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Management of Abortion
Caesarean Section Procedure
Treatment Of Female Sexual Problems
Termination Of Pregnancy Procedure
Treatment Of Pregnancy Problems
Well Woman Healthcheck
Treatment Of Female Sexual Problems
Treatment Of Medical Diseases In Pregnancy
Treatment Of Menstrual Problems
Intra-Uterine Insemination (IUI) Treatment
Medical Termination Of Pregnancy (Mtp) Procedure
Gynecology Laparoscopy Procedures
Pap Smear Procedure
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With increasing globalization and lifestyle changes, even general practitioners are getting more and more young patients willing to adopt contraceptive measures. An optimum clinical choice of contraceptive can only be done through a mutual discussion between the physician and patient taking into consideration both clinical aspects and patient's choice. This article gives a brief general summary of the methods of contraception.
Contraception is the process of taking steps to ensure about not becoming pregnant after having sex. There are different types of contraceptive measures. They all have pros and cons. Different methods will be right for different couples, or right at different times in life.
Types of contraceptives:
* percentages mentioned within brackets are failure rates
It involves the use of estrogen and progesterone to prevent fertilization; associated with a 2-3% failure rate.
Oral contraceptive pills suppress the action of fsh/lh from the pituitary gland, they also suppress the lh surge, alter the cervical mucosa to inhibit penetration by spermatozoa, and they inhibit atrophic change in the endometrium.
Complications: venous thrombosis, pulmonary embolism, cva, mi, htn, amenorrhea, cholelithiasis, hepatocellular adenoma. Risks increase with smoking.
Contraindications: dvt, pe, cvd, cva, pregnancy, cancer, abnormal lfts
Monophasic (fixed combination: take estrogen and progesterone on days 1-21 and placebo on days 22-28. Increased estrogen increases the side effects of a headache, weight gain, nausea, and edema decreased estrogen and progesterone increase the risk of breakthrough bleeding and increases the failure rate.
Multiphasic: low-dose estrogen with varying doses of progesterone on days 1-21.
Progestin-only pills: not as effective and can cause breakthrough bleeding.
Levonorgestrel: lasts up to five years.
Medroxyprogesterone: lasts three months.
Decreases the risk of ovarian and endometrial cancer and decreased the risk of ectopic pregnancy.
It involves the insertion of a small device into the uterus with the hopes of inhibiting implantation, altering tubal motility, or inflaming the endometrium.
Intrauterine contraceptive devices are associated with a relatively low failure rate (2-4% pregnancy rate) but do suffer from a higher rate of complications (e. G, four times increased the risk of ectopic pregnancy).
Intrauterine device (iud) with progestogen: it releases progesterone and must be replaced annually.
Iud with copper-t: it contains copper and can last up to 4-6 years.
Increased blood loss and duration of menses, increased dysmenorrhea
Expulsion of iud, pregnancy, perforation of the uterine wall when inserted, increased risk of tubo-ovarian abscess (esp. Among younger nulliparous females with greater than ;1 sex partner). Pid is not as common with the newer iuds but still a significant risk factor.
Indicated for: multiparous women greater than 35 years who smoke.
Concerns about pelvic infections and subsequent fertility often limit the use of iucds to women who are at low risk for sexually transmitted disease and to those less likely to desire further children, i. E, monogamous multigravid patients.
It involves the use of an artificial device to inserted into the vagina or fitted to the penis with the intent to retain the products of intercourse.
Condoms: condoms have a 2% failure rate in consistent couples and a 10% failure rate in occasional users. They are best indicated for std prevention.
Vaginal diaphragms: they have a 15-20% failure rate, but when combined with a spermicidal jelly and left in for 6-8 hours post-coitus failure rate declines to 2%. Diaphragms are associated with side effects of bladder irritation and cystitis, also colonization with s. Aureus if left in too long.
Cervical caps: they must be properly fitted and can be left in for a longer time than the diaphragm.
It has a 15- 20% failure rate and involves the use of sponges and spermicides.
Spermicides contain surfactants to disrupt cervical membranes; placed in the vagina up to 30 minutes before intercourse.
It involves the avoidance of intercourse from an onset of menses to 2-days post ovulation.
This method involves manipulation of parts of male and female anatomy such that conception is prevented by failure and gametes to combine.
Vasectomy: lesser than 1% failure and can be successfully reversed in some cases.
Tubal ligation: lesser than 1% failure rate. Increase risk of ectopic.
Emergency contraception pills - emergency contraception can be used if one had sex without using contraception; or if someone had sex but there was a mistake with contraception.
Emergency contraception options are usually very effective if started within 3-5 days of unprotected sex. The earlier you take this pill, the more effective it is. It works either by preventing or postponing ovulation or by preventing the fertilized egg from settling in the womb (uterus).
A proper patient counseling informing the success rate and complication of contraception should be an integral part of the treatment regime.
Respected Sir this is to inform you that I am having benign fibroadenoma sice 2 years and on may 2016 I again did thoroughly check up and I did biopsy too. Result came negative like before. And size is 2 cm. Since two years the tumor is not growing. No discomfort is there but if pressed pain in there. No family history of fibroadenoma. Actually I was having irregular periods and I took medicine for 5 years primolut tablet, now it's been a year I have stopped medicine. Fibroadenoma will increase the chances of breast cancer. If I will not remove the tumor in lifetime what will happen. If surgery has to be done at what age I have to do ? Right now I am 24 and I am married. What will be the best option sir?
I am 18 years old and I have a problem in my period and I miss my period for three month and a lot of white discharge and I have stomach and headache badly.
Is it safe to take vitamin d supplement (uprise d3) in first trimester of pregnancy. I was on supplement before pregnancy also due to low level of vitamin d.
Tash level is 6.30 T3 is 1: 04 and T4 IS 8: 50 and i am facing problem of irregular menstrual PERIOD and i am also over weight so please advice me for that how to treat with that
Hello, I am a 30 years old unmarried girl with a healthy lifestyle and good eating habits. I am having vaginal yeast infection with cottage cheese like discharge from my Vagina. Its very itchy and burns while having sex. There are fine cuts on the vaginal opening too. I wash the area with V wash twice a day and keep it clean and dry still the problem occurs on and of for the past 5 to 6 months. Please prescribe some medicine. Thank you!
After how many cycles of follicular study and tablets for conception can we go for intrauterine insemination.
It is common for most of us to wonder how some celebrities just don't seem to age, both in terms of looks and physique. It is not easy and requires in addition to a lot of hard work, loads of determination and self-constraints to achieve that. however, different bodies react differently to different food items and there is no one size that fits all. Though media claims and promotes various celebrity diet plans, but a word of caution. A detailed physical examination and discussion should be done with your dietician to identify what will work best for you. Listed below are some things that has helped celebrities to lose weight.
- Regular, well balanced meals: It is popular belief and advise that eating regular, small proportioned meals with the right mix of protein, carbs, and fats is the best way to lose weight. Of course, there have to be supplements to this including a good workout regime, reduced alcohol, reduced refined sugars, etc., but most people believe starving to be skinny is not the healthy way to go. Another good rule to follow is the 80/20 rule that is enforce discipline and let 80% of your food be nutritious and 20% can be damaging (chocolate cake included!). Most would also set a daily intake target and keep a count of the calories that are ingested.
- Increased fiber: Be it greens or vegetables, fruits, or dry fruits, added fiber makes you feel full and reduces the amount of food ingested. Atkins diet, which pumps your body with fiber for 3 consecutive days helps by flushing out a lot of toxins and is one of the most widely followed detox diet plans.
- Flush out with Lime Juice: Beginning your day with a glass of lime juice and warm water is supposed to flush out the toxins and reduce weight. Adding ginger and mint is believed to make this work better.
- Replace red meat with chicken: While chicken is believed to increase the protein intake levels, reducing red meat is believed to help reduce weight.
- Do away with the dairy: A lot of dairy products, which forms the main source of proteins, especially for vegetarians is believed to add to the weight. If weight loss is your goal, then dairy should stay out of your food diary.
A lot of celebrities also use natural boosters and suppressants to reduce appetite. Removing alkaline food items from your menu, gluten laden foods, alcohol, refined carbs, are followed as well. Weight loss supplements are another option, but should be used only under supervision and as a last resort. As mentioned, celebrity diet patterns should not be followed blindly. They are highly personalized and seek advice before adapting it.
I have been on birth control for about two months skipping the placebo week as my doctor instructed and starting right away the next pack. I have not skipped any days but on two different occasions I took my pill at a later time. About a week ago I had sex with my ex and we did not use condoms and he did in fact cum in me about 3 or 4 times and I was and currently still am on my period. My period had gotten heavier as they usually do and mines usually last about a week and a half to two weeks so I still have a some bleeding days ahead of me. My question is, is there any chance I could be pregnant? Also I have PCOS which I know is supposed to make it harder for me to get pregnant. Thank you for your time in advance.
I have regular acidity problem. Its happens hence last two year. Its increase more and more since over the period of time. I take many suggestion from many expert doctors to killed this problem. But relief only 2or 3 days. What medicine take to totally killed it and what precaution I take to killed problem.
Hoi. Dr. I want to ask a question DAT what precautions should I do while in pregnancy in the month of seven.
Adverse respiratory events (AREs) are leading causes of post-operative morbidity and mortality. Anesthesia is the use of medicine to prevent or reduce the feeling of pain or sensation during surgery or other painful procedures (such as getting stitches). Giving as an injection or through inhaled gases or vapours, different types of anesthesia affect the nervous system in various ways by blocking nerve impulses and, therefore, pain.
Anesthesia can help control your breathing, blood pressure, blood flow, and heart rate. It may be used to:
- Relax you,
- Block pain,
- Make you sleepy or forgetful,
- Make you unconscious for your surgery.
Adverse Respiratory Events (ARE)
Adverse outcomes of such events are fatal and lead to Death & Brain Damage. Three mechanisms of injury are reported to account for highest adverse respiratory events:
Inadequate Ventilation: Insufficient Gas Exchange can produce the adverse outcome. Esophageal Intubation: Incubation between the two sides of the esophagus inadvertently.
Difficult tracheal intubation: Tracheal Intubation is the placement of a flexible plastic tube into the trachea (windpipe) to maintain an open airway. It is performed facilitate ventilation of lungs in severely ill, anesthetized patients.
Other’s are as listed below:
- Airway Obstruction
- Inadequate inspired oxygen delivery
- Endobronchial Intubation
- Premature Extubation
Residual neuromuscular blockade is an important postoperative complication associated to the use of neuromuscular blocking drugs and is commonly observed in the post-anesthesia care unit (PACU) after non-depolarizing neuromuscular blocking agents (NMBAs) are administered intra-operatively. Incomplete neuromuscular recovery can be minimized with acceleromyography monitoring. The risk of adverse respiratory events during early recovery from anesthesia can be reduced by intra-operative acceleromyography use.
Reintubation is a serious adverse respiratory event and the consequences include increased cardiac and respiratory complications, prolonged length of stay at the PACU, intensive care unit (ICU) and hospital, prolonged mechanical ventilator support, higher costs, and increased mortality. Overweight and obesity have also been identified as risk factors for postoperative respiratory complications. Most adverse respiratory events are considered preventable with improved monitoring such as:
- Pulse Oximetry
- Combination of Both
Closed observation of the clinical factors and appropriate monitoring by well trained people are factors necessary to prevent adverse outcome. If you wish to discuss about any specific problem, you can consult a General Surgeon.
Vaginal yeast infection occurs when too many yeast cells grow in the vagina, causing inflammation. It can spread by sexual contact but is not considered as a sexually transmitted infection. A yeast infection results in soreness or itching in the vagina with a burning sensation while urinating.
Causes of yeast infections in the vagina:
The vagina contains a balanced mix of yeast and bacteria; but if the balance is disrupted, it can lead to yeast infection. The reasons for overgrowth of yeast infections are:
- If antibiotics are used more than usual, they can decrease the level of lactobacillus bacteria present in the vagina, changing the pH of vagina
- Having high estrogen levels during pregnancy by using high dose birth control pills and hormone therapy can lead to the overgrowth of yeasts.
- Having diabetes, especially when the blood sugar level is not checked and tends to be high
- Having a weak or impaired immune system
- Being overweight and having poor eating habits, including foods high in sugar level
Risk factors associated with the condition:
A number of factors can increase your risk of getting a vaginal yeast infection.
- Using antibiotics heightens your risk of developing vaginal yeast infection as it disrupts the balance between yeast and bacteria. Excessive intake of antibiotics can kill healthy bacteria, leading to overgrowth of yeast organisms.
- Having a weak immune system with conditions such as poorly controlled diabetes and HIV can lead to an overgrowth of yeast in the vagina. Corticosteroid medicines also weaken the immune system.
- Wearing pants that are tight-fitting, nonabsorbent and undergarments that trap warmth and moisture
- Having high estrogen levels due to an imbalance of hormone levels during pregnancy or menstrual cycle can also lead to vaginal yeast infection. If you wish to discuss any specific problem, you can consult a gynaecologist.