This document provides an overview of various contraception methods. It discusses natural family planning methods like the rhythm method, withdrawal, and lactational amenorrhea. It also covers barrier methods like condoms, diaphragms and spermicides. Major hormonal contraceptives like combined oral contraceptives and progestin-only pills are explained in detail, including their mechanisms of action, effectiveness, advantages, disadvantages and contraindications. Surgical sterilization methods are also briefly mentioned. The document aims to inform readers on the different temporary and permanent contraception options available.
HYSTERECTOMY
Hysterectomy
Hysterectomy
Term origin:
hyster + ectomy
uterus surgical removal
Definition:
Hysterectomy is defined as the surgical removal of uterus.
Routes for Hysterectomy
Abdominal Hysterectomy
Vaginal Hysterectomy
Laparoscopic Hysterectomy
Caesarean Hysterectomy
Types of Hysterectomy
Total Hysterectomy
Removal of entire uterus.
Subtotal Hysterectomy
Removal of body or corpus leaves behind the cervix.
Panhysterectomy / Hysterectomy with bilateral salpingo oophorectomy
Removal of uterus along with tubes and ovaries of
both sides.
Indications
HYSTERECTOMY
Hysterectomy
Hysterectomy
Term origin:
hyster + ectomy
uterus surgical removal
Definition:
Hysterectomy is defined as the surgical removal of uterus.
Routes for Hysterectomy
Abdominal Hysterectomy
Vaginal Hysterectomy
Laparoscopic Hysterectomy
Caesarean Hysterectomy
Types of Hysterectomy
Total Hysterectomy
Removal of entire uterus.
Subtotal Hysterectomy
Removal of body or corpus leaves behind the cervix.
Panhysterectomy / Hysterectomy with bilateral salpingo oophorectomy
Removal of uterus along with tubes and ovaries of
both sides.
Indications
Family planning: is defined as "educational, comprehensive medical or social activities and services which enable individuals, including minors, to determine freely the number and spacing of their children and to select the means by which this may be achieved.
Birth control: Birth control is the use of any practices, methods, or devices to prevent pregnancy from occurring in a sexually active woman. Also referred to as family planning, pregnancy prevention, fertility control, or contraception; birth control methods are designed either to prevent fertilization of an egg or implantation of a fertilized egg in the uterus. Birth control methods may be reversible or irreversible.
Contraception: (birth control) prevents pregnancy by interfering with the normal process of ovulation, fertilization, and implantation. There are different kinds of birth control that act at different points in the process.
Benefits of Family planning
Women/family
• Better health
• Less physical/emotional strain
• Improved quality of life
• Increased educational opportunities
• Increased economic opportunities
• More energy for household activities
• More energy for personal development and community activities
For Children:
• Better health
• More food and other resources available
• Greater opportunity for emotional support from parents
• Better opportunity for education
Factors that affect on the decision of using contraception:
• husband involvement
• Effectiveness--statistics show two numbers:
- Failure rate: no. of women per 100 who become pregnant after 1 yr. when using a birth control consistently & correctly
- Typical use failure rate: takes into account improper or inconsistent use
• Cost
• Ease of use
• Side effects
Family planning methods
• Hormone-based contraceptives
6 types
1) Oral contraceptives (pills)
2) Vaginal ring
3) Transdermal patch
4) Injected hormones
5) Hormonal implants
6) Hormonal IUDs
Oral contraceptives pills
Types of Contraceptives Pills
Combined oral contraceptives (COCs)
Most widely used
Contain both estrogen & progestagen
Triphasic pill
Levels of hormones (estrogen & progestin) fluctuate during cycle
Progestin-only pills (POPs)
Contain only a progestagen, mostly Levonorgestrel (no estrogen).
Especially suitable for breastfeeding women.
How hormonal contraceptives work
FSH & LH trigger ovulation
How to use oral contraceptives
Uterine Fibroids: Symptoms, Causes, Risk Factors & Treatment uterine fibroids aren't associated with an increased risk of uterine cancer and almost never develop into cancer
Explain the wider meaning of family planning.
Give contraceptive counselling.
List the efficiency, contraindications and side effects of the various contraceptive methods.
List the important health benefits of contraception.
Advise a postpartum patient on the most appropriate method of contraception.
Family planning: is defined as "educational, comprehensive medical or social activities and services which enable individuals, including minors, to determine freely the number and spacing of their children and to select the means by which this may be achieved.
Birth control: Birth control is the use of any practices, methods, or devices to prevent pregnancy from occurring in a sexually active woman. Also referred to as family planning, pregnancy prevention, fertility control, or contraception; birth control methods are designed either to prevent fertilization of an egg or implantation of a fertilized egg in the uterus. Birth control methods may be reversible or irreversible.
Contraception: (birth control) prevents pregnancy by interfering with the normal process of ovulation, fertilization, and implantation. There are different kinds of birth control that act at different points in the process.
Benefits of Family planning
Women/family
• Better health
• Less physical/emotional strain
• Improved quality of life
• Increased educational opportunities
• Increased economic opportunities
• More energy for household activities
• More energy for personal development and community activities
For Children:
• Better health
• More food and other resources available
• Greater opportunity for emotional support from parents
• Better opportunity for education
Factors that affect on the decision of using contraception:
• husband involvement
• Effectiveness--statistics show two numbers:
- Failure rate: no. of women per 100 who become pregnant after 1 yr. when using a birth control consistently & correctly
- Typical use failure rate: takes into account improper or inconsistent use
• Cost
• Ease of use
• Side effects
Family planning methods
• Hormone-based contraceptives
6 types
1) Oral contraceptives (pills)
2) Vaginal ring
3) Transdermal patch
4) Injected hormones
5) Hormonal implants
6) Hormonal IUDs
Oral contraceptives pills
Types of Contraceptives Pills
Combined oral contraceptives (COCs)
Most widely used
Contain both estrogen & progestagen
Triphasic pill
Levels of hormones (estrogen & progestin) fluctuate during cycle
Progestin-only pills (POPs)
Contain only a progestagen, mostly Levonorgestrel (no estrogen).
Especially suitable for breastfeeding women.
How hormonal contraceptives work
FSH & LH trigger ovulation
How to use oral contraceptives
Uterine Fibroids: Symptoms, Causes, Risk Factors & Treatment uterine fibroids aren't associated with an increased risk of uterine cancer and almost never develop into cancer
Explain the wider meaning of family planning.
Give contraceptive counselling.
List the efficiency, contraindications and side effects of the various contraceptive methods.
List the important health benefits of contraception.
Advise a postpartum patient on the most appropriate method of contraception.
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!
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
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
HOT NEW PRODUCT! BIG SALES FAST SHIPPING NOW FROM CHINA!! EU KU DB BK substit...GL Anaacs
Contact us if you are interested:
Email / Skype : kefaya1771@gmail.com
Threema: PXHY5PDH
New BATCH Ku !!! MUCH IN DEMAND FAST SALE EVERY BATCH HAPPY GOOD EFFECT BIG BATCH !
Contact me on Threema or skype to start big business!!
Hot-sale products:
NEW HOT EUTYLONE WHITE CRYSTAL!!
5cl-adba precursor (semi finished )
5cl-adba raw materials
ADBB precursor (semi finished )
ADBB raw materials
APVP powder
5fadb/4f-adb
Jwh018 / Jwh210
Eutylone crystal
Protonitazene (hydrochloride) CAS: 119276-01-6
Flubrotizolam CAS: 57801-95-3
Metonitazene CAS: 14680-51-4
Payment terms: Western Union,MoneyGram,Bitcoin or USDT.
Deliver Time: Usually 7-15days
Shipping method: FedEx, TNT, DHL,UPS etc.Our deliveries are 100% safe, fast, reliable and discreet.
Samples will be sent for your evaluation!If you are interested in, please contact me, let's talk details.
We specializes in exporting high quality Research chemical, medical intermediate, Pharmaceutical chemicals and so on. Products are exported to USA, Canada, France, Korea, Japan,Russia, Southeast Asia and other countries.
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
Follow us on: Pinterest
Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
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
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
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
3. Objectives
• Unwanted pregnancy
• Spacing between two child
• Prevention of sexually transmitted infection
• Avoid the risks of abortion
• In medical cases contraindicated to pregn.
4. ISSUES
• Decision made by individual or by couple
• Many factors influence decision:
– Advantages & disadvantages of various
methods
– Side effects & contraindications
– Effectiveness
• Perfect use vs. typical use
– Expense
– Spiritual/cultural beliefs
– Practicality of method
8. Calendar Method
• 1st unsafe period: deducting 20 days from
length of the shortest cycle
• Last unsafe period: deducting 10 days from
length of the longest cycle.
e.g. longest cycle 33 day & shortest cycle 28
day.
Unsafe period 8 to 23 day.
9.
10. Temperature Rhythm
• Maintain Basal body temperature (Biphasic
pattern)-
• The BBT temp is maintained throughout 1st
half of cycle.
• First there will be a dip in temp by 0.5
degree-which coincides with ovulation.
• BBT will rise by 0.5 to 1 degree F, just 2
days after ovulation
11. Mucous rhythm
• Around ovulation there will be excessive
mucous secretion.
• Noting excessive mucus on vaginal mucosa
12.
13. Success and Failure of use of
Contraceptives
• Typical Use: When contraception is not
used every time, or it’s not used according
to instructions every time.
• Perfect Use: When contraception is used
every time, and it is used according to
instructions every time.
• Efficacy: Unpredictable
• Perfect user failure rate 9%
• Typical user 12%.
14. Coitus Interupptus
• Requires control from male partner
• Ejaculating outside the female genital
tract
• But before ejaculation seminal secretions
occur, which contains sperm, so chance
of pregnancy is high
15. coitus interruptus (withdrawal)
• Very high failure rates
• Perfect use: 4%
• Typical Use: 15-28%
• Less sexual sensation
• More chance of ectopic pregnancy.
18. Lam Criteria
1. Baby is being only breastfed
The baby is not receiving any other solid food or liquids; only breast milk
Breastfeeding on demand
Breastfeeding at least every 4 hours
No more than 4 hours between feeds during day
No more than 6 hours between feeds at night
2. Amenorrhea – Menstruation has not returned since the birth of the child
Bleeding during the first 2 months post-partum does not count as
menstruation
Bleeding after 2 months post-partum can be an indication of the return
of ovulation and the return of fertility
3. The baby is less than 6 months old
Biologically appropriate cut-off point.
WHO recommends supplementing after 6 months.
Supplemental food will decrease suckling.
21. DEFINITION
• The methods which prevent sperm
deposition in the vagina or prevent
sperm penetration through the cervical
canal- are called barrier methods of
contraception.
• The objective is achieved by mechanical
devises or by chemical means which
produce sperm immobilization, or by
combined means.
22. Barrier methods of
contraception
1. Male condom
2. Female condom
3. Diaphragm
4. Vaginal contraceptives (spermicides,
vaginal contraceptive sponge)
5. Cervical cap
23. Male Condom
• A male condom is one of the most
common types of barrier contraceptives.
• It is made out of either latex,
polyurethane, or lamb skin.
24. Non-contraceptive Benefits of Condom
1. Protect against STI (sexually transmitted
infections), gonorrhoea, chlamydia, HPV, HIV.
2. Protect against PID (Pelvic inflammatory disease).
3. Reduces incidence of tubal infertility & ectopic
pregnancy.
4. Protect against cervical cell abnormality.
25. Uses of Condom
1. As an elective contraceptive,
2. As an interim form of contraception,
3. During treatment of Pelvic infection
(Trichomonal vaginitis),
4. Immunological infertility.
5. During trans-vaginal ultrasound,
6. Semen collection for analysis,
7. As condom catheter.
27. Disadvantages
1. Accidental break or slip during coitus.
2. Inadequate sexual pleasure.
3. Allergic reaction (Latex).
4. Not reusable.
5. Failure rate are high 15/ HWY.
28. WHO MEC
1. A condition for which there is no restriction for
the use of the contraceptive method
2. A condition where the advantages of using the
method generally outweigh the theoretical or
proven risks
3. A condition where the theoretical or proven risks
usually outweigh the advantages of using the
method
4. A condition which represents an unacceptable
health risk if the contraceptive method is used
29. Failure Rate
• Used properly condom a success rate of
98%.
• Typical user failure rate is 15/ HWY.
30. Female Condom
• This type of contraceptive is put into the
vagina before having sex
• It has two ends with rings on them
• The end that goes into the vagina has a
closed rim
• The end that stays outside has an open rim
• 17 cm length
31.
32.
33. Cervical sponge
• This is an actual sea sponge
• It is inserted into the vagina before sex
• It has spermicide on it which is a
substance that kills sperm
• This substance kills the sperm before it
enters the uterus
34. Spermicides
• Available as vaginal foam, gel, cream,
tablet and suppository.
• Contain surfectants like nanoxynol-9,
octoxynol, banzalkonium bromide.
37. Mechanism of Action
• Inhibit ovulation: Both hormones acts
synergistically on the HPO axis.
• The release of GnRH from the
hypothalamus is prevented through a
negative feedback mechanism.
• So, no peak release of FSH & LH from the
anterior pituitary occurs.
• So, follicular growth is either not initiated or
if initiated –recruitment doesn’t occur.
• Resulting Anovulation.
38. Contraceptive action
• By Blocking Ovulation
• By altering cervical mucous
• By changing lining endometrium
• By altering fallopian tube motility
41. iNSTRUCTION
• New users should normally start their pill pack on
Day 1 of their menstrual cycle.
• 1 tab daily preferably at the same time (e.g. bed
time)
• Continue upto 21 days and then a 7 days gap.
• During this 7 days period there will be withdrawl
bleeding.
• Then start new pack on the 8th day (irrespective of
the withdrawl bleeding)
• 3 wks & 1 wk off
• Pill which contains 28 tabs have 7 placebo tablets,
so no need to give a gap.
42. IF SHE STARTS LATE
• She can start upto day 5.
• But has to take additional precaution
(condom) for next 7 days.
43. IDEAL CANDIDATES
• Age: menarche to 40 yr
• Newly married/ frequent sexual activity
• Non obese
• Normotensive
• Can take pills regularly without missing.
• No contraindications.
47. OTHERS
• Pregnancy
• Breast feeding (post partum upto 6 wk)
• Major surgery or prolonged immobilization
• Estrogen dependent cancers (Breast
cancer)
48. WHO MEC cat-3
• Benign liver tumour
• Breast feeding (post partum from 6 wk to
6 month)
• Heavy smoker (>20 cig/day)
• Past H/O breast cancer
• Hyperlipidaemia
• Unexplained vaginal bleeding
49. WHO MEC cat-2
• Age ≥40 yr
• Smoker <35yr
• H/O jaundice
• Mild Htn
• Gallbladder disease
• Diabetes
• Sickle cell ds
• Headache
• Cancer cervix or CIN
51. MINOR AD
• Nausea, vomiting
• Mastalgia
• Weight gain
• Cholasma & acne
• Menstrual abnormalities (Break-through bleed,
Hypomenorrhoea, Menorrhagia, Post pill
amenorrhoea)
• Loss of libido
• White vaginal discharge (leukorrhoea)
53. COC & NEOPLASIA
Protects against:
• Endometrial Ca
• Epithelial ovarian Ca
• Colorectal Ca
No direct relation with Breast cancer &
cervical cancer with low dose estrogen
COCs.
54. ADVANTAGES
• Highly effective
• Good cycle control
• Convenient to use
• Not intercourse related
• Reversible
• Additional non-contraceptive benefits.
55. NON-CONTRACEPTIVE
Improvement of menstrual abnormality:
• Cycle regulation
• ↓Dysmenorrhoea
• ↓Menorrhagia
• ↓ PMS
• ↓ Mittelsmerz’s syndrome
• Protect against anemia
• In patients with PCOS.
57. Disadvantages
• Requires education & motivation
• Requires initial check-up & follow-up
• Risk of drug interaction & failure
• Side effects may develop
• Many contra-indications are there.
• Miss pill problems.
58. POP
• Pills that contain very low doses of a
progestin like the natural hormone
progesterone in a woman’s body.
59. MOA
• Work primarily by:
• – Thickening cervical mucus (this blocks
sperm from meeting an egg)
• – Disrupting the menstrual cycle,
including preventing the release of eggs
• from the ovaries (ovulation)
60. Effective
• Effectiveness depends on the user: For women who have
monthly bleeding, risk of pregnancy is greatest if pills are
taken late or missed completely.
• Breastfeeding women:
• As commonly used, about 1 pregnancy per 100 women
using POPs over the first year. This means that 99 of
every 100 women will not become pregnant.
• When pills are taken every day, less than 1 pregnancy
per 100 women using POPs over the first year(3 per 1,000
women).
61. Effective
• Less effective for women not breastfeeding:
• As commonly used, about 3 to 10 pregnancies per 100
women using POPs over the first year. This means that
90 to 97 of every 100 women will not become pregnant.
• When pills are taken every day at the same time, less
than 1 pregnancy per 100 women using POPs over the
first year (9 per 1,000 women).
• Return of fertility after POPs are stopped: No delay
• Protection against sexually transmitted infections (STIs):
None
62. Side-effects
• Changes in bleeding patterns including:
– For breastfeeding women, longer delay in return of monthly bleeding after
childbirth (lengthened postpartum amenorrhea)
– Frequent bleeding
– Irregular bleeding
– Infrequent bleeding
– Prolonged bleeding
– No monthly bleeding
• Breastfeeding also affects a woman’s bleeding patterns.
– Headaches
– Dizziness
– Mood changes
– Breast tenderness
– Abdominal pain
– Nausea
• Other possible physical changes:
– For women not breastfeeding, enlarged ovarian
63. Misunderstandings
Progestin-only pills:
• Do not cause a breastfeeding woman’s milk
to dry up.
• Must be taken every day, whether or not a
woman has sex that day.
• Do not make women infertile.
• Do not cause diarrhea in breastfeeding
babies.
• Reduce the risk of ectopic pregnancy.
Progestin-only pills:
67. TYPES
• Most common:
– T-shaped, copper bands on plastic
stem/arms
• Inserted in uterus through vagina and
cervical opening
• Strings:
– assure IUCD is in place; facilitate removal
• Most common copper IUCD: TCu-380A
• Less common: hormonal IUCDs
69. MECHANISM of ACTION
• Causes increase in uterine & tubal fluids
containing copper ions, enzymes,
prostaglandins, and macrophages that
impair sperm function and prevent
fertilization
• Prevent blatocyst implantation through
enzymatic inference
70. FAILURE RATE
1st Year Failure
per 100 women
Recommended
Lifespan
TCu 380A 0.3 10 years
Multiload Cu 250 1.2 3 years
Multiload Cu 375 1.4 5 years
TCu 200 2.3 3 years
Nova T 3.3 5 years
72. WHO Eligibility Criteria for Contraceptive Use
Category Description
When clinical
judgment is
available
When clinical
judgment is
limited
1
No restriction for
use
Use the method
under any
circumstances Use the method
2
Benefits generally
outweigh risks
Generally use the
method
3
Risks generally
outweigh benefits
Use of method not
usually
recommended,
unless other
methods are not
available/acceptabl
e
Do not use the
method
4
Unacceptable
health risk
Method not to be
used
73. ELIGIBILTY:
Can be used safely by women who:
• Are of various age and parity
• Young and nulliparous women should be
– counseled on expulsion risk
• Are postpartum, post-abortion, or breastfeeding
• Have a chronic condition, including
• hypertension, cardiovascular disease, diabetes,
• liver or gall bladder disease
74. WHO SHOULD NOT INSERT IUD
• The copper IUD should not be inserted in women with
• Known or suspected pregnancy
• Cervical or endometrial cancer or unexplained vaginal
bleeding
• Malignant trophoblastic disease or known pelvic
tuberculosis
• Uterine distortion that impedes correct IUD placement
• Infection following childbirth or following
• Incomplete abortion
75.
76. EXPULSION : CONTINUATION
• MULTIPARA,PNC INSERTION
• DURING M/C ,UT. CRAMPS
• DATA POPULATION COUNCIL & WHO
TRIALS
• PER 100 USERS PER YEAR
• EXPULSION 2-5
• MEDICAL REMOVAL 2-3
• PAIN, BLEEDING REMOVAL 8-10
• CONTINUATION 78-90 (ICMR TASK FORCE
1994)
• LEAVE DEVICE IN PROPER POSITION
• RETAIN MEMORY OF DEVICE
77. DISPLACED IUD
• 1-2 PER 1000 INSERTIONS CU T
• 0.5-1 PER 3000 INSERTIONS NEWER
DEVICES
• MISSING THREADS
• IN UTERO DISPLACEMENT
• PERFORATION –PERITONEAL CAVITY—
POD—BLADDER---RECTUM
• SOUNDING,X RAY, USG
89. LEVONORGESTREL
Dose 1.5mg Single oral dose
MOA-
• Work primarily by inhibition of ovulation.
• Administration of LNG appears to prevent
follicular rupture or cause luteal
dysfunction.
• Not effective once the process of
fertilisation has occurred.
• LNG does not affect embryo-endometrial
attachment.
• Action on cervical mucus also helps.
90. EFFECTIVENESS
• How Effective- The efficacy of LNG has
been demonstrated up to 72 hours after
UPSI.
• But it can be also be used upto 120 hr.
91. COPPER-IUCD
MOA-
• Copper is toxic to the ovum and sperm and
thus the copper-bearing intrauterine device
(Cu- IUD) is effective immediately after
insertion and
• works primarily by inhibiting fertilisation.
92. CU-IUCD
TIMING
Timing- Within the first 5 days (120 hours)
following first UPSI in a cycle
or
within 5 days from the earliest estimated
date of ovulation.
93. HOW EFFECTIVE
• the failure rate for use of the Cu-IUD as EC
is 0.1%. So, it’s the GOLD Std.
• Contraindications- Use of an Cu-IUD for
EC carries the same contraindications as
routine Cu-IUD insertion.
• Side-efffects- Pain is a common side effect
associated with insertion.
94. Ulipristal Acetate (UPA)
• Progesterone receptor modulator
• Dose- 30 mg single oral dose
• Timing- within 120 hours of UPSI
95. Ulipristal Acetate (UPA)
MOA-
• Inhibition or delay of ovulation.
• Can prevent ovulation after the LH surge
has started, delaying follicular rupture until
up to 5 days later.
98. Contraindications
• Where multiple episodes of UPSI have
occurred and there is a risk pregnancy, UPA
should not be used.
• Breastfeeding is not recommended for up to
36 hours after ingestion of UPA
• Hepatic dysfunction
• Severe asthma
99. Can UPA be used more than once
• UPA should not be used more than once
in a cycle or concomitantly with LNG
• If there has been an earlier episode of UPSI
outside the treatment window (>120 hours)
LNG can be repeated but not UPA.
100. Morning After Pill
• Ethinyl Estradiol 2.5 mg twice daily for 5
days.
• Starting within 72 hr of UPSI.
• Not preferred now a days.
• Nausea/ vomiting.
101. YUZPE method
Combined hormonal regimen
• High dose COC (EE 50 mcg + LNG 250
mcg) e.g.Ovral.
• Should be started within 72 hr of UPSI.
• 2 tabs stat and 2 after 12 hr
• Nausea/ vomiting can be very severe, use
of anti emetics recommended.
• Not preferred now a days.
102. Mifepristone
• Also called RU 486.
• Anti progesterone
• Binds with progesterone receptor but
causes no action.
• Due to lack of progesterone, implantation
is hampered.
• Basically its not contraception but
interception.
103. Mifepristone
• Can be used upto 17 days after UPSI.
• Single dose of 100 mg tab to be taken.
• Pregnancy rate is 0.6%.
• If pregnancy occurs, it is to be terminated.
• Mifepristone is rarely used as EC.
104. Drugs Dose Pregnancy rates
LNG 1.5 mg single dose within
72 hr
0-1%
Cu IUD (Gold Std) Within 5 days of UPSI 0- 0.1%
(BEST)
UPA 30 mg single dose within
120 hr
0-1 %
Yuzpe (EE 50 mcg + LNG
250 mcg)
2 tab within 72 hr and
repeat 2 tab after 12 hr
0-2 %
EE 2.5 mg 2.5 mg twice daily x 5days
(starting within 72 hr of
UPSI)
0-0.6 %