CLOSTRIDIUM DIFFICILE often called C-difficile, or C- diff, is a type of bacteria that causes symptoms that can range from diarrhea to life threatening inflammation of the colon.Since the commonest cause of this diarrhea is long term use of antibiotics , it is also called antibiotic diarrhea. In recent years C-diff has become more frequent, more severe and difficult to treat. Your risk is greatest if you are taking or have recently taken antibiotics. The risk is higher if you take multiple antibiotics for a prolonged period. Seen more in older age group, recently hospitalized for an extended period. C-diff infections are seen more in nursing home or longterm care facilities. It is found more among patients with weakened immunity and those who have some underlying medical illnesses. Patients who have had some abdominal surgeries or have colon disease such as inflammatory bowel disease , colorectal cancer or previous C-diff infection are also at risk. The antibiotic that most often leads to C-diff infection include fluroquinolones, cephalosporins, clindamycin and penicillins. These drugs can destroy some of the normal, helpful bacterias in your colon. Once established it produces toxins that attacks the lining of the intestine. The toxin destroys cells and produces plaques of inflammatory cells and decaying cell debris inside the colon. Some new strains of C-diff has emerged that are resistant to certain medications and are deadly. Stool tests like enzyme immune assay and tissue cultures are used to detect this infection.Flexible sigmoidoscopy is sometimes used to confirm the diagnosis. CT scan may be ordered if there is a concern about possible complications like pseudomembranous colitis. Bowel perforation and toxic megacolon are also some of the complication of C-diff.Severe diarrhea may cause dehydration and in some cases kidney function may deteriorate. If not treated promptly this can be fatal.Most common symptoms are, watery diarrhea 10-15 times a day, abdominal cramping, fever, pus or blood in the stool, nausea, dehydration, loss of appetite and weight loss. The first step in treating C-diff is to stop taking the antibiotic that triggered the infection. In an ironic twist, the standard treatment for C-diff is another antibiotic. Usually metronidazole , for mild to moderate and vancomycin, for severe symptoms are the drug of choice. Probiotics are given in conjunction with the antibiotics to restore intestinal flora.For people with severe pain, organ failure or inflammation of the colon , surgery to remove the diseased portion of the colon may be the only option. Would you like to share this with your colleagues? Email Be the first one to share this post

नामस्मरण आणि तारुण्य डॉ. श्रीनिवास कशाळीकर

बाल वयातच जर नामस्मरण सुरु केलेले तर आपले मन विशाल होऊ लागते. निष्कपट होऊ लागते. निष्पाप होऊ लागते.

यामुळे; वयोमानानुसार पती - पत्नीने वासना आणि आवडी निवडी जरी पुरविल्या नाही तरी आकर्षण आणि प्रेम कमी होत नाही.

प्रेम आणि समाधान टिकतात आणि वाढतात.

तारुण्यातला अपरिपक्व आणि संकुचित प्रणय ओसरला तरी त्याची जागा हा परिपक्व आणि लोकोत्तर ऋणानुबंध घेतो आणि चिरकाल टिकतो.

INDIAN MOS HEALTH ANUPRIYA PATEL SAYS "ILLEGAL SURROGACY IS A 2 BILLION DOLLAR INDUSTRY "



The government said commercial surrogacy has become a USD 2 billion illegal industry and a means to exploit vulnerable women even as it vowed not to let women in India become “baby factories”.

Minister of State for Health Anupriya Patel said commercial surrogacy has also become a means of exploiting children also, when they get abandoned. “We want to communicate that surrogacy should be the last option and we in no way are going to promote the idea of commercial surrogacy,” Patel told NDTV.


The minister also spoke on Surrogacy (Regulation) Bill 2016, which was recently approved by the Union Cabinet, and has drawn criticism from several quarters. She said the government is “conscious and sensitive” and various issues which has not been touched so far may be addressed in the course of discussions in the parliament. The bill is yet to be tabled in Parliament and there will be many more rounds of deliberation, Patel said.

“It’s a long process. I believe that the outcomes are going to be in the larger interest of the nation,” she said. She said 80 per cent of the total child births taking place through surrogacy in India are for foreign nationals. “Women in India are not baby factories. If you consider the total number of births of children which are taking place through surrogate mothers, 80 per cent of such births have been for foreign nationals. “Why are they doing this? Are Indian women only made for this purpose? They are trying to escape the tough laws of surrogacy in their own homeland and therefore they are coming to India because poor, vulnerable tribal women are easily available. They give them petty money,” she said. The bill proposes a complete ban on commercial surrogacy and allows only legally-wedded Indian couples to opt for it. It also seeks to bar unmarried couples, single parents, live-in partners and homosexuals from opting for surrogacy.

I THINK WHAT SHE SAYS IS ALMOST CORRECT ILLEGAL SURROGACY TREAT OUR POOR MOTHERS BADLY AND ONLY AS COMMIDITY TO BE PURCHASED BY MONEY

When couples start their family, they have many dreams. Subsequently many of them, if not all, plan to extend their family to give a sense of accomplishment. That is a journey from being couples to being parents. But unfortunately, in some couples the journey is not smooth and some of them have to struggle a lot for it. Yes, you are right. We are talking about difficulty to conceive, popularly known as “Infertility”.

To achieve successful pregnancy, there must be production of sperms, transport of them and proper deposition of them into the vagina by the male partner. In female partner, the deposited perms must travel through vagina and uterus to reach the Fallopian tubes (the tubes that are attached to the both sides of the uterus) where the sperms must meet the egg (ovum). The ovum is produced by the ovary and released into the abdomen at the time of ovulation (rupture of the surface of ovary to release the ovum). That ovum must be taken by the tube and thus inside the tube an embryo (earliest form of the baby) is formed, which then travels through the tube into the uterus and the uterus attaches the embryo firmly with it and thus the pregnancy starts. So, if there is defect in any one of them there will be difficulty in achieving pregnancy.

Perhaps you have heard that infertility may be due to problems in male (defect in production, transport or deposition of sperms) or female (defect in ovaries or ovulation, bock in the tubes and defects in the uterus). But sometimes there may be more than one problems in either of the couples or apparently no reason is found (everything is normal, so pregnancy depends on chance factor). To clarify the latter, in normal healthy couples with regular unprotected timely intercourse, the chance of pregnancy in one menstrual cycle is only 15%, so it may be matter of time for some couples to conceive. But another important reason for infertility in female is endometriosis.

What is endometriosis?
Endometrium is the inner lining of the uterus. It responds to hormones secreted by the ovaries during normal menstrual cycle. It tends to thicken from the time of ovulation (as described above) and if pregnancy occurs, it continues to grow and supports the embryo to help in continuing pregnancy. If pregnancy does not occur, it is shed off outside the body and is seen as “menstrual Bleeding” or “Period”. Unfortunately in some women, the endometrium may be present outside the normal position. That condition is called endometriosis. It is commonly present around the ovaries, tubes, surrounding the uterus (outside normal lining) but may be present anywhere in the body (even in lungs, urinary system and rectum). As this endometrium (outside the uterus lining) also responds to the hormones in the same way as normal endometrium (that lines the uterus), there will be bleeding around this abnormal endometrium at the time of menstruation. But this bleeding, unlike normal menstrual bleeding cannot come outside the body and so the blood accumulates and forms a chocolate coloured material (old blood is chocolate coloured) and leads to adhesion between organs. Adhesion is a condition where different organs of our body attaches abnormally with each other leading to various problems. Sometimes this chocolate coloured blood may be surrounded by a membrane formed by body tissue and is then called “Chocolate Cyst” that is found around the ovaries.

What is the reason for endometriosis?
Unfortunately, despite extensive research throughout the world, the reason for endometriosis is not known. It is said to be due to some genetic factors or some environmental factors. Sometimes, delaying pregnancy is stated as the reason. In some women, however, it is caused by backward flow of menstrual blood (that enters into the tubes during menstruation). Usually these women have abnormal development of uterus (problems in uterus since birth), so that all the menstrual blood cannot come outside the body)

What is the problem with endometriosis?
Endometriosis usually causes pain. The pain may be long standing and usually occurs at the time of periods (dysmenorrhoea) or sometimes even between periods. The nature and site of pain depends on where it is located. If it is located very deep inside abdomen, it can cause pain during sexual intercourse (dysparaeunia). In some cases there may be pai duing passing urine or stool or bleeding during urination or with stool.
In around 50% cases, it can cause infertility. The cause of infertility is not always properly understood. But it has been seen that endometriosis can cause adhesion and thus can makes it difficult for the Fallopian tubes to pick up the ovum from the ovaries. Apart from this pain during intercourse often makes the woman avoid intercourse. In addition it can interfere with ovulation, sperm transport, meeting between sperms and eggs and also the process of attachment of uterus with the embryo.

However, endometriosis does not always cause pain or infertility. In some women, there may be both pain and infertility, some women only one symptom and in some women no symptom is found but endometriosis is discovered accidentally during treatment for other purpose (like during laparoscopy for appendicitis or during Caesarean Section).

How endometriosis is diagnosed?
Endometriosis is suspected by history of pain or infertility and examination findings. Like some women may have pain during examination of abdomen or vagina by doctors, even sometimes vaginal ultrasound causes pain. In ultrasonography (or sometimes CT scan is done) there may be presence of cysts or adhesion can be detected. But the “Gold standard” of diagnosis is laparoscopy. It is an operation where (“Microsurgery”), making a small opening in the abdomen under anaesthesia, a telescope is introduced and the area is seen through camera in a television monitor. At that time the chocolate cysts, adhesions and condition of the organs can be seen and diagnosed and if there is any doubt, biopsy can be taken. But in all cases, laparoscopy is not needed and treatment is started after the doctors presume the diagnosis by history from the patients, examination and the ultrasonography reports.

Endometriosis is a peculiar condition in the sense that women with severe endometriosis may not have any symptoms, while women with very mild disease may have severe pain or infertility.
How endometriosis is treated, in general?

As mentioned earlier, endometriosis does not always cause symptoms and so, it does not always need treatment. The common reason for treatment is presence of pain and infertility. Endometriosis-related pain is usually treated by medicines or sometimes by surgery. Before surgery, usually medicines are given to reduce the size and to reduce the blood loss during surgery. All these medicines can cause hormonal imbalance and thus deprives the endometriosis tissues of hormonal stimulation and thus reduces pain. As a result, during the treatment, patients usually cannot conceive because of this intentional hormonal deprivation. Unfortunately after stoppage of medicines, often the symptoms of pain come back.

Surgery for endometriosis is usually done under laparoscopy but it needs properly trained and skilled surgeons to do these operations. Operations can range from “minor” (like separating the adhesions, draining the chocolate colored fluid) and “major” (like removing the cyst or removing major organs). The surgery has the advantage over medicines is that it confirms the diagnosis and removes the diseased tissues. But there are problems with risks related to anaesthesia and surgery. In particular, there is risk of injury to intestine and urinary tracts, even with the best hands, that may increase patient’s sufferings. Apart from this, even after surgery, the disease can come back again after few months or years.

What is the cure for endometriosis?
Only cure for endometriosis is total deprivation of hormones. That is possible if the woman attains menopause (permanent cessation of menses). This is possible by natural way (around 45-50 years of age when menses cease permanently) or by operations to remove the ovaries and uterus. Another simpler way is achieving pregnancy, as usually after pregnancy most endometriosis patients feel better in relation to pain.

What happens if it is not treated?
Endometriosis is not like cancer. It is not life threatening usually. That means it will make you suffer in the worst way by causing severe pain and infertility but cannot endanger your life. So, you can have the options of not treating it, even if you have the symptoms. And of course, if you do not have symptoms, endometriosis may not require any treatment.

What is the treatment for endometriosis with infertility?
First of all, you have to make sure that you have difficulty in conception (that means you have given sufficient time to attempt but failed). Then we have to see whether there is any pain or other problems and what the condition of the disease by examination or ultrasonography is. We also have to look for any additional problems like problems in male partner, problems in uterus or ovaries or the hormones (like FSH, LH, prolactin, thyroid etc).

Then we have to plan the treatment. As there is no hard and fast rule, your doctor will explain you the options for you and you can decide what suits you the most, after judging merits and demerits of every option.
You may choose directly for surgery. In that case, you may be offered medicines for 2-3 months before surgery to make surgery safer for you and easier for the surgeon. The extent of surgery varies, depending on the disease status and your opinion. Remember, your opinion is important. You can choose for extensive operation (that may mean removal of both the tubes, that may be needed in advanced disease, leaving only option for IVF for pregnancy in future) or only diagnosis (just introducing the telescope and see) or minor operations (like separation of adhesions or removal of the cysts), after judging the merits and demerits of each options. But remember, you should not have any medicines for endometriosis after operation as most of the medicines (with some exceptions) interfere with pregnancy. This is, because, after operation is the best time to conceive and that time gives you the highest chance for pregnancy. If natural conception (or 1. ovulation induction- giving medicines to stimulate growth of your eggs, or 2. IUI- inserting your husband’s sperms by special process inside your uterus) does not occur within 12 months after operation, that’s probably the best time to consider IVF (“Test tube baby”). Of course, if you had extensive surgery or have advanced age (more than 35 usually), your doctor may advise you to go for IVF directly after operation without wasting the time.

You can opt for trial of treatment by medicines. You must know why I have used the word “Trial”. This is because, during medicine treatment, you cannot conceive. But you will be seen after 2-3 months to see if the disease has disappeared or decreased in size significantly. If this is the case, you can start infertility treatment (Ovulation Induction or IUI or IVF in some cases) directly. But if the disease did not respond to medicines by this time, you may need surgery, the extent of which has been described above.

You also have the options of not treating endometriosis at all. In that case, you can request your doctor to start infertility treatment directly. But remember, endometriosis (even treated endometriosis- after medicines or surgery) can interfere with any form of infertility treatment. It can lead to decreased response to medicines used for ovulation induction, thus reducing success rate(normal success rate is 20-25% in a menstrual cycle- that is without endometriosis). It can lead to low success rate after IUI (normal success rate is 25-30% in a menstrual cycle). Even with IVF (where normal success rate is 40-50% per cycle of IVF), the effectiveness of IVF may be reduced in presence of endometriosis.

What if I do not go for any treatment at all?
Infertility is a peculiar thing. Very few men or women are absolutely infertile. That means they do not have ability to achieve pregnancy naturally. Majority of them are subfertile. That means most of them have lower than normal chance (compared to healthy couples) to achieve pregnancy in a normal menstrual cycle. Often we find that patients planning for treatment and in the mean time, they conceive naturally. That means even without treatment, there is some chance of pregnancy. But that chance decreases in presence of any disease (like endometriosis) or increased age. And of course, nobody usually relies on chance. But the important message is that do not forget to have regular sexual intercourse eve if you are awaiting any test or endometriosis treatment. Of course, it’s stressful situation for both the partners. Stress affects conjugal relationships and lead to many couples avoiding conjugal life. Indeed stress can affect the hormone levels in females and affects sexual performances in males. It’s easier for us to advise you to stay stress-free but is difficult to practice. Nevertheless, try relaxation as much as possible. Think that majority of the couples ultimately conceive by some form of treatment. Have faith in yourself and have faith in your doctor.

१७. प्रपंच हे साधन आहे, परमार्थ हे साध्य आहे डॉ. श्रीनिवास कशाळीकर

श्री. सद्गुरू ब्रह्मचैतन्य गोंदवलेकर महाराज म्हणतात, “प्रपंच हे साधन आहे, परमार्थ हे साध्य आहे”.
लहानपणी साधन आणि साध्य ह्यामध्ये घोळ होतो हे खरे, पण मोठेपणी देखील समजुतीमध्ये जरी नाही तरी पण वागण्यात मात्र गोंधळ होतो!

नामस्मरणाचा अभ्यास करताना एकदम काही आपल्याला आत्मज्ञान होत नाही. आपण सामान्यच असतो. आतील आणि बाहेरील जगाचे आपल्यावर बरे-वाईट परिणाम होतच असतात. त्यामुळे आपली माफक अपेक्षा असते की; सरकारने अश्या योजना आखाव्या, अशी धोरणे राबवावी, असे कायदे आणि नियम करावे की ज्यांचे पालन करताना आपल्या सदसद्विवेक बुद्धीचा कोंडमारा होणार नाही, आपले जगणे मुश्कील होणार नाही आणि असहाय्य होणार नाही! कारण तसे झाले की कायदे मोडावे लागतात किंवा कायद्यामधून पळवाटा काढाव्या लागतात. मनात असो वा नसो अशी चोरी करावी लागते. मग कायद्याने शिक्षा मिळण्याची जशी भीती असते तशीच स्वत:चे मन देखील स्वत:ला खात असते.

उलट, हे कायदे जर सुयोग्य असले, तर ते पाळल्यामुळे आपल्या अंतरात्म्याचे समाधान होत राहील आणि जीवनाची कृतकृत्त्यता, कृतार्थता आणि सार्थकता झाल्याची जाणीव आपल्याला होत राहील!
पण असे घडताना दिसत नाही! कायदे पाळताना (ते अन्याय्य असल्यामुळे) आणि मोडताना (भीतीमुळे वा मन खात असल्यामुळे) दोन्ही प्रसंगी आपल्या आतल्या आत संघर्ष चालूच राहतो. काय करावे हे आपल्याला सुचत नाही! आपण खिन्न होतो. असहाय्य होतो.

नाम आणि नामस्मरण यांची तोंडओळख झाली की, नकळत आपल्या संकुचित बुद्धीनुसार आपल्या मनात त्याविषयी अवास्तव कल्पना तयार होतात. नामाची सत्ता बलवत्तर आहे असे ऐकल्यामुळे; नामस्मरणाने सर्व परिस्थिती बदलेल ही आशा पल्लवित होते! नामस्मरणाने आपल्या वैयक्तिक आणि सामाजिक अश्या सर्वच कल्पना आणि अपेक्षा पूर्ण होतील असे आपल्याला वाटू लागते.

त्याप्रमाणे; परिस्थिती बदलण्यासाठी आपण अधिक जोर देऊन नामस्मरण करू लागतो. असे करताना अनवधानाने आपण नामस्मरणाला (भगवंताला) साधन बनवतो आणि आपल्या कल्पनेतल्या कौटुंबिक व सामाजिक प्रपंचाला साध्य! मग कुटुंबात वा समाजात मनासारखे घडले नाही की निराश होतो!
पण आपली वैयक्तिक आणि सामाजिक परिस्थिती कशीही असली तरी हताश न होता आणि खचून न जाता; आपण आपल्या सद्गुरूंचे, श्री. ब्रह्मचैतन्य गोंदवलेकर महाराजांचे वचन, पुन्हा पुन्हा लक्षात आणून आहे त्या परिस्थितीचा (प्रपंचाचा) उपयोग परमेश्वर प्राप्ती साध्य करण्यासाठी केला तर असहाय्यता नक्कीच कमी होते.

थोडक्यात सांगायचे तर, चिकाटीने नामस्मरण करीत गेले, की कालांतराने समजू लागते, की वैयक्तिक आणि सामाजिक जीवनातील सारे काही आपल्या मनाप्रमाणे नाही, तर प्रारब्धाच्या नियमांनुसार, पण नामाच्या सत्तेनेच घडत असते! तसेच हे देखील कळू लागते की सरकार सरकार असे ज्याला आपण म्हणतो, ते सरकार देखील कालमहात्म्यानुसार खरे, पण नामाच्या सत्तेखालीच वावरत असते!
नामाच्या सत्तेनेच आपल्या कळत-नकळत; अगदी तंतोतंत आपल्या मनाप्रमाणे जरी नाही तरी श्री. सद्गुरू ब्रह्मचैतन्य गोंदवलेकर महाराजांना अभिप्रेत असलेल्या संस्कृती आणि सुधारणा; आपल्या व्यक्तिगत आणि सामाजिक जीवनात अधिकाधिक प्रमाणात आविष्कृत होत असतात! सदभिरुची, सदिच्छा, सत्संकल्प, सत्प्रेरणा, सत्बुद्धी, सद्भावना, सद्वासना, सदाचार; वेगवेगळ्या स्वरूपात प्रत्यक्षात येत असतात.

अश्या तऱ्हेने; नामस्मरण करता करता नामाचे गोडी वाढते. नामातील शक्ती जाणवते. अलगद आपल्या कल्पना, आपल्या अपेक्षा आणि आपल्या आवडी निवडी बाजूला पडतात.
नामच धरून राहिले की, नामाच्या इच्छेनुसार आपण स्वत: आणि जग दोन्हीही नामाच्या सत्तेने आणि सुयोग्य पद्धतीने बदलतात; याचा प्रत्यय घेऊ लागतो. मग नामासाठीच नाम घेऊ लागल्यावर नाम साध्य व प्रपंच साधन आहे हे नुसते पटत नाही, तर साधनरूप प्रपंचामागे होणारी आपली फरफट कमी कमी होत जाते. नामासाठी आणि नाम (परमार्थ) हे साध्य म्हणून आहे ती परिस्थिती (प्रपंच) साधन म्हणून वापरून नामस्मरण करणे हेच आपल्या सर्वांच्या कल्याणाचे आहे ह्याची खात्री पटत जाते!