.B.B.S, Dip Card working and maintaining following sitesDiabetes Complications and Blackhead Remover.
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