Pregnancy is said to occur due to the fertilization of the egg by a sperm which grows in size a woman’s uterus which is called the womb. It takes 270 days for the womb to develop into a baby but the gynecologist will consider the date from the last menstrual period or 300 days (40 weeks).

Abnormalities of pregnancy :
* Excessive vomiting – The usual morning sickness will not get worse and this may result in a situation called hyperemesis gravidarum.
* Bleeding in early pregnancy – This is not a normal phenomenon and a lot of care and caution must be ensured as it may prove to be fatal for the life of the woman. Its causes are abnormalities of the cervix, abortion, ectopic gestation, vesicular mole.
* Albuminuria – The presence of albumin in urine is a known complication of pregnancy. The cause may be cystitis or infection in urinary tract. Cystitis is said to be an infection in the bladder. A lot of pain is felt in the lower abdomen which causes frequent urination as well as burning. Another infection also has its striking postures which involve in the infection of the kidney and ureter. A lot of pain is felt in the loins with nausea, vomiting as well as fever. This sort of syndrome is known as pylo-nephrites.
* Pre-eclampsia – This occurs usually after 30 weeks of pregnancy. Early signs are raised blood pressure, increase of albumin in the urine, visual disturbances, severe frontal headache, and abdominal pain, vomiting and oedema of feet and ankles. This disease is dangerous for the fetus and for the mother.
* Eclamsia – This means that
the woman has fits similar to those of epilepsy, and coma. The condition may develop suddenly in a severe case of pre-eclampsia. The fits may occur during pregnancy, during labor, or soon after delivery. Eclampsia is a dangerous for both the mother and the baby. This condition should be prevented by means of good pre-natal care.
* Ante-partum hemorrhage – This means bleeding during pregnancy after the 28th week. If it is slight, the cause could be some lesion of the cervix.
* High risk cases of pregnancy – all cases of abnormality or high risk should be identified as early as possible.
* Back ache – Slight backache may be due to poor posture and is more common in multiparous women whose abdominal muscles are weak. It can be prevented or lessened by attention to posture and by exercises.
* Fainting – Sudden changes of posture, or standing for a long time, may cause the pregnant woman to faint. If she feels faint when lying on her back, this is due to pressure on the large veins, and she should be turned on her side immediately. Check for anemia, which may be the cause of fainting.

Pregnancy Weeks :
* 1 to 4 weeks – menstruation stops, pricking in the breasts, whitish vaginal discharge.
* 5 to 8 weeks –
frequent urination, breasts grow larger, nipple become darker, and surface veins can be seen, nausea and perhaps vomiting especially in the morning, cervix is soft.
* 9 to 12 weeks – breast become darker round the nipple, vagina becomes a bluish color. By 12th week, weight gain is about 1.12 kilograms.
* 13 to 16 weeks – tiny lumps appear on the areola of the breasts, the uterus rises out of the pelvis, by 16 weeks you can feel the fundus about half way between the symphisis pubis and umbilicus, the mother may feel the fetus moving.
* 17 to 20 weeks – a second dark ring appears round the breasts, a little fluid comes from the nipples, the fundus is nearly up to the umbilicus, fetal movement can be felt and fetal heart sound heard, weight gain is about 250 grams per week.
* 21 to 24 weeks – dark patches may appear on the face, the fundus is at or above the umbilicus.
* 25 to 28 weeks – the blood pressure is slightly below normal, there may be shortness of breath, and quicker respirations, the fundus is 4 to 5 fingers above the umbilicus, weight gain about 450 grams per week.
* 29 to 32 weeks – there may be slight swelling of the angles; the fundus is half way between the umbilicus and xiphisternum (bottom of the breast bone).
* 33 to 36 weeks – again there is
frequent urination; the fundus is at or almost at the xiphisternum.
* 37 to 40 weeks – the uterus drops into the pelvis at about 38 weeks, and the fundus is then at a lower level. Breathing becomes easier, but sitting and walking may be difficult. Vaginal discharge increases. The total weight gain by the 40th week is from 9 to 11 kilogram.

Nutrition in pregnancy:

The pregnant woman’s diet should provide for the needs of the growing fetus, maintenance of the mother’s health, physical strength required during labor, successful lactation. Protein foods are essential for growth of the fetus. If possible the pregnant woman should have plenty of milk, eggs, and meat. If she is vegetarian she will need to have different cereals, a lot of pulses and nuts. Iron is important for making the baby’s food and to avoid or lessen anemia. She should have jaggery instead of sugar, sesame seeds, and plenty of dark green leafy vegetables. Calcium is necessary for making the baby’s bones and teeth. The best source of calcium is milk. Vitamins are very important for pregnant women. She should have plenty of vegetables and fruits, and modified diets like low salt diet, high protein diet is necessary during pregnancy.

Labor administration – stages:

First stage of labor is from the start of regular contractions until the cervix is fully dilated. During the first stage care should be taken such as when she has been examined and prepared, the mother may walk around or rest as she wishes. Encourage her to empty her bladder frequently, and to take nourishing drinks.

Second stage is from the time the cervix is fully dilated until the birth of
the baby. Signs that the second stage has begun are rupture of membranes, bearing down pains, dilated anus and vagina.

The third stage is after delivery of
the baby until the placenta and membranes have come out. While waiting for the placenta to come, give immediate care to
the baby.

After attending to the mother at the end of the third stage, give
the baby bath, examine, weigh and dress
the baby.

Sleep apnea may increase sudden cardiac death risk

Washington,A new study by Mayo Clinic researchers has suggested that obstructive sleep apnea (OSA) - and, in particular, the low nighttime oxygen saturation of the blood it causes - may be a risk factor for sudden cardiac death (SCD).

OSA is a condition that disrupts breathing during sleep and is associated with obesity. The new study identified OSA as one of two traits that increase the risk of SCD. The other is age - patients who are 60 years old or older.

If further studies confirm these findings, OSA would join established risk factors such as smoking, obesity, high cholesterol and high blood pressure.

Doctors have suspected for years that OSA might be implicated in SCD because of evidence that low oxygen alters the blood vessels in a way that

promotes heart disease.

Mayo Clinic cardiologist Apoor Gami, M. D., the lead author of the study, said that this is the first large study to rigorously test the hypothesis.

Virend Somers, M. D., Ph. D., the study’s principal investigator, said: “Nighttime low oxygen saturation in the blood is an important complication of obstructive sleep apnea.”

“Our data showed that an average nighttime oxygen saturation of the blood of 93 percent and lowest nighttime saturation of 78 percent strongly predicted SCD, independent of other well-established risk factors, such as high cholesterol. These findings implicate OSA, a relatively common condition, as a novel risk factor for SCD,” Somers added.

The researchers reviewed data from 10,701 consecutive adults who underwent an initial diagnostic sleep laboratory analysis session between 1987 and 2003.

During a follow-up period of up to 15 years, researchers assessed cases where patients had sudden cardiac arrest, and either died (SCD) or were resuscitated, in relationship to the presence of OSA and other data, including nighttime levels of oxygen saturation in the blood.

Results showed that during an average follow-up of 5.3 years, 142 patients had suffered SCD and either died or were resuscitated.

The study has been presented at the American Heart Association’s Scientific Sessions 2008 in New Orleans

Apelin hormone injections can lower blood sugar

Recent research showed that Apelin, a hormone produced by fat and other tissues, might serve as a promising target for managing insulin resistance and type 2 diabetes. Researchers led by Philippe Valet found that our cells are equipped with a second pathway for the assimilation of glucose, which involves “apelin”.

Using animal models, researchers found that acute intravenous injections of apelin have a powerful blood sugar-lowering effect. Findings also proved that apelin stimulates muscle and fat tissue to take up glucose from the bloodstream by stimulating a known glucose transport pathway. Specifically, apelin activates a pathway including an enzyme called AMP-activated protein kinase (AMPK), which plays a pivotal role in the control of skeletal muscle glucose and the metabolism of fatty acids.

Study pointed that apelin treatment restores glucose tolerance and improves glucose intake in mice that are obese and insulin resistant. Isabelle Castan-Laurell of Institut National de la Sante et de la Recherche Medicale and Universite de Toulouse said they aren’t quite sure yet what it means that obese individuals tend to have high apelin levels. It could be that apelin levels don’t rise enough to curb rising blood sugar or perhaps insulin resistance without apelin would be even worse. Alternatively, obese animals and humans might grow resistant to the action of apelin just as they do insulin.

Researchers concluded that further research will be done to check the action of this protein in man. Researchers said that they are developing a synthetic molecule that may be used if the tests in man are positive

Three-pronged approach to osteoporosis can reduce hip fractures

Recent research showed that aggressive osteoporosis screening and treatment can reduce the rate of hip fractures. Richard Dell, M. D., of Kaiser Permanente Bellflower and colleagues claim that their strategy could cut U. S. hip fractures by 25% or more.

Researchers followed three-pronged approach to osteoporosis. The researchers gave bone scans using dual X-ray absorptiometry (the gold standard for bone density tests) to the all patients over age 50 with a history of fragility fractures (fractures not due to trauma), women over age 65, men over age 70 and patients on high doses of corticosteroids and certain other drugs in the first step.

The second step focused at giving osteoporosis education and treatment to patients with poor bone density or previous fragility fractures. Patients who needed osteoporosis treatment were also given home safety checks to help prevent falls along with bone drugs. The third step comprised of fall-reduction program, including physical therapy, for at-risk patients.

Kaiser Permanente researchers conducted a prospective observational study of more than 620,000 patients evaluate the effect of three-pronged approach to osteoporosis. Researchers found that that was 37% reduction in hip fractures ranging from 23% to nearly 61% across the 11 centers.

Anti-Frailty Pill Boosts Natural Growth Hormone In Older Adults

A new study conducted by researchers at the University of Virginia Health System revealed that intake of an investigational drug, MK-677, on a daily basis increased muscle mass in the arms and legs of healthy older adults.

The study discovered that MK-677 increases the levels of growth hormone (GH) and of insulin-like growth factor I (IGF-I) in aged, to the levels found in healthy youngsters.

Michael O. Thorner, professor of internal medicine and neurosurgery at University of Virginia (UVA), explained, “Our study opens the door to the possibility of developing treatments that avert the frailty of ageing.”

“The search for anti-frailty medications has become increasingly important because the average American is expected to live into his or her 80s, and most seniors want to stay strong enough to remain independent as they age,” Prof. Thorner added.

The two-year study, funded by the National Institutes of Health, involved 65 men and women aged between 60 to 81.

As a part of the study, half the volunteers were administered an oral dose of MK-677, while half were given a placebo for a period of one year.

At the end of a year in a reversal of roles the participants on placebo were given MK-677, and those on the drug given the placebo randomly.

The study results disclosed that MK-677 stimulates appetite and hormone growth, restoring 20 percent 20% of muscle mass loss linked with ageing.

The so called ‘anti-frailty’ drug could also prove positive to fight metabolic disorders such as those related to body weight and body composition.

The study researchers said that MK-677 was effectual for those who received it for full two years, but the benefits wore off once the medicine was stopped.

The findings of the study were published in Tuesday’s issue of Annals of Internal Medicine.

The results raise the possibility that an environmental trigger for autism may be associated with precipitation and may affect genetically vulnerable children.

According to the study, in the past thirty years autism rates have increased from one in 2500 children to one in 150, and the higher rate of precipitation affecting genetically vulnerable children can be held responsible for the growing rate.

The authors behind the study say that precipitation may be allied with disorder, as more indoor activities, such as television and video viewing, affect behavioral and cognitive development.

The greater amount of time spent indoors may also expose children to more harmful chemicals, such as those in cleaning products, or decrease their exposure to sunshine, which helps the body produce vitamin D, which is vital for proper growth.

“Finally, there is also the possibility that precipitation itself is more directly involved. For example, there may be a chemical or chemicals in the upper atmosphere that are transported to the surface by precipitation,” the author said.

Michael Waldman, Ph. D., of Cornell University, Ithaca, N. Y., and colleagues obtained autism prevalence rates from state and county agencies for children born in California, Oregon and Washington between 1987 and 1999. The daily precipitation reports from the National Climatic Data Center, they calculated average annual rainfall by county from 1987 through 2001—which spans the dates when the children were school-aged.

The calculation indicated that Autism prevalence rates for school-aged children in California, Oregon and Washington in 2005 were positively related to the amount of precipitation these counties received from 1987 through 2001.

“Similarly, focusing on Oregon and California counties with a regional center, autism prevalence was higher for birth cohorts that experienced relatively heavy precipitation when they were younger than 3 years. This corresponds to the time at which autism symptoms usually appear and when any post-natal environmental factors would be present,” the author said.

Thus the study indicated that precipitation or its consequences like increased television watching, reduced vitamin D levels and enhanced exposure to indoor chemicals might increase the rate of autism.

The study has been published in the November issue of Archives of Pediatrics & Adolescent Medicine, one of the JAMA/Archives journals.

health

Expert advice to help you maintain a healthy weight

Dissatisfied with your weight?
We’re bombarded with scare stories about weight, from size zero to the obesity ‘epidemic’. But a healthy weight is determined by different factors for each of us. Our expert advice is designed to help you achieve and maintain a healthy, life-enhancing weight.

Overweight or underweight?
Being the right weight has a positive effect on wellbeing but also on our health, as being the wrong weight can cause a range of medical problems.More and more of us are eating out on a regular basis, whether it’s for a business lunch, a girls’ get together, or for a family meal.

The 2006 Family Food Survey found that households where the head of the household was under 30 years old were spending more than 40 per cent of their food budget on eating out.

Eating out usually means that we have little control over how the food is prepared or how large the portion is. Foods eaten out tend to be higher in fat and research has shown that those who eat out regularly generally have higher intakes of fat, salt and calories. Studies have also shown that eating with friends can tempt us to overeat. Meals with multiple courses eaten over longer periods and with alcohol are all associated with overindulgence. Large serving bowls and spoons increase the likelihood of piling more food on your plate than you usually eat.

Unlike packaged food, foods bought from cafes, restaurants etc don’t have to carry nutritional information and so opting for the healthiest option might not always be obvious, or easy. However, with some knowledge and thought, eating out can be enjoyable and healthy!

General tips
If you’re unsure as to what something is, or what it contains - ask! If the waiter/waitress doesn’t know, then the chef will.
Think ahead, if you know you’re eating out later and it could be a lavish affair, choose wisely earlier in the day to keep calories, fat, sugar and salt intakes under control.
Don’t eat an extra course just to be polite.
Only order a sweet after the main course, and only if still hungry. Opt for sorbets, or fruit dishes to balance out a heavy main course.
Think about sharing a course with a companion if the portions look large.
Speak up about how you’d like a dish prepared eg ask for no mayonnaise, dressing on the side.
You’re more likely to overeat at an ‘all you can eat’ style buffet.
Choose side orders of salad or vegetables to fill up on.
Cut off any visible fat from meat to keep saturated fat intake down.
Look out for smaller portions ie a main meal option as a starter size.
Opt for dishes which are grilled, baked, steamed, poached or cooked in own juice rather than fried.
Check the menu for dressings on salads and ask for it to be served separately. An otherwise healthy and nutritious salad could be drowned in a high fat sauce, bumping up its calorie content.
Avoid cheese, cream or butter-based sauces
If you’re a cheese lover, think about sharing the cheese board option to keep saturated fat, salt and calorie intakes in check.

health

More than any other time in history, people are all vying to have the best, healthiest body possible. The health and fitness industries are making billions of dollars every year on herbal supplements, fitness equipment, gyms, and special diets. If you watch TV or read magazines, there is always some intriguing commercial asking for money to help you get into shape.

While many of these options are good and healthy, others you should stay as far away from as possible. Recently, a professional baseball player died at the age of 23. In his locker, a bottle was discovered containing Ephedrine. Consequently, the FDA just issued a warning that people need to heed.

Now that you have made a commitment to take care of your body, both internal and external, it is critical to your overall health that you do it the right way. Here are some tips for diet, health, and fitness that will help you lose weight, discover ways to maintain a better healthy lifestyle, and be in the best shape of your life - all the smart way!

For sake of clarity, we have broken this down into two categories. One for diet and health, which focuses on herbal supplements, weight loss, dieting, rest, and everything you need to know about taking care of your body on the inside.

The other section is health and fitness, which has both internal and external benefits. On the outside, fitness includes weight lifting, running, sports, walking, things you can do to enhance, tone, and build muscle. However, fitness also has benefits for the inside such as great cardiovascular benefits among others.

Most Americans do not know about or value prevention. One out of five diabetics and one out of three hypertensives are unaware of their condition. Those that do know what they should do often skip treatments or steps to improved health. Prevention’s perceived value is low since its potential benefits are distant.

The answer, according to conservatives, is increased individual “ownership” of health care dollars. Our failure to promote prevention, they reason, lies in government mandates and over-insurance that de-emphasize personal responsibility. Why diet when insurance pays for gastric bypass surgery? Why exercise when you can take a pill to lower your blood pressure? When people can be treated for any problem with first-dollar coverage, goes the reasoning, they may not prevent those problems in the first place. As one conservative says, the incentives are upside down. Therefore, if individuals reap the financial as well as the health rewards of prevention, they may be motivated to action. In policy terms, this means replacing traditional insurance with health savings accounts linked to high-deductible health plans.

Problem is, this “solution” has not seemed to work in reality. Information provided to enrollees in these consumer-driven health plans is infrequent and inadequate to help consumers make smart decisions.

Even Americans who know about preventive medicine tend to use it less when it costs them money. One study showed that even $10 co-pays caused a significant reduction in the use of mammograms among seniors. This is why effective health insurance plans often make prevention free or linked with some monetary benefit.

High deductibles also appear to harm efforts designed to forestall or prevent complications of an established disease as well: People with arthritis, heart disease, high cholesterol, and asthma were two to three times as likely to not fill a prescription due to cost when enrolled in a high-deductible plan versus a traditional insurance plan.

Even the insurance industry doesn’t stand behind the belief that consumer-driven health plans drive improved prevention. It recently issued a report focusing entirely on how high-deductible health plans are increasingly waiving deductibles for preventive care. This is more than an exception to the rule: It repudiates the theory behind these plans.

There is a better way. Prioritizing prevention means paying for services wherever, whenever, and for whoever needs it. It means investing in communities, schools, and workplace wellness efforts. And it means moving beyond private insurance as the sole solution: those companies simply have no incentive to invest in prevention today that benefits others later.

For additional reading:

Elise Gould, “Consumer-Driven Health Care is a False Promise,” Economic Policy Institute, October 11, 2006.

Marjorie Ginsberg, “Rearranging The Deck Chairs: Consumer-directed health care confronts the problems of health insurance,” Health Affairs- Web Exclusive, October 24, 2006.

James C. Robinson, Ph.D., “Health Savings Accounts — The Ownership Society in Health Care,” New England Journal of Medicine, September 22, 2005.

Jeanne Lambrew and John Podesta, “Commentary: The Wellness Trust,” Forbes.com, September 4, 2007.

Background Basics on Prevention

What is Prevention? In the United States, more than 125 million people suffer from a chronic disease such as hypertension, heart disease, cancer, or diabetes. Many people also suffer from acute diseases that can be prevented through vaccination or other means (e.g., daily aspirin use to prevent heart attacks). Preventive medicine attempts to reach these individuals before they become patients or develop disease complications. There are three levels of preventive medicine:

* Primary prevention is focused on preventing the actual occurrence of a disease or injury (immunization against measles or influenza, for example)
* Secondary prevention identifies those with significant risk factors for particular diseases, such as cancer, hypertension, or diabetes, and helps them manage their future health
* Tertiary prevention provides care for those with an established disease to prevent or forestall progression and complications (treating high blood pressure before it leads to stroke, or diabetes before someone develops cardiovascular or kidney disease, for example).

Prevention measures can be performed in a clinical setting or undertaken by the larger community. Clinical prevention includes services performed by medical professionals—mammograms, colonoscopies, and cholesterol screenings, to name a few. Community prevention extends to population-based services to limit disease, injury, or disability—measures such as efforts to build playgrounds and bike paths to promote physical activity, and tobacco taxes and use restrictions to reduce smoking.

The National Commission on Prevention Priorities ranks clinical prevention services based on cost and health effectiveness. Their results have led to a core list of recommended preventive services (see Table).