Dr. R. Melitha Clinic

Hi,

Good morning I am Dr R Melitha, practicing as general physician at Rohini Delhi.

Now I am going to talk about most common topic which is which everybody knows that is PCOD. PCOD is Polycystic ovarian syndrome occurring in females affecting 5 to 10% of women, often effects in the age group of 15 to 45 years. Whenever you come across here, young fat girl having menstrual disturbance, facial hair growth, gain in weight, acne and if a young married woman comes across not becoming pregnant, it may be a case of Polycystic ovarian syndrome. Polycystic ovarian disease is a syndrome is characterized by excess of androgen production. Next is an ovulation and increase insulin resistant, how will the patient present a symptom, patient usually comes to the clinic having menstrual problems, menstrual problems are either scanty menses or they are not getting menses for 3 to 4 months. They come with hairy growth on the face, obesity, recurrent miscarriage, chronic pelvic pain that is pain in lower abdomen and they may come across with insulin resistant problem like hypertension, cardiovascular diseases and obesity and acanthosis nigerians that is pigment and patch, usually seen on the nape of the neck, the axilla and inner aspect of the thigh. Now you all come to know what are the causes which produces PCOD, causes are usually unknown, it is genetic it may be due to change in lifestyle, diet and stress. What are the pregnancy complications are with PCOD they are usually come with recurrent abortion, impaired glucose tolerance test, gestational diabetes that is blood sugar level usually high during pregnancy and small for deep babies which means the babies size do not correspond with the duration of pregnancy. Then out of diagnose a case of PCOD, PCOD is diagnosed by simply by doing ultrasound, ultrasound examination tells multicystic enlarged ovary or Polycystic Ovary with oyster wall effects. Secondly you can do blood test, blood test includes thyroid including hormones, fasting insulin level, triglyceride, cholesterol, testosterone, progesterone, FSH, LH and androgen level. How to diagnose, in case diagnose is done by these things what is the aim of the treatment of polycystic ovarian syndrome, aim of the treatment is reduce the symptoms, First is to reduce the weight, how will reduce the weight? Weight is reduced by exercise, diet, diet you have to have is which in carbohydrate, Omega 3 fatty acids, reduce calorie intake, reduce saturated fat and reduce cholesterol level. The next is to increase fertility, the patients usually come with not becoming pregnant, so do ovulation induction and in very rare cases you have to go for surgery to treat the polycystic ovarian disease syndrome. Secondly, you have to treat the fertility cases treatment of recurrent infection, diet advice, reducing cholesterol level and treatment of facial hair growth.

I am Dr R Melitha, practicing in general physician, practicing in Rohini and Gandhi Vihar.

Today my topic of discussion is regarding diabetes mellitus. Diabetes is one of the most talk about disease across the world, especially in India. WHO estimated that 80% of diabetes occurs in lower and middle income guys. India has more great result 50 million in term Type-2 diabetics which is called diabetes mellitus. And this is increasing in all mainly incidence in India.

Now let me talk about what is diabetes, diabetes is a disease creates by hypoglycemia and glycosuria that means increase in blood sugar level and appearance of sugar in urine. It occurs due to deficient production or deficient absorption of insulin which comes in the pancreas. Now what are the types of diabetes, there are 4 types of diabetes, one is Type 1 Diabetes which is naturally called insulin-dependent diabetes, it occurs insulin childhood, it is insulin dependent, it usually asymptomatic, it is due to pancreas not able to produce sufficient insulin.

Second is type 2 diabetes mellitus, it is a most common, it occurs in adulthood, it occurs due to deficient absorption of insulin, secondly, it also occurs due to change in lifestyle, not adequate exercise and diet patterns.

Third is gestational diabetes, gestational diabetes is the diabetes increase in blood sugar level during pregnancy and such cases are likely to go into type 2 diabetes mellitus in the letustis, if they are not already suffering from diabetes before these. Last is pre-diabetes, Pre-diabetes is a condition in which blood sugar level is not that much high enough to be classified in Type 1 and Type 2.

What are the symptoms of diabetes? Diabetes symptoms are usually classified as a track Polyuria, Polydipsia, Polyphagia which means increasing urination, increase in thirst and increase in appetite. Secondly, patient complaint of blurring of vision, they complaint of high blood sugar level, wound is not healing despite taking treatment. They may come with the nausea, vomiting, loss of weight, fatigue and where is may come with Sexual problems, may come with infections and they may come with skin problems. Secondly Dash investigate a case of diabetes there are three tests, four tests, mainly fasting blood sugar and postprandial blood sugar, fasting blood sugar is taken under is everybody knows, postprandial Dash 2 hours after breakfast heavy breakfast or after taking glucose Dash, which is normally 120 to 160 milligrams.

Next is Oral GTT which is positive grade control the milligrams and continuous to this further and the last is HbA1C test which is the most important test then insulin which is like it Hemoglobin level, this gives the level of blood sugar level for the past 2 to 3 months that is 8 weeks to 12 weeks. How the diabetes is transmitted? Diabetes transmitted by genetic, due to recently due to change in Lifestyle, fat, diet, and poor exercise and family history, due to hypertension patient with hypertension, cardiovascular diseases also likely to develop diabetes.

Now next is how will you prevent or control the diabetes, prevention starts with changing Lifestyle, diet pattern, exercise and taking care of body, taking care of skin and all other things and what are the complications of diabetes, complications it can affect major target organs like eye, kidney, liver, skin, nervous system and also causes hypertension and cardiovascular diseases and strokes. Is diabetes is curable everybody ask, unfortunately there is not any cure for diabetes but maintaining good exercise, healthy lifestyle, diet and taking medication on regular time you may lead a normal healthy life in diabetes. It is such a big topic, difficult to cover everything in short time.

If you have got any problem you can come to my clinic.