Lady Problems

Many women suffer from this problem but very few are willing to speak about it. Urinary stress incontinence is the condition whereby a person involuntarily urinates when sneezing, coughing, laughing or exercising. However, there is a solution for this problem.

“There is a large number of women who suffer from this problem, and naturally, too many are embarrassed to speak about it.” Says Dr. Kiran Bijlani, Specialist Gynecologist at Royal Bahrain Hospital. The difficulties faced day to day by sufferers are numerous. A woman wouldn’t be able to keep fit and go to the gym because of the possible occurrence, and some women may limit their social life as they’re afraid that laughing, coughing or sneezing in public could lead to an embarrassing situation. In fact, many of these women find themselves worrying constantly when in public, because a cough or a sneeze could cause them major public humiliation. The stress compounded from worrying about this situation and constantly being cautious could have many side effects on the woman.

On that note, Dr. Kiran delivers some positive news. “There is a way to solve this problem. In fact, some of the treatments would take no more than 15 to 20 minutes!” All treatments are minimally invasive or non-invasive, and the majority of them do not take a lot of time. Dr. Ravisankar Pillai, Specialist Urologist at Royal Bahrain Hospital, explains about the treatments. “For example, trans-cutaneous electric nerve stimulation is a non-invasive treatment done over a series of sessions, whereas Botox injections, sub-urethral slings and the use of bulking agents are minimally invasive procedures. Additionally, Royal Bahrain Hospital also offers all the major surgeries in case the problem is found to be more severe.”

The problem is pinpointed through urodynamic testing, an advanced test that will analyze the urine in order to conclude what is the source of the urinary incontinence. From there, the doctor can decide on a procedure that will solve the issue.

“This is truly a life changing procedure for many women.” Says Dr. Kiran. “Women who were afraid to exercise can enjoy a trip to the gym, and laugh with their friends and family without worry.”

Dr. Kiran Bijlani [MBBS, M.D., DGO] is a Specialist Gynecologist and Dr. Ravisankar Pillai, [MBBS, MD, FEBU] is a Specialist Urologist at Royal Bahrain Hospital. To book your appointment, call 17246800 and visit www.royalbahrainhospital.com for more information.

50th Baby Milestone!

Last Wednesday, on the 14^th of December, Royal Bahrain Hospital celebrated the birth of the 50^th baby in the hospital’s state-of-the-art maternity ward. During the celebratory cake cutting ceremony, Dr. Ravi Preet, Chief Operating Officer at the hospital commented that “We’re very pleased with reaching this milestone. To have arrived at this point shows the fruit of our hard work.”

It was only back in August, when the first baby was born, and to have reached the 50^th baby in less than five months shows how fast news about the hospital’s high-end maternity department has spread.

The newborn Bahraini boy was born on Wednesday afternoon, and medical staff reports that he and the mother are well and healthy. Her doctor was Dr. Kiran Bijlan [MD, BGO], Specialist Gynecologist, who is currently working at Royal Bahrain Hospital.

The family has expressed their happiness and gratitude to the hospital staff for their services. The mother says “Dr. Kiran was very good, I was very pleased with her support and work throughout the process, especially as it was my first baby. It went by very smoothly thanks to her.”

In celebration of this milestone, Royal Bahrain Hospital has gifted the new baby with some privileges, including three months’ worth of free consultations with the pediatrician, a substantial discount on vaccines and laboratory investigations, in addition to a baby kit for the newborn.

Dr. Abdul Gaffar, Medical Director of Royal Bahrain Hospital cheerfully added in that “Our hospital aims to provide services for people of all walks in Bahrain, and we’re very happy to celebrate this baby, and wish to have the privilege of having more births in the future.”

Breast Cancer: What Do You Actually Know?

According to the World Health Organization, breast cancer is the top cancer to affect women in both the developed and developing world. Considering that October is Breast Cancer Awareness months, it is important to be aware of the risk factors, prevention and treatments for this devastating disease.

There are many risk factors, some of which we can control and some that we cannot. Of course, being a woman greatly increases your chances. The American Cancer Society estimates that 5%-10% of breast cancer cases are hereditary. Your risk of breast cancer doubles if a first degree relative (i.e. mother, sister, or daughter) has had cancer.

Factors that can be controlled would include our diet and exercise habits, as obesity increases the risk of cancer, while indulging in physical activity for 1.25 to 2.5 hours per week can reduce the risk by 18%.

Although many believe that it starts with a lump, that is not the only sign. Pain, irritation, redness, dimpling, scaliness or swelling or any other unusual changes are possible symptoms, and are not diagnosable unless reviewed by a doctor.

In fact, not all breast lumps are cancerous. Some lumps are benign, such as cysts, which are sacs of fluid that build up in the breast tissue. According to the Macmillan Cancer Support, a top cancer support charity in the United Kingdom, nearly 1 in 10 women will have cysts at some time during her life. Another type of lump is a fibroadenoma, a solid tumor that is made of glandular and fibrous tissue and most commonly found in women in their 20s and 30s. Cysts and fibroadenomas are easily treated, and therefore you should visit a doctor regardless of your fear of finding out if it may be cancer.

If it has unfortunately been found to be cancer, many women should still hold hope. Getting screened as earliest as possible is a must, as the National Cancer Data Base shows a survival rate of women treated whilst in the earliest stages between 81% to 93%, while being treated at much later stage shows a survival rate from 67% to as low as 15%.

Schedule a normal check-up or a mammogram with your doctor if you feel you’re at risk or if you’ve noticed any unusual changes.

To schedule a women’s health check-up, call Royal Bahrain Hospital on 1724 6800 or 8000 1090 and schedule your appointment.

Newborn Baby Health II: Skull and Skin

Having a newborn baby, especially if it’s your first, could cause parents a lot of stress if they don’t know what’s medically normal. Does my baby’s skull feel normal? Is that skin color natural? Dr. Suresh Chandran will tell you what to look out for in your newborn, and when it’s necessary to see a doctor.

Common illnesses found in the skull: According to Dr. Suresh, ‘caput’ is probably the most common finding in a neonatal skull, which is the swelling of the skull. You will notice the swelling across the midline which is soft to the feel. Normally, this resolves itself within a few days. However, if you notice a swelling not across the midline, which lasts from weeks to months, then you must definitely take your baby to a doctor. This type of swelling occurs if blood collects in the deep layers of the skull, and it could cause anemia at birth, jaundice, calcification and hardening over the skull bone.

Jaundice means the yellowish discoloration of skin and mucus membrane, and it’s quite normal as all babies get jaundice in the first week. This happens because the hemoglobin is changing from fetal to adult type. Adequate hydration, urine output and bowel movements are essential for the clearance of bilirubin (which is released by the dying fetal red cells) from the body. This discoloration will appear after the third day, but if it appears within the first two days and persists beyond two weeks. If detected early, then a simple treatment with blue light and adequate feeding will suffice. However, if the baby remains jaundiced beyond two weeks need to see a doctor and have a number of investigations done.

In some occasions, the jaundice could be breast milk jaundice, where the baby would have high yet safe levels of jaundice that last up to three months. This is diagnosed by exclusion, and usually mothers have a given history of previous babies with prolonged jaundiced.

Look out for Dr. Suresh’s next article in this series on newborn health. Dr. Suresh Chandran [MD, MRCP, MRCPCH (UK), DCH, FRCPCH (Lond), CCST] is the Consultant Neonatologist available exclusively at Royal Bahrain Hospital from September 10th until September 17th. Call 1724 6800 to book your appointment now.

Don't Have a Lazy Pregnancy

“During the 40 weeks of pregnancy, exercise maybe the last thing on your mind.” Says Dr. Siti Saleha, Senior Specialist of Obstetrics & Gynecology at Royal Bahrain Hospital. “However, staying physically active can make your pregnancy easier.”

According to Dr. Siti, exercise can strengthen the muscles used in labor and delivery, lessen some of the discomfort of pregnancy, give you more energy and make you feel better. The American College of Obstetrician & Gynecology recommends at least 30 minutes of moderate activity daily during pregnancy.

Most doctors will agree on one thing, and that is that the type of exercises you can do depend on your health and how active you were prior to pregnancy. However, this is a dangerous time to take up a new and exciting sport states Dr. Siti, “Although, swimming, walking, Pilates, yoga, and low impact aerobics (designed for pregnant ladies) are okay in moderation.”

“However, do remember in pregnancy that your center of gravity shifts and your balance changes. This may put you to a greater risk of falls.” She advises, asking pregnant women to remember to avoid getting heated (so limit outdoor exercise in hot weather), avoid activities that make women tired or have a high risk of falling or abdominal trauma, and be sure to drink loads of water and wear good support shoes and bra.

Safe well planned exercises during pregnancy will lead to a healthier pregnancy and a quicker post-pregnancy recuperation time. Dr. Siti’s final thought? “I will advise any pregnant woman out there to exercise, but if you are having complications during pregnancy, you will need to consult your obstetrician.”

Dr. Siti Saleha is the Senior Specialist of Obstetrics & Gynecology at the Royal Bahrain Hospital. To book your appointment, call 17246800 or visit www.royalbahrainhospital.com

Revealing Your Baby

Every mother- and father-to-be dreams of having a healthy baby. One of the first signs of baby’s health can be established by verifying whether or not it has a normal chromosome set and no organ abnormalities. To achieve this goal, antenatal ultrasound examinations (U/S) play the most important role. Also, preventing a preterm delivery and ensuring maternal health are essential. This involves taking care of chronic diseases, such as diabetes or hypertension, and determining which mothers have high-risk pregnancies (for example, identify those mothers likely to develop preeclampsia, which is pregnancy related high blood pressure and associated with kidney damage).

Nowadays, U/S examination is a major part of the routine antenatal follow-up and every couple should be offered a First Trimester U/S, with or without screening (biochemistry and measurement of nuchal translucency, etc.) and can accurately determine the estimated date of delivery. The earlier multiple pregnancies are detected, the better. If fetuses share a single placenta (monochorionic twin pregnancy), there is an increased risk for pregnancy complications when compared to fetuses with their own placenta. Therefore, monochorionic twin pregnancies should be followed by U/S every 2-3 weeks; other twin pregnancies can be examined every 4-6 weeks. Certain abnormalities can be identified at this early stage and genetic counseling given to parents. If parents want to know their risk for genetic problems, combining the U/S examination with the biochemistry allowing the identification of mothers at high risk for abnormal chromosomes or other pregnancy complications in up to 92-95% of cases. 

After genetic counseling, invasive genetic testing can be offered (chorion villus sampling (11-14 weeks) or amniocentesis (15 weeks onwards). A detailed organ scan at 20-22 weeks completes the risk assessment. If U/S shows a normal intrauterine pregnancy and no soft markers for abnormal chromosomes, a sensitivity of up to 96% can be achieved for finding chromosomally abnormal babies without invasive testing. This is especially pertinent today when more and more prospective mothers are above 35 year of age. The risk of having a Down syndrome baby, for instance, increases with age. As an example, a 25 year old woman has a risk of 1:1352 (at 40 weeks) whereas at 35 years the risk is 1:356 and at 40 years 1:97. The doctors performing a First Trimester Screening should be certified by the Fetal Medicine Foundation.

Dr. Heli Spalding [MD, PhD] is a Consultant Obstetrician and Gynecologist and Specialist in Fetal Medicine at Royal Bahrain Hospital. For more information or to book your appointment, call 1724 6800 or plan your visit at www.royalbahrainhospital.com.