The patient, a full-time working professional, had long depended on her parents to manage bowel evacuation. A previous surgical intervention—Antegrade Continence Enema (ACE)—performed over ten years ago at another facility had failed, leaving her reliant on manual enemas administered by caregivers.

In search of a sustainable solution, she turned to Dr. VVS Chandrasekharam, Chief Surgeon – Paediatric Surgery and Paediatric Urology at Ankura Hospital. Following a comprehensive assessment, the multidisciplinary team proposed a novel, minimally invasive procedure—reportedly the first of its kind in India. The approach involved placing a PEG (Percutaneous Endoscopic Gastrostomy) tube into the cecum (the beginning of the large intestine) using only colonoscopic guidance. The method eliminated the need for traditional surgery or incisions, enabling the patient to flush her bowels independently.

“This advanced technique, known as colonoscopic cecostomy, was technically demanding due to her previous abdominal surgeries and expected adhesions. After careful planning and a thorough review of available literature, we successfully placed a 14 Fr PEG tube into the cecum using colonoscopic access,” shared Dr. Parijat Ram Tripathi, Senior Consultant – Paediatric Gastroenterologist and Hepatologist, Ankura Hospital who performed the procedure.

Just 24 hours post-procedure, a saline flush through the tube resulted in spontaneous stool passage—an unprecedented experience for the patient. She reported no discomfort, required no pain medication, and was discharged the next day in stable and satisfied condition.

“This procedure is a significant step forward in addressing bowel management challenges in individuals with neurological disorders like Spina Bifida,” said Dr. VVS Chandrasekharam. “Such customized, minimally invasive solutions can dramatically improve patient autonomy and quality of life”, he added.

Dr. Tripathi acknowledged the support of the OT team, in executing this complex case. He expressed optimism that similar patients could benefit from this innovative approach, offering a new lease on life through improved bowel control and independence.

Dr. Krishna Prasad Vunnam, Chairman & Managing Director, Ankura Hospital, added, “At Ankura, we strive to go beyond conventional care by combining compassion with clinical innovation. This case reflects our team’s unwavering dedication to transforming lives through personalized, forward-thinking medical solutions. I commend the doctors and staff involved in this pioneering effort, which sets a new benchmark in neurological and paediatric care in India.”

With a robust team of paediatric and super-specialty experts under one roof, Ankura Hospital remains committed to advancing clinical excellence and offering tailored, compassionate care to women and children. This successful procedure reinforces its growing reputation as a trusted centre for complex paediatric care in India.

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Dr. Krishna Prasad Vunnam, Founder and Managing Director of Ankura Hospitals, expressed his excitement about this significant milestone, said “This significant financial support from the Asian Development Bank is a testament to our commitment to improving Women & Children health in India. It will allow us to enhance our Pediatric, maternity and gynecology services, expand our facilities, and reach more families, ensuring they receive the highest standards of care.”

As part of its expansion strategy, Ankura Hospitals is focused on establishing new state-of-the-art facilities in key cities across India.

Ankura Hospitals specializes in providing world-class care in maternity and gynecology, offering services such as normal deliveries, cesarean sections, fertility treatments, high-risk obstetrics, and comprehensive prenatal and postnatal care. The hospital also features advanced surgical solutions in gynecology, including laparoscopic surgeries and treatment for various gynecological conditions.

Also, Ankura Hospitals is committed to providing world-class services, including advanced neonatal intensive care,all Pediatric sub-specialties pediatric surgery, child development, and behavioral health for children.

With the support from ADB, Ankura Hospitals is poised to enhance its facilities, broaden its impact, and continue delivering exceptional care across India.

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Thyroid disorders are among the most common endocrine conditions affecting women, significantly influencing fertility and pregnancy. The thyroid gland plays a crucial role in regulating metabolism, hormone production, and reproductive health. An imbalance in thyroid hormones—either hypothyroidism (underactive thyroid) or hyperthyroidism (overactive thyroid)—can disrupt ovulation, menstrual cycles, and overall reproductive function.

The classic definition of SCH is a thyrotropin (thyroid-stimulating hormone [TSH]) level greater than the upper limit of the normal range (4.5–5.0 mIU/ L) with normal free thyroxine (FT4) levels. With this definition, the incidence of SCH in the reproductive-age population is approximately 4%–8%.

 Recommendations for SCH vary between the American Society for Reproductive Medicine (ASRM), the Endocrine Society, the American Thyroid Association (ATA), the American Association of Clinical Endocrinologists, the American College of Obstetricians and Gynecologists (ACOG), and others

Available studies used a wide range of TSH levels to define SCH, ranging from >2.5–10 mIU/L, meaning various studies measured different exposure levels and are challenging to compare.

In addition, the goal of achieving a TSH level <2.5 mIU/L has resulted in significant delays in women receiving the appropriate infertility treatment or initiating an IVF treatment cycle.

Thyroid Disorders and Fertility

1. Hypothyroidism and Infertility
   Hypothyroidism occurs when the thyroid gland produces insufficient hormones, leading to symptoms like fatigue, weight gain, depression, and irregular periods. The deficiency of thyroid hormones can impact ovulation, reducing the chances of conception. In some cases, it can lead to anovulation (absence of ovulation), making it difficult for women to conceive. Hypothyroidism is also associated with an increased risk of polycystic ovary syndrome (PCOS), a condition that further affects fertility.

In India, approximately 10-12% of the population is affected by hypothyroidism, with women being more vulnerable. According to a study by the Indian Thyroid Society, nearly 22% of women in Hyderabad suffer from thyroid disorders, impacting their reproductive health significantly.

2. Hyperthyroidism and Fertility Issues
   Hyperthyroidism, caused by excessive thyroid hormone production, leads to symptoms such as weight loss, rapid heartbeat, anxiety, and irregular menstrual cycles. Women with untreated hyperthyroidism may experience difficulty in conceiving due to hormonal imbalances and increased metabolic activity that can alter reproductive hormone levels. Conditions like Graves’ disease, an autoimmune disorder, are often responsible for hyperthyroidism and can further complicate fertility.

In India, the prevalence of hyperthyroidism is lower than hypothyroidism but still affects around 1-2% of the population. Hyderabad-specific hospital records indicate that 15% of thyroid-related cases among women are due to hyperthyroidism.

3. Thyroid Antibodies and Autoimmune Infertility
   Autoimmune thyroid conditions, such as Hashimoto’s thyroiditis, can lead to the production of thyroid antibodies that interfere with ovarian function and embryo implantation. Studies indicate that elevated levels of thyroid peroxidase (TPO) antibodies are linked to an increased risk of miscarriage and infertility in women.

Thyroid Disorders and Pregnancy Complications

Thyroid disorders, if left untreated during pregnancy, can lead to serious maternal and fetal complications. Some of the major risks include:

• Miscarriage and Preterm Birth: Uncontrolled hypothyroidism or hyperthyroidism can increase the likelihood of early pregnancy loss and preterm labor. In India, thyroid disorders contribute to 8-12% of pregnancy complications, with Hyderabad recording a higher prevalence of 14% due to lifestyle and dietary factors.
• Preeclampsia: Hypothyroidism is associated with high blood pressure and proteinuria during pregnancy, increasing the risk of preeclampsia.
• Low Birth Weight and Developmental Issues: Poor thyroid function in the mother can impact fetal brain development, leading to cognitive impairments and growth restrictions in newborns. Studies from Indian hospitals indicate that nearly 20% of infants born to mothers with untreated hypothyroidism have low birth weight.
• Gestational Hypertension: Abnormal thyroid hormone levels can lead to high blood pressure during pregnancy, posing health risks to both the mother and baby.

Managing Thyroid Disorders for Healthy Fertility and Pregnancy

1. Thyroid Function Tests: Women planning to conceive should undergo regular thyroid function tests (TSH, T3, and T4) to detect any imbalances early. In Hyderabad, major fertility centers report that nearly 30% of infertility cases are linked to thyroid dysfunction.
2. Medication and Treatment: Hypothyroidism is usually treated with levothyroxine, while hyperthyroidism may require anti-thyroid medications, beta-blockers, or, in severe cases, radioiodine therapy or surgery.
3. Diet and Lifestyle Changes: A well-balanced diet rich in iodine, selenium, and zinc can support thyroid function. Managing stress, avoiding excessive caffeine intake, and maintaining a healthy weight can also improve reproductive health. In India, iodine deficiency is a major cause of thyroid disorders, with over 42 million people affected.
4. Monitoring During Pregnancy: Pregnant women with thyroid disorders should undergo frequent monitoring and medication adjustments to ensure optimal hormone levels and a healthy pregnancy.

Conclusion

Thyroid disorders play a vital role in female fertility and pregnancy outcomes. Early diagnosis, proper treatment, and lifestyle modifications can help women with thyroid imbalances conceive successfully and have a healthy pregnancy. Women experiencing difficulty in conceiving or recurrent miscarriages should consult an endocrinologist and gynecologist for comprehensive thyroid evaluation and management. Given the increasing prevalence of thyroid disorders in Hyderabad and across India, awareness and early intervention are crucial to improving reproductive health outcomes.

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The patient was brought to Ankura Hospital, Gachibowli and was suffering from recurring headaches for a long period affecting his academic performance and daily activities. Despite the child parents having sought medical attention multiple times for his recurring headaches including taking chronic analgesics and ayurvedic medications for the past five years, no relief in symptoms. Apart from worsening headaches, the child experiences weight gain and other symptoms like dizziness, and fear of light which eventually led them to visit Ankura Hospital for Women and Children, Gachibowli.

Dr K Uday Kumar, a Pediatric Intensivist, Ankura Hospital for Women and Children, said, “The child had been suffering from headaches for a long period, affecting his academic performance and daily activities. As this appeared to be more than a common headache, a consultation with a Paediatric Neurologist at our center was sought.”

Dr Amol Kumar Jadhav, Paediatric Neurologist, Ankura Hospital, Gachibowli, said, “Based on the child’s complaint of increased headaches at night and in early morning, which got particularly worse when lying down, we suspected it to be Idiopathic Intracranial Hypertension. After discussing with his parents the use of advanced diagnostics including MRI of the brain and CSF analysis and taking their approval, we have confirmed the underlying problem. The CSF pressure was found to be 34 cm of water, which is significantly higher than normal pressure, and neuroimaging revealed features of IIH thus confirming the diagnosis of Idiopathic Intracranial Hypertension in the child. “

Dr Amol Kumar informed, “Missed diagnoses in conditions like IIH can have serious health consequences. It also increases everyday debility for the patients and their families. Though more common in females, it’s always prudent to suspect IIH in males too, especially if they are obese and have typical symptoms. Identifying this condition early is crucial for effective management.”

According to Dr Krishna Prasad Vunnam, Medical Director, Ankura Hospital, Hyderabad said, “At Ankura Hospital, we are committed to identifying and managing even the most challenging medical conditions. Diagnosing this rare case of idiopathic intracranial hypertension in a young patient highlights the importance of early detection and specialized care. Our team worked carefully to ensure accurate diagnosis and tailored treatment, offering the best possible outcome for the patient.”

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Hyderabad: 02^nd December, 2024: Ankura Hospital, a leading and trusted chain of women and child care hospitals, is proud to announce the official opening of 9M Fertility, a state-of-the-art and exclusive infertility treatment center, at KPHB, Hyderabad. The facility is a level 2 IVF centre designed to provide comprehensive fertility services, blending the latest technology with personalized care. The center focuses on ethical, evidence-based treatment, offering a wide range of cutting-edge services aimed at addressing the diverse needs of couples seeking to start or expand their families.

9M Fertility stands out for its focus on four key pillars: ethical and transparent service, an individualized approach, evidence-based treatments, and the use of advanced technology. Equipped with state-of-the-art facilities, the center offers a variety of infertility services, including fertility preservation, vitrification of sperm and eggs, pre-genetic testing for chromosomal abnormalities, and treatment options for male infertility. Additional, services include fertility testing, egg donation, and surrogacy options, making 9M a one-stop solution for all infertility needs. A multi-disciplinary team of fertility experts, embryologists, neonatologists, and other healthcare professionals work together to provide the best and most predictable solutions for each couple, ensuring a personalized and safe treatment experience

Dr. Krishna Prasad Rao Vunnam, Founder and Managing Director of 9M Fertility and Ankura Hospital for Women and Children, shared his excitement about the new center, “KPHB is where the journey of Ankura Hospital first began. It’s incredibly satisfying to have supported women and children here with specialized healthcare services. With 9M Fertility, we now bring much-needed solutions for infertility to this community. Looking ahead, we recognize the growing demand for specialized infertility care, and we are thrilled to extend our trusted solutions for infertility to more communities. We have plans for expansion to other locations in Telangana and Andhra Pradesh, helping even more couples with their journey to parenthood.”

9M Fertility, a sun brand of Ankura Hospital for Women and Children, is renowned for its exceptional fertility treatments, boasting an 87% success rate over a year, well above international standards. Committed to top-tier care and ethical practices, 9M Fertility aims to support families on their journey to parenthood.

Ankura Hospital remains committed to delivering the highest standard of holistic healthcare for women and children, continuing to be a beacon of trust and excellence in the medical field.

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Menstruation, a natural and cyclical occurrence in a women’s life, typically happens once a month. However, in some cases, women may experience menstruation twice a month. This irregularity can be concerning and may warrant a closer look into the underlying factors contributing to this phenomenon.

Understanding the Menstrual Cycle

Before we dive into the reasons behind menstruating twice a month, it’s essential to have a comprehensive understanding of the menstrual cycle. On average, a menstrual cycle lasts around 28 days, although it can range from 21 to 35 days and still to be considered as normal. The menstrual cycle consists of several phases, including menstruation (the shedding of the uterine lining), the follicular phase, ovulation (the release of an egg from the ovary), and the luteal phase.

Common Causes of Menstruating Twice a Month

Hormonal Imbalance: One of the most frequent reason behind experiencing two period in a month is Hormonal Imbalance. Hormones like estrogen and progesterone play a pivotal role in regulating the menstrual cycle. An imbalance in these hormones can lead to irregular periods, including more frequent menstruation. It’s crucial to understand that hormonal imbalance can be triggered by various factors such as Stress, Medical Condition and Lifestyle Change.

Stress: High levels of stress can disrupt the normal functioning of the menstrual cycle. Chronic Stress may lead to hormonal imbalances and erratic menstrual patterns, causing more frequent periods. Stress management techniques, including mindfulness, meditation, and exercise can help restore regularity to the menstrual cycle.

Polycystic Ovary Syndrome (PCOS): PCOS is a common hormonal disorder that can result in irregular periods and also might get periods twice in a month. Women with PCOS often experience multiple small cysts on their ovaries, which can interfere with the regularity of their menstrual cycles. Treatments for PCOS typically involves lifestyle changes, medications, and sometimes surgery depending on the severity of the condition.

Uterine Fibroids: Uterine fibroids are noncancerous growths that can develop in or around the uterus. Depending on their size and location, fibroids can lead to heavy or irregular bleeding, sometimes causing two periods in a month. Treatment options for uterine fibroids include medication, minimally invasive procedures and in severe cases surgery.

Birth Control: Some forms of birth control, such as certain birth control pills or intrauterine devices (IUDs), can alter menstrual patterns. Women who have recently started or changed their birth control method may experience more frequent periods their bodies adjust to the hormones. If irregular bleeding persists, it’s essential to consult a healthcare provider to explore alternative birth control pills.

Perimenopause: Perimenopause is the transitional phase leading up to menopause, and it typically occurs when woman’s in 40s. During this time, hormonal fluctuations can cause irregular periods, including having two periods in a month. While perimenopause is a natural part of a woman’s life, the symptoms can often be managed with the guidance of a healthcare provider.

Thyroid Disorders: Thyroid conditions, such as hyperthydroidism or hyperthyroidism, can disrupt the menstrual cycle. These conditions affects the thyroid gland’s hormone production, which can leads to changes in the frequency and intensity of periods. Treatment for thyroid disorders may involve medications to regulate thyroid hormone levels.

What to do if you Menstruate Twice a Month

If you find yourself menstruating twice in a month or experiencing irregular periods, it’s essential to consult a healthcare provider. They can help determine the underlying cause of your menstrual irregularity through a thorough evaluation, which any include blood tests, imaging studies, and medical history review.

Once the condition is identified, treatment options will depend on the specific factors contributing to your irregular periods. In many cases, hormonal imbalances can be managed with medication or lifestyle changes. For conditions like PCOS, uterine fibroids or thyroid disorders targeted treatments are available to address the root cause and restore menstrual regularity.

Stress management techniques, such as exercise, meditation, and counseling, can be helpful for those whose menstrual irregularity is linked to stress. Additionally, maintaining a healthy lifestyle, including a balanced diet and regular exercise, can support overall reproductive health and hormonal balance.

Conclusion

Experiencing menstruation twice a month can be a concerning and disruptive issue for many women. However, it’s crucial to remember that there are various factors that can contribute to this irregularity, and most of them are treatable with the help of a healthcare provider. If you are facing this issue, don’t hesitate to seek medical advice and guidance to determine the cause and find a suitable treatment plan to regulate your menstrual cycle and overall health.

In summary, menstruating twice a month is not uncommon, and there are several potential factors at play. By understanding these factors and seeking appropriate medical guidance, women can take control of their reproductive health and ensure that their menstrual cycles remain regular and healthy.

The post Menstruation Twice a Month: Know the Factors behind its Occurrence By Dr. Sirisha Mallamuri, Consultant Obstetrician & Gynecologist, Ankura Hospital appeared first on newsmantra.in l Latest news on Politics, World, Bollywood, Sports, Delhi, Jammu & Kashmir, Trending news | News Mantra.