This document discusses hormonal contraception, including combined oral contraceptives (COCP), the contraceptive patch, vaginal ring, and progestogen-only methods. It covers the types of hormones used, modes of action, indications, contraindications, risks and side effects. Combined methods primarily prevent ovulation while also thickening cervical mucus and thinning the endometrium. Progestogen-only methods primarily work by thickening cervical mucus but can also prevent ovulation or thin the endometrium. Contraindications depend on medical conditions and are classified by the WHO. Risks include minor side effects as well as serious risks like blood clots and certain cancers.
family planning program
Definition
important of family planning
Human right principles guide family planning services
type of family planning
Combined Oral Contraceptives.
Progestin-Only Pills
Emergency Contraceptive Pills
Progestin-Only Injectable
Monthly Injectable
Combined Patch
Combined Vaginal Ring
Progesterone-Releasing Vaginal Ring
Copper-Bearing Intrauterine Device
Levonorgestrel Intrauterine Device
Female Sterilization
Vasectomy
Male Condoms
Female Condoms
Cervical Caps
Lactational Amenorrhea Method
family planning content with recent advances ..family planning is for everyone ...content can be used for educational purposes ....by sharanjit kaur jhajj
contraception is a very important topic for pg entrance.....so all about it has been discussed in detail as required for pg entrance....do make use of it...
Most oral contraceptives contain a combination of 2 types of hormones: an estrogen and a progestin. Both of these hormones are naturally found in women’s bodies. There are many different types of estrogens and progestins, and different types of pills contain different combinations, but they all work similarly. Some pills contain only progestin, sometimes called the “mini-pill.”
family planning program
Definition
important of family planning
Human right principles guide family planning services
type of family planning
Combined Oral Contraceptives.
Progestin-Only Pills
Emergency Contraceptive Pills
Progestin-Only Injectable
Monthly Injectable
Combined Patch
Combined Vaginal Ring
Progesterone-Releasing Vaginal Ring
Copper-Bearing Intrauterine Device
Levonorgestrel Intrauterine Device
Female Sterilization
Vasectomy
Male Condoms
Female Condoms
Cervical Caps
Lactational Amenorrhea Method
family planning content with recent advances ..family planning is for everyone ...content can be used for educational purposes ....by sharanjit kaur jhajj
contraception is a very important topic for pg entrance.....so all about it has been discussed in detail as required for pg entrance....do make use of it...
Most oral contraceptives contain a combination of 2 types of hormones: an estrogen and a progestin. Both of these hormones are naturally found in women’s bodies. There are many different types of estrogens and progestins, and different types of pills contain different combinations, but they all work similarly. Some pills contain only progestin, sometimes called the “mini-pill.”
the presentation includes a definition of oral contraceptives, type of oral contraceptives, detail description of both types with its mode of action and potential beneficial and unwanted effects also include pharmacokinetics of oral contraceptives and knowledge of emergency contraceptives
Gynecology Medical Student notes describing use of contraceptives and application in the medical field. A guide on the criteria use of oral contraceptives and their indications for use.
A slight description on contraception, its types along with a brief explanation on Oral Contraceptives. Types of oral contraceptives, it's types, mechanism of action, contraindications, dosing, advantages, disadvantages, risk, benefit amd recent research trends.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
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Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
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micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
1. Hormonal Contraception
By Dr. Nesreen Abdelfattah Abdallah Shehata
Associate professor in Obstetrics and Gynecology
Faculty of Medicine - Beni-Suef University
2. Points to be considered:
What is contraception?
Types?
Mechanisms of action.
Complications.
Contraindications
Other indications for methods of contraception
5. COCP
Types of hormones in each pill:
--Ethinyl estradiol 20-50? μg. Most women now use the so-called ‘low-
dose’ pills containing 20–35 μg. Low-dose pills are potentially safer since
the cardiovascular risks of the pill are mainly due to oestrogen. The lowest
dose pill 15 μg is as effective as 30 μg but is associated with breakthrough
bleeding due to less endometrial control.
-- Progestogens used in currently available pills fall into three groups: first-
and second generation progestogens (e.g. norethisterone and
levonorgestrel), third-generation progestogens (gestodene, desogestrel
and norgestimate) and newer progestogens with anti-androgenic activity
such as drospirenone and dienogest.
Co-cyprindiol is a preparation containing ethinylestradiol in combination
with the anti-androgen cyproterone acetate, which is licensed for the
treatment of severe acne and hirsutism.
6. COCP
Way of administration: Most combined pill preparations are taken for 21 days
followed by a 7-day break when withdrawal bleeding usually occurs.
Preparations: Combined pills are available as monophasic preparations, in
which every pill in the packet contains the same dose of steroids, and as
biphasic, triphasic and, more recently, tetraphasic preparations in which the
dose of both steroids changes during the cycle.
7. Contraceptive Patch
Only one contraceptive patch is currently available (20 cm2 in size) and it
delivers 20 μg ethinylestradiol and 150 μg norelgestromin daily.
Each patch lasts 7 days, three patches being used consecutively with a patch-
free interval in week 4 when withdrawal bleeding occurs.
The effectiveness is not significantly different from combined pills.
8. Vaginal Ring
A combined contraceptive vaginal ring releasing 15 μg ethinylestradiol and 120
μg etonorgestrel daily .
The ring is made of soft ethylene-vinyl-acetate copolymer, has an outer
diameter of 54 mm and a crosssectional diameter of 4 mm.
Designed to last for 3 weeks, a 7-day ring-free interval.
10. The principal mode of action of combined hormonal contraception is inhibition
of ovulation.
Oestrogen inhibits pituitary FSH, suppressing the development of ovarian
follicles, while progestogen inhibits the development of the LH surge.
Additional contraceptive properties of combined hormonal contraceptives
include changes in characteristics of cervical mucus that interfere with sperm
transport, possible alteration in tubal motility, endometrial atrophy and impaired
uterine receptivity.
11. Contraindications
World Health Organization developed a system addressing medical eligibility
criteria for contraceptive use in which the conditions are classified into one of
four categories.
Category 1 includes conditions for which there is no restriction for use of the
method
category 2 indicates that the method may generally be used but that more
careful follow-up is required.
Category 3 conditions are those for which the risks of the method generally
outweigh the benefits (relatively contraindicated). Use the method only if there
is no acceptable alternative.
category 4 includes conditions that represent an unacceptable health risk if the
contraceptive method is used (absolutely contraindicated).
12. Relative contraindications:
Hypertension ˂ 160/100 or adequately
treated ˂140/90.
Diabetes mellitus controlled.
Smoking (even less than 15
cigarettes/day) and age 35 or over
Obesity (BMI ≥ 35 kg/m2).
Migraine or past history.
Breast cancer, with more than 5 years
without recurrence.
Breast-feeding until 6 months post
partum
Current or medically treated
gallbladder disease
Family history of venous
thromboembolism in first-degree
relative under age of 45years
Absolute contraindications:
Hypertension: systolic ≥ 160 mmHg or
diastolic ≥ 100 mmHg
Diabetes with vascular disease or
nephropathy, retinopathy or
neuropathy
Smoking ≥ 15 cigarettes/day and age
≥ 35 years.
Migraine with aura
Current breast cancer
Breast-feeding < 6 weeks postpartum
Acute viral hepatitis.
Severe cirrhosis
Benign or malignant liver tumours
Current or history of deep vein
thrombosis/pulmonary embolism
14. Minor side effects:
Combined hormonal contraception affects almost every system in the
body. Contraceptive steroids are metabolized by the liver and affect the
metabolism of carbohydrates, lipids, plasma proteins, amino acids,
vitamins and clotting factors.
Fluid retention, nausea and vomiting, chloasma, mastalgia and breast
enlargement.
All but chloasma (which gets worse with time) improve within 3–6
months.
A different dose of oestrogen or type of progestogen or a different
delivery system may help if time alone does not solve the problem.
15. Serious side effects:
Cardiovascular disease: The adverse effect on clotting is related to the dose
of oestrogen and, for pills, lower doses are theoretically associated with
reduced risk. There is a threefold to fivefold increase in the risk of venous
thromboembolism (VTE) associated with combined pill use. The risk is higher in
obese women.
Malignant disease: Many studies showed that use of the combined pill was
associated with a small increase in the risk of breast cancer. The increased risk
persists for 10 years after stopping the pill. In a recent studies, women with
persistent infection with human papillomavirus (HPV) using hormonal
contraception (mainly combined) for more than 5 years had an increased risk of
cervical cancer.
There is substantial evidence that the oral contraceptive pill protects
against ovarian, endometrial and colon cancer.
Drug interactions: --A number of medicines (some anticonvulsants,
antifungals, antiretrovirals and antibiotics) induce liver cytochrome P450 and
will thus reduce the efficacy of low-dose hormonal contraception. – The use of
combined hormonal contraception increases the clearance of lamotrigine and
reduces serum levels of this drug. This increase seizures.
17. A number of types of progestogen-only pills are
available. The older formulations contain a very low
dose of second-generation progestogen which does
not consistently inhibit ovulation. A newer pill contains
the third generation progestogen desogestrel at a
dose sufficient to inhibit ovulation in almost every
cycle.
18. Long-acting depot medroxyprogesterone acetate (DMPA) is given by deep
intramuscular injection, 150 mg every 12weeks. A new micronized
preparation of DMPA that is administered subcutaneously is licensed. This
micronized preparation is a lower dose (104 mg DMPA), but has the same
efficacy as the intramuscular preparation and is given at the same injection
intervals. Since it is administered subcutaneously, this affords the
possibility of self-administration.
19. The first contraceptive implant to become available was a
six-rod system known as Norplant® . The currently
available implant (Implanon®) is a single rod, containing
Desogestrel providing contraception for 3 years. The
implant is preloaded into a sterile disposable inserter and
is inserted subdermally on the inner aspect of the non-
dominant arm above the elbow. It is inserted and removed
using local anaesthetic.
20. The intrauterine system (Mirena®) has a T-shaped plastic frame with a reservoir
on the vertical stem containing 52 mg levonorgestrel releasing 20 μg/ day for at
least 5 years. The IUS is inserted and removed using the same procedures as
for copper IUD insertion.
The IUS is licensed for the management of heavy menstrual bleeding.
21. Mechanism of Action:
The injectable, implant and desogestrel-containing progestogen-only pill inhibit
ovulation. Older progestogen-only pill formulations inhibit ovulation only
inconsistently.
All progestogen only contraception, regardless of the route of administration,
affect cervical mucus, reducing sperm penetrability and transport, and all (but
particularly the IUS, which has little effect on ovarian activity but causes marked
endometrial atrophy) have an effect on the endometrium compromising
implantation if ovulation and fertilization occur.
22. Indications and contraindications
Progestogen-only contraception is commonly prescribed for women in whom
oestrogen is absolutely or relatively contraindicated, for example women with
cardiovascular disease, migraine, diabetes or mild hypertension.
Breast-feeding women are advised to use progestogen only methods since
oestrogen impairs milk production.
There are few contraindications to use of progestogen only methods. A history
of breast cancer (within last 5 years) is category 4 and postpartum sepsis or
septic abortion (IUS method only).
23. Side effects:
Bleeding disturbances: High levels of irregular vaginal bleeding? in pills and
implants. This is due partly to their effect on ovarian function. In the normal
cycle, ovulation determines regular menstruation. Inconsistent ovulation and
fluctuating endogenous oestrogen production from irregular follicle growth lead
to irregular bleeding. However, there is also evidence to suggest that
progestogen-only methods directly affect the vasculature of the endometrium,
increasing the chance of bleeding.
Headache, nausea, bloating, breast tenderness and weight and mood change.
Oily skin and acne can be a problem, particularly with the more androgenic
progestogens levonorgestrel and norethisterone.
Bone mineral density: Reduction due to complete inhibition of ovulation by
DMPA injection leading to hypoestrogenism and amenorrhea.
24. Other indications of hormonal contraceptive
methods:
The commonest benefit of hormonal methods is an improvement in menstrual
bleeding patterns (including amenorrhoea).
Hirsutism
Endometriosis