Menstrual cycle is an integral part of a woman's life. Isse mahilao ki reproductive shakti ka pata lagta hai. A typical menstrual cycle has a timeframe of about 28 days. Lekin kuch ladies mein yeh timeframe 35 days tak bhi ho sakta hai. Every female has different cycle. Usually, it is 11th to 14th day, counting from 1st day of the period, are the most fertile days.

Periods are important because it signifies the childbearing age of a woman. In a normal menstrual cycle, the innermost lining of the uterus starts to thicken to prepare itself for embedding of a growing foetus. In the absence of a foetus, the lining breaks down and results in periods.

Aap periods ke baad kitne din mein pregnant hote hain ye aapke menstrual cycle ki length pe depend karta hai. Typically, in a woman with a normal menstrual cycle length of 28 days, ovulation happens around the 14th day.

Ovulation ke waqt aapki ovary ek mature egg release karti hai. The released egg sits in the Fallopian tube to meet a sperm for fertilization, jiske turant baad aapki pregnancy start ho jaati hai. While a sperm can survive in the uterus of a woman for up to three to five days, female egg sirf 12 to 24 hours ke liye available rehta hai.

Yadi is timeframe ke beech sperm, egg se mil jaata hai toh aapke pregnant hone ke chances zyada hote hain. While it may not be a great idea to try getting pregnant after ovulation, egg release hone se pehle agar aap koshish karein toh pregnancy possible hai.

Therefore, periods hone ke baad se 12th to 16th day pregnancy ke liye kaafi crucial hote hain. In case you have unprotected sex during these days, then there are bright chances that you may get pregnant in this window.

There are certain signs of ovulation that indicates that your body is the most fertile in those particular days. For example, ovulation ki date ke aaspaas aap abdominal bloating, pet ke ek side mein dard aur increases sense of smell mehsus kar sakte hain.

In addition, there is an excessive production of clear cervical mucous, which closely resembles egg white. Agar aap ye symptoms experience karein to iska matlab hai ki your ovulation date is near and you can try and get pregnant around this time.

One way to determine your individual fertile period is to keep a record of your menstrual cycle (for eight or more months, if possible). Select your shortest cycle (say 27 days) and subtract 18 from it. The resulting number nine is your first potentially fertile day. Subtract 11 from your longest cycle (say 30 days) and you get 19. This marks your last potentially fertile day. So if the cycles you measured over several months were between 27 and 30 days long, you would be most fertile somewhere between days 9 and 19. 

This is still a very wide window of opportunity. You can narrow it further by charting your basal body temperature (your morning temperature before getting out of bed). For most women, it ranges from 96 to 98 degrees Fahrenheit. When your temperature rises slightly (four- to eight-tenths of a degree), it usually means you have ovulated within the past 12 to 24 hours. 


Periods Ke Kitne Din Baad Pregnant Hote Hai

Acute viral fever is a type of fever that includes various viral infections, primarily characterized by an increase in the body temperature. This disorder is very common among children and the elderly as they tend to have a weak immune system. Some common characteristics of this condition are skin rashes, body ache and headache.

Causes
The virus that causes this disorder is transmitted from one person to the other. The usual modes of transmission include direct contact, sneezing, coughing and even talking; anything that makes you exposed to physical contact with the body fluids of the infected person. Once the virus enters your body, it can take around 20-48 hours to get activated.

Symptoms
The symptoms of this disorder include a rise in body temperature, vomiting, weakness, loss of taste, swelling of the face. You may feel very lethargic, weak and nauseated. Apart from these symptoms, it may also cause pain in the joints and the stomach. In severe cases, this disease can lead to complications such as arthritis, pneumonia and diarrhea.

Treatment
Antibiotics, analgesics and antipyretics are prescribed when you have viral fever. Apart from the medications, you need to increase fluid intake and take complete bed rest. The body needs to heal; hence being extremely active will be counterproductive to the healing process. Heavy antiviral treatments are prescribed only in severe cases. Apart from medications, there are certain dietary changes that you may have to make to boost the healing process. Avoid spicy and fat laden foods as the digestive system is weak and consumption of such foods may lead to stomach disorders such as diarrhea and acidity. Try keeping your diet restricted to warm soups and fruit juices. Another factor you should be aware of is dehydration, as the body tends to lose fluids during this period. Drink a lot of water and fruit juices to keep your fluid intake at optimal levels.

You can also follow some preventive measure to avoid this disorder:
1. Wash your hands with antibiotic soaps
2. Stay away from crowded places
3. Avoid touching your face with unwashed hands

Acute Viral Fever - Know its Causes and Symptoms

Migraine is the most severe forms of headaches. Migraine attacks usually include nausea, vomiting, and sensitivity to light along with the severe headaches, which are sometimes unbearable. If faced with this condition, there is only one way out to suffer through it, though pain medications do help manage the pain.

Being such a common condition, there is constant research being done about how to help people deal with migraines. In addition to popping pain killers, there is more than what a person can do to reduce the pain.

Identify the triggers: Those who have had migraine for a while would know what triggers the attack. Whether it is chocolates or eggs, get to know what can induce an attack, and if possible, stay away from it.
Stick to a schedule: Whether it is in terms of food or sleep, try and develop a routine and follow it.
Physical workout: Develop an exercise regime to cover at least 30 minutes of physical exercise. Most people see a dramatic difference with a regular exercise routine.
Bid goodbye to smoking: If you are a smoker, work at quitting this habit. It is one of the known triggers and also aggravates regular headaches.
Stress management: Whether you are going through physical or emotional stress, migraine attacks can become more frequent and severe. Manage physical stress by not sitting at the same location for prolonged periods and by doing small exercises to relax the shoulders, knees, and jaws. For emotional stress, identify what helps you relax and follow it. While deep breathing works for some, for others, it could be music. Whatever your relaxation technique may be, ensure that you follow it. Work on improving relationships that stress you out. A regular exercise routine and sleep pattern also helps in reducing physical stress.
Despite these methods, migraine attacks do happen. Follow the next few steps when you know you are getting an attack.

Stop your regular activities and find a calm environment for yourself. Let this place have less of light and sound as they can aggravate migraines.
Sleep if you are able to.
Go for a warm bath if possible.
Try hot or cold compresses, which can numb the senses and reduce the pain.
Have a caffeinated beverage as this will provides relief. Do not have it in excess as you will have hangover effects from the caffeine.
Use only those medications that were prescribed by your doctor. Do not experiment.
Lifestyle changes including exercise, diet, and stress management play a vital role in dealing with migraines.

Migraine - How To Deal With It?

As life expectancy is increasing so is the incidence of vertebral body (VB) fractures now being the commonest fracture of the body. PVP is an established interventional technique in which bone cement is injected under local anaesthesia via a needle into a fractured VB with imaging guidance providing instant pain relief, increased bone strength, stability, decreasing analgesic medicines, increased mobility with improved quality of life and early return to work in days.

In this era of minimally access surgery replacing open surgeries, PVP is a novel procedure & should be in the first line of management in place of conservatism or major spine surgery for painful uncomplicated compression fracture spine.

Morbidity & consequences of spinal fracture:

Traumatic VB is a painful condition requiring bed rest restricting daily activities markedly
Left untreated it can cause DVT, increase osteoporosis, loss of VB height, respiratory & GI disturbances, emotional & social problems secondary to unremitting pain, loss of independence with high cost of rehabilitation.
High risk of primary or consequential damage to neural, bony or disc element
Increased wedging, deformity & increase incidence of adjacent VB
Chronic pain of altered spine mechanics
Uncomfortable braces & sleep disturbance because of pain & discomfort with its sequels.
Cost of surgery and hospital treatment
Cost of implants
Phobia of surgery
Prolonged recovery period & Extensive rehabilitation
Changed spinal mechanics & transition syndrome
Major surgery & anesthesia with its own complications
Results / Outcome

PVP is a novel procedure with high benefit to risk ratio, which is highly underutilized in relation to the high prevalence of the vertebral.
Different studies show an immediate pain relief in (85   90)% of patients with low complication rate ranging from (1-5)% depending upon the type of lesion.
PVP does augment height of VB but ideal would be kyphoplasty
Patient is either off medicine or on reduced doses.
Patient feels so well that he almost forgets if he had VB

Percutaneous Vertebroplasty (PVP) is an emerging interventional technique in which surgical polymethyl methacrylate bone cement is injected under local anaesthesia via a large bore needle into a vertebral body (VB) under imaging guidance providing increased bone strength, stability, pain relief, decreased analgesics, increased mobility with improved QOL and early return to work. Started in 1984 by Galibert PVP is done in host of indications.

Senile osteoporotic compression remains the commonest Indication. Other indications are Metastatic VB, Multiple myeloma VB, VB haemangioma, Vertebral osteonecrosis & for strengthening VB before major spinal surgery. The benefit has been extended to the traumatic stable uncomplicated VB compression (VCF) which is commoner in younger age group with active life profile and prime of their career where strict bed rest and acute or chronic pain are unacceptable and they are more demanding for proactive treatment approach so as to be back to work ASAP.

Discovering the fact that VB is the commonest of body, its incidence >the hip, it becomes imperative to take it more seriously. With increasing life-span there is more of aged osteoporotic population, more so due to sedentary indoor lifestyle and post menopausal osteoporosis. Diabetics, smokers & alcoholics are at higher risk of developing osteoporosis. I have seen such alcoholic patient developing six spine fractures in just three months time from a single fracture being on complete bed rest.

Quick fix of fracture spine makes patient walk back same day instead of bed rest of months together avoiding morbidity & mortality of prolonged bed rest, making bedridden patient walk, in a way bringing patient back to normal life.

In this era of MAS replacing open surgeries, PVP is a novel procedure & should be in the first line of management in place of conservatism or major spine surgery for painful uncomplicated compression.

Morbidity & consequenses of spinal 

Traumatic VB is a painful condition requiring bed rest restricting daily activities markedly.
Left untreated it can cause DVT, increase osteoporosis, loss of VB height, respiratory &
GI disturbances, emotional & social problems secondary to unremitting pain, loss of independence with high cost of rehabilitation.
High risk of primary or consequential damage to neural, bony or disc elements.
Increased wedging, deformity & increase incidence of adjacent VB
Chronic pain of altered spine mechanics.
Uncomfortable braces & sleep disturbance because of pain & discomfort with its sequels.
Morbidity and complication of spinal surgery 

Cost of surgery and hospital treatment
Cost of implants
Phobia of surgery
Prolonged recovery period & Extensive rehabilitation
Changed spinal mechanics & transition syndrome
Major surgery & anesthesia with its own complications
Preparation & Procedure:
X-ray spine in a/p & lat view. CT is more informative of bone & morphology. MRI is good for soft tissue injuries. Ask for pedicle size in all dimensions and construct a 3D image aiming needle placement and cement filling in scan room itself as rehearsal of PVP. This reduces operative time & gives better results. Conventionally PVP is done by hammering the vertebroplasty needle through the bone. Here we use light weight drill to bore through the vertebra. It is important to set the needle at exact entry site & side with right trajectory aiming the defects.

In lateral view needle should go through middle of the pedicle going up to anterior 1/3 of VB. In P/A view the needle can be in midline or paramedian depending upon & if uni/bipedicular approach is planned. Approach varies as per location of vertebra, anterolateral in cervical, costotransverse/parapedicular in thoracic & transpedicular in lumbar vertebra.

Do bone biopsy if there is any doubt about lession. Do dye test (vertebral venography). Make cement more radiopaque by adding barium /or tungsten. Inject cement with 1or2 ml luerlock syringes strictly under fluoroscope in lateral view & cross checking in P/A view. Stop injecting either there is adequate filling or at the first sight of ectopic cement leak. Keep sample cement to see for hardening. Remove needle with rotational movement before cement hardens.

Pain relief is by virtue of different mechanisms postulated :

Cementing of fragments.
Thermal neurolysis of VB nerve ending due to heat of polymerization.
Washing away of nociceptor chemicals.
Neurolytic action of liquid monomer.
By allowing early ambulation decreasing pains of immobility & bed rest.
Complications 

PVP is generally safe with low risk.
Ectopic cement leak is frequent but generally inconsequential.
Outcome 

PVP is a novel procedure with high benefit to risk ratio, which is highly underutilized in relation to the high prevalence of the vertebral
Different studies show an immediate pain relief in (85   90)% of patients with low complication rate ranging from (1-5)% depending upon the type of lesion.
PVP does augment height of VB but ideal would be kyphoplasty.
Patient is either off medicine or on reduced doses.
Patient feels so well that he almost forgets if he had VB

Vertebroplasty (PVP) / Kyphoplasty - Approach To Management Of Vertebral Body Fractures!

Pcos or polycystic ovary syndrome is an endocrine disorder in women, in which the female hormones, progesterone and estrogen, are imbalanced. This imbalance leads to the formation of cysts (benign masses) in the ovaries. Pcos tends to affect your heart functions, fertility, menstrual cycle and appearance.

There are certain symptoms, which can be indicative of pcos; these symptoms tend to begin as a woman's menstrual cycle starts. In certain cases, however, pcos may also affect a woman in her mid age. Pcos can also cause excessive hair growth in unwanted places like above the upper lip, chin, arms and chest like a male.
The symptoms are:

Increase in the production of male hormone, leads to development of male characteristics
The size of the breasts may reduce
The tone and the texture of the voice may change and become similar to a man's voice
Hair may start to fall
You may suffer from acne and pimple breakouts on your face
It can lead to sudden weight gain
It may affect a woman's fertility
It may lead to pain in the pelvis
Other symptoms: apart from these symptoms, a woman may also experience other health complications such as high levels of bad cholesterol, high blood pressure and diabetes.

Causes: the causes of pcos are not well known, however, the likely causes are genetics and hormonal complications. If someone in the family has pcos, then the risk of being affected by pcos rises significantly. The other likely cause is the overproduction of the male hormone androgen in the female body. Although androgen is a male hormone, the female body also produces it in trace amounts. However, in some cases, when it is overproduced, it might impair the ovulation process.

Diagnosis and treatment: once the condition is diagnosed, there are certain treatments, which are recommended for the patient. The condition in itself does not have a cure, but the symptoms can only be controlled. Medications to control the androgen levels in the female body may be administered if you have androgen hormone complication. A balanced diet and an exercise regimen can be chalked out to control body weight and regulate blood sugar levels. If pcos leads to ovulation problems, then medications to facilitate ovulation may be advised.

PCOS: What You Need to Know About It

4 reasons why your vagina can be hurtful

In India, along with a lack of sex education, there is also a lack of knowledge about hygiene of the privates amongst women even in urban areas. When a woman experiences pain in her vagina, while it could be because of various reasons and not necessarily alarming, one does get alarmed. 

Let us understand the reasons.

1. Yeast infection: Dry and itchy vagina can feel painful after a while. Yeast infections are very common and usually most women experience them. They can be treated by medicines, yet it is best to get in touch with your doctor and get a prescription. Your doctor will prescribe an anti-fungal cream after a pelvic exam.

2. Vaginal dryness: This usually happens to post-menopausal women but can also happen to younger women because of certain birth control pills which are low in estrogen and dry up the moisture in one's vagina.

3. Pelvic inflammatory disease: If you are having regular pains during penetration and during your periods, it could be endometriosis. During examination, the pain is usually linked to the lower abdomen where the ovaries are.

4. Vulvodynia: These are mysterious pains which come &amp; go and can be treated with medicines.

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Top 4 Reasons Why Your Vagina Hurts

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