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WHO prequalified vaccine: What is it? (+Podcast)

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What is a WHO prequalified vaccine and why should it matter to you as a parent


Vaccines and immunization are significant causes of concern for parents. It is a topic with many opinions. For me, it’s always about the best possible choice for my child. I want her to be safe from diseases where prevention is better than cure.

Going through well-researched, reliable, and scientific data and recommendations from the highest regulatory bodies lets me choose confidently as a parent. I do what I have to do. I talk to my Paediatrician hubby, discuss with some more Paediatrician friends, read books and current protocols by WHO, IAP, and AAP, and vaccinate my baby accordingly.

But being a doctor, it is easy for me to understand these terms and also understand what they mean. So let me tell you why WHO prequalified vaccines are a big help and as parents, what you need to know about them.

What is a WHO Prequalified vaccine?Listen and read on Haelthwealthbridge #Podcast

What is a WHO prequalified vaccine?[1]

WHO has a vaccine prequalification method. It’s a service to help UNICEF and other UN agencies buying vaccines to do so with less worry. WHO checks the acceptability of a vaccine from different sources.

The World Health Organization (WHO) takes care of a lot of my headache as a mommy and a doctor. Their stringent quality guidelines for vaccines in children help me choose the right immunization schedule for my child. There is a strict protocol for assessment as well as a regular reassessment of vaccines for quality control.

Podcast : Click to listen

What does WHO check?

  • They check the safety profile and efficacy
  • Whether the efficacy of the vaccine is relevant to the target population – this means whether the vaccination for the disease is needed in that particular region according to incidence /prevalence data.
  • The vaccine must meet the specific needs of the programme – its potency, presentation, labelling, shipping conditions, etc. are all critical for it to do what it’s supposed to do.
What does WHO check in vacinnes Read on Healthwealthbridge

Combination vaccines[2,3]

Vaccines are available in combination protecting against major childhood diseases such as Diphtheria, Tetanus, Pertussis, Hepatitis B, Poliomyelitis, and Haemophilus influenza type B. This reduces the total number of shots required to vaccinate babies.

How does a WHO prequalified combo vaccine works?

This vaccine-like other acts by inspiring the body’s immune cells to produce specific protein agents (antibodies) for its own protection against these diseases. You should talk to your Paediatrician, to know which vaccines your child requires. Vaccination is the best way to keep our children protected and safe from diseases. Most of the time a Government will want a bridging trial for the vaccine in the country under consideration. Ultimately it’s the Health of the Nation and the penultimate call is the Health Department of the Government. But the final one rests with parents.

How is the Health of the Nation: The report is an eye-opener!

Health of the Nation Report
Apollo Pro Health

Disclaimer: The article is written after consultation with Dr.Abhijit Misra (MBBS, MD Pediatrics) who is a part of the Healthwealthbridge editorial board. All decisions of vaccination should only be done after in person consultation with your child’s Pediatrician. This is meant for public awareness and not to be taken as professional medical advice.

Reference:

  1. https://www.who.int/immunization_standards/vaccine_quality/pq_system/en/
  2. IAP2018-2019 Immunization guidelines: IAP ACVIP 2018_1 Recommendation (PDF)
  3. Nelson Text Book of Pediatrics

Rape and Murder: Crimes against Society

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The incident of a Hyderabad veterinary doctor ,who worked with animals, being killed by so-called human beings, has created uproar and social media storms. But what happens with each such case?

You know what happened in this case, right? The police were late, family faced hardship lodging FIR, the state minister tried victim-blaming, the young doctor was found burnt to death. Sadness and tears have no words.

Every day we hear of minor girls, elderly women being raped and murdered. Where are their human rights?

The Nirbhaya incident had an underage criminal. What precautions did the state take when he was released in public? Is he getting regular assessments under a criminal psychologist? What about the many other underage rapists and murderers?

‘The problem is it’s not a lone incident and if a proper investigation is followed through, we may find many more such incidents along the regions these people have worked.

Many are asking ”what are we teaching our boys?”

One must remember psychopaths are often born that way and the environment also has a role to play.  What is needed is an early diagnosis, treatment, careful lifelong monitoring, to prevent criminal incidents. This is often difficult. Parents are often afraid of the stigma. Sometimes the parents are killed too. The devious nature of such minds, helps them stay undetected without remorse. The problem is,many of these cases hover just under the radar of detection.Till something gruesome rips of their mask. Timely treatment will possibly lower the chances of criminal activity.

The keyword is timely.

What can the Government do more?

Registration of all people going in and out of every state,(like we do in Arunachal) should be monitored at the railway stations, airports, toll plaza, and local police stations.

Valid identification should be made mandatory.  Especially people who travel frequently from one place to another.If the person is a known criminal with a police record, his entire plan of travel needs to be reported at a local police station and appropriate surveillance to be maintained.

This will help in terror tracking, drug smuggling, arms and money laundering prevention too. It is logistically immense and needs serious intent on the part of state law enforcers and good coordination between center and state.

Registration of sex offenders and the criminal registry should be maintained at all police stations with digital syncing and regular updates.

Maintaining a national database and profiles of such criminals, will maybe help us prevent such crimes? They should not be allowed to live in residential regions with family, near schools and colleges. All illegal encroachers need strict action, as they are often harbouring such elements amongst them by default .The women and children there are also at high risk from them.It’s better if such places atleast have a registry of inhabitants, mainatined to avoid becoming nexus for criminals and drugs.

Make policemen accountable for every case they delay registering and investigating, with strict action and an effect on their retirement benefits. Like good work needs rewarding, shoddy work needs checks and balances.

Rape is not just a physical crime it is a psychological crime and a crime against the fabric of society.

Women should not have to live in fear.  Where is our right to live, die and earn with dignity?

Why are the criminals not afraid?

Why are the law and order forget about zero FIR in each such case? 

Why not make profiles of such criminals and check where they are in localities?

Communities need to come together. Schools need to come together.  Remember the Ryan international school incident?  We never got to know whether justice was served.

Schools need to have a yearly psychological assessment of all students.  Teachers should be given a checklist for warning signs of mental health disorders and drug abuse.This can help in early diagnosis and treatment.  Remember some crimes and some criminals need to be kept strictly in a monitored environment and are not socially fit.

Murder

Taking someone’s life with intent is one of the worst crime against humanity. If not in self-defense, this is against the laws of nature. When someone has done it once, rest assured he could do it again. The more he kills, the easier it will become. The barrier of morality which makes us respect another life when broken with criminal intent, is an irreversible action. Heinous crimes need exemplary punishment. Justice delayed is no justice at all.

My heart breaks with sadness, when I think about this young woman with so much to do in this world, facing such cruelty and untimely death.  If as parents and citizens of this country, we can’t teach our men right from wrong, we will teach our daughters to respond in the language,they will understand.

We may be women,but we are not weak.  You need to remember when the going gets tough we must get tougher.

The Government, lawmakers and those in charge of law and order, do remember Karma. We need you to be the leaders we chose. We want accountability. In each such case. We are waiting.

Does Sugar cause Dental Caries? One favorite habit I gave up

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Does Sugar cause Dental Caries? Yes, it’s the primary cause behind the rotting tooth and also the best-kept secret.

Sugar crash after a chocolate heavy day is one favorite habit I gave up. Almost.

I had a severe sweet tooth. I saved up money to buy chocolates when I was a little girl.  Dairy milk was a favorite, but now I love silk, the Lindt Swiss chocolates, and Bournville too. Do you get the drift?

How sugar causes Dental Caries

I also used to have chocolate grilled sandwiches for breakfast when I was pregnant to ensure calorie count. Life was blissful . At least so I thought. There was only one minor toothache, in this rosy picture.

The problem was two folds:

I started having a toothache

I had severe GERD.

Even with cutting down on fried and spicy food, the GERD didn’t go away, The dental Xray, revealed no caries tooth, but an unerupted molar. That one I had extracted uneventfully, but the teeth sensitivity continued.

My dentist is an excellent doctor and gave me tips about brushing after breakfast to ensure more extended fresh mouth. That helped a lot. I skipped morning milk tea and tried ginger Green, and still, the sensitivity continued

My serum calcium and vitamin D were perfect. But the sensitivity continued.

What was wrong?

It worried me. I knew the answer at the back of my head and just didn’t acknowledge it. My hubby was becoming concerned.

Then a year back after a severe episode of tooth sensitivity, while in the cold mountains of Ladakh, my hubby put his foot down. He told me to keep a record of the food I ate on the days I had tooth sensitivity.

I still wanted to ignore the nagging voice in my head.

 I decided to talk to a few other Dental surgeons and did my own research.

The culprit was sugar!

WHO advisory mentions‘free sugars’ to be limited in your diet. The daily average of a maximum of  10% of total calories (‘strong recommendation’) for adults and lower for children. This helps to minimize the risk of dental caries throughout the life course.[1]

Coincidentally I found an article in the Newspaper, about the World Dental association talking about how no one discusses this simple step of lowering sugar, for better dental hygiene. They were very vocal about how cosmetic dentistry is the rage, but Dentists were keeping quiet about preventive Dental care.

Why does no one give advice about saying no to excess sugar? Maybe because you and me we all know that sugar is bad, just didn’t want to acknowledge it. Sugar addiction helps big processed food corporations mint money. They would be the last people to tell you that.

 The right amount of calcium, magnesium, phosphorus, and VitaminD, fluoride are all critical. But low dietary simple sugar is non-negotiable.

The worse culprits are processed sugary snacks like packaged cakes, cookies, pies, frozen desserts, ice creams, ice lollies, definitely candies, sweets, and most chocolates.

Calories in Sugar

That’s about 40 -55 grams of sugar per day. That’s 1o teaspoons of sugar. Remember one teaspoon holds about 4/5 grams of sugar. One tablespoon is equal to 3 teaspoons. One gram sugar is around 4 Calories.

The American Heart Association recommends about 100 calories from free sugar. That comes to even lower than the WHO recommendation to about 6 teaspoons per day.

I have perfectly normal blood sugar, but eating sweet stuff made my tooth sensitive and gave me a sour taste in the mouth!

I combatted this by eating something savory at the end of meals and not sweet. Interestingly I face no problems with fresh fruits. The nature of the carb is obviously important.

I avoid sugar in my morning tea. The morning coffee does have sugar, but very little and  I brush afterward that helps. When I do have a piece of chocolate, it’s not more than one piece a day. I just nibble the chocolate and take a long time eating it. It’s a little sad but I like being healthy and toothache free better!

But what are these free sugars in your diet?

List of Simple sugars in your food labels will have sugar dressed up as raw, brown, processed, molasses, syrups, etc.

List of simple sugars causing Dental caries
List of simple sugars causing Dental caries

Monosaccharides:glucose,fructose,galactose

Disaccharides are two monosaccharides holding hands in chemical composition.

Maltose:glucose +glucose

Lactose: Glucose +galactose

Sucrose: Glucose+Fructose

Table sugar, granulated sugar, or regular sugar has sucrose. Inside your body, these disaccharides easily break down into monosaccharides.

They are added to your food at multiple steps and build up.

What about the sugar content in Jaggery?

Jaggery is a natural sweetener having several benefits nutritionally.But it has a whole lot of simple free sugars too! It has 65-85% sucrose and 10-15 % glucose and/or galactose. For people with dental caries or diabetes, you cannot go overboard with jaggery or any other natural sweeteners.

Who adds the sugar in your food?

Types of sugars in your food which are bad

The manufacturer ( processed food and packaged food), cook (in a restaurant, by you (consumer at home).These are also sugar present in honey, corn syrup, maple syrup, fruit concentrates, fruit juice, health drinks, energy drinks, candies, sweets, chocolates, packaged snacks, etc.

High dietary sugar has a significant role to play in the early onset of obesity, diabetes, cardiovascular disease, dementia, and tooth decay.

When fruit juices with pulp are packaged, most of the fruit sugars are already broken down. Until you do a chemical analysis, there is no way of knowing the nature of the calorie you consume.

The rule of thumb. The more processed it is, the simpler is the sugar form. Sugar intake has a strong correlation with a noncommunicable disease like caries with a worldwide load.

What is the Primary Cause of Dental Caries

The primary cause of Dental caries is Dietary free sugar, as proclaimed by the World Dental federation[1], who took out a policy statement to fight misinformation regarding Dental preventive healthcare.

What happens when you eat a free sugar or a simple sugar and  don’t brush your teeth immediately after

Sugar anywhere in the oral cavity acts as a bacterial medium, helping in bacterial growth.

The proliferation of Dental caries causing harmful bacteria is caused by that sugar in the chocolate.

The sugar is converted into acids that erode the dental enamel and cause cavity!

Oral hygiene, levels of care, other deficiencies, and educational profiles all have a role to play but are not aetiological factors [2].

How to Prevent Dental Caries?

Remember, this is the most extensive worldwide study, which found that higher prevalence and severity of dental caries intimately related to free dietary sugar intake. If sugar is more than 10% of total daily calories,higher it is the risk of caries. The risk is lifelong, and so are the benefits.[1,4]

Tooth brushing helps prevent the severity and prevalence of Dental caries.[5]I prefer Sensodyne for my family, and low free sugar is my new mantra.

Dental Caries in India [3]

In India, the prevalence of dental caries range from 33.7% to 90% in childhood and is alarming due to rampant advertisement and ingestion of sugary food.[4]

Decayed missing and filled teeth are more in teenagers than younger children. Boys more than girls have more sugary drinks and often report more oral health issues [6,7].

Conclusion

Oral health has a deep relationship with overall health. Sugar is also addictive. Unfortunately, a lack of transparency in dental health awareness has led to a massive childhood dental caries incidence with lifetime disease burden.

Low free sugar means small dental caries. The recommended minimum is 40-55 grams of free sugar [6,7].

Food manufacturers should lower sugar quotient in packaged food and clearly declare the relation of HFSS. Affordable toothpaste with good fluoride content and national health authorities creating awareness and food safety guidelines will go a long way in preventing this problem.

This post is a part of Blog Anniversary celebrations of Thoughts by Geethica Turns 3 co-hosted by Zainab and Ashvini.

References:

1 )Dietary Free Sugars and Dental Caries
2)The effects of sugars intake and frequency of ingestion on dental caries increment in a three-year longitudinal study.
Burt BA1, Eklund SA, Morgan KJ, Larkin FE, Guire KE, Brown LO, Weintraub JA.
https://www.ncbi.nlm.nih.gov/pubmed/3053822
3) Salivary levels of Streptococcusmutans and Lactobacilli in 13-15 years
old children of Belgaum city, Karnataka. J Indian Soc Pedod Prev Dent.
2005;23(1):23-26. Hegde PP, Ashok Kumar BR, Ankola VA.
4)Effect on caries of restricting sugars intake: a systematic review to inform WHO guidelines.
Moynihan PJ1, Kelly SA. J Dent Res. 2014 Jan;93(1):8-18. doi: 10.1177/0022034513508954. Epub 2013 Dec 9.
https://www.ncbi.nlm.nih.gov/pubmed/24323509
5) Prevalence of dental caries, the effect of sugar intake and tooth brushing practices in children aged 5-11 years in Bangalore North
Deepak Viswanath, Nimmy Sabu
http://www.srmjrds.in/article.asp?issn=0976-433X;year=2014;volume=5;issue=3;spage=155;epage=162;aulast=Viswanath
6)Chi, D.L., Hopkins, S., O’Brien, D. et al. Association between added sugar intake and dental caries in Yup’ik children using a novel hair biomarker. BMC Oral Health 15, 121 (2015) doi:10.1186/s12903-015-0101-z
7) Association of sugary foods and drinks consumption with behavioral risk and oral health status of 12- and 15-year-old Indian school children
Kailash Asawa, Nandini Sen, Nagesh Bhat, Mridula Tak,1 Pratibha Sultane, and Vishal Patil2
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5852983/

52 Weeks of Thankfulness: Looking Back #ThankfulThursdays

By on 26

The last year has been amazing. One of my most challenging years. It has also been extraordinarily fulfilling. Today I decided to look back on the year and say thank you.

52 weeks of Thankfulness has made me stronger. What you focus on grows is a truth that we often ignore. In our surroundings, we can’t avoid terror attacks, murders crimes, and horror stories. But inside us, we can make a garden. We have control over what we want to grow in our heads and hearts.In my own mind, I  have a blueprint.

The few things  I do to find inner Thankfulness:

One: Do something I love every day. Read a book/doodle, garden

Two: Exercise

Three: Remind me of all the good things that happened to me.

 I write many thankfulness posts. It started when I was celebrating Thankful Thursdays.

I wrote on many topics to express Thankfulness. You can find all of them by following the link below. You can also pin the list to help you write your thank you notes to the Universe!

53 Weeks of Thankfulness 

52 Weeks Thankfulness Writing Prompt by Amrita Misra

How is the Health of the Nation: The report is an eye-opener!

Health of the Nation Report
Apollo Pro Health

If you have missed writing for any of this you can write  and tag me on Twitter @misra_amrita #ThankfulThursdays

Trust me when I say my life changed when  I wrote thank you. Now when I look back, 3 Reasons I am most thankful for are:

1)I am sticking to my walking routine and even wrote a book about it.

2)I  am definitely getting better at  being a yogini and practicing meditation

3)My amazingly supportive family and friends.

Here are 3o more reasons you can identify with.

IVF Treatment Quick Truths:How to make Test Tube Baby the Right way (Podcast with Doctor)

By on 26

How to make Test Tube Baby the right way? IVF treatment needs expertise and the right set up.

I recently interviewed Dr.Jayalakshmi Suraj and while talking to her a few things emerged. Listen to the podcast or watch the video and for more information don’t forget to read the post.

Dr.Jayalakshmi Suraj Medical Director and IVF coordinator, of Dreamflower IVF center talks in detail about what couples should know about healthy lifestyle practices when they are planning an IVF treatment. While talking to her a few things emerged.

Questions the Doctor answered

What is the average success rate of successful live births at the Dreamflower clinic?

What are the steps you take to help couples prevent IVF failure?

How to make Test Tube Baby the right way? Interview with Dr.Dr.Jayalakshmi Suraj

What can the couple do by themselves, to improve the emotional bonding while going through a tough process like IVF?

Where can the listeners connect with you for more information Doctor?

Children are definitely God’s blessings. Some people want children, and some are not yet in that space, and some definitely don’t want to. One of my friends delayed planning a baby for ten years. Then they tried the conventional way. It didn’t happen. Her Obstetrician,  checked them out found them, healthy and advised them to try some more. The baby still didn’t arrive. They went for IVF for 2 years, and my poor friend was a wreck. But she was yet to have a baby.

Now my friend and her hubby probably had something called an Idopathic variety of infertility. That’s when both partners are okay anatomically, physiologically, and still somethings not clicking. They finally did have two children, but that’s part of another story. But today, I will tell you about what you need to know if you are planning IVF.

Quick Fact: Only 25% of intercourse in healthy adults, even when timed, result in pregnancy. So implantation needs work. But what about IVF or in-vitro fertilization? How successful is it?

What is IVF treatment or In vitro fertilization ?

In simplest terms: When the union of the female egg and male sperm happens inside a petri dish in the laboratory,  under controlled circumstances, to increase the chance of creating a live embryo its called in-vitro fertilization or IVF. The embryo is frozen for future use or transferred into the uterus of the mother to be.

What is Test tube baby?

When an embryo is created inside a petri dish .test tube through IVF its  called a test tube baby.

The egg, sperm, the embryo can be yours and your partners or donated, depending on the medical profile of each couple.

In some cases, drugs to enhance fertility and intra-uterine  seminal injection may help, and IVF may not be needed. Every couple is unique, and your doctor will help you understand what will help you most.

What is Recurrent implantation failure?

Recurrent implantation failure is defined as the failure to achieve a clinical pregnancy, following the transfer of a minimum of four good-quality embryos in a minimum of three fresh or frozen cycles of a woman less than 40 years.

Quick fact: Higher the age of the mother, higher is the risk of Implantation failure

If you are thinking about IVF or having RIF, be aware of the tests needed and lifestyle changes you must make. Emotional preparedness will help you on this journey. Both partners must be positive about the process, and conflict should be resolved before starting. The women’s body is flooded with hormones during the process, spousal support is essential.

Watch on Youtube and don’t forget to subscribe to my channel.

What can be done for a successful IVF and prevent RIF?

Doctor at the IVF center may suggest

  • A detailed blood workup including hormonal assays, Antiphospholipid syndrome screening
  • Ultrasonography
  • Hysteroscopy
  • Endometrial Receptivity Assay(ESA)
  • Platelet-rich plasma(PRP)

Depending on the couple, the success rate of IVF-ICSI can further be improved by egg donation, sperm donation, embryo donation, or surrogacy. You can visit a center like Dreamflower IVF clinic who are trying to bring joy in north Malabar with their work.

Listen to the services they offer. (Podcast embedded)

What you can ask the doctor:

Ask them about the team of doctors who will be treating you. Experience and qualification both are important.

  1. Ask for data about successful live births following IVF.
  2. Successful live births in couples with  RIF.
  3. How they approach cases of RIF, and what can you do to increase the chances of having a baby.

9 Positive Lifestyle changes which will help make IVF successful

  1. Obesity is linked to increased miscarriage rates and other complications of pregnancy.
  2. Stop smoking, alcohol, and drug abuse.  This is recommended for both partners.  Caffeine intake should also be limited.
  3. Don’t stress it.  Stress causes the release of the stress hormone cortisol, which is terrible for you in all sorts of ways.  If you confirm doing it, the good work is undone. If you stress about becoming pregnant, that’s a significant barrier to becoming pregnant. Relax, talk to your partner.  Enjoy cuddles and being emotionally intimate.  The love in a relationship makes the baby-making fun.
  4. Stay active, fit with a healthy average.  Underweight or overweight both can cause significant problems. Walking is a good exercise.
  5. If you have a thyroid problem, diabetes mellitus gets checked and correct that before planning conception.
  6. The truth is both the egg and sperm quality go downhill as women and men grow older.  Time waits for no one.  Quality and quantity both may be affected.
  7. The timing: Know about your ovulation time.  From five days before ovulation till the date it happens, it is the most fertile period.  That’s about 10-14 days before your next period.
  8. Staying positive will help as it floods your body with endorphins.
  9. If you are sad about miscarriages and RIF: Please be kind to yourself

There is also an immunologic basis behind infertility. This means your immune system can help or hinder the process.  Creating an environment to activate the reward system can help.  Stop thinking about baby-making and focus on having fun.  Enjoy activities together or with friends to encourage positive interactions.  This helps boost up the immune system without medication or invasive procedures and can be done at home or anywhere you are comfortable.  Creative hobbies, travel, visit a park, nature walk, meeting friends, can help boost positivity.  This can be tailored to your hobbies and habits and could be a significant first step.

What are the causes of Repeated Implantation Failure?

Its a complex mix of anatomical, endocrine, immunological, hematological, and endocrinological and genetic causes.

First, you have to find out what is causing the problem?

The uterus needs to be assessed. Inadequate uterine receptivity causes an average of two-thirds of implantation failures. The embryo itself is responsible for only one-third of these failures [1].

The two main factors in this are

1 )Maternal  factors

  • Uterine anatomic abnormalities are:
  • Other Common Maternal factors:
  • Septate uterus
  • bicornuate uterus
  • Uterine fibroids, especially submucous type
  • Endometrial polyps
  • Intrauterine adhesions
  • Hydrosalpinx.

This is a complex area. But uterus distorting lesions which can prevent implantation may need to be treated in case of RIF.

  • Thrombophilia
  • Connective tissue disorders
  • Non-receptive endometrium(uterus lining not sticky enough to hold on to the baby)
  • Immunological factors

2)Embryological factors are :

Genetic abnormalities or other elements of the embryo that reduces its ability to get attached and develop in utero. When miscarriages happen in the first trimester, this is more likely to be a  chromosomal anomaly making the embryo nonviable.

Embryo abnormality occurs due to either paternal sperm factors, or egg, and also its ability to being fertilized regularly and cleave. The abnormal karyotype of the embryo is a significant reason for implantation of failure as well as miscarriage.

About Preimplantation Genetic diagnosis: Should you do it?

If you are facing RIF, you and your partner may be advised to undergo karyotype testing to rule out balanced chromosomal translocations, genetic counseling. But there is inadequate data to justify routine preimplantation genetic testing.

IVF is a complex topic and needs a detailed understanding of the physical, emotional, financial, and legal implications before going for it.

Conclusion:

Repeated implantation failure can occur due to many reasons related to the couple and Technology. From the age of mother to  timing of collection of eggs, quality and quantity of eggs collected, Quality of sperms, Chromosomal issues, Idiopathic causes.

But don’t be disheartened. A positive outlook helps in more ways than one.  Look for a center equipped to handle situations like yours. 

Before choosing a center, ask for data related to successful live births after IVF. Having access to such information may empower you to make a more informed decision.

Successful implantation is multifactorial. It depends on a tango between a working endometrium and a healthy embryo. Any abnormality in one or both these variables can cause repeated implantation failure. The condition should be assessed for its different causes and be treated accordingly. In all cases, a good doctor and a good set up can help you.

Make baby joyfully.

Test Tube baby
Test Tube baby

How is the Health of the Nation: The report is an eye-opener!

Health of the Nation Report
Apollo Pro Health

References

Homer, H. A. (2019), Modern management of recurrent miscarriage. Aust N Z J Obstet Gynaecol, 59: 36-44. doi:10.1111/ajo.12920

https://www.ncbi.nlm.nih.gov/m/pubmed/25775926/

https://www1.racgp.org.au/ajgp/2018/july/recurrent-pregnancy-loss/

https://obgyn.onlinelibrary.wiley.com/doi/full/10.1111/ajo.12920

Recurrent pregnancy loss: A summary of international evidence-based guidelines and practice

Ying Hong Li   Anthony Marren 

doi: 10.31128/AJGP-01-18-4459 |

Nepomnaschy PA, et al. Cortisol levels and very early pregnancy loss in humans: Proc Natl Acad Sci U S A; 2006. p. 3938–42.

Bashiri, A., Halper, K.I. & Orvieto, R. Recurrent Implantation Failure-update overview on etiology, diagnosis, treatment and future directions.  Reprod Biol Endocrinol 16, 121 (2018) doi:10.1186/s12958-018-0414-2

https://www.ncbi.nlm.nih.gov/pubmed/24269084

Biomed Online.  2014 Jan;28(1):14-38. doi: 10.10

16/j.rbmo.2013.08.011. Epub 2013 Sep 14.

https://rbej.biomedcentral.com/articles/10.1186/s12958-018-0414-2

Recurrent implantation failure: definition and management.

Coughlan C1, Ledger W2, Wang Q3, Liu F4, Demirol A5, Gurgan T5, Cutting R1, Ong K6, Sallam H7, Li TC8.

Superfans by Pat Flynn (Book Review):7 Reasons Bloggers must read the book

By on 22

I listened to Superfans by Pat Flynn , expecting good things. I was definitely not disappointed. I also reviewed the Switchpod tripod for phone vlogging.

If you are in the online space,  blogging, writing, digital content marketing, social media ninja whatever, you need a community supporting you. Nothing works in a vacuum. There must be human interaction. But who are these humans? Who are your readers, followers superfans?

While Pat Flynn has a superfan in me, many of you will be shaking your head and thinking. Nah, I am no SRK, I don’t have superfans. This book is then something you need to read.

The short  Superfans review:

This book is not just about creating Super fans but relationships. If you are selling anything, online or offline, Superfans will give you a 360 view. It tells you how to set up your brand that your customers, readers, the audience will love you from day one. It’s not just about a good product or great service, it’s about the human connection. Think of it as a must-read if you want to build communities. I received the audio file as a gift, and the opinion is in no way influenced by anyone. Pat, as the narrator pleasant to hear and makes one pause and think.

Now read the extended version. or buy the book by clicking here.

 

7 reasons Superfans is a must-read for Bloggers

  1. If you have a blog, you know the drill. Publish and wait for traffic. But what if people waited for your blog posts and your books? Is it possible for a new blogger like you and me to do that? Yes, it is, and Pat tells you how.
  2. You are an introvert and don’t like interacting with people, superfans make you uncomfortable. Don’t worry, the book tells you about how to be friendly without losing balance.
  3. The side effect of having Superfans and how you can avoid it.
  4. How to build your brand so that people remember you from the noise. He tells us about his early days, the problems he faced and the decisions he made.
  5. You will know that people who work with you need to have a similar ethical stand if you want your brand to shine. Online or offline people around you reflect your choices too.
  6. How you can grow your business while staying loyal to your superfans. A customer will buy once a superfan will not only purchase but will refer to promote and support you even without asking.
  7. How can you give back to your community and build a circle of kindness? Because likes,  followers, customers, and subscribers are not just numbers. They are real people with real emotions. People who help create magic in other’s lives through the work they do create superfans.

Think first about making the world a better place. Writer, blogger, author, small or big business owners everyone can make more money while helping people if they remembered this

Because giving back is essential.

This book by Pat Flynn Superfans definitely does.

The Book

Superfans:  The Easy Way to Stand Out, Grow Your Tribe, and Build a Successful Business

Niche: Nonfiction

Author Pat Flynn

Version:Listened to the Audiobook.

SUPERFANS by Pat Flynn Book review by Dr.Amrita Basu
SUPERFANS by Pat Flynn Book review by Dr.Amrita Basu

About the Author

Pat Flynn is a fantastic podcaster, author, and founder of several successful websites, including SmartPassiveIncome.com.

Don’t forget to let me know what you think about this book in the comments below. Buy the book here

The book I reviewed last week 

How is the Health of the Nation: The report is an eye-opener!

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  • Vishakha Talreja says "Amrita has immense knowledge of health-related content. Her writing style is reader-friendly and I have seen her blog posts go viral for the sheer fact that they are informative and helpful.
    As a doctor too her knowledge is noteworthy and she always gives the right consultation that is in beat interests of those consulting her. She is also hands-on on the issues faced by her own community. Having worked with her I can definitely vouch for her professionalism and punctuality."  
    Vishakha Talreja
  • Roshan Radhakrishnan says "An extremely talented doctor and author of multiple books, Dr. Amrita does a great job managing multiple roles with ease." Anaesthesiologist (Human painkiller) ¦¦ Winner #TOIWriteIndia - S01 & 02 ¦¦ Finding #HeroesOfKindness across the world
    Roshan Radhakrishnan

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