Types of Hernia – Prevention, recovery and aftercare

During the hernia an internal organ protrudes out through any weak spot on the body, and it can either be in the muscle or tissue. There are several types of hernia, such as umbilical hernia. femoral hernia, inguinal hernia, hiatal hernia, etc. But, the real question lies – how important is it to treat a hernia?

According to medical specialists, a hernia must be treated immediately; otherwise, it can lead to life-threatening conditions. So, let’s get to know how you can prevent it. However, if you already have a hernia, then we will guide you on what should be your next step.

What is the cause of hernia?

The primary cause of a hernia is – if there is any weak muscle, which may be due to birth or due to aging, or if you have put any repeated pressure on the abdomen or groin, then it can lead to a hernia. Other than that, unintentional strain can occur due to obesity, pregnancy, or strain on the toilet due to constipation or repeated coughing. This puts pressure on the abdominal cavity, leading to a hernia.

Symptoms of hernia

The general symptoms are that – at the very beginning, you will notice a lump which can be pushed back or disappears when you lie down. The lump reappears only when you are coughing, putting strain during bowel movements, laughing or crying. 

If you ignore this lump, it can lead to a pouch-like appearance with intensive pain. You can also feel pain while lifting, walking or running. An aching sensation can be felt all the time, along with a sensation of bowel obstructions.

However, in the case of a hiatal hernia, there are no such symptoms. Instead, you will feel digestion problems, difficulty in swallowing, heartburn, severe chest pain and regurgitation.

Diagnosing hernia

When you consult with a doctor, the first process is to conduct a physical examination and then you will be prescribed a certain tissue imaging test, such as a CT scan.

Treatment for hernia

The treatment prescribed for hernia is surgery. There are 3 types of surgery that are conducted –

  • Open surgery – A small cut is made into the body, specifically at the location of the hernia, and the protruding tissue is placed at its original position. Finally, the muscles are stitched back together. If required, a mesh is implanted to provide extra support. This procedure requires more time to get cured when compared with the other types of surgery.
  • Laparoscopic surgery – This is quite similar to open surgery; however, the only exception is that the cut is made right outside the abdomen, and surgical tools are used to insert the protruding tissue back in its place. This requires minimal cuts and heals much more quickly.
  • Robotic hernia repair – Here also laparoscope is used to perform the incision, but the surgeon operates the entire surgery through a console. All the surgical instruments are handled by the console, and these are usually performed for smaller hernia or to construct the abdomen wall.

Based on the patient’s condition, condition of the hernia, type of hernia, and previous medical history of the patient, the surgery is recommended and performed.

If the hernia is not treated on time, it can lead to obstructions within the intestine, leading to chronic chest pain, vomiting, stomach pain, nausea, etc. Along with that, a part of the intestine can also get trapped in the lump, and it will restrict the proper blood flow. If this keeps on occurring for a couple of hours, it can lead to tissue death.

Prevent hernia

The best way to prevent hernia is to maintain a healthy life, along with –

  • You must eat healthy food, exercise regularly and maintain your ideal body weight. 
  • Add fruit, vegetables and green to your diet to avoid constipation. 
  • Do not lift heavy weights without consulting with the gym instructor or beyond your capability. 
  • If there is persistent coughing or sneezing, then do consult with the doctor. 
  • Smoking cigarettes can lead to coughing, which triggers a hernia, so avoid smoking.

After hernia surgery 

It is usually advised that the patient can go back home after a few hours after the surgery is done. However, this can extend to the next day or 24 hours, based on the surgical process. However, if there is a chance of developing an infection or if the case is quite critical, then a few more days can be required till the hospital discharges.

Restrictions after the surgery

Mostly there is nothing to fear about, and the patient can resume normal eating and activities within the next 4 to 6 weeks. But, it is strictly prohibited that strenuous exercises should be avoided. If the surgical wounds do not recover properly, then it can lead to complications, such as urine retention, infection, scrotal edema or collection of fluid around the testis. 

So, there are specific doses and don’ts that you need to follow right after the surgery. This will help quicken the recovery phase.

Do’s after hernia surgery

  • Take a brisk walk in the evening or early in the morning.
  • Avoid direct sunlight or working outside at noon.
  • Try to do some stretching exercises.
  • Eat a lot of vegetables, fibers and add a healthy diet to your food list.
  • Drink fresh, hygienic and enough fluid. You can also drink fluid in the form of broth or soup. 

Don’ts after hernia surgery

It is usually said that it takes 4 to 5 weeks to get back to normal activities, but you must take precautions for at least 6 months. This will help to prevent the chances of recurrence of the hernia. So, try –

  • Avoid any heavy lifts or go to the gym for 3 to 4 months. 
  • Avoid smoking and drinking for at least 6 -7 months. 
  • You should not put pressure on your bowel movements. 
  • Try to avoid running on the staircase or any task that requires strenuous activity.


A hernia is not life-threatening, but ignoring the symptoms and not paying attention to its treatment can lead to severe risk. So, you must consult with the best medical facilities of ILS Hospitals for proper treatment. To avoid complications, you must also go for follow-ups, as prescribed, even after the surgery.

Spot a Stroke – 3 Things to Do and Not to Do

A stroke is also referred to as a “brain attack” and every moment is important during these medical situations. You need to act accordingly in order to save someone’s life who is getting a stroke. Usually, the oxygen and blood supply get cut off from the brain, which disrupts the function. Stroke can occur due to a blockage or a clot, or a bursting of a blood vessel. If the stroke is left untold and untreated, then the brain cells die, which leads to a life-threatening situation for the patient. There are various treatments that are advised and recommended to save the person during this critical moment. However, it is also very much essential to take the person to the hospital on time. You can also consult with the best neurologist in Kolkata.

So, let’s get to know how you can help a friend, family member or any acquaintance who is suffering from a stroke.

What are the types of stroke?

Strokes can happen without any warning, and the most affected part is the brain, which can put a halt to the functioning of other organs or any fatal incident.

Strokes are usually of two types:

  • Hemorrhagic stroke: Here the blood vessel gets ruptured, which usually leads to brain bleeding. 
  • Ischemic stroke: This is caused due to a clot, and the blood vessel which carries blood to the brain gets blocked.

Both these types require equal attention and immediate action.

What are the ways to detect a Stroke?

If you do not know about the symptoms of stroke, then a FAST test from National Stroke Association can help you to recognise and act fast. You can also seek help from the best neurologist in Kolkata.

  • F- Face: You need to observe the patient and ask them to smile. If one side is looking drooling, then it is a symptom of stroke.
  • A- Arm: Ask the patient to raise both arms together. If one arm drifts downwards automatically, it is a clear sign of stroke.
  • S- Speech: Try to talk to the person and ask them to reply. If they are unable to process your question or unable to say anything or make a strange sound, then this is a stroke.
  • T- Time: If you observe all these symptoms, you must immediately call for help without waiting a second.

Do’s – When a person is suffering from stroke

If a person is suffering from a stroke then –

Call for help or request an ambulance

Immediately call the helpline number and inform them about the situation. Try to note down the time as soon as you see the symptoms. It is said that to reverse the symptoms of the developing threat, the treatment must start within 4.5 hours of the onset of the symptoms. Advanced therapies and surgeries can be the way out to ease the pressure that is building up in the blood vessels and brain.

Perform a CPR

If necessary, you must perform CPR. However, most patients do not need this. If you see that the person has become unconscious, check the breathing rate, whether it is quite abnormal, and then start CPR before the ambulance reaches the location. If you do not know about CPR, you must perform a repeated and steady chest compression.

Don’t allow the patient to sleep

If the patient is already a stroke survivor, then during the second stroke they might feel sleepy. Do not let the person go to sleep or lie down, talk to them continuously and keep them engaged until the ambulance reaches the location. The patient may feel tired even during the first stroke, but remember that if the person is allowed to sleep, then it can decrease the survival rate. At first, reach out to the primary doctor or the one where the patient usually goes for follow-up. Then, act according to the advice given.

Don’t’s – When a person is suffering from stroke

There are certain restrictions that must be maintained if a person is suffering from a stroke, such as-

Do not give any food or drink

The patient should not be given any kind of food or drink without consulting with the doctors. Stroke can also affect the ability to swallow, and so it can lead to choking or breathing problems. Along with that, it can also lead to chances of development of infections.

Do not give any over-the-counter medicines

You should avoid aspirin, the most recommended over-the-counter medicine to reduce pain. But, remember, the pain caused during stroke is either due to blood clots or vessels bursting. Aspirin acts as a blood thinner which increases the chances of damage. Mostly 80% of the strokes are ischemic, and 20% are hemorrhagic strokes, so without a CT scan, medicine should not be referred.

Never drive the patient to the hospital

Never drive a stroke victim to the hospital. If you find that somebody is severely affected by a stroke, then it is better to call an ambulance or inform the primary doctor. Ambulances have all the essential life-saving treatment facilities to respond to emergencies. So, by the time you drive the patient to the hospital, it might be too late for medications and treatment. Also, you must get information about the hospital and whether it has facilities to treat stroke.

What are the symptoms of stroke?

Strokes can be frightening, and you must always be prepared. It’s all about staying focused and taking immediate action. So, you need to inform the ambulance as quickly as possible to initiate the treatment. 

Every minute counts when a person is suffering from a stroke. If it is left untreated, then it can lead to permanent damage to the brain. So, once you recognise any symptoms, take the patient immediately to the hospital and get an appointment with the best neurologist in Kolkata.

There are various of symptoms, such as –

  • A drool on one side of the face.
  • Difficulty lifting one hand to the full height or using only one hand.
  • Difficult to move one leg or drag the leg while walking.
  • Slurred speech, difficulty talking, thinking or taking any action.
  • Poor vision or unable to see anything clearly.
  • Dizziness, vertigo, imbalance in walking difficulty.

In certain cases, even severe headaches are also noticed, along with severe pain that flows from the right side of your neck. However, headache cannot be taken to be the potential sign of stroke because in most cases strokes are not accompanied by any kind of pain.


You might also notice that in certain situations, within a few minutes, the pain vanishes, but that does not mean you are going to postpone visiting the doctor. These are usually called mini-strokes. These should also be taken seriously as they are signs of severe underlying conditions that can lead to stroke in the future. If you are unable to distinguish whether it was a symptom of stroke, get the situation evaluated by a specialist at ILS Hospitals.

Is your child having strep throat?

Strep throat is most likely to occur in children of 5 to 15 years. However, even children who are below 2 years old can get infected with Strep throat, but the chances are quite rare. The primary cause is a bacterial infection. It is of two types: if it involves the pharynx, it is called strep pharyngitis, and if the infection involves the tonsils, it is called Strep tonsillitis. Usually, pediatrics in Kolkata advise parents to maintain good hygiene and a healthy diet for the child to prevent the chances of getting infected by Strep throat. There is no vaccination available to date to prevent Strep throat, but early detection can help to get cured easily. Let’s get to know how you can detect Strep Throat in your child and the steps that should be taken to get them relief immediately.

What are the symptoms of Strep Throat?

The symptoms that will help you to identify whether your child is suffering from a Strep throat infection are:

  • Pain and discount felt within the throat.
  • Having a raw feeling or not getting a proper sensation of the throat.
  • Solenness of the throat as the pain gets worse.
  • Fever, stomach pain and vomiting all together.
  • Severe headache that lasts for a long time.
  • Painful or swollen neck glands.
  • Scarlet fever rash and this is also known as a sandpaper-like rash.

If the throat is monitored using light, it will show a bright red swollen lump, as well as the tonsils will get covered with pus and appear to be reddish.

How to diagnose Strep Throat?

If you notice more than 3-4 symptoms mentioned above, then it is time to take your child to pediatrics in Kolkata. At first, the doctor will conduct a physical examination and then a test will be suggested to get a confirmation about the infection.

To diagnose the problem, various throat secretions are taken, and a Strep test is done. It is also called the Rapid Strep test, where a cotton swab is used to take the sample from the throat, usually in the form of liquid. It takes merely 5 minutes to get the results.

If the result is positive, then the samples will be sent for a throat culture whose results you can get within 2 to 3 days.

What if Strep throat is left undiagnosed?

If you ignore the problem and think that Strep throat is quite similar to a common cold, then you are completely wrong. It can turn critical over time:

  • It can lead to struggling in breathing, or even the child can clearly speak or cry. 
  • It will lead to difficulty swallowing the liquid.
  • A stiffness is noticed in and around the neck.
  • The child is unable to move the neck like normally they do.
  • Dehydration is quite suspected.
  • The child may have no urine or dark urine.
  • Dehydration in the child can lead to a very dry mouth or no tears.
  • Fever can reach up to 104 Fahrenheit.
  • There is no eagerness to drink water for more than 8 hours 
  • Can’t open their mouth at all or are half open.

Other than these, the child can faint or even be too weak to stand. You can also notice that the child has purple or blood color spots on the body, along with a high fever. A strep throat infection can become a life-threatening emergency if the doctor is not called on time.

How do you understand whether it is just a common cold or Strep throat?

The common cold occurs due to viral infections and mostly due to seasonal changes. It lasts about 4-5 days without any severe symptoms. You might notice a fever and a runny nose. It can be prevented by taking proper precautions. However, pediatrics in Kolkata can help you to get a clear idea. 

The Strep throat symptoms usually start showing within about 3 days, and the child gets trouble swallowing, headache, general discount, loss of appetite, nausea, rashes, etc. These symptoms are completely missing during the common cold.

Is Strep throat infectious?

Strep throat is very infectious and one of the most contagious diseases. It mostly spreads among school-aged or teenage children. It has a high chance of occurring during winter and early spring. Even a simple handshake or sneezing can lead to the spread of the infection.


Maintaining proper hygiene and washing hands before eating can help to prevent the spread of a Strep throat infection. Moreover, it is advised to keep the child at home under complete supervision for at least 3 weeks till they get completely cured. Otherwise, they have the chance to spread the infection among their peers or classmates. 

Even the adults who are taking care of the infected child have a high chance of getting infected. Every crowded area, be it daycare center, schools, or activity camps, increases the probability of spreading the disease.

How to take care of the child during Strep throat?

There are various complications associated with Strep throat. So, it is highly recommended to consult with pediatrics in Kolkata. You need to go by the prescribed antibiotics and not overlook the symptoms. The medicines must be continued till the child gets relief from the pain or gets completely cured.

If the child is over 1 year, then they can shift to a liquid diet that includes chicken broth. If the child is above 6 years, then they can be given lollipops, ice creams, etc. Moreover, if the child is above 8 years, then they are prescribed to gargle with warm water, along with a little bit of salt added to it.

Medicines prescribed during Strep throat

Usually, to subdue the pain, acetaminophen is prescribed, along with Ibuprofen. This helps to fight the infection and reduces the fever. Further, you need to keep a child hydrated from time to time. You need to keep persuading the child to drink adequate fluid, be it in the form of milkshakes or soup. 

It is very much important to maintain a healthy diet that includes a proper proportion of carbohydrates, proteins and fats. In this case, it is usually advised to avoid salty and spicy foods, such as fries, oily food, cold drinks, etc. The doctor prescribes a soft diet where the food has to be broken into simple pieces so that the child has no problem ingesting them.


Strep throat can be cured easily, and all you need to do is follow proper precautions. It is always advised to take the child to a pediatrician if the symptoms appear to be complicated. You can book an appointment with the pediatrics in Kolkata associated with ILS Hospitals. They have been in this field for years and understand the concern and treat the disease accordingly.

8 Misconceptions about Kidney disease

We have access to unlimited information owing to the digital space, and it gets quite difficult to segregate the facts from myths. If we take a closer look at certain medical conditions, then it is no surprise that people still try our age-old practices to get a cure. Moreover, people never think twice before believing a false statement with no scientific reason. The maximum number of false allegations are associated with Chronic Kidney Disease (CKD). These need to be cleared to help you achieve healthy well-being and understand the kidney disease symptoms.

Kidneys require more attention   

Kidney overwork, as well as their condition, is overlooked. You need to take care of these bean-shaped paired vital organs of the body. They help to filter out the toxins from your body and maintain the flow of fluids in the body. 

Kidneys help to keep your blood clean, help you stay hydrated, and also regulate various hormone functions. The degradation of these organs leads to Chronic Kidney Disease (CKD).

9th March is celebrated as World Kidney Day to spread global awareness about the importance of kidney function and how to reduce the damage and protect it from daily impact. It is an initiative to debunk the myths associated with kidney treatment, cause and occurrence.

Let’s step into and debunk 8 common myths associated with kidney disease.

Myth 1: Kidney disease doesn’t affect everyone

Kidney disease or kidney stone symptoms is quite common nowadays due to a sedentary lifestyle. Even if a person appears healthy, they might be suffering from some level of kidney disease. 

High blood pressure, aging, diabetes, history of kidney problems running in the family are the potential reasons behind every 1 out of 7 being affected by the disease. So, kidney disease can affect anybody irrespective of caste, sex and race. 

Myth 2: Kidney testing process is time-consuming and costly

After consulting with a kidney specialist, it becomes quite easy to determine the testing process. You might be surprised that the kidney testing process requires two inexpensive tests:

  • Urine test- This helps diagnose the amount of protein in the kidney and shows the sign of kidney damage.
  • Blood test- This test helps determine the GFR (Glomerular Filtration Rate) number and shows how well the kidney functions.

Myth 3: Kidney diseases can be detected through symptoms 

It is difficult to understand whether a person is affected by kidney disease. There are no specific kidney disease symptoms in the relay stage of the kidney disease. Most people do not even realize that they have a kidney disorder and remain unaware of the condition for years. 

Usually, the symptoms start appearing when the disease reaches its advanced stage. So, it is always advised that if you have high blood pressure, diabetes or any other health issues, opt for a yearly health assessment. 

Myth 4: Kidney disease has no treatment

People think that those who are at risk of kidney disease are not curable. But, you can easily reduce the severity and prevent kidney disease by maintaining a healthy lifestyle, and this includes :

  • Regular exercise
  • Eating healthy and nutritious food
  • Ditching the junk and oily food
  • Maintaining blood sugar level and blood pressure
  • Quitting overuse use of painkillers
  • Quitting smoking and drinking. 

These small steps will help to keep your kidney healthy. Moreover, a proper diagnosis at the right time can help to reduce the progression of the severity.

Myth 5: It is still unknown what causes kidney disease

The latest medical facilities have made it possible to understand what can lead to kidney disease. The two common reasons are – high blood pressure and diabetes. Both these diseases have the intensity to damage the tiny blood vessels present in the kidney. Other than these, there are many secondary reasons as well, such as – 

  • Heart disease
  • Polycystic kidney disease
  • Inborn kidney malfunction
  • Glomerulonephritis

Myth 6: Dialysis is the only treatment for kidney disease

Dialysis is required when the disease progresses toward a severe condition or when the patient reaches the last stage of kidney disease. But, if the problem is detected in its early stage, then there are manageable approaches that can reduce the intensity of the disease. 

You must exercise daily, take proper medications after consulting with the medical specialist and maintain a healthy diet. So, if you can stop the condition from getting worse, then you can prevent dialysis as well as the chances of kidney failure. 

Myth 7: Back pain is a clear symptom of kidney disease

Back pain can originate from various reasons, and kidney disease might be one of them. But, a person suffering from pain in the back might not have any sign of kidney damage. So, you must consult the specialist to get a definite result and treatment. 

If there is a blockage of kidney infection symptoms, you might suffer pain in the back that radiates from the flank and spreads to the side. This pain can even be felt when stretched or spread into the groin areas.

Myth 8: Kidney disease can be completely cured

The damages to the kidney are irreversible, and thus it is not curable. Yes, you can slow down the progression of damage to these blood filtration organs, but only if detected at the early stage. You can also try to reduce sodium intake and maintain a healthy lifestyle to keep the disease under check. It usually has a high chance of progressing toward kidney failure.

Chances of getting affected by CKD

Reports show that women suffer from kidney disease more than men. Usually, people above the age of 20, suffering from diabetes, hypertension, or both, can lead to Chronic Kidney Disease (CKD). 

Can CKD generate diabetes?

Even if you do not have diabetes, chronic kidney disease can lead to its development eventually. The reason is that the kidney helps to break down insulin. But, if the organ is unable to perform, then insulin accumulates in the body over time, leading to high blood sugar levels or diabetes.

How to treat CKD?

Kidney failure has two treatments, dialysis or kidney transplant, which can only be undertaken if the doctor prescribes them. It is true that the treatments to cure Chronic Kidney Disease (CKD) are quite limited in most cases. 

Moreover, there are fewer chances to prevent kidney disease, but debunking the myth can help you get health advice without losing time. So, you must always consult with the specialist at ILS Hospitals who are experienced in treating kidney damage and add a kidney protective edge to your prescription.

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How to manage gastric problems during pregnancy?

Gas formation during pregnancy is quite natural and frequent too. You are not alone, and there is nothing to be embarrassed about. It is common to feel bloated when pregnant as your body is undergoing many changes. The digestive problems can range from feeling uncomfortable to severe stomach pain. The two culprits are hormones and diet, which causes a bloating effect and gastric problem during pregnancy and after childbirth.

Thus, there is no embarrassment to talking about it as everyone releases gas. Gas formation is quite natural as there are bacterias in the stomach that break down the food and release the gas in your body. 

However, if the gas troubles are bothering you, we have some remedies that can help you for the time being. Subsequently, seek advice from your doctor before starting any new gas relief practice.

Why is there the excessive formation of gas when you are pregnant?

Your body goes through many changes during pregnancy, starting from weight gain, hormonal changes, changes in the reproductive organ and more. All these create discomfort in digestion and the formation of gas in comparison to the normal body processes.

Release of progesterone

The most common reason for gas formation is the hormone progesterone which is released in excess amounts triggering the production of gas. Progesterone is required to support pregnancy as it helps in the relaxation of the body muscles, including the intestines. 

Thus, the digestion process slows down, resulting in the building up of gas, leading to bloating, flatulence and burping. This seems to be quite uncomfortable, but your body needs to absorb more nutrients for the growing baby by slowing down the movement of food.

Pressure on the abdominal cavity

During the changing phases of pregnancy, the pressure on the abdominal cavity increases when you reach the third trimester. This is created due to the growth of the uterus leading to the gastric problem during pregnancy.

Change in diet

Food contributes to being the major reason behind the development of gas when you are pregnant. You need to eat a lot to feed the growing baby and, along with it, depend on prenatal vitamins and iron components which causes constipation. These changes in food habits lead to gas formation, which is released frequently.

Emotional stress

Anxiety and stress are part and parcel of pregnancy. You might find yourself to be emotionally distressed, feeling depressed or even going through short-term panic. So, it can lead to more intake of air which triggers gas formation.

Lactose intolerance

Pregnant women are often advised to drink milk as the body requires enough nutrients for both mother and baby. If you haven’t had a glass of milk for years, it becomes very difficult to determine whether you’re lactose intolerant. If you cannot tolerate a glass of milk, gas formation and painful diarrhea are quite common.

Ways to combat the gas formation 

Proper gas formation management is very important for a comfortable and painless pregnancy.

Add plenty of water to your diet

You must drink 8 ounces of water every day. Also, check whether you have irritable bowel syndrome, which causes bloating whenever you drink any kind of juice. Usually, juices that have low FODMAP are considered. You must also check on sugar intake levels, such as soda, as it induces gestational diabetes.

Try ginger or peppermint tea

You can try ginger tree or peppermint tea, as both have been known to ease stomach discomfort or digestive problems. Take your time, enjoy the beverage and drink at a slow pace. Thus, you are taking in an extra amount of air with each sip. These little habits can help to reduce the stress on gas formation.

Exercise daily 

Take a brisk walk or try yoga for at least 30 minutes. This will help you to stay emotionally and physically stable. It will prevent constipation and gas formation. Further, daily activities also speed up the digestion process and prevent the feeling of bloating. But, you need to learn how you can exercise safely. If you are in the third trimester of pregnancy, always consult with the gynecologist before you start any exercise regime.

Maintain a healthy diet 

A balanced diet during your pregnancy helps to eliminate gas symptoms that are triggered by certain food. Yes, you indeed need to gain weight during pregnancy, so do not restrict your diet and eat fully. However, try to eliminate foods such as cabbage, potato, broccoli, nuts, etc., as these trigger the gas buildup. You can also consult with the dietician before incorporating a new food item into your diet, as it might risk your and your baby’s health. Always remember during pregnancy, you and your baby both require proper nutrition.

Add dietary fiber to your menu 

Fiber helps soften the stool by retaining water, allowing passage of stool easily and managing constipation. You can add high fiber foods to ease the gastric problem in pregnancy or also consider fruits and whole grains, which are fiber boosters. If you do not like high-fiber food, consult a doctor for an alternative supplement such as methylcellulose, Metamucil etc.

Rely on a stool softener

It is quite natural to feel constipated during pregnancy. So, adding a gentle stool softener can help regulate stool passage and control the formation of gas. However, you must not use any stimulant laxative as it can increase complications and add risk to the baby’s health.

Medications prescribed for gastric problems during pregnancy

You should not opt for over-the-counter medicines during pregnancy. Always consult with the doctors about medicine or enzyme intake that can help to digest. They can also advise you to take a Lactose test and prescribe enzymes to help cope with dairy digestion.

You must avoid certain medicines even if it is part of home remedies to take good care of you and the baby. Thus, you must follow up with the doctor for every change you make in your lifestyle.

When should you consult with the doctor?

During pregnancy, you must go through routine checkups to ensure that you and your baby are doing well and are healthy. Gas formation is not a joke and can lead to life-threatening problems. If the pain increases and a bloating sensation is felt for more than a week or constipated, seek immediate medical attention.

Along with that, you must also switch to a healthy lifestyle and stay positive about your diet and exercise. If you find blood in your stool or intestinal discomfort, it’s time to call your doctor. Sometimes, it might be confusing whether it is a pain due to gas formation or something else. So, consult with the specialist at ILS Hospitals and get a safe and proper cure to relieve digestion or any other problem.

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Gastroenteritis – Causes, Symptoms and Treatment

You must be quite familiar with the words “Diarrhea”, “Vomiting”, and “upset stomach”, and these are also known to be part of Stomach flu. The stomach and intestines undergo inflammation in this condition due to bacterial infection. Moreover, these symptoms are medically known as Gastroenteritis. It can also occur due to viral and parasitic infections in your digestive tract.

Gastroenteritis affects a child and the elderly much more severely than a healthy adult. Moreover, it can turn life-threatening if the gastroenteritis symptoms are overlooked. 

Let’s get to know about Gastroenteritis causes and symptoms and treatment to prevent it. This will help you to get a better understanding of when to consult with a medical specialist.

Symptoms of Gastroenteritis

Gastroenteritis can affect you irrespective of age. The most common symptoms are diarrhea, vomiting, stomach cramps, fever, abdominal pain, nausea, mild fever, loss of appetite, muscle ache, incontinence, inability to eat properly, general weakness of the body and headache.

Suppose these symptoms continue for a long time. In that case, it can lead to dehydration, dry skin, dry mouth, feeling thirsty all the time, problems in urination, urine is dark in color, unable to urinate for more than 8 hours, cold hands and feet and sunken eyes and cheeks. You might get the feeling of nauseated, lightheaded, lethargic, dizzy, etc.

Dehydration can affect a child more quickly than an adult. Most often, small children are unable to convey the gastroenteritis symptoms. So, you need to look for the signs, check the diapers and stay aware.

These symptoms start appearing within 3 days of getting affected and can last for more than 10 days, depending on the infection range (mild to severe). The symptoms can go beyond control, including vomiting, constant body ache and bloody stool.

Thus, you must immediately consult a doctor to get proper treatment before it gets severe. Otherwise, the patient might have to be hospitalized to retrieve the lost fluid.

Causes of Gastroenteritis

Rotavirus and norovirus are the two specific causes of Gastroenteritis. There are several ways through which Gastroenteritis can get spread:

  • If you intake contaminated food and water, the virus is generally foodborne.
  • If you come in contact with a person affected by the virus.
  • Dirty or unwashed hands after the use of the toilet.

Other than viruses, bacteria such as E.coli, Shigella, and Salmonella can also trigger Gastroenteritis. And, the ways you can get infected are:

  • If you have undercooked poultry items, then the chances of the disease increase.
  • If you do not wash the bed covers, change the bedsheets from time to time.
  • Not washing hands before consuming any food with bare hands.
  • In case you come in contact with an infected person at an office or daycare center (for children)

Gastroenteritis can also occur due to parasite infection, such as Giardia and Cryptosporidium, and they spread through:

  • These parasites can be present in a contaminated swimming pool.
  • There are chances of stomach flu if your drinking water is contaminated.
  • If you eat unwashed fruits or vegetables.

There are certain unusual ways, too, through which you might get infected by Gastroenteritis, such as:

  • Eating too much citrus food
  • Eating seafood that might have toxins.
  • Laxatives, chemotherapy drugs, allergic to antibiotics, etc.

Who gets most affected by Gastroenteritis?

Anybody can suffer from Gastroenteritis, but few specific individuals come directly under the risk radar.

  • Infants and children get affected easily due to their pre-developing immunity system or under-developing immunity.
  • The elderly can also experience stomach flu due to reduced immunity power with age.
  • Individuals working in nursing centers or hospitals deal with gastroenteritis patients and are usually in direct contact with the infected person.
  • Students who live in hostels or dormitories can experience a sudden outbreak of Gastroenteritis.
  • Children who attend daycare or school can get affected if other students already suffer from Gastroenteritis.
  • Individuals intaking immunosuppressant medicines due to auto-immune disease mostly get infected easily.
  • Patients who are suffering from HIV/AIDS or going through chemotherapy.

How to prevent Gastroenteritis?

As we know, prevention is better than cure. So, if you see the preliminary signs of Gastroenteritis, your first step should be to prevent dehydration. You must take oral rehydration and start drinking clear fluids. This should be done slowly but frequently, as too much can make you feel nauseated.

You must check your diet and eat easy-to-digest food, such as bananas, toast, chicken, rice, etc. During this phase, you must avoid aerated drinks, caffeine, alcohol, and dairy products altogether. 

Other than this, maintain hygiene, wash your hands before cooking or eating, sanitize the kitchen more often, change your bedsheets daily, and wash dirty clothes every day. 

You must stay away from work or try working from home if there have been symptoms of Gastroenteritis among your colleagues until the situation improves. If there have been stomach flu symptoms at daycare or school, keep your children away for a few days.

Medical Treatment for Gastroenteritis

The doctor would first confirm the cause of the Gastroenteritis, whether it is bacterial, viral or due to parasites. This is done by examining stool or feces samples and conducting a blood test and physical examination. Now, depending on the results, and gastroenteritis symptoms treatment is prescribed.

  • Put restrictions on certain foods such as dairy products, caffeine, alcohol, nicotine, seasoned food, and sugary items.
  • Advising to drink plenty of liquid, either in the form of soup, broth, sports drinks, and rehydration formulas. These are easily available at your nearby pharmacy.
  • Prescribing to avoid medicines such as antibiotics, aspirin, ibuprofen or any kind of pain relief drug.
  • Medication for fever and pain is prescribed, which is generally paracetamol. Along with that, antidiarrheal medications are advised, including Imodium.
  • For children, there are vaccinations that can prevent stomach flu due to rotavirus. Oral vaccination helps to reduce the severity of rotavirus. Your doctor will be able to help with the proper guidance.


It is always advised not to go for over-the-counter medicines as it can lead to severe abdominal pain and worsen the condition if you intake the wrong dose of a drug. So, get an appointment with certified doctors at ILS Hospitals who are there to assist you around the clock through high-end medical facilities.


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5 Complications of PCOS – Causes and Treatment

PCOS or Polycystic Ovary Syndrome is part of a lifestyle disorder where small follicles develop within the ovaries and restrict the regular menstrual cycle. Women of any age can experience PCOS, a hormonal disorder. In this condition, ovaries produce androgens, which are in general present in the least quality. Interestingly, some women develop cysts while others do not. So, the name might seem to be quite misleading. However, the exact cause behind the polycystic ovary syndrome symptoms is yet to be retrieved. 

PCOS has an association with long-term complications, such as Type 2 diabetes and heart disease. Only early diagnosis and proper treatment is the only feasible treatment. 

Let’s get to know about the symptoms, complications, causes and treatment.

Symptoms of PCOS

PCOS can either develop during puberty with the initiation of the first menstrual cycle or later in life due to the response to increased BMI. You need to opt for immediate diagnosis if any of these polycystic ovary syndrome symptoms show up:

  • Irregular periods – Prolong menstrual cycle or infrequent menstruation, which includes abnormally heavy flow.
  • Excess androgen – Physical signs such as the growth of facial and body hair, medically known as hirsutism, baldness, and severe acne and oily skin due to elevated male hormone levels.
  • Skin problems – Dark patches at the back of the neck, near armpits or under the breasts. You can see the formation of skin tags near the neck and armpits.
  • Overweight – Sudden gain in weight primarily around the abdomen.
  • Polycystic ovaries – Missing out periods based on the monthly schedules because ovaries may fail to function normally. The ovaries become enlarged, and cysts develop.

Causes of Polycystic Ovary Syndrome

The exact cause is yet to be determined; however certain factors have been found to be associated with the syndrome, such as:

  • An abnormal rise in androgen leads to male baldness, acne and hirsutism. 
  • Excessive Insulin production leads to a rise in sugar levels in the blood, which triggers the production of androgen.
  • Reduction in progesterone makes it challenging to predict the time for period. Further, you may even miss your periods. Mostly there are chances of a rise in infrequent periods. 
  • Obesity can also trigger the rise in insulin levels, which eventually affect the ovaries and hormonal production.
  • Heredity reasons or mutation in genes can also be the reason behind PCOS.

5 Noteworthy complications associated with PCOS

PCOS can lead to a number of complications due to an abnormal rise in hormones, such as –


Cystic ovaries create a restriction on the proper ovulation schedule. As you know, one egg gets released every month from these ovaries, and due to a lack of sperm, it does not undergo fertilization. But, in case the egg is not released or unhealthy, conceiving can become quite difficult even with the presence of sperm. This can lead to infertility or the inability to get pregnant. 

Type 2 diabetes or prediabetes

If your body becomes insulin resistant, it will start secreting more androgens. Subsequently, the cells in the muscles, organs and tissues are not able to absorb the blood sugar leading to an increase in glucose levels in the blood. This medical condition is known as diabetes which increases the risk of cardiovascular as well as nervous disorders. 

Metabolic syndrome 

These are a group of symptoms that aid in increasing the risk of cardiovascular disease, including heart disease, stroke, etc. The common symptoms associated with metabolic syndromes are high triglyceride, low good cholesterol levels, high blood pressure and high sugar level. 


PCOS generates a high abnormality in the hormonal level, and this leads to unwanted changes being noticed in the body. Subsequently, hormonal fluctuations affect emotions negatively and generate depression and anxiety.

Sleep Apnea

This is a medical condition that interrupts your sleep, where you might feel a repeated pause in your breathing. Most women who are overweight suffer from sleep apnea. Moreover, the risk associated with sleep apnea increases due to PCOS, which can become life-threatening.

Other complications due to PCOS

PCOS also have several other ways to affect your well-being, such as –

  • Gestational diabetes or pregnancy-induced high blood pressure
  • Miscarriage or premature birth
  • Severe liver inflammation 
  • Abnormal uterine bleeding
  • Endometrial cancer

Diagnosis and treatment process for PCOS

As soon as you see the polycystic ovary syndrome symptoms, you must consult with a certified medical specialist. They will go through your medical history, understand the symptoms, and conduct a physical examination. Along with that, several tests confirm the disorder.

  • Physical examination – Pelvic examination, which includes the checkup of your reproductive organs, both internal and external is mandatory.
  • Ultrasound test – To understand the size of the ovary and the presence of cysts. It also determines the thickness of the endometrium.
  • Blood test – To detect the level of androgens and other hormones. Blood glucose level is also checked, along with cholesterol and triglycerides.

How can you reduce the chances of PCOS?

Treatment of PCOs requires focusing on multiple aspects and is also based on the severity of the symptoms. The entire treatment process is divisible into two segments:

Category 1: Do you want to become pregnant in the future? If “YES”, then –

Change in diet and lifestyle activities 

You must focus on maintaining a stable BMI, reduce weight, carry out more physical activities and add a healthy diet to your daily routine. This will help to maintain the insulin secretion in your body and reduce glucose levels.

Medications prescribed by doctors

Drugs can help to maintain a normal flow during menstruation and also clear all the restrictions during the menstrual cycle. However, these often lead to abdominal bloating and pain around the pelvic region.

Category 2: Do you want to become pregnant? If NO, then –

Birth Control Pills

These can reduce the androgen level, control the menstrual cycle, and reduce acne.

Medicines for Diabetes

These are prescribed to reduce androgen and insulin resistance and help in regular ovulation.

Along with these medications, a healthy diet, ditching smoking and drinking, and regular activity are also necessary.

Additional treatment for PCOS

If you have been struggling through PCOS for quite some time and have excessive hair growth on your face and body, then opt for cosmetic treatment, such as laser hair removal. However, always consult with a doctor because PCOS has a risk of developing into endometrial cancer.


Diagnosis at the preliminary stage can help to prevent the situation from turning into a severe condition. So, book an appointment with a certified specialist of ILS Hospitals and do not miss out on the follow-up appointments.

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7 Ways to manage Endometriosis

If menstrual cramps or ‘Dysmenorrhea’ stops you from carrying out everyday tasks, including climbing up the stairs and walking, you consult with a reputed gynecologist. These are signs of Endometriosis, a common reproductive disorder that is found in women 25-35 years of age. Endometriosis has a long-term impact where the tissues of the innermost lining of the uterus start to grow outside. This results in inflammation, scars and lesions, and only a gynecologist can help to manage endometriosis treatment.

The latest report shows that 1 in 10 women are globally affected by endometriosis. The condition affecting women below 25 years of age or postmenopause is rare but not ignorable. It has been reported that women who are lean and tall with low BMI get affected primarily.

What is the risk and cause of Endometriosis?

The common risk of Endometriosis is – Low BMI, abnormalities in the reproductive tract, short menstrual cycle, heavy flow during menstruation, problem in conceiving, etc.

Read Also: First Aid For Heart Attack Everyone Should Know

The cause is not quite clear. It is presumed that the endometriosis developing tissues might have been there since fetal development. Possibly, the condition has taken a spike due to puberty hormonal changes. 

How to detect if you have Endometriosis?

Gynecologists always advise you to follow the signs and symptoms of a disease. This will help in early detection as well as manage endometriosis treatment. 

If you have these symptoms, then it requires immediate medical consultation:

  • Painful periods
  • Severe premenstrual cramps
  • Painful sexual intercourse
  • Irregular bowel movement or constipation
  • Pain during urination
  • Heavy menstrual bleeding
  • Constant fatigues
  • Chronic pelvic pain

You must not skip the diagnosis, as untreated Endometriosis has the risk of developing into ovarian cancer. Further, mismanagement of Endometriosis might lead to infertility.

What are the ways to manage endometriosis treatment?

Doctors recommend a proper medical diagnosis, and based on that, treatments are prescribed.

Medical diagnosis includes:

  • Examination of the pelvis to detect the presence of cysts
  • Imaging tests, including USG, MRI, etc.
  • Laparoscopy
  • Biopsy

Management of Endometriosis

Your choice of endometriosis treatment depends on the severity of the disease. Pain management supplements and home therapies can help at the preliminary stage. If the risk of disease increases, surgeries are the best alternatives. Proper management of the disease can keep it under control but cannot cure it.

To manage Endometriosis, you have to include specific lifestyle changes, and that includes:

Regular exercise

Exercises help to keep the hormone balance in your body, especially estrogen. However, you must never step back if you feel pelvic pain during a workout. You can try brisk walking or any light exercises as an alternative. This would reduce the estrogen level, and you will feel less painful cramps during the period. 

Working out helps the body to create more endorphins which make your body less susceptible to pain. So, with a regular habit of exercising, you will gain the endurance to bear menstrual pain.

Add green to your diet

The latest reports show that with a plant-based diet, you will be able to manage Endometriosis. So, try to add green fresh leaf veggies and fruits to your diet. 

You can also add omega-3 fatty acid, such as walnuts and salmon, which is a healthy fat and helps in the management process. Try to cut down pork, beef, and red meat as these can trigger estrogen levels and increase inflammation.

Stop drinking alcohol

As soon as your body shows signs of Endometriosis, it would be best if you cut down on your drinking habits. Alcohol can trigger Endometriosis and make things worse. 

Moreover, it can lead to severe abdominal pain and also increase abnormal tissue growth. If you are a heavy drinker, then, for the time being, you can switch to wine and beer; that won’t be a problem.

Add a healthy habit

A warm bath can help to relieve endometriosis pain. A long bath soaking in the tub feels quite relaxing. 

Instead of relying on painkillers, you can also put a hot bag or a hot water bottle on your stomach. But, do check the heat intensity and do not burn yourself. 

Try yoga or medication

Stress is part and parcel of the sedentary life and can worsen the endometriosis pain and symptoms. So, try to get involved in meditation or yoga. These have low intensity and involve less movement of the body, but they are highly impactful. 

However, if the pain gets too intense, you can also consult with a therapist or a counselor and learn how to manage stress. These are all part of the self-care routine, and you must learn tricks and tips for stress busters. 

Try to avoid caffeine and gluten products

Caffeinated drinks have the possibility of increasing inflammation and the risk of Endometriosis. This also includes soda, gluten and any sugary products. So, you must keep track of your diet and monitor what you are eating. 

You must also avoid processed food, including bread, pasta, wheat and dessert. Try to include anti-inflammatory food in your diet, such as turmeric.

Get quality sleep

Maintaining a strict sleeping hour can help to boost the immune system of your body, and this helps to fight back Endometriosis. 

So, avoid heavy meals at night and go to bed early. At least 6 hours of quality sleep is necessary to improve your fitness and reduce the severity of Endometriosis.

Try out alternative therapies

There have been proven results of endometriosis pain management for women who indulge in alternative treatment. 

The list includes acupuncture, ayurvedic treatment, herbal body massage or herbal medicines. However, it is always advised to consult with the doctor before considering any therapy.

Medical Treatments to cure Endometriosis

It is most likely that you won’t be able to stand the pain as the conditions get worse. But, we cannot ignore the fact that some women are completely unaware and do not feel the extreme. Thus, regular checkups are suggested to eliminate all possibilities of the disease. 

Doctors take the detailed history, go through the medical test and then suggest treatment –

  • Painkillers – Supplement for the preliminary stage of pain management.
  • Hormone medicines and contraceptives – These to control the growth of the endometriosis layers. 
  • Surgery – When medication is unable to control Endometriosis, surgery is the last option. The surgeon cuts the extra patches of tissues before it infects other organs of the body. Often, this involves hysterectomy (removal of the womb) to reduce the complications and life threats. 


You must not ignore any kind of symptoms and immediately consult with a medical specialist. Based on the conditions, they can suggest the treatment options that would be suitable. 

Delay Further, do not take over-the-counter supplements, as overdose can lead to extreme side effects. At ILS Hospitals, you can consult with the best gynecologist in Kolkata.


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Chest Pain in General Practice: A Systematic Review of Prediction Rules

If ignored, chest pain can lead to life-threatening conditions. Most commonly, chest pain is associated with angina, where the heart muscle fails to receive oxygen. But, there can be other reasons that trigger sudden chest pain.

Thus, consult with a chest pain specialist to determine the predictive rules to understand the reasons behind chest pain. Even predictive tools can help assess the condition in patients suffering from severe chest pain. This helps in clinical decision making. 

Types of chest pain

Chest pain can be classified into various types, such as –

  • Cardiac – In the case of cardiac chest pain, there is a clear sign of blockage within the blood vessels.
  • Possible cardiac – In the case of possible cardiac chest pain, it is not clear whether the pain is due to heart-related ailments. Thus, tests are conducted to affirm the disease.
  • Non-cardiac – In non-cardiac chest pain, it occurs due to an anxiety attack or inflammation of pectoral tissue or pulmonary embolism.

So, it is very much essential to identify the accurate disease by undergoing a specific blood test or any other imaging or procedure base test. Let’s get to know them to help you detect any severe indications.

Test conducted to detect the reason behind chest pain

Often, a combination of all these tests is done to determine the cause of the chest pain. The latest advancement has brought in a high-sensitive serial assessment of cardiac troponin (cTn) blood tests. It assists in detecting the troponin T content in the blood. 

This protein determines whether the patient would suffer from a heart attack. This test can also reveal whether the patient has suffered from any heart attack recently or if there is any heart muscle damage.

Factors to predict chest pain severity

It is very much essential to determine the category of chest pain, and thus you must consider these factors:

  • Age (Cardiovascular risk can increase with time)
  • Family history of coronary artery disease
  • Overall condition of the health
  • Severe and persistent chest pain that fails to go away
  • Feeling extreme pressure on the chest

Symptoms of chest pain associated with heart ailments

Chest pain is the primary symptom of artery blockage, and heart attack and is an indicator of coronary artery disease. However, many patients report feeling vague pain and discomfort. 

Here is the level of chest pain that indicates a heart-related disease:

  • Tightness or pressure on your chest.
  • Crushing pain spreads from the chest to jaw, shoulders, neck and arm.
  • There is a slow rise in the intensity of the pain, and it keeps getting worse due to everyday activities.
  • Compression on the chest with shortness of breath.

Along with these cold sweats, dizziness, and vomiting are clear indications of heart-related disease that require immediate consultation with a chest pain specialist.

Symptoms of chest pain associated with other ailments

Chest pain has always been considered a symptom of heart-related disease, but there might be other underlying reasons that can lead to it. 

Digestive causes

Heartburn, gallbladder problems and swallowing disorder can also lead to chest pain. But, these have a clear association with the body’s digestive system.  

Lung disorders

A blood clot within the lungs, inflammation of the lungs, and high blood pressure can also be a reason behind severe chest pain.

Muscle & bone ailments

Injury in the ribs and sore chest muscles are the primary reason behind chest pain. 

Symptoms distinguish the chest pain associated with other conditions, rather than the heart, are – sour taste or a sensation of food in the mouth, trouble swallowing, the pain increases when coughing and deep breathing and the pain lasts for several hours.


Chest pain can also occur due to anxiety or smallpox. Thus, it is advised to seek immediate professional help without any delay. To lead a healthy life, it is necessary to incorporate specific lifestyle changes. You must maintain a nutritious diet, quit smoking, and exercise regularly. However, do not ignore the complications and book an appointment with an experienced and certified medical specialist at ILS Hospitals.

First Aid for Heart Attack Everyone Should Know

Heart attack is considered to be one of the common life-threatening medical emergencies. However, it is often confused with cardiac arrest, but both are quite different medical conditions. 

During a heart attack, blood flow is blocked, and the heart gets deprived of proper nutrition and oxygen. This situation typically arises due to blockage in arteries or a clogged artery due to deposition of plagues. Thus, a person suffering from a heart ailment is asked to take heart attack precautions.

Further, it is imperative to know that the heart does not stop beating during a heart attack, while in the case of cardiac arrest, the heart stops beating and occurs suddenly.

In India, the death rate due to cardiac diseases is relatively high. So, one must always be aware of the first aid for heart attack. Awareness can help save a life, be it yours or a family member or an acquaintance.

The symptoms of heart attack

Heart attacks have become quite common and can occur in between everyday activities such as relaxing on the balcony, shopping, hanging out with friends or after a peaceful sleep. It is essential to recognise the symptoms of a heart attack to provide first aid.

A heart attack occurs suddenly, and the warning side includes –

  • Discomfort around the chest area
  • Feeling excessive pressure or pain in the chest
  • Excessive pain in the peripheral areas of the body, including arms
  • Pain in the jaw and stomach
  • Shortness of breath
  • Cold sweat 
  • Lightheadedness

In women, specific symptoms differ from men, and these are – extreme fatigue, fainting and pressure on the upper back. Thus, one must take note of the heart attack precautions.

First aids for heart attack

No, you do not need to be a specialist to provide first aid in case of a heart attack. If you have already detected the symptoms, it’s time to take action.

 1. Call an emergency number

It would bring help within minutes, and the patient could be shifted to the hospital at the earliest. Usually, ambulances have a life-saving kit and equipment that can assist the patient

until professional intervention is received at the hospital. This helps to increase the survival rate. Further, the paramedics are trained to revive a person’s heartbeat in severe conditions.

 2. Provide medication 

Aspirin is the standard medicine prescribed during a heart attack as it stops or even slows down the artery-clogging effect. You can either ask the patient to chew or swallow one tablet of aspirin (dose for an adult). Otherwise, if the patient is on heart medication, they can also take that, such as nitroglycerine.

 3. Do not panic 

In this situation, you must keep yourself calm, try to loosen the tight clothes of the patient, and help them sit down and rest. Further, assure them that it’s just a minor health issue. You must try to keep them awake. Do not provide water or food in this scenario, and it is part of heart attack precautions.

 4. Chest compression 

If the patient is about to lose consciousness, then you can provide chest compression. The process is quite simple – kneel next to the patient and lock your hands together. Now, place your hands on the middle of the chest. Next, using the pressure of your entire body, push downwards hard and fast. Try to cover at least two inches deep. 

Continue the compression until the person regains consciousness. You must continue for 100 beats per minute and switch every two minutes. This is also called hands-on CPR and is associated with a “chain of survival” technique. Technically, this helps to increase the chance of someone’s survival rate.


The most important part of dealing with a heart attack is to act quickly. It takes minutes for the heartbeat to stop, so do not wait for the symptoms to fade away. Even if the patient has regained consciousness, you must immediately take the patient to a cardiac hospital for a complete checkup. ILS Hospitals provide the best medical facility in terms of heart attack emergencies.