Wednesday, August 11, 2021

Ovulation induction follicular study & IUI!

We plan to treat you for ovulation, so you need to consider your fertility issues. It is administered by taking tablets or injections from 2/3 days of menstruation (count the first day of menstruation as 1 day). This treatment is monitored by serial ultrasonography or transvaginal sonography (TVS) of the lower abdomen from 9/10 days of menstruation. Occasionally, monitoring begins 2/3 days before menstruation, so that there are no cysts or old follicles in the ovaries from the previous cycle. Evaluate through observations to determine ovarian follicles (developing egg sacs containing liquid eggs) and endometrium (where the embryo settles and develops in the uterine bed). Helps us to recommend suitable days (s) for timely intercourse (TI), intrauterine insemination (IUI), or donor insemination (DI)!

You may have to come for follicular studies, each menstrual cycle/month, up to 3-6 times in full! It is better to do a follicular study every day from 9 am to 12 noon! This study should follow the rules and regulations exactly as it is suitable for you! Every day, after finishing the study you will be seen by the doctor or his assistant, anyone can be available at that time! Necessary treatment will then be advised by reviewing all reports.

This time we recommend a special injection that helps to release the ovum (ovulation) at a specific day and time when your follicles are ready. Alternate days) should be within 10-18 days of menstruation. Two days after the last injection, a final session of follicular study will be held to confirm ovulation.

Some of you may need Intrauterine insemination (IUI) using your husband's semen, as part of reproductive therapy! Donor Sample for Pregnancy (DI) We can use If your husband's semen report is abnormal, we do so with your permission. But the exact day and time you will be informed according to the results of the follicular study is just then, IUI / DI is usually performed just before the estimated time of ovulation. Your husband should abstain from sexual intercourse until the day after menstruation before IUI.

You have to report to your husband at our center on the day of IUI / DI as per the given appointment. The procedure will be completed about 1-2 hours after semen collection, as it takes some time to prepare the sample properly, you have to lie down for 15 minutes IUI / DI. After DI, normal life and activities are allowed that. The chances of success are greatly improved on IUI days and the same day with normal sexual activity. The final session of follicular study will be held the day after IUI / DI to confirm ovulation. If there is no ovulation, a repeat injection will be given the next day by a repeat IUI / DI.

You may need to do follicular studies about 6-12 cycles a month, of which IUI / DI can be done in 4-6 cycles. As a result, most patients become pregnant by then.

Friday, July 30, 2021

An Effective solution for infertility couples is in Vitro Fertilization (IVF)!

 Infertility is a significant problem and has a considerable impact on the lives of couples, especially in social and cultural contexts. It is very hard on couples and in India, is often regarded as a curse. Most of the couples try everything under this planet from quacks to alternative systems of medicine and often resort to astrologists and tantriks performing blank magic to become fertile. The Western system of medicine did not have much to offer earlier. However, in the 1970s and 1980s, infertility was considerably treatable and thus liberated the couples from the limited options available at the point of time (like adoption using donor insemination or becoming reconciled to childlessness). Fortunately. Over the last few decades our understanding of infertility. Its cause diagnosis and management have taken major strides forward. Couples with infertility began to see new hopes with the advent of in vitro fertilization (IVF). This technique is also known as “test-tube baby” as life is created outside the body with the union of sperm and egg in the laboratory and then transferred into the womb to grow until delivery. An array of assisted reproduction techniques (ART), each designed for treating different causes of infertility were then developed.


Launch of IVF


The technique of IVF was developed in the United Kingdom by Patrick Steptoe and Robert Edwards. The first ‘test-tube baby, Louise Brown, was born in Oldham. Greater Manchester, England. On July 25, 1978, amidst intense controversy over the safety and morality of the procedure. In India, Subash Mudhopadhyay became the first physician, and the second in the world to perform the procedure and produced the test tube baby ‘Durga’ on October 3. 1978. However, unfortunately, and paradoxically, instead of reorganization, the social ostracism, insult, reprimand, and refusal of the Indian Government to allow him to attend international conferences led him to commit suicide in 1981. Subsequently, major pioneering developments in IVF have occurred and IVF has exploded in popularity with as many as 1% of all births now being conceived in vitro, and since then 3 million babies have conceived through IVF.


Evolution of IVF


The introduction of fertility drugs and the ovarian stimulation process led to the concomitant increase in eggs recovered and embryos transferred. However, multiple eggs and embryos production necessitated the development of suitable embryo freezing techniques ( cryopreservation) which enabled the preservation of embryos for subsequent use by the IVF patients. Improvements in culture media, ovarian stimulation, and the introduction of oocyte maturation in IVF led to the sustenance of IVF pregnancies.


New techniques for egg and embryo donation were developed. Embryo donation was integrated into ART and helped to establish pregnancy in infertile or sterile women who had no ovarian function (sterile and older women usually> 40 years), worldwide. While IVF was considered a potential benefit for the treatment of male and idiopathic infertility, the development of Intracytoplasmic sperm injection (ICSI) in 1992 was a breakthrough in managing male infertility. In this technique, a single sperm is injected into the egg under microscopic guidance to ensure fertilization of the egg even with few sperms. Subsequently, ICSI has been adopted as the treatment of choice for all categories of male infertility, provided some sperm can be recovered from ejaculation or from testes. 


Glimpses of Statistics


Infertility defined as the inability to conceive after one year of unprotected intercourse affects approximately  10% of couples. This is due to the fact that the probability of conception in one reproductive cycle is typically 20- 25%. And in One year is approximately 90%. There are various male and female factors leading to infertility; however, regardless of the cause of infertility, the treatment that leads to the highest pregnancy rate per cycle is IVF. There has been a remarkable increase in the number of IVF cycles worldwide since its inception in 1978. And success rates have increased every year approximately 1 in 50 births in Sweden. 1 in 60 births in Australia and 1 in 80- 100 births in the USA now result from IVF. In 2003 more than 1000,000 IVF cycles were reported from around 400 clinics in the USA. Resulting in the birth of > 48,000 babies.


Indications of IVF


Several groups of patients in which IVF treatment is useful to include women with blocked, damaged fallopian tubes or removal of fallopian tubes after ectopic pregnancies along with women with endometriosis cervical mucus problems. Men with infertility problems, men or women with immunological infertility, and couples with unexplained infertility are also groups in which IVF is beneficial. Even though the original indication for IVF was tubal damage, it is now used for a wide range of disorders such as unexplained infertility, endometriosis, male factor infertility, failure to conceive after successful ovulation induction, and failure to conceive after intrauterine insemination (IUI). In the case of severe male infertility, IVF is converted to ICSI. However, in the total absence of sperm and eggs, donor samples are used.


In spite of such a revolution in infertility management, until recently, the majority of infertile couples anywhere unable to get the benefits of IVF and ICSI. This is largely due to centers offering such treatments were few and the cost of procedures was beyond the reach of the majority.

Saturday, January 2, 2021

Why the idea of ​​high-quality healthcare is often confusing when it comes to big profits

Many healthcare facilities do not focus on achieving the goal of providing high-quality healthcare to patients. Some of these benefits are mainly focused on making a profit. Most of these companies hire business conscious people to manage their operations/business departments. As a result, the operational managers of some hospitals, nursing homes, or home care agencies may not have a clinical background.

The decision to hire a professional operational manager with no clinical background can adversely affect the quality of healthcare in many settings. These individuals generally do not prioritize patient safety or optimal patient outcomes. While some operational managers may perform certain tasks as an operational manager for strategy managers and nurse managers, all work must be taken over by the nurse manager. Whether a nurse manager who has been deputed for this role shows any benefit from being treated by him or her physician can be regularly pressed.

High-quality healthcare and beneficial coexistence can occur. However, it is rare in many places. An appropriate business model should be applied to facilitate high-quality healthcare and coexistence. High-quality healthcare means providing the care that patients need. There are successful business models in well-structured healthcare environments, where qualified and highly trained individuals are placed in key positions.

Individuals in key positions are charged with making important decisions within the organization. Failure of the healthcare profession may result in dissatisfaction of patients, defects, or deaths of properly trained persons within their business model deb.

The safety of the patient can be compromised to create the number

In some settings, clinical staff may find themselves in various trajectory courses in the operational department. An operational manager who focuses on making a profit can neglect the safety needs of patients. This is not surprising to those working in the healthcare sector.

Over the years, nurses and certified nurse assistants (CNAs) have found themselves with fewer resources. Despite the lack of resources, they are still hoping for some positive results. Decisions to limit resources among employees are usually reciprocated by operational managers or nurse managers.

It is a common practice in healthcare settings to focus on reaping the benefits of high-quality care. Some time ago, the staff at the dialysis unit were given several pairs of gloves in a ziplock bag. Employees were told by the non-clinical operations manager that it was their day’s glove quota. The high risk of infection and the high probability of cross-contamination from the blood was never included in this decision.

A nursing home was probably pressed for cutting costs known for the chronic absence of gloves and soaps that had a persistent odor of stool and urine on some floors.

To save money, the operations department of a home care agency refused to follow the clinical manager's instructions that more than two hours of paid field training was required before nurses could insist on innocent patients. The operations manager/account manager of the same home care agency protested against the child protection services at home, fearing that the child's family might be ruined and the contract may be withdrawn from the agency.

A nursing home staff advised that some defective supplies needed for daily patient use could not be sent overnight because the agency did not pay for them. In that nursing home, there is a CNA that voices fatally; "We have enough staff and adequate supplies at this time when the state is expected to appear."

The above law can make a person serious with clinical training but does not focus on anyone for profit.

Reducing costly patient protection costs can result in large savings. However, those who make these decisions cannot believe that their overall goal is to provide patients with high-quality healthcare. The decision-making power that affects patient safety and comfort also shows who has the power in certain healthcare.

The diagnostic department is hesitant as it does not meet the expectations of the operations department.

Because of professional decisions where patient safety is compromised, many nurses are afraid to report to external agencies. Nurses, This is often at odds with the training that nurses receive in nursing school.

Some nurses may recall that while in nursing school there were professors who regularly insisted on it; "Nurses are agents of change." After real life for the healthcare system, some nurses May question the idea or refuse to believe it.

How many changes can a person nurse apply in his or her job? Healthcare facilities are focused on making a profit and are less likely to change their policies and procedures due to the advice of nurses.

When a New Jersey nurse was not informed of the cause of the problem by her nurse manager, the doctors refused to comply with a special state rule for the presence of doctors during an emergency demonstration of a particular procedure. The rationale was that doctors could not lose the contract with some of the benefits that physicians kept for their patients. When the nurse refused to comply, the supervising nurse continued to tolerate the company’s employment. Here, it was preferred to gain inpatient protection.

On another occasion, a nurse was told by her manager that she needed to be productive. As such, he was instructed to leave patients during a treatment process to regularly clean equipment in another part of the department. When the nurse refused, the supervisor countered.

As far as Texas doctors can go, the employer is inclined to take revenge on those who tried to criminalize the two nurses after reporting to the medical board.

For example, many nurses are afraid to create waves and are afraid to report the matter to outside agencies. In the case of organizations such as health or child protection services, reporting cases is usually seen to result in immediate loss of employment due to unintentional reasons.

Nurses can accept themselves as “agents of change” as they identify themselves as problem solvers and are unable to find employment with other organizations. The harsh reality is that employers still don’t mention it to employees. In 2013 a home care agency requested a staff reference from a hospital where an applicant had previously been employed. The hospital advised the agency to terminate the employee to whom the reference was requested, as it did not fit its requirements.

Personal sacrifice

Conscientious nurses often feel that the best care they can get is the best because there are very few who can change company policies and procedures.

Often, the best care is possible through personal sacrifice. The clock works to complete assignments or documentation that nurses accept as a general personal sacrifice. A caregiver at a healthcare center advised nurses that being punched late was tantamount to stealing from a company. Some nurses with that advantage have felt that their innings have many loose ends and are often poked late. While some nurses stayed up until the clock and finished their work, others punched, then went back to work to finish their work.

The caregiver of that facility was not able to understand where many nurses were placed in a position where they could not finish their work, but the amount of work assigned was excessive. The supervisor told the nurses that she had complained about her condition, only to find a way to finish the job. Punching late was no substitute.

In other situations, a caretaker learned that a certain process must be completed within a certain time frame. The nurses started working on the clock because they did not complete the process in a short time, putting their jobs at risk. These nurses were punished for working after a large part of the process was over. By punching after some time has elapsed, their time cards will not reflect that it has taken longer than is mandatory.

Many nurses who are forced into this kind of behavior often do not consider reporting to labor boards.

Cut corners to survive

Resource constraints can force employees with weak personalities to behave badly.

One nurse reported that while working in a particular nursing home she was often unable to change the timing of her medication passes and dressings. He finds himself working late several days a week. He was only able to complete these tasks much earlier than proposed. The nurse later discovered that there were other nurses in the same situation who found a way to deal with the situation.

Several years after leaving the aforementioned place of work, the nurse sat down with a former colleague to remind her of her experience on that special occasion. The nurse asked her former colleague how a nurse could prescribe so many drugs to so many patients in one ward. Many drugs require crushing and administration via G-tube. The second nurse reported that this kind of situation was usually handled Only with important drugs. Simply put, some drugs have never been given. Surprisingly, this behavior is still prevalent in health facilities.

Of course, the average nurse is not involved in doing wrong. However, it appears that the benefits that are profiting above patient protection or why they exist encourage these bad behaviors.

The solution

There is a solution to rehabilitating or creating a healthcare environment where profit-making and high-quality patient care are equally valuable. One solution is to hire only medically trained staff to manage all aspects of the healthcare facility. This includes CEOs, account managers, and administrators.

Healthcare administration programs can provide courses such as leadership skills, health information, accounting, marketing, and planning as part of a master's degree course. However, none of these courses prepare patients for interaction with patients in a way that connects physicians and nurses. If a patient suffers from poor quality healthcare, they are less likely to lose sleep without a doctor. A clinical operations manager may be more focused on the financial impact of a treatment error. As a result, the clinical training that nurses and physicians go through can play an important role in preventing certain behaviors driven by benefactors that physicians are often prepared to tolerate.

A long clinical component should be included in all healthcare management training programs offered by universities. All students in these programs must undergo practical training in clinical settings before qualifying for their degree. In-depth education about the disease process, impact on patients, proper nursing, and treatment interventions can change the mindset of these benefit-focused individuals.

As such, all treatment and nursing programs must include a wide range of business and operational components. This will ensure that all people working in the healthcare profession are equally skilled and motivated to ensure high-quality healthcare to patients while making a profit.

Conclusion

High-quality healthcare can coexist with great benefits. However, we should arrange for college-level clinical training of the accused persons for conducting healthcare activities and running the business department.