Situations when emergency contraception is appropriate - details about pills

Situations when emergency contraception is appropriate.

I-pill

Emergency contraception can be appropriate:
. in cases where the woman has not used contraception
. in cases where sex has been forced or coerced, or the woman has been raped
. when a woman must deal with a contraceptive mistake, such as a
condom breaking or used incorrectly, an IUCD dislodging, a diaphragm removed too early, or the man failing to withdraw before
ejaculation.

I-pill

Emergency contraceptive pills
Emergency contraceptive pills (ECPs) are hormonal methods of
contraception that can be used to prevent pregnancy following unprotected
sexual intercourse. Some women call this method ‘morning-after pills’or ‘post￾coital pills’.
ECPs contain the same concentrated dose of hormones found in daily
contraceptive pills. You will remember from your study session on oral
contraceptives that these comprise combined pills containing oestrogen and
progesterone, and pills containing progesterone only.
The exact mechanism by which emergency contraceptive pills prevent
pregnancy is not completely understood. But the principles behind the
mechanism of action are summarised in Box.  If a woman is already pregnant when she uses ECPs, they will not cause an
abortion, or any disruption to the fertilised egg, once implantation has taken
place. So they do not affect an existing pregnancy.
Women who take ECPs should understand that they could still become
pregnant the next time they have sex, unless they immediately start using
another method of contraception. This is because ECPs delay ovulation in
some women, so they may be at their most fertile soon after taking ECPs. You
should therefore advise women that they use condoms until the beginning of
their next menstrual period. For ongoing protection from pregnancy, they must
start using another contraceptive method at once.

Combined emergency contraceptive pills
Combined emergency contraceptive pills are formulations of oestrogen
(commonly ethinyl estradiol) and progesterone (commonly levonorgestrel or norgestrel).

 There are two common types of combined emergency contraceptives available in Ethiopia, and it is recommended that they be taken
within five days following unprotected sexual intercourse.

1. The Neogynone pill contains 50 mg ethinyl estradiol and 0.5 mg norgestrel. You give two pills as the first dose as soon as convenient within five days (120 hours) after unprotected sexual intercourse. The second dose of the two pills should be after 12 hours. This is a total of four pills within a 12 hour period.
2. The Eugynon pill contains 30 mg ethinyl estradiol and 0.3 mg norgestrel.
   You give four pills as the first dose within five days (120 hours) after
   unprotected sexual intercourse, and another four pills after 12 hours as a
   second dose. This is a total of eight pills within a 12 hour interval.

I-pill

Progestin-only pills

The progestin-only or levonorgestrel pill has less effect than the combined
one, but has fewer side-effects. The timing of the pill is the same as above.

•  The Postinor pill contains 0.75 mg levonorgestrel. You give one pill as afirst dose within five days (120 hours) of unprotected sexual intercourse,and the second dose of one pill should be repeated 12 hours after the first dose.
• If the only pill available is Microlut or Norgeston, which only contain 0.03
  mg Levonorgestrel, then give 20 pills for the first and the second dose,
  each dose 12 hours apart, so a total of 40 pills are needed.

The female condom , advantage , disadvantage , precaution - Health Tips

Mechanism of action

Female condom

A female condom is a thin, loose-fitting and flexible plastic tube worn inside the vagina. It has inner and outer rings. A soft ring at the closede end of the tube covers the cervix during intercourse and holds it inside the vagina . Another ring at the open end of the tube stays outside the vagina and partlycovers the lip area. The female condom helps protect partners from pregnancy and STIs, including HIV/AIDS. It is the only female-controlled device offering this protection. Like the male condom, the female condom provides a barrier between partners during sexual intercourse, to prevent the sharing of bodily fluids, like semen and blood. This ensures that pregnancy does not occur, and STIs are not transmitted.

FemlFe condom

How to use a female condom

Female condoms can be inserted up to 8 hours before intercourse, and are only effective when placed prior to intercourse. At first, female condoms can be uncomfortable to use, but they become easier with practice. Note that a female condom and a male condom should not be used at the same time because this can cause friction that may lead to slipping or tearing of the condoms.

To insert the condom , the woman has to squeeze the ring at the closed end of the tube. She can use her other hand to spread the outer lips, and insert the squeezed condom into the vaginal canal. The inner ring should be pushed just past the pubic bone and over the cervix. After insertion, she has to make sure the condom is not twisted. About one inch of the open end will stay outside the body. The outer ring of the female condom needs to be held in place during intercourse. After intercourse, she has to squeeze and twist the outer ring to keep all fluids, including sperm, inside the condom, and gently pull it out and throw it away . 

Advantages and disadvantages of female condoms

Advantages

Female and male condoms have many advantages in common. However, the following advantages are specific to female condoms.

.Unlike the male condom, erection is not necessary to keep the condomi n place.

Female condoms do not reduce a male partner’s stimulation.

Female condoms can be used by people who are known to be sensitive tol atex because, while most male condoms are made of latex, femalec condoms are made of plastic, which rarely causes an allergic reaction.

Disadvantages

These are the most common disadvantages of the female condom:

Female condoms make a noticeable sound during sexual intercourse.

It is sometimes difficult to insert or use, and some women can have difficulty on the first attempt at self-insertion . 

It can break or leak.

It is much more expensive than a male condom.

Disinfection Procedures for COVID-19 Isolation Ward Area

Disinfection Procedures for COVID-19 Isolation Ward Area

2.1 Disinfection for Floor and Walls
 (1) Visible pollutants shall be completely removed before disinfection and handled in accordance with disposal procedures of blood and bodily fluid spills;
(2) Disinfect the floor and walls with 1000 mg/L chlorine-containing disinfectant through floor mopping, spraying or wiping;
(3) Make sure that disinfection is conducted for at least 30 minutes;
(4) Carry out disinfection three times a day and repeat the procedure at any time when there is contamination.

2.2 Disinfection of Object Surfaces
(1) Visible pollutants should be completely removed before disinfection and handled in accordance with disposal procedures of blood and bodily fluid spills;
(2) Wipe the surfaces of objects with 1000 mg/L chlorine-containing disinfectant or wipes with effective chlorine; wait for 30 minutes and then rinse with clean water. Perform disinfection procedure three times a day (repeat at any time when contamination is suspected);
(3) Wipe cleaner regions first, then more contaminated regions: first wipe the object surfaces that are not frequently touched, and then wipe the object surfaces that are frequently touched. (Once an object surface is wiped clean, replace the used wipe with a new one).

2.3 Air Disinfection 
(1) Plasma air sterilizers can be used and continuously run for air disinfection in an environment with human activity;
(2) If there is no plasma air sterilizers, use ultraviolet lamps for 1 hour each time. Perform this operation three times a day.

2.4 Disposal of Fecal Matter and Sewage
(1) Before being discharged into the municipal drainage system, fecal matter and sewage must be disinfected by treating with chlorine-containing disinfectant (for the initial treatment, the active chlorine must be more than 40 mg/L). Make sure the disinfection time is at least 1.5 hours;
(2)The concentration of total residual chlorine in the disinfected sewage should reach 10 mg/L.


More About Helath

Prevention and Control Management COVID-19 

Virginity and Marriage

MENSTRUATION

One Prevention and Control Management COVID-19

Isolation Area Management

Isolation Area Management for COVID-19

Fever Clinic 

1.1 Clinic Layout

(1) Healthcare facilities shall set up a relatively independent fever clinic including an exclusive one-way passage at the entrance of the hospital with a visible sign;
(2) The movement of people shall follow the principle of “three zones and two passages”: a contaminated zone, a potentially contaminated zone and a clean zone provided and clearly demarcated, and two buffer zones between the contaminated zone and the potentially contaminated zone;
(3) An independent passage shall be equipped for contaminated items; set up a visual region for one-way delivery of items from an office area (potentially contaminated zone) to an isolation ward (contaminated zone);
(4) Appropriate procedures shall be standardized for medical personnel to put on and take off their protective equipment. Make flowcharts of different zones, provide full-length mirrors and observe the walking routes strictly;
(5) Infection prevention and control technicians shall be assigned to supervise the medical personnel on putting on and removing protective equipment so as to prevent contamination;
(6) All items in the contaminated zone that have not been disinfected shall not be removed.

1.2 Zone Arrangement
(1) Set up an independent examination room, a laboratory, an observation room, and a resuscitation room
(2) Set up a pre-examination and triage area to perform preliminary screening of patients
(3) Separate diagnosis and treatment zones: those patients with an epidemiological history and fever and/or respiratory symptoms shall be guided into a suspected COVID-19 patient zone; those patients with regular fever but no clear epidemiological history shall be guided into a regular fever patient zone.

1.3 Patient Management
 (1) Patients with fevers must wear medical surgical masks.
(2) Only patients are allowed to enter the waiting area in order to avoid overcrowding.
(3) The duration of the patient’s visit shall be minimized so as to avoid cross infections
(4) Educate patients and their families about early identification of symptoms and essential preventative actions

1.4 Screening, Admission and Exclusion
(1) All healthcare workers shall fully understand the epidemiological and clinical features of COVID-19.
(2) Nucleic acid testing (NAT) shall be conducted on those patients who meet the screening criteria for suspected patients.
(3) Patients who do not meet the screening criteria above, if they do not have a confirmed epidemiological history, but cannot be ruled out from having COVID-19 based on their symptoms, especially through imaging, are recommended for further evaluation and to obtain a comprehensive diagnosis.
(4) Any patient who tests negative shall be re-tested 24 hours later. If a patient has two negative NAT results and negative clinical manifestations, then he or she can be ruled out from having COVID-19 and discharged from the hospital. If those patients cannot be ruled out from having COVID-19 infections based on their clinical manifestations, they shall be subjected to additional NAT tests every 24 hours until they are excluded or confirmed.
(5) Those confirmed cases with a positive NAT result shall be admitted and treated collectively based on the severity of their conditions (the general isolation ward or isolated ICU).

MENSTRUATION

THE first function with which the girl will be confronted, which will impress upon her that She is a creature of sex, that She is decidedly different from the boy, is menstruation. And this function we will now proceed to study.

Mensuration Period

What is menstruation?

 "Menstruation action is a monthly discharge of blood. The word is derived from the Latin word men sis, which means a month; and menstruation is also frequently Spoken Of as the menses.  It is also called the catamenia or catamenial flow. Other terms are: the periods, courses, monthlies, turns, monthly changes, monthly sickness, Sickness, flowers, to be unwell, to be regular. “ Not to see anything is the common term for having missed the menses. This the flow of blood recurs in most cases with remarkable regu larity once a month ; not a calendar month, but on cellular month,  i e . , once every twenty- eight days. 

Where does the menstrual blood come from?

 The inside lining of the womb (what we call the mucous membrane or endometrium) becomes congested and its blood vessels become distended with blood. If the woman has sexual intercourse and pregnancy happens to take place, then this extra blood is used to nourish and develop the new child; but if no pregnancy takes place, that extra blood exudes from the blood vessels ( some Of the blood vessels rupture ) and is discharged from the uterus into the vagina, and from there to the out side, where it is caught on cotton, sanitary nap kins or some other pad. At what age does menstruation begin. The usual age at which menstruation begins in this country is thirteen or fourteen ; in some, it may occur as early as twelve, in others as late as fifteen, sixteen, or even seventeen. For menstruation to begin earlier than twelve or later than seventeen is in this country a rare exception. But in cold northern climates, the age of eighteen is not rare, and in the hot southern climates, menstruation Often starts at the ages of ten or eleven. Change of climate or of the country will often have an influence on the menses. In the early years of his medical practice, the author had
many  Finnish girls as patients. It was very a common occurrence for them to stop menstruating for the first few months or even for the first year of their residence in this country. At what age does menstruation cease. The age at which menstruation ceases is called menopause or climacteric. It usually takes place at the age of forty- eight or fifty. In some cases it does not take place until the age of fifty - two, in others it takes place as early as forty-five or forty- four. In general, it may be said that the woman’s menstruating period, ’ during which She is able to have children, lasts about thirty-five years. And if no restraint be taken, and if no precautions are taken against conception, a woman could have twenty or thirty children during her childbearing period.

How many days does a woman menstruate? 

The usual number of days is from three to five ; in some cases menstruation lasts only two days, in others as long as seven. As a rule, the greatest amount of blood passed is during the first two days. The amount of blood. It is hard to estimate the exact amount of blood passed by a woman during her menses, but it reaches about announce and a half to three announces. In some women the amount may reach as much as four or five ounces and in exceptional cases as much as eight ounces.

 Where it exceeds this mount?
It is an abnormal condition, requiring treatment. The usual statement that a normally menstruating woman should not have to use more than three napkin s during the four hours is correct.